21 States Wage War Against American Academy of Pediatrics Over Puberty Blockers for Kids

A halt on what is "fairly described as medical experimentation on children is long overdue."

In an unprecedented move, 21 states put the American Academy of Pediatrics (AAP) on notice for possible violations of state consumer protection laws over its misleading “evidence-free standards” on gender dysphoria care for minors.

Led by Idaho Attorney General Raúl R. Labrador, the coalition is demanding transparency from the AAP after the organization adopted guidance that endorses treating minors with gender dysphoria with puberty blockers, cross-sex hormones, and surgical interventions while claiming to its 67,000 pediatrician members, the public, and parents that puberty blockers are “reversible.”

Gender dysphoria refers to psychological distress that results from an incongruence between one's sex assigned at birth and one's gender identity. The vast majority of children initially diagnosed with this condition grow out of it by the time they are adolescents or adults.

The AAP’s claim that puberty blockers are “reversible” is misleading, deceptive, and scientifically unsupported, and the states are demanding an “immediate retraction and correction,” a 10-page letter to the organization states.

“It is beyond medical debate that puberty blockers are not fully reversible but instead come with serious long-term consequences,” they wrote.

Puberty blockers are not the harmless, reversible treatments the AAP claims they are. These drugs can have significant, irreversible side effects, and the AAP has not been forthcoming about these risks. Instead, it is promoting a false narrative.

In April 2024, the National Health Service in England released a groundbreaking independent review called the Cass Report. This report took a hard look at the use of puberty blockers in minors and identified multiple risks. It warned of interference with neurocognitive development, compromised bone density, negative impacts on metabolic health and weight, and even the suppression of normal pubertal development.

The report further cautioned that the use of puberty blockers, especially when followed by cross-sex hormones, may result in infertility and sterility. Despite these documented risks, the AAP continues to market puberty blockers as a safe and reversible option, leading the coalition to argue that the organization is providing parents with a false sense of security about the long-term effects of these treatments on their children.

“That halt on what is fairly described as medical experimentation on children is long overdue—particularly since the majority of children initially diagnosed with gender dysphoria desist and “grow out” of the condition by the time they are adolescents or adults. It is abusive to treat a child with biologically altering drugs that have an unknown physiological trajectory and end point. It is also inhumane to endorse such experimentation without a confident safety profile, especially if more times than not, it proves to be medically unnecessary.

“And yet, the AAP continues to authoritatively declare that puberty blockers are ‘reversible.’ That claim is scientifically unsupported and contradicts what is medically known.”

This is medical experimentation on children, and endorsing such experimentation without a solid safety profile is not just bad medicine—it’s inhumane, they added.

Interestingly, the AAP's own policy statement from 2018 acknowledged the lack of research on the long-term risks of puberty blockers, particularly in relation to bone metabolism and fertility. Yet, the organization has since doubled down on its support for these treatments, ignoring the lack of evidence.

The states expressed concern over the AAP’s reliance on the World Professional Association for Transgender Health (WPATH) for its guidelines. WPATH has come under fire for allegedly allowing political pressures to influence its standards rather than sticking to rigorous scientific evidence.

WPATH has received funding from pharmaceutical companies and other corporate entities, particularly those involved in producing hormones, puberty blockers, and other medical treatments relevant to transgender healthcare. (The AAP also receives funding from pharmaceutical companies that manufacture these drugs.) The coalition is demanding full transparency on all communications between the two entities.

In their letter, the states are requesting the AAP back up its claims that puberty blockers are both reversible and based on evidence-driven, nonpartisan reviews. They want answers on how the AAP’s current stance aligns with its previous admissions that research on the long-term effects of puberty blockers is limited. The coalition is urging the AAP to retract its claims about the reversibility of puberty blockers and to start providing honest, clear information to both physicians and parents.

The AAP’s guidance shapes how doctors discuss treatment options with parents and children. This influence means that misleading claims are not just theoretical; they result in real-world harm. By promoting puberty blockers as a reversible solution, the AAP risks guiding pediatricians toward treatment recommendations that may not be in the child's best interest, especially considering the lack of solid research on using these drugs to treat gender dysphoria.

The coalition is demanding that the AAP immediately retract its claims and respond to a detailed list of questions about its review process, evidence, and communications related to its policy on puberty blockers.

This fight is not just about transparency; it’s about protecting children from unnecessary and potentially harmful medical interventions. The coalition of states is forcing a critical conversation that the AAP seems all too eager to avoid.

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