Expressing “grave concerns,” a group of over 6,000 clinicians, scientists, and researchers signed an open letter calling on the American Psychiatric Association (APA) to withdraw its new textbook on gender care.
The textbook, Gender-Affirming Psychiatric Care (GAPC), edited by Teddy G. Goetz, M.D., M.S., and Alex S. Keuroghlian, M.D., was released in November. According to the APA’s publishing house, the book “is the first textbook in the field to provide an affirming, intersectional, and evidence-informed approach to caring for transgender, non-binary, and/or gender-expansive (TNG) people.”
“The book’s claims of being evidenced-informed are untenable,” states the letter, posted in January by the New York City-based Foundation Against Intolerance & Racism (FAIR). The 1,267-word letter says “GAPC omits any in-depth analysis of evidence to date, dismisses ‘scientific neutrality’ as a ‘fallacy,’ and chooses authors with the correct ‘lived experiences’ and ‘community impact of prior work over academic titles.’”
Out-of-Date
The letter notes that the authors have failed to consider the latest thinking on psychiatric care for young children and adolescents confused about their biological sex.
“After conducting careful systematic reviews of the evidence, Finland, Sweden, and the United Kingdom are drastically retrenching from their earlier affirmation model for treating gender dysphoria in minors,” states the letter. “In Norway, the Netherlands, Denmark, France, Australia, and New Zealand we see either critical reviews by public health agencies or pushback by professional societies and in mainstream medical journals. Having omitted these international developments and heated debates, GAPC was out of date before its publication.”
The letter says the authors are “disturbingly nonchalant” about co-occurring behavioral problems in young people struggling with gender dysphoria, and they neglect to recognize the young people who regret the surgeries and cross-sex hormone treatments.
“Such detransitioned individuals are now suing surgeons, endocrinologists, and psychiatrists for damages, claiming their doctors encouraged them to follow measures that are not backed by rigorous science and did not address their co-morbid conditions.”
‘Affirming a Delusion’
Jane Orient, M.D., executive director of the American Association of Physicians and Surgeons and one of the signers of the FAIR letter, deplores both the textbook’s shoddy science and its potential to do irreversible harm to children.
“The problem with the book starts with the title,” said Orient. “A psychiatric textbook about affirming a delusion, instead of trying to treat the patient’s illness and helping the person connect with reality, is a dangerous aberration. It’s a simple biological fact that there are two sexes, determined immutably at conception.”
“One can interfere with a patient’s normal maturation, resulting in lifelong dependence on medical treatment for the adverse effects, but cannot change the person’s sex,” said Orient. “For APA to advocate for sterilizing and mutilating children is an outrageous breach of ethics and has no scientific justification.”
Bonner Russell Cohen, Ph.D. (bcohen@nationalcenter.org) is a senior fellow at the National Center for Public Policy Research.
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