AAP-CA Members:

The American Academy of Pediatrics California (AAP CA), representing over 3500 pediatricians across the state, joins the National American Academy of Pediatrics (AAP) and Texas Pediatric Society (TPS) in strongly opposing the actions taken recently in Texas that threaten the health and well-being of transgender youth.

On February 22, Texas Governor Greg Abbott directed the Texas Department of Family and Protective Services and other state agencies to investigate certain gender affirming services as child abuse, following a legal opinion by the Texas attorney general.

We affirm the statement put out by the AAP and TPS on 2/24/22.

AAP CA supports gender-affirming care for transgender patients, including puberty blockers when appropriate, with an evidence-based approach as outlined in the AAP policy statement, “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents”.

The statements of the Texas Governor and attorney general are a gross misrepresentation of the principles of gender-affirming care, with potential physical, psychosocial, and mental ramifications to transgender and gender diverse youth who are denied these services. They additionally misconstrue evidence-based, safe, and necessary care as child abuse, which is both irresponsible and dangerous.

Pediatricians are all too familiar with child abuse and the devastating lifelong consequences it has for those who experience it. We are very familiar with our responsibilities to both identify and report abuse when we believe it is present. We are equally aware of the unique and critical support and care that our transgender patients and their families need from us.

AAP CA and our member pediatricians advocate for the health and welfare of ALL children from ALL families. Let us be very clear: We are speaking up in support of transgender children and the families who have their best interest at heart.

Suicide is the second leading cause of death of US adolescents. LGBTQ+ youth are over four times more likely to attempt suicide, and over half of transgender and nonbinary youth attempt suicide. These disparities are even greater for transgender and gender-diverse youth of color. Studies show that gender-affirming care can reduce emotional distress and depression and reduce the risk of suicide.

To equate the critical medical care that physicians provide and conflate the love and support that families give to their transgender children with the violence and cruelty that is present in cases of true child abuse is abhorrent.
It is our job to ensure the optimal health and well-being of all children. The provision of evidence-based, culturally appropriate, patient and family-centered care is central to that.

Every child deserves the right to live and thrive as their authentic self, and to have access to all the resources they need. What Governor Abbott and the Texas attorney general have proposed amounts to a direct threat to the health and safety of transgender youth in Texas. No child should ever be targeted by politicians in ways that will result in predictably dangerous and destructive consequences. Decisions regarding medical care should be made by patients and families, in consultation with their pediatrician and a trained medical team, not by politicians.

American Academy of Pediatrics, California, Board of Directors