Michelle Cretella, M.D., is president of the American College of Pediatricians, a national organization of pediatricians and other health care professionals dedicated to the health and well-being of children.
Dr. Cretella is also an ideologue, as this page on the "Family Life Today" website notes:
"Dr. Cretella has been an active prolife advocate for over twenty years, and she has been published in several lay publications. Avocations include personal training, youth ministry and serving as a certified abstinence educator for her local Catholic school. She lives in Rhode Island with her husband of twenty years and their four children: Christopher, John, Michael and Marianna."
While well spoken, she obviously has a bone to pick with transgender issues, and this article appearing on the pro-Trump "Daily Signal" speaks to that. Also, when I see people talk about the "X Agenda" (just fill in the X with the disliked group), that pretty much throws me off from taking anything they are going to say very seriously, or at least with the proverbial grain of salt.
Some of the points she brings up are absolutely valid -- there are serious issues of physical development that are being affected when kids are given puberty blockers. Also, lack of fertility is a real issue as well when given such blockers accompanied with hormones of the biological opposite sex.
However, I have serious issues with Dr. Cretella’s article. First of all, she's a bit disingenuous, lumping in gender non-conformity with gender dysphoria. The difference between these two is that a person who is gender non-conforming does not feel their body to be "wrong" and has no desire to make major physical changes. People that are transgender (as the word is used today) have feelings of gender dysphoria -- they dislike their body and wish to make changes. To bring in a little evidence based material from the APA and their fact sheet on adolescent gender issues:
Prevalence of gender diverse and transgender adolescents has been difficult to estimate given barriers to research, treatment, and disclosure. No systematic epidemiological studies have been published on the prevalence of gender diversity or transgender identity in youth. Gender diverse youth are thought to be more prevalent than transgender youth and may make up 5 to 12% of birth assigned females and 2 to 6% of birth assigned males. Transgender youth may be as prevalent as 0.5%.
As patient data is confidential, and data concerning children even more so, these numbers are anecdotal and come from generalizations with doctors. That said, cross-sectioning these data with what we know about adult populations brings no surprise. The actual number of children that would desire to seek medical interventions is very low, while kids that express their gender in various non-conforming ways is much higher. Simply put, Dr. Cretella's anxieties are the proverbial tempest in a teapot.
The idea that the "Trans-Agenda" (which has conveniently replaced the "Gay Agenda" as homosexual acceptance has increased over the years) wants to have every kid that questions their gender to be on puberty blockers and on the hormones of the opposite sex immediately is patently absurd. Activists want those avenues discussed and open to families, along with doctors, that feel that such is the best choice for their kids. Are there some pushy activists? Sure. But the idea that doctors can’t decide what is best for their patients, and must bow to some PC line of thinking and treatment plan, is hyperbole. The same is said of college professors, and I an attest, as a college professor, there is no systemic, PC line of thinking that all professors must hold or be removed.
Even if there is a decision made all around that such medical intervention is the best course, the other problem is the cost -- a cost that is most of the time not covered by insurance. As this much more balanced PBS Frontline article points out:
The cost of puberty blockers is approximately $1,200 per month for injections and can range from $4,500 to $18,000 for an implant. The least expensive form of estrogen, a pill, can cost anywhere between $4 to $30 a month, while testosterone can be anywhere between $20 to $200 a vial.
While well to do families might be able to afford this out-of-pocket treatment for their kids, this is out of reach for many, if not most, non-middle-class families. The fact that most children would not want such changes doesn’t alleviate the fact that even if warranted in the small number of cases, such treatment would be out of reach.
As this article posted in the peer-reviewed journal for pediatricians, Pediatrics, points out concerning children who are having gender issues:
The pediatrician or family medicine doctor should be on the lookout for the child who is gender nonconforming. Sometimes during the physical exam the issue is revealed. The male child with gender nonconforming behavior will sometimes indicate that he wants his testes and penis removed or that he wants breasts. Likewise, the female child may be complaining of breasts and menstrual periods. The pediatrician who observes gender nonconformity should address the issue straightforwardly and look for a number of associated psychosocial problems including abuse, PTSD, difficulty in school, depression, or increased anxiety. Referral to and working with the mental health professional provides a good safety net for the child as he/she struggles with exploration of gender orientation, gender, and gender role as well as the related conditions. If indicated, adolescent patients might be referred to a pediatric endocrinologist for help in getting a better long-term physical outcome.
Telling kids that are having gender issues to just “deal with it,” that they’ll “grow out of it” and the parents will just “pray this sickness out of you” is not going work. The APA fact sheet above clearly states that children that go from pre-pubescence into puberty questioning their gender will very likely NOT desist in their feelings, but those feelings will grow, and if not resolved could lead to a slew of self-destructive behaviors, family abuse, and potentially suicide.
The medical issues involved in these decisions are many, and they must be weighed carefully against the psycho-social needs of the child. I would agree that in many, perhaps most cases, such medical intervention would not be necessary. But for the small number of children that are increasing their gender dysphoria as they go into puberty, these things must be discussed, and the pros and cons carefully considered. Simply labeling this as “child abuse” is short-sighted, and doesn’t consider the real needs of a small number of kids that are feeling more and more frustrated with their bodies vis-à-vis their gender.
This is an issue that is emerging. I understand that ideologues such as Dr. Cretella will react strongly against it, just as Conservative activists did when the thought of discussing homosexuality with pubescent kids was considered to be proof of the “Gay Agenda” trying to convert children into “sodomites.” Society needs a new boogie man, so now it is Trans issues that replace the Gay Plague.
