A group of Republican state attorneys general has launched an investigation into the influential American Academy of Pediatrics’s controversial support for so-called “gender treatments” — operations and hormone therapies to change a person’s gender characteristics — for minors, which the officials say could violate consumer protection laws. 

In a letter sent to the AAP’s president and president-elect, 20 state attorneys general ask that the organization provide information about a 2018 policy statement that claimed puberty blockers and other transgender medical treatments were “reversible.” The study, which was reaffirmed in 2023, is titled “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents.”

“These reversible treatments can … be used in adolescents who experience gender dysphoria to prevent development of secondary sex characteristics and provide time up until 16 years of age for the individual and the family to explore gender identity, access psychosocial supports, develop coping skills, and further define appropriate treatment goals,” a committee of AAP members, led by Dr. Jason Rafferty, wrote in the study. “If pubertal suppression treatment is suspended, then endogenous puberty will resume.”

The claims that the treatments are reversible have been increasingly disputed by “detransitioners” who’ve regretting undergoing gender treatments and claim to suffer irreversible physical changes as well as permanent loss of fertility. Dr. Rafferty, the AAP study’s lead author, is being sued by two detransitioners who are backed by a Dallas law firm devoted “to suing proponents of gender treatments, especially for minors”justice for the detransitioner community.” One of these suing detransitioners, Isabelle Ayala, was a minor when she underwent the gender treatment to become a boy, and she now fears she will be infertile for the rest of her life.

The attorneys general say the contested AAP’s claims that the treatments are irreversible may violate certain consumer protection laws that protect Americans from misleading or dishonest claims. They write that the AAP — which boasts more than 67,000 members — has a “great influence” over the healthcare choices Americans make for their children.

“It is beyond medical debate that puberty blockers are not fully reversible but instead come with serious long-term consequences,” the attorneys general, led by Idaho’s Raul Labrador, write. They specifically cite the Cass Report from the United Kingdom, which has refuted much of the recent claims made about so-called “gender-affirming care” being necessary for the wellbeing of children with gender dysphoria. The report found that puberty blockers and other hormone treatments have debilitating, chronic effects on children’s mental and physical development. 

Proponents of gender treatments for minors argue it’s lifesaving treatment for children experiencing “gender dysphoria” — or distress due to feeling misaligned with one’s birth gender — since these children are, they claim, at high risk of suicide. That claim, like many in the field of pediatric gender care, is hotly disputed.

New research in the gender field has also challenged the prevailing orthodoxy that transgender kids — children who identify as the opposite of their birth gender — will end up being transgender adults.

The number of patients who undergo gender treatments during their minority and later seek to reverse them is also a subject in great dispute.

The AAP did not immediately respond to an email seeking comment from the New York Sun. 

“The AAP has no basis to assure parents that giving their children puberty blockers can be fully reversed. It just isn’t true,” the attorneys general continue. “That is why the World Health Organization refuses to endorse puberty blockers or otherwise provide treatment guidelines for children with gender dysphoria.”

They say that state consumer protection laws may have been violated because the AAP may have tried “to mislead and deceive consumers by maintaining its claim that puberty blockers are ‘reversible.’”

They ask that the AAP turns over a wide array of documents, studies, and communications in order to determine if those consumer protection laws were violated, including evidence demonstrating that puberty blockers are “reversible,” as well as communications related to the publishing of the 2018 report. 

In recent years, numerous states in the south and southwest have passed laws banning gender treatments for minors. The Biden Administration has challenged these bans in court, and the Supreme Court has agreed to review a challenge to Tennessee’s ban in the fall.