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Why won’t the AMA follow the evidence on gender-affirming care?

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The Australian Medical Association’s recent position paper trades impartiality for ideology, and ignores the growing body of evidence against gender-affirming care’s purported benefits. Photo:
The Australian Medical Association’s recent position paper trades impartiality for ideology, and ignores the growing body of evidence against gender-affirming care’s purported benefits. Photo:

The Australian Medical Association has done itself a disservice with its recently released position paper on “LGBTQIASB+ Health.”  The AMA lets the cat out of the bag on the very first page of the statement, where it states that public “celebration of people who are LGBTQIASB+” is a vital part of boosting their health and wellbeing, and asserts that “being LGBTQIASB+ is normal, healthy, and representative of the diversity in human sexuality, gender identity, and sex characteristics.”

It’s one thing for an LGBT advocacy organisation to make such bold claims; it is something entirely different for them to be coming from what is supposedly the country’s peak medical authority.

After restating the ethical and professional duty of doctors to provide “evidence-based care impartially,” the new position statement goes on to say gender-affirming care is “linked with a range of positive health outcomes for people who are trans and gender diverse” and “beneficial to trans and gender diverse people in all medical contexts, including if they are seeking care for reasons unrelated to their gender.”

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The problem with this extraordinary and—I would suggest, reckless—statement from the AMA is that the suggestion that gender affirming care is beneficial is itself not evidence-based. Indeed, there is an increasing body of international evidence that suggests there is no therapeutic benefit to gender affirming treatments and there is growing discomfort about the long-term impacts of gender affirming care on children.

For example, a study on more than 95 per cent of Sweden’s total population found that neither surgical nor hormonal treatment provided mental health benefits to a patient, and surgical treatment actually increased a person’s risk of mood and anxiety disorders. Following this study, the use of puberty blockers, cross-sex hormones and surgery on minors in Sweden was banned altogether. The Norwegian Healthcare Investigation Board has defined gender-affirming treatment for children and young people as “experimental” and the UK has similarly banned the use of puberty blockers because “there is not enough evidence to support their safety or clinical effectiveness.”

Even the World Health Organisation last month confirmed that its new guidelines on trans and gender diverse health would not deal with the care of minors, because “the evidence base for children and adolescents is limited and variable regarding the longer-term outcomes of gender affirming care for children and adolescents.”

Not only does the AMA’s position statement not even acknowledge this growing body of evidence or the latest statement from WHO, it makes the opposite claim, saying that “recent systematic reviews have found evidence of increased quality of life following both gender-affirming hormone treatment and gender-affirming surgery.” Unfortunately, the two references cited to support the AMA’s claim did not consider any studies published after June 2020, meaning all the evidence of recent years is being largely ignored.

What makes ignorance of recent evidence even more bizarre is an interview given by AMA president Professor Steve Robson to ABC radio following the statement’s release. In that interview, Robson said it was important that care is provided by teams who follow the evidence and noted that “the evidence changes in medicine.” Given this acknowledgment of the ever-changing evidence base, it is negligent that recent evidence has not been considered in the production of this statement.

The AMA is so supportive of the gender-affirmative model that the position statement also calls on the Australian government to, “urgently enhance access to beneficial gender-affirming treatment … including through appropriate avenues under the Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule.”

The AMA also wants the government to force insurers to provide insurance coverage to doctors who provide gender-affirming treatment, even though some insurers have declined to offer coverage because of the unquantifiable insurance risk such treatments posed.

It is difficult to overstate how ideological this position statement from the AMA is, and it is highly disappointing that gender ideology’s capture of institutions has managed to infect what is supposed to be one of Australia’s most trusted bodies.

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