Gender Dysphoria and Interventions
Gender Dysphoria and Interventions
The American College of Pediatricians (ACPeds) affirms the medical fact that the sex of an individual is based upon an immutable, genetically-determined biological reality.1 The two sexes, male and female, are defined by reproductive design. A female has the anatomy (ovaries) to form the larger gametes (eggs) and support the development of the offspring in her uterus. A male has the anatomy (testicles) to produce the smaller gametes (sperm) and a penis which delivers the sperm into the female by way of her vagina. Sexually specific genes are encrypted in every nucleated cell of the body. Outward appearances as well as hormonal or surgical interventions do not change a person’s sex. The “transition” that individuals who are uncomfortable with or distressed by their biological sex (“gender dysphoria”) undergo only involves a change in outward appearance or presentation.
Those with gender dysphoria have higher rates of co-occurring mental health concerns than other LGBTQ+ identifying adolescents.2 Many children and adolescents with sexual identities incongruent with their sex have experienced significant psychological trauma leading to their gender dysphoria. Although parents are often told that their children will commit suicide if their false sexual identity is not supported, there is no long-term evidence that transgender interventions prevent suicidal ideation or behaviors. In fact, pursuing interventions to align with the opposite sex is more likely to result in deleterious long-term mental and physical health outcomes, including sterility. Many individuals who have gone through those interventions later regret them and seek to align again with their biological sex.
Social affirmation, puberty blockers, cross sex hormones and drugs, and surgical interventions used with the intent of “transitioning” a child are harmful to the physical, psychological, and emotional health of the child.3 Informed consent for these interventions from either the parent or the child cannot be obtained without good long-term studies on the risks and benefits of the procedures. Thus far there are no good long term studies showing any benefits. Nor can informed consent by pediatric patients be legitimate given the immaturity of their brains.3 In many cases, these interventions are irreversible and may render the adolescent infertile for life. Because of discovered risks and unrealized benefits of social, medical, and surgical interventions, many European countries are now cautioning against these interventions while encouraging mental health therapy as the proper course of treatment for children and adolescents.
Therefore, the ACPeds cannot condone any of these interventions for children and adolescents. Intensive psychotherapy for the individual and family to determine and hopefully treat the underlying etiology of their gender incongruence should be pursued. That approach has been shown to resolve gender dysphoria while allowing the child to progress through natural puberty.
Approved by the ACPeds Board of Directors (May 2025)
Approved by ACPeds Members (June 2025)
Pertinent ACPeds Referenced Papers:
Sex is a Biological Trait of Medical Significance (March 2021)
Mental Health in Adolescents with Incongruence of Gender Identity and Biological Sex (Feb. 2024)
Gender Dysphoria in Children (Oct. 2018)
Adolescent Brain: Under Construction (May 2022)
Other ACPeds Resources Available:
