The textbook could make it more difficult for practitioners who disagree with the 'gender-affirming care' model, critics say.
By Darlene McCormick Sanchez | Nov 30, 2023 Updated:Nov 30, 2023 A new "cutting-edge" textbook on transgenderism written with the help of activists will be used to train psychiatrists and could harm millions of children in the future, some experts have warned.
"Gender-Affirming Psychiatric Care," just released on Amazon at $58, is a textbook printed by American Psychiatric Association (APA) Publishing. The textbook signals early on that it's more subjective than objective, quoting a feminist studies professor saying, "Scientific neutrality is a fallacy." More Articles The Sinister Theory Behind the Q in LGBTQ Parents' Personality Disorders Driving Surge in Trans Kids: Psychiatrists The content has prompted some critics to question the textbook's reliance on a mix of transgender-identifying professionals writing about their experiences, limited scientific studies, and neo-Marxist critical theories. "This is a huge issue; millions more kids will be harmed," said Lauren Schwartz, a psychiatrist in Oklahoma speaking out against the rush to "transition" children. The textbook's introduction says the book is based on an "evidence-informed approach" instead of an evidence-based approach, which is more scientific, she told The Epoch Times. The 26 chapters are written by 56 authors, 50 of whom are in the transgender community, according to the textbook's foreword. Chapters include affirming "two-spirit people," a term used to refer to someone who believes he or she is both sexes, and one about "double queer" people—or people who identify as transgender and have a mental disability. California State Superintendent of Schools Tony Thurmond reads from the book "Red: A Crayon's Story" to 2nd grade students at Nystrom Elementary School in Richmond, Calif., on May 17, 2022. Thurmond celebrated the donation of thousands of LGBT books from Gender Nation to 234 elementary schools in nine California districts. (Justin Sullivan/Getty Images) The book's editors are listed as an associate professor of psychiatry at Harvard Medical School and investigator at the National LGBT Health Education Center; and a transgender-identifying psychological resident at the University of Pennsylvania, whose work is influenced by her background as a "non-binary/trans, queer, neurodivergent, chronically ill, Jewish person." Ms. Schwartz noted that the authors were chosen by "prioritizing lived experience, diversity of perspectives, and community impact of prior work over academic titles."'Disturbing Gibberish' The problem is the textbook will be perceived as authoritative because it was printed by the APA's publishing arm, she said. "Anyone wanting to practice gender-affirming care, any attorney wanting to defend it, and any legislator who wants to protect it, now they have a new peer-reviewed textbook, not just 'evidence' in a journal or a study," she said. Alan Hopewell, a prescribing neuropsychologist in Texas who saw transgender-identifying patients decades ago, called the textbook "disturbing." "This is nonsensical gibberish which has no foundation whatsoever in science," he told The Epoch Times. Hospitals could demand doctors go by the textbook because the APA put it out, or it could even be used to remove the license of doctors who don't go along with it, he said. Abigail Martinez (R), the mother of a transgender teen who committed suicide, sheds tears as Erin Friday comforts her and transgender activists block TV cameras from capturing her story in Anaheim, Calif., on Oct. 8, 2022. (John Fredricks/The Epoch Times) "This reminds me of brain-damaged hippies free-associating at a commune," Mr. Hopewell said. The book foreword says that most of the contributing authors recognize they are "obscenely privileged" as English-speaking doctors with access to elite schools. It asserts that the psychiatric field was built on "the work [and assumptions] of European, white, cisgender men, including their colonial, Anglo-centric, cis-heteropatriarchal worldview and pathologization of experiences that did not fit their own 'norm.'" "For millennia, outside of European colonial influences, gender diversity has flourished to varying degrees among hundreds of indigenous communities around the world," the foreword reads. The idea that Western countries were colonizing land stolen from indigenous people is part of critical race theory (CRT), which critics say is rooted in neo-Marxism.Straight White Bias CRT and gender theories see white people and heterosexuals in Western civilization as "oppressors" of minority identity groups, who are viewed as victims. Activists are encouraged to dismantle oppressive societies in order to right discrimination of the past, according to ideology architects such as Ibram X. Kendi, who wrote "How to Be an Antiracist." Detransition advocates meet outside of the annual Pediatric Endocrine Society conference held in San Diego, Calif., on May 6, 2023. (John Fredricks/The Epoch Times) Proponents of CRT and gender theories contend that discrimination against identity groups such as white people and heterosexuals is needed to right the wrongs against racial and sexual minorities. "The entire document is predicated on an uncritical acceptance of queer theory, which is more accurately queer Marxism," conservative author James Lindsay told The Epoch Times. Queer theory is a gender ideology advocating the destruction of traditional sexual norms; some queer theorists support sexual acts such as pedophilia and bestiality that aren't accepted by society. The textbook describes heterosexuals as cisgender people who are part of a "cultural and systemic marginalization" of LGBT people who don't align with societal norms. To prove the point, the authors object to the idea that only women can have babies. "For example, naming an obstetrics and gynecology practice a women's health center is cis-normative because it assumes the practice will only serve patients with one gender," the foreword reads. Mr. Lindsay, author of "The Marxification of Education," said the idea of "treating" gender dysphoria with hormones or surgery is akin to performing lobotomies on the mentally ill decades ago. History teaches that communist theories applied to the real world have deadly results, he said.
Mr. Lindsay pointed to the forced application of Trofim Lysenko's Soviet agriculture program based on pseudo-science as an example of a communist idea gone bad. The program caused millions of innocent people in the former Soviet Union to starve by forcing them to plant seeds close together in the belief that plants from the same class never compete with each other. The theory contributed to widespread famine. Trofim Lysenko speaks at the Kremlin in 1935. Behind him are (L–R) Stanislav Kosior, Anastas Mikoyan, Andrei Andreev, and Soviet leader Joseph Stalin. Dallas attorney Ron Miller agreed that a textbook affirming gender transitioning could lead to the harming of millions of children through sterilization and side effects from hormones and surgery. He started a boutique law firm to represent de-transitioners, who no longer identify as the opposite of their birth sex. His clients are suing doctors who prescribed hormones and surgery for gender dysphoria. Like Ms. Schwartz, he told The Epoch Times that he sees danger ahead if the textbook is universally adopted. Mr. Miller pointed to the American Academy of Pediatrics, which came out with guidance on "gender-affirming care" for children in 2018. "We're already in a world where thousands of kids are at risk of this ideology or this practice," he said. According to the group's website, the organization supports the affirmation model. The guidance "aims to help pediatricians and parents navigate health concerns of gender-diverse youth while advocating for ways to eliminate discrimination and stigma." Likewise, a textbook put out by a professional psychiatric organization such as the APA is seen as credible, Mr. Miller said. However, studies referenced in the textbook have come under fire for being flawed, such as the Dutch Protocol studies that are the basis of the affirmation model used today. Attendees look over petitions against X-rated children's books in libraries, and against gender hormone blockers for underage children, at the North Carolina Republican Party Convention in Greensboro, N.C., on June 10, 2023. (Allison Joyce/AFP via Getty Images) "The studies that they're referencing in this textbook are all low-quality studies," he said. The APA is one of the largest nonprofit publishers of "psychological science" in the world, giving the new book an air of legitimacy in professional circles. The professional psychological organization says it's made up of 146,000 researchers, educators, clinicians, consultants, and students of psychiatry in the United States. These "standards" end up trickling down, even into elementary schools, where school counselors could affirm millions of children, Mr. Miller said. The APA didn't immediately respond to a request for comment by The Epoch Times.'Double Queer' The textbook discussed "double queer" children, who are confused about their gender and suffer from other mental disorders. It addresses the effects of hormones administered to these transgender-identifying children with coexisting cognitive ailments. Queer is used in this term to mean outside of what is considered normal. One chapter gives a scenario of a boy called Rosie with a history of attention deficit/hyperactivity disorder (ADHD) whose endocrinologist recommends starting him on puberty blockers because he is worried about the changes puberty will bring. The parents are concerned about the interaction of hormone blockers and ADHD medicine in the scenario. The annual New York City Pride March in New York City on June 25, 2023. (Samira Bouaou/The Epoch Times) The chapter goes on to assert that puberty blockers "have been used safely in children of all genders" to pause early-onset puberty and to treat prostate cancer in adults. It also claims that "pubertal suppression is fully reversible." The idea that there are no consequences for puberty blockers "is the opposite of everything coming out of Europe," Ms. Schwartz said. "That's the lie that they're promoting all across the country," Mr. Hopewell said. He contended that puberty blockers can affect bone growth and brain development in adolescents, noting that the brain controls hormones. Hormone drugs such as Lupron, which suppress testosterone production, also must be managed carefully, Mr. Hopewell said.
Testoserone medication, regularly injected into fatty tissue, is prescribed to some females who want to become male. (John Fredricks/The Epoch Times) But the textbook said "gender-affirming" hormones appear to be "overwhelmingly safe and linked with positive outcomes."
Proponents of transitioning children to their preferred sex say it makes them less likely to commit suicide and improves their mental health. The textbook noted that evidence on cardiovascular risk associated with cross-sex hormones is mixed.
However, a new Danish study reinforces medical evidence that transgender-identifying people taking cross-sex hormones dramatically increases their chances of developing heart disease.
Published in the European Journal of Endocrinology in August, the study included 2,671 transgender-identifying people in their early to mid-20s who took cross-sex hormones in Denmark.
Children read a book in the library at a school in New York City on Feb. 2, 2022. (Michael Loccisano/Getty Images)
The study showed that the risk of developing heart disease for males and females taking cross-sex hormones was "significantly higher" than those in the control group. Besides ADHD, the textbook talks about the presence of other conditions frequently associated with gender dysphoria, such as autism and obsessive-compulsive disorder. The chapter states that an autism diagnosis could "interfere" with transgender health care by "causing clinicians to be more cautious than they otherwise would be."
Mr. Hopewell said the book seems to blame "evil doctors" who want to treat autism as causing problems for autistic children who want to transition. He said that caution should be used when dealing with society's most vulnerable children, instead of pushing them into "treatment."