Monday, October 29, 2018

Witherspoon Institute's pseudo-intellectual blog and the hate group

Dr. Andre Van Mol
Dr. Andre Van Mol should decide whether he wants to be a Christian cleric carrying water for a hate group or a physician who puts the interests of patients above all else.
Photo: Facebook
Monday, Dr. Andre Van Mol writes: Transing California Foster Children & Why Doctors Like Us Opposed It. Van Mol is co-chair of American College of Pediatricians, a roughly 200 member conservative Christian organization and hate group. Thus “doctors like us” is irrelevant. It refers to a relative handful of medical crackpots who subvert science to the ancient texts of their religion.

Van Mol, out of Redding California, is board certified in family medicine. He is unfaithful to his oath.
According to Van Mol:
California’s AB2119, “Foster care: gender affirming health care and behavioral health services,” was signed into law by Governor Jerry Brown on September 14, 2018. We called it the transgender foster child bill. The law assures that trans-identified foster children will have the legal right and full support of the state to go as far down the path of medical and surgical transition as each vulnerable child chooses. It is the removal of protection from sexually confused minors couched in a deep parlance of ideology, not science. The proposed therapies enrich hospitals, drug companies, tech firms, and medical personnel at the expense of misled children. It’s the foster kids that need affirming, not mistaken identities and propaganda terms. Nouns have gender, people have sex.
Van Mol knows perfectly well that children are not generally candidates for gender-affirming surgery. The bill provides:
…the rights of minors and nonminors in foster care, as described above, include the right to be involved in the development of case plan elements related to placement and gender affirming health care, with consideration of their gender identity. The bill would also provide that the right of minors and nonminors in foster care to health care and mental health care includes covered gender affirming health care and gender affirming mental health care…
None of the above happens in a vacuum. Gender-affirming care is provided by pediatricians and behavioral health specialists. Apparently Dr. Van Mol has little faith in his colleagues to properly evaluate and treat children with gender dysphoria. Even Van Mol's language is twisted by religion. Medical professionals who are experts in this area do not consider these to be “sexually confused minors.” That is conservative Christian rhetoric.
Bronze Age texts take precedence over modern science:
The gender-affirming care model is the policy of the American Academy of Pediatrics, the real peer group. In 2012, Van Mol was championing the thoroughly discredited Regnerus Study. More recently he wrote:
By contrast, transgenderism is a belief system that increasingly looks like a cultish religion—a modern day Gnosticism denying physical reality for deceived perceptions—being forced on the public by the state.
Religious captives have a way of projecting. Sexuality that their ideology or dogma does not approve of becomes a philosophy or a doctrine. The fact is that people have become transgender since the beginning of time because it mitigates the discomfort of incongruous gender and natal sex. It has been written about for thousands of years. The idea that the public and the state are somehow victimized is loony (as Van Mol attempts to victimize a sexual minority). People should not suffer because of religious opprobrium based on Bronze Age chronicles.
Having opposed what is now law:
To fight and win would benefit sexually confused foster children in California and beyond. To fight well and lose would provide a pathway made of research, presentation, influencing, and honor-filled protocol for allies in other states to follow and perhaps succeed.
“Research?” What research? There is no science behind any of Van Mol's rhetoric. His group (ACPeds) is a Christian group. He fought against the bill in question with California Family Council, another Christian group. Van Mol's buddy in all this is an endocrinologist, Michael Laidlaw, who is unqualified (Laidlaw is essentially a diabetes doctor). Laidlaw, an ultra-conservative Catholic, is also at odds with his own professional association, the Endocrine Society. Van Mol and Laidlaw should scare the crap out of parents. Who in the hell wants a doctor who acts as a cleric?
And they testified before legislative committees …
Correcting the errors and ad hominems of the opposition does not achieve that. Mike and I were joined as witnesses by two courageous men—Rene Jax and Hacsi Horvath—who greatly regretted having pursued the path of so-called male-to-female transition. Rene Jax was the first transsexual to be sworn in as a police officer before becoming an author and lecturer.
Jax had surgery nearly 20 years ago and did so late in life. I cannot find information about Horvath's journey but neither of these people have medical expertise. A handful of people who regret sex changes is meaningless without knowing a great deal more about them. Neither's experience has anything to do with whether or not a kid should receive fully reversible puberty blockers from a qualified professional.
Van Mol lays out the losing arguments:
Transgenderism/gender dysphoria has an overwhelming probability of desistance, resolving on its own 80 to 95 percent of the time by adulthood, according to professional literature.
Van Mol is combining being transgender with a medical condition; gender dysphoria. The nation's leading researcher on trans youth (Kristina Olson) has made two points:
  1. The studies on which those statistics are based are unreliable and;
  2. Once the severity of gender dysphoria is severe enough that the child insists on transitioning, desistence is very rare.
Trying to lump being trans with having gender dysphoria is intellectually dishonest.
Underlying issues need addressing first; there can be many, and foster children are more likely to have them. The APA Handbook of Sexuality and Psychology specifically warns against a rush to affirm or transition because it risks neglecting underlying psychological issues. Yet this bill encourages rushing. Endocrine Society guidelines state that psychological intervention is all that is needed in some forms of gender dysphoria. Yet this bill says the opposite.
A common religious refrain is that there are underlying psychological causes to be treated and the gender dysphoria will go away. That is false. Van Mol cannot cite research supporting that theory. That APA handbook is from 2014 (things have changed). It is also $400 so I have to take his word for it including the fact that his summary is in context. However, nothing in the bill encourages rushing. That is just unfounded rhetoric. The only thing that is expedited is healthcare — not specific treatment since that is the province of medical professionals.
The risks and permanent consequences of a minor undergoing transitioning are sobering. It makes someone a patient for the rest of his or her life, and kids don’t grasp this.
Van Mol doesn't provide details of the risks and consequences that he refers to. This is just baseless fear rhetoric. Furthermore, until late teens a child might be on puberty blockers which are fully reversible. What about the risks and consequences of not properly treating gender incongruity because of religious disapproval?
There is no medical proof of the long-term benefits or safety of a child undergoing hormonal therapy and surgical transitioning. So it is impossible to scientifically recommend these to minors. The hormones are not FDA-approved for this use. This bill is not pro-science, it’s no [sic] science.…
In its recent statement, the American Academy of Pediatrics cites nearly 100 studies to support the gender-affirmative care model. As for the hormones, they are the recommendation of the Endocrine Society.
Regret is not rare, poor outcomes are not rare, but what is gone is gone. Two pro-LGBT groups (YouthTransCriticalProfessionals.org and 4thWaveNow.com) oppose transitioning therapy for minors due to high rates of regret and de-transitioning. A 2011 Swedish study showed that post-gender-reassignment adults were nineteen times more likely to commit suicide than the general population. Affirming transition is not proven to reduce suicides. It appears to worsen the outcomes.
Those two websites are not “pro-LGBT.” They are largely anonymous and anti-transgender. There is no science that he cites in support of regret not being rare.

As for the Swedish study, Van Mol sort of forgets to inform the reader that these were surgical patients between 1973 and 2003. Those people faced enormous levels of societal disapproval and rejection. The study concludes:
Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.
In other words, they are not judging gender-affirming surgery as a risk but adding additional counseling as necessary. Moreover, it is impossible to know what might have happened to these people had they not had the surgery. We can speculate that the suicide rate would probably have been greater. It is also important to note that the science has improved (as most science will) over the seven years since that study.

In general, new science that replaces older science is more reliable and accurate. As the science matures, gender affirmation is being recommended with increasing frequency to relieve suffering. Maybe the science will change in ten years but right now it represents the best information that is available.
Children have developing brains; their minds change often, and they don’t grasp long-term consequences. Kids should not be making permanent decisions about altering their bodies.
See above about desistence rates These children are in the care of qualified professionals. Kids are not making decisions without qualified medical counseling and support.
People of faith help keep our troubled foster systems afloat. Driving them out of foster parenting is a blow the system doesn’t need.
I cannot. I simply cannot. But I will try. Not all people of faith are opposed to what amounts to best practices. Even then, he wants the state to allow superstition to prevail over science. Children deserve better.
To his credit, Van Mol does realize that his talking points were refuted by qualified practitioners. Obviously they won the day. I am going to skip past Laidlaw's testimony because it is at complete odds with his own professional association. He is putting religion above both the best interests of children and the best available science.
A welcome conclusion
The tragedy of “gender-affirming health care” for minors mirrors the calamities of the lobotomy movement and California’s former eugenics sterilization program. AB2119 is a triumph of ideology posing as science. …
The … replaces reiteration of the same BS. Likening transition to a lobotomy was first floated by one of the crazy, anonymous parents behind 4thWaveNow in a word: Nuts. Sterilization was done without consent and often without knowledge. If Van Mol has a problem he should take that up with the American Academy of Pediatrics whose statement was made after the final text was approved by both houses. It was signed into law on September 16, 2018.

I am not a physician. Imagine what someone like Jack Turban or Kristina Olson could do to these religious zealots in a debate. It would not be pretty. The very idea that there are doctors who place religion over science is scary. The fact that they mischaracterize the science to conform to their religion is even scarier.

These people avoid that kind of debate because their job is to defend the faith. They cannot prevail with an audience when up against a true medical professional.

Parents are advised to scan the walls of their pediatrician's office. If there is an official looking document from the American College of Pediatricians they should snatch up their kid or kids and run like hell. No child should be subjected to the beliefs of these maniacs who have their priorities out of order.

Medicine is a science. Science is based on evidence. Religion is a belief system. Religion is based on faith. We expect our doctors to defer to the scientific evidence over faith. That reasonable expectation is lost on people like Dr. Van Mol.

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