Tuesday, February 2, 2021

Iowa, Uranus

Welcome to Iowa
Five Iowa state representatives, none of whom are physicians, have sponsored a measure that would outlaw pediatric gender-affirming medical care. They are Sandy Salmon, Jeff Shipley, Anne Osmundson, Skyler Wheeler and Bobby Kaufmann. All five are Republicans.

I sent these geniuses an email as a media inquiry. My terse text was admittedly rhetorical in nature which limits the potential of receiving a reply. What can I tell you? I get pissed off when farmers, plumbers and small business owners presume to be qualified to make medical decisions adverse to the wellbeing of children.
My missive:
None of you folks seem to be physicians, let alone board-certified psychiatrists or pediatricians. Exactly what qualifies you to sponsor a measure that makes following the clinical practice guidelines of the American Academy of Pediatrics a crime?

Have any of you reviewed those guidelines? Can you cite any peer-reviewed research that supports this measure? Do you understand the severe risk of denying gender-affirming care?
H.F.2272 makes it a crime to provide puberty blockers, hormones and any surgery related to gender affirmation. While they were at it the bill bans municipalities from banning conversion therapy.

Underpinning the measure, in part, is the possibly intentional misunderstanding of desistance in minors.
  • It is true that a majority of kids who experience gender incongruence will grow out of the condition.
  • It is also true that persistence of the condition correlates to its severity.
  • Research confirms that children who naturally desist never transition in the first place.
  • In other words about 2% of all children experience some form of gender dysphoria.
  • However, only about 0.6% of children actually transition. Those who do not transition do not require medical interventions.
The religious right has come up with the “wait-and-see approach” referenced in this bill. Sometimes they call it “watchful waiting.”

Meanwhile the child will be in distress. Denied puberty blockers they will develop natal sex characteristics. For example, trans boys will grow breast tissue. Trans girls will develop male Adams apples. This adds to the distress. That, in turn, often leads to self-harm.
To put it succinctly, they are going to kill kids.
These decisions should be made by qualified medical professionals in concert with the child and his or her parents. These decisions should not be made by legislators who might be farmers, plumbers, accountants, lawyers and small business owners.
These bills in other states have failed once clinicians address the issue. However the bill does not have to pass to do damage. The misleading rhetoric in the measure and in the promotion of the measure does real harm to trans kids and could cause parents to withhold consent for proper treatment.

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