Members of America's leading pediatrics associations discussed possible ways to “circumvent” Republican-leaning states' bans on sex-reassignment surgeries and drugs for children, according to emails obtained by the Daily Caller News Foundation.

The email was sent by the American Academy of Pediatrics (AAP), the largest pediatric association in the United States. Member The organization, which represents 67,000 doctors, quietly partnered with transgender activist groups such as the Human Rights Campaign and the World Professional Association of Transgender Healthcare (WPATH) to promote child gender reassignment across the country. (Related article: WPATH Tapes: Behind-the-scenes recordings reveal what top gender doctor really thinks about sex-reassignment surgery)

Internal AAP communications from July 2023 indicate that members are developing strategies to provide gender reassignment interventions to children living in states that ban gender reassignment surgery, including using telehealth to access hormones from out-of-state providers. Currently, 25 states Passed laws banning or restricting child sex reassignment.

Through a public records request, DCNF obtained internal communications from members of the AAP’s Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness (SOLGBTHW), a group within the AAP that provides expertise and education on LGBT issues to the organization.

The AAP has several subgroups or “sections” within the organization that focus on different specialties and connect “like-minded professionals who share a pediatric subspecialty, surgical specialty, special area of ​​interest, or stage of life.” Joining the section on LGBT health requires an additional fee for AAP members. Healthcare professionals who are not pediatricians, such as registered nurses, psychologists, and social workers, can also join the group through section membership.

In a July 2023 email thread, Dr. Patricia Wells wrote, Australian Airlines fellow Wells, a member of the LGBT Health Section email group, noted a federal court decision that allowed Tennessee's ban on child gender reassignment to go ahead, calling it a “major setback.” Wells enlisted the help of colleagues to “work around” the Tennessee ban and suggested telehealth as a possible option for providing medical interventions to minors.

“Question for this group: Can care be coordinated to provide telehealth for sick children in states where it's prohibited?” Wells wrote. “I'd like to see a breakdown of which states still allow telehealth and whether it can get around regulations.” [Tennessee] Ban.”

“We've had calls from desperate parents from other states, including Indiana. [sic]”If you are in a ban state and need help caring for a patient, please let me know what I can do. I would be happy for this group to develop a strategy for providing care to border ban states,” Wells wrote to the group.

It's unclear whether any steps were taken to circumvent Tennessee and other Republican-leaning states' bans on child sex reassignment. Wells did not respond to DCNF requests for comment.

Tennessee Senate Majority Leader Jack Johnson sponsor of legislation Lawmakers who have banned pediatric gender reassignment told the DCNF that the law specifically prohibits the use of telehealth to provide gender reassignment medical interventions to minors.

“Our law is clear that prescribing medications or procedures to treat gender dysphoria in minors is prohibited, including via telehealth. Physicians who attempt to use common telehealth services to circumvent this law are violating the Legislature's clear intent,” Governor Johnson said in a statement.

The Supreme Court recently announced it would hear a case challenging Tennessee's ban on child sex reassignment. AAP, with support from WPATH, Amicus Brief The state legislature is set to approve support for overturning the state's child sex change ban in December 2023. According to the DCNF report, AAP has secretly partnered with WPATH for years to fight child sex change bans.

“I am incredibly proud of the work we've done to protect children from the long-term, irreversible and harmful effects of these medical procedures. I am grateful that the Supreme Court will soon take up our law and look forward to the Court providing further legal clarity to this situation,” Johnson said.

“We have a planned birth system.”

Dr. Jean Wagner, AAP Fellow The LGBT Health Section member responded to Wells' email a few hours later, Planned Parenthood of Illinois It may become possible to “prescribe/manage” cross-sex hormones for children via telehealth.

“We have had to look elsewhere for children who are ready to begin hormone therapy,” Wagner wrote. “There is a Planned Parenthood organization in our neighborhood, Fairview Heights, Illinois, that prescribes and manages hormone therapy and I believe also offers telehealth for children over 16.”

Transgender hormone therapy is offered via telehealth at Planned Parenthood Illinois for individuals age 16 and older, Website“We are open to everyone, regardless of zip code,” it says.

Planned Parenthood Illinois has seen explosive growth in its transgender services area, reporting an increase from 3,299 transgender visits in 2020 to 6,842 in 2022. Annual ReportCross-sex hormone therapy is “growing faster than any other service,” according to the group's 2022 report. Planned Parenthood Federation of Illinois received nearly $150,000 in state reimbursements for transgender services in 2022, according to records obtained by DCNF through a public records request.

Neither Wagner nor Planned Parenthood of Illinois responded to DCNF's requests for comment.

FOIA documents discussing bans on pediatric sex change.

“This activity by section members is wonderful.”

“We are committed to protecting the health and wellness of our communities,” said Dr. Christopher Harris, AAP's director of LGBT health and wellness. Chair in 2021joined the July 2023 email thread, warning the group not to take any action before consulting AAP's legal counsel.

“Hi everyone, I think this activity by section members is great,” Harris wrote. “But given the political climate, is this discussion risky? Is there any risk in running this? Maybe I should check with AAP's legal counsel?”

In another email thread, AAP state government affairs analyst Sarah Khan sent the LGBT health section a list of states where child gender reassignment is banned. Khan's June 2023 email to the section's executive committee included a table listing the effective dates of various state bans and the status of legal challenges to them.

“I wanted to follow up on the group's interest expressed at last week's SOLGBTHW EC meeting about having a chart showing the enactment/effective dates of anti-GAG laws across the country,” Khan wrote. “I hope this will be a useful tool for you as we continue to track states that are enacting anti-GAC laws.”

Neither Khan nor Harris responded to DCNF's requests for comment.

The AAP's Child Gender Reassignment Prohibition List.

“Ideological Gender Beliefs”

Khan sent another email in July 2023 with the subject “Fight to Protect GAC” and reported the “very positive news” of a judicial ruling that blocked the implementation of the ban on child sex change. Khan thanked members of the AAP section for their “continued dedication to this fight.”

GAC stands for “gender-affirming therapy,” a euphemism often used by activists and doctors to describe experimental treatments such as puberty suppressants, cross-sex hormones and sex-reassignment surgery.

“We are extremely grateful to everyone for their dedication to this fight. It is very heartening to see hard work and support translating into victory. We will continue our work and hope to see many more such rulings,” Khan wrote.

Public record emails from the AAP discussing pediatric gender reassignment.

“Very influential”

AAP's LGBT health unit is credited with crafting the organization's controversial transgender policy. support Use of puberty blockers, cross-sex hormones, and sex-reassignment surgery on minors. The AAP's transgender policy, reaffirmed in 2023, specifically excludes age limits for medications or surgical interventions. In fact, according to recently unsealed court documents, the AAP pressured WPATH to remove age limits for sex transition in its clinical guidelines, The New York Times reported. report.

of Cast ReviewAn independent report that reviewed the evidence in support of pediatric gender transition found that the WPATH standards of care, despite lacking “rigor,” form the basis for nearly all other guidelines in the field of transgender medicine.

“[WPATH] The Cass Review noted that “although the York University evaluation process found the guidelines to lack developmental rigor, they have been highly influential in guiding international practice,” and that “early versions of the two international guidelines have influenced almost all other guidelines.”

Although several European countries have halted child sex change practices following the Cass review, neither the AAP nor WPATH have withdrawn their support for such procedures.

moreover, Litigation The lawsuit against the AAP by detransitioned woman Isabel M. Ayala calls into question the credibility of the organization's transgender policies, specifically citing the role of its LGBT health and wellness division in developing the policies, and saying that “ideological beliefs about gender identity and gender theory” were at the core of the organization's founding.

“A small number of individuals in positions of power within the AAP are deeply committed to certain political and ideological beliefs related to gender identity and gender theory and felt that there was a lack of guidance for primary care physicians,” the lawsuit states. “Based on their information and belief, in 2016 these individuals formed a committee within the AAP called LGBT Health and Wellness (the “Committee”) to seize the opportunity to take leadership on this issue and to be the first to provide what they viewed as authoritative guidance and to ensure that that guidance was consistent with their ideological gender beliefs.”

“Upon information and belief, the Commission quickly began a nearly two-year process to develop a new 'policy statement' that would introduce a fundamentally new model for transgender and 'gender diverse children and youth,' based on the ideological views of these individuals,” the lawsuit states.

The “100% problem”

Dr. Brittany Allen, who is named as a defendant in the Ayala lawsuit, is a member of the AAP's executive committee for LGBT health and a co-author of the AAP's transgender policy. Allen is also the medical director of a pediatric transgender clinic in Wisconsin, a state bordering Iowa, where child gender transitions will be banned in 2023.

On June 21, 2023, AAP officials asked Allen whether the state's ban on pediatric gender reassignment was causing an influx of patients to states that don't have the ban, such as Wisconsin, according to emails obtained by the DCNF. The next day, Allen responded that this was “100% an issue and concern” and wrote that she had been advised not to perform medical interventions remotely in Iowa because telehealth options are limited by state law.

FOIA emails discussing bans on pediatric gender reassignment.

“I would say this is 100% an issue and a concern. I don't live in a Shield state, but we are one of the closest clinics to Iowa,” Allen wrote, who did not respond to DCNF requests for comment.

“Nursing care [Iowa] “Because the law includes medical care over the phone, we are currently advised not to provide medical care over the phone (such as questions about medications), which makes it very difficult to provide actual medical care, especially in remote areas,” Allen wrote.

Allen did not respond to multiple requests for comment.

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