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Monica,

This is a misleading statement. First, The American Academy of Pediatrics and the American Medical Association guidelines do not advocate surgery before for minors wishing to explore their gender identity, in fact, it is medical malpractice to do so. FAIR's Statement and your statement imply that somehow physicians and medical professionals are not transparent when discussing with the parent of the children the appropriate medical and scientific evidence is downright dangerous. The CASS review is not a peer reviewed document, the AAP, Endocrine Society and American Psychology Association questioned the biases in the report and reaffirmed that the CASS study did not shine any new information on the subject matter. The concerns raised by professionals were similar to the reactions from professionals regarding the Wakefield MMR paper. If a review should be conducted, it should be a meta-analysis which is the gold standard in scientific research.

There are decades worth of research. Here are a few papers you can read if you believe that there is "lack" of research regarding this subject matter.

Abbott-Smith, S., Ring, N., Dougall, N., & Davey, J. (2023). Suicide prevention: What does the evidence show for the effectiveness of safety planning for children and young people? - A systematic scoping review. Journal of psychiatric and mental health nursing, 30(5), 899–910. https://doi.org/10.1111/jpm.12928

Jason Rafferty, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, COMMITTEE ON ADOLESCENCE, SECTION ON LESBIAN, GAY, BISEXUAL, AND TRANSGENDER HEALTH AND WELLNESS, Michael Yogman, Rebecca Baum, Thresia B. Gambon, Arthur Lavin, Gerri Mattson, Lawrence Sagin Wissow, Cora Breuner, Elizabeth M. Alderman, Laura K. Grubb, Makia E. Powers, Krishna Upadhya, Stephenie B. Wallace, Lynn Hunt, Anne Teresa Gearhart, Christopher Harris, Kathryn Melland Lowe, Chadwick Taylor Rodgers, Ilana Michelle Sherer; Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics October 2018; 142 (4): e20182162. 10.1542/peds.2018-2162

Virupaksha, H. G., Muralidhar, D., & Ramakrishna, J. (2016). Suicide and Suicidal Behavior among Transgender Persons. Indian journal of psychological medicine, 38(6), 505–509. https://doi.org/10.4103/0253-7176.194908

Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D'Augelli, A. R., Silverman, M. M., Fisher, P. W., Hughes, T., Rosario, M., Russell, S. T., Malley, E., Reed, J., Litts, D. A., Haller, E., Sell, R. L., Remafedi, G., Bradford, J., Beautrais, A. L., Brown, G. K., … Clayton, P. J. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of homosexuality, 58(1), 10–51. https://doi.org/10.1080/00918369.2011.534038

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Interesting that many of the medical proponents of these treatments are currently being sued by those who were subject to them. The pediatric gender clinic in Rhode Island run by Jason Rafferty has scrubbed its web presence. Rafferty is the sole author of the American Academy of Pediatrics’ policy statement on the 'gender-affirming care' method and is being sued along with the AAP by a detransitioner.

Cass is not "peer reviewed" because it IS a review. And a very careful and scrupulous one. American medicine ignores it at its peril, and shame.

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Whether they support it (medicalization of 'gender' distressed minors) or not, that medicalization has been happening.

Why are they not opposing it?

Where is the ethical compass of the Hippocratic Oath?

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