Oh, The Hypocrisy

Have you read the new treatment guidelines for childhood obesity recently published by The American Academy of Pediatrics? If you haven’t, you should. But pour yourself a stiff drink first. You’re going to need it.

Seems that these pediatricians are moving away from their “watchful waiting” stance and recommending, depending on age, intensive therapy, drugs and/or surgery. According to the Washington Post, “People of both sides express uneasiness about the potential long-term consequences of putting millions of children on drugs or under the knife, instead of doing more to prevent the condition in the first place”. Really?  But don’t obese children just want to be their authentic selves? Shouldn’t we let children lead the way since they know what is best for themselves and their bodies? Shouldn’t a parent prefer an obese child to a dead one?

According to Arthur Caplan, a bioethicist at the NYU Grossman School of Medicine, “Turning to surgery and pills is quintessentially American”. He goes on to describe medication and surgery as “Band-Aids in a society that can’t figure out what to really do to protect the interest of its kids”. I don’t know Dr. Caplan’s professional recommendation for kids who identify as trans. But I bet a lot of parents on this site, myself included, wonder why our kids couldn’t have been spared the “band-aids” of drugs and surgery when they “came out” as trans. Why couldn’t the interests of our kids be protected?

Good for the AAP. They are seriously concerned about the potential damaging lifelong health consequences of obesity. And what’s their policy on trans-identifying youths? Well, they recommend taking a “gender-affirming,” nonjudgmental approach that helps children feel safe in a society that too often marginalizes or stigmatizes those seen as different. They refer to this as the gender-affirming model.

And what exactly is the gender-affirmation model?

As youth who identify as TGD (transgender and gender diverse) reflect on and evaluate their gender identity, various interventions may be considered to better align their gender expression with their underlying identity. This process of reflection, acceptance, and, for some, intervention is known as “gender affirmation.” It was formerly referred to as “transitioning,” but many view the process as an affirmation and acceptance of who they have always been rather than a transition from one gender identity to another.

In other words, give us your confused, distressed child who believes transitioning will solve their mental health struggles—and we will give you back a life-long patient with myriad damaging on-going health issues. These are all concerns they wish to avoid for obese children. But, not to worry, we’ll throw in sexual dysfunction and infertility for the trans kids too. 

Don’t get me wrong. I’m happy that the AAP is addressing the issues of obesity in children. No one wants a child to suffer from health issues or to be bullied at school.  And you have to give them points for consistency. Drugs and surgery for obesity. Drugs and surgery for transgender. It’s the media’s reaction, their double standards, that is driving me to the brown liquors.

From the New York Times, “New Guidelines Underscore How Complicated Childhood Obesity Is for Patients and Providers”, January 20, 2023:

“Some experts on adolescent health have warned that such interventions may be harmful, noting that the use of anti-obesity medications in children is still relatively new, while surgery requires a long-term commitment to strict nutrition requirements.”

Why not the same reaction to cross-sex hormones which, not “might be”, but are harmful and are relatively new. Why no concerns about the long-term commitments after surgery?

From the same article:

“What I fear is that we are proposing treatment strategies that are expensive, not readily available and most often unsuccessful, even under the best of circumstances,” she said. “At the same time, we are setting kids up for a challenging relationship with their bodies and increasing their risks of other serious medical conditions.”

All these fears (except the readily available part) are realized for trans-identifying kids who start down the medicalization path. Where is the media concern? Why aren’t they calling this out?

And this:

This would involve a paradigm shift to weight-inclusive approaches, which see weight change as a possible symptom of, or a contributing factor toward, a larger health concern or struggle. These approaches focus providers on addressing that issue rather than managing weight loss.

Why not a paradigm shift for trans-identified youths who see their discomfort with their body as a possible symptom of a larger mental health struggle?

Can the media not see the double standard here? Can they not see the ideology driving their reaction to medical intervention for trans-identifying kids vs. children suffering from obesity. Why are we parents asked to celebrate trans-identity, but parents aren’t expected to be “body positive” about obesity?

Maybe someday we’ll see an article like this (“World’s largest body of human geneticists apologizes for eugenics role”.), where the AAP apologizes for their misguided transgender policies. And, in response, we can ask where our daughters can go to get their voices, hair, breasts and fertility back.