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“Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.”
Who We Are

As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.
Doctors Protecting Children Declaration
As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.
We affirm:
- Sex is a dimorphic, innate trait defined in relation to an organism’s biological role in reproduction. In humans, primary sex determination occurs at fertilization and is directed by a complement of sex determining genes on the X and Y chromosomes. This genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions
- Consideration of these innate differences is critical to the practice of good medicine and to the development of sound public policy for children and adults alike.
- Gender ideology, the view that sex (male and female) is inadequate and that humans need to be further categorized based on an individual’s thoughts and feelings described as “gender identity” or “gender expression”, does not accommodate the reality of these innate sex differences. This leads to the inaccurate view that children can be born in the wrong body. Gender ideology seeks to affirm thoughts, feelings and beliefs, with puberty blockers, hormones, and surgeries that harm healthy bodies, rather than affirm biological reality.
- Medical decision making should not be based upon an individual’s thoughts and feelings, as in “gender identity” or “gender expression”, but rather should be based upon an individual’s biological sex. Medical decision making should respect biological reality and the dignity of the person by compassionately addressing the whole person.
We recognize:
- Most children and adolescents whose thoughts and feelings do not align with their biological sex will resolve those mental incongruencies after experiencing the normal developmental process of puberty.
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- Desistance is the norm without affirmation as documented by Zucker in his article “The Myth of Peristence”. (1)
Zucker, KJ. The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender nonconforming children” by Temple Newhook et al. International Journal of Transgenderism. 2018: 19(2), 231–245. Published online May 29, 2018.http://doi.org/10.1080/15532739.2018.1468293 [1] - In the “largest sample to date of boys clinic-referred for gender dysphoria,” there was a desistance rate of 87.8%. (2)
Singh D, Bradley SJ and Zucker KJ. A Follow-Up Study of Boys With Gender Identity Disorder. Front Psychiatry. 2021;12:632784. doi: 10.3389/fpsyt.2021.632784 - The pro-affirmation Endocrine Society Guidelines (2017) admit: “…the GD/gender incongruence of a minority of prepubertal children appears to persist in adolescence.” (3)
Hembree, W., Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline J Clin Endocrinol Metab. 2017; 102:1–35. - A longitudinal study from the University of Groningen in the Netherlands followed 2772 adolescents (recruited from a psychiatric clinic) from age 11 years through 22 – 26 years. “In early adolescence 11% of participants reported gender non- contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26).” Even in this psychiatric patient study group for which interventions were not addressed, but “gender affirmation” is most likely, gender non-contentedness (essentially gender noncongruence) decreased substantially from early adolescence to young adulthood.(4)
Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5
- Desistance is the norm without affirmation as documented by Zucker in his article “The Myth of Peristence”. (1)
-
- Responsible informed consent is not possible in light of extremely limited long-term follow-up studies of interventions, and the immature, often impulsive, nature of the adolescent brain. The adolescent brain’s prefrontal cortex is immature and is limited in its ability to strategize, problem solve and make emotionally laden decisions that have life-long consequences.[2]
- Sex-trait modification or “Gender affirming” clinics in the United States base their treatments upon the “Standards of Care” developed by the World Professional Association for Transgender Health (WPATH). However, the foundation of WPATH guidelines is demonstrably flawed and pediatric patients can be harmed when subjected to those protocols.
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- The two Dutch studies that form the foundation for treatment guidelines as documented in the WPATH “Standards of Care” guidelines version 7 (SOC 7) had serious flaws.[3]
- These studies did show that the appearance of secondary sex characteristics in adolescents and young adults could be changed by hormonal and surgical interventions, but they failed to demonstrate meaningful long-term improvement in psychological well-being.
- Scientific concerns with these studies also include a lack of a control group, small sample sizes, significant numbers of patients lost to follow up, and the elimination of patients who experienced significant mental illness from entering the studies.
- It is concerning that the Dutch studies did not address complications and adverse outcome in the adolescent cohort that underwent transition. These complications included new onset diabetes, obesity and one death.[4]
- There is now sufficient research to further demonstrate the failure of the WPATH, American Academy of Pediatrics and Endocrine Society protocols.
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- The Cass Review was released on April 10, 2024, as an “independent review of gender identity services for children and young people”. The following points are from Cass’s final report:[5]
- Commissioned by the National Health Service (NHS) England, and chaired by Dr. Hilary Cass, the 388-page report utilized systematic reviews, qualitative and quantitative research, as well as focus groups, roundtables and interviews with international clinicians and policy makers.
- As part of the evaluation, they reviewed the research on social transition, puberty blockers, and cross-sex hormones.
- Social transition
- “The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence.
- However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.”
- Puberty blockers
- “The systematic review undertaken by the University of York found multiple studies demonstrating that puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression. However, no changes in gender dysphoria or body satisfaction were demonstrated [emphasis added].”
- “There was insufficient/inconsistent evidence about the effects of puberty suppression on psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk or fertility.”
- “Moreover, given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinizing/ feminizing hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.”
- Cross-sex hormones
- “The University of York carried out a systematic review of outcomes of masculinising/feminising hormones.” They concluded, “There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up. No conclusions can be drawn about the effect on gender dysphoria, body satisfaction, psychosocial health, cognitive development, or fertility.”
- “Uncertainty remains about the outcomes for height/growth, cardio-metabolic and bone health.”
- The Cass Review further stated, “Assessing whether a hormone pathway is indicated is challenging. A formal diagnosis of gender dysphoria is frequently cited as a prerequisite for accessing hormone treatment. However, it is not reliably predictive of whether that young person will have longstanding gender incongruence in the future, or whether medical intervention will be the best option for them.”
- A 2024 German systematic review on the evidence for use of puberty blockers (PB) and cross-sex hormones (CSH) in minors with gender dysphoria (GD) also found “The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn’t suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD.”[6]
- The Cass Review was released on April 10, 2024, as an “independent review of gender identity services for children and young people”. The following points are from Cass’s final report:[5]
- There are serious long-term risks associated with the use of social transition, puberty blockers, masculinizing or feminizing hormones, and surgeries, not the least of which is potential sterility.
-
- Youth who are socially affirmed are more likely to progress to using puberty blockers and cross-sex (masculinizing or feminizing) hormones.
- “Social transition is associated with the persistence of gender dysphoria as a child progresses into adolescence.”[7]
- “Gender social transition of prepubertal children will increase dramatically the rate of gender dysphoria persistence when compared to follow-up studies of children with gender dysphoria who did not receive this type of psychosocial intervention and, oddly enough, might be characterized as iatrogenic.”[8]
- Puberty blockers permanently disrupt physical, cognitive, emotional and social development.
- Side effects listed in the Lupron package insert include emotional lability, worsening psychological illness, low bone density, impaired memory, and the rare side-effect of pseudotumor cerebri (brain swelling).[9]
- A coalition of physicians and medical organizations from around the world submitted a petition to the Commissioner of the U.S. Food and Drug Administration requesting urgent action be taken to eliminate the off-label use of GnRH (growth hormone) agonists in children.[10]
- Testosterone use in females and estrogen use in males are associated with dangerous health risks across the lifespan including, but not limited to, cardiovascular disease, high blood pressure, heart attacks, blood clots, stroke, diabetes, and cancer.[xi],[12]
- Genital surgeries affect future fertility and reproduction.
- Youth who are socially affirmed are more likely to progress to using puberty blockers and cross-sex (masculinizing or feminizing) hormones.
- A report from Environmental Progress released on March 4, 2024, entitled “The WPATH Files” revealed “widespread medical malpractice on children and vulnerable adults at global transgender healthcare authority.”[13]
-
- “The WPATH Files reveal that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along.”
- “Members are fully aware that children and adolescents cannot comprehend the lifelong consequences of ‘gender-affirming care’ and, in some cases due to poor health literacy, neither can their parents.”
- In addition, developmentally challenged and mentally ill individuals were being encouraged to “transition”, and treatments were often improvised.
- Evidence-based medical research now demonstrates there is little to no benefit from any or all suggested “gender affirming” interventions for adolescents experiencing Gender Dysphoria. Social “affirmation”, puberty blockers, masculinizing or feminizing hormones, and surgeries, individually or in combination, do not appear to improve long-term mental health of the adolescents, including suicide risk.[14]
- Psychotherapy for underlying mental health issues such as depression, anxiety, and autism, as well as prior emotional trauma or abuse should be the first line of treatment for these vulnerable children experiencing discomfort with their biological sex.
- England, Scotland, Sweden, Denmark, and Finland have all recognized the scientific research demonstrating that the social, hormonal and surgical interventions are not only unhelpful but are harmful. So, these European countries have paused protocols and are instead focusing on evaluating and treating the underlying and preceding mental health concerns.
- Other medical organizations are adhering to the evidence-based medicine documented in the Cass Review Final Report.
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- The constitution of the National Health Service in England will be updated to state, “We are defining sex as biological sex.”[15]
- The European Society of Child and Adolescent Psychiatry issued a document titled “ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards.”
- In this paper, they stated, “The standards of evidence-based medicine must ensure the best and safest possible care for each individual in this highly vulnerable group of children and adolescents. As such, ESCAP calls for healthcare providers not to promote experimental and unnecessarily invasive treatments with unproven psycho-social effects and, therefore, to adhere to the “primum-nil-nocere” (first, do no harm) principle”.[16]
- Health care professionals around the world are also acknowledging the urgent need to protect children from harmful “gender-affirming” interventions.
-
- In a letter to the British newspaper, The Guardian, sixteen psychologists, some of whom worked at the Tavistock Center for Gender Identity Development Service, acknowledged the role clinical psychologists played in placing children on an “irreversible medical pathway that in most cases was inappropriate.”[17]
- In the United States, a group of psychiatrists, physicians and other health care workers wrote an open Letter to the American Psychiatric Association (APA), calling on the APA to explain why it glaringly ignored many scientific developments in gender-related care and to consider its responsibility to promote and protect patients’ safety, mental and physical health.[18]
- Despite all the above evidence that gender affirming treatments are not only unhelpful, but are harmful, and despite the knowledge that the adolescent brain is immature, professional medical organizations in the United States continue to promote these interventions. Further, they state that legislation to protect children from harmful interventions is dangerous since it interferes with necessary medical care for children and adolescents.
-
- The American Psychological Association states it is the largest association of psychologists worldwide. The organization released a policy statement in February 2024 stating, “The APA opposes state bans on gender-affirming care, which are contrary to the principles of evidence-based healthcare, human rights, and social justice.”[19]
- The Endocrine Society responded to the Cass Review by reaffirming their stance. “We stand firm in our support of gender-affirming care…. NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care.”[20]
-
- The American Academy of Pediatrics (AAP) Board of Directors in August 2023, voted to reaffirm their 2018 policy statement on gender-affirming care. They did decide to authorize a systematic review but only because they were concerned “about restrictions to access to health care with bans on gender-affirming care in more than 20 states.”[21]
- Of note, Dr. Hilary Cass called out the AAP for “holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”[22]
- The American Academy of Pediatrics (AAP) Board of Directors in August 2023, voted to reaffirm their 2018 policy statement on gender-affirming care. They did decide to authorize a systematic review but only because they were concerned “about restrictions to access to health care with bans on gender-affirming care in more than 20 states.”[21]
In Conclusion
Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.
In the United States of America, on June 6, 2024, this declaration was authored and signed by the American College of Pediatricians and co-signed by:
Co-Signers
Medical and Health Policy Organizations*
Alliance for Hippocratic Medicine (AHM)
American Academy of Medical Ethics
American Association of Christian Counselors (AACC)
American College of Family Medicine (ACFM)
American College of Pediatricians (ACPeds)
Association of American Physicians and Surgeons (AAPS)
Catholic Health Care Leadership Alliance (CHCLA)
Catholic Medical Association (CMA)
Christian Medical & Dental Associations (CMDA)
Coalition of Jewish Values
Colorado Principled Physicians
Genspect
Honey Lake Clinic
International Foundation for Therapeutic and Counselling Choice (IFTCC)
National Association of Catholic Nurses, USA
National Catholic Bioethics Center (NCBC)
North Carolina Physicians for Freedom (NCPFF)
South Carolina Physicians for Freedom (SCPFF)
*These organizations represent over 75,000 physicians and healthcare professionals.
Doctors and Health Leaders
Steven Albrechta, MD
Clinical Assistant Professor, Primary Care Sports Medicine, Ohio State University Sports Medicine
Jane E. Anderson, MD, FCP
Pediatrician
Vice President, American College of Pediatricians
Clinical Professor, Pediatrics, University of California, San Francisco (retired)
Michael Artigues, MD, FCP
Pediatrician
President, American College of Pediatricians
Errol Baptist, MD
Physician, Pediatrics and Adolescent Medicine
Clinical Professor of Pediatrics, University of Illinois College of Medicine at Rockford
President, Rockford Guild, Catholic Medical Association
Jeff Barrows, MD
Obstetrician and Gynecologist
Senior Vice President of Bioethics and Public Policy, Christian Medical & Dental Associations
Thomas Benton, MD, MPH, FCP
Pediatrician
Board Member and Healthcare Conscience Council Chair, American College of Pediatricians
Co-Founder, American College of Pediatricians
Karl Benzio, MD
Psychiatrist
Chief Medical Officer, Honey Lake Clinic
New Jersey State Co-Director, American Association of Medical Ethics
Medical Director, American Association of Christian Counselors
Sexual and Gender Identity Task Force Member, Christian Medical &; Dental Associations
Physician Resource Council Member, Focus on the Family
Jonathan Berry, MD
Cardiologist
Advisory Board, North Carolina Physicians for Freedom
Jessica Bishop-Funk, DDS
Dentist
Advisory Board, North Carolina Physicians for Freedom
Darren Bodkin, MD
Neonatologist
David Bohle, MD
Cardiologist
Advisory Board, North Carolina Physicians For Freedom
Michael R. Bouchard, MD, PhD
Clinical Sexologist, Sexology and Psychology
Lisa Brandes, MD
Physician, Family Medicine
Board Member, American College of Family Medicine
Carl Brophy, MD
Assistant Professor, Family Medicine, Central Florida College of Medicine
Louis Brown, Jr., JD
Executive Director, Christ Medicus Foundation
Founding Board Member and Vice President of Public Policy, Catholic Health Care Leadership Alliance
Oscar Brown, MD
Pediatrician
Retired, Part-time faculty at University of Texas Medical Branch, Galveston
Greg Burke, MD
Physician, Internal Medicine
Co-Chair, Catholic Medical Association Ethics Committee
Michael Byrne, MD
Vascular Surgeon
Medical Director of Hospice of Southern Kentucky
Sr. Deirdre Byrne, MD
Physician, General Surgery and Family Medicine
Little Workers of the Sacred Hearts
Joshua Carr, PhD
Assistant Professor, Exercise Physiology, Texas Christian University
Katherine Carranza, MD
Obstetrician and Gynecologist, Costa Rica
Kelly Casey, MD
General Surgeon
Christina Chan, MD, MABHP, FIDSA, FA, FCP
Adult and Pediatric Infectious Disease Specialist and Clinical Researcher
American College of Pediatricians
Mike Chupp, MD
General Surgeon
Chief Executive Officer, Christian Medical and Dental Associations
Paul Cieslak, MD
Physician, Infectious Disease
West Regional Director, Catholic Medical Association
Michelle Cretella, MD, FCP
Pediatrician
Adolescent Sexuality Council Co-Chair and Past Executive Director, American College of Pediatricians
Sharon Curtis, MD
Child and Adolescent Psychiatrist
Paul Dassow, MD, MSPH
Physician, Family Medicine
President, American College of Family Medicine
Arthur Delorimier, MD
Pediatric Gastroenterology
Director, Pediatric Gastroenterology, University of California, Davis
Mario Dickerson, MTS
Executive Director, Catholic Medical Association
Allen Donkin, MD
Physician, General Practitioner
First Do No Harm Southern Africa
Joe Dougherty, MD
Physician, Family Medicine
Board Member, American College of Family Medicine
Lisa Erhlich, MD
Physician, Internal Medicine
Matthew Eich, MD
Orthopedic Surgeon, retired, Mayo Clinic
Fred Fakharzadeh, MD
Orthopedic Surgeon
Chair, Catholic Social Teaching and Justice in Medicine Committee, Catholic Medical Association
John Falcon, M.S., MD
Physician, Emergency Medicine
Founding Physician, South Carolina Physicians for Freedom
Scott Field, MD, FCP
Pediatrician, Pediatric Clinical Researcher
Membership Committee Chair and Past Board Member, American College of Pediatricians
Steven Foley, MD
Obstetrician and Gynecologist
Francisco Bernardo Fragoso Gutiérrez, MD, PhD
Physician, Critical Care Medicine, Mexico
Sheila Furey, MD
Child and Adolescent Psychiatrist
Virginia Medical Freedom Alliance
Kenneth Gall, PhD
Medical Physicist, Tufts Medical Center
Salwa Gendi, MD, FCP
Pediatric Cardiologist, Associate Professor of Pediatric Cardiology
Board Member, American College of Pediatricians
Brooke Gensler, MD
Physician, Family Medicine
At-Large Board Member, Catholic Medical Association
Ernesto Gil Deza, MD
Clinical Oncologist, Argentina
Prof. Luis Giraldo-Cadavid, MD, PhD
Physician, Internal Medicine, Pulmonary Medicine
Universidad de La Sabana, Fundacion Neumologica Colombiana, Colombia
Stanley Goldfarb, MD
Nephrologist
Russell Gombosi, MD, FCP
Pediatrician
Past Treasurer and Past Board Member, American College of Pediatricians
George Gonzalez, MD
Physician, Family Medicine
President, Christian Medical and Dental Associations
Diane T. Gowski, MD
Physician, Internal Medicine and Critical Care Medicine
Southeast Regional Director, Catholic Medical Association
Miriam Grossman, MD
Child, Adolescent, and Adult Psychiatrist
Author, Lost in Trans Nation
Prof. James Grinols, MD
Pediatrician
Pediatrics, Liberty University
Joe Guarino, MD, MPH
Physician, Occupational Medicine
Board Member, North Carolina Physicians for Freedom
Eithan Haim, MD
General Surgeon
Donna Harrison, MD
Obstetrician and Gynecologist
Chair, Alliance for Hippocratic Medicine
Sr. Edith Mary Hart, RSM, DO, FAAFP
Physician, Family Medicine/Geriatrics
Religious Sisters of Mercy of Alma
Nicole Hayes, MPA
Executive Vice President, American Academy of Medical Ethics
Laura Haygood, MD,
Dermatologist
Laura Haynes, Ph.D.
Executive Board, USA Country Representative, Chair-Science and Research Council,
International Foundation for Therapeutic and Counselling Choice
Jim Heid, MD
Physician, Family Medicine
Board Member, American College of Family Medicine
Roy Heyne, MD
Pediatrician
Co-Chair, Education Committee, Catholic Medical Association
David Hilger, MD
Diagnostic Radiologist
Vice President, Catholic Medical Association
Marie Hilliard, MS, MA, JCL, PhD, RN
Co-Chair of the Ethics Committee, Catholic Medical Association
Senior Fellow, National Catholic Bioethics Center
Mark Hoch, MD, MDiv, DABIHM
Physician, Family Medicine, Holistic Medicine
Past President, American Holistic Medical Association
Masters of Divinity in Spiritual Ministry and Healing
Past Member of the Hospital Medical Ethics Committee
Alan Hopewell, PhD
Clinical Medical Neuropsychologist
Robert Howe, MD
Reproductive Endocrinologist
Jane Hughes, MD
Ophthalmologist
President, Association of American Physicians and Surgeons
Patrick Hunter, MD, MSC (Bioethics)
Pediatrician
Janet Hurley, MD
Physician, Family Medicine
Vice President, American College of Family Medicine
Mohamad Hussein, MD
Physician, Medical Oncology and Hematology
Professor of Medicine, University of South Florida
Thomas Jensen, MD
Endocrinologist
Assistant Professor
Denver Catholic Medical Association
Nicole M. Johnson, MD, DNBPAS
Independent Consultant, Pediatrics and Pediatric Critical Care Medicine
Blaise Jones, MD
Professor, Pediatric Neuroradiology
Jeremy Jones, MD
Pediatrician
Associate Professor of Primary Care, Marian University College of Osteopathic Medicine
Patricia Lee June, MD, FCP
Pediatrician
Scientific Policy Committee Chair and Past Board Member, American College of Pediatricians
Rachel Kaiser, MD
Emergency Physician
David Kay, MD
Cardiologist
Medical Director, North Carolina Physicians for Freedom
Staci Kay, NP
Nurse Practitioner
Board Member, North Carolina Physicians for Freedom
Mary Keen-Kerchoff, MD, FCP
Pediatrician
Co-Chair, Education Committee, Catholic Medical Association
Chistopher Kolker, MD, FAAFP
Physician, Family Medicine/Hospice and Palliative Medicine
Clinical Instructor, Yale University
Assistant Professor of Medicine, Quinnipiac University
Assistant Professor of Nursing, Yale University
Michael K. Laidlaw, MD
Endocrinology, Diabetes, and Metabolism
Jane Hughes, MD
Ophthalmologist
President, Association of American Physicians and Surgeons
Patrick Hunter, MD, MSC (Bioethics)
Pediatrician
Janet Hurley, MD
Physician, Family Medicine
Vice President, American College of Family Medicine
Nicole M. Johnson, MD, DNBPAS
Independent Consultant, Pediatrics and Pediatric Critical Care Medicine
Patricia Lee June, MD, FCP
Pediatrician
Scientific Policy Committee Chair and Past Board Member, American College of Pediatricians
David Kay, MD
Cardiologist
Medical Director, North Carolina Physicians for Freedom
Staci Kay, NP
Nurse Practitioner
Board Member, North Carolina Physicians for Freedom
Mary Keen-Kerchoff, MD, FCP
Pediatrician
Co-Chair, Education Committee, Catholic Medical Association
Michael K. Laidlaw, MD
Physician, Endocrinology, Diabetes, and Metabolism
Flavio Lacerda, MD
Physician, Internal Medicine, Brazil
Marian Laderoute, PhD
Medical Sciences-Immunology
Immune System Management, PHAC, and HC (retired), Canada
Jennifer Lahl, RN
Founder, The Center for Bioethics and Culture
Patricia Landry, MD
Physician, Family Medicine
Chair of the Physician Resource Council, Focus on the Family
John I. Lane, MD
Radiologist
Vice President, Federation Internationale des Associations de Médecins Catholiques
Past President, Catholic Medical Association
Erika L. LeBaron, DO, MSN
Physician, Family Medicine
President-Elect, Association of American Physicians and Surgeons
Prof. James Lee, PhD
Associate Professor, Psychology, University of Minnesota Twin Cities
Diana Lightfoot
Policy Director, North Carolina Physicians for Freedom
Katarina Lindley, DO
Physician, Family Medicine
President, Global Health Project and Texas Association of American Physicians and Surgeons
Deirdre Little, MD
Physician, GP Obstetrician
National Bioethics Convenor, Catholic Women’s League Australia, Inc, Australia
John Logan, MD
Associate Professor of Pediatrics, Neonatal-Perinatal Medicine, University of Florida College of Medicine
Edmund Lowrie, MD
Physician and Health Care Executive (retired)
Steven Lucking, MD
Physician, Pediatric Critical Care Medicine (retired)
Professor of Pediatrics, Penn State College of Medicine (retired)
Katelyn Makar, MD
Physician, Plastic Surgery
Assistant Professor of Surgery, Indiana University School of Medicine
Edgar Manrique, MD
Anesthesiologist, Colombia
Fiona Mao, NP, PMHNP, FNP
Chief Executive Officer, Elevate Health Now
Gloria Marmolejo, PhD
Professor of Psychology, Winona State University
Martin McCaffrey, MD
Neonatologist
Professor of Pediatrics, University of North Carolina, Chapel Hill School of Medicine
Peter McCullough, MD, MPH
Cardiologist, Internal Medicine
President, McCullough Foundation
David McKalip, MD
Neurological Surgeon
President, Bartow County (Georgia) Medical Association
Joseph Meaney, PhD, KM
President, National Catholic Bioethics Center
Founding Board Member, Catholic Health Care Leadership Alliance
Carrie Mendoza, MD
Physician, Emergency Medicine
Director, Genspect USA
Rabbi Yaakov Menkin
Managing Director, Coalition for Jewish Values
Bradford Merrelli, MD
Physician, Family Medicine
Ascension Providence Rochester Board of Directors 2005-2019
Tim Millea, MD
Orthopedic Surgeon
Chair, Health Care Policy Committee, Catholic Medical Association
M. Shawn Morehead, MD, MPH
Physician, Family Medicine
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Travis J. Morell, MD, MPH
Dermatologist
Chair, Colorado Principled Physicians
Julie Morgan, MD
Pediatrician
Peter Morrow, MD
Physician, Internal Medicine
Past President, Catholic Medical Association
Jennifer Roback Morse, Ph.D.
Founder and President, The Ruth Institute
Saturnino Nascimento Neto, MD
General and Digestive Surgeon, Brazil
Thomas Nelson, MD, MA
Psychiatrist, Consultation-Liason Psychiatry, Addiction Medicine
Emeritus Staff, Mayo Clinic
Michael Nowicki, MD
Pediatric Gastroenterologist
Professor of Pediatrics, University of Mississippi Medical Center
Alfonso Oliva, MD, FACS
Surgeon, Plastic and Reconstructive Surgery
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Anthony Oliva, MD
General Surgeon
Northeast Regional Director, Catholic Medical Association
David Olson, MD, FCP
Pediatrician
Board Member, American College of Pediatricians
Stella O’Mally
Executive Director, Genspect
Jane Orient, MD
Physician, Internal Medicine
Executive Director, Association of American Physicians and Surgeons
Philip Overby, MD
Pediatric Neurologist
Associate Professor of Neurology and Pediatrics
Megan Pasookhush, PharD
Pharmacist
Board Member, North Carolina Physicians for Freedom
L. David Perry, MD, FCP
Pediatrician
Board Member, American College of Pediatricians
Spencer Phelps
Director, Office of Clinical Research, Trinity Health New York Region
David Pickup, LMFT-S
Psychotherapist, Gender/Sexuality
The Alliance
Robin Pierucci, MD, FCP
Neonatologist
Board Member and Pro-Life Council Co-Chair, American College of Pediatricians
Thomas M. Pitre, MD
Urologist
Past President, Catholic Medical Association
Matthew R. Porter, MD, FAAFP
Physician, Family Medicine
Treasurer, American College of Family Medicine
Gloria Portilla, MD
Physician, Bioethics
Fundación Ventris/ Custodiandovidas, Colombia
Karin Quiero-Flory, MS
Educational and Clinical Psychologist
VozconCiencia (Voice with Science) Asociación of Catholic Psychologist)), Chile
Samuel “Bose” Ravenel, MD
Pediatrician
Advisory Board, North Carolina Physicians for Freedom
Kathleen Raviele, MD
Obstetrician and Gynecologist
Past President, Catholic Medical Association
Nora H. Riani-Llano, MD
Pediatrician, Bioethics
Colombia
Michael Robb, MD
Oto-Neurologist
Past President, Association of American Physicians and Surgeons
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Cardiologist
Instituto National Cardiovascular INCOR, Peru
Prof. David Roll, PhD
Professor Emeritus of Biological and Chemical Sciences, Roberts Wesleyan University
Sven Román, MD
Child and Adolescent Psychiatrist
Senior Consultant, Sven Román AB, Sweden
Michael Romanelli, MD
Cardiologist
Clinical Professor of Medicine, Wayne State University School of Medicine
Prof. Charles Romig, LMFT
Professor Emeritus Marriage and Family Therapy (retired)
Christopher Rosik, PhD
Clinical Psychologist
Past President, Alliance for Therapeutic Choice and Scientific Integrity
Member, American Psychological Association
Steven Roth, MD
Anesthesiologist
Chairman, Coalition for Jewish Values Healthcare Council
Stephen Sammut, PhD
Neuroscience
Professor of Psychology, Franciscan University of Steubenville
Nathan Samora, MD
Urologist
Vanderbilt University School of Medicine
Richard W. Sams II, MD
Physician, Family Medicine, MA (Ethics)
Board Member, American College of Family Medicine
Richard H. Sandler, MD, FCP
Pediatric Gastroenterologist
Treasurer and Pro-Life Council Co-Chair, American College of Pediatricians
Professor of Pediatrics, University of Central Florida
Emily Saunders
Network Director, North Carolina Physicians for Freedom
Jeffrey Sarinover, MD, PhD
Psychiatrist
Managing Director, Sterling Institute for Neuropsychiatry and Behavioral Medicine
Weston Saunders, MD
Physician, Family Practice
Medical Director, North Carolina Physicians for Freedom
Rabbi Yoel Schonfeld
President, Coalition for Jewish Values
Bob Schucts, PhD
Marital and Family Therapist (retired)
Founder, John Paul II Healing Center
Mike Semelka, DO
Physician, Family Medicine
Board Member, American College of Family Medicine
Janae Shamp, RN
Perioperative Nurse
Senator, Arizona State Senate
Bryan C. Shen, MMSAC
Registered Counsellor and Supervisor, SAC
Board Member, International Foundation for Therapeutic and Counseling Choice
Prof. Emerson Silva, Md, PhD
Pediatrician, Brazil
Jill M. Simons, MD, FCP
Pediatrician
Executive Director, American College of Pediatricians
Ingrid Skop, MD
Obstetrician and Gynecologist
Vice President and Director of Medical Affairs, Charlotte Lozier Institute
Franklin Smith, MD
Urologist
President, Milwaukee Guild of the Catholic Medical Association
Dr. Andrew Sodergren
Clinical Psychologist
Director of Psychological Services, Ruah Woods Institute
Kevin Speight, MD
Anesthesiologist
North Carolina Physicians for Freedom
Dr. Jillian Spencer
Psychiatrist
Queensland Children’s Hospital, Australia
Michelle Stanford, MD, FCP
Pediatrician
President, Catholic Medical Association
Lisa Stewart, CPA
Chief Executive Officer, Honey Lake Clinic
Kristin Strange, MD
Pediatrician
Advisory Board, North Carolina Physicians for Freedom
Raphael Stricker, MD
Physician, Internal Medicine
Medical Director, Union Square Medical Associates
Rev. D. Paul Sullins, Ph.D.
Research Professor of Sociology, The Catholic University of America
Senior Research Associate, The Ruth Institute
Katy Talento, ND
Naturopathic Doctor
Chief Executive Officer, AllBetterHealth
David Tomasi, MA, MS, PhD
Clinical Psychologist, Neuroscience
Professor, Doctor, Researcher
Vermont State Colleges, Vermont Academy of Arts and Sciences, Community College of Vermont
Prof. Luke Torre
Intensive Care Doctor, Professor
Sir Charles Gairdner Hospital, Australia
Angela Thompson, MD
Obstetrician and Gynecologist
Craig Treptow, MD
Physician, Family Medicine
Immediate Past President, Catholic Medical Association
Den Trumbull, MD, FCP
Pediatrician
Board Member, American College of Pediatricians
Co-Founder, American College of Pediatricians
Kimberly Vacca, MD, FCP
Pediatrician
Secretary, American College of Pediatricians
Jonathan VanGeest, PhD
Professor of Health Policy and Management, Kent State University
Quentin Van Meter, MD, FCP
Pediatric Endocrinologist
Adolescent Sexuality Council Co-Chair and Past President, American College of Pediatricians
Andre Van Mol, MD
Physician, Family Medicine
Sexual & Gender Identity Task Force Co-Chair, Christian Medical and Dental Associations
Christian Medical & Dental Associations and American Academy of Medical Ethics Transgenderism Scholar
Miroslav Verner, MD
Medical Doctor, Internal Medicine, Clinical Biochemistry and Laboratory Medicine
Hospital Ceske Budejovice, Czech Republic
Felipe Vizcarrondo, MD, MA
Pediatric Cardiology, Bioethics
Associate Professor, Institute for Bioethics and Social Policy, Miller School of Medicine, University of Miami, Florida
Cristl Ruth Vonholdt, MD
Pediatrician (retired)
Deanne Waldman, MD
Pediatric Cardiologist, Healthcare Policy
Emeritus Professor of Pediatrics, Pathology, and Decision Science
Former Director of Center for Healthcare Policy, Texas Public Policy Foundation (retired)
Tessa Walters, MD
Anesthesiologist
Ron Waterer, MD
Physician
Advisory Board, North Carolina Physicians for Freedom
James Weidner, MD
Pediatrician
New Jersey State Co-Director, American Academy of Medical Ethics
President, South New Jersey chapter of Christian Medical and Dental Associations
David Westbrock, MD
Physician, Endocrinology and Metabolism
Member, Association of American Physicians and Surgeons
Steven White, MD
Pulmonologist
President, Catholic Health Care Leadership Alliance
Past President, Catholic Medical Association
Donna Whittington, RN
Registered MH Nurse
NHS (retired), United Kingdom
William Williams, MD
Physician, Internal Medicine
Editor in Chief Emeritus, the Linacre Quarterly
Member, Catholic Medical Association
Ilene Yohay, MD
Endocrinologist
University of Chicago
Joseph Zanga, MD, FCP
Pediatrician
Founding President, American College of Pediatricians
Nancy Zeitoun, MD
Physician, Hospital Medicine
Director, Saint Francis Hospital and Heart Center, Catholic Health
Supporting Organizations
Advocates Protecting Children
CHANGED Movement
Child & Parental Rights Campaign (CPRC)
Desert Stream Ministries
Discovery Institute
Family Research Council
Family Watch International
Focus on the Family
International Partners for Ethical Care (PEC)
Liberty & Justice for All
Moms for Liberty
Will Pen for Change, LLC
Supporting Leaders
Arina Grossu Agnew, MA, MS
Fellow, Center on Human Exceptionalism, Discovery Institute
Founder and Principal, Areté Global Consulting
Paul Ashby, PhD
Staff Scientist, Lawrence Berkeley National Laboratory
Jennifer Bauwens, PhD
Director of the Center for Family Studies, Family Research Council
Prof. Christopher Blackwell, PhD
Louis G. Forgione University Professor, Furman University
Erin Brewer, PhD
Advocates Protecting Children
Rev. Michael Brown, MA
Pastor, United Reformed Churches in North America
Dean Broyles, Esq.
President and Chief Counsel, The National Center for Law & Policy
Vernadette R. Broyles, Esq.
President and General Counsel, Child & Parental Rights Campaign
Alexandra Cardona, LCSW
Licensed Clinical Social Worker
Osceola County School District
Eileen Christian, Esq.
Vice President, Advocates Protecting Children
Gabrielle Clark
Founder, Affirming Reality
Prof. Marco Colombini, PhD
Professor Emeritus, Membrane Biophysics, University of Maryland
Andrew Comiskey, MDiv
Founding Director, Desert Stream Ministries
Katie Comisky, MA
Director at Large, Desert Stream Ministries
Robert M. Copeland, PhD
Professor Emeritus, Geneva College
Gregg Cunningham
Retired Attorney, Bioethics
Center for Bio-Ethical Reform
Rev. Daniel Deyell, MA
Pastor Emeritus, Lutheran Church, Canada
Chris Elston
Billboard Chris, Canada
Theresa Farnan
Fellow, Person and Identity Project, Ethics and Public Policy Center
Abigail Foard, MA, LPC
Associate Director, Desert Stream Ministries
Gilberto A. Gamboa Bernal, MS, PhD
Bioethicist, Universidad de La Sabana
Editor, Persona y Bioética, Colombia
Lori Gimelshteyn
Executive Director, Colorado Parent Advocacy Network
Simone Gomez
Change the Story, Australia
Diane Gramley
President, American Family Association of Pennsylvania
Vermelle Greene, PhD
Executive Director, Vision: Concepts in Education, LLC
Glenn Gruenhagen
Senator, Minnesota State Senate
Mary Rice Hasson, JD
Director, Person and Identity Project, Ethics and Public Policy Center
Tiffany Justice
Co-Founder, Moms for Liberty
Jacqueline Kay
Our Duty UK, United Kingdom
Anna Kerr
Principal Solicitor, Feminist Legal Clinix Incorporated, Australia
Meg Kilgannon
Senior Fellow for Education Studies, Family Research Council
Liv Levey
Detransitioner
Jaimee Michell
Founder and President, Gays Against Groomers
Roland Millare, Dr.
Vice President of Curriculum, Director of Clergy Initiatives, St. John Paul II Foundation
Nicholas Molinari, PhD
Adjunct Professor of Philosophy and Humanities, Salve Regina University
Caitlin Neal-Karhut
Detransitioner
Rachael Nelson
Outreach Coordinator, Libertarian Institute
John Paulton
Vice President, State Alliances, Family Policy Alliance
Amy Reynolds
Detransitioner
Director of Content, Gays Against Groomers
Eine Ricklon
Detransitioner, Sweden
Gheorghe Rosca
Pastor, Protect Our Kids
Judith Rose
Secretary of the Board, Gays Against Groomers
Martha Shoultz, Esq.
Attorney and Board Member, International Partners for Ethical Care
Hannah Smith
Founding Director, Liberty & Justice for All
Joshua & Naomi Stringer
Co-Founders, Will Pen for Change, LLC
Wendy Terry
President, Outpost Ministries
Randy Thomasson
Founder and President, Campaign for Children and Families, SaveCalifornia.com, SaveAmerica.com
Ken Williams
Co-Founder, CHANGED Movement
Jolene Wojcik
Executive Director, Central Catholic Development Foundation
Rev. Elizabeth Woning
Co-Founder and Executive Director of Advocacy and Government Affairs, CHANGED Movement
Christopher Yuan, DMin
Speaker, Author (Holy Sexuality and the Gospel), Producer (The Holy Sexuality Project, holysexuality.com) Holy Sexuality
Jozef Zalot, PhD
Director of Education, The National Catholic Bioethics Center
Join those from 58 countries who have signed the Declaration!

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References
[1] Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5
[2] Diekema DS. Adolescent brain development and medical decision-making. Pediatrics. 2020; 146(s1): e20200818F
[3] deVries ALC, McGuire JK, Steensma TD, et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014; 134(4):696-704. https://doi.org/10.1542/peds.2013-2958
deVries ALC, Steensma TD, et al. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011; 8(8):2276-83. DOI: 10.1111/j.1743-6109.2010.01943.x
[4] Abbruzzese E, Levine SB, Mason JW. The myth of ‘reliable research’ in pediatric gender. medicine: A critical evaluation of the Dutch studies – and research that has followed. J Sex & Marital Therapy. 2023; 48(6): 673-699.
[5] Cass H. The Cass Review. April 2024. https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf
[6] This article is in German (author is Zepf) and the link is https://econtent.hogrefe.com/doi/10.1024/1422-4917/a000972
The National Library of Medicine has the summary in English
Zepf FD, Konig L, et al. (Beyond NICE: Updated systematic review on the current evidence of using puberty blocking pharmacological agents and cross-sex-hormones in minors with gender dysphoria.) Z Kinder Jugendpsychiatr Psychother. 2024; 52(3):167-187. https://pubmed.ncbi.nlm.nih.gov/38410090/
[7] Hembree, W., Cohen-Kettenis, et al., (2017) Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab,102:1–35.
[8] Zucker, K.J. Debate: Different strokes for different folks. Child Adolesc Ment Health. 2020; 25(1): 36-37. https://doi.org/10.1111/camh.12330
[9] Lupron Depot Prescribing Information. https://www.lupron.com/pi.html
[10] Supplement to Citizen Petition from Nancy Stade et al. Posted by the Food and Drug Administration on April 15, 2024. https://www.regulations.gov/document/FDA-2023-P-3767-0654
[11] Endocrine Society Guidelines at Hembree, W., Cohen-Kettenis, et al., (2017) Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab;102:1–35.
[12] Laidlaw M, Van Meter QL, Hruz PW, Van Mol A and Malone WJ. The Journal of Clinical Endocrinology & Metabolism, 2019;104(3): 686–687. https://doi.org/10.1210/jc.2018-01925
[13] Hughes, M. The WPATH Files. Pseudoscientific surgical and hormonal experiments on children, adolescents, and vulnerable adults. Environmental Progress. March 4, 2024. https://environmentalprogress.org/big-news/wpath-files
[14] American College of Pediatricians. Mental Health in Adolescents with Incongruence of Gender Identity and Biological Sex. Position Statement. Feb 2024. https://acpeds.org/position-statements/mental-health-in-adolescents-with-incongruence-of-gender-identity-and-biological-sex
[15] Zindulka K. Win for Reality: UK’s National Health Service constitution to declare ‘sex is biological’. Breitbart News. April 30, 2024. https://www.breitbart.com/europe/2024/04/30/win-for-reality-uks-national-health-service-constitution-to-declare-sex-is-biological/
[16] Radobuljac MD, Groselj U, et al. ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards. European Child & Adol Psych. 2024. doi.org/10.1007/s00787-024-02440-8
[17] Letters to the Editor. We are ashamed of the role psychology played in gender care. The Guardian. April 21, 2024. https://www.theguardian.com/theobserver/commentisfree/2024/apr/21/we-are-ashamed-of-role-psychology-played-gender-care-observer-letters
[18] An open letter to the American Psychiatric Association regarding the publication of gender-affirming psychiatric care. Foundation Against Intolerance and Racism. January 2024. https://www.fairforall.org/open-letters/open-letter-apa/?fbclid=IwAR17__BG0RtNqbUVcivxTRkx0AmABT5t7o-8Vg_tYKydzKBBXJ6xgsEYbQ8
[19] APA policy statement on affirming evidence-based inclusive care for transgender, gender diverse, and nonbinary individuals, addressing misinformation and the role of psychological practice and science. American Psychological Association February 2024. https://www.apa.org/about/policy/transgender-nonbinary-inclusive-care.pdf
[20] Endocrine Society statement in support of gender-affirming care. May 8, 2024. https://www.endocrine.org/news-and-advocacy/news-room/2024/statement-in-support-of-gender-affirming-care
[21] Wyckoff AS. AAP reaffirms gender-affirming care policy, authorizes systematic review of evidence to guide update. August 4, 2023. https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy?autologincheck=redirected
[22] Ghorayshi A. Hilary Cass says U.S. doctors are ‘out of date’ on youth gender medicine. The New York Times. May 13, 2024. https://www.nytimes.com/2024/05/13/health/hilary-cass-transgender-youth-puberty-blockers.html
