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A board-certified pediatrician and fellow of the American Academy of Pediatrics (AAP) – an organization that supports sex-rejecting hormone drugs for children with gender dysphoria – has criticized activists who fight bans on puberty blockers for minors with the claim that the effects of the drugs simply pause development and can be reversed.
“Those activists are mistaken,” wrote Julia Mason, MS, MD, FAAP in an op-ed last week at Physicians Weekly. “The drugs do have lasting effects, and there’s little credible evidence that puberty blockers actually help patients. In fact, there is growing reason to believe they are exacerbating the very dysphoria they are supposed to resolve and placing vulnerable children on a largely self-reinforcing path toward permanent transitions, often with serious and lasting physical consequences.”
Mason continued that, while “gender nonconformity has existed throughout history, persistent pediatric gender dysphoria—defined as distress severe enough to prompt a desire for medical transition—was exceedingly rare, particularly among children, until relatively recently.”
The pediatrician’s remarks echo recent studies of so-called “gender-affirming care” protocols – including the UK’s 2024 “Cass Report” and the U.S. Department of Health and Human Services’ (HHS) November 2025 “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.”
These reviews revealed the “remarkably weak evidence” that has been touted as research support for the invasive treatments for minors (Cass Report) and “a growing body of evidence pointing to significant risks—including irreversible harms such as infertility—while finding very weak evidence of benefit” (HHS).
In her column, Mason pointed to the so-called “Dutch Protocol,” introduced in the 2010s, as the catalyst for the recent sudden surge in gender dysphoria in minors.
Led by Annelou de Vries, MD, et al, the Dutch Protocol was published in October 2014 in Pediatrics, the flagship journal of the AAP.
“A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults,” the protocol’s researchers wrote – a conclusion significantly at odds with the views of both the Cass and HHS reports, as well as those of Mason.
Though medical reassignment for minors was covered by Dutch health insurance, Mason observed that “roughly two decades later, not a single one of the gender variant children had decided to pursue a medical transition. Instead, their gender distress appeared to resolve on its own, with many ultimately identifying as gay or lesbian as adults.”
“Contrast that with today, when children as young as 8 years old can be prescribed drugs that halt normal pubertal development,” she noted. “Modern studies show that once children begin receiving puberty blockers, the majority go on to take cross-sex hormones, with very few discontinuing medical transition once suppression has begun.”
The upshot, Mason wrote, is the creation of a “clinical pipeline – one that channels children toward permanent medicalization rather than allowing their distress to resolve naturally.”
In August 2023, AAP, which now has already filed several lawsuits against the Trump administration, reaffirmed its 2018 policy titled “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents.”
In its policy statement, AAP defines sex as “an assignment that is made at birth, usually male or female,” and “gender diverse” as a “term that is used to describe people with gender behaviors, appearances, or identities that are incongruent with those culturally assigned to their birth sex; gender-diverse individuals may refer to themselves with many different terms, such as transgender, nonbinary, genderqueer … gender fluid, gender creative, gender independent, or noncisgender.”
“’Gender diverse’ is used to acknowledge and include the vast diversity of gender identities that exists,” asserts AAP.
The national pediatricians’ group also supports puberty blockers for children, referring to them as “reversible treatments” that can “be used in adolescents who experience gender dysphoria to prevent development of secondary sex characteristics and provide time up until 16 years of age for the individual and the family to explore gender identity, access psychosocial supports, develop coping skills, and further define appropriate treatment goals.”
When the Trump HHS delivered its review of pediatric medical treatments for gender dysphoria, former AAP President Susan J. Kressly, MD said she was “deeply alarmed by the report.”
“This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care,” Kressly said, adding:
As we have seen with immunizations, bypassing medical expertise and scientific evidence has real consequences for the health of America’s children. AAP was not consulted in the development of this report, yet our policy and intentions behind our recommendations were cited throughout in inaccurate and misleading ways. The report prioritizes opinions over dispassionate reviews of evidence.
Kressly’s remarks referenced the fact that AAP has also rejected the Trump HHS’ efforts to reevaluate the recommended child immunization schedule and study the effects of vaccines on health. The group has joined with other establishment medical associations to maintain the status quo vaccine schedules while rejecting the new HHS recommendations.
AAP’s website also continues to boast of its corporate donors to its Friends of Children Fund. Indeed, many of its largest donations come from its Big Pharma “partners.”
The pediatricians’ organization is among those being cited in the lawsuits and legislative proposals of states led by Democrats as proof of their claims’ credibility.
In Connecticut, for example, a bill initiated by Gov. Ned Lamont (D) titled “An Act Establishing Connecticut Vaccine Standards” states:
The standard of care for immunization shall … be based on a consideration of the recommended schedules for active immunization for [normal] adults, infants and children, including, but not limited to, such recommended schedules published by the National Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American College of Obstetrics and Gynecology and the American Academy of Family Physicians …
Mason, nevertheless, diverts sharply from the organization of which she is a “fellow.”
“Health policy leaders are right to proceed with caution,” she asserted. “Right now, the widespread use of puberty blockers amounts to conducting large-scale, uncontrolled medical experiments on children. The more we normalize these interventions, the greater the risk that children will be steered onto irreversible paths they might never have chosen if given time, psychologic support, and honest information.”
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