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Submitted by American College of Pediatricians on June 7, 2017 - 10:39am
The American College of Pediatricians is a professional organization confident in the science we present and in the traditional ethics we uphold. In the past, we have typically directed critics to the relevant content on our website. Mr. Jack Turban that is not only libelous, but also denies the fact that untold numbers of American children are being experimented upon, and many of them permanently sterilized, under the guise of treating a largely transient disorder known as Gender Dysphoria of Childhood. This warrants a more public response.

The American College of Pediatricians has held true to its founding principles summarized by its slogan, “Best for Children.” The College has also endured ad hominem attacks for making factual statements that threaten agendas which promote the wants of adults over the needs of children. Attacking the messenger is a tactic commonly used by those who cannot refute a truthful message. Labels, such as hate group, extremist, right wing, miniscule, Christian fundamentalist, and deceptively named, reveal desperate attempts to deflect attention away from facts that undermine a desired agenda.

The American College of Pediatricians is precisely what its name implies: a national nonsectarian organization of child and adolescent physicians and health professionals. We have never surveyed the religious identities of our membership, nor attempted to attract physicians of a given religion. In fact, members of our Board of Directors and various committees have identified themselves as Christian, Jewish, Muslim and Buddhist. We are physicians and healthcare professionals united by a commitment to traditional Hippocratic medicine; a medical tradition that respects life from conception to natural death and provides care to all patients, as delineated in our Statement of Inclusiveness. It is true that we are relatively smaller than other medical organizations; we have 500 members and counting. Ultimately, however, this is irrelevant to the veracity of our statements; sound science and ethics are not determined by majority vote.

Responsible journalism requires thorough investigation of the subject at hand. This appears lacking with Mr. Turban’s report on the ACPeds. He and others have expressed deep concern over our very legitimate name, yet they erroneously designate us as the “ACP,” which stands for the American College of Physicians. Our proper designation is ACPeds. Our web address, pretty much gives it away. Then again, most of our detractors have never bothered to give our website, position statements, let alone any of the hundreds of scientific references there, a careful read. Were they to do so, they would realize how easily their alternative facts would be refuted, particularly those regarding Gender Dysphoria in Children.

Yes, Mr. Turban, prior to the widespread promotion of transgender affirmation, 75 - 95 percent of prepubertal children with Gender Dysphoria eventually outgrew that distress. The vast majority came to accept their biological sex by late adolescence after passing naturally through puberty. The alternative fact, recently put forth by activists, that large numbers of children who desisted were actually “misdiagnosed” with Gender Dysphoria is debunked by data in Dr. Devita Singh’s doctoral thesis, and also by Dr. T.D. Steensma et. al., as noted in slides 23-25 of our Gender Dysphoria power point.

Yes, Mr. Turban, children diagnosed with Gender Dysphoria pre-pubertally are permanently sterilized when the World Professional Association for Transgender Health and Pediatric Endocrine Society Guidelines are followed. According to these Guidelines, children are placed on puberty blockers as early as Tanner stage II of puberty (as young as age 11) and then placed directly on cross-sex hormones by age 16. An article by Dr. A. Evan Eyler, referenced in our full position statement, confirms that children administered blockers beginning at Tanner stage II and seamlessly transitioned to cross-sex hormones are prevented from producing gonadal tissue (eggs or sperm) for cryopreservation. They will be unable to have genetic offspring of their own even with artificial reproductive technology.

There is an obvious self-fulfilling effect in helping children to impersonate the opposite sex both socially and pharmacologically. Logic leads one to predict that most, if not all, pre-pubertal gender dysphoric children treated in this way will lose the potential to identify with their biological sex, and instead go on to claim a transgender identity. As noted in our position statement, the single follow-up study of such children finds just that; 100% of the pre-pubertal children placed on the social affirmation/puberty blocker protocol failed to desist.

According to the APA Handbook of Sexuality and Psychology (2014), among those youth who did resolve their Gender Dysphoria prior to the present-day transgender affirmation ethos, 63 - 100% of boys would identify as gay adults, and 32-50% of the girls would identify as lesbian by young adulthood. Affirming pre-pubertal gender dysphoric children as transgender potentially translates into a significant percentage of LGB adults being sterilized. Consequently, some members of the LGB community stand with the ACPeds against this “transgendering of children” which they view as nothing less than the single greatest form of homophobic hatred, namely, eugenics.
Contrary to popular belief, there is no evidence that the elevated rates of mental illness and suicide among transgender-identified youth and adults are due solely, or even predominately, to societal prejudice or discrimination. At least one 2008 study by LGBT-affirming researchers, noted in our Gender Dysphoria position statement, found these factors not to be causative. Mr. Turban’s article also alleges that the College has ignored evidence that transition improves mental health in gender dysphoric children. The “evidence” consists of two small short term studies that contain methodological flaws, and therefore, prove no such thing. There is also no scientifically rigorous, large, prospective or sufficiently longitudinal evidence that transition of gender dysphoric children prevents suicide in the long term. However, there is long-term research on the mental health of adults who transitioned with Gender Dysphoria. This reveals that despite initial relief of the dysphoria, one or more decades after transition, they often present with worse mental health than that of the general population, including a suicide rate nearly twenty times greater. This observation raises more questions than it answers, and should, therefore, give pediatric health professionals great pause- at least those who value evidence-based medicine and are dedicated to ‘first do no harm’.

Some members of the transgender community recognize this and have expressed solidarity with the ACPeds. Rene Jax, a Male to Female Trans author, wrote:

"Dear Dr. Cretella,
Chemical castration, sterilization and surgical mutilation are more than just words to me. They are personal and brutal realities; no child should be subjected to this. Thank you."

The ACPeds has also been contacted by clinicians and academic physicians across the political spectrum, including LGB affirming clinicians. They have expressed their gratitude to the ACPeds for saying publicly what they cannot. Division chairs in psychology and sociology, and many pediatric endocrinologists have told us that to stand for science and go against transgender group think is professional suicide and often results in relentless harassment including death threats.

Belief is in the mind; not in the body. Everyone knows that thinking or feeling that something is true does not make it true. When people consistently and persistently insist something that is contrary to physical reality, they are, at best, confused, or at worst, delusional. According to the alternative logic of transgender experts, however, this is true in every instance except where biological sex is concerned. In this case alone, the persistent and consistent insistence of something contrary to physical reality is definitive proof of the metaphysical claim that an immaterial essence, or in the words of Dr. John Money, “[an] internal sexed identity” is trapped in the wrong body. This foundational claim of transgender medicine has far more in common with a quasi-religion than it has with evidence-based science. How much longer will society sacrifice the health of its children upon these altars?

Michelle Cretella, MD, FCP President

There’s this doctor who’s written books about all these hellish NDEs. How come he has so many people in hell and other researchers don’t hardly at all?”

The doctor was cardiologist Maurice Rawlings, in Chattanooga, who did indeed write almost a half-dozen books about hellish near-death experiences between 1978 and 2008 (he died at 87 in 2010). Here’s what I can say with any certainty about why he reported encountering so many distressing experiences.

Rawlings told the story of his patient who collapsed during a stress test, and “before we could stop the machine, he dropped dead.”

Well, apparently not completely dead, because in the patient’s own words,

“When I came to, Dr. Rawlings was giving me CPR, and he asked me what was the matter, because I was looking so scared. I told him that I had been to hell and I need help! He said to me, ‘keep your hell to yourself, I’m a doctor and I’m trying to save your life, you need a minister for that.’ — And I would fade out every so often, so then he would focus CPR again and bring me back—Whenever I would come back to my body, I kept asking, “Please help me, please help me, I don’t want to go back to hell.” Soon a nurse named Pam said, “He needs help, do something!” At that time, Dr. Rawlings told me to repeat this short prayer. “I believe Jesus Christ is the Son of God. Jesus, save my soul. Keep me alive. If I die, please keep me out of hell!”

The experience of the patient, Charles McKaig, then became pleasant, and he reported seeing his deceased mother and stepmother and being surrounded and comforted by the Holy Spirit. Upon awakening, he was an immediate evangelical Christian.

In Rawlings words, “After this was all over, I realized what really happened. It was a double conversion. Not only had this make-believe prayer converted this atheist — it had also converted this atheist doctor that was working on him”

Years later, Rawlings told his audiences,

“If you can catch people before they die and give them the option of accepting Jesus Christ as their personal savior, then they can’t loose [sic] whether they live or die. That is with them forever. And when they die like this, we don’t have to question where they went. And the preacher will be right when he says they are in Heaven. She went to heaven to be with God.

“But for those who die on the street, where do they go? It is the minister’s fault, your fault and mine because we did not approach them with the Gospel which is the free gift to anyone that wants it.”

Essentially, that is the backstory of why Maurice Rawlings reported so many hellish experiences: He wanted to get people’s attention in order to save them from the hell he believed in; he wanted to give them a chance to accept a faith he trusted completely, and telling heavenly NDE accounts was not going to achieve that. He was being steadfastly and thoroughly evangelical.

Despite his faith, a great many people object strenuously to that point of view and discount his work because of it. The real problem underlying the Rawlings material, however, is not theological. The problem is, as his fellow cardiologist (and fellow evangelical Christian) Michael Sabom pointed out repeatedly, a distortion of data.

A reading of any of Rawlings’ books will immediately give the impression that he resuscitated countless near-death experiencers—he himself said that his first book summarized “several hundred” cases—and heard their testimonies immediately, roughly half of them “hellish.” Sabom’s painstaking investigation of Rawlings’ data turned up quite a different picture.

Despite what was reported in Beyond Death’s Door, those “several hundred” cases “were represented by only 21 cases of ‘heavenly NDEs and 12 ‘hellish’ NDEs. Many of these were clearly not from Rawlings’ own practice, having been excerpted from other published sources. Others were simply left unidentified.”

The same situation presented with To Hell and Back, Rawlings’ second book. In a 1996 review in the Journal of Near-Death Studies, Sabom noted that of the 32 cases Rawlings claimed, twenty “were clearly lifted and referenced from other sources, and six were personally acquired examples used in his previous books. The remaining six NDEs appear to be new, previously unpublished accounts obtained from his own experience. However, two of these six cases were mentioned only in passing and never described.”

In other words, by reusing previous accounts and padding from other sources, Rawlings was able to give the impression of a greater number of distressing NDEs than he actually had. Further, his books leave one with the impression that many, many more distressing NDEs would be revealed if only people were interviewed immediately upon resuscitation. Sabom’s research indicated that conclusion also not to be supported by the data.

“In fact,” Sabom wrote, “the cases he presents actually seem to favor the opposite conclusion: out of 15 ‘hellish’ cases, ten (67 percent) were clearly shown to have been brought to Rawlings’ attention long after the golden ‘first few minutes’ after resuscitation, four were elicited at an unspecified time, and one 7 percent) was clearly noted as immediate.”

There are too many other problems to detail here. The gist of them all is that Rawlings, who was without question a lovely man, sincere in his beliefs and genuine in his concern for people, was working from a highly personal agenda more than from a desire for unbiased information.

What Michael Sabom reported after years of carefully reviewing Rawlings’ work was this:

[Rawlings] establishes himself before his audience as a cardiologist with impeccable credentials, a near-death researcher, and a committed Christian. Using these medical, scientific, and religious qualifications, he then presents the NDE as a glimpse of an afterlife and directly applies the Christian doctrine of heaven and hell to these experiences. This gridlike approach, however, poses problems to Rawlings in his interpretation of his and others’ research when the type of person (for example, non-Christian) or type of near-death event (for example, suicide attempt) does not jibe with the expected afterlife destination (for example, hell). Rawlings confronts the data of others with authoritative statements substantiated with little or no data of his own and illustrated with anecdotal accounts that, over time, appear to have been altered to fit his own designs—”

Sabom concluded, “I am a Christian and believe in heaven and hell. Based on current knowledge, however, we have much to learn about the NDE, both distressing and pleasant, before we can say confidently just what the experience means and how it fits into our spiritual beliefs.”

What this says to us is that before believing any claim about “ultimate truth,” or any researcher’s sincere pronouncement of having a final explanation about NDEs, it is wise, as Dorothy discovered about the Wizard of Oz, to look behind the curtain to find out who is providing the answers, where they are getting their facts, and what other people of substance are saying about them. This is not cynicism but discernment.