{"id":3283,"date":"2025-06-03T09:00:48","date_gmt":"2025-06-03T13:00:48","guid":{"rendered":"https:\/\/journals.law.harvard.edu\/jlpp\/?p=3283"},"modified":"2025-12-20T14:29:12","modified_gmt":"2025-12-20T18:29:12","slug":"the-facade-of-medical-consensus-chloe-jones","status":"publish","type":"post","link":"https:\/\/journals.law.harvard.edu\/jlpp\/the-facade-of-medical-consensus-chloe-jones\/","title":{"rendered":"The Facade of Medical Consensus – Chloe Jones"},"content":{"rendered":"\n
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The Fa\u00e7ade of Medical Consensus: How Medical Associations Prioritize Politics Over Science<\/h2>\n\n\n\n

Chloe K. Jones*<\/a><\/h2>\n\n\n\n

Introduction<\/h2>\n\n\n\n

Private medical associations are front and center as the nation\u2019s highest court considers the constitutionality of restrictions on \u201cgender-affirming care\u201d for transgender-identifying children. The question before the Supreme Court in United States v. Skrmetti <\/em>is whether Tennessee\u2019s prohibition of certain medical interventions for minors violates the Fourteenth Amendment\u2019s Equal Protection Clause. Despite the legal nature of that question, the nation\u2019s largest medical associations\u2014or, at least, a few activist leaders within those groups[1]<\/a>\u2014have dominated the debate.<\/p>\n\n\n\n

Courts have traditionally relied on major medical associations as authoritative sources, assuming that their status as \u201cexpert[s]\u201d[2]<\/a> rendered them ideologically neutral. But recent revelations cast doubt on this assumption, causing some to question the associations\u2019 scientific authority.[3]<\/a> Some of these missteps appear to stem from institutional overconfidence, while others reflect a deeper entanglement between political advocacy and scientific evidence.[4]<\/a><\/p>\n\n\n\n

One of the most consequential missteps involves medical interventions for transgender-identifying minors. Critics have highlighted two main reasons these groups have declining scientific credibility in this medical sphere. First, independent scientific reviews have identified significant discrepancies between the medical associations\u2019 claims and the quality of scientific data, calling into question these associations\u2019 claims to unbiased expertise. Second, litigation discovery uncovered how the creation of the standards of care for minors was driven, in large part, by political considerations rather than objective evidence.<\/p>\n\n\n\n

While the first two criticisms were recent revelations, a neglected third criticism should have been obvious much earlier: the associations have espoused inconsistent views of juvenile psychological development, depending on the political valence of the legal issue at hand. As a case study, this article compares the associations\u2019 amicus curiae briefs in the transgender-identifying-juvenile context with the criminal-defendant-juvenile context. This comparison reveals a striking inconsistency in how these organizations characterize adolescent psychology and decisionmaking. These incompatible scientific conclusions suggest that many associations selectively shape scientific findings to advance specific policy outcomes. If so, courts may justifiably reassess the weight they afford to such amici in future cases.<\/p>\n\n\n\n

I.                 \u201cA United Front\u201d<\/h2>\n\n\n\n

Long before Skrmetti<\/em>, activists understood that to win the controversial legal \u201cbattle\u201d on gender-transition treatments for minors, the medical field needed to present \u201ca united front.\u201d[5]<\/a> Through coordinated efforts, these authoritative groups framed procedures like puberty blockers, cross-sex hormones, and surgeries such as double mastectomies as \u201cstandard medical care, supported by major medical organizations in the United States.\u201d[6]<\/a> This perceived consensus became a powerful tool in litigation, often used to argue that state-level restrictions were medically unfounded and constitutionally suspect. If states enacted laws restricting these procedures for minors, attorneys could seek injunctions, citing a \u201cmedical consensus [that] is grounded in a wealth of studies\u201d that undermined the states\u2019 safety concerns.[7]<\/a> Indeed, after states began enacting such restrictions, opponents described the laws as extreme departures from scientific norms and even alleged that they \u201cmake it a crime for doctors to act ethically\u201d and increase the likelihood that \u201csome [transgender-identifying children] will die.\u201d[8]<\/a><\/p>\n\n\n\n

Federal district courts, relying on the asserted consensus, enjoined states from enforcing (what the courts deemed) unconstitutional medical restrictions. For instance, a district judge in Alabama found it significant that \u201cat least twenty-two major medical associations in the United States endorse transitioning medications as well-established, evidence-based treatments for gender dysphoria in minors.\u201d[9]<\/a> Another in Idaho concluded that these procedures were \u201csafe, effective, and medically necessary\u201d chiefly because they were \u201caccepted by every major medical organization in the United States.\u201d[10]<\/a> Judges in Arkansas and Tennessee were likewise convinced.[11]<\/a><\/p>\n\n\n\n

But subsequent developments revealed that this widespread consensus did not derive from a wealth of scientific evidence that was so overwhelming that no reputable medical organization could disagree. Instead, the consensus appears to have been artificially manufactured, driven by a small subset of ideologically driven professionals that \u201cleverage[d] moralized claims and low-quality evidence to promote medical interventions for gender dysphoria in minors.\u201d[12]<\/a><\/p>\n\n\n\n

II.               \u201cAn Area of Remarkably Weak Evidence\u201d<\/h2>\n\n\n\n

Recent scientific reviews undermine the associations\u2019 \u201cmedical consensus\u201d claims. Several European nations that once spearheaded treatment regimens for transgender-identifying juveniles have now reversed course, emphasizing caution, with many labeling these procedures as experimental and declaring that their harm to juveniles outweighs any ascertainable benefits.[13]<\/a> The most prominent review, led by Dr. Hilary Cass on behalf of England\u2019s National Health Service, produced one overarching conclusion: \u201cThis is an area of remarkably weak evidence.\u201d[14]<\/a> Dr. Cass found that other systematic reviews likewise \u201chave demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to base clinical decisions.\u201d[15]<\/a> Following Dr. Cass\u2019s findings, the United Kingdom banned all new prescriptions for puberty blockers to minors.[16]<\/a><\/p>\n\n\n\n

The United Kingdom was not alone. Sweden\u2019s health authority also found the evidence to be \u201cinsufficient and inconclusive\u201d with risks \u201coutweigh[ing] the possible benefits.\u201d[17]<\/a> Neighboring Finland also restricts treatment, requiring psychosocial care first.[18]<\/a> Groups in France, Australia, and New Zealand likewise discourage \u201cearly medicalisation.\u201d[19]<\/a> Notably, these seismic shifts occurred in progressive countries, signaling that\u2014unlike the United States\u2014scientific positions were not influenced by ideology.[20]<\/a><\/p>\n\n\n\n

Compounding these doubts, some researchers have attempted to suppress the weak evidence behind these medical interventions. The New York Times <\/em>recently reported that a long-anticipated, federally funded study of puberty blockers will remain unpublished because its findings suggested that the drugs \u201cdid not lead to mental health improvements.\u201d[21]<\/a> The leading researcher\u2014\u201cone of the country\u2019s most vocal advocates of adolescent gender treatments\u201d\u2014asserted that the study could be \u201cweaponized\u201d and \u201cfuel the kinds of political attacks that have led to bans of the youth gender treatments.\u201d[22]<\/a> The suppression of negative findings raises concerns about the integrity of scientific discourse in ideologically-charged areas of medicine.[23]<\/a><\/p>\n\n\n\n

III.             \u201cAn Untenable Position. . . in Winning Lawsuits\u201d<\/h2>\n\n\n\n

Litigation discovery revealed further politicization\u2014this time through the creation of the standards of care for transgender-identifying minors. In 2022, an organization of self-appointed experts and activists[24]<\/a> called the World Professional Association for Transgender Health (WPATH) issued updated standards of care for medical interventions for transgender-identifying minors.[25]<\/a> Several medical associations issued policy statements adopting these standards wholesale.[26]<\/a><\/p>\n\n\n\n

But as revealed during discovery in a case concerning Alabama\u2019s law prohibiting puberty blockers, cross-sex hormones, and surgeries on minors, evidence-based science appeared to have little to do with WPATH\u2019s standards. Internal communications showed that WPATH acted on the advice from \u201csocial justice lawyers\u201d when it deliberately declined to conduct a systematic review (unlike its European counterparts) before crafting treatment recommendations for minors.[27]<\/a> They determined that \u201cevidence-based review reveals little or no evidence and puts us in an untenable position in terms of affecting policy or winning lawsuits.\u201d[28]<\/a> One WPATH author was more succinct: \u201c[W]e need[] a tool for our attorneys to use in defending access to care.\u201d[29]<\/a> But WPATH went a step further: after hiring Johns Hopkins to review the evidence, WPATH suppressed the publication of the team\u2019s conclusion that \u201clittle to no evidence\u201d supported experimental transgender medicine for minors.[30]<\/a><\/p>\n\n\n\n

The medical associations faced outside political pressure too. Admiral Rachel Levine, President Biden\u2019s Assistant Secretary for Health at the Department of Health and Human Services, met regularly with WPATH leaders and told them that their failure to promptly publish standards of care was \u201cproving to be a barrier to [President Biden\u2019s] optimal policy progress\u201d and that the Administration was \u201cvery keen to bring the trans health agenda forward.\u201d[31]<\/a> Before publishing its guidelines, WPATH confidentially sent Admiral Levine a completed copy.[32]<\/a> Levine then pressured WPATH to remove its minimum age recommendations for drugs and surgeries on minors, believing that the recommendations would \u201cresult in devastating legislation for trans care.\u201d[33]<\/a> Days before the standards of care were set to be published, WPATH yielded to the Biden Administration\u2019s demands after the American Academy of Pediatrics threatened to oppose the guidelines if WPATH failed to remove the recommendations.[34]<\/a> These internal communications indicate that WPATH made changes in its clinic guidelines \u201cpurely on political considerations,\u201d not on scientific evidence.[35]<\/a><\/p>\n\n\n\n

IV.            \u201cEbbs and Flows\u201d<\/h2>\n\n\n\n

In Jones v. Mississippi<\/em>, Justice Thomas remarked how \u201ccurious\u201d it was that the Supreme Court\u2019s \u201cview of the maturity of minors ebbs and flows depending on the issue.\u201d[36]<\/a> Jones <\/em>was an Eighth Amendment case involving a minor sentenced to life without parole for homicide. Justice Thomas compared the context of \u201cjuvenile murderers\u201d\u2014in which the Supreme Court \u201chas stated that \u2018children<\/em> are different\u2019 and that courts must consider \u2018a child<\/em>\u2019s lesser culpability\u2019\u201d\u2014with the context of abortion rights\u2014in which the Court \u201ctake[s] pains to emphasize a \u2018young woman<\/em>\u2019s\u2019 right to choose.\u201d[37]<\/a><\/p>\n\n\n\n

One likely reason the justices\u2019 conclusions about the maturity of minors ebbs and flows depending on the political context is because\u2014according to the nation\u2019s most prominent medical associations\u2014so does the science<\/em>. After all, the constitutionality of regulating medical care for transgender-identifying minors is not the only legal sphere in which these medical associations insert themselves as \u201cthe voice of America\u2019s medical profession in legal proceedings across the country.\u201d[38]<\/a> Most of these prominent associations have filed hundreds<\/em> of amicus curiae briefs[39]<\/a> nationwide on issues ranging from LGBT rights[40]<\/a> to immigration.[41]<\/a><\/p>\n\n\n\n

To see how the associations often chose their positions in these cases to advance policy objectives rather than scientific principles, it\u2019s helpful to compare Skrmetti<\/em> with another legal context involving minors\u2014juvenile criminal defendants. Nine years before Justice Thomas made his observation in Jones<\/em>, the Supreme Court considered in Miller v. Alabama <\/em>whether mandatory life-without-parole sentences for minors were unconstitutional under the Eighth Amendment.[42]<\/a> The Court answered yes.[43]<\/a> In doing so, the justices in the majority explicitly relied on the amici curiae support provided by the American Psychological Association and the American Psychiatric Association.[44]<\/a> Citing their briefs, the majority explained that children possess a unique \u201ccapacity for change\u201d because of their \u201cdistinctive (and transitory) mental traits and environment vulnerabilities.\u201d[45]<\/a> Because of minors\u2019 \u201ctransient rashness\u201d and \u201cinability to assess consequences,\u201d there is an \u201cenhanced. . . prospect that, as the years go by and neurological development occurs, [their] deficiencies will be reformed.\u201d[46]<\/a><\/p>\n\n\n\n

The associations\u2019 characterization of juvenile psychology espoused in Miller <\/em>centered on the minor\u2019s \u201cincomplete identity and \u2018sense of self\u2019\u201d and his or her \u201cstruggle to define [that] identity.\u201d[47]<\/a> Science shows how juveniles are \u201cless oriented to the future\u201d and do not consider the consequences of their actions.[48]<\/a> Indeed, they \u201clack experience navigating the changing social and environmental contexts, and regulating the new emotional pressures, of adolescence.\u201d[49]<\/a> The associations explained that \u201cwhat may be perceived as fixed personality traits in juveniles may in fact result from malleable factors such as present maturity level or social context, rather than engrained or enduring aspects of personality or worldview.\u201d[50]<\/a> After all, the scientific \u201c[r]esearch has shown that personality traits change significantly during the developmental transition from adolescence to adulthood, and the process of identity-formation<\/em> typically remains incomplete until at least the early twenties<\/em>.\u201d[51]<\/a> Accordingly, the medical associations urged the Supreme Court that the Constitution mandates <\/em>a lower degree of criminal culpability for juvenile murderers because of \u201cwhat [the] research confirms: Adolescence is transitory, and juveniles change.\u201d[52]<\/a><\/p>\n\n\n\n

But the medical associations painted an entirely different portrait of the juvenile mind in their Skrmetti <\/em>briefs. They abandoned their former citations to the \u201cstrong consensus among developmental neuroscientists\u201d regarding \u201cadolescents\u2019 observed psychosocial immaturity,\u201d particularly in the areas of the brain that are \u201ccritical\u201d to \u201cfunctions such as planning, motivation, judgment, and decisionmaking, including the evaluation of future consequences, the weighing of risk and reward, [and] the perception and control of emotions.\u201d[53]<\/a> Instead, they resolutely affirmed that juveniles are sufficiently mature to provide \u201cinformed consent\u201d to the \u201cirreversible\u201d \u201ceffects and side effects\u201d[54]<\/a> of transgender medical interventions, including infertility, \u201cneurocognitive development, psychosexual development[,] and longer-term bone health.\u201d[55]<\/a> According to the experts, a seventeen-year-old murderer must be constitutionally less culpable because he \u201cstill struggle[s] to define [his] identity,\u201d[56]<\/a> but a nine-year-old girl can consent to the loss of her child-bearing capabilities, despite \u201cthe lack of robust information to help [her] make decisions.\u201d[57]<\/a><\/p>\n\n\n\n

Holding the medical associations to their scientific arguments espoused in Miller<\/em>, their position in cases like Skrmetti <\/em>should have been a foregone conclusion\u2014mentally and emotionally immature minors still in the process of forming their identities cannot consent to life-altering and often permanently damaging physical interventions to treat their mental distress and discomfort with their changing bodies. Considering that minors do not appropriately weigh the \u201ccorresponding risks and longer-term consequences\u201d of their decisions,[58]<\/a> the associations should presumably agree with the United Kingdom\u2019s conclusion that \u201cthese decisions [are] uniquely difficult for children.\u201d[59]<\/a><\/p>\n\n\n\n

Likewise, the fact that \u201cimpetuous and ill-considered\u201d behavior \u201cis amplified by exposure to peers\u201d should also raise the associations\u2019 alarm bells.[60]<\/a> According to them, minors\u2019 \u201cactions are shaped directly by\u201d their \u201cpeers in ways that adults\u2019 are not,\u201d and they are more likely to \u201cconform to peer expectations to achieve respect and status among their peers.\u201d[61]<\/a> Given the documented peer pressure that many minors (particularly girls) experience in their decision to identify as transgender, these scientific findings should prompt the associations to adopt, at a minimum, a more hesitant approach to medical interventions for minors.[62]<\/a> And if the medical associations counted it as \u201cwishful thinking\u201d to expect a juvenile to \u201cresist and control emotional impulses,\u201d especially in \u201cemotionally charged settings,\u201d \u201cto gauge risks and benefits in an adult manner,\u201d or \u201cto envision the future consequences of one\u2019s actions\u201d before \u201cage eighteen or nineteen,\u201d[63]<\/a> then they cannot expect that a minor could consent to life-altering procedures before that age either.<\/p>\n\n\n\n

The associations have never argued that the underlying neuroscience has changed during the brief interim between Miller <\/em>and Skrmetti<\/em>. What changed were the policy objectives. The selective application of science reveals an underlying pattern: scientific characterizations are reshaped to fit the preferred legal outcomes. The associations\u2019 inconsistency should have exposed the fa\u00e7ade of medical consensus long before discovery revealed the politicization of the WPATH standards and before other countries imposed treatment restrictions.<\/p>\n\n\n\n

Conclusion<\/h1>\n\n\n\n

By promoting a narrative of medical consensus around treatments for transgender-identifying minors, professional medical associations have played a central role in shaping judicial interpretations of constitutional rights. But subsequent scientific reviews, together with revelations from internal communications, have undermined the reliability of that purported consensus. The associations\u2019 tailoring of science to their political ends should have been obvious long before those revelations, given their divergent characterizations of juvenile maturity in the Eighth Amendment context versus the gender-transition context. This comparison suggests a broader concern about the role of ideological advocacy within institutions that purport to offer neutral expertise. As courts continue to rely on the claims of private medical associations in constitutional adjudication, they should do so with particular care\u2014especially when the scientific claims advanced seem to shift in accordance with the litigation context. Judicial deference to claims of professional consensus should be earned through demonstrated objectivity, not assumed as a matter of course.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

 <\/p>\n\n\n\n

 <\/p>\n\n\n\n

*<\/a> Chloe K. Jones is an Appellate Fellow at Alliance Defending Freedom. She graduated from the University of Virginia School of Law and Baylor University.<\/p>\n\n\n\n

[1]<\/a> Medical associations have claimed that, because nearly all major medical associations endorse the practice of cross-sex hormones and puberty blockers for minors, \u201chundreds of thousands of doctors, researchers, and mental health professionals support gender-affirming care.\u201d Brief for American Psychological Association et al. as Amici Curiae Supporting Petitioners at 16, United States v. Skrmetti, No. 23-477 (argued Dec. 4, 2024) [APA Skrmetti Brief]. Although these professional organizations have thousands of members, they do not assess their members\u2019 support for political statements and litigation strategies. So it is, at best, unclear whether most members of these professional associations endorse these policy positions. Indeed, the evidence we do have supports the opposite contention\u2014these major medical associations do not even consult their professional members when crafting policy documents. In 2022, the American Academy of Pediatrics wrote a letter to the Florida Board of Medicine claiming that it represented 67,000 pediatricians (including 2,600 Floridian pediatricians) in \u201cendors[ing] and recommend[ing]\u201d these medical interventions as the \u201cirrefutable\u201d \u201cstandard of care.\u201d See <\/em>Brief for Florida House of Representatives as Amicus Curiae Supporting Respondents at 6\u20139, United States v. Skrmetti, No. 23-477 (argued Dec. 4, 2024). Yet in later litigation, the organization was forced to admit that its Florida chapter actually had not even \u201cbeen involved in the national organization\u2019s policy-making process.\u201d Id. <\/em>at 8\u20139. And to the extent the Florida chapter was consulted, it was the organization\u2019s national headquarters that drafted the chapter\u2019s statement to Florida\u2019s health regulators\u2014the chapter president simply \u201csign[ed] and submit[ed] the comments on behalf of 2,600 Florida pediatricians who apparently were never consulted.\u201d Id. <\/em>at 11\u201312.<\/p>\n\n\n\n

[2]<\/a> Brandt v. Rutledge, 551 F. Supp. 3d 882, 891 (E.D. Ark. 2021), aff\u2019d sub nom. <\/em>Brandt by & through Brandt v. Rutledge, 47 F.4th 661 (8th Cir. 2022).<\/p>\n\n\n\n

[3]<\/a> Vinay Prasad, The AAP (American Academy of Pediatrics) Is Broken, Failed Organization<\/em>, Sensible Med. (Aug. 27, 2022), https:\/\/www.sensible-med.com\/p\/the-aap-american-academy-of-pediatrics<\/a> [perma.cc\/K4UJ-BQ2W<\/a>] (discussing the AAP\u2019s \u201ccatastrophic errors,\u201d such as giving the wrong medical advice on peanut allergies and the COVID-19 pandemic).<\/p>\n\n\n\n

[4]<\/a> Id.<\/p>\n\n\n\n

[5]<\/a> Christy Olezeski et al., Denying Trans Youth Gender-Affirming Care Is an Affront to Science and Medical Ethics<\/em>, L.A. Times (June 13, 2022), https:\/\/www.latimes.com\/opinion\/story\/2022-06-13\/trans-youth-healthcare-state-bans<\/a> [perma.cc\/U9VW-EP5R<\/a>].<\/p>\n\n\n\n

[6]<\/a> Id.<\/p>\n\n\n\n

[7]<\/a> Brief for Petitioner at 36, United States v. Skrmetti, No. 23-477 (filed Aug. 27, 2024).<\/p>\n\n\n\n

[8]<\/a> Olezeski, supra <\/em>note 5.<\/p>\n\n\n\n

[9]<\/a> Eknes-Tucker v. Marshall, 603 F. Supp. 3d 1131, 1145 (M.D. Ala. 2022), vacated sub nom. <\/em>Eknes-Tucker v. Governor of Alabama, 80 F.4th 1205 (11th Cir. 2023).<\/p>\n\n\n\n

[10]<\/a> Poe by & through Poe v. Labrador, 709 F. Supp. 3d 1169, 1182 (D. Idaho 2023), appeal docketed<\/em>, No. 24-142 (9th Cir. Jan. 9, 2024).<\/p>\n\n\n\n

[11]<\/a> L.W. by & through Williams v. Skrmetti, 679 F. Supp. 3d 668, 709 (M.D. Tenn.), rev\u2019d<\/em>, 83 F.4th 460 (6th Cir. 2023), cert. dismissed in part sub nom. <\/em>Doe v. Kentucky, 144 S. Ct. 389 (2023), and cert. granted sub nom. <\/em>United States v. Skrmetti, 144 S. Ct. 2679 (2024); Brandt<\/em>, 551 F. Supp. 3d at 891.<\/p>\n\n\n\n

[12]<\/a> Expert Report of Kristopher Kaliebe at 7, Boe v. Marshall, No. 2:22-cv-184-LCB (M.D. Ala. May 19, 2023).<\/p>\n\n\n\n

[13]<\/a> See generally<\/em> Joshua P. Cohen, Europe and U.S. Diverge Sharply on Treatment of Gender Incongruence in Minors<\/em>, Forbes (Dec. 2, 2023), https:\/\/www.forbes.com\/sites\/joshuacohen\/2023\/12\/02\/europe-and-us-diverge-on-treatment-of-gender-incongruence-in-minors\/<\/a> [perma.cc\/E3QH-N9G8<\/a>]; Azeen Ghorayshi, Youth Gender Medications Limited in England, Part of Big Shift in Europe<\/em>, N.Y. Times (Apr. 9, 2024),  https:\/\/www.nytimes.com\/2024\/04\/09\/health\/europe-transgender-youth-hormone-treatments.html<\/a> [perma.cc\/7RSX-FG76<\/a>].<\/p>\n\n\n\n

[14]<\/a> The Cass Review, Independent Review of Gender Identity Services for Children and Young People<\/em>, 13 (Apr. 2024) https:\/\/cass.independent-review.uk\/wp-content\/uploads\/2024\/04\/CassReview_Final.pdf<\/a> [perma.cc\/3EA6-3ACG<\/a>] [hereinafter Cass Review].<\/p>\n\n\n\n

[15]<\/a> Id. <\/em>annex A.<\/p>\n\n\n\n

[16]<\/a> U.K. Department of Health and Social Care, Ban on Puberty Blockers To Be Made Indefinite on Experts\u2019 Advice<\/em> (Dec. 11, 2024), https:\/\/www.gov.uk\/government\/news\/ban-on-puberty-blockers-to-be-made-indefinite-on-experts-advice<\/a> [perma.cc\/6NVW-H7B7<\/a>].<\/p>\n\n\n\n

[17]<\/a> Jennifer Block, Gender Dysphoria in Young People Is Rising\u2014And So Is Professional Disagreement<\/em>, BMJ (Feb. 23, 2023), https:\/\/www.bmj.com\/content\/380\/bmj.p382<\/a> [perma.cc\/UGK5-2NYW<\/a>].<\/p>\n\n\n\n

[18]<\/a> Id.<\/p>\n\n\n\n

[19]<\/a> Id.<\/p>\n\n\n\n

[20]<\/a> Cohen, supra<\/em> note 13; Leor Sapir, A Consensus No Longer<\/em>, City J. (Aug. 12, 2024), https:\/\/www.city-journal.org\/article\/a-consensus-no-longer<\/a> [perma.cc\/Q8TD-66F6<\/a>].<\/p>\n\n\n\n

[21]<\/a> Azeen Ghorayshi, U.S. Study on Puberty Blockers Goes Unpublished Because of Politics, Doctor Says<\/em>, N.Y. Times (Oct. 23, 2024), https:\/\/www.nytimes.com\/2024\/10\/23\/science\/puberty-blockers-olson-kennedy.html<\/a> [perma.cc\/DD7M-JG85<\/a>}.<\/p>\n\n\n\n

[22]<\/a> Id.<\/p>\n\n\n\n

[23]<\/a> This is not the only example of suppression. As reported in the same New York Times<\/em> article, the United Kingdom significantly delayed the publication of a study that found puberty blockers do not change minors\u2019 rates of self-harm. Id.<\/em><\/p>\n\n\n\n

[24]<\/a> WPATH president Dr. Marci Bowers explained that it was \u201cimportant\u201d for each WPATH author \u201cto be an advocate for [transitioning] treatments before the guidelines were created.\u201d Boe v. Marshall, No. 22-184, Doc. 564-8, Unsealed Marci Bowers Dep., 121:7-10, (May 3, 2024), https:\/\/www.alabamaag.gov\/wp-content\/uploads\/2025\/02\/SJ.DX18-564-8-Bowers-Depo-Tr.-UNSEALED.pdf<\/a> [perma.cc\/VQT8-NVCX<\/a>].<\/p>\n\n\n\n

[25]<\/a> World Pro. Ass\u2019n For Transgner Health, Standards of Care for the Health of Transgender and Gender Diverse People (8th ed. 2022).<\/p>\n\n\n\n

[26]<\/a> Brief for Alabama as Amicus Curiae Supporting Respondents at 11, United States v. Skrmetti, No. 23-477 (argued Dec. 4, 2024) [hereinafter Alabama Skrmetti Amicus Brief] (highlighting the circularity of reasoning when \u201cWPATH authored the initial guidelines, which other groups used as the basis for their recommendations, which WPATH then cited as \u2018evidence\u2019 for the next edition of its guidelines\u201d).<\/p>\n\n\n\n

[27]<\/a> Id.<\/em> at 7.<\/p>\n\n\n\n

[28]<\/a> Id. <\/em>The state of Alabama argued to the Supreme Court that the United States \u201cstrategically chose to seek certiorari in a case with only a preliminary record and no discovery\u2014and then tried to shut down discovery in Alabama on the basis that it had merely filed a cert petition here.\u201d Id. <\/em>at 4.<\/p>\n\n\n\n

[29]<\/a> Boe v. Marshall, No. 22-184, Doc. 700-10 at 34 (Jan. 6, 2022 Email), https:\/\/www.alabamaag.gov\/wp-content\/uploads\/2024\/10\/SJ.DX181-700-10-WPATH-8-REDACTED-560-31.pdf<\/a> [perma.cc\/MTC2-BFYK<\/a>].<\/p>\n\n\n\n

[30]<\/a> Research into Trans Medicine Has Been Manipulated<\/em>, Economist (June 27, 2024), https:\/\/www.economist.com\/united-states\/2024\/06\/27\/research-into-trans-medicine-has-been-manipulated<\/a> [perma.cc\/TN26-V4DD<\/a>].<\/p>\n\n\n\n

[31]<\/a> Alabama Skrmetti Amicus Brief at 15\u201316; Azeen Ghorayshi, Biden Officials Pushed to Remove Age Limits for Trans Surgery, Documents Show<\/em>, N.Y. Times (June 25, 2024), https:\/\/www.nytimes.com\/2024\/06\/25\/health\/transgender-minors-surgeries.html<\/a> [perma.cc\/3GAG-6S4L<\/a>].<\/p>\n\n\n\n

[32]<\/a> Alabama Skrmetti Amicus Brief at 16.<\/p>\n\n\n\n

[33]<\/a> Ghorayshi, supra <\/em>note 31.<\/p>\n\n\n\n

[34]<\/a> Alabama Skrmetti Amicus Brief at 19.<\/p>\n\n\n\n

[35]<\/a> Id. <\/em>at 21.<\/p>\n\n\n\n

[36]<\/a> 593 U.S. 98, 125 n.2 (2021) (Thomas, J., concurring).<\/p>\n\n\n\n

[37]<\/a> Id. <\/em>at 125 n.2 (emphasis in original) (internal citations omitted).<\/p>\n\n\n\n

[38]<\/a> The Litigation Center<\/em>, Am. Med. Assoc. (Aug. 22, 2023), https:\/\/www.ama-assn.org\/health-care-advocacy\/judicial-advocacy\/litigation-center<\/a> [perma.cc\/25AA-FWSZ<\/a>].<\/p>\n\n\n\n

[39]<\/a> See, e.g.<\/em>, Brief for American Psychological Association, et al. as Amici Curiae Supporting Petitioner at 2, United States v. Skrmetti, No. 23-477 (argued Dec. 4, 2024) (explaining that the APA has filed nearly 250 amicus briefs) [hereinafter American Psychological Association Skrmetti Amici Brief].<\/p>\n\n\n\n

[40]<\/a> See, e.g.<\/em>, Brief for American Medical Association, et al. as Amici Curiae Supporting Employees, Bostock v. Clayton County, 590 U.S. 644 (2020) (No. 17-1618).<\/p>\n\n\n\n

[41]<\/a> See, e.g.<\/em>, Brief for the Association of American Medical Colleges, et al. as Amici Curiae Supporting Respondents, Trump v. Hawaii, 585 U.S. 667 (2018) (No. 17-965).<\/p>\n\n\n\n

[42]<\/a> 567 U.S. 460 (2012).<\/p>\n\n\n\n

[43]<\/a> Id.<\/em> at 470.<\/p>\n\n\n\n

[44]<\/a> Id. <\/em>at 471 n.5.<\/p>\n\n\n\n

[45]<\/a> Id. <\/em>at 473.<\/p>\n\n\n\n

[46]<\/a> Id. <\/em>at 472 (quotation omitted).<\/p>\n\n\n\n

[47]<\/a> Brief for American Psychological Association, et al. as Amici Curiae Supporting Petitioner at 19\u201320, Miller v. Alabama, 567 U.S. 460 (2012) (No. 10-9647) [hereinafter American Psychological Association Miller Amici Brief].<\/p>\n\n\n\n

[48]<\/a> Id.<\/em> at 3\u20134.<\/p>\n\n\n\n

[49]<\/a> Id.<\/em> at 10.<\/p>\n\n\n\n

[50]<\/a> Id. <\/em>at 19\u201320.<\/p>\n\n\n\n

[51]<\/a> Id. <\/em>at 20.<\/p>\n\n\n\n

[52]<\/a> Id. <\/em>at 35.<\/p>\n\n\n\n

[53]<\/a> Id.<\/em> at 25\u201326.<\/p>\n\n\n\n

[54]<\/a> Brief for American Academy of Pediatricians, et al. as Amici Curiae Supporting Petitioner at 14, United States v. Skrmetti, No. 23-477 (argued Dec. 4, 2024); see also <\/em>American Psychological Association Skrmetti Brief at 11, 24 (explaining how physicians can be \u201ccareful\u201d by seeking \u201cinformed consent\u201d from juvenile patients).<\/p>\n\n\n\n

[55]<\/a> Cass Review, supra<\/em> note 14, at 196.<\/p>\n\n\n\n

[56]<\/a> American Psychological Association Miller Amici Brief at 20.<\/p>\n\n\n\n

[57]<\/a> Cass Review, supra<\/em> note 14, at 195\u201396.<\/p>\n\n\n\n

[58]<\/a> American Psychological Association Miller Amici Brief at 12; see also <\/em>Brief for American Medical Association, et al. as Amici Curiae Supporting Petitioner at 2\u20133, Miller v. Alabama, 567 U.S. 460 (2012) (No. 10-9647) [hereinafter American Medical Association Miller Amici Brief].<\/p>\n\n\n\n

[59]<\/a> Cass Review, supra<\/em> note 14, at 195.<\/p>\n\n\n\n

[60]<\/a> American Psychological Association Miller Amici Brief at 5, 7.<\/p>\n\n\n\n

[61]<\/a> Id.<\/em> at 15, 18; see also <\/em>American Medical Association Miller Amici Brief at 3.<\/p>\n\n\n\n

[62]<\/a> Cass Review, supra<\/em> note 14, at 122.<\/p>\n\n\n\n

[63]<\/a> American Psychological Association Miller Amici Brief at 10, 13\u201315 (citations omitted).<\/p>\n","protected":false},"excerpt":{"rendered":"

The Fa\u00e7ade of Medical Consensus: How Medical Associations Prioritize Politics Over Science Chloe K. Jones* Introduction Private medical associations are front and center as the nation\u2019s highest court considers the constitutionality of restrictions on \u201cgender-affirming care\u201d for transgender-identifying children. The question before the Supreme Court in United States v. Skrmetti is whether Tennessee\u2019s prohibition of certain medical interventions for minors violates the Fourteenth Amendment\u2019s Equal Protection Clause. Despite the legal nature of that question, the […]<\/p>\n","protected":false},"author":147,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[72],"tags":[13,103,104],"class_list":["post-3283","post","type-post","status-publish","format-standard","hentry","category-per-curiam","tag-constitutional-law","tag-healthcare","tag-transgenderism"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/peZSiL-QX","_links":{"self":[{"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/posts\/3283","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/users\/147"}],"replies":[{"embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/comments?post=3283"}],"version-history":[{"count":0,"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/posts\/3283\/revisions"}],"wp:attachment":[{"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/media?parent=3283"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/categories?post=3283"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/jlpp\/wp-json\/wp\/v2\/tags?post=3283"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}