AMA: We Didn’t Change Our Stance on Gender Affirming Care (NY Times: You Lie!)

Last month the American Society of Plastic Surgeons became the first major US medical group to announce that it was opposed to gender affirming care for minors. Almost immediately, the American Medical Association (AMA) came out with a statement saying that it was also skeptical of gender surgeries for minors.

The AMA statement was given to two outlets, National Review and the New York Times. Here’s how National Review first reported it:

The AMA said in a statement to National Review that because “the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement . . . the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

The AMA supports “evidence-based treatment,” including other types of gender-affirming care for minors, the organization added.

Notice that the AMA statement wasn’t very definitive. It said gender surgeries should “generally” be deferred to adulthood not that it should never be allowed for children. Still it was a clear shift from their earlier position which was fully supportive of gender affirming care with no hesitation about surgery for minors.

That seemed to be the end of it until yesterday when the AMA’s chair put out a newsletter essentially claiming that the AMA had not shifted its view of gender affirming care whatsoever. [emphasis added]

In early January members of AMA leadership met with Dr. Oz at the Department of Health and Human Services (HHS) as part of a grand rounds on gender dysphoria…

That January meeting included representatives from several specialties, including the American Society of Plastic Surgeons (ASPS). During the discussion, it became clear that HHS was looking for each society to share their position on gender affirming care. The representative for ASPS stated its opposition to gender-affirming surgery in minors and described an increase in requests for surgical reversals. In fact, shortly after the meeting, ASPS released a nine-page position statement outlining their position of opposition to gender affirming care in minors.

Knowing the press would pick up the statement and preparing for the inquiry, the AMA Board chair convened the Executive Committee of the Board to discuss a possible response. That meeting was followed by a full Board meeting, given the level of interest and importance of the issue. The Board agreed on language to be used only if the AMA was contacted by the media, and for the AMA President to use in interviews. During our Board discussion, we were clear that we were not changing AMA policy.

The AMA did not issue a preemptive statement on these issues. We responded only after being contacted by media outlets, using the language approved by the Board. While some media coverage characterized this as agreement with the ASPS statement, that phrasing did not come from the AMA. Unfortunately, how reporters frame their stories is beyond our control.

In recent days, AMA communications to the New York Times have requested a correction on their part to reflect the actual language the AMA used in response to their inquiry. Additionally, a letter to the editor has been submitted requesting a public correction—this was neither a policy change nor was it an endorsement of a position taken by another medical society…

As noted above, AMA policy on gender-affirming care is unchanged.

They’re claiming the NY Times botched its coverage of their statement and that they’ve taken steps to request a public correction. Today the Times responded with a fact-check. The Times is calling the AMA chair a liar. [emphasis added]

The New York Times’s body of reporting on the American Medical Association’s stance on gender-related care for minors is accurate and factual, and remains so despite the recent statement from the Chair of the A.M.A. Board, which contradicts the A.M.A.’s own statements.

The Times has received no requests to correct, clarify or update our articles from the A.M.A. After the board chair’s comments, Times reporters also confirmed with the A.M.A. spokesperson that the statements reflected in our previous reporting remain accurate in reflecting the association’s stated positions. The board chair’s claims are not based in fact, and are in contradiction to both the association’s own statements provided to The Times.

“Our colleagues at ASPS concluded that the evidence supporting gender-related surgery in minors is insufficient and of low certainty. The American Medical Association respects the expertise and dedication of surgeons who care for patients every day. The AMA supports evidence-based treatment, including gender-affirming care. Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

The Times’s March 16 article (“In Tense Meeting, Mehmet Oz Pressed Medical Societies on Trans Care for Teens”) reports from a meeting convened by Dr. Oz, which included A.M.A. leadership. Both articles are clear and factual in representing the stated positions of the organization, and no update or correction to either is necessary.

The AMA did change their position, saying there was insufficient evidence to support gender surgery for minors, which matched with what the American Society of Plastic Surgeons had said. And then, more than a month later, the chair is claiming that was a mistake introduced by journalists and that the AMA’s position hadn’t changed at all. The AMA chair also lied about requesting a correction, which never happened.

You can probably guess what happened here behind the scenes. The AMA issued its statement and Human Rights Watch or some similar group came down on them hard, demanding they “clarify” their position. So rather than admit they had actual doubts and were now retracting their statement reflecting those doubts, they simply blamed the NY Times.

What this shows is that politics, not medicine is guiding the AMA. That’s been obvious for a while but this messy attempt at a retraction makes clear that the organization is more interested in toeing the partisan line than it is in stating the facts. It would be great if we could get a story revealing how this change of heart and subsequent retraction really happened, but I suspect no one involved will talk.

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