Accreditation for medical schools emerges as weak spot for youth gender transition industry

Hospitals nationwide are running away from so-called gender-affirming care for young people, most recently New York University's Langone academic medical center, under Trump administration threats to strip federal funding and FBI and Federal Trade Commission investigations of "female genital mutilation" and consumer deception, respectively.

The pipeline for practitioners who provide puberty blockers, cross-sex hormones and surgical interventions for minors is now also under scrutiny, adding to years of pressure on the only accreditor of conventional medical schools in the U.S. for allegedly going woke.

The Board of Governors of the State University System of Florida sought answers from the Liaison Committee on Medical Education and Association of American Medical Colleges on why they didn't "speak out against such unproven and dangerous treatments" in light of recent mainstream acknowledgment of weak evidence for their benefit.

In light of "the role of accreditation in protecting the integrity of medical teaching and the care of patients," Chairman Alan Levine asked AAMC President David Skorton and LCME Chair Bradley Britigan "how have we arrived at a place where primarily academic institutions have been actively promoting and providing these procedures to children" when "organized medicine is now suggesting there was no evidence to support" it.

"I am left puzzled as to how such permanent and potentially harmful surgical procedures have been performed so widely on children and adolescents, primarily at our nation’s medical schools, without clear evidence to support such an approach," Levine said.

He noted the American Medical Association reversed its position on youth gender surgeries, saying they "should be generally deferred to adulthood," shortly after the American Society of Plastic Surgeons issued guidance this month against any procedures for minors in light of widespread natural desistance from gender confusion and weak evidence of benefit.

Gender doctors have long admitted trial and error, not research

ASPS cited a systematic review of youth gender medicine commissioned by the Department of Health and Human Services, finalized this fall with its authors' names made public to validate it was written by experts, most of whom are considered politically liberal.

While the guidance closely followed a massive jury award for a "disfigured" detransitioner against her plastic surgeon and psychologist, ASPS has been on the record as ambivalent about gender surgeries for youth since the Biden administration, citing "considerable uncertainty as to the long-term efficacy" and "low quality/low certainty" evidence.

Shortly after the final HHS report, The Free Press documented how youth gender doctors admitted "we are all just winging it," as one clinician put it, in footage from gender-affirming care conferences obtained by Leor Sapir, one of the HHS-commissioned reviewers. 

Other obtained footage going back years shows similar disclosures. 

Before he became House speaker, Rep. Mike Johnson, R-La., showed a 2023 hearing a viral clip of youth surgeon Blair Peters admitting "no one's published" research on genital operations on "pubertally suppressed adolescents" describing how he procures skin from a child to make vaginal lining.

AAMC spokesperson Christina Spoehr, to whom LCME's website directs accreditation queries, referred Just the News to LCME. An email from "LCME Administrative Staff," based in AAMC's K Street office in D.C., said the accreditor will answer Levine this week.

While AAMC and the AMA cosponsor LCME, they don't "establish accreditation standards, adjudicate compliance, or comment on accreditation matters or related correspondence," Spoehr wrote in an email. 

"More broadly, medical education is grounded in rigorous, evidence-based standards to ensure physicians are prepared to care for patients across a wide range of clinical needs," she said.

Medical advocacy group Do No Harm praised Levine for asking how academic medical centers became so entwined with "high-risk interventions on minors" in spite of "standards designed to ensure evidence-based practice, ethics, and patient welfare." 

Chief Medical Officer Kurt Micelli said accreditors are "prioritizing political ideologies" over "high-quality clinical care." He co-wrote Do No Harm's report in December rebutting the Utah Department of Health and Human Services' defense of "pediatric medical transition."

Do No Harm Chair Stanley Goldfarb, a former associate dean at the University of Pennsylvania's medical school, called for sweeping reform of medical education accreditation in The Wall Street Journal the same day Levine wrote to the two groups, hammering LCME for standards he says prioritize diversity over competence in would-be doctors.

The group also recently targeted the AMA for ideological bias in its continuing medical education courses, which medical professionals need to maintain their licenses. It invites scrutiny on the Accreditation Council for Continuing Medical Education for whether its standards "are being applied in a way that genuinely safeguards scientific rigor," Micelli said.

The AMA notably went to the Supreme Court to defend the Biden administration's prerogative to pressure social media to censor what the AMA considers medical disinformation.

'Ideologically driven' faculty may cause 'some students to question their doubts'

The spotlight on medical education accreditation follows years of gunning for the American Bar Association's grip on law school accreditation, culminating in a multi-agency Trump administration offensive a year ago, due in part to its lowering of standards in the name of racial equity and promotion of lawyer speech codes.

Texas became the first state in January to formally sever ties with the ABA, with its state supreme court now deciding which schools qualify graduates to take the Texas bar. Florida followed suit by allowing graduates of competing accreditors to sit for the bar.

A former health secretary of Florida and Louisiana who now leads Appalachia's integrated health system Ballad, BOG's Levine told AAMC and LCME he wasn't going to "argue the merits, or lack thereof," for medicalized gender transitions for kids, but portrayed them as asleep at the switch as accredited institutions rushed into treatments with so little evidence.

Months before the HHS systematic review, the U.K. government and National Health Service imposed an indefinite ban on "the sale and supply" of puberty blockers for gender confusion, he noted. The HHS report, which "invited peer reviews from major medical associations," used the "strongest language I’ve seen" on how this treatment violates "the Hippocratic oath."

Levine cited videos of faculty "providing guidance on how to effectively coerce parents into believing these procedures are beneficial for minor patients" and resorting to "scare tactics" with parents, saying "their child could be at high risk of suicide" without procedures known for "permanent disfigurement and irreversible damage" to their fertility.

He asked AAMC and LCME to explain how medical schools' practices line up with their accreditation standards on "professional behaviors," "governance and policymaking processes," "scientific and ethical principles of clinical and translational research," "medical consequences of common societal problems," "cultural competence" and "medical ethics."

"In the accreditation process, how does LCME ensure" the professional-behaviors standard is applied to protect patients from "experimental or other procedures which may be driven more by ideology than by clinical evidence?" Levine asked.

"How does an institution maintain its accreditation if it endorses the use of harmful surgical procedures which permanently alter the bodies of children?" he also queried. "This would seem to clearly violate" the "scientific and ethical principles" standard.

Regarding cultural competence, Levine asked whether the "ideologically driven desire for some in organized medicine to perform" these procedures, to the point of "scaring parents" who resist, "cause some medical students to question their doubts about such procedures?"