Doctors don’t have enough evidence to know the long-term effects of what happens to someone who takes puberty blockers as a child, the executive director of the American College of Pediatricians says. 

“We know that if you stop puberty with these puberty blockers, you stop a whole sequence of events,” Dr. Jill Simons says, adding that there also are “effects on the brain.”

“There’s effects on the biology that you need that for sexual organ development to become fertile in the future,” she says.

But according to Simon, “There’s a lot of things we don’t know about stopping puberty, and you can’t get that back once you stop the puberty blockers.”

Given the rise in gender-identity treatments for children, the American College of Pediatricians launched a new initiative Wednesday called the Biological Integrity Initiative to provide not only medical professionals, “but also parents, teachers, policymakers, even teens themselves who are questioning some of these things” with resources and scientific data on the known effects of gender treatments on children, Simons says.

Simons joins “The Daily Signal Podcast” to explain what medical professionals do and don’t know about the effects of puberty blockers and hormone treatments on young people and what resources the Biological Integrity Initiative offers. You can learn more about the new initiative at BiologicalIntegrity.org.

Listen to the podcast below or read the lightly edited transcript:

Virginia Allen: Dr. Jill Simons. Dr. Simons is the executive director of the American College of Pediatricians. Dr. Simons, thank you so much for being here today.

Dr. Jill Simons: Thank you for having me.

Allen: Well, go ahead and share a little bit of the mission of the American College of Pediatricians. What is your aim, especially in this moment in history, and just talk a little bit about how you all were founded and where your goals are right now.

Simons: So, the American College of Pediatricians was founded a little over 20 years ago, and it was founded by a group of pediatricians who were unhappy with the direction that the [American Academy of Pediatrics] and other organizations were going, in that they were becoming more political-minded and ignoring some of the science and abandoning some of those principles we hold dear in medicine.

So, they started the American College of Pediatricians, and the mission from the beginning has been to do what’s best for children, and that means supporting them in supporting their families, and also using sound research and science when we make decisions for medical care for children.

Allen: And Dr. Simons, how long have you been a pediatrician?

Simons: Gosh, I’ve been almost 20 years.

Allen: When did you begin to notice that there was this shift taking place, not just in medicine, but specifically in the pediatric world? I’m paraphrasing your words a little bit here, but that pediatric practices were starting to be more so dictated by a social agenda than purely by medicine and science?

Simons: I think the shift maybe started a couple of decades ago, with what the founders of [the American College of Pediatricians] noticed. Personally, and maybe for most of us, it’s been the last 10 years, about the last decade, where some of these really radical ideologies, like the transgender ideology, have really started to have an effect on medicine.

It was a shock to me as a general pediatrician practicing medicine—ear infections, colds, well checks—and then to, all of a sudden, be starting to hear about this transgender medicine and really different approach from anything else I had done.

Most of us kind of ignored it. It wasn’t in my specialty, didn’t get into it, but once I started having to be pulled in either by patients or peers, I researched and did some looking on my own and discovered that what we’re hearing is not the truth.

So, I think it’s long story short, probably the last 10 years with this transgender ideology specifically, but maybe even just the last couple years, it’s really amped up.

Allen: In response to what we’re seeing in the medical community and specifically in the world of pediatrics, you all have literally just launched a new initiative called the Biological Integrity Initiative. What is the aim of this brand new project?

Simons: So, the No. 1 thing we get calls for in my office is questions about the transgender … Anything transgender, whether it’s a parent calling, and these are horrible calls and emails devastated by what it’s done to their child or their family, or it’s pediatricians wondering what to do, or policymakers wondering what does this law mean and wanting to look into it.

So, by far, the No. 1 resource that we were being called on for was our resources on transgender.

And it was a part of our website and a part of our organization, but we really wanted to do this so that it could be easy for those who are searching to find. So, the website is the biggest part of this, but it’s really our commitment as pediatricians and other physicians and health care workers to speak out about the harms about the transgender ideology and what it is, and what it really needs is, these children need compassionate care and they need to be cared for and the real issues addressed, and we shouldn’t be doing these things to them.

So, we’re just trying to raise awareness, and we hope that this website and everything else we’re doing with this initiative really gets the word out there. Because once people hear it like I did, you can’t ignore, it’s common sense. And so, as much as we can get the word out there about this and the facts and the science, that’s what’s needed.

Allen: I think so many Americans agree with you that it is common sense, and yet there is disagreement within the pediatric community. Why do you think that there are pediatricians who are willing to prescribe a young child puberty blockers or sex hormones, or even go so far as giving a minor a double mastectomy?

Simons: There’s a lot of fear out there. I have a lot of respect for my colleagues in pediatrics, but other specialties, and I know a lot of the pediatricians that I talk to don’t agree with this, don’t agree with these protocols that are so-called standards of care, but they are afraid to speak out or don’t have the research to back up their gut feeling that this isn’t right, and so they don’t speak out.

A lot of people have lost their jobs or been threatened to lose their jobs or livelihood, their license for speaking out about this. So, it’s incredibly hard for doctors to do that.

That being said, that’s what we do. If we’re not going to be speaking out … we’re the experts. These parents are coming to us with their children, trusting us with their care. So, we have to be bold. We have to be brave. We do it with everything else in medicine. We get the facts, we have cordial discord, we discuss this, but this issue, by those that want to push this agenda do not want to debate, do not want to have a discussion. They don’t want to look into the research.

I think it is a harmful ideology in that it has convinced people that if you do question it, it’s an issue of you’re not being kind, you’re being “transphobic,” you’re being “bigoted.” And so people just … their human nature, you don’t want to offend people. And so, I think right there, that stops a lot of people from speaking out and don’t think much further from that. And a little bit of groupthink thrown in there.

Allen: Let’s go ahead, though, and take a few minutes and dive into some of those facts. I think that’s really important to talk about. And just for the American people in general to be aware of what is the truth when we talk about the biological differences between men and women, and the effects that things like puberty blockers have on young people.

If a child who has not yet gone through puberty takes puberty blockers, what are the known effects on their body?

Simons: Sure. We know that if you stop puberty with these puberty blockers, you stop a whole sequence of events. And most of it, we don’t know. There’s effects on the brain, there’s effects on the biology that you need that for sexual organ development to become fertile in the future.

There’s so many things, bone health, cardiovascular health, muscle growth, brain growth, I think I mentioned. So, the biggest thing is, there’s a lot of things we don’t know about stopping puberty, and you can’t get that back once you stop the puberty blockers.

We do sometimes pause puberty, but that is only for cases where something has gone wrong with the natural timing of puberty, and it started too early. So, we are actually using those to treat a condition. When you apply puberty blockers, in the case of a child who wants to try to be the opposite sex, you’re stopping a normal body function, and that’s dangerous.

Allen: Let’s say a child is 10 years old, and they go on puberty blockers for three years, and then they decide to go off them at the age of 13. Do we know what happens in that child’s body? Will puberty more or less restart? Or will there be permanent damage, or do we have enough research to even know?

Simons: That’s the big question. There’s not research. These are being done without knowing the true side effects. We know from some children who’ve been through this, but unfortunately, most of the time, once they start on puberty blockers, that puts them on a path to cross-sex hormones. And so that’s a danger in itself that you’re taking them to this medicalized life, a chronic patient.

But like I mentioned before, when you stop these, when you take them off, it’s not like puberty just restarts. There’s growth that has to happen during that time with your bones, with your brain. There’s a sequence of events, and so, when you stop it, it’s dangerous.

Allen: We hear so much debate specifically right now around the issue of sports, and obviously this brings up questions of sports teams and biological men trying to compete in women’s sports, and that’s been such a hot topic in the news over the past couple of years, and we’re increasingly starting to hear a really interesting argument of folks who say, “Well, there really aren’t any proven biological differences between a transgender, “transgender woman,” so, a male who identifies as a woman and a biological woman. What is your response to that?

Simons: I think they’re just ignoring the science. There’s definite biological differences between men and women, especially once they’ve gone through puberty. But even before it’s innate, it’s in every cell in your body. So, you can’t undo the muscle mass that a male obtains through the natural effects of puberty, even if you put puberty blockers and then you give them estrogen or female hormones. There’s just a size difference, a muscle difference, cardiovascular difference.

There may be on an individual level, of course, some girls who are faster than boys or who are physically stronger. But as a whole, no doubt that boys, men have these physical advantages when it comes to sports.

Allen: Well, moving forward with the debate over transgenderism and gender ideology and gender identity, how do you see this debate shifting, let’s say, in the next five years? And how do you see your platform at Biological Integrity Initiative, how do you see that playing a role even in the conversation moving forward in the medical community specifically?

Simons: Some interesting developments in this whole debate. First is internationally. If you look at the trends, many countries, European countries, Sweden, the U.K., Finland, they’ve walked back these policies, and they’ve become more conservative, going to what we would like to see, is counseling and really looking into the underlying mental and social, physical problems that these children are having.

So, they’ve gone a reverse to that. So, introducing that into the debate certainly makes people want to stop and pause what we’re doing here in the U.S., and learn from other countries’ experiences.

The other important piece of this debate is the insurance companies are now getting involved. As detransitioners are bravely stepping forward and saying, “I was not informed. I could not consent to this, and how could this have happened to me?” So, now insurance companies are getting into the mix and they’re looking into, ‘Is this something we want to support?” And, of course, the health care dollars speak when it comes to it.

And then the other part that you mentioned is the sports aspect. So, not only just the medical harms to these children, but the harms that we’re doing to women and children, basically making them irrelevant. So, those are three key, newer developments in the debate that I think will take us further in the next couple of years.

Allen: Within the pediatric community and within the community that’s debating transgenderism and gender identity, not only do you all have folks that are just saying that they don’t agree, but you have really faced a lot of pushback as well. You look at groups like the Southern Poverty Law Center. They’ve labeled you all as a hate group. What is your response to those that are really vehemently opposing the work that you’re doing?

Simons: It’s cowardly. We’ve offered to debate and to talk about this. We’re here for the best for children. We have no other agenda. And people who know the Southern Poverty Law Center, and what they do know, that they themselves are a hate group and have attacked some other good groups that are doing good things. So, people know their true colors.

But any other attacks we get, or name-calling, all that, I mean, it’s cowardly. So, we know what’s right, and we’ve got friends backing us up, like [The Heritage Foundation] and lots of other groups. [The Daily SIgnal is the news outlet of The Heritage Foundation.]

And so, we know in our hearts that this is the right thing to do. So, there’s no question in my mind that you can’t silence us, and we’re just going to keep doing what we do.

Allen: Well, let’s talk about some of those resources specifically that people can find at biologicalintegrity.org. That’s the website. Who should be going to this website, and what can they expect to learn there when they visit it?

Simons: So, it’s going to go live Wednesday, the 27th, and unlike our … website, which is maybe a little bit more medical-ese and a little bit more technical, this site is meant to be more user-friendly. So, not only pediatricians can go there, but also parents, teachers, policymakers, even teens themselves who are questioning some of these things, who want a trusted resource.

We do, though, provide concrete scientific evidence and the research to back up the statements we make on there. It’s just presented in a little bit more easy-to-read format.

We will have fact sheets that people can print out with some of the things you and I talked about with the puberty blockers. What do you need to know in a nutshell? But then if you want to dive deeper and see the sources for these papers and have that for what you’re working on, that will be available.

We’ve got videos, testimony from some of these detransitioners. We have links to other groups who are in this with us; so, linking their resources. Because we truly all are on the same side of this and just want to combine our efforts and speak together. So, there’ll be resources for that.

We have a country map that has all the states, and you can see what’s happening in your state, and the direction that this country is going. So, you can get to support that or just stay involved on the political side of this.

So, lots of things. There’s also a “contact us” if you want to get in touch with a pediatrician or someone, a counselor, if your family or your child is going through this. So, we just hope that this can just be a beacon for people to go and find what they need.

Allen: Well, that’s critical. Dr. Simons, thank you so much for your time today. We encourage everyone to check out both the American College of Pediatricians’ website, as well as please visit biologicalintegrity.org. Those are such needed resources at this moment in history. So, Dr. Simons, thank you for all the work that you’re doing today. Thanks for being with us.

Simons: Thank you so much.

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