American Academy of Family Physicians Pushed 'Gender-Affirming Care' for Kids at Annual Conference

Seeking to bolster support for pediatric “gender care,” the American Academy of Family Physicians devoted a breakout session at its annual conference last month to discuss research asserting that puberty suppression and gender-transition procedures for minors are essential practices, peddling misleading claims about the beneficial effects of such procedures on young people.

The AAFP Family Medicine Experience is a private annual conference "where clinical expertise, practical strategies and real connection come together to lead what’s next in primary care." The conference is not open to the press; National Review obtained presentation materials from an attendee.

One session, titled “Gender Affirming Puberty Suppression: Initiation and Management,” focused specifically on promoting gender ideology to children, and underscored the importance of parents embracing the "gender-affirming" care model to the exclusion of alternative approaches, such as watchful waiting, which has traditionally been used to treat gender dysphoric children and relies on talk therapy rather than medicalization.

The presentation uses the story of a child questioning their gender to walk physicians through the step-by-step process by which they should encourage gender-dysphoric children toward transition.

Dr. Kelsey Leanordsmith, who uses she/they pronouns, and Dr. Erik Haugland, who is openly gay, spoke in the breakout session. Both speakers operate gender clinics in Minnesota, where they perform pediatric sex-change procedures. Haugland, for example, started the first "gender care program that was fully integrated into primary care within the North Memorial Health system," according to his bio on the AAFP website.

AAFP declined to comment on the contents of the presentation. Leanordsmith and Haugland did not respond to requests for comment.

In the session, the two speakers discuss Gonadotropin-Releasing Hormone Agonists, or GnRH agonists, a synthetic drug that mimics the hormone GnRH. The hormone, present in both males and females, is crucial in reproductive and sexual development. AAFP asserts that the use of these synthetic hormones has no long-term consequences for the patient — but GnRH agonists stunt the development of secondary sex characteristics in a process that cannot be reversed.

AAFP fails to mention in the session any of the potential negative repercussions associated with GnRH agonists, including weight gain, metabolic issues, cardiovascular effects, and fertility problems. When AAFP mentions fertility, for example, it is only to deter doctors from having conversations about childbearing and future fertility concerns with their patients. In one testimonial included in the presentation, a gender-dysphoric child said that their doctor's desire to discuss future fertility issues was "misogynistic," yet AAFP also suggests that children as young as nine can "participate meaningfully in personal health care decision-making."

GnRH agonists, including other puberty blockers, were banned indefinitely in the United Kingdom in 2024 for all patients under the age of 18, due to "an unacceptable safety risk." Other countries that have reduced or restricted access to puberty blockers for minors include Australia, Finland, France, New Zealand, and Sweden.

"Evidence reviews by NICE and NHS England... clearly showed there is not enough evidence to support the safety or clinical effectiveness of puberty suppressing hormones for the treatment of gender dysphoria or incongruence, which is why the NHS decided that they would no longer be routinely offered to children and young people," James Palmer, NHS medical director for Specialised Services, said.

The Food and Drug Administration also issued a warning on GnRH agonists for a condition called pseudotumor cerebri. Some symptoms include headache, papilledema, blurred or loss of vision, diplopia, tinnitus, and nausea, according to the FDA. Studies found that all cases of this illness "supported plausible association" with the use of GnRH agonists, and each case was reported in female patients ages five to 12.

Other concerns include dangerously decreased bone density, impaired brain development, and sterilization.

The AAFP presentation not only advocates "gender affirming" care to the exclusion of other approaches, but also discourages doctors from deferring to parents or guardians, arguing instead that they should adhere to a "patient-first" model, even if that patient is a child. The patients AAFP references, for example, are as young as 12 years old. "There's no one right story or one right way to have a gender," the presentation reads.

"Not only did the AAFPs 'Gender Affirming Puberty Suppression' lecture wrongfully encourage physicians to push aggressive sex change interventions like puberty blockers on confused children, but it cited studies riddled with methodological limitations, rejecting good, sound science," Dr. Kurt Miceli, medical director for Do No Harm, told National Review. "Systematic reviews have found the evidence on puberty suppression to be weak and insufficient with significant risk of bias."

The presentation also states that "Gender diverse youth are more vulnerable for mental health concerns such as anxiety and depression; high suicide rate." The studies, however, contradict themselves, with one stating that there are "Lower odds of recent depression and seriously considering suicide for trans youth with access to GAHT."

AAFP advocates what it calls the "Biopsychosocial" approach, in which doctors break down a pediatric patient's biological, psychological, and social factors. Notably, the presentation includes the caveat that "Active mental health symptoms, disordered eating/body dysmorphia, and differences of development are NOT contraindications to puberty suppression." Meaning, AAFP endorses prescribing puberty suppressors to children who suffer from underlying ailments such as mental illness and body image issues.

The AAFP website includes testimonials from attendees, with one 2025 attendee saying, "FMX reminds me of the full scope of family medicine. I practice in the hospital and ER. I need this kind of community to rehab myself on areas of practice I'm not doing every day, so I can keep that part of my family medicine mind alive."

The case study included in the presentation states that the 12-year-old experiencing gender dysphoria wants "hips and boobs," and through AAFP's "Biopsychosocial" approach, the exercise deems that the patient is ready for hormones, noting potential long-term and irreversible effects on fertility and body changes.

"Children struggling with gender dysphoria deserve high-quality, evidence-based care, not to be victims of a political ideology enforced by radical activists," Miceli said. "The annual meeting offered yet another sign that political agendas are being woven into medicine – a trend that must end.”