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A Voice for Private Physicians Since 1943

AAPS Opposes NJ Board of Education Anti-Science Vote to Enact Harmful “Equity Code”

August 15, 2023

Dear Members of the New Jersey State Board of Education,

This letter details our opposition to the anti-scientific and unethical amendments to school “equity” requirements passed by the board on August 2, 2023.[i] Among other changes, the approved amendments attempt to redefine and even erase the terms “male” and “female.”

We, the Association of American Physicians and Surgeons (AAPS), founded in 1943, and including its member physicians, who care for many thousands of patients in New Jersey, urge the board to immediately reverse the amendments for the following reasons:

The amendments are not based on science, but instead on ever-changing sociological ideas and political influence. Biology dictates that there are two sexes of mammals and humans, males and females. Publicly funded entities straying away from basic science into such ideologies, will clearly harm, not help, our children. 

There has been an explosive increase[ii] in children who identify with the construct of gender different from sex, at an age where identity is easily malleable and brain development is not fully concluded.[iii] The board’s actions risk further exacerbating this harmful trend.

Why is the trend harmful? Far too often these children are pressured into, “life-altering treatments that have little scientific evidence of their long-term safety and efficacy,” reports Reuters in a 2022 analysis.[iv] Recommendations for these interventions rely on “an abundance of claims that are not backed by evidence,” explains a peer-reviewed summary of studies of subsequent mental health outcomes. This raises questions about whether physicians can even ethically and legitimately obtain informed consent from patients (particularly minor children) being prescribed puberty-blockers or undergoing surgical interventions for gender confusion.[v]

In November 2022, an investigation published by the New York Times found that, “Concerns are growing among medical professionals,” about the long-term consequences of these drugs on crucial bodily systems like brain development and bone strength.[vi]

Nations across Europe are increasing restrictions and even imposing bans on “gender affirming” surgeries and pharmaceutical interventions for minors as, “public health authorities in Finland, Sweden, the Netherlands and England have concluded that the risk-benefit ratio of youth gender transition ranges from unknown to unfavorable.”[vii]

Following Europe’s lead is in the best interest of children, not moving further in the wrong direction as the NJ Board of Education has done. Pediatrician Michelle Cretella notes:

It is now alleged that discrimination, violence, psychopathology, and suicide are the direct and inevitable consequences of withholding social affirmation of a child’s gender discordance and allowing a gender dysphoric child to pass through puberty in accordance with his biological sex. Yet, the fact that 80 percent to 95 percent of gender-dysphoric youth emerge physically and psychologically intact after passing through puberty without social affirmation refutes this claim. Furthermore, more than 90 percent of people who die of suicide have a diagnosed mental disorder. There is no evidence that gender-dysphoric children who complete suicide are any different. Therefore, the cornerstone for suicide prevention should be the same for them as for all children: early identification and treatment of psychological co-morbidities.[viii]

Dissecting a study used to claim “gender-affirming care” reduces suicide, Dr. Cretella finds:

Yes, teens labeled as transgender attempt suicide more frequently than adolescents generally. Unfortunately, this data may be used to pressure parents to put their children through radical transition-affirming therapies. This would be a serious mistake. The new study assumes the unproven belief that all gender identities are equally healthy and fixed in all children and teens. This is an ideological premise touted by professional medical and psychiatric guilds, not scientific fact. The study also offers no proof that these radical therapies—puberty-blocking drugs, double mastectomies for girls, and so on—will prevent adolescents from attempting suicide. If anything, the findings of the survey reinforce the dire need for serious scientific research into the potential environmental causes of gender dysphoria and the risks—both physical and psychological—of medical transition.[ix]

American medicine and schools should inform and team up with parents to seek help, not overlay and drive artificial paths to hormonal and surgical panaceas. These are tragically irreversible, and victims are doomed to a life of hormones and surgical procedures, guaranteeing the individual is, “never quite right.” Males are male, and females are female beyond secondary sex characteristics, specific organs, sex hormones, but down into each cell’s genetic code.

Furthermore, public schooling is the right of all citizen taxpayers, who are mandated to fund it. Schools are necessary to teach reading, writing and arithmetic. They have expanded to biology and other sciences. They have no mandate to teach fluid, ever changing, social multi-influential societal constructs or political missions, especially to parental dependent minors.

Children, both girls and boys, are indeed equal under the law, but unique and unequal in physical characteristics and skills predisposition. This is yet another reason why biological male and female sports should remain separate, to promote fairness in competition, due to sex-related physical features and neurology. Differences between the sexes exist and should be not only acknowledged but embraced in our diverse world.

Additionally, we want to take this opportunity to oppose any policies that prohibit schools from alerting parents of a minor child’s gender confusion. We are perplexed as to why anyone would take any position other than empowering families and partnering with parents. This is a dangerous position, potentially placing caring, dedicated teachers in an adversarial relationship with the very people they are here to support. While privileged health information must be kept in the strictest of confidence from other people and entities, it must be shared freely with parents who have ultimate responsibility for the upbringing of their own children.

The most important takeaway here is that no information can be properly withheld from a child’s parents, particularly and especially when it comes to the medical and mental health of their children. The current NJBOE disruptive amendments will create an adversarial relationship between child and parent, parent and teacher, potentially fueling a dangerous and life-threatening environment. 

Finally, as schools prepare to open for the 2023-2024 academic year, we remind the board that every state,[x] including New Jersey,[xi] is facing unprecedented challenges in properly staffing classrooms. In addition to the above stated facts illuminating why the amendments are harmful, we urge the NJ Board of Education to realize that the new mandate is yet another reason for young people to gravitate away from careers in education, and for experienced teachers to retire early.

In conclusion, please rescind the amendments to the, “equity,” code for schools. In fact, we should repeal the entire equity code and move far away from the so-called diversity, equity and inclusion (DEI) sociological and political movements.

Let’s celebrate our differences and true diversity. Thank you.

Respectfully submitted,

Jane M. Orient, M.D.
Executive Director
Association of American Physicians and Surgeons

[i] https://newjerseymonitor.com/2023/08/03/new-jersey-school-board-oks-new-equity-rules-slammed-by-critics

[ii] https://nypost.com/2023/06/28/new-study-on-rise-in-transgender-shows-its-a-fad-especially-among-young-girls

[iii] https://aapsonline.org/aaps-statement-on-gender-affirming-care-for-minor-children/

[iv] https://www.reuters.com/investigates/special-report/usa-transyouth-care/

[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027312/

[vi] https://www.nytimes.com/2022/11/14/health/puberty-blockers-transgender.html

[vii] https://www.forbes.com/sites/joshuacohen/2023/06/06/increasing-number-of-european-nations-adopt-a-more-cautious-approach-to-gender-affirming-care-among-minors/?sh=3e2f77977efb

[viii] https://www.jpands.org/vol21no2/cretella.pdf

[ix] https://www.dailysignal.com/2018/09/18/new-study-on-transgender-teen-suicide-doesnt-prove-kids-need-gender-transition-therapy/

[x] https://www.epi.org/publication/shortage-of-teachers/

[xi] https://www.northjersey.com/story/news/education/2022/01/10/nj-teacher-shortage- substitutes-njea/9126283002/

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