Last week, Republican Sen. Rand Paul of Kentucky used part of his allotted time during the Senate confirmation hearing for Dr. Rachel Levine, President Joe Biden’s pick for assistant secretary of health and human services, to draw a comparison between genital mutilation and gender confirmation surgery.
Dr. Levine, who previously served as Pennsylvania’s health secretary, is the first out transgender person to be nominated for a Senate-confirmable position and, if confirmed, would be the highest-ranking such person to ever serve in the federal government.
In his comments, which have been widely circulated online, Paul talked at length about the ills of genital mutilation, saying it “is recognized internationally as a violation of international human rights,” and drew a comparison between that and gender confirmation surgeries.
Paul claimed that “most genital mutilation is not typically performed by force but, as WHO notes, by social convention.” He then argued that “American culture is now normalizing the idea that minors can be given hormones to prevent their biological development of their secondary sexual characteristics.”
Facts First: Paul’s analogy relies on a misunderstanding of gender affirmation treatments and misinformation from non-credible sources. In making his comparison, Paul draws on data from the American College of Pediatricians, a group that many health experts believe is on the wrong side of a number of controversial medical topics, especially the issue of gender conversion therapy.
Most medical professionals disagree with Paul’s comparison, including Dr. Jason Rafferty, who authored the American Association of Pediatricians’ policy statement on transgender and gender diverse youth health care. The World Health Organization (WHO), which the Kentucky senator cited, also distinguishes between the two practices, outlining best practices for the gender-affirming health care in 2017 while opposing all forms of female genital mutilation.
“The outcome is trying to better align [a trans young person’s] body with their sense of self rather than a process that causes [an] ongoing sense of distress and harm throughout their lives,” said Rafferty, differentiating between gender confirmation surgery and genital mutilation, respectively. In addition to the WHO, gender-affirming treatment is supported by the AAP, as well as the American Medical Association, among other mainstream medical organizations in the United States.
It should be noted that it is the AAP, not the ACP, that is the primary organization representing pediatricians in the United States. The ACP formed in 2002 over the AAP’s endorsement of same-sex couples adopting children. The ACP, among other things, also supports conversion therapy for LGBTQ youth, a medically discredited practice.