​Updated May 2017 
​
The American College of Pediatricians urges healthcare professionals, educators and legislators to reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex. Facts – not ideology – determine reality.

1. Human sexuality is an objective biological binary trait: “XY” and “XX” are genetic markers of male and female, respectively – not genetic markers of a disorder. The norm for human design is to be conceived either male or female. Human sexuality is binary by design with the obvious purpose being the reproduction and flourishing of our species. This principle is self-evident. The exceedingly rare disorders of sex development (DSDs), including but not limited to testicular feminization and congenital adrenal hyperplasia, are all medically identifiable deviations from the sexual binary norm, and are rightly recognized as disorders of human design. Individuals with DSDs (also referred to as “intersex”) do not constitute a third sex. 1

2. No one is born with a gender. Everyone is born with a biological sex. Gender (an awareness and sense of oneself as male or female) is a sociological and psychological concept; not an objective biological one. No one is born with an awareness of themselves as male or female; this awareness develops over time and, like all developmental processes, may be derailed by a child’s subjective perceptions, relationships, and adverse experiences from infancy forward. People who identify as “feeling like the opposite sex” or “somewhere in between” do not comprise a third sex. They remain biological men or biological women. 2,3,4

3. A person’s belief that he or she is something they are not is, at best, a sign of confused thinking. When an otherwise healthy biological boy believes he is a girl, or an otherwise healthy biological girl believes she is a boy, an objective psychological problem exists that lies in the mind not the body, and it should be treated as such. These children suffer from gender dysphoria. Gender dysphoria (GD), formerly listed as Gender Identity Disorder (GID), is a recognized mental disorder in the most recent edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-V).5 The psychodynamic and social learning theories of GD/GID have never been disproved. 2,4,5

4. Puberty is not a disease and puberty-blocking hormones can be dangerous. Reversible or not, puberty- blocking hormones induce a state of disease – the absence of puberty – and inhibit growth and fertility in a previously biologically healthy child. 6

5. According to the DSM-V, as many as 98% of gender confused boys and 88% of gender confused girls eventually accept their biological sex after naturally passing through puberty. 5

6. Pre-pubertal children diagnosed with gender dysphoria may be given puberty blockers as young as eleven, and will require cross-sex hormones in later adolescence to continue impersonating the opposite sex. These children will never be able to conceive any genetically related children even via articifial reproductive technology. In addition, cross-sex hormones (testosterone and estrogen) are associated with dangerous health risks including but not limited to cardiac disease, high blood pressure, blood clots, stroke, diabetes, and cancer. 7,8,9,10,11

7. Rates of suicide are nearly twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery, even in Sweden which is among the most LGBTQ – affirming countries.12 What compassionate and reasonable person would condemn young children to this fate knowing that after puberty as many as 88% of girls and 98% of boys will eventually accept reality and achieve a state of mental and physical health?

8. Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and healthful is child abuse. Endorsing gender discordance as normal via public education and legal policies will confuse children and parents, leading more children to present to “gender clinics” where they will be given puberty-blocking drugs. This, in turn, virtually ensures they will “choose” a lifetime of carcinogenic and otherwise toxic cross-sex hormones, and likely consider unnecessary surgical mutilation of their healthy body parts as young adults.

Michelle A. Cretella, M.D.
President of the American College of Pediatricians
Quentin Van Meter, M.D.
Vice President of the American College of Pediatricians
Pediatric Endocrinologist
Paul McHugh, M.D.
University Distinguished Service Professor of Psychiatry at Johns Hopkins Medical School and the former psychiatrist in chief at Johns Hopkins Hospital

Originally published March 2016
Updated August 2016
Updated January 2017

CLARIFICATIONS in response to FAQs regarding points 3 & 5:

Regarding Point 3: 
“Where does the APA or DSM-V indicate that Gender Dysphoria is a mental disorder?”
The APA (American Psychiatric Association) is the author of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition(DSM-V). The APA states that those distressed and impaired by their GD meet the definition of a disorder. The College is unaware of any medical literature that documents a gender dysphoric child seeking puberty blocking hormones who is not significantly distressed by the thought of passing through the normal and healthful process of puberty.

From the DSM-V fact sheet:
“The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.”
“This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

Regarding Point 5:  
“Where does the DSM-V list rates of resolution for Gender Dysphoria?”
On page 455 of the DSM-V under “Gender Dysphoria without a disorder of sex development” it states: “Rates of persistence of gender dysphoria from childhood into adolescence or adulthood vary. In natal males, persistence has ranged from 2.2% to 30%. In natal females, persistence has ranged from 12% to 50%.”  Simple math allows one to calculate that for natal boys: resolution occurs in as many as 100% – 2.2% = 97.8% (approx. 98% of gender-confused boys)  Similarly, for natal girls: resolution occurs in as many as 100% – 12% = 88% gender-confused girls

The bottom line is this:  
Our opponents advocate a new scientifically baseless standard of care for children with a psychological condition (GD) that would otherwise resolve after puberty for the vast majority of patients concerned.  Specifically, they advise:  affirmation of children’s thoughts which are contrary to physical reality; the chemical castration of these children prior to puberty with GnRH agonists (puberty blockers which cause infertility, stunted growth, low bone density, and an unknown impact upon their brain development), and, finally, the permanent sterilization of these children prior to age 18 via cross-sex hormones. There is an obvious self-fulfilling nature to encouraging young GD children to impersonate the opposite sex and then institute pubertal suppression. If a boy who questions whether or not he is a boy (who is meant to grow into a man) is treated as a girl, then has his natural pubertal progression to manhood suppressed, have we not set in motion an inevitable outcome? All of his same sex peers develop into young men, his opposite sex friends develop into young women, but he remains a pre-pubertal boy. He will be left psychosocially isolated and alone. He will be left with the psychological impression that something is wrong. He will be less able to identify with his same sex peers and being male, and thus be more likely to self identify as “non-male” or female. Moreover, neuroscience reveals that the pre-frontal cortex of the brain which is responsible for judgment and risk assessment is not mature until the mid-twenties. Never has it been more scientifically clear that children and adolescents are incapable of making informed decisions regarding permanent, irreversible and life-altering medical interventions. For this reason, the College maintains it is abusive to promote this ideology, first and foremost for the well-being of the gender dysphoric children themselves, and secondly, for all of their non-gender-discordant peers, many of whom will subsequently question their own gender identity, and face violations of their right to bodily privacy and safety.

For more information, please visit this page on the College website concerning sexuality and gender issues.

A PDF version of this page can be downloaded here: Gender Ideology Harms Children


References:
1. Consortium on the Management of Disorders of Sex Development, “Clinical Guidelines for the Management of Disorders of Sex Development in Childhood.” Intersex Society of North America, March 25, 2006. Accessed 3/20/16 from http://www.dsdguidelines.org/files/clinical.pdf.
2. Zucker, Kenneth J. and Bradley Susan J. “Gender Identity and Psychosexual Disorders.” FOCUS: The Journal of Lifelong Learning in Psychiatry. Vol. III, No. 4, Fall 2005 (598-617).
3. Whitehead, Neil W. “Is Transsexuality biologically determined?” Triple Helix (UK), Autumn 2000, p6-8. accessed 3/20/16 from http://www.mygenes.co.nz/transsexuality.htm; see also Whitehead, Neil W. “Twin Studies of Transsexuals [Reveals Discordance]” accessed 3/20/16 from http://www.mygenes.co.nz/transs_stats.htm.
4. Jeffreys, Sheila. Gender Hurts: A Feminist Analysis of the Politics of Transgenderism. Routledge, New York, 2014 (pp.1-35).
5. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Arlington, VA, American Psychiatric Association, 2013 (451-459). See page 455 re: rates of persistence of gender dysphoria.
6. Hembree, WC, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94:3132-3154.
7. Olson-Kennedy, J and Forcier, M. “Overview of the management of gender nonconformity in children and adolescents.” UpToDate November 4, 2015. Accessed 3.20.16 from www.uptodate.com.
8. Moore, E., Wisniewski, & Dobs, A. “Endocrine treatment of transsexual people: A review of treatment regimens, outcomes, and adverse effects.” The Journal of Endocrinology & Metabolism, 2003; 88(9), pp3467-3473.
9. FDA Drug Safety Communication issued for Testosterone products accessed 3.20.16: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161874.htm.
10. World Health Organization Classification of Estrogen as a Class I Carcinogen: http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf.
11. Eyler AE, Pang SC, Clark A. LGBT assisted reproduction: current practice and future possibilities. LGBT Health 2014;1(3):151-156.
12. Dhejne, C, et.al. “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden.” PLoS ONE, 2011; 6(2). Affiliation: Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden. Accessed 3.20.16 from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885.

Dear Friends,
 
The Elders at Knox Church Perth recently began a session meeting with the discussion of a very helpful article by Rev. Bill Schweitzer, from the book, “Jonathan Edwards for the Church: The ministry and means of Grace”. This was chosen on the basis of our shared commitment to a ministry which is truly grounded in, and driven by, the “ordinary means of grace” – those means which God has set down for the order, rhythm and blessing of His church: the preaching of God’s word, right administration of the sacraments and prayer.
 
Following that encouraging discussion, I was all poised to write an article entitled “Ordinary” in which I was hoping to say something about these reformed, biblical convictions and why they really matter. However, I quickly discovered that almost 10 years ago, Rev. Ligon Duncan had already done a far better job on this subject than I ever could (there really is nothing new under the sun!). I would therefore urge you to read Ligon’s excellent article below, used here with thanks to Ligonier Ministries.
 
Before that though, a brief word on why this is more important today than ever. The truth is we live in a day when pragmatism and the perceived need to “strategise” are increasing trends, even pressures, in the church. Before being called into ministry I worked in management consultancy for almost 10 years and so I know at least a little bit about strategy and I’ve certainly seen the importance of having such things tightly defined in a business environment. However, whilst there are often important lessons to learn from secular entrepreneurialism, there is also a vital distinction we would do well to keep in mind: whereas there is no golden, universally-applicable rule book which stipulates the mission and means of success in the business world, there is such a book which orders the life and blessing of the church.
 
When it comes to the body of Christ, both the mission and the means have been given - for every culture and generation - within God’s Inspired Word. These “means” may not always appear successful (see Jeremiah, Acts 21:30; John 16:2 and think about what became of the apostles themselves!) - in fact, they will typically appear foolish in the eyes of a fallen world (1 Cor 1:21) - yet it is nevertheless our duty and privilege to embrace not only God’s mission, but also His means. The church exists first to bring glory to the name of our Triune God (Exodus 20:3; Matt 22:37-38) and second to make disciples of the Lord Jesus Christ (Matthew 28:19). The means God has chosen for this glorious task are the preaching of His word, sacrament and prayer (Romans 10:14; 1 Cor 2:1-4; Luke 22:19; James 5:14-16).  The order - as Jonathan Edwards said - is important since it is from Scripture that “the others have their basis, but the reverse is not true.”
 
The Westminster Confession – our church’s subordinate standard – is particularly instructive: “The outward and ordinary means whereby Christ communicates to his church the benefits of his mediation, are all his ordinances (that which He has instructed); especially the word, sacraments and prayer; all of which are made effectual to the elect for their salvation.” How is the Word made effectual to salvation? “The Spirit of God maketh the reading, but especially the preaching of the Word, an effectual means of enlightening, convincing, and humbling sinners; of driving them out of themselves, and drawing them unto Christ; of conforming them to his image, and subduing them to his will; of strengthening them against temptations and corruptions; of building them up in grace, and establishing their hearts in holiness and comfort through faith unto salvation.”
 
With these glorious truths in mind, let us continue to live as a church which is not only unswervingly committed to God’s own mission, but one which recognises that in His world, He is always the best and only strategist we will ever need.
 
With love in Christ, your pastor and friend,
 
Paul
 

​Dear friends,

Several years ago, I attended a lecture during which the speaker made the point that the extent to which the early chapters of Genesis (especially 1-3) were being undermined - both by society at large and even large sections of the church - was not only a demonic attack on the very foundations of the gospel, but ultimately one that would have catastrophic consequences for society in the present age. That was back in 2006.

As I survey the horizon in contemporary Scotland, particularly the current plans and proposals of the Scottish Government, I must say that I think we are much further down the road towards that catastrophe than even that speaker would have predicted. As well as the fact that all new guidance and promoted teachers will be made to undertake “training on equality”, a “key priority” for a future SNP Government is to “review and reform gender recognition law for all Trans (transgender) people to ensure it is line with international best practice”. In real terms, this means passing a law that would create a new third gender in addition to male and female, as well as allowing all people to legally change their gender (subject to parental consent, if under 16). Not only that, but the SNP’s highly controversial Named Person Scheme will effectively give the state the right to usurp the unique role of parents in the raising of their children.

At the very heart of the Christian faith is the truth that God created the heavens and the earth and established His order by making mankind, male and female, in His own image. The Scriptures plainly teach that God is the author of all life (and therefore the sole designator of each person’s sex) and that He ordained the institution of marriage between a man and woman as the pinnacle of all human relationships. Within that context, He has not only enabled the biological process of procreation but also given this married partnership a divinely ordained responsibility of raising their offspring according to His precepts.

In short, when it comes to a person’s sexual designation, the appropriate context for sexual relations, the meaning of marriage and the question of who has the final authority for the raising of children, God has not been silent. Our Creator has made clear that living as His image bearers in His world will mean accepting and celebrating our God-given gender (whether male or female), upholding the institution of marriage between a man and a woman and - in the case of parents – embracing that unique responsibility of training our children in the fear and admonition of the Lord.

It appears that the Scottish Government is in the process of doing everything in its power to destroy these essential foundations of a God-honouring society in ways that will have disastrous consequences for generations to come. We have already seen widespread celebration of the oxymoron that is same-sex marriage. But now, not content with this assault on the most important institution for the right ordering of society, our authoritarian “progressives” want to take us further into the darkness by effectively disregarding the God-given authority and responsibility of parents, as well as allowing - if not even encouraging - all people to choose which gender they wish to identify with. You almost have to pinch yourself each time you even think about it – so extreme is the departure, not just from biblical morality, but basic wisdom and common sense. Can a government really be this foolish and that Satanic?! The answer, tragically, is yes.

When you contrast and compare the proposals and policies of our current political parties you would have to say there is a good degree of truth to the statement, “they’re all as bad as each other” - at least from a Christian perspective.  I for one have no burning desire to champion the cause of one party over the others within the church, nor to make out that one is worse than the others purely on the basis of some long held political bias. However, when you consider the massive potential there is for the Named Person Scheme to be used as a means of interfering with the role of parents who seek to raise their children according to Christian values, coupled together with our government’s plans regarding gender, you would have to conclude that true believers need to think long and hard as to whether such a political party – one which seems intent on destroying any lasting imprint of God’s design - can honestly be supported in good conscience before our Creator.

We read in Scripture that “righteousness exalts a nation, but sin is a reproach to any people” (Proverbs 14.34). That’s not to say that when God is revered and His order upheld, we will suddenly be rid of all problems. Of course not: this side of eternity we still live in a fallen and corrupted world. But it is to say, as history - both biblical and otherwise - underlines, that where God and His precepts are destroyed, so too is the health, stability and, dare I say it, prosperity of that nation. It is therefore imperative that we not only pray fervently for the repentance of all our political leaders in these days, but given the near certainty of the SNP’s retention of office, the church must brace herself for the inevitable out-workings of what is surely the most extreme attack against God’s good order by a Scottish Government in living memory.
 
With my love in Christ,
 
Paul
 

Dear Friends, 

One of the very weighty responsibilities that falls to ministers is not just the privileged task of proclaiming the good news of redemption through Christ and Him crucified (Romans 10:14), but also the daunting duty of refuting such false teaching as would undermine and confuse that glorious truth (Jude 1:3).

As with every age of church history, even the briefest of reflections on the contemporary religious landscape reveals a range of such corruptions. However, it is arguably the case that no religious system has been more consistently damaging to the true gospel of Jesus Christ than the teachings of Roman Catholicism. The idolatry of the mass, the teaching of a works-based salvation and the elevation of Mary are well documented heresies, alongside many others besides, but one particular corruption which continues to undermine, confuse and in the end keep unsuspecting people from a genuine salvation is the “sacrament” of penance and the belief that the Pope and his priests can absolve a person of their sins.

Recently Pope Francis decreed that 2016 will be a “Holy Year of Mercy” during which priests will be allowed to “absolve women” of the “sin of a procured abortion”. Historically, only bishops and the Pope himself have been considered eligible to absolve this particular sin – considered one of the gravest within Roman Catholicism – but for 2016 priests will be able to apply to become ‘missionaries of mercy’, thus allowing them to absolve the sin of abortion and other sins that are considered “serious”.

As we reflect on this recent move by the Vatican, it is somewhat ironic to think that it was a Roman Catholic who once made the wise statement: “When people stop believing in God, they don’t believe in nothing, they believe in anything.”

But how do we respond?

First of all, the desire of the Pope to extend mercy towards women who have had abortions is commendable. Abortion, a form of murder, is surely a great burden to carry and the thought of being pardoned and relieved of that heavy weight will surely be welcomed by millions of Roman Catholic women throughout the world.

The problem of course, is that the Pope and every priest within the Roman Catholic Church is absolutely powerless to do that which only the Lord Jesus Christ Himself can do – namely forgive a person’s sin! Jesus said, “Come to me all who are weary and burdened and I will give you rest” (Matthew11:28); the Apostle Paul writes, “For there is one God, and there is one mediator between God and men, the man Christ Jesus…(1 Timothy 2:5). The apostle Peter proclaimed, “This Jesus is the stone that was rejected by you, the builders, which has become the cornerstone. And there is salvation in no one else, for there is no other name under heaven given among men by which we must be saved.”

But why is this so serious?

Firstly, millions of poor, burdened souls are being given empty hope – namely the promise of forgiveness (or “absolution”) by the “blessing” of fallen sinners (the papacy), when the reality is that the only One who can provide such a pardon is He who died as a ransom for many.

Secondly, by issuing this particular decree the Pope has again demonstrated that he not only believes himself to be the head of the church and her Pontifex Maximus (or Supreme Priest) – a position held by Jesus Christ alone (Colossians 1:18; Hebrews 4:14) – but in so doing he attempts, whether knowingly or unknowingly to rob our Saviour Christ of His rightful glory.

There are a reportedly 1.2 billion Roman Catholics in the world today - each one subscribing to a religion which offers false hope and attempts to place a fallen sinful man in the seat that is occupied by the sinless Christ alone. It is therefore incumbent on the true church of Jesus Christ, that if she is genuine in her concern for reaching the lost, then she must avoid the unclear sound that has been created by the ecumenical trumpet in recent years and instead contend for the faith once for all delivered to the saints.

As we do so, and as we proclaim Christ and Him crucified, may all who are who are burdened with the guilt of abortion - and indeed all who have bowed the knee to the Baal of Rome – be granted the grace to repent and to trust in the only One who can say, “your sins are forgiven…go in peace.” (Luke 7:48-50)

With my love and affection in Christ our Lord, 

Paul.