When Advocacy Replaces Science: Political Agendas Masquerading as Medical Education

The American Medical Association (AMA) has fully eschewed any pretense of representing physician interests. Instead, it has unfortunately become a tool for far left advocacy that uses its once-noble mission as cover to advance leftist policy. While many physicians see through the charade, the organization responsible for overseeing continuing medical education (CME) ostensibly does not. 

Case in point: The AMA Ed Hub Continuing Medical Education module, ‘LGBTQ+ Patient-Centered Practices, clearly violates the Accreditation Council for Continuing Medical Education’s standards. This is especially true regarding Standard 1, which requires that all educational recommendations for patient care be grounded in current science, supported by clinical reasoning, and presented in a fair and balanced manner. It also prohibits the promotion of practices that lack sufficient evidence or pose risks outweighing benefits. 

Consider:

1. Claims Without Clear Citation of Evidence

The Accreditation Council for Continuing Medical Education (ACCME) requires that “all recommendations for patient care … must be based on current science, evidence, and clinical reasoning” and that “all scientific research referred to … must conform to generally accepted standards.”

However, the module presents interventions such as hormone therapy and surgical procedures under the umbrella of “gender-affirming care” without acknowledging any consideration that the overall quality of evidence for benefit is very low in the pediatric population. Similarly, the CME makes the claim that “research consistently shows that access to gender-affirming care is associated with better mental health outcomes for transgender and gender-diverse youth.” High quality systematic reviews, as noted in the U.S. Department of Health and Human Services (HHS) Report, do not show this to be the case. This lack of transparency violates the ACCME mandate for evidence-based clinical recommendations.

Additionally, the module recommends “focus[ing] on social transition and reversible interventions for younger children,” ignoring all research demonstrating that hormonal interventions are generally irreversible. Even social transition, such as going by a different name or different pronouns, is an extremely slippery slope; experts warn that it is “not a neutral act,” but a powerful signal that validates the child’s gender distress. It’s no wonder that five years after transitioning socially, nearly two-thirds of children in a 2022 study were using puberty blockers or receiving cross-sex hormones. 

2. Lack of Balanced View of Diagnostic and Therapeutic Options

Standard 1 also requires providers to ensure their content “is fair and balanced and that any clinical content presented supports safe, effective patient care.” Standard 1.3 permits debate on “new and evolving topics,” but clearly prohibits providers from “promoting practices that are not, or not yet, adequately based on current science, evidence, and clinical reasoning.” New or evolving topics must be “clearly identified as such.” 

Yet, the AMA module frames “gender-affirming care” as a best practice without acknowledging controversies in the scientific community and limitations of current evidence, or even mentioning alternative approaches (e.g., watchful waiting, psychotherapy, non-medical support). By not identifying areas where evidence remains emerging or contested, the module is taking an advocacy stance rather than a neutral educational perspective.

3. Advocacy of Practices Without Clear Evidence

ACCME states: “Organizations cannot be accredited if … education promotes recommendations, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective.”

The module advises clinicians on when and how to implement “gender-affirming” interventions, particularly in minors, but does not discuss potential long-term risks. Providers, for instance, are told to tell parents the “benefits of gender-affirming care” without any mention of the risks. 

More so, these same providers–according to the module–are to inform administrators of the “medical necessity of gender-affirming care,” which certainly does not exist when it comes to caring for gender confused children. As noted in the HHS Report, the World Professional Association for Transgender Health’s use of the term “medical necessity” was a “strategic move” that “remove[d] key safeguarding criteria” and “compel[ed] insurance coverage.” Clinical rationale was lacking.

Unfortunately, the AMA’s CME reads more like an advocacy directive than balanced guidance, straying from ACCME’s expectation to differentiate between established science and evolving or experimental practices.

4. Lack of Content Validation

ACCME clarifies that accredited providers must ensure content validity through “generally accepted standards of experimental design, data collection, analysis, and interpretation.”

There is no indication in the module description of a process or methodology that confirms clinical reasoning and ensures validity. In fact, many of the organizations it cites are not medical organizations, but left-leaning advocacy groups, including the ACLU, Human Rights Campaign, the Trevor Project, Pronouns.org and GLAAD. The module also cites the AMA several times, employing a sort of circular logic that undermines its credibility.

By presenting unsubstantiated interventions as best practices, omitting discussion of risks and alternative approaches, and lacking transparency, the module prioritizes advocacy over scientific rigor. 

CME is supposed to make doctors better at their occupation. Instead, the AMA, with the apparent blessing of the ACCME, is corrupting the process so that it places political agendas ahead of scientific rigor. Unless that corruption is ended, patients will inevitably pay the price.