We at Do No Harm are devoted to combating divisive ideology in health care. To date, we’ve focused on the rise of race-based medicine, most notably Critical Race Theory and the diversity-industrial complex that endanger patients by lowering standards and demanding discrimination. Now, another destructive ideology demands our attention – so-called “gender affirming care.” The health and happiness of countless children are at stake, which is why we’re now fighting to curtail this unscientific and individually harmful practice.

Race-based medicine and “gender-affirming care” arise from the same distorted view. In both cases, patients are viewed as part of a group, instead of unique individuals with unique medical challenges, including psychological ones. In the case of race-based based medicine, minority patients are seen as victims of oppression, which leads to disparate health outcomes, instead of individuals with specific health issues and treatment needs. As for “gender-affirming care,” it holds that any child who questions his or her sex should automatically be given the benefit of the doubt, instead of first identifying and treating underlying or contributing medical problems. In both cases, medical associations are quick to demand adherence to this view, while dismissing any counter-arguments – a clear sign of elevating political ideology over individual patients.

The refusal to approach each patient on an individual basis is reason enough to oppose the movement toward “gender-affirming care.” Yet there’s another reason it deserves criticism: It ignores the impossibility for informed consent of the children who are subjected to this approach. Put simply, young children and adolescents are inappropriately being allowed to make potentially irreversible life-altering decisions.

“Gender-affirming car involves several treatment stages. First, children as young as 6 to 8 years are encouraged to change their names, their hair styles, and their dress to enable their belief that they are the opposite sex. Then, as early as 8 to 10 years, they are treated with drugs called puberty blockers to prevent the development of secondary sex characteristics that develop during puberty. As early as 13 to 15 years, they begin hormonal treatments that lead to secondary sex characteristics of their desired gender. Finally, and once again as early as 13 to 15 years old, they can receive surgical procedures like mastectomies, genital revisions, and plastic surgery.

These procedures are not cost-free. To the contrary: They can lead to altered bone development and cognitive maturation, and even infertility and the inability to engage in sexual relations. It is dangerous and destructive to let children, whose minds are still developing, make decisions at such young ages.

Then there’s the lack of scientific research – a key component to sound medical treatment. No one knows the risk/benefit ratio for these procedures. No one knows how many children decide to reaffirm their biological sex in the middle of these procedures, during which time their minds are developing and maturing. And no one knows how many of these patients ultimately regret their decisions and are left with devastating alterations in their psyches and bodies.

What we do know is this: As few as 12% of children who believe they are a different gender continue to hold that view as adults. Yet the gender-affirming care model assumes that 100% will maintain this belief, while subjecting them to invasive and often irreversible medical procedures. While these children may feel supported and even satisfied for a few months after entering even the earliest stages of the treatment, the longer-term results are unknown and unstudied, and the likelihood is that they’ll wish they had waited before pursuing such a drastic course. Overall, the lack of evidence makes informed consent on the part of children impossible to obtain.

To be clear, adults who decide to undergo “gender transition” have the right to pursue such treatments. But children do not. In holding this position, Do No Harm parallels the best medical judgments of most European countries, including Sweden, Finland, and the United Kingdom, which have abandoned the “gender-affirming care” model precisely because it endangers children. European countries have largely adopted a first step of intense psychological assessment and counseling, which makes sense. If there is an underlying condition or medical need, it should be addressed first, instead of jumping straight to life-altering treatments.

Sadly, the United States refuses to take this common-sense approach. At best, psychological assessments are a quick pro-forma step with no chance of derailing a gender transition. In fact, the American Academy of Pediatrics and transgender activists oppose any delay in providing gender-affirming care, including the cautious and thoughtful assessment of depression, eating disorders, and other underlying problems that have been found in many children seeking synthetic transition. As a result, compared to Europe, the U.S. offers treatments like puberty blockers and sex-reassignment surgeries to patients at a much younger age and with much less mental development. The U.S. is an outlier – and children are being victimized because our country puts ideology ahead of individual patients.

Do No Harm is committed to ensuring that children who believe they have Gender Identity Disorder are treated with the utmost care, caution, and concern. We are working closely with experts in Pediatrics, Psychiatry, Endocrinology and Social Sciences to assess the literature on this topic and identify the path forward, both for medical practice and government policy. Yet this much is already clear: The U.S. should follow Europe’s lead and abandon “gender-affirming care” for children, instead applying a more individualized and medically accurate approach. In the same way that Do No Harm fights for equal access to care, and against divisive race-based medicine, we will fight to protect children from the dangerous ideology of “gender-affirming care.

Just how woke is North Carolina’s ECU Brody School of Medicine? Their score on the AAMC’s Diversity, Inclusion, Culture, and Equity (DICE) Inventory speaks for itself.

Here’s the background. In October 2022, the Association of American Medical Colleges released a report showing that the vast majority of medical schools have embraced identity politics, despite their divisive and even discriminatory nature. The report was based on surveys of specific medical schools, which the AAMC didn’t name.

For the sake of transparency and accountability, Do No Harm submitted freedom of information requests to public medical schools nationwide, including East Carolina University. We asked for a copy of its survey response, so that North Carolina taxpayers and policymakers could learn the truth about this institution.

Here’s what the ECU Brody School of Medicine has self-reported:

  • It has adopted racially discriminatory admissions practices under the guise of “affirmative action.” This means it’s potentially lowering standards in the name of diversity, thereby threatening patient health.  
  • It has a “dedicated office, staff, or resources” dedicated to DEI. In fact, it reports two such offices: The Office of Diversity Affairs and Office of Faculty Affairs and Leadership Development. This means there’s a permanent woke bureaucracy pushing ideology on faculty and students. 
  • It lobbies for woke policies at the federal, state, and/or local levels. This means it’s wading into toxic public debates instead of fully focusing on educating future physicians. 
  • It offers tenure and promotion to faculty who prove their commitment to extreme identity politics and woke priorities. This is a litmus test that requires faculty to toe the party line instead of teaching medicine at the highest level. ECU reported that new promotion and tenure policies are under development.
  • Its administrators are active within local, regional, and national forums to promote equity, diversity, and inclusion. This means it’s wasting resources that would be better spent on real medical education.  

In response to question 83 on the DICE Inventory (Does the institution/school provide scholarships for students from diverse backgrounds?), ECU responded “no” and added the comment “Prohibited for targeting diverse candidates over others.” However, the Office of Diversity Affairs clearly promotes Scholarships for Underrepresented Minorities in Medicine (URMM) Students.

East Carolina University Scholarships for Underrepresented Minorities in Medicine page.

All told, ECU Brody School of Medicine has instituted 70.6% of the divisive and discriminatory woke policies listed by the AAMC. With a score in AAMC’s yellow zone, you can bet it is feeling pressure from activists and outside groups to go even further down the radical rabbit hole – doing even more damage to faculty, medical students, and ultimately, the millions of patients they’ll see.

ECU Brody School of Medicine DICE Inventory score.

North Carolina taxpayers help fund East Carolina University. They, and the policymakers who represent them, should ask why they’re giving so much money to an institution that’s putting divisive and discriminatory ideology at the heart of medical education. More importantly, they should ensure the ECU Brody School of Medicine stops, and soon.