Doctors who are uncomfortable prescribing hormone treatments or doing gender reassignment surgeries could soon potentially be in violation of federal law, warns Dr. Michelle Cretella, a pediatrician and executive director of the American College of Pediatricians. And they’re not the only ones at risk: Parents, too, could find themselves unable to decide on their own child’s medical treatment. Read our interview with Cretella, posted below, or listen to it on the podcast:

We also cover these stories:

The U.S. seizes a North Korean ship.

President Donald Trump pledges to take action to end surprise medical billing.

Colorado teens walk out of a vigil following a school shooting when politicians start advocating gun control.

The Daily Signal podcast is available on Ricochet, iTunes, SoundCloud, Google Play, or Stitcher. All of our podcasts can be found at DailySignal.com/podcasts. If you like what you hear, please leave a review. You can also leave us a message at 202-608-6205 or write us at [email protected]. Enjoy the show!

Kate Trinko: We’re joined today by Dr. Michelle Cretella, a pediatrician and executive director of the American College of Pediatricians. Dr. Cretella, thanks for joining us.

Dr. Michelle Cretella: Thank you for having me here.

Trinko: We’re looking at the Equality Act, which is legislation that House Speaker Nancy Pelosi and the Democrats have been advocating. It would essentially make sexual orientation and gender identity classes that you can’t discriminate against. Dr. Cretella, what do you think about this legislation?

Cretella: This is very dangerous legislation in that it literally mandates that health professionals do harm to people. This act says that a health professional cannot deny treatment to a person based on their gender identity.

Now, at first blush, people may say, “Well, what’s wrong with that?” The problem is this: A person who identifies as trans can very readily and easily go and access medical care for a common cold, an ankle sprain, etc. The issue is when they go into a doctor’s office and say, for example, a woman goes in and says, “I identify as a man. I want you, my OB-GYN, to perform a hysterectomy. Take my healthy uterus out of my healthy body.” That’s forcing a physician to violate his oath to first do no harm.

Now, the transgender activists claim that, “Oh, no. These transgender surgeries, removing reproductive organs, putting them on hormones is lifesaving.” It’s simply not true. That is not what the science shows.

As a matter of fact, the Centers for Medicare and Medicaid Services, under the Obama administration, found that the evidence for any benefit is too weak and that the risk of side effects and harm too great for the government mandate that Medicare or Medicaid pay. We’re talking about experimental procedures that H.R. 5 will mandate every single physician to participate in. And that’s the biggest problem.

It’s being mandated, as I say, under the guise of helping trans-identified people when, in point of fact, it does nothing to decrease their risk of suicide.

There’s a huge study out of Sweden that followed transgender individuals for 10, 20, and 30 years out. At 10 years out from surgery, their mental health was significantly worse than the general populations. So despite getting hormones and surgery, their underlying issues were not healed. By 30 years after surgery, the transgender-identified population had a suicide rate 19 times greater than the general population.

We are not helping. … These individuals who are suffering, we’re giving them toxic hormones that set them up for heart attacks, strokes, cancers, and worse, and we’re not even diminishing their suicide rate.

Daniel Davis: Yeah, it’s interesting that you talk about how doctors would be forced under this law to mutilate their patients, basically, under legal sanction. What kind of sanction would they be facing? Would they face jail time or fines if they refused to go along with gender transition surgery?

Cretella: Refusing to go along with prescribing these dangerous hormones, refusing to go along with performing the mutilating surgeries, you would be in violation of federal discrimination laws, and you would be subject to those penalties.

This isn’t just speculation. There are some states that have already enacted state laws similar to the Equality Act, and just based on that, in New Jersey, one Catholic hospital has been sued by a woman claiming to be a man. She sued the Catholic hospital because the hospital refused to perform a hysterectomy.

Similarly, in California, another Catholic health system is being sued by another woman who identifies as a man and wants a hysterectomy. And this is at a time when these individuals … have a choice. They can still go elsewhere.

Davis: It’s a lot like the cake baker who was forced to make a wedding cake for the gay wedding—

Cretella: Exactly.

Davis: There’s plenty of other providers out there. It’s not a question of availability.

Cretella: Right. So it’s not a question of availability, which is why if H.R. 5 passes and becomes the law of the land, you are essentially putting Catholic health care out of business. You’re literally driving them out of business. …

So in other words, a surgeon who performs breast surgery for cancer patients must perform double mastectomies for physically healthy women who identify as men. But it’s not just in terms of surgeries or prescribing toxic hormones that would impact doctors.

It would also—it really should be the Inequality Act—will mandate physicians to also do other morally objectionable procedures, such as abortions, sterilizations. This is because H.R. 5 applies to sex and gender identity and sexual orientation without any moral conscience or religious exemptions.

Since H.R. 5 defines sex discrimination as including so-called reproductive health care, this H.R. 5 would also mandate physicians and health professionals to participate in sterilizations, dispensing contraception, and performing abortions against their moral conscience.

So there is a groundswell of opposition, certainly among the Christian Medical Association, Catholic Medical Association, but also in organizations like ours, the American College of Pediatricians, the American Association of Physicians and Surgeons, and the American Association of Pro-Life OB-GYNs.

We stand for the traditional Hippocratic Oath, which means we don’t kill our patients—

Davis: Or harm them in any way.

Cretella: Or harm them in any way. So, although, as you would expect, Christian and Catholic physicians are especially alarmed, it is not only those two groups, but all of us who consider ourselves traditional Hippocratic physicians.

Trinko: You’ve obviously studied this legislation quite a lot. Do you have concerns about the Equality Act’s impact for parental rights, when they’re dealing perhaps with a child who doesn’t accept their gender identity, or for the curriculum and what it might start to include on LGBT issues?

Cretella: Parent rights in medicine, we’ll take first. There are none anymore. If this Equality Act passes, it literally says that any action by anyone to interfere with access to “transgender procedures or reproductive health,” that’s discrimination. That’s not allowed.

Again, we don’t have to speculate. In states already that have gender identity laws on the books, parents are losing their right to know.

We’re having kids who go to the school nurse, kids in middle school and high school going to the school nurse or another faculty member saying, “I’m trans, but I don’t want my parents to know.” And the schools are actually facilitating the puberty blockers and cross-sex hormones.

We’ve had one family in Ohio already had their parental rights terminated because they would not consent to their adolescent daughter getting puberty blockers and cross-sex hormones.

So no, H.R. 5, the kids essentially become the state’s. And similarly, as you alluded to, public schools, because they receive federal dollars, will actually be required to teach this transgender ideology from Pre-K on forward, all the way up.

… In terms of local control of your public schools—no. Out the door. No. Sex ed and this transgender ideology will be force fed to all kids from preschool on up.

Again, if you look at the states that have gender identity enshrined in law, this is already happening, so these aren’t scare tactics. I’m not making this up, it’s already happening in states that wrongly identify gender identity as though it’s race or skin color.

Davis: Yeah, it makes me wonder, if it were to pass, and obviously, with divided controlled government it may not happen this year—but imposing this on the entire country … Yeah, some parts of the country are already doing it, they’re already progressive and liberal, but other parts of the country are not, and I can just imagine what kind of backlash there would be.

Cretella: There would be tremendous backlash. But I think it’s important for us to even step back. Even in the states that have gender identity enshrined as an innate and unchangeable characteristic, I think it’s important for our listeners to understand that even states that currently have gender identity protected as though it were skin color, they still have religious carve-outs. H.R. 5 has none.

This means, if H.R. 5 passes, that private schools and even churches and Catholic hospitals, all private institutions will have to bow down to the transgender ideology of the state.

Again, it’s because H.R. 5 rewrites civil rights law on so many different levels. It literally guts religious rights, parent rights, it eliminates the female half of the human race in law.

There won’t be anymore girls sports, it’ll be men’s sports versus coed sports. There won’t be any women’s restrooms, or women’s locker rooms, or even women’s shelters. It’s going to be coed everything. Yeah, coed everything. It completely undoes our entire way of life.

Trinko: Speaking of the sports issue, I was actually reading a liberal site the other day that was arguing that it shouldn’t matter if transgender athletes play women’s sports because some men are smaller than some women, and yada, yada, yada, and essentially, this shouldn’t be an issue.

What would you, as a doctor, say about the biological differences, even after transition, between biological females and biological males? And are there safety issues for biological females if they’re playing sports with transgender persons who were born male?

Cretella: You don’t get anymore anti-science than the claim that there are no biological differences between males and females. From fertilization, if you have a Y chromosome, you are male. That’s the normal pathway.

The fact that 0.02% of the time, you may have a mismatch, the fact that it’s this tiny … 99.98% of the time, you have a Y chromosome, you’re a male, XX, you’re a female. That’s the norm.

If you have that Y chromosome, it is present in every cell in your body, and it impacts the development of every organ system. So what does this mean? It means that every male has male musculature, bone structure. Yes, our brains are different. Every organ system is male at that basic cellular level. The muscle fibers of males are stronger than those of females.

Physiologically, we are a bimodal … Yes, there’s a range of normal in males and a range of normal in females, but at the most basic cellular physiological level, men are going to be bigger, faster, stronger.

Look, a man on estrogen is still a man. He’s still a man. He’s doping estrogen. He’s going to be weaker and slower than men who don’t dope estrogen, but he’s still not a woman.

Davis: One of the things we’ve also seen is some tension in the academic world. There was a study from Brown University that was very controversial, as you well know, it came out last year, and got a lot of flack because it reached some conclusions that the trans activist community didn’t like.

That study went under review for like six months, it came out again this past spring, basically with the same conclusions.

But that made me wonder, how many other studies are there that are being suppressed, or researchers are being, behind closed doors, pressured not to pursue this kind of thing because of ideological pressure?

You’re closer to that world than we are. Do you think intimidation is a factor in shaping the kinds of questions and the kinds of approaches that researchers take?

Cretella: Absolutely, absolutely. Really, for a couple decades now, academia has been really controlled by progressive leftist elites, and American College of Pediatricians, we have many academic members who … won’t get their research funded because it doesn’t tow the ideological line, whether that is with regard to the life issues, or ideal family structure, and certainly the transgender issue.

One of our members is engaged in a lawsuit against his academic institution because he testified in favor of parents’ rights to not give their child the toxic cross-sex hormones, and his institution didn’t like that, and they basically fired him within three weeks, despite his stellar record as a clinician as well as a scientist. We anticipate he will win that lawsuit.

But you’re right, to come out in favor of caution with regard to affirming transgender beliefs in children can be career ending. And if that weren’t bad enough, you’re ostracized and vilified, so socially, you take a hit. It’s horrible.

Davis: So when we hear about “the science,” it’s important to remember that that “consensus” is being shaped by a lot of these ideological factors.

Cretella: Absolutely.

Davis: When Nancy Pelosi throws out, “Well, the scientific community has confirmed” so and so, that’s not exactly gospel.

Cretella: No. And the American Academy of Pediatrics is a great example. The American Academy of Pediatrics is roughly 87 years old. They were the only game in town. The American College of Pediatricians, we have been growing since 2002. So the AAP’s first statement on the care of gender dysphoria in children was written by an employee of the Human Rights Campaign. That would be like the American—

Davis: Which, for our audience, is the leading LGBT activist group.

Cretella: The leading LGBT activist group, yeah. And their update, the AAP’s updated statement, which was just released last October, sure, that one’s written by a physician. They weren’t counting on anyone fact-checking it, but a gender identity specialist and psychologist, Dr. James Cantor, was so shocked that the AAP was recommending that all children be transitioned, he fact-checked their policy.

Well, every single one of their references contradicts what they say. He pulled their references, read the references. Each reference they tuck away in their policy actually recommends watchful waiting, to support the young child through puberty, where the vast majority will accept their biological sex.

And the way this happens, by the way, it’s not that 66,000 pediatricians are lying. No. It’s that one extremist wrote the paper, and roughly 50 pediatricians get to vote on and pass the policy for everybody. We’re talking about large, so-called medical and mental health organizations publishing policies that are really reflecting the ideological belief system of a tiny minority of their members.

Trinko: Why do you think these big doctors’ groups are caving like this? Why are they going along with this agenda? And do you ever have doctors approaching you who say, “I’m afraid to speak out on this issue, but I agree with you.”?

Cretella: Absolutely. … The leadership in academia, over time, became very progressive, elitist, Marxist, if you will. The same has happened. That’s filtered over to medicine, psychology. The groups are caving because their leaders are of this mindset.

There’s a study from within the last five or 10 years that found people with gender identity disorder have a chemical factor in their brain that is elevated, and this particular factor is elevated in mental illness. You’re not going to hear about that study because, “Oh, it suggests that maybe gender dysphoria, trans identity might be related to mental illness somehow.” You won’t hear about that.

… The common person doesn’t realize that there are oodles and oodles of brain studies showing differences between girls who have anorexia nervosa and those who don’t.

Those studies are very solid, they’re replicated, but because there’s no political agenda there, doctors are free to say, “Oh, yeah. These differences. We know that the brain changes appearance and function based on behavior. We also know that if there is biology there, it’s only predisposition.” So they look at those brain changes and say, “Maybe one day there’ll be some medicine to help with the treatment of anorexia.”

But when we’re dealing with transgender, that’s not how the discussion goes. And by comparison, they’re very poor. Very few and far between, very poorly designed brain studies, but all you’ll hear is, “Oh, there’s differences here, there’s differences there in these brains. You know what? We’ve got some boys with girl brains, we’ve got some girls with boy brains.” … A boy can no more have a girl brain than he can have a girl hand. It’s all about political ideology.

Davis: I think that’s a great place for us to leave this. But Dr. Cretella, really appreciate you coming back to Heritage and joining us on the podcast.

Cretella: Thank you for having me.