WASHINGTON – More than a decade ago, pediatrician Michelle Cretella treated a male patient named “Andy.” Andy enjoyed playing with girls’ toys and made friends with girls more easily than with boys. He was eventually referred to a therapist for his gender confusion.

According to Cretella, the breakthrough came when Andy told the therapist that he believed his parents would love him more if he were a girl. Cretella claims that the therapist looked further into this admission and found that Andy’s confusion may have stemmed from the birth of his little sister, who had special needs and required a lot of attention from parents. The theory was that Andy gravitated toward girly behavior to get the attention of potentially neglectful parents.

Though Cretella did not discuss the ultimate resolution to Andy’s gender confusion, she said that today a patient like Andy would be wrongfully referred to a gender specialist or clinic instead of a therapist. The treatment, she said, would be focused on supporting that child’s inclination toward the opposite sex, which could lead to more extreme treatment in adolescence like hormone blockers and organ modification.

Cretella detailed Andy’s story on Wednesday at the Heritage Foundation, where she argued that ideology-driven beliefs about gender identity are inflicting serious damage by relying on treatments that are not scientifically proven.

She pointed to a case in Rockland, Calif., where a teacher at a Sacramento-area charter school this year held a coming-out party for an apparently transgender 5-year-old without parents’ consent. According to The Daily Wire, Rocklin Academy Schools claimed it had no obligation to let parents know about the celebration.

Cretella didn’t address the validity of the school’s argument, but instead focused on a female classmate who went home after the celebration and told her mother that she might be turning into a boy.

During the panel discussion, psychiatrist Allan Josephson noted that children consistently demand things that are bad for them, like unhealthy food, and they resist things that are good for them, like bedtime and daily structure. He said that medical treatments being offered for gender confusion today are missing the underlying issues, which could be abuse and neglect, as was evidenced in the case of Andy.

“This is why the confusion is there,” Cretella said. “This is why it is psychologically damaging to young children in preschool and in our school system to tell them the lie that some people are trapped in the wrong body. ‘You could be trapped in the wrong body.’ We are undermining their reality testing from preschool forward. If they can’t trust their physical bodies to tell them who they are or what they are, who or what can a child trust?”

Paul Hruz, an associate professor of pediatrics at the Washington University School of Medicine in St. Louis, said that this new paradigm shift in gender treatment has evolved in the past decade. Before the paradigm shift, he said gender confusion was assigned to physiological conditions, as was the case with Andy. But it’s since been put forward that “the mind was correct and the body was diseased,” without any scientific backing, he said.

“It’s certainly something that is a threat to our practice of medicine and to scientific integrity itself,” he said.

Josephson was asked during the discussion if he believes that psychotherapy has been effective in treating emotional disorders for gender-confused individuals. He countered with a question, asking if medical treatments in support of sex changes have helped cure the individuals’ problems.

Cretella argued that transgender inclinations are not predetermined, but are developed over time, which is evidenced by studies on identical twins. A biological sex is imprinted by DNA at conception, she said, while gender identity has to do with thoughts and feelings that are sculpted over time. In today’s clinical landscape, she said, a person who asks to have a healthy arm or leg removed is rendered insane or mentally unstable. But if a person asks to have their breasts or penis removed, they are transgender, and shifts in ideology have made it impossible to question that claim because it would be considered discrimination, she said.