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Claims that three medical schools in North Carolina are offering gender transition treatments to toddlers have provoked outrage on social media

In a post earlier this week by the North Carolina chapter of the Education First Alliance—which professes to “help conservative candidates around the country dedicated to the pro-American, pro-parent ideals”—contended that Duke University School of Medicine, the University of North Carolina School of Medicine (UNC Health) and the East Carolina University School of Medicine (ECU Health) were accepting toddlers as patients “for starting gender transitions.”

Transgender rights and the sorts of care afforded to minors are proving to be deeply polarizing issues. In the U.S., a 2022 survey by the Pew Research Center found that 38 percent of Americans believe society had gone too far in accepting transgender people, while 36 percent said it had not gone far enough.

While proponents of gender-affirming care argue that it helps those with gender dysphoria avoid the anxiety and higher rates of suicide the condition brings, opponents say treatments such as hormone therapy are harmful to children, who may later want to revert to their original gender.

“Top medical schools in the state are now transitioning toddlers,” the Education First Alliance alleged, adding: “These doctors and clinics know that by catching children and their families at two or three, they can generate enormous amounts of cash because patients will likely rely on a lifetime of medication.”

A spokesperson for ECU Health told Newsweek it was “extremely concerned by the escalating rhetoric and threats aimed at team members and medical providers in recent days and especially given those comments are a result of misinformation.”

They added: “ECU Health does not offer gender-affirming surgery to minors nor does the health system offer gender-affirming transition care to toddlers.”

In a statement, officials at the Duke School of Medicine said: “Online misinformation about toddlers starting gender transitions at Duke is false.”

They added: “Care decisions are made by patients, families and their providers and are both age-appropriate and adherent to national and international guidelines.”

Newsweek approached UNC Health via email for comment on Friday.

Much of the online outrage centers on the Education First Alliance’s claim that one of the doctors it mentions would “see a 2-year-old girl play with a toy truck, and then begin treatment for gender dysphoria,” for which it did not provide evidence.

Reacting to the claims, Gays Against Groomers, which describes itself as an “organization of gays against the sexualization, indoctrination and medicalization of children,” wrote: “How dare anyone tell young children—TODDLERS—that if they’re a girl and like playing with trucks, or a boy and they like playing with Barbie’s, that they were born in the wrong body?!?”

Radical gender theory is genuinely the most sexist, regressive and homophobic ideology in the western world.

How dare anyone tell young children — TODDLERS — that if they’re a girl and like playing with trucks, or a boy and they like playing with Barbie’s, that they were born…— Gays Against Groomers (@againstgrmrs) May 4, 2023

“This is horrifying to say the least,” Proma Nautiyal tweeted. “I used to play with cars and trucks, did not play with dolls, wore my brother’s clothes, and was even addressed by typically male names upon my request. But this in no way meant I identified as a male for life.”

“I have 4 brothers, and while growing up I played with trucks and climbed trees and played in the dirt all day. Glad my parents were sane,” one user said, while another wrote: “That’s insane!”

The Education First Alliance cited a report in The Charlotte Observer from 2016, in which Dr. Deanna Adkins, founder of the Duke Center for Child and Adolescent Gender Care, told the local paper she had transgender patients as young as 2.

That’s insane!— Blessed Momma (@truth_finder40) May 4, 2023

It went on to reference comments Adkins made to a federal district court in North Carolina in 2016, that gender identity was “the only medically supported determinant of sex.”

However, it linked to her expert testimony in a case in Idaho in 2020, in which Adkins states that when gender reassignment surgery had been undertaken “prior the child’s understanding and expression of their gender identity, significant distress can result.”

She also says: “Before puberty, treatment does not include any drug or surgical intervention. For this group of patients, treatment is limited to ‘social transition,’ which means allowing a transgender child to live and be socially recognized in accordance with their gender identity.”

“In accordance with accepted medical standards, hormone therapies are explicitly not provided to children prior to puberty and gender-affirming surgeries are, except in exceedingly rare circumstances, only performed after age 18,” Duke health officials said.

The Education First Alliance said UNC Health would evaluate children as young as three for gender dysphoria. It published what it described as a UNC Department of Psychiatry gender clinic intake form.

On that form, “psychoeducation and support for child and family” is listed as a reason for referral for children aged 3-11, as is “evaluation of gender dysphoria” separately, however, both are able to be ticked concurrently.

The UNC Health webpage the Education First Alliance linked to has since been taken down, but an archived version dated April 17 says it accepts referrals of all ages from 4 to 30 of those “undergoing or exploring all forms of gender-affirming care.”

A referral form from 2020 asks potential patients to specify their age group, including ages 3-6, and a reason for referral is “letters for surgery”—yet this is only for those aged over 18. As a psychiatric facility, the firm says it only offers “treatment recommendations” and evaluations.

The Education First Alliance also named ECU Health as offering gender transitions from the age of four.

It cited an interview with Dr. Colby Dendy, an assistant professor at ECU Health, in The East Carolinian in April 2022, in which Dendy said: “The literature tells us that kids can start around age four having their gender identity, so we do not want to exclude anybody within the pediatrics realm.”

The article also said that Dendy “believes gender-affirmation care for people of all ages should be included in primary care.”

However, gender-affirming care can include social affirmation, such as adopting a look and pronouns that match a person’s gender identity, while puberty blockers and hormone therapy are only used during adolescence, according to the Department of Health and Human Services.

“Gender-affirming primary care includes important services like mental health care, nutrition and social work, all aimed at ensuring LGTBQ+ patients and their guardians have access to the care, information and resources required to make decisions that fit their unique needs,” an ECU Health spokesperson said.

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