As a longtime pediatrician in Washington state, Dr. Erica Li does not doubt that some individuals—“a very small percentage”—have gender-identity disorder that persists into adulthood. And as someone who has treated children who have been physically abused, Li said there are clearly instances where the state must step in and protect children from parents or guardians.

But that doesn’t mean most parents should be denied a major role in determining whether and how their child will be medically treated if the child expresses a belief that they have gender dysphoria.

“When parents are cut out of the decision-making process,” Li said, “bad things happen.”

She noted that many individuals who identified as transgender in their teenage years later de-transitioned and have come forward to say they and their parents were never properly counseled on the risks associated with medical transitioning, which include sterilization, loss of sexual function, liver failure, recurring surgical infections, failure of surgical tissue graft, bone-density loss, incontinence, brain damage, persistent suicidal ideation, and chronic pain.

“Instead of properly counseling the parents and the teenagers, these families were told that if they didn’t go along with medical transitioning, the kids will kill themselves—which is not true,” Li said. “Instead of being given the opportunity to give informed consent, these families have been emotionally blackmailed.”

And that’s just in cases where parents were involved, at least loosely. In other instances nationwide, parents have been cut out of the process.

Li said there are signs many children who claim to be transgender or profess some other similar gender identity are victims of Munchausen Syndrome by Proxy, a situation in which a person of influence makes up fake symptoms or is the cause of real symptoms in a child, in order for the adult to receive social approval.

“When it comes to the care of the gender dysphoric pediatric population, I propose that we have a problem of systemic Munchausen’s by Proxy,” Li said. “The abusers of these kids are not the parents, but activists and ideologues who pose as counselors, social workers, teachers, and doctors.”

Li noted whistleblowers from child gender clinics have reported signs that some patients’ parents were the cause of the child’s reported gender dysphoria and that clinics have also worked to cut other parents out of the medical-decision process when those parents appeared unlikely to support use of cross-sex hormones or puberty blockers on their child.

“Why do people commit Munchausen’s by Proxy?” Li said. “It’s usually something like this: ‘Look at me. I’m such a victim. I’m so good. I’m taking care of a child who’s so complex and vulnerable. Give me attention. Give me sympathy.’ And these narcissists usually broadcast to people who are very empathetic and agreeable, and those people tend to amplify that message.”

To reduce exploitation of children, she said states must strengthen parental rights.

“We have a crisis of systemic medical child abuse,” Li said. “To correct the errors of institutions, of schools and clinics, we must reestablish the primacy of individual rights in accordance with the ideal of a classically liberal society enshrined in the Constitution. This means codifying parental rights in education and in medical-decision making. When children face invasive educational, psychological, and medical interventions, both custodial parents and, more, all the guardians involved have to be guaranteed the full right to informed consent.”

State officials debate measures to boost parental rights, notification

Li’s comments, made during a recent speech before the Original Constitutional Principles Affecting Culture Foundation, come at a time when Oklahoma policymakers are advancing measures to strengthen parental rights.

Most recently, the State Board of Education approved regulations that state, “No School district, and no employee of the district or its schools, shall encourage, coerce, or attempt to encourage or coerce a minor child to withhold information from the child’s Parent(s) or guardian(s).” Under the regulations, school officials are also required to disclose to a child’s parents “any information” regarding “material changes reasonably expected to be important to parents regarding their child’s health, social, or psychological development, including Identity information.”

Some groups opposed the legislation, claiming parents should not be informed when a child begins displaying signs of psychological challenges.

At a public hearing on the rules, Sherri Brown, legislative chair for the Oklahoma Parent Legislative Action Committee (OKPLAC), indicated parents should be kept in the dark about student conversations with adults at school unless the child authorizes disclosure.

“Children have the right to privacy when they share thoughts and feelings with a trusted counselor, teacher, or principal,” Brown said.

Nicole McAfee, executive director of Freedom Oklahoma, a group that advocates for transgender causes, also opposed requiring school officials to inform parents when a child expresses mental and emotional challenges—even though McAfee also bashed teachers during her comments.

“Even as an adult coming out on my own terms, I had educators I knew from my small town who harassed me online, who suggested that my gender was invalid, who refused to respect my pronouns,” McAfee said.

She proclaimed that parental-rights measures are “being pushed by extremist organizations around the country.”

Tamya Cox-Touré, ACLU of Oklahoma executive director, also opposed the regulations, saying, “Under the proposed rules, teachers or administrators would be required to disclose highly personal information to a parent or guardian.”

But other individuals supported the regulations, citing cases like those noted by Li in her speech.

“I have spoken with three moms just in the past month alone, whose minor child was coerced to change their gender,” said Janice Danforth, chapter chair of Moms for Liberty in Tulsa County. “The stories of these women, it’s heartbreaking. One of them in particular her child is now sterile and unable to have children, and she has gone back to being a woman and is married to a man.”

Parallels with China’s ‘Cultural Revolution’

During her presentation, Li noted many social-pressure techniques employed against families today when discussing child transgender issues have parallels with techniques used on citizens during the Cultural Revolution in China, where Li’s parents were born.

During the Cultural Revolution, citizens were given “red” or “black” status with those in the red category being favored and allowed to scapegoat those in the black category. Those in the black category were socially shunned, had their homes ransacked, and could be drug into the streets and subjected to “struggle sessions” involving various forms of public humiliation. Physical assaults and even executions occurred.

Li’s grandfather was in the black category because he was a Christian minister. He died in a Maoist “thought reform prison,” Li noted.

“In order for inclusion to happen, my mom was asked to stand in front of the class and tell the teacher and the 50 or so kids in the classroom that she would denounce her Christian religion, denounce God and church. This means defying her widowed mother and sullying the memory of her father who had been murdered, or martyred,” Li said. “My mother refused to do this because she believed that she would be accountable before God. But millions of black-category children did denounce their family, and wives and husbands turned against each other. Families were torn apart. In order to become red, you were given extraordinary pressure to give up your soul. You were asked to give up your humanity and betray those closest to you.”

During her presentation, Li displayed photos of the scars left by double mastectomies, noting that many young girls are now pressured to undergo the procedure to appear more masculine in alignment with a professed transgender-male identity. Yet many of those girls suffer continued infections and ongoing pain long after the surgery, and some detransition, regretting their prior surgical decision.

“This is the price of becoming ‘red,’” Li said, pointing to the photos. “This is ‘liberation’ from the white, cis heteronormative patriarchy. It is a macabre horror show cobbled together by an astonishing level of professional hubris.”

She noted the leadership of the American Academy of Pediatrics has “refused” to allow Resolution 27 to come to a vote of the academy membership. That resolution calls for a systematic review of the scientific evidence regarding transgender care.

“Ultimately, the onus is on our medical institutions to safeguard children against medical child abuse,” Li said. “Unfortunately, multiple medical societies have failed in that regard.”