The greatest threat to vaccine trust in America isn't Robert F. Kennedy Jr.—it's the medical establishment itself.
Trust in public health is crumbling. While Donald Trump's nominee for secretary of health and human services is seen as the face of the anti-vaccine movement, the real problem is the medical establishment's own willingness to embrace partisan politics over evidence-based science.
Perhaps the most egregious example of this phenomenon is the "expert" support of so-called "gender-affirming care" for children, meaning drugs and surgeries designed to alter their sex characteristics.
More than 20 major medical organizations endorse these practices, including the American Academy of Pediatrics (AAP). The AAP and other medical organizations also advocate for insurance coverage for puberty blockers, hormone therapy, and "sex-change" surgeries. The most influential guidelines on transgender health care, the World Organization for Transgender Health (WPATH) Standards of Care, removed age limits from their guidelines in 2022.
All of this advocacy persists despite a lack of solid evidence that what is commonly called gender-affirming care alleviates gender dysphoria in kids or reduces the chance that gender-distressed youth will commit suicide. Indeed, there is evidence that these treatments hurt the children they're supposed to help.
Earlier this year, the Cass Review—a comprehensive review of research from the United Kingdom, commissioned by the National Health Service—found "remarkably weak evidence" pertaining to "gender-affirming care" and documented its potential risks and downsides, such as fertility loss and delayed bone growth. Following the report's release, the British government immediately banned this practice for patients under 18 years of age. Several European countries have imposed similar restrictions, also citing the weakness of the evidence in favor of it.
Unfortunately, in the United States, the gender-transition industry has repeatedly worked to suppress damning information.
A group of doctors critical of "gender-affirming care" were not allowed to attend an AAP conference. WPATH fought to suppress a systematic review of evidence from Johns Hopkins because its conclusions didn't support broad access to "gender-affirming care." A recent study of the use of hormone drugs went unpublished because again, it came to the "wrong conclusion," that the drugs in question didn't really help the kids studied.
When medical organizations suppress information indicating these practices are not beneficial, and indeed may be harmful, they lose credibility. It's only natural, then, for parents to question whether similar tactics are at play regarding vaccines.
This underscores the real issue: public trust.
Historically, strong vaccine uptake rates in the U.S. have been driven by high levels of trust between Americans and their doctors. Traditionally most parents have relied on the recommendations of pediatricians, whom they trusted. But that trust is now damaged.
As the internet has made information more readily available, more patients and parents have been educating themselves about various health questions. While access to more information can be good, it can also be overwhelming. Most parents do not want to spend hours researching every vaccine—we want to trust our children's doctors. And doctors, in turn, want to be trusted.
Many excellent doctors take the time to listen to and counsel vaccine-hesitant parents about the recommended vaccine schedule. This is one avenue toward bolstering patient trust, but office visits are short, doctors' time is limited, and each conversation only reaches one patient at a time. Even so, the answer is not another large-scale pro-vaccine PR campaign. Without trust, these messages fall on deaf ears.
The best way to restore trust is to demonstrably change the culture of leading medical associations to make them less political and reopen them to challenge, criticism, and debate.
Open criticism and debate are vital, especially in the sciences, where inquiry is foundational. Rather than calling for censorship or slapping "misinformation" labels on podcasts that question the mainstream medical guidelines, representatives of medical organizations should appear on those very podcasts to correct the record.
And when critics are right—as they are about pediatric "gender-affirming care"—the medical establishment must acknowledge it and close the door to these politically motivated, anti-scientific practices. Public trust depends on it. Public health depends on it. Our children depend on it.
Hadley Heath Manning is the executive vice president of the Steamboat Institute.
The views expressed in this article are the writer's own.
English (US) ·