1. “Physicians and medical professionals should refuse to be mandated or coerced to participate in procedures to which they have ethical or scientific objections or which they believe would harm a patient.

  2. Reproduction requires a male gamete (sperm), which can only be produced by a person of XY genotype, and a female gamete (egg), which can only be produced by a person of XX genotype. Primordial germ cells are present at birth.

  3. Biological sex is determined at conception by genotype and apart from rare anomalies, which result in ambiguous genitalia, sex is correctly identified at birth—and is indeed obvious.

  4. The construct of gender fluidity in the current cultural discourse is controversial.

  5. Through medical, surgical, and other interventions, it is possible to change the physical appearance of one’s body. Changing physical appearance does not change biological sex.

  6. There has been an explosive increase in persons who identify with the construct of gender different from sex, at an age where identity is easily malleable and brain development is not fully concluded.

  7. Conflicting motivations have led to a growing industry dedicated to providing “gender-affirming” procedures that are generally irreversible and have a high probability of causing sterilization. These include puberty “blockers,” sex hormones, and surgery, such as castration, penectomy, and mastectomy. They commit a patient to a lifelong need for medical, surgical, and psychological care.

  8. “Gender-affirming care” in minors is medically and ethically contraindicated because of a lack of informed consent. There are inherently unknown and unknowable long-term risks, and the consequences of removing normal, healthy organs are irreversible.