By yourNEWS Media Newsroom
A growing dispute over parental authority in children’s medical treatment has reached the pages of one of the nation’s leading medical journals, where two university researchers are calling on physicians to resist state laws requiring greater parental involvement in adolescent healthcare decisions.
The October 12 commentary published in JAMA Pediatrics, titled “When Parents’ Rights Lead to Policy Wrongs,” argues that legislation intended to strengthen parents’ control over their children’s medical and personal decisions may interfere with confidential treatment, restrict communication between patients and physicians, and discourage teenagers from seeking certain healthcare services.
The article was written by Denise Lillvis, a researcher at the University at Buffalo, and Anna Kirkland, a professor at the University of Michigan. Their argument extends beyond medical treatments related to gender identity to include adolescent vaccinations, reproductive and sexual health services, HIV/AIDS care, mental health treatment and substance abuse interventions.
“Through contemporary moves at the state level, parents’ rights policy is becoming increasingly unbounded: what seemingly started in education is spreading into health care in ways that can compromise quality and outcomes,” the researchers wrote.
Their commentary maintains that expanding parental oversight creates additional obstacles for teenagers who want confidential medical guidance or treatment without obtaining permission from a parent. The authors described such restrictions as particularly consequential for adolescents seeking healthcare involving sensitive personal circumstances.
“Such policy is a barrier to acceptable care,” the commentary stated, emphasizing the importance of providing medical environments that are welcoming, respectful and nonjudgmental toward teenagers.
The publication has prompted objections from medical policy advocates who contend that parents should retain authority over consequential medical decisions involving their minor children, particularly when treatments could have permanent physical consequences.
Ian Kingsbury, a researcher and director of the Center for Accountability in Medicine at Do No Harm, criticized the journal’s decision to publish the commentary in remarks to the Daily Caller News Foundation. Do No Harm is a medical policy organization that opposes gender-transition medical interventions for minors.
“That JAMA allows commentary on their official page to take such a radical and unscientific position is highly concerning,” Kingsbury said. “There is no evidence to support transgender inventions on minors, including social transition. JAMA publishing this commentary shows how captured by transgender activists much of the medical establishment is. JAMA should drop the fringe ideologues and focus on high-quality, evidence-based science.”
The disagreement reflects a broader national debate over whether decisions involving adolescents’ gender identity, medical confidentiality and potentially irreversible treatments should primarily rest with parents, healthcare professionals or the minor patients themselves. Laws addressing these questions have increasingly become a focus of state legislatures, particularly when schools and medical providers are involved.
Lillvis and Kirkland identify Idaho’s Pediatric Secretive Transitions Parental Rights Act as a significant example of the legislative approach they oppose. The measure, enacted through House Bill 822, was signed by Republican Gov. Brad Little in April and took effect July 1, 2026.
The legislation establishes requirements governing how schools, healthcare professionals and other covered entities respond when a minor expresses interest in adopting a gender identity or presentation that differs from the child’s biological sex. Its provisions include parental notification requirements involving changes to names, pronouns and participation in certain sex-separated activities.
Under the law, covered entities generally must notify a minor’s parents within 72 hours after receiving requests connected to a social transition. The requirements address circumstances involving alternative names or pronouns, access to restrooms or changing facilities designated for the opposite sex, and participation in certain school activities.
The statute also prohibits covered entities from assisting a child’s social transition without first obtaining written parental consent. Violations can expose covered entities to civil litigation and penalties reaching $100,000, depending on the circumstances and the court’s determination.
Legislators included an explicit statement of parental authority and potential medical harm in the measure’s findings.
“Parents have a fundamental right to raise their children and make medical and educational decisions on their behalf; Medical and social sex transitions can inflict severe and irreversible harm to a child’s well-being,” the act says.
The JAMA Pediatrics authors contend that requirements of this kind could damage trust between adolescent patients and healthcare professionals, particularly when a teenager is reluctant to discuss questions of gender identity or sexuality with family members.
“With the passage of the Idaho law and other legislative efforts, including recent proposals in Florida, access to care and ensuing formation and maintenance of a caring physician-patient relationship is now in jeopardy for adolescents,” the commentary stated.
The researchers also argue that parental authority over medical appointments can extend well beyond the legal power to approve or reject a particular treatment. Parents commonly arrange transportation, schedule visits, manage insurance coverage and determine whether a child can consult a medical professional.
“If a parent controls physician access, the parent functionally controls the appointment, the transportation, the timing, the payment, and what can be discussed,” the authors wrote. “These barriers can be significant even if the teen feels comfortable initiating a request for care, but become insurmountable if the teen desires privacy over parent involvement.”
Their position places particular emphasis on preserving opportunities for adolescents to communicate confidentially with physicians, even when parents object to certain services or discussions. The authors recommend that medical professionals oppose legislative efforts they believe unnecessarily restrict those interactions.
The commentary concludes that physicians should challenge policies expanding parental control over adolescent healthcare “because youth are better off with more pathways open to access care and confide in supportive adults.”
The dispute is receiving additional attention because of the publication’s standing within the medical profession. JAMA Pediatrics belongs to the JAMA Network, which is associated with the American Medical Association. Its parent publication, JAMA, is among the most recognized medical journals internationally.
A journal impact-factor analysis identifies JAMA as one of the highest-ranked medical publications worldwide, placing it fourth among 336 journals in its comparison and reporting an acceptance rate of approximately 4%. Those figures concern JAMA rather than establishing equivalent rankings or acceptance rates for JAMA Pediatrics, the journal that published the commentary.
Questions have also emerged concerning the researchers’ previous federal grant funding and whether taxpayer-supported research contributed to their advocacy on parental rights legislation.
Publicly available National Institutes of Health records identify Lillvis as the recipient of more than $159,000 in federal research support for a project she led in 2024. Additional NIH project records associated with Kirkland list approximately $2.08 million in funding connected to three projects spanning 2024 through 2026, with support attributed to the NIH, Centers for Disease Control and Prevention, and Food and Drug Administration.
Those funding records establish that the academics have participated in federally supported research, but they do not demonstrate that federal money paid for the JAMA Pediatrics opinion article.
The journal’s financial disclosure identifies NIH grant support reported by Lillvis. However, the federal agency explicitly rejected any suggestion that it financed the commentary when contacted by the Daily Caller News Foundation.
“The authors did not receive NIH funding to write this opinion article. The authors are not NIH employees, and the views expressed in the article are their own,” an NIH spokesperson said. “NIH is committed to ensuring federal funding supports rigorous research that advances public health.”
The distinction is relevant because federal grant recipients may participate in policy discussions, but their use of government funding is governed by restrictions on lobbying and related political activities.
According to the NIH’s official guidance governing lobbying by grant recipients, organizations receiving federal research money are subject to limitations that depend in part on their governmental or nongovernmental status and the activities involved.
“These non-governmental entities do not have recognized executive- legislative relationships, and their allowable activities using Federal funds are therefore more constrained than state and local government recipients,” the agency’s guidance states.
No evidence has been presented establishing that either author improperly used federal grant money to prepare the commentary or violated NIH funding restrictions.
Kirkland has previously taken public positions on medical policies affecting educational institutions. During a 2021 interview with Civic Center TV, she supported mandatory COVID-19 vaccination requirements across the University of Michigan’s three campuses.
That earlier position concerned university vaccination policy rather than parental authority over minors’ healthcare. Nevertheless, it provides additional context for Kirkland’s history of supporting institutional policies involving medical and public health decisions.
The exchange underscores a central disagreement over how far state governments should go in protecting parental oversight when minors seek medical information, counseling or treatment involving sensitive subjects.
Supporters of stronger parental rights laws maintain that parents have both legal responsibilities and legitimate interests in decisions affecting their children’s physical and emotional well-being. They argue that medical professionals and educational institutions should not independently facilitate major changes involving a minor’s gender identity without parental knowledge or consent.
Lillvis and Kirkland, by contrast, argue that broad notification and consent requirements can prevent adolescents from obtaining appropriate medical advice and undermine the confidential relationships that allow physicians to identify and address healthcare needs.
Although the commentary focuses heavily on gender-related policies, its implications extend into longstanding debates over adolescent confidentiality in sexual health, infectious disease treatment, mental healthcare and other medical services.
The controversy now centers on the boundary between parental decision-making authority and the discretion of healthcare professionals to provide confidential services to minors. As states continue adopting legislation addressing those competing interests, the JAMA Pediatrics commentary adds a prominent medical-policy voice to the growing dispute over who should control adolescents’ access to healthcare.
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