The AAP has shown sustained moral failure when it comes to confronting the genocide—as I know firsthand.
Palestinian children receive treatment at es-Seraya Sahra Hospital in Gaza on November 9, 2025.(Majdi Fathi / NurPhoto via Getty Images)
“We allow negroes to come to our meeting and we fix a separate place for them to sit. They do not become members. If they became members they would want to come and eat with you at the table. You cannot hold them down.”
These notes from a November 1944 American Academy of Pediatrics (AAP) Executive Committee meeting capture the conundrum leaders of the relatively new medical society faced over the anticipated challenge of allowing highly regarded Black pediatricians, specifically Drs Alonzo deGrate Smith and Roland Boyd Scott, to become members.
Nearly 60 years later, in the months after the murder of George Floyd, the AAP board of directors issued a statement titled, “Truth, Reconciliation, and Transformation: Continuing on the Path to Equity,” formally apologizing for “the racism that contributed to the inequities that Drs deGrate Smith, Scott, and other pediatricians have endured.” The Board then declared, “The AAP as an organization is on a firm pathway to broadly establishing an equity agenda through meaningful diversity and inclusion.”
As a board-certified physician in pediatrics and internal medicine, that 2020 statement made the AAP a compelling professional home for me. I believed the AAP had stood by its values of putting kids first and being dedicated to the health of all children. During the 75th Anniversary of AAP’s flagship publication, Pediatrics, I was invited to write a reflective perspective and noted that “the AAP calls out pediatrics’ history, reckons with its current state, and calls all in to a future in which Pediatrics, both the journal and profession, truly meet all the needs for all children to live full and healthy lives.” I was proud to serve the AAP in a variety of state and national capacities, eventually being elected by my peers as the Chair of the AAP’s Council on Health Equity.
But just over five years after AAP’s national leadership publicly committed to moral clarity and courage in the work to bring about health equity, we have seen that commitment tossed aside in favor of a sustained moral decay—particularly when it comes to the AAP’s failure to speak out against Israel’s slaughter of children as part of what is now widely agreed to be a genocide in Gaza.
I know this firsthand, because in February, I was summarily removed from my chairmanship and barred from serving in any leadership role in the Academy for 5 years—all because I urged the AAP to follow its own stated principles as they pertained to the Gaza genocide. But my expulsion was only one part of a larger pattern of complicity from the organization.
Throughout 2024 and 2025, numerous members, including the AAP’s member-elected health equity leadership, raised serious concerns about the Academy’s handling of the genocide as well as anti-Palestinian racism. A group of over 100 pediatricians sent a letter to the Board and CEO in the fall of 2024, stating that unless the AAP advocated for all children, it did not represent them. They committed to leave the Academy unless the AAP used its lobbying resources to speak up for, and help end the active killing of, children in Gaza.
Their deadline came and went. AAP leadership seemed unconcerned about losing engaged members who were clearly aligned with the vision laid out in the AAP’s bylaws, “that all children shall have optimal health and well-being and are valued by society.” A letter was eventually sent from then-AAP president Dr. Sue Kressly to outgoing Secretary of State Anthony Blinken regarding kidnapped Palestinian pediatrician Dr. Hussam Abu Safiya and inquiring about the status of access to pediatric care in Gaza. After this small step received backlash from pro-Israel groups, the AAP did not offer further public advocacy, policy action, or clear guidance to its members on addressing the urgent humanitarian crises affecting children in Gaza, or how they are contributing to a rise in Islamophobia and antisemitism in our own communities.
An inability to sustain principled engagement, grounded in a stated “core value” that “we believe in the inherent worth of all children,” calls into question whether the current AAP deserves its mantle as a leader in child health and human rights. Many have noticed the AAP’s principled courage advocating for vaccines and Medicaid. This landed us in the crosshairs of the Trump administration, which moved to cancel $12 million of grants to the AAP last December, triggering a lawsuit that reinstated the funding. The AAP rightly argued that the government’s move was an attack on freedom of speech. US District Court judge Beryl Howell noted in her ruling that “the federal government has exercised power in a manner designated to chill public health policy debate by retaliating against a leading and generally trusted pediatrician-member professional organization” and that “retaliatory actions serve both to punish past disfavored speech and as a warning shot to chill such speech in the future.” These quotes were shared by the AAP’s social media accounts, aligning the efforts of the Academy with those of oppressed peoples and evidence of an organization holding the line for academic freedom and due process.
That line, however, has a gaping breach. Over the last two years, as tens of thousands of children have been murdered and even more scarred by our nation’s decision to fund, without condition, Israel’s genocide in Gaza, the CEO & the 17-member Board of Directors of the AAP have repeatedly rejected calls from members to create spaces for dialogue.
Leadership not only failed to act on several petitions signed by over 1000 pediatricians but also disregarded the AAP’s own internal processes for identifying member priorities. In 2024, the #2 priority, as voted upon by 166 AAP leaders, was “Advocacy for Children and Adolescents Exposed to Military Conflict and Major Disaster Zones.” In 2025, the #9 priority, voted upon by 167 AAP leaders, was “Adopting a Child Rights Framework to Guide the American Academy of Pediatrics’ Advocacy Strategy.” Both align with the AAP’s 2018 statement on The Effects of Armed Conflict on Children (reaffirmed December 2023 and since updated in March of 2026), which stressed, “Core human rights principles should be integrated into U.S. policy” and emphasized the responsibility of “Governments and nongovernmental entities to…maintaining the sanctity of safe spaces for children, ensuring medical and educational neutrality.”
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The response from AAP leaders to these clear signals was censorship. Since March 2025, the AAP has arbitrarily prohibited any discussion of Gaza or Israel on several member-led email listservs. When pushed on the legitimacy of this prolonged censorship, they doubled down. And, when I spoke up, they removed me as Chair of the Council on Health Equity and barred me from serving in any leadership role in the Academy for five years.
The justification? At the end of a video welcoming Council members to our national conference that I posted to YouTube and shared on our Council listserv, I identified myself as an AAP leader and stated, “One thing you won’t see in this year’s national conference is the space to discuss and confront the AAP’s ongoing complicity as we sit in a nation funding Israel’s genocide in Gaza. So we need to keep pushing the AAP to face these multiple fronts in solidarity with our communities that are the most impacted and most disadvantaged.”
Within weeks I was facing allegations of an “ethics” violation and was put through disciplinary steps that abandoned due process, disregarded requests for transparency, and ignored other AAP leaders’ proposals for repair over punitive action.
When the AAP board issued its 2020 Truth & Reconciliation statement, it noted that a 1945 Board conversation placed this significant caveat upon the soon-to-be first Black members: “I impressed upon them the importance should they be elected, of their being leaders and not pushers.” Throughout my career however, I had seen an Academy that fostered academic freedom and welcomed mission-aligned “pushers.” That has made the current AAP leadership’s intransigence regarding the impact of Israel’s acts of genocide (as described here) in Gaza on children and health care workers so appalling and, a source not only of moral outrage but, for me, a profound professional heartbreak.
In the course of my Aspen Ascend fellowship, I have read dozens of papers, essays and book excerpts to help me reflect on what transformative leadership alongside children and families can look like. The one most on my mind the last 2 years has been “The Ones Who Walk Away from Omelas” by Ursula K. Le Guin. In it, a town full of joy, abundance, and potential exists only because a single child is forced to live alone in a windowless, basement closet: “They all know that it has to be there. Some of them understand why, and some do not, but they all understand that their happiness… depend wholly on this child’s abominable misery.”
In the AAP, and among medical, public health and academic institutions across the nation, you can be awarded for your advocacy, recognized as a champion of human rights and lay out a diagnosis to bring forth a better world without racism or inequity. But you must not advocate for Palestinians. You must look at the Palestinian child in a dark, windowless closet, and say nothing. Or perhaps worse, as I discovered admittedly far too late in my health equity journey, many are simply unaware that this is the price for being considered a “leader.”
Children, all children, deserve better. Pediatricians deserve better, not organizational leadership that publicly co-opts the language of the oppressed while privately using the tactics of oppressors. In “Omelas,” not everyone accepts the tradeoff. There are those who, as the title foreshadows, walk away from this brokered utopia. I now find myself on their path.
Once my membership expires, it will not be renewed until there is authentic truth and reconciliation between the current CEO, the current board, and its leadership around commitments to health equity, academic freedom and integrity. There must also be true accountability when leaders fail to use their power to bring forth our shared vision for child health and instead punish speech that brings their misalignment into plain view.
When confronted with an overwhelming denial of the humanity of children and the right of healthcare workers to care for their community, we have seen medicine and public health’s moral courage give way to moral decay. Those who stay in these institutions must continue to push for a true reckoning that leads to accountability, commitments to academic freedom, and codifies policies of transparency and due process.
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But the work of health equity and justice has never been dependent on these institutions. And more often it is not physicians but other health care workers who demonstrate how to show up in solidarity and be vanguards of change. Over the last several months in Minnesota I’ve seen and joined colleagues across disciplines to help meet the health care needs of our community, independent of our institutions.
We don’t need the AAP to lead us to a world where, as James Baldwin once noted, “the children are always ours, every single one of them, all around the globe.” What we do need is a commitment to each other to disrupt the normalization of mass suffering and death. To use our voices, our time, our talents, and our money to support organizations that educate and empower rather than silence and punish. To advocate for all children in all spaces, whether or not they want us at the table or try to hold us down.
Nathan T. ChomiloNathan T. Chomilo is a pediatrician in Minnesota.