Thread by @benryanwriter

New Evidence Challenges Institutionalized Belief That Transgender Teens Become Transgender Adults, Undermining Core Defense of Medical Gender Transitions for Minors

🧵New from me for @NewYorkSun:
A pair of analyses of insurance-claims data each found that the majority of youths diagnosed with gender-related distress saw that diagnosis vanish from their medical chart within six years.

LINK:

New Evidence Challenges Institutionalized Belief That Transgender Teens Become Transgender Adults, Undermining Core Defense of Medical Gender Transitions for Minors

nysun.com/article/new-ev…

A pair of new analyses of medical-records data are challenging the orthodoxy on the permanence of adolescent gender dysphoria. German and American investigators found that the majority of gender dysphoria-related diagnoses, including so-called gender incongruence, recorded in a minor or young adult’s medical chart were gone within within five or six years.

The belief that youth gender dysphoria is permanent is likely behind a bold argument recently made by the World Professional Association for Transgender Health. Wpathis an influential, largely U.S.-based medical activist group that publishes widely followed care and treatment guidelines for trans persons. The organization stated in April that the majority of trans-identified youths would be best served by a medical transition.

The ethics of beginning minors on what is typically meant to be lifelong hormonal treatment are controversial. Such powerful drugs pose the risk of rendering young people infertile and burdening them with permanent sexual dysfunction. And a half-dozen systematic literature reviews — the gold standard of scientific evidence — have found that the use of such medications to treat pediatric gender dysphoria is supported by weak and largely inconclusive research. nysun.com/article/new-ev…

Vocal supporters of broad pediatric access to such medical interventions, such as the Lgbtq nonprofits Human Rights Campaignand GLAAD and the ACLU, frequently seek to tip the ethical balance by claiming that gender-transition treatment is “life saving” for adolescents. The only study ever to assess the veracity of this oft-repeated claim — a paper that was published in February to considerable pushback and scrutiny from the pediatric gender medicine field — found that such treatment was not independently associated with a statistically significant difference in the suicide death rate among young people. nysun.com/article/new-ev…

All these complex ethical considerations notwithstanding, a widely influential 2018 policy statement from the American Academy of Pediatrics on what’s known as the gender-affirming care method for trans-identified minors instructs care providers to show deference to the child’s self-concept and preferences. These can include a medical gender transition.
The AAP policy statement goes so far as to assert that “research substantiates that children who are prepubertal and assert an identity of TDG”—meaning transgender or what’s known as gender diverse — “know their gender as clearly and as consistently as their developmentally equivalent peers” whose sex and gender identity are aligned. nysun.com/article/new-ev…

Leor Sapir, a research fellow at the Manhattan Institute, analyzed insurance-claims information from a database covering about 85 percent of insured Americans and spanning from 2017 to 2023. Publishing his findings on August 30 in the institute’s lay publication, City Journal, Dr. Sapir estimated that overall, about 320,000 to 400,000 minors received a gender dysphoria-related diagnosis during this period.  

@LeorSapir zeroed in on a cohort of about 6,600 adolescents who in 2017 were between 12.5 years and 17.5 years old, had a gender dysphoria-related diagnosis in their medical chart that year, and for whom doctors continuously filed medical claims through 2023. He found that at the end of this six-year period, only about 45 percent of these young people had such a diagnosis entered in their file. 

nysun.com/article/new-ev…

In June, a German team published a similar study in Deutsche Aertzeblatt, for which they analyzed 2013 to 2022 medical claims data in Germany among those who were 5 to 24 years old. They found that the annual diagnosis rate of gender dysphoria-related conditions in these young persons increased eightfold over the course of the decade, with 15- to 19-year-old natal females consistently posting the highest diagnosis rates. nysun.com/article/new-ev…

The investigators found that of the nearly 7,900 young persons with gender dysphoria-related diagnoses in 2017, just 36 percent, including the majority of all age groups, still had such a diagnosis entered in their file in 2022. The steepest drop-off was among the group of natal females who were in their late teens in 2017, just 27 percent of whom retained such a diagnosis five years later. nysun.com/article/new-ev…

M.I.T. philosophy professor Alex Byrne @byrne_a, on Monday published a letter to the editor in the Archives of Sexual Behavior in which he summed up the persistent enigma about this medical field: “Is childhood-onset gender dysphoria that persists into early puberty — or, alternatively, worsens with early puberty — highly persistent in adolescence and adulthood if untreated?” he asked. “In the opinion of many experts, yes. But the published evidence does not bear this out. The persistence rate, like the detransition rate, is unknown.”

link.springer.com/article/10.100…

Referring to pediatric gender medicine, @LeorSapir said in an email, “The field is virtually built on the assumption that, unlike childhood gender dysphoria which almost always desists, adolescent GD almost never does, resulting in a favorable risk: benefit ratio and ethical justification. At minimum, the evidence simply isn’t there.”

He continued: “Nor is the retreat to ‘true trans’ persuasive. As noted by the Cass Review, there is no diagnostic test that’s reliable enough to pick out the true trans kids from the temporary trans kids. And even if such a test existed, the vast majority of gender clinicians (it would seem) are not even trying to make such distinctions.”

nysun.com/article/new-ev…

Thomas D. Steensma, a health psychologist at Amsterdam UMC in the Netherlands and a leading pediatric gender medicine researcher, tells the Sun that identity exploration is a central, and perhaps the defining, quality of adolescence. “What we can conclude from these analyses,” he said of the new medical-claims investigations, “is that the prevalence of gender incongruence-related diagnoses has increased over the years; that the diagnosis does not persist in all people diagnosed; and that gender identity is still in development in children and minors.” nysun.com/article/new-ev…

Stephen Rosenthal, a professor of pediatrics in the division of pediatric endocrinology and the emeritus medical director of UCSF’s Child and Adolescent Gender Center, added that the pair of new insurance-claims analyses are limited by the fact that they don’t provide information about the context in which the gender dysphoria-related diagnoses were made. “In particular,” he said, “was there a thorough assessment by a qualified mental health gender specialist prior to making a determination of gender dysphoria and initiating some form of gender-related care?”
“Unfortunately, in my opinion,” Dr. Rosenthal said, “this interdisciplinary model of care is not followed by all gender clinics.” nysun.com/article/new-ev…

In stark contrast to his junior colleague at @UCSF, Dr. @Jack_Turban, Dr. Stephen Rosenthal suggested that a wider adoption and optimization of such comprehensive assessments could help identify which adolescents with gender dysphoria are most likely to see the condition persist.

“Can thorough mental health assessments be more widely integrated into care and optimized so that those who really need or benefit from gender-related care can be more clearly identified?” Dr. Rosenthal asked. nysun.com/article/new-ev…

@byrne_a @LeorSapir @UCSF @jack_turban Dr. Robert Garofalo, a pediatric gender clinician at @LurieChildrens in Chicago, has no means of assessing whether a child’s gender dysphoria is likely to persist. If the kid comes in looking for blockers, he just asks them their gender identity.

Diane Ehrensaft and @Jack_Turban of UCSF, who are major leaders in the pediatric gender field, published a paper in the journal of @AACAP about how to conduct a @WPATH assessment of a gender dysphoric adolescent. They tell people not to assess whether the child is “truly trans.”
jaacap.org/article/S0890-…

@jack_turban @AACAP @wpath In his new book, @UCSF’s @Jack_Turban strongly suggests he thinks that assessments before putting minors on gender transition treatment should be done away with entirely and that such drugs should be as easy to obtain as Prozac.

open.substack.com/pub/benryan/p/…

@ValidScience @NewYorkSun

@ValidScience @NewYorkSun Here’s the 2022 update:

nytimes.com/2022/05/04/hea…

Here is the original 2020 video of Robert Garofalo of Lurie Children's, in which he said that there is no method to determine whether a child is truly trans when they come in seeking puberty blockers. All they do is ask the kid what their gender ID is.

Over and over, I have told the truth about Dr. @Jack_Turban's writing and statements and how they sometime totally contradict one another. And so he tells a falsehood about my reporting. My reporting about him is solid. It is accurate.

Whistleblower Jamie Reed on how, she says, gender clinics work:

If you're interested in more reporting from me about gender medicine, check out and subscribe to my newsletter:
benryan.substack.com