EZ Profile picture
21 Jul, 14 tweets, 4 min read
Dear @gorskon, have you read the UK NICE systematic review of evidence for pediatric transition? The conclusions are: very low certainty of evidence (modified GRADE). Unclear how to balance certainty of benefits against risks of harm. It's is a high quality systematic review. /1
The home of the Nobel Prize of Medicine (the Karolinska hospital, affiliated with Karolinska Institute) no longer thinks transitioning minors should be done in general medical settings b/c of the risks and uncertainties, only allowing it in clinical trials [none are ongoing]. /2
A prominent gender program in Finland (a leader in pediatric transitions) issued new guidelines last June saying "psychotherapy first" after they noted kids who suffer from MH problems (majority of GD youth) fail to improve with hormonal treatment. /3
Two principal investigators of the Dutch protocol (the backbone of "affirmative care") went on record expressing concerns that their protocol is being applied to a vastly different population of youth than the one designed for originally, and it could harm rather than help. /4
Karl Heneghan, the director of Oxford's Center for Evidence-Based Medicine and former Editor-in-Chief of BMJ Evidence-Based Medicine reviewed the evidence, found the lack of evidence alarming, and called the practice an "an unregulated live experiment" on youth. /5
None of these are "gender critical" facts. They are simply facts derived from a rigorous analysis and observation of novel trends in youth GD. Those raising concerns range from neutral in their stance, to ardent proponents of affirmative care.
Do YOU think they are ideologues? /6
In this debate, it's easy to get cornered quickly. Once you pick a side, it's seemly impossible to be reasonable again and save face: the stakes seem too high. That's the goal of those trying to shut down the debate. Yet I suggest you are not yet at a point of no return. /7
As of 2021, 1 in 10 youth (7 mil) identify as transgender (per Pediatrics). Even if it's 2% (per CDC), it's 1+ mil. The concern over 1-7 million US youth on track to get radical interventions based on very low quality evidence cannot be written off as a "transphobic position"./8
Also don't overlook the influence of big pharma. Puberty blockers are trending to be a several billion dollar a year business, from a fraction just a few yrs ago, with key researchers on advisory boards of big pharma. Does this not remind u of other recent scandals in medicine?/9
Last but not least: Finland. Let's shed our American exceptionalism. Finland may be small but they are a key pediatric gender program in the world. They were among the first ones to scale the Dutch protocol broadly: and now the first ones walking away. /11 segm.org/Finland_deviat…
I hope you can get away from the toxicity of Twitter and spend some time deeply engaging with these materials. I hope you will look beyond the abstracts that project confidence, instead critically engaging with the studies. Your followers & science-based medicine deserve it. /12
Gorski went from "respectful insolence" fighting alternative medicine to willful ignorance, blindly promoting youth gender medicine. Standing up to the pressures of the Big Coffee Enema industry must have worn him out.
*Carl not Karl.

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More from @ZaneEmma

17 Jul
I had a dream. A dream that our children are no longer treated differently because of the length of their hair or the clothes they wear; but get the same quality of medical care demanded of other areas of medicine: the benefits must outweigh the harms.
My dream was really more of a nightmare.
Me (in the dream):"My kid is generally happy, has friends, doing well in school. But does not like (his/her) body. Pls help"
The doctor responds: "I can chemically, then surgically castrate your child. Later we'll cut off their bits". /1
The doctor goes on:
"Your child's bones will get frail. We DK about brain development. Heart attach /stroke risk will go up by 300-500%. He/she will be sterile, may never experience desire. Will be a patient for life. But I can get you a 3-9% improvement in "functioning" now". /2
Read 13 tweets
17 Jul
Jack Turban likes to make things up. He went to a good school. In theory he should have decent analytical skills. Why does he work so hard to create an illusion of certainty, when the only intellectually honest position is to acknowledge profound uncertainty? Let's #factCheckJack
𝙙𝙚𝙑𝙧𝙞𝙚𝙨 𝙚𝙩 𝙖𝙡 2011: Before puberty blockers (PBs) were given, the Dutch adolescents were mentally healthy: no depression (BDI=8); high global functioning (CGAS=70). After PBs there were minor changes, from healthy to healthy. But 100% proceeded to cross-sex hormones./1
𝙙𝙚𝙑𝙧𝙞𝙚𝙨 𝙚𝙩 𝙖𝙡 2011 was attempted to be replicated once, and failed upon replication (Carmichael 2021). They could not find any mental health benefits. Even worse, the interim results broken by sex showed girls’ suicidal ideation increased while on puberty blockers./2
Read 10 tweets
5 Jun
Parents of ROGD kids. When your kids were in still diapers, WPATH was called the Harry Benjamin Foundation. Harry was a quack who, besides his passion for transitions, used turtle fluids to "cure" TB, and performed vasectomies to increase "vim and vigor" in middle aged men. /1
Then, in 2006, came a major re-branding. Eli Coleman, who is still a WPATH leader, unveiled his "10 principles" at a board retreat, and a new name was created. Each word in the name was strategically chosen to signal credibility that wasn't there. It was an aspirational name. /2
The 10 principles are a worth a read. "Let old paradigms die and new ones emerge", proclaimed principle 3. Take over public and religious institutions, change laws and policies. 10 years later (and a few hundred million $ from transwomen billionaires) they achieved these goals./3
Read 10 tweets
15 Apr
@AnnelouDe @olsonista Annelou, for a long time many of us have looked to the Dutch team for your ethical approach to care for gender dysphoric youth (even if some disagreed). I understand you are feeling cornered by the UK judgement. But citing Turban's terrible research is discrediting your stance /1
@AnnelouDe @olsonista Do you know that the US researchers like Turban don't believe the basic fact (demonstrated by a dozen studies & acknowledged in the Dutch protocol) that most trans-identifying youth will NOT be trans-identifying adults; don't believe it's problematic to socially transition kids/2
@AnnelouDe @olsonista Do you realize that your careful protocol administered by experts in the Netherlands is being misused egregiously in the US; that kids with post-pubsecent onset of GD are not differentiated from childhood-onset; that "therapists" are required only to confirm a teen's self-dx /3
Read 12 tweets
11 Apr
You are the average of your 5 friends. In research, you are the average of the references you rely on. The Dutch team's choice to quote Turban and his debunked work speaks volumes. The UK ruling's put them in the survival mode. They r getting desparate. /1
This is the same team that rightly criticized Turban's earlier claim that autism is curable w/transition.
To use their own words, relying on Turban's laughable study "seems counterproductive and not contributing to better care for those who need it". /2
Turban has quite a reputation in the scientific community. A medical trainee with a huge ego and a God savior complex, he is known for his thirst for the limelight, ad hominem attacks on researchers who challenge him, and a proclivity for online samples/3
Read 10 tweets
10 Apr
WPATH is a curious nonprofit: no conflict of interest policy (highly unusual); managed by a for-profit company w/ a stake in pharma companies. And now WPATH's own journal has invented a new definition of financial conflict of interest: "𝙙𝙪𝙧𝙞𝙣𝙜 the writing of the article."/1
Every person on this list is fighting for their livelihood: they have staked their carriers on medically transing youth. They can't afford neutrality and integrity. How is this for a COI? Then, Veritas, which manages WPATH and has a stake in PB Pharma companies, gets to benefit/2
Perhaps it's no surprise that when groups of scientists with NO financial interest in perpetuating transitioning of minors examine the data, they come to vasty different conclusions../3
Read 4 tweets

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