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Benjamin Ryan Profile picture
@benryanwriter
Feb 23, 2023 • 41 tweets • 33 min read • Read on X
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A bombshell article by @writingblock challenges claims by activists that the science supporting the treatment of gender dysphoria in minors is "settled" and that the use of puberty blockers and hormones in transgender kids is "evidence based." 🧵⬇️
press.psprings.co.uk/bmj/february/t… Image
Many argue that giving puberty blockers and hormones to trans minors is uncontroversial & backed by high-quality science. Block's reporting disputes this. Swedish health authorities, for example, say the risks "currently outweigh the possible benefits". 2/
press.psprings.co.uk/bmj/february/t… Image
@glaad, in its recent protest before the @nytimes building, echoed a common refrain: that "the science is settled" regarding giving puberty blockers and hormones to trans-identifying minors. @writingblock's peer-reviewed reporting challenges this claim. 3/ press.psprings.co.uk/bmj/february/t… Image
Trans kids has been a minefield topic, w/ activists like @Esqueer_ & lefty pundits like @RottenInDenmark battling heterodox writers @jessesingal @bariweiss @sullydish @LeorSapir & @AbigailShrier & w/ @MattWalshBlog throwing bombs. @JoyceCarolOates has lent her support to kids. 4/ ImageImageImageImage
The prescription of hormones to trans-identifying minors is often framed as a choice of life on meds vs death by suicide. But researchers have not actually shown that hormonal treatment for gender dysphoria impacts death by suicide. 5/
press.psprings.co.uk/bmj/february/t… Image
@HRC said in a press release today that "ALL gender-affirming care is age appropriate and medically necessary." But in the UK, health experts found there's "scarce & inconclusive evidence to support clinical decision-making" for kids with dysphoria. 6/
press.psprings.co.uk/bmj/february/t… Image
Mark Helfand of Oregon Health & Science University criticized @wpath's recommendations for treating #transgender minors, including a lack of grading system to assess the quality of scientific evidence backing the guidelines. #trans 7/
press.psprings.co.uk/bmj/february/t… Image
At an October meeting of the AAP, @writingblock reports, @DrScottHadland of Harvard Med said, "Ten thousand pediatricians stand in solidarity for trans and gender diverse kids & their families to receive evidence-based, lifesaving, individualized care." 8/
press.psprings.co.uk/bmj/february/t… Image
Gordon Guyatt (@GuyattGH) of McMaster University found "serious problems" with the Endocrine Society's guidelines for treating #trans kids, such as making strong recommendations based on weak evidence--meaning they should not be called "evidence based". 9/
press.psprings.co.uk/bmj/february/t… ImageImage
In contrast to @DrScottHadland, @GuyattGH said, "When there's been a rigorous systematic review of the evidence" about treating #trans kids "and the bottom line is 'we don't know,' anybody who then claims they *do* know is not being evidence based." 10/
press.psprings.co.uk/bmj/february/t… ImageImage
While myriad medical organizations in the US back prescribing puberty blockers & hormones to trans-identifying minors, standards abroad are very different. Sweden did systematic reviews in '15 and '22, found evidence was "insufficient and inconclusive."11/
press.psprings.co.uk/bmj/february/t… ImageImage
The Endocrine Society (@TheEndoSociety) commissioned 2 systematic reviews for its clinical practice guideline for treating #trans adolescents with sex steroids and found the quality of the evidence regarding health risks was "low" or "very low". 12/ press.psprings.co.uk/bmj/february/t… Image
In sum, @writingblock's reporting suggests that @wpath and @TheEndoSociety's guidelines for treating #trans adolescents are not truly "evidence based", nor uncontroversial, nor do they balance the known and potential risks v benefits of such treatment. 13/ press.psprings.co.uk/bmj/february/t… Image
@MattWalshBlog, who doesn't so much debate the science behind care for trans minors as douse the field with gasoline & set it on fire, has made the topic so combustible in Tennessee, he teed up the politicization of #HIV prevention there, I reported:
14/ nbcnews.com/feature/nbc-ou…
@writingblock reviews the history of gender medicine in @bmj_latest. Note that her article was peer reviewed.
15/
 press.psprings.co.uk/bmj/february/t… ImageImage
@writingblock's assessment of the evidence backing standards of care for treating gender dysphoria in #trans minors comes a week after activists (eg: @glaad) and writers have pressured @nytimes to refrain from the type of reporting she has done. 16/ glaad.org/new-york-times…
Other articles finding a lack of high-quality science backing the treatment of trans minors have been published by @nytimes & Reuters, by @emilybazelon @mega2e @chadterhune @RobinRespaut @michelleconlin. 17/
nytimes.com/2022/06/15/mag…
nytimes.com/2022/11/14/hea…
reuters.com/investigates/s…
Myriad writers have criticized @nytimes reporting on #transgender issues, such as @_WrittenByHanna and @jackmirkinson in @thenation: 18/ thenation.com/article/societ…
thenation.com/article/societ…
Scores of @nytimes writers have pushed back against the charge by the paper's guild that its reporting on trans issues caused a hostile work environment, including @GiniaNYT @mattfleg @tripgabriel @apoorva_nyc @powellnyt @jimrutenberg @charlie_savage. 19/
@PressSec of @POTUS weighs in on the onslaught of bills introduced to statehouses this year that target #LGBTQ people:
20/
@ryanlcooper and @RottenInDenmark’s take on @assignedmedia:
@writingblock’s thread:
@jack_turban, MD, who treats trans kids, says there’s a lot of misinformation going around:
21/
@Esqueer_ responds to this thread: Image
The emailed responses to this thread are starting to come in. This is new: now I'm a Nazi and have autism to boot. Image
More charming exchanges with the readers of this tweet thread. Have a good one, @zunetopia. Image
Kindly do not come to this thread disrespectfully. I will not tolerate malicious statements toward anyone and the misgendering of transgender people.
Also, for anyone coming to this thread who thinks they know who I am, what I think or believe or what I'm about, do take note that I do not share my personal opinions about many issues on Twitter. I invite you to read my reporting on LGBTQ issues: benryan.net/lgbtq.html
@HRC will fly an airplane banner down the Hudson River protesting @nytimes coverage of #transgender issues today: Image
@Esqueer_ claims @writingblock can’t count, but the figure she cited in her BMJ article is the total number of minors receiving hormones and puberty blockers during that period, whereas the chart refers only to puberty blockers. Image
On the political front: cbsnews.com/news/texas-bil…
I get a lot of venomous emails, but I’d say this one regarding my tweet thread about the strength of the science behind the treatment of gender dysphoria in minors is one of the most heinous. Sadly for this person’s hopes, I was cured of cancer and have a 5% recurrence chance. Image
Also: it sucks for that person, but no one dies of testicular cancer anymore.
@meetzow wants me to die because I am engaging in science reporting and have illuminated the weakness of the science backing the treatment of gender dysphoria in minors.
Image
Also, gay people on Twitter get hit with a lot of tweets like this in the Musk era: @UIgliori Image
People tweet this to suggest that reduced stigma is the sole reason for the apparent tripling in trans identification between older adults & youths. But I think we can agree that gender identity is far more complex and driven by more complex factors than left vs right-handedness. Image
@CISCHASER hopes I die of the cancer I had: Image
If only this @ryanlcooper @TheProspect podcast had brought on academic experts to discuss youth gender care science. Instead, @RottenInDenmark provides a misleading overview that, for example, fails to note Finland & Sweden disagree with the US on this. 1/
prospect.org/podcasts/02-20…
@RyanCooper claims that what @jessesingal says about youth gender care science "makes no sense scientifically." Except Singal knows the science better than just about anyone, as he assiduously demonstrates. And his coverage is way more nuanced than Hobbes claims. 2/
My favorite is @ryanlcooper saying the best thing for science journos to do is: "You go into the studies to talk to the scientists, you don't talk to individual people, who may and probably do have an ax to grind," as he interviews two individual non-scientists about science. 3/
Hobbes himself is extraordinarily ideological, meanwhile. 4/

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More from @benryanwriter

Benjamin Ryan Profile picture
May 4
Azeen Ghorayshi and Austin Mitchell were 2026 Pulitzer Prize finalists for their podcast The Protocol about youth gender medicine. Image
A must listen: nytimes.com/2025/06/02/pod…
Like clockwork, Harvard Law School clinical instructor and trans activist Alejandra Caraballo has expressed her rage that Azeen Ghorayshi was a Pulitzer Prize finalist. Caraballo does not seem to understand that being a finalist in and of itself is a considerable honor. Image
Read 5 tweets
Benjamin Ryan Profile picture
Apr 28
Taylor Lorenz publishes effective advertorial

In @TaylorLorenz’s new Substack, she used Panagram to detect how many top Substackers are using AI to produce their articles, in an apparent effort to criticize their ethics.

Panagram sponsored Lorenz’s Substack, revealing that it is effectively an advertorial. She doesn’t make a note of this sponsorship until the very end of her article.

This comes after Lorenz was widely criticized for posting a free ad for The Bark Phone, which is parental-control software for a children’s smartphone. In the ad, Lorenz touted smartphones as good for kids because they help kids express themselves.Image
Image
Should a tech journalist such as @TaylorLorenz weave sponsorship of tech products into her reporting thanks to receiving payments from tech companies? That’s what Lorenz did here with Panagram:
usermag.co/p/how-much-of-…
@TaylorLorenz When magazines run advertorials, they typically change the layout to make abundantly clear that this is sponsored content. The disclaimer about it being sponsored content is typically at the top of the text, not buried at the very end, as Lorenz has done.
Read 7 tweets
Benjamin Ryan Profile picture
Apr 26
In Erin Reed’s chat group, people debate whether it would be better to attend this Sunday conference panel of four skeptics of pediatric gender medicine and ask pointed questions, boycott it, or disrupt it with boos. Frank Dowling, who refers to the group as “frauds”, was among the AMA members whose LGBTQ message board posts I quoted from in my reporting for @thefp about how members reacted to the organization coming out against youth gender surgeries: thefp.com/p/the-medical-…Image
Image
Image
Same guy: thefp.com/p/the-medical-…Image
Psychiatrist Frank Dowling advocates disrupting Sunday’s conference panel from the pediatric gender medicine skeptics: Image
Read 6 tweets
Benjamin Ryan Profile picture
Apr 24
Controversial Pediatric Gender Panel Draws Trans-Activist Push for Cancellation
benryan.substack.com/p/transgender-…
Trans-activist Substacker Erin Reed has prompted an uproar over a panel of skeptics of pediatric gender medicine slated for Sunday at the Pediatric Academic Societies meeting in Boston.

Transgender activists and their allies are in an uproar over an upcoming medical-conference panel concerning pediatric gender medicine that features skeptics of this field whom activists accuse of being anti-trans.

Since the prominent trans-activist Substacker Erin Reed published an article about the panel on Tuesday, conference organizers have apparently been inundated with tens of thousands of emails demanding it cancel the panel, in particular due to the panelists’ connections to a small nonprofit known as the Society for Evidence Based Gender Medicine, or @SEGM_EBM.

This burgeoning deplatforming campaign raises questions about the place that the free exercise of scientific ideas has within a medical field as peerlessly politicized as pediatric gender medicine. As transgender activists seek to shut down what they argue are toxic fringe positions akin to climate-change deniers, a relatively small but determined collection of scientific and medical experts have remained committed to publicly scrutinizing this field and defending themselves against what they say are baseless accusations that their perspectives are rooted in bigotry and animus.Image
Many of you will be surprised to learn that Erin Reed has a habit of publishing claims about her adversaries that are not firmly nestled in a bed of truth. open.substack.com/pub/benryan/p/…Image
Update:
Read 4 tweets
Benjamin Ryan Profile picture
Apr 9
About Health Nerd's take-down of the Finnish study on mental health outcomes among youth attending gender clinics
🧵👇
The study isn't perfect by any means. There are fair reasons to criticize it. But Health Nerd's central thesis falls apart upon the simplest examination.

I find it very disappointing when people leverage their academic credentials to supposedly bust bad science or misinformation but only wind up spreading more misinformation in the process. Where are we these days if we can't trust people to use their credentials wisely and inspire trust in those with advanced degrees?

I've tried explaining to Health Nerd what he got wrong, to no avail. It was like arguing with a character in a Lewis Caroll poem.

See the thread below.Image
Health Nerd's argument depends on redefining the study’s outcome variable as “how many times kids saw a psychiatrist for any problem.” No, that's not what the paper measures. It measures contacts with specialist-level psychiatric treatment. In Finland, that is referral-based care generally reserved for more serious mental illness. Milder mental health problems are handled in primary care. gidmk.substack.com/p/does-gender-…Image
That distinction between primary-care services and specialist psych care matters. It's the reason the authors use this variable in the first place. It's not a measure of casual or routine mental health visits.
Read 14 tweets
Benjamin Ryan Profile picture
Apr 3
Queer editor James Ball declares Bluesky a “dying social network,” blaming aggressive censoriousness by Blueskyites of perceived ideological enemies:

“There's a large cadre that basically cheers on chasing off any lib/centrist/academic who's the punchbag of the day. There's a culture of saying ‘fuck off back to X, then.’ And the anti- bedtime leftists set too much of the culture.

“I don't know if it's fixable, especially as I think quite a lot of the people here don't *want* to fix it. But at the rate users are quitting they'll run out of targets soon enough, and the rest of us will lose what is – for a fair few of us I suspect – the last fun/useful social network. Sigh.”Image
Image
More from James about Bluesky’s demise: Image
The grim Bluesky stats. Turns out echo chambers are not big business. Image
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Read 8 tweets

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