Benjamin Ryan Profile picture
Feb 23, 2023 41 tweets 33 min read Read on X
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…
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/
@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

Sep 13
Update: Now The Guardian has cut from this article about Tyler Robinson the quote from the unnamed high school friend about his being “leftist”. Image
I would very much like to know whether the unnamed source got cold feet and demanded a retraction of his quote (and if so, why), or if his words and his capacity to recall a time from about six or seven years ago were somehow misrepresented in the first place.
WaPo reports:

Xander Luke, another high school classmate, said he remembers Tyler Robinson being smart, funny and active online, trafficking in silly memes and jokes.

They would talk politics, Luke said, and discuss their “frustration with the system,” particularly feeling let down by the two major political parties. Robinson did not appear to like “hateful people” and “people who would talk down” to others, said Luke, 22.Image
Read 4 tweets
Sep 3
I report for @UnHerd on the tangled and tortured case of Gordon Guyatt, the towering figure of evidence-based medicine who has caved to transgender-activist pressure and thrown under the bus the funder of his systematic reviews of pediatric gender-transition treatment, @SEGM_EBM. He and his colleagues also contradicted their own research findings by adopting activist language touting the benefits of these interventions as “medically necessary.”

My reporting plumbs the depths of the internal tensions at McMaster University, where Guyatt is a star professor, over the mounting activist pressure. I spoke with one of the authors of the review papers, who was sharply critical of Guyatt’s decision to take sides on how his work should be used in the policy arena. This source shared with me internal emails diagramming the thought process of Guyatt and one of his key McMaster colleagues as they tried to quell the furor over their commissioned work for SEGM.

I also report on how Guyatt’s team is seeking to sink or at least divorce themselves from two other systematic reviews about youth gender medicine, and also kill an analysis of @WPATH’s trans care guidelines.Image
Dr. Steven Montante, a plastic surgeon in Richmond, Va., was among the four review-paper coauthors who didn’t sign the statement. “I don’t necessarily agree that he has the authority to dictate” how his work is used, he said of Guyatt. “To be so prescriptive waters down the notion of why we do these systematic reviews, and the notion of evidence-based medicine. There should be some level of detachment.”

“Why didn’t the institution defend the science?” said Dr. Paul Garner, an emeritus professor of evidence synthesis in global health at Liverpool School of Tropical Medicine. “I see this is an institutional failure.” He added: “This is obviously a toxic ideological area.”Image
Read 12 tweets
Aug 31
I interviewed a number of the first monkeypox (mpox) cases in 2022. They were largely affluent gay men who enjoyed traveling around the world and going to sex parties. I am not certain how stigma is connected to such a pastime.

During the outbreak, the CDC downplayed how central sex between men was to driving the outbreak. Dr. Daskalakis in particular invariably led with the exceptions to the rule of who was at risk, such as by uttering the misleading slogan, “Anybody can get monkeypox.” I once challenged him on this fact during a press call in August 2022 and asked why he wasn’t instead being direct and clear that gay men were overwhelmingly the ones at risk. He responded by saying he thought he and the CDC were doing a fantastic job.

Meanwhile, I was constantly getting DMs from parents who were scared to send their kids back to school or to daycare, despite the fact that their children were literally at greater risk of being struck by lightning than getting mpox.

Many people were angry that summer that some of the same people who insisted on masking children or keeping everyone at home during Covid were now insisting that gay men should not be asked to take a break from sex with multiple partners. It is evident that this contradiction eroded trust in public health, as you can see here from what @steveguest is saying:
I cannot begin to tell you how much rage people directed at me for simply saying gay men should modify their sexual behaviors to lower their risk of monkeypox. I broke a cardinal gay sin: Never tell a gay man to reel in his sex life. washingtonpost.com/opinions/2022/…
Read 5 tweets
Aug 5
Nearly 40 percent of students at Brown University identify as something other than straight. The growth has been largely among students identifying as bisexual or as queer, pansexual, asexual or questioning. There has been little growth in gay identity. Image
I sourced the survey on LGBAPQ identities from this @BostonGlobe editorial by Sandy Ernest Allen.
archive.is/20250804154202…Image
Read 4 tweets
Aug 3
Mother Jones is re-upping this article from January. The study in question found that, among minors with private health insurance, by age 17, about 1 in 1,000 were on cross-sex hormones during 2018 to 2023. The rate was higher than that for natal girls and was likely higher overall by 2023.
One way of reporting this news is to simply provide readers with the figures and let them decide whether they represent a little or a lot. open.substack.com/pub/benryan/p/…Image
Puberty blockers themselves, multiple studies have found, are not actually associated with any change in mental health metrics.

But MJ reports: Image
Read 5 tweets
Jul 28
The Advocate reports: "Asked whether a parent concerned about their child facing a trans kid in girls’ sports 'has a case,' Pete Buttigieg @PeteButtigieg said, “Sure.” But he rejected blanket policies like the federal bans being enacted by the Trump administration, saying, “These decisions should be in the hands of sports leagues and school boards and not politicians, least of all politicians in Washington trying to use this as a political pawn.”

This statement has inspired a blistering response on Bleuskie—see the 🧵⬇️Image
Journalist Walter Bragman issues a blistering response to @PeteButtigieg’s statement over trans inclusion in sports, calling it “craven shit” and saying Mr. Buttigieg is catering to bigots.

“To just put a fine point on it: Parents do not, in fact, have legitimate concerns about trans kids playing sports,” Mr. Bragman says.

“Just because they believe bullshit doesn’t make it legitimate.

“Fuck anti-trans bigots.”Image
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@PeteButtigieg A person called Guillotine Hunger Force argues that sports is not about winning. Image
Read 10 tweets

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