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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
Jun 5
The long-awaited New York Times six-part podcast series on pediatric gender medicine, The Protocol, is up. Image
Apple: podcasts.apple.com/us/podcast/the…

YouTube: youtube.com/playlist?list=…
Wouldn't it be amazing if people listened to the entire six-part Time series on pediatric gender medicine before they made up their minds about it?
Read 34 tweets
Benjamin Ryan Profile picture
Jun 4
I have been subjected to Alejandra Caraballo’s calls for people to blacklist me. She is one of the loudest and most effective voices to silence and intimidate reporters covering pediatric gender-transition treatment.
How Cancel Culture Is Still Coming For Me


And how activists will eagerly cut off their noses to spite their faces in service of virtue signaling and maintaining an image of ideological purity amid the battle over pediatric gender medicine. open.substack.com/pub/benryan/p/…Image
Jesse Singal covered Caraballo's unhinged attacks on me two years ago:
jessesingal.substack.com/p/on-alejandra…Image
Read 5 tweets
Benjamin Ryan Profile picture
May 28
Pete Buttigieg told @BulwarkOnline that if he could do it over, he would’ve worked to get the schools open faster in 2020. In response, @TaylorLorenz denounced him as a eugenicist.

Meanwhile, @DavidZweig’s new book presents an avalanche of evidence indicating that school closures likely did not reduce morbidity and mortality and harmed children. He also demonstrates that there was considerable evidence of the apparent lack of benefit from European nations as early as May 2020.Image
I interviewed @davidzweig about his book about the folly of the Covid school closures, An Abundance of Caution, for my pod. I drew parallels to the pediatric gender medicine field:

open.substack.com/pub/benryan/p/…Image
@davidzweig “Today, there is broad acknowledgment among many public health and education experts that extended school closures did not significantly stop the spread of Covid, while the academic harms for children have been large and long-lasting.” nytimes.com/2024/03/18/ups…
Read 5 tweets
Benjamin Ryan Profile picture
May 25
The Utah state government commissioned a report on pediatric gender-transition treatment. It comes in at over 1,000 words and concludes that the evidence favorably backs such treatment.

But despite the fact that it bills itself as a systematic literature review, it isn't one.

The authors of the report, from the University of Utah College of Pharmacy, did not register their methodology on PROSPERO in advance as is required for a systematic literature review. Nor did they rate the quality of the evidence as all other systematic reviews of this field have. What's more, their report explicitly takes on faith the claims of authors of treatment guidelines that their own process in developing those guidelines was rigorous. This after the University of York's systematic literature review on such guidelines, published in April 2024, found that all but a couple of such guidelines were of poor quality and not reliable.

Essentially, this report is a narrative review that summarizes the bulk of the research in this field. But it does not seek, like all the actual systematic literature reviews have, to make sense of whether that research is reliable and whether it can properly guide doctors and families in making a solid calculation about the risks vs benefits of these drugs when given to children.

In sum, this report reflects everything that the authors of systematic literature reviews and groups like @SEGM_EBM have been seeking to respond to.Image
Source: le.utah.gov/AgencyRP/repor…
Note also that the bulk of the report's 1,000 pages is taken up by a compendium of abstract after abstract of the studies they considered, or chart after chart breaking them down. So it's not as if the authors actually wrote anything approaching 1,000 pages.
Read 11 tweets
Benjamin Ryan Profile picture
May 14
I strongly advise people who think that @AlecMacGillis, who wrote one of the finest Covid-era articles critiquing the school closures, is “lying” about their impacts read @DavidZweig’s scathing new book about the lockdowns, An Abundance of Caution.

Zweig makes a very strong case that there was substantial evidence by spring 2020 that lockdowns did not substantially lower COVID morbidity and mortality. And he further makes a very strong case that the lockdowns harmed kids in myriad ways.

I also suggest people stop and consider that Blooskie is just as toxic as X, but in a kind of mirror image.
Here is my interview with @davidzweig about his book on the Covid school closures. open.substack.com/pub/benryan/p/…Image
This is @AlecMacGillis’ heartbreaking article about how the Covid school closures impacted a small town, and how the lack of them in a neighboring town didn’t seem to lead to worse covid outcomes. propublica.org/article/the-lo…
Read 5 tweets
Benjamin Ryan Profile picture
May 14
Helping out young people need not be a zero-sum effort. Accurately observing that boys are falling behind in many respects need not divert attention away from the plight of women and girls. The real problem is when people pit the interests of the sexes against one another. Moira Donegan really should go read @RichardVReeves’ work and stop trying to be so divisive and dismissive about a real and serious problem facing boys and young men.Image
In fact, Moira's attitude, which is essentially, "Screw those boys, the girls need help," is a pervasive bias that is likely part of the reason why boys are struggling! People look at boys and see the patriarchy and something that needs to be pushed down. This is harmful to everyone in the long run, boys and girls alike.
Also Moira Donegan: She made the "Shitty Media Men" list and paid a six-figure settlement to Stephen Elliott over it after he sued her.
washingtonpost.com/media/2023/03/…
Read 5 tweets

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