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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
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
Image
Image
Read 8 tweets
Benjamin Ryan Profile picture
Apr 1
HOW GENDER MEDICINE SET ITSELF UP FOR DISASTER

For @CompactMag, I report on what the 100s of WPATH conference videos I obtained tell us about this troubled field: compactmag.com/article/how-ge…

👉I 'll be publishing the conference videos on my Substack: benryan.substack.com/p/i-obtained-1…

As I write for Compact magazine:

This catalogue, which the World Professional Association for Transgender Health, or WPATH, fought to keep shielded, provides a rich account of how leading figures in pediatric gender medicine approached scientific research, drove the evolution of medical practices, and strategized politically during a critical turning point in this field’s brief and tortured history. The two years following Chase Strangio’s 2021 address were a period in which statehouse Republicans escalated their attacks on this field. The WPATH conference presenters largely responded to the political siege by doubling down. Rather than engage in soul searching over whether their methods in pediatrics were ethically sound and whether any criticisms had merit, they overwhelmingly stuck to their guns.

Presenters frequently downplayed fundamental hazards about irrevocably altering adolescents’ bodies. Meanwhile, a parade of systematic reviews—the gold standard of scientific evidence—was concluding that the evidencebacking pediatric gender medicine is weak and inconclusive. These findings have led health authorities in a number of European nations, concerned about risks such as infertility, to reverse course. They reclassified pediatric gender-transition interventions as experimental and sharply restricted minors’ access.

Not WPATH. The organization remained on an inexorable trajectory in the opposite direction, toward its eventual head-on collision with the second Trump administration.

For highlight clips, see the 🧵👇Image
Kellan Baker counseled against saying “gender-affirming care.” Messaging research indicated that when people hear it, he said, “they think ‘trans kids in the driver’s seat.’” But he said this was an accurate assessment. “I think we all support trans kids in the driver’s seat because it’s their bodies, it’s their lives,” he said.

“But when you think about folks who don’t know trans people, they are very scared by the idea that young people are making irreversible decisions and that no one else has any oversight over those decisions.”

To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…

I will be publishing the most notable conference videos on my Subsack: benryan.substack.com/p/i-obtained-1…
Johanna Olson-Kennedy: “I think that a lot of this conversation...gets talked about through a lens of ‘How can we make sure people are really trans,’ right? And ‘They’re not going to regret their decision later?’” But “that’s actually not the discussion that I’m interested in participating in," she said. "I’m interested in discussing and having a conversation about giving the very best possible care to trans young people—the care that they need and deserve.”

To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…

I will be publishing the most notable conference videos on my Subsack: benryan.substack.com/p/i-obtained-1…
Read 6 tweets
Benjamin Ryan Profile picture
Mar 29
🧵👇Debunking podcaster Michael Hobbes is wrong about the American Medical Association’s longstanding position about youth gender surgeries.

Before Feb. 2026, the AMA had never specified that gender surgeries should generally be reserved for adults.

In 2024, the AMA asserted: “Our American Medical Association recognizes that medical and surgical treatments for gender dysphoria and gender incongruence, as determined by shared decision making between the patient and physician, are medically necessary as outlined by generally-accepted standards of medical and surgical practice.”

No mention of age limits.

policysearch.ama-assn.org/policyfinder/d…Image
Hobbes is pointing to this WPATH FAQ without acknowledging (or knowing) that it actually misrepresents what the organization’s trans-care guidelines, The Standards of Care Version 8 (SoC 8) says. WPATH famously removed all age limits (except for phalloplasty) in the SoC 8 when it was published in Sept 2022 under pressure from the American Academy of Pediatrics.Image
Hobbes fails to understand that the original reporter who published the AMA’s statement saying it sided with the ASPS on youth gender surgeries was not Jeremy Peters, it was Andrew Jacobs, who could in no way be considered a part of this supposed “anti-trans braintrust.” Peters was only reiterating what Jacobs originally reported.

And yes, the statement was a shift, otherwise the AMA wouldn’t be trying to walk it back and say they were misquoted. Because the AMA knows that the statement reads as if they did make a shift in policy.Image
Read 6 tweets
Benjamin Ryan Profile picture
Mar 26
Is the AMA Telling the Truth About Their Expressed Positions on Youth Gender Surgeries?

The American Medical Association to the @StrackHaley at the National Review @NRO on Feb. 3: "[T]he AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood."

The @AmerMedicalAssn today: "We responded" to questions about the American Society of Plastic Surgeon's opposition to pediatric gender-transition surgeries "only after being contacted by media outlets, using the language approved by the board. While some media coverage characterized this as agreement with the ASPS statement, that phrasing did not come from the AMA."
The AMA on Feb 3:
nationalreview.com/news/first-maj…Image
The AMA today: Image
Read 5 tweets
Benjamin Ryan Profile picture
Mar 17
Meghan Wachspress, who accused Illinois congressional candidate Daniel Biss of an "inappropriate relationship" after he, at 26, was her math prof and she, 20, was his student and the 2 dated for a while and made out in '04, wrote on Substack in 2025 that MeToo didn't go far enough.

"In an alternate universe the experiences encompassed by #metoo could have expanded outward to include other kinds of workplace interactions and structural inequalities that minimized or objectified women in the Kantian sense (making them men’s tools), costing women status, money, and time compared to their male colleagues," she wrote.
substack.com/home/post/p-16…Image
She also posted this:
Wachspress did a stint on Jeopardy.

jeopardyhistory.fandom.com/wiki/Megan_Wac…
Read 4 tweets
Benjamin Ryan Profile picture
Mar 3
IN DEFENSE OF EFFEMINATE GAY BOYS

If anyone had suggested that I might really be a girl, I don’t know how I would have responded, by @BenAppel for @TheAtlantic.

GIFT LINK: theatlantic.com/ideas/2026/03/…Image
Similarly, @chadfelixg wrote:

thefederalist.com/2020/02/24/if-…
@chadfelixg Harvard Law School clinical instructor and trans activist Alejandra Caraballo is unhappy about @BenAppel’s article in @TheAtlantic, calling it the “‘they're transing the gays’ conspiracy theory.” Image
Read 5 tweets

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