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Leor Sapir

@LeorSapir

Jun 1

NEW: Two coauthors of the HHS review on treatment for pediatric gender dysphoria argue in @JAMAPediatrics that the Centers for Medicare and Medicaid "should carefully consider whether the proposed rules may be improved by the inclusion of a grandfather clause." 🧵

Kathleen McDeavitt, a psychiatrist at Baylor College of Medicine, and Moti Gorin, a philosopher and bioethicist at Colorado State University, are coauthors (with me) of the U.S. Department of Health and Human Services' peer-reviewed report from last year.

The centerpiece of the HHS review was an "umbrella review" (systematic review of systematic reviews) which confirmed the finding that pediatric medical transition is based on very low certainty evidence (using GRADE).

Appendix 4 contains the umbrella review in full 👇

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Leor Sapir

@LeorSapir

May 21

NEW: @jessesingal with new revelations, based on FOIAs, about the Johanna Olson-Kennedy-led, @NIH-funded ($10m) research initiative on pediatric gender medicine. 🧵

NIH was misled with help from @wpath and @TheEndoSociety.

Olson-Kennedy and her colleagues intended to study the effects of puberty blockers and cross-sex hormones in minors.

NIH initially "expressed qualms" about the proposed study being observational rather experimental. Singal explains the difference, and why it matters.

With support from @wpath and @TheEndoSociety, however, Olson-Kennedy told NIH that the treatments are known to work and that withholding them (i.e., having a control group) would be unethical.

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Leor Sapir

@LeorSapir

May 6

I'm often asked: “What makes pediatric gender doctors do what they do?"

Good question.

Here are 9 overlooked factors, to add to the obvious one: ideological agreement with the “gender-affirming” outlook.

These are unsystematic observations, so take with a grain of salt. 🧵

1. Lack of experience. Early-career doctors lack clinical experience, a critical corrective mechanism to the abstractions they absorb in the classroom. Also, being young, they typically don’t have kids themselves and therefore have not experienced the ways of developmentally typical children and teens. If a young clinician lacks these experiences but constantly sees trans-identified patients, it's easy to see how s/he would have a skewed understanding of human sexual development.

2. Action bias. Medicine—and, some would argue, most of healing—often consists of not doing anything, counting on the body’s natural tendency to heal itself while watchfully waiting to see if/when intervention is needed. For adolescents in the throes of puberty, time and experience typically build resilience and mitigate distress. It’s tempting for inexperienced healers to want to “do something” and to equate inaction with not helping or even harming.

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Leor Sapir

@LeorSapir

Apr 29

Even liberal commentators now realize that the Southern Poverty Law Center is little more than a smear machine.

But it's more than that. It's a vital component in the left-wing policy network encompassing epistemic institutions, media, and parts of the Democratic Party. 🧵

Pediatric gender medicine is an example. A 2023 SPLC report claimed to find that the Society for Evidence-Based Gender Medicine (SEGM), an organization focused on scrutinizing the evidence base for pediatric transition, is a "hate group" and the "hub" of misinformation.

Dig into the report and you'll find that the basis of this allegation is the fact that SEGM disagrees with purported medical authorities claiming that "gender-affirming care" is backed by good evidence. (SEGM's position is confirmed by every systematic review to date.)

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Leor Sapir

@LeorSapir

Mar 27

BREAKING: The New York Times (@nytimes) has just called out the Chair of the Board of the American Medical Association (@AmerMedicalAssn), Dr. David Aizuss (@lasereyedoc), for misrepresenting his organization's recent media statements on pediatric gender medicine.

Here's what happened🧵

On February 3, the American Society of Plastic Surgeons (@ASPS_News) published its policy statement acknowledging the low quality of evidence for hormones and surgeries in <19 and recommending that surgeries be deferred to age 19+.

The following day, the American Medical Association told National Review (@NRO) and the New York Times (@nytimes) that it agreed with ASPS on surgeries.

Here is what the AMA's communications officer, Joshua Zembik, told the NYT:

Read 6 tweets

Leor Sapir

@LeorSapir

Mar 3

Two articles came out today on pediatric gender medicine and its current political context.

Both are worth reading🧵

In @TheAtlantic, @benappel writes about the difficulties growing up as an effeminate boy. He would later discover that so-called "progressives" were now nudging effeminate boys to interpret their feelings of difference as evidence that they are really girls.

Appel calls for an honest conversation among liberals of how a regressive outlook, now fueling a medical practice, has managed to pass itself off as progressive. And he calls for greater tolerance for gender nonconformity in boys from liberals and conservatives.

(Link below)

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