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Leor Sapir Profile picture
@LeorSapir
Apr 4, 2023 • 6 tweets • 2 min read • Read on X
Two groups representing LGBTQ+ medical professionals (@GLADDUK and @prism_surgery) submitted a letter of complaint to the prestigious British Medical Journal (@bmj_latest).
The BMJ’s crime: pointing out problems in the “gender affirming care is science-based” narrative. GAC is consensus-based (that is, if you ignore doctors, medical groups, and European health authorities who disagree), but not evidence-based.

bmj.com/content/380/bm…
Since “the science is settled” on this issue and any questioning of that science is clear evidence of bigotry, the letter demanded an apology.
The two groups also demanded that the BMJ disclose whether the author or the editor harbor “gender critical” beliefs (read: beliefs that question the activist-approved narrative on pediatric gender medicine).
“Gender critical” beliefs, you see, are strictly verboten and those who adhere to them must confess and atone.
BMJ’s editor in chief politely declined the requests, telling the two orgs to fu… I mean, to rediscover their commitment to the scientific process.

Let’s hope American medical journals get inspired.

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More from @LeorSapir

Leor Sapir Profile picture
May 13
This statement by @AAPPres of @AmerAcadPeds, in response to the interview with Hilary Cass in the NYT times, is so utterly dishonest. It implies that the AAP's position was articulated in response to state age restriction laws. 1/5 Image
The AAP's policy position was published in 2018--well before age restriction laws were first introduced in the states (2020).



@AbigailShrier's Irreversible Damage, which brought the issue to public attention, also didn't come out until 2020. 2/5publications.aap.org/pediatrics/art…
Here are two key passages from the AAP's 2018 statement, "Ensuring Comprehensive Care": one clearly suggesting that "the available data" support puberty blockers, and another deferring to WPATH SOC-7 and Endo 2017, which the Cass systematic review on guidelines found to be untrustworthy. 3/5Image
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Read 5 tweets
Leor Sapir Profile picture
May 8
NEW: UCSF's (@UCSF @UCSF_IHPS) Dr. Jack Turban (@jack_turban) claimed at @theDPUnion debate that the Cass-related systematic reviews found moderate quality evidence that puberty blockers improve mental health.

In a new article, I explain why this claim is false.

⬇️⬇️⬇️
2/ First, Turban confuses quality of studies with quality of evidence. These are distinct concepts in evidence-based medicine, and any clinician opining on the evidence base of medical treatments should understand the difference.
3/ Quality of studies has to do with risk of bias in research. Quality of evidence has to do with our confidence in the estimate of the effects of an intervention on outcomes of interest.
Read 18 tweets
Leor Sapir Profile picture
May 5
UCSF's (@UCSF @UCSF_IHPS) Jack Turban (@jack_turban) claims that a new systematic review of the evidence for puberty blockers, published alongside the Cass Review (@thecassreview), finds “moderate quality evidence" for the use of these drugs in youth gender medicine.

⬇️⬇️⬇️
In an upcoming article, I explain how Turban confuses quality of studies with quality of evidence—two very different concepts in evidence-based medicine—and ignores the significance of the scoring tool the authors of the systematic reviews used. 2/
As science journalist Ben Ryan (@benryanwriter) points out, Turban conveniently forgot to disclose to the Dartmouth audience that the new systematic review excluded his own 2020 study on puberty blockers from the final synthesis. 3/

Read 10 tweets
Leor Sapir Profile picture
Mar 27
I just read the complaint filed by the ACLU of Ohio (@acluohio) asking a state court for temporary injunction against HB68, the new law that restricts “gender-affirming care" to adults only.

What a mess of a document.

⬇️⬇️⬇️
1. ACLU can’t seem to decide if it’s alleging disparate treatment or disparate impact. These are different theories for why some law or policy may violate civil rights or constitutional provisions.
The ACLU says that “transgender people have obvious, immutable, and distinguishing characteristics that define that class as a discrete group.” HB68 “expressly discriminates against transgender adolescents… based on the incongruence between their sex and gender identity.”
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Read 26 tweets
Leor Sapir Profile picture
Mar 22
Andrea Long Chu's (@andrealongchu) March 11th cover story for @NYMag has sparked some thoughtful reflection in liberal journalism.

⬇️⬇️⬇️
Chu’s essay is worth reading. It makes the case for unrestricted minor access to hormones and surgeries, ignores everything we know about child and adolescent psychology, and openly states that humans have no obligation to come to terms with reality.
I would argue that what Chu says *should* happen in pediatric medicine *already is* happening, more or less.

nymag.com/intelligencer/…
Read 13 tweets
Leor Sapir Profile picture
Mar 10
The Mary Bridge Children's Gender Health Clinic (@Mary_Bridge), which is part of MultiCare health system (@MultiCareHealth) in Tacoma, Washington, and site of whistleblower Tamara Pietzke, offers kids resources on binding and tucking. /1

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Tucking is the process by which boys push their testicles up into the inguinal canal, use their testicle-free scrotum to wrap their penis, and then secure their wrapped penis within their butt cheeks using methods like compression underwear or tape. /2
The Mary Bridge gender clinic says that tucking is "normal for many identities." It admits, however, that "research on the safety" of this practice, including about harmful side-effects, "is very limited and sparse," and recommends that kids do "[their] own research." /3
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Read 8 tweets

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