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Leor Sapir Profile picture
@LeorSapir
Jul 13, 2023 • 12 tweets • 3 min read • Read on X
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BREAKING:

21 leading experts on pediatric gender medicine from 8 countries have written a Letter to the Editor of @WSJopinion expressing disagreement with the @TheEndoSociety and its new president @StephenHammes over the treatment of youth gender dysphoria.

This is huge. 🧵
Although they have commented on the problems of the American "affirming" model in the past (e.g., Cass Report), this is the first time international experts have publicly weighed in on the American debate over "gender-affirming care."
Among the intl' experts is Dr. Riita Kaltiala, chief psychiatrist at Tampere University gender clinic, author of numerous peer-reviewed articles on trans medicine, and Finland's top authority on pediatric gender care.
The letter follows an illuminating exchange between @donoharm and @TheEndoSociety @StephenHammes in the pages of @WSJopinion.

The letter states that while Endocrine Society president and "gender-affirming care" practitioner Dr. Hammes’ may think his own clinical experience and existing research support his position, his belief "is not supported by the best available evidence."
It mentions that (unlike U.S. medical associations) health authorities abroad have relied on systematic reviews of evidence for the benefits of hormonal interventions and found these benefits to be without reliable evidence.
To recall, the main value of systematic reviews is that they don't just summarize the available studies but assess their strengths and weaknesses. This is key, because proponents of child sex trait modification frequently just mention individual studies.
Dr. Hammes' claim that "gender-affirming care" is a suicide prevention measure, the intl' experts say in their WSJ letter, "is contradicted by every systematic review."
Dr. Kaltiala had previously called the affirm-or-suicide narrative "purposeful disinformation" and its promotion (given the contagious nature of suicide) "irresponsible."

tabletmag.com/sections/scien…
"The politicization of transgender healthcare in the US is unfortunate," write the intl' experts. "The way to combat it is for medical societies to align their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks."
Read the letter here: wsj.com/articles/trans…
For an analysis of how and why the U.S. and Europe are diverging:

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More from @LeorSapir

Leor Sapir Profile picture
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. Image
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)
Read 7 tweets
Leor Sapir Profile picture
Feb 24
NEW: “I’ve been covering this controversy for about a decade from a left-of-center perspective, and I’ve found that anyone who questions these treatments, even mildly, is invariably accused of bigotry.”

🧵on @jessesingal’s important new piece in the New York Times this morning. Image
For years, LGBT organizations insisted that the science of youth gender medicine was settled, citing an apparent consensus of medical associations. Image
Now that the American Society of Plastic Surgeons has backed away from gender surgeries in <19, with the American Medical Association endorsing the move, there is no longer a consensus. The ASPS also acknowledged the lack of supportive evidence for hormones. Image
Read 8 tweets
Leor Sapir Profile picture
Feb 18
🚨A group of 106 members of Congress wrote a letter to Secretary of HHS RJK, Jr., criticizing the Department's efforts to roll back what they call "medically necessary, evidence-based care" in the form of puberty blockers and cross-sex hormones (but not surgeries). 🧵 Image
With surgeries unmentioned, the authors say that endocrine interventions are supported by "every major medical and mental health association in the U.S." Image
Astoundingly, they claim that "numerous studies and systematic reviews... have confirmed the safety, efficacy, and benefits" of these interventions.

Their only citation is the Utah report, which is not a systematic review.

See, e.g., Section 2.4 here: opa.hhs.gov/sites/default/…Image
Read 6 tweets
Leor Sapir Profile picture
Feb 7
🚨While attention has been focused on medical groups backing off from gender surgeries in minors and a $2M detransitioner lawsuit, an important exchange has taken place in Stat News Opinion First between authors and critics of the HHS report on pediatric gender dysphoria.

👇
Last week, a group of self-described “pediatric bioethicists” and advocates for pediatric medical transition (PMT), including Yale Medicine’s Meredithe McNamara, criticized the HHS report, writing that “analysis of its poor ethical reasoning remains urgently needed.” Image
Today, a group of HHS report authors responded, explaining why the report’s reasoning is consistent with widely accepted principles of medical ethics and pointing to serious flaws in the McNamara group’s article. Image
Image
Read 5 tweets
Leor Sapir Profile picture
Feb 3
BREAKING: American Society of Plastic Surgeons issues new position statement opposing "gender-affirming" surgeries in adolescents under the age of 19.

ASPS also acknowledges risks of endocrine interventions, poor guidelines, and inappropriate use of "autonomy" principle. Image
plasticsurgery.org/for-medical-pr…
Here is the @HHSGov @HHSResponse press release

hhs.gov/press-room/asp…
Read 10 tweets
Leor Sapir Profile picture
Feb 2
Thousands of U.S. parents have consented to having surgeons remove their daughters' breasts after being assured that their daughters were at serious risk of suicide otherwise.

Now, the incoming president of WPATH says mastectomy "in and of itself" doesn't prevent suicide.
This is the result of our data analysis of U.S. insurance claims. A bare minimum of 5,200 teen girls had their breasts amputated as part of a "gender-affirming" procedure between 2017 and 2023.

The true number is likely quite a bit higher. Image
city-journal.org/article/a-cons…
Read 4 tweets

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