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Leor Sapir Profile picture
@LeorSapir
Jul 13, 2023 • 12 tweets • 3 min read • Read on X
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
Aug 12
BREAKING: The American Society of Plastic Surgeons, an organization representing 92% of all board-certified plastic surgeons in the U.S., becomes the first major medical association to break from the consensus over “gender-affirming care” for minors.

This is big news. 🧵
2/ In the U.S., the use of puberty blockers, cross-sex hormones and surgeries to help kids who feel distressed about their developing bodies has depended on a perceived consensus of medical groups.
3/ Critics argue that the consensus is manufactured and enforced through suppression of alternative viewpoints and of evidence reviews. The @AmerAcadPeds, for instance, has suppressed member initiatives to get the group to conduct a systematic review of the evidence.
Read 15 tweets
Leor Sapir Profile picture
Aug 7
🚨 This is an extremely important new report by @writingblock for @TheFP about Planned Parenthood (@PPFA), a leading supplier of on-demand hormones to troubled teens and young adults.

Highlights... 🧵 1/9

thefp.com/p/how-did-plan…
2/ # of PPs offering "gender-affirming" hormones:

2005: 1
2015: 24 (approx.)
2024: 450

Current annual revenue: $2 billion (approx.)
3/ "Insurance claim information provided to @TheFP by @ManhattanInst shows that at least 40,000 patients went to Planned Parenthood for this purpose last year alone, a number that has risen tenfold since 2017. The largest proportion, about 40 percent, were 18- to 22-year-olds."
Read 11 tweets
Leor Sapir Profile picture
Jul 26
In a new article in @latimes, @MackenzieMays takes aim at @ChoooCole, a prominent detransitioner.

Mays' article is full of errors & misrepresentations.

Here is just one example of how Mays misrepresents the science she herself cites. ⬇️

latimes.com/california/sto…
Arguably, Mays' most important empirical claim is that regret is very rare, and that “some studies” show a regret rate of “as little as 2%.”

The study she cites for this claim is Dhejne et al., “An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets,” Arch Sex Behav (2014). This is a Swedish study based on data from a national database.
In the Dhejne study, a person is defined as transsexual (and thus part of the denominator) only if s/he had undergone “sex reassignment surgery” (SRS) and had obtained a new legal document reflecting the “new” sex. This required prior approval by Sweden’s National Board of Health and Welfare.
Read 16 tweets
Leor Sapir Profile picture
Jul 8
NEW: @ManhattanInst colleagues @ishapiro @JKetcham91 and I have submitted an amicus brief in support of parents suing the Eau Claire Area School District in Wisconsin over its secret gender transition policy.

This is a "Brandeis brief" on social transition.

⬇️⬇️⬇️
2/ The school district instructed staff that “parents are not entitled to know their kids’ identities [at school]. That knowledge must be earned.”

According to the complaint, a teacher posted a flyer with: “If your parents aren’t accepting of your identity, I’m your mom now.” Image
3/ The school district's policy requires developing a "Student Gender Support Plan" while using the student's given name and actual sex when communicating with parents, thus keeping them in the dark.
Read 8 tweets
Leor Sapir Profile picture
Jul 3
1/ This is incredible. In the last 24 hrs, the Biden White House’s lack of message discipline accidentally revealed that its official statements on youth gender medicine are dictated to it by outside transgender activists and pressure groups.
2/
3/
Read 4 tweets
Leor Sapir Profile picture
May 21
McMaster University's @Real_Yuan24, an expert in evidence-based medicine, makes some important comments about the "values and preferences" component of clinical guidelines, specifically in the context of gender medicine.

Here is a thread with his observations. 🧵
2/ For context, in EBM evidence alone is not enough for the development of clinical guidelines. When moving from evidence to recommendations, clinical practice guideline developers are also supposed to take into account patient "values and preference" (among other things).
3/ The bedrock ethical principle here is respect for patient autonomy. But the risk of leaning too much on V&P is having medicine deteriorate into consumerism. So, the question is how to balance V&P (autonomy) with medical expertise and clinician responsibility.
Read 18 tweets

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