Benjamin Ryan Profile picture
Oct 3, 2023 13 tweets 5 min read Read on X
Nebraska has issued a new, quite intense set of regulations for kids with gender dysphoria. To access gender-transition medication, they must receive 40 hours of therapy that is "clinically neutral and not in a gender-affirming or conversion context." 🧵⬇️
web.archive.org/web/2023100123…
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Nebraska's new regulations for gender dysphoric youth seeking puberty blockers require that clinicians document that the child's distress is driven by the dysphoria and not by other mental or physical health conditions, and that the dysphoria is unlikely to naturally resolve. 2/ Image
The gender dysphoric child in Nebraska (defined as under 19 years old) must live in the preferred gender for six straight months before qualifying for puberty blockers. 3/ web.archive.org/web/2023100123…
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To access puberty blockers, Nebraska kids must be informed of risks: "long-term effects on bone density, brain development, impact on fertility, sexual side effects including, but not limited to, loss of sexual gratification, and effects upon physical growth and development." 4/ Image
To provide cross-sex hormones to children in Nebraska, providers must document that the use of puberty blockers, if prescribed, "has been successful at reducing patient distress and discomfort". 5/ web.archive.org/web/2023100123…
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Nebraska children seeking cross-sex hormones must be informed of risks, including: "long-term effects on cardiovascular and cerebrovascular systems, metabolic disorders, increased risk of cancer, bone density, brain development, impact on fertility, sexual side effects." 6/ Image
Nebraska children seeking cross-sex hormones must be informed of potential sexual side effects, "including, but not limited to, loss of sexual gratification, and effects upon physical growth and development." 7/ Image
Trans legislative analyst Erin Reed @ErinInTheMorn denounces the Nebraska regulations. And the fact that the regulations explicitly state that the required therapy should not be conversion therapy notwithstanding, she asserts that it will be just that. 8/ erininthemorning.com/p/nebraska-to-…
@ErinInTheMorn has previously denounced a new model of psychological counseling for gender dysphoric youth, "gender-exploratory therapy" as conversion therapy. 9/ erininthemorning.com/p/gender-explo…
Gender-exploratory therapy has been championed by Erica Anderson, a clinical psychologist and a past president of the trans health care group USPATH, and Laura Edwards-Leeper, the founding psychologist of the first pediatric trans clinic in the U.S. 10/ washingtonpost.com/outlook/2021/1…
I spoke with Edwards-Leeper this week and she told me: "Conflating conversion therapy and identity exploration is perhaps the largest threat to both gender distressed cisgender youth and transgender youth, alike. The rhetoric being used to conflate the two must stop immediately."
Florence Ashley, of the Faculty of Law at the Univ of Alberta, is among the trans advocates who have denounced as apparent conversion therapy various counseling modalities for gender dysphoric kids that don’t follow the affirmative model. @ButNotTheCity
journals.sagepub.com/doi/10.1177/17…
Trans activist and clinical instructor at the Harvard Law Cyberlaw Clinic, Alejandra Caraballo (@Esqueer_) has denounced gender-exploratory therapy as "conversion therapy, full stop." x.com/Esqueer_/statu…
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More from @benryanwriter

Jun 30
Fact checking Michael Hobbes

Debunking podcaster Michael Hobbes has a new episode of his podcast If Books Could Kill, about the US v. Skrmetti Supreme Court decision upholding Tennessee's ban on pediatric gender-transition treatment.

In this🧵I will fact check Hobbes:
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Here is a link to the podcast: podcasts.apple.com/us/podcast/the…
Michael Hobbes, referring to a video, published in 2022 by @MattWalshBlog, of a Vanderbilt doctor talking about the money that gender-transition surgeries bring in, including bottom surgeries: “Bottom surgeries are essentially not performed on children," Hobbes says. "So the fact that she's talking about bottom surgeries here makes it very clear that she's talking about adults.”

This depends on your definition of "essentially." Phallopasties are not recommended by @WPATH for minors, but vaginoplasties are. Dr. Marci Bowers, a gender-affirming surgeon and a former WPATH president, recommends that trans girls get a vaginoplasty the summer before they leave for college, when they are 17 or 18.

A 2023 paper on a limited dataset of US minor patients did find evidence of one vaginoplasty in 2021. This suggests that if the study authors had access to all records in the nation, they would identify more such surgeries in minors.

Consequently, Hobbes is incorrect to presume that the Vanderbilt doctor was not referring to minors in the speech that Walsh published. It is entirely possible she was.

pmc.ncbi.nlm.nih.gov/articles/PMC10…Image
Read 26 tweets
Jun 30
If, for the sake of argument, no one can prove that pediatric gender-transition treatment prevents suicide death only because such deaths are so rare, then why has this treatment been sold, first and foremost, as “lifesaving”?

Why have people who have called that claim into question been savagely attacked and sidelined?

Marci Bowers, former head of WPATH, herself told me last year that suicide death has never been a good metric of the success of this treatment.Image
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Debunking podcaster Michael Hobbes is himself one of the prime sources of misinformation about pediatric gender-transition treatment. He has routinely falsely claimed that there is no evidence that children get these drugs after absent or cursory assessment periods. There is copious evidence that this happens routinely at some of the top gender clinics in the nation. Despite all this evidence, Hobbes has never acknowledged his fault.

But you can see here that he is combining his longstanding claim about assessments with a claim about what he characterizes as false claims that there are large numbers of kids getting these drugs. That question should not necessarily be conflated with the assessment question.

About 1 in 1,000 youth with private health insurance went on cross sex hormones by age 17 between 2018 and 2022. That number was higher for natal girls and was probably higher for all youth by the end of that period.

One thing that has concerned some people is not necessarily the number of kids getting these drugs, but the rate of increase of that number. They have been concerned over where that figure might end up.Image
If suicide deaths are so rare even in youth with gender dysphoria, then why have leading gender clinicians routinely told parents that absent blockers and hormones, their child was extremely likely to wind up dead? That’s what the mantra “Would you rather have a dead son or a live daughter?” implies. We now know from the leading litigator in this field that that threat was a false one, at the very least in the suggestion of how likely suicide death was in the first place.Image
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Read 4 tweets
Jun 29
The Liberal Misinformation Bubble About Youth Gender Medicine

How the left ended up disbelieving the science

By @HelenLewis for @TheAtlantic Image
Debunking podcaster Michael Hobbes, a prime source of misinformation about pediatric gender-transition treatment, slams @HelenLewis of @TheAtlantic for criticizing people such as him.
Read 5 tweets
Jun 27
The Bleuskie crowd is livid over Andrew Sullivan’s Times opinion essay about LGBTQ activism: 🧵 Image
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Read 6 tweets
Jun 26
How the Gay Rights Movement Radicalized, and Lost Its Way

By Andrew Sullivan for @nytopinion
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GIFT LINK: How the Gay Rights Movement Radicalized, and Lost Its Way

By Andrew Sullivan
nytimes.com/2025/06/26/opi…
Ten years ago Thursday, the movement for gay and lesbian equality scored a victory that only a decade before had seemed unimaginable. We won equal rights to civil marriage in every state in the country. In 2020 came another stunning win. In a majority opinion written by one of President Trump’s nominees, Justice Neil Gorsuch, the Supreme Court found that gay men, lesbians and transgender men and women are covered under Title VII of the 1964 Civil Rights Act, and protected from employer discrimination.

In 2024, the Republican Party removed opposition to marriage equality from its platform, and the current Republican Treasury secretary, Scott Bessent, is a married gay man with two children. Gay marriage is backed by around 70 percent of Americans, and discrimination against gay men, lesbians and transgender people is opposed by 80 percent. As civil rights victories go, it doesn’t get more decisive or comprehensive than this.Image
Read 41 tweets
Jun 21
Debunking podcaster Michael Hobbes has issued a stream of false or misleading claims about the Times article about the @ACLU’s tangled path to Skrmetti—the SCOTUS case on pediatric gender-transition treatment.

Allow me to demonstrate how wrong Hobbes is.

🧵⬇️ Image
The thing about conspiracies is that sometimes they actually occur. Subpoenaed records show WPATH squelched systematic reviews of gender care they commissioned when the results did not support their advocacy movement.

And Hobbes, perhaps because he doesn’t know or understand what those reviews are about, issues a sleight of hand by suggesting that the reviews were irrelevant since there is no evidence kids are getting rushed into surgeries. But that’s not what the reviews were about. They were about the strength of the evidence backing gender-transition treatments.Image
One of Hobbes’ methods is he believes that all the supposedly bad-faith actors he scrutinizes work out of a common playbook.

The subpoenaed records show that WPATH leaders went well beyond trying to keep their work from being weaponized. They coordinated with Chase Strangio and others at the ACLU to draft their trans-care guidelines for the purpose of helping them win lawsuits, even as WPATH leaders themselves were already directly involved in such suits. And absent scientific justification, they included words like “medically necessary” in the guidelines for the purpose of securing insurance coverage.

But in Hobbes’ telling, the only bad-faith actor in this story is the Alabama attorney general for uncovering these records that revealed these actions on WPATH’s part.

This raises the question: Should those who create medical guidelines be transparent and remain honest with doctors and the public about the ways that the science is lacking?Image
Read 16 tweets

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