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…
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/
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…
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/
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…
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/
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/
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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Dr. Blair Peters,a gender-transition surgeon at OHSU, responds with disdain to the American Society of Plastic Surgeons coming out against such surgeries for minors. He says the broader membership was never polled about this.
Which is the same thing that has happened at the American Academy of Pediatrics, for example, but going in the other direction. No matter how hard @JuliaMasonMD1 has pushed, the AAP’s 2018 policy statement on the gender-affirming care method has never been up for a vote by the broader membership.
All of the major medical organizations that have led the way in establishing pediatric gender medicine’s broader credibility, including the AAP and the Endocrine Society in particular, have supported these practices in minors based on the decisions of small committees.
The AAP’s 2018 policy statement was written by a single person, Dr. Jason Rafferty, who was a resident at the time.
All of the other medical societies’ little committees have followed these other groups’ lead, along with WPATH. This has given the illusion that all medial providers support these practices in minors.
But I’ve spoken to pediatricians who are too afraid to express their concerns at the AAP’s annual conference for fear this will destroy their careers.
More from Blair Peters:
In 2024, Dr. Blair Peters, aka “Queer Surgeon,” spoke with the head of the ASPS and they had this remarkable exchange about whether doctors can be trusted to self police.
People are shocked that all it took for the AMA to change its policy on pediatric gender transition surgeries was for another medical group, the ASPS, to do it. But this phenomenon is how the unanimity among the medical groups fell into place in the first place. It was only ever based on a few small committees within a couple of medical organizations, putting aside WPATH, which is a quasi-activist-medical organization.
It got started in the 2010s as WPATH and the Endocrine Society, which have a lot of overlap between them and referred to one another's guidelines in their citations, put out guidelines. And then in 2018 a single medical resident wrote the American Academy of Pediatrics' policy statement on the gender-affirming care method. Along the way, other major medical associations took these other groups' lead, including the APA and AMA. And then all the other ones fell in line.
These groups did not conduct major independent analyses of the evidence. Even the AAP never conducted a systematic literature review to support its policy statement. And in August 2023, the AAP said it was going to conduct one. But there is no sign that the organization has even started on that. Because if they ever did, there is only one conclusion that it could have: that the evidence backing providing gender-transition interventions to minors is weak and inconclusive.
All this is to say is that the mantra "all major medical association support gender affirming care for kids" was always a hallow claim. What it really meant is that: "A few small committees at a few organizations decided to support this, in part because of one another, and all the other small committees at all the other organizations followed their lead."
If you want to go down the rabbit hole of how citation laundering laid the groundwork for the supposed medical consensus on gender-transition treatment for minors, I highly recommend @buttonslives's reporting: buttonslives.news/p/new-systemat…
At 16, Fox Varian got a mastectomy while undergoing a gender transition. She sued her psychologist and plastic surgeon for leaving her ‘disfigured for life.’ Benjamin Ryan reports from the courtroom.
Follow and support my Substack, where I cover pediatric gender medicine: benryan.substack.com. I was the only reporter to attend the entire three-week trial and will be providing more in-depth reporting and commentary on the case.
The opening of my Free Press article:
Fox Varian had a turbulent childhood. Her parents split when she was seven, triggering a three-year custody battle that ultimately saw her estranged from her father. She suffered from a constellation of mental health problems, including depression, anxiety, and social phobia. She was diagnosed with autism and bounced around various schools. Her first period sent her into a meltdown, and she battled disordered eating and body-image issues. By mid-adolescence, she was completely lost.
At 15, she began questioning her gender during sessions with her psychologist. She changed her birth name, Isabella, to Gabriel, which she saw as androgynous. Over the next two months, she cut her hair short, began binding her breasts, switched her name again, to Rowan, and started telling people she was transgender.
In December 2019, 11 months after she started this public social transition, Varian underwent surgery to remove her breasts. She was 16 years old.
Varian, who adopted the name Fox at 18 and is now 22, is one of thousands of minors who underwent gender-transition surgery over the past decade. And she is just one of the young people who have come to regret permanently addressing what was only a temporary identity shift.
Three years after her mastectomy, Varian stopped identifying as transgender and began a process known as detransitioning. In May 2023, she filed a medical malpractice lawsuit against the two principal Westchester County, New York, care providers who oversaw her gender transition: her long-time psychologist, Kenneth Einhorn, and Dr. Simon Chin, who performed the mastectomy.
On Friday, a jury in White Plains, New York, awarded Varian $2 million in damages. Varian’s case is the first malpractice suit from a detransitioner to go before a jury, and I was the only reporter to attend the entire three-week trial. Represented by personal-injury attorney Adam Deutsch, Varian said she had been injured by the defendants due to their deviation from standard practices and a lack of informed consent. While there are no guarantees in medical malpractice lawsuits, legal experts believe Varian’s victory could inspire a wave of similar cases that would significantly disrupt pediatric gender medicine.
Claire Deacon, mother to Fox Varian, the detransitioner who won a $2M jury award after suing her care providers over the mastectomy she got at 16, testified that Varian's psychologist, Kenneth Einhorn, browbeat her into consenting with threats of her child's suicide.
Subscribe to my Substack for further in-depth reporting about the case. I was the only reporter to attend the entire three-week trial. benryan.substack.com
Dr. Loren Schechter, the head of gender-affirming surgery at Rush University Medical Center in Chicago and the president-elect of the World Professional Association for Transgender Health (WPATH), testified that gender-transition surgery is not form of suicide prevention. thefp.com/p/a-legal-firs…
NYU neurologist/psychiatrist Jonathan Howard has been making a stink over @MichaelShermer's recent statements about transgender issues on @BrianLehrer's show.
Here, Howard cites a @Harvard study that falsely claimed youth "rarely" get gender-transition surgeries. In fact, about 1,000 minors got a mastectomy for this purpose annually in recent years, before state bans set in.
I wrote about that Harvard study when it came out. I demonstrated how its authors had quite evidently sought to mislead the public about this issue: benryan.substack.com/p/how-harvard-…
So, in fact, it is not Shermer who is "making things up" about this point in particular, it was Harvard researchers that at least effectively did so.
As for expressing concerns about minors getting these surgeries, I would like Howard to look into the eyes of the mother who testified in the detransitioner civil trial that I just finished attending yesterday (the plaintiff won a $2M judgment against her care providers; my article on the suit will run in a major outlet next week) and tell her that the loss of her daughter's breasts when she was 16 amounts to a false concern.
How Harvard Teed Up the False Claim That the 'Vast Majority of Minors Getting Gender-Affirming Surgeries Are C-s Kids'
An opaquely written Harvard study and linked press release prompted false reporting that gynecomastia surgeries for boys are vastly more common than gender-affirming surgeries for transbenryan.substack.com/p/how-harvard-…
The other day, Howard wrote some screed where he referred to me as a "malignant actor" nefariously pursuing this line of inquiry for money. (Someone suggested that as a cancer survivor, maybe I am intrinsically malignant...) To that I say that Howard might get his facts straight about any of this stuff before he passes judgement on my reporting.
BREAKING: 1st Detransitioner to Take a Medical-Malpractice Lawsuit to Trial Wins $2 Million Judgement
Fox Varian sued her Westchester, NY, area psychologist and plastic surgeon for the gender-transition mastectomy she got at 16.
I was the only reporter to attend the entire 3-week, historic trial. Subscribe to my Substack to receive an alert about the feature article I have coming out next week in a major publication out about the trial: benryan.substack.com. I cover pediatric gender medicine as a specialty on my Substack.
Sorry to just give just a teaser for now about the case! But I wanted to get the word out about the verdict promptly, the slower pace of feature-article publishing notwithstanding.
The entire case file was put under seal when the trial started (although I obtained all those documents before they was sealed), and all the transcripts from the trial are also under seal. The riveting trial was sparsely attended and there was only one other reporter at the trial; and he only attended for part of it and, as I observed, took few notes. So my own hundreds of pages of notes from the trial will likely remain the only way for the public to learn about the all finer details of what transpired, possibly ever (or until an appeal, should that happen).
In addition to my article coming out in the media outlet soon, I intend to write a lot about what I observed and learned on my Substack over the coming weeks. Stay tuned…
I have identified 28 detransitioner lawsuits filed to date. Varian v. Einhorn was the first to go to trial and the first to win a judgment, making history. If anyone knows of any additional cases that are not on my spreadsheet below or sees any errors, please DM me.
Quite a few of the detransitioner lawsuits have run up against strict statutes of limitation, such as the case against leading pediatric gender doctor Johanna Olson-Kennedy. Attorneys intend to appeal this dismissal, as I wrote in November: benryan.substack.com/p/detransition…
Media outlets that claim that transgender women have no competitive advantage over women in athletics are not making evidence-based claims.
Two recent review papers, by @DrMJoyner and @Fondofbeetles, have found that even after sustained testosterone suppression and estrogen treatment, biological males still maintain a competitive advantage in women's sports. The research is less clear about those who have undergone pubertal suppression and then estrogen treatment starting soon after puberty's onset. However, Dr. Joyner's research indicates that prepubescent boys have a small but significant competitive advantage over girls, likely because of exposure to testosterone in utero and a surge of T during "mini puberty" during infancy.
Notice how @NPR doesn't even mention the review papers by @DrMJoyner and @Fondofbeetles finding that trans women on gender-transition treatment maintain a competitive advantage in women's sports. I spoke with Dr. Joyner and other experts who criticized the methodology of the IOC study. They all called its conclusions weak and unreliable. npr.org/2026/01/11/nx-…
@NPR @DrMJoyner @FondOfBeetles The claim by NPR that there is only a handful of trans youth playing sports is belied by survey data, reported by @HRC, that 19% of trans and gender expansive youth play sports. That translates, based on data from a CDC survey, to about 135,000 middle and high school students.