Benjamin Ryan Profile picture
Apr 27, 2024 10 tweets 5 min read Read on X
The lead author of the new paper finding low gender-transition treatment regret is Dr. Katy Gast, a gender-affirming surgeon at UWHealth. She has been sued by a detransitioner accusing her of not properly obtaining informed consent before a double mastectomy at 21.

The patient also received a hysterectomy from a different surgeon at 19. The woman was diagnosed with gender dysphoria in her late teens.

The Milwaukee Journal Sentinel reports: "The suit alleges malpractice and failure to obtain informed consent by both doctors, negligence by the hospital, discrimination under the Affordable Care Act against the doctors and the hospital, and the denial of benefits and care that would have been provided to a non-transgender woman, according to the Wisconsin State Journal, which first reported the lawsuit."

The paper:
Dr. Gast's info:
An article about the suit: americanjournalofsurgery.com/article/S0002-…
witranshealth.org/providers/kath…
jsonline.com/story/news/hea…Image
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I asked Dr. Gast for a PDF copy of the study. She declined to provide it, saying she'd agreed with the publisher not to do so. She directed me to the web site where I'd have to pay for it.

I have never in my career had a study author refuse me a PDF.
americanjournalofsurgery.com/article/S0002-…
I emailed Dr. Gast again and asked her this: "You did not grade the quality of the evidence, and yet you call this a systematic literature review. That seems to be a conflict. Can you reconcile this for me?"

She has not replied. Image
Here is the email in which Dr. Katy Gast refused to provide me a PDF of her paper finding low regret rates following gender-transition treatment. This is an unheard of refusal for me as a science reporter. Image
The title of Dr. Gast’s paper is:
“A Systematic Review of Patient Regret After Surgery- A Common Phenomenon in Many Specialties but Rare Within Gender-Affirmation Surgery” Image
Here @LeorSapir critiques the new paper reporting low regret rates following gender-transition surgery. A major problem with such studies is loss to follow-up. The investigators do not capture the full numerator.
To read my reporting on detransitioner lawsuits against medical providers and the @AmerAcadPeds for the @NewYorkSun see: benryan.net/the-new-york-s…
Image
@AmerAcadPeds @NewYorkSun Psychologist @JamesCantorPhD says that the very title of this paper, specifically the fact that it calls itself a systematic literature review, is an error warranting not just a correction but a retraction by the journal. Image
For those just joining the thread, here is the paper that @JamesCantorPhD said is not a systematic literature review.
A Systematic Review of Patient Regret After Surgery- A Common Phenomenon in Many Specialties but Rare Within Gender-Affirmation Surgery
americanjournalofsurgery.com/article/S0002-…
@AmerAcadPeds @NewYorkSun @JamesCantorPhD Here is another critique of the paper about post-gender transition regret, by @JLCederblom, who does not mince words or pull punches. JL accuses the authors of not reading some of the literature they analyzed, given their apparent misinterpretations. medium.com/@JLCederblom/a…

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More from @benryanwriter

Jul 14
Clara Jeffery, editor in chief of Mother Jones, says that it is for the best that JD Vance’s children be subjected to boos at Disneyland, so that they “know now what their father is about.” Image
Debunking podcaster Michael Hobbes also endorses the jeers at @JDVance’s family at Disneyland. Image
Clara Jeffery, editor in chief of Mother Jones, adds the following to her post endorsing the jeering of @JDVance while he is with his children at Disneyland. She argues that he actually wants the optics of being booed while having family time in public.
bsky.app/profile/claraj…Image
Read 5 tweets
Jul 13
Democrats Lost Voters on Transgender Rights. Winning Them Back Won’t Be Easy.

The party’s vanguard position got ahead of voters in 2024, and the internal debate now underway reveals an uncertainty on how to adapt, by @chashomans for @nytimes.

"Stuck in a widening gulf between the views of the party’s liberal voters and advocacy organizations on one side, and those of the broader American electorate on the other, many Democratic politicians had resolved to say as little as possible about the subject. In surveys, Ms. Erickson and other public-opinion researchers had found that this allowed Republicans, who spent hundreds of millions of dollars on ads attacking Democrats on transgender rights in 2024, to define voters’ perceptions of Democratic policy positions."Image
The dilemma is reflective of the Democratic Party’s broader struggles with identity politics as it dissects its losses in 2024. Recovering its standing with voters, many in the party believe, requires coming to terms with the party’s transformation during the Obama and first Trump presidencies, when American liberals broadly embraced what had previously been vanguard positions on a range of social and cultural issues, including gender and race, immigration and policing.Image
Read 8 tweets
Jul 10
Dr. Rachel Levine, a former Biden administration health official, tells @TheAdvocateMag that "the evidence base is strong for the safety and efficacy" of prescribing puberty blockers and cross-sex hormones to treat gender dysphoria in minors.

A slew of systematic literature reviews have found this is not the case. Instead, they have found that the relevant evidence is weak and inconclusive. They have suggested that the World Professional Association for Transgender Health erred in making strong recommendations for these treatments. Evidence-based medicine guidelines discourage making a strong recommendation based on weak evidence.Image
Despite subpoenaed email records showing that Dr. Rachel Levine pushed WPATH to remove age limits on pediatric gender-transition treatments and surgeries for political reasons, Dr. Levine denied ever having done so in an interview with @TheAdvocate. Image
The New York Times reported last year:
nytimes.com/2024/06/25/hea…
One excerpt from an unnamed member of the WPATH guideline development group recalled a conversation with Sarah Boateng, then serving as Admiral Levine’s chief of staff: “She is confident, based on the rhetoric she is hearing in D.C., and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care. She wonders if the specific ages can be taken out.”

Another email stated that Admiral Levine “was very concerned that having ages (mainly for surgery) will affect access to care for trans youth and maybe adults, too. Apparently the situation in the U.S.A. is terrible and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them.”Image
Read 7 tweets
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:
⬇️Image
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
Image
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

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