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Benjamin Ryan Profile picture
@benryanwriter
Apr 27, 2024 • 10 tweets • 5 min read • Read on X
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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
Image
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

Benjamin Ryan Profile picture
May 28
Pete Buttigieg told @BulwarkOnline that if he could do it over, he would’ve worked to get the schools open faster in 2020. In response, @TaylorLorenz denounced him as a eugenicist.

Meanwhile, @DavidZweig’s new book presents an avalanche of evidence indicating that school closures likely did not reduce morbidity and mortality and harmed children. He also demonstrates that there was considerable evidence of the apparent lack of benefit from European nations as early as May 2020.Image
I interviewed @davidzweig about his book about the folly of the Covid school closures, An Abundance of Caution, for my pod. I drew parallels to the pediatric gender medicine field:

open.substack.com/pub/benryan/p/…Image
@davidzweig “Today, there is broad acknowledgment among many public health and education experts that extended school closures did not significantly stop the spread of Covid, while the academic harms for children have been large and long-lasting.” nytimes.com/2024/03/18/ups…
Read 5 tweets
Benjamin Ryan Profile picture
May 25
The Utah state government commissioned a report on pediatric gender-transition treatment. It comes in at over 1,000 words and concludes that the evidence favorably backs such treatment.

But despite the fact that it bills itself as a systematic literature review, it isn't one.

The authors of the report, from the University of Utah College of Pharmacy, did not register their methodology on PROSPERO in advance as is required for a systematic literature review. Nor did they rate the quality of the evidence as all other systematic reviews of this field have. What's more, their report explicitly takes on faith the claims of authors of treatment guidelines that their own process in developing those guidelines was rigorous. This after the University of York's systematic literature review on such guidelines, published in April 2024, found that all but a couple of such guidelines were of poor quality and not reliable.

Essentially, this report is a narrative review that summarizes the bulk of the research in this field. But it does not seek, like all the actual systematic literature reviews have, to make sense of whether that research is reliable and whether it can properly guide doctors and families in making a solid calculation about the risks vs benefits of these drugs when given to children.

In sum, this report reflects everything that the authors of systematic literature reviews and groups like @SEGM_EBM have been seeking to respond to.Image
Source: le.utah.gov/AgencyRP/repor…
Note also that the bulk of the report's 1,000 pages is taken up by a compendium of abstract after abstract of the studies they considered, or chart after chart breaking them down. So it's not as if the authors actually wrote anything approaching 1,000 pages.
Read 11 tweets
Benjamin Ryan Profile picture
May 14
I strongly advise people who think that @AlecMacGillis, who wrote one of the finest Covid-era articles critiquing the school closures, is “lying” about their impacts read @DavidZweig’s scathing new book about the lockdowns, An Abundance of Caution.

Zweig makes a very strong case that there was substantial evidence by spring 2020 that lockdowns did not substantially lower COVID morbidity and mortality. And he further makes a very strong case that the lockdowns harmed kids in myriad ways.

I also suggest people stop and consider that Blooskie is just as toxic as X, but in a kind of mirror image.
Here is my interview with @davidzweig about his book on the Covid school closures. open.substack.com/pub/benryan/p/…Image
This is @AlecMacGillis’ heartbreaking article about how the Covid school closures impacted a small town, and how the lack of them in a neighboring town didn’t seem to lead to worse covid outcomes. propublica.org/article/the-lo…
Read 5 tweets
Benjamin Ryan Profile picture
May 14
Helping out young people need not be a zero-sum effort. Accurately observing that boys are falling behind in many respects need not divert attention away from the plight of women and girls. The real problem is when people pit the interests of the sexes against one another. Moira Donegan really should go read @RichardVReeves’ work and stop trying to be so divisive and dismissive about a real and serious problem facing boys and young men.Image
In fact, Moira's attitude, which is essentially, "Screw those boys, the girls need help," is a pervasive bias that is likely part of the reason why boys are struggling! People look at boys and see the patriarchy and something that needs to be pushed down. This is harmful to everyone in the long run, boys and girls alike.
Also Moira Donegan: She made the "Shitty Media Men" list and paid a six-figure settlement to Stephen Elliott over it after he sued her.
washingtonpost.com/media/2023/03/…
Read 5 tweets
Benjamin Ryan Profile picture
May 10
One of the authors of a just published critique of Britain’s Cass Review on pediatric gender medicine and the systematic reviews on which it was partially based suggests that the authors were “bribed.”

It’s unclear what McLamore means by the comparison of how long peer review took for them, since the Cass Review took four years and was not peer reviewed. But the SRs on which it was based were peer reviewed and published in a journal.

Quinnehtukqut McLamore (they/them) is an assistant professor of social psychology in the Department of Psychological Sciences at the University of Missouri at Columbia.Image
“The Cass report’s recommendations, given its methodological flaws and misrepresentation of evidence, warrant critical scrutiny to ensure ethical and effective support for gender-diverse youth.”

bmcmedresmethodol.biomedcentral.com/articles/10.11…
The lead author says: Image
Read 4 tweets
Benjamin Ryan Profile picture
May 9
Today, I was on a Zoom call by an HIV advocacy group about their efforts to combat the Trump admin's cancellation of HIV research grants. One of the activists presenters said he refused to present if I was on the call, clearly due to my reporting on pediatric gender medicine.

The organizer said he couldn't eject anyone from the call; there were about 80 participants. (This despite the fact that that organizer, a longtime activist, had already ejected me from his HIV-advocacy listserv.) So the activist refused to present and had his colleague present in his place. She made a big point about how he had made an "ethical" stand not to present.

I told everyone via the chat on the Zoom that I stood by my reporting on pediatric gender medicine. Which I do.

The irony is that I am among only a small handful of reporters who maintains a specialty in HIV coverage—I have been writing about HIV for 25 years and started doing work in the field in 1995—and who writes for mainstream outlets. And I just published a major article in NBC News about the cancelation of LGBTQ-related research grants, the very subject of the Zoom call, that was totally sympathetic to the activists' cause.

I see a lot of this in my work, in which HIV activists seek to punish me for my reporting by seeking to stonewall and blacklist me. They go to great lengths. It winds up just being inconvenient for me; I still get my work done. What it does accomplish is it ensures that these activists' voices are not heard in my reporting. And it does not stop me from writing about gender medicine. It boils down to ideological purity on their part. They need to take that stand.
If these activists had their way, I would not publish articles like this that are very critical of the Trump administration and bring attention to the activists’ cause. Some of them tried to get my sources for this piece to join the blacklist against me. nbcnews.com/nbc-out/out-ne…
One of the sources for the piece above is a major academic advocate in the transgender space. I’ve interviewed him many times over the years. To his credit, he dismissed the demands from activists to blacklist me and said he’d just ask me himself what the story was with my gender medicine reporting. Imagine that!
Read 9 tweets

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