Benjamin Ryan Profile picture
May 8, 2024 9 tweets 5 min read Read on X
The American Academy of Pediatrics and the Endocrine Society, the two most influential US medical societies in pediatric gender medicine, have issued their first known statements on England's Cass Review on the subject, to @WBUR's @OnPointRadio:

STATEMENT FROM AMERICAN ACADEMY OF PEDIATRICS: Statement from American Academy of Pediatrics President, Dr. Ben Hoffman:

“The AAP’s gender -affirming care policy, like all our standing guidance, is grounded in evidence and science. Pediatricians understand the complexities of gender-affirming care and they know how to counsel families. The goal is not a certain treatment or timeline, but instead to listen to the patient and create a safe environment to address their needs. “What we’re seeing more and more is that the politically infused public discourse is getting this wrong — and it’s impacting the way that doctors care for their patients.

Physicians must be able to practice medicine that is informed by their medical education, training, experience, and the available evidence, freely and without the threat of punishment. Instead, state legislatures have passed bills to ban and restrict gender-affirming care, which means that right now, for far too many families, their zip code determines their ability to seek the health care they need. Politicians have inserted themselves into the exam room, and this is dangerous for both physicians and for families.”Image
Here is the Endocrine Society's statement on the Cass Review, given to @WBUR's @OnPointRadio. In short, "Medical evidence, not politics, should inform treatment decisions."

STATEMENT FROM ENDOCRINE SOCIETY: We stand firm in our support of gender-affirming care. Transgender and gender-diverse people deserve access to needed and often life-saving medical care.

NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care.

The guideline, which cites more than 260 research studies, recommends a very conservative approach to care, with no medical intervention prior to puberty. Estimates indicate only a fraction of transgender and gender-diverse adolescents opt to take puberty-delaying medications, which have been used to treat early puberty in youth for four decades.
• The guideline recommends beginning treatment with puberty-delaying medications that are generally reversible.
• As adolescents grow older and can provide informed consent, then hormone therapy can be considered.
• Our guideline suggests waiting until an individual has turned 18 or reached the age of majority in their country to undergo gender-affirming genital surgery.

Medical evidence, not politics, should inform treatment decisions.

Our Clinical Practice Guidelines are developed using a robust and rigorous process that adheres to the highest standards of trustworthiness and transparency as defined by the Institute of Medicine (now the National Academy of Medicine).

Our guideline development panels spend years developing each guideline based on a thorough review of medical evidence, author expertise, rigorous scientific review, and a transparent process.

More than 18,000 Endocrine Society members worldwide have an opportunity to comment on guideline drafts prior to publication.

The Society is in the process of updating the 2017 Clinical Practice Guideline. It was one of six selected for a routine update.

The process will incorporate the latest research and conduct systematic reviews to provide guidance on the safe and effective treatment of gender incongruence and dysphoria from an endocrine perspective.

We agree that increased funding for youth and adult transgender health research programs is needed to close the gaps in knowledge regarding transgender medical care and should be made a priority.

Although the scientific landscape has not changed significantly, misinformation about gender-affirming care is being politicized.

In the United States, 24 states have enacted laws or policies barring adolescents’ access to gender-affirming care, according to the Kaiser Family Foundation. In seven states, the policies also include provisions that would prevent at least some adults over age 18 from accessing gender-affirming care.

Cisgender teenagers, together with their parents or guardians, are deemed competent to give consent to various medical treatments.

Teenagers who have gender incongruence and their parents and guardians should not be discriminated against.

Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment.

Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions.

Medical evidence, not politics, should inform treatment decisions.Image
The @AmerAcadPeds never responded to @JamesCantorPhD's scathing fact check of its 2018 policy statement on the affirmative care model for gender distressed children. Instead, it reaffirmed the policy statement in Aug 2023 with no changes.
ohchr.org/sites/default/…
The AAP is subject to a lawsuit from a detransitioner, as I wrote for the @NewYorkSun:
nysun.com/article/lawsui…
The AAP has become increasingly secretive about its work on the subject of gender distressed children. nysun.com/article/sued-o…
In its statement to @WBUR, the Endocrine Society says that "only a fraction" of gender distressed children receive medical transition. This after @WPATH said in a statement responding to the Cass Review that the majority of such children would do better to medically transition.
Here is Dr. Hilary Cass's first US interview, on this @WBUR @OnPointRadio podcast:
wbur.org/onpoint/2024/0…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Benjamin Ryan

Benjamin Ryan Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @benryanwriter

Feb 7
How Can Doctors Like This Provide Competent Care To Their Patients?

Some beef with Dr. Jonathan Howard, by @JesseSingal.
jessesingal.substack.com/p/how-can-doct…
Dr. Jonathan Howard, a neurologist and psychiatrist at @NYULangone Health, is furious at Michael Shermer, the founding publisher of Skepticmagazine.

Howard is an impressive figure. Like many doctors at university-affiliated medical centers, he also serves as a professor, in this case at the @NYUGrossman School of Medicine. He has, according to his biography, “authored and edited multiple textbooks” on multiple sclerosis, his area of specialty.

Why is Dr. Jonathan Howard furious at @MichaelShermer? It has to do with a recent exchange between Senator Josh Hawley and an OB-GYN named Dr. Nisha Verma. Hawley, seeking to make a point about “gender ideology” (as he might call it) during a hearing, repeatedly asked Verma if men can get pregnant and Verma could not give a straight answer. Shermer chimed in to suggest an answer Verma could have given that accounts for the fact that, as Shermer (and anyone else using the traditional, biological definition of the term) sees it, men cannot, in fact, get pregnant.

That’s why Howard is furious, and that’s why he wrote a deeply aggrieved article in Science-Based Medicine about Shermer’s bigotry. The headline? “The Anti-Trans Obsessions of ‘Skeptic’ Michael Shermer: Hallucinating Imaginary Demons to Empower Actual Villains, Once Again.” The subheadline? “I want to demonstrate to Michael Shermer that it’s possible for men like us to not talk about trans people constantly. If I can do it, so can he.” (If you’re unfamiliar with Science-Based Medicine’s strange recent trajectory, see here or here.)

Not only does Dr. Jonathan Howard of NYU Langone Medical Center disagree with Michael Shermer that men can’t get pregnant — Howard thinks that to even ask this question puts other humans in danger.

That probably sounds like a caricature on my part, or a sloppy and inaccurate gloss of Howard’s actual views. But that’s exactly what he wroteImage
Image
Jonathan Howard has gotten it into his head, meanwhile, that I am personally responsible for the MAHA movement because once I published an essay on Vinay Prasad’s Substack about trans medicine researchers deceiving the public. This is bonkers conspiracy thinking by Howard.
After @jessesingal explained in exacting detail why the study Jonathan Howard cited as evidence of pediatric gender-transition treatment’s efficacy was bunk, Howard respond with this mischaracterization of what Singal said about Howard’s inability to understand the paper. Image
Read 6 tweets
Feb 6
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.Image
More from Blair Peters: Image
Image
Image
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.

The ASPS president, Dr. Steven Williams, brought up Tuskegee. open.substack.com/pub/benryan/p/…Image
Image
Read 6 tweets
Feb 4
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…Image
@buttonslives Hollow, not hallow*
Read 5 tweets
Feb 2
A Legal First That Could Change Gender Medicine

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.

Read the @TheFP article: thefp.com/p/a-legal-firs…

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.Image
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.

I report for @TheFP:
thefp.com/p/a-legal-firs…

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.comImage
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…Image
Read 12 tweets
Jan 31
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.Image
Image
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-…Image
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.
Read 5 tweets
Jan 31
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…Image
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.Image
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…Image
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(