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…

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More from @benryanwriter

Apr 28
Taylor Lorenz publishes effective advertorial

In @TaylorLorenz’s new Substack, she used Panagram to detect how many top Substackers are using AI to produce their articles, in an apparent effort to criticize their ethics.

Panagram sponsored Lorenz’s Substack, revealing that it is effectively an advertorial. She doesn’t make a note of this sponsorship until the very end of her article.

This comes after Lorenz was widely criticized for posting a free ad for The Bark Phone, which is parental-control software for a children’s smartphone. In the ad, Lorenz touted smartphones as good for kids because they help kids express themselves.Image
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Should a tech journalist such as @TaylorLorenz weave sponsorship of tech products into her reporting thanks to receiving payments from tech companies? That’s what Lorenz did here with Panagram:
usermag.co/p/how-much-of-…
@TaylorLorenz When magazines run advertorials, they typically change the layout to make abundantly clear that this is sponsored content. The disclaimer about it being sponsored content is typically at the top of the text, not buried at the very end, as Lorenz has done.
Read 7 tweets
Apr 26
In Erin Reed’s chat group, people debate whether it would be better to attend this Sunday conference panel of four skeptics of pediatric gender medicine and ask pointed questions, boycott it, or disrupt it with boos. Frank Dowling, who refers to the group as “frauds”, was among the AMA members whose LGBTQ message board posts I quoted from in my reporting for @thefp about how members reacted to the organization coming out against youth gender surgeries: thefp.com/p/the-medical-…Image
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Psychiatrist Frank Dowling advocates disrupting Sunday’s conference panel from the pediatric gender medicine skeptics: Image
Read 6 tweets
Apr 24
Controversial Pediatric Gender Panel Draws Trans-Activist Push for Cancellation
benryan.substack.com/p/transgender-…
Trans-activist Substacker Erin Reed has prompted an uproar over a panel of skeptics of pediatric gender medicine slated for Sunday at the Pediatric Academic Societies meeting in Boston.

Transgender activists and their allies are in an uproar over an upcoming medical-conference panel concerning pediatric gender medicine that features skeptics of this field whom activists accuse of being anti-trans.

Since the prominent trans-activist Substacker Erin Reed published an article about the panel on Tuesday, conference organizers have apparently been inundated with tens of thousands of emails demanding it cancel the panel, in particular due to the panelists’ connections to a small nonprofit known as the Society for Evidence Based Gender Medicine, or @SEGM_EBM.

This burgeoning deplatforming campaign raises questions about the place that the free exercise of scientific ideas has within a medical field as peerlessly politicized as pediatric gender medicine. As transgender activists seek to shut down what they argue are toxic fringe positions akin to climate-change deniers, a relatively small but determined collection of scientific and medical experts have remained committed to publicly scrutinizing this field and defending themselves against what they say are baseless accusations that their perspectives are rooted in bigotry and animus.Image
Many of you will be surprised to learn that Erin Reed has a habit of publishing claims about her adversaries that are not firmly nestled in a bed of truth. open.substack.com/pub/benryan/p/…Image
Read 4 tweets
Apr 9
About Health Nerd's take-down of the Finnish study on mental health outcomes among youth attending gender clinics
🧵👇
The study isn't perfect by any means. There are fair reasons to criticize it. But Health Nerd's central thesis falls apart upon the simplest examination.

I find it very disappointing when people leverage their academic credentials to supposedly bust bad science or misinformation but only wind up spreading more misinformation in the process. Where are we these days if we can't trust people to use their credentials wisely and inspire trust in those with advanced degrees?

I've tried explaining to Health Nerd what he got wrong, to no avail. It was like arguing with a character in a Lewis Caroll poem.

See the thread below.Image
Health Nerd's argument depends on redefining the study’s outcome variable as “how many times kids saw a psychiatrist for any problem.” No, that's not what the paper measures. It measures contacts with specialist-level psychiatric treatment. In Finland, that is referral-based care generally reserved for more serious mental illness. Milder mental health problems are handled in primary care. gidmk.substack.com/p/does-gender-…Image
That distinction between primary-care services and specialist psych care matters. It's the reason the authors use this variable in the first place. It's not a measure of casual or routine mental health visits.
Read 14 tweets
Apr 3
Queer editor James Ball declares Bluesky a “dying social network,” blaming aggressive censoriousness by Blueskyites of perceived ideological enemies:

“There's a large cadre that basically cheers on chasing off any lib/centrist/academic who's the punchbag of the day. There's a culture of saying ‘fuck off back to X, then.’ And the anti- bedtime leftists set too much of the culture.

“I don't know if it's fixable, especially as I think quite a lot of the people here don't *want* to fix it. But at the rate users are quitting they'll run out of targets soon enough, and the rest of us will lose what is – for a fair few of us I suspect – the last fun/useful social network. Sigh.”Image
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More from James about Bluesky’s demise: Image
The grim Bluesky stats. Turns out echo chambers are not big business. Image
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Read 8 tweets
Apr 1
HOW GENDER MEDICINE SET ITSELF UP FOR DISASTER

For @CompactMag, I report on what the 100s of WPATH conference videos I obtained tell us about this troubled field: compactmag.com/article/how-ge…

👉I 'll be publishing the conference videos on my Substack: benryan.substack.com/p/i-obtained-1…

As I write for Compact magazine:

This catalogue, which the World Professional Association for Transgender Health, or WPATH, fought to keep shielded, provides a rich account of how leading figures in pediatric gender medicine approached scientific research, drove the evolution of medical practices, and strategized politically during a critical turning point in this field’s brief and tortured history. The two years following Chase Strangio’s 2021 address were a period in which statehouse Republicans escalated their attacks on this field. The WPATH conference presenters largely responded to the political siege by doubling down. Rather than engage in soul searching over whether their methods in pediatrics were ethically sound and whether any criticisms had merit, they overwhelmingly stuck to their guns.

Presenters frequently downplayed fundamental hazards about irrevocably altering adolescents’ bodies. Meanwhile, a parade of systematic reviews—the gold standard of scientific evidence—was concluding that the evidencebacking pediatric gender medicine is weak and inconclusive. These findings have led health authorities in a number of European nations, concerned about risks such as infertility, to reverse course. They reclassified pediatric gender-transition interventions as experimental and sharply restricted minors’ access.

Not WPATH. The organization remained on an inexorable trajectory in the opposite direction, toward its eventual head-on collision with the second Trump administration.

For highlight clips, see the 🧵👇Image
Kellan Baker counseled against saying “gender-affirming care.” Messaging research indicated that when people hear it, he said, “they think ‘trans kids in the driver’s seat.’” But he said this was an accurate assessment. “I think we all support trans kids in the driver’s seat because it’s their bodies, it’s their lives,” he said.

“But when you think about folks who don’t know trans people, they are very scared by the idea that young people are making irreversible decisions and that no one else has any oversight over those decisions.”

To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…

I will be publishing the most notable conference videos on my Subsack: benryan.substack.com/p/i-obtained-1…
Johanna Olson-Kennedy: “I think that a lot of this conversation...gets talked about through a lens of ‘How can we make sure people are really trans,’ right? And ‘They’re not going to regret their decision later?’” But “that’s actually not the discussion that I’m interested in participating in," she said. "I’m interested in discussing and having a conversation about giving the very best possible care to trans young people—the care that they need and deserve.”

To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…

I will be publishing the most notable conference videos on my Subsack: benryan.substack.com/p/i-obtained-1…
Read 6 tweets

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