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

Sep 17
NEWS: ABC Pulls ‘Jimmy Kimmel Live!’ Indefinitely After Host’s Charlie Kirk Comments

Disney’s ABC said it would take Jimmy Kimmel‘s popular late-night show off its schedule “indefinitely” after one of the biggest owners of TV stations in the U.S., Nexstar Media, said it would pre-empt airings of the program following remarks the host made about the killing of conservative activist Charlie Kirk.

In his monologue Monday night , Kimmel said that the “MAGA gang” was trying to score political points off Kirk’s murder. Kirk, a prominent conservative activist, was shot and killed Sept. 10 at a debate at Utah Valley University. Three days later, authorities announced they had arrested the suspected shooter.

“We hit some new lows over the weekend with the MAGA gang trying to characterize this kid who killed Charlie Kirk as anything other than one of them,” Kimmel said.

Nexstar said Wednesday that its “owned and partner television stations affiliated with the ABC Television Network will preempt “Jimmy Kimmel Live!” for the foreseeable future, beginning with tonight’s show.” The company said it  “strongly objects to recent comments made by Mr. Kimmel concerning the killing of Charlie Kirk and will replace the show with other programming in its ABC-affiliated markets.”Image
Read 9 tweets
Sep 13
Update: Now The Guardian has cut from this article about Tyler Robinson the quote from the unnamed high school friend about his being “leftist”. Image
I would very much like to know whether the unnamed source got cold feet and demanded a retraction of his quote (and if so, why), or if his words and his capacity to recall a time from about six or seven years ago were somehow misrepresented in the first place.
WaPo reports:

Xander Luke, another high school classmate, said he remembers Tyler Robinson being smart, funny and active online, trafficking in silly memes and jokes.

They would talk politics, Luke said, and discuss their “frustration with the system,” particularly feeling let down by the two major political parties. Robinson did not appear to like “hateful people” and “people who would talk down” to others, said Luke, 22.Image
Read 4 tweets
Sep 3
I report for @UnHerd on the tangled and tortured case of Gordon Guyatt, the towering figure of evidence-based medicine who has caved to transgender-activist pressure and thrown under the bus the funder of his systematic reviews of pediatric gender-transition treatment, @SEGM_EBM. He and his colleagues also contradicted their own research findings by adopting activist language touting the benefits of these interventions as “medically necessary.”

My reporting plumbs the depths of the internal tensions at McMaster University, where Guyatt is a star professor, over the mounting activist pressure. I spoke with one of the authors of the review papers, who was sharply critical of Guyatt’s decision to take sides on how his work should be used in the policy arena. This source shared with me internal emails diagramming the thought process of Guyatt and one of his key McMaster colleagues as they tried to quell the furor over their commissioned work for SEGM.

I also report on how Guyatt’s team is seeking to sink or at least divorce themselves from two other systematic reviews about youth gender medicine, and also kill an analysis of @WPATH’s trans care guidelines.Image
Dr. Steven Montante, a plastic surgeon in Richmond, Va., was among the four review-paper coauthors who didn’t sign the statement. “I don’t necessarily agree that he has the authority to dictate” how his work is used, he said of Guyatt. “To be so prescriptive waters down the notion of why we do these systematic reviews, and the notion of evidence-based medicine. There should be some level of detachment.”

“Why didn’t the institution defend the science?” said Dr. Paul Garner, an emeritus professor of evidence synthesis in global health at Liverpool School of Tropical Medicine. “I see this is an institutional failure.” He added: “This is obviously a toxic ideological area.”Image
Read 12 tweets
Aug 31
I interviewed a number of the first monkeypox (mpox) cases in 2022. They were largely affluent gay men who enjoyed traveling around the world and going to sex parties. I am not certain how stigma is connected to such a pastime.

During the outbreak, the CDC downplayed how central sex between men was to driving the outbreak. Dr. Daskalakis in particular invariably led with the exceptions to the rule of who was at risk, such as by uttering the misleading slogan, “Anybody can get monkeypox.” I once challenged him on this fact during a press call in August 2022 and asked why he wasn’t instead being direct and clear that gay men were overwhelmingly the ones at risk. He responded by saying he thought he and the CDC were doing a fantastic job.

Meanwhile, I was constantly getting DMs from parents who were scared to send their kids back to school or to daycare, despite the fact that their children were literally at greater risk of being struck by lightning than getting mpox.

Many people were angry that summer that some of the same people who insisted on masking children or keeping everyone at home during Covid were now insisting that gay men should not be asked to take a break from sex with multiple partners. It is evident that this contradiction eroded trust in public health, as you can see here from what @steveguest is saying:
I cannot begin to tell you how much rage people directed at me for simply saying gay men should modify their sexual behaviors to lower their risk of monkeypox. I broke a cardinal gay sin: Never tell a gay man to reel in his sex life. washingtonpost.com/opinions/2022/…
Read 5 tweets
Aug 5
Nearly 40 percent of students at Brown University identify as something other than straight. The growth has been largely among students identifying as bisexual or as queer, pansexual, asexual or questioning. There has been little growth in gay identity. Image
I sourced the survey on LGBAPQ identities from this @BostonGlobe editorial by Sandy Ernest Allen.
archive.is/20250804154202…Image
Read 4 tweets
Aug 3
Mother Jones is re-upping this article from January. The study in question found that, among minors with private health insurance, by age 17, about 1 in 1,000 were on cross-sex hormones during 2018 to 2023. The rate was higher than that for natal girls and was likely higher overall by 2023.
One way of reporting this news is to simply provide readers with the figures and let them decide whether they represent a little or a lot. open.substack.com/pub/benryan/p/…Image
Puberty blockers themselves, multiple studies have found, are not actually associated with any change in mental health metrics.

But MJ reports: Image
Read 5 tweets

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