Claim of Suicide Surge in Youths on U.K. Wait List for Gender Care Undermined by ‘Cass Review’
🧵: I report for The @NewYorkSun: The report on pediatric gender care also undermines suggestions by @GoodLawProject's @JolyonMaugham that after the Tavistock v Bell decision in Dec. 2021, the UK GIDS pediatric gender clinic all but eliminated gender-transition treatment referrals in 2021 and that this drove a wave of suicides on the waiting list.
The @GoodLawProject said there was a “huge increase” in suicide deaths in those on the waiting list for the UK's pediatric gender clinic, GIDS. @JolyonMaugham said the clinic’s harsh restrictions, starting in 2021, on treatment access drove the surge.
However, the Cass Review, the recent landmark British report on the care of minors who are distressed about their gender, calls into question the specifics of @JolyonMaugham's claims, as does documentation posted on social media by him. nysun.com/article/claim-…
The @GoodLawProject's @JolyonMaugham claimed, based on whistleblower reports and associated documents, that there was one suicide death among a GIDS patient on the waiting list from 2014 to 2020 and 16 deaths in such patients from 2021 to 2023. nysun.com/article/claim-…
The @GoodLawProject/@JolyonMaugham attributed the 16 suicides to GIDS having “immediately pulled down the shutters” on kids' access to gender-transition treatment following the Bell v Tavistock judgment, which he said caused the waiting list to balloon.
But Cass suggests that at least some of the 16 suicides were in youths who were either non-wait-list GIDS patients or had already turned 18 and aged out. The review's data also counters the suggestion that GIDS all but shut down access to puberty blockers starting in 2021.
“Making assumptions about what has caused any suicide and talking about that assumption in public is known to be dangerous,” said Dr. Anna Hutchinson, a GIDS staffer whistleblower, referring to research indicating suicide can be socially contagious. nysun.com/article/claim-…
On X, @JolyonMaugham attributed GIDS's new screening policies, adopted in 2021, solely to the Bell v Tavistock ruling. He did not mention that the new system, which added an extra screening layer, was also driven by the Care Quality Commission's scathing report on GIDS.
The pace of endocrinology referrals from GIDS definitely slowed after the Bell judgment, they did not all but grind to a halt as @JolyonMaugham suggested, per data reported in the Cass Review. nysun.com/article/claim-…
The wording of a statement in the Cass Review suggests that @JolyonMaugham of @GoodLawProject was incorrect when he claimed that all 16 apparent recent suicides were minors on the GIDS waiting list. nysun.com/article/claim-…
Screenshots from Tavistock board meetings that @JolyonMaugham posted on X also contradict or otherwise do not support his claim that all 16 apparent recent suicides were in minors on the GIDS waiting list.
A former GIDS whistleblower said: “In clinical work, unless you have full records and follow-up data," noting that GIDS kept very little data, “then to pluck any kind of meaning from clinical incidents, accidents or suicide statistics is of little or no clinical relevance.”
To date, only one study has directly assessed the association between gender-transition treatment and suicide death among young people. The study, which examined comprehensive national health records in Finland, found no such association. nypost.com/2024/02/24/opi…
Systematic literature reviews conducted for Cass's found no conclusive mental health benefits tied to puberty blockers and some moderate-quality evidence suggesting mental health improvements when minors are put on cross-sex hormones for gender distress. nysun.com/article/claim-…
A 2022 paper by Oxford sociologist Michael Biggs found that @JolyonMaugham of @GoodLawProject was incorrect when he claimed there was only one suicide of a minor on the GIDS waiting list from 2014 to 2020. link.springer.com/article/10.100…
Trans activist and Harvard Law School clinical instructor Alejandra Caraballo @Esqueer has made a "spreadsheet tracking the suicide deaths of trans youth in the UK." It's unclear what overlap this has with what @JolyonMaugham reported, but 5 out of 9 of the deaths were in adults.
I asked Oxford sociologist Michael Biggs about Alejandra Caraballo's list of trans youth suicides in the UK and he said the following:
@Esqueer_
Claim of Suicide Surge in Youths on U.K. Wait List for Gender Care Undermined by ‘Cass Review’ nysun.com/article/claim-…
For @ErinInTheMorn's blog, @MiraLazine credulously reported @JolyonMaugham's claims about recent suicides at GIDS without doing reporting on the details, including the various ways that the Cass Review undermines the specifics of Maugham's claims. erininthemorning.com/p/trans-youth-…
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The Advocate reports: "Asked whether a parent concerned about their child facing a trans kid in girls’ sports 'has a case,' Pete Buttigieg @PeteButtigieg said, “Sure.” But he rejected blanket policies like the federal bans being enacted by the Trump administration, saying, “These decisions should be in the hands of sports leagues and school boards and not politicians, least of all politicians in Washington trying to use this as a political pawn.”
This statement has inspired a blistering response on Bleuskie—see the 🧵⬇️
Journalist Walter Bragman issues a blistering response to @PeteButtigieg’s statement over trans inclusion in sports, calling it “craven shit” and saying Mr. Buttigieg is catering to bigots.
“To just put a fine point on it: Parents do not, in fact, have legitimate concerns about trans kids playing sports,” Mr. Bragman says.
“Just because they believe bullshit doesn’t make it legitimate.
“Fuck anti-trans bigots.”
@PeteButtigieg A person called Guillotine Hunger Force argues that sports is not about winning.
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.”
Debunking podcaster Michael Hobbes also endorses the jeers at @JDVance’s family at Disneyland.
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…
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."
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.
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.
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.
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.”
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.
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.
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.
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.
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.