Thread by @jessesingal

1/ New from me in @TheEconomist: Emails released during discovery in a youth gender medicine case demonstrate that the World Professional Association for Transgender Health interfered w/the systematic reviews it commissioned from Johns Hopkins University.

economist.com/united-states/…

2/ The emails are damning, showing that for many months WPATH sought to control the output of the JHU team it paid $200k to examine questions pertaining to transgender healthcare as the Standards of Care 8 was developed.

3/ The quotes couldn’t be more explicit: “Hopkins as an academic institution, and I as a faculty member therein, will not sign something that limits academic freedom in this manner,” said Karen Robinson, head of the JHU effort, at one point. She consistently pushed back.

4/ WPATH appeared to relent and signed a contract that gave it review/feedback rights, but no real power to interfere. After Robinson’s team submitted two manuscripts to WPATH in July 2020, however, WPATH responded that there were many “concerns” about the papers.

5/ WPATH claimed JHU hadn’t followed a policy that… WPATH had just created. As outlined in this flowchart, JHU would first submit its study design *and results*, and then a WPATH team would vote on whether to allow the team to proceed with completing and writing the study.

6/ This completely undermines the purpose and integrity of SRs. Robinson pushed back (again), noting that the contract did not give WPATH this power and that it violated important principles of academic freedom and independence. But there’s some evidence she relented:

7/ Another discovery document includes a checklist indicating a WPATH team member was involved “in the design, drafting… and final approval of” the one paper Robinson and her team published after the new policy went into effect. The paper itself claims the opposite.

8/ All this suggests a corrupted evidence-gathering process. While there are many gaps in the story and no one is talking — my article relies almost entirely on the documents — it’s indisputable WPATH sought to interfere with the systematic reviews.

9/Perhaps most damning: a fall 2020 WPATH email coauthored by then-incoming president Walter Bouman said research must be “thoroughly scrutinised and reviewed to ensure that publication does not negatively affect the provision of transgender health care in the broadest sense.”

10/ This is an explicit call to suppress negative results, and it makes it hard to trust *any* of WPATH’s evidentiary claims. Once you’ve openly admitted you’re seeking a particular outcome and won’t publish research that deviates from that outcome, why should anyone trust you?

11/ That’s it. It’s likely more will come out about all of this soon, but please read my article in the meantime:

economist.com/united-states/…

12/ I was blocked awhile ago after criticizing his own website's coverage of this subject, but I'm genuinely curious what @gorskon, whose whole thing is sound and unbiased science, thinks about this. Or @stevennovella

13/ One thing I forgot to mention: The discovery documents also reveal that the JHU team apparently completed six systematic lit reviews. We have no idea what happened to any of them. They could have helped shed light on a very troubled area of medicine; instead they disappeared.

14/ And here, new, is WPATH prez Marci Bowers saying the quiet part out loud in an unsealed portion of her deposition