Benjamin Ryan Profile picture
Jul 12 6 tweets 3 min read Read on X
Jack Turban dismisses as “nonsense” what Pamela Paul’s states about attitudes about “gatekeeping”. And yet in Turban’s new book he strongly suggests psychosocial assessments should be done away with because, he suggests, they are useless. He suggests in the book that puberty blockers and cross-sex hormones should be as easy for children to get as Prozac. He has also suggested that kids should be able to get blockers without parental approval, like birth control.Image
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Here is the first section in @Jack_Turban’s book where he strongly suggests that he thinks psychosocial assessments for gender-transition treatment for children should be discarded.

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This is the third time this month that Jack Turban has held up the virtues of the psychosocial assessment—he did so in the essay he published with coauthors criticizing the Cass Review and he did it in his NYT opinion essay. All this despite his suggesting in his book that the assessment is useless and should be done away with.
At another point in his book, @Jack_Turban recounts prescribing a teen Prozac and the kid remarks how easy that was and wouldn’t it be nice if it were that easy for minors to get gender-affirming care? Turban makes very clear he agrees, which suggests he believes that kids should be able to get blockers and hormones on their first visit to a doctor about gender dysphoria.
@jack_turban Also, Pamela Paul is not referring to what WPATH and the Endocrine Society recommend, she is referring to what activists like Florence Ashley say. @ButNotTheCity Image

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More from @benryanwriter

Jul 13
NEW STUDY: Trans identification has surged in young adults, driven by natal females; increase is greater in whites.
From 2014-2022, trans identification:
▶️Nearly quintupled in 18-24 year olds
▶️Quadrupled in 25-34 y/os
▶️Stayed flat or declined in those age 35+
▶️By 2022, 2.78% of 18-24 year-old adults identified as trans, up from 0.59% in 2014.
▶️The increase was driven by those identifying as trans men or gender non-conforming; identification as a trans woman did not change significantly among young adults and declined significantly among all adults.
▶️The increase in identifying as trans was larger among White individuals than among Black or Hispanic individuals.

The study is based on nationally representative data
link.springer.com/article/10.100…Image
In a new essay posted on the Yale Law website, researchers in the pediatric gender medicine space such as @Jack_Turban lambasted the Cass Review for saying that trans identification has "increased exponentially." But this new study finds what looks like exponential growth when trans identification is broken down by birth year:
link.springer.com/article/10.100…Image
Trans identification nearly quintupled among 18 to 24 year olds and quadrupled among 24 to 34 year olds from 2014 to 2022:
link.springer.com/article/10.100…
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Read 10 tweets
Jul 12
Blogger-activist Erin Reed has published a fact check of Pamela Paul's opinion essay about pediatric gender medicine.

A few fact checks of Reed in the 🧵⬇️ Image
As Cass wrote in her review, studies about youths who have transitioned are plagued by high drop-out rates and short follow-up times. It is simply not possible to determine the true detransition rate as a result. Image
I've been over this one many times with Erin and others, but there are several limitations to the "<10 out of 3,000" claim:
1) 465 GIDS patients actually medically transitioned in the group in the audit.
2) So let's say 8 had detransitioned by age 18, that's 1.7%
3) Cass was told by pediatric gender care experts that detransition can take 5-10 years. Since this audit was based solely on discharge data, there were no data for anyone past age 18. Thus, it is not possible to fully assess the detransition rate in this group of medically transitioned youths.Image
Read 10 tweets
Jul 12
Pamela Paul writes for @NYTOpinion:

In U.S. Gender Medicine, Ideology Eclipses Science. It Hurts Kids.

Imagine a comprehensive review of research on a treatment for children found “remarkably weak evidence” that it was effective. Now imagine the medical establishment shrugged off the conclusions and continued providing the same unproven and life-altering treatment to its young patients.
This is where we are with gender medicine in the United States.
It’s been three months since the release of the Cass Review, an independent assessment of gender treatment for youths commissioned by England’s National Health Service. The four-year review of research, led by Dr. Hilary Cass, one of Britain’s top pediatricians, found no definitive proof that gender dysphoria in children or teenagers was resolved or alleviated by what advocates call gender-affirming care, in which a young person’s declared “gender identity” is affirmed and supported with social transition, puberty blockers and/or cross-sex hormones. Nor, she said, is there clear evidence that transitioning kids decreases the likelihood that gender dysphoric youths will turn to suicide, as adherents of gender-affirming care claim. These findings backed up what critics of this approach have been saying for years.
“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass concluded. Instead, she wrote, mental health providers and pediatricians should provide holistic psychological care and psychosocial support for young people without defaulting to gender reassignment treatments until further research is conducted.
After the release of Cass’s findings, the British government issued an emergency ban on puberty blockers for people under 18. Medical societies, government officials and legislative panels in Germany, France, Switzerland, Scotland, the Netherlands and Belgium have proposed moving away from a medical approach to gender issues, in some cases directly acknowledging the Cass Review. Scandinavian countries have been moving away from the gender-affirming model for the past few years. Reem Alsalem, the United Nations special rapporteur on violence against women and girls, called the review’s recommendations “seminal” and said that policies on gender treatments have “breached fundamental principles” of children’s human rights, with “devastating consequences.”

But in the United States, federal agencies and professional associations that have staunchly supported the gender-affirming care model greeted the Cass Review with silence or utter disregard.
There’s been no response from the Department of Health and Human Services, whose website says that “gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents” and which previously pushed to eliminate recommended age minimums for gender surgery. Nor has there been a response from the American Medical Association, which also backs gender-affirming care for pediatric patients.
When I reached out to H.H.S. officials, they declined to speak on the record. The A.M.A. referred me to the American Academy of Pediatrics and the Endocrine Society. The Endocrine Society, the primary professional organization of endocrinologists, told me, “the Cass Review does not contain any new research that would contradict the recommendations made in” the society’s own guidelines. (Cass’s mandate was to assess the quality and importance of existing research.)
When the NPR station WBUR interviewed Cass, it asked the American Academy of Pediatrics for a response to the review. The pediatricians’ group issued a statement that said nothing about the Cass Review. Instead, it denounced what it characterized as “politically infused public discourse” and promised to stay the course, conducting its own research review, which it agreed to do last year under intense pressure. In later comments to The Times, Dr. Ben Hoffman…Image
Pamela Paul refers to my reporting in the @NewYorkSun about detransitioner lawsuits:

nysun.com/article/damnin…
Image
Read 9 tweets
Jul 10
‘Damning’ Information About Trans Medical Group Expected To Reach Supreme Court, as Justices Consider Challenge to Ban on Gender Treatments for Minors
🧵⬇️I report for the @NewYorkSun: Unsealed internal communications from the trans medical organization @WPATH will likely undermine pediatric gender-transition treatment in litigation, including a Supreme Court case.Image
‘Damning’ Information About Trans Medical Group Expected To Reach Supreme Court, as Justices Consider Challenge to Ban on Gender Treatments for Minors
nysun.com/article/damnin…
The World Professional Association for Transgender Health is tasked with promoting and defending access to gender-transition treatment for minors. Amid a storm of litigation over these practices @WPATH’s leaders now find that their own words threaten to undermine this mission.
Read 23 tweets
Jul 2
NEWS: WPATH's Eli Coleman disputes claims that the Standards of Care 8 guideline committee bowed to political pressure from Rachel Levine to remove age limits on treatment and suppressed the systematic literature reviews WPATH commissioned from Johns Hopkins, in a new filing in the Alabama court case over the state's ban. That case received a stay today.

"First, it is not true that the development of SOC8 turned on any ideological or political considerations. Development of SOC8 followed the rigorous methodology designed by Johns Hopkins University to approve recommendations through the Delphi Method, a well-established methodology to develop clinical practice guidelines," Coleman said on July 1, 2024.

"WPATH’s review and revisions based on public feedback after the transparent review process was not ideological or political. It rested on the same measured, scientific basis as did the earlier development of the draft.

"WPATH did dispute the timing of when Johns Hopkins could publish their systematic reviews because WPATH wanted to include the information gleaned from the systematic reviews in its publication of SOC8. WPATH did not want Johns Hopkins University to publish its research prior to WPATH’s opportunity to release SOC8. This was not because WPATH had any interest in suppressing Johns Hopkins’ research. To the contrary, WPATH wanted to ensure that its release of SOC8 would be the first publication of the research.

"The recommendations included in SOC8 were based on the rigorous process set up by Johns Hopkins and supported by the scientific evidence base provided to us by Johns Hopkins and upon which the members of the chapter committees voted through the Delphi process."Image
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Here is the summary judgment to which Dr. Coleman refers:
Here are more details, the likes of which Dr. Coleman is refuting.
Read 5 tweets
Jul 1
WPATH had internal dissent over its controversial eunuchs chapter in its Standards of Care 8 trans-care guidelines
Internal communications, subpoenaed and newly unsealed as part of the Alabama court case over the state's pediatric gender-transition ban, reveal such dissent. 🧵
The names are redacted, so it is not known who is saying the following, but a series of internal WPATH emails revealed: Someone saying, "I struggle with the concept of 'Eunuch as a gender identity.'" Image
This WPATH member said that not all Eunuchs and intersex people have gender dysphoria/gender incongruence. Image
Read 7 tweets

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