Thread by @ProfLAppleby

It’s a week since the Govt published my report on suicide in young people with gender dysphoria.

What did the reaction tell us about the necessary dialogue with the public on issues of evidence? 🧵

First, a reminder of the wider #suicideprevention task, beyond the focus of my report & the specific suicide claim it addressed.

Young people distressed over gender may be at risk.

And we are likely to see a rise in their number, reflecting a broader social trend.

The “evidence base” is a key tenet of modern health care.

But what happens when evidence & opinion clash?

Especially on social media, increasingly designed, it seems, to thrive on discord.

Here, I can tell you, is how it goes:

• I disagree with your conclusions

➡️Your review of evidence was rigged

➡️You have an agenda

➡️You’re part of a cover-up.

How do we go from this to a productive discussion of data?

Some researchers give up, it’s not worth it, the ad hominem attacks scattered along the laughable-sinister spectrum.

Understandable perhaps - but it leaves the stage clear for charlatans & misinformation.

Instead, we need to be able to talk honestly about evidence.

Every dataset has flaws. Which is why every academic paper has a section on its limitations. There are uncertainties that statistical tests are designed to address.

We - researchers - are purveyors of uncertainty.

The problem with public discussion of evidence is not uncertainty but certainty - because it is a sign of bias.

We - all of us - need to understand our own bias.

Beware certainty.

And in an age where information comes at us from every angle, we need to spot dubious data.

Online surveys, self-selected samples, small numbers, unreliable sources.

Even - especially - when the findings tell us what we want to hear.

We have to be particularly careful when discussing evidence on suicide.

There are risks in making alarming claims, risks of identification & imitation, to which young people appear most susceptible.

My report quoted below.

Suicide was once too stigmatised to mention but no longer, thanks to the bereaved families who have told their stories.

No-one would want to go back to when the subject was surrounded by secrecy & shame.

But there is now a mirror-image risk, that unsubstantiated suicide claims are too easy to make & essential to any story about mental health. An apparent validation no claim is complete without.

There were, for example, countless bogus suicide claims in the pandemic (below).

I examined the Tavistock’s own figures (yes, including some who died on the waiting list). There was no suicide “explosion” as claimed.

And no single cause to these tragic young deaths. Suicide is complex.

I also called for better evidence in future. Young people & their worried families deserve it.

And a positive public dialogue depends on it.

The report is here. Posted for the last time.

gov.uk/government/pub…