Benjamin Ryan Profile picture
Oct 16, 2024 • 8 tweets • 5 min read • Read on X
🧵Minors cannot consent to receiving puberty blockers and cross-sex hormones, which pose the risk of rendering them infertile and with lifelong sexual dysfunction. They are too young to be able to predict their future fertility desires or even to know how an orgasm feels and to be able to weigh those future needs against their desire to treat their current gender dysphoria. Only their parents or guardians may consent on their behalf. Therefore adults must decide on behalf of children whether the presumed benefits of this treatment outweigh the risks, known and unknown. These decisions must be made even with an evidence base that can provide no clear conclusions as to the actual benefits of treatment, according to a half-dozen systematic literature reviews—the gold standard of scientific evidence. Also, the one study that directly assessed whether these treatments were tied to a difference in the suicide death rate found they were not. Therefore the claim that the treatments are a matter of life and death is not evidence-based. @KristopherWells makes such a claim despite being an academic who is well versed in evidence-based-medicine principles. @tylerblack32Image
Here is Marci Bowers, the president of @WPATH, describing how natal males with gender dysphoria who under go pubertal suppression and estrogen treatment have no sexual function whatsoever. This child was going in for a vaginoplasty and didn’t even know what an orgasm was. alabamaag.gov/wp-content/upl…Image
Tyler Black, however, says that “Parents do not have absolute rights” when their kid wants gender-transition treatment. He dismisses various qualms about such treatment, such as the fact that its efficacy is unknown. And he makes a false comparison to cancer care, neglecting to note that absent treatment, cancer is typically certifiably fatal; whereas the same cannot be said about pediatric gender dysphoria. There is considerable evidence, in fact, that most minors with GD will grow out of it. Also, cancer surgery, such as an orchiectomy (testicular cancer does occur in teenage boys), removes a part of the body that is diseased. Gender-transition surgery removes a healthy part of the body that might have been used for a specific purpose if left in place (eg: sexual reproduction, breastfeeding). Lastly, saying that “Parents do not have the right to do whatever they want to kids” is moot when parents are arguing *against* doing something to their child and *for* leaving their child’s body alone to experience its own endogenous puberty.Image
@wpath New Evidence Challenges Institutionalized Belief That Transgender Teens Become Transgender Adults, Undermining Core Defense of Medical Gender Transitions for Minors nysun.com/article/new-ev…
@wpath None of the examples that Black provides in this thread are fair comparisons to gender-transition treatment for minors. And yet he concludes the thread suggesting that he’s just proven that minors have the capacity to consent to such treatment. He absolutely has not.
@TylerBlack32 is insinuating that either doctors or the state have the right to overrule parents who object to their child’s wish to undergo a gender-transition treatment. This poses the question of how these external authority figures can be certain they know better than the parents what is best for their child. Based on what research? We have established that the efficacy of this treatment remains unknown and that the known risks, saying nothing of the unknown risks, are severe. So how is this dynamic so exceptional that outside forces may be permitted to overrule the parents and put a child under a medical treatment that has very intense, irreversible, lifelong impacts?
Dr. @TylerBlack32's scenario in which parents' refusal to consent to gender-transition treatment for children is overruled by an outside authority is, in fact, supported by the American Academy of Pediatrics. After acknowledging what Dr. Black does not, that parental or guardian consent is required for such treatment, the @AmerAcadPeds then strongly suggests that pediatricians should look into having the state seize control of the child in question if the parents refuse to consent to a medical gender transition.

This screen shot is from the AAP's 2018 policy statement on gender-affirming care, which is thus far the subject of a detransitioner lawsuit and will likely soon be the subject of a lawsuit from Republican attorneys general, who suggested in a recent letter to the AAP that it violates consumer protection laws. publications.aap.org/pediatrics/art…Image
@tylerblack32 WPATH President Marci Bowers acknowledges that gender transition treatment can destroy the capacity for natal males to have an orgasm. @tylerblack32 insists that parents cannot always be trusted should they deny consent for such treatment.

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More from @benryanwriter

Jun 30
Fact checking Michael Hobbes

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.

In thisđź§µI will fact check Hobbes:
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Here is a link to the podcast: podcasts.apple.com/us/podcast/the…
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.

pmc.ncbi.nlm.nih.gov/articles/PMC10…Image
Read 26 tweets
Jun 30
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.Image
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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.Image
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.Image
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Read 4 tweets
Jun 29
The Liberal Misinformation Bubble About Youth Gender Medicine

How the left ended up disbelieving the science

By @HelenLewis for @TheAtlantic Image
Debunking podcaster Michael Hobbes, a prime source of misinformation about pediatric gender-transition treatment, slams @HelenLewis of @TheAtlantic for criticizing people such as him.
Read 5 tweets
Jun 27
The Bleuskie crowd is livid over Andrew Sullivan’s Times opinion essay about LGBTQ activism: 🧵 Image
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Read 6 tweets
Jun 26
How the Gay Rights Movement Radicalized, and Lost Its Way

By Andrew Sullivan for @nytopinion
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GIFT LINK: How the Gay Rights Movement Radicalized, and Lost Its Way

By Andrew Sullivan
nytimes.com/2025/06/26/opi…
Ten years ago Thursday, the movement for gay and lesbian equality scored a victory that only a decade before had seemed unimaginable. We won equal rights to civil marriage in every state in the country. In 2020 came another stunning win. In a majority opinion written by one of President Trump’s nominees, Justice Neil Gorsuch, the Supreme Court found that gay men, lesbians and transgender men and women are covered under Title VII of the 1964 Civil Rights Act, and protected from employer discrimination.

In 2024, the Republican Party removed opposition to marriage equality from its platform, and the current Republican Treasury secretary, Scott Bessent, is a married gay man with two children. Gay marriage is backed by around 70 percent of Americans, and discrimination against gay men, lesbians and transgender people is opposed by 80 percent. As civil rights victories go, it doesn’t get more decisive or comprehensive than this.Image
Read 41 tweets
Jun 21
Debunking podcaster Michael Hobbes has issued a stream of false or misleading claims about the Times article about the @ACLU’s tangled path to Skrmetti—the SCOTUS case on pediatric gender-transition treatment.

Allow me to demonstrate how wrong Hobbes is.

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The thing about conspiracies is that sometimes they actually occur. Subpoenaed records show WPATH squelched systematic reviews of gender care they commissioned when the results did not support their advocacy movement.

And Hobbes, perhaps because he doesn’t know or understand what those reviews are about, issues a sleight of hand by suggesting that the reviews were irrelevant since there is no evidence kids are getting rushed into surgeries. But that’s not what the reviews were about. They were about the strength of the evidence backing gender-transition treatments.Image
One of Hobbes’ methods is he believes that all the supposedly bad-faith actors he scrutinizes work out of a common playbook.

The subpoenaed records show that WPATH leaders went well beyond trying to keep their work from being weaponized. They coordinated with Chase Strangio and others at the ACLU to draft their trans-care guidelines for the purpose of helping them win lawsuits, even as WPATH leaders themselves were already directly involved in such suits. And absent scientific justification, they included words like “medically necessary” in the guidelines for the purpose of securing insurance coverage.

But in Hobbes’ telling, the only bad-faith actor in this story is the Alabama attorney general for uncovering these records that revealed these actions on WPATH’s part.

This raises the question: Should those who create medical guidelines be transparent and remain honest with doctors and the public about the ways that the science is lacking?Image
Read 16 tweets

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