🧵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. @tylerblack32
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…
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.
@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…
@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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Queer editor James Ball declares Bluesky a “dying social network,” blaming aggressive censoriousness by Blueskyites of perceived ideological enemies:
“There's a large cadre that basically cheers on chasing off any lib/centrist/academic who's the punchbag of the day. There's a culture of saying ‘fuck off back to X, then.’ And the anti- bedtime leftists set too much of the culture.
“I don't know if it's fixable, especially as I think quite a lot of the people here don't *want* to fix it. But at the rate users are quitting they'll run out of targets soon enough, and the rest of us will lose what is – for a fair few of us I suspect – the last fun/useful social network. Sigh.”
More from James about Bluesky’s demise:
The grim Bluesky stats. Turns out echo chambers are not big business.
This catalogue, which the World Professional Association for Transgender Health, or WPATH, fought to keep shielded, provides a rich account of how leading figures in pediatric gender medicine approached scientific research, drove the evolution of medical practices, and strategized politically during a critical turning point in this field’s brief and tortured history. The two years following Chase Strangio’s 2021 address were a period in which statehouse Republicans escalated their attacks on this field. The WPATH conference presenters largely responded to the political siege by doubling down. Rather than engage in soul searching over whether their methods in pediatrics were ethically sound and whether any criticisms had merit, they overwhelmingly stuck to their guns.
Presenters frequently downplayed fundamental hazards about irrevocably altering adolescents’ bodies. Meanwhile, a parade of systematic reviews—the gold standard of scientific evidence—was concluding that the evidencebacking pediatric gender medicine is weak and inconclusive. These findings have led health authorities in a number of European nations, concerned about risks such as infertility, to reverse course. They reclassified pediatric gender-transition interventions as experimental and sharply restricted minors’ access.
Not WPATH. The organization remained on an inexorable trajectory in the opposite direction, toward its eventual head-on collision with the second Trump administration.
For highlight clips, see the 🧵👇
Kellan Baker counseled against saying “gender-affirming care.” Messaging research indicated that when people hear it, he said, “they think ‘trans kids in the driver’s seat.’” But he said this was an accurate assessment. “I think we all support trans kids in the driver’s seat because it’s their bodies, it’s their lives,” he said.
“But when you think about folks who don’t know trans people, they are very scared by the idea that young people are making irreversible decisions and that no one else has any oversight over those decisions.”
To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…
Johanna Olson-Kennedy: “I think that a lot of this conversation...gets talked about through a lens of ‘How can we make sure people are really trans,’ right? And ‘They’re not going to regret their decision later?’” But “that’s actually not the discussion that I’m interested in participating in," she said. "I’m interested in discussing and having a conversation about giving the very best possible care to trans young people—the care that they need and deserve.”
To read my article in @CompactMag about the 100s of videos I obtained from the World Professional Association for Transgender Health (WPATH) and its US offshoot, USPATH: compactmag.com/article/how-ge…
🧵👇Debunking podcaster Michael Hobbes is wrong about the American Medical Association’s longstanding position about youth gender surgeries.
Before Feb. 2026, the AMA had never specified that gender surgeries should generally be reserved for adults.
In 2024, the AMA asserted: “Our American Medical Association recognizes that medical and surgical treatments for gender dysphoria and gender incongruence, as determined by shared decision making between the patient and physician, are medically necessary as outlined by generally-accepted standards of medical and surgical practice.”
Hobbes is pointing to this WPATH FAQ without acknowledging (or knowing) that it actually misrepresents what the organization’s trans-care guidelines, The Standards of Care Version 8 (SoC 8) says. WPATH famously removed all age limits (except for phalloplasty) in the SoC 8 when it was published in Sept 2022 under pressure from the American Academy of Pediatrics.
Hobbes fails to understand that the original reporter who published the AMA’s statement saying it sided with the ASPS on youth gender surgeries was not Jeremy Peters, it was Andrew Jacobs, who could in no way be considered a part of this supposed “anti-trans braintrust.” Peters was only reiterating what Jacobs originally reported.
And yes, the statement was a shift, otherwise the AMA wouldn’t be trying to walk it back and say they were misquoted. Because the AMA knows that the statement reads as if they did make a shift in policy.
Is the AMA Telling the Truth About Their Expressed Positions on Youth Gender Surgeries?
The American Medical Association to the @StrackHaley at the National Review @NRO on Feb. 3: "[T]he AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood."
The @AmerMedicalAssn today: "We responded" to questions about the American Society of Plastic Surgeon's opposition to pediatric gender-transition surgeries "only after being contacted by media outlets, using the language approved by the board. While some media coverage characterized this as agreement with the ASPS statement, that phrasing did not come from the AMA."
Meghan Wachspress, who accused Illinois congressional candidate Daniel Biss of an "inappropriate relationship" after he, at 26, was her math prof and she, 20, was his student and the 2 dated for a while and made out in '04, wrote on Substack in 2025 that MeToo didn't go far enough.
"In an alternate universe the experiences encompassed by #metoo could have expanded outward to include other kinds of workplace interactions and structural inequalities that minimized or objectified women in the Kantian sense (making them men’s tools), costing women status, money, and time compared to their male colleagues," she wrote. substack.com/home/post/p-16…
@chadfelixg Harvard Law School clinical instructor and trans activist Alejandra Caraballo is unhappy about @BenAppel’s article in @TheAtlantic, calling it the “‘they're transing the gays’ conspiracy theory.”