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Leor Sapir Profile picture
@LeorSapir
Oct 23, 2024 • 11 tweets • 5 min read • Read on X
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NEW: Azeen Ghorayshi reports in the @nytimes that prominent gender clinician Johanna Olson-Kennedy of @ChildrensLA has refused to publish data from a study on puberty blockers, fearing that the unimpressive results will be "weaponized" by critics of "gender-affirming care." 🧵 Image
Olson-Kennedy told the Times that the kids didn't improve because their mental health was "in really good shape" at the start of the study.

As Ghorayshi notes, this seems to contradict what Olson-Kennedy et al. reported in 2022 about the study's cohort at baseline. Image
Olson-Kennedy fears the study's results could be cited by critics of pediatric sex "change" in court cases. She doesn't seem to think that, as a medical researcher and clinician, her primary responsibility is to her current and future patients.

Doctors as agents of lawfare. Image
Ghorayshi's report is helpful in holding members of the gender Rx industry accountable, but it also has at least three problems.
First, Ghorayshi mentions the reported findings of the Dutch puberty blocking study but not the highly important critique of those findings, nor that systematic reviews (e.g., NICE 2020) have found it to be unreliable due to risk of bias.

More here: tandfonline.com/doi/full/10.10…Image
Second, Ghorayshi mentions the reported findings of the NIH-funded cross-sex hormone study but doesn't mention that the boys showed no improvement while the girls' improvement was very small. Nor does she mention the authors' HARK-ing and goalpost shifting. Critical problems. Image
I discuss these issues re: the NIH study in our recent amicus brief: supremecourt.gov/DocketPDF/23/2…

Jesse Singal has also written about the NIH study at length.

Part 1: jessesingal.substack.com/p/on-scientifi…

Part 2: jessesingal.substack.com/p/the-new-high… Image
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Finally, it's disappointing to see the Times continue to refer to the kids given Rx as "transgender adolescents." This isn't a neutral term. Whether these kids "are transgender," or what it means to say such a thing, is half the debate in a nutshell.
Neutral terms for journalists who want to remain independent of the controversy and not (intentionally or unintentionally) put their thumb on the scale:

Adolescents with gender dysphoria.
Adolescents who identify as transgender.
The article in the New York Times: nytimes.com/2024/10/23/sci…
x.com/benryanwriter/… x.com/benryanwriter/…

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More from @LeorSapir

Leor Sapir Profile picture
Jun 17
NEWS: The Federal Trade Commission has just announced its lawsuit (with four states) against the World Professional Association for Transgender Health. 👇 Image
The FTC alleges that WPATH "misled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness" of gender transition interventions (puberty blockers, cross-sex hormones, and surgeries), "in violation of the FTC Act."
The complaint has been filed in the federal district court for the northern district of Texas, a traditionally friendly venue for such actions.
Read 6 tweets
Leor Sapir Profile picture
Jun 16
Another Major Transgender Suicide Study Crumbles

A widely cited study published in the prestigious @NatureHumBehav claimed that “anti-transgender laws” encouraged teen suicide attempts.

A new methodological review dismantles that finding.

New from me in @cityjournalImage
In 2024, amidst a wave of state legislation on transgender issues, a leading academic journal published a study claiming to find that that legislation increased suicide attempts by up to 72%. Image
The finding was blasted all over left-of-center media, with even some healthcare outlets uncritically citing its conclusion as well. Image
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Read 11 tweets
Leor Sapir Profile picture
Jun 8
NEW: Last week, the Senate Health, Education, Labor & Pensions committee held a hearing on pediatric gender medicine.

The hearing was predictable and largely unremarkable but for a very curious, and potentially very important, omission. 🧵Image
At no point did the Senate Democrats or their expert witness, @shannonminter5 of the National Center for LGBTQ (formerly Lesbian) Rights (@NCLRights), refer to or cite the authority of the World Professional Association for Transgender Health, or WPATH (@wpath). Image
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In 2023, Minter, an attorney, testified before the House Judiciary Committee on the same topic.

Minter's submitted written testimony from that hearing cited WPATH and its Standards of Care, v. 8.Image
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Read 13 tweets
Leor Sapir Profile picture
Jun 1
NEW: Two coauthors of the HHS review on treatment for pediatric gender dysphoria argue in @JAMAPediatrics that the Centers for Medicare and Medicaid "should carefully consider whether the proposed rules may be improved by the inclusion of a grandfather clause." 🧵 Image
Kathleen McDeavitt, a psychiatrist at Baylor College of Medicine, and Moti Gorin, a philosopher and bioethicist at Colorado State University, are coauthors (with me) of the U.S. Department of Health and Human Services' peer-reviewed report from last year. Image
The centerpiece of the HHS review was an "umbrella review" (systematic review of systematic reviews) which confirmed the finding that pediatric medical transition is based on very low certainty evidence (using GRADE).

Appendix 4 contains the umbrella review in full 👇 Image
Read 11 tweets
Leor Sapir Profile picture
May 21
NEW: @jessesingal with new revelations, based on FOIAs, about the Johanna Olson-Kennedy-led, @NIH-funded ($10m) research initiative on pediatric gender medicine. 🧵

NIH was misled with help from @wpath and @TheEndoSociety.Image
Olson-Kennedy and her colleagues intended to study the effects of puberty blockers and cross-sex hormones in minors.

NIH initially "expressed qualms" about the proposed study being observational rather experimental. Singal explains the difference, and why it matters.
With support from @wpath and @TheEndoSociety, however, Olson-Kennedy told NIH that the treatments are known to work and that withholding them (i.e., having a control group) would be unethical.
Read 7 tweets
Leor Sapir Profile picture
May 6
I'm often asked: “What makes pediatric gender doctors do what they do?"

Good question.

Here are 9 overlooked factors, to add to the obvious one: ideological agreement with the “gender-affirming” outlook.

These are unsystematic observations, so take with a grain of salt. 🧵
1. Lack of experience. Early-career doctors lack clinical experience, a critical corrective mechanism to the abstractions they absorb in the classroom. Also, being young, they typically don’t have kids themselves and therefore have not experienced the ways of developmentally typical children and teens. If a young clinician lacks these experiences but constantly sees trans-identified patients, it's easy to see how s/he would have a skewed understanding of human sexual development.
2. Action bias. Medicine—and, some would argue, most of healing—often consists of not doing anything, counting on the body’s natural tendency to heal itself while watchfully waiting to see if/when intervention is needed. For adolescents in the throes of puberty, time and experience typically build resilience and mitigate distress. It’s tempting for inexperienced healers to want to “do something” and to equate inaction with not helping or even harming.
Read 11 tweets

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