Big news 🚨

District court vacates Biden-era rule declaring that “sex” in Section 1557 of the ACA includes “gender identity.”

This rule and its antecedents in the Obama years mandated that healthcare providers offer “gender-affirming care.” 1/ 2/ The court disagreed with the Biden HHS that the Supreme Court’s reasoning in Bostock v. Clayton Country (2020) requires interpreting Title IX (imported into 1557) to mean that sex = gender identity.

Even if that were true, the court adds, Bostock doesn’t compel gender Rx.

NEW: My analysis of the @AmerMedicalAssn videos published yesterday and today by @realDailyWire @benshapiro is now available at @CityJournal.

This is the most vivid illustration I’ve seen of the broken chain of trust in medicine. 1/ 2/ The AMA president, Dr. Bobby Mukkamala, cites false stats on gender medicine and suicide (“50 to 70 percent”).

Worse, he seems unaware of how evidence-based medicine works, specifically with regard to conflicts of interest in evidence evaluation.

Scott Leibowitz, a gender clinician and author of @wpath SOC-8, writing in @medpagetoday makes some pretty astonishing claims about the recently published @HHSGov report on pediatric gender dysphoria.

Here are four examples🧵 Regret and Bans

According to Leibowitz, the report "heavily emphasizes concern for regret to justify its extreme positions supporting gender care bans."

FACT: The report explains that while "proponents and critics alike consider the question of regret as central to the ethics of PMT," in fact "regret alone... is not a valid indicator of whether an intervention is medically justified." Patients can regret justified medical interventions or be satisfied with unjustified ones. See Section 13.4.

The report does not recommend or condemn bans; it explicitly says that it "does not issue legislative or policy recommendations" (p. 10).

🚨Dr. Daniel Shumer of @UMichMedSchool is a prolific expert witness in transgender litigation. He has served as expert witness in “about 15” lawsuits and has been paid around $150,000 over the past 4-5 years.

Shumer has admitted to plagiarism in his expert report.

🧵 The admission was made in a deposition on March 5, in the context of litigation (Doe v. Horne) over an Arizona law prohibiting males from competing in female sports.

🚨The New England Journal of Medicine is one of the most prestigious medical journals in the world.

In a new investigation for @CityJournal, I show how @NEJM has put ideological commitments over scientific rigor and debate on the topic of youth gender medicine.

Thread 🧵 2/ My investigative dive into NEJM’s conduct is based on published documents, unpublished submissions and backdoor communications with journal editors.

NEW: The Deposition of Eli Coleman

For the first two articles in this series, I covered the depositions of @Jack_Turban and Meredithe McNamara.

Today’s article in @CityJournal is all about the chair and lead author of @wpath’s latest “standards of care." 🧵 Dr. Eli Coleman, a professor emeritus at @UNM_MEDS and founder of U of M's @Human_Sexuality, which was renamed in his honor, submitted to an 8-hour deposition at the hands of Roger Brooks of @ADFLegal in the context of Boe v. Marshall, the Alabama age restriction lawsuit.

One benefit of the new lawsuit against Johanna Olson-Kennedy is that newspapers will have little choice but to report on it, and on her, and will inevitably reveal to the public one of the darkest and most twisted figures in “gender medicine.”

It is truly something to behold. To give just one example:

https://twitter.com/4th_wavenow/status/1397547754000420864

BREAKING: Johanna Olson-Kennedy, perhaps the top name in pediatric "gender-affirming care" in the U.S., is being sued by a former patient.

@jessesingal reports in @TheEconomist 🧵 JOK does not believe in mental health assessments, Singal reports. "I don't send someone to a therapist when I'm going to start them on insulin," she once explained.

The @ChildrensLA doctor has referred children as young as 12 and 13 for, respectively, hormones and mastectomy.

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." 🧵 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.

NEW: On behalf of @ManhattanInst, @ishapiro @JKetcham91 and I filed an amicus brief in support of Tennessee in U.S. v. Skrmetti, the Supreme Court case dealing with state age restrictions for sex trait modification procedures ("gender-affirming care").

🧵 2/ Our brief is a rebuttal to the amicus brief submitted by "Expert Researchers and Physicians" (McNamara et al.), which is a version of the Yale Integrity Project's white paper, which criticizes the Cass Review.

🚨NEW DOCUMENTS in the Alabama lawsuit over sex "change" age restrictions.

Some very interesting facts now coming to light. 🧵 1/ @wpath sought but did not receive the American Academy of Pediatrics’ (@ameracadpeds) endorsement for its eighth “Standards of Care” (SOC8).

In private emails to WPATH a colleague, SOC-8 lead author Eli Coleman said that this was “highly confidential.”

🚨 CRITICAL FINDING

An ongoing @manhattaninst analysis of an all payer, all claims insurance database shows that the 7-year diagnostic persistence rate of adolescent gender dysphoria is between 40-50%.

I discuss this major finding in a new article for @CityJournal 🧵 A central belief justifying medical interventions for gender dysphoric (GD) adolescents is that, unlike childhood GD, GD that persists into (or even arises in) adolescence is almost always permanent. If the condition isn’t permanent, why offer Rx with permanent effects?

🚨NEW: I’ve received a FOIA’d file from the Washington State Department of Social and Health Services (@waDSHS) about a 17-year-old receiving puberty blockers.

I’ve seen some extreme cases of medicalization in the past, but this one stands out even for a deep blue state. 1/5 The kid is reported to have a “past [of] extensive abuse [including sexual] and neglect” and to have been through “93 different placements,” which include Qualified Residential Treatment Programs. 2/5

"McNamara et al. [the misleadingly titled 'Yale report' criticizing the @thecassreview @Hilary_Cass] is an exceptionally misleading, confused, and fundamentally unprofessional document."

A must-read by @jessesingal, but let me add a few additional details. 🧵 2/ The white paper is a good example of "eminence-based medicine." Its authors seemed to want to use the reputation of @Yale @YaleMed @YaleLawSch to bolster the credibility of the report. But they did so seemingly without first getting the approval of Yale.

BREAKING: The American Society of Plastic Surgeons, an organization representing 92% of all board-certified plastic surgeons in the U.S., becomes the first major medical association to break from the consensus over “gender-affirming care” for minors.

This is big news. 🧵 2/ In the U.S., the use of puberty blockers, cross-sex hormones and surgeries to help kids who feel distressed about their developing bodies has depended on a perceived consensus of medical groups.

🚨 This is an extremely important new report by @writingblock for @TheFP about Planned Parenthood (@PPFA), a leading supplier of on-demand hormones to troubled teens and young adults.

Highlights... 🧵 1/9

thefp.com/p/how-did-plan… 2/ # of PPs offering "gender-affirming" hormones:

2005: 1
2015: 24 (approx.)
2024: 450

Current annual revenue: $2 billion (approx.)

In a new article in @latimes, @MackenzieMays takes aim at @ChoooCole, a prominent detransitioner.

Mays' article is full of errors & misrepresentations.

Here is just one example of how Mays misrepresents the science she herself cites. ⬇️

latimes.com/california/sto… Arguably, Mays' most important empirical claim is that regret is very rare, and that “some studies” show a regret rate of “as little as 2%.”

The study she cites for this claim is Dhejne et al., “An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets,” Arch Sex Behav (2014). This is a Swedish study based on data from a national database.

NEW: @ManhattanInst colleagues @ishapiro @JKetcham91 and I have submitted an amicus brief in support of parents suing the Eau Claire Area School District in Wisconsin over its secret gender transition policy.

This is a "Brandeis brief" on social transition.

⬇️⬇️⬇️ 2/ The school district instructed staff that “parents are not entitled to know their kids’ identities [at school]. That knowledge must be earned.”

According to the complaint, a teacher posted a flyer with: “If your parents aren’t accepting of your identity, I’m your mom now.”

1/ This is incredible. In the last 24 hrs, the Biden White House’s lack of message discipline accidentally revealed that its official statements on youth gender medicine are dictated to it by outside transgender activists and pressure groups. 2/

https://twitter.com/LeorSapir/status/1808333209844814288

McMaster University's @Real_Yuan24, an expert in evidence-based medicine, makes some important comments about the "values and preferences" component of clinical guidelines, specifically in the context of gender medicine.

Here is a thread with his observations. 🧵 2/ For context, in EBM evidence alone is not enough for the development of clinical guidelines. When moving from evidence to recommendations, clinical practice guideline developers are also supposed to take into account patient "values and preference" (among other things).

This statement by @AAPPres of @AmerAcadPeds, in response to the interview with Hilary Cass in the NYT times, is so utterly dishonest. It implies that the AAP's position was articulated in response to state age restriction laws. 1/5 The AAP's policy position was published in 2018--well before age restriction laws were first introduced in the states (2020).



@AbigailShrier's Irreversible Damage, which brought the issue to public attention, also didn't come out until 2020. 2/5publications.aap.org/pediatrics/art…