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…

NEW: UCSF's (@UCSF @UCSF_IHPS) Dr. Jack Turban (@jack_turban) claimed at @theDPUnion debate that the Cass-related systematic reviews found moderate quality evidence that puberty blockers improve mental health.

In a new article, I explain why this claim is false.

⬇️⬇️⬇️ 2/ First, Turban confuses quality of studies with quality of evidence. These are distinct concepts in evidence-based medicine, and any clinician opining on the evidence base of medical treatments should understand the difference.

UCSF's (@UCSF @UCSF_IHPS) Jack Turban (@jack_turban) claims that a new systematic review of the evidence for puberty blockers, published alongside the Cass Review (@thecassreview), finds “moderate quality evidence" for the use of these drugs in youth gender medicine.

⬇️⬇️⬇️ In an upcoming article, I explain how Turban confuses quality of studies with quality of evidence—two very different concepts in evidence-based medicine—and ignores the significance of the scoring tool the authors of the systematic reviews used. 2/

I just read the complaint filed by the ACLU of Ohio (@acluohio) asking a state court for temporary injunction against HB68, the new law that restricts “gender-affirming care" to adults only.

What a mess of a document.

⬇️⬇️⬇️ 1. ACLU can’t seem to decide if it’s alleging disparate treatment or disparate impact. These are different theories for why some law or policy may violate civil rights or constitutional provisions.

Andrea Long Chu's (@andrealongchu) March 11th cover story for @NYMag has sparked some thoughtful reflection in liberal journalism.

⬇️⬇️⬇️ Chu’s essay is worth reading. It makes the case for unrestricted minor access to hormones and surgeries, ignores everything we know about child and adolescent psychology, and openly states that humans have no obligation to come to terms with reality.

The Mary Bridge Children's Gender Health Clinic (@Mary_Bridge), which is part of MultiCare health system (@MultiCareHealth) in Tacoma, Washington, and site of whistleblower Tamara Pietzke, offers kids resources on binding and tucking. /1

⬇️⬇️⬇️ Tucking is the process by which boys push their testicles up into the inguinal canal, use their testicle-free scrotum to wrap their penis, and then secure their wrapped penis within their butt cheeks using methods like compression underwear or tape. /2

With the release of the WPATH Files, it's important to keep in mind that WPATH has been using mainstream medical associations like the Endocrine Society (@TheEndoSociety) to launder its pseudoscientific claims and promote experimental and harmful practices.

A thread. At least 6 of the 10 authors of the Endocrine Society’s 2017 Clinical Practice Guideline were/are WPATH members. That guideline is still in effect today.

In a new article for @CityJournal, MI's Joe Figliolia explains the problems with the "minority stress" hypothesis in the context of "gender-affirming care" and the mounting evidence against it. /1

city-journal.org/article/gender… The "minority stress" theory occupies a central role in the "gender-affirming" worldview and model of care. It is used to explain the extremely high rates of coexisting mental health and neurocognitive problems in trans-identified youth. /2

UCSF’s Jack Turban (@jack_turban) and Yale’s Meredithe McNamara recently criticized a new Finnish study that further weakens the “suicide prevention” narrative.

Their criticisms are wrong and hypocritical.

Here’s why. 🧵 To recall, the Finnish study found that suicide in gender clinic-referred (GR) youths <23 was uncommon (0.3%), and when the model adjusted for severe psychiatric comorbidities, there was no statistically significant difference in suicide rates between GR youth and controls. /2

1/ 🚨Some MultiCare UPDATES following Tamara Pietzke blowing the whistle in The Free Press and my follow-up report in City Journal. 2/ The Mary Bridge Children's Gender Health Clinic, which is owned and operated by MultiCare, has deleted a webpage where the clinic's social worker, Aytch Denaro (they/them), proudly reports: "Since joining Mary Bridge Children’s Gender Health Clinic in 2019, I have witnessed our referrals increase from less than five to more than 35 monthly."

1/ UPDATE: I've received email communications between Tamara Pietzke, the new whistleblower from the state of Washington, and her coworkers and supervisors at MuiltiCare. I will be making these emails public soon, but in the meantime, here's a snippet of what's inside them. 🧵 2/ On January 2, 2024, a month before Tamara went public, she sent an email to MultiCare's "gender-affirming care" specialist (who is also part of MC's DEI team) expressing her concerns about a young teen girl whose heartbreaking story was among those revealed in the Free Press article.

The 10 most popular NYT reader comments to the piece on detransitioners and the harms of "gender-affirming care" today: ⬇️⬇️⬇️ 1. "I predict we will look back on this period with the same disgust we feel about the overprescription of amphetamines like Adderall to every 8-year-old boy who couldn't sit still for an entire day. The most damage is often done by doctors and parents who are so well-meaning that they cease to think critically."

Pamela Paul's piece on detransitioners and "gender-affirming care" in the New York Times today is a welcome journalistic contribution to the ongoing debate on a thorny subject.

Paul gets many things right and one thing wrong.

Thread 🧵 Let's start with what Paul gets rights.

1. The recommendations of U.S. medical associations are out of sync with a growing number of countries and are not based on reliable evidence. These groups are not accountable for the harmful practices they are promoting.

Every time I recommend "The Myth of 'Reliable Research'" to medical professionals, they tell me it's a superb article, research at its finest.

They're not wrong.

A thread 🧵 The foundation for sex trait modification in minors ("gender-affirming care") is a Dutch study, published in two papers (2011 and 2014), and widely cited even today, even by transgender advocacy groups like WPATH, as the gold standard of research in this area.

🚨🚨 IMPORTANT 🚨🚨

The World Health Organization is convening a guideline development group (GDG) on gender medicine.

I rarely circulate or ask followers to sign petitions, but I’m making an exception because WHO’s actions are very troubling.

Thread. ⬇️ On December 18, WHO announced that it will be developing a guideline on “the health of trans and gender diverse people.” As the petition notes, there are three areas of concern here.

NEW: In a Letter to the Editor in Archives of Sexual Behavior (@ArchSexBehav), Lisa Littman (@LisaLittman1), Michael Biggs and I analyze a recent study by Jack Turban (@jack_turban) of @UCSF and colleagues related to #ROGD.

Thread 🧵 Turban et al.’s paper, “Age of Realization and Disclosure of Gender Identity Among Transgender Adults,” was published in the Journal of Adolescent Health last March.

jahonline.org/article/S1054-…

LEAKED 🚨🚨: The American Academy of Pediatrics (@AmerAcadPeds) is instructing its members to avoid using work emails when communicating about “AAP matters,” especially “sensitive topics,” due to concerns about “subpoenas” and “FOIA requests.” The directive from CEO Mark Del Monte (a lawyer) takes force on January 1, 2024, and applies “only to members who serve on committees councils, sections, task forces, editorial boards, [and] other advisory bodies.”

NEW: In an important Letter to the Editor, bioethicist Moti Gorin (@GorinMoti) criticizes a recent article by lawyer and transgender activist Alejandro Caraballo (@esqueer_), titled “The Anti-Transgender Medical Expert Industry,” published in @JLME_ASLME.

Thread 🧵 As state age restriction laws on “gender-affirming care” are fought over in the courts, a key question is who counts as an expert in pediatric gender medicine, and thus whose testimony should guide judges in their decisions.