NEWS: The Federal Trade Commission has just announced its lawsuit (with four states) against the World Professional Association for Transgender Health. 👇 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."

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 @cityjournal 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%.

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. 🧵 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).

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." 🧵 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.

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. 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.

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.

Even liberal commentators now realize that the Southern Poverty Law Center is little more than a smear machine.

But it's more than that. It's a vital component in the left-wing policy network encompassing epistemic institutions, media, and parts of the Democratic Party. 🧵 Pediatric gender medicine is an example. A 2023 SPLC report claimed to find that the Society for Evidence-Based Gender Medicine (SEGM), an organization focused on scrutinizing the evidence base for pediatric transition, is a "hate group" and the "hub" of misinformation.

BREAKING: The New York Times (@nytimes) has just called out the Chair of the Board of the American Medical Association (@AmerMedicalAssn), Dr. David Aizuss (@lasereyedoc), for misrepresenting his organization's recent media statements on pediatric gender medicine.

Here's what happened🧵 On February 3, the American Society of Plastic Surgeons (@ASPS_News) published its policy statement acknowledging the low quality of evidence for hormones and surgeries in <19 and recommending that surgeries be deferred to age 19+.

Two articles came out today on pediatric gender medicine and its current political context.

Both are worth reading🧵 In @TheAtlantic, @benappel writes about the difficulties growing up as an effeminate boy. He would later discover that so-called "progressives" were now nudging effeminate boys to interpret their feelings of difference as evidence that they are really girls.

NEW: “I’ve been covering this controversy for about a decade from a left-of-center perspective, and I’ve found that anyone who questions these treatments, even mildly, is invariably accused of bigotry.”

🧵on @jessesingal’s important new piece in the New York Times this morning. For years, LGBT organizations insisted that the science of youth gender medicine was settled, citing an apparent consensus of medical associations.

🚨A group of 106 members of Congress wrote a letter to Secretary of HHS RJK, Jr., criticizing the Department's efforts to roll back what they call "medically necessary, evidence-based care" in the form of puberty blockers and cross-sex hormones (but not surgeries). 🧵 With surgeries unmentioned, the authors say that endocrine interventions are supported by "every major medical and mental health association in the U.S."

🚨While attention has been focused on medical groups backing off from gender surgeries in minors and a $2M detransitioner lawsuit, an important exchange has taken place in Stat News Opinion First between authors and critics of the HHS report on pediatric gender dysphoria.

👇 Last week, a group of self-described “pediatric bioethicists” and advocates for pediatric medical transition (PMT), including Yale Medicine’s Meredithe McNamara, criticized the HHS report, writing that “analysis of its poor ethical reasoning remains urgently needed.”

BREAKING: American Society of Plastic Surgeons issues new position statement opposing "gender-affirming" surgeries in adolescents under the age of 19.

ASPS also acknowledges risks of endocrine interventions, poor guidelines, and inappropriate use of "autonomy" principle. plasticsurgery.org/for-medical-pr…

Thousands of U.S. parents have consented to having surgeons remove their daughters' breasts after being assured that their daughters were at serious risk of suicide otherwise.

Now, the incoming president of WPATH says mastectomy "in and of itself" doesn't prevent suicide.

https://twitter.com/benryanwriter/status/2018183879035629603

This is the result of our data analysis of U.S. insurance claims. A bare minimum of 5,200 teen girls had their breasts amputated as part of a "gender-affirming" procedure between 2017 and 2023.

The true number is likely quite a bit higher.

1/ As @abigailandwords correctly notes in @NRO, the @APApsychiatric agreed to participate in the peer-review process and condemned the report for overlooking 16 studies, but the APA itself overlooked the HHS report's evidence review, which included 12 of those studies. In fact, several of them (e.g., Tordoff, Chen, de Vries) were discussed in detail in the main report. Of the remaining 4 studies, 3 were on adults rather than youth, and 1 was published after the HHS Review came out (though the final version does account for it).

#ReadtheReport 2/ Here is a summary of the allegedly overlooked studies cited by @APApsychiatric and where they appear in the HHS Review. It can easily be found in the Supplement, which was published on Wednesday.

🚨With a puberty blocker trial looming in the UK, here is why the HHS Review concludes: "administering [pediatric medical transition] to adolescents, even in a research context, is in tension with well-established ethical norms for human subjects research." 1/5

#ReadtheReport 2/5

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.