About Health Nerd's take-down of the Finnish study on mental health outcomes among youth attending gender clinics
🧵👇
The study isn't perfect by any means. There are fair reasons to criticize it. But Health Nerd's central thesis falls apart upon the simplest examination.

I find it very disappointing when people leverage their academic credentials to supposedly bust bad science or misinformation but only wind up spreading more misinformation in the process. Where are we these days if we can't trust people to use their credentials wisely and inspire trust in those with advanced degrees?

I've tried explaining to Health Nerd what he got wrong, to no avail. It was like arguing with a character in a Lewis Caroll poem.

See the thread below.

https://x.com/benryanwriter/status/2041856288234025373

Health Nerd's argument depends on redefining the study’s outcome variable as “how many times kids saw a psychiatrist for any problem.” No, that's not what the paper measures. It measures contacts with specialist-level psychiatric treatment. In Finland, that is referral-based care generally reserved for more serious mental illness. Milder mental health problems are handled in primary care. gidmk.substack.com/p/does-gender-…

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:

HOW GENDER MEDICINE SET ITSELF UP FOR DISASTER

For @CompactMag, I report on what the 100s of WPATH conference videos I obtained tell us about this troubled field: compactmag.com/article/how-ge…

👉I 'll be publishing the conference videos on my Substack: benryan.substack.com/p/i-obtained-1…

As I write for Compact magazine:

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…

I will be publishing the most notable conference videos on my Subsack: benryan.substack.com/p/i-obtained-1…

🧵👇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.”

No mention of age limits.

policysearch.ama-assn.org/policyfinder/d… 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.

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." The AMA on Feb 3:
nationalreview.com/news/first-maj…

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… She also posted this:

https://twitter.com/benryanwriter/status/2033954350033473592

IN DEFENSE OF EFFEMINATE GAY BOYS

If anyone had suggested that I might really be a girl, I don’t know how I would have responded, by @BenAppel for @TheAtlantic.

GIFT LINK: theatlantic.com/ideas/2026/03/… Similarly, @chadfelixg wrote:

thefederalist.com/2020/02/24/if-…

"The science doesn’t seem so settled after all, and it’s important to understand what happened here. The approach of left-of-center Americans and our institutions — to assume that when a scientific organization releases a 'policy statement' on a hot-button issue, that the policy statement must be accurate — is a deeply naïve understanding of science, human nature and politics, and how they intersect," writes @JesseSingal for @NYTOpinion.

GIFT LINK: nytimes.com/2026/02/24/opi… For @NYTOpinion, @JesseSingal writes:

The A.P.A. presents a particularly striking case of why transparency is important. In 2024, it published what it touted as a “groundbreaking policy supporting transgender, gender diverse, nonbinary individuals” that was specifically geared at fighting “misinformation” on that subject. But when I reached out to the group this month, it pointed me to a different document, a letterwritten by the group’s chief advocacy officer, Katherine McGuire, in September in response to a Federal Trade Commission request for comment on youth gender medicine.

The documents, separated by about a year and a half (and, perhaps as significantly, one presidential election), straightforwardly contradict each other. The A.P.A. in 2024 argued that there is a “comprehensive body of psychological and medical research supporting the positive impact of gender-affirming treatments” for individuals “across the life span.” But in 2025, the group argued that “psychologists do not make broad claims about treatment effectiveness.”

In 2024, the A.P.A. criticized those “mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence.” In 2025, it cautioned that gender dysphoria diagnoses could be the result of “trauma-related presentations” rather than a trans identity, and noted that “co-occurring mental health or neurodevelopmental conditions (e.g., depression, anxiety, autism spectrum disorder) … may complicate or be mistaken for gender dysphoria.” It seems undeniable that the 2025 A.P.A. published what the 2024 A.P. A considered to be “misinformation.” (“The 2024 policy statement and the 2025 F.T.C. letter are consistent,” said Ms. McGuire in an email, and “both documents reflect A.P.A.’s consistent commitment to evidence-based psychological care.”)

NEWS: Mt. Sinai, the sprawling hospital system, has joined NYU Langone in shuttering its pediatric gender clinic in the face of threats from the Trump administration of cutting off its Medicaid funding.

NYC Mayor Zohran Mamdani @ZohranKMamdani @NYCMayor pledged in his campaign to spend $65M in city funds on gender-transition treatment to evade pressures from the Trump administration to cut off such access. But since NYU announced it would no longer provide gender-transition drugs or surgeries to minors, the mayor has been mum on the potential for spending public funds on these interventions. gothamist.com/news/nyc-paren…

Taylor Lorenz Plagiarism Scandal Erupts

YouTube sleuths found: @TaylorLorenz apparently copied substantial portions of a TechDirt article about Joseph Gordon-Levitt @hitRECordJoe and Section 230.

Lorenz appeared to pass off the article's text as if it was her own script.🧵⬇️


Go to 4:22 in this video to see the part where the YouTube hosts assert that @TaylorLorenz has plagiarized her narration from a TechDirt article about Joseph Gordon-Levitt @hitRECordJoe and Section 230:
youtube.com/live/JXI9uRwfG…

I can’t even begin to enumerate all the nasty things Parker Molloy has said about me in an effort to punish me for reporting about pediatric gender medicine and to scare off other reporters who might dare to enter this arena. My policy with responding to such behavior is I report what people such a Molloy say or do, and will often fact check errors. They then turn around and make vicious and demeaning claims about who I am.

https://x.com/benryanwriter/status/2023952437447639280

Update: Parker Molloy is expressing her rage toward me on Bluesky right now.

The Federal Trade Commission has opened a consumer protection probe into the American Academy of Pediatrics and has demanded its records regarding pediatric gender medicine.

In 2018, the AAP published its foundational policy document on the gender-affirming care method. It was written by a single medical resident, Dr. Jason Rafferty, and edited by a small committee. It was subjected to a brutal fact check by Canadian sex researcher Dr. James Cantor the following year. The AAP never responded to the fact check. In 2023, the AAP reaffirmed the policy statement with no changes.

The statement asserts that even very young children know their gender identity as well as anyone and should be trusted to guide the way in their own pathway of transition. bloomberg.com/news/articles/…

How Can Doctors Like This Provide Competent Care To Their Patients?

Some beef with Dr. Jonathan Howard, by @JesseSingal.
jessesingal.substack.com/p/how-can-doct…
Dr. Jonathan Howard, a neurologist and psychiatrist at @NYULangone Health, is furious at Michael Shermer, the founding publisher of Skepticmagazine.

Howard is an impressive figure. Like many doctors at university-affiliated medical centers, he also serves as a professor, in this case at the @NYUGrossman School of Medicine. He has, according to his biography, “authored and edited multiple textbooks” on multiple sclerosis, his area of specialty.

Why is Dr. Jonathan Howard furious at @MichaelShermer? It has to do with a recent exchange between Senator Josh Hawley and an OB-GYN named Dr. Nisha Verma. Hawley, seeking to make a point about “gender ideology” (as he might call it) during a hearing, repeatedly asked Verma if men can get pregnant and Verma could not give a straight answer. Shermer chimed in to suggest an answer Verma could have given that accounts for the fact that, as Shermer (and anyone else using the traditional, biological definition of the term) sees it, men cannot, in fact, get pregnant.

That’s why Howard is furious, and that’s why he wrote a deeply aggrieved article in Science-Based Medicine about Shermer’s bigotry. The headline? “The Anti-Trans Obsessions of ‘Skeptic’ Michael Shermer: Hallucinating Imaginary Demons to Empower Actual Villains, Once Again.” The subheadline? “I want to demonstrate to Michael Shermer that it’s possible for men like us to not talk about trans people constantly. If I can do it, so can he.” (If you’re unfamiliar with Science-Based Medicine’s strange recent trajectory, see here or here.)

Not only does Dr. Jonathan Howard of NYU Langone Medical Center disagree with Michael Shermer that men can’t get pregnant — Howard thinks that to even ask this question puts other humans in danger.

That probably sounds like a caricature on my part, or a sloppy and inaccurate gloss of Howard’s actual views. But that’s exactly what he wrote
Jonathan Howard has gotten it into his head, meanwhile, that I am personally responsible for the MAHA movement because once I published an essay on Vinay Prasad’s Substack about trans medicine researchers deceiving the public. This is bonkers conspiracy thinking by Howard.

Dr. Blair Peters,a gender-transition surgeon at OHSU, responds with disdain to the American Society of Plastic Surgeons coming out against such surgeries for minors. He says the broader membership was never polled about this.

Which is the same thing that has happened at the American Academy of Pediatrics, for example, but going in the other direction. No matter how hard @JuliaMasonMD1 has pushed, the AAP’s 2018 policy statement on the gender-affirming care method has never been up for a vote by the broader membership.

All of the major medical organizations that have led the way in establishing pediatric gender medicine’s broader credibility, including the AAP and the Endocrine Society in particular, have supported these practices in minors based on the decisions of small committees.

The AAP’s 2018 policy statement was written by a single person, Dr. Jason Rafferty, who was a resident at the time.

All of the other medical societies’ little committees have followed these other groups’ lead, along with WPATH. This has given the illusion that all medial providers support these practices in minors.

But I’ve spoken to pediatricians who are too afraid to express their concerns at the AAP’s annual conference for fear this will destroy their careers. More from Blair Peters:

People are shocked that all it took for the AMA to change its policy on pediatric gender transition surgeries was for another medical group, the ASPS, to do it. But this phenomenon is how the unanimity among the medical groups fell into place in the first place. It was only ever based on a few small committees within a couple of medical organizations, putting aside WPATH, which is a quasi-activist-medical organization.

It got started in the 2010s as WPATH and the Endocrine Society, which have a lot of overlap between them and referred to one another's guidelines in their citations, put out guidelines. And then in 2018 a single medical resident wrote the American Academy of Pediatrics' policy statement on the gender-affirming care method. Along the way, other major medical associations took these other groups' lead, including the APA and AMA. And then all the other ones fell in line.

These groups did not conduct major independent analyses of the evidence. Even the AAP never conducted a systematic literature review to support its policy statement. And in August 2023, the AAP said it was going to conduct one. But there is no sign that the organization has even started on that. Because if they ever did, there is only one conclusion that it could have: that the evidence backing providing gender-transition interventions to minors is weak and inconclusive.

All this is to say is that the mantra "all major medical association support gender affirming care for kids" was always a hallow claim. What it really meant is that: "A few small committees at a few organizations decided to support this, in part because of one another, and all the other small committees at all the other organizations followed their lead."

https://x.com/benryanwriter/status/2018889106298990779

If you want to go down the rabbit hole of how citation laundering laid the groundwork for the supposed medical consensus on gender-transition treatment for minors, I highly recommend @buttonslives's reporting: buttonslives.news/p/new-systemat…

A Legal First That Could Change Gender Medicine

At 16, Fox Varian got a mastectomy while undergoing a gender transition. She sued her psychologist and plastic surgeon for leaving her ‘disfigured for life.’ Benjamin Ryan reports from the courtroom.

Read the @TheFP article: thefp.com/p/a-legal-firs…

Follow and support my Substack, where I cover pediatric gender medicine: benryan.substack.com. I was the only reporter to attend the entire three-week trial and will be providing more in-depth reporting and commentary on the case.

The opening of my Free Press article:

Fox Varian had a turbulent childhood. Her parents split when she was seven, triggering a three-year custody battle that ultimately saw her estranged from her father. She suffered from a constellation of mental health problems, including depression, anxiety, and social phobia. She was diagnosed with autism and bounced around various schools. Her first period sent her into a meltdown, and she battled disordered eating and body-image issues. By mid-adolescence, she was completely lost.

At 15, she began questioning her gender during sessions with her psychologist. She changed her birth name, Isabella, to Gabriel, which she saw as androgynous. Over the next two months, she cut her hair short, began binding her breasts, switched her name again, to Rowan, and started telling people she was transgender.

In December 2019, 11 months after she started this public social transition, Varian underwent surgery to remove her breasts. She was 16 years old.

Varian, who adopted the name Fox at 18 and is now 22, is one of thousands of minors who underwent gender-transition surgery over the past decade. And she is just one of the young people who have come to regret permanently addressing what was only a temporary identity shift.

Three years after her mastectomy, Varian stopped identifying as transgender and began a process known as detransitioning. In May 2023, she filed a medical malpractice lawsuit against the two principal Westchester County, New York, care providers who oversaw her gender transition: her long-time psychologist, Kenneth Einhorn, and Dr. Simon Chin, who performed the mastectomy.

On Friday, a jury in White Plains, New York, awarded Varian $2 million in damages. Varian’s case is the first malpractice suit from a detransitioner to go before a jury, and I was the only reporter to attend the entire three-week trial. Represented by personal-injury attorney Adam Deutsch, Varian said she had been injured by the defendants due to their deviation from standard practices and a lack of informed consent. While there are no guarantees in medical malpractice lawsuits, legal experts believe Varian’s victory could inspire a wave of similar cases that would significantly disrupt pediatric gender medicine. Claire Deacon, mother to Fox Varian, the detransitioner who won a $2M jury award after suing her care providers over the mastectomy she got at 16, testified that Varian's psychologist, Kenneth Einhorn, browbeat her into consenting with threats of her child's suicide.

I report for @TheFP:
thefp.com/p/a-legal-firs…

Subscribe to my Substack for further in-depth reporting about the case. I was the only reporter to attend the entire three-week trial. benryan.substack.com

NYU neurologist/psychiatrist Jonathan Howard has been making a stink over @MichaelShermer's recent statements about transgender issues on @BrianLehrer's show.

Here, Howard cites a @Harvard study that falsely claimed youth "rarely" get gender-transition surgeries. In fact, about 1,000 minors got a mastectomy for this purpose annually in recent years, before state bans set in.

I wrote about that Harvard study when it came out. I demonstrated how its authors had quite evidently sought to mislead the public about this issue: benryan.substack.com/p/how-harvard-…

So, in fact, it is not Shermer who is "making things up" about this point in particular, it was Harvard researchers that at least effectively did so.

As for expressing concerns about minors getting these surgeries, I would like Howard to look into the eyes of the mother who testified in the detransitioner civil trial that I just finished attending yesterday (the plaintiff won a $2M judgment against her care providers; my article on the suit will run in a major outlet next week) and tell her that the loss of her daughter's breasts when she was 16 amounts to a false concern.
How Harvard Teed Up the False Claim That the 'Vast Majority of Minors Getting Gender-Affirming Surgeries Are C-s Kids'

An opaquely written Harvard study and linked press release prompted false reporting that gynecomastia surgeries for boys are vastly more common than gender-affirming surgeries for transbenryan.substack.com/p/how-harvard-…

BREAKING: 1st Detransitioner to Take a Medical-Malpractice Lawsuit to Trial Wins $2 Million Judgement

Fox Varian sued her Westchester, NY, area psychologist and plastic surgeon for the gender-transition mastectomy she got at 16.

I was the only reporter to attend the entire 3-week, historic trial. Subscribe to my Substack to receive an alert about the feature article I have coming out next week in a major publication out about the trial: benryan.substack.com. I cover pediatric gender medicine as a specialty on my Substack.

Sorry to just give just a teaser for now about the case! But I wanted to get the word out about the verdict promptly, the slower pace of feature-article publishing notwithstanding.

The entire case file was put under seal when the trial started (although I obtained all those documents before they was sealed), and all the transcripts from the trial are also under seal. The riveting trial was sparsely attended and there was only one other reporter at the trial; and he only attended for part of it and, as I observed, took few notes. So my own hundreds of pages of notes from the trial will likely remain the only way for the public to learn about the all finer details of what transpired, possibly ever (or until an appeal, should that happen).

In addition to my article coming out in the media outlet soon, I intend to write a lot about what I observed and learned on my Substack over the coming weeks. Stay tuned… I have identified 28 detransitioner lawsuits filed to date. Varian v. Einhorn was the first to go to trial and the first to win a judgment, making history. If anyone knows of any additional cases that are not on my spreadsheet below or sees any errors, please DM me.

Media outlets that claim that transgender women have no competitive advantage over women in athletics are not making evidence-based claims.

Two recent review papers, by @DrMJoyner and @Fondofbeetles, have found that even after sustained testosterone suppression and estrogen treatment, biological males still maintain a competitive advantage in women's sports. The research is less clear about those who have undergone pubertal suppression and then estrogen treatment starting soon after puberty's onset. However, Dr. Joyner's research indicates that prepubescent boys have a small but significant competitive advantage over girls, likely because of exposure to testosterone in utero and a surge of T during "mini puberty" during infancy.

Sources: link.springer.com/article/10.100…

pubmed.ncbi.nlm.nih.gov/39716906/ Notice how @NPR doesn't even mention the review papers by @DrMJoyner and @Fondofbeetles finding that trans women on gender-transition treatment maintain a competitive advantage in women's sports. I spoke with Dr. Joyner and other experts who criticized the methodology of the IOC study. They all called its conclusions weak and unreliable. npr.org/2026/01/11/nx-…

Supreme Court To Grapple With the Role of Transgender Athletes in Sports

I report for @NewYorkSun: On Tues, the justices will hear oral arguments about Idaho & West Virginia laws that restrict those born male from sports specifically for girls and women.
nysun.com/article/suprem… The trans-sports ban cases before the Supreme Court raise critical questions about how the Equal Protection Clause of the 14thAmendment applies to restrictions on transgender athletes competing on teams traditionally reserved for the opposite sex. The court will also be asked to consider how such laws square with the aims of Title IX, the federal law governing sex-based opportunities in education, and its associated regulations pertaining to sex-segregated sports teams. nysun.com/article/suprem…

Bluesky is not amused by this WSJ article on people gaming the wheelchair system at airports, but not because people are gaming the wheelchair system at airports.