📖 Free to Be: Understanding Kids & Gender Identity | Pediatric Psychiatrist | Director, Gender #Psychiatry Program @UCSF | Views Mine & Not Med Advice
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Jul 19 • 6 tweets • 3 min read
Who wrote this @NHS independent report?
The Ruuska study doesn’t run a single analysis looking at the impact of gender-affirming care on suicide deaths. This description of the paper is entirely made up.
The only thing that’s vaguely related is this paragraph, but you’ll see it compares people who got gender affirming medical care to cisgender controls, which doesn’t tell you if the treatment worked (you’d need a control of people with gender dysphoria who desired but didn’t get treatment).
Even if it did, that would still bear no resemblance to the summary provided in this NHS report.
Apr 30 • 5 tweets • 2 min read
The Cass report systematic review methodology doesn’t match its PROSPERO pre-registration.
The authors used an entirely different scale (an adapted one they created) instead of the scale from their pre-registration.
That’s about as big of a bias red flag as there is.
Even with this major issue, their new customized scale labels a large number of studies “moderate quality” and some “high quality.”
Yet the non-peer reviewed Cass report repeatedly says there is only low quality research.
Apr 18, 2023 • 7 tweets • 9 min read
I appreciate the #NYT for finally covering that recent anti-#trans laws are a political strategy, not driven by real concern for children
However, I wish they would acknowledge the ways in which their inaccurate reporting amplified misinformation & contributed to where we are 🧵
For example, @mega2e amplified fear-mongering around gender-affirming medical care for adolescents by falsely claiming researchers from a large NIH-funded study on the benefits of gender-affirming medical care for #trans youth never reported their results:
I'm a Harvard-trained psychiatrist who has spent a decade studying #trans youth mental health
After 100+ #NYT contributors expressed concern about the paper's #trans youth coverage, the NYT replied it's "proud" of its work
Let's take a look at the work they're proud of 🧵
In one recent piece, @mega2e falsely claimed that researchers from a large NIH-funded study on the benefits of gender-affirming medical care for #trans youth never reported their results:
🧵I'll try to dive into this new NYT story on blockers in more detail later, but some initial points:
1. Yes starting puberty can be clarifying re: gender dysphoria. That's a major reason why blockers aren't started until after puberty starts. It's sad the reporters missed that.
2. It's not news that adolescent fall behind on bone density while on pubertal suppression. This is noted in all guidelines and families and patients are always counseled on it. Bone density starts to increase again once blockers are stopped or gender-affirming hormones started.
1. That youth identify as #trans due to "social contagion" & adolescents assigned female are more susceptible
2. That youth identify as trans to flee LGB-related stigma
Neither was supported by data. 🧵
We used the 2017 & 2019 CDC Youth Risk Behavior Survey - a nationally representative sample of adolescents in the US
Sadly, not all states choose to collect sexual orientation & gender identity data, so we included the 15 states that did. This meant ~100,00 teens per year🧵
Jul 13, 2022 • 6 tweets • 3 min read
JK Rowling is trending again. I’m just going to go ahead and post this each time that happens.
This quick primer “JK Rowling & The Echo Chamber of Trans Youth Misinformation” lays out some of her favorite lies about #trans kids.
She interviewed @cmoutierMD about three studies that found associations between access to gender-affirming medical care during adolescence and lower odds of suicidality
Two from our group, one from Green et al. (1/3)
Dr. Moutier states that these findings could have been due to the confounding effects of socioeconomic status or family support of gender identity
She and the NYT fact-checkers missed that all three studies in question adjusted for those variables in their models (2/3)
Jun 15, 2022 • 4 tweets • 3 min read
@emilybazelon@NYTmag You were offered an opportunity to send me questions via email, and you did not.
As a journalist, I would hope you know the difference between an interview and fact-checking. @emilybazelon@NYTmag If you were satisfied with my comments from the fact-checking, you should not have included a line implying I refused to be interviewed for the piece.
If you weren't, you should have emailed me some questions, which you did not do.
Jun 13, 2022 • 7 tweets • 4 min read
This is making the rounds. It’s a paper from the conservative @Heritage Foundation claiming to show gender-affirming care increases suicidality.
The methodology and conclusions are absurd, which is likely why they didn’t submit it for peer review.
Overall, we found that accessing gender-affirming hormones during adolescence is linked to better mental health outcomes in adulthood
Thread 🧵 (1/6)
#trans#LGBTQ#medtwitter journals.plos.org/plosone/articl…#Trans people who accessed gender-affirming hormones during adolescence had lower odds of adverse mental health outcomes, including suicidality, when compared to those who didn't access hormones until adulthood. (2/6)
Dec 28, 2021 • 11 tweets • 6 min read
Let’s talk about “complex #PTSD.” Have you learned about it but don’t understand it? That’s because it’s controversial! But a useful construct in my opinion. #medtwitter#psychtwitter 🧵
Classic PTSD can occur after one big life threatening event (think a car crash). Common symptoms include nightmares, flashbacks, startling more easily, and avoiding things that remind you of the trauma.
Apr 13, 2021 • 7 tweets • 5 min read
Republicans cite “science” as why they oppose the #EqualityAct - a bill that would extend federal civil rights protections to all #LGBTQ Americans.
In summary: 13.1% of currently identified #trans people report that they detransitioned at some point in their lives. Most (82.5%) report that detransition was driven by at least one external factor (e.g., harassment, stigma, etc.) #detrans 🧵
A minority (15.9%) reported that detransition was driven by at least one internal factor (e.g., fluctuation in or uncertainty regarding gender identity). Clinicians should be aware of potential factors - internal and external - that may drive detransition. Examples:
Feb 24, 2021 • 7 tweets • 7 min read
As a @Harvard undergrad, I read an @AnnCoulter book and was struck by this line:
"Liberals can't have #gay marriage and evolution. For that we would need survival of the most fabulous."
Turns out she's wrong, but it took my whole evolutionary bio class to learn why (1/2) #LGBTQ
My favorite reconciliation of male homosexuality & evolution comes from studies suggesting it is an X-linked trait. For XY folks, it makes them gay, but for XX folks it makes them more fecund (i.e. fertile). This results in a stable but low % of gays in the population over time
Jan 13, 2021 • 4 tweets • 6 min read
A new book about #trans youth from The Wall Street Journal's @AbigailShrier has some truly disturbing recommendations.
Page 215: She recommends parents isolate their trans children by sending them to live on horse farms with no internet, hoping that will make them cisgender.
She asserts that children whose parents isolated them in this way all "desisted" from identifying as #transgender.
If a parent sends their kid to a horse farm with no internet to try to make them cisgender, it's not surprising that the kid's going to go back in the closet.
Jan 13, 2021 • 7 tweets • 2 min read
So many proposed anti-#trans bills contain text stating something along the lines of "most #transgender adolescents will grow up to be cisgender, so they should not be given gender-affirming medical interventions."
Let's break down the problems with this false statement 🧵 (1/6)
First, the literature they're referencing is about children who have not yet reached puberty (eg Steensma et al. JAACAP 2013). Medical interventions are not offered until trans youth reach adolescence, at which point it's rare for trans youth to later identify as cisgender (2/6)
The misinformation about #trans youth and #mentalhealth in this piece from @TheEconomist is astounding. Thread (1/9)
They cite that most adolescents who start pubertal suppression (PS) go on to take gender-affirming hormones. This isn't evidence PS made them trans. It's evidence they were trans to begin with & the clinic wasn't giving PS to kids who would later identify as cisgender (2/9)
Oct 25, 2020 • 8 tweets • 4 min read
I'm a gay physician-scientist with Harvard and Yale training, and I research #LGBTQ health. Amy Coney Barrett's confirmation next week likely means more LGBTQ people like me will die early. Here's why (a thread) 🧵(1/8) #medtwitter#SCOTUS
Difference-in-differences analyses show that marriage equality results in fewer suicide attempts among sexual minority youth. (2/8) jamanetwork.com/journals/jamap…