Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Tyler Black, MD Profile picture
Tyler Black, MD
@tylerblack32
Suicidologist, emergency psychiatrist, pharmacologist, data geek. 🫘 Debunking misinformation rather easily. Views expressed are my own opinions. He/him (😊)
May 5 • 20 tweets • 4 min read
RFK is no better at psychiatric medications than he is about vaccines.

RFK's "overmedicalization crisis" thread is a master class in using true-ish numbers to imply a false conclusion. Let's go through it. 🧵

/1 The core trick: he treats prescription prevalence as self-evidently bad. But high rates only signal a problem if the meds don't work, are given to people who don't need them, or cause net harm. He establishes none of this. He just gestures at numbers.

/2
May 4 • 10 tweets • 2 min read
Disabled people should not live in poverty.

It makes no sense the way we treat our people with disabilities in Canada. Canada has the full apparatus to implement adjusted payments, yet we typically support disabled people WELL under the poverty line.

/1 Image Canada has an official poverty line: the Market Basket Measure. It's regionally calibrated, methodologically sound, and updated by StatCan.



A single person on BC PWD receives ~$18.4k/year. The Vancouver MBM is ~$29k.

/2www150.statcan.gc.ca/t1/tbl1/en/tv.…
May 2 • 15 tweets • 8 min read
Quick thread: "How do SSRI's work" 🧵

I've had a few patients ask me how SSRI's work.

To be clear, my first answer is "well we know they are supposed to block serotonin reuptake, but it's not that simple and we don't really know."

But, if you want the best 2026 science...

/1Image For a few particularly science-interested patients, I walk them through what we currently have for the 'best evidence' even though we're still not sure.

This is the "best story" I can tell about SSRI's right now.

(nb, this is NOT locked in, this is MY best synthesis)

/2
May 2 • 10 tweets • 2 min read
The Ihben story is making the rounds. "Judge forced 18 vaccines, child got autism." It's being treated as a smoking gun. It is not a smoking gun. It is barely a story.

/1 Sourcing: one father, one advocacy org (CHD), one GiveSendGo. Records sealed. No filings. No named physicians. Every outlet repeating it cites the same Defender article. This is a closed loop, not corroboration.

/2
Apr 30 • 16 tweets • 4 min read
🧵Borderline Personality Disorder (BPD) 🧵

Ask any person who has been even suggested to have BPD; they will uniformly tell you that they have been told to try DBT (Dialectical Behavioural Therapy). Reflexively recommended. "Gold standard."

This is not science-supported.

/1Image Quick history: Marsha Linehan developed DBT in the late 1980s, published the foundational manual in 1993. She drew on CBT, Zen Buddhism, and dialectical philosophy. Brilliant clinician, brilliant marketer. Her institute has trained tens of thousands of therapists worldwide.

/2 Image
Apr 30 • 7 tweets • 2 min read
The McCullough Foundation's @NicHulscher — who posts garbage medical misinformation — styles himself an "independent epidemiologist."

His entire career has been spent publishing with, and working for, McCullough. Image No academic post, no health agency, no clinical role, no pre-Foundation experience. Hired straight out of his 2024 MPH by the senior author on nearly every paper bearing his name.

/2
Apr 29 • 5 tweets • 1 min read
The discourse on GLP-1 is unhinged.

Science brought a drug that :
⏬cardiovascular events
reverses fatty liver
⏬kidney decline
⏬addictive cravings
⏬all-cause mortality

And the worst, loudest part of the internet decides the real problem is that people are using it.

/1Image The data isn't subtle.

SELECT: 20% ⏬in MACE in overweight/obese patients without diabetes.
FLOW: stopped early for kidney benefit and all cause mortality

It's NOT a vanity drug.

It's one of the most consequential CV drugs of the century.

/2
Apr 22 • 6 tweets • 2 min read
Since MAID has been enacted in 2014, approximately 90,000 Canadians have chosen dying by this method rather than painful, drawn out, or medically complicated deaths.

This represents 0.2% of the Canadian population and accounts for approximately 2% of all deaths since 2014.

/2 The amount of time that American & Canadian right wingers spent on MAID is ridiculous. It is certainly a controversial policy, but it boogeymanning about it is bonkers.

It's not the #1 cause of death. Cancer, for example, kills 90k per year, or as many as MAID in 14 years.

/2
Sep 22, 2025 • 11 tweets • 3 min read
Fun child psychiatry fact!

If we analyze a group of 40-year-old adults with the same diagnostic criteria & screening as we use currently on children, we get virtually identical rates of autism.

"Exploding rates of autism" likely a reflection of our exploding understanding. A 2025 Canadian study estimated 1.8% autism prevalence in adults, similar to child rates, showing diagnosis consistency across ages despite evolving awareness.

/2
May 30, 2025 • 12 tweets • 4 min read
New JAMA study (2025) claims social media use → increased depression in 9-13yo.

🧵But let’s dissect:

overall:
* Within-person effects: β=0.07-0.09 (small/medium)
* No between-person effects (β=-0.01)
* 4 waves, n=11,876, caregiver-reported depressive symptoms

1/🧵 Image The study is here:



However, I have a lot of critiques of this study and its conclusions.

Let's dig in:

2/jamanetwork.com/journals/jaman…
Apr 10, 2025 • 4 tweets • 1 min read
We currently have almost zero explanatory power for autism aside from some very obscure genetic and prenatal influences.

We already know what has caused the autism "epidemic"... Increased awareness, broader diagnoses, and more screening/requests for assessment. Bobby Kennedy frequently likes to say it was "1 in 10000 when [he] was a kid". It was not. Studies have shown that if we used modern diagnostics on we would arrive at similar rates, and syndromic presentations of youth for neurodiversity were IDENTICAL to those in the 80s.

/2
Jan 2, 2025 • 11 tweets • 3 min read
🚨Countering COVID Myths:🚨

❌Myth: "Lockdowns definitely caused massive learning loss"

✅Reality: Using a large set (n=2mil) of Ontario students, we see more improvements then losses, and trend of older students doing better than younger students.

/1Image As an example of the statistical reason why I can say the above is a myth, zoom in on ALL the grade 3 scores (Grade 3 did the "worst")

Looking at the distribution, we see more deteriorations (52%) than improvements (45% of scores) achievement scores, but its very broad!

/2Image
Dec 16, 2024 • 9 tweets • 2 min read
Vaccines and "placebo control"

Placebo-controlled trials compare a vaccine to an inactive substance (placebo). This helps measure how effective the vaccine is. In the case of vaccines, often, the placebo is not "saline", but rather a previous vaccine or vaccine solution.

/1Image When a safe, effective vaccine already exists, using an inactive placebo means some participants are deliberately left unprotected against disease. This creates unnecessary harm.

/2
Dec 15, 2024 • 7 tweets • 2 min read
🚨🇨🇦Correcting Disinfo🇨🇦🚨
"COVID vaccination didn't work"

In Canada during the Delta wave, vaccination prevented infection (unvaccinated 6x higher chance of being infected). As well, being unvaccinated led to a 22X chance of being hospitalized and an 18X chance of dying.

/1Image For confirmed infections, the IFR for unvaccinated was a whopping 2.4%. The IFR for being vaccinated was much lower, both due to preventing infection and reducing the consequences of it.

Delta was a very deadly strain, and unvaccinated people died/suffered the most.

/2 Image
Nov 30, 2024 • 6 tweets • 3 min read
Correcting revisionist history:
"COVID is not a problem for young people in the US"

Covid responsible (not "with", underlying cause) for 2% of all deaths <20. That's 1 out of every 50 deaths of all kids who die. #1 in infectious diseases, 5th in disease overall.

/1Image COVID-19 deaths created 300,000 American orphans, 330,000 if we count "primary caregivers" and 380,000 if we count "secondary caregivers". That's a lot of childhood harm.

2x as common for Black kids
4x as common for Indigenous kids
1.6X as common for Hispanic kids

/2 Image
Nov 28, 2024 • 14 tweets • 2 min read
🏳️‍⚧️FAQ for posterity:

Why do you use pronouns in your bio?
Because it's an easy way to promote inclusivity & to increase awareness of gender expression. It costs me nothing, &because I work with kids who are establishing their identity it shows that I don't make assumptions.

/1 Is being transgender a mental illness?
Being transgender is not a mental illness. It is a natural variation of human phenotype, though some transgender individuals may experience distress, called gender dysphoria, which is addressed through appropriate care.

/2
Nov 24, 2024 • 10 tweets • 4 min read
🧵RFK Jr. is an antivax, AIDS-denying, absolutely antiscientific conspiracist.🧵

ANTIVAX:
“They get [vaccinated], that night they have a fever of 103, they go to sleep, and three months later their brain is gone... This is a Holocaust, what this is doing to our country.”

/1Image ANTIVAX:
"I do believe that autism does come from vaccines"

Metaanalyses involving MILLIONS of children have confirmed there is no link. The lie started with another antivaxxer, disgraced fraudster Andrew Wakefield, who fabricated data.

/2Image
Nov 19, 2024 • 7 tweets • 2 min read
Battling Election Misinformation
Part 2: "The Mandate"

Contrary to media/republican pronouncements, the election of Donald Trump was one of the narrowest (by popular vote, +1.73%) in history, with only 7 elections since 1800 being narrower.

/1Image In fact, if we look at the margin of victory when we include all eligible voters, Trump wins with 31.3% of the voting population, compared to Harris' 30.2% and 1% going to other candidates. 37.4% did not vote.

If we only include voters, Trump wins 50.03% to 49.97%

/2Image
Nov 15, 2024 • 7 tweets • 2 min read
"[AIDS] is not being caused by a virus. It's not a virus... These people are dying because of 'poppers'... they were people who were part of a gay lifestyle... "

"This is not a viral disease, but it's a disease that is environmental."

- HHS Secretary Nominee RFK Jr

/1Image Chemicals in water are causing trans kids: "A lot of the problems we see in kids... are coming from chemical exposures, including a lot of the sexual dysphoria that we’re seeing."

- HHS Secretary Nominee RFK Jr

/2Image
Nov 7, 2024 • 8 tweets • 2 min read
🧵Battling Antivax Disinfo🧵
Vaccination did NOT increase cancer deaths.

Here I took the 6 deadliest cancers (all 5 survival rates under 50%) in a highly vaccinated population (25-54), and we can see ZERO evidence of vaccine-related cancer deaths, all the way to May 2024.

/1Image If i move ages to 55+, we see the same thing, and we are now looking at a lot of deaths from these extremely aggressive cancers, so this isn't some underpowered stuff here. There is NO evidence that deadly cancers have increased due to vaccination.

None.

/2Image
Nov 7, 2024 • 11 tweets • 4 min read
The Presidential Election
Data Geekery with my interpretations

1) The Country Shifted, but More Didn't.

The final share will be ~ +1.3 to +1.5% for Trump, which is a shift of ~+5.8%.

If America was a room with 65 people in it, only 2 out of the 65 people switched shirts.

/1Image Note: this math might seem like it doesn't work, but we have to remember to include those that voted 3rd party (1.5%ish) and those that didn't vote (about 35%).

Excluding non-voters who were eligible,
2020: 22/43 D & 20/43 R
2024: 20/42 D & 21/42 R

/2Image