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Doctors: Biden Administration’s Dangerous Push for Trans Treatments for Kids Falsifies Science


REPORTED BY: JANE ROBBINS | APRIL 19, 2022

Read more at https://thefederalist.com/2022/04/19/doctors-biden-administrations-dangerous-push-for-trans-treatments-for-kids-falsifies-science/

pride parade

HHS isn’t run by honest medical professionals. It’s in the grip of ideologues determined to destroy troubled children.

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JANE ROBBINS

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The nation’s public-health establishment lost all credibility during the Covid era by either ignoring or politicizing scientific data. But health bureaucrats seem to have learned nothing. With respect to the highly charged issue of gender dysphoria, they continue to substitute politics for science when necessary to advance the leftist narrative.

The Department of Health and Human Services (HHS) recently released an official document designed to enshrine experimental medical interventions as the standard treatment for transgender-identifying children. Prepared by HHS’s Office of Population Affairs (OPA), the document is a political statement unmoored from actual medical research.

According to Gender-Affirming Care and Young People,” medical interventions such as puberty-blocking drugs, wrong-sex hormones, and surgical mutilation are “crucial to overall health” of young people confused about their sex. (For what it’s worth, OPA falls under the supervision of Dr. Rachel Levine, a man who identifies as a woman.) The document complements a proposed rule announced by HHS in March, mandating insurance coverage for such “gender-affirming care.”

But the claims made in HHS’s new release have been deftly dismantled by an organization of physicians and scientists who still care about reality, and about ethical medical practice. The Society for Evidence Based Gender Medicine (SEGM which exists “to promote safe, compassionate, ethical and evidence-informed healthcare for children, adolescents, and young adults with gender dysphoria”  points out that HHS’s discussion is deeply misleading and indeed dangerous. SEGM identifies seven serious misrepresentations of fact crammed into the two-page HHS document. Most of these involve cherry-picking, distorting, or simply ignoring the results of studies on the many facets of so-called gender-affirming treatment.

HHS Mischaracterizes Studies

For example, HHS flatly mischaracterizes a study that failed to find any benefits of “social transition” (presenting oneself as the opposite sex, with a new name, hairstyle, dress, etc.). As SEGM notes, the HHS document cites that study for the opposite conclusion, “wrongly assert[ing] that social transition improves functioning.” HHS presumably assumes readers won’t read the actual study and thus will accept the agency’s false claims about its findings.

SEGM identifies other falsifications of the supposed mental-health benefits of wrong-sex hormones and surgeries. HHS’s “claims of benefits coming from cherry-picked studies do not hold up when the entire body of evidence is properly evaluated in a systematic and reproducible way,” according to SEGM.  

The design of the studies cited by HHS made it impossible to link medical interventions and improved mental health, SEGM observes. By contrast, multiple European studies “concluded that there is a lack of convincing evidence for the mental health benefit for children and adolescents of either puberty blockers or cross-sex hormones.”

SEGM notes, in fact, that the Swedish health authority warned that “the risks of puberty suppressing treatment . . . and gender-affirming hormonal treatment currently outweigh the possible benefits, and that the treatments should be offered only in exceptional cases.”

HHS ignored all this research, which would have led honest medical professionals to at least acknowledge the scholarly debate about the wisdom of these interventions. But HHS isn’t run by honest medical professionals. It’s in the grip of ideologues determined to drive troubled children and their families into the clutches of the trans industry.

Dishonest Use of Data on Suicide

SEGM also criticizes the HHS document for dishonesty about the related issue of suicide among trans-identifying youth. In claiming alarmingly high rates of suicidal ideation in this population — a claim routinely used to pressure desperate parents into consenting to dangerous medical interventions — HHS relies only on “a low quality, non-probability online survey.”

In fact, SEGM reports, “recent research from one of the world’s largest pediatric gender clinics estimated the rate of suicide in trans-identified youth as 0.03% over a 10-year period, which is comparable to youth presenting for care with mental health problems.”

Even more critically, despite HHS’s strong implication that drugs, hormones, and surgeries reduce suicide rates, SEGM clarifies that “no study to date has demonstrated that transition reduces the rate of serious suicide attempts.” Is HHS afraid that telling the truth about suicide will make parents less likely to place their troubled children on the trans-industry conveyor belt?

Puberty Blockers Are Not Fully Reversible

The mendacity of HHS extends beyond misrepresenting or ignoring studies. For example, the document states, without supporting citation, that puberty blockers are fully reversible (i.e., natural puberty will resume once the drugs are discontinued). But SEGM warns about the utter dearth of research supporting this claim. In fact,

concerns have been raised that puberty blockers are psychologically irreversible (since over 95% of all treated youth proceed to cross-sex hormones), that they may harm bone development, may permanently alter the brain, that it is not yet known how they affect other vital organs, all of which undergo significant structural changes during uninterrupted puberty.

Once again, public-health agencies in Europe are more honest. As SEGM reports, Britain’s National Health Service says that “[l]ittle is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.”

But ignoring the risks of these interventions is HHS’s modus operandi. SEGM calls out the HHS ideologues for mentioning only the supposed (in some cases imaginary) benefits of interventions while failing to mention documented risks to bone development, cardiovascular health, and the mental health of patients who later regret their transition decisions.

Sterility Expected After Trans Treatments

SEGM particularly targets HHS’s failure to mention the effect on reproductive health, which is supposed to be the focus of Levine’s Office of Population Affairs. “When puberty blockers are administered in early puberty and followed by cross-sex hormones,” SEGM notes, “sterility is expected.”

HHS is silent about this potentially devastating consequence. Nor does it acknowledge the “serious ethical questions about whether adolescents can be considered competent to waive their future reproductive rights at an age when they are unlikely to be able to appreciate or predict the importance of fertility to their adult selves.”

Ethics, it appears, is not HHS’s strong suit.

HHS also misleads in stating that mutilating surgeries are “typically used in adulthood or case-by-case in adolescence.” In fact, as SEGM notes, draft recommendations from the influential (though highly politicized) World Professional Association for Transgender Health (WPATH) urge broad availability of mastectomies to patients at age 16.

Even worse, patients as young as 13 had their healthy breasts removed as part of a study funded by the National Institutes of Health – i.e., by you and me through our tax dollars. The HHS bureaucrats who prepared this report surely knew this, but distort the facts.

This HHS document, then, is a farce. As SEGM summarizes, HHS inadequately reviewed the scientific literature, issued “biased recommendations that do not acknowledge the low quality of evidence,” failed to solicit input from professionals and patients whose experiences contradict the government narrative, and utterly ignored possible alternatives to medical interventions, such as psychotherapy. The result:

This incomplete representation of the relevant issues is likely to mislead the public to believe that this is the best and only alternative, particularly when no other alternatives are mentioned. The public is also likely to erroneously assume that the risks of affirmative care are low. Patients and families are not capable of providing valid informed consent when the information they receive is inaccurate and incomplete

If the public-health establishment wants to rehabilitate its tattered reputation after the Covid debacle, this isn’t the way to do it. Health policy is too important to be entrusted to political hacks.


Jane Robbins is an attorney and a retired senior fellow with the American Principles Project in Washington DC. In that position she crafted federal and state legislation designed to restore the constitutional autonomy of states and parents in education policy, and to protect the rights of religious freedom and conscience. She is a graduate of Clemson University and the Harvard Law School.

The Studies Cited To Support Gender-Bending Kids Are Largely Junk Science


REPORTED BY: NATHANAEL BLAKE | MARCH 10, 2022

Read more at https://www.conservativereview.com/the-studies-cited-to-support-gender-bending-kids-are-largely-junk-science-2656908394.html/

New York Times building

The transgender misinformation machine is at it again. The New York Times recently published an extensive essay arguing against screening before medical transition — if someone says she wants hormones or surgery, doctors should immediately break out the syringes and prep the operating room.

The article, by Alex Marzano-Lesnevich of Bowdoin College, exemplifies how the transgender movement uses misinformation to advance its agenda. Marzano-Lesnevich asserts, “That gender-affirming health care saves lives is clear: A 2018 literature review by Cornell University concluded that 93 percent of studies found that transition improved transgender people’s heath [sic] outcomes, while the remaining 7 percent found mixed or null results. Not a single study in the review concluded negative impact.”

That seems dispositive — unless you look at the studies. The cited literature review was titled the “What We Know Project” and was directed by the LGBT scholar and activist Nathaniel Frank, who cited it in his own New York Times piece on transgenderism a few years ago, writing that “Our findings make it indisputable that gender transition has a positive effect on transgender well-being.”

Poorly Conducted Studies

These proclamations that the science is settled are a bold facade on rickety scaffolding. When this New York Times article invokes the authority of science, it seeks to evoke the image of careful statisticians sifting through data collected by diligent doctors.

But it is actually appealing to self-selected online surveys with cash prizes, studies with tiny samples, and studies that are missing more than half of their subjects. Stacking a bunch of weak studies on top of each other doesn’t provide a strong result, but The New York Times presumes readers won’t bother to check the details — the editors certainly didn’t.

Back in 2019, I took a closer look at the studies the What We Know Project cites, and found a methodological mess. Many of the studies had serious flaws, beginning with small sample sizes. As I noted, “Of the fifty relevant papers identified by the project, only five studies (10 percent) had more than 300 subjects, while twenty-six studies (52 percent) had fewer than 100. Seventeen studies (34 percent) had fifty or fewer subjects, and five of those had a sample size of twenty-five or less.”

The flaws extended far beyond small sample size, and the largest studies tended to be the weakest, often consisting of little more than online surveys with a self-selecting sample. Nor should we put much faith in a study that recruited subjects for an online survey by advertising “on online groups and discussion forums that were dedicated to FTM [female-to-male] members. . . . Upon survey completion, participants were entered into a lottery drawing for cash prizes.”

Even the better-designed long-term studies were often plagued by poor response rates. A European study had 201 out of 546 respond — just 37 percent. And though missing data is, by definition, missing, it is reasonable to suspect that those with poor outcomes are overrepresented among those who could not or would not respond.

Regret Rates

Nor did The New York Times check Marzano-Lesnevich’s claim that “gender-affirming health care has some of the lowest rates of regret in medicine. A 2021 systemic review of the medical literature, covering 27 studies and 7,928 transgender patients, found a regret rate of 1 percent or less.” But read the paper and it is quickly apparent both that the review has significant weaknesses and that The New York Times allowed its conclusions to be misrepresented.

Of the 27 studies used in their analysis, the review authors ranked only five as “good” and only four as having a low risk of bias. Many of the studies had the same flaws as those examined in the What We Know Project (indeed, some studies were used in both).

Another problem is that the majority of the data in the 2021 review came from a single study conducted by a Dutch group retrospectively examining the records of their own gender clinic. But a retrospective review of medical files will only identify regrets from patients who shared them with the gender clinic that performed their surgeries. Furthermore, the study only identified regrets following gonadectomy, and not those who regretted other surgeries, or who never had surgery but did regret taking cross-sex hormones or puberty blockers.

In addition to the problem of allowing a flawed data set to dominate the 2021 review, this illustrates another persistent difficulty with studies of transgender regret, which is that they are often conducted by those who provide medical transition, rather than independent researchers. People whose livelihoods and reputations depend on facilitating medical transition might be less than diligent and rigorous in looking for regret.

To their credit, the authors of the 2021 review do discuss some of the limits and difficulties of their work, writing that various problems:

represent a big barrier for generalization of the results of this study. The lack of validated questionnaires to evaluate regret in this population is a significant limiting factor. In addition, bias can occur because patients might restrain from expressing regrets due to fear of being judged by the interviewer. Moreover, the temporarity of the feeling of regret in some patients and the variable definition of regret may underestimate the real prevalence of ‘true’ regret.

None of these qualifications regarding regret were even hinted at in the published column. Despite The New York Times’ citing it, the 2021 review does not prove that “gender-affirming health care has some of the lowest rates of regret in medicine.”

As the authors note, regret is not only an imperfect measure, but it is often difficult to measure, with no set criteria defining it. In one Swedish review cited by the What We Know Project, it was defined “as application for reversal of the legal gender status among those who were sex reassigned,” which excludes those who succumbed to depression or addiction, or who lived unhappily after transition without seeking to legally detransition.

Gatekeeping before Transition

Furthermore, even if we uncritically accept the results of the 2021 review, it does not support the argument that gatekeeping before medical transition is unnecessary and harmful. Rather, the authors claim that the low regret rate they found “reflects and corroborates the increased [sic] in accuracy of patient selection criteria for GAS [gender affirmation surgery].”

In short, the review argues that medical gatekeeping keeps regret rates low. That The New York Times allowed this review to be used as evidence against medical screening, and in favor of self-ID for medical transition, exemplifies the persistent practice of American transgender activists using studies of (mostly) carefully screened European adults to argue against screening before medical transition, even for children.

Unfortunately, the aggregation of (often questionable) studies, and the exaggeration of their conclusions by activists, is only part of the problem. These efforts to spread misinformation are augmented by the intimidation of dissenting scientists and the suppression of results that trans activists dislike.

Suppressing Dissent

Researchers have learned to fear the wrath of LGBT activists, and take pains to avoid it. Results that undermine the narrative have to be carefully presented lest the public draw the wrong conclusions. Thus, when scientists concluded that there is no “gay gene” they “worked with LGBTQ advocacy groups and science-communication specialists on the best way to convey their findings in the research paper and to the public.”

With regard to transgender ideology, the intimidation is even more overt. For example, Lisa Littman’s qualitative study describing the phenomenon of rapid-onset gender dysphoria met a ferocious response from transgender activists. Similarly, activists smeared Canadian psychologist Kenneth Zucker and forced him out of his position as the leader of a gender identity clinic, even though he sometimes supported transitioning children. He was just more cautious about it than activists wanted. He was eventually vindicated, but targeting him still sent a warning to any researchers who are seen as insufficiently pro-trans.

As these cases demonstrate, the science is being manipulated to fit transgender ideology. Shoddy studies — often conducted by activists and doctors with a stake in medical transition — are boosted if they support the trans narrative, while results and researchers who challenge it are suppressed. This skewed data is then used by trans activists and their allies to shape the discourse.

Uncomfortable facts and stories are kept out of the official narrative. Insightful and moving first-person accounts of transition and detransition are confined to non-traditional outlets such as Substack, as are the warnings of leading trans doctors about the reckless rushing of children into transition. The information bubble is the point.

Going forward, disagreement will be labeled “misinformation” and banned from social media, and dissidents will be labeled as bigots who should be fired from their jobs. Doctors will be required to practice only according to the approved narrative, and educators will encourage children to transition without parental knowledge and consent. Worse still, the government will take children from parents who do not support transition.

The purpose of the transgender misinformation machine is not so much to persuade, but to provide justification for coercion. The point of the lies and distortions is to impose transgender ideology on all of us, especially children.


Nathanael Blake is a senior contributor to The Federalist and a postdoctoral fellow at the Ethics and Public Policy Center.

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