Activist-blogger Erin Reed has published a guest article:
"Washington Post Editorial Board Misleadingly Attacks Care Of Trans Youth"
In, fact, many of the claims in this essay challenging WaPo are themselves misleading.
I will go through them in this 🧵⬇️
"It selectively cites three European reviews critical of
gender-affirming care, while ignoring the consensus of leading medical
organizations—including the American Academy of Pediatrics, the American
Psychological Association, the American Medical Association, the
Endocrine Society, and the World Professional Association for
Transgender Health—all of which support such care."
▶️While WaPo hyperlinks to three European reviews, there have, in fact,
been a half-dozen systematic literature reviews of pediatric
gender-transition treatment. All of them have found the evidence backing
such interventions weak and inconclusive.
▶️This has lead the health authorities in the UK and four Scandinavian
nations to reclassify such treatment as experimental, and to sharply
restrict access, in some cases to research settings only.
▶️The Cass Review found that WPATH and the US medical societies that
endorse such interventions have engaged in "circularity," which is a
more polite term for "citation laundering." WPATH made claims that were
not supported by strong evidence in its 2013 Standards of Care 7. Then
other US medical societies referred to those claims. And then it its SoC
8 in 2022, WPATH referred to those other societies, not mentioning that
the claim they were referring to originated with WPATH. The near
unanimity in these organizations is in part a product of the same people
cross-pollinating their ideas from one organization to the next.
*Hilary Cass was chosen not in spite of her lack of experience in
pediatric gender medicine, but because of it. Ideally, people assessing
the strength of evidence in a field will not have financial or
intellectual conflicts of interest, as did every single author of
WPATH's SoC8.
*A couple of dozen members of the BMA moved to denounce and scrutinize
the Cass Review this summer. But after an internal outcry and a letter
of protest signed by over 1,000 members, the BMA backpedaled and now has
a neutral posture as it conducts its review of the Cass Review.
*Despite the fact that the Yale Law School put up the white paper
criticizing Cass on its website, claiming it is the product of experts
at Yale is a stretch. There is a Yale Law author, and otherwise Meredith
McNamara is the lead author. Speaking of people who have no experience
with pediatric gender medicine: she is such a person. Under pressure in a
deposition in a Alabama civil case, she admitted that in her entire
career as a pediatrician, she has only ever referred two patients to a
pediatric gender clinic and has never prescribed pediatric
gender-transition treatment. And yet she presents herself in myriad
forums as a leading expert on this medical care.
Critics of the GRADE system who feel it holds pediatric
gender-transition treatment to too high a standard, one that demands
randomized controlled trials, can look, if they like, to the University
of York systematic literature reviews that fed into the Cass Review.
They used the Newcastle-Ottowa Scale, which allowed them to assess the
observational research that makes up all the literature in the field of
pediatric gender medicine.
Even with this more flexible standard, the reviews found of puberty
blockers: "There is a lack of high-quality research assessing puberty
suppression in adolescents experiencing gender dysphoria/incongruence.
No conclusions can be drawn about the impact on gender dysphoria, mental
and psychosocial health or cognitive development. Bone health and
height may be compromised during treatment."
And of cross-sex hormones they found: "There is a lack of high-quality
research assessing the use of hormones in adolescents experiencing
gender dysphoria/incongruence. Moderate-quality evidence suggests mental
health may be improved during treatment, but robust study is still
required. For other outcomes, no conclusions can be drawn."
This RCT gave natal females testosterone immediately or on a three-month delay. During the early days of taking this hormone, it can cause an immediate feeling of euphoria. But it typically takes longer than this for the physical changes to set it. So a three-month delay is likely to be biased by the first factor and not include the impacts of the latter, the impact of which is what the trial should be measuring. So no, this is hardly a definitive, high quality RCT that is free from bias and whose findings likely reflect real world impact. jamanetwork.com/journals/jaman…
*The entire pediatric gender medicine global field got started because
of a tiny study of just 70 people, and 55 during it's last follow-up,
out of the Netherlands (published in 2011 and 2014).
*The researchers at the NHS pediatric gender clinic, GIDS, attempted to
replicate those findings with what ultimately included 44 participants.
While the Dutch study had various positive findings (which have been
criticized by many researchers, mind you), this study found null
findings. The youth did not improve psychologically. But the purpose of
the study was indeed to demonstrate that they would. Thus, the study was
a failure. And so the researchers hid the findings for years until
Oxford sociologist Michael Biggs smoked it out.
* The notion that puberty blockers provide a time to think should have
been put to rest long ago. Numerous analyses have shown that almost
everyone who starts blockers for gender dysphoria goes on to take
cross-sex hormones. It is extremely unlikely that this is because the
assessments for kids seeking blockers were nearly perfect. That just
does not happen in psychology.
*The reference to the 72% suicidal ideation is misleading in various
ways. For one, the study was mostly concerned with sports laws, not
gender-transition treatment. So it is not right to hold it up as solid
proof that such bans lead to suicidal attempts. Also, the study was
about suicidal attempts ,not ideation. Actually, oddly, it found that
there was evidence these laws led to attempts, but NOT to ideation. And
it found that they led to such attempts 2 years later, but not 1 or 3
years later. It's a messy study to say the least.
The citation laundering diagram:
ohchr.org/sites/default/…
The person who wrote this piece for Erin has once expressed that
they saw it as a badge of honor that I fact checked them.
It is not.
