It is my pleasure to introduce this article by the intrepid reporter Benjamin Ryan. I learned of Mr. Ryan during the monkeypox outbreak, our empirical research found that he was the single most accurate source of information on Twitter/X.
Now, he turns his attention to the third rail of American medicine— gender dysphoria and its treatment. This article is worth your time, and he is worth reading & following.
Vinay Prasad, MD MPH
On Wednesday, The New York Times reported that one of the leading figures in the field of pediatric gender medicine, Dr. Johanna Olson-Kennedy, was deliberately shielding from the public research findings indicating that prescribing puberty blockers to gender-distressed children had no apparent psychological benefit. She cited political motivations for withholding from the public vital scientific information that we all paid for, given her investigation was sponsored by the National Institutes of Health.
Many members of the wider public were shocked by Dr. Olson-Kennedy’s apparent subterfuge.
They shouldn’t have been.
I have spent the past two years immersed the controversial and combustible field of pediatric gender medicine, first as a devoted student of its byzantine and contradictory literature and eventually as a dogged reporter. In my over two decades of science reporting, I have never encountered a medical field in which activist and advocacy goals are so consistently prioritized over dispassionate, honest and transparent science.
I’m talking about everyone from researchers and doctors at prestigious intuitions such as Harvard, Brown and UCSF. I’m talking about the leadership in the American Academy of Pediatrics and other major medical societies (with the notable exception of the American Society of Plastic Surgeons) and a major Biden administration health official. And perhaps the most shadowy and deceptive of all is the U.S.-based activist-medical organization World Transgender Association for Transgender Health, or WPATH.
As I wrote on Substack yesterday, this medical field is brimming with egregious examples of researchers hiding inconvenient research findings, refusing to share data that might lead to such findings, and discouraging researchers from conducting or publishing research that might prove inconvenient to the mission of providing open access to gender-transition treatment and surgeries for minors. All this goes on within the larger context of the fact that a half-dozen systematic literature reviews—the gold standard of scientific evidence—have found the evidence backing such interventions is largely weak and inconclusive.
Constructing a fearsome buffer zone around this medical and scientific field is an activist cabal that stands in waiting to attack, silence and cancel any researcher, journalist or other public figure who dares step out of line—anyone who questions the wisdom of, or evidence base behind, prescribing puberty blockers and cross-sex hormones to gender-distressed minors.
This includes the major LGBTQ organizations, such as the Human Rights Campaign and GLAAD; as well as prominent and highly aggressive activists, including Alejandra Caraballo, who is a clinical instructor at Harvard Law School and who is particularly fond of defaming people; the popular Substacker Erin Reed, who has proven herself incapable of publishing reliably accurate science reporting; and the pugilistic Northwestern Journalism professor Steven Thrasher.
These activists and nonprofits utter streams of falsehoods as they seek to bully anyone who betrays a perspective on the subject of pediatric gender medicine that is misaligned with their advocacy goals.
Behind them is a liberal media that for the most part does GLAAD’s biddings and publishes advocacy talking points instead of conducting incisive, circumspect journalism. (There are notable exceptions, mind you.)
I spent much of last year crafting pitches about articles I wanted to write about the many questionable aspects of pediatric gender medicine. I took my ideas to major left-leaning media outlets, hoping they would publish my reporting. They all refused. All of them. They were too scared of the blowback and of GLAAD in particular. One told me they feared for their job if they ever stuck their neck out the way I have. Another was clearly fearful of his junior staffers.
They are right to be afraid. There is profound risk in publicly questioning the dogma in this medical field.
Since I began investigating this subject as a reporter and ultimately publishing my work with conservative outlets, I have had friends and colleagues denounce me as evil for defending the small group of fine journalists who also work in this space, such as Jesse Singal. I had the child of a family friend seek to eject me from her mother’s book party (I refused to comply). And I’ve received streams of harassing calls, texts, emails and DMs and even received a threat of harm to my person. All for doing what I have done my entire career: report the truth about science and medicine without fear or favor.
I have heard from countless parents who report, without any trace of bigotry or animus, that their adolescent children have begun identifying as transgender despite any prior indication of gender nonconformity. These parents are heartbroken, terrified and alone. They love their children, but they sincerely do not believe that a medical gender transition will help them.
This week, I had a Zoom call with one parent whose former spouse had transitioned genders and whose very young children then followed suit. This was a lifelong liberal whose sociopolitical principles left them with searing cognitive dissonance as they pushed back on potentially medicalizing one child’s trans identity. The parent believed that the child’s self-conception was surely the product of the former spouse’s influence.
I wish I could show you the restrained agony on this parent’s face as they spoke with resigned sadness about their effort to protect their child from doctors who might, with the best of intentions, harm the kid and to maintain their relationship.
Because I want you all to remember that at the center of this debate is the well-being of a population of profoundly vulnerable children.
The best way to ensure these kids get the best care is to advocate for better science. Doing so takes bravery these days.
But it must be done.
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I am an independent journalist, specializing in science and health care coverage. I contribute to The New York Times, The Guardian, NBC News and The New York Sun. I have also written for the Washington Post, The Atlantic and The Nation.
Follow my Substack: https://benryan.substack.com
Follow me on Twitter: @benryanwriter.
Visit my website: benryan.net
Thank you, Benjamin, for your integrity and courage. We must keep asking for data, the best data available, and not poor quality studies.
Sweden and the Netherlands have toughened their screening process for hormones and puberty blockers and increased the requirements for psychological assessment, but as Hanna Barnes book details, their updated screening processes, and their followup research, leave many questions.
You seem over confident about how easy it is to assess and treat a depressed, anxious, and dysphoric child. It can take years of at least monthly appointments with psychiatrists and therapists to stabilize a depressed, autistic, anxious or self harming teenager. I'm with Dr. David Bell of the Tavistock clinic, and not with the simplistic screening process of a few visits that you suggest.