Gender Medicine Monthly
2024: January - February
This is the 10th edition of my newsletter Gender Medicine Monthly, dedicated to sharing updates related to gender medicine with a particular focus on pediatric gender medicine and the affirmative model of care, for paying subscribers.
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Here are some important headlines in gender medicine from January and the first few days of February 2024 covered in this edition of Gender Medicine Monthly.
The WHO acknowledges limited evidence for youth medical transition, proceeds with adult guidelines
The New York Times publishes boldest trans coverage yet that systematically debunks gender activists’ claims
Alberta becomes the first Canadian province to restrict youth medical transition and enact common sense trans policies
A new documentary spotlights male detransitioners
An open letter opposing the American Psychiatric Association’s radical new gender-affirming textbook now seeks public signatures
New organization helps fund detransitioner lawsuits
Democrats from 4 states have voted against youth medical transition policies
Richard Dawkins defends the sex binary
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1. The WHO acknowledges limited evidence for youth medical transition, proceeds with adult guidelines
Source: SEGM 2/1/23
On January 15, 2024, the World Health Organization (WHO) updated its announcement on developing healthcare guidelines for “trans and gender diverse (TGD) people.” The initial announcement in late December 2023 sparked widespread concern, including a petition garnering nearly 12,000 signatures, coverage in the British Medicine Journal (BMJ), and even a powerful letter addressed to the WHO Director from Reem Alsalem, the U.N.'s Special Rapporteur on Violence Against Women and Girls.
In response to the criticism, WHO extended the public comment period to February 2, removed a particularly outspoken activist from their Guideline Development Group (GDG), and stated in an FAQ that it would not be making recommendations that impact minors.
Importantly, they made the following admission: "[O]n review, the evidence base for children and adolescents is limited and variable regarding the longer-term outcomes of gender affirming care for children and adolescents" (January, 2024).
Despite these changes, major issues with the planned guidelines persist, as laid out by the Society for Evidence-based Gender Medicine (SEGM). The concern is that the WHO is advancing recommendations based on unproven assumptions instead of solid evidence that could potentially endanger many vulnerable adults.
SEGM has reviewed WHO documents and previous guidelines relevant to transgender individuals, notably the 2022 self-care and HIV guidelines. SEGM discovered that these guidelines assert the need for widespread hormone availability and legal gender self-identification without adequate evidence support. These assertions are not grounded in thorough reviews or human rights analyses but rather in circular referencing. Additionally, the composition of the GDG remains biased — riddled with conflicts of interest.
Significance: WHO's acknowledgment of the insufficient and inconsistent evidence for transitioning minors highlights a significant divergence between the U.S. and a growing international consensus that has begun heavily restricting youth medical transitions. This acknowledgment is a critical admission, suggesting that the agreement among many U.S. medical groups may reflect the stance of the U.S. medical industry rather than scientific consensus. The decision by WHO not to develop guidelines for minors represents a significant victory; however, vulnerable adults remain at risk.
The term “vulnerable adults” broadly refers to individuals, especially those aged 18-25, and particularly those on the autism spectrum or with psychiatric comorbidities, who have not previously experienced gender-related distress but come to identify with an “underlying trans-identity” after encountering gender ideology. This contrasts with persistent, lifelong gender dysphoria. Careful and individualized assessments, grounded in the best available evidence and scientific rationale, are crucial to help prevent adults from making potentially regrettable long-term decisions. By facilitating easier access to hormones, WHO risks leading vulnerable adults towards harmful outcomes.
2. The New York Times publishes boldest trans coverage yet that systematically debunks gender activists’ claims
Source: New York Times 2/2/24
The New York Times has released its most courageous article yet on the controversy surrounding youth gender transition, titled "As Kids, They Thought They Were Trans. They No Longer Do," an op-ed by Pamela Paul. This piece shines a light on detransitioners, health professionals speaking out against the gender-affirming care model, and the faulty science supporting it, which Paul meticulously dismantles.
The NYT took its time to start covering this topic, beginning in June 2022, and has since published several significant articles. These articles have adopted a cautious, objective stance on youth transition, but were too often conciliatory towards the activist viewpoint — likely in an effort to avoid provoking gender activists (who ended up being provoked anyway).
What distinguishes this op-ed from previous coverage is its unapologetic tone. It employs assertive language previously unseen in the NYT and systematically counters activist claims with solid scientific evidence. Here are some highlights from the article that set it apart from others:
Paul says that transgender activists have “pushed their own ideological extremism” and “describe any opposition as transphobic.” She notes that individuals raising concerns are often “attacked as anti-trans and intimidated into silencing their concerns.”
She characterizes gender activist assertions as a “narrative” and an “ideology.”
She details how young people encounter transgender influencers on platforms like TikTok and YouTube, and in schools through “curriculums supplied by trans rights organizations.”
Paul describes the coercive tactic of presenting parents with a choice between a dead child or a trans child as “emotional blackmail.”
She discredits numerous activist claims with studies that directly challenge their assertions.
Paul addresses the challenges faced by detransitioners, who “face ostracism and silencing because of the toxic politics around transgender issues,” and observes that “only conservative media outlets seem interested in telling their stories.” She poignantly states: “These are people who were once the trans-identified kids that so many organizations say they’re trying to protect — but when they change their minds, they say, they feel abandoned.”
She references research indicating that most children who identify as transgender do not maintain that identification into adulthood, and she highlights a comprehensive review on youth detransition, noting: “Studies show that around eight in 10 cases of childhood gender dysphoria resolve themselves by puberty and 30 percent of people on hormone therapy discontinue its use within four years, though the effects, including infertility, are often irreversible.”
Paul critiques the Dutch studies for being “falsely presented to the public as settled science” and highlights their “methodological flaws and weaknesses,” stating they provide “no evidence that any intervention was lifesaving.”
She discusses the tactics by trans activists to “suppress any discussion of rapid onset gender dysphoria, despite evidence that the condition is real.”
Paul calls out activist groups like GLAAD and the Human Rights Campaign for their efforts to pressure the media into silence.
She highlights how many countries have now reconsidered their stance on medical transition for youth and asserts that the American medical community is clinging to an “outdated model of gender affirmation.”
Significance: The significance of this article is apparent from the responses it has generated, especially from comments like this:
The intense reaction from gender activists, who have tried to dismiss the piece as merely an opinion that supposedly bypassed rigorous fact-checking, also highlights its impact. Despite the NYT opinion editor Kathleen Kingsbury publishing a letter in an attempt to temper the criticism, it has not calmed the activists.
The New York Times has previously navigated the topic of youth medical transition with caution, yet its role in shaping the discourse is significant, given its wide-reaching, predominantly left-leaning audience and esteemed reputation. This op-ed represents a pivotal shift, indicating a movement in the right direction as it brings to light the controversies surrounding pediatric gender medicine that challenge activist narratives.