On June 22 I reported on a sort of “cancellation”. The respected website Science-Based Medicine (SBM), at the urging of editors David Gorski and Steve Novella, removed a review of a book by one of the other editors, physician Harriet Hall. As I wrote at the time:
So much the worse, then, that the site removed a book review written by another respected physician, Harriet Hall, known for being one of the Air Forces’s first women flight surgeons as well as a notable advocate for science based medicine and a vociferous debunker of quackery. And—get this—Hall is one of the journal’s five editors.
Hall’s “mistake” was to write a fair and objective review of Abigail Shrier’s new book, Irreversible Damage (see my post here) about the sudden increase in transgender males drawn from teenaged girls. (The numbers have increased 4,400% from 2008 to 2018!) Shrier and Hall, who admittedly note that there are very few studies about why these transitions have skyrocketed, and involve nearly all girls who want to transition to males rather than the other way round, call for more research and argue that transitions should be done under “a research setting”.
I read Shrier’s book and thought it was fair, empathic, and certainly not transphobic. But because Shrier was unfairly accused of transphobia for simply calling for more research on a topic that deserves it, it seems like SBM got cold feet. They replaced Hall’s review with three negative articles about Shrier’s conclusions, saying that Hall’s analysis failed to meet SBM’s standards for “high quality scientific evidence and reasoning to inform medical issues.” I’ve written a fair bit about this controversy, which does debase SBM quite a bit for promoting science because it conformed to a preferred ideology; see my collection of posts here.
Jesse Singal, who knows this literature well, has spent a fair amount of time taking apart SBM’s behavior in this case as well as the criticisms leveled at Hall and Shrier (see here and here, for example). Singal:
SBM has, in the wake of this retraction, published three articles about Shrier, Hall’s review of her book, and the broader controversy over youth gender medicine: “The Science of Transgender Treatment” by Novella and Gorski themselves, “Abigail Shrier’s Irreversible Damage: A Wealth of Irreversible Misinformation” by Rose Lovell, who as of February was finishing up a medical residency, and “Irreversible Damage to the Trans Community: A Critical Review of Abigail Shrier’s book Irreversible Damage (Part One)” by AJ Eckert, who serves as “the Medical Director of Anchor Health’s Gender and Life-Affirming Medicine (GLAM) Program” in Connecticut. Part Two is presumably on the way and I’ll read it when it’s published. (For what it’s worth, neither Lovell nor Eckert had written for SBM previously — they appear to have been brought on specifically for the task of responding to Irreversible Damage.)
Yet according to Kimball Atwood, a former editor at SBM as well as a physician and clinical professor, the articles that replaced Hall’s were laden with their own problems—philosophical, biological, and logical. Atwood wrote a letter to Gorski and Novella and gave Singal permission to publish the letter on Singal’s own website. So here it is in all its glory. Click on the screenshot to read. PCC(E) gets a brief mention at the end.
The first bit is my favorite (I’ve added a link to “DSD”):
Harriet has told me that you stated that her article “dragged SBM into a raging controversy.” She feels, and I agree, that it was your retracting that article and replacing it by very bad articles written by advocates of “gender affirmation” that dragged SBM into a raging controversy. I’ve attempted to explain why previously, but here I’ll mention a couple of the most obvious reasons.
You claimed that Harriet’s article was below SBM’s minimal standard for “high quality scientific evidence and reasoning to inform medical issues.” Yet you replaced it with articles stating things such as the following:
- “Biology is a binary and differences of sex development (DSDs) are vanishingly rare”. False. DSDs are as common as 1 in 5,000 births, and increase to 1 in 200 or 1 in 300 if you include hypospadias and cryptorchidism. Biology is very, very well known to be a spectrum.
[Lovell attributes the sentence in quotes to Shrier; I’ve been unable to find it in her book]
Do you, Steve, think that sex is a spectrum? Yes, I know Lovell wrote “biology is a spectrum,” but that is an incoherent claim. Her implication is that sex is a spectrum. If that were true, it would upend all that we know about sex in mammals and many other life forms, including sexual dimorphism, reproduction, and selection. Do you think that Lovell’s statement constitutes “high quality scientific evidence and reasoning”? OMG, apparently you do. What’s happened to you?
Do you think that hypospadias and cryptorchism are DSDs? They are not, and to suggest that they are does not meet SBM’s minimal standard for reasoning about medical issues.
The citation is to a paper that discusses real DSDs, not cryptorchism or hypospadias, and makes no claims about a “spectrum.” It supports the very statement that Lovell claims to be false (even though Shrier seems never to have made that statement). Where was the editor here?
There’s more, and the letter is short but sweet. I still think Gorski and Novella stepped in it by ditching Hall’s review. There’s no explanation other than the fact that Hall generally liked Shrier’s book, that the book has been attacked (wrongly) as “transphobic,” and that Gorski and Novella were afraid of backlash for being insufficiently attentive to the Zeitgeist of trans-activism.