Ex-editor of Science-Based Medicine chews the site’s tuchas for its treatment of Abigail Shrier’s book

September 26, 2021 • 12:15 pm

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”):

Hi Steve,

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.

25 thoughts on “Ex-editor of Science-Based Medicine chews the site’s tuchas for its treatment of Abigail Shrier’s book

  1. There’s no explanation other than … that Gorski and Novella were afraid of backlash for being insufficiently attentive to the Zeitgeist of trans-activism.

    I suggest that they are not so much afraid of the backlash, but have swallowed that Zeitgeist whole and are now full-blown believers.

  2. “[Lovell attributes the sentence in quotes to Shrier; I’ve been unable to find it in her book]” – well let’s hope that S-BS verified it before allowing Lovell to publish that hit piece on their site! (Sadly, I have my doubts.)

  3. The first comment below the line at Singal’s post is good: “Thought I’d be calling in to my robot maid/cook on my jetpack ride home from work in 2021, not having to argue human sexual dimorphism, or that the earth is round…”

  4. 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.

    Depends on precisely what is meant by “raging controversy.” On Sept 11, 2018 Dr. Hall published an article called “Gender Dysphoria in Children” and it drew 5,224 comments, many of them furious. She followed it up a week later with “Rapid-onset Gender Dysphoria and Squelching Controversial Evidence” and the comment section was closed at only 1,2227 heated replies. From the point of view of SBM, I’d say those two unretracted posts dragged the community into a raging controversy. But, from what I can tell, it remained internal. The new little game of retraction-bad counterpoints taking place when there’s more public controversy lead to a wider-ranging raging controversy.

    Harriet is no fool, and probably had a pretty clear idea of what she was stepping into 3 years ago, and with the Shrier review. She also had the background to understand and address the issue, and neither Gorski nor Novella should have been surprised that she exercised her usual caution in urging more research. That she was surprised that her article was actually removed is probable, though. The men editors must not have sat her down and explained that transgenderism is very complicated and hard, so it would be wiser if a white cis woman just stayed off the whole topic, okay?

    Horse threw her once and she got right back up. Count on it.

    1. And she at least stays true to the skeptical ethic regarding the issue of transgenderism, as opposed to Gorsky and Novella.

  5. Heather Heying is quoted in the endorsements for the book, which is unfortunate now (although not at the time she praised it).

    1. D’oh – for clarity, “in the endorsements for Shrier’s book”. Something Shrier could do without now, I suspect.

    2. That is unfortunate, in the light of Bret and Heather’s recent mind-rot.

      Not quite as unfortunate as the fact that Peter Boghossian once wrote a blub/foreword for one of Dan “The Zionists” Arel’s unread books. A huge embarrassment for Boghossian, no doubt, given Mad Dan’s descent into extremism and cringe.

      1. Yikes. How long ago was that, and what was the book about? Because Dan Arel is about as “toxic” a person as one can find without going beyond the bounds of physical abuse.

  6. I started reading Eckart’s and Lovell’s guest articles (I read SBM), and it did not take long for me to get the impression that both authors were biased and embedding ideology into their arguments. Both Shrier (when interviewed by Sheree) and Hall sounded more sensible and reasonable then they did. Eckert and Lovell should not have been published on SBM, and Hall’s article should not have been deleted.

    1. Those articles were very poor examples of evidence-based opionion. It’s easy for skeptics to approach other people’s bailiwicks with a skeptical process. That’s why so many skeptics like to go after bigfoot, flat-earthers, UFOs, and other obvious pseudoscience. When it gets to things we want to believe, being skeptical is a bit more sketchy.

      You’d be surprised, for example, at how many skeptics believe in the paleo diet (not that it isn’ good,) based on bad anthropology, or the alkaline diet based on a misinterpretation of a German study from 1938 on acidity of liver cancer.

      Once skeptics accept that there is a gender identity that is biologically based, it’s hard to shake the idea and it’s natural to resist any contrary evidence; and if your belief also incorporates the idea that transgender people are more oppressed than women, well, the only explanation for contrary beliefs becomes bigotry.

      1. I’m not sure what you’re arguing for here. Of course there is a biological basis for what are often termed gender differences. Some, but not all, are due to society, but many or most or biological.

        Are you saying that people who are normally skeptics aren’t skeptical enough when it comes to transgenderism because they want to believe it?

        Of course, there have always been dandies and tomboys, people who perhaps confirmed to gender ideas in conflict with their sex in the eyes of some. However, they usually didn’t see themselves as transgender in the modern sense of the term, and at least with tomboys probably not a higher fraction were lesbian than in the general population.

        Truly biologically intersex people are very rare and have nothing to do with transgenderism. In fact, they are often in conflict with the ideology, as they support the idea of not having to conform to one or the other sex, while most transgender advocates believe in a strict binary, more strict than, say, Leave It To Beaver. They just think that they were assigned the wrong sex at birth.

        1. It’s useful to clarify terms here, since those promoting Gender Identity doctrine often muddle concepts or use words in unusual ways. There’s:

          Common definition of Sex: the type of gamete ones body is organized to support.
          Reflects underlying reality. In humans, a binary of female/woman and male/man.

          Gender Identity advocates, however, view sex as mostly a construct of cultural, historical, and conceptual discourses. It’s a spectrum which only includes male and female.

          Common definition of Gender: the socially-constructed norms, behaviors and roles regarding what’s masculine and feminine. (Amplifies any biological bases for sex differences.)

          Gender Identity advocates place “woman” and “man” here (sometimes “male” and “female,” too.) They use the word “gender” to mean:

          1.) Socially constructed norms, etc.
          2.) Sex
          3.) An internal sense of being a man or woman which is unrelated to sex OR gender norms. May be either metaphysical or neurological (biology-based.)

          Michael Haubrich here is probably arguing against Gender Meaning #3.

        2. Young people are biologically (brain development incomplete) and/or psychologically (not very experienced, well self-defined, and self-confident) vulnerable to seeking to impress their peers and being influenced by their peers, so when their peers are encouraging adopting a gender different from sex, and some adults then do the same either in an effort to be empathetic or for business profit, those young people make not well thought out decisions that they may later regret but are difficult or costly to reverse. What is needed is more awareness that young people are vulnerable to peer pressure and adult authority, that businesses which participate in gender changing medicine be government regulated, and maybe also an age restriction on when difficult or costly to reverse gender changing medical interventions are permitted.

  7. This is a sad development. Where can we go now to debunk quackery if it touches on any of the Woke’s plethora of third rails?

    1. Well you won’t have to worry about Homeopathy & Chriopractic any more like ‘Science Based Medicine’ they are ‘of the White Man’ and can be rejected without thought.

  8. not surprising if you are familiar with gorski’s online persona via twitter or his blog, though i appreciate him for it: insight into the mind of an “expert” is useful in deciding how much weight to give the scientific opinion of anyone.

Leave a Reply