The exaggerated or false assertions of extreme gender activists are starting to wane—thanks to scientific research. The fact that the article below appeared in a liberal magazine, The Atlantic, is a sign that these activists can no longer bully the public into accepting bogus arguments and claims (e.g., “would you rather have a dead son or a live daughter?”), for research shows otherwise. The article below concentrates on two especially distressing antiscientific phenomena:
1.) The persistence of “zombie” facts: false assertions that nevertheless hang on because they suit a liberal, virtue-signaling ideology. One of them is the supposed increase in suicide among youth who aren’t given “affirmative care” for gender dysphoria.
2.) The reluctance of organizations like WPATH and the U.S. government to publish research that goes against the accepted ideology.
Both of these can lead not only to public ignorance, but also to real harm of children and adolescents pushed into transitioning genders without complete information (or with false information). I am not saying, of course, that changing genders, or having surgery, or taking hormones to do so, should never be permitted. In many cases those allowed to transition report that they are happier for having done so. (One must nevertheless be wary of such self-reporting after the fact.) But while I don’t believe in bans on medically changing gender, I do object to affirmative care and to unscientific assertions, which can lead young people to make poorly informed decisions. (Older people, say over 21, should have the ability to weigh the facts and make their own decisions.)
The fact that MSM like the New York Times and The Atlantic can now get away with publishing articles like these is a sign that the times are a-changin’. And I’m glad that they are changing because the change is coming from science.
The Atlantic article below was published here, but unless you subscribe it will be paywalled. However, you can find it archived here, and clicking the headline below will take you to the archived version.
The article begins with an anecdote about the ACLU attorney and deputy director for transgender justice Chase Strangio, whom we’ve met before. Strangio, a trans-identified woman, is the lawyer who advocated the banning of Abigail Shrier’s book on social causes of gender dysphoria Irreversible Damage: The Transgender Craze Seducing Our Daughters. Few reasonable people now doubt that Shrier was right: some transitions are promoted by social pressure.
Strangio later removed these tweets, which incorrectly characterize Shrier’s book. And the ACLU was arguing for banning books? Oy!
Strangio argued, and lost, a case in the Supreme Court, one of the reasons being he adduced a false “zombie fact” (all quotes below are from Lewis’s Atlantic article, and are indented):
“We often ask parents, ‘Would you rather have a dead son than a live daughter?’” Johanna Olson-Kennedy of Children’s Hospital Los Angeles once explained to ABC News. Variations on the phrase crop up in innumerable media articles and public statements by influencers, activists, and LGBTQ groups. The same idea—that the choice is transition or death—appeared in the arguments made by Elizabeth Prelogar, the Biden administration’s solicitor general, before the Supreme Court last year. Tennessee’s law prohibiting the use of puberty blockers and cross-sex hormones to treat minors with gender dysphoria would, she said, “increase the risk of suicide.”
But there is a huge problem with this emotive formulation: It isn’t true. When Justice Samuel Alito challenged the ACLU lawyer Chase Strangio on such claims during oral arguments, Strangio made a startling admission. He conceded that there is no evidence to support the idea that medical transition reduces adolescent suicide rates.
At first, Strangio dodged the question, saying that research shows that blockers and hormones reduce “depression, anxiety, and suicidality”—that is, suicidal thoughts. (Even that is debatable, according to reviews of the research literature.) But when Alito referenced a systematic review conducted for the Cass report in England, Strangio conceded the point. “There is no evidence in some—in the studies that this treatment reduces completed suicide,” he said. “And the reason for that is completed suicide, thankfully and admittedly, is rare, and we’re talking about a very small population of individuals with studies that don’t necessarily have completed suicides within them.”
Here was the trans-rights movement’s greatest legal brain, speaking in front of the nation’s highest court. And what he was saying was that the strongest argument for a hotly debated treatment was, in fact, not supported by the evidence.
Even then, his admission did not register with the liberal justices. When the court voted 6–3 to uphold the Tennessee law, Sonia Sotomayor claimed in her dissent that “access to care can be a question of life or death.” If she meant any kind of therapeutic support, that might be defensible. But claiming that this is true of medical transition specifically—the type of care being debated in the Skrmetti case—is not supported by the current research.
Here Strangio and the ACLU lost out because they adduced a “zombie fact”. Yes, thought of “suicidality” might increase if blockers aren’t given, but the data are inconclusive, and we should always remember that the great majority of children and adolescents with gender dysphoria who don’t transition turn out to be cis, gay or bisexual, outcomes that doesn’t lead to more dysphoria, much less sterility, medical complications, bone problems, and so on.
Zombie facts, like zombies themselves, are hard to kill, not least because people who adduce them are ideologues who are resistant to facts. In this respect they resemble creationists.
Marci Bowers, the former head of the World Professional Association for Transgender Health (WPATH), the most prominent organization for gender-medicine providers, has likened skepticism of child gender medicine to Holocaust denial. “There are not two sides to this issue,” she once said, according to a recent episode of The Protocol, a New York Times podcast.
Here’s one result of those zombie facts:
When red-state bans are discussed, you will also hear liberals say that conservative fears about the medical-transition pathway are overwrought—because all children get extensive, personalized assessments before being prescribed blockers or hormones. This, too, is untrue. Although the official standards of care recommend thorough assessment over several months, many American clinics say they will prescribe blockers on a first visit.
This isn’t just a matter of U.S. health providers skimping on talk therapy to keep costs down; some practitioners view long evaluations as unnecessary and even patronizing. “I don’t send someone to a therapist when I’m going to start them on insulin,” Olson-Kennedy told The Atlantic in 2018. Her published research shows that she has referred girls as young as 13 for double mastectomies. And what if these children later regret their decision? “Adolescents actually have the capacity to make a reasoned logical decision,” she once told an industry seminar, adding: “If you want breasts at a later point in your life, you can go and get them.”
Yes, you can go and get them. “Two new breasts, please.” Of course those breasts will have no sensation, sexual or otherwise.
Finally, the organization that perhaps promulgates the most zombie facts is The World Professional Association for Transgender Health (WPATH), which has spread the false rumor that Britain’s 2020 Cass Review, was shoddy and wrong. That report concluded that “the evidence base and rationale for early puberty suppression was unclear, which led to a UK ban on prescribing puberty blockers to those under 18 experiencing gender dysphoria (with the exception of existing patients or those in a clinical trial).” This led to the closure of the UK’s main Gender Identity Center (GIDS) and a revision of the way patients are referred for treatment. But WPATH, firmly wedded to affirmative care and the transitioning of those not of age to make such decisions, opposed the report, spreading misinformation about it:
The reliance on elite consensus over evidence helps make sense of WPATH’s flatly hostile response to the Cass report in England, which commissioned systematic reviews and recommended extreme caution over the use of blockers and hormones. The review was a direct challenge to WPATH’s ability to position itself as the final arbiter of these treatments—something that became more obvious when the conservative justices referenced the British document in their questions and opinions in Skrmetti. One of WPATH’s main charges against Hilary Cass, the senior pediatrician who led the review, was that she was not a gender specialist—in other words, that she was not part of the charmed circle who already agreed that these treatments were beneficial.
Another: the Biden Administration’s Rachel Levine, a trans-identified man who was the Assistant Secretary for Health and Human Servies, even tried to completely get rid of any age minimums for “affirmative care”. She said in emails that having age limits would make it harder for people to allow youths to transition. But what’s wrong with that given we have age limits for decisions (like driving or drinking) with health import? As far as I know, Levine failed,
But to me as a scientist, the worst part of the whole mess is when scientists get data showing that the claims of gender activists are wrong, and then the data are withheld or delayed. This is exactly the kind of ideological distortion of science that Luana and I described in our Skeptical Inquirer article. But it’s even worse, because distorting medical issues not only misrepresents the facts, but also leads to uninformed medical practice, something far more harmful to people than, say, attacking evolutionary psychology on ideological grounds. Here are two examples of data being withheld or delayed because it didn’t support “accepted” gender medicine (words are from The Atlantic):
A) The Alabama litigation also confirmed that WPATH had commissioned systematic reviews of the evidence for the Dutch protocol. [The Dutch Protocol, developed in the Netherlands, is pretty much what we call “affirmative care” in the U.S., involving blockers followed by hormone treatment and perhaps surgery.] However, close to publication, the Johns Hopkins University researcher involved was told that her findings needed to be “scrutinized and reviewed to ensure that publication does not negatively affect the provision of transgender health care.” This is not how evidence-based medicine is supposed to work. You don’t start with a treatment and then ensure that only studies that support that treatment are published. In a legal filing in the Alabama case, Coleman insisted “it is not true” that the WPATH guidelines “turned on any ideological or political considerations” and that the group’s dispute with the Johns Hopkins researcher concerned only the timing of publication. Yet the Times has reported that at least one manuscript she sought to publish “never saw the light of day.”
B) The Alabama disclosures are not the only example of this reluctance to acknowledge contrary evidence. Last year, Olson-Kennedy said that she had not published her own broad study on mental-health outcomes for youth with gender dysphoria, because she worried about its results being “weaponized.” That raised suspicions that she had found only sketchy evidence to support the treatments that she has been prescribing—and publicly advocating for—over many years.
Last month, her study finally appeared as a preprint, a form of scientific publication where the evidence has not yet been peer-reviewed or finalized. Its participants “demonstrated no significant changes in reported anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, aggressive behavior, internalizing problems or externalizing problems” in the two years after starting puberty blockers. (I have requested comment from Olson-Kennedy via Children’s Hospital Los Angeles but have not yet heard back.)
Clearly this study was delayed because it showed that puberty blockers did not relieve symptoms of gender dysphoria—a claim that is part of the “dead son or live daughter” trope. Author Lewis’s quote about how evidence-based medicine is supposed to work is absolutely appropriate here. Two studies didn’t show what they should have, so people didn’t want them published.
Now Lewis, like me, is not in favor of total bans on young people getting transitions. But given the fact that the bulk of young people who don’t get affirmative care wind up as gay is, to me, a powerful argument for making it very hard to undergo medical gender transitions. Even Lewis has changed her mind a bit in view of the fact that puberty blockers are not (as everyone thinks) always completely reversible, and also we lack good long-term studies of their effects. As Lewis notes:
However, the revelations from Skrmetti and the Alabama case have made me more sympathetic to commentators such as Leor Sapir, of the conservative Manhattan Institute, who supports the bans because American medicine cannot be trusted to police itself. “Are these bans the perfect solution? Probably not,” he told me in 2023. “But at the end of the day, if it’s between banning gender-affirming care and leaving it unregulated, I think we can minimize the amount of harm by banning it.” Once you know that WPATH wanted to publish a review only if it came to the group’s preferred conclusion, Sapir’s case becomes more compelling.
Lewis concludes that it shouldn’t be embarrassing to revise one’s views in light of scientific data. That, in fact, is how science works. But when it comes up against ideologues—particularly the diehard advocates of gender ideology—many people don’t want to change their minds. This is a palpably unscientific attitude, and one harmful to young people.
Despite the concerted efforts to suppress the evidence, however, the picture on youth gender medicine has become clearer over the past decade. It’s no humiliation to update our beliefs as a result: I regularly used to write that medical transition was “lifesaving,” before I saw how limited the evidence on suicide was. And it took another court case, brought by the British detransitioner Keira Bell, for me to realize fully that puberty blockers were not what they were sold as—a “safe and reversible” treatment that gave patients “time to think”—but instead a one-way ticket to full transition, with physical changes that cannot be undone.
Lewis’s conclusion seems sound, at least until we have more data:
We can support civil-rights protections for transgender people without having to endorse an experimental and unproven set of medical treatments—or having to repeat emotionally manipulative and now discredited claims about suicide.
I’m not sure why this one issue has evoked so much rancor and attempt to distort science, but somehow permissiveness to undergo “affirmative care,” combined with the sacralization of those who change gender, has turned this into an argument about virtue rather than science. In the end, though, you can’t decide what is virtuous unless you have the data. As Richard Feynman said, referring to the Challenger disaster, “For a successful technology, reality must take precedence over public relations, for Nature cannot be fooled.”
h/t: Norman
“Gender” – and the obsessions that surround it (e.g. Gayle Rubin’s Thinking Sex, et. al.) – it is worth noting, did not materialize out of thin air :
Gender in Mystical and Occult Thought – Behmenism and its Development in England
B. J. Gibbons
Cambridge U. Press
1996
Or
The Kybalion
1908
And my favorite quote on the word :
” “gender” is a kind of lexical brainworm, a parasite eating away at understanding.”
Alex Byrne
https://fairerdisputations.org/journey-of-gender/
17 May 2024
… that is, science starts with some set of premises and works out one increment at a time.
The premise of “gender” is never examined. I think it is clear why they are not – it is more like the inverse of the process of science.
For the post-Capitalist utopia to work, humans must be completely perfectible. Human nature is just one of the many aspect of bourgeois false-consciousness. When the revolution comes, you can be anything you want, as long as it’s not counterrevolutionary. That has to be true or people will not be able to abandon the thoughts and habits of the past. If it’s not true, and it isn’t, then Marxism is just another utopian socialism.
When the Dutch Protocol was quietly used mostly for an extremely small cohort of biological boys, trans was on nobody’s radar. Via internet wormholes trans social contagion produced an explosion of biological girls with no other potential explanation than social contagion. Very few people will be honest about this, but it is plainly obvious.
I also never gave trans anything a thought until the pandemic. I had a kindergartener watching a school video at home telling him the doctors “just guessed” if he were a boy or girl when he was born. He had long been staring off into space but that statement got my antenna up and I watched the rest of what I would honestly call a gender indoctrination video produced by Seattle Public Schools. The following year my daughter’s 3rd grade SJW teacher had lead 2/3 of the class to declare a trans or non-binary identity. She would inform me that our neighbor, her best girl friend, had socially transitioned and the teacher was helping her keep it secret from her parents. This girl was writing and talking about killing herself during this period, so I saw it as a teacher being quite reckless in the interest of ideology, ignoring child welfare. The following year on the soccer field my daughter was flung several feet through the air in a collision with a biological boy playing girls soccer. And there it was… everything I was told only far right bigots made up was happening in real life.
I didn’t want to care about the issue, but like millions of people the issue found our community. Our school policies are full access to all female spaces if a boy self IDs as female. Men too for that matter. Yeah, as a father of a now 7th grade daughter I have a problem with that.
Most people in my liberal Seattle neighborhood check skeptic inquiry on the issue at the yard sign before the door and go along with right think. I just can’t pretend the evidence supports what activists (and my local school admins) claim. I steel man the pro-GAC stances regularly but that only bolsters my skepticism. I’m now at a point where I believe there is a medical scandal afoot in GAC and I think people who define themselves as trans exist, but I reject any claim that they have a gendered soul/self in conflict with their body. And of course they cannot change sex. I think the best outcome is always for kids to reach equanimity with their bodies. Exceptions to this should be astronomically rare.
I think the Atlantic is really more heterodox. I was astounded by this WBUR/NPR piece featuring Cass and 2 clinical psychologists involved in GAC who basically blew the lid off the scandal and liberal America seems to have instantly memory holed it:
https://www.wbur.org/onpoint/2024/05/08/hilary-cass-review-caution-nhs-gender-affirming-care-youth
I live in your state, a bit south down the freeway from Seattle. In our state, a 13 year old can access all forms of medically provided gender affirming care. Available with or without their parents’ consent or in some cases, knowledge. A person can’t use alcohol or tobacco until age 21 and we won’t even recognize a marriage that takes place before age 18. Taken together, our policies on youthful transitions to adult behaviors are absolutely bananas.
These policies are deliberately being pushed by people who believe in Queer Theory. Their ultimate aim is to remove ALL barriers that exist to protect people. That includes not just the sex boundary, but the age boundary for sex with minors. If they manage to convince society that a child can give consent to genital mutilation, then it’s a simple step to convince society that a child can agree to sex with an adult. This is why they prioritise removing the surgery barrier, but pay less attention to the barrier for using alcohol or tobacco. This is what is behind the modern genderwoo movement. It’s a well thought out plan and, for a while, it looked like they were going to succeed.
This is the article that first drew my attention to the reasons behind the ‘transitioning’ of children. Genderwoo people tell me that this is a right wing website. I have no idea if it is or not, i just know that everyone should read this article as it rings so true.
https://www.city-journal.org/article/the-real-story-behind-drag-queen-story-hour
Thanks for Chris Rufo’s article, Joolz.
Anecdote alert:
At a gathering of mostly drifted-away Liberal boomer friends in Toronto, one related how the small town they used to spend winters in in North Carolina (pre-Trump, of course) suffered a power outage last time they were there. Some shadowy hillbilly group had sabotaged a small transformer station to retaliate against the town council’s decision (after noisy protests at the council meeting) to promote drag-queen story hours for children at public schools and the library. I recalled that it had made the news. (I don’t know where they got the drag queens from. “Outside agitators”, no doubt.)
I could tell he had a vastly different take on the story from mine. He was telling us why he and his wife — they have no children — stopped going to the U.S. Fair enough. Violence against infrastructure hurts everyone: not cool. But the part of me that shares Rufo’s concerns about drag queens, which the North Carolina hillbillies got and which my liberal friends did not, wanted to do a fist pump: “Yes!”
I didn’t argue with him because politics you know. The thing I notice about people who say you shouldn’t argue politics at gatherings, though, is what they mean is they themselves want to offer any political opinion they care to, but no one else can take it up. They want to enforce conformity, not forbearance and civility.
I was sickened when I read the article and realised what the underlying aim is. I felt I should probably ‘educate myself’ and read the books and manifestos mentioned in the piece, but I really don’t have the stomach for it.
Well done the hillbillies! There have been protests against DQSH here too, but when police are called, they often defend the trans mob. In a recent conversation about DQSH on twitter, I pointed out that several men in dresses with little girls on their laps and a man hugging a little girl were acting inappropriately. The genderwoo people immediately went on the offence and asked if I would object if a father did that to his child, or if a child asked a male relative for a hug. If I had more time, I might have explained the difference to them, but they probably wouldn’t have listened anyway.
“They want to enforce conformity, not forbearance and civility.” 🎯
The Manhattan Institute is a right-wing institution. So what? Only left-wing people and institution can be right?
Here’s something new:
Joseph Figliola: The Anatomy of Institutional Capture: Gender Medicine Policy and the Texas Medical Association. Manhattan Institute, Oct 16, 2025
https://manhattan.institute/article/the-anatomy-of-institutional-capture-gender-medicine-policy-and-the-texas-medical-association
I shared it because it’s a powerful article, regardless of which political side it comes from. Neither side has exclusive claim to the truth. I mentioned the complaints that some people have made because I don’t want anyone to use the politics of the writer as an excuse not to read it.
My understanding is that research shows 80% of kids with gender dysphoria end up happy with themselves after puberty and possibly gay. I don’t know about the other 20%, maybe they are still unhappy after puberty. Given this, it seems wrong to say all kids with gender dysphoria need medical treatment to transition unless you can identify the 20%.
I have not seen this addressed. Either I am wrong about the 80%, or they are being put through treatment for no reason.
In medicine, if you invent a treatment that is on balance harmful (to your great disappointment), you can’t use it. If you think, well, maybe it would work better in those children not destined to come out as homosexual once their sexuality emerged during puberty, that is a so-what? question unless we have some way to identify those adolescents before their puberty gets going. We don’t. And it would remain only a hypothesis that it worked in that subset of trans-identifying adolescents until we tested it.
But even then, some adolescents will become resigned to the rigours of puberty even though they take a heterosexual track but still remain unhappy. Some of the homosexual teens will be unhappy, too, anything but gay. Becoming homosexual doesn’t necessarily improve one’s mental health although sometimes it does if it resolves gender confusion. Straight kids can be happy or unhappy for lots of reasons, even if relieved that they didn’t go through with transitioning based on how they appeared at age eleven.
The challenge for the advocates (and demanders) of sex trait manipulation in adolescents is to show that it improves mental health in anyone (proto-gay or proto-straight) who can be identified ahead of time, and that the benefit is enough to justify a lifetime of medical complications. The debunking of the suicide canard pretty much puts the second challenge out of reach. Deal with your puberty, kid. We all had to. There’s no such thing as “wrong-sex puberty”, except of course an iatrogenic one.
My concern is that if one doesn’t support the state stepping in to ban this treatment in minors, but still wants those minors to be protected from it, who is going to say “No, this isn’t right. We ain’t doing it.”? The medical profession, who ought to say No, won’t. They’ve abandoned the field to the activists. They won’t help. This where the state does step in, just as it did with the tainted blood scandal. (The profession eventually stopped doing lobotomies — they “fell out of favour”. They won’t stop doing sex-trait manipulation as long as there is a lucrative demand for it.)
You are correct about the 80%. Of the people who think they have GD as a child, many don’t even have GD. Several other things can be misinterpreted as GD. Clinical depression can lead to confusion in a child, and a frequent cause of the desire to transition is child sexual abuse. Female victims often hate their bodies and convince themselves that they should be male as they think their sex is to blame for their abuse. With proper therapy and treatment for their PTSD from SA the imagined ‘dysphoria’ can pass. Several female detransitioners have said publicly that they should have had therapy for SA and had their desire to transition affirmed.
Mike, I think the problem is that there is a very small group of people for whom sex-trait modification via hormones and/or surgery brings relief from suffering. But some of these people then draw the erroneous conclusion that it would help anybody who suffers confusion about their sex or experiences gender dysphoria.
As far as pediatric transgender medicine is concerned, once we admit that most children with gender dysphoria grow out of it, we will, of course, make access to sex-trait modification treatments very restrictive. That is the rational thing to do. You play the odds, and chances are that any kid with gender dysphoria will get over it before it reaches adulthood. The downside is that the very rare male individual who does not grow out of gender dysphoria will have a male-looking adult body while desiring to pass as a woman.
Yeah, promoting the idea that a child is in conflict with their body is so obviously going to harm more than it helps. If it actually helps anyone vs working through it. I’m not Buddhist but I subscribe to the idea that life is suffering and the only way out of suffering is ceasing to identify with your thoughts and sitting in the present at peace with what IS. This includes your body of course. There are many disturbing things about the trans phenomenon but this core premise is the worst IMHO.
If you haven’t listened to that OnPoint podcast you should. It will blow your mind. The debate in liberal spaces should have ended after its broadcast.
I’m not aware of any quality evidence that says anyone has benefited from medical interventions to change sex traits to better align with a delusion. (People saying their life is better or that they wouldn’t have survived doesn’t qualify, and I believe the available data based on standard quality of life variables tell another story). And the idea that there’s an assessment that could determine this cohort is equally questionable. What exactly would you be assessing for? No one can change sex, so who exactly is helped by physically and irreversibly locking in the delusion? What other delusions and obsessions work like this? What makes “trans” exceptional? Why should any clinician profit off of creating an endocrine disorder and increasing risk of serious illness in someone who is so destabilized that they reject their own healthy body? And this one is for Dr. Coyne: How many worldly, wise 21 year-olds do you know and why don’t they deserve evidence-based medicine? What other pointless, harmful, medical interventions unburdened by evidence do we make available to troubled or autistic young adults or are we okay with “buyer beware” medicine for them?
Also, it’s worth noting that two kids out of 315 took their lives within the first year of participating in Olson-Kennedy’s NIH study. These were the most “affirmed” and “supported” kids in the world. Why are we still pretending there is any merit to this? No need to keep harming people and hoping for the best. Let’s look at the evidence available — plenty of kids have been given these interventions, but of course, clinics aren’t tracking them.
I agree with you. Even if the state can’t prohibit an autonomous individual from doing anything he likes to his own body, it absolutely can and should prohibit a professionally licensed practitioner from providing harmful treatments to anyone, just as it prohibits ritual female genital mutilation without exception. In the meantime it should also support insurance companies who want to declare these treatments medically unnecessary, and should investigate doctors and hospitals for improper and misleading billing practices that could be fraud. (The U.S. Dept. of Justice is looking into that now.)
Ideally the profession should regulate itself as the public interest trusts it to and tell its members to stop doing this but it won’t, owing to capture as described in Figliola cited by Peter above.
The original post was about youth gender medicine, where the political way forward is a little easier, but there is no basis for stopping there. The fiduciary duty doesn’t evaporate at the age of majority. Doctors and trans activists fought the states that wanted to ban treatment in minors and they lost. They’ll lose in the case of adults, too, if the states want to act.
Thank goodness that some people are now trying to get the truth out there. The genderwoo movement has had control of the media for far too long.
“Adolescents actually have the capacity to make a reasoned logical decision”
Marci Bowers is on a zoom video stating that children put on blockers before Tanner Stage II will never orgasm. He doesn’t seem to care. A child CANNOT give informed consent to that when they have no idea what an orgasm is. There are innumerable side effects that children aren’t told about, like osteoporosis, uterus atrophy, heart problems. You can’t make a “reasoned logical decision” when you aren’t informed about the topic.
There are filmed examples of people obtaining wrong sex hormones in their very first phone call to a doctor. Many people don’t get psychological examinations first. Trans websites coach children in what to say to the doctor to get them.
Hilary Cass didn’t need to be a gender specialist, she is a highly respected paediatrician. Her study was based on multiple high quality research projects carried out by other specialists.
“If you want breasts at a later point in your life, you can go and get them.”
This is patently false, but Dr Crane, who pushes gender mutilation, has a public video where he states you can grow breasts back again. He then said that to get them, you have to gain a lot of weight 🤦♀️
https://exulansic.substack.com/p/dr-crane-of-the-crane-center-and
“puberty blockers were not what they were sold as—a “safe and reversible” treatment”
Anyone who has half a brain has known for many years that blockers are not reversible if used to skip puberty*. Many years ago, when Jazz Jennings had his penis removed at aged 17, his penis was the size of a nine year old’s. This is documented in his tv show. His penis didn’t grow at puberty because he skipped his puberty. Stopping blockers AFTER missing puberty does not trigger puberty and would have left him him stunted for life.
when they are used to prevent precocious puberty, they are stopped before a normal puberty would start and puberty then proceeds normally.
Jerry already had a longer post on this article by Helen Lewis from June 29, 2025. This post was published on July 2, 2025, entitled “The Atlantic takes on “affirmative care.”
But hey, this is a fascinating topic, but in a very negative way, and it also illustrates so well the bad consequences that follow when political activism mixes with science (here: evidence-based medicine).
“Trans” is the rock on which evidence-based medicine foundered and sank.
Mia Hughes: “In a pathetic act of cowardice McMaster gave in to the demands of these unhinged lunatics, and Dr. Gordan Guyatt [McMaster University Medical School, father of evidence-based medicine] beclowned himself and torched his reputation trying to appease the rabid mob.”
Her essay here
t.co/Wnhwsqs3LN
The best clip (it was a crowded field) from the interview by Hughes & Stella O’Malley:
x.com/_CryMiaRiver/status/1965155081038561553
No word on whether Guyatt later jumped off a bridge.
Jesse Singal’s take on Guyatt and everything wrong with gender-based medicine.
jessesingal.substack.com/p/the-disaster-at-mcmaster-part-1
Thanks Mike for the link to Mia Hughes’ essay on the McMaster scandal.
Hughes really know her stuff and is also a very effective communicator.
Even before the takeoff of transgender youth medicine, evidence-based medicine was in trouble:
Eric M. Patashnik, Alan S. Gerber & Conor M. Dowling: Unhealthy Politics: The Battle over Evidence-Based Medicine. Princeton UP, 2017
Vinayak K. Prasad & Adam S. Cifu: Ending Medical Reversal: Improving Outcomes, Saving Lives. Johns Hopkins University Press, 2015
Otis Webb Brawley: How We Do Harm: A Doctor Breaks Ranks About Being Sick in America. St. Martin’s Press, 2011
I could write more, but the Atlantic article and Jerry’s synopsis/analysis cover the issue well. One thing that jarred me to attention—both when I read the Atlantic article and again when I read it here—is this quotation from Johanna Olson-Kennedy.
“If you want breasts at a later point in your life, you can go and get them.”
Someone should tell Olson-Kennedy that those “breasts” would be fake.
Unless you’re a nursing mom, all breasts are “fake”! 😉
What do you mean Barbara?
Sorry if my poor effort at humor fell a bit flat. I meant that, since the function of breasts is to provide milk for infants, any breasts that are not being used that way are, well, superfluous? Unnecessary? Surplus to requirements? More seriously, if, in the U.S., breasts serve a sexual signaling function, it might not matter if any or all of a person’s breast material is organic, saline, or silicone.
There is an aesthetic issue with the latter two options. Have you ever seen reconstructed breasts? The best you can say is that they may look adequate fully clothed.
After 50 years of research in sub-Saharan countries in which women are often ‘topless’, I’ve seen plenty of breasts that have taken a serious beating from nursing 10 kids, gravity, etc. Reconstructed breasts in the U.S. don’t look quite so bad by comparison!
One might be surprised that those so concerned about “suicidal ideation” among gender dysphoric children overlooked another safe and once very prestigious medical procedure: prefrontal lobotomy. It garnered a 1949 Nobel Prize for its inventor, Antonio Egas Moniz, who described it thus: “Prefrontal leukotomy is a simple operation, always safe, which may prove to be an effective surgical treatment in certain cases of mental disorder.” Maybe not quite as reversible as is claimed for puberty suppression— but a Nobel Prize presumably carries even more prestige than WPATH has awarded to itself.
My personal cynicism often remarks that the past social treatment of LGBTQ+ of say the 1950s has about-faced in a similar toxic direction.
Hopefully a more central stance is coming. The mind and body not being on the same page isn’t something to discriminate but neither is those who match up.
” She said in emails that having age limits would make it harder for people to allow youths to transition.”
isn’t using the preferred (i.e., wrong) pronouns what got us sliding down the slippery slope in the first place?
Thanks for the thoughtful article Jerry. One thing I would like to draw attention to follows from your correct comment that left alone, 80-90% of gender dysphorics will desist and mostly become gay men and women. When legislative bodies try to prevent anyone asking kids if they are sure, calling it conversion therapy, they are actually ensuring that people who would be gay become simulacra of the opposite sex. This is conversion therapy, just as enforced sex change surgery for gay men is in Iran. They may dress this up as ‘kindness’ but it reveals an underlying homophobia of a surprising intensity. (This is directly akin to what is disguised as sympathy for Palestinians actually being anti-semitism.) It is distressing to realise that our supposedly civilised nations’ institutions are actually full of such regressive attitudes.
Thank you for the shoutout, but I’ve been covering this issue in The Atlantic for years now, including pieces on the Cass Report and the general European move away from affirmation (I joined in 2019, and wrote about it before that in the New Statesman). The magazine was the place that published Jesse Singal’s 2018 cover story on youth transition, which was the first time anyone had looked seriously and sceptically at the evidence base and the possibility of over-reach.
I’m sorry I haven’t cited you before, but I don’t subscribe to The Atlantic and a reader called my attention to your piece. At any rate, it was very good and I’m baffled that you seem upset that I haven’t cited you before. It’s only because I haven’t read any of your previous articles. Much of what I post about comes from readers.
I hate to offer suggestions to an accomplished professional writer, but could I suggest you might have run into trouble with the “negatory ‘but’”? If you had cast the first sentence as two sentences without the “but”, your thanks to Jerry for the shout-out would not have been diminished or negated, even though surely unintentionally, by your following mention that you had been covering this beat for some time (which I am aware of myself, so thanks.). The more I look at that “but”, the more awkward it looks, like saying, “My love for you is unbounded but anchovies are fishy.” The “but” seems to be limiting my love but exactly how isn’t clear. It just sounds like a slight, though. Did one of us order anchovies when he knows the other doesn’t like them?
Having got in trouble professionally for saying “but” when I didn’t actually mean negation, just a change of subject, I now hardly ever say it. “I love you, but . . .” never portends good news, either. I used it deliberately in the first sentence, where, taking my own advice I wouldn’t have, to show how ambiguous the “but” is. Was I lying about hating to give advice to writers, or do I truthfully hate to “but” going to do it anyway? In either case I shouldn’t have said the hate part at all, just given the advice. No buts.
Now having waded into something that really wasn’t my business, I’m going to withdraw gracefully and thank you for a good article. I do say that “but” almost always causes hurt feelings, though.