Ginger K. called my attention to what seems to me a violation of ethical and journalistic standards by a respected website, all in the name of appeasing the woke. Science-Based Medicine, whose editors include David Gorski and Steve Novella, is a site designed to promote the kind of medicine described in its title, as well as to debunk medical woo. I haven’t read it often, but I’m sure a lot of readers have, and I know the site is greatly respected.
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”. From Hall’s review (it’s been removed, but the screenshot below will take you to an archived copy):
This book will undoubtedly be criticized just as Lisa Littman’s study was. Yes, it’s full of anecdotes and horror stories, and we know the plural of anecdote is not data, but Shrier looked diligently for good scientific studies and didn’t find much. And that’s the problem. We desperately need good science, and it’s not likely to happen in the current political climate. Anyone who addresses this subject can expect to be attacked by activists. Is ROGD [rapid onset gender dysphoria, a phenomenon discussed by Shrier] a legitimate category? We don’t know, since the necessary controlled studies have not been done. I fully expect Shrier to be called a transphobe and to be vilified for harming transgender people, and I’m sure I will be labeled a transphobe just for reviewing her book. [JAC: Yep, Hall got it right!]
She brings up some alarming facts that desperately need to be looked into. The incidence of teen gender dysphoria is rising and appears to be linked to internet influences and social peer groups. The number of people identifying as lesbians is dropping. Therapists are accepting patients’ self-diagnoses unquestioningly, and irreversible treatments are being offered without therapist involvement. We know at least some of these patients will desist and detransition, and we have no way to predict which ones. Children are being instructed in how to lie to parents and doctors to coerce them into providing the treatments they want. Families are being destroyed.
For what it’s worth, I will stress again that I am not a transphobe. I support hormones and gender surgeries for adults who will benefit from them. I care about the welfare of these adolescent girls and it bothers me that some of them may be unduly influenced and take irreversible steps they will later regret.
What to do? I think limiting surgeries to a research setting is a good idea. I think the affirmative care model is a mistake and a dereliction of duty and should stop.
Shrier’s hypothesis is that many of these girls who want to transition do so without proper supervision, and are eagerly and uncautiously urged to do so by peers, some parents, and the medical establishment. Some, she says, may be doing so because of social pressure (presumably the status that transitioning confers) rather than gender dysphoria. Many, she thinks, might be lesbians (whose numbers have dropped precipitously), and some have wanted to detransition once the process is begun, though once you start taking puberty-blocking hormones—the first step in becoming a transsexual male—it’s usually too late. Shrier is not a transphobe at all and fully supports the rights of transsexual people, but is calling for careful evaluation, both sociological and medical, before the drastic step of medical intervention is taken. Instead, the standard is invariably “affirmation, which Hall summarizes in seven “matras” used by the affirmationists. (See her review for the list.)
Neither Shrier nor her reviewer Hall are transphobes, but now they are irrevocably typed as that. The ACLU staff attorney for transgender issues, Chase Strangio, has called for the banning of Shrier’s book from bookstores (odd for the ACLU, no?), and an uproar has arisen—all because Shrier is urging caution about a social phenomenon whose sudden increase demands scrutiny and investigation. To even deny the need for instant affirmation of a wish to be a boy if you’re a girl is to label yourself someone dedicated to eliminating transsexual rights or even advocating the genocide of transsexuals. That is hogwash, of course, and Shrier’s book and Hall’s careful review implicitly show that. She was instantly labeled a transphobe for not damning the book, and Science-Based Medicine got hundreds of outraged comments (see below).
At any rate, read the original version of Hall’s book review by clicking the screenshot below:

The reason Hall’s review was archived is because Science-Based Medicine retracted it—a review by one of its own editors! (I don’t expect Hall will be an editor much longer.) When you go to the site where the review formerly reside (click on screenshot below), you see this note:

I don’t fully believe Novella and Gorski’s claim that readers’ objections had nothing to do with the removal. What else would call their attention to opponents of Hall’s review? Since they didn’t vet the review themselves, how would they find out that the article was “below their standards”? Note, too, how they use the euphemism “quality control” for “censorship”.
I ask readers to look at Hall’s original review (and read Shrier’s book) and see where the “quality” falls off. Hall, after all, calls attention to the lack of research on the epidemic of girls becoming transgender boys, but the data on its prevalence, and the ubiquity and unquestioning nature of “affirmation therapy”, are undeniable.
On Bari Weiss’s Substack website Common Sense, Weiss allows Shrier to respond to Hall’s “cancelation” and her own demonization as the book’s author (click on screenshot below). There’s also a brief intro by Weiss herself; I’ll give one quote from that:
You do not need to agree with Shrier about whether or not children should be able to medically transition genders without their parents’ permission (she is opposed), or for that matter with Weinstein and Heying’s bullishness about ivermectin (I had never heard of of the drug before they put it on my radar). That’s not the point. The point is that the questions they ask are not just legitimate, they are of critical importance. Meantime, some of the most powerful forces in our culture are conspiring to silence them.
That is precisely the reason it is so important to stand up and say: no. To say: progress comes only when we have the freedom to disagree. To say: It is outrageous that tech platforms are censoring such debates and that some journalists are cheering them on. To say, in public: enough. In my case, that means making sure to publish those voices who have been shut out of so many other channels that ought to be open to them.

I’ll highlight just three bits of Shrier’s piece on Weiss’s site. First, the circumstances under which Hall’s review was removed from Science-Based Medicine were dubious:
On Tuesday, one of the blog’s long-time contributors, Dr. Harriet Hall — a family physician and flight surgeon in the Air Force with dozens of publications to her name — posted a favorable review of my book. She examined the scientific claims as well as the medical ones and wrote that the book “combines well-researched facts with horrifying stories about botched surgeries, people who later regret their choices and therapists who are not providing therapy but just validating their patient’s self-diagnosis.” Dr. Hall not only shared my criticisms of “affirmative care” — that is, immediately agreeing with a teen’s self-diagnosis of gender dysphoria and proceeding to hormones and surgeries — but also noted that many physicians and therapists feel the same way but are afraid to say so.
Within a day, Dr. Hall’s article was flooded with nearly 1,000 comments, mostly, she says, from activists demanding the article be stripped from the site, but also from some readers expressing their appreciation. Angry emails from activists swamped the blog’s editors. Within two days, those editors had given Dr. Hall an ultimatum: retract, rewrite, or allow them to add a disclaimer.
“What surprised me was that my fellow editors attacked me, too. Basically what they said was that my article was not up to my usual standards as far as medicine, science and critical thinking went. And I didn’t feel that I did anything but what I always do. That surprised me,” she told me. Considering the editors’ ultimatum, she elected to have the editors who disagreed add a disclaimer to the website. “I told them I did not want it retracted. And the next thing I knew, they had retracted it.”
Let that sink in: a book review by a respected physician was bullied out of existence in America.
Second, there are two copies of Shrier’s book in the Halifax Public Library in Canada, and a line of 146 people waiting to read them. Meanwhile Canadian activists are trying to bully the library into getting rid of the book. (So far the library has not relented.)
It’s not only corporations facing this type of activist pressure. Public libraries now do, too.
Halifax Pride, the annual LGBTQ festival, announced late last month that it would cut ties with the city’s library system over its insistence on carrying Irreversible Damage, calling it “transphobic,” and claiming that it “jeopardizes the safety of trans youth” and “debates the existence of trans people.”
So far, the Halifax Public Libraries have resisted. Their position is straightforward and apolitical: libraries exist to expose the public to the widest array of views, “including those which may be regarded as unorthodox or unpopular with the majority.”
The Halifax Public Libraries tried to compromise with the activists by pasting a note inside the book’s cover, directing readers to a list of “trans-affirming” resources. But the activists were unappeased. No ties with the libraries were restored. They want the book gone from the library and scrubbed from existence. Two copies in a library of nearly 1.2 million volumes are two too many. [JAC: I would suggest that readers buy more copies of Shrier’s book and donate them to the library so people won’t have to wait so long to read it.]
Not even the Nova Scotia Library Association or the Canadian Library Association has come to the library’s defense, though their standing orders explicitly require member libraries “to guarantee and facilitate access to all expressions of knowledge and intellectual activity, including those which some elements of society may consider to be unconventional, unpopular or unacceptable.”
The lack of support by the Nova Scotia Library Association and the Canadian Library Association are reprehensible. Librarians, famous for promulgating free speech and avoiding censorship or making books unavailable, should spring to the defense of the Halifax Public Library. I find it odious that the HPL has even pasted a note inside the books’s cover “directing readers to trans-affirming resources”. Do they do that with other books to which people object? This shows that there’s something about transsexuality that brooks no questioning of the tenets of its enthusiasts, or of “affirmationists”. The topic is simply taboo. If you don’t toe the line of the enthusiasts, you are a “transphobe.”
And what Shrier writes about is, as Weiss notes, worthy of discussion: it’s not like it’s Mein Kampf or anything (and even that book should be available in libraries).
Finally, Shrier (whose book I’ve publicly defended as something worth reading and considering) is now fed up with people supporting her via emails but not doing so publicly, nor revealing their names. She wants people to publicly affirm her right to write such a book, using their names. The epidemic of transsexual boys is a phenomenon that needs to be examined, and if some young people are making irreversible medical changes in their bodies and lives without proper consideration, or proper caveats, well, that also needs to be examined.
The reasons for private approbation for Shrier but lack of public support is clear: nobody wants to be seen as a “transphobe”, just as nobody wants to be called a “racist.” Such is the power of demonizing labels. From Shrier’s conclusions:
Whether or not most people admit it, what keeps them from speaking up in the face of what they know is wrong is fear. Fear not primarily of unemployment, though that is a pressing concern, but fear of ostracism. This deep and ancient fear is behind our desperate reach for innocence and safety when we virtue signal. By contrast, we stand exposed when we speak unpopular truth. Within your tribe, there will be people who pull away from you, and if you think well of them — and sadly, even if you don’t — this causes pain.
. . . What can make it bearable? According to Professor Williams, getting yourself accepted by another group. This is also the way to confront most of life’s heartaches — surrounded by those you love. And there is no better way to gain respect from those you don’t already know than by being identified with truthfulness.
Fear of ostracism is rational. But we are now living in a world in which evolutionary biologists are threatened with losing their platforms for engaging in debate about the source and treatment of a deadly virus; in which prize-winning composers have been professionally ruined for saying arson is bad; in which authors are editing already-published books to placate online mobs. That should scare us far more than losing friends or status.
So look to the Halifax Library. Summon what faith you can in those things you know to be right and true: a person is not defined by her race; biological sex is real; scientific research requires ideologically unencumbered investigation; activists shouldn’t bully libraries; and books should not be banned.
The first hundred or so silent supporter emails meant the most to me. They made me feel less crazy and less alone. But the inescapable reality is that defeating this ideology will take courage. And courage is not something that can happen in private. Courage requires each one of us to speak up, publicly, for what we believe in. Even when — especially when — it carries costs.
You are not a transphobe if you read Shrier’s book. You are not a transphobe if you read her book and see that it highlights a problem that needs to be addressed. You are not a transphobe if you refuse to call for the censorship of Shrier’s book. Those who sling about insults without addressing the problem Shrier discusses are not virtuous, nor are they “transphiles”. They are censors, pure and simple, and the embodiment of the Authoritarian Left. They are opponents of free speech, who think that some topics don’t need discussion because their own views are the right views. They are the Big Brothers of our time.
So, Ms. Shrier, here is my public statement of support for your book. My name is Jerry Coyne, and I think your book deserves to be read widely by anybody interested in the new onset of transsexual conversions. And I deplore the ad hominem arguments used to attack it.