Category: medicine

The Atlantic criticizes youth gender medicine

October 17, 2025 • 10:30 am

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

The Atlantic takes on “affirmative care”

July 2, 2025 • 11:02 am

One sign that there has been a sea change in America’s gung-ho enthusiasm for “affirmative care” of minors with gender dysphoria is the mainstream media’s recent critiques (or just objective analyses) of the problems with such care. These critiques have exposed the lies promulgated about such care, largely by the “progressive” Left. The new article in The Atlantic by staff writer Helen Lewis is one such journalistic corrective (read it by clicking on the screenshot below or by reading it archived here). And you should read it.

One of the factors prompting the article appears to have been the Supreme Court case The United States v. Skrmetti, which upheld a Tennessee law banning the use of hormones or puberty blockers for “gender affirming care” in cases of gender dysphoria in minors. Such care was allowed, however, if modification of sexual traits was necessary to allow an individual with a disorder of sex determination to “conform to their sex assigned at birth” (Wikipedia’s words, not mine).  The case was decided along ideological lines by a 6-3 vote, but in general I agreed with the decision, having felt that medical treatment for transition should be permitted only if a person with gender dysphoria was old enough to have mental maturity to decide. (I waffle between 16 and 18 on this one, but it’s 18 in Tennessee).

Author Lewis, in fact, was willing to allow medical transitioning to begin in younger children with dysphoria, but changed her mind after seeing WPATH, progressives, doctors, and government officials repeatedly lie about the condition and how to fix it. To quote her (all the article’s quotes are indented):

I have always argued against straightforward bans on medical transition for adolescents. In practice, the way these have been enacted in red states has been uncaring and punitive. Parents are threatened with child-abuse investigations for pursuing treatments that medical professionals have assured them are safe. Children with severe mental-health troubles suddenly lose therapeutic support. Clinics nationwide, including Olson-Kennedy’s, are now abruptly closing because of the political atmosphere. Writing about the subject in 2023, I argued that the only way out of the culture war was for the American medical associations to commission reviews and carefully consider the evidence.

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.

Here are three of the issues that Lewis raises:

1.) Lying or misleading people about gender dysphoria and its treatment.

ACLU lawyer Chase Strangio was guilty of promulgating the lie that failure to effect gender transition in dysphoric children would lead to their suicide. He in fact made this statement when he argued Skrmetti before the Supreme Court, and had to admit under questioning that there was acxtuallyno evidence for this assertion:

“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.

Strangio is one of the biggest proponents of affirmative care, and even took to Twitter advocating censoring Abigail Shrier’s book on gender dysphoria, Irreversible Damage. (Strangio is a trans-identified female.) Imagine an ACLU lawyer advocating censorship!

The “Dutch Protocol” (see below) was often cited by American organizations like the World Professional Association for Transgender Health (WPATH) or by physicians to justify affirmative care of minors. But the Dutch Protocol (affirmative care with medical intervention in children of younger ages) is basically without convincing clinical evidence:

Perhaps the greatest piece of misinformation believed by liberals, however, is that the American standards of care in this area are strongly evidence-based. In fact, at this point, the fairest thing to say about the evidence surrounding medical transition for adolescents—the so-called Dutch protocol, as opposed to talk therapy and other support—is that it is weak and inconclusive. (A further complication is that American child gender medicine has deviated significantly from this original protocol, in terms of length of assessments and the number and demographics of minors being treated.) Yes, as activists are keen to point out, most major American medical associations support the Dutch protocol. But consensus is not the same as evidence. And that consensus is politically influenced.

There’s an article at the site of Our Duty that discusses the shortcomings of the Dutch protocol, and is accompanied by a video of Dr. Patrick Hunter  testifying before the Florida Board of Medicine; it’s a summary of the flaws of that protocol, which was applied to children much younger than 18. Here’s the video, which is short (9 minutes):

2.) Demoniziong those who question “affirmative care”.

There’s Strangio, of course, who tweeted this (and later removed it):

And this:

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.

Boasting about your unwillingness to listen to your opponents probably plays well in some crowds. But it left Strangio badly exposed in front of the Supreme Court, where it became clear that the conservative justices had read the most convincing critiques of hormones and blockers—and had some questions as a result.

. . .Trans-rights activists like to accuse skeptics of youth gender medicine—and publications that dare to report their views—of fomenting a “moral panic.” But the movement has spent the past decade telling gender-nonconforming children that anyone who tries to restrict access to puberty blockers and hormones is, effectively, trying to kill them. This was false, as Strangio’s answer tacitly conceded. It was also irresponsible.

Questioning affirmative care has been something that marks you as “transphobic” (I myself have been called that), but when all the facts are in, I suspect that this demonization of people who want to know the scientific and medical truth will be seen as oppressive and, given its medical results, even barbaric. As Lewis notes, the British Cass Review that resulted in closing all but one gender clinic in the UK has been falsely demonized as being discredited. It has not been discredited.

3.) Withholdiong research that doesn’t support “affirmative care”.

This is the other side of the Dutch Study coin. First you promulgate bad research that supports your side, then you are slow to publish better studies that do not support your side. The author notes that WPATH comissioned reviews of the flawed Dutch protocols and, apparently because the protocols were weak, tried to block their publication.

And then there’s the infamous study by Dr.  Johanna Olson-Kennedy on the effect of puberty blockers on mental health (remember, blockers were touted as essential to prevent depression and suicide in children with gender dysphoria). Olson-Kennedy, a big proponent of affirmative care, didn’t find what she hoped for, and so withheld the study for several years!

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.)

And note, this is in an unreviewed preprint.

Withholding evidence that doesn’t support your favored hypothesis is scientifically unethical, somewhat akin to falsifying data. That’s because doing this means you’re simply allowing false conclusions to persist when you have evidence for their falsity. And that means that medical practice based on those false conclusions also persists, and, in this case, children were being treated on the basis of untested ideas.

There’s a lot more in this article to chew on, but the important thing is that it was published in a reputable (and left-leaning) magazine. The NYT has had similar articles about the weak evidence for “gender affirming care.”  (In my view, Pamela Paul’s 2024 critique of this care in the NYT was a big factor in her being let go by the paper. They thus lost one of their best heterodox writers.)

To paraphrase Walter Cronkite, an advocate of gender-affirming care might say, “When we’ve lost The Atlantic and the New York Times, we’ve lost America.”

I don’t oppose the use of hormones or blockers when the decision to use them is made by adolescents with sufficient mental maturity. If you’re 18 and want to change, well, go ahead and take the hormones and cut off pieces of your top or bottom. But not in minors—not until we have evidence that that this practice actually helps them—and we don’t. Lewis closes her piece this way:

Some advocates for the Dutch protocol, as it’s applied in the United States, have staked their entire career and reputation on its safety and effectiveness. They have strong incentives not to concede the weakness of the evidence. In 2023, the advocacy group GLAAD drove a truck around the offices of The New York Times to declare that the “science is settled.” Doctors such as Olson-Kennedy and activists such as Strangio are unlikely to revise their opinions.

For everyone else, however, the choice is still open. 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.

Misguided branch of British Medical Association rejects UK’s Supreme Court decision that “woman” is defined by biological sex

April 30, 2025 • 10:00 am

As I reported two weeks ago, the Supreme Court of the United Kingdom voted unanimously to affirm that the term “woman” under the legal Equality Act refers only to biological women and not trans-identified men. That means that a biological male holding a gender reassignment certificate would not have the same legal status as a biological women.  I added this:

In all the stuff I was able to read this morning, I was unable to find the definition of a “biological woman”, save that it refers to one’s natal sex, though they don’t mention gametes. The ruling does refer to the binary nature of sex (see below). And the ruling implies as well that the word “man” can mean in law only a “biological man”

That would seem to settle things, at least as far as the Equality Act is concerned, and the ruling was celebrated by those who favor the existence of “women’s spaces,” including sports competition, locker rooms, and jails.

But some members of the British Medical Association (BMA), as reported by the Times of London and other venues, have taken issue with the Supreme Court’s decision, implying that rrans-identified men are also women.  The subgroup of the BMA that voted against the Supreme Court Decision was the group of “resident doctors,” previously known as “junior doctors,” and so represent younger physicians. Note that the BMA is a registered trade union and does not regulate doctors; that role is given to the General Medical Council.

Click below to see an archive of the Times report:

A précis:

Doctors at the British Medical Association have voted to condemn the Supreme Court ruling on biological sex as “scientifically illiterate” and “biologically nonsensical”.

The union’s wing of resident doctors — formerly known as junior doctors — passed a motion at a conference on Saturday criticising the ruling that a woman is defined by biological sex.

The doctors claimed that a binary divide between sex and gender “has no basis in science or medicine while being actively harmful to transgender and gender-diverse people”.

The branch of the British Medical Association (BMA) — representing about 50,000 younger doctors — said it “condemns scientifically illiterate rulings from the Supreme Court, made without consulting relevant experts and stakeholders, that will cause real-world harm to the trans, non-binary and intersex communities in this country”.

The BMA’s stance is likely to raise concerns that the medical profession may seek to obstruct attempts at implementing new NHS guidance on trans patients, being drawn up after the Supreme Court ruling. It follows the union’s decision last summer to lobby against the Cass Review and to call for an end to the ban on puberty blockers for children identifying as transgender.

Lobbying against the Cass Review—a sensible report that banned the use of puberty blockers on individuals under 18 and dismantled the dysfunctional Tavistock Clinic that hustled gender-dysphoric children into “affirmative therapy”—shows where the ideology of this group lies. Although the Cass Review was widely applauded by doctors, these “resident doctors” are clearly infected with the mantra that anyone can claim to be any sex they want. As the yahoo! article below notes, “Last year, the BMA became the only medical organisation in the UK to reject the findings of the Cass Review into the provision of gender identity services for young people.”

And their ideology is clear:

The BMA motion, responding to the ruling, said: “This meeting condemns the Supreme Court ruling defining the term ‘woman’ with respect to the Equality Act as being based on ‘biological sex’, which they refer to as a person who was at birth of the female sex, as reductive, trans and intersex-exclusionary and biologically nonsensical.

“We recognise as doctors that sex and gender are complex and multifaceted aspects of the human condition and attempting to impose a rigid binary has no basis in science or medicine while being actively harmful to transgender and gender diverse people.”

It added that the BMA is committed to “affirming the rights of transgender and non-binary individuals to live their lives with dignity, having their identity respected”.

Of course we all respect the rights of transgender individuals–as transgender individuals. But those rights clearly clashed with the rights of other groups, most notably biological women, and the court adjudicated that clash in its definition of “woman”. Nobody of good will wants “erasure” of trans people, but we have to recognize that the claim that “trans women are women” leads to a clash of rights whose solution was taken up by the UK Court.

Note the “sex and gender are complex” assertion often used by ideologues or the benighted to claim that sex is not binary. (Yes, there are a very, very few exceptions., as I mention below, but for all practical purposes biological sex is binary.)  And, of course, it is binary in nearly all transsexual individuals, who even recognize the binary by wanting to adopt the role of their non-natal sex.

A bit more:

Sex Matters, the campaign group, accused the doctors of being an “embarrassment to their profession” and said it is “terrifying” that people who have undergone years of medical training can claim there is “no basis” for biological sex.

Indeed; for the doctors are redefining sex (and gender) as some multifactorial, “multifaceted aspect of the human condition”.  Perhaps gender roles fit that definition, but the Supreme Court was defining sex, not gender, and stayed away from gender, which is not part of the Equality Act.  This clearly shows the ideological nature of the resident doctors’ efforts and their unwarranted conflation of sex and gender.  Sex is a biological issue; gender a social one, also mixed to some degree with biology.  Don’t these doctors know that? Yes, of course they do, but pretend otherwise. If they’re not pretending, they are witless and don’t deserve to be doctors.

Yahoo News! (click below) gives the text of the resident doctors’ resolution:

Here’s the text of the resolution:

“This meeting condemns the Supreme Court ruling defining the term ‘woman’ with respect to the Equality Act as being based on ‘biological sex’, which they refer to as a person who ‘was at birth of the female sex’, as reductive, trans and intersex-exclusionary and biologically nonsensical.

“We recognize as doctors that sex and gender are complex and multifaceted aspects of the human condition and attempting to impose a rigid binary has no basis in science or medicine while being actively harmful to transgender and gender diverse people. As such this meeting:

“i: Reiterates the BMA’s position on affirming the rights of transgender and non-binary individuals to live their lives with dignity, having their identity respected.

“ii. Reminds the Supreme Court of the existence of intersex people and reaffirms their right to exist in the gender identity that matches their sense of self, regardless of whether this matches any identity assigned to them at birth.

“iii. Condemns scientifically illiterate rulings from the Supreme Court, made without consulting relevant experts and stakeholders, that will cause real-world harm to the trans, non-binary and intersex communities in this country.

“iv. Commits to strive for better access to necessary health services for trans, non-binary and gender-diverse people.”

The deeming of the Supreme Court’s ruling as “trans and intersex-exclusionary” is confusing.  Most trans people do indeed fit into the Court’s categorization of “man” or “woman.” The exception, the “true” intersex people, range in frequency from 1/5600 to 1/20,000, and so are very rare, making biological sex as binary as you can get. (In contrast, the frequency of people born with extra fingers or toes is about 1/2500 to 1/800, and yet we refer to humans as having “ten fingers and toes”.) It’s clear that this controversy is really not about the rare “true intersex” individuals, but about individuals who fit the biological definition of “man” or “woman” but identify otherwise—as either “nonbinary” or “transsexual”.

h/t: cesar, nick

Gender-altering surgery raises the incidence of mental illness in those with gender dysphoria

March 3, 2025 • 11:00 am

Here’s a new article in the Journal of Sexual Medicine that investigated the effects of gender-changing surgery on both males and females (over 18) with a diagnosis of gender dysphoria.  The results won’t make gender extremists happy, as in both cases rates of mental distress, including anxiety, and depression, were higher than those having surgery than those not having surgery after two years of monitoring. However, this doesn’t mean that the surgery shouldn’t be done, as the authors note that other studies show that people undergoing surgical treatment are, over the longer term, generally happy with the outcome.  The main lesson of the paper is that people who do undergo such surgeries should be monitored carefully for post-surgical declines in mental health.

Click the headline below to read.

The authors note that there are earlier but much smaller studies that show no decline in mental health after surgery, but these are plagued not only by small sample size, but also by non-representative sampling reliance on self-report, and failure to diagnose other forms of mental illness beyond gender dysphoria before surgery. The present study, while remedying these problems, still has a few issues (see below).

The advantages of this study over earlier ones is that the samples of Lewis et al. are HUGE, based on the TriNetX database of over 113 million patients from 64 American healthcare organizations. Further, the patients were selected only because they had a diagnosis of gender dysphoria and no record of any other form of mental illness (of course, it could have been hidden). Patients were divided into four groups (actually six, but I’m omitting two since they lacked controls): natal males with gender dyphoria who had or didn’t have surgery, and natal females with and without surgery. Here are the four groups, and I’ve added the sample size to show how much data they have:

  • Cohort A: Patients documented as male (which may indicate natal sex or affirmed gender identity), aged ≥18 years, with a prior diagnosis of gender dysphoria, who had undergone gender-affirming surgery.

  • Cohort B: Male patients with the same diagnosis but without surgery. [Cohorts A and B had 2774 patients.]

  • Cohort C: Patients documented as female, aged ≥18 years, with a prior diagnosis of gender dysphoria, who had undergone gender-affirming surgery.

  • Cohort D: Female patients with the same diagnosis but without surgery. [Cohorts C and D each had 3358 patients.]

A and B are the experimental and control groups for men, as are C and D for women.  Further, within each comparison patients were matched for sex, race, and age to provide further controls.  And here are the kinds of surgeries they had:

To be included, all patients had to be 18 years or older with a diagnosis of gender dysphoria, as identified by the ICD-10 code F64. This criterion was chosen based on literature highlighting elevated mental health concerns for transgender and nonbinary patients with gender dysphoria [15, 16]. Gender-affirming surgery cohorts consisted of patients with a documented diagnosis of gender dysphoria who had undergone specific gender-affirming surgical procedures. For transmen, this primarily included mastectomy (chest masculinization surgery, CPT codes 19 303 and 19 304), while for transwomen, this encompassed a range of feminizing procedures such as tracheal shave (CPT code 31899), breast augmentation (CPT code 19325), and vaginoplasty (CPT codes 57 335 and 55 970). These surgeries were identified using clinician-verified CPT codes within the TriNetX database, allowing for precise classification.

Note that there were a lot more “bottom” surgeries for trans-identifying men (as the authors call them, “transwomen”) than for trans-identifying women (“transmen”). Men prefer to change their genitals more often than women, even though, if you know how vaginoplasties are done, you have to be hellbent on getting one. (I don’t know as much about the results of getting a confected penis.)

I’ll be brief with the results: in both comparisons, those patients who had surgery had a significantly higher postsurgical risk of depression, anxiety, suicidal ideation, and substance abuse. But surgery had no effect on body dysmorphia: the obsession with flaws in one’s appearance.  Here are the tables and statistical comparisons of cohorts A vs. B and C vs. D, and the effect of surgery is substantial (results on women are similar though differences are smaller).  Some of the differences are substantial: anxiety in men, for example, was nearly five times higher in those who had surgery than those who did not.

As you see, there are significant differences for everything save body dysmorphia, for which there are no differences at all. The authors conclude that yes, at least over the two-year measurement period (again, mental states were monitored by professionals, and were not due to self report). Given that surgery does seem to improve well being over the long term, as the authors note twice, they conclude that the results provide more caution about taking care of patients who have transitional surgery:

The findings of this study underscore a pressing need for enhanced mental health guidelines tailored to the needs of transgender individuals following gender-affirming surgery. Our analysis reveals a significantly elevated risk of mental health disorders—including depression, anxiety, suicidal ideation, and substance use disorder—post-surgery among individuals with a prior diagnosis of gender dysphoria. Importantly, however, our results indicate no increased risk of body dysmorphic disorder following surgery, suggesting that these individuals generally experience satisfaction with their body image and surgical outcomes. Notably, the heightened risk of mental health issues post-surgery was particularly pronounced among individuals undergoing feminizing transition compared to masculinizing transition, emphasizing the necessity for gender-sensitive approaches even after gender-affirming procedures.

Possible problems. There are two main limitations of the study noted by the authors. First, individuals electing surgery may have higher levels of distress to begin with than those who didn’t, so the elevated rate of mental disorders in the surgery group could be artifactual in that way. Second, patients who have had surgery may be wealthier or otherwise have more access to healthcare than those who didn’t, and so higher rates of mental distress could result simply from a difference in detectability.

Now I don’t know the literature on long-term effects of surgery on well-being, so I’ll accept the authors’ statement that they are positive, even though patients with greater well being could, I suppose, still suffer more depression and anxiety. But those who are looking to say that there should be no surgery for those with gender dysphoria will not find support for that in this paper. What they will find is the conclusion that gender-altering surgery comes with mental health risks, and those must be taken into account. It’s always better, when dealing with such stuff. to have more rather than less information so one can inform those contemplating surgery.

New book argues that Alzheimer’s research is flawed, fraudulent, and incompetent

February 13, 2025 • 11:00 am

I have a friend with Alzheimer’s so I was especially depressed to read Jesse Singal’s discussion of a new book, Doctored, claiming that research on both Alzheimer’s disease and drugs that purport to ameliorate is all badly flawed, even fraudulent. You can read Singal’s discussion below (free access by clicking on the headline), and access the book on Amazon by clicking on the cover below.

An excerpt from Singal:

In his book, Piller, an investigative reporter at Science magazine, presents copious evidence of severe fraud, negligence, and buck-passing in Alzheimer’s research. From fabricated images published in major research journals (many of them still unretracted) to data manipulation conducted by pharmaceutical companies to the complete negligence of federal watchdogs, Piller’s reporting demonstrates indisputably that the field of Alzheimer’s research is in sorry shape.

Things are so bad, in fact, that the dominant theory that has guided researchers’ efforts this century — that Alzheimer’s symptoms are caused by the buildup of proteins called “amyloid plaques” in the brain — is now in serious question. That might explain why, as Piller notes, a recent meta-analysis of the available research found no evidence that any of the available Alzheimer’s drugs cause noticeable improvements in the cognition or daily functioning of patients. We’re two decades and many billions of dollars into the modern era of Alzheimer’s research, and we have precious little to show for it — a particularly dire state of affairs given that this dread condition is only going to hit us harder as America’s population continues to age. Piller’s book, which was released February 4, tells the story of a wild and heartbreaking goose-chase.

While Doctored is gripping in its own right, it also serves as a warning about the collapse of trust in expert authority. Thanks to the capacious new markets for crankery carved out by social and “alternative” media — not to mention a worldwide populist revolt against “the establishment” in general — there’s more grifting and science-denial than ever before, and the worst purveyors of pseudoscientific sludge rake in millions precisely by positioning themselves in opposition to mainstream science.

The lesson for scientists is to clean up their act and to stop misleading people about their work. I mean, I never had any doubt whatever that Alzheimer’s was caused by plaques in the brain.  Now that is not at all certain; the plaques could be a byproduct or a correlate and not a cause. If there’s that much uncertainty about it, why haven’t I heard about it.  Of course, journalists are responsible for this, too, but good scientific journalism is a species going extinct.

I believe that Singal has already been demonized on BlueHairSky, though he hasn’t been banned. The reason: the place is full of immigrants from Twitter who are “progressive” liberals and couldn’t stand the free speech on X. Singal described his apostasy: 

The background here is that a subset of users on Bluesky disagree with my reporting on youth gender medicine—a subject I’ve been investigating for almost a decade, and have written about frequently, including in The Atlantic and TheEconomist. (I’m currently working on a book about it, commissioned by an imprint of Penguin Random House.) I’m not going to go deep here, but I’d argue that my reporting is in line with what is now the mainstream liberal position: See this Washington Post editorial highlighting “scientists’ failure to study these treatments slowly and systematically as they developed them.”

But perhaps because I wrote about this controversy earlier than most journalists, and have done so in major outlets, I’ve become a symbol of bigotry and hatred to a group of activists and online trolls as well as advocacy orgs like GLAAD that push misinformation about the purported safety and efficacy of these treatments, and attempt to punish journalists like Abigail Shrier for covering the controversy at all.

Bluesky appears to have attracted a particularly high number of these trolls, and even before I arrived on the platform, some of them were making sure I wouldn’t feel welcome there. Nora Reed, an online influencer and cultural critic, wrote in November that “I think we need a plan for if Jesse Singal shows up here in advance.”

Back to his own Substack, though; Singal won’t win many friends by arguing that both scientists and liberals have exacerbated the problem, the former by acting precipitously or even duplicitously (the attempt to dismiss a lab-leak theory for the covid virus by scientific officials in the Biden ambit is a good example), while the left-wing public by always saying “trust the science” without realizing that a. scientists are human, with all the good and bad behavior that implies and b. science like investigating covid moves quickly, and what is true today could be false tomorrow.

But I shouldn’t exculpate the Right as well. After all, that’s the side of the political spectrum that still pushes creationism as well as quacks like RFK Jr. And Trump and his cronies are busy slashing scientific research almost willy-nilly. Singal, though, concentrates on the Left, perhaps because that’s where he resides:

At a time of such uncertainty and such dangerous overcorrection, it can feel awkward or difficult to point out, as Piller does in Doctored, just how broken some of our cherished mainstream scientific institutions are. Isn’t that playing right into Trump’s hands?

I don’t think so. The strategy adopted by many mainstream liberals in response to the populist surge — effectively, plugging our ears and chanting “trust the science” over and over — might be comforting, in that it offers a Manichaean worldview in which improving the world is a relatively straightforward matter of convincing people of their own ignorance so that they will board the science train with the rest of us.

But this effort has clearly failed. Some populist distrust of mainstream science is unwarranted and harmful, such as most strains of vaccine skepticism, but in plenty of instances, they are more or less correct not to automatically trust mainstream scientists, even if they arrive at that conclusion for reasons some of us might find uncouth. (Update: I added ‘automatically’ post-publication because I think it’s an important modifier here.)

In other words, while it’s easy to accuse those red-staters out there of exhibiting an alarming lack of faith in science, especially now that their wrecking-ball avatar is in power, it’s harder — and arguably just as important — to ask whether perhaps we have too much faith in it. The scientific establishment hasn’t exactly covered itself in glory in recent decades, given the replication crises that have roiled multiple fields, the data-fraud scandals popping up everywhere from cancer research to business-school psychology, and the frequently overconfident proclamations experts made about thorny Covid-era issues like mask mandates and school closures. And yet liberals tend to continue to reflexively trust many institutions that haven’t earned it, to the point where some of us have turned this sentiment into a mantra: “Science is real,” you will see on signs planted in front of many liberal homes.

I will read this book, as I’m particularly interested in how “fraud” was involved in Alzheimer’s research. Here’s one bit from Singal:

Piller’s book provides numerous damning examples of the difference between science as we idealize it and science as it is practiced by real-life human beings. For example, much of the data fraud in Alzheimer’s research, alleged and proven, involves doctored images. This fraud was uncovered not by journal editors or peer-reviewers — the individuals supposedly responsible for such quality-control — but by unpaid sleuths “who use pseudonyms to post comments” online, as he writes, in the hopes of someone who matters noticing and acting. (One notable exception is Elizabeth Bik, a Dutch microbiologist and legendary image sleuth who has taken on Alzheimer’s fraud.)

Who would have thought that we’d be catching so much fraudulent work by analysis of published images. One might conclude that reviewers of manuscripts aren’t doing their work, but I suspect that a lot of the fraud involves the same images repeated in different papers, and no reviewer has time to compare images in a submitted manuscript to other images by the same authors, but in different journals.

Doctored was released February 4 of this year.

To avoid making this post too long, I’ve put the book-publisher’s (Simon and Schuster’s) description below the fold. Click “read more” to see it:

Continue reading “New book argues that Alzheimer’s research is flawed, fraudulent, and incompetent” →

Washington Post calls for research on puberty blockers and other affirmative treatment; notes lack of improvement in some studies

December 16, 2024 • 11:45 am

This WaPo article below (click headline to read, or find the piece archived here), discusses the new case about gender transitioning being adjudicated by the Supreme Court. It’s judging the constitutionality of a Tennessee law that, according to the paper, “bans the use of puberty blockers and hormones for gender-transition treatments in minors on the grounds that it unlawfully discriminates based on sex.” (23 other states have similar laws). I’m not sure how a ban on blockers can discriminate on the basis of sex if the hormones are banned in both males and females, but I’ll leave that up to the lawyers.

What’s important here is that the dispute about the blockers is now being discussed openly, in an Editorial Board op-ed in the Washington Post, while previously such discussion was taboo. Even questioning the use of such “affirmative treatments” was seen as “transphobic,” though there wasn’t good clinical evidence that they had good outcomes. They could even have been harmful, and in light of a lack of efficacy, they’re now banned in the UK and regarded as experimental treatments in much of Europe.

What we need, as the paper says, are “gold standard” studies: large controlled studies (double blind ones would be impractical given that the drugs have easily discernible effects) over a fairly long period of time.

Read below, and I’ll give some quotes (indented):

This unresolved dispute is why Tennessee has a colorable claim before the court; it would be ludicrous to suggest that patients have a civil right to be harmed by ineffective medical interventions — and, likewise, unconscionable for Tennessee to deny a treatment that improves patient lives, even if the state did so with majestic impartiality. The issue is subject to legal dispute in part because the medical questions have not been properly resolved.

Multiple European health authorities have reviewed the available evidence and concluded that it was “very low certainty,” “lacking” and “limited by methodological weaknesses.” Last week, Britain banned the use of puberty blockers indefinitely due to safety concerns.

“Children’s healthcare must always be evidence-led,” British Health and Social Care Secretary Wes Streeting said in a press release. “The independent expert Commission on Human Medicines found that the current prescribing and care pathway for gender dysphoria and incongruence presents an unacceptable safety risk for children and young people.”

An early Dutch study of blockers showed “promising results”, but the sample was too small to give definitive results, and wasn’t replicable:

Yet as other doctors began copying the Dutch, clinical practice outraced the research, especially as treatment protocols rapidly evolved. A British study attempting to replicate the Dutch researchers’ success with puberty blockers “identified no changes in psychological function” among those treated.

Some clinicians appear reluctant to publish findings that don’t show strong benefits. The British lackluster results were published nine years after the study began, after Britain’s High Court ruled that children younger than 16 were unlikely to be able to form informed consent to such treatments.

And here is the unconscionable censorship on the part of both the American government and the WPATH organization that I haven’t yet written about:

Internal communications from the World Professional Association for Transgender Health [WPATH] suggest that the group tried to interfere with a review commissioned from a team of researchers at Johns Hopkins University

Johanna Olson-Kennedy, medical director of the Center for Transyouth Health and Development at Children’s Hospital of Los Angeles, told the New York Times that a government-funded study of puberty blockers she helped conduct, which started in 2015, had not found mental health improvements, and those results hadn’t been published because more time was needed to ensure the research wouldn’t be “weaponized.” Medical progress is impossible unless null or negative results are published as promptly as positive ones.

Weaponized?  WEAPONIZED? The study is done, but the results aren’t ideologically pleasing to gender activists, and so the study languishes, unpublished. That is unethical, for whether or not one uses blockers can have permanent effects on the well being and future fertility of adolescents.

And so we have one more example of science being suppressed because it didn’t give the results activists wanted. But this story isn’t over. As the Post recommends, Congress should fund larger and wlll-conducted trials of blockers with followups on adults who have gone on to estrogen or testosterone therapy. Given the increasing number of people who want to transition, such studies are imperative. But now we lack evidence, and without that the use of blockers should, I think, be stopped. Anecdotal evidence is not enough.

“The latest from the asylum”: New Zealand nurses directed to foster, accept, and prioritize indigenous culture, including specious “ways of healing”

December 13, 2024 • 10:00 am

The bit in quotes in the title may be a bit mean, but it’s the title an anonymous reader gave in an email linking to several articles from a New Zealand site (here, here, and here). The articles describe a new set of standards for registered nurses in the country, standards that I read in the official government document (see below).

Why this seems “asylum-ish” is because the standards are almost entirely directed to prioritizing and catering to the indigenous Māori population of the country, even though they are in a minority of the population (16.5%) compared to Europeans (70%) but also very close in numbers to Asians (15.3%, with most of the remainder being Pacific Islanders).  The standards direct New Zealand nurses to become “culturally competent”, which is okay if it means being sensitive to differences in psychology of different groups, but is not okay if it means medically treating those groups in different ways, or having to become politicized by absorbing the Treaty of Waitangi or learning about intersectionality.  And that is in fact the case with the new standards, which also prompt NZ nurses to engage in untested herbal and spiritual healing, including prayers.  The whole thing is bonkers, but it takes effect in January.

As one of the articles says, “critics argue that these changes prioritise ideology over practical skills.” And I suspect you’ll agree after you read the relatively short set of official standards given below. Here’s an excerpt from one of the articles in the news:

The updated Standards of Competence require nurses to demonstrate kawa whakaruruhau (Māori cultural safety) by addressing power imbalances in healthcare settings and working collaboratively with Māori to support equitable health outcomes.

The standards place a strong emphasis on cultural competency, including the need for nurses to establish therapeutic relationships with individuals, whānau [Māori extended families], and communities. They must also recognise the importance of whanaungatanga (building relationships) and manaakitanga (hospitality and respect) in fostering collective wellbeing.

One of the more significant additions involves requiring nurses to “describe the impact of colonisation and social determinants on health and wellbeing.” Additionally, nurses must advocate for individuals and whānau by incorporating cultural, spiritual, physical, and mental health into whakapapa-centred care (care focused on family and ancestral connections).

The new Standards of Competence have faced sharp criticism from some nurses, who argue the requirements impose ideological perspectives and unnecessarily complicate training processes.

However, none were willing to speak on the record for fear that voicing their concerns could jeopardise their employment.

The standards are unbelievable, so extreme in their catering to indigenous peoples that they seem racist against everyone else. But don’t take my word for it: simply click on the document below and look it over. It’s no wonder that many nurses are flummoxed by the new directive, which, as usual, is heavily larded with indigenous jargon that many (including Māori) don’t understand.  The language is simple virtue flaunting.

The very start of the standards promotes the 1840 Treaty of Waitangi (“Te Tiriti o Waitangi”)—an agreement between some (not all) Māori tribes and the British governance that established three principles. First, Māori would become British citizens with all the rights attending thereto. Second, the governance of New Zealand would remain in the hands of Britain and British settlers (“the Crown’). Finally, the Māori would be able to keep their lands and possessions and retain “chieftainship” of their lands.

Even though this agreement was never signed by all indigenous tribes on the island, it has assumed almost a sacred status in New Zealand, with a newer interpretation that goes something like this: “The Māori get at least half of everything afforded by the government, and their ‘ways of knowing’ would be considered coequal to modern knowledge (including in science and medicine). Further, Māori, as ‘sacred victims’, would get priority in educational opportunities and, in this case, medical treatment.”

If you read The treaty of Waitangi, you’ll see it says nothing of the sort. It simply establishes rights of governance and possession in a deal between Europeans and Māori. But the Māori have used it to inflict considerable guilt on the non-Māori population, to the extent that you simply cannot question the interpretation of the treaty above, or of the increasing forms of “affirmative action” for Māori, because people who raise those questions, like the baffled nurses above, risk losing their jobs. This is the reason that virtually every academic and citizen who writes to me from New Zealand about the fulminating and debilitating wokeness of the country asks me to keep their names confidential.   The fear of questioning what’s happening in that country is almost worse than the burgeoning affirmative action towards a small moiety of the population. Granted, the Māori have been discriminated against and had it bad for a while, but those days are really over now, and it’s time to treat everyone according to the same rules. And of course nurses know that they have to have different bedside manners towards different patients. But that doesn’t mean that they must treat some of them with chants and prayers.

Well, on to the rules. And they begin, in the very first directive, by emphasizing the importance of the Treaty of Waitangi!. I’ll post screenshots as well as text, and will highlight some bits in red. Here’s the first page of “standards of competence”. Te Tiriti doesn’t take long to appear!

“Pou” are “standards”. Here are the first two. Note that the introduction to the document doesn’t say explicitly that these standards are culture-directed and a subset of other standards of nursing skill. No, these are just “the standards.”

Pou one: Māori health. Reflecting a commitment to Māori health, registered nurses must support, respect and protect Māori rights while advocating for equitable and positive health outcomes. Nurses are also required to demonstrate kawa whakaruruhau by addressing power imbalances and working collaboratively with Māori.

Pou two: Cultural safety Cultural safety in nursing practice ensures registered nurses provide culturally safe care to all people. This requires nurses to understand their own cultural identity and its impact on professional practice, including the potential for a power imbalance between the nurse and the recipient of care.

The two pou expanded, which are directives about how registered nurses are supposed to behave.

Under standard (pou) #4, called “Pūkengatanga [expertise] and evidence-informed nursing practice”, we see this.

What is Rongoā? Ask the Museum of New Zealand, which describes it as “Māori medicine”, characterizing it like this:

In traditional Māori medicine, ailments are treated in a holistic manner with:

  • spiritual healing
  • the power of karakia [prayers of incantations]
  • the mana [supernatural essence] of the tohunga (expert)
  • by the use of herbs.

In other words, nurses are supposed to allow patients to choose their own therapy, even if it includes untested herbal remedies, spiritual healing, supernatural power, and prayers. Is it any wonder that nurses are both confused and opposed to this?

It goes on and on in this vein, consistently outlining standards of care that favor Māori, and then ending with a glossary heavily laden with woke and postmodern terms, Again, these are being given to registered nurses (no, not shamans) to tell them how they must behave. A few items from the glossary, which have no clear connection with nursing:

 

Again, as far as I can determine, these are not just standards for nurses to become culturally sensitive, but appear to be general standards for nurses that want to be qualified as nurses. And the standards have become so ideological and political that—and I don’t say this lightly—they seem pretty racist, favoring one group over another and telling nurses to afford indigenous people care and treatment that others don’t get. Is there to be no cultural sensitivity towards Asians, who have their own form of indigenous herbal medicine?

Here are some sentiments expressed by Jenny Marcroft, the Health Spokesperson for the New Zealand First political party.

It goes without saying that it nurses must do all this stuff to practice their skills, many might be compelled to leave New Zealand and practice overseas, something that the country can’t afford to happen. And so, because opponents of this stuff are silenced, the country, immersed in wokeness, continues to go downhill.