42 Comments

Jesse crushes this stuff. There is so, so much research being put into the world. Then journalists cherry pick it to support their political positions that they sell to the public. We need more people pursuing truth and less tribal politics. Let’s get more rigorous. The details matter. I hope other young journalists follow Jesse’s lead. I think there is a lot of opportunity in this space.

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Jesse Signal's critiques of this literature have been "out there" for some time now. If they were weak critiques, someone would have challenged them. So far, no one has.

There are going to be children who are hurt by the sloppy research and reasoning. And the lawsuits will follow.

Mr. Signal has done his best and, as a former Professor of Psychology (Ph.D. from Vanderbilt) and licensed Clinical Psychologist (until I retired 16 years ago), I thank him. Keep at it!

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there were 2 suicides after getting this lifesaving care in the 4 center study by chen et al which jesse and others tore to pieces. they are being hurt already. Unfortunately many of the regrets and long term problems don't appear for years....

If you have connections in your field, please spread the word about how bad this field is, and that sending a kid to a gender clinic is as much good "care" as sending someone in pain to purdue pharma to get medical advice!

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There was a death from cross-sex surgery during the study that pioneered the famous "Dutch Protocol" ! One of the 70 youths in the "positive outcome" group died from the treatment.

It wasn't a freak accident. The youth's organs were underdeveloped due to puberty blockers, which directly contributed to surgery complications.

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If the facts of the suicides were admitted, the charlatans would lose the insurance coverage that is indispensable to their practices! The racket is all based on the notion that pediatric "gender affirming care" is "life saving" and "medically necessary". The foundational myth is the supposed threat of the child's suicide if transition is denied. Parental consent, where still required, is manufactured with the threat, "What do you want, a live boy or a dead girl?"

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When I was a child, one of my goals for a time was to persuade my parents to take me on a vacation to Candyland, not the theme park (if there ever was such a thing) but the imaginary setting of the board game. In hindsight, I am grateful my mother and father did not seek to align their parenting plan with their child's goals.

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Disagree. As a child you knew yourself. You knew you needed Candyland. Your parents should have respected that but didn't. I suspect you have undiagnosed PTSD from it. Stay strong buddy.

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And multiple personalities!

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If you had had TicToc available, you could have gotten coaching on how to make a credible threat of suicide if your persistent and strong identification with the need for Candyland was not affirmed unconditionally.

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LOL

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"Emotional abuse involves actions, either as a repeated pattern or an extreme single incident, that thwart a child’s basic psychological needs." (14)

Reference (14) is an article about adults who were asked how familiar they were with state-level transgender sports bans. Their familiarity with sports eligibility rules is paired with data about how suicidal they feel. Did I read that right? The study participants aren't necessarily athletes or residents in the states with restrictions, so it's a strange study taken on its own. It also has nothing to do with the emotional experiences of kids.

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Is there no recourse against this? Where are the pediatricians demanding better out of their professional journals? Why are the pediatricians (at least four of them?) that are inquisitive and skeptical?

Jesse, you're truly a hero of mine for all you do--thank you.

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Brilliant critique, Jesse! It's shocking how slanted and yes, sloppy, this article was. Keep on chipping away at the crumbling foundation of gender medicine, which is built on sand. Eventually, the whole thing is going to fall.

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Interesting that to counter claims of medical abuse, they lean on gender-affirming care being "patient driven" and children "initiating" their own treatment. Sounds like something a pedophile would say to justify sexual abuse. "The kid came on to me." "They initiated it."

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In no other facet of life is a child or adolescent allowed, much less encouraged, to “initiate” any action that has lifelong consequences.

Where are the “professionals” demanding ten year olds be allowed to get tattoos?

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I'm so glad Jesse Singal is writing about this very important issue. I'm continually amazed/blown away that the AAP, (Amer. Acad. Of pediatrics, JAMA, the ACLU, and Planned Parenthood are all falling into some weird lock step about gender care for kids. it's bizarre and disturbing. Looks like a good time to challenge WPATH'S vise grip on our medical care for gender questioning kids in this country. Americans deserve to know the truth about the actual available data. Keep it up Jesse, we need your vigilant good work more than ever.

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The ommisions are very concerning.

In Australia, a longitudinal study was proposed to follow 600 kids who started hormone treatment between February 2017 and February 2020. They are to be followed for 20 years and given surveys every 2 years. We're now nearly 4 and 6 years into the study. Where's outcome data for the first few years post treatment? All that's been published is baseline data of the kids before they started treatment.

Sources:

https://pubmed.ncbi.nlm.nih.gov/31690608/

https://pubmed.ncbi.nlm.nih.gov/36729456/

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These are pretty typical delays in research.

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Wow. What are they hiding?

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They're just waiting for the good news to flow in before the give out the results. Don't worry, it'll be any day now.

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Insisting on accurate citations is a form of white supremacy. Do better.

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😂

Wait, that was in fact sarcasm right?

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I think so, too. In some quarters, however, I'm sure it would be taken seriously

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Okay, I realized I didn't say quite enough! Jesse Singal is a rare journalist these days. Willing to do the work, be humble and have a sense of humor, all kinda lacking these days.

I listen to blocked and reported and love it. Its combination of delicious irreverence, while talking about serious issues is like a soothing balm in a sea of painful media/ news stories. Just wanted to say, love your work! Jesse. I rely on it. Thanks

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"papers that are extremely weak, methodologically speaking"--that's a gentle way of saying it--

here are more things wrong with Turban et al., 2020, which all have been known since 2021:

https://link.springer.com/article/10.1007/s10508-020-01743-6

"Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria" (Biggs, 2021). This is a peer reviewed article (3 reviewers plus the editor).

Note that: "The journal that published the target article, Pediatrics, rejected an earlier version of this Letter as an online comment without providing a reason."

The journals publishing these inaccurate and dangerously misleading papers should be held responsible as well.

But beyond these journals, it's not clear why the people working in this field have not actually checked the claims being made about their work--rebuttals seem to involve ad hominem attacks, rebuttals to straw man (i.e. irrelevant) arguments, or further false statements. It's your job to check whether what you are doing is justified by the evidence and whether your statements are true, if you are going to be advocating for or prescribing sterilizing drugs that damage young people's endocrine systems or cutting off functional healthy parts of their bodies in an attempt to help their mental condition, even when it hasn't been shown that the long term outcome will be beneficial.

Turban, the leading author of this article, appears to have thought that a systematic review of the evidence is simply a literature search (see Leor Sapir's analysis of Turban's recent testimony https://www.city-journal.org/article/the-deposition-of-jack-turban), so it seems Turban neither understands the evidence or what is provided by a systematic review and evidence GRADE.

I am very glad the AAP is being sued. How does one get the journals to publish rebuttals and to retract seriously wrong articles? Misinforming patients and clinicians about these interventions has consequences. Terrible ones.

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We are seriously living through another "recovered memory" moment in this nation.

Can anyone point me to an explainer of what a "systematic review" is, exactly? I want to make sure I fully understand what it is that the American medical establishment isn't doing.

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Essentially a systematic review is a summary of the medical literature that uses explicit and reproducible methods to systematically search, critically appraise, and synthesize on a specific issue. It can also synthesizes the results of multiple primary studies related to each other by using strategies that reduce biases and random errors. It should be done by a team (or at least 2 people) to eliminate bias and can take years to do properly.

Here is a good overview - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024725/

A good systematic review should use PRISMA - http://www.prisma-statement.org/ as a basis for the process. Cochrane is the gold standard for medical systematic reviews - https://www.cochrane.org/about-us.

BUT just because something calls itself a systematic review, it doesn't always mean that the authors have followed the correct protocols or that is it's flawed in other ways. All research should be critically appraised. For more on that, see - https://casp-uk.net/casp-tools-checklists/.

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Oooh thanks! Looks like I have some reading to do, later today.

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I can’t remember which one, but a major American medical association recently announced they are going to do a systematic evidence review. It’s overdue, imho. Idk how frequently such reviews are done badly or corruptly, but if so, I worry. We’ve already seen how bad science and/or bad science reporting can mislead; hopefully this upcoming evidence review is honest and methodologically sound. At this point I have little trust in our medical institutions where this topic is concerned.

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Jesse

You’re a careful, honest, thoughtful, respectful guy.

It’s driving me crazy. Initially in a deeply sexual way, of course, as I am also a pervert for nuance.

Now it’s just driving me crazy. You are too soft on this issue. They’re mutilating gay kids because of ideology. A literary theory has escaped from the humanities and these people are basically wearing lab coats and pretending they “know” things, with *horrendous* consequences. Time to figuratively slap the shit out of these monsters. Stop holding back, buddy. Go for the jugular.

O

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Wait until the malpractice suits start rolling in. That's the next thing coming. "Attnetion: Was your child harmed by..." The story writes itself.

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Don't hold your breath. The radical trans ideologues have carefully followed the legal and political strategy laid out for them by the gigantic London law firm Denton. See, e.g.,

https://www.spectator.co.uk/article/the-document-that-reveals-the-remarkable-tactics-of-trans-lobbyists/.

If you find the Spectator article paywalled, try googling "Denton Only adults? Good practices in legal gender recognition for youth". Both Denton and the client have taken the document off their websites. I did find a copy of the Denton document on "gendercriticalwoman.blog".

In deciding issues such as pediatric gender medicine, courts depend on "expert testimony", and the witnesses will always refer especially to any relevant publications from professional societies. The trans lobby has been exceptionally successful in securing supporting statements or Standards of Care from relevant organizations.

Several states have enacted laws prohibiting medical treatment of minors. All have been attacked, mostly successfully, in trial courts. For whatever it says about the spread of the postmodernist view of sex, in the Arkansas case of Brandt v. Rutledge, the plaintiff seeking to overturn the law was represented by the prominent Wall Street firm of Sullivan and Cromwell. I have to suspect the Arkansas AG 's office was badly out gunned.

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There is room for comments on the article, perhaps anyone who is a pediatrician can point to this article???

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