Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

Journalism at its not-best

Yesterday CNN published an article by senior writer Tara John about the UK National Health Service’s newly skeptical stance toward youth gender medicine. The main takeaway, which is big news to observers of this debate, is that the NHS will no longer provide puberty blockers to young people, other than in research contexts. (As for cross-sex hormones, a relatively strict-seeming regime is set to be implemented, and they will be offered to youth only “from around their 16th birthday.”)

As myself and a number of others pointed out, the article contains a sentence that is, in context, rather wild: John writes that “Gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender — the one the person was designated at birth — to their affirmed gender — the gender by which one wants to be known.” But of course, whether youth gender medicine is medically necessary and evidence-based is exactly the thing being debated, and anyone who has been following this debate closely knows that every national health system that has examined this question closely, including the NHS, has come to the same conclusion: the evidence is paltry. That’s why so many countries, including Sweden, Finland, the UK, and Norway have significantly scaled back access to these treatments for youth.¹ So it’s very strange to see this sentence, which reads as though it comes from an activist press release, published in a news article in CNN, an outlet that generally adheres to the old-school divide between news and opinion.

There’s a strong case to be made that CNN’s sentence, as written, is false. Gender medicine is at best unproven, when it comes to the standards society (and regulatory bodies) expects medical researchers to adhere to. The situation with youth gender medicine is particularly dicey, given that this is a newer area of medicine suffering from an even severer paucity of quality studies.

It would be bad enough for this sentence to have appeared in one article on one of the most important news websites in the world. But here’s the thing: this wasn’t the first time. Rather, this exact sentence, and close variants of it, has been copied and pasted into dozens of CNN.com stories over the last few years, as a Google search quickly reveals. 

This sentence, and its close variants, appear over and over and over. I asked my researcher to create a list of all the instances he could find. Here’s what he sent back, in reverse chronological order.

1. England’s health service to stop prescribing puberty blockers to transgender kids by Tara John (March 15, 2024)

2. First on CNN: Major medical society re-examines clinical guidelines for gender-affirming care by Jen Christensen (February 26, 2024)

3. Record number of anti-LGBTQ bills were introduced in 2023 by Annette Choi (January 22, 2024)

4. Gender-affirming surgeries in US nearly tripled from 2016 to 2019, study finds by Jen Christensen (August 23, 2023) — start slightly modified to fit sentence structure, otherwise identical.

5. Trump-appointed judge blocks parts of Indiana ban on gender-affirming care for trans youth by Sydney Kashiwagi (June 17, 2023)

6. The debate on the American right isn’t about classified documents. It’s about fear of transgender rights by Zachary B. Wolf (June 15, 2023)

7. 19 states have laws restricting gender-affirming care, some with the possibility of a felony charge by Annette Choi and Will Mullery (June 6, 2023)

8. Alabama governor signs bill placing limits on transgender athletes in college sports by Rebekah Riess and Dakin Andone (May 31, 2023) — start slightly modified to fit sentence structure, otherwise identical.

9. Missouri attorney general drops controversial emergency rule that would have banned gender-affirming care for children and many adults by Andy Rose and Nouran Salahieh (May 17, 2023)

10. Maryland governor signs bills protecting abortion rights and gender-affirming care by Liam Reilly and Kaanita Iyer (May 3, 2023)

11. Oklahoma governor signs legislation banning gender-affirming care for minors by Jack Forrest and Joe Sutton (May 2, 2023) — start slightly modified to fit sentence structure, otherwise identical.

12. Missouri judge pauses enforcement of limits on gender-affirming care for trans youth and adults for 15 days by Devan Cole (May 1, 2023)

13. Transgender health care restrictions hit roadblocks in 3 states as gender-affirming care becomes marquee issue for state GOP leaders by Dakin Andone (April 27, 2023) — start slightly modified to fit sentence structure, otherwise identical.

14. The clock is ticking in Missouri as health care providers race to establish care regimens for trans patients by Alisha Ebrahimji, Kyung Lah, and Anna-Maja Rappard (April 26, 2023)

15. Missouri judge temporarily blocks limits on gender-affirming care for trans youth and adults from going into effect by Devan Cole (April 26, 2023)

16. Gender-affirming care, a ‘crucial’ process for thousands of young people in America by Jen Christensen (April 25, 2023)

17. Advocacy groups sue to block an emergency rule limiting gender-affirming care that’s expected to go into effect this week in Missouri by Michelle Watson, Claudia Dominguez, Taylor Romine, and Kyung Lah (April 25, 2023)

18. Utah state senator’s home vandalized in possible retaliation for transgender bill, police say by Rebekah Riess and Sara Smart (April 22, 2023) — start slightly modified to fit sentence structure, otherwise identical.

19. North Dakota governor signs gender-affirming care ban for most minors by Michelle Watson and Jack Forrest (April 20, 2023)

20. Indiana and Idaho enact bans on gender-affirming care for transgender youth by Sydney Kashiwagi (April 6, 2023) — start slightly modified to fit sentence structure, otherwise identical.

21. Kentucky GOP overrides governor’s veto of youth gender-affirming care ban by Jack Forrest (March 29, 2023) — start slightly modified to fit sentence structure, otherwise identical.

22. Kentucky governor vetoes ban on gender-affirming care for youth by Kaanita Iyer and Paradise Afshar (March 24, 2023)

23. Georgia’s governor signs ban on certain gender-affirming care for minors by Maxime Tamsett, Pamela Kirkland, and Jack Forrest (March 23, 2023) — start slightly modified to fit sentence structure, otherwise identical.

24. Florida sued over bans on gender-affirming care for transgender youth by Devan Cole (March 23, 2023) — has a slightly more measured framing, opening with “LGBTQ advocates and many physicians regard. . . ”

25. Missouri AG seeks to restrict gender-affirming care for minors by Raja Razek and Shawna Mizelle (March 21, 2023) — has a slightly more measured framing, opening with “LGBTQ advocates and many physicians, however, regard the treatment as. . . ”

26. New Mexico governor signs bill protecting access to reproductive and gender-affirming care into law by Paradise Afshar and Kaanita Iyer (March 18, 2023)

27. Minnesota governor signs order protecting access to gender-affirming health care by Chris Boyette and Jack Forrest (March 8, 2023)

28. Tennessee governor signs ban on gender-affirming care for minors by Shawna Mizelle (March 3, 2023) — has a slightly more measured framing, opening with “LGBTQ advocates and many physicians regard the treatment as. . . ”

29. Democratic AGs condemn DeSantis administration for asking Florida colleges for information on students receiving gender-affirming care by Devan Cole (March 3, 2023)

30. Mississippi enacts ban on gender-affirming care for transgender minors by Devan Cole (February 28, 2023)

31. GOP lawmakers escalate fight against gender-affirming care with bills seeking to expand the scope of bans by Devan Cole (February 13, 2023)

32. South Dakota governor signs bill prohibiting gender-affirming treatment for transgender minors by Sydney Kashiwagi (February 13, 2023)

33. Woman faces federal charge for calling in a false bomb threat to a Boston hospital providing gender-affirming care by Sonia Moghe (September 16, 2022)

34. Boston Children’s Hospital says it’s gotten violent threats over care for transgender children by Jen Christensen (August 17, 2022)

35. Texas can continue investigating families seeking gender-affirming care for their transgender children, state Supreme Court says by Alisha Ebrahimji, Ashley Killough, and Raja Razek (May 13, 2022)

I haven’t triple-checked every single one of these, but it’s undeniable that effectively the same words have appeared in about three dozen CNN articles since May of 2022, which was already years after the present wave of European nations rethinking these treatments had begun. 

When I asked CNN about this, I heard back from someone there who explained on background that it’s standard for outlets to provide reporters with guidance about accurate and appropriate language. While that’s true, it doesn’t really answer my question. Sure, it’s not unusual for an outlet to have a house style, sometimes enshrined in a stylebook, that provides rules about how to refer to, for example, individuals in the United States who lack legal status. They used to be called “illegal immigrants,” and now they’re often called “undocumented immigrants,” or language to that effect. This is a fairly normal process by which language changes and, sometimes as a result of a push-pull between outlets and advocacy groups, outlets decide which changes to make and when. So you may or may not agree with the fact that many outlets have switched from “biological sex” to “sex assigned at birth” when discussing trans issues, but the underlying process of switching from one phrase to another is standard and occurs in many areas. 

This is quite different. You do not generally see the same complex sentence pasted over and over and over into news stories written by different authors and published in different sections. I asked CNN if it could provide me any other examples of CNN.com publishing the same sentence in multiple stories by different authors, and posed the same question in an email to Virginia Moseley, the CNN executive editor who, according to the website, “oversee[s] international and domestic news operations across platforms.” I didn’t hear back about this.

This copy-paste job is journalistically problematic for a number of reasons. For one thing, it suggests that CNN has decided, at the editorial level, that its institutional stance is that youth gender medicine is “medically necessary” and “evidence-based.” While they’re being used somewhat colloquially in these articles, these terms have fairly specific definitions in certain medical and legal contexts, and treatments only qualify for such designations if they have exceeded a certain evidentiary benchmark based on solid published research. That is not the case here — far from it, actually. As written, this is a deeply misleading sentence.

The language also puts CNN writers in an awkward position. Does each and every bylined author of these stories believe that youth gender medicine is “medically necessary” and “evidence-based”? Maybe they do (which would be disturbing), but the fact is that they didn’t write these sentences — they, or one of their editors, grabbed that language from somewhere else and pasted it in. They are effectively outsourcing their own judgment on a hotly contested controversy to their employer. This is not what journalists are supposed to do, and, at the risk of repeating myself, it’s significantly different from a reporter rolling their eyes when using language like “undocumented immigrant” or “sex assigned at birth,” rather than their own preferred verbiage. Those are rather small-stakes linguistic quibbles, different not only in degree but in kind from the question of whether or not youth gender medicine is medically necessary and evidence-based. And it goes without saying that a CNN reporter who does develop doubts about youth gender medicine is likely to be deterred from investigating further by the fact that their bosses have already decided that this is the way they’re going to cover this subject — say the line, Bart. Why bother?

It’s a pattern, unfortunately. Many outlets dug themselves into a deep hole on this issue by simply acting as stenographers and megaphones for activist groups rather than doing their jobs. And now that there is ever-mounting evidence undercutting the loudest activist claims, climbing out of this hole is going to be awkward. But there’s no other option, really. Because right now there’s absolutely no reason to take CNN.com seriously on this issue — the site has proven, demonstrably, that it doesn’t take itself seriously on this issue. 

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Questions? Comments? Reminders that gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender — the one the person was designated at birth — to their affirmed gender — the gender by which one wants to be known? I’m at singalminded@gmail.com or on Twitter at @jessesingal. Image: ATLANTA, GEORGIA - SEPTEMBER 05: The CNN headquarters on September 05, 2023 in Atlanta, Georgia. CNN announced earlier this year it has plans to move its global headquarters from downtown Atlanta to the Warner Bros. Discovery’s Techwood Turner Broadcasting campus a few miles north in midtown Atlanta. (Photo by Kevin Dietsch/Getty Images)

1. The sentence doesn’t specifically mention youth gender medicine, but that’s clearly the context in which it was presented. The sentence wouldn’t be accurate as applied to adult care either, anyway — an independent systematic review commissioned by the World Professional Association for Transgender Health came back with rather dismaying results about the quality of research there as well, more info on which here.