Your Questions, Answered: Therapy, Whether Jon Stewart Ruined Political Discourse, And, As Always, Youth Gender Medicine Stuff

And so much more...

(Questions from here.)

I don’t know how familiar you are with other areas of medical science, so ignore if you just don’t know. But I’m curious whether you view youth gender medicine as an unusually bad area of medical science, or whether it’s a mostly-par-for-the-course area that has gotten spotlighted because of the politicization and the high stakes of medical interventions in children? —C MN

AS LUCK WOULD HAVE IT I am starting to get fixated on exactly that question! Though there are similarities, medical research is, of course, different from psychological research, and I’m trying to better understand how the former goes wrong. 

I think there’s a tidy and satisfying storyline that goes something like this: medical research is pretty good, overall, but then those damn trans activists came along and Politicized it. As a result, a lot of junk research has been published, muddying the waters and making it harder to ascertain whether and to what extent puberty blockers and hormones help trans kids.

As I’ve taken my first baby steps toward better understanding medical research, I’ve realized that this is almost certainly false. I think there’s just a ton of bad, underpowered work in all sorts of different areas. I’m most of the way through Ben Goldacre’s Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients and am going to have to do a lot more reading before I can speak with any authority about any of this, but my general sense is that many of the same problems that plague psych research plague medical research as well.

That’s not to say there’s nothing uniquely troublesome about this area of medicine. I want to better understand how strong the case is that there are some conflicts of interest going on here: it seems like the vast majority of the research about youth gender medicine, in the United States at least, is published by doctors at clinics, who for obvious reasons want it to be the case that their treatments are great. It’s not like these sorts of conflicts are unheard of elsewhere — drug companies fund and are involved with drug research all the time — but youth gender medicine is unusual because there’s really only a small set of medical treatments. It’s not like depression, where there are a bunch of different competing drugs and psychotherapeutic treatments; if you’re in youth gender medicine, on some level you have to support hormones and/or surgery, because they are the only games in town.

Anyway, yeah, I don’t know enough yet but that was a good question.

Do you think that any of the toxicity of today’s ‘political discourse’ is attributable to the popularity of Jon Stewart’s Daily Show (1999–2015)?

In 2004 a Pew survey found 21% of people aged 18–29 cited The Daily Show (or Saturday Night Live!) as their source of news. I presume the percentage grew with the popularity of the show. (If yes, how significant?)

Growing up, I enjoyed the show and often found it funny. Looking back, it can still be funny (often the people mocked seem to deserve it so much) but it also seems to be such a terrible model for serious political (or intellectual) engagement. For so many people, this seems to be their only experience of political engagement. Is it possible that this contributes to the fact that so many young people equate preening-quippy-dunking with ‘doing politics’? —James