Article - In U.S. Gender Medicine, Ideology Eclipses Science. It Hurts Kids

[UtopiaPlanitia]

There is an article in the New York Times today regarding American medical bodies’ refusal to accept the findings of the Cass Review. I’ve pasted what I think is an important part of the article below:

https://www.nytimes.com/2024/07/12/opinion/gender-affirming-care-cass-review.html

https://archive.is/gq2ba

‘It’s hard to imagine another clinical protocol in which such serious medical decisions, with potential risks and permanent consequences, is so heavily grounded in a young patient’s self-diagnosis. In this light, gender transition treatments for minors can even be considered unethical.

This is not to say that doctors are in any way trying to harm children. Nor that all doctors and mental health professionals necessarily believe in every aspect of gender-affirming care or interpret it the same way. Many members of professional organizations, and many Americans, have embraced gender-affirming care because it has been portrayed as the most compassionate approach for an often marginalized group.

Already the gender-affirmation model is taught in leading medical schools, and all the major professional medical organizations in the United States have officially embraced it in their guidelines, a fact often cited by advocates as evidence of their validity.

This wholesale adoption of gender-affirming care is also a result of the differences between a centralized public health system like Britain’s and a privatized, diffuse health care system like ours. “Doctors are paid for each intervention, and thus have an incentive to give patients what they ask for,” The Economist noted in a recent editorial urging the United States to catch up with recent developments in gender medicine.

Given how entrenched the gender-affirmating model has become, reversing course won’t be easy. If the medical profession turns away from the notion that transitioning young people is necessary and lifesaving, it could open itself up to malpractice suits. Consider that in Britain, a lawsuit by a gay girl named Keira Bell against Britain’s leading gender clinic instigated the investigation that led to the Cass Review.

“I’m already hearing from the boards of directors and trustees of some hospital systems who are starting to get nervous about what they’ve permitted,” Erica Anderson, a former president of the U.S. Professional Association for Transgender Health and a transgender woman, told the British Medical Journal in May. In recent years, a number of detransitioners in the United States have brought suit charging malpractice or the failure to provide informed consent. If American doctors admit their approach was wrong, it’s going to be a costly and politically explosive practice to undo.’

I suppose it's a good thing if the NYT is seeing sense on this. I wonder does this apply to other liberal papers like the WashPo?

Very good to see this. Pamela Paul has written for the NYT about this before - she may even have been the first journalist at the NYT to take a stance against its previously heavy pro-gender ideology line.

I have come across a few articles in the last year in the NYT that are critical of the current American standards for treating paediatric gender distress but I don’t know if the Washington Post has done very many stories of that nature.

The NYT prints articles from both sides of the debate now which is definitely progress from years past when only one side was allowed to publish in the NYT. This particular article is the least euphemistic one yet in that it lays out the issues with American medical standards clearly.

Bump. I am just reading this article via a link from Twitter. She doesn't pull her punches and my goodness does the US need to hear what she's saying.

This is a link to the Tweet. Currently this article is available via this link as a Gift Article (like the share tokens for The Times), and you can also see the comments. https://x.com/genspect/status/1811765428890357908

What a good piece that is in the NYT. Why can't the Guardian produce articles like that?

[I know the answer to that: it's Kath Viner, isn't it?]

I'm pleased the author has gone as far as to put "gender identity" in quotation marks. It really does reinforce the ludicrous notion of the concept.

Off to read the article now that I know it's by Pamela Paul. She's the lone voice at the NYT who's not a member of the Church of Trans. I wouldn't read any change of thinking in the US into her article. So far, she's a voice in the wilderness.

Eventually, people will have to join her because she's right on this, but they're putting up a giant fight. Just one example: I don't think I've seen one single mention of the Cass report in any general interest news sources. Probably they're hoping if they keep their eyes closed long enough, it'll vanish.

This is an excellent piece. One of the best layings out of the issue I've seen.
It is good to see how understanding has grown and, though we are still.in the midst of this mess, it gives me some hope.
Thanks for posting this.

What an amazing journalist. I'm amazed she wasn't fired

You summed things up well there: I'm mystified as to why the US media has largely ignored the Cass Review (and various other reviews on puberty blockers carried out in other European countries in the last year).

Gasp0de thanks for posting the share link - I always find the comments under articles like this very interesting.

The comments are interesting too, though I've only had time to read a few. If you click the OP's link to the article, then click the comments link, they open before the site log in pops up and you can read them (well that worked for me).

The author of the article is also engaging with the commenters.

Interesting to note just how influential Cass is. Not just in the England, but Ireland, Scotland and now elsewhere.

The more damaging thing TRAs did was to block independent research and silence concerned academics and medics.

The report might have taken three years, and is still subject to attack, but Cass’ work starting to look as if it could be the most important piece of medical research this decade.

FWR, and the pressure put on the last Government to reverse their stance on gender recognition. Sayid Javid recognising that proper policy had to be based on proper research. Then Cass the brave. Which gave us something that Governments annd health authorities are finding hard to ignore. Good to see cracks appearing even in the NYT, previously a complete bastion of gender woo.

As agonizing and frustrating as it was waiting for the Cass Review to be completed, the level of detail and effort that was put into it means that it is compliant with high standard evidence-based reviews and thus has considerable weight with medics and anybody else with their head screwed on.

The American organisations who disagree with the Cass findings have not produced any evidence to the same standard that refutes any of the Review’s findings and so all that’s available to them is to trash the Review and smear Cass. It’s unfortunate that they can’t just read the findings and analyse them through a scientific rather than ideological lens. I mean, children’s health and quality of life is at stake here and the first principal of medicine is ‘Do no harm’, so if I were them I’d want to know whether or not I was doing harm.

@UtopiaPlanitia

The American organisations who disagree with the Cass findings have not produced any evidence to the same standard that refutes any of the Review’s findings.

This is true. When discussing this on Reddit others will often just post a list of the 30 or so bodies that immediately came out to criticise the report. Having read their responses, none challenge it on a factual basis, with many admitting to not having reviewed it at all.

Ingenieur It's so frustrating and I also think very irresponsible of these orgs. In a society like the US where litigation is often how medical failures are resolved, I can't understand how these orgs are getting away with substandard care, for children and adolescents in particular.

Already the gender-affirmation model is taught in leading medical schools, and all the major professional medical organizations in the United States have officially embraced it in their guidelines, a fact often cited by advocates as evidence of their validity.

Going back to this fact that all the major professional medical organisations have signed up to the gender affirmation model reminds me of the US opioid crisis.

Purdue Pharma and other pharmaceutical companies engaged in collaborative and highly successful efforts to have pain medication standards rewritten.

The result was such that medical practitioners felt compelled to prescribe according to those guidelines despite the (largely hidden) fact that an analgesic such as OxyContin was a highly addictive pain medication.

In 20 years time will we be looking at a similar medical scandal with once again medical practitioners and pharmaceutical companies having collaborated to disguise the reality of malpractice? With sadly similarly tragic outcomes?

Let's hope the very existence of Cass, and its evidence based conclusions will put the heebie-jeebies into US medical negligence insurers.

The report exists, it is accepted by the UK and other Governments, senior gender medicine practitioners in the US should be aware of it. (Not least the NYT is referencing it.) Unless there is clear alternative evidence that affirmation only is safe, they need to take it on board.

Absolutely DrBlackbird.

Watching Dopesick at the moment and the parallels are breathtaking. It's all so recent too!
This talk by an American MD at Genspect outlines this very well I think.
(Pretty sure I've posted this before on another thread- but worth re-doing).
There's not learning from history that is distant, but to not learn from something so recent is quite shocking to me.

Link for the Genspect talk :

We have noted many times that many parents who have transitioned their children find it impossible to accept that this may have been the wrong thing to do. Accepting that would mean accepting responsibility for their child’s ongoing issues.

I think this argument applies to many medical professionals too. In the US particularly, it comes with huge financial penalties. Doctors and professionals working in medical insurance simply can’t afford to acknowledge the flaws in “gender identity”. I think there is/will be some serious fight back there before, as a society, we can acknowledge the truth.

Yup, it's a sunk cost, and a big one.

Needmoresleep you make a great point, insurance companies are supposed to deal in facts and might be more able to see the negatives (financially if not morally) inherent in these medical procedures. It seems crazy to me that profit is what might cause these treatments to be stopped rather than ethics i.e. doctors see genderism as a profitable new niche and move into providing services whereas insurance companies want to maintain their profits so they refuse to pay for the treatments. We effectively have to wait and see which side wins in this battle for money over ethics.

Runor I hadn’t considered that the denials by doctors and medical organisation might be a conscious or unconscious way of denying liability. If it’s conscious then I think it’s venal and, like Gender GP, it needs closing down asap because profiting from damaging patients is horrific. If it’s unconscious then it’s slightly more understandable but no less ethical and continuing to campaign for something that is hurting people, in order to avoid dealing with the fact that you’re mistaken, seems pretty sociopathic to me.

I'm mystified as to why the US media has largely ignored the Cass Review (and various other reviews on puberty blockers carried out in other European countries in the last year)

I think it is like the article said, that there is no going back now, because it would be admitting they were wrong. This would mean there could be law suits against them. Now they may even have to establish the affirmation protocol even more firmly. There may even be all sorts of academic papers written soon to say Cass was wrong.

Yes the fact that it’s now that Purdue is being sued under thousands of multiple litigation and it is only this year that SCOTUS ruled enabling the possibility of the Sacklers being personally sued. That gender affirming medical practitioners don’t see, and are not concerned by, the parallels is baffling!