Jesse Singal on the furore over Systematic Reviews of Gender Medicine

[Mermoose]

Let me know if there's already a thread on this, I can't see one. Jesse Singal has a very good two part Substack on the fiasco at McMaster.

SEGM funded five systematic reviews of different aspects of gender affirmative treatments. The research team included Gordon Guyatt, the man who in 1991 coined the term "evidence based medicine". The SRs found (unsurprisingly) that the evidence was very poor.

The research team and the university were both targeted by trans activists. SEGM have been branded a hate group, and Guyatt and colleagues have been denounced for working with "a hate group".

The researchers (not all, but this includes Guyatt) have variously scuppered the publication of some of the reviews; added notices on how the SRs should affect policy (eg that they should not be used to support bans on puberty blockers) and have given apology money to a trans charity that disseminates false information on these treatments.

https://jessesingal.substack.com/p/the-disaster-at-mcmaster-part-1

https://jessesingal.substack.com/p/the-disaster-at-mcmaster-part-2-my

Unbelievable

Thanks for the link, the researchers statement is jaw dropping

Are they saying that we shouldn't ban unproven puberty blockers and hormones for children because trans kids are "enlightened individuals" who "often legitimately and wisely choose such interventions."

There’s big money somewhere behind all this, I suspect. This is far from being normal, even for the US.

This is Canada. Sadly, extremely normal there.

eta, In fact, I’m somewhat surprised that the researchers agreed to do the studies in the first place. They must really have thought the results would go a different way.

You can't work in Canada in universities unless you are politically compliant. Including in the sciences.

As Canada has a public healthcare system, do they not set criteria for efficacy of treatment?

I’ve now read the interview with Gordon Guyatt. He’s saying with profound clarity that the university have allowed themselves and their staff to be bullied by transactivist groups out of publishing the evidence they’ve collected. He probably wouldn’t like me saying that, because he’s gaslighting himself and telling g himself over and over that it’s all about SEGM, because he wants to believe he’s one of the good guys, but that’s exactly what’s happened.

https://share.google/vF0SaRAgCewnv8Suj

This is a response from Dr Ethan Haim.

That’s an excellent question, for which I do not have an answer. Certainly Eva Kurilova (in one of the Gender a Wider Lens episodes) identifies the public/private healthcare system differences between the US and Europe (including the UK) as one of the reasons that paediatric gender medicine took hold in different ways, and will be eradicated in different ways, in each. But Canada seems an outlier in that regard.

Thanks for sharing this OP - will bookmark to read in full later.

Unfortunately, it is entirely believable. I think anyone doing the same systematic reviews in this country would also suffer the same pressures and it would be a brave group to attempt it in the first place.

Are they saying that we shouldn't ban unproven puberty blockers and hormones for children because trans kids are "enlightened individuals" who "often legitimately and wisely choose such interventions."

They are (badly) making an argument that although evidence based medicine is the gold standard, sometimes there is a lack of evidence so medics - in consultation with patients - have to make judgement calls. If you think about the beginning of COVID, there was no evidence about effective treatments so the most ethical thing to do was to try treatments that would work for similar diseases and see what works. Only by doing that experimentation, can you find effective treatments.

Of course, this argument doesn't work well for gender questioning kids where the similarities to allowing anorexics to starve themselves or people to demand their healthy limbs are removed that are often brought up on here are much more accurate.

The gender medics have been operating for decades now and the fault lies entirely in their court that there is no good quality evidence. My hypothesis is that they know deep down that their treatments are not ethical and so have deliberately self-sabotaged any attempts at good quality studies.

I'm not convinced that's much of a factor tbh. What about Australia or NZ?

This isn't the only area of medicine in Canada, or elsewhere, where politics seems to outweigh evidence, look at the crazy stuff they were doing during covid.

Many doctors won't even look at the medical evidence on this stuff, in the most basic sense it's not a medical issue for them, it's about affirming their (legally protected) identity.

Many doctors won't even look at the medical evidence on this stuff, in the most basic sense it's not a medical issue for them, it's about affirming their (legally protected) identity.

But if those doctors are treating them with medication or surgery, then they are treating it as a medical issue aren't they?

Or do you mean that the surgery is just treated like cosmetic surgery, and if the patient wants it and can pay, they can have it? But this wouldn't apply to children, would it?

Have I misunderstood your post?

Are they saying that we shouldn't ban unproven puberty blockers and hormones for children because trans kids are "enlightened individuals" who "often legitimately and wisely choose such interventions."
They are (badly) making an argument that although evidence based medicine is the gold standard, sometimes there is a lack of evidence so medics - in consultation with patients - have to make judgement calls. If you think about the beginning of COVID, there was no evidence about effective treatments so the most ethical thing to do was to try treatments that would work for similar diseases and see what works. Only by doing that experimentation, can you find effective treatments.

Your comparison with COVID patients/treatments again shows how different this branch of 'medicine' is. Would anyone have described those initial COVID patients, or the doctors treating them, as enlightened or wise?

Dr Haik mentions The Southern Poverty Law Center was the source used by Margaret White to support the claim that SEGM is an “anti-LGBT hate group". The SPLC used to do amazing work. Now, like so many progressive institutions and organisations, it too has fallen at the TG / MRA altar. Seemingly happy to have children sterilised and women to lose our rights.

The rapid expansion of uncritical thinking amongst highly intelligent people is frankly depressing. The longer term impacts are political though. The majority of ordinary people who may be supportive of gender dysphoria but easily see that men should not be in women’s sports, toilets, prisons, or refuges and who see tv programmes about TG surgery on young people are now turning to conservative political parties as the Overton window shifts. This is worrying.

And I feel angry that parties such as Labour, the Democrats, or the Lib Dem’s have abandoned us with this harmful retrograde bullshit. The worst of them all are the Greens who have not only swallowed the lie that people can change sex, but seemingly embrace the likes of Amy Challoner and Sophie Molly at a time of immense environmental destruction. Just why?

No getting around the fact that it’s a cost issue, whether you are considering the cost of medication, the cost of ongoing healthcare or the cost of being sued.

I’ve been watching this unfold on Twitter with horror. Im lost for words to be honest.

From a website about funding for cancer care in Ontario:

https://www.cancercareontario.ca/en/cancer-treatments/chemotherapy/funding-reimbursement/drug-funding-faqs

“Ontario's drug review process is in place to make sure that drug funding decisions are made (and Ontarians' healthcare dollars are spent) responsibly and fairly. This process ensures the decisions are based on the best available evidence of a drug's effectiveness and cost effectiveness.”

If research on efficacy is apparently only considered in some areas of Canadian healthcare, doesn’t that call into question the fairness of the entire healthcare system?

Oh give over. Until the Trump regime started Canada was not a place where big pharma and its activist wolves in social justice clothing were able to pressure medical researchers to disavow their own work. This is a new and troubling development, not just “Canada.”

I’m not sure what you’re getting at.

The researchers are disavowing their work because the results they found don’t align with Canada’s current widespread support for transgenderism and paediatric gender medicine. This support is well-known and out in the open - look at the vilification of eg, BC nurse Amy Hamm for speaking out against it.

It’s true, big pharma doesn’t have the same government policy pushing power in Canada as in the US, but it’s not true that it has no power to influence individual people - for instance, Canadian TV coverage of the Olympics two summers ago was visibly (as in, at every ad break) sponsored by Ozempic.

And while I am as far from a Trump supporter as it is possible to be, I think you have things backwards about Trump in regard to this particular issue. If Trump’s government had funded this research, the researchers would not have been allowed to disavow their findings, because (for better or worse for those of us who approve of the research) it aligns with Trump’s (well, his government’s) views.

I think the reason that the researchers did
disavow, and did so so publicly, is exactly as a PP said: in the current political climate in Canada, they could not have done otherwise without risking their research funding and possibly their jobs.

As I said before, given the current climate, I am surprised that the researchers agreed to carry out these studies, especially funded by SEGM, which is not a government-funded body. They can only have assumed that they, out of the entire planet who have been carrying out similar studies, would find different results than they did. I’d be really curious to know.

Whilst there may be merit in the view that big pharma/money is behind so called gender affirming care, the much vaster reality for Canada is that thousands of Canadian healthcare professionals have rushed to affirm because they believe they are #beingkind. It is virtue signalling but sadly based on a heartfelt - insane - belief that there are ‘trans kids’, that you can be born in the wrong body, the drugs, surgery and permanent infertility is the way to go.

I started reading Singal's part 2 article and on a dull beginning was asking myself if it was the effort. I continued on and wow. I just couldn't get over how captured Guyatt was. His line all the way through was that people who must be obeyed have denounced SEGM and therefore he's basing his now very negative view on the organisation on what is the correct way to think. Either he's so brainwashed he's comfortable doing this or he must have been utterly cringing inside in sticking to this line.

The essence of his argument is that a powerful group of people are attacking SEGM so viciously that it is a bad thing for him or his university to be associated with SEGM because they'll be attacked because of guilt by association. This applies irrespective of whether or not the powerful group are wrong and unhinged and whether or not the attacks are fairly based.

Fundamentally, Guyatt believes that scientific research can be suppressed if a certain group of people (who are on the "right" side of a debate) are sufficiently upset by it being published.

It is such a revealing interview.

So this team believe in evidence based medicine until the lack of evidence is outweighed by the yelling of the trans activists?

It brings to mind this quote:

“The only thing necessary for the triumph of evil is for good men to do nothing.”

I believe that countries such as Canada, Australia, New Zealand, the USA are so captured by gender ideology because they are ex UK colonies, and their history sees a white, European oppressor arriving to impose its cultural norms on the local population - such as the gender binary, western ideas of what male and female look like etc. They want to atone for their part in this history but instead of returning land, say, they focus on the gender oppression stuff.

But they are imposing gender norms?

Well, that's one way of looking at it. They are much more into believing that the indigenous people did not see gender the way we do, that it's not binary, and so they welcome the idea that you can choose for yourself. It is a rejection of supposed white oppression