Let people speak to the press and the press speak to the people
If you are reading the unpaid version of this, thanks! Here’s a break on the paid version!
Yesterday, I wrote a post called “It’s All True.” Some people reached out to me to remind me that, no, not everything we’re hearing is true. A lot of it is patently false. I was not talking about the research around the efficacy of gender-affirming care, or the flimsiness of the narrative about suicide and trans kids, which you can hear more about from a very experienced psychologist on Meghan Daum’s fantastic Unspeakable podcast. And the only thing I corrected was about when the term gender identity was coined—it was not an apology, just a clarification. As always, I find it important to acknowledge that there is not just one way to think about this issue. I know some people want me to be didactic, but the main thing I’m didactic about is nuance.
The point is, I have to keep revising what I say because I am constantly learning—and because I am constantly trying to work up the courage to be braver. The more I learn about the actual research, the more my views evolve on what we in the media should cover. (I’m still including myself in that we, which may be wishful thinking.) That research includes the high desistance rates of gender dysphoric young people who aren’t socially transitioned, and the “very low quality” evidence the UK’s National Institute for Health and Care Excellence turned up about puberty blockers and hormones.
Every single journalist reporting on trans kids, or gender dysphoric youth (and those two populations should not be lumped together), should look at this evidence and report honestly about it. It doesn’t mean we don’t scrutinize these studies, but we should be sharing them with the public, and not just to say why they should be discredited.
So, I think, should WPATH and USPATH, the organizations that create guidelines for treating youth with gender dysphoria. In response to Abigail Shrier’s piece in which two trans women, a gender-affirming surgeon and a gender-affirming therapist, essentially blew the whistle on reckless practices within the industry, these organizations released a joint statement, including what some see as a chilling tidbit: “USPATH and WPATH oppose the use of the lay press, either impartial or of any political slant or viewpoint, as a forum for the scientific debate of these issues, or the politicization of these issues in any way.”
I agree that the press should not politicize these issues. That’s exactly what I’m asking for. But in fact, the press is a perfectly reasonable place to debate these issues. And one would argue that the places WPATH AND USPATH do want the issues debated— “peer-reviewed journals or scientific conferences”—are so politicized that they are not open to debate. The American Academy of Pediatrics booted the Society for Evidence-Based Gender Medicine from its annual conference. Some hotly contested studies about puberty blockers’ relief of suicidal ideation are still used, despite the objections.
Many people in the field of gender-affirming care want to speak openly to the press (though are often too scared to do so). But the press—the left and center press, that is—isn’t open to speaking to them. And it seems to me that WPATH is discouraging others from doing so, doubling down rather than being willing to look critically at the whistleblowers’ complaints. That said, I know that new WPATH guidelines are to be released soon, and I have heard from several sources that the new ones will emphasize the importance of therapy, and that eventually they will also address care for detransitioners.
But until then, I find this clamping down deeply disturbing. Freedom of the press is essential to democracy. But on this matter, I do not think either the media or the gender-affirming care industry are behaving democratically.
Another brilliant essay!
I would add that Wpath self appointed itself to create guidelines, the current guidelines did poorly in a rigorous guideline review (Dahlen et al, 2021). 5 reviewers said do not use, one said only if modified, None recommended use as is. They're called standards of care but are not, those words mean something. See Malone et al, 2021, in jcem.
And the UK also reviewed evidence for hormones for minors, same conclusion. Very low quality certainty.
You are already braver than the journalists who refuse to look at this, to think about it!
You don't need to be braver, they do!
Thank you for your insights and your voice, they are badly needed in this medical and misinformation crisis.
The truth is what matters, and yes it is nuanced. Families deserve better information so that they are able to support their gender non conforming children in many ways, not simply by affirming a son who was a daughter 16 years and one day ago without being labeled as transphobic. And to use the term dead name!? It’s so disrespectful of loving parents trying to find their way here. The Wild Wild West of gender affirming medicine must stop! Do no harm … remember that WPATH? Who gains from the misinformation? No one.