'Gender affirming medicine' studies for kids draw new scrutiny with possible DOJ involvement

When three medical associations recently asked Attorney General Merrick Garland to investigate those who are "provoking" threats against pediatric gender clinics, their letter repeatedly used the phrase "evidence-based health care." 

This description of pharmaceutical and surgical interventions for gender-confused children and even "gender-nonconforming" children prompted a sarcastic response from journalist Andrew Sullivan, who helped mainstream the idea of same-sex marriage in the 1990s. 

He rewrote the phrase as "experimental off-label sex-change drugs not FDA approved for children with natural puberty."

The Oct. 3 letter from the American Medical Association, American Academy of Pediatrics and Children's Hospital Association, which seeks wholesale censorship and prosecution of journalism that prompts scrutiny of "gender affirming medicine," also stands to widen interest in the evidence for and against it.

As with COVID-19 vaccine policy for children and young adults, the U.S. is out of step with some European countries when it comes to GAM for minors.

This summer, the U.K shuttered its central gender clinic, known as Tavistock, following a lawsuit by detransitioner Keira Bell and an independent review that found "major gaps in the research base underpinning the clinical management" of youth and "diagnostic overshadowing" of other healthcare issues when gender dysphoria was diagnosed.

Sweden and Finland have restricted and even banned some GAM treatment for minors in favor of so-called talk therapy, possibly putting them in the crosshairs of the U.S. State Department. 

Secretary of State Antony Blinken recently instructed embassies to report back on "conversion therapy" in their host countries, described as treatment that seeks to "suppress or change" a person's self-expressed, and possibly transient, gender identity, according to a memo leaked to City Journal. The State Department didn't answer, when asked, whether it considers talk therapy a form of conversion therapy.

Following methodological criticisms from its own allies in August, the American Academy of Pediatrics opened an investigation of a study it published that claimed to discredit the "social contagion" explanation for the explosion of gender-confused adolescent girls in recent years.

The paper, led by University of California San Francisco psychiatrist Jack Turban, "underwent a separate statistical review post-publication in response to calls for retraction," AAP media relations manager Lisa Black told Just the News Wednesday. 

That review "concluded that neither an erratum nor a retraction were necessary," she said, but didn't answer requests to share the review or provide its time frame.

The article page in Pediatrics doesn't disclose any post-publication review, but includes criticisms from outside researchers at the bottom.

This spring, the University of Washington was caught misrepresenting its own research on gender-affirming care, sparking inaccurate global media coverage.

It falsely claimed that gender-confused children at Seattle Children's Hospital who took puberty blockers or cross-sex hormones had improved mental health outcomes. The study, published in JAMA Network Open and praised by UCSF's Turban, in fact found no improvement in GAM recipients but worse outcomes in children who didn't receive the treatment. 

Science journalist Jesse Singal, known for his reporting on gender identity, said the study itself had glaring methodological problems, including no explanation for "why some kids accessed GAM and others did not" and a steep drop-off in participants from the "no-GAM" cohort by the study's end. He said the researchers refused to share their data with him.

Emails obtained by local radio host Jason Rantz in August show UW's epidemiological spokesperson refusing to further promote the study, owing to Singal's analysis, but declining to correct the record with news media because of "an overwhelming amount of positive coverage of the study's findings."

UW Medicine's communications manager also cited "the extremely positive pick up by mainstream media" as a reason to "just let this be," while the Seattle Children's communications team agreed to "not engage" if it received further inquiries about the study.

While UW Medicine revised its press release on the study a month later, with an editor's note that said it now "more directly reflect[s] the findings," the epidemiological spokesperson complained that the revision still falsely claimed GAM "likely decreased rates of depression and suicidality."

The Department of Epidemiology stealth-edited the headline of its Feb. 22 release, which initially said GAM "improves" mental health and was changed to "can improve" between April 19 and April 23, two weeks after Singal's analysis.

It still claims the study shows "gender-affirming hormones and puberty blockers have a beneficial impact on depression and suicide risk in transgender and nonbinary youth," using the language of odds ratios to allude to the fact that it found no improvement in mental health. UW Medicine's May 9 video for the press release also uses "odds ratios."

UW Medicine's Twitter account also has yet to remove its March 11 tweet quoting one of the paper's authors, medical student Arin Collin: "Gender-affirming care is lifesaving care."

Lead author Diana Tordoff, who recently left UW for a Stanford Med postdoctoral program, does not appear to have addressed the controversy on Twitter. 

Her last mention was May 20, when she retweeted UW Epidemiology, which shared a Scientific American article mentioning the paper but not the prior month of controversy sparked by Singal over its methodology and promotion.

The med school confirmed to Rantz it "did not proactively reach out to any media outlet to correct the information" but did "provide the updated language to any media who inquired about the study from that point forward."

Local news station KING 5 updated its report on the study, nearly six months later, with the false information from the first revision: that the GAM recipients had "likely reduced rates of depression, self-harm and suicidal thoughts."

Singal brought fresh scrutiny on UW Medicine two weeks ago, saying it wasn't clear the researchers even understood the problem of the no-GAM cohort losing 86 of 92 participants for the paper's statistical validity.

"WE KNOW APPROXIMATELY NOTHING ABOUT HOW THE NO-TREATMENT KIDS WERE DOING 12 MONTHS LATER," Singal wrote, accusing Collin of repeatedly mischaracterizing the findings in media interviews and social media.

"If this exact data and methodology were being used to defend the claim that Muslims are more likely to be terrorists ... the internet's ever-growing ranks of debunkers, fact-checkers, and anti-misinformation experts would be all over it like ants on a discarded scoop of ice cream," he wrote.

"It's genuinely dangerous ... to spread misinformation about adolescent suicide," because parents may brush off the "complex health problems" faced by transgender youth if they believe "GAM alone alleviates" their problems, Singal wrote.

UW Medicine spokesperson Susan Gregg provided a statement to Just the News Oct. 6 reiterating the study's findings that "youth who received either cross-sex hormones or pubertal blockers had lower odds of depression and suicidality compared with youth who did not receive these treatments over the first year of care."

She said the "analysis was conducted in a way that allowed researchers to analyze the data at several timepoints in the first year of care."

The findings didn't change "when the data were analyzed in multiple different ways," Gregg said. "This included a supplemental analysis omitting the final (12 month) timepoint at which fewer youth responded due to the fact that this timepoint was added late, and youth had to be recontacted to ask if they wanted to participate."

UW's early statements on the study "used language that was unintentionally inaccurate in interpreting the findings" such as the word "reduction," Gregg said. "This language has been corrected and we believe those updates reflect what is represented in the study."

Collin didn't respond to a query through her Facebook account. Tordoff didn't respond to a query to her UW address, which she's still using as a corresponding author in newly published research. The media email for the Stanford Med PRIDE Study she joined bounced back.