Scare stories and newspaper nonsense
Just over two hours before Parliament closed for the election, the Tories rushed through an emergency statutory instrument to ban the private prescription of puberty blockers for under-18s. The reason for the ban, and for the rush? The health secretary says it is “essential to make the order with immediate effect to avoid serious danger to health”.
This medicine is so dangerous that the government is not banning, and does not propose to ban, NHS or private prescriptions for cisgender kids.
The ongoing wrecking spree by Hilary Cass continues, but it’s getting significant pushback from medical experts. As Erin Reed reports, “both the American Academy of Pediatrics and the Endocrine Society have categorically rejected the review as a justification for bans on care and have challenged many of its alleged findings.”
Every time Cass speaks to the press things get worse: she’s now suggesting that trans healthcare shouldn’t be measured in satisfaction or regret rates (which are exceptionally high and exceptionally low respectively compared to other forms of healthcare) but in factors such as “employment”, which suggests that she’s either completely unaware of or couldn’t care less about the discrimination that means one in three UK employers say that – despite it being illegal – they would refuse to hire trans people. And more details of the people in her review board are starting to emerge; many have links with pseudoscientific anti-trans organisations. Cass herself met with people from Ron DeSantis’s anti-trans administration and appears to have lied about it.
As the Endocrine Society says in a strongly worded statement:
“We stand firm in our support of gender-affirming care. Transgender and gender-diverse people deserve access to needed and often life-saving medical care. NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care… Medical evidence, not politics, should inform treatment decisions.”
I’ve been loath to post about the current cavalcade of cruelties the Tories are heaping on trans people right now, but I wanted to point out something about the proposed NHS guidance that would force trans women out of single-sex wards: it’s illegal under multiple laws, especially for trans women who have gender recognition certificates. Not for the first time, the party of law and order is attempting to undermine the law by issuing guidelines encouraging organisations to practice illegal discrimination.
The Cass review is a lengthy document and it’ll take time for detailed criticisms to emerge, but there’s already plenty of evidence to indicate that the worst fears of trans people and allies were correct. The review team included people vocally opposed to trans healthcare, applied different standards of evidence to trans-supportive and trans-antagonistic studies, is happy to accept anecdote and hearsay provided it is not trans-supportive, and appears to advocate conversion therapy and demand that doctors be involved in social transition, which is not a medical matter.
the Cass Review final report seems to assume, as an unspoken starting point, that growing up to be a trans person is a bad thing, and the rest of the conclusions follow from that assumption.
…We have previously identified a number of professionals involved in both the Cass Review and the NHS Gender Dysphoria Working Group which helped commission the review who are involved either in lobbying efforts against trans affirmative healthcare, or who have actively promoted conversion therapy.
In the US, the people who want to ban abortion will tell you that they don’t want to ban abortion; they just want to put some protections around some of it. This is a lie.
Also in the US, the people who want to ban healthcare for all trans people – who, not coincidentally, are usually people who want to ban abortion – will tell you that they don’t want to ban healthcare for all trans healthcare; they just want to protect children. This too is a lie.
We know these lies are lies because the people telling them admit it. For example in January, US Republican legislators discussed the importance of disguising their “endgame”, which was to ban all healthcare for trans adults. It was important to focus initially only on trans kids, the legislators said, because “what we know legislatively is we have to take small bites.”
As one of the legislators said:
we have to be looking at the endgame simultaneously, maybe even using that to move the window to say that this isn’t just wrong 0-18, it’s wrong for everyone and we shouldn’t be allowing that to happen.
This is how you ban people’s healthcare: slowly, and with small bites.
Here in the UK, we’re told that nobody wants to ban trans adults’ healthcare. This is a lie.
In the wake of the Cass review into teen healthcare, a review that prioritised anti-trans junk science and anti-trans activists over actual science and medical expertise, it has now been announced that there will be a review into the provision of trans healthcare for adults. If it too prioritises anti-trans junk science and anti-trans activists, then like the Cass review it will conclude that trans healthcare – which after years of underfunding and now political attacks is barely functioning, with people dying on waiting lists that in some cases are now decades long – needs to be restricted too, despite overwhelming evidence to the contrary.
This is dangerous not just for trans people, but for everybody. Because the Cass review now has people openly discussing a ban on trans healthcare for anyone under 25 to “protect children”, even though 18 to 25 year olds are adults, on the spurious (and untrue) grounds that brains are not fully developed until then. In effect, the claim is that you cannot consent to healthcare until you’re 25.
So far, this is only being discussed in relation to trans people. But if we establish the precedent that under-25s do not have bodily autonomy, women’s reproductive rights are next.
That’s the endgame.
You’ll see a lot in the papers about the Cass review of NHS care for gender-questioning kids today, as the report is finally released. What you won’t see are any suggestions that it’s a political project, not a medical one. Its job was to undermine healthcare for trans people, and that’s exactly what it’s delivered.
The review’s conclusion, that there isn’t enough evidence to support affirming treatment for trans teens, was arrived at by discounting nearly 100% of the available research into affirming care (101 out of 103 studies) for spurious reasons; it centred the views of people and organisations opposed to trans healthcare, some of which believe that trans people don’t exist, while refusing to consider evidence from trans-supportive people or organisations as they would be biased; it applied different standards of evidence to pro- and anti-trans studies; and its core analyst is a supporter of conversion therapy and has previously supported the anti-trans pressure group Genspect. And while the review’s scope does not extend to adult healthcare, it’s nevertheless being used to demand restrictions on healthcare for adults until they’re 25.
The problems with the Cass review have been apparent for some time, and Trans Safety Network has been particularly good at highlighting them. This piece, from late March, is a good overview. It’s telling that freedom of information requests regarding conflicts of interest have been refused.
The tories will be out of power soon, and rightly so. But the damage they have done will take years, and perhaps decades, to undo.
It’s been said so often that it’s a cliché, but the job of journalism is to report the truth. Its job is to investigate, to find facts, and to follow those facts to see where they lead. It is a process of discovering, of uncovering, of seeing and telling what’s really going on.
In order to do that, you need to be objective. We all have biases, assumptions and other weaknesses. But in journalism the job is to put them aside, to accept that if the facts contradict your pre-existing beliefs then those beliefs need to change. Because your job is not to shore up your own biases, but to find the truth.
With some irony, the publisher of The New York Times has written extensively about that here.
Independence asks reporters to adopt a posture of searching, rather than knowing. It demands that we reflect the world as it is, not the world as we may wish it to be. It requires journalists to be willing to exonerate someone deemed a villain or interrogate someone regarded as a hero. It insists on sharing what we learn—fully and fairly—regardless of whom it may upset or what the political consequences might be. Independence calls for plainly stating the facts, even if they appear to favor one side of a dispute. And it calls for carefully conveying ambiguity and debate in the more frequent cases where the facts are unclear or their interpretation is under reasonable dispute, letting readers grasp and process the uncertainty for themselves.
Sulzberger’s words here are absolutely true, but it’s worth considering why he’s writing the piece: it’s in response to growing criticism that the New York Times often breaks those rules. That’s certainly the case in its reporting of trans issues where, often by using the opinion section to avoid fact-checking, journalists act as anti-trans propagandists.
One of the worst of many such propagandists is Pamela Paul, whose ongoing campaign against trans people continued this week with a really shoddy piece about teen detransition. When some trans journalists identified howling errors in her reporting, she dismissed them as activists; when they wrote to the NYT about the flaws in her piece, the paper refused to publish it because it was a criticism in part of their output. Their letter is here.
The issue with Paul’s work is simple enough: she apparently adopts a policy of knowing, rather than searching. She appears to reflect the world as she may wish it to be, not the world as it is. She does not plainly state the facts. And she does not carefully convey ambiguity or debate.
At its very simplest, journalism’s job is all about the Ws: who, what, when, why. For every assertion you make, you need to provide solid evidence. So if you say there is an epidemic of X, you need to demonstrate that there is indeed an epic of X. But Paul doesn’t do that. Quite the opposite.
Writing in Slate, epidemiologist Gideon Meyerowitz-Katz, who is neither trans nor a trans activist, investigates the numbers behind Paul’s claimed epidemic of detransition. And – surprise! – they don’t back up her claims.
That’s not to say that there aren’t detransitioners, or that there isn’t regret. Of course there are. Of course there is. But the question that journalism should be answering isn’t “does this happen?” but “how significant is it?” For example, there are cis women who regret having breast reduction or breast enhancement surgeries, and as far as I can tell the regret rates there are similar, and possibly slightly higher, than the regret rates for top surgery for trans men. Where are the endless editorials about that?
What’s clear from this evidence is that the vast majority of people do not experience regret, howsoever defined, after transitioning genders. Regret rates are actually much higher for a lot of medical procedures.
The whole premise for these articles is a house built on sand. And competent reporters will know that, which means the people who choose not to let the facts colour their articles are incompetent, malevolent or compromised.
By any metric, the rate of trans detransitioners is tiny; the rate of trans people who regret transition similarly so. Which invites a key question: why the panic? What motive does Paul have to consistently misrepresent what’s actually happening, to abandon the basic tenets of journalism to scaremonger instead? Why is the potential regret of a handful of cisgender people a crisis when the actual removal of healthcare for thousands of trans people is not?
That’s a rhetorical question.
Meyerowitz-Katz:
Ultimately, the question of what proportion of kids or adults regret their transition is only important to a select group: the people who want to transition, and their clinicians. At worst, the rate of regret is still better than other treatments which don’t require national debates over their use, which really begs the question of why anyone who isn’t directly involved with the treatment of transgender people is even weighing in on the topic at all.
Science writer Ed Yong’s coverage of COVID was superb, and his reporting of long COVID even more so. In a thoughtful piece for the NYT, he explains how journalists should and could do better: Reporting on Long Covid Taught Me To Be a Better Journalist.
Covering long Covid solidified my view that science is not the objective, neutral force it is often misconstrued as. It is instead a human endeavor, relentlessly buffeted by our culture, values and politics. As energy-depleting illnesses that disproportionately affect women, long Covid and M.E./C.F.S. are easily belittled by a sexist society that trivializes women’s pain, and a capitalist one that values people according to their productivity. Societal dismissal leads to scientific neglect, and a lack of research becomes fodder for further skepticism.
…How could so many people feel so thoroughly unrepresented by an industry that purports to give voice to the voiceless?
As Yong explains, some of the defining characteristics of journalism can make it a powerful enemy of people who are suffering.
many journalistic norms and biases work against us. Our love of iconoclasts privileges the voices of skeptics, who can profess to be canceled by patient groups, over the voices of patients who are actually suffering. Our fondness for novelty leaves us prone to ignoring chronic conditions that are, by definition, not new.
…We are not neutral actors, reporting on the world at a remove; we also create that world through our choices, and we must do so with purpose, care and compassion.
The Tory government have confirmed that they intend to ban conversion therapy but not for trans people: according to equalities minister Kemi Badenoch, providing a safe space for kids to explore their feelings about gender rather than mentally torturing them is the real conversion therapy.
It’s egregious bullshit, of course, but it’s entirely in keeping with Badenoch’s war on trans people, a war she and Liz Truss have been waging for several years now.
The idea that gender-affirming care is really conversation therapy is a fiction concocted by the evangelicals and parroted widely by their useful idiots. Once again, our politicians are happily dancing to the evangelical right’s tune.
It’s yet another week in the ongoing demonisation of trans women; former prime minister Liz Truss wants to introduce a member’s bill that would ban healthcare for trans teens and make it illegal for trans women to use women’s spaces, and a bunch of bigoted right-wing shits have made a film mocking trans women in sports. The coverage of both has been dreadful – for example most reports of Truss’s bill use the sense-free dog-whistle “biological males” instead of trans women, while the bigots’ film has been described as a comedy – and in the case of the movie, the coverage has missed a crucial point.
According to risible bigot Ben Shapiro, the film was not originally intended as a scripted movie. It was supposed to be a documentary. His intention was to get men to join women’s sports teams by claiming they were women, but when the men tried to do that they were told (politely, I assume) to fuck off – because you can’t just join women’s sports teams by claiming to be a woman. As Shapiro has admitted, the men “weren’t willing to go the full distance in terms of, you know, the actual hormone treatments and everything to play in some of the ladies’ leagues.”
Right-wing bigots in “making shit up to demonise minorities” shocker? This is my surprised face.
As is so often the case, writer and academic Julia Serano has been talking about this for years: as she wrote in her book Whipping Girl, if changing gender were that simple, that easy, far more people would do it. Actors would do it for roles, criminals would do it to go undercover, reality show contestants would do it for fame, women would do it to escape the glass ceiling and other discrimination, struggling gay or lesbian people would do it for an easier life. And right-wing assholes would do it to get on women’s sports teams.
The reason they don’t is because deep down, they understand that gender transition is not something anybody does lightly, that hormones have a profound effect on your brain and on your body. To be blunt, they weren’t willing to risk feeling for even a few weeks what many trans people have to feel for years or even decades.