Category: Health

Scare stories and newspaper nonsense

  • Facts checked

    The US advocacy group GLAAD just published an absolutely blistering fact-check of a very biased New York Times article that was yet again scaremongering about trans healthcare for teens, part of an ongoing panic that the paper has been fuelling for 16 consecutive months.

    Among the key points is a staggering statistic. The number of trans teens getting gender-affirming surgery in the US, the subject of the endless why-oh-why articles in the NYT, is around 514 per year. The number of cisgender teens getting gender-affirming surgery, which includes operations such as breast reduction or breast enhancement, is 229,000 per year. And yet the NYT is not running any articles about that.

    That’s not the only detail in the GLAAD response. It points out, using much more temperate language than I’d manage, that the supposed expert quoted by the NYT is a shill for the Alliance Defending Freedom whose testimony has previously been thrown out of court because he has no expertise whatsoever in trans-related healthcare. And the writer of the piece has been called out again and again for sloppy journalism that appears to be driven by an anti-trans agenda.

    We don’t have GLAAD in the UK, but a post doing the rounds on social media currently names the key anti-trans writers who’ve been pushing the moral panic here – a panic that’s been implicated in the deaths of at least 16 people. And when you see them listed it’s notable how many of them are friends with one another; it’s saddening to see how few people it’s taken to wage war on trans people and open the door for the extreme right.

    As someone put it on social media, you could pretty much end the UK media trans panic by poisoning the cocaine at just one dinner party.

  • Not an experiment

    One of the lies genital-obsessed weirdos like to push is that trans-related healthcare is new and experimental, so much so that it must be heavily regulated or better still, banned altogether. But trans healthcare is old. Puberty blockers have been prescribed for four decades, and trans surgeries have been performed since the 1910s.

    This BBC report suggests it’s even older than that, going back thousands of years. But while that claim is a bit of a stretch the article does make the important point that while there is a real problem with trans healthcare, it’s not the one the weirdos claim: it’s that trans people have to battle to get even basic healthcare and in some cases are simply refused it. The article was written before the current anti-trans moral panic really kicked into gear and made trans healthcare even harder to access.

    This piece, by Julia Serano, is an excellent round-up of trans healthcare from over 100 years ago to the present day. It’s not an entirely happy history:

    Throughout the mid-twentieth century… skeptical doctors subjected trans people to all sorts of alternate treatments — from perpetual psychoanalysis, to aversion and electroshock therapies, to administering assigned-sex-consistent hormones (e.g., testosterone for trans female/feminine people), and so on — but none of them worked. The only treatment that reliably allowed trans people to live happy and healthy lives was allowing them to transition.

    Not only does transition work, but it works very effectively: the surgical regret rate for gender-affirming surgery is lower than 2%, a regret rate that’s much lower than the regret rate for pretty much every other form of surgery.

    Trans healthcare isn’t dangerous. But restricting or removing our access to it is harmful and for some of us, even fatal. The UK puberty blocker ban has been implicated in at least 16 deaths so far; we have no idea how many other people have taken their lives while languishing on waiting lists that in some parts of the UK are now decades long.

    The misinformation and disinformation around trans healthcare is harmful and just adds to the difficulties we experience in a system that is even more broken for trans people than it is for everyone else even once we get past the horrendous waiting lists. I’ve just experienced an exceptionally difficult and unpleasant few weeks due to a bureaucratic mess that has stopped my healthcare completely for more than a month. The problem still hasn’t been resolved – I’m now into the sixth week of trying to get my usual healthcare restored and I’ve had to pay for private care in the interim – but if I were cis, it’d have been sorted out in a single day.

  • “Protecting children”

    Content warning: this is very, very bleak.

    Jolyon Maugham of the Good Law Project has posted a lengthy thread about what appears to be a national scandal: the deaths of multiple young trans people since the NHS began restricting their healthcare, and the NHS’s ongoing attempts at a cover-up.

    I have now seen further evidence that, since the Bell decision in the High Court (1 December 2020), there has been a huge increase in deaths of young trans people on the NHS waiting list – and that NHS management has sought to suppress that evidence.

  • Uniquely dangerous

    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.

     

  • Doctors speak out against Cass

    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.”

  • Illegal and cruel

    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.

  • Snakes in the Cass

    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.

    This, by Trans Safety Network, is an excellent overview of some of the most blatant problems with the report.

    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. 

  • The endgame

    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.

  • No surprises

    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.

  • The job

    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.