Bigmouth Strikes Again: Carrie Marshall's blog

Carrie’s books | Carrie’s band

Category: Health

Scare stories and newspaper nonsense

  • 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.

  • Be better

    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.

  • Ignorance is strength

    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.

  • An admission

    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.

  • Unethical. Unscientific. Unsafe

    The ever-growing waiting times for adult trans healthcare have effectively privatised medicine for trans adults: good luck waiting 25 years or more for a first appointment if you can’t afford a private GP and a life of private prescriptions; shared care, where a private GP prescribes your medicine and your local GP oversees it, is largely banned (so for example it’s been stopped in my bit of Scotland). And now the NHS in England is turning its attention to teenagers. Its new policies are unethical, unscientific and unsafe, and have effectively banned best practice healthcare for trans teens.

    Healthcare will be withheld – a clear human rights violation – if patients don’t agree to be part of research studies – another human rights violation; patients have the right not to be forced into such studies – and private clinicians who provide the care the NHS denies may be investigated by regulators with the threat of withdrawing their licence to practice medicine. The proposed protocols enshrine dangerous and discredited conversion therapy as a preferred course of action instead of providing evidenced and effective treatment we know to be life-enhancing and in some cases life-saving.

    This article by Susie Green goes into the detail.

    What we’re seeing here is healthcare decisions made not by clinicians but by columnists; not by medical experts but by propagandists.

    Green:

    So where did these protocols come from? Who created them? We don’t know and they aren’t telling us. It seems ridiculous that they would ignore WPATH Standards of Care V8, especially when you consider the rigorous work done to ensure that it is based on extensive literature review and contributions, and scrutiny from over 4,000 clinicians worldwide who specialise in transgender healthcare. But with a government hellbent on damaging trans people as a way to distract from their failings, I don’t think it is difficult to work out that NHSE has become a politically manipulated service. And trans people are the ones who are suffering because of it… [the NHS] doesn’t want to improve trans healthcare for children. They want to stop it.

    These new protocols aren’t medical. They’re political.

  • HRT+DNA

    Over at Stained Glass Woman, Doc Impossible has written a fun piece about HRT and what it does regarding DNA.  As ever, the “basic biology” crowd are ignorant about actual biology: the super-short version is that DNA is an instruction book but hormones decide which specific instructions your body will actually follow. Change those hormones and the body changes too, and not just superficially.

    I love this stuff: as in other areas of science, the more we know the more we discover about the sheer complexity, variety and, if faith is your thing, miraculousness of it all. To paraphrase Hamlet: there are more things in heaven and Earth than are understood by social media science deniers.

  • “I no longer feel safe”

    Jane Fae writes in Metro about the UK government’s demonisation of trans women:

    “I no longer feel safe as a transgender woman. I no longer feel included.

    …Did I mention I was angry? Well, yes, that. But also scared; fearful for my future in a country that can contemplate this; and – having seen how vicious, how violent the anti-trans backlash has been in some parts of the world – wondering just where this one stops.”

  • Pain

    I really love Cat Valente’s writing, and her latest essay – Pain Is Not Penance – is a thoughtful piece about pain and our understanding of it. Some of it feels like an exorcism.

    Pain, Valente writes, is something many of us have learnt to believe is a punishment:

    For something you’ve done, something you’ve been, something you failed to do, something you wanted, chose, strove for, resisted, something you couldn’t stop, something you turned away from or turned toward or turned into, something you gave in to, something you saw or didn’t see, something you lost or took or abandoned or wouldn’t let go.

    And that can lead to one of the most dangerous beliefs in our society:

    Pain is payback. You earned this hurt. It didn’t happen to you, you collided with it. It isn’t random, it is your pain, for you, because of you, and if you’d only been better, if only you’d been stronger, if only you’d held on a little longer or let go a little sooner, if only you’d been more, if only you’d been less, if only you’d managed to be Goldilocks’ Own Brand Pristinely Precisely Perfect Fucking Porridge, you wouldn’t be doubled over in the dark right now, burning alive from the inside out.

    I don’t want to spoil the rest of the article. It’s well worth your time.

  • Now they’re closing clinics

    A US health clinic for trans people has closed its doors permanently after the introduction of a state-wide ban on healthcare for trans teens. As Xtra magazine reports, the ban was largely based on wild allegations by a single person, allegations that appear to be largely or completely baseless. But the national press, and the New York Times in particular, doesn’t let the facts get in the way of a good scare story – and those scare stories often end up being used as evidence by the bigots in support of their bans.

    From the article:

    While the bulk of the blame for the clinic’s shuttering lies with the state’s conservative legislature, its closure was also accelerated by a group of anti-trans journalists who presented Reed’s unsubstantiated allegations to a wide audience.

    …[despite the claims being debunked] Reed got a rosy portrayal from New York Times journalist Azeen Ghorayshi. Ghorayshi reported that she couldn’t substantiate most of Reed’s claims, and yet still went on to paint Reed as a brave truth teller in the pages of the paper of record.

    Evan Urquhart in Assigned Media has more, including interviews with the parents of trans teens.

    “We care about the clinic we take our children to. We care that it is providing ethical care. We care that it is following the standards of care. But using the words of this person [Reed] who has been shown to be unethical, to deny healthcare to all these people, just isn’t right. In Missouri, politicians are making health care decisions right now, none of whom are qualified to do so.”

    For too many journalists, this is a game. But for the people losing their healthcare – and the right-wingers have adults in their sights as well as teens – it’s a matter of life and death.

     

  • Fake science, real cash

    The Huffington Post has an interesting exposé of the people making good money from bad takes and pseudoscience: you can make tens of thousands of dollars presenting pseudoscience in the employ of anti-trans religious extremists. And while the article is mainly about the US, the UK gets a look-in too. You may recognise the names here from their very frequent appearances in the UK press.

    The spike in anti-trans legislation means states need even more experts to defend it. And in order to deepen the bench, states have started enlisting academics who aren’t in health care or don’t even primarily research humans. One is a Manchester University professor named Emma Hilton, who mainly studies a particular species of frog and how it offers an understanding of inherited human genetic disorders. Hilton is a founder of a British group, Sex Matters, that advocates for legally segregating spaces by sex. She earned $300 an hour last year defending bans on trans girls playing on girls’ sports teams in Utah and Indiana.

    By way of explaining why she was qualified to weigh in on school sports, she told one court, “I participate keenly in sports at an amateur level, playing netball recreationally.”

    “Our understanding of human biology is in part a result of the study of animal models,” Hilton said in an email. She declined to address the relevance of netball, which is like basketball without dribbling.

    Another is Michael Biggs, an Oxford sociology professor who admitted in court to writing transphobic tweets under the pseudonymous handle @MrHenryWimbush and described himself as a “teenage shitlord [turned] Oxford professor.” “Transphobia is a word created by fascists, and used by cowards, to manipulate morons,” reads one representative post.

    Florida paid Biggs $400 an hour to defend its Medicaid ban.