Gender Clinicians Needs to Stop Politicizing the Research

So do politicians

I have much more to stay about this, and especially about the overlap with the language of abortion rights, but I’m down to the wire on book-writing. I’ll be writing more about this post-election, but wanted to share this now.
- LD

On Monday, a new study was released to great fanfare and much publicity. Lead researcher and MacArthur genius Kristina Olson’s paper showed high rates of satisfaction, and low rates of regret, among trans-identified young people who had socially transitioned, and then medically transitioned. The paper’s conclusion: “In the last few years, there have been moves to ban or restrict access to gender-affirming care for minors…” “Our hope is that these data, reflecting the experiences of youth who accessed these treatments, will contribute to continued updating of decisions regarding the provision of gender-affirming care to adolescents.”

Two days later, Dr. Johanna Olson-Kennedy—no relation—was in the news about another youth gender study. She had neglected to publish the data gathered as part of an almost $10 million NIH-funded study “because of the charged American political environment,” Olson-Kennedy admitted. The results hadn’t shown what she’d expected—that puberty blockers would have positive effects on adolescents’ mental health—and “I do not want our work to be weaponized.” That is, she didn’t want the unfavorable data used to bolster the bans on gender-affirming care, which the Supreme Court is set to consider on December 4th.

Many of us immersed in this topic have lamented how it has become a political controversy, rather than one of science or medical ethics. Red states ban these interventions, and blue states create sanctuaries for them. But gender-affirming clinicians themselves are playing politics. And the bans, and subsequent lawsuits, have led to shocking discoveries. That includes the revelation, detailed in documents released last week, that Dr. Rachel Levine, the U.S. assistant secretary of health, pressured WPATH, the advocacy group creating “standards of care,” to remove all age limits for gender medicine, including almost all gender surgeries. 

However one feels about bans, they are filling a regulatory vacuum left by medical associations that act more like lobbying groups than scientific organizations. The American Psychological Association published a series of talking points for members to combat bans against gender-affirming care, but issued no statement about the Cass Review—the most comprehensive document ever produced about these interventions, which found no good evidence to support it. When I asked a representative for the APA why they hadn't engaged, he told me they saw youth gender medicine not as a scientific issue, but one of human rights. The American Academy of Pediatrics still hasn’t conducted systematic review of the evidence.

Meanwhile, politicians themselves are using gender medicine. If the Republicans have unleashed a series of “anti-trans” presidential ads, one Democrat is shooting up T in an ad.

In a polarized world, in which each side believes the other is not only wrong but bad, almost all of liberal America believes questioning or objecting to the gender-affirming model is wrong and bad. Politicizing the science hides the truth, and the scientists are acting like politicians.

My advice to the politicians and clinicians who don’t like the bans: Halt transition care temporarily. Conduct follow-up. Gather data. Listen to those who’ve been hurt, as well as helped. Stop censoring. Be completely transparent. Get the whole picture, and let all of us see it, too.