17 Comments
May 9Liked by Gender: A Wider Lens

This is huge for us here in the US. While I have been known to shout expletives at NPR, I have actually never entirely stopped listening to it or stopped sending them emails that they DO THEIR JOB and report responsibly about facts and developments in this area without "the science is settled" spin. They do report responsibly on other subjects of interest to me, for one thing. Hillary Cass herself said in this interview that the interviewer had obviously read the Cass Review more carefully than interviewers in the UK. I hope the interviewer doesn't get death threats. And I hope that this opens some doors to more reporting. While this interview with On Point is incredibly important, I would also like to hear news developments such as the Cass Review reported on NPR news shows that have a much wider audience, such as Weekend Edition, All Things Considered or any news shows.

Expand full comment

Not sure, but perhaps there was a teaser segment somewhere on a news show with wider listenership…?

Expand full comment
May 9Liked by Gender: A Wider Lens

For people who want to read transcripts instead (and to see the Endocrine Society and AAP responses in full), you can go to: https://www.wbur.org/onpoint/2024/05/08/hilary-cass-review-caution-nhs-gender-affirming-care-youth

The link to the full interview with Hilary Cass is at top on that page and directly here: https://www.wbur.org/onpoint/2024/05/08/nhs-hilary-cass-review-gender-transgender-care

Expand full comment

Chakrabarti did not push back on Guest Amy Tishelman who paints a false urgency for transition. Had the host familiarized herself with the WPATH files, she might have asked about the rush to medicalize given that "treatments" render kids and young adults sterile, sexually dysfunctional and mutilates their genitals

Expand full comment

This may be a needle moving interview. Meghna Chakrabarti deserves a lot of credit for doing her homework. I'd like to note a few things from the segment where she interviewed Dr. Laure Edwards Leeper and Dr. Amy Tishelman. LEL started by saying the landscape has changed in the last 10 years or so and more girls have come in with MH conditions which predate their gender issues, and that those kids risk being put on a medical pathway unnecessarily. She worries about MH conditions bcs of the internet and social media. AT thanked the interviewer for acknowledging the existence of transgender youth, though I didn't hear that. I think the interviewer used the phrase gender questioning youth. AT worries about politics being infused and is against bans but says that care can be psychosocial, medical or both though says that research isn't tracking which work so we should be moving to an individualized approach. There was a question to both drs. about parents being told would they rather have a dead daughter or a living son. All agreed there is an inadequate evidence base for this phrase. LEL said there is an in ability to think critically bcs of fear in the trans community about bans. It was then noted that the AAP and the endocrine society reiterated their statements. The next question was on the WPATH SOC8. AT was the lead author for the children's section and that LEL was on that committee too. AT says they were a diverse group and agreed with Cass that there isn't enough research, but then said that is frequently the case in children's medicine and gave an example of psychopharmacology and went on to caution against doing nothing. LEL then went on to say she was concerned with the statements from the AAP and endocrine society bcs that's not what they wrote in the SOC8. She says they wrote to use caution which isn't doing nothing but that MH concerns need to be addressed 1st. LEL said socially transitioned children need to be monitored closely. Then AT said we can't get mental heathcare for all the socially transitioning kids in the US bcs we don't have an NHS. Both drs. agreed the trans adovcates (TRAs) need to permit more debate. LEL says she's terrified to engage in conversation but does anyway. The end of their conversation was very interesting. AT called for more research to be done as soon as possible and said they need to know more about data and outcomes. LEL stated the focus needs to be on MH needs 1st and thorough assessments and supports having a research basis. AT then said we don't know how to make assessments and that we should pull together clinicians who believe trans youth exist to come up with assessment guidelines. This is when the journalist reminded us again that there isn't an evidence basis and we don't have assessments. Final words were asked about what a parent should do who has a child who is very distressed. LEL said she felt great empathy for these parents bcs they were caught in a political field but then recommended asking any clinician if they read the Cass review before letting them see their child/teen. AT's comment was that there ins't one approach which will fit all.

Expand full comment
May 12·edited May 12

" AT then said we don't know how to make assessments and that we should pull together clinicians who believe trans youth exist to come up with assessment guidelines." This is how we got SOC 8. consensus rather than outcomes. And what does "believe trans youth exist" mean? Do they mean young people who identify as trans or who have gender dysphoria exist, in that case, why is she requiring that, it is a very strange requirement? Of course they exist, that is why there is a controversy about how to help them? If she means something else about the nature of those who might benefit from medical intervention, a belief requirement, why is that part of guideline development? In fact, you don't even want all the guideline development people to be subject matter experts.

There's a great explanation of how to do this by Ivan Florez https://www.youtube.com/watch?v=smRzaGjQU0Y "what is a trustworthy guideline".

Also, AT is an author of Chen et al., 2023, in NEJM. Where they didn't even release the outcomes for 6 of the 8 things they said they'd measure and where there was no psychosocial improvement for MTF (not mentioned in the abstract!) and only small in FTM. And two suicides. They have data, she has data, that is not being released. There was a great reddit thread on this. https://www.reddit.com/r/medicine/comments/15hhliu/the_chen_2023_paper_raises_serious_concerns_about/

It is one thing when you are just starting and there are very few kids. But if you have been doing it for 17 years....why don't you know what is happening to the ones you are treating? Why should you be given more young people to treat outside of carefully controlled clinicial trials with IRB approval protecting safety and informed consent-- if you aren't even tracking outcomes to protect both those young people and those who follow in their footsteps? Instead AT didn't want more oversight at all, it seemed?

Expand full comment

Here's a link for the interview with Dr. Cass and then Dr. Edwards Leeper and Dr. Tishelman. https://www.wbur.org/onpoint/2024/05/08/hilary-cass-review-caution-nhs-gender-affirming-care-youth

Expand full comment

I remain cautiously optimistic about the future with this interview. We don’t have a good track record of admitting mistakes in the US, so let’s wait and see. A lot of work remains in the backlog for parents who knew this was not the path, but still have children, adolescents, and young adults stuck in this situation. I am concerned with some of the language we continue to use, like “gender assigned at birth” when biology says sex is established at conception and it is identified at birth (or a mother’s 20-week sonogram). We must continue to work hard to keep our children safe! This is progress, but we must keep our guard on RED alert.

Expand full comment
founding

All astute comments. I won't hold my breath waiting for this interview to show up on All Things Considered or Weekend Edition. On Point had the only interview with Hannah Barnes I could find on NPR. Good on Chakrabarti. Cass interview was detailed and insightful although it seemed like Chakrabarti was soft on the other guests. One of the other guests stated she was fearful of coming on the show because she might appear to be against gender affirmation. When one is fearful of retribution how is one able to have an honest discussion regarding theory? Emails from WPATH, AAP and the Endocrine Society...positions unchanged? What? That's their response to a detailed well respected 388 page scientific report on all of the available information? Unfortunately in our culture, the US, litigation will be more influential in correcting this current social medical contagion. The youth in our culture are suffering because of a disconnect. My heart goes out to the parents who I know care and are trying to do the right thing with the information or misinformation they're offered. Unbridled, uninformed activism, vested interests, lack of medical ethics...not good.

Expand full comment

I agree that the NPR "On Point" piece could signal a real turning point. Hillary Cass delivered an excellent interview and I sincerely hope she will make this same case on many, many more mainline media outlets. I thought that the portion on WPATH was quite damning and, by association, the AAP and the Endocrine Society should feel the sting of this as well. I wished the interview had given more attention to ROGD boys and the negative affects from their long-term medicalization.

Expand full comment

Here’s hoping lefties will WAKE UP. This is a dam-break, I pray. For NPR to cover Cass like this is… IMPORTANT. Podcasts and TV and YouTube with republican or conservative hosts do basically nothing but preach to the converted. I myself have a gag reflex when I start a podcast that’s interviewing or discussing these issues and their intro is heavy with references to Christianity. But NPR?! Good lord, the eagle has landed.

Expand full comment

I just joined the Conservative Party in Canada, left of left my whole life, but this issue made me realize I can’t even with the progressives who call this “life-saving medical care.”

Expand full comment

About damn time NPR!!!!😡

Expand full comment
May 12·edited May 12

Chakrabarti did a great job (and I see there are two other authors for the piece, congratulations to all 3 of them!!)!

Expand full comment
founding

Dr. Cass spoke about a Johns Hopkins systematic review done at the behest of WPATH, which WPATH then ignored. Did I get that right? If so, does anyone have a link to that study?

Expand full comment

Baker et al., 2021, https://pubmed.ncbi.nlm.nih.gov/33644622/

Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review

Expand full comment

I wish Steensma & De Vries would be up for another public interview with Stella & Sasha. Let's track their and Cohen-Kettenis' thought progressions. <dream> And revoke thousands of professional medical and psychological credentials for being part in this scandal. </dream>

Expand full comment