Medical group refutes 'gender-affirming' doctor's testimony before Florida medical boards
An international group of medical professionals concerned about what they see as minimal evidence for prescribing puberty-blocking drugs and hormones to children accused a proponent of the practice of making false claims before a joint medical board in Florida.
The Society for Evidence Based Gender Medicine, compromised of over 100 clinicians and researchers, responded on Twitter Tuesday to the testimony of Dr. Meredithe McNamara during an Oct. 28 meeting of the Florida Boards of Medicine and Osteopathic Medicine.
The joint meeting was held to evaluate the effectiveness of medical interventions for children with gender dysphoria. Earlier this month, the boards voted to ban minors in the state from obtaining puberty blockers, cross-sex hormones and gender transition surgeries.
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McNamara, an assistant professor of pediatrics at the Yale School of Medicine, also treats patients ages 11 to 25 at various Yale-affiliated health sites.
During her testimony, the doctor argued that pediatric "gender-affirming care" is not "experimental" nor "investigational," questioning the validity of a June 2022 report commissioned by the state.
The report concluded there is "insufficient" evidence supporting the effectiveness of "sex reassignment treatment," stating that more substantial research demonstrates the harm it causes.
"The deeply flawed June 2 report was commissioned by the state to provide cover for the deprivation of health care of 9,000 transgender Floridians who are insured by Medicaid," McNamara said.
The Yale professor claimed the report's conclusion is "incorrect" and relies on "pseudoscience" that "ignores the truth."
Jennifer Bauwens, the director of the Center for Family Studies for the socially conservative Family Research Council, argues that studies purporting "gender-affirming" care improve mental health suffer from flawed methodology, not the other way around.
While she is hesitant to make such a sweeping statement about all research on the topic, Bauwnes told The Christian Post that many studies in this area are more about scientific confirmation instead of inquiry.
"In other words, they're not doing it to inquire if puberty blockers are effective," she claims. "Are cross-sex hormones or these surgeries effective in treating gender dysphoria? It's more like, 'Let's go out and conduct a study and try to show that it is."
In response to a Friday inquiry from The Christian Post, McNamara provided a July analysis from her and her colleagues offering similar criticisms of Florida's June report on medical treatment of gender dysphoria.
One criticism McNamara stated during her testimony is that the lead author of the Florida report, Romina Brignardello-Petersen, is a dentist, alleging she is not an expert on the subject.
As SEGM noted in its response to McNamara's testimony, Brignardello-Petersen has a Ph.D. in Clinical Epidemiology and Health Care Research and has published more than 140 peer-reviewed publications on evidence evaluation and clinical practice guideline methods.
"Not only did the FL evidence analysis author train with the 'father' of evidence-based medicine, but she now teaches and advances research methods at [McMaster University in Ontario's] leading center in systematic reviews & clinical practice guidelines development," SEGM tweeted. "The board noted this."
SEGM asserts that McNamara is wrong to claim the Florida report is invalid because it was conducted by a team of Canadians that "violated" U.S. standards. The group stated that this misrepresented the type of analysis Florida had commissioned.
"While 'systematic reviews of evidence' are still the gold standard for evidence evaluation (as we explained in a recent thread), FL commissioned a different analysis: an evaluation and synthesis of the already existing systematic reviews," SEGM wrote.
"The purportedly violated 'standards' don't apply to the type of review FL commissioned because it was not a 'systematic review of evidence,'" SEGM continued. "Further, the author of the analysis is a methodologist with significant 'pertinent clinical content area expertise,' which she disclosed."
The Florida report appears to echo the conclusions of an independent reviewcommissioned by the United Kingdom's National Health Service on the effectiveness of "gender-affirming care" for minors.
Last month, the NHS proposed new guidelines advising doctors not to quickly encourage trans-identifying minors to socially transition by changing their names or pronouns. The guidelines warn that youth who desire to identify as the opposite gender may be going through a "transient phase."
The document advises that the "clinical approach in regard to prepubertal children will reflect evidence that suggests that, while young people who are gender querying or who express gender incongruence may have started their journey as younger children, in most prepubertal children, gender incongruence does not persist into adolescence."
After an exponential rise in children across the U.K. being referred to the gender clinic at Tavistock and Portman Trust in London, the government launched an independent investigation carried out by Dr. Hillary Cass, the former president of the Royal College of Paediatrics and Child Health.
The inquiry found that "potentially irreversible treatments" were "given to children and young people, when the evidence base underlying the treatments is inconclusive, and when there is uncertainty about whether, for any particular child or young person, medical intervention is the best way of resolving gender-related distress."
Following Cass' review, NHS announced in July that it would shut down its gender identity clinic at the Tavistock and Portman Trust, moving away from the sole provider model to develop regional clinics to meet the needs of patients.
Last year, doctors at the Karolinska University Hospital in Sweden announced that they would no longer prescribe puberty blockers to youth younger than 16 as the interventions have faced scrutiny amid a rising number of youth patients.
"These treatments are potentially fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis," the statement from the hospital reads. "This makes it challenging to assess the risk/benefit for the individual patient, and even more challenging for the minors and their guardians to be in a position of an informed stance regarding these treatments."
In the U.S., the prescription of puberty blockers and cross-sex hormones to minors is accepted by medical bodies such as the American Academy of Pediatrics.
In August, Dr. Julia Mason and Manhattan Institute Senior Fellow Leor Sapir accused the American Academy of Pediatrics of stifling debate on how best to treat youth with gender dysphoria by shutting down critics in their quest to present better scientific approaches at conferences. In an op-ed, the writers claimed that AAP "used technicalities to suppress resolutions to bring it into line with better-informed European countries."
Five AAP members proposed a resolution at the academy's leadership meeting this year, calling for an update to 2018 policy statement supporting the use of puberty blockers and cross-sex hormones for gender dysphoria.
AAP President Dr. Moira Szilagyi wrote an op-ed stating that her organization "advises pediatricians to offer developmentally appropriate care that is oriented toward understanding and appreciating the youth's gender experience." She stated that AAP "doesn't push medical treatments or surgery; for the vast majority of children, it recommends the opposite."
"This care is nonjudgmental, includes families and allows questions and concerns to be raised in a supportive environment," Szilagyi stated. "This is what it means to 'affirm' a child or teen; it means destigmatizing gender variance and promoting self-worth."
She also contends that European countries aren't moving away from "gender-affirming care" models but "moving toward a more regional, multidisciplinary approach, similar to what is practiced in the U.S."
Samantha Kamman is a reporter for The Christian Post. She can be reached at: [email protected].
