60 Minutes ticks toward 50/50 balance on gender-questioning kids

Detransitioner. Bet you didn’t know that was a dirty word (if you knew the word at all). Accordingly, CBS’ 60 Minutes and Lesley Stahl in their recent segment Health care challenges for transgender youth should be applauded for talking about “the other side” of automatic affirmation of gender-questioning young people – those who regret their transition. It is among the first mainstream media in the US to approach something resembling balance on this contentious issue and to add the word “detransitioner” to our collective lexicon.

60 Minutes and Stahl should also be thanked for standing (somewhat) firm on journalistic integrity in the face of tremendous pressure to cancel from activist groups like GLAAD and the ACLU (via Chase Strangio) as well as activist doctors like Jack Turban (a recently minted doctor and fellow) and Johanna Olson-Kennedy, all of whom seem intent on suppressing any evidence that runs counter to their preferred narratives.

60 Minutes got a lot of things right: the lack of screening of which gender-questioning people might possibly benefit from medical transition; how young people are self-diagnosing themselves with gender dysphoria, often based on online and peer advice; how many doctors express hesitation over the current affirmation-only model; how clinicians are under intense pressure from activists to adhere to certain politics.

However, the show would benefit from a sequel to convey critical information it either omitted or did not cover in an unbiased way.

1. 60 Minutes characterized objections to the rapidly emerging model of so-called “gender-affirmative care” as simply being “part of a culture war” (Stahl) and due to “ignorance and prejudice” (Anderson), thus missing the big picture: There is growing international concern, scrutiny, and pushback on “gender-affirming” medical treatments for children and young people. The US Endocrine Society’s guidelines for gender dysphoric adolescents, published in 2017, are only supported by evidence they themselves graded mostly  “low” or “very low” quality or of ungraded quality [+ here], yet they inform a number of medical societies, including the American Association of Clinical Endocrinologists, American Society of Andrology, European Society for Pediatric Endocrinology, European Society of Endocrinology, Pediatric Endocrine Society, and World Professional Association for Transgender Health (WPATH).
2. Dr. Lee Savio Beers, an authoritative medical professional interviewed for the segment, claimed that gender-affirming hormonal treatments are not experimental, implying they are settled science. In fact, hormonal treatments ARE experimental, as noted above. The Swedes as of May now only allow them in clinical studies. The original researchers of the so-called Dutch Protocol have expressed concern it is not being used as intended. All of the drugs are being used off label in the US, meaning the FDA says the benefits have not been shown to outweigh the risks. One of the most frequently prescribed, Lupron, is meant to treat endometriosis in women and prostate cancer in men, is also used for chemical castration, and may cause bone damage and infertility. Moreover, PBs are almost always a one-way path to cross-sex hormones, which have many dangerous side effects (risks [here, here], including for the heart [also here], bones, brain, the endocrine and possibly the immune systems, and of course fertility), and do not improve mental health. 
3. The program characterizes gender dysphoric children and young people as “transgender youth.” Phrases like “trans kids” and” transgender youth” are problematic. Gender dysphoria is not innate or immutable. For most, it is transient. It is thus best not to box children into such labels at a time when they are exploring their identities. Research shows that 85% (61% – 98%) of children with childhood onset [+here] grow out of it. Adolescent-onset GD may be a symptom of other conditions (including OCD, autism, [+here], trauma, anxiety, distress [+here]) and also may only be temporary. Many with gender dysphoria are really gay. Detransitioners in a new survey report other reasons as well.
4. The segment grossly underestimates the proliferation of “gender affirmative” clinics now prescribing hormonal treatments in the United States. “In 2007, there was one major youth gender clinic in the entire country. Today there are at least 50.” (Stahl) Stahl failed to report the exponential growth in youth identifying as trans and seeking hormonal treatments in the US and around the world (4000% in the UK, 1500% in Sweden). Anecdotal evidence suggests there are not 50 but over 300 pediatric gender clinics in the US alone. Every state has a pediatric gender provider. The largest American provider of gender services is Planned Parenthood, which operates on an “informed consent” model (age to qualify varies by state).
5. The program did not challenge claims of low rates of regret. “While the vast majority of transgender youth and adults are satisfied with their transitions, not all are“ (Dr. Erica Anderson). This is assuming, without evidence, low rates of regret, when in fact we have no data on this. No researcher is following up at long-enough periods (only one Swedish study followed as long as 10 years), and most children and youth have only been taking drugs for a few years anyway. Detransitioners rarely return to their doctors to provide an update, and studies on detransitioners are often cancelled or not even attempted.
6. The program perpetuates the labelling of evidence-based concern about medicalization as “anti-transgender discrimination.” “Long before the anti-trans legislation was introduced across the country, the challenges facing the transgender community were daunting” (Stahl). This is conflating care for gender-dysphoric minors with hormonal and surgical treatments that lack evidence showing they are effective or safe. As a result, this is an inaccurate characterization of bills outlawing hormonal and surgical treatments on minors, such as the one in Arkansas. Government regulations on health care exist for safeguarding reasons, especially when there is medical and activist overreach. Whistleblowers and concerned parents and professionals are not “anti trans” or “transphobic.”
7. The program perpetuates inaccuracies about suicide risks. “The trans community is facing an epidemic of violence. We’ve had at least 44 transgender people killed last year. Transgender youth, in many cases, attempt suicide at a rate of four times that of their peers” (Alphonso David). This figure is not from generalizable data. In truth, we don’t know what the rate is. Speculation about cause of a suicide can oversimplify the issue and should be avoided. Suicide is extremely complex, and generally no single event or factor leads someone to take their own life. Moreover, homosexuals as well as all psychiatric patients are at greater risk of suicide. This is unfortunate but not exclusive to gender-dysphoric individuals. One Swedish longitudinal study (and the only one on the issue using high-quality data) shows transitioned adults have a 19x greater rate of suicide than controls. In other words, transition doesn’t prevent suicide but in fact may lead to it. This point is buttressed by the program’s own interview of the young man in the program feeling suicidal after his testicles were removed.

Finally, longtime expert clinician Dr. Laura Edwards-Leeper of WPATH is quoted as saying: “It greatly concerns me where the field has been going. I feel like what is happening is unethical and irresponsible in some places.”

Indeed, this is key. Who is being unethical? Who is doing the gaslighting? Given the significant mental and physical dangers and lack of a reliable way of who may benefit or be harmed, is it the parents who want their gender-questioning children to take it slow and resolve their gender distress through unbiased, evidence-based methods? Or is it the very doctors and researchers who are pushing unproven gender affirmation on an unwitting generation of guinea pigs in what might turn out to be the biggest medical scandal of the 21st century?

UPDATED JUNE 24, 2021: In the last few days, 60 Minutes aired a follow-up which only featured the views of ACLU lawyer Chase Strangio, Dr. Michele Hutchinson, and an Arkansas youth. It is not a problem to show these viewpoints – as long as the show also aired the viewpoints of other experts and those who want to take the recent evidence base more into account (for instance, puberty blockers being experimental). One Genspect parent was in fact interviewed for the piece, but in the end her testimony found its way to the cutting room floor. Unfortunately, it appears that 60 Minutes has now ticked away from balance when it comes to reporting on gender-questioning kids.