“Sloppy healthcare”: Two top gender-affirming doctors finally speak out

On Monday October 4, Bari Weiss’ Common Sense released a bombshell article written by Abigail Shrier: Top Trans Doctors Blow the Whistle on “Sloppy” Care.

In it, Shrier interviewed Drs. Marci Bowers and Erica Anderson, two transwomen who prominently practice gender medicine on children and adolescents. Both of these doctors – who are WPATH members and have treated thousands of patients – are now urging a more cautious approach instead of the current no-holds-barred affirmative-care-only model advocated by many of their colleagues.

None of what Bowers, a surgeon and vaginoplasty expert, and Anderson, a clinical psychologist, revealed is really news to the parents who have done their homework and are skeptical of the unproven affirmative approach that lacks a solid evidence base. But it will be shocking to those unaware of the raging debate on this issue, echoed by fellow WPATH member Dr. Laura Edwards-Leeper’s equally surprising interviews on the Unspeakable podcast also released this week.

The question remains: With two critical doctors finally stepping up to admit that mistakes have been made and professionals need to do more assessment and yes even perhaps “watchful waiting” especially when it comes to kids, will the mainstream media, in particular outlets that tilt left, now do their part to report on it to the general public? 

As Shrier wrote in a follow up, Why Marci Matters:

“For the first time in the U.S., top gender medical providers collectively acknowledged four facts: early puberty blockade can lead to significant surgical complication and also permanent sexual dysfunction; peer and social media influence do seem to play a role in encouraging the current, unprecedented spike in transgender identification by teen girls; and the World Professional Association of Transgender Health (WPATH) – of which both Bowers and Anderson are board members – has been excluding doctors who question current medical protocols to its detriment.”

“When you block puberty, the problem is that a lot of the kids are orgasmically naive. So in other words, if you’ve never had an orgasm pre-surgery and then your puberty’s blocked, it’s very difficult to achieve that afterwards. And I think that I consider that a big problem, actually. It’s kind of an overlooked problem that in our informed consent of children undergoing puberty blockers, we’ve in some respects overlooked that a little bit.”

-Dr. Marci Bowers

The original piece contained some stunning admissions:

When I asked Anderson if she believes that psychological effects of puberty blockers are reversible, she said: “I’m not sure.” When asked whether children in the early stages of puberty should be put on blockers, Bowers said: “I’m not a fan.

Regarding WPATH:

“There are definitely people who are trying to keep out anyone who doesn’t absolutely buy the party line that everything should be affirming, and that there’s no room for dissent,” Bowers said. “I think that’s a mistake.”

On when to start puberty blockage:

Bowers told me she now finds early puberty blockade inadvisable. “I’m not a fan of blockade at Tanner Two anymore, I really am not,” she told me, using the clinical name of the moment when the first visible signs of puberty manifest. “The idea all sounded good in the very beginning,” she said. “…But honestly, I can’t sit here and tell you that they have better — or even as good — results. They’re not as functional. I worry about their reproductive rights later. I worry about their sexual health later and ability to find intimacy.

On admitting there’s a rapid rise of a new cohort of teenage girls:

While both Anderson and Bowers pointed out that “ROGD” has yet to be accepted as a diagnosis, Anderson said: “At our clinic at UCSF, for two years now, we’re running two to one natal females to natal males.” Two to one.

On social influence:

“As for this ROGD thing,” Bowers said, “I think there probably are people who are influenced. There is a little bit of ‘Yeah, that’s so cool. Yeah, I kind of want to do that too.””

On detransitioners:

Anderson agreed that we’re likely to see more regret among this teenage-girl population. “It is my considered opinion that due to some of the — let’s see, how to say it? what word to choose? — due to some of the, I’ll call it just ‘sloppy,’ sloppy healthcare work, that we’re going to have more young adults who will regret having gone through this process. And that is going to earn me a lot of criticism from some colleagues, but given what I see — and I’m sorry, but it’s my actual experience as a psychologist treating gender variant youth — I’m worried that decisions will be made that will later be regretted by those making them.”

On ignoring comorbid mental health issues:

What, exactly, was sloppy about the healthcare work? “Rushing people through the medicalization, as you and others have cautioned, and failure — abject failure — to evaluate the mental health of someone historically in current time, and to prepare them for making such a life-changing decision,” Anderson said. 

It’s apt that Shrier chose to publish her article on Weiss’ substack, since it really all comes down to common sense.

Image credit: Magda Ehlers, Pexels

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