SEGM Bulletpoints The Madness

The Society for Evidence-Based Gender Medicine (SEGM)1 An international group of over 100 clinicians and researchers concerned about the lack of quality evidence for the use of hormonal and surgical interventions as first-line treatment for young people with gender dysphoria. They represent expertise from a range of clinical disciplines. was mentioned in my last two posts. They have done a great job accumulating the relevant studies from which today’s Gender Science is based. If you enjoy reading technical scientific abstracts and journal articles, and who doesn’t <grin>, you will find your fill at their website.

But for now let’s just focus on their home page Bullet Points which outline the single Dutch study upon which today’s Gender Affirming Care Model of hormones and radical surgery is based.

A single Dutch study!

  • 55 subjects (only 40 with complete data)
  • 100% had childhood-onset gender dysphoria (no adolescent-onset gender dysphoria cases which are the vast majority of cases today)
  • Only 1.5 year post-surgery follow-up at an average age of under 21
  • No control group
  • No physical health effects evaluation
  • One adolescent died as a result of post-operative complications. Several others could not pursue treatment due to new health issues arising following hormonal administration.
  • Unchanged or worsening gender dysphoria and body image difficulties while on puberty blockers, especially among natal adolescent females.

Multiple subsequent studies have found the following associations with the “standard care” treatments:

  • Bone/skeletal impairments
  • Cardiovascular complications
  • Premature death
  • High rates of post-surgery suicide

Despite the uncertainties and poor evidence, hormonal and surgical interventions are being scaled up. They go beyond the experimental “Dutch protocol” by:

  • Encouraging early social transition, explicitly discouraged by the Dutch protocol
  • Being applied to young people with adolescent-onset gender dysphoria, a population not included in the Dutch study.

***

This past May the Karolinska Hospital in Sweden, home of the Nobel Prize in Medicine, rejected the so-called Dutch protocol. [See story here]

And yet in North America trans-advocates are shouting “full-steam ahead” on prescribing radical experimental treatments for children and teens with gender-dysphoria. All on the basis of seriously incomplete scientific research. If you say slow down, you are suspected of being a bigot interested only in so-called “conversion therapy.

This is madness.

And some in Europe, like the Swedes above, may be finally coming to their senses.

One of the lead researcher-clinicians at the Center of Expertise on Gender Dysphoria in Amsterdam, Thomas Steensma, is asking some critical questions today. On Feb 27 Algemeen Dagblad, the second-most widely read newspaper in the Netherlands published an astonishing article. Here are some excerpts:

Because what is behind the large increase of children who have suddenly registered for transgender care since 2013?  And what is the quality of life for this group long after the sex change?  There is no answer to those questions.  And that must happen, thinks Steensma and colleagues from Nijmegen.

  
Thomas Steensma

"We don't know whether studies we have done in the past can still be applied to this time.  Many more children are registering, and also a different type," says Steensma.  "Suddenly there are many more girls applying who feel like a boy.  While the ratio was the same in 2013, now three times as many children who were born as girls register, compared to children who were born as boys."

[About the effect of early medical intervention on future fertility Steensma has this to say]

It is still unclear whether these administered hormones affect the fertility of boys and girls.  "We just don't know," says Steensma.  "Little research has been done so far on treatment with puberty blockers and hormones in young people.  That is why it is also seen as experimental.  We are one of the few countries in the world that conducts ongoing research about this.  In the United Kingdom, for example, only now, for the first time in all these years, a study of a small group of transgender people has been published.  This makes it so difficult, almost all research comes from ourselves."  

[Lamenting the lack of research, and decrying the fact that other practitioners are applying Dutch research without adequate assessment of their patients he says]

"We conduct structural research in The Netherlands.  But the rest of the world is blindly adopting our research.  While every doctor or psychologist who engages in transgender health care should feel the obligation to do a proper assessment before and after intervention."

You can read the full article here:

How can we justify a full-steam ahead mentality when the Dutch clinicians who do “almost all research” on these questions say stop “blindly adopting our research.”

Stop the Madness!

***

If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend the book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]

Institutional Capture

In previous posts I mentioned the lack of interest in viewpoint diversity and the effort to stifle debate by the American Academy of Pediatrics (AAP). Abigail Shrier’s recent Wall Street Journal Article provides more detail. (Somehow I avoided the paywall, so I have a few more quotes for you below).

Many of our cultural institutions are in the process of being captured by Gender Ideology. It has been a well-funded, walk through those institutions that lately became a sprint! Our school board members and many school administrators, leaders of our Academic institutions, leaders of our professional associations, business leaders, even some of our Church leaders have been won over. One need not ascribe bad motives to the “captured” leaders of these institutions. The debate has been cleverly framed to be about “civil rights” and “health care.” Certainly unobjectionable goals. But when you silo yourself off from those who have a different way of viewing the world, and reaching unobjectionable goals, it is very easy to develop social myopia. Often you find the rank and file membership does not support what the leaders are doing, but if licensing, professional credentials, employment or reputation are on the line many remain silent.

Unfortunately when it comes to the issue of Gender Ideology, and the Medicalization of Identity, our silence is harming our children.

More are speaking up, as I’ve shown. For example, Rev Randall, Abigail Shrier, nurse Amy Hamm, Isabella Malbin, J.K. Rowling, Dalea Rundblad, and a DeTransitioner named Cari.

Also recent polling shows that support for LGBTQ+ is dipping. I strongly suspect this is due to the TQ+ side of the spectrum. And the outrageous “queer theory” inspired “gender-fluid” claims being made, not to mention the uncivil actions & rhetoric exercised on behalf of those claims. Some on the LGB side acknowledge a classic case of having “overplayed our hand.”

Mostly people are waking up to the absurdity of the claim that there are more than two sexes. Or more than two genders. People are willing to accept diversity of expression and folk who do not conform to rigid stereotypes. But they insist our sexuality is not a social construct from top to bottom. There are real differences between male and female that must be recognized and celebrated. People increasingly refuse to be intimidated into accepting the absurd proposition that a man can become a woman or a woman can become a man. When I use the word “radical” this is why. I can’t think of anything more radical than the desire to dissolve the female – male sex binary, or to treat it as less than normal. Without that binary and its proper ordering we cease to exist as a species.

Those who believe they are born in the wrong body have a mental disorder. We must lovingly care for them but we can’t affirm their confusion. I encourage all of us to Embrace, Don’t Affirm.

***

Ironically, after having ridden in on the coattails of viewpoint diversity, continued diversity no longer interest Gender Ideologues. Any student of political history recognizes the pattern. Having gained power via a “free and fair election” those elected effectively abolish any future elections. The objective was power. And they intend to keep it. Although concerns about the use of violence to acquire & retain power are minimal in the Western world (notwithstanding the year of organized violence by Antifa and Black Lives Matter in some of our major cities, or the QAnon inspired radicals that stormed the Capital) other tactics, like shaming, silencing, cancelling, deplatforming, and shutting down debate have become commonplace throughout our institutional and online life. Even professional associations which support free and open inquiry based on the scientific method are shutting down debate. Why? Is the science settled?

I’m documenting some of these non-violent “shutdown” tactics on this blog as it relates to questions about Sex, Gender and Identity. As you will read below some medical professionals fear losing their jobs for speaking up. These uncivil, unprofessional capturing tactics matter.

For with the medicalization of Identity we are engaged in an outrageous experiment on our children. Many leaders in Europe are finally waking up & speaking out about this childhood experimentation. Will the leaders of North American cultural institutions listen?

***

From Shrier’s Wall Street Journal Article:

Clinicians across the West are acknowledging that the evidentiary basis supporting medical transition for kids is shaky and that hormone treatments on adolescents don’t produce significant mental-health benefits. Yet “there’s no home for that message inside U.S. medical societies,” as endocrinologist and SEGM co-founder Will Malone said.
The so-called Dutch protocol, a widely adopted standard of care that has been used to justify starting gender-dysphoric minors as young as 8 on puberty blockers, is based on a study of a narrow population: children with severe gender dysphoria since early childhood and no other mental-health comorbidities. The protocol is now being applied to a wildly different demographic—teenage girls who seem to have had no prior history of dysphoria, and who have high rates of anxiety and depression. Many young women who underwent hormone treatments and surgeries over the past decade now regret having done so; they call themselves “detransitioners.”

The AAP is “working very hard to give an appearance that everything’s been decided and there’s no debate. The growing numbers of detransitioners suggests that [pediatricians] don’t really know what we’re doing in this case,” said Julia Mason, a pediatrician, SEGM adviser and AAP fellow. 

The National Peanut Board, Gideon International (bible distributors), and Infinity Massage Chairs were able to secure booths to present their “point of view.” But not the Society for Evidence-Based Gender Medicine. [See my next post for more details about their work]

“We show up with a valid argument, we’re not politically or ideologically driven,” Dr. Malone said. “Other countries, more liberal countries, have already come to the conclusion that we should have come to as a country years ago. And yet, because we can’t open this debate in any form . . . the debate is not occurring and kids are being harmed.”

Many of the pediatricians I spoke to for this article say they fear professional retribution because of their views and asked not to be identified. In March, one of them submitted a proposed resolution, seconded by an AAP leader, asking that the AAP re-evaluate its commitment to affirmative care in light of the growing international skepticism about this treatment protocol for children and adolescents. Among the group’s membership, the resolution received wide approval: 80% of responding pediatricians indicated that they supported it, according to Dr. Mason. “What we’re dealing with is institutional capture,” she said. “The leadership is not in the same place as the membership.”

Dr. Malone, the endocrinologist, points out that they didn’t even apply for the opportunity to debate current protocols. They simply wanted to staff a booth: “This is baby stuff. Set up a booth and hand out some information? No, we can’t even do that.” Source: Abigail Shrier, Wall Street Journal, Aug 9, 2021 [emphasis mine]

In Europe a major shift away from body altering treatments and surgeries for those under 18 couldn’t come soon enough for those of us convinced these alterations subvert God’s creational design.

Will American medicine follow that most welcomed development?

***

If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend the book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]