A few thoughts on Dr. @jack_turban's tweetstorm in which he purports to fact-check the inaccuracies of my book, Irreversible Damage.

/1 https://twitter.com/jack_turban/status/1295235990617907200

The essential claim of my book is that most of the teen girls who identify as "trans" suddenly in adolescence are caught in a social current that has little to do with actual gender dysphoria. This is the sort of claim that ought cause a doctor to pause /2

and examine whether it is true for some or any of these patients. Are girls being fast-tracked to transition? Are docs sure the girls' desire for transition is motivated principally, if at all, by GD? Because the most important question is whether these girls are being harmed. /3

I believe I lay out a strong case that an unnecessary transition *is* a harm.

Ask a detransitioner how she feels about the therapists and doctors who led her down the path to transition, if you have any doubts about this central truth. /4

Instead of engaging this thesis, Jack attacks the cover art, dust jacket copy, my publisher, all in an attempt to discredit the book. He even attacks @ZUCKERKJ for his endorsement, a scientist who oversaw the writing of the definition of "gender dysphoria" for the DSM-5. /5

Jack says he's "disappointed" in Ken Zucker for endorsing my book, if you can imagine anything so absurd as someone barely out of residency, condescending to one of the giants in the field. Well, that's Harvard for you. /6

As for his criticisms, each is wrong. 1) I did interview trans-identified adolescents. 2) As Dr. @lisalittman points out in response to him, in 67.2% of cases of kids with GD, the GD resolved on its own. 3) I never claim that "due to contemporary social pressures adolescents /6

today can't come out as LGB." That was a specific claim I made about *lesbians*. Lesbian teens who are pushed to transition to boys. Lesbians, who are treated as a lesser identity and whose concerns about their own welfare and community integrity are constantly trivialized. /7

Lesbians' treatment in the broader culture has been scandalous and shameful and if I had had the space to do it, I would have gone to greater lengths to expose the outrage of their abuse by so many biological men claiming to speak for LGBTQ. /8

Finally, there is no false assertion: Puberty blockers, when used on this population, puts fertility at risk. When followed by a course of testosterone (as they invariably are), infertility becomes all but guaranteed. /9

What I can't understand, amid so much game playing, is: Why do so many gender-affirming doctors sniff at these risks & all attempts to explore them? Shouldn't they consider that my book’s thesis - backed by many experts - is right, even for a handful of their patients? /10

Or are today’s doctor-activists forgetting the oath they took to admit “I know not” in the face of gathering uncertainty? I hope these doctors return to patient-centered medicine with all deliberate speed.

Adolescent girls don't need more activists. They need good doctors. /e