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Consumers of healthcare have virtually no understanding of just how much the economic incentives influence healthcare. In the United States, medical trade groups like WPATH are not unique--they routinely mint guidelines that benefit their members financially. /1 https://twitter.com/UGMediaLtd/status/1295706961405673477
But the US also has a robust system of insurance companies, which have their own small army of doctors who do their best to deny coverage for anything unproven & expensive. The patient is blissfully unaware how two financially interested sides duke it out "medical necessity." /2
It's a wicked system, but it works--sort of. Each side unreasonably pushes in their own direction, and some semblance of "truth" is found in the middle. Much like in a court of law. This adversarial system of US healthcare breaks down when the government takes a side. /3
In 2013, Obama wrote an innocuous memo saying, for the purposes of healthcare, non-discrimination based on sex should include gender. Since all insurance companies accept federal money (medicare, medicaid, exchange), they have to follow the rule. Did he know what he was doing? /4
This decision had serious consequences. Trans adults whose trans surgeries had been denied due to poor evidence of effectiveness and terrible long term outcomes sued insurance companies, using this new little innocent clause, claiming this was discrimination based on gender/5
Insurance companies contested--they typically are allowed to decide what's necessary medically and what's not based on their own evidence review. But the judge ruled based on the new language by Obama (section 1557 of the non-discrimination provision of Obamacare) and they lost/6
And then insurance companies made a financial decision (which is what they do best). The cost of trans surgeries is high. However, the prevalence is low. So the total cash outlay is relatively low, compared to the high cost of legal bills. And so they caved in. /7
And that's how our kids got sacrificed. No other procedure would be covered with this level of evidence. And once the Medicaid plans began to cover it in blue states, it was off the the races. The number of girls wanting to cut off their breasts skyrocketed. WPATH docs obliged./8
Trans movement is full of contradictions. They want payments covered by insurance, but hate the mental health diagnosis that's required for coverage. They weaponize suicide to justify transition, but ignore all long term data that show high post-tran suicides. /9
Since quality data never showed any benefit, they stick with "soft measures'. Self-reported happiness; satisfaction. Yet those studies lose 40% of participants-presumably the less happy ones. They deny the rise of harmed detransitioners (5K on them on 1 site in just 2 years). /10
Back to the money. The fact that @jack_turban accepted 15K from Pharma is just the tip of the iceberg. Jack's entire career is built on it. That's why it's so dangerous that he is also the "researcher"-he no longer can afford to seek truth. He has too much to lose. /11
