Yet again, @jack_turban accuses journalists of “agenda-driven propaganda” & “astounding misinformation.” Jack’s new target is the @TheEconomist ‘s coverage of the UK High Court ruling re: experimental hormonal interventions for gender-dysphoric youth./1

https://segm.org/Keira_Bell_ruling_global_repercussions https://twitter.com/jack_turban/status/1338919340901462016

Jack labels the thorough review of evidence undertaken by the UK High Court and their decision to consider puberty blockers (PBs) an experimental treatment “a blatant disregard for scientific evidence.” Jack lists studies he claims support his position. Let’s #factcheckjack. /2

Let’s start with de Vries, the “gold standard” 2011 study on which PB usage in gender dysphoric adolescents is based. The results? Puberty blockade didn’t improve #genderdysphoria or body image in boys or girls. /3
https://pubmed.ncbi.nlm.nih.gov/20646177/ 

The de Vries 2011 study did show improvements in psychological function w/ PBs over baseline. The authors state they don’t know why these improvements occurred, and that psychological support or other reasons may have helped. This illustrates the need for control groups. /4

A recently released UK study attempted to replicate the de Vries study and failed to show any improvements. This failure to replicate research findings is not unique. That’s why single-site uncontrolled studies are considered *low-quality* evidence. /5
https://www.medrxiv.org/content/10.1101/2020.12.01.20241653v1.full

Moving on to Costa 2015. The study had 2 gps: (psych support) vs (PBs + psych support). Both gps improved at 18 months, but no difference was seen btw the 2 groups, meaning the study provides no evidence PB’s improve psychological functioning. /6
https://www.jsm.jsexmed.org/article/S1743-6095(19)31424-9/fulltext

Now on to Turban 2020. The paper contributes nothing to our understanding of pubertal blockade. Why? Analysis of a poor-quality online convenience sample with respondents confused by what puberty blockers are, renders meaningless findings. /7
https://link.springer.com/article/10.1007%2Fs10508-020-01743-6

Although those who mistakenly claimed to have taken PBs were removed from the analysis, this correction wasn’t possible for those in the “wanted PBs but didn’t get them” control arm, compromising the entire analysis. Lack of control for mental health was also a key mistake./8

Even if we believe the results of the study’s flawed analysis, those who took puberty blockers were 2x as likely to be hospitalized for suicide attempts than those who didn’t. Not good. (Yes, it did get the “Study of the Year award” by Pediatrics. Will address another time.) /9

Van der Miesen 2020: Newly-referred 14 yr vs. 17 yr-olds w/ yrs of psych support and on PBs. The latter group did better. New referrals (younger) often come in a crisis. 17-yr-olds are older, had more therapy. Did PBs help? The authors aren’t sure. /10
https://pubmed.ncbi.nlm.nih.gov/32273193/ 

Finally, Achille 2020. 50 participants, no control group. The authors say they could not determine whether PBs were the cause of observed changes in psychological function over time. The authors are not overstating their level of confidence—Jack is. /11
https://ijpeonline.biomedcentral.com/articles/10.1186/s13633-020-00078-2

And although Jack does not mention it, there is another alarming finding from the UK GIDS study: while on puberty blockers, girls reported increased self-harming behavior. /12

Then there are surgical issues. Although girls’ future mastectomies may be more minimal, the boys’ vaginoplasties will be more complicated since PBs impeded tissue development. This played out in a very public way for Jazz./13 https://pediatrics.aappublications.org/content/146/5/e20193653

To sum up: De Vries showed some improvement in psych function(but not GD). However, the newly released UK GIDS study failed to replicate this. Neither applies to the current wave of adolescent-onset GD. The other 4 studies quoted by Jack fail to support his claim./14

The UK Court reached the correct conclusion: puberty blockers are experimental. While other sources are silent regarding this decision or propagate false #genderfolklore, @TheEconomist provided nuanced and accurate coverage for which many are grateful. /15