by Tyler O’Neil | Arizona Sun Times
An organization of doctors, nurses, and health care professionals poked holes in a study claiming to prove the marginal benefits of cross-sex hormones for teenagers who persistently identify with the gender opposite their biological sex.
The group, Do No Harm, called the study “fatally flawed and borderline unscientific” in a report first provided to The Daily Signal. The report criticizes the study, “Psychosocial Functioning in Transgender Youth after 2 Years of Hormones,” led by Dr. Diane Chen at the Lurie Children’s Hospital of Chicago and published by the New England Journal of Medicine in January.
The study analyzed 315 participants, identified as transgender and nonbinary, between the ages of 12 and 20, over the course of two years. These participants received “gender-affirming hormones,” i.e. hormones to make their male or female bodies resemble bodies of the opposite sex.
“During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased,” Chen’s article on the study claims. Eleven participants experienced suicidal ideation, and two committed suicide.
Yet the Chen article “raises several questions that weaken its overall conclusions that this form of therapy is truly beneficial to these subjects,” Dr. Stanley Goldfarb, board chair at Do No Harm, told The Daily Signal in a statement Tuesday.
Many scientific studies break participants into two groups—a test group and a control group. The test group receives the drug or intervention while the control group either receives a false version of the drug—a placebo—or receives a different treatment that is less experimental, such as counseling. This study did not have a control group.
“The absence of any control group raises the possibility that ongoing psychological counseling and therapy may explain the slight improvement in some parameters of the study,” Goldfarb argued. Cross-sex hormones may not have been the only factor in reported improvement, and without a control group, it becomes much harder to isolate the exact role hormones may have played.
Goldfarb also noted that “the fact that the subjects were seen in these clinics for some prolonged period of time prior to entry into this study may produce spurious results due to the well-known phenomenon in surveys called ‘demand characteristics’. If a survey is conducted under the auspices of the study authors, the results may be influenced by a ‘cheering on’ effect.”
The full Do No Harm report expands upon this flaw.
“The researchers and four clinics featured in this study have a well-publicized history of radical activism and advocacy for the medical transition of children,” the report states. “For example, Boston Children’s Hospital posted and later removed a video on its YouTube channel that endorsed the idea that some children know their gender identity ‘from the womb.’”
“Given this obvious bias, there is a high likelihood that study participants were steered toward responses that align with the activism promoted by these clinics,” the report notes.
Do No Harm also notes that the study’s results “indicate that the only meaningful improvement over time was participant scores for ‘appearance congruence.’ Improvement in positive affect, life satisfaction, depression and anxiety only improved by the smallest margins.”
While the study found no measurable change in self-reported mental health for the youngest cohort of participants, the article’s authors wrote that “these observations align with other published reports that earlier access to gender affirming medical care is associated with more positive psychosocial functioning.”
“In other words, they assert that the lack of improvement among this subsample constitutes evidence in support of their radical worldview,” Do No Harm notes. “It’s a ‘heads I win, tails you lose’ proposition.”
“This study, despite the headlines it has received, is fatally flawed and borderline unscientific,” Do No Harm concludes. “Like other studies on the topic, it obfuscates rather than clarifies questions around the medical transition of children. Policymakers must accept that elite gatekeepers have become cheerleaders and that their recommendations on politicized topics warrant healthy skepticism.”
Do No Harm recommends that American policymakers follow the trend of European countries, which “increasingly prohibit access to these experimental treatments for minors, largely due to acknowledgement that the evidence base fails to establish that these treatments are beneficial on balance.”
“American children deserve better than risky medical treatments justified by activism cloaked as research,” the report concludes.
Chen, the author of the journal article and leader of the study, did not respond to The Daily Signal’s request for comment.
Sen. Mike Lee, R-Utah, requested information about the study in July 2020, and the National Institutes of Health told him that it had granted $477,444 in a five-year grant to the Boston Children’s Hospital, the University of California at San Francisco, and the Lurie Children’s Hospital of Chicago for the study.
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