A recent New York Times article by reporter Maggie Astor relies on biased experts and organizations — and the studies they produce — to make the case that concerns about gender-transition procedures for minors are overblown, whipped up by a handful of detransitioners who themselves are being used as political pawns by conservatives.
The article, titled “How a Few Stories of Regret Fuel the Push to Restrict Gender Transition Care,” doesn’t link to or explicitly cite any scientific research. Instead, Astor gestures toward a nebulous scientific consensus while making sweeping claims about the likelihood that an adolescent, once given puberty-blockers, cross-sex hormones, or surgery, will eventually come to regret the decision.
Astor begins by explaining that a small number of detransitioners such as Chloe Cole, who underwent a mastectomy at just 15, are traveling around the country testifying before state legislatures about the harm done to them, distorting the public’s understanding of largely benign procedures.
“Most people who transition do not change course. And yet, the influence of these activists has been striking,” Astor writes.
“As more American teenagers have identified as transgender, it is difficult to say how many will transition medically — many transgender people do not — and precisely how many will later change course,” she writes. “Methodology, demographics and even the definition of detransition vary widely from study to study, which typically show that between 2 percent and 13 percent of people detransition, and not always because of regret.”
While Astor did not respond to a National Review request for clarification as to where she sourced her detransition rate, the numbers appear to be drawn from a paper by prominent child-gender-transition doctor Jack Turban.
In a May/June 2021 analysis, Turban concluded that the vast majority of people who detransitioned in adulthood were driven to do so by “external pressures” rather than a genuine internal desire to revert to their biological sex. Based on the 2015 U.S. Transgender Survey, the study found that 13.1 percent of respondents who had transitioned in their lifetime had later detransitioned.
The 2015 survey relied exclusively on adults, excluding the pool of young people who underwent gender medical interventions in adolescence and began to regret them as their bodies matured and the side effects of sexual dysfunction set in. Anyone who had that experience but was not yet 18 in 2015 would not have shown up in the numbers.
The pool of participants were also more likely than the general population to be ideologically committed to the necessity of medical intervention, since they were drawn from “active transgender, LGBTQ, and allied organizations who served transgender people and would eventually support the survey by spreading the word through multiple communication platforms and in some cases providing direct access to the survey at their offices or facilities.” Presumably, detransitioners would be less likely to continue affiliating with such organizations than their counterparts who remained transgender. Participants were offered a cash-prize drawing as an incentive for completing the survey.
The survey that Turban — and by extension, Astor — relied on was also conducted before the recent explosion in the number of minors, particularly girls, seeking gender transition. According to a study reported in Astor’s own paper, the number of 13- to 17-year-olds who identify as transgender nearly doubled from 2017 to 2020, to say nothing of the three years since. That entire group of teens, many of whom may have been led to transition because of the effects of social contagion, are left out of Turban’s analysis.
Then there’s Turban’s personal bias and professional conflict of interest.
Throughout his career, Turban has published studies that reliably conclude that there are great benefits and minimal risks to providing gender-dysphoric minors with “gender-affirming care,” a euphemism for hormonal therapy for puberty suppression, reconstructive surgery, and social and behavioral reconditioning. Turban was trained at Fenway Clinic in Boston, “a place where ideologically they are the innovators of trans care in America,” Dr. Stephen Levine, a professor of psychiatry at Case Western Reserve University and gender-identity expert, told National Review in August.
Levine has advocated “a slow, patient, thoughtful question-and-answer period” for gender-questioning children before the age of neurological maturity — a proposal that Turban has repeatedly dismissed. Turban has characterized non-affirmative psychotherapies as the new “conversion therapy,” which he claims is detrimental to the mental health of trans kids.
Turban has also come under fire for conducting financially compromised research. In particular, his past work was made possible by a grant from the American Academy of Child & Adolescent Psychiatry (AACAP), where Turban is a member of the media committee. AACAP has received funding from pharmaceutical companies Arbor and Pfizer, which produce off-label puberty blockers that inhibit the onset of physical changes aligning with a person’s sex.
“The drug company is giving him a grant that will promote their product,” Levine told National Review at the time.
Astor also appeals to the authority of activist medical organizations such as the American Academy of Pediatrics, which in 2022 published a study arguing that social contagion is not a factor in explaining the rise of trans-identifying youth. In 2018, gender expert and physician-scientist Lisa Littman published a study in the science journal PLOS One that posited social contagion among peers as a major contributing factor in the rising number of gender-dysphoric youth.
The politicization of the AAP is well documented. In October 2022, the AAP urged the Department of Justice to investigate and prosecute threats against health-care facilities that provide gender-transition procedures to children. The AAP claimed there had been rampant attacks against hospitals that advertise so-called gender-affirming care. It cited incidents in multiple cities including Nashville, where Daily Wire host Matt Walsh led an exposé on a Vanderbilt University gender clinic’s performing of gender-transition procedures, including mastectomies, on minors. In the letter, the AAP alleged that “an intentional campaign of disinformation” perpetrated by a few high-profile social-media pundits such as Walsh was largely to blame for the rise in intimidation against hospitals.
In June 2022, the AAP released a policy statement on “breastfeeding and the use of human milk,” which included a section on “infants born to gender-diverse families.”
“Children of gender-diverse parents may have less access to human milk because of both social and biological constraints,” the section states. “Breastfeeding is used throughout this document; however, the word ‘breastfeeding’ itself may be both triggering, and less accurate, for gender-diverse parents, who may prefer the term ‘chest feeding,’ which is more inclusive of lactation in the context of varying physiologic anatomies.”
Our Madeline Kearns previously noted that the AAP’s 2010 policy statement on female genital mutilation, euphemistically called “ritual genital cutting of female minors,” emphasized that “above all” what was key to addressing the issue was “sensitivity to the cultural background of the patient and her parents and appreciation of the significance of this custom in their tradition.”