Site icon Transgender Map

They Paused Puberty, but Is There a Cost?

In 2022, New York Times writers Megan Twohey and Christina Jewett co-wrote a scaremongering article on puberty blockers for gender diverse youth that culminated in a 2023 newsroom revolt against Times leadership.

The article promoted and popularized several anti-trans talking points about gender affirming care for minors, including “bone density” and “low quality evidence.”

The piece is part of a strategy by anti-trans hate groups like Genspect to get FUD propaganda (fear, uncertainty, and doubt) about gender affirming care into mainstream media. Focusing on uncommon side effects and unknown risks is a long-used pretense to restrict or ban similar healthcare like contraception and abortion, especially for minors.

Background

The story is about “emerging evidence of potential harm” and the “long-term physical effects and other consequences” of Lupron and other medications that can manage onset of puberty. Any drug carries a risk of side effects, which the US Food and Drug Administration (FDA) tracks via adverse event reports. FDA approved Lupron for central precocious puberty in 1993. It has since been used for trans and gender diverse youth experiencing unwanted puberty. Doctors have wide latitude to use approved drugs “off label,” including use to delay puberty for trans and gender diverse youth.

Several years earlier, Jewett began reporting on cisgender people who believe puberty blockers which they took as minors led to short- and long-term adverse side effects. Children whose puberty starts at 5 to 8 years old often face social problems, and those capable of pregnancy are at higher risk of sexual harassment and assault. Doctors work with parents to weigh the risks and benefits before getting informed consent. As with any medical treatment, some people will be harmed more than they were helped.

Headlines used for the story include:

Below are anti-trans talking points that were promoted and popularized via this article.

Bone density

Puberty involves a release of hormones that affect bone deposition throughout the body. Puberty blockers affect that process, so bone health is monitored in adolescent patients, usually with a baseline measurement before treatment followed by scheduled measurements.

One of the three young people profiled had to stop puberty blockade due to done density issues. While this is a well-known risk and uncommon side effect, it can usually be monitored and managed. Having to stop hormone blockade altogether due to bone density is rare.

Via USPATH/WPATH:

The anecdote provided of an adolescent who began, and then stopped pubertal suppression due to bone density loss lacks important details, including age and pubertal stage at initiation of puberty blockers, length of time on blockers, baseline bone density (“Z-score”), and whether the bone density comparison was made to identified gender or birth-assigned sex. Additional important information not provided includes calcium intake, and vitamin D intake and level, as well as level of physical activity, all of which play a substantial role in maintenance of bone mineral density.

“Low-quality evidence”

Jewett and Twohey also parrot the “low-quality evidence” claim put forth by anti-trans activists, based on a scale devised by Gordon Guyatt. Federal judge Sarah E. Geraghty rejected these claims in a 2023 Georgia case where anti-trans activists Paul Hruz, Michael Laidlaw, and James Cantor testified against Yale University professor of pediatrics Meredithe McNamara:

The undisputed record shows that clinical medical decision-making, including in pediatric or adolescent medicine, often is not guided by evidence that would qualify as “high quality” on the scales used by Defendants’ experts. 30 (Doc. 70-1, McNamara Decl. ¶¶ 23–28; Tr. 74:11–75:1 (McNamara Testimony); Tr. 133:614 (Hruz Testimony).) In fact, the record shows that less than 15 percent of medical treatments are supported by “high-quality evidence,” or in other words that 85 percent of evidence that guides clinical care, across all areas of medicine, would be classified as “low-quality” under the scale used by Defendants’ experts. (Doc. 70-1, McNamara Decl. ¶ 25; Tr. 74:11–75:1.) Defendants do not refute Dr. McNamara’s testimony on this point, and indeed they “concede” that “low-quality” evidence “can be considered.” 31

Geraghty (2023) [emphasis mine]

Geraghty also noted the obvious biases of Hruz, Laidlaw and Cantor:

Defendants’ experts’ insistence on a very high threshold of evidence in the context of claims about hormone therapy’s safety and benefits, and on the other hand their tolerance of a much lower threshold of evidence for claims about its risks, the likelihood of desistance and/or regret, and their notions about the ideological bias of a medical establishment that largely disagrees with them. That is cause for some concern about the weight to be assigned to their views, although the Court does not doubt that those they express are genuinely held.

(“Dr. [Paul] Hruz fended and parried questions and generally testified as a deeply biased advocate, not as an expert sharing relevant evidence-based information and opinions. I do not credit his testimony.”); Eknes-Tucker v. Marshall, 603 F. Supp. 3d 1131, 1142–43 (M.D. Ala. 2022) (explaining that the court gave Dr. James Cantor’s “testimony regarding the treatment of gender dysphoria in minors very little weight”); C. P. by & through Pritchard v. Blue Cross Blue Shield of Illinois, No. 3:20-CV-06145-RJB, 2022 WL 17092846, at *4 (W.D. Wash. Nov. 21, 2022) (noting that it was a “close question” as to whether Dr. Michael Laidlaw was qualified to testify about the medical necessity of gender-affirming care because he has treated only two patients with gender dysphoria and has done no original research on gender identity).

Geraghty (2023)

Mentioned

Supporters

Critics

References

Twohey, Megan; Jewett, Christina (November 14, 2022). They Paused Puberty, but Is There a Cost? New York Times https://www.nytimes.com/2022/11/14/health/puberty-blockers-transgender.html [archive]

WPATH / USPATH (November 22, 2022). USPATH and WPATH Respond to NY Times Article “They Paused Puberty, But Is There a Cost?” published on November 14, 2022. [PDF] https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/USPATHWPATH%20Statement%20re%20Nov%2014%202022%20NYT%20Article%20Nov%2022%202022%20CORRECTION.pdf

GLAAD (February 14, 2023). 180+ journalists, New York Times contributors call out biased coverage of transgender people in joint letter as 100+ organizations and notables echo call, citing pattern of inaccurate, harmful trans coverage in the New York Times https://glaad.org/releases/new-york-times-contributors-call-out-biased-coverage-of-transgender-people-in-joint-letter/

2022 NYT story links

Exit mobile version