Scott Leibowitz and transgender people

Scott Farrell Leibowitz (born May 20, 1978) is an American pediatric psychiatrist best known for his work with gender diverse youth.

Background

Leibowitz was born in Smithtown, New York. He earned a bachelor’s degree in human development from Cornell University and his medical degree from the Tel Aviv University Sackler School of Medicine New York State/American Program. He completed residencies at the Zucker Hillside Hospital in Queens and the Albert Einstein College of Medicine’s Long Island Jewish Health System. He then did a Fellowship at the children’s gender clinic at Boston Children’s Hospital with colleague Laura Edwards-Leeper. In 2013 he tool a similar positios at the Ann & Robert H. Lurie Children’s Hospital in Chicago. In 2015 he was recruited to Nationwide Children’s in Columbus, Ohio.

2018 Atlantic article

Leibowitz was quoted throughout a 2018 Atlantic article by Jesse Singal on the ex-transgender movement. Similar to the ex-gay movement, the people who promote the medicalized concepts of “desistance” and “detransition” believe that being trans is a disease that can resolve on it own or through medical intervention. Proponents of these loaded terms make several assumptions that are not value-neutral and therefore not scientific.

[Laura] Edwards-Leeper is hoping to promote a concept of affirming care that takes into account the developmental nuances that so often come up in her clinical work. In this effort, she is joined by Scott Leibowitz, a psychiatrist who treats children and adolescents. He is the medical director of behavioral health for the THRIVE program at Nationwide Children’s Hospital, in Columbus. Leibowitz has a long history of working with and supporting TGNC youth—he served as an expert witness for the Department of Justice in 2016, when President Barack Obama’s administration challenged state-level “bathroom bills” that sought to prevent trans people from using the public bathroom associated with their gender identity. Edwards-Leeper and Leibowitz met at Boston Children’s, where Leibowitz did his psychiatry fellowship, and the two have been close friends and collaborators ever since.

While it’s understandable, for historical reasons, why some people associate comprehensive psychological assessments with denial of access to care, that isn’t how Leibowitz and Edwards-Leeper view their approach. Yes, they want to discern whether a patient actually has gender dysphoria. But comprehensive assessments and ongoing mental-health work are also means of ensuring that transitioning—which can be a physically and emotionally taxing process for adolescents even under the best of circumstances—goes smoothly.

[…]

Scott’s assessment process centered mostly on the basic readiness questions Edwards-Leeper and Leibowitz are convinced should be asked of any young person considering hormones. 

[…]

But progressive-minded parents can sometimes be a problem for their kids as well. Several of the clinicians I spoke with, including Nate Sharon, Laura Edwards-Leeper, and Scott Leibowitz, recounted new patients’ arriving at their clinics, their parents having already developed detailed plans for them to transition. “I’ve actually had patients with parents pressuring me to recommend their kids start hormones,” Sharon said.

[…]

Leibowitz noted that a relationship with a caring therapist may itself be an important prophylactic against suicidal ideation for TGNC youth: “Often for the first time having a medical or mental-health professional tell them that they are going to take them seriously and really listen to them and hear their story often helps them feel better than they’ve ever felt.”

[…]

“Would you rather have a live daughter or a dead son?” is a common response to such questions. “This type of narrative takes an already fearful parent and makes them even more afraid, which is hardly the type of mind-set one would want a parent to be in when making a complex lifelong decision for their adolescent,” Leibowitz said.

Johanna Olson-Kennedy, a physician who specializes in pediatric and adolescent medicine at Children’s Hospital Los Angeles and who is the medical director of the Center for Transyouth Health and Development, is one of the most sought-out voices on these issues, and has significant differences with Edwards-Leeper and Leibowitz. In “Mental Health Disparities Among Transgender Youth: Rethinking the Role of Professionals,” a 2016 JAMA Pediatrics article, she wrote that “establishing a therapeutic relationship entails honesty and a sense of safety that can be compromised if young people believe that what they need and deserve (potentially blockers, hormones, or surgery) can be denied them according to the information they provide to the therapist.”

[…]

Perhaps a first step is to recognize detransitioners and desisters as being on the same “side” as happily transitioned trans people. Members of each of these groups have experienced gender dysphoria at some point, and all have a right to compassionate, comprehensive care, whether or not that includes hormones or surgery. “The detransitioner is probably just as scarred by the system as the transitioner who didn’t have access to transition,” Leibowitz told me. The best way to build a system that fails fewer people is to acknowledge the staggering complexity of gender dysphoria—and to acknowledge just how early we are in the process of understanding it.

Publications

Leibowitz, Scott (June 14, 2020). OPINION: J. K. Rowling and her inaccuracies about trans youth. Thomson Reuters Foundation News https://news.trust.org/item/20200614160303-acghe/

Leibowitz SF,  Lantos JD (2019). Affirming, Balanced, and Comprehensive Care for Transgender Teenagers. Pediatrics. June 2019, 143 (6) e20190995 https://doi.org/10.1542/peds.2019-0995

Janssen A, Scott Leibowitz SF, eds. (2018). Affirmative Mental Health Care for Transgender and Gender Diverse Youth: A Clinical Guide. ISBN 9783319783079

The research term for this is desistance. This has become a rather controversial discussion because the studies themselves vary in the populations they included and how they handled the children that were lost to follow up. 

Strang JF, Powers MD, Knauss M, Sibarium E, Leibowitz SF, Kenworthy L, Sadikova E, Wyss S, Willing L, Caplan R, Pervez N, Nowak J, Gohari D, Gomez-Lobo V, Call D, Anthony LG (2018). “They Thought It Was an Obsession”: Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents. J Autism Dev Disord. 2018 Dec;48(12):4039-4055. https://doi.org/10.1007/s10803-018-3723-6

Strang JF, Janssen A, Tishelman A, Leibowitz SF, Kenworthy L, McGuire JK, Edwards-Leeper L, Mazefsky CA, Rofey D, Bascom J, Caplan R, Gomez-Lobo V, Berg D, Zaks Z, Wallace GL, Wimms H, Pine-Twaddell E, Shumer D, Register-Brown K, Sadikova E, Anthony LG (2018). Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):885-887. https://doi.org/10.1016/j.jaac.2018.04.023

Calzo JP, Melchiono M, Richmond TK, Leibowitz SF, Argenal RL, Goncalves A, Pitts S, Gooding HC, Burke P (2017). Lesbian, Gay, Bisexual, and Transgender Adolescent Health: An Interprofessional Case Discussion. MedEdPORTAL. 2017 Aug 9;13:10615. https://doi.org/10.15766/mep_2374-8265.10615

Exhibit 37: Expert Declaration of Scott F. Leibowitz, MD. United States of America v. State of North Carolina, et al. (2017). No. 1:16-cv-00425 [PDF] https://www.aclu.org/sites/default/files/field_document/de_076-37_-_leibowitz_decl_iso_mot_for_pi_us_07-06-2016.pdf

Edwards-Leeper L, Leibowitz SF, Sangganjanavanich VF (2016). Affirmative practice with transgender and gender nonconforming youth: Expanding the model. Psychology of Sexual Orientation and Gender Diversity 3(2):165-172 https://doi.org/10.1037/sgd0000167

Simons LK, Leibowitz SF, Hidalgo MA (2014). Understanding gender variance in children and adolescents.Pediatr Ann. 2014 Jun;43(6):e126-31. https://doi.org/10.3928/00904481-20140522-07

Leibowitz SF, Telingator C (2012). Assessing gender identity concerns in children and adolescents: evaluation, treatments, and outcomes. Curr Psychiatry Rep. 2012 Apr;14(2):111-20. https://doi.org/10.1007/s11920-012-0259-x

Leibowitz SF, Spack NP (2011). The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives. Child Adolesc Psychiatr Clin N Am. 2011 Oct;20(4):701-24. https://doi.org/10.1016/j.chc.2011.07.004

Stoddard J, Leibowitz SF, Ton H, Snowdon S (2011). Improving medical education about gender-variant youth and transgender adolescents. Child Adolesc Psychiatr Clin N Am. 2011 Oct;20(4):779-91. https://doi.org/10.1016/j.chc.2011.07.008

Ford, Zack (July 5, 2018). Scholars dismantle the myth policing trans kids’ genders. ThinkProgress https://archive.thinkprogress.org/scholars-dismantle-the-myth-policing-trans-kids-genders-55f78df59c50/

[from original version] In his Atlantic story, Singal also justified his skepticism of letting kids transition by relying heavily on two care providers, Scott Leibowitz and Laura Edwards-Leeper, who believe in the desistance myth, and whom Singal has cited in the past. Despite the fact that their views are shared by few other experts, Singal has suggested in the past that their theory is mainstream.

CORRECTION: An earlier version of this article referenced child and adolescent psychiatrist Scott Leibowitz and his colleague Laura Edwards-Leeper in a context that misrepresented their work. It has been updated to remove reference to them.

References

Association of American Medical Colleges. “Teaching Gender Identity and Transgender Health with Scott Leibowitz.” (October, 2015). AAMC Videos and Resources. Washington, DC: Association of American Medical Colleges. 

Borchardt, Jackie (February 11, 2020). Ohio bill would punish doctors who help transgender kids transition. Opponents decry ‘fear-mongering.’ Cincinnati Enquirer. https://www.cincinnati.com/story/news/2020/02/11/ohio-bill-would-punish-doctors-who-provide-gender-affirming-treatment-transgender-kids/4715761002/

Gurvis, Sandra (November 21, 2018). Dr. Scott Leibowitz is Caring for Transgender Youth. Columbus Monthly https://www.columbusmonthly.com/lifestyle/20181119/caring-for-transgender-youth

Korry, Elaine (August 19, 2016). Transgender Youth Using Puberty Blockers. KQED https://www.kqed.org/futureofyou/226462/transgender-youth-using-puberty-blockers https://www.pbs.org/newshour/nation/puberty-blockers-may-improve-mental-health-transgender-adolescents

Moroney, Murphy (February 8, 2021). A Pediatric Psychiatrist Explains the Best Way to Talk to Kids About Gender and Pronouns. Popsugar. https://www.popsugar.com/family/how-to-discuss-gender-preferred-pronouns-with-kids-48135634

Pappas, Stephanie (February 20, 2012). Mental Health Problems Plague Transgender Kids. LiveScience https://www.livescience.com/16110-transgender-teen-mental-health.html

Savage, Rachel (November 25, 2019). U.S. lawmakers weigh bans on trans youth treatments. Reuters https://www.reuters.com/article/us-usa-lgbt-health-trfn-idUSKBN1XZ26C

Shute, Nancy (November 12, 2014). Training The Next Generation Of Doctors To Get LGBT Health Right. NPR https://www.npr.org/sections/health-shots/2014/11/12/363319642/training-the-next-generation-of-doctors-to-get-lgbt-health-right

Singal, Jesse (July 2018). When a child says she’s trans. The Atlantic. https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

Perry, Kimball (November 5, 2017). Love and acceptance help transgender teen’s journey. The Columbus Dispatch https://www.dispatch.com/news/20171105/love-and-acceptance-help-transgender-teens-journey

Resources

Twitter (twitter.com)

Nationwide Children’s (nationwidechildrens.org)

Association of American Medical Colleges (aamc.org)

Teaching Gender Identity and Transgender Health with Scott Leibowitz