While public sentiment toward transgender people in the U.S. continues to warm, anti-transgender campaigners are exploiting the public’s uncertainty about trans youth to promote Florida-style bans on gender-affirming care.
Claims about the irreversible dangers of transition-related care were once the bread and butter of far-right pundits, they have officially entered the mainstream with Monday’s front-page story in The New York Times: “Pressing Pause on Puberty. Drugs Can Buy Time for Trans Youth. Is There a Cost?”
And the stakes couldn’t be higher. Boston Children’s Hospital has been on the receiving end of at least three bomb threats this year due to misinformation about health care for transgender youth being provided there.
The piece hinges on what the authors describe as “emerging evidence of potential harm” related to the use of puberty-suppressing medications for transgender youth. But transgender health experts say that the data referenced in the Times‘ reporting comes to a different conclusion. The Times’ analysis of this data is so misleading that some advocates are questioning the motives behind the piece.
I talked with three experts – a trans advocate and educator, a psychology researcher, and a gender-affirming healthcare provider – to better understand what the Times got wrong and why it matters. Their criticisms touched on a range of issues including the data, the sources, and the framing of the issues. Many of these concerns are echoed by transgender people and care providers across the country.
“Basically, any way you slice it, this is not investigative journalism,” said Dr. Quinnehtukqut McLamore,
who has a Ph.D. in Psychology and conducts research at the University of Missouri at Columbia. “This is storytelling and editorializing from science they – at best – don’t understand because they don’t apply a logical lens to it.”
Critics of the Times piece said the reporters did get a few things right: More research on transgender health topics is needed. The reticence of drug companies to conduct research with transgender people creates barriers for FDA approval. Bone scans are beneficial for youth before and during treatment with puberty blockers.
And the most concerning is the fear that research findings could be exploited in the current political climate.
The Times article is itself a clear example of this exploitation in action and is arguably more dangerous than the transparently transphobic content published by opponents of trans rights. By echoing their claims in an ostensibly objective news outlet with a large, mainstream audience, the authors lend legitimacy to hateful extremists.
Many of the false claims promoted by those who believe gender-affirming care is tantamount to child abuse are presented to readers as if they’re objective fact. While this would be dangerous enough in an opinion piece, the Times framed this reporting as a well-vetted public service piece:
As growing numbers of adolescents who identify as transgender are prescribed drugs to block puberty, the treatment is becoming a source of confusion and controversy.
We spent months scouring the scientific evidence, interviewing doctors around the world and speaking to patients and families.
Here’s a closer look at what we found.
The celebratory response from far-right pundits is revealing. The Daily Wire‘s Matt Walsh, whose film What is a Woman? manipulates the documentary format in an attempt to legitimize harmful transphobic myths, took credit for “[forcing] the NYT to admit that puberty blockers are dangerous.”
We forced the NYT to admit that puberty blockers are dangerous. They're a decade late and deserve no credit or applause. But it's still great news because it shows that our movement is winning. We're dragging left wing institutions into the light, kicking and screaming.
— Matt Walsh (@MattWalshBlog) November 14, 2022
Jenn Burleton, director of the TransActive Gender Project at Lewis and Clark’s College of Education and Counseling, has watched media narratives about transgender people evolve over 35 years of advocacy work. She’s seen the damage anti-transgender rhetoric can do. As part of the college’s first-of-its-kind certificate program in Gender Diversity in Children and Youth, Burleton lectures on the origins and impacts of anti-transgender bias.
She was one of the experts interviewed for the Times article. But Burleton told LGBTQ Nation she was disappointed that the reporter declined to include any discussion of the forces behind the current campaign against gender-affirming care.
“I primarily discussed the immense amount of disinformation being spread about trans-affirming healthcare, specifically as it impacts adolescents and teens,” Burleton recalled. “[Megan Twohey] seemed very interested in looking into that, and I believed the story was going to have content that exposed the false claims being made in white nationalist media and in some state legislatures.”
Instead of delving into the well-documented rise in trans antagonism promoted by far-right religious and political groups, the brief mention of Burleton portrays her as a pushy activist, prodding healthcare providers and advocating for “early and easy access” to puberty-suppressing medication.
“That insinuation feeds right into the Tucker Carlson anti-trans narrative,” Burleton said.
‘Another Hit Piece’
Dr. AJ Eckert, who directs the gender-affirming care program for Anchor Health in Connecticut and teaches at Quinnipiac University’s school of medicine, described the report as “another hit piece against trans people.” He also expressed frustration about the timing of the story, which was published on the first day of Transgender Awareness Week.
“I don’t understand how a journalist in good faith can publish something like this,” Eckert told LGBTQ Nation. “Trans youth are a vulnerable target and this is just so extremely sh**ty.”
Far from clarifying confusion about the safety and efficacy of “puberty blockers” in easing gender dysphoria, the reporting fuels an increasingly vitriolic debate over the existential rights of transgender people. The most vocal opponents of prescribing medications like Lupron to temporarily suspend exogenous puberty – or puberty a person would go through absent puberty blockers – are not calling for a more cautious approach. Rather, they advocate for the eradication of transgender identities altogether.
As trans Harvard Law instructor Alejandra Caraballo pointed out on Twitter, “The anti-trans side doesn’t want research, they want us eliminated.”
The NYT claims to want more science and studies but then contributes to the same climate that chills more research and studies. Florida banned research as part of it's gender affirming care ban. The anti-trans side doesn't want research, they want us eliminated.
— Alejandra Caraballo (@Esqueer_) November 14, 2022
But no amount of research will make a difference if media outlets like the Times are unable or unwilling to accurately translate its findings and their significance.
“The entire article is based on the premise that puberty blockers are horrible for bone health,” Dr. Eckert explained. Through cherry-picked anecdotes and quotes, the story paints a picture of children being pushed into taking a dangerous and untested drug that might give them osteoporosis and which locks them into a medical transition process.
The Times describes one teen’s experiences:
During treatment, the teen’s bone density plummeted — as much as 15 percent in some bones — from average levels to the range of osteoporosis, a condition of weakened bones more common in older adults.
The anecdote elicits an emotional response, but there is no data to support the claim that puberty blockers are giving teenagers osteoporosis. Unfortunately, the average reader won’t dig into the cited research studies to fact-check these claims – they will simply trust that the Times’ interpretation of that data is accurate and presented without bias.
What Does the Data Say?
“Simply put, there’s no evidence in their review that puberty blockers lower adolescents’ bone mineral density at all. And here’s how I know this: [the studies] say so,” Dr. McLamore explained.
They explained that the difference in bone density between trans youth on blockers and their cisgender peers is attributable to the difference in exposure to sex hormones. Also, trans youth are more likely to have lower bone density before starting puberty blockers, due to a dysphoria-related lack of exercise and nutritional deficiencies.
“Puberty causes an increase in bone density. Blocking puberty will then halt this increase; therefore, bone density will decrease in these trans youth compared to cis youth, an expected result,” Dr. Eckert explained. “Trans youth treated with puberty blockers in early puberty have changes in bone health comparable to those of cis youth of their experienced gender.”
Also unfounded is the claim that gender-affirming care reinforces trans identity, as if healthcare providers are encouraging a bad habit by indulging a patient’s desire for medically-appropriate care.
“According to the gender-critical crowd, affirming a youth’s gender identity, whether socially and/or medically with blockers, causes a youth to double down on that identity. It’s an oft-cited argument to dissuade parents and school environments from affirming youths’ true identities,” Eckert explained. “There is precisely zero evidence that blockers ‘lock in’ a trans identity. Yes, many trans youth start gender-affirming hormones. Trans adolescents know who they are. Those youth who started on blockers and moved on to gender-affirming hormones do so because they are trans.”
To force youth to delay transition in the hopes that puberty will reaffirm their sex assigned at birth is cruel and potentially deadly. Heightened gender dysphoria is associated with an increased risk of suicidality.
“Puberty does not ‘help clarify gender,’” Eckert said. “For many of us, puberty can be highly traumatic and irreversible; waiting to see if gender dysphoria resolves is not a neutral response.”
On the contrary, puberty blockers can prevent the need for future surgeries by preventing the development of noncongruent sex characteristics like breasts or facial hair.
What’s the Harm?
As many transgender folks have observed, the study authors and named sources include a cast of familiar antagonists. And while the Times mentions in passing that some of these sources have testified in favor of state-level bans on gender-affirming care, their names are not cited in connection with the article’s dubious claims, leaving readers to take them at face value.
Of the 50-plus sources the authors say they interviewed, only about a dozen are named in the article. According to the Times, this is because several sources requested to not be named and more than a dozen declined the interview. Instead, they are cited under the syntactical cover of “some experts,” significant enough to matter but not specific enough to be held accountable.
Why do these concerns matter? Because they have a real-world impact. A well-functioning press has the power to “comfort the afflicted and afflict the comfortable.” But a reckless reporter’s pen can be just as harmful as a drunk surgeon’s scalpel.
The article repeatedly and uncritically leans into the talking points of anti-transgender extremists, parroting their narratives without examining their sources. As a result, advocates of gender-affirming care are finding themselves in a never-ending game of Whack-a-Myth.
“I’m tired of repeatedly refuting the same points,” Eckert said, noting that they have been so busy responding to the false claims that they have gotten little sleep since Monday. “But I have to keep doing it until mainstream media starts platforming trans voices alongside these biased and transphobic editorials.”
Though public trust in media is on the decline, the Times has managed to maintain a reputation as a trustworthy news source, particularly among the sort of well-educated, left-leaning readers who are most likely to support transgender rights.
The credibility of this story is also bolstered by its byline. Lead author Megan Twohey is best known for helping break the Harvey Weinstein sexual assault story. A film about her journalistic accomplishments, She Said, hits theaters this week. Co-author Christina Jewett is an award-winning journalist who focuses on issues including drug safety. Readers can’t be blamed for seeing them as trustworthy.
“The harm done by this article is not that it reveals disagreement about treatment methodologies among a relatively small group of providers and researchers. Disagreement and unbiased, ethical discussion about healthcare is imperative to delivering improved healthcare,” TransActive’s Burleton explained. “The harm done by this article is that it implies that trans-affirming providers and advocates oppose asking questions that will improve trans-affirming healthcare. The article ignores the [denial] that anti-trans zealots – including some care providers/’experts’ – have about the very existence or authenticity of gender expansive identity.”
Whether the author’s missteps are due to malice or ignorance is up for debate. But it is worth noting that neither of the reporters has much experience covering transgender issues. That much is clear from the language they use to describe the experience of being transgender. The authors conflate gender dysphoria and trans identity with “the discomfort of puberty” and cite an interest in wearing dresses as evidence that a child must not have a masculine gender identity. At one point, they go so far as to describe supporters of gender-affirming care as “enthusiasts.”
The Times owes transgender people an apology – and some serious soul-searching – after platforming anti-trans extremism under the guise of investigative journalism. While Monday’s front-page story purports to be a thorough analysis of the scientific research, it traffics in a dangerous misrepresentation of the data. It’s not the first problematic piece from the Times, but it is the most high profile. And while other media outlets are guilty of similar missteps, reporters like Twohey and Jewett (and their editors) should be capable of better. And if they aren’t, perhaps the Times should consider assigning these stories to transgender journalists.