Documentary Exposes Politics Trumping Science in Child Transgender Medicine

The “follow the science” movement has an awkward relationship with medical evidence.

5 minute read

Independent journalist Jennifer Block has been reporting on contested areas of medicine and public health for two decades, on topics as wide-ranging as maternity care, dangerous contraceptives, alternative medicine, and how courts handle medical evidence. For several years, she has been covering one of the most controversial topics in public health—transgender medicine for children—publishing several revealing investigations in The BMJ and the Free Press, as well as essays in outlets such the Boston Globe.

Block recently partnered with filmmaker Eric Vaughan on a mini-documentary examining the medical guidelines for gender treatments in youth, which are presented as “science-based,” despite lacking scientific rigor. In fact, she uncovered political meddling by the Biden administration and medical societies to promote gender change in children without hard facts.

I caught up with Jennifer while she was on the road, traveling the East coast, to discuss her new film and US politics around transgender medicine for children. After our exchange, please watch her short film: “Inside the fight over gender treatments in youth.”

THACKER: This film is rather shocking, how it presents a much different picture than we get from legacy media of the behind-the-scenes machinations to promote youth gender medicine as science-based. What got you interested in this topic?

BLOCK: I had been reporting on health-related issues for many years and had seen up close how medical orthodoxy and conflict of interest can overshadow evidence, how a practice or device can persist in spite of poor outcomes—and cause net harm. When I was promoting my last book I started getting questions about puberty blockers and trans medicine generally, and I was honest at the time that I hadn't looked into it. But as I did, I found a lot more disagreement and contradictory evidence than what was being relayed by advocates and reported by legacy media.

THACKER: It’s pretty obvious that traditional American liberals who champion “follow the science” are bending reality to promote gender medicine in kids. How did these people end up this way?

BLOCK: Everyone in our film is coming from a left/liberal background or point of view. Many of the most dogged journalists and outspoken activists are lefties. Polls do show that liberals skew more committed to the “affirming protocol”, but both parties have played their part in politicizing science over the last few decades. Having said that, I think what happened here is that a novel treatment was wrapped in a banner of LGBTQ rights. And it happened at a time of increasing illiberalism on the left, in which questions and debate got coded as reactionary.

On the right, meanwhile, criticism of gender medicine is often unnecessarily cruel, intolerant, and inflammatory: "grooming" "mutilation" "child abuse". And Trump has entrenched progressives' resistance by targeting trans service members, pledging to prosecute doctors, etc….

But there's more than politics driving this. Journalists trust medical experts and organizations, as do busy physicians. And the general public believes what they read and hear repeated in story after story over years. The real question to me is why the medical establishment has proved itself so vulnerable to marketing and advocacy claims. Look at opioids, for another example.

I covered a contraceptive device that was sold as "minimally invasive"—it was a novel product being permanently implanted in the fallopian tubes, despite having gone through minimal testing. You and I have both reported on the twin problems of overdiagnosis and overtreatment. This was supposed to be the era of evidence-based medicine.

THACKER: European liberals led the way on transgender medicine, but then pulled back in recent years, after re-examining the medical evidence. America is in a very unique place by ignoring the science. Do you think the US is just lagging behind Europeans or is there something unique happening in the States?

BLOCK: What's different in the US is that we have no centralized system and a profit seeking one at that. This creates a lot of what academics call "perverse incentives." The system favors haste and intervention. And it has become clear that when this protocol migrated to the US, the extensive psychotherapy and assessment that was part of the Dutch experiment shrunk immediately. Over years, "affirming care" evolved into a consumer-led "informed consent" model, essentially based on patient demand. Even by very young patients.

Unlike European countries, the US has few guardrails once a treatment has become standard of care. One of them is litigation, which we're seeing. Our political polarization further hinders correction because any information from "the wrong side" is tainted and dismissed.

THACKER: The New York Times has zigzagged all over the place on this topic, at times exposing the lack of evidence for these interventions, then pivoting back to promoting the false idea that there’s a “consensus” that transgender medicine saves kids. What is going on here?

BLOCK: The New York Times was not on my career path, so I can only imagine that like any traditional paper there are firewalls between news, investigations, and opinion. What's shocked and baffled me more are the calls from journalists for their peers to stop reporting on a medical issue that affects young people's future sexual function and health.