Dr. Rachel Levine Is Uninformed, Or Worse

People with Gender-Critical views like mine are constantly told that “the science” is unequivocal on this issue and in favor of “gender-affirmative care.”

Dr. Rachel Levine
Dr. Rachel Levine

Assistant Secretary of Health, Dr. Rachel Levine, who is a Trans-female, and the highest-ranking transgender member of the federal government dismisses those of us who criticize new federal guidelines that recommend “gender-affirming” care for transgender minors — saying that no responsible doctors oppose it.

Here’s a NY Post article with more details of her criticism.

A few days ago, Dr. Levine made the following comment to National Public Radio (NPR)

"There is no argument among medical professionals - pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc -- about the value and the importance of gender-affirming care." 

To suggest that “the science is settled” on this issue is patently false.

Here is a recent peer-reviewed and heavily researched article with links to more studies than you could ever read on the subject.

Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults. Published in the Journal of Sex & Marital Therapy.

A few important findings.

In less than a decade, the western world has witnessed an unprecedented rise in the numbers of children and adolescents seeking gender transition. Despite the precedent of years of gender-affirmative care, the social, medical and surgical interventions are still based on very low-quality evidence. The many risks of these interventions, including medicalizing a temporary adolescent identity, have come into a clearer focus through an awareness of detransitioners. 

When uncertain parents of children and teens consult their primary care providers, they are usually referred to specialty gender services. Parents and referring clinicians assume that specialists with “gender expertise” will undertake a thorough evaluation. However, the evaluations preceding the recommendation for gender transition are often surprisingly brief (Anderson & Edwards-Leeper, 2021) and typically lead to a recommendation for hormones and surgery, known as gender-affirmative treatment.

Despite the widely recognized deficiencies in the evidence supporting gender-affirmative interventions (National Institute for Health & Care Excellence, 2020a; 2020b), the process of obtaining informed consent from patients and their families has no established standard. 

Social transition, hormones, and surgeries are unproven in a strict scientific sense, and as such, to be ethical, require a thorough and fully informed consent process.

...the dramatic growth in demand for youth gender transition witnessed in the last several years that has led to a perfunctory informed consent process. A rushed process does not allow for a proper discussion of not only the benefits, but the profound risks and uncertainties associated with gender transition, especially when gender transition is undertaken before mature adulthood.

Although the incidence of natal males asserting a trans identity in adolescence has significantly increased, the dramatic increase is driven primarily by the natal females requesting services. Many suffer from significant comorbid mental health disorders, have neurocognitive difficulties such as ADHD or autism or have a history of trauma.

To respond to growing demand, an innovative informed consent model of care has been developed. Under this model, mental health evaluations are not required, and hormones can be provided after just one visit following the collection of a patient’s or guardian’s consent signature....we believe this model is the antithesis of true informed consent, as it jeopardizes the ethical foundation of patient autonomy. Autonomy is not respected when patients consenting to the treatment do not have an accurate understanding of the risks, benefits, and alternatives.

It is common for gender-affirmative specialists to erroneously believe that gender-affirmative interventions are a standard of care. Despite the increasingly widespread professional beliefs in the safety and efficacy of pediatric gender transition, and the endorsement of this treatment pathway by a number of professional medical societies, the best available evidence suggests that the benefits of gender-affirmative interventions are of very low certainty and must be carefully weighed against the health risks to fertility, bone, and cardiovascular health.

The ‘transition or suicide’ narrative falsely implies that transition will prevent suicides. [N]either hormones nor surgeries have been shown to reduce suicidality in the long-term.

Full Article at this link.

For those of you sitting on the fence about where the science comes down on this issue (forget the ethical-religious questions for a moment), you need to read this article published in a medical journal.

Abigail Shrier questions the Secretary…