Category: Health Care

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When Science Silences Itself: Censorship in Gender Medicine Research

In recent years, debates around gender medicine have become some of the most polarized in the scientific and cultural landscape. What was once the realm of cautious inquiry has, in many institutions, hardened into dogma. Researchers who raise empirical or ethical concerns about puberty blockers, cross-sex hormones, or surgical interventions for minors increasingly find their work censored or discredited—not through evidence, but through social pressure and editorial gatekeeping.

A new paper by J. Cohn in the Journal of Controversial Ideas shines a bright and uncomfortable light on this phenomenon.

In “Censorship of Essential Debate in Gender Medicine Research,” (see below) Cohn exposes a disturbing trend in modern medicine: the systematic censorship of scientific debate in the field of gender medicine. The piece reveals how leading medical journals and professional societies have created an echo chamber that suppresses scrutiny, silences dissent, and promotes ideology under the guise of science.

The Core Problem: Debate Is Being Shut Down

Cohn argues that medical research on gender dysphoria—especially regarding hormonal and surgical interventions for minors—has been overtaken by advocacy rather than evidence. The core claim is simple but explosive: major journals like JAMA and The New England Journal of Medicine routinely reject well-documented critiques of published research, allowing false or exaggerated claims to circulate uncorrected. Letters highlighting factual or methodological errors are blocked, and even platforms like PubPeer have removed accepted criticisms without explanation.

This, Cohn warns, is not merely academic malpractice—it is a corruption of science itself. When editors silence valid scientific debate, public policy and medical practice are shaped by untested assumptions and political pressure rather than by evidence.

What the Evidence Actually Shows

The article points to a striking fact: despite the confident tone of many advocacy-driven statements, there is no scientific consensus on the effectiveness of medical transition, especially for youth. Systematic reviews—the gold standard of evidence—consistently find the evidence base to be weak or of very low certainty. The long-term outcomes of puberty blockers, cross-sex hormones, and surgeries remain largely unknown.

Even basic questions about etiology, persistence, and predictors of benefit in gender dysphoria are unresolved. Yet, U.S. medical bodies have promoted these interventions as both safe and necessary—often claiming they are “lifesaving” while dismissing alternatives like psychotherapy or watchful waiting.

False Claims and the Refusal to Correct Them

Cohn provides concrete examples of misinformation that have been published and then protected from correction. Some articles claim that regret rates after transition are “low” or “rare,” despite the fact that true rates are unknown because of poor follow-up and incomplete data. Others assert that randomized controlled trials would be unethical—a claim that is scientifically indefensible, since experimental rigor is what distinguishes genuine medicine from ideology.

Cohn recounts instances where he attempted to submit brief corrections or letters to editors, only to see them rejected without explanation. One such letter challenging NEJM was dismissed; another, initially accepted by JAMA, was later withdrawn before publication. In both cases, his critiques were grounded in empirical evidence.

How Journals and Societies Reinforce Error

The article describes what Cohn calls a “closed loop” between medical journals and professional associations. Guidelines by groups like the American Academy of Pediatrics cite the very same uncorrected journal articles that overstate the evidence for gender transition. The result is a self-reinforcing cycle: advocacy-based claims become the official line, while attempts at correction are buried.

The International Picture: Caution Abroad, Ideology at Home

Outside the United States, several nations have already reevaluated their approach. Sweden, Finland, and the United Kingdom have all pivoted away from automatic medicalization toward a more cautious model emphasizing psychotherapy and holistic care. The 2024 Cass Review in the U.K. and a 2025 U.S. Department of Health and Human Services review both acknowledge the same reality: the evidence for pediatric gender medicine is extraordinarily weak.

Why This Matters

The censorship of debate in gender medicine is not just a matter of professional ethics—it directly affects vulnerable patients and the integrity of public trust in science. When unsupported claims about safety and efficacy are treated as settled facts, doctors cannot give truly informed consent, and policymakers are misled into endorsing experimental treatments for children.

Cohn concludes with a reminder drawn from JAMA’s own editorial policy: “The integrity of the scientific process hinges on the free exchange of scientific ideas grounded in rigorously conducted inquiry.” That principle, he argues, is being betrayed by the very institutions charged with upholding it.

The Way Forward

True science welcomes scrutiny. It is strengthened by disagreement and refined by debate. Cohn calls for the restoration of open, evidence-based discourse in gender medicine—a return to the first principles of inquiry: transparency, humility, and courage. Until that happens, medical journals risk losing what makes them credible in the first place.

The article ends with a simple warning that resonates far beyond gender medicine: when science silences itself, ideology rushes to fill the void.

You can download a PDF version of this article for easy sharing and reference.

Censorship of Essential Debate in Gender Medicine ResearchDownload

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Grace and Truth

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‘You Cannot Change Sex’: Veteran NHS Doctor Challenges Gender Medicine

Step into the Light

In a strongly worded open letter, Dr. Joseph Chrysostom warns young people against what he calls “deceptive” gender medical practices, including irreversible surgeries and hormone treatments. He claims these interventions do not create functioning sexual organs, but rather permanent wounds and dependencies on the medical system. He also accuses institutions of failing to protect youth and predicts growing accountability in the years ahead.

Open Letter to British Youth Considering Gender Surgery

Dear Young People, I am Dr. Joseph Chrysostom, a medical doctor who has served in the NHS for over 25 years. I am writing to you out of deep concern and genuine care — to warn you about what I believe to be some of the most harmful and deceptive medical practices currently happening in our country. These include the use of cross-sex hormones and surgeries such as vaginoplasty, orchidectomy, and phalloplasty, offered both within and outside the NHS. What I write here reflects my professional opinion and sincerely held belief based on my knowledge of human biology and surgical practice.

You have been told that you can “change sex.” But biologically, that is impossible. Every one of your body’s trillions of cells carries either XX or XY chromosomes — a genetic signature that cannot be altered by hormones or surgery. To claim otherwise is, in my view, deeply misleading. Any doctor or institution promising to “feminise” or “masculinise” the human body without changing its DNA is, in effect, deceiving you.

I believe this deception began early — in schools, through Relationship and Sex Education materials that claimed gender is fluid and that sex is “assigned at birth.”

That is false. Sex is determined at conception, and by the seventh week of foetal development, it is already biologically clear whether a person is male or female. By teaching that doctors might have “assigned” you the wrong sex, these materials planted a dangerous idea — one that could easily take hold during adolescence, a time when self-doubt and confusion are common.

In my view, this was not education but indoctrination. Schools were instructed to hide these matters from parents — the very people best placed to support you through emotional confusion. This isolation mirrors the pattern seen in cult-like ideologies: separating young people from those who love them most. Once detached from parental guidance, vulnerable youth become easy targets for ideologues and, later, for those in medicine who profit from these falsehoods. Sadly, some doctors, surgeons, endocrinologists and psychologists — knowingly or not — have become part of this system.

Cross-sex hormones are being prescribed despite well-documented long-term complications. Surgeons have begun to perform irreversible operations on healthy bodies. When challenged, the professional institutions — Royal Colleges, GMC, NHS England, and the Department of Health — all pass responsibility between themselves. No one will say these surgeries are not deceptive. Yet none will take accountability either.

Let me be clear about what these procedures truly involve:

Vaginoplasty does not create a vagina. It creates a deep surgical slit-like narrow space lined with skin. It is a wound tending to heal and contract, not an organ. It lacks the glands, microbiome, glycogen-rich inner lining, acidic pH (to protect against infections) and natural functions of a female reproductive tract.

Phalloplasty does not create a penis. It forms a mound of skin and fat from another part of the body. It cannot perform erection, emission, or ejaculation — the defining functions of male sexual anatomy.

Mastectomy cannot make a female chest into a male one. It leaves irreversible scars and removes healthy breasts permanently leaving you incapable of lactation. These are not restorative surgeries — they are destructive ones. In my opinion, they have the potential to turn healthy young people into lifelong patients, dependent on the medical system for repairs, revisions, and mental health support.

What you truly need is not surgery, but psychotherapy — compassionate, skilled counselling to help you understand and accept your biological reality.

You deserve truth, not ideology. You deserve to be treated with honesty, not with the promise of impossible transformations. I believe that within a few years, many of those who underwent these surgeries will express deep regret — but by then, it will be too late. Lost organs cannot be replaced. The physical and psychological scars are permanent.

I urge you: step away from the conveyor belt that starts in classrooms and ends in operating theatres. Parents and professionals across the world are now awakening to the dangers of gender ideology. Within the next few years this conveyor belt will be empty due to the alertness of current generation of parents.

Accountability is coming. I believe, those who performed, assisted, promoted, or profited from these procedures will one day have to answer for them. Thank you for reading this letter with an open mind. I write not to condemn you, but to protect you — before irreversible harm is done.

With sincerity and concern,
Dr. Joseph Chrysostom,
MBBS, MS (Gen Surg), FRCSEd GMC 5199143

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Step into the Light

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Suicide Shock and Study Correction

Originally posted Sept 5, 2021

Transgender activists often claim if the “affirmative care model” is not followed the mental health of those suffering from gender dysphoria will worsen and increase the likelihood of suicide.

Parents are shocked into action when told by health professionals that puberty blockers and cross sex hormones, and eventually “gender affirming surgery” may be the only way to prevent their children from committing suicide. Starting them on a medicalized pathway from their “sex assigned at birth” to the sex they now identify with is the most beneficial and humane course of action, parents are instructed.

[Please view this post which rebuts the “assigned at birth” fiction]

In 2019 one of the few major studies on this issue released its findings. The study analyzed health records of 2,679 Swedes diagnosed with gender dysphoria between 2005 and 2015 to determine whether hormonal or surgical treatments improved their mental health over time.  This was one of the first longitudinal studies done about the efficacy of cross-sex hormonal therapy and sex reassignment surgery. And the largest population study to date. Plus it was done in perhaps the most Trans-friendly country on the planet, Sweden.

The original study conducted by a researcher from the Karolinska Institute in Sweden and a researcher from the Yale School of Public Health was published in the American Journal of Psychiatry in 2019. (The Karolinska Institute is the same institute that awards the Nobel Prize in Medicine and in May advised its hospital to stop hormone treatments and surgery for young people under 18!) The study concluded that “Transgender individuals who undergo gender-affirming surgery are significantly less likely to seek mental health treatment for depression and anxiety disorders or attempt suicide in the years following the procedure.”

Still from the perspective of the “affirmers” the results were decidedly mixed.

We learned two things from this study.

The main finding of the study was that hormonal transition showed no signs of mental health improvement for “gender incongruent” patients. This “no improvement” finding was largely ignored by the news media and trans-activists.

Administering cross-sex hormones to gender confused folk did not improve their mental health.

But the 2019 study did show that gender affirming surgery improved the mental health of those in the study. Patients from 2005-2015 who underwent surgical procedures to assist their transition to the opposite sex showed an overall 8 percent improvement.

This was widely reported as evidence that the “affirmative care model” works!

You may think an 8% improvement for those who underwent radical irreversible surgery is not a lot to “hang one’s hat on.” But this result was widely used to denounce Gender Critical viewpoints like mine as anti-science. (read on)

Study Correction

That was then. This is now. (as of August 2020)

After criticism for the study’s flawed methodology, the American Journal of Psychiatry was forced to retract those findings. What was the flawed methodology? For starters: No control group! The researchers looked at a large group of transgender patients over a 10 year period, making it a good longitudinal study. But they failed to compare those results with a control group of transgender patients who had not undergone body altering surgery. Once that was done the rather small 8 percent improvement evaporated. 

“the results [of the reanalysis] demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts” - AJP correction

Surgery did not improve psychological well-being. It did not decrease suicide attempts relative to those transgender patients who went the non-surgical route. (Remember this is a study of Swedish patients in the most trans-friendly country on Earth so blaming unaccepting social factors as a cause for continued distress doesn’t work.)

Hormones & mutilating surgery did not improve outcomes for transgender patients!

Here’s a link to the correction. And here is an assessment by the Society For Evidence-Based Gender Medicine (SEGM) an international group of over 100 clinicians and researchers. Their assessment is worth your careful attention. For those of you interested in the details of the flawed methodology make sure you click on the “click here for more” link in the section labeled “Vigorous Debate Leads to Correction of Key Finding.”

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So, after the retraction how did the media respond?

Crickets….

Journalists, like scientists can be biased too.

But sadly parents are still being pressured by pediatricians, gender clinics and Trans-activists into accepting a single medicalized pathway if they want to prevent their kids from committing suicide.

In my research this past year I’ve noticed parents and confused young people hear the following statement all the time from social media influencers and medical professionals:

“Do you want a live “son” or a dead daughter?

That will cause any parent to sit up and take notice! But that is a bald assertion with no evidence to support it. Yes, there is a much higher incidence of suicide among this population but that is because they are psychologically troubled to begin with. Social transitioning, hormones and surgery doesn’t change that reality. My recommendation to parents is get non-affirming treatment and “hold your ground.” Your children and teens are confused.

You’ll meet some of those parents in my next post. They are distraught over the advice they and their children have been given by health care providers.

Obviously, it’s hard to know whether the flaws of the above study were just human error or whether the scientists involved desired a preferred outcome. If you read the end of my last post you’ll find one of our top Psychiatrists admitting that when it comes to questions about “Sex and sexual behavior” many scientists who view humans as infinitely malleable would rather not look too hard for empirical evidence to back up their claims. Ideology drives some of them, just like the activists.

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If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend a book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]