Health Care

Major Swedish Hospital Bans Puberty Blocking for Gender Dysphoria

(Sergey Tinyakov/Getty Images)

The actual science is beginning to overcome transgender ideology. First, the U.K.’s National Institute for Health and Care Excellence — basically the NHS’s decision-maker for what to cover — determined that there was “very low” evidence of benefit to allow children with gender dysphoria to have their natural puberty blocked — which is an “off label” use of those drugs, by the way.

Now, Karolinska Hospital, a major health institution in Sweden, is stopping their use. First, there is little scientific to support such interventions. From the hospital’s official statement:

In December 2019, the SBU (Swedish Agency for Health Technology Assessment and Assessment of Social Services) published an overview of the knowledge base which showed a lack of evidence for both the long-term consequences of the treatments, and the reasons for the large influx of patients in recent years.

Even more importantly, the potential for harming the patient physically is very real:

These treatments are potentially fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis. This makes it challenging to assess the risk/benefit for the individual patient, and even more challenging for the minors and their guardians to be in a position of an informed stance regarding these treatments.


As a consequence the hospital wisely enacted the following policy:

In light of the above, and based on the precautionary principle, which should always be applied, it has been decided that hormonal treatments (i.e., puberty blocking and cross-sex hormones) will not be initiated in gender dysphoric patients under the age of 16.

For patients between ages 16 and 18, it has been decided that treatment may only occur within the clinical trial settings approved by the EPM (Ethical Review Agency/Swedish Institutional Review Board). The patient must receive comprehensive information about potential risks of the treatment, and a careful assessment of the patient’s maturity level must be conducted to determine if the patient is capable of evaluating, and consenting to, the treatment.

Maybe the American Academy of Pediatrics will also come to its senses and reconsider that organization’s misguided policy supporting puberty blocking. Alas, I am not holding my breath. Transgender ideology sparked an acute moral panic that — more than in-depth scientific research — led to allowing puberty blocking of gender-dysphoric children.

Now — will the usual woke major corporations organize a boycott of Sweden for being “transphobic?” Or is such bullying reserved exclusively for the U.S.?

National Security & Defense

Where Are Republicans on Afghanistan Anyway?

A U.S. Marine walks near Afghan National Army soldiers during training in Helmand Province, Afghanistan, July 5, 2017. (Omar Sobhani/Reuters)

As Isaac Schorr noted earlier, one sideshow of the debate over Liz Cheney’s position in the House leadership has been the claim that she should go because her foreign-policy views are no longer in sync with the party’s, an argument made with varying degrees of sincerity.

The biggest recent divide between Republican hawks and doves has concerned the pending withdrawal from Afghanistan. If Republican voters want out of the country and it’s important for the party’s leadership to reflect their sentiment, then there’s a bigger problem than Cheney: The top Republicans on the House Armed Services Committee and the House Foreign Affairs Committee have both expressed support for keeping troops in Afghanistan. So have the top Republicans on the Senate Armed Services Committee and the Senate Foreign Relations Committee. So has the Senate’s Republican leader.

There’s surprisingly little public polling on what Republican voters think about it. In an October 2019 poll, 46 percent of Republicans wanted a decrease in troop levels or a full and rapid withdrawal while 34 percent wanted to keep current troop levels. In another poll a few weeks ago, 52 percent of Republicans backed President Biden’s planned withdrawal while 33 percent disagreed. Unsurprisingly, Democrats were more supportive of Biden’s policy. Both of these polls are notable for the large fraction of undecideds.

A few conclusions from those polls: 1) Republican voters have diverse opinions on Afghanistan but lean against staying. 2) Republicans in leadership positions in Congress tend to be more hawkish than their voters on Afghanistan. 3) You can favor or oppose Biden’s withdrawal while being within the mainstream of the opinion of Republican voters.

Law & the Courts

Another Federal Court Invalidates the Eviction Moratorium

Centers for Disease Control and Prevention headquarters in Atlanta, Ga. (Tami Chappell/Reuters)

Our Brittany Bernstein reports that a federal district judge in Washington, D.C., has invalidated the eviction moratorium ordered by the Centers for Disease Control, initially during the Trump administration, and recently extended (for the second time) during the Biden administration. It is now set to run through June 30.

In her 20-page opinion, Judge Dabney L. Friedrich (a Trump appointee) observes that hers is only the most recent of several rulings holding that the CDC exceeded its statutory authority (two district court decisions go the other way, at least at the preliminary injunction stage).

As Brittany points out, the issue before Judge Friedrich was statutory, viz., whether the CDC exceeded the authority given it by Congress to make rules to combat the spread of communicable disease. Judge Friedrich persuasively reasons that Congress empowered the agency to prescribe conditions related to “specific targets” — basically, objects or animals — that could be sources of infection. That is far afield from prohibiting owners from evicting tenants who don’t pay rent.

Americans should disturbed, though not surprised, by the government’s contention that Congress has empowered the CDC to decree any regulation, no matter how attenuated, that unelected government experts, in their wisdom, deem necessary to suppress infectious disease.

Friedrich observed that, in addition to the statutory cases, a federal district court in Texas ruled that the government lacks the constitutional authority to order a nationwide moratorium on evictions. Back in mid-March, I wrote about that case, decided by Judge J. Campbell Barker, another Trump-appointee, here.

In light of the Justice Department’s position in the statutory case in Washington, it’s worth reiterating what I related about Justice Department’s position in the constitutional case:

In the end, there is only one reason I think Judge Barker’s ruling has a chance of standing: The sheer arrogance exhibited by federal officials at the suggestion that the Constitution limits their power.

Before issuing his opinion, the judge conducted oral argument between the parties. In response to his questions, the Justice Department admitted that COVID-19 was merely the excuse used — the opportunity exploited — by the federal government in dictating what owners may do with their property. The judge asked: What if there were no COVID-19? Could Congress forbid evictions because of some other reason it decided was important? A reason that had nothing whatsoever to do with commerce?

The Justice Department lawyer asserted that merely by invoking the Commerce Clause — Washington’s own talisman — the federal government could suspend residential evictions for any reason. Judge Barker was struck by the government’s proclamation that any reason includes an agency’s subjective view of what “fairness” calls for.

For that alone, the courts — the Supreme Court especially — should rethink the monster they’ve created. They should . . . but they probably won’t.

Politics & Policy

Kevin McCarthy Actively Undermined Liz Cheney’s Ability to Serve in Leadership

House Minority Leader Kevin McCarthy (R., Calif.) speaks to the media during a briefing on Capitol Hill in Washington, D.C., March 11, 2021. (Joshua Roberts/Reuters)

If she wanted to stay honest about the legitimacy of the election and about Trump’s election lies, that is.

There is a line of thought according to which Cheney should have been more like Mitch McConnell and just tried to move on. I have always found that possibility unrealistic, for the reason that, as Ramesh notes in his Bloomberg Opinion column, Trump has no interest (in either sense) in fading away. Sure, it’s possible not to respond to every little provocation. But Trump’s campaign to perpetuate demonstrably false conspiracy theories, to maintain that Mike Pence could somehow have thrown out the whole election, to primary and otherwise avenge himself upon elected officials who stood up to him with integrity, etc., is inveterate and continuing.

But the thing is, even if you grant that Republicans might have suffocated Trump by ignoring him, this isn’t what Kevin McCarthy wanted to do. Instead he made a pilgrimage to Mar-a-Lago on January 28, posed for a lovely photo with the former president, and welcomed Trump’s help in taking back the House. McCarthy has also dissembled when asked about January 6, as the editors of NR observe in the current print issue:

On January 6, in the midst of the Capitol Hill riot, House minority leader Kevin McCarthy called President Trump, urging him to use his influence to stop it. McCarthy later repeated to several members of his caucus, including Representative Jaime Herrera Beutler, Trump’s initial comment: “Well Kevin, I guess these people are more upset about the election than you are.” Sarcastic, belittling, the president tried to wrong-foot a congressional ally about an attack on Congress. Three and a half months later, Fox host Chris Wallace asked McCarthy about the remark. “Is that what President Trump said to you?” McCarthy replied with generalities. But Wallace pressed him: “I’m asking you specifically, did he say to you, ‘I guess these people are more upset’?” “No, listen,” McCarthy answered, “my conversations with the president are my conversations with the president.” If Trump had told McCarthy no such thing, loyalty and honesty would unite and McCarthy would stoutly deny it. His evasion can only mean: Yup, Trump said it. Let the record show.

If Cheney should have acted more like McConnell, McCarthy should have done so first. Instead he helped create a situation in which it became impossible for Cheney to stay on his team while remaining true to her conscience and true to the truth.


Trumpism as Threat to Religious Conservatives

Former President Donald Trump speaks at the Conservative Political Action Conference in Orlando, Fla., February 28, 2021. (Joe Skipper/Reuters)

Donald Trump has endorsed New York congresswoman Elise Stefanik to replace Liz Cheney as chair of the House Republican caucus.

“Liz Cheney is a warmongering fool who has no business in Republican Party Leadership” Trump said in a statement. “We want leaders who believe in the Make America Great Again movement, and prioritize the values of America First. Elise Stefanik is a far superior choice, and she has my COMPLETE and TOTAL Endorsement for GOP Conference Chair. Elise is a tough and smart communicator!”

This is an odd argument for Trump to make. Elise Stefanik voted against President Trump’s agenda items far more often than Cheney, and Stefanik is just as much a hawk as Cheney. She voted in opposition to Trump’s withdrawal from Afghanistan. She voted for the Paris Climate Accords and to end the border emergency declaration. She also voted for the Equality Act, a sweeping piece of legislation that would dramatically weaken religious-liberty protections in the face of LGBT claims.

Many religious conservatives have embraced Donald Trump’s movement in the Republican Party. They saw an opportunity in the populist and nationalist drift of the party to get away from libertarianism, which they see as an electoral anchor, and an ally of big business, which is now a cultural enemy. In nationalism, they see a principle of cohesion or communitarianism. Some see it as an inchoate desire to enact the justice elements of Catholic social teaching.

But, there has always been another side to the Trumpian coin. Trump was always stronger among voters who identified as non-church-going Evangelicals. And there are political figures such as Stefanik who like Trump precisely because he will wave the rainbow flag and declare himself the “most pro-gay president” ever. They like him because his nationalist culture-warring can act as a replacement for the religious culture war. They are happiest when lowering taxes and denouncing political correctness.

We may really see this tested in a candidacy such as Caitlyn Jenner’s in California. Jenner is being advised by people from Trump’s orbit.

Politics & Policy

Caitlyn for California Launches

Caitlyn Jenner at the 2018 Vanity Fair Oscar Party, Beverly Hills, Calif., April 3, 2018 (Danny Moloshok/Reuters)

Caitlyn Jenner, the former Olympic gold-medal winner and TV star, has opened a campaign against California governor Gavin Newsom with a powerful three-minute video.

“The American Dream grew up here, yet career politicians and their policies have destroyed that dream,” Jenner says. “Career politicians and their policies have destroyed that dream, It’s been locked away, closed, shuttered, left in the dark, burned down. The government is now involved in every part of our lives. They’ve taken our money, our jobs, and our freedom.” Jenner is clearly running as the anti-lockdown candidate.

Jenner faces a steep climb to becoming governor. Newsom would have to be removed by a majority of voters in the November recall, and then Jenner would have to win a majority of votes in the race to replace him that’s being held at the same time. At least two other Republicans, businessman John Cox and former San Diego mayor Kevin Faulconer, are already running.

As tough as the odds are, the pandemic has eroded Newsom’s credibility. “This past year has redefined our career politicians as elitists,” Jenner says, as scenes of Newsom dining without a mask at a French restaurant and a maskless Nancy Pelosi visiting a hair salon are shown.

Jenner will appear at a town-hall meeting during Fox News’ Hannity program on Wednesday. It should be quite a show.


‘Catholics’ for (the) Choice (to Abort)

A woman receives an ultrasound (Ints Kalnins/Reuters)

I regret to inform you that the misnomer of an organization known as ‘Catholics for Choice’ is at it again:

If only there were some way to find out what the Catholic Church actually says about this matter. Oh wait, there is. Here is what the Catechism of the Catholic Church, the authoritative compendium of Church teaching, says about abortion (footnotes omitted):  

2270 Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person — among which is the inviolable right of every innocent being to life.

Before I formed you in the womb I knew you, and before you were born I consecrated you.

My frame was not hidden from you, when I was being made in secret, intricately wrought in the depths of the earth.

2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law:

You shall not kill the embryo by abortion and shall not cause the newborn to perish.

God, the Lord of life, has entrusted to men the noble mission of safeguarding life, and men must carry it out in a manner worthy of themselves. Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes.

2272 Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life. “A person who procures a completed abortion incurs excommunication latae sententiae,” “by the very commission of the offense,” and subject to the conditions provided by Canon Law The Church does not thereby intend to restrict the scope of mercy. Rather, she makes clear the gravity of the crime committed, the irreparable harm done to the innocent who is put to death, as well as to the parents and the whole of society.

2273 The inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation:

“The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights depend neither on single individuals nor on parents; nor do they represent a concession made by society and the state; they belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard every human being’s right to life and physical integrity from the moment of conception until death.”

“The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined. . . . As a consequence of the respect and protection which must be ensured for the unborn child from the moment of conception, the law must provide appropriate penal sanctions for every deliberate violation of the child’s rights.”

2274 Since it must be treated from conception as a person, the embryo must be defended in its integrity, cared for, and healed, as far as possible, like any other human being.

Prenatal diagnosis is morally licit, “if it respects the life and integrity of the embryo and the human fetus and is directed toward its safe guarding or healing as an individual. . . . It is gravely opposed to the moral law when this is done with the thought of possibly inducing an abortion, depending upon the results: a diagnosis must not be the equivalent of a death sentence.”

2275 “One must hold as licit procedures carried out on the human embryo which respect the life and integrity of the embryo and do not involve disproportionate risks for it, but are directed toward its healing the improvement of its condition of health, or its individual survival.”

“It is immoral to produce human embryos intended for exploitation as disposable biological material.”

“Certain attempts to influence chromosomic or genetic inheritance are not therapeutic but are aimed at producing human beings selected according to sex or other predetermined qualities. Such manipulations are contrary to the personal dignity of the human being and his integrity and identity” which are unique and unrepeatable.

Organizations and individuals may advocate abortion in our political system. But those that do so have no business calling themselves Catholic. 


How the Cronyism Sausage Is Made

Fred Hochberg, chairman and president of the Export-Import Bank of the United States, testifies before a Senate Banking, Housing and Urban Affairs Committee hearing on Capitol Hill in Washington on January 28, 2014. (Joshua Roberts/Reuters)

It is rare that we taxpayers get to see how crony deals are made in Washington. But what follows is an example provided to us by the Export-Import Bank.

Bear with me while I give you some background. In January, ExIm announced a deal extending a 90 percent guarantee of a $50 million supply-chain-finance facility from Greensill Capital to Freeport LNG Marketing, LLC, a Texas-based company. The loan was extended through supply- chain-finance (SCF) provider Greensill.

This came on the tail of a massive $4.7 billion ExIm deal to support the development and construction of an LNG project in Mozambique. Leading up to this project, the U.S. Liquefied Natural Gas (LNG) industry warned it would be hurt by its own government giving a leg up to a foreign LNG projects, and ExIm analysts warn the agency of security concern in the country that could lead to the demise of the project (that means the loss of taxpayers’ money). That didn’t matter, as the ExIm press release makes clear:

As the Mozambique LNG project marks further milestones, we want to underscore EXIM’s continuing commitment to this project,” said EXIM President and Chairman Kimberly A. Reed. “This project continues to serve as a great example of how a revitalized EXIM can help ‘Made in the USA’ products and services compete in a fierce global marketplace and counter competition from countries like China and Russia.

Two projects, two milestones, as the ExIm chairman loved to say — and two examples of the utter lack of due diligence performed by the agency when it is committed to serving powerful special interests.

This has become obvious in the wake of the Greensill’s collapse into insolvency only a few weeks after ExIm announced the deal and the Mozambique project’s operator Total had to declare force majeure, which allows the company to cancel contracts and withdraw all its staff because of a jihadist attack.

Indeed Greensill Capital was already under investigation last year by the German financial regulator, an investigation that led to a criminal complaint in March. Then, as the FT reports, “Greensill had been notified last September that its insurer would not extend cover for its lending, a move that ultimately led to its collapse.” (I wrote and testified about the lack of due diligence at ExIm here). A good summary is here:

When Exim directors approved the loan arrangement in September 2020, Greensill was already embroiled in controversy.

Credit Suisse had announced in June that it would review its Greensill-linked funds after clients withdrew more than $1.5bn when a string of debtors defaulted. The same month, a report revealed that Greensill’s borrowers included a company that runs a hotel in Mogadishu and a coal miner whose owner had settled several legal actions over alleged nonpayment of bills. In August it emerged that Greensill was under scrutiny from German regulators.

As for the Mozambique deal, the FT notes that “Exim Bank’s own analysis warned of security concerns that have since caused the project’s operator Total to declare force majeure following jihadi attacks.”

But beyond the lack of due diligence from ExIm staff, its board of directors, and its chairman, there is a serious cronyism at play here. It is not simply the type of cronyism that we are so used to with ExIm, such as the fact that many of the companies involved and getting preferential borrowing terms and rates through ExIm, like Freeport LNG, are large firms with no problem accessing capital.

As it happens, we just learned that it wasn’t in ExIm’s interest to figure out if the Greensill deal was even a good one, because the real reason for its existence was to placate the U.S. LNG industry and to get it to withdraw its opposition to the Mozambique deal.

This is how the FT describes the trade that took place at ExIm:

The Freeport LNG deal came after lobbying from the US LNG industry, including trade association LNG Allies, which had initially opposed Exim Bank’s Mozambique loan and pushed for ways in which the agency could help domestic producers.

LNG Allies withdrew its opposition to the Mozambique loan after an August 2019 meeting between groups representing the LNG industry and Exim Bank, according a letter released under transparency laws and provided to the FT by Source Material, a non-profit investigative journalism organisation.

According to the letter, LNG Allies pointed to the “active engagement” by Exim Bank “in developing creative financing solutions” to create opportunities for the LNG industry.

For the details on how that trade was made, read this.

The bottom line is this: ExIm extended the deal to Freeport LNG through Greensill (after being lobbied by former British prime minister David Cameron, apparently) in order to temper the anger of the U.S. LNG industry and to make it withdraw opposition to the Mozambique deal. In that context, due diligence over how sound lenders are is small potatoes.

And that, my friends, is how the crony sausage is made in Washington.

Politics & Policy

The Median House Republican’s Turn Against Cheney


It’s not MAGA Republicans in the House who are forcing Representative Liz Cheney (R., Wyo.) out of leadership. It’s Republicans who aren’t especially fond of former president Donald Trump but want to stop talking about him. I have a column at Bloomberg Opinion about what they’re thinking and why they may not get their wish.

Most Republican politicians would like Trump to fade away on his own without their doing anything that upsets him or his strongest supporters. They don’t want to join Trump in claiming that the Democrats stole the 2020 election. They don’t want to join Cheney in denying it, either. It will take a lot of luck to keep dodging through next year’s primaries.

Trump, meanwhile, seems unwilling to cooperate in fading away. A Republican Party that incorporates some of the changes he has wrought, moves on and succeeds is not in his interest. And even without a Twitter account, he has a flair for getting attention.

No Fate but What We Make

Members of the boy scouts carry an American flag during the Independence Day Parade in Independence, Iowa, July 4, 2011. (Jessica Rinaldi/Reuters)

Over at The Week, Samuel Goldman writes, “Arbitrary and confusing public health restrictions, political polarization, lurid media, and escalating culture war create a pervasive sense of disorientation verging on madness,” and he contends this is part of a historical cycle:

Several causes of this condition are contingent — not least the pandemic that put many aspects of normal life on hold. But there are deeper sources of our present freakout. In his 1981 study American Politics: The Promise of Disharmony, political scientist Samuel Huntington argued that American history is characterized by nervous breakdowns that recur approximately every 60 years. If our last

Politics & Policy

Trump Backs ‘Warmongering’ Elise Stefanik to Replace Liz Cheney


At last, we find ourselves on the cusp of ridding the Republican Party of the warmongering “neocons” that have plagued it for so long. “We” being a euphemism for Donald Trump, who has denounced GOP House conference chair Liz Cheney as “a person that loves seeing our troops fighting” — that’s the only possible explanation for opposing troop withdrawals — and only utters her name after applying the “warmonger” epithet before it.

It looks more and more likely that Trump will get his most fervent wish and Cheney will be removed from her position in leadership. It also seems probable that Representative Elise Stefanik, whom Trump has endorsed, will replace her.

Remember, this is a principled fight over foreign-policy issues.

Politics & Policy

Jeff Flake v. Mitch McConnell


Of course, Liz Cheney isn’t lying about the 2020 election, and she isn’t the provocateur on this question — Trump is. But she had won the first time around, and all she had to do was be a little politic — something often required of politicians — and she wouldn’t be on the verge of getting dumped from leadership next week, which is looking like a near-certainty. Neither Jeff Flake nor Mitch McConnell has lied about Donald Trump, but one immolated his career, and one has survived to fight for a post-Trump future within the party. Cheney looks as if she’s chosen the Flake route, which is admirable on its own terms, but not consistent with serving in House Republican leadership.


Oh, Great — Baseball Got Even More Boring 


Long-time readers who are baseball fans know I’ve been complaining about the length of games for a long time, but now MLB has added a new twist: astonishing little offense during the interminable games.

Maybe this is just an early-season trend, but it’s pretty remarkable. From an AP report:

Major league batters are hitting just .232 overall through April, down from .252 two years ago and under the record low of .237 set in the infamous 1968 season that resulted in a lower pitcher’s mound.

The Mendoza line may not mean what it used to.

Strikeouts have averaged 9.06 per team per game, on pace to set a record for the 13th consecutive full season — up from 8.81 two years ago and nearly double the 4.77 in 1979. Strikeouts already are 1,092 ahead of hits, just three years after exceeding hits for the first time over a full season.

Hits are averaging a record-low 7.63 after fluctuating from 8 to 10 from 1937 through last year, excepting 1968′s dip to a then-alarming 7.91.


The McFlurry Everyone Wants


We have a feature talking about minor personal stuff at the end of The Editors podcast. In the latest episode, I mentioned that I had been at a McDonald’s over the weekend and meant to order the special Carmel Brownie McFlurry going through the drive-thru, but I forgot at the end of my order. As soon as I realized my mistake, I was filled with regret and considered driving through the usually long drive-thru line again, but let it drop and have been regretting it ever since. Phil Klein mentioned that he, too, had wanted to order this McFlurry but got diverted, and a listener texted soon after the episode posted saying the same thing. My fear is that this special one-time McFlurry will be gone by the time I make it back to McDonald’s, and I will have completely missed out.

Politics & Policy

‘Liz Cheney in the Hot Seat Again’


This week on The Editors, Rich, Jim, Maddy, and Phil discuss Liz Cheney, the lockdowns, and Caitlyn Jenner. Listen below, or follow this podcast on iTunes, Google Podcasts, Stitcher, TuneIn, or Spotify.