The New England Journal of Ideological Medicine

The editors of the New England Journal of Medicine are destroying the publication’s brand by immersing its pages ever more deeply into advocacy for woke ideological agendas.

The most recent issue is a case in point, with not one but two “Perspective” articles pushing gender-affirming care. The articles are more generalized statements of ideological advocacy than learned presentations. Here’s an example, from “Protecting Transgender Health and Challenging Science Denialism Policy:”

A virulent brand of science denialism is emerging in the U.S. legal system, as states enact bans on gender-affirming health care. Misused clinical research and disinformation have provided legal cover for bans on essential treatments for transgender and gender-expansive (TGE) people.

Many of these bans restrict Medicaid reimbursement of gender-affirming care for people of all ages or prohibit gender-affirming care for minors. The recent end of federal protection for abortion and the lifting of Covid-19 protections such as mask mandates may signal an expansion of this dangerous force in health policy. Deeper government interference in health care could well follow.

It is obvious where the authors are coming from. But rather than grapple with the actual controversies about the proper approach to treating children with gender dysphoria, the authors merely make general categorical statements:

Legal measures that block access to gender-affirming care are riddled with falsehoods about gender dysphoria and gender-expansive people. Many contain inflammatory statements that gender dysphoria should be treated with psychotherapy alone, thereby evoking the same dangerous stereotyping that once pathologized homosexuality.

Bans on gender-affirming care also reference social contagion, a theory that has been used to describe the mode by which gender dysphoria “spreads” among adolescents but has been debunked in this context. [The citation is to an article one of the co-authors wrote, meaning the author is self-citing.] Harmful terms such as “desistance” and “regret” have been misapplied to gloss over the suffering that TGE people experience in an overwhelmingly cisgender society

Reading the piece, one would think that all the legitimate science is in agreement with the gender-affirming ideological approach. But that isn’t true at all. Indeed, puberty-blocking drugs and surgeries are increasingly controversial in countries such as the U.K., France, Sweden, and Finland, which are hitting the brakes hard on providing the kind of interventions these authors argue should be standard. Indeed, a major British gender clinic was recently shuttered because of the intense controversy over the gender-affirming approach.

As to the social-contagion issue, here’s what France’s National Academy of Medicine opined in urging a pullback from aggressive gender-affirming care for minors (my emphasis):

While this condition has long been recognized, a sharp increase in demand for medical interventions has been observed first in North America, then in Northern Europe, and, more recently, in France, particularly among children and adolescents. . . .

Whatever the mechanisms involved in adolescents — excessive engagement with social media, greater social acceptability, or influence by those in one’s social circle — this epidemic-like phenomenon manifests itself in the emergence of cases or even clusters of cases in the adolescents’ immediate surroundings. This primarily social problem is due, in part, to the questioning of an overly dichotomous view of gender identity by some young people.

Is France’s National Academy of Medicine controlled by “virulent science deniers”? Of course not. Yet, tellingly, the authors don’t mention these developments. A real science paper would engage them head-on, because that is the nature of true professional discourse.

The authors also deflect from the drastic nature of some of these interventions by diminishing their importance or frequency. For example:

Government officials seeking to enact bans on gender-affirming care frequently spread disinformation about standard practice. [They rely] on false claims that performing genital surgery in children is common practice and that physicians push medicalized transition.

Notice, the text doesn’t deny that some children do receive genital surgery, because that’s a fact. It merely criticizes those who claim it is a “common practice” — an allegation, I note, that the article makes without a quotation or naming a source.

Moreover, there is no question that some doctors (and other so-called “experts”) “push for medicalized transition” by means of puberty-blocking drugs and cross-hormone injections. Worse, we now know that hundreds of minors receive mastectomies each year — with the median age at 16, meaning half are younger — and many others receive radical facial reconstruction surgeries to masculinize or feminize their appearances. This, despite the NHS’s warning — again, no science deniers they — that gender confusion in children is often “a transient phase.”

The authors end with a call for medical and legal “experts” to collaborate on defeating opponents of these radical approaches to gender dysphoria.

Bans on gender-affirming care are grounded in science denialism, harm the health of marginalized people, and degrade medical authority. Collaboration between lawyers and scientists is critical to defeating such bans in the courts. The U.S. Supreme Court’s recent ruling in Dobbs v. Jackson Women’s Health Organization signals a new legal era in which states may attempt to restrict reproductive autonomy, marriage equality, and the right to same sex intimacy. The combined powers of medicine and law could safeguard the credibility of science and civil liberties in health law.

It seems to me that the real science denialism comes from those who distort the professional discourse by engaging in ideological polemics, an advocacy tactic that is antithetical to the scientific method. Perhaps the NEJM should change its name to the “New England Journal of Ideological Medicine” to better reflect its current chosen role in society.