Higher Education
An Uproar Over Facts
Canadian experts reported accurate information about “gender-affirming” therapies. Naturally, everyone is furious.
In a recently published essay, famed British evolutionary biologist Richard Dawkins notes the parallel between today’s pseudoscience regarding gender, and 1940s-era Soviet pseudoscience regarding genetics. In our own era, activists demand that we reject scientific principles of biological sex insofar as they prevent men from announcing themselves as women. In the USSR, similarly, Joseph Stalin’s scientists were instructed to reject principles of biological inheritance that contradicted the communist dream of remaking the natural kingdom (humans included) according to Marxist-Leninist dogma.
The scale of the damage wrought by these two movements is vastly different, of course. (Stalin’s junk science—championed by a crackpot autodidact named Trofim Lysenko—resulted in disastrous agriculture policies and widespread famine that killed millions.) But the overall pattern of ideologically programmed delusion is the same: Where scientific reality and fantasy are in conflict with fantasy, it is the science that’s discarded, not the fantasy.
In a contribution to a new collection of essays on the misuses of science, Dawkins details the fate of Soviet scientists who initially resisted Lysenko’s program. They were publicly denounced at an infamous 1948 session of the Lenin All-Union Academy of Agricultural Sciences, where Lysenko and others railed against “reactionary” (which is to say, ideologically non-compliant) theories of biology. In keeping with the strange Soviet practice of categorising dissident ideologies with lengthy hyphenations (the “Zinoviev-Kamenev deviationists,” etc.), the preferred communist slur for heretics in the field of genetics was “Mendelist-Morganist-Weissmanist” (a term referencing legendary scientists Gregor Mendel, Thomas Hunt Morgan, and August Weismann)—roughly analogous to “TERF” in the idiom of modern gender ideology.
Helen Joyce
Many principled Soviet scientists committed suicide or were imprisoned during this period. Others tried to save themselves by staging pitiful public spectacles of confession in which they disavowed their heresies. Dawkins quotes from one such confession:
When I leave this session, the first thing I must do is to review… my entire earlier activity. I call upon my comrades to do likewise… From tomorrow on, I shall not only myself, in all my scientific activity, try to emancipate myself from the old reactionary Weismann-Morganian views, but shall try to reform and convince all my pupils and comrades.
Needless to say, no one believes in Lysenkoism anymore. But its modern gender analogue, which had its heyday in the mid-to-late 2010s, remains a powerful pseudoscientific influence in progressive academic enclaves. In 2020, evolutionary biologist-turned-writer Colin Wright, then an editor at Quillette, described his own experience as a neo-Mendelist-Morganist-Weissmanist at Penn State University (PSU), where he’d been engaged as a postdoctoral researcher, after he’d co-published a Wall Street Journal article entitled The Dangerous Denial of Sex with Emma Hilton:
Even more than other pieces I’d bylined, this one unleashed a tidal wave of online hate—perhaps because we’d pricked the precious conceit that gender ideology saves children instead of harming them. Several Penn State professors publicly denounced the essay as transphobic. Students and faculty complained to my department’s diversity committee that I’d launched “a personal attack on individuals with non-binary gender identity,” and that my presence at PSU “made them feel less comfortable.”
A Canadian version of this farce has recently been playing out at McMaster University in Hamilton, Ontario. (It’s a school that Quillette readers may remember for the social panic that tore through its campus in 2020, when McMaster’s president, David Farrar, publicly promoted bizarre claims that a predatory sex ring was being run out of his school’s psychology department). Except that in this instance, the impugned heretics aren’t just rank-and-file graduate students. Rather, they include established researchers—led by none other than Gordon Guyatt, a Distinguished University Professor, internationally renowned for his leadership in the field known as evidence-based medicine—a discipline he personally pioneered in the 1990s.
From 2021 to early 2025, Guyatt and his research collaborators systematically reviewed the evidence as to whether various “gender-affirming” interventions actually deliver psychological, psychiatric, or physical benefits to gender-distressed children and youth; and whether such benefits outweigh the attendant risks. It’s a classic application of the “evidence-based” methodology that Guyatt has championed for decades. No surprise: As anyone who’s followed this issue in recent years might have predicted, Guyatt’s team, led by McMaster Health Research Methods, Evidence, and Impact scholar Romina Brignardello-Petersen, found that the available medical evidence supporting transition therapies is generally of low quality.
One of the three published articles that have emerged from their research is Mastectomy for Individuals with Gender Dysphoria Younger Than 26 Years: A Systematic Review and Meta-Analysis. Its authors are listed (in order) as Health Research Methodologist Anna Miroshnychenko; Paediatrician Yetiani Roldan, PhD; student Sara Ibrahim, researcher Chan Kulatunga-Moruzi; psychologist Kristen Dahlin; plastic surgeon Steven Montante; research coordinator Rachel Couban; Guyatt; and Brignardello-Petersen. (In a sign of the trouble to come, several of these individuals had already been targeted as “transphobic” by online activists.)
In the Abstract, the authors report that
Observational studies… comparing mastectomy to chest binding provided very low-certainty evidence for the outcome of GD [gender dysphoria]. One observational study comparing mastectomy to no mastectomy provided very low-certainty evidence for the outcomes of global functioning and suicide attempts, and low-certainty evidence for the outcome non-suicidal self-injury. Before-and-after… studies provided very low-certainty evidence for all outcomes. Evidence from case-series studies ranged from high to very low certainty… Case series studies demonstrated high-certainty evidence for the outcomes of death, necrosis, and excessive scarring; however, these are limited in methodologic quality. In comparative and before-and-after studies, the evidence ranged from low to very low certainty.
In another published analysis by an overlapping team of authors (Dahlin’s name doesn’t appear on this one), 24 separate studies on gender-affirming hormone therapy were examined. It was found that
there is considerable uncertainty about the effects of GAHT [gender-affirming hormone therapy], and we cannot exclude the possibility of benefit or harm. Methodologically rigorous prospective studies are needed to produce higher certainty evidence.
A third published analysis produced by the same team was titled, Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis. The authors’ conclusions, summarised in the Abstract, were as follows:
We included 10 studies. Comparative observational studies (n=3), comparing puberty blockers versus no puberty blockers, provided very low certainty of evidence on the outcomes of global function and depression. Before–after studies (n=7) provided very low certainty of evidence addressing gender dysphoria, global function, depression, and bone mineral density… There remains considerable uncertainty regarding the effects of puberty blockers in individuals experiencing [gender dysphoria]. Methodologically rigorous prospective studies are needed to understand the effects of this intervention.
The overarching theme here is clear: Notwithstanding the confident slogans we’ve all heard about the life-changing wonders of gender affirmation, there is little to no solid statistical evidence that any of the associated therapies and treatments are helpful. (The research team had originally planned on publishing two additional papers, these dealing with social transition and chest-binding. But for reasons described below, these may never see the light of day.)
The Quillette Editorial Board
Notwithstanding the furore that this research has generated at McMaster (more on this below), these results are hardly shocking. In fact, they’re generally consistent with the 2024 report produced by Hilary Cass, a former president of Britain’s Royal College of Paediatrics and Child Health, who was mandated to produce a comprehensive review of the gender-identity services for children and young people provided under the auspices of Britain’s National Health Service. In regard to puberty blockers, her analysis of published literature from international sources led her to conclude as follows:
[A] systematic review… found multiple studies demonstrating that puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression. However, no changes in gender dysphoria or body satisfaction were demonstrated. There was insufficient/inconsistent evidence about the effects of puberty suppression on psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk, or fertility. Moreover, given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.
Crucially, Cass found that while “it has been suggested that hormone treatment reduces the elevated risk of death by suicide in this population,” the scientific literature “did not support this conclusion.” Like Guyatt and his co-authors, Cass found that insofar as gender-transition procedures offer any benefits, more studies—and higher-quality studies—should be conducted to demonstrate them.
Had Guyatt’s team been performing meta-studies on, say, experimental diabetes treatments, or vitamin supplements, none of its work would have been seen as controversial or newsworthy. But when it comes to gender dysphoria, the search for evidence is viewed as an ideologically suspect activity. For years now, activists have insisted that failing to speedily provide on-demand transition therapies to trans-identified children and youth puts them at risk of permanent harm—even suicide. The fact that Guyatt’s research was aimed at looking past these slogans, to the actual data, was therefore seen as a bug not a feature. And in recent months, his colleagues told him as much.
The public originally learned this from a somewhat cryptic confession that Guyatt, Brignardello-Petersen, Ibrahim, Couban, and Roldán posted on McMaster’s Faculty of Health Sciences website last month. Therein, they lament that “members and allies of 2SLGBTQIA+ communities have raised concerns” about their systemic reviews—concerns that include “the potential for the research to be misused” so as to “deny gender-affirming care.” (“2SLGBTQIA+” is the Canadian government-endorsed equivalent of LGBT. The “2S” component refers to “two spirit,” a vaguely defined category that is reserved for individuals who are ethnically Indigenous.)
Decoded into plain language, the confession would seem to amount to the following: Our critics are worried that fewer gender-distressed children and youth will receive mastectomies, cross-sex hormones, and puberty blockers now that our research has reaffirmed that there’s scant high-quality evidence to justify the use of mastectomies, cross-sex hormones, and puberty blockers.
Which is a very strange kind of “concern,” assuming one’s overarching goal is to actually help gender-distressed patients—as opposed to chalking up mastectomies and drug prescriptions for their own sake. But again, that’s been the academic party line in this field for at least a decade: transition first, evidence later.
The authors then go on to argue that the “autonomy” of gender-distressed individuals must be the paramount consideration (the word appears three times)—which is also a strange claim. As Jesse Singal writes in his detailed analysis of this strange confessional manifesto, patient autonomy is just one of several factors traditionally regarded as foundational to medical ethics. And doctors properly refuse to indulge patient demands for requested therapies when such therapies are regarded as dangerous, useless, unproven, or medically counterproductive. These considerations are particularly important in the internet era, since many patients now arrive at the doctor’s office with their own (often extremely dubious) self-researched theories about their ailments. It’s a phenomenon that’s particularly acute among gender-distressed teenagers.
Later in the article, Guyatt and his four co-signatories claim “it is unconscionable to forbid clinicians from delivering gender-affirming care,” and that “forbidding delivery of gender-affirming care and limiting medical management options on the basis of low certainty evidence is a clear violation of the principles of evidence-based shared decision-making and is unconscionable.” They also exhort “all those who use our work” to “prioritize the delivery of compassionate and conscientious care that fully respects the autonomy of the TGD [i.e. trans, nonbinary, and gender-diverse] patient.”
There are two possible meanings here, and it is hard to know which one the authors intended to convey, thanks to the (perhaps intended) obscuring effects of euphemisms and jargon. Do they mean only that their evidence should not be used to support blanket bans on all forms of therapy for gender-distressed individuals (as with the Tennessee law at issue in a recently decided US Supreme Court case)? Or are they going further by also suggesting that, no matter how weak the evidence base supporting transition therapies may be, such considerations should never be invoked so as to thwart individual patients’ gender-bending “autonomy”?
Either way, the authors clearly believe they have engaged in some kind of moral transgression (or at least pretend to believe as much), as they’ve announced that, by way of penance: “as recommended by community advocates, we have also personally made a donation to Egale Canada’s legal and justice work, noting their litigation efforts aimed at preventing the denial of medically necessary care for gender-diverse youth.” (Egale Canada is an organisation dedicated to advancing the rights of “2SLGBTQI people in Canada and [enhancing] the global response to 2SLGBTQI issues.”)
There was also another, more specific, reason why Guyatt and the others felt the need to write this mea culpa: their research had been funded by the Society for Evidence-Based Gender Medicine (SEGM), a registered 501(c)(3) nonprofit organisation whose mission is embedded in its name. In this (especially cryptic) section of their statement, the authors don’t spell out why this arrangement is allegedly problematic, however. They merely state that “we will no longer accept funding from the SEGM,” while assuring readers that the SEGM had presented itself to them as “legitimately evidence-based”—the clear suggestion being that somehow the SEGM had tricked them with a transphobic ruse.
That suggestion is false. As Signal explains in great detail (far more than I can summarise here), the SEGM is a legitimately evidence-based organisation. And its funding relationship with McMaster was completely transparent and above-board. We know this because Guyatt himself shared his cache of SEGM-related emails with Singal, who duly summarised them for his readers.
We also know that once Guyatt’s research team had established its research protocols, the SEGM had no role in performing the actual research, nor in the process by which that research was interpreted and reported.
The real back story here gets buried by Guyatt and co. in a footnote, which directs readers to a letter to the editor published in a medical journal, denouncing the SEGM as an agent of “anti-gender ideology,” and noting that “SEGM is listed by the Southern Poverty Law Center (SPLC) as an anti-LGBT hate group.” This all sounds like a smoking gun, until you realise that—as Quillette detailed in 2023—SPLC’s ever-expanding list of “hate groups” has become largely meaningless over the last decade.
The Quillette Editorial Board
As early as 2017, Politico noted that the once-hallowed group was increasingly accused of being “more of a partisan progressive hit operation than a civil rights watchdog,” and that “critics say the group abuses its position as an arbiter of hatred by labelling legitimate players ‘hate groups’ and ’extremists’ to keep the attention of its liberal donors and grind a political ax.” Two years later, the New Yorker, hardly a right-wing outfit, published a lengthy exposé by Bob Moser, a former SPLC staffer, arguing that the SPLC’s endless headline-grabbing denunciations function as props for “hyperbolic fund-raising appeals.” Moser ruefully recollected that his disaffected ex-colleagues invented a new slogan to describe what their employer had become: “The SPLC—making hate pay.”
In a lengthy interview with Singal, Guyatt could provide no coherent response when asked what exactly was “hateful” about SEGM. And the SPLC itself refused to answer Singal’s questions about why they’d labelled the SEGM a hate group in 2024. (“I’ve reached out to the SPLC repeatedly since November in the hopes of getting on the phone with someone who can explain this decision,” he writes. “But I have never heard a peep back.”) Singal reports that he’s personally attended SEGM conferences, interviewed SEGM experts, and scrutinised SEGM literature without detecting any sign of the “hate” cited by the SPLC. As far as I can tell, the real reason the Southern Poverty Law Center smeared the SEGM is that (1) the SPLC has put down stakes with its stridently pro-transition donor base, and (2) the SEGM’s research projects have exposed the lack of sound evidence supporting youth gender medicine.
It’s an exercise in shooting the messenger, in other words. And by these same specious methods, Guyatt’s own Department of Health Research Methods, Evidence, and Impact is vulnerable to being denounced as a “hate group” in similar fashion. This is presumably one of the reasons why Guyatt is throwing his SEGM funders under the bus: By turning state’s evidence in this manner, he and his colleagues might be given a pass for their own ideological crimes—at least for now.
In his interview with Singal, Guyatt gushed that the trans community was “ecstatic” about the public statement he’d made. He also claimed that “the young people and my colleague who got us into this [research area] in the first place are now so traumatised by the whole scene that they want nothing to do with it. That is, they all pulled their names off [the group’s draft research papers]. They’re all terrified. They’re all traumatised.” The fact that anyone at McMaster would feel “terrified” or “traumatised” because they performed proper scientific research doesn’t speak well for the intellectual climate at the university. But other actors share some of the blame as well, including journalists.
On 12 July, Hamilton’s Spectator newspaper published an op-ed jointly written by Katherine Boothe, Sasha Skaidra, Dr Angela Jones, and Dr Jessica Johnson—self-described as “the parent of a trans youth, a transgender woman, and primary care providers for trans patients”—denouncing McMaster for taking money from the SEGM. After repeating the SPLC “hate group” smear, reminding readers of the SPLC’s faded Cold War-era glories, and rehashing conspiratorial claims that the SEGM had somehow masterminded a nefarious “network” composed of “antiwoke” racists, the authors go on argue that the SEGM “opposes basic health care for trans people” (not true, unless one regards unproven and potentially dangerous sex-change procedures as “basic health care”); “promotes discredited ‘conversion therapy’ ” (absolutely not true); “commissions pseudoscience reports” (not true, unless Guyatt and other evidence-based researchers are to be considered “pseudoscientists”); and “makes legal submissions to justify bans on gender-affirming care.”
That last one appears to be a reference to the SEGM’s 3 September 2024 amicus brief to the US Supreme Court in United States v. Skrmetti, the above-referenced case in which the Court upheld a Tennessee law banning puberty blockers and hormone therapy for the treatment of gender dysphoria in minors; and to Koe v. Noggle, in which the SPLC challenged a Georgia ban on performing transitioning procedures on trans-identified adolescents.
The SEGM brief in Skrmetti is a public document. On page 15, it is clearly stated that “SEGM’s brief is neither in support of, nor in opposition to [the Tennessee law at issue].” In Koe, on the other hand, the SEGM had no role whatsoever. It is absolutely true that SEGM research was cited in both cases—and that it’s been used by jurists and politicians to argue against no-questions-asked transition therapies. But again, claiming this as an indicator of transphobia is simply an exercise in shooting the scientific messenger.
The whole Spectator article, which evidently didn’t go through even a rudimentary fact-check before publication, is full of this kind of hysterical nonsense. And these lies did much to set the McMaster farce in motion. Shortly after the op-ed appeared, a group identifying itself as “McMaster faculty, alumni, and students; community members and organizations; and professionals and experts in trans health care and human rights” declared itself “shocked to learn in the Hamilton Spectator” of McMaster’s affiliation with SEGM. On the basis of the nonsense they’d read, the signatories claim that “McMaster’s reputation helps launder SEGM’s hateful pseudoscience,” and—here’s the real kicker—that the university must “pursue retraction of SEGM-funded publications authored by McMaster faculty on the grounds of compromised scientific integrity and real-world harm.”
It was shortly after that when Guyatt and his colleagues published their grovelling confession and repentance. As far as I know, there’s no plan in the works to “pursue retraction” of the three papers published before this public mobbing gathered steam. But who knows what coming weeks will bring, as these “terrified” and “traumatised” modern-day Mendelist-Morganist-Weissmanists go through the mortifying rituals of ideological submission.
Keep reading
An Uproar Over Facts
Mahmood Mamdani Wants to Dismantle America
A Guest Workers’ Son in the IDF
Beautiful Visions
It’s All Too Much
The Next Generation of Wokeness
