All posts filed under: Health

Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs

Over the past five years, there has been a 400 percent rise in referrals to the Tavistock Centre in north London, the only National Health Service (NHS) clinic in Britain that treats children with gender-identity developmental issues. During this period, there also has been an abrupt shift in the composition of the children seeking treatment. Formerly, a significant majority of patients had been young male-to-female children. Now, a significant majority are biological females who claim to have a male gender identity, often following the rapid onset of gender dysphoria in their teenage years. We do not fully understand what is going on in this complex area, and it is essential to examine the phenomenon systematically and objectively. But this has become difficult in the current environment, as debate is continually being closed down amidst accusations of transphobia. As I argued in a May, 2019 presentation before the House of Lords, this de facto censorship regime is harming children. Those who advocate an unquestioning “affirmation”-based approach to trans-identified children often will claim that any delay or …

Gambling in a Time of Despair

Last year in June, the New York State Senate voted to legalize mobile sports betting. For a moment, it seemed like New York was poised to join its neighbor. New Jersey had sued and successfully convinced the Supreme Court to overturn a federal ban on sports gambling outside Nevada the previous year. The state legalized mobile betting apps shortly afterwards. Now, it was collecting the gambling fees of frustrated commuters from across the Hudson River while New York’s government lost millions of dollars in potential revenue. It was New York’s chance to catch up with the Joneses. “I got racinos who could use the help. I have racetracks who are suffering. This helps everyone and it stops people from going to Jersey,” Senator Joseph Addabbo Jr. asserted. As the author of the bill, he claimed that legalization also had “tremendous potential to create jobs and raise significant funding for education and other vital public programs.” Not everyone was so buoyant about the proposal. “I am not a fan, pardon the pun, of the new mobile …

The Ranks of Gender Detransitioners Are Growing. We Need to Understand Why

A recent NBC News report warned that media coverage of detransitioners—formerly transgender individuals seeking to return to the gender associated with their biological sex—is misleading and potentially harmful. “No one disputes that transition regret does exist,” author Liam Knox writes. “However, trans advocates say some of the recent coverage around the topic portrays detransitioning as much more common than it actually is.” The article suggests that journalists are creating a “panic” about detransition, and fuelling the “misconception” that trans individuals are “just temporarily confused or suffering from a misdiagnosed psychological disorder.” Knox quotes Dr. Jack Turban, a psychiatric resident at Massachusetts General Hospital who researches the mental health of trans youth, to the effect that “affirming” a child’s gender transition in general (and providing puberty-blocking drugs, in particular) is usually the most prudent course of action—though the article does not offer evidence to support this assertion, nor specify how the associated risks and benefits might be compared. Readers of such articles might not realize that data regarding the medical transition of children and adolescents is …

No One Is Born in ‘The Wrong Body’

The idea that all people have an innate “gender identity” recently has been endorsed by many health-care professionals and mainstream medical organizations. This term commonly is defined to mean the “internal, deeply held” sense of whether one is a man or a woman (or, in the case of children, a boy or a girl), both, or neither. It also has become common to claim that this sense of identity may be reliably articulated by children as young as three years old. While these claims about gender identity did not attract systematic scrutiny at first, they now have become the subject of criticism from a growing number of scientists, philosophers and health workers. Developmental studies show that young children have only a superficial understanding of sex and gender (at best). For instance, up until age 7, many children often believe that if a boy puts on a dress, he becomes a girl. This gives us reason to doubt whether a coherent concept of gender identity exists at all in young children. To such extent as any …

Diet Reporting—the Real Fake News

No one would choose to study diet as a way to understand the way humans metabolize food. Effects are delayed, often for years. Experimentation is usually impossible for ethical and practical reasons—subjects cannot be sacrificed and dissected to see the physiological effects of different food regimens. And much better methods are available to study how food is processed by the body. On the other hand, people are very interested in what they should eat. There is a huge market for ‘diet science.’ Diet Reporting Should Go on a Diet The New York Times once had a reputation as the “paper of record,” a reliable, if left-of-center, source of information. I’m not sure it’s ever been reliable when it comes to diet. In an article published on 26th August headlined ‘Our Food Is Killing Too Many of Us’ (should our food be killing just the right number?), the paper recounts a list of ‘facts’ and prescriptions about how Americans—indeed, everybody—should change their diet in order to prolong their lives. The article is written by two dietary …

Preventable Deaths and the Need for Data-Driven Journalism

In the wake of the recent mass shootings in Texas and Ohio that claimed the lives of more than 30 people, Neil deGrasse Tyson drew significant controversy by posting a tweet which compared the death toll from the shootings to the (larger) numbers of people who died from other preventable causes over a 48-hour time period. Dr. Tyson concluded his message with a warning: “Often our emotions respond more to spectacle than to data.” In the past 48hrs, the USA horrifically lost 34 people to mass shootings. On average, across any 48hrs, we also lose… 500 to Medical errors300 to the Flu250 to Suicide200 to Car Accidents40 to Homicide via Handgun Often our emotions respond more to spectacle than to data. — Neil deGrasse Tyson (@neiltyson) August 4, 2019 The negative responses to his tweet were swift and numerous, with many users voicing outrage, disappointment, and disgust. The next morning, he issued an apology on his Facebook page and acknowledged that he “got this one wrong.” But did he? I don’t disagree that his timing …

I’m a Feminist Mother. But I Don’t Need a ‘Feminist Birth’

When my first was born—a bit early, just shy of 36 weeks—he couldn’t breathe. He let out a brief, warbled cry, then fell silent. He was taken from my grasp in seconds, before it felt like he had ever really been with me at all. He required resuscitation. I held him again, for a few seconds, when he was stable and wearing a continuous positive airway pressure mask. Then he was taken to another floor of the hospital. There were a lot of things for a mother to be upset about. My labour included medical interventions, including intravenous medications, that I had no say about. I was confined to bed to allow continuous fetal monitoring, making labour—which took place without analgesics—more painful. I didn’t see my son for over two hours after he was taken to the neonatal intensive care unit. He never breastfed well in the months that followed, possibly because he was given a soother and feeding tube without my consultation or knowledge. “Mommy” blogs and other online fora are rife with similar …

Rationalizing Modern Drug Prejudices

Congressman Jared Polis: Is crack worse for a person than marijuana? DEA Agent Michele Leonhart: I believe all illegal drugs are bad for you. Congressman Jared Polis: Is methamphetamine worse for somebody’s health than marijuana? DEA Agent Michele Leonhart: I don’t think any illegal drug is good for you. Congressman Jared Polis: Is heroin worse for someone’s health than marijuana? DEA Agent Michele Leonhart: Again, all drugs. Congressman Jared Polis:  I mean either ‘yes’, ‘no’, or ‘I don’t know.’ I mean if you don’t know you can look at this up. You should know this as the Chief Administrator of the DEA. I’m asking you a straightforward question, is heroin worse for someone’s health than marijuana? DEA Agent Michele Leonhart: All illegal drugs are bad. *   *   * How dangerous are different substances compared with each other, and do the laws get it right in banning some substances but not others? This question is not as immediately answerable as it might seem. For a start, no final and absolute answer can ever be given to …

The Rise of ‘Drag Kids’—and the Death of Gay Culture

Last month, the CBC—Canada’s public television network—ran a lavishly publicized documentary about “four kid drag queens as they prepare to slay on Montreal stage.” This was marketed as child-friendly content. Indeed, the CBC promoted the documentary, titled Drag Kids, on its “CBC Kids News” channel as a fun look at children who “sashay their way into the spotlight.” For me, as a gay man, watching the documentary was traumatic. The interviewed parents defend themselves against accusations they are abusing their children by encouraging them to dress up in drag. But to do so, the parents must purport to separate drag from sex and sexuality, which is simply ahistorical. They define drag as “a way of expression,” and assure everyone that “there’s nothing sexual to it” (a premise that the CBC clearly embedded in the marketing around the documentary). The kids themselves are very much on message. One remarks, “I was called gay-boy, but I did nothing but dress up.” That last remark actually brought tears to my eyes—though not for the reasons you might think. …

Choosing a Good Death

As a doctor working in palliative care, I treat people who have a terminal illness, in a healthcare system that favours more, rather than less, clinical intervention. Of course, when you go to a hospital, you expect investigations and treatments. You expect the right balance to be struck between finding out if something is wrong, and hopefully not having to return for test after test, procedure after procedure, to the point where your ailment takes over your entire life. Medicine’s goal is, after all, to extend life, and patients will often sacrifice life quality today for the chance of gaining time or feeling better later. Healthcare professionals are rightfully trained to treat first and ask questions later. But what about the last years of life, when, with the benefit of hindsight, too much time appears to have been spent in hospitals and in clinical areas? Opportunities for holidays and weekends away or family dinners are exchanged for the multiple scars of clinical intrusions visible all over a frail body: cuts, bruises, cannulae, tubes. This is …