Jack Turban – A Life on the Frontlines
Assigned Media interviews Jack Turban, Director of the Gender Psychiatry Program at the University of California.
by Riki Wilchins
Jack Turban (@jack_turban) is Director of the Gender Psychiatry Program at the University of California. A tireless advocate he regularly testifies, writes journal articles, tweets, and published books and popular articles
Assigned Media: The definitive review cum takedown of which you were an author—“An Evidence-Based Critique of the Cass Report”—was published by the Yale Law Review. They seem to be behind so many authoritative reports on anti-trans disinformation.
Jack Turban: They have a program called the Yale Integrity Project of lawyers and medical professionals looking at disinformation and misinformation, and they've been interested in this topic since there’s been a lot of really high-profile misinformation.
AM: There were nine authors on that report. How is it that you suddenly seemed to become the go-to person for all things Cass?
JT: I hope I'm not the go-to person.
AM: You seem to be among the main ones.
JT: One thing that has happened over the past years is more threats against researchers and physicians who research or care for trans youth. This has escalated to bomb threats towards children's hospitals and clinics. People are not so much worried for their own personal safety, but they do worry about their patients and their families—and if they speak too much in the media, their clinics are going to be targeted and they won’t be able to care for their patients. I’ve been talking about these issues for so many years, I've given up on not being politically attacked. So it's a little bit easier for me to speak out.
AM: It’s awful that terrorism tactics are silencing people. In our original emails, I was struck by what sounded like an undertone of tiredness. Has being a front man been emotionally and professionally exhausting?
JT: Yes, and more so over the past few years. It comes in these waves. Any time I'm involved as an expert witness or I have a new research paper, there is this huge increase in hit pieces from places like Manhattan Institute or the Heritage Foundation, and also death threats. You probably caught me soon after our paper on the Cass Report and I was probably getting more harassment than usual. I’m currently in a lull, where it's not so bad.
AM: I can’t imagine regularly getting death threats for my work. How do you cope?
JT: When I first started getting them, it was scary and definitely took a toll. At a certain point, you received so many, that you just kind of become numb to it. I'd rather it weren't happening, but I don't know that there's all that much I can do about it at this point.
AM: While many wonderful clinicians like you have stepped up, the civil and women’s rights community has largely sat on their hands. In researching “When Texas Came for Our Kids,” we found that 100% of the 18 biggest groups gave statements supporting abortion and gay marriage—but only 44% for affirming care. The volume also dropped from 70 statements to just 10. Are these groups ambivalent about trans kids’ care?
JT: Yes. I think that's unambiguously true. And we've seen a massive investment in time and financial resources from right-wing and anti-trans groups. Trump’s campaign spent $120m on anti-trans ads. But while the medical community has done a good job, and every major medical organization has made a statement, I haven't seen anything like that kind of investment promoting evidence-based policy from the left.
AM: As you mentioned, all 27 medical groups now support affirming care, and Yale says the Cass Report violates its own standards, draws conclusions based on speculation, and recycles debunked disinformation. And then the New York Times quotes Cass stating that all of these are left-leaning.
JT: Yes, her public statements have been surprising. The one that caught me off guard was when she claimed that American physicians are out of date on pediatric gender medicine. As someone who published many of the studies in this area over the past few years, that was news to me.
Look, the Cass Report had a lot of problems, but it didn't even recommend banning care. In fact, it affirmed that blockers should be available, and hormones could be considered at age 16. So the UK government really jumped the gun, not even following the report’s recommendations or spirit.
AM: I could disagree on the latter: it’s spirit read quick dark to me. But I don't think Cass is the point: there were plenty of TERFs who would have gladly produced that report anyway because their government was looking for a fig leaf to do what it wanted to do anyway. And Cass has been rewarded with a peerage: it’s like an Oxford don published a report that Galileo was wrong and the sun does revolve around the earth, and getting a seat in the House of Lords for it. It's weird and scary to see a western government so thoroughly captured by obvious pseudoscience in its eagerness to attack trans kids.
JT: Yeah, I was definitely surprised by that. I don't think most American physicians saw this coming, but maybe we should have. Because there's been such a massive financial investment in attacking trans rights in the US.
AM: You published a wonderful book, Free to Be: Understanding Kids & Gender Identity which opens with this poignant personal story where your father suddenly declares, “If I'd ever knew someone who was gay, I'd shoot them. Gay people don't deserve to live.” You were just 14. You write that, “I grew up terrified if anyone found out I was gay, I would be kicked out of my house, beaten or killed. I spent years trying to make myself straight…”
JT: Yeah. The sad thing is, as horrible as that experience is, it's so like the experience of many trans kids today is. Honestly it’s so sad to see that same kind of kind of bigotry impacting kids. If anything, I think we would hope that as society progresses, we see less.
AM: You say his statement came out of nowhere, but I think we smell different to our fathers and these declarations are intentional.
JT: My dad was actually like really kind of MAGA before MAGA existed: a member of the KKK and a white supremacist. Growing up I hoped this was a small community thing, or just the bad luck of being born into my family. It's been really scary to see those views take off and take over.
AM: Your book tells the story of a mom who was shocked when her trans daughter came out, and it was a non-issue at school: kids asked a few questions and moved on. I did a book of interviews with affirming parents who had to flee red states. I’d interviewed blue state parents too, but there was no story: just like you said, it was a giant nothing-burger. You’re smiling…
JT: Yes. Beautiful story. I try to really hold on to those stories to remember that that's possible.
AM: I wonder how it will be one day when almost every kid gets blockers and then hormones and people like me who had to go through the wrong puberty and then try to unwind it all in adulthood are like these transgender dinosaurs.
JT: I'm seeing so many glimpses of it and we were really headed in that direction, right? We were having this whole cohort of kids who were doing really, really well. And it really was a non-issue. But obviously this has been building all the way back to bathroom bills. Maybe I'm naive, but I did not see this escalation with half the states banning care. I'm still shell-shocked.
AM: They’re helped by the fact that their manufactured pseudoscience about affirming care keeping being trumpeted by the New York Times. You just did a wonderful guest essay: “I'm a Psychiatrist: Here's How I Talk to Transgender Youth and Their Families About Gender Identity.” How was it publishing something so positive in a lead outlet for disconfirming trans kids?
JT: The first op-ed I wrote was for the Times was 2017’s “Hannah Is a Girl. Doctors Finally Treat Her Like One,” a very positive story of her starting hormones and doing really well that got a huge spread in the Sunday Times—their most read opinion section. In the 2020s, I published again with “What South Dakota Doesn’t Get About Transgender Children” when the state introduced one of the first bans. and I just really critiqued that piece of legislation as not being evidence based, explaining all the reasons it shouldn't pass. And it didn't pass.
And then I was absent for many, many years. Something happened after 2020 where—you know a lot more about it than I do—something very dramatic changed. My impression is that there is not a uniform anti-trans opinion among the op-ed staff and they're dealing with their own internal things. I did pitch a piece years ago which was, What is up with the Times’ news side's coverage of trans issues? but it wasn’t accepted.
AM: The Associated Press ran an unremarkable story noting that most trans kids don't detransition, but you can’t imagine that running in the Times.
JT: A new study just this month in AMA journal Pediatrics found very high rates of satisfaction and very low rates of regret. This is one of the highest-impact pediatrics journals, but although the Washington Post has covered it, I haven’t seen it in the Times.
AM: I wouldn't hold my breath. Affirming care is the only area of pediatrics where treatment has to prove it causes no harm: others just have to demonstrate a benefit.
JT: Nothing in medicine has a 100% success rate: it’s a field of probabilities, not certainties. Every treatment involves weighing risks, benefits, and side effects. The anti-trans movement has capitalized on this to make it seem like it’s a unique issue for affirming care, saying We don't have 20-year follow up data, so how can it be okay? But if we followed that logic, we’d ban every medication the FDA approved in the past ten years.
AM: Turning to politics, Erin Reed just posted polling finding that even Republican voters don’t prioritize banning health care. But sports does have traction. You were out front on this issue in 2021 with “Trans Girls Belong on Girls’ Sports Teams” in Scientific American.
JT: I'm on an NCAA committee, so anything I say is my own opinion, not the NCAA’s. The big problem is this hyper focus on the supposed “physical advantages” with no acknowledgment that the deck is stacked against trans kids in every other way: bullying, harassment, anxiety, depression, dysphoria—it frustrates me that this is rarely, if ever, acknowledged.
I think it's a strategy to dehumanize trans people. For trans girls in sports to be fair, they have to never win. As somebody who takes care of young trans girls all day, why are they never allowed to win? Why can't they at least win proportional to how many like trans girls there are in society—which they don’t.
AM: That brings me to the Olympic boxing disaster with ciswoman Imane Khelif who was attacked by She Who Must Not Be Named—Countess Voldemort. In your Twitter exchanges with her you wrote, “I don't know where to start with this lengthy, misinformed diatribe about trans folks by JK Rowling…she doesn't understand the science she's citing…” I liked when you tweeted about her upcoming book, “JK Rowling and the Chamber of Trans Misinformation.”
JT: The Rowling situation makes me sad because—she's not going to like that I said this one bit and it's probably going to feed into her complex—but I think she's been manipulated. Her lengthy essay about why she’s so invested is because she herself has been a victim of misogyny and domestic violence. I think trans exclusionary radical feminists saw she was vulnerable and took advantage, sweeping her in very effectively. And I don't think she has any insight into that.
AM: There are unsubstantiated rumors that at one point, she threatened to personally sic the Dementors on you and have you taken off to Azkaban Prison. Any truth to that?
JT: I can't comment on an ongoing situation…
AM: In addition to recommending your book, “Free to Be,” I also want to recommend your free “Primer on gender-affirming care for transgender youth” on MDedge.com Thank you so much for being in the frontlines, for all you do, and for making time for us today.
JT: Thank you.
Riki Wilchins writes on trans theory and politics at: www.medium.com\@rikiwilchins. Her two last books are: BAD INK: How the NYTimes SOLD OUT Transgender Teens, and Healing the Broken Places: Transgender People Speak Out About Addiction & Recovery. She can be reached at TransTeensMatter@gmail.com.