WPATH Experts Rebuke NYT on Puberty Blockers
The body resposible for setting guidelines for gender affirming care labeled the NYT piece “misinformation.”
by Evan Urquhart
This almost got lost in the holiday excitement: On November 22 the medical organization responsible for setting standards for providers of gender affirming care, WPATH, released a statement in response to the terrible New York Times piece on puberty blockers. Saying that the Times piece “furthers the atmosphere of misinformation and subjectivity,” WPATH did not mince words, condemning the use of sources unfamiliar with transgender medicine as well as some of the methods undertaken by the Times reporters.
While the gist of the critique is similar to pieces on Assigned and Slate critiquing the Times’ shoddy, biased work, this statement adds useful detail about where the story went wrong on the science, and adds the institutional weight of WPATH to the Times’ critics. The statement highlights several experts who were used that have no experience in transgender medicine, including Dr. Sundeep Khosla, who was used to introduce concerns about bone density. Khosla is an endocrinologist working with adults who has only one publication on transgender health. That lone publication includes this conclusion “bone mineral density is generally preserved in both trans women and trans men.” They also criticized the expert who was chosen to perform the literature review, Dr. Farid Foroutan, PhD.
WPATH’s statement also criticizes how anecdotes were chosent and presented. The statement points out a lack of important information on the young people’s overall health or specifics of when and how their bone density was measured and what was found. It also criticizes the anecdoes as unrepresentative of youth who access puberty blockers, in particular highlighting the choice to include a person who has detransitioned, which is misleading because detransition is so uncommon for such patients.
One other thing the WPATH statement points out is that the article is never clear about whether trans youth's bone density is being compared to the norms for their birth-assigned sex, or to cis people of the same gender identity. This is important, because males on average have greater bone densitity than females. If trans women on hormone therapy achieve normal bone density for women, this may be misleadingly portrayed as having low bone density if the comparison is being made to cisgender men. This might well explain why the Times concluded that trans women’s bone density tends to be lower than average (while still, potentially, falling in the normal range for women), but trans men’s bone density isn’t (because testosterone therapy promotes higher than average bone density, if anything).
The Times piece was a dismal failure, on all levels. Journalists can learn from its example of what not to do in covering transgender medicine, and the level of detail in the WPATH statement will be helpful for those who want to move to unbiased, scientifically-grounded coverage in the future.