Medical Journal’s False Consensus on ‘Gender-Affirming Care’

Springer has decided to retract a paper, that received activist blowback, on a technicality.

This essay was originally published in The Wall Street Journal on June 9, 2023.

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A federal court earlier this month temporarily blocked enforcement of a Florida law that prohibits the administration of sex-change procedures on children under 18. The opinion, by Judge Robert L. Hinkle, leans heavily on medical and scientific rationales to argue that it is unconstitutional to ban the use of puberty blockers, cross-sex hormones and surgery on teenagers who feel alienated from their bodies.

Twenty states maintain age restrictions on sex-change procedures, and the problem they face is explaining to judges that American medical associations aren’t following the best available evidence. This is known to European health authorities and has been reported in such prestigious publications as the British Medical Journal. But American judges need some way to evaluate conflicting scientific authorities—especially as institutions responsible for ensuring that medical professionals have access to high-quality research aren’t functioning as they should.

A case in point: Springer, an academic publishing giant, has decided to retract an article that appeared last month in the Archives of Sexual Behavior. The retraction is expected to take effect June 12.

The article’s authors are listed as Michael Bailey and Suzanna Diaz. Mr. Bailey is a well-respected scientist, with dozens of publications to his name. The other author writes under a pseudonym to protect the privacy of her daughter, who suffers from gender dysphoria.

Their new paper is based on survey responses from more than 1,600 parents who reported that their children, who were previously comfortable in their bodies, suddenly declared a transgender identity after extensive exposure to social media and peer influence. Mr. Bailey’s and Ms. Diaz’s sin was to analyze rapid onset gender dysphoria, or ROGD. Gender activists hate any suggestion that transgender identities are anything but innate and immutable. Even mentioning the possibility that trans identity is socially influenced or a phase threatens their claims that children can know early in life they have a permanent transgender identity and therefore that they should have broad access to permanent body-modifying and sterilizing procedures.

Within days of publication, a group of activists wrote a public letter condemning the article and calling for the termination of the journal’s editor. Among the letter’s signatories is Marci Bowers, a prominent genital surgeon and president of the World Professional Association for Transgender Health, an advocacy organization that promotes sex changes for minors.

Nearly 2,000 researchers and academics signed a counter letter in support of the article. Springer nonetheless decided to retract the paper without disciplining its editor. Springer initially asserted that the study needed approval from an institutional review board. But it quickly abandoned that rationale, which was false.

The publisher now maintains that the retraction is due to improper participant consent. While the respondents consented to the publication of the survey’s results, Springer insists they didn’t specifically agree to publication in a scholarly or peer-reviewed journal. That’s a strange and retrospective requirement, especially considering that Springer and other major publishers have published thousands of survey papers without this type of consent.

Anyone familiar with the controversy over transgender medicine knows what is going on. Activists put pressure on Springer to retract an article with conclusions they didn’t like, and Springer caved in. We’ve become accustomed to seeing these capitulations in academia, media and the corporate world, but it is especially disturbing to see in a respected medical journal.

Rather than appreciate the long-term risk to itself and the scientific community from doing the bidding of activists, Springer has instead agreed to evaluate and retract all survey papers that lack the newly required consent. If Springer follows through on its promise, hundreds of authors who chose to publish in Springer’s journals may have their research retracted.

The publications that support what they call “gender-affirming care” rely heavily on surveys. The U.S. Transgender Survey of 2015, for instance, has generated several influential papers. As it happens, the USTS didn’t inform participants that their answers would be published in peer-reviewed journals.

This kind of double standard runs through gender-medicine research. Papers advocating “gender transition” are readily accepted by leading scientific journals despite having grave methodological flaws and biases. Work that questions gender-transition orthodoxy stands almost no chance of being published in the best-known journals. Every now and then, an errant research paper slips past the censors, but should it prove significant enough to threaten the settled science narrative, retribution is swift and merciless. The researcher Lisa Littman learned this lesson in 2018, when she was widely attacked after publishing on the topic. Mr. Bailey and Ms. Diaz are learning it now.

The idea is to manufacture the appearance of scientific consensus where there is none. The pseudo-consensus then allows such American medical associations as the American Academy of Pediatrics and the Endocrine Society to recommend body-altering procedures for children.

While many Americans have heard news about the wave of states passing legislation that curbs sex changes for the young, few realize that an equally fierce, and arguably far more important, battle is raging: the battle for the integrity of the scientific process. It is a fight for the ability to have censorship-free scientific debate as a means to advance human knowledge.

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