THE POLITICS OF REPRODUCTIVE MEDICINE A NON-CONFORMING PERSPECTIVE ON GENDER-AFFIRMING MEDICAL CARE –
shamefully an ongoing political football
By Norbert Gleicher, MD, who is the Medical Director and Chief Scientist at the Center for Human Reproduction in New York City (NYC) and a Visiting Researcher at Rockefeller University in NYC. He can be contacted through THE REPRODUCTIVE TIMES or directly at either ngleicher@thechr.com or ngleicher@rockefeller.edu.
Briefing: There can be no question about gender-affirming care (GAC) having, especially over the last two years, been awarded disproportionate attention by legacy and other media, considering the small volume of medical care this new specialty area in medicine occupies within all of medicine. One of the reasons for this excess in attention has obviously been the politicization of the subject mainly regarding two very specific patient groups, the first being children and teenagers and the second being, yes, prisoners; both, of course, are small minority groups within the already small-volume practice of GAC. Yet both were central issues in this month’s elections. This article, however, does not intend to dwell on the details of GAC, but informs on the subject through a married couple with five children whose very personal story was not only closely interwoven with the subject of GAC rising to such prominence, but who also—in very personal ways—contributed to GAC becoming such a political football. And how political this subject has become is well demonstrated by what has likely become the end of a promising academic career.
Likely accentuated by the recent elections, gender affirming care has remained a core subject in the political conflict between left and right, and we are not even referring here only (or even in principle) to gender-affirming care in prisons or for illegal migrants. We are just flabbergasted by how a relatively rare medical circumstance and its treatment could have become such a central concern for society.
Unsurprisingly, we, therefore, must bring up two recent occurrences: The first is a truly remarkable article in The Free Press by Tiger Reed (1), a 44-year-old librarian who since 2016 has been married to Jamie Reed, known as the whistleblower who exposed in 2023 the alarming effects of gender-affirming medical care given to minors at the Washington University Transgender Center in the St. Louise Children’s Hospital. Her exposure also was published in an article in The Free Press (2). They also are mother and father of five children, two from Jamie’s prior marriage and three they adopted together.
And if you have not already started to expect some kind of a shocker, - here it is: After living for 13 years as a married trans-man, Tiger (see photo) now was publicly announcing that he was detransitioning back to becoming again a woman.
And here is why, using, more or less, his own words: He had grave doubts about Jamie—at the time working as a case manager at the hospital in St. Louis—blowing the whistle. He wondered why she just didn’t quietly quit in protest of what she had witnessed. He was scared for himself, her, and their five children’s safety (and still is) and all of this “created a huge rift in their marriage which they are still working on to heal.”
He then, however, noticed something he initially did not want to face but which ultimately became unavoidable to recognize: His spouse and a growing number of knowledgeable critics had been correct!
“There was something fundamentally amiss with the message – especially to younger people – that a swift gender transition was a safe, all-purpose solution to profound problems.” And with this acknowledgment, he had to start addressing his own doubts about his own original transition.
Like Jamie has been speaking out against medical practices affecting young children and teenagers, Tiger now believes that he must speak out about adult gender medicine, “and how people have been misled – sometimes unintentionally – by gender clinicians about its safety and effectiveness.”
He also noted the Cass Review in England (3) (repeatedly discussed in recent months in THE VOICE), which noted “the lack of scientific underpinnings for the widely accepted treatments of gender dysphoria especially in children – hormones and surgery – while failing to explore the often complex personal and psychological histories that lead people to believe that transition is what they need.”
And then there were – just recently – stories all over the newspapers that one of those academic gender physicians funded by the NIH to investigate long-term effects of gender-based medical interventions in young children withheld publication of study results, once she recognized that the study did not demonstrate the beneficial long-term effects they had expected: puberty blockers—as the Cass Review already had properly deduced from the study of published literature—in young children did not improve the children’s mental health.
The principal investigator of this NIH-funded study (the broader project apparently had received $9.7 million in funding) was Johanna Olson-Kennedy, MD, a graduate of Chicago Medical School, who now is the Medical Director of the Center for Transyouth Health and Development at the Children’s Hospital in Los Angeles and Professor of Clinical Pediatrics at the Keck School of Medicine of the University of Southern California in Los Angeles. The New York Times, which must be given credit where credit is due for covering the subject of medical gender transition better and in more detail than any other U.S. publication, described Olson-Kennedy’s study as “unpublished because of politics” (4).
Interviewed by The New York Times reporter Anzeen Ghorayshi, Olson-Kennedy explained the delay in publication of the results of the study as “not wanting to weaponize the work” – of course, an inexcusable excuse for withholding any study results (to place results into an appropriate framework is an author’s responsibility in the discussion section of every publication). It is, however, potentially a breach of law when it involves federally funded research, and it seems unlikely that this investigator will ever be given again access to federal funding. Her standing at the NIH was likely also not helped by furthermore claiming in her interview that NIH cuts in her funding also contributed to the delay in publication. Not only is this excuse (to be polite) equally far-fetched as the first one, but based on the New York Times article, it was also denied by the NIH.
What this scandal, however, once more demonstrates is the intrusion of politics into medical research as well as practice. Olson-Kennedy – unconsciously or consciously if she is as smart as her position would suggest – was working in a politically highly controversial field, and likely, had secured considerable federal funding in anticipation of producing confirmatory data, not for a very logical hypothesis, but for a politically very opportune hypothesis. When the data did not support the political hypothesis, she decided to withhold it from publication because – once known – other parts of her grant support might have evaporated. At least she had the integrity of not manipulating the data!
This is, however, one more brilliant example that demonstrates the need to award research grants based on scientific merit and not based on political and/or ideological popularity of ideas.
References
1. Reed T. The Free Press. November 3, 2024. https://www.thefp.com/p/tiger-jamie-reed-detransition-wash-u-transgender-affirming-care
2. Reed J. The Free Press. November 3, 2024. https://www.thefp.com/p/i-thought-i-was-saving-trans-kids
3. Cass H. The Cass Review. 2024; https://cass.independent-review.uk/home/publications/final-report/
4. Ghorayshi A. The New York Times. October 23, 2024. https://www.nytimes.com/2024/10/23/science/puberty-blockers-olson-kennedy.html