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Society for Evidence-Based Gender Medicine

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We heard they'd ignite if we did this for long enough.
It's a social construct
Gender
Icon gender.svg
Spectra and binaries
Can you get me links to those Kiwifarms pages? […] Links are being passed to Fox News.
—Lisa Marchiano, SEGM advisor[1][2]
Society for Evidence-Based Gender Medicine (SEGM) and Genspect – key hubs of anti-LGBTQ+ pseudoscience identified in the SPLC's CAPTAIN report.
Southern Poverty Law Center,[3] which designated the two as anti-LGBT hate groups[4][5]

The Society for Evidence-Based Gender Medicine (SEGM) is a group that, despite its name, is averse to evidence and "gender medicine", i.e. modern transgender medicine.[6][7][8] According to a Yale School of Medicine-led report, SEGM's methods are detached enough from evidence-based medicine that they constitute "a major violation of the scientific method and the accepted conventions of research."[6] The group and its auxiliaries have been accused of pushing conversion therapy as an alternative to the standards of transgender healthcare that are accepted by conventional, independent medical institutions.[9][10][11][12][13] SEGM categorically denies there's such a thing as anti-trans conversion therapy.[9]

Or, if you're the attorney-general of Texas (a job always stocked with the brightest of medical minds, like Greg Abbott and subsequently Ken Paxton), they're a group of brave doctors exposing with facts and logic that live genital surgeries are taking place inside elementary school classrooms, that transition desistance rates are 100%, and that all gender transition is child abuse. Fine, we're exaggerating, but only a little.[6] SEGM has regularly been cited by governments fishing for rigorous-looking sources favorable to their anti-transgender policies: other than Texas, SEGM was a self-described provider of "critical evidence" in the UK's later-overturned Bell v TavistockWikipedia case.[9][14][note 1] Where it's been received well by politicians, it hasn't been received so well by large, independent medical bodies: SEGM's application for a booth at the conference of the American Academy of PediatricsWikipedia was denied.[9][note 2]

The authors of the aforementioned Yale report summarized their view of SEGM in a letter to the Florida Agency for Health Care Administration (which had by then been stacked by Ron "Pudding Fingers" DeSantis with anti-LGBT activists[16][17][18]), stating: "Although SEGM claims to be an international medical society, it is actually an activist group that opposes standard medical care for gender dysphoria. The SEGM has no publications or conferences and seems to consist solely of a website created by a small group of people with limited or no scientific credentials or clinical experience.[note 3] The site presents a cherry-picked collection of studies and narrative content that is full of scientific errors."[19] Be that as it may, DeSantis' government opted to pay at least one SEGM-affiliated "expert" as a consultant: Romina Brignardello-Petersen received $34,650.[20][21][22]

In one connection that does not instill much further confidence, SEGM's treasurer is an executive for Bon Secours Mercy Health,[23] which has been singled out by The New York Times and the Lown Institute for its especially greedy and dysfunctional practices, including: skimming money off a federal program intended to assist impoverished patients, then reinvesting that money in hospitals located in wealthier neighborhoods instead (or as they like to say, "A heritage rooted in the healing ministry of Jesus"[24]).[25][26][27] SEGM's own exact funding sources aren't well-known, but analysis of one of their 2020 fundraisers found that they received several anonymous donations of about $20,000 each.[28] In 2023, Health Liberation Now! analyzed some of SEGM's later funding, based on tax form disclosures.[22]

Expertise[edit]

What, you mean beyond having an official-sounding name and a sleek website? Isn't that expertise in itself? Fiiiine…

As of 2022 (though no longer as of 2023), SEGM listed its advisors on its website, and conveniently it listed their credentials.[2] Listed there were William Malone (the only endocrinologist) and Julia W. Mason (the only pediatrician).[note 4] And then there are the rest, where things begin to look somewhat questionable at points. There is Marcus Evans (a Freudian psychoanalyst[30]), Roberto D'Angelo (another psychoanalyst — but also a psychiatrist), Sasha Ayad (a counselor), Michael Biggs (a sociologist),[note 5] Richard Byng (a doctor),[note 6] Lisa Marchiano (a Jungian psychoanalyst!),[note 7] Stella O'Malley (a psychotherapist),[note 8] Avi Ring (a physiologist),[note 9] Sven Román (a child and adolescent psychiatrist),[note 10] Catherine Williamson (another psychoanalyst — that's the fourth one), and finally Colin Wright (a biologist, and the managing editor of Quillette).[2] In 2021, they did list pediatrician Julie Maxwell (who is also known for anti-LGBT and pro-abstinence activism within the Christian group LoveWise UK) as an advisor, but by 2022 she was delisted for unknown reasons.[28][2] A 2022 review of literature published by SEGM's fourteen "core members" found 75% of their academic publications consisted of "letters to the editor", which could be of limited scientific value since they are generally not peer-reviewed or fact checked.[6] According to a 2024 Current Opinion in Endocrinology, Diabetes & Obesity paper,[note 11] SEGM itself does "not produce scientific research".[37]

SEGM freely admits in its FAQ that most of the individuals who collaborate with them, among those who actually happened to be licensed clinicians (which, as seen above, might be defined such that "licensed clinicians" includes roughly thirty percent Freudian psychoanalysts…), are not specialists in transgender medicine but rather "clinicians who provide healthcare to young people more generally".[38] This should completely dispel the idea that it's anything more than a loose, often ideologically-motivated coalition, and not a group of "gender medicine" specialists as its title may suggest to a casual onlooker. If you were looking for a professional association for trans medicine specialists, the World Professional Association for Transgender HealthWikipedia (WPATH) fits the bill more closely; it also produces the Standards of Care for the Health of Transgender and Gender Diverse People.Wikipedia It may not surprise you that these standards of care are quite different from what SEGM proposes.[39] That's despite the fact that WPATH has sometimes been criticized by some transgender health activists as too conservative (most usually in the sense of being old-fashioned, or overcautious).[40][41]

Misrepresentations and bad science[edit]

Neuroscience[edit]

SEGM and Genspect (another anti-trans group which SEGM is pretty much joined at the hip with) have argued against gender transition for people under the age of 25 (SEGM emphasizes a "need to safeguard" 18–25-year-olds), based on the idea that ~25 has been proven as the age at which the human brain is fully matured,[42][28][43] which is a myth denounced even by the researchers whose work it is based on.[44][45] Brain maturity can reach "adult-level" by the teenage years, and some don't even reach that level of maturity by their thirties.[46][47][44] Beyond promoting the myth, they ignore decades of accumulated medical knowledge culminating in practices such as mature minor doctrineWikipedia and Gillick competence.Wikipedia These are based partly in prior research that suggests teenagers and in some ways even preadolescents can make medical decisions about as rigorously as adults.[48][49] One paper on this topic in the Journal of Bioethical Inquiry articulates, "Literature examining advances in neuroscience and understanding of adolescent development explains that decisions made in medical contexts are generally not rapid, emotionally charged, or highly subject to peer influence, the conditions that may lead to impulsive decisions in non-medical contexts".[48] In other words, trans youth accessing gender-affirming care isn't some radical trans activist plot bankrolled by Big Pharma, but an extension of existing medico-legal frameworks that allow teens to make informed decisions independently (and sometimes in opposition to) their parents on matters such as abortion,[50] contraception,[51] pregnancy care,[52] and life-saving treatment.[53][note 12]

Rapid-onset gender dysphoria[edit]

See the main article on this topic: Rapid-onset gender dysphoria

SEGM has also repeatedly promoted the contentious and unproven rapid-onset gender dysphoria (ROGD) hypothesis — a hypothesis that would appear to contradict the above-described general principle that adolescents are capable of making decisions at an adult-level when they are in a medical context, that aren't "highly subject to peer influence" (or "social contagion", as the ROGD hypothesis puts it).[8][9][48]

Other than the original Littman 2018 ROGD study, SEGM posted a notice on its website of a paper which, according to SEGM, lent "further credibility to the rapid onset gender dysphoria (ROGD) hypothesis".[54] That paper, which was later retracted by the journal's publisher, was conducted by J. Michael Bailey, a generally questionable figure;[note 13] the other name cited as an author is a pseudonym for "the mother of a gender dysphoric child she believes has ROGD" (clearly, we're recruiting only the most neutral of co-authors). Like Lisa Littman's 2018 paper, this one used surveys of parents who used an anti-transgender website (in this case, it was Parents of ROGD Kids) as its body of evidence.[55] Although the intrinsic weaknesses and caveats of this methodology could be inferred from the many criticisms of Littman's 2018 paper,[56][45] what actually got the paper retracted was a concern about a lack of informed consent in collecting the data.[57] Kenneth Zucker, the editor of the journal this was published in (Archives of Sexual Behavior), has himself previously been accused of overseeing practices at his clinic that amounted to anti-transgender conversion therapy.[58][59] As editor of the same journal, he approved publication of a study (alongside critical commentary) promoting anti-gay conversion therapy, skipping formal peer review (the author later denounced his own paper).[60] Indeed, Zucker would later become a speaker for SEGM in October 2023.[61]

It is suggested by Julia Serano,Wikipedia based on some evidence, that one of SEGM's top advisors, psychoanalyst Lisa Marchiano, is in fact the originator of the "transgender social contagion" hypothesis that culminated in the 2018 Littman study.[62][63] It is also suggested by leaked email correspondence that she was the operator of the blog Youth Critical Trans Professionals, which was one of that study's sources of data.[32]

A factoid promoted by SEGM, that would appear to be related to its promotion of the ROGD hypothesis, is its use of charts that illustrate an increase in gender dysphoria referrals among young people in the United Kingdom over some ten years. Although this is made to look like a big deal, the Yale report puts it like this: "in fact, the absolute numbers are small … taking the data at face value, in 2020 about 2600 children and teens sought treatment at the UK gender clinic. That is a very small percentage of Britain's child population. Further, the data appear to show only the number of children and adolescents referred for consultation; only a subset of these will ultimately be diagnosed with gender dysphoria and will continue with medical treatment. The claimed 'spike' in referrals certainly reflects the reduction in social stigma over the past decade and the expansion of care options."[6] Aside from broader social acceptance (which may be quite key alone), we might add that there is a greater general awareness of transgender people existing at all in recent decades.[64][65] It's hard to articulate oneself through words and concepts one doesn't even yet know about.

Desistance[edit]

Do 61-98% of young transgender people desist in their trans identification if left untreated? SEGM supposes that they do, but they erroneously based this on Steensma et al. (2013).[6] This study wasn't designed to examine such a figure reliably, as its lead author acknowledges (Steensma himself emphasizes that this paper should not be used as though it accurately calculated desistance/persistence figures that could be widely-generalized), and it shows: patients are considered to have "desisted" if they simply don't respond later to the researchers, or opt out of participating.[6] What this paper was actually designed to do was to "study the characteristics of those who persisted". As the aforementioned Yale report points out: "Patients can fail to respond to a study request for many reasons, including having moved away, receiving treatment elsewhere, or being uninterested in participating in a study."[6] Similar limitations are found in some other studies cited for this matter, including Steensma et al. (2011), plus Wallien and Cohen-Kettenis (2008).[66]:3 This exact misrepresentation by SEGM is what the Yale report called "a major violation of the scientific method and the accepted conventions of research".[6] Studies that were designed to calculate desistance/persistence figures have found high persistence rates, with or without medical intervention.[6][67][68][69] Astonishingly, SEGM and its auxiliaries have fiercely criticized the limitations of the studies produced by the Dutch research group that Steensma is a part of, but despite this, continue to selectively cite this exact same group of studies as proof of desistance anyway.[22]

Other studies cited by SEGM in fact count many minors as "transgender" using antiquated definitions: by simple virtue of the fact that they did not strictly conform to society's gender roles. Many in the "desisted" groups were not ever diagnosed with gender dysphoria and in fact were explicitly marked as not meeting the threshold for diagnosis. To quote just part of the critique as put by Newhook et al. (2018):

"Rather than a representative group of transgender children, which is assumed in many interpretations, this literature focused on small groups of gender-non-conforming children in two clinics. … As noted by Ehrensaft (2016) and Winters (2014), those young people who did not show indications of identifying as transgender as children would consequently not be expected to identify as transgender later, and hence in much public use of this data there has been a troubling overestimation of desistance. … Furthermore, even within Toronto and the Netherlands, this research was limited to children whose parents chose to bring them to a clinic for diagnosis and treatment and thus may have believed the child's difference was a problem, and one that required psychological treatment. Children whose parents affirmed their gender (or who did not wish to or who were unable to access clinical treatment for any reason) were likely not included in these studies. This is significant because more recent work has shown that children raised by parents who validate their gender identity (Durwood, McLaughlin, & Olson, 2017; Olson & Durwood, 2016) are likely to demonstrate a different (and in some respects healthier) life course than children with parents who are reluctant or unwilling to affirm gender-nonconformity."[66]

Conversion therapy[edit]

See the main article on this topic: Conversion therapy

SEGM and its leadership hold the position that conversion therapy aimed at changing one's gender identity does not exist; they contend that the category known as "conversion therapy" only describes attempts to change sexual orientation.[9][70] The group doesn't even appear to agree with use of the term "transgender" without appending "-identified" to it.[71] The group's secretary, William Malone, alongside SEGM advisor Colin Wright, have claimed that: "Counseling can help gender dysphoric adolescents resolve any trauma or thought processes that have caused them to desire an opposite sexed body."[9]

One paper in the Journal of Sex & Marital Therapy, criticizing another paper that had itself been published in that same journal and funded by SEGM, compared SEGM to the National Association for Research & Therapy of Homosexuality (NARTH), a group dedicated to preparing pseudoscientific reports in favor of conversion therapy.[10] The comparison may have been more apt than the author realized, considering NARTH's apparent affinity for Sigmund Freud.[72] (Would Freud leave us alone for five minutes?)

Such attempted-conversion practices are, almost needless to say, well outside the mainstream of evidence-based medicine. The Substance Abuse and Mental Health Services Administration has considered them inappropriate since at least 2015.[73] The American Academy of Pediatrics is likewise opposed to such practices on the grounds they are "unfair and deceptive".[74][9] According to the Independent Forensic Expert Group: "Conversion therapy is a set of practices that aim to change or alter an individual's sexual orientation or gender identity. It is … performed despite evidence that it is ineffective and likely to cause individuals significant or severe physical and mental pain and suffering with long-term harmful effects."[75]

Freudian slop[edit]

The recurring appearance of psychoanalysts among SEGM's advisors is perhaps not totally coincidental. At least one of them, Marcus Evans, has more or less expressed that the mainstream view of gender dysphoria and transgender medicine conflicts with his view of Sigmund Freud's theories.[28][30][76] Although Freud's theories could be considered a precursor to modern psychiatry, the continued insistence on applying many Freudian aspects is now most likely a quite antiquated approach (some argue it is simply pseudoscientificKarl Popper was one such detractor).[77][78] A paper in The Canadian Journal of Psychiatry that discusses the relevance (or lack thereof) of psychoanalysis to modern psychiatry states, "In fact, one of the main reasons for the decline of psychoanalysis is that the ideas of Freud and his followers have gained little empirical support. … The absence of solid and persuasive evidence for the theory may be the consequence of its self-imposed isolation from the empirical sciences. … virtually all attempts to carry out revisions [to psychoanalysis] have fallen into the same trap as afflicted Freud, that is, basing theory on clinical experience rather [than] on replicable scientific evidence."[77]

Anti-trans advocates frequently insist transness is caused by trauma or abuse.[79][80][note 14] It is perhaps unsurprising to find their ranks brimming with Freudian psychoanalysts given that Freud infamously attributedWikipedia a host of psychological issues to childhood sexual trauma. SEGM has claimed that "adverse childhood histories and poor attachments" predispose young people to gender dysphoria.[83] Nicolas Evzonas, writing in the journal Research in Psychoanalysis in 2020, observed that while psychoanalysis created an "epistemological turning point by drawing attention to the complex psychic reality" of people, it tends to "regress to a[n] univocal and linear conception of material truth when it comes to gender."[84] He held that psychoanalysts dealing with "gender-variant people" often become "deaf to the subject's [the patient's] singular speech" and "parasitized by the most common prejudices," leading them to equate "trans identities" with "psychoses, borderline pathologies, or perverse structures."[84] He argued that such pathological frameworks contribute to transmedicalism, situating the "phallocentric dichotomy between the 'real' and the 'fake' trans, between the curable and the incurable" as a legacy of Freud's older conception of the "presumed homosexual" ("curable") and "true homosexual" ("incurable").[84] Sheila L. Cavanagh, in the journal Trans Studies Quarterly, also pointed to the the historical tendency of psychoanalysts to frame "trans* subjectivity and gender variance as pathological", citing Freud's construction of the "masculinity complex" and "penis envy"Wikipedia as helping "render female masculinities [transmasculinity] deviant" while Lacan's writing on "transsexualist jouissance"Wikipedia has "been used to substantiate claims of trans* mental illness" in transfeminine subjects.[85]

Despite all of this, it can't be precluded that there are psychoanalysts who have reinterpreted or rehashed these theories in an LGBT-friendly way (given the mention by The Canadian Journal of Psychiatry that there have been attempts to revise psychoanalysis for a more contemporary age), including such a way that it would be inclusive to transgender people.[86] There is a diversity of interpretations within any movement, and psychoanalysis is likely no exception. This is true regardless of whether it's to be considered a pseudoscience.

Relation to other entities[edit]

The aforementioned Yale report states: "The core members of SEGM frequently serve together on the boards of other organizations that oppose gender-affirming treatment and, like SEGM, feature biased and unscientific content. These include Genspect, Gender Identity Challenge (GENID), Gender Health Query, Rethink Identity Medicine Ethics, Sex Matters, Gender Exploratory Therapy Team, Gender Dysphoria Working Group, and the Institute for Comprehensive Gender Dysphoria Research."[6]

Stephen Beck, who is also SEGM's treasurer,[87] co-founder, and an early board member, is also an executive at Bon Secours Mercy Health,Wikipedia one of the largest Catholic health networks in the US.[33][88] Bon Secours has been cited as among the "worst examples of profiteering and dysfunction in health care", engaged in the "sleaziest kind of theft" from the poor by the Lown Institute; allegations also corroborated by a New York Times investigation.[25][26] In one correspondence letter penned by five SEGM advisors to The Lancet Child & Adolescent Health, they used a book by gender critical writer Kathleen Stock (who, at the time of their writing, was a trustee for the LGB Alliance[89]) as a citation to refute a clinical study.[90]

Two SEGM affiliates, Romina Brignardello-Petersen and Quentin Van Meter,Wikipedia are part of the Catholic Medical AssociationWikipedia (Brignardello-Petersen having done work for SEGM in the past, Van Meter being an ally to SEGM),[33] a group that views homosexuality as non-inborn and preventable;[91] it has a "faith-based commitment" against gender transition, because it "violates the teachings of the Church".[18] Van Meter himself takes this view, calling gender transition for minors an "abomination", "from social to medical to surgical" — and adds that his faith drives his medical practice.[22] In 2020, Van Meter was "discredited as an expert" on the subject by a Texan court.[92] SEGM's secretary William Malone, treasurer Stephen Beck, and director Julia Mason have also co-signed letters alongside members of other anti-LGBT groups (including ACPeds president Van Meter and ACPeds "expert witness" Paul Hruz[93][9]), in opposition to the standard guidelines for transgender healthcare as laid out by the Endocrine Society.Wikipedia[28][94][95]

Genspect[edit]

SEGM is closely affiliated with Genspect in particular, with which they shared at least seven top advisors as of 2022, including Genspect's founder and director Stella O'Malley.[96][97][70] Audio that was leaked from O'Malley in 2022 demonstrated the ideologically anti-trans nature of that organization.[98][45] Leaked chat logs proved it even further — in one instance, Genspect's vice director says their focus on under-25s is mere marketing.[70] O'Malley also once appeared in a documentary produced by (infamously anti-reptilian) conspiracy theorist David Icke's company.[99]

Another Genspect/SEGM advisor, Kathleen Goonan, is known to have attended at least two events for the right-wing Moms for Liberty group.[100] O'Malley is also the co-founder of Thoughtful Therapists, and known to have met with the Christian conservative group, Family Education Trust, in a supportive capacity.[101][14][102][103] One advisor for Genspect is Abigail Shrier, who wrote the book Irreversible Damage: The Transgender Craze Seducing Our Daughters (a Regnery Publishing output).[104]

Both SEGM and Genspect have faced scrutiny for promoting James Cantor.[105][98] Cantor is an anti-trans psychologist who has no clinical experience in treating transgender youth, though, he worked under Ray Blanchard and the aforementioned Kenneth Zucker.[45][106] Something even more contentious, however, is that Cantor explicitly advocates for the inclusion of pedophilia in the gay community.[107][98]

See also[edit]

External links[edit]

Notes[edit]

  1. An underrated feature of the Bell case was that, as an attack on Gillick competence,Wikipedia the anti-transgender side of the case rubbed shoulders with anti-abortion interests (Gillick competence doctrine has been targeted in the past by such interests because it bolsters the case that minors may receive contraception, including abortions). Bell's solicitor, Paul Conrathe, is known for his involvement in various cases dedicated both to restricting access to abortion and/or to transgender medicine (British GQ, July 4, 2022); (Refinery29, May 19, 2022); (openDemocracy, December 2, 2022). It has been suggested that this alliance of interests could have benefited SinclairsLaw financially, the Religious Right-linked law firm with which Conrathe is associated, by way of numerous anti-trans fundraisers (Trans Safety Network, January 16, 2021).
  2. A paper in the journal Social Science & Medicine cites: "According to a Yale School of Medicine report, both [Genspect and SEGM] have spread 'biased and unscientific content' about GAC [gender-affirming care] and that SEGM is 'without apparent ties to mainstream scientific or professional organizations' (Boulware et al., 2022, p.29)."[15]
  3. As shown below, it's likely at least some of their members do have some clinical experience, so "limited" rather than "no" was more accurate here. As SEGM itself admits, though, its members don't have especially abundant experience in treating transgender people in particular (as the people who wrote the Yale report do).
  4. Although a fellow of the American Academy of Pediatrics (AAP), Mason clashed with them about their position on transgender medicine, co-writing an opinion piece with (Manhattan Institute fellow) Leor Sapir on the subject that was published in the Wall Street Journal. The op/ed subsequently received a response by the AAP itself.[29]
  5. Who made a number of transphobic posts under an online pseudonym, according to The Oxford Student, a student newspaper at his university. He also accused the top medical journal in the world, The Lancet, of supporting eugenics because it wasn't transphobic.[31]
  6. Doctor that he may be, he still writes a bad study.[22] He signed a letter titled "Trans ideology is damaging children" in The Times,[32] and as of April 2022 was part of the NHS England working group on gender dysphoria.[33]
  7. Her "gender exploratory therapy", which involves attempting to convince a transgender patient to delay transitioning, has been called "a new form of conversion therapy".[34]
  8. Also the founder of Genspect and Thoughtful Therapists, two more anti-trans groups.
  9. A proponent of the contentious rapid-onset gender dysphoria hypothesis. Deceased in September 2023.[35] Seems we're down one more doctor from now on — that's a shame.
  10. Founding member of Läkaruppropet, called "a Swedish version of the Koch-supported Great Barrington Declaration".[15][36]
  11. Transgender medicine falls under endocrinology, since it includes hormone replacement.
  12. The legal history and bioethical thought concerning the right of minors to refuse life-saving treatment is more complex than that of reproductive care given the stakes. Courts have sometimes overidden young patients seeking to decline treatment for life-threatening illnesses. For example, in a widely-reported 2009 case, Daniel Hauser, a 13-year-old Minnesota boy, was ordered to undergo chemotherapy for treatable Hodgkin lymphoma. Hauser was reportedly "unable to articulate" the religious basis for his refusal "beyond the notion of 'do no harm'."
  13. Do NOT look up "The Fucksaw Incident".
  14. Genspect asserts that "developmental trauma may drive trans identification in kids."[81] Parents of ROGD Kids considers "sexual trauma" a "cause" of gender dysphoria.[82]

Further reading[edit]

References[edit]

  1. Jude Ellison S. Doyle (March 23, 2023). "Inside the TERF Harassment Machine". Medium. Archived from the original. Based on email correspondence that was leaked by an "ex-detransitioner" who was previously active in anti-trans activism.
  2. 2.0 2.1 2.2 2.3 (August 16, 2022). "About Us". Society for Evidence-Based Gender Medicine, via the Wayback Machine.
  3. "Anti-LGBTQ". Southern Poverty Law Center.
  4. "Hate Map: Idaho, Anti-LGBTQ Groups". Southern Poverty Law Center.
  5. "Hate Map: California, Anti-LGBTQ Groups". Southern Poverty Law Center.
  6. 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 (April 28, 2022). "Biased Science in Texas & Alabama". Yale School of Medicine.
  7. Caraballo, Alejandra (Winter 2022). "The Anti-Transgender Medical Expert Industry" (in en). Journal of Law, Medicine & Ethics (Cambridge University Press) 50 (4): 687–692. doiWikipedia:10.1017/jme.2023.9. ISSN 1073-1105. "The most prominent of the pseudo-scientific organizations in the anti-trans space is the Society for Evidence Based Gender Medicine (SEGM). SEGM posits that the level of medical evidence for the treatment of gender dysphoria in youth is of 'low quality' and as a result treatments for gender dysphoria should be barred by law[.] ... They cite to the results of their own advocacy efforts in the UK NHS, and the Swedish Karolinska Hospital which has been subject to substantial public pressure to restrict access to gender affirming care. In a snowball effect, the small successes in their efforts are built up to create momentum to further restrict care for trans youth around the world. Unfortunately, the veneer and 'teach the controversy' tactics are beginning to gain traction in the courts." 
  8. 8.0 8.1 "Trans Rights: Finding and Evaluating Information". Cornell University Library. Retrieved November 13, 2023; page had then been last updated November 2, 2023. (Archived). Quote: "Be alert for groups that present as scientific/medical organizations but which are actually activist groups (e.g., the 'Society for Evidence-based Gender Medicine', or SEGM: it has been widely reported that despite presenting itself as a mainstream medical association, this organization is actually a think tank aligned with several anti-LGBT groups, and promotes the rapid-onset gender dysphoria, or ROGD, hypothesis - a term discredited and actively discouraged by medical associations worldwide, due to the lack of scientific evidence behind it and the potential harm that its' use may cause)."
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 AJ Eckert (October 17, 2021). "Conclusions Not So NICE: A Critical Analysis of the NICE Evidence review of puberty blockers for children and adolescents with gender dysphoria". Science-Based Medicine.
  10. 10.0 10.1 Drescher, Jack (2023-01-02). "Informed Consent or Scare Tactics? A Response to Levine et al.’s “Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults”" (in en). Journal of Sex & Marital Therapy 49 (1): 99–107. doiWikipedia:10.1080/0092623X.2022.2080780. ISSN 0092-623X. 
  11. Castro, Saúl (2022-06-16) (in es). Ni enfermos ni pecadores: La violencia silenciada de las «terapias de conversión» en España (Neither sick nor sinners: The silenced violence of 'conversion therapies' in Spain). Penguin Random House Grupo Editorial España. pp. ~40. ISBN 978-84-666-7252-8. 
  12. Erin Reed (January 13, 2023). "Unpacking ‘gender exploratory therapy,’ a new form of conversion therapy". Xtra.
  13. Ashley, Florence (2022). Association for Psychological Science. "Interrogating Gender-Exploratory Therapy" (in en). Perspectives on Psychological Science (SAGE Publications) 18 (2): 472–481. doiWikipedia:10.1177/17456916221102325. ISSN 1745-6916. PMID 36068009. 
  14. 14.0 14.1 Lee Leveille (June 1, 2022). "A New Era: Key Actors Behind Anti-Trans Conversion Therapy". Health Liberation Now!.
  15. 15.0 15.1 Wuest, Joanna; Last, Briana S. (March 2024). "Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors". Social Science & Medicine 344: 116533. doiWikipedia:10.1016/j.socscimed.2023.116533. 
  16. Quinnehtukqut McLamore and Lauren McNamara (January 15, 2023). "Submission to the report on FoRB and SOGI". Office of the United Nations High Commissioner for Human Rights (recipient).
  17. Brooke Baitinger (August 3, 2022). "Showdown: LGBTQ+ rights vs. state ban on transition-related medical care for trans kids". Florida Phoenix. Quote: "The board consists of fifteen members appointed by the governor and confirmed by the Senate. It’s been stacked with anti-trans doctors, some of whom are affiliated with anti-trans fringe movements such as Genspect and the Society for Evidence-based Gender Medicine, known as SEGM."
  18. 18.0 18.1 Zinnia Jones (August 25, 2022). "Catholic Medical Association members wrote a majority of Florida Medicaid’s anti-trans expert reports. Last year, CMA declared a faith-based commitment against approving of any transition care." Gender Analysis.
  19. Alstott et al. (July 8, 2022). "A Critical Review of the June 2022 Florida Medicaid Report on the Medical Treatment of Gender Dysphoria" Yale University.
  20. (January 23, 2023). "Florida runs up tab in Medicaid transgender case". CBS News. CBS Miami.
  21. Mahoney, Emily L.; Ellenbogen, Romy (August 2, 2023). "Florida veered from norms to strip transgender care from Medicaid, records show". The Tampa Bay Times. 
  22. 22.0 22.1 22.2 22.3 22.4 Lee Leveille and Quinnehtukqut McLamore (February 7, 2023). "SEGM Exposed Reloaded: The Shadow Money Behind a Leading Anti-Trans Think Tank". Health Liberation Now!.
  23. Citations:
  24. Our History Bon Secours Mercy Health.
  25. 25.0 25.1 Brooks Sutherland (January 11, 2023). "'Sleaziest kind of theft:' Nonprofit names Bon Secours Mercy Health on list of profiteers". The Cincinnati Enquirer.
  26. 26.0 26.1 Katie Thomas and Jessica Silver-Greenberg (September 24, 2022). "Profits Over Patients: How a Hospital Chain Used a Poor Neighborhood to Turn Huge Profits". The New York Times. Archived from the original.
  27. Nathan J. Robinson (October 3, 2022). "Is There Anyone Worse Than a For-Profit Hospital Operator?". Current Affairs. Quote: "A separate Times investigation of a different hospital chain revealed yet more skulduggery. That one, ​​Bon Secours Mercy Health in Richmond, Virginia, was accused of extorting poor Black patients while making enormous profits. A “hollowed-out” hospital in a Black part of town had “the highest profit margins of any hospital in Virginia, … generating as much as $100 million a year,” in part because the hospital took advantage of “a federal program that allows clinics in impoverished neighborhoods to buy prescription drugs at steep discounts, charge insurers full price and pocket the difference.” The Times documents how a hospital that had been founded by Black doctors in 1907 to serve the community eventually became a cash-cow that offered bare-bones services but made immense amounts of money for its owners."
  28. 28.0 28.1 28.2 28.3 28.4 Mallory Moore (August 26, 2021). "SEGM uncovered: large anonymous payments funding dodgy science". Trans Safety Network.
  29. Academy of Pediatrics Responds on Trans Treatment for Kids: To ‘affirm’ a child or teen means destigmatizing gender variance and promoting the child’s self-worth. by Moira Szilagy, President, American Academy of Pediatrics (Aug. 21, 2022 12:37 pm ET) Wall Street Journal.
  30. 30.0 30.1 (June 22, 2021). "Susan & Marcus Evans- ‘Gender Dysphoria’, a review". By Lily Maynard.
  31. Transphobic tweets linked to Oxford sociology professor by James Ashworth and Charlie Willis (26th October 2018) The Oxford Student.
  32. 32.0 32.1 Zinnia Jones. "Lisa M. Marchiano, LCSW". Gender Analysis.
  33. 33.0 33.1 33.2 Zinnia Jones (January 11, 2023). "Anti-trans group SEGM’s cofounder Stephen Beck is an executive at Bon Secours Mercy Health, the fifth-largest Catholic healthcare network in the US". Gender Analysis.
  34. Unpacking ‘gender exploratory therapy,’ a new form of conversion therapy: The practice is sold as supportive care—but in reality, it’s used to delay transition until a person no longer identifies as trans by Erin Reed (January 13, 2023 2:41 pm EDT) Xtra*.
  35. Avi Ring (2023). "Stortinget bør ikke godkjenne forbudet mot konverteringsterapi". Subjekt.no. Quote: "Avi Ring was visiting professor at the University of Oslo, and helped found the Gender Identity Challenge (GENID) Scandinavia. The author of the article died shortly after this text was written. His wish was for relatives to have the text published."
  36. "Sven Román". Brownstone Institute. Quote: "He is also one of three physicians who in March 2021 founded Läkaruppropet (The Physicians' Appeal), a Swedish response to The Great Barrington Declaration".
  37. Preston, Stephanie; Lopez, Ximena (2024). "Legislation, medicine, and politics: care for gender diverse youth" (in en). Current Opinion in Endocrinology, Diabetes & Obesity 31 (1): 43–52. doiWikipedia:10.1097/MED.0000000000000845. ISSN 1752-296X. 
  38. (November 3, 2023). "Frequently Asked Questions". Society for Evidence-Based Gender Medicine, via the Wayback Machine.
  39. For example, the standards of care are more supportive of gender transition for teenagers than SEGM would like. See: Coleman, E.; Radix, A. E.; Bouman, W. P.; Brown, G. R.; de Vries, A. L. C.; Deutsch, M. B.; Ettner, R.; Fraser, L. et al. (2022). "Standards of Care for the Health of Transgender and Gender Diverse People, Version 8" (in en). International Journal of Transgender Health 23 (sup1): S1–S259. doiWikipedia:10.1080/26895269.2022.2100644. ISSN 2689-5269. 
  40. Jedeed, Laura (2023). "The Parent Trap". Lux. 
  41. Dr. William Powers (November 14, 2022). "The transgender community really should be nicer about WPATH as a whole." Reddit.
  42. Brooke Migdon (January 13, 2023). "Transgender youth health care bans have a new target: adults". The Hill. (Article links Genspect's tweet on the subject).
  43. (February 27, 2022). "Summary of Key Recommendations from the Swedish National Board of Health and Welfare (Socialstyrelsen/NBHW)". Society for Evidence-Based Gender Medicine, via the Wayback Machine. Quote: "Another significant gap in the current guidelines is that they do not address the care for 18–25-year-olds. … The need to safeguard this vulnerable cohort requires careful consideration because though they are recognized as “young adults,” this cohort is distinctly different from mature adults due to differences in terms of brain maturity and life experiences."
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  56. Rider, G. Nic; Tebbe, Elliot A. (2021). "Anti-Trans Theories". In Goldberg, A. E.; Beemyn, G.. The SAGE Encyclopedia of Trans Studies, Volume 1. Thousand Oaks, Calif.: SAGE Publications. pp. 39–43. doiWikipedia:10.4135/9781544393858.n12. ISBN 978-1-5443-9382-7. "Another critical concern in the methodology underlying Littman’s ROGD paper is that although the parents themselves who were sampled may have been surprised by their child’s trans identity or felt that their identity development was rapid or abrupt, data from the youth themselves were not collected. … That is, the youth themselves may not have experienced their gender identity development as rapid or a sudden onset. Rather, they may have chosen to not disclose their trans identity to their parents or caregivers for a variety of reasons" 
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