I am aware of the McNamara et al’s Yale critique. Unfortunately, the paper appears to suffer from much of the self-interested groupthink that prompted the Cass Review.
My first red flag about the integrity of the Yale critique was the identity of the authors. Unlike Hilary Cass — who is a completely disinterested and ob…
I am aware of the McNamara et al’s Yale critique. Unfortunately, the paper appears to suffer from much of the self-interested groupthink that prompted the Cass Review.
My first red flag about the integrity of the Yale critique was the identity of the authors. Unlike Hilary Cass — who is a completely disinterested and objective professional with no stake in the outcome of her review — the Yale critique was authorized by Meredithe McNamara, and co-authored by some of the most prominent figures in gender medicine activism, including Johanna Olson-Kennedy and Jack Turban. Turban, especially, is infamous for dismissing and ignoring any practitioners who question “gender affirming care” (members of my organization, FAIR, have experienced this first hand). Olson-Kennedy, on the other hand, derives significant income from the practice of youth transitions. The financial conflicts of interest are significant.
The Yale critique was widely-hailed as the “debunking” of the Cass Review, but this is very misleading. To the contrary, the Yale Critique quickly unraveled under scrutiny from the BMJ:
Archives of Disease in Childhood (ADC) — an international pediatric journal from BMJ and the Royal College of Paediatrics and Child Health (RCPCH) — is a peer-reviewed analysis of the claims in the Yale paper. The BMJ’s analysis, co-authored by several of the U.K.'s leading clinicians including the past President of RCPCH, lays bare the naked self-interest in the Yale paper, concluding that the paper by McNamara et al. **is not a credible scientific effort, but rather, an attempt to influence U.S. litigation while masquerading as scientific critique.**
Here’s a sampling of the self-interest at play in the Yale paper: McNamara and several of the paper's co-authors serve as paid expert witnesses in over a dozen similar cases concerning youth gender medicine in the U.S., opposing state-imposed age restrictions on the practice. Its contributing authors have openly stated that their primary goal is to re-interpret the evidence for U.S. courts and judges, with the goal of overturning various laws imposing minimum age restrictions on youth transitions. In other words, this paper was intended to influence pending litigation.
The central premise of McNamara et al.'s paper is based on a fundamental confusion: they read the Review as if it is a clinical practice guideline, which it is not. *The Cass Review is an "independent review," a regulatory process specific to the U.K.; clinical practice guidelines are developed using a distinctly different process.*
The BMJ analysis also highlights several factual errors and misrepresentations found in the paper being examined, including its portrayal of the research conducted by the University of York. The authors conclude that it is time to move forward and focus on the implementation of the Cass Review's recommendations, in line with the NHS and the U.K.’s main medical societies.
Lastly, I frankly find it appalling that the Yale paper doesn’t address the most salient issue for parents of transgender children and addressed in the Cass Review: the unknown potential long-term adverse effects of “gender affirming care.”
Far from being a *bona fide* critique of the Cass Review, the Yale Critique is yet another example of why the medical and scientific establishment face such grave mistrust from a once-trusting citizenry. Like the media, the bias in these spaces has become so flagrant now that it may take decades to recover what has been lost.
Thank you, Enrique.
I am aware of the McNamara et al’s Yale critique. Unfortunately, the paper appears to suffer from much of the self-interested groupthink that prompted the Cass Review.
My first red flag about the integrity of the Yale critique was the identity of the authors. Unlike Hilary Cass — who is a completely disinterested and objective professional with no stake in the outcome of her review — the Yale critique was authorized by Meredithe McNamara, and co-authored by some of the most prominent figures in gender medicine activism, including Johanna Olson-Kennedy and Jack Turban. Turban, especially, is infamous for dismissing and ignoring any practitioners who question “gender affirming care” (members of my organization, FAIR, have experienced this first hand). Olson-Kennedy, on the other hand, derives significant income from the practice of youth transitions. The financial conflicts of interest are significant.
The Yale critique was widely-hailed as the “debunking” of the Cass Review, but this is very misleading. To the contrary, the Yale Critique quickly unraveled under scrutiny from the BMJ:
https://adc.bmj.com/content/early/2024/10/15/archdischild-2024-327994
The BMJ’s analysis, published in
Archives of Disease in Childhood (ADC) — an international pediatric journal from BMJ and the Royal College of Paediatrics and Child Health (RCPCH) — is a peer-reviewed analysis of the claims in the Yale paper. The BMJ’s analysis, co-authored by several of the U.K.'s leading clinicians including the past President of RCPCH, lays bare the naked self-interest in the Yale paper, concluding that the paper by McNamara et al. **is not a credible scientific effort, but rather, an attempt to influence U.S. litigation while masquerading as scientific critique.**
Here’s a sampling of the self-interest at play in the Yale paper: McNamara and several of the paper's co-authors serve as paid expert witnesses in over a dozen similar cases concerning youth gender medicine in the U.S., opposing state-imposed age restrictions on the practice. Its contributing authors have openly stated that their primary goal is to re-interpret the evidence for U.S. courts and judges, with the goal of overturning various laws imposing minimum age restrictions on youth transitions. In other words, this paper was intended to influence pending litigation.
The central premise of McNamara et al.'s paper is based on a fundamental confusion: they read the Review as if it is a clinical practice guideline, which it is not. *The Cass Review is an "independent review," a regulatory process specific to the U.K.; clinical practice guidelines are developed using a distinctly different process.*
The BMJ analysis also highlights several factual errors and misrepresentations found in the paper being examined, including its portrayal of the research conducted by the University of York. The authors conclude that it is time to move forward and focus on the implementation of the Cass Review's recommendations, in line with the NHS and the U.K.’s main medical societies.
Lastly, I frankly find it appalling that the Yale paper doesn’t address the most salient issue for parents of transgender children and addressed in the Cass Review: the unknown potential long-term adverse effects of “gender affirming care.”
Far from being a *bona fide* critique of the Cass Review, the Yale Critique is yet another example of why the medical and scientific establishment face such grave mistrust from a once-trusting citizenry. Like the media, the bias in these spaces has become so flagrant now that it may take decades to recover what has been lost.
Very sad, and very shameful.
Standing ovation, Monica.