Bench Memos

Health Care

A Puberty-Blocker Bombshell 

A person holds a sign during a ‘March for Queer & Trans Youth Autonomy’ in Washington, D.C., March 31, 2023. (Leah Millis/Reuters)

The New York Times yesterday revealed the simultaneously astonishing and unsurprising news that one of America’s most prominent gender-transition providers, Johanna Olson-Kennedy, has intentionally not published the results of her “multimillion-dollar federal project” on puberty blockers in minors — because she found that “[p]uberty blockers did not lead to mental health improvements.” According to the Times, Olson-Kennedy “was concerned the study’s results could be used in court to argue that ‘we shouldn’t use blockers’” in minors.

Olson-Kennedy tried to rationalize the finding that puberty blockers did not improve mental health by asserting that it was “most likely because the children were already doing well when the study began.” Of course, as the Times points out, “[t]hat conclusion seemed to contradict an earlier description of the group, in which Dr. Olson-Kennedy and her colleagues noted that one quarter of the adolescents were depressed or suicidal before treatment.” And these weren’t older adolescents — the mean age in the puberty blocker cohort was just 11.2 years old. Their reported issues were significant: According to Olson-Kennedy’s own study, “[e]levated depression was endorsed by 28.6%,” 23.6 percent “endorsed lifetime [suicidal ideation],” and 22.1 percent “scored in the clinical range for total anxiety.”

In short, Olson-Kennedy’s reason for withholding publication and her excuse for the finding of no positive effect are contrary to principles of evidence-based medicine, as Abigail Anthony notes over on The Corner. But none of this is surprising when it comes to gender-transitioning issues, given that the major American medical-interest groups are focused here on ideology rather than science. What this episode reveals is another major deficiency in the body of gender-transitioning evidence.

Naturally, data about gender interventions in minors can only come from providers who already believe in those interventions — lack of evidence and significant risks notwithstanding — so when data come back with adverse results, those results are simply not published. Thus, for instance, not just this latest revelation but also a widely publicized 2023 study about cross-sex hormones stemming from the same Olson-Kennedy NIH grant. That study “suspiciously omitted data about most of the outcomes that the study set out to examine.” (As explained here at page 36 and by Tennessee’s experts in United States v. Skrmetti at J.A. 425-27 and 578-81.) That study also glossed over that two of about 315 participants committed suicide. (As explained on pages 25-28 here.)

Likewise, we now know that when the World Professional Association of Transgender Health commissioned systematic reviews of the evidence before publishing its latest standards, Johns Hopkins “found little to no evidence about children and adolescents” — so WPATH simply did not publish most of the reviews. And the Times notes that a British attempt to replicate a small study suggesting limited improvements was unsuccessful — but that result was “not made public” for years.

Even if academics were to try to publish results that the gender-transitioning medical complex dislikes, they would face the ideological block of medical journals. When Professor Lisa Littman published results suggesting a social-contagion element of gender dysphoria in adolescents, the blowback was so severe that the journal forced a republication with a new title and a commentary — even though no error in methods or results was found. Yet the Biden administration and medical-interest cheerleaders use this forced “correction” to pronounce the study “discredited.”

So when the Biden administration, the ACLU, and the AAP claim that medical evidence supports transitioning minors, it is worth keeping in mind not only the weakness of the evidence they cite but also the ideological hegemony that influenced the body of existing evidence. Unfortunately, this deficiency is not a new problem in medical research, as Dr. Marty Makary from Johns Hopkins explains in the new book, Blind Spots.

The Times does not address the intriguing question of whether the Biden administration via the NIH had access to Olson-Kennedy’s withheld data showing that puberty blockers did not improve mental health — particularly when it was telling the Supreme Court that “overwhelming evidence establishes that” “treatment with puberty blockers” “directly and substantially improves the physical and psychological wellbeing of transgender adolescents with gender dysphoria.” Of course, we know that the Biden administration already knew that Johns Hopkins found poor evidence, as HHS officials wrote that “[k]nowing that there is little/no evidence about children and adolescents is helpful.” But that did not stop the Biden administration from making its claim about “overwhelming evidence” to the Supreme Court in convincing it to hear Skrmetti.

Meanwhile, the Biden administration continues to emphasize to the Supreme Court that “the Nation’s leading children’s hospitals” “offer [transitioning] to adolescent patients.” But we now know that at least University of Southern California, Northwestern, Harvard, and the University of California San Francisco (all of which participated in Olson-Kennedy’s research) found no evidence that puberty blockers improve mental health. One wonders how much other evidence has been suppressed for ideological reasons by medical providers and authorities who loudly adhere to “evidence-based medicine.”

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