Rantz: UW Med used false claims to push gender affirming care for trans teen

UW Medicine propped up false claims by researchers who said gender-affirming care via puberty blockers leads to positive mental health outcomes for transgender teen patients. But that’s not what the research concluded, forcing the UW to edit the press release. After questions by the Jason Rantz Show on KTTH, the UW even removed a video created to promote the work.

It appears the researcher presented false claims to push back at recent policies the researchers and school abhor.

Fourth-year student at UW Medicine Arin Collin and UW Ph.D. epidemiology candidate Diana Tordoff tracked the mental health of 104 transgender patients aged 13 to 20 over the course of a year. The patients went through gender-affirming care, which the researchers defined as taking either Leuprolide, Testosterone, or Estradiol.

Using the data collected from patient experiences, the researchers and UW claimed in a press release that gender-affirming care “dramatically reduces” depression, calling it “lifesaving care.”  The study was published in JAMA Open Network.

“The results were very dramatic,” Collin declared.

Collin said this research shows that gender-affirming care has “a great deal of power in walking back baseline adverse mental health outcomes that the transgender population overwhelmingly burdens at a very young age.”

But the actual data did not show that.

 

The data showed gender affirming care didn’t impact depression

The study makes a bold claim.

“Our study provides quantitative evidence that access to PBs [puberty-blockers] or GAHs [gender-affirming hormones] in a multidisciplinary gender-affirming setting was associated with mental health improvements among TNB [transgender/non-binary] youths over a relatively short time frame of 1 year,” it reads.

As independent journalist Jesse Singal first noted, the research paper doesn’t back up this claim. In fact, there was virtually no improvement in mental health outcomes at all for the patients receiving gender-affirming care.

At the start of the study, the baseline number of patients that experienced severe-to-moderate depression was 59%. These 54 patients had not yet received gender-affirming care. By the end of the study, of the patients receiving gender-affirming care, the rate of severe-to-moderate depression was at 56% — or, just 3% better.

There was no difference when assessing anxiety. At the start of the study, 51% of teen patients not receiving gender-affirming care reported severe-to-moderate anxiety. By the end of the study, 51% of the patients receiving gender-affirming care still reported severe-to-moderate anxiety.

The “dramatic” improvement did not exist. In fact, it’s more in line with a 2021 study published in the British Medical Journal showing puberty blockers “had no significant effect” is the mental health of young trans patients.

When it comes to suicidality, there was a slight increase of 8% improvement — but not one that was statistically significant. The researchers did not articulate why this would be attributable to the puberty blockers, yet rates of depression and anxiety had no meaningful movement.

The poor outcomes are likely why a researcher, speaking on background, admitted to Singal that the data did not, in fact, improve mental health outcomes.

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The disingenuous claims

Researcher Collin explained that “receipt of any form of gender-affirming care, either or the puberty blockers or the gender-affirming hormones, was associated with a 60% reduction in depression and a 73% reduction in suicidality.” This is remarkably misleading

The stats Collin present come from comparing patients who went on gender-affirming care to those who didn’t. That’s it.

In other words, the patients who were not receiving gender-inclusive care at the end of the study reported higher levels of depression or anxiety than the comparable group at the start of the study. We’re supposed to assume it got worse because they weren’t receiving the gender-affirming care, but there’s no evidence presented explaining that’s why.

And, per Signal, it was based on data collected over the course of the year, not comparing the start of the study to the end of it. Indeed, 20 patients dropped out of the study within three months, but the researchers don’t explain why.

The data doesn’t show a “reduction in depression” because of the gender-affirming care. This is important because activists and activist-physicians claim that withholding gender-affirming care will lead to higher rates of suicide. But they don’t cite the long-term effects of this kind of care on teens because it doesn’t exist. Still, advocates of this kind of treatment insist it’s safe. They just can’t back up the claims.

The researchers also refuse to share the raw data for review, which is a red flag. Signal spoke with one of the most widely-cited researchers on the statistical technique Collin and her colleagues used to review the data. That expert excoriated the paper.

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The heavy press push

UW engaged in a heavy PR campaign to promote the research and hoped to make a political point. UW’s press release notes the research comes after Texas and Idaho passed what activists believe to be transphobic healthcare.

The push paid off.

KING 5, always happy to uncritically advance left-wing causes in the name of equity, rewrote the press release as a news story. Psychology Today added it to a list of studies showing the positive impacts of gender-affirming care, and it received glowing support from Science Friday. 

According to a spokesperson with UW, the researchers helped to craft the language used in the press release. But it was so misleading that the UW made substantial edits and pulled a video it produced to promote the research.

“The original version was the result of collaboration between the communications staff and researchers. After receiving some inquiries, there was acknowledgment that some of the language in the post could be misconstrued, therefore it was updated to more directly reflect the findings as reported in the study,” the spokesperson told the Jason Rantz Show on KTTH.

But by the time the edits were made, the false information was already regurgitated by uncurious outlets looking to push an agenda instead of getting the science correct.

I've updated this article to include the new study by @DianaTordoff et al. in @JAMANetworkOpen that examined the mental health impact of gender-affirming medical care for #trans youth.

There are now sixteen studies.#medtwitter #mentalhealth #LGBTQhttps://t.co/gMUjtrEaKP

— Jack Turban MD 🏳️‍🌈🧠 (@jack_turban) February 26, 2022

The bias in the research

For Collin, the work is personal. Perhaps, it’s so personal that she can’t overcome some bias.

For example, she argues that “gender identity is not a choice, and it isn’t something you can really change.” Perhaps that was true for her as a transgender woman. But individuals quite literally are choosing which gender they identify with — some claim to identify with multiple genders. That is a choice, disconnected from the biological reality of an individual.

“De-politicization of transgender folks would do so much. We’re just a community of people trying to live our lives and get the care we need, the science indicates that we need, in order to function as well as we can,” she said in UW publicity material.

Is she speaking as an objective researcher or as a member of the community looking for data to allow her to live as she wants to live? If the research results weren’t presented in such a misleading way that it forced the UW to edit its publicity materials, perhaps we wouldn’t need to even ask that question.

Why did the researchers mislead the public?

We don’t know why these researchers misled the public — or if they even believe they did. Neither Collin nor Tordoff agreed to an interview, but the UW stands behind the research. The study, however, was presented through a political lens.

Not only did the press release and subsequent coverage frame the research as a response to Republican-backed laws, but the actual research did as well. It concluded with the following:

Our findings have important policy implications, suggesting that the recent wave of legislation restricting access to gender-affirming care may have significant negative outcomes in the well-being of TNB youths. Beyond the need to address antitransgender legislation, there is an additional need for medical systems and insurance providers to decrease barriers and expand access to gender-affirming care.

They clearly believe there is an urgency to this, in light of legislation that’s either passed or will pass.  The study reads as if the researchers went into it to prove what they already believed was the case. It’s why they had to dramatically overstate the data and twist it into making their point, in my view.

This is not good science. It may, indeed, have implications as it relates to legislation. But it also has implications as it relates to teen patients who aren’t served by the misleading data.

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