Society for Evidence-Based Gender Medicine

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Society for Evidence-Based Gender Medicine (SEGM)
AbbreviationSEGM
Established2020;4 years ago (2020)
Type Nonprofit
Affiliations Genspect
Website segm.org

The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying, to limit and remove the rights of transgender youth and adults. The group routinely cites the unproven and discredited conspiracy of rapid-onset gender dysphoria and has falsely claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. [1] SEGM is often cited in anti-transgender legislation and court cases, sometimes filing court briefs. [2] [1] It is not recognized as a scientific organization by the international medical community. [3] [4] [5]

Contents

Researchers at the Yale School of Medicine issued a report which described SEGM as “a small group of anti-trans activists.” [6] [7] Joshua Safer, a spokesperson for the Endocrine Society, described them as “outside the medical mainstream.” [4]

SEGM is closely affiliated with Genspect. Seven advisors to SEGM are on Genspect's team of advisors, including Stella O'Malley, [8] Genspect's founder. [9]

Activities and positions

SEGM has indicated its belief that "gender exploratory psychotherapy" should be a first-line treatment for those age 25 and under. [10] William Malone, a founder of SEGM, has opposed the informed consent model for transgender healthcare, where adults older than 18 can start hormones after signing an informed consent document without requiring an evaluation by a mental health professional. He told Medscape that "cognitive maturity doesn’t occur until the age of 25." [4]

SEGM made a submission [11] in defense of the state of Arizona's ban on Medicaid coverage for transgender healthcare. [1] In it, they advanced the controversial idea of rapid-onset gender dysphoria (ROGD), which suggests a subtype of gender dysphoria caused by peer influence and social contagion. ROGD has been condemned as unevidenced and nonscientific by the majority of the worlds' major psychological bodies. [12] [13] Lambda Legal and Cooley LLP filed an amicus brief opposing the ban on behalf of LGBT advocacy organizations such as PFLAG, the Southern Arizona Gender Alliance, and the TransActive Gender Project. The Pediatric Endocrine Society and the World Professional Association for Transgender Health also filed amicus briefs opposing the ban. [14]

In March 2022, Julia Mason, a board member of SEGM who also works with Genspect, proposed Resolution 27 along with four other members of the American Academy of Pediatrics (AAP), stating the AAP should reconsider hormone therapy as a first line of treatment and called for an evidence review to update AAP's 2018 policy statement on gender affirmative care. The AAP said that the resolution mischaracterized its policy, which instead promotes "following a systematic, collaborative evaluation by clinicians and mental health professionals". The resolution was not passed. After the resolution's proposers said that the AAP changed procedures to block discussion of the resolution, the AAP said that their processes worked normally and that Resolution 27 did not pass because it received no co-sponsorship and the majority of AAP members did not agree with the resolution. The AAP stated the guidelines were already under review as part of a routine procedure and that "there is strong consensus among the most prominent medical organizations worldwide that evidence-based, gender-affirming care for transgender children and adolescents is medically necessary and appropriate." [15] [16]

In April, the Florida Department of Health wrote a memo which misrepresented the scientific consensus to stop minors in the state from socially or medically transitioning and cited Malone. [6] [17]

Professor Dianna Kenny, speaking for SEGM, told the Daily Telegraph that "Let’s Talk About Bodies, Identity and Sexuality", a video produced by the Australian Human Rights Commission (AHRC), teaches "gender ideology". An AHRC spokesperson disputed this, stating that the video was "an age-appropriate teaching resource" that reflected a "rights-based approach to gender and sexual identity". [18]

Conversion therapy

Malone and fellow SEGM member Colin Wright asserted in a September 2019 Quillette article that counselling can address "any trauma or thought processes that have caused them" to identify as transgender. [1] The American Academy of Pediatrics have said that "conversion" or "reparative" treatment models such as this have been used to deter children and adolescents from displaying non-cisgender gender identities and gender expressions. [1] [19] The Substance Abuse and Mental Health Services Administration has said that any therapeutic interventions that seek to change a child or adolescent's gender identity or gender expression are inappropriate and may cause harm. [1] [20]

In May, 2021, SEGM called for an amendment to the Canadian criminal code C-6, which outlawed conversion therapy, falsely claiming that conversion therapy can only be applied to lesbian, gay, and bisexual people as opposed to transgender people as well. This position is not supported by any major medical organization, which define conversion therapy as including efforts to change sexual orientation or gender identity. [1]

Citations in anti-trans legislation

In March 2020, SEGM was cited in an Idaho bill barring transgender people from changing their sex on their birth certificate. A SEGM spokesperson said they never expressed support for the bill. [21] The legislation stated SEGM "has declared that the conflation of sex and gender in health care is alarming, subjects hundreds of thousands of individuals to the risk of unintended medical harm, and will greatly impede medical research" without providing evidence for the claims. The ACLU condemned the state for their actions. [22] Malone also testified to the legislature in favor of a bill that would make it a felony to prescribe hormone blockers to people under 18 or refer them to gender-reassignment surgery. [1]

In February 2023, Mike Leman spoke for the Catholic Dioceses in support of Wyoming Senate File 111, which aimed to ban gender-affirming care for minors. He cited a study from SEGM that questioned Dutch research into such care. [5]

Affiliations

A report by the Southern Poverty Law Center described SEGM as a hub of the "anti-LGBT pseudoscience network", and specified that the relationship was strongest between SEGM, Genspect, and the Gender Exploratory Therapy Association (GETA), who shared over 24 personnel connections. [10] The report also stated SEGM members are affiliated with the "anti-LGBTQ+ far right". [10] SEGM is closely affiliated with the non-profit organization Genspect: Julia Mason, Marcus Evans, Roberto D’Angelo, Sasha Ayad, Stella O'Malley, Lisa Marchiano, and Avi Ring are advisors for SEGM and are on Genspect's team or advisors; O'Malley is the founder of Genspect. [8] [23] [12] GETA is a group of therapists founded in 2021 by four SEGM members and a Genspect advisor to market what experts believe is transgender conversion therapy. [10] Marchiano and O'Malley are on the board of Lisa Littman's Institute for Comprehensive Gender Dysphoria Research (ICGDR). [10] SEGM members O'Malley and Robert P. George are also advisors to the Foundation Against Intolerance and Racism. [10]

A report by seven people in various departments of the Yale School of Medicine stated that the 14 core members of SEGM regularly worked together on the boards of other organizations that oppose gender-affirming healthcare and "feature biased and unscientific content." [7]

South Dakota House Bill 1057, which was launched in 2020 to prohibit gender-affirming care for transgender youth, relied on a document created and distributed within a secret working group including multiple members of the American College of Pediatricians (ACPeds), representatives from other conservative groups, and founders of SEGM. [24] SEGM members have repeatedly co-authored papers and letters to the editor with members of ACPeds. SEGM director Julia Mason tweeted that SEGM would not work with members of ACPeds and denied knowing ACPeds member Paul Hruz despite co-authoring papers and co-hosting symposia with him. [24] ACPeds has explicitly promoted the work of SEGM; Quentin Van Meter encouraged audience members to work with SEGM at a conference held by “ex-gay” ministry First Stone Ministries. [24]

Reception

In August, Vice News characterized William Malone as an "anti-trans activist". Vice reached out to authors cited in the memo, who said it took their research out of context as the research, and later research, supported gender-affirming care. [6]

In August 2021, Trans Safety Network described SEGM as "an anti-trans psychiatric and sociological think tank" and fringe group and reported that most of SEGM's funding in 2019 came in donations greater than $10,000. [23] [12] In 2020, SEGM received a $100,000 donation from the Edward Charles Foundation, and in 2021 SEGM's annual revenue grew to nearly $800,000, the largest of which was a $350,000 donation from Fidelity Investments Charitable Gift Fund. [10]

In 2023 Alejandra Caraballo described SEGM as "the most prominent of the pseudo-scientific organizations in the anti-trans space" and stated they use "teach the controversy" tactics and cite the results of their advocacy efforts in the United Kingdom NHS and Swedish Karolinska Hospital to build momentum to restrict care for trans youth globally. [25]

The Southern Poverty Law Center wrote in 2023 that "Since its founding, members of SEGM have undertaken a global media and public policy blitz to challenge the affirming care model, advocate against gender-affirming care, and lend scientific credibility to legal claims against LGBTQ+ civil rights." [10]

Medical community

In April 2021, Medscape Medical News asked Joshua Safer –an endocrinologist from Mount Sinai acting as a spokesperson for the Endocrine Society on transgender issues –about SEGM, SEGM member Will Malone, and their concerns about treatment for transgender youth, he stated: "This is a relatively small group that has been making the same arguments for a number of years, and they are very much outside the mainstream". [4]

In March 2022, SEGM funded a paper titled "Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults" [26] which appeared in the Journal of Sex & Marital Therapy. In June, the journal published a response which compared SEGM to the National Association for Research & Therapy of Homosexuality (NARTH), a prominent conversion therapy advocation organization which focused on sexual orientation change efforts, as they both provide "scientific experts" to testify against LGBT rights. [27]

In April 2022, researchers at the Yale School of Medicine issued a report in response to the attacks on transgender healthcare in Arizona and Texas which described the core of SEGM as a small group of anti-trans activists acting outside of mainstream scientific consensus and organizations, and help lawmakers criminalize transgender care. [3] [6] [7]

In October 2022, Science-Based Medicine described SEGM as a "transphobic organization" which is closely affiliated with Genspect, who they described as "an anti-trans gender critical (GC) organization", and stated they "both regularly peddle anti-trans pseudoscience". [1] [8]

Kaiser Health News while fact checking a political campaign ad by America First Legal, said the leaders of SEGM are "wholly skeptical of the acceleration in gender-affirming care". [28]

See also

Related Research Articles

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.

The Standards of Care for the Health of Transgender and Gender Diverse People (SOC) is an international clinical protocol by the World Professional Association for Transgender Health (WPATH) outlining the recommended assessment and treatment for transgender and gender-diverse individuals across the lifespan including social, hormonal, or surgical transition. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.

Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.

<span class="mw-page-title-main">Transgender youth</span> Children and adolescents who are transgender

Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they differ in challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.

<span class="mw-page-title-main">LGBT rights in Florida</span>

Lesbian, gay, bisexual, and transgender (LGBT) people in the U.S. state of Florida have federal protections, but many face legal difficulties on the state level that are not experienced by non-LGBT residents. Same-sex sexual activity became legal in the state after the U.S. Supreme Court's decision in Lawrence v. Texas on June 26, 2003, although the state legislature has not repealed its sodomy law. Same-sex marriage has been legal in the state since January 6, 2015. Discrimination on account of sexual orientation and gender identity in employment, housing and public accommodations is outlawed following the U.S. Supreme Court's ruling in Bostock v. Clayton County. In addition, several cities and counties, comprising about 55 percent of Florida's population, have enacted anti-discrimination ordinances. These include Jacksonville, Miami, Tampa, Orlando, St. Petersburg, Tallahassee and West Palm Beach, among others. Conversion therapy is also banned in a number of cities in the state, mainly in the Miami metropolitan area, but has been struck down by the 11th Circuit Court of Appeals. In September 2023, Lake Worth Beach, Florida became an official "LGBT sanctuary city" to protect and defend LGBT rights.

<span class="mw-page-title-main">American College of Pediatricians</span> Right-wing anti-LGBTQ advocacy group

The American College of Pediatricians (ACPeds) is a socially conservative advocacy group of pediatricians and other healthcare professionals in the United States, founded in 2002. The group's primary focus is advocating against abortion rights and against rights for gay, queer, and transgender people. ACPeds promotes conversion therapy and purity culture. As of 2022, its membership has been reported at about 700 physicians.

<span class="mw-page-title-main">LGBT rights in Missouri</span>

Lesbian, gay, bisexual, and transgender (LGBT) people in the U.S. state of Missouri face some legal challenges not experienced by other residents throughout the state, excluding St. Louis, Kansas City, and Columbia. Same-sex sexual activity is legal in Missouri, in accordance with 2003's Lawrence v. Texas decision.

Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. In addition to their use in treating precocious puberty, which involves puberty occurring at an unusually early age in children, puberty blockers are also used for transgender children to delay the development of unwanted sex characteristics, so as to allow transgender youth more time to explore their gender identity.

Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:

Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as gender-affirming care, for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world.

Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social pressure, or discrimination and stigma.

Rapid-onset gender dysphoria (ROGD) is a controversial, scientifically unsupported hypothesis which claims that some adolescents identify as transgender and experience gender dysphoria due to peer influence and social contagion. ROGD is not recognized as a valid mental health diagnosis by any major professional association, which discourage its use due to a lack of reputable scientific evidence for the concept, major methodological issues in existing research, and its stigmatization of gender-affirming care for transgender youth. The paper initially proposing the concept was based on surveys of parents of transgender youth recruited from three anti-trans websites; following its publication, it was re-reviewed and a correction was issued highlighting that ROGD is not a clinically validated phenomenon. Since the paper's publication, the concept has frequently been cited in legislative attempts to restrict the rights of transgender youth.

<i>Irreversible Damage</i> 2020 book by Abigail Shrier

Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, published by Regnery Publishing, which endorses the controversial concept of rapid-onset gender dysphoria (ROGD). ROGD is not recognized as a medical diagnosis by any major professional institution nor is it backed by credible scientific evidence.

<span class="mw-page-title-main">Arkansas House Bill 1570 (2021)</span> 2021 Arkansas state law

Arkansas House Bill 1570, also known as the Save Adolescents From Experimentation (SAFE) Act or Act 626, is a 2021 law in the state of Arkansas that bans gender-affirming medical procedures for transgender people under 18, including puberty blockers, hormone therapy, and sex reassignment surgery. The law also bans the use of public funds for and prohibits insurance from covering gender transition procedures, while doctors who provide treatment in violation of the ban can be sued for damages or professionally sanctioned. The measure makes Arkansas the first U.S. state to make gender-affirming medical care illegal.

<span class="mw-page-title-main">Transgender Trend</span> British pressure group

Transgender Trend is an anti-trans British pressure group, which describes itself as a group of parents, professionals and academics who are concerned about the number of children diagnosed with gender dysphoria. It was founded in 2015 by Stephanie Davies-Arai.

Stella O'Malley is an Irish psychotherapist and author, with three books on parenting and mental health. She is a regular contributor to Irish national newspapers, podcasts, and TV. She made a documentary about gender dysphoria in children for Channel 4, and is the founder of Genspect, a self-described gender critical organisation opposed to gender affirming care.

<span class="mw-page-title-main">Genspect</span> Organization opposing transgender rights

Genspect is an international group founded in June 2021 by psychotherapist Stella O'Malley that has been described as gender-critical. Genspect opposes gender-affirming care, as well as social and medical transition for transgender people. Genspect opposes allowing transgender people under 25 years old to transition, and opposes laws that would ban conversion therapy on the basis of gender identity. Genspect also endorses the unproven concept of rapid-onset gender dysphoria (ROGD), which proposes a subclass of gender dysphoria caused by peer influence and social contagion. ROGD has been rejected by major medical organisations due to its lack of evidence and likelihood to cause harm by stigmatizing gender-affirming care.

Quentin Van Meter is a pediatric endocrinologist and president of the American College of Pediatricians, a socially conservative advocacy group which is known for opposing gay marriage, gender reassignment surgery, and abortion. He has advocated and referred his clients to conversion therapy and is known for rejecting the medical consensus on the efficacy and safety of transgender health care.

<span class="mw-page-title-main">Chloe Cole</span> American activist (born 2004)

Chloe Cole is an American activist who opposes gender-affirming care for minors and supports bans on such care following her own detransition. She has appeared with conservative politicians and in the media, supporting and advocating for such bans. Cole says that she began transitioning at 12 and detransitioned at 17 after having undergone treatment which included puberty blockers, testosterone, and a double mastectomy.

<span class="mw-page-title-main">Cass Review</span> Review of gender identity services in England

The Independent Review of Gender Identity Services for Children and Young People was commissioned in 2020 by NHS England and NHS Improvement and led by Hilary Cass, a retired consultant paediatrician and the former president of the Royal College of Paediatrics and Child Health. It dealt with gender services for children and young people, including those with gender dysphoria and those identifying as transgender. The final report was published on 10 April 2024, and its recommendations were endorsed by NHS England and both the Conservative and Labour parties. The review has been criticised by some international medical organisations.

References

  1. 1 2 3 4 5 6 7 8 9 Eckert, AJ (17 October 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. Retrieved 24 October 2022.
  2. ↑ Kuper, Laura E.; Cooper, M. Brett; Mooney, Megan A. (1 September 2022). "Supporting and advocating for transgender and gender diverse youth and their families within the sociopolitical context of widespread discriminatory legislation and policies". Clinical Practice in Pediatric Psychology. 10 (3): 336–345. doi:10.1037/cpp0000456. ISSN   2169-4834. S2CID   252476919.
  3. 1 2 Ring, Trudy (5 May 2022). "'Science' Behind Texas/Alabama Anti-Trans Policy Is 'Full of Errors'". The Advocate. Archived from the original on 16 June 2022. Retrieved 16 June 2022.
  4. 1 2 3 4 McCall, Becky; Nainggolan, Lisa (26 April 2021). "Transgender Teens: Is the Tide Starting to Turn?". Medscape Medical News. Retrieved 20 October 2022.
  5. 1 2 Beck, Madelyn (2 February 2023). "Health experts: Gender-affirming care saves lives". WyoFile. Retrieved 2 February 2023.
  6. 1 2 3 4 Greenspan, Sam (3 August 2022). "How Florida Twisted Science to Deny Healthcare to Trans Kids". Vice News. Retrieved 22 August 2022.
  7. 1 2 3 "Biased Science in Texas & Alabama". medicine.yale.edu. Retrieved 26 June 2022.
  8. 1 2 3 Eckert, AJ (22 October 2022). "Cutting through the Lies and Misinterpretations about the Updated Standards of Care for the Health of Transgender and Gender Diverse People". Science Based Medicine. Retrieved 24 October 2022.
  9. ↑ Dixon, Hayley (26 June 2021). "CBBC's trans messaging is damaging children, says mother". The Telegraph. Retrieved 30 May 2023.
  10. 1 2 3 4 5 6 7 8 "Group dynamics and division of labor within the anti-LGBTQ+ pseudoscience network". Southern Poverty Law Center . 12 December 2023. Retrieved 21 December 2023.
  11. ↑ "Brief of Amicus Curiae Society for Evidence Based Gender Medicine in Support of the Defendant Appellee" (PDF). 7 July 2021.
  12. 1 2 3 Moore, Mallory. "SEGM uncovered: large anonymous payments funding dodgy science". transsafety.network. Archived from the original on 7 June 2022. Retrieved 26 June 2022.
  13. ↑ "ROGD Statement". Coalition for the Advancement & Application of Psychological Science. Archived from the original on 4 August 2021. Retrieved 4 August 2021.
  14. ↑ Rochman, Joseph Hayes (April 2022). "9th Circuit Panel Affirms Arizona District Court's Denial of a Preliminary Injunction Against the State's Categorical Medicaid Exclusion for Gender Confirmation Surgeries". LGBT Law Notes.
  15. ↑ "AAP Stands By Policy on Gender-Affirming Care for Trans Youth". MedPage Today . 23 August 2022. Archived from the original on 29 August 2022. Retrieved 29 August 2022.
  16. ↑ Ault, Alicia; Nainggolan, Lisa (16 August 2022). "Pediatricians at Odds Over Gender-Affirming Care for Trans Kids". Medscape Medical News. Retrieved 20 October 2022.
  17. ↑ Baitinger, Brooke (3 August 2022). "Showdown: LGBTQ+ rights vs. state ban on transition-related medical care for trans kids". Florida Phoenix. Archived from the original on 23 August 2022. Retrieved 24 August 2022.
  18. ↑ Bye, Clarissa (27 December 2022). "Human rights video schooling kids on gender and sex slammed". The Daily Telegraph (Sydney).
  19. ↑ Rafferty, Jason; Yogman, Michael; Baum, Rebecca; Gambon, Thresia B.; Lavin, Arthur; Mattson, Gerri; Wissow, Lawrence Sagin; Breuner, Cora; Alderman, Elizabeth M.; Grubb, Laura K.; Powers, Makia E.; Upadhya, Krishna; Wallace, Stephenie B.; Hunt, Lynn; Gearhart, Anne Teresa; Harris, Christopher; Lowe, Kathryn Melland; Rodgers, Chadwick Taylor; Sherer, Ilana Michelle (1 October 2018). "Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents". Pediatrics. 142 (4). American Academy of Pediatrics (AAP). doi: 10.1542/peds.2018-2162 . ISSN   0031-4005.
  20. ↑ Substance Abuse and Mental Health Services Administration (October 2015). Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth (PDF) (Report). Rockville, MD. p. 27. Retrieved 30 June 2023.
  21. ↑ Stahl, Aviva (16 April 2021). "The Science Behind Those Anti-Trans Healthcare Bills Is Bullsh*t, According To Experts". BuzzFeedNews. Retrieved 22 August 2022.
  22. ↑ Tracy, Matt (1 April 2020). "Idaho Bans Trans Girls' Sports, Bars Birth Certificate Changes – Gay City News". Gay City News. Retrieved 22 August 2022.
  23. 1 2 Ferreyra-Carroll, Lilith (21 October 2021). "A state of collapse: Trans healthcare in Ireland is a national emergency". Gay Community News . Archived from the original on 4 July 2022. Retrieved 28 June 2022.
  24. 1 2 3 "Manufacturing the doubt that fuels the network". Southern Poverty Law Center. 12 December 2023. Retrieved 31 December 2023.
  25. ↑ Caraballo, Alejandra (2022). "The Anti-Transgender Medical Expert Industry". Journal of Law, Medicine & Ethics. 50 (4): 687–692. doi: 10.1017/jme.2023.9 . ISSN   1073-1105.
  26. ↑ Levine, Stephen B.; Abbruzzese, E.; Mason, Julia W. (3 October 2022). "Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults". Journal of Sex & Marital Therapy. 48 (7): 706–727. doi: 10.1080/0092623X.2022.2046221 . ISSN   0092-623X. PMID   35300570. S2CID   247521800.
  27. ↑ Drescher, Jack (1 June 2022). "Informed Consent or Scare Tactics? A Response to Levine et al.'s "Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults"". Journal of Sex & Marital Therapy. 49 (1): 99–107. doi: 10.1080/0092623X.2022.2080780 . ISSN   0092-623X. PMID   35642738. S2CID   249235587.
  28. ↑ Farmer, Blake (9 November 2022). "Ad Goes Too Far With Claim That Joe Biden Promotes Surgery for Trans Teens". Kaiser Health News.
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