Rachel Levine, assistant secretary for health at the U.S. Department of Health and Human Services (HHS), recently made waves in predicting that “wheels will turn” on so-called “gender-affirming care” for minors. A new report clarifies that HHS intends to initiate much of the spinning, and that the department is willing to throw around the weight of the federal government to stop sensible state-driven reforms.
Moving Beyond Change Efforts: Evidence and action to support and affirm LGBTQI+ Youth is a newly published report commissioned and recirculated by the Substance Abuse and Mental Health Services Administration (part of HHS).
The report argues that a child’s expressed sexual and gender identity preferences should be affirmed by parents, schools, and medical practitioners: “Withholding timely gender-affirming medical care when indicated, withholding support for a gender-affirming exploratory process, and/or withholding support of social transition when desired, can be harmful because these actions may exacerbate and prolong gender dysphoria.”
Reality is far more complex and demands greater nuance and caution. Indeed, the full 111-page report reveals itself to be inundated with rhetorical sleight of hand, oversold claims based on evidence cited, and misrepresentation of basic facts. We highlight three particularly egregious examples below.
Claim #1: “The Minority Stress Model provides an empirically validated conceptual model for understanding how stress due to anti-LGBTQI+ stigma, coupled with general life stressors, puts individuals of diverse sexual orientation and/or gender identity at increased risk for negative behavioral health outcomes.”
Context: The “minority stress model” that the report endorses asserts that mental health distress typically arises from gender dysphoria rather than vice-versa. Attitudes toward the minority stress model differ across health systems globally – major medical organizations in the United States generally embrace the concept whereas European countries typically and increasingly reject it. Attitudes toward the minority stress framework have major implications for standards of care. If it’s true that mental health distress occurs from a lack of affirmation of enduring incongruence between gender identity and biological sex, then social and medical transition represent a sensible treatment protocol. If, however, expressions of gender dysphoria arise from psychosocial stressors or afflictions but do not signal lasting incongruence, then social and medical transition are more likely to cause harm than benefit.
Reality: There is a strong body of evidence to indicate that children with psychosocial distress, particularly homosexual or bisexual kids navigating their sexual identity, temporarily channel their emotions and anxiety as expressions of gender dysphoria. A study of children referred to gender clinics in Finland reported that 57% had been “significantly bullied at school” and that 75% were undergoing psychiatric treatment for other conditions at the time of their referral. Critically, another study relays that about 4 in 5 children who meet criteria for gender dysphoria will have such feelings recede during puberty. “Instead,” the study notes, “many of these adolescents will identify as non-heterosexual.” The phenomena of rapid onset gender dysphoria (ROGD) and detransition further illuminate the hazards in defaulting to social and medical transition in response to expressions of gender dysphoria.
Expressions of gender dysphoria are especially prevalent among autistic youth, a population that disproportionately struggles with impaired emotional processing and social isolation and vulnerable to the allure of medical explanations and solutions. A study out of the Tavistock gender clinic in the United Kingdom revealed that an estimated 48% of children seen in the clinic were mildly or severely autistic. Rather than acknowledge the high incidence of autism among referrals to gender clinics, the report notes that “some neurodiverse youth are gender diverse.”
Claim #2: “SOGI (sexual orientation and gender identity) change efforts, commonly referred to as ‘conversion therapy’ or ‘reparative therapy,’ are practices that aim to suppress or alter an individual’s sexual orientation or gender to align with heterosexual orientation, cisgender identity, and/or stereotypical gender expression…Efforts to change or suppress a person’s sexual orientation or gender identity are grounded in the belief that being LGBTQI+ is abnormal. They are dangerous, discredited, and ineffective practices.”
Context: The report repeatedly conflates conversion therapy (the practice of attempting to change an individual’s sexual orientation) with resistance to socially or medically affirming expressions of gender dysphoria. Historically, so-called “conversion efforts” referred to efforts to change an individual’s sexual orientation while it is now being used as a rhetorical weapon to describe any treatment that doesn’t automatically affirm a gender identity. For example, Wikipedia archives reveal that “gender identity” first appeared in the “conversion therapy” article in December 2021.
Reality:
Much of the push to conflate resistance to affirmation of gender dysphoria with conversion therapy originates from a 2020 paper authored by activist/researcher Jack Turban and colleagues which asserts that so-called gender identity conversion efforts are mentally detrimental to gender dysphoric youth. Notably, their findings have received strong criticism. For example, a letter to the editor in Archives of Sexual Behavior observes that “Their analysis is compromised by serious methodological flaws, including the use of a biased data sample, reliance on survey questions with poor validity, and the omission of a key control variable … Arguably, even more problematic than the flawed analysis itself is the simplistic ‘affirmation’ versus ‘conversion’ binary, which permeates Turban et al.’s (2020) narrative and establishes the foundation for their analysis and conclusions. The notion that all therapy interventions for GD (gender dysphoria) can be categorically classified into this simplistic binary betrays a misunderstanding of the complexity of psychotherapy.”
The comparison between gender dysphoria and homosexuality is problematic for other reasons. Most critically, while an estimated 4 out of 5 children who meet the criteria for gender dysphoria will eventually desist in such feelings, there is no indication that majorities of children who express same-sex romantic preferences will eventually experience a cessation of those preferences. Resistance to affirming expressions of gender dysphoria is not a rejection of an individual’s identity. Rather, it is a sensible acknowledgement that most children who express gender dysphoria will not persist in such feelings and that affirmation of transitory feelings with irreversible medical treatments is harmful.
Claim #3: “Legal prohibitions on gender-affirming care (including medical treatment) are harmful to LGBTQ+ children and adolescents.”
Context: Some states are beginning to restrict minor access to medical transition interventions, including puberty blockers, cross-sex hormones, and surgery. Advocates of allowing minors to medically transition argue that these interventions are needed to decrease the high incidence of depression and suicide among gender dysphoric children.
Reality: Studies that claim that access to medical transition causes a decrease in depression and suicide are fraught with methodological problems. For example, a recent paper in the prestigious New England Journal of Medicine observed that children and adolescents who initiated hormones experienced modest improvement in self-reported mental health over time. However, the “study” did not feature a control group, so it is impossible to determine whether these modest changes represent an improvement over alternative approaches. Another recent paper concludes that restrictions on medical transition for children are associated with an increased in Google searches for “depression” and “suicide,” but close inspection plainly reveals that the underlying data does not support the conclusion.
Restricting minor access to medical transition is not simply a red state phenomenon. Sweden, Finland, and the United Kingdom – three of the most LGBTQ-friendly nations in the world – have recently moved to impose greater restrictions around minor access to gender-affirming treatments. Even before these restrictions, the nations of Western and Northern Europe all but banned sex reassignment surgeries for those under the age of 16. Indeed, states that allow for puberty blockers at 8, cross-sex hormones at 12, or double mastectomies at 13 – all of which have occurred in the United States – are far greater outliers from Western norms than are states that prohibit these interventions before age 18.
The proselytization of gender ideology is falling flat: The share of Americans who say that gender cannot be changed has increased in recent years and as of June 2022 six in ten adults agree that gender is determined by sex at birth. Part of the challenge for gender ideology advocates is that they are stuck between admitting lunacy or playing fast and loose with facts. HHS and the Biden White House for their part appear bearish on the prospect of turning wheels on the merit of honest arguments.
UC Irvine School of Medicine Tells AAMC It Considers Applicants “With GPA Below Benchmark” – If They Meet Certain Criteria
Uncategorized California DEI University of California Irvine School of Medicine Medical School Commentary Do No Harm StaffThe University of California system continues to show its commitment to the implementation of woke policies at the UC Irvine School of Medicine (UCI SOM), including those related to its admissions criteria. The institution’s own words and actions speak for themselves.
Here’s the background. In November 2022, the Association of American Medical Colleges released a report showing that the vast majority of medical schools have embraced identity politics, despite their divisive and even discriminatory nature. The report was based on surveys of specific medical schools, which the AAMC didn’t name.
For the sake of transparency and accountability, Do No Harm submitted freedom of information requests to public medical schools nationwide, including UCI SOM. We asked for a copy of its survey response, so that California taxpayers and policymakers could learn the truth about this institution.
Here’s what the UC Irvine School of Medicine has self-reported:
All told, UCI SOM has instituted 95.2% of the divisive and discriminatory woke policies listed by the AAMC. And you can bet it is feeling pressure from activists and outside groups to go even further down the radical rabbit hole – doing even more damage to faculty, medical students, and ultimately, the millions of patients they’ll see.
California taxpayers help fund the UC Irvine School of Medicine. They, and the policymakers who represent them, should ask why they’re giving so much money to an institution that’s putting divisive and discriminatory ideology at the heart of medical education. More importantly, they should ensure UCI SOM stops, and soon.
UVA Is On A DEI Hiring Spree
Uncategorized Virginia DEI University of Virginia Medical School, Public university Commentary Do No Harm StaffForget teaching medicine. The University of Virginia’s medical education programs are too busy hiring woke ideologues. A source recently sent us the job posting for the UVA Comprehensive Cancer Center’s new DEI Program Coordinator, and the School of Medicine is hiring a Program Manager and Events Coordinator. These are the sorts of things the UVA Board should investigate, and better yet, stop.
The job descriptions are everything you’d expect from positions grounded in divisive and discriminatory concepts like DEI. The cancer center job, for instance, will develop “DEI related trainings, programs, seminars, and presentations,” ensuring faculty and students receive woke indoctrination. They will also help implement a “5-year strategic plan,” with the goal of making the Cancer Center more woke every year.
The program coordinator will also “engage in the day-to-day advance of the Plan to Enhance Diversity,” which likely involves putting skin color ahead of merit. The same is surely true of the person’s responsibility to “assist with recruitment activities of trainees and faculty.” In the context of DEI, that typically means hiring educators and admitting students based on their race. In other words, racial discrimination.
Naturally, these jobs slot into a rapidly growing DEI bureaucracy, with the cancer center position “reporting to the Associate Director of Diversity, Equity and Inclusion.” As experience shows, DEI departments always grow and exert a bigger influence. With these new jobs, DEI will come to affect more and more of what faculty teach, students learn, and trainees practice – across the entire UVA School of Medicine.
What’s most concerning are the implications for medical care. When a patient asks a UVA cancer center physician about a lump she discovered, will she get woke extremism instead of medical expertise? When a patient needs lung cancer surgery, will the surgeon’s implicit bias training lead them to provide worse care to white patients? These DEI positions will influence clinical care, contributing nothing but potentially worsening the quality of medical treatment.
Do No Harm has already called attention to the UVA School of Medicine’s discriminatory scholarship, filing a federal civil rights complaint. We have separately spurred the federal government to open a civil rights investigation into the school’s participation in a discriminatory outreach program. Now it’s time for the UVA Board of Visitors to investigate, as well.
Perhaps Bert Ellis, who Gov. Youngkin placed on the board to help fight divisive and discriminatory ideology, would be interested in leading the charge. DEI should be driven from UVA’s medical education, to say nothing of the rest of campus.
The Emergency Nurses Association Advances Anti-Racism “To Be a DEI Leader in Healthcare”
Uncategorized Illinois DEI Nursing organization Commentary Do No Harm StaffThe Emergency Nurses Association (ENA) is doing its part to align with the DEI and anti-racism narrative and is seeking the buy-in of its membership “to be a DEI leader in healthcare.”
Last fall, the ENA engaged Nonprofit HR’s “Equity, Diversity, Inclusion, and Justice” team to survey its members and staff to determine the current state of DEI at the organization. ENA sought to use that information “to outline a strong roadmap for the future.” What does that roadmap look like at the ENA?
The Diversity, Equity, and Inclusion in Action page lists three goals of the organization’s DEI initiatives. “Guide the profession to become better providers,” the first goal says, “through greater awareness and understanding of structural and social determinant [sic] of health, including racism and other forms of bias.” Anna Valdez, chair of the ENA DEI Committee, recommends one of her “favorite resources” for nurses: Overdue Reckoning on Racism in Nursing. This group’s Principles of Reckoning “take a bold anti-racist stand for nursing.” These principles include:
Do these “principles” reflect the values of the ENA? More resources on its website demonstrate similar messaging. More “staff recommendations” include the American Medical Association’s (AMA) publication titled Advancing Health Equity: A Guide to Language, Narrative, and Concepts; the World Professional Association for Transgender Health (WPATH) version 8 standards of care; and the 1989 essay titled White Privilege: Unpacking the Invisible Knapsack. Multiple webinars on structural racism and DEI-related topics are available, and the Antiracism Resources for Nurses list recommends Ibram Kendi’s book “How to Be an Antiracist.” Kendi advises that “the only remedy to past discrimination is present discrimination. The only remedy to present discrimination is future discrimination.” How does that align with the “culture and climate of mutual respect” and “welcoming environment” the ENA’s DEI Vision Statement proclaims?
The DEI and anti-racism resources are plentiful on the ENA website. Glossaries borrowed from Harvard and the University of Missouri provide definitions for terms such as:
Additional DEI resources are available to members, but the ENA wants even more. “Wherever you are in your DEI journey,” ENA wants to know about additional content that nurses want to share.
What would the implementation of DEI look like in the emergency department (ED)? Suppose two patients come in at the same time: one with a broken arm and one with a heart attack. If the first patient has darker skin, will he or she be taken care of sooner, even though the second patient has a more serious condition? How did the ENA conclude that nursing must claim an “anti-racist identity?” Did ED nurses previously push black patients to the end of the line because of “white privilege,” creating disparities in their health outcomes? If there is a wait for an x-ray, will patients belonging to a particular racial group be moved to the head of the line? Who will be the arbitrator of such race-based approaches? A slippery slope indeed.
It’s disappointing to see the ENA taking this path, as it has traditionally been a reliable resource for emergency nurses who seek specialty certification and completion of vital courses in trauma and pediatric patient care. Division and identity politics have no place in this profession, and certainly not in the ED. Front-line nurses are taking care of patients who may be experiencing their worst day, and who may be frightened and vulnerable. They deserve to be addressed as individuals with unique needs instead of being seen as a member of a particular group.
We call on the ENA to continue its mission “to advance excellence in emergency nursing” and abandon the destructive DEI and anti-racism ideologies that have infiltrated other sectors of the healthcare industry.
Is your professional organization pushing woke ideology instead of supporting its clinical or educational mission? Do No Harm wants to hear from you – anonymously and securely.
The Radiological Society of North America Apologizes to Members for Its History of Racism
Uncategorized Illinois DEI Medical association Commentary Do No Harm StaffThe Radiological Society of North America (RSNA) recently contacted its members with a message of apology for the organization’s “contributions to structural racism in the specialty.”
“We write this statement to acknowledge our historical contribution to structural racism in radiology,” said the Board of Directors, “and apologize for RSNA’s actions that perpetuated systemic racism, both through omission and commission.”
The source of RSNA’s “sadness and remorse” is an article published in the February 2023 issue of RadioGraphics titled “How We Got Here: The Legacy of Anti-Black Discrimination in Radiology” (Goldberg et al). The commentary goes back to the 19th century to describe “radiology’s history and resultant structural racism,” with the objective of advising readers of what must be done to address it. “Multiple opportunities exist today for antiracism work to improve quality of care,” the abstract notes, “and to apply standards of social justice and health equity to the field of radiology.”
Improving access to services is a rational and worthwhile aim for all healthcare disciplines to undertake. However, the RSNA’s approach is to apply “antibias methodology” and “antiracist” workforce policies and training and an “antiracist workplace culture” to achieve it. To ensure readers understand the organization’s perspective on these and other terms, the article posts the RSNA’s definitions related to “healthcare disparities and discrimination.”
Among the apologies in their statement, the Board of Directors said the conclusions of Goldberg et al “likely do not represent a full accounting of RSNA’s harmful actions,” but demonstrate examples of “when our organization failed.” Predictably, the response from the society includes the implementation of two separate committees to address “equity” and to push an agenda based on racial identity politics.
RSNA makes its position known on its website. Its “commitment to diversity, equity, and inclusion” states the RNSA acts to “combat inequity” and was the first professional association for radiology to require its leadership to complete unconscious bias training. Members are also encouraged to participate in bias training, as well as education offerings on additional topics such as “gender equity and disparities in imaging” and to demonstrate “allyship in everyday actions.”
RNSA’s message to its members suggests that they must accept that they are biased against their patients, even if they aren’t aware of it. Even worse, they are paying to belong to a professional organization that supports the tenets of anti-racism: Past discrimination must be met with present discrimination, and present discrimination must be met with future discrimination. Considering that radiologists are interpreting x-rays and images that do no show the patient’s skin color, isn’t it a bit bizarre to conclude that they are racists?
Is your professional organization or medical society pushing anti-racism and implicit bias training? Do No Harm wants to hear from you via our secure online portal.
Dr. Stanley Goldfarb Acknowledges Mississippi State Auditor for Requesting Accounting of DEI Spending at the State’s Public Universities
Uncategorized Mississippi DEI State government Commentary Do No Harm StaffDr. Stanley Goldfarb, Do No Harm chairman, praised Mississippi State Auditor Shad White for his leadership in requesting an accounting of spending on diversity, equity, and inclusion (DEI) initiatives in the state’s public colleges and universities.
“Medical schools have arguably embraced DEI to an even greater extent than other institutions – and the consequences are liable to be much more dangerous, even deadly,” Dr. Goldfarb wrote in a letter to Auditor White. “By its nature, DEI demands a greater focus on people’s skin color instead of their character or individual characteristics. It has already been used to lower standards for admission to medical school, leading to worse quality students who will provide worse quality care as physicians. DEI has even been used to justify policies like preferential medical treatment by race, which is racial discrimination by another name.”
See the full letter below.
Dr. Marilyn Singleton on The Megyn Kelly Show
Uncategorized DEI Video Marilyn Singleton, MD, JDDo No Harm Visiting Fellow Dr. Marilyn Singleton discusses the effects of DEI in medicine with host Megyn Kelly.
Dr. Ben Carson Addresses Texas Senate on DEI in Higher Education
Uncategorized Texas DEI State legislature Commentary Do No Harm StaffThe Texas Senate Subcommittee on Higher Education held a hearing on April 6 to hear testimony on Senate Bill 17 and efforts to eliminate DEI initiatives in the state’s institutions of higher learning. Renown pediatric neurosurgeon and former Secretary of the U.S. Department of Housing and Urban Development Dr. Ben Carson provided testimony in support of the bill, and he had some wise words for the committee members.
Dr. Carson voiced his concerns about medical schools that are engaging in “the rejection of colorblind standardized testing” in the name of equity, failing to set a minimum MCAT score or GPA, and withdrawing from national ranking systems. “Putting aside merit, and instead emphasizing qualities like race, sex, religion, and all the others we hear about endlessly today,” he stated, “can very well cost people their lives when it comes to the medical field.”
“This ubiquitous DEI virus,” Dr. Carson said, “has a chilling effect on free speech and open inquiry.” He warned of “the power of even the mere accusation of racism,” and how false allegations can have severe consequences to the person being accused. “Senate Bill 17 is a great step toward rejecting the entire framework of DEI and restoring us to a country our founding fathers envisioned so many years ago,” he concluded.
State Senator Brandon Creighton, SB 17’s sponsor, explained that the bill’s goal was to end mandatory diversity statements and DEI-related training in Texas universities, and he noted how several schools have already started to close their DEI offices and departments.
Senator Royce West responded with his concerns for “throwing out” DEI and “dismantling the entire program,” insisting that “it has begun to work” and any problems are isolated incidents that can be dealt with on an individual basis. “There will be us that will stand up and say, ‘It’s wrong.’ It’s totally wrong, what’s getting ready to happen in this legislative process,” he said.
Senator Creighton noted that the committee was “here to vet” the narratives and “root out any inefficiencies” in programs that are receiving millions of taxpayer dollars.
When it came time to pose questions to the panelists, Senator West reiterated his concerns about abandoning DEI and starting over with a different approach. “We’ve been dealing with the same issues” regarding DEI and universities saying that they are “hamstrung” by Supreme Court or federal court decisions. “Here we are tonight,” he said, “dealing with the same issues again, and we don’t have the results.” He asked Dr. Carson, “What do we do?”
“We need solutions; not names,” Dr. Carson replied. He recounted an experience he had in medical school when he had performed poorly on a set of comprehensive tests and was told by a university counselor that he “wasn’t cut out to be a doctor.” After much thought and contemplation, he discovered that the problem was simply a matter of preferred learning style, and he adjusted his method of study. “It wasn’t a problem with me intellectually,” he said, advising that “a variety of different mechanisms are needed on an individual level. “Those are the kinds of things we need to be looking at, rather than trying to artificially fit people into other people’s molds.”
Another senator asked Dr. Carson about instances in which some DEI programs are presented as “not required,” but failure to participate can affect an individual’s ability to receive promotions. “DEI is heavy-handed,” Dr. Carson responded. “The reason why I say ‘wipe the slate clean’ is because the atmosphere has been poisoned by what has happened already.” The impact DEI’s role in medical school curriculum and hiring “[has] been disturbing” and “creates an atmosphere” that does not support differences of opinion and constructive discourse on sensitive topics. “The only thing that can really destroy us is division,” Dr. Carson concluded.
Senate Bill 17 contains essential measures that Texas medical schools would be required to honor to ensure that faculty, staff, and students are not mandated to subscribe to DEI principles and programs that do not deliver what they promise. Valuing diversity at the expense of merit creates conditions in which “all aspects of society will suffer,” Dr. Carson told the committee. With Senate Bill 17, lawmakers are taking action that will ultimately protect Texans by refocusing medical education programs onto what matters most: Developing doctors with the knowledge and skills to provide safe, individualized patient care.
CUNY Med School Is Proud Of Not Having Standards
Uncategorized New York DEI City University of New York Medical School Commentary Do No Harm StaffShould medical schools have standards for who they accept? Every patient in America would obviously say yes, since lower quality physicians inevitably provide worse levels of care. Yet the CUNY School of Medicine apparently disagrees, and it’s openly touting its disregard for standards.
We discovered this fact after watching a recent seminar hosted by the International Association of Medical Science Educators. The seminar was titled, “building pathways and bridges on the bumpy road towards equity in STEM and medicine.”
The moderator asked, “are there any programs to support the next step of MCAT preparation in admissions process for those students that go on?” A representative at CUNY’s medical school response: “I can say for our school at the CUNY School of Medicine, when they get accepted into the BS/MD program, there is no MCAT to gatekeep them from going into medical school.”
This is an astounding statement. Medical schools should want to “gatekeep” in order to accept the most qualified students. And the MCAT in particular is proven to help find the medical students who are most likely to become the best physicians. Yet the MCAT, along with the whole concept of gatekeeping, have come under assault from woke activists who believe that standards prevent schools from achieving their demands for greater diversity.
CUNY is not alone. At least 40 medical schools have abandoned the MCAT for at least some applicants. For instance, the University of Pennsylvania Perelman School of Medicine waives MCAT requirements for some applicants from Historically Black Colleges and Universities.
This is a dangerous trend – and it’s deeply disturbing that medical schools are patting themselves on the back. The CUNY School of Medicine may be proud of abandoning key standards for applicants, but patients should perhaps be worried the next time they’re treated by one of its graduates.
Tennessee’s New Legislation Is A Huge Victory
Uncategorized Tennessee DEI State legislature Commentary Do No Harm StaffThe Tennessee legislature just passed one of the best bills in America. The “Tennessee Higher Education Freedom of Expression and Transparency Act,” sponsored by Rep. Ragan and Senator Hensley, starts rolling back divisive Diversity, Equity, and Inclusion requirements at publicly funded colleges and universities, including medical schools. It’s exactly the sort of reform that other states should look to as they push back against Critical Race Theory’s takeover of education.
The bill’s findings clearly state that “public medical institutions of higher education best serve the state when providing meritorious education and training that positions future healthcare professionals to serve all patients adequately and to the best of their ability.” Do No Harm could not agree more.
To ensure that happens, the bill includes several key provisions:
There are even more victories in the bill, including welcoming campus speakers with differing views, banning discrimination against student groups based on their ideologies, requiring DEI officers to focus on workforce training and promote intellectual diversity, and notifying students and teachers of their rights, among others.
Once Governor Lee signs the bill, Tennessee will have gone further than any other state in weeding out DEI at medical schools. Hopefully it will be the first of many such measures in Tennessee. And it should be a model for every other state that wants to ensure its medical schools uphold the highest standards of education and excellence in health care.
Missouri State Rep. Mazzie Boyd On Sex Change Treatments for Minors: Stop This “Moneymaking Machine”
Uncategorized Missouri Gender Ideology State legislature Commentary Do No Harm StaffLast week, Missouri State Representative Mazzie Boyd provided dynamic testimony in support of House Bill 419, which opposes radical sex change procedures on minors.
In her remarks, Rep. Boyd stated that puberty blockers, cross-sex hormones, mastectomies, and ‘top surgeries’ being performed on minors in Missouri “are all things that make insurance companies and gender clinics more money.” She read from the St. Louis Children’s Hospital website content about the effects of puberty blockers, which include “lower bone density, delayed bone growth plate closures, less development of genital tissue, [and] other possible long-term side effects that are not yet known.”
Rep. Boyd noted how the medical industry has a vested interest in continuing these procedures. “It’s a money-maker,” she said.
Do No Harm senior fellows Chloe Cole and Luka Morris received special recognition from Rep. Boyd for the challenges they have faced while de-transitioning. “They always ask me,” Boyd said, “‘Where are the doctors lining up to help minors” once they have had these procedures or taken these drugs? “Is it because there’s no money to help the very children that the doctors led down the dark road of ‘gender-affirming care’?” Boyd also questioned where the guidelines to wean minor females off testosterone are. “We should never let children be their own doctors,” she stated.
“It’s a never-ending cycle that the research doesn’t know much about,” Boyd concluded. “We have to put an end to making a child a lifetime patient.”
Kudos to Rep. Boyd for standing up to protect children from the dangers of gender ideology, and for engaging with Chloe and Luka on this important piece of legislation. It’s time for Missouri lawmakers and healthcare providers to do the same.
HHS Turns Wheels on Sex Changes for Minors
Uncategorized Washington DC Gender Ideology Federal government Commentary Executive Do No Harm StaffRachel Levine, assistant secretary for health at the U.S. Department of Health and Human Services (HHS), recently made waves in predicting that “wheels will turn” on so-called “gender-affirming care” for minors. A new report clarifies that HHS intends to initiate much of the spinning, and that the department is willing to throw around the weight of the federal government to stop sensible state-driven reforms.
Moving Beyond Change Efforts: Evidence and action to support and affirm LGBTQI+ Youth is a newly published report commissioned and recirculated by the Substance Abuse and Mental Health Services Administration (part of HHS).
The report argues that a child’s expressed sexual and gender identity preferences should be affirmed by parents, schools, and medical practitioners: “Withholding timely gender-affirming medical care when indicated, withholding support for a gender-affirming exploratory process, and/or withholding support of social transition when desired, can be harmful because these actions may exacerbate and prolong gender dysphoria.”
Reality is far more complex and demands greater nuance and caution. Indeed, the full 111-page report reveals itself to be inundated with rhetorical sleight of hand, oversold claims based on evidence cited, and misrepresentation of basic facts. We highlight three particularly egregious examples below.
Claim #1: “The Minority Stress Model provides an empirically validated conceptual model for understanding how stress due to anti-LGBTQI+ stigma, coupled with general life stressors, puts individuals of diverse sexual orientation and/or gender identity at increased risk for negative behavioral health outcomes.”
Context: The “minority stress model” that the report endorses asserts that mental health distress typically arises from gender dysphoria rather than vice-versa. Attitudes toward the minority stress model differ across health systems globally – major medical organizations in the United States generally embrace the concept whereas European countries typically and increasingly reject it. Attitudes toward the minority stress framework have major implications for standards of care. If it’s true that mental health distress occurs from a lack of affirmation of enduring incongruence between gender identity and biological sex, then social and medical transition represent a sensible treatment protocol. If, however, expressions of gender dysphoria arise from psychosocial stressors or afflictions but do not signal lasting incongruence, then social and medical transition are more likely to cause harm than benefit.
Reality: There is a strong body of evidence to indicate that children with psychosocial distress, particularly homosexual or bisexual kids navigating their sexual identity, temporarily channel their emotions and anxiety as expressions of gender dysphoria. A study of children referred to gender clinics in Finland reported that 57% had been “significantly bullied at school” and that 75% were undergoing psychiatric treatment for other conditions at the time of their referral. Critically, another study relays that about 4 in 5 children who meet criteria for gender dysphoria will have such feelings recede during puberty. “Instead,” the study notes, “many of these adolescents will identify as non-heterosexual.” The phenomena of rapid onset gender dysphoria (ROGD) and detransition further illuminate the hazards in defaulting to social and medical transition in response to expressions of gender dysphoria.
Expressions of gender dysphoria are especially prevalent among autistic youth, a population that disproportionately struggles with impaired emotional processing and social isolation and vulnerable to the allure of medical explanations and solutions. A study out of the Tavistock gender clinic in the United Kingdom revealed that an estimated 48% of children seen in the clinic were mildly or severely autistic. Rather than acknowledge the high incidence of autism among referrals to gender clinics, the report notes that “some neurodiverse youth are gender diverse.”
Claim #2: “SOGI (sexual orientation and gender identity) change efforts, commonly referred to as ‘conversion therapy’ or ‘reparative therapy,’ are practices that aim to suppress or alter an individual’s sexual orientation or gender to align with heterosexual orientation, cisgender identity, and/or stereotypical gender expression…Efforts to change or suppress a person’s sexual orientation or gender identity are grounded in the belief that being LGBTQI+ is abnormal. They are dangerous, discredited, and ineffective practices.”
Context: The report repeatedly conflates conversion therapy (the practice of attempting to change an individual’s sexual orientation) with resistance to socially or medically affirming expressions of gender dysphoria. Historically, so-called “conversion efforts” referred to efforts to change an individual’s sexual orientation while it is now being used as a rhetorical weapon to describe any treatment that doesn’t automatically affirm a gender identity. For example, Wikipedia archives reveal that “gender identity” first appeared in the “conversion therapy” article in December 2021.
Reality:
Much of the push to conflate resistance to affirmation of gender dysphoria with conversion therapy originates from a 2020 paper authored by activist/researcher Jack Turban and colleagues which asserts that so-called gender identity conversion efforts are mentally detrimental to gender dysphoric youth. Notably, their findings have received strong criticism. For example, a letter to the editor in Archives of Sexual Behavior observes that “Their analysis is compromised by serious methodological flaws, including the use of a biased data sample, reliance on survey questions with poor validity, and the omission of a key control variable … Arguably, even more problematic than the flawed analysis itself is the simplistic ‘affirmation’ versus ‘conversion’ binary, which permeates Turban et al.’s (2020) narrative and establishes the foundation for their analysis and conclusions. The notion that all therapy interventions for GD (gender dysphoria) can be categorically classified into this simplistic binary betrays a misunderstanding of the complexity of psychotherapy.”
The comparison between gender dysphoria and homosexuality is problematic for other reasons. Most critically, while an estimated 4 out of 5 children who meet the criteria for gender dysphoria will eventually desist in such feelings, there is no indication that majorities of children who express same-sex romantic preferences will eventually experience a cessation of those preferences. Resistance to affirming expressions of gender dysphoria is not a rejection of an individual’s identity. Rather, it is a sensible acknowledgement that most children who express gender dysphoria will not persist in such feelings and that affirmation of transitory feelings with irreversible medical treatments is harmful.
Claim #3: “Legal prohibitions on gender-affirming care (including medical treatment) are harmful to LGBTQ+ children and adolescents.”
Context: Some states are beginning to restrict minor access to medical transition interventions, including puberty blockers, cross-sex hormones, and surgery. Advocates of allowing minors to medically transition argue that these interventions are needed to decrease the high incidence of depression and suicide among gender dysphoric children.
Reality: Studies that claim that access to medical transition causes a decrease in depression and suicide are fraught with methodological problems. For example, a recent paper in the prestigious New England Journal of Medicine observed that children and adolescents who initiated hormones experienced modest improvement in self-reported mental health over time. However, the “study” did not feature a control group, so it is impossible to determine whether these modest changes represent an improvement over alternative approaches. Another recent paper concludes that restrictions on medical transition for children are associated with an increased in Google searches for “depression” and “suicide,” but close inspection plainly reveals that the underlying data does not support the conclusion.
Restricting minor access to medical transition is not simply a red state phenomenon. Sweden, Finland, and the United Kingdom – three of the most LGBTQ-friendly nations in the world – have recently moved to impose greater restrictions around minor access to gender-affirming treatments. Even before these restrictions, the nations of Western and Northern Europe all but banned sex reassignment surgeries for those under the age of 16. Indeed, states that allow for puberty blockers at 8, cross-sex hormones at 12, or double mastectomies at 13 – all of which have occurred in the United States – are far greater outliers from Western norms than are states that prohibit these interventions before age 18.
The proselytization of gender ideology is falling flat: The share of Americans who say that gender cannot be changed has increased in recent years and as of June 2022 six in ten adults agree that gender is determined by sex at birth. Part of the challenge for gender ideology advocates is that they are stuck between admitting lunacy or playing fast and loose with facts. HHS and the Biden White House for their part appear bearish on the prospect of turning wheels on the merit of honest arguments.
Washington State Endangers Kids – And Ignores Parents
Uncategorized Washington Gender Ideology State legislature Commentary Do No Harm StaffShould parents have a say in whether their children undergo transgender medical treatments? No, according to a bill that looks set to become law in Washington state. It’s one of the most extreme measures we’ve seen yet, and it shows how aggressive and uncaring gender activists really are.
The soon-to-be state law is deeply concerning. It allows homes for runaway children to refuse to notify parents if their kids are getting transgender treatments – think puberty blockers, cross-sex hormones, and even sex-change surgeries. In the legislation’s own words, so-called “gender affirming treatment can be prescribed to two-spirit, transgender, nonbinary, and other gender diverse individuals” without parental notification.
Make no mistake: This policy endangers kids. It’s been proven that huge numbers of kids who believe they’re a different gender struggle with mental health issues. It’s also been proven that the vast majority of these children will ultimately choose their actual gender when they become adults. Yet transgender treatments are often invasive and even irreversible. They can leave children with a life of physical and mental health problems, on top of any psychological problems they may already have.
Parents are essential to protecting their children from doing things they’ll regret and will hurt them for the rest of their lives. That’s why it’s so concerning that Washington state is on the verge of stripping parents’ ability to keep their kids safe.
The bill has now passed the state legislature and is waiting for Gov. Jay Inslee’s signature. Will he really ignore parents and endanger their kids? Or will he protect these especially vulnerable young people by keeping their parents involved? The choice shouldn’t be that hard, but sadly, it looks like the governor is listening to extremists instead of common sense.
ETSU Keeps Its Foot on the Gas with a “Moon Shot for Equity” Initiative
Uncategorized Tennessee DEI East Tennessee State University Medical School, Public university Commentary Do No Harm StaffEast Tennessee State University (ETSU), home of the Quillen College of Medicine (QCOM), is doubling down on its woke DEI efforts. In fact, it’s shooting for the moon.
Last month, we reported that the dean of medicine at QCOM sent an email to university staff in response to Do No Harm gaining traction with our report that pointed out the elite DEI establishment in Tennessee’s medical schools. His message was clear: Stay focused and stay the course with ETSU’s commitment to DEI. This time, it’s Dr. Keith Johnson’s turn, VP for Equity and Inclusion.
The April 3 edition of the Office of Equity and Inclusion Newsletter sets the expectation by opening with the message that DEI efforts should be considered “long-term investments, rather than expecting an immediate turnaround.” While the initial tidal wave of diversity statements, strategic plans, implicit bias training, and establishment of DEI offices accelerated quickly in the summer of 2020, “many of those plans have not yielded positive results.” Johnson notes that employees are often “frustrated, exhausted, and even skeptical” of their DEI work being successful, and this may be due to “charging already marginalized individuals with solving or fixing their own problem.”
He goes on:
Considering all that negativity, it makes sense to abandon the DEI agenda and focus the school’s resources on more positive and productive initiatives, right?
Not at ETSU.
Forget the carrot. It’s time to get out the stick. “Just like incentives given to employees who meet or exceed established performance goals,” says Johnson, “there should be consequences as a result of not achieving those same goals.” Enter the “Moon Shot for Equity”. Policies and processes that will be scrutinized with this program include admissions, financial aid, advising, student engagement, and “climate,” with the goal of closing the “equity gaps” at ETSU.
The Moon Shot for Equity is a partnership with EAB, a private company that uses the same language Johnson used in his newsletter: “To fulfill the promise of student success,” EAB states, “we must eliminate persistent equity gaps at our colleges and universities.” ETSU’s webpage for the program hosts a video promoting EAB and the “systemic barriers to attending and graduating college” that “historically underserved students continue to face.”
ETSU’s flurry of goings-on and expensive partnerships to cement DEI concepts into its operations suggests the university is feeling the heat from the Tennessee General Assembly’s recent legislative action concerning state-funded medical education providers. House Bill 1376 and Senate Bill 817, sponsored by Rep. Ragan and Senator Hensley, specifically calls out the importance of competency-based education and training in medicine. It bans required DEI oaths, pushes back against woke national organizations, places limits on DEI-related positions at schools, and includes other necessary reforms. HB 1376/SB 817 just passed the House and Senate and will become law after Governor Lee signs it. Additionally, HB 158 and SB 102, sponsored by Rep. Zachary and Senator Gardenhire, ban implicit bias training requirements.
The initiatives of the Office of Equity and Inclusion have a direct effect on the medical education programs at ETSU’s Quillen College of Medicine. Tennessee’s lawmakers must continue their efforts to counteract the consequences of programs and actions that are based on ideology and activism instead of science and facts. Patients will insist on a moonshot for quality and skill in their future physicians and ETSU must refocus its objectives toward serving them.
We Found More Discriminatory Scholarships at the University of Kansas School of Medicine
Uncategorized Kansas DEI University of Kansas School of Medicine Medical School Commentary Executive Do No Harm StaffThe University of Kansas School of Medicine at the KU Medical Center (KUMC) continues to violate civil rights laws with two more discriminatory scholarships.
We previously reported about the Department of Education’s Office for Civil Rights’ investigation of KUSM for its Urban Scholars Program for Students Underrepresented in Medicine. In response the school quietly changed the eligibility requirements by removing the race/ethnicity criteria that originally created the violation of Title VI of the Civil Rights Act of 1964.
But KUMC has more scrubbing to do.
The KUMC Department of Plastic, Burn, and Wound Surgery offers the Summer Diversity Research Scholarship for First and Second Year Medical Students. According to the department’s informational document, “To be considered for a scholarship through the KU Department of Plastic Surgery Scholarship Program, the student must be a member of a population that is underrepresented in Plastic Surgery; i.e. African American/Black, American Indian, Native Hawaiian, Alaska Native and/or Hispanic/Latino.”
The application for this scholarship requires applicants to list their “Racial Identification/Ethnicity:”
Under these requirements, medical students who are white, Asian, Pacific Islander, or Middle Eastern/North African are illegally excluded from this scholarship on the basis of their race, color, or national origin.
The school also offers the Department of Plastic Surgery Sub-Internship in Plastic Surgery Diversity Scholarship:
The informational document is available for download from this page, which lists the same racially discriminatory eligibility criteria:
The application for this scholarship also collects the student’s “Racial Identification/Ethnicity:”
Both scholarships at KUMC cover the awardee’s travel costs and provide stipends of $1,500 and $500, respectively.
Do No Harm senior fellow Mark Perry filed a federal civil rights complaint against KUMC for these two scholarships. Perry requested the Kansas City OCR investigate KUMC for violations of Title VI, which prohibits discrimination on the basis of race/ethnicity.
Do No Harm Lawsuit Charges Arkansas Minority Health Commission with Discrimination against Students Based on Skin Color
Uncategorized Arkansas DEI Press ReleaseToday, Do No Harm, an organization working to protect healthcare from discriminatory, divisive ideologies, filed a lawsuit on behalf of a member against Kenya L. Eddings, the Executive Director of the Arkansas Minority Health Commission. The suit asserts Ms. Eddings, in her official capacity as head of the AMHC, is responsible for a scholarship – the Minority Healthcare Workforce Diversity Scholarship – that discriminates against students based on their skin color.
“This scholarship clearly violates the Fourteenth Amendment to the United States Constitution, said Dr. Stanley Goldfarb, Board Chair of Do No Harm. “The Arkansas Minority Health Commission is illegally excluding and discriminating against certain medical students and denying them opportunities based on their race, color, or national origin – the scholarship should be declared unconstitutional and promptly enjoined.”
The Do No Harm suit, filed in the Eastern District of Arkansas, maintains that the scholarship is blatantly illegal. The Equal Protection Clause requires racial classifications to satisfy strict scrutiny, and the scholarship’s gross racial exclusion obviously fails to meet those standards.
To be eligible for the scholarship, an applicant must “confirm that [he is] a racial minority,” meaning “African American, Hispanic, Native American/American Indian, Asian American or Marshallese.” In other words, Arkansas’s white and Arab-American students need not apply.
Do No Harm seeks the following:
ABOUT DO NO HARM:
Do No Harm is a diverse group of physicians, healthcare professionals, medical students, patients, and policymakers united by an ethical mission: Protect healthcare from a radical, divisive, and discriminatory ideology. They believe in making healthcare better for all – not undermining it in pursuit of a political agenda. Learn more at www.donoharmmedicine.org.
Legislative Update: Kansas
Uncategorized Kansas Gender Ideology Medical School, Public university, State legislature Commentary Do No Harm StaffAfter Do No Harm Board Chairman Dr. Stanley Goldfarb testified in front of the Kansas state legislature on February 1, legislators advanced three important reforms that are headed to Governor Laura Kelly’s desk in the form of two bills. Here is a short summary of each:
SB 26: Thanks to significant work by Senator Beverly Gossage and Representative Susan Humphries, this bill creates the Kansas Child Mutilation Prevention Act aimed at protecting children from the harmful, life-changing impacts of sex reassignment surgeries.
The bill would:
In addition, SB 26 would require the Kansas State Board of Healing Arts to revoke the license of a physician who performed a childhood sex reassignment service.
HB 2184: Thanks to the strong leadership by Senate President Ty Masterson, Speaker Dan Hawkins, and Majority Leader Chris Croft, and tireless efforts from Rep. Steven Howe and Senator J.R. Claeys, two important provisions were included in the state’s general budget bill.
Diversity, Equity, and Inclusion (DEI) reforms to the Behavioral Sciences Regulatory Board:
Diversity, Equity, and Inclusion (DEI) reforms for the Board of Regents at any publicly funded Kansas institution of higher education:
These reforms are tremendous strides forward in the effort to keep discrimination out of medicine and to protect children. While SB 26 and HB 2184 successfully passed the Kansas House and Senate, they could still be vetoed by Governor Kelly. Stay tuned for more information on potential legislative veto overrides should this occur.
S1E12: The Dangerous Influence of the Anti-Racism Movement on Society
Uncategorized DEI Podcast Benita Cotton-OrrDr. Stanley Goldfarb and Benita Cotton-Orr discuss how the woke movement towards anti-Racism has transformed how Americans view one another, shifting from a perspective of opportunity to one of oppression.
The University of Kansas School of Medicine Partners with California School to Promote Far-Left Anti-Racism Program
Uncategorized Kansas DEI University of Kansas School of Medicine Health system, Medical School Commentary Executive Do No Harm StaffThe KU Medical Center (KUMC) at the University of Kansas School of Medicine (KUSOM) has teamed up with UC San Francisco (UCSF) in a program that promotes radical, discriminatory, and divisive concepts – all in the name of research.
A source let us know about the REPAIR Project at KUMC, which is an “anti-racism collaboration” the school is taking part in with UCSF, as well as engaging with “communities of color” in the geographic areas surrounding the KUMC campuses.
KUMC’s Office for Diversity, Equity, and Inclusion (ODEI) is involved in recruiting participants for the REPAIR Project, citing it as a framework of “anti-racism initiatives” to integrate into the MD program’s curriculum and continuing medical education. The goal is “addressing unequal outcomes in our clinics” and “anti-Black racism” by using “a social justice and anti-racism curriculum throughout the medical center.” The structure claims that racial inequities in the healthcare industry and academic medicine are caused by “systemic race-based structural violence and racism in society as a whole.”
The ODEI’s website has a short recruitment video that invites area residents to take part in “an oral history research project” and have their stories heard if they have “received substandard medical care.”
Participants will be asked:
The site also lists several resources from UCSF:
At UCSF, where the program originated, “REPAIR” is an acronym for “REParations and Anti-Institutional Racism, which provides the unifying theme behind this project.” The three-year initiative, backed by the Regents of the University of California, aims to “address Anti-Black Racism and augment Black, Indigenous, People of Color voices and presence” in the fields of science, healthcare, and medicine. The divisive rhetoric of the REPAIR Project is outlined in the “strategic annual themes:”
Year One: Medical Reparations: Addressing the Ongoing Legacies of Slavery in American Medicine
Year Two: Medical Abolitionism
Year Three: Decolonizing the Health Sciences
The University of Kansas School of Medicine and the KU Medical Center is already under investigation by the Office for Civil Rights for a racially discriminatory scholars’ program. Why is the institution also participating in this far-left, California-sponsored project?
Patients shouldn’t be frightened into believing that their doctors don’t have their best interests in mind when seeking treatment at KU Health. Kansas policymakers must act now to remove the REPAIR Project and other destructive ideologies from further degrading the quality of medical education in “the region’s premier academic health center.”