🔴 WATCH THE FULL EPISODE: https://ept.ms/4bCo1shShow more "There is no credible evidence that puberty blockers... address anxiety, depression, suicidal ideation," Leor Sapir tells us. In a recent interview, Sapir, a senior fellow at the Manhattan Institute and co-author of the 2025 HHS review of pediatric gender medicine, detailed a systemic lack of rigor and transparency within the field. Show less
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| The bottom line is that there is no credible evidence that puberty blockers, for example, address anxiety, depression, suicidal ideation, that they're not needed to address those conditions. | |
| Now, you know, you also need to think about what are the risks of these drugs. | |
| And part of the problem in this field, in the field of gender medicine in general, and pediatric gender medicine in particular, is that the people who do studies in this area are typically gender clinicians, people who are invested in this type of practice, who believe in it for very, you know, sometimes very ideological reasons, sometimes financial reasons, sometimes they just believe that they're helping kids. | |
| And I think their belief may very well be sincere. | |
| But we have plenty of evidence that these studies don't try to track harmful outcomes. | |
| Usually the studies are very short-term. | |
| They have very high dropout rates. | |
| Even when the researchers are interested in registering and looking at potential harms, for example, the lack of bone density accrual, or cognitive impacts, or cardiovascular events, they don't end up following up. | |
| They don't end up publishing the results. | |
| So just to give one example, in 2024, the New York Times reported that a major NIH-funded study, $10 million, the lead researcher in that study, Johanna Olson-Kennedy of Children's Hospital Los Angeles, or I should say formerly of Children's Hospital Los Angeles, had the mental health outcomes from puberty blockers and the kids in her study, and she chose not to publish the results because they were unimpressive. | |
| And so she just, she said, told the New York Times, I didn't want this to be used by critics of this area of practice, to be cited by them. | |
| So she just didn't publish the results. | |
| So this is fairly characteristic of the field. | |
| It's dominated by clinicians who are deeply invested in this type of practice. | |
| And so that results in all types of biases and distortions. | |
| And you can imagine the study design also is something that I did once in my life. | |
| And I was sort of struck by how easy it is to design studies to go in the direction of your favorite outcome to get closer or something like that. | |
| That's right. | |
| So I imagine that most of these studies, based on what you're telling me, must be sort of set up for particular outcomes. | |
| And if they don't get them, it's almost like that itself is evidence, might be evidence. | |
| I'm just hypothesizing here, of course. | |
| Yeah, I mean, that's, so just to give an example of what you're talking about, one study that was published a few years back on the outcomes of mastectomy in girls actually was also led by Johanna Olson Kennedy. | |
| They developed this tool for measuring outcomes. | |
| They called it the chest dysphoria tool. | |
| And basically what this tool, essentially, when you look at kind of how they conceptualize chest dysphoria, it's, do you like the way your chest looks now after you've had a mastectomy? | |
| And they asked all these girls a few months after they got the procedure, do you like how your chest looks now? | |
| And naturally, most of them said yes. | |
| Okay, but what does that tell us? | |
| What does that tell us about their long-term mental health outcomes? | |
| What does that tell us about what's going to happen when they're in their 30s and they want to breastfeed and they can't? | |
| Are they still going to be happy with their decision then? | |
| This study has no ability to tell us, give us any of that information. |