By: Socha Verbeke
Politics appears to be polarized to an extent that necessitates their exclusion from science and medicine. In 2015, Dr. Johanna Olsen-Kennedy, an American physician at the Children’s Hospital Los Angeles, and her team, received $6 million (USD) from the National Institute of Health (NIH) to study the effects of puberty blockers on children. The study was part of a 9.7$ million project to examine youth transgender care. Puberty blockers were administered to 95 children of an average age of 11.5 years old. The researchers planned to follow their mental health developments over two years.
Seven years after the study ended, in 2024, the results have not yet been published. Dr. Olson-Kennedy revealed in a New York Times interview that the study found zero evidence of mental health improvements in transgender teens who took the puberty blockers. Indeed, the researcher stated that the children were in “really good shape” before and after taking the drugs. This assessment contradicts her hypothesis, and previously agreed upon opinion, that puberty blockers improve transgender youth’s mental health. Dr. Olson-Kennedy expressed concern that her findings could be ‘weaponized’ in the current ‘political climate’ especially in debates about gender affirming treatments for minors.
Evidently, researchers, at least one researcher, feels pressure to suppress information and to report findings selectively based on feared political response to the findings. Refusing to publish results compromises scientific objectivity. The purpose of scientific research is to pursue and deliver objective truth, irrespective of preconceived expectations. Copernicus might have feared the political and social state of his country when he revealed the remarkable fact of heliocentrism. The great scientific advances that have led to modern life, would not have occurred if researchers withheld information for fear of political backlash. Science must be a neutral arbiter of knowledge.
Additionally, Dr. Olsen-Kennedy’s study was funded by taxpayers. The perception that political considerations influence the decimation of scientific information can erode the relationship between scientific institutions, policy makers and the public. Taxpayers are entitled to value for money. Value lies in the delivery of objective results they pay for, regardless of what the outcomes of the results are.
Moreover, the research is not really Dr. Olsen-Kennedy’s to withhold. Taxpayers funded it. By withholding her research findings she is arguably misappropriating public funds.
Aside from the philosophical purpose of science and funding ethics, transgender and gender-dysphoric children deserve informed and evidence-based care. Children are dying: 40% of transgender adolescents attempt suicide as compared to 5% of cis-gender teenagers and globally, suicide attempt rates among transgender people range from 32% to 50% across countries. In an attempt to help them, physicians began administering puberty blockers ‘off label’. Puberty blockers have been used and approved in many countries to treat precocious puberty which is when children begin the transition to adulthood very early in their youth, usually around 8 years old.
Both Sweden and Finland have cautious approaches to puberty blocker use in gender-dysphoric youth. Both countries have restricted use exterior to clinical trials and cite insufficient evidence for their long-term safety and efficacy. There is a growing global concern for more robust research for off-label puberty blocker use.
In the United Kingdom, an independent review commissioned by the National Health Service England (NHSE) and led by eminent pediatrician, Dr. Hilary Cass, evaluated the nation’s gender identity services to youth. Dr. Cass concluded that there is insufficient evidence to support the safety or the clinical effectiveness of puberty-suppressing hormones for treating gender dysphoria or incongruence. In the research they reviewed, only one of the fifty studies examining puberty blockers was found to be of ‘high quality’ according to their metrics. The study concluded that the advantages of puberty blockers have been “overstated” and there is “very limited” evidence supporting their efficacy. In 2024, following the publishing of Dr. Cass’s study, the United Kingdom placed an indefinite ban on the administration of puberty blockers for children under 18 years old to treat gender dysphoria or incongruence except in clinical trials. The prohibition includes NHS and European public and private providers preventing the administration of medications through private healthcare.
The response to this ban has been mixed with division in the medical community and in the LGBTQ+ community. The British Medical Association (BMA) initially called for the ban to be lifted but after facing significant backlash from its members and other medical professionals, the organization changed its stance and now supports the ban. TransActual, a transgender youth organization, challenged the ban in the UK High Court; their claim was unsuccessful.
If a pediatric cancer drug were found to have inconsistent or unsubstantiated evidence of effectiveness, then it would not be used. Administering a medication without robust proof of efficacy risks harming patients and is, therefore, unethical.
The NIH-funded study’s unpublished findings and the Cass Review’s conclusions show that there is a lack of efficacy evidence. Continuing to prescribe puberty blockers contradicts the medical principle of ‘do no harm’. The outcry over the puberty blocker ban, in this context, reflects ideology rather than adherence to scientific rigour in the practice of medicine. There is substantial funding for research on medical care of gender dysphoric youth. Innovative scientific research will, over time, reveal best practice. These youth will be cared for. They deserve to be cared for. They deserve the same evidence-based care as everyone else.
Political polarization is directly undermining the purpose of science and medicine: objective and evidence-based care. Political concerns should not influence the conduct of scientific research or the publication of its findings. The proper medical care of children’s mental and physical health demands caution and integrity, not ideology.
References
Image Source: Vuk Valcic, SOPA Images/LightRocket via Getty Images file, https://docs.google.com/document/d/1PCYVxBkZdbg2uOfeuPorT1Epz4df5wJ5nSUOcR9fjWQ/edit?tab=t.0
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