Society for Evidence-Based Gender Medicine

The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for opposing standards of care for transgender youth and engaging in political lobbying. The group routinely cites the theory of rapid-onset gender dysphoria and has claimed that conversion therapy can only be practiced on the basis of sexual orientation rather than gender identity.[1] SEGM is often cited in anti-transgender legislation and court cases, sometimes providing evidence briefs themselves.[2][1] It is not officially recognized as a scientific organization by the international medical community.[3][4][5]

Society for Evidence-Based Gender Medicine (SEGM)
AbbreviationSEGM
Established2020 (2020)
TypeNonprofit
AffiliationsGenspect
Websitesegm.org

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

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[10] 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.[11][12] 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.[13]

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."[14][15]

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][16]

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".[17]

Conversion therapy
See also: Conversion therapy

Malone and fellow SEGM member Colin Wright asserted in a September 2019 Quillette article that counselling can 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][18] 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][19]

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.[20] 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.[21] 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 ban gender-affirming care for minors. He cited a study from SEGM that questioned Dutch research into such care.[5]

Affiliations
See also: Genspect

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][22][11]

A report by Debra Kroszner 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]

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][23]

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 came in donations greater than $10,000.[22][11]

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"[24] 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.[25]

In April, 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]

A commentary published in Clinical Practice in Pediatric Psychology published in September 2022 cited SEGM and the American College of Pediatricians as examples of "discriminatory advocacy organizations" who spread misinformation about gender-affirming healthcare by mischaracterising clinical best practices and scientific research by relying on and inaccurately interpreting a "very small, nonrepresentative sample of the available literature"[2]

In October, 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".[26]

See also

References
  1. Eckert, AJ (2021-10-17). "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 2022-10-24.
  2. Kuper, Laura E.; Cooper, M. Brett; Mooney, Megan A. (September 1, 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. Ring, Trudy (2022-05-05). "'Science' Behind Texas/Alabama Anti-Trans Policy Is 'Full of Errors'". The Advocate. Archived from the original on 16 June 2022. Retrieved 2022-06-16.
  4. McCall, Becky; Nainggolan, Lisa (April 26, 2021). "Transgender Teens: Is the Tide Starting to Turn?". Medscape Medical News. Retrieved 2022-10-20.
  5. Beck, Madelyn (2023-02-02). "Health experts: Gender-affirming care saves lives". WyoFile. Retrieved 2023-02-02.
  6. Greenspan, Sam (2022-08-03). "How Florida Twisted Science to Deny Healthcare to Trans Kids". Vice News. Retrieved 2022-08-22.
  7. "Biased Science in Texas & Alabama". medicine.yale.edu. Retrieved 26 June 2022.
  8. Eckert, AJ (2022-10-22). "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 2022-10-24.
  9. Dixon, Hayley (26 June 2021). "CBBC's trans messaging is damaging children, says mother". The Telegraph. Retrieved 30 May 2023.
  10. "Brief of Amicus Curiae Society for Evidence Based Gender Medicine in Support of the Defendant Appellee" (PDF). July 7, 2021.
  11. Moore, Mallory. "SEGM uncovered: large anonymous payments funding dodgy science". transsafety.network. Archived from the original on 2022-06-07. Retrieved 2022-06-26.
  12. "ROGD Statement". Coalition for the Advancement & Application of Psychological Science. Archived from the original on August 4, 2021. Retrieved August 4, 2021.
  13. 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.
  14. "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.
  15. Ault, Alicia; Nainggolan, Lisa (August 16, 2022). "Pediatricians at Odds Over Gender-Affirming Care for Trans Kids". Medscape Medical News. Retrieved 2022-10-20.
  16. 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.
  17. Bye, Clarissa (December 27, 2022). "Human rights video schooling kids on gender and sex slammed". The Daily Telegraph (Sydney).
  18. 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 (2018-10-01). "Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents". Pediatrics. American Academy of Pediatrics (AAP). 142 (4). doi:10.1542/peds.2018-2162. ISSN 0031-4005.
  19. 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.
  20. Stahl, Aviva (April 16, 2021). "The Science Behind Those Anti-Trans Healthcare Bills Is Bullsh*t, According To Experts". BuzzFeedNews. Retrieved 2022-08-22.
  21. Tracy, Matt (2020-04-01). "Idaho Bans Trans Girls' Sports, Bars Birth Certificate Changes – Gay City News". Gay City News. Retrieved 2022-08-22.
  22. 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.
  23. Scheide, R.V. (January 17, 2023). "Shasta County Threat Assessment: Code Red as Publisher Threatened, Trans Students Endangered and Gateway Board Prepares to Hire Sketchy Superintendent – anewscafe.com". A News Cafe. Retrieved 2023-01-19.
  24. Levine, Stephen B.; Abbruzzese, E.; Mason, Julia W. (2022-10-03). "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.
  25. Drescher, Jack (2022-06-01). "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.
  26. Farmer, Blake (2022-11-09). "Ad Goes Too Far With Claim That Joe Biden Promotes Surgery for Trans Teens". Kaiser Health News.
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