Leading ‘Gender Affirming’ Psychiatrist’s Popular Article Updated After Fact-Check Reveals Misleading Claims

A popular article claiming to show mental health benefits from “gender-affirming” care has been updated by the publisher after it was shown to contain distortions and misleading information.

Dr. Jack Turban, an activist researcher, published an article in Psychology Today in January of this year claiming that scientific studies demonstrate clear mental health benefits of “gender-affirming” care for trans-identifying youth, for which he is a strong proponent. However, after a recent thorough fact-check of the article by Manhattan Institute Fellow Leor Sapir, the popular psychology website issued numerous updates. This came months after ignoring multiple attempts by experts to quietly address the inaccuracies.

“NOTE: This post was updated on October 11, 2022. In discussions of studies 5, 7, 8 and 10, the final sentence was appended to include further information about the study,” an addendum at the top of the Psychology Today article now reads.

Turban’s article, cited widely among trans activists to support medically transitioning gender dysphoric minors, references 16 studies that he claims demonstrate gender-affirming care “results in favorable mental health outcomes” for trans-identifying youth.

Despite being fresh out of his residency and having far less clinical experience than many other experts calling for a more cautious approach to managing gender dysphoria in youth, Turban is widely and frequently quoted by popular legacy media outlets, including the New York Times, as an authority on the topic.

When Sapir found that Turban’s claims of a causal link between “gender affirming” care and positive mental health outcomes were not supported by evidence, he published a rebuttal in Reality’s Last Stand, a popular Substack-based online magazine dedicated to the sex and gender debate. Sapir found that some of the studies commonly touted as evidence of the benefits of “gender affirming” care show no or even a negative association between hormones and mental health.

Sapir broke down the 16 studies Turban relied upon and showed how Turban oversold and/or misrepresented the strength of evidence and misled his readers into embracing the controversial “gender affirmation” protocol. Several of the studies were short-term follow-ups, which by definition cannot capture long-term feelings about medical transition.  

After the changes to the Psychology Today article were brought to his attention, Sapir took to Twitter to outline the four new “corrections” and two “stealth edits” made to the report on Tuesday.

For the first update, regarding Turban’s interpretation of Kaltiala et al.’s 2020 study, Psychology Today included a quote from the study’s authors saying that hormones are “not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria.” 

“As I mentioned in my fact-check, Kaltiala herself emphasized to me that their study should not be used to claim that hormones reduce suicidality,” said Sapir. “That is a stronger caveat than the one Turban now acknowledges.”

The second update, on van der Miesen et al.’s 2020 study, a note was added that the authors found no “direct evidence” of mental health benefits from puberty blockers. 

The third update, having to do with a 2020 study by Achille et al., now acknowledges that the “improvement” seen in patients only applied to male-to-female trans-identified youth and only to those who took puberty blockers. 

“As I pointed out, however, this group was 1/3 of the total cohort studied, and represents a minority of those referred for treatment these days,” said Sapir. “Why not mention this?”

A fourth update, which references Turban’s own research from 2020, now acknowledges that his study did not control for psychotherapy as a confounding variable. According to Sapir, this means that “it’s possible those who reported better mental health did so for reasons having little to do with getting hormones.”

Two “stealth edits” that Sapir noticed were in reference to a 2019 study by Allen et al. and a 2021 study by Carmichael et al. With respect to the former, Psychology Today added the sentence, “Of note, the adolescents also received psychotherapy.” Regarding the latter, a caveat regarding the study’s small sample size was removed.

“As I noted in my fact-check, Turban dismisses studies that found no improvement in mental health when they have low sample sizes, but includes studies with small (or even smaller!) sample sizes when they support his conclusion,” said Sapir. 

While Sapir noted that the updates Psychology Today made were a step in the right direction, he felt there were additional inaccuracies not addressed. Most notably, the subtitle, which Psychology Today chose not to alter, reads: “Research suggests gender-affirming medical care results in better mental health.”

“Which brings me to the biggest correction that should have, but didn’t, happen: Turban continues to say that 16 studies show, on the whole, that hormones ‘result in’ better mental health. That’s very misleading causal language. At most, he should have said: ‘coincides with,’” said Sapir.

“The studies show no evidence of hormones being the cause of improved mental health, even with the often very short follow-up times,” Sapir told The Daily Wire.

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