Tucker Carlson Misrepresents the Science on Transgender Youth

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The Arkansas legislature recently passed the Save Adolescents from Experimentation Act, which prohibits minors from receiving hormones, puberty blockers, and surgeries related to a gender transition. Moreover, any healthcare provider who offers these services would face penalties.

The Republican Governor of Arkansas, Asa Hutchinson, viewed the bill as “vast government overreach," arguing that it would interfere with medical care between physicians, parents, and patients. He vetoed it.

"The bill is overbroad, extreme and does not grandfather those young people who are currently under hormone treatment,” Hutchinson added. “The young people who are currently under a doctor’s care will be without treatment when this law goes into effect."

Hutchinson's veto was overridden by the legislature Tuesday. That night, he appeared on Fox News' Tucker Carlson Tonight to explain his decision. During the interview, Carlson repeatedly mangled and misrepresented the science on gender dysphoria and transgender youth.

Carlson's first misleading assertion was that using hormonal treatments to halt puberty constitutes "chemical castration". It's true, some of the same drugs used to help dysphoric youth transition were used in the past to reduce libido and sexual activity in criminals convicted of sex crimes, and this was termed "chemical castration". When used in adolescents, however, studies have suggested that the drugs are safe, and their effects both well-tolerated and reversible.

As Sai Shanthanand Rajagopal, a researcher at the Center for Gender Surgery at Boston Children’s Hospital, and Henna Hundal, a public health graduate student at McGill University, wrote for Stat, "These drugs suppress the release of sex hormones, including testosterone and estrogen, during puberty, putting puberty [on hold] by halting the onset of secondary sex characteristics such as breast development and voice deepening. This pause provides another extended reflection period to assess if gender dysphoria is persistent and requires further intervention."

Puberty-blocking hormones have actually been used safely for decades to treat precocious puberty, where a child's body begins changing to that of an adult too soon, before age 8 for girls and age 9 for boys.

Carlson terming the use of these drugs for gender dysphoric youth "chemical castration" was really an attempt to poison the well of the debate.

Tucker's next question for Hutchinson was prefaced with outright misinformation.

"This is an emerging field. There's not a lot of research, but the research that exists suggests that depression and the urge to self-harm and commit suicide is a side-effect of taking these hormones. A study in the U.K. showed the overwhelming majority of children on puberty-blocking hormones had the urge to hurt themselves. Why is that responsible medicine to do that to children?" he asked.

Carlson is correct that transgender medicine remains an emerging field, and that quality, placebo-controlled studies are scarce, (partly because they're very hard, and perhaps unethical, to do in this instance) but the research which has been conducted thus far almost universally suggests that the measured use of puberty blockers is linked to boosted mental health, decreased suicidality, and improved social life for gender dysphoric adolescents.

Hutchinson answered Carlson's loaded question by beginning to discuss some of this research, but Carlson cut him off.

"Cite one specific study that shows puberty-blocking drugs improve the condition," he said. "Does it make children less depressed? Does it make children less likely to harm themselves, to commit suicide. Just name one study that shows that please."

Without having the PubMed database loaded and ready on his smartphone, Hutchinson side-stepped Carlson's question by correctly noting that the American Academy of Pediatrics and the Endocrine Society both support medical care for gender dysphoric youth and opposed the bill.

Carlson cut Hutchinson off again.

"There is not a single study that I'm aware of that shows improvement in the mental health of children who take puberty blockers, who are chemically castrated. And you couldn't cite one."

To directly resolve Tucker's ignorance, here are two systematic reviews published late last year which document improved mental health outcomes for gender dysphoric youth given puberty-blockers.

Tucker subsequently made an offhand reference that most dysphoric kids will end up wanting to keep their birth gender, and that many who choose to transition end up regretting it. This assertion goes against available evidence.

"Empirical studies... show this isn’t a widespread phenomenon," Rajagopal and Hundal wrote in Stat. "In a 2015 national survey of nearly 28,000 transgender people in the U.S., only 8% of patients detransitioned — and of that 8%, two-thirds detransitioned temporarily."

Youth gender dysphoria and transgender medicine are complex issues. That's why, when discussing them, it's important to be intellectually humble, deferential to patients, doctors, and parents, and informed and honest about available scientific evidence. Tucker Carlson failed in all of these respects on Tuesday night.

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