January 27, 2023

Should the venerable NEJM be renamed?

The world’s most prestigious medical journal, the New England Journal of Medicine, is digging its heels in over the controversial issue of transgender medicine. The latest issue features two “Perspectives” arguing that transgender medicine is a fundamental human right and that restrictions imposed by states are abhorrent.

Restrictions are “coordinated attacks on bodily autonomy by extremist conservative ideologues, which have targeted sexual and reproductive rights (including abortion and contraception access)”, according to one of the articles.

The other article, by academics from Yale University, describes bans on “gender-affirming healthcare” as “a virulent brand of science denialism”. They identify four denialist themes:

“… repudiation of the medical condition that is the target of treatment, misrepresentation of the standard of care, false claims about risks associated with treatment, and misuse of existing research. Such tactics allow policymakers with anti-transgender agendas to reject medical authority, stoke public fear, and legally codify falsehoods. Once detected and exposed, these false claims can be deconstructed with the use of robust evidence.”

The notion that gender dysphoria should be treated with psychotherapy alone is described as “inflammatory”; social contagion amongst teenagers has been “debunked”; rates of “regret” are less than 1%; and “claims that performing genital surgery in children is common practice” are false. They conclude: “Bans on gender-affirming care are grounded in science denialism, harm the health of marginalized people, and degrade medical authority.”

Curiously, neither of the articles refers to developments in England, Sweden, Finland, and France, where there is increasing scepticism about the value of hormonal and surgical treatment for gender dysphoria. The trans debate appears to have become so inextricably enmeshed in America’s culture wars that the authors cannot see beyond its borders.

Wesley J. Smith, the bioethics contributor to the National Review, was scathing in his comments about the NEJM’s unquestioning support for transgenderism:

It seems to me that the real science denialism comes from those who distort the professional discourse by engaging in ideological polemics, an advocacy tactic that is antithetical to the scientific method. Perhaps the NEJM should change its name to the “New England Journal of Ideological Medicine” to better reflect its current chosen role in society.