Censorship of Essential Debate in Gender Medicine Research

The integrity of the gender medicine research literature has been compromised, not only by censorship of correct articles, but also by censorship of critiques of articles with unsupported (for instance exaggerated), misleading or erroneous statements. Many such statements concern the evidence base, which can be evaluated rigorously using a key component of evidence-based medicine, systematic reviews of the evidence. These reviews currently find there is limited to very little confidence that estimates of benefit from (and sometimes harm from) medical gender intervention, that is, puberty blockers, hormones and/or surgeries, are likely to match true outcomes. Several medical societies and articles in medical journals have been claiming otherwise, misrepresenting the evidence base as a whole and/or relying upon unsupported or non-representative individual study findings or conclusions. For example, high likelihood of benefit and low risk of adverse outcomes from medical gender interventions are often claimed, while less invasive alternative treatment options are either omitted or mischaracterized. Other unsupported, erroneous or misleading statements occur when studies minimize or omit mention of significant limitations, or report findings or conclusions not supported by their own data; these are then sometimes quoted by others as well. In addition, correctly reported studies are sometimes misrepresented. Critiques which attempt to rectify such statements are frequently rejected. Some examples are presented here. Such rejections have stifled scientific debate, interfering with the continual scrutiny and cross checks needed to maintain accuracy in the research literature. Currently, erroneous and unsupported statements circulate and repeat between journals and medical society guidelines and statements, misinforming researchers, clinicians, patients and the general public.