Exclusive: The American Psychiatric Association Rejects Evidence-Based Gender Medicine Presentation
You won’t believe the reason
Today, I am here, in New York City, where over 9,000 mental health professionals from around the world are gathering for the final day of the American Psychiatric Association’s (APA) annual meeting- which boasts over 500 educational sessions and 1000+ research posters.
But, there is one presentation attendees have NOT been allowed to see.
READ ON for an exclusive report from our friend, Child & Adolescent Psychiatrist Dr. Kris Kaliebe about his rejected presentation, which, to me, exemplifies the intolerance to viewpoint diversity that I have encountered over the past few days.
Here’s Kris:
I am not attending the American Psychiatric Association (APA) conference in New York City this week.
I had hoped to present with two therapists and another psychiatrist.
We submitted a presentation entitled Sociocultural Aspects of Gender Dysphoria in Minors and Young Adults. Our symposium aimed to reintroduce psychotherapy as an initial approach to gender dysphoria in minors and young adults.
It was to include a discussion of the link between homosexuality and gender dysphoria, barriers preventing youth from entering into psychotherapy, cultural and social media influences on gender dysphoria, and a look at deceiving slogans permeating gender-affirming care.
This presentation was rejected.
The process is that each presentation has three reviewers. For my submission, one reviewer had no comments, and one reviewer had favorable comments, including stating that this presentation focused on an important topic and would be well attended. The third reviewer gave poor enough grades to sink the presentation and wrote that our group has “an agenda against gender-affirming care”.
This censorship of alternative viewpoints is precisely why you cannot trust the APA. As long as APA allows an intolerant, pious few to police APA’s journals and conference proceedings, this intransigent minority will prevent any rigorous scholarly dialogue on youth gender medicine. Nassim Taleb's The Most Intolerant Wins: The Dictatorship of the Small Minority illuminates how in complex systems, such as medical associations, a small cohort of zealots can get their way, in this case, to halt the free and open exchange of ideas. Contrary to expectations, an intransigent few can control an entire organization.
For just one example of how dysfunctional it is at APA, last year I received an email promoting the APA webinar “Postpartum Psychosis: Are Birthing People of Color Falling Through the Treatment Gap?”
Postpartum psychosis is a serious topic.
When APA replaces “women” with “birthing people” this needless distortion of language only appears righteous and sophisticated within the APA’s activist bubble. Most people see it as anti-scientific nonsense.
Professional medical organizations are trade guilds, susceptible to tribal influences and politicization. Their influence and credibility which took years to build can quickly vanish. I have directly observed that over the last five years, the APA has prioritized a politicized and narrow vision of social justice advocacy.
The third reviewer gave poor enough grades to sink the presentation and wrote that our group has “an agenda against gender-affirming care”.
This is not the first time APA has gone wildly off course in my career.
In the 2000s, an audit found that over 90% of psychiatrists who created the clinical practice guidelines were being paid by the pharmaceutical industry (Cosgrove 2009). Not surprisingly, the treatment guidelines were overly focused on medications and downplayed other approaches.
At psychiatric meetings and in our medical journals, psychiatrists whose approach went beyond medications were marginalized. Pharmaceutical industries’ manipulations to promote antidepressants were aided by the American Psychiatric Association, which at the time was receiving significant funding from the industry.
After being sued under the Freedom of Information Act, pharmaceutical companies released all their data. This previously buried data revealed that for depression, especially for children and adolescents, antidepressants often do not beat placebo.
While these medications are important treatment options and treat other conditions, the "long tail" of this systematic misinformation is that the antidepressant overtreatment continues today at great expense. (McCormack 2018, Hopcroft 2018)
This overtreatment also occurred in part because providers tend to be fooled by their clinical experience of seeing patients improve. When patients improve it might be the natural process of healing over time or psychosocial supports provided with the intervention. Improvement could also be placebo effects, which are now broadly considered and would be expected to increase in proportion to how much the treatment is promoted by medical organizations (Clayton 2022).
That it is why there are serious ethical concerns regarding the APA's and other organizations overly-enthusiastic endorsements of gender-affirming care: promoting care based on short term improvement and patient satisfaction has the potential to cause harm at scale.
Why did the overtreatment with antidepressants occur? In part, it was because prescribers did see patients tend to get better. Yet it also was due to manipulations of science. For years, when antidepressant medication research obtained unfavorable or neutral results, these results were often never submitted for publication or buried in an obscure journal. (Turner 2008).
If published at all, unfavorable results of antidepressant trials were also significantly delayed, known as time lag bias (Reyes 2011). Positive antidepressant trials were typically published quickly and in the most prestigious journals. Those reading the positive results in the APA’s journals we being misled about the risks and benefits of anti-depressants.
Those considering trusting the APA on youth gender medicine should consider that as noted above on at least one other occasion within the last twenty years the APA spread misinformation at scale. After their previous embarrassment, in the late 2000s, the American Psychiatric Association implemented reforms to limit the undue influence of pharmaceutical companies. These reforms have helped achieve a better, but not perfect, balance.
APA’s current narrative that gender-affirming care for young people is effective, virtuous, and has minimal risk is the latest systematic misinformation peddled at APA. I hope that I’m wrong, but I’ll bet you that the psychiatrists attending this week's APA conference won’t hear about the Cass Review.
They are not bad people at the APA, but their system is broken. The APA's silent majority will need to demand a process where those of us with a humanistic and science-based agenda against gender-affirming care can state our case in APA journals and at APA conferences. Until then, the APA is not a scientific organization, and the APA can't be trusted.
Read Dr. Kaliebe’s past articles for Restore Childhood HERE and HERE.
Right up there with the AAP in pushing non-scientific agendas that are harming children. Thank you for at least trying to make a presentation, and for exposing the ways in which our organizations are failing patients in the "name of science"
Can we publish in social media, approach interested, mainstream media outlet to publish this information ?
It doesn't come at a surprise, but these organizations use be exposed for what they are doing: censuring, disinformation and harm to children .