Activist-Blogger Erin Reed Can't Stop Telling Falsehoods About Gender Medicine
Even when fact checked, Erin Reed, who has a popular Substack and X account, has repeatedly made demonstrably false claims about England's Cass Review and about pediatric gender-transition treatment.
The prominent American transgender activist Erin Reed has repeatedly and insistently made demonstrably false claims about pediatric gender medicine.
During the two weeks since the publication of the
Cass Review, England’s mammoth report about this controversial and politicized medical field, Reed has emitted a fusillade of false claims about the review, its findings and the
systematic literature reviews on which it was partially based. Reed has only doubled down when fact checked, even when the corrections have come from lead author of the report, pediatrician Dr. Hilary Cass, herself.
Reed publishes a popular daily Substack, “
Erin In The Morning,” focusing on trans legislative, civil-rights and medical issues. Over the past couple of years, as access to gender-transition treatment by children has become a major political fight in U.S. statehouses, Reed has amassed a large following, both through her coverage of these issues and her activism against such laws and for gender-distressed children’s access to such treatments.
The Cass Review was four years in the making and
published to considerable fanfare in the UK on April 9. The 388-page report scrutinized the field of pediatric gender-transition treatment and found it was based on “remarkably weak evidence,” as I
reported for The New York Sun.
The report has heralded the end of an era in England. It helped shutter the troubled pediatric gender clinic, known as GIDS, that once provided puberty blockers and cross-sex hormones to members of a burgeoning population of thousands of British minors distressed about their gender. Going forward in England, holistic psychological care will be prioritized for such young people, as it now is in multiple Scandinavian nations.
For gender-distressed minors in England, puberty blockers will only be available through a planned clinical trial. And the nation’s National Health Service looks likely to heed Cass’s counsel to reverse its
recently announced policy to permit cross-sex hormones to 16 and 17 year olds. Furthermore,
signs from Parliament suggest that the government will likely crack down on any private and overseas clinics prescribing of puberty blockers for gender distress. Even members of the Labour party have expressed support for Cass’s findings and recommendations.
Reed stands at the forefront of a full-court press by British and North American activists and online influencers to
undermine and cast doubt on the Cass Review, including through falsehoods. This comes as English politicians and medical societies, the NHS, and even major UK LGBTQ organizations have fallen in line and pledged their support of the report’s findings, or at least refrained from fighting them. U.S. medical societies, meanwhile, have remained notably silent on the matter. They all unwaveringly support pediatric gender-transition treatment.
Most notably, Reed has falsely claimed on repeated occasions that the Cass Review simply “disregarded” a substantial proportion of the available medical literature on pediatric gender-transition treatment. Sometimes phrased as the notion that Cass tossed out
98% of available studies, some version of this false claim ran rampant during the first week after the report’s publication. The game of falsehood telephone stormed across social media, showed up in the opinions of LGBTQ charity leaders and English MPs, and in an error-laden Canadian Broadcasting Corporation article that I
fact checked on X.
Finally, Dr. Cass herself
cried foul.
In an
interview with The Times published April 19, Dr. Cass did not mince words. She denounced those who had falsely claimed she had not included 100 papers on pediatric gender medicine in her review. (I explained the finer details of why this claim is egregiously incorrect in my
Substack from last week, so I’ll go into only just a bit of explanatory detail about this later in this report.)
The Times reported:
Calling the assertion “completely wrong”, Cass said that it was “unforgivable” for people to undermine her report by spreading “straight disinformation”.
The physician, 66, who has spoken about the toxic debate around the issue, also revealed that she had been sent “vile” abusive emails and been given security advice to help keep her safe.
Of her critics, Cass said: “I have been really frustrated by the criticisms, because it is straight disinformation. It is completely inaccurate.
Reed’s false claims, about the Cass Review in particular and pediatric gender-transition treatment in general, have likely had a substantial impact on the global conversation about the care of young people with gender distress, given the wide reach of her platform. She has many eager followers and her tweets routinely rack up tens or hundreds of thousands of views. She is taken seriously by media outlets and even doctors and is routinely asked to speak at medical conferences.
I spoke with Erica Anderson, a trans woman, psychologist and the former head of USPATH, the U.S. branch of the World Professional Association for Transgender Health, or
WPATH, about Reed’s influence on the larger conversation about pediatric gender medicine.
Dr. Anderson, who has become a vocal critic of WPATH’s full-throated support for pediatric gender-transition treatment, told me:
“It’s unfortunate that Erin Reed in her mistaken efforts to advocate for transgender persons repeatedly and demonstrably promotes falsehoods, including most recently about the Cass Commission report.”
Referring to the fact that, in every tweet thread that Reed posts promoting her Substack essays, Reed asks people to pay for a subscription, Dr. Anderson continued: “She asks the trans community to support her efforts financially. There is no way I can do so.”
Reached for comment, Reed said: “Readers should not trust a fact check done by somebody like Benjamin Ryan, who himself has consistently misrepresented studies on gender affirming care and gotten basic facts about them incorrect.”
I stand by my own
23 years of professional science reporting and am proud that I have never had to run a major correction.
Erin Reed’s Two-Week Marathon of Falsehoods About the Cass Review
Over the past two weeks, Reed has
repeated various versions of the false claim that Dr. Cass simply “
disregarded” a stack of papers about pediatric gender medicine. Why did the author of the Cass Review do such a thing? Because, Reed claimed, those studies didn’t suit her “predetermined conclion [sic] ”—meaning conclusions.
Without going into too much detail, here is the truth:
- Two systematic literature reviews, conducted by the University of York on behalf of the Cass Review and published by the BMJ the same day as the Cass Review, examined puberty blockers and cross-sex hormones as treatments for gender distress in minors.
- Between them, these two reviews examined 103 studies. Using a validated scoring method, they identified two high-quality papers, 58 moderate-quality papers, and 43 low-quality papers.
- Only the high-quality and moderate-quality papers were included in the review papers’ syntheses.
- When reaching their ultimate conclusions—essentially that the evidence base was largely unreliable and inconclusive, although there was some evidence that hormones were associated with psychological benefits—the review papers leaned on the high-quality papers, but did not discount the moderate-quality papers.
https://substackcdn.com/image/fetch...ges/af8846b7-99c0-4ef8-87ba-b8d0766006ec.heic
The conclusion of the systematic literature review on cross-sex hormones.
- Cass considered all these papers in her own analysis and did not simply disregard or discard any of them, as I reported on Substack last week.
- That said, the central purpose of an evidence-based medicine approach is to discern which studies are more likely to provide reliable results and which are less likely to do so. This is mean to keep false study results, such as those driven by bias, from influencing medical practices. Reed and other activists mischaracterize this effort as capricious and biased, one that starts with a desired outcome and then reverse engineers it.
- Discernment of study quality is particularly important, evidence-based medicine experts have insisted, when caring for the particularly vulnerable population of gender-distressed children. And it is of paramount importance, these experts say, to prioritize higher quality research when devising treatment guidelines for this group, considering that children cannot consent to their own care and may lose their fertility and sexual function as a result of treatment with puberty blockers and cross-sex hormones.
These systematic reviews were conducted independently and were structured to be agnostic about their results.
Reed was not convinced.
On April 18, she
denounced the Cass Review as a member of a collection of “sham reports concocted to justify escalating crackdowns on their care.”
The day after the Cass Review was published, Reed published a
Substack condemning it. The
false or misleading claims Reed made in this report included:
- The report did not, as Reed claimed, “call for restrictions” on social transition. It advised that families observe “caution” when considering the social transition of a child.
- The Cass Review did not “[advocate] for the blocking” of trans young adults receiving cross-sex hormones,” as Reed claimed. It advised a review of young-adult gender services, suggesting that the problems that have plagued the pediatric clinic may be similar in young-adult care.
- The theory of rapid-onset gender dysphoria has not been “discredited”, as she claimed. It remains a hypothesis under investigation by researchers.
- Systematic literature reviews are considered the gold-standard source of scientific evidence. They are not mere “reviews”, as she wrote—in scare quotes meant to dismiss them.
The Cass Report stated that there was not sufficient research to determine the rate at which young people who receive cross-sex hormones will detransition—meaning revert to identifying and presenting as their biological sex.
https://substackcdn.com/image/fetch...ges/0ce19a25-040a-4705-8580-63ec0bab157c.heic
But
Reed insisted that an audit of some 3,500 GIDS patients, mentioned in Appendix 8 of the Cass Review, showed that only
8 out of 3,000 detransitioned, for a rate of just 0.27%. (Approximately 9,000 patients were seen at GIDS since 2011.)
As I explained in the
tweet below, Erin had the denominator wrong, and the true rate was about 1.6%.
Regardless, the 1.6% figure is woefully incomplete. Because this audit only considered GIDS patients assessed upon discharge, including because they turned 18 and aged out. And as Cass stated, her interviews with clinicians suggested that detransitioning can take 5 to 10 years. So the young people would likely need to be followed into their mid- to late-20s to establish a true detransitioning rate. But such data was unavailable to Dr. Cass’s team, because the NHS adult gender services refused to share it with them. (It looks likely the British government will ultimately force those clinics to hand over the data. However, activists have sought to convince these patients to forbid the NHS to share their personal, if anonymized, health records.)
In an April 18
appearance on the super-lefty Majority Report podcast with the super-cranky Emma Vigeland, Reed claimed that Dr. Cass was secretly conspiring to ban pediatric gender-transition treatment. Reed also falsely claimed that the Cass Review did not factor in the voices of trans people or their care providers.
Here is how the Cass Review diagrammed all the sources Dr. Cass and her team drew upon when crafting the report, including trans people and their care providers:
Reed
then suggested to a super-credulous Vigeland that the Cass Review was aligning itself with an anti-trans propaganda machine, because in a footnote it referred to a video posted by that account’s YouTube channel.
Below is the video in question, which is an unedited, 37-minute video of GIDS director Dr. Polly Charmichael speaking at the 2016 WPATH conference. The YouTube account’s politics notwithstanding, the video itself is provided with no extra editorial comment by the account; it is just the words and slides of Dr. Charmichael.
https://youtu.be/8HQBfuV3V98
In an April 18
Substack that she characterized as an opinion piece, Reed argued that “
England’s Anti-Trans Cass Review Is Politics Disguised As Science.”
In the single paragraph below from that Substack, she made at least six
false or misleading claims.
- Reed falsely claimed that the Cass Review was crafted with a predetermined conclusion. In fact, as I mentioned, Dr. Cass commissioned seven independent systematic literature reviews on various facets of pediatric gender medicine from the University of York. Their findings informed Cass's conclusions.
- Reed falsely claimed the systematic literature reviews were “highly susceptible to subjectivity.” The reviews used a validated scoring method, the Newcastle-Ottawa scale (NOS), and two independent reviewers each. The paper on the NOS scale to which Reed linked in her Substack actually states much more modestly that there is apparent “room for subjectivity in the NOS tool.”
- She falsely claimed the Cass Review disregarded all research not deemed high quality.
- She falsely claimed that the theory that gender dysphoria and trans identity may be influenced by social contagion has been "debunked". This remains an open question subject to ongoing research.
- She makes the misleading suggestion about the YouTube footnote.
- She falsely claims that the Cass Review asserts that rates of detransition are high. In fact, Cass states that the detransition rate is “unknown due to the lack of long term follow-up.”
In an April 19
Substack, Reed began pushing the particularly far-fetched claim that Dr. Cass had somehow, after publishing a nearly 400-page report following a four-year effort, suddenly reversed herself and endorsed the prescribing of puberty blockers and cross-sex hormones to minors outside of a clinical trial.
“
Dr. Cass Backpedals From Review: HRT, Blockers Should Be Made Available,” Reed trumpeted in her headline.
Her source for this claim was a supposed transcript from an interview Dr. Cass had
apparently given to
The Kite Trust. The transcript was inexplicably written in the third person, referring repeatedly to “Dr. Cass.” Reed mischaracterized statements that Dr. Cass apparently made about how she envisioned children receiving puberty blockers and cross-sex hormones in clinical trials of such drugs; Reed presented those statements as if they applied to everyday prescribing of drugs.
Fact Checked By Cass, Reed Doubles Down, Repeats the Same Falsehoods
Reed has remained resolute that she is right and Dr. Hilary Cass is wrong regarding the evidence backing pediatric gender-transition treatment.
After Cass castigated those who propogate such “disinformation” in her interview with The Times, Reed repeated her false claim that Cass discarded perfectly good research.
In response to an April 22 BBC
tweet thread that painstakingly diagrammed how the misinformation about the Cass Review spread around the world, and why it was wrong,
Reed responded:
“Not accurate.”
Reed then proceeded to mischaracterize the systematic reviews syntheses, describing them as if they were capricious processes and not structured to weed out study results that are unreliable. Referring to the 58 moderate-quality studies that were factored into the syntheses, Reed wrote: “Much of what was in the moderate section was also discarded, especially in Cass’s conclusions.”
This tweet came as the UK LGBTQ charity Stonewall backed off of its previous claims that Cass had egregiously discarded a large crop of research.
“We are grateful to Dr Cass for taking the time to clarify that both ‘high’ and ‘moderate’ quality research were considered by as part of the evidence review, both in the media and directly to trans and LGBTQ+ organisations,” a contrite
Stonewall tweeted.
That same day, the UK Royal College of Psychiatrists
also backed the Cass Review. Its president, Dr. Lade Smith CBE,
stated in a press release: “It is a comprehensive and evidence-based assessment that needs to be acted upon with a fully resourced implementation plan.”
Who Is Erin Reed?
Reed has been Substacking for a relatively short time, but has quickly amassed a large following. She has 54,000 subscribers, among whom a group that is apparently in the thousands pays either $50 per year or $5 per month for their premium subscription.
She is recommended by doctors.
In the wake of the March publication of the so-called
WPATH Files by Michael Shellenberger’s nonprofit Environmental Progress, Dr. Carl Streed, the current USPATH head, wrote in a
letter to USPATH colleagues that he was “grateful” for Reed’s reporting about the Files—for correcting the “numerous false claims running rampant in the media.”
(Dr. Streed, whom I’ve interviewed a couple of times, took a clear swipe at me in the letter. First he called into question the findings of a recent
Finnish study that found no independent association between receiving gender-transition treatment and the suicide death rate among gender-distressed youths. Then he wrote, “I seriously question the motives and ethics of any reporter, legislator, or professional citing it as evidence.” I was the only reporter to cover the study for a major U.S. media outlet, the
New York Post. Reed was no fan of the article either and, as she noted in her message to me about this Substack, published her own takedown of my work in the
Los Angeles Blade. I stand by my reporting. My motive is to report the truth. As it happens, Cass also found that there was no evidence backing the suggestion that gender-transition treatment impacts suicide deaths in youths.)
The Cass Review excoriated WPATH, saying that it exaggerated the strength of the research backing its influential guidelines for treating gender distress in children.
The LGBTQ nonprofit GLAAD, which has falsely claimed the “science is settled” on pediatric gender-transition treatment, is also a
vocal supporter of Reed’s writing.
However, not all doctors see Reed as a trustworthy intellectual. Last October, at the Society for Evidence Based Medicine conference in New York City, I cited Reed when asking a question of a panel of researchers and physicians. When I noted that one major media outlet refers to Reed as a “legislative analyst,” the room broke out into derisive laughter.
Reed is no fan of SEGM’s and repeatedly claims they are a hate group. I got no such impression from the conference in particular, which provided a crash course on evidence-based medicine practice. Politics came up only briefly. This was a science conference.
Reed recently became engaged to Montana state Rep. Zooey Zephyr, a Democrat.
Reed, whose writing has also been published by
Harper’s Bazaar, was recently
lionized as a journalistic force to be reckoned with by The Nation. The progressive outlet (which I have written for
a few times) charactered Reed’s Substack as one of “the most reliable sources for information on the exploding campaign against trans rights.”
Don’t tell that to
Laura Edwards-Leeper. She is a child psychologist who was part of the team to first import to the U.S., in 2007, the so-called Dutch model for prescribing puberty blockers and cross-sex hormones to treat gender-related distress in children. More recently, Edwards-Leeper, who practices in Oregon, has become one of the most
prominent voices calling for reform and caution in the pediatric gender-care field from within its ranks.
Dr. Edwards-Leeper is no fan of Reed’s.
“Erin Reed is harming children with her false claims about the Cass Review,” Dr. Edwards-Leeper told me. “Because many providers, parents, and even professional organizations are believing these claims without taking the time to read the actual review themselves. By ignoring the Cass Review, the most comprehensive examination of the evidence for treating gender-distressed youth medically to date, providers and parents who believe Erin’s false synopsis are making decisions that are not accurate and will undoubtedly harm children.”
Echoing Dr. Cass, who said, “This must stop,” of the toxic bullying that has intimidated many health professionals out of speaking out about the subject of pediatric gender medicine, Dr. Edwards-Leeper said of Reed’s routine publication of falsehoods about the Cass Review and pediatric gender medicine:
“This behavior is unforgivable and must stop immediately.”
I encourage you to retweet
a thread about this Substack:
https://x.com/benryanwriter/status/1782653360207761431
I am an independent journalist, specializing in science and health care coverage. I contribute to
The New York Times,
The Guardian, NBC News and The New York Sun. I have also written for
the Washington Post,
The Atlantic,
The Nation, Thomson Reuters Foundation, New York,
The Marshall Project,
PBS,
The Village Voice,
The New York Observer, the New York Post, Money, Men's Journal, City & State, Quartz, Out and The Advocate.
Follow me on Twitter:
@benryanwriter
And visit my website:
benryan.net
