A Hatchet Job Or Fair And Balanced?

Boy a lot of talk is being generated over the 60 Minute piece last night, some are calling it an attack on our rights, while others are saying not so fast that the CBS 60 Minutes segment raised so valid points.

State bills would curtail health care for transgender youth
Lesley Stahl reports on the spate of legislation being introduced in states that would limit care for transgender youth.


Last month, Arkansas passed a law prohibiting doctors from treating transgender youth with puberty blockers, testosterone or estrogen, and surgery to assist their transitions. As part of a new culture war, similar bills have been introduced in at least 20 other states: in some cases, doctors could go to jail. Many physicians and therapists are appalled, like Erica Anderson, ahighly respected gender psychologist at the University of California San Francisco who is transgender herself.

Lesley Stahl: Have you ever seen anything like that before in your lifetime?

Dr. Erica Anderson: No. No. And it's a clear overreach on the part of such legislatures. Clearly, they are demonstrating their ignorance and prejudice.

At least six major medical associations have weighed in against these bills, including the American Academy of Pediatrics of which Dr. Lee Savio Beers is the president.

Lesley Stahl: I'm gonna read you something that was said in support of this law in Arkansas. One of the Republican senators said gender-affirming treatments are, quote, "...at best, experimental, and, at worst, a serious threat to a child's welfare."

Dr. Lee Savio Beers: These are not experimental treatments. They're really based in scientific literature, they're based in decades and decades of expert experience, and they're backed by a number of major medical organizations.

So far no controversy.

While the vast majority of transgender youth and adults are satisfied with their transitions, not all are. In some cases, patients are choosing to reverse the process. It's called detransitioning. In her early 20s, Grace Lidinsky-Smith was seriously depressed and developed gender dysphoria. She began searching for answers in transgender communities on the internet.

Grace Lidinsky-Smith: And when I saw them being so happy and excited about doing this wonderful, transformative process to really, like, become their true selves I was like, have I considered that this could be my situation, too?

Lesley Stahl: Did this have any part of it, a sense that men had it easier in life than women did and that your road might be easier if you were male?

Grace Lidinsky-Smith: Yes. I just had this sense that if-- if I could inhabit life as, like, a trans man, as a man, then I wouldn't feel so self-conscious. I was thinking that it would make me feel very free.

Grace says she found a gender therapist on the internet and told her, "I'm thinking of transitioning."

Grace Lidinsky-Smith: She thought it all sounded pretty good.

Lesley Stahl: Did the therapist not question you about how deep the feeling was and what it was stemming from?

Grace Lidinsky-Smith: She didn't go - really go into what my gender dysphoria might've been stemming from. We only did a few sessions.

So now we have the crux of the question. Have quacks jumped in and treating patients and they have no knowledge if how to treat trans people or have we made too easy to get hormones?

Dr. Laura Edwards-Leeper: It greatly concerns me where the field has been going. I feel like what is happening is unethical and irresponsible in some places.

Laura Edwards-Leeper was the first psychologist at the first major youth gender clinic in the U.S. at Boston Children's Hospital. She says she has helped hundreds of teens and young adults transition successfully after a comprehensive assessment.

Lesley Stahl: Do you have conversations with your colleagues about this whole area of accepting what young people are saying too readily?

Dr. Laura Edwards-Leeper: Yes. Everyone is very scared to speak up because we're afraid of not being seen as being affirming or being supportive of these young people or doing something to hurt the trans community. But even some of the providers are trans themselves and share these concerns.

What 60 Minutes had to say…

Inside the 60 Minutes report on transgender health care issues

Correspondent Lesley Stahl takes viewers inside her report on the health care challenges facing the transgender community.

[…]

The report, titled "Transgender Healthcare," introduced the 60 Minutes audience to a group of people who call themselves "detransitioners," those who took steps to transition but chose to reverse the process. Their stories highlight an issue of increasing concern for some providers in the transgender healthcare field. They said some patients are not being properly evaluated in accordance with professional guidelines before being prescribed hormone treatments or approved for surgery.

Stahl and the producing team of Alexandra Poolos and Collette Richards began reporting on the story in December, methodically contacting doctors, clinicians, activists, transgender people and their families, and people who detransitioned.

"I think we spoke to more people on this story than any other story I can remember reporting on in my whole time at 60 Minutes," Stahl told 60 Minutes Overtime. "We wanted to be thorough. We wanted to be fair. And we wanted to understand every aspect of this story. And it was really focused on health care. That was the primary idea for the story. Health care."

Stahl told 60 Minutes Overtime that she cannot remember another story she has worked on at 60 Minutes where comments and criticisms began surfacing from advocates before the piece aired. 

"We were concerned that the groups that oppose transgender people might try to weaponize our story and use it against transgender people," Stahl said. "Some of the activists who reached out to us told us they were worried about it too. Our story was really about health care. And we wanted to keep it focused on health care and not make it a political story."

During the interview with Dr. Bowers...

Stahl also interviewed Dr. Marci Bowers, a gynecologist who has performed more than 2,000 transgender surgeries and who transitioned herself in the 1990s. Bowers said that it is an issue if someone who transitioned comes to regret the decision, but noted that it does not "damn the entire process."

"What it should do is cause pause and reemphasize the fact that our informed consent model has to be very, very good," Bowers said. "And we also have to be certain that people who are providing care do so under the standards of care that have been established."

People have regrets for all types of surgery, PubMed found that... "Interestingly, self-reported patient regret was relatively uncommon with an average prevalence across studies of 14.4%." Regret numbers that I have seen in studies of trans people is less than ten percent.

We don’t have any hard evidence on what happens after surgery or they go on Cross Gender Hormones. It is a black hole. As far as I know there are few longitudinal studies on the effectiveness of the Standard of Care.

There is a lack training given to medical students on the care and treatment of trans patients. I know a number of medical universities in the area have… now get this… one trans panel and that is the extent of training that give medical students about treating trans people.

There are a number of seminars given by healthcare providers and therapists who are experts in the field to pass along their knowledge… but there are also a few quacks that I have seen calling themselves experts.

The World Professional Association of Transgender Health (WPATH) has started offering certificates for trans healthcare… But there is worry that insurance companies will start to demand only certified doctors give us healthcare.

I can only go by what I have seen. When I knew that I was going to transition and started going to peer support groups, I took years of listening of other people journeys, their pitfalls, their successes. I lived as Diana for many years except for work, I basically lived full time minus 40 hours. I saw those who rush to transition or had chips on their shoulders, they were the ones who had problems later.

I know of a couple of adults who have detransition and those two did so because of outside pressure, they couldn’t find work or were fired. One retransitioned. One went back to living as a gay man.

So what do you think?

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