Will Malone MD

Endocrinologist. Opinions my own. Society for Evidence-Based Gender Medicine
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[Will Malone MD @will_malone]

Please read our “No One is Born in the Wrong Body” essay published today on @Quillette. @SwipeWright @JuliaDRobertson

https://t.co/m7T7qMGnPQ

[ℂ𝕙𝕒𝕟𝕂𝕦𝕝𝕒𝕥𝕦𝕟𝕘𝕒 @ChanKulatunga]

Our new paper examines limitations in the PATHWAYS trial design that constrain its ability to detect and characterize potential harms of puberty suppression. We discuss why assessing safety requires more than an RCT alone. Please read- Open access.

https://t.co/pTXpa9Ftz5

[Leor Sapir @LeorSapir]

NEW: At least 15,437 Washington minors had a transgender-related diagnosis on their insurance claims from 2017 to 2023.

In 2022, that included 1 in 58 teen girls.

A new @ManhattanInst analysis of insurance-claims data 🧵

[Hannah Barnes @hannahsbee]

🚨Hilary Cass has called for an independent inquiry into how Brighton GPs were allowed to prescribe cross-sex hormones to children as young as 12.“There urgently needs to be an investigation of why every system that should have protected children, young people, and indeed young adults has failed,” she told me.

The employment tribunal between Dr Sarah Redvers and NHS Sussex has highlighted how regulators and the NHS collectively failed to stop prescribing of puberty blockers and hormones against national guidelines - for years - and how instead the person raising concerns was accused of transphobia and herself investigated.

Dr Redvers sat down with me for her only newspaper interview about her treatment in a scandal which, Cass now says, “dwarfs” that of the Tavistock’s GIDS.

Me for the Sunday Times…

https://t.co/WWzrkuv3db

[SEGM @segm_ebm]

We’re delighted that investigative journalist Hannah Barnes will speak at Rethinking Youth Gender Medicine in Washington, DC, November 5–7.

Author of the Sunday Times bestseller Time to Think, she recently received the Medical Journalists’ Association Award for Outstanding Contribution to Health Journalism.

Her talk, “Exploiting Gaps: How an NHS Clinic Evaded Restrictions on Puberty Blockers and Hormones and Harmed Children,” is based on her investigation into the WellBN GP clinic in the UK.

Register for in-person or livestream attendance
📅 https://t.co/wYtd1Qs8Bb

Single-day tickets are also available.

[SEGM @segm_ebm]

Registration for Rethinking Youth Gender Medicine, November 5–7 in Washington, DC, has already surpassed attendance at any SEGM conference in the past five years.

In-person registration closes soon. Secure your place today and be part of this important conversation. ⬇️

https://t.co/wYtd1Qs8Bb

[SEGM @segm_ebm]

Congratulations to Professor Sallie Baxendale on being shortlisted for the Maddox Prize!
https://t.co/jAxbYcsFw9

Sallie will speak at our Washington DC conference, Nov 5–7. Her talk: “Wandering Rationales in Youth Gender Medicine.”
Attend in person or online: https://t.co/o0kXaAyhjT

[SEGM @segm_ebm]

"When some young people proceeded to hormonal treatments we started to see that their mental health and functioning did not improve. Actually they often deteriorated." Dr. Rittakerttu Kaltiala, MD, PhD

Rethinking Youth Gender Medicine, November 5–7, in Washington, DC or by livestream. Link to register⬇️

[marcus evans @marcuse99903226]

@jbvconnor For many, a fixed trans identity provides a rigid psychological structure that hides underlying uncertainty and doubt about who they are and where they fit in. They may believe that a trans identity is the solution to their underlying insecurities. It may also create an idealised avatar that promises, in effect: “If only I’d been born differently, I’d be much happier with myself and free of self-hatred.” Any invitation to think or explore the nature of this belief system can be experienced as a threat, causing psychological pain. The young person’s own doubts and confusion may be disowned and attributed to therapists or parents.

Good therapy involves two stages: first, understanding the way the individual sees the world; then, helping them gain enough distance from that identification to become interested in other perspectives and ways of thinking about themselves. This means bringing their beliefs and the function they serve into view. The affirmation model can bypass this process by supporting the young person unreservedly without first bringing those beliefs and their function into view, or helping them consider other perspectives. In this way, there can be a collusion between the patient and the clinician. What remains unexamined is that the capacity to tolerate psychological turbulence is essential for psychological development.

Therapeutic work requires experienced therapists who can support the individual over time, often working uncomfortably between two risks: on the one hand, pushing the patient to face reality in a way that may rupture the therapeutic relationship; on the other, avoiding the difficulty by becoming collusive and ineffective.

In effect, the affirmation model exchanges short-term relief from doubt, confusion and uncertainty for security, leading to a psychic retreat from developmental opportunities. In this way, it protects both the patient and the clinician from the psychic pain and turbulence involved in exploring and thinking things through. Another problem is that these psychic defences flatten the capacity to experience pleasure as well as pain. Tragically, short-term solutions to psychic pain can have hidden long-term consequences.

A symptom of this problem is clinical teams’ proud boasts that they knew the patient should transition because the young person was so certain. These boasts treat the young person’s certainty as a sign of health, rather than a red flag that they may be caught in a rigid belief system that exchanges thought for certainty.

A more in-depth version of this argument is available in this open-access paper: https://t.co/Bim2Y1Ghit @CASCltd @rachelbaxendale @stellaomalley3

[SEGM @segm_ebm]

"How has this been allowed to develop as a treatment when we know so much about brain development and stopping puberty? How has nobody been looking at this? All of the thousands of patients that have gone through this treatment." Prof. Sallie Baxendale, PhD

Rethinking Youth Gender Medicine, November 5–7, in Washington, DC or by livestream. Link to register⬇️

[SEGM @segm_ebm]

🚨 Claims that youth trans identities have "plummeted" are greatly exaggerated. SEGM's new analysis shows that trans identification on U.S. college campuses reached an all-time high in 2025—a 3,600% increase since 2000. The trend is female-dominated.

Read the Spotlight ⬇️ /1

[SEGM @segm_ebm]

"Their future happiness and their future functional capacities are at stake here because this 15-year-old is supposed to live for the next 65 years." Stephen Levine, MD.

Rethinking Youth Gender Medicine, November 5–7, in Washington, DC or by livestream. Link to register⬇️

[SEGM @segm_ebm]

🚨A new peer-reviewed paper argues that some detransitioners may suffer from PTSD, with medical transition as the traumatic event. Their trauma is further compounded by moral injury—the damage from feeling betrayed by the doctors & institutions they trusted.

New Spotlight/1 ⬇️

[SEGM @segm_ebm]

Pediatric gender medicine rests on several key myths:
•adolescent gender dysphoria is likely permanent
•puberty blockers are proven safe and fully reversible
•detransition is rare and results from external pressures

SEGM debunks 10 common myths in our latest Spotlight. ⬇️

[Chris Williamson @ChrisWillx]

4 steps to radically transform your life - @hubermanlab

[Will Malone MD @will_malone]

7 years ago:
“…a lack of understanding regarding the distribution of sex-related personality and behavioral differences has led to confusion that impacts children who fall at the extreme tail-ends of the distribution…”

[Will Malone MD @will_malone]

Please read our “No One is Born in the Wrong Body” essay published today on @Quillette. @SwipeWright @JuliaDRobertson

https://t.co/m7T7qMGnPQ

[Leor Sapir @LeorSapir]

Clinical proponents of the transgender brain theory never say that young patients should undergo brain scans as part of diagnosis.

The theory seems intended purely for lay consumption and reassurance of parents (& maybe clinicians).

New peer reviewed article on the science👇

[SEGM @segm_ebm]

📢The American Society of Plastic Surgeons decided to put evidence above politics in the care of gender-dysphoric youth.

We're thrilled to announce that the past president of @ASPS_News will speak at SEGM's upcoming conference in DC Nov 5-7.

Register for in-person & online⬇️

[Colin Wright @SwipeWright]

🚨NEW: Our critique of a major "brain sex" study is now published.

@AdamRochussen, @NeuroSGS, and I evaluate a central premise of gender activism and medicine: that trans-identifying people have brains that are shifted away from their sex and toward their "gender identity."

The "brain sex" concept is so central because it purports to provide an empirical scientific basis for the notion that a child can be "born in the wrong body" and would therefore benefit from body-altering medical procedures to align their body with their mind/brain.

The problem is that this concept is pure pseudoscience and propped up by deeply flawed methods and badly misinterpreted data.

One of the most prominent studies is Kurth et al. (2022), published in the Journal of Clinical Medicine, which claimed that the brains of transgender women are shifted away from their sex and toward their "gender identity." The paper became one of the journal’s most accessed articles and has been cited in major media outlets, scientific papers, legal arguments, and policy discussions involving pediatric gender medicine and sports.

We point out that the paper's headline conclusion rests on a series of serious methodological problems.

Each group contained only 24 participants. The authors used poorly justified parametric methods, one-tailed post hoc tests, made no correction for multiple comparisons, and omitted important robustness checks. Once accounted for, the main finding is no longer statistically significant.

An even more glaring failure of the study was that it failed to account for sexual orientation, despite its known association with neuroanatomical variation and despite the authors having the relevant participant data needed to examine it!

We each repeatedly requested the anonymized participant-level data from the paper's lead author so we could independently evaluate the findings.

We received no response.

The evidence simply does not justify the sweeping "brain sex" conclusion for which this study has become famous.

Our full critique in @Theory_Society is open access. Read it at the link below, and please cite it and share it whenever you encounter the false claim that trans people have brains that more closely resemble the sex they identify than their own sex.
🔗https://t.co/AZS6slEAJx

[SEGM @segm_ebm]

🚨A new peer-reviewed article by the Past President of @TheEndoSociety sharply criticizes the Endocrine Society & WPATH's gender dysphoria guidelines for minors. Dr. Santen notes that unmanaged conflicts of interest unduly shaped the recommendations for hormones and surgery. /1

[SEGM @segm_ebm]

Dedicated detransition services are opening at several US hospitals. What are detransitioner experiences, and are their needs being met?
Clementine and Forrest will discuss this with Drs Hunter & Leonhardt at SEGM's conference in DC, Nov 5–7.🐦Early bird registration ends today!