NYT Sends Push Review For Anti-Trans Cass Article; Buries AAP Response

The response to Dr. Cass was in the form of a letter to the editor to the New York Times, which was placed last among the letters presented.

Photo by David Smooke on Unsplash

On Thursday, The New York Times published a response from the American Academy of Pediatrics to an interview with Dr. Hillary Cass. In that interview, Dr. Cass calls the AAP, the largest professional organization of pediatricians in the United States, “a left-leaning organization” and chastises them for their guidelines supporting care for transgender youth. Following publication of the article, it was even given a push notification to New York Times subscribers, being treated the same way as major breaking news. Rather than give the American Academy of Pediatrics and other experts supporting transgender care equal space to respond, however, The New York Times instead published a limited-word Letter to the Editor under the top headline, “Why Biden Is Behind in the Polls,” placing it last among 6 letters to the editor. No such push notification was delivered.

The deprioritized and easy-to-miss letter contains substantial criticisms of Dr. Cass and the use of her review, which was developed in England and is currently being used to target transgender care there. In it, Dr. Benjamin Hoffman, who leads the AAP, states that youth are not being rushed into a one-size-fits-all approach to transition. Instead, he stresses the importance of individual care, stating that the AAP policy calls for “individualized health care for each patient, in consultation with their family and health care team.”

"Dr. Cass says that politics should have no role in medical decision-making. We agree. In the U.S., politicians in over 20 states have placed their judgment ahead of parents and doctors by seeking to ban this care and criminalize those who provide it. Even following the publication of Dr. Cass’s report, no European country except Russia has fully banned the provision of gender-affirming care when medically necessary.

Dr. Cass casts broad-scale doubt on existing research. We disagree. The evidence supporting our recommendations is far more nuanced than is represented in the interview. An independent review that is already underway will evaluate the body of evidence so the A.A.P. can continue to provide the best guidance to pediatricians. Dr. Cass’s conclusions will be considered in this review.

He also criticizes the idea that gender-affirming care is being “aggressively pushed,” stating that “Gender-affirming care begins with conversation, and it often goes no further than that. For many young people, having the space and time to explore their gender identity with the support of their loved ones and health care team is critical to their well-being. This health care approach integrates medical, mental health and social services, including resources and supports for parents and families.”

The letter to the editor was published last among a list of six letters to The New York Times, with the top headline of the page focused on Biden’s poll numbers. Though it is uncertain whether The New York Times limited the AAP to a letter to the editor, it is notable that no similar interview was published with major medical experts who support transgender care in response to the Cass Review. Importantly, the American Academy of Pediatrics’ response was not given the same kind of “breaking news” coverage that Dr. Cass’s interview received. For example, after publishing the interview with Dr. Cass, The New York Times sent out a push notification to at least some readers.

Cass review Push Notification from the New York Times

The New York Times has come under criticism in recent years for its poor coverage of transgender issues. One article, “The Battle Over Gender Therapy,” for instance, used dehumanizing language for one of the first trans youth receiving puberty blockers, calling them “patient zero.” Organizations like Genspect are presented with little context as "an international group.” In another story, “They Paused Puberty, But Is There a Cost,” the article contained so many inaccuracies that the World Professional Association of Transgender Health released a full fact-check rebutting many of the claims. Upon investigating the journalists covering these stories, it was found that they tend to follow almost exclusively anti-trans sources and groups. It is clear that the reporters' media diet came from people who oppose transgender individuals.

Despite this, the American Academy of Pediatrics, along with other American medical organizations, has responded to the Cass Review by stating that gender-affirming care is medically necessary. In an earlier response to Cass’s interview with “On Point,” which aired on many NPR stations across the United States, both the AAP and the Endocrine Society criticized Cass’s review. The Endocrine Society stated, “Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment. Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions.”

Those who support transgender youth and their care argue that scientists, doctors, medical organizations, and advocates should be given equal time and space to defend that care. In an article posted last week in The Washington Post opinion section, anti-trans blogger Benjamin Ryan stated in a headline, “Trans-identified kids deserve an open debate on the science of care.” Ignoring a slur often used towards transgender people (calling them “trans-identified” to deny their identities), that debate likely cannot happen if medical organizations and scientists are buried in “letter to the editor #6” while those who oppose trans care are given major featured coverage with breaking news style push notifications.