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Open Letter in Support of Dr. Kenneth Zucker and the Need to Promote Robust Scientific Debate

Sponsored by FAIR in Medicine

May 5, 2023

We, the undersigned signatories, are expressing our support for Dr. Kenneth Zucker, an academically robust and unbiased editorial process at the Archives of Sexual Behavior, and uninterrupted publication of “Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases” by Diaz and Bailey. We condemn and reject the censorious demands being directed at Springer Nature, the company that publishes Archives of Sexual Behavior, that this paper be retracted, and that the editor of the journal, Dr. Zucker, be sanctioned for allowing the paper’s publication. The appropriate action is to have an open debate about the paper—not to silence those whose views one finds disagreeable.

Currently as many as one in 1020 youth report gender dysphoria. The paper by Diaz and Bailey adds to the growing body of knowledge about the various factors contributing to the rapid rise of adolescent-onset gender dysphoria–a phenomenon that was exceedingly rare in the past. Specifically, the paper engages with parental reports of the cases of “Rapid Onset Gender Dysphoria,” or ROGD. The ROGD hypothesis posits that in some cases, gender dysphoria in adolescence may be mediated by social factors.

The potential viability of the ROGD hypothesis has been endorsed not only by the parents, as described by Diaz and Bailey, but also by the clinicians working with this patient population, and the affected patients themselves. If it proves to be correct, then the treatment approaches to this novel population of adolescents may need to be different, including the possibility that such cases may benefit from less invasive interventions that do not carry the irreversible effects of hormonal and surgical interventions known as “gender-affirming care.” The concern that the currently-presenting gender dysphoric youth are different from the originally-studied cases, and that they may be better helped by psychotherapy, has also been expressed by the originators  of the “Dutch” protocol for gender-transitioning minors.

We are particularly disappointed that among the signatories demanding that the research be retracted is the current President of WPATH. WPATH recently acknowledged the role of social influence as a possible contributing factor to gender dysphoria in adolescents, saying: “For a select subgroup of young people, susceptibility to social influence impacting gender may be an important differential to consider.” (Coleman et al., 2022, p. 45) Signing a demand to retract one of the very few papers examining the possible influence of social factors is inconsistent with WPATH’s own statements.

We are aware of the allegation that a lack of an Institutional Review Board approval of this publication warrants a retraction. However, this is demonstrably false. Springer’s policies explicitly allow the Editor-in-Chief the discretion to accept a publication that has not sought IRB approval. The first author of this study was not affiliated with a university and did not need to seek IRB approval.

Further, we are aware that the activists are alleging that the paper’s methodology was biased by only relying on parental reports. However, parental reports are commonly used to gather information about children and adolescents. A highly influential paper in the field that is often cited to support social transition for youth also relied on parental reports. However, in this case the methodology was not criticized. The difference appears to be that in this example, the parents supported their children’s gender transition, whereas in the Diaz and Bailey paper, the parents were concerned with the risks of inappropriate medicalization of their children. 

Unfortunately, this is not the first time journals and researchers who dare explore the subject of ROGD have been targeted for cancellation. What is currently happening to the Diaz and Bailey paper bears a marked resemblance to the prior attempt to silence the original “ROGD” paper by Lisa Littman, MD. Under tremendous pressure from critics, PLOS ONE subjected the paper to a second round of peer review post-publication. The paper withstood this unprecedented scrutiny, with its results unchanged. 

To quote Jeffrey S. Flier, MD, the 21st Dean of Harvard Medical School, who wrote eloquently about the the attempts to silence research into ROGD, “Many papers face questions after they have been published, which is well and proper: the systematic assessment and scrutiny of published work is a core method by which the scientific community corrects errors, and builds upon imperfect preliminary observations…But that is not what has happened…. [the] critics have not performed any systematic analysis of her findings, but seem principally motivated by ideological opposition to [the] conclusions.

We fear that just like in the case of the original ROGD paper, the demands for retraction and sanctioning of Dr. Zucker, the Editor-in-Chief are principally motivated by the ideological opposition to Diaz and Bailey’s conclusion.

Because of Dr. Zucker’s unique experience in the field and his role as the Editor-in-Chief, the journal, Archives of Sexual Behavior, has become a formidable force in the growing debate about how to best care for the rapidly growing numbers of gender-diverse youth. Dr. Zucker has demonstrated neutrality by routinely publishing articles on both sides of this contentious issue. 

While the paper by Diaz and Bailey–like all research–has limitations, it is vital to continue to study the ROGD hypothesis. Ongoing attempts to silence any research into the explosion of teens who are now identifying as transgender only stands to hurt the very patients the activists are claiming to help–young gender nonconforming people.

We, the undersigned signatories, ask that Springer Nature, the company that publishes Archives of Sexual Behavior, takes a nuanced view of this situation, examines the context in which these complaints have been leveled, and chooses to uphold the principles and practice of scientific discussion, debate, and freedom of expression by rejecting calls to retract the paper “Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases” by Diaz and Bailey and refusing to sanction Dr. Kenneth Zucker for his decision to publish the paper.

*FAIR in Medicine is the professional healthcare network within The Foundation Against Intolerance and Racism (FAIR). We support open and robust debate to advance high quality, ethical medicine for all.

On June 15, 2023, Springer Nature retracted the Diaz and Bailey article. We are grateful Dr. Zucker has retained his position as Editor. Please see notable press below commenting on the retraction.

Signatories

Carrie D. Mendoza, MD
Director, FAIR in Medicine, Emergency Medicine Physician

Sally Satel, MD
Psychiatrist, American Enterprise Institute Fellow

E. Abbruzzese
Researcher

Faisal Al Mutar
Board Chairman, Foundation Against Intolerance & Racism

Dr. Colin Wright, PhD
Fellow, Manhattan Institute; Evolutionary Biologist

Angel Eduardo
Board Member, Foundation Against Intolerance & Racism

Stella O’Malley
Psychotherapist, Director, Genspect

Joe Burgo, PhD
Psychologist, Gender Exploratory Therapy Association (GETA)

Lauren H. Schwartz MD
Fellow, FAIR in Medicine, Psychiatrist & Psychotherapist

Dr. Emma Hilton
University of Manchester, UK

Dr. Carole Hooven
Harvard University

Dr. Jon Pike
Philosophy, The Open University, UK

Mara Yamauchi
Two-time Olympian & Coach

Prof. Ross Tucker
University of Stellenbosch and World Rugby

Pamela Paresky
Visiting Fellow, Johns Hopkins University – SNF Agora Institute

Stephen B. Levine, MD
Clinical Professor of Psychiatry, Case Western Reserve University School of Medicine

Marshi Smith
Co-founder, Independent Council on Women’s Sports

Dr. Ram Duriseti, MD, PhD
Stanford University

Miriam Grossman, MD *
Psychiatrist

Patrick K. Hunter, MD MSc
Bioethics, Pediatrician

Richard Bosshardt, MD
Plastic Surgeon and Fellow, FAIR in Medicine

Zander Keig, MS, MSW, LCSW
WPATH Harry Benjamin Distinguished Educator of the Year (2020), FAIR Board of Advisors

Monica Harris, JD *
FAIR Board of Advisors

Jay Bhattacharya, MD *
Professor of Health Policy, Stanford University School of Medicine

Sasha Ayad, M.Ed., LPC *
Therapist and Parent Coach

Maya Forstater *
Executive Director, Sex Matters

Desh Amila *
FAIR Board of Advisors

Roy Eappen MDCM , FRCP (c) , FACP, FACE *
Fellow, American College of Endocrinology

Robert George *
McCormick Professor of Jurisprudence
Princeton University

Lisa Littman, MD, MPH
Physician Scientist

Abigail Shrier *
Independent Journalist

Maud Maron
Board Member & Interim Executive Director, Foundation Against Intolerance & Racism

Leor Sapir, PhD *
Fellow, Manhattan Institute

Ilya Shapiro
Board Member, Foundation Against Intolerance & Racism

Dr. Michael Biggs
Associate Professor of Sociology, University of Oxford

William Malone, MD
Director, Society for Evidence Based Gender Medicine; Endocrinologist

Aida Cerundolo, MD
Fellow, FAIR in Medicine, Emergency Medicine Physician

Maya Forstater
Executive Director, Sex Matters

Linda Blade, PhD
Kinesiology

Nancy Hogshead
Olympic Champion and CEO of Champion Women

Donna de Varona
Olympic Champion, Broadcaster, Sport Leader

Sharron Davies, MBE
Olympic medalist, Three-time Olympian

Tracy Sundlun
Team USA Olympic Coach, CEO Everything Running

Sue Evans *
Psychoanalytic Psychotherapist, Tavistock GIDS Whistleblower

Kim Jones
Co-founder, Independent Council on Women’s Sports

Julia Mason, MS MD FAAP
Pediatrician

Jordan Peterson *
Professor Emeritus, Department of Psychology, University of Toronto

Jonathan Haidt *
Professor, New York University, and Advisory Board Member, Foundation Against Intolerance & Racism

Stephanie Davies-Arai
Director, Transgender Trend

Dr. Ram Duriseti, MD, PhD
Stanford University

Jeffrey Flier, MD *
Harvard University, Distinguished Service Professor at Harvard Medical School

Peter Boghossian *
Founding Faculty Fellow, University of Austin

Doug VanderLaan *
Associate Professor, Psychology, University of Toronto
Editorial Board Member, Archives of Sexual Behavior

Dr. Emma Hilton *
University of Manchester, UK

Lisa Bildy *
FAIR Board of Advisors, Lawyer

Ian Kingsbury *
Director of Research, Do No Harm

* Highlighted signatures are counted only once if they also appear below under Additional Supporters.

Additional Supporters