To Restore Faith in Public Health, We Need Truth Commissions
Two blazing political controversies are destroying our trust in the integrity of medicine. One is, thankfully, mostly in the past — the COVID-19 pandemic emergency. The second is ongoing and growing increasingly bitter: How to best care for children who “feel” that they aren’t the sex they were born.
These are different debates, but they share certain commonalities. Both issues involve the suspicion that officially preferred policies are more ideological than scientific. Both involve intense efforts by the establishment institutions to squelch heterodox opinions. Both have seen the erosion of the scientific method through the suppression of dissenting points of view. Both controversies have become so mired in partisan politics and culture war argumentation that it’s difficult to separate the wheat of truth from the chaff of propaganda.
A Vexing Question
But how to reverse course and restore societal comity is a vexing question. How do we find accord in an atmosphere of intense factionalism when even the most basic facts can’t be agreed upon?
On the COVID front, a group of medical notables known as the Norfolk Group — which includes two co-authors of the Great Barrington Declaration, along with others — have issued a public call for the creation of a national commission to dispassionately investigate the nation’s response to the pandemic. Importantly, the Norfolk Group isn’t calling for a stacked deck inquiry that’s primarily about pointing fingers, but rather, an objective fact-finding process to learn what was done right during COVID, what was mistaken, and how to best prepare policies to deploy next time. Among the questions they want explored are:
“What could have been done to better protect older high-risk Americans, so that fewer of them died or were hospitalized due to COVID-19?”
“Why was there widespread questioning of infection-acquired immunity,” aka “natural immunity,” by government officials and some prominent scientists?
Why were schools closed despite early data showing that they weren’t “major sources of spread and early evidence that school closures would cause enormous collateral damage to the education and mental health of children”?
“Why was there an almost exclusive focus on COVID-19 to the detriment of recognizing and mitigating collateral damage on other aspects of public health,” such as cancer screening and treatment, diabetes, and mental health?
“How did certain drugs become heavily politicized?”
“Why did vaccine randomized trials not evaluate mortality, hospitalization, and transmission as primary endpoints?”
“Why was the United States slow to approve and roll out critical COVID-19 testing capacity?”
“Why was there an emphasis on community masking and mask mandates, which had weak or no data to support them?”
Were Mandates Ever Justified?
These are important questions worthy of public exploration. Nor do they represent a complete list of issues that should be explored. For example, here’s one I want to know: Since we know that vaccination doesn’t prevent COVID transmission, were mandates ever justified?
Organizing a formal inquiry into official responses to COVID will take heavy lifting. It will require lawmakers to create the panel and craft its parameters: Not easy in this age of partisan distrust. It should grant the committee subpoena power to ensure that recalcitrant witnesses can’t just refuse to cooperate. And then the President will have to sign off. It will also have to be created in such a way that fairness and transparency rather than score-settling are controlling.
As one of the Great Barrington Declaration authors and Norfolk Group member Dr. Jay Bhattacharya told me in a recent podcast interview for Humanize, “The only way you get trust back is asking these questions, answering them honestly, and just essentially saying mea culpa in areas where we need reform so that we don’t have this problem again.”
Heterodoxy Suppressed
The same approach could be deployed to explore the efficacy of “gender-affirming care” because trust in the orthodox one-size fits all, “go for it” policy currently pushed by the medical establishment, politicians, liberal journalists, on social media, and among heavyweight LGBT advocacy groups such as the Human Rights Campaign, hasn’t been earned. Indeed, just as we saw during the darkest days of COVID, heterodox views on how to best care for gender dysphoric children are being actively suppressed as argumentation against vaccine and mask mandates were during the pandemic. Worse, those expressing substantial concerns about transitioning adolescents are accused of “transphobic” bigotry and intentional harm-causing. That’s hardly a path to achieving consensus.
Moreover, the argument that “the science is settled” about the propriety of gender-affirming care is hard to believe when the mass numbers of young people — particularly girls — deciding they’re transgender, non-binary, or some other non-conforming gender identification is unprecedented. Moreover, public health officials in other countries are reviewing the same available data as U.S. medical experts and coming to opposite conclusions.
If we’re going to fully understand what’s going on — is this a case of moral panic, or people feeling more free in a less judgmental age to reveal their true selves? — and determine a trustworthy methodology for treating underage patients, an honest and dispassionate investigation is essential. Here are just a few of the questions such a public inquiry should pose:
Why do organizations such as the American Association of Pediatrics and World Professional Association for Transgender Health (WPATH) claim that it’s science denialism to oppose gender-affirming care when public health officials in the UK, Norway, Sweden, France, and Finland have concluded that scientific evidence doesn’t demonstrate that the benefits of medical affirmation are real or worth the attendant risks of physical and emotional harm?
Is the risk of suicide higher for children with gender dysphoria if they don’t receive social and medical affirmation, or is that an ideological scare tactic?
Why are so many young people who have previous histories of mental illness being diagnosed as trans?
Why provide body-altering medical affirmation to underaged patients when the data appears to indicate that transgender ideation in the young is often transitory?
How many transgender patients “de-transition,” i.e., return to identifying as their own sex?
Do the parents of children receiving gender-affirming care receive sufficient information to fully give their informed consent to transitioning their children?
To Earn Our Trust
Trust can’t be imposed. It must be earned. The formal investigation the Norfolk Group proposes around COVID and the less formal investigation that I’m suggesting about gender dysphoria in youth could achieve that end. But they will have to be scientifically, rather than ideologically, oriented. Their aim should be to learn, explore, debate, and share data, not dictate, punish, castigate, or exclude heterodox thought.
We’d better get to it. Another pandemic could threaten us at any time. Children’s bodies are daily being impacted in potentially catastrophic ways. Only dispassionate inquiries can forge a consensus that will allow us to find commonality in these contentious arenas of health policy conflict.
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