Dr. Jack Turban found his research niche in the treatment of pediatric gender-identity disorders nearly a decade ago and quickly rose through the ranks of the discipline. In a prestigious fellowship at Stanford Medical Center following a residency at Massachusetts General Hospital, he focused on child and adolescent psychiatry with an emphasis on transgender youth, or facilitating sex change through surgical, medical, and social interventions.
Years prior at Fenway Clinic in Boston, Turban was “trained in a place where ideologically they are the innovators of trans care in America,” says Dr. Stephen Levine, a professor of psychiatry at Case Western Reserve University. He is a longtime gender-identity expert who’s been a target of Turban for his skepticism of gender transitions for children, adolescents, and young adults.
Turban quickly became a prodigy in the field, studying transgenderism with the conviction that the medical establishment should accommodate rather than challenge a validating approach to youth gender dysphoria. His prolificacy propelled him to STEM superstardom, making him the de-facto in-house scientist to whom many left-wing media outlets appeal when writing about gender ideology. Turban’s work has been featured in the Washington Post, the New York Times, CNN, Scientific American, The Hill, Psychology Today, Vox, and other publications.
“He has a belief system. He is ambitious and has been successful in gaining national recognition,” Levine said.
But Levine and other questioners, including some sympathetic to Turban’s political mission, wondered whether his research reflected scientific curiosity and discovery or confirmation bias and an axe to grind. Throughout his career, Turban has authored studies which conclude that there are great benefits and minimal risks to providing gender-confused minors with “gender-affirming care,” a medically cryptic way of saying hormonal therapy for puberty suppression, reconstructive surgery, and social and behavioral re-conditioning.
Levine has written extensively about the dangers of rapid affirmative care for minors and has urged an informative consent process for parents and patients that educates them on the limitations and unknowns of transition, citing the growing number of detransitioners who reverted to their natural sex in adulthood. For children before the age of neurological maturity, “a slow, patient, thoughtful question and answer period” would empower parents and patients and help relieve clinicians of some of the ethical dilemmas, he argued in the Journal of Sex and Marital Therapy.
But Turban has been dismissive of such proposals and has characterized non-affirmative psychotherapies as the new “conversion therapy,” which he claims is detrimental to the mental health of trans kids.
In many of Turban’s published papers, the sources of the funding for his research reveal conflicts of interest. Particularly, his past work was made possible by a grant from the American Academy of Child & Adolescent Psychiatry (AACAP), where Turban is a member of its media committee and where “it’s hard to get any contrary opinions on the symposia,” according to Levine.
Most notably, AACAP is financially supported by pharmaceutical companies Arbor and Pfizer. Both produce off-label puberty blockers that inhibit the onset of physical changes aligning with a person’s sex.
Given that even progressive European nations, such as England, France, Finland, and Sweden, have started to adopt an increasingly cautious approach towards minor gender transitioning, the relationship between Turban’s funding and his conclusions has come under scrutiny.
“The drug company is giving him a grant that will promote their product,” Levine claimed.
In February, Sweden’s National Board of Health and Welfare (NBHW) updated its service guidelines for children and youth with gender dysphoria, citing “uncertain science” and “no definite conclusions about the effect and safety of the treatments” as reasons to conclude that “the risks outweigh the benefits at present.” Multiple Republican state legislatures, recognizing the unknowns and moral and ethical uncertainties, have limited access to the treatments.
Turban’s indirect benefactors Arbor and Pfizer manufacture Triptudor and Synarel, respectively, or gonadotropin-releasing hormone analogues (GnRHa) that are often recommended as initial treatment for adolescents diagnosed with gender dysphoria. Such treatment has potential long-term effects on future fertility, bone growth and density, and growth spurts, in addition to short-term effects such as weight gain and headaches. The FDA recently added another concerning side effect: pseudotumor cerebri, or high-pressure buildup in the brain that can cause progressive and permanent loss of vision if unaddressed.
For a February 2020 study Turban co-authored titled “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation,” he received a $15,000 Pilot Research Award for General Psychiatry Residents from the AACAP. The study conveniently found that administering GnRHa for puberty suppression for gender dysphoria during adolescence was correlated with fewer suicidal thoughts and better mental health among transgender adults.
AACAP funding also sponsored a January 2022 study Turban co-authored titled, “Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults,” according to a Stanford press release.
In a study published earlier this month titled, “Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents in the United States,” Turban again reports financing from the AACAP Pilot Research Award. The research attempts to refute the social-contagion theory, spelled out in Abigail Shrier’s book Irreversible Damage, that peer pressure and social maladjustment among young girls especially is driving a surge of cases of “rapid onset gender dysphoria” (ROGD) and that gender-affirming care should therefore not be hastily prescribed.
Using the 2017 and 2019 Youth Risk Behavior Survey across 16 states that collected gender-identity data, Turban found that boys experience gender dysphoria at a higher rate, thus supposedly weakening the ROGD hypothesis.
“The sex assigned at birth ratio of transgender and gender diverse adolescents in the United States does not appear to favor assigned-female-at-birth adolescents and should not be used to argue against the provision of gender-affirming medical care for TGD adolescents,” Turban concluded.
However, the study relied upon 2017 and 2019 sex ratio data sets from 16 states in the abstract based on respondent answers to the following precariously phrased question: “What is your sex?” Researchers widely believe that such a question is distorting, as transgender respondents are likely to answer the opposite of their actual sex and give their preferred gender instead.
🚨We have a new paper out today in @aap_peds🚨
We examined 2 hypotheses:
1. That youth identify as #trans due to “social contagion” & adolescents assigned female are more susceptible
2. That youth identify as trans to flee LGB-related stigma
Neither was supported by data. 🧵
— Jack Turban MD 🏳️⚧️🧠🏳️🌈 (@jack_turban) August 3, 2022
Another blind spot in the study, Levine notes, is that it “did not study applications to pediatric gender clinics in multiple continents that have been documenting the increase in adolescent girls declaring a trans identity.”
Moreover, “His data do not provide confidence in a two-year trend. The trend has been occurring over 15+ years,” Levine says. “The changing epidemiology over the past 15 years is based on clinic referral data. Turban’s recent study is based on survey data.”
Medical/surgical treatment is ethically easier to administer if dealing with congenital problems, or a condition determined to be present from birth, Levine suggests. This, it seems, is why Turban wants to discredit social contagion theory.
“If it comes from culture and not biology, it is harder to justify changing the body to please the current mind set,” Levine explains.
Despite the study’s shaky foundations, Turban doubled down on its conclusion in an interview with NBC News, one of the press outlets he does frequent media hits for, pushing for the medicalization of kids struggling with gender dysphoria.
“The idea that attempts to flee sexual minority stigma drive teenagers to come out as transgender is absurd, especially to those of us who provide treatment to [transgender and gender-diverse] youth,” said Turban, who is now an incoming assistant professor of child and adolescent psychiatry at the University of California, San Francisco.
Turban did not respond to request for comment.
“He is an advocate rather than a scientist. A scientist looks at the data rather than a pro and con,” Levine said.