"It's possible to criticize and raise questions about pediatric gender medicine today in a way that was not possible even six months ago. We have definitely turned a corner."

Year Zero is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Leor Sapir is a scholar at the Manhattan Institute who has become a leading figure in the ongoing effort to bring accountability to a medical field that has run off the rails.

In this episode of the Year Zero podcast, which was recorded in July, we discuss the fast evolving state of the legislative bans on child sex trait modification procedures and the wider project to bring an ongoing medical scandal to heel.

Excerpts:

Parallels between the opioid epidemic and pediatric gender medicine

“There are really interesting parallels between the opioid epidemic and the gender medicine issue. In both cases, for example, it started with medical authority, citing very, very low quality studies, claiming that the use of opioids in cancer patients could be scaled at large, and that the same type of risk benefit ratio would would apply to other types of patients — patients who are not, for example, terminally ill, or even patients with a history of addictions and patterns of addictive behavior. And that, of course, turned out not to be the case. The medical associations got involved and also fueled the opioid epidemic, sometimes for good intentions, sometimes, as in the case of the American Pain Society, because they were influenced by Big pharma money. So there, I think in the case of the opioid epidemic, there was just a clear villain, and the villain was Purdue Pharma. And it was a villain that the American Left loves to hate. Big corporate interests that make money off of health care. Here, I wouldn't want to argue that there aren't kind of pharma interests involved in general medicine, of course, there are, it's a big business, and it's growing too. And we have some evidence that clinics and hospitals that do the procedures as opposed to the psychotherapy get a net benefit from them. And they also, of course, boost their scores on the Corporate Equality Index, and, you know, ESG, and all that stuff. So there's definitely a lot of institutional self interest in doing so called gender affirming care. But I wouldn't argue that the financial motives are primary here. I think that they they definitely play a role. But I would say that the ideology is by far and away the most important factor. But in any case, there are strong parallels to the opioid epidemic. And, you know, this is another example of how we don't learn our lessons.

On the capture of American policymaking by the NGO Borg

“The ACLU never has to face voters. It's accountable only to its own funders. And those funders are increasingly a small number of deep pocketed foundations, individuals or corporations that give money. And often these people either don't know what's going on or they are themselves highly ideological and out of tune with what what most Americans agree on.

And so the first problem is that with the ACLU, there's no mechanism of accountability between these interest groups and the general public in a way that there is with political parties in the general public. The second problem is that these interest groups almost by definition, are going to get more and more extreme over time, right? Because they usually they're founded for a certain purpose, they have a strong sense of mission. And that sense of mission tends to attract people who are ideologically aligned with that mission. So if it's the ACLU — first of all civil liberties, then it was civil rights, now it's what you might call — what you have called “Successor Ideology.” If it's environmentalism, who's gonna go work at the Environmental Defense Fund, who is going to go work at at the UN — all these organizations: environmentalists, people who are very, very gung ho about environmentalism, and importantly, people who are willing to impose very costly policies on the public, because the kind of trade offs that they're willing to accept are much more extreme than the kind of trade offs that the average citizen would accept.

So these groups, the ACLU, for example, will attract young, very ideological, very woke lawyers — people like Chase Strangio to its ranks and promote them. And so gradually, over time, these groups tend to become more and more extreme in their positions. And because of the way in which the American political system gives them so much power and so much leverage over the policy process, we end up with the politics of radical policymaking. So it's not that other countries don't have similar problems. But here in the United States, because of how our system of government works, these problems tend to be much more extreme and much more intractable.”

Thank you for reading Year Zero. This post is public so feel free to share it.