Friday, May 10, 2019

Inhale the religious dogma - Exhale bullshit

Verdicts on some of Michelle Cretella's assertions in defense of the faith.
Thursday, Michelle Cretella, executive director of the American College of Pediatricians (an anti-LGBT hate group), was interviewed by Heritage Foundation's Katrina Trinko and Daniel Davis. This was not exactly a Mensa colloquium. Cretella is a former pediatrician. She has not practiced medicine in a number of years and is unlicensed. Trinko and Davis are bloggers for Heritage Foundation. The subject of this confab was the Equality Act.
Confirmation bias
Heritage is a Christian-right operation. It employs people like anti-LGBT extremist Ryan T. Anderson. Michelle Cretella's views are not shaped by medical science. In contrast, Cretella represents the Catholic Church. Cretella accepts the teachings of the Church and then seeks external confirmation, conveniently ignoring contradictory evidence. She also lies.

This is very dangerous legislation in that it literally mandates that health professionals do harm to people.
[…]
The issue is when they go into a doctor’s office and say, for example, a woman goes in and says, “I identify as a man. I want you, my OB-GYN, to perform a hysterectomy. Take my healthy uterus out of my healthy body.” That’s forcing a physician to violate his oath to first do no harm.
Cretella is incapable of uttering the words “transgender man.” Cretella is not referring to a hysterectomy for reasons apart from gender. More importantly, “bottom” surgery is usually a metoidioplasty and/or a phalloplasty which craft male genitals out of female genitalia. These are highly specialized surgical procedures. Moreover, they require a year of RLE (Real Life Experience) living as one's gender with a record of intensive counseling.

A candidate for these procedures is already in the care of qualified gender specialists. The surgeons who do perform these procedures are not doing harm regardless of the sensitivities of pampered prelates at the Vatican.
Verdict:
Michelle Cretella is fabricating a situation that cannot occur. She is lying.
As a matter of fact, the Centers for Medicare and Medicaid Services, under the Obama administration, found that the evidence for any benefit is too weak and that the risk of side effects and harm too great for the government mandate that Medicare or Medicaid pay. We’re talking about experimental procedures that H.R. 5 will mandate every single physician to participate in. And that’s the biggest problem.
According to CMS:
Currently, the local Medicare Administrative Contractors (MACs) determine coverage of gender reassignment surgery on a case-by-case basis. We received a complete, formal request to make a national coverage determination on surgical remedies for gender identity disorder (GID), now known as gender dysphoria. The Centers for Medicare & Medicaid Services (CMS) is not issuing a National Coverage Determination (NCD) at this time on gender reassignment surgery for Medicare beneficiaries with gender dysphoria because the clinical evidence is inconclusive for the Medicare population.

In the absence of a NCD, coverage determinations for gender reassignment surgery, under section 1862(a)(1)(A) of the Social Security Act (the Act) and any other relevant statutory requirements, will continue to be made by the local MACs on a case-by-case basis.…
In the details of the review is this:
Collectively, the evidence is inconclusive for the Medicare population.
So, for starters this involves only Medicare, not Medicaid as Cretella states. The most important matter is the fact that this involves gender confirmation surgery for senior citizens. The Medicare population is 65 years of age, plus. CMS did not rule out Medicare coverage of gender confirmation surgery but asked local Medicare administrators to treat this on a case-by-case basis.

Medicaid coverage is determined by each state. Some states explicitly cover transgender medical care; some states explicitly exclude coverage and some states have no policy one way or the other.

Cretella also claimed: “H.R. 5 will mandate every single physician to participate in. And that’s the biggest problem.”
Verdict:
Cretella is lying on all counts. CMS simply decided not to make a national policy determination for senior citizens, Medicaid was not at issue and physicians remain free to determine what procedures they will or will not offer regardless of HR 5. Transgender medical care is, and will continue to be, provided by specialists who elect to be providers.
There’s a huge study out of Sweden that followed transgender individuals for 10, 20, and 30 years out. At 10 years out from surgery, their mental health was significantly worse than the general populations. So despite getting hormones and surgery, their underlying issues were not healed. By 30 years after surgery, the transgender-identified population had a suicide rate 19 times greater than the general population.
Some the participants in this study had surgery 40 years prior. The authors of the study state that the results reflect Meyer Minority Stress Syndrome (I have the email). In other words, transgender people suffer from discrimination and persecution.
Verdict:
In the world of minority stress syndrome, Cretella is a carrier. Offering no viable alternatives to gender confirmation she is creating distress by routinely lying about gender dysphoria and transgender people. Moreover, although she has an MD she is thoroughly unqualified. She has no training or experience in gender medicine, has never done research and has never published a paper on the subject. To support the teachings of the Catholic Church, Cretella is a proponent of thoroughly discredited conversion therapy.
We are not helping. … These individuals who are suffering, we’re giving them toxic hormones that set them up for heart attacks, strokes, cancers, and worse, and we’re not even diminishing their suicide rate.
Cretella's own former professional association, the American Academy of Pediatrics, disagrees. Research on surgical outcomes four to six years out shows significant improvement in quality of life. We can reasonably infer that those results correlate to lower rates of suicide.
Verdict:
Cretella is misrepresenting one study while ignoring considerable evidence contrary to her religiously based view. The misrepresentation is a lie. Ignoring competing evidence (selective observation) is confirmation bias.
Refusing to go along with prescribing these dangerous hormones, refusing to go along with performing the mutilating surgeries, you would be in violation of federal discrimination laws, and you would be subject to those penalties.

This isn’t just speculation. There are some states that have already enacted state laws similar to the Equality Act, and just based on that, in New Jersey, one Catholic hospital has been sued by a woman claiming to be a man. She sued the Catholic hospital because the hospital refused to perform a hysterectomy.
The first paragraph suggests that physicians are required to be gender specialists which is not only untrue but the assertion is spectacularly stupid. For example, board certified endocrinologists are not qualified to administer cross-sex hormones unless they elect to be specialists in that area (which would not preclude an otherwise general practice).

In the second paragraph, Cretella undermines her own argument. Note that the state has no pursued sanctions in New Jersey. A trans man has had to litigate the matter. The allegation is that a) the surgery was medically necessary and; b) that the hospital contradicted its own nondiscrimination policy. I have not reviewed the pleadings but, according to Time.com:
Jionni Conforti’s doctors concluded that a hysterectomy was medically necessary for him, so he found a surgeon and scheduled the procedure at St. Joseph’s Regional Medical Center in Paterson in 2015. He didn’t expect any problems —until a hospital administrator told him they could not allow his surgery because it was a “Catholic hospital,” he alleges in the federal lawsuit.
[…]
St. Joseph’s allegedly denied Conforti’s surgery despite having a “patient’s bill of rights” that guarantees medical service without discrimination based on categories including “gender identity or expression.”
Conforti is represented by Lambda legal which is not known for frivolous litigation. I have not followed this case as closely as I should and I have not read the reply brief. I will do so in the near future.
Verdict:
Cretella is lying, yet again, in claiming that physicians will be required to perform certain procedures. Moreover, either she failed to investigate the case in New Jersey that she cites or she chose to ignore the evidence.
Since H.R. 5 defines sex discrimination as including so-called reproductive health care, this H.R. 5 would also mandate physicians and health professionals to participate in sterilizations, dispensing contraception, and performing abortions against their moral conscience.
Cretella is not the only religious crackpot claiming that the Equality Act applies to abortion. It has become a common theme. The text includes: “pregnancy, childbirth, or a related medical condition shall not receive less favorable treatment than other physical conditions [due to sex]”
Verdict:
Cretella is uncritically repeating nonsense from the echo chamber. It is a lie if she knows better. She should.
Parent rights in medicine, … There are none anymore. If this Equality Act passes, it literally says that any action by anyone to interfere with access to “transgender procedures or reproductive health,” that’s discrimination. That’s not allowed.

Again, we don’t have to speculate. In states already that have gender identity laws on the books, parents are losing their right to know.
The word transgender is used six times in the findings section of HR 5 which outlines what we know to be currently true. For example:
Lesbian, gay, bisexual, and transgender (referred to as “LGBT”) people commonly experience discrimination in securing access to public accommodations …
The text that Heritage has within quotation marks does not appear in the bill. Cretella asserts that the measure “literally says” something that is not within the bill.
Verdict:
Outright lie. The Equality Act has no effect on parental rights or required parental consent.
We’re having kids who go to the school nurse, kids in middle school and high school going to the school nurse or another faculty member saying, “I’m trans, but I don’t want my parents to know.” And the schools are actually facilitating the puberty blockers and cross-sex hormones.
Schools are generally obligated to keep certain matters confidential in order to encourage students to obtain necessary counseling. This has nothing to do with HR 5. For a minor to receive puberty blockers or hormones, one of two things must happen:
  1. Parental consent or;
  2. A court order.
We’ve had one family in Ohio already had their parental rights terminated because they would not consent to their adolescent daughter getting puberty blockers and cross-sex hormones.
Not exactly, the child was in significant distress, had to be hospitalized several times and was already in the custodial care of his maternal grandparents who were supportive. This was essentially a squabble between husband and wife with the child in the center. Substantial medical evidence was provided to the Court that gender affirmation would improve the child's quality of life.

Ohio does not have a comparable nondiscrimination law. Daddy, by the way, told the kid that he might as well kill himself because he was going to hell anyway. Courts step in when parents are morons.
Verdict:
Cretella is exaggerating through the use of generalizations (school nurses) and an extreme example of parental stupidity. Cretella is outright lying when she claims that school nurses are facilitating gender-affirming medications.
So no, H.R. 5, the kids essentially become the state’s. And similarly, as you alluded to, public schools, because they receive federal dollars, will actually be required to teach this transgender ideology from Pre-K on forward, all the way up.

… In terms of local control of your public schools—no. Out the door. No. Sex ed and this transgender ideology will be force fed to all kids from preschool on up.

Again, if you look at the states that have gender identity enshrined in law, this is already happening, so these aren’t scare tactics. I’m not making this up, it’s already happening in states that wrongly identify gender identity as though it’s race or skin color.
I wish that this idiot could stop using the phrase “transgender ideology.” Being transgender is not an ideology. It is a process to mitigate the distress caused by gender dysphoria. It is called an ideology because the Catholic Church and specifically the Pope do not approve.

Curricula are determined by local school boards. HR 5 does not mandate curricula. There is nothing sinister is teaching children medical and scientific facts. Cretella is also confusing correlation with causation. State law determining that gender identity is a protected class has no effect on school curricula. Some states that protect gender identity have determined that school children should receive age-appropriate information which also includes the many contributions of LGBT people. As I type I am listening to Copland's Appalachian Spring. In 1964 Copland received the Presidential Medal of Freedom.
Verdict:
Despite her claim to the contrary, Cretella is “making it up.” HR 5 has no effect on school curricula.
I think it’s important for our listeners to understand that even states that currently have gender identity protected as though it were skin color, they still have religious carve-outs. H.R. 5 has none.
Verdict:
Half-truth. California, for example, does not have a religious exemption to its nondiscrimination law. Some states do have religious exemptions. They should not.

The reason that there are no religious exemptions in HR 5 is because it modifies existing civil rights laws which do not have religious exemptions. In 1964 pervasive anti-Semitism was based on religious belief.
You don’t get anymore anti-science than the claim that there are no biological differences between males and females. From fertilization, if you have a Y chromosome, you are male. That’s the normal pathway.
Verdict:
No one claims otherwise. It is a lie because Cretella is claiming that people are making an argument that is not made.
Really, for a couple decades now, academia has been really controlled by progressive leftist elites, and American College of Pediatricians, we have many academic members who … won’t get their research funded because it doesn’t tow [sic] the ideological line, whether that is with regard to the life issues, or ideal family structure, and certainly the transgender issue.
What is an “elite?” Someone who preferences scientific evidence over religious dogma? Without specifics it is impossible to evaluate the status of research grants. Furthermore, research grants go to accomplished investigators. ACPeds is a religious organization which is more interested in faith than medical science. It seems unlikely to attract members who have published significant peer-reviewed research.
Verdict:
Toss-up. Insufficient information. As for the control of academia, this is a frequent theme. It is used to “explain” why contrary peer-reviewed research is not published. The more likely explanation is a dearth of evidence to support faith-based dogma. Deception.
One of our members is engaged in a lawsuit against his academic institution because he testified in favor of parents’ rights to not give their child the toxic cross-sex hormones, and his institution didn’t like that, and they basically fired him within three weeks, despite his stellar record as a clinician as well as a scientist. We anticipate he will win that lawsuit.
I believe she is referring to Allan Josephson. Josephson's religious beliefs are at odds with medical science which creates a problem for a medical department head. He was demoted and his contract was not renewed. His “stellar record” does not include research on gender dysphoria. I expect him to lose his lawsuit because he is time barred.
Verdict:
Essentially truthful except for the part about parental rights which were not at issue. Josephson has testified on behalf of school districts that discriminate against trans students at least three times that I am aware of. Claiming that his testimony was in favor of parental rights is an outright lie.
And the American Academy of Pediatrics is a great example. The American Academy of Pediatrics is roughly 87 years old. They were the only game in town. The American College of Pediatricians, we have been growing since 2002. So the AAP’s first statement on the care of gender dysphoria in children was written by an employee of the Human Rights Campaign.
In 2016 ACPeds received membership dues in the amount of $75,609. In 2017 that number was $70,768. That depicts a decline rather than growth. As for the AAP's statement which I believe goes back to 2012, it cites as an educational resource:
Supporting and Caring For Transgender Children

A co-branded educational resource from the AAP, Human Rights Campaign, and the American College of Osteopathic Pediatricians, this document reviews what medical and education experts know about transgender children, explores some myths about gender transition in childhood, and offers suggestions for adults with a transgender child in their life. ​
Verdict:
Outright pants-on-fire lies. The evidence is that ACPeds is shrinking, not growing and citing a resource that was co-authored by HRC doesn't mean that a non-policy statement was written by an employee of HRC.
The leading LGBT activist group, yeah. And their update, the AAP’s updated statement, which was just released last October, sure, that one’s written by a physician. They weren’t counting on anyone fact-checking it, but a gender identity specialist and psychologist, Dr. James Cantor, was so shocked that the AAP was recommending that all children be transitioned, he fact-checked their policy.
Presumably she is referring to the AAP statement which recommends the “gender-affirming care model”. It is supported by a significant body of research and it does not recommend “that all children be transitioned.” As for Cantor, his specialties are not gender identity but, rather, hypersexuality and paraphilias. He is especially knowledgeable in the area of pedophilia.
Well, every single one of their references contradicts what they say. He pulled their references, read the references. Each reference they tuck away in their policy actually recommends watchful waiting, to support the young child through puberty, where the vast majority will accept their biological sex.
Cantor is a proponent of transgender rights. He is in Canada. Were he in the United States he would support the Equality Act. The references are not “tucked away” as if they are hidden from view. This is a familiar trope on Cretella's part (that children grow out of gender dysphoria). Most children do. However those children are unlikely to socially transition in the first place, let alone be on puberty blockers. I think that Cantor would agree that a pre-pubertal child in significant distress should be treated with gender affirmation.

The AAP has not responded to Cantor's concerns, particularly with respect to their methodology. Cantor, by the way, is not a psychiatrist. He is a psychologist. The primary author of the AAP's statement, Jason Richard Rafferty, is a board certified psychiatrist and a board certified pediatrician. He also has a master's in public health and a doctorate in education. Rafferty seems to have the better qualifications. I wish that Cantor had contacted Rafferty. He did not.
Verdict:
None of this has anything to do with HR 5. It is a lie to presume that Dr. Rafferty was trying to slip something past people who would not fact check the conclusions. Cretella is suggesting that Rafferty had a nefarious agenda. Cretella's take on Cantor is somewhat truthful.
There’s a study from within the last five or 10 years that found people with gender identity disorder have a chemical factor in their brain that is elevated, and this particular factor is elevated in mental illness. You’re not going to hear about that study because, “Oh, it suggests that maybe gender dysphoria, trans identity might be related to mental illness somehow.” You won’t hear about that.
Cretella does not identify the author of the study making it virtually impossible to fact check. The American Psychiatric Association has already issued a determination that gender dysphoria is not a mental illness or disorder.
Verdict:
Unknown but based on the APA determination probably incorrect if not untruthful. It is a lie to suggest that the APA is trying to be politically correct which is often the claim of religious conservatives. It is a lie of convenience.

Fact checking Michelle Cretella is an exercise in drudgery that is sometimes entertaining. Cretella's agenda is to conform to religious dogma rather than the best interests of people who have a medical condition. Cretella is willing to say just about anything in defense of the faith.

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