What evidence? Anti-trans scientists and academic journals fueled concern about youth transition with opinion, not data.

The global regression in trans rights is a direct consequence of medical practitioners who are hostile to trans existence. Overcredulous media outlets give voice to fringe professional groups like the Society for Evidence-Based Gender Medicine (SEGM), rather than the trans youth whose care is being questioned. SEGM, an SPLC-designated hate group and pseudoscience organization, is presupposed to have a scientific evidence base that informs their restrictive point of view.

But what exactly is this evidence? On its website, SEGM maintains a “compendium” of academic articles in support of transition restrictions, highlighting the compelling nature of systematic reviews. But when I examined each of the 400+ articles, only 6% were systematic reviews and less than half (46%) contain any data analysis at all. In fact, 26% are editorials in semi-obscure academic journals. They even cited five news articles and two blog posts. Rich irony from SEGM, who recently criticized the standards of transition care as mere opinion.

By their own criteria, SEGM’s evidence base does not stand up, even before considering the stilted designs in the paltry collection of work. To name a few: a 2018 article that promoted rapid-onset gender dysphoria (ROGD) by only interviewing non-affirming parents of trans youth, and a retracted 2023 ROGD study without ethics approval from an IRB, and a paper from this April that uses surveillance bias to claim that transition is unsafe. Meanwhile, rigorous work concluding that transition is safe and effective, like comprehensive reports from the Netherlands and Utah, are omitted.

This deficient compendium still offers insights into the anti-trans movement’s strategy to flood the zone and obscure a field of knowledge. Using this data, I identify the anti-trans researchers (i.e. activists) pushing pseudoscience, the academic journals which platform and profit off them, and the streams of capital funding the work. Together, this analysis names the individuals and institutions responsible for anti-trans disinformation, allowing us to begin to chart a path forward in challenging their power and legitimacy.

All the data and code used here have been deposited in GitHub, and I hope to keep it updated from time-to-time.

The sociopolitical panic over childhood transition is allegedly built on new data supporting a departure from the current standards of care. If you examine the articles in the SEGM compendium by year of publishing, there is an uptick around 2020 (below, left). But as I manually perused each entry, I noticed that many were opinion pieces that shared no new data, just rabid critiques of trans existence.

Scientific publishing operates like the magazine business: Issues are published on a regular basis and include different genres of writing. Not all academic articles are equal. Dense lab reports with data analysis are only one type of publication. Semi-rigorous long-form syntheses of published work are another.¹ Last, there is scientific opinion writing: editorials, commentaries, letters to the editor, debates. The intellectual bar for publishing an editorial is lower because the genre is often used to express ideas outside of a field’s consensus view or to directly critique others’ work.

I hand-coded each article by its form: data analyses (including systematic reviews), case studies, syntheses, editorials, and so on. When the same timeline of work is visualized by genre, the uptick disappears. Editorials constitute most of the new volume of cited works, since 2018 (below, right).

Trans people and our allies have always known that we are being gaslit by bad-faith researchers and a tendentious media environment, but the extent of the operation never fails to amaze. The surge in professional concern about youth transition is literally built on opinion.

Next, I identified the authors cited in the compendium, anticipating that the most would be affiliates and grantees² of SEGM and of other anti-trans pseudoscience groups like the Institute for Comprehensive Gender Dysphoria Research (ICGDR) and the American College of Pediatricians (ACPeds). But surprisingly, most of the top authors have no formal affiliation with these groups (below, top). Instead, they are affiliated with WPATH (the professional organization which sets the standards of transition care) and specifically are co-authors of the most recent protocols, Standards of Care 8 (SOC8).

For example, the two most cited researchers are Thomas Steensma and Annelou de Vries, Dutch psychiatrists and collaborators (with the highly cited Baudewijntje Kreukels) who have inflated estimated rates of detransition and routinely give interviews to far-right media. Steensma and de Vries both attended a 2022 conference organized by SEGM - the same year they co-authored the SOC8. de Vries even co-led the chapter on treating trans adolescents.

Of note, the third most-cited researcher is Riitakerttu Kaltiala, a Finnish psychiatrist and frequent recipient of SEGM funding. Kaltiala’s practice as a leader of an adolescent psychiatry unit has been subject to investigations by the Finnish government which found that her staff surveils patient-family meetings, oversees overcrowded youth inpatient facilities, and routinely uses physical restraints on children.

With the role of editorials in the propagation of anti-trans pseudoscience, I next isolated the most prolific editorialists in the SEGM compendium (below, bottom). Here, we can see the outsized role of SEGM (and, to a lesser extent, ACPeds). Eight of the eleven most-cited opinion authors are SEGM affiliates including SEGM president Roberto D’Angelo, co-founder William Malone, advisor Michael Biggs, and affiliates J. Cohn and Alison Clayton. Here, we clearly see the strategy of anti-trans activists: “flood the zone” with half-baked opinion to provide a semblance academic consensus.

For example, a 2021 opinion piece by a team of SEGM affiliates (Malone, D’Angelo, Stephen Beck, Julia Mason, and Marcus Evans) was written in response to a statement from the editorial board of The Lancet Child & Adolescent Health. The SEGM writers specifically took issue with the following line from journal’s editors: “Trans youth seek gender-affirming care because they are trans, and they have the same right to health and wellbeing as all humans.” SEGM refuted this statement in support of trans existence with their opinions, not an evidence-based consideration of trans realities.

In contrast, SOC8 authors are not represented among the most prolific opinion writers. This suggests that WPATH and the SOC8, frequent targets of SEGM’s criticism, rarely attempt to defend their standards from anti-trans hardliners. For example, Steensma and de Vries have each written only one editorial. Tellingly, both pieces negatively frame access to childhood transition.

Next, I wanted to understand which authors collaborate on anti-trans research. It is possible that the formal pseudoscience groups operate independently of the SOC8 authors, but alternatively these two groups may be linked directly through co-authorships or indirectly through intermediary collaborators. By identifying collaborations, we can begin to understand how the pseudoscience network works in practice.

The co-authorship network within the SEGM compendium is shown below. Individual researchers are represented by circles, and the size of the circle corresponds to the total number of articles where that researcher was cited by SEGM. The color corresponds to known professional affiliations (if any). Lines connecting circles indicate that two researchers have co-authored a paper cited by SEGM, and thicker lines represent multiple co-authorships. Names of individual researchers are omitted for readability but are maintained in the GitHub repository.

Immediately, we see that anti-trans pseudoscience is borne from a series of authorship networks of various sizes, and SEGM is involved with at least 3 of them. The largest network links SEGM, ICGDR, ACPeds, and the SOC8 authors where most affiliates of anti-trans organizations are a few degrees of separation from the people who wrote our standards of care. However, there are direct collaborations.

Kenneth Zucker of ICGDR (yes, the Canadian conversion therapist) has authored two studies with Steensma and one with de Vries and Kreukels. These studies hyped-up increases in transmasc youth seeking transition care, considered by anti-trans activists to be evidence of ROGD and therefore justification for restrictions on trans youth. These shifts are more likely due to differences in social stigma against gender non-conformity and increased transmasc visibility in recent years.  

Outside of this major network, SEGM also has influence in smaller and more insular networks through SEGM advisors Richard Byng and Anastassis Spiliadis. Small but active coauthor networks like these help SEGM to flood the zone and are therefore a tangible part of the group’s publishing strategy.

Together, these networks visualize the strategic collaborations by SEGM and other pseudoscience groups. The direct and indirect connections to the authors of SOC8 suggest that SEGM may have shifted from their initial approach (in 2019) to discredit WPATH. Instead, SEGM, ICGDR, and others have criticized WPATH while simultaneously capitalizing on existing (and longstanding) anti-trans sentiment among WPATH practitioners.  By 2022, SOC8 was published, in part, by major players in the anti-trans pseudoscience network like Steensma and de Vries.

Why did WPATH, whose vision is “a world wherein people of all gender identities and gender expressions have access to evidence-based healthcare, social services, justice and equality,” task trans-skeptical researchers with writing the SOC8? The group may have tried to stave off far-right attacks on its legitimacy, advanced compliance that did not protect them from an FTC lawsuit.

The more difficult answer is that Steensma, de Vries, et al. likely have longstanding affiliations with WPATH, and the organization has never lived up to its vision. Contrary to right-wing narratives of an organization in thrall to trans activists, WPATH tepidly defends their own SOC in the academic press and repeatedly puts themselves before the people they are supposed to serve.

These initial analyses allow us to identify who is abusing the scientific process and misleading the public, but it offers little information as to how these ideas get laundered into semi-professional discourse. This dirty work is done by the journals and their editors who platform the authors’ bigotry.

Like an editor at a newspaper or magazine, academic editors assess works and make decisions about what gets published (typically with input from peer reviewers). Ideologically motivated editors can put their thumbs on the scale for favored submissions by sending manuscripts to friendly peer reviewers and/or overlooking flaws.

We can gauge whether these dynamics are at play in anti-trans pseudoscience by examining which journals are most often cited in the SEGM compendium. If editors are rigging the system, then some journals (i.e. those with anti-trans editors) would be heavily cited while most other citations would be interspersed among other, less friendly journals.

Indeed, the two most-referenced journals are Archives of Sexual Behavior (34 citations) and Journal of Sex & Martial Therapy (24 citations). These two journals make up over 13% of the entire compendium (more than double the number of systematic reviews). Then, there is a large drop-off: The Journal of Sexual Medicine, was cited only 13 times. A similar trend is observed for editorials: Archives is cited 18 times, Sex & Marital Therapy is cited 11 times.

Archives is no stranger to anti-trans pseudoscience. Established in 1971 for “the prevention of transsexualism”, Archives is currently led Zucker³ who has been editor-in-chief since 2001. Zucker’s Archives has promoted conversion therapy and ROGD, including publishing the aforementioned 2023 study that did not get IRB approval – a major breach of basic ethics. While the paper was eventually retracted after pushback from queer researchers and allies, it was still cited in a 2025 report by the US Department of Health and Human Services (HHS).

Zucker’s other moves as editor-in-chief have garnered less attention but are still impactful. He has installed a coterie of anti-trans pseudoscientists on the Archives editorial board, including deVries, Steensma, Kreukels, Lisa Littman (of ICGDR), Alex Byrne (co-author of HHS report), two SEGM-funded researchers (Kaltiala and Steven Levine), and autogynephilia enthusiasts Ray Blanchard and J. Michael Bailey. Sex & Marital Therapy is similarly stacked with anti-trans editors, including Zucker, Levine, Biggs, and Clayton.

The volume of academic anti-trans opinion is a direct result of the editorial power given to these activists, and the misleading posture of concern from the academy will not stop until these abuses of epistemic power are redressed. For example, it is past time for Archives, which has spewed anti-trans hate for 55 years, to go out of press.

But academic journals do not exist in a vacuum. They are owned by and managed by a few large publishing houses which extract profit from academics’ dependence on them, and these profit incentives are a major barrier to progress.

Journals charge fees to publish articles, and we can therefore estimate the revenue of individual journals (number of articles x the cost of publishing one article). Archives generated an estimated $870,870 in revenue for its publisher Springer Nature in 2025, and Sex & Marital Therapy collected an estimated $327,675 for its publisher Taylor & Francis. I also estimated the total publishing revenue from the entire SEGM compendium: over $1.56 million.

Individual research teams are responsible for paying these fees, often using grant money. Publishers require authors to disclose funding sources, and I logged funding disclosures for each entry in the SEGM compendium. Most studies did not report any funding, so their money likely came from their home institutions (i.e. the researchers’ hospital system or university) unless they simply omitted their funding sources.

Of those who did report funding, SEGM is the most common single funding source (26 studies). In an ideal publishing environment, journals would reject studies funded by professional pseudoscience organization like SEGM. But journals’ profit motives are agnostic to the sources of funding. Dirty money is still valid currency.

National research institutes, like the National Institutes of Health (NIH, USA) and the National Health Service (NHS, UK), have also funded a considerable number of studies. In aggregate, national funding bodies far outpace anti-trans organizations (below), raising questions of whether state-funded research paradigms have benefited trans citizens whose taxes are appropriated for this use and whose wellbeing is jeopardized.

Funding from anti-trans pseudoscience organizations also raises questions about these groups’ incomes, a portion of which ends up in the hands of researchers and academic publishers. In a 2024 tax disclosure, SEGM reported over $1.6 million in revenue mostly from donations. Their largest known sources were from donor-advised funds, often-abused charitable funds where large donors retain influence over the ultimate beneficiaries of their money (while obscuring their identity). For example, in 2024 Fidelity Investments Charitable Gift Fund gave SEGM $746,000. That year, DonorsTrust donated $500,000 to SEGM and another $100,000 to ICGDR.

Which donor(s) are responsible for these decisions remains unknown. However, 2013 reporting from Mother Jones concluded that DonorsTrust is “the dark-money ATM of the conservative movement” identifying the Koch brothers and DeVos family (remember Betsy?) as major donors. DonorsTrust has a long history of donating to anti-science causes like climate denialism, yet another link between the money funding climate disinformation and anti-trans activism.

Overall, this analysis highlights the primary publishing tactic of SEGM and other anti-trans pseudoscience groups: inflate claims with editorials in anti-trans journals, cite data analyses conducted by a few WPATH leaders, and pretend all the noise represents scientific consensus. As researchers, pseudoscientists need to publish to keep their jobs and maintain their professional status; as activists, they are committed to infusing their cissexist worldview into political discourse; and as grifters, they’ll do it all while making a quick buck from their oligarch benefactors.

An array of institutions beyond anti-trans organizations (like WPATH, academic journals, publishing houses, national funding bodies, and opaque financial institutions) bear responsibility for the rampant pseudoscience we face today. We must demand accountability and reform from all of these if we are to move on from today’s panic. Historical struggles for queer rights have often been forged in response to abuse from medical scientists.

In the 1960’s, transition care was first offered by infamous sexologists who pathologized gender non-conformity and gatekept care for a select few. Yet, trans people still found ways to navigate this unjust system to get the care they needed. Some even wrote letters to prominent sexologists, asserting their personhood by directly confronting the sources of harm. Today’s anti-trans pseudoscientists are the direct inheritors of the abusive legacy of sexology, and we can still act to disrupt their work like the ongoing AYAGDOS study led by Zucker, Littman, and Bailey.

In the late 1980’s, HIV/AIDS ravaged communities of queer people and drug users while medical science slow-walked research into prevention and treatment. In response, ACT UP descended on the US Food and Drug Administration in 1988 and to demand that federal researchers take the epidemic seriously. Their direct action worked, and ACT UP was soon granted access to provide feedback on the design and implementation of research into treatments for HIV/AIDS.

Similarly, we can demand direct input on research, funding, and clinical guidelines at WPATH and national science funding bodies (NIH, NHS, etc.). Bad actors have too long manipulated these groups to oversee decisions that concern our immediate health and wellbeing. We need representation in the decision-making processes - and not just representation by trans people deemed acceptable in these spaces by virtue of education and/or wealth.

Last, in 2023 after Archives published a blatantly unethical study, queer researchers and allies called for the study’s retraction and the removal of Zucker as editor-in-chief. They succeeded in the first aim but not the second. Yet, the message is simple: pressure works. We can and should demand that Springer Nature put an end to the infamous Archives and the countless falsehoods it has spewed for 55 years. Similar pressure can also be applied to Taylor & Francis to remove Zucker, Levine, Biggs, and Clayton from the editorial board of Sex & Martial Therapy.

SEGM’s deceptive evidence base is only the superficial layer of epistemic abuse. Their activism is propped up by a series of institutional and financial incentives. By targeting these underlying structures, we can begin to address the harms of contemporary anti-trans pseudoscience.