Transgender Activists Sink Medical-Education Course Skeptical of Gender Transitions for Minors

A campaign by transgender activists has succeeded in overturning the accreditation of a course series for doctors that cast doubt on the controversial practice of providing gender-transition interventions to minors. Following a short investigation, the national body that regulates continuing medical education for doctors deemed that the courses did not present a “fair and balanced” account of the relevant science.This development represents the culmination of a conflict that began after Erin Reed, a prominent transgender activist, in October reported in her widely read Substack that Washington State University, or WSU, had accredited a seven-part video series developed by a small academic nonprofit, the Society for Evidence Based Gender Medicine, or SEGM. The videos featured presentations from a 2023 SEGM conference (which this reporter attended) that scrutinized the research behind pediatric gender medicine. Between them, the presenters questioned the ethics and safety of treating gender-related distress in minors with puberty blockers, cross-sex hormones and gender-transition surgeries.The reporting in Ms. Reed’s publication, paired with her online advocacy, apparently prompted a swift uproar, with the ACCME receiving scores of complaints. But according to internal communications obtained by The Sun, the ACCME launched its investigation into the videos immediately prior to Ms. Reed running her article in late October; and the organization did so based on a single initial inquiry, the wording of which is nearly identical to portions of an email Ms. Reed’s staff writer sent to a WSU spokesperson the week before the article’s publication. The ACCME compelled WSU to suspend accreditation of the videos even before the conclusion of the investigation. The ACCME assigned two anonymous reviewers to scrutinize the videos and ultimately concluded that the course did not pass muster. Consequently, the organization voided the accreditation in January—a resolution of the conflict that has not been previously reported.ACCME acted based on a single initial inquiry, the wording of which is nearly identical to portions of an email by a staff writer to Erin Reed (pictured). Via X”WSU, which is a public land-grant university based in conservative-leaning eastern Washington, opted not to contest the decision.This activist victory has raised questions about whether the ACCME’s monopoly over these continuing medical education, or CME, courses and the particulars of its grievance-review process provide special-interest factions the opportunity to exert outsize sway over scientific discourse regarding contested medical subjects.“Open debate is vital to truth-seeking endeavors like academia and science,” Jessie Appleby, program counsel at the nonpartisan civil-liberties nonprofit the Foundation for Individual Rights and Expression, said in an email. “The effect of institutional capture by activists is all the more dire when an institution is the sole authority or single point of failure in the field, able to alone determine the acceptable standard and impose it on the entire field.” The ACCME concluded the course failed its standard that, above all, CME content should be “valid.” SEGM cofounder Evgenia Abbruzzese protested in an email to The Sun that the organization had not identified “a single element of the course that was factually invalid.” But given WSU faced losing its ability to accredit CME courses, this bind served “as a strong deterrent against challenging the ACCME directly,” Ms. Abbruzzese said. And there was no higher authority to whom the university could appeal. “The effect,” Ms. Abbruzzese said, “is that activist pressure succeeds in chilling scientific discussion.” Representatives for WSU did not return requests for comment.SEGM cofounder Evgenia Abbruzzese protested in an email to The Sun that the ACCME had not identified ‘a single element of the course that was factually invalid.’”Ellen J. Sullivan, a spokesperson for the ACCME, said in an email that the organization did not comment on confidential inquiries related to CME courses. She said: “Our approach to accreditation and oversight is grounded in our published Criteria and Standards, which apply consistently across all accredited providers and activities.”A Small Nonprofit Drives a Huge BacklashFounded in 2019, SEGM maintains a small staff and is otherwise loosely affiliated with a network of physicians, researchers and other scientific experts who generally share a concern that the evidence backing providing gender-transition interventions to minors is too weak and inconclusive to justify the attendant risks, such as infertility and the loss of healthy body parts. SEGM has in recent years quietly exerted increasing influence over the scientific and political dialogue across the Western world about the optimal methods for caring for minors with gender-related distress — a population that surged starting in the early-to-mid 2010s, in particular among adolescent biological girls. In response, supporters of youths’ access to gender-transition interventions have sought to tarnish SEGM’s reputation and professionally isolate the nonprofit. This ad-hoc campaign has further sought to deplatform and silence professionals with any affiliation with SEGM, such those who have spoken at one of its conferences or received a research grant from the organization. Central to this activist effort is a sprawling report published in 2023 by the left-wing advocacy organization the Southern Poverty Law Center, or SPLC, that accused SEGM of standing at the nexus of a shadowy, right-wing hate group–affiliated network of groups peddling “pseudoscience” as a cover for anti-transgender animus — characterizations that SEGM has firmly denied. (Last month, the Department of Justice indicted the SPLC for its historical practice of paying informants in the organizations it scrutinizes.) The report, which included transgender activists as coauthors, has been criticized by skeptics of pediatric gender medicine as relying on shoddy, guilt-by-association inferences that fall apartupon inspection. Nevertheless, the SPLC used the report as the basis of its official branding of SEGM as a hate group in 2024.Leor Sapir, who studies pediatric gender medicine as a senior fellow at the Manhattan Institute, on April 29 argued on social media that the SPLC’s hate-group designation egregiously relies on circular reasoning, saying: “SEGM is a hate group because it questions the quality of medical research, and its questioning should be disregarded from the outset because it is a hate group.”The SPLC and the authors of the report did not return a request for comment.Critiques of their report notwithstanding, the hate-group designation has provided transgender activists with a potent weapon to thwart SEGM’s efforts to raise questions among academics, physicians, policymakers and the media about the science backing pediatric gender medicine. Notably, early last year, researchers at McMaster University in Ontario published three SEGM-commissioned systematic literature reviews — the gold standard of scientific evidence — finding, like all other such reviews of this field, that the evidence backing pediatric gender medicine was wanting. The papers were meant to be the first in a series of five such reviews. But after an activist outcry, a faction of their authors publicly disavowed SEGM and sought to remove themselves as authors of the two pending papers, putting those publications in limbo.Leor Sapir studies pediatric gender medicine as a senior fellow at the Manhattan Institute. Via YouTubeAs Ms. Reed’s Substack has grown in popularity — she currently boasts 132,000 subscribers and 470,000 TikTok followers — she has increasingly flexed her muscles as an activist holding considerable sway over the left wing of the raging national debate over transgender-related issues. Such influence has raised concerns about Ms. Reed’s objectivity in reporting about the subjects of her activism and whether the reading public can discern reported facts from what critics characterize as propaganda. In an email, Ms. Abbruzzese criticized Ms. Reed’s methods. “This blogger’s ‘journalism’ functions less like reporting and more like an organized intimidation campaign,” she said. “The pattern is familiar: contact a hosting organization under the guise of requesting comment, signal that controversy is coming if the event proceeds, publish a piece framing the conference or panel as dangerous or illegitimate with helpful instructions for how to disrupt the event — and then report on the backlash that the article itself helped generate.”Ms. Reed and her staff reporter, S. Baum, did not return a request for comment.But Ms. Reed’s explicit efforts to suppress voices she sees as harming transgender rights is not always successful, even if she often manages to stir up a sizeable crowd to call for such a silencing.On April 21, Ms. Reed’s Substack reported that the Pediatric Academic Societies conference in Boston would feature a panel of four prominent skeptics of pediatric gender medicine. The article led to an immediate campaign to cancel the panel, which Ms. Reed promoted. Despite the fact that SEGM did not sponsor the panel, the backlash was fueled in particular by the panelists’ various affiliations with the nonprofit. The approximately 90-minute panel was nevertheless held as planned at 8am on April 26 and was attended by around 100 people, according to multiple people present. Washington State University’s Elson S. Floyd College of Medicine is one of the newest in the nation, having launched in 2017 and become fully accredited in 2021.The panel most notably included Dr. Riittakerttu Kaltiala, a psychiatrist at Tampere University in Finland, who founded one of Finland’s two youth gender clinics in 2011 and ultimately became a leading global critic of the typical practices at such clinics. Ms. Reed considers Dr. Kaltiala a bête noire and has characterized her as a tool of the anti-transgender right-wing.Dr. Kaltiala and the other three panelists were interrupted by unruly protesters. Their panel was later criticized by the Pediatric Endocrine Society for being, the organization asserted, “made up entirely of individuals who have espoused views that run counter to the bulk of the primary literature and the advice around care provided by the vast majority of major medical associations.”E. Kale Edmiston, an associate professor of psychiatry at the UMass Chan Medical School, interrupted the panel at multiple points by speaking out of turn and objecting to the panelists’ points of view, according to multiple people who were present and a recording of one such interruption that The Sun obtained. Dr. Edmiston called upon the attendees to complain to the ACCME about the capacity to receive CME credits for attending the panel.Dr. Edmiston did not reply to a request to comment. A representative for Baylor College of Medicine, which provided the CME accreditation of the panel, declined to comment and referred questions to the ACCME. The ACCME declined to comment on whether it had received complaints about the panel or had launched an investigation into the matter.The panel was led by Moti Gorin, a bioethicist at Colorado State University who, along with Leor Sapir, was a coauthor of the mammoth 2025 report that was commissioned by the U.S. Department of Health and Humans Services and that intensely criticized the field. (The report was widely maligned by supporters of pediatric gender medicine and dismissed as a political hatchet job.) In an email, he reflected on Ms. Reed’s prominent role in marshalling the deplatforming efforts against her perceived adversaries.“Activists like Erin Reed deliberately spark campaigns of intimidation and harassment against those who carefully examine the scientific evidence or ethical justification for the freewheeling ‘affirming’ model currently favored by many American gender clinicians,” Dr. Gorin said of what’s known as the gender-affirming method of caring for youth with gender-related distress. “The intended effect of such campaigns — beyond their punitive effect — is to scare off anyone else who might have concerns from airing them.”Erin Reed and her wife, Zooey Zephyr, a Montana state representative, are described by the Associated Press as a ‘power couple.’ Via APA Young Medical School Under the MicroscopeWashington State University’s Elson S. Floyd College of Medicine is one of the newest in the nation, having launched in 2017 and became fully accredited in 2021. The school ran into considerable turbulence with one of its early efforts with accrediting a CME course. The Sun obtained multiple internal email exchanges that detailed how Ms. Reed’s influence apparently threw the WSU team that accredited the SEGM course into turmoil. On October 22, SEGM first posted about the CME course on X. The following morning, Pam Scott, a WSU spokesperson, received an email from Ms. Reed’s staff reporter, S. Baum, bearing the subject line “TIME SENSITIVE: WSU + Hate Group?” The four-paragraph email referenced WSU’s accreditation of the course by SEGM, and noted that the organization “is designated as an anti-trans hate group.” Seeking comment on the matter, the email further stated: “Does hosting a hate group live up to the standards of the WSU community?” The following evening, Ms. Scott responded that the medical school “cannot choose, when acting in its accreditation capacity, to use other standards.” She further stated: “This designation does not represent endorsement or co-sponsorship of the group.”While the resulting October 29 article on Ms. Reed’s Substack did detail Ms. Scott’s distinction between providing SEGM accreditation and not endorsing the nonprofit, the article made no mention of the WSU representative’s suggestion that the university could not rely on the SPLC’s hate-group designation to guide its accreditation process.By November 13, the ACCME had received 78 complaints related to the SEGM course, according to an internal email. All but one arrived after the point on October 29 when, within an hour of Ms. Reed publishing the article on the matter, WSU acceded to ACCME’s strong urging to take down the videos pending the investigation.That single initial expression of concern, two sentences of which the ACCME provided to WSU administrators, officially triggered the investigation. The author of inquiry’s name was redacted; but its wording is almost identical to portions of S. Baum’s email to Ms. Scott, including the question: “Does hosting a hate group that is regarded as peddling disinformation lives [sic] up to the standards of the ACCME accreditation?” ACCME subsequently assigned two anonymous experts to review the SEGM course. They were asked to respond to six yes-or-no questions to determine whether the videos adhered to the ACCME’s standards, such as whether the content was “fair and balanced,” adhered to “current science, evidence and clinical reasoning,” and conformed “to the generally accepted” research standards.The responses from the two reviewers, which The Sun obtained, did not address SEGM’s hate-group status. Nor did the reviewers, whose names were not provided, make any suggestion that they had detected anti-transgender animus in the videos. The reviewers were nevertheless sharply critical of the course series, with one of them judging that the presentations had failed on five of the questions. The reviewer asserted that “this content was skewed towards literature and professional stances against gender affirming care or at least expressing significant questions or concerns” about gender-transition interventions for minors. The reviewer further stated, however, that such concerns represented “a legitimate position or stance.” But they concluded that absent more supportive perspectives regarding pediatric gender medicine, the videos lacked the requisite balance. The reviewer then took a wider view of the review process and suggested that, in fact, subjecting CME courses favorable to pediatric gender medicine to a litmus test based on balance could also render those courses invalid under ACCME policy.“Due to the politicization of this domain of care and the high voltage risks and outcomes that are often implicated,” the reviewer wrote, “it has become very difficult for truly balanced discussions to be had.” Even as the reviewer criticized the SEGM course for coming “across as dismissive of all” gender-transition treatment, they stated: “I wish there were more forums for opposing views to be shared synchronously” with supportive ones. Dr. Alison Clayton, a Melbourne, Australia, psychiatrist, gave one of the talks included in the course, which cast doubt on common claims that cross-sex hormone treatment prevents suicide in youths identifying as transgender. In an email to The Sun, she pointed to two courses about pediatric gender medicine available for CME credits that she asserted were “noticeably one-sided” in their support for the field. Scrutinizing one hour-long course — a presentation by Columbia University psychiatrist Dr. Jack Drescher at 2023 American Psychiatric Association — Dr. Clayton said: “When discussing opposing points of view, the presenter appears biased and makes derogatory comments/allegations—for example, suggesting that opposition to gender-affirming treatment for minors is emotion-based rather than evidence based.” Dr. Drescher did not return a request for comment.Seeing Dr. Drescher’s CME remain online while the SEGM course series was taken down, Dr. Clayton said, “suggests an overall CME environment that is likely to be unbalanced, unfair and misinforms clinicians about this field of medicine.” She said that “this risks harm to vulnerable young children and their families and is likely to undermine the public’s trust in the medical profession.” She called for a broad, “truly independent audit” of CMEs covering this topic.The Final Decision On January 23, the ACCME’s vice president of accreditation and recognition, Dion Richetti, sent a letter, which The Sun obtained, to WSU’s associate director of continuing medical education, Andrea Keesey. The letter documented the organization’s conclusion that the SEGM course “does not comply with ACCME’s Standards for Integrity and Independence: Standard 1.” That four-part standard states that CMEs must be “fair and balanced and that any clinical content presented supports safe, effective patient care.” The ACCME’s conclusion was in direct conflict with a November 19 letter from Ms. Keesey and others at WSU to Dr. Richetti, in which they expressed confidence that the course met the organization’s standards. That letter noted that 36 people had completed at least one of the seven courses (which went online in the spring of 2025), all of whom asserted, the letter stated, that “the content provided a fair and balanced coverage of the topic.”Nevertheless, two WSU administrators, Dr. James M. Record, the medical school’s dean, and Dr. Radha Nandagopal, a vice dean, accepted the ACCME’s decision to invalidate the accreditation of SEGM’s courses in a February 11 letter to the organization, which The Sun obtained.And yet their letter protested, albeit in polite and cautious language, what they suggested was the ACCME’s monopoly over the CME system and its resulting capacity to unilaterally undermine a university’s judgment. The letter complained about what it suggested was a lack of transparency in the review process, noting that the documentation the ACCME provided “did not describe the qualifications of the physicians who reviewed the material.” Nor did the reviewers, the letter stated, “specify which parts of the materials were noncompliant.” Asking how the university was expected to adhere to the ACCME’s guidelines given such an opaque review process, the WSU letter concluded that the organization’s decision regarding the SEGM courses could send “a chilling effect on the CME providers who accredit medical education programming.” Dr. Radha Nandagopal, a vice dean at WSU, was part of a team that accepted the ACCME’s decision to invalidate the accreditation of SEGM’s courses. Via LinkedInThe letter called attention to the considerable risks that academics assume when wading into the combustible debate over youth gender medicine, noting that “WSU staff and faculty experienced a substantial amount of online harassment that gave rise to serious safety concerns.” This assertion is in keeping with an email that Ms. Keesey sent to an ACCME representative on October 31, in which she further reflected on the considerable anger directed at the school: “I have never encountered a situation like this.” Dr. Erica Li, an assistant professor of pediatrics at WSU who served as SEGM’s liaison to the CME accreditation team, expressed her dismay over seeing her efforts undone by activist blowback. “This saga adds further fuel to the patient perception, justified or not, that healthcare institutions and health authorities cater to activist groups whose interest do not align with theirs,” she told The Sun.Dr. Li added: “This makes the practice of medicine far more difficult for doctors.”

Transgender Activists Sink Medical-Education Course Skeptical of Gender Transitions for Minors

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