“A February 2025 review study of ivermectin randomized controlled trials in Annals of Medicine & Surgery concluded that ivermectin showed no significant impact on critical outcomes such as mortality, mechanical ventilation, viral clearance rates, ICU admissions, or hospitalization rates compared to controls. Similarly, a February 2025 review article of randomized controlled trials by a team of Indian pharmaceutical researchers observed that “we consider Ivermectin ineffective in the management of COVID-19 disease, both as treatment and prophylaxis.””
Twenty-six U.S. states have banned certain medical interventions for children with gender dysphoria. In a free country, the barrier for straight up banning a medical intervention needs to be very high. The evidence needs to be overwhelming that such interventions are bad—that they do far more harm than good. That is not the case for puberty suppressing drugs, hormone replacement therapy, or even surgery. Such bans are an insult to liberty and should be removed.
If a doctor, parent, and child, all agree that a particular medical intervention is the best solution for their problem, then who the Hell is the government to stop them? Who the Hell are you to stop them? It doesn’t matter how you feel about transgenders, unless such interventions are clearly net bad for patients to the point where no reasonable person would perform them, they should not be banned.
There are lots of studies on transgender interventions, and there is some evidence that puberty suppression, hormones, and/or surgery help children and adolescents with their gender dysphoria, their quality of life, depression, and even lessens their chance of suicide. Unfortunately, that evidence is mixed and the studies are far from conclusive. Researchers on both sides seem biased and exaggerate the quality of evidence for their positions while undervaluing the evidence in favor of other positions.
The evidence is mixed enough that doctors and parents need to approach such decisions with a heavy dose of caution. The burden of evidence for stopping, and especially changing, a child’s natural puberty needs to fall on the intervention. If doctors are negligently transitioning kids who should not be transitioned, then those doctors should be charged and sued under normal medical malpractice or negligence laws. We don’t need to ban procedures to enforce basic medical law.
I strongly encourage parents and medical professionals to be careful about transitioning children, and for parents to get second opinions from different-thinking doctors. The evidence in favor of such interventions is quite modest, and it’s hard to tell which children are more likely to benefit from them. Nevertheless, such decisions should be in the hands of the parents, doctors, and the children, not the government. We are not truly a free country if medical interventions can be banned on such weak justifications.
What the Science on Gender-Affirming Care for Transgender Kids Really Shows Heather Boerner. 2022 5 12. Scientific American. https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows Mastectomy John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/mastectomy#:~:text=A%20mastectomy%20is%20surgery%20to,a%20high%20risk%20for%20it. Correction: Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults Jack L. Turban et
“In the first of the two new analyses, a team of researchers led by McMaster University’s Anna Miroshnychenko looked at evidence from 10 studies on the effects of puberty blockers. Three of these studies compared patients given puberty blockers to those who were not, while the others assessed patients before and after being treated with puberty blockers. In both sets of studies, there was “very low certainty evidence” on tested outcomes, including their effect on gender dysphoria, depression, and bone mineral density.
“Most studies provided very low certainty evidence about the outcomes of interest, thus, we cannot exclude the possibility of benefit or harm,” write the study authors.”
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“The second analysis—also led by Miroshnychenko—looked at evidence related to hormone therapy, using data from 24 studies. Evidence about the effects of hormone therapy was mostly low certainty or very low certainty, they found. Many of the study designs were “limited in assessing intervention effects” and the studies were at risk of “bias and imprecision” resulting “from an insufficient sample size.”
“The best available evidence reporting on the effects of [hormone therapy] in individuals experiencing [gender dysphoria] ranged from moderate to high certainty for cardiovascular events, and low to very low certainty for the outcomes of [gender dysphoria], global function, depression, sexual dysfunction, [bone mineral density], and death by suicide,” they write.
On one level, these analyses don’t tell us much about the best course of action when it comes to young people with gender dysphoria and hormone treatments. They leave open the possibility that puberty blockers and hormone therapy may be beneficial, but also the possibility that they may be harmful or have little effect at all.”
“Five months later, federal health officials, industry executives and the public health community say they’re more worried than ever.
Kennedy in his first seven weeks atop the Department and Health and Human Services has dramatically reshaped the U.S. health apparatus, eliminating entire agency divisions, abruptly shifting policy priorities and leaving the sprawling department in what six current and former employees described as an unprecedented state of upheaval.
The health secretary and his team forced out top scientists in charge of developing new vaccines and evaluating the safety of medicines, stripping away centuries of collective expertise and institutional knowledge. Government offices that manage key functions like ensuring safe drinking water and alerting Americans to contaminated drugs have been decimated.
In the meantime, Kennedy appointees have sought greater control over scientific decision-making in agencies such as the Centers for Disease Control and Prevention and Food and Drug Administration — going against longstanding norms and roiling a health sector that accounts for nearly one-fifth of the U.S. economy.
“It’s a mess,” said one former senior HHS official granted anonymity to discuss internal matters. “What was once a very robust place to work, that was trying to lead on innovation, is gone. It’s just gone.”
The rapid overhaul, punctuated by last week’s mass firing of 10,000 employees, has left the HHS workforce traumatized and the broader health community in deep distress, according to interviews with nine current and former health officials, as well as five other public health experts and industry officials, most of whom were granted anonymity for fear of retribution.”
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““They got rid of all the people who made the place work,” said one health official. “It doesn’t seem to be achieving their aims. Unless their aim was just to cause chaos and torpedo morale.””
““He could be misinterpreted that vitamin A will save your suffocating suffering child,” Brett Giroir, a first-term Trump health official now advising Kennedy on infectious disease policy, wrote in a post on X. “It will not.”
In Texas, some local officials have grown concerned that Kennedy’s messaging risks diluting their own communication efforts. They warn that his equivocations could undermine their only hope of ending the outbreak: persuading people to get the measles vaccine.
“We don’t want to diminish the primary message,” Phil Huang, director of health and human services in Dallas County, Texas, said in an interview. “It’s the vaccines that are the most important.”
Katherine Wells, director of public health for the city of Lubbock, Texas, echoed that sentiment.
“We need to make sure that we’re all talking about the importance of vaccination, and although there’s some focus on treatment, preventing the disease in the first place is really what public health works on.”
Since President Donald Trump nominated him to run HHS late last year, Kennedy has labored to convince skeptics that he is not anti-vaccine, despite his past as an activist who repeatedly raised doubts about the safety and effectiveness of various immunizations.
As recently as 2021, Kennedy suggested without evidence that measles outbreaks may have been fabricated to “inflict unnecessary and risky vaccines on millions of children.” But now confronted with a high-risk, real-world opportunity to demonstrate whether his views have changed, the HHS secretary has instead appeared to seek a middle ground — calling the measles vaccine protective for individuals and broader communities, yet stopping well short of the full-throated endorsement public health experts say is necessary from the nation’s top health official.
“What he should be saying is that these kinds of outbreaks are fully preventable and unacceptable, and that as secretary he will do everything in his power to ensure the public that it never happens again,” said Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law. “It’s the first major public health crisis that he’s had to face, and he hasn’t reassured doubters about his ability to get on top of it.””
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“Most importantly, health experts said, Kennedy could simply hit the bar already set by health officials in Texas: Declaring unequivocally that vaccination is the central way to contain the outbreak.”
“Physicians elsewhere do not bear the same financial burden. I traveled in 2019 to the Netherlands, Australia, and Taiwan, which have three distinct health care systems that still manage to cover all of their citizens: universal private insurance, a public-private hybrid, and single payer, respectively.
In the Netherlands, physicians take three years of undergraduate studies, three years of master’s studies, and complete a one- to two-year internship before being licensed; certain specialties then require further training. Dutch university students typically graduate with much less debt (less than 25,000 euros on average, or about $26,200) than their American counterparts. In Australia, the training requirements would look familiar to US doctors — a decade or so of education and then on-the-job training — but the tuition would not, with annual medical school costs capped at less than $10,000 per year. Taiwanese doctors likewise spend significantly less money on their education, even relative to differences in cost of living, than US doctors.
What all of those countries have in common is more robust public support for higher education and generous loan repayment programs. The high cost of college is a longstanding issue in the US, and that contributes to the prohibitive cost of a medical education for reasons that have little to do with health care itself.”
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“There is another way in which the US health system places an unusual burden on doctors: the headaches of health insurance paperwork. As left-leaning policy analyst Matt Bruenig wrote on the recent brouhaha over insurers and doctors after the killing of Brian Thompson, at least some of the excess pricing of US medical services can be attributed to the administrative costs that providers incur while dealing with private insurers.
The demands of insurance claims on doctors’ time and attention not only make for a less pleasant working experience, they also take them away from patients, which can contribute to worse health outcomes.
Here is perhaps the most telling statistic, from the Commonwealth Fund’s 2024 international survey of doctors: 20 percent of US doctors said they spend “a lot” of time on paperwork or disputes over medical bills. That was nearly double the rate in the country with the next highest share; 12 percent of Swiss doctors said the same working in their country’s system, which also relies on private insurers to oversee benefits.
Only 5 percent of Dutch doctors and 9 percent of Australian doctors said paperwork and billing took up a large chunk of their time.
This wasteful activity affects both the cost and quality of our health system. Among wealthy countries, US patients have the fewest number of consultations with a doctor in a given year, with the exception of Sweden, and spend the least time with their physicians. Time and money spent on administrative work, for both insurers and providers, account for about 30 percent of the excess medical spending in the United States.”
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“The average physician salary in the US ranges from about $260,000 (for endocrinologists and pediatricians) to $550,000 (for certain surgeons). The most elite providers earn more than $1 million annually.
Dutch general practitioners, by contrast, make about 120,000 euros ($126,000). Even senior hospital surgeons typically earn about 250,000 euros. Australia, with a more robust private market, can be more generous: While primary care doctors earn between AUD$100,000 and $150,000 ($60,000 to $93,000) on average, senior practitioners make more and specialized surgeons can rake in as much as AUD$750,000 ($460,000) — much closer to the American norms.
Doctors in Taiwan — where, it should be noted, nationwide average incomes are about half of what you find in the United States — can make between $60,000 and $100,000 per year. The policy experts I spoke to there agreed that doctors are underpaid relative to the high number of patients they see, substantially more than a typical American physician will see in a day.
Whatever complaints American physicians may have, doctors in those countries feel undercompensated.”
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“The blame game between insurers and doctors is ultimately a distraction. Other countries have private health plans and private providers and yet don’t experience nearly the same waste and out-of-control price increases as the US has. The whole system — the prices and how they’re paid — will need to be addressed in the long run. As one landmark health economics paper put it 20 years ago: “It’s the prices, stupid.””
“Measles, mumps, and polio are supposed to be diseases of the past. In the early to mid-20th century, scientists developed vaccines that effectively eliminated the risk of anyone getting sick or dying from illnesses that had killed millions over millennia of human history.
Vaccines, alongside sanitized water and antibiotics, have marked the epoch of modern medicine. The US was at the cutting edge of eliminating these diseases, which helped propel life expectancy and economic growth in the postwar era.”
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“As long-accepted, lifesaving public health measures increasingly become politically polarized, routine vaccination rates are rapidly declining in much of the US. In the 2019–2020 school year, three states had less than 90 percent of K–12 students vaccinated against measles, mumps, and rubella. By the 2023–2024 school year, 14 states had fallen below that threshold. The number of states with more than 95 percent of schoolchildren vaccinated — the preferred level of coverage to prevent outbreaks — dropped from 20 to 11 during that same period.
It is no surprise then that the number of US measles cases more than quadrupled from 2023 to 2024. Nobody has died of measles in the US since 2015, but if vaccination rates continue to decline, this highly contagious disease (one person can infect more than a dozen other people) will spread with increasing ease, which raises the risk that American kids could die.
We know how to prevent that. We’ve had remarkably safe, effective shots for decades. We just need to keep using them.”