Monday, October 3

Ohio LGBTQ+ orgs call for ties to be cut with psychiatrist whose words are used to deny trans rights

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Ten Ohio LGBTQ+ organizations have signed an open letter to Case Western Reserve University, University Hospitals, and the State Medical Board asking that they cut all ties with Dr. Stephen Levine, a psychiatrist that the LGBTQ+ orgs say “has made his life’s work the denial of trans and gender non-conforming people’s healthcare.” 

Dr. Stephen Levine

In the letter, the LGBTQ+ orgs say that Levine has “become the go-to medical expert that is called upon to testify in favor of denying gender affirming healthcare to trans and gender non-conforming individuals.”

Levine is a Clinical Professor of Psychiatry at Case Western Reserve University School of Medicine, having started at the University as an Assistant Professor in 1973 and receiving tenure in 1982, according to his resume.

The letter links to a July 2021 article in Wired that describes several instances when Levine supported state legislation that would oppose the rights of the trans community.

“In recent years, Levine also has become an expert in other cases and bills involving gender nonconforming people. In Idaho, he submitted an affidavit in support of bills that would ban trans youth from playing on the sports teams that match their identity; in Washington, he’s serving as an expert witness in support of litigation to overturn the state’s ban on conversion therapy; he testified in a British high-court case to limit trans kids’ access to gender-affirming care.” 

More recently, Levine’s work was cited on February 17 in the Ohio Statehouse during proponent testimony for HB 454, which would deny gender-affirming care to trans youth and force school staff to out trans youth to their parents. Ohio State Representative Gary Click, the bill’s sponsor, cited Levine’s work in supporting his argument that trans youth in Ohio should be denied affirming care. 

The letter—signed by Cleveland Stonewall Democrats, CWRU AIDS Clinical Trials Unit, LGBT Community Center of Greater Cleveland, Colors+ Youth Center, LGBTQ Allies Lake County, B. Riley House, TransOhio, Cleveland Aquatic Team, Geauga SOGI Support Network, and Plexus LGBT and Allied Chamber of Commerce—calls for: 

  1. Removal of Dr. Stephen Levine’s affiliation with Case Western Reserve University and University Hospitals.
  2. Stoppage of any ongoing faculty development involving Dr. Levine.
  3. Notice be sent to all who have participated in professional development with Dr. Levine about the nature of why his affiliation is being revoked.
  4. Removal of Dr. Levine from all university honors, honorariums and directories.
  5. End to all ongoing and future publication of Dr. Levine’s work with university resources and partners.
  6. Addition of a qualifying asterisk referring to the harm Dr. Levine has done to all of his published work held in campus libraries and bibliographic resources.
  7. Revocation of Dr. Levine’s license from the Ohio State Medical Board.

The Buckeye Flame reached out to Levine with questions and a response to these demands. This article will be updated with his response if one is received. In the Wired article, Levine denied withholding treatment from trans people. 

In response to these requests, Case Western emailed the following response to The Buckeye Flame:

Diversity and inclusion are core values at Case Western Reserve, and we strive to ensure that every member of our community feels welcomed and supported. The university consistently ranks among the nation’s most LGBTQ-friendly campuses and prohibits discrimination of all kinds. We appreciate the perspectives of those who strongly object to Dr. Levine’s scholarship and related statements, particularly given the context of recent governmental actions in Texas involving transgender youth and their families. Nevertheless, academic freedom is also a core university value, one that is essential to its mission of discovering new knowledge and deepening understanding.

In their response, University Hospitals said Dr. Levine was retired and no longer practices at its hospitals. :

“His opinions are his own and he does not speak for UH,” a spokesperson said in an email

The hospital system is monitoring the progress of HB 454 and it believes “that decisions about care are best made individually by patients with their physician. UH providers strive to deliver the highest quality care and compassion for the LGBTQ+ community and all of the patients we serve.”

Though not one of the signatories on the letter, Equality Ohio released a statement on Dr. Levine condemning his support for anti-trans positions and encouraging Case Western, University Hospitals, and the State Medical Board of Ohio to distance themselves from association with him.

“Dr. Stephen Levine has built a national name for himself as one of the leading purveyors of a dangerous, fringe ideology as it relates to gender identity. His clinical analyses of the science behind gender identity deviate substantially from the medical best practices according to nonpartisan experts and medical professional associations across the country. Far from groundbreaking scientific breakthroughs, Dr. Levine’s writings rely on outdated social and scientific assumptions that have since been disproven by an array of experts in the medical field.

Unfortunately, it appears to be profitable to be outside of the mainstream. Dr. Levine’s writings have been frequently cited by anti-transgender activists who seek to discredit mainstream medical bodies. His analysis has even been used to push harmful anti-transgender legislation, policy, and lawsuits. In fact, he often helps prison systems justify denying affirming medical care to inmates under their care.

Doctors swear to a hippocratic oath to do no harm. Platforming a doctor who is committed to pushing a fringe ideology that flies in the face of his medical peers has and will continue to cause severe harm to Ohioans and in particular transgender individuals. We hope these institutions will show leadership in protecting already vulnerable community members from doctors putting their personal prejudices above science.”

The Buckeye Flame also reached out to the State Medical Board. This article will be updated with their response if one is received. 🔥 

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About Author

Ken Schneck is the Editor of The Buckeye Flame. He received the 2021 Sarah Pettit Memorial Award for the LGBTQ Journalist of the Year from the NLGJA: The Association of LGBTQ Journalists. He is the author of "Seriously, What Am I Doing Here? The Adventures of a Wondering and Wandering Gay Jew" (2017), "LGBTQ Cleveland" (2018), "LGBTQ Columbus" (2019), and "LGBTQ Cincinnati" (2020). In his spare time, he is a professor of education at Baldwin Wallace University.

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  1. Dr. Levine has worked in the field of gender medicine for decades, helping some transition and others not transition. He has a careful approach we should all praise, not vilify. He has researched this extensively and is questioning the rush that is the current affirmation approach. I commend Dr. Levine and hope the gender “industry” begins to listen and rethink how they are “treating” the very real distress our kids are experiencing. How many false positives are being sterilized in the name of “believe the kids” and “kindness”. What other life altering condition do we blindly affirm when 12-18yo’s ask us to? I applaud Dr. Levine (and others) willingness to expose themselves to such ridicule in order to help kids who are being groomed into being a life-long patients through surveys, porn, Reddit, Deviant Art and Tumblr, just because during puberty they don’t fit in and life gets harder.

  2. I write with care and concern for the author and the community which he and these organizations seek to protect. Sadly for those in the trans community by making a choice to ignore science and research, carried out by compassionate people like Dr Steven Levine you are hurting yourselves and young people who believe they can travel the transition path and pretend there are no consequences.Walk a mile in the shoes of someone who has been hurt by transitioning and be grateful for the Dr Levines in the world because you need them.

  3. What comes through to me reading the Wired article and other available information about Dr. Levine and his work is Dr. Levine’s deep thoughtfulness, compassion, and heartfelt attempt to do the right thing for each of his patients. This is a complicated topic and those activists who would oversimplify, prescribing a blanket solution for everyone, foster much harm, especially where young people are concerned.

    If activists continue to treat conscientious, ethical medical providers so unfairly, soon the only clinicians who will be left to “care” for them are doctors motivated solely by ambition and profit. And perhaps a few who are very well trained in social justice but know little about actual science.

  4. I am a fan of Dr. Levine from listening to his interview on Gender:A Wider Lens. I actually listened twice. He is a compassionate doctor who looks to treat patients as human beings whose greatest desire is love! I will not forget how he described the chain of trust is broken within the medical profession in regard to transgender healthcare. This article here is full of gross mischaracterizations.

  5. What we are witnessing here is another chapter in the Ideology vs. Science war, which like almost all wars, is senseless — and most of the casualties are young adults with their lives in front of them. Dr. Levine’s work is relevant, well-researched, and frankly, brave. He must have known that advocating for caution and further inquiry would result in clamoring for his silence. Now let’s see which side Case Western chooses.

  6. Ken Schneck and those from the 10 Ohio LGBTQ+ organizations should carefully consider what it is to provide sound ethical care to those with gender dysphoria. Dr. Steven Levine’s perspectives are based on his extensive work with this population as well as the growing body of research indicating that “gender medicine” is based on extremely poor-quality evidence, plagued by weak research design and bias. Several recent health policy documents based on available evidence from the UK (NICE, Cass), Sweden and Finland would side with Dr. Levine; the available evidence indicates that the potential costs of medical interventions would outweigh the benefits. These documents also highlight that there are many etiological pathways to and out of gender dysphoria. The current affirmation model assumes gender dysphoria is prima facie evidence of being transgender, which is clearly wrong considering that detransition occurs – and may, in fact, be happening at a greater rate since the “affirmation approach” was implemented. Research on detransitioners indicate that for 70%, their gender dysphoria was related to other issues, not being transgender, and that they did not get the care they needed. Simply providing gender medicine is not providing sound ethical care.
    Ken Schneck and his colleagues should also make note to read the research indicating that the vast majority of youth who experience gender dysphoria outgrow their dysphoria by late adolescence, realign with their bodies, and many grow up to be gay, lesbian or bisexual. The LGB individuals in these groups might want to consider what this means for confused youth today who may be given irreversible hormone treatment (no, they are not reversible) and surgery without sufficient time to explore their sexuality.
    Sound, ethical, quality treatment for trans-identifying individuals requires open dialogue and the consideration of many perspectives, including those like Dr. Levine who have compassionately worked with this population for decades. These perspectives can inform quality research that is sadly lacking. Censoring dialogue is doing a disservice to the community you represent.

  7. If Dr. Levine is going to be defamed, then Dr. Laura Edwards-Leeper, Dr. Monica Bowers, and Dr. Erica Anderson, all WPATH leaders, need to be defamed. (See this Washington Post article– An increasing number of physicians, mental health specialists, and gender specialists in Sweden, England, Finland, France, Australia, and New Zealand will also need to be defamed.

    Many reasoned people, all over the world, are recognizing the low-quality evidence that supports youth sex transitions. Risks and harms are becoming evident. Reports of regret and detransition are increasing. Turning a blind eye to the truth and denying harms is becoming harder and harder to do.

    What is the ultimate goal?

    Is it helping youth – many of them psychologically troubled — as they emerge into their adult lives, exploring their sexuality, and discovering their identities?

    Or is the goal to forward an ideology, even as youth are harmed in the wake of ideological progress? Contrary opinions and even facts need to be suppressed in service to the ideology.

    If the goal is the later we are in a world of hurt.

  8. As a health care provider who has looked after transgender adults for many years, I find articles like this one to be shocking. I would be concerned about such opinionated, unscholarly and slanderous ideology placing good clinical care at risk. Threatening scientists who have extensive knowledge and experience, and who are skilled at critical appraisal is also threatening the integrity and quality of clinical medicine that we provide. I support the care of transgender adults in affirming and non-judgemental settings. What Dr. Levine and his colleagues are speaking to is the loss of diligence and beneficience, the sloppy approach to – and neglect of – important pediatric mental health interventions and the over-taking of evidence-based medicine by politically-charged and emotionally unbounded ideology. This is a threat to quality in healthcare for all LGBTQI individuals.

  9. I write in full support of Dr. Stephen Levine. Dr. Levine is the farthest thing from transphobic. He is in fact extremely thoughtful and nuanced and is calling for more caution when it comes to assessing and treating gender dysphoria, particularly in young people, based on his decades of experience and research in the field of psychiatry. His voice is badly needed in a sea of one-sided activism that has become untethered from evidence.

    Moreover, universities have an obligation to allow freedom of speech and research for their professors. There is perhaps no other field of medicine that is as contested and controversial as gender medicine, and thus Dr. Levine’s research is even more sorely needed.

    At at time when Sweden and Finland, two of the most trans-forward countries in the world, have completely changed how they treat gender-dysphoric youth, banning or discouraging medicalization and prioritizing ethical and exploratory psychotherapy, and just when the UK’s independent Cass Review’s interim report has come out also advising caution and assessment, North America needs more brave and evidence-based researchers like Dr. Levine willing to stand up to the narrative that there is only one way.

  10. “His clinical analyses of the science behind gender identity deviate substantially from the medical best practices according to nonpartisan experts and medical professional associations across the country. ”

    I don’t see any evidence in this article that Dr. Levine has said anything that is incorrect–he disagrees with other experts in the field–yes, this is a controversial field right now, because the evidence is low quality, so people cannot predict outcomes. But Dr. Levine’s evaluation of the evidence is in agreement with major evidence reviews in all countries that have done them, including the US Endocrine Society.

    Which nonpartisan experts? Several “experts” in the field right now are misrepresenting the evidence. Many Americans have no idea that most children grow out of their gender dysphoria, that medical intervention has not been shown to improve mental health, gender dysphoria or quality of life, that it is completely unknown how many people have medical intervention fail (detransition) and that there are people who develop gender dysphoria due to underlying other issues (trauma, being on the spectrum, depression, anxiety, anorexia…) whose gender dysphoria goes away when the underlying issues are addressed.

    These are facts. Dr. Levine doesn’t get to choose his, and he hasn’t, he’s following the evidence. What exactly has he said or done that is “disproven”?

    Why don’t you look at his latest research paper and explain what is wrong in it. It agrees with all the evidence at hand. The US is becoming a backwater in treating gender dysphoria because most other countries are following evidence (or the lack of it). This is a medical issue and requires medical facts.

    As far as “do no harm”, the experts who are disagreeing with Dr. Levine need to show their evidence or stop giving out medical interventions which they cannot back up with data.

  11. Leonore Tiefer, PhD on

    Steve Levine is a cautious, caring, highly experienced psychiatrist whom I have known for over 40 years. His prolific writing as well as his work is characterized by respect for his patients and their struggles to be fulfilled and happy. This slanderous article is full of mischaracterizations of his work. Read his books, for heaven’s sake.

  12. I am familiar with some of this doctor’s work and his last paper was reasoned, fact-based, and scientifically legitimate even if he’s had anything actually problematic I am not aware of. To any gay or lesbian people reading this, if you think that normalizing child “sex changes” is not going to track at least some pre-gay and lesbian kids into medicalization with chemical castration drugs that will drastically impact their development, you are lying to yourselves. Just so everyone knows, they are in fact giving children puberty blockers as young as age 9, double mastectomies at 12, and vaginoplasties at 16. Pre-gay kids can experience CLINICAL, repeat DSM positive gender dysphoria but resolve it if allowed to go through natural puberty (check Drummond et al (2008),
 Wallien and Cohen-Kettenis (2008), 
Singh (2012), 
Steensma et al (2013) and others). As someone well informed on this I wish it was not true, but there has been an intentional effort to downplay this reality.

    Tell me what is going to happen to the previous desisters when they are socially transitioned at 5 and given Lupron at the crack of puberty before they are old enough to have had their first crush? You don’t, and these doctors and therapists who push this don’t either. Neither do “LGBTQ” organizations. I have spent hours and hours researching this issue since 2015 and they don’t care much. They also don’t care much about the mounting numbers of young people expressing transition regret. Guess what? A large percentage of them are LGB youth, now detested by “LGBTQ” organizations as hated road blocks to child and teen medicalization as this article is the perfect example of, highlighting this appalling call for silencing and witch-hunting scientific discourse, presented totally uncritically. This site could have reached out to the many LGB people and even trans people who oppose pediatric transition, not just Levine.

    Also know much of what your are fed regarding how happy and healthy this is in “LGBTQ” media is unsubstantiated, cherry picked, or outright lies. Hormone blockers are not always reversible under this protocol (they were used for precocious puberty/cancer but there are over 20,000 adverse side-effect reports to the FDA for these approved uses, this one is off-label). Karolinska hospital is dialing back medicalizing minors due to bone injuries from blocker use. So is Finland, France, and maybe the UK soon. Natural hormones are needed for bone development. There is some evidence blockers may reduce IQ. They cause micro penis when the youth goes on HRT. That may mean permanent anogasmia and the need for a gnarly, experimental bottom surgery using the colon or peritoneal lining. WPATH, yes a very pro transing kids org, has members now questioning the ethics of this and claiming it looks like worries of a social contagion in female teens are valid. I could say a lot more. Oh, the suicide narrative, yes it is a concern and no one should spin the suicide issue. But in summery they over report the danger in adolescence and haven’t tied prevention to medical access clearly, and while adults are happy with their transitions overall, suicide rates remain high. Some studies show suicide ideation is improved (see Cornell review). A few fail to prove that (see Branstrom, Dhejne, Marshall, Adams, Lipson). None of these studies are that great. But the media reporting is atrocious. Also, ignore anything by Jack Turban as sloppy, yet he is an LGBTQ org and media darling. You can find solid critiques of his work and the flawed survey it is based on.

    I expect a lot of refutable or spun activist comments to follow. Wish I could address them all but my time is limited. But just know, if you support this protocol, you must own the trail of damage (on largely LGB minors) as well. It’s already happening. There are scores of young people on the detrans subreddit. This is going to make the over-medicalization of intersex youth look like child’s play in numbers. As a case study: Thailand had to raise their age of consent at one point due to too many effeminate young gay males with transition regret. What is going on in the US happens even younger. No one in “LGBTQ” media & organizations will see these young people as anything other than morally acceptable collateral damage. And there is now an irreparable rift between “LGBTQ” people who want this and those who don’t. The organizations above do not have the right to speak for us all. And given studies show many trans people want biological kids and adults have sued in places like Sweden that required their sterilization, maybe you should not be sterilizing the persister trans youth either and harming they bone density. This isn’t just gay’lesbian eugenics. It’s trans eugenics.

  13. Dr. Levine’s writings are far from outdated social and scientific assumptions. They are fact, evidence-based, and supported. In my dealings with Dr. Levine, he has been compassionate and understanding; he has provided me with very balanced perspectives regarding my trans-identified child regarding trans healthcare options, risks, and benefits, both physical and mental. There is no legitimate reason to try and discredit someone who brings substantial value to improving the health of individuals with balance, reason, and proper safeguarding. He brings knowledge and understanding to a topic that should not be silenced. If healthcare for trans-identified individuals is to evolve and improve, as all healthcare should, everyone benefits from Dr. Levine’s perspective. It is perplexing why articles like this- seek to remove people who only have an interest in assessing the appropriate level of care for all individuals at appropriate development stages, instead of the current forced upon us “one size fits” all approach that we dare not to question without repercussion.

  14. Dr Levine is a thoughtful, caring and highly experienced psychiatrist. He is merely calling for balance and sanity to replace the current, nonevidence based approach to gender questioning children and youth. In addition, I know for a fact that others have left comments in support of Dr Levine, yet there are no comments posted. Clearly you are censoring them. The thousands who support cessation of the harm being done to gender questioning kids through medical transition see you. We are watching.

  15. Sweden and France have moved toward “restraint” in the use of hormonal drug treatments for medicalized gender change, warning that the risks appear to outweigh the benefits. Sweden’s Karolinska Ends All Use of Puberty Blockers and Cross-Sex Hormones for Minors Outside of Clinical Studies. And gays and lesbians are more likely to be non-conforming but will be medically transitioned if not allowed to go through puberty and desist, as most would do if left alone and not put on so-called puberty blockers. Attacking a doctor for seeing the evidence base for medically transitioning children is weak is not helping anyone.

  16. Dr Levine is greatly respected by many parents who have children who have been put on a pathway of puberty blockers, hormones and surgeries without regard for the underlying cause of the gender dysphoria.

  17. What utter disgrace for the buckeye flame to defame Dr. Levine’s life’s work in this way. He is an ethical clinician who understands that hormones and surgeries come with tremendous risks and uncertainties. He is willing to share his medical knowledge on this matter. He has cared for trans people for longer than most people on this planet. To call him transphobic is nonsense!

    Rather than looking at developed western countries who have recognized the enormous problems with on-demand hormones and surgeries for youth, 10% of whom now identify as transgender, the US maligns the few ethical doctors who can dispassionately speak the truth.

    Please reflect on the fact that countries with the longest-running record of recognizing trans adults’ legal rights, such as Sweden, no longer offer hormones and surgeries for youth as of this year. The UK is on its way to have a very similar approach. But in the US, publications such as this only fuel the divide and attempt to scare concerned clinicians into silence.