Tiktoker tries and fails to find randomized placebo-controlled trial of gender-affirming interventions

Good times on the clock app

"Therapy is not a fucking placebo" guy just tried to snow me with a paper claiming to be placebo-controlled trial showing improvement for gender dysphoria following testosterone. It was a review of many studies yet was not a meta-analysis (red flag). Let’s look into this “lesser round-up.”

The "controlled" (with non trans people taking nothing) study: https://tinyurl.com/2sam97f4

The study the Tiktoker linked to when asked for a citation where testosterone was shown to be helpful beyond placebo effect: https://tinyurl.com/mr2r64kt

I searched up “placebo” and got 0 returns. I then searched for “control” and got 16, some of which referred to the control issues teen girls have. Only one study was controlled and related to gender affirming hormones. However, it was not randomized, meaning the participants were not randomly assigned to one of two arms of the study. The inclusion criteria for the control group was that they "not identify as transgender," so strike two for study design, comparing a transgender treatment group to a non-transgender control group. That’s like testing chemotherapy by giving it to cancer patients and then judging the effects against a control group of people without cancer, or testing an antidepressant with a control group of non-depressed people. The control group was not given a placebo shot of testosterone.

Further problems with the study design relate to the fact that the outcome measure was based on a survey, i.e., self-report. The people reporting their mental state knew they were participating in a study designed to prove they benefited from the drug they had already, on their own, either decided they wanted to take or had already begun to take. The drug was not provided by the study authors. Baseline tests were completed after at least some in the treatment group knew they'd received testosterone because they had gotten their first injection on their own before being recruited into the study.

Overall grade: F-, trans lobby. This study is designed in such a warped way that either the study designers are incompetent, or they already know a well-designed study will likely expose the con or otherwise not generate the data they want. Or they know they lack the clinical equipoise to get IRB approval. Transgender study participants were motivated and able to report shittier outcomes at the start of care, and improved outcomes at the end of care. Non-transgender controls were also motivated to report no change, assuming they supported trans access to hormones. This is why you randomize with a placebo control and don’t nothing-control your studies that people self-selected into. At no point were any suicides conclusively prevented. Who falls for this?! Other than an unbelievably large fraction of America, it feels like.

Bonus: the same Tiktoker also told me they wouldn’t have been approved for clinical trial if they hadn’t already been FDA approved, and that all drugs that are FDA approved have such trials, and that’s how we know lupron and testosterone are superior to placebo for gender dysphoria. These drugs are not FDA approved for this purpose. I’ll be looking into these studies more in an upcoming video.