Public health research at the service of political correctness

By Rebecca Oas, Ph.D. | April 1, 2020

At a time when the entire world is grappling with a true public health crisis in the COVID-19 pandemic, The Lancet Public Health decided to use its April issue to mark the International Transgender Day of Visibility by dedicating its cover image and two out of three headlines to that pressing cause.

There are times when the need for urgent public health messaging outstrips the available information.  For example, with COVID-19, scientists are working around the clock to better understand the common modes of virus transmission, the most frequent early signs of exposure, the life span of the virus on different types of surface or in the air, and what practical advice the public should take in order to protect themselves and their communities.  Sometimes messages need to be altered or even withdrawn as new information emerges.  But the urgency is driven by the desire to save lives in the face of a globally-recognized threat.

When it comes to the featured Lancet article, which suggests that having government-issued IDs that reflect their preferred names and gender assignments “might improve mental health among trans persons,” the driver of urgency is entirely political.

“Poor mental health and psychological distress are disparately high among transgender people,” says an editorial published in the same issue.  This association is so striking, in fact, that up until very recently, the World Health Organization in fact considered “gender identity disorder” to be a mental disorder in and of itself.  The removal of that classification was heavily lobbied for by political activists.

So what does it take to get on the cover of The Lancet Public Health these days?  The authors of the article “hypothesised that having an ID that reflects one’s preferred name and gender marker would be associated with reduced psychological distress and suicide risk.”  They found that “gender-concordant ID status was not associated with suicide attempts,” but possibly with some psychological distress, including suicidal ideation.

Among the survey data being analyzed is the question of why a person did or did not seek to change their official ID(s).  Among those surveyed, over 43% said they “hadn’t tried yet” at all, and over 40% claimed the available “gender options” do not fit their gender identity.

It is notable that according to the study findings, those who have none, some, or all of their IDs reflecting their gender identity report the number of years they have lived in that gender identity as 2.1, 5.1, and 8.5, respectively.  In other words, getting one’s legal documents changed may be more a factor of time than anything else, and one could hypothesize that the stability of one’s perceived gender identity could also be a variable influencing one’s mental health.

At best, these findings are interesting, but hardly earth-shattering.  But it’s not really about public health at all, as The Lancet Public Health seems unafraid to admit.  It’s really all about politics.

The authors of the study are glad to say, “[O]ur findings support the substantial global momentum for legislative change for gender recognition policies as a fundamental human right.”  Indeed, if the findings had not been supportive, one might speculate they never would have been published at all.

But as another accompanying editorial makes clear, with or without the support of this study, the “substantial global momentum” already has support in high places:

According to the UN, “…it is vital that States fully recognize gender diversity in order to guarantee full exercise of all the human rights of everyone, including trans and gender diverse persons”

To the authors of that comment, “the UN” means a few bureaucrats working at the Office of the High Commissioner for Human Rights, as opposed to, say, the General Assembly.

The timing, packaging, and contents of this article and its accompanying comments leave little doubt as to its intended purpose, which is less about being a reasoned addition to the public health literature and far more about being a frequently-cited footnote in political briefs and petitions presented to lawmakers.

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