Jack Turban, a researcher, medical journalist, and assistant professor of child & adolescent psychiatry at University of California San Francisco, is the lead author on the following four studies which are widely cited as evidence to justify sex-trait modification interventions. Each study is based on responses to the 2015 United States Transgender Survey (USTS), which recruited respondents aged 18-36 years old online via transgender advocacy organizations. All four of the studies have the following flaws:

 

Biased selection of study participants or cohort:

• Only those who identified as “transgender, trans, genderqueer, and non-binary” at the time of the survey were allowed to participate. Therefore, those who were given puberty blockers, and/or who took hormones or had surgery and later stopped identifying as transgender did not qualify to participate in the survey, eliminating the people most likely to have been harmed by medical interventions. Of course, people who committed suicide after transitioning would not have been included either.

• Nearly 40% of the participants had not transitioned medically or socially at the time of the survey, and a significant number reported no intention to transition in the future, so their responses are not relevant to the studies’ claims.

• Respondents to this type of survey tend to skew young and are likely to be more politically engaged so the survey results do not represent the entire trans-identifying population. 

• The survey did not include any questions about gender dysphoria which is typically the justification for medical interventions.

• The survey explicitly stated goals “to highlight the injustices suffered by transgender people during the recruitment stage and in the introduction of the survey instrument itself.” This could have encouraged respondents to overreport bad experiences.

 

Correlation vs. causation: Turban et al acknowledge that survey design did not allow for “determination of causation.” This means that the studies can only show associations, but can’t provide actual proof for any of the claims. Nonetheless, all four studies treat the results as a valid basis for major policy recommendations.