Complaint regarding research integrity at the British Medical Journal
23rd March 2025
Dear BMJ,
I would like to make a complaint regarding what I see as your failure to facilitate academic debate on the nature of cross-sex identification (gender dysphoria).
In 2023, the BMJ recommended that I submit a "rapid response” regarding my experience of autogynephilia, and my concerns regarding the medicalisation of vulnerable children and young people, particularly girls and young women, who have falsely misdiagnosed themselves with gender dysphoria.
I attempted to do this twice, but I found that this recommendation appeared to be without genuine intent to ever publish any of my concerns. I have documented my two attempts to submit rapid responses here:
https://transpolicy.substack.com/p/rapid-response-to-transgender-identity
My second attempt at a rapid response was made with the help of a respected and published medical professional.
I am opening this complaint with you now, as I can see that the medical atrocities around this issue, which I tried to caution against, have started to ramp up: "The mothers left distraught after the NHS removed their daughters' healthy breasts because the girls said they were transgender" (Daily Mail, 27th February 2025).
I have submitted a objection to the Health Research Authority regarding the proposed puberty blocker clinical trial. In my objection, I note that there is a false academic consensus around the idea that one can literally have a "gender identity" of the opposite sex, which is the false premise behind which the trial is being conducted.
Therefore, please could I ask, that you publish my rapid response to McKetchnie, et. al., so at least there can be some debate around alternative explanations behind why someone might identify as the opposite sex, namely autogynephilia. I have included this at the bottom of this message.
The current false consensus, that it is possible to detect someone's “gender identity”, even of children, and prescribe them any manner of irreversible medical treatments, such as puberty blockers, or surgeries, is a false prior, which is causing unrestricted harm in the medical profession.
Other medical professionals share my concerns, which is why I have been published by the UK charity HealthSense, who campaign for "science and integrity in healthcare".
https://www.healthsense-uk.org/publications/newsletter/newsletter-127/420-127-orlando.html
https://www.healthsense-uk.org/publications/newsletter/newsletter-128/434-128-letter.html
Dear Editor,
McKechnie’s paper on “Transgender identity in young people and adults recorded in UK primary care electronic patient records: retrospective, dynamic, cohort study” [1] was interesting but coloured by ideological biases and unreliable results. The authors assert that “trans” is a matter of a supposed mismatch between one’s “gender identity” and one’s “sex assigned at birth” -- both concepts that are controversial in the literature.
Sex is not “assigned” [2] and the idea that “trans” is the result of a mismatched “gender identity” does not accord with research and my personal experience. As an adolescent in the late 1990s, I found myself questioning my sex. I searched for a reason for what I was feeling and found a synopsis of Blanchard’s research, theorising that the male cause of cross-sex identification was connected to atypical sexual orientation, namely, either homosexuality, or what he termed “autogynephilia”, meaning “love of oneself as a woman”, [3] which included the phenomenon of what Blanchard would later call “pseudobisexuality”. [4] This accurately described my experience and many others of my generation.
The authors assert that “Sexual orientation is distinct from gender identity” however it is clear to me that cross-sex identification and sexual orientation are, and can be, connected, and explains the nature of “trans” rather than the theory of “gender identity”. The assertion that a person even has a “gender identity” suggests that “Male-to-female transsexuals are, in some literal sense and not just in a figurative sense, women inside men’s bodies”. It is arguable that “gender identity” has merely replaced what Blanchard clarified as “feminine essence theory”. [5] There is no evidence that “feminine essence theory” nor its supposed reformulation as "gender identity", are the truth behind male cross-sex identification. Thus, I and many others, continue to watch with growing concern as “gender identity” theory has been taught as established dogma to children by schools, charities and non-governmental organisations.
Furthermore, it is likely that teaching children that “trans” is a matter of a mismatched “gender identity” has created a social contagion amongst girls; social contagions being a well-documented phenomenon in this cohort (and especially amongst detransitioners). [6] Abigail Shrier gives the example that in Hong Kong there had never been an epidemic of “anorexia” until their local media publicised the “Western ailment” of anorexia nervosa, which was said to have been responsible for a girl’s death. [7] The fact that the presentation of these girls is outside what researchers know about the nature of cross-sex identification, [8] further suggests the cause of their cross-sex identification is likely to be external, rather than internal.
Finally, the authors fail to comment on the value of keeping biological sex in medical records, even if patients undergo social or medical transitions. Their estimates would have been much more reliable if they could have anchored their research in the one fact (sex) from which all definitions and identity flow (whether congruent, incongruent, mismatched or not).
[1] McKechnie, DGJ, O’Nions, E., Bailey J., et. al. “Transgender identity in young people and adults recorded in UK primary care electronic patient records: retrospective, dynamic, cohort study”, BMJ Medicine 2023;2:e000499. 10.1136/bmjmed-2023-000499.
[2] “Gender-questioning children deserve better science”, Byng, R., Bewley, S., Clifford, D., McCartney, M. The Lancet 392 (2018).
[3] “The Classification and labelling of nonhomosexual gender dysphorias”, Blanchard, R., Ph. D. Archives of Sexual Behavior 18(4) 315-334 p. 323.
[4] Blanchard, R. (1990). “Gender identity disorders in adult men”, in R Blanchard & B. W. Steiner (Eds.), Clinical management of gender identity disorders in children and adults (pp. 47-76). Washington, DC: American Psychiatric Press.
[5] “Deconstructing the Feminine Essence Narrative”, Blanchard, R. Ph. D. Archives of Sexual Behavior (2008) 37:434–438.
[6] “Detransition and Desistance Among Previously Trans-Identified Young Adults”, Littman, L., O’Malley, S., Kerschner, H. et al. Archives of Sexual Behavior (2023) https://doi.org/10.1007/s10508-023-02716-1
[7] Abigail Shrier, Irreversible Damage. Regnery Publishing: 2020 p. 168.
[8] “Gender dysphoria is not one thing”, Bailey, J. M. Ph. D., Blanchard, R. Ph. D. 7 December 2017 4thWaveNow https://4thwavenow.com/2017/12/07/gender-dysphoria-is-not-one-thing/
Yours,
Orlando Woolf
4th April 2025
Dear Orlando,
Thank you for contacting complaints@bmj.com with your concerns.
We understand that you're dissatisfied with the editorial decision not to publish your online comment submitted to BMJ Medicine, as you believe that decision limits academic debate on the topic.
We've reviewed this case and we conclude that the editor followed a reasonable process in evaluating your comment and deciding against publication.
The reasons for this decision were explained to you, and the decision-making process aligns with our approach to rapid responses. We consider it inappropriate to reverse an editorial decision made in a reasonable way.
Best regards,
Dr Helen Macdonald and Mrs Helen Beynon
Content Integrity
4th April 2025
Dear BMJ,
You write “The reasons for this decision were explained to you”. No they weren't.
This following is the only response I received; there was no explanation regarding what was wrong with my content:
In comparison, the BMJ published a rapid response that suggests the drastic rise in adolescent girls presenting to gender clinics is comparable to being “left-handed”, which is absurd:
https://www.bmj.com/content/380/bmj.p382/rr-6
You've failed to facilitate academic debate regarding this issue, and this field of medicine is now badly harming people: primarily adolescent girls and young women:
“The mothers left distraught after the NHS removed their daughters’ healthy breasts because the girls said they were transgender” (Daily Mail, 27th February 2025)
“Revealed: More than 1,000 patients a year have trans chest surgery on the NHS” (Telegraph 10th February 2025)
“Father's letter begging top surgeon to cancel trans operation on ‘depressive’ 20-year-old: ‘Please don't remove my daughter's breasts ...in just one day you'll ruin her life for ever’” (Daily Mail, 27th July 2024).
Yours,
Orlando Woolf