When Hate Groups Masquerade as Medical Research

A Deep Dive into Anti-Trans Pseudoscience

Well, well, well. What do we have here? A shiny new “literature review” that claims to have uncovered all sorts of terrifying health risks from hormone therapy for transgender women. Published in a real journal and everything! Surely this must be legitimate medical research that we should all take seriously, right?

Not so fast there, partner.

Today we’re going to take a nice, long look at “Emerging and accumulating safety signals for the use of estrogen among transgender women” - a paper that reads less like objective medical research and more like a greatest hits compilation of anti-trans talking points wrapped in academic language. And when you peek behind the curtain to see who’s pulling the levers, things get even more interesting.

Meet Your Authors: A Rogues’ Gallery of Anti-Trans Activism

Let’s start with the elephant in the room - or should I say, the five elephants who authored this study. Because when you’re trying to assess the credibility of medical research, it’s kind of important to know whether the researchers have any, oh I don’t know, massive conflicts of interest.

Carrie D. Mendoza: The Network Leader

Dr. Carrie Mendoza isn’t just affiliated with anti-trans organizations - according to the Southern Poverty Law Center (SPLC), she’s a central coordinator of what they call the “anti-LGBTQ+ pseudoscience network” [1].

The SPLC documents that Mendoza “leads the FAIR in Medicine program and serves as an advisor to Genspect and Detrans Help” [1] - making her a key figure spanning multiple organizations in this coordinated network. She’s also the Director of Genspect USA [2] and formerly served as Director of FAIR in Medicine with the Foundation Against Intolerance and Racism [3].

As I have pointed out a few times now, Genspect was designated as an anti-LGBTQ+ hate group by the Southern Poverty Law Center in June 2024 [4]. The SPLC didn’t just wake up one morning and decide to throw darts at a board. They classified these groups based on documented evidence of coordinated anti-trans activities.

The SPLC report details how this network’s key strategies include “producing and disseminating anti-LGBTQ+ pseudoscience, narrative manipulation, legal advocacy, and political lobbying” with tactics including “promoting conversion therapy, challenging gender-affirming care, and influencing public opinion through media campaigns” [1].

So when we see Mendoza’s name as lead author on this paper published in June 2025 - a full year after her organizations were designated as hate groups - we’re not looking at independent medical research. We’re looking at documented pseudoscience production by someone whose explicit goal, according to civil rights experts, is “challenging gender-affirming care” through “narrative manipulation.”

M. Lal (Mungeri Lal - Pseudonym): The Unaccepting Parent Turned Activist

The image they use for the Killarney Group

Now this is where things get really interesting. M. Lal (

ML

- @mungerilal) is actually Mungeri Lal, who goes by “mungeribabu” online and is described as “the unaccepting parent of a transfeminine child” [5].

Let that sink in for a moment. One of the co-authors of this “objective medical research” is a parent who has rejected their own transgender child and has channeled that rejection into anti-trans activism.

Lal is affiliated with the Manhattan Institute (a conservative think tank) and “Democrats for an Informed Approach to Gender” - one of those concern-trolling organizations that tries to sound reasonable while pushing restrictive policies [5]. Furthermore, they also are credited in the author section of the published paper as being a member of The Killarney Group, Genspect, Offaly, Ireland.[25] They run a Substack called “ML’s Substack” where they publish articles with subtle titles like “Estrogen is really bad for men” (March 2023) and have co-authored pieces with Leor Sapir, another Manhattan Institute anti-trans activist, claiming “HHS Has Misled on Gender Medicine” (September 2024) [5,26].

This represents perhaps the most glaring conflict of interest in the entire paper. Lal has a deeply personal investment in “proving” that transgender healthcare is harmful - because accepting that it’s beneficial would mean acknowledging they’re actively harming their own child by rejecting them.

This isn’t dispassionate scientific inquiry. This is a parent who has made a decision to reject their transgender child and is now desperately seeking evidence to justify that rejection rather than following evidence to a conclusion.

I cannot find who this pseudonym belongs to, nor can I seem to find any photo from which to positively identify this author to their work. As such, I cannot speculate as to their profession or credentials.

J. Cohn (Jay Cohn): The Detransition Narrative Specialist

Jay Cohn is a prominent researcher within SEGM, who has made detransition narratives and regret rates their specialty within the anti-trans movement [8][9][10]. Jay Cohn is, as far as I can tell, an endocrinologist.

Cohn has authored multiple papers for SEGM, most notably “The Detransition Rate Is Unknown”(2023), which argues that “regret and detransition can be traumatic” and claims that current research showing low regret rates relies on “inaccurate estimates due to premature measurements of outcomes, inappropriate measurement instruments, and sample biases” [10][11][13].

SEGM features Cohn prominently in their publications, describing how “Cohn alerts readers that reports of detransition are increasing in frequency” and regularly highlighting their work in the “SEGM Digest” series [11][14]. Cohn also promotes ROGD (Rapid Onset Gender Dysphoria) theory, noting that it “receives a consistently unscholarly, unfair, and biased treatment by the gender medicine establishment” [1][21].

Cohn’s body of work consistently argues that “the likelihood of regret, detransition, and discontinuation is unknown” [13], making their co-authorship of a paper questioning the safety of transgender healthcare entirely predictable - it’s exactly the predetermined conclusion their previous research has been building toward.

The fact that someone whose entire research portfolio is dedicated to undermining confidence in gender-affirming care is now co-authoring “safety signals” about that same care represents yet another undisclosed conflict of interest that calls into question the objectivity of this research.

I cannot seem to find any photo from which to positively identify this author to their work. I was able to track down this much: jaycohn77@gmail.com - I believe I may know which Jay Cohn this is, but I lack enough evidence to say, and I don’t want to speculate.

Lauren Schwartz: The Campaign Organizer

Dr. Lauren Schwartz is an Oklahoma City psychiatrist who has positioned herself as a key organizer in the anti-trans medical establishment. They’re not just commenting on regulatory proceedings - they’re actively leading campaigns against major medical organizations.

In January 2024, Schwartz authored and organized an open letter calling for the withdrawal of the American Psychiatric Association’s gender-affirming care textbook [7]. This wasn’t just signing onto someone else’s letter - the document explicitly states “Lauren Schwartz, MD… Author of Letter” [7].

The letter, hosted on Genspect’s website and promoted internationally by them starting in April 2024, has gathered over 6,000 signatures and represents a coordinated attack on evidence-based psychiatric care for transgender people [7]. In it, Schwartz and co-signers dismiss decades of research as “fundamentally flawed” and demand that the APA withdraw their official textbook on gender-affirming psychiatric care [7].

Schwartz has also provided official comments to Oregon’s regulatory body in February 2024 arguing that “affirming a child’s belief that he or she is actually the opposite gender puts that child on a fast-track to medical interventions” [6], and has been featured in conservative outlets warning about the supposed dangers of accepting transgender youth [8].

The timeline here is crucial: Schwartz was organizing opposition to the APA’s transgender care guidelines throughout 2024, the same year their affiliated organizations were designated as hate groups, and then in 2025 co-authored this “research” questioning transgender healthcare. This isn’t coincidence - it’s a coordinated campaign.

Leslie MacMillan: The Canadian Terminology Comment Warrior

Dr. Leslie MacMillan is, a retired Canadian physician from Hamilton, Ontario, who graduated from the University of Toronto in 1978 and specialized in Internal Medicine (1982) and Medical Microbiology (1984) [9]. MacMillan resigned from the College of Physicians and Surgeons of Ontario in 2017 and is now inactive - not permitted to practice medicine [9].

Despite having no apparent expertise in endocrinology, psychiatry, or transgender healthcare, MacMillan has found a late-career calling arguing against basic terminology used in gender medicine, particularly in one online blog “why evolution is true” from the self titled book. [24] They have argued that “gender is for words” and that only in the 1980s did “gender” start to get applied to people [10], suggesting they believe the very concept of applying gender to human identity is fundamentally flawed. He is one of the 21 signatories to an open letter against gender affirming care in Canada after the January 28, 2025 executive order was signed declaring “his administration will not “fund, sponsor, promote, assist, or support” so-called “gender-affirming” medical treatment for minors”.[23]

MacMillan’s journey from respected internist and microbiologist to co-author of anti-trans pseudoscience with known hate group affiliates represents a troubling trend of retired physicians lending their credentials to ideologically motivated research outside their areas of expertise.

The Network Effect: When Hate Groups Collaborate

Here’s where things get really interesting. SEGM and Genspect aren’t just two separate organizations that happen to share similar views - they have extensive overlap in membership and collaborate regularly [11]. As one analysis put it: “The crossover in membership between SEGM and Genspect is remarkable” [11].

In fact, “Genspect developed from, and expanded on the activities of a collection of anti-trans campaigners, with a large number of therapists and psychiatrists in its initial membership drawn from the so-called Society for Evidence-Based Gender Medicine (SEGM)” [11].

This isn’t a case of independent researchers from different institutions coming to similar conclusions. This is a coordinated network of anti-trans activists producing research designed to support their pre-existing ideological positions. The SPLC has documented this as part of what they call the “anti-LGBTQ+ pseudoscience network” that uses strategies including “producing and disseminating anti-LGBTQ+ pseudoscience [and] narrative manipulation” [1].

Follow the Money: Anonymous Funding and Shadow Networks

Speaking of coordination, let’s talk about the financial side of this operation. Research has revealed that SEGM receives “large anonymous payments funding dodgy science” [12]. These organizations aren’t just ideologically aligned - they’re financially coordinated by anonymous donors who have a vested interest in restricting transgender healthcare [13].

When you have anonymous money funding coordinated “research” by hate groups to produce predetermined conclusions, that’s not science - that’s propaganda with footnotes.

Methodological Malpractice: How to Cherry-Pick Your Way to Predetermined Conclusions

Now let’s talk about the “research” itself. And folks, this is where things get really special.

The Case Report Con Game

The authors admit upfront that much of their evidence comes from “case reports” and acknowledge these are “often criticized as weak evidence.” But then they perform some impressive mental gymnastics, arguing that case reports are actually perfect for identifying harms.

That’s not how evidence works, folks. Case reports can suggest areas for further investigation, but they can’t establish causation. If I publish a case report about someone who ate a banana and then got hit by a bus, that doesn’t mean bananas cause traffic accidents.

The Missing Control Problem

Throughout the paper, the authors consistently compare transgender women to cisgender men in the general population. But here’s the thing - that’s not the relevant comparison. If you want to assess the risks of hormone therapy, you need to compare transgender women who receive hormones to transgender women who don’t.

Why don’t they make that comparison? Well, probably because studies that do make proper comparisons consistently show that gender-affirming care improves mental health outcomes and quality of life [14].

The Confounding Variable Shuffle

The authors repeatedly acknowledge that their studies suffer from “uncontrolled confounding” - meaning they can’t separate the effects of hormones from other factors like discrimination, social stress, or pre-existing health conditions. But then they just… proceed as if hormones are definitely the culprit anyway.

It’s like saying “We know we can’t tell if the increased stress these people experience is from societal discrimination or from medication, but we’re going to blame the medication anyway.” That’s not science - that’s advocacy.

Fact-Checking the Fear Campaign

Let’s dive into some specific claims and see how they hold up to scrutiny:

Claim: Gender-affirming care gives children “access to body-altering drugs without question”

Fact Check: FALSE

Gender-affirming care for minors follows strict clinical guidelines requiring comprehensive psychological evaluation, ongoing therapy, and staged interventions appropriate to age and development [15]. The process typically involves multiple healthcare professionals over extended periods. This is the opposite of “without question”.

Claim: “Many kids undergo surgeries to remove healthy body parts upon demand”

Fact Check: FALSE

Gender-affirming surgeries for minors are extremely rare and limited primarily to chest surgeries for older adolescents with persistent gender dysphoria and parental consent [16]. These surgeries are never performed “upon demand” and require extensive evaluation. Genital surgeries are not recommended for minors under current guidelines [17].

Claim: Cardiovascular risks are uniquely concerning for transgender women

Fact Check: FALSE/MISLEADING

While the authors cite studies showing increased cardiovascular risks, they fail to provide proper context. Many medications carry cardiovascular risks - including birth control pills, which millions of cisgender women take daily. The question isn’t whether there are any risks, but whether the benefits outweigh the risks for individual patients. It is true that taking hormones, particularly estrogens or birth control, carries a risk for any woman. Again, when we look at the data they are using and the groups they are comparing, we see that either they are comparing conjugated or synthetic estrogens/analogues which are hardly used anymore for GAHC/HRT, or trans women compared to cis men, as opposed to trans or cis women. So true that there is some risk, but misleading as to the severity and liklihood, or just plain false when proper comparison and HRT method is considered. As is written and stated, it is at the very least, misleading.

Claim: Brain changes from estrogen are inherently harmful

Fact Check: FALSE/MISLEADING

The authors cite studies showing brain changes in people taking hormones, then speculate about potential negative implications. But correlation is not causation. The brain changes constantly in response to all sorts of factors, and the authors provide no evidence that the observed changes translate to actual functional problems. So it is true that changes occur, but false that these are shown/proven to cause any issue.

Logical Fallacy Bingo: How Many Can You Spot?

This paper is a masterclass in flawed reasoning. Let’s count the ways:

Cherry Picking / Selection Bias

The authors systematically select studies and case reports that support their predetermined conclusion while ignoring the substantial body of research showing benefits of gender-affirming care.

Appeal to Fear

The entire paper is structured to maximize alarm by presenting every possible risk signal while minimizing discussion of benefits or proper risk-benefit analysis.

False Cause (Post Hoc Ergo Propter Hoc)

Throughout the paper, the authors assume that because adverse events occurred after hormone therapy, they must have been caused by hormone therapy - ignoring numerous potential confounding factors.

Moving the Goalposts

When acknowledging that their evidence is weak or confounded, the authors argue that weak evidence of harm should be treated as strong evidence anyway - but only when it supports their position.

Appeal to Consequences

The authors argue that even uncertain risks should lead to avoiding treatment, without considering the well-documented consequences of withholding gender-affirming care.

Guilt by Association

The authors attempt to discredit gender-affirming care by associating it with profit motives in healthcare, while conveniently ignoring their own financial backing from anonymous donors with anti-trans agendas.

The Real Scandal: Manufacturing Doubt for Profit

Here’s what’s really going on, folks. This isn’t medical research - it’s an advocacy document dressed up in scientific clothing. The authors represent organizations that have been designated as hate groups specifically because of their coordinated campaign to restrict access to transgender healthcare.

They’re using the same playbook that tobacco companies used to cast doubt on smoking research, and that fossil fuel companies use to cast doubt on climate science. Find some credentialed people willing to cherry-pick data, publish papers that superficially look legitimate, and flood the information environment with doubt and confusion.

The goal isn’t to advance medical knowledge - it’s to provide ammunition for legislators and activists who want to ban transgender healthcare. And the timeline makes this crystal clear: this paper was published a full year after the lead author’s organizations were designated as hate groups, suggesting they’re doubling down on their pseudoscience campaign rather than engaging with the evidence.

What Actual Medical Organizations Say

While we’re being told to panic about the risks of gender-affirming care, it’s worth remembering that every major medical organization in the world supports evidence-based gender-affirming care:

• The American Medical Association [18]

• The American Academy of Pediatrics [19]

• The American Psychological Association [20]

• The World Professional Association for Transgender Health [21]

• The Endocrine Society [22]

These organizations, representing hundreds of thousands of medical professionals, have reviewed the same evidence and reached the opposite conclusion. They support gender-affirming care because the research shows it saves lives.

The Bottom Line

Look, nobody’s saying that hormones are risk-free. All medications have risks. The question is whether those risks are outweighed by the benefits for individual patients - and that’s a decision that should be made by patients, their families, and their doctors based on comprehensive assessment and informed consent.

What we’re seeing with this paper is a coordinated attempt by anti-trans hate groups to manufacture a medical controversy where none exists. The timeline shows escalating coordination: organizing opposition to professional medical guidelines in 2024, maintaining that campaign after being designated as hate groups, and now publishing pseudoscience in 2025 to provide academic cover for their activism.

Don’t fall for it. When organizations designated as hate groups start publishing “medical research” without disclosing their conflicts of interest, it’s time to ask who benefits from the conclusions they’re drawing.

And in this case, the answer is clear: the same people who profit from keeping transgender people marginalized, afraid, and denied basic healthcare.

The real safety signal we should be worried about? The emerging threat to evidence-based medicine from ideologically motivated pseudoscience funded by anonymous donors with political agendas.

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Citations

[1] Southern Poverty Law Center. (2023, December 12). Dynamics within the anti-LGBTQ+ pseudoscience network. https://www.splcenter.org/resources/reports/defining-pseudoscience-network/

[2] Genspect. (2024, March 13). Dr Carrie Mendoza Launches Genspect USA. https://genspect.org/dr-carrie-mendoza-launches-genspect-usa/

[3] See [1] above.

[4] LGBTQ Nation. (2024, June 1). Anti-trans organizations Genspect & SEGM are now listed as hate groups by the SPLC. https://www.lgbtqnation.com/2024/06/anti-trans-organizations-genspect-segm-are-now-listed-as-hate-groups-by-the-splc/

[5] James, A. (2025). Mungeri Lal vs. transgender people. Transgender Map. https://www.transgendermap.com/politics/mungeri-lal/

[6] Oregon Department of Financial Regulation. (2024, February 9). Lauren Schwartz, MD - 02/09/24; Gender Affirming Treatment. https://dfr.oregon.gov/help/committees-workgroups/Documents/RAC/gender-affirming-treatment/20240209-Lauren-Schwartz-comments.pdf

[7] Genspect. (2024). Open letter to the APA. https://genspect.org/apa-open-letter/

[8] OKC.net. (2023, August 10). Transgender ‘affirmation’ has long-term consequences, Oklahoma City psychiatrist says. https://ocpathink.org/post/independent-journalism/transgender-affirmation-has-long-term-consequences-oklahoma-city-psychiatrist-says

[9] College of Physicians and Surgeons of Ontario. (2025). Physician Register - Leslie MacMillan. Registration #51078. https://register.cpso.on.ca/physician-info/?cpsonum=51078

[10] Why Evolution is True. (2023, July 16). An international group of gender-change specialists urges caution for American doctors and therapists. https://whyevolutionistrue.com/2023/07/16/an-international-group-of-gender-change-specialists-urges-caution-for-american-doctors-and-therapists/

[11] Trans Safety Network. (2022, August 4). Genspect exploit confusion over UK trans health reviews to spread misinformation. https://transsafety.network/posts/genspect-misleading-letters/

[12] Trans Safety Network. (2021, August 26). SEGM uncovered: large anonymous payments funding dodgy science. https://transsafety.network/posts/segm-uncovered/

[13] Health Liberation Now. (2023, February 7). SEGM Exposed Reloaded: The Shadow Money Behind a Leading Anti-Trans Think Tank. https://healthliberationnow.com/2023/02/07/segm-exposed-reloaded-the-shadow-money-behind-a-leading-anti-trans-think-tank/

[14] Cornell University. (2018). What does the scholarly research say about the effect of gender transition on transgender well-being? What We Know Project. https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

[15] Coleman, E., et al. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(sup1), S1-S259. https://pubmed.ncbi.nlm.nih.gov/36238954/

[16] Olson-Kennedy, J., et al. (2018). Chest reconstruction and chest dysphoria in transmasculine minors and young adults: Comparisons of nonsurgical and postsurgical cohorts. JAMA Pediatrics, 172(5), 431-436. https://pubmed.ncbi.nlm.nih.gov/29507933/

[17] Mahfouda, S., et al. (2019). Gender-affirming hormones and surgery in transgender children and adolescents. The Lancet Diabetes & Endocrinology, 7(6), 484-498. https://pubmed.ncbi.nlm.nih.gov/30528161/

[18] American Medical Association. (2023). Health care for transgender and gender diverse individuals. https://www.ama-assn.org/press-center/ama-press-releases/ama-reinforces-opposition-restrictions-transgender-medical-care

[19] American Academy of Pediatrics. (2018). Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics, 142(4), e20182162. https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for

[20] American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832-864. https://www.apa.org/practice/guidelines/transgender.pdf

[21] See [15] above.

[22] Hembree, W. C., et al. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869-3903. https://pubmed.ncbi.nlm.nih.gov/28945902/

[23] https://macdonaldlaurier.ca/medical-organizations-and-media-let-canadians-believe-gender-medicine-is-safe-and-universally-accepted-its-not-14-physicians-sign-statement-for-inside-policy/

[24] https://whyevolutionistrue.com

[25] The Killarney Group Think Tank. https://genspect.org/meet-the-team/the-killarney-group-think-tank/

[26] Substack. M.Lal. ML’s Substack. Link