Society for Evidence-Based Gender Medicine

The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. The group routinely cites the unproven concept of rapid-onset gender dysphoria and has falsely claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. SEGM is often cited in anti-transgender legislation and court cases, sometimes filing court briefs. It is not recognized as a scientific organization by the international medical community.

Researchers at the Yale School of Medicine issued a report which described SEGM as "a small group of anti-trans activists". Joshua Safer, a spokesperson for the Endocrine Society, described them as "outside the medical mainstream".

SEGM is closely affiliated with Genspect. Seven advisors to SEGM are on Genspect's team of advisors, including Stella O'Malley, Genspect's founder. The Southern Poverty Law Center has designated SEGM and Genspect as anti-LGBTQ+ hate groups.

Activities and positions
The Society for Evidence-based Gender Medicine (SEGM) was founded in 2019 as an international group of clinicians and researchers. Its co-founders include William Malone, an American endocrinologist; Julia Mason, an American pediatrician; and Zhenya Abbruzzese, an American healthcare researcher.

SEGM has indicated its belief that "gender exploratory psychotherapy" should be a first-line treatment for those age 25 and under. Malone has opposed the informed consent model for transgender healthcare, where adults older than 18 can start hormones after signing an informed consent document without requiring an evaluation by a mental health professional. He told Medscape that "cognitive maturity doesn’t occur until the age of 25".

SEGM made a submission in defense of the state of Arizona's ban on Medicaid coverage for transgender healthcare. In it, they advanced the controversial idea of rapid-onset gender dysphoria (ROGD), which suggests a subtype of gender dysphoria caused by peer influence and social contagion. ROGD has been condemned as unevidenced and nonscientific by the majority of the world's major psychological bodies. Lambda Legal and Cooley LLP filed an amicus brief opposing the ban on behalf of LGBT advocacy organizations such as PFLAG, the Southern Arizona Gender Alliance, and the TransActive Gender Project. The Pediatric Endocrine Society and the World Professional Association for Transgender Health also filed amicus briefs opposing the ban.

In March 2022, Julia Mason, a board member of SEGM who also works with Genspect, proposed Resolution 27 along with four other members of the American Academy of Pediatrics (AAP), stating the AAP should reconsider hormone therapy as a first line of treatment and called for an evidence review to update AAP's 2018 policy statement on gender affirmative care. The AAP said that the resolution mischaracterized its policy, which instead promotes "following a systematic, collaborative evaluation by clinicians and mental health professionals". The resolution was not passed. After the resolution's proposers said that the AAP changed procedures to block discussion of the resolution, the AAP said that their processes worked normally and that Resolution 27 did not pass because it received no co-sponsorship and the majority of AAP members did not agree with the resolution. The AAP stated the guidelines were already under review as part of a routine procedure and that "there is strong consensus among the most prominent medical organizations worldwide that evidence-based, gender-affirming care for transgender children and adolescents is medically necessary and appropriate".

In April, the Florida Department of Health wrote a memo which misrepresented the scientific consensus to stop minors in the state from socially or medically transitioning and cited Malone.

Professor Dianna Kenny, speaking for SEGM, told the Daily Telegraph that "Let’s Talk About Bodies, Identity and Sexuality", a video produced by the Australian Human Rights Commission (AHRC), teaches "gender ideology". An AHRC spokesperson disputed this, stating that the video was "an age-appropriate teaching resource" that reflected a "rights-based approach to gender and sexual identity".

Conversion therapy
Malone and fellow SEGM member Colin Wright asserted in a September 2019 Quillette article that counselling can address "any trauma or thought processes that have caused them" to identify as transgender. The American Academy of Pediatrics have said that "conversion" or "reparative" treatment models such as this have been used to deter children and adolescents from displaying non-cisgender gender identities and gender expressions. The Substance Abuse and Mental Health Services Administration has said that any therapeutic interventions that seek to change a child or adolescent's gender identity or gender expression are inappropriate and may cause harm.

In May, 2021, SEGM called for an amendment to the Canadian criminal code C-6, which outlawed conversion therapy, falsely claiming that conversion therapy can only be applied to lesbian, gay, and bisexual people as opposed to transgender people as well. This position is not supported by any major medical organization, which define conversion therapy as including efforts to change sexual orientation or gender identity.

Citations in anti-trans legislation
In March 2020, SEGM was cited in an Idaho bill barring transgender people from changing their sex on their birth certificate. A SEGM spokesperson said they never expressed support for the bill. The legislation stated SEGM "has declared that the conflation of sex and gender in health care is alarming, subjects hundreds of thousands of individuals to the risk of unintended medical harm, and will greatly impede medical research" without providing evidence for the claims. The ACLU condemned the state for their actions. Malone also testified to the legislature in favor of a bill that would make it a felony to prescribe hormone blockers to people under 18 or refer them to gender-reassignment surgery.

In February 2023, Mike Leman spoke for the Catholic Dioceses in support of Wyoming Senate File 111, which aimed to ban gender-affirming care for minors. He cited a study from SEGM that questioned Dutch research into such care.

Affiliations
A report by the Southern Poverty Law Center described SEGM as a hub of the "anti-LGBT pseudoscience network", and specified that the relationship was strongest between SEGM, Genspect, and the Gender Exploratory Therapy Association (GETA), who shared over 24 personnel connections. The report also stated SEGM members are affiliated with the "anti-LGBTQ+ far right". SEGM is closely affiliated with the non-profit organization Genspect: Julia Mason, Marcus Evans, Roberto D’Angelo, Sasha Ayad, Stella O'Malley, Lisa Marchiano, and Avi Ring are advisors for SEGM and are on Genspect's team or advisors; O'Malley is the founder of Genspect. GETA is a group of therapists founded in 2021 by four SEGM members and a Genspect advisor to market what experts believe is transgender conversion therapy.

Marchiano and O'Malley are on the board of Lisa Littman's Institute for Comprehensive Gender Dysphoria Research (ICGDR). SEGM members O'Malley and Robert P. George are also advisors to the Foundation Against Intolerance and Racism.

A report by seven people in various departments of the Yale School of Medicine stated that the 14 core members of SEGM regularly worked together on the boards of other organizations that oppose gender-affirming healthcare and "feature biased and unscientific content."

South Dakota House Bill 1057, which was launched in 2020 to prohibit gender-affirming care for transgender youth, relied on a document created and distributed within a secret working group including multiple members of the American College of Pediatricians (ACPeds), representatives from other conservative groups, and founders of SEGM. SEGM members have repeatedly co-authored papers and letters to the editor with members of ACPeds. SEGM director Julia Mason tweeted that SEGM would not work with members of ACPeds and denied knowing ACPeds member Paul Hruz despite co-authoring papers and co-hosting symposia with him. ACPeds has explicitly promoted the work of SEGM; Quentin Van Meter encouraged audience members to work with SEGM at a conference held by “ex-gay” ministry First Stone Ministries.

Reception
In August, Vice News characterized William Malone as an "anti-trans activist". Vice reached out to authors cited in the memo, who said it took their research out of context as the research, and later research, supported gender-affirming care.

In August 2021, Trans Safety Network described SEGM as "an anti-trans psychiatric and sociological think tank" and fringe group and reported that most of SEGM's funding in 2019 came in donations greater than $10,000. In 2020, SEGM received a $100,000 donation from the Edward Charles Foundation, and in 2021 SEGM's annual revenue grew to nearly $800,000, the largest of which was a $350,000 donation from Fidelity Investments Charitable Gift Fund.

In 2023 Alejandra Caraballo described SEGM as "the most prominent of the pseudo-scientific organizations in the anti-trans space" and stated they use "teach the controversy" tactics and cite the results of their advocacy efforts in the United Kingdom NHS and Swedish Karolinska Hospital to build momentum to restrict care for trans youth globally.

The Southern Poverty Law Center wrote in 2023 that "Since its founding, members of SEGM have undertaken a global media and public policy blitz to challenge the affirming care model, advocate against gender-affirming care, and lend scientific credibility to legal claims against LGBTQ+ civil rights." The Southern Poverty Law Center added SEGM and Genspect to its list of anti-LGBTQ+ hate groups in its 2023 "Year in Hate & Extremism" Report.

Medical community
In April 2021, Medscape Medical News asked Joshua Safer – an endocrinologist from Mount Sinai acting as a spokesperson for the Endocrine Society on transgender issues – about SEGM, SEGM member Will Malone, and their concerns about treatment for transgender youth, he stated: "This is a relatively small group that has been making the same arguments for a number of years, and they are very much outside the mainstream".

In March 2022, SEGM funded a paper titled "Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults" which appeared in the Journal of Sex & Marital Therapy. In June, the journal published a response which compared SEGM to the National Association for Research & Therapy of Homosexuality (NARTH), a prominent conversion therapy advocation organization which focused on sexual orientation change efforts, as they both provide "scientific experts" to testify against LGBT rights.

In April 2022, researchers at the Yale School of Medicine issued a report in response to the attacks on transgender healthcare in Arizona and Texas which described the core of SEGM as a small group of anti-trans activists acting outside of mainstream scientific consensus and organizations, and help lawmakers criminalize transgender care.

In October 2022, Science-Based Medicine described SEGM as a "transphobic organization" which is closely affiliated with Genspect, who they described as "an anti-trans gender critical (GC) organization", and stated they "both regularly peddle anti-trans pseudoscience".

Kaiser Health News while fact checking a political campaign ad by America First Legal, said the leaders of SEGM are "wholly skeptical of the acceleration in gender-affirming care".