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SEGM Exposed Reloaded: The Shadow Money Behind a Leading Anti-Trans Think Tank

By: Lee Leveille and Quinnehtukqut McLamore

The Society for Evidence-Based Gender Medicine (SEGM), a fringe organization known for intentionally misrepresenting the state of evidence for gender-affirmative care and for collaborating with anti-trans and anti-queer hate groups, has been a key source for anti-trans legislation and policies worldwide. Their members and affiliates are not only cited by conservative governments, but have been paid large sums by these same governments as “experts.” Governor Ron DeSantis of Florida went so far as to appoint a member of SEGM—Patrick Hunter—to the Florida Board of Medicine, where he has worked to ban care for trans youth in the state. Such striking influence in an organization so young has made activists, researchers, and lawyers alike interested in SEGM’s infrastructure and finances—particularly because despite the organization being required to submit tax documentation as a 501(c)(3) non-profit, SEGM’s are opaque. Past reporting by researchers at Trans Safety Network (TSN) has noted that large chunks of SEGM’s early financing came from three large, anonymous donations on a GoFundMe, and that collaborations with known anti-queer hate organizations like American College of Pediatricians (ACPeds) and conversion therapy networks like International Federation for Therapeutic and Counselling Choice (IFTCC) helped launch the group’s influence.

Now, Health Liberation Now has been able to identify another source of funding for SEGM—as well as the overall assets and income reported to the IRS by SEGM in December 2020 and December 2021. During the first year of SEGM’s official tenure as a non-profit (occurring some time between July 1, 2020-June 30th, 2021), the EDWARD CHARLES FOUNDATION (website here) made a “charitable gift” to SEGM in the amount of $100,000, as per public tax records available on ProPublica (Form 990, Schedule I) obtained searching for any reference to SEGM’s tax identification number (84-4520593). This donation potentially represented more than half SEGM’s reported income for 2020 as per the Master File maintained by the IRS, which was previously unknown. This report aims to contextualize this large influx of cash with respect to SEGM’s background, activities as an organization, and policy influence. We not only detail what is known regarding SEGM’s history and activities, but provide a detailed timeline of all known fundraising efforts and key figures.

Background Context: SEGM’s Origins and Activities

SEGM was formally incorporated as a 501(c)(3) tax-exempt non-profit centered in Idaho (US) on January 27th, 2020, with its initial board of directors consisting of Julia Mason, William Malone, and Marcus Evans. Currently, SEGM’s board of directors consists of Roberto D’Angelo (President), Malone (Secretary), Stephen Beck (Treasurer), and Mason (Director).[1] SEGM itself claims to have “over 100 clinicians and researchers,” but only lists key personnel on its website.

However, SEGM’s formal incorporation was neither the beginning of the organization using that name, nor the beginning of its core membership opposing the medical consensus on transgender care through any means necessary, including laundering pseudoscience, courting press attention, and litigation. William Malone had co-authored a letter to the editor of The Journal of Clinical Endocrinology & Metabolism opposing the Endocrine Society’s consensus on gender-affirming care in collaboration with the leadership of the American College of Pediatricians and Paul Hruz, a Fellow of the National Catholic Bioethics Center (NCBC) who (in accordance with that organization’s policy) opposes queer and trans rights on religious principle and a frequent “expert witness” for another hate group, the Alliance Defending Freedom). Hruz in particular has been condemned by his own university for his complete lack of expertise on trans youth. All these coauthors are also affiliated with the Catholic Medical Association (CMA), which (alongside ACPeds) has a long history of advocating for gay conversion therapy as recently as 2018, and has worked with Alliance Defending Freedom against gay and trans rights since at least 2017. Malone himself stated in an interview with The Christian Post that “[n]o child is born in the wrong body, but for a variety of reasons some children and adolescents become convinced that they were.”

The current President, Roberto D’Angelo, was part of the Pediatric and Adolescent Gender Dysphoria Working Group (PAGDWG, or sometimes just referred to as “GD Working Group” by members) in 2018. This group also included SEGM members Lisa Marchiano and Sasha Ayad, ACPeds member Michael K. Laidlaw, and a collection of infamous sexologists including James Cantor, Ray Blanchard, and Michael Bailey—who have collectively advanced antiquated and inaccurate ideas about trans people (”autogynephilia”), championed categorizing pedophilia as a sexual orientation, and (in Bailey’s case) claimed bisexual men didn’t exist for decades until co-authoring a paper which claimed to “discover” that bisexual men do, in fact, exist…in 2020. The group also involved Susan Bradley and Kenneth Zucker of CAMH fame—themselves closely associated with these sexologists. These two in particular were infamous both for their work on the outdated and stereotype-reliant DSM-IV and DSM-IV-TR concepts of gender identity disorder, and for their work at CAMH, infamous among trans communities for decades for its antiquated practices and insistence on trying to prevent children from being trans (see Tey Meadow’s Trans Kids). Bradley, Bailey, and Laidlaw in particular also cosigned a 2018 letter from ACPeds alongside key ADF personnel to Trump’s acting attorney general beseeching Trump’s justice department to explicitly exclude trans people from discrimination protections—an act called (at the time) “the cruelest thing the Trump administration has done to trans people yet.” PADGWG’s work consisted of championing the viral pseudoscientific idea of Rapid-Onset Gender Dysphoria—which has been thoroughly rejected by every relevant scientific organization and eviscerated by scientists and the press. As such, the president of SEGM’s prior work includes ready collaborations with hate groups and laundering of baseless pseudoscience.

Other key staff have similar trajectories. Marcus Evans, alongside his wife Susan Evans, rose to fame as “whistleblowers” of the UK adolescent gender identity development services. Marcus Evans specifically served as a governor of NHS’s foundation trust before resigning in 2019 over youth access to medical transition (as rare as that actually was and still is in the UK). Incidentally, the types of intrusive psychoanalytic therapies that the NHS actually practiced during Marcus Evans’s governorship have been described by patients and their families as fundamentally degrading, unhelpful, destabilizing, and pathologizing. Rather than suggesting solutions for the inherent systemic problems of youth access to trans care in the UK, the Evanses instead worked to advocate for psychoanalytic conversion therapy in Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults. Not only has this book been roundly criticized by transgender activists, including the Polish transgender knowledge base Tranzycja, it has been scathingly reviewed by Avgi Saketopoulou in The Psychoanalytic Quarterly for its blatant transphobia, inaccurate psychoanalytic reasoning, grandiose claims, and insinuations that gender dysphoria represents a psychic defense against homosexuality, violence directed against oneself and ones parents, and other equally ridiculous speculations such as describing supportive families as suffering “Munchausen by proxy.” The Evanses themselves were later outright condemned by the general board of the Polish Sexological Society for their extremist views. Susan Evans would later go on to help found the Gender Exploratory Therapy Association (GETA) in 2022. The “gender exploratory therapy” advocated by this group has proven popular among NHS Trust leadership despite being regarded as attempts at conversion therapy.

Other key personnel have similar prior activity. SEGM’s current treasurer, Stephen Beck, is a high-ranking medical officer at the Catholic hospital Bon Secours Mercy Hospital—the fifth largest Catholic hospital in the United States—and has a long history of collaborations with homophobic and transphobic NCBC fellows, including Paul Hruz. A retrospective on Beck’s career is detailed in an investigative report by trans health writer Zinnia Jones. Meanwhile, Julia Mason was making a name for herself as an anti-trans pediatrician. According to her Twitter bio, Mason claims she was “pulled into the pediatric transgender dilemma” in 2018. This led to her drafting a post for KevinMD.com in 2019, using four unverified anecdotes of trans youth she saw at her practice. KevinMD.com, founded and edited by physician media commenter Kevin Pho, has been under fire before for publishing a fake article from a pseudonymous surgeon without verifying its facts. The author later recanted and said it was fictional (despite originally being presented as nonfiction), and Pho ultimately retracted the article and claiming to have “learned from the experience”. While Mason has not recanted her own accounts, her post attracted comments from self-labeled pseudonymous clinicians comparing being trans to a delusion or Munchausen by Proxy, with one (”Drbedbug”) encouraging her and her readers to look into American College of Pediatricians.

Since then Mason has gone full throttle against gender affirming care for trans youth. After co-founding SEGM, she became one of the contacts for quotes representing SEGM and would testify defending trans-eliminationist infiltration from Women’s Declaration International into the Georgia Green Party. By 2022 she joined forces with Leor Sapir from the Manhattan Institute, targeting both Jack Turban and the American Academy of Pediatrics (AAP). Mason, with Sapir, claimed that the AAP was “captured” and blocking comment on a proposed resolution by unnamed “members”—later revealed to include Mason herself as part of SEGM.[2, sec. 1:06:06-1:07:24] The publication with Sapir made its way through the Heritage Foundation as part of their push against all gender affirming care. She also joined Genspect as an advisor, which similarly joined the push against the AAP in an open letter cosigned by SEGM member Stephen Levine, where she writes their Ask Dr. Julia column.

As such, even prior to officially incorporating themselves as SEGM, these figures were already influential opponents to youth access to transgender care in spite of the medical and scientific consensus. Even before they formally organized as SEGM, the connections to long-standing hate groups and right-wing religious lobbying organizations were already present. And while they only officially incorporated as SEGM in January of 2020, they began organizing (and fundraising) under that name as early as 2019—indeed, the first mention of an organization calling itself “SEGM” that we could obtain stemmed from Stephen Beck (representing SEGM) submitting a comment to the Trump Administration in support of removing trans people from coverage under section 1557 of the Affordable Care Act as Republican-led states flooded their legislatures with anti-trans bills in 2019. In recent years, experts have gone so far as to explicitly compare SEGM’s motus operandi to NARTH in published commentaries—outright ridiculing their propositions and conclusions in the process.

Since then, SEGM’s membership has worked to produce, publish, finance, and distribute papers in scientific journals so as to manufacture a case against any kind of transition (even social transition) for trans youth. They maintain a website which purports to educate about the existing literature on gender-affirming care, while in reality either promoting their own papers, promoting unsubstantiated pseudoscience like rapid-onset gender dysphoria, or (at best) offer selective and decontextualized analyses of papers to support SEGM’s stance. Multiple reports from Yale School of Medicine have identified SEGM’s deliberate misrepresentations and their application within American attempts to ban care for trans youth.[3, 4]

Both SEGM-affiliated publications and SEGM’s actual website have been referenced to support attempts to legally ban, or even criminalize, youth access to transition-related care in the United States. Texas Attorney General Ken Paxton specifically referenced them twice in his Attorney General opinion on whether gender affirming care for trans youth legally constitutes child abuse.[5] Florida references multiple SEGM-affiliated publications in their guidance “Treatment of Gender Dysphoria for Children and Adolescents.” Their “independent” review by Romina Brignardello-Petersen and Wojtek Wierchioch,[6] hired by the Florida Agency for Health Care Administration, argues that social and medical transition for trans youth should be replaced by counseling[7, para. 4] and that current studies about quality of life following medical transition are invalid because “there are no randomized controlled trials, well-conducted comparative observational studies, or very large case series”[6, p. 5] in the review pool. There are, of course, two key problems here: first, randomized controlled trials are impossible for puberty blockers and hormone replacement therapies. The patient would notice if puberty started. Second, Romina Brignardello-Petersen is either a member of SEGM, or a close affiliate, as implied by the acknowledgments section of this commentary.

SEGM (or their members) have filed briefs or expert testimony for high-profile trans rights cases such as Brandt v Rutledge in Arkansas,[8] D.H. et al v Snyder in Arizona,[9] and Kadel v Folwell in North Carolina,[10] or have been cited by GOP states in favor of legislation that would criminalize providing gender affirmative care.[11] One member and commonly cited author, Stephen Levine, also served as an expert witness in the Bell v Tavistock case in the United Kingdom that was later overturned on appeal. SEGM membership has also campaigned against legislation to ban conversion therapy, and suggest that conversion therapy cannot be applied as a term to describe attempting to make trans children grow up cisgender.

Activities at this scale require significant funding—even with the large sums these “experts” are evidently paid by Republican administrations.

For example, the open-access fee for a review paper based in the United States published by the Journal for Sex and Marital Therapy (a popular choice by SEGM) is $2,885, before taxes, for a single paper. Another popular choice—Archives of Sexual Behavior, operated by Kenneth Zucker—lists their open access fees as $2,890 before taxes. Open access fees for other journals can be as high as $4,000 USD—to say nothing of the costs involved with their other activities. Filings such as the SEGM amicus brief in D.H. et al v Snyder also incur their own costs, such as attorney fees—to say nothing of the sheer travel and logistical costs involved with SEGM’s globe-trotting.

Mallory Moore, an investigative researcher at Trans Safety Network, drew attention to SEGM’s finances by highlighting SEGM’s attempts to crowdfund their operations. The GoFundMe in question was created on December 14th, 2019—shortly before SEGM was formally incorporated. According to Trans Safety Network, the vast majority (69.96%) of the $83,616 they raised from 148 total donors came from just three anonymous donations totaling $58,500 around August-September of 2020. Further investigations also placed the large, anonymous donations reported by TSN within the context of a pressure campaign against a 2019 research paper by Richard Bränström and John Pachankis on mental health following gender affirming surgery, forcing a correction by the journal. Excluding these three undisclosed large donors, the average contribution to this GoFundMe was just $166.15. The GoFundMe in question never met its goal of $150,000, despite its final donation occurring on August 15th, 2022 (meaning it ran for nearly two years).

Attorneys have also raised questions regarding SEGM’s finances. In B.P.J. v West Virginia State Board of Education, attorneys from Cooley LLP deposed Stephen B. Levine, a frequent author of SEGM-backed work. He was solicited for an expert report for the defendants as a counter against medical experts for the plaintiffs, arguing that trans girls shouldn’t be allowed to play on girl’s sports because “social transition of children is an experimental therapy that exposes vulnerable children to dangerous lifelong physical, social, and mental health risks”.

His representative—Roger Brooks of Alliance Defending Freedom (ADF), itself a notorious anti-queer hate group directly responsible for overturning Roe v. Wade—took great pains to prevent Levine from revealing too much information regarding SEGM’s finances.

HARTNETT (Cooley LLP): Do you know where SEGM receives its funding from?

LEVINE (SEGM): I believe that — that the hundred or so people that are, quote, members contribute something, but it’s something as modest, perhaps, as I gave, $200. There must be a large donor or set of donors. And the answer to your question is I don’t know the answer.

HARTNETT: Is there someone at SEGM that you think would know that answer?

LEVINE: Yes.

HARTNETT: Who is that?

BROOKS (ADF): Objection.

LEVINE: There are several people. May I answer that question?

BROOKS: You may answer.

LEVINE: Stephen Beck, Dr. Stephen Beck, and Ema Zane, E-M-A Z-A-N-E.

BROOKS: And, Counsel, we will designate the testimony about finances of SEGM as confidential. [12, p. 105-106]

Ignoring for the moment how inherently suspicious that is, given that SEGM’s finances are required to be public information under tax laws, it would appear that the $100,000 “charitable gift” the Edward Charles Foundation gave to SEGM qualifies as one such “large donor” that Levine suggests must exist. While the exact time at which this donation occurred is impossible to determine, it is clear that this “gift” occurred during the time period in which SEGM’s initial GoFundMe—which had generally poor outcomes, distribution, and attention—was already active and SEGM was already being cited in legislative and court proceedings.

The immediate question one is left with is…

What is the Edward Charles Foundation?

According to their website, “Edward Charles Foundation is an independently audited, IRS approved 501(c)(3) tax-exempt organization, classified as a public charity able to operate both fiscal sponsor funds as well as donor advised funds. We help educate our clients on each of the types of funds and handle all of the compliance, fiscal and fiduciary obligations associated therewith.” The Edward Charles Foundation (ECF) functions to “[assist] changemakers including donors, philanthropists, funders, charity founders, social entrepreneurs, executives and corporations in establishing legal and compliant charitable funds to do good and have maximum impact.”

To paraphrase for those unfamiliar with non-profit jargon, ECF essentially acts as a startup funder and logistics operator for other non-profits. It provides funding, support, labor, and various other services through case-by-case arrangements with “changemakers” looking to start new non-profit ventures.

Their most advertised and encouraged function is to act as a “fiscal sponsor.” Typically, a fiscal sponsor allows projects to operate as a non-profit and gather tax-deductible donations without filing the paperwork for incorporation with their state government or the IRS, instead using the tax status of their sponsor. ECF advertises (and promotes) such fiscal sponsorship arrangements (and often promote projects that they back, which often disclose such a relationship, such as this one). See also: their advertisement of their services. ECF advertises itself as one of just 4-5 foundations registered to be a fiscal sponsor in all 50 states, allowing them to jumpstart projects “in less than one week”. ECF claims to have “incubated over 250 charitable projects” since it was founded and “overseen and administered over 400 charitable initiatives”.[13] They also offer “accelerate & incubate” courses that train enrollees on how to build social capital and build professional relationships.

ECF does indeed have a storied history, according to its public-facing tax documents available through ProPublica. Its 990 forms (dating back several years) show vast numbers of contributions and charitable gifts; however, in its listing on FiscalSponsorDirectory.org, the ECF states that it has only sponsored 60 projects, and describes the fee for fiscal sponsorship thusly: “Variable start-up fee plus 10% on the first $250,000; 5% on the next $750,000; 4% on $1 million or more.” It also notes that Eligibility Criteria include a minimum budget, “aligned” mission values, and “must feel that leaders and mission have merit.” As such, there appears to be a distinction made between projects that ECF acts as a fiscal sponsor for, and projects it merely “incubates,” “oversee[s],” or “administer[s].” Nevertheless, when ECF does act as a fiscal sponsor, those terms clearly incentivize ECF to bet on missions that they believe can grow and snowball over time: the bigger the project gets, the bigger the return for ECF.

When such relationships do occur, they can take on multiple forms. The options ECF provides are described as “Model A, Direct Project” and “Model C, Preapproved Grant Relationship.” Model A (”Direct Project”) financial sponsorships are common arrangements for new non-profits, and involve the fiscal sponsor effectively considers the recipient part of its own arrangements, and thus is responsible for its activities and liabilities. This is often used when the new non-profits or charities are very new and have no structure of their own. Model C (Preapproved Grant Relationship) typically involves less risk and less responsibility on the part of the fiscal sponsor, and is done within the context of one charity supplying funds and donations as a grant or “re-grant” to the other party. If an organization already has an explicit structure (and is formally incorporated) this is usually the model used.[14] Oftentimes, ECF operates donation pages for its clients through the donor management platform Network For Good, which they integrate into client dashboards.

When ECF serves as a fiscal sponsor, the terms are currently unknown. While they have previously posted blog posts discussing what terms and fee rates could look like for projects working with a fiscal sponsor, ECF does not have their own terms and fee rates available in an easy to find location on their website.

The projects that ECF sponsors in this capacity are varied. While there is no official list that we can find, their Instagram highlights several. One which they repeatedly highlight is Women Who Tech, which is trans-inclusive (to a point; their language potentially hedges out AMAB enbies, even if femme). Other examples included “Your Mom Cares,” a mental health advocacy organization, and the better-known Dr. Brandt Foundation. Notably, some of these arrangements (the Dr. Brandt Foundation and Women Who Tech) are not present in their Form 990 Tax Documents, but others are, which are reported as a “charitable gift” (e.g., Your Mom Cares).

ECF’s tax documents from the same year as their donation to SEGM also reveal several large donations,[15] such as:

In terms of where ECF’s own money comes from (given that they, themselves, are a 501(c)(3) non-profit), their sources are varied, but quite notable. Indeed, ECF notes this as a selling point on their website: they list the W.K. Kellogg Foundation, the Ford Foundation, the Bill and Melinda Gates Foundation, and the Silicon Valley community foundation, among others, as current or former funders. Indeed, ECF notes receiving a multi-million dollar grant from the Bill and Melinda Gates Foundation, stating on Instagram that they are “proud to work with one of the top Silicon Valley Incubators to assist start up companies and act as the 501(c)(3) umbrella for newly created charitable and social enterprises”, though the year of the grant is unknown. In 2017, the W.K. Kellogg foundation awarded them a million dollars that year alone for “implement[ing] the Truth, Racial Healing and Transformation principles in children and youth programs in Los Angeles, Cleveland, Chicago, and Syracuse through a collaboration with four high profile sports family foundations to gain support and traction in the entertainment, media and journalism sector.”

However, these are not the sole source of money for ECF. In that same year (2017) ECF received a grant from the National Christian Charitable Foundation (NCCF) for $450,000 for, direct quote, “growth.” With an annual revenue averaging $1.5-1.8 billion, the NCCF is one of the largest donors to religiously motivated American hate groups. It’s infamous. Reporters from the Atlanta Journal-Constitution described NCCF as “one of the most influential charities you’ve never heard of”, noting that “many of NCF’s grants have gone to nonprofits that are immensely influential on the right, shaping some of the policies embraced by the Trump administration.” They have been criticized for distributing over $56 million to 23 different organizations designated as hate groups by the Southern Poverty Law Center between 2015 and 2017, using a gifting model that allows donors to allocate cash, stock and land contributions to NCCF for anonymous distribution to organizations via grants. One of those groups is Alliance Defending Freedom (ADF). In the same year it gave ECF $450,000, it gave the ADF nearly seventeen million dollars.[16] In a similar vein, a routine source of money for ECF is the American Endowment Foundation. The American Endowment Foundation donated to both the ADF and ECF in 2017,[17] as well as several Christian organizations and universities. Come 2020 American Endowment Foundation donated another $41,000 to the ECF, along with $42,600 to the ADF.[18]

That ECF saw no problem taking money from either National Christian Charitable Foundation or American Endowment Foundation is revealing. This doesn’t necessarily mean that the Christian Right used the ECF to launder funding for SEGM—there’s no evidence of that at present. What it does suggest, however, is that ECF doesn’t particularly care about where its money does come from.

As such, ECF effectively operates as facilitator for new non-profit ventures, while also donating sums of money to a number of causes and organizations. It routinely receives donations from large philanthropic foundations, including religious ones. It must be noted that while the foundation does not object to sharing funding sources with far-right, religious extremist organizations and outright hate groups, they only took money from the NCCF once—and did so several years before SEGM itself existed. Yet, that is part of where their money comes from.

What’s the Deal Between SEGM and Edward Charles?

Given all this information, one is left with a handful of questions regarding the exact nature of the $100,000 that the Edward Charles Foundation (ECF) allocated to SEGM as a “charitable gift.” Sadly, it’s completely unclear what relationship exists between the two organizations, and how they came to be associated in the first place. The descriptor of “charitable gift” is also given to funds allocated to Your Mom Cares, an organization which is explicitly in a fiscal sponsorship arrangement with Edward Charles. However, some of ECF’s clients who are explicitly in such relationships aren’t anywhere to be seen in ECF’s 990 Schedule I. Indeed, Women Who Tech doesn’t show up on ProPublica at all. Women Who Tech discloses on its website that they are fiscally sponsored by the Edward Charles Foundation. They also disclose this on their donation page. Other organizations known to be in a fiscal sponsorship arrangement with ECF (e.g., the Dr. Brandt Foundation) are similarly not found.

It’s unclear what, if anything, this means. It’s entirely possible that the ECF simply gave Your Mom Cares a charitable donation on their own terms, donating a set amount to one of their own clients. It’s also possible that, for some reason, their arrangement with Your Mom Cares differs from these other arrangements.

What’s even more unclear is whether SEGM is in any type of fiscal sponsorship arrangement with Edward Charles Foundation. If they are, why is it not stated on SEGM’s website? If they are not, then that simply raises the question of why ECF inexplicably gave $100,000 to a then-new organization after that organization had wholly failed to crowdfund their activities? We don’t know, and can’t infer that from the available data.

Timeline: SEGM’s Funding and Spending

SEGM’s reported income is sizable for a new organization and with rapid growth. According to the Exempt Organizations Master File from the IRS,[19] SEGM reported $126,654 in assets and $199,566 in income for 2020. For 2021, SEGM reported $769,095 in assets and $793,975 in income, a growth of nearly 300%. However, we don’t have access to SEGM’s 990s. Those statistics are gross (not net) figures, nor do they report what the money is used for. For hard numbers on SEGM’s net income or what they’re spending it on, such as amounts going to open access fees or contracts, we’d need access to their 990s.

What we can infer is where SEGM’s energy is going, including possible costs, using a few comparisons from what information is available on SEGM’s finances, the publications that they’re known to have published and/or funded, and coordinated actions they’ve been involved with.

To get a better sense of SEGM’s funding and how it’s used, we have constructed a rough timeline of everything known about their activities, finances, papers, and campaigns.

Note: Not all hard dates are known. Estimates are given where necessary. Fiscal years are broken down by fiscal cycles for Edward Charles Foundation (ECF), which begins every June, so as to better place the grant issued by ECF to SEGM and SEGM’s initial activities.

Fiscal year 2019 (June 2019 – June 2020)

A brief year, SEGM spent the majority of this time period working on the logistics of founding the organization, creating a web presence and gathering donations, with just one lobbying campaign. Curiously, their one lobbying campaign for this period occurred before SEGM officially existed.

Table 1: Donations to SEGM by SEGM leaders in their first month (Dec 2019)

DateNameAmountPosition
2019-12-22 12:22:31-06:00Stephen Beck$400Director (2020), Treasurer (2021 - present)
2019-12-18 00:54:05-06:00Julia Mason$250Director (2020 - present)
2019-12-17 17:10:46-06:00Avi Ring$200Advisor (2020 - present)
2019-12-16 22:54:27-06:00Will Malone$200Secretary (2020 - present)
  • January 27 2020: SEGM formally incorporated as a nonprofit corporation in Idaho. At the time they listed their founding directors as William Malone, Julia Mason, and Marcus Evans.
  • January 23 2020: SEGM’s GoFundMe received another anonymous donation of $1,000.
  • March 2020: SEGM’s website was live. At this point it was mostly made up of a splash page with medical disinformation, an About Us page, and a large footer soliciting donations. They noted by their GoFundMe that they “are currently forming a 501(c) nonprofit. Your donation may be tax-deductible.”
  • March 1-11 2020: With the release of their website, SEGM received a boost of smaller value donations after a dry spell.

Fiscal year 2020 (June 2020 – June 2021)

After their initial launch in late 2019, SEGM’s activities (and therefore income) ramped up. During 2020 and 2021 they received both their “gift” from the Edward Charles Foundation and the three anonymous five-figure donations reported on by Trans Safety Network. During this period, they published a number of letters-to-the-editor, commentaries, blog posts, Twitter threads, and began populating their website—all in collaboration with figures from right-wing groups like ACPeds and NCBC. They also began being cited by the press much more commonly.

  • Some time between June 2020 and June 2021: SEGM received $100,000 from Edward Charles Foundation (ECF) as a “charitable gift”.[15]
  • June 2020: Donations to SEGM’s GoFundMe picked up again, including another $1,000 anonymous donation on June 29.
  • July 21 2020: SEGM advisor Richard Byng published “Sex, gender and gender identity: a re-evaluation of the evidence” alongside Lucy Griffin, Katie Clyde, and Susan Bewley in the BJPsych Bulletin via open access. Within they not only repeat misinformed and long-debunked claims about desistence rates, but insinuate that adolescents presenting for gender dysphoria aren’t really trans, but rather their transness results from underlying mental health problems, going so far as to claim that youth access to gender-affirming care represents a form of gay conversion therapy without direct citations. The paper draws loose connections to a detransition community survey on Tumblr done by Cari Stella in 2016, which they describe as “mainly young women who have rejected their trans identities and are reconciling with their birth sex”, while failing to address that 62.9% of respondents said that they stopped their transition for “Political/ideological concerns”—the highest of any of the answer options—or that the survey was recruiting participants through a hashtag for radical feminism. While the second highest response was “Found alternative ways to cope with dysphoria”, a former participant in the survey has since shared how she would actively suppress their dysphoria using radical feminism—drawing direct connections to conversion therapy with serious mental health consequences like thoughts of suicide, dissociation, feelings of violation, and self-destructive coping methods like addiction and self-harm. Said paper also fundamentally embraces gender essentialism, objects to the concept of non-binary identities in principle, and outright describes being transgender as a “state of mind with multiple causative factors,” on the basis of the dubious and outdated desistence research that they cite—leading them to conclude by suggesting banning conversion therapy on trans youth is anti-gay conversion therapy.
  • August 1 2020 (a): SEGM director William Malone and advisor Sven Román published the Letter to the Editor “Calling Into Question Whether Gender-Affirming Surgery Relieves Psychological Distress” in the American Journal of Psychiatry with open access, responding to “Reduction in mental health treatment utilization among transgender individuals after gender-affirming surgeries: a total population study” by Richard Bränström and John Pachankis based out of Sweden. At no point did any of the SEGM membership on these letters disclose their affiliation, or funding for open access fees (if applicable). The substance of this collective letter writing campaign objected to an overstatement in the conclusion of the original paper—that statement being “the longitudinal association between gender-affirming surgery and lower use of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.” To be clear, this was a fair criticism: the methodology of the study and the practicalities of its design did, in fact, proscribe so firm a statement—which the authors revised in a correction to the article (see below). Indeed, the authors agreed in principle with many of the points made. This particular letter by Malone and Román is factually correct. Rather, it’s their suggestions for improvement that were illogical and impractical for actual research. For example, they argue that, “[l]oss to follow-up, death from suicide of the most psychologically distressed individuals, or death from cardiovascular disease, all known to be increased in the transgender population, could have falsely skewed the ≥10-year data. Comparisons with a control group would be best to answer these questions,” raises the logistical question of what a control group would even look like. Bränström and Pachankis discuss such problems in their response to the letter campaign when making a statement on correction (see entry August 1 2020 (e)).
  • August 1 2020 (b): William Malone and Avi Ring, another SEGM advisor, published the Letter to the Editor “Confounding Effects on Mental Health Observations After Sex Reassignment Surgery” in the American Journal of Psychiatry with open access, again in response to Bränström and Pachankis. Malone and Ring claim that “accounting for the increase in mental health issues from 2005, together with an assumption of increased mental health treatment due to this surgery, fits the data in the article and overturns the authors’ conclusions, suggesting that sex reassignment surgery is in fact associated with increased mental health treatment”.[20, para. 4] They reference two sources for this argument: the book The Coddling of the American Mind by Jonathan Haidt and Greg Lukianoff and the paper “Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development” by Riittakerttu Kaltiala-Heino, Maria Sumia, Marja Työläjärvi and Nina Lindberg. The Coddling of the American Mind, which argues that the real reason why college students are depressed is because of identity politics and trigger warnings, has been criticized by reviewers for coddling their own minds in the comfort of TED Talks, think tanks and CBT worksheets instead of addressing the economic collapse and anti-Black racism that gave rise to student-led justice movements. Kaltiala-Heino’s paper “Two years of gender identity service for minors”, meanwhile, is a foundational paper for the insinuation that transmasculine youth aren’t really trans, they just have “unrelated” mental and psychiatric problems that make them think they’re trans. Malone, Ring, and Kaltiala-Heino et al. all ignore that the paper can’t actually determine whether psychopathology pre-dated their cross-gender identification, or that the “epidemiological expectations” the authors compared their rates to stemmed from a reference admitted by its own authors in the text to be speculative, based on inadequate evidence and noted in the text that the figures Kaltiala-Heino cite stem from data recorded between 1958 and 1968.[21] As with “Calling Into Question” by Malone and Román, neither Malone or Ring disclosed being with SEGM or how the article’s open access was funded.
  • August 1 2020 (c): Henrik Anckarsäter, yet another SEGM advisor, published a third Letter to the Editor (”Methodological shortcomings undercut statement in support of gender-affirming surgery”) in response to Bränström and Pachankis, also with open access. He did not disclose his relationship with SEGM or the funding for the open access fee.
  • August 1 2020 (d): ACPeds members and occasional SEGM collaborators Andre van Mol and Michael K. Laidlaw (a PAGDWG alumnus) also co-authored a letter to the editor alongside infamous homophobes Paul McHugh (who also gained “fame” as an expert witness in defense of pedophile priests) and Miriam Grossman, a known conversion therapy advocate who formerly worked with NARTH. This letter also criticized a lack of control groups and limited longitudinal timeframes.
  • August 1 2020 (e): A correction of “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries” was issued by the editors at the American Journal of Psychiatry, which claimed that “some letters containing questions on the statistical methodology employed in the study led the Journal to seek statistical consultations. The results of these consultations were presented to the study authors, who concurred with many of the points raised. Upon request, the authors reanalyzed the data to compare outcomes between individuals diagnosed with gender incongruence who had received gender-affirming surgical treatments and those diagnosed with gender incongruence who had not.” Bränström and Pachankis, in their response, cite 7 Letters to the Editor pushing for a correction, including one by Christian Right “experts” associated with American College of Pediatricians.[22, p. 21-23, 44-45] This raises the question of a pressure campaign, which neither the authors or editors address. However, the response from the authors is worth reading in its entirety—as it highlights that while the study itself was flawed, and the original article did overclaim, the corrected study still lends support for gender-affirming treatment (albeit with many limitations to its evidence).
  • August 4 2020: SEGM published their first tweet thread, centered on the pressured corrections to “Reduction in Mental Health Treatment Utilization” and pushing for Medscape to change their reporting and continuing education credit training for clinicians. Within the thread SEGM revealed that their members or advisors were authors of three of the seven Letters to the Editor issued during the campaign.
  • August 12 2020: The first press article citing SEGM was published in The Australian by gender critical journalist Bernard Lane, citing the pressure campaign against the paper by Bränström and Pachankis. Lane refers to SEGM as a “new watchdog group”.
  • August 28 2020: SEGM received a $20,000 anonymous donation.[23]
  • August 30 2020: SEGM published their first post on their website, “Correction of a Key Study: No Evidence of “Gender-Affirming” Surgeries Improving Mental Health”, also centered on the 2019 study by Bränström and Pachankis. Despite not disclosing their affiliation in the Letters to the Editor, SEGM does claims credit for some of the pressure on the editors for a correction: “After the study was published, many researchers and scientists (including some SEGM advisors) alerted the AJP to multiple serious methodological problems that challenged the study’s conclusion.”[24, para. 4] In the post they do not disclose that SEGM advisors or directors were involved in three of the seven Letters, that one of those “advisors” was founding director and secretary William Malone, or that Malone was lead author of two of the seven Letters. Similarly they don’t address the limitations of their own sources used in said Letters despite their pointed criticisms of Bränström and Pachankis.
  • August 31 2020: SEGM received a second $20,000 anonymous donation.[23]
  • September 22 2020: SEGM received a third large anonymous donation, this time $18,500.[23]
  • October 21 2020: Roberto D’Angelo, Ema Syrulnik, Sasha Ayad, Lisa Marchiano, Dianna Theadora Kenny, and Patrick Clarke published the Letter to the Editor “One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria” in Archives of Sexual Behavior with open access. The Letter targets “Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults”, published in September 2019 by Jack Turban, Noor Beckwith, Sari Reisner, and Alex Keuroghlian. D’Angelo et al. argue that the study is invalid because Turban et al. didn’t use a stringent definition of gender identity conversion efforts that focused on coercion (while, ironically, asserting that studies finding low rates of transition regret are invalid because their definitions of transition regret were too restrictive). All authors of “One Size Does Not Fit All” are listed as being affiliated with SEGM, though they do not disclose any funding or acknowledgments.“One Size Does Not Fit All” becomes one of SEGM’s landmark publications, being frequently cited in expert reports defending the Texas administration’s investigations of trans youth and Florida’s ban on Medicaid coverage for gender affirming care, propaganda opinion articles such as those in Newsweek, and plants into medical resources like WebMD and Medscape. Medscape and WebMD have been criticized for misleading readers with a mixture of poor quality sources and sponsored content from the pharmaceutical industry. As of January 26 2023, the Letter has been accessed over 67,000 times, ranking at #1 in the Archives of Sexual Behavior among all of their papers published in 2021.
  • November 12 2020: Following the pressure from SEGM, Medscape retracts their 2019 article on the study by Bränström and Pachankis.
  • November 16 2020: SEGM published a blog post about Turban et al’s paper and their own Letter to the Editor “One Size Does Not Fit All”. The blog post quickly re-iterates the point of the letter, while claiming that Turban et al.’s paper provides “the study provides no credible evidence that either psychological distress or suicide attempts (which are present at elevated rates in gender dysphoric individuals), are a result of ethical psychotherapy,” which relies upon a very skewed conception of “credible” and “ethical,” given that SEGM also considers hearsay from parents of trans youth to be credible evidence in other posts on their website. As in their paper, they insinuate that continued mental health struggles in trans populations are evidence that transition procedures aren’t effective or life-saving, ignoring that constant exposure to transphobia might exacerbate and maintain these struggles.
  • December 3 2020: SEGM released their position statement on the initial ruling in the UK Bell v Tavistock case, claiming that the United Kingdom courts had ruled puberty blockers as “experimental”. They reinforce this with claims that reviews from Sweden and Finland also found puberty blockers to be experimental, citing and linking to large documents in Swedish and Finnish that the majority of readers won’t be able to read, and without context for their health care systems, official English translations (which do not use the phrase “experimental” and still note pathways for the use of puberty blockers for trans youth), or page numbers for claim verification for people who can read the documents. They also claim that the correction to “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries” by Bränström and Pachankis ultimately found no long-term mental health benefit of gender affirming surgery. This is true in the sense that the authors couldn’t causally associate gender-affirming surgery with long-term mental health benefits; however, such an account omits the detail that “the odds of receiving mental health treatment in 2015 were reduced by 8% for every year since receiving gender-affirming surgery over the 10-year follow-up period.” Practically speaking, a reasonable reader might infer that (at bare minimum) this constitutes evidence that gender-affirming surgery might be implicated in the improvement of mental health. It’s also objectively true that even after gender-affirming surgeries, the participants had worse mental health compared to the general Swedish population—which the authors attribute both to a need for structural changes (e.g., protections from violence and discrimination) and psychological care for transgender Swedes. SEGM does not engage with these considerations, and ignores that even with the (important) caveats their letters to the editor raised, the evidence still supports treatment. Nor did SEGM issue a correction or new statement when the initial Bell v Tavistock ruling was overturned in the UK Court of Appeals. As a result, the current version has been circulated in amicus briefs by Christian Right organizations[25] and social media after the ruling was overturned without noting as such. The statement was signed by all SEGM board members, with Roberto D’Angelo being listed as President. Curiously, Stephen Beck was listed as a Director despite the paperwork adding him not being filed yet (see entry January 14 2021).
  • December 19 2020: SEGM released their 2020 end-of-the-year review. Claiming over 120 members since their founding, SEGM claimed success in “impact[ing] the quality of scientific discourse regarding treatments for gender-dysphoric young people.” They do this by having “established a thriving online collaboration space, with a number of researchers evaluating the current evidence basis, writing research papers, and engaging with medical societies.” They also announced their 2021 goals, including drafting “practice guidance” and their targeted campaigns towards medical associations, researchers, and policy makers, which they stated takes “significant resources”. Beyond linking to their donate page, they did not disclose where said “significant resources” has historically come from.
  • January 14 2021: SEGM filed their first annual report to the Idaho Secretary of State. Two new board members were added: Roberto D’Angelo (President) and Stephen Beck (Treasurer).
  • March 10 2021: SEGM was granted 501(c)(3) tax-exempt status from the IRS, backdated to their incorporation on January 27 2020. The determination letter notes requiring SEGM to file a Form 990, 990-EZ, or 990-N. As of January 26 2023, the IRS has not released any 990, 990-EZ, or 990-N for SEGM.
  • Some time after March 10 2021: The IRS Exempt Organizations Master File was updated to include SEGM’s EIN, the determination date for 501(c)(3) status, and their 2020 assets ($126,654) and income ($199,566).[19]
  • March 27 2021: SEGM directors William Malone, Julia Mason, and Stephen Beck published the Letter to the Editor “Proper Care of Transgender and Gender-diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective” alongside Paul Hruz of American College of Pediatricians (ACPeds) and National Catholic Bioethics Center (NCBC) in the Journal of Clinical Endocrinology & Metabolism with open access. Beyond his connections to ACPeds, Hruz has also spoken on behalf of the Heritage Foundation and Alliance Defending Freedom. None of the authors disclosed their affiliations.
  • April 26 2021: Michael Biggs published the Letter to the Editor “Revisiting the effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria” in the Journal of Pediatric Endocrinology and Metabolism via open access, responding to a 2019 publication by Tobin Joseph, Joanna Ting, and Gary Butler about long term findings of puberty blockers and impact on bone mineral density. Similar to the August 2020 Letters to the Editor published by William Malone, Avi Ring, and Sven Román, Biggs points to random data points that he claims leads to the opposite conclusions than Joseph, Ting and Butler found. Biggs does not disclose being an advisor to SEGM or who funded the open access fee.
  • May 25 – June 29 2021: SEGM received a series of GoFundMe donations after another dry spell.

Fiscal year 2021 (June 2021 – June 2022)

SEGM members continued to publish commentaries and letters to the editor during this period, while also publishing a handful of actual academic papers. Members also got involved in a pressure campaign against the American Academy of Pediatrics (AAP).

  • August 9 2021: SEGM published the blog post “The AAP Silences the Debate on How to Best Care for Gender-Diverse Kids”, detailing their attempts to secure an exhibitor table at the 2021 American Academy of Pediatrics (AAP) conference in Philadelphia. To secure the table, SEGM director Julia Mason recounted in a 2022 speech how SEGM had paid AAP $2,500.[2, sec. 1:08:43-1:09:33] The table was denied by the AAP, which Mason tried and failed to appeal (though the in-person conference was ultimately cancelled due to the pandemic). Within the blog post they also reference a resolution submitted to the AAP (”Addressing Alternatives to the Use of Hormone Therapies for Gender Dysphoric Youth”) that they claim was stifled by the AAP leadership despite “over 80% of AAP members giving feedback on the resolution […] signif[ying] that they supported the resolution.” Later it would be revealed by Mason that she drafted this “resolution” as part of SEGM’s strategy to “push back” against gender affirming care.[2, sec. 1:06:06-1:07:24]
  • September 1 2021: SEGM directors William Malone, Roberto D’Angelo, Stephen Beck, Julia Mason, and former director Marcus Evans published the comment “Puberty blockers for gender dysphoria: the science is far from settled” in the The Lancet Child & Adolescent Health. All authors disclose themselves as “board members of the Society for Evidence Based Gender Medicine”.
  • September 15 2021: Stephen Levine published “Reflections on the Clinician’s Role with Individuals Who Self-Identify as Transgender” in the Archives of Sexual Behavior. He does not disclose his affiliation with SEGM and claims no funding or organizational support. Originally the article is released online without open access.
  • September 30 2021: SEGM created a second GoFundMe (archive) connecting their 501(c)(3) status to PayPal Giving Fund. At the time, their first GoFundMe was still active and receiving donations.
  • October 6 2021: A correction was issued on “Reflections on the Clinician’s Role”, noting that Levine has opted in for open access.
  • November 1 2021: Stephen Levine’s “Reflections on the Clinician’s Role” was re-released via open access. The re-released article does not disclose who paid for the open access fee.
  • November 30 – December 2 2021: SEGM received a wave of donations to their second GoFundMe on and following Giving Tuesday, an annual fundraising day for nonprofits. Most donations follow typical Giving Tuesday fundraising patterns, with one anonymous $1,000 donation.
  • December 9 2021 – January 15 2022: The wave of higher value donations to their second GoFundMe kicked up, with 10 out of 24 (41.6%) being $500 or more (the majority being anonymous). Three—all anonymous—were for $1,000 each.
  • December 17 2021: SEGM filed their second Annual Report to the Idaho Secretary of State, removing Marcus Evans from the board of directors.
  • December 22 2021: Alison Clayton, William Malone, Patrick Clarke, Julia Mason, and Roberto D’Angelo published the commentary “The Signal and the Noise—questioning the benefits of puberty blockers for youth with gender dysphoria—a commentary on Rew et al. (2021)” in Child and Adolescent Mental Health with open access. In the Acknowledgments, the authors state that the open access fees were paid for by SEGM and that they received no “external” funding. They also thank several SEGM members—giving Romina Brignardello-Petersen, Michael Biggs, and Ema Syrulnik shoutouts by name—for “providing access to several experts who helped shape this commentary and ensure its accuracy”. The commentary was used by the Florida Department of Health to justify barring gender affirming care for trans youth. Brignardello-Petersen, meanwhile, drafted a report on behalf of the Florida Department of Health alongside Wojtek Wiercioc (see entry May 16 2022).
  • End of December 2021: SEGM submitted their annual 2021 income information to the IRS. They report their annual income as $793,975, a 297.8% increase from $199,566 in 2020.[19]
  • January 18 2022: SEGM advisor Michael Biggs published the Letter to the Editor “Suicide by Clinic-Referred Transgender Adolescents in the United Kingdom” in the Archives of Sexual Behavior via open access. Over time it became a central citation for the claim that the risk of suicide for trans youth is overblown. While Biggs does disclose being an expert witness for the Bell v Tavistock case and several SEGM members he consulted with by name, he doesn’t disclose their or his own affiliation with SEGM or who funded the open access fee.
  • January 19 2022: SEGM published their blog post “Suicide by Adolescents Referred to the World’s Largest Pediatric Gender Clinic” about the Letter to the Editor by Michael Biggs. Despite his lack of disclosure in the Letter, SEGM notes that Biggs is one of their advisors.
  • March 3 2022: SEGM published their blog post “National Academy of Medicine in France Advises Caution in Pediatric Gender Transition”. They include an unofficial translation of a press release issued by the French National Academy of Medicine (Académie nationale de médecine). This is less prestigious an endorsement than it sounds from France because this institution is a holdover from the days of royally charted institutions and has no actual decision-making power; it is a loosely regulated semi-public organization with both public and independent funding and minimal oversight which can be freely ignored or taken under advisement as the actual French Government sees fit. Further, the press release itself was riddled with inaccuracies, false equivalencies, and outright misinformation—a noticeable pattern with this institution, as it also recently engaged in reactionary fearmongering that increasing access to in-vitro fertilization would result in a plague of “fatherless children.” The measure, incidentally, passed, because this institution doesn’t actually make policy. SEGM does not disclose where they obtained the unofficial translation from or how it was funded. The Academy, meanwhile, has since released an official translation.
  • March 8 2022: Joanne Sinai published the Letter to the Editor “Rapid onset gender dysphoria as a distinct clinical phenomenon” in the Journal of Pediatrics in response to “Do clinical data from transgender adolescents support the phenomenon of “rapid-onset gender dysphoria”?” by Trans Youth CAN!. Beyond the study she’s responding to, Sinai’s only other citation is Lisa Littman’s debunked ROGD study. Sinai does not disclose any affiliation with SEGM despite past publications with their members or leadership.
  • March 17 2022: Stephen Levine, E. Abbruzzese, and Julia Mason published the paper “Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults” in the Journal of Sex & Marital Therapy with open access. Under Funding, the authors note that “[t]his work was supported by the Society for Evidence-based Gender Medicine.” In a deposition on March 30 2022 for the court case B.P.J. v West Virginia State Board of Education, Levine describes this paper as “in [the] ballpark” of trying to “create treatment guidelines” in contradiction to current guidelines for gender affirming care.[12, p. 103] In a deposition on April 27 2022 for Fain v Crouch in Virginia, he also confirms that he received a $5,000 grant from SEGM for this publication.[26]
  • March 31 2022: An internal resolution to the American Academy of Pediatrics for their 2022 Annual Leadership Conference (Resolution #27) was drafted. The leaked document was released by Genspect with the co-author names blacked out. Titled “In Support of a Rigorous Systematic Review of Evidence and Policy Update for Management of Pediatric Gender Dysphoria”, the resolution used the disinformation on health care systems in the UK, Finland, Australia, France and Sweden to push for an update to the AAP’s 2018 policy statement on care for trans youth. The resolution relied heavily on Substack articles, publications written by various SEGM members, opinion articles, and references to international medical or regulatory bodies without context on how those health care systems operate. Deanonymization revealed the co-authors to be Julia Mason (SEGM director and Genspect advisor) and Patrick Hunter (SEGM member and Florida Board of Medicine) alongside Sarah Palmer (who had written a previous resolution to the AAP on gender affirming care), Paula Brinkley (Stanford Children’s Health), and Debra Hendrickson. While the authors originally refused or failed to comment, even to journalists, Mason eventually acknowledged her role in drafting the resolution.[2, sec. 1:06:06-1:07:24]
  • April 25 2022: Founding SEGM secretary William Malone requested a meeting with the United States Department of Human Services, challenging the Biden administration’s reversal of Trump’s reversal of nondiscrimination against trans people in the Affordable Care Act. While several attendees do disclose their affiliation with SEGM, other known members do not, including board member and treasurer Stephen Beck and advisor Avi Ring. Other notable attendees include Lisa Littman (representing self), who popularized the pseudoscientific label “rapid onset gender dysphoria”; Riittakerttu Kaltiala (representing self), whose papers on trans adolescent mental health have been used by SEGM and other groups to insinuate that trans youth are neither actually trans nor competent to consent to care due to other existing psychiatric conditions; as well as Patrick Hunter (representing SEGM), who is also a member of the Catholic Medical Association (CMA) and approaches transgender healthcare from the position of Catholic bioethics. Lisa Marchiano and Sasha Ayad, who alongside Stella O’Malley co-founded seven projects or groups promoting “gender exploratory therapy”,[22, p. 28-29] also attended as SEGM members.
  • May 9 2022: Alison Clayton published “Commentary on Levine et al.: A Tale of Two Informed Consent Processes”, one of two solicited reviews of “Reconsidering Informed Consent” by Stephen Levine, E. Abbruzzese, and Julia Mason, in the Journal of Sex & Marital Therapy via open access. While Clayton does disclose being affiliated with SEGM and having co-written with Mason, she doesn’t disclose funding for the open access and claims no funding for the review.
  • May 16 2022: Romina Brignardello-Petersen and Wojtek Wiercioc draft the report “Effects of Gender Affirming Therapies in People with Gender Dysphoria: Evaluation of the Best Available Evidence” for the Florida Agency for Health Care Administration as part of the campaign to stop Florida Medicaid coverage of gender affirming care. The report lists Brignardello-Petersen as having “acted as a research methodologist for several groups and organizations, including the World Health Organization, the Pan-American Health Organization, the Society of Hematologists, the American College of Rheumatology, and the Society for Evidence Based Gender Medicine, among others.”[6, p. 2, emphasis added] Brignardello-Petersen and her co-author Wiercioc include SEGM as a “grey literature source” for their data pool despite it being a new organization with no transparency about their funding, selective sampling of papers, and questionable expertise among its members in providing gender affirming care.
  • May 17 2022: SEGM receives an anonymous donation of $3,000 to their first GoFundMe, which at that point was still active.
  • June 2 2022: The Florida Agency for Health Care Administration (AHCA) released their report on gender affirming care, claiming that they requested a review of generally accepted professional medical standards (GAPMS) for Medicaid coverage. The AHCA report cited SEGM to argue that Sweden was giving trans youth “gender exploratory therapy”.[27, p. 35] As of January 2023, an AHCA employee alleged via email that the report “did not come through the traditional channels and was not handled through the traditional GAPMS process” and that it “does not present an honest and accurate assessment of the status of the current evidence and practice guidelines as I understand them to be in the existing literature.”
  • June 13 2022: Jay Green, a Senior Research Fellow for the Heritage Foundations’ Center for Education Policy, published the report “Puberty Blockers, Cross-Sex Hormones, and Youth Suicide”. Within he relied heavily on SEGM publications or papers from their members.

With the 990 from ECF, 83% of SEGM’s income for fiscal year 2020 has theoretically been accounted for. Assuming that the grant from ECF occurred between June and December 2020, then just over 50% of SEGM’s 2020 income came from ECF, another 29.31% from the 3 aforementioned anonymous large dollar donations identified by Trans Safety Network, and 3.64% from smaller donations (both named and anonymous). For fiscal year 2021, donations via GoFundMe only appear to make up 1.41% of SEGM’s reported income to the IRS. The amount they received via grants and other funding sources during 2021 is currently unknown as the IRS is still processing 990s for 2021.

Table 2: SEGM income sources for fiscal year 2020 and 2021*

Income typeFY 2020FY 2021
Donations$65,761$11,180
Grants$100,000Unknown
Total accounted for$165,761 out of $199,566$11,180 out of $793,975
* Data compiled using SEGM’s two GoFundMe pages and the available 2020 990 for Edward Charles Foundation on ProPublica. Dates for fiscal year 2020 and 2021 are based on calendar year in alignment with SEGM’s annual report and income filings.

 

It must be stressed that these numbers are estimates; since we do not know for sure if the ECF donation came before or after December 2020, and SEGM’s annual income is reported in December instead of in June like ECF’s, it’s possible that the grant applies to SEGM’s 2021 reported income instead of 2020. Similarly, we can’t know what other foundations have donated to SEGM in 2021 since not all of the forms have been processed by the IRS, and we can’t account for donations given through methods other than GoFundMe. More research is needed to generate hard numbers.

Fiscal year 2022 (June 2022 – June 2023)

SEGM’s influence continued to grow to new heights during this time period, and began to much more directly influence (and benefit from) Republican administrations.

  • June 17 2022: Florida Governor Ron DeSantis appoints SEGM and CMA member Patrick Hunter to the Florida Board of Medicine as part of the state’s efforts against youth access to trans healthcare. This represents SEGM explicitly obtaining executive positions in government.
  • July 7 2022: Alison Clayton, Roberto D’Angelo, and Patrick Clarke published the Letter to the Editor “Parental consent and the treatment of transgender youth: the impact of Re Imogen” in the Medical Journal of Australia. Unlike past letters, this one was not released via open access. None of the authors disclose their affiliations with SEGM, including D’Angelo’s status as President.
  • Some time between August 15th and December 30th, 2022: SEGM deactivated their first GoFundMe.
  • August 4 2022: The US Department of Health and Human Services, via the Biden administration, announced another proposed rule change to Section 1557 of the Affordable Care Act to reverse the Trump administration’s removal of gender identity as a protected class against health care discrimination. Request for comment was opened to the public until October 3 2022.
  • August 16 2022: SEGM President Roberto D’Angelo and member Dianna Kenny co-author an updated version of “Managing Gender Dysphoria in Young People: The National Association of Practising Psychiatrists Guide” with the Australian organization National Association of Practising Psychiatrists (NAPP). SEGM member and Letter author Alison Clayton also signed the NAPP guide in support. Joining them is NAPP’s President Philip Morris and Vice President Vivienne Elton. Previously Morris advocated for the use of ivermectin to treat COVID-19 despite the craze being based on bunk science with signs of faked data. In the NAPP guide, the authors include the pressure campaign prompting the correction on Bränström and Pachankis’s 2019 paper and SEGM’s unofficial translation of the French National Academy of Medicine’s statement. D’Angelo, Kenny, and Clayton do not disclose their affiliation with SEGM.
  • August 23 – September 28 2022: Another pressure campaign kicks up against the proposed change to Section 1557 of the Affordable Care Act. Several comments submitted relied heavily on SEGM disinformation to oppose the rule change, even copy-pasting the same collection of citations. Illinois Catholic Health Association submitted their own, citing SEGM disinformation on health care systems in the UK, France, Finland, and Sweden. Andre van Mol, representing American College of Pediatricians, also submitted a letter citing SEGM, the SEGM funded review “Reconsidering Informed Consent” by Stephen Levine, and SEGM President Roberto D’Angelo’s Letter to the Editor “One Size Does Not Fit All”.[28]
  • September 15 2022: Sarah Jorgensen, Patrick Hunter, Lori Regenstreif, Joanne Sinai, and William Malone published the Letter to the Editor “Puberty blockers for gender dysphoric youth: A lack of sound science” in the Journal of the American College of Clinical Pharmacy via open access. In the Acknowledgments section, the authors note that SEGM paid the open access fee. They do not disclose the associations of the authors with SEGM.
  • September 19 2022: Michael Biggs published the research article “The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence” in the Journal of Sex & Marital Therapy via open access. Biggs didn’t disclose being an advisor for SEGM and claims no funding, though he thanks SEGM member/affiliate Ema Abbruzzese by name (without disclosing Abbruzzese as a member).
  • October 2 2022: Comments are submitted opposing the proposed rule for Section 1557 by the Florida Agency for Health Care Administration (AHCA) and Christian Right organizations Christian Medical & Dental Associations, Ethics & Public Policy Center, and Alliance Defending Freedom. All four comments rely on citations from SEGM to argue against Joe Biden’s executive efforts to strengthen non-discrimination clauses protecting sexual orientation and gender identity. The Florida AHCA, in their submission, pointed to their June 2022 report.
  • October 8 2022: SEGM director Julia Mason gave a speech for the First Do No Harm Unity Rally organized by Our Duty,[2, sec. 1:03:34-1:15:10] an international anti-trans parent group based in the UK reputed for violent threats from its leader Keith Jordon, connections to conversion therapists, and advocating for “target[ing] 100% desistance.”[29] Our Duty was protesting the 2022 American Academy of Pediatrics (AAP) Annual Convention in California. During the speech she detailed her drafting of “resolutions” to the AAP as a member of SEGM to push them to do an internal review and change their stances in their 2018 policy statement on gender affirming care for trans youth.
  • October 11 2022: Mason released a secretly recorded video of an AAP Convention presentation given by Dr. Morissa Ladinsky, a clinician and plaintiff in the legal suit against Alabama’s ban on gender affirming care for youth, claiming that Ladinsky glorified suicide of trans youth and was “concretizing gender ideation”. The video led to a flurry of attacks through the press against both Ladinsky and the AAP, ranging from tabloids like the Daily Mail to the TERF outlet Reduxx, the neoconservative for-profit publication Washington Free Beacon, and Fox News anchor Laura Ingraham.[30]
  • October 20 2022: Levine, Abbruzzese, and Mason published the commentary “What Are We Doing to These Children? Response to Drescher, Clayton, and Balon Commentaries on Levine et al., 2022” in the Journal of Sex & Marital Therapy. The article in question is an attempt to deflect from salient criticisms of SEGM’s procedures, misrepresentation of informed consent models, and similarities to NARTH published as commentaries upon an earlier publication in that same journal—most notably Drescher’s—and accuses the commentaries of ignoring detransitioners. In the Funding section, the authors claim “there is no funding associated with the work featured in this article.” Notably, this commentary is not open access, indicating that no one paid open access fees for it.
  • November 14 2022: Alison Clayton published the Letter to the Editor “Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice” in the Archives of Sexual Behavior. Initially it was released for subscribers only. In the acknowledgments she thanks “the three peer reviewers, the Editor, and several of [her] colleagues for their thoughtful and helpful comments on earlier drafts of this paper”, though claims she didn’t receive funding for it.
  • December 3 2022: Gender Exploratory Therapy Association (GETA) published their clinical guide “A Clinical Guide for Therapists Working with Gender-Questioning Youth”. On the author page GETA thanks SEGM for “their support in the creation and production of this guide”.[31]
  • December 6 2022: SEGM submitted their third Annual Report to the Idaho Secretary of State.
  • December 13 2022: A correction on “Gender-Affirming Treatment of Gender Dysphoria in Youth” was issued, noting that Clayton has opted in for open access. The correction doesn’t name who paid for the open access fee.
  • Some time between December 26 and January 13: SEGM purchased a monthly subscription to Twitter Blue,[32] giving them access to a checkmark previously only available to verified accounts recognized by Twitter as being “authentic, notable, and active”. The switch to a subscription service to access checkmarks on Twitter has been criticized for allowing misrepresentation of notability, in turn making it easier to spread disinformation. This is particularly an issue for medical disinformation such as COVID-19 anti-vaccination conspiracies.
  • December 30-31 2022: SEGM received a last minute wave of donations in their second GoFundMe for the end of the year, almost all of which are $500 or more. Several came from known SEGM members or directors. Some of the highest donations came from authors of viral, open access papers regularly used to organize against trans health.

Table 3: SEGM member donations to SEGM’s second GoFundMe

DateNameAmountAssociated Papers
2022-12-30 17:53:15-06:00Patrick Clarke$1,000One Size Does Not Fit All (2020)
2022-12-31 00:44:32-06:00E. Abbruzzese$3,500Reconsidering Informed Consent (2021)
The Myth of “Reliable Research” in Pediatric Gender Medicine (2023)
2022-12-31 19:29:16-06:00William Malone$500Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons (2018)
Calling Into Question Whether Gender-Affirming Surgery Relieves Psychological Distress (2020)
Confounding Effects on Mental Health Observations After Sex Reassignment Surgery (2020)
Proper Care of Transgender and Gender-diverse Persons in the Setting of Proposed Discrimination (2021)
  • January 1 2023: SEGM published their 2022 Year-End-Summary, later republished on Person & Identity of the Christian Right organization Ethics and Public Policy Center. They described themselves as having “catalyzed positive developments in the field of youth gender medicine worldwide” and note that “[e]very year, clinicians and researchers contact SEGM with requests to collaborate with [them] in upcoming research publications or initiatives within their respective professional societies”. Among their successes they listed:
    • 60 publications since their organizing in 2019, including 15 “key scientific publications” by SEGM members.
    • Funding open access fees to “promote dissemination of key publications by SEGM and non-SEGM-affiliated researchers”. SEGM claims that “these publications as well the [sic] information disseminated on the SEGM website have been accessed more than half a million times in 2022”.
    • Giving feedback on treatment and policy guidelines throughout the United States, Canada, Australia, Sweden, Norway, and Iceland.
    • Becoming “a trusted source for a growing number of mainstream media organizations that now routinely contact SEGM for comment”, though they do not disclose which media organizations.
    • “Fact-checking” government issued documents on gender affirming care for trans youth, including from the U.S. Department of Health and Human Services, with disinformation pulled from their own papers.[33]
  • January 2 2023: E. Abbruzzese, Stephen Levine, and Julia Mason published the article commentary “The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed” in the Journal of Sex & Marital Therapy via open access. Unlike their paper “Reconsidering Informed Consent”, the authors claim no funding for the piece, despite SEGM paying the open access fees. E. Abbruzzese is also therein listed as an SEGM member and thanks “all of those who helpfully read earlier versions of this manuscript and contributed in various ways.” The paper itself is transparently a bad-faith response to criticism of SEGM’s description of the state of gender medicine by both Annelou L.C. de Vries which notes flaws with the initial Dutch studies, but argues that subsequent research has advanced upon these flaws. The authors, to their credit, accurately criticize many weaknesses with the Dutch studies—in particular, they note that the applicability of the early Dutch studies to modern populations is questionable given that many people currently undergoing gender-affirmative care would have been hedged out of the Dutch studies due to heavily restrictive gatekeeping and the diagnostic criteria of the time. However, the authors seem to believe this is a good thing rather than an obfuscation of the truth through inadequate measurement. Further, the authors then proceed to uncritically cite these same Dutch Studies as if they’re ironclad evidence of desistence rates. They cite Ristori & Steensma (2016), which relies upon the same studies that SEGM is criticizing to make inferences about desistence rates (and which also criticizes the criteria used in these same studies in its text). And despite raising concerns about limitations and quality of Dutch studies and modern studies of gender-affirming care models, they uncritically cite the fatally flawed Littman (2018) study and advance the blatantly pseudoscientific ROGD hypothesis as evidence against the applicability of the Dutch studies. SEGM’s concerns about evidence quality are subject to intensive bias: if it agrees with their viewpoint, it’s acceptable, and its flaws are acceptable limitations, whereas if it doesn’t, it’s deeply flawed and its flaws are unacceptable.
  • January 11 2023: SEGM published a blog post about “The Myth of “Reliable Research””, targeting two formative Dutch studies which SEGM’s own claims about desistence and prior presentation rates for gender care rely wholly upon, while championing their paper as “question[ing] whether even those with childhood-onset are best served with hormones and surgery.” The blog post also highlights the author’s insinuations that the Dutch studies caused the “crisis” of gender-variant youth seeking care by offering access to that care. Because of this SEGM claimed that the paper “demands urgent attention from the medical community”. Unlike past blog posts, SEGM did not disclose that all of the authors are SEGM members or directors, nor who paid for the open access fee. Instead SEGM refers to Abbruzzese, Levine, and Mason as simply “the authors”.

This timeline demonstrates the effectiveness of SEGM’s strategies off the back of its initial funding. Using the combined strategy of Letters to the Editor and commentaries in academic journals, paying for their open access fees so non-academics can read and share them, and offering grants or administrative support for “Reconsidering Informed Consent”[34] and the newly released “clinical guide” by GETA,[31] they’ve injected scientific and therapeutic literature with medical disinformation on gender affirming care for trans youth and young adults. Meanwhile, ECF’s bet paid off: SEGM’s reported income exploded, tripling by the end of 2021. They have surpassed annual reported incomes from anti-LGBTQ+ disinformation goliaths like American College of Pediatricians[35] and Alliance for Therapeutic Choice and Scientific Integrity (previously known as NARTH),[36] all in just two years.

Poisoning the Well from the Right to the Left

SEGM would not be nearly as successful without the efforts by the Christian Right to target trans rights. In 2017, when National Christian Charitable Foundation (NCCF) gave their donation to ECF,[16] gears were already turning to divide the LGBTQ+ community. That October the Family Research Council held its annual Values Voter Summit, where Christian Right activists revealed their main strategy to undermine LGBTQ+ rights. They had just lost a challenge against the Fairfax school board’s trans-inclusive policies and needed to up their game. Two strategies emerged: build coalition with seemingly-progressive allies that are also campaigning against trans people, and rely on “science” instead of faith. “Trans and gender identity are a tough sell, so focus on gender identity to divide and conquer[,]” explained Meg Kilgannon, then-executive director of Concerned Parents and Educators of Fairfax County prior to joining Family Research Council in 2021. “[G]ender identity on its own is just a bridge too far. If we separate the T from the alphabet soup we’ll have more success.”[37, para. 8]

Success they certainly had. A report from Media Matters for America detailed a barrage of anti-LGBTQ+ campaigns coming from Alliance Defending Freedom (ADF) throughout 2017. Eight states tried to introduce statewide anti-trans bathroom bills, most being filled with language eerily similar to model bills drafted by the ADF. The ADF’s actions went all the way to the federal level when they pushed for an amendment to the 2018 defense spending bill, arguing that the military should not have to pay for gender affirming care (though the amendments were rejected by the House of Representatives). By December, they were scheduled to speak before the Supreme Court for the case Masterpiece Cakeshop v. Colorado Civil Rights Commission, where they argued that business owners could legally refuse to serve gay couples based on religious beliefs. And their reach wasn’t limited to the United States: in Australia and Romania they backed campaigns against gay marriage, defended European laws requiring sterilization of trans people to update gender markers on legal documents, and called on the Spanish Parliament to reject a proposed LGBTQ+ anti-discrimination bill.

None of this would be possible without funding organizations like NCCF. Being one of the largest Christian philanthropy foundations, NCCF donated to several Christian Right groups focusing on opposing LGBTQ+ and reproductive rights in 2017:

Table 4: Donations from the National Christian Charitable Foundation to anti-gender Christian Right organizations in 2017*

AmountRecipientGift designationNotes
$16,807,339Alliance Defending FreedomJusticeLeading US Christian Right legal firm. Reputed for shadow writing anti-trans bills across the US. Has international branches in Europe that funds far right groups.
$5,234,898Focus on the FamilyGrowthOne of the frontrunners in promoting Christian conversion practices.
$2,118,989Heritage FoundationCultureChristian policy thinktank which launched the anti-LGBTQ+ campaign Promise to America’s Children alongside Family Policy Alliance and the ADF. Frequent host of anti-LGBTQ+ panels.
$1,828,786Family Research CouncilCultureHosts the aforementioned Values Voter Summit. Family Research Council members have served on (now former) president Donald Trump’s transition team.
$147,750Crisis Pregnancy Centers of Greater PhoenixGrowthA network of predatory, anti-abortion clinics that worked with Catholic Medical Association and other Christian groups to uphold Arizona state monitoring of abortion services.
$69,800Liberty CounselJusticeA notorious litigation troll firm whose founder Mathew Staver targeted conversion therapy bans and school boards with trans-inclusive policies such as the one in Fairfax County,[38, p. 7-9, 19-23] As the firm is registered with the IRS as an “association of churches”, their main sources of income are protected from scrutiny, though hacked records shows at least $12 million in donations from just 44,000 donors since 2015.
$27,500Council for National PolicyCultureA notorious shadow funding group for actors of the Christian Right. Best known for its roster of highly influential US Republicans, including CEOs and court justices, all of whom are sworn to secrecy about its activities. The Council for National Policy has been investigated for their role in the election of Donald Trump in 2016, with several members becoming part of his federal administrative team.
$21,800Eagle Forum of AlabamaGrowthA state branch of Eagle Forum. Currently subject to investigation for its suspected role in drafting health care bans for trans youth.
$17,500Freedom of Conscience Defense FundCultureA nonprofit legal firm whose founder Charles LiMandri defended JONAH for fraudulently telling people they could cure them of being gay. The firm is a regular recipient of grants from the ADF. Presently LiMandri is representing Chloe Cole, an anti-trans detransitioned activist, in a suit against Kaiser Permanente.
* Data from National Christian Charitable Foundation IRS Form 990 (2017), Schedule I, via ProPublica.

 

With this funding and these tools at their disposal, Christian Right actors can reshape every piece of the narrative on trans rights all while ducking scrutiny from the IRS and investigators. This is a known strategy for them, including within the context of LGBTQ+ issues. “Because the IRS has not been very diligent in enforcing the law, many 501(c)(3) groups are pushing the envelope when it comes to politics,” Rob Boston, a senior adviser at Americans United for Separation of Church and State, noted for an Intercept investigative report into Liberty Counsel’s donors.[39, para. 17] Meanwhile, such actors are able to kick up fear against trans people using sleight-of-hand tactics and people’s fears surrounding privacy, safety, and child welfare. After test-running the strategy—alas, quite successfully—on bathroom scares to gut non-discrimination laws, the Right increased their focus on fearmongering surrounding gender affirming care and trans youth.

That’s where the American College of Pediatricians (ACPeds) comes in. As a reminder: ACPeds leadership has extensively collaborated with SEGM leadership from the very beginning, even before SEGM existed as an organization. Led by Michelle Cretella and Quentin Van Meter, ACPeds discussed their strategy in a series of board meetings from 2013 to 2020. Cretella, then Vice President, noticed that ACPeds was seen as “being single-issue on GLBQT” in the media and among potential members. “Threats to our work[,]” she described in her presentation to the board, “are the current world culture, the law and the media as well as the GLBQT activists.”[40, p. 2] To push back against being perceived as “right winged crazies” for not wanting trans people to use the bathroom or play sports, ACPeds concocted a plan be “proactive and aggressive” and take back the narrative.[41, p. 7-8] Soon they were fixated on trans youth, whether that’s in bathrooms, sports, or the doctor’s office, with Van Meter, Cretella, and Paul McHugh taking point. Discussing strategies on blending scientific-sounding arguments with their Christian faith,[40, p. 7-8] drafting papers and statements, filing briefs, giving presentations, and connecting with trusted partners,[42, p. 2] ACPeds sought to reshape the narrative on LGBTQ+ youth to push conversion therapies all while protecting their own careers.[42, p. 12-13] The flurry of disinformation on trans health had begun.

Such climates are what give “secular” groups like SEGM room to grow. SEGM grew from the roots of two other projects, Youth Trans Critical Professionals and Pediatric and Adolescent Gender Dysphoria Working Group (PAGDWG). Youth Trans Critical Professionals, originally launching in March 2016, immediately made their anti-trans positions known. “Given the seriousness and permanence of most medical transition treatments,” they wrote in their first ever post, “remaining intervention-free for as long as possible ought to be the goal.” With a fixation on “social contagion”, False Memory Syndrome, sterility and detransition, the site made its way through parent and Christian Right anti-trans circles alike. Youth Trans Critical Professionals gained traction as a source among anti-trans actors despite only running for about a year and a half, being used as a recruitment source for Lisa Littman’s debunked “ROGD” paper and cited by ACPeds, the US representative of international conversion therapy organization IFTCC Laura Haynes,[43] and the Anglican Church Diocese of Sydney. They also quickly joined forces with heavy hitters among conservatives when their founder Lisa Bell signed on to a letter—just three months after launch—calling on GOP legislators to “Stop [Transgenderism] Transforming American Self-Government & Putting All Children at Risk”. Joining her were representatives from Family Research Council and Eagle Forum, Cretella from ACPeds, and Michael Farris (prior to him becoming the ADF’s President and CEO). By 2017 Youth Trans Critical Professionals aligned with ACPeds in the push against conversion therapy bans, serving the role of the token “pro-LGB adult T rights” party at the table.

Youth Trans Critical Professionals disappeared as quickly as it came, with the site going private between February and July of 2018. It’s in this short window that Pediatric and Adolescent Gender Dysphoria Working Group (PAGDWG, not to be confused with the trans-affirming Gender Dysphoria Affirmative Working Group) appeared. Unlike Youth Trans Critical Professionals, PAGDWG was the first “gender critical” group of clinicians to operate with a membership roster. They ran from April 2018 to 2020, focusing their attention on the theorycrafting supporting the recently published Littman paper on ROGD. Joining them was Michael Laidlaw, a member of ACpeds who works closely with their leadership,[44, p. 2] and Canadian clinicians from the then-closed Toronto Centre for Addiction and Mental Health’s Gender Identity Clinic.

Then, the switch happens again, this time between PAGDWG and SEGM. Once SEGM got itself established in January through March of 2020, PAGDWG put up their announcement ceasing activity after one last recruitment post for Lisa Littman’s latest study on detransition (currently unpublished). Yet membership records between both show overlap between the groups: the President of SEGM Roberto D’Angelo, three advisors (Stella O’Malley, Sasha Ayad, and Lisa Marchiano), and Dianna Kenny. Four would go on to found Gender Exploratory Therapy Association (GETA) in early 2022 alongside Susan Evans, and then co-authoring GETA’s “practice guidelines” with Kenny and SEGM member Stephen Levine.

Figure 1: Overlapping networks of the members and associates of Society for Evidence-Based Gender Medicine (SEGM, left) and Pediatric and Adolescent Gender Dysphoria Working Group (PAGDWG, right). In the center between the two are Stella O’Malley, Sasha Ayad, Lisa Marchiano, Roberto D’Angelo and Dianna Kenny, founders of anti-trans conversion therapy organization Gender Exploratory Therapy Association (GETA) and authors of the 2022 GETA guide “A Clinical Guide for Therapists Working with Gender-Questioning Youth” alongside Stephen Levine. Full image description pending.

Groups like PAGDWG and Youth Trans Critical Professionals served a single, core purpose in the anti-trans arsenal. As explained by Southern Poverty Law Center, the Christian Right needed a pseudoscience evidence base to point to.[37] Yet they couldn’t rely solely on religious-based sources. So when SEGM came onto the scene, it was a slam dunk among secular and Christian conservative pundits alike, with the crossover between SEGM and Christian Right organizations hiding in plain sight. Another SEGM member, Patrick Hunter, was revealed as being connected to the Catholic Medical Association (who also submitted a comment supporting the Trump administration’s proposed rule). Meanwhile, their members would endorse Minnesota Family Council’s “Parent Resource Guide”,[45] a critical example of the “progressive” and Christian Right coalitions strategized by Meg Kilgannon during the 2017 Values Voter Summit. The cross-pollination between the Right and SEGM was well underway before SEGM even had a website.

Like PAGDWG and Youth Trans Critical Professionals, SEGM gained a reputation as the go-to source for “secular” clinical voices opposing gender affirming care. They hit the media by storm, with their first coverage describing them as a “watchdog group” following the first pressure campaign against the 2019 paper by Richard Bränström and John Pachankis. “[The correction] has great international significance,” commented Paul McHugh of ACPeds to The Australian. “[T]hey’ll know people are watching.” McHugh claimed that gender affirming care “would be reined in by the courts, not by the psychiatric profession”, a battle which was already well underway. Multiple bans on gender affirming care for trans youth were proposed across the country in 2020, plus sports bans, attacks on sex education, removing gender identity from anti-discrimination law, and more. By 2021 the number of bills soared, with over 100 bills filed by June. SEGM’s disinformation would be cited both by “experts” hired by states as legal justification for the health care bans[46] and coalitions of other conservative state governments supporting them.[11] Later it was revealed that the group responsible for drafting the bills was the ADF, the very organization protecting record of SEGM’s finances in court, as part of the massive campaign of Christian Right lobby organizations Promise to America’s Children. And when legislative bans can’t go through, SEGM is leveraged by backdoor attempts to regulate insurance coverage.[4]

While SEGM dodges direct affiliation, the Right looks to them as a friend and colleague. This was best laid out by ACPeds President Quentin Van Meter himself. During the 2022 conference God’s Voice, hosted by a faith-based conversion ministry called First Stone Ministries, Van Meter explained what role SEGM played in their broader campaign.[47] “So there are little chinks in the armor that are starting to form[,]” Van Meter explained to an audience unseen to the camera. “There’s a group called the Society of Evidence-Based Gender Medicine, SEGM. You should look them up because they are a reference-a beautiful scientifically based reference group that has a broad clinical spectrum of politics in terms of the backgrounds of these individuals. But what we all agree on is that the affirmation from social to medical to surgical is an abomination for these children. It is the wrong thing to do, not based on a faith base, however faith may work through you to recognize that this is what it is.” [emphasis added]

Further in the presentation, Van Meter makes the strategy very clear during a section titled “What can we do to turn the tide back to sanity?” For one, “join with a broad-based group of diverse backgrounds—the SEGM I mentioned[,]” actively encouraging Christian Right collaboration with SEGM based on mutual goals. Yet at the same time he instructed people on how to incorporate their religious beliefs while undermining scrutiny. “Never be afraid to introduce your faith into the discussion[,]” he said while explaining his methods for deflecting scrutiny. After questions from attorneys at Lambda Legal and ACLU about his church’s beliefs on trans issues, he intentionally flipped the script to focus on love for children. Explaining to the audience, “I just didn’t give them that answer because I wanted them to know how my faith drives me. I’m not going to play a game where I can be quoted out of context, and yet my faith does drive what I do in my practice every single day.” [emphasis added]

SEGM has put in enormous effort into protecting the records of their finances and connections with the Christian Right. While SEGM may not have financially benefited from the NCCF donations to ECF, ADF and others—as far as we know, they are not time travelers—it’s clear that they benefited socially and professionally. So much so that, as evidenced by this report, SEGM contributed to Christian Right campaigns opposing trans health coverage and equity before they were even known to exist. The relationship is mutual, receiving glowing endorsement from leaders of ACPeds and protection from the ADF’s legal team. With nearly a million dollars of unknown origins in their coffers from 2021 alone, plus high ranking connections, the supposedly “secular” anti-trans think tank is well equipped to continue their rampage against trans health care.

Notes

  1. Per SEGM’s Annual Report filed December 6. Idaho Secretary of State Business Entity Search, retrieved 31 December 2022.
  2. Rev FoXX USA (Director). (2022, October 8). First Do No Harm Unity Rally—Livestream.
  3. Boulware, S. D., Kamody, R., Kuper, L., McNamara, M., Olezeski, C., Szilagyi, N., & Alstott, A. (2022). Biased Science: The Texas and Alabama Measures Criminalizing Medical Treatment for Transgender Children and Adolescents Rely on Inaccurate and Misleading Scientific Claims (p. 17, 28-29). Yale School of Medicine. Link
  4. McNamara, M., Abdul-Latif, H., Boulware, S. D., Kamody, R., Kuper, L., Olezeski, C., Szilagyi, N., & Alstott, A. (2022). A Critical Review of the June 2022 Florida Medicaid Report on the Medical Treatment of Gender Dysphoria. Yale School of Medicine. Link
  5. Texas Opinion Attorney General No. KP-040. (2022, February 18). p. 3-4. Link
  6. Brignardello-Petersen, R., & Wiercioc, W. (2022). Effects of gender affirming therapies in people with gender dysphoria: Evaluation of the best available evidence [PDF]. Florida Agency for Health Care Administration. Link
  7. DeSantis, R. & Ladapo, J. A. (2022, April 20). Treatment of Gender Dysphoria for Adolescents and Children [PDF]. Florida Department of Health, Office of the State Surgeon General. Link
  8. Declaration of Stephen B. Levine, Brandt et al. v. Rutledge et al., U.S. District Court Eastern District of Arkansas (2021) (no. 4:21-CV-00450-JM). Link
  9. Brief for Society for Evidence Based Medicine as Amici Curiae Supporting Defendant, D.H. et al. v. Snyder, 4:20-cv-00335-SHR (2021) (no. 21-15668), 2020 12165779. Link
  10. Declaration of Stephen B. Levine, Kadel et al. v Folwell et al., U.S. District Court Middle District of North Carolina (2021) (no. 1:19-cv-272-LCB-LPA). Link, p. 63-153
  11. Brief for Alabama et al. as Amici Curiae in Support of Defendants’ Opposition to Plaintiffs’ Motion for a Preliminary Injunction. Brandt et al. v. Rutledge et al., U.S. District Court Eastern District of Arkansas (2021) (no. 4:21-CV-00450-JM). Link
  12. Deposition transcript of Stephen B. Levine, B.P.J. v. West Virginia State Board of Education et al, U.S. District Court Western District of West Virginia (2022, March 30) (no. 2:21-cv-00316). Link.
  13. Per ECF’s page Making an Impact, retrieved 31 December 2022. It’s unclear how many of the 250-400+ charity projects and initiatives had a formal fiscal sponsorship relationship with ECF.
  14. For a detailed explanation of this terminology, see “What’s the difference between Model A and Model C fiscal sponsorship?” by Benjamin Takis at Sustainability Education 4 Nonprofits.
  15. Edward Charles Foundation IRS Form 990 (2020), Schedule I, via ProPublica.
  16. National Christian Charitable Foundation IRS Form 990 (2017), Schedule I, via ProPublica. The donation to Alliance Defending Freedom is item 619.
  17. American Endowment Foundation IRS Form 990 (2017), via ProPublica, items 77 and 1118 respectively. It should be noted that in the same tax year, American Endowment Fund also gave to a range of ACLU branches, so… thanks?
  18. American Endowment Foundation IRS Form 990 (2020), via ProPublica, items 2941 and 205 respectively.
  19. The IRS Exempt Organizations Master File is broken down by state. SEGM’s income is noted in records for Idaho (ID), where they’re incorporated, under EIN 844520593. While the Master File records for Idaho have been updated for fiscal year 2021, year 2020 is still available via Wayback Machine.
  20. Ring, A., & Malone, W. J. (2020). Confounding Effects on Mental Health Observations After Sex Reassignment Surgery. American Journal of Psychiatry, 177(8), 768–769. Link
  21. Kaltiala-Heino, R., Sumia, M., Työläjärvi, M., & Lindberg, N. (2015). Two years of gender identity service for minors: Overrepresentation of natal girls with severe problems in adolescent development. Child and Adolescent Psychiatry and Mental Health, 9(1), 9. Link
  22. Leveille, L. (2022). A New Era: Key Actors Behind Anti-Trans Conversion Therapy. Health Liberation Now! Link
  23. Moore, M. (2021, August 26). SEGM uncovered: Large anonymous payments funding dodgy science. Trans Safety Network. Link
  24. Society for Evidence-Based Gender Medicine. (2020, August 30). Correction of a Key Study: No Evidence of “Gender-Affirming” Surgeries Improving Mental Health. SEGM.org. Link
  25. Brief for the Family Research Council as Amicus Curiae Supporting Defendants-Appellants and Reversal, Brandt et al. v. Rutledge et al., U.S. Court of Appeals for the Eighth Circuit (2021) (no. 21-2875), 2021 U.S. District Court Eastern District of Arkansas. Link, p. 10
  26. Deposition transcript of Stephen B. Levine, Fain et al. v. Crouch et al, U.S. District Court Southern District of West Virginia (2022, April 27) (no. 3:20-cv-00740). Link, p. 8 of pdf
  27. DeSantis, R., & Marstiller, S. (2022). Florida Medicaid: Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria. Florida Agency for Health Care Administration. Link
  28. Van Mol, A. (2022). Comment submitted on RIN 0945-AA17, Nondiscrimination in Health Programs and Activities, HHS proposed rule on Section 1557 of the Affordable Care Act (ACA) [PDF]. American College of Pediatricians. Link
  29. Jordon, K. (2021). Submission of Evidence to the Nuffield Council on Bioethics by Our Duty [PDF]. Our Duty. Link, p. 9
  30. Fox News (Director). (2022, December 7). Ingraham: Mattel is becoming a gender cult.
  31. Ayad, S., D’Angelo, R., Kenny, D. T., Levine, S. B., Marchiano, L., & O’Malley, S. (2022). A Clinical Guide for Therapists Working with Gender-Questioning Youth. Gender Exploratory Therapy Association. Link
  32. Dates via comparative archives of SEGM’s twitter feed on December 26th 2022 and January 13th 2023.
  33. Society for Evidence-Based Gender Medicine. (2022, April 7). Fact-Checking the HHS. SEGM.org. Link. While SEGM does not include reference notes at the end like many of their other posts, several embedded links point to Letters to the Editor or reviews published by their own members as outlined in this report.
  34. Levine, S. B., Abbruzzese, E., & Mason, J. W. (2022). Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults. Journal of Sex & Marital Therapy, 48(7), 706–727. Link. The authors note in Acknowledgements that they “wish to thank SEGM staff for their grant and bibliographic support[,]” and under Funding, that “[t]his work was supported by the Society for Evidence-based Gender Medicine.”
  35. American College of Pediatricians IRS Form 990 (FY 2020), via ProPublica. Founded 21 years ago, American College of Pediatricians claimed to have over 500 members by 2016.
  36. Alliance for Therapeutic Choice and Scientific Integrity IRS Form 990 (FY 2020), via ProPublica. Alliance for Therapeutic Choice and Scientific Integrity was founded as National Association for Research & Therapy of Homosexuality (NARTH) in 1992, serving as one of the main sources of anti-LGBTQ+ junk science and promotion of conversion therapy.
  37. Barthélemy, H. (2017, October 23). Christian Right tips to fight transgender rights: Separate the T from the LGB. Southern Poverty Law Center. Link
  38. Leveille, L. (2021). When Ex-Trans Worlds Collide: Unpacking a New Era of Anti-Trans Conversion Therapy. Health Liberation Now! Link
  39. Lee, M., & Sherrard, M. (2022, August 25). Liberty Counsel’s Donor Records and Pro-Trump Election Messaging Exposed in Data Breach. The Intercept. Link
  40. Board of Directors Meeting Minutes [PDF]. (2013, September 13-14). American College of Pediatricians. Link
  41. Board of Directors Meeting Minutes [PDF]. (2014, March 21-22). American College of Pediatricians. Link
  42. Board of Directors Meeting Minutes [PDF]. (2015, September 12-13). American College of Pediatricians. Link
  43. Haynes, L. (2017). Psychologist Testimony Calling for Repeal of the “Conversion Therapy” Ban in Seattle [PDF]. National Task Force for Therapy Equality. Link, p. 6. Haynes notes in the citation that “SOGI change therapy for minors is recommended by the American Association of Christian Counselors, Alliance for Therapeutic Choice and Scientific Integrity, American College of Pediatricians, Association of American Physicians and Surgeons, Youth Trans Critical Professionals, Catholic Medical Association, Christian Medical Association, and International Network of Orthodox (Jewish) Mental Health Professionals[,]” placing Youth Trans Critical Professionals on the same ideological lines as established, secular and faith-based conversion therapy lobby groups.
  44. Board of Directors Meeting Minutes [PDF]. (2018, October 24-25). American College of Pediatricians. Link
  45. Minnesota Family Council. (2019). Parent Resource Guide: Responding to the Transgender Issue. Link. The guide was described as “the product of a unique collaboration between organizations with very diverse political opinions and goals”: Family Policy Alliance, Heritage Foundation, Kelsey Coalition, Parents of ROGD Kids, and Women’s Liberation Front. SEGM members Sasha Ayad and William Malone endorse the guide on pdf pages 5 and 8, respectively.
  46. Declaration of Mark Regnerus, Brandt et al. v. Rutledge et al., U.S. District Court Eastern District of Arkansas (2021) (no. 4:21-CV-00450-JM). Link, p. 18
  47. God’s Voice (Director). (2022, June 6). 2022 God’s Voice 7th Presentation “The Growing Deception of Transgender Medicine” by Dr.Van Meter. Quotes are from sections 53:23-54:00, 59:27-59:37, and 1:01:00-1:01:20 respectively.
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