March 31, 2020
Liberals and the media have been criticizing President Trump for touting the possibility of using some anti-malarial drugs to fight the coronavirus. Chloroquine, hydroxychloroquine, or a “drug cocktail” combining one of those with the antibiotic azithromycin have been proposed as possible drugs to prevent and/or treat the coronavirus, and what the Washington Post referred to as “tantalizing early results” of research showed that they might have promise.
However, although these drugs have been around and used safely against malaria for decades, they have not yet been tested and proven safe and effective for use against the coronavirus. This has led to shock and outrage on the part of some. The Post’s headline read, “Trump keeps touting an unproven coronavirus treatment,” and their article reported:
The effort has raised concerns among health experts about safety risks — including the danger of fatal heart arrhythmia and vision loss associated with the drugs — and of raising false hopes in the American public.
In fact, the Post was alarmed enough to print an editorial on the subject as well, explaining:
Widespread testing for drug safety and efficacy is essential . . . Normally in the United States, a set of controlled clinical trials would be required before a drug is approved by the Food and Drug Administration . . .
A Bloomberg headline read, “Trump Pushes an Unproven Coronavirus Drug,” and the article opens with this:
A tiny trial of a malaria drug may or may not have helped several patients in France fight off their coronavirus infections. The FDA has said it needs more study. Some expert doctors are skeptical. President Donald Trump is all for it.
Slate downplayed the drugs’ potential, saying, “Trump cited a report in a scientific journal that only studied 20 patients and was not a controlled clinical trial.” And the left-wing magazine Mother Jones headlined, “Trump Keeps Promoting Unproven Drugs: The cocktail carries significant risks and may not fight the coronavirus.”
It is true that the “off-label” use of a drug means that it has not been scientifically proven to be safe and effective for that particular condition. Such use is not illegal, however—and is fairly common. It has been estimated that one in five prescriptions written in America is for an off-label use.
And liberals have been far more enthusiastic about “off-label” use of some drugs—if they support one of their ideological pet projects.
The Off-Label Use of Drugs for Gender Transition
Take gender transition medical procedures, for example. Pre-teens who experience “gender dysphoria” (distress regarding their biological sex) are increasingly being treated with a regimen featuring puberty-blocking drugs (such as Lupron), followed by cross-sex hormones (testosterone or estrogen) followed by gender reassignment surgery.
These interventions are touted with terms like “evidence-based” and “standard of care”—so it might surprise some people (including the patients subjected to them) that all of these are “off-label” uses of such drugs. Puberty blockers, for example, are intended (in children) to treat a medical condition called “central precocious puberty,” in which the child begins to show the biological signs of puberty prematurely, at an age far younger than would normally be expected. The drugs stop the physical progression of puberty until they are removed at a more normal age for such development. The effect of their use to stop normal puberty, followed by their withdrawal at an older age or when beginning to take cross-sex hormones, has not been well-studied.
Sex hormones like estrogen are officially used to treat symptoms of menopause or certain cancers. However, an article in the Journal of Sexual Medicine reported, “Long-term effects and side effects of cross-sex hormone treatment in transsexual persons are not well known.”
Gender reassignment surgery (while not subject to the same testing as medications) has also not been proven safe and effective. The Centers for Medicare and Medicaid Services in 2016 found that “there is not enough high quality evidence to determine whether gender reassignment surgery improves health outcomes,” in part because patients in the best studies “did not demonstrate clinically significant changes” after surgery.
Indeed, if you look closely, advocates of gender transition medical procedures do not even try to deny this. Fenway Health, which serves the LGBT community in Boston, writes that “no medications or other treatments are currently approved by the Food and Drug Administration (FDA) for the purposes of gender alteration and affirmation.” A 2018 article in the journal Transgender Health reiterated that “there are no medications or other treatments that are FDA-approved for the purpose of gender affirmation.” And the American Medical Association’s Council on Science and Public Health reported that “steroidal hormones,” “GnRH analogs” (puberty blockers) and “antiandrogens” are all used “off-label” for “gender re-affirming therapy”—because their use “lacks scientific evidence.”
Trusting Ideology Over Science
The “off-label” use of a drug—any drug—may sometimes be justified, but should always be pursued with caution. However, there is one big difference between the drugs President Trump has shown enthusiasm for and the drugs that social liberals so eagerly tout. The coronavirus causes very real physical disease, which is killing more and more Americans every day. Expediting the experimental “off-label” use of malaria drugs may be justified because of the massive scope of the public health problem we face.
The off-label use of drugs for “gender transition” is quite different. Not only is there no comparable public health crisis—there is not even a physical illness that is being treated. Neither puberty nor being biologically male or female is a “disease.”
Liberals should be careful showing self-righteousness about putting “our trust in the scientists.” Their hypocrisy is showing when it comes to the transgender movement.