Leor Sapir: The Questions the New York Times Refused to Ask (#27)
7 August 2025
With Leor Sapir
North America
Leor Sapir, a Fellow at the Manhattan Institute, argues that the New York Times spent two years investigating youth gender transition without once defining its central concept. His critique exposes how unvalidated clinical tools were framed as cautious medicine, how detransitioners were sidelined, and how gender identity — the theoretical foundation of the entire field — remains undefined and unfalsifiable. The parallels with the UK are direct: the Cass Review found the same evidential vacuum at the heart of NHS gender services, and the question of institutional accountability now faces medical bodies on both sides of the Atlantic.
The New York Times devoted six episodes and two years to examining youth gender transition in its 'The Protocol' podcast. Yet according to Leor Sapir, a Fellow at the Manhattan Institute whose investigative work has focused on paediatric transition policy and bioethics, the series systematically avoided the most basic question the subject demands: what does gender identity actually mean? Without that definition, Sapir argues, the entire clinical framework built around it rests on circular reasoning — a problem that maps directly onto the evidential failures documented in the Cass Review. Sapir's critique is not a dismissal of journalism but an anatomy of deliberate omission. He details how the NYT framed unvalidated assessment tools as a reasonable middle ground, presenting clinical practices that lack a proper evidence base as though they were settled, cautious medicine. This mirrors the pattern Hilary Cass identified in the academic literature underpinning youth gender medicine globally: studies that were low in quality, ideologically influenced, and peer-reviewed within a system where critical voices struggled to publish. Central to Sapir's account is an interview he conducted with Laura Edwards-Leeper, a psychologist influential in shaping American protocols for treating gender-dysphoric children. She reportedly acknowledged in that conversation that gender identity, as a clinical concept, is grounded in stereotypes rather than any independently verifiable characteristic. This admission matters well beyond the United States. NHS England's 2024 decision to halt routine prescribing of puberty blockers for gender dysphoria was driven in part by the recognition that the evidence base for those interventions was weak, and that the theoretical construct justifying them had never been subjected to adequate independent scrutiny. The episode also addresses the treatment of detransitioners in the NYT podcast. Sapir describes those who had undergone transition and subsequently regretted it as receiving minimal airtime, while a clinical whistleblower faced an adversarial framing. This imbalance has a direct UK parallel: detransitioner testimony has been cited in parliamentary evidence sessions and informed the findings of the NHS service review, yet it remains consistently marginalised in coverage that treats access to treatment as the overriding concern rather than long-term patient outcomes. Sapir closes with a structural observation about accountability. He identifies a fork in the road for American medical institutions: either they acknowledge that WPATH misled clinicians by overstating the evidence base for its guidelines, or they face federal investigation. That reckoning has a British equivalent. NHS England, the relevant royal colleges, and the regulatory bodies that oversaw UK gender services for a generation are now working through how protocols lacking robust evidence came to govern clinical practice. The question Sapir directs at the New York Times — why spend two years investigating something without asking what you are actually talking about — applies with equal force to every institution on this side of the Atlantic that waved through those same protocols without demanding an answer.
