The BMJ

The BMJ is an influential medical journal that was founded in 1840, making it pretty old. It's published by a company simply named BMJ (formerly BMJ Group), which is owned by the British Medical Association. The journal was previously called the British Medical Journal before they decided to shorten it in 1988, leaving us only to obliviously ponder what "BMJ" now stands for. Its was 477 for the years 2022-2023, which is outstanding.BMJ, The (October 31, 2023) Resurchify (archived from January 7, 2024).
It has a number of subsidiary journals also focused on medicine and health, such as BMJ Open, Heart, Gut, Thorax, and Tobacco Control. The BMJ is respected in its field for the most part and has a history of high-profile accomplishments: for example, The BMJ published the reports that exposed Andrew Wakefield's scientific fraud in 2011. A massive portion of the published papers in the company's various journals, even The BMJ itself, are simply so uncontroversial that they don't warrant much mention here.
However, it has noticeable shortcomings that have likely only worsened with time. Perhaps most worryingly, The BMJ appears to have a track record promoting certain alternative medicine practices such as acupuncture. On the brighter side, they have also published papers critical of such practices. Yet, their level of skepticism towards pseudomedicine leaves one wanting when they have essentially offered alternative medicine promoters a foot in the door to (grossly undeserved) mainstream respectability: the journal is widely read by doctors in the United Kingdom and is occasionally cited as a source by bodies writing important medical policy or recommendations.
Another major issue, at times, has been their choice of editors. Peter Doshi, a senior editor for The BMJ itself, is a concern troll regarding vaccines and has even previously waded into germ theory denialism territory. (Or would that be terrain?). One BMJ journal, Open Heart, previously had James DiNicolantonio for an associate editor.Editorial Board Open Heart (archived from October 4, 2023).
==Overview==
The BMJ is owned by the British Medical Association (BMA), a large trade union for medical professionals in the United Kingdom. All members for the BMA receive issues of The BMJ free of charge. The journal is meant to be editorially independent of the BMA — though one has to wonder if that can truly be the case when such a large portion of its readership is made up of BMA members.
===History===
File:Provincial medical surgical journal.png|The first issue of the Provincial Medical and Surgical Journal, 1840. This is The BMJ in utero.
File:Clover_portable_regulating_ether_inhaler_1877.jpg|An illustration of an early inhaler. British Medical Journal, 1898.
File:British Medical Journal, June 2,1917 Wellcome L0027200.jpg|A page from a 1917 issue of the British Medical Journal. Shows a photo from a trench during World War I.
File:British medical journal (1917) (14594863360).jpg|Another 1917 page pertaining to World War I. Instructions for treating gunshot wounds.
File:Antimonyall Cupps.jpg|An illustration of that appeared in a 1923 issue of the British Medical Journal.
File:Advert, scarlet fever treatment, Burroughs Wellcome, 1929 Wellcome L0035387.jpg|1929 advertisement in the journal for a scarlet fever treatment.
File:Advertisement for insulin, Burroughs Wellcome, 1930 Wellcome L0035381.jpg|1930 advertisement in the BMJ for insulin.
Surprise! The BMJ began not as the British Medical Journal, but as the Provincial Medical and Surgical Journal — which first published an issue on October 3, 1840. That journal later merged with the London Journal of Medicine to form the Associated Medical Journal in 1853. Then in 1857, that became the British Medical Journal."History of The BMJ". The BMJ.
The journal has a long-running rivalry with another top medical journal, The Lancet. Evidently, this rivalry dates back to the very founding of the Provincial Medical and Surgical Journal in 1840, with the two editors at the time gloating that they received just as much advertiser interest for their first issue as The Lancet (founded a bit earlier, in 1823) typically would. This rivalry can be observed to this very day, with high-profile critiques of papers published in The Lancet often finding their way into The BMJ.
In the 1840s, the journal had a number of papers written by James Young Simpson on chloroform, helping to popularize the drug's medical use. In the 1860s and 1870s, The BMJ published papers by the medical pioneer Joseph Lister about antisepsis in surgery, contributing to the foundations of germ theory. The 1890s brought papers on the mosquito as a vector for malaria.
A 1905 article reported a spontaneous human combustion of an old lady who loved drinking spirits. That article has managed to receive citations more than a century later.Spontaneous Human Combustion: The truth behind the myth of Mary Carpenter by Matt Mills (May 10, 2021) The Skeptic (UK).Documents Re Sarah Morley by Jan Willem Nienhuys (2021) Skepsis.Spontaneous Combustion (1905) British Medical Journal 1905 2(2328):345-346. The journal also took a look at faith healing in a 1910 series of papers. Reading through some of them does not give the impression that its writers took a very critical view of the practice. The British Medical Association later inspected faith healing themselves in 1956, finding it to be effective for psychogenic problems but not for organic diseases.Peter May (July 8, 2022). "Miracles Today?" A Medical Critique of Craig Keener’s miracle claims by Peter May (8th July 2022) The Skeptic (UK).Articles (1910) The British Medical Journal 1(2581).
The BMJ carried Richard Doll's articles written about the link between tobacco smoking and certain causes of death such as lung cancer in the 1950s. The journal stopped running advertisements for cigarette products in 1957, and we'd take a wild guess that Doll's papers probably had something to do with it.
 a psychiatric doctor and Baroness in the House of Lords, hoaxed the BMJ in 1974. She and her then-husband ( a marketer) fabricated a condition called supposedly a chafing experienced by male cello players in their nether regions. It was submitted to The BMJ as part of a fake case report (i.e., a letter to the editor, thereby bypassing peer review and just needing editorial approval). Probably suspecting some gullibility on the part of the editors, the referenced an earlier case report to The BMJ of a condition that the author called "guitar nipple".Letter: Cello scrotum by J. M. Murphy (1974) The BMJ 2(5914):335. doi:10.1136/bmj.2.5914.335-a.Letter: Guitar nipple by P. Curtis (1974) The BMJ 2(5912):226. doi:10.1136/bmj.2.5912.226-a. It stood in the medical literature for decades, and even received some citations in relevant papers, though the condition's existence was seen as questionable.Contact dermatitis and other skin conditions in instrumental musicians by Thilo Gambichler, et al. (2004) BMC Dermatology 4:3. doi:10.1186/1471-5945-4-3. Elaine and John Murphy sent a letter to The BMJ in 2008 admitting the hoax, and a correction was published in 2009.Idea retraction: Did Picasso suffer migraines? Do 'guitar nipple,' 'cello scrotum' exist? Ask pigeons" by Ivan Oransky (May 27, 2011) Retraction Watch.Doc's confession: We made up "cello scrotum" (January 28, 2009) Reuters via NBC News.
===Rapid responses===
The BMJ's "rapid responses" section was added in 1998. It's basically a fancy comments section present on each BMJ article's online edition. That makes for a favorite point of citation for cranks looking to pass off said rapid responses as if they were scientific papers formally published by the BMJ.Did the BMJ Have a Debate About the Risk of Dying from the MMR Vaccine Vs Measles? by Vincent Iannelli (August 7, 2019) Vaxopedia.The BMJ Asks If Injections Are Part of the 'Mystery' of Acute Flaccid Myelitis/AFM by Vincent Iannelli (November 2, 2018) Vaxopedia. For a reader unfamiliar with the journal's nuts and bolts, it's easy to mistake a rapid response for that, and not everyone writing one has their head screwed on correctly. Though, the responses are manually approved by moderators, for whatever that's worth. There's some racial and gender bias in moderator approval of rapid responses, apparently.Gender and ethnic differences in publication of BMJ letters to the editor: an observational study using machine learningby Mohamad Zeina et al. (2020) BMJ Open 10(2):1-9. doi:10.1136/bmjopen-2020-037269. Rapid responses are also used as a platform for patients and professionals alike to mount honest critiques of the BMJ's work — some such responses are cited in this very article.
===Christmas edition===
The BMJ is known for its annual Christmas issue, which began appearing in 1982, and always contains many whimsical, novel, and strange articles.Journal Offers Dose of Fun for Holiday by Lawrence K. Altman (December 17, 2012) The New York Times. (Archived).Fake study on moms' kisses risked sowing confusion just for a laugh by Ivan Oransky and Adam Marcus (January 13, 2016) STAT News. Apparently many of the articles are about food. One article debunked a claim that alcohol could be absorbed through your feet. Another mocked a reflexology conference because it fell for a hoax submitted by a skeptic.Cassandra Willyard (December 17, 2010). "BMJ's Bizarre and Boisterous Christmas Issue". The Last Word On Nothing. In one feature, one finds not a research article, but some guy playing through The Sims 4.I tried to survive as a Doctor in The Sims 4 by Jordan Oloman (2022) The BMJ379:o2721. doi:10.1136/bmj.o2721.A peer-reviewed Ho, Ho, Ho: Highlights from the BMJ's Christmas issue by Naseem S. Miller (December 21, 2022) The Journalist's Resource. Tongue-in-cheek articles contain blatantly obvious results, such as "sleep deprived people appear tired". Others appropriately focus on Christmas-oriented themes, such as Santa Claus.It must be Christmas, the BMJ is funny by Isobel Maciver (December 19, 2016) Promega Connections.
Though the Christmas edition often contains sound research, a downside to this yearly event is that researchers also often torture data in order to reach a conclusion fit for publication during the festive spotlight. Some articles in the Christmas edition have won the satirical Ig Nobel Prize.The British Medical Journal's Top Picks in Offbeat Medical Science by Gary Smith (December 23, 2020) Mind Matters. One paper published in the 2010 edition purportedly identified the head of French King Henry IV. The paper somehow managed to reach controversial status, with a third of the authors calling for it to be retracted. It never was, though.Off with his paper! Some authors want to retract claim to have identified Henry IV's head by Ivan Oransky (October 29, 2013) Retraction Watch.Henry IV, part 2: No retraction necessary, say some authors of royal head identification paper by Ivan Oransky (November 5, 2013) Retraction Watch.
===Peer review===
Richard Smith, who edited the BMJ between 1991 and 2004, has been critical of peer review. One of the points he uses to bolster his argument for "slaughtering" the "sacred cow" of peer review is an experiment done by the BMJ, demonstrating that their peer reviewers were subpar at catching intentional errors. Smith wrote:Classical peer review: an empty gun by Richard Smith (2010) Breast Cancer Research 12(Suppl 4), S13. doi:10.1186/bcr2742.
This experiment may say more about the BMJ's peer review system (at least while it was under his watch) than peer review in general.Is scientific peer review a 'sacred cow' ready to be slaughtered? by David Gorski (December 21, 2015) Science-Based Medicine.Slay peer review 'sacred cow', says former BMJ chief by Paul Jump (April 21, 2015) Times Higher Education.
==Contemporary controversies==
===Alternative medicine===
The BMJ's promotion of alternative medicine started in 1999 when it published a series of what could charitably be described as unevenly critical articles. They were published under the title "ABC of complementary medicine", and written by (a biostatistician) and Catherine Zollman (an integrative medicine MD). Notable articles included:
In 2009, Steven Novella commented that The BMJ "is a strange journal – it is generally of high quality but seems to have a blind spot for certain CAM modalities, like acupuncture." He added, "While it will publish critical reviews […], it also has published some low quality positive reviews" such as one about "acupuncture and IVF (in vitro fertilization). The review glosses over the disparity in study quality and location. Other reviews published around the same time showed no effect from acupuncture in IVF."
The same year, Novella also covered an editorial published in The BMJ titled "Closing the evidence gap in integrative medicine". As Novella puts it:
Nearly a decade later, Edzard Ernst and David Gorski (among others) took exception to "state of the art reviews" published by The BMJ in 2017, which seemingly promoted alternative medicine. The reviews used the term "complementary and integrated medicine", apparently a nonsensical allusion to CAM and/or "integrative medicine". In an article discussing The BMJ's reviews, Gorski commented that they could "only be described as fully buying into the false paradigm that quackery needs to be 'integrated' with medicine."Quackery infiltrates The BMJ by David Gorski (May 22, 2017) Science-Based Medicine. Also published in Respectful Insolence.Alternative medicine for chronic pain: 'State of the Art' review in the BMJ (May 9, 2017) Edzard Ernst.
==== Acupuncture ====
As far back as 2000, the British Medical Association endorsed the usage of acupuncture, stating it "should become more widely available on the NHS and family doctors should be trained in some of its techniques".Acupuncture wins BMA approval by Mark Silvert (July 1, 2000) The BMJ 321:11. doi:10.1136/bmj.321.7252.11/b. This received some push-back in the rapid responses, with challenges to the flimsy evidence that was used to reach this conclusion.Rapid Response: Acupuncture evidence is flawed by Andrew Moore (July 26, 2000) The BMJ.
In 2008, The BMJ published a paper that was a meta-analysis and systematic review article, that suggested acupuncture could aid success with in vitro fertilization.Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis by Manheimer et al (2008) The BMJ 336:545. doi:10.1136/bmj.39471.430451.BE. David Gorski, writing in Science-Based Medicine, criticized the paper on several grounds. Among these points, he considered that one passage constituted a fallacious appeal to ancient knowledge. He referred to much of the authors' writing as speculation or based on poor citation. He added, "when clinical studies are done about a hypothesis with a very low prior plausibility, noise predominates, producing a disturbingly high proportion of seemingly 'positive' studies." Further, he criticized the lack of blinding ("much less" double blinding) in several of the examined studies. He concluded that the paper "does not provide particularly compelling evidence".Hype over science: Does acupuncture really improve the chances of success for in vitro fertilization? by David Gorski (February 11, 2008) Science-Based Medicine.
For some unknown reason, The BMJ published the journal Acupuncture in Medicine from 2008 to 2018 to "build the evidence base for acupuncture" (giving the game away that this would be an advocacy journal).BMJ Group promotes acupuncture: pure greed (November 11, 2008) DC's Improbable Science.Is acupuncture a medical sham or a genuine treatment? by Vi-Jean Khoo (9 Jan 2017) MIMS (archived from January 18, 2017). It was published on behalf of the British Medical Acupuncture Society, which encourages the use of acupuncture for a number of ailments.Acupuncture – Disconnected from Reality by Steven Novella (March 18, 2009) Science-Based Medicine.BMJ Group promotes acupuncture: pure greed by David Colquhoun (November 11, 2008) DC's Improbable Science. The editor for the journal, Michael Cummings, wrote a 2016 column in BMJ Blogs complaining that Wikipedia "branded" (described, really) acupuncture as a pseudoscience.Is acupuncture pseudoscience? (January 3, 2017) Edzard Ernst.Is acupuncture pseudoscience? by Michael Cummings (September 26, 2018) BMAS Blog. The original post from December 30, 2016 at BMJ Blogs was taken down and is archived here.
One article published in Acupuncture in Medicine under BMJ's watch was criticized when it claimed that ear acupuncture (see also ear stapling) could help with weight loss.Scientists query study saying ear acupuncture aids weight loss by Kate Kelland (December 16, 2013) Reuters.Acupuncture Whac-a-Mole by Mark Crislip (January 10, 2014) Science-Based Medicine. Sticking needles through your ears to lose weight is, of course, a brilliant idea. Another paper in the journal studied acupuncture performed on human corpses. Steven Salzberg, a professor of biomedical engineering, criticized the journal as "fake" (along with other journals that gave as examples published by other large "respectable" academic publishing groups) and "filled with fake science".Fake Medical Journals Are Spreading, And They Are Filled With Bad Science by Steven Salzberg (January 3, 2017) Forbes. Before BMJ gave the journal the boot in 2018, they retracted a paper about acupuncture and Chinese herbal medicine for stroke patients, that had misreported facts about the clinical trial.Authors claim clinical trial data came from one center. It came from three. by Victoria Stern (March 26, 2018) Retraction Watch.
A 2019 study published in BMJ Open said that acupuncture was effective for treating menopause symptoms.Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study) by Kamma Sundgaard Lund et al. (2019) BMJ Open 9:e023637. doi:10.1136/
bmjopen-2018-023637. Several experts criticized the study. One stated that it was "deeply shocking that BMJ Open should publish a test of acupuncture in which the patients were aware of which group they were in." Many also pointed out that the purportedly positive results were likely to be due to a placebo effect.Expert reaction to study on acupuncture for symptoms of menopause by David Colquhoun (February 19, 2019) Science Media Centre. Steven Novella summarized a paper published in The BMJ in 2020 that tested the impact of acupuncture on migraines as "a study with high risk of bias showing a small reduction in subjective reports but no reduction in more objective measures of migraine." In particular, he pointed out that the study was only single-blinded rather than double-blinded, and that it may have had a geographical publication bias (99% of acupuncture studies from China show positive results;Do certain countries produce only positive results? A systematic review of controlled trials by A. Vickers et al. (1998) Controlled Clinical Trials 19(2):159-66. doi:10.1016/s0197-2456(97)00150-5. a Chinese government investigation also once showed that 80% of biomedical research in the country was fabricated80% of China's clinical trial data are fraudulent, investigation finds by Michael Woodhead (2016) The BMJ 355:i5396. doi:10.1136/bmj.i5396.). He was also skeptical that "acupuncture points" exist at all, since acupuncturists themselves can't agree on them.Acupuncture for Migraine Unconvincing by Steven Novella (April 1, 2020) Science-Based Medicine.Chinese BioMedical Research: Sturgeon's Law In Action by Mark Crislip (January 20, 2017) Science-Based Medicine.
In 2022, The BMJ itself even published an acupuncture collection funded by the Chinese government, long known as advocates for traditional Chinese medicine (which includes acupuncture).Acupuncture: How to improve the evidence base (2022) The BMJ. "Funding for this collection, including open access fees, was provided by the special-purpose funds for the belt and road, China Academy of Chinese Medical Sciences, National Natural Science Foundation of China, the National Center for Complementary and Integrative Health, the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine, the Special Project of 'Lingnan Modernization of Traditional Chinese Medicine' of the 2019 Guangdong Key Research and Development Program, and the Project of First Class Universities and High-level Dual Discipline for Guangzhou University of Chinese Medicine.<BR>
The BMJ commissioned, peer reviewed, edited, and made the decision to publish these articles."In the tradition of Chairman Mao, traditional Chinese medicine gets a new boost by the Chinese government by David Gorski (January 2, 2017) Science-Based Medicine.China adopts law on traditional medicine (December 26, 2016) Xinhua. "China's top legislature on Sunday adopted a law on traditional Chinese medicine (TCM) to give TCM a bigger role in the medical system." Edzard Ernst commented that it contained "a bonanza of logical fallacies, sloppy thinking, and uncritical promotion".A new BMJ article on acupuncture turns out to be a bonanza of logical fallacies, sloppy thinking, and uncritical promotion (03 March 2022) Edzard Ernst. Time magazine cited one of the analyses published in that collection as an example of acupuncture "going mainstream", quoting the paper in question as demonstrating the efficacy of acupuncture for a breadth of ailments — from post-stroke aphasia to lactation issues.Why Acupuncture Is Going Mainstream in Medicine by Elizabeth Millard (April 29, 2022) Time. To this uncritical coverage, infectious disease doctor pointed to placebo: "What does post-stroke aphasia have in common with lactation issues? […] What all these processes have in common is a large subjective/psychological component."Mark Crislip (July 28, 2022). Zeno's Paradox by Mark Crislip (July 28, 2022) Science-Based Medicine.
Another paper in that collection gave recommendations for designing "high quality" acupuncture trials. In fact, the paper appeared to dissuade researchers from blinding acupuncturists and patients (though advocating blinding for data collectors, outcome assessors, and data analysts). In a blatant demonstration of bias, the authors argued that trialists should "carefully consider the desirability of a sham that leads to underestimation of acupuncture's treatment effects in clinical practice." Gorski commented, "The whole point of a placebo control or a 'sham' treatment is to reduce nonspecific (i.e., placebo) effects."How to design high quality acupuncture trials: The Good, The Bad, and The Ugly by David Gorski (April 11, 2022) Science-Based Medicine.
Despite the fact that there is no commonly accepted explanation for why acupuncture could be effective in the treatment of pain symptoms, the US Department of Health and Human Services (HHS) reports that "research has shown that acupuncture may be helpful for several pain conditions, including back or neck pain, knee pain associated with osteoarthritis, and postoperative pain. It may also help relieve joint pain associated with the use of aromatase inhibitors, which are drugs used in people with breast cancer. An analysis of data from 20 studies (6,376 participants) of people with painful conditions (back pain, osteoarthritis, neck pain, or headaches) showed that the beneficial effects of acupuncture continued for a year after the end of treatment for all conditions except neck pain."Acupuncture: What You Need To Know National Center for Coplementary and Integrative Health, US Department of Health and Human Services. The HHS uncritically cited two papers published in The BMJ's Acupuncture in Medicine (the journal mentioned above) as well as another two published in the Journal of Alternative and Complementary Medicine, a journal that Quackwatch defines as "fundamentally flawed"."Nonrecommended Periodicals" by Stephen Barrett (November 15, 2019) Quackwatch.
===Vaccines===
====MMR vaccine and autism====
In 2004, Brian Deer began publishing a series of exposés in The BMJ that would completely discredit Andrew Wakefield's proposed link between the measles, mumps and rubella vaccine (MMR vaccine) and autism. This proposed link had been published in The Lancet years earlier as part of a sham study based on conflicts of interest, unethical treatment, and fraudulent research, as Deer was able to demonstrate. Ten of Wakefield's 12 co-authors backed the retraction of the study.The Anti-Vaccine Movement’s New Frontier by Moises Velasquez-Manoff (May 25, 2022) The New York Times Magazine.Wakefield's article linking MMR vaccine and autism was fraudulent by Fiona Godlee, Jane Smith, and Harvey Marcovitch (2011) The BMJ 342:c7452. doi:10.1136/bmj.c7452.Secrets of the MMR scare: How the case against the MMR vaccine was fixed by Brian Deer (2011) The BMJ 342:c5347. doi:10.1136/bmj.c5347 . As far as the rivalry between the two journals goes (as seemingly one-sided as it is), this would be The BMJ's crowning achievement — Retraction Watch declared of Wakefield's paper, "If there were a Canon of Scientific Retractions, it would be in it."Some quick thoughts and links on Andrew Wakefield, the BMJ, autism, vaccines, and fraud by Ivan Oransky (January 6, 2011) Retraction Watch.
Other researchers failed in 2008 to replicate Wakefield's supposed findings, and he was stripped of his medical license by the UK General Medical Council.The General Medical Council to Andrew Wakefield: 'The panel is satisfied that your conduct was irresponsible and dishonest' by David Gorski (February 1, 2010) Science-Based Medicine. Wakefield's sham research likely sparked (with a sensationalist British press as fuel to the fire) a resurgence in measles outbreaks in the United Kingdom to the extent that it went from an under-control disease to one that was again endemic in Britain. So, the exposure of fraud was clearly important.'Piltdown medicine' and Andrew Wakefield's MMR vaccine fraud by David Gorski (January 6, 2011) Science-Based Medicine.Medical journal retracts flawed autism study (February 2, 2010) The Associated Press via NBC News.
In 2023, David Gorski commented that The BMJ's publication of Deer's investigations must have been run by the journal's lawyers first, because of the "very plaintiff-friendly" libel laws present in the United Kingdom.Andrew Wakefield after 25 years: Paving the way for COVID-19 quacks and antivaxxers by David Gorski (February 27, 2023) Science-Based Medicine. Wakefield had nonetheless attempted a libel lawsuit against Deer, BMJ editor Fiona Godlee, and The BMJ itself in 2012. Wakefield inexplicably enlisted a lawyer who was specialized in copyright instead of libel suits, one of many reasons that the suit was doomed from the start.An antivaccine tale of two legal actions by David Gorski (March 12, 2012) Science-Based Medicine. It very quickly failed on jurisdictional grounds, since he filed it in Texas instead of the United Kingdom!Andrew Wakefield's libel suit against Brian Deer: Dismissed! by David Gorski ((August 4, 2012)) Respectful Insolence. D'oh!
====Influenza vaccine====
Not all has been so right and well, however. Peter Doshi is currently a senior editor at BMJ, and has worked there for some time now. His writings (both in and out of The BMJ) have, for at least a decade, been received with delight by the anti-vaccination movement. He wrote on the subject of influenza death tolls as early as 2005, when he wrote in The BMJ that flu death estimates were heavily flawed. He posed the question: "Are US flu death figures more PR than science?"Are US flu death figures more PR than science? by Peter Doshi (2005) The BMJ 331(7529):1412. In March 2006, he wrote on the topic of influenza vaccines for the Christian Science Monitor (CSM) and Harper's Magazine.Viral marketing by Peter Doshi (March 2006) Harper's Magazine.Selling 'pandemic flu' through a language of fear by Peter Doshi (March 21, 2006) The Christian Science Monitor. Reviewing his flu death statements and his CSM piece, 'Revere' of the blog Effect Measure said that Doshi "didn't understand the system or the basis for the estimates. Moreover if one really counted [non-respiratory] flu-associated deaths the figure could easily be a gross underestimate."Unhelpful commentary by Revere (March 23, 2006) Effect Measure.
In the late 2000s, Doshi began studying for a graduate degree in the HASTS programme at MIT, describing his focus as "debates over causality, standards of evidence, and how to handle scientific uncertainty."Study challenges notion of 'pandemic' flu: CDC-labeled pandemics no deadlier than seasonal influenza (11 April 2008) MIT News.Graduate Student Info: Peter Doshi MIT HASTS (archived on 24 January 2008). He submitted his first "Rapid Response" to a BMJ article assessing respiratory virus prevention methods in January 2008.Reason for optimism by Peter Doshi (2008) The BMJ 336(7637):172. doi:10.1136/bmj.39465.484421.3A. That year also saw a paper by Doshi questioning the risk of pandemic influenza published in the American Journal of Public Health.Trends in Recorded Influenza Mortality: United States, 1900–2004 by Peter Doshi (2008) American Journal of Public Health 93(5):939–945. doi:10.2105/AJPH.2007.119933. The paper took aim at the CDC statement that the "hallmark of pandemic influenza is excess mortality", arguing that this "notion" may represent an example of "generaliz[ing] the exception" of the He suggested that this event's death toll may have been high due to the limitations of medicine in 1919, holding that falling flu mortality rates in subsequent decades "cannot be the result of influenza vaccination", and may instead be the product of "improvement in living conditions or naturally acquired immunity." His 2011 doctoral thesis contended that "contemporary influenza policy" was an example of a "disease that for most people is rather unremarkable" becoming the "focus of intense (and costly) public health campaigns based on a shaky scientific basis."Influenza: A Study of Contemporary Medical Politics by Peter Doshi (2011) MIT.
Doshi spoke at a 2009 (NVIC) conference, which is an anti-vaccination group that gets a large chunk of its funding from Joseph Mercola. Unsurprisingly, the founder of NVIC has also stood in defense of Andrew Wakefield. Indeed, Wakefield showed up to the very same conference as Doshi to receive NVIC's "Humanitarian Award".Crank 'scientific' conferences: A parody of science-based medicine that can deceive even reputable scientists and institutions by David Gorski (September 21, 2009) Science-Based Medicine. One must wonder how The BMJ can keep a top editor who has spent his time at a conference undermining The BMJ's own past achievements in exposing scientific fraud.
But Doshi's biggest controversies in virology seemingly began in the early 2010s. In June 2013, Doshi wrote in JAMA Internal Medicine to challenge the assumption that influenza is a "major public health threat for which the annual vaccine offers a safe and effective solution." Bizarrely, he also claimed that "influenza viruses appear to be a minor contributor" to flu, which smacks of germ theory denial.Influenza vaccines: time for a rethink by Peter Doshi (2013) JAMA Internal Medicine 173(11):1014-1016. doi: 10.1001/jamainternmed.2013.490.The zombie anti-vaccine lie – Peter Doshi and the appeal to authority by Michael Simpson (December 5, 2014)Skeptical Raptor. That is perhaps unsurprising given that Doshi signed a letter supporting the HIV/AIDS denialist group Rethinking AIDS while a student at MIT.The AIDS Industry and Media Want You to Think There Are Only a Handful of Scientists Who Doubt the HIV-AIDS Hypothesis (December 2012) Rethinking AIDS (archived from 18 Mar 2023 04:43:56 UTC).'Shocking' Report On Flu Vaccine Is Neither Shocking Nor Correct by Steven Salzberg (November 3, 2014) Forbes.Science and Reality and AIDS Denialism by Reuben (October 7, 2013) The Poxes Blog. This letter states its intent is to counter an alleged false narrative promoted by "the AIDS industry and media" that "only a handful of scientists who doubt the HIV-AIDS hypothesis". When confronted about this by Forbes journalist in 2014, Doshi claimed that he had "written the list owner and asked for [his] name to be removed," but his signature is still there nearly ten years later.
For a prominent writer on vaccines, that is strange indeed. A month before the JAMA Internal Medicine article, he wrote one for The BMJ that was critical of the CDC's influenza vaccination drives, too. He emphasized the potential dangers of flu shots, and questioned their efficacy.Influenza: marketing vaccine by marketing disease by Peter Doshi (2013) The BMJ 346:f3037. doi:10.1136/bmj.f3037. His piece was trumpeted across anti-vaccination websites with headlines such as "Johns Hopkins Scientist Reveals Shocking Report on Flu Vaccines". Doshi's critics soon responded, with some pointing out that he was not an epidemiologist; rather, he is an anthropologist. According to Snopes, Doshi "completed a fellowship in at Johns Hopkins. He conducted no research into influenza or vaccines at Johns Hopkins, nor does he speak for the university on that subject."Non-epidemiologist tries to do epidemiology, feeds anti-vaccine activists. 'by Reuben (July 25, 2013) The Poxes Blog.Did a Johns Hopkins Scientist Expose Flu Vaccine Dangers? by Kim LaCapria & David Mikkelson (October 22, 2014) Snopes. Michael Simpson, a biologist, writes that Doshi "has no knowledge, training or expertise in these highly specialized fields, yet he pontificates in a manner that makes one believe he [does]."
Since their name had been invoked, Johns Hopkins felt it necessary to comment on the matter:
Simpson added: 
Despite his lack of actual expertise in real vaccine research, Doshi was an "expert witness" for Children's Health Defense, Robert F. Kennedy Jr.'s anti-vaccine group.Peer review fail: Vaccine publishes antivax propaganda disguised as "reanalyses" of Pfizer and Moderna COVID-19 vaccine clinical trial data by David Gorski (September 5, 2022) Science-Based Medicine.Editorial staff: Peter Doshi The BMJ. "During 2020, I wrote two affidavits (unpaid) for lawsuits in California and Massachusetts that argued against mandatory influenza vaccination for students."
====VAERS====
In 2017, Doshi wrote an entire article for The BMJ because he was upset that the website for the Vaccine Adverse Events Reporting System (VAERS) was temporarily troublesome to access for some popular Web browsers. He stated: "If anyone was looking for a good illustration of how little respect pharmacovigilance gets in the US healthcare system, this might be it." As he acknowledges, though, there are other methods to report an adverse event (such as by phone, fax, or mail).US government website for collecting adverse events after vaccination is inaccessible to most users by Peter Doshi (May 19, 2017) The BMJ 357:j2449. doi:10.1136/bmj.j2449.Peter Doshi, vaccine denier, sees a conspiracy about VAERS by Michael Simpson (November 27, 2017) Skeptical Raptor. At the time, the website was merely undergoing a technical overhaul.Who Are, or Should Be, the Vaccine Watchdogs? René F. Najera (November 14, 2017) EpidemioLogical. "First, he complained that the Vaccine Adverse Events Reporting System’s web page was broken and that no one was taking care of it. Well, it wasn’t broken. There was just a glitch in the website. And, as I learned through contacts at CDC, the site was undergoing a major revamping, and there is now a new front page that is working quite well." VAERS is not considered (or treated as if it were) very robust, anyway. It's quite open for people to submit bullshit claims, and experts know this.What VAERS Is (And Isn't) by Amy Dusto (May 3, 2022) Bloomberg School of Public Health, Johns Hopkins University. In one demonstration of this fact, a doctor submitted a claim that a flu shot had turned him into the Incredible Hulk. VAERS required his permission to remove it from their database (fortunately, he obliged).Diving into the VAERS Dumpster by Harriet Hall (November / December 2018) Skeptical Inquirer 42(6).
====COVID-19 vaccine====
Before the initial COVID-19 vaccine trials had even finished, Doshi got to work casting doubt on them — as early as September 2020. He suggested the trials couldn't prove that COVID-19 vaccines prevent severe cases (among some other miscellaneous complaints that mostly don't make a lot of sense).Beware of Folks Pushing the Idea That COVID-19 Vaccine Trials Will Fail from the Start by Vincent Iannelli (September 23, 2020) Vaxopedia.Peter Doshi discusses COVID vaccine clinical trials – once again, he’s wrong by Michael Simpson (August 18, 2021) Skeptical Raptor. John Skylar, a virologist, criticized Doshi's statements:
Doshi additionally complained that Pfizer had excluded 0.5% of the subjects in one of their trials from the final analysis, due to protocol deviations. He notes that there were more exclusions in the vaccinated group than the control group, but David Gorski noted that "even given the imbalance in deviations between the placebo and vaccine groups this is a number too small to have significantly affected the final analysis."Why is Peter Doshi still an editor at The BMJ? Peter Doshi is at least borderline antivaccine and has been casting doubt on vaccine efficacy since 2009. Earlier this month, he posted a badly flawed “analysis” casting doubt on the efficacy of the Moderna and Pfizer COVID-19 vaccines. Why does The BMJ still employ him? by David Gorski (January 15, 2021) Respectful Insolence. Other critics of Doshi on this topic included professor of public health & preventative medicine Jeffrey Morris, and scientist/health advocate who provided their own respective write-ups.Refuting Peter Doshi's claims doubting 'trustworthiness & meaningfulness' of COVID vaccine results by Jeffrey Morris (Jan 17, 2021) COVID-19 Data Science.Unpacking Doshi's Take at BMJ on Covid Vaccine Trials (January 19, 2021) Hilda Bastian.
Later, in 2021, Doshi testified for a panel led by GOP Senator Ron Johnson. There he claimed that it showed most COVID-19 hospitalizations were among vaccinated people; in fact, the report was an error, originating with a mistaken swapping of the word "vaccinated" with "unvaccinated". Doshi also claimed that mRNA vaccines (e.g. the Pfizer–BioNTech and the Moderna COVID-19 vaccine) are not really vaccines.
 (an anti-GMO guy who used to work for GOP Senator Chuck Grassley), published a 2021 "exposé" in The BMJ, alleging sloppy laboratory management by one company operating three clinical sites (out of 153 total) for Pfizer's large COVID-19 vaccine trial.What the heck happened to The BMJ? by David Gorski (November 8, 2021) Science-Based Medicine.Experts Blow Whistle on Alleged COVID Vaccine Whistleblower Claims by Cheryl Clark (November 5, 2021) MedPageToday. This involved such abuses as placing sharps into biohazard bags instead of a sharps container box; much of it had little apparent impact on data integrity. Several experts such as questioned the authenticity of Thacker's report; David Gorski commented that it was framed deceptively. A spokeswoman for the company involved stated that the whistleblower's allegations "were investigated and determined to be unsubstantiated". The whistleblower alleged that she had only worked for the company for two weeks.Fact Check: The British Medical Journal Did NOT Reveal Disqualifying And Ignored Reports Of Flaws In Pfizer COVID-19 Vaccine Trials by Dean Miller (November 10, 2021) Lead Stories FactChecker. The Thacker/Jackson report was later developed into a video on The BMJ's YouTube channel, which received over three million views.Covid-19: Researcher blows the whistle on data integrity issues in Pfizer’s vaccine trial (March 16, 2022) The BMJ on YouTube.
In 2022, Doshi published a paper which Health Feedback, along with numerous other sources, described as engaged in p-hacking to bias its results "in favor of the conclusion that the risk of serious adverse [vaccine-related] events are greater than the risk of serious COVID-19 outcomes."Studies show that the benefits of COVID-19 vaccines outweigh their risks; preprint claiming to show otherwise is flawed by Flora Teoh (July 1, 2022) Health Feedback."Unsafe and Ineffective: Aseem Malhotra" by Jonathan Laxton (May 21, 2023) Science-Based Medicine. "Later in the paper, he cites another re-analysis of the mRNA vaccine clinical trial data for Pfizer and Moderna by Fraiman, Doshi, et al., who p-hacked an interim analysis to support the claim that serious adverse events significantly outnumber the benefit of preventing COVID-19 hospitalisation. The issues with this paper have been comprehensively discussed by Orac, Dr Susan Oliver, and Dr Jonathan Howard. Still, in brief, it downplays the benefits of vaccination and over-counts adverse events."Canadian cardiologists debunk Florida COVID-19 vaccine claims by Megan DeLaire (March 14, 2023) CTV News. Jonathan Howard and Harriet Hall (among others) wrote their own critiques of the paper; both point out that Doshi used VAERS as if it were a robust source."Apples, Oranges, and How Not to Analyze a Vaccine RCT by Jonathan Howard (July 4, 2022) Science-Based Medicine.Statistical Shenanigans? by Harriet Hall (July 5, 2022) Science-Based Medicine. Originally gone viral among anti-vaccination activists while it was a mere pre-print, these "reanalyses" by Doshi somehow managed to receive publication in not only The BMJ, but also another major journal, Vaccine.
===Chronic fatigue and CFS/ME===
==== Skirting ethical review ====
In 2011, BMJ Open published a study investigating whether undiagnosed cases of chronic fatigue syndrome (CFS) (also called myalgic encephalomyelitis or ME) could be discovered among schoolchildren by examining school absence records.Unidentified Chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics by Esther M. Crawley et al. (2011) BMJ Open 1:e000252. doi:10.1136/bmjopen-2011-000252. The paper was published without ethical review, as Esther Crawley and her co-authors claimed the paper should qualify for an exemption, applied to papers that only involve "service evaluation" (i.e. evaluating the current state of health service to people already diagnosed with CFS) rather than original research involving human subjects — though the paper was actually labeled explicitly as research by BMJ Open in a subheading and certainly did involve human subjects.
This was raised as a concern by the paper's pre-publication reviewer, who suggested the authors publish their correspondence with the REC (Research Ethics Committee) as well as more information about the researchers' contact with the involved families, however the paper was published anyway without such information. Later, the journal's editor agreed that the paper did not strictly constitute service evaluation, yet should still be exempt somehow.Trial By Error: A Letter to Health Officials About BMJ's Lax Editorial Standards by David Tuller (June 6, 2018) Virology Blog.
Crawley cited a 2007 REC reference number regarding a separate procedure that would in fact have constituted service evaluation, attempting to apply it to the 2011 study, clearly outside the bounds of the original exemption. That the REC correspondence took place four years earlier was not apparently made clear to the pre-publication reviewer. She additionally claimed that the REC had indicated that a paper "recording outcomes on school based clinics run by school nurses" should be exempt from ethical review — which was seemingly irrelevant to the research at hand. As an example for why this research may have required ethical review, a letter to BMJ Open on the subject notes that inviting undiagnosed children to a meeting to determine whether they had chronic fatigue syndrome due to their school absences could cause anxiety and distress among parents.Trial By Error: A Letter to BMJ Open by David Tuller (February 19, 2018) Virology Blog. The 2007 REC letter was also cited to exempt at least ten other studies (or parts of studies) from ethical review, at least four of which were also published in BMJ journals; In one case, it was used to cite a study published in 2017, ten years after the original exemption letter.Trial By Error: How Bristol Investigators Avoided Ethical Review by David Tuller (November 12, 2018) Virology Blog.Trial By Error: How BMJ Enabled Bristol's Ethics Exemptions by David Tuller (December 4, 2018) Virology Blog.Trial By Error: The HRA's Letter about the Investigation of Bristol Research by David Tuller (October 28, 2019) Virology Blog.
An editor for BMJ Open stated in response to an email inquiry, that the school absence research would have been exempted from ethical review because it qualified as "research limited to secondary use of information previously collected in the course of normal care (without an intention to use it for research at the time of collection), provided that the patients or service users are not identifiable to the research team in carrying out the research". This was very obviously not the case with the given research. The journal's editor-in-chief later suggested that all was handled correctly by the authors in the original pre-publication review. The journal then submitted the case to the Committee on Publication Ethics (COPE).Trial By Error: No Ethical Review of Crawley School Absence Study by David Tuller (August 28, 2017) Virology Blog.Trial By Error: The School Absence Study, Revisited by David Tuller (January 2, 2018) Virology Blog. The COPE Forum responded in a way that made clear that ethical review should have been required.Trial By Error: COPE to BMJ Open: More Details, Please! by David Tuller (January 3, 2018) Virology Blog.Trial By Error: Our Exchange of Views with BMJ Open by David Tuller (February 26, 2018) Virology Blog. Instead of complying with the COPE's advice to review the paper's methodology (which would have yielded an obvious conclusion that it should have received ethical review), BMJ Open opted to simply close the case.Trial By Error: My Letter to Fiona Godlee by David Tuller (July 2, 2018) Virology Blog.
====The Lightning Process====
A clinical trial for the use of (an alternative medicine commercial programme created by a former "tarot healer" that incorporates aspects of neurolinguistic programming and osteopathy) as a treatment for chronic fatigue syndrome in children was published in 2017 in Archives of Disease in Childhood, a BMJ journal. It found that the Lightning Process may be useful for these children.Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial by Esther M. Crawley et al. (2017) Archives of Disease in Childhood 103:155-164. doi:10.1136/archdischild-2017-313375.Training for children with chronic fatigue works better than medical care alone, finds study by Nigel Hawkes (2017). The BMJ 358:j4372. doi:10.1136/bmj.j4372. Crawley, who was also an author in this study, acknowledged many limitations and stated she was "not advocating people go out and get the Lightning Process".Controversial Lightning Process 'helps children with chronic fatigue syndrome' by Sarah Boseley (September 20, 2017) The Guardian. In a September 2017 article for The BMJ's "Research News" section about the trial, Nigel Hawkes was somewhat critical of the practice, commenting that "The Lightning Process is secretive about its methods, lacks overall medical supervision, and has a cultish quality because many of the therapists are former sufferers who deliver the programme with great conviction. Some children who do not benefit have said that they feel blamed for the failure."Chronic fatigue syndrome patients, long victimized by discredited research, turn to a dubious self-help program by David Tuller (April 20, 2021) Coda Story.
A letter to the Archives of Disease in Childhood signed by 21 researchers critical of the study, calling for major corrections to the paper, was published in January 2018. It stated that the study's self-reported outcomes were vulnerable to bias. They also pointed out that the Lightning Process (which they called pseudoscientific) "encourages participants to report that it has made them better, another source of potential bias" and that "the study suffered from major cross-contamination between treatment arms and significant loss-to-follow-up, among other problems."Trial By Error: A Letter to Archives of Disease in Childhood by David Tuller (January 30, 2018) Virology Blog.
David Tuller (a Doctor of Public Health who signed the letter to the Archives of Disease in Childhood) also noted that the paper violated BMJ policy and International Committee of Medical Journal (ICMJE) recommendations (there to protect against bias and ensure research integrity) it was subject to, and suggested this may be grounds for the paper to be retracted entirely. In particular, he wrote that "more than half the participants were enrolled before the trial registration date" and "the outcome measures were swapped based on those first results – meaning that this was not a properly registered prospective trial."Trial By Error: My Exchange With Archives of Disease in Childhood by David Tuller (March 7, 2018) Virology Blog.Trial By Error: Yet Another Letter About the Lightning Process Study by David Tuller (November 7, 2018) Virology Blog.
The journal never retracted the paper when made aware of these flaws, but did instead issue a lengthy correction (that consisted of "mainly clarifications") that surprisingly culminated in a republication of the paper in 2019, allowing the dubious findings from the paper to stand. The paper's authors also acknowledged that the study lacked full compliance with ICMJE recommendations.Editor's note on correction to Crawley et al. (2019) by Nick Brown Archives of Disease in Childhood 104:e3. doi:10.1136/archdischild-2017-313375ednote.Trial By Error: Our Exchange with BMJ Journal about 'Correction' of LP Study by David Tuller (July 15, 2019) Virology Blog. A follow-up letter signed by 72 experts along with dozens of patient and advocacy groups for CFS/ME condemned the republication of the paper as "scientifically and ethically indefensible" and contrasted the decision with BMJ's previously stated policy on the matter.Trial By Error: An Open Letter to Dr Godlee about BMJ's Ethically Bankrupt Actions (2) by David Tuller (November 22, 2019) Virology Blog.Trial By Error: An Open Letter to Dr Godlee about BMJ’s Ethically Bankrupt Actions by David Tuller (28 August 2019) Virology Blog.
 (a Norwegian pediatrician) and (a virologist), among others, further called for the paper to be retracted.Trial By Error: Calls for Retraction of the LP Study by David Tuller (September 3, 2019) Virology Blog.Trial By Error: More Experts Urge Godlee to Retract Lightning Process Study by David Tuller (September 9, 2019) Virology Blog.Trial By Error: Experts Send More Tough Letters to Dr Godlee by David Tuller (September 11, 2019) Virology Blog. Brian Hughes, an academic psychologist, criticized the paper's vulnerability to confirmation bias.The BMJ's ambiguous editorial commitment to scientific rigour by Brian Hughes (September 11, 2019) The Science Bit. Edzard Ernst stated: "The trial was designed as an 'A+B versus B' study which practically always generates a positive outcome. It did not control for placebo effects and is, in my humble view, worthless and arguably unethical. It certainly does not warrant the conclusion that [LP] is effective or cost-effective."The 'Lightning Process': implausible, unproven, hyped and expensive (June 1, 2020) Edzard Ernst. Tuller further listed his gripes with the study in an opinion article for STAT News, a medical news outlet. He added: "BMJ's inability to detect problems in these cases, despite supposedly rigorous oversight systems, suggests that its peer-review and editorial processes might need a significant overhaul."BMJ should retract flawed research paper on chronic fatigue syndrome by David Tuller (December 13, 2019) STAT News.
====CBT with music therapy====
In 2020, BMJ Paediatrics Open published a paper that examined the use of cognitive behavioral therapy (CBT) combined with in adolescent patients with chronic fatigue following Epstein-Barr virus (EBV) infection.Malik et al. (2020). Retracted: Cognitive–behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study by Sadaf Malik et al. (2019) BMJ Paediatrics Open 4:e000620. doi:10.1136/bmjpo-2019-000620.Trial By Error: More on that Norwegian CBT/Music Therapy Study by David Tuller (May 16, 2020) Virology Blog. One of the two peer reviewers stated in his review, "I haven't read beyond the abstract". Yes, really.Peer Review History BMJ Paediatrics Open.Trial By Error" Norway's Double Whammy of Fuzzy Science by David Tuller (May 20, 2020) Virology Blog. The paper was fully retracted later due to its being labeled as a "feasibility study"; it was republished and re-labeled as a randomized controlled trial.BMJ journal retracts, replaces study on chronic fatigue in children by Adam Marcus (October 21, 2020) Retraction Watch.Retraction: Cognitive–behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study BMJ Paediatrics Open 4:e000620ret. doi:10.1136/bmjpo-2019-000620ret. Tuller listed several critiques of this study, including its premise that CBT is effective for treating CFS/ME; a CFS/ME patient also wrote a critical rapid response to the paper.Inaccuracy in reporting CEBA part II by Michiel Tack (May 19, 2020). Rapid responses: BMJ Paediatrics Open. BMJ refused to publish some other critical responses to the paper written by patients.Music therapy study: BMJ refuses to publish critical comments (22. november 2020) MElivet.
The study's main focus (physical activity levels between the intervention and control groups) showed that those who received CBT/music therapy actually fared worse. However, the researchers decided to emphasize self-reported measures of success instead, leading them to the conclusion that the treatment was feasible. Notably, 6 of the 21 patients in the intervention group had dropped out of the study during the treatment period, and there was no similar drop-out rate for the control group. The senior author for the CBT/music therapy trial, Vegard Bruun Wyller, noted that avoidance of school absence was cited by many as a reason for dropping out of the trial.Norwegian researchers have tested music therapy for chronic fatigue by Ingrid Spilde (July 1, 2020) sciencenorway.no. Wyller was also a proponent for another planned trial of the Lightning Process but the trial was rejected by Norway's research ethics authorities.Trial By Error: My Letter to Senior Author of Norway's CBT-Music Therapy Study by David Tuller (May 22, 2020) Virology Blog.Trial By Error: Norway Rejects New Clinical Trial of Woo-Woo Lightning Process by David Tuller (June 7, 2021) Virology Blog.Kritikken av Forskningsrådets prosess må bero på en misforståelse: Brukerpanelet vurderte ikke prosjektenes faglige kvalitet by Jesper W. Simonsen (February 16, 2017; updated March 27, 2017). Dagbladet. (in Norwegian).
===Trans healthcare===
Despite more recent publications covered below, The BMJ previously hosted writers who called for quicker transition care. For instance, James Barrett (a psychiatrist) wrote in a 2016 issue about how the British healthcare system was not doing enough for transgender patients.Personal View: Doctors are failing to help people with gender dysphoria by James Barrett (2016) The BMJ352:i1694. doi:10.1136/bmj.i1694.
===="Too far, too fast?"====
On March 11, 2023, the print edition of The BMJ featured a front cover posing the question, "Transgender Medicine for Young People: Too Far, Too Fast?"11 March 2023(vol 380, issue 8374), The BMJ. In this issue, BMJ editor-in-chief framed the "debate on gender dysphoria" as representative of "all that is unsavoury about the intersection of science, medicine, and social media."Caring for young people with gender dysphoria by Kamren Abbasi (2023) The BMJ 380:p553. doi:10.1136/bmj.p553. In the piece, Abbasi claims that "closer inspection" reveals "the strength of clinical recommendations [on treatment of trans youth] is not in line with the strength of the evidence", arguing that "the risk of overtreatment of gender dysphoria is real." Abbasi praised a Guardian op-ed defending the "cancelled" TERF artist Jess de Wahls as "an important and entirely feminist view" in a 2021 tweet.Assigned gender and biological sex both matter. An important and entirely feminist view. by Kamran Abbasi (@KamranAbbasi) (10:17 AM · Jun 28, 2021) Twitter (archived from 18 Mar 2023 06:59:16 UTC).
Surgeon Alex Ashman tweeted that they found it "so sickening to open the magazine of [their] union and find that the culture war about trans people is right there on the front cover."It's so sickening to open the magazine of your union and find that the culture war about trans people is right there on the front cover. by Alex Ashman (@AlexAshman) (6:21 AM · Mar 11, 2023) Twitter (archived from March 21, 2023). The British Medical Association issued a statement in response, stating that, although BMA membership includes a BMJ subscription, the journal is "editorially independent" from the union and "BMJ coverage does not reflect BMA policy positions."BMJ coverage does not reflect BMA policy positions. The BMJ is editorially independent from the BMA. We acknowledge that by association and by receiving the BMJ as part of BMA membership this separation may appear indistinct. by The BMA (@TheBMA) (9:47 AM · Mar 17, 2023) Twitter (archived from March 21, 2023). It also affirmed its support for the right of trans people to access care that is "timely, patient-centred and meets their individual needs."
====More JAQing off====
The March 2023 issue featuring Abbasi's article included a related piece by Jennifer Block.Gender dysphoria in young people is rising — and so is professional disagreement by Jennifer Block (2023) The BMJ 380:p382. doi:10.1136/bmj.p382. The piece, actually a "BMJ Investigation" rather than a research paper, was published online in late February. Block describes herself as an "independent journalist who writes frequently about health, gender, and contested areas of medicine."Bio Jennifer Block (archived from 17 Mar 2023 14:57:22 UTC). The BMJ previously ran a cover story by Block in September 2021 on COVID vaccine mandates in the United States that argued "evidence is mounting that natural immunity is at least as protective as vaccination."Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US? by Jennifer Block (2021) The BMJ 374:n2101. doi:10.1136/bmj.n2101. Block co-authored a piece with BMJ editor for a January 2021 New York Times series on COVID vaccine rollout problems, which called it "needlessly divisive to use pressure, shame or mandates to get people vaccinated."Four Ways to Fix the Vaccine Rollout: Don’t Pressure the Vaccine Hesitant by Peter Doshi & Jennifer Block (7 January 2021) The New York Times (archived from January 7, 2021). Block has more recently taken to Twitter to express her opposition to school mask mandates and vaccinating kids against COVID.The vaccine "offered almost no protection against infection" to ages 5-11, per NYT. Where is the rationale to deprive the youngest and most developmentally vulnerable their humanity? "All the science" doesn't cut it by Jennifer Block @writingblock (7:36 PM · Mar 3, 2022) Twitter (archived from 17 Mar 2023 15:22:57 UTC).#urgencyofnormal taking the lead in advocating for end to kids' testing & vax mandates. @CDCgov guidelines "continue to cause significant disruption to children’s education and to working parents, while providing no demonstrable public health benefit in limiting COVID-19 spread." Twitter thread by Jennifer Block (@writingblock) (Jun 21, 2022) Twitter (archived from 17 Mar 2023 15:24:25 UTC). She also has a long history of promoting a "natural" approach to obstetric care, advocating home birth and decrying medical interventions such as Caesarean sections, inductions, and epidurals.Babies, the old-fashioned way by Jennifer Block (July 9, 2008 12 AM PT) Los Angeles Times (archived from 17 Mar 2023 15:56:49 UTC).How To Scare Women: Did a Daily Beast story on the dangers of home birth rely too heavily on the views of one activist? by Jennifer Block (3 July 2012) Slate.The Criminalization of the American Midwife by Jennifer Block (10 March 2020) Longreads. Block defended Goop in a 2020 New York Times piece co-written with a doula novelist.Who’s Afraid of Gwyneth Paltrow and Goop? by Elisa Albert & Jennifer Block (3 February 2020) The New York Times.
Block's 2023 article for The BMJ rehashes anti-trans scaremongering about the surge in youth transition; Block's article cites Lisa Littman. The article presents "surgical removal or augmentation of breasts, genitals, or other physical features" as interventions that gender-dysphoric children may be offered under the standard of gender-affirming careBlock places the term "gender-affirming care" in scare quotes. practiced in the U.S. It uncritically quotes the claim of far-right detrans activist that "many of us were young teenagers when we decided, on the direction of medical experts, to pursue irreversible hormone treatments and surgeries." Cole has spent much of 2022 and 2023 travelling across the U.S. to testify in support of bills banning gender-affirming care for minors.California ex-trans teen is national right-wing media’s darling by Dawn Ennis (11 September 2022) Los Angeles Blade.A transgender patient’s lawsuit against Kaiser is a front for the conservative war on LGBTQ rights by Michael Hiltzik (2 March 2023) Los Angeles Times. Nine U.S. states have passed bans on gender-affirming care for trans youth as of March 2023.Georgia House Passes Bill Banning Gender-Affirming Care for Trans Kids by Tori Otten (16 March 2023) The New Republic. Block's article also cites a 2022 study commissioned by the Florida Agency for Health Care Administration (AHCA), which had been stacked with Catholic Medical Association members (who have a "faith-based commitment" against homosexuality and transition care) by Ron DeSantis.Catholic Medical Association members wrote a majority of Florida Medicaid’s anti-trans expert reports. Last year, CMA declared a faith-based commitment against approving of any transition care. by Zinnia Jones (August 25, 2022) Gender Analysis.Chrissy Stroop (August 18, 2022). "Media Fail to Acknowledge That 2024 Hopeful Ron DeSantis is as Catholic as Biden". Religion Dispatches. The Human Rights Campaign now recognizes Florida's AHCA as a body that "is willfully misinterpreting studies, ignoring evidence, and lending credence to prejudice."DeSantis Administration Moves Toward Denying Health Care to Transgender Floridians; Human Rights Campaign Calls on State Health Officials to Reverse Course on Discriminatory Proposed Rule by Delphine Luneau (June 17, 2022) Human Rights Campaign.
The BMJ published several rapid responses to Block's article in the weeks following its online publication.All rapid responses to "Gender dysphoria in young people is rising—and so is professional disagreement" One supportive response came from Jonathan D. Block, a Utica, New York-based urologist.Gender dysphoria in young people is rising—and so is professional disagreement by Jonathan D. Block (2023) The BMJ 380:p382. doi:10.1136/bmj.p382. He did not disclose any conflicts of interest in his submission despite being married to the article's author."Dr. Jonathan & Jennifer Block" are included on a A Glimpse of Notre Dame Commencement 2019 The Juggler Journal. List of donors to a Notra Dame Schools, Utica, New York.
London-based doctor George R. Huntington wrote that he was "disappointed in [the] lack of rigour" of the piece.Re: Gender dysphoria in young people is rising—and so is professional disagreement by George Huntington (2023) The BMJ 380:p382. doi:10.1136/bmj.p382. Huntington found it "curious" that an "author criticising a medical consensus for lack of strong evidence" had relied on "quotations and single cases" drawn from "self-citations or Cornish QIPs" instead of citing primary sources. He noted that the article centered the "0.3% [who] regret their transition" while ignoring the "voices of the other 99.7%," concluding this was because it is "not a piece of scientific journalism" but rather a hit piece "lean[ing] on the authority of a medical journal to push an agenda, one of muddying the waters."
New Zealand psychiatrists Zoe Kristensen and David B. Menkes took issue with Block's conflation of social transition with surgical and hormonal therapies.Professional responses to gender dysphoria: reality checks needed by Zoe Kristensen and David B. Menkes (2023) The BMJ 380:p382. doi:380:p382. They criticised her for "mistakenly equat[ing] the limited evidence underpinning gender affirming care with its propensity for harm", explaining that research on trans youth is complicated by small sample sizes and "other aspects of study design" such as the "ethical protection of minors", the "realities of studying a hard-to-reach community", and "prioritisation of clinical care over research" where resources are lacking. A group of three British surgeons (Ashman et al.) concluded that "the assertions made by Block are in some cases unsupported by reference, and in others are based on only some of the available evidence."Gender dysphoria in young people: not a balanced investigation by Alex Ashman, Ginny Bowbrick, and Xander Stephenson-Allen (2023) The BMJ 380:p382. doi:10.1136/bmj.p382. They pointed out that the two studies that Block cited in her discussion of detransition do not support her claims. One study investigated HRT discontinuation rather than detransition and the other included "just five cases of detransition or regret and was not specifically looking at children and young people." 
Three neurodivergent (ND) doctors objected to Block's mention of the scientific finding that trans youth are more likely to have depression, anxiety, autism, or ADHD.Diversity in gender identity and neurotypes by Samira Khan, Matthew Sellen, Bethan Carey Jones (2023) The BMJ 380:p382. doi:10.1136/bmj.p382. They found that this fact, presented out of context in a paragraph about the increase in youth transition, serves to "imply that there is less capacity [among ND people] for making good choices about our bodies, evaluating risks and benefits." Ashman et al. similarly held that, while the "co-existence of gender dysphoria with autism and ADHD is worthy of future study", this does not "represent a reason to deny these children effective treatment for gender dysphoria."
==See also==
* Elsevier
* Intelligence (journal)
* Nature (journal)
* Nobel disease
==External links==
* The BMJ's website
* Articles archive (also found here)
* 
* The BMJ's entries in Retraction Watch
* "What the heck happened to The BMJ? (2023 version)". By David Gorski, in Science-Based Medicine.
==Notes==
==References==
Category:Alternative medicine
Category:British media
Category:Journals
Category:Medicine
Category:Publishers
Category:Science
Category:Transphobia
Category:Websites