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Jack Turban
Jack Turban
Jack Turban
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Jack Turban is an American psychiatrist, author, and commentator who researches the mental health of transgender youth.[1][2] His writing has appeared in The New York Times,[3][4][5][6] The Washington Post,[7][8] The Los Angeles Times,[9] CNN,[10][11][12] Scientific American,[13][14][15] and Vox.[16][17][18] He is an assistant professor of child and adolescent psychiatry at The University of California San Francisco and affiliate faculty in health policy at The Philip R. Lee Institute for Health Policy Studies.[19][20]

Key Information

Early life and education

[edit]

Turban was born in Pittsburgh, Pennsylvania.[1] Fearful of violence from his father, he did not come out as gay until he attended college.[21] He later wrote in The New England Journal of Medicine about his early experiences of childhood homophobia and how they influenced his experience of medical education.[21] Turban attended Harvard College where he studied neuroscience, then earned his medical and master of health science degrees from Yale School of Medicine. He completed psychiatry residency at McLean Hospital (Harvard Medical School) in 2020 and child and adolescent psychiatry fellowship at Stanford University School of Medicine in 2022.[20][19]

Career

[edit]

Turban is an assistant professor of child and adolescent psychiatry and health policy at the University of California, San Francisco.[19][20] He has published studies showing that gender identity conversion therapies (attempts to make transgender people cisgender) are widespread in the US[22][23] and associated with suicide attempts.[24][25][26] His research has shown that access to gender-affirming medical care (puberty blockers and gender-affirming hormones) during adolescence is linked to better mental health outcomes in adulthood.[27][28][29][30] He has also been one of the few researchers to publish on the topic of gender de-transition,[31][32] including in the academic literature.[33][34][35]

Turban has been critical of Wall Street Journal writer Abigail Shrier's book Irreversible Damage, which alleges that a recent surge in adolescents becoming transgender is taking place, supposedly due to social contagion. He claimed that the book misinterpreted and omitted important scientific evidence about young people and gender identity.[36] He subsequently co-authored a study arguing that gender dysphoria in children was not caused by social contagion.[37]

Turban has been critical of the geosocial networking application Grindr, and argued in Vox that the app may have detrimental effects on the mental health of gay men.[38][17] He has complained that Grindr does not do enough to keep minors off of their platform, and that this may pose sexual risk to young people.[39] His opinion piece for The New York Times about minors on Grindr was one of several LGBT articles that were conspicuously censored with large white boxes in The New York Times print edition in Qatar.[40]

Turban resigned from the NCAA Committee on Competitive Safeguards and Medical Aspects of sports following the NCAA's decision to prohibit transgender women from competing in women's sports leagues, noting that the organization did not consult its medical or scientific experts prior to issuing the decision, which was viewed as a political reaction to the Trump administration.[41][42][43]

References

[edit]
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Jack Turban

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Jack L. Turban is an American child and adolescent specializing in the mental health of and gender-diverse youth, where he advocates for medical interventions such as pubertal suppression and cross-sex to alleviate symptoms. As an assistant professor of at the (UCSF), he directs the institution's Gender Psychiatry Program and conducts research aimed at informing on youth access to these treatments. His studies, often drawing from large surveys of adults, report associations between adolescent hormone access and reduced lifetime risks of or , though such findings derive from cross-sectional, self-reported data unable to establish causation or account for selection effects like supportive environments. Turban's publications, including contributions to journals like Pediatrics and JAMA Pediatrics, have influenced professional guidelines endorsing gender-affirming care, positioning him as a prominent voice in debates over youth transitions. He co-edited sections on in psychiatric textbooks and authored Free to Be: Understanding Kids & Gender Identity (2024), which uses case studies to argue for early intervention while critiquing restrictions on treatments amid rising youth gender referrals. However, his research has been faulted for overstating benefits without addressing harms, such as bone density loss from puberty blockers or regret in a subset of cases, and for conflating exploratory with prohibited conversion practices. In legal contexts, including a 2023 deposition related to youth treatment bans, Turban acknowledged limited familiarity with evidence hierarchies, such as the superiority of randomized trials over observational data, highlighting tensions between his advocacy and rigorous standards. The UK's 2024 Cass Review, assessing the broader evidence base, classified studies like Turban's as low-quality due to methodological flaws and biases in self-selected samples, urging comprehensive evaluations of comorbidities before .

Biography

Early life and education

Jack Turban was born in , , around 1989. Public information on his childhood and family background remains limited, with no detailed accounts of early influences on his interests in neurobiology or available from primary sources. Turban graduated from in 2011 with a B.A. in neurobiology, earning magna cum laude honors. He then attended , where he obtained both an M.D. and an M.H.S. in 2016. During medical school, Turban completed a thesis titled "Transgender Youth: Evolving Treatment Paradigms," which analyzed shifts in psychological and medical interventions for adolescents since the early , including critiques of prior approaches like promoting identification with birth-assigned sex and proposals for enhanced psychiatric training and curriculum development. For this work, he received the Ferris Thesis Prize from in 2017. These academic achievements laid the groundwork for his subsequent training in , focusing initially on gender-related issues.

Academic and clinical career

Training and initial positions

Turban completed his general psychiatry residency at the combined / program affiliated with , following his graduation from in 2017. During this four-year residency, which concluded around 2020, he engaged in early research on transgender youth mental health, contributing to initial publications while affiliated with Harvard. Following residency, Turban pursued a two-year fellowship in at , where he served as chief fellow from July 2020 to August 2022. This training focused on clinical and research aspects of pediatric psychiatric care, building on his prior work in gender-related mental health topics.

Current roles at UCSF

Jack Turban holds the position of of at the (UCSF), within the Department of and Behavioral Sciences. He also serves as Director of the Gender Program at UCSF, overseeing clinical services dedicated to the needs of and diverse youth. The Gender Psychiatry Program provides specialized psychiatric care, including and medication management, targeted at children, adolescents, and their families experiencing gender-related challenges. In addition to his directorial duties, Turban maintains an affiliate faculty role at UCSF's Philip R. Lee Institute for Studies, integrating clinical practice with broader institutional responsibilities in education and patient care at UCSF facilities.

Research on transgender youth

Key studies and findings

In a 2018 review published in the Journal of Child Psychology and Psychiatry, Turban examined treatment paradigms and controversies surrounding in youth, including epidemiological data estimating that approximately 1% of adolescents experience persistent or incongruence, alongside notably high rates of co-occurring anxiety (up to 50-60% in some cohorts) and depression (around 40-50%). A 2019 cross-sectional study by Turban in JAMA Psychiatry, analyzing survey data from 27,715 transgender adults via the 2015 U.S. Transgender Survey, reported that recalled lifetime exposure to conversion efforts was associated with increased odds of severe psychological distress in the past month (adjusted [aOR], 1.56; 95% CI, 1.09-2.22) and lifetime attempts (aOR, 2.27; 95% CI, 1.75-2.95), with similar associations for childhood exposure (aOR for distress, 1.83; 95% CI, 1.22-2.76; aOR for attempts, 2.32; 95% CI, 1.72-3.13). In a analysis published in , Turban and colleagues used data from the same 2015 U.S. Survey (n=20,619 transgender adults aged 18-36) to assess pubertal suppression, finding that access to pubertal blockers during was linked to lower odds of lifetime (aOR, 0.3; 95% CI, 0.2-0.6) compared to those who desired but did not receive such interventions, after adjusting for factors like family support and history. Turban's 2022 study in , drawing on 2015 U.S. Survey responses from 21,598 adults, indicated that receiving gender-affirming hormones during correlated with reduced past-year depressive symptoms (aOR, 0.7; 95% CI, 0.6-0.9), past-year (aOR, 0.6; 95% CI, 0.5-0.8), and lifetime attempts (aOR, 0.4; 95% CI, 0.3-0.6) relative to desiring but not accessing hormones, with comparable benefits observed for adult initiation after controlling for demographics and prior .

Evidence base for gender-affirming interventions

Turban's research has emphasized associations between early access to pubertal suppression and reduced lifetime suicidal ideation among transgender adults who received such interventions as adolescents. In a 2020 retrospective study using data from the U.S. Transgender Survey (USTS), which included 20,619 participants, those who accessed puberty blockers had lower odds of lifetime suicidal ideation (adjusted odds ratio [aOR] 0.3; 95% CI, 0.2-0.6) compared to those who desired but did not receive them, after controlling for factors like age and parental support. The authors noted the cross-sectional design's limitations, including recall bias and inability to rule out unmeasured confounders that might explain the inverse association rather than causation. Similar patterns emerged in Turban's analyses of gender-affirming hormones (GAH). A 2022 study drawing from 27,715 USTS respondents found that adults who initiated GAH during (ages 14-17) exhibited lower odds of past-year (aOR 0.6; 95% CI, 0.4-0.8), lifetime suicide attempts (aOR 0.7; 95% CI, 0.6-0.9), and binge alcohol use (aOR 0.6; 95% CI, 0.4-0.8) relative to those starting in adulthood. This , self-reported data again highlighted potential selection biases, such as healthier adolescents more likely to access care early, though Turban interpreted the findings as supporting timely intervention to mitigate risks. In prospective cohort research, Turban co-authored a 2022 study of 104 and nonbinary (TNB) youths at an urban multidisciplinary clinic, where receipt of puberty blockers or GAH over 12 months correlated with decreased odds of moderate to severe depression (aOR 0.4; 95% CI, 0.2-0.8) and suicidality (aOR 0.3; 95% CI, 0.1-0.6). The short follow-up period and small sample size were acknowledged as constraints, with the observational nature limiting causal attribution beyond temporal associations. Turban has cited data challenging social contagion explanations for rising identifications among youth. In a 2022 cross-sectional analysis of 36,415 USTS respondents assigned female at birth (AFAB), the proportion identifying as or gender diverse (TGD) did not disproportionately increase among those realizing their identity post-puberty, countering claims of rapid-onset (ROGD) driven by peer influence.00070-8/fulltext) The study's reliance on adult recall of adolescent experiences was noted as a limitation, potentially underestimating variability in youth cohorts.00070-8/fulltext) Regarding , Turban's 2021 mixed-methods survey of 17,151 USTS participants identified a 13.1% lifetime rate, predominantly attributed to external pressures like family rejection (82.5%), rather than internal or resolution of (15.9%). He has interpreted this as indicating low rates of true —estimated below 1% in some discussions—based on the subset citing internal factors like experimentation or alternative management, though the self-selected sample and lack of longitudinal tracking were recognized as caveats.

Criticisms and methodological debates

Concerns over study quality and design

Critics have pointed to Turban's frequent reliance on , self-reported data from surveys like the 2015 U.S. Survey (USTS), which is prone to as adult respondents reconstruct adolescent experiences years later, potentially inflating associations between interventions and outcomes such as reduced suicidality. This design limits , as self-reports may reflect current beliefs or demand characteristics from advocacy-distributed surveys rather than objective history, with vague questions conflating diverse therapeutic encounters without contextual controls. Turban's studies often draw from small, non-randomized convenience samples recruited via advocacy networks or clinics, introducing by overrepresenting individuals already pursuing gender-affirming care and underrepresenting detransitioners or those with differing outcomes. These samples lack long-term controls or , relying instead on cross-sectional comparisons that cannot disentangle intervention effects from natural resolution of or concurrent therapies, as evidenced in analyses of his suppression research. Potential confounders, including comorbid psychiatric conditions, trauma history, and neurodivergence such as autism spectrum traits—which Turban has acknowledged correlate with —are frequently not adequately adjusted for in his analyses, undermining claims of intervention-specific benefits. For instance, failure to control for baseline or social factors like linked to broader complicates attribution of improved to medical transitions rather than supportive care or regression to the mean. Such design limitations contribute to "very low" quality ratings for Turban's cited evidence in systematic reviews employing GRADE criteria, due to high risk of , inconsistency, and imprecision from observational data without robust controls or prospective follow-up. These flaws reduce generalizability beyond motivated clinic cohorts, as samples exclude population-based representation and overlook international trends like rising female referrals potentially driven by rather than innate .

Responses to systematic reviews like Cass

The Cass Review, commissioned by and published on April 10, 2024, systematically evaluated the evidence for gender-affirming interventions in youth, concluding that the overall quality was low due to methodological limitations such as lack of , high attrition rates, and factors in observational studies, including those cited by proponents like . Specifically, the review rated studies on blockers and hormones as weak, noting that many, including retrospective analyses associating early interventions with reduced suicidality, suffered from biases like self-selection and absence of control groups, which undermined causal claims. This assessment aligned with prior European systematic reviews, such as Sweden's 2022 SBU , which similarly found insufficient evidence for routine use of blockers in adolescents, prompting restrictions in countries like (2020 guidelines prioritizing therapy) and the (2024 adjustments post-reanalysis). Critics, including the Society for Evidence-Based Gender Medicine (SEGM), highlighted Turban's reliance on such observational data—e.g., his 2020 study linking pubertal suppression to lower lifetime suicidality—as exemplifying the field's overinterpretation of low-quality evidence without randomized controlled trials (RCTs), arguing that ethical concerns do not obviate the need for rigorous designs to establish efficacy amid risks like bone density loss. SEGM contended that Turban's work, often drawn from U.S. clinic samples with potential selection bias, contributed to policy advocacy despite failing GRADE criteria for moderate or high evidence, influencing debates that led to NHS England's halt on routine puberty blockers for under-18s outside research protocols. In response, Turban co-authored a July 2024 Yale Integrity Project paper critiquing the Cass Review for allegedly misapplying evidence standards and ignoring contextual factors like ethical barriers to RCTs, asserting that withholding care for controls would be immoral given observational correlations between interventions and improvements. On his in March 2025, Turban argued that the review does not endorse bans but supports individualized care, emphasizing alignment between U.S. and U.K. clinicians on using available data ethically rather than demanding unattainable perfection amid rising youth distress. He maintained that critiques like SEGM's impose unrealistic thresholds, prioritizing real-world outcomes over idealized study designs, though this position has been challenged for conflating association with causation in the absence of robust controls.

Advocacy, publications, and public commentary

Books and media contributions

In 2024, Turban authored Free to Be: Understanding Kids & , a published by Atria Books that examines the , , and surrounding in children and adolescents, drawing on his clinical experience to address public misconceptions about youth. The volume, released on June 4, 2024, emphasizes evidence-based approaches to supporting gender-diverse youth and has been promoted through interviews on platforms like PBS NewsHour. Turban has contributed opinion pieces to , including a 2017 article advocating for medical recognition of identities in youth through the case of a named Hannah, and a 2020 piece criticizing South Dakota's restrictions on healthcare as overlooking established medical practices for minors. In July 2024, he published an proposing alternative framings for discussions on to reduce polarization, positioning it as a communicative strategy informed by psychiatric perspectives. On , Turban has written posts explaining aspects of and interventions, such as a January 2022 entry outlining evidence supporting medical care for youth, framed as a response to ongoing policy debates. These contributions aim to educate lay audiences on clinical protocols for gender-related , distinct from his peer-reviewed work. Turban has provided expert declarations in multiple federal lawsuits challenging state bans on gender-affirming medical interventions for youth, arguing that such care is medically necessary and supported by clinical evidence. In April 2023, he submitted a declaration for plaintiffs in a case represented by the ACLU, asserting that blockers and reduce risks of suicidality based on his research and professional experience. Similarly, in May 2023, he filed a declaration in an ACLU case, emphasizing the benefits of these interventions for alleviating in adolescents. In the 2021 Brandt v. Rutledge litigation in , his declaration opposed provisions barring state funds and insurance coverage for such care under age 18, contending that denying coverage would exacerbate disparities. Turban co-authored an amicus brief filed with the U.S. in August 2025 in support of gender-affirming care, highlighting his expertise in child psychiatry and citing studies linking access to interventions with improved outcomes for youth. These filings have defended against restrictions in states like , where a 2023 law criminalizing such care prompted rebuttal declarations from him in Poe v. Labrador, reinforcing claims of harm from bans. In depositions during these proceedings, Turban faced scrutiny over the quality of evidence underpinning his positions. A November 2023 deposition, analyzed in legal commentary, revealed reliance on studies rated "very low" quality by systematic reviews due to methodological limitations like lack of randomization and confounding factors. In July 2025, during his deposition in Wailes v. Jefferson County Public Schools—a case involving school policies on transgender students—attorneys questioned his interpretations of data on intervention efficacy, prompting admissions on evidential gaps. Turban's policy advocacy extends to opposing restrictions on reimbursement for gender-affirming treatments, as articulated in declarations against state laws limiting coverage, amid over 20 U.S. states enacting such bans by 2023. Regarding conversion therapy bans, his 2019 research associating gender identity conversion efforts with increased suicidality has informed extensions of prohibitions to include practices targeting youth, though critics contend this conflates coercive methods with exploratory , potentially overbroadening regulatory scope. He has supported these bans as protective, aligning with amicus arguments that they do not infringe on religious counseling.

Recent developments

Post-2023 activities and responses to bans

In response to the Cass Review published in April 2024, which recommended restrictions on blockers and hormones for gender-dysphoric youth in due to weak evidence, Turban co-authored an evidence-based critique through Yale Law School's Project. The paper argued that the review's dismissal of the evidence base for gender-affirming interventions lacked support, emphasizing methodological flaws in its exclusion of non-randomized studies and overreliance on risk-of-bias tools ill-suited for rare conditions like . This critique, released in July 2024, was positioned amid U.S. legal challenges to state bans, with Turban's involvement highlighting ongoing advocacy against policy shifts inspired by the review. Turban has continued to comment on U.S. state-level restrictions on gender-affirming care for minors, which expanded to 25 states by mid-2024. Following the U.S. Supreme Court's June 18, 2025, ruling in United States v. Skrmetti upholding Tennessee's ban on blockers and for those under 18, Turban stated in media appearances that the decision incorporated factual inaccuracies about treatment outcomes and evidence quality. He has critiqued such bans for overriding medical decision-making, as in his September 2025 opposition to a Texas law expanding restrictions, arguing it could exacerbate harms like increased assaults on individuals. In early 2025, Turban launched a series defending the evidence for pediatric gender interventions amid heightened scrutiny from accounts and federal analyses, such as the U.S. Department of Health and Human Services' May 2025 report on treatments for . A March 2025 post clarified alignments between U.S. and U.K. s, noting the Cass Review explicitly avoids blanket bans on suppression or hormones when clinically indicated, countering interpretations used to justify U.S. prohibitions. Turban, cited in the HHS report as lead author of a supporting statement, emphasized family support and screening as key to low regret rates, drawing on his prior mixed-methods analysis of factors like external pressures rather than inherent treatment flaws. Turban maintains leadership of the Gender Psychiatry Program at the , where he oversees clinical care and policy-relevant research into youth mental health outcomes, including updated explorations of influenced by social and familial dynamics post-policy changes. His work continues to inform amicus briefs and legislative testimonies opposing bans, prioritizing empirical longitudinal data over anecdotal narratives.

References

  1. https://profiles.ucsf.edu/jack.turban
  2. https://publications.aap.org/pediatrics/article/145/2/e20191725/68259/Pubertal-Suppression-for-Transgender-Youth-and
  3. https://www.city-journal.org/article/the-deposition-of-jack-turban
  4. https://scholar.google.com/citations?user=0gnZBgIAAAAJ&hl=en
  5. https://quillette.com/2020/11/01/jack-turbans-dangerous-campaign-to-smear-ethical-psychotherapy-as-anti-trans-conversion-therapy/
  6. https://www.city-journal.org/article/what-does-quality-of-evidence-mean
  7. https://www.nbcnews.com/feature/nbc-out-pride30/pride30-physician-jack-turban-dedicated-trans-kids-health-n763171
  8. https://healthpolicy.ucsf.edu/profile/jack-turban
  9. https://www.researchgate.net/profile/Jack-Turban
  10. https://elischolar.library.yale.edu/ymtdl/2179/
  11. https://www.aclu.org/wp-content/uploads/2023/04/TN-32-Decl.-of-Dr.-Jack-Turban-ISO-PI-Motion.pdf
  12. https://www.psychologytoday.com/us/contributors/jack-turban-md-mhs
  13. https://advances.massgeneral.org/contributors/contributor.aspx?id=1524
  14. https://media4.manhattan-institute.org/wp-content/uploads/sites/5/Turban-Transcript.pdf
  15. https://www.linkedin.com/in/jack-turban-md-mhs-12218130
  16. https://www.jackturban.com/about-dr-turban
  17. https://gender.ucsf.edu/gender-psychiatry-program-team
  18. https://www.ucsfhealth.org/providers/jack-turban
  19. https://pubmed.ncbi.nlm.nih.gov/29071722/
  20. https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12833
  21. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2749479
  22. https://pubmed.ncbi.nlm.nih.gov/31509158/
  23. https://pubmed.ncbi.nlm.nih.gov/31974216/
  24. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261039
  25. https://pubmed.ncbi.nlm.nih.gov/35020719/
  26. https://pmc.ncbi.nlm.nih.gov/articles/PMC7073269/
  27. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423
  28. https://pmc.ncbi.nlm.nih.gov/articles/PMC8213007/
  29. https://www.city-journal.org/article/a-new-low
  30. https://segm.org/Cass_Integrity_Project_Yale
  31. https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf
  32. https://jackturban.substack.com/p/where-american-and-british-doctors
  33. https://www.simonandschuster.com/books/Free-to-Be/Jack-Turban/9781668017050
  34. https://www.pbs.org/newshour/show/new-book-free-to-be-dives-into-medical-science-of-gender-identity-for-young-people
  35. https://www.nytimes.com/2017/04/08/opinion/sunday/hannah-is-a-girl-doctors-finally-treat-her-like-one.html
  36. https://www.nytimes.com/2020/02/06/opinion/transgender-children-medical-bills.html
  37. https://www.nytimes.com/2024/07/08/opinion/gender-identity-communication.html
  38. https://www.psychologytoday.com/us/blog/political-minds/202201/the-evidence-trans-youth-gender-affirming-medical-care
  39. https://www.acluok.org/sites/default/files/field_documents/006-04_-_dr._turban_expert_decl_0.pdf
  40. https://www.aclu.org/cases/brandt-et-al-v-rutledge-et-al?document=Declaration-of-Jack-Turban
  41. https://www.supremecourt.gov/DocketPDF/24/24-539/370817/20250826173111769_24-539%2520Amicus%2520Brief.pdf
  42. https://www.aclu.org/cases/poe-v-labrador?document=Rebuttal-Declaration-of-Jack-Turban
  43. https://adflegal.org/wp-content/uploads/2025/09/wailes-v-jefferson-county-public-schools-2025-07-14-turban-deposition.pdf
  44. https://pmc.ncbi.nlm.nih.gov/articles/PMC9418844/
  45. https://law.yale.edu/yls-today/news/white-paper-addresses-key-issues-legal-battles-over-gender-affirming-health-care
  46. https://www.erininthemorning.com/p/yale-researchers-international-experts
  47. https://www.wnyc.org/story/a-doctors-perspective-on-the-scotus-youth-gender-affirming-care-decision/
  48. https://www.supremecourt.gov/opinions/24pdf/23-477_2cp3.pdf
  49. https://www.instagram.com/p/DO_X6S5kZvg/
  50. https://opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report.pdf
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