Dear Bernie

February 20, 2023

This is an open letter to Bernie Sanders. I’m concerned the letter I wrote him personally will not make it to his desk so I’m publishing this in hopes that he may find it, or that someone reading it will find a way to contact him directly.

Dear Bernie,

As a supporter, I received an email from you about the “greed of the pharmaceutical industry.” I agree with some, but certainly not all of your views on the pharmaceutical industry. I do support you and voted for you in the last Democratic Presidential primary. In addition, I think you are the most influential politician with respect to young people in the US today.

Given your strong views about the pharmaceutical industry combined with your popularity among young people, I’m appealing to you personally about something of grave consequence happening in the pharmaceutical industry right now.

While your staff has issued a report investigating certain practices of the pharmaceutical industry, there is one class of drugs that AbbVie and other pharmaceutical companies like it are profiting from that receives no questioning at all from progressives or Democrats—the sale of puberty blockers for the treatment of gender dysphoria in youth.

I ask you to consider: Could the current view on the treatment of gender dysphoria – that it requires immediate pharmaceutical intervention – be driven in part by the pharmaceutical industry? To say that you support every human’s gender identity does not prevent you from examining the safety of the drugs being used to treat gender dysphoria.

Your staff’s report revealed that 50 pharmaceutical executives in just 10 companies made $1.9 billion in total compensation in 2021. The report notes, in particular, that AbbVie CEO Richard Gonzalez reported 2021 compensation of $23.9 million, but after accounting for the value of his stock and stock options, that number jumps to $62 million.

So how much money is AbbVie making from its puberty-blocking drug Lupron, which is used to treat gender dysphoria in youth, but shown to be extremely dangerous?

The answer: $752M in 2020 alone.

Lupron costs around $1500/month for use as treatment for gender dysphoria. I understand it can cost tens of thousands for a shot used for cancer.

AbbVie has kept the price high – although this is a very old drug – likely because it has refused to do clinical studies to have the drug approved for on label use for gender dysphoria (and other IP issues that I would not know how to examine in depth). I do not write to ask that such studies be done – I think such trials would be horrific – but I ask you to examine why the studies have not been done. It is not because the trials are expensive (as the company claims). We know how much money they have. Then why haven’t they? Why do they rely on doctors prescribing the drug off-label?

Your staff has the ability to look into this—along with my hypothesis that off-label marketing is also happening.

What do we know about Lupron and puberty blockers in general? We know that parents with children with gender dysphoria are being told that these blockers are a harmless pause button to allow a child the time to determine his or her gender identity. I know this to be a fact, as I personally was told this after after one visit with a therapist for my gender-questioning son. I also know it also because of the 1000s of parents who have had the exact same experience as me. The prescribing doctors will tell you just the same.

I can give you all the evidence here of the harms, but you must have the bravery to look into it yourself. The FDA, for example, has added a warning to the labeling for gonadotropin-releasing hormone (GnRH) agonists such as Lupron in July citing six cases of females who were taking a puberty blocker and suffered from brain swelling and vision loss.

You often cite that drug prices outside the US are less than inside the US and that pharmaceutical companies profit more off of drugs sold in the US. So, what are progressive countries doing with respect to puberty blockers?

• United Kingdom: In the UK, the National Institute for Health and Care Excellence (NICE) published a systemic review which found that GnRH agonists lead to little or no change in gender dysphoria, mental health, body image and psychosocial functioning. In the few studies that did report change, the results could be attributable to bias or chance, or were deemed unreliable. The Tavistock clinic, named the Gender and Identity Development Service (GIDS), launched in 1989 to help people aged 17 and under struggling with their gender identity, is shutting down.

• Sweden: In Sweden, they have halted the use of puberty blockers (in almost all circumstances). Sweden’s Karolinksa Hospital has reported itself to the Health and Social Care Inspectorate after multiple adverse events in youth treated with GnRH agonists, such as the development of significant osteoporosis with vertebral fractures leading to chronic pain.

• Finland: In Finland, they are prioritizing the use of psychotherapy and limiting the use of puberty blockers due to the lack of evidence for their use.

We understand there are good people out there who unequivocally support the use of puberty blockers in kids with gender dysphoria. However, this view should not be devoid of a reality check into the potential harms.

As your report says, the pharmaceutical industry has spent $8.5B on lobbying in the past 25 years, over $745 million on campaign contributions, and over last year hired over 1,700 lobbyists including former congressional leaders of both major political parties —over three pharmaceutical industry lobbyists for every Member of Congress.

We’ve just had the opioid epidemic. Let’s not repeat the sins of the past. We need a full, non-ideological investigation into the safety and efficacy of these drugs to protect the rights of those with gender dysphoria to receive proper treatment.