Doctors cannot be trusted

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#1
No you cannot assume your doctor knows best or even tries to do what's best for you. These people are busy working and thus may not have much time to look up scientific studies, they just follow their education.

They also make a lot of errors which can be partly mitigated by making sure to always get a second opinion.

If the probability for your doctor giving one particular incorrect advice/diagnosis is X than the probability for two independent doctors making said error is X², this will mostly protect you iff most doctors actually give you a correct diagnosis or are inconsistently wrong (both diagnosis you incorrectly but differently).

A far better way to protect yourself is to actually look into the science for your particular condition yourself. Does what your doctor recommend fall in line with the science? if not then it's likely you are dealing with a quack or someone who hasn't bothered to update his knowledge since he/she received his/her education which can be decades ago.

Regulators are there to please politicians and lobbyists, it's not actually in their own best interest to follow enforce actual evidence based medicine. Politicians are mostly interested in pleasing their voters and donors and can absolutely not be trusted with any medical decision whatsoever.

If someone is democratically elected or appointed by people that are then clearly they cannot be trusted any more than you can trust your neighbor with medical advice.

In most countries you are not the one paying for the treatment so you are not even the costumer, therefore there isn't any real incentive for the doctor to actually do what's best for you, instead doctors will be incentives to please regulators and politicians.

Even if you pay for it them pleasing regulators will still be more important since they have far more power than you have with your money. Furthermore since a lot of people blindly trust doctors there will not actually be a particularly strong incentive for them to do a good job since they will get a lot of patients anyway.
 

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#2
Vitamin D effective in the case of covid-19
For some reason they seem very unwilling to use it even though it's safe and very likely to be effective

 

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#3
Chiropractors are quack
People have died due to not sticking to evidence based medicine, it's not just about the money and time wasted.

 

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#4
Genital mutilation
For some reason doctors seem to have a thing for mutilating genitals, possibly due to christian insanity (they view sexual pleasure as sinful).

 

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#5
Questionable transgender surgeries
I have noticed a general phenomenon in the trans community where people tell each other that bad surgery results isn't bad. Low regret rate does not mean the surgery was beneficial since people may tell themselves it was the right thing since it's irreversible. Even if the surgery was an improvement it's still likely they could have gotten a better result by going to a better clinic/surgeon.

This is a rather sensitive topic but ignoring the harm done by these surgeries wouldn't be ethical at all, trying to sweep these things under the rug isn't helpful.

There is also the general issue of the neo-vagina being created between the anus and the prostate which is very likely to make anal sex significantly less pleasurable, i have not heard anyone even talk about this, it's just an obvious issue i realized on my own.

To a very large degree the issue is simply bad clinics/surgeons butchering people. Most SRS results you can find when looking them up online are very bad but there are a few exception

reddit.com/r/transmaxxing/comments/dy9dyk/srs_is_not_that_bad_when_you_get_it_with_a_good/

Another option to consider is penis preserving SRS.

Orchiectomy
I dont see any real benefit with this when you injections or ethinyl estradiol alone supresses testosterone enough to the level of castrated men

http://hrt.vintologi.com

This will also make you permanently infertile and thus the only way for you to have children willbe via sperm you have backed up.

Breast enlargement
If you look at natural vs enhances breasts you will see a very clear difference, you can tell it's fake when it's fake (few exceptions) and it doesn't look right

http://www.boobpedia.com/boobs/Category:Categories

Compensating for bad HRT
Whats common with these questionable surgeries is that they are done because the HRT regime was bad or the individual simply started too late, no amount of surgeries will compensate for the fact that you didn't transition in time, this is why it's important to start early.
 

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#7
Is only 18% evidence based?
Even mainstream medicine is lacking when it comes to being based on good science. A lot of it is just an educated guess your doctor gave and often there are not even any good studies you can look at.

https://www.aiin.healthcare/topics/...8-clinical-recommendations-are-evidence-based

But in that study they classified psychiatric interventions as the highest grade, i have not found any good evidence in favor of any medical mental health intervention. Therefore we can conclude that the real number is a lot lower than 18%, even when recommendations are based on scientific studies these studies are often highly flawed.

A cochrane review rated 13.5% of the evidence as high quality https://pubmed.ncbi.nlm.nih.gov/27032875/
 

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#8
Who actually benefit from medical transition?
There is decent evidence in favor of MtF hormone replacement therapy.

https://sci-hub.se/https://doi.org/10.1080/15532739.2014.899174

MtF prior to transitioning
Body Image scale, 43.25
Quality of Life scale, 62.50
Quality of Sexual Life scale, 56.25
Interpersonal Relation-ship scale, 50.25

MtF after transition
Body Image subscale average score was 68.75 (p<0.05)
Quality of Life score was 72.2 (p<0.05)
Quality of Sexual Life scale score was 62.05(p<0.05)
The Interpersonal Relationship scale reported an average score of 75 (p<0.05)

FtM comparason
Despite being significantly more dysphoric prior to transitioning they did not improve as much in terms of quality of life. It seems like AFAB individuals where more reluctant to transition (less of them in the study, more dysphoric) but the ones that actually transitioned were very happy with the physical results regarding their bodies.
MtF Body image: +25.5
FtM body image: +41.4
MtF quality of life: +9.7
FtM quality of life: +5.5

FtM prior to transitioning
Body Image scale, 21.85;
Qual-ity of Life scale, 63.25
Quality of Sexual Lifescale, 50.25
Interpersonal Relationship scale, 50.02.

FtM after transition
Body Image subscalescore was 63.25 (p<0.05)
the average Quality of Life score was 68.75 (p=ns)
the average Quality of Sexual Life scale scorewas 56.25 (p=ns)
the Interpersonal Relationship scale average score was 81.25(p<0.05).

Most MtF individuals in the study probably didn't pass
This explains why their social relationships did not improve as much as FtM individuals, it was difficult for them to pass as the opposite sex.
Age: 32.7±8.8 yr
Height: 172±7.38 cm
 

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#9
Long term outcomes
The study above only laster a year, we do however have the following in the case of people who had transgender surgery

1601647213072.png


https://sci-hub.se/10.1176/appi.ajp.2020.20050599

Of course not everyone have surgery and individuals who do not have surgery actually receive less treatments, these groups however are not equal.

https://sci-hub.se/10.1176/appi.ajp.2020.20050599

People are required to be screened for mental health problems before gender-affirming surgery and might therefore have particularly high odds of mental health treatment in the perioperative year because of their perhaps involuntary receipt of mental health services. These individuals might be less likely to voluntarily seek treatment for mental health problems with greater time since surgery.
 

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#10
Why do some people regret transitioning?
The main reason causing regret is lack of social support.
1619939419140.png

https://sci-hub.se/https://doi.org/10.1111/j.1600-0447.1998.tb10001.x

The study above is however outdated (done 1998) and it did not study transexuals who did not opt for SRS, there is a very large (probably majority) who do not want SRS in the first place.

We found transsexuals to be more at risk for dropping out of treatment when they were MFs, showed more psychopathology, more GID symptoms in childhood, yet less gender dysphoria at application
So if you were more dysphoric as a child but it's getting better now you might not be the best candidate for medical transition. It so worth nothing that childhood gender identity disorder is largely defined as being gender-nonconformative 0 1 it's not surprising that many of these will later realize medical transition isn't for them.


https://sci-hub.se/https://doi.org/10.1017/S0033291704002776

Only non-homosexuals reported some regrets during treatment, and two during and after SR, which they all related to a lack of acceptance and support from others.
This is a general pattern we are seeing in these studies, social factors are the biggest factor when it comes to regrets and worse outcomes.

Overall, adolescents with poorer peer relations, poorer general family functioning, advanced age, and a female sex assigned at birth showed more behavioral and emotional problems, or lower psychosocial functioning. Thus, the present study confirms the important role the social environment - both peers and family support - play with regard to the mental health outcomes in this group. Consequently, incorporating the family and social environment into Transgender Healthcare seems crucial in order to adequately tend to the needs of adolescents with GD.
https://epath.eu/wp-content/uploads/2019/04/Boof-of-abstracts-EPATH2019.pdf#page=139

https://sci-hub.se/10.1007/s10508-014-0300-8

As we see the regret rate is dropping despite more people transitioning.

The FMs who applied for reversal were younger at application than those who did not(median 22 years compared to 27 years for the whole FM group). Conversely, the MFs who later applied for reversal were older when they applied for sex reassignment than those who did not (median 35 years vs. 32 years for the whole MF group). Since the group is small, these data must, however, be interpreted cautiously.
What many people ignore is that surgeries is more or less a requirement for AFAB individuals, you will not be taken seriously as a male if you do not have a penis or if your penis is very small. There is less need for surgery if you are AMAB and can pass facially without FFS.
It is worth nothing that surgeries (especially mastectomy) can leave visible scars which can out people as transgender.
Eleven FMs (28.9%) weresatisfied with their breast removal, 5 (13.2%)were dissatisfied due to the visibility of the scars,and 22 (57.9%) were not completely satisfied.Four FMs were satisfied with their metaidoio-plasty or phalloplasty. One FM was dissatisfied because of urinary problems, while four were not completely satisfied.
The dating market is changing
Old studies are misleading since what was true 10 years ago no longer holds
  1. now it's significantly harder to date as heterosexual male
  2. the transbian dating pools is a lot bigger making it easier to date as gynephilic trans female.
  3. dating as androphilic female is now a lot easier.
Because of that we can expect trans-females to have better outcomes when they transition while gynephilic trans-males will have significantly worse outcomes.
 

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#11
Puberty blockers
Puberty blockers are sometimes used to medically 'treat' precocious puberty in cis people, this is however very questionable

https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00044/full#B8

There is no good medical reason for delaying puberty (cis or trans), its done for social reasons. It's against christian moral dogma for young teens to be sexually active and people having early puberty may also be teased by peers.

It was only when puberty blockers started to be used to delay puberty in trans people (for no good reason) that they finally came under scrutiny and results are bad.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694455/

They are not effective at preventing bone masculinization in the case of AMAB individuals


If children could get on HRT earlier there wouldn't be any need to use puberty blockers at all. Instead we would have the following 3 option

A: start full HRT before puberty. This has the advantage of allowing the individual to pass better as a female but the price is very high, the child will become sterilized for life and SRS will be significantly more difficult since there isn't enough tissue to work with.

B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.

C: have the child undergo puberty and delay HRT.

The following study does seem to show puberty blockers to be better than C but even then it can be strongly argued A or B would have been a far better option.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/

The methodology used was very poor so its not in any way a convincing result.

It is worth noting that its very rare for children that started on puberty blockers to desist, almost without exception they will proceed with cross-sex hormones meaning they will be infertile for life unless some medical advancement is made allowing them to somehow have biological children.

Spack has, he says, put “about 200 children” on to hormone blockers at the onset of puberty. Of these, 100% have gone on to take cross-sex hormones.
theguardian.com/society/2016/nov/13/transgender-children-the-parents-and-doctors-on-the-frontline

No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment.” These were out of 70 children put on hormone blockers.
pinktherapy.com/Portals/0/CourseResources/de_Vries_Puberty_Suppression_in_Adolescents_with_GD.pdf

What was the point in delaying puberty if they all ended up on cross-sex hormones anyway?

DreamGirlReb wrote:

B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.
This is what I would go for.

The puberty blocking route sometimes lead to awkward situations. Like having to use a breast prosthesis to keep up with the other girls in the class. And also change it regularly for correct size for the age. Kinda weird and fake and feel horrible to wear. But you have to do it as Its just to important to not miss out on teen years.
 

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#12
Dentists
They can claim you have a cavity when there is nothing wrong with your teeth.


Do not let your children be alone with your dentist


Making sure to get a second opinion will mostly eliminate the risk of a dentist drilling in your teeth when there is nothing wrong with it, even if the second dentist also is a quack he will be unlikely to pick the same teeth to drill in, especially if they find multiple 'cavities'.
 

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#13
About Dr will powers
He specializes in transgender healthcare and like to be a bit experimental when it comes to treatments, there isn't any good evidence in favour of his protocol so it's probably not ideal.

https://transfemscience.org/articles/powers-fact-check/

https://www.reddit.com/r/estrogel/comments/jjvwqr/looks_like_the_stopandgo_is_also_endorsed_read/

He have stated that he offers informed consent but that is only if you pass his psuedoscientific psych-evaluation.

1605916359262.png


He is good at sounding convincing at presentations


For example he sounded really authoritive when he claimed that "only 1 of 1500 had autogynephilia" when in reality "autogynephilia" is a normal aspect of female sexuality and very common both in cis and trans females, this really illustrates how poorly he has researched these topics.

https://www.tandfonline.com/doi/full/10.1080/00918369.2010.486241

https://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=3350&context=thesesdissertations

https://www.juliaserano.com/av/Serano-CaseAgainstAutogynephilia.pdf

The following MRI study failed to see any difference between cis and trans female sexuality but their methodology wasn't the best.

researchgate.net/publication/23227895_Specific_Cerebral_Activation_due_to_Visual_Erotic_Stimuli_in_Male-to-Female_Transsexuals_Compared_with_Male_and_Female_Controls_An_fMRI_Study

It took me 60 seconds to find the study falsifying his claim regarding male genital mutilation.

https://sti.bmj.com/content/76/6/474

Regarding the power method
Dr will power anecdotally observed that people had better results starting on oral estradiol, thinks this is becuase of estrone itself when it's far more likely it's simply because oral estradiol is less potent and thus you get closer to cis female puberty.

The only real advantage with starting with oral administration is that it's easy, injections are harder to do on your own (DIY) and not needed if you do not want to get a big dosage (even then transdermal might be superior).

Vandenberg (2006) found a non-monotonic response of size of breasts developed as a function of the dose of exogenous estrogen administered to ovariectomized female mice. Size of breasts was smaller in mice administered the highest dose of estradiol than mice administered an intermediate dose. The optimum dose for breast growth in humans can not be extrapolated from this study because metabolization of pharmaceuticals does not scale linearily with body mass and the growth of the human body is slower than that of mice. This result suggests the hypothesis that to maximize breast growth in transsex people it can be appropriate to use a lower dose of the estrogen or increase the dose slowly. However many HRT regimes rely on the estrogen to suppress endogenous androgens; therefore, starting with low dose of an estrogen potentially risks some degree of continued masculinization and sub-optimal feminization.

https://male-to-female.org/en/mtf_pharmacology

https://academic.oup.com/jcem/article/97/12/4422/2536439

I would not recommend blindly following his protocal, you can do better than that https://vintologi.com/threads/male-to-female.5/page-2#post-1808

Constantly getting the science wrong
He claimed in one video that trans females have a the brain of the sex they identify as prior to transitioning, this largely false

https://www.ncbi.nlm.nih.gov/pubmed/25720349

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754583/

There is zero evidence that "non-sexual dysphoria" would be needed to benefit from transitioning, in reality the amount of dysphoria and "belonging to a core group of transexuals" is a poor predictor of whether or not an individual would benefit from transitioning. See posts above.

His post regarding covid-19
In this case he got it largely correct. He did recommend the moderna vaccine which is maybe the best vaccine you can get currently (still the evidence in favor of it is a lot weaker than required for me to recommend it to people who are at low risk for severe covid).

https://vintologi.com/threads/vaccines.883/#post-5443

Stopping people from crossing the border does not stop covid. COVID-19 is literally everywhere on the planet and closing borders is like closing the barn door after the horse is already out. Wearing a face covering does almost nothing to protect you against covid, it simply limits your own respiratory aerosol emissions and therefore is only useful for protecting other people from you. Wearing an effectively fitted n95 mask is about the only way to prevent infection from respiratory aerosols if you are unvaccinated. If you're wearing a mask for your own protection, it should be a fitted n95 mask or better.

Regardless, there is almost no good reason why you shouldn't be already vaccinated (sparing some really rare reasons why not).

All these public control measures and continued "delta variant" fear mongering will not stop Covid.

Getting vaccinated does.

In the past two weeks we have had multiple new infections of patients in the practice. These are people that have heard everything I've had to say for the past 2 years, and still did not get vaccinated for some reason.

Thankfully, we have had no deaths, but we do have active patients in the hospital right now.

Please, listen to my advice. Go get yourself a moderna vaccine, it's effective against the delta variant. I have seen ZERO infections in moderna vaccinated patients. Let's put this thing in the same place where we put HIV. A virus that will be part of humanity forever, but that we have incredibly effective tools to both treat and prevent. Where if you take reasonable precautions, you can reduce your risk of contracting it to nearly zero.
 
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#14
What's going on with ivermectin?
There are many randomized controlled trials showing it to be beneficial but there is also a lot of opposition to it. One egyptian study showing it to be beneficial turned out to very likely be research fraud but that does not mean ivermectin itself isn't beneficial.

https://archive.is/66ijF

theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns

Because of that all meta studies incorporating these results will have to be re-done and then the results will no longer show the same statistical significance of any

https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214

Other meta studies:
Overall, death from any cause, taking into account all composite analyses, was judged to provide moderate-certainty evidence
journals.lww.com/americantherapeutics/fulltext/2021/08000/ivermectin_for_prevention_and_treatment_of.7.aspx

https://ivmmeta.com/ they seem to include all studies without doing any critical analysis.


This meta-study is often cited against ivermectin but it did show some benefit in terms of preventing deaths, it wasn't statistically significant though:

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab591/6310839

1630659445534.png


The Niaee study they included was poor quality unfortunatily so the evidence in favor of it is actually worse than the graph above make you think.


Media shitshow
We are seeing partisan media on the left discarding it as a "horse dewormer" even though it's also approved for humans (for other purposes) the FDA has not evaluated it in the case of covid-19 (why not?)

https://www.youtube.com/watch?v=VwntyCN7lGM

In this case the judge rules that ivermectin had to be used after being requested by relative but the hospital refused:


Approved in several countries?
In this opinion piece (swedish) they mentioned that ivermectin is already approved in other countries:

https://www.dagensmedicin.se/opinion/debatt/ivermektin-skulle-kunna-vara-det-som-avslutar-pandemin/

I was unable to find anything about formal approval, just approval for trials:

The EMA added that they have not received any formal application by EU member states to use ivermectin during the pandemic, although the Czech Republic and Slovakia have allowed its temporary use in trials.
euronews.com/2021/03/25/ivermectin-is-not-a-cure-for-covid-19-says-the-european-medicines-agency

Critical voices
Here are 3 articles critical of ivermectin claiming low-quality of evidence

https://ebm.bmj.com/content/early/2021/05/26/bmjebm-2021-111678

https://sciencebasedmedicine.org/ivermectin-is-the-new-hydroxychloroquine-take-2/

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub2

A general issue seems to be small sample size so maybe with more data (hopefully coming soon) we will see which camp who was betting on the right horse.

 

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#16
Did new york kill people with ventilators?
Early on in the pandemic the standard of care was to go straight to invasive mechanical ventilation rather than first trying less invasive options, it then turned out that 88% of the intubated died (early study):

As seen in other COVID-19 studies, increasing age was associated with a higher risk of death. Of patients receiving mechanical ventilation and whose outcomes (discharge or death) were known, 88.1% died. When stratified by age, the mortality rates for ventilated patients were 76.4% for those aged 18-65 years and 97.2% for those older than 65 years.
mdedge.com/hematology-oncology/article/221468/coronavirus-updates/large-study-covid-19-nyc-hospital-cases-shows

The initial message from the Chinese medical teams was to intubate early, somewhere around a 5-6 liter by nasal prong O2 requirement. This seemed to stem from the accurate observation that many of these patients deteriorated precipitously and that they may be more safely intubated at an earlier stage, particularly given the levels of hypoxia encountered during intubation. Additionally, a high work of breathing generating large swings in intrapleural pressure may result in self-inflicted lung injury and worsen the disease process. There is certainly a rationale for early intubation.

However, this also can come at a cost. Mechanical ventilation is inherently associated with a number of well described and accepted complications such as ventilator associated pneumonia, ventilator-induced lung injury, hemodynamic disturbances, as well as all those related to sedation and immobilization.
https://archive.is/srOtG

This was partly due to not wanting to spread sars-CoV-2 but there was also uncertainty about how well the alternatives to invasive mechanical ventilation would work:

https://www.youtube.com/watch?v=i7U2pkeysXI
Unfortunately, no. Clinicians initially considered the use of CPAP (continuous positive air pressure) machines for COVID-19 patients with relatively mild breathing problems. However, it turns out that these types of breathing machines have the potential to increase the spread of COVID-19 infection by sending viral particles into the air. In fact, this very scenario is thought to have contributed to the spread of the virus in the Kirkland, Washington, nursing home that became ground zero for the illness in early March.
Later it was found out that oxygen therapy is have similar results (RCT, slighty worse for CPAP):

https://www.physiciansweekly.com/outcomes-similar-with-cpap-oxygen-therapy-for-severe-covid-19/

This study wasn't an RCT but the ones who got mechanical ventilation did have far lower survival rate (likely in part due to being more seriously ill):



https://pubmed.ncbi.nlm.nih.gov/34089483/

It's still unclear when it's beneficial to intubate someone, no proper study has been done on this unfortunately:
Options for ventilating covid-19 patients have expanded since the first wave of the pandemic, but doctors are unsure of the best management pathway because evidence is lacking
https://www.bmj.com/content/372/bmj.n121

I could only find one documented case of someone surviving after refusing mechanical ventilation:

myrgv.com/featured/2021/05/08/near-death-nurse-says-she-refused-ventilator-in-bid-to-fight-covid-with-her-own-breath/

Comparing with the German Helthcare
According to the following documentary Germany had a 50% survival rate for people put on ventilators despite trying to avoid using them (they followed the more modern norm which is to try to use less invasive ventilation when possible. Their higher survival rate is likely in part due to them using ECMO machines (few US patients got that).


Meta analysis

This meta analysis did not include any RCTs (none has been done so far) but there does not seem to be an issue with early intubation in terms of survival, it may however have other negative consequences.

https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03540-6

https://sciencebasedmedicine.org/intubations/
 

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#17
Why isn't people being taught in school how to read scientific studies?
I did study in Sweden and despite studying a lot of STEM (especially mathematics and physics) we never once was though how to actually read scientific papers.

At highschool i did study all math courses available pretty much but that never included statistics (which is important when reading studies) i do think that was later changed but that didn't really help me. At university we was though basic statistics (when studying physics) but never as a standalone course.
This leads me to think that authority figures do not actually want people do themselves read studies, they instead want authority figures to interpret that for them so they can gatekeep scientific information, only let through what happens to benefit the ideologies pushed politically.

Furthermore with many studies the full text is hidden behind paywall further making it more difficult for the public to access these things, you end up having to use resources such as https://sci-hub.se https://sci-hub.st which they are of course trying to shut down.

Notice how lately media has pushed "doing your own research" as a bad thing claiming "you should just blindly trust the experts" even though these 'experts' are politically appointed and it's not in their self-interest to do what's actually best for you.
 
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