The parachute study is actually a wonderful piece of art because it demonstrates so succinctly the kind of situation where randomized controlled trials are not the gold standard of evidence, and in fact reach misleading conclusions.
Because you can't recruit people to willingly jump out of mid-flight passenger planes for science, you redesign the study to engineer a scenario where the risk to the control group is minimsed. The plane is landed.
And then, because you've removed the main reason to use a parachute, you find that parachutes have "no effect" on mortality or injury.
The constraints of performing an ethical RCT guarantee this result. A result that we obviously know is dangerously wrong to extrapolate to the real-life uses of parachutes.
Now here's the thing: The people insisting that "evidence-based medicine" says we need RCTs of trans healthcare know this is what they're doing. It's extremely well established that you can abuse these "standards" to engineer incorrect results.
SEGM and their ilk are doing this on purpose because they know it's an effective way to dress up science denial in a veneer of scientific rigor.
How would one go about making such a study though?
As in, how would an RCT look like that attempts to create misleading data, when it comes to HRT or trans healthcare in general?
I agree with the post, I just can't think of a way to create a control group with that effect
Well, barring exceptionally fortunate cases like this one, where they were able to use "skip the conventional wait time" as the test group and "wait as usual" as the control, you sort of can't.
It's foundational medical ethics that when you have a treatment that's known to be effective, you don't withhold it for a study. The demand for RCTs is done knowing that it's unserious.
