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Who determines the number of genders- and how?

Well, you know, I don't know what the truth is on that. Much of the positive follow-up seems to be based on voluntary questionnaires, or looking at records of patients easily contactable because they're still in the system. I have read critiques saying that there is an element of cherry-picking, conscious or unconscious, because the unhappy patients are more likely to withdraw from engagement and so not be picked up by this sort of study.

But on the other hand I know a number of male-to-female trans-sexuals who are indeed very happy with their outcome and who wouldn't go back. One feature mentioned in the Johns Hopkins context however was very long-term follow-up, and increasing depression after several decades. Much of the modern follow-up seems to be shorter term. In particular the long-term effects of testosterone on a female body are likely to be problematic, and we all know about the reservations regarding giving progesterone to post-menopausal women, what do we know about giving it to men for decades?

I don't know one way or the other and I'm not sure there are definitive studies. The sort of study that demonstrated the increase in breast cancer in women receiving HRT simply doesn't seem to be being done on sex reassignment patients taking similar hormones, even though the fact that in that case the hormones ae being administered to bodies not actually intended to cope with that endocrine environment might be expected to increase the risk of adverse events.

It seems a bit ironic that women often can't get HRT for a bad menopause now because prescribers are concerned about what is a relatively small increase in risk, even though it's statistically significant, but off-label use on the opposite sex is happening relatively freely. It's also a concern thay very young people are starting on cross-sex hormones without much in the way of informed consent in many cases. They're expecting to stay on these hormones for the rest of their natural life, but what will this do to them? Or to some of them at least?
 
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For the suicide study:

For the purpose of evaluating the safety of sex reassignment in terms of morbidity and mortality, however, it is reasonable to compare sex reassigned persons with matched population controls. The caveat with this design is that transsexual persons before sex reassignment might differ from healthy controls (although this bias can be statistically corrected for by adjusting for baseline differences). It is therefore important to note that the current study is only informative with respect to transsexuals persons health after sex reassignment; no inferences can be drawn as to the effectiveness of sex reassignment as a treatment for transsexualism. In other words, the results should not be interpreted such as sex reassignment per se increases morbidity and mortality. Things might have been even worse without sex reassignment. As an analogy, similar studies have found increased somatic morbidity, suicide rate, and overall mortality for patients treated for bipolar disorder and schizophrenia.[39], [40] This is important information, but it does not follow that mood stabilizing treatment or antipsychotic treatment is the culprit.

Linky.

From an interview with one of the authors:

Dhejne: People who misuse the study always omit the fact that the study clearly states that it is not an evaluation of gender dysphoria treatment. If we look at the literature, we find that several recent studies conclude that WPATH Standards of Care compliant treatment decrease gender dysphoria and improves mental health.

Linky.

The comparison with body dysmorphia is too far off-base to be useful, except as contrast. BD is an anxiety disorder where the person focuses on and misperceives how their body actually is. A person with gender dysphoria has that dysphoria because they accurately recognise how their body actually is. And then of course there is the difference in treatment, where physical alterations don't relieve BD but do seem to relieve GD, and therapy seems to correct BD but not GD.
 
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No reasonable person is asking you to completely obliterate gender while also recognizing differences in gender.

There are a lot of unreasonable people in the world.

My experience is that the people who do this usually do it at different times, and never notice the irony.
 
There are a lot of unreasonable people in the world.
No kidding. In every institution, movement, or project.

Which is why it's always a mistake to impute the beliefs of a handful of unreasonable people on a group they represent as a whole.
 
It seems a bit ironic that women often can't get HRT for a bad menopause now because prescribers are concerned about what is a relatively small increase in risk, even though it's statistically significant, but off-label use on the opposite sex is happening relatively freely. It's also a concern thay very young people are starting on cross-sex hormones without much in the way of informed consent in many cases. They're expecting to stay on these hormones for the rest of their natural life, but what will this do to them? Or to some of them at least?

I don't think these people consider themselves "opposite sex", and your choice to refer to them as such highlights your own bias that you bring to the discussion.
 
I don't think these people consider themselves "opposite sex", and your choice to refer to them as such highlights your own bias that you bring to the discussion.
Wait, what? I thought gender and sex were conceptually distinct.
 
Wait, what? I thought gender and sex were conceptually distinct.
Oh, they are.

But claiming to be aggrieved (even on others' behalf) is a great way to derail the conversation.

ETA: nevermind the substantive exchange going on, the topic is now about how you are biased and that you should feel bad.

This is where the tapatalk signature that annoys people used to be
 
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My driver's license says that my sex is male. Sex, not gender. Let's just go with that eh?

Also, I used a unisex bathroom yesterday at a restaurant and I really feel sorry for women who have to share public toilets with men. We won't always lift the seat in a public restroom (gross) and we won't always wipe it if we drip onto it. Some will, most will not.

Have fun with that.

My Dad a few days ago during a much needed vent session about another topic:
"If you have a **** use that door. If you have a ***** use that one. If you're not sure just pick whichever you think is best because if you're not sure, chances are pretty good that nobody else will be sure either'
 
Oh, they are.

But claiming to be aggrieved (even on others' behalf) is a great way to derail the conversation.


It doesn't derail the conversation, it's literally the essential core of what the conversation is about. Trans-women use the women's bathroom because they are women, they look like women, they act like women and consider themselves to be women. Even more importantly, they're safer using the women's room because looking like and acting like women they are far less likely to be the target of trans-phobic violence.

Sure, maybe cis-women should have better access to hormone replacement therapy for menopause, but that's really a very separate issue.

ETA: nevermind the substantive exchange going on, the topic is now about how you are biased and that you should feel bad.

No, it's not about feeling bad. It's about recognizing your own biases so you can correct them. Nobody cares if you feel bad or not.
 
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I'm pretty sure I posted this link already. Gender dysphoria is not one thing. This is an extremely important point and I really don't think anyone can have an informed conversation about this issue unless they are familiar with the material presented in this article.
No one can have an informed conversation about this issue by quoting Bailey and Blanchard. They have done no real research on transgender issues and are generally considered crackpots by those who did.

The three (main) presentations are homosexual trans-sexualism (HSTS), which presents at a very early age, before puberty, and which affects both sexes, rapid onset gender dysphoria (ROGD) which almost exclusively affects adolescent girls and is largely a social contagion, and autogynaephilia (AGP) which is a paraphilia only affecting men and which manifests at or after puberty, never before.
These are not categories used in any real research and almost exclusively by Bailey and Blanchard.

Anyone claiming "you're saying the only reason for being trans is a sexual perversion" is either being utterly disingenuous or can't read.
Sure, but saying something like "In western societies AGP is the predominant group" does suggest that you think "sexual perversion" is in most cases the reason for being trans. This is not based on any scientific data, only on Bailey and Blanchard's say so.
 
It doesn't derail the conversation, it's literally the essential core of what the conversation is about. Trans-women use the women's bathroom because they are women...

Ok, now, I'm really not sure what this even means. How are we defining "women" here, precisely?
 
No one can have an informed conversation about this issue by quoting Bailey and Blanchard. They have done no real research on transgender issues and are generally considered crackpots by those who did.

I mean, agree or disagree with them, your claims are just not accurate. They have authored numerous peer reviewed, published studies, and are cited in the field.

For example, here is a published, peer reviewed article on brain structure differences:

The fact that two subtypes of MtFs and FtMs can be distinguished has important theoretical and clinical implications for the etiology of transsexualism (Blanchard, 2005). Consequently, distinctions between early- and late-onset GD and androphilic and gynephilic sexual orientation become essential when approaching the brain of transsexuals. Moreover, predictions for brain differences between MtF subtypes have been advanced in light of this distinction (Blanchard, 2008).

...

Following this line of thought, Cantor (2011, 2012, but also see Italiano, 2012) has recently suggested that Blanchard’s predictions have been fulfilled in two independent structural neuroimaging studies. Specifically, Savic and Arver (2011) using VBM on the cortex of untreated nonhomosexual MtFs and another study using DTI in homosexual MtFs (Rametti et al., 2011b) illustrate the predictions. Cantor seems to be right. Nonhomosexual MtFs present differences with heterosexual males in structures that are not sexually dimorphic (Savic & Arver, 2011), while homosexual MtFs (as well as homosexual FtMs) show differences with respect to male and female controls in a series of brain fascicles (Rametti et al., 2011a, 2011b). If other VBM and CTh studies on the cortex of homosexual MtFs are added (Simon et al., 2013; Zubiaurre-Elorza et al., 2013), there is a more substantial number of untreated homosexual MtFs and FtMs that fulfill Blanchard’s prediction but still only one study on nonhomosexual MtFs; to fully confirm the hypothesis, more independent studies on nonhomosexual MtFs are needed. A much better verification of the hypothesis could be supplied by a specifically designed study including homosexual and nonhomosexual MtFs.

Linky.

There are many other papers that also found the theories useful and relevant. For example:

Homosexual transsexuals were found to be younger when applying for sex reassignment, reported a stronger cross-gender identity in childhood, had a more convincing cross-gender appearance, and functioned psychologically better than nonhomosexual transsexuals. Moreover, a lower percentage of the homosexual transsexuals reported being (or having been) married and sexually aroused while cross-dressing. The pattern of findings was different for MFs and FMs. No differences between homosexuals and nonhomosexuals were found in height, weight, or body mass index. A distinction between subtypes of transsexuals on the basis of sexual orientation seems theoretically and clinically meaningful. The results support the notion that in the two groups different factors influence the decision to apply for sex reassignment. The more vulnerable nonhomosexual transsexuals may particularly benefit from additional professional guidance before and/or during treatment.

Linky.

Here's a paper looking at age of onset, again citing Blanchard:

Research on transsexual developments has
shown that transsexual individuals show a
number of developmental pathways (e.g., [1,2])
with perhaps different etiologies [3,4]. Since the
beginning of the 20th century, the role of sexual
orientation (SO) in transsexual developments has
been theorized repeatedly [5]. In the last 20 years,
most of the research in this field has focused on
this subtyping of transsexual individuals [6]. SO
has also been linked to onset age (OA) in transsexual
individuals [2,4,6–9]. In a recent review by
Lawrence [6], the conclusion was drawn that subtyping
on the basis of SO is more promising than
on the basis of OA for research and clinical purposes.
However, she also states that subtyping on
the basis of OA has received little attention since
the increase in attention to SO that resulted from
a number of studies by Blanchard [7–9].

Linky.

They have definitely been the subject of a smear campaign and are hated by activists, though.

This paper is a good review of the debate that has gone on in the research field. The author is pro, but it gives a good narrative structure for debates and arguments that have happened, and recent developments with professional organizations.

Here is a 2010 paper stating it is the first peer reviewed paper to critique the theory:

Over the last 20 years, Ray Blanchard, Ph.D., with a variety of coauthors and collaborators, has proposed a theory that links the sexual orientation of male-to-female transsexuals with the presence or absence of autogynephilia (erotic arousal by the thought or image of “himself” as a woman). Blanchard's Autogynephilia Theory suggests that the association between sexual orientation and autogynephilia among male-to-female transsexuals is clinically important and the association is always (or almost always) present. Although the theory has been criticized by clinicians, researchers, and transsexuals themselves, it has not been critiqued in a peer-reviewed article previously. This article will attempt to fill that gap. Key studies on which the theory is based will be analyzed and alternative interpretations of the data presented. I conclude that although autogynephilia exists, the theory is flawed.

Linky.


Again, they may be wrong to varying degrees, but they aren't non-expert, universally rejected "crackpots" in the field.
 
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It doesn't derail the conversation, it's literally the essential core of what the conversation is about. Trans-women use the women's bathroom because they are women, they look like women, they act like women and consider themselves to be women.

Trans women may look like women (not always), they may act like women (not always) and consider themselves to be women.

But they aren't women.

This is the bit that is arguable.

You think they suddenly become women. A lot of people don't.
 
It doesn't derail the conversation, it's literally the essential core of what the conversation is about. Trans-women use the women's bathroom because they are women, they look like women, they act like women and consider themselves to be women.

Trans women may look like women (not always), they may act like women (not always) and consider themselves to be women.

But they aren't women.

This is the bit that is arguable.

You think they suddenly become women. A lot of people don't.

Because this isn't a matter of science or biology, it's one of social categorization and semantics.

Again it's one of those fundamental, almost philosophical questions of language. Does language create reality or describe it?

Like I said earlier how many legs does a dog have if you call a tail a leg?

Some people say 5 because you're explicitly calling the tail a leg.

Others say 4 because calling a tail a leg doesn't make it so.
 
Because this isn't a matter of science or biology, it's one of social categorization and semantics.

Again it's one of those fundamental, almost philosophical questions of language. Does language create reality or describe it?

Like I said earlier how many legs does a dog have if you call a tail a leg?

Some people say 5 because you're explicitly calling the tail a leg.

Others say 4 because calling a tail a leg doesn't make it so.
Unless the tail is a leg, as is the case with kangaroos.

This has nothing to do with the relationship between language and reality. It's just that the reality isn't nearly so clear-cut as many imagine it to be.
 
This has nothing to do with the relationship between language and reality. It's just that the reality isn't nearly so clear-cut as many imagine it to be.

Yes and it's also something that if you torture it long enough it will say anything you want it to say.

Again going back to my very first post in this thread this is a question of conceptualization.

I think a human being with a penis should be able to wear a dress, have sex with (adult, consenting) men, and just overall not have to do or not do anything just because of some arbitrary standards put on sexes and genders in the past.

The question is do I have to literally conceptualize this person as a woman or does that concept even make any sense outside of the arbitrary gender and sex standards.
 
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Yes and it's also something that if you torture it long enough it will say anything you want it to say.
You keep making this objection that someone could abandon the traditional definition because they're being completely unreasonable, as if this was of any concern to people who are abandoning the traditional definition because it isn't adequate.

The question is do I have to literally conceptualize this person as a woman or does that concept even make any sense outside of the arbitrary gender and sex standards.
Yes, I think it makes sense within non-arbitrary accounts of gender and sex. To the same extent that referring to a woman with Swyer syndrome as a woman makes sense, despite the fact that she has no egg cells.

You won't go to jail for referring to that woman as a man. You'll just be an *******.
 

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