Cont: Transwomen are not women - part XI

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An interesting anecdote. A girl who decided she was trans and a mother who would not accept that. It is a long interview. Both the mother and daughter share their experience. Don’t remember how I stumbled on this but here it is.
Fair warning an hour long interview.

https://www.youtube.com/watch?v=oaBYyvh6Z0w
 
And just so we don't lose sight of the actual context here... We're talking about my 17 year old relative - the female child of my female sibling - who obtained damaging drugs from a 30 minute interview with someone who knows nothing about them, without consideration for the existing diagnosis of bipolar disorder (I doubt the doctor was even told of the diagnosis), and without consideration for a family history of autism spectrum disorder, without consideration for the in-progress very stressful and messy divorce, and without any actual due diligence whatsoever. And your take on this is that the minor who is seeking a panacea for their emotional pain doesn't need adults to make sure they don't cause themselves harm?
Can someone else confirm that the US medical profession works in this slipshod manner?

In Australia it is extremely difficult for a young trans person to gain treatment, most GPs won't give a referral for this kind of treatment.

I doubt any professional medical person would go prescribing drugs without access to medical history.

Also, I'm not sure how the autism spectrum diagnosis would be relevant in any case.
 
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Can someone else confirm that the US medical profession works in this slipshod manner?

It's Gender Affirming Care:

In most cases your clinician will be able to prescribe hormones the same day as your first visit. No letter from a mental health provider is required.
you may be requested to provide a complete medical history

https://www.plannedparenthood.org/planned-parenthood-mar-monte/patient-resources/gender-affirming-care/hormone-therapy-first-visit

Also, I'm not sure how the autism spectrum diagnosis would be relevant in any case.

Tavistock clinic date in the UK showed a high proportion of same sex attraction, and autism diagnosis in the ROGD cohort.
 
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Gender dysphonia may be more prevalent among those on the spectrum, I haven't seen the research yet.

I don't see why that would be a problem though.

But any prescriber of drugs should have the full picture regarding mental health conditions.

Sounds like it is the medical system that is in need of an overhaul.
 
Sounds like it is the medical system that is in need of an overhaul.

Yes, which is why there is the Cass review in the UK.

In the US Gender Affirming Care has become a hot political issue and review of the medical system less likely.
 
Also, I don't see any surprise that people with gender dysphoria might be more likely to be attracted to members of their own biological sex.
 
I believe the multi disciplinary care approach is regarded as the best.
 
Norwegian review of treatment guidelines

https://ukom.no/rapporter/pasientsikkerhet-for-barn-og-unge-med-kjonnsinkongruens/sammendrag

Ukom recommends:

that the Ministry of Health and Care Services assigns the Directorate of Health to revise the National Professional Guideline, Gender Incongruence. The revision must be based on a systematic review. We point to several factors that should be included in the audit.

that puberty-delaying treatment (puberty blockers) and hormonal and surgical gender-confirming treatment for children and adolescents are defined as experimental treatment. This is especially important for teenagers with gender dysphoria.

that the Ministry of Health and Care Services considers whether a national medical quality register should be established for the treatment of children and adolescents with gender incongruence and gender dysphoria. Necessary measures must be implemented in order for such a national quality register to be established, operated and financed in order to contribute to an overview, improve quality and reduce unwarranted variation in patient treatment.
 

This is saying the same as the Cass Review and the Swedish and Finnish reviews (except that this is calling for a more systematic review that has not yet been conducted in Norway).

'The evidence base, especially research-based knowledge for gender-confirming treatment (hormonal and surgical), is deficient and the long-term effects are not well known. This is especially true for the teenage population where the stability of their gender incongruence is also not known.'

Every properly-conducted independent systematic review will find the same as we already know from looking at the primary source literature. The US will become more and more an outlier.
 
Also, I'm not sure how the autism spectrum diagnosis would be relevant in any case.
It goes back to the history and development of the Dutch Protocol:
Eligibility criteria for puberty suppression appeared strict. First, gender dysphoria should have begun early in childhood, and dysphoria should have worsened with the onset of puberty. Second, the patient should be psychologically stable, and not suffer from other mental health problems. Third, the patient should have support from their family. As the protocol was formalized, the number of children undergoing puberty suppression increased markedly.
All three criteria have been relaxed in the U.S. but the original Dutch studies are still cited as support for why we should expect the treatment to work out well for individual patients.
 
"Labels are evil" but "Identities are holy and sacrosanct" is a center that cannot hold.

Especially when the "identity" is "It's complicated, now stop asking."
 
Gender dysphonia may be more prevalent among those on the spectrum, I haven't seen the research yet.

Research on the topic has been done. There is a positive correlation.

I don't see why that would be a problem though.

The potential problem is that autism may be leading to misdiagnosis. There's a lot of overlap in symptoms in terms of not fitting in, not feeling like you meet social expectations of behavior, etc. Given the propensity for so many practitioners to jump straight to "validation", that's a big risk.
 
The US will become more and more an outlier.
At the rate things are going, there will be some states in which there is almost no serious medical or psychological evaluation prior to the puberty blockers / cross-sex hormone pathway and some other states where even the most consistently dysphoric youth cannot access any gender-affirming care. Federalism plus political polarization is going to bless us with the both of worst possible outcomes.

:usa:
 
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At the rate things are going, there will be some states in which there is almost no serious medical or psychological evaluation prior to the puberty blockers / cross-sex hormone pathway and some other states where even the most consistently dysphoric youth cannot access any gender-affirming care. Federalism plus political polarization is going to bless us with the both of worst possible outcomes.

Unfortunately yes.
 
At the rate things are going, there will be some states in which there is almost no serious medical or psychological evaluation prior to the puberty blockers / cross-sex hormone pathway and some other states where even the most consistently dysphoric youth cannot access any gender-affirming care. Federalism plus political polarization is going to bless us with the both of worst possible outcomes.

:usa:
Non intervention has worked for most of 700 million years.
 
Research on the topic has been done. There is a positive correlation.



The potential problem is that autism may be leading to misdiagnosis. There's a lot of overlap in symptoms in terms of not fitting in, not feeling like you meet social expectations of behavior, etc. Given the propensity for so many practitioners to jump straight to "validation", that's a big risk.
But that would imply that we should now be seeing fewer gender dysphoria diagnoses since autism is now better understood and being diagnosed more frequently and earlier.

Also any stigma about being on the spectrum is quickly evaporating.

Since there doesn't appear to have been any dramatic decrease of diagnoses of gender dysphoria then it seems highly unlikely that there was ever any significant misdiagnosis of autism as GD.
 
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