[Continuation] Transwomen are not women - part 13

[Trausti]

To be fair, TERF island is rapidly descending into "developing world" status. If I were you, I'd lean heavier on the other European powers that aren't collapsing inward on themselves as better examples of responsible, sober governance.

How is it responsible to cause irrevocable harm to a child rather than leave the child alone to pass through the phases we all did as adolescents?

 

[Emily's Cat]

Respectfully, I don't think "all cases of GID in childhood and adolescence" is the reference population here, when we're trying to compare to those patients who were eventually referred to the endocrinologists from centres of excellence in paediatric gender medicine such as GIDS Tavistock. While some practitioners played it a bit fast and loose in terms of screening, the endocrine net wasn't cast over 100% of children presenting with at least some symptoms of GID.

Yeah... no. It's well established that if left untreated, about 80% of the cases of childhood and early pubertal dysphoria will resolve on their own with no negative long term consequences.

It's also been more recently established that social-> hormonal -> surgical intervention does NOT result in improved mental health status over the long term.

 

[TurkeysGhost]

Edited by Agatha: 

Removed for a breach of rule 11

 

[Emily's Cat]

To be fair, TERF island is rapidly descending into "developing world" status. If I were you, I'd lean heavier on the other European powers that aren't collapsing inward on themselves as better examples of responsible, sober governance.

Yep, I can totally see how Sweden and Finland are just total *********.

 

[TurkeysGhost]

Yep, I can totally see how Sweden and Finland are just total *********.

Yeah, that's my point. Much more flattering example than the island where a majority of people decided they'd rather be poor than have to see a Romanian or Pole in public. Lean harder on those nordic examples, free PR tip.

 

[d4m10n]

Yeah... no. It's well established that if left untreated, about 80% of the cases of childhood and early pubertal dysphoria will resolve on their own with no negative long term consequences.

Which leaves open the question of how well folks like Tavistock did at focusing their medical interventions on the remaining 20%. What we need here is a proper RCT, where patients are carefully screened into a treatment group and then randomly assigned to one treatment pathway or another. Patients who are likely to resolve on their own should be left out of the entire process.

 

[Emily's Cat]

Which leaves open the question of how well folks like Tavistock did at focusing their efforts on the remaining 20%.

They didn't. That's the problem. They didn't focus on the other 20% - they accepted for treatment all 100% that were referred to them. Not all were set on a medicalized pathway... but not for lack of desire to do so. Those who didn't get medicalized avoided it due to lack of resources. Had there been enough providers at Tavistock, they would have treated them all with interventionary affirmation.

By the way, if you look into the watchful waiting approach, one of the fundamental elements is that there is no way to know which child will persist and which will not. There's no way to identify the 20% that will persist and disambiguate them from the 80% that will desist. All you can do is wait and watch (hey fancy that coinkidink of a name) to see which ones continue to persist post puberty.

 

[d4m10n]

They didn't. That's the problem. They didn't focus on the other 20% - they accepted for treatment all 100% that were referred to them. Not all were set on a medicalized pathway... but not for lack of desire to do so.

What fraction should have been referred to the endocrine pathway? What fraction of those actually were? I've read Hannah Barnes book and these answers still prove elusive.



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[Emily's Cat]

What fraction should have been referred to the endocrine pathway? What fraction of those actually were? I've read Hannah Barnes book and these answers still prove elusive.

There is no way to know until after they have completely puberty.

For any child who has not completely puberty, treating them with cross sex hormones represents an 80% chance of being a misdiagnosis.

 

[d4m10n]

For any child who has not completely puberty, treating them with cross sex hormones represents an 80% chance of being a misdiagnosis.

Assuming zero screening and totally random assignment to the treatment group.



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[Matthew Best]

Yeah, that's my point. Much more flattering example than the island where a majority of people decided they'd rather be poor than have to see a Romanian or Pole in public. Lean harder on those nordic examples, free PR tip.

This didn't happen, oh inhabitant of Trumpistan.

 

[Emily's Cat]

Assuming zero screening and totally random assignment to the treatment group.

I think you're missing the point - there is no way to tell which kids will persist and which will not. There is no screening that can distinguish them.

What screening do you think should be done in order to identify the 20% of young people expressing dysphoria who will persist beyond puberty?

 

[Trausti]

Are there any other irrevocable procedures that we allow on adolescents without an objective basis for “treatment”?

 

[d4m10n]

What screening do you think should be done in order to identify the 20% of young people expressing dysphoria who will persist beyond puberty?

We know what screening was actually done under the ordinary standard of care, the question is how well it worked to identify those who would persist rather than desist.

 

[Matthew Best]

We know what screening was actually done under the ordinary standard of care,

We do? What screening did Dr Helen Webberley do, when she treated an 11-year-old with puberty blockers, and a 12-year-old with testosterone?

 

[d4m10n]

If Webberly came to your attention as an outstanding example of gender affirmation with minimal medical gatekeeping, there is a good chance they weren't following the ordinary standard of care linked above.

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[Ziggurat]

If Webberly came to your attention as an outstanding example of gender affirmation with minimal medical gatekeeping, there is a good chance they weren't following the ordinary standard of care linked above.

Sure. But there seem to be an awful lot of providers who fail in practice to meet the stated standards of care. At this point I would be more amazed to find practitioners that rigorously adhered to stated standards.

Plus, to follow up on EC's point, nobody knows how to screen for desistance. Certain standards such as trans identity having persisted long term are intended to help screen, but nobody knows how effective any of these factors actually are as screening tools, or what the error rates are. The entire field is flying blind.

Moreover, treatment itself may prevent desistance. If we have a child who would desist in the absence of medical transition, but would not desist or detransition if medically transitioned, is it ethical to medically transition them? I would say no, it's not, but I bet a lot of trans activists would say it is.

 

[Horhang]

Take Chloe Cole's own example of taking years of slowly escalating trans affirming care, by no means rushed. Diagnosed with gender dysphoria at 9, socially transitions at 12, begins puberty blockers and hormone treatment at 13, and surgery at 15. hardly a gallop.

I do not believe the highlighted is correct. Based on the interviews I have seen she began social transition at 10-11. Came out to her parents and was then taken to a therapist and diagnosed at 11 and on puberty blockers at 12, then on testosterone a month later. The gallop is a few months from first visit to a therapist to hormone blockers to testosterone.

 

[TurkeysGhost]

I do not believe the highlighted is correct. Based on the interviews I have seen she began social transition at 10-11. Came out to her parents and was then taken to a therapist and diagnosed at 11 and on puberty blockers at 12, then on testosterone a month later. The gallop is a few months from first visit to a therapist to hormone blockers to testosterone.

I imagine a detailed timeline is probably outlined in her complaint, but it's long and I'm not reading all that. 9 is what Wikipedia lists.

 

[Darat]

https://www.huffingtonpost.co.uk/en...-gibson-speaks-out_n_649d7449e4b028e6472f1700

.... He’s The Trans Son Of An Anti-Trans Influencer. It’s His Turn To Speak.
Renton Sinclair’s mother is a former Miss Illinois who wants to force trans people out of public life. That’s exactly what makes her a rising star in MAGA World....

....“It’s demonic,” Tania said about the existence of transgender people. “My daughter is in there, my daughter who was born and prophesied over and given the name from God is in there, but the Devil has taken and twisted her mind…”...

I suppose it's a view.

 

[Matthew Best]

If Webberly came to your attention as an outstanding example of gender affirmation with minimal medical gatekeeping, there is a good chance they weren't following the ordinary standard of care linked above.

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According to her, the example above "was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care." So it looks like this is following the standard of care that exists in the UK.

https://www.bbc.co.uk/news/uk-wales-65136838

 

[theprestige]

If we have a child who would desist in the absence of medical transition, but would not desist or detransition if medically transitioned, is it ethical to medically transition them? I would say no, it's not, but I bet a lot of trans activists would say it is.

Reminds me of the creepy fringe of the hard of hearing community: deaf parents refusing to prevent, cure, or mitigate deafness in their children because they'd rather keep the kids as part of their "deaf culture".

 

[theprestige]

https://www.huffingtonpost.co.uk/en...-gibson-speaks-out_n_649d7449e4b028e6472f1700



I suppose it's a view.

Honestly I'd probably turn trans too, if my mom was like that. My mom was manic, though, so I got clinical depression instead.

 

[theprestige]

According to her, the example above "was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care." So it looks like this is following the standard of care that exists in the UK.

https://www.bbc.co.uk/news/uk-wales-65136838

Either that or the MPT members don't actually have a good handle on what the standard of care is or should be.

 

[d4m10n]

According to her, the example above "was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care." So it looks like this is following the standard of care that exists in the UK.

Assuming the panel applied the usual standard of care, I'd say it is fair to conclude that Patient C was "persistent, consistent, and insistent" in their assertions regarding the experience of dysphoria and desire to transition. Since I don't have any more information on this particular patient, I'm inclined to trust the professional judgement of the tribunal.

Either that or the MPT members don't actually have a good handle on what the standard of care is or should be.

Is there some specific reason to doubt their judgement in this case?

 

[Trausti]

 

[smartcooky]

Assuming the panel applied the usual standard of care, I'd say it is fair to conclude that Patient C was "persistent, consistent, and insistent" in their assertions regarding the experience of dysphoria and desire to transition.

Patient C was "persistent, consistent, and insistent" at a time in their life when such terms are utterly meaningless. Generally, 10-11 year olds have no ******* idea what they really want. When I was 10 years old, I was "persistent, consistent, and insistent" that I was going to be an astronaut - inspired by the Mercury, Gemini and Apollo programs, and by my heroes John Glenn, Alan Sheppard and Gus Grissom. I remained "persistent, consistent, and insistent" until I was about 14, when I finally matured enough emotionally to realize that what I really wanted was to be a professional cricket player. That lasted three years before I finally joined the Air Force and trained to become a Radar Mechanic - and that eventually led to a degree in Aeronautical Engineering.

Kids of ages around 9-13 are neither emotionally nor socially mature enough to understand the consequences of following through with their perceived desires. A child often knows that it needs, but rarely does it know what it needs.

It is criminally negligent to start pumping children full of drugs and starting them on a path that four out of every five will eventually reject and will be negatively impacted by suffering severe physical, emotional and psychological trauma for the rest of their lives. If we persist with this madness of treating kids with debilitating, life-altering drugs purely on their say so, then over the next decade, the suicide rate among young adults who regret transitioning will skyrocket.

 

[d4m10n]

It is criminally negligent to start pumping children full of drugs and starting them on a path that four out of every five will eventually reject and will be negatively impacted by suffering severe physical, emotional and psychological trauma for the rest of their lives.

I don't recall seeing this statistic anywhere in my reading; it's certainly not in Hannah Barnes' book about the history of Tavistock and Portman Trust. Once on the endocrine pathway, detrans rates are actually fairly low.

If we persist with this madness of treating kids with debilitating, life-altering drugs purely on their say so, then over the next decade, the suicide rate among young adults who regret transitioning will skyrocket.

This is precisely the argument made by the people who strongly support gender affirming care for young people, except that they say that affirmation prevents suicide. With no one is pointing to any studies on point, it's impossible to know whether either claim might be more likely than the other.

 

[smartcooky]

I don't recall seeing this statistic anywhere in my reading;

Work out what four out of five is as a percentage?

(then go back and read the posts by Emily's Cat that you have already responded to).

rates are actually fairly low.

Cite?

This is precisely the argument made by the people who strongly support gender affirming care for young people, except that they say that affirmation prevents suicide.

Cite?

With no one is pointing to any studies on point, it's impossible to know whether either claim might be more likely than the other.

So, we proceed to pump these kids with drugs, and perform irreversible, life-altering surgery on them all while "it's impossible to know" what the long term effects will be. What a great plan that is

In most pre-pubescent kids, the idea that they might be the wrong gender is nothing more than a fad, like being a fan of some pop idol, encouraged by the BS they read on Social media.

 

[theprestige]

I can't help but think there's a whole narrative that first exacerbates the risk of suicide, and then offers one and only one solution for mitigating that risk.

Compare:

"Your suffering will be endless, and life will not be worth living, if you cannot have these treatments for your condition."

With:

"Puberty is hard, but most kids get through it just fine. There's a lot we can do to aid and comfort you during this process, so let's not jump to drastic and irrevocable changes just yet."

Kids who are told they are doomed if they don't get this one specific thing are probably more likely to consider suicide without that thing, than kids who are reassured that this too shall pass and there's light at the end of the tunnel.

 

[Trausti]

I can't help but think there's a whole narrative that first exacerbates the risk of suicide, and then offers one and only one solution for mitigating that risk.

Compare:

"Your suffering will be endless, and life will not be worth living, if you cannot have these treatments for your condition."

With:

"Puberty is hard, but most kids get through it just fine. There's a lot we can do to aid and comfort you during this process, so let's not jump to drastic and irrevocable changes just yet."

Kids who are told they are doomed if they don't get this one specific thing are probably more likely to consider suicide without that thing, than kids who are reassured that this too shall pass and there's light at the end of the tunnel.

Telling a kid that they were born in the wrong body is child abuse.

 

[Samson]

I can't help thinking the research is completely back to front.

All treatment has a guaranteed outcome, weakening of the body. 15 years appears to be the life shortening figure for adults, with obviously no data available for teens.
Yet we already have a vast control group of adults for whom there was no realistic access to any form of treatment. Someone asked how many 40 year old women have elective mastectomies outside the reduction or cancer fields as an example. Apparently none.
We need to interview thousands of this group to start with.
The whole business can be resolved with a few thought experiments of this type, with the conclusion we are in a mass social contagion fueled by big pharma and keen surgeons.
Elective removal of testicles of 40 year old men similarly.

I put this as a proposition in complete good faith, and would be keen to hear the refutation by LJ, Turkey's ghost and the others. I could have this completely wrong!

 

[Ziggurat]

Cite?

Here's what I've seen when I went digging. When kids are put on puberty blockers to treat gender dysphoria, basically none of them get off the medical path. Virtually all of them go on to take cross-sex hormones. This is one of the reasons that there's basically no support for the claim that puberty blockers are reversible, because we've never studied kids getting off them, because there are basically no kids who get off them and try to resume normal puberty. This is consistent across multiple studies.

There are basically two obvious possible explanations for why kids don't get off puberty blockers once put on. One possible explanation is that the screening process works, so only kids for whom the treatment is appropriate go on them in the first place. The other is that being on puberty blockers locks the kids into the transition path. Given that the screening process was not refined over time to reach that virtually 100% state, I find the latter explanation much more likely than the former.

Now, as to the detransition rate for such kids, that's a harder question, because nobody has really looked at it. If you go on puberty blockers, transition to cross-sex hormones, and then detransition later, many of those studies I mentioned wouldn't pick you up. And there's been almost no long-term studies of what happens to these kids. Furthermore, the detransition rate for kids who have gone through with treatment may be different than what the detransition rate for those same kids would have been had they not gone through treatment. The treatments cause irreversible changes. I have to wonder how many regret transition but don't detransition because they can't fully go back to their natal sex. Or even if they don't regret it, how many would have still accepted their natal sex if not pushed through the medical path early.

 

[d4m10n]

(then go back and read the posts by Emily's Cat that you have already responded to).

EC was talking about desistance among youthful GID patients who remain untreated, "It's well established that if left untreated, about 80% of the cases of childhood and early pubertal dysphoria will resolve on their own." By contrast, you mentioned "pumping children full of drugs and starting them on a path that four out of every five will eventually reject" which refers to the treatment group, not the control group. No one has yet shown that there is a high regret rate among the group which opts into either hormonal or surgical treatment.

Cite?

I'd say that we need to look at regret rates for each discrete intervention. Here is a paper about Gender-Affirming Mastectomy with a regret rate just under 1%.

 

[Samson]

EC was talking about desistance among youthful GID patients who remain untreated, "It's well established that if left untreated, about 80% of the cases of childhood and early pubertal dysphoria will resolve on their own." By contrast, you mentioned "pumping children full of drugs and starting them on a path that four out of every five will eventually reject" which refers to the treatment group, not the control group. No one has yet shown that there is a high regret rate among the group which opts into either hormonal or surgical treatment.

I'd say that we need to look at regret rates for each discrete intervention. Here is a paper about Gender-Affirming Mastectomy with a regret rate just under 1%.

And then the regret rate for the mature cohort for not having elective mastectomies as children. Maybe now it is a thing these women are lining up. I just don't know. The study is absurdly easy to run, as easy as a question in a census.

 

[smartcooky]

Here's what I've seen when I went digging. When kids are put on puberty blockers to treat gender dysphoria, basically none of them get off the medical path. Virtually all of them go on to take cross-sex hormones. This is one of the reasons that there's basically no support for the claim that puberty blockers are reversible, because we've never studied kids getting off them, because there are basically no kids who get off them and try to resume normal puberty. This is consistent across multiple studies.

There are basically two obvious possible explanations for why kids don't get off puberty blockers once put on. One possible explanation is that the screening process works, so only kids for whom the treatment is appropriate go on them in the first place. The other is that being on puberty blockers locks the kids into the transition path. Given that the screening process was not refined over time to reach that virtually 100% state, I find the latter explanation much more likely than the former.

As do I.

Its like a sort of physiological Big Lie. If you keep lying to the body by pumping it full of puberty blockers, the body will eventually believe what its being told, and the puberty blockers will take full effect. You can never know whether the gender dysphoria was real, or imaged, because at that point, its too late

Now, as to the detransition rate for such kids, that's a harder question, because nobody has really looked at it. If you go on puberty blockers, transition to cross-sex hormones, and then detransition later, many of those studies I mentioned wouldn't pick you up. And there's been almost no long-term studies of what happens to these kids. Furthermore, the detransition rate for kids who have gone through with treatment may be different than what the detransition rate for those same kids would have been had they not gone through treatment. The treatments cause irreversible changes. I have to wonder how many regret transition but don't detransition because they can't fully go back to their natal sex. Or even if they don't regret it, how many would have still accepted their natal sex if not pushed through the medical path early.

Well, this gender dysphoria thing hasn't been around long enough, or widespread enough for any meaningful long term studies. I fear that by the time enough time has elapsed, its going to be too late for tens of thousands of people. The irreversible damage will have already been done.
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[Samson]

As do I.

Its like a sort of physiological Big Lie. If you keep lying to the body by pumping it full of puberty blockers, the body will eventually believe what its being told, and the puberty blockers will take full effect. You can never know whether the gender dysphoria was real, or imaged, because at that point, its too late




Well, this gender dysphoria thing hasn't been around long enough, or widespread enough for any meaningful long term studies. I fear that by the time enough time has elapsed, its going to be too late for tens of thousands of people. The irreversible damage will have already been done.
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Yep, and the job losses and bank account closures for people who try to say this in the real world are escalating.

 

[smartcooky]

EC was talking about desistance among youthful GID patients who remain untreated, "It's well established that if left untreated, about 80% of the cases of childhood and early pubertal dysphoria will resolve on their own." By contrast, you mentioned "pumping children full of drugs and starting them on a path that four out of every five will eventually reject" which refers to the treatment group, not the control group. No one has yet shown that there is a high regret rate among the group which opts into either hormonal or surgical treatment.

I'd say that we need to look at regret rates for each discrete intervention. Here is a paper about Gender-Affirming Mastectomy with a regret rate just under 1%.

209 out of over 150,000 is far too small a sample to get any meaningful statistics from. It also suffers from pre-selection bias. Most people who realize they have made a really big mistake are not going to admit it or willingly participate in such a study, so those people are likely to be self-selected absent from any statistics.

 

[d4m10n]

209 out of over 150,000 is far too small a sample to get any meaningful statistics from.

Not if the sample proves to be representative of the relevant population; it's easy to get highly significant p-values with n=200.

 

[Ziggurat]

I'd say that we need to look at regret rates for each discrete intervention. Here is a paper about Gender-Affirming Mastectomy with a regret rate just under 1%.

That study is far too short of a timescale to really tell. You really want to follow up in later, well into adulthood. Furthermore, they did not even ask the patients if they regretted the decision, they only concluded that if that information was already in their patient records independently from the study. If patients didn't talk to their provider about regret, or if they changed providers, then they won't show up in that statistic. I would say that's a lower limit, but by no means would I conclude the regret rate is known to be that low. It could be considerably higher.