Thursday, April 25, 2024

As Kids, They Thought They Were Trans. They No Longer Do.

I like TRAs' selective reading of this, where they claimed the "transphobic" claims were proven to be wrong. Probably they got distracted by all the sops condemning conservatives thrown in to appease left wingers:

Opinion | As Kids, They Thought They Were Trans. They No Longer Do. - The New York Times

"At no point during her medical or surgical transition, Powell says, did anyone ask her about the reasons behind her gender dysphoria or her depression. At no point was she asked about her sexual orientation. And at no point was she asked about any previous trauma, and so neither the therapists nor the doctors ever learned that she’d been sexually abused as a child.

“I wish there had been more open conversations,” Powell, now 23 and detransitioned, told me. “But I was told there is one cure and one thing to do if this is your problem, and this will help you.”...

Transgender activists have pushed their own ideological extremism, especially by pressing for a treatment orthodoxy that has faced increased scrutiny in recent years. Under that model of care, clinicians are expected to affirm a young person’s assertion of gender identity and even provide medical treatment before, or even without, exploring other possible sources of distress.

Many who think there needs to be a more cautious approach — including well-meaning liberal parents, doctors and people who have undergone gender transition and subsequently regretted their procedures — have been attacked as anti-trans and intimidated into silencing their concerns...

Parents in America’s vast ideological middle can find little dispassionate discussion of the genuine risks or trade-offs involved in what proponents call gender-affirming care.

Powell’s story shows how easy it is for young people to get caught up by the pull of ideology in this atmosphere.

“What should be a medical and psychological issue has been morphed into a political one,” Powell lamented during our conversation. “It’s a mess.”...

Laura Edwards-Leeper, the founding psychologist of the first pediatric gender clinic in the United States, said that when she started her practice in 2007, most of her patients had longstanding and deep-seated gender dysphoria. Transitioning clearly made sense for almost all of them, and any mental health issues they had were generally resolved through gender transition.

“But that is just not the case anymore”... “As far as I can tell, there are no professional organizations who are stepping in to regulate what’s going on.”

Most of her patients now, she said, have no history of childhood gender dysphoria. Others refer to this phenomenon, with some controversy, as rapid onset gender dysphoria, in which adolescents, particularly tween and teenage girls, express gender dysphoria despite never having done so when they were younger. Frequently, they have mental health issues unrelated to gender. While professional associations say there is a lack of quality research on rapid onset gender dysphoria, several researchers have documented the phenomenon, and many health care providers have seen evidence of it in their practices.

“The population has changed drastically,” said Edwards-Leeper, a former head of the Child and Adolescent Committee for the World Professional Association for Transgender Health, the organization responsible for setting gender transition guidelines for medical professionals.

For these young people, she told me, “you have to take time to really assess what’s going on and hear the timeline and get the parents’ perspective in order to create an individualized treatment plan. Many providers are completely missing that step.”

Yet those health care professionals and scientists who do not think clinicians should automatically agree to a young person’s self-diagnosis are often afraid to speak out... “primary and secondary care staff have told us that they feel under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters.”

Of the dozens of students she’s trained as psychologists, Edwards-Leeper said, few still seem to be providing gender-related care. While her students have left the field for various reasons, “some have told me that they didn’t feel they could continue because of the pushback, the accusations of being transphobic, from being pro-assessment and wanting a more thorough process,” she said.

They have good reasons to be wary. Stephanie Winn, a licensed marriage and family therapist in Oregon, was trained in gender-affirming care and treated multiple transgender patients. But in 2020, after coming across detransition videos online, she began to doubt the gender-affirming model. In 2021 she spoke out in favor of approaching gender dysphoria in a more considered way, urging others in the field to pay attention to detransitioners, people who no longer consider themselves transgender after undergoing medical or surgical interventions. She has since been attacked by transgender activists. Some threatened to send complaints to her licensing board saying that she was trying to make trans kids change their minds through conversion therapy.

In April 2022, the Oregon Board of Licensed Professional Counselors and Therapists told Winn that she was under investigation. Her case was ultimately dismissed, but Winn no longer treats minors and practices only online, where many of her patients are worried parents of trans-identifying children.

“I don’t feel safe having a location where people can find me,” she said.

Detransitioners say that only conservative media outlets seem interested in telling their stories... These are people who were once the trans-identified kids that so many organizations say they’re trying to protect — but when they change their minds, they say, they feel abandoned.

Most parents and clinicians are simply trying to do what they think is best for the children involved. But parents with qualms about the current model of care are frustrated by what they see as a lack of options.

Parents told me it was a struggle to balance the desire to compassionately support a child with gender dysphoria while seeking the best psychological and medical care. Many believed their kids were gay or dealing with an array of complicated issues. But all said they felt compelled by gender clinicians, doctors, schools and social pressure to accede to their child’s declared gender identity even if they had serious doubts. They feared it would tear apart their family if they didn’t unquestioningly support social transition and medical treatment. All asked to speak anonymously, so desperate were they to maintain or repair any relationship with their children, some of whom were currently estranged.

Several of those who questioned their child’s self-diagnosis told me it had ruined their relationship. A few parents said simply, “I feel like I’ve lost my daughter.”

One mother described a meeting with 12 other parents in a support group for relatives of trans-identified youth where all of the participants described their children as autistic or otherwise neurodivergent. To all questions, the woman running the meeting replied, “Just let them transition.” The mother left in shock. How would hormones help a child with obsessive-compulsive disorder or depression? she wondered...

Many parents of kids who consider themselves trans say their children were introduced to transgender influencers on YouTube or TikTok, a phenomenon intensified for some by the isolation and online cocoon of Covid. Others say their kids learned these ideas in the classroom, as early as elementary school, often in child-friendly ways through curriculums supplied by trans rights organizations, with concepts like the gender unicorn or the Genderbread person.

After Kathleen’s 15-year-old son, whom she described as an obsessive child, abruptly told his parents he was trans, the doctor who was going to assess whether he had A.D.H.D. referred him instead to someone who specialized in both A.D.H.D. and gender. Kathleen, who asked to be identified only by her first name to protect her son’s privacy, assumed that the specialist would do some kind of evaluation or assessment. That was not the case.

The meeting was brief and began on a shocking note. “In front of my son, the therapist said, ‘Do you want a dead son or a live daughter?’” Kathleen recounted.

Parents are routinely warned that to pursue any path outside of agreeing with a child’s self-declared gender identity is to put a gender dysphoric youth at risk for suicide, which feels to many people like emotional blackmail. Proponents of the gender-affirming model have cited studies showing an association between that standard of care and a lower risk of suicide. But those studies were found to have methodological flaws or have been deemed not entirely conclusive. A survey of studies on the psychological effects of cross-sex hormones, published three years ago in The Journal of the Endocrine Society, the professional organization for hormone specialists, found it “could not draw any conclusions about death by suicide.” In a letter to The Wall Street Journal last year, 21 experts from nine countries said that survey was one reason they believed there was “no reliable evidence to suggest that hormonal transition is an effective suicide prevention measure.”

Moreover, the incidence of suicidal thoughts and attempts among gender dysphoric youth is complicated by the high incidence of accompanying conditions, such as autism spectrum disorder. As one systematic overview put it, “Children with gender dysphoria often experience a range of psychiatric comorbidities, with a high prevalence of mood and anxiety disorders, trauma, eating disorders and autism spectrum conditions, suicidality and self-harm.”

But rather than being treated as patients who deserve unbiased professional help, children with gender dysphoria often become political pawns...

Many medical and mental health practitioners feel their hands have been tied by activist pressure and organizational capture. They say that it has become difficult to practice responsible mental health care or medicine for these young people.

Pediatricians, psychologists and other clinicians who dissent from this orthodoxy, believing that it is not based on reliable evidence, feel frustrated by their professional organizations. The American Psychological Association, American Psychiatric Association and the American Academy of Pediatrics have wholeheartedly backed the gender-affirming model.

In 2021, Aaron Kimberly, a 50-year-old trans man and registered nurse, left the clinic in British Columbia where his job focused on the intake and assessment of gender-dysphoric youth. Kimberly received a comprehensive screening when he embarked on his own successful transition at age 33, which resolved the gender dysphoria he experienced from an early age.

But when the gender-affirming model was introduced at his clinic, he was instructed to support the initiation of hormone treatment for incoming patients regardless of whether they had complex mental problems, experiences with trauma or were otherwise “severely unwell,” Kimberly said. When he referred patients for further mental health care rather than immediate hormone treatment, he said he was accused of what they called gatekeeping and had to change jobs.

“I realized something had gone totally off the rails,” Kimberly, who subsequently founded the Gender Dysphoria Alliance and the L.G.B.T. Courage Coalition to advocate better gender care, told me.

Gay men and women often told me they fear that same-sex-attracted kids, especially effeminate boys and tomboy girls who are gender nonconforming, will be transitioned during a normal phase of childhood and before sexual maturation — and that gender ideology can mask and even abet homophobia.

As one detransitioned man, now in a gay relationship, put it, “I was a gay man pumped up to look like a woman and dated a lesbian who was pumped up to look like a man. If that’s not conversion therapy, I don’t know what is.”

“I transitioned because I didn’t want to be gay,” Kasey Emerick, a 23-year-old woman and detransitioner from Pennsylvania, told me...

At age 17, she was cleared for a double mastectomy.

“I’m thinking, ‘Oh my God, I’m having my breasts removed. I’m 17. I’m too young for this,’” she recalled. But she went ahead with the operation.

“Transition felt like a way to control something when I couldn’t control anything in my life,” Emerick explained. But after living as a trans man for five years, Emerick realized her mental health symptoms were only getting worse. In the fall of 2022, she came out as a detransitioner on Twitter and was immediately attacked. Transgender influencers told her she was bald and ugly. She received multiple threats.

“I thought my life was over,” she said. “I realized that I had lived a lie for over five years.”

Today Emerick’s voice, permanently altered by testosterone, is that of a man. When she tells people she’s a detransitioner, they ask when she plans to stop taking T and live as a woman. “I’ve been off it for a year,” she replies.

Once, after she recounted her story to a therapist, the therapist tried to reassure her. If it’s any consolation, the therapist remarked, “I would never have guessed that you were once a trans woman.” Emerick replied, “Wait, what sex do you think I am?”

To the trans activist dictum that children know their gender best, it is important to add something all parents know from experience: Children change their minds all the time. One mother told me that after her teenage son desisted — pulled back from a trans identity before any irreversible medical procedures — he explained, “I was just rebelling. I look at it like a subculture, like being goth.”

“The job of children and adolescents is to experiment and explore where they fit into the world, and a big part of that exploration, especially during adolescence, is around their sense of identity,” Sasha Ayad, a licensed professional counselor based in Phoenix, told me. “Children at that age often present with a great deal of certainty and urgency about who they believe they are at the time and things they would like to do in order to enact that sense of identity.”

Ayad, a co-author of “When Kids Say They’re Trans: A Guide for Thoughtful Parents,” advises parents to be wary of the gender affirmation model. “We’ve always known that adolescents are particularly malleable in relationship to their peers and their social context and that exploration is often an attempt to navigate difficulties of that stage, such as puberty, coming to terms with the responsibilities and complications of young adulthood, romance and solidifying their sexual orientation,” she told me. For providing this kind of exploratory approach in her own practice with gender dysphoric youth, Ayad has had her license challenged twice, both times by adults who were not her patients. Both times, the charges were dismissed.

Studies show that around eight in 10 cases of childhood gender dysphoria resolve themselves by puberty and 30 percent of people on hormone therapy discontinue its use within four years, though the effects, including infertility, are often irreversible...

Early interventions may cement children’s self-conceptions without giving them time to think or sexually mature...

“The process of transition didn’t make me feel better. It magnified what I found was wrong with myself.”

“I expected it to change everything, but I was just me, with a slightly deeper voice,” she added. “It took me two years to start detransitioning and living as Grace again.”

She tried in vain to find a therapist who would treat her underlying issues, but they kept asking her: How do you want to be seen? Do you want to be nonbinary? Powell wanted to talk about her trauma, not her identity or her gender presentation. She ended up getting online therapy from a former employee of the Tavistock clinic in Britain. This therapist, a woman who has broken from the gender-affirming model, talked Grace through what she sees as her failure to launch and her efforts to reset. The therapist asked questions like: Who is Grace? What do you want from your life? For the first time, Powell felt someone was seeing and helping her as a person, not simply looking to slot her into an identity category.

Many detransitioners say they face ostracism and silencing because of the toxic politics around transgender issues.

“It is extraordinarily frustrating to feel that something I am is inherently political,” Powell told me. “I’ve been accused multiple times that I’m some right-winger who’s making a fake narrative to discredit transgender people, which is just crazy.”

While she believes there are people who benefit from transitioning, “I wish more people would understand that there’s not a one-size-fits-all solution,” she said. “I wish we could have that conversation.”

In a recent study in The Archives of Sexual Behavior, about 40 young detransitioners out of 78 surveyed said they had suffered from rapid onset gender dysphoria. Trans activists have fought hard to suppress any discussion of rapid onset gender dysphoria, despite evidence that the condition is real. In its guide for journalists, the activist organization GLAAD warns the media against using the term, as it is not “a formal condition or diagnosis.” Human Rights Campaign, another activist group, calls it “a right-wing theory.” A group of professional organizations put out a statement urging clinicians to eliminate the term from use.

Nobody knows how many young people desist after social, medical or surgical transitions. Trans activists often cite low regret rates for gender transition, along with low figures for detransition. But those studies, which often rely on self-reported cases to gender clinics, likely understate the actual numbers. None of the seven detransitioners I interviewed, for instance, even considered reporting back to the gender clinics that prescribed them medication they now consider to have been a mistake. Nor did they know any other detransitioners who had done so.

As Americans furiously debate the basis of transgender care, a number of advances in understanding have taken place in Europe, where the early Dutch studies that became the underpinning of gender-affirming care have been broadly questioned and criticized. Unlike some of the current population of gender dysphoric youth, the Dutch study participants had no serious psychological conditions. Those studies were riddled with methodological flaws and weaknesses. There was no evidence that any intervention was lifesaving. There was no long-term follow-up with any of the study’s 55 participants or the 15 who dropped out. A British effort to replicate the study said that it “identified no changes in psychological function” and that more studies were needed.

In countries like Sweden, Norway, France, the Netherlands and Britain — long considered exemplars of gender progressmedical professionals have recognized that early research on medical interventions for childhood gender dysphoria was either faulty or incomplete. Last month, the World Health Organization, in explaining why it is developing “a guideline on the health of trans and gender diverse people,” said it will cover only adults because “the evidence base for children and adolescents is limited and variable regarding the longer-term outcomes of gender-affirming care for children and adolescents.”

But in America, and Canada, the results of those widely criticized Dutch studies are falsely presented to the public as settled science.

Other countries have recently halted or limited the medical and surgical treatment of gender dysphoric youth, pending further study...

Meanwhile, the American medical establishment has hunkered down, stuck in an outdated model of gender affirmation. The American Academy of Pediatrics only recently agreed to conduct more research in response to yearslong efforts by dissenting experts, including Dr. Julia Mason, a self-described “bleeding-heart liberal.”...

The Biden administration has “unequivocally” supported gender-affirming care for minors, in cases in which it deems it “medically appropriate and necessary.” Rachel Levine, the assistant secretary for health at the U.S. Department of Health and Human Services, told NPR in 2022 that “there is no argument among medical professionals — pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, et cetera — about the value and the importance of gender-affirming care.” ...

The Economist published a thorough investigation into America’s approach to gender medicine. Zanny Minton Beddoes, the editor, put the issue into political context. “If you look internationally at countries in Europe, the U.K. included, their medical establishments are much more concerned,” Beddoes told Vanity Fair. “But here — in part because this has become wrapped up in the culture wars where you have, you know, crazy extremes from the Republican right — if you want to be an upstanding liberal, you feel like you can’t say anything.”...

Paul Garcia-Ryan is a psychotherapist in New York who cares for kids and families seeking holistic, exploratory care for gender dysphoria. He is also a detransitioner who from ages 15 to 30 fully believed he was a woman.

Garcia-Ryan is gay, but as a boy, he said, “it was much less threatening to my psyche to think that I was a straight girl born into the wrong body — that I had a medical condition that could be tended to.” When he visited a clinic at 15, the clinician immediately affirmed he was female, and rather than explore the reasons for his mental distress, simply confirmed Garcia-Ryan’s belief that he was not meant to be a man.

Once in college, he began medically transitioning and eventually had surgery on his genitals. Severe medical complications from both the surgery and hormone medication led him to reconsider what he had done, and to detransition. He also reconsidered the basis of gender affirmation, which, as a licensed clinical social worker at a gender clinic, he had been trained in and provided to clients.

“You’re made to believe these slogans,” he said. “Evidence-based, lifesaving care, safe and effective, medically necessary, the science is settled — and none of that is evidence based.”

Garcia-Ryan, 32, is now the board president of Therapy First, an organization that supports therapists who do not agree with the gender affirmation model. He thinks transition can help some people manage the symptoms of gender dysphoria but no longer believes anyone under 25 should socially, medically or surgically transition without exploratory psychotherapy first.

“When a professional affirms a gender identity for a younger person, what they are doing is implementing a psychological intervention that narrows a person’s sense of self and closes off their options for considering what’s possible for them,” Garcia-Ryan told me.

Instead of promoting unproven treatments for children, which surveys show many Americans are uncomfortable with, transgender activists would be more effective if they focused on a shared agenda. Most Americans across the political spectrum can agree on the need for legal protections for transgender adults. They would also probably support additional research on the needs of young people reporting gender dysphoria so that kids could get the best treatment possible.

A shift in this direction would model tolerance and acceptance. It would prioritize compassion over demonization. It would require rising above culture-war politics and returning to reason. It would be the most humane path forward. And it would be the right thing to do."

Related:

Vindication of transgender whistleblower exposes media bias yet again - "After months of reckless gaslighting, the national media is backpedaling and finally exonerating Jamie Reed, the whistleblower who exposed the sloppy, rushed treatment of children suffering gender dysphoria. It’s too little, too late... Despite Reed’s horrifying report, taken seriously by Missouri lawmakers and resulting in needed legislative changes, the national media turned a blind eye.  MSNBC anchor Chris Hayes wrote a lengthy thread on Twitter, now called X, excoriating Reed, claiming “multiple other outlets have conducted dozens and dozens of interviews with parents, employees, and patients and found no corroboration.”  New York magazine ran an early March article slamming Reed’s claims and highlighting negative articles from the St. Louis Post Dispatch and the Missouri Independent. It’s only now some six months later that The New York Times does the responsible thing and actually verifies the horrific claims that Reed exposed.  The Times noted that even secular Europe is backing away from minor medical transgenderism due to reported health dangers.  But don’t expect the Times to be too fair.  Even though the article is among its reporting pages, it editorializes and labels as “draconian” the commonsense moves by lawmakers in more than 20 states to ban or severely restrict gender treatments for minors.  Free Press founder Bari Weiss rightfully called out Hayes for his irresponsibility, noting the Times largely confirmed Reed’s account.   This woke approach to gender dysphoria is hurting lives.  The media gave scant attention when last year, the FDA slapped a warning on puberty blockers because several minors on the drugs experienced tumor-like masses in the brain, including visual disturbances, headache or vomiting, swelling of the optic nerve, increased blood pressure, and eye paralysis.  Hayes and his compatriots omit reporting that the UK National Health Service lists the following potential side effects of cross-sex hormones: blood clots, gallstones, weight gain, acne, abnormal levels of fat in the blood, elevated liver enzymes, and hair loss. In their rush to condemn Reed, national reporting also left out the risks of reassignment surgery, including surgical complications and infections."

NY Times vindicates trans-clinic whistleblower Jamie Reed — Keep up the scrutiny - "Reed’s bravery soon spurred the Missouri Legislature to ban so-called “gender affirming” care for minors.   But in the meantime the national media — fully on board the progressive gender crusade — began doing everything in their power to discredit Reed... New York magazine took up the attack, as did a Condé Nast online mag, them. Lefty attack dog Media Matters for America got in on the action.   And on and on down the list... gender extremists already have the Times in their crosshairs — including some from inside the paper — who’ve published not one but two open letters attacking its coverage of trans issues merely for mildly questioning the party line.   These ideologues are viciously opposed to data and reason.  Not even the rapidly growing expert consensus in Britain and Europe that no evidence supports giving cross-sex hormones and gender surgery to minors has made the slightest difference to America’s trans-cult warriors.   Any concern over the fact that kids are being fast-tracked into medical treatments that can — quite literally — ruin their lives is instantly branded as bigotry.   Mention the fact that this sometimes happens against parents’ wishes, and the pitchforks come out.   That makes Reed and others who speak up all the more admirable.   And highlights the need for continued hard scrutiny and exposure, until the needless damaging of kids in service of this ideology is ended for good."

NYT Publishes 'Greatest Hits' of Bad Trans Healthcare Coverage - FAIR - "The New York Times has taken a lot of heat recently for its coverage of transgender issues. More than 370 current and former Times contributors signed an open letter detailing how the Times has covered trans issues with “an eerily familiar mix of pseudoscience and euphemistic, charged language.” The contributors emphasized the Times’ coverage of adolescent gender-affirming care, and detailed how its articles are being cited in court by states seeking to ban these treatments.  Though the Times’ immediate response was underwhelming, critics had hoped that the paper might take their criticisms to heart in future coverage. That hope was dashed when the Times doubled down with a nearly 6,000-word story about the unsubstantiated claims made by former Washington University in St. Louis gender clinic employee Jamie Reed. The piece by Azeen Ghorayshi, headlined “How a Small Gender Clinic Landed in a Political Storm” (8/23/23), serves as a greatest-hits album of all of the Times’ problematic coverage on adolescent gender-affirming care, filled with familiar tropes and tactics the paper of record has used to distort the issue."
Left wingers cannot tolerate opposing points of view
I like how claims that are backed up by experts, patients & parents and documentation are "unsubstantiated" - because they contradict trans mania
I like how briskly this hit piece glosses over why European countries are pulling back from trans mania

NYT Downplays St. Louis Gender-Medicine Scandal - "One might think the fact that the medical establishment is endorsing and performing experimental, irreversible, and often sterilizing medical procedures on children would be an immense journalistic discovery. But a recent New York Times article—investigating allegations made by Jamie Reed, a former case manager at the Washington University Transgender Center at St. Louis Children’s Hospital who blew the whistle on medical malpractice at the clinic traveling under the guise of “gender-affirming care”—downplays the results of that discovery in a way that privileges personal testimony over evidence... As Leor Sapir observes, the Times investigation corroborated most of Reed’s claims. A discerning reader who cuts through the article’s euphemisms and sidesteps the author’s political asides would discern as much.  Indeed, the newspaper of record has verified concerns that critics of “gender-affirming care” have raised for years. The current influx of trans-identified youth, primarily girls with no previous gender-related distress, symbolizes a fresh patient group exhibiting a new and as-yet-unstudied form of gender dysphoria. Gender-affirming care is experimental, with no long-term, rigorous studies demonstrating its advantages over the many obvious risks.  Yet throughout, the Times article alludes to the realities of pediatric gender medicine, while simultaneously obscuring them... As a Reuters investigation recently revealed, U.S. gender clinics aren’t adhering even to the Dutch approach. Instead, they’re adopting a less rigorous, highly medicalized “gender-affirming” model, which entails automatic social transition and on-demand puberty blockers, cross-sex hormones, and surgeries. Considering that this form of gender dysphoria is new and rapid, it would seem prudent to gather more data about its possible causes before offering medical interventions... The Times article inadvertently suggests the importance of evidence-based medicine. Evaluating the effectiveness of a drug or surgery solely based on patient satisfaction constitutes a significant departure from its fundamental objectives. Were observers to start taking personal testimonies as sufficient evidence for the success of a medical treatment, the FDA would become obsolete. We’d all be forced to embrace the extravagant and pseudoscientific assertions of any self-styled health guru or medical quack.  Compare the use of testimony to support gender-affirming care at the St. Louis hospital with the Minnesota-based “healing center” known as Spring Forest Qigong (SFQ)... One woman even says that qigong eradicated her Stage 4 breast cancer... But if we’d be hesitant to accept these testimonials about how qigong cured some people’s energy imbalance, then why are many political progressives so quick to accept similar testimonials from minors who claim their mind-body imbalance was corrected after undergoing sex-trait modification procedures? Why is such testimony taken as definitive proof of these procedures’ benefits? Ideology couldn’t possibly be the reason—right?"

A Slow Trek Back to Truth? - "Research in gender medicine has found no necessary relationship between subjective satisfaction and more objective measurements of mental health and psychosocial functioning. One of the first follow-up papers on gender medicine published by Dutch clinicians in 1988, right around the time they began experimenting with hormonal interventions in adolescents, reflected on the question of subjective versus objective measurements of improvement. The paper acknowledged “a trend” in existing research on adult transsexuals at the time: “the subjective well-being of the transsexuals has increased, whereas an ‘improvement’ in their actual life situation is not always observed.” A 2020 study by Finnish gender clinicians in the Nordic Journal of Psychiatry did look at more objective outcome measures. To assess whether hormonal interventions are beneficial, the authors used “proxies for adolescent development” including “age-appropriate living arrangements, peer relationships, school/work participation, romantic involvement, competence in managing everyday matters and need for psychiatric treatment.” The researchers found that patients “who did well in terms of psychiatric symptoms and functioning before cross-sex hormones mainly did well during real-life. Those who had psychiatric treatment needs or problems in school, peer relationships and managing everyday matters outside of home continued to have problems during real-life.” Thus, “Medical gender reassignment is not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria.” Presumably, most of the patients were satisfied with their treatment.   The pivot in PSTM research from objective to subjective metrics may reflect an exasperation of the field with trying to find good, causal evidence of improvement in mental health and psychosocial functioning. It may also reflect the true but rarely acknowledged purpose of sex-trait modification, which is to achieve “embodiment goals,” i.e., desired cosmetic outcomes... Given the poor quality of research in this field, we do not currently know the true rates of satisfaction and regret among adults who transitioned as adults. Still less do we know about regret and satisfaction in those who transitioned as adolescents. Another problem with relying on satisfaction—especially when, as is often the case in this field of research, follow-up happens mere months after procedures—is that it may be confounded by placebo and Hawthorne effects. (The latter term refers to “the phenomenon where clinical trial patients’ improvements may occur because they are being observed and given special attention.”)  Rigorous long-term data, which is more important than short-term data when it comes to adolescent decisions, will take at least another decade to collect and analyze.  Also missing from the Times piece is any serious treatment of the question of harms...   After conducting an internal investigation, in which it never bothered to interview Reed, Washington University reported that it did not find evidence of any “adverse physical reactions” among those treated at the gender clinic. Not a single case... Using subjective satisfaction as the sole metric is reasonable for cosmetic procedures, but not for “medically necessary” ones...   Ghorayshi’s question seems to suggest that the debate between Europe and the U.S. is over how much mental-health screening and counseling to offer adolescents before putting them on a medical track. In truth, the European countries have adopted an approach that emphasizes, for most gender dysphoric adolescents, mental health support instead of hormones. Though she notes the divergence in medical policy in Europe versus the U.S., Ghorayshi doesn’t fully explain the nature of this divergence and understates its extent... Ghorayshi calls Republican laws “draconian,” but the truth is that these laws reflect a view of the underlying medical research and a policy stance much closer to those of European health authorities than those held by Democrats and U.S. medical associations. Condemning Republican laws while implying that the European changes are consistent with evidence-based medicine is, to put it mildly, puzzling...   While Ghorayshi acknowledges the “affirming” model as part of the problem, she does not grapple with the true nature of that problem: the infiltration into medicine of a novel set of ideas, including that children have an innate and infallibly knowable “gender identity” and that “a child’s sense of reality” is the “navigational beacon to orient treatment around.” Ghorayshi’s use of terms like “transgender children” and “8-year-old transgender daughter,” though probably intended as a show of respect, implies that kids can know that they have a permanent transgender identity. Current research does not support this belief. Common sense and millennia of experience contradict it. The U.S. Endocrine Society itself says: “With current knowledge, we cannot predict the psychosexual outcome for any specific child.”... As Hannah Barnes discusses in her book on Tavistock, GIDS was founded on a strong ethos of psychotherapy rather than medicalization. The story of Tavistock’s collapse is largely one of institutional mission creep: the founding ethos of 1989 was gradually replaced with a new understanding of the role of mental-health clinicians as rubber-stampers for experimental drugs.  In contrast, U.S. pediatric gender clinics were founded well after the Dutch started their experiment with puberty blockers and, it can reasonably be argued, for the purpose of offering these drugs. Endocrinologist Norman Spack, the founder of the first clinic in Boston, would later recall “salivating” at the prospect of using puberty blockers for children entering adolescence. In contrast with the Tavistock clinic, which referred patients to nearby hospitals for endocrine consultations, American gender clinics regularly employ endocrinologists like St. Louis’s Christopher Lewis, who, Ghorayshi notes, has prescribed hormones to patients after only a single visit. As the old saying goes, if you’re a hammer, every problem is a nail. Given these important differences in the founding purpose, personnel composition, and sense of mission in American versus English clinics, it makes little sense to imply that the rush to medicalize at St. Louis was due to inadequate staffing of mental-health professionals. The surge in referrals may have been an aggravating factor, but it is not the root cause. The true root cause is the new ideology of gender and the mountain of subpar research that has been created to justify early intervention."
The power of lived experience (i.e. self deception)!

Nate Jackson: Confirming a Gender Clinic Whistleblower's Claims - "At least The New York Times didn’t wait a year and a half like the “newspaper of record” did to confirm that Hunter Biden’s laptop was real.   On February 9, 2023, a whistleblower named Jamie Reed wrote an op-ed for The Free Press — founded by New York Times refugee Bari Weiss to allow for real journalism — to tell the world about some of the horrific abuse being perpetrated on kids she thought she was “saving” in her work at a gender clinic at St. Louis Children’s Hospital. We covered it the next day.  The Times? Meh, we’ll get around to it in six months.  Journalism takes time, we suppose. But so does thorough partisan hackery...  this social contagion is only allowed to go one direction.  Unfortunately, Reed never mentioned money as a motivator for the burgeoning “transgender” industry, and the word “money” doesn’t show up in the Times exposé either. But make no mistake: Money is a primary driver of this butchery. Ideological bankruptcy notwithstanding, doctors, clinics, and other snake-oil peddlers rake in enormous piles of money by creating lifelong patients who continue needing round after round of “affirming care.”   Reed also took her allegations to Missouri Attorney General Andrew Bailey, who opened an investigation of the clinic. The Times says, “Missouri’s ban of gender care for minors will begin on Aug. 28.” Apparently, that was all the Times needed to utterly twist the story. Its headline says it: “How a Small Gender Clinic Landed in a Political Storm.”  Uh, maybe by butchering kids to cash in on an ideological cult?   Essentially, while the Times admits that nearly all of what Reed charged was correct, most of its article is dedicated to talking about the “unrelenting surge in demand” of young people struggling immensely with their need for “affirming care.”...   In other words, mistakes were made, but it’s just because the clinic was understaffed and the intrepid clinic workers were just so “overwhelmed” by the need for their services, “all while facing intense political pressure and an adolescent mental health crisis.”  Speaking of that crisis, the Times expresses practically no curiosity while reporting this nugget:      Their patients were part of a striking generational change: Between 2017 and 2020, about 1.4 percent of 13- to 17-year-olds in the United States identified as transgender, nearly double the rate from a few years earlier...   Isn’t it odd that there’s been a sudden explosion of young people, especially girls, claiming to be “transgender”? Why, it’s almost like it’s a social contagion caused by social media and that aforementioned ideological cult. In any case, the Times shrugs and moves on."

Leor Sapir on X - "I share Meghan's sentiment here about the NYT's role in allowing this medical scandal to go on for as long as it has. Imagine if in 2020 the Times had published 5 deep investigations into pediatric gender medicine: one on the origins of the Dutch protocol, one on the basis of the consensus among U.S. medical groups, one on the lack of scientific rigor in gender medicine research, one on the then-emerging policy changes in Europe, and one on detransitioners. What a different world it would have been. The gender industry would have gone on the defensive. Woke medical school students who want to be civil rights heroes would have found another outlet for their vanity. Child sex "changes" would have been all but over in one year. And many parents would have been spared the lifelong torment of knowing they subjected their kids to medical harm. And yet, as flawed as the NYT's reporting has been on this issue, it was and remains better than other left-of-center outlets like CNN, WaPo, NBC, Vox, etc. The best writing in the Times on this issue has come in the form of deeply-researched opinion pieces--itself a revealing fact about how liberal institutions navigate pressures from radical progressive activists. Though not perfect, some of these opinion pieces are very good. Has the NYT consciously started a revisionist campaign to present itself as having always known that "gender-affirming care" for kids is a scandal? I don't pretend to know what goes on in other people's minds, but it wouldn't surprise me."

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