Stonewall's response to Transgender Trend

And the Zinnia Jones is also from 2017 and doesn't cite the Van de Grift, Cerwenka, Cohen-Kettenis, De Cuypere et al case.

Although Jones pulls a lot from Steensma.

And Steensma has also recently pointed out that the current cohort of young female transitioners have different needs to those of the past. And that the 'Dutch protocol' may not be a good fit for their needs.

@suggestionsplease1 Actually, you probably did make up that spiel, which is nonsense on a number of levels. Are you trying to get to grips with clinical drug trials protocol and attempting to shoehorn your opinion into a similar framework? Ok!

[quote suggestionsplease1]@DoubleTweenQueen

I'm not going to write out everything again which is already visible to you through simple research - I thought you said research is your area?

I really don't know why you are finding this so hard or why you expect me to devote hours of my life when the information is at your fingertips with a 5 second internet search.

Here we go:

whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Here's also an in depth account of issues with historic research on desistance. I think you posted a study about that earlier?

zinniajones.medium.com/when-desisters-arent-de-desistance-in-childhood-and-adolescent-gender-dysphoria-90a0857f2472[/quote]
Is that your answer to a request for "your considered view of these studies and what you gleaned from each one"?

An anonymous literature review on a university website and a medium article?

Did you write both of them?

I see we have the link again that often appears on these threads of the 51 study review. I will also point out that this review is actually not very meaningful for the current batch of young female transitioners. I have been through these 51 studies in the past looking for the relevant to young teenaged female transitioners that form this current cohort.

These studies are pre 2017 and therefore did not really capture a true snapshot of what is currently effecting young female transitioners in the UK, or indeed anywhere in the world.

whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Overview

We conducted a systematic literature review of all peer-reviewed articles published in English between 1991 and June 2017 that assess the effect of gender transition on transgender well-being. We identified 55 studies that consist of primary research on this topic, of which 51 (93%) found that gender transition improves the overall well-being of transgender people, while 4 (7%) report mixed or null findings. We found no studies concluding that gender transition causes overall harm. As an added resource, we separately include 17 additional studies that consist of literature reviews and practitioner guidelines.

Sorry. Are you really posting a review of studies that states this position. And you believe it still applies?

That "We found no studies concluding that gender transition causes overall harm."

So.... detransitioners are, what? non-existent? That bone density issues and other health issues encountered by transitioners are also what? didn't happen? I can post a link to the detrimental bone density for female transitioners on medicalised pathways here if you wish.

I mean these are just two situations that make that statement less than credible.

Speaking of detransition

There was a European study published in Aug 2017 and released that showed that 8.3% females detransitioned and 8.8% male transitioners detransitioned.

www.ncbi.nlm.nih.gov/pmc/articles/PMC5580378/

135 natal males (119 living in the female role, 12 in the male role, 4 did not report their current gender role) and 66 natal females (60 living in the male role, 5 in the female role, 1 did not report a current gender role)

So... 8.88% of males and 8.33% of the females (this does not include those who did not answer the question which if the answer was to detransition would make these figures higher). And in Figure 3. 22.2% of those who socially transitioned, detransitioned.

That study seems to counter this claim.

Regrets following gender transition are extremely rare and have become even rarer as both surgical techniques and social support have improved. Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.

Considering that 'blog post' from Cornell includes a citation from 2018, it certainly should have included the study I have linked.

Although, I did have to pull those figures out myself.

I personally find that Cornell collection very dangerous in that it clearly shows absolutely no balance and the 'findings' have not seemed to be updated. I would be very hesitant to ever recommend it as a balanced overview at all.

So I am wondering:

When young people are faced with others refusing to use preferred pronouns and name they might double down on their stance - eg. "What do I have to do to convince others that I am male/female? They won't accept me as a male/female now, but perhaps if I take the hormones and have the surgery they'll have to acknowledge me for who I really am."

This kind of implies that if a male child that feels they are female, gets told they can't use the girls changing room as that is for female children, this pushes the male child down the medical pathway. So basically let male children in the girls or you are responsible for the child going down a path that will harm their body and destroy their fertility. I am sure that that was not the intention of suggesting as that would be cohersion and blatant manipulation.

@suggestionsplease1 If you cut and paste, it’s protocol to cite the source.

It is difficult to conduct prospective studies or randomized control trials of treatments for gender dysphoria because of the individualized nature of treatment, the varying and unequal circumstances of population members, the small size of the known transgender population, and the ethical issues involved in withholding an effective treatment from those who need it.

@DoubleTweenQueen

I'm not going to write out everything again which is already visible to you through simple research - I thought you said research is your area?

I really don't know why you are finding this so hard or why you expect me to devote hours of my life when the information is at your fingertips with a 5 second internet search.

Here we go:

whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Here's also an in depth account of issues with historic research on desistance. I think you posted a study about that earlier?

zinniajones.medium.com/when-desisters-arent-de-desistance-in-childhood-and-adolescent-gender-dysphoria-90a0857f2472

@suggestionsplease1 It’s a bit awkward if I have to explain to you how to identify suitable control cohorts. Your view is simplistic, pre-determined, and short-term.
You posted links to a number of studies, without sharing your considered view of these studies and what you gleaned from each one, but plonked them en masse as evidence,
While they may be good enough for market research, they are not sufficiently robust on which to define psychological and clinical treatment policy for minors.

I have written a great deal here, as have others, looking at the wider frame, and long-term considerations. You answer with a case study.
I’m out.

Poor Max seems to be suffering from a bad case of the stereotypes.

The research is pretty clear; social affirmation is instrumental in improving the mental health and well-being of young people experiencing conflict over their gender.

I think if we are going to have a discussion about this, we need some clear definitions. What do you mean by 'young people experiencing conflict over their gender'?

It seems to me that the idea that people 'have' a gender is problematic in itself. Why does anyone need or want to 'have' a gender?

We all have a sex and until recently, we were making progress towards a world where people no longer had to fit into gender boxes to live their lives the way they wanted to, regardless of their sex. Now the gender boxes are back, with the only difference that people can choose which one to inhabit and make modifications to their bodies accordingly so that sex and gender 'match' as they did in the past.

Wouldn't you agree that we are making problems for these children by telling them to choose a gender box rather than just living as who they are?

[quote DoubleTweenQueen]@suggestionsplease1 I have looked at a great deal of sources, studies and data, but due to my background am able to review the design, methodology, results, conclusions made, and limitations of all of these, at a deeper level and build a comprehensive overall opinion based on that.
I'm not clear on your conclusions other than young people who identify n a certain way (not detailed) are at higher risk of self-harm, suicide ideation, suicide attempt.

That seems to be a specific focus of causality and solution - affirmation.

I don't agree with that. Others don't agree with that. How you talk about this area does not lead me to consider you have credibility, and I don't mean to be at all rude by that.

It's essential all young people have the support and understanding, in the fullest and most informed way, humanly and scientifically possible.
What is your solution? I'm not sure what that is, tbh.[/quote]
Well I think we both agree the other lacks credibility. I find it hard to believe you are competent in reviewing study designs given the bizarre expectation you had for a control for the first study I posted about.

Anyone in the business would know immediately the impossibilities there. These are not experimental design studies - you are not getting 20 people in a lab and giving half of them a drug and half of them a placebo.

The research is pretty clear; social affirmation is instrumental in improving the mental health and well-being of young people experiencing conflict over their gender. A summary of some research below.

nortonchildrens.com/news/social-gender-affirmation-depression-anxiety/

I don't agree that it necessarily leads to a medical pathway, in fact I think the opposite could well be the case. When young people are faced with others refusing to use preferred pronouns and name they might double down on their stance - eg. "What do I have to do to convince others that I am male/female? They won't accept me as a male/female now, but perhaps if I take the hormones and have the surgery they'll have to acknowledge me for who I really am."

I don't like the thought of children going down medical pathways myself (although I recognise there are times when this is important), I would rather nobody felt the need for that, which is why I support social processes to support anyone in their chosen identity. GC feminism conflicts with my thoughts over this, as it directed at making it harder, and the world more unwelcome to people who choose to identify outside of their birth sex. I feel the push back makes medical transitioning more likely, as people feel they face a higher threshold to be recognised in their identity and so they feel obliged to take the additional steps beyond social transitioning.

I believe in giving young people space to explore identities, keeping support high and pressure low, so that they can readily try things out, walk back from IDs if they later feel that they no longer fit without fearing the 'I told you so's' from others.

Of course there are real complexities in these issues and comorbidities, I don't think anyone doubts that. The following link has a good account of this and how these should all be taken into account during therapeutic work.

Vignette below but the whole of the page is very worthwhile reading.

www.psychiatrictimes.com/view/comorbidity-issues-in-in-gender-diverse-youth-the-tangled-web

Case Vignette

To bring light to the issue of comorbidities and the need to understand the external and internal contributing and maintaining factors with TGD individuals, we will use a case example:

“Max” is an affirmed male (assigned female at birth), aged 14 years, who presented to our program to discuss gender-affirming care. Max reported that he had always known he was a boy and had preferred stereotypical masculine clothing, mannerisms, and activities for as long as he could remember. Max was raised by his maternal aunt, “Linda,” who was his sole custodian. Both of Max’s parents had struggled with substances since he was a young child, and they did not have secure housing. None of Max’s family consistently used his chosen name or pronouns, although teachers and peers regularly used them in school. Linda was convinced that Max’s identity was “just a phase” and that the real presenting problem was that he had an eating disorder and was depressed. Linda wanted Max to be admitted to an inpatient unit, as she believed he needed “to get more meds.” She was very upset that the school was “reinforcing ‘her’ issues.”

Upon further discussion alone with the patient, he reported he was restricting food intake because he wanted to stop his menses, as it was very distressing, and he wanted to prevent his chest from growing, as he did not have access to a binder to compress his chest area. He experienced a lot of gender dysphoria when thinking about or discussing his body/bodily functions. Max also reported that he felt like his family would never understand him, use his name or pronouns, or allow him to proceed with any medications to stop his menses, let alone masculinize his body. To “let out” some of his pain, Max would use pencil sharpeners to cut his arms and thighs. Although he felt supported by friends and teachers at school, he felt his family would never accept him, would always make fun of him, and would never support who he is.

Discussion

In this case example, we see cooccurring gender dysphoria (eg, discomfort with body, effects of estrogen-based pubertal development), symptoms of depression, and restrictive eating. Max’s discomfort with his body and attempts to align his body with his gender identity appear to be directly impacting his eating. Therefore, traditional treatment for an eating disorder would not work with Max, and it could potentially lead to more gender dysphoria, depressive symptoms, and self-injurious behavior. Relatedly, Max’s nonaffirmation at home, negative expectations about his future ability to identify as male in the eyes of his family, and negative expectations about treatment appear to be directly related to some of his depressive symptoms and self-injurious behaviors. In addition to a traditional cognitive behavioral therapy, dialectical therapy, or assertive community therapy approach, understanding the GMSRM and educating the family members on the importance of using chosen name/pronouns to decrease depression and suicidal ideation would be imperative to share, as would the general importance of family and peer support.

co-morbities is of course comorbidities.

I did go through the other links. Some were behind paywalls, most were from the USA which I feel is not really relevant considering the different legal environment and health care system. And quite a few were sourcing data from that same large survey that was self selected, via social media and with an incentive.

Has anyone on this thread disputed the poor mental health that these young people have? I doubt there is one person on this thread who would disagree with improving mental health treatments for the trans community, including timely diagnosis of co-morbities. There are clinicians around the world expressing concern that this poor mental health is not being prioritised in the push for medicalisation. In fact, it is often over looked. This has also been reported by detransitioner statements.

There are also reports from clinicians that even after receiving hormones and surgery patients are suffering poor mental health. That treatments are not necessarily working as patients wished and their mental health is just as poor.

The focus on suicide by these lobby groups is not really giving the full picture. And it should also be very carefully considered in line with the Samaritans advice, which often seems to be ignored.

You might find the correction below relevant to the “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study” by Richard Bränström, Ph.D., and John E. Pachankis, Ph.D. study you listed.

While this comparison was performed retrospectively and was not part of the original research question given that several other factors may differ between the groups, the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison.

ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.1778correction

Can't help feeling that Stonewall, Mermaids and friends are doing a lot of damage to the mental health of trans identified children themselves.

It is them telling them they were born in the wrong body because they don't fit the stereotypes. Instead of helping them come to terms with the only body they have.
It is them telling children they need to embark on a gravely damaging medical path. One where they will inevitably not achieve their dream because that isn't possible, and will end up damaged and medicalised for life. Physical health is a big driver of mental health.
(Or alternatively that they don't need to go on any medical path but that being recognised as the sex they obviously are is a dreadful affront and means that someone hates them. )
It is them telling children that anyone who doesn't share their belief that they are magically the opposite sex or no sex at all hates them and is a nasty bigot. Isolating them from loving friends and family.
It is them telling children that fixing gender will make them feel better, and trying to ban exploratory therapy.
It is them telling a group of children that that group is often suicidal, repeatedly asking them if they've ever felt suicidal, in the case of mermaids coaching them to claim to be suicidal to get their own way. Generally seeding the idea.

It would be a wonder if trans identified children didn't have poorer mental health with Stonewall and Mermaids "support".

Now, don't get me wrong, real bullying is also a problem. Homophobic bullies don't tend to be believers in gender ideology. They will go for anyone stereotype nonconforming and being "trans" won't make you an exception. So let's all get together and work on that instead of crying wolf all the time about "transphobia" that turns out to just be a belief that sex exists.

www.tandfonline.com/doi/abs/10.1080/19359705.2016.1207581

This one is behind a paywall.

www.liebertpub.com/doi/full/10.1089/lgbt.2019.0338

This one concludes:

The findings from this systematic literature review highlight the importance of considering both individual and contextual factors in the mental health of TGD youth. Given the significance of findings related to the association between depression and gender-based victimization and suicidality, it is critical to advocate for destigmatization of gender identity at a policy level.

This one also pointed out that the studies they reviewed mentioned the other contributing factors for suicide issues. I am not sure that any poster on this thread would dispute that gender identity should be 'distigmatised'.

We are disputing the constant push in the media of the high prevalence of suicide in the UK. We are not disputing that these teenagers have complex mental health issues. More so than other comorbidities - such as eatng disorders.

And again, we are discussing UK numbers.

guilfordjournals.com/doi/abs/10.1521/suli.2007.37.5.527

This is a study from 2007.

Abstract:

Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity is a key risk factor for life-threatening behaviors among transgender youth.

experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor

So, this study also makes reference, like some posters on this thread, that there is complex issues at play here. This is expected and known. In fact, these are the very issues that clinicians around the world have expressed deep concern about because they are now often left with little treatment.

While I see that you find it compelling, if I remember seeing the data from the survey, I found that there were quite a number of issues with the results. And, it is a US survey, based on US treatments and other factors quite different to the UK.

I would trust the judgement of UK clinicians who have personal contact and can make judgements over this.

@Datun I see. Makes sense.

[quote DoubleTweenQueen]@suggestionsplease1 I have looked at a great deal of sources, studies and data, but due to my background am able to review the design, methodology, results, conclusions made, and limitations of all of these, at a deeper level and build a comprehensive overall opinion based on that.
I'm not clear on your conclusions other than young people who identify n a certain way (not detailed) are at higher risk of self-harm, suicide ideation, suicide attempt.

That seems to be a specific focus of causality and solution - affirmation.

I don't agree with that. Others don't agree with that. How you talk about this area does not lead me to consider you have credibility, and I don't mean to be at all rude by that.

It's essential all young people have the support and understanding, in the fullest and most informed way, humanly and scientifically possible.
What is your solution? I'm not sure what that is, tbh.[/quote]
I'm not surprised you haven't received an answer to that question. Since that poster is telling women on another thread that discomfort with cross dressing men practicing their fetish in women's spaces/in public is 'prejudice'.

I understand that other people hold prejudices that might make them uncomfortable, yes.

In response to "That's good. You understand why other people might be uncomfortable though?"

@suggestionsplease1 I have looked at a great deal of sources, studies and data, but due to my background am able to review the design, methodology, results, conclusions made, and limitations of all of these, at a deeper level and build a comprehensive overall opinion based on that.
I'm not clear on your conclusions other than young people who identify n a certain way (not detailed) are at higher risk of self-harm, suicide ideation, suicide attempt.

That seems to be a specific focus of causality and solution - affirmation.

I don't agree with that. Others don't agree with that. How you talk about this area does not lead me to consider you have credibility, and I don't mean to be at all rude by that.

It's essential all young people have the support and understanding, in the fullest and most informed way, humanly and scientifically possible.
What is your solution? I'm not sure what that is, tbh.

Follow the data, the research, the evidence; look at it in detail yourselves to find the best way forward to support loved ones that are struggling.

This is exactly what is being advocated here. Read ReliablyMum's long post from yesterday. What these children need is an understanding of what has brought them to where they are, considering all the factors which could be a cause of their distress. Just focusing on a transgender identity, and suggesting to them that 'fixing' that through unquestioning affirmation is the only possible solution, is doing them a disservice which could be disastrous for them in the long run.

[quote DoubleTweenQueen]@suggestionsplease1 Makes zero difference to me where you are or when you reply, if at all.
You are not answering to the complexity of the wider issue.
I wouldn’t get on to vaccines, if I were you. It’s in my field.[/quote]
Ok, but you understand the parallels made, right?

That when there is a very large body of evidence it's problematic to just focus on a minority of studies which shore you up in your opinion, or a depend on a critique which comes from a particular political stance when the mast majority of studies are pointing in a different direction.

GC feminists often go on about ideology in the present debate; but this is ideology at work when you ignore the evidence that is out there.

Follow the data, the research, the evidence; look at it in detail yourselves to find the best way forward to support loved ones that are struggling.