Huge new study of trans people released.

[crispbuttyfan]

thinkprogress.org/what-we-know-transgender-surgery-72ae4737545a/

1. The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

1. Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

1. The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

1. 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.

1. Factors that are predictive of success in the treatment of gender dysphoria include adequate preparation and mental health support prior to treatment, proper follow-up care from knowledgeable providers, consistent family and social support, and high-quality surgical outcomes (when surgery is involved).

1. Transgender individuals, particularly those who cannot access treatment for gender dysphoria or who encounter unsupportive social environments, are more likely than the general population to experience health challenges such as depression, anxiety, suicidality and minority stress. While gender transition can mitigate these challenges, the health and well-being of transgender people can be harmed by stigmatizing and discriminatory treatment.

1. An inherent limitation in the field of transgender health research is that 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.

1. Transgender outcomes research is still evolving and has been limited by the historical stigma against conducting research in this field. More research is needed to adequately characterize and address the needs of the transgender population.

I am always pleased to see that research is being undertaken in the area of gender identity and dysphoria. As Polly Carmichael keeps saying, there is just too little out there for proper evidence based decisions to be made. I am not sure that this meta-analysis answers the question about whether transitioning is right for any one individual.

Institutions need to support, not block, studies of de-transitioning individuals as well as transitioning. Understanding more about who it tends to work for and who it doesn't would be really helpful.

I am saddened that research is often considered or promoted as a 'win' for differing ideological stances. Surely the goal is to step away from ideology and to understand more about the full range of experiences out there.

We know that transitioning works for some and it doesn't work for others. The goal is surely to make sure that all routes to a better life are explored and that different routes work for different people.

What is transition? Is it sticking on a dress, or is it a medical procedure

Good question. The SR at hand is not clear. For example, one included study refers to individuals in the process of SRS (surgery) and another refers to CSH (hormones). This is waaaaaay to broad to be considered credible.

I am always pleased to see that research is being undertaken in the area of gender identity and dysphoria. As Polly Carmichael keeps saying, there is just too little out there for proper evidence based decisions to be made. I am not sure that this meta-analysis answers the question about whether transitioning is right for any one individual

I'm not sure that this SR answers any question!

The only credible finding that I can see from a quick perusal of the included studies is that 'we don't know enough to make any firm conclusions'.

Here are summaries of the four reports that this report is based on.

And the last one.

I've learned to read all the studies, too. There was a trans research review in 2009 by the Equality and Human Rights Commission.

On suicide it said:

^Some evidence for a high suicide rate is provided by Whittle
et al’s (2007, p. 78) survey of 872 trans people which reported
that 34.4 per cent of respondents had attempted suicide at least once.^

So I looked for and found the study.

The actual question was (page 116):

As an adult (over the age of 21) Did you ever attempt suicide, or self harm, because of being a crossdresser, transgender/transsexual or because of other people’s reactions to you being trans? (my emphasis)

34.4% answered yes to this question. Inexplicably, although the pie chart in the paper was directly below this explanation:

Figure 8.1: Respondents who reported attempting suicide or self harm, as an adult, resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans

In the discussion below the pie chart no mention is made of self-harm at all. Although none of the survey questions allowed the respondents to qualify their statement and choose between self-harm or suicide attempt, that percentage is taken to refer only to the latter:

Almost 14% of adult trans people have attempted to commit suicide more than twice, and 34.4%, over 1 in 3, reported having attempted suicide at least once as an adult.

And then the Research Review lifts that number as the suicide rate from the original study. Despite the fact that we know from a whole range of other studies of course that self-harm is more prevalent than actual suicide attempts.

And that's not even considering that suicide researchers usually follow up such a survey with qualitative interviews with those who stated they had suicidal thoughts or attempted suicide because they consistently find the number who have actually attempted suicide to be half of that who tick the box.

That's why I go to the source. And look at the methodology and how it differs from that of others in the specific field.

Have I misunderstood, or is this huge new study based on 18 or 19 individuals, who are not demographically representative?

Have I misunderstood, or is this huge new study based on 18 or 19 individuals, who are not demographically representative

Its a systematic review of the literature. Such studies are designed to 'bring together' all the known, credible research on a particular topic. Specifically, they answer a specific question or address a hypothesis. So, for example, they could examine 'what do we know about the effects of the low-oestrogen pill on breast cancer in women over 30?' (or similar). That is what this study claimed to do with respect to the outcomes of gender transition (being positive or negative). But there are so many weaknesses with the study that I'm surprised Cornell wants it on their website.

This is NOT a scientific meta analytical study.

I'm wary of this link because it's simply not scientific and contains basic grammar and spelling errors:

That’s not to say that transgender people don’t face higher races of depression and anxiety.

On that quote, whilst the surgery is successful it still seems that it's not a panacea because of course being trans means that you are the most oppressed on the planet.

SimonBridges

Those reports conflate biological sex and gender so much that I've no idea what the report refers to when they describe someone as to whether they are male or female or what? It's a miss mash of pronouns.

The headline to the link is far from scholarly and reads like tabloid click bait headline.

This is the link to the actual SR

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

And another thing I don't like about that link from the OP is this:

'contradicting popular conservative claims.'

What does that mean in the context of the link? It speaks to me of being antifa. Just to put this into perspective, the most conservative countries in the world embraces transgender operations, such as Iran.

And secondly, other than gender dysphoria, what reason is there to transition?

This is the crux of the issue here. I don't see any other basis why people should be given special protection in law to access the spaces of the opposite sex.

As I already said, has everyone actually asked all trans people?

That's not how research works. We can extrapolate from a sample of the whole. Otherwise your small group brain scan study findings can only be said to apply to the 45 or so subjects in that study, right?

Here is the parent org

en.wikipedia.org/wiki/Center_for_American_Progress

However, the actual study (SR) appears to have been carried out by a public policy research centre at Cornell University.

In the discussion below the pie chart no mention is made of self-harm at all. Although none of the survey questions allowed the respondents to qualify their statement and choose between self-harm or suicide attempt, that percentage is taken to refer only to the latter:

If you read the limitations section in the Williams Institute study (cited by many trans orgs) on suicide attempts it gives you a good idea of the pitfalls and caveats of this kind of research.

As others have said, if research into transgender people is improving then great, I’m pleased things may start looking up for that group. This does not have anything to do with the need for sex-based rights for women and girls.

As an aside I bloody love Mumsnet. So many fantastic posters who take the time to read, process and discuss these sorts of studies so that people like me from a non-academic background can understand. Thank you

1. The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

Good, that's helpful to know. In schools for example with kids, being much more relaxed about gender non conformity makes it much easier for kids to feel less gender dysphoria and to socially transition as statistics suggest a significant number of those kids will actually move to defining themselves as gay rather than transgender in time. It's important not to hustle people towards irreversible procedures when social transition is something that can easily be reversed, or built on at a later time if the person chooses to.

2. Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

Great!

3. The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

Also great!

4. 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.

That's also good to know, although I note the part of the report commenting that regret and difficulties after transition had to do with mental health diagnoses and needs that had not been properly met. Which suggests it's very important that proper mental health support is not reduced or removed from the process of transitioning when it begins to involve drugs or surgery, or legal change of sex. I know how threatening this can seem to someone who is desperate to transition and that they will be somehow not believed or talked out of it, but the perception of what that mental health support is for is what needs changing, not just removing it from the process.

I also still feel very strongly that drugs and surgery should not be given to children, although this is a very emotional and difficult line to draw. Children have a right to their fertility and there are cases of regret, there are cases of adults who feel they were allowed to rush into surgery and have procedures that can't be undone, and there aren't really 'acceptable' numbers of people to let suffer in this way. We're currently experimenting on a generation without having properly researched or risk assessed it and the potential is there for in a decades time to have some very distressed, angry adults rightfully suing for lack of child protection. That some of those adults will be happy with the changes doesn't make it ok for the ones that may not be.

5. Factors that are predictive of success in the treatment of gender dysphoria include adequate preparation and mental health support prior to treatment, proper follow-up care from knowledgeable providers, consistent family and social support, and high-quality surgical outcomes (when surgery is involved).

Great. Another vote for proper mental health support in the process. AND for much better funded, widespread mental health support in schools and the CAMHS service to address things like bullying, identification and support for MH needs and much better support for children with Autism, all of which can contribute to struggling with gender stereotypical pressure and sense of identity.

6. Transgender individuals, particularly those who cannot access treatment for gender dysphoria or who encounter unsupportive social environments, are more likely than the general population to experience health challenges such as depression, anxiety, suicidality and minority stress. While gender transition can mitigate these challenges, the health and well-being of transgender people can be harmed by stigmatizing and discriminatory treatment.

Very understandably it can be harmed. However care needs to be taken about misuse of the word 'stigmatising' and 'discrimination', and sex and gender need to not be conflated. For example it is one thing to provide a proper, designated gender neutral changing room (which is not a disabled loo or a stock cupboard) where a gender transitioning person can feel safe, and have their privacy and dignity maintained. It is another to insist that they must use an opposite sex changing room, irrespective of the feelings of safety, privacy and dignity of those users. It is one thing to be very clear that bullying, intimidation and harassment is absolutely unacceptable and will not be tolerated. It is another, and equally unacceptable, to insist that someone's sex orientation for sexual partners must be put aside to avoid stigmatising or discriminating on the grounds that gender identity is more important than their biological sex.

8. Transgender outcomes research is still evolving and has been limited by the historical stigma against conducting research in this field. More research is needed to adequately characterize and address the needs of the transgender population.

Yes, plus as many have eloquently explained above, this is regarding people with gender dysphoria, and it is important that the specific needs, vulnerabilities and social development of provision for people with gender dysphoria is not automatically extended to those without gender dysphoria, without proper and fully informed discussion.

Bebanjo , there ARE plenty of transsexuals who transitioned and had surgery decades ago. I am one. Transitioned 1973, surgery 1976. I know several others. There are people out there who transitioned even earlier - for instance Jan Morris, the brilliant travel writer who climbed Everest with Hillary and announced the news it had been conquered on the day the Queen had her coronation. She is in her 90s One of the first UK surgeries was to a World War Two pilot.

Many of us are not out there visibly declaring anything or being on TV chat shows or campaigning for anything. Because we transitioned, were cured of dysphoria and just wanted to live our lives rather than change the world. Which seems to be the modern thing.

But they are out there in numbers.

Transsexuals are focused through changing the body but are also almost always perfectly well aware of biological reality and the limits of what can be done.

The numbers have been steady since the first Gender Identity Clinic was set up in the late 60s and this became an ongoing series of cases rather than one offs done privately abroad (Jan Morris in Casablanca as the NHS declined her case as not matching their then strict criteria).

It has hardy varied between 100 and 300 in all those years. So across decades where there was no huge waiting list as there was no huge demand. Until quite recently when now there are so many people that the percentage will be the same but the numbers are rising.

In 10 years up to 2010 there were under 900 NHS surgeries in the UK.

In the past five years the number of people being granted a GRC, most of whom have had some surgery, has not changed and has stayed in the 200s and 300s each year.

So those having surgery and wanting a GRC have been very consistent throughout up until very recently.

I am not arguing that some of the 600,000 or so who now identify as being trans (not transsexual) might not want surgery. But if they do these are the same ones saying that self ID should be introduced and the process demedicalised.

But if they feel they need surgery it is self evidently a medical matter for them, surely? So they need the gatekeeping and if many more might want it in future and we demedicalise it then what are we going to see?

I think we can reasonably predict an increase in those medically transitioning without proper assessment or going abroad to ask no question clinics via Easy Jet.

Either self ID is needed because most people do not want medical help so that check and balance needs to be taken away.

Or more and more and more people want medical help and that has to mean medicalising the process.

So why change the GRA as it stands that requires this up front?

I should also add that in the 1970s when I was going through the long process of evaluation in hospitals, clinics and psych units they were VERY reluctant to take the step of surgery. It had to be for doctors a last resort. The only thing they believed would cure you.

This is why someone like Jan Morris, for whom it clearly was the right thing to do, was not helped by the NHS. They erred on the side of caution then, probably more than they do now.

But one thing I discovered from several of them was that around 1000 people a year went through the NHS programme then seeking to transition and 90% of them were turned away. Because the NHS investigation into them believed it was not the appropriate treatment in their cases. Either they were unsure which gender they were and changed from one to the other or flip flopped over whether they wanted to make any permanent changes. Or they suspected other psychological conditions of which the desire to 'change sex' was a side effect. Or they simply could not accept the ground rules and face reality as you had to clearly accept and sign a form agreeing that you did to stare you KNEW that your sex was not being changed.

So the process was onerous and self limiting but the doctors then were at the start of an unknown era and had to be cautious when nobody knew where this would go decades later.

It is also worth equating the above with the figures from gender clinics treating children at present. Where a number not dissimilar to 90% do not ultimately transition. They grow out of it, or change their mind,. or puberty reinforces natal biology. But in any case the drop out rate is not unlike the one introduced by the NHS all those years ago when they were treating adults.

Impossible to trust a meta study when you can't trust the individual studies.

Take the study with a cohort of 55 young trans which reported a 'good outcome' response one year after surgery.

Except the original cohort was 70
and one of those excluded from the results was a boy who died aged 20 of a necrotic vaginoplasty. Why did they leave him out? 'Because he couldn't fill in the survey.' Because he was dead.

Absolutely, Baby.

Live how you want to live calling yourself what you want. But don’t throw me and other women under the bus to get it.
Don’t tell me to hush up.
Don’t mislabel me.
Don’t tell me how to behave.

'state' not stare, sorry 7nlines from bottom

You know what I'm not actually very interested in trans people and I'm tired of discussing them....I do care though about women, the law, vulnerable children and free speech. When those intersect with trans I'll discuss those issues.

Exactly, baby. The problem we have here is that crispbuttyfan sees FWR as an anti-trans forum and not a feminist forum. Hence posting a study about how successful transition is for transgender people - which is completely off topic as it has nothing to do with feminism.

Yes, trans issues get discussed a lot here - but, crucially, in terms of how they impact on women and girls. We've already spent a thousand posts trying to explain this to crisp on another thread this week but I don't think it's sinking in!

BabyItsAWildWorld

Every single fucking word.

You know what I'm not actually very interested in trans people and I'm tired of discussing them....I do care though about women, the law, vulnerable children and free speech. When those intersect with trans I'll discuss those issues

I kind of agree... but if I accept 'old school' transwomen as allies (assuming they support me/us) then I will fight for them too.

So the study suggests people who do a thing they wanted to do are happier when they've done it?

Brilliant.

Doesn't really answer any concerns about the effects on women and girls, though, does it?