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Feminism: Sex and gender discussions

Huge meta-study finds that transition helps trans people

205 replies

WAKAME · 31/05/2018 10:30

whatweknow.inequality.cornell.edu/topics/lgbt-equality/%20what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people%20/

Some excerpts:

"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."

"This search found a robust international consensus in the peer-reviewed literature that gender transition, including medical treatments such as hormone therapy and surgeries, improves the overall well-being of transgender individuals. The literature also indicates that greater availability of medical and social support for gender transition contributes to better quality of life for those who identify as transgender."

"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."

"the health and well-being of transgender people can be harmed by stigmatizing and discriminatory treatment."

OP posts:
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Faceicle · 01/06/2018 13:45

Brilliant.

GibbertyFlibbert · 01/06/2018 13:45

"Matthew Greenfield on Twitter did a marvellous take down of each and every one of the 56 studies referred to by Cornell:
twitter.com/doormatt134/status/984339908658651138"

Hardly.

More importantly the whole point of a meta study is to address any weaknesses in individual studies (such as a sample size which is less than ideal) by aggregating across them and he doesn't seem to understand or address that at all. It's a gestalt.

Faceicle · 01/06/2018 13:47

How are trans women women?

GibbertyFlibbert · 01/06/2018 14:02

"Women on the whole are uncomfortable with having overt physical masculinities. We are also on the whole, uncomfortable with being perceived as male by other people. So transition is the process by which trans people change their physical characteristics from masculine to feminine, and their legal and social status to female."

It might be for transgender people but for those who have classically (but still inaccurately) been termed transsexual, that's not really right. Rather, it is a recognition that one was born with a mixed physiology - certainly a female brain as many studies have shown (in the case of females), possibly a karyotype which isn't entirely XY or with epigenetics which aren't male but with a penis, albeit possibly small because of the underlying mixed physiology. In cases like this, the doctors at birth - because they don't do brains scans or genetic assays - often pick the wrong sex. Transition for a significant number of people is the process of dealing with that mistake and the consequences which flowed from it and medically aligning to the experientially strongest sex characteristics.

I appreciate that some people who are trans transition too. They tend to be the vocal ones. But please don't airbrush out the significant minority who quietly and calmly deal with the problem and then get on with being the women (men as the case maybe) they always were.

DN4GeekinDerby · 01/06/2018 14:17

The most recent British source I have for 'Most dysphoric people do not transition' comes from GIRES, Gender Identity Research & Education society which, as the name suggests, is a trans research group which is well known to be pro-self ID. They have further research on their website though not always to the detail I would like (like they say things like 'assessment takes 6 months'', but they don't seem to yet have published research on how much face-to-face with a professional that involves or whether that's waiting for one appoinement which I think is an important difference and both should be monitored and discussed)

This was the evidence GIRES gave to Parliament as part of a consultation. It quotes Dutch research primarily but other research as well and from that clearly states that only a fifth of the estimated dysphoric population are likely to seek out medical help specifically for gender dysphoria, with that percentage being far far lower in the UK. That means over 80% of estimated dysphoric people in the UK do not seek out medical transition. Even if we take self-prescribers into account (most of whom in my experience have sought out medical care but, due to the abysmal waiting lists caused by underfunding, choose to self medicate during and continue after the waiting period), most dysphoric people don't transition. We never have. In the days of 'strict gatekeeping' dysphoria was not by itself grounds for support to transition because it's rather extreme care and for most things, it's generally thought to do that which has the least risk first and see if that helps first and then move up.

Just because we have the internet doesn't mean anyone should be self-prescribing. I can't actually believe anyone thinks that web forums are a reliable place to get medical advice. As someone who has had to help care in the aftermath for a trans woman who was taking over 5 times the dose recommended by her doctors because so many people online told her that much E was safe, that doctors just don't understand so she doesn't really need to talk to them, and if she did take that dose she would get results she wanted faster (when no, it wasn't safe and none of these hormones are a guarantee of any particular result) I think people like you who want to say 'we have the internet now, we don't need medical professionals' are putting vulnerable lives at risk. The internet is full of so much bullshit, why in the universe would anyone think the internet is in any possible way a substitute for proper on-going medical care. WAKAME, would you recommend people self-prescribe for everything? Should people be able to self-prescribe morphine or tramadol because 'we have the internet now'? Self medication is as old as brain function has allowed it, rats will do it if you put them in shitty conditions, that doesn't mean we should encourage or enable it and certainly shouldn't rely on random people online to tell you how much you should take. I mean, seriously, asking about sizing a bra is one thing but body altering medications really kinda need a professional.

Transition can help some people with dysphoria, but it's not for the majority of us. Those it can help, we know from research - some of which are in that Cornell study - that it works significantly better with a thourough screening and therapy process and for many on-going therapy. Every dysphoric person who feels a need to reach out should get that. Dysphoric people, we deserve better than to have our medical needs thrown aside because the internet mobs think they know better than medical professionals. You know, the kinds of people who wrote those articles you're quoting as the voice of authority and then spitting on when you say that people don't need them to transition well. All the people in pre- to post- studies were cared for and monitored by the medical professionals, their main sources for medication were not the internet.

My saying that the study isn't huge doesn't say it isn't the biggest. It's stating that in terms of meta-studies within research in general, it's pretty small and if these were the only studies they could get...that pretty much means to me that research is lacking, which I've been saying for years though I'd prefer it research into gender dysphoria was not transitioned focused. And, as I said, the metastudy can not claim causation - as Cornell said, to prove causation would be unethical because individualized nature of the care required (the therapy components) means we can't do that. It would be like proving causation of alcohol for fetal alcohol syndrome which would require randomisation and having some mums drink heavy amounts. For some things, we only have hindsight and correlation data (and papers published in 2017 are not about people who transitioned in 2017, to show improved well-being means it was done significantly after to remove initial emotional spikes as those would bring the data into question, the Dhejne studies included those who transitioned in 2003 but her work published in 2011. That's an okay gap but to prove long term well being you have to wait awhile). We have enough evidence to show how important the therapy is for dysphoric patients, if you look at research gate there are some going back to decades. That's pretty much done, hopefully the ones on transition will be done soon too because there is so much else to research about gender dysphoria.

They can a show correlation between transition and improved well-being. None of the studies are transition only though which is why I am banging on about the issue with treating transition as the goal, as the one thing dysphoric people need, when the research doesn't say that. It says, as part of wider medical care for dysphoria, transition has a positive effect on some adults suffering from gender dysphoria. That's really enough. We have something which helps some people, great, let's look at other options for other people, let's see which talking therapies work help transition to work the best, let's look at resurgance in self medicating on hormones and maybe compare them to the '70s group, let's see what helps little dysphoric kids the most to ease their distress before puberty because as someone who used to be one of them, who was talking about a sex change at 7, I think everyone deserves better care, but particularly kids. Honestly, I am astounded how in the Midwest/Bible belt where I grew up I somehow got better and more thourough care for my mental health as a kid through the schools than I see for most adults I know trying to get help now. I got general individual therapy, I got group therapy, at the second high school there was specifically LGBTQ+ group therapy run by the UU church down the road which was all about what we would now call affirmation, I was typically the first and only known dysphoric kid in the schools - and I moved a lot - and I got excellent care and accomodations (though I think some would think it odd I was in the boys' locker room under the supervision of two men who checked everyone was dressed before I entered. Never changed in there but was in there for other things but saying I was in the guy's locker room with a few dozen boys and two men does sound weird to most). I think if people are who are too often said to hate people like me can consider all my needs, progressives who are meant to care a lot more should be pushing for more than pills, injections, patches, surgery, and changing some letters on a bit of paper. That that seems to be GIRES focus in their consultation research - how fast can we get people on hormones - is frustrating because that's really a small part of the dysphoric puzzle and not all dysphoric people even want to consider that. Dysphoric people deserve better than that, hell, I think everyone deserves better.

And please look into the Samaritans and their media advice for writing about suicide. Your remark breaks evidence-based best practice in suicide prevention.

Ereshkigal · 01/06/2018 14:32

It seems my society and my government already accept me as female

It's what's known as a legal fiction. As you will be aware there can be exemptions to it. Because the law recognises that you wish to change your sex but are biologically male, and that women have rights to some sex segregated services and spaces. In some cases we are permitted to exclude you. One of the examples given is a rape counsellor. The guidelines state that an exemption may potentially be permitted even when the person has a GRC. This is so as not to cause further distress to a female rape victim. Because the person is male. This is the heart of the matter. Do you respect this?

Disorders of sex development and other chromosome anomalies do not refute that humans are a sexually dimorphic species. Female sex is a producer of large gametes (ova), Male sex produced small ones (sperm). There are no other sexes.

Society doesn't accept you as female on the whole. Most people know perfectly well what a woman is. But often they don't want to offend or get into trouble.

Ereshkigal · 01/06/2018 14:36

More importantly the whole point of a meta study is to address any weaknesses in individual studies (such as a sample size which is less than ideal) by aggregating across them and he doesn't seem to understand or address that at all. It's a gestalt.

Not if they're all poor. See Mossandclover's post below. Perhaps you'd better read all of Matthews tweet thread because it's not actually mostly the sample size he's criticising.

GibbertyFlibbert · 01/06/2018 15:00

"Not if they're all poor. See Mossandclover's post below. Perhaps you'd better read all of Matthews tweet thread because it's not actually mostly the sample size he's criticising."

I did. He is completely lacking in rigour. If someone wants to not take an ademic study at face value the counter argument needs to be presented to academic standards. He hasn't

GibbertyFlibbert · 01/06/2018 15:11

"Because the person is male"

If you say that of someone with a GRC then I think that is a contempt of court since you are refusing to abide by a legal judgement - in law the Gender Recognition Panel is a tribunal. Free speech entitles you to say that you think the matter was wrongly decided, or that the law should be changed, but you can't just ignore a judgement because you dislike it. Henceforth if people here describe women with GRCs as men, I will be reporting them

GibbertyFlibbert · 01/06/2018 15:16

"How are trans women women?"

If you buy a male rabbit you might discover several months later that she is female. Sexing humans isn't a precise science and doctors get it wrong. If that didn't happen to you, rejoice, but it does happen to some people

AssassinatedBeauty · 01/06/2018 15:23

Rabbits are nothing like people and have similar appearing external genitals. This is the most bizarre and irrelevant comparison I think I've ever come across in this area.

Boys or adult human men who want to change gender presentation are not the same as female rabbits that were mistaken for male.

spontaneousgiventime · 01/06/2018 15:28

Henceforth if people here describe women with GRCs as men, I will be reporting them

Report away, I will not be party to a lie that says men are women, GRC or none.

GibbertyFlibbert · 01/06/2018 15:38

"Disorders of sex development and other chromosome anomalies do not refute that humans are a sexually dimorphic species. Female sex is a producer of large gametes (ova), Male sex produced small ones (sperm). There are no other sexes."

So, by your definition post-menopausal women, or women who have had hysterectomies, aren't female because they can't produce ova? Similarly, anyone born infertile is neither male nor female. Sorry, but your definition doesn't work.

Male and female are fuzzy sets.

AssassinatedBeauty · 01/06/2018 15:44

No, they are female because they are of the sex that can produce ova. A person can only be post-menopausal because they are female. A woman who has had a hysterectomy needed one because she is female.

GibbertyFlibbert · 01/06/2018 15:46

"No, they are female because they are of the sex that can produce ova. A person can only be post-menopausal because they are female. A woman who has had a hysterectomy needed one because she is female."

That's a circular argument

AssassinatedBeauty · 01/06/2018 15:50

How? Can you explain?

spontaneousgiventime · 01/06/2018 15:54

That's a circular argument Crap! Truth is not a circular argument no matter how much you try to twist it. You can tie your brain in knots trying to make truth a circular argument, I for one will enjoy watching you try.

LangCleg · 01/06/2018 15:57

That's a circular argument.

Please provide the transactivist definition of circular argument.

Presumably, like most other transactivist definitions, it's the reverse of anything commonly understood. If you redefine every word and term in the English language, you do realise that material reality will not be affected, right?

Ereshkigal · 01/06/2018 16:00

So, by your definition post-menopausal women, or women who have had hysterectomies, aren't female because they can't produce ova? Similarly, anyone born infertile is neither male nor female. Sorry, but your definition doesn't work.

Typical idiotic trans gotcha.

It does work. Because there are two sexes. Infertile females are still females i.e. they are a member of the only one of the two sexes that can produce ova. And infertile males are still male, whether or not they produce sperm.

Dull.

Ereshkigal · 01/06/2018 16:02

There isn't a special third sex for all biologically infertile people. Intersex conditions are disorders of sex development.

Ereshkigal · 01/06/2018 16:03

Presumably, like most other transactivist definitions, it's the reverse of anything commonly understood. If you redefine every word and term in the English language, you do realise that material reality will not be affected, right?

This!

CharlieParley · 01/06/2018 16:41

Report away Gibberty.

That tribunal obligates companies and public services to recognise a legal fiction, just like other legal fictions that exist in our laws today.

It does not obligate me or anyone else here who acts in a private capacity. It also doesn't override my right to free speech and my right to share or refuse to share in a belief system. We can even say transwomen are male, are men, in public. No matter how many GRCs you wave in my face, there is no government mandate forcing me to accept your belief system. So transwomen are born male, they die male and there's really nothing else to it.

Now I wish you well, I support you being able to express femme if that's what you want to do and I even supported the GRC for post-op/medically transitioning transsexuals back when that was the best solution. But I don't have to agree with a belief system that in my view espouses dangerous lies, threatens my rights and especially not if it involves an attempt to make me participate in someone else's delusion of doing the impossible.

Much as some very religious people I know are allowed to say that they think homosexuals must not live in sin and have same-sex relationships and that those who do will go to hell and that they want nothing to do with such people. Totally free to say it, wherever they go. We argue about it, but I can't have them arrested for it if they are acting in a private capacity. And yet sexual orientation is as protected in law as gender reassignment is.

UpstartCrow · 01/06/2018 17:07

Rabbits are very easy to sex. If you can't do it its your inexperience. The males don't have hair over their testes, which are held internally. So they have two small bald patches either side of the penis.
The females have a similar looking sheathed vulva. but no bald patches.

Humans are not rabbits. The majority are not intersex and so are easy to sex, no matter how inexperienced you are, because we are sexually dimorphic.

Mossandclover · 01/06/2018 17:11

A transwoman with a GRC is a man who has been classified as a woman for various legal purposes. However, they remain a man. I am not required by law to call them a woman or ignore the fact they are a transwoman. However, if I were an organisation providing services then I would be required to treat them as a woman in many (but not all) circumstances. If I were a doctor and treated them as a woman I could be had up for malpractice.

Ereshkigal · 01/06/2018 17:17

But I don't have to agree with a belief system that in my view espouses dangerous lies, threatens my rights and especially not if it involves an attempt to make me participate in someone else's delusion of doing the impossible.

Exactly this.