[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.