Deep dive into childhood transition evidence by Jesse Singal

[NecessaryScene]

I've not seen this mentioned on FWR at all yet, so thought I'd better bring it to attention, given how much time Jesse has clearly spent on it.

"Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

Summary Twitter thread here: twitter.com/jessesingal/status/1535305016768086018

It's a long read, and he's utterly brutal.

Some of the highlights (chopped up a lot, so don't expect any paragraph to follow sensibly from the previous):

Zukerman is clearly saying that if you, the parent listening, have a kid who wants to go on hormones, and you don’t put them on hormones, you risk raising the probability they will become suicidal and/or attempt suicide. This is a profoundly serious claim — an invocation of every parent’s worst nightmare — so one would hope that it’s backed by nothing but ironclad evidence. But that isn’t the case.

Their biggest problem is citational mischief: They make claims, and then link those claims to research that doesn’t actually support them

Maybe the studies get clearer? Maybe there’s higher-quality and more impressive evidence forthcoming?

This is just very weird and amateurish science, to mention the scale, provide the baseline readings, and then sort of wander off to look at a butterfly.

Let’s imagine Science Vs were evaluating a study not of puberty blockers and hormones, but of a novel treatment for coronavirus promoted by Joe Rogan. Let’s also imagine that the authors of that study published a study evaluating the treatment in which they argued, “Well, we didn’t reach statistical significance in most of our tests, but we had a small sample size. Plus, there are some potentially promising results in a subgroup that comprised one-third of our sample.” It goes completely without saying that Science Vs would describe this as a weak finding that should nudge us toward skepticism, not acceptance, of the treatment in question. Why do different standards apply here?

Steven Novella and David Gorski commited a similar error on their website, Science-Based Medicine, which has had its own Nordberg-in-the-opening-scene-of-The-Naked-Gun-level issues covering this subject accurately.

It should tell us something that when it comes to the youth gender medicine debate, some of the leading, supposedly skeptical voices are making the exact same sorts of mistakes in the exact same direction, over and over and over. They never make mistakes the other way — they never falsely understate the strength of the evidence for puberty blockers and hormones.

In other words, so many respondents wrongly said they took puberty blockers that the test’s architects simply had to toss the vast majority of the affirmative responses to this question. Okay. Why should we trust that everyone else in the survey had a firm grasp on which medication they had taken?

If Biggs is correct, then the data here provide an even more conflicting storyline — one in which a lot of the results aren’t just null, but point in the exact wrong direction. Turban and his team, by their own reasoning, would be forced to conclude that estrogen is dangerous for trans women from a suicidality perspective.

Because, as he notes, testosterone has established antidepressant properties, it would be very hard to suss out what’s what here. Even assuming causality flows the way Turban’s team wants it to, did the trans men in this study experience improvement because of the specific nature of gender-affirming medical treatment, or because anyone — particularly someone dealing with preexisting mental health problems — would feel better from regularly taking T?

I don’t want to belabor the point but it should be seen as quite damning — as a major abdication of the staff’s responsibility as science journalists — that Science Vs told an audience of God knows how many hundreds of thousands or millions of people that there’s no controversy here (and that Jack Turban said the same thing, for that matter). It’s infuriating that they would hold over parents’ heads the threat of their kids killing themselves despite not appearing to have much familiarity with the research they themselves are citing.

Thank you for signposting this, Necessary.

It's a good analysis. It's very troubling that so many people who are ostensibly pro- evidence and science affect to be uninterested in material reality for this topic.

Would it be worthwhile to send this to Hilary Cass?

Deeply concerning. This is something I intend to share with my MP. Who is doing the due diligence and checking all these claims and statements? For example I notice that the suicide claim is thrown around the HoC like confetti - which statistics? Where is the evidence? This suggests it's not a bug in the system - it's become a standard, accepted feature.

Thanks Necessary. I am baffled by the fact that so many people seem to think about this issue with a different part of their brain than they use for other topics. Thank heavens for the adults in the room. We need more people saying things like this.

This suggests it's not a bug in the system - it's become a standard, accepted feature.

Full Fact has had a lot of success in ensuring this sort of behaviour can't be repeated on different topics.

Whether it's FPFW, WPUK, Sex Matters, or a coalition, we need an organisation that can protest to the appropriate people about this mis-use in the HoC or similar arenas every time it happens.

For example I notice that the suicide claim is thrown around the HoC like confetti - which statistics? Where is the evidence? This suggests it's not a bug in the system - it's become a standard, accepted feature.

Someone in the comments of the Substack draws an apt analogy:

I'm reminded of the Senate Select Committee report about intelligence failures leading up to the Iraq War. The intelligence community had a few flawed pieces of information, but as analysts started citing them and then getting cited by other analysts and then those analysts getting cited. Suddenly, you have a consensus that there's an abundance of iron-clad information just from the mass circle of citations.

I missed one of the most important things here - it's something that's come to light this year - I first heard Stella + Sasha bring it up on their Wider Lens podcast a couple of months ago, when they had an interview with some of the Dutch researchers who started this whole "puberty blockers for kids" thing.

We need to keep highlighting this:

One of the genuinely impressive-seeming findings is that the Dutch subjects’ high-at-baseline gender dysphoria “was alleviated” at follow-up. But there’s a catch there, too, according to Levine and his coauthors. It involves the measure the researchers used, the Utrecht Gender Dysphoria Scale:

'This 12-item scale, designed by the Dutch to assess the severity of gender dysphoria and to identify candidates for hormones and surgeries, consists of “male” and “female” versions. At baseline and after puberty suppression, biological females were given the “female” scale, while males were given the “male” scale. However, post-surgery, the scales were flipped: biological females were assessed using the “male” scale, while biological males were assessed on the “female” scale. We maintain that this handling of the scales may have at best obscured, and at worst, severely compromised the ability to meaningfully track how gender dysphoria was affected throughout the treatment. [citations omitted]'

So after the trans boys went on blockers, took testosterone, and had double mastectomies, they were given an instrument with prompts like “My life would be meaningless if I had to live as a boy”; “I hate myself because I am a boy”; and “It would be better not to live than to live as a boy.” It would be shocking if someone who put this much effort into transitioning to a boy/man answered these questions in the affirmative. This seriously calls into question one of the best results the Dutch team got

Even the right way round, those are disturbing questions to diagnose anything on. It really brings home that the diagnostic criteria are basically do you feel alienated by the stereotypes associated with your sex. Being a halfway nonconforming feminist would seem to qualify you for a diagnosis of gender dysphoria.

It really brings home that the diagnostic criteria are basically do you feel alienated by the stereotypes associated with your sex. Being a halfway nonconforming feminist would seem to qualify you for a diagnosis of gender dysphoria.

Today's relevant cartoon from Tatsuya Ishida.

I have read that properly trained psychologists make more precise distinctions than the use of gender stereotypes which are often quite sexist, but the latter are very very common in the way trans activists talk about these issues online.

Their framework of what women and men might be is not at all dissimilar from very sexist ways of looking at the division of sexual labour or of gendered dress, hobbies, gendered occupations etc.

Most of it is much closer to religious conservative and Alt Right and incel views about women, in particular, than it is to more old-time feminist views. I sometimes feel I have skipped to a different alternative reality where feminism never existed in the past but rigid sex roles continued and now some people are allowed an escape clause by changing their box, but this cannot be available for the vast majority of women as that would collapse the system.

An excellent piece by Jesse Singal (as usual) - thanks, Necessary