I am on a small phone and without access to a large screen for one month. And I cannot see how I can access the data outside a few charts.
So, the reality is, I am not going to be able to analyse it properly.
And it actually doesn’t matter. Because I have been discussing a particular cohort that is not adequately represented in this data to be of relevance.
This will not include enough of the young female cohort I refer to to make relevant conclusions.
anyway, some initial thoughts in any case, this is apparently survey data and I cannot see the collection mechanic.
In just reading this abstract though there are some other concerns.
The control group included respondents who desired gender-affirming surgeries but had not yet received any. Respondents were included in this group if they answered “Want it some day” for at least 1 of the aforementioned gender-affirming procedures but did not answer “Have had it” for any of them. We excluded participants who did not report desire for any gender-affirming surgeries.
Isn’t this self fulfilling?
Any patient who might desire, even desperately desire because they see this as a panacea, would be expected to have poorer mental health.
Wouldn’t it be logical to compare those who have had the surgery to those who did not want it and who might be happy with their bodies? That would assess whether the surgery brought the mental health issues in line with those who are not distressed about having to wait / may never get the surgery.
Also, smoking?
We know from conversations with transitioned males that they are constantly told not to smoke. I would expect to see some questioning to weed out those who have stopped smoking due to medical advice… and that the reality is that a large % would have stopped smoking due to those reasons, not necessarily because their mental health improved.
And did they stop smoking nicotine and switch to vaping or other alternatives? That would need investigating.
Plus hysterectomies. Almost as many females had hysterectomies as mastectomy (euphemistically called top surgery when most other operations were given appropriate medical terms..
but hey it is just women’s health being discussed…). There is no way to ascertain the reason for those hysterectomies.
Was it due to atrophy and other issues due to the drug regime? Was it purely voluntary?
And the age of the females having surgeries compared to the males.
That is hugely significant for several reasons (only one being that those females if young have not encountered the long term health issues associated with their decisions).
Also
Respondents in the exposure group were more likely to endorse a history of gender-affirming counseling,
Ie. This group also was more likely to have had counselling services to improve their mental health.
I cannot read on this screen exactly how (and no data) this ‘co-variate’ was treated in the analysis.
How were other comorbities treated too?
I think I want to see the data collection device and the data on this one.
Also, in regards to the ‘prestige’ appeal ‘it’s Harvard’. It is not led by a clinician with experience it seems. I think they were master’s students at the time. And you could say ‘it’s Yale!’ For that Yale study where the conclusion was retracted just over 12 months later.
I will wait and see whether there is any corrections for this study. I am too tired to look for any now.
But. Again. It may be that the previous cohort is well treated by surgeries. Do you deny the current clinicians, and past clinicians now doing research, are saying there are issues with using the same treatment plans for this current cohort of young transitioners who are the majority female? and that the two cohorts are different?
I look forward hearache to any answers to my concerns that I have mentioned.