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Feminism: Sex and gender discussions

Interesting view of the Cass Review

51 replies

DameMaud · 28/09/2022 17:09

www.stephsplace.uk/cass-interim-report-review.cfm

Not sure if this has been discussed on here before?
Was looking up summaries on Cass to help me raise questions in a training I'm going to and came across this. Very interesting to read a critical reading of the review (and even more helpful for prep around understanding the POV from those who have a different response to it than me/most of us on here).
Would appreciate peoples' thoughts/reactions.

OP posts:
TheClogLady · 28/09/2022 17:19

It’s by an adult male transitioner who transitioned in adulthood and has absolutely no lived experience of being a child experiencing gender distress, nor of puberty blockade and it’s considerable effects, nor professional knowledge of paediatric healthcare within the NHS.

Cass wants the paediatric gender service to be organised the way all other specialist paediatric care is - with differential diagnosis and multi disciplinary care.

The author of this website just wants transitioned children to be an unquestioned phenomenon.

Clymene · 28/09/2022 17:30

I couldn't read beyond this line: Note : I use ‘young people’ as shorthand throughout, it applies to both children and adolescents, both of whom are people

Adults who insinuate children are no longer children when they are teenagers concern me. As does lumping prepubescent children in with teenagers and calling them all young people. It is a tactic used by people who want to argue that children are able to make decisions about things which have lifelong implications.

IIRC Steph's Place organised the disruption of the Standing for women event in Portsmouth

A TRA doesn't want children to stop being given blockers and hormones. I am aware.

PriOn1 · 28/09/2022 17:48

”The Review also clarified that puberty blockers aren’t actually ‘experimental’ and the NHS has not classed them as such since 2014, which bring into serious doubt why the web page was changed a couple of years back to make the statement that they were experimental. Will the NHS change that page now the cat is out of the bag?”

They haven’t been running it as an experiment, that is true. Without any back-up evidence from their own experiment, or change in more general evidence, they brought it in as a treatment. A man rose by any other name…

”It also highlights that there is a need for help for detransitioners, something trans people have been saying for years.”

Well that’s bollocks. According to most activists, there aren’t any detransitioners.

”The first is that Dr Cass is cisgender. No cisgender people are unbiased when it comes to trans lives, but they have excluded trans people from the decision making here,”

And yet almost all medical doctors who review evidence, in most areas of medicine are experts in that area and are not patients. Indeed much of the reason trans medicine has become so skewed is because patients are running the show, with what they want foremost, rather than based on carefully following the evidence available, which is completely inadequate. Dr Cass is an experienced expert in this kind of assessment. Steph however, is so filled with bias that it appears to make seeing reality and recognizing the genuine lack of bias impossible.

”Uninvolved is just another name for ignorant,”

Steph is becoming abusive and starting with the insults now. No surprises there.

”Because what trans young people really need is the encouragement of uninformed and untrained medical professionals to chip in with their own opinions on trans lives and existence.”

So trained medics from other areas of medicine must be excluded because they’re not believers. The fact that these are rational, educated people, who are likely to be expected to have some input, if the treatment of these young people is broadened out, rather than dealt with by super-specialized clinicians, who have been traveling down a tunnel (which excludes non-believers by default as they can see what’s happening and can’t live with it) is intolerable to those of the one-true-faith persuasion, as Steph so clearly is.

”There is one thing that the report makes very, very clear. And that is that trans lives and identities, especially for young people, must be pathologised and medicalised under the strictest of supervision. Having lost the power of continued pathologisation of adult trans identities, they turn their sights to the more vulnerable members of our community.”

Not a pathology, but requires extensive, extreme, damaging medical intervention. And yet that extensive, extreme, damaging medical intervention must be provided on demand, with no gatekeeping from the medics expected to put their careers on the line to provide it. Either it’s a medical condition which requires treatment (and diagnostic criteria and medical expertise) or it’s not, and no treatment is required or provided. Demanding one without the other: the illogic is off the charts.

Stepg certainly goes on a bit. Might come back to this later, but for now, I think that’s enough.

CharlieParley · 28/09/2022 17:49

Why? I mean why exactly would you want to take into account what someone* without relevant knowledge, experience, qualifications, expertise or standing as a stakeholder has to say about an in-depth, evidence-based review carried out by expert professionals with both qualifications and expertise in healthcare?

(*Someone with a vested interest in maintaining the status quo which we know harms children btw)

Just because it's a critical opinion?

Now I believe that anyone has the right to freely voice their opinion on this or any other issue, regardless of their actual knowledge. But I don't believe that those of us concerned about safeguarding children should pay any attention at all to this particular one.

TastefulRainbowUnicorn · 28/09/2022 17:53

What are your reactions, OP?

Mine was “what a load of unhinged bollocks” but presumably you thought there was something of value in it or you wouldn’t have posted it. What parts did you find persuasive? Did I miss something of value?

DameMaud · 28/09/2022 17:54

@CharlieParley I'm anticipating pushback from the other side (with arguments like Stephsplace I imagine) and I am not confident yet in how to, so I am shamelessly mining articulate MNetters for good argument.
So far so good!
Thanks all

OP posts:
DameMaud · 28/09/2022 17:59

TastefulRainbowUnicorn · 28/09/2022 17:53

What are your reactions, OP?

Mine was “what a load of unhinged bollocks” but presumably you thought there was something of value in it or you wouldn’t have posted it. What parts did you find persuasive? Did I miss something of value?

@TastefulRainbowUnicorn . Lord no!
Same reactions as you, but struggling to formulate. As yet no practice arguing or challenging in person and highly anxious about training that I expect takes this viewpoint (no response when I sent a link to Cass review ahead of training).
See my previous reply to Charles parley.
This discussion is what I needed and is helpful

OP posts:
DameMaud · 28/09/2022 18:01

Didn't know who Steph was so even that is helpful

OP posts:
TheClogLady · 28/09/2022 18:01

Here’s another biased response to Cass.

This one written by a mother who has transed their young child and is so wedded to the concept of trans children she’s doing some sort of Goldsmiths PhD in ‘cisnormativity, minority stress and the rights and wellbeing of socially transitioned trans children under 12.’

growinguptransgender.com/2022/04/06/the-failure-of-the-cass-review/

www.bera.ac.uk/person/cal-horton

TheClogLady · 28/09/2022 18:02

This is Steph: www.stephsplace.uk/stephs-place-uk-my-trans-woman-story.cfm

Helleofabore · 28/09/2022 18:03

”It also highlights that there is a need for help for detransitioners, something trans people have been saying for years.”

Umm.... which trans people? Because detransitioners have constantly reported not be 'supported' and of being completely ostracised by the trans community and by trans lobby and support groups.

One could say that this Steph is telling 'their' version of the truth straight out with that one.

DameMaud · 28/09/2022 18:07

"Not a pathology, but requires extensive, extreme, damaging medical intervention. And yet that extensive, extreme, damaging medical intervention must be provided on demand, with no gatekeeping from the medics expected to put their careers on the line to provide it. Either it’s a medical condition which requires treatment (and diagnostic criteria and medical expertise) or it’s not, and no treatment is required or provided. Demanding one without the other: the illogic is off the charts."

Yes! This is what I need to have ready

OP posts:
CharlieParley · 28/09/2022 18:16

DameMaud · 28/09/2022 17:54

@CharlieParley I'm anticipating pushback from the other side (with arguments like Stephsplace I imagine) and I am not confident yet in how to, so I am shamelessly mining articulate MNetters for good argument.
So far so good!
Thanks all

FAOD that was not only my reply to you but also how I would respond to anyone citing this particular opinion as proof that the Cass Review ought to be discounted.

Now I don't know if you are aware or not, but the government commissions these reviews in contested areas of healthcare. I have reason to know about another recent one which you'll find here:

www.gov.uk/government/publications/topical-steroid-withdrawal-reactions-a-review-of-the-evidence/topical-steroid-withdrawal-reactions-a-review-of-the-evidence

I would treat an opinion from someone as unqualified on that condition as the one you're asking about in the exact same way - I wouldn't pay any attention to it whatsoever.

DameMaud · 28/09/2022 18:33

CharlieParley · 28/09/2022 18:16

FAOD that was not only my reply to you but also how I would respond to anyone citing this particular opinion as proof that the Cass Review ought to be discounted.

Now I don't know if you are aware or not, but the government commissions these reviews in contested areas of healthcare. I have reason to know about another recent one which you'll find here:

www.gov.uk/government/publications/topical-steroid-withdrawal-reactions-a-review-of-the-evidence/topical-steroid-withdrawal-reactions-a-review-of-the-evidence

I would treat an opinion from someone as unqualified on that condition as the one you're asking about in the exact same way - I wouldn't pay any attention to it whatsoever.

No, wasn't aware. That's good to know too. Thanks.
And thanks @TheClogLady for the other links.
I'm only just aware that some are dismissive of Cass (as illustrated) and that it can't be relied on as a way to back up dissent unless it's clear where the people who dismiss it are coming from- and to have counter-reponses is helpful.
So far all this dis-ease and strong response I have to what's happening has been in my head, with my poor OH, and one safe friend (and MN only recently after lurking for a year).
Until now, I've not had to face it head on and professionally.
My silence has caused me much distress (as I know it has many others)- I've

even had nightmares about being hacked and outed via MN!

So, rather than avoid the training, I've realised I just need to go in with courage (not quite fearlessness), and with some ready challenges- despite finding it all a bit overwhelming tbh!

OP posts:
DameMaud · 28/09/2022 18:37

And I'm not putting my pronouns in (as has been requested). Just that is giving me the jeebies!

OP posts:
CentaureaCyanus · 28/09/2022 18:43

Steph was an organiser of the misogynistic protests outside the Filia conference in Portsmouth last year. Steph's opinions on this subject don't come from a neutral or objective place.

Interesting view of the Cass Review
TheClogLady · 28/09/2022 18:43

Put N/A

They won’t know if you are a conscientious objector or if it’s a newfangled neopronoun!

CharlieParley · 28/09/2022 18:45

Fair enough DameMaud, I'm just a few years ahead of you on this journey and now familiar with the arguments and counterarguments, so I didn't quite understand your reason for asking.

As for worrying about outing yourself, I can only speak for myself when I say it has been rather freeing to be frank on the issue. I'm very public on it and have never regretted it.

I get tired of the whole debate sometimes, but I don't know any other women's rights campaigners who don't get tired of it from time to time.

Take care of yourself, take baby steps, take breaks and don't put yourself at unnecessary risk.

DameMaud · 28/09/2022 18:48

CharlieParley · 28/09/2022 18:45

Fair enough DameMaud, I'm just a few years ahead of you on this journey and now familiar with the arguments and counterarguments, so I didn't quite understand your reason for asking.

As for worrying about outing yourself, I can only speak for myself when I say it has been rather freeing to be frank on the issue. I'm very public on it and have never regretted it.

I get tired of the whole debate sometimes, but I don't know any other women's rights campaigners who don't get tired of it from time to time.

Take care of yourself, take baby steps, take breaks and don't put yourself at unnecessary risk.

Thanks! Will do.
DameMaud (N/A)

OP posts:
PriOn1 · 28/09/2022 18:53

”The use of language throughout is disturbing, directly pandering to the trans hostile movement within and outside of the NHS and medical community.”

”Trans hostile” language = any use of normal language, including, medical terminology, that seeks to express concepts in a manner that will be understood by all and avoiding use of terminology that locks in controversial, unproven concepts such as “gender identity”.

TastefulRainbowUnicorn · 28/09/2022 19:03

I think that person’s lack of credibility is apparent from tone alone, and from their inability to directly quote what they’re arguing against. And from weird criticisms like “the systemic lit review didn’t use anything after November 2021, they should update it monthly” indicating they’ve got no idea what’s involved.

But this part should be the nail in the coffin.

There are no ‘other causes’ of gender dysphoria / gender incongruence, and it’s high time the NHS & UK Medical Community got to grips with this basic fact...At various points through the Report, it mentions the need to find or use ‘alternative’ or ‘different’ treatments for Gender Dysphoria...This is frankly chilling and ventures dangerously close to advocating for conversion abuse, given that there are no other effective treatments for gender dysphoria other than transition,

There are no other causes for gender dysphoria than being trans. Gender dysphoria may not be treated in any other way than transition. It’s forbidden to even research these issues. This person is a religious fanatic.

PriOn1 · 28/09/2022 19:50

“There are no other causes for gender dysphoria than being trans. Gender dysphoria may not be treated in any other way than transition. It’s forbidden to even research these issues. This person is a religious fanatic.”

Exactly. Others have commented that, because of the unevidenced push towards the idea that thinking or feeling you are the opposite sex is not a pathology, nor a psychiatric issue, those advances that have been made in psychiatric treatments in recent years (CBT has been mentioned) have not been examined as possible treatments.

Research into other treatments has been deemed blasphemous, just as Zucker and Littman have been deemed blasphemous. Medical experts ought to be able to defend their evidence, rather than smearing those who offer an alternative view. Neither Zucker’s or Littman’s work has been discredited scientifically. Both have simply been smeared and subjected to attack and attempted cancellation. Steph’s anger that Cass is actually looking at ALL the evidence, is an absolutely clear sign which side is genuinely neutral, and which side is madly projecting.

This statement is unintentionally hilarious, for example:

”There are glaring failures in what should be fundamental, baseline investigations, such as not even appearing to look at the diagnostic processes in WPATH and comparing them to the NHS protocols, instead focussing on much more vague targets such as research papers,”

Look at the original research papers rather than blindly following the interpretation of those papers (or at least the limited number of those papers that confirm the bias) by a lobby group with vested interests! Shocking!

WPATH is the absolute epitome of the syndrome I mentioned earlier, where patients (with what I suspect will shortly be rerecognized as being a mental health issue - believing or feeling you are something you clearly aren’t would, in almost all other circumstances, be recognized as pathological) are much more influential than independent and unbiased medics.

You wouldn’t allow those still suffering from anorexia to direct a treatment plan for others with anorexia. Similarly those whose gender confusion has not been treated, but who instead have been medically assisted to enable and strengthen their false feelings/beliefs about their sex, should not be those running the medical program as, by definition, they are wholly unable to view the situation dispassionately.

CharlieParley · 28/09/2022 21:27

There are no ‘other causes’ of gender dysphoria / gender incongruence, and it’s high time the NHS & UK Medical Community got to grips with this basic fact...

In reality, as can be seen from the patient studies, gender dysphoria in childhood is a stronger predictor for homosexuality than transsexualism. That's what the specialists involved in treating these children found (including the Dutch clinicians who pioneered the affirmative approach using puberty blockers).

Evidence also shows that a number of adverse childhood experiences can cause gender dysphoria, such as trauma, sexual abuse, bereavement or neglect. Which is reflected in the sheer number of articles a simple query on Google Scholar will return when you search for papers on "gender dysphoria" and "trauma".

Non-homosexual transsexuals aka late-onset transitioners cannot and will not acknowledge this fact, because it isn't at all helpful to their narratives. Said narratives involve retconning their own personal histories to claim the same childhood experiences of sex stereotype and sex role stereotype distress as homosexual transsexuals aka early-onset transitioners. And yet, these two groups are distinct and mutually exclusive with completely different pathways into gender dysphoria. And different childhood experiences of sex stereotypes and sex role stereotypes (or "gender" in their language).

At various points through the Report, it mentions the need to find or use ‘alternative’ or ‘different’ treatments for Gender Dysphoria...

Because the treatments currently used are demonstrably failing to help these children. That's not merely an entirely fair and logical statement, the authors would be negligent in their duty to the children involved if they didn't highlight this need.

This is frankly chilling and ventures dangerously close to advocating for conversion abuse, given that there are no other effective treatments for gender dysphoria other than transition,

This is bullshit and the author knows it. There is an argument being made that there is no effective treatment for transsexualism other than a medical (!) transition, but gender dysphoria - which is not the same as transsexualism - can be alleviated and effectively cured through psychological treatments in many child patients. (This is why pre-current-madness studies show 50% and more of the children diagnosed with gender dysphoria desisting i.e. learning to reconcile mind and body).

Of course, if you don't believe that transsexualism is accurately defined, then it is merely a severe form of gender dysphoria - a body dysmorphic disorder, caused by sex stereotype and sex role stereotype distress (which like all other body dysmorphic disorders is a mental health condition which requires psychological and/or psychiatric treatment and not a medical transition).

DameMaud · 28/09/2022 22:40

Evidence also shows that a number of adverse childhood experiences can cause gender dysphoria, such as trauma, sexual abuse, bereavement or neglect. Which is reflected in the sheer number of articles a simple query on Google Scholar will return when you search for papers on "gender dysphoria" and "trauma".

This is great too. Thanks @CharlieParley

OP posts:
Bosky · 29/09/2022 06:46

There are no ‘other causes’ of gender dysphoria / gender incongruence, and it’s high time the NHS & UK Medical Community got to grips with this basic fact...

Lots of psychiatrists disagree - which is probably why people like Steph want psychiatrists out of the picture, ie. "depathologisation". Also why it was the influence of activists that prompted the WHO to reclassify gender dysphoria/gender identity issues from "mental health" conditions to "sexual health" conditions and remove "transvestic fetishism" from the International Classification of Diseases (ICD) in ICD-11.

eg.

Gender identity disorders as a symptom of psychosis, schizophrenia in particular
pubmed.ncbi.nlm.nih.gov/11605311/

Neural Correlates of Psychosis and Gender Dysphoria in an Adult Male
(In this case report, we describe the use of LSD as a triggering factor of confusion in the gender identity of a 39-year-old male patient, with symptoms of psychosis and 25 years of substance abuse, who sought psychiatric care with the desire to undergo sex reassignment surgery. The symptoms of GD/psychosis were resolved by two therapeutic measures: withdrawal of psychoactive substances and use of a low-dose antipsychotic.)
pubmed.ncbi.nlm.nih.gov/26597648/

Gender role strain, core schemas, and psychotic experiences in ethnically diverse women: A role for sex- and gender-based analysis in psychosis research?
pubmed.ncbi.nlm.nih.gov/29978520/

Gender dysphoria symptoms in schizophrenia
pubmed.ncbi.nlm.nih.gov/30659566/

Gender Identity Disorder and Schizophrenia: Neurodevelopmental Disorders with Common Causal Mechanisms?
(Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception.)
www.hindawi.com/journals/schizort/2014/463757/

Psychiatric Comorbidity of Gender Identity Disorders: A Survey Among Dutch Psychiatrists (2003)
(OBJECTIVE: In the Netherlands, it is considered good medical practice to offer patients with gender identity disorder the option to undergo hormonal and surgical sex reassignment therapy. A liberalization of treatment guidelines now allows for such treatment to be started at puberty or prepuberty. The question arises as to what extent gender identity disorder can be reliably distinguished from a cross-gender identification that is secondary to other psychiatric disorders.
METHOD: The authors sent survey questionnaires to 382 board-certified Dutch psychiatrists regarding their experiences with diagnosing and treating patients with gender identity disorder.
RESULTS: One hundred eighty-six psychiatrists responded to the survey. These respondents reported on 584 patients with cross-gender identification. In 225 patients (39%), gender identity disorder was regarded as the primary diagnosis. For the remaining 359 patients (61%), cross-gender identification was comorbid with other psychiatric disorders. In 270 (75%) of these 359 patients, cross-gender identification was interpreted as an epiphenomenon of other psychiatric illnesses, notably personality, mood, dissociative, and psychotic disorders.
CONCLUSIONS: These data suggest that there is little consensus, at least among Dutch psychiatrists, about diagnostic features of gender identity disorder or about the minimum age at which sex reassignment therapy is a safe option. Therapy options proposed to patients with gender identity disorder appear to depend on personal preferences of psychiatrists. These results underline the need for more specific diagnostic rules in this area.)
ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.160.7.1332

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