Horrible BACP article obsfuscating the risks of medical transition

[keikothewhale]

Claiming people who highlight the risks of medical transition are just uncomfortable with anything that isn't cisheteronormative.

No mention of infection risk, ongoing need to dilate neo vaginas, phalloplasty grafts or anything whatsoever about the harm to children on puberty blockers.

No it's all dismissed as 'bigots are uncomfortable with men having breasts'.

[timeforsheroes]

@hallouminatus

Excellent email!
However, a minor nit-pick:
The vast, vast majority of trans people do not have genital surgery. Only 2.8% have any surgery, including facial feminisation or breast surgery, the numbers having genital surgery is only a small subset of that 2.8% of trans people (2).

This is attributed to fairplayforwomen.com/penis/, using stats from GIRES, but although the FPFW article does reference GIRES, and does includes the 2.8% figure, they actually quotes a 20% estimate from GIRES, while the 2.8% figure comes from this 2016 meta-analysis: https://www.sciencedirect.com/science/article/abs/pii/S1743609516001338

Bugger I've sent it, good spot! Never mind, BACP will never know cos they won't read it anyway

[hallouminatus]

@timeforsheroes

Resurrecting this thread to say I finally lowered my blood pressure enough to email Therapy Today about this absolute shitshow article. Not that they'll take any notice, but I can't not point out to them that some of us can still see the Emperor is stark bollock naked. Copied below in case anyone wants to crib or improve it for their own use.


Dear Therapy Today,

This article is at best, misguided and at worst, dangerous. I genuinely believe that therapists using this article as a source of information may do serious harm to clients. Firstly, the authors' statements are not supported by physical reality. The idea that 'people and their materially-sexed body do not fit into a hitherto binarised male/female man/woman isomorphic categorisation' is put simply, not true. Every human is biologically male or female. Including those with DSDs such as CAIS, used in this article to support the authors position despite the fact that people with DSDs have repeatedly asked that their medical conditions not be conflated with trans identities.(1)

The authors' assumptions that medical/surgical transition is a) common amongst trans people and b) desirable is again, not supported by the evidence (the authors references consisting of philosophers, self-appointed non medically trained experts and a private GP selling hormones off shore has not escaped my notice either). The vast, vast majority of trans people do not have genital surgery. Only 2.8% have any surgery, including facial feminisation or breast surgery, the numbers having genital surgery is only a small subset of that 2.8% of trans people (2). Contrary to the article, the majority of trans people are not 'waiting for surgical intervention'. The authors also airily dismiss concerns about the safety of the medications some trans people use thus: 'all of these 'harmful' characterisations stem from the...'cis' account of what 'healthy' looks like'. I don't think increased rates of osteoporosis, blood clots, infertility and heart attacks, all documented risks of cross sex hormones, are anyone's definition of healthy, and it is at best reckless to suggest that the problem lies in harmful characterisations, rather than known harmful outcomes of these drugs (3). For those who do have genital surgery, these can have serious complications, including incontinence (up to ¼ of patients in one study), inability to orgasm (up to 30%), fistulas, stenosis and even death, and many require multiple surgeries (4)

The authors also dismiss the experience of detransitioners, and cite low detransition rates using references from the aforementioned off shore GP selling hormones and EPATH, self described experts in trans care with a vested interest in encouraging transition. If therapists were to hear accounts from detransitioners, such as Ritchie Herron (5) or Scott Newgent (6), they would hear about both the huge lifelong illness burden caused by medical and surgical transition, and the failure of therapists to address their fears and uncertainties before surgery; similarly a study of detransitioners showed that 55% felt they were not properly evaluated by a doctor or mental health professional (7).

Far from destroying myths around trans care, this article is perpetuating them. Human bodies are not mix and match, or lego to be rearranged; 'affirming' medical and surgical interventions are serious, potentially dangerous and lifechanging, and we as therapists should not be opining on these to our clients, as this is outside our expertise and role. Ethical practice requires us to work within our knowledge and competence, and BACP should not be encouraging therapists to believe that it is good practice to 'affirm' interventions outside of our expertise. Therapy could have a huge role to play in supporting and valuing both trans and detrans people, but this article does nothing to inform or educate therapists on how to do that; it is purely a political statement, and one which could have serious detriment both to therapists and clients if held as good practice.

I realise that you will not be publishing this article, as it doesn't subscribe to your political viewpoint.


(1)differently-normal.com
(2)fairplayforwomen.com/penis/, using stats from GIRES
(3)statsforgender.org/medical-transition ,citing more than 15 separate studies
(4)statsforgender.org/medical-transition , citing 12 separate studies
(5)tullipr.substack.com/p/scrambled-eggs?utm_campaign=post&utm_medium=web
(6)genderdysphoriaalliance.com/post/meet-scott-newgent
(7)www.spectator.co.uk/article/the-grim-reality-of-gender-reassignment/

Excellent email!
However, a minor nit-pick:
The vast, vast majority of trans people do not have genital surgery. Only 2.8% have any surgery, including facial feminisation or breast surgery, the numbers having genital surgery is only a small subset of that 2.8% of trans people (2).

This is attributed to fairplayforwomen.com/penis/, using stats from GIRES, but although the FPFW article does reference GIRES, and does includes the 2.8% figure, they actually quotes a 20% estimate from GIRES, while the 2.8% figure comes from this 2016 meta-analysis: https://www.sciencedirect.com/science/article/abs/pii/S1743609516001338

[Signalbox]

@Britinme

According to someone I know with connections to Metanoia there's more to Esses' story than appears in his account but she said she wasn't allowed to say more than that.

Ooh such intrigue.

But considering he’s taking them to court and will be completely exposed at that point he’d be mad to hide something nefarious wouldn’t he? TRAs do have a tendency to spread false rumours about anyone standing up to the ideology so probably best to take such vague remarks with a pinch of salt.

[Britinme]

The above article has been retracted by the journal, presumably because it wasn't on TRSOH.

[Britinme]

Here's an article worth reading:

[timeforsheroes]

Resurrecting this thread to say I finally lowered my blood pressure enough to email Therapy Today about this absolute shitshow article. Not that they'll take any notice, but I can't not point out to them that some of us can still see the Emperor is stark bollock naked. Copied below in case anyone wants to crib or improve it for their own use.


Dear Therapy Today,

This article is at best, misguided and at worst, dangerous. I genuinely believe that therapists using this article as a source of information may do serious harm to clients. Firstly, the authors' statements are not supported by physical reality. The idea that 'people and their materially-sexed body do not fit into a hitherto binarised male/female man/woman isomorphic categorisation' is put simply, not true. Every human is biologically male or female. Including those with DSDs such as CAIS, used in this article to support the authors position despite the fact that people with DSDs have repeatedly asked that their medical conditions not be conflated with trans identities.(1)

The authors' assumptions that medical/surgical transition is a) common amongst trans people and b) desirable is again, not supported by the evidence (the authors references consisting of philosophers, self-appointed non medically trained experts and a private GP selling hormones off shore has not escaped my notice either). The vast, vast majority of trans people do not have genital surgery. Only 2.8% have any surgery, including facial feminisation or breast surgery, the numbers having genital surgery is only a small subset of that 2.8% of trans people (2). Contrary to the article, the majority of trans people are not 'waiting for surgical intervention'. The authors also airily dismiss concerns about the safety of the medications some trans people use thus: 'all of these 'harmful' characterisations stem from the...'cis' account of what 'healthy' looks like'. I don't think increased rates of osteoporosis, blood clots, infertility and heart attacks, all documented risks of cross sex hormones, are anyone's definition of healthy, and it is at best reckless to suggest that the problem lies in harmful characterisations, rather than known harmful outcomes of these drugs (3). For those who do have genital surgery, these can have serious complications, including incontinence (up to ¼ of patients in one study), inability to orgasm (up to 30%), fistulas, stenosis and even death, and many require multiple surgeries (4)

The authors also dismiss the experience of detransitioners, and cite low detransition rates using references from the aforementioned off shore GP selling hormones and EPATH, self described experts in trans care with a vested interest in encouraging transition. If therapists were to hear accounts from detransitioners, such as Ritchie Herron (5) or Scott Newgent (6), they would hear about both the huge lifelong illness burden caused by medical and surgical transition, and the failure of therapists to address their fears and uncertainties before surgery; similarly a study of detransitioners showed that 55% felt they were not properly evaluated by a doctor or mental health professional (7).

Far from destroying myths around trans care, this article is perpetuating them. Human bodies are not mix and match, or lego to be rearranged; 'affirming' medical and surgical interventions are serious, potentially dangerous and lifechanging, and we as therapists should not be opining on these to our clients, as this is outside our expertise and role. Ethical practice requires us to work within our knowledge and competence, and BACP should not be encouraging therapists to believe that it is good practice to 'affirm' interventions outside of our expertise. Therapy could have a huge role to play in supporting and valuing both trans and detrans people, but this article does nothing to inform or educate therapists on how to do that; it is purely a political statement, and one which could have serious detriment both to therapists and clients if held as good practice.

I realise that you will not be publishing this article, as it doesn't subscribe to your political viewpoint.


(1)differently-normal.com
(2)fairplayforwomen.com/penis/, using stats from GIRES
(3)statsforgender.org/medical-transition ,citing more than 15 separate studies
(4)statsforgender.org/medical-transition , citing 12 separate studies
(5)tullipr.substack.com/p/scrambled-eggs?utm_campaign=post&utm_medium=web
(6)genderdysphoriaalliance.com/post/meet-scott-newgent
(7)www.spectator.co.uk/article/the-grim-reality-of-gender-reassignment/

[Orangedoll]

I’ll take a look at the petition. Thanks.

There must be so many other GC therapists out there, but none of us are represented by the main professional bodies. There’s even a bit in this issue that basically says as members we have no choice but to sign up to the memorandum of understanding on conversion therapy. They do not care about alienating their membership because they are so certain they are right.

😡

[nothingcomestonothing]

@Orangedoll

Has anyone else just received the June issue?

I can’t find adjectives for how it makes me feel reading this one-sided propaganda. There’s no balance or discussion, no empowerment for therapists to trust their instincts, only rules for what we should be doing. Also shaming anyone who isn’t completely on board with it.

I’ve been turning a blind eye to the BACP’s capture, because the whole fucking profession is doing it. But this is a whole new level of ridiculous. I don’t know what to do! I’m stuck being a member or I won’t be able to work ☹️

sorry for incoherent rant, but I can’t believe it and feel so powerless ☹️☹️☹️

Same, if I didn't have to be accredited for my job, I'd have long since left BACP. They are utterly captured and Therapy Today would be a joke if this wasn't so bloody serious

There is a petition asking BACP to enter dialogue about this on the thoughtful therapists website, I'm not sure how long it's been up, I only saw it today.

[Orangedoll]

Has anyone else just received the June issue?

I can’t find adjectives for how it makes me feel reading this one-sided propaganda. There’s no balance or discussion, no empowerment for therapists to trust their instincts, only rules for what we should be doing. Also shaming anyone who isn’t completely on board with it.

I’ve been turning a blind eye to the BACP’s capture, because the whole fucking profession is doing it. But this is a whole new level of ridiculous. I don’t know what to do! I’m stuck being a member or I won’t be able to work ☹️

sorry for incoherent rant, but I can’t believe it and feel so powerless ☹️☹️☹️

[nothingcomestonothing]

Does anyone happen to have the reference for the percentage of transwomen who have surgery? I think it's 95% don't, but I haven't got a reference to cite. Am composing (yet another) stiff email for BACP to ignore.

[SinnerBoy]

WhiteFire · Today 13:20

The NHS is not an on-demand service. Many individuals are refused treatment / interventions for many reasons and there is the added element of postcode lottery. There was an article on the BBC today about a couple being refused IVF as he already has a child (he is paralysed following a fall down the stairs)

He already has a child, from a previous relationship and that means they can't have free treatment. We paid for a round of ICSI and two rounds of IVF, despite neither of us having children previously.

It may be annoying for them but it's been the case in Tyne & Wear for many years.

[Babdoc]

Does this paper make any mention of the eighteen year old who died in the Netherlands of necrotising fasciitis (known as the zombie flesh eating bug in tabloids, and a gruesome way to die), after complications of mutilating surgery to change gender presentation? Or is that just acceptable collateral damage in the rainbow unicorn world of unnecessary surgery on children?

[IWillNoLie]

@MagicSpring

I thought the whole 'trans people will actually die if they don't transition' was the reason put forward to counter the very obvious disadvantages of medical and surgical transition.

Has the argument moved on to 'these are advantages, not disadvantages'?

Or are they possibly lumping together things like 'grow a beard' and 'have vaginal atrophy and pain' under changes to secondary sex characteristics, even though only one of those is desirable even to someone with a strong wish to be seen as a man?

It is also untrue. They are many times more likely to commit suicide post transition and some have died as a direct result of the surgery itself.

[WhiteFire]

The NHS is not an on-demand service. Many individuals are refused treatment / interventions for many reasons and there is the added element of postcode lottery. There was an article on the BBC today about a couple being refused IVF as he already has a child (he is paralysed following a fall down the stairs) A pp has talked of a friend unable to be sterilised. This is the reality, many other things are just refused outright. Waiting lists are forever, and services refuse referrals on the flimsiest of reasons

I hate the term but this is not about being a race to the bottom, it is reality. I'm not sure why the BACP feel that trans individuals are getting any worse a deal than anyone else, and in fact should have better.

[MagicSpring]

I thought the whole 'trans people will actually die if they don't transition' was the reason put forward to counter the very obvious disadvantages of medical and surgical transition.

Has the argument moved on to 'these are advantages, not disadvantages'?

Or are they possibly lumping together things like 'grow a beard' and 'have vaginal atrophy and pain' under changes to secondary sex characteristics, even though only one of those is desirable even to someone with a strong wish to be seen as a man?

[nothingcomestonothing]

BACP is an absolute disgrace, and their journal is not worth the paper it's printed on. I have to pay them £150 a year to be patronised and lied to

[ZeldaFighter]

This makes me ragey - my friend asked to have her tubes tied after the birth of her second child. She was told No, she was too young. Which is presumably doctor speak for "you're just a silly woman (now mother of two) in your twenties - you can't make decisions about your future fertility!"

How on Earth is it OK for people to make these life-changing decisions?

[Rightsraptor]

I was puzzled by the implication that TW are waiting so very long for 'bottom surgery', taking testosterone suppressants all the while, and this means they are taking medication for longer than they need to. If, however, we were all kind and let go of our cis hetero-normative views, then TW would quickly get the desired surgery and live a drug-free life ever after.

Which is absolutely untrue.

Idiots indeed.

[Truthlikeness]

"People with gender dysphoria taking hormone replacements as part of gender affirmation therapy face a substantially increased risk of serious cardiac events, including stroke, heart attack and pulmonary embolism,"

It's so cis-normative to have a heart that works.

https://www.acc.org/About-ACC/Press-Releases/2023/02/22/20/29/Hormone-Therapy-for-Gender-Dysphoria-May-Raise-Cardiovascular-Risks

[IWillNoLie]

Reminds me of the article (obit?) in a leading science magazine that stated how awful someone was in using the normal distribution to set an arbitrary standard of normal which they compared everyone else against…

I wish I could find the article again.

[keikothewhale]

The whole article smacks of 'we're just so much more intelligent and liberal than the squares who object to this stuff'.

Reminds me of when my friend - who was investigating her fertility options at the time - asked me if I would be ok with my DH donating his sperm to an acquaintance.

And when I said no I wouldn't, because then my DC would have siblings they had no kind of relationship with and I'd feel uncomfortable/sad about that she tried to shame me by saying "oh god, you're so conservative."

Ok.

[keikothewhale]

@JellySaurus

All of these 'harmful characterisations stem from the 'unnatural' and distinctly 'cis (in other words, not trans) normative account of what healthy looks like.

Thinking about transmen here - which I will, because feminism is for all females, whereas TRAs only ever seem to bother about tw - I wonder whether the writer has any notion of the hideousness that is vaginal atrophy. I know I'm merely a menopausal woman, so no doubt the writer would feel justified in dismissing my ' lived experience', but having experienced it myself, I can assure you that there is nothing healthy about it, regardless of how you chose to characterise vaginal atrophy or my 'normative' account of what healthy looks like. Neither does adolescent osteoporosis feature in my 'normative' account of what healthy looks like.

Exactly.

I'm sorry to hear of your experience.

[JellySaurus]

All of these 'harmful characterisations stem from the 'unnatural' and distinctly 'cis (in other words, not trans) normative account of what healthy looks like.

Thinking about transmen here - which I will, because feminism is for all females, whereas TRAs only ever seem to bother about tw - I wonder whether the writer has any notion of the hideousness that is vaginal atrophy. I know I'm merely a menopausal woman, so no doubt the writer would feel justified in dismissing my ' lived experience', but having experienced it myself, I can assure you that there is nothing healthy about it, regardless of how you chose to characterise vaginal atrophy or my 'normative' account of what healthy looks like. Neither does adolescent osteoporosis feature in my 'normative' account of what healthy looks like.

[keikothewhale]

If you read that excerpt they seem to imply that chopping off a man's balls negates the 'need' for cross sex hormones which I doubt is the case, given reduction in testosterone is not the same thing as increase in oestrogen, but there we are.

I'm embarrassed for the pair of them to be honest.

[keikothewhale]

@IWillNoLie

I presume the article is written by a psychologist rather than a doctor or anyone with training in medical research?

I chucked it in the bin but I can confirm it was written by two authors, one a psychotherapist the other something also not medical - both phd students.

Both idiots.

It was an article about why trans affirming therapy.