Continuation Transwomen are not women - X (XY?)

[Jono]

Originally Posted by Rolfe

Pronouns have now become a matter of coercive control. They are part of the battle and if women concede to "be kind" it's the first wave of the flag of surrender.

In general, I rarely experience any problem using someone's preferred pronoun (after I've learned about it). It doesn't change what I perceive, of course. The prefix 'trans' matter. It matters for someone who is trans and so it will matter for others who are not, without any necessary negative view of the given person.

One of the main contentions I've struggled with is, when in discussions about sex (wether its binary, bimodal, spectrum etc...), the accusation that if I don't affirm their view about it I am by default a bigotted transphobe whose online musings about sex will lead to more suicides by trans people. It's a ghastly dishonest and dirty way of framing a debate/discussion, adding the "you've got blood on your hands"-trope.

It reminds me of dealing with mentally unstable patients, where in any discussion you always find yourself at odds, walking on egg shells, not wanting to set them off into lunacy.

[Nick Terry]

British 'trans kids' charity Mermaids is now under formal investigation by the Charities Commission (i.e. the investigation has started). Their CEO Susie Green resigned a week ago, or was ousted, nobody is quite sure.
https://twitter.com/ChtyCommission/s...70350404960258

[Elaedith]

Originally Posted by Nick Terry

British 'trans kids' charity Mermaids is now under formal investigation by the Charities Commission (i.e. the investigation has started). Their CEO Susie Green resigned a week ago, or was ousted, nobody is quite sure.
https://twitter.com/ChtyCommission/s...70350404960258

I'm sure Susie Green resigning a week ago is just coincidence /s

A thread from Maya Forstater about some things the Commission could look at.

Thread reader app version.

I hope they do the investigation properly.

[Rolfe]

This has nothing directly to do with the trans debate, but it's what happens when public bodies pander to trans demands by making intimate spaces mixed-sex.

Mum's anguish as girl, 9, sexually assaulted in Waterworld communal changing room

Ironically, trans-identifying men don't want mixed-sex changing rooms. They want access to women-only changing rooms. But the response of the "be kind" lobby to their whining about not wanting to use men's changing rooms has resulted in this.

[Nick Terry]

Telegraph article with a source inside Mermaids, exposing a weird internal culture. Susie Green was involving her mates, half the trustees were new, 8 of 44 staff resigned in recent months including 3 of 5 minority staff, and staff felt Green wasn't providing proper leadership and took criticisms overly personally. There was some puzzlement at the lawsuit against the LGB Alliance.
https://archive.ph/q7vzG

Quote:

The whistleblower told The Telegraph: “A lot of new board members came in who were Susie’s friends, no one really knew they were there, which was an added shock when the whole Jacob stuff happened.
“We had a staff call then, [Mermaids said] ‘staff can drop in and say what they’re feeling’. Susie wasn’t on that call and there were a lot of staff asking for accountability and who dropped the ball but no one really got answers for it.
“People were very frustrated then around Susie’s lack of being on the ball with staff and talking to staff about what happened, and shoving her head in the sand without giving answers to anyone.
“More recently there’s been scandal after scandal after scandal at Mermaids, and a lot of them are like ‘well why hasn’t Mermaids done its due diligence of Jacob or their background checks on staff’. There’s clearly been some failure.”

It's striking how rapidly Mermaids grew - Green was the first paid staffer as recently as 2016, yet they'd reached 44 staff six years later.

[lionking]

Originally Posted by Nick Terry

It's striking how rapidly Mermaids grew - Green was the first paid staffer as recently as 2016, yet they'd reached 44 staff six years later.

Thankfully they look like sinking just as quickly.

I hope the new directors have very good public liability insurance.

[Elaedith]

https://archive.ph/q7vzG#selection-1383.0-1383.304

'Shocked staff were hauled into an “emergency meeting” on Friday with Dr Belinda Bell, the chair of trustees, and told Ms Green was gone and her replacement “needs strong EDI (equality, diversity and inclusion) experience, ideally lived experience”, with some staff believing this means being transgender.'

I know a few trans people who would be great in the role. Unfortunately, they are unlikely to get offered it because they are 'the wrong kind of trans' (have the wrong beliefs about sex and gender) and actually believe that other people have rights too, which is not allowed.

Or perhaps they should appoint a detransitioner. After all, they have 'lived experience' and are currently almost completely unrepresented.

[Nick Terry]

Originally Posted by Elaedith

Or perhaps they should appoint a detransitioner. After all, they have 'lived experience' and are currently almost completely unrepresented.

[Elaedith]

Earlier this year Upchurch posted a video 'Sex and Sensibility' in a previous incarnation of this thread, which claimed to give evidence for the neurology of transgenderism and 'debunk myths about sex and gender'. It didn't get a great reception here.

I just saw this thread giving detailed critical evaluation of the claims in the video and thought it might be of interest.

To his credit, Forrest Valkai (the producer of the video) has apparently encouraged criticism of it (rather than jumping on the bandwagon of shouting 'transphobia' to suppres criticism)

[d4m10n]

Did we cover this ground yet?

https://twitter.com/gorskon/status/1599404195328950272


Sent from my SM-G996U using Tapatalk

[theprestige]

Originally Posted by d4m10n

Did we cover this ground yet?

https://twitter.com/gorskon/status/1599404195328950272


Sent from my SM-G996U using Tapatalk

I mentioned the NYT article somewhat favorably when it first came out. I don't think anything much has been said here about it since.

[Elaedith]

Originally Posted by d4m10n

Did we cover this ground yet?

https://twitter.com/gorskon/status/1599404195328950272


Sent from my SM-G996U using Tapatalk

Gorski has me blocked so I had to use an incognito window to see what you are referring to.*

Yes, that is a new low for SBM if there can be such a thing. Most of what I have read so for consists of smears (implying without evidence that gender critical people are linked to anti-vaxxers, and both are linked to fascists, supported by misrepresenting religious conservatives as gender critical) as well as outright misrepresentations of the research literature.

*Gorski blocked me for pointing out that he had tweeted statements about Dr Zucker that were potentially defamatory, repeating lies concocted by activists that were used to get him fired. Zucker already won a lawsuit over his dismissal, and I know he is willing to sue for libel. It was actually Andrea James who led the campaign to get Zucker fired. James also lead the campaign to ruin the life and career of Dr Bailey, including posting images of his children online with sexually explicit captions. James is very friendly with Gorski and was praised by one of SBM's guest writers. When I pointed out that Gorski's tweets were untrue and defamatory, he ranted about transphobes and blocked me. A few weeks later I looked back and found the defamatory tweets were deleted.

Lost cause I'm afraid.

[Elaedith]

Originally Posted by theprestige

I mentioned the NYT article somewhat favorably when it first came out. I don't think anything much has been said here about it since.

This is about a ridiculous hatchet job on the article by two gender quacks published on so-called 'science-based medicine'.

[Ziggurat]

Originally Posted by d4m10n

Did we cover this ground yet?

https://twitter.com/gorskon/status/1599404195328950272

That's really long, and I don't feel like digging through it in its entirety. So I took a shortcut, and did a word search for "reversible" since the subtopic of the reversibility of puberty blockers is something I've already spent some time on.

One of the things I turned up was this:

Quote:

The 2017 International Endocrine Society Clinical Practice Guideline also says,

Pubertal suppression is fully reversible, enabling full pubertal development in the natal gender, after cessation of treatment, if appropriate. The experience of full endogenous puberty is an undesirable condition for the GD/gender-incongruent individual and may seriously interfere with healthy psychological functioning and well-being. Treating GD/gender-incongruent adolescents entering puberty with GnRH analogs has been shown to improve psychological functioning in several domains.

The reversibility isn't the central point the authors of your link were trying to make, but it's very important nonetheless. The paper they cite makes that claim, but the basis for that claim is that children treated with puberty blockers for precocious puberty will develop fertility after stopping puberty blockers. But halting precocious puberty isn't the same treatment as halting normal puberty. The authors of the cited paper provide no evidence AT ALL to justify the claim that halting normal puberty with puberty blockers is reversible. As we have discussed before, the evidence is that starting puberty blockers for gender dysphoria treatment in teens is not reversible.

tl;dr: I took a look at one technical point which I am already familiar with, and the author of your link gets it wrong. I doubt that I caught their only mistake by chance.

[Ziggurat]

I tried to add this comment to that article:

Originally Posted by Me

You cite a passage from a paper claiming that puberty blockers are reversible. But that claim is not actually well founded. The basis for that claim, as explained in that paper, is that children who are treated for precocious puberty will develop normal fertility after being taken off puberty blockers. But halting precocious puberty is not the same thing as halting normal puberty. We do not have data showing that puberty blockers administered during normal puberty are in fact reversible. Some of the studies about the effects of puberty blockers as a treatment for trans kids (often centered around psychological and not medical outcomes) would actually be unable to even look into this question because none of the participants who started puberty blockers ever desisted, but instead went on to cross-hormone treatment. So the claim that puberty blockers are reversible is really not founded in any actual data.

That comment was rejected. I wonder why.

[Elaedith]

What-the-new-york-times-gets-wrong-about-puberty-blockers-for-transgender-youth

Let's look at this quote:

'Studies have yet to show any detrimental effect on executive function in youth on blockers, no significant differences in brain development, and significantly better global functioning in trans youth on blockers than in trans youth not on blockers. The study linked to the NYT quote above is a 2020 Consensus Parameterexamining puberty blocker outcomes which noted significant improvement in overall psychosocial functioning and lessened depression in youths treated with puberty blockers.'

The 'no significant differences in brain development' links to this article, which is also the Consensus Parameter referred to which they claim is 'examining puberty blocker outcomes'.

The article is actually about establishing a consensus for the best approach to conduct long-term studies on the neurodevelopmental effects of puberty blockers, given that they may have detrimental long-term effects and there are currently no such studies.

Quotes from the abstract:
'Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment.'

'An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.'

The article is not about 'puberty blocker outcomes', it is about using the Delphi procedure to establish consensus for the best research protocol to study long-term outcomes, after noting '......suppressing sex hormone production during this period could alter neurodevelopment in complex ways—not all of which may be beneficial.'

The same author already misrepresented this article on a previous post by citing it to support a claim that studies have shown puberty blockers do not affect brain development. Now they are misrepresenting it again, although their poor wording actually says that 'studies have yet to show no difference in brain development', which is technically true. Anyone reading this, however, would assume without checking that the article refers to a consensus that blockers do not affect brain development.

This can't be an error, especially given their previous blatant misrepresentation was pointed out and not corrected.

[lionking]

The other thing the SBM article didn’t deal with is explosion of the young girls seeking to transition to transmen. Yet the article argues that there is no social basis for people transitioning. What is causing the increase then?

Also I found the attempted comparison with anti-vaxxers to be unconvincing.

[Gulliver Foyle]

Originally Posted by Elaedith

This is an interesting account of another gender critical discrimination case. Social Work England (SWE) brought a fitness to practice hearing against a social worker, Rachel Meade, over complaints made about posts on her private Facebook page. In the wake of the Forstater ruling they concluded last month that there was no case to answer and discontinued, but only after seeing the submissions on behalf of Meade. The case is still going to an employment tribunal next year.

The position taken by SWE is quite incredible. They ignored that fact that the complaint came from another social worker who engaged in hostile and abusive behaviour towards those with different philosophical views about sex and gender, including potentially defamatory statements. They also appear to have endorsed the position that gender critical beliefs are inherently bigoted, and that social workers are required to believe that trans people have literally changed sex: '...those who hold or espouse gender critical beliefs, generally speaking, are unlikely to accept that transgender people who have socially and/or medically transitioned from one sex to another, are as matter of fact, biology and reality members of their chosen sex'. This is contrary to current law as well as science.

It is of course legitimate to conduct fitness to practice hearings is there are valid grounds to think that somebody would actually discriminate against people with a protected characteristic. The tactics used by activists/cancel mobs is to frame disagreement with ideological, philosophical and political positions as hatred of people. This is no different from, for example, trying to destroy the career of an atheist on the grounds that somebody who rejects and criticizes religion is bound to discriminate against religious people, even when they have never done so.

The irony is that the complainant against Meade is the one who is not just stating their beliefs, but actually trying to foster illegal discrimination on the basis of protected belief yet apparently faces no consequences.

Absolutely noting controversial in what you're taking exception to. The Forstater appeal case was an extremely bad ruling, legitimising hate speech in the workplace.

[d4m10n]

Which of Forstater's statements was most obviously hateful, in your view?

[Ziggurat]

Originally Posted by Ziggurat

That comment was rejected. I wonder why.

So I was wrong about this, the comment wasn't rejected, it just disappeared while waiting for the approval process. It's up now.

[Elaedith]

A prominent trans activist, Dana Rivers was recently convicted of a triple murder.

A small group of women were protesting that Rivers (a transwoman) may be sent to a female prison (in California). Apparently, they were assaulted by the usual masked adult human males in black.

[d4m10n]

Originally Posted by Elaedith

Apparently, they were assaulted by the usual masked adult human males in black.

Someone check for Ye's whereabouts.

Ok, but seriously I've got some misgivings about the new SBM article. There are many misleading claims in there; I'm just going to point out a couple here.

1) The SBM article claims "There is no evidence beyond the parents’ intuition that the puberty blockers caused bone density decline."

This is categorically false. See, for example, the prescribing information sheet for Lupron:

Quote:

The total duration of therapy with LUPRON DEPOT 3.75 mg plus add-back therapy should not exceed 12 months due to concerns about adverse impact on bone mineral density.

There is ample evidence that GnRH agonists cause BMD loss over time, it is beyond misleading to say that mere parental intuitions are in play here.

2) The SBM article implies that zero change in bone density is healthy even during puberty.

Quote:

“The change in bone density while adolescents were on blockers was observed to be zero,” according to the article.

Here is what ordinary, non-pathological bone density development looks like during puberty:

capture.jpg

Fig. 11.1. Changes in bone density throughout life.

A practicing doctor of osteopathic medicine would presumably already know that puberty is a time of steeply increasing bone density, so I'm not going to be particularly charitable on this point; Eckert has misled her readers into believing that leveling off at childhood levels of BMD is nothing to worry about. She "advances an intensely skewed and selective perspective on these risks" even while accusing the NYT of doing so.

Further down in the article, we have this characterization of seven relevant studies:

Quote:

In other words, there was no change in bone density in 500 adolescents on blockers. Z-scores, expected to decrease on blockers, were indeed observed to decrease.

Z-scores are what matters here, in terms of bone development over time. The relevant research question is how much BMD these patients are able to make up after some number of months of "pausing" non-precocious puberty, and the preliminary answers are not encouraging.

[Elaedith]

Originally Posted by d4m10n

Someone check for Ye's whereabouts.

Ok, but seriously I've got some misgivings about the new SBM article. There are many misleading claims in there; I'm just going to point out a couple here.

Good analysis.

But almost everything Eckert has posted is misleading or downright false. It is quite clear that this doesn't matter to Gorski & Novella and their adoring flock.

Still, you could post this as comment on SBM and also email Jesse Singal since he is considering another fact-check.

[Samson]

Meanwhile transwomen assuredly are women to the satisfaction of the deputy prime Minister of New Zealand.

https://www.nzherald.co.nz/nz/politi...I2WKMIREEOMMY/

Winstone Peter's, leader of a minor party, is none so sure, having the bravura to suggest men should not thump females in non elite sport.

[Matthew Best]

US Rowing's new Gender Identity Policy states that women's events are for whoever identifies as a woman at the start of a season, but in mixed 8 events (where four rowers are men and four are women) then the women must be female at birth. Weirdly, that would be the only event where the admission of male born athletes into the women's category would actually adversely affect males.

[Nick Terry]

Being cruel to #BeKind
https://4w.pub/these-men-were-promised-lesbians/

Quote:

Whose idea was it to tell heterosexual men that they could change their wardrobe and the world would see them as women? A non-exhaustive list: your local government, your national government, your federal government, your national broadcaster, the HER app, and your local arts centre.

Any time women made it known that, as one half of a sexually dimorphic species, we can spot the phenotypical traits of men before we clock literally anything else about them, we were shouted down, expelled, fired or attacked. But the threats did nothing to change our innate sexual attraction.

[Elaedith]

Originally Posted by Ziggurat

So I was wrong about this, the comment wasn't rejected, it just disappeared while waiting for the approval process. It's up now.

Good luck. Most of the commenters there are quite happy deciding what is correct based on emotion and politics first, then shaping the evidence to fit it. I'm having a hard time these days working out if people are not aware they are doing this, or that they actually think it's normal and desirable to do this as long as it's the correct politics. Most people seem more concerned with fitting in with the right tribe than with truth, which means of course that they do not support science or skepticism at all.

[Matthew Best]

Originally Posted by Ziggurat

So I was wrong about this, the comment wasn't rejected, it just disappeared while waiting for the approval process. It's up now.

That's an interesting conversation going on in the comments there. Nobody seems to be responding to your actual point, they all seem to respond to what they imagine your point is.

[Ziggurat]

Originally Posted by Matthew Best

That's an interesting conversation going on in the comments there. Nobody seems to be responding to your actual point, they all seem to respond to what they imagine your point is.

Yeah, that's a very common phenomenon.

[Elaedith]

Originally Posted by Matthew Best

That's an interesting conversation going on in the comments there. Nobody seems to be responding to your actual point, they all seem to respond to what they imagine your point is.

There is a hard core contingent painting any questioning of the narrative as coming from 'the Republican right' and 'anti-trans reactionaries'. At this point it it resembles a cult. They have managed to remove most critics by either making it too futile and unpleasant or banning them. Moderators are allowed to insult and encourage others to insult posters, and to ban people for anything deemed 'transphobic', which basically means they can spout whatever rubbish they want and those answering back have to tread on eggshells.

Frightening to think more and more so-called 'skeptics' behave like this. Soon there may be nowhere left to have discussions with people who care more about truth than demonstrating tribal allegiance, regurgitating narratives, and destroying heretics.

P.S. Their moderator compared proceedings against Dr Helen Webberley, who was suspended for misconduct over prescribing blockers, to the treatment of Nelson Mandela.

[Elaedith]

Originally Posted by lionking

The other thing the SBM article didn’t deal with is explosion of the young girls seeking to transition to transmen. Yet the article argues that there is no social basis for people transitioning. What is causing the increase then?

Also I found the attempted comparison with anti-vaxxers to be unconvincing.

One of the funniest (?) things about the article is their working away at this spurious analogy with anti-vaxxers based on 'all the experts agree with the affirmation-only approach and medical transitioning for minors', whilst simultaneously including statements such as '.....the example of the Swedish adolescent is not neutral and comes from a dubious source, specifically the documentary Transbarnen, the latest in a line of programs skeptical of trans medicine produced by Swedish broadcast network SVT in a country that has deemed the risks of blockers to outweigh the benefits.....'.

Also referring to the UK Cass Review as 'much-maligned', supported by a link to their own previous post maligning it.

You could hardly make this stuff up (except that they did).

[Rolfe]

It's one more example where I'm baffled by the institutional capture of a group that should be able to think their way through this. We see it on this forum too, it's just that the transcult members have decided this thread is "toxic" and avoid it rather than presenting a reasoned case. And earlier, when it was intimated that a prerequisite for participation was that one first had to concede defeat by adopting the language of submission required by the opposite camp.

It may simply be another example of what I have observed time and time again in this forum and among self-IDed "sceptics" in general, that what is really going on is extreme adherence to the mainstream view. Most people think homoeopathy is nuts, that Bigfoot doesn't exist, that vaccines are a good thing and that man really did walk on the moon. It's not a sign of a towering intellect to argue these positions, but that's what most of this forum was about for a long time.

However, when a situation arises (and this was most obvious for me in the miscarriage of justice discussions) where someone is presenting a rational argument against the establishment view (in these cases, the verdict of a court), it all falls apart. Argument from authority becomes the main tactic. "Who are you to question the decision of a judge?" "Most court verdicts are correct so I come from the position that this one is too." (Fair enough, but actually getting anyone to listen to rational arguments that this particular verdict is way doubtful is like pulling back teeth.)

That's why the Trials and Errors subforum was created - to give posters somewhere to argue these doubtful cases. When they were discussed in this subforum all debate was stifled by cries of "CT is thataway ---->" and so on. Questioning the establishment position, even from a reasonable stance and without invoking clear breaches of the laws of physics, was against the forum ethos.

So I'm wondering if that's what's going on here. The "Science Based Medicine" people have decided that the pro-trans position is the establishment one, and they're here to defend it. That's their modus operandi and they're sticking to it. Actual science and actual evidence don't really come into it and never have.

[Rolfe]

What is autogynaephilia, with Dr Ray Blanchard

This is an excellent podcast, well worth a listen.

I remember some way back in this thread I was getting pelters for bringing this topic up at all. Some posters seemed to think I'd made the whole thing up! Then we got on to all the "that's discredited" nonsense. This calm, low-key conversation really puts all that to bed, I think.

I have a lot of sympathy for men who are autogynaephilic. They didn't choose to be that way and it isn't making their lives any easier. But I do not have any sympathy at all for the way some of them choose to deal with it.

Women are not your support mechanism, guys. Our lives are not yours to be co-opted to validate your paraphilia and get you off on being accepted into women's society.

[Rolfe]

Doomed to Repeat: Gender Ideology and the Repressed Memory Movement

This article says what I've been thinking for quite some time about the issue of transing children.

Quote:

Children and sex are perennially two of the chief lightning rods around which mass hysterias often take form. The false memory and satanic ritual abuse panics of the ‘80s and ‘90s occurred in conjunction with a significant cultural shift, as women left home to go to work in huge numbers, leaving their children in daycare. The allegations of ritual abuse that swirled around daycares in the panic may have served as an expression of anxiety and ambivalence about this rapid societal transformation.

Now, the popular imagination has been captured by transgender children. We celebrate the “courage” of these children and their families and rush to endorse hormonal treatment to forestall the “trauma” of puberty. What cultural current might this be in reaction to?

[Elaedith]

Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice

Interesting letter by Dr Alison Clayton in the Archives of Sexual Behavior on the neglect of the placebo effect in gender-affirming treatment of youth. Placebo effects are very complex to determine when the primary outcome measure is reported psychological wellbeing and blinding is not possible. I've often been surprised at how little discussion this there is, even given the attempts by activists to suppress critical evaluation of gender-affirming treatment.

A quote from the article referring to something else I've noticed about the way gender-affirmative therapy (GAT) is represented:

"Some professional organizations and leading GAT clinicians, in publicly available communications to GD youth, the public, and policy makers, appear to overstate the certainty of GAT’s benefits and provide inadequate discussions of risks (Clayton, 2022a; Cohen, 2021a, b; Olson-Kennedy, 2015, 2019; Telfer, 2019, 2021). For example, GATs have been described in such communications as “absolutely life-saving” (Olson-Kennedy, 2015) and being underpinned by “robust scientific research” (Telfer, 2019). It is notable that these same clinicians in their peer reviewed publications acknowledge the sparse empirical evidence with critical knowledge gaps (Olson-Kennedy et al., 2019), and the urgent need for more evidence for this relatively new treatment approach (Tollit et al., 2019). Thus, there seems to be a kind of Janus-faced narrative, with a placebo effect-enhancing face of overstated certainty/strong evidence of benefit displayed to GD youth, their families, and policy makers, and the more realistic face of uncertainty/lack of evidence turned toward peer reviewers and the research community."

This is one reason why some people who haven't bothered to examine the primary source literature are surprised by recent decisions to move away from these approaches. The article is also pointing out that the way affirmative treatment is portrayed is likely to enhance placebo effects.

The article also discusses the exaggerated suicide narrative and lack of evidence that puberty blockers reduce suicidality.

[Rolfe]

Yeah, placebo surgery is known to be heap powerful medicine.

[LondonJohn]

Originally Posted by Elaedith

Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice

Interesting letter by Dr Alison Clayton in the Archives of Sexual Behavior on the neglect of the placebo effect in gender-affirming treatment of youth. Placebo effects are very complex to determine when the primary outcome measure is reported psychological wellbeing and blinding is not possible. I've often been surprised at how little discussion this there is, even given the attempts by activists to suppress critical evaluation of gender-affirming treatment.

A quote from the article referring to something else I've noticed about the way gender-affirmative therapy (GAT) is represented:

"Some professional organizations and leading GAT clinicians, in publicly available communications to GD youth, the public, and policy makers, appear to overstate the certainty of GAT’s benefits and provide inadequate discussions of risks (Clayton, 2022a; Cohen, 2021a, b; Olson-Kennedy, 2015, 2019; Telfer, 2019, 2021). For example, GATs have been described in such communications as “absolutely life-saving” (Olson-Kennedy, 2015) and being underpinned by “robust scientific research” (Telfer, 2019). It is notable that these same clinicians in their peer reviewed publications acknowledge the sparse empirical evidence with critical knowledge gaps (Olson-Kennedy et al., 2019), and the urgent need for more evidence for this relatively new treatment approach (Tollit et al., 2019). Thus, there seems to be a kind of Janus-faced narrative, with a placebo effect-enhancing face of overstated certainty/strong evidence of benefit displayed to GD youth, their families, and policy makers, and the more realistic face of uncertainty/lack of evidence turned toward peer reviewers and the research community."

This is one reason why some people who haven't bothered to examine the primary source literature are surprised by recent decisions to move away from these approaches. The article is also pointing out that the way affirmative treatment is portrayed is likely to enhance placebo effects.

The article also discusses the exaggerated suicide narrative and lack of evidence that puberty blockers reduce suicidality.

There definitely needs to be much more qual and quant research done into a) gathering relevant data on gender-affirming interventions for U18s, b) working towards optimising policy & practice in this area (ie maximising beneficial outcomes and minimising undesirable outcomes), and c) constantly evaluating the relevant data as policies/practices evolve, in a positive feedback loop, to get as close as possible to the optimal steady state.

As the report rightly says, this is an area of medicine which is relatively new, and with relatively few current data points to work with. And there's no doubt whatsoever that - in spite of sincere attempts within the global medicine community to optimise therapeutic intervention for u18s with GD - mistakes have been made and there have been regrettable outcomes in some cases as a result (although of course there have also been many, many beneficial outcomes, which don't make the headlines...).

Personally, I have little doubt that within around 5-7 years from now, this area of medicine will be sufficiently mature for optimal policies and practices to have evolved and been implemented. Obviously there will still be some mistakes and some undesirable outcomes (as there are in many areas of medical intervention in all disciplines), but they will be very heavily outweighed by beneficial outcomes. Which, in practice, will mean that U18s with genuine GD and no comorbidity will get the intervention (whether medical or surgical) that they need, and at the appropriate time, while U18s who present with GD but who in fact have other mental health issues will get appropriate counselling without medical/surgical intervention.

[Elaedith]

Originally Posted by LondonJohn

There definitely needs to be much more qual and quant research done into a) gathering relevant data on gender-affirming interventions for U18s, b) working towards optimising policy & practice in this area (ie maximising beneficial outcomes and minimising undesirable outcomes), and c) constantly evaluating the relevant data as policies/practices evolve, in a positive feedback loop, to get as close as possible to the optimal steady state.

As the report rightly says, this is an area of medicine which is relatively new, and with relatively few current data points to work with. And there's no doubt whatsoever that - in spite of sincere attempts within the global medicine community to optimise therapeutic intervention for u18s with GD - mistakes have been made and there have been regrettable outcomes in some cases as a result (although of course there have also been many, many beneficial outcomes, which don't make the headlines...).

Personally, I have little doubt that within around 5-7 years from now, this area of medicine will be sufficiently mature for optimal policies and practices to have evolved and been implemented. Obviously there will still be some mistakes and some undesirable outcomes (as there are in many areas of medical intervention in all disciplines), but they will be very heavily outweighed by beneficial outcomes. Which, in practice, will mean that U18s with genuine GD and no comorbidity will get the intervention (whether medical or surgical) that they need, and at the appropriate time, while U18s who present with GD but who in fact have other mental health issues will get appropriate counselling without medical/surgical intervention.

Given that a large part of the article was discussing a) how the frequent celebration of positive (short-term) outcomes in the media may contribute to the placebo effects and to social contagion, and b) this environment can contaminate the validity of research protocols currently in place to examine treatment outcomes, I suspect you didn't do more than skim the opening paragraph.

[Rolfe]

Oh, nevermind.

[lionking]

Originally Posted by Elaedith

Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice

Interesting letter by Dr Alison Clayton in the Archives of Sexual Behavior on the neglect of the placebo effect in gender-affirming treatment of youth. Placebo effects are very complex to determine when the primary outcome measure is reported psychological wellbeing and blinding is not possible. I've often been surprised at how little discussion this there is, even given the attempts by activists to suppress critical evaluation of gender-affirming treatment.

A quote from the article referring to something else I've noticed about the way gender-affirmative therapy (GAT) is represented:

"Some professional organizations and leading GAT clinicians, in publicly available communications to GD youth, the public, and policy makers, appear to overstate the certainty of GAT’s benefits and provide inadequate discussions of risks (Clayton, 2022a; Cohen, 2021a, b; Olson-Kennedy, 2015, 2019; Telfer, 2019, 2021). For example, GATs have been described in such communications as “absolutely life-saving” (Olson-Kennedy, 2015) and being underpinned by “robust scientific research” (Telfer, 2019). It is notable that these same clinicians in their peer reviewed publications acknowledge the sparse empirical evidence with critical knowledge gaps (Olson-Kennedy et al., 2019), and the urgent need for more evidence for this relatively new treatment approach (Tollit et al., 2019). Thus, there seems to be a kind of Janus-faced narrative, with a placebo effect-enhancing face of overstated certainty/strong evidence of benefit displayed to GD youth, their families, and policy makers, and the more realistic face of uncertainty/lack of evidence turned toward peer reviewers and the research community."

This is one reason why some people who haven't bothered to examine the primary source literature are surprised by recent decisions to move away from these approaches. The article is also pointing out that the way affirmative treatment is portrayed is likely to enhance placebo effects.

The article also discusses the exaggerated suicide narrative and lack of evidence that puberty blockers reduce suicidality.

I read this, thanks. It’s a pity that the SBM guys did not rear, or read and ignored, this letter.