Moderators: Elvis, DrVolin, Jeff
Wombaticus Rex » Thu Aug 31, 2023 2:29 pm wrote:DrEvil » Thu Aug 31, 2023 12:33 am wrote:The current hysteria around trans issues is fueled by the republican party as a culture war issue, the kind of divisive distractions that around here usually gets dismissed as kayfabe cover for the actual nefarious stuff the ruling class is up to, except in this case it's apparently very important that we be very upset about this and think about the children.
I think there's also a disgust thing underneath it. Once people really come to grips with what "gender affirming surgery" is, what it does and how it leaves people, there is a certain ... alarm.
Fueled by culture war, sure, but those operators always target existing fires to dump gas onto. And the exertions of pervert hypocrites in the GOP and DNC are an epiphenomenon, after all: the real issue here is, in fact, minors.
I'm friends with a staunchly NPR liberal older couple who read Jamie Reed's testimony and came away shaken. What I found most interesting is they did not so much assert this to me as confide it, confess it, because they felt like it was heresy. It is very unfortunate how difficult it has become for Americans to process facts outside of partisan politics.
It is also deeply pathetic and highly contemptible.
Wombaticus Rex » Thu Aug 31, 2023 8:29 am wrote:
It is also deeply pathetic and highly contemptible.
Harvey » Thu Aug 31, 2023 11:49 pm wrote:Doctor of Evil:
Science is institutionally corrupt, a fraud factory for those who can pay. Everything confirms this, from irreproducibility to the near total censorship of scientific debate - in a climate where industrial propaganda is the decisive factor. Reality is bought and sold and science is mistress to a new and rapacious priesthood, blood still wet on their lips.
Look around.
“By the mid-1960s, Money’s interest had turned to transsexualism and the possibility of surgical treatment: between 1964 and 1967 he was part of a research team… whose study of transsexualism was funded by the Erickson Educational Foundation. The latter had been established in 1964 by the wealthy trans man Reed Erickson. Research undertaken by the group was integral to the official establishment of the Johns Hopkins Gender Identity Clinic (in July 1966) as well as to the formation of the Harry Benjamin Foundation (in 1967). Moreover, Money “was probably more responsible than any other individual for the decision that such an august institution as Johns Hopkins Hospital would . . . endorse sex-altering surgery in suitable subjects,” a practice for which, at the time, there was little support among medical professionals.”
“It has been a quarter of a century since Dutch clinicians proposed puberty suppression as an intervention for “juvenile transsexuals,” which became the international standard for treating gender dysphoria. This paper reviews the history of this intervention and scrutinizes the evidence adduced to support it. The intervention was justified by claims that it was reversible and that it was a tool for diagnosis, but these claims are increasingly implausible. The main evidence for the Dutch protocol came from a longitudinal study of 70 adolescents who had been subjected to puberty suppression followed by cross-sex hormones and surgery. Their outcomes shortly after surgery appeared positive, except for the one patient who died, but these findings rested on a small number of observations and incommensurable measures of gender dysphoria. A replication study conducted in Britain found no improvement. While some effects of puberty suppression have been carefully studied, such as on bone density, others have been ignored, like on sexual functioning.” ...
“At the Amsterdam clinic, 56 transgender adolescents were treated with GnRHa, commencing at ages ranging from 11 to 18, for an average duration of 1.7 years. After puberty suppression, a significant minority of patients have abnormally low bone density after puberty suppression.”
“The claim for reversibility was contradicted from the outset by the unknown effect of puberty suppression on brain development. Irreversibility has now been demonstrated by randomized control trials in nonhuman animals. The central justification for puberty suppression was that it increases outward resemblance to the opposite sex and requires less surgical intervention. Paradoxically, however, early puberty suppression for males will most likely make subsequent genital surgery more risky—this is what killed one of the initial Dutch cohort—with worse results.”
“approximately one third of children and young people referred to the U.K.’s Gender Identity Development Service (GIDS) have autism or other types of neurodiversity”.
“Our study demonstrates that transgender and gender-diverse individuals have elevated rates of autism diagnosis, related neurodevelopmental and psychiatric conditions, and autistic traits compared to cisgender (normal) individuals. This study has clinical implications by highlighting that we need to improve access to care and tailored support for this under-served population.”
“The question, “Just because we can, should we?” is not unique to pediatric gender medicine. What makes this arena exceptional is the radical, irreversible nature of “gender-affirming” medical and surgical interventions desired by the exponentially growing numbers of youth in the Western world.”
“Another unique aspect of the gender medicine field is that a number of clinicians tasked with caring for gender-distressed have taken on the role of political campaigners—and in doing so, have traded wisdom and nuance for blunt activism. Their insistence that today’s gender-dysphoric teens are tomorrow’s transgender adults, and that their future happiness and mere survival hinges on early access to gender reassignment, is demonstrably false. While still reported as “rare” by the gender medicine establishment, the rate of medical detransition is already 10%-30% just a few years following transition. These numbers are likely to rise in the future as regret historically has taken over a decade to materialize”
Based on a thorough review of the clinical evidence available at this time, there is not enough evidence to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria. There were conflicting (inconsistent) study results—of the best designed studies, some reported benefits while others reported harms. The quality and strength of evidence were low due to the mostly observational study designs with no comparison groups, potential confounding, and small sample sizes. Many studies that reported positive outcomes were exploratory type studies (case-series and case-control) with no confirmatory follow-up.
Overall, the quality and strength of evidence were low due to mostly observational study designs with no comparison groups, subjective endpoints, potential confounding (a situation where the association between the intervention and outcome is influenced by another factor such as a co-intervention), small sample sizes, lack of validated assessment tools, and considerable lost to follow-up.
“I have watched as all-women’s safe spaces, universities, and sports opened their doors to any man who chose to identify as a woman. Whereas men who identify as transwomen are at the forefront of this project, women who identify as transmen seem silent and invisible. I was astonished that such a huge cultural change as the opening of sex-protected spaces was happening at such a meteoric pace and without consideration for women and girls’ safety, deliberation, or public debate.”
“One of the biggest organizations the government funds is Planned Parenthood. Coincidentally, Planned Parenthood is now the second largest provider of ‘gender-affirming’ hormone therapy. From 2016 to 2017, they received $543.7 million in funds from all levels of government. From 2013 to 2015 they received $1.5 billion in federal program funds. $1.2 billion was from Medicaid, and $289 million came from six separate departments within our government.”
The 10 most popular NYT reader comments to the piece on detransitioners and the harms of "gender-affirming care" today:
1. "I predict we will look back on this period with the same disgust we feel about the overprescription of amphetamines like Adderall to every 8-year-old boy who couldn't sit still for an entire day. The most damage is often done by doctors and parents who are so well-meaning that they cease to think critically."
2. "Thank you for presenting a non-polarized view of this complex issue. Having been a 13 year old, I have a dim view of the enduring wisdom of decisions made at that age."
3. "Thank you for publishing this. The conversation across liberal media has been too one-sided and has caused real harm for some. This is a very very complex issue. We can't ignore how lucrative this has been for the medical complex."
4. "Isn’t being 'uncomfortable' part of being a teenager? There are transgender people, but I’m skeptical that the massive upswing in those that think they are transgender is the reality."
5. "This is an incredibly important story - THANK YOU for bringing this conversation to light. The lack of space for thoughtful, left leaning people to debate this issue is terribly harmful. We need to be able to talk about this and ask questions without being labeled as being transphobic. The push for young people to disown their families as part and parcel of their journey towards transitioning is devastating for families but mostly for the individuals themselves in the long run. So, I say YES to open, calm, healthy conversations and lots of questions. NO to illiberal name calling from the left and the right."
6. "Thank you, Ms. Paul, for your thoughtful column. No doubt you and the NY Times will be accused of being transphobic again. Any healthy movement and community should be able to engage in critical dialogue rather than shutting down conversations by labelling others as hateful or phobic. I have taught health care workers to give compassionate care to older transgender adults and as a wedding officiant, I have served couples where one or both identify as transgender. Yet when I have written about misogyny or concerns about women's spaces, I have been dismissed as a TERF. With kids, I have three primary areas of concern. Since the vast majority of kids seeking to transition are girls, I ask why are girls so unhappy? Do they feel so disempowered that they think they would be better off as boys? How are we failing to teach girls to love themselves? Second, the medical industry is a highly profitable one. We should question the motives from medical providers and big pharma. Third, is this movement for kids to make them heteronormative? I know lesbian and gay activists who are concerned that transitioning is the new conversion therapy. If a girl is attracted to other girls, is she encouraged to transition rather than to be a lesbian? I was always suspicious of the pink and blue flag--the gender conforming colors. I believe in equality for transgender adults and I also believe this recent phenomenon with kids should be examined more deeply."
7. "I am a seasoned clinical psychologist. 20 years ago, if someone expressed discomfort with their gender and sought what was called medical "reassignment", standard treatment involved two years of psychotherapy with a gender dysphoria psychologist, including 6 months of living as the desired gender. Clinicians looked for evidence that the gender dysphoria was "persistent and consistent" and the person "insistent" about it, usually from early childhood. One might argue with the time frame for treatment, but it took very seriously both the patient's feelings and the life-long changes that the desired treatment would bring. Now, at least one highly respected health care organizations in my city prescribe hormones to adolescents 16+ and adults upon request. Here's a quote from their website: "In most cases your clinician will be able to prescribe hormones the same day as your first visit. No letter from a mental health provider is required." Imagine going to your MD and saying "I have diabetes and need medication" and the response was "I believe you - here's your insulin". Would anyone consider this medical care? I would consider this medical malpractice."
8. "'To the trans activist dictum that children know their gender best, it is important to add something all parents know from experience: Children change their minds all the time.'" The fact that children change their minds all the time is one of the oldest insights of psychology. Yet the transgender movement totally leaves it out of their calculus. Both right-wing and left-wing thought are absolutely certain about way too much. Beware of both."
9. "This is an excellent piece. I grew up in the 70s and 80s when very few people questioned their gender but there was a lot of freedom around expression - especially for women. Young people today seem to have lost that - if you don't fit the strictly feminine or masculine then you must be trans or non-binary. We need to re-expand our gender roles."
10. "'I felt so detached from my body, and the way it was developing felt hostile to me,' Powell told me. It was classic gender dysphoria, a feeling of discomfort with your sex.' This is how a large number of kids feel when going through puberty, as their body is uncomfortable due to rapid changes. Assuming that feeling uncomfortable while going through puberty is "classic gender dysphoria" is a mistake. That may be one symptom, but it must be one of many, not the only or even primary symptom."
OPINION
PAMELA PAUL
As Kids, They Thought They Were Trans. They No Longer Do.
Feb. 2, 2024
@LeorSapir
NYT’s Pamela Paul has a good follow up to her piece from Friday on detransitioners. We don’t know the current rate of regret and detransition.
Kudos to Paul for showing curiosity about the reliability of studies that are said to show an extremely low regret rate. She links to a critique of the widely cited Bustos systematic review of regret following surgery, which misleadingly claims to show the rate is <1%.
This is what journalists reporting on this issue must do. The bigger story here is the dysfunction of scientific institutions, including peer-reviewed medical journals.
Users browsing this forum: Elihu and 6 guests