Recently, the journalist Jesse Singal – who has a well-earned reputation for being anti-trans – made an error that he thought was understandable, but to many people – me included – seemed ridiculous. He came across an interview with a trans girl and her mother, during which the mom said:
“So the pediatrician at the time talked to Cam for maybe 10 minutes and then said, Well, I think Cam knows what she needs and let’s get her an appointment with an endocrinologist to move forward with treatment.”
Singal – who has written multiple articles and blogs implying that there is an epidemic of young people being pushed too fast into transitioning without examination, although he’s never documented an actual example – then tweeted:
“Pediatrician with no specific training in gender/developmental issues approves hormones after a *10-minutes* assessment.””
Virtually any trans person – and for that matter, anyone who knows trans people and has listened to their stories – would hear that quote and assume that there was more to it than that ten minutes. And they’d be right. Indeed, the patient herself, understandably annoyed, responded to Singal:
“A substantial amount of time passed between coming out to my mom and that doctor’s visit. I actually had been seeing a therapist for years, and the doctor had those notes indicating my experience with dysphoria.”
“During those *months of waiting* I met two separate psychologists and spoke to them about dysphoria. There aren’t details in the interview about that because it was traumatic, but if Singal wanted to ACTUALLY hear about my experiences he could have asked me…”
“I wasn’t “approved for hormones” as Singal claims. I was referred to THRIVE for an *informational session and evaluation* at their endocrinology clinic. A majority of patients at these clinics don’t receive HRT.”
So why didn’t Singal – who considers himself an expert on all things trans – double check with anyone before running with an obviously implausible “ten minutes” narrative?
Singal lives and works in a bubble of anti-trans misinformation, which has given him a warped misunderstanding of how the transitioning process works – so warped that, despite years of writing on this subject, he can’t even recognize an obviously implausible story, if the story aligns with his misconceptions.
This cartoon wasn’t inspired by Singal alone. There’s nothing special about Singal’s mistake; so many anti-trans people share his misinformation bubble they’re gonna have to build new high-rise housing.
This one was a challenge to write. I wanted to have nine panels of how gender affirming care works in reality. Nine panels is simultaneously a lot of panels – necessary because I wanted to emphasize that a lot goes into this – and also not nearly enough room to give more than a gloss on a process that for most people is long and complicated, and really isn’t the same for everybody. I ended up rewriting those nine panels a whole lot of times.
The other difficulty with those first nine panels is trying to avoid nine panels of the same character talking at the reader. Panel five is my favorite; I’ve heard multiple people who came out as kids talk about how amazing it felt to finally be supported in having the right hair and clothing, and I always find it touching.
TRANSCRIPT OF CARTOON
This cartoon contains ten panels; the left half of the cartoon is a three-by-three grid, containing nine panels, while the right half is a single large panel.
A big caption above the left half of the cartoon says, in large friendly lettering:
HOW TRANSITIONING HAPPENS FOR KIDS
PANEL 1
A young man is speaking directly to the reader. He has hair that’s carefully combed on top and buzz-cut on the sides, a short beard, and is wearing a reddish tank top and a black leather wrist band. He’s smiling and friendly. Let’s call him “Bob,” because why not.
BOB: The process isn’t always the same, but here’s how it went for me.
PANEL 2
In the foreground, we can see a child with hair in a ponytail. The kid is sitting across a table from two people (presumably Bob’s parents), who both look stunned.
BOB (in a caption): When I was ten, I finally told mom and dad I’m a boy. They were, um… surprised.
PANEL 3
Bob is again speaking directly to the reader, smiling, hands on hips.
BOB: But eventually they got me an appointment with a trans-friendly therapist.
PANEL 4
Bob raises one hand in a classic “cartoon explaining hands” motion.
BOB: After months of sessions with the therapist, my parents agreed to the next step…
PANEL 5
A shot of kid Bob, in a short boy’s haircut, wearing an Elmo t-shirt, jeans shorts, and red high-top sneakers, grinning and glowing with pride, with his chest puffed out.
BOB (in a caption): A new name, new clothes and a new haircut!
PANEL 6
A hand is sticking into the panel, holding up a letter. The letter says “Dear Doc, YUP! HE TRANS! yrs, Therapist”
BOB (in a caption): Armed with letters from two therapists, we contacted a gender clinic…
PANEL 7
Bob – narrator Bob now, not kid Bob – is sort of emerging from a calendar, leaning his head on one arm. He looks a bit sad.
BOB: But there was a waiting list… I lived as myself over a year before I got in.
PANEL 8
A hand is holding a prescription bottle, although it looks a bit more complicated than most pill bottles do, with an oversize cap, and we can see it has a big stopper. (This is because it contains injectable liquid, not pills.) We can see that the bottle is labeled “Leuprolide.”
PANEL 9
We’re now seeing Bob from head to toe, as if the camera is backing away. He’s continuing to talk, but each successive word balloon has slightly smaller lettering, as if it’s fading into the distance.
BOB: That was only the start! It was years before I began hormones.
BOB: So next I…
BOB: And then…
PANEL 10
This is a huge panel, taking up the entire right half of the cartoon. A small girl, with her hair in pigtails and holding a teddy in one hand, is in what’s obviously a medical office of some kind, standing in front of the counter and talking to the person behind the counter. Her eyes are wide.
The woman behind the counter is leaning forward, almost over the counter, and looks rather predatory. She’s wearing blue scrubs over a black shirt.
A big caption at the bottom of the panel says “HOW THEY IMAGINE IT HAPPENS.”
LITTLE GIRL: My teacher says I’m a tomboy.
WOMAN BEHIND COUNTER: That means you’re a boy! We’ll start you on hormones right now!
Singal “has a reputation for being anti-trans” for the simple reason that he has a long history of being explicitly anti-trans. A history that’s long enough and loud enough that one can say with confidence that Singal is just flat out anti-trans.
Also, sure, Singal “lives” and works “in a bubble of anti-trans misinformation.” But, more to the point, he has mightily helped to engineer that bubble and its noxious contents. And has staked his professional bona fides on sustaining and expanding it.
Jacque, I think you and I may have different definitions of what “explicitly” means? Singal is (unfortunately) effective because he isn’t explicitly anti-trans; when people ask him, he says that he’s totally pro-trans. That he’s not explicit about it, is part of what makes him an attractive hire for mainstream “liberal” publications like The Atlantic.
But I certainly agree that Singal’s rep for being anti-trans comes from Singal being anti-trans.
Saurs, I agree.
ETA: I’ve made a couple of minor changes to the post.
Would “transparently anti-trans” work better for you?
He IS transparently anti-trans… to you, to me, to a lot of people we know.
I’m not at all certain he’s transparently anti-trans to a lot of Americans who are less engaged with the issues. In his articles, he works hard to craft this “I’m just being reasonable here, I don’t hate anyone” tone that I suspect fools a lot of people.
I think the problem isn’t that the guardrails as started are bad, I think the problem is that the guardrails are not adhered to.
There was a Jubilee episode not too long ago, “trans conservatives vs. trans liberals” and because Blaire White and Blossom Brown were on it it was about as odious a shitshow as one might expect (which was unfortunate, Middle Ground often has some good conversation in it).
One of the things from that episode that stood out was that all 7 of the people who had transitioned on the panel said that they got their first dose of hormones either during or shortly after their first appointment, none of them ever having seen a therapist to that point. You could argue that some of them were adults, and that would be fair, except several of them weren’t. Andrew in particular got his first dose of testosterone *during* his first appointment at 15.
Another interesting episode was “detransitioners vs. trans”, where there was another slew of stories where the system just utterly broke down.
I can’t speak for all of conservatism, but I’m not overly concerned in situations where the process as described above happened. I’m horrified by situations where it isn’t.
I don’t accept anything from a 1.5 hour video as evidence, unless you provide a specific time stamp for each and every example you’d like us to consider. (“It’s somewhere in chapter ___” is not specific enough.)
A link might be nice too. Maybe I’ve been living under a rock and everyone else knows, but I’ve never heard of Jubilee before and don’t even know what sort of media it is.
As far as the “guardrails” go, I don’t think they would be a bad thing if there were enough therapists, doctors who knew how to treat trans people, etc to make the wait times reasonable. But there aren’t. So when you’ve got the choice between allowing a child to go through or continue to go through a puberty that is causing their body to change in a way that is so distressing that it leads to depression and possible suicidality and giving hormones, which are relatively low risk and most of the effects of which can be reversed by not continuing to take them, giving hormones a bit prematurely seems the lower risk act. So if you want to ensure that all the forms have been completed, all the boxes checked, and the risk of regret minimized, the most effective thing to do is add more practitioners to evaluate and treat trans or possibly trans people, including children and adolescents.
ETA: Okay, I found “Middle Ground” and have to say that most of the episodes sound like TERRIBLE conversations. Are men and women equal? Yes, and the opinion of anyone arguing otherwise should be discounted. They are simply wrong and have prejudices that do not allow them to be useful on the topic of gender until they deal with them. Does feminism include trans women? Only if you want it to actually be feminism and not an exclusive club for some women. See above regarding the counterargument. Is abortion murder? No. Next! Are men falling behind? No. Some men are disadvantaged due to intersectional issues, but men as a group retain massive privilege. If a white straight born wealthy man is failing, it’s because he’s a failure, eh Donald? And let’s not even get into the flat earthers vs reality based people or the astronomer versus astrologer? Why?
@Dianne
I’d add in that any “guardrails” need to be applied equally to cis and trans people, which none of them currently are.
@bcb: Agreed. I’m fine with people needing to think about it a little before making major alterations to their bodies, but requiring trans people to go through more hoops than a cis person would for an equivalent level of alteration makes little sense. For example, are people who are considering bariatric surgery required to get counseling first? Are children who are considering it or having it considered for them? I don’t know, but I hope so, since that is a life altering event that there’s no going back from (unlike hormonal therapy).
There is no requirement for talking to any mental health professional before bariatric surgery. Typically you meet with the surgeon once, then schedule the surgery. Some places advertise that it takes “as little as two days.“
I actually didn’t think that this would be controversial. My first thought was “Do you actually need timestamped evidence of trans people who say that they were given their first dose of hormones during their first appointment at 15?” But sure, fine: Link is here the conversation was under the topic “Doctors are manipulating trans medical care” which was from the 59 minute mark to the 1 hour ten minute mark, while all the trans patients outlined their journey and said that they were rushed through the system, the person who specifically said he was given Testosterone during his first appointment at 15 was Andrew, the exact time stamp starts at 59:45.
But I think that you should probably consider watching at least that whole section for context.
To the rest:
I actually think Dianne @8 perfectly represents what concerns me about this:
Desistance has basically been measured for as long as we’ve kept records. Detransition is relatively new. And I believe that can largely be attributed to the attitude above. I believe, and I’m sure you all disagree with me, and that’s fine, but I believe that while there are obviously people who experience gender dysphoria who will be best treated by transition, there are also people who between a cocktail of depression, trauma, social pressure, and sunk cost fallacy are being fast tracked towards very expensive, life altering surgeries that may itself kill them. And the way to determine who would be best helped by transition as opposed to someone who would be best helped by another form of therapy is to actually apply these standards.
I wonder…. Can we agree that it’s a tragedy to give hormones to someone not actually experiencing gender dysphoria?
Diane @ 8
Some are better than others. I find the calmer conversations better because I think that the people having these conversations are specifically chosen to be able to well articulate the perspectives of their side and rub them against each other. Frankly, I understand why that might not be appealing to you. But the reason I chose to mention this one in particular is because I don’t think you’ll have many opportunities to hear seven trans people talking about their experiences from different points of view like that. Do you have a better example?
BCB @ 9
Dianne @ 10
Amp @ 11
While I agree in principle that if there were a similar situation effecting cis people that there should also be guardrails… I’d have thought the obvious parallel might be breast implant or reduction surgery. In that case, and because I’m specifically talking about kids: Sure. I have no issue with that. Your terms are acceptable!
But obviously, not all surgeries are the same. Obviously, some are more studied than others. Some are safer than others. Some are more reversible than others.
Specifically on the topic of bariatric surgery, because that’s what was brought up: Again… There are guardrails on that: Your mileage may vary depending on where you are, but in Canada, you have to be at least 14, at Tanner stage 4, been on a supervised weight loss program for at least 6 months, and maintained a BMI of 40 or greater (35 if there’s an immediate health concern).
On the topics of studies done, safety, reversibility, or guardrails, can anyone enunciate what concerns they have with someone getting bariatric surgery?
I don’t usually respond to Corso but this does require me to do so.
First, how many people die from gender affirming surgeries? A link would be awesome. As would one supporting the “very expensive” assertion. Do you mean expensive to the insurance company or expensive to the patient?
Second, as a trans woman who transitioned in her 50s in what is, perhaps, the trans paradise of the US I have my doubts about “fast tracking” of gender affirming care existing, much less being common.
For this 51 year old who decided to transition in a city with a higher trans population than any I’ve known – a city that people move to specifically for gender affirming care and supportive community – nothing was “fast tracked”. I spoke to a therapist weekly for months. It took me 2 months to get an appointment with a medical provider who was competent and willing to prescribe HRT. This is for a fully adult human being. Months of therapy and months waiting for an appointment. At the first appointment with the medical provider, she was careful to make sure that this is something that I wanted.
As for surgery? In order for a surgeon to even speak to you about top surgery, you have to have a letter from a therapist and then you have to wait months for an appointment once the letter has been submitted and approved.
Vaginoplasty? You need a letter from 2 different therapists before they’ll even talk to you about that. Then there’s the months before an appointment is available and then the waiting list from the time you decide this is something you want is well over a year.
Please provide links t0 the gender affirming surgeons in the US who will 1) perform any gender affirming surgery on kids under 16 and 2) who will perform that surgery within months of a child’s first appointment with a gender affirming care practice.
The fact is that the patient dissatisfaction rate is lower than that of plastic surgeries (25% dissatisfaction rate! Maybe we should be putting guardrails in place for facelifts, breast enhancement, and tummy tucks first.), hip replacement surgery and knee replacement surgery to name just a few. Gender affirming surgeries have one of the lowest rates of regret of any surgery for which we have statistics.
This kind of hysterical anti-gender affirming care propaganda is just shameful.
(I shall now bow out as gracefully as I can.)
Why? What evidence do you base this belief on?
No. Gender dysphoria is not the only diagnosis that can be treated with hormones. It’s a tragedy if someone is forced to take hormones when they don’t want to or, equally, forced to forgo them when they want them and have a condition that could be effectively treated with them.
Okay, so surgery. I admit to having contributed to this confusion about surgical treatment versus medical treatment, but let’s try to separate the two. Surgery is inherently and always a permanent bodily change. Medical treatment may or may not be. I would not be adverse to requiring at least brief counseling for any surgery that is being performed for anything other than a life or bodily integrity issue. (In fact, that’s more or less what an informed consent form is.)
Hormonal therapy, OTOH, is something that affects you while you take it. So, would you require a person to see two therapists before they, for example, started taking oral contraceptive hormones? What if they chose that form of birth control because they wanted bigger breasts? How is that inherently different from wanting secondary sex characteristics other than those associated with the gender you were assigned at birth?
Jacqueline @ 13
I don’t think you’ve ever managed not to.
Frankly, we’ve beaten this bush too often for me to take your questions seriously, and very little of what you said actually interacts with what I said meaningfully.
I think if there’s a further point to be made it might be in my use of “fast-tracked”. My point isn’t that there’s this bullet train between someone’s first appointment and a surgery. My point is that once a kid goes on puberty blockers, they are put on a path that is fairly straightforward and doesn’t always have an off ramp, and I’m just not convinced that all of these cases are legitimate.
Like we’ve both said before: The data is lacking. A lot of this is relatively new. I feel like the sudden and recent class of detransitioners is at least a signal that I might be correct, but I admit I could be wrong. Like was said in that video, maybe a generation of young people need to get fucked up similar to what happened around AZT and AIDS in order for us to find Biktarvy.
But I don’t think I need to convince anyone here of the truth of this because I think that while all of these cases are tragic, there’s really nothing anyone here can do about them. And as they inevitably work their way through the legal system, and this starts to hit clinics and insurers, the guardrails will snap back up so fast our collective heads will spin.
I know you have this caricatured idea of who I am, but really… I don’t think that your journey at 50 should have been so hard. I think that adults should have agency over what happens to them. I’m sorry that was your experience.
I believe, and you can disagree all you want, but I believe that this current class of young people being medicalized in part by a profit-motivated system and in part by ideological capture has a whole lot of false positives in it. And those false positives are doing damage. And that damage will be litigated. And restrictions will follow the litigation. I see a future where, at least in the mid range, transition becomes harder for adults because of the blowback from what’s happening to kids.
Or I could be wrong.
Diane @ 14
This isn’t right though, and I think it’s the kind of misinformation that circulates in progressive circles.
While it is true that oral contraceptive hormones are hormones, not all hormones are the same, and not all hormones are reversible. Trans men who take testosterone very quickly go through menopause. That doesn’t unhappen. Again… Going back to that Jubilee video I linked: Andrew almost certainly experienced menopause before he was 18.
And that’s for hormones that are at least being used as intended. Puberty blockers were meant to treat precocious puberty. They are being used off brand to pause normal puberty, and there is absolutely no way of knowing that there will be no long-term effects of taking blockers, particularly at the doses and over the timeframes they are being administered. The current use of them is not FDA approved and see above as to where I think that’s going to go from a liability standpoint.
Do you have a reference for that statement? In particular, a primary source reference? Given the number of men and non-binary people who have children, I don’t think it’s an invariant effect in any case.
Actually, they’re mostly approved for the treatment of advanced prostate cancer. Use of lupron or triptorelin for precocious puberty or pausing “normal” puberty (normal is in quotes because there is nothing normal about going through the puberty of the opposite sex) is off label. It’s not actually a liability issue as much as, at least in the US, an insurance issue.
If we are talking about surgery, gender confirmation surgery in cis boys (ie breast reduction/top surgery for cis boys with gynecomastia) is not controversial, even though this is a cosmetic surgery that removes a “natural” body part, could be fatal, and is performed on a minor. Probably the best analog for top surgery for trans boys. If cis teens have access to this surgery, why shouldn’t trans teens?
Many people are A-OK with cosmetic surgery on minors as long as the minor is cis. My neighbor let her child Spock her ears. The child is currently 13, but was 12 at the time of surgery. I am thinking this is WAAAY more likely to be regretted later in life than hormone therapy or top surgery. Same for breast augmentation performed on cis minor girls. There are definitely many more breast augmentation surgeries performed on minors than top surgeries in the US (source that points to the underlying data: https://www.advocate.com/transgender/2022/9/28/more-teens-get-breast-implants-trans-top-surgery), and that is with plastic surgery guidelines stating that cosmetic breast enhancement should only be done on people 18 or older. No one is writing laws to stop this. Or picketing. Or attacking the parents. Or even thinking about it in any serious way.
There should be different rules for kids than for adults, but 18 is a totally arbitrary line. Where I live, the age of medical consent for non-cosmetic medical care is 14. We as a society do need to draw a line somewhere, which I understand. But there needs to be some mechanism for kids whose parents refuse health care (increasingly a problem for vaccines, for example). Trans kids need to be able to access appropriate care, especially to help them decide on the best path forward for themselves. I think that many more trans kids lack access to even the most basic of gender-oriented care than get fast tracked into a quick transition. For the most part, we are discussing what happens with well-off kids with good medical insurance and at least somewhat supportive parents in the US, who are probably not the majority of trans kids. Personally, I think everyone should be given proper information and enough time to make life changing medical decisions, and the criteria for what counts as proper information and enough time should not depend on if the person is cis or trans.
Since Corso brought it up, I wonder about detransition (which is definitely not a new thing). Many people seem to detransition/regret their transition because they are treated poorly due to anti-trans bigotry (see the late Danielle Berry, video game author) or because of access issues and not because they are unhappy with themselves post-transition. That is not the same thing as someone deciding that they weren’t trans after all (which I know also happens, but I don’t think all that often), since in a world with no transphobia and good access to medical care, it would no longer be a major issue. I also know a couple of non-binary people who always planned to take cross hormones for less than a year in order to develop their desired level of androgyny. Gatekeeping means they sometimes had to lie about transition in order to get access to hormones. They are technically detransitioners, since they no longer take hormones and don’t live as their cross gender, but I think we would all agree that this is not exactly what is meant by detransition.
The fact that some people regret their choices does not mean that the choice should be taken away from everyone. We as a society don’t do that with anything else except for choices that revolve around sex and gender, which tells us something about motivations and/or bias.
I think you remembered what they said inaccurately.
I don’t think the experience you’re implying is commonplace – someone who has never before been diagnosed, never seen a therapist, etc – is common. That’s based on how a lot of trans people I know and have read have discussed their experiences. Now, obviously that’s not a random representative sample; but neither are the people on this panel.
There’s no way to question the conservatives on this panel – to talk to their doctors, etc, and get another view – but if we could, I strongly suspect that for most of them, there’s more to the story than they’re telling here. I bet some of them were referred to these doctors by other doctors; I bet some of them who didn’t say anything about if they ever spoke to a counselor, therapist, or social worker prior to the appointment they’re describing, had an experience of that sort. But that’s just a guess on my part, not something I claim to know for sure, and obviously I could be wrong.
As Alexander says, surely it does happen, but it probably doesn’t happen often.
Amp @ 19
Just for Clarity – Alexander was the non-binary person on the panel, they were never on hormones, and I don’t see why they’d be in any position to know. Sarah was the other trans person, and she nodded and said yes when the topic was broached.
And then I think you’re being a little disingenuous. Does it really matter that Andrew might have been seeing a therapist if the clinic didn’t know whether or not he had?
After that: The points about frequency. I’m saying a thing is happening, the phenomenon of detransition and all these stories are signals that to some extent that thing is happening. You can take issue with some or all of Jamie Reed’s account, but that doesn’t change the fact that parts of it were verified, and was generally consistent with the rational the NHS had for closing the Tavistock clinic. And yet, I’m being told, very authoritatively, that they are uncommon. I don’t know how anyone would know that. It begs the question: How do you know that?
I don’t have the time or the patience to respond more than minimally in this discussion. The time I have available to trans issues I am spending where it seems far more likely to result in less actual future suffering.
Briefly, though, this:
Corso:
Perhaps not:
https://www.assignedmedia.org/breaking-news/jamie-reeds-allegations-are-not-even-partially-confirmed
Also:
Corso:
Neither of those phenomena is new, and the line between them depends on your definitions. So, when discussing them, it’s useful to define how you’re using the terms. Otherwise we end up with apparent disagreements where there are none, which is a waste all around.
Grace
This, sadly, seems like a thread where this needs to be linked.
The Desistance Myth
There are 8 billion odd people in the world and IIRC, 1% or so are trans. It would be shocking if no one among that many people ever regretted their transition related medical decisions or doubted their gender identity. People change their minds. People make mistakes. That doesn’t mean that an option shouldn’t exist or should be made so hard to get that it is effectively nonexistent.
Yes, it does. Because Andrew knew whether he did or not and he’s the one that it matters to most. In fact, do we even know that the clinic didn’t know? They may have just failed to document it or not referred Andrew to a therapist because he mentioned having already been to one. And, as Barry points out, endocrinologists are sub-specialists. The pre-hormone requirements may well have been checked off by the primary care provider.
Grace @ 21
I would take a deeper look at the spreadsheet they link as their work on this. I’m willing to look at that and stand by what I said. Even they admit that parts of it were verified, what they consider refuted is kind of funny, really. And it doesn’t change the fact that the Tavistock clinic was in fact closed for reasons that mirror her allegations.
I also don’t understand what people thought her motivation was here. We’re talking about a queer woman married to a trans man who worked at multiple clinics for decades, not some kind of conservative ideologue looking to ruin her own livelihood.
Regardless,
This is fair. I never said either was new, full stop, I said that detransition was relatively new. And in looking back, that was a mistake.
I view desistance as the phenomenon where youths who reported experiencing gender dysphoria desist in their reporting. My expectation is that this is because they no longer have those feelings, and my impression is that that’s because having experienced a normal puberty, they’ve adjusted to the hormone cocktail that is adolescence and puberty.
I view detransition as someone who has taken some manner of physical transition as treatment for gender dysphoria and stopped following a realization that they were not actually experiencing gender dysphoria. I would not count people like Shane in this group, who said he stopped taking testosterone because he wanted to preserve his ability to reproduce naturally.
Like I said, I said that detransition was relatively new and that that was a mistake. It’s not new in and of itself. But it seems like a population disproportionately on the rise. I think the reasons that there have been so many detransitioners over the last four or five years is new.
I say this fully admitting that I don’t know this to be true, because it’s new. We don’t know. There is no data. It’s my impression based on the information I’m taking in. But even if I’m wrong and the rate of detransition is proportionate to what it used to be and there’s just more because there’s more people transitioning, these stories are horrifying. Young people crying crying about their ruined bodies, who will die young because of the damage of transition, like Luka Hein, who was given a double mastectomy at 16 before even going on hormones. I think we can and should do better.
How does a mastectomy cause early death? I mean, assuming the surgery was done right and there were no medical complications, whether foreseeable or not. Which is true of any surgery.
I once met someone who insisted that an appendectomy ruined their body. Would you argue that appendectomies should be banned or made much more difficult to obtain?
Jacqueline @ 22
I honestly don’t know whether you just don’t recall our previous conversations on this, or are just this bad faith.
The study they refer to in that article is “Gender Identity 5 Years After Social Transition” by Olson, and like Every. Single. Study. that finds a desistance rate of less than 10%, they didn’t measure the same things as the ones that found a desistance rate of between 50-90%.
In the Olson study, the mean age of people entering the study in 2020 was 6. The mean age of the original sample was 4. You add five years to either of those numbers and the mean age of someone at the end of that study was either 9 or 11.
“It is common for between 60 and 90% of children with gender dysphoria to desist following a normal puberty” is not refuted by “Here’s a study where none of the subjects have undergone puberty.”
In order for you to be correct, you would have to find a study that showed low desistance rates in youths that reported dysphoria young and maintained it to adulthood *having experienced puberty*. Because the rates of desistance dropped precipitously in these studies when puberty was arrested or hormones were administered.
Anything else is just not responsive.
Diane @ 25
I mean… I guess in a general case there could be complications. But Luka’s journey didn’t end at the double mastectomy. Currently 21, Luka is post menopausal, experiencing bone density issues, and in constant pain.
Honestly… If you weren’t aware of this, and you’re curious, I wouldn’t take me as a subject expert, seek knowledge.
Disingenuous? Don’t be ridiculous. I don’t say things if I don’t think they’re true.
Again, this is what you said:
Objectively, you don’t know if all of this is true or not; you either misunderstood, or just made it up.
I’d expect you, having been caught making an extreme and impressive claim that just isn’t true – after you had to be pressured to give your source in any detail – to at least say “I misunderstood, sorry about that,” in which case we could just move on. But instead you attack me and accuse me of lying. Try to do better.
Thanks for the correction re: Alexander. Doesn’t change the fact that you said things that you just don’t know, and that you were clearly wrong about in the case of Sasha.
Also, what Diane said. :-)
Also, I don’t think any important accusation made by Jamie Reed has been confirmed. (Obviously, many trivial things she said have been confirmed, like where she worked.) And there have been several cases where we know that what she said was misleading at best. (Grace’s link includes a few examples).
AFAIK, the only thing she said of any significance at all, that’s been confirmed, is that she isn’t the only employee there to have had doubts about some cases. And even that isn’t very significant. There’s a huge range between “sometimes had doubts” – at any large-scale medical practice, there will always be some employees who have doubts about some cases, because people aren’t robots and even in the best-run medical practice in the world, not every treatment can have 100% certainty – and Reed’s stronger accusations and extremist beliefs.
And now we need to know what you think “gender dysphoria” is.
A specific example: A child, identified as a girl at birth, is a tomboy, and sometimes says things like “I sometimes imagine if I were a boy.” But they never socially transition, and at no point to they ever persistently identify as a boy. (That is, saying “I am a boy,” rather than “I sometimes imagine being a boy”). Ten years later, she’s an extremely gender-typical cis girl in every way.
In your view, has she desisted?
Amp @28
What I find disingenuous (which is different from lying, but still not honest) is the hyperfocus on inconsequential data to distract from the actual point. I stand by that.
Take exactly this for instance. I think the reason Blossom (and Blaire) said that was because all seven trans people on that panel had actually made that claim, it just might have been in a different portion of the session. If I recall correctly, I believe that Sasha said it in the context of how hormones were great, but he’d have preferred a mastectomy earlier because it would have saved him some back pain due to binding, and I think the experience he mentioned in the 1:00:00-1:15:00 portion was in reference to his surgeries. But I’m loathe to slog through another hour and a half to find the timestamp.
And the reason I’m loathe to do that is because it Does. Not. Matter.
In context, my point was that sometimes the system fails to have the guardrails that you illustrated in your panel. My example was Andrew, who without providing a note from a therapist (whether he’d seen one or not), was given his first injection at 15 during his first appointment with his doctor. The color around that was a panel where all seven people (I think) expressed having been given hormones within days of their first appointment. Even if only six of the seven had said that, I would still find that shocking.
Maybe I’m missing something. Can you explain to me why that’s the point you’re focusing on?
I don’t know when Luka transitioned/received hormones, but you mentioned that he had a mastectomy first, so I assume no younger than 14. Seven years of post-menopausal life should not make one in constant pain. Most cis-women live decades after menopause–many decades in some cases where the menopause was early or the life long. Few are in constant pain. Bone density issues are harder to avoid, but manageable with a combination of lifestyle and medication.
Obviously, I don’t know Luka’s medical history, but I have to assume something went wrong. This is a risk with any medication or surgical procedure. So, yes, people who are trans should consider their options carefully, including whether and how much surgical and medical intervention they want. The same is true of cis people with medical issues. Risk and benefit have to be balanced in medicine. That’s not exceptional to gender affirming care.
Corso:
I agree. Human suffering as a result of having something unwanted happen to your body is horrifying.
Grace
First, this isn’t really accurate. Folks generally go through counseling before starting hormones and before any surgeries.
Second, what puts you, rather than the patients, their doctors, and their parents if they’re a minor, in the position to judge whether their case is “legitimate”?
You don’t mention relevant medical experience or professional experience working with LGBTQ youth as a group. What, precisely, makes you or any random layperson the arbiter of someone else’s medical care?
This is an expectation that doesn’t mesh with a lot of the avaliable evidence.
To start with, you’re assuming that a child who stops talking about a feeling has stopped experiencing that feeling. That’s one possibility. Other possibilities include experiencing negative consequences for expressing those feelings. A majority of trans kids experience bullying, and they’re at higher risk for child abuse. Even something as simple as not being believed makes it less likely that a young person will continue to express those feelings, even when they’re still occurring.
A lot of “desisters” go on to transition later in life.
Additionally, some studies that have the biggest numbers of “desisters” get those numbers by conflating gender non-conformity with trans identity. A kid who never said they were trans but played with “inappropriate” toys for their gender gets counted as a “desister” despite never having expressed a trans identity.
But that doesn’t matter when you really want your imagination to be true. Facts and evidence, iirc, Do. Not. Matter. If your imaginary situations and circumstances of the world aren’t true, how can you be a crusader for good?
This is exactly the personal philosophy I follow to stamp out satanism in day care facilities. I’m on the side of good!
Diane @ 31
What I said what that she had a mastectomy at 16 and started hormones after that and is currently 21. Again… All these questions. What are you trying to do?
Kelly @ 33
You don’t understand. I’m not doing that. I suspect that there are all kinds of illegitimate cases in the system, and that on a long enough timeline they’ll assert themselves. But I’m also fully admitting that I could be wrong, and I’m not commenting on any individual case until the patient self reports. I am listening to the patients.
Kelly @ 34
If this were true, why is it that no one has ever refuted those findings by actually running the test populations with adjusted metrics? This is the point that both you and Jacqueline don’t seem to understand. Based on the results of the desistance studies we have, I think you could probably even socially transition those kids, and absent hormonal intervention, their gender identity would align after puberty.
I am not aware of a single study that has ever showed low desistance rates in populations that were actually allowed to experience puberty.
Does anyone know of one?
It’s extremely unusual for someone in transition to have top surgery before starting HRT. It’s even more unusual for that person to be under 16. I wonder what the real story is.
Oh. It turns out that Luka didn’t have top surgery at 14, she had it at 16. So that was a lie.
I’ll wait to see the outcome of the lawsuit before I make any judgements about what actually went down. It’ll be interesting to see what the doctors’ contemporary notes say and to compare that to what Luka remembers.
I think we may have an unreliable narrator telling us about these trans kids for whom what they say in the video he’s referenced Does. Not. Matter.
I begin to suspect that someone is not telling us the truth about trans kids, but rather making things up to support his wishes about how the world currently works. The Crusades were nothing to be proud of, it turns out.
I know Jacqueline. She is a friend of mine, and we talk sometimes about the discussions on Alas.
The only data available to you is her replies. You don’t get to see the times when she chooses, for whatever reason, not to reply. You have no window on how she decides that.
Food for thought.
Grace
Corso, I have a question.
There is exactly one medical procedure which has a regret rate of zero. That procedure is suicide. In all of human history, there is not one person, ever, who has stated they regret it after committing suicide. None.
Given your repeated claims on this very thread that your primary concern about trans kids getting the same medical treatment as cis kids is that they might hypothetically regret it in the future, I am quite curious to know your stance on legalizing suicide.
Do you support the full legalization of suicide for anyone who wants it?
Corso is right. He didn’t say Luka had top surgery at 14. I misremembered a comment from Diane as being a thing Corso had claimed. My apologies for misremembering that as something you had written, Corso.
Nonetheless, my point stands. Corso told us, in comment 30, that the facts don’t matter to his argument. Similarly, Corso told us – in comment 24 – that he had no idea if what he was saying about detransition was true, but he was going to say it anyway.
Corso, alas, is not a person for whom evidence and facts matter wrt transition, trans folks, or trans kids. Corso often makes his first response to a comment I make on a thread an accusation that I’m acting in bad faith, frequently to distract from the points I bring up. While I have many flaws, acting in bad faith is not one of them But as the cliche goes, every accusation is a confession. That cliche exists for good reason.
bcb, you should know that there actually is a way to measure some amount of suicide regret rate: jumpers.
Bridge-jumping is a common way to kill yourself, but it’s unreliable, and there are often survivors. A majority of the survivors (I don’t recall the percentage; it’s been awhile) regard it as a mistake in the moments after they have jumped and before they hit the water.
So, it turns out that the measurable suicide attempt regret rate is far, far higher than the regret rate for gender-affirming surgeries, which is astonishingly low, much lower than surgeries for elective procedures and medically necessary surgeries.
Grace
My apologies for creating confusion on when Luka underwent top surgery. Earlier Corso had said that it was before hormones and I was trying to calculate when the earliest it could plausibly have been to give a worst case scenario.
My apologies for misgendering Luka. I had made the erroneous assumption that she had transitioned and continued to identify as male. Clearly wrong and bad practice to make such assumptions.
As far as when it happened, you had previously said that she had a mastectomy before starting hormones. If you said what her age was at that point, I missed it. See above.
I’m puzzled by the first statement, since my most recent comment contained zero questions. However, to answer your question, I’m trying to get you to think about the plausibility of what is being reported medically and think about what might be being left out.
For example, if Luka had the mastectomy before hormones and at the age of 16, she presumably didn’t start hormones until she was 17. Maybe still at 16 at the outside. So if she is post-menopausal at 21, she has been post-menopausal for, at most, 5 years, probably less. Severe osteoporosis or osteomalacia and chronic pain are not normal effects of being post-menopausal for 5 years. No, not even if the menopause was induced at age 16 (or later). There are quite a number of people who have been made surgically post-menopausal in their late teens because of various issues (BRCA mutation, illness, etc). They are not universally or even usually in constant pain or experiencing severe osteoporosis in their early 20s. There is something else going on that is not being reported.
Indeed, since the story was in the NY Post, I have doubts about any of it. The Post was run by Murdoch for many years and still has the same editorial and reporting biases as during the Murdoch era. Murdoch also ran Fox News. The same Fox News that, when accused of libel, defended itself by claiming that they were an entertainment network and no sensible person would take their “reporting” to be a true report of events. So, what does that say about how likely it is that Luka’s story is being completely and fairly described?
Corso, you’re banned from this thread.
In your most recent two comments in a row (neither of which is now approved) you, in part or most of the post, have written things that aren’t arguments, but just purely attacks on Jacqui. Not even “you’re wrong and I think you’re speaking in bad faith because ______________.” Just flat-out insulting Jacqui with no actual argument.
Jacqui is a very good friend of mine, who I’ve known for decades. She’s not a troll. Like you, she’s someone who is passionate about her beliefs. Unlike you, when it comes to trans related issues, she actually has stakes in the argument; you have no stakes here, comparatively.
You and Jacqui have both acted in ways that aren’t ideal, imo, in that both of you have talked about each other, rather than sticking purely to arguments. I think that’s totally understandable – although again, given which of you has actual stakes here, much more understandable in Jacqui’s case. But we all lose our tempers in arguments, me included.
But with your two most recent comments, you’ve stepped over a line, and can’t continue to let this discussion spiral.
So: Don’t post on this thread. Not at all. Don’t reply to this comment from me, either. Or reply to anything in this thread on an open thread. Just accept that your participation in this thread has ended.
And consider that I’ve let you make HUNDREDS of comments in which you’ve disagreed with me, often in ways that pissed me off. But this may literally be the first time I’ve moderated you like this. (If not, it certainly hasn’t happened often). So maybe consider that if I’m finally moderating you here, where I haven’t in the past, it’s not because I’m treating you unfairly; it’s because you’ve crossed the line here moreso than your usual.
No apology necessary, Dianne, that was entirely my mistake. I’ve done it before and I’ll do it again.
You know what surgery I believe there should have been guardrails for? Rhinoplasty. I was definitely pushed into it before I was 17, I never found it beneficial and, over 3 decades later, I’ve had to have 2 more surgeries, so far, to repair the damage. I wonder why there’s no outrage about teens being pressured into rhinoplasty. Probably because it’s not seen as gender affirming by the anti-trans crowd.
In addition, let me say that I don’t feel my transition was significantly delayed by the guardrails in place. It took that long because there are guardrails for gender affirming care for trans people. If I hadn’t needed reconstruction after surgery I might not have had top surgery at all. As to needing letters from 2 therapists to get bottom surgery – that’s the way it works pretty much globally. That’s the standard of care and it’s not exceptionally onerous. The current standards of care for gender affirming treatment, while not perfect, make transitioning a hell of a lot more accessible than the standards that were in place before. If we’d been following the WPATH standards, I’d have transitioned in 1998, if not earlier. Why don’t the anti-trans care people care about the damage I suffered by that 20 year delay? IMO, it’s because they’re not concerned about the harm. No, their concerns lie elsewhere. What they ignore entirely is a pretty clear indicator of that.
If you don’t know what they are, look up the WPATH standards. Guardrails – more properly called standards of care exist – and anyone who tells you otherwise is either wrong or lying.
Agree with you on that. An in law of mine had much the same experience. I don’t think I want to go as far as to say that cosmetic surgery should never be legal for children, but it should be rare and only after careful consideration (and making sure that the child is really in favor of it, not being pushed into it by their parents…which means a therapist evaluation and probably social work as well.)