Receipts: Corrections to 2022 Psychology Today Piece

A tiny victory four years ago

Tue, Jan 25, 2022, 9:03 AM

Hi, XXXX and XXXX. I’m writing—in confidence—in response to this article, which makes claims about the efficacy (though not the safety) of gender-affirming care. I have been writing about gender for the last five years, mostly about gender nonconformity, and as it happens I too have spent the last few weeks sifting through many of these studies to try to access what they actually say for an article which will appear next month in a science publication. In the meantime, I attach a piece that’s going up on my Substack later this week—I will amend it to include and correct some of what you’ve published.

This piece says Abigail reviewed it, but I wanted to make sure you looked at what the studies actually assert. Most are a real mixed bag, and show both positive and negative outcomes. In addition, especially in studies of Dutch participants, those with other mental health problems would have been turned away—this is key to the Dutch protocol—and only people with higher-functioning mental health would have been gone through with medical interventions in the first place, so those who didn’t get gender-affirming medical interventions already had worse mental health.

The Dutch protocol is based on kids with lifelong gender dysphoria, who were not socially transitioned (because this practice tends to increase dysphoria at puberty). It has no bearing on the kids that make up the bulk of gender clinic practices today, whose dysphoria appears at puberty and who tend to have many co-occurring mental health problems. In addition, most of those kids with childhood GD grew out of it and the majority were same sex attracted. It is vital that we look at ALL the research, not just that which helps our own arguments or our own careers.

As for what’s actually written here, it obscures the complexity of the research. For instance, the very first entry in this article:

“Study 1: De Vries, A. L., Steensma, T. D., Doreleijers, T. A., & Cohen‐Kettenis, P. T. (2011). Puberty suppression in adolescents with gender identity disorder: A prospective follow‐up study. The Journal of Sexual Medicine, 8(8), 2276-2283.

This study from the Netherlands followed 70 transgender adolescents and measured their mental health before and after pubertal suppression. Study participants had improvements in depression and global functioning following treatment.”

Here’s what it actually says: “Feelings of anxiety and anger did not change between T0 and T1. While changes over time were equal for both sexes, compared with natal males, natal females were older when they started puberty suppression and showed more problem behavior at both T0 and T1. Gender dysphoria and body satisfaction did not change between T0 and T1. No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment.”

Clearly, there were some improvements, some things got worse, some things got better. Notably, gender dysphoria—the very reason for the treatment—did not improve.

I would also ask that you correct Turban’s assertion that those trying to correct the record on gender-affirming care research are bots. I see you have no link or citation for that. People objecting to this narrative are neither right-wing nor bigots nor bots. They are mostly against bans and feel that speaking out about the medical abuses—and there are many, which I am happy to share with you, as I’ve been cataloging them for months—are the only way to continue the medical interventions that they have seen work, after careful evaluation. They include many adult trans people, and some of the most experienced clinicians in the country, far more experienced than your writer. I am happy to put you in touch with many of these people, whom I’m sure would like to rebut this article or write other things for you.

I’d also be willing to write for you about the many trans adults who are happily transitioned but who advocate for the watchful waiting technique, or why most of the long term studies about kids with gender dysphoria don’t apply to today’s cohort, or the controversies over social transitioning. But it concerns me that you are allowing someone to cherry-pick outcomes from studies that tend to not show what he’s saying they show. You must know that there are vehement debates about how to handle this never-before seen cohort, and that the ranks of detransitioners are growing. I believe it is the media’s duty to report this story in all its complexity and honesty, and I don’t believe this article reflects that duty.

The only outlet I have found that reports well on it is Medscape. If you haven’t followed the debates there, I’d suggest looking at it.

I’m happy to talk more if either of you are open to it. I am working very hard to correct the media record on this subject, at great cost to me personally and professionally. I ask that you not forward this note to the author—or that, if you do, you don’t use my name—because I find him to be a bully who paints people who are concerned about medical abuses as bigots and transphobes. I do not wish to draw attention to myself, especially from him. I am only doing this because I believe the media has the story very, very wrong, and I only understand this after many months of going deep into the research. It’s incredibly complicated, and we should always present it that way.

Thanks,

Lisa

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Wed, Jan 26, 2022, 7:54 AM

Hello. Just making sure you both saw this. I can go through all the citations if you want and pick out what else needs to be corrected, but in the meantime if you can correct the first citation, which shows no improvement in gender dysphoria, anger or anxiety, and correct the misinformation about “bots” objecting to this care, I’d appreciate it. The main people objecting to affirmation-only are the most experienced clinicians in the country, including those who brought the medical protocol to this country, some of whom are trans. If you’d like to speak to them, I’ve been interviewing them extensively and can put you in touch.

Thanks,

Lisa

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Wed, Jan 26, 2022, 5:06 PM

Dear Lisa,

Thank you for your email, and we have updated this blog post.

Best,

XXXX

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Wed, Jan 26, 2022, 5:58 PM

Thanks so much. I see it is stealth-edited, though—is it possible to put the corrections so people who read earlier versions know that the most experienced clinicians are not bots (!) and that it was printed that global functioning improved but left out the other outcomes? Many people are trying to whistleblow—including many trans people, as I mentioned. They’re actual compassionate, lefty, empathic, kind humans who care about kids with gender dysphoria.

I will try to find time to go through the rest of the studies to see if there are other factual errors, but if you have anyone there who is able to do that, I imagine he did this cherry picking for each of the studies. I have read many of them, which is how I came to understand that what he’s asserting here isn’t supported. I don’t know if you know what’s going on in Sweden, Finland or the UK, but you can read this evidence review from the UK which showed that the research largely doesn’t support what’s happening. Nothing ideological at all—just science. Any remotely balanced article would have to include that there is tremendous disagreement about how to help these kids, and that the science is very, very unclear.

Thanks for the stealth edits for now!

Lisa

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No response ever again. Later, Leor Sapir succeeded in getting further corrections.