Re: "No treatment with such low-quality evidence can be described as evidence-based, life-saving, and/or medically necessary": I hope some health insurance reps were at the conference.
Your last point is something I haven't thought about but so important! We need to be clearer about the differences between ROGD (especially the classic case of the highly distressed adolescent girl who finds "gender dysphoria" through online or peer groups and latches onto it as a way to understand, express, and deal with extreme distress that is not actually gender dysphoria) vs traditionally gender dysphoric children as seen in the Dutch studies needing to be separated out and recognized as different and needing different approaches I think these two very different groups have become so conflated in the debates over this and it's not helping anyone. It reminds me of the excellent and 100% essential point that I once heard Leor Sapir make about why he doesn't like the term "gender ideology." It's because it allows the conflation of two very different ideas that have only surface similarities: the biological "born in the wrong body" gender dysphoria framework and queer theory. These two frameworks are largely contradictory yet they end up getting lumped together under the larger umbrellas of "trans" and "gender ideology." People often switch back and forth between the two contradictory frameworks to understand and defend ideas without understanding they're doing it, which is how we get people simultaneously arguing that your gender identity is unchangeable and fixed at birth and also fluid and always able to change while being both a social construct and located in the brain. I think maybe something similar is happening with ROGD and traditional gender dysphoria in children.
Thank you so much for this report! I only learned too late that the conference was in NYC, darn it! Also, a question: Lisa, was there any discussion/critique of the DSM-V diagnosis itself? I recently watched a video parsing each of its sections (which, with apologies, I can no longer find), and it seemed to me that part of the problem is the diagnosis itself, which is far too broad and also circular. Allied with that, wouldn’t a diagnosis called “sex dysphoria” be clearer? It does seem, and your previous article is excellent on this point, that the word “gender” no longer has any stable meaning (if it ever did), which suggests strongly to me that using it as the basis of a psychiatric diagnosis is highly problematic. Any thoughts, Lisa, or anyone?
The Dutch model long term outcomes are starting to come out. Not what you'd show someone to convince them an intervention was medically necessary. Or beneficial. Abbruzzese et Al (2023, the myth of....) Atalks about how a large fraction of respondents have had sexual dysfunction, around 25% regret their lost fertility, and " a sizable percentage reporting one or more instances of identity changes after treatment completion, especially among the individuals on the autistic spectrum (Steensma et al., Citation2022)."
Chen et Al showed how little they improve with the affirmative criteria (sort of, as they didn't report most of the outcomes they said they'd measure, the improvements they did see were small, it seems even compared to placebo, mtf didn't improve, and 2 committed suicide - a much higher suicide fraction than in the treated or waitlisted groups in the UK). Singal has torn this apart as has an excellent Reddit essay.
There are surely some happy with their transition but it is not clear how to identify them ahead of time. Given the thousands in the US who have been medicalized, this information is walking around out there and we should push the ("keep sending us your kids") clinicians to show up what happened to them.
We wouldn't take this sort of outcome ignorance as ok for cancer treatment, but somehow, for kids and young people, where it's not even known what will happen to these young people without medical intervention (we know with cancer,cancer worsens), we just as a society, say,sure?!
We have the Dutch and others just saying they were happy a year later,even with times to regret on the 4-10 year time scales (on average!). We know there are short term outcomes that change after a year or two for many.
The evidence is walking around here in the US, and should be collected!
Thank you so much for this heartening update from the SEGM conference. Very eager to learn more about what was shared re: social transition especially with regard to the new cohort of teenage girls.
I suggest watch a new YouTube channel, a male detransitionver, Ray Williams (also the name of the channel) in which he describes stopping estrogen because of "health issues" (probably blood clots, high blood pressure, etc) and now just "dressing" at home because "my wife doesn't mind." If his wife grows tired of his dress up time (I never witnessed this, but most of the trans widows in my data of 54 of did tire of this charade) and his sexualization of his erogenous self as female, she may leave. Then will he "retransition" and blame his wife, as so many do? Since he's in his thirties and making good money in tech, would he push for a uterus from some woman implanted in his lower torso?
Re: "No treatment with such low-quality evidence can be described as evidence-based, life-saving, and/or medically necessary": I hope some health insurance reps were at the conference.
Your last point is something I haven't thought about but so important! We need to be clearer about the differences between ROGD (especially the classic case of the highly distressed adolescent girl who finds "gender dysphoria" through online or peer groups and latches onto it as a way to understand, express, and deal with extreme distress that is not actually gender dysphoria) vs traditionally gender dysphoric children as seen in the Dutch studies needing to be separated out and recognized as different and needing different approaches I think these two very different groups have become so conflated in the debates over this and it's not helping anyone. It reminds me of the excellent and 100% essential point that I once heard Leor Sapir make about why he doesn't like the term "gender ideology." It's because it allows the conflation of two very different ideas that have only surface similarities: the biological "born in the wrong body" gender dysphoria framework and queer theory. These two frameworks are largely contradictory yet they end up getting lumped together under the larger umbrellas of "trans" and "gender ideology." People often switch back and forth between the two contradictory frameworks to understand and defend ideas without understanding they're doing it, which is how we get people simultaneously arguing that your gender identity is unchangeable and fixed at birth and also fluid and always able to change while being both a social construct and located in the brain. I think maybe something similar is happening with ROGD and traditional gender dysphoria in children.
"No treatment with such low-quality evidence can be described as evidence-based, life-saving, and/or medically necessary."
And with such high risk of harm.... we're not talking about bananas Vs apples here people!
Thank you!
Thank you so much for this report! I only learned too late that the conference was in NYC, darn it! Also, a question: Lisa, was there any discussion/critique of the DSM-V diagnosis itself? I recently watched a video parsing each of its sections (which, with apologies, I can no longer find), and it seemed to me that part of the problem is the diagnosis itself, which is far too broad and also circular. Allied with that, wouldn’t a diagnosis called “sex dysphoria” be clearer? It does seem, and your previous article is excellent on this point, that the word “gender” no longer has any stable meaning (if it ever did), which suggests strongly to me that using it as the basis of a psychiatric diagnosis is highly problematic. Any thoughts, Lisa, or anyone?
Thank you!
The Dutch model long term outcomes are starting to come out. Not what you'd show someone to convince them an intervention was medically necessary. Or beneficial. Abbruzzese et Al (2023, the myth of....) Atalks about how a large fraction of respondents have had sexual dysfunction, around 25% regret their lost fertility, and " a sizable percentage reporting one or more instances of identity changes after treatment completion, especially among the individuals on the autistic spectrum (Steensma et al., Citation2022)."
Chen et Al showed how little they improve with the affirmative criteria (sort of, as they didn't report most of the outcomes they said they'd measure, the improvements they did see were small, it seems even compared to placebo, mtf didn't improve, and 2 committed suicide - a much higher suicide fraction than in the treated or waitlisted groups in the UK). Singal has torn this apart as has an excellent Reddit essay.
There are surely some happy with their transition but it is not clear how to identify them ahead of time. Given the thousands in the US who have been medicalized, this information is walking around out there and we should push the ("keep sending us your kids") clinicians to show up what happened to them.
We wouldn't take this sort of outcome ignorance as ok for cancer treatment, but somehow, for kids and young people, where it's not even known what will happen to these young people without medical intervention (we know with cancer,cancer worsens), we just as a society, say,sure?!
We have the Dutch and others just saying they were happy a year later,even with times to regret on the 4-10 year time scales (on average!). We know there are short term outcomes that change after a year or two for many.
The evidence is walking around here in the US, and should be collected!
I encourage you to just refer to Twitter and not even bother with the "ok X"... This was very heartening - thanks for the recap.
Thank you so much for this heartening update from the SEGM conference. Very eager to learn more about what was shared re: social transition especially with regard to the new cohort of teenage girls.
I suggest watch a new YouTube channel, a male detransitionver, Ray Williams (also the name of the channel) in which he describes stopping estrogen because of "health issues" (probably blood clots, high blood pressure, etc) and now just "dressing" at home because "my wife doesn't mind." If his wife grows tired of his dress up time (I never witnessed this, but most of the trans widows in my data of 54 of did tire of this charade) and his sexualization of his erogenous self as female, she may leave. Then will he "retransition" and blame his wife, as so many do? Since he's in his thirties and making good money in tech, would he push for a uterus from some woman implanted in his lower torso?
Ray Williams, in his own words:
https://www.youtube.com/watch?v=Avz6G9_TzbI&t=378s
Trans Widows, in my voice:
https://www.youtube.com/watch?v=L8-3fYh3TVc&t=540s
Were the Jack Turbans of the world represented at all?
Thank you for this update! It is very encouraging to hear- where we’re the Jack Turban’s of the world? We’re they in the room where it happened?