Another brilliant post. It does not matter how frequent detransitioning might be. The individual cases must be addressed and these people need care. The system is clearly biased against them. As a physician, I believe that our society is harmed by malpractice attorneys and juries but suing the physician and surgeon perpetrators of the kind of poor care documented in this post would be a wake-up call. Another reason not to live on the west coast.
I can add another reason why numbers for regret, detransition, and desistance are not accurately counted
My minor daughter is a desister. She was diagnosed by multiple psychiatrists with “gender dysphoria” and by one as a “transsexual.” These diagnoses were submitted to our insurance company. She was heavily encouraged to obtain hormones as soon as she could get away from us. If you read the Reuters article in which Reuters commissioned a review of private insurance records during a specified time frame to get the number of minors with a gender dysphoria diagnosis (which they reported in that article) my daughter’s diagnosis was in that number.
But now she does not identify as trans or have gender dysphoria. She said she doesn’t want that diagnosis on her insurance records. But there’s no ICD code for desistance or detransition. There’s no way to record or document that in her - or anyone else’s - records. Reuters can’t commission an insurance review and report those numbers.
Both she and I have informed individual medical professionals. How is it documented? For most, we don’t know because they refused to respond. She was no longer their patient, so it’s not their problem. One provider defended their diagnosis and refused to acknowledge the harm caused afterward. Another just changed her pronouns in their charts and went along like nothing happened.
So how is anyone going to collect and count data that isn’t coded or recorded anywhere even when it is reported
What a disturbing irony it is that "trans activists" seek to invalidate the "lived experience" of detransitioners in part by claiming "there aren't any/very many," given the solid data suggesting that trans people are about 0.6% of the population — and that they insist their own "lived experience" be adopted as gospel truth by everyone, in order for them to feel validated.
Question: if a child or young adult starts taking hormones that they obtain from a place like Planned Parenthood, then stops on their own, are they also considered Detransitioners? I’m sure PP and the like keep no record for people who get the prescriptions then just cease and never report back.
Watching this Rep. Goodwin respond to the inconvenient facts of how the system abused a young mentally-vulnerable man reminds me of the story about philosopher Cremonini, who clung to the perfection of his dogma so desperately he refused to even look through Galileo's telescope at any evidence that might disprove it.
Why is the answer to everything a bill to make insurance companies pay? Where do insurance companies get their money? From people who pay for health insurance. So you’re basically asking your neighbor to pay for transitioning and then when it doesn’t work out, asking them to pay for de transition.
The answer should be to make the doctors who advised and performed the transition pay for de transitioning. They should be held responsible. Only then will they be more careful with their diagnosis and treatment of such a serious endeavor.
Right now, they have only incentives to transition. And take no responsibility when things don’t work out.
Thank you Lisa for this thoughtful article and assessment of the situation. Frank Smith was the inspiration for the bill we drafted and Representative Jeff Leach is carrying in Texas. As we worked with Frank over the last several years on a possible lawsuit and just getting to know each other, it became clear that insurance companies (and Medicaid) need to be in for the long haul. If the upfront treatment has been deemed "medically necessary" as documented in a Blue Cross Blue Shield policy, then the long term implications, whether detrainsitioned or not, must be covered. Thanks again for your persistence in following gender.
Thank you for writing this! There must be better medical and mental healthcare for detransitioners (and may I add better mental health and social supports for desisters).
How can they continue to deny detransition care if they are going to claim it’s just a “natural” and “healthy” part of the gender journey? They can’t have it both ways.
“Yet in the trenches of trans health care, there is a growing idea that pushes back against the “one true gender for each individual” framing altogether—one that could allow us to resolve the bitterly divisive culture war over the psychological and medical care of transgender children. What if, instead of viewing gender as a fixed trait, we started to think of it as something that could evolve over the course of a lifetime? Or if detransitioning wasn’t considered a sign of failure and was instead regarded as a natural and healthy part of the gender development process?”
In her opening listing of the reasons Frank Smith gives for his medical transition, Lisa highlights his pornography addiction. Heretofore, in contrast to conservative critics, sexual liberal critics of legal and medical sex change have been generally avoiding any discussion of pornography as a causal factor. Why are these liberal critics protecting pornography? Also, it’s important to remember that children have access to the same pornography that adults do. Pornography like tobacco must be openly criticized as a social ill in terms of the consequences of its use. Thank you, Lisa, for this breakthrough.
Lisa, once again you shine a light on a woefully under covered aspect of these issues, with, as always, thorough research to guide your way, and therefore ours.
Relatedly, if folks haven’t seen this, Lisa has an excellent tweet thread in response to yet another lazy piece of reporting in the New York Times. As part of that, Lisa writes: “The Left has to stop blaming the Right for the gender culture war. Whether or not you like what they're doing with it, conservatives understand the science. They've listened to people who got hurt, to young women who lost to men they competed against. The Left didn't.” What we see in Lisa’s post are examples of that, in which not only does the R rep have the science right, but also is the one to come up with a compassionate approach, which the D side shoots down.
I’m interested, BTW, what Lisa or anyone here thinks about the MO AG’s Emergency Resolution on gender medicinal interventions. It appears to me he has got the science right, and may also, at least insofar as pediatric interventions are concerned, have a reasonable approach. Yet the New York Times, in a recent article, characterizes this as a “partial ban.” https://www.nytimes.com/2023/04/15/upshot/bans-transgender-teenagers.html Recently, when I tried to engage a friend in a discussion about this and started to describe the AG MO’s approach, she cut me short and said, “Josh Hawley. You sure are making strange bedfellows with this.”
As Jamie Reed, the St. Louis whistle blower said in her recent Triggernometry interview, the language is cult-like. In "gender" clinics, "assigned female at birth" and "assigned male at birth" (AFAB and AMAB) are used instead of boy or girl, for pre-adolescents and adolescents. It is now believed in the field that, because Black females often go through puberty earlier than whites, they should get puberty blockers as early as age 9. Required is accurate, sex-based terms, such as cross-sex ideation, genital plastic surgeries, mastectomies, penile and testicle removal. The harsh realities of these treatments, completely unsupported by peer-reviewed or quality research, will surface. Dr. Ray Blanchard's "true life test" cited in my divorce papers by my former husband and his diagnosing psychologist, is not in any way reflecting an approximation of "true life." My ex was allowed to present to our sons as their father, did not explain why he dressed differently, and only told them after the surgeries. His journals recording this, which he took dutifully to his "therapy' with an uncertified practitioner, went on in gay bars in Greenwich Village, where he flirted with gay men. The entire diagnosis, as per expert witness testimony of Dr. Stephen B. Levine, is unstable and unpredictable. The Triggernometry interview with Jamie Reed is a must view for all of you here.
Would that it was just the coastal elites. The same thing is happening in Minnesota, which recently became a sanctuary state both for women seeking abortions and for those with gender dysphoria who want "gender affirming" care. Of course, the radical right's obsessive focus on this also doesn't help get us to a place where we can have real, civil, honest discussions about the issues related to this phenomenon.
I have been going back to KathyD’s excellent question, and how, as pediatric medical gender interventions are permitted and insured, it puts us in what I would call a doom loop, as I think Lisa is right, it then requires insurers to cover correction of bad outcomes experienced by detransitioners.
This brings me back to the concept of medical necessity, and I pose this question to all here for your thoughts. “Gender identity” is an idea, not a physical fact, condition, or disease. Under what circumstances is it medically necessary to medically “treat” a person for that idea, and what treatments should be considered medically necessary?
Another brilliant post. It does not matter how frequent detransitioning might be. The individual cases must be addressed and these people need care. The system is clearly biased against them. As a physician, I believe that our society is harmed by malpractice attorneys and juries but suing the physician and surgeon perpetrators of the kind of poor care documented in this post would be a wake-up call. Another reason not to live on the west coast.
I can add another reason why numbers for regret, detransition, and desistance are not accurately counted
My minor daughter is a desister. She was diagnosed by multiple psychiatrists with “gender dysphoria” and by one as a “transsexual.” These diagnoses were submitted to our insurance company. She was heavily encouraged to obtain hormones as soon as she could get away from us. If you read the Reuters article in which Reuters commissioned a review of private insurance records during a specified time frame to get the number of minors with a gender dysphoria diagnosis (which they reported in that article) my daughter’s diagnosis was in that number.
But now she does not identify as trans or have gender dysphoria. She said she doesn’t want that diagnosis on her insurance records. But there’s no ICD code for desistance or detransition. There’s no way to record or document that in her - or anyone else’s - records. Reuters can’t commission an insurance review and report those numbers.
Both she and I have informed individual medical professionals. How is it documented? For most, we don’t know because they refused to respond. She was no longer their patient, so it’s not their problem. One provider defended their diagnosis and refused to acknowledge the harm caused afterward. Another just changed her pronouns in their charts and went along like nothing happened.
So how is anyone going to collect and count data that isn’t coded or recorded anywhere even when it is reported
I just sent this to my governor. thank you!!!!!
What a disturbing irony it is that "trans activists" seek to invalidate the "lived experience" of detransitioners in part by claiming "there aren't any/very many," given the solid data suggesting that trans people are about 0.6% of the population — and that they insist their own "lived experience" be adopted as gospel truth by everyone, in order for them to feel validated.
Question: if a child or young adult starts taking hormones that they obtain from a place like Planned Parenthood, then stops on their own, are they also considered Detransitioners? I’m sure PP and the like keep no record for people who get the prescriptions then just cease and never report back.
Watching this Rep. Goodwin respond to the inconvenient facts of how the system abused a young mentally-vulnerable man reminds me of the story about philosopher Cremonini, who clung to the perfection of his dogma so desperately he refused to even look through Galileo's telescope at any evidence that might disprove it.
Why is the answer to everything a bill to make insurance companies pay? Where do insurance companies get their money? From people who pay for health insurance. So you’re basically asking your neighbor to pay for transitioning and then when it doesn’t work out, asking them to pay for de transition.
The answer should be to make the doctors who advised and performed the transition pay for de transitioning. They should be held responsible. Only then will they be more careful with their diagnosis and treatment of such a serious endeavor.
Right now, they have only incentives to transition. And take no responsibility when things don’t work out.
Thank you Lisa for this thoughtful article and assessment of the situation. Frank Smith was the inspiration for the bill we drafted and Representative Jeff Leach is carrying in Texas. As we worked with Frank over the last several years on a possible lawsuit and just getting to know each other, it became clear that insurance companies (and Medicaid) need to be in for the long haul. If the upfront treatment has been deemed "medically necessary" as documented in a Blue Cross Blue Shield policy, then the long term implications, whether detrainsitioned or not, must be covered. Thanks again for your persistence in following gender.
Thank you for writing this! There must be better medical and mental healthcare for detransitioners (and may I add better mental health and social supports for desisters).
How can they continue to deny detransition care if they are going to claim it’s just a “natural” and “healthy” part of the gender journey? They can’t have it both ways.
“Yet in the trenches of trans health care, there is a growing idea that pushes back against the “one true gender for each individual” framing altogether—one that could allow us to resolve the bitterly divisive culture war over the psychological and medical care of transgender children. What if, instead of viewing gender as a fixed trait, we started to think of it as something that could evolve over the course of a lifetime? Or if detransitioning wasn’t considered a sign of failure and was instead regarded as a natural and healthy part of the gender development process?”
https://thewalrus.ca/new-gender-paradigm/
In her opening listing of the reasons Frank Smith gives for his medical transition, Lisa highlights his pornography addiction. Heretofore, in contrast to conservative critics, sexual liberal critics of legal and medical sex change have been generally avoiding any discussion of pornography as a causal factor. Why are these liberal critics protecting pornography? Also, it’s important to remember that children have access to the same pornography that adults do. Pornography like tobacco must be openly criticized as a social ill in terms of the consequences of its use. Thank you, Lisa, for this breakthrough.
Lisa, once again you shine a light on a woefully under covered aspect of these issues, with, as always, thorough research to guide your way, and therefore ours.
Relatedly, if folks haven’t seen this, Lisa has an excellent tweet thread in response to yet another lazy piece of reporting in the New York Times. As part of that, Lisa writes: “The Left has to stop blaming the Right for the gender culture war. Whether or not you like what they're doing with it, conservatives understand the science. They've listened to people who got hurt, to young women who lost to men they competed against. The Left didn't.” What we see in Lisa’s post are examples of that, in which not only does the R rep have the science right, but also is the one to come up with a compassionate approach, which the D side shoots down.
I’m interested, BTW, what Lisa or anyone here thinks about the MO AG’s Emergency Resolution on gender medicinal interventions. It appears to me he has got the science right, and may also, at least insofar as pediatric interventions are concerned, have a reasonable approach. Yet the New York Times, in a recent article, characterizes this as a “partial ban.” https://www.nytimes.com/2023/04/15/upshot/bans-transgender-teenagers.html Recently, when I tried to engage a friend in a discussion about this and started to describe the AG MO’s approach, she cut me short and said, “Josh Hawley. You sure are making strange bedfellows with this.”
As Jamie Reed, the St. Louis whistle blower said in her recent Triggernometry interview, the language is cult-like. In "gender" clinics, "assigned female at birth" and "assigned male at birth" (AFAB and AMAB) are used instead of boy or girl, for pre-adolescents and adolescents. It is now believed in the field that, because Black females often go through puberty earlier than whites, they should get puberty blockers as early as age 9. Required is accurate, sex-based terms, such as cross-sex ideation, genital plastic surgeries, mastectomies, penile and testicle removal. The harsh realities of these treatments, completely unsupported by peer-reviewed or quality research, will surface. Dr. Ray Blanchard's "true life test" cited in my divorce papers by my former husband and his diagnosing psychologist, is not in any way reflecting an approximation of "true life." My ex was allowed to present to our sons as their father, did not explain why he dressed differently, and only told them after the surgeries. His journals recording this, which he took dutifully to his "therapy' with an uncertified practitioner, went on in gay bars in Greenwich Village, where he flirted with gay men. The entire diagnosis, as per expert witness testimony of Dr. Stephen B. Levine, is unstable and unpredictable. The Triggernometry interview with Jamie Reed is a must view for all of you here.
This piece is powerful and focused on a critical issue. Thank you, Lisa!
Would that it was just the coastal elites. The same thing is happening in Minnesota, which recently became a sanctuary state both for women seeking abortions and for those with gender dysphoria who want "gender affirming" care. Of course, the radical right's obsessive focus on this also doesn't help get us to a place where we can have real, civil, honest discussions about the issues related to this phenomenon.
I have been going back to KathyD’s excellent question, and how, as pediatric medical gender interventions are permitted and insured, it puts us in what I would call a doom loop, as I think Lisa is right, it then requires insurers to cover correction of bad outcomes experienced by detransitioners.
This brings me back to the concept of medical necessity, and I pose this question to all here for your thoughts. “Gender identity” is an idea, not a physical fact, condition, or disease. Under what circumstances is it medically necessary to medically “treat” a person for that idea, and what treatments should be considered medically necessary?
Good read thx u