The Correct Treatment for Gender Dysphoria

On the issue of gender dysphoria, I have followed Jesse Singal closely. I admire his willingness to dig deeply into the numbers and to let the numbers speak louder than the many one-size-fits-all "experts" out there (on both sides of the political spectrum). An enormous problem facing therapists and health care professionals is that the data is not clear yet. There are a lot of studies that are highly suspect for methodological reasons. Yet families are demanding treatment now and they want certitude. What should a therapist do when the evidence is not clear? To put it another way, where should they set their default? I'm not a therapist or health care professional, but I would set the default here: Don't surgically and permanently cut off an adolescent girl's breasts and inject her with male hormones (which will almost certainly render her sterile) when there is a reasonable possibility that the gender dysphoria is a consequence of other psychological and health issues that can be treated (or a consequence of cultural pressures). Do no harm. Singal recently summed up his current position, which is well worth considering:

My understanding of social transition is that it is a psychological intervention that may itself have downsides, such as making it harder for the kid to grow out of his or her gender dysphoria (I don’t think this is established, but I do think you can make a circumstantial case that it’s sometimes true from the available evidence). So even that shouldn’t be approached lightly — you should be certain the kid’s gender dysphoria is durable, severe, and causing problems. Is it “many” kids who fit these criteria? I dunno. Same deal with medical treatments. They really, really shouldn’t be taken lightly. The evidence base sucks, regardless of what major liberal media figures keep saying. A kid should go on blockers or hormones only if they’ve been assessed very carefully.

I don’t think there’s any evidence that treating gender dysphoria qua gender dysphoria with “therapy and medication” will do much good in most cases. I do think that in some subset of instances in which a kid tells a therapist they have gender questions, or definitely feel they are some “other” gender than their biological sex, basic exploration of other factors will reveal some other issue. Sometimes it might be recent trauma, sometimes it could be anxiety or depression, and sometimes it could be other issues involving, say, the onset of puberty. I think those issues probably can be treated with therapy and drugs, at least in a lot of cases, and that doing so may cause the gender issues to abate, because they weren’t the root issues in the first place.

There’s a lot of disagreement among clinicians over whether the causal chain (1) is always gender dysphoria → other psychological issues, or (2) whether it can sometimes go in the other direction. This is a pretty high-stakes question, because it obviously will affect the direction of therapy. If a kid has gender questions, anxiety, and depression, then a therapist operating under (1) will assume that ameliorating the GD will in turn ameliorate the other issues (so no need to pay them much mind at first), while a therapist operating under (2) will have more of a winding road to traverse.. ..

Anyway, all of this is to say that no, I haven’t been swayed from the idea that on balance, these treatments are probably good for kids who would otherwise suffer from severe, unremitting gender dysphoria. But even in these instances, no one should act like they know exactly what they’re doing. Sometimes even severe, prolonged cases of GD go away!

I am concerned that much of what passes as dysphoria is cultural dissing of women, passed by contagion. The following Tweet thread was well articulated.

Much of this resonates with me. Society has, in many ways, belittled women. If you think this is overstatement, go turn on your TV. Our culture continues to do this in thousands of ways. If I were about to be born and you could choose your sex and you would be growing up in the United States, what is the likelihood that you would choose to be a girl in our current cultural stew?

Continue ReadingThe Correct Treatment for Gender Dysphoria

Colin Wright Warns of the Danger Posed by Innocuous-Seeming Requests for “Pronouns”

I have no business telling any adult what to do with his or her body. That is their own business. It's a different story with children. We need to make sure that our children (and their parents) are not being given false information that leads to irreversible physical damage to their bodies (cross-sex hormones and surgeries), in many cases leading to sterility. There are real cases of gender dysphoria but, historically speaking, they have been rare (1/10,000) and they have overwhelmingly been boys. Today, almost 2% of teenagers are claiming to be transgender and they are overwhelmingly girls who tend to fall into social clusters, which would not be expected if dysphoria were truly a medical condition.

What is going on and why should be be concerned? Much of the left-leaning news media cheerleads for those who promote gender ideology and totally ignore the numerous and growing cases of those teenagers who detransitioned--who permanently altered their bodies, often through double mastectomies then, years later, declared that they were, indeed, the sex aligning with their chromosomes, their gametes and their sex organs readily apparent at birth. It's not rocket science to figure out the sex of most people (intersex cases are extremely rare). These stories by numerous detransitioners are extremely difficult to read. They are stories of deep regret, stories of how these teenagers got caught up in a fad encouraged by their peers, and enabled by well-meaning activist school teachers and counselors, as well as almost instant access to cross-sex hormones, often at Planned Parenthood. The parents are often concerned that they must allow their children to transition based on commonly touted but false statistics and unsubstantiated claims that suicide is the only other option.

Biologist Colin Wright recently wrote "How to Make a Trans Kid." It is well-written and accurate upon my own extensive readings. I recommend reading Wright's entire article. Here is an excerpt:

Most people understand the terms “man” and “boy” refer to adult and adolescent human males, respectively, and that “woman” and “girl” refer to adult and adolescent human females, respectively. These are not “identities,” but terms that describe objective facts about one’s age and biological sex.

Gender ideology, conversely, is a belief system asserting that what makes someone a woman or a girl, or a man or a boy, has nothing whatsoever to do with their sex, but is based entirely on the social roles and stereotypes with which they “identify.” Therefore, a person who identifies with feminine roles and stereotypes is a girl or woman, and a person who identifies with masculine roles and stereotypes is a boy or man—regardless of their biological sex. According to gender ideology, people who do not identify with the social roles and stereotypes typically associated with their sex are considered “transgender.”

That’s Gender Ideology 101. If it comes across as completely insane, that’s because it is.

Gender ideology has therefore proven to be a hard sell for many adults who rightfully view such ideas as regressive and sexist. After all, this worldview entails that a woman who does not fully embrace femininity is not actually a woman, and a man who does not embrace masculinity is not actually a man. If this sounds similar to the regressive and oppressive system that women’s and other human rights groups fought for decades to overcome, that’s because it is. But it’s actually much worse, since it also promotes the idea that a “mismatch” between one’s sex and “gender identity” can be medically “corrected” with hormones and surgeries.

[More . . . ]

Continue ReadingColin Wright Warns of the Danger Posed by Innocuous-Seeming Requests for “Pronouns”

Reading the Polls Regarding Transgender Ideology

Are you trying to interpret polls regarding transgender ideology? At City Journal, Leor Sapir warns us about the terminology and the numbers:

Last April, a Marist poll commissioned by the organization Do No Harm asked 1,377 Americans about their views on the infiltration of “social justice” ideology into medicine. One question asked whether “minors who identify as transgender and want to undergo hormone treatment or gender transition surgery” should be able to do so “without parental consent,” “only with parental consent,” or not until adulthood (regardless of parental consent). Only 10 percent of all adults surveyed said that minors should be able to access these interventions without parental consent. Twenty-five percent said that parental consent should be required, and 60 percent said minors should never be subject to hormonal or surgical interventions in this context (5 percent were unsure). These findings more or less track with those from a recent New York Times/Siena Poll on (among other things) teaching “sexual orientation and gender identity” content in elementary schools, and it is reasonable to assume that the same people who believe it’s unacceptable for teachers to introduce first-graders to, say, the concept of “non-binary” also think that 12-year-old children should not be given puberty blockers for feeling like they were “born in the wrong body.”

It’s useful to compare the Marist poll with yet another recent poll, this one by Pew, which deals with gender-identity issues, as a way to illustrate the importance of how questions are phrased. The Pew poll asked whether it should be “illegal for health care professionals to provide someone younger than 18 with medical care for a gender transition.” Note how this phrasing avoids specifying the procedures (hormones and surgeries), uses terms like “professionals” and “medical care,” and shifts the focus from the procedures themselves to the issue of state involvement in the doctor-patient relationship. Unsurprisingly, public opinion was more evenly divided in the Pew poll, though a plurality still favored restrictions: 46 percent said they support making it illegal for providers to administer medical intervention, 30 percent opposed it, and 22 percent were undecided.

Sapir also warns us about the euphemisms. He lists these in particular:

“Hormone replacement therapy.” A person administered cross-sex hormones (testosterone or estrogen), usually through periodic injections, is not having his or her hormones “replaced;” rather, hormones are introduced to counter the effects of the body’s natural hormone production.

“Gender dysphoria.” For those going through or after puberty, the relevant experience here is usually a strong aversion to one’s body parts (such as breasts) or to the body’s natural processes (for example, menstruation).

“Cisgender.” Activists define this as “identifying with the sex one was assigned at birth,” but what this word really means in practice is the lack of debilitating distress associated with one’s sexed body. To be “cisgender” means to feel comfortable, or comfortable enough, with your body and its natural processes such that you don’t seek to make it appear like that of the other sex.

“Children know their gender identity.” This language obscures the key question of whether even sincere and stable cross-gender feelings—or indeed any feelings—in fact amount to “knowledge.”

“LGBTQIA+.” The sole purpose of this acronym is to enable activists making radical claims about human nature and society to piggyback off the far more broadly accepted claims of gay rights.

Continue ReadingReading the Polls Regarding Transgender Ideology

Maybe Next Time There is a Pandemic, We Will Do a Cost-Benefit Analysis Before Shutting Down Schools

Excerpt from a new article at Reason: New Data Show COVID School Closures Contributed to Largest Learning Loss in Decades: Teachers unions and progressive politicians pushed for school closures during the pandemic.

Last week, the National Center for Education Statistics (NCES) released new data showing a dramatic decline in test scores among American 9-year-olds since the start of the COVID-19 pandemic. The data indicate a devastating learning loss among American schoolchildren, marking the largest decline in reading scores since 1990, and the first ever recorded drop in mathematics scores.

These results come from a special administration of the National Assessment of Educational Progress long-term trend (LTT) assessments, which measured reading and mathematics outcomes among 9-year-olds. Since its inception, the LTT has tracked a steady rise in educational performance among 9-year-olds. However, from 2020 to 2022, the LTT revealed a steep drop in 9-year-old students' performance. Reading scores dropped by five points over the two-year period, while mathematics scores dropped by seven points. In all, the decline in test scores represents the reversal of around two decades of improvement in math and reading scores.

"These results are sobering," Peggy G. Carr, commissioner of the National Center for Education Statistics, told The Washington Post. "It's clear that covid-19 shocked American education and stunted the academic growth of this age group."

Glenn Greenwald was excoriated by many people when he suggested (in August 2021) that we do a cost-benefit analysis before shutting down schools. We do such a cost-benefit analysis in most other walks of life, such as automobile safety. We failed to think rationally with regard to our schools and now we've hurt millions of children. Too many of us became obsessed with achieving something that clearly impossible: Zero Covid." Too many of us were not interested in looking at statistics showing that Covid presented only a tiny risk to most school children. We did not follow the science.  Why are so many people still not willing to admit that Ron DeSantis made the right call about keeping the schools open in Florida? Why am I not confident that we've learned a damned thing from this tragedy?

Continue ReadingMaybe Next Time There is a Pandemic, We Will Do a Cost-Benefit Analysis Before Shutting Down Schools

Citing Accurate Statistics Can be Harmful to Your Career: The Cases of Zac Kriegman and Roland Fryer

Zac Kriegman lost his job at Thomson Reuters for the sin of doing his job well.  Citing accurate statistics collided with the prevailing Black Lives Matter narrative regarding the extent of police violence against unarmed blacks.  Unfortunate for his career, Kriegman also concluded that the Ferguson Effect stemming from the BLM protests and riots has resulted in the deaths of thousands of black men.

[Please assume that wherever I use the terms "black" or "white" that I am using these terms in scare quotes.  I am asking readers to make this assumption because I am convinced that concept of "race" is illusory and pernicious and should be eliminated from all discourse. I am quite aware that people come in various shapes and shades of skin color, but none of this is evidence supporting a belief in "race."  I have been convinced that this is the proper course based on writings of Sheena Mason, Thomas Chatterton Williams, Zuby (and see here), Kmele Foster, Coleman Hughes, Angel Eduardo and Inaya Folarin Iman.  In an earlier post, I characterized the belief in "race" to be as absurd as the belief in astrology.]

What follows is an excerpt from Kriegman's article at Common Sense, "I Criticized BLM. Then I Was Fired: The data about police shootings just didn't add up, but no one at Thomson Reuters wanted to hear it.":

I had been following the academic research on BLM for years (for example, here, here, here and here), and I had come to the conclusion that the claim upon which the whole movement rested—that police more readily shoot black people—was false.

The data was unequivocal. It showed that, if anything, police were slightly less likely to use lethal force against black suspects than white ones.

Statistics from the most complete database of police shootings (compiled by The Washington Post) indicate that, over the last five years, police have fatally shot 39 percent more unarmed whites than blacks. Because there are roughly six times as many white Americans as black Americans, that figure should be closer to 600 percent, BLM activists (and their allies in legacy media) insist. The fact that it’s not—that there’s more than a 500-percentage point gap between reality and expectation—is, they say, evidence of the bias of police departments across the United States.

Continue ReadingCiting Accurate Statistics Can be Harmful to Your Career: The Cases of Zac Kriegman and Roland Fryer