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?

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Colin Wright Offers a Front Row Seat to a Seminar Featuring Gender Ideology

Colin Wright is a biologist who has followed transgender issues for years and who is not afraid to ask obvious questions. He recently attended an online workshop directed to parents, facilitated by two purported experts in transgender issues. The name of May 26, 2022 workshop was “Supporting Your Trans/Non-Binary Youth: A Starter Guide for Parents and Caregivers." Wright's article sets forth the content of the the seminar along with his criticisms and concerns. You can read Wright's entire article here: "EXPOSED: Gender Workshop for Parents Supporting Trans/Non-Binary Youth Gender “experts” say that children are the real experts." These were experts who could not even tell Colin the difference between a man and a woman or a boy and a girl.

Here is Wright's summary:

This workshop represents the standard introduction into transgender issues. It is not an outlier in terms of content and ideology. The only thing that makes this workshop somewhat unique is the fact that I was there asking the questions that your standard believer never does in order to force the presenters to grapple with fundamental issues with gender ideology.

Are gender identities based on stereotypes? How are “man” and “woman” defined? How can we expect children to understand concepts that people with masters degrees claim is beyond their capacity to understand? These questions should not be viewed as aggressive or out of bounds. These are fundamental questions that any gender “expert” should be able to easily answer, but they can’t. Yet they somehow remain so sure of the truth of what they believe that they’re willing to shuttle children down the path to irreversible hormone and surgical treatments to conform to identities they readily admit are “arbitrary words to describe experiences.”

Children are not the paragons of wisdom and self-knowing that gender “experts” claim they are. Children lack the life experience and perspective to make radical permanent decisions about extreme body modification. It is the duty of parents to apply their real life experience and perspective in order to ensure their children make it through childhood with healthy bodies and minds.

Gender ideology indoctrination does the exact opposite.

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The Hurdles Faced by Science Teachers

Biologist Luana Maroja, is deeply concerned about hurdles science teachers are facing. Here article is "An Existential Threat to Doing Good Science: What scientists are able to teach and what research we can pursue are under attack. I know because I’m living it.". Here is an excerpt:

We each have our own woke tipping point—the moment you realize that social justice is no longer what we thought it was, but has instead morphed into an ugly authoritarianism. . . .

One of the most fundamental rules of biology from plants to humans is that the sexes are defined by the size of their gametes—that is, their reproductive cells. Large gametes occur in females; small gametes in males. In humans, an egg is 10 million times bigger than a sperm. There is zero overlap. It is a full binary.

But in some biology 101 classes, teachers are telling students that sexes—not gender, sex—are on a continuum. At least one college I know teaches with the “gender unicorn” and informs students that it is bigoted to think that humans come in two distinct and discrete sexes.

Even medical schools and the Society for the Study of Evolution have issued statements suggesting that sexes are on a “continuum.” If this were true, the entire field of sexual selection would be baseless, as its bedrock insight lies in the much larger female investment in reproduction, explaining the demonstrated choosiness in females (who have more to lose) and competitiveness in males (the “abundant” sex in most species, one male can fertilize multiple females). Published papers (see here, for example) ask us to be “inclusive” by limiting the sex discussion to the few species of algae and protists (such as amoebas) that have equal size gametes—even when that has no relevance to any animal or vascular plant.

In psychology and public health, many teachers no longer say male and female, but instead use the convoluted “person with a uterus.” I had a colleague who, during a conference, was criticized for studying female sexual selection in insects because he was a male. Another was discouraged from teaching the important concept of “sexual conflict”—the idea that male and female interests differ and mates will often act selfishly; think of a female praying mantis decapitating the head of the male after mating—because it might “traumatize students.” I was criticized for teaching “kin selection”—the the idea that animals tend to help their relatives.

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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.

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