Hey look, we’re back to concern-trolling trans people so that we can deny them care again
I’m not concern trolling. I genuinely don’t know the science and I’m genuinely interested in learning. To me, it seems like supporting transgender adults is obviously right, because they’re free individuals and they should be able to do what they want to do regardless of what I or anybody thinks about it. But, to me it seems a lot less clear for adolescents; it’s a confusing time of life, and giving children the ability to make that type of permanently life-altering decision at seems a lot less obviously right. That’s not any kind of code for anything malicious (just like when I talk to conservatives about certain things, it shouldn’t get dismissed as “virtue signaling”). That is honestly what I think. Maybe I am wrong, but in the meantime, am I allowed to say so?
I don’t actually necessarily think that there’s a contradiction between the Economist article and the links Huckleberry sent (which I did take a look at, yes). Huckleberry points to clear research that indicates that as a whole, giving gender-affirming care to transgender individuals is overwhelming good for them. I can believe that. The Economist says that when you limit it to adolescents, it’s a lot less clear. I can also believe that. Do you have sources indicating clear positive outcomes for adolescents? Like I say, I’m genuinely interested in learning.
One thing that I would like to make clear is that I was not calling you a concern troll. However, this article is absolutely concern trolling in an attempt to de-legitimize the concept of being trans and the practice of providing gender-affirming treatment for trans children. The problem with all of the arguments made in articles like this is that they can’t explain why giving puberty blockers to trans teens is bad, they just pretend like we don’t know the side effects of these drugs in children. We know the side effects. We’ve been prescribing these drugs to children for decades, and it was never controversial until we started giving it to trans kids. These drugs are safe, with minimal side effects (see previous citation, as well as those at the bottom). The Economist was not concerned about these drugs being given to children with precocious puberty prior to its application to trans children. Publications like The Economist and the NY Times are only wringing their hands about this because the people writing these articles do not want trans kids to get care. Period. Puberty blockers are safe for kids with precocious puberty, but not for trans kids. Cis teen girls get 3,200 cosmetic breast implants and 4,700 breast reduction in the US each year, and The Economist has no editorial position on that . They are, however, very concerned about the 200 gender-affirming top surgeries performed each year. These treatments are fine for cis kids, safe for cis kids, but for some reason we have lots of concerns about how these treatments will affect trans kids. Because certain groups in this country are very focused on finding arguments that will allow them to deny gender-affirming care to trans kids. This seems like a good time to note that while 78% of trans people report wanting hormone therapy (note: this is trans adults, not trans kids), but only 49% get it (source is the 2015 US transgender survey. PDF warning on this link. This is a very interesting document that I would recommend reading in detail). 15% reported wanting puberty blocking medications, but only 1% reported getting them. Keep that in mind when you read these concern troll articles. All this hand-wringing over a tiny percentage of trans people, which is already a tiny percentage of the population. But I suppose it’s worth it if the overall goal is to make sure that 0% of trans kids get gender affirming care
And, of course, there’s always the question of de-transitioning and people regretting the changes done to their body during the transition process. One thing I would like you to think long and hard about, is the fact that 20% of people who get total knee replacements are dissatisfied with their outcome. 1 in 5 that get knee surgery are unhappy with the results, and that’s a surgery that is generally very successful. Compare that to transitioning (this includes all forms of transition, however only 25% of trans people have any type of gender affirming surgery, source 2015 US transgender survey). Only 8% of trans people report de-transitioning. 62% of them do so temporarily and return to living as trans full time. So less than 4% of trans people de-transition permanently. And the great thing about puberty blockers is that if someone wants to de-transition during the course of taking them, all they have to do is to stop taking them, at which point they will go through puberty
What bothers me the most about articles like this is that they paint a world of medical and psychological care for trans kids that simply does not exist. The vast, vast majority of them will receive no gender affirming care before the age of 18. Those that do need to receive significant psychological assessment before being put on puberty blockers. For nearly all trans kids, treatment ends here until after they have reached adulthood. Many will continue to be denied care in adulthood. These articles act like trans kids are having their genitals surgically altered before the age of 18, and I simply have not seen any credible assertion that this happens at all. But for some reason, we need to keep asking the question of whether it is safe to treat trans kids over and over again even though it is easy to show that it is both safe and leads to far better outcomes for them (see below)
Anyway, you wanted articles discussing the effects of puberty blockers on kids. Here they are:
Here’s an article looking at 84 trans kids on puberty blockers. The only adverse outcome was one person stopping the treatment due to mood swings: https://www.jpeds.com/article/S0022-3476(13)01364-4/fulltext
Here’s another study looking at 89 kids on puberty blockers. No adverse outcomes noted, and use of puberty blockers in adolescence was associated with a decreased suicide risk: https://publications.aap.org/pediatrics/article/145/2/e20191725/68259/Pubertal-Suppression-for-Transgender-Youth-and?autologincheck=redirected
Study of 201 trans youth that found that kids using puberty blockers fared better than those that received no treatment and those that received psychological treatment alone: https://academic.oup.com/jsm/article-abstract/12/11/2206/6980064
Longitudinal study of 55 trans adults that received puberty blockers as kids. Turns out that their well-being is similar to same-age young adults from the general population: https://publications.aap.org/pediatrics/article-abstract/134/4/696/32932/Young-Adult-Psychological-Outcome-After-Puberty
If you feel that those articles are cherry-picked, here’s a recent literature review: https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12437?casa_token=0douQYkH2gQAAAAA:_LXV46NipUXSCNWFxYr_dyGbCDEXXpG6wcVXoaTuwyZa57JWjUBoEe85pOSX-44j2a3A1D9YXkmmd48
Just in case you missed this one earlier, here’s a review of the use of puberty blockers for precocious puberty. It turns out that they are safe and effective and for some reason totally uncontroversial: https://pubmed.ncbi.nlm.nih.gov/19064674/
We know that these drugs are safe. All of this research took me less than a day to compile. If the author of this article actually wanted to know if these drugs are safe, they would have found all of this information. The reason why they didn’t is because the purpose of that article was to stigmatize providing gender-affirming care to trans kids.
The problem with all of the arguments made in articles like this is that they can’t explain why giving puberty blockers to trans teens is bad, they just pretend like we don’t know the side effects of these drugs in children. We know the side effects.
I’m not aware of anyone who claims that side effects of the drugs are the issue. From my point of view, the concern is that successfully changing the gender of a child, with 0 side effects, might not be the best thing for the child in the long run.
Like I say, I’m not agreeing or disagreeing with the concern, just articulating it. I think the sensible thing to do is just to study it objectively and follow the science; if it seems like the mental health outcomes for the kids is better one way or another, than that way is the way to do it.
And, of course, there’s always the question of de-transitioning and people regretting the changes done to their body during the transition process. One thing I would like you to think long and hard about, is the fact that 20% of people who get total knee replacements are dissatisfied with their outcome. 1 in 5 that get knee surgery are unhappy with the results, and that’s a surgery that is generally very successful.
I also think the way we do joint replacements isn’t right, but that’s a totally separate topic.
Compare that to transitioning (this includes all forms of transition, however only 25% of trans people have any type of gender affirming surgery, source 2015 US transgender survey). Only 8% of trans people report de-transitioning. 62% of them do so temporarily and return to living as trans full time. So less than 4% of trans people de-transition permanently. And the great thing about puberty blockers is that if someone wants to de-transition during the course of taking them, all they have to do is to stop taking them, at which point they will go through puberty
This all seems like a pretty cogent argument. Actually, I’d take it a step further than what you’re saying – I’d say that if a fully functioning adult wants to get a knee replacement or a gender transition, it’s nobody’s business but theirs whether or not they should do it. It’s relevant to talk about the long term outcomes and etc, but at the end of the day it’s up to them.
But that whole thing is separate from the question of doing it in adolescents. I asked for something about them specifically, and you did send me specific studies, which was what I was asking for so that’s excellent. Here’s my reaction:
https://www.jpeds.com/article/S0022-3476(13)01364-4/fulltext
“Long-term follow-up studies are needed to determine the safety of these treatments in this age group.”
“Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment.”
“This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.”
So that sounds pretty good to me.
https://academic.oup.com/jsm/article-abstract/12/11/2206/6980064
I think this one is a very poorly formed study. When we study physical health, we’re careful to avoid the placebo effect because it will foul up the data severely if it’s not controlled for. Taking a group of people who have received life-altering care, and asking them on a timeline of 6 months whether the life-altering care they received benefited their mental health, creates a huge bias in favor of them saying that yes, it did.
That doesn’t mean the care doesn’t help them in the long run. But to me this study doesn’t indicate anything in particular about whether or not it does.
This one seems a little better, although it suffers from that same self-reporting issue, the sample size is 55, and the timeline ends at age 20, all of which are problems.
This is the first one that sounds rigorously structured to me, and that I was really starting to look at as capable of giving a good answer… and then when I got to the conclusions, I arrived at:
“Given the potentially life-saving benefits of these medications for TGD youth, it is critical that rigorous longitudinal and mixed methods research be conducted that includes stakeholders and members of the gender diverse community with representative samples.”
Well… I mean, I’d agree with that. It sounds like what they’re saying is exactly the same as what I’m saying – that a lot of studies in this area had some sort of moderate-to-severe flaws that made it difficult to draw rigorous conclusions from them, and that we need to study this with a lot of scientific rigor, because the potential impacts (positive and negative) on the lives of the people involved are huge.
That’s not me “concern trolling” or anything, and I’m really not trying to come at this from some kind of ignorant perspective. It just seems to me like a lot of people tend to take it for granted that of course giving gender-impacting hormones to adolescents who want them is a good thing, and any attempt to raise concerns about it, or argue that we need to study it with a lot of rigor, is some kind of coded hatred that’s designed to ruin their lives, and we need to attack that person and say they’re just covering up their malicious and hateful intent.
Can’t we agree on that? That studying the long-term impact of something so hugely impactful to a person’s life is a good thing to do, and not just assuming one side of it is right and attacking anyone on the other side?
Gee, it’s almost like the economist isn’t a scientific publication
Where the hell are the mods for this sub?
Is this a propaganda sub?
Not everything that you strongly disagree with is automatically propaganda.
I’m not giving the Economist my info to read this. However, you know what’s a lot less safe than puberty blockers? Teenage suicidality. I’m not trans, but I was a very suicidal teenager, and if trans people say puberty blockers make them safer and less suicidal, I believe them, and we should do everything we can to reduce the number of teens that feel that way. Including puberty blockers. They’re reversible, safe (we’ve been giving them to kids for conventional medical reasons for a long time), and the community affected says they help. How many kids are we willing to let die while we’re waiting for more evidence?
How many kids are we willing to let die while we’re waiting for more evidence?
So - I’m actually not saying we need to ban this use of these drugs until it’s been studied more. The honest truth is, I have no idea about that side of it; my only real opinion on it is that it would be a really good thing to study them in a lot of detail and then make the recommendation based on that.
That’s what bothers me more than anything about the whole conversation. It’s like this reaction of “Well you must be the ENEMY, you really hate trans people and you’re just LYING about wanting to study the drugs, even you being allowed to say that is TERRIBLY DANGEROUS. Just approve the drugs, they’re clearly safe, because I say so, and if you disagree there’s something TERRIBLY WRONG WITH YOU.” I don’t know how else to say it: I am not the enemy, I don’t think.
As far as I can tell, the Economist article is saying that the drugs haven’t been studied in adolescents as much as would be reasonable. I took a bunch of time to look over @sphenoid’s sources in detail, because it’s important to me, and my overall conclusion was in agreement with that statement. So I took time to respond, giving a bunch of detail from my own desire to know more about it, and then the conversation ended.
It just seems weird that my whole viewpoint is “the enemy” and engenders this kind of hatred because everyone assumes that the reasons I’m saying it are borne out of some kind of hatred on my side.
Gee, maybe it’s because we’re talking about a group that’s extremely vulnerable, a group that a lot of people are determined to commit democide against. Even if you feel how you feel for completely innocent reasons, it’s reasonable for people to assume otherwise. Lots of extremists start out sounding vaguely reasonable.
Yeah I get that. The initial reasonable assumption I 100% understand. But I also think a vulnerable community that makes a habit of lashing out and accusing of crypto-democide anyone who’s showing good faith, but just not willing to 100% agree with them on everything without any discussion permitted, is going to find itself more vulnerable and demonized as a result, not less.
The thing of “you have to agree with me or else you’re the enemy” isn’t a good way to go, whether you’re in the majority or the minority. Again I get the reasons why people arrived there. I’m just saying it’s not a good place to be.
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I was talking about the reaction I was getting in this thread, not anything from any outside source.
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Scorecard: 21 downvotes, 1 call for my post to be removed, 4 people vigorously telling me I’m wrong, and 0 responses to my polite request for sources showing why this article isn’t accurate.
Guys, I am genuinely asking for information, because I don’t know. Being eager to yell at me and silent about informing me is a bad way to be.
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Yeah, sure. I know if there’s one thing I hear Tucker Carlson say all the time, it’s stuff like:
This all seems like a pretty cogent argument. Actually, I’d take it a step further than what you’re saying – I’d say that if a fully functioning adult wants to get a knee replacement or a gender transition, it’s nobody’s business but theirs whether or not they should do it. It’s relevant to talk about the long term outcomes and etc, but at the end of the day it’s up to them.
Also, in what sense is this verifiable bullshit? Can you point to a specific claim and why you say it’s bullshit?
Do you have sources indicating clear positive outcomes for adolescents? Like I say, I’m genuinely interested in learning.
Out of all the people who engaged with me on this, one person sent me any kind of links for that last question, which is basically the factual core of the matter that I was looking for. I’m asking that question so I can learn. I took a bunch of time to read over them and responded in detail to each one. Most of them I pretty much agreed with, and I said so.
If you can’t tell the difference between someone who’s attacking you, and someone who actually is genuinely asking for information although they don’t fully agree with you, you’re going to wind up “counterattacking” a lot of people for more or less no reason, and making enemies of them.
