Elevated rates of autism in transgender and gender-diverse individuals | Hacker News Reader

Elevated rates of autism in transgender and gender-diverse individuals

nature.com

245 pointsapsec112315 comments

All: there's quite a bit that's interesting here, so please don't post predictable things on any side of the discussion. If it's a political talking point, it's a predictable thing, so please omit those. Instead, remember this from the site guidelines: Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. Fortunately there are many commenters in the thread exemplifying that spirit, so no one has far to look for fine examples.

https://news.ycombinator.com/newsguidelines.html

  The transgender and gender-diverse vs. cisgender effect sizes are equivalent to or larger than the autism vs. non-autism effect sizes and the cisgender male vs. cisgender female effect sizes in non-autistic individuals.

if i understand that right, whether you're trans is a better indicator of whether you have autistic traits than a) your assigned sex or b) whether you are diagnosed with autism

That doesn't necessarily surprise me, actually. I suspect a decent chunk of people here a) consider themselves to have autistic behavioural traits, b) don't see the value of a diagnosis.

The term "diagnosis", to me at least, implies a disorder. Deciding what is a behavioural trait and what is a disorder is, at a guess, not robustly decidable.

This is my 2020 paper in a similar vein.

We found attenuated sex differences in amygdala resting-state connectivity between boys and girls with autism, but robust sex differences in amygdala connectivity in typically developing boys and girls. This pattern was observed using both univariate and multivariate analytical approaches, consistent with gender incoherence hypothesis, which stands in contrast with extreme male brain theory. [addendum: We are examining other networks now, and this pattern is found in other prominent brain networks, but not all.]

https://www.sciencedirect.com/science/article/abs/pii/S24519...

oh interesting. I've had a pet theory for awhile now re: trans/autism comorbidity that they're better thought of as symptoms (among others! op's link notes higher incidence of every surveyed mental disorder) of some underlying brain abnormality, rather than being tangled up in some causal relationship with each other. had not heard of gender incoherence theory before

One thing I would respectfully suggest here is to use language like 'atypical' rather than 'abnormal', as it avoids some of the unpleasant subtext of the latter word. (At least so far - the euphemism treadmill makes for an unending race, but it's still worth putting in the effort.)

maybe it's an overly optimistic hill to die on but imo, the best thing we could do for divergent people is to normalize abnormality rather than codify softer language to avoid describing it as abnormal or creating 32 new checkboxes of 'normal'

You mean eliminate "abnormality" and "divergence" as a concept? Yes. Better to focus on needs difficulties and abilities, not irrelevant comparisons to population averages. And better to treat differences as something to accept appreciate, and not arbitrarily idealize the median.

"Normality" is a factor in estimating public health costs, not relevant to individual care.

The point in which autism moves from "neuro-diversity" to "disorder that affects quality of life" is a difficult and controversial discussion. In general we try to use sensitive language, and respect the spectrum.

Many of the genes that control brain development are also linked to sex differentiation, and so it not surprising to me that in the presence of greater number of mutations (technical term) in these genes, the more sexual development will be differentially regulated, and will follow a different trajectory. I suspect, but do not know how to model, that this would tend to result in less sexual differentiation, making the binary male/female extreme phenotypes less likely in ASD.

My mother's family is all autistic engineers. I and two of my cousins transitioned as teenagers, so I've had my own theories about this for years.

I'd love to hear your theories if you'd be willing to share them.

I'm not the OC but many of my friends and peers are trans and I find "agender" to be the most useful descriptor to myself.

One thing I've noted is that once you start to identify the ways in which gender is fundamentally a social construct the link with autistic/neurodivergent folks makes much more sense. Anybody who struggles to instinctively navigate social norms and behaviors will also struggle to instinctively navigate gendered norms and behaviors, simply because the two are inextricable.

That pretty much describes my relationship with gender.

I was undiagnosed as a kid, gender was confusing, different standards were confusing. I just didn't care, among other reasons, I decided to transition.

Very happy, but still have an idea of how I would navigate things different... but that's life, right?

> Anybody who struggles to instinctively navigate social norms and behaviors will also struggle to instinctively navigate gendered norms and behaviors, simply because the two are inextricable.

But if masculine and feminine gender roles are equally difficult to navigate, that doesn't explain why transitioning would help. You'd just be swapping out one difficult gender role with another.

They may be "equally difficult to navigate" in a grand scheme of things, but they're probably not equally difficult for a particular person. Everyone got their own set of traits and interests that may make adhering to a particular gender role easier than the others.

So that would imply that non autistic people may also feel like their brains don't match their bodies, but since they're better at navigating gender roles, they're more likely to just adapt around the dysphoria instead of transitioning?

I think this is exactly right.

> But if masculine and feminine gender roles are equally difficult to navigate

Suicide rates are much higher among males. So maybe this assumption does not hold.

Suicide rates are higher for men, attempted suicide rates are higher for women. Men just tend to use more successful methods in their attempts.

Even within a given category of method of suicide, men are more successful. If you look at countries where gun suicides are pretty much nonexistent, men still "successfully" complete suicide at a rate approximately 10x that of women.

That should be taken as a sign that "suicide attempt" numbers shouldn't be taken at face value as evidence that women have it harder than men.

Maybe a neurotypical boy who is born with predominantly feminine traits gets them overridden by social learning, but without that mechanism they would persist.

Trans people in general were largely ignored by research until the 2010s, so there's very little we do know at this point.

But as for unresearched hunches...

There's lots of jokes in the trans community about how your stereotypical trans girl is on the autism spectrum, with rainbow-colored hair, and into kink, anime, and programming.

I think there's more of a willingness to challenge societal expectations of us in the neurodiverse community, and many of us feel uncomfortable with expectations placed on us around gender roles and sexuality. So I'm curious how much is a causal relationship, and how much of it is a willingness to reject societal expectations that seem irrational. I value my freedom a lot, and the expectations placed on me when I lived as a boy felt stifling and exhausting.

I can only speak to my personal experiences, and I don't believe in policing peoples' decisions to transition, but I have strong memories from as early as five of wanting to be a girl. I was very sensitive as a child. Typical autism-spectrum stuff like sensitivity to sounds, lights, and pain, but also an intense emotional empathy - I was a huge crybaby until my teens, and never felt like I fit in with guys my age or shared many interests with them. So when I found out that transitioning was an option, I pushed hard for it. It's possible that in today's age of greater gender freedoms I wouldn't have had as much reason to transition. But I just don't identify with the male experience at all, and have no desire to see my body masculinize more and more as I age. Also, I can wear so much more colorful and expressive clothes now :)

I think some people transition because they identify very strongly as the other gender, and others (particularly on the autism spectrum) identify outside of the gender binary, so they transition to better express that identity.

Interesting. What you describe about not fitting in etc. is very similar to my experience. Only that I’m a straight male. Could it be that transitioning is not so much about gender but about fitting in? If I could put a name to my angst and the barriers with others, it might be “transgender”. Which could give me a community of similar folks, a measure of acceptance, a handle, on why I’m not like the others. The research describes correlation, but maybe the causality is the other way around with “weird” people finding ways to cope with their being in a particular fashion?

I can't speak for anyone else, but I transitioned before I had met another tg person. When I transitioned I was already apart of a social group. I didn't need to fit in or find my place. When I was a kid I got along with both boys and girls making friends with both.

People do seek out others like themselves, but transgender communities are rare, because transgender people are rare. There are not many of them. When there are hundreds of people gossiping about transgendered people for every transgendered person it's easy for faulty information to be spread. There is a lot of misunderstandings about transgender people.

Interestingly enough in computer nerd communities, tg are more common then females.

Yeah, not fitting in is probably pretty common among introverted programmer types. But for me, feeling like I identified more as a girl was really what pulled me in that direction.

It had nothing to do with fitting in for me. It felt more like I already was a girl, but my body grew into the wrong direction. I just had to transition otherwise I didn't feel like myself, and now I do.

> ...and the expectations placed on me when I lived as a boy felt stifling and exhausting

I don't find that as extremely as you've given it here, but I do know what you mean and I'm a bog-standard cis male. But I never fitted in, never understood the blokey stuff - or maybe I did, but blokes take their nature (which are different from women, no doubt) and then push it to extremes[0] (you like to go out? Great! We must drink whether you like it or not! Maybe you like footy? OK, let's get extreme and tribal about it! But that brightly coloured thing you're wearing makes you look like a poof by the way).

I never fitted in and it can wear you down. As a straight guy I find the company of gays quite fine because they are more accepting.

edit: [0] this seems more prevalent in younger males. As we age, we become less so and more thoughtful, and therefore tolerant.

>I just don't identify with the male experience at all

this is a big part of it imo, your stereotypical effeminate depressed autist has virtually no connection to traditional cultural overtures of masculinity except in the body they inhabit and it's very easy to reach a point where it feels like that body is working against you.

> also an intense emotional empathy

I've read people saying this before, but DSM-5 299.00 (F84.0) for ASD suggests the complete opposite. So where do you get this description as a trait for ASD?

Is it not seen as societally acceptable in the States to wear colorful clothes as a male teenager/adolescent? I know I grew up in the ‘90s (in Europe) and as a kid I knew I liked colorful shirts (red, yellow) well into my mid-teens, I didn’t see them as male or non-male. The only comment I received about the color of a thing I own happened relatively recently (I’m almost 40 now), as one of my aunts remarked that my car is “girlish” because of its color (red). I found that strange and an interesting sociological input, but nothing more.

> Is it not seen as societally acceptable in the States to wear colorful clothes as a male teenager/adolescent?

Anecdote: I visited the US last year and happened to be invited by a friend to a climbing gym in the bay area. Said friend wore a shirt that was pink/purple. I was there for two hours or so.

In this time he got two comments about the color, jokingly painting a picture of him as being gay.

In New York City you can literally wear anything and no one will say a word or acknowledge your existence as a human being.

But I also knew a boy from rural Texas who was regularly harassed and beaten growing up because he wore athletic clothes (Adidas track suits) instead of cowboy boots and 10-gallon hats.

I grew up in the 90s in rural Texas and never owned western attire and was just fine. Your friend is overstating the role of clothing in his experience I suspect.

He was college age by the 90s. I’m fairly confident you grew up in different towns, also.

It is a big country, which is the point of the retelling. (Not intending to throw shade on Texas)

Anecdotally speaking, not just in their teens. (Certain coastal pockets excluded).

I once overheard an American (M, 30s) visiting Europe commenting on European men wearing coloured trousers (red, orange, turquoise, etc).

You’ll also find colours of outdoor clothing in the US to be more muted, or the overly garish ones in fewer numbers.

On that note, men in tights without over-shorts is increasingly common in my parts of Europe. And nobody here gives me shit for wearing pink.

I thought about something like this in a more broader spectrum.

Also completely judgment free, if not even with a little bit of envy.

Do you know people who have strong hobbies? Like not just building sometimes a lego set but having a basement full of it, sorted etc. Only doing this for a long time as well.

Or people who dress very strongly: Punks, Certain Type of homosexual people,Hippies, Antifa, Nazis.

I was and still not sure what my thing is and i have the feeling that i'm going thorugh my life looking a little bit left, a little bit right. Hardcore fetishes don't bother me but don't have an appeal that i would do it. Wearing stuff like artsy stuff is entertaining to look at but i wouldn't put the effort into it.

But what is the difference to those people who get stuck? Yeah thats what i call it basically. Stuck people. They have been Antifa for 20 years. They go to work, don't throw in window but still a little bit alternative. More extreme, more passionate about those kind of things perhaps?

I'm not an expert at all in Transgen etc. and yes i personally from my simplified worldview, i would probably not risk an op if i would feel different. I would perhaps (and of course i don't know that) just sit it out?

When i see Transgen people on hacker events, they created a subculture.

I'm a nerd but i always wanted to play with all the other 'normal' kids and a subculture is effort and perhaps group thinking and group pressure.

And on the other side, they have their crazy cool lego sets, and train models and are experts in a niche. They know exactly what they will do for the rest of their lives. I will continue to look left and right and just continue.

I would love to understand more what type of shades are out there and why.

> and into kink, anime, and programming.

The anime one is an interesting example, because I've seen the perspective in the anime community is that trans people are also disproportionately common there, similar to your mention that anime is an interest that is disproportionately common among trans communities.

The common brightly coloured hair seems to come from the fact that society is not fully accepting of trans people and depending on the level of that in your social circles, it may feel like you need to break a taboo just to be yourself, so other social expectations (like modest hair colours) are also downgraded in importance.

>other social expectations (like modest hair colours) are also downgraded in importance

The old school "goth" style, well that was breaking the social clothing/makeup etc conventions. Rebelling against the norms. But there would be a group of 5 people doing the exact same thing, rebelling in the same way, and bonding together over it.

I'm not sure to what extent it generalises to the above, but just a thing that was commonly observable

not op, but i think that western gender roles are a scam. i'm not suggesting that there aren't differences between biological sexes, but gender != sex and the false idea that there are only two ways to express your gender is quite limiting.

And eastern gender roles aren't? Is there something I don't know?

'Western' in this context presumably means the binary model of man/woman dominant in the West (e.g., Europe, North America) and gradually exported to be the default worldwide (via colonisation and later cultural exports).

There have been, and are, exceptions to this model in what might broadly be called 'the East'. Think of the Hijra on the Indian subcontinent, or the Kathoey (Ladyboys) in Thailand.

Thanks. Still I think to call binary genders western is a bit revisionist at best. It has been the most dominant model worldwide for a really long time.

Being from India, I'd like to point out that these groups of people you are talking about actually reinforce a gender binary rather than muddling it. Hijra are men who take on all the societal roles of women. They aren't "non-binary" or some "third" gender at all. They espouse and exude femininity, and in India there are two modes of being in society: feminine and masculine. Hijra do not add a third way of being that is separate from both masculinity and femininity.

I'd also argue that their existence is not a proof that Indians have different ideas about gender than Westerners. They are a marginalized people because most of Indian society thinks it is odd / unfortunate / a disorder to be a man and yet want to be socially a woman.

It isn't Western to have two gender roles in society. Men and women are different in lots of ways and it's valuable to society to reinforce differences between the two for the sake of procreation.

Making a claim about the culture one is familiar with does not exclude that the same might be true in other cultures.

Not OP, but I fancy this rough theory:

According to armchair psychologists and a joke, the answer to every psychological question is 'your mother'.

If you look at ways to deal with conflicts [1], it could be that being transgender is a form of dealing with inner conflicts.

Being autistic means that there is some distortion (no judgement intended) in the relationship to other people. The distortion most likely originates from the first relationship, i.e. the relationship to the mother. Since there is a need for a fulfilled relationship, it will be fulfilled by one way or another. If e.g. the mother is absent, then the mind looks for another way to fulfil it.

One way for fulfilment is becoming the desired object itself. So, to bring it to a point: Autism can origin from an absent mother. One way to replace the need for a mother is becoming a female object for others.

[1] https://en.wikipedia.org/wiki/Defence_mechanism

I think you're overthinking it :) Trans people I know just feel wrong in their bodies. It looks wrong, it feels wrong. There seems no need to suppose it was right at first then got distorted by relationship problems to the point you want your male genitals removed (I know a tgirl who is waiting for that).

You’re not allowed to say it, apparently, but there is/was evidence that it can be acquired: https://www.nbcnews.com/feature/nbc-out/brown-university-cri...

The paper that article references was discredited for being bad science, not because of any kind of agenda. They collected their 'data' by surveying parents on online forums - most of them explicitly anti-trans / 'gender critical' - instead of from transgender youth or medical professionals.

To expand on this a bit, the paper can be found at [0] and a notice of republication can be found at [1].

The study's "Methods" section reads in part:

> For this descriptive, exploratory study, recruitment information with a link to a 90-question survey, consisting of multiple-choice, Likert-type and open-ended questions was placed on three websites where parents had reported sudden or rapid onsets of gender dysphoria occurring in their teen or young adult children. The study’s eligibility criteria included parental response that their child had a sudden or rapid onset of gender dysphoria and parental indication that their child’s gender dysphoria began during or after puberty. To maximize the chances of finding cases meeting eligibility criteria, the three websites (4thwavenow, transgender trend, and youthtranscriticalprofessionals) were selected for targeted recruitment. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques.

The online forums surveyed were:

- 4thwavenow, which describes itself as "A community of people who question the medicalization of gender-atypical youth"

- transgender trend, whose opening paragraph states "This site is for everyone who is concerned about the social and medical ‘transition’ of children, the introduction of ‘gender identity’ teaching into schools and new policies and legislation based on subjective ideas of ‘gender’ rather than the biological reality of sex."

- youthtranscriticalprofessionals, whose site appears to be defunct at this time.

[0]: https://journals.plos.org/plosone/article?id=10.1371/journal... [1]: https://journals.plos.org/plosone/article?id=10.1371/journal...

I'd pursue a different avenue honestly. Autism as I understand it is a difference in brain development, it is not something you can cause by wanting.

Your same logic has previously been tried on gay men too varying levels of insistence, it hasn't stuck yet.

Autistic people somewhat commonly experience Alexithymia, which is an inability to understand their own feelings. The common example is an autistic person chronically dehydrated because they cannot identify their own sensation of thirst. Emotions are also physical sensations.

I think a much more promising angle is to look at incidence of Alexithymia and gender dysphoria.

One hypothesis is that disbalance of 'gender-related' hormones during fetal development is a factor that can cause not only gender dysphoria but also autism / Asperger's spectrum related issues.

You shouldn’t be allowed to use transitioned unless there is literal gene replacement happening.

In HN's context, this and your other posts in the thread constitute flamebait—that is, inflammatory and unsubstantive. You're violating these two guidelines:

"Comments should get more thoughtful and substantive, not less, as a topic gets more divisive."

"Eschew flamebait."

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and sticking to the rules, we'd be grateful.

It’s a clear disagreement and not “bait”. But yes, I get it.

Let's discuss.

You see male/female as being genetic therefore effectively unalterable, therefore the label of male/female cannot be changed.

I am comfortable with the idea that if a person wishes to be seen in a particular way that I do so. Actual example: a couple I know were F/F when I first met them. Now one prefers to use a male name and be referred to as 'he'. Took a bit of adjusting to, ok.

Now genetically one thing, but socially speaking another, isn't it just polite to make them feel comfortable? Would you call them 'her' to their face, knowing how it could upset them?

(not parent)

>Would you call them 'her' to their face, knowing how it could upset them?

Maybe, maybe not. What I don't want to do however is keep track of everyones imaginary genders, and face legal repercussions for "misgendering" them.

Here's an interesting search to look through: https://duck.com/?q=illegal+misgendering

When they have become what they want, they quite well look male/female so you don't have to remember anything. Indeed, you'd have to make an effort to get it wrong.

If they are transitioning they're very forgiving of genuine mistakes.

Your links don't support your position - did you read them yourself?

"Good News: Law Penalizing “Misgendering” with Hefty Fine and/or Jail Time being Legally Challenged" (california)

"Misgendering is not a crime and not a hate-crime, no. However, it can be a hate-crime if done in combination with another criminal offence, which suggests that the offender is motivated by a hatred for transgender people." (UK)

"California health care workers who “willfully and repeatedly” decline to use a senior transgender patient's “preferred name or pronouns” could face punishments ranging from a fine to jail time under a newly signed law." (california)

so as you see it's mostly about intent.

I don't think you actually know any TG people.

>Your links don't support your position

My position is that it's stupid, and I was illustrating that there are forces that want to make it illegal. And they have succeeded in some places. The Canadian Bill C16 is one example.

https://en.wikipedia.org/wiki/An_Act_to_amend_the_Canadian_H...

>I don't think you actually know any TG people.

And I think you have no basis for making that assumption. You are wrong.

> there are forces that want to make it illegal

Yep, in the context of a hate crime. Not standalone. Seems reasonable.

I don't think you read the link you posted. To quote from it

" Speaking for the [Canadian Bar Association], the President, [...] made explicit the protections for transgender people which were already contained in the prohibition on discrimination based on sexual orientation; and did not pose any risk to freedom of expression"

So it's about discrimination, and freedom of expression is not affected. Further

"Peterson argued that the law would classify the failure to use preferred pronouns of transgender people as hate speech. According to legal experts, including law professors Brenda Cossman of the University of Toronto and Kyle Kirkup of the University of Ottawa, not using preferred pronouns would not meet legal standards for hate speech"

So getting him/her wrong is not hate speech, so... problem?

What I'm getting from you is anger+fear, and what I'm not getting is why treating TGs decently bother you so much.

Please don't perpetuate flamewars on HN.

https://news.ycombinator.com/newsguidelines.html

Tricky for me to understand that, @DanG. There was zero flaming on my side - that I can see - and not much on his, just an opinion I truly can't understand but think I need to.

He posted honestly, I posted honestly in response factually and no shouting. So I don't get it.

Indeed. There is a whole subreddit dedicated to documenting instances of people being arrested because of the travesty of justice that is Bill C16: check out https://reddit.com/r/ArrestedCanadaBillC16

OMG this might or might not be worse than I could have imagined. Thanks for bringing it to my attention.

Please don't perpetuate flamewars on HN.

https://news.ycombinator.com/newsguidelines.html

A comment can easily be both, and the flamebait is the high-order bit.

You just did it again, predictably starting a flamewar. Not cool.

I've already seen people suggesting that this link exists, but I've always read it the other way around - that there are elevated rates of transgenderism along autistic people, which kinda makes sense to me. People on the spectrum ask themselves more questions about their own bodies and feelings and don't get easily satisfied by adhering to social norms as neurotypicals do.

Some form of interrelationship would make sense right? It seems that a lot of gender is tied up in social signaling, which is less relevant to people on the spectrum. For instance, social signaling might regulate gender-non-conformance in a way which is felt less strongly to people on the spectrum.

I'm gonna be honest, using kernel density estimates on discrete data is almost bad enough to make me discount the result outright. Almost.

"In all five datasets, we investigated if rates of autism diagnosis significantly differed by gender by first conducting χ2 tests (Model 1, unadjusted), and then by conducting logistic regressions adjusted for age and educational attainment as covariates (Model 2, adjusted)."

It appears the kernel density estimates is being used as a display of the data, not the actual method of statistical analysis, or perhaps I missed something.

Using a technique that's entirely inappropriate for the kind of data you're dealing with doesn't exactly inspire confidence. That it doesn't affect the actual result is lucky, I guess.

Adding another 2020 study that observes the autism / transgender overlap: https://www.sciencedirect.com/science/article/pii/S175094671...

Interestingly enough, the correlation is observed to a greater extent with trans men (though not in all studies).

> observed to a greater extent with trans men

I wonder if that's a result of autism being under-diagnosed in women (and that under-diagnosis carrying over to trans women).

I would be surprised if that carried over to trans women, i.e. people assigned male at birth, especially if most are diagnosed as children (and thus prior to transitioning, in most cases).

I'd bet that jauer meant to say trans men (the terminology can be confusing at first) because autism is typically diagnosed earlier in life than a gender transition, so if it's under-diagnosed in women then it would also be under-diagnosed in trans men.

Transitioned a while back, didn't get it backwards :)

To elaborate: I was wondering if trans men (AFAB) acquire the male-gendered autistic traits and trans women (AMAB) acquire the female-gendered traits (and underdiagnoses from diagnostic criteria being focused on male norms).

Why I'm curious: I was diagnosed with Asperger's as an adult (no access to MH care as a child because raised in a cult), transitioned, and after 3 years of HRT got a new psych who laughed at the idea that I could have AS and removed it from my chart. His reasoning was that my interpersonal skills were not impaired in a way that is typical of autistic people. This is a common reason why women with autism are under-diagnosed.

I had terrible interpersonal skills pre-transition. HRT gave me access to a wider range of emotions, which might have something to do with it. E.g. I can actually understand the emotional currents in movies, which is nice. But, now I'm curious if autistic symptoms are another one of those things that change with hormones.

Oh, thanks for the clarification! I'm also wondering if I've become "more autistic" since transitioning (to male), but it's not clear to me how much of it would be due to hormonal changes and how much would be due to no longer needing to perform certain kinds of social/emotional upkeep.

Damn I’m gonna see myself on /r/DontYouKnowWhoIAm :)

It's well documented that autistic individuals are having difficulties resolving or tolerating emotionally conflicting situations.

If a male non-autist has girlish interests, he might be proud of his uniqueness and thereby accept it as part of himself.

For a male autist, the socially conflicting girlish interests will be much more painful, thereby driving a higher percentage of autists to resolve the conflict by adjusting their gender.

That would also explain the data, but with causality reversed.

And from personal experience: I received a lot of criticism as a kid because I was a guy but I liked purple shorts and playing dress-up with my sisters. It's just that since I never identified with the stereotypical guys from movies, I wasn't bothered that other people considered me unequal to them.

But I've seen how much effort my math genius classmate put into proving his manliness, so I assume the gossip about us having girlish interests must have bothered him a lot more than me.

I see arguments like this a lot, and they usually miss the importance and impact of hormonal transition.

I'm trans, and thus in trans circles a lot, and almost everyone I know had some high impact mental health issue resolve upon starting hormonal transition, even if those were present before they realized they were trans. These range from generic depression over behavior that gets people autism diagnoses that suddenly resolve to a depersonalization. [1] Even if you want to attribute those to placebo, the effect is so pronounced and long-lastingly positive, it wouldn't really matter if it was.

Gender dysphoria is measurable[2], and gender dysphoria severe enough to lead someone to transition seems to be rooted more deeply than just the socially constructed assignments of what constitutes male and female behavior. Of course gender-non-conformance would still be expressed more strongly in such people.

What is also positively correlated to transness are conditions that could be classified as intersex, even if we don't generally diagnose them as such because they have no easy to recognize physical impact. We know about some of those, pre-natal exposure to estrogens for instance. And I'm sure there's a lot of factors we're entirely missing. There are a few neurology studies that show deviations that are are usually associated with the other sex in transgender people, even before they can hormonally transition.

[1]: https://the-orbit.net/zinniajones/2013/09/that-was-dysphoria...

[2]: https://pubmed.ncbi.nlm.nih.gov/30991464/

I wonder if studying gender affirmation among cis people wouldn't help to solidify the science behind transitioning and well-being. With presentation of gender being as much of a spectrum as gender itself, it would stand to reason that there are cis individuals who experience dysphoria by way of not physically presenting as as masculine or feminine as they feel themselves to be (waves).

Non-clinical avenues are somewhat more open to them in a way that they aren't to trans folk (e.g., diet and exercise), but I wonder if hormonal supplementation for the express purposes of enhancing gender identification (rather than to correct a clinical deficiency or for birth control) could be beneficial.

EDIT: The great thing about suggesting that cis people might experience gender dysphoria is that it pisses off the transphobes AND trans folk. Anyone looking for an edgy stand-up routine, have I got a subject for you.

Since "gender dysphoria" hasn't been scientifically defined yet, you're free to make up a definition so that everyone has it ;)

https://www.psychiatry.org/patients-families/gender-dysphori...

"Gender dysphoria - as a general descriptive term refers to an individual’s discontent with the assigned gender."

That is a very weak definition, if you ask me.

You'll have to take it up with the APA, the authority on psychiatric disorders in the US and the author of that page.

As a dead comment stated, nobody asked you.

While a lot of trans people would like it to be the case, quantity doesn't really matter past receptor saturation. Most badly adjusted doses are badly adjusted because they're not consistent instead (estradiol has a very short half life). If you have gonads producing your hormones you don't usually have this issue.

We do however have cases of gender dysphoria when treating cis people with antiandrogens for prostate cancer, so it seems to be a phenomenon not limited to trans people.

This assumes that gender dysphoria is exclusively physiological, an impossibility given that gender itself is partially socially- and psychologically-constructed. As mentioned, perhaps hormone treatment could still benefit people who don't have a clinically-indicated deficiency solely because (even in men and women with functional gonads) their application enhances the secondary sexual characteristics (behavioral, psychological, and physical) that a dysphoric individual might find lacking.

My personal take is that a good deal of dysphoria is misdiagnosed as dysmorphia. Because those people are left to self-medicate, unfortunately you end up with the kind of abuse that makes people question the legitimacy of such treatment. I think, though, it's dangerous to lump in people who could benefit from hormonal support for their exercise and antidepression goals (which, for some cis men, would be a gender affirmative strategy), with people who inject synthol or silicone without any medically-viable rationale and in so doing radically damage their bodies (which is what happens now).

In the end, what I'm hoping to see someday is an understanding of a fundamental similarity between the cis and trans experiences, because it would mean both buy-in from and benefits for both groups.

There are definitely social, psychological and neurological factors involved, and none should be discounted. It's just that the social factor is much harder to control when our society is so hostile to gender-nonconformity. And that explicitly includes internalized transphobia. I would not be surprised in the slightest if social rejection accounts for most of the remaining difference to cis controls for transgender suicidality.

I would consider neither [1] nor [2] to be of any scientific merit.

=== [1] ===

I find your reference [1] to be incredibly intellectually dishonest:

I agree with the initial paragraph that "gender dysphoria" as well as "dysphoria" in general are not well defined terms. Obviously, I was then expecting a definition by the author, but none was given. Instead, the author moves on to use the term as if it was a well-defined scientific thing.

The list of symptoms that follows is so overly generic as to be useless in practice:

1. Continual difficulty with simply getting through the day

That's called depression.

2. A sense of misalignment, disconnect, or estrangement from your own emotions

Usually called borderline/mania

3. A feeling of just going through the motions in everyday life, as if you’re always reading from a script

My feeling after a day of reading mathematics papers.

4. A seeming pointlessness to your life, and no sense of any real meaning or ultimate purpose.

I've heard that a lot from people who studied languages and then ended up working as a supermarket cashier.

5. Knowing you’re somehow different from everyone else, and wishing you could be normal like them.

I believe everyone has these feelings during puberty.

6. A notable escalation in the severity of these symptoms during puberty

Since you just described common puberty side-effects in #1 to #5, this is not an independent symptom anymore.

7. Attempting to fix this on your own through various coping mechanisms.

Reminds me of guys who are awkward at dating and try to push through by getting drunk.

8. Substantial resolution of these symptoms in a very obvious way upon transitioning, particularly upon initiating HRT

That sounds like "try hormone therapy to see how you like it".

After reading the article, I had a strong feeling that the author is probably selling related drugs and has a financial incentive to classify everything as trans symptoms. And while the author is describing herself like a researcher in this article, she's calling herself "adult demon anti-cis pro-trans activist" elsewhere and she has made this statement:

"I don't see a problem with telling straight guys who are exclusionary of trans women partners that they should try to work through that" Which I find incredibly ignorant and selfish, considering that many men plan to have kids the traditional way and for that goal you necessarily need to exclude trans women partners.

=== [2] ===

Your reference [2] appears to be a bit more scientific at first, but they published in the "highly prestigious" journal "Federation of European Neuroscience Societies and John Wiley & Sons Ltd" which allows anyone who is willing to pay the fees to publish practically anything. As such, the article has exactly 2 citations, both of which have shared authors.

They defined "gender dysphoria" as "An experience of incongruence between gender identity and birth‐assigned sex", meaning their working definition is based purely on self-reported feelings after the fact and, therefore, unsuitable for any scientific analysis.

Plus, the peer review for [2] is online here: https://publons.com/publon/10.1111/EJN.14420/ and you can see that their paper was rejected in the first round with the comment:

When we think of the manuscript as a whole: is there a clear and proven evidence of a "cerebral signature of gender dysphoria"? Please consider revising.

But then it was approved later on by the "co-Editors in Chief, EJN", meaning by the people that get paid from the paper printing fees... That looks like the kind of fake review cycle that I would expect from a pay-to-publish journal.

To sum it up, the fact that this uses scientific terminology and is published in a journal doesn't mean anything. It would only have meaning if it was either well-cited or published in a journal with critical peer review.

"After reading the article, I had a strong feeling that the author is probably selling related drugs and has a financial incentive to classify everything as trans symptoms."

For the record, this is just totally false, Zinnia does not sell drugs (do you mean HRT? That would be illegal in the US without a medical or pharmacy license).

"she's calling herself "adult demon anti-cis pro-trans activist" elsewhere"

Pretty sure that's a joke.

"they published in the "highly prestigious" journal "Federation of European Neuroscience Societies and John Wiley & Sons Ltd" which allows anyone who is willing to pay the fees to publish practically anything."

Wiley is the publisher, not the journal. The journal is the European Journal of Neuroscience. I went and checked, and I can see no evidence that this journal is predatory or doesn't meet normal academic peer review standards.

https://en.wikipedia.org/wiki/European_Journal_of_Neuroscien...

"their working definition is based purely on self-reported feelings after the fact and, therefore, unsuitable for any scientific analysis."

Most things in psychiatry (depression, anxiety, etc.) are based on self-reported feelings, does that make psychiatry "unsuitable for scientific analysis"? Heck, there's a whole academic field about the economics of happiness, which is obviously subjective:

https://en.wikipedia.org/wiki/Happiness_economics

"and you can see that their paper was rejected in the first round"

Requesting revisions does not mean rejection, it's a normal part of academic peer review.

I also did not find any evidence of Zinnia benefiting financially from drug sales.

But just reading her writing, I couldn't shake the feeling that Zinnia has a very strong interest in increasing the rate of "gender dysphoria" diagnosis. Plus it is very obvious that Zinnia is not a neutral researcher on this topic.

As for the journal, EJN has an impact factor of 2.9. As a student, I used to publish stuff for fun in an IF 4.3 journal. So I'd consider EJN in the "motivated hobbyists" category. For comparison, Nature (the article discussed here) has an IF of 24.3.

Edit for your edit: Requesting revisions is OK, but accepting a paper that was rejected in the first round and DID NOT fix the issue that caused it to be rejected ... that looks suspicious.

Zinnia is in fact not a researcher. She just writes on her and other trans people's experience.

It is an incredible show of bias on your side that you expect my response to an uncited comment to hold up to the standards of the original article, while you don't for the comment I initially responded to.

I took your response as your opinion and it was argued well, which is why I took the time to read your references.

But it did give me a weird feeling that your link 1 pretends to be science when it isn't and link 2 pretends to be solid science when it's just an opinion piece written by researchers.

My statement was clearly identifiable as my private unscientific opinion on the topic, so I consider it safe for outsiders to read.

But articles on medical topics that pretend to be science when they are not, that can cause a lot of pain if outsiders read it without being aware that it's only sudo science.

That's why I thought it would be useful to criticize your references.

I am generally inclined to regard IF arguments for disregarding research as rather disingenuous. Yes, there are predatory journals which will publish anything if paid, but IF as a metric to judge a journal which doesn't seem to be obviously fraudulent is a farce at best, because IF is also heavily correlated with readership which may not be large for relatively niche topics (to be fair, I haven't actually looked at other articles in EJN). For example, consider Annals of Mathematics, one of the most "prestigious" math journals, has an IF of 3.027.

I'm not trying to claim anything about the science in this particular article because I haven't read it in enough detail but a PI I worked with had this habit of dismissing research based on journal IFs, which was pretty annoying.

I think it is disingenuous to expect me to post rigorously cited studies and contrasting my response to the original article, when I was instead responding to some conjecture made in this thread. Mostly with a personal anecdote, with some sources mirroring and expanding on such.

I also think a lot of your points are made in bad faith:

* Taking a joke way too serious, in order to discredit the author. Based on what exactly?

* Implying transition health care is sold for large profit margins when estradiol is one of the cheapest medications around (and blockers don't exactly have high margins either). Zinnia is also not a health care provider. All these drugs are Rx.

* Doing the exact bad faith "as gospel" misreading of the symptom list zinnia warned against. This is not a diagnostic check list, these are just the things that trans people report.

* You also miss the entire point, that these symptoms resolve or get substantially better, and do not recur.

* You are seemingly content with "generic depression" as a diagnosis when depression is a symptomatic diagnosis, usually with different underlying problems. Especially at the severity we're talking about.

* You misread depersonalization as borderline. This is funny because a different diagnosis that is corelated to trans status, CPTSD, is often misdiagnosed as BPD!

Of course you can say she has a heavy bias, but neither I nor she implied otherwise. It is simply documentation of our experiences.

I don't expect you to provide references as part of our discussion. Just your well-argued opinion is enough to move the thread along.

But I find Zinnia problematic because her playing researcher has the potential to cause harm to others. Plus I wasn't referring to her joke, I was referring to the part where she attempted to shame cis guys into not excluding trans women, which is obviously useful for her, but also obviously manipulative and if she was successful, it might make other people unnecessarily unhappy. Since she gave interviews about it, I am also reasonably confident that it wasn't a joke.

I would say it is fair to judge a self-proclaimed activist by their actions, and hers were of the kind that I would not be able to support her statements in good conscience, even though I support the cause of treating everyone fairly in general.

Zinnia is entitled to her opinion, and at no point was anything in her article implied to adhere to scientific standards. It's a discussion piece, and a piece that might be helpful for those that are considering transition. Usually HN is not so hot on theoretical harm that speech can cause. It also has nothing to do with the content of the article, so I'd appreciate if you didn't try to disregard her speech with unrelated information, so to speak cancel her. I don't believe in cancel culture being real, but the last time someone on HR pointed out someone was a TERF they got dead-flagged, so better not go there.

Anyway, if you just wanted more studies, you could've just let me known. I was not expecting to be attacked on the impact factor or size of the citation pool - I was aiming to provide a study with an easy to read abstract, but have a few studies that are strong in at least one of those factors.

Neurology:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754583/

https://www.sciencedirect.com/science/article/abs/pii/S00223...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4585501/

And the "transition is beneficial" master list:

https://whatweknow.inequality.cornell.edu/topics/lgbt-equali...

As a trans non-autist who grew up embracing a uniquely girly personality (and was accepted by friends and family as just being uncommonly feminine) I can say that this did not reduce the impact of gender dysphoria. Especially after looking at the community at large, I believe these are entirely unrelated issues.

I was trying to argue the other direction: Maybe some autists will mistake their acceptance issues as gender dysphoria, thereby leading to a higher trans percentage among autists (which was the main observation from the paper).

As such, I disagree with you that trans and autism are unrelated issues, because the paper measured a correlation. It's just that nobody knows in which direction the effect goes.

I love how cis people, after reading (likely only the abstract) of one paper and now fashion themselves experts on the lived experience of trans people.

Measuring a correlation says nothing about causation (either way; there's a lot of room for confounding factors). The implication that autistic people will "mistake" their dysphoria is incredibly patronizing and just frankly rude.

Your post sounds like you strongly disagree with me, but it looks like we do agree on the facts. The paper measured a correlation but whether that implies causation is anyone's guess. The paper argued one direction, I argued the other direction, but both explanations fit the data which just shows that we don't know yet if there is causation.

It is surely fraught with peril to just say "well here is an explanation that makes sense to my gut", especially when applied to controversial topics.

I presume this is a consequence of the datasets they had to work off but it is really frustrating that they have one catchall "transgender and gender-diverse" category, segmenting by birth sex or particular gender identified with would be interesting/valuable

I realize this might be rude but I'm not sure what the polite way to ask is, isn't your sex always your birth sex for the most part? Outside the effects of the medications and the cosmetic effects of the surgery isn't your body still mostly the same as far as the nuts, bolts, and genetic disorders, are concerned?

Medication has a profound effect.

That depends on what you mean by "sex." And even then, it's not a neat binary thing by any definition. Most things that involve humans fall on a bimodal distribution. Cropping out the wide fields in that distribution is convenient for statistics, forms, and rhetoric, but it doesn't reflect the true range humans are capable of.

Can you elaborate on this more? I meant "sex" in the way that my physician would use the word. I'm aware of things like intersex conditions but, unless someone is actually intersex or otherwise complicated, your reply doesn't really answer my original question.

I'm not that poster but I can elaborate. Basically your physician couldn't easily use "biological sex" as a blanket term to accurately asses the risk factors and health needs of a medically transitioned person. Our sex is "otherwise complicated."

The reason for this is that medical transition, primarily through the mechanism of hormone replacement therapy, actually changes some aspects of biological sex and the associated risk factors at a "nuts and bolts" level even though its not touching every single aspect of biological sex. It's not purely cosmetic, though that's a common misconception. Hormones ultimately control a lot about how human bodies express sex and the associated medical factors. In reality "biological sex" is composed of multiple sexually differentiated systems within the human biology that can theoretically operate somewhat independent of each other, and changing the dominate hormone in your body will flip or at least shove a lot of those systems towards the other end of the distribution. I guess a way to phrase this in developer terminology would be that "biological sex" is sometimes a leaky abstraction.

As a personal example: despite my birth sex, it would be a mistake for my doctor to ask that I routinely get regular breast cancer screenings in the same way it would be a mistake to ask a cis man to regularly screen himself for breast cancer. My risk of breast cancer is much lower than a cis woman's and comparable to a cis man's. But at the same time I have absolutely zero risk of prostate cancer, and it would also be a mistake to try and test for that based on any possible symptoms I'm having. An ideally perfect doctor would be able take my history and be cognizant of what risk factors of biological sex, exactly, which conditions were associated with, and then be able to map that onto my body to figure out what I'm at risk for. As you can probably imagine, this is very difficult to do. A lot of times what makes a condition linked to sex isn't actually understood in the first place.

I wanted to say thanks for giving such a detailed reply. I still have some things that I'm unsure about as far as the framing of everything but having concrete examples like your point about your lowered risk of breast cancer is immensely helpful in understanding where I'm making social judgements vs. just being ignorant about the topic as a whole. It's often hard to get clear answers like yours because just phrasing these kinds of questions often feels like a minefield. So your patience in answering what I'm sure is an at least somewhat demeaning line of questioning is very appreciated and helps a lot in wrapping my head around this.

I appreciate this, thanks. Answering these kinds of questions can feel like unwrapping bandages in front of strangers. So it's good to hear that it helped somebody out. Thank you for your empathy.

when it comes to this topic, "sex" "gender" "male" "female" "man" "woman" etc etc are overloaded with contradictory meanings by people trying to make sneaky ontological arguments. unless I'm specifically talking about the signifier itself, I don't really care about these kinds of games, so I just try to say unambiguous things

anyway aside from language legerdemain, the word "sex" is also used to refer to what sex you're legally designated as, which is only loosely coupled to biology by now

The terms "gender" and "sex" are defined differently by different people, but in general the definition is something like this: Sex is usually defined in terms of genitalia, genotype (chromosomes) or similar biological properties. However, this is still not a binary male/female property, see for example intersex people. Depending on your definition, undergoing surgery may change your sex, gender, or both.

Should intersex conditions be considered normal human genetic variances (like eye colour), or genetic disorders (like Down Syndrome)?

It’s humane and polite not to describe people as abnormal, but being medically accurate I’d argue that humans are indeed binary sexed, and immutably so.

It really depends where you draw the line of "intersex condition", it's not really a term physicians specialized in the field use anymore, because variance in sexual development is ubiquitous if you look hard enough. "DSD" is typically used when there's a pronounced effect that is physically diagnosable, but it often misses other neurological factors that, for instance, corelate in transgender people.

Then again, a lot of severe conditions that would often fall under the DSD umbrella are often overlooked until they become somehow important. For instance, complete androgen insensitivity, so zero functional testosterone in an XY individual, is often not diagnosed until you notice the lack of periods / cervix.

Calling it bimodal is a much more precise way to go about it that acknowledges we have two broad categories, with lots of exceptions and caveats.

> Should intersex conditions be considered normal human genetic variances (like eye colour), or genetic disorders (like Down Syndrome)?

Doesn't really matter, for this purpose.

> I’d argue that humans are indeed binary sexed, and immutably so.

Unless you defining terms such that the variations are not merely disorders but actually nonhuman, you are clearly wrong; human alignments of sex characteristics are non-binary though bimodal.

> human alignments of sex characteristics are non-binary though bimodal.

You either produce sperm, or ova - or neither (which if caused genetically is an abnormal variant).

“Producing the wrong gamete for one’s perceived gender doesn’t construct an additional sex, nor alter the definition of sex such that there are female sperm / male ova producers - this holds even if that perception has genetic as well as psycho-environmental causes” - in my opinion.

But .. we’re philosophical / political at this point .. which is the problem.

> You either produce sperm, or ova - or neither (which if caused genetically is an abnormal variant).

Or both, at least in theory, though true hermaphroditism with both ovulation and spermatogenesis, while theoretically possible and observed on other mammals has not, AFAIK, been conclusively shown in humans.

But, sure, you can redefine “sex” to be restricted to any one of a number of axes of sexual variation that exist in human and result in either a simple quaternary, trinary (or, if you try a little harder than you have, binary) distinction, but what is the point?

the commonly accepted estimate for intersex conditions is 1.7% of lives births, via https://pubmed.ncbi.nlm.nih.gov/11534012/ from this basis it's not much of a stretch to imagine the reality is that there's a greater spectrum of sex difference that is illegible because it hasn't been medicalized. certainly seems like a more plausible explanation than "ok ok, so there's people who don't fit into our perfect platonic ideal categories, but other than the 1.7% of weirdos the categories are still perfect"

it's god of the gaps thinking, people are addicted to drawing clean lines around discrete categories as a vestige of modernism. taxonomy brain. we don't have good ways to say "there are two major clustering points, which most people are roughly close enough to one or the other to call them that, but there's enough overlap and so many dimensions that it makes drawing clean boundaries impossible"

I suspect as gene sequencing gets commoditized and personalized medicine actually becomes practical, we'll find a lot more cases where it makes sense to analyze people on the basis of their individual traits rather than what broad groups we can class them under

Can someone answer my genuine question on this topic? At my high school in California I knew a trans girl (m to f used she/her) that was super chill and maybe a bit on the spectrum.

At the same time there were a couple dozen girls that called themselves trans and asked everyone to use they/them but acted and dressed all 100% within female stereotypes (not that trans is about stereotypes I’m just illustrating my point). I didn’t know any boys that did this.

Has the term trans grown beyond just (for lack of a better term) those with body dysmorphia? What is this second category of trans because I have yet to figure it out.

briefly, expecting a trans person to have dysmorphia is called "transmedicalism." it's highly controversial in the trans community because on the one side you have people who suffer from gender dysmorphia who don't always like the idea that other people are transitioning because of a preference; on the other side you have people advocate that gender identity is a personal choice and should not be subject to a particular diagnosis by a professional.

Two big factors go into not liking transmedicalism

* it usually relies on very narrow definitions of gender dysphoria. The relation between gender dysphoria and gender euphoria for instance is often discarded. Gender dysphoria itself is poorly defined and often does not specifically manifest as gender-related until the idea is confronted. Lots of trans people suppressed for years or sometimes decades because they thought their pain was not specific enough to not be rejected by gatekeeping.

* it does not account for people that feel more comfortable outside the gender binary, no matter if they want to medically transition (some do). Transmeds and "truscum" often require strict adherence to binary gender norms, in alignment to historical guidelines where doing anything not absolutely in alignment with your binary gender would set you back significantly.

> Has the term trans grown beyond just (for lack of a better term) those with body dysmorphia?

As far as I am aware, no. But bear in mind that there’s not always an abrupt transition between gender-associated behavior, due to social circumstances beyond personal preference. High School, a setting which implies an age where parental figures retain overwhelming leverage over minors’ lives, is a fairly good example. E.g. clothing choices at home are open to parental scrutiny, whereas pronoun use at school is not.

Beyond that, though, like any term that is applied at one’s own volition and in response to subjective internal cues, there is going to be some variation in the folks identifying that way. Not in a “liar” sort of way, just in a “there’s no precise cut-off on what behaviors or feelings constitute trans” kind of way.

Especially as social stigma decreases or, depending on one’s precise social micro-environment, possibly even turns into a form of social prestige. Again, without any deceit intended, you can imagine that someone that feels they fall in a gray area and needs to explore their identity may verbalize (or even conceptualize) that feeling differently based on the quality and magnitude of social connotation.

this has been a contentious argument for at least half a decade that I've seen, and I won't rehash it here, but the magic words to google if you want to read more are "truscum" and "theyfab"

Trans people generally have gender dsyphoria, a different condition from body dysmorphia, which they usually don't have. The actual diagnostic criteria for gender dysphoria in adults and adolescents given by the DSM-5 are quite broad, and would include anyone who exhibits "A strong desire to be of […and…] be treated as a gender other than one's assigned gender" for at least six months. It also explicitly states that gender they identify as does not have to be the one opposite their birth sex. It can be neither i.e. non-binary.

By the diagnostic criteria, those non-binary students you were talking about may well have had gender dysphoria... it might have extended to discomfort with their bodies too: Did you ask any of them? Dress and presentation doesn't necessarily mean that much, especially among teenagers who are still figuring things out and might not be ready to change everything. I knew a teenage trans boy who had long, pink hair. I also knew an adult trans man with a beard who still liked to wear dresses sometimes. Being trans doesn't just mean escaping from one cage that's colored pink into another one that's colored blue.

I think it's more common for teenagers who were assigned female at birth to publicly identify as non-binary because most cis people unfortunately just perceive it as meaning "quirky tomboy," which is more socially acceptable than the transfeminine equivalent, "weird f * * ." I'm a trans woman, but I thought I was non-binary for about a year while I was in high school. I was sure as hell too scared to tell anyone that, though.

I ended up determining that I was the gender opposite the one I was assigned at birth. Some teens who identify as non-binary will probably end up identifying as their assigned gender. Others will continue to identify as non-binary: Kate Bornstein is non-binary and in their 70s. I think it's good that people get the space to explore their identity, even if a few end up having been attracted to a label for the wrong reasons.

Regarding the expanding definition of trans, in the past, trans people had to fall squarely within the norms for the gender they were transitioning to, or else they couldn't usually get treatment. For instance, Harry Benjamin, who was one of the early doctors who performed sexual reassignment surgery in the US, classified trans women into six groups, only two of which he labelled "True Transsexual" and approved for surgery. For a trans woman, you had to be attracted to men, be conventionally feminine, have believed you were a girl from an early age, etc.

Most of the trans community is glad that we've moved past this, but there's a minority that wants to bring back the stricter standards. They're called "transmedicalists" or sometimes "truscum" and and can often be identified by conspicuously using the word "transsexual" rather than "transgender" in 2020 (although some people use it for more benign reasons). They often say things like "we just think you need to have dysphoria to be trans." However, as noted, the clinical definition of gender dysphoria includes just about anyone who self-identifies as trans, and the actual argument is whether you have to be a binary gender, have meet the typical norms for that gender, and have to want to pursue all the medical options for transitioning to that gender. There's no agreed-upon word for trans people who don't meet the arbitrary standards required of a "true transsexual," but some transmedicalists call them "tucutes." Others call them "transgender" and call anyone they thing is really trans "transsexual." To be clear, though, speaking this way is very offensive to most trans people and you should never do it.

Are there leading candidate hypotheses for the cause of autism? Do we know things like heritability, correlation with environmental pollutants, anything?

The short answer is that nobody really knows, although it probably has some genetic component. Wikipedia has a long article covering the different hypotheses: https://en.wikipedia.org/wiki/Causes_of_autism

because the definition consists of many different phenomena and in places does not specify whether all or some should be present, i suspect there is never going to be any single cause.

In psychology how we define a thing is constructed from a series of observable characteristics.

The problem is, there are multiple situations that can cause the same series of characteristics. "Are there leading candidate hypotheses for the cause of autism?" is like asking, "Are there leading candidate hypotheses for the cause of a headache?" There is no single cause.

What we do know is most people with autism do not process facial expressions as much as the average person. This causes a lack of paying attention to body language, which then ripples into most of the characteristics that define autism. Studies have shown eye training on infants can completely remove symptoms of autism.

But a root cause is more complex when there are multiple. Some people get overloaded when they look at people's faces. Some just didn't pick up the proper habits of looking at others when interacting with them. The root cause can vary from person to person.

> Studies have shown eye training on infants can completely remove symptoms of autism.

Do you have any links for these studies? I’ve never heard any credible claims of a treatment for (or prevention of) autism.

There are studies that shows that all of those things have effects on the likelyhood of a person becoming autistic.

Autism is a complex mental thought pattern that I think is best described as having “erroneous“ metacoginitive models. That is people with autism has problems “comprehending” how the mind works on a intuitive level. Not “comprehending” the mind then leads to them having a hard time following other people’s thought trains. And various other problems.

Why people get in to that thought pattern differs between individuals. So “Ultimate” cause is not so easy.

Off topic: I appreciate the HN community for being able to tackle the discussion and a topic like this in a substantive way.

One other correlation I have seen is "intelligence" <-> trans person.

It's very weird how many absurdly smart people happen to be trans. It plays into the idea that mental illness correlates with IQ.

Being "mentally ill" and having the specifics of that diagnosis changed every time the DSM does due to social pressure (from homosexual/bipolar DSM 4 to schizo in DSM 5), I honestly think "mentally ill" has just become another loaded term. Most "menatlly ill" people are simply people who have used the faculties that have to choose to be abnormal. The reasons for that non-conformist decision are varied, but are rarely irrational. Generally, I've found that any non-conformist person, regardless the category of such they've been assigned, has a unique and valuable perspective at some level if you just get to know them. Sadly, that's rare in an age where everything new is threatening and everyone I don't understand is the boogey man. Protected groups do the same villification to those who practice societal norms. A genuine smile and a ready heart for other people that also bleed red and feel more pain than life should ever have allowed is probably a better start than pissing matches over who is right and who is evil.

TLDR - non-conformists are almost always interesting and brilliant in some sense, but they generally lack the ability to reach within the Overton window and effect change.

Do you have any source on that? It sounds like it might be just anecdotal due to the fact that trans people tend to be more noticeable.

previous poster's claim is a common piece of folk wisdom that ultimately stems from this paper: https://pubmed.ncbi.nlm.nih.gov/16298429/ 2005, n=187. the authors are blanchardites so the language they use is needlessly confusing, but they find 107.3 mean iq among the male-attracted trans women, 121.7 among the female-attracted

interestingly while pulling this up I also found this one from 1967(!) https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.2... n=34, which found half in the 110-119 range and eight over 140

Interesting, thanks!

Autism has this "savant"[0] stereotype, so what you're seeing might be an autistic symptom in some tg people.

[0] https://en.wikipedia.org/wiki/Savant_syndrome

I noticed the same thing, particularly with programmers.

More than once, I stumble upon some remarkable piece of software, to find that its author is a trans person.

Autists are disproportionally online. This matters for two reasons.

The first is that on the internet you can easily assume any identity.

The second is that the trans lobby has much stronger control over online than offline spaces. The pattern is clearly visible in this thread. Views that you might hear from "the man on the street" are flagged or downvoted.

If "the man on the street" shared their views when evaluating a transgender person's job / grant application that would invite discrimination lawsuits in many jurisdictions. That's an IRL flagging.

Oh certainly. But this doesn't change my point. That autists and neurotypicals come across different perspectives due to the differences in how they socialize.

Not just “higher”, the paper is talking about 3,4,5 or even more times higher.

Hanging out in trans circles (as a non-binary person myself), this seems commonly known within the community. Interesting to see research done here, but I'd be careful about over generalizing (e.g. "All trans people are neurodiverse").

Edit: Also, happy to answer questions about being non-binary (specifically, gender fluid) if folks have good faith questions.

What is the distinguishing characteristic of someone who is gender fluid vs. someone who is not?

There isn't one, besides them identifying as genderfluid. Same as any other gender identity (like man or woman). I think this makes the terms slightly less useful but it is very important to some people that they're used this way

> Same as any other gender identity (like man or woman).

I think there are some distinguishing characteristics for someone who is male vs someone who is female.

It’s not clear to me what this means. I’ve never made any positive choice to be a man. I’ve never told anyone “I’m a man”. But everyone somehow concludes that I’m a man.

What does it mean to “identify as” something?

It means you come to a conclusion that you are that something. This may or may not coincide with your outward appearance or anything else.

> I’ve never made any positive choice to be a man.

Do you perceive yourself as a man?

I’m not sure what that means.

I'll ask the question a different way: when people perceive and address you like a man, do you feel any reason to disagree with how they address or perceive you?

No, I don’t. Is that really the entirety of “identifying as” something - not disagreeing with other people identifying you as that?

That's one means to understand your identity.

Generally, if you'd say, "I am a ..." then you identify as that.

You might say, for instance, I am a Catholic. Or I am a Muslim. I am a man. I am a woman. I am a chef. I am a zookeeper. I am a gun owner. I am a pacifist. I am a vegetarian. etc. etc.

Whatever your "I am a ..." statements are, they are how you identify. You will find some of them you feel strongly about and others you don't really care about but you might say them anyways. "I am a man" might not be a statement that carries a lot of feelings with it for you, whereas something like, "I am an atheist" might. Some folks are proud Republicans or Democrats, others aren't.

Others might disagree with how you identify. They might say, "Well, you might think you are a Christian, but...", and that's where we all have to collectively decide where we should be policing identities of others.

To add to what Pfhreak says: no, identity can be more nuanced than that (identities can change, and identity only as a negative may not even make sense in non-binary contexts), but the easiest way I find to address the issue to (presumably) cis people is to address particular identities in terms of being perceieved as the opposite, because that can highlight the discomfort of self- and other-identity mismatching.

If someone said "you're a woman", would you disagree?

I think I wouldn’t really care, to be honest. Nobody has ever done that, so I can’t be sure.

In that case, perhaps you're one of the people out there who doesn't strongly identify with any particular gender.

See, this is an exercise in deliberate confusion. If someone said I was female, of course I would contradict them if it was warranted. My male characteristics are objectively verifiable, up to and including having sired children rather than having given birth to them. My identity has nothing to do with any of this.

And for most people, “man” and “male” are synonyms. This is why people always express confusion about what it means to “identify” one way or the other. Identity is irrelevant to reproductive role, and sex is about reproduction, and gender is about sex.

> And for most people, “man” and “male” are synonyms.

OK. If you call someone gay in the 1800s, it'll probably not mean the same thing as doing it today. Terms change; distinctions between similar terms get made as they're needed.

> Identity is irrelevant to reproductive role, and sex is about reproduction, and gender is about sex.

There's several bald assertions in there. I'm infertile, so "sex is about reproduction" makes me chuckle a bit, for example.

> Terms change; distinctions between similar terms get made as they’re needed.

And the distinction among “man,” “woman,” and “non-binary” without referencing sex is explained... how exactly?

> I’m infertile, so “sex is about reproduction” makes me chuckle a bit, for example.

I am now infertile too; doesn’t change the fact that I know which one of only two kinds of gametes (“sex” cells) my body could produce.

> And the distinction among “man,” “woman,” and “non-binary” without referencing sex is explained... how exactly?

No one said they're not related concepts. Just that they're not the same.

The term "butch", for example, tends to describe a female with more manly outward presentation, where "manly" describes "characteristics generally associated by society with males". Short hair isn't an inherently male thing; it's frequently considered a man thing, though.

> I am now infertile too; doesn’t change the fact that I know which one of only two kinds of gametes (“sex” cells) my body could produce.

I don't produce gametes of either kind. Am I genderless and sexless?

are leg amputees no longer members of a bipedal species? ¯\_(ツ)_/¯

But that's the point, isn't it?

"Sex is about reproduction" is as silly as "people who lose their legs aren't humans", because both are clearly untrue.

Yes, people who lose their ability to walk are still human, and people who lose their ability to produce sperm are still male.

What is the "correct" gender for an intersex person, or someone born without genitalia, or someone with 45,X/46,XY mosaicism?

Like all genders, I would ask them what is “correct.”

If you’re asking about _sex_, however...

in the case of intersex conditions, they arise from a disorder of sexual development which by definition arises by diverging from the typical developmental pathway of one sex or the other. Much the same as someone with a much later and artificial divergence (e.g. hysterectomy), this sex is still their sex despite their intersex condition.

Being born “without genitalia” is still going to be one of these conditions, or the result of some other unspecified trauma or non-sexual-development disorder. They would still be either one sex or the other.

Mosaicism is an interesting case. It would depend on which cells were activating sexual development.

> Like all genders, I would ask them what is “correct.” If you’re asking about _sex_, however...

Ah, we've switched arguments. Upthread, you stated:

> And for most people, “man” and “male” are synonyms.

If you're now arguing for a distinction between the terms, we're now in agreement.

Yes, there is good reason to make a distinction between the terms, just like there’s a good reason to distinguish between “brain” and “soul.”

I don’t have to believe the shahada in order to conduct myself respectfully with a person of the Muslim faith, and I don’t have to believe a female is a man in order to conduct myself respectfully with a trans man.

> And the distinction among “man,” “woman,” and “non-binary” without referencing sex is explained... how exactly?

It's the difference between "maleness" and "manliness". Those words are clearly related, but they mean different things. See also: "femaleness" vs. "feminine".

The latter term in either case describes cultural behaviors, clothing, accepted roles, and a whole bunch of other stuff that isn't the same as their sex. Someone can be very "manly" independent of whether they have XY chromosomes, for instance. I find it useful to be able to describe the cultural elements as one's gender separately from what organs or genes they have under the hood.

See, I view this as a system of oppression. “Manly” characteristics are those that are societally praiseworthy for males but considered negative for females, and “womanly” the reverse.

I actively seek to avoid that game, as it is untenable in a just society.

I think a lot of trans/nonbinary people would agree with you. :D

I think a lot of people of any identity would agree with me... but are we outnumbered by those who are rigorously inspecting what toys a four-year-old is playing with, as a lens towards gauging their future conformity to one traditional gender role or the other?

The deconstruction of gender norms is relatively common among gender-progressive people.

You seem to be confusing inspecting toys for conformity and inspecting systems that encourage (or require) conformity. And it's much easier to attack or be concerned about straw-positions than actual ones.

It's not problematic for someone to play with toys, or do things, stereotypical to their gender. It's a problem when they are encouraged (tacitly or not) or forced to stick within a predefined scope.

This is an actual position, not a straw position.

https://www.goodhousekeeping.com/life/parenting/a43702/trans...

The only way this person could resolve her discomfort at her child’s inclination to play with “girl things” was to start considering her a girl.

Meanwhile where are the “gender-progressive” people sticking up for a two-year old’s right to play with whatever toys they want without sanction or punishment? Certainly not raising any concerns about this sort of story.

Combine it with the well-documented higher incidence of gender nonconformity of cis gay people at a young age, we see many supposedly “progressive” people allowing the sentiment “better a straight daughter than a gay son” get normalized without challenge.

The child "was verbalizing that she was a girl at least six times a day" and praying for her boy self to die. The mother talked to professionals. She only began to change her mind after a transgender teenager's suicide note made her realize her own child might commit suicide. Even then she studied and prayed for months.

What makes you think the mother assumes her daughter will be straight?

Because she already knows he is a homosexual male, which ends up a straight trans woman.

Less than 25% of trans people are straight.[1]

[1] https://en.wikipedia.org/wiki/Transgender_sexuality#Sexual_o...

it's only confusing because you're not aware of the difference between sex and gender. take a look at this article i found from a quick google: https://www.healthline.com/health/sex-vs-gender#gender

Oh, I’m well aware.

https://sexandgenderintro.com/

> Identity is irrelevant to reproductive role, and sex is about reproduction, and gender is about sex.

Every part of this is wrong.

First, let's look at sex. You've said sex is tied to reproduction (as an aside, this feels a bit cruel to all the infertile people out there) but that's wrong.

https://www.who.int/genomics/gender/en/index1.html

> Humans are born with 46 chromosomes in 23 pairs. The X and Y chromosomes determine a person’s sex. Most women are 46XX and most men are 46XY. Research suggests, however, that in a few births per thousand some individuals will be born with a single sex chromosome (45X or 45Y) (sex monosomies) and some with three or more sex chromosomes (47XXX, 47XYY or 47XXY, etc.) (sex polysomies). In addition, some males are born 46XX due to the translocation of a tiny section of the sex determining region of the Y chromosome. Similarly some females are also born 46XY due to mutations in the Y chromosome. Clearly, there are not only females who are XX and males who are XY, but rather, there is a range of chromosome complements, hormone balances, and phenotypic variations that determine sex.

You've then said that gender is tied to sex, but that's only true in some countries at this point in history, and it mostly stems from Christian colonialists imposing their view (often using violence to do so) across the world.

https://www.who.int/genomics/gender/en/index1.html

> Gender, typically described in terms of masculinity and femininity, is a social construction that varies across different cultures and over time. (6) There are a number of cultures, for example, in which greater gender diversity exists and sex and gender are not always neatly divided along binary lines such as male and female or homosexual and heterosexual. The Berdache in North America, the fa’afafine (Samoan for “the way of a woman”) in the Pacific, and the kathoey in Thailand are all examples of different gender categories that differ from the traditional Western division of people into males and females. Further, among certain North American native communities, gender is seen more in terms of a continuum than categories, with special acknowledgement of “two-spirited” people who encompass both masculine and feminine qualities and characteristics. It is apparent, then, that different cultures have taken different approaches to creating gender distinctions, with more or less recognition of fluidity and complexity of gender.

https://gal-dem.com/black-trans-lives-matter-we-cant-let-the...

> There is a particular, deep-rooted racist violence in the UK iteration of transphobia. The invention and export of the concept of a rigid and oppressive gender binary was used as a device of subjugation throughout the British empire during colonialism. This included the attempted eradication of ancient and deeply spiritual understandings and lived realities of gender fluidity, including among two-spirit people in indigenous North American cultures; fa’afafine people in Samoa; nat kadaws in Burma, and hijras in India, who were criminalised during British colonial rule by Section 377 – a law used after a rebellion to “reassert colonial authority”.

You've said that identity is irrelevant to reproductive role. That's wrong, which is why there are trans-fathers who give birth.

https://mana.org/healthcare-policy/use-of-inclusive-language

> The signatures below indicate affirmation and respect for people of all genders; full agreement regarding the use of gender inclusive language in the MANA Core Competencies and in all documents regarding the profession of midwifery and provision of midwifery care; and the welcoming of transgender, genderqueer and intersex people into safe, culturally sensitive, shame-free reproductive health care. We do not refute the “life-giving power in female biology.” Rather, we support a larger vision that includes the provision of midwifery care to all pregnant and birthing people.

You may want to read this: https://www.nature.com/articles/d41586-018-07238-8

You managed to state “every part of this is wrong” without refuting anything I wrote, and in many cases confirming what I wrote with your citations.

1. “Sex is about reproduction”

WHO page: “ When a Y chromosome is present, early embryonic testes develop around the 10th week of pregnancy. In the absence of both a Y chromosome and the influence of a testis-determining factor (TDF), ovaries develop.”

These are reproductive organs.

Each detailed description of chromosomal variations references “sterility,” “infertility,” or “fertile.”

2. “Gender is about sex.”

> You've then said that gender is tied to sex, but that's only true in some countries at this point in history, and it mostly stems from Christian colonialists imposing their view (often using violence to do so) across the world.

This is an absurd claim and appears to imply that pre-colonization, people could not figure out which individuals would bear children and which would sire them based on their physical characteristics, and sort them accordingly. Hammurabi’s code had bride prices, Aztec women were not permitted be soldiers, Chinese women were taught the three followings 2500 years ago. Your statement is simply profoundly absurd. All societies — even the ones listed in your citations — especially the ones listed in your citations — have been capable of distinguishing sex, and setting up different rules of behavior that depend on sex. That is gender.

3. “You've said that identity is irrelevant to reproductive role. That's wrong, which is why there are trans-fathers who give birth.”

This is again deliberate confusion. No matter what pronoun or title you afford this trans man, his reproductive role was to bear a child and not to sire one. Only female mammals produce eggs and only female mammals bear young.

On further thought, whether I disagree with someone calling me a “woman” depends on what they mean by that term.

If they’re using it in the traditional definition (someone with a uterus and XX chromosomes) then I would disagree, because they are factually wrong. If they’re using it in the more modern sense to describe some abstract “gender”, I wouldn’t disagree because I don’t really know what that means. In either case, it wouldn’t offend me.

Only on the basis of everyone until that person having said differently, up to and including someone else already having defined “man” as a male human.

Some people feel differently. If you were addressed as "ma'am" everywhere you went, you may not be that bothered. You might find it really frustrating.

Even within the bounds of a gender (e.g. masculine), people will find themselves wanting to be seen as a particular point within that gender's spectrum. (E.g. you might want to be seen as a tough guy, or a sensitive man, etc.) It can be frustrating to feel like you are the tough guy but no one seems to treat you that way.

The point is that experience is different for different people. Many people are comfortable with whatever, others aren't and want to try to take deliberate actions to make themselves be perceived more like how they see themselves.

If everyone called me ma’am all the time everywhere I went, I wouldn’t be bothered. That’s how I ended up getting sir’d in the first place.

I guess if they suddenly changed en masse, I’d wonder what’s up.

Simplified explanation that leaves out the discussion of people who are agender, genderqueer, etc.:

If you conceptualize gender as 'manliness' or 'femininity', you can pretty easily see that some folks are more or less 'manly', that gender must therefore exist as a spectrum. There are men who are very feminine, and women who are quite manly, so in my mind, these spectrums have some overlap.

Most folks have a pretty rigid understanding of where they fit -- they see themselves as a manly man, or ladylike, or a tomboy, etc. and that remains relatively unchanging over time. For me, it's not so simple, there are days I feel masculine and days where someone using "Mr." or "Sir" feel really viscerally wrong.

That's the quick version of how I conceptualize my own gender fluidity.

I think you might overestimate how strongly or rigidly people in general conceive of how they “fit” on a daily basis, or how strongly they link activities, dress, or title to “manliness” or “womanliness.”

For a simple example, some days I want to listen to Tori Amos and cry, and other days I want to listen to Metallica and punch things, but nothing in any of this has any bearing on my identification with any gender.

I have some pretty obvious male secondary sex characteristics so it would be a big problem if that caused me daily discomfort, but that doesn’t really seem to be what genderfluidity is about?

Many of us are not tightly attached to all parts of our identities. For some, they might care deeply about their identity as a devout Christian/Muslim, others might not really care. Some might care about their political party affiliation, others might not care. Some might care about their gender deeply, others might not care.

But for you, as gender fluid, it seems the thing you care deeply about is the ability to be free to conform or not conform to gender expectations of any particular sort?

If so, isn’t this freedom something that would just be good for anyone?

I think so, unfortunately many people do not. Ideally I'd be free to express myself however I wanted without facing prejudice for it, but we're not in that world today.

Have you heard of Abigail Shrier's book "The Transgender Craze Seducing Our Daughters"? She was on Joe Rogan's podcast recently though I have yet to listen to it. A quick search turned up, not surprisingly, some negative critiques and others that are more positive.

If you have heard of it, or read it, I'd love to hear what you think of her position.

I appreciate the offer to be part of a dialogue. I think it's important to improve understanding for people. As a white, middle aged (45) cismale I know I'm viewing a lot of this stuff through a very specific lens.

It don’t think it should be part of the conversation because it seems transparently little more than culture war scapegoating for an audience hungry for a moral panic.

If you want a more considered text for a general audience, I’d recommend Brynn Tanehill’s, “Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask).”

Also useful is this point-by-point, sourced rebuttal to the misinformation Rogan repeatedly spreads (which references the above text):

https://www.adamconover.net/adding-evidence-to-the-discussio...

The part of the rebuttal about puberty blockers being 100% reversible seems outdated. The NHS recently said that there isn't enough information about puberty blockers to say for certain that there are no long-term side effects from their use.

Thanks for the link and info.

This interview is well worth the time.

It’s not sound and ultimately it’s based in the grief of people who believe they have somehow lost their child (or spouse, or sibling) because they transitioned. I don’t want to minimize the pain of people who have this mindset, no matter how destructive it is. Their sense of loss is genuine and it drives them to the same level of commitment that you see from parents who lose a child to a drunk driver. But, while the pain is real, the loss is either not real or is self-inflicted. Trans people leave the lives of people who won’t let them be themselves, but we don’t stop loving our family because we’re trans.

More people are transitioning, at all ages. More of the people who do so are visible, because of modest reductions in stigma and because there’s no longer a requirement that we disappear and cut all ties (the medical establishment used to require this). Your typical 40-50 year old parent has no idea how many of the people they went to High School and College with are trans, because they were hidden. In much the same way people had no idea how many people were gay. So this looks like an explosive change. I do expect we will see much less late transition (later than early adulthood), because more of those trans people will transition earlier.

So, why are more people transitioning? Because it’s possible and they understand it to be possible, not because there are more people who are trans. This is why it’s happening across all ages. I am a late transitioner. I started to transition as soon as I understood three things: that being trans and transitioning was a real thing, that I would not destroy my life by doing so, and that trans people can live happy fulfilled lives.

What about desistance? Some small percentage of people who transition decide that it wasn’t right for them. Most of them because of oppression, but some because it doesn’t work for them. This is much smaller than the set of people who regret that they didn’t transition, or that they waited so long to do so. It’s lower than the rate of regret for any elective surgery. There is some risk that non-binary kids who emphatically reject their assigned sex at birth are getting social pressure to conform to the other end of the binary. The pressure to be not trans at all is still very high. High enough that I don’t worry about cis kids being pressured into transition.

And there are many trans people who don’t need or want to transition, who find sufficient expression or acknowledgement in other ways. They aren’t less trans, you just don’t know they are.

Thank you for the thoughtful response. I have no agenda here. I have one trans friend (that I know of). After seeing the topic on Rogan's podcast I did some quick searching online and it opened up a few lines of thought I hadn't considered or wasn't aware of.

Edit: added "(that I know of)" to acknowledge my limited knowledge of my friend's gender or sexuality.

Rogan has been, at best, insensitive to trans people. Given the volume of people who hold agendas against trans people and trans rights and Rogan's willingness to host people without holding a critical eye to their opinions, I'd be very careful about using his podcast as a jumping off point to the topic. I'd really recommend reading the stories of trans people directly and engaging with the scientific community.

so could you produce some numbers about transitions? because frankly this discussion (just as the more street-oriented fraction of BLM...) seems driven by a very vocal but ultimately minuscule number of people. And if now in some avantgarde-circles (which never were related to the majority of people and also today generally have their very own orthodoxy... ) trans is en vogue, I doubt that this is the mass phenomenon you think it is.

It’s not a mass phenomenon. Neither is Autism. Fewer people are trans than are gay, but nobody really knows. At the bottom end it’s 0.3%-0.6% of the population, but that’s only people who are out. If you survey people in their low 20s, it’s higher. We’re a little less common than redheads in all likelihood. Gay people in the early 80s knew there were a lot more gay people than straight people saw, but they had no idea what the true numbers were. It’s like that.

Most of the trans people I know aren’t remotely avant-garde. I know a bunch of suburban women in monogamous relationships with their spouses or partners. I know a couple of suburban trans guys who are still married to the men they married before they figured it out, one of them with kids. I know several trans guys in health care. I do know a few trans people who are artist and writer types and are more flamboyant. The first trans woman I met worked at the same Wall Street brokerage I did and was very quiet.

When I go to (back when travel was a thing) places that are less friendly than the coasts and people see the trans flag pin on my bag, I frequently have people come out to me and talk about how they can never transition.

There is really no orthodoxy beyond believe people about their gender. Trans people are very different from each other and their experience of being trans varies wildly. There’s some agreement around language and tropes that seem to provoke violence towards us, but many trans people use language to describe themselves that other trans people would be offended by. But that’s true of gay people too.

I haven't heard of it. Reading the synopsis on Amazon suggests that it's not something I'd find much to agree with. While I do believe that trans identities are in the forefront of the discourse right now and that some folks might be inclined to question their identities more, I don't find the idea that kids are being forced into a craze very compelling. (Shrier's writing reminds me of the satanic panic of the 80s, where my parents were asking me if I was worshiping satan because I played D&D.)

I went through, as an adult, a period where I was sure I was a trans woman, and I sought therapy. This led to experimentation and further discussions that no, that wasn't the right label for me. I do regret, even as someone who is masculine presenting most of the time, that I didn't have more of a choice in my hormonal changes during my teens. Many bodily changes via testosterone are irreversible, and it would have really helped me had someone said, "let's hold off on those changes for just a little bit so we can figure out what makes you feel right."

So, that's a bit anecdotal, and it definitely doesn't apply to every child's situation, but I sure wish that we had the resources and available knowledge back then that we do now, because I probably would have taken a different path.

> Have you heard of Abigail Shrier's book "The Transgender Craze Seducing Our Daughters"? She was on Joe Rogan's podcast recently though I have yet to listen to it. A quick search turned up, not surprisingly, some negative critiques and others that are more positive.

So, you're asking an honest question, but it's pretty insensitive and I hope you're curious because this is the truth. Framing that as a curious question makes me wonder if you even read the title of the book -- the title is quite obviously meant to be antagonizing to trans people. So that's not a great start. But here we go.

As for the contents of the book itself, it's little different from much trans-antagonistic pseudoscience and literature -- the main difference being that it's focused on guys rather than gals. It cherry-picks studies and anecdotes to promote harmful stereotypes, and presents trans-ness as a status symbol (it's not, it fucking sucks to be trans in the presence of cisgender people who know that).

To address the "craze", we need only look at history. I'll use mine. In the 1990s, when I was in middle school, I noticed distinct feelings that I now understand to be gender dysphoria. I didn't get it at the time; but sexual orientation was quite the buzz, and I knew I was bi very early on. In the 2010s, our society underwent a phase transition on its view of trans people. I met some other trans people, had some curious conversations, and started to put the pieces together. It took me several years to overcome my transphobic cultural upbringing; and several more to overrule the same of my ex-spouse. Coming out was hard. As with many, I lost friends and family to their prejudice. But even so, it's way easier now than it was in the 90s or even the 00s.

One commonality between trans and autistic people is that we don't always feel welcome around cis / allistic people. Not really knowing why, we form cliques of people who are feeling the same stuff. Many of the trans people I know are, yes, autistic, but also were outcasts as kids. In speaking with other late-transitioning people of my age, I've seen a pattern: others in our friends group have transitioned in the intervening years. Do groups of trans kids gravitate towards one another and have shared gender discoveries? Well duh, of course they do! It's not a "craze", it's a result of teenagers talking to eachother about their feelings, having appropriate language to talk about them, and having even the slimmest feeling of safety in coming out.

It never says that the crazy describes all trans people. It doesn't call all trans fakes. You seem to even admit you didn't make it past the title with your uncharitable read, so how do you expect to respond to something it actually claims?

It points out that there are some social contagion factors to some expressions in our youth. Which is completely reasonable given how much clout gives you in modern social media, for example. And that an impressionable girl with low self-esteem can suddenly "become trans" and win social favor, which I don't see how you could find unreasonable if you've ever been a teen.

Maybe approach it a little more open-mindedly. You basically dismiss everyone in the book as just being unable to "cope with loss" which isn't much different than dismissing any group (like trans people) with some convenient reason that leaves your world-view untouched.

Also not sure how your anecdote disproves the craze, especially since the craze is talking about the last 5 years. Your experience in the 90s has little bearing on 2020 where you get instant social proof on social media in some circles by putting a rainbow flag in your username. Times are different. You don't think social contagion could explain any part of the 800% increase in trans identity among the youth? I don't see how you couldn't believe that on any 800% increase in what the youth are doing.

It's like amphetamine abuse among kids. I have extreme ADHD and to some degree depend on the drug to get what I want in life. Just because you could write a book about kids claiming to have ADHD just to get prescribed a great recreational drug (and I bet you could even call it a craze, as it seemed in uni) doesn't mean I can't have ADHD or that everyone is an abuser. I would consider myself weirdly defensive to the point of dismissing inconvenient truths if I were to believe that, yet that's what I see you doing.

That you give yourself so much authority on trans matters, especially in response to such a reasonable point, is kind of an example of what I see as modern trans clout these days. Why wouldn't a teen want that? As the book points out, it's incredibly easy to "be trans" when the rest of your friend group in high school is suddenly on the non-binary spectrum unlike when you were a kid.

> That you give yourself so much authority on trans matters, especially in response to such a reasonable point, is kind of an example of what I see as modern trans clout these days.

Your insistence that you have more authority than an actual transperson to explain the emotions driving trans identity because you've read a book about the 'transgender craze' is probably a more realistic reflection of 'modern trans clout'...

> "become trans" and win social favor

This is not how it works in the real world, is it?

Someone becoming trans will lose access to a large number of potential dating partners, they will be bullied and ostracized, they face increased levels of violence, they face reduced worker protections, etc etc.

I think it depends on how they maintain their social circle. If they spend most of their time in online communities, it'd be easy to surround themselves with people telling them how brave and beautiful they are for transitioning. Abigail Shrier said that one of the trans people she interviewed said that after Katelyn Jenner transitioned and being trans became more "popular", they would regularly have strangers approach them on the street and at restaurants to tell them how brave they are for being trans.

> how brave they are for being trans

Doesn't this confirm my point? Why is it brave to be trans? It's because you face increased violence, ostracism (often from your own family), etc etc.

Not everyone has to deal with that though; some have supportive families and social circles. It's like when people say that everyone in the military is a hero, even if they have no idea what the person did in the military. People do the same thing when they call every trans person "brave", even when they don't know their background, and whether or not they face daily struggles due to being trans.

Hi, are you here for a curious conversation? Please review the guidelines, because you're cross-examining and attacking the weakest interpretation of what I've said.

> Be kind. Don't be snarky. Have curious conversation; don't cross-examine. Comments should get more thoughtful and substantive, not less, as a topic gets more divisive.

> Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith.

I specifically referenced the title of the book, because it should be a dead giveaway that the book isn't a great start for this conversation. Nowhere did I say that I only looked at the title, that's your weakening interpretation. I read about a dozen reviews, pro and con, and I'm quite familiar with the literature and science on the subject of trans people.

> It never says that the crazy describes all trans people. It doesn't call all trans fakes.

Sorry, did you even read what I wrote? I didn't say anything about "all trans people". I said that the book is cherrypicking. I'm not denying that those cases exist, I'm saying that those cases are rare.

> You basically dismiss everyone in the book as just being unable to "cope with loss"

Who are you responding to??? I didn't say anything about that.

> Your experience in the 90s has little bearing on 2020 where you get instant social proof on social media in some circles by putting a rainbow flag in your username.

Oh hey, an actual reference to something that I wrote! I'll respond to that. I specifically noted my experience in the 90s, because my transition was delayed 'til the 2010s. I specifically explained why we're seeing a massive increase in the rate of people coming out. But you missed it, because you're focused on attacking the weakest interpretation of what I said.

> That you give yourself so much authority on trans matters, especially in response to such a reasonable point, is kind of an example of what I see as modern trans clout these days.

Yeah, I've got so much "clout". People in my industry are happy to give plaudits for my "bravery", but multiple previous co-authors have ghosted me. Co-workers don't take me seriously like they used to. So professionally, I experience tokenization and isolation. I've lost family, I've lost friends, but if I had a twitter account I'm sure I'd get some followers. But some of my trans friends do get extra followers for being trans -- many of them chasers and trans antagonists who are variously bent on making their lives hell. Whoop di fucking doo. I'd strongly prefer to not be trans, but that's not a choice I've got.

Am I an authority on trans matters? Well, I am a member of the community and I see the good the bad and the ugly -- both from within, and from without. I'm also in regular contact with high-school age trans kids through group counselling -- I don't share their experiences because that would violate their confidentiality.

So what's your basis for authority? All I see is your experiences with amphetamines and you may have read a book about trans people that was written by a blatant transphobe. And you're imploring me to have an open mind. Guffaw.

You might be interested in his interview with Dr. Debra Soh. There is a lot of misunderstanding among parents regarding what counseling/therapy psychologists can provide and that interview clarifies some recent changes.

I've watched the stream, and it painful. Not only is the book built on very little evidence, but Shrier just gets so many things wrong on stream, I have to wonder if she actually did her homework. Things that aren't even up for debate like effects of HRT, even in instances where it'd strengthen the optics of her argument.

It doesn't help that Rogan only seems to have one hard opinion (legalize drugs) and seems to disagree with most of his guests very little, which makes for a good stage for his guests but not a very balanced discussion.

I'm still hoping he'll eventually have a trans person on (that's not Debbie Hayton, Blair White or Buck Angel).

> I'm still hoping he'll eventually have a trans person on (that's not Debbie Hayton, Blair White or Buck Angel).

why not one of them?

I'm going to assume this is not a gotcha question.

Debbie Hayton is trans exclusionary feminist, while being trans. She also writes on transgender topics for RT. I have no idea what her motivations are, she doesn't usually talk about them and in fact blocks people on twitter when they ask.

Blair White is a transmedicalist, who is so concerned about her own validity as a trans person that she insists on narrow diagnostic critera that just about include her. This makes her popular with a certain crowd. Her take on trans people that aren't exactly like her has been inconsistent. For a critical discussion with her and someone confronting her with said inconsistencies, see https://www.youtube.com/watch?v=-o_yuAuzl6Q

Buck Angel is similarly a transmedicalist, but more by virtue of transitioning at a time where only extremely few trans people were allowed to transition. Buck is a bit of a special case as one of the first trans men to transition, but he heavily relates to the Harry Benjamin Standards of Care, about which you can read some fun things here: https://twitter.com/orclesbian/status/1190481639501160449

I'm not really opposed to either of these people being on JRE, but their views on trans people have already been represented on the show a few times, whereas I haven't really seen any more inclusive advocates discuss this issue with Rogan.

This is part of a wider issue with the JRE guest selection, but that'd go too far for a HN comment already way too long.

> "The Transgender Craze Seducing Our Daughters"?

Some parents of trans children talk about "rapid onset gender dysphoria". They claim their child was happy until they got to about 12 and then all of a sudden BAMN they became trans because the Internet told them to. They'll sometimes claim that science supports them.

There's no evidence that ROGD exists. It's a term that's only ever used by people who are trans-excluding, or by people debunking it.

https://www.psychologytoday.com/us/blog/political-minds/2020...

> The paper claims that there is a new diagnostic entity called "rapid-onset gender dysphoria." This term comes from a paper published in the journal PLoS One, in which the author anonymously surveyed parents recruited from websites that focus on the theory that trans youth identify as transgender due to "social contagion" and online influences. Unfortunately, the paper did not survey any of the youth themselves or their clinicians. The only thing the paper established is that some people online believe that youth rapidly become transgender as a result of watching trans-related content on Youtube and Reddit. article continues after advertisement

> People should be aware that parents often think that transgender youth became transgender "all of a sudden," because youth were closeted prior to coming out, due to fear of family rejection. Presumably, youth with parents who believe being transgender is a disease would be likely to conceal their identity for prolonged periods of time. It would be important to interview the youth themselves to know if this were the case.

https://medium.com/@KatyMontgomerie/jkrs-claims-part-6-lisa-...

> There was a lot wrong with Littman’s paper. Firstly the study involved no trans people, just the parents of trans people. Secondly all of the participating parents were found on just a handful of websites such as “Transgender Trend” and “Youth Trans Critical Professionals”, which run forums specifically for unsupportive parents of trans kids. As JKR notes the controversial paper received a lot of criticism from within the scientific community:

> "The journal took the paper offline and re-reviewed it before republishing it."

> But it is deceptive of JKR to describe what happened in this way. The post-publication review resulted in major corrections to the paper and an apology from the editor of the journal. The editor noted “the corrected article now provides a better context of the work, as a report of parental observations, but not a clinically validated phenomenon or a diagnostic guideline”. For a comprehensive takedown of this paper see here.

That last sentence links here: https://genderanalysis.net/2018/02/rapid-onset-gender-dyspho...

What is the difference between being gender fluid and having some traits & preferences typically associated with the other gender?

Great question. For me it's that sometimes I have those traits and sometimes I don't. I don't really have a set of traits and preferences that is consistent from day to day or hour to hour. Some days I'd prefer others see me as a man, other days I find that repulsive.

So, gender fluid, because my gender is dynamic and shifting. I don't always see myself as femme, or masculine, but rather shifting between and around them.

but why bother with gender at all in this case?

The feeling of gender dysphoria is not a pleasant one. Coming to an understanding helped me rationalize and address my anxiety.

Ultimately, gendered stuff is all around us and it is not so easy to "just not bother".

so you are a non-transsexual transgender? or did you transition to a suitable body?

because yes, gendered stuff is all around us, but in most "though" cases, it mostly seems to relate to sex, because that's something which is easily determinable for a large fraction of human beings.

So your problem was that other people didn't accept you for what you are: is this really different from society not accepting that you would like to have 5 wives, your parents wishing you to be a lawyer, whilst you want to be a shepherd or any other discrimination? Why do we have to divide people on a spectrum (which also suggests that personality is a measurable, which is disturbing...) to remedy this? And why is it necessary for people to advertise their pronouns, when most of the communication, where you need that is non-personal anyway?

There isn't a body that's suitable for me, unfortunately. The best I could hope for might be a somewhat waifish androgyny, but even that would only be a very, very loose approximation.

> So your problem was that other people didn't accept you for what you are

No, the problem is that my identity didn't match my external presentation. Yes, fixing that comes with some stigma (and that sucks), but fundamentally the problem is making the outside match the inside.

> And why is it necessary for people to advertise their pronouns

Being called he causes dysphoric feelings and anxiety for me. This is not something that I have conscious control over. I have learned some adaptive behaviors, but ultimately it's much less uncomfortable for people to use they/them for me. I ask people to do this, and generally people don't have an issue. You could also use my name and avoid pronouns if you want. Ultimately, you can choose not to use my pronouns knowing it makes me uncomfortable. I ain't going to yell at you, but I'll also remember that you made a choice knowing how it impacts me.

> Why do we have to divide people on a spectrum

Great question. I actually think of gender as much more complex than a spectrum, but there are folks who see it as two, concrete points and will loudly exclaim "ONLY TWO GENDERS" to me. I'm just sharing my own observations about the behaviors I've seen and how I choose to interpret them.

Some detractors often say transgender people have mental health issues.

But they mean it in the sense that they should be in an asylum or should not be catered to.

A reality is that:

A) Gender dysphoria is an imbalance of neural state. Therefore that would by definition be a mental health issue but not like the detractors say.

B) Acknowledging and accommodating gender dysphoria discomfort costs cisgender people nothing and unlocks the productiveness of an additional population in society.

> But they mean it in the sense that they should be in an asylum or should not be catered to.

I have often heard it in a sense of "should not be catered to but rather given medical help". A fellow student once told me that he considers the current way of treating gender dysphoria irresponsible and that, if we'd treat schizophrenia the way we treat gender dysphoria, we'd all have to aknowledge the voices they hear and pretend we hear them too.

I didn't know how to respond to that. I still don't, actually. My knowledge about anything mental health is quite limited.

that response honestly sounds like he is referring to a caricature of schizophrenia as the ultimate ignorable and irreconcilable mental health disorder and doesn't actually know how we treat schizophrenia either

how do we treat schizophrenia? it is something that can also be managed

thats the primary limitation of the analogy. the secondary limitation of the analogy is that un-ironically accepting pronouns that otherwise bend the English language really costs us nothing, and gives us productive members of society instead of marginalized.

> if we'd treat schizophrenia the way we treat gender dysphoria, we'd all have to aknowledge the voices they hear and pretend we hear them too.

Transgender people have existed in some form for a long time, the medicalization of it only started in the late 19th + early 20th century.

The difference I see between the two is that there isn't a known 'fix' for gender dysphoria besides transition. I don't think any trans person would protest to never having to go through transition... but they definitely don't advocate for extermination of trans people either.

There are plausible biological causes for being transgender that are parallel but not equal to intersex issues.

> "If we'd treat schizophrenia the way we treat gender dysphoria, we'd all have to acknowledge the voices they hear and pretend we hear them too."

This is easy to dismiss by pointing to evidence based treatment practices. The treatment which is most effective at reducing suicide rates among people experiencing gender dysphoria is gender affirming care [0]. I doubt it is the case that the treatment that is most effective at helping folks experiencing schizophrenia is "acknowledging the voices" (not to mention as sibling commenters have that this is a gross caricature of schizophrenia in the first place).

It's extremely strange to me that we pretend like gender affirming care is "everybody pretending" and not a well studied and evidence based set of treatments that has been shown to be effective.

[0] https://www.thetrevorproject.org/2020/01/29/research-brief-g...

can anyone shed light on why this comment is controversial, compared to all the sibling, parent and cousin comments?

Thank you for your reply. I have to work but will make sure to read the link you provided on my tablet before hitting the hay tonight.

> I have often heard it in a sense of "should not be catered to but rather given medical help".

The thing i worry about is that folks that go through all of the physical and emotional (and financial) stress of transitioning only to find that it doesn’t soothe the pain are likely to perceive a social pressure to keep a lid on it.

The current trend of acceptance is obviously good but it seems likely our approach to treatment will evolve over time.

> The thing i worry about is that folks that go through all of the physical and emotional (and financial) stress of transitioning only to find that it doesn’t soothe the pain are likely to perceive a social pressure to keep a lid on it.

Nope, "de-transitioners" are very welcome in the trans community, to tell their story, to hang out, to help others.

There's absolutely nothing that should force them to not speak out about their experiences as long as they treat others with basic respect; there are a few that have turned religious zealot and sue people.

Detransiton / desisting is relatively rare and frequently happens not because the person desisted trans identity but because they couldn't feasibly continue to transition due social or financial causes.

That’s great to hear, thank you.

I find your broad "nope" troubling. How are you so comfortable speaking for the entirety of several others' experiences? (While problematic) the nature of the gp's claim would be impossible to prove or disprove without mind reading powers. Even if many or most trans-accepting groups make an active effort to support those with regrets...the social pressures for someone to not voice those regrets are blatantly obvious.

I know a couple of folks who transitioned thusly, retained their trans friends and continue to hang out in the community. For one, I was present during one's "de"-transition (it's just a transition). It went fine, because the community I know is supportive of how folks identify their gender. They talked about not feeling right for a few months, later announced that their pronouns were changing, so we supported them when they felt off and changed pronouns when asked. It was a fairly simple matter, really. It's not uncommon for trans / nonbinary people to experience fluidity over short or long time periods, and "de"-transition is on that spectrum. No biggie, the world keeps turning and we're there for eachother.

Notably, I've heard one such person say something along the lines of "well, no, I'm not cisgender, I transitioned twice so I'm definitely trans." Labels are pretty silly that way.

>the nature of the gp's claim would be impossible to prove or disprove without mind reading powers

Or by using inferential statistics.

People making claims like that generally no nothing of the procedure by which mental health issues are diagnosed - which is to say, mental health treatment is about addressing issues which are negatively affecting someone's quality of life, until they are not. This is the same reason you can't just go through the DSM V and ascribe mental health conditions to people on TV or in the media or whatnot - it doesn't work that way.

People who hear voices don't have a problem because they hear voices, they have a problem because in general schizophrenia presents those voices as hostile and aggressive towards the person. People who hear voices that are positive or helpful (which is not uncommon, though it seems to be less common in Western culture socialized people) don't have a problem, probably don't even need treatment if they do not cause any distress.

That trans-people live happier lives after transitioning means that the treatment they receive (hormones,gender reassignment surgery, remembering that all of those are quite optional) is completely adequate.

Don’t they have much higher suicide rates? How happy can that be?

Abused children also have high suicide rates, but that's presumably not because of some inherent internal tendency to suicide, right?

Not a question of inherent tendency but cause of. Those who have elected to adapt to their convictions through surgery, hormones, etc. still have very high suicide rates. The studies (I don’t have them handy) undermine the notion that the increased risk and incidence of suicide of “pre-transition” individuals with gender dysphoria are suicidal because they’re “forced” to live in a way that seems to then to be at odds with how they feel. But we find that “post-transition” we still see high rates. Some claim that this is because of the environment, but I believe that was also addressed and found unconvincing.

On the other hand, I have heard therapy for gender dysphoria (GD), such as that which addresses GD in children, can be highly effective in resolving whatever issues that are causing the confusion in the first place.

> But we find that “post-transition” we still see high rates

But lower than pre-transition.

> but I believe that was also addressed and found unconvincing.

I can't say I understand how a paper would account for systemic discrimination, but even if they did so successfully, treatments for most things don't have 100% rates of success.

> On the other hand, I have heard therapy for gender dysphoria (GD)

Yes, and this is normally part of treatment for GD for anyone. It just very often doesn't work.

41% meme aside, we really do not have good data for this yet imo, the life experience of someone who transitions at 25+ with little to no support and someone who never even went through the puberty of their birth gender and had a supporting family/school etc is so dramatically different

Post-transition transgender people have lower suicide rates and better mental health overall than those that are pre-transition[0].

[0]: https://pubmed.ncbi.nlm.nih.gov/24344788/

n = 57. You can't be serious, right?

How large should the sample be before it's substantive?

The British polling institute advises a sample of 1000 for a total UK population of around 60,000,000. Trans people make up 1% so roughly 600,000, with that in mind 57 doesn't seem that low?

Bigger than 57. Bad power is bad power whether or not it's the best you can get.

The required sample size doesn't depend on population size that much.

As a trans person that has started hormone therapy "late" ( I'm in my 40s), I can tell you I _feel_ much better since...

I know it's just one data point...

The appropriate comparison to judge the treatment is not "suicide rate in trans people vs in the general population" but "suicide rate in trans people vs in people who experience dysphoria but do not transition".

I don't think this is true. A psychiatrist would never validate positive voices, except perhaps in the pursuit of further treatment. "Yes, your positive voices are real."

They would treat it as an illness, whether or not they prescribe treatment.

> if we'd treat schizophrenia the way we treat gender dysphoria, we'd all have to aknowledge the voices they hear and pretend we hear them too

That might not be the worst idea.

https://www.theatlantic.com/health/archive/2014/07/when-hear...

> But a new study suggests that the way schizophrenia sufferers experience those voices depends on their cultural context. Surprisingly, schizophrenic people from certain other countries don't hear the same vicious, dark voices that Holt and other Americans do. Some of them, in fact, think their hallucinations are good—and sometimes even magical.

> In an article for the American Scholar, Luhrmann describes one such patient, a 20-year-0ld Dutch man named Hans, whose inner voices were urging him to study Buddhism for hours each day. He cut a deal with his demons, telling them he'd say Buddhist prayers for one hour per day, no more, no less. And it worked—the voices subsided and he was able to taper his dose of psychosis medications.

I'd like to argue a little bit for treating the voices in your head as real.

There is a phenomenon of "plurality" where you perceive yourself as a system of multiple people/personas with unique personalities and interests and identities. Psychologists would generally classify patients who show up this way as having dissociative identity disorder - but only if they meet the criterion of the symptoms causing distress/affecting your lives, and many plural systems seem to be just fine with it.

https://www.reddit.com/r/plural/wiki/faqs is probably a good starting point for reading about it from an inside-the-community view. (There's a plural community for essentially the same reasons that there's a transgender community.) https://smallcedarforest.org/on-transgender-and-plural-exper... is an interesting post from someone who connects plural and transgender identity. (FWIW, the one person I know IRL who is out about being plural is also trans.)

Going further back, we have stories across cultures of people who (either positively or negatively) claimed the ability to communicate internally with other personalities/identities, and occasionally those personalities would "front" (in the language of the contemporary plural community).

And then, of course, there's the case of the woman who heard voices insisting that she get a CT scan. Her psychologist, who was giving her medication to suppress the voices, decided to do the scan just to prove she was fine - and she had cancer that required operation. When she woke up after surgery, they said, "We are pleased to have helped you. Goodbye," and they never returned. https://www.researchgate.net/publication/232271307_A_difficu...

And while I was trying to find that story, I found this one, of an organization that helps people who hear voices in their heads by telling them the voices are real and helping them work through it: https://www.minnpost.com/mental-health-addiction/2014/04/mos...

While carefully not expressing an opinion one way or the other, a more clear-cut example might be body integrity dysphoria: https://en.wikipedia.org/wiki/Body_integrity_dysphoria, in which some feel that parts of their body are alien to them and should be removed. Should people support those who have this dysphoria and allow them to proceed or do the negatives outweigh the positives?

If it reliably produces better outcomes why wouldn't you?

What next, prevent women from having tubal ligation because you're offended that they don't want children?

> should not be catered to but rather given medical help

Would they say the same for gay people? It wasn't that long ago that being gay was considered a mental disorder in need of fixing.

> I didn't know how to respond to that.

Ask him why WHO and the UN are working on depathologization of transgender, trying to remove it from diagnostic manuals.

Ask him what breakout symptoms in schizophrenia are, and why we think it's better that people continue to hear voices (so long as they're not distressing) than be medicated so heavily all voices disappear.

You could try this response: treating every every mental health issue as a hallucination is similar to treating every medical issue as a heart attack. As an example, treating depression as if it were the same as hearing voices would hurt the person and be medically irresponsible. And since you wouldn't offer to do heart surgery on a friend, you should also stop trying to be people's psychologist until you are trained and qualified.

if we treated gender identity disorders the way we treated schizophrenia we would consider them to be credible & serious conditions that require medical intervention at an early age as opposed trying to pretend they'll go away if you close your eyes long enough.

I believe parents subjecting their children aged 5-9 to hormone treatments are abusers running after a trend. Schizophrenia usually develops after puberty, previous cases can happen but are extremely rare. The parents decision ultimately, but I don't see the advantage of medical interventions for anything related to gender "at an early age".

You must think doctors are fucking idiots if you think they're handing out hormones to pre-pubertal children on the say so of a parent.

Unfortunately there are private clinics practicing this very thing despite a majority of people growing out of their desire to transition at a later age. Medical abuse is not unprecedented. I believe it to plain child abuse and propose the the children affected get some legal support for possible recourse.

This is nonsense.

Maybe, in that case giving them a possible vehicle to defend themselves shouldn't pose a problem. And that includes holding parents and practitioners accountable.

No, it's nonsense to suggest that 5 year olds are being given hormones to trans them.

Making the assumption that a mental health issue, perhaps disorder, equates to an illness is a non scientific prejudice.

Where is the line between "mental health issue" and "mental health illness" if both decrease the patient's quality of life?

An illness is an unhealthy condition, suggestive of treatment if treatment is available. A medical issue is an identifiable subject in the realm of medicine. Most things identifiable are not immediately unhealthy.

I agree and understand what you are saying

> equates to an illness

It really seems like we have overlapping and limited words here. I think there isn't a clear distinction between "illness" and "disorder" and this confuses people or isn't helpful in curbing insensitivities.

I think we do have to acknowledge that if we want a safer environment for trans people, a safer environment in the sense that it relies on the mutual cooperation of currently dismissive and insensitive people that aren't willing to cater to people with "mental health issues but not that kind".

Nobody is suggesting that.

>Acknowledging and accommodating gender dysphoria discomfort costs cisgender people nothing and unlocks the productiveness of an additional population in society.

This seems like a pretty broad generalization. Forget the semantic fact that by definition, accommodating something takes effort. Some people's worldviews may not account for gender identity being expressed this way. Whether you agree or disagree with the worldview, saying it costs them nothing to acknowledge it seems pretty unfair. Especially when it assigns a label to people its imploring to be accepting and accommodating of. It's a strange way to try to win allies.

if hyperbole doesn't match your worldview of being pedantic then we can rephrase: it is an extremely low effort patch that has a net positive for society. The net positive is empowering productive people in the workforce. People that were otherwise marginalized, or uncomfortable enough to be suicidal. A prerequisite to this worldview is that we don't want them to go away or be dead, which seems to underlie some people's perspective.

The unfortunate truth of the world is that no one cares about everyone. Asking people to adjust their worldview so someone they don't know or don't care about doesn't off themselves just isn't a great sales pitch (especially to the conservatively inclined). Some of those people mean it when they say "go f* yourself".

Being inclusionary isn't costless - historically the marginalization of trans (or other minority groups) gave the establishment / mainstream / cis in this case peoples power to dictate the material conditions of that group. The marginalization of trans people empowered the rest to drive them to suicide or normalize their abuse. That kind of power dynamic is appealing to sociopaths and other hostile personality types.

That doesn't create any economic benefit of course - bigotry in general is an economic impediment. That does not stop its widespread practice, it just means that in macrospect practitioners of hate repress their populaces productive potential and we can hope over sufficient time frames that leads to their own self inflicted obsolescence.

> B) Acknowledging and accommodating gender dysphoria discomfort costs cisgender people nothing and unlocks the productiveness of an additional population in society.

jesus that's a shocking thing to read. Nothing about how they feel or wish to be treated - the very basis of human decency - but how they should be tolerated for society's industrial needs. OMG that's so cold.

You chose to read it that way for the sole purpose of finding fault with it

There are other ways, try again

Here is a hint, read it under the presupposition that a marginalized population is the worst thing possible, and that “productive” doesnt mean industrial

Seems possible it arises from a greater willingness to accept things about themselves and do things like transitioning that are socially stigmatized.

I think it would be good for people with autism to investigate probiotic food supplements. Digestive tummy issues is more common in people with autism. This is likely due to differences in tummy food metabolism in people with autism. There is a link between brain / autism and metabolism in the tummy bacteria system.

I would recommend looking into and reading up on Biogaia l.reuteri dsm 17938 and l.reuteri atc pta 6475. Brand name “Biogaia Gastrus”. There is a sub community which blends these food supplements with Yoghurt. Some people report better functionality of autism eating Biogaia Blue. Do Internet search for these Probiotic strands and Autism. Hope this can help.

Microbiota transfer improves autism symptoms

https://microbiomejournal.biomedcentral.com/articles/10.1186...

I think the last thing autistic people need is snakeoil salesmen telling them what product they should buy that has no scientific basis whatsoever.

Reply on news.ycombinator.com