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Comment by faeriechangling | Hacker News Reader

The evidence of the efficacy of some of the treatments for gender dysphoria like hormones are among the very best we see in mental health, we see outcomes just a bit below what we see for stimulants for ADHD, and they smack the shit out of crap like SSRIs. One can question the quality of this evidence, and how strong of an endorsement we should be giving, but things look good.

My biggest point of caution is that the past is not the present, and the amount of patients has exploded to such an extreme that said evidence is very arguably irrelevant because we're not treating the same body of patients as we were when most long-term evidence was gathered. We're seeing a tripling in the amount of people identifying as transgender. I question if we truly know how these drugs affect the MAJORITY of people seeking them.

https://www.nytimes.com/2022/06/10/science/transgender-teena...

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> I question if we truly know how these drugs affect the MAJORITY of people seeking them.

My suspicion is that they'll help in the short term, but I do worry about the long term. As long as we're careful about keeping research active and objective at least it won't take very long to start getting answers.

Since it seems we've already committed to the experiment, our focus should be on collecting data on the outcomes and making sure that no matter what those outcomes are these children are given our support and are treated with compassion as they grow.

You’re also not treating patients the same way.

Previously hormone treatments were always combined with extensive psychotherapy. Now the psychotherapy is optional.

I suggest reading “Time to Think” - it’s a journalism book about the Traviston clinic. It started out as a rigorous, comprehensive treatment center, but became a pill mill.

It’s a sad book, because it’s about people not getting the treatment they need.

Thisntake only makes sense if you ignore the years-long waitlists to see a therapist vs the week or two for shipping from and international pharmacy or traveling to an informed consent clinic.

You don't think trans people want the therapy lol? We're literally dying to get it.

Greetings from year 3 on a waitlist for a therapist

And that's just to resume care, I already have a diagnosis

Yeah it’s a really shitty situation.

> but things look good

There is an ocean of difference between medical transition and stimulants/SSRIs. The main one being that the latter category do not cause irreversible change to the body. You can just stop taking them and be more or less as you were before. This isn't true for a medical transition that begins in adolescence. Infertility, mastectomy, and significant increases in lifetime cancer risk all represent irreversible harm.

Both SSRIs and stimulants can absolutely result in permanent changes to the body, as do hormones.

None of these drugs are free of risk, but refusal to undertake effective treatment can also cause negative permanent changes to the body indirectly, so simply doing nothing isn't free of risk either.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... https://en.wikipedia.org/wiki/Post-SSRI_sexual_dysfunction

>We're seeing a tripling in the amount of people identifying as transgender.

This really makes me wonder if there isn't something else going on, such as young people simply being unhappy with their lives or the gender roles expected of them, and jumping on the "transgender" bandwagon as a way to escape that. The idea that 20% of the population is transgender really makes no sense. Maybe a large part of the population simply doesn't want to conform to what conservative society expects of "masculinity" or "femininity", so instead of simply ignoring that crap like they did in the past, now they believe they're "transgender" and try acting like the opposite sex.

It seems like desperate kids, full of Internet obtained knowledge but lacking any real wisdom, looking for a panacea.

Do you know any of these people personally, or is that just what it seems like (based on what you’ve seen on the web or something?). I know a few trans and non-binary people and they don’t really fit the picture you paint (admittedly also an anecdote, but still)

Green accounts concern-trolling in one comment and referring to a transgender "ideology" in another aren't here in good faith.

Thanks, had dark mode on so didn’t notice the green username, but that does make more sense of the tone of the comment

I promise these are in good faith. For what it's worth. I'm green because I lurk more than I post and I don't tend to save my account data after more than a few threads and this is a topic which personally affects me in which I have experience to share.

One of my best friends from school chose reassignment.

And yes at that age we all fit that description, only he decided to take hormone pills and surgery rather than deal with the real issues he had from childhood and school.

I wanted to be a girl too to a while, I wanted a sister so I made one up and lied about it. I can't tell you why at my age now, my solutions to my feelings weren't really all that logical. I'm fine now. I'm a happy to be male, I got used to shouldering some of the responsibilities of being a man, still learning though.

And I'm a green account because I don't stick with an account for more than a few threads. I don't see the point anymore.

But I am being genine in my experiences shared, for what it's worth to you, which seems very little at this point.

Thanks for sharing your experience, I think that adds a lot more to the discussion than your previous comment, which frankly came off kind of callous and out of touch because it reads like you’re writing off “kids these days”.

I don’t much see the point of rotating accounts if you lurk more than post (I lurk more than post too, usually), but whatever. But comments that come off as not thoughtful from new accounts tend to get less grace because there’s a non-negligible amount of bad faith posters, especially on politically charged topics

Honestly I still think this is an alt account, because the account age almost exactly matches the age of the thread (12h now) but your first post is only like an hour old. Plus the initial tone, I don’t know. I’ll give you the benefit of the doubt, but it’s lot of doubt. please post more thoughtfully in the future, your followup was good discussion at least but the initial post was borderline noise IMO

That linked article says 0.5% of adults and 1.4% of teenagers are transgender. Maybe you misread the stat that says 18% of transgender people are teenagers, compared to 7.5% of the general population being teen-aged.

I think there's some truth to the idea that people who might have previously "just" been gender non-conforming now identify as transgender.

See also: The Calhoun Mouse Experiments.

https://cosmosmagazine.com/science/mathematics/calhoun-roden...

Faced with population pressures, a lot of rats just gave up or altered their behavior.

> Among the aberrations in behavior were the following: expulsion of young before weaning was complete, wounding of young, increase in homosexual behavior, inability of dominant males to maintain the defense of their territory and females, aggressive behavior of females, passivity of non-dominant males with increased attacks on each other which were not defended against

> After day 600, the social breakdown continued and the population declined toward extinction. During this period females ceased to reproduce. Their male counterparts withdrew completely, never engaging in courtship or fighting and only engaging in tasks that were essential to their health. They ate, drank, slept, and groomed themselves – all solitary pursuits. Sleek, healthy coats and an absence of scars characterized these males. They were dubbed "the beautiful ones". Breeding never resumed and behavior patterns were permanently changed.

https://en.wikipedia.org/wiki/John_B._Calhoun

This was also just a social structure; those rats might not have been exposed to high levels endocrine disrupting plastics, lead, obesity, etc., that modern humans are. But that mouse behavior looks an awful lot like what we're seeing these days in online incel, or trans, communities, et al.

The flaw I see here is that there have been many instances where humans have been "overpopulated", especially compared to US population density, and we don't see these kinds of behaviors to such extents. There's no place in the US that has the kind of population density that exists in many different cities in the world today, particularly in India, yet there's no trans movement there that I've ever heard about.

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