The mode for treating trans kids is puberty blockers until they’re 18 and then they can choose their own treatment - but that pathway is being blocked by more and more laws and fear mongering about kids being transitioned against their will
When patients are given puberty blockers, desistence rates are miniscule, in the single digits. Proponents of hormonal intervention insist that this is proof that doctors are selecting kids that would persist in a cross sex gender absent blockers. But that's hard to reconcile with psychologists previous failures to predict persistence. While they're billed as giving "time to think", it's pretty much impossible to deny that blockers are causing patients who would have desisted in their cross sex gender identity if they went through their natal puberty.
It's not just conservative American States that are changing course on blockers for children: Finland, Sweden, the UK, Italy, Denmark, and Norway have all stopped prescription of blockers in children. Plenty of other countries never allowed it in the first place.
That is an extremely generous interpretation. I think you're giving way too much credit to the average person that uses that argument.
Also I really have to wonder how much of that desistance is giving up versus actually being satisfied.
I feel like as a society we put trans people in a situation where it is controversial for them to transition as children, but also controversial for them to transition as adults. (The notion of a man in a dress no longer exists if the man never had male puberty, but not only is it controversial for such a boy to never have male puberty, we villainize the now-man's attempts to become a woman!) But then we say that outcomes for trans people are bad so them staying in the closet is good. Which is weird, because the cause of the bad outcomes is that there is no stage of their life where trans people can transition noncontroversially.
Higher rates of suicidality: https://pmc.ncbi.nlm.nih.gov/articles/PMC7011156/
~4x the rate of depression: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
Even if these disparities are due to discrimination, those disparities still exist. We don't measure health outcomes based on what hypothetically would happen in an ideal world where people genuinely do not recognize or distinguish between the sexes. We measure health outcomes based on what happens in real world.
You will say "but then you were not a desister" but I would be counted as one, just like the other kids in my position.
I wonder how many left handed people were beaten into becoming right handed, and remained right handed. In a society where left handed people continue to be beaten, would these people be considered happily right handed since they continue to use their right hand? How would we be able to tell?
I wonder if we existed in a world where soft boys were beaten into becoming less emotional, who grow up to be unemotional men. In a society where adult men are beaten if they express softness, are these men considered happily unemotional? How would we be able to tell?
How do we tell if someone is cis when it is stigmatized to be trans or express gender dysphoria? Genuinely not sure, honestly.
This is why talking about what the outcomes would be in some hypothetical world is pointless. Doctors are striving to deliver the best outcomes in the real world, not the outcomes in some hypothetical world that doesn't actually exist and probably never will.
> yet also use the discrimination against trans people as a justification to discriminate against children exploring gender, i.e. trans children.
Children are free to explore their gender. Just not with powerful drugs that have lifelong effects. Refusing to prescribe puberty blockers to a child experiencing gender dysphoria isn't discrimination any more than it is to refuse to prescribe artificial testosterone to a boy that has normal levels of testosterone for his age. We "discriminate" against this boy that wants to explore hypermasculinity, too.
> I wonder if we existed in a world where soft boys were beaten into becoming less emotional, who grow up to be unemotional men. In a society where adult men are beaten if they express softness, are these men considered happily unemotional? How would we be able to tell?
You would measure their health outcomes: do the latter experience depression or other negative mental health conditions at different rates? Do they die by suicide at different rates? I haven't dug deeply into the effects of corporal punishment, but presumably it's discouraged because we've observed negative outcomes.
> How do we tell if someone is cis when it is stigmatized to be trans or express gender dysphoria? Genuinely not sure, honestly.
I'm not sure what you mean by "how do we tell if someone is cis". I think you mean something along the lines of "how do we tell which gender dysphoric children will or won't continue to experience dysphoria in their cis gender past natal puberty?" If that's the case then the answer is "we can't". Psychologists tried, for decades, and failed to predict the minority of patients that would persist in cross sex gender identity. We know that ~80% become comfortable in their cis gender after natural puberty. This is why it's hard to justify prescribing puberty blockers. Suppressing natal puberty will help someone pass better in a cross-sex gender, but the benefits of passing better need to be weighted against the probability that the child would live comfortably in their cis gender without dysphoria absent blockers.
Which is the better health outcome? 5 trans people who medically transitioned before puberty, or 4 cis people who live comfortably without dysphoria in their cis gender and 1 trans person who transitioned after natal puberty? Ideally we'd be able to predict the 1 patient that would persist, and transition them medically before puberty. But again, we don't have that ability. Thus, it's insufficient to justify prescription of puberty blockers by pointing to the one trans person who medically transitioned as an adult and say that they would have had a better live if they were able to transition medically before puberty. This is the big reason why advocates for puberty blockers tend to dislike discussion of persistent rates with versus without puberty blockers. It's fairly easy to justify them in the simplistic world where all gender dysphoric youth are guaranteed to persist. But factor in the persistence rates without blockers and it becomes vastly harder to make the case for them.
Coulda said the same about homosexuality ~30 years ago. It’s a bad reason then, it’s a bad reason now.
> You are counting kids with GNC behavior who never talked about transitioning themselves stopping said GNC behavior.
These children met the criteria for GID in the contemporary iteration of the DSM. The author of the study I linked would go on to write the criteria for gender dysphoria in the DSM-V. The idea that we'd see a substantially different rate of desistence if the DSM-V was used is not likely: the author of the study has stated that most of the children would have met the criteria for gender dysphoria under the DSM-V.
> You are also counting kids who end up repressing (some of which end up transitioning with worse outcomes years down the line)
The study followed up with patients for an average of over 10 years. Do you have any actual evidence that a significant portion of desisters in this study transitioned later in life? Or are you just stating this without evidence?
People have not offered a good explanation why these rates of desistence are false. They either insist that the criteria used was wrong, or baselessly claim that desisters are repressing a desire to transition.
Puberty blockers are a huge step. Not one taken lightly. Kids who are unsure, by and large don’t take that step.
I injured my wrist a few years back. Doctors offered me pt or surgery + pt. They clearly advised me that given the low severity of my injury, surgery would likely improve some things while causing other impacts. I declined the surgery.
This is how most medical choices are made. Doctor advises, patient listens and choses best option. For patients who are also minors - their parents are also involved. Every day a parent and child choose between consequences of the intervention and consequences of non intervention. The only difference with trans kids is apparently you and the gov want a say in the choice. It’s not your body, nor your kid. It’s none of your business.
Well, first off - we trust children to make life-altering decisions every day - sometimes without good access to info about potential downsides. A great example is sports. Many sports (ballet, football) can and do have life-long health and quality of life impacts. Minors can commit to those and yet there’s no widespread moral panic about it.
The thing is I actually do trust children to figure out what’s best for themselves. Children are impulsive, yes - they have poor in-the-moment judgement. But medical transition isn’t something that can be done impulsively. It takes years of consistent action, not minutes or hours.
> Do you have any actual evidence that a significant portion of desisters in this study transitioned later in life?
I don't have enough funds to perform such a research, maybe there exists such a paper but I have not looked for it. In general trans topics are woefully underfunded. But I know enough people that ended up desisting either due to conversion therapy or due to shame and lack of support from their family, and transitioned years afterwards (5-15+ years) after living shitty and depressing empty lives pretending to be cis.
> But I know enough people that ended up desisting either due to conversion therapy or due to shame and lack of support from their family, and transitioned years afterwards (5-15+ years) after living shitty and depressing empty lives pretending to be cis.
This is called "anecdote". As I said, the claim that a sizeable chunk of desisters transition later in life is being made without evidence.
And again, with a mean followup time of over 10 years, most of the people who transitioned 5-15 years later would be counted as persisters, not desisters.
> This is called "anecdote"
When you are lacking proper research all you are going to get are anecdotes. Let's not put our heads in the sand.
> with a mean followup time of over 10 years, most of the people who transitioned 5-15 years later would be counted as persisters, not desisters.
10-15 years means that you are 25-30 if you came out at 15. At that point people often self-medicate with hrt and nobody ends up knowing. The mean age of 10 years is because they tracked younger children, if you came out at 7 its unlikely that you will transition at 17 with unsupportive parents, especially back then.
Of course not. There is an assessment period. They are assessed for gender dysphoria, and if diagnosed they may be prescribed puberty blockers to treat their gender dysphoria. And what is the criteria for diagnosing a patient with gender dysphoria? Whether or not you think the criteria in the DSM are effective, at the end of the day these are the criteria that would be used to approve puberty blockers. If you think these criteria erroneously include kids who aren't "trans kids" then we're approving puberty blockers for patients who aren't "trans kids".
Of course a longer follow up time is strictly better, but it's not valid to simply fill in a gap in data with whatever better suits your worldview. If a study measuring rates of detransition follows up with patients for 10 years, then patients that detransition after 10 years would not be counted. Is it valid to point to a couple anecdotes of detransition, and then claim that the study's finding are false because there's loads of people who detransitioned after 10 years? Of course not. But that's the same flawed criticism you're making here.
Why the scarequotes? For the record I don't think I have used these two words together, but I obviously do think that kids can be trans just like anyone else, is that even debatable?
> don't get prescribed blockers
I am quoting here out of context but correct, there is no point in puberty blockers before the "natural" puberty.
> There is an assessment period. They are assessed for gender dysphoria, and if diagnosed they may be prescribed puberty blockers to treat their gender dysphoria
Sure, and we have been saying that these criteria are unscientific, inaccurate, and based on social stereotype.
> at the end of the day these are the criteria that would be used to approve puberty blockers
The difference being that teenagers who don't explicitly seek them because they don't consider themselves as trans are never considered for undergoing puberty blockers. All that study shows is what we have been saying all the time about the DSM.
> If you think these criteria erroneously include kids who aren't "trans kids" then we're approving puberty blockers for patients who aren't "trans kids".
No, because teenagers who don't consider themselves trans do not seek puberty blockers and are therefore never considered for them. The main distinguisher between trans and nontrans people is their self identification.
> Of course a longer follow up time is strictly better, but it's not valid to simply fill in a gap in data with whatever better suits your worldview. There certainly seems to be a pattern.
I don't think it's surprising or debatable that trans people who undergo conversion therapy or grow up in oppressive/conservative environments often end up repressing.
1. Expressed a cross-sex gender identity. They were trans kids, as you choose to term it.
2. Met the assessment criteria that would be used to approve a patient for blockers.
Yes, the desisters in the study would most likely be prescribed blockers if they went to a gender clinic that prioritized affirmation.
> The difference being that teenagers who don't explicitly seek them because they don't consider themselves as trans are never considered for undergoing puberty blockers
Again, these patients did express a cross-sex gender identity, or "consider themselves as trans" to use your language. If they never did, then they can't desist from a cross sex gender identity if they never expressed one in the first place.
> No, because teenagers who don't consider themselves trans do not seek puberty blockers and are therefore never considered for them. The main distinguisher between trans and nontrans people is their self identification.
To re-use your terminology, studies found that ~80% of the children who considered themselves trans stop considering themselves trans and become comfortable and no longer experience gender dysphoria in their cis gender after natal puberty. It seems like the root of the problem is the lack of understanding that the children in the study did "consider themselves trans", as you choose to put it.
If all you're going to do is continue to erroneously claim that the patients in this study weren't expressing a cross sex gender identity ("consider themselves trans"), or baselessly claim that the desisters are actually just repressing a trans identity then there's no value in continuing this.
I am talking about d6e
In the UK, Canada, most of the rest of the world? Single payer public health systems mean trans healthcare isn’t more profitable than any other type of health care. Doctors have no profit incentive, as there are easier less controversial specialities that have larger patient bases and higher patient thru-put.
Well there was never going to be a perfect solution, right? So a solution that results in the most number of satisfied adults is an okay goal.
If you ask trans people, "it's too late to live as my gender" is a common sentiment. You even see it in the gay community, where gay/bi people who come to acceptance of their sexualities late in life, feel like it's "too late" to live with that identity, and choose to continue to live and identify as straight people.
Hence the option for puberty blockers.
Turns out trans people will opt to go through the puberty that matches their gender if the opportunity arises, just as more people come out gay/bi/etc at an earlier age now that the opportunity arose.
Same thing with gay people, as per your example. I'm sure some do remain closeted their entire lives. But plenty of them come out as gay later in life.
Plenty do, but the ones that don't give credence to the idea that forced closeting as a teenager makes it harder to follow your heart later. And that's in a situation where it doesn't get more difficult to come out later (if you're not married). Transitioning pre- and post- puberty is very different with current medical technology, so a lot more people will get "stuck".
> But plenty of them come out as gay later in life.
Some do, but statistics show that the majority don't. At some point it stops making sense to identify as a gay/bi person if you've been married for 20 years and have no intention of leaving. That ship has sailed, so to speak. The same thing happens with trans people for very practical and biological reasons post-puberty.
Well, yeah. That's because it literally was a passing phase that the child experienced. That's why there's so many studies (some of them linked in this thread) showing that if you simply defer the decision until the minor is a major , the majority of gender dysphoria desists.
IOW, once the child has actually matured a little, their identity confusion goes away.
Deferring is the path of least harm; is it any wonder then that most of the people in the world, including highly secular countries, go that route?
There's a reason there's nearly 10x as many gay identifying people in recent generations compared to past, and you can't generalize it as being a "phase". The true rates are likely the same, but people who identify that way dip off as you go back generations.
You notice the same pattern with left-handedness and those who identify as left-handed over time.
Left handedness increased from about 5% to 12% over the span of more than 60 years: https://www.datawrapper.de/blog/history-of-left-handedness
By comparison rates of transgender identification among minors has increased by a factor of a hundred over the span of just 10 years: https://www.researchgate.net/figure/Rates-of-newly-recorded-...
We're talking about an increases that are multiple orders of magnitude greater, over a fraction of the time span.
We've always done so - popular opinion as reflected by the voters dictate that you aren't getting a prescription for arsenic (anymore? Or crack cocaine, for that matter.)
The government, for good or bad, regulates all healthcare, and that government is guided by its voters.
The majority of voters don't see this as a bigger problem than the issue they are currently voting on.
That began in 1906; it's hardly something we've "always done".
As someone else pointed out, the idea of gov deciding what our doctors can and cant give us is a VERY modern concept.
But your examples: arsnic & crack
1. Cocaine is legal for doctors to prescribe and use in specific circumstances. What is legally prohibited is recreational use. Most of the restrictions on use are due to the threat of addiction, not the threat of appropriate medical use.
2. Arsnic is similarly entirely legal for medical use. Restrictions are around putting it in FOOD because it’s POISON. Nobody is saying you can’t treat cancer with it, if it’s shown to be effective.
Your examples are not examples of the majority regulating medical care for individuals.