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I don’t know if it’s naïve, but I’ve always sort of assumed that transition is something which gets recommended after years of therapy where someone is consistently exhibiting being gender dysphoric.
I’m curious because I think this is a key point where left assumptions and right assumptions tend to diverge. Left assumption: you talk about gender dysphoria with a therapist and they evaluate you for a long time to make sure it’s actually there and is affecting your life in a severe way before recommending any life altering treatments. Right assumption: any old kid reads something online about gender fluidity, experiments with the idea for a short phase, the doctor algorithm says, dysphoric, boom here’s some hormones to take.
Idk which one it looks more like in reality.
Like, I think it’s fine that people transition, but I also know it’s easy to basically trick psychologists until I get prescribed Adderal. Right? So ideally transition would be there but you’d have to spend a huge amount of time and commitment to get anybody to open up the door where it’s locked up at.
That feels to me like a place where some common ground can be found? But maybe I’m also naïve there too, lol.
This is part of a bigger suspicion that all of our problems are solvable by understanding that there are fractions of truth claims in what both sides tend to offer, but it’s very unpopular to say so because we immediately perceive the other side as the worst consequences of their way of thinking rather than looking for where there is a bit of truth in what they say.
Hospital in Canada:
I suppose if the hospital's "Gender Pathways Service" is already prescribing puberty blockers so freely that there's no requirement for diagnosis beyond the child or child's parent getting a referral by saying something about transgenderism to the family doctor, giving them before the first appointment saves time. While doing so based on 0 appointments is obviously unusual, quite a few of the anecdotes I've heard mention prescriptions after the 1st appointment. The way you describe it used to be much more standard, I remember trans-activists complaining about previous requirements like living for 6-months to a year as the opposite gender, but doesn't seem common anymore.
It's possible they justify this with the argument that puberty blockers are much less significant than opposite-sex hormones and are just "giving the child time to choose" or some such thing, but that seems heavily contradicted by the evidence. For one it amounts to much the same decision: 97% of children put on puberty blockers go on to take hormones (page 38), but around 60%-90% of trans children who aren't given any intervention (the previously standard "watchful waiting" approach) grow up to not be trans. For another puberty blockers themselves, particularly when used to avert puberty entirely rather than delay precocious-puberty a couple years, are serious business. We know about them impacting bone density based on the use with precocious-puberty, but we also have reason to believe they impact brain development but have zero research on what that impact is in humans. The best I've found is this study on sheep. A concern mentioned by the NHS's independent review:
Given how the medical system is normally so obsessed with the precautionary principle (like the FDA shutting down early unapproved COVID testing) it seems crazy that something as significant as preventing puberty entirely has become standard practice based on no more than the same drugs previously being approved to delay precocious puberty. There's a severe lack of research on even the safety/side-effects of using those drugs that way, let alone a randomized control trial of effectiveness indicating it actually performs better as a treatment of trans-identifying children than doing nothing.
Broadly, I don't necessarily disagree, but surely got to be careful with selection effects here, and the direction of causation. It would seem likely that the kids who felt 'strongest' about their dysphoria would want to go on blockers immediately and those who weren't so sure watch and wait, and further that those kids who felt strongly would be more likely to persist in transition. Which is to say, it isn't that blockers make it more likely to continue transition, but that people more likely to continue transition take blockers.
The selection effects wouldn't be that straightforward because the second link is to a meta-study of studies by clinics on outcomes for all the children they diagnosed with gender dysphoria, none of whom were given puberty blockers. There unfortunately aren't many studies like that and the children in question were diagnosed before use of puberty-blockers became widespread.
Now, that definitely raises its own serious problems in comparing the two groups. In particular, the number of children diagnosed with gender dysphoria since those studies has risen enormously. At the recently-closed Tavistock/Gender Identity Development Service clinic in the UK, the NHS's only gender clinic for children, referrals rose from 94 in 2010 to 2,519 in 2018. So there's not a lot of reason to believe those diagnosed with gender dysphoria in the earlier studies included in that meta-study are representative of more than a small fraction of those diagnosed today. But it seems difficult to justify that those diagnosed with gender dysphoria before the increase would be more prone to desistance under a watchful-waiting approach than those who seemingly wouldn't have been diagnosed if they were born a decade earlier. It's possible to construct a narrative like that - I've heard arguments that the ability to diagnose gender dysphoria has become more accurate, or that the desisters would be better-off as trans but were forced back into the closet by a transphobic society. But it certainly doesn't seem safe to assume, let alone prescribing puberty-blockers based on that assumption.
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I just have to repeat that. Because the usual excuses I see made are that the doctors that screen these patients are just that damned good at their job. 100% success rate at identifying which pre-pubescents need puberty blockers. Nothing at all to do with the puberty blockers actually prolonging or increasing dysphoria.
But when the doctor hasn't even seen them yet, shifting the goalpost to "Yeah, I guess only kids that really want puberty blockers take puberty blockers" seem... weak? And inconsistent with everything everyone who's ever had any proximity to any children what so ever knows about this little thing called a "phase".
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Lol, yeah that’s pretty wild.
I stand very corrected.
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I think you laid out part of the "two movies" effect at play. Personally, I know one trans person, and as I keep saying, she got on estrogen literally the first time she had a meeting with a healthcare professional. She got a round of bloodwork done within a few days; results came in a couple weeks later and showed a severely low T level. Neither that, nor the obvious other severe issues (alcoholism, depression, political radicalization, Covid alienation induced mania) gave anyone any pause.
Maybe that's extremely unusual. But the Tavistock Clinic was recently shut down over complaints that they single-mindedly pushed transitioning, and apparently the UK is reconsidering those policies.
Wow, yeah that’s wild. I’ve never really talked to anyone who is trans about it so I’m blind on how it really works.
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Am teacher in Canada. You are naive. Social transition is instant. You’re a girl. You fail a test, you get scolded for it, you say “I’m trans” and suddenly everyone is terrified you’ll kill yourself and the test is forgotten. All you have to change is your name. Your clothes, behaviour, love of manly stuff like anime and fan fiction all remain unchanged, only now you don’t have to do any work at school because of your “mental health.” The other girls trip over themselves to affirm your new identity, and you all hug and giggle together in the cafeteria. If a social worker or counsellor is in on this, they will insist that your identity must be affirmed and your (in most cases, single) mother, aiming to literally save your life (because, suicide) will take you to the doctor to begin treatment. You dare not refuse, because you told everyone this was Not Just A Phase.
You can overdo it and say you’re a demon or something, but if you stick to the script and go to the right places, you can be well on your way to embodying the masculine ideal (5”2’ , blue hair, with a hint of a moustache) in a few weeks.
I don't live in Canada, I'm in the UK, but I've got to say the world you have described sounds fucking alien to me. I live in a very blue-tribe sort of sphere, but people who say that being trans has become 'cool' feel like they're on a different planet to me. Not sure how to resolve this really; I'm left thinking, if I, a very left-leaning person, have 0 experience with 'trans-trending', where are these trenders?
I mean, being trans sounds like a fucking nightmare to me.
They trenders are 16. If you don’t hang around teenagers you won’t meet them.
It’s probably a nightmare if you really are trans. What is crystal clear, though, is that almost none of the kids who say they are, actually are. That’s why it’s all girls. If a guy is trans he has to bear a lot of costs: get new clothes, look weird, change his voice, etc. A girl can change nothing, not even her clothes, (changing your name is really something you make everyone else change)and everyone will cheer-lead her bravery, and fall in line to affirm her new name and identity. The costs are borne by everyone else. It’s a cost-free power move, so it’s not surprising that kids are drawn to it.
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Wait what? In my perception this was always a girly thing.
I meant that these "trans" kids have zero masculine qualities. Nowadays, there's nothing girlier than saying you're a boy. One of them skipped my class, and when asked where they had been, replied "Home Depot." I felt bad, because I had judged this kid to be most unconvincing. But Home Depot? Perhaps I had been blinded by bias. "What did you buy there?," I asked. The reply? "This potted pansy! It's gardening day!"
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I think so too. Calling it "manly" feels like sarcasm to me - that the standard for counting as a trans boy is so low, no one cares if the hypothetical girl shows interest in any manly interest.
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As an older millennial I can only marvel, not without a little jealousy, at the brave new world we live in. Wow.
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I don't think the gender skeptic side thinks doctors immediately recommends medical intervention, although some rhetoric around puberty blockers being harmless and "buying time to question" being held as important is worrisome. I think the main concern is that everyone is just so unquestioningly affirming in such a way that there isn't a good offramp. Growing into your body is an often not affirming process and an alternative where you're constantly affirmed, on a topic where there isn't actually some objective or even internally subjective way to really verify the truth value of a claim like "I'm really a woman" is troubling. I don't trust the advocates to frankly lay out the case that a kid might not be trans and the only people in the pipeline are advocates. Hell, I have trouble actually rigorously proving to myself that I'm not trans if I adopt the framework that these advocates advance and I'm a pretty masculine person who is quite happy with my station in life. Seriously, I can't stress enough just how underdefined the whole thing is, a sufficiently charismatic person may be able to talk nearly anyone into questioning their gender if they buy in the premises of the ideology. I fear that the social groups these kids will find them surrounded by are the likes of /r/egg_irl who have memetic antibodies against all counterevidence that it's a phase. I fear puberty happening might actually be the thing that cures many of gender dysphoria and naive use of puberty blockers might force someone who could have been perfectly happy with their body to live as a permanent and sterile consumer of pharmaceutical drugs to poorly imitate the opposite sex.
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