Treatments for trans children and politics, world-wide

[Matrim Fox Cauthon]

5 minutes ago, Ran said:

As to puberty blockers, it's interesting that the German countries have come up with their own guidelines. One decision they've made is that long-running gender dysphoria in childhood is not a reason to prescribe puberty blockers prior to the onset of puberty, as they see evidence that the hormonal jolt of puberty can resolve dysphoria. Only if dysphoria persists for some period after the onset of puberty would they conside the use blockers to halt the process.

The mean age of youths receiving PBs as per the study in the Cass Review was 15.8, which would certainly not be prior to the onset of puberty for most youths, which is listed in the report as being on average age 11 for [birth-assigned] girls and age 12 for [birth-assigned] boys. I would be curious what is meant by "some period" after the onset of puberty here. 

----------------------------- 

It's pretty notable, IMHO, that the tone of the Cass Review is not so much about whether the NHS should provide gender-affirming care. The Cass Review repeatedly affirms gender-affirming care for GNC youths. On this matter, it's more about whether PBs effectively solve the issue(s) they are commonly being prescribed for in regards to GNC youths. This is to say, are PBs effective for youths experiencing gender dysphoria? Or is it that PBs have more of a psychosomatic placebo effect on their dysphoria? Are there more effective ways to help GNC youths with resolving their dysphoria? If the vast majority of trans youths on PBs transition,* does the rationale of "buying time to think about it" make sense? 

* Less than 10 of the 3306 people on PBs used in the study detransitioned. That is a 0.3 percentage. But I would also add that we do not necessarily know if these <10 individuals will transition later in life. I have been told that this is actually a point where statistics on detransitioning can be misleading, because a number of people who detransition will transition later in life and that detransitioning does not necessarily reflect "regret" or a sign of not being "trans" or GNC. Sometimes it's monetary reasons. Sometimes there are social and family pressures to detransition. 

[Rippounet]

Let's be honest, this threads exists because conservatives (on this forum and no doubt elsewhere) are spinning the Cass review as a vindication of their views, that is to say that the gender/trans- "ideology" is dangerous for kids, that gender and sex are identical, and that it is not scientific to allow kids (or anyone, really) to transition from their biological sex.

And I mean, sure, you can see it that way, it would be silly to deny it. I would certainly say that the Cass review has a conservative tone. But then, a bit of context, uh? The review comes in the wake of a lawsuit involving GIDS, so it's also the British government having to cover its agency's ass, the Conservatives have been in power since forever now, and the topic is highly political (Sunak making recently a bad joke on the topic during PMQs, and being called out for it by Starmer comes to mind).
So given the context, maybe it's good to take a bit of critical distance. Will access to medical treatment be more difficult? Probably a bit, but we don't know to what extent yet - for all we know it just means more interviews and paperwork. Nor do we know what the long-term consequences of the review will be - there's no guarantee that better procedures will mean numbers plummet.
Because spin aside, there's a lot the review doesn't say. It doesn't say that there has been widespread abuse of malpractice, it doesn't say kids have been put in danger, and it doesn't deny the reality of trans-identity ; in fact, one might say the report goes out of its way to not say such things in spite of its conservative requirements.
And for the record, the one figure I could find in the review about detransitioning was 6,9% (12 cases). There was also mention of an article studying detransition, but on about 235 individuals worldwide.

So I think the spin that is being attempted here doesn't have much to stand on. All in all the report is what one can expect: it's a technical document to improve medical practices and procedures in the wake of a legal case. Of course it errs a bit on the cautious side, but refrains from making any sweeping claims or definitive assertions. The document can be spinned or implemented in various ways but in itself it really doesn't say that much. It's what you can expect from an official document after there was a legal issue.

I'd be more concerned about the claim that it was impossible to have a discussion on the practices and procedures because of accusations of transphobia. I wouldn't know. Seen from a distance, there's far more of a conservative obsession with trans-identity than a widespread progressive "agenda" or "ideology." I would tend to assume that most people don't care that much, and that (like on this forum), it's a vocal minority that insists on stirring the pot and discussing these issues - until everyone eventually chimes in.
In fact, I'd even be inclined to think that an important reason why there isn't more discussion on the issue is also because people on the right are loudly spreading reactionary views at every turn, and that moderates are relecutant to be associated with such a crowd.
My point here being that while I know there are progressives with extreme views on gender, I haven't personally met any who are actively proselytizing on the topic whereas I have countless examples of people openly spreading their transphobic views.
Lastly, if conservatives are so concerned about science being ignored in the political sphere, maybe they should turn this concern to an issue that's an actual existential threat for civilisation, like, I dunno, the fact that human activity is - slowly bur surely- making the planet uninhabitable? I don't like whataboutism as an argument, but FFS, if what you're afraid right now (April 2024) for your kids of is trans-identity of all things, perhaps your priorities are fucking bollocks.
 

[TrackerNeil]

29 minutes ago, mormont said:

The quoted is not my 'mind', though. It's not an opinion, it's an observation. 

With respect to that observation, if the facts change, the facts change. If a medicine does show evidence of harm, the consideration then - made by far more qualified folks than you or I - would be about a balance of the harm versus the benefit. Again, it's not unusual for that to happen, in fact it's commonplace. 

I'm going to try not to be rude here. But there are, we can agree, numerous medical interventions that have weak evidence and many that show evidence of harm, and we're not discussing those. Do you accept, then, that it's not solely the weakness of the evidence or the possibility of evidence of harm that is making you ask that question, and making you so curious about whether these particular interventions cause harm, or should be approved? 

I'm not exactly sure if your answer to my question is yes or no, but I am happy to answer your question. Indeed, this is the first time in any of these threads anyone has asked me one, and I appreciate the opporunity.

I certainly agree that all medical interventions, even well-supported ones, carry risk. The question to my mind is not if risk exists, but a) the level of risk; and b) the value of the intervention itself. So before I take a drug, I want to know as many of the risks as I can know, and if there is good reason to believe that drug will actually fix the problem it is intended to fix. So, you are correct that the weakness of the evidence is not my only concern in this regard.

Hopefully, that answers your question.

[mormont]

Well, yes: it answers it by avoiding it.

[TrackerNeil]

17 minutes ago, mormont said:

Well, yes: it answers it by avoiding it.

You asked:

Quote

Do you accept, then, that it's not solely the weakness of the evidence or the possibility of evidence of harm that is making you ask that question, and making you so curious about whether these particular interventions cause harm, or should be approved? 

I replied:

Quote

So, you are correct that the weakness of the evidence is not my only concern in this regard.

Let me try again:

I do accept, yes, that it's not solely the weakness of the evidence or the possibility of evidence of harm that is making me ask that question, and making me so curious about whether these particular interventions cause harm.

I left out the "should be approved" part, because I think that's another issue, one which I have never yet addressesd on this forum. We can get into that if you want.

Does that address your question? If there is something more specific you want to know, please feel free to ask and I will do the best I can to answer.

[karaddin]

10 hours ago, TrackerNeil said:

Indeed, this is the first time in any of these threads anyone has asked me one, and I appreciate the opporunity.

Well let me ask you another one - when did your skepticism around the suitability of trans treatments develop? It certainly predated the release of the Cass review which you seemed to receive as vindicating your skepticism rather than causing it. Have you always felt the research was insufficient and just didn't voice that opinion much until the last couple of years? 

I ask because I'm human and wind up drawing conclusions based on what I see like everyone else and perhaps those conclusions aren't the whole picture. Based on what I've seen it looks a lot like you became concerned about trans activists strategy of attempting to deplatform TERFs, which you view as deeply illiberal and a threat to free speech on the left. Given I have only seen you posting about trans treatments since then it made me feel this has colored your view of all trans issues since then, but that's obviously a major assumption on my part. Hence this question.

[Tears of Lys]

I'm somewhat uncomfortable with the incidence of previously self-identifying male persons who have just recently discovered their gender dysmorphia only to show up in female sports where they invariably achieve a success they were unable to achieve when competing against birth-assigned male persons.  

I would self-describe as a birth-assigned woman who is concerned for other birth-assigned women who only fairly recently (50 yrs ago?) won the right to be treated equally WRT government funds for sports.  

Would I be labeled a TERF or an extreme feminist?  What am I missing?  

[Conflicting Thought]

Just now, Tears of Lys said:

I'm somewhat uncomfortable with the incidence of previously self-identifying male persons who have just recently discovered their gender dysmorphia only to show up in female sports where they invariably achieve a success they were unable to achieve when competing against birth-assigned male persons.  

is it really that important? is it really that many people that do that? has anyone done that?  seems like a variation of the argument that cis males are going to transition to abuse women in bathrooms.  i mean trans people are a tiny fraction of the population even less trans people are in sports.  its not even clear that trans women are better than cis women, there are cases of trans women that lose competitions and trans women that win competitions, but the trans women that lose are never mentioned, but they exist. 

seems like a non issue to me, or if it exist its incredibly rare, and many terfs use this as an argument against trans people when i would argue that men and patriarchy are and has being so much more damaging to womens sports.

idk seems at least terf adjacent to me

[Mr. Chatywin et al.]

No, there are not many trans athletes in general and as you go up the levels the number is incredibly small.

Have we forgotten that coed sports have been a thing for a long time? Letting a trans youth feel like they're a part of the group is so much more important than worrying about dudes pretending to be women so they can excel at sports. It's an old lazy trope. 

[Tears of Lys]

Well, you've set my mind at ease then.  No worries.  Nothing to see here.  

[karaddin]

Genuine question - Are you open to an actual discussion of the issue with the possibility of changing your mind, or

50 minutes ago, Tears of Lys said:

Would I be labeled a TERF or an extreme feminist?  What am I missing?  

Was this the only question you were actually asking? I'm asking separate from the two responses you've already received, I don't want to waste either of our time if that's the only thing you were asking but I'm willing to engage if you're actually interested.

[Tears of Lys]

Yes.  Absolutely.  It's a genuine concern of mine.  You hear different things, and if the "worst case scenarios" are extremely rare, I accept that.  

I lived through the times when birth-assigned women were shunted to the side, not given the same opportunities, etc., etc., WAY fewer opportunities for the Olympics.  I'm truly concerned that some men may see this as a chance for an easy win, or even a cheap thrill. 

These are the types of things your average person is concerned about too, so laying it to rest is definitely a good thing.  

[TrackerNeil]

3 hours ago, karaddin said:

Well let me ask you another one - when did your skepticism around the suitability of trans treatments develop? It certainly predated the release of the Cass review which you seemed to receive as vindicating your skepticism rather than causing it. Have you always felt the research was insufficient and just didn't voice that opinion much until the last couple of years? 

Fair question. I will do my best to answer, and apologies in advance for the length of my reply.

I think this started with a growing skepticism of social-justice, identity-focused, purity-over-pragmatism ideology--people can use whatever term they like, but for these purposes I'll use wokeness. (I have no interest in semantic debates on this.) This movement became increasingly untethered from the liberal values of free inquiry, empiricism, and tolerance, and was in my view downright dogmatic, unsettlingly similar to that of the religious right back in the 80s even though it was coming from the left. There was this constant pressure for lefties not only to do and say the same things, but even to think the same way. As tolerance vanished so did the notion of civil disagreement; if someone did not sign on to the doctrine, they deserved to be shamed, shunned, and harassed. 

I've never been comfortable with being told what words I must use or thoughts I must think, so I started pushing back, even if only in my own mind. I applied the same skepticism to the left that I had formerly reserved for the right. I never moved to the right, mind you, but as I started expressing my skepticism I was increasingly classified as--gasp!--a centrist. And to be clear, people are free to view me as right-leaning if they like, but if a Medicare-for-all, abortion-on-demand, labor-union-loving, long-time Democrat-voting, drag-queen-friendly gay guy is right-leaning...well, we're certainly breeding a strange crop of conservatives these days.

So that's the path that brought me to my position on this issue. The Cass Review did not cause my skepticism--that started several years ago--but, as you say, it confirmed that my skepticism was reasonable. If some want to call that transphobia I can't stop them, but if a person who thinks trans people should be able to work, get housing, and dress any way they damn well please is a transphobe...well, we're breeding a strange crop of transphobes these days.

I hope that answers your question, but if anything remains unclear, feel free to ask. I appreciate the opportunity.

[Conflicting Thought]

1 minute ago, Tears of Lys said:

I'm truly concerned that some men may see this as a chance for an easy win, or even a cheap thrill. 

trans women are women though

[karaddin]

13 minutes ago, Tears of Lys said:

Yes.  Absolutely.  It's a genuine concern of mine.  You hear different things, and if the "worst case scenarios" are extremely rare, I accept that.  

I lived through the times when birth-assigned women were shunted to the side, not given the same opportunities, etc., etc., WAY fewer opportunities for the Olympics.  I'm truly concerned that some men may see this as a chance for an easy win, or even a cheap thrill. 

These are the types of things your average person is concerned about too, so laying it to rest is definitely a good thing.  

I'll do my best to give a response then, but it will take a while. 

[Tears of Lys]

@karaddin  That's fine.  I'm about ready to hit the sack now, anyway.

  

[BigFatCoward]

5 hours ago, Tears of Lys said:

I lived through the times when birth-assigned women were shunted to the side, not given the same opportunities, etc., etc., WAY fewer opportunities for the Olympics.  I'm truly concerned that some men may see this as a chance for an easy win, or even a cheap thrill. 

 

While I am very much in the camp of fairness is more important than inclusion when it comes to elite sports, I refuse to accept anyone would put themselves through that much, just to win an Olympic medal.

[Rippounet]

8 hours ago, TrackerNeil said:

I never moved to the right, mind you, but as I started expressing my skepticism I was increasingly classified as--gasp!--a centrist. And to be clear, people are free to view me as right-leaning if they like, but if a Medicare-for-all, abortion-on-demand, labor-union-loving, long-time Democrat-voting, drag-queen-friendly gay guy is right-leaning...well, we're certainly breeding a strange crop of conservatives these days.

Sounds like you discovered you could be conservative on some issues.

8 hours ago, TrackerNeil said:

I think this started with a growing skepticism of social-justice, identity-focused, purity-over-pragmatism ideology--people can use whatever term they like, but for these purposes I'll use wokeness. (I have no interest in semantic debates on this.) This movement became increasingly untethered from the liberal values of free inquiry, empiricism, and tolerance, and was in my view downright dogmatic, unsettlingly similar to that of the religious right back in the 80s even though it was coming from the left. There was this constant pressure for lefties not only to do and say the same things, but even to think the same way. As tolerance vanished so did the notion of civil disagreement; if someone did not sign on to the doctrine, they deserved to be shamed, shunned, and harassed.

I've never been comfortable with being told what words I must use or thoughts I must think, so I started pushing back, even if only in my own mind. I applied the same skepticism to the left that I had formerly reserved for the right.

This is a familiar narrative. I've read or heard it quite a few times now.

I had a friend who spoke that way for a while, until I asked him what he meant. Turns out, he struggled to give me a single real-life example. The "woke movement" was nothing more than a feeling he had, based on the declarations of the most progressive politician here, some vague rumors of stuff that may or may not have happened at the other end of the country, and lots of stuff he'd seen on the internet. He hadn't seen or heard anything himself, he was just reacting to a reaction, with no first-hand knowledge of what had started the outrage in the first place.
It's as if he was begging me to tell him that it wasn't real, and that "woke" was just a loosely connected ensemble of ideas and evolutions with little organizing behind them. After this discussion he never used the word again in my presence.
Of course, that's my experience from outside the anglosphere, in a country which isn't *that* progressive, where there is no DEI in the workplace, where trans-identity is not being debated, and religious liberty or affirmative action are very limited... So it's easy for me to see attacks against "wokeness" as being manufactured by the right in my country. For historical reasons (the Revolution), France is not a place that focuses much on individual identity (we do all eat smelly cheese and drink wine, that's our thing), so it's mainly the right and the far-right that have invented the "woke movement" through public declarations and dodgy media outlets. If "woke" is anything here, it's both the right's bogeyman and a label for fasionable things that teenagers tell their middle-aged parents about.
But I can't rule out that there is in fact such a movement in the US and UK. Maybe it's not just the right building up moral outrage over minor evolutions. After all, "woke" originally meant being aware of systemic racism, right?
So I'm curious. When you speak of "social-justice, identity-focused, purity-over-pragmatism ideology," what do you mean exactly? How do you define "ideology" here? Who represents this movement and what do they say? Is the movement embodied by any specific organization? What have been the concrete real-life applications of the movement's principles? Has the movement had any legislative victories? Or are we merely talking about sociological trends, i.e., peer-pressure?

[Ran]

5 hours ago, BigFatCoward said:

While I am very much in the camp of fairness is more important than inclusion when it comes to elite sports, I refuse to accept anyone would put themselves through that much, just to win an Olympic medal.

I'm not sure one needs to do it just to win a medal. It's enough that the result is you might win a medal and you act on it.

Laurel Hubbard comes to mind. She's someone who, pre-transition, was a junior national competitor (never competed internationally) and stopped competing in 2001, and then nearly two decades later started again, entered international competition for the first time, and won a place to compete in the Olympics, bumping Samoa's Iuniarra Sipaia (she's qualified for the 2024 Olympics, it turns out, so good on her). She  didn't go through it all just to win a medal, but it's a pretty extraordinary journey for someone who had stopped competing entirely two decades earlier. (ETA: I should hasten to add that Hubbard did nothing wrong. She competed under the rules that existed at that time. The rules simply were wrong from a competitive fairness sense.)

Hubbard bombed out at the Olympics, but then again she was in her mid-40s at the time, a decade or two older than her competitors.

If there are monetary prizes, sponsorship money, endorsement money, and/or scholarships involved, sports that have traditionally divided the sexes should probably still do so, at least until such time as we come up with some alternative categorization of competition (.e.g handicap systems) to level the field. For things like youth sports (at lower levels, anyways) and intramural co-ed sports, safety should really be the only consideration.

As to those who say, well, does it really matter, it's just sports... By 2028, global sports are expected to be a $680 billion industry. People make careers out of it. In the US, young athletes can get scholarships that may change the courses of their lives. Unfair competition for these opportunities is, well, unfair, and does actually matter to those people.

Edited April 23 by Ran

[karaddin]

9 hours ago, Tears of Lys said:

@karaddin  That's fine.  I'm about ready to hit the sack now, anyway.

  

Sorry - busy day with a migraine, just wanted to note I haven't forgotten!