Topic Updates for 2023: TOPIC 1 (Part 2)
Original Topic Post= 1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA. YES
We are updating our Topics in 2023 with the most recent and relevant information regarding over-medicalized youth and identity confusion due to queer theory/gender ideology. Since the launch of our website in 2019, only more information has come to light validating our view that pediatric transition is dangerous for children and teens. We support honest and open inquiries regarding this topic. Our focus relates to protecting lesbian, gay, and bisexual youth from harm, and we want the best long-term health outcomes for all youth, regardless of identity or orientation.
One of the main reasons why LGB people are so concerned about the move to transition cognitively immature minors socially and medically is that they may desist from wanting to be the opposite sex or find less invasive ways to cope. Desistance/persistence research is very relevant to protecting LGB and other youth from the culture, parents, and health professionals tracking them into medical pathways they otherwise may avoid if given proper support and allowed to mature.
The increasing but unproven narrative in the “gender affirmative” movement is that no therapy can resolve gender dysphoria, and social and medical transition are the only options. Here is a case study where an individual resolved gender dysphoria with therapy by addressing homophobia, making this study pertinent to the concerns of GHQ:
Behavioral treatment of transsexualism: A case report:
Patients who believe themselves to be transsexual seek only confirmation of their diagnosis so that they may proceed with their pre-chosen course of management: hormones and surgery. Their syntonic emotional set generates resistance to any other therapeutic direction. Despite this attitude, it is the therapist's responsibility to assess each case individually and to decide, with the patient, on realistic goals even if they be different from the original one. This case emphasizes this need since a probing history revealed underlying conflict and anxiety related to severe homophobia. With revelation of the homophobia, various behavioral techniques could be used therapeutically. These resulted in acceptance of lesbianism as a life style. Careful assessment of patients with self-diagnoses of transsexualism can sometimes uncover a different etiology to which appropriate therapy can be applied.
There is a critical study, Singh et al. (2021), called A Follow-Up Study of Boys With Gender Identity Disorder. It shows high rates of desistance in boys with DSM-diagnosed gender dysphoria. Many desisters grew up to be gay men, as indicated in previous studies. The results- 139 participants, 17 (12.2%) were persisters, and the remaining 122 (87.8%) were desisters. This is a very high rate of desistance from a clinical diagnosis, thus involving some amount of distress. These were not just “boys who liked pink.”
It appears persisters on average will be the most “gender variant,” which is not surprising:
Compared to the reference group, the biphilic/androphilic persisters tended to be older at the time of the assessment in childhood, were from a lower social class background, and, on a dimensional composite of sex-typed behavior in childhood were more gender-variant. The biphilic/androphilic desisters were more gender-variant compared to the gynephilic desisters. Boys clinic-referred for gender identity concerns in childhood had a high rate of desistance and a high rate of a biphilic/androphilic sexual orientation. The implications of the data for current models of care for the treatment of gender dysphoria in children are discussed.
But this doesn't mean no desisters fell into this range, given these are averages. In fact, many did. There was more detailed information in the dissertation by Devita Singh that was the basis for this paper. One measure of particular interest was a composite score of each subject's scores on several tests that may indicate more intense levels of dysphoria or gender nonconformity:
As can be seen from Table 15, the childhood sex-typed behavior measures on which the groups differed were significantly correlated.24 From these six measures (first drawn person on the Draw-a-Person, free play, Gender Identity Interview, cross-sex peer preference on the Playmate and Play Style Preferences Structured Interview, 21 cross-sex toy preference on the Playmate and Play Style Preferences Structured Interview, and the Gender Identity Questionnaire for Children), a composite score of childhood sex-typed behavior was derived for each participant by taking the average of the six variables 25 (each expressed as z-scores). Thus, the composite score was expressed as a z-score. A higher composite z-score indicates more cross-gender behavior at assessment (Fig. 2).
We see that the differences between the Draw-a-Person test, was not significantly different between the persisters and homosexual desisters:
On the Draw-a-Person, there was one significant post-hoc contrast. The bisexual/ homosexual persisters were, on average, significantly more likely to draw a female first compared to the heterosexual desisters (p = .04). The comparison between the bisexual/ homosexual desisters and heterosexual desisters approached significance (p = .09), with the bisexual/homosexual desisters showing a greater tendency to draw a female first. The comparison between the bisexual/homosexual persisters and bisexual/homosexual desisters was not significant (p > .05)
Also:
The bisexual/homosexual persisters had a 274% increase in odds of having a higher composite score (i.e., more childhood cross-gender behavior)…
And regarding desisters:
The bisexual/homosexual desisters had a 48% increase in odds of having a higher composite score compared to the heterosexual desisters.
We see that a significant number of homosexual desisters, a larger group than the persisters (N=66 v n=16), fell into the range of the persisters’ z-score. This is the population Gender Health Query is most concerned about, very gender nonconforming and cross-sex identified boy children, who now will be reinforced in body dissociation and possibly medicalized at puberty before testosterone exposure to their brains during the maturation process.
The paper discovers the most relevant variables, as seen below. Interestingly, lower socioeconomic status increases the likelihood of persistence, and they suggest these families may be more likely to have negative views of homosexuality and prefer a trans status in their child.
To evaluate the influence of childhood sex-typed behavior and demographic variables on group outcome at follow-up, a multinomial logistic regression was performed using the composite score and the demographic variables on which the groups differed26–age at assessment, IQ, and social class–as predictor variables. It can be seen from Table 16 that both social class and the composite score of childhood sex-typed behavior were significant predictors of group outcome at follow-up in the first model which compared the bisexual/ homosexual persisters to the bisexual/homosexual desisters
Dr. Ken Zucker stated on his twitter account the study has flaws but:
I think that this is the best follow-up study to date in terms of the sample size and the methods of assessment. It does, of course, have its flaws, but I think that the data speak for themselves.
See the entire thread here https://threadreaderapp.com/thread/1376412138227503104.html
Zucker notes in a tweet thread:
This will probably be the last follow-up study in the literature that tracks longer-term psychosexual development of children (i.e., those seen clinically for the first time between the ages of 3-12 years) during an era where "treatment"--when there was treatment--came in a...
variety of shapes and forms. But the one type of "treatment" (with one exception) that these children did not receive was what is now known as pre-pubertal social transition. Thus, this follow-up study can be used as a comparative benchmark with regard to the persistence and...
desistance of gender dysphoria for any new follow-up studies that look at persistence and desistance among children who socially transitioned prior to puberty. I have argued elsewhere (Zucker, 2018) and in the Discussion that pre-pubertal social transition (where it is...
implemented by parents, on their own, without any clinical input from "professionals" or at the suggestion of professionals, or in combination is a form of psychosocial treatment of gender dysphoria...just of a very different kind.
We did internet searches to see if any “LGBTQ” organizations such as the HRC, PFLAG, or The Trevor Project referenced this study, given they are recommending social and medical transition of children and teens. They have not, to our knowledge. We believe these entities have become a danger to pre-gay and lesbian youth despite putting LBG in their names. Their purpose is exclusively promoting the interests of current trans activism, medicalizing children/teens, and replacing sex-based rights in law with gender identity.
The high desistance rate in the above study that took place at a time when they were not being "affirmed" is in stark contrast to an extremely high persistence rate in a follow-up study by The Trans Youth Project regarding fully "affirmed" minors called “Gender Identity 5 Years After Social Transition.”
RESULTS
We found that an average of 5 years after their initial social transition, 7.3% of youth had retransitioned at least once. At the end of this period, most youth identified as binary transgender youth (94%), including 1.3% who retransitioned to another identity before returning to their binary transgender identity. A total of 2.5% of youth identified as cisgender and 3.5% as nonbinary. Later cisgender identities were more common among youth whose initial social transition occurred before age 6 years; their retransitions often occurred before age 10 years.
This paper will be discussed in more detail in an update to Topic 4 due to their avoidance of contemplating that they are tracking would-be desisters into trans identities, and that this could account for their drastically higher persistence rates versus prior studies.
The same group of researchers published a paper called Retransitioning: The experiences of youth who socially transition genders more than once that focused on the youth who keister from a cross-sex identity. Their use of the term “retransition” is the new preferred parlance of affirmative model advocates.
They state:
Conclusions: These findings largely do not support common concerns about retransitions. In supportive environments, gender diverse youth can retransition without experiencing rejection, distress, and regret.
This comment lends no proof one way or the other that the affirmative protocol is or isn’t significantly increasing the likelihood that youths will medicalize.
The study Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study tracked youth from an insurance database:
METHODS
A cohort of 958 gender-diverse (GD) children and adolescents who did not have a gender dysphoria–related diagnosis (GDRD) or GAHT at index were identified. Rates of first GDRD and first GAHT prescription were compared across demographic groups.
And:
The STRONG cohort includes participants from Kaiser Permanente (KP) integrated health care systems in Georgia, Northern California, and Southern California.
They found that some youth with gender dysphoria diagnosis were not dysphoric post puberty. It also appears females may be less likely to desist than males:
Both Dutch studies found that most participants did not experience gender dysphoria beyond puberty. This result is consistent with our observation that less than one-third of children presenting with GD behaviors received a GDRD and only approximately one-quarter initiated hormone therapy during follow-up. The Dutch researchers also reported a greater likelihood of unalleviated gender dysphoria in children who presented at an older age and among AFAB participants, both results in agreement with our findings.
A study, Karrington (2022), published by a trans-identified individual in Transgender Health, is called “Defining Desistance: Exploring Desistance in Transgender and Gender Expansive Youth Through Systematic Literature Review.” It claims that desistance isn’t a relevant concept for study. Desistance in the paper is defined below:
Thirty definitions of desistance were found, with four overarching trends: desistance as the disappearance of gender dysphoria (GD) after puberty, a change in gender identity from TGE to cisgender, the disappearance of distress, and the disappearance of the desire for medical intervention.
The conclusion of the paper obviously advocates for the affirmative model trans activists are demanding. Not bothering with tracking social and medical influences on persistence/desistance serves their priorities:
Conclusions: This review demonstrates the dearth of high-quality hypothesis-driven research that currently exists and suggests that desistance should no longer be used in clinical work or research. This transition can help future research move away from attempting to predict gender outcomes and instead focus on helping reduce distress from GD in TGE children.
Another trans activist produced a similar paper, Ashley (2022), called “The Clinical Irrelevance of “Desistance” Research for Transgender and Gender Creative Youth.”
Lisa Selin Davis, who has been writing on this subject, discussed desistance research in an article for Skeptic called “Trans Matters: An Overview of the Debate, Research, and Policies.”
She also reported on an individual case of desistance in an article titled “A Desister’s Tale.” The article concludes:
Children and their families should know about the desistance literature, and that the way they feel now, no matter how intensely, isn’t necessarily a sign of how they’ll feel in the future. By exposing them to a diversity of stories, including Ash’s, we can restore balance to the discussion in a way that may help many distressed young people navigate a difficult and confusing time.
Individual cases of desistance are also in “’Desistance’ in two cases of transgender men” on Why Evolution is True.
Despite the existence of desistance, WPATH is removing any recommendation for age restrictions on medicalizing minors.
Elkadi et al. (2023), a paper called “Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study,” discusses desistance rates:
This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment for gender dysphoria (GD) and for potential gender-affirming medical interventions. All of the young people had attended a screening medical assessment (including puberty staging) by paediatricians. The Psychological Medicine assessment (individual and family) yielded a formal DSM-5 diagnosis of GD in 66 of the young people. Of the 13 not meeting DSM-5 criteria, two obtained a GD diagnosis at a later time. This yielded 68 young people (68/79; 86.1%) with formal diagnoses of GD who were potentially eligible for gender-affirming medical interventions and 11 young people (11/79; 13.9%) who were not. Follow-up took place between November 2022 and January 2023. Within the GD subgroup (n = 68) (with two lost to follow-up), six had desisted (desistance rate of 9.1%; 6/66), and 60 had persisted on a GD (transgender) pathway (persistence rate of 90.9%; 60/66). Within the cohort as a whole (with two lost to follow-up), the overall persistence rate was 77.9% (60/77), and overall desistance rate for gender-related distress was 22.1% (17/77). Ongoing mental health concerns were reported by 44/50 (88.0%), and educational/occupational outcomes varied widely. The study highlights the importance of careful screening, comprehensive biopsychosocial (including family) assessment, and holistic therapeutic support. Even in highly screened samples of children and adolescents seeking a GD diagnosis and gender-affirming medical care, outcome pathways follow a diverse range of possibilities.
This abstract confirms DSM diagnosed minors do desist from the clinical definitions of gender dysphoria as listed in the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” which is supposed to have more rigid criteria, reducing the likelihood of defining desisters as “true trans.” The desistance rate is still low compared to prior studies where children were not affirmed in their gender dysphoria and cross-sex identification which is concerning. We can also see two of the minors who didn’t receive an initial DSM diagnoses, wound up with one later. The affirmation of gender dysphoria in youth with forming identities is a severe risk to these minors as transition regret appears to be increasing.
Topic 8 deals with detransition and regret. One can find many examples are LGB youth.
See Original Post 1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA. YES
More blog posts relating to this Topic are here.
CONTINUE TO TOPIC 2:
Hormone blockers, trans youth, & permanent side effects such as sterility & loss of sexual function
Medical consequences of hormone blockers, cross-sex hormones, surgery, to gender dysphoric & trans youth