Book Recommendation: So, you think you may be trans... A critical guide to the debate around trans identities for parents, teachers and others involved with caring for children and young people.

News Commentary

Gender Health Query recommends the book by Tim Davies, 'So, you think you may be trans... A critical guide to the debate around trans identities for parents, teachers and others involved with caring for children and young people.

This book covers many of the issues addressed on our website. The book is factual and written with compassion. Some topics include the history of the trans movement, a clear description of gender ideology, and the complex issue regarding gender dysphoric minors and mental health.

Book description:

In the last ten years there has been a meteoric rise in the number of children and young people self-identifying as 'trans' and seeking to transition to the opposite gender. This is a global phenomenon, apparent throughout the English-speaking world, Europe, South America and beyond. In England and Wales, the explosion in referrals to gender identity clinics has resulted in long waiting lists and, in 2022, to the proposal to reconfigure and extend NHS gender identity services for children and young people.
The response to this development encouraged by the World Professional Association for transgender Health and many official medical bodies (and endorsed by trans-activist organisations) is 'affirmative care': accepting what a child says on the basis that only they can know their 'true' gender identity.
There are now dozens of books available providing parents, teachers and other carers with step-by-step guides to facilitating the child or young person's transition. This is not one of them!
In the last few years, increasing numbers of young adults have appeared on on-line platforms expressing 'transition regret' and seeking to de-transition. At the same time, medical authorities in a number of countries - Finland, Sweden, France, England - have rejected affirmative care and adopted a much more cautious approach to treating minors suffering from gender dysphoria.
All of this leaves parents, teachers, residential care workers, etc. in an invidious position. How should they best support a child or young person who tells them that they're trans? Clearly, there are people for whom transition offers the chance to relieve deeply-felt distress about being 'trapped in the wrong body'. But, equally clearly, there are many troubled youngsters caught up in this new social phenomenon who wrongly believe that transitioning offers a quick fix for more deep-seated problems.
This book aims to provide parents, teachers and others with caring responsibilities with the knowledge and understanding they need to feel confident in responding to gender-questioning children and adolescents. It is not a step-by-step route guide, but a guide to the terrain.
The book provides a brief history of transsexuality, suggests why there has been this explosive growth in cases (and why it is adolescent girls who have been the most affected), explores what children and adolescents might mean when they say they're 'trans' and takes an in-depth look at the medical debate around diagnosis, assessment and treatment. In addition, it examines the role of what has been called 'gender ideology' and - in order to contextualise the debate surrounding trans youngsters -provides a commentary on the wider debate surrounding girls' and women's sex-based rights.

Gender Dysphoria Endocrine Society & Pediatric Endocrine Society Guidelines Intentionally Hide Risk & Harm

Editorial

Heading: “Your Dangerous, Inaccurate, and Ideological Guidelines for Trans-Identified Youth”

Sending this to 100s of mental health and medical professionals as this is a wide-spread problem- apathy about risk to LGB and other youth. This is profoundly destructive to these individuals and to our communities. The younger children are transitioned, the more of them there will be.

To the Endocrine Society and Pediatric Endocrine Society,

We are board members for an LGBT medical watchdog organization regarding pediatric medical transition for minors with gender dysphoria. In 6 years of intensely researching this issue, your recent statements and guidelines on this topic are some of the most unethical and sloppy of anything we have seen, in our free-speech opinion. And we have seen a lot of substandard discourse, confirmation bias, censorship, and blatant disregard for the safety of mostly LGB youth who may resolve GD as all prior research shows many do. There are so many ideological spins and factual errors in these documents it would take far too long to go over them all. And that should not be the public’s job. That is your job as the leadership and board members of The Pediatric Endocrine Society and the Endocrine Society, tasked with the most important goal of all, being trustworthy. Your organizations are experiencing ideological capture by extremist gender identity activists (even PhDs and MDs), and our guess is that you are entrusting small, agenda-driven committees to write balanced information. This is a huge mistake regarding this contentious and complicated issue that requires responsible nuance.

No, the “affirmative model” is not universally recognized as “safe” by all gender dysphoria experts, and it is clearly proving to be unsafe for some young people. That is the truth.

BBC

FB comment from WPATH member

Science bodies have a moral obligation to present facts and accurate information to the doctors and scientists they represent and the public. If you don’t, you will justifiably be accused of negligence and malpractice for the harm we are seeing befall young people due to the dishonesties represented in your documents regarding gender dysphoric youth. These dishonesties are being exposed by a groundswell of well-informed parents, doctors, mental health professionals, trans-rationalists, detransitioners, podcasters, and concerned LGB people who have been going public for years, negating the possibility of plausible deniability by organizations such as yours. 

The documents in question: 

https://transhealthproject.org/resources/medical-organization-statements/endocrine-society-statements/

https://www.endocrine.org/-/media/a65106b6ae7f4d2394a1ebeba458591d.ashx

https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaa816/6031005

https://www.endocrine.org/-/media/endocrine/files/advocacy/position-statement/transgender_health_minors_fact_sheet.pdf

And here is this statement demonstrating the Endocrine Society and Pediatric Endocrine Society have a complete lack of concern or compassion for the young woman in the Bell v Tavistock case (she won) who transitioned at too young an age who is now permanently scarred by doctors such as yourselves. She is here merely as a prop to be kicked to the side and aggressively opposed so you can continue to prescribe extreme and experimental medical treatments on minors who don’t reach full executive function until age 25:

https://www.eurekalert.org/pub_releases/2020-12/tes-dpt121120.php

While there are too many errors and hard ideological slants to go over in the material in these links, we will review a few of the most egregious. This is unacceptable for doctors’ organizations.

Your attempt to debunk this quote falls flat to those of us who know what is really going on:

“Texas should ban chemical castration, puberty blockers, cross-sex hormones and genital mutilation surgery on all minor children for transition purposes, given that Texas children as young as three (3) are being transitioned from their biological sex to the opposite sex.” Even though “chemical castration” and “genital mutilation” are not part of gender-affirming care for minors, such wording serves to alarm the general public, and 94.57% of the electors supported the measure [15].

Not part of gender-affirming care for minors? While you may dislike the phrase “chemical castration” because it doesn’t have the marketable ring of “gender affirming” it is the proper term for the use of hormone blockers. These are the very drugs and terminology used to “chemically castrate” sex offenders. When you give puberty blockers to an 11-year-old, you stunt their genital growth. The problem of “micropenis” is well documented and the state becomes permanent when the youth goes on estrogen. This can permanently destroy the youth’s sexual response making a fully realized adult romantic relationship impossible. Due to lack of tissue, the youth now requires a rectosigmoid or peritoneal graph vaginoplasty to create a neovaginal canal as surgeons can’t do the “gold standard” one. These protocols sterilize both sexes. The wording in the quote above is hardly hyperbolic.

And now to the second part of the inaccuracy of the sentence. Genital surgeries are done on minors. Jazz Jennings, who likely has permanently destroyed sexual function for life, had this procedure done at 17 on national television. Jazz had to have 3 corrective surgeries after the experimental vaginoplasty “popped” and collapsed, an incident described by Jazz as extremely messy and painful. This path was decided by Jazz at age 11 when doctors such as yourselves prescribed hormone blockers. One of the patients in the Steensma/de Vries cohort died from the vaginoplasty, despite this being the #1 “success” study cited to promote pediatric transition. These young people are guinea pigs. We contest a child who hasn’t had a first boyfriend or crush even, can consent to permanent sexuality destruction despite your confidence in the face of conflicting data and views. There are trans people who adamantly oppose this.

Should the public feel “alarm” over this?

Reddit

Here is evidence of vaginoplasty surgeries underage. The same is true for double mastectomies performed on tweens.

https://www.prweb.com/releases/2014/09/prweb12141694.htm:

“The patient, a California high school student who began administering estrogen and anti-androgens to transition from male to female at the age of 11, is the youngest transgender patient in U.S. history to completely avoid male puberty and subsequently undergo gender reassignment surgery at the age of 16.”

Another problem:

"Gender identity was considered malleable and subject to external influences. Today, however, this attitude is no longer considered valid."

A detransition subreddit with thousands of people holds views that say otherwise. We also document many social factors that influence gender dysphoria linked below. Of particular concern to us, but not you, is that homophobic bullying pushes youth towards trans identification. This is according to a peer-reviewed study and many anecdotal examples of LGB youth who claimed this was the case or their therapists saying so. Lack of stability in the home appears to be another environmental factor. There are many examples of social contagions throughout history, and most involve young females. We believe there is robust evidence to support this is currently the case with spiking levels of trans identification in females. Responsible doctors analyze situations when epidemiology has drastically changed. 

We are an intellectually honest, evidence-based organization. We cover the valid "nature" data on brain research, lending credence to the above claim's possibility. But why does a layperson org have more comprehensive, evidence-based information than the Endocrine Society or Pediatric Endocrine Society? You pretend people who flatly state their social environment helped fuel their dysphoria and desire to transition don't exist. You pretend the multiple sex and gender researchers who worry that early social transitions may groom pre gay and lesbian children for medicalization don’t exist (Dr. Wren, Dr. Carmichael, Dr. Cantor, Dr. Zucker, Dr. Soh, Dr. Bailey, Dr. Blanchard, Dr. Korte, Dr. Drescher, Dr, Bradley, even Dr. Steensma have made these statements). The very design of your materials is to hide harm and risk. This is intentional, isn’t it? To see yourselves as protecting the important children even if it means recklessly endangering others by pretending they don’t exist, and ensuring your doctors and the public don’t know they exist.

https://www.genderhq.org/trans-nature-vs-nurture-innate-gender-identity-culture

https://www.genderhq.org/increase-trans-females-nonbinary-dysphoria 

https://www.genderhq.org/trans-children-gender-dysphoria-desistance-gay/#anchor-page1-section-b

You cite Jack Turban and pretend serious critiques by GD experts of his work don't exist. A good list of these professionals can be found in the comments on his JAMA article (under paywall), which should have been published if people were acting with integrity around this issue. 

https://www.genderhq.org/blog/conversion-therapy-trans-study-turban?rq=Turban

https://www.genderhq.org/blog/2020/11/2/recent-article-criticizes-the-quality-of-jack-turbans-analysis?rq=Turban

Miesen (2018)

Another criticism: 

https://pubmed.ncbi.nlm.nih.gov/30392631/

“We work and live with the co-occurrence of autism and gender diversity on a daily basis, and we are concerned that perpetuating misunderstanding about the co-occurrence places individuals at risk.”

More on Jack Turban: 

http://link.springer.com/10.1007/s10508-020-01844-2

Moving on:

“Pre-pubertal youth who are supported and affirmed in their social transition long before medical interventions are indicated, experience no elevation in depression compared to their cis-gender peers.” (12)

Your reference is Achilles (2020). Should this not be Olson (2016)? Achilles is a drug study on adolescents. And the social transition Olson study is far from perfect.

Here is another example of the malpractice of your documents that violate all standards of informed consent:

"Over the last decade, there has been considerable research on and development of evidence-based standards of care that have proven to be both safe and efficacious for the treatment of gender dysphoria/gender incongruence in youth and adults.”

Where is this hard evidence this is “proven” “safe?” Jazz Jennings had 4 sexuality-destroying vaginoplasty corrective surgeries and will never have any sexual feeling, and you call this “safe.” Multiple gender dysphoria experts are concerned about this harming potential desisters, and you call this “safe.” There is information that this impacts bone health, and you call this “safe.” It looks like the blockers you are prescribing cognitively immature children can negatively impact pubertal brain development by lowering IQ. IQ is something very pertinent to career choice and earned income. But this is “safe.” There is no mention of the study that indicates a significant increased risk of heart attack in FtMs or mitochondrial damage or vaginal atrophy. You don’t mention you have no idea what the long-term consequences are of transitioning tweens on their bodies over the decades to come. How is this ethical, this hiding by you of negative, valid data? How? Having a good, honest desire to help this population is not a valid excuse for violating basic tenants of informed consent and “do no harm.” Citations for serious medical side-effects below:

https://www.genderhq.org/trans-youth-side-effects-hormone-blockers-surgery

We highly recommend you look at historical accounts of how medical and mental health professionals have harmed the public due to mirthful excitement about new protocols that wound up harming people because sterilizing children, destroying their sexual response forever, harming LGB youth, impacting bone health, IQ, and circulatory health are grave matters. We aren’t lawyers, but it sounds like “safe” is lawsuit-worthy (and was in the Bell v Tavistock case).

Bottom line- The sheer extremity of what you are doing to children is because you are being led to believe you are preventing suicides (referenced in your documents). There is a lack of robust proof that this is true, and several media-covered suicides used to promote underage transition involved fully affirmed youth with access to medical protocols. Inflating suicide risk, something often employed by affirmative model doctors and therapists to the public, violates all anti-suicide reporting guidelines, even those for LGBT youth laid out specifically by the American Foundation for the Prevention of Suicide. Suicide is highly socially contagious. Sending the message youth will kill themselves if not given strong drugs immediately is harmful. GHQ does not spin suicide. It is too serious a matter. No one should. Some studies indicate transition is helpful in this way. The studies in the Cornell review and others that have this information is on our evidence-based website.

But we will list studies/articles that should alarm you given the soaring numbers of children endocrinologists are “chemically castrating,” leading to underage surgeries: 

Branstrom (2020) recently had to be corrected (authors really wanted positive results). The reality is this study from Sweden’s healthcare system, with a large population, failed to prove mental health benefits to either hormonal therapy or sex reassignment surgery. This is in a country that is very pro LGBT, where people have access to public healthcare. It’s not perfect data but better than much in the Cornell review.

Lipson (2019) should concern you. This is a large population of college students surveyed. Why is the mental health so poor in trans people at universities where trans identity is celebrated, minority status is elevated in general, and they have access to student health care that often pays for transition?

Graph circulated by a researcher on SM regarding Lipson (2019)

The use of puberty blockers has not been shown to improve mental health in the UK, one of the reasons Tavistock lost the Bell v Tavistock case. There are likely thousands of kids on these blockers now in the US.

http://users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf?fbclid=IwAR2X8HdzFfeUnaY0995EiTh9-gYCBKz5FmHG98PTdMjbXgZd5IhhGvl6uhY

At this time there are 20,000 adverse effects reported to the FDA from Lupron. An older article-

https://khn.org/news/women-fear-drug-they-used-to-halt-puberty-led-to-health-problems/

See Adams (2017)- This study, a meta-synthesis analysis, indicates transition may be ineffective in reducing suicide risk. When combining averages across 42 of the more recent studies (relevant because being trans was likely more difficult and unaccepted in the past), they found very high suicide ideation rates, even within the last year. Past year's stats also are not much better than lifetime stats in this review. And these are individuals accessing "gender-affirming" medical care. 

Stop engaging in desistance denial. This data is not presented in your documents. Having researched this for years, we understand why. Desistance data clearly shows pediatric transition is a risk to pre-gay and lesbian kids and ROGD (Littman 2018) shows this is a risk to teens struggling with puberty. This isn't included because you do not care about these youths. No one does in “affirmative” discourse. If you cared, you would address the risks to them and their needs. You can see it every time any data or evidence shows they are being harmed (they are) or may be harmed. You can see a long list of censorship incidences enforced not only by activists (who always threaten people) but by major universities, LGBT media, and magazines like Psychology Today. Everyone does it who wants to appear "progressive." Because LGB youth don’t matter. Girls struggling with puberty don’t matter. Girls who may have a sexual assault in their background don’t matter. If they mattered, you would talk about their needs and suffering, how they are scarred when their body parts are removed at too young an age, and how you are destroying their human right to just grow up and work out their identity issues.

You can't bring yourselves to write one sentence in care of them. Not one.

http://www.heather-brunskell-evans.co.uk/body-politics/1114/

There is so much that is sloppy about your material and ignoring of legitimate studies and critiques of the happy/safe narrative. Please fix this. It delegitimizes you and violates your moral and professional obligations. There are too many people who are very well informed who will hold those accountable for ignoring risk and, worse, lying about it and covering it up. We will leave by summarizing the problems:

1) No acknowledgment of high rates of desistance in all prior research and the likelihood of them being gay or lesbian, thus obscuring risk to pre-gay kids by putting them in social transition at age 5 and interfering with their natural puberty with blockers.

2) No acknowledgment of bizarre trends of clusters of teenage females coming out as trans in a gender dysphoria spike unheard of 20 years ago. Any responsible health professional takes a close look at a condition when its epidemiology changes drastically, especially when treatment results in permanently altering a minor and social contagion is a well-established phenomenon with many historical examples.

3) No acknowledgment of several disturbing studies indicating the hormone blockers, hormones and sex reassignment surgery overall may not reduce the likelihood of mental health problems and suicide risk. And no honest review of information showing very significant negative health impacts.

4) References to Jack Turban and no references to the critiques of this barely out of med school doctor’s work. 

5) No care from the Endocrine Society and Pediatric Endocrine Society for mounting numbers of mostly young women, many ASD and/or lesbian and bisexual, encouraged to hate their bodies as struggling same-sex attracted tomboys, who are now permanently scarred by the mental health and medical profession. See their stories on this subreddit with thousands (assume a high 90% are lurkers and just 10% detrans/desisters, this is a lot of people with regret on this site with 17K subscribers).

https://www.reddit.com/r/detrans/

Tout data that shows benefits to pediatric transition. It’s there. We don’t deny that. But this is an unfolding nightmare and major human rights violation for those of us who care about pre-gay and lesbian kids and LGB teenagers, known to experience intense but ultimately transient GD. We are also very small minority groups. More and more detransitioned young people are significantly impacted. Our communities and our humanity are significantly impacted. We do not blame the mounting numbers of scarred and permanently altered young people. We are working to ensure mental health and medical professionals involved in these inappropriate transitions are held accountable and are not allowed to kick these “bad optics” youth under the rug as morally acceptable collateral damage. Your endocrine guidelines/statements do just that and it’s intentional.

We are a trans-inclusive organization that cares about the obsession with passing being worshipped over brain development, bone health, genital development, avoiding severe and experimental bottom surgeries, and fertility.

This will be on our website. We will provide documentation of this to anyone who later feels they were harmed by the doctors in your organizations following substandard informational guidelines and want them held accountable. This has been successfully done in the UK. Don’t assume there isn’t an intense motivation to hold those accountable in the US. Don’t assume you are immune.

We aren’t the only people/organization/group concerned about this international issue. And some of them are trans.

https://segm.org

https://rethinkime.org

https://detranscanada.com

https://www.gccan.org

https://lgballiance.org.uk (with chapters in the US, Canada, Poland, and Australia)

https://www.transgendertrend.com

Supporting parents of children with gender dysphoria

https://genderreport.ca

_____________________________________

Our board

https://www.genderhq.org/about

A list of supporters

https://www.genderhq.org/letter-signatures 

References:

Adams, N., Hitomi, M., & Moody, C. (2017). Varied Reports of Adult Transgender Suicidality: Synthesizing and Describing the Peer-Reviewed and Gray Literature. Transgender Health, 2(1), 60-75. doi:10.1089/trgh.2016.0036

Holt, A. (2020, December 1). Puberty blockers: Under-16s 'unlikely to be able to give informed consent.' BBC. Retrieved from https://www.bbc.com/news/uk-england-cambridgeshire-55144148

Correction to Bränström and Pachankis. (2020, August). The American Journal of Psychiatry. Retrieved from https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.1778correction

Biggs, M. (2019, July 29). The Tavistock’s Experiment with Puberty Blockers. Retrieved from http://users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf?fbclid=IwAR2X8HdzFfeUnaY0995EiTh9-gYCBKz5FmHG98PTdMjbXgZd5IhhGvl6uhY

Brunskill-Evans, M. (2018, June 21). A Woman’s Place is Standing Her Ground. Retrieved from http://www.heather-brunskell-evans.co.uk/body-politics/1114/

D’Angelo, R., Syrulnik, E., Ayad, S, Marchiano, L., Kenny, D.T., Clarke, P. One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria. Archives of Sex Behavior (2020). Retrieved from https://doi.org/10.1007/s10508-020-01844-2

Endocrine Society (2020, December 16). Discriminatory policies threaten care for transgender, gender diverse individuals. EurekAlert. Retrieved from https://www.eurekalert.org/pub_releases/2020-12/tes-dpt121120.php

Endocrine Society, Pediatric Endocrine Society. Transgender Health: Suporting Gender Diverse Youth to Improve their Health, Well-being, And Safety. Retrieved from https://www.endocrine.org/-/media/endocrine/files/advocacy/position-statement/transgender_health_minors_fact_sheet.pdf

Endocrine Society, Pediatric Endocrine Society. Endocrine Society and Pediatric Endocrine Society Transgender Health Position & Statement (2020). Retrieved from https://www.endocrine.org/-/media/a65106b6ae7f4d2394a1ebeba458591d.ashx

Endocrine Society (2020, December 16). Discriminatory policies threaten care for transgender, gender diverse individuals. EurekAlert. Retrieved from https://www.eurekalert.org/pub_releases/2020-12/tes-dpt121120.php

Jewett, C., & Kaiser Health News. (2017, November 30). Women Fear Drug They Used To Halt Puberty Led To Health Problems. Retrieved from https://khn.org/news/women-fear-drug-they-used-to-halt-puberty-led-to-health-problems/

Lipson, S.K, Raifman, J., Abelson, S., Reisner, S.L. Gender Minority Mental Health in the U.S.: Results of a National Survey on College Campuses. American Journal of Preventative Medicine 53(3), 293–301. doi.org/10.1016/j.amepre.2019.04.025

Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20153223. doi:10.1542/peds.2015-3223

PRWeb. (2014, September 5). Beverly Hills Plastic Surgeon, Gary Alter, MD, Performs Gender Reassignment Surgery on Youngest Transsexual Patient in the United States. Retrieved from http://www.prweb.com/releases/2014/09/prweb12141694.htm

Strang, J.F., Janssen, A., Tishelman, A., Leibowitz, S.F., Kenworthy L, McGuire, J.K., Edwards-Leeper, L., Mazefsky, C.A., Rofey D., et al. (2018) Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. Journal of the American Academy of Child & Adolescent Psychiatry 57(11), 885-887. doi: 10.1016/j.jaac.2018.04.023

TLDEF's Trans Health Project (2020, December 17). Endocrine Society. Retrieved from https://transhealthproject.org/resources/medical-organization-statements/endocrine-society-statements/

van der Miesen, A., Cohen-Kettenis, P., de Vries, A. (2018) Is There a Link Between Gender Dysphoria and Autism Spectrum Disorder? Journal of the American Academy of Child & Adolescent Psychiatry 57(11), 884-885. doi:https://doi.org/10.1016/j.jaac.2018.04.022

Walch, A., Davidge-Pitts, C., Safer, J.D., Lopez, X., Tangpricha, V. Iwamoto, S.J. (2020, December 16). Proper Care of Transgender and Gender Diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective. The Journal of Clinical Endocrinology & Metabolism. doi.org/10.1210/clinem/dgaa816

Mermaids Blames J.K. Rowling for Trans Suicide Attempts

News Commentary

GHQ is concerned by the latest statement by Mermaids, an organization in the UK that promotes social and medical transition underage for gender dysphoria in which they suggest that debating the critical issues of appropriate healthcare for gender-dysphoric children and young adults leads to self-harm and suicide and therefore must be avoided. In the area of gender medicine, where little quality evidence exists regarding treatments and outcomes, and where the results of the treatments are life-long and irreversible, the debate is essential. Further, invoking youth self-harm attempts in a sensational and emotive way is at odds with the principals outlined by Good Samaritan, and other suicide prevention groups, which specifically caution against such practices due to the highly contagious nature of self-harm among young people. It violates the principles laid out in a fact sheet specifically addressing LGBT youth and suicide risk put out by the American Foundation for the Prevention of Suicide.

The fact that suicidality among transgender identifying individuals is elevated is yet another reason to promote, rather than suppress, vigorous debate. A recent report by the Sweden’s National Board of Health published in 2019 established that 0.6% of gender dysphoric individuals have committed suicide since 1998, which is 4.9-13.7 times higher than the general population. Suicides are complex, multifactorial events. The Swedish National Board found that people with gender dysphoria who commit suicide have a very high rate of co-occurring serious psychiatric diagnoses, which in themselves sharply increase risks of suicide. Further, they found that the general population with no gender dysphoria diagnosis but with other psychiatric diagnoses, had even higher suicide rates than the gender-dysphoric population. Another study (Wiepjes 2020) states that suicides happen at all stages of transition, including post medical transition.

Unfortunately, no studies to date have shown that affirmation of children or adolescents reduces suicide, prevents suicidal ideation, or improves long-term outcomes, as compared to either “watchful waiting” or psychotherapy (Biggs 2020). High post-transition suicide rates found in the adult populations further complicates the “transition or suicide” narrative. It is vital that debate regarding the treatments and outcomes in the area of transgender health is conducted in a fair, responsible, and intellectually rigorous way, to improve the quality of the available evidence and to provide gender-dysphoric individuals, their families, and their clinicians with accurate information on which they can base their decisions.

The media, LGBT organizations, and even some of the most prominent affirmative model mental health professionals and doctors (Diane Ehrensaft, Johanna Olson-Kennedy) promote a “transition or die” narrative to parents of trans-identified children to enforce affirmation in ways that Mermaids does. The information from Sweden’s National Board of Health and psychologist Dr. Zucker indicates suicide risk for gender dysphoric people is in line with other mental health issues such as depression and anxiety, a serious concern but not the “epidemic” some portray it as.

From GHQ Topic 15:

Dr. Zucker has noted that suicide ideation in trans youth should be a concern of parents and mental and medical health professionals involved in treatment of dysphoric youth. However, it is no different than the concern for the elevated suicide risk for all youth seeking mental health treatment.

We reference other problems with Mermaids regarding extremist behavior and promoting false narratives on the GHQ site:

https://www.genderhq.org/search?q=Mermaids

References:

American Foundation for the Prevention of Suicide. (2020). Talking About Suicide & LGBT Populations. Retrieved from https://www.datocms-assets.com/12810/1576937561-talking-about-suicide-and-lgbt-populations-2nd-edition.pdf

Bailey, M., Blanchard, R. (2017). Suicide or transition: The only options for gender dysphoric kids? 4thwavenow. Retrieved from https://4thwavenow.com/2017/09/08/suicide-or-transition-the-only-options-for-gender-dysphoric-kids/

Good Samaritans. Guidance for covering self-harm in the media. Retrieved from https://media.samaritans.org/documents/Guidance_for_covering_self-harm_in_the_media_FINAL_1.pdf

Mermaids. (August 28, 2020). A call to J.K. Rowling. Retrieved from https://mermaidsuk.org.uk/news/a-call-to-j-k-rowling/

Wiepjes, C.M., den Heijer M., Bremmer M.A., de Blok C.J.M, Coumou B.J.G., Steensam T.D. (2020). Trends in suicide death risk in transgender people: results from the Amsterdam Cohort of Gender Dysphoria study (1972–2017). Acta Psychiatrica Scandinavica 2020,1-6. doi.org/10.1111/acps.13164

Zucker, K. (2019). Gender Identity and Kids (starts at 1:03:32). Retrieved from https://www.youtube.com/watch?v=FHREA4Q4V4Q.

GHQ Responds to the American Psychological Association Guideline for TGNC People

News Commentary

This is our response to a request for feedback from the public regarding the APA’s guidelines for trans and nonbinary-identified people. A complete copy of “Guidelines for Psychological Practice With Transgender and Gender Nonconforming People” can be found here and comments are received until 9/30/20:

Guideline 1. “Psychologists understand that gender is a nonbinary construct that allows for a range of gender identities”

This is an ideological statement. How is the APA defining gender? There is no universal agreement gender should be defined as something subjective with limitless variations believed by others. Very few people in the human population experience gender incongruence. Declaring all of gender to be a “nonbinary construct” is an overstatement. The APA may choose to engage this recently popularized language (mostly with roots in postmodern gender studies in academia) that values subjective experience over the scientific method, but a more grounded way to phrase this is:

“Human beings are a binary, sexually reproducing species with some intersex conditions that still fall under male & female. While males & females have differing bell curves for many traits, they overlap, & it is normal to have females who fall into ranges closer to male averages & vice versa. Some individuals experience incongruence with their biological sex due to factors that research indicates are both biological & environmental. Gender dysphoria is a spectrum.”

Word choice by the APA is important to your organization’s image & mission. Does the APA want to be a science organization or one that uses language derived from activist circles & identity studies in academia whose proponents often don’t engage their ideas in rigorous scientific discourse? There have always been gender outliers. That isn’t evidence the concepts & language used in current gender identity activism are all positive for mental health & society at large. Many people have adopted a myriad of identities (belief one is a shaman, MPD, the Glass Delusion) throughout history not grounded in material reality. Everyone has rights to become their happiest self. The issue regarding the wording of this section is if others around them MUST adopt their self-perception as literally true. A more critical approach is warranted.

Some context: Gender Health Query is bringing this up due to our perspective as a medical & cultural watchdog organization around pediatric medical transition & contemporary gender ideology. We formed because we are starting to observe real-world harm to young people resulting from the gender identity movement despite its positives. This section assumes that genderfluidity ideology discourse is progressive & the healthiest possible framing for people struggling with gender issues. & that if we all believe that gender is indeed a spectrum, that there are multiple genders, & that this should be validated by not only health professionals but the public at large, that dysphoric people will experience reduced problems with mental health.   

Many of us (we are an LGBT organization & trans-inclusive) have come not to believe that, & we have evidence. We range from LGB people observing body hatred issues in gender nonconforming young females not alleviated by transition to “transmedicalists” who believe that the genderqueer movement, with its myriad of pronouns & demands on the outside world for validation, is harming transsexuals (a term they embrace to distinguish themselves as having a definable medical condition). 

The language you are using in this whole section is concerning because demands are being made. Demands that psychologists not only support their clients with kindness, compassion, & coping skills but must also adopt their clients’ worldviews & subjective experience as facts about gender (217-219). & this from the APA’s Nonbinary Fact Sheet:

“Practice using singular pronouns such as they/them & zie/ hir. Using non-binary pronouns can feel awkward at first. Practicing using these pronouns outside of the therapy room will allow clinicians to get more comfortable & fluent in doing so & will make speaking with clients easier.”  

Not all LGBT people support the language used here because of where it has led. We are seeing some harm arising from telling young people that biological sex is irrelevant & that gender is a spectrum. “Harm” meaning a glorification of body dysmorphia now viewed as “cool” identities. Harm meaning an increase in stories of transition regret. Harm meaning “queer” youth who seem to have difficulty coping with even minor challenges to their worldviews about their long growing lists of sexual & gender identities & demands to be sexually & emotionally validated by people who don’t agree with identity over biology. Harm meaning any young bisexual who doesn’t want to identify as “pansexual,” or lesbian who doesn’t want sex with MtFs, is being called a bigot, an unhealthy form of sexual harassment disguised as social justice, behavior now rife in LGBT youth & even some adult spaces. Harm meaning young people who are so gender/sexually confused they are being put at risk for sexual exploitation by peers & adults online & in real life in “queer” spaces. Harm meaning an obsession with identity in youth culture over accomplishment & human values. We have many examples to justify these statements (see genderhq.org).

Guideline 2. Psychologists understand that gender identity & sexual orientation are distinct but  

Mental health professionals should educate themselves on the specific & often-ignored needs of trans people & that trans & sexual orientation are two different things. 

It is also important to acknowledge the association of even intense childhood dysphoria & adult GL identity (https://www.genderhq.org/trans-children-gender-dysphoria-desistance-gay/#anchor-page1-section-b). Evidence such as “the older brother effect” indicates certain biological processes create both trans & gay outcomes. Hormone in utero effects may affect FtM or lesbian identity (https://www.genderhq.org/trans-nature-vs-nurture-innate-gender-identity-culture). This is why there is a growing community of LGB people who are very concerned about socially reinforcing a child’s cross-sex identification at age 5 & giving them Lupron as early as age 11. & the push to socially & medically transition the large increase in trans-identified bio females. We don’t know the number of medicalized false positives that will occur, but it won’t be zero. There is currently a detrans subreddit (https://www.reddit.com/r/detrans/) with thousands of people in it & most appear to be L & B young women dealing with medical side effects who transitioned at too young an age. 

In line 279, you use the term “Sexual orientation identity.” Sexual orientation is based on bio sex, as in male & female. It is not an “identity.” Individuals are free to view themselves as they wish. But our org. protests any attempt by mental health bodies to define gay & lesbian people based on gender identity & not same-sex attraction. We aren’t alone in this. If the APA adopts the stance that sexual orientation is something one can identify into, you are taking sides on an issue that is extremely contentious. You will be taking a position many gay men & lesbians view as offensive to the interests of their minority groups. Why? The answer is in the way this ideology plays out in the real world. Contemporary gender identity activism (that uses the same language used in this document) is framing gays & lesbians as bigoted for not including dysphoric, opposite-sex people in their sexuality. It’s causing much strife. There are even psychologists who are “problematizing” homosexuality & heterosexuality by framing not emotionally & sexually validating trans people’s identities in terms of social justice (Blair 2018). Our board had to write a response.  https://www.genderhq.org/blog/2019/6/17/ghq-board-opinion-sexuality-as-social-justice-creates-problems-especially-among-lgbt-youth?rq=Blair

Some people in the LGB population will view the APA  as a hostile entity to LGB identity if you validate the concept one can identify into homosexuality or gay & lesbian identity or that bisexuality is anything other than attraction to the 2 biological sexes. Changing these definitions reflects genderqueer activism, not facts.

Line 266 “range of gender identities that exist.”

The APA may want to consider if adopting queer theory views of gender as a spectrum is helping in the real world as it relates to NB-identified people. Most research showing benefits of transition relates to binary FtM & MtF. While studies such as Russel (2018) show a boost in happiness if pronouns are respected, & this may include third gender pronouns, other studies indicate many people are not being helped by the rise in the NB identity. Several studies on NB identities show they have worse mental health than binary trans people (Jellestad 2018, James 2016, Tebbe 2016). This is often blamed on the outside world’s failure to validate them properly. Our position is that youth should not be encouraged to seek & demand validation from others to achieve happiness, but the current genderqueer movement relies heavily on this concept.

Other plausible scenarios are persons may adopt an NB identity due to ASD, BPD, BDD, HPD, NPD, or AGP. They may be struggling with internalized anti-gay/lesbian feelings. There are personal accounts that say so & at least one study that shows homophobic bullying increases the likelihood of trans identification (Delay 2017). They may be experiencing a female inferiority complex as one of the many females identifying as trans or NB in exploding numbers. The compassion in this section is good. We want support for GNC people too. We must create space in society for them & support them. We ARE them as an LGBT organization. But mental health is complex & mental health issues should not be rebranded as “identities” because we believe that is what we see in some cases. Given affirmative model advocates openly admit minors are undergoing permanent medical alteration like double mastectomy for NB identities, the APA must look at what is causing this increase in mostly female minors with these identities. We are seeing more stories of transition regret & some of these mostly lesbian & bisexual or ASD young women had adopted NB identities.

Guideline 5. Psychologists recognize how stigma, prejudice, discrimination, & violence affect the health & well-being of TGNC people. 

“Discrimination can include…not using a person’s preferred name or pronoun”

We hope the APA believes there are limits to defining not using preferred pronouns as “discrimination” given there are now dozens of them. Is an LGB person or transmedicalist “discriminating” against someone if they do not believe in pronouns such as ze, ve, zir, they, & it, all pronouns you will see people use. The APA must be mindful not to advocate for imposing worldviews on others who may not agree with them by framing it as bigotry & discrimination. This is an increasing problem in academia & has infiltrated science bodies. Real discrimination is kicking someone out of a home or firing them.

Discrimination, suicide ideation, mental health issues, & violence inflicted on poor black & brown people are all real issues that must be addressed. We also see a huge amount of paranoia in the trans community that is not in line with reality when one examines crime statistics. Trans people overall may not be at higher risk for violence relative to other groups such as women in general or black men. & the media reported murders, with hyped headlines, often involve situations where they weren’t targeted in an anti-trans hate crime. One study shows they are at lower risk for violence than women overall. Since anxiety, depression, suicide ideation, & paranoia are all socially contagious phenomena, it is best to educate trans people about how to be mindful to keep themselves safe & healthy without fomenting fear that may harm their mental health and make them feel hated. Targeted programs for poor people at risk for drug addiction & prostitution are most needed. Trans people can live safe & happy lives in tolerant areas. It is crucial to promote messages of hope.

https://www.channel4.com/news/factcheck/factcheck-how-many-trans-people-murdered-uk

https://quillette.com/2019/12/07/are-we-in-the-midst-of-a-transgender-murder-epidemic/

https://www.washingtontimes.com/news/2019/dec/8/transgender-homicide-rate-remarkably-low-despite-h/

This section mentions “stigma.” Our position is that many mental health professionals are participating in stigmatizing autogynephilia by refusing to recognize it exists due to political pressure from certain activists. Many trans people admit they experience this. We believe we see a lot of harm, shame, & acting out resulting from people participating in AGP denial. 

https://www.genderhq.org/trans-youth-identity-politics-rights-conflicts-lgbt-part3

The APA should start talking about this condition openly. We consider it malpractice to continue to deny it exists, which may prevent a therapist from helping people in the most honest way possible without shame.

Guideline 7: Psychologists understand the need to promote social change that reduces the negative effects of stigma on the health & well-being of TGNC people. 

Some concerning parts of this section-

"Psychologists may choose to become involved with an organization that seeks to revise law & public policy"

"Psychologists may consult the National Center for Transgender Equality"

This is an ideological trans rights organization. For example, they make these claims about trans students- "Some are denied opportunities to go on field trips or participate in sports."

This is a lie. People want policies to protect female students & female sports. All evidence is leading to MtFs having very significant biological advantages in sports over biological females even once they medically transition (https://fairplayforwomen.com/sports/). MtFs are blowing away females in track in high school and college, for example. No one is preventing anyone from participating in sports based on biological sex. FtMs on testosterone may be included in male sports if they wish as they will still retain a disadvantage but have unacceptable advantages over girls and women. We believe males need to learn to be kind & compassionate towards gender nonconforming males who may identify as girls, not force girls to be nurturers at the expense of their ability to win sports competitions because they don't matter as much as a male with GD. There is a trans Muay Thai fighter who identifies as a trans woman & fights males and recognizes they are trans & takes pride it that. This is preferable role-modeling, not forcing society to deny biological reality.

Imagine an unaltered MtF goes on a field trip, stays in sleeping quarters with a girl & has consensual sex with her on a school field trip. She gets pregnant. That is a situation where the parents will have every right to sue the school. A school worried about this is not "discriminating" against a trans student who is undoubtedly allowed to attend field trips as any other student. Safe, compassionate accommodations must be made for all. The APA should not follow organizations such as this uncritically for advice.

The APA should stay away from inserting itself "to promote social change" when it results in potentially harming other groups. Adhere to "change" that protects the safety, health, & ability to live & work for trans people. If you go beyond that & promote current gender identity activist demands like MtFs are "literally female," you will be viewed as an anti-woman & anti-LGB rights organization by many. The eradication of women's sports, prisons, rape crises centers for biological females, medicalizing children who may be pre-LGB, & eliminating the ability to collect valid data regarding sex due to the change of public records are very contentious issues. Many people, including conservatives, far leftists, trans-rationalists, LGB people, parents, feminists, scientists, and detransitioners are working against some of the biology denialism in current gender identity activism. LGB people are breaking off from LGBT organizations to form new ones due to this ideological capture. Best avoid "promoting social change" in those areas unless you want your organization torn apart by this.

Guideline 8. Psychologists working with gender-questioning 4 and TGNC youth understand the different developmental needs of children and adolescents, and that not all youth will persist in a TGNC identity into adulthood. 

"As a result, this research runs a strong risk of inflating estimates of the number of youths who do not persist with a TGNC identity."

This is debatable when one takes a close look at the Steensma study.

https://medium.com/@jesse.singal/everyone-myself-included-has-been-misreading-the-single-biggest-study-on-childhood-gender-8b6b3d82dcf3

We review desistance stats here. 

https://www.genderhq.org/trans-children-gender-dysphoria-desistance-gay

We already know false positives on minors are happening. We just don't know the numbers. The APA should take this on as an ethical duty. Detransitioners will be a growing population. We see rapid validation of trans identity in minors by psychologists leading to irreversible medical consequences. At the same time, we see young people who meet full DSM criteria but are desisting or detransitioning. These are minors being put under extreme medical protocols. It's good always to be mindful of this reality. Transition underage is considered a human right now. Is growing up without being permanently medically altered for intense, but ultimately transient feelings a human right? We believe it is. 

We consider stories like this malpractice. This 15-yr-old girl would have taken testosterone had her father not let her before desisting after meeting DSM criteria. As a medical watchdog org, we hear a lot of stories like this. Altering physically healthy bodies underage would normally be considered a major human rights violation. The inevitable false positives on mostly pre-LGB youth, ASD, and girls with trauma that will result from transitioning youth before brain maturation are acceptable collateral damage to trans-positive healthcare. This is the reality of the new paradigm, and we would like to see organizations like the APA be more upfront about it, given the serious medical consequences. For example, altering pre-LGB youth can be considered akin to what was done to intersex babies when doctors surgically altered them given the Lupron to estrogen protocol stunts genital growth, and they are doing surgeries underage now. 

https://www.genderhq.org/blog/2020/4/8/teen-girl-outgrows-gender-dysphoria-dangers-pediatric-medical-transition

Medical transition under age causes sterility, may permanently destroy sexual function and may impact cognition and bone health.

https://www.genderhq.org/trans-youth-side-effects-hormone-blockers-surgery

"Much greater consensus exists regarding practice with adolescents. Adolescents presenting with gender identity concerns bring their own set of unique challenges."

This comment should be removed. The demographics of this condition have completely changed, with many more females seeking SRS, more heterosexual females wanting to be gay men, and an overall increase in youth requesting medical treatments. There is not a consensus about what to do. The Tavistock gender clinic in the UK has seen multiple public resignations. That doesn't indicate "consensus." It indicates safeguarding and ethics problems. It's unethical as a mental health body to not to take a closer look at ROGD and other trends when one sees these graphs. We believe there is very robust evidence GD is a socially contagious and iatrogenic condition for some people, particularly female teens and YAs. 

https://www.genderhq.org/increase-trans-females-nonbinary-dysphoria

Much evidence points to social factors contributing to GD. Society is currently being set up to maximize the number of medicalized young people.

https://www.genderhq.org/trans-nature-vs-nurture-innate-gender-identity-culture/#anchor-page10-section-a

Guideline 11. Psychologists recognize that TGNC people are more likely to experience positive life outcomes when they receive social support or trans-affirmative care.

We have reason to believe younger cohorts will have more regret and less positive mental health outcomes due to the substantial increases in the numbers of young people transitioning and the move to the affirmative model and informed consent model for adults. For example, the Williams Institute study is touted as an example of a study validating the need to offer easy medical transition access. But if one looks at the question about passing better, there is no benefit. In that study, natal females (in contrast to natal males) who say other people don't recognize them as trans or GNC have the same or higher suicide attempt rate as females who are dysphoric and recognized as female, not male. 

If you look at Lipson (2019) there are incredibly high rates of mental health problems among the trans college students surveyed. This is at a time when celebration of trans identity is at an all-time high. And college students are often given access to transition healthcare. Yet the rate of mental health problems is alarming, particularly among biological females. Given it is known females are prone to body dysmorphia contagions or BPD, which involves identity instability, we hope the APA is asking questions beyond blind affirmation. We are seeing many therapists blindly and immediately affirming young people assuming transition will solve all of their problems. It's one reason we felt we had to form GHQ.

Another recent study (Branstrom 2019) calls into question the overall benefits of SRS on mental health. The conclusions of this study initially claimed a benefit. The study had to be corrected after several LTEs pointed out major flaws. It showed no benefit. It's disingenuous they have not changed the title, and bias may be involved in them not retracting it altogether. 

https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2019.19010080?journalCode=ajp

https://www.genderhq.org/blog/2020/8/19/american-journal-of-psychiatry-study-purported-to-show-benefits-of-transgender-medical-transition-made-false-claims 

We review the positive studies on GHQ.  

https://www.genderhq.org/trans-youth-suicide-statistics-kill-themselves-manipulate-parents/#anchor-page15-section-b-what 

We also cover studies such as Dhejne, Adams, and Marshall that call into question the positive effects of medical transition in the long run on mental health & suicide risk.

https://www.genderhq.org/trans-youth-suicide-statistics-kill-themselves-manipulate-parents/#anchor-page15-section-b-below

The APA may want to take a closer look at what is going on now rather than rely on the Cornell review and other positive studies. Detransition and rapid onset gender dysphoria (Littman 2018) will likely be growing topics. Please don't acquiesce to the intense and often successful efforts to shut this down.

https://www.reddit.com/r/detrans/

https://www.genderhq.org/trans-activism-identity-politics-harassment-censorship

Guideline 15. Psychologists respect the welfare and rights of TGNC participants in research and strive to represent results accurately and avoid misuse or misrepresentation of findings. 

“One group of experts has recommended that population research, & especially government-sponsored surveillance research, use a two-step method, first asking for sex assigned at birth, & then following with a question about gender identity (GenIUSS, 2013).”

Yes- it is critical to collect data knowing the biological sex of all involved. This is creating problems. We look at studies on LGBT youth and we don’t even know the biological sex of those involved. It’s an example of the many problems identity over biological reality causes. Scientists, women, gay people, and trans people all need access to proper data.

Thank you so much for allowing us to participate.

Teen Vogue and Heron Greensmith Deny There Are Any Consequences to Minors with Gender Dysphoria who Medically Transition. There Are.

Editorial

Teen Vogue and Heron Greensmith, a female who doesn’t appear to have medically transitioned but goes by they/them pronouns, have published an article mentioning Gender Health Query and several other organizations skeptical about the safety of pediatric medical transition for gender dysphoria. One of the organizations listed is the American College of Pediatricians. It is an anti-same-sex marriage and adoption activism organization, and Gender Health Query does not endorse organizations that do not align with our interests.

All of the other organizations listed are not religiously motivated, anti-LGBT organizations. They include some trans people as ours does. They have evidence to support the claims on their sites and have the same concerns we do for the same evidence-based reasons.

Greensmith states there are no medical reasons for minors not to transition underage:

Among them are the Gender Care Consumer Advocacy Network, ReThink Identity Medicine and Ethics, the Society for Evidence-Based Gender Medicine, Gender Health Query, and the Pediatric and Adolescent Gender Dysphoria Working Group. Looking at these names, one could easily assume there was a strong medical argument against trans-affirming care for youth, or even potentially a discussion worth having. But let me repeat:

There is no valid medical argument against trans-affirming care for youth

Greendsmith fails to include another pro-homosexual/bisexual rights organization site, Transgendertrend, where one can find evidence-based reasons for concern, with some material written by scientists.

While Greensmith mentions our website, there is no mention of our section laying out significant medical consequences to underage transition. We will list them below to counter this irresponsible article allowed by Teen Vogue editors Lindsay Peoples Wagner, Samhita Mukhopadhyay, and Emily Shippee. There is also debate about the quality of the studies Greensmith cites, such as those done by Jack Turban that appear to suffer from confirmation bias and methodological issues (see here, here, and here), a common problem in social science research. All citations can be found in the hyperlinked section.

Significant Consequences Pro-Child-Transition Media Often Avoid Mentioning

1) Permanently destroyed sex organs resulting in a lack of ability to ever have an orgasm-

If a male who wants to be a girl takes hormone blockers as a tween, the youth will always have the penis of a prepubescent child if the child later takes estrogen. This, in of itself, may destroy the youth’s ability to have a fully functioning, adult sex life. If the youth wants a vaginoplasty surgery (they are doing them on minors), they will have to undergo a rectosigmoid vaginoplasty using the colon or one using the peritoneal lining around the stomach. This can create significant order problems later. They also must take skin flaps from the inner thigh leaving considerable scarring. There isn’t enough tissue to do what is called the “gold standard” vaginoplasty, which inverts the penis and scrotum. These other techniques are experimental surgeries.

There are already examples of the vaginoplasty falling apart and needing repair. A trans child reality TV star, has undergone at least four surgeries, describes this ordeal as extremely painful, and will likely go through life not experiencing orgasm even once. In one of the cohorts from a study Heron Greensmith sites (the de Vries/ Steensma cohort from the Netherlands), one of the youths died from the vaginoplasty surgery. Some of these minors making these decisions as tweens will never have sexual feelings in their lives. Many adults decide never to get bottom surgery. It is perfectly rational to question the ethics of destroying such a major choice when doctors transition a tween. And it is shoddy journalism to avoid mentioning this in an article discussing medical risks to under-age youth.

While we understand a dysphoric minor may have a very strong desire to live as the opposite sex and pass better, we believe it is a very sex-negative approach to destroy all ability to fully experience an adult romantic relationship and sexual fulfillment based on a decision the child made before ever having a relationship or even just a crush or sexual desire. The significance of these things is not understood by children. And while it is uncomfortable, this topic must be discussed honestly:

2) Sterility-

The hormone blocker to cross-sex hormone protocol causes sterility. There is a plethora of news articles about trans people who have children or say they want them. There is also a study that shows many trans people want biological children. There was a lawsuit in Sweden regarding trans adults suing because they were sterilized as a requirement for transition, so fertility is important to trans people. A tween or teen will not know how they will feel about children later.

3) A reduction in cognitive function-

A few studies indicate hormone blockers significantly lower IQ test scores. IQ is strongly correlated with career choice and earned income:

Schneider et al.(2017): “Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression”

4) A reduction in bone health-

Blockers appear to give a young person the bones of a much older person. Weakening bone density of a young person is worth mentioning:

Micheal Biggs bone density review paper

5) Gay, Bisexual, and Lesbian Eugenics-

All prior research shows that a very significant number of children with even acute gender dysphoria outgrow it and are very likely to grow up gay or lesbian. This graph is a review of the four most recent and best studies tracking desistance from gender dysphoria. Dr. Ken Zucker created this graphic. The percent of desistance is 67%, a majority:

Zucker, Power Point presentation USPATH 2017

Greensmith mentions Dr. Ken Zucker derisively in this piece but fails to mention that Dr. Zucker believes that children who would grow up gay or lesbian are at risk of having their bodies permanently medically altered prematurely. Any risk of permanently altering physical appearance with cross-sex hormones of potentially LGB youth is a serious ethical concern, especially for people who care about the health and diversity of expression of LGB populations. This is why Zucker took a more cautious approach, the protection of likely gay, bisexual, and lesbian youth from harm. Other gender dysphoria experts like Dr. Korte, Dr. Steensma, and Tavistock clinicians have mentioned this as a concern. Heron mentions conversion therapy laws. We are starting to see that transitioning minors is conversion therapy for some youth, particularly lesbian youth struggling with puberty. This is LGB eugenics. It’s already happening:

The London Times

And eugenics is the correct word as these protocols have the potential to sterilize, destroy sexuality, and permanently change the youth's features and voice. There are now too many stories of mostly young lesbian and bisexual women who transitioned as minors and have regrets. There are so many, the days of plausible deniability one doesn't know are over. It is callous of Heron Greensmith to fail to even mention them considering these are mostly lesbian and bisexual young women. Greensmith may want to consider if cheerleading tomboy teenagers (likely to be same-sex attracted) in their body dysmorphia and female inferiority complex is healthy for them in the long-term because it isn't. It's harming some of them.  Lesbian and bisexual youth who struggle with gender dysphoria but are better served by being allowed to just grow up without medical damages matter too. Some heterosexuals males and females also may have regrets.

6) Evidence of serious negative long-term side-effects from using Lupron, a hormone blocker-

Many women are suing due to side-effects from Lupron, a common gender clinic hormone blocker, that doctors gave them for precocious puberty or endometriosis:

As with many drugs, side effects have long been a problem. More than 20,000 adverse-event reports have been filed with the FDA in the last decade. Women have reported to the FDA hundreds of cases of insomnia, depression, joint pain and more than 100 cases of blurred vision. About 900 reports cite side effects that children below age 13 have suffered, mostly within months of taking Lupron. Those reports frequently note injection-site pain but also include dozens of cases of bone problems, such as pain or disorders, and the inability to walk.

And from Righting Injustice:

Last month, the FDA required the safety labels of GnRH agonists to be updated to include new psychiatric side effects causing emotional lability such as crying, irritability, impatient, anger and aggression. The labels were also updated with a warning that use of the drugs were linked to convulsions, particularly in patients with a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and in patients taking drugs that can increase the risk of convulsions, such as bupropion and SSRIs.

Other side effects are deteriorating jaw joints, degenerative disks, growth of preexisting tumors, deteriorating vision, exacerbation of asthma, osteopenia, memory loss, hair loss, and fibromyalgia. In adult men, some of the labeled risks of Lupron are heart attacks, strokes, and sudden death.

7) The large increase in trans-identified females looks like other body dysmorphia social contagions of which there are many in history-

Please see this section and view the graphs showing soaring numbers of female teens identifying as trans. It is not responsible to fail to question this. We would appreciate it if Teen Vogue would write a story on the massive increases of female teens identifying as trans with what appears to be a spike in transition regret by female young people:

8) A list of just a few of medical the consequences trans youth will have to deal with as adults-

• Vaginal atrophy in FtMs that causes severe pain during sex

• Increase risk of heart attack and stroke

• Liver problems

• Need for repeat vaginoplasty surgeries if they collapse

• Unknown cancer risks from underage transition 

9) The validity of the argument about the benefits of hormone blockers is debatable-

The hormone blocker study done by the Tavistock clinic in Britain has shown blockers may worsen mental health.

We believe that this was a very irresponsible article designed to hide the risk of this to the health of all gender dysphoric children regardless of how stable their trans-identity is. We support the promotion of coping skills, and the importance of brain development and physical health to support these youths for the long-term, not extreme medical fixes youth are led to believe will be a panacea. This article is especially insensitive to the concerns of the growing numbers of gay, lesbian, and bisexual people who are upset about what appears to be substantial increases in stories of transition regret among youth in their early twenties who are mostly lesbian or bisexual women. Transition regret among young females would be a good topic for a Teen Vogue article. The stories of regret are very easy to find at a time of massive increases in trans-identified youth.

Heron Greensmith needs to make the morally and intellectually honest argument. That argument is that false positives, resulting in permanently altered bodies of cognitively immature tweens/teens, resulting in sterilization and other health issues, are worth trans-positive healthcare in hopes more good than harm will be done. That argument is that it is a good thing for an 11-year-old, with no concept of sexuality or desire for children, to permanently destroy their sex organs in order to have a more feminine face, because looks and access to extreme plastic surgery to relieve distress are more important than coping skills and long-term physical health. Instead, Greensmith engages in ideological, black and white, biased, and cherry-picking discourse. This is bad journalism. And as an opinion piece be clear, Greensmith doesn’t represent the opinions of all LGBT people. We recommend that Teen Vogue find someone willing to engage with all of the facts around permanently altering minors. While we are a medical watchdog organization, and harm is our emphasis, we lay out a more unbiased picture, including arguments Greensmith makes, about the ethics of pediatric transition in “17) MORAL DILEMMAS.”

-Justine Kreher

References can be found in links at the end of these sections:

1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA?

2) CONSEQUENCES & PERMANENT SIDE-EFFECTS THAT RESULT FROM THE USE OF HORMONE BLOCKERS

11) WHY ARE SO MANY FEMALES COMING OUT AS TRANS/NON-BINARY?

Here is a list of references for our Topics section.

Thanks to The Australian and Bernard Lane for Publishing Our Comments About the Affirmative Model

News Commentary

Bernard Lane has been writing articles about transgender issues for The Australian. Those articles can be found listed under his BIO.

Lane included GHQ statements for an article about conversion therapy laws and how these will be used to immediately affirm the significant increases in trans-identified youth:

“Health chiefs can’t ignore ‘global epidemic’ of transgender teens”

Here is the quoted GHQ commentary:

Justine Kreher, from a new US-based LGBT group Gender Health Query worried about overdiagnosis of gender dysphoria and medicalisation of minors, said most LGBT people were not aware of the risks.

“The evidence is strong that early social transition (living as the opposite sex) and use of hormone blockers will lead to the over-medicalisation — or “conversion” — of LGB minors who would have outgrown gender dysphoria with maturation,” she said.

“It’s already happening as known cases are mounting. The question is, how high will the percentage be?”

Gender Health Query’s international board includes trans adult Miranda Yardley and lesbian feminist philosopher Holly Lawford-Smith from the University of Melbourne.

Ms Kreher, also a board member, said LGBT lobbies and progressive media refused to discuss “the reality that for many gender-nonconforming youths, or even adults, there isn’t a clear line between gay and trans”.

“Trans people argue transition as a minor is a human right (but troubled) LGB people would argue the right to mature and accept oneself, without being medically defaced by the psychology and medical profession, is a human right.”

Ms Kreher said activist promotion of medicalised gender change had been “extremely effective in inducing suicide terror in the public”.

“People should take suicide risk seriously, but it is also exaggerated and employed to manipulate people to not care about serious risks to minors who may (grow out of gender dysphoria) with time,” she said.

“These risks include sterilisation, loss of sexual function, impacts on bone and circulatory health, and a reduction in IQ if they take hormone blockers.”

The article included commentary from mental health professionals expressing similar concerns:

The internationally recognised sex researcher, Ray Blanchard, joined online debate about the Queensland bill, tweeting: “Conversion therapy laws are Trojan Horses, ostensibly about banning attempts to change sexual orientation in adults, actually about banning therapy to help gender-dysphoric children and youth become comfortable with their anatomic sex”.

And:

Dr Parry pointed out that many children grew out of gender dysphoria, becoming “more comfortable with birth gender or a same-sex orientation”. Clinicians say this is a reason to be cautious about medical interventions.

Psychologist Dianna Kenny, who treats gender dysphoric youth, told the committee that trans activists “vehemently denied the role of social contagion in the spread of gender dysphoria in young people because it flies in the face of their flawed ideology that children are the experts regarding their own gender identity”.

Dr Kenny, a specialist in developmental psychology and a former professor at Sydney University, said beliefs and attitudes were especially contagious in centralised social networks.

“This network is highly centralised with only one voice — the trans activist lobby — being heard above the desperate cries of terrified parents and horrified academics, doctors, psychologists and psychotherapists.”

She said this social contagion was affecting not just children and adolescents but also medical practitioners, legislators and educators.

The article confirms this is mainly affecting young females:

There were at least 216 patients on controversial puberty blocker drugs (up 108-fold over six years).

The clinic refuses to reveal birth sex data but 94 per cent of the 84 under-18s on opposite-sex hormones were taking testosterone, meaning they were born female.

Thanks to the paper and author for airing our concerns.

References

Lane, B. (2020, February 11) “Health chiefs can’t ignore ‘global epidemic’ of transgender teens.” The Australian. Retrieved from https://www.theaustralian.com.au/nation/health-chiefs-cant-ignore-global-epidemic-of-transgender-teens/news-story/5849a55ba47884befdc9eb72d25d32d7

Medical Ethics and Pediatric Medical Transition for Gender Dysphoric Youth

News Links

Recently there have been many more health professionals, and others, who have been critiquing the pros and cons of pediatric medical transition, and the benefits of medical transition overall, to gender dysphoric people. We are updating these links to be tagged to our section on medical ethics for those who are interested in researching and understanding health and psychological consequences of transitioning minors.

Questioning Medical Ethics

1) Dr. James Cantor has written a critique of The American Academy of Pediatric’s guidelines on treating gender dysphoric youth. These guidelines ignore desistance statistics and support full social and medical transition for minors. Link to both the paper and a podcast interview below.

“PODCAST 68: Clinical psychologist Dr James Cantor Criticises the American Academy of Pediatrics’ Guidelines for Treating Trans Children:”

Dr James Cantor, clinical psychologist and sexologist, talks to Jonathan Kay about his recent peer-reviewed critique of the American Academy of Pediatrics’ guidelines on treating trans children.

2) Sky News has covered the ethics topic and the fact that therapists can not provide therapy to youth beyond fully affirming them as trans.

“NHS 'over-diagnosing' children having transgender treatment, former staff warn:”

Thirty five psychologists have resigned from the children's gender-identity service in London in the last three years, Sky News research suggests.

Sky News- clip of Dr. Evans:

Dr Marcus Evans resigned from the Tavistock & Portman NHS Trust over concerns about its gender identity service. He questions how a child of 11 can consent to treatment that will 'profoundly effect' their physical and psychological well-being.

3) Below is an article written by Marcus Evans about his deep misgivings about transitioning minors and the affirmative model.

“Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs”

A similar article exists on Medscape.

“UK Gender Identity Service at Crunch Point as Pressure Mounts”

4) Another article on the Tavistock gender clinic in the UK was published in The Telegraph.

“Children's transgender clinic hit by 35 resignations in three years as psychologists warn of gender dysphoria 'over-diagnoses'“

5) This is an article about another British psychologist.

“Transgender Children: 'The concept of being born in the wrong body is troubling'“

6) A former Tavistock employee is bringing a legal case:

Children cannot consent to transgender treatment, a nurse bringing a landmark legal case has said, claiming that many are autistic, homosexual or just confused. 

Susan Evans, 62, a former psychiatric nurse at the Tavistock and Portman NHS foundation trust, said that “experimental” and “invasive medical treatment” should be prevented in order to protect children. 

7) The Economist has printed an article on the possible dangers of pediatric medical transition and the use of hormone blockers. GHQ covers some of those risks here.

“What to do about puberty blockers”

8) The increase in and complexity of gender dysphoria cases are making ethical decisions more difficult and some Australian health professions believe there are problems with the quality of a new study in Australia designed to track outcomes in trans people.

“What are the health outcomes of trans and gender diverse young people in Australia? Study protocol for the Trans20 longitudinal cohort study:”

Our specific ethical concerns centre on whether the ‘informed consent’ offered to parents and their children reflect the rapid advances in complexity and uncertainty that have been reported in recent studiesiv,v,vi

9) Below are three links on The BMJ.

“Family doctors lack training and feel under pressure to prescribe, finds Sally Howard”

“The struggle for GPs to get the right care for patients with gender dysphoria:”

I am concerned to see yet another article in the BMJ trying to persuade GPs to get involved in prescribing for patients who express a desire to be the opposite sex. I am concerned at the journal’s editorial bias on this issue at a time when, as the article says, the number of young people wanting referrals to gender identity clinics because of gender issues has risen hugely and we are reading and seeing more cases of detransitioners who start going down the gender changing pathway and then regret it. 

And a response from a parent is linked.

10) Sasha Ayad is a therapist who supports mental health exploration for gender dysphoric teens.

“What does the word transgender mean?”

11) A psychiatrist, David Bell, is having to deal with legal fees for having raised alarms about what has been happening with the NHS in Britain, indicating there is a price to be paid by whislteblowers.

12) Some individuals have filed complaints against a plastic surgeon who posts pictures of young people who have had mastectomies along with pictures of biohazard buckets full of breast tissue for marketing purposes.

“News Release: Complaint Filed Against Gender-Affirming Surgeons:”

A coalition including Canadian Gender Report, Parents of ROGD Kids, Canadian Women’s Sex-based Rightsand GNC Centric have submitted a complaint to the College of Physicians and Surgeons of Ontario about the McLean Clinic and two of its physicians: Dr Hugh McLean and Dr Giancarlo McEvenue.

13) This paper (Steensma 2017) reviews the difficulties in these types of cases.

Abstract

Our analysis focuses on the importance of balanced decision making when counseling and treating adolescents with nonconforming gender identities. We argue that clinicians’ communicating appropriate expectations about the effectiveness and limitations of hormone therapy and the risks of psychological and physical iatrogenic effects is critical.

14) This is a translated version of a German presentation about the ethics of transitioning minors.

The AFFIRMATIVE MODEL

1) This is a pro affirmative model paper that doesn’t express concern that social transition could lead to inappropriate medical transition and argues transition should be allowed.

“Importance of being persistent. Should transgender children be allowed to transition socially?”

2) The below paper promotes the informed consent model, stating any gatekeeping is unethical:

“Gatekeeping hormone replacement therapy for transgender patients is dehumanising”

3) It appears therapists in the Seattle area actively encourage trans identification, even when a lesbian is attempting to detransition (see 56:00):

“Trauma and Transition | with Rachel”

Adding Three Studies Regarding the Ability of Minors to Consent to Medical Treatment

News

GHQ tries to document all of the pertinent research studies and news articles regarding the issue of pediatric medical transition for gender dysphoria.

We are adding two links and tagging it to Topic 3, the section on age and the ability to consent to medical treatments.

”Ethical issues arising in the provision of medical interventions for gender diverse children and adolescents” is by Bernadette Wren from the Tavistock clinic in Britain. It is an attempt to balance all of the arguments about how able minors are to consent to the irreversible effects of hormones and surgery.

A letter to BMJ expresses that there are reasons to be concerned about giving minors hormone blockers:

Gonadotrophin releasing hormone (GnRH) agonists are generally given under the premise that they provide “breathing space” for a child or teen to explore their identity without the distress caused by pubertal changes.3 It is becoming clear, however, that once started on GnRH agonists to block puberty almost all children go on to receive cross sex hormones.4 The information given to parents and children that GnRH agonists are completely reversible might therefore be construed as misleading.

“The Medico-Legal ‘Making’ of ‘The Transgender Child’” discusses trans identity and cultural context in terms of the medical ethics of medically altering minors:

Abstract

Thirty years ago, the transgender child would have made no sense to the general public, nor to young people. Today, children and adolescents declare themselves transgender, the National Health Service diagnoses ‘gender dysphoria’, and laws and policy are developed which uphold young people’s ‘choice’ to transition and to authorize stages at which medical intervention is permissible and desirable. The figure of the ‘transgender child’ presumed by medicine and law is not a naturally occurring category of person external to medical diagnosis and legal protection. Medicine and law construct the ‘transgender child’ rather than that the ‘transgender child’ exists independently of medico-legal discourse. The ethical issue of whether the child and young person can ‘consent’ to social and medical transition goes beyond legal assessment of whether a person under16 years has the mental capacity to consent, understand to what s/he is consenting, and can express independent wishes. It shifts to examination of the recent making of ‘the transgender child’ through the complex of power/knowledge/ethics of medicine and the law of which the child can have no knowledge but within which its own desires are both constrained and incited.

References

Brunskull-Evans, H. (2019). The Medico-Legal ‘Making’ of ‘The Transgender Child’. Medical Law Review 27(4), 640- 657. doi.org/10.1093/medlaw/fwz013

Maxwell, J. (2019). Gender dysphoria: a question of informed consent. BMJ (367), 16442. Retrieved from doi.org/10.1136/bmj.l6442

Wren, B. (2019, June 14). issues arising in the provision of medical interventions for gender diverse children and adolescents. ACAMH National Conference. Retrieved from https://www.acamh.org/app/uploads/2015/06/16_05_Dr_Bernadette_Wren.pdf

Several New Groups Have Formed to Question the Safety of Medically Transitioning Minors with Gender Dysphoria And The Affirmative Model

News

Several new groups/organizations have formed to question the safety of social and medical transition of minors and young adults with gender dysphoria. These concerns are all in line with the concerns listed on the Gender Health Query website.

Rethinking Identity Medicine is based in the United States and says they will focus on best mental health practices and standards of care.

The MISSION of ReIME is to promote the highest standards of care and ethics in the area of identity medicine for children and youth.  To this end, we gather, curate and distribute up-to-date evidence-based information on best practices that ensure individualized, developmentally appropriate standards of care and treatment related to gender and identity non-conformity, variations and dysphoria. Our GOAL is to better inform individuals, friends, family members, communities including clinicians and policy makers at all levels who are seeking information to best safeguard the long term interests and physical autonomy of such children and youth.

We support the right of minors and young people to explore identities, including sexuality and gender that are developmentally appropriate. And that care is required to prevent prematurely foreclosing such exploration that may lead to permanent, invasive medical procedures.

Gender Identity Challenge is a group in Sweden and Norway.

Ever more parents feel that their child or adolescent wants to change their gender without previous warning. We wonder what has brought this about and how to deal with this phenomenon called

Rapid Onset Gender Dysphoria - ROGD

KIRJO is a group in Finland.

The transgender phenomenon is based on gender ideology which harms our society in many ways. It is now time to start the conversation about gender ideology. Is gender dysphoria the new anorexia?

PS. The word “Kirjo” is a Finnish equivalent to the English term “spectrum” (of color or types of people). You can follow and join us here.

Baywater Support is a group of parents from Britain and Ireland who wish to have a more cuatious approach to medicalizating minors:

We are a group of parents in the UK and Ireland who have been brought together by our experiences of parenting children with gender dysphoria or who have declared a transgender identity.

Having looked for the best support for our children, we have found only the 'affirmative' approach to their new identity, backed up by affirmative environments in schools and elsewhere. We've found little scope to explore the new identity as a young person's solution to trauma or distress, as a response to the challenges of adolescence, or to understand its role within underlying mental health or developmental contexts

A new consumer rights organization called Gender Care Consumer Advocacy Network has formed to support people questioning their gender, trans people, and detransitioners seeking mental health and medical services.

Their Mission:

Our mission is to empower recipients of gender transition-related care to become healthy and whole.

They have created a patients bill of rights:

GCCAN is a consumer rights group for any person who has previously or is currently receiving gender care related services. Our aim is to empower consumers of gender-transition related care to get the best health care possible.

GCCAN was founded by gender care consumers because we determined that the level of care we receive during or after gender care treatment is inadequate to achieve healthy mental and physical outcomes. Members of our group have been subject to harms from inadequate gender care services, and our goal is to reduce or mitigate similar harms to other consumers. The current delivery of care does not match established best-practice protocols. Established institutions often fail to balance the interests of consumers with the interests of gender care providers. We seek improvements to accountability, provider education, holistic care protocols, medical research, and public policies. We deserve better.

GCCAN is a registered 501(c)(3) consumer-run nonprofit organization that is non-partisan and non-ideological. Our membership represents many perspectives and experiences, and GCCAN is inclusive to all gender care consumers. As a result, our focus is on every consumer's wellbeing. We advocate for more informed consumers and better gender health care, under the presumption that the best outcome is different for each person. Our Consumer Bill of Rights outlines the necessary improvements to gender care that we seek.

A Recent Spate of Articles Regarding the Effects of Trans Activism And Cultural/Legal Conflicts

News

Recently there have been many articles that demonstrate there are conflicting opinions around pediatric medical transition for gender dysphoria and ideological views about sex and gender. These conflicts are happening around the medical treatment of minors, free speech and censorship, sex-based rights issues with girls, and cultural disagreements in and outside of the LGBT population.

Medical Ethics & Parental Rights

A Canadian Court declines to consider criticism that giving tweens cross-sex hormones is too experimental to be given to minors (“Consent form for trans child's hormone therapy was insufficient, lawyer argues at appeal court”):

The father takes the position in court filings that Bowden erred by delivering a “rush to judgment,” and Dunton on Wednesday questioned whether the risk of suicide may have been “trumped up.”

The child and his supporters state in court filings that proper consent was obtained and that the law in B.C. is settled when it comes to affording youth the authority to decide their own medical treatments.

A father in Texas is fighting the transition of his son. A video the father took of the child, circulating online, seems to indicate the mother is actively encouraging the child’s transition. He is now under a gag order from the judge.

The Texas Governor is calling for an investigation (“A Texas man says his 7-year-old isn’t transgender. Now his custody fight has reached the governor’s office’).

A politician in Georgia is proposing outlawing medical treatment for minors:

State Rep. Ginny Ehrhart, R-Powder Springs, wants to make it a felony to change a child’s gender through surgery or drugs and plans to introduce her “Vulnerable Child Protection Act” in the Georgia General Assembly.

The Endocrine Society has urged its members not to make statements against pediatric transition. They are commenting on a case where it appears the mother may be leading the child to identify as trans based on a video the father released to the public.

Suppressing puberty is fully reversible.

The claim puberty suppression is fully reversible is very debatable.

In the UK, a mother is suing Britain’s youth gender clinic, claiming minors can’t give consent to irreversible medical treatment or possible side-effects from hormone blockers (“Mother sues Tavistock child gender clinic over treatments”). Other parents have joined the lawsuit (“Parents battle ‘state‑sponsored sterilisation’ of trans children”):

More than 30 families with transgender children are to lobby the government and the NHS against what they claim is “coerced medicalisation” — propelling vulnerable young people convinced they are the wrong gender towards treatments that risk leaving them infertile.

The group, provisionally called Our Duty, was formed after one mother went public to describe gender reassignment medication and surgery for those with autism or psychological problems as “state-sponsored sterilisation”.

The London Times has released a statement skeptical of the safety of current pediatric transition protocols (“The Times view on the Tavistock clinic and hormone-blocking drugs for the young: Informed Consent”).

The Times concerns mirrors that of some people in the health professions. “Gender dysphoria in children: puberty blockers study draws further criticism” criticizes the handling of medical treatment of gender dysphoric youth in the UK.

An Australian doctor and lawyer have written a paper questioning the safety of puberty blockers for transgender youth.

The court decisions, as in other areas, have followed medical evidence applications where there appears to have been no contrary opinion argued for. It would perhaps be helpful for a matter to come before the courts where a contrary opinion may be fully ventilated – for example, where the parents of a child had different views (supported by appropriate expert evidence) on the merits of Stage 1 and or Stage 2 treatment in a particular case. The current relative ease by which gender dysphoric children

Not everyone believes promoting gender ideology to children is healthy and safe. The article “How the trans debate entered the classroom” covers commentary from several professionals on the rise in the number of medicalized young people. The article states that people want to remain anonymous for fear of backlash if they offer up their honest concerns. Censorship is an ongoing problem around this issue:

‘This is one of the most complicated clinical areas of mental health and clinicians are often put under huge pressure to refer individuals, who believe this will solve their dysphoria, on for medical interventions,’ Dr Evans says. ‘Adolescence involves biological, psychological and sociological changes, and feelings of anxiety and confusion about their role required by society, and experimentation. I’m not saying no to gender transition, but services should resist the pull towards a quick solution that bypasses thoughtful exploration. How an adolescent feels now may not be how they feel in ten years’ time.’…

A senior psychoanalyst (like many I contacted, they asked to remain anonymous) told me ‘children are being seriously damaged’. ‘Gender dysphoria is being treated like an aesthetic,’ he said. ‘How can you consent for a 12-year-old? They’ll be infertile, on medical treatment for life, and if you cut out a piece of their gut to turn into a vagina, you’re not really making them into a woman. There should be a distinction between what someone wants and what is good for them.

Jenn Smith, a transgender person who is opposed to pediatric transition, has released a video discussing Smith’s viewpoints. Smith was a foster child, and there appears to be a link with adoption and foster situations and an increase in gender dysphoria. A gender clinician in BC (Dr. Wong) where Smith is from has stated 1/2 of his patients are “from the Ministry” in Canada. That information can be found here.

Jenn Smith states a caveat that these numbers are going by what Dr. Wong said himself and have not been verified by official statistics. If true, these are very high numbers of trans-identified foster kids:

500 of Wong’s patients are from the Ministry. The Ministry has 6500 kids in it’s care. So when you do the math there what you discover is that that 7.7% of all the children is the Ministry’s care are identifying as transgender and under the care of one doctor, just one doctor. There are other doctors out thoere. Like any family physician can basically perscribe hormones or whatever to kids and stuff. So it is not unreasonable for us to conclude the numers of foster children idenifying as transgender, might be as high as 1 in 10.

Another trans person who is against pediatric medical transition, FtM in this case, has posted an article about the harshness of medical transition on the body (What the medical professionals won't tell you about Transitioning genders, but I will).

Open Debate, Free Speech, & Censorship Issues

Several law professors in Australia signed a letter pledging to support transgender students after a Dean made comparisons of the increase of trans-identified youth to eating disorders.

Almost 40 law academics at the University of Queensland have signed an open letter pledging to support transgender students after the university’s law school dean presented a paper that compared transgender children to teens with eating disorders.

The dean’s response:

‘None of my colleagues have raised any concerns with me, and none have asked for a copy of the 14,000-word paper that I delivered last week. Had they done so, they would have found that it deals with issues that are being widely discussed in the medical and scientific literature.’

‘‘My background is in child protection. To suggest that we don’t tackle difficult issues because it might be challenging is to avoid the responsibilities of intellectual leadership.’

It is a fact that even some experts in gender dysphoria are raising concerns that there may be cases that are influenced by body dysmorphia and social contagion. GHQ covers the reasons for these concerns here.

Below are two articles about the threats to people’s careers coming from trans activism. This topic is extensively covered in this section: Problems with a politicized climate of harassment & censorship. These problems include censorship, threats to one’s career, and threats to people's physical safety. or the safety of their family:

“The purge of trans-sceptical academics”

“Meet the academics hunted down and hounded out of jobs for having the 'wrong' thoughts”

“The trans-activists' witch hunt against academics threatens the whole of society”:

A chaperone accompanies you to your office. Inside, a panic alarm is kept within reach. Once, your office door was covered in urine. You’ve faced multiple death and rape threats. Abuse and harassment, delivered online and in person, have become routine features of your working life.

Sex-Based Rights and Trans Rights

MtF trans individuals have been dominating women and girls in sporting events. Recent research shows that males retain a biological advantage, even post medical transition. The article “‘Justice’ for trans athletes is unfair to girls like my daughter” article discusses the advantages MtF teens have over biological girls in high school:

Alanna has devoted countless days, nights and weekends to training. She pushes herself to shave mere fractions of a second from her race times, yet she positions herself at the starting line knowing that, even with all that training and with her best effort, the odds are against her, the numbers are against her and that fairness doesn’t really exist.

A school is reconsidering the transgender bathroom policy and has received backlash from trans activist:

PICKENS COUNTY, Ga. -- A Georgia school district says it's reversing its decision that would have allowed transgender students to use the bathroom that fits their gender identity.

The Pickens County school district cited death threats, student harassment and vandalism of school property in their decision.

The Economist has an article addressing the conflicts around trans policies in British schools where girls who are uncomfortable with dysphoric males in female changing areas are being expected to leave the area.

Cultural Conflicts within the LGBT Population

Some LGB people have split off from Europe’s largest LGBT organization, Stonewall UK, in Britain. Encouraging the medicalization of gender non-conforming children and the eradication of girls’ sex-based rights are cited as some reasons why. The new organization is called LGBAlliance.

Two articles about this split are below:

“Gay groups clash over ‘homophobic policies’”

“Lesbian barrister: my bosses bowed to transgender ‘hate mob’”:

Bailey was subjected to a torrent of abuse and death threats after she posted on social media: “Gender extremism is about to meet its match.”

Allison Bailey is a lesbian who supports the new LGBAlliance in the UK. She and others have received criticism and even harassment, mostly from the far left, because some believe they should not form their own LGB organization or be criticizing current trans activist policies. She responds in a Twitter thread saved here:

Stonewall UK is a political lobbying group. It‘s not democratically elected. It has no mandate to declare itself the voice of *all* LGBT ppl, yet it behaves as if it does — & is treated by government, charitable & private sector orgs as if it speaks for us all. It does not. 1/

Stonewall UK has spun LGBT rights so completely that *any* challenge or question to its agenda is deemed hate speech, rather than being a healthy & essential part of a functioning democracy. It made it respectable for youth to no platform, scream at & threaten feminists. 2/…

Brad Polumbo, a gay man, has written two articles supporting the concept of a separate LGB movement:

“Gay rights depend on our rejecting transgender radicalism and standing up for James Younger”

“It’s Time for ‘LGB’ and ‘T’ to Go Their Separate Ways”

Other gay men have started a Facebook group called Gay Men Address Gender Identity.

An article called “The Great Erasure” has been posted on Medium and is in line with the dissatisfaction some LGB people have with current LGBT organizations. The article is part opinion but is factually useful in tracking where funding is going for current LGBT organizations.

*GHQ remains a trans-inclusive organization as trans people are not all supportive of pediatric medical transition or denying the concept of biological, chromosomal, sex. Some LGB people are supportive of these things. But all identity groups should be free to organize individually to focus on specific issues.

Not everyone believes the current cultural obsession with pronouns, and identity in general, is healthy. GHQ holds that position as well. This culture is resulting in protests like the recent “S***-In” at San Francisco University protesting the need for more non-binary bathrooms. And this presentation of postmodern queer theory to children by the BBC that lacks scientific discourse and promotes views that are controversial within the LGBT population.

An article written by a GHQ advisory board member called “Amid ‘Erosion in Acceptance’ L Word Loses the Plot & GLAAD Targets Youth” covers some of these cultural issues and the growing numbers of lesbians critical of current “LGBT activism:”

Amid “erosion of acceptance,” the organizations that were supposed to protect us, have campaigned to silence us, using threats and slurs to invoke fear and shame. The L Word has lost all sense of the plot… Yet although mainstream media and “LGBTQ” organizations have pulled out every trick in their “playbook,” the one thing they’ve deeply underestimated is the power of dyke rage.

Andrew Sullivan, a gay man, has written an article about transitioning children and the effects of trans activism on gay rights called “When the Ideologues Come for the Kids”:

Last week, I defended drag queens reading stories to kids in libraries. I don’t take back my words. Getting children interested in reading with costumed clowns strikes me as harmless. But when I was directed to the website of Drag Queen Story Hours, I found the following:

“[DQSH] captures the imagination and play of the gender fluidity of childhood and gives kids glamorous, positive, and unabashedly queer role models. In spaces like this, kids are able to see people who defy rigid gender restrictions and imagine a world where people can present as they wish, where dress up is real.”

However well-meant, this is indoctrination into an ideology, not campy encouragement for reading and fun.

Sullivan included a link to our evidence supported section on the large increases of trans-identified youth ("sky-rocketed”):

In the last few years in Western societies, as these notions have spread, the number of children identifying as trans has skyrocketed. In Sweden, the number of kids diagnosed with gender dysphoria, a phenomenon stable and rare for decades, has, from 2013 to 2016, increased almost tenfold. In New Zealand, the rate of girls identifying as boys has quadrupled in the same period of time; in Britain, where one NHS clinic is dedicated to trans kids, there were around a hundred girls being treated in 2011; by 2017, there were 1,400.

It is not only LGB people critical of aspects of current trans activism. “I am a trans woman – but I think this woke world has gone too far” is written by an MtF trans person:

Trans people have lost the plot. Every day, an increasing amount of absurdity floods in as they do more harm than good. They scream for acceptance without realizing that the ones damaging their image aren't bigots, but themselves.

From anger directed at celebrities for the rational belief that parents shouldn't decide whether their three-year-old is trans, to a culture of outrage that freaks out at the most minor of offenses, transgender activists have become detrimental to my, and others', very existence.

Not helping matters is the fact that these people are laying bombs within our language in the hope they trigger, so they themselves can become triggered. Saying 'transgendered' instead of 'transgender' can see you labeled as transphobic, as can saying 'transwomen' instead of 'trans (notice the space) women.' This is a linguistic minefield with the sole intent of catching people off guard. And those who are caught in its blast are branded as bigots. 

Two articles have been released criticizing the recent pronoun announcements and the LGBT Townhall with Democratic candidates. The Townhall was complete with pronoun announcements, a trans-identified small child presented in front of the camera, and an accusation that misgendering is “violence:”

”Democratic Candidates Displaying Gender Pronouns On Their Twitter Accounts Are Making A Big Mistake”

“CNN LGBTQ town hall reveals the madness of identity politics”

Dr. Karen Blair, a psychologist and SOGI advisor in Canada, has released a video calling sexual orientation that is not inclusive of trans identities problematic and in need of social change. GHQ responded to this type of discourse by sending Dr. Blair a letter in June adhering to the reality that there are biologically driven sexual orientations and that people have the right to them without being painted as problematic and in need of social justice activism by the psychology profession.

From the video:

I, and this study’s researchers involved in this study, believe that this is an issue that needs to be discussed openly and honestly, not ignored. Because only then can we fix it.

This type of commentary is causing major conflicts within the LGBT population and is one of the reasons for the LGB split from Stonewall UK. We cover that issue here.

There are conflicts happening around race and identity at WPATH (who sets the standards for trans healthcare), where minorities took over the stage to call for more representation.

References:

Armus, T. (2019, October 24). A Texas man says his 7-year-old isn’t transgender. Now his custody fight has reached the governor’s office. Washington Post. https://www.washingtonpost.com/nation/2019/10/24/james-younger-luna-transgender-greg-abbott/

BBC. (2019). RSE KS2: Identity - Understanding sexual and gender identities. Retrieved from https://www.bbc.co.uk/teach/class-clips-video/rse-ks2-identity-understanding-sexual-and-gender-identities/zfqrhbk

Brunskell-Evans, H. The purge of trans-sceptical academics. Spiked. Retrieved from https://www.spiked-online.com/2019/06/26/the-purge-of-trans-sceptical-academics/?fbclid=IwAR3ixz9mTy2UeKeDmOYZ4RkKD2niM6c95lz3KHIyCzsaGl_l5ko5XtL8CUM#.XbDDKGf9i18.facebook

Cohen, B. (2019, July 22). Democratic Candidates Displaying Gender Pronouns On Their Twitter Accounts Are Making A Big Mistake. https://thebanter.substack.com/p/democratic-candidates-displaying

Cohan, D., Barnes, H. (2019, September 20) “Gender dysphoria in children: puberty blockers study draws further criticism”. The BMJ (366). doi.org/10.1136/bmj.l5647

Driscoll, M. (2019, September 19). Meet the academics hunted down and hounded out of jobs for having the 'wrong' thoughts. The Telegraph. Retrieved from https://www.telegraph.co.uk/women/life/meet-academics-hunted-hounded-jobs-having-wrong-thoughts/

Donym, S. (2019, October 16). The Great Erasure. Retrieved from https://medium.com/@sue.donym1984/the-great-erasure-203a124fa02c

Emmons, L. (2019, October 14). CNN LGBTQ town hall reveals the madness of identity politics. The Post Millenial. Retrieved from https://www.thepostmillennial.com/cnn-lgbtq-town-hall-reveals-the-madness-of-identity-politics/

Endocrine Society.. (2019, October). Endocrine Society Urges Policy Makers to Follow Science on Transgender Health. Endocrine News. Retrieved from https://endocrinenews.endocrine.org/endocrine-society-urges-policymakers-to-follow-science-on-transgender-health/

Gibbons, K. (2019, October 26). “Gay groups clash over ‘homophobic policies’.” The Times.[London]. Retrieved from https://www.thetimes.co.uk/article/gay-groups-clash-over-homophobic-policies-t95958fmn?shareToken=c602067cb10e7c01e71fba89ac8bbdab

Hellen, N. (2019, October 27). Lesbian barrister: my bosses bowed to transgender ‘hate mob.’ The Times [London]. https://www.thetimes.co.uk/article/lesbian-barrister-my-bosses-bowed-to-transgender-hate-mob-shm6x09v8?fbclid=IwAR1bP7iQHAj2hK7-xaV3v2AaTvOHy7wkkrT5ZcIxxWAqq7lc47ca7Lj6fKM

Hurst, G. (2019, October 12). Mother sues Tavistock child gender clinic over treatments. The Times.[London]. Retrieved from https://www.thetimes.co.uk/article/mother-sues-tavistock-child-gender-clinic-over-treatments-r9df8m987

Intersectional Bullies Crash Trans Health Town Hall. Retrieved from https://www.youtube.com/watch?time_continue=69&v=zHlnQMY9KM0

Jenn Smith Calls for National Inquiry into mass gender transitioning of Vulnerable kids. Retrieved from https://www.youtube.com/watch?app=desktop&feature=youtu.be&v=VxTtkI51xH4

Manins, R. (2019, October 30). Cobb legislator proposes new law to criminalize physical gender change of children. Marrietta Daily Journal. Retrieved from https://www.mdjonline.com/news/cobb-legislator-proposes-new-law-to-criminalize-physical-gender-change/article_01d7e572-fb4c-11e9-b280-5bf7ecee1ac6.html

O’Conner, M., Madden, B. (2019). In the Footsteps of Teiresias: Treatment for Gender Dysphoria in Children and the Role of the Courts. Journal of Law and Medicine 27 (1). Retrieved from http://sites.thomsonreuters.com.au/journals/2019/10/22/journal-of-law-and-medicine-update-vol-27-pt-1/

Narwitz, S. (2019, October 19). I am a trans woman – but I think this woke world has gone too far. RT. Retrieved from https://www.rt.com/op-ed/471025-trans-woman-woke-too-far/

Polumbo, B. Gay rights depend on our rejecting transgender radicalism and standing up for James Younger. Washington Examiner. Retrieved from https://www.washingtonexaminer.com/opinion/gay-rights-depend-on-our-rejecting-trans-radicalism-and-standing-up-for-james-younger

Polumbo, B. It’s Time for ‘LGB’ and ‘T’ to Go Their Separate Ways. Quillette. Retrieved from https://quillette.com/2019/10/26/its-time-for-lgb-and-t-to-go-their-separate-ways/

Radachowsky, C. (2019, October 13). ’Justice’ for trans athletes is unfair to girls like my daughter. New York Post. Retrieved from https://nypost.com/2019/10/13/justice-for-trans-athletes-is-unfair-to-girls-like-my-daughter/

Roberson J.D. (2019, September 10). Amid ‘Erosion in Acceptance’ L Word Loses the Plot & GLAAD Targets Youth. The Velvet Chronicle. Retrieved https://thevelvetchronicle.com/amid-erosion-in-acceptance-glaad-targets-youth-l-word-loses-the-plot/

Quan, D. (2019, September 4). Consent form for trans child's hormone therapy was insufficient, lawyer argues at appeal court. National Post. Retrieved from https://nationalpost.com/news/consent-form-for-trans-childs-hormone-therapy-was-insufficient-lawyer-argues-at-appeal-court

Smee, B. (2019, September 18). University of Queensland academics sign open letter after law dean's trans comments. The Guardian. Retrieved from https://www.theguardian.com/australia-news/2019/sep/18/university-of-queensland-academics-sign-open-letter-countering-law-deans-trans-comments?fbclid=IwAR3Rh2y75YlstvJ86xp0OjHzPajCgMghWaAIOBJjtiwUYrTlvk9iJg6EZZA

Stonewall UK . Retrieved from https://threadreaderapp.com/thread/1190704005648965632.html

Sullivan, A. (2019, September 20). When the Ideologues Come for the Kids. New York Magazine. Retrieved from http://nymag.com/intelligencer/2019/09/andrew-sullivan-when-the-ideologues-come-for-the-kids.html?utm_medium=s1&utm_campaign=nym&utm_source=tw

Transgender rules for English schools face a backlash from women. (2019, )ctober 3). The Economist. Retrieved from https://amp-economist-com.cdn.ampproject.org/c/s/amp.economist.com/britain/2019/10/03/transgender-rules-for-english-schools-face-a-backlash-from-women

Terry, M. (2019, September 4). How the trans debate entered the classroom. Spectator Life. Retrieved from https://life.spectator.co.uk/articles/the-gender-agenda/

The Exclusion of Trans People from the World of Dating. Retrieved from https://www.patreon.com/posts/new-video-29553352

The Times view on the Tavistock clinic and hormone-blocking drugs for the young: Informed Consent. The Times [London]. Retrieved from https://www.thetimes.co.uk/article/def68adc-ec4f-11e9-b931-c019e957f02a

Walsh, J. (2019, October 26). Parents battle ‘state‑sponsored sterilisation’ of trans children. The Times [London]. Retrieved from https://www.thetimes.co.uk/article/parents-battle-state-sponsored-sterilisation-of-trans-children-mb55fxt60

WGXA. (2019, October 16). Georgia school district reverses decision on transgender bathroom policy. Retrieved from https://wgxa.tv/news/local/georgia-school-district-reverses-decision-on-transgender-bathroom-policy.

What the medical professionals won't tell you about Transitioning genders, but I will. (2019, October 15). Retrieved from https://thetransgendertruth.wixsite.com/mysite/post/what-the-physiologists-surgeons-and-physicians-don-t-tell-you-about-transitioning-genders

Williams, J. (2019, October 8). “The trans-activists' witch hunt against academics threatens the whole of society.” The Telegraph. Retrieved from https://www.telegraph.co.uk/news/2019/10/08/trans-activist-witch-hunt-against-academics-threatens-whole/?WT.mc_id=tmg_share_tw

Yavitch, E. (2019, October 24). Students hold ‘Shit In’ to demand more gender-neutral bathrooms. The College Fix. Retrieved from https://www.thecollegefix.com/students-hold-shit-in-to-demand-more-gender-neutral-bathrooms/

Tavistock's Hormone Blocker Study Cleared but They Admit Blockers are Given for Cosmetic Reasons, not to provide "Time for Exploration"

News

Due to criticisms of the study (also here) in the UK on hormone blockers given to gender dysphoric children to stop normal puberty, the Health Research Authority investigated the study. They claim it meets their ethical standards. The report can be found here. They describe the purpose of the original blockers study below:

The study 'Early pubertal suppression in a carefully selected group of adolescents with gender identity disorders' was developed in 2010 in response to broadening use of early pubertal suppression treatments across Europe, in the USA and in Australia. There were debates about the evidence of benefits and safety, and whether young adolescents could consent to treatments due to the potential for unknown risks or harms in the future. Some clinicians argued that the consequences of non-treatment were likely to be greater than those of treatment.

Michael Biggs, an Oxford sociologist who has been criticizing the study, comments below:

The Health Research Authority (HRA) has just published its investigation into the 2010 experiment with puberty blockers, or more precisely its role in giving ethical approval and oversight. The investigation was prompted by research published on Transgender Trend in March 2019, with an update in July (the full paper is here). The HRA report’s conclusions are predictably bland. Firstly, ‘the research team involved in the design and delivery of the study … worked in accordance with recognised practice for health research, and in some areas such as patient involvement and transparency were ahead of normal practice at the time’ (p. 11). Secondly, ‘The HRA has acted within its Standard Operating Procedures and its normal practice in relation to this study’ (p. 10).

He goes on to highlight that the main reason they are giving youth hormone blockers is so they pass better later and not to allow time for identity exploration. Identity exploration is often the reason affirmative model advocates give for putting youth on these powerful drugs that stop normal hormonal development by affecting the pituitary gland. Some of those quotes, as well as questionable claims hormone blockers are “fully reversible,” can be found here.

Dr. Biggs from “The astonishing admission in the Health Research Authority report: The purpose of puberty blockers is to commit children to permanent physical transition”:

On close reading, however, the report contains an astonishing admission. The paragraph deserves to be quoted in full:

“It would have reduced confusion if the purpose of the treatment had been described as being offered specifically to children demonstrating a strong and persistent gender identity dysphoria at an early stage in puberty, such that the suppression of puberty would allow subsequent cross-sex hormone treatment without the need to surgically reverse or otherwise mask the unwanted physical effects of puberty in the birth gender. The present study was not designed to investigate the implications on persistence or desistence of offering puberty suppression to a wider range of patients, it was limited to a group that had already demonstrated persistence and were actively requesting puberty blockers. (p. 5, my own emphasis added in bold)”

In fact the 2010 research protocol declared that one of its three aims was ‘[t]o evaluate persistence and desistence of the gender identity disorder and the continued wish for gender reassignment’ (Early pubertal suppression in a carefully selected group of adolescents with gender identity disorder, proposal submitted to Central London REC 2, November 2010, obtained under Freedom of Information from the HRA; italics added). History is being rewritten to alter the rationale for the experiment. It is not clear whether this revisionist history originates with the HRA, or whether the HRA is conveying the current views of the experiment’s chief investigator, Professor Russell Viner (Professor in Adolescent Health at University College London) or his co-investigator, Dr Polly Carmichael (Director of the Gender Identity Development Service, GIDS).

Whatever the source, this is a clear admission that puberty blockers were the first stage on the predestined path to cross-sex hormones. After four assessment interviews, a child of 12 would be consenting in effect to a lifetime of drug dependence and the loss of fertility and the probable loss of sexual functioning. Because the “treatment” was intended to enhance the child’s desire to change sex, it naturally exacerbated her or his gender dysphoria. ‘Worsening behavioural and emotional symptoms of dysphoria’, the HRA notes cheerily, ‘would therefore not in itself be unexpected’ (p. 6).

Micheal Biggs goes on to discuss what he believes to be other ethical problems with the study in the full article.

Two BBC reporters have covered this story in, “Questions remain over puberty-blockers, as review clears study”.

References:

Biggs, M. (2019, March 5). Tavistock’s Experimentation with Puberty Blockers: Scrutinizing the Evidence. Transgendertrend. Retrieved from https://www.transgendertrend.com/tavistock-experiment-puberty-blockers/

Biggs, M. (2019, July 22). Tavistock’s Experiment with Puberty Blockers: an Update. Transgendertrend. Retrieved from https://www.transgendertrend.com/tavistock-experiment-puberty-blockers-update/

Biggs, M. (2019, October 17). The astonishing admission in the Health Research Authority report: The purpose of puberty blockers is to commit children to permanent physical transition. Transgendertrend. Retrieved from https://www.transgendertrend.com/health-research-authority-puberty-blockers-commit-children-permanent-physical-transition/

Clay R. A. (2018). Embracing a gender-affirmative model for transgender youth. APA: CE Corner (49)8, 29. Retrieved from https://www.apa.org/monitor/2018/09/ce-corner

Cohen, D., Barnes, H. (2019, October 15). Questions remain over puberty-blockers, as review clears study. BBC. Retrieved from https://www.bbc.com/news/health-50046579

NHS Health Research Authority, (2019, October 14). Investigation into the study 'Early pubertal suppression in a carefully selected group of adolescents with gender identity disorders.' Retrieved from https://www.hra.nhs.uk/about-us/governance/feedback-raising-concerns/investigation-study-early-pubertal-suppression-carefully-selected-group-adolescents-gender-identity-disorders/

A Recent Spate of Articles about Doctors & Scientists Questioning Pediatric Medical Transition for Gender Dysphoria

News

While the majority of articles and discourse around socially and medically transitioning minors with gender dysphoria have featured positive stories, there have recently been more doctors, scientists, and academics publicly calling for proof of safety and claiming there are dangers involved.

Heather Brunskell-Evans (Philosopher/ Social Theorist) and Michele Moore (Professor, Social Justice & Global Responsibility) are the editors of a book with several contributors who believe trans identity is being actively promoted and over-diagnosed in minors. The book is called Inventing Transgender Children and Young People. Brunskell-Evans describes the threats of censorship and threats to their careers for holding these viewpoints:

Since the publication of the book Transgender Children and Young People: Born In Your Own Body there have been ferocious attempts to silence myself and my co-editor Michele Moore, including sustained attacks on our careers, livelihoods and reputations the likes of which we have never previously experienced in our long academic careers. The publication of our second book, Inventing Transgender Children and Young People, was temporarily interrupted following a threat of litigation by the NHS Tavistock and Portman Hospital Trust UK, home to the Gender Identity Development Services (GIDS). So, not only have we experienced constant attempts to silence our views on the transgendering of children, in the past few weeks we have undergone the nerve-racking fear that our second book might not even be published.

An interview with Brunskell-Evans can be found in “No child is born in the wrong body” with Michele Moore & Heather Brunskell-Evans.”

The Gender Identity Development Service (GIDS) in Britain hired lawyers in regards to the book:

“Britain's first children's gender identity clinic hired lawyers to 'silence' book publishers who warned the rocketing number of youngsters seeking to change sex is 'becoming a scandal’”

A law firm instructed by the Gender Identity Development Service (GIDS) wrote to the editors of 'Inventing Transgender Children and Young People', which warns that the rocketing number of youngsters now seeking to change sex is becoming a scandal.

Lawyers representing Tavistock and Portman NHS Trust, which runs the clinic, claimed many of those who had contributed to the book will have been employed by the gender service and may have broken NHS confidentiality rules.

They said the Tavistock feared the book may contain comments 'defamatory' of its staff.

There are health professionals from Tavistock (the clinic where youth with GD are treated in Britain by the GIDS) and the National Health Service also raising concerns:

“Transgender children who are medically treated risk 'serious and irreversible damage', leading psychiatrist warns”

Transgender children who undergo medical or surgical treatments risk “serious and irreversible damage”, a leading psychiatrist has warned, as he accuses lobby group of “silencing debate”.

Sue Evans is a former Tavistock therapist commenting on a mother’s lawsuit:

“Former Tavistock therapist claims doctors are over diagnosing transgender children”

Today we’re joined by former Tavistock therapist Sue Evans, who after becoming alarmed at the speed in which the clinic offered treatment to children, has now become a whistleblower in support of the mother’s legal action.

Marcus Evans, a former psychiatrist with Tavistock, criticizes what he feels is a lackadaisical attitude toward irreversible medical treatments offered to children/teens:

Normal medical practice is not taking place in my view. There’s not enough research. There’s not enough interest in the downside of what’s going on. There’s not enough scrutiny of the issue of consent. And I think we need an independent regulatory body that would oversee this controversial area.

This creative writing professor comments on transgender books in schools:

“Children being put at risk by transgender books that 'misrepresent' medical knowledge, academic claims”

Children are being put at risk by transgender books in primary schools that “misrepresent” medical knowledge on puberty blockers, an academic has claimed.

Books and lesson plans that are designed educate pupils about transgender issues “fail child safeguarding and conflict with the law”, according to Dr Susan Matthews, an honorary senior research fellow in creative writing at Roehampton University.

The below blog post contains commentary from a Swedish psychiatrist translated into English from this newspaper article:

“Psychiatrist: Gender dysphoria spreads like an epidemic online”

The number of cases of gender dysphoria has increased explosively in recent years, especially among young people. I am appalled at the drastic, irrevocable and unscientific treatment. This may be our country’s biggest healthcare scandal ever…

There needs to be an independent investigation into the probably biggest health scandal in our country’s history.

The public blogging platform Medium censored the original post by removing it altogether for an unspecified “violation.” Censorship around these issues is common.

The same author has written another other piece questioning the safety of pediatric medical transition:

“Läkartidningen: Off-label prescribing of hormones in gender dysphoria should be investigated”

In the United States, Dr. Laidlaw, an endocrinologist, discusses the serious health risks involved with the hormone blocker to cross-sex hormone protocol for minors:

Dr. Laidlaw on the real dangers of puberty and hormone blockers on young people

Another more cautiously minded US doctor:

Johns Hopkins professor on child transgender trend: ‘Many will regret this’

A psychiatrist from Johns Hopkins University has slammed the medical and psychiatric industries for what he says is reckless and irresponsible treatment of patients who claim to be transgender.

Julia Mason is a US pediatrician (and on the GHQ advisory board). Her comments are below:

“A physician is worried about gender transition in pediatrics”

I’ve learned that if I refer a patient to the gender clinic, they are going to get the maximalist treatment. They’re not going to get any help figuring out if they really need the full medical/surgical transition. I am now wary of referring to the gender clinic.

This letter from Australia, by the National Association of Practising Psychiatrists, was written in addition to one by several other doctors, scientists, and concerned individuals, calling for a government inquiry into the safety of pediatric medical transition.

The Hon Greg Hunt
Federal Minister for Health
Parliament House
Canberra

The National Association of Practising Psychiatrists respectfully request:

1. The commonwealth government set up a parliamentary enquiry into the treatment of gender dysphoria in children in Australia;

2. All medical colleges who have member doctors involved in treating gender dysphoria children (paediatricians, general practitioners, surgeons, endocrinologists, gynaecologists, psychiatrists), along with the AMA, the NAPP and other representative medical bodies, and the Medical Board of Australia form a joint committee to develop a set of practice guidelines for the assessment and treatment of children and adolescents under the age of 18 years presenting with gender dysphoria.

Psychologist Dr. Oren Amitay is a Canadian concerned about the affirmative model and the risks to young people who may need more mental hea;th exploration and time to mature. He has faced social punishment from other Canadian psychologists:

“Telling the truth on trans issues got me cancelled: one psychologist’s story“

These comments are in stark contrast to the opinions of affirmative model advocates, like Johanna Olson-Kennedy (head of USPATH), who believe in lowing age of consent for surgery and hormones.

References:

Amitay, O. (2019, September 20). Telling the truth on trans issues got me cancelled: one psychologist’s story. The Post Millennial. Retrieved from https://www.thepostmillennial.com/telling-the-truth-on-trans-issues-got-me-cancelled-one-psychologists-story/

Brunskell-Evans, H. Inventing Transgender Children and Young People. (2019, October 12). Retrieved from http://www.heather-brunskell-evans.co.uk/body-politics/inventing-transgender-children-and-young-people-2/Turner

Dr. Laidlaw on the real dangers of puberty and hormone blockers on young people. (2019, September 12). Retrieved from https://www.youtube.com/watch?v=04rbrvuV1z4&feature=youtu.be&fbclid=IwAR0dDYgL1p13SpKWBLe1R1RJAo6wCuBQhzgJW2M0VIshETuuqJW-AwK4r54

Kids Aren’t Alright. (2019, October 14). RT International. Retrieved from https://www.youtube.com/watch?v=vxL3uFGstmw

Lencki, M. (2019, September 17). Johns Hopkins professor on child transgender trend: ‘Many will regret this.’ The College Fix. Retrieved from https://www.thecollegefix.com/johns-hopkins-professor-on-child-transgender-trend-many-will-regret-this/

Manning, S. (2019, October 12). Britain's first children's gender identity clinic hired lawyers to 'silence' book publishers who warned the rocketing number of youngsters seeking to change sex is 'becoming a scandal.' Daily Mail. Retrieved from https://www.dailymail.co.uk/news/article-7566851/Britains-childrens-gender-identity-clinic-hired-lawyers-silence-critics-new-book.html

Mason, J. (2019, October 7). A physician is worried about gender transition in pediatrics. Retrieved from https://www.kevinmd.com/blog/2019/10/a-physician-is-worried-about-gender-transition-in-pediatrics.html?fbclid=IwAR0J3bCERzR9hjAC1meocJJnEXUL5detxhyoNHPfpPs24ONyO3qAhYnOwjw

Lane, B. (2019, Septemeber 25). Doctors back inquiry on kids’ trans care. The Australian. Retrieved from https://www.theaustralian.com.au/nation/doctors-back-inquiry-on-kids-trans-care/news-story/6f352bc99da430b194620a2605e8a50d

NAAP. (2019, October 16). Gender Dysphoria – National Enquiry. Retrieved https://napp.org.au/2019/10/gender-dysphoria-national-enquiry/

Roman, S. (2019, September 13). DN Åsikt. ”Könsdysfori sprids som en epidemi på nätet”. Dagens Nyheter. Retrieved from https://www.ihmistenkirjo.net/blog/psychiatrist-gender-dysphoria-spreads-like-an-epidemic-online (English translation here)

Svens, K., Roman, S. (2019, October 10). Läkartidningen: Off-label prescribing of hormones in gender dysphoria should be investigated. KIRJO. Retrieved from https://www.ihmistenkirjo.net/blog/lkartidningen-off-label-prescribing-of-hormones-in-gender-dysphoria-should-be-investigated

Transgendertrend. (2019, April 17). Johanna Olson-Kennedy and the US Gender Affirmative Approach. Retrieved from https://www.transgendertrend.com/johanna-olson-kennedy-gender-affirmative-approach/

Transgendertrend. (2019, June 21). Transgender Trend Statement in Support of Michele Moore. Retrieved from https://www.transgendertrend.com/transgender-trend-statement-support-michele-moore/

Turner, C. (2019, September 4). Children being put at risk by transgender books that 'misrepresent' medical knowledge, academic claims. The Telegraph. Retrieved from https://www.telegraph.co.uk/news/2019/09/04/transgender-children-medically-treated-risk-serious-irreversible/

Turner, C. (2019, September 4). Transgender children who are medically treated risk 'serious and irreversible damage', leading psychiatrist warns. The Telegraph. Retrieved from https://www.telegraph.co.uk/news/2019/09/04/transgender-children-medically-treated-risk-serious-irreversible/

Womansplaceuk. (2019, October 14). “No child is born in the wrong body” with Michele Moore & Heather Brunskell-Evans. Retrieved from https://womansplaceuk.org/2019/10/14/no-child-is-born-in-the-wrong-body-with-michele-moore-heather-brunskell-evans/amp/

Articles Covering Medical Risks of Treating Trans Youth

News Commentary

GHQ is a pro-LGBT website. However, liberal-leaning news sites refuse to address any of the possible downsides to minors medically treated for gender dysphoria. Two recent articles on conservative news sites review some of these downsides. The problem with this dynamic is that it polarizes the issue in a way that it should not be. The overall health and safety of all youth should be the goal.

The article in The Federalist “Gender Clinic Doctor: Plenty Of Kids I’m Giving Trans Drugs Have Already Been Prostitutes” speaks to the precarious mental health of trans-identified youth who are being put on powerful hormones, often with little follow-up. It also speaks to the poor quality of Johanna Olson-Kennedy’s NIH study due to high rates of “lost to follow-ups.” This is a common problem in trans research.

At that conference Olson-Kennedy described the mental-health struggles of her cohort of patients. “Thirty percent of my sample had moderate to severe depression symptoms. Thought about suicide, 49 percent. . . . Attempted suicide, over 30 percent. . . . A lot of drug use . . . A lot of kids were sexually active, and a not insignificant number of my kids have actually done . . . sex work [prostitution].” Many patients, she reported, have been homeless or in foster care.

Olson-Kennedy also admitted that 40 percent of her patients, to whom presumably she administered GAT, were “lost” to follow-up since her previous study. Are these kids still even alive? We’ll never know, but the good doctor apparently is content to assume the best.

The conservative website PJ Media “Medical Expert: Doctors Are Actually Giving Trans Kids a Disease, and It's Child Abuse” reviews some of the realities of giving youth large doses of cross-sex hormones.

Some quotes about the side-effects of medical transition from Dr. Laidlaw, an endocrinologist:

"I call it a development blocker — it’s actually causing a disease," Dr. Michael Laidlaw, an independent private practice endocrinologist in Rocklin, Calif. who consults with Sutter Roseville Medical Center, told PJ Media. The disease in question is hypogonadotropic hypogonadism. It occurs when the brain fails to send the right signal to the gonads to make the hormones necessary for development…

While endocrinologists — doctors who specialize in hormones and the endocrine system — are familiar with the disease and gladly treat it when a patient has been diagnosed, many of them are effectively causing their patients to contract the same disease in an attempt to affirm gender identity, Laidlaw said…

When people are given far more of the opposite sex hormone than their bodies can handle, they are at "increased risk for cardiovascular disease, cardiovascular death, deep vein thrombosis. They’ve looked at adults taking these hormones and have seen already these cardiovascular risks." When these drugs are administered to children, "one would presume it's the same or even worse, in the long run."…

In a healthy human body, the pituitary gland "sends signals to the gonads to produce testosterone or estrogen." By preventing this natural secretion of hormones, Lupron in kids "blocks development of their organs, and their growth is stunted. If it’s started in early puberty, these kids will not develop mature sperm or eggs, they will be infertile. If they have gonads removed, they will be sterilized."

"They’re going to end up with lower bone density, perhaps stunted brain development," the doctor explained. "A lot of the brain impact is unknown. There seems to be some brain development that is sex hormone-dependent."

He comments on how young the children are who are on these drugs:

Indeed, two doctors involved in the transitioning of children, Ilana Sherer and Johanna Olson-Kennedy, explained in a video that they give "puberty blockers" to children at age 8 or 9, when they are in third and fourth grades. Olson-Kennedy has received a $5.7 million grant from the National Institutes of Health (NIH) for a 5-year study on mastectomies done on girls as young as 13. The documents unearthed due to Laidlaw's FOIA request showed the minimum age for cross-sex hormones in the study had been lowered to 8 in 2017.

It’s obvious in the tone of articles on sites like this that they are not supportive of LGBT issues. At times they even make statements that diminish the reality of trans people’s experiences. It would be in the best interests of dysphoric youth to have non-politicized discussions about the risks of medical transition in the news beyond right-wing websites.

Reference:

O'Niel, T. (2019, August 25). Medical Expert: Doctors Are Actually Giving Trans Kids a Disease, and It's Child Abuse. PJ Media. Retrieved from https://pjmedia.com/trending/medical-expert-doctors-are-actually-giving-trans-kids-a-disease-its-child-abuse/

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

Letter Sent to Australian Pediatrician Who Acquiesces to Pressure from the Trans Lobby to Disregard Risks of Pediatric Transition For Gender Dysphoria

OPINION

by Justine Kreher

In another incidence reflecting a pattern of intimidation and censorship to any discussion about minors who could be hurt by the pediatric medical gender reassignment movement, a doctor in Australia has recanted comments expressing concern about medically altering minors.

Dr Suzanne Packer, Australian Senior of the Year, has offered an apology for the distress a submission regarding transgender children, that carried her endorsement, has caused for young people experiencing gender dysphoria and their families.

Her apology:

As a paediatrician and child advocate, I care deeply for the wellbeing of all children and their families.

I am extremely sorry for any distress that I have caused to families through my support of Dr Holloway’s article on Gender Transitioning and Responsible Responses.

When I endorsed the article, I wanted to shine a light on the issue to promote additional research and support for children and their families.

I deeply regret that I did not foresee just how devastating it would be for families already dealing with these complex situations. I apologise unreservedly for the distress I have caused.

Supporting all children has been the central tenet of my life’s work in paediatrics and with the other organisations I have been involved with.

My hope is that experts can work together for the best outcomes for these children and their families, however, I will exit from public comment on this complex and sensitive topic.

Through this experience I have come to understand just how hurtful and damaging negative media can be for vulnerable children and their families. I call for the media to consider the wellbeing and vulnerabilities of the children and families when reporting on this issue.

I sent a response to her apology, along with a general announcement about the formation of GHQ, to her university and organization where she serves on the board

“Hello Dr. Packer,

I am writing this to you and the other members of ANU in response to this article about you apologizing to the trans lobby for questioning the safety of the affirmative model in treating gender dysphoric minors. I am a board member of an LGBT organization that functions as a medical and censorship watchdog organization. The site is heavily cited and well researched. There is plenty of evidence these practices will inappropriately transition some cognitively immature minors, especially LGB ones who have their own vulnerabilities as minority populations.

The pressure put on you and the subsequent apology is understandable as trans youth are an at-risk population. But this is part of a highly disturbing pattern of activist extremism intimidating the health professions. Your acquiesces to it is part of an alarming new reality on the part of scientists, who are supposed to support objective research, to fail to discuss the very real and serious risks here in order to protect one viewpoint at the expense of others that are valid.

Please see the thread below which points to many facts that support concern about false positives here is warranted. Part of the reason we created our organization is that we do not trust mental health and medical professionals are doing their job without being controlled by trans activism. The side effects of pediatric transition are severe.

Thank you for your time,

Justine Kreher
GHQ Board Member”

REFERENCES:

Watson, G. (2019, August 14). Dr Suzanne Packer apologises for upset caused by trans debate. Out in Perth. Retrieved from https://www.outinperth.com/dr-suzanne-packer-apologies-for-upset-cause-by-transgender-debate/

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

Health Professionals Taking a More Critical View of Youth Gender Dysphoria Treatment

News

Recent blog posts on the GD Working Group website (a site generally taking a more skeptical view of immediate affirmation and medical transition) indicate some doctors are concerned enough about current gender dysphoria protocols (often recommended by official health entities) to write some of their own information.

Professor Dianna Kenny, PhD (”KEY ISSUES IN DECISION-MAKING FOR GENDER TRANSITION TREATMENT: Questions and answers”):

In this article, I address key issues in the transgender debate as they pertain to children and young people. These include: Are “gender transition treatments” safe, “curative” and in the child’s best interest? In considering these questions, I explore the known negative consequences of puberty suppression and cross-sex hormones, including infertility and other medical conditions and the purported increase in suicidality without treatment. Can children and young people give truly informed consent to these interventions? What role should parents play in decision-making? On what basis are decisions made to proceed to gender transition? Are the foundations of such decisions logical and scientific? and What social forces are at play in this decision-making process? 

Safety: Does the current scientific evidence support a conclusion that the administration of Gender Transition Treatment (social transition, puberty blocking agents and cross-sex hormones) can be safe for children and adolescents?

Answer:  No. 

She goes on to list many of the associated health problems with medical transition also covered on our site. These include circulatory health risks, risks to bone health and cognition, sexual problems, and other issues.

She also addresses the data on suicide risk:

…though the suicide risk in this population is high, as the table below attests, there is scant research evidence that gender transition treatment results in lower risk for suicide. There is also a problem in studies on gender dysphoria and suicidality related to how suicidality is measured. Different rates will be obtained in different studies because of the use of different forms of measurement. For example, being asked if you have suicidal ideation will produce higher rates than counting the number of potentially lethal suicide attempts (Aitken, VanderLaan, Wasserman, Stojanovski, & Zucker, K. (2016).

She makes a more definitive statement:

Transgender treatment does not prevent suicide, and may have other adverse effects on mental health post transition.

This assertion may be debatable. Suicide risk post transition remains high. Many studies show improved mental health and suicide risk post transition. A few show that transition does not resolves many problems dysphoric people face. GHQ has a review of most of the pertinent studies surrounding the issue of suicide with a motivation to present the issue as honestly as possible.

Most associated with GHQ would agree with her concern about the affirmative model and lack of mental health support in favor of transition offered as a solution to all problems:

The vexed question is one of causality. Does gender dysphoria cause suicidality or is it the discriminatory treatment and social exclusion suffered by the transgender community that is causative, or are suicidality and gender dysphoria caused by a third factor, such as mental illness, family dysfunction, parental or social factors? In my work with transgender adolescents, I have noted with great concern the serious underlying emotional disturbance in these young people who need intensive psychotherapy and parental and family therapy to resolve these disturbances. I wonder about those who go straight to gender clinics and gender affirming professionals who skate over these cracks in their personalities and social adjustment and proceed to gender transition in the naïve belief that this will resolve all of their presenting difficulties

She goes on to address issues of age of consent, the politcized climate shutting down debate, and the importance of the inclusion of parental feedback.

Dr, William Malone, critical of the medical establishment’s embrace of the affirmative mode (which includes medical treatment on minors) has written up some of his own guideline suggestions (“Gender Dysphoria Resource for Providers”).

References:

GD Working Group. (2019, August 9). Key Issues in Decision-making for Gender Transition Treatment: Questions and answers. Retrieved from http://gdworkinggroup.org/2019/08/09/key-issues-in-decision-making-for-gender-transition-treatment-questions-and-answers/

GD Working Group. (2019, August 2nd). Gender Dysphoria Resource for Providers. Retrieved from http://gdworkinggroup.org/2019/08/02/gender-dysphoria-resource-for-providers/

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

A Call for More Research into the Safety of Medically Transitioning Minors for Gender Dysphoria in Australia

News

Several professionals are calling for an inquiry into the raising numbers of youth being medically treated for gender dysphoria. The story covered in The Weekend Australian is called “Warnings over surge in youth transgender cases:”

The call for an inquiry by health sociologist Geoff Holloway, who wrote the submission, has been backed by 2019 Senior Australian of the Year paediatrician Sue Packer, Western Sydney University paediatrics professor John Whitehall and developmental psychologist Dianna Kenny.

One doctor is very critical about what has been happening:

“Who gave ethics approval for this treatment (at children’s hospitals) when it lacks any scientific basis and therefore is an experiment?” Professor Whitehall said. “We should give the psychiatry and psychology a full run before we start castrating children.”

Critics make a point made on the GHQ website that blockers may prevent desistance:

Critics point out virtually all those on blockers go on to cross-sex hormones (and sometimes surgery), meaning an irrevocable transition to a medical approximation of the opposite sex. This makes them lifelong patients with a range of potential compli­cations and a high risk of infertility, clinicians say.

Commentary on the politicized climate:

Critics say still-maturing young people are immersed in a world where many parents, teachers, clinicians, friends and social media are captured by emotive promotion of trans status, while activists try to suppress scepticism or inquiry as “hateful transphobia”.

Dr Holloway, who says the role of culture in gender dysphoria is unmistakeable, said: “People who object to what’s going on, they can lose their jobs, quite apart from being ostracised. This is supposed to be a scientific endeavour, not a witch hunt.”

This story is similar to what some health and social science professionals are doing in the U.K.

Another similar article about health professionals in Australia can be found in here.

Update 08/17/19: Another Australian article on this topic: "'They're being fast-tracked': Psychologist wants inquiry into children's transgender clinics"
Update 08/18/19: Relevant TV program on this topic: “‘Lots of factors’ converge to increase child transgender treatment”
Update 08/24/19: Another Australian article on this topic: “Trans medical model to bear ‘cost of regret’,” “Parents feel new gender was a foregone agenda,” “Concerns on gender transition”
Update 10/14/19: The Australian and Bernard Lane have been doing a regular series on this subject: https://www.theaustralian.com.au/author/Bernard%20Lane

References:

Hook, C. (2019, August 13). 'They're being fast-tracked': Psychologist wants inquiry into children's transgender clinics. 7News. Retrieved from https://7news.com.au/news/social/theyre-being-fast-tracked-psychologist-wants-inquiry-into-childrens-transgender-clinics-c-397125

Lane, B. (2019, August 9). Trans project ‘out of balance. The Australian. Retrieved from https://www.theaustralian.com.au/nation/trans-project-out-of-balance/news-story/aa7e3aa89a9f42d74e76b3ef31aaa961

Lane, B. (2019, August 9). Warnings over surge in youth transgender cases. The Australian. Retrieved from https://www.theaustralian.com.au/nation/warnings-over-surge-in-youth-transgender-cases/news-story/8b4efbf389a0bd61e664f93a5eaf7315

Lane, B. (2019, August 12). Trans medical model to bear ‘cost of regret’. The Australian. Retrieved from https://www.theaustralian.com.au/nation/trans-medical-model-to-bear-cost-of-regret/news-story/eb60e562a78c5ebf3c45c53d8f433cd1?fbclid=IwAR3inWWXYR1YDSGNUrFC8ZDYasHJ6nt0BArHktAHY5Z1DvJfkuvI_2y7F4s

Lane, B. (2019, August 24). Parents feel new gender was a foregone agenda. The Australian. Retrieved from https://www.theaustralian.com.au/inquirer/parents-feel-new-gender-was-a-foregone-agenda/news-story/08fe653987f5838f5a8c09d41f1cc436

The Daily Telegraph. (2019) Lots of factors’ converge to increase child transgender treatment [Video file]. Retrieved from https://www.dailytelegraph.com.au/news/national/lots-of-factors-converge-to-increase-child-transgender-treatment/video/9eee63d898aa7df17476c20dc7cb4170

Editorial Board, (2019, August 21). Concerns on gender transition. The Australian. Retrieved from https://www.theaustralian.com.au/commentary/editorials/concerns-on-gender-transition/news-story/3af1378fd499f11bd94bec3fc8dd3695

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

Psychologist Ken Zucker Releases a New Paper on Gender Dysphoria

News Commentary

Psychologist Ken Zucker has released a paper called “Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues” discussing various issue around gender dysphoria covered on the GHQ website. These include the increase of natal females reporting they have gender dysphoria, suicidality, rapid onset gender dysphoria, and debates surrounding treatment.

Below is one quote regarding an explanation Zucker and other gender clinicians have for the increase of natal females identifying as trans or non-binary:

For example, per- haps behavioral masculinity (or behavioral “androgyny”) in birth-assigned females is subject to less social ostracism than behavioral femininity in birth-assigned males. If this conjecture is correct, then perhaps fewer birth-assigned males feel com- fortable coming out as transgender and, therefore, are less likely to present at specialized gender identity clinics. It is conceiva- ble, therefore, that, with further destigmatization, it will become easier for birth-assigned males to “come out” as transgender and the sex ratio will move closer to parity. Another possibility is related to the observation that gender-variant/gender noncon- forming behavior is more common in birth-assigned females than in birth-assigned males (from childhood onwards). If this is, in fact, the case, then it would imply that there would be a greater percentage of birth-assigned females at the “gender- atypical” side of the bell curve. In the contemporary era of increased destigmatization, perhaps more of these females are self-identifying as transgender or some other gender-variant self-identity and, as a result, more are presenting at specialized gender identity clinics.

There is a third and fourth possibility Zucker did not mention in this paragraph (although ROGD is mentioned later). The third is there are more females identifying as trans because of social contagion. There is historical evidence young females are prone to social contagions and body dysmorphia. The fourth is that same-sex attracted females and other “tomboys” in general are more prone to internalized homophobia or general insecurity about their gender. This is the opposite possibility Zucker mentions. It is that it is not socially acceptable to be a gender non-conforming girl or woman and this drives the transition, rather the social acceptability of being a trans-identified female. Some female desisters and detransitioners have cited anti-homosexual attitudes or fears around the treatment of females as part of the issues they had around their gender. This section reviews some of those statements, as well as a study that shows homophobic bullying increases trans identification.

Zucker discusses the sensitive topic of suicide risk in trans youth. Suicide risk is heavily promoted to enforce a view the affirmative model is the best mode of treatment. He has found that the suicide risk in gender dysphoric youth is about the same as the risk for any youth with any other mental health problem presenting for treatment:

Based on a variety of measurement approaches (e.g., standard- ized parent or self-report questionnaires, structured psychiatric diagnostic interview schedules, etc.), it has been found that adolescents referred for gender dysphoria have, on average, more behavioral and emotional problems than non-referred adolescents, but are more similar than different when compared to adolescents referred for other mental health concerns

He addresses the various explanations for the increased risk of suicidality:

There are several ways to conceptualize the elevated rate of co-occurring mental health issues among adolescents with gender dysphoria. In some instances, it may be that the gen- der dysphoria has emerged as secondary to another, more “primary” mental health diagnosis, such as autism spectrum disorder or borderline personality disorder, or as a result of a severe trauma (e.g., sexual abuse). Another explanation is that gender dysphoria is inherently distressing, i.e., the marked incongruence between one’s felt gender and somatic sex—even within psychosocial milieus that are largely “affirming/support- ive”—which leads to clinically significant symptoms such as anxiety or depression. A more common explanation (and one that is often favored by “gender-affirming” clinicians and theo- rists) is that the co-occurring mental health issues are simply secondary to factors such as family rejection or social ostracism within the peer group vis-à-vis the gender dysphoria (see, e.g., Grossman, Park, & Russell, 2016; Janssen & Leibowitz, 2018; McDermott, Hughes, & Rawlings, 2017).

In this section GHQ discusses the use of suicide terror in promotion of the affirmative model and how this discourse actually violates every suicide prevention groups policies on how suicide (which is socially contagious) should be discussed.

In this broader context of co-occurring mental health issues, concern about suicide risk has become a topic of intense focus in recent years (see, e.g., Tanis, 2016). On the Internet, for example, one might come across the comment made by some parents “I would rather have a trans kid than a dead kid” (see, e.g., Biggs, 2018; Digitale, 2017; “I’d Rather Have a Living Son Than a Dead Daughter,” 2016) and instances of completed suicide receive intense media scrutiny (e.g., Bever, 2016; Savva & Small, 2019). Indeed, Karasic and Ehrensaft (2015) asserted that completed suicides are “alarmingly high”—a statement which, in my view, has no formal and systematic empirical basis. In fact, I would argue that the statement itself is alarming.

He cites some studies that show support for the youth’s transition reduces suicide risk. GHQ also covers some of this information here.

From a treatment perspective, therefore, one can consider both non-specific and specific factors that might reduce the risk of suicidality. Regarding the latter, for example, it has been argued that (perceived) social support of an adolescent’s transgender identity reduces the risk of suicidality (Bauer, Scheim, Pyne, Travers, & Hammond, 2015). In another com- munity-based study, it was found that the number of social settings in which adolescents felt comfortable in using their preferred name was associated with less suicidal ideation and behavior (Russell, Pollitt, Li, & Grossman, 2018). Lastly, in a clinic-based study, Allen, Watson, Egan, and Moser (2019) reported that commencement of “gender-affirming” hormonal treatment was related to a decrease in self-reported suicidal feelings.

He discusses the issue of rapid onset gender dysphoria and the resistance to discourse around what could be causing it, sometimes by mental health and medical professionals even.

It is not entirely clear to me why some clinician and “armchair” critics have been so skeptical about the possible veridicality of ROGD. Perhaps because Littman (2018) advanced a set of hypotheses about predisposing psychosocial factors in its genesis, the objection is that this disrupts an essentialist model of gender dysphoria and, therefore, has therapeutic implications.

He also addresses the reality that some of the increasing numbers of young people coming out as trans are also desisting or detransitioning:

Because ROGD appears to be a new clinical phenome- non, we know very little about its subsequent developmental course, i.e., its “natural history.” For example, we know very little about rates of persistence versus desistance, which, in my view, is a critical issue in thinking about the applicabil- ity of the Dutch model with regard to the therapeutic care of these youth. At present, there are some compelling examples of desistance or even “detransition,” but right now this is largely in the form of individual testimony and parent’s report (see, e.g., “It’s not conversion therapy to learn to love your body: A teen desister tells her story,” 2017; Pique Resilience Project at https://www.piqueresproject.com/; Rae, 2017; Wil- liams, 2019). Thus, we urgently need systematic data on this point in order to inform best practice clinical care.

Since control groups are considered unethical he has some ideas about how to determine desistance overtime before the initiation of medical treatment:

Suppose, for example, an adolescent had to wait for a year, if not longer, to be seen for a baseline assessment. (Thus, they already have had time and space to continue to think about their gender identity, albeit without hormonal suppression and probably without ongoing psychosocial therapeutic support.) If one collected baseline data at the time of referral, and not the time of assessment, one could argue that if the adolescent continued to experi- ence gender dysphoria after sitting on a waiting list for a long time, this would, perhaps, be an argument for the institution of hormonal suppression. For those adolescents who, while on a wait-list, remitted with regard to their gender dysphoria, it is likely that they would not choose to even be seen for an assessment. Thus, one could use long wait-list times as a type of control as a partial way to evaluate the stability of the gender dysphoria.

Lastly, one could consider recommending exploratory psychosocial treatment without social transition and hormo- nal suppression, particularly if the case formulation is that the gender dysphoria has emerged in the context of other psy- chosocial factors or as a result of other mental health issues. Given the substantial uncertainties about best practice care for these youth, the frontline clinician will have to weigh carefully the benefits and risks of various treatment options and proceed with caution.

References:

Allen, L. R., Watson, L. B., Egan, A. M., & Moser, C. N. (2019). Suicidality and well-being among transgender youth after gender- affirming medical interventions. Clinical Practice in Pediatric Psychology. doi.org/10.1037/cpp0000288

Bauer, G. R., Scheim, A. I., Pyne, J., Travers, R., & Hammond, R. (2015). Intervenable factors associated with suicide risk in transgender persons: A respondent driven sampling study in Ontario, Canada. BMC Public Health, 15(525). doi. org/10.1186/s12889-015-1867-2.

Littman, L. (2018). Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. PLOS ONE, 13(8). doi:10.1371/journal.pone.0202330

Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisex- ual, and transgender (LGBT) youth. Annual Review of Clinical Psychology,12, 465–487. doi: 10.1146/annurev-clinpsy-021815-093153

Zucker, K. (2019). Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues. Archives of Sexual Behavior doi.org/10.1007/s10508-019-01518-8

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

Italian Politicians Seek to Ban the Use of Puberty Blockers for Childhood/Teen Gender Dysphoria

News

Voice of Europe has published an article stating that Italian politicians are seeking to ban the use of puberty blockers for the treatment of trans-identified, gender dysphoric minors.

The regional council of Friuli Venezia Giulia in northern Italy has approved a motion which calls on the national government to prohibit the use of hormone-blocking prescription drugs used in so-called ‘gender reassignment treatment’ for gender-confused children…

Bordin argued that the motion is not an “ideological position but a proposal of common sense in the exclusive interest of the health of children throughout Italy.”

A recent negative report has come out of the U.K. about the safety and efficacy of hormone blockers. The health consequences of medical transition are serious and can be found on our website here.

References:

Lyons, A. (2019, July 28). Italian council to ban gender-altering drugs for kids. Voice of Europe. Retrieved from https://voiceofeurope.com/2019/07/italian-council-to-ban-gender-altering-drugs-for-kids/

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

Puberty Blockers, Studies on Trans-Identified Youth, & Ethical Dilemmas

News

Commentary by bioethics professionals, who will be publishing in Pediatrics, appeared in The Conversation regarding the recent criticisms of a study of hormone blockers used to treat gender dysphoric children. The article is called “Puberty-blocking drugs: the difficulties of conducting ethical research” and it addresses the ethical dilemmas around randomized trials and treating people with gender dysphoria.

Some commentators on the UK trial have claimed that the study was flawed because it lacked a control group. But would it have been ethical to perform a controlled trial? To our knowledge, all of the previous studies of puberty blocking in adolescents have had a similar observational design (that is, no comparison group that is not treated). Potentially, this is based on either ethical or practical grounds. The ethical argument is that it would be wrong to withhold treatment from distressed adolescents who may benefit from delaying or halting the physical changes of puberty.

These ethical concerns about control groups was expressed by Kristina Olson, head psychologist researcher on the Trans Youth Project. She repeated an opinion many affirmative model advocates (and others) have about using control groups for gender dysphoria treatment. There are ethical concerns in using control groups on human subjects in general.

Some scientific caveats, none of these involve random assignment. I think every single person involved in this debate agrees that the scientific claim that we really want to randomly assign people would be the most unethical behavior ever. So, we are not going to say you get hormones and you don’t. No one’s ever going to do that.

Due to the possible dangers of hormone blockers, and that the psychological impacts can’t be determined without a control group, they lay out a case for more accurate studies.

In a forthcoming commentary in the journal Pediatrics, we also set out an ethical argument in favour of controlled trials of puberty suppression. We argue that one of the goals of medical ethics is to promote well-being. But in gender dysphoria it is uncertain whether puberty suppression achieves this goal. The drugs have potentially serious physical side effects. The nature and extent of the psychological benefits are unclear and may differ from person to person. It remains uncertain whether they are in the overall best interests of the adolescent.

They address the fact that a strict randomized trial may not be the best option as it forecloses treatment options for a youth who may be very distressed.

If puberty suppression is to be used with uncertain consequences, it is imperative that we study the effects as systematically as possible. Where a controlled trial is impractical, this might be through an observational design.

They discuss the difference between adults and cognitively immature minors who can’t truly consent to the harsh realities of what medical treatment does to the body.

Medical professionals also have an ethical obligation to promote the well-being of patients, and they also have an obligation to promote their autonomy. In the case of adult patients (with capacity), the right thing to do, in the face of uncertainty about the patient’s best interests, is usually to respect their wishes.

But autonomy is more complicated in the case of young adolescents. Adolescents have varying degrees of cognitive development, which is relevant to their capacity to make decisions. Autonomy is not merely desiring something, it is genuinely and accurately understanding oneself and the options available, and vividly imagining the consequences of all feasible courses of action. How much does an adolescent understand themselves, and how well have they understood and reflected on the consequences of their choices? Clearly, there are some situations where it would be a mistake to automatically comply with an adolescent’s expressed wishes.

Topic 17: Moral Dilemmas, on the GHQ site, has a table that contains the pro and con arguments for socially and medically transitioning minors.

References:

Wilkinson, D., Savulescu, J. (2019, July 25). Puberty-blocking drugs: the difficulties of conducting ethical research. The Conversation. Retrieved from https://theconversation.com/puberty-blocking-drugs-the-difficulties-of-conducting-ethical-research-120906?utm_source=twitter&utm_medium=twitterbutton

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.

A Damning Review of the Justifications for Puberty Blocker Use in the U.K.

News

Oxford professor Micheal Biggs has been vocal in criticizing the protocols for treating gender dysphoric minors at the Gender Identity Development Service in the United Kingdom. He has completed a review of the decisions that have been made by the Tavistock clinic around the use of puberty blockers and a move towards an affirmative model titled “The Tavistock’s Experiment with Puberty Blockers.”

The first quote provides the history of the use of puberty blockers for gender dysphoria:

In 1994 a 16-year-old girl who wished to be a boy, known to us as B, entered the Amsterdam Gender Clinic. She was unique for having her sexual development halted at the age of 13, after an adventurous paediatric endocrinologist gave her a Gonadotropin-Releasing Hormone agonist (GnRHa). Originally developed to treat prostate cancer, these drugs are also used to delay puberty when it develops abnormally early: in girls younger than 8, and boys younger than 9. The endocrinologist’s innovation was to use the drug to stop normal puberty altogether, in order to prevent the development of unwanted secondary sexual characteristics—with the aim of administering cross-sex hormones in later adolescence. Dutch clinicians used B’s case to create a new protocol for transgendering children, which enabled physical intervention at an age far below the normal age of consent (Cohen-Kettenis and Goozen 1998).

His review is not positive:

This paper describes the origins and conduct of this study and scrutinizes the evidence on its outcomes. It draws on information obtained by requests under the Freedom of Information Act to the Tavistock, to the NHS Health Research Authority, and to University College London (UCL). I will argue that the experimental study did not properly inform children and their parents of the risks of triptorelin. I will also demonstrate that the study’s preliminary results were more negative than positive, and that the single published scientific article using data from the study is fatally flawed by a statistical fallacy. My conclusion is that GIDS and their collaborators at UCL have either ignored or suppressed negative evidence. Therefore the NHS had no justification for introducing the Dutch protocol as general policy in 2014

The paper addresses the fact that the hormone blocker protocol has been called reversible and that this has not actually been proven and is very likely not true. GHQ covers the many statements by affirmative model advocates that blockers are “fully reversible” and the actual serious consequences of blockers here.

The paper also describes the reality that the blocker to cross-sex hormone protocol stunts genital growth:

One further absence deserves emphasis. The 2005 Symposium had noted the paradox that blocking a boy’s puberty left him with stunted genitalia, which were then not sufficient to transform into a pseudo-vagina. 

This necessitates a more drastic vaginoplasty surgery. We cover the ramifications of this protocol.

Biggs goes on to criticize the Tavistock professionals:

Three years after the experiment began, Carmichael announced success to the tabloid press. “Now we’ve done the study and the results thus far have been positive we’ve decided to continue with it” (Mail on Sunday, 17 May 2014). Her statement was at best misleading.

Biggs on bone density, something the GHQ website covers here:

The authors state reassuringly that bone density did not decline in absolute terms. This is misleading, because growing children need density to increase (Laidlaw 2018). The abstract acknowledges that the children experienced a decline relative to the norm for their age group, and this decline was especially marked for girls. By year three, the average girl on GnRHa had lower bone density than 97.7% of the population in her age group. Surely this raises serious concerns?

A graph:

He describes on the psychological outcomes (particularly in females who are coming out as trans in unprecedented numbers) and what appears to be an intention to spin them in the most positive way possible, despite some negative findings:

Diligent searching has uncovered unpublished results on the psychological effects. Most revealing is an appendix to Carmichael’s report to the Tavistock’s Board of Directors (GIDS 2015).4 It tracks 30 of the children on triptorelin, measuring changes after one year of the drug regime; presumably the remaining 14 subjects had not completed their first year on the drug.5The text is sometimes internally inconsistent and occasionally contradicts the tabulated figures, suggesting that the appendix was prepared in haste. But we can summarize those changes that were reported as statistically significant (p-value < .05). Only one change was positive: “according to their parents, the young people experience less internalizing behavioural problems” (as measured by the Child Behavior Checklist). There were three negative changes. “Natal girls showed a significant increase in behavioural and emotional problems”, according to their parents (also from the Child Behavior Checklist, contradicting the only positive result). One dimension of the Health Related Quality of Life scale, completed by parents, “showed a significant decrease in Physical well-being of their child”. What is most disturbing is that “a significant increase was found in the first item ‘I deliberately try to hurt or kill self’” (in the Youth Self Report questionnaire). Astonishingly, the increased risk of self-harm attracted no comment in Carmichael’s report. Given that puberty blockers are prescribed to treat gender dysphoria, it is paradoxical that “the suppression of puberty does not impact positively on the experience of gender dysphoria” (measured by the Body Image Scale). When differentiated by sex, the impact was positive for boys on one aspect of body image, but negative for girls on two aspects.

Another problematic example:

The abstract proclaims that “adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa ... compared with when they had received only psychological support” (Costa et al. 2015: 2206). The literature treats this article as providing evidence in favour of puberty blockers (e.g. Butler et al. 2018; Heneghan and Jefferson 2019). But the abstract is misleading: the analysis actually failed to detect any difference between children who were given GnRHa and those who were not

The paper ends with a suggested ban on hormone blockers and more extensive research:

What, then, is to be done? Richard Byng (2019) recently demanded a moratorium on the use of GnRHa for children suffering from gender dysphoria until there is robust evidence that this drug regime is safe and effective. A team of independent researchers must be given access to all the data from the 2011 experiment. They will need expertise in statistics, psychiatry, and endocrinology; most importantly, they must have no vested interests in the promotion of GnRHa. Given that this experiment has been used since 2014 to justify the provision of these drugs to children under the NHS, the outcomes of this experiment—on all the physical and psychological measures that were collected—must be published urgently.

Update 08/18/19: Adding information on late puberty and lack of bone density “Teenagers who identify as transgender taking powerful ‘puberty blocker’ drugs ‘may suffer from weaker bones in the future’”

Update 10/22/19: The study has been cleared of ethics concerns by the Health Research Authority but criticisms continue.

References:

Adams, S. (2019, August 17). Teenagers who identify as transgender taking powerful ‘puberty blocker’ drugs ‘may suffer from weaker bones in the future.’ Daily Mail. Retrieved from https://www.dailymail.co.uk/debate/article-7368017/Teenagers-identify-transgender-taking-puberty-blocker-drugs-suffer-weaker-bones.html

Biggs, M. (2019, July 29). The Tavistock’s Experiment with Puberty Blockers. Department of Sociology and St Cross College, University of Oxford. Retrieved from http://users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf

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