TOPIC UPDATES FOR 2023: TOPIC 1- DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA. YES

Topic Updates for 2023: TOPIC 1 (Part 2)

Original Topic Post= 1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA. YES

We are updating our Topics in 2023 with the most recent and relevant information regarding over-medicalized youth and identity confusion due to queer theory/gender ideology. Since the launch of our website in 2019, only more information has come to light validating our view that pediatric transition is dangerous for children and teens. We support honest and open inquiries regarding this topic. Our focus relates to protecting lesbian, gay, and bisexual youth from harm, and we want the best long-term health outcomes for all youth, regardless of identity or orientation.

One of the main reasons why LGB people are so concerned about the move to transition cognitively immature minors socially and medically is that they may desist from wanting to be the opposite sex or find less invasive ways to cope. Desistance/persistence research is very relevant to protecting LGB and other youth from the culture, parents, and health professionals tracking them into medical pathways they otherwise may avoid if given proper support and allowed to mature.

The increasing but unproven narrative in the “gender affirmative” movement is that no therapy can resolve gender dysphoria, and social and medical transition are the only options. Here is a case study where an individual resolved gender dysphoria with therapy by addressing homophobia, making this study pertinent to the concerns of GHQ:

Behavioral treatment of transsexualism: A case report:

Patients who believe themselves to be transsexual seek only confirmation of their diagnosis so that they may proceed with their pre-chosen course of management: hormones and surgery. Their syntonic emotional set generates resistance to any other therapeutic direction. Despite this attitude, it is the therapist's responsibility to assess each case individually and to decide, with the patient, on realistic goals even if they be different from the original one. This case emphasizes this need since a probing history revealed underlying conflict and anxiety related to severe homophobia. With revelation of the homophobia, various behavioral techniques could be used therapeutically. These resulted in acceptance of lesbianism as a life style. Careful assessment of patients with self-diagnoses of transsexualism can sometimes uncover a different etiology to which appropriate therapy can be applied.

There is a critical study, Singh et al. (2021), called A Follow-Up Study of Boys With Gender Identity Disorder. It shows high rates of desistance in boys with DSM-diagnosed gender dysphoria. Many desisters grew up to be gay men, as indicated in previous studies. The results- 139 participants, 17 (12.2%) were persisters, and the remaining 122 (87.8%) were desisters. This is a very high rate of desistance from a clinical diagnosis, thus involving some amount of distress. These were not just “boys who liked pink.”

It appears persisters on average will be the most “gender variant,” which is not surprising:

Compared to the reference group, the biphilic/androphilic persisters tended to be older at the time of the assessment in childhood, were from a lower social class background, and, on a dimensional composite of sex-typed behavior in childhood were more gender-variant. The biphilic/androphilic desisters were more gender-variant compared to the gynephilic desisters. Boys clinic-referred for gender identity concerns in childhood had a high rate of desistance and a high rate of a biphilic/androphilic sexual orientation. The implications of the data for current models of care for the treatment of gender dysphoria in children are discussed.

But this doesn't mean no desisters fell into this range, given these are averages. In fact, many did. There was more detailed information in the dissertation by Devita Singh that was the basis for this paper. One measure of particular interest was a composite score of each subject's scores on several tests that may indicate more intense levels of dysphoria or gender nonconformity:

As can be seen from Table 15, the childhood sex-typed behavior measures on which the groups differed were significantly correlated.24 From these six measures (first drawn person on the Draw-a-Person, free play, Gender Identity Interview, cross-sex peer preference on the Playmate and Play Style Preferences Structured Interview, 21 cross-sex toy preference on the Playmate and Play Style Preferences Structured Interview, and the Gender Identity Questionnaire for Children), a composite score of childhood sex-typed behavior was derived for each participant by taking the average of the six variables 25 (each expressed as z-scores). Thus, the composite score was expressed as a z-score. A higher composite z-score indicates more cross-gender behavior at assessment (Fig. 2).

 We see that the differences between the Draw-a-Person test, was not significantly different between the persisters and homosexual desisters:

On the Draw-a-Person, there was one significant post-hoc contrast. The bisexual/ homosexual persisters were, on average, significantly more likely to draw a female first compared to the heterosexual desisters (p = .04). The comparison between the bisexual/ homosexual desisters and heterosexual desisters approached significance (p = .09), with the bisexual/homosexual desisters showing a greater tendency to draw a female first. The comparison between the bisexual/homosexual persisters and bisexual/homosexual desisters was not significant (p > .05)

Also:

The bisexual/homosexual persisters had a 274% increase in odds of having a higher composite score (i.e., more childhood cross-gender behavior)…

 And regarding desisters:

The bisexual/homosexual desisters had a 48% increase in odds of having a higher composite score compared to the heterosexual desisters.

We see that a significant number of homosexual desisters, a larger group than the persisters (N=66 v n=16), fell into the range of the persisters’ z-score. This is the population Gender Health Query is most concerned about, very gender nonconforming and cross-sex identified boy children, who now will be reinforced in body dissociation and possibly medicalized at puberty before testosterone exposure to their brains during the maturation process.

The paper discovers the most relevant variables, as seen below. Interestingly, lower socioeconomic status increases the likelihood of persistence, and they suggest these families may be more likely to have negative views of homosexuality and prefer a trans status in their child.

To evaluate the influence of childhood sex-typed behavior and demographic variables on group outcome at follow-up, a multinomial logistic regression was performed using the composite score and the demographic variables on which the groups differed26–age at assessment, IQ, and social class–as predictor variables. It can be seen from Table 16 that both social class and the composite score of childhood sex-typed behavior were significant predictors of group outcome at follow-up in the first model which compared the bisexual/ homosexual persisters to the bisexual/homosexual desisters

Dr. Ken Zucker stated on his twitter account the study has flaws but:

I think that this is the best follow-up study to date in terms of the sample size and the methods of assessment. It does, of course, have its flaws, but I think that the data speak for themselves.

See the entire thread here https://threadreaderapp.com/thread/1376412138227503104.html

 Zucker notes in a tweet thread:

This will probably be the last follow-up study in the literature that tracks longer-term psychosexual development of children (i.e., those seen clinically for the first time between the ages of 3-12 years) during an era where "treatment"--when there was treatment--came in a...

variety of shapes and forms. But the one type of "treatment" (with one exception) that these children did not receive was what is now known as pre-pubertal social transition. Thus, this follow-up study can be used as a comparative benchmark with regard to the persistence and...

desistance of gender dysphoria for any new follow-up studies that look at persistence and desistance among children who socially transitioned prior to puberty. I have argued elsewhere (Zucker, 2018) and in the Discussion that pre-pubertal social transition (where it is...

implemented by parents, on their own, without any clinical input from "professionals" or at the suggestion of professionals, or in combination is a form of psychosocial treatment of gender dysphoria...just of a very different kind.

We did internet searches to see if any “LGBTQ” organizations such as the HRC, PFLAG, or The Trevor Project referenced this study, given they are recommending social and medical transition of children and teens. They have not, to our knowledge. We believe these entities have become a danger to pre-gay and lesbian youth despite putting LBG in their names. Their purpose is exclusively promoting the interests of current trans activism, medicalizing children/teens, and replacing sex-based rights in law with gender identity.

The high desistance rate in the above study that took place at a time when they were not being "affirmed" is in stark contrast to an extremely high persistence rate in a follow-up study by The Trans Youth Project regarding fully "affirmed" minors called “Gender Identity 5 Years After Social Transition.”

RESULTS
We found that an average of 5 years after their initial social transition, 7.3% of youth had retransitioned at least once. At the end of this period, most youth identified as binary transgender youth (94%), including 1.3% who retransitioned to another identity before returning to their binary transgender identity. A total of 2.5% of youth identified as cisgender and 3.5% as nonbinary. Later cisgender identities were more common among youth whose initial social transition occurred before age 6 years; their retransitions often occurred before age 10 years.

This paper will be discussed in more detail in an update to Topic 4 due to their avoidance of contemplating that they are tracking would-be desisters into trans identities, and that this could account for their drastically higher persistence rates versus prior studies.

The same group of researchers published a paper called Retransitioning: The experiences of youth who socially transition genders more than once that focused on the youth who keister from a cross-sex identity. Their use of the term “retransition” is the new preferred parlance of affirmative model advocates.

They state:

Conclusions: These findings largely do not support common concerns about retransitions. In supportive environments, gender diverse youth can retransition without experiencing rejection, distress, and regret.

This comment lends no proof one way or the other that the affirmative protocol is or isn’t significantly increasing the likelihood that youths will medicalize.

The study Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study tracked youth from an insurance database:

METHODS
A cohort of 958 gender-diverse (GD) children and adolescents who did not have a gender dysphoria–related diagnosis (GDRD) or GAHT at index were identified. Rates of first GDRD and first GAHT prescription were compared across demographic groups.

And:

The STRONG cohort includes participants from Kaiser Permanente (KP) integrated health care systems in Georgia, Northern California, and Southern California.

They found that some youth with gender dysphoria diagnosis were not dysphoric post puberty. It also appears females may be less likely to desist than males:

Both Dutch studies found that most participants did not experience gender dysphoria beyond puberty. This result is consistent with our observation that less than one-third of children presenting with GD behaviors received a GDRD and only approximately one-quarter initiated hormone therapy during follow-up. The Dutch researchers also reported a greater likelihood of unalleviated gender dysphoria in children who presented at an older age and among AFAB participants, both results in agreement with our findings.

A study, Karrington (2022), published by a trans-identified individual in Transgender Health, is called “Defining Desistance: Exploring Desistance in Transgender and Gender Expansive Youth Through Systematic Literature Review.” It claims that desistance isn’t a relevant concept for study. Desistance in the paper is defined below:

Thirty definitions of desistance were found, with four overarching trends: desistance as the disappearance of gender dysphoria (GD) after puberty, a change in gender identity from TGE to cisgender, the disappearance of distress, and the disappearance of the desire for medical intervention.

The conclusion of the paper obviously advocates for the affirmative model trans activists are demanding. Not bothering with tracking social and medical influences on persistence/desistance serves their priorities:

Conclusions: This review demonstrates the dearth of high-quality hypothesis-driven research that currently exists and suggests that desistance should no longer be used in clinical work or research. This transition can help future research move away from attempting to predict gender outcomes and instead focus on helping reduce distress from GD in TGE children.

Another trans activist produced a similar paper, Ashley (2022), called “The Clinical Irrelevance of “Desistance” Research for Transgender and Gender Creative Youth.”

Lisa Selin Davis, who has been writing on this subject, discussed desistance research in an article for Skeptic called “Trans Matters: An Overview of the Debate, Research, and Policies.”

She also reported on an individual case of desistance in an article titled “A Desister’s Tale.” The article concludes:

Children and their families should know about the desistance literature, and that the way they feel now, no matter how intensely, isn’t necessarily a sign of how they’ll feel in the future. By exposing them to a diversity of stories, including Ash’s, we can restore balance to the discussion in a way that may help many distressed young people navigate a difficult and confusing time.

Individual cases of desistance are also in “’Desistance’ in two cases of transgender men” on Why Evolution is True.

Despite the existence of desistance, WPATH is removing any recommendation for age restrictions on medicalizing minors.

Elkadi et al. (2023), a paper called “Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study,” discusses desistance rates:

This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment for gender dysphoria (GD) and for potential gender-affirming medical interventions. All of the young people had attended a screening medical assessment (including puberty staging) by paediatricians. The Psychological Medicine assessment (individual and family) yielded a formal DSM-5 diagnosis of GD in 66 of the young people. Of the 13 not meeting DSM-5 criteria, two obtained a GD diagnosis at a later time. This yielded 68 young people (68/79; 86.1%) with formal diagnoses of GD who were potentially eligible for gender-affirming medical interventions and 11 young people (11/79; 13.9%) who were not. Follow-up took place between November 2022 and January 2023. Within the GD subgroup (n = 68) (with two lost to follow-up), six had desisted (desistance rate of 9.1%; 6/66), and 60 had persisted on a GD (transgender) pathway (persistence rate of 90.9%; 60/66). Within the cohort as a whole (with two lost to follow-up), the overall persistence rate was 77.9% (60/77), and overall desistance rate for gender-related distress was 22.1% (17/77). Ongoing mental health concerns were reported by 44/50 (88.0%), and educational/occupational outcomes varied widely. The study highlights the importance of careful screening, comprehensive biopsychosocial (including family) assessment, and holistic therapeutic support. Even in highly screened samples of children and adolescents seeking a GD diagnosis and gender-affirming medical care, outcome pathways follow a diverse range of possibilities.

This abstract confirms DSM diagnosed minors do desist from the clinical definitions of gender dysphoria as listed in the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” which is supposed to have more rigid criteria, reducing the likelihood of defining desisters as “true trans.” The desistance rate is still low compared to prior studies where children were not affirmed in their gender dysphoria and cross-sex identification which is concerning. We can also see two of the minors who didn’t receive an initial DSM diagnoses, wound up with one later. The affirmation of gender dysphoria in youth with forming identities is a severe risk to these minors as transition regret appears to be increasing.

Topic 8 deals with detransition and regret. One can find many examples are LGB youth.

See Original Post 1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA. YES

More blog posts relating to this Topic are here.

CONTINUE TO TOPIC 2:

Hormone blockers, trans youth, & permanent side effects such as sterility & loss of sexual function
Medical consequences of hormone blockers, cross-sex hormones, surgery, to gender dysphoric & trans youth

Stats for Gender: A New Resource for Accurate Information Regarding Gender Dysphoria

News Commentary

Stats for Gender (statsforgender.org) is an organization that has formed recently to provide people with legitimate resources regarding gender dysphoria. There is a lot of misinformation and spin in the press regarding gender dysphoric youth and the trans movement in general. This also extends to medical bodies that fail to describe gender dysphoria research accurately. This is particularly true in regards to desistance and suicide risk. Stats for Gender will be a good resource for those seeking accurate information. GHQ does it’s best to source our material and examine data in legitimate ways regarding gender dysphoria research. References can be found in links at the end of each “Topic.”

American Journal of Psychiatry Study Purported to Show Benefits of Transgender Medical Transition Made False Claims

The American Journal of Psychiatry published a study from Yale School of Public Health and the Karolinska Institute in Sweden touting the benefits of surgeries for gender dysphoria:

“Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study”

Gender identity surgeries include double mastectomy and phalloplasty for FtMs, and vaginoplasty and facial feminization for MtFs. They have now had to issue corrections indicating the study was flawed and shows no benefit.

The study, as others, indicates overall worse mental health and suicide risk for transgender people compared to the general population:

Results:

Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98).

They found no evidence of benefits of hormones alone. They did report a “longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment.” The positive message about “gender-affirming surgeries” was widely cited by the media. Current media appears eager to promote pro-medical transition stories, even when it involves minors, as any critical commentary about these protocal is lacking in US media. Dr. Pachankis himself claimed in an interview:

No longer can we say that we lack high-quality evidence of the benefits of providing gender-affirming surgeries to transgender individuals who seek them.

However, the study is flawed and the data shows no benefits from these expensive surgeries that may have negative side-effects such as infection, loss of sexual function, and need for repeat vaginiplasty surgeries. After several letters to the editor criticized it, the journal redid the study’s statistical analysis and found the conclusions are wrong.

While the positive claims were reported in the media, some retractions have not been. Gender Health Query is sending out a request to media outlets who repeated the positive claims of this poorly done study whose authors may have been suffering from confirmation bias to correct the record. We are also asking the American Journal of Psychiatry why they continue to display this title prominently. It’s misleading. Notice the positive sounding title remains intact, but there is only a small link at the top mentioning that there are corrections to the article. Sometimes corrections are minor. That is not the case with this study. Does the AJP want to mislead the public? Because that will be the result based on this title. What are the reasons they did not retract the study altogether?

This study had a high quality, very large data set (2,600 transgender individuals diagnosed with gender incongruence between 2005 and 2015 versus all the rest of the Swedish population). It is one of the better data sets used in a study, with many studies on transgenderism being poor quality (ex- survey studies, convenience sampling, lost to follow-ups). It contricits the finding of the Cornell review And this analysis fails to show improvements in the mental health with hormone use and surgeries. That is significant given the huge increase in medicalized minors.

Most studies on outcomes for trans individuals are of poor quality in terms of research standards. Many studies indicate trans people have improved quality of life post-transition. Others indicate that long-term mental health outcomes are not good, calling into question the effectiveness in reducing suicide risk and improving mental health.

A list of “Letters to the Editor” and their response is listed under the published article:

35 Anckarsäter H, Gillberg C: Methodological shortcomings undercut statement in support of gender-affirming surgery. Am J Psychiatry 2020; 177:764–765Abstract, Google Scholar

36 Van Mol A, Laidlaw M, Grossman M, et al.: Gender affirmation surgery conclusion lacks evidence. Am J Psychiatry 2020; 177:765–766Abstract, Google Scholar

37 Curtis D: Study of transgender patients: conclusions are not supported by findings. Am J Psychiatry 2020; 177:766Abstract, Google Scholar

38 Malone W, Roman S: Calling into question whether gender affirming surgery relieves psychological distress. Am J Psychiatry2020; 177:766–767Abstract, Google Scholar

39 Landén M: The effect of gender-affirming treatment on psychiatric morbidity is still undecided. Am J Psychiatry 2020; 177:767–768Abstract, Google Scholar

40 Wold A: Gender corrective surgery promoting mental health in persons with gender dysphoria not supported by data presented in paper. Am J Psychiatry 2020; 177:768Abstract, Google Scholar

41 Ring A, Malone M: Confounding effects on mental health observations after sex reassignment surgery. Am J Psychiatry 2020; 177:768–769Abstract, Google Scholar

42 Bränström R, Pachankis JE: Toward rigorous methodologies for strengthening causal inference in the association between gender-affirming care and transgender individuals’ mental health. Am J Psychiatry 2020; 177:769–772Abstract, Google Scholar

Here is a list of URLs citing this study that now need correction:

https://www.bustle.com/p/affirming-peoples-gender-improves-trans-mental-health-a-study-says-19345160

https://www.madinamerica.com/2019/11/gender-affirming-interventions-reduce-mental-health-issues-study-suggests/

https://www.jwatch.org/na50059/2019/10/11/gender-affirming-surgery-durably-improves-mental-health

https://www.medpagetoday.com/psychiatry/generalpsychiatry/82642

https://www.nydailynews.com/news/national/ny-transgender-gender-affirming-surgery-mental-health-study-20191004-bxvqkg4gj5budinawa3bogp5oa-story.html

Here is a list of journal articles that referenced this study and quotes used:

Sevelius J.M., Gutierrez-Mock L., Zamudio-Haas S., et al. (2020). Research with Marginalized Communities: Challenges to Continuity During the COVID‑19 Pandemic, AIDS and Behavior, Volume 24, 2009–2012. https://doi.org/10.1007/s10461-020-02920-3

> Among our transgender and gender diverse staff and participants, delays in gender-affirming treatment, such as hormone injections and surgeries, due to the shutdown of clinics and delays in "elective" surgeries, can cause serious mental health issues, including depression, anxiety, and suicidality [16].

Wang Y., Pan B., Liu Y., et al. (2020). Health care and mental health challenges for transgender individuals during the COVID-19 pandemic, Lancet Diabetes Endocrinology, Volume 8, Issue 7, 565-565. https://doi.org/10.1016/S2213-8587(20)30182-0

> Besides access to health care, it is also important to highlight mental health issues of transgender individuals. Previous studies showed that gender-affirming surgery was associated with reduced mental health problems.4

Roque R.A. (2020). Transgender pediatric surgical patients—Important perioperative considerations, Pediatric Anesthesia, Volume 30, Issue 5, 520-528. https://doi.org/10.1111/pan.13845

> "Importantly, surgeries for transgender individuals are medically necessary procedures, proven to improve dysphoria, mental health, and quality of life,26, [29]-33 and should not be viewed as elective.14, 15"

Konrad, M., & Kostev, K. (2020). Increased prevalence of depression, anxiety, and adjustment and somatoform disorders in transsexual individuals, Journal of Affective Disorders, Volume 274, 482-485, https://doi.org/10.1016/j.jad.2020.05.074

Aldridge Z., Patel S., Guo B., et al. (2020). Long term effect of gender affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study, Andrology, published online 10 August. https://doi.org/10.1111/andr.12884

> "In contrast, Bränström and Pachankis [40] using the Swedish population register showed no significantassociation between the likelihood of accessing mental health treatment and time since initiation of GAHT.

"Flaherty, A.J., Sharma, A., Crosby, D. (2020). Should Gender-Affirming Surgery Be Prioritized During the COVID-19 Pandemic?,  Otolaryngology–Head and Neck Surgery, Published June 30, https://doi.org/10.1177/0194599820939072

> A recent study found significantly reduced risk of mental health treatment in TGNC patients after receiving GAS but not HRT alone.13

Schvey, N.A., Klein, D.A., Pearlman, A.T., Riggs, D.S. (2020), A Descriptive Study of Transgender Active Duty Service Members in the U.S. Military, Transgender Health, first published 19 May 2020, https://doi.org/10.1089/trgh.2019.0044

> The finding that transmales, who were significantly more likely to have taken steps toward gender affirmation, presented with better mental health may provide further evidence supporting the effectiveness of gender-affirming treatments in ameliorating distress and improving quality of life.69,[70]

Surmaitis, R.M., Greenberg, M.R., Ebeling-Koning N.E., et al. (2020). Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017–June 2019, J Med Tox, Published: 17 June 2020 

> It would be helpful for further study to gather more information on whether patients have undergone surgical procedures or hormonal therapy because it has been shown that rates of suicidality and utilization of mental health services may differ based on transition-related medical interventions [20, 21].

Giraldi A. (2020). Mental health and gender dysphoria – why does it matter? Acta Psychiatrica Scandinavica, Volume 141, Issue 6, 483-485, https://doi.org/10.1111/acps.13182

> Though, some studies indicate that some of the increased risk of mental health problems persist, which may in part be related to internal and external factors (17-19).

References

Bränström, R., Pachankis, J. (2019). Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study. American Journal of Psychiatry, 77(8):727-734. doi.org/10.1176/appi.ajp.2019.19010080

Cornell University. (2018, March 26). What does the scholarly research say about the effect of gender transition on transgender well-being? Retrieved from https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

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

GHQ Letter Sent to USC Neuroscientist Who Wants to Study Transgender Brains

News Commentary

Jonathan Vanhoecke, who has an MA in neuroscience, wants to use neuroimaging to study the brains of transgender people and compile data in ENIGMA (a global research network based at USC).

The article, Researcher explores links between transgender brain and gender identity, explains:

Understanding how their brains develop and change as transgender people grow up could help doctors and other health professionals provide better treatment and support.

There is a lot of evidence showing there is a grey area between gender nonconforming gay and lesbian people and trans people. This is demonstrated in research statistics showing desistance rates from childhood gender dysphoria and its association with adult homosexuality and Increasingly bisexuality. It is also apparent in the increasing numbers of accounts of desisted and detransitioned (underwent medical procedures) lesbian and bisexual females. If neuroimaging could be used to tell a “true trans child/teen” from a minor who could outgrow gender dysphoria, this would be a useful tool in how to best support the young person. It is unlikely to be this simple. There is a lot of evidence on the GHQ website to support the argument that environment and other factors influence gender dysphoria and trans-identification.

The article mentions that there is a mix of information provided by the previous studies:

So far, results from the few existing studies are inconclusive, Vanhoecke said. Some evidence suggests differences in gender identity could be linked to ways the brain develops in childhood and adolescence, and that the observed patterns correspond to gender identity. Other studies have indicated that neural patterns generally match the sex a person is assigned at birth. Yet other studies found evidence that doesn’t seem to support either of these, but rather that there are unique neural patterns in transgender people.

Topic 10 thoroughly covers the research that is available on biological and environmental causes of both transgenderism and homosexuality, and in some cases, the causes may be similar.

The article discusses a brain region that may be involved in gender dysphoria:

Vanhoecke aims to study systems of the brain, including a part of the brain’s white matter that might be involved in differences between sex assigned at birth and gender identity. It’s called the inferior fronto-occipital fasciculus, a bundle of white brain fibers that runs along the lower portion of the brain between the occipital and frontal lobes. Analyzing its structure in greater detail might offer clues about its role in gender identity and guide future studies, he said.

Interestingly, it is the inferior fronto-occipital fasciculus that may be involved in anorexia nervosa, bulimia nervosa, and body dysmorphic disorder. Medical transition used for gender dysphoria appears to be more effective than plastic surgery is for BDD.

One of the goals of this organization is to put pressure on researchers to admit that there is a blurry line between trans and gay and to keep this in mind conducting research:

15) Insist that brain research studies trying to determine the causes of transsexualism, use very gender nonconforming gays and lesbians as controls, before they reach their conclusions. There are likely spectrum effects in the causes of homosexuality and transgenderism. Heterosexuals are not the best controls to determine if transgenderism is completely innate. There is much information that shows that for some individuals it isn’t, and that it’s influenced by culture. In relation to the medical transition of minors, and it’s safety to desisters, comparing gays/lesbians with trans people is more relevant.

Below is a letter written in response to Vanhoecke and the other researchers listed in this article around this subject:

To Mr. Vanhoecke, Ms. Savic, Mr. Thompson,and Mr. Feusner,

This letter is about the article Researcher explores links between transgender brain and gender identityon the USC’s news website about using neuroimaging to study transgender people. 

Gender Health Query is an LGBT organization that was formed as a result of the increasing numbers of LGBT people who have major concerns about the number of minors who are being permanently altered by medical treatments for gender dysphoria. This includes concerns about the hormone blocker protocol, which can begin as young as 10 years old, as well as double mastectomy and vaginoplasty surgeries under the age of 18. 

There are concerns about this for two main reasons. The first is that these medical techniques are very invasive and may cause bone weakening, permanent sexual dysfunction, sterility, possible cognitive effects, and a very large increase in circulatory health risks. The second main reason for concern by our group is that all research, as well as more recently observed examples, shows an association with youth gender dysphoria and adult lesbian, gay, and bisexual identity. And indeed, there appears to be more transition regret, particularly among lesbian and bisexual females, who transitioned before they were cognitively mature (full maturity is not reached until age 25). 

So the worry is, particularly in the gay and lesbian community, that borderline gay, lesbian, and bisexual youth are going to be over-medicalized with the current enthusiasm to socially and medically transition children, teens, and young adults. These fears seem warranted given that five gender clinician professionals in the United Kingdom have quit because of ethics concerns. They cite internalized, as well as parental homophobiaas reasons they believe early medical treatments risk pre-gay and lesbian youth. These fears also seem warranted due to reports from parents, or the young people themselves, that a trans-identification lasted several years in the tweens and teens before desistance. This is long enough to receive an official DSM diagnosis and receive testosterone and doublemastectomy. 

Our website documents many examples of factorsbeyond innate biological gender identity that appear to influence gender dysphoria. These include homophobic bullying, parental instability, mental health issues, and social contagion. There are people who wish to be the opposite sex from a young age and who will choose transition. But it seems unlikely that a brain scan will be enough to determine which minors are “truly trans,” as it appears there is more of a continuum between homosexual and trans, rather than a clear line. Dr. Ray Blanchard’s work on the “older brother effect”on both trans and homosexual identity supportsthis idea.

For these reasons, it seems that using very gender nonconforminghomosexual controls, as well as opposite sexcontrols, in brain imaging studies would provide interesting comparisons. Several studies of homosexuals’ brains also show cross-sex similarities. One of the goals of our organization is to notice when researchers seem uninterested in the blurred line between trans and gay because it worries so many of us when it comes to transitioning children. 

And a brain study will not necessarily be able to answer what causes the differences in areas such as the inferior fronto-occipital fasciculus. This area may be affected in body dysmorphias as well. Could more cultural acceptance mitigate any bodyanxiety in people who are gender outliers? What did the brains of the desisted teens look like during and after their trans-identification lifted? The cultural questions are still interesting.

Another relevant factor in brain imaging studies not mentioned in the article is the difference between males who transition who are attracted to men versus males who are attracted to women. Dr. Ray Blanchard, the researcher mentioned above, is an expert in adult gender dysphoria. He categorized the two groups as homosexual transexuals (HSTS) and autogynephilic (AGP) males. The de-emphasis of this categorization in research is all political, as Blanchard describes AGP as a type of paraphilia, rather than a brain feminization. Despite the fact that some trans activists find this offensive, there is no scientific reason not to pursue this theory and one brain imaging study has already indicated that HSTS and AGP are two different phenomena.

Sexologist Dr. James Cantor:

“[T]he brains of both homosexual and heterosexual male-to-female transsexuals probably differ from the brains of typical heterosexual men, but in different ways. In homosexual male-to-female transsexuals, the difference does involve sex-dimorphic structures, and the nature of the difference is a shift in the female-typical direction. If there is any neuroanatomic intersexuality, it is in the homosexual group. In heterosexual male-to-female transsexuals, the difference may not involve sex-dimorphic structures at all, and the nature of the structural difference is not necessarily along the male–female dimension. (p. 437”)

Many parents are starting to see gender nonconforming children as transgender. This is facilitating large numbers of children being socially transitioned and given hormone blockers before they have experienced any puberty (the time when gnc gay and trans identities often separate out). Some of these children may not be adults who would definitely transition. It would be irrelevant if not for children being put on medical pathways, with serious health consequences, at younger and younger ages. The efforts in brain research should also focus on protecting these grey area children from over-medicalization, not just trans medical treatment. 

Thank you for your time.

References:

Buchanan, B.G., Rossell, S.L., Maller J.J., Toh W.L., Brennan S., Castle, D.J. (2013). Brain connectivity in body dysmorphic disorder compared with controls: a diffusion tensor imaging study. Psychology Medicine. 43(12), 2513-2521. doi:10.1017/S0033291713000421

Cantor, J. M. (2011). New MRI Studies Support the Blanchard Typology of Male-to-Female Transsexualism. Archives of Sexual Behavior, 40(5), 863-864. doi:10.1007/s10508-011-9805-6

Cornell University. (2018, March 26). What does the scholarly research say about the effect of gender transition on transgender well-being? Retrieved from https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Dreger, A. (n.d.). Answers to Some Questions about Autogynephilia. Retrieved from http://alicedreger.com/autogyn

Gaudio, S., Carducci, F., Piervincenzi, C., Olivo G., Schiöth H.B. (2019). Altered thalamo–cortical and occipital–parietal– temporal–frontal white matter connections in patients with anorexia and bulimia nervosa: a systematic review of diffusion tensor imaging studies. Psychiatry Neuroscience, 44(3),1-16. doi:10.1503/jpn.180121

Higgins, S., Wysong, A. (2018). Cosmetic Surgery and Body Dysmorphic Disorder – An Update. International Journal of Women's Dermatology, 4(1), 43–48. doi:10.1016/j.ijwd.2017.09.007

Lindberg, E. (2019, July 15). Researcher explores links between transgender brain and gender identity. USC News. Retrieved from https://news.usc.edu/158899/transgender-research-usc-brain-gender-identity/

Travisa, K. Golden, N. Heidi, Feldman, H., Solomon M., Nguyen J., Mezer, A., Yeatman, Dougherty, R. (2015). Abnormal white matter properties in adolescent girls with anorexia nervosa. NeuroImage: Clinical, 9, 648-659. doi:10.1016/j.nicl.2015.10.008

Vanderlaan, D. P., Blanchard, R., Zucker, K. J., Massuda, R., Fontanari, A. M., Borba, A. O., … Lobato, M. I. (2016). Birth order and androphillic mate-to-female transsexualism in Brazil. Journal of Biosocial Science, 49(4), 527-535. doi:10.1017/s0021932016000584

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.