Bravo, Leor Sapir! The shocking acceptance of studies where N=33 and the like, where follow-up is limited to 18 months and the like, where the subjects were convenience samples, self-selected through internet inquiries and not even vetted for natal sex vs. claimed "gender" and the like, must result in rejection of any of Turban's writings. They are fiction, relevant as any Ray Bradbury's science fiction in the mental health sphere.
As the ex-wife of a mentally unstable man, father of our children now claiming to be their mother, I can tell you there are so many complicating factors that the entire diagnosis, even of "persistent, since early childhood" individuals has in fact, never been defined scientifically. The PhD "sexologist" who diagnosed him in one appointment claimed in a sworn affidavit that I, his wife, was responsible for his decision to "live full-time as a woman" because I said this is too destructive of me, the mother raising the children, that I served divorce papers. Jack Turban and his ilk are not scientists. They are not researchers. They are political activists and influencers with financial backing from corporate pharma. By the way, my ex never smiled after he had the surgeries.
For methods to reconnect with your natal body, to have strength, vibrancy and self-awareness:
A little follow-up, just another female POV: on my blog, uteheggengrasswidow.wordpress.com, I received an inquiry from a female caregiver to elderly women. Her English was not perfect, don't know yet where she's writing from. She was sent to dress a spinal abrasion on an elderly "woman." This person insisted on being unclothed from the waist down, not necessary for the treatment, and made a show of the breast implants, then pointed to the "sports awards" trophies in amateur women's categories. This minimum wage worker never expected to wash and changed a man's bandage. Please do contact me at uteheggengrasswidow.wordpress.com if you've had a similar experience. And, be strong, love our binary world. Thanks, Colin, for linking the above comment. Do get in touch. Ute
Eager to convert all to the banana oil, bunkum, nonsense that is "transgenderism," Jack is the three-card monte scammer, the grifter, the bamboozling flimflam man who distorts, deceives, and dupes us with sophistry, trickery and chicanery.
Jack Turban is the purveyor of hoaxes and lies. The love child of Piltdown Man and Mechanical Turk
Thanks for putting all these studies and names in one place. With Nova Scotia being continuously lobbied to remove all psychiatric checks and implement “Gender Affirming Care” this will be a good reference when assessing what material they provided to the political committee they are presenting to. 
What an impressively thorough and convincing article. It's a strikingly sober assessment of the current research. It sits in stark contrast to the madness of Jack Turban's activism which is revealed to be sophistry.
It's great that Substack authors are putting in the work to debunk claims about "gender affirming" care. It would be even better if mainstream news outlets would pay attention and start issuing corrections to their glowing articles about these "life-saving" interventions. How much longer will they continue to rely on sloppy research and the bad-faith assertions of trans activists and their allies? Will it just take a few more years of Sapir, Singal, Wright, et al. hammering away at these lies and inconsistencies? Or will it be necessary to have a few class action lawsuits filed by the people irrevocably harmed?
Great question. I recommend sending this article to each reporter and editor at your local newspaper. We can't expect them to find this info in obscure locations such as one substack. It would be far more effective for us to just supply local reporters with this info. I'll make you a deal: I will do this if you'll do this. Also, please send this to at least one local pediatrician. I include more details in my comment, below.
There is another fundamental problem with all these studies, now that gender mutilating surgery has become so political and the issue been forced down everyone's throat.
Anyone who undergoes this surgery has immense internal pressure on their psychological well-being to believe that they did the right thing and that they are now happier and less psychologically distressed. In addition, there is immense external pressure from the outside world and from their doctors to shun any thoughts of regret and to validate the medical intervention.
How do you think that will affect how the patient fills out their psychological survey? It's not just the researchers with the confirmation bias. Even worse Many patients will also has have a strong confirmation bias. This is the reason why, for clinical studies of medicines where subjective outcomes are measured, it is critical for the study to be double blinded. Unfortunately, there is no way to make gender mutilating surgery blind to either patient or physicians.
It's not just the analysis and conclusions that are corrupted, but reliability of the basic data on which those conclusions are also suspect. We saw a glimpse of that when Sapir noted how in one study a huge number of participants outright lied and said they were given puberty blockers at the age of 18, AFTER they had passed through puberty.
To get publicity for Sapir and others trying to shine a light into the despicably dishonest world of activist medicine, we need Republicans to hold hearings where Sapir and others can testify. Then their research and explanation will be in the congressional record and recorded on C-SPAN and Youtube. Conservatives can cite this testimony to fight back when the Left uses their "experts say" argument.
When people are tested with symptom surveys it is usually pretty easy to deny, minimize, or alternatively, amplify and exaggerate psych symptoms. Psychologists call this "faking good or bad," and it is a common testee strategy. People applying for jobs usually try to minimize symptoms and people who are trying to get disability payments may try to look sicker. Some symptom surveys (particularly the MMPI series) are more difficult to fake, but even so, aren't impervious.
I don't really know what the incentives currently are for adolescents to present at a gender clinic as more or less depressed, anxious, self-harming, etc. In the earlier years of gender treatment patients were selected for surgery only if they were evaluated as stable and free of other mental health issues along with trans-identification. In that case, I would expect the patients to deny symptoms both before and after surgeries. Now it appears that a high percentage of patients present themselves as distressed and as high suicide risks during psych evaluations, and the gender clinics are saying that, "People have a right to seek care regardless of what other problems they might have."
I found much of the research about gender clinic patients to be appallingly biased. Some of the articles I read explicitly instructed the reader to "frame" evidence that trans-identified adolescent patients have other diagnosable mental disorders as evidence for "minority stress" (as the one and only likely cause). These statements show extreme bias and disregard for scientific norms in research. The investigators writing up their study are not supposed to presume what caused patients' symptoms, or anything else. They are supposed to look into the problem they are studying without ruling out any variables that might be related to it. If the investigators can show that a patient's anxiety is diagnosable as situational they can move on to identify as many environmental stressors as they can think of as possible causes. It is not at all easy to meet the first requirement, showing that the patients' anxiety symptoms are like those that are caused by environmental stress, as opposed to OCD or something else. To really argue for causation the researchers have to design a longitudinal study, which takes years to complete and involves so many other logistical difficulties that doing this kind of research is almost unfeasible.
For the investigators to order the reader to "frame" an unwanted result as having been caused by "minority stress," without at least conducting an open search for all variables that potentially influence and sustain trans patients' anxiety is not research at all. It is unethical and scientific malpractice to conduct and then publish research for the preconceived purpose of selling a type of treatment that the researchers like to do.
I agree with you, it would be great if those of us who question the gender treatment industry could present in Congress the counterarguments against gender affirmative care. I find that most healthcare providers in general practices are uninformed about the controversies regarding gender clinic referrals, and this includes physicians who treat adolescents. That demographic is still typically nerdy and science-minded, especially if they graduated from medical school before the woke takeover. They could potentially be influenced if there were debates in Congress about the dissenting arguments with respect to "safe and effective treatment" of disorders focused on self-rejection of one's bio sex.
One of the main problems in combating the woke cult generally is that half the population still thinks the anti-woke effort is about "far right conspiracy theories." Getting evidence in front of the public requires doing some kind of end run around the repression of dissent in the MSM. Congress does seem to be the place people turn now when they want to get the word out about something that the MSM won't cover.
This is a long term solution but it may turn out to be the only solution. We have to discredit the MSM so much that they lose their audience. Otherwise they will have no incentive to even contemplate changing and conservative reason and evidence will lose to government directed MSM propaganda. And you have to do what the Left does so effectively to discredit the right. Frame their opponents as not just wrong but actually evil, because in this case it actually is. And it may be most effective for conservatives to do this by co-opting the language of the left. So William Thomas stealing women's swimming wins and parading her junk around the women's locker room (as well as Adidas having men model women's bathing suits and Target making women's bathings suits for men) has to be considered an evil example of "Toxic Transgender Masculinity". "Gender Affirmation" needs to be called "The Mullah's Conversion Therapy", because that's what they force upon homosexuals in Iran to punish them. And because the data says that, if you leave most of those with real gender dysphoria alone (not the huge increase in girls affected by social contagion) almost 90% of them will settle down as homosexuals, you need to call all those medical experts, activists, journalists, neighbors attacking you as a transphobe what they really are: homophobes trying to do what the mullahs are doing - committing homogenocide by sterilization. The conflagration is too big to fight fire with water, i.e. by trying to cool things down. It is time to fight fire with fire. The Left wants to exterminate the views and lives of common sense people by using the fascist collusion of powerful government and corporate coercion. We have to fight back like our lives and the lives of our children depend on it.
I emphatically agree with your position! At this point I take for granted that our country is under attack via psychological warfare. With respect to the activists, I believe we need to identify them as "the enemy," as our troops normally due during wars, and treat them accordingly. A lot of their weapons work against them, especially critical theory, which always assumes that an opponent's arguments are just covert power strategies designed to oppress somebody.
I was reading articles on Persuasion and Reason for a while but had to take a break from them because of the persistent push by their authors to treat all interactions with the woke like dialogues in which people are seeking mutual understanding. The stance being promoted by F.I.R.E. is also tilted towards protecting woke rights. Liberals have so much difficulty with accurately perceiving an enemy as such and behaving accordingly.
Regarding study 6, the comparison is between GD patients who receive CHT and non-GD subjects (who presumably did not). This seems like a pointless comparison. Not one of these studies compare GD patients who receive CHT with GD patients who do not.
Not to mention the measured endpoints are all self-reported. If you have been asking a doctor to give you a certain intervention and then they do it, of course you will say you feel better.
This really is not science at all as far as I can see.
People who aren't trans do t understand just how little research is out there. And in many respects most experts don't know what they are doing with patients who are adults or minors because of the trial-and-error nature of transgender medicine, and the tiny demographics that make research extremely difficult.
With that said, that's not entirely a bad thing and it alone should not be the definitive basis for restricting access to medical care the patient and/or their guardian and medical practitioner seems to be a reasonable option to treat underlying problems.
Historically doctors and surgeons have never fully comprehended the causes of effects of their treatment beyond "it works" or "good enough". Anesthesiologists are specialists in a field of medicine required for many procedures, yet anesthesia in of itself is not well understood.
These practitioners, like all practitioners, care enough to take a shot in the dark, they hope for the best, plan for the worst. And over the decades have gotten a good "feel" (and policies) for what to do with treatments and medicines that are still scientific enigmas.
A lot of smart people try to quantify something that can't be quantified. What's the cash value of the life of a child? Should a school bus driver with one passenger be paid more than truck drivers who handle high value and restricted loads? Should a school bus driver have much stricter training? Should school busses have more safety features?
My sociological bias is this: at a certain point, nuances don't matter, and it's up to the individual and/or the legal guardian to make the appropriate decision they believe is best for them.
"Believe" is also a good term to use here because of the implications of freedom of religion in conjunction with medical autonomy. But my faith is "agnostic" (don't know, don't care).
----------------------------------
I argue this: If pandering to the transgender, nonbinary, and intersexed populations was never important because transgender individuals were statistically insignificant for the past hundred years, then I assert that people who have no vested interest should not engage in any debate, research, or have any influence over a statistically insignificant population. Because there are more statistically significant individuals and other utilitarian public policies.
You know who has a very clear, very important "vested interest"? Women and girls, whose human rights are being violated by this nonsense. Wear a dress and masturbate if you want, but you don't get to do it in public and you don't get to force women and girls to be involuntary participants in your sexual paraphilia.
I would like to ask you both how those paradigms are working out for you, but I'm sure you both are happy to keep doubling down on your extremist conservative ideologies. If you were genuinely concerned about the treatment of children, you wouldn't exclude their doctors and therapists from being able to speak on behalf of their patients, whose interests they represent. Or does representation only matter in public office, and has nothing to do with gerrymandering in order to twist the results in your favor????
We are not focusing primarily on the tiny incidence of trans people that was true historically. We are highly concerned about the inappropriate treatment of children and adolescents who are being presented by their families in epidemic numbers at gender clinics, and who are apparently suffering from other mental disorders. The issue is one of misdiagnosis, then gross mistreatment following that misunderstanding.
In addition, some of us are very skeptical or critical with regard to any young patients of the value of medically changing the appearance of a child's body to look like the other sex.
Everyone, please print and send a copy of this to at least one pediatrician in your community. And to the American Academy of Pediatricians (AAP) board in your state. Perhaps include some other great articles from this substack, along with the subscription link.
Most pediatricians are not hearing from diverse perspectives on sex-role ("gender") identity ideology, and wish to, according to an AAP survey of its members last year.
So we must supply it. This article is an excellent choice, because it concisely refutes research claims that pediatricians are reading.
**
For any of us to make good decisions, it is necessary to *read from sources from across the ideological spectrum* on any given issue, and in general.
Unfortunately, biophobes ("transgender activists") are stifling discussion and debate in medical organizations as effectively as they do in the rest of society.
They falsely and hypocritically accuse *anyone who disagrees with them of making meetings, organizations, and publications "unsafe," and "exclusionary," likely to increase "trans" suicides and violence against biophobes.
This is a slick manipulation to persuade individuals and organizations to shut their minds to any but one viewpoint.
That is what cults do.
Biophobes effectively label biological realists as "dangerous," when it is the biophobes who are promoting unfettered access to harmful, experimental medical practices: for children, teens, and adults.
So please, get this into the hands of a pediatrician and your state's AAP board.
Thank you for your very helpful article, Leor Sapir. This was a huge amount of work.
My personal beef with a lot of these "studies" is that they don't split out MTF and FTM kids. If the mental health of the boys goes up by 11% and the mental health of the girls goes down by 9%, then the mental health of the group as a whole goes up.
There's also the problem of "getting out of one's own head." People join cults, move across the country, take drugs, go to grad school, all kinds of things just because they're dissatisfied with what's happening inside their own head. I can see going on cross-gender hormones having that initial boost where different means good, but then a year later they have the same problems in a new place.
Don't we have kids who have been on blockers followed by cross-sex hormones for 10+ years now? Or who started and went off? Yet there are zero published studies?
Maybe some of these studies should follow the parents of a hundred or a thousand trans kids and see what their sense of the effectiveness of these treatments is over a 10-year period. It might be easier to find an ethical control sample, too.
Even when such studies are not rife with caveats and design limitations, what is not being discussed is the vulnerability to debilitating adjustment disorders that accompanies the chronic health problems inevitably resulting from long-term endocrine disruption.
As a means of momentarily removing the topic from all of the motivated reasoning employed, reviewing the literature analyzing emotional challenges attendant to chronic illness, can be helpful.
I have my own thoughts about sex/gender change, but recognize the need to hear both sides (remembering the explosives expert who claimed the atomic bomb could not work).
I am extremely suspicious when the major media, national government, and big tech allow only one side to be heard, and am grateful for the review of the studies presented in this article. I also look forward to seeing any responses.
Am I in the least surprised Turban lied? Not at all! Studies are open to twist and being presented to lay audiences as that which they are not, especially by ideologues with an agenda. This deserves to be published much more widely.
Please see link below for a critique and reanalysis of the raw data from the GIDS/UCLH Paediatric Endocrinology paper, Carmichael, Butler et al, 2021. Comments welcome.
Bravo, Leor Sapir! The shocking acceptance of studies where N=33 and the like, where follow-up is limited to 18 months and the like, where the subjects were convenience samples, self-selected through internet inquiries and not even vetted for natal sex vs. claimed "gender" and the like, must result in rejection of any of Turban's writings. They are fiction, relevant as any Ray Bradbury's science fiction in the mental health sphere.
As the ex-wife of a mentally unstable man, father of our children now claiming to be their mother, I can tell you there are so many complicating factors that the entire diagnosis, even of "persistent, since early childhood" individuals has in fact, never been defined scientifically. The PhD "sexologist" who diagnosed him in one appointment claimed in a sworn affidavit that I, his wife, was responsible for his decision to "live full-time as a woman" because I said this is too destructive of me, the mother raising the children, that I served divorce papers. Jack Turban and his ilk are not scientists. They are not researchers. They are political activists and influencers with financial backing from corporate pharma. By the way, my ex never smiled after he had the surgeries.
For methods to reconnect with your natal body, to have strength, vibrancy and self-awareness:
https://wordpress.com/post/uteheggengrasswidow.wordpress.com/4778
A little follow-up, just another female POV: on my blog, uteheggengrasswidow.wordpress.com, I received an inquiry from a female caregiver to elderly women. Her English was not perfect, don't know yet where she's writing from. She was sent to dress a spinal abrasion on an elderly "woman." This person insisted on being unclothed from the waist down, not necessary for the treatment, and made a show of the breast implants, then pointed to the "sports awards" trophies in amateur women's categories. This minimum wage worker never expected to wash and changed a man's bandage. Please do contact me at uteheggengrasswidow.wordpress.com if you've had a similar experience. And, be strong, love our binary world. Thanks, Colin, for linking the above comment. Do get in touch. Ute
Jack is a hack, a flack, a quack, a mountebank.
A fraud, a faker, a charlatan.
A jack off jackass.
Eager to convert all to the banana oil, bunkum, nonsense that is "transgenderism," Jack is the three-card monte scammer, the grifter, the bamboozling flimflam man who distorts, deceives, and dupes us with sophistry, trickery and chicanery.
Jack Turban is the purveyor of hoaxes and lies. The love child of Piltdown Man and Mechanical Turk
Jack Turban -- thy name is mud.
Thanks for putting all these studies and names in one place. With Nova Scotia being continuously lobbied to remove all psychiatric checks and implement “Gender Affirming Care” this will be a good reference when assessing what material they provided to the political committee they are presenting to. 
What an impressively thorough and convincing article. It's a strikingly sober assessment of the current research. It sits in stark contrast to the madness of Jack Turban's activism which is revealed to be sophistry.
i just can't understand why the push to mutilate children. what's their end game?
Societal devolution. It's emergent behavior that boundary-violating psychopaths perpetrate.
Hard to understand on anything other than a large-scale system level.
It's great that Substack authors are putting in the work to debunk claims about "gender affirming" care. It would be even better if mainstream news outlets would pay attention and start issuing corrections to their glowing articles about these "life-saving" interventions. How much longer will they continue to rely on sloppy research and the bad-faith assertions of trans activists and their allies? Will it just take a few more years of Sapir, Singal, Wright, et al. hammering away at these lies and inconsistencies? Or will it be necessary to have a few class action lawsuits filed by the people irrevocably harmed?
Great question. I recommend sending this article to each reporter and editor at your local newspaper. We can't expect them to find this info in obscure locations such as one substack. It would be far more effective for us to just supply local reporters with this info. I'll make you a deal: I will do this if you'll do this. Also, please send this to at least one local pediatrician. I include more details in my comment, below.
There is another fundamental problem with all these studies, now that gender mutilating surgery has become so political and the issue been forced down everyone's throat.
Anyone who undergoes this surgery has immense internal pressure on their psychological well-being to believe that they did the right thing and that they are now happier and less psychologically distressed. In addition, there is immense external pressure from the outside world and from their doctors to shun any thoughts of regret and to validate the medical intervention.
How do you think that will affect how the patient fills out their psychological survey? It's not just the researchers with the confirmation bias. Even worse Many patients will also has have a strong confirmation bias. This is the reason why, for clinical studies of medicines where subjective outcomes are measured, it is critical for the study to be double blinded. Unfortunately, there is no way to make gender mutilating surgery blind to either patient or physicians.
It's not just the analysis and conclusions that are corrupted, but reliability of the basic data on which those conclusions are also suspect. We saw a glimpse of that when Sapir noted how in one study a huge number of participants outright lied and said they were given puberty blockers at the age of 18, AFTER they had passed through puberty.
To get publicity for Sapir and others trying to shine a light into the despicably dishonest world of activist medicine, we need Republicans to hold hearings where Sapir and others can testify. Then their research and explanation will be in the congressional record and recorded on C-SPAN and Youtube. Conservatives can cite this testimony to fight back when the Left uses their "experts say" argument.
When people are tested with symptom surveys it is usually pretty easy to deny, minimize, or alternatively, amplify and exaggerate psych symptoms. Psychologists call this "faking good or bad," and it is a common testee strategy. People applying for jobs usually try to minimize symptoms and people who are trying to get disability payments may try to look sicker. Some symptom surveys (particularly the MMPI series) are more difficult to fake, but even so, aren't impervious.
I don't really know what the incentives currently are for adolescents to present at a gender clinic as more or less depressed, anxious, self-harming, etc. In the earlier years of gender treatment patients were selected for surgery only if they were evaluated as stable and free of other mental health issues along with trans-identification. In that case, I would expect the patients to deny symptoms both before and after surgeries. Now it appears that a high percentage of patients present themselves as distressed and as high suicide risks during psych evaluations, and the gender clinics are saying that, "People have a right to seek care regardless of what other problems they might have."
I found much of the research about gender clinic patients to be appallingly biased. Some of the articles I read explicitly instructed the reader to "frame" evidence that trans-identified adolescent patients have other diagnosable mental disorders as evidence for "minority stress" (as the one and only likely cause). These statements show extreme bias and disregard for scientific norms in research. The investigators writing up their study are not supposed to presume what caused patients' symptoms, or anything else. They are supposed to look into the problem they are studying without ruling out any variables that might be related to it. If the investigators can show that a patient's anxiety is diagnosable as situational they can move on to identify as many environmental stressors as they can think of as possible causes. It is not at all easy to meet the first requirement, showing that the patients' anxiety symptoms are like those that are caused by environmental stress, as opposed to OCD or something else. To really argue for causation the researchers have to design a longitudinal study, which takes years to complete and involves so many other logistical difficulties that doing this kind of research is almost unfeasible.
For the investigators to order the reader to "frame" an unwanted result as having been caused by "minority stress," without at least conducting an open search for all variables that potentially influence and sustain trans patients' anxiety is not research at all. It is unethical and scientific malpractice to conduct and then publish research for the preconceived purpose of selling a type of treatment that the researchers like to do.
I agree with you, it would be great if those of us who question the gender treatment industry could present in Congress the counterarguments against gender affirmative care. I find that most healthcare providers in general practices are uninformed about the controversies regarding gender clinic referrals, and this includes physicians who treat adolescents. That demographic is still typically nerdy and science-minded, especially if they graduated from medical school before the woke takeover. They could potentially be influenced if there were debates in Congress about the dissenting arguments with respect to "safe and effective treatment" of disorders focused on self-rejection of one's bio sex.
One of the main problems in combating the woke cult generally is that half the population still thinks the anti-woke effort is about "far right conspiracy theories." Getting evidence in front of the public requires doing some kind of end run around the repression of dissent in the MSM. Congress does seem to be the place people turn now when they want to get the word out about something that the MSM won't cover.
This is a long term solution but it may turn out to be the only solution. We have to discredit the MSM so much that they lose their audience. Otherwise they will have no incentive to even contemplate changing and conservative reason and evidence will lose to government directed MSM propaganda. And you have to do what the Left does so effectively to discredit the right. Frame their opponents as not just wrong but actually evil, because in this case it actually is. And it may be most effective for conservatives to do this by co-opting the language of the left. So William Thomas stealing women's swimming wins and parading her junk around the women's locker room (as well as Adidas having men model women's bathing suits and Target making women's bathings suits for men) has to be considered an evil example of "Toxic Transgender Masculinity". "Gender Affirmation" needs to be called "The Mullah's Conversion Therapy", because that's what they force upon homosexuals in Iran to punish them. And because the data says that, if you leave most of those with real gender dysphoria alone (not the huge increase in girls affected by social contagion) almost 90% of them will settle down as homosexuals, you need to call all those medical experts, activists, journalists, neighbors attacking you as a transphobe what they really are: homophobes trying to do what the mullahs are doing - committing homogenocide by sterilization. The conflagration is too big to fight fire with water, i.e. by trying to cool things down. It is time to fight fire with fire. The Left wants to exterminate the views and lives of common sense people by using the fascist collusion of powerful government and corporate coercion. We have to fight back like our lives and the lives of our children depend on it.
I emphatically agree with your position! At this point I take for granted that our country is under attack via psychological warfare. With respect to the activists, I believe we need to identify them as "the enemy," as our troops normally due during wars, and treat them accordingly. A lot of their weapons work against them, especially critical theory, which always assumes that an opponent's arguments are just covert power strategies designed to oppress somebody.
I was reading articles on Persuasion and Reason for a while but had to take a break from them because of the persistent push by their authors to treat all interactions with the woke like dialogues in which people are seeking mutual understanding. The stance being promoted by F.I.R.E. is also tilted towards protecting woke rights. Liberals have so much difficulty with accurately perceiving an enemy as such and behaving accordingly.
Regarding study 6, the comparison is between GD patients who receive CHT and non-GD subjects (who presumably did not). This seems like a pointless comparison. Not one of these studies compare GD patients who receive CHT with GD patients who do not.
Not to mention the measured endpoints are all self-reported. If you have been asking a doctor to give you a certain intervention and then they do it, of course you will say you feel better.
This really is not science at all as far as I can see.
People who aren't trans do t understand just how little research is out there. And in many respects most experts don't know what they are doing with patients who are adults or minors because of the trial-and-error nature of transgender medicine, and the tiny demographics that make research extremely difficult.
With that said, that's not entirely a bad thing and it alone should not be the definitive basis for restricting access to medical care the patient and/or their guardian and medical practitioner seems to be a reasonable option to treat underlying problems.
Historically doctors and surgeons have never fully comprehended the causes of effects of their treatment beyond "it works" or "good enough". Anesthesiologists are specialists in a field of medicine required for many procedures, yet anesthesia in of itself is not well understood.
These practitioners, like all practitioners, care enough to take a shot in the dark, they hope for the best, plan for the worst. And over the decades have gotten a good "feel" (and policies) for what to do with treatments and medicines that are still scientific enigmas.
A lot of smart people try to quantify something that can't be quantified. What's the cash value of the life of a child? Should a school bus driver with one passenger be paid more than truck drivers who handle high value and restricted loads? Should a school bus driver have much stricter training? Should school busses have more safety features?
--------------------------------------------------
My sociological bias is this: at a certain point, nuances don't matter, and it's up to the individual and/or the legal guardian to make the appropriate decision they believe is best for them.
"Believe" is also a good term to use here because of the implications of freedom of religion in conjunction with medical autonomy. But my faith is "agnostic" (don't know, don't care).
----------------------------------
I argue this: If pandering to the transgender, nonbinary, and intersexed populations was never important because transgender individuals were statistically insignificant for the past hundred years, then I assert that people who have no vested interest should not engage in any debate, research, or have any influence over a statistically insignificant population. Because there are more statistically significant individuals and other utilitarian public policies.
- Remrie
You know who has a very clear, very important "vested interest"? Women and girls, whose human rights are being violated by this nonsense. Wear a dress and masturbate if you want, but you don't get to do it in public and you don't get to force women and girls to be involuntary participants in your sexual paraphilia.
I would like to ask you both how those paradigms are working out for you, but I'm sure you both are happy to keep doubling down on your extremist conservative ideologies. If you were genuinely concerned about the treatment of children, you wouldn't exclude their doctors and therapists from being able to speak on behalf of their patients, whose interests they represent. Or does representation only matter in public office, and has nothing to do with gerrymandering in order to twist the results in your favor????
We are not focusing primarily on the tiny incidence of trans people that was true historically. We are highly concerned about the inappropriate treatment of children and adolescents who are being presented by their families in epidemic numbers at gender clinics, and who are apparently suffering from other mental disorders. The issue is one of misdiagnosis, then gross mistreatment following that misunderstanding.
In addition, some of us are very skeptical or critical with regard to any young patients of the value of medically changing the appearance of a child's body to look like the other sex.
Everyone, please print and send a copy of this to at least one pediatrician in your community. And to the American Academy of Pediatricians (AAP) board in your state. Perhaps include some other great articles from this substack, along with the subscription link.
Most pediatricians are not hearing from diverse perspectives on sex-role ("gender") identity ideology, and wish to, according to an AAP survey of its members last year.
So we must supply it. This article is an excellent choice, because it concisely refutes research claims that pediatricians are reading.
**
For any of us to make good decisions, it is necessary to *read from sources from across the ideological spectrum* on any given issue, and in general.
Unfortunately, biophobes ("transgender activists") are stifling discussion and debate in medical organizations as effectively as they do in the rest of society.
They falsely and hypocritically accuse *anyone who disagrees with them of making meetings, organizations, and publications "unsafe," and "exclusionary," likely to increase "trans" suicides and violence against biophobes.
This is a slick manipulation to persuade individuals and organizations to shut their minds to any but one viewpoint.
That is what cults do.
Biophobes effectively label biological realists as "dangerous," when it is the biophobes who are promoting unfettered access to harmful, experimental medical practices: for children, teens, and adults.
So please, get this into the hands of a pediatrician and your state's AAP board.
Thank you for your very helpful article, Leor Sapir. This was a huge amount of work.
Brilliant article!
My personal beef with a lot of these "studies" is that they don't split out MTF and FTM kids. If the mental health of the boys goes up by 11% and the mental health of the girls goes down by 9%, then the mental health of the group as a whole goes up.
There's also the problem of "getting out of one's own head." People join cults, move across the country, take drugs, go to grad school, all kinds of things just because they're dissatisfied with what's happening inside their own head. I can see going on cross-gender hormones having that initial boost where different means good, but then a year later they have the same problems in a new place.
Don't we have kids who have been on blockers followed by cross-sex hormones for 10+ years now? Or who started and went off? Yet there are zero published studies?
Maybe some of these studies should follow the parents of a hundred or a thousand trans kids and see what their sense of the effectiveness of these treatments is over a 10-year period. It might be easier to find an ethical control sample, too.
Even when such studies are not rife with caveats and design limitations, what is not being discussed is the vulnerability to debilitating adjustment disorders that accompanies the chronic health problems inevitably resulting from long-term endocrine disruption.
As a means of momentarily removing the topic from all of the motivated reasoning employed, reviewing the literature analyzing emotional challenges attendant to chronic illness, can be helpful.
I have my own thoughts about sex/gender change, but recognize the need to hear both sides (remembering the explosives expert who claimed the atomic bomb could not work).
I am extremely suspicious when the major media, national government, and big tech allow only one side to be heard, and am grateful for the review of the studies presented in this article. I also look forward to seeing any responses.
Am I in the least surprised Turban lied? Not at all! Studies are open to twist and being presented to lay audiences as that which they are not, especially by ideologues with an agenda. This deserves to be published much more widely.
Thanks
Please see link below for a critique and reanalysis of the raw data from the GIDS/UCLH Paediatric Endocrinology paper, Carmichael, Butler et al, 2021. Comments welcome.
https://www.medrxiv.org/content/10.1101/2023.05.30.23290763v3