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Affirmation model as gay conversion therapy


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Things we do know:

The vast majority of kids that do ID as nonconforming eventually do settle in to their gender assigned at birth. 

The threshold for prescribing drugs that delay puberty is low because they're understood to be safe and reversible, unlike actual hormone administration or puberty, which has many very well known irreversible effects.

End of the day, what they effectively do is buy some time while the kid in question figures it out. 

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18 minutes ago, AUDub said:

They're generally understood to be safe and reversible. We have been using these drugs to delay precocious puberty for a while. 

There are no known certainties with regard to adverse effects, but there are open questions with regard to bone density and height. 

Claimed to be safe and reversible by those who want them to be. Not known. Probably relatively safe when used as originally intended— delaying an 8 year old’s early puberty to 12 or so, and letting it resume. Not delaying it indefinitely until cross hormones are administered. 

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10 hours ago, savorytiger said:

The question is...does it matter?

Does reality matter?  I’m not talking about *your* reality just reality.

Is it appropriate to require other people to call you by your *preferred pronouns*?

10 hours ago, savorytiger said:

Also, outside of a religous argument, is there a reason to view it as a negative in the first place?

There are a lot of stories out there about regretting transitioning by the ones that have been transitioned at an early age.  Why did these individuals feel the need to have the transition done so early?  Who applied the pressure?  Would it have been better to wait until the mind of the child progressed?  Basically, why the rush?  Why are the schools teaching and encouraging such behavior?  Why are the medical professionals doing the same?

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6 minutes ago, AUDub said:

End of the day, what they effectively do is buy some time while the kid in question figures it out. 

How does a kid figure it out when the blockers do not allow nature to take its course?  The deck seems to be stacked.

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12 minutes ago, TexasTiger said:

Claimed to be safe and reversible by those who want them to be. Not known. Probably relatively safe when used as originally intended— delaying an 8 year old’s early puberty to 12 or so, and letting it resume. Not delaying it indefinitely until cross hormones are administered. 

We have 3 decades or so of data on precocious puberty that blocking puberty is safe and effective, though obviously that's a different population. Given the demographics of precocious puberty - something like 90% female - almost all the studies were done on girls - so the data admittedly isn't as robust for boys.

Most of the data for blocking trans puberty is extrapolation from there, but there have been some small studies and it appears to be just as safe and reversible with regard to physiology. We don't have any data implying otherwise at least, except for the open questions of bone health and height I brought up above.

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7 minutes ago, I_M4_AU said:

How does a kid figure it out when the blockers do not allow nature to take its course?  The deck seems to be stacked.

It's a dilemma. Psychology in teens is such a mess as it is. 

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15 minutes ago, AUDub said:

 

We have 3 decades or so of data on precocious puberty that blocking puberty is safe and effective, though obviously that's a different population. Given the demographics of precocious puberty - something like 90% female - almost all the studies were done on girls - so the data admittedly isn't as robust for boys.

Most of the data for blocking trans puberty is extrapolation from there, but there have been some small studies and it appears to be just as safe and reversible with regard to physiology. We don't have any data implying otherwise at least, except for the open questions of bone health and height I brought up above.

“Except for bone health and height?” Just irreversible bone health? How do you dismiss bone health as insignificant? And height? Delaying puberty UNTIL normal puberty age is totally different than delaying normal puberty age. You can’t meaningfully extrapolate from one for the other. And it’s a pathway— the vast majority put on that path are transitioned to cross sex hormones. 

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26 minutes ago, TexasTiger said:

“Except for bone health and height?” Just irreversible bone health? How do you dismiss bone health as significant? And height? Delaying puberty UNTIL normal puberty age is totally different than delaying normal puberty age. You can’t meaningfully extrapolate from one for the other. And it’s a pathway— the vast majority put on that path are transitioned to cross sex hormones. 

I don't. I said they're open questions. We're still gathering data on that to figure out if these claims are clinically significant. 

And I can't really say with certainty that these changes are irreversible. I'm a lay endocrinologist but do know the basics. Our epiphyseal plates don't close until puberty in response to estrogen and we don't hit peak bone mass until our 20s. It's quite possible time and treatment could rectify any potential issues. 

Finally, regarding "pathways:" again, it's a dilemma. You can't really get good numbers there unless you're denying treatment to a subset while treating another, which would be highly unethical. That's not to say that no scientific results would emerge, just that those that did emerge would be obscured by the horror of systematically denying treatment for what is quite possibly a perfectly treatable disease. Think Tuskegee, for example. 

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And before someone spins "Dub just called puberty a disease!" I'm quite obviously referring to gender dysphoria. 

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I think one of the big issues here is that a lot of prominent trans advocates are speaking/evangelizing on the long-term safety of puberty blockers and cross-sex hormones with far more confidence and certainty than the data warrants.  And they often suggest or outright insist that to point out or question the safety of it is transphobic or "doing violence" to trans people.   They won't even allow for the discussion to really be had in a serious way because they want to present the entire enterprise as settled science when it's far from it.

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5 minutes ago, AUDub said:

I don't. I said they're open questions. We're still gathering data on that to figure out if these claims are clinically significant. 

And I can't really say with certainty that these changes are irreversible. I'm a lay endocrinologist but do know the basics. Our epiphyseal plates don't close until puberty in response to estrogen and we don't hit peak bone mass until our 20s. It's quite possible time and treatment could rectify any potential issues. 

Finally, regarding "pathways:" again, it's a dilemma. You can't really get good numbers there unless you're denying treatment to a subset while treating another, which would be highly unethical. That's not to say that no scientific results would emerge, just that those that did emerge would be obscured by the horror of systematically denying treatment for what is quite possibly a perfectly treatable disease. Think Tuskegee, for example. 

It’s far from clear there aren’t irreversible side effects even when used to delay precocious puberty. 
 

https://www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

Transmen tend to rapidly respond to testosterone post-puberty— facial hair, deeper voice, larger muscles and for some, balding. Experiencing female puberty didn’t prevent their physical transitioning in a convincing way. But those changes are permanent. The voice does not return after stopping testosterone. Ignore the fact that Ngo posted this. Listen to this young lady’s story:

 

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45 minutes ago, AUDub said:

It's a dilemma. Psychology in teens is such a mess as it is. 

I agree, I’m glad I’m through that as a parent.

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2 minutes ago, TitanTiger said:

I think one of the big issues here is that a lot of prominent trans advocates are speaking/evangelizing on the long-term safety of puberty blockers and cross-sex hormones with far more confidence and certainty than the data warrants.  And they often suggest or outright insist that to point out or question the safety of it is transphobic or "doing violence" to trans people.   They won't even allow for the discussion to really be had in a serious way because they want to present the entire enterprise as settled science when it's far from it.

People with facts & science on their side don’t act this way. Genuine inquiry into the unknown is not transphobic.

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5 minutes ago, TitanTiger said:

I think one of the big issues here is that a lot of prominent trans advocates are speaking/evangelizing on the long-term safety of puberty blockers and cross-sex hormones with far more confidence and certainty than the data warrants.  And they often suggest or outright insist that to point out or question the safety of it is transphobic or "doing violence" to trans people.   They won't even allow for the discussion to really be had in a serious way because they want to present the entire enterprise as settled science when it's far from it.

Two things can be true at the same time.

Yes, I'm exhausted with the trans movement and the cultural veto power they have. They and their advocates on Twitter are some of the most annoying and toxic people out there.

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4 minutes ago, I_M4_AU said:

I agree, I’m glad I’m through that as a parent.

My oldest was convinced she was gay lol. She's not and grew out of it. Even her psychologist didn't really buy that one. Not that she told her that, but you definitely got eye rolls when addressing it with the shrink in private lol. 

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6 minutes ago, TexasTiger said:

People with facts & science on their side don’t act this way. Genuine inquiry into the unknown is not transphobic.

 

4 minutes ago, AUDub said:

They and their advocates on Twitter are some of the most annoying and toxic people out there.

 

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2 minutes ago, AUDub said:

My oldest was convinced she was gay lol. She's not and grew out of it. Even her psychologist didn't really buy that one. Not that she told her that, but you definitely got eye rolls when addressing it with the shrink in private lol. 

I’m glad she was allowed to see for herself, a win/win.

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Just now, I_M4_AU said:

I’m glad she was allowed to see for herself, a win/win.

That's the key. She had to figure it out for herself. We neither affirmed or denied it.

Just roll with the punches lol. 

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43 minutes ago, AUDub said:

That's the key. She had to figure it out for herself. We neither affirmed or denied it.

Just roll with the punches lol. 

Exploring identity issues around sexuality and gender seems to be a defining characteristic of this generation— let them explore and consider with love & support, but not undue encouragement to pursue a particular direction and certainly not medicalization.

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30 minutes ago, TexasTiger said:

Exploring identity issues around sexuality and gender seems to be a defining characteristic of this generation— let them explore and consider with love & support, but not undue encouragement and certainly not medicalization.

We're dealing with unique challenges in this day and age. Who would you prefer has the final say? I choose the physicians. Sometimes they get it wrong, the vast majority of time they get it right. I'll leave it to them. 

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8 minutes ago, AUDub said:

We're dealing with unique challenges in this day and age. Who would you prefer has the final say? I choose the physicians. Sometimes they get it wrong, the vast majority of time they get it right. I'll leave it to them. 

I want there to be more responsibility within professions making decisions with lifelong impacts. I don’t see that with the AMA or APA on these issues. It’s been eye opening. They’ve become deeply politicized, ignoring what they’ve always known about the pre-frontal cortex. The lawsuits are going to be epic.

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1 hour ago, TitanTiger said:

I think one of the big issues here is that a lot of prominent trans advocates are speaking/evangelizing on the long-term safety of puberty blockers and cross-sex hormones with far more confidence and certainty than the data warrants.  And they often suggest or outright insist that to point out or question the safety of it is transphobic or "doing violence" to trans people.   They won't even allow for the discussion to really be had in a serious way because they want to present the entire enterprise as settled science when it's far from it.

At a minimum it's the application of unnatural medical methods (not really science) to alter natural biological chemistry.  I agree with your point, a very serious question needs to be asked "what are the long term side effects", which I would assume, if honestly reported, are serious. But in the end, no matter the medical issues, it will be like talking to someone who smokes concerning the bad things that come with unnatural chemical consumption with a response something like..."hey I've got to die from something, plus my mom's great grandmother's cousin's second child lived to be 95 and she smoked".

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2 hours ago, I_M4_AU said:

Does reality matter?  I’m not talking about *your* reality just reality.

Is it appropriate to require other people to call you by your *preferred pronouns*?

There are a lot of stories out there about regretting transitioning by the ones that have been transitioned at an early age.  Why did these individuals feel the need to have the transition done so early?  Who applied the pressure?  Would it have been better to wait until the mind of the child progressed?  Basically, why the rush?  Why are the schools teaching and encouraging such behavior?  Why are the medical professionals doing the same?

Okay, we're definitely not talking about the same things. I'll clarify: you brought up data about a growing number of people who are LGBTQ, and I responded about whether it matters. Does that growing number have a negative effect on society? 

Aaand now you're moving on to a completely different topic: early transitions. I don't really think I know enough about early transitions to make up my mind. If mistakes happen what is reversable and what isn't? What are the chances that a mistake could occur? How much does quality of life improve after such a transition (hey maybe this is related to your question about why they would like the transition done early)? Does an early transition open up options like fairly participating in sports competitions where a late transition is now imo a fairly gray area? A lot of this is already mentioned in this thread, but I haven't seen enough actual sources to go either way on it.

Oh and as a cis straight male, I'd certainly prefer to be called he/him and be very confused otherwise. If someone were to purposefully to try to push a different pronoun, I'd probably be offended? This is a pretty straightforward topic for me (note I do understand other people have differing points of view on the issue). If someone wishes to be called a pronoun different from what I perceive, I'll make an attempt to change what I say and they shouldn't be offended if I make a mistake. Requirements are silly, and intent matters. 

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17 minutes ago, TexasTiger said:

I want there to be more responsibility within professions making decisions with lifelong impacts. I don’t see that with the AMA or APA on these issues. They’ve become deeply politicized, ignoring what they’ve always known about the pre-frontal cortex. The lawsuits are going to be epic.

I think that's largely a myth, to be honest. There are some bad physicians,  sure, but the vast majority of the field take their oath seriously.

The core idea of gender affirmative care is not to blindly affirm trans youth, but to provide a safe space for a differential diagnoses and treatment. As a term of art, the affirmatives in "gender affirmative model" or "gay affirmative model" are no more about making kids trans or gay than the affirmative in "disability affirmative model" is about making patients disabled. It's to remove notional biases that may hinder treatment. 

I'm no psych, but if treating a patient conditioned to hate themselves, it makes sense. 

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I think the biggest issue is that certain parts of society have taken a serious medical condition and made it trendy, for lack of a better term. 

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