Dylan Mulvaney

[TitanTiger 20,498]

1 minute ago, icanthearyou said:

That is not what I am doing.  I have said several times that there is little data due to privacy concerns.  The fact that you have to manufacture your case from other countries should tell you something.

You asserted that the US is more conservative than other countries (such as Netherlands) on gender reassignment surgeries based on...vapor.  Then when challenged on it, have said "well it's hard to find" and now are trying to push it on me to show one way or the other.

There's nothing wrong with the example I posed and the fact that it was from another country has no bearing on the validity of the concern.  You're now just trying to shoehorn an assumption into the conversation that you've yet to prove.

[icanthearyou 4,463]

1 minute ago, TitanTiger said:

You asserted that the US is more conservative than other countries (such as Netherlands) on gender reassignment surgeries based on...vapor.  Then when challenged on it, have said "well it's hard to find" and now are trying to push it on me to show one way or the other.

There's nothing wrong with the example I posed and the fact that it was from another country has no bearing on the validity of the concern.  You're now just trying to shoehorn an assumption into the conversation that you've yet to prove.

Your not being honest.  I have said several times that data here is very limited.  However, that does not change the fact that these treatments began in Europe.  That alone should tell you something.  The comparison of numbers means something.

You do not agree that the U.S. has been much more conservative than Europe in the treatment of gender dysphoria?   Did you check the date of the treatment in your original post.  We are not the leaders in this area.

 

[TitanTiger 20,498]

4 minutes ago, icanthearyou said:

Your not being honest.  I have said several times that data here is very limited.  However, that does not change the fact that these treatments began in Europe.  That alone should tell you something.  The comparison of numbers means something.

No, you're not being honest.  Or you simply type stuff randomly without giving a second of thought as to the meanings of words.  Your posts:

 

I do think it is important to understand that the medical community in this country has taken a more cautious, less experimental approach.

https://www.aufamily.com/topic/186824-dylan-mulvaney/?do=findComment&comment=3730161

 

Then when I said the same procedures were happening here, you said:

With much greater caution.  Surgeries are difficult to obtain data for but,,, by most accounts only mastectomies and, only on patients 16 and older and, are very rare.

https://www.aufamily.com/topic/186824-dylan-mulvaney/?do=findComment&comment=3730164

 

Then when I said to provide some evidence for the claim that the US takes a more cautious approach, you did mention the dearth of data, but then ended again with the implication that this example being from another country somehow makes it less reliable:

Look at the data that is available.  The numbers are quite low just in terms of patients being treated.  Look at the number of dissatisfied patients.  Again, numbers are low.

Sort of the point, every time the issue comes up, many of the examples given are from other countries.

https://www.aufamily.com/topic/186824-dylan-mulvaney/?do=findComment&comment=3730166

 

 

4 minutes ago, icanthearyou said:

You do not agree that the U.S. has been much more conservative than Europe in the treatment of gender dysphoria?

Again, this is your contention.  Throwing the question back to me isn't evidence.  Demonstrate your contention or drop the insinuation.

 

4 minutes ago, icanthearyou said:

  Did you check the date of the treatment in your original post.  We are not the leaders in this area.

You realize that case wasn't some pioneering effort, right?

[wdefromtx 3,159]

17 minutes ago, icanthearyou said:

Your not being honest.  I have said several times that data here is very limited.  However, that does not change the fact that these treatments began in Europe.  That alone should tell you something.  The comparison of numbers means something.

You do not agree that the U.S. has been much more conservative than Europe in the treatment of gender dysphoria?   Did you check the date of the treatment in your original post.  We are not the leaders in this area.

 

Let me get this straight….you are trying to say that Titan is being dishonest about this? Don’t get me wrong….I don’t really agree with much of what he says but let’s call a spade a spade…you are being dishonest and disingenuous. He provided back up to his stance and you just rattled something out of your brain. You also tried to discredit what he said because it wasn’t the US. 
 

[icanthearyou 4,463]

This, very long article comprises about everything I know on the subject.   https://www.nytimes.com/2022/06/15/magazine/gender-therapy.html

My statement was largely based on this quote: "As the United States battled over whether gender-related care should be banned or made more accessible, a few European countries that had some liberal practices concerning young people seeking medication imposed new limits recently."

I agree with you Titan and with you, fromtx.  I was reaching.  I apologize.

 

[icanthearyou 4,463]

BTW, I think the article in my post above is a very good, albeit, long assessment.  It's worth the effort.  I also think it demonstrates a lot about the intentions on all sides of the multiple arguments.

 

[TexasTiger 12,947]

5 hours ago, icanthearyou said:

BTW, I think the article in my post above is a very good, albeit, long assessment.  It's worth the effort.  I also think it demonstrates a lot about the intentions on all sides of the multiple arguments.

 

That is a pretty good article. Pretty balanced and informative . She was absolutely skewered for it and accused of trying to “eliminate trans people” after writing it. Reportedly spat on. This article was a key to the complaint 100 NYTIMES contributors sent a letter unfair coverage of the issue. The response was unhinged in my view. Untethered from reality. The editor stood up for her. She’s a excellent journalist.

https://www.nbcnews.com/news/amp/rcna70800

[TitanTiger 20,498]

6 hours ago, TexasTiger said:

That is a pretty good article. Pretty balanced and informative . She was absolutely skewered for it and accused of trying to “eliminate trans people” after writing it. Reportedly spat on. This article was a key to the complaint 100 NYTIMES contributors sent a letter unfair coverage of the issue. The response was unhinged in my view. Untethered from reality. The editor stood up for her. She’s a excellent journalist.

https://www.nbcnews.com/news/amp/rcna70800

Unhinged is the perfect word for it.  We've reached a point where certain subjects are all but impossible to discuss rationally because emotional commitments trump critical analysis and facts.  No one is willing to do real scientific research because there's only one conclusion that will be accepted.  Reaching an unfavored conclusion could be a career ending action.

[TitanTiger 20,498]

This passage to me is Exhibit A for "Unhinged."  The people who react this way to even the most lenient of basic guard rails...I cannot fathom why such people get to be part of the accepted, trusted conversation on these matters:

The group was stocked with experts, including Leibowitz’s co-leader for the adolescent chapter, the Dutch child psychiatrist Annelou de Vries, who for 19 years has worked at what was the first transgender pediatric clinic in the world, and the clinical psychologist Ren Massey, who is a former president of the Georgia Psychological Association and is transgender. When WPATH released the draft of the SOC8 for public comment, Leibowitz and his co-authors braced for the inevitable conservative attack. For teenagers who have parental consent, the draft adolescent chapter lowered to 14 (from 16 in the previous guidelines) the recommended minimum age for hormone treatments, which can permanently alter, in a matter of months, voice depth and facial and body hair growth and, later, other features like breast development. It set a minimum recommended age of 15, for breast removal or augmentation, also called top surgery. (The previous standards didn’t set a minimum age.)

Opponents of gender-related care did, indeed, denounce all of this. But Leibowitz and his co-authors also faced fury from providers and activists within the transgender world. This response hit them harder, as criticism from your colleagues and allies often does. It arose from two of the conditions the draft chapter established in order for young people to start taking puberty suppressants and hormones. First, the draft said, preteens and teenagers should provide evidence of “several years” of persistently identifying as, or behaving typically like, another gender, to distinguish kids with a long history from those whose stated identification is recent. And second, they should undergo a comprehensive diagnostic assessment, for the purpose of understanding the psychological and social context of their gender identity and how it might intersect with other mental-health conditions.

Assessments for children and adolescents have long been integral to the Standards of Care. But this time, the guard rails were anathema to some members of a community that has often been failed by health care providers. “The adolescent chapter is the worst,” Colt St. Amand, a family-medicine physician at the Mayo Clinic and a clinical psychologist, posted on the Facebook page of International Transgender Health, which has thousands of members and functions as a bulletin board for the field. (St. Amand is on the working group for another chapter in the SOC8 on hormone treatments.) In a publicly streamed discussion on YouTube on Dec. 5, activists and experts criticized the adolescent chapter, with the emotion born of decades of discrimination and barriers to care. “This statement sucks,” Kelley Winters, a moderator of International Transgender Health who is an interdisciplinary scholar and community advocate in the field, said of the assessment. “This is talking about singling out trans kids, and specifically with a mental-health provider, not medical staff, to interrogate, to go down this comprehensive inquisition of their gender.” The requirement for evidence of several years of gender incongruity before medical treatment is “harmful and destructive and abusive and unethical and immoral,” said Antonia D’orsay, another moderator of the group who is a sociologist and psychologist. In January, in a public comment to WPATH, International Transgender Health blasted the adolescent chapter for “harmful assertion of psychogatekeeping” that “undermines patient autonomy.”

Let's be clear about what this reveals.  These are not anonymous randos on Reddit or Twitter spouting these irrational reactions.  They are well-known scholars, activists, sociologists and psychologists and they are seething at the idea that even the most common sense steps such as a child showing several years of persistently behaving like the other gender or expressing a desire to be the other gender, or meeting with a mental-health provider to confirm these things not as merely unnecessary or inconvenient but "harmful and destructive and abusive and unethical and immoral."  How do you respect the views of someone who behaves this disconnected from reality and prudence?

This isn't the behavior of medical professionals or scientists searching for truth.  It's the kind of behavior you see from members of a cult.

 

[TexasTiger 12,947]

1 hour ago, TitanTiger said:

This passage to me is Exhibit A for "Unhinged."  The people who react this way to even the most lenient of basic guard rails...I cannot fathom why such people get to be part of the accepted, trusted conversation on these matters:

The group was stocked with experts, including Leibowitz’s co-leader for the adolescent chapter, the Dutch child psychiatrist Annelou de Vries, who for 19 years has worked at what was the first transgender pediatric clinic in the world, and the clinical psychologist Ren Massey, who is a former president of the Georgia Psychological Association and is transgender. When WPATH released the draft of the SOC8 for public comment, Leibowitz and his co-authors braced for the inevitable conservative attack. For teenagers who have parental consent, the draft adolescent chapter lowered to 14 (from 16 in the previous guidelines) the recommended minimum age for hormone treatments, which can permanently alter, in a matter of months, voice depth and facial and body hair growth and, later, other features like breast development. It set a minimum recommended age of 15, for breast removal or augmentation, also called top surgery. (The previous standards didn’t set a minimum age.)

Opponents of gender-related care did, indeed, denounce all of this. But Leibowitz and his co-authors also faced fury from providers and activists within the transgender world. This response hit them harder, as criticism from your colleagues and allies often does. It arose from two of the conditions the draft chapter established in order for young people to start taking puberty suppressants and hormones. First, the draft said, preteens and teenagers should provide evidence of “several years” of persistently identifying as, or behaving typically like, another gender, to distinguish kids with a long history from those whose stated identification is recent. And second, they should undergo a comprehensive diagnostic assessment, for the purpose of understanding the psychological and social context of their gender identity and how it might intersect with other mental-health conditions.

Assessments for children and adolescents have long been integral to the Standards of Care. But this time, the guard rails were anathema to some members of a community that has often been failed by health care providers. “The adolescent chapter is the worst,” Colt St. Amand, a family-medicine physician at the Mayo Clinic and a clinical psychologist, posted on the Facebook page of International Transgender Health, which has thousands of members and functions as a bulletin board for the field. (St. Amand is on the working group for another chapter in the SOC8 on hormone treatments.) In a publicly streamed discussion on YouTube on Dec. 5, activists and experts criticized the adolescent chapter, with the emotion born of decades of discrimination and barriers to care. “This statement sucks,” Kelley Winters, a moderator of International Transgender Health who is an interdisciplinary scholar and community advocate in the field, said of the assessment. “This is talking about singling out trans kids, and specifically with a mental-health provider, not medical staff, to interrogate, to go down this comprehensive inquisition of their gender.” The requirement for evidence of several years of gender incongruity before medical treatment is “harmful and destructive and abusive and unethical and immoral,” said Antonia D’orsay, another moderator of the group who is a sociologist and psychologist. In January, in a public comment to WPATH, International Transgender Health blasted the adolescent chapter for “harmful assertion of psychogatekeeping” that “undermines patient autonomy.”

Let's be clear about what this reveals.  These are not anonymous randos on Reddit or Twitter spouting these irrational reactions.  They are well-known scholars, activists, sociologists and psychologists and they are seething at the idea that even the most common sense steps such as a child showing several years of persistently behaving like the other gender or expressing a desire to be the other gender, or meeting with a mental-health provider to confirm these things not as merely unnecessary or inconvenient but "harmful and destructive and abusive and unethical and immoral."  How do you respect the views of someone who behaves this disconnected from reality and prudence?

This isn't the behavior of medical professionals or scientists searching for truth.  It's the kind of behavior you see from members of a cult.

 

Several years ago, young people with dysphoria were treated by healthcare professionals out of the media spotlight and absent a political movement and a financially motivated element of the medical industry. They could explore each individual’s situation privately without numerous outside influences. For some, transition would be deemed an appropriate course of action. Now, there’s a movement and a huge social media apparatus that markets “trans joy” to adolescents at the most awkward and frustrating point in their lives. Therapy & treatment is often secondary to these forces that impact young people every day for hours. They often seek a medical care with a plan they’ve gotten from social media. This is the problem. It distorts the process. Any effort to slow the plan is dismissed as “gatekeeping” and thwarting patient autonomy.

[homersapien 11,385]

Hardly sounds like an issue that's ripe for a legislative solution.  

Edited April 26, 2023 by homersapien

[TexasTiger 12,947]

There’s a lot of talk about bigots not wanting certain categories of people to “exist.” The changes in language those folks promote suggest it’s not actually who they point the finger at. This silliness is a distraction that makes it harder to keep the focus on acceptance and compassion.

[DKW 86 7,426]

10 hours ago, TitanTiger said:

This passage to me is Exhibit A for "Unhinged."  The people who react this way to even the most lenient of basic guard rails...I cannot fathom why such people get to be part of the accepted, trusted conversation on these matters:

The group was stocked with experts, including Leibowitz’s co-leader for the adolescent chapter, the Dutch child psychiatrist Annelou de Vries, who for 19 years has worked at what was the first transgender pediatric clinic in the world, and the clinical psychologist Ren Massey, who is a former president of the Georgia Psychological Association and is transgender. When WPATH released the draft of the SOC8 for public comment, Leibowitz and his co-authors braced for the inevitable conservative attack. For teenagers who have parental consent, the draft adolescent chapter lowered to 14 (from 16 in the previous guidelines) the recommended minimum age for hormone treatments, which can permanently alter, in a matter of months, voice depth and facial and body hair growth and, later, other features like breast development. It set a minimum recommended age of 15, for breast removal or augmentation, also called top surgery. (The previous standards didn’t set a minimum age.)

Opponents of gender-related care did, indeed, denounce all of this. But Leibowitz and his co-authors also faced fury from providers and activists within the transgender world. This response hit them harder, as criticism from your colleagues and allies often does. It arose from two of the conditions the draft chapter established in order for young people to start taking puberty suppressants and hormones. First, the draft said, preteens and teenagers should provide evidence of “several years” of persistently identifying as, or behaving typically like, another gender, to distinguish kids with a long history from those whose stated identification is recent. And second, they should undergo a comprehensive diagnostic assessment, for the purpose of understanding the psychological and social context of their gender identity and how it might intersect with other mental-health conditions.

Assessments for children and adolescents have long been integral to the Standards of Care. But this time, the guard rails were anathema to some members of a community that has often been failed by health care providers. “The adolescent chapter is the worst,” Colt St. Amand, a family-medicine physician at the Mayo Clinic and a clinical psychologist, posted on the Facebook page of International Transgender Health, which has thousands of members and functions as a bulletin board for the field. (St. Amand is on the working group for another chapter in the SOC8 on hormone treatments.) In a publicly streamed discussion on YouTube on Dec. 5, activists and experts criticized the adolescent chapter, with the emotion born of decades of discrimination and barriers to care. “This statement sucks,” Kelley Winters, a moderator of International Transgender Health who is an interdisciplinary scholar and community advocate in the field, said of the assessment. “This is talking about singling out trans kids, and specifically with a mental-health provider, not medical staff, to interrogate, to go down this comprehensive inquisition of their gender.” The requirement for evidence of several years of gender incongruity before medical treatment is “harmful and destructive and abusive and unethical and immoral,” said Antonia D’orsay, another moderator of the group who is a sociologist and psychologist. In January, in a public comment to WPATH, International Transgender Health blasted the adolescent chapter for “harmful assertion of psychogatekeeping” that “undermines patient autonomy.”

Let's be clear about what this reveals.  These are not anonymous randos on Reddit or Twitter spouting these irrational reactions.  They are well-known scholars, activists, sociologists and psychologists and they are seething at the idea that even the most common sense steps such as a child showing several years of persistently behaving like the other gender or expressing a desire to be the other gender, or meeting with a mental-health provider to confirm these things not as merely unnecessary or inconvenient but "harmful and destructive and abusive and unethical and immoral."  How do you respect the views of someone who behaves this disconnected from reality and prudence?

This isn't the behavior of medical professionals or scientists searching for truth.  It's the kind of behavior you see from members of a cult.

 

How dare you be rational when there is a BS Narrative not being hailed as religious canon... "Democracy is at stake!" <fer>

[TitanTiger 20,498]

I think this article does an excellent job contrasting the Dutch/European approach in recent years to the US approach:

https://www.city-journal.org/article/affirming-deception

Read the whole thing, but I thought this was a particularly illustrative example of the differences:

One of the main public relations strategies of “gender-affirming care” advocates is to deny that the model of treatment being used in American clinics differs in any significant way with the one now used in European clinics. Over the past two years, and following systematic reviews of evidence, health authorities in Sweden, Finland, and the U.K. have agreed that no evidence exists that the benefits of puberty blockers and cross-sex hormones outweigh the risks. All three countries have since imposed measures to reduce drastically the accessibility of these drugs to teenagers.

Just two weeks ago, the World Professional Association for Transgender Health (WPATH)—a U.S.-based promoter of “gender affirmation” that now recognizes “eunuch” as a valid childhood “gender identity”—was still insisting that Europe’s only change was a decision by health authorities to conduct “more studies” and gather data. But with evidence of the actual changes increasingly hard to deny, WPATH has now finally had to reckon with reality.

....

The third key point of divergence between the affirmative and Dutch protocols concerns how to understand and what to do about co-occurring mental-health problems in clinically referred adolescents. In recent years, Western countries have observed a change in the main cohort presenting at their gender clinics. In the Dutch study, most of the minors were boys. Candidates were eligible for puberty suppression only if they had early-onset “gender identity disorder,” supportive families, and no serious co-occurring mental-health problems. In contrast, most referrals to pediatric gender clinics over the past decade have been teenage girls with no prepubertal history of dysphoria and with high rates of such mental-health problems as anxiety, depression, ADHD, and autism.

The Cass report, for instance, found that about one-third of the adolescents referred to Tavistock’s gender identity service for treatment had autism or some other neuroatypical condition. Finland’s Council for Choices in Healthcare reported that “psychiatric disorders and developmental difficulties may predispose a young person to the onset of gender dysphoria.” One plausible explanation for why transgender-identified teenagers exhibit such high rates of suicidal ideation and behavior, then, is that minors—specifically teenage girls—with preexisting mental health problems including suicidality are more likely to identify as trans.

Affirmative-model proponents argue that co-occurring mental-health problems should always be presumed as secondary to—meaning, caused by—unaffirmed gender identity and lack of social acceptance for transgender people. This belief system is known as the “minority stress” model, and it is important to clarify that, as with many other claims made on behalf of gender identity and medicine, it is borrowed from research on homosexuality. Practitioners of the Dutch approach, by contrast, argue that the causes of mental-health problems should be investigated and treated prior to gender transition, on the view that these might be causing the gender issues rather than the other way around, and that a less invasive psychotherapeutic approach is likely to be less risky than drugs and surgeries.

Not only are co-occurring mental-health problems not a red flag for medication, according to the affirmative model, but if anything, their presence makes “gender-affirming” drugs even more urgent. As Diana Tordoff, lead author of a controversial study done earlier this year at Seattle Children’s Hospital, admitted in response to a critic, “the only instances when it would have been appropriate to delay initiation of [puberty blockers and cross-sex hormones] is if there was a concern that a patient did not have the capacity to provide informed consent (which is exceedingly rare in adolescence). Therefore, youth who reported moderate to severe depression, anxiety, or suicidal thoughts were not precluded access to [these drugs], especially since initiating [them] is known to improve or mitigate these symptoms.” This was a remarkable thing for Tordoff to say, considering that the point of her study was to discover whether “gender affirming” drugs are needed to “mitigate these symptoms.”

 

 

[TexasTiger 12,947]

1 hour ago, TitanTiger said:

I think this article does an excellent job contrasting the Dutch/European approach in recent years to the US approach:

https://www.city-journal.org/article/affirming-deception

Read the whole thing, but I thought this was a particularly illustrative example of the differences:

One of the main public relations strategies of “gender-affirming care” advocates is to deny that the model of treatment being used in American clinics differs in any significant way with the one now used in European clinics. Over the past two years, and following systematic reviews of evidence, health authorities in Sweden, Finland, and the U.K. have agreed that no evidence exists that the benefits of puberty blockers and cross-sex hormones outweigh the risks. All three countries have since imposed measures to reduce drastically the accessibility of these drugs to teenagers.

Just two weeks ago, the World Professional Association for Transgender Health (WPATH)—a U.S.-based promoter of “gender affirmation” that now recognizes “eunuch” as a valid childhood “gender identity”—was still insisting that Europe’s only change was a decision by health authorities to conduct “more studies” and gather data. But with evidence of the actual changes increasingly hard to deny, WPATH has now finally had to reckon with reality.

....

The third key point of divergence between the affirmative and Dutch protocols concerns how to understand and what to do about co-occurring mental-health problems in clinically referred adolescents. In recent years, Western countries have observed a change in the main cohort presenting at their gender clinics. In the Dutch study, most of the minors were boys. Candidates were eligible for puberty suppression only if they had early-onset “gender identity disorder,” supportive families, and no serious co-occurring mental-health problems. In contrast, most referrals to pediatric gender clinics over the past decade have been teenage girls with no prepubertal history of dysphoria and with high rates of such mental-health problems as anxiety, depression, ADHD, and autism.

The Cass report, for instance, found that about one-third of the adolescents referred to Tavistock’s gender identity service for treatment had autism or some other neuroatypical condition. Finland’s Council for Choices in Healthcare reported that “psychiatric disorders and developmental difficulties may predispose a young person to the onset of gender dysphoria.” One plausible explanation for why transgender-identified teenagers exhibit such high rates of suicidal ideation and behavior, then, is that minors—specifically teenage girls—with preexisting mental health problems including suicidality are more likely to identify as trans.

Affirmative-model proponents argue that co-occurring mental-health problems should always be presumed as secondary to—meaning, caused by—unaffirmed gender identity and lack of social acceptance for transgender people. This belief system is known as the “minority stress” model, and it is important to clarify that, as with many other claims made on behalf of gender identity and medicine, it is borrowed from research on homosexuality. Practitioners of the Dutch approach, by contrast, argue that the causes of mental-health problems should be investigated and treated prior to gender transition, on the view that these might be causing the gender issues rather than the other way around, and that a less invasive psychotherapeutic approach is likely to be less risky than drugs and surgeries.

Not only are co-occurring mental-health problems not a red flag for medication, according to the affirmative model, but if anything, their presence makes “gender-affirming” drugs even more urgent. As Diana Tordoff, lead author of a controversial study done earlier this year at Seattle Children’s Hospital, admitted in response to a critic, “the only instances when it would have been appropriate to delay initiation of [puberty blockers and cross-sex hormones] is if there was a concern that a patient did not have the capacity to provide informed consent (which is exceedingly rare in adolescence). Therefore, youth who reported moderate to severe depression, anxiety, or suicidal thoughts were not precluded access to [these drugs], especially since initiating [them] is known to improve or mitigate these symptoms.” This was a remarkable thing for Tordoff to say, considering that the point of her study was to discover whether “gender affirming” drugs are needed to “mitigate these symptoms.”

 

 

Same guy following the Oregon legislation where Democrats, like Republicans in red states, go overboard in the other direction. Insurance covers everything related to transition, but not detransition? Do they care about people or not?

 

[icanthearyou 4,463]

On 4/26/2023 at 8:10 AM, TitanTiger said:

This passage to me is Exhibit A for "Unhinged."  The people who react this way to even the most lenient of basic guard rails...I cannot fathom why such people get to be part of the accepted, trusted conversation on these matters:

The group was stocked with experts, including Leibowitz’s co-leader for the adolescent chapter, the Dutch child psychiatrist Annelou de Vries, who for 19 years has worked at what was the first transgender pediatric clinic in the world, and the clinical psychologist Ren Massey, who is a former president of the Georgia Psychological Association and is transgender. When WPATH released the draft of the SOC8 for public comment, Leibowitz and his co-authors braced for the inevitable conservative attack. For teenagers who have parental consent, the draft adolescent chapter lowered to 14 (from 16 in the previous guidelines) the recommended minimum age for hormone treatments, which can permanently alter, in a matter of months, voice depth and facial and body hair growth and, later, other features like breast development. It set a minimum recommended age of 15, for breast removal or augmentation, also called top surgery. (The previous standards didn’t set a minimum age.)

Opponents of gender-related care did, indeed, denounce all of this. But Leibowitz and his co-authors also faced fury from providers and activists within the transgender world. This response hit them harder, as criticism from your colleagues and allies often does. It arose from two of the conditions the draft chapter established in order for young people to start taking puberty suppressants and hormones. First, the draft said, preteens and teenagers should provide evidence of “several years” of persistently identifying as, or behaving typically like, another gender, to distinguish kids with a long history from those whose stated identification is recent. And second, they should undergo a comprehensive diagnostic assessment, for the purpose of understanding the psychological and social context of their gender identity and how it might intersect with other mental-health conditions.

Assessments for children and adolescents have long been integral to the Standards of Care. But this time, the guard rails were anathema to some members of a community that has often been failed by health care providers. “The adolescent chapter is the worst,” Colt St. Amand, a family-medicine physician at the Mayo Clinic and a clinical psychologist, posted on the Facebook page of International Transgender Health, which has thousands of members and functions as a bulletin board for the field. (St. Amand is on the working group for another chapter in the SOC8 on hormone treatments.) In a publicly streamed discussion on YouTube on Dec. 5, activists and experts criticized the adolescent chapter, with the emotion born of decades of discrimination and barriers to care. “This statement sucks,” Kelley Winters, a moderator of International Transgender Health who is an interdisciplinary scholar and community advocate in the field, said of the assessment. “This is talking about singling out trans kids, and specifically with a mental-health provider, not medical staff, to interrogate, to go down this comprehensive inquisition of their gender.” The requirement for evidence of several years of gender incongruity before medical treatment is “harmful and destructive and abusive and unethical and immoral,” said Antonia D’orsay, another moderator of the group who is a sociologist and psychologist. In January, in a public comment to WPATH, International Transgender Health blasted the adolescent chapter for “harmful assertion of psychogatekeeping” that “undermines patient autonomy.”

Let's be clear about what this reveals.  These are not anonymous randos on Reddit or Twitter spouting these irrational reactions.  They are well-known scholars, activists, sociologists and psychologists and they are seething at the idea that even the most common sense steps such as a child showing several years of persistently behaving like the other gender or expressing a desire to be the other gender, or meeting with a mental-health provider to confirm these things not as merely unnecessary or inconvenient but "harmful and destructive and abusive and unethical and immoral."  How do you respect the views of someone who behaves this disconnected from reality and prudence?

This isn't the behavior of medical professionals or scientists searching for truth.  It's the kind of behavior you see from members of a cult.

 

Do you not support the other extreme position?

[TitanTiger 20,498]

9 minutes ago, icanthearyou said:

Do you not support the other extreme position?

What extreme position is that?

[icanthearyou 4,463]

Just now, TitanTiger said:

What extreme position is that?

Seriously?

Complete ban of any drug therapy, surgical procedure for all under 18 years of age.

[TitanTiger 20,498]

10 minutes ago, icanthearyou said:

Seriously?

Complete ban of any drug therapy, surgical procedure for all under 18 years of age.

I'm pretty close to inline with where those notable conservative extremist countries, Sweden, Norway, the UK are headed:

...following systematic reviews of evidence, health authorities in Sweden, Finland, and the U.K. have agreed that no evidence exists that the benefits of puberty blockers and cross-sex hormones outweigh the risks. All three countries have since imposed measures to reduce drastically the accessibility of these drugs to teenagers.

I'd probably go further, yes, but if the US would at least move toward common sense like these folks, I'd be quite happy.

And yes, it should go without saying that we should not be doing cosmetic surgery for gender dysphoria on minors.  That you believe that's extreme says more about you than me - none of it good.

[icanthearyou 4,463]

Just now, TitanTiger said:

I'm pretty close to inline with where those notable conservative extremist countries, Sweden, Norway, the UK are headed:

...following systematic reviews of evidence, health authorities in Sweden, Finland, and the U.K. have agreed that no evidence exists that the benefits of puberty blockers and cross-sex hormones outweigh the risks. All three countries have since imposed measures to reduce drastically the accessibility of these drugs to teenagers.

I'd probably go further, yes, but if the US would at least move toward common sense like these folks, I'd be quite happy.

And yes, it should go without saying that we should not be doing cosmetic surgery for gender dysphoria on minors.  That you believe that's extreme says more about you than me.

Please explain.  What does it say about me?

Do I lack some sort of prejudice.  Do I lack compassion?  Do I believe that I know what is best for all others?  Do I believe we should try children as adults in criminal court but not allow them to have any other responsibilities for their behaviors, futures.  Am I wrong for not choosing an extreme?  Please tell me what is wrong with me. 

Why do you insist on making this personal? 

Once again, we are in a pretty good place with people self regulating.  Just like we were with abortion.  Unfortunately, there is no political value in such moderate, reasonable views or, practices.

The "moral majority" will not respect freedom, democracy, self determination.

[TitanTiger 20,498]

Just now, icanthearyou said:

Please explain.  What does it say about me?

Do I lack some sort of prejudice.  Do I lack compassion?  Do I believe that I know what is best for all others?  Do I believe we should try children as adults in criminal court but not allow them to have any other responsibilities for their behaviors, futures.  Am I wrong for not choosing an extreme?  Please tell me what is wrong with me. 

No, you lack wisdom, prudence and common sense.

 

Just now, icanthearyou said:

Why do you insist on making this personal? 

Once again, we are in a pretty good place with people self regulating.  Just like we were with abortion.  Unfortunately, there is no political value in such moderate, reasonable views or, practices.

The "moral majority" will not respect freedom, democracy, self determination.

You just called me an extremist and then have the temerity to act offended when I swat you back with a dose of reality.  That's rich.

[icanthearyou 4,463]

1 minute ago, TitanTiger said:

You just called me an extremist and then have the temerity to act offended when I swat you back with a dose of reality.  That's rich.

That is a lie.  I asked you to define your position.   Your initial response was coy.  If you are going to take the extreme view,,, own it. 

[TitanTiger 20,498]

1 minute ago, icanthearyou said:

That is a lie.  I asked you to define your position.   Your initial response was coy.  If you are going to take the extreme view,,, own it. 

Do you have short term memory loss?

icanthearyou:  Do you not support the other extreme position?

I guess your next reply is, "I didn't say you were an extremist, I just said you hold extreme positions"....which is a distinction without a difference.

Again, you aren't just arguing with me.  You're arguing with a growing number of doctors and scientists in the field about this.  Are they extremists too?
 

As to your other question, the taking of another person's life through violent premeditated murder and taking puberty blockers, cross-sex hormones and getting irreversible surgical procedures are not equivalent decisions.

But if push comes to shove, I would gladly give up prosecuting minors as adults in exchange for not permanently maiming children or subjecting them to possibly far more risky procedures down the line because puberty blockers stunted the development of sex organs.

[icanthearyou 4,463]

1 minute ago, TitanTiger said:

Do you have short term memory loss?

icanthearyou:  Do you not support the other extreme position?

I guess your next reply is, "I didn't say you were an extremist, I just said you hold extreme positions"....which is a distinction without a difference.

Again, you aren't just arguing with me.  You're arguing with a growing number of doctors and scientists in the field about this.  Are they extremists too?
 

As to your other question, the taking of another person's life through violent premeditated murder and taking puberty blockers, cross-sex hormones and getting irreversible surgical procedures are not equivalent decisions.

But if push comes to shove, I would gladly give up prosecuting minors as adults in exchange for not permanently maiming children or subjecting them to possibly far more risky procedures down the line because puberty blockers stunted the development of sex organs.

Don't forget suicide.  Don't forget persecution. 

[TitanTiger 20,498]

Just now, icanthearyou said:

Don't forget suicide.  Don't forget persecution. 

Don't forget emotional support and professional counseling.  Persecution isn't going to change because you give someone hormones and surgery. 

Watchful waiting is the better approach and never should have been abandoned to begin with.  Sweden, Norway and the UK get that.  And it's because of data like this:

This contrasts starkly with the Dutch model, which, drawing on decades of research, acknowledges that gender dysphoria in children is very likely to desist by adolescence or early adulthood, in many cases resolving into homosexuality. Moreover, research published in recent years strongly suggests that if a child’s cross-gender feelings are affirmed as evidence of a wrongly “assigned” sex at birth, that child is far more likely to persist in his dysphoria and seek puberty suppression. It is in light of the high likelihood of desistance that the Dutch model recommends “watchful waiting,” not affirm-first. Indeed, the Dutch team did not even recommend social transition (“real life experience” in the felt gender) in the early stages of puberty, but only after the teenager tried living as his true sex and found it too distressing. Social transition was seen as something to be done cautiously and incrementally, in conjunction with pharmaceutical puberty suppression, which the Dutch team thought of as part of the diagnostic rather than treatment phase. In its new draft guidance, England’s NHS strongly advises against childhood social transition and recommends it for adolescents only, based on informed consent and with a diagnosis of gender dysphoria.

This rush to affirmative care with puberty suppression, hormone treatment and surgery in light of this reads more like conversion therapy for gay kids than true care.