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Doctors have failed detransitioners Teenage distress is being inappropriately treated

Keira Bell regretted transitioning. Credit: Sky News

Keira Bell regretted transitioning. Credit: Sky News


July 7, 2023   6 mins

Every medical student should acquaint themselves with the discomfiting history of epilepsy surgery. Regardless of their eventual speciality, they will become better clinicians for it. As a cautionary tale of what happens when we lose sight of primum non nocere as our guiding principle in medicine, the sorry narrative is exemplary, putting well-intentioned doctors on the wrong side of history again and again.

Trepanning (drilling a hole in someone’s skull) has been conducted for millennia, with evidence of the oldest procedure dating back several thousand years. Archaeological finds of skulls with multiple holes in various states of repair indicate that at least some of our ancestors survived these treatments and came back for more. Opening a space to let the demons out of someone’s head makes sense, if you believe the pesky things have taken up residence and are running amok inside. At least this treatment was in the right anatomical ballpark, according to our current understanding of epilepsy as a neurological condition. Less than 130 years ago, surgery for epilepsy had “advanced” (or regressed) to the extent that the head was no longer the sole target of the surgeon’s scalpel.

They had branched out to recommend limb amputation. The rationale was straightforward: if someone’s arm keeps shaking, what more effective cure than to cut it off? Other surgical approaches to epilepsy in the 1890s included clitoridectomy and castration — both attempts to curb the immoral sexual appetites that were “well known” to cause epilepsy at the time. For the squeamish patients who wished to retain their sexual organs, alternative treatments included admonitions to avoid coffee, chocolate and amorous love songs. Late Victorian treatments for epilepsy were nothing if not eclectic.

Into the mid-20th century, people with epilepsy were once again the unwitting participants in a dark era of medical experimentation. In an enterprising spin-off, the radical surgical techniques developed in the Forties’ psychosurgery movement were trialled as treatments for epilepsy. All undergraduate psychology students (and fans of the film Memento) will be aware of Henry Molaison, better known by his initials. In October 1953, Mr Molaison underwent surgical excision of the right and left temporal lobes of his brain. In a short paper delivered six weeks after the surgery, his surgeon reported that the operation had resulted in no real changes, “with the exception of a very grave recent memory loss”; H.M. was unable to remember where his room was in the hospital, or how to find the toilet.

H.M.’s profoundly disabling amnesia persisted for the next 55 years, until his death in 2008. He became the most famous neuropsychological case study in the history of the profession. But he was not the first person to undergo this procedure and suffer this devastating outcome. Scores of others were discovered in a retrospective review, triggered by Mr Molaison’s case. His memory loss could have been anticipated and prevented if the outcome of this procedure had been fully evaluated in his predecessors. More shocking still is that a similar fate was allowed to befall a number of other patients after his amnesia was discovered. Ignorance is one thing, inertia something entirely different.

The lessons from this sobering history are clear. When doctors fundamentally misunderstand the cause of a condition and treat the symptoms instead, and fail to properly monitor outcomes, and modify their practice in response to known adverse outcomes, our patients suffer — often greatly and for the rest of their lives — if indeed they survive. These fundamental errors underpin the depressingly regular scandals that punctuate the history of medicine. (The stakes are particularly high if surgery is involved.)

It is naĂŻve to think that all these scandals are in the past. Our descendants will look back at some aspects of our current medical practice and wonder that we could have been so stupid. They will shudder at how barbaric and crude some of our current treatments are. So where might the next medical scandal be brewing?

The increasing visibility of detransitioners suggests it may lie in wait in gender-affirming medicine. Many detransitioners are young women who underwent treatment for psychological distress that has left them with irreversible, life-long changes to their bodies: a deep voice, a beard, and compromised sexual function. Some have had their breasts surgically removed; some may be infertile. Others are young men who have been castrated.

This is not an argument about the pros and cons of these treatments for trans-identified young people. Nor is it an argument about the percentage of people who may “regret” undergoing these procedures. The existence of just one detransitioner suggests that an individual was not offered the correct treatment for their condition by the doctors charged with their care. It is a clear case where the medical profession caused harm. We are ethically bound to learn, and widely disseminate, the lessons from these cases.

For many detransitioners, the cause of their distress as a teenager was misattributed by their clinicians to the notion that they had been born in the wrong body, and that they would be helped by the surgical creation of the “correct” body. Regardless of the validity of this treatment for some — on which I make no comment — this assumption was incorrect in the case of many detransitioners. Once these fundamental errors of misattribution had been made by the treating clinicians (who in the case of GIDS were primarily psychologists, and not medically qualified), surgeons and endocrinologists embarked on a procedure akin to that of limb amputation for epileptic seizures. The detransitioners’ discomfort with their body was a symptom of psychological distress, not a cause, but their medical team prescribed treatments with an irreversible impact and surgically removed healthy tissue in an effort to cure their symptoms.

In most other fields of surgery, this would be classified as a “never event”, and an exhaustive investigation would be launched. But in the case of many detransitioners, their treating medical team has failed their patient at every stage. They have fundamentally misunderstood the nature of the condition the patient has presented with and have treated the symptom rather than the cause. The astonishing failure of the Tavistock & Portman NHS trust to monitor even primary outcomes were laid bare in the original trial of Bell vs Tavistock, with further shocking details subsequently presented in Hannah Barnes forensic account of the collapse of the service. This failure means there is no opportunity to modify practice in response. It is unsurprising that the results have been catastrophic for some.

However, in the case of detransitioners, there is an additional, darker layer to this cascade of medical errors. The patients themselves are being held responsible, by the very doctors who made them. The term “post-treatment regret” appears to abrogate any responsibility on behalf of the treating clinicians for these outcomes. Some argue that there is some degree of regret associated with every medical procedure. However, there is a fundamental difference between patients who are unhappy with the outcome of elective treatments recommended for their condition, and those who have been misdiagnosed, and have had healthy tissue surgically removed as a result. Many detransitioners were given the wrong treatment for their condition. These people are not experiencing post-treatment regret, they are responding appropriately to the consequences of a grave medical failure.

Advocates of gender-affirming care argue that “no one can know whether post-treatment regret will occur; therefore what matters ethically is whether an individual has a good enough reason for wanting treatment”. This is a remarkable position to take. Surely what matters ethically is that the medical profession offers appropriate, evidence-based treatment to patients who will benefit from them. Others argue that young trans people have “the right to be wrong”. They do indeed; doctors, less so, particularly when they are wielding a scalpel. Just as trans youth deserve access to the very best in evidence-based medicine, so doctors have a fundamental duty not to offer harmful treatments to young people who will not benefit from them. It is not good enough to shrug and say, “no one knows whether this will occur”. We know that poor outcomes do occur, and are duty-bound to find out as much as we can about these in order to predict and prevent them.

Since 2014, there has been a phenomenal increase in young women referred to specialist services for gender dysphoria. There is, therefore, a greater number of people who are at potential risk of receiving inappropriate treatments. To respond by creating a “fast-track” to medical transition is to ignore everything history has to teach us. Meticulous assessment of a young person’s symptoms is not transphobic, nor does it invalidate anyone’s identity. It is good medicine, and ensures that the right treatment is given to the right patient.

No branch of medicine can be exempt from rigour. Exceptionalism lies at the heart of many medical scandals. That way catastrophe lies and, as ever, it will be our patients who suffer. This is not hypothetical: detransitioners stand before us as living, breathing examples of people who have been harmed. To change nothing as the result of their experience — or, even worse, to make changes that mean similar errors could potentially harm even more people — is immoral. Upholding scientific principles is the least we can do to protect our current patients and honour the thousands who have been failed by the medical profession in the past. The history of surgery can teach us that much. It is our responsibility to take note.


Sallie Baxendale is a consultant clinical neuropsychologist and a professor of clinical neuropsychology at University College London.

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Stephen Walsh
Stephen Walsh
11 months ago

This, incredibly, is an actual statement in a Lancet editorial quoted in the article: “Disproportionate emphasis is given to young people’s inability to provide medical consent, a moot point given that—like any medical care—parental consent is required”. One wonders what level of emphasis on this rather salient fact would be “proportionate”. Particularly where any discussion with a child on the topic that is other than “gender affirming” can be quite literally illegal. To the extent that The Lancet speaks for the medical profession, that profession is utterly lost.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Stephen Walsh

With the abject failure of every other treatment approach well demonstrated throughout recent history, it should be illegal — since it is snake oil fraud to do so — to mention anything but gender affirmative care.

Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

Listen to yourself. You’re saying that it’s snake oil fraud NOT to castrate boys with a psychiatric disorder.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

I am saying it is true that no such thing occurs as you imply it does, ever.
It is “snake oil” to claim being transgender is a mental illness, that is why it is no longer listed as being so little as a disorder.

Last edited 11 months ago by Talia Perkins
Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

I am saying it is true that no such thing occurs as you imply it does, ever.
It is “snake oil” to claim being transgender is a mental illness, that is why it is no longer listed as being so little as a disorder.

Last edited 11 months ago by Talia Perkins
Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

Listen to yourself. You’re saying that it’s snake oil fraud NOT to castrate boys with a psychiatric disorder.

dan sefton
dan sefton
11 months ago
Reply to  Stephen Walsh

The Lancet is not the medical profession.

RM Parker
RM Parker
11 months ago
Reply to  Stephen Walsh

Recall, also, that in 2021 the Lancet tied itself in semantic knots to avoid using the word “woman” on its cover. “Bodies with vaginas” was the dehumanising alternative they plumped for. I haven’t expected much better from them since.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Stephen Walsh

With the abject failure of every other treatment approach well demonstrated throughout recent history, it should be illegal — since it is snake oil fraud to do so — to mention anything but gender affirmative care.

dan sefton
dan sefton
11 months ago
Reply to  Stephen Walsh

The Lancet is not the medical profession.

RM Parker
RM Parker
11 months ago
Reply to  Stephen Walsh

Recall, also, that in 2021 the Lancet tied itself in semantic knots to avoid using the word “woman” on its cover. “Bodies with vaginas” was the dehumanising alternative they plumped for. I haven’t expected much better from them since.

Stephen Walsh
Stephen Walsh
11 months ago

This, incredibly, is an actual statement in a Lancet editorial quoted in the article: “Disproportionate emphasis is given to young people’s inability to provide medical consent, a moot point given that—like any medical care—parental consent is required”. One wonders what level of emphasis on this rather salient fact would be “proportionate”. Particularly where any discussion with a child on the topic that is other than “gender affirming” can be quite literally illegal. To the extent that The Lancet speaks for the medical profession, that profession is utterly lost.

Jim Veenbaas
Jim Veenbaas
11 months ago

Transitioning children reminds me of net zero. All you have to do is scratch the surface to discover the utter incoherence and depravity of the so-called solutions. Anyone with basic comprehension skills can figure this out with five minutes of research. Yet people with decades of education have invested their lives rationalizing something that doesn’t make sense, and vast swaths of useful idiots maintain the lie because they’re too stupid or too lazy to think for themselves.

Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Jim Veenbaas

I am a net-zero sceptic but I can understand someone having a differing view as the number of moving parts in connection with climate are complex and require some level of expertise to appreciate and most people don’t have time to look into the arguments in much detail.

I do find it harder to understand those in favour of the drastic step of hormonal and surgical treatment for the psychologically troubled. My father was a research pathologist and his advice was to keep away from surgeons if you could as their default view was to see surgery as the answer to every ill whereas many problems could be treated more satisfactorily without surgical intervention. Mutilation and hormonal interventions should be very much a last resort after all other treatments for sexual dysphoria.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

“I do find it harder to understand those in favour of the drastic step of hormonal and surgical treatment for the psychologically troubled.” <– That would be some combination of your being unable to imagine transgender people actually exist, and, your ignorance in thinking they neccessarily have some reason other than a developed while in utero biological one for their “trouble”.
“Mutilation” <– There is no mutilation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/
The phrase is gender dysphoria, not sexual dysphoria. Until some better term is adopted, try to use those currently defined, if you desire to be understood and taken seriously.
And there is no reason to undertake anything but gender affirming care, because no other treatment approach has ever done any good at all — and it works very well.
https://www.newswise.com/faseb/prompt-testosterone-treatment-improves-mental-health-of-transgender-gender-diverse-people
https://www.inverse.com/article/59830-gender-incongruence-transgender-surgey-survey#%3A~%3Atext%3DThe%20research%2C%20led%20by%20Richard%20Branstrom%2C%20Ph.D.%2C%20and%2Cdiagnosis%20of%20gender%20incongruence%20between%202005%20and%202015.
https://www.hsph.harvard.edu/news/hsph-in-the-news/mental-health-benefits-associated-with-gender-affirming-surgery/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771131/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

You know as well as I do that all these institutions have been captured.If your last statement is true how do you account for the increasing numbers of detransitioners. I think that since the cerebral cortex hasn’t fully developed until 25 no-one should be doing any irreversible treatments until then. 80% of gender non-conforming children realise they’re same sex attracted if left to go through normal puberty, however much they don’t like it. The biology is simple, no-one can actually change sex so getting the appearance of the opposite sex is bound to require lots of (very expensive) medical intervention involving undesirable side effects.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

I know as well as you do they were captured. Captured by the likes of the pious fraud Paul McHugh for decades, which decades saw that infamous 40%+ suicide attempt rate because “modern” medicine was gaslighting transgender people with oppositional, aversive, and conversion therapies.

As the abject failure of every other treatment approach other than gender affirming care became unignorable, those captured institutions were freed to do good instead of harm.

And no, transgender people are about evenly split into 1/3rd gay with respect to their gender, 1/3rd bi, and 1/3rd straight and so what? Variances in the development of sexual attraction have nothing to do with variances in the development of gender, they are independent axis of sexual dimorphism in the brain.

Gender non-conforming and transgender are only slightly overlapping, to be gender non-conforming has nothing necessarily to do with being transgender.

And of course the sex can be quite substantially changed — you are here to object to the overwhelmingly common happiness of those who do so.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

I know as well as you do they were captured. Captured by the likes of the pious fraud Paul McHugh for decades, which decades saw that infamous 40%+ suicide attempt rate because “modern” medicine was gaslighting transgender people with oppositional, aversive, and conversion therapies.

As the abject failure of every other treatment approach other than gender affirming care became unignorable, those captured institutions were freed to do good instead of harm.

And no, transgender people are about evenly split into 1/3rd gay with respect to their gender, 1/3rd bi, and 1/3rd straight and so what? Variances in the development of sexual attraction have nothing to do with variances in the development of gender, they are independent axis of sexual dimorphism in the brain.

Gender non-conforming and transgender are only slightly overlapping, to be gender non-conforming has nothing necessarily to do with being transgender.

And of course the sex can be quite substantially changed — you are here to object to the overwhelmingly common happiness of those who do so.

Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

You know as well as I do that all these institutions have been captured.If your last statement is true how do you account for the increasing numbers of detransitioners. I think that since the cerebral cortex hasn’t fully developed until 25 no-one should be doing any irreversible treatments until then. 80% of gender non-conforming children realise they’re same sex attracted if left to go through normal puberty, however much they don’t like it. The biology is simple, no-one can actually change sex so getting the appearance of the opposite sex is bound to require lots of (very expensive) medical intervention involving undesirable side effects.

Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Jeremy Bray

Talia Perkins posted comments which have now disappeared in response to two of my comments although not through any objection on my part. I appreciate anyone willing to challenge the prevailing sentiment of Unherd commentators even if I don’t agree with them provided they can do so civilly.

Talia I recall suggested I did not believe transgender people existed. I certainty believe people who do not feel identity with their biological sex exist and in that sense I believe in transgender people. What I don’t believe is that such people have a real gender different to their biological sex.

How should such people be treated where that feeling causes them significant distress? When they are mature adults that is perhaps a matter between their doctor/psychiatrist and themselves. Different considerations apply to those under age.

I had a look at two of the articles Talia cited.

The first article indicated that those who believed they did not feel identity with their biological sex were mostly happier if they were given hormone treatment immediately rather than having to sit without any treatment on a waiting list for three months. An unsurprising result I would have thought.

The second article indicated that perioperative depression etc levels were very high as were suicide attempts in people who believed they did not feel identity with their biological sex. These mental problems diminished somewhat after a year from surgery but mental problems persisted at a far higher level than in the general population so the “treatment” could hardly be called a success. The one area that seem to have improved was a reduction in suicide attempts after about 5 years – perhaps because all those who were determined in their efforts had succeed after a few years.

The link to other articles disappeared before I could access them.

At present there is enormous pressure on those who have been hormonally treated or surgically treated to affirm the value of the treatment so it is no surprise that few want to admit that it has not – even to themselves. However, detransition seems to be rising. 

Such evidence as there is seems to suggest that in the case many of the confused young who do not identify with their biological sex if they are not pushed down the path of affirmative care they reconcile with the idea that they are in fact their biological sex but homosexual or otherwise non-conforming with the social expectations of their biological sex. Transition would undoubtedly be harmful to this group that trans enthusiasts disingenuously dismiss on the grounds that they must have dishonestly presented as trans in the first place.

I first became interested in the matter when the 17 year old son of a friend declared that he wished to transition to become a woman despite having shown few feminine characteristics previously. The therapists and care industry were only too eager to push him down the path of transition despite the distress of his parents and it was only when he left home that he fortunately discontinued his desire to transition.

Talia’s dismissal of psychological treatments as unsuccessful was not supported by evidence but even if true does not justify “affirmative care” for the young nor the whole ideology that goes with the concept of being Trans.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

Nonsense, liar, everything I claimed was sourced extensively — you are merely rejecting reality. Because the UnHerd is an echo chamber for a herd – in this case a herd out to abuse some children for the sake of that herd’s moral vanity, because this is a place with no honesty or moral courage this too will likely be disappeared.
But like every Social Conservative moral panic, this one over the fact some people are born transgender will come to nothing. The same as the moral panic over the pizza place that still has no basement, the same as that 2nd one over violent video games, the same as that over satanic daycares, the same as that over rock music played forwards, the same as that over Dungeons and Dragons, the same as that over rock music played backwards, the same as that over the Whites Only signs coming down, the same as that over comic books, that same as that over Elvis’ pelvis, the same as that over movies — there is nothing to this.

Last edited 11 months ago by Talia Perkins
Julie Coates
Julie Coates
11 months ago
Reply to  Talia Perkins

I’m not sure why you’re reading Unherd if you completely disagree with the articles and subsequent comments that are posted. If you truly think it’s an immoral site, what good can come from reading it?
You seem to have failed to grasp that the comments demonstrate a true empathy for anyone suffering from gender dysphoria. Most people are simply saying ‘wait and see’ for children struggling with their gender identity.
This is because the evidence is so strong that the vast majority of them will accept their gender and/or sexuality in time. I can’t see why you would think that this view means that people reading Unherd don’t believe that there are some people who are genuinely trans.
It’s simply about not rushing into surgery and hormone treatment which would be detrimental to the majority of children as they are simply confused.
This is why it’s so important for us to actually listen to each other and try to understand each other’s perspectives.

Adrian Smith
Adrian Smith
11 months ago
Reply to  Talia Perkins

Good to see your comments restored.
You are right in one thing: none of us believe trans people, as you (trans dogma) define them, really exist. You see them as a natural and expected human variation like having bright copper coloured hair and that the feelings they develop of being born in the wrong body, which manifest as Gender Dysphoria, are the reality; ie trans women really are women etc.
We see Gender Dysphoria and a mental health condition, which is extremely distressing to the sufferers and whilst we don’t want to be unkind to them, cannot accept that large numbers of young people, particularly girls, should be encouraged down a path that ultimately destroys their fertility based on very flimsy evidence that that is what is best for them. Especially as it is known that Gender Dysphoria in adolescents does resolve itself over time in many but not all cases. Treatment may be correct for those for whom the feelings do not resolve and there are many successful transitions, which would lend weight to this argument.
However, when you listen to what detransitioners have to say and those who have not detransitioned but have not found the solution they thought they would, it is crystal clear that the treatments are being applied to the wrong people in a lot more cases than trans activists are willing to admit exist, because they do not fit into the dogma. The way the trans community treats detransitioners is as disgraceful as the way the very worst transphopes treat trans people.
The number of places that are now at least questioning if not banning gender affirming treatments on minors are doing so because finally they are looking objectively at the evidence and not because they are transphobes / trans genocidal.
Yes the unravelling of trans dogma is highly likely to cause further distress to the Gender Dysphoric. But just like a child upset by the realisation Santa does not exist, is that the fault of the person who told them he doesn’t or the person who told them he does in the first place?
The inclusion of both sides of the argument in a thread like this helps all to understand the issues better and hopefully encourages some to see themselves in the mirror a bit more clearly.

Last edited 11 months ago by Adrian Smith
Julie Coates
Julie Coates
11 months ago
Reply to  Talia Perkins

I’m not sure why you’re reading Unherd if you completely disagree with the articles and subsequent comments that are posted. If you truly think it’s an immoral site, what good can come from reading it?
You seem to have failed to grasp that the comments demonstrate a true empathy for anyone suffering from gender dysphoria. Most people are simply saying ‘wait and see’ for children struggling with their gender identity.
This is because the evidence is so strong that the vast majority of them will accept their gender and/or sexuality in time. I can’t see why you would think that this view means that people reading Unherd don’t believe that there are some people who are genuinely trans.
It’s simply about not rushing into surgery and hormone treatment which would be detrimental to the majority of children as they are simply confused.
This is why it’s so important for us to actually listen to each other and try to understand each other’s perspectives.

Adrian Smith
Adrian Smith
11 months ago
Reply to  Talia Perkins

Good to see your comments restored.
You are right in one thing: none of us believe trans people, as you (trans dogma) define them, really exist. You see them as a natural and expected human variation like having bright copper coloured hair and that the feelings they develop of being born in the wrong body, which manifest as Gender Dysphoria, are the reality; ie trans women really are women etc.
We see Gender Dysphoria and a mental health condition, which is extremely distressing to the sufferers and whilst we don’t want to be unkind to them, cannot accept that large numbers of young people, particularly girls, should be encouraged down a path that ultimately destroys their fertility based on very flimsy evidence that that is what is best for them. Especially as it is known that Gender Dysphoria in adolescents does resolve itself over time in many but not all cases. Treatment may be correct for those for whom the feelings do not resolve and there are many successful transitions, which would lend weight to this argument.
However, when you listen to what detransitioners have to say and those who have not detransitioned but have not found the solution they thought they would, it is crystal clear that the treatments are being applied to the wrong people in a lot more cases than trans activists are willing to admit exist, because they do not fit into the dogma. The way the trans community treats detransitioners is as disgraceful as the way the very worst transphopes treat trans people.
The number of places that are now at least questioning if not banning gender affirming treatments on minors are doing so because finally they are looking objectively at the evidence and not because they are transphobes / trans genocidal.
Yes the unravelling of trans dogma is highly likely to cause further distress to the Gender Dysphoric. But just like a child upset by the realisation Santa does not exist, is that the fault of the person who told them he doesn’t or the person who told them he does in the first place?
The inclusion of both sides of the argument in a thread like this helps all to understand the issues better and hopefully encourages some to see themselves in the mirror a bit more clearly.

Last edited 11 months ago by Adrian Smith
Adrian Smith
Adrian Smith
11 months ago
Reply to  Jeremy Bray

Talia’s responses to my comments have also disappeared along with a counter response of mine. This is a disgrace! Unherd is supposed to be about free speech and contrary ideas. Talia was quite courageous in expressing her views and stimulating debate when clearly most of the sentiment on here was against her.
What this issue requires most is proper study and debate across all its aspects. Screaming transphobe at anyone who initiates debate does not help, but neither does removing the views of people who think that way.
Come on Unherd, I thought you were better than this.
My counter response was to point to a link in the article which is really worth reading as essentially it is about how a transman, who thought detransitioners due to regret did not really exist, actually went and talked to real people and changed his mind
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
“In the past year, MacKinnon and his team of researchers have talked to 40 detransitioners in the United States, Canada and Europe, many of them having first received gender-affirming medical treatment in their 20s or younger. Their stories have upended his assumptions.”

Last edited 11 months ago by Adrian Smith
Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Adrian Smith

I agree. Talia is doing a service here, you don’t have to agree with her, but she should be able to put her point across like everyone else.

Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Adrian Smith

I agree. Talia is doing a service here, you don’t have to agree with her, but she should be able to put her point across like everyone else.

RM Parker
RM Parker
11 months ago
Reply to  Jeremy Bray

Bravo to all who’ve raised this issue here; also bravo to Talia Perkins for having the bravery to make a case for a viewpoint not usually represented in these comment threads.

I would also have liked to have seen the (now deleted) exchanges, and I welcome dissenting opinions and debate: we’re all poorer for suppression of this.

Please, mods, reconsider and reinstate: we’re all adults here and don’t require protection from words.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

Nonsense, liar, everything I claimed was sourced extensively — you are merely rejecting reality. Because the UnHerd is an echo chamber for a herd – in this case a herd out to abuse some children for the sake of that herd’s moral vanity, because this is a place with no honesty or moral courage this too will likely be disappeared.
But like every Social Conservative moral panic, this one over the fact some people are born transgender will come to nothing. The same as the moral panic over the pizza place that still has no basement, the same as that 2nd one over violent video games, the same as that over satanic daycares, the same as that over rock music played forwards, the same as that over Dungeons and Dragons, the same as that over rock music played backwards, the same as that over the Whites Only signs coming down, the same as that over comic books, that same as that over Elvis’ pelvis, the same as that over movies — there is nothing to this.

Last edited 11 months ago by Talia Perkins
Adrian Smith
Adrian Smith
11 months ago
Reply to  Jeremy Bray

Talia’s responses to my comments have also disappeared along with a counter response of mine. This is a disgrace! Unherd is supposed to be about free speech and contrary ideas. Talia was quite courageous in expressing her views and stimulating debate when clearly most of the sentiment on here was against her.
What this issue requires most is proper study and debate across all its aspects. Screaming transphobe at anyone who initiates debate does not help, but neither does removing the views of people who think that way.
Come on Unherd, I thought you were better than this.
My counter response was to point to a link in the article which is really worth reading as essentially it is about how a transman, who thought detransitioners due to regret did not really exist, actually went and talked to real people and changed his mind
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
“In the past year, MacKinnon and his team of researchers have talked to 40 detransitioners in the United States, Canada and Europe, many of them having first received gender-affirming medical treatment in their 20s or younger. Their stories have upended his assumptions.”

Last edited 11 months ago by Adrian Smith
RM Parker
RM Parker
11 months ago
Reply to  Jeremy Bray

Bravo to all who’ve raised this issue here; also bravo to Talia Perkins for having the bravery to make a case for a viewpoint not usually represented in these comment threads.

I would also have liked to have seen the (now deleted) exchanges, and I welcome dissenting opinions and debate: we’re all poorer for suppression of this.

Please, mods, reconsider and reinstate: we’re all adults here and don’t require protection from words.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

“I do find it harder to understand those in favour of the drastic step of hormonal and surgical treatment for the psychologically troubled.” <– That would be some combination of your being unable to imagine transgender people actually exist, and, your ignorance in thinking they neccessarily have some reason other than a developed while in utero biological one for their “trouble”.
“Mutilation” <– There is no mutilation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/
The phrase is gender dysphoria, not sexual dysphoria. Until some better term is adopted, try to use those currently defined, if you desire to be understood and taken seriously.
And there is no reason to undertake anything but gender affirming care, because no other treatment approach has ever done any good at all — and it works very well.
https://www.newswise.com/faseb/prompt-testosterone-treatment-improves-mental-health-of-transgender-gender-diverse-people
https://www.inverse.com/article/59830-gender-incongruence-transgender-surgey-survey#%3A~%3Atext%3DThe%20research%2C%20led%20by%20Richard%20Branstrom%2C%20Ph.D.%2C%20and%2Cdiagnosis%20of%20gender%20incongruence%20between%202005%20and%202015.
https://www.hsph.harvard.edu/news/hsph-in-the-news/mental-health-benefits-associated-with-gender-affirming-surgery/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771131/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Jeremy Bray

Talia Perkins posted comments which have now disappeared in response to two of my comments although not through any objection on my part. I appreciate anyone willing to challenge the prevailing sentiment of Unherd commentators even if I don’t agree with them provided they can do so civilly.

Talia I recall suggested I did not believe transgender people existed. I certainty believe people who do not feel identity with their biological sex exist and in that sense I believe in transgender people. What I don’t believe is that such people have a real gender different to their biological sex.

How should such people be treated where that feeling causes them significant distress? When they are mature adults that is perhaps a matter between their doctor/psychiatrist and themselves. Different considerations apply to those under age.

I had a look at two of the articles Talia cited.

The first article indicated that those who believed they did not feel identity with their biological sex were mostly happier if they were given hormone treatment immediately rather than having to sit without any treatment on a waiting list for three months. An unsurprising result I would have thought.

The second article indicated that perioperative depression etc levels were very high as were suicide attempts in people who believed they did not feel identity with their biological sex. These mental problems diminished somewhat after a year from surgery but mental problems persisted at a far higher level than in the general population so the “treatment” could hardly be called a success. The one area that seem to have improved was a reduction in suicide attempts after about 5 years – perhaps because all those who were determined in their efforts had succeed after a few years.

The link to other articles disappeared before I could access them.

At present there is enormous pressure on those who have been hormonally treated or surgically treated to affirm the value of the treatment so it is no surprise that few want to admit that it has not – even to themselves. However, detransition seems to be rising. 

Such evidence as there is seems to suggest that in the case many of the confused young who do not identify with their biological sex if they are not pushed down the path of affirmative care they reconcile with the idea that they are in fact their biological sex but homosexual or otherwise non-conforming with the social expectations of their biological sex. Transition would undoubtedly be harmful to this group that trans enthusiasts disingenuously dismiss on the grounds that they must have dishonestly presented as trans in the first place.

I first became interested in the matter when the 17 year old son of a friend declared that he wished to transition to become a woman despite having shown few feminine characteristics previously. The therapists and care industry were only too eager to push him down the path of transition despite the distress of his parents and it was only when he left home that he fortunately discontinued his desire to transition.

Talia’s dismissal of psychological treatments as unsuccessful was not supported by evidence but even if true does not justify “affirmative care” for the young nor the whole ideology that goes with the concept of being Trans.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jim Veenbaas

“Transitioning children reminds me of net zero. All you have to do is scratch the surface to discover the utter incoherence and depravity of the so-called solutions.” <– All of them but one, which is gender affirmative care, and which you can not find any accurate research to disparage.
The reason the US courts have among other things referred to the transphobic side’s “experts” as being”obvious charlatans” is that there are no relevant facts standing in oppositon to the WATH SoC as they are currently formulated.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

Well, are there any relevant facts standing in *favour* if gender-affirmative care?? If so, can you point us to them?

The message we are getting in the UK *from various official enquiries* is that the famous Tavistock gender-care clinic did not even have a record of patient outcomes, let alone proper follow-up. For an irreversible treatment protocol with known, serious side effects like infertility and problems with informed consent from children that does not sound at all convincing. In fact, according to the (normally very woke) Guardian, the Tavistock clinic was shut down following “a damning judicial review […] in 2020 and the production of the highly critical Cass Report“. What do *you* have to back up your claim?

Paul MacDonnell
Paul MacDonnell
11 months ago
Reply to  Talia Perkins

The burden of proof is not on those who think so called gender affirming care is a bad idea but on those who would wield the scalpel on the basis that it is a good idea. There is no literature supporting surgical transition – If for no other reason than that the procedures are too recent.

Last edited 11 months ago by Paul MacDonnell
Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

Well, are there any relevant facts standing in *favour* if gender-affirmative care?? If so, can you point us to them?

The message we are getting in the UK *from various official enquiries* is that the famous Tavistock gender-care clinic did not even have a record of patient outcomes, let alone proper follow-up. For an irreversible treatment protocol with known, serious side effects like infertility and problems with informed consent from children that does not sound at all convincing. In fact, according to the (normally very woke) Guardian, the Tavistock clinic was shut down following “a damning judicial review […] in 2020 and the production of the highly critical Cass Report“. What do *you* have to back up your claim?

Paul MacDonnell
Paul MacDonnell
11 months ago
Reply to  Talia Perkins

The burden of proof is not on those who think so called gender affirming care is a bad idea but on those who would wield the scalpel on the basis that it is a good idea. There is no literature supporting surgical transition – If for no other reason than that the procedures are too recent.

Last edited 11 months ago by Paul MacDonnell
Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Jim Veenbaas

I am a net-zero sceptic but I can understand someone having a differing view as the number of moving parts in connection with climate are complex and require some level of expertise to appreciate and most people don’t have time to look into the arguments in much detail.

I do find it harder to understand those in favour of the drastic step of hormonal and surgical treatment for the psychologically troubled. My father was a research pathologist and his advice was to keep away from surgeons if you could as their default view was to see surgery as the answer to every ill whereas many problems could be treated more satisfactorily without surgical intervention. Mutilation and hormonal interventions should be very much a last resort after all other treatments for sexual dysphoria.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jim Veenbaas

“Transitioning children reminds me of net zero. All you have to do is scratch the surface to discover the utter incoherence and depravity of the so-called solutions.” <– All of them but one, which is gender affirmative care, and which you can not find any accurate research to disparage.
The reason the US courts have among other things referred to the transphobic side’s “experts” as being”obvious charlatans” is that there are no relevant facts standing in oppositon to the WATH SoC as they are currently formulated.

Jim Veenbaas
Jim Veenbaas
11 months ago

Transitioning children reminds me of net zero. All you have to do is scratch the surface to discover the utter incoherence and depravity of the so-called solutions. Anyone with basic comprehension skills can figure this out with five minutes of research. Yet people with decades of education have invested their lives rationalizing something that doesn’t make sense, and vast swaths of useful idiots maintain the lie because they’re too stupid or too lazy to think for themselves.

Michael K
Michael K
11 months ago

This is an excellent article precisely because it steers away from all the hysteria and entrenched positions around trans activism and focuses on medical ethics.

“Surely what matters ethically is that the medical profession offers appropriate, evidence-based treatment to patients who will benefit from them.”

How can anyone argue with that aim, or seek to subvert it?

Kirk Susong
Kirk Susong
11 months ago
Reply to  Michael K

No one will argue with it, because it is too vague to mean anything. *Everyone* thinks their perspective is the one supported by the ‘evidence.’

Vincent R
Vincent R
11 months ago
Reply to  Kirk Susong

Fair point, but that is where the concept of ‘evidence based medicine’ comes in, (or at least should come in).
Determining what treatments ‘the evidence’ does or does not support, is not a new idea in health care, and though it can of course at times lead to lively debates about its interpretation in any area of medicine, there are nevertheless quite robust systems for reviewing it and generally agreed ‘rules’ for doing so.
One of the (many) disturbing things about this so called gender healthcare is the apparent complete disregard for any robust evidence whatsoever.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Vincent R

The question (in this debate) is what constitutes ‘evidence’ at all. A lab test showing the presence of a nefarious bacteria in a transitioner’s genital surgical wound is one kind of evidence. How does the transitioner’s pain from the infection weigh against his self-report that his dysmorphia has been alleviated by the transition? Do they have the same weight? Are we ultimately going to let self-reported feelings determine all medical procedures? Until we reconcile that there is a massive ideological element to the concept of ‘evidence’ in this medical field, we will not be able to invoke ‘evidence-based medicine’ successfully.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“Are we ultimately going to let self-reported feelings determine all medical procedures?” <– Try searching “pain scale chart” and do try to grow up. Self-reported feelings are the foundation of all medicine, and that a surgical site will experience infection of some sort as often as 1 time in 50 — that is normal.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

So exciting to have a contrary point of view represented on Unherd! Thank you for chiming in. But of course, I think are very, very wrong. Self-reported feelings are far from the foundation of all medicine… when you report a pain in your arm, they take an X-ray, and look for external evidence of a break. It is hard to think of any medical (non-psychological) treatment that is administered solely on the basis of self-reported feelings.
The ‘pain scale chart’ is, in fact, *counter evidence* to your claims – because the whole point of the ‘pain scale chart’ is that personal evaluations of inner feelings are completely unreliable unless and until they are connected to external observable evidence – in that case, the contortions on your face. That’s why the chart exists: to ground our self-reports with external criteria… so you know when someone says ‘the pain is a 10′ but they are otherwise completely placid and calm, that they mean something very different from ’10’ than everyone else does. (Ever heard of Wittgenstein’s ‘private language argument’? It’s right on point here.) Anyhow, thanks for engaging…

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“Self-reported feelings are far from the foundation of all medicine
 when you report a pain in your arm, they take an X-ray, and look for external evidence of a break” <– Maybe they take an X-Ray, maybe they don’t — the fact remains all elective care is done on the basis of some complaint for all who can speak.
And no, the subjective estimation of pain is itself the basis for treatment. Ibuprofen or X-Ray? How bad is the pain?

Last edited 11 months ago by Talia Perkins
Richard Craven
Richard Craven
11 months ago
Reply to  Kirk Susong

Very good, but much too polite.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“Self-reported feelings are far from the foundation of all medicine
 when you report a pain in your arm, they take an X-ray, and look for external evidence of a break” <– Maybe they take an X-Ray, maybe they don’t — the fact remains all elective care is done on the basis of some complaint for all who can speak.
And no, the subjective estimation of pain is itself the basis for treatment. Ibuprofen or X-Ray? How bad is the pain?

Last edited 11 months ago by Talia Perkins
Richard Craven
Richard Craven
11 months ago
Reply to  Kirk Susong

Very good, but much too polite.

Valerie Lute
Valerie Lute
11 months ago
Reply to  Talia Perkins

Just want to note that the â€œpain scale chart” was invented by Purdue Pharma to increase sales of opiate painkillers. Not saying that the subjective feelings of the patient never matter, but that’s a great example of how they can be manipulated by the for-profit medical industry.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Valerie Lute

No, it was invented to give a relative scale of perceived pain in reporting such.
Fascinating how many presumed conservatives become collectivists when they don’t like what free will does.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Valerie Lute

No, it was invented to give a relative scale of perceived pain in reporting such.
Fascinating how many presumed conservatives become collectivists when they don’t like what free will does.

Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

Immediately turning to insults . Typical.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

The observation of conclusory immaturity is well founded, not insult.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

The observation of conclusory immaturity is well founded, not insult.

J Hop
J Hop
11 months ago
Reply to  Talia Perkins

The pain scale chart helps a doctor determine symptoms but there are no procedures done just on the pain scale chart. Doctors don’t remove an appendix because a patient says their side hurts. A patient’s report of side pain prompts the doctor to check their appendix, and if it has burst then the surgery is conducted.
The only truly emotion based surgery is cosmetic, and even then cosmetic surgury doesn’t remove body functions and leave a person medicalized for life. We also don’t perform even costmetic surgery on minors, let alone surgeries that render people sexually deficient, infertile with triple risk for heart attack, stroke, cognitive delays, osteoperosis, etc,

Talia Perkins
Talia Perkins
11 months ago
Reply to  J Hop

An X-Ray isn’t a procedure? Because a report of subjective relative pain will be grounds for an X-Ray.

QED, you are proven wrong.

Talia Perkins
Talia Perkins
11 months ago
Reply to  J Hop

An X-Ray isn’t a procedure? Because a report of subjective relative pain will be grounds for an X-Ray.

QED, you are proven wrong.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

So exciting to have a contrary point of view represented on Unherd! Thank you for chiming in. But of course, I think are very, very wrong. Self-reported feelings are far from the foundation of all medicine… when you report a pain in your arm, they take an X-ray, and look for external evidence of a break. It is hard to think of any medical (non-psychological) treatment that is administered solely on the basis of self-reported feelings.
The ‘pain scale chart’ is, in fact, *counter evidence* to your claims – because the whole point of the ‘pain scale chart’ is that personal evaluations of inner feelings are completely unreliable unless and until they are connected to external observable evidence – in that case, the contortions on your face. That’s why the chart exists: to ground our self-reports with external criteria… so you know when someone says ‘the pain is a 10′ but they are otherwise completely placid and calm, that they mean something very different from ’10’ than everyone else does. (Ever heard of Wittgenstein’s ‘private language argument’? It’s right on point here.) Anyhow, thanks for engaging…

Valerie Lute
Valerie Lute
11 months ago
Reply to  Talia Perkins

Just want to note that the â€œpain scale chart” was invented by Purdue Pharma to increase sales of opiate painkillers. Not saying that the subjective feelings of the patient never matter, but that’s a great example of how they can be manipulated by the for-profit medical industry.

Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

Immediately turning to insults . Typical.

J Hop
J Hop
11 months ago
Reply to  Talia Perkins

The pain scale chart helps a doctor determine symptoms but there are no procedures done just on the pain scale chart. Doctors don’t remove an appendix because a patient says their side hurts. A patient’s report of side pain prompts the doctor to check their appendix, and if it has burst then the surgery is conducted.
The only truly emotion based surgery is cosmetic, and even then cosmetic surgury doesn’t remove body functions and leave a person medicalized for life. We also don’t perform even costmetic surgery on minors, let alone surgeries that render people sexually deficient, infertile with triple risk for heart attack, stroke, cognitive delays, osteoperosis, etc,

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“Are we ultimately going to let self-reported feelings determine all medical procedures?” <– Try searching “pain scale chart” and do try to grow up. Self-reported feelings are the foundation of all medicine, and that a surgical site will experience infection of some sort as often as 1 time in 50 — that is normal.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Vincent R

There is no such apparent disregard. There is an ideological refusal by Social Conservatives to concede they are simply wrong on the topic. The evidence is robust and overwhelming that people being born transgender is a regular occurrence on the order of magnitude as other variances in sexual dimorphism like being visibly intersex or gay. As many as 1 in 50 people have some identifiable intersex trait, and depending on what definition is used between 1 in 10 to 30 people are same sex attracted or bisexual.

Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

You’re conflating the LGB with the T. Please stop. And use the correct medical terminology for people with Disorders of Sexual Development. All 40 of which are sex specific eg XY get PAIS, XX get MRKH. And a few folks get chromosomal aberrations like Klinefelters (XXY) or Turners (XO). Most of the force-teamed “I” people keep telling you to leave them out of this they have a clear medical condition zero to do with “identity “ and certainly not suggesting that sex is anything other than male/female

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

“You’re conflating the LGB with the T. Please stop.” <– No, because all are equally variances from a strictly binary and false idea of how human sexually dimorphise while in utero.
“You’re conflating the LGB with the T. Please stop.” <– Why would I care when what should be cared about is evidence?
Male and female are the sole directions in which human sexual dimorpishm can occur — so what? –that fact is not evidence against the existence of gay, visibly intersex, or invisibly intersex people.

Last edited 11 months ago by Talia Perkins
Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

“You’re conflating the LGB with the T. Please stop.” <– No, because all are equally variances from a strictly binary and false idea of how human sexually dimorphise while in utero.
“You’re conflating the LGB with the T. Please stop.” <– Why would I care when what should be cared about is evidence?
Male and female are the sole directions in which human sexual dimorpishm can occur — so what? –that fact is not evidence against the existence of gay, visibly intersex, or invisibly intersex people.

Last edited 11 months ago by Talia Perkins
Alison Wren
Alison Wren
11 months ago
Reply to  Talia Perkins

You’re conflating the LGB with the T. Please stop. And use the correct medical terminology for people with Disorders of Sexual Development. All 40 of which are sex specific eg XY get PAIS, XX get MRKH. And a few folks get chromosomal aberrations like Klinefelters (XXY) or Turners (XO). Most of the force-teamed “I” people keep telling you to leave them out of this they have a clear medical condition zero to do with “identity “ and certainly not suggesting that sex is anything other than male/female

Kirk Susong
Kirk Susong
11 months ago
Reply to  Vincent R

The question (in this debate) is what constitutes ‘evidence’ at all. A lab test showing the presence of a nefarious bacteria in a transitioner’s genital surgical wound is one kind of evidence. How does the transitioner’s pain from the infection weigh against his self-report that his dysmorphia has been alleviated by the transition? Do they have the same weight? Are we ultimately going to let self-reported feelings determine all medical procedures? Until we reconcile that there is a massive ideological element to the concept of ‘evidence’ in this medical field, we will not be able to invoke ‘evidence-based medicine’ successfully.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Vincent R

There is no such apparent disregard. There is an ideological refusal by Social Conservatives to concede they are simply wrong on the topic. The evidence is robust and overwhelming that people being born transgender is a regular occurrence on the order of magnitude as other variances in sexual dimorphism like being visibly intersex or gay. As many as 1 in 50 people have some identifiable intersex trait, and depending on what definition is used between 1 in 10 to 30 people are same sex attracted or bisexual.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

And yet, the transphobes side of things has no evidence in favor of it.
Instead, there is almost 70 years of history of their preferred treatment approach being a useless one in the almost 100 year period when the occurrence of transgender people in a Western culture was clinically recognized and studied empirically.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

A comparable argument is that we should cut off body parts from schizophrenics because nothing else has worked. In fact post-intervention trans- patients still demonstrate drastically higher levels of mental and physical disorder than people without gender dysphoria. It’s just another mental illness, the cause and nature of which we do not know, and treatments for which have made no progress. Personally I think there’s a lot of evidence that its a social contagion with a social cure, but I agree that is not thoroughly documented yet. In any event, the solution is not to re-structure society against nature to accommodate their mental illness. Compassion should never take the form of a lie.

Last edited 11 months ago by Kirk Susong
Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“A comparable argument is that we should cut off body parts from schizophrenics because nothing else has worked” <– No, because schizophrenics have recognizably malfunctioning brains. A transgender person in the sexually dimorphic structures of their brain will quite commonly be recognizable as the sex opposite that of their birth.
https://www.jsm.jsexmed.org/article/S1743-6095(21)00425-2/fulltext
https://psychcentral.com/news/2018/03/16/structural-brain-differences-for-transgender-people#1
https://pubmed.ncbi.nlm.nih.gov/31134582/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955456/
https://www.sciencedaily.com/releases/2018/05/180524112351.htm
Without realizing — owing to your deliberate ignorance — you are making the argument that being a man or woman is mental illness — or — that no one is a man or woman other than by that sexual dimorphism between their legs … that latter proposition finally definitively falsified by the discovery of the fraud of Dr. John Money RE David Reimer.
There is no possibility that meeting the criteria for being termed transgender by the DSM5 or WPATH SoC is generically or even frequently a mental illness. There is no logic or evidence for that idea, neither have you presented any.
Instead, it seems to be the result of both having these and as yet other undiscovered genetic variances also probably interactions with the fetal environment.
https://pubmed.ncbi.nlm.nih.gov/31882810
https://pubmed.ncbi.nlm.nih.gov/17765230/
https://academic.oup.com/jcem/article/104/2/390/5104458
There is no excuse for the social conservative position.
You are the monsters trying to force by law and policy, some girls to grow up with beards and deep voices, and trying to force some boys to grow up with breasts and a period.
There are facts and logic involved, only none support you — and this is no dry intellectual debate.

For 1 in 150 people to be transgender is natural. The bestial bigotry inherent to your opinions is socially constructed.

L Walker
L Walker
11 months ago
Reply to  Talia Perkins

I’m pretty sure boys can’t have periods.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

I love that you are weighing in here! This place can be an echo chamber, so welcome. But still what you say makes no sense at all. You say I am “trying to force by law and policy some girls to grow up with beards.” What a bizarre Orwellian characterization of… what happens biologically and naturally if no human intervenes! Allowing nature to take its course is “me trying to force by law and policy”? This is (but one) example of the extraordinary doublespeak that transactivists use to justify their upside down worldview.
Anyhow, you cited an awful lot of articles which say a wide variety of things – none of them support your view, in my opinion, but we would need to drill down on a specific article (or assertion) to be able to have a meaningful conversation. (You are welcome to do that if interested.) Suffice it to say, I don’t deny the genuine distress of gender dysphorics, nor do I deny that mental disorders sometimes (often? always? who knows?) are connected with physical/neurological traits, nor do I deny that gender dysphorics have many traits of the opposite sex (normal folks do, too, you know). None of these points is at issue.
What’s at issue is whether sexual norms (gender roles, sexual ethics, etc.) should be a lodestar which societies acknowledge and support, or whether we should reshape the created order to accommodate the mental distress of a tiny minority – and in the process undermine the essential building blocks of successful societies.

L Walker
L Walker
11 months ago
Reply to  Talia Perkins

I’m pretty sure boys can’t have periods.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

I love that you are weighing in here! This place can be an echo chamber, so welcome. But still what you say makes no sense at all. You say I am “trying to force by law and policy some girls to grow up with beards.” What a bizarre Orwellian characterization of… what happens biologically and naturally if no human intervenes! Allowing nature to take its course is “me trying to force by law and policy”? This is (but one) example of the extraordinary doublespeak that transactivists use to justify their upside down worldview.
Anyhow, you cited an awful lot of articles which say a wide variety of things – none of them support your view, in my opinion, but we would need to drill down on a specific article (or assertion) to be able to have a meaningful conversation. (You are welcome to do that if interested.) Suffice it to say, I don’t deny the genuine distress of gender dysphorics, nor do I deny that mental disorders sometimes (often? always? who knows?) are connected with physical/neurological traits, nor do I deny that gender dysphorics have many traits of the opposite sex (normal folks do, too, you know). None of these points is at issue.
What’s at issue is whether sexual norms (gender roles, sexual ethics, etc.) should be a lodestar which societies acknowledge and support, or whether we should reshape the created order to accommodate the mental distress of a tiny minority – and in the process undermine the essential building blocks of successful societies.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

“A comparable argument is that we should cut off body parts from schizophrenics because nothing else has worked” <– No, because schizophrenics have recognizably malfunctioning brains. A transgender person in the sexually dimorphic structures of their brain will quite commonly be recognizable as the sex opposite that of their birth.
https://www.jsm.jsexmed.org/article/S1743-6095(21)00425-2/fulltext
https://psychcentral.com/news/2018/03/16/structural-brain-differences-for-transgender-people#1
https://pubmed.ncbi.nlm.nih.gov/31134582/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955456/
https://www.sciencedaily.com/releases/2018/05/180524112351.htm
Without realizing — owing to your deliberate ignorance — you are making the argument that being a man or woman is mental illness — or — that no one is a man or woman other than by that sexual dimorphism between their legs … that latter proposition finally definitively falsified by the discovery of the fraud of Dr. John Money RE David Reimer.
There is no possibility that meeting the criteria for being termed transgender by the DSM5 or WPATH SoC is generically or even frequently a mental illness. There is no logic or evidence for that idea, neither have you presented any.
Instead, it seems to be the result of both having these and as yet other undiscovered genetic variances also probably interactions with the fetal environment.
https://pubmed.ncbi.nlm.nih.gov/31882810
https://pubmed.ncbi.nlm.nih.gov/17765230/
https://academic.oup.com/jcem/article/104/2/390/5104458
There is no excuse for the social conservative position.
You are the monsters trying to force by law and policy, some girls to grow up with beards and deep voices, and trying to force some boys to grow up with breasts and a period.
There are facts and logic involved, only none support you — and this is no dry intellectual debate.

For 1 in 150 people to be transgender is natural. The bestial bigotry inherent to your opinions is socially constructed.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Talia Perkins

A comparable argument is that we should cut off body parts from schizophrenics because nothing else has worked. In fact post-intervention trans- patients still demonstrate drastically higher levels of mental and physical disorder than people without gender dysphoria. It’s just another mental illness, the cause and nature of which we do not know, and treatments for which have made no progress. Personally I think there’s a lot of evidence that its a social contagion with a social cure, but I agree that is not thoroughly documented yet. In any event, the solution is not to re-structure society against nature to accommodate their mental illness. Compassion should never take the form of a lie.

Last edited 11 months ago by Kirk Susong
Vincent R
Vincent R
11 months ago
Reply to  Kirk Susong

Fair point, but that is where the concept of ‘evidence based medicine’ comes in, (or at least should come in).
Determining what treatments ‘the evidence’ does or does not support, is not a new idea in health care, and though it can of course at times lead to lively debates about its interpretation in any area of medicine, there are nevertheless quite robust systems for reviewing it and generally agreed ‘rules’ for doing so.
One of the (many) disturbing things about this so called gender healthcare is the apparent complete disregard for any robust evidence whatsoever.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Kirk Susong

And yet, the transphobes side of things has no evidence in favor of it.
Instead, there is almost 70 years of history of their preferred treatment approach being a useless one in the almost 100 year period when the occurrence of transgender people in a Western culture was clinically recognized and studied empirically.

Alison Wren
Alison Wren
11 months ago
Reply to  Michael K

And of course the Tavistock failed to do any follow up of their patients as was pointed out to the judge’s amazement in the Keira Bell case!

Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

An aspect of socialized medicine not pertaining to the US — and — as Keira Bell’s deceits became known to the higher court on appeal, the decision in Bell’s favor was overturned.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

According to the Guardian the judgement was overturned because the judges had gone beyond their remit. Nothing said about the judgement being wrong, let alone Keira Bell being deceitful. Again, a link to your evidence?

As for ‘An aspect of socialized medicine’ are you saying that since UK health care is not private, any conclusion coming out of it is by definition unreliable? I suspect that even most Republicans would not be so categorical.

Last edited 11 months ago by Rasmus Fogh
Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

I am stating the claims made by Bell as to what treatments she undertook when were proven false — she was an adult.
I am saying that socialist healthcare systems will provide substandard care is obvious.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

I am stating the claims made by Bell as to what treatments she undertook when were proven false — she was an adult.
I am saying that socialist healthcare systems will provide substandard care is obvious.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

According to the Guardian the judgement was overturned because the judges had gone beyond their remit. Nothing said about the judgement being wrong, let alone Keira Bell being deceitful. Again, a link to your evidence?

As for ‘An aspect of socialized medicine’ are you saying that since UK health care is not private, any conclusion coming out of it is by definition unreliable? I suspect that even most Republicans would not be so categorical.

Last edited 11 months ago by Rasmus Fogh
Talia Perkins
Talia Perkins
11 months ago
Reply to  Alison Wren

An aspect of socialized medicine not pertaining to the US — and — as Keira Bell’s deceits became known to the higher court on appeal, the decision in Bell’s favor was overturned.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Michael K

“Surely what matters ethically is that the medical profession offers appropriate, evidence-based treatment to patients who will benefit from them.” <– That is nothing to be argued with, but the article is conclusory nonsense which presumes that is not what is happening.

Kirk Susong
Kirk Susong
11 months ago
Reply to  Michael K

No one will argue with it, because it is too vague to mean anything. *Everyone* thinks their perspective is the one supported by the ‘evidence.’

Alison Wren
Alison Wren
11 months ago
Reply to  Michael K

And of course the Tavistock failed to do any follow up of their patients as was pointed out to the judge’s amazement in the Keira Bell case!

Talia Perkins
Talia Perkins
11 months ago
Reply to  Michael K

“Surely what matters ethically is that the medical profession offers appropriate, evidence-based treatment to patients who will benefit from them.” <– That is nothing to be argued with, but the article is conclusory nonsense which presumes that is not what is happening.

Michael K
Michael K
11 months ago

This is an excellent article precisely because it steers away from all the hysteria and entrenched positions around trans activism and focuses on medical ethics.

“Surely what matters ethically is that the medical profession offers appropriate, evidence-based treatment to patients who will benefit from them.”

How can anyone argue with that aim, or seek to subvert it?

Tina Lennon
Tina Lennon
11 months ago

The author of this article is being very careful. This article therefore is very confusing to read. Saying she doesn’t want to talk about pros and cons of this treatment and to not comment on the validity of the treatment. She knows that no one benefits from this treatment. Detransitioners speak out but there are the people who will regret but say nothing because the don’t want to admit their mistake. No doctor should offer this treatment. There are no pros. Doctors whether psychologists or surgeons who affirm and cut people up are evil.

Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Tina Lennon

You described the doctors offering hormonal and surgical treatment as evil. While I agree that such treatment is almost always wrong (I can envisage such treatment as a last resort giving psychological relief to some when all other interventions have failed), if by evil you mean knowingly malevolent, I would have to disagree.

I believe all too many doctors have convinced themselves that what they are offering is of benefit to their patients but that they have done so on the basis of inadequate research and analysis just as doctors have in the past offered for extended periods treatments that have eventually been abandoned when the evidence for the pernicious effects have become overwhelming. Negligent malpractice is probably the appropriate category.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

Jeremy, no other treatment approach does anything but fail. In the 70+ years of the contiguous history of the matter being clinically considered, only gender affirming care has done any good — and it has done a great deal of it.
It is malpractice to first try everything that has never worked.

Last edited 11 months ago by Talia Perkins
Talia Perkins
Talia Perkins
11 months ago
Reply to  Jeremy Bray

Jeremy, no other treatment approach does anything but fail. In the 70+ years of the contiguous history of the matter being clinically considered, only gender affirming care has done any good — and it has done a great deal of it.
It is malpractice to first try everything that has never worked.

Last edited 11 months ago by Talia Perkins
Adrian Smith
Adrian Smith
11 months ago
Reply to  Tina Lennon

The author has rightly been careful precisely to avoid getting into controversial issues like the one you assert without any evidence to support it. Just as detransitioners are clear evidence that the wrong treatment was given, those who are now living their best lives with a modified body are evidence that they received the right treatment. There are plenty on both sides and quite a few in the middle. It is shocking that the statistics are not readily available from proper scientific study of the outcomes of the treatments. However as the author rightly says just one wrong treatment should be enough to raise the question for open an proper debate in the medical community.
The points the author does make should all be incontrovertible. The problem is that trans activists screaming transphobe or even trans genocide at anyone who dares to raise the really rather obvious and incontrovertible issues the author raises, have downed out the voices of reason for too long leading to what I am certain in a few years time will be seen as a medical scandal of even greater proportions to the ones the author uses at the beginning to introduce her argument.
Yes the doctors who did not apply sufficient professional scrutiny must take some of the blame, but most of the blame lies with the trans activists and the politicians who were sucked in by them and the politicians who were too weak to stand up for what is right and the media who gave the activists the voice and intimidated those weak politicians.

Last edited 11 months ago by Adrian Smith
Martin Terrell
Martin Terrell
11 months ago
Reply to  Adrian Smith

… to be shared with the doctors, the highly trained, ethical professionals who could just say no, or at least ‘hang on a bit’.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Adrian Smith

“There are plenty on both sides and quite a few in the middle. It is shocking that the statistics are not readily available from proper scientific study of the outcomes of the treatments.”
But those statistics are available. With results sizes in aggregate large enough to speak to a 95% confidence level for the whole human population!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

OK, that is at least a scientific article. Being at work I do not at the moment have time to read through all the articles they cite. Can you answer a couple of questions:

What are the counterarguments from people who criticise the article, and might they have any merit? That is the quickest way of looking for potential problems.
Did these studies check *all* the people who had been through a given institute, and what percentage did they manage to follow up? Low response numbers could invalidate the result.
How do the age and circumstances of the people investigated match the current profile of transitioners? Older people might be rather less at risk of regretting their decision.
How much did the long-term mental health and social well-being *improve* after transition?

Last edited 11 months ago by Rasmus Fogh
Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

No, as is solely appropriate, only people who responded were counted in numerator or denominator.
Pretending those who did not respond had desisted is the sort of fraud which lost Zucker his job.
Surgery could only effect what dysphoria was perceived about the body parts operated on, and lack of regret about the decision to undertake surgery the only thing to be properly measured about it in a study about such a regret rate.
The fraud of pretending that not everything thought regrettable about a person by the researcher involved was sen to be improved after surgery was the fraud which eventually saw McHugh’s decision at Johns Hopkins reversed.
Of course there is more.
https://www.newswise.com/faseb/prompt-testosterone-treatment-improves-mental-health-of-transgender-gender-diverse-people

https://www.inverse.com/article/59830-gender-incongruence-transgender-surgey-survey#%3A~%3Atext%3DThe%20research%2C%20led%20by%20Richard%20Branstrom%2C%20Ph.D.%2C%20and%2Cdiagnosis%20of%20gender%20incongruence%20between%202005%20and%202015.

https://www.hsph.harvard.edu/news/hsph-in-the-news/mental-health-benefits-associated-with-gender-affirming-surgery/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771131/

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

https://fenwayhealth.org/new-study-shows-transgender-people-who-receive-gender-affirming-surgery-are-significantly-less-likely-to-experience-psychological-distress-or-suicidal-ideation/

Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

No, as is solely appropriate, only people who responded were counted in numerator or denominator.
Pretending those who did not respond had desisted is the sort of fraud which lost Zucker his job.
Surgery could only effect what dysphoria was perceived about the body parts operated on, and lack of regret about the decision to undertake surgery the only thing to be properly measured about it in a study about such a regret rate.
The fraud of pretending that not everything thought regrettable about a person by the researcher involved was sen to be improved after surgery was the fraud which eventually saw McHugh’s decision at Johns Hopkins reversed.
Of course there is more.
https://www.newswise.com/faseb/prompt-testosterone-treatment-improves-mental-health-of-transgender-gender-diverse-people

https://www.inverse.com/article/59830-gender-incongruence-transgender-surgey-survey#%3A~%3Atext%3DThe%20research%2C%20led%20by%20Richard%20Branstrom%2C%20Ph.D.%2C%20and%2Cdiagnosis%20of%20gender%20incongruence%20between%202005%20and%202015.

https://www.hsph.harvard.edu/news/hsph-in-the-news/mental-health-benefits-associated-with-gender-affirming-surgery/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771131/

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

https://fenwayhealth.org/new-study-shows-transgender-people-who-receive-gender-affirming-surgery-are-significantly-less-likely-to-experience-psychological-distress-or-suicidal-ideation/

Adrian Smith
Adrian Smith
11 months ago
Reply to  Talia Perkins

A meta study of flawed studies gives a flawed answer. There is an excellent Reuters article linked in the article:
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
Well worth a read. A trans man doctor who used to believe as you do went out and actually talked to a lot of people who had regrets and had transitioned and he changed his mind. There are just too many real people who according to trans activists don’t really exist for those tiny percentages to have any validity at all. A proper follow up study would reveal the truth but when they have been proposed trans activists just scream that asking the question is transphobic.

Last edited 11 months ago by Adrian Smith
Talia Perkins
Talia Perkins
11 months ago
Reply to  Adrian Smith

There are no flaws demonstrated there pertaining to that metastudy. That is why you can cite the article but nothing in it supporting you.
That someone desists prior to surgery is not evidence those who have the surgery regret it — in fact, it is rather evidence the screening period inherent to the WPATH SoC works well to exclude those who can not benefit from surgery.

The truth is revealed — you just don’t like it.

MacKinnon does not there dispute a <1% regret rate.

For that matter, Choe Cole has nothing to say about gender affirming care, because no such standards of care were followed in their case — instead, their parents doctor shopped them around until they found one who would do the surgery contrary those standards.

Last edited 11 months ago by Talia Perkins
Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

If you want to actually, you know, debate this, or maybe even convince someone, it is not enough to try to shout louder. Granted many from the other side have the same problem, but still. And, especially, it is *not* the case that you are right by default until someone else *proves* that you are wrong.

That Reuters article shows pretty well that the number of people who regret is uncertain (from 1% to 25%), including listing the weak points of each survey. And that there is a lack of reliable research results, in either direction. Also ‘that someone desists prior to surgery’ *is* evidence – that children can be quite convinced they are of the opposite sex but still change their mind later. Which suggests that you need to very cautious about making irreversible social or medical interventions based on the decisions of minors.

Claiming that it works perfectly well if you follow a specific set of guidelines, and that if people (like Chloe Cole) who suffer from ‘gender-affirmative care’ it is their own fault (or their parents’) is a colossal cop-out. First because you have shown no evidence. If there is a specific protocol that is capable of avoiding the medical disaster of detransitioning that is great news – but the way to prove it is to show a rigorous follow-up study proving that people who *do* follow the protocol do not have these problems. And you do not have that, do you? Second because you are setting this up as ‘heads I win, tails you lose’. Unless you establish the protocol ahead of time, you can (and do) use it to exclude anyone who is not happy with the result – because if they had followed the right protocol they would have been happy.

How about calming down, stop calling people bigots, and arguing the evidence, or lack thereof? I know from experience that it is possible, even when you strongly disagree about something.

Last edited 11 months ago by Rasmus Fogh
Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

“That Reuters article shows pretty well that the number of people who regret is uncertain (from 1% to 25%),” <– No, it shows no such thing, as it gives no indication of what it is claiming is regret, as if all regret was the same.
There is no lack of reliable research results, social conservatives only call the overwhelming number of studies which refute them unreliable.
“Also ‘that someone desists prior to surgery’ *is* evidence – that children can be quite convinced they are of the opposite sex but still change their mind later.” <– No, that is not any evidence that anyone is so “convinced”, it is evidence some are exploring and exploring and finding out.
“Which suggests that you need to very cautious about making irreversible social or medical interventions based on the decisions of minors.” <– Not on the conclusively large studies showing they make such decisions over time as they do. 7928 patients overall.
“Claiming that it works perfectly well if you follow a specific set of guidelines, and that if people (like Chloe Cole) who suffer from ‘gender-affirmative care’ it is their own fault (or their parents’) is a colossal cop-out.” <— It is no cop-out at all to observe that an instance of a protocol not being followed has nothing to say about the validity of a protocol.
“How about calming down, stop calling people bigots, and arguing the evidence, or lack thereof?” <– I am quite calmly calling bigots to be bigots, and doing so only on the basis of evidence.
“If there is a specific protocol that is capable of avoiding the medical disaster of detransitioning that is great news” <– I have already cited in this thread evidence the WPATH SoC are accurate in resulting surgery 99%+ of the time.
Reality is heads I win tails you lose — because there is no evidence for what you claim and there is excellent evidence for what I claim and I have been citing it.
There is no excuse whatsoever for the Social Conservative opinions on the topic. You may as well be arguing the “whites only” signs need to go back up, for all the validity your concerns have, with only the proportions of the general population you wish to abuse in law and policy being different.

Last edited 11 months ago by Talia Perkins
harry storm
harry storm
11 months ago
Reply to  Talia Perkins

RE: There is no excuse whatsoever for the Social Conservative opinions on the topic. 
That alone outs you as a nutcase. And not all the critics are social conservatives or have socially conservative opinions. They just want to safeguard children and women’s spaces.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

OK, you have given a lot of references. I ought to read them, then read an equal number who criticize them, then come back with a considered opinion. Maybe some day, but right now I do not have time. Full marks for backing up your assertions though.

Unfortunately I still do not believe you (pending my literature, review, OK). For a start no one else accepts that there is conclusive evidence (either way) on the effect of gender reassignment as currently practised. But mainly because you are so incredibly shrill and aggressive. If you actually had overwhelming evidence you would not need to shout so much, your evidence would speak for you. And you would be able to accept that there was some prima facie evidence on the other side (that you just do not think is conclusive), instead of having to dismiss all all counterarguments as bigoted nonsense.

And your argument is a cop-out. The scientific approach is that you list all the people who want to transition, you establish a protocol, you predict that they will have clear benefit from it, and then you see. If a lot do not benefit from it, that is evidence that the choice or the protocol have problems, maybe serious ones. You are arguing backwards. You take it as given that transition is good for you, and if someone do not benefit from it you use that to prove that the person was wrong to ask for it or his doctors were incompetent. That way positive results prove that transition is good, but negative results prove that the transitioner of the doctor was in error. Heads, I win – tails you lose. What cannot be disproved, even in theory, is not science, but faith. You are arguing from a faith position, and that makes your claims to have all the evidence on your side sound rather suspect.

harry storm
harry storm
11 months ago
Reply to  Talia Perkins

RE: There is no excuse whatsoever for the Social Conservative opinions on the topic. 
That alone outs you as a nutcase. And not all the critics are social conservatives or have socially conservative opinions. They just want to safeguard children and women’s spaces.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

OK, you have given a lot of references. I ought to read them, then read an equal number who criticize them, then come back with a considered opinion. Maybe some day, but right now I do not have time. Full marks for backing up your assertions though.

Unfortunately I still do not believe you (pending my literature, review, OK). For a start no one else accepts that there is conclusive evidence (either way) on the effect of gender reassignment as currently practised. But mainly because you are so incredibly shrill and aggressive. If you actually had overwhelming evidence you would not need to shout so much, your evidence would speak for you. And you would be able to accept that there was some prima facie evidence on the other side (that you just do not think is conclusive), instead of having to dismiss all all counterarguments as bigoted nonsense.

And your argument is a cop-out. The scientific approach is that you list all the people who want to transition, you establish a protocol, you predict that they will have clear benefit from it, and then you see. If a lot do not benefit from it, that is evidence that the choice or the protocol have problems, maybe serious ones. You are arguing backwards. You take it as given that transition is good for you, and if someone do not benefit from it you use that to prove that the person was wrong to ask for it or his doctors were incompetent. That way positive results prove that transition is good, but negative results prove that the transitioner of the doctor was in error. Heads, I win – tails you lose. What cannot be disproved, even in theory, is not science, but faith. You are arguing from a faith position, and that makes your claims to have all the evidence on your side sound rather suspect.

Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Rasmus Fogh

Never play chess with a pigeon. The pigeon just knocks all the pieces over. Then shĂŻts all over the board.

Talia Perkins
Talia Perkins
11 months ago

The pigeons would be the editors removing my posts.

Apparently, the herd is allergic to facts with which they disagree.

Talia Perkins
Talia Perkins
11 months ago

The pigeons would be the editors removing my posts.

Apparently, the herd is allergic to facts with which they disagree.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Rasmus Fogh

“That Reuters article shows pretty well that the number of people who regret is uncertain (from 1% to 25%),” <– No, it shows no such thing, as it gives no indication of what it is claiming is regret, as if all regret was the same.
There is no lack of reliable research results, social conservatives only call the overwhelming number of studies which refute them unreliable.
“Also ‘that someone desists prior to surgery’ *is* evidence – that children can be quite convinced they are of the opposite sex but still change their mind later.” <– No, that is not any evidence that anyone is so “convinced”, it is evidence some are exploring and exploring and finding out.
“Which suggests that you need to very cautious about making irreversible social or medical interventions based on the decisions of minors.” <– Not on the conclusively large studies showing they make such decisions over time as they do. 7928 patients overall.
“Claiming that it works perfectly well if you follow a specific set of guidelines, and that if people (like Chloe Cole) who suffer from ‘gender-affirmative care’ it is their own fault (or their parents’) is a colossal cop-out.” <— It is no cop-out at all to observe that an instance of a protocol not being followed has nothing to say about the validity of a protocol.
“How about calming down, stop calling people bigots, and arguing the evidence, or lack thereof?” <– I am quite calmly calling bigots to be bigots, and doing so only on the basis of evidence.
“If there is a specific protocol that is capable of avoiding the medical disaster of detransitioning that is great news” <– I have already cited in this thread evidence the WPATH SoC are accurate in resulting surgery 99%+ of the time.
Reality is heads I win tails you lose — because there is no evidence for what you claim and there is excellent evidence for what I claim and I have been citing it.
There is no excuse whatsoever for the Social Conservative opinions on the topic. You may as well be arguing the “whites only” signs need to go back up, for all the validity your concerns have, with only the proportions of the general population you wish to abuse in law and policy being different.

Last edited 11 months ago by Talia Perkins
Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Rasmus Fogh

Never play chess with a pigeon. The pigeon just knocks all the pieces over. Then shĂŻts all over the board.

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

If you want to actually, you know, debate this, or maybe even convince someone, it is not enough to try to shout louder. Granted many from the other side have the same problem, but still. And, especially, it is *not* the case that you are right by default until someone else *proves* that you are wrong.

That Reuters article shows pretty well that the number of people who regret is uncertain (from 1% to 25%), including listing the weak points of each survey. And that there is a lack of reliable research results, in either direction. Also ‘that someone desists prior to surgery’ *is* evidence – that children can be quite convinced they are of the opposite sex but still change their mind later. Which suggests that you need to very cautious about making irreversible social or medical interventions based on the decisions of minors.

Claiming that it works perfectly well if you follow a specific set of guidelines, and that if people (like Chloe Cole) who suffer from ‘gender-affirmative care’ it is their own fault (or their parents’) is a colossal cop-out. First because you have shown no evidence. If there is a specific protocol that is capable of avoiding the medical disaster of detransitioning that is great news – but the way to prove it is to show a rigorous follow-up study proving that people who *do* follow the protocol do not have these problems. And you do not have that, do you? Second because you are setting this up as ‘heads I win, tails you lose’. Unless you establish the protocol ahead of time, you can (and do) use it to exclude anyone who is not happy with the result – because if they had followed the right protocol they would have been happy.

How about calming down, stop calling people bigots, and arguing the evidence, or lack thereof? I know from experience that it is possible, even when you strongly disagree about something.

Last edited 11 months ago by Rasmus Fogh
Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Adrian Smith

I looked at the meta-study. A 1% regret rate sounds strange. The regret rate for ordinary cosmetic surgery is 50%, according to some. If the regret rate here was 5% or 10% it would sound more plausible. But less than 1%?

Talia Perkins
Talia Perkins
11 months ago
Reply to  Adrian Smith

There are no flaws demonstrated there pertaining to that metastudy. That is why you can cite the article but nothing in it supporting you.
That someone desists prior to surgery is not evidence those who have the surgery regret it — in fact, it is rather evidence the screening period inherent to the WPATH SoC works well to exclude those who can not benefit from surgery.

The truth is revealed — you just don’t like it.

MacKinnon does not there dispute a <1% regret rate.

For that matter, Choe Cole has nothing to say about gender affirming care, because no such standards of care were followed in their case — instead, their parents doctor shopped them around until they found one who would do the surgery contrary those standards.

Last edited 11 months ago by Talia Perkins
Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Adrian Smith

I looked at the meta-study. A 1% regret rate sounds strange. The regret rate for ordinary cosmetic surgery is 50%, according to some. If the regret rate here was 5% or 10% it would sound more plausible. But less than 1%?

Rasmus Fogh
Rasmus Fogh
11 months ago
Reply to  Talia Perkins

OK, that is at least a scientific article. Being at work I do not at the moment have time to read through all the articles they cite. Can you answer a couple of questions:

What are the counterarguments from people who criticise the article, and might they have any merit? That is the quickest way of looking for potential problems.
Did these studies check *all* the people who had been through a given institute, and what percentage did they manage to follow up? Low response numbers could invalidate the result.
How do the age and circumstances of the people investigated match the current profile of transitioners? Older people might be rather less at risk of regretting their decision.
How much did the long-term mental health and social well-being *improve* after transition?

Last edited 11 months ago by Rasmus Fogh
Adrian Smith
Adrian Smith
11 months ago
Reply to  Talia Perkins

A meta study of flawed studies gives a flawed answer. There is an excellent Reuters article linked in the article:
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
Well worth a read. A trans man doctor who used to believe as you do went out and actually talked to a lot of people who had regrets and had transitioned and he changed his mind. There are just too many real people who according to trans activists don’t really exist for those tiny percentages to have any validity at all. A proper follow up study would reveal the truth but when they have been proposed trans activists just scream that asking the question is transphobic.

Last edited 11 months ago by Adrian Smith
Martin Terrell
Martin Terrell
11 months ago
Reply to  Adrian Smith

… to be shared with the doctors, the highly trained, ethical professionals who could just say no, or at least ‘hang on a bit’.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Adrian Smith

“There are plenty on both sides and quite a few in the middle. It is shocking that the statistics are not readily available from proper scientific study of the outcomes of the treatments.”
But those statistics are available. With results sizes in aggregate large enough to speak to a 95% confidence level for the whole human population!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/

Martin Terrell
Martin Terrell
11 months ago
Reply to  Tina Lennon

The author is walking through a minefield and being as careful as she can.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Martin Terrell

The author is expressing their ideological bias towards what ignorance they prefer in as slippery a fashion as possible.

Last edited 11 months ago by Talia Perkins
Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Talia Perkins

The author is expressing her opinion based on her professional scientific knowledge.

Last edited 11 months ago by Lennon Ó Náraigh
Talia Perkins
Talia Perkins
11 months ago

No, they are expressing skepticism not merely on the on the basis of no facts, but in defiance of them.
She has no excuse for not knowing them.

Talia Perkins
Talia Perkins
11 months ago

No, they are expressing skepticism not merely on the on the basis of no facts, but in defiance of them.
She has no excuse for not knowing them.

Lennon Ó Náraigh
Lennon Ó Náraigh
11 months ago
Reply to  Talia Perkins

The author is expressing her opinion based on her professional scientific knowledge.

Last edited 11 months ago by Lennon Ó Náraigh
Talia Perkins
Talia Perkins
11 months ago
Reply to  Martin Terrell

The author is expressing their ideological bias towards what ignorance they prefer in as slippery a fashion as possible.

Last edited 11 months ago by Talia Perkins
Allison Barrows
Allison Barrows
11 months ago
Reply to  Tina Lennon

Her refusal to comment stood out for me, too. It’s a cowardly stance, especially since primum non nocere was in her very first paragraph and the entire crux of the article. These hideous mutilations are not “gender-affirming health care”, they are the exact opposite, and this doctor knows it or she wouldn’t be comparing them to hideous “treatments” of the past. Why can’t she just come out and say it? Because, as in academia and the media, there are professional consequences for telling the truth.

Talia Perkins
Talia Perkins
11 months ago

To be like a member of a factless, hateful, child abusing, bigoted minority as the members of the American College of Pediatricians are should have severe negative professional consequences — consequences for lying about proper medical care, as ACPEDS does.

Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

Pretty rich coming from someone who supports sadistic paedophilia.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

A lie for which you will never have any evidence — you are making it up entire.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

A lie for which you will never have any evidence — you are making it up entire.

Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

Pretty rich coming from someone who supports sadistic paedophilia.

Talia Perkins
Talia Perkins
11 months ago

To be like a member of a factless, hateful, child abusing, bigoted minority as the members of the American College of Pediatricians are should have severe negative professional consequences — consequences for lying about proper medical care, as ACPEDS does.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Tina Lennon

“She knows that no one benefits from this treatment.” <– She is deluded in that fashion, certainly.
“Detransitioners speak out but there are the people who will regret but say nothing because the don’t want to admit their mistake. No doctor should offer this treatment. There are no pros. Doctors whether psychologists or surgeons who affirm and cut people up are evil.” <– There is a reason why fewer than 1% of people who transition regret it as being a mistake entire, and that reason is, you have no idea what you are going on about.

Julian Farrows
Julian Farrows
11 months ago
Reply to  Talia Perkins

The problem is that the article you cite is written by surgeons who specialize in reconstructive plastic surgery. It’s no more reliable than a research paper funded by Big Tobacco on the effects of cigarette smoking.

Julian Farrows
Julian Farrows
11 months ago
Reply to  Talia Perkins

The problem is that the article you cite is written by surgeons who specialize in reconstructive plastic surgery. It’s no more reliable than a research paper funded by Big Tobacco on the effects of cigarette smoking.

Jeremy Bray
Jeremy Bray
11 months ago
Reply to  Tina Lennon

You described the doctors offering hormonal and surgical treatment as evil. While I agree that such treatment is almost always wrong (I can envisage such treatment as a last resort giving psychological relief to some when all other interventions have failed), if by evil you mean knowingly malevolent, I would have to disagree.

I believe all too many doctors have convinced themselves that what they are offering is of benefit to their patients but that they have done so on the basis of inadequate research and analysis just as doctors have in the past offered for extended periods treatments that have eventually been abandoned when the evidence for the pernicious effects have become overwhelming. Negligent malpractice is probably the appropriate category.

Adrian Smith
Adrian Smith
11 months ago
Reply to  Tina Lennon

The author has rightly been careful precisely to avoid getting into controversial issues like the one you assert without any evidence to support it. Just as detransitioners are clear evidence that the wrong treatment was given, those who are now living their best lives with a modified body are evidence that they received the right treatment. There are plenty on both sides and quite a few in the middle. It is shocking that the statistics are not readily available from proper scientific study of the outcomes of the treatments. However as the author rightly says just one wrong treatment should be enough to raise the question for open an proper debate in the medical community.
The points the author does make should all be incontrovertible. The problem is that trans activists screaming transphobe or even trans genocide at anyone who dares to raise the really rather obvious and incontrovertible issues the author raises, have downed out the voices of reason for too long leading to what I am certain in a few years time will be seen as a medical scandal of even greater proportions to the ones the author uses at the beginning to introduce her argument.
Yes the doctors who did not apply sufficient professional scrutiny must take some of the blame, but most of the blame lies with the trans activists and the politicians who were sucked in by them and the politicians who were too weak to stand up for what is right and the media who gave the activists the voice and intimidated those weak politicians.

Last edited 11 months ago by Adrian Smith
Martin Terrell
Martin Terrell
11 months ago
Reply to  Tina Lennon

The author is walking through a minefield and being as careful as she can.

Allison Barrows
Allison Barrows
11 months ago
Reply to  Tina Lennon

Her refusal to comment stood out for me, too. It’s a cowardly stance, especially since primum non nocere was in her very first paragraph and the entire crux of the article. These hideous mutilations are not “gender-affirming health care”, they are the exact opposite, and this doctor knows it or she wouldn’t be comparing them to hideous “treatments” of the past. Why can’t she just come out and say it? Because, as in academia and the media, there are professional consequences for telling the truth.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Tina Lennon

“She knows that no one benefits from this treatment.” <– She is deluded in that fashion, certainly.
“Detransitioners speak out but there are the people who will regret but say nothing because the don’t want to admit their mistake. No doctor should offer this treatment. There are no pros. Doctors whether psychologists or surgeons who affirm and cut people up are evil.” <– There is a reason why fewer than 1% of people who transition regret it as being a mistake entire, and that reason is, you have no idea what you are going on about.

Tina Lennon
Tina Lennon
11 months ago

The author of this article is being very careful. This article therefore is very confusing to read. Saying she doesn’t want to talk about pros and cons of this treatment and to not comment on the validity of the treatment. She knows that no one benefits from this treatment. Detransitioners speak out but there are the people who will regret but say nothing because the don’t want to admit their mistake. No doctor should offer this treatment. There are no pros. Doctors whether psychologists or surgeons who affirm and cut people up are evil.

Annette Lawson
Annette Lawson
11 months ago

Thank you for this careful, rational argument against surgery for distress, which removes perfectly healthy tissue which cannot be replaced. As the author points out, the victims of this malpractice are now mainly young women with much evidence of social contagion as influence/ cause of their belief that they need to become boys/men. Since the binary of sex is undermined these girls don’t know and/or believe they can become anything they choose gender-wise.
It would be wonderful if the medical profession would take more seriously the principle of doing no harm.
Might the editor of The Lancet take note?

Talia Perkins
Talia Perkins
11 months ago
Reply to  Annette Lawson

“which removes perfectly healthy tissue which cannot be replaced” <– An irrelevancy that you think it is healthy tissue, it is not your tissue about which to make any decision. No boy wants to have breasts or a period, no girl wants to have p***s or a beard.
You propose to force that on them instead.
There is no evidence of any “social contagion”, that is just a lie you love which you console yourself with as you seek to abuse children by law and policy.
“It would be wonderful if the medical profession would take more seriously the principle of doing no harm.” <– With the regret rates at transition under 1%, you would do better to consider it.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Annette Lawson

“which removes perfectly healthy tissue which cannot be replaced” <– An irrelevancy that you think it is healthy tissue, it is not your tissue about which to make any decision. No boy wants to have breasts or a period, no girl wants to have p***s or a beard.
You propose to force that on them instead.
There is no evidence of any “social contagion”, that is just a lie you love which you console yourself with as you seek to abuse children by law and policy.
“It would be wonderful if the medical profession would take more seriously the principle of doing no harm.” <– With the regret rates at transition under 1%, you would do better to consider it.

Annette Lawson
Annette Lawson
11 months ago

Thank you for this careful, rational argument against surgery for distress, which removes perfectly healthy tissue which cannot be replaced. As the author points out, the victims of this malpractice are now mainly young women with much evidence of social contagion as influence/ cause of their belief that they need to become boys/men. Since the binary of sex is undermined these girls don’t know and/or believe they can become anything they choose gender-wise.
It would be wonderful if the medical profession would take more seriously the principle of doing no harm.
Might the editor of The Lancet take note?

Doug Mccaully
Doug Mccaully
11 months ago

Good article. Tragically, the courts will have the final say on this, with regretful transitioners as the victims.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Doug Mccaully

With great frequency, detransitioners are victims only of themselves — they lie their way concertedly into treatment for a condition they do not have.

Cal R
Cal R
11 months ago
Reply to  Talia Perkins

“It’s their [children/minors] fault for LYING to doctors [educated/ trained professionals/adults with ethical and scientific imperatives to avoid harming the vulnerable].”

Julian Farrows
Julian Farrows
11 months ago
Reply to  Talia Perkins

Yes, of course. Much in the same way a child that threatens suicide and actually goes through with it is to blame. The adults that tried to talk them out of it were noticing more than red neck rubes.

Cal R
Cal R
11 months ago
Reply to  Talia Perkins

“It’s their [children/minors] fault for LYING to doctors [educated/ trained professionals/adults with ethical and scientific imperatives to avoid harming the vulnerable].”

Julian Farrows
Julian Farrows
11 months ago
Reply to  Talia Perkins

Yes, of course. Much in the same way a child that threatens suicide and actually goes through with it is to blame. The adults that tried to talk them out of it were noticing more than red neck rubes.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Doug Mccaully

With great frequency, detransitioners are victims only of themselves — they lie their way concertedly into treatment for a condition they do not have.

Doug Mccaully
Doug Mccaully
11 months ago

Good article. Tragically, the courts will have the final say on this, with regretful transitioners as the victims.

Andrzej Wasniewski
Andrzej Wasniewski
11 months ago

The criminals who mutilated those children in the first place should be removed from any profession related to health care.

Talia Perkins
Talia Perkins
11 months ago

Only if actual malpractice can be proven — and it seems that occurs much less often than 1 time in 100.
There is no lack of ambulance chasers. There has been no backlash, there will be none.

Talia Perkins
Talia Perkins
11 months ago

Only if actual malpractice can be proven — and it seems that occurs much less often than 1 time in 100.
There is no lack of ambulance chasers. There has been no backlash, there will be none.

Andrzej Wasniewski
Andrzej Wasniewski
11 months ago

The criminals who mutilated those children in the first place should be removed from any profession related to health care.

Peter Johnson
Peter Johnson
11 months ago

One of my favourite quotes came my friends father who was a physician. It is “surgery is for other people.” As someone who had routine surgery that went terribly wrong I can attest to this. When I read about what they are doing to these young peoples bodies I am appalled. Removing a length of colon to make a fake vagina – what could possibly go wrong with that? I think we will look back on this like we now look at the practice of lobotomies.

Peter Johnson
Peter Johnson
11 months ago

One of my favourite quotes came my friends father who was a physician. It is “surgery is for other people.” As someone who had routine surgery that went terribly wrong I can attest to this. When I read about what they are doing to these young peoples bodies I am appalled. Removing a length of colon to make a fake vagina – what could possibly go wrong with that? I think we will look back on this like we now look at the practice of lobotomies.

Andrew Roman
Andrew Roman
11 months ago

What is missing from this article is any understanding of the psychology of doctors doing this gender affirming surgery and hormone treatment on children who won’t be made healthier because of it. In the NHS the doctors doing this aren’t paid enormously, so it isn’t greed. If trans children are seen as a vulnerable and disadvantaged minority in need of protection these doctors see themselves as rescuing them from gender-based social discrimination. A saviour complex?

Aphrodite Rises
Aphrodite Rises
11 months ago
Reply to  Andrew Roman

Allegedly, God complexes are extremely rare apart from in the medical profession.

Last edited 11 months ago by Aphrodite Rises
Wendy Barton
Wendy Barton
11 months ago

Susie Green?

Wendy Barton
Wendy Barton
11 months ago

Susie Green?

Talia Perkins
Talia Perkins
11 months ago
Reply to  Andrew Roman

The doctors doing the work are A) generally operating on fully aware adults and B) on people who will benefit immensely from the procedures no less than 99% of the time.

Aphrodite Rises
Aphrodite Rises
11 months ago
Reply to  Andrew Roman

Allegedly, God complexes are extremely rare apart from in the medical profession.

Last edited 11 months ago by Aphrodite Rises
Talia Perkins
Talia Perkins
11 months ago
Reply to  Andrew Roman

The doctors doing the work are A) generally operating on fully aware adults and B) on people who will benefit immensely from the procedures no less than 99% of the time.

Andrew Roman
Andrew Roman
11 months ago

What is missing from this article is any understanding of the psychology of doctors doing this gender affirming surgery and hormone treatment on children who won’t be made healthier because of it. In the NHS the doctors doing this aren’t paid enormously, so it isn’t greed. If trans children are seen as a vulnerable and disadvantaged minority in need of protection these doctors see themselves as rescuing them from gender-based social discrimination. A saviour complex?

Richard Craven
Richard Craven
11 months ago

Dr Transmengele will see you now.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

With the possible exceptions of Dr. Gallagher and Rumer, no such person’s exist.

Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

You people are utterly disgusting. I have a close relative caught up in your child mutilation cult. She’s 14. She needs to be protected from you people.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

No, the odds are she needs to be protected from you. Over 99 to 1.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

No, the odds are she needs to be protected from you. Over 99 to 1.

Richard Craven
Richard Craven
11 months ago
Reply to  Talia Perkins

You people are utterly disgusting. I have a close relative caught up in your child mutilation cult. She’s 14. She needs to be protected from you people.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Richard Craven

With the possible exceptions of Dr. Gallagher and Rumer, no such person’s exist.

Richard Craven
Richard Craven
11 months ago

Dr Transmengele will see you now.

R S Foster
R S Foster
11 months ago

…the only hope I can see is that somebody with deep pockets and high-level organisational skills organises the de-transitioners into a class-action suit demanding eye-watering damages against each and every organisation and individual who has had a hand in perpetrating this barbarism…and pursues it obsessively in every jurisdiction where it can be admitted…and does so until everyone involved has died.
These monsters might understand what they have done if each and every moment of their waking life is in future accompanied by the fear of bankruptcy, professional disgrace and perpetual public excoriation…if every one of their lives is utterly destroyed…
…can you hear me, Mr Musk?

Talia Perkins
Talia Perkins
11 months ago
Reply to  R S Foster

There has been no backlash for over 70 years, and there have been many decades of ambulance chasers — there will be no backlash because no grounds exist for it.

Talia Perkins
Talia Perkins
11 months ago
Reply to  R S Foster

There has been no backlash for over 70 years, and there have been many decades of ambulance chasers — there will be no backlash because no grounds exist for it.

R S Foster
R S Foster
11 months ago

…the only hope I can see is that somebody with deep pockets and high-level organisational skills organises the de-transitioners into a class-action suit demanding eye-watering damages against each and every organisation and individual who has had a hand in perpetrating this barbarism…and pursues it obsessively in every jurisdiction where it can be admitted…and does so until everyone involved has died.
These monsters might understand what they have done if each and every moment of their waking life is in future accompanied by the fear of bankruptcy, professional disgrace and perpetual public excoriation…if every one of their lives is utterly destroyed…
…can you hear me, Mr Musk?

Septima Williams
Septima Williams
11 months ago

Shamefully, much of this has been ideologically driven. When it is all over the culprits will dust themselves down and pretend they had nothing to do with it.

Talia Perkins
Talia Perkins
11 months ago

Opposition to gender affirming care is exclusively ideologically driven, from the time of Paul McHugh to the present day.

Talia Perkins
Talia Perkins
11 months ago

Opposition to gender affirming care is exclusively ideologically driven, from the time of Paul McHugh to the present day.

Septima Williams
Septima Williams
11 months ago

Shamefully, much of this has been ideologically driven. When it is all over the culprits will dust themselves down and pretend they had nothing to do with it.

Kirk Susong
Kirk Susong
11 months ago

Though I appreciate the historical reference to epileptics’ amputations, otherwise this article’s willful blindness is a strange choice. She writes, “Many detransitioners were given the wrong treatment for their condition.” Suggesting that some detransitioners were given the right treatment, and so were some transitioners. She really wants to avoid the real issues here.
Without an analysis of the underlying ideological conflict that is at the heart of this debate, you’ll never be able to make sense of whether transitioning follows the evidence or not – because what constitutes ‘evidence’ of positive health outcomes is itself in dispute.
This is what happens when ‘evidence’ in psychology – oftentimes consisting essentially of self-reporting how you feel – infiltrates the world of ‘hard’ medicine. In other words, an infection in a transitioner’s surgically altered genitalia is evidence of a negative medical outcome; it causes a certain kind of pain. But is it the same *kind* of evidence – i.e., to be measured on the same scale – as the transitioner’s self-reports of esteem, anxiety, self-assurance, etc.?
The answer is No, but under the powerful influence of the sexual revolution and its ideological fellow travelers, the medical community says Yes. This seems like the essential medical question, to me.

Last edited 11 months ago by Kirk Susong
Kirk Susong
Kirk Susong
11 months ago

Though I appreciate the historical reference to epileptics’ amputations, otherwise this article’s willful blindness is a strange choice. She writes, “Many detransitioners were given the wrong treatment for their condition.” Suggesting that some detransitioners were given the right treatment, and so were some transitioners. She really wants to avoid the real issues here.
Without an analysis of the underlying ideological conflict that is at the heart of this debate, you’ll never be able to make sense of whether transitioning follows the evidence or not – because what constitutes ‘evidence’ of positive health outcomes is itself in dispute.
This is what happens when ‘evidence’ in psychology – oftentimes consisting essentially of self-reporting how you feel – infiltrates the world of ‘hard’ medicine. In other words, an infection in a transitioner’s surgically altered genitalia is evidence of a negative medical outcome; it causes a certain kind of pain. But is it the same *kind* of evidence – i.e., to be measured on the same scale – as the transitioner’s self-reports of esteem, anxiety, self-assurance, etc.?
The answer is No, but under the powerful influence of the sexual revolution and its ideological fellow travelers, the medical community says Yes. This seems like the essential medical question, to me.

Last edited 11 months ago by Kirk Susong
Melissa Martin
Melissa Martin
11 months ago

If every child neutered by the Tavistock was happy all their lives, effectively remaining forever twelve inside, untroubled by sexual or reproductive function or desire, it would still be immoral.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Melissa Martin

In the UK concept of treatment, I doubt you will find any child so neutered, they reserve surgery for people 18yo and older within the NHS, and what is immoral is treating a physical birth variance as if it were a mental illness arising after parturition.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Melissa Martin

In the UK concept of treatment, I doubt you will find any child so neutered, they reserve surgery for people 18yo and older within the NHS, and what is immoral is treating a physical birth variance as if it were a mental illness arising after parturition.

Melissa Martin
Melissa Martin
11 months ago

If every child neutered by the Tavistock was happy all their lives, effectively remaining forever twelve inside, untroubled by sexual or reproductive function or desire, it would still be immoral.

Derek Smith
Derek Smith
11 months ago

The Crown Prosecution Service are in on the act now.

Here is a recent CPS guidance document:

https://www.cps.gov.uk/legal-guidance/domestic-abuse

According to Annex D in this document, under the heading of ‘Trans and non-binary victims’, forms of domestic abuse may include ‘withholding money for transitioning’ as well as ‘refusing to use their preferred name or pronoun’.
It will be quite easy to use this ‘guidance’ against parents.

Last edited 11 months ago by Derek Smith
harry storm
harry storm
11 months ago
Reply to  Derek Smith

Absolutely frightening. The CPS is as bad as UK cops in this regard.

harry storm
harry storm
11 months ago
Reply to  Derek Smith

Absolutely frightening. The CPS is as bad as UK cops in this regard.

Derek Smith
Derek Smith
11 months ago

The Crown Prosecution Service are in on the act now.

Here is a recent CPS guidance document:

https://www.cps.gov.uk/legal-guidance/domestic-abuse

According to Annex D in this document, under the heading of ‘Trans and non-binary victims’, forms of domestic abuse may include ‘withholding money for transitioning’ as well as ‘refusing to use their preferred name or pronoun’.
It will be quite easy to use this ‘guidance’ against parents.

Last edited 11 months ago by Derek Smith
Margaret TC
Margaret TC
11 months ago

This is an eye opening if very disturbing account of what is being done to gender distressed adolescents: https://www.city-journal.org/article/oregon-health-science-universitys-castration-machine

Talia Perkins
Talia Perkins
11 months ago
Reply to  Margaret TC

No, it is Social Conservative screed based on no evidence.

Talia Perkins
Talia Perkins
11 months ago
Reply to  Margaret TC

No, it is Social Conservative screed based on no evidence.

Margaret TC
Margaret TC
11 months ago

This is an eye opening if very disturbing account of what is being done to gender distressed adolescents: https://www.city-journal.org/article/oregon-health-science-universitys-castration-machine