I mean, the methodology exists, it's just extremely flawed. Affirmative care is the methodology, which more or less means doctors are required to rubberstamp any and all GAM requests.
As for whether a total child-GAM ban would throw the baby out with the bathwater, the argument for keeping child-GAM is that if someone is 100% guaranteed t…
I mean, the methodology exists, it's just extremely flawed. Affirmative care is the methodology, which more or less means doctors are required to rubberstamp any and all GAM requests.
As for whether a total child-GAM ban would throw the baby out with the bathwater, the argument for keeping child-GAM is that if someone is 100% guaranteed to get a sex change as an adult, it's medically much easier to start the process before puberty. It would also facilitate greater fairness in sports; Lia Thomas wouldn't have such a huge advantage if she'd transitioned before undergoing male puberty rather than after.
That said, Progressives like to THINK our current experts can accurately identify future transitioners at an early age, but the reality is they can't. Most kids with symptoms of youth gender dysphoria either outgrow it or grow up to be gay.
That's also why progressives want so badly to silence detransitioners, as they're the canary in the coal mine that current trans medicine is rife with false positives. It doesn't help that testosterone (aka steroids) tends to boost self-confidence, so adolescent girls are using it to self-medicate for depression and anxiety by identifying as trans, driving the rates of false positives up even further.
The other issue with trans medicine is it's currently repeating the same mistakes that gave us the opioid addiction crisis. Big Pharma is notorious for overpromising and underdelivering on the latest greatest Miracle Drug. For example, Oxycontin was heralded as the world's first non-addictive opioid painkiller. 20 years and countless overdoses later, that claim was clearly bullshit. Progressives have forgotten how to be skeptical of Big Pharma's constant overpromising, from "The covid vaccines will prevent you from infecting Grandma" to in the case of trans medicine "Puberty Blockers are completely reversible".
Because Progressives believe puberty blockers to be reversible, they think the occasional false positive in trans medicine is not that big of a deal, especially when they've convinced themselves that withholding said puberty blockers more or less guarantees the children in question will commit suicide.
Affirmative care is NOT a methodology for sorting out who SHOULD and SHOULD NOT receive blockers/hormones. Jesse stated that there are children who "SHOULD" receive blockers/hormones ("absolutely"), and (presumably) there are children who should not. What is Jesse's methodology for sorting gender dysphoric kids into these two groups (medically treat, medically don't treat)?
I have no idea, and I don't think Jesse does either.
Therefore I continue to support legal bans on GAM for children, as I believe the harm far far outweighs the good, and because the medical community has been completely captured by trans ideology and therefore is not making scientifically and medically sound decisions.
Sweden changed their rules recently to conform more to the "Dutch Protocol" and I believe a summary of it is that for children with persistent early dysphoria (that is, teenagers who have been dysphoric since childhood) that transition has very low "regret" rates and is highly justified.
Their more recent concerns are about adolescent onset dysphoria, and that it was better to do mental health therapy rather than hormones in these cases (at least, they were switching to limiting hormones etc to rare exceptions)
This is a summary for me from memory - but my PERSONAL takeaway was that blocking kids who have been dysphoric since early childhood from access to these medications is causing trans kids needless harm, but that sharply limiting teenagers who have only recently exhibited dysphoria symptoms from these same treatments was probably the right call.
So that's where I would currently lean on putting the line.
I would like to see the evidence that shows that "blocking kids who have been dysphoric since early childhood from access to these medications is causing trans kids needless harm". I would like to be sure that this conclusion is not based on godawfully bad statistical analysis, as so much of "trans" medicine is.
mmm.. Would you agree that if someone was 100% absolutely positively going to transition as an adult that they'd be better off if they got access to GAM as a teenager?
For "needless":
Now, even if you agree, that doesn't mean that you'd agree, for instance, that the result of having 98% of people go through GAM for whom it was correct and 2% end up having gotten drugs they shouldn't have gotten that was net positive. You might decide that was a net negative (and I don't know that you're wrong - it depends on the relative harms of course)
For the actual analysis, I encourage to you read Sweden's info for yourself.
"Would you agree that if someone was 100% absolutely positively going to transition as an adult that they'd be better off if they got access to GAM as a teenager?"
Yes. But the issue is what is the ACTUAL success rate of predicting adulthood transition on the basis of pre-puberty symptom presentation? It sure ain't 100%.
Also, it seems to me that it is essentially impossible to have good data on this. To collect it, you would need to have large numbers of pre-puberty gender dysphoric children, run the diagosis protocol, predict who will or will not transition as adults, and then DENY GAM to a large group who you predict will transition as adults, and then see what fraction actually do.
I very much doubt that this has ever been done, or ever will be done.
And so we are flying blind on GAM even for gender dysphoria even in early childhood.
Still, I will look at the Swedish report to see if they did better than this.
I've now read your link. There is no evidence presented that there exists a diagnostic protocol that can distinguish "true" gender dysphoria in a child (meaning that the child will choose to transition as an adult) from "false" (the child will choose not to transition as an adult).
According to SBU, based on current evidence, it is also not possible to determine how common it is for people who undergo gender-confirming treatment to later change their perception of their gender identity, interrupt treatment or in some aspect regret it. At the same time, it has been documented that detransition occurs, and there may also be an unknown figure, the National Board of Health and Welfare states.
For the group that regrets or interrupts an initiated treatment, there may be a risk that the treatment has led to poorer health or quality of life, says Thomas Lindén.
According to the National Board of Health and Welfare, puberty blocking or cross-sex hormone treatment should therefore only be offered in exceptional cases outside the framework of studies. The authority has developed criteria that care can be based on in the clinical assessment.
According to the authority, the clinical assessments should be in line with the criteria in the ‘Dutch protocol’. Central to this is that gender incongruity debuted during childhood, persisted over time, and that the development of puberty led to clear suffering.
===============
It sounds like they agree it is understudied - and that with exceptions for studies to determine whether this is generally the correct course, and an emphasis on persistent dysphoria (no ROGD) they're not doing any blockers.
That sounds more in line with your stance than I recalled reading - thanks for checking.
My question is, if kindergarteners are being actively encouraged to experiment with identifying as trans, could that muddy the waters between persistent dysphoria and "this gets me special attention" pseudo-dysphoria?
I think this “late onset dysphoria” is a fad. Everything about it is wrong. The absence of childhood symptoms, the gender distribution, the clamoring for attention.
All the pre-fad GD men I knew were quiet about their condition.
I don't think Jesse has or knows a methodology, he's just pointing out quite effectively that the medical community is not doing honest non idealogical research on this topic.
Maybe I'm splitting hairs, but I think affirmative care is a methodology. A godfuckingawful methodology, but a methodology nonetheless. It basically works on an opt-in basis; the kids who ask for GAM get GAM, and the kids who don't, don't.
I agree that Jesse seems to have rejected affirmative care without proposing an alternative methodology in its place.
Yes, this is my complaint with Jesse: he ends this piece by blasting Republcians for wanting to ban GAM for kids, but does not (it seems to me) have an actual reason for opposing such a ban.
This is one of my ongoing nits with Jesse, who I really enjoy reading - he seems to frequently feel the need to trumpet his lefty bona fides in ways that often seem a bit ham-fisted
Well, there's a difference between not having a reason and not having a better alternative.
The reason is that a blanket ban on child GAM could potentially be an overcorrection that harms legitimately trans kids.
However, until we can reliably tell the difference between lifetime gender dysphoria and temporary "it's just a phase" gender dysphoria, a temporary moratorium on child GAM does seem prudent to me as well.
We can't reliably tell the difference, and the prospects for ever being able to do so are very dim. Just think through the experimental protocol that would be needed for such a verification (I've outlined it in another comment).
Isnt Jesse always advocating for better screening and counseling prior to medical interventions? Isn’t that the piece that’s largely been dropped from GAM in the States?
Yes, but I think the question is what exactly does that screening process look like? How do you know if a 12 year old with Gender Dysphoria will still have GD in 10 years, or if it will wear off?
I see what you’re asking. It just seems to me that Jesse has always held up the Dutch protocol—which worked with a different population than the current cohort, and which screened much more carefully for patients—as the gold standard, even if that standard still has flaws.
"The other issue with trans medicine is it's currently repeating the same mistakes that gave us the opioid addiction crisis. Big Pharma is notorious for overpromising and underdelivering on the latest greatest Miracle Drug. For example, Oxycontin was heralded as the world's first non-addictive opioid painkiller. 20 years and countless overdoses later, that claim was clearly bullshit."
I mean, the methodology exists, it's just extremely flawed. Affirmative care is the methodology, which more or less means doctors are required to rubberstamp any and all GAM requests.
As for whether a total child-GAM ban would throw the baby out with the bathwater, the argument for keeping child-GAM is that if someone is 100% guaranteed to get a sex change as an adult, it's medically much easier to start the process before puberty. It would also facilitate greater fairness in sports; Lia Thomas wouldn't have such a huge advantage if she'd transitioned before undergoing male puberty rather than after.
That said, Progressives like to THINK our current experts can accurately identify future transitioners at an early age, but the reality is they can't. Most kids with symptoms of youth gender dysphoria either outgrow it or grow up to be gay.
That's also why progressives want so badly to silence detransitioners, as they're the canary in the coal mine that current trans medicine is rife with false positives. It doesn't help that testosterone (aka steroids) tends to boost self-confidence, so adolescent girls are using it to self-medicate for depression and anxiety by identifying as trans, driving the rates of false positives up even further.
The other issue with trans medicine is it's currently repeating the same mistakes that gave us the opioid addiction crisis. Big Pharma is notorious for overpromising and underdelivering on the latest greatest Miracle Drug. For example, Oxycontin was heralded as the world's first non-addictive opioid painkiller. 20 years and countless overdoses later, that claim was clearly bullshit. Progressives have forgotten how to be skeptical of Big Pharma's constant overpromising, from "The covid vaccines will prevent you from infecting Grandma" to in the case of trans medicine "Puberty Blockers are completely reversible".
Because Progressives believe puberty blockers to be reversible, they think the occasional false positive in trans medicine is not that big of a deal, especially when they've convinced themselves that withholding said puberty blockers more or less guarantees the children in question will commit suicide.
Affirmative care is NOT a methodology for sorting out who SHOULD and SHOULD NOT receive blockers/hormones. Jesse stated that there are children who "SHOULD" receive blockers/hormones ("absolutely"), and (presumably) there are children who should not. What is Jesse's methodology for sorting gender dysphoric kids into these two groups (medically treat, medically don't treat)?
I have no idea, and I don't think Jesse does either.
Therefore I continue to support legal bans on GAM for children, as I believe the harm far far outweighs the good, and because the medical community has been completely captured by trans ideology and therefore is not making scientifically and medically sound decisions.
Sweden changed their rules recently to conform more to the "Dutch Protocol" and I believe a summary of it is that for children with persistent early dysphoria (that is, teenagers who have been dysphoric since childhood) that transition has very low "regret" rates and is highly justified.
Their more recent concerns are about adolescent onset dysphoria, and that it was better to do mental health therapy rather than hormones in these cases (at least, they were switching to limiting hormones etc to rare exceptions)
This is a summary for me from memory - but my PERSONAL takeaway was that blocking kids who have been dysphoric since early childhood from access to these medications is causing trans kids needless harm, but that sharply limiting teenagers who have only recently exhibited dysphoria symptoms from these same treatments was probably the right call.
So that's where I would currently lean on putting the line.
I would like to see the evidence that shows that "blocking kids who have been dysphoric since early childhood from access to these medications is causing trans kids needless harm". I would like to be sure that this conclusion is not based on godawfully bad statistical analysis, as so much of "trans" medicine is.
Is your concern "needless" or "harm"?
For "harm":
mmm.. Would you agree that if someone was 100% absolutely positively going to transition as an adult that they'd be better off if they got access to GAM as a teenager?
For "needless":
Now, even if you agree, that doesn't mean that you'd agree, for instance, that the result of having 98% of people go through GAM for whom it was correct and 2% end up having gotten drugs they shouldn't have gotten that was net positive. You might decide that was a net negative (and I don't know that you're wrong - it depends on the relative harms of course)
For the actual analysis, I encourage to you read Sweden's info for yourself.
Here is a link:
https://genderreport.ca/the-swedish-u-turn-on-gender-transitioning/#:~:text=Sweden%20National%20Board%20of%20Health%20and%20Welfare%20Update&text=%E2%80%9CThe%20diagnosis%20of%20gender%20dysphoria,at%20birth%20has%20increased%20most.
"Would you agree that if someone was 100% absolutely positively going to transition as an adult that they'd be better off if they got access to GAM as a teenager?"
Yes. But the issue is what is the ACTUAL success rate of predicting adulthood transition on the basis of pre-puberty symptom presentation? It sure ain't 100%.
Also, it seems to me that it is essentially impossible to have good data on this. To collect it, you would need to have large numbers of pre-puberty gender dysphoric children, run the diagosis protocol, predict who will or will not transition as adults, and then DENY GAM to a large group who you predict will transition as adults, and then see what fraction actually do.
I very much doubt that this has ever been done, or ever will be done.
And so we are flying blind on GAM even for gender dysphoria even in early childhood.
Still, I will look at the Swedish report to see if they did better than this.
I've now read your link. There is no evidence presented that there exists a diagnostic protocol that can distinguish "true" gender dysphoria in a child (meaning that the child will choose to transition as an adult) from "false" (the child will choose not to transition as an adult).
Hmm, maybe I sent you the wrong link I thought I remembered seeing more information, but when I went looking myself I had trouble finding it.
Reading this:
https://genspect.org/breaking-sweden-drastically-changes-protocol-prioritizes-psychotherapy/
=====================
According to SBU, based on current evidence, it is also not possible to determine how common it is for people who undergo gender-confirming treatment to later change their perception of their gender identity, interrupt treatment or in some aspect regret it. At the same time, it has been documented that detransition occurs, and there may also be an unknown figure, the National Board of Health and Welfare states.
For the group that regrets or interrupts an initiated treatment, there may be a risk that the treatment has led to poorer health or quality of life, says Thomas Lindén.
According to the National Board of Health and Welfare, puberty blocking or cross-sex hormone treatment should therefore only be offered in exceptional cases outside the framework of studies. The authority has developed criteria that care can be based on in the clinical assessment.
According to the authority, the clinical assessments should be in line with the criteria in the ‘Dutch protocol’. Central to this is that gender incongruity debuted during childhood, persisted over time, and that the development of puberty led to clear suffering.
===============
It sounds like they agree it is understudied - and that with exceptions for studies to determine whether this is generally the correct course, and an emphasis on persistent dysphoria (no ROGD) they're not doing any blockers.
That sounds more in line with your stance than I recalled reading - thanks for checking.
My question is, if kindergarteners are being actively encouraged to experiment with identifying as trans, could that muddy the waters between persistent dysphoria and "this gets me special attention" pseudo-dysphoria?
I think this “late onset dysphoria” is a fad. Everything about it is wrong. The absence of childhood symptoms, the gender distribution, the clamoring for attention.
All the pre-fad GD men I knew were quiet about their condition.
I don't think Jesse has or knows a methodology, he's just pointing out quite effectively that the medical community is not doing honest non idealogical research on this topic.
Maybe I'm splitting hairs, but I think affirmative care is a methodology. A godfuckingawful methodology, but a methodology nonetheless. It basically works on an opt-in basis; the kids who ask for GAM get GAM, and the kids who don't, don't.
I agree that Jesse seems to have rejected affirmative care without proposing an alternative methodology in its place.
Yes, this is my complaint with Jesse: he ends this piece by blasting Republcians for wanting to ban GAM for kids, but does not (it seems to me) have an actual reason for opposing such a ban.
This is one of my ongoing nits with Jesse, who I really enjoy reading - he seems to frequently feel the need to trumpet his lefty bona fides in ways that often seem a bit ham-fisted
Well, there's a difference between not having a reason and not having a better alternative.
The reason is that a blanket ban on child GAM could potentially be an overcorrection that harms legitimately trans kids.
However, until we can reliably tell the difference between lifetime gender dysphoria and temporary "it's just a phase" gender dysphoria, a temporary moratorium on child GAM does seem prudent to me as well.
We can't reliably tell the difference, and the prospects for ever being able to do so are very dim. Just think through the experimental protocol that would be needed for such a verification (I've outlined it in another comment).
yeah I've wondered myself how the hell you'd ever maintain a proper control group.
I vote for return to responsible criteria: strict diagnosis, a year of living as the opposite gender, no medical treatment before 18.
Isnt Jesse always advocating for better screening and counseling prior to medical interventions? Isn’t that the piece that’s largely been dropped from GAM in the States?
Yes, but I think the question is what exactly does that screening process look like? How do you know if a 12 year old with Gender Dysphoria will still have GD in 10 years, or if it will wear off?
I see what you’re asking. It just seems to me that Jesse has always held up the Dutch protocol—which worked with a different population than the current cohort, and which screened much more carefully for patients—as the gold standard, even if that standard still has flaws.
"The other issue with trans medicine is it's currently repeating the same mistakes that gave us the opioid addiction crisis. Big Pharma is notorious for overpromising and underdelivering on the latest greatest Miracle Drug. For example, Oxycontin was heralded as the world's first non-addictive opioid painkiller. 20 years and countless overdoses later, that claim was clearly bullshit."
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