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> Reasonable, empathetic people are capable of thinking that "gender-affirming care" is an ideologically-driven phenomenon that does more harm than good. The o

> Reasonable, empathetic people are capable of thinking that "gender-affirming care" is an ideologically-driven phenomenon that does more harm than good. The only way it is possible for a reasonable, empathetic person to believe that the state government banning GAC is good, is if they're stupid. Which is ok to some degree, many people are stupid.

all2 4y ago
If the point of gender affirming care (GAC) is to improve the mental health outcomes of the one being cared for, then it is a colossal waste of time. Mental health outcomes do not demonstrably improve after a person is placed on HRT and had their genitalia suitably modified. In fact, their long term health outcomes decline significantly later in life [0]. The suicide rate of transgender individuals is about 40%. This does not take into account whether they received GAC or not [1]. Per [0], even GAC does not improve late life all cause morbidity. I oppose gender affirming care on the grounds that it does not effectively improve a person's life (which we can see over a 30 year period in [0]) and that it often requires damaging the delicate balance of the biological machine that is the human body. If that makes me "stupid", so be it. [0] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885 https://journals.plos.org/plosone/article?id=10.1371/journal... [1] https://www.thetrevorproject.org/wp-content/uploads/2020/07/The-Trevor-Project-National-Survey-Results-2020.pdf https://www.thetrevorproject.org/wp-content/uploads/2020/07/... << Warning, PDF.
- howinteresting 4y ago
  Correct, that makes you stupid. Your premise is wrong (the correct endpoint is satisfaction and regret rates, since there are many confounding factors with something like mental health), your data doesn't show why you think it shows (the Sweden study was done in a time when the Swedish government mandated sterilization for trans people), and GAC changes the balance of the body much less than, say, lithium. Next question?
  - all2 4y ago
    GAC, by definition, sterilizes the person. Both on the hormonal front and, if they have bottom surgery, physically as well. HRT vs lithium? Dunno, I'm not a doctor. I do know that exogenous hormones can cause a body to stop producing the hormone, even at sub-clinical levels. I also know that GAC surgeries cannot be undone. But you can stop taking lithium. And all of this in the face of 40+% suicide rate that isn't affected by GAC in the slightest. Who is the ideological one here?
    - howinteresting 4y ago
      The correct endpoint is satisfaction and regret rates. GAC has some of the highest satisfaction rates and lowest regret rates in all of medicine. edit: I'm going to say this very slowly: The Sweden study about suicide rates was done in a time when the Swedish government mandated sterilization for trans people. Does that help? edit 2: since it's still not clear: The Sweden study about suicide rates was done in a time when the Swedish government mandated sterilization for trans people.
      - all2 4y ago
        A 40% attempted suicide rate does not suggest "satisfaction" to me. It suggests mental illness.
        ofcourseyoudo 4y ago
        "seriously considered" != "attempted" And the Trevor Project report shows a number of interventions that provide statistically significant reduction in suicidal ideation and attempts. I assume you support those interventions, since you seem extremely considered with the suicide rates of LGBTQ youth.
      - all2 4y ago
        The Sweden study is backed up by the Trevor Project (which I linked above somewhere) that shows as many as 80% of the transgender population have suicidal ideations and as many as 60% have attempted suicide. And this is from self-reporting. The stats aren't just from Sweden.
prottog 4y ago
If a teenage girl standing 5'7" and weighing 80 pounds came to the doctor and said she feels too fat and needs to lose weight, the doctor would rightly tell her that she is anorexic, that her being too fat is only in her head, and that she should instead gain a bit of weight to be healthy. A doctor who instead prescribes her weight loss pills would be treated with skepticism; a doctor who performed gastric bypass on her would rightly be excoriated and maybe even have their medical license taken away. If there was an epidemic of such doctors, voters would rightly take alarm and may even petition the state legislature to ban such a practice. None of this would be stupid.
- howinteresting 4y ago
  Correct, but anorexia is very different from gender dysphoria and involves diametrically opposite treatment protocols. edit: responding to prottog: > gender dysphoria was classified a mental illness [...] It's only very recently that with the former we started to take the (mentally unwell) patient's word over evidence. You're the one begging the question now. If gender dysphoria really is a mental illness, why are regret rates for gender-affirming care so low? One of the defining characteristics of a mental illness is that if you "feed into it", it gets worse. For example, with schizophrenia, you should not validate the voices someone might be hearing because doing so makes it worse. The situation with gender dysphoria is exactly the opposite.
  - prottog 4y ago
    Treatment protocols aren't divine edicts. They can be wrong. The medical community is as susceptible as any to groupthink and being taken in by the current culture milieu, as well as being influenced by moneyed interests. As recently as ten years ago, with DSM-5, gender dysphoria was classified a mental illness, much like how anorexia is still classified as one. It's only very recently that with the former we started to take the (mentally unwell) patient's word over evidence. Doctors used to say that cigarettes were good for you. I suspect that we'll look back at gender-affirming care the same way in a few decades.
    - 4y ago

all2 4y ago

If the point of gender affirming care (GAC) is to improve the mental health outcomes of the one being cared for, then it is a colossal waste of time. Mental health outcomes do not demonstrably improve after a person is placed on HRT and had their genitalia suitably modified. In fact, their long term health outcomes decline significantly later in life [0]. The suicide rate of transgender individuals is about 40%. This does not take into account whether they received GAC or not [1]. Per [0], even GAC does not improve late life all cause morbidity. I oppose gender affirming care on the grounds that it does not effectively improve a person's life (which we can see over a 30 year period in [0]) and that it often requires damaging the delicate balance of the biological machine that is the human body. If that makes me "stupid", so be it. [0] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885 https://journals.plos.org/plosone/article?id=10.1371/journal... [1] https://www.thetrevorproject.org/wp-content/uploads/2020/07/The-Trevor-Project-National-Survey-Results-2020.pdf https://www.thetrevorproject.org/wp-content/uploads/2020/07/... << Warning, PDF.

howinteresting 4y ago
Correct, that makes you stupid. Your premise is wrong (the correct endpoint is satisfaction and regret rates, since there are many confounding factors with something like mental health), your data doesn't show why you think it shows (the Sweden study was done in a time when the Swedish government mandated sterilization for trans people), and GAC changes the balance of the body much less than, say, lithium. Next question?
- all2 4y ago
  GAC, by definition, sterilizes the person. Both on the hormonal front and, if they have bottom surgery, physically as well. HRT vs lithium? Dunno, I'm not a doctor. I do know that exogenous hormones can cause a body to stop producing the hormone, even at sub-clinical levels. I also know that GAC surgeries cannot be undone. But you can stop taking lithium. And all of this in the face of 40+% suicide rate that isn't affected by GAC in the slightest. Who is the ideological one here?
  - howinteresting 4y ago
    The correct endpoint is satisfaction and regret rates. GAC has some of the highest satisfaction rates and lowest regret rates in all of medicine. edit: I'm going to say this very slowly: The Sweden study about suicide rates was done in a time when the Swedish government mandated sterilization for trans people. Does that help? edit 2: since it's still not clear: The Sweden study about suicide rates was done in a time when the Swedish government mandated sterilization for trans people.
    - all2 4y ago
      A 40% attempted suicide rate does not suggest "satisfaction" to me. It suggests mental illness.
      - ofcourseyoudo 4y ago
        "seriously considered" != "attempted" And the Trevor Project report shows a number of interventions that provide statistically significant reduction in suicidal ideation and attempts. I assume you support those interventions, since you seem extremely considered with the suicide rates of LGBTQ youth.
    - all2 4y ago
      The Sweden study is backed up by the Trevor Project (which I linked above somewhere) that shows as many as 80% of the transgender population have suicidal ideations and as many as 60% have attempted suicide. And this is from self-reporting. The stats aren't just from Sweden.

prottog 4y ago

If a teenage girl standing 5'7" and weighing 80 pounds came to the doctor and said she feels too fat and needs to lose weight, the doctor would rightly tell her that she is anorexic, that her being too fat is only in her head, and that she should instead gain a bit of weight to be healthy. A doctor who instead prescribes her weight loss pills would be treated with skepticism; a doctor who performed gastric bypass on her would rightly be excoriated and maybe even have their medical license taken away. If there was an epidemic of such doctors, voters would rightly take alarm and may even petition the state legislature to ban such a practice. None of this would be stupid.

howinteresting 4y ago
Correct, but anorexia is very different from gender dysphoria and involves diametrically opposite treatment protocols. edit: responding to prottog: > gender dysphoria was classified a mental illness [...] It's only very recently that with the former we started to take the (mentally unwell) patient's word over evidence. You're the one begging the question now. If gender dysphoria really is a mental illness, why are regret rates for gender-affirming care so low? One of the defining characteristics of a mental illness is that if you "feed into it", it gets worse. For example, with schizophrenia, you should not validate the voices someone might be hearing because doing so makes it worse. The situation with gender dysphoria is exactly the opposite.
- prottog 4y ago
  Treatment protocols aren't divine edicts. They can be wrong. The medical community is as susceptible as any to groupthink and being taken in by the current culture milieu, as well as being influenced by moneyed interests. As recently as ten years ago, with DSM-5, gender dysphoria was classified a mental illness, much like how anorexia is still classified as one. It's only very recently that with the former we started to take the (mentally unwell) patient's word over evidence. Doctors used to say that cigarettes were good for you. I suspect that we'll look back at gender-affirming care the same way in a few decades.
  - 4y ago