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by howinteresting 1163 days ago
> 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.

2 comments

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... [1] https://www.thetrevorproject.org/wp-content/uploads/2020/07/... << Warning, PDF.

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?

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?

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.

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.
None of those stats are in the Trevor Project report. Cite the pages if you think they are, or surrender the argument.

It does say:

>Affirming gender identity among transgender and nonbinary youth is consistently associated with lower rates of suicide attempts.

And the report actually says nothing about transition healthcare.

A 40% attempted suicide rate does not suggest "satisfaction" to me. It suggests mental illness.
"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.

>GAC, by definition, sterilizes the person

That's crazy, my trans masc friend Kyle just carried a baby to term and delivered it, but to be fair I can't 100% confirm he didn't just hide a frozen turkey under his cardigan for 9 months

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.
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.

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.

> 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.

Do your suspicions in this instance merit an intervention in care for other people? At what point do your 'feelings' matter so much that you get to tell other people what to do medically with their own children? Apply this in an inverse fashion -- at what point do other people who suspect doctors are not right get to tell you how to make medical decision regarding your children?

Let's compare how many times Doctors as a group have been wrong about something vs Politicians. Are you still for Politicians making medical decisions for people?