Let's re-think South Carolina ban on gender-affirming care

[Evangelicalhumanist]

The National Center for Transgender Equality has just released "Early Insights" from its 2022 survey -- the largest ever done -- of transgener people in the United States. And boy, does it ever seem to contradict a lot of what the nay-sayers in the previous thread on this topic continue to claim!

The survey covered 92,329, including 84,170 adults (18 and older), from all fifty states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the U.S. Virgin Islands, and U.S. military bases overseas. So this is a very non-trivial survey, as these things go.

So check out these survey results -- and then can we hear from the nay-sayers again, please?

Life Satisfaction after Transitioning Gender

A lot more satisfied ----------- 79%
A little more satisfied --------- 15% (Total more satisfied = 94%)
Neither more nor less --------- 3%
A little less satisfied ------------1%
A lot less satisfied ------------- 2%

Life Satisfaction after Receiving Hormone Treatment

A lot more satisfied ----------- 84%
A little more satisfied --------- 14% (Total more satisfied = 98%)
Neither more nor less --------- 0%
A little less satisfied ------------ 1%
A lot less satisfied -------------<1%

Life Satisfaction after Gender-Affirming Surgery

A lot more satisfied ------------ 88%
A little more satisfied ----------- 9% (Total more satisfied = 97%)
Neither more nor less ----------- 1%
A little less satisfied ------------ <1%
A lot less satisfied --------------- 1%

 

[Revoltingest]

Clearly, those results are so terrible that
transition should be banned.
(I'm beating another poster to the punch.)

 

[Evangelicalhumanist]

Clearly, those results are so terrible that
transition should be banned.
(I'm beating another poster to the punch.

And I'm expecting that "other poster" to not reply at all -- for obvious reasons.

 

[Quintessence]

None of this will matter to the bigots forwarding discriminatory legislation.

My state literally was considering being the first in the nation to remove a civil right - equality based on gender identity - this session.

That is now deep the bigotry runs with these folks. It's disgusting.

Vote.

Them.

Out.

 

[Soandso]

And I'm expecting that "other poster" to not reply at all -- for obvious reasons.

I think they will - after a time. They will bring up some unrelated things such as putting the rights of trans people over real women or some such

 

[Valjean]

Hormonal and surgical intervention needs to be started before puberty creates permanent physical changes and obstacles to transition. That seems to be where much of the problem lies -- the age intervention must be initiated.

 

[Revoltingest]

Hormonal and surgical intervention needs to be started before puberty creates permanent physical changes and obstacles. to transition. That seems to be where much of the problem lies -- the age intervention must be initiated.

It appears that the "other poster" doesn't consider this
in light of improving screening, counselling, & counseling.
The only solution for some is 100% prohibition.
That's very destructive, as you point out.
You're smart....for a racoon.

 

[icehorse]

So check out these survey results -- and then can we hear from the nay-sayers again, please?

I might be off base here, but I suspect I fall into the "nay-sayer" category?

If so, I'd be happy to discuss this survey, and dig into the details a bit. But long experience on this topic is that I get a LOT of personal insults, so I will not engage with any posters who start in with personal insults.

==

I skimmed through the 23 page report and I might have missed a few things, but here are some initial thoughts:

1 - My main criticism has concerned GAC for kids. This study is limited to the 16+ demographic.
2 - I did not see any mention of longitudinal studies. In other words, how long ago did a "very satisfied" person transition? We know that from a psychological perspective, people tend to initially be very happy with the results of big, irreversible decisions they make. Regret often comes years or decades later. Hence the very existence of longitudinal studies.
3 - This report was done mostly by advocacy groups, and they're very explicit about that in the intro pages.

So, more to unpack later, this is a start to see if we can have a good faith discussion

 

[icehorse]

It appears that the "other poster" doesn't consider this
in light of improving screening, counselling, & counseling.
The only solution for some is 100% prohibition.
That's very destructive, as you point out.
You're smart....for a racoon.

And @Valjean -

"If" you're talking about me (which is likely but not certain), then you're strawmanning me. I have been very explicit on this point.

First - this study is about the 16+ demographic, and you're presumably talking about kids?
And yes, my criticisms have been focused on GAC for kids. So the OP might tell us we're already off topic but...

Many kids and adolescents go thru severe GD, and grow out of it without drugs or surgeries. A large percentage of these kids end up realizing that they are gay.

As I've said before, IF counselors had crystal balls, and could somehow determine which kids would not grow thru GD naturally, then GAC would be somewhat more ethical. But no such crystal ball exists. Without that crystal ball, GAC is a crap shoot. Might help some kids, might needlessly destroy the lives of others.

So what's your ethical math?

 

[Valjean]

And @Valjean -

"If" you're talking about me (which is likely but not certain), then you're strawmanning me. I have been very explicit on this point.

I'm not talking about any individual. I'm talking about medicine.

First - this study is about the 16+ demographic, and you're presumably talking about kids?
And yes, my criticisms have been focused on GAC for kids. So the OP might tell us we're already off topic but...

Many kids and adolescents go thru severe GD, and grow out of it without drugs or surgeries. A large percentage of these kids end up realizing that they are gay.

Which is why careful screening is necessary. If a anatomical male is found to have a woman's brain, what is to be done, change the brain, change the body, change the lifestyle/presentation, or do nothing?

As I've said before, IF counselors had crystal balls, and could somehow determine which kids would not grow thru GD naturally, then GAC would be somewhat more ethical. But no such crystal ball exists. Without that crystal ball, GAC is a crap shoot. Might help some kids, might needlessly destroy the lives of others.

Don't councilors have PET, fMRI, or CAT?

So what's your ethical math?

Do no ham. Maximize well-being.

 

[icehorse]

Do no ham. Maximize well-being.

Hey! I don't eat pork either

So we agree on the above, which gets us back to the problem of administering dangerous, irreversible drugs on kids that don't need them? Since we DO NOT know which kids will be trans after adolescence how do we decide which kids to put thru GAC?

If a anatomical male is found to have a woman's brain, what is to be done, change the brain, change the body, change the lifestyle/presentation, or do nothing?

I don't think scientists strictly say that their are male brains and female brains. There is a lot of overlap, and their are some statistical differences, but we do not have the technology to say: "this kid with GD has a "female brain" and therefore they will identify as female once they've gone thru adolescence.

==

Is it scientifically true that the brain of a transgender person is similar to the brain of the gender they identify with?
It is NOT correct to say that. BUT popular articles DO have titles that say something like transgender people have brains of their desired gender primarily to draw your attention. Always pay attention to the methodology when you read a paper.

A literature review published in 2021 says “Results suggest that, although the majority of neuroanatomical, neurophysiological, and neurometabolic features in transgenders resemble those of their natal sex rather than those of their experienced gender, and in homosexuals these resemble those of their same-sex heterosexual population rather than their opposite sex heterosexual population, in the gender identity investigation, in MtF it was possible to find traits which are “feminine and demasculinized” and in FtM it was possible to find traits which are “masculine and defeminized” (Kreukels & Guillamon, 2016

). The same could be said with regard to the investigation on sexual orientation, where some brain features in the homosexual population from the studies reviewed resembled those of the heterosexual population of their opposite sex. Due to conflicting results, it was, however, not possible to identify specific brain features which consistently differ between cisgender and transgender nor between heterosexual and homosexual groups.

Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same-sex heterosexual population rather than their opposite-sex heterosexual population.”
https://link.springer.com/article/10.1007/s10508-021-02005-9
https://link.springer.com/article/10.1007/s10508-021-02005-9
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
This review systematically explored structural, functional, and metabolic features of the cisgender brain compared with the transgender brain before hormonal treatment and the heterosexual brain compared to the homosexual brain from the analysis of the neuroimaging literature up to 2018, and identified and discussed subsequent studies published up to March 2021. Our main aim was to help identifying neuroradiological brain features that have been related to human sexuality to contribute to the understanding of the biological elements involved in gender identity and sexual orientation. We analyzed 39 studies on gender identity and 24 on sexual orientation. Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same-sex heterosexual population rather than their opposite-sex heterosexual population. However, it is always difficult to interpret findings with noninvasive neuroimaging. Given the gross nature of these measures, it is possible that more differences too subtle to measure with available tools yet contributing to gender identity and sexual orientation could be found. Conflicting results contributed to the difficulty of identifying specific brain features which consistently differ between cisgender and transgender or between heterosexual and homosexual groups. The small number of studies, the small-to-moderate sample size of each study, and the heterogeneity of the investigations made it impossible to meta-analyze all the data extracted. Further studies are necessary to increase the understanding of the neurological substrates of human sexuality.
https://link.springer.com/article/10.1007/s10508-021-02005-9
https://link.springer.com/article/10.1007/s10508-021-02005-9

If anything, it's more accurate to say tansgender people have certain parts of their brains that are morphologically closer to their desired gender. BUT most of their brains resemble structurally to their natal sex. Male brain? Female brain? Mm … all brains are “intersex.” So it's not incorrect to say transgender people have an intersex brain in this sense. But who doesn't have an intersex brain?

 

[Shadow Wolf]

So what's your ethical math?

It involves uninformed and uneducated laymen and bigots butting out and letting healthcare providers take care of their patients free of your ignorant opinions.

 

[Valjean]

Hey! I don't eat pork either

So we agree on the above, which gets us back to the problem of administering dangerous, irreversible drugs on kids that don't need them? Since we DO NOT know which kids will be trans after adolescence how do we decide which kids to put thru GAC?

We do our best to determine which kids are, in fact, trans. We are pretty good at this, and getting better all the time.
Consider consequences and identification rates.
The negative consequences of failing to treat actual trans kids is statistically greater than the harm from treating non-trans claimants.

I don't think scientists strictly say that their are male brains and female brains. There is a lot of overlap, and their are some statistical differences, but we do not have the technology to say: "this kid with GD has a "female brain" and therefore they will identify as female once they've gone thru adolescence.

We have CTs that can identify the anatomical differences, and fMRI and PET scans that can see the neuronal variations. There is also the behavioral evidence and parental and personal claims. The number of false IDs is low.

Is it scientifically true that the brain of a transgender person is similar to the brain of the gender they identify with?
It is NOT correct to say that. BUT popular articles DO have titles that say something like transgender people have brains of their desired gender primarily to draw your attention. Always pay attention to the methodology when you read a paper.

A literature review published in 2021 says “Results suggest that, although the majority of neuroanatomical, neurophysiological, and neurometabolic features in transgenders resemble those of their natal sex rather than those of their experienced gender, and in homosexuals these resemble those of their same-sex heterosexual population rather than their opposite sex heterosexual population, in the gender identity investigation, in MtF it was possible to find traits which are “feminine and demasculinized” and in FtM it was possible to find traits which are “masculine and defeminized” (Kreukels & Guillamon, 2016

). The same could be said with regard to the investigation on sexual orientation, where some brain features in the homosexual population from the studies reviewed resembled those of the heterosexual population of their opposite sex. Due to conflicting results, it was, however, not possible to identify specific brain features which consistently differ between cisgender and transgender nor between heterosexual and homosexual groups.

Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same-sex heterosexual population rather than their opposite-sex heterosexual population.”
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
This review systematically explored structural, functional, and metabolic features of the cisgender brain compared with the transgender brain before hormonal treatment and the heterosexual brain compared to the homosexual brain from the analysis of the neuroimaging literature up to 2018, and identified and discussed subsequent studies published up to March 2021. Our main aim was to help identifying neuroradiological brain features that have been related to human sexuality to contribute to the understanding of the biological elements involved in gender identity and sexual orientation. We analyzed 39 studies on gender identity and 24 on sexual orientation. Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same-sex heterosexual population rather than their opposite-sex heterosexual population. However, it is always difficult to interpret findings with noninvasive neuroimaging. Given the gross nature of these measures, it is possible that more differences too subtle to measure with available tools yet contributing to gender identity and sexual orientation could be found. Conflicting results contributed to the difficulty of identifying specific brain features which consistently differ between cisgender and transgender or between heterosexual and homosexual groups. The small number of studies, the small-to-moderate sample size of each study, and the heterogeneity of the investigations made it impossible to meta-analyze all the data extracted. Further studies are necessary to increase the understanding of the neurological substrates of human sexuality.
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature - Archives of Sexual Behavior
If anything, it's more accurate to say tansgender people have certain parts of their brains that are morphologically closer to their desired gender. BUT most of their brains resemble structurally to their natal sex. Male brain? Female brain? Mm … all brains are “intersex.” So it's not incorrect to say transgender people have an intersex brain in this sense. But who doesn't have an intersex brain?

What is our batting average? What is the percentage of positive outcomes from medical intervention compared to the negative?
Should we go with the current percentages, or err on the side of caution even when it statistically produces more negative results than current rates of intervention?

 

[icehorse]

The negative consequences of failing to treat actual trans kids is statistically greater than the harm from treating non-trans claimants.

Can you expand on that? There are at least 3 claims in that sentence, all of which would need to be true...

And how would you measure "negative consequences"?

I will say though that your arguments are much more thoughtful than I'm used to seeing, thanks!

 

[Twilight Hue]

And @Valjean -

"If" you're talking about me (which is likely but not certain), then you're strawmanning me. I have been very explicit on this point.

First - this study is about the 16+ demographic, and you're presumably talking about kids?
And yes, my criticisms have been focused on GAC for kids. So the OP might tell us we're already off topic but...

Many kids and adolescents go thru severe GD, and grow out of it without drugs or surgeries. A large percentage of these kids end up realizing that they are gay.

As I've said before, IF counselors had crystal balls, and could somehow determine which kids would not grow thru GD naturally, then GAC would be somewhat more ethical. But no such crystal ball exists. Without that crystal ball, GAC is a crap shoot. Might help some kids, might needlessly destroy the lives of others.

So what's your ethical math?

That's why the legislation is there to prevent those disasters from happening.

In the end however, I think regardless of the outcomes if a decision is made, that person's going to have to live with their decisions good or bad. So my logic is if you want to destroy your life go ahead , because you will have nobody to blame but yourself.

So if it's overwhelming to the point where you're throwing up your hands in the air, I would say don't ban it for the sake of preserving the individual freedom to choose, and just let the chips fall where it may and with any, if at all consequences that could follow such decisions.

Life goes on.

 

[icehorse]

That's why the legislation is there to prevent those disasters from happening.

In the end however, I think regardless of the outcomes if a decision is made, that person's going to have to live with their decisions good or bad. So my logic is if you want to destroy your life go ahead , because you will have nobody to blame but yourself.

So if it's overwhelming to the point where you're throwing up your hands in the air, I would say don't ban it for the sake of preserving the individual freedom to choose, and just let the chips fall where it may and with any, if at all consequences that could follow such decisions.

Life goes on.

My take is that's all fine for adults, but not for kids.

 

[Twilight Hue]

My take is that's all fine for adults, but not for kids.

True. But sometimes I think people ought to freely destroy lives in their ignorance and pride keeping the gene pool as stable as possible as life lessons at times must be learned the hard way.

 

[libre]

Hormonal and surgical intervention needs to be started before puberty creates permanent physical changes and obstacles to transition. That seems to be where much of the problem lies -- the age intervention must be initiated.

Yep.
When people say that puberty blockers need to be banned for minors, they are really saying that puberty blockers need to be banned period, they aren't really useful if one has already been subjected to the puberty they wanted to avoid.

 

[icehorse]

Yep.
When people say that puberty blockers need to be banned for minors, they are really saying that puberty blockers need to be banned period, they aren't really useful if one has already been subjected to the puberty they wanted to avoid.

Nope.
First, the context is limited to GAC.
Second, what should the healthcare provider's only goal be?

 

[libre]

Second, what should the healthcare provider's only goal be?

Hippocratic Oath, which includes respecting the scientific gains of prior physicians, not doing harm, and providing all medical treatment required by circumstance.

NOVA | Doctors' Diaries | The Hippocratic Oath: Modern Version | PBS

(Image 2) In this interactive feature, let vintage aircraft expert Dan Taylor guide you on an audio tour of a Demoiselle #20 replica owned by Old Rhinebeck Aerodrome, a museum of antique aviation.

www.pbs.org

Laws restricting GAC force doctors to violate all of the above when they make children go through a puberty that is causing them harm, because of the concerns of politicians and their base of zealots.