The Age of Advanced Incoherence 3: Desistance & Mythmaking

One thing that needs emphasizing is that the whole pro- vs. anti-transgender dichotomy may be largely imaginary, because there’s no clarification about what, exactly, one is supposed to be for or against. Or rather, since there’s no room for questioning the premises, “pro-trans” becomes about fully supporting individuals in their choices, regardless of their age, of whether they have been arrived at in a legitimate fashion, or of whether the choices are informed, healthy, sensible, or likely to lead to lasting well-being. By extension, implicitly, this unexamined approval entails becoming complicit with corporate, medical, and governmental malpractice around the subject of transgender, and the tacit agreement to pretend it simply does not—and cannot—exist (i.e., that “our” government never deceives or exploits its subjects).

In fact—from my own perspective, having looked at the facts I have looked at—gender dysphoric children, teens, and adults are victims, but not merely (or even primarily) victims of the misunderstanding, hostility, and negative discrimination of “ignorant” people. They are also, I think much more significantly, victims of the agendas that claim to be creating a safe and supportive environment for them, or by “educating” them (and those around them) to accept the medical, corporate, and pharmaceutical interventions prepared for them.

If young people—even toddlers—are being coached to perceive an experience that no one fully understands in a set way that is nested in an entire ideological framework, and to then make “decisions” (at ever-earlier ages) based on illegitimately coerced perceptions, what are the chances they will later regret those decisions and resent the very people who “supported” them? Not that there aren’t alternate—and considerably more cautious—approaches.

The GIC, which operates out of CAMH, pronounced “Cam-H,” had been standing firm against a changing tide in the world of psychological treatment for children with gender dysphoria. The “gender-affirmative” approach, which focuses on identifying young transgender children and helping them socially transition—that is, express their gender to others through their everyday clothes, name changes, or other means—has been on the rise in recent years, and has become the favored protocol of many activists and clinicians. GIC clinicians, who saw clients between ages 3 and 18, had a much more cautious stance on social transitioning for their younger clients—they believed that in many cases, it was preferable to first “help children feel comfortable in their own bodies,” as they often put it, since in the GIC’s view gender is quite malleable at a young age and gender dysphoria will likely resolve itself with time. (Ref.)

There are no forthcoming figures of the detransitioned—“or detrans.” It’s not even clear how many people identify as transgender, in the US at least, because the US Census Bureau doesn’t collect data on gender identity or sexual orientation. (A 2016 study from the Williams Institute at UCLA Law estimated 1.4 million trans adults in the United States, about 0.6 percent of the adult population.) Almost a dozen studies looking at the rate of “desistance” among trans-identified kids, and despite differences in country, culture, time period, and follow-up length and method, have come to a similar conclusion: “Only very few trans-kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks.”

These studies concluded that “about 80 percent trans kids eventually identified as their sex at birth.” (Ref.) There has been a counter-push from multiple trans-activist journalists and “affirmative” gender clinicians claiming that desistance is a “myth,” arguing (among other things) that researchers such as Dr. Kenneth Zucker have wrongly conflated gender nonconforming children with “true trans” kids and that their entire body of research is essentially worthless. Some critics have accused clinicians (including Zucker) of forcing harmful reparative therapy on gender dysphoric children.

Zucker is—or rather was, before he was fired—a psychologist and head of the gender-identity service at the Center for Addiction and Mental Health in Toronto. He disagreed with the “free to be” approach with young children and cross-dressing in public. Over a period of 30 years, he treated about 500 preadolescent gender-variant children, and his studies indicated that 80% grow out of the behavior, while 15 to 20% may ultimately change their sex. His approach was to “help these kids be more content in their biological gender” until they were older and could determine their sexual identity. This was accomplished “by encouraging same-sex friendships and activities like board games that move beyond strict gender roles.” (Ref.)

From “The ​Myth of the ‘Desistance Myth’” by  Julian Vigo :

Desistance has been at the center of the transgender advocates’ fight to have transgender identity publicly accepted as an urgent medical condition. At the same time, these same advocates have pressured clinicians to remove the stigma of its psychiatric diagnosis in order to create a social acceptance of the idea that “gender” is truly biological and that “sex” is a social construct. Stunningly anti-scientific rhetoric like this is taking as its hostage the bodies and lives of children in order to prove the point that children are “born transgender.” This assertion is a self-fulfilling prophecy involving a domino effect of parents and clinicians who are effectively engaging in Munchausen  syndrome by proxy  (MSbP).

Zucker’s view is that most cases of childhood gender dysphoria resolve themselves over time and that non-intervention or “watchful waiting” is the more appropriate response. His approach of helping children feel comfortable in their own bodies is viewed by trans activists as a form of gatekeeping of “true transgender” children.  Even though Zucker’s approach allows children to avoid a lifetime of medication that includes sterilization and other health complications, the American Psychological Association (APA) and the World Professional Association for Transgender Health (WPATH) have framed this non-interventionist approach as “an intervention that pushes the child toward suicide.” The 2011 WPATH Standards of Care states that:

Refusing timely medical interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization. As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al., 2010), withholding puberty suppression and subsequent feminizing or masculinizing hormone therapy is not a neutral option for adolescents.

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Demonstrable evidence suggests that children who are put on puberty blockers do not generally desist. London’s GIDS clinic reports that persistence is  “correlated with the commencement of physical interventions such as the hypothalamic blocker (t=.395, p=.007) and no patient within the sample desisted after having started on the hypothalamic blocker.” And yet: “90.3% of young people who did not commence the blocker desisted.” This suggests, not surprisingly, that chemically treating gender dysphoria massively reduces the chances of desistance, or the natural cessation of gender dysphoria.

Another 2010 Dutch study showed that 100% of the children put on puberty blockers went on to receive cross-sex hormone treatment. And while the numbers vary, there is a general consensus among the various studies that anywhere between 60 and 90 percent of children with gender dysphoria who receive no medical interventions desist when they reach adulthood. (Ref.)

For years, transgender activists accused Zucker and his clinic of practicing “reparative” or “conversion” therapy. They claimed that one of the clinic’s primary goals was to “fix” trans people by turning them “cisgender.” Zucker’s treatment protocol came under scrutiny in March 2015 when Cheri DiNovo MPP tabled a private member’s bill that banned conversion therapies for gender identity. (Ref.)

Many of Zucker’s critics

believe that even moderate limit-setting with regard to gendered activities, dress, or peers could traumatize children by interfering with their expression of their gender identity. . . . GIC clinicians view this as a conceptual error: The critics are conflating sexual orientation—which can’t be changed, which is part of the reason we view attempts to mess with it as unethical—and gender identity, which they say isn’t some hardwired thing, but is instead formed from a variety of factors. “You’re not born with a certain gender identity,” said Owen-Anderson, “so it’s not as though it’s an expression of some innate factor.” (Ref.)

Central to the trans activists’ criticism of Zucker’s approach is the conflation of psychotherapeutic methods with “conversion therapy.” Any attempt to help a person to relieve their gender dysphoria and except their biological sex is seen as ignorant and prejudicial crushing of their sacred “trans” identity. Zucker addresses this problem in his essay by pointing out a glaring contradiction. Psychotherapy that questions the etiology of gender dysphoria and attempts to help the child to adjust to their biological sex is seen as biased and as therefore illegitimately influencing the outcome (i.e., of coercing gender dysphoria children to desist and accept their biological sex). But at the same time, it encourages using psychotherapy that focuses “on reducing a child’s . . . distress related to the gender dysphoria” and giving “ample room for clients to explore different options for gender expression.” (Ref.)

(Continued next week)

2 thoughts on “The Age of Advanced Incoherence 3: Desistance & Mythmaking

  1. Some findings I did forever ago, probably inspired by your “Dream State” paper.
    According to Zucker et al, of 50 adolescents classically diagnosed as GID, 46% of families were upper or upper middle class on the [Hollingshead Four-Factor Index of Social Status], less than half had biological parents who were married, 74% were white. 64% were homosexual in relation to the sex assigned at birth while those classified as nonhomosexual was 36%.
    80% had a prior outpatient assessment for reasons other than GID, 78% had outpatient therapy, 20% had inpatient psychiatric admission, over half had prior or current psychopharmacologic treatment. That’s anti-psychotics, anti-depressants,(WHICH SPECIFICALLY), 60% had a prior DSM diagnosis other than GID.
    Most commonly, mood disorders. Over half with a history of suicidal ideation, one quarter had at least one suicide attempt. On third had dropped out of high school.
    In one case study, a girl came out to her upper middle-class parents with her desire to transition sex and, when rebuked, sought a physician in the community who immediately prescribed this bright young 17 year old testosterone without any knowledge of her prior psychological concerns, including a relationship with a boyfriend who was gay and a body obsession expressed through the taking of hundreds of selfies a day. The physician refused to meet with the parents.
    Another case study featured a 15 year old birth-assigned female who had been seeing a mental health counselor for years to treat her anxiety and depression. When she made an overture to her parents for transitioning surgery, they accepted her desire and a physician working with transgender youth recommended hormonal suppression.
    The mental health clinician who saw this young person for her gender dysphoria gave her an assessment overwhelmingly biased toward the assumption of GID and the girl’s other issues were left at the door. Several months after turning 16 the child put away most of a bottle of aspirin, nearly killing herself, her first attempt.
    All studies prior to this had deliberately examined a truncated range of mental health conditions in their clients, thus finding lower counts of prior diagnosis and psychopharma treatment. So by using a broader range and thus demonstrating a trend of psychosocial vulnerabilities, this study’s writers, primarily Zucker, have been deemed alarmists, even transphobic in the case of his loss of position. Preaching caution or, in the very least, the prudent use of research parameters, gets you fired in this context: the ‘Trans’ war of conversion.
    “This suggests, not surprisingly, that chemically treating gender dysphoria massively reduces the chances of desistance, or the natural cessation of gender dysphoria.”
    If so, is the parent branch of this debate about psycho-pharmacological and transition drugs? Have you heard of Lupron, or DES?
    “By extension, implicitly, this unexamined approval entails becoming complicit with corporate, medical, and governmental malpractice around the subject of transgender…”
    Currently blown away that the institutional sea change in the treatment of gender identity hasn’t become mainstream talking-head fodder. What the hell? How has this not been politicized along party lines? I mean, maybe it has, but in a ‘backpage’ fashion.
    “There are no forthcoming figures of the detransitioned—“or detrans.””
    Correct, just personal narratives- and they’re heart-crushing. Human biological devastation.
    Thanks for your vigilance on the subject, friend Jasun.

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