Transgender

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  • edited September 2018
    Again, the issue was that this was published in a prominent Canadian newspaper, so it's getting press. And references a published peer-reviewed article which makes points which reflect an experience of parents and families. And is getting criticised it appears for non-science reasons. I didn't find the study as not supported by the evidence. It has limitations but within its methodology it makes some points worthy of consideration. That is all.

    Your characterisation of the writer of the newspaper article doesn't match what the paper has about her here. I found all sorts of information about her. I don't know Ann Coulter nor Katie Hopkins. Never heard of the second one, heard of the first, know nearly nothing about her. I don't consume much American news. Which is all irrelevant anyway to the journal article news paper article reports on.
  • Your characterisation of the writer of the newspaper article doesn't match what the paper has about her here.
    That says she's a columnist who "provokes heated debate with her views on health care, education, and social issues", which seems not inconsistent with what Leaf wrote. It's certainly not claiming that she's known for her dispassionate expertise in reporting.
  • This blog discusses Rapid Onset Gender Dysphoria and finds that:
    Zinnia Jones from Gender Analysis has written two excellent articles chronicling the origins of the phrase “Rapid Onset Gender Dysphoria.” Basically, it originated in July 2016 on three blogs (4thwavenow.com, Transgendertrend.com, and YouthTransCriticalProfessionals.org) that have a history of promoting anti-transgender propaganda. The term was intended to explain some parents’ observations that 1) their children came out as transgender seemingly suddenly, often during puberty, and 2) their children also had trans-identified peers and interacted with trans-themed social media. Unfortunately, it’s not uncommon for reluctant parents to presume that their child has adopted a trans (or LGBTQ+ more generally) identity as a result of undue influence from other children and/or outside sources — hence the recurring accusations about transgender agendas, peer pressure, and trans identities supposedly being “trendy.” ROGD takes this presumption one step further: It asserts that any gender dysphoria these adolescents experience represents an entirely new phenomenon that is wholly distinct from the gender dysphoria that transgender people have historically experienced (e.g., as described in the DSM-5, the WPATH Standards of Care, and many decades of past research).

    The research study you are quoting is the only study that has been published on Rapid Onset Gender Dysphoria, and it has been published in PLOS, which from Wikipedia:
    PLOS One is built on several conceptually different ideas compared to traditional peer-reviewed scientific publishing in that it does not use the perceived importance of a paper as a criterion for acceptance or rejection. The idea is that, instead, PLOS One only verifies whether experiments and data analysis were conducted rigorously, and leaves it to the scientific community to ascertain importance, post publication, through debate and comment
    So the Littman paper has been published for "debate and comment" by the scientific community to "ascertain importance, post publication". The research contained in this paper is now subject to serious criticisms by the scientific community now ascertaining the importance of this research - while the same paper has been given much publicity as peer reviewed science. This really feels disingenuous to me.
  • LeafLeaf Shipmate
    I don't know Ann Coulter nor Katie Hopkins.
    Leaf wrote: --> For our non-Canadian friends: <-- think of someone with half the viciousness of Ann Coulter and none of the charm of Katie Hopkins.

    The more I read about this, the more convinced I am of the phenomenon of Rapid Onset Parental Transphobia (ROPT).

  • Yes, but they are "concerned parents", who are worried about gender ideology in schools and in the media. They want their sons and daughters to be, well, like them.
  • edited September 2018
    Yes, but they are "concerned parents", who are worried about gender ideology in schools and in the media. They want their sons and daughters to be, well, like them.
    Not in our case.
    If families are convinced that their teen is transgender, they will generally facilitate and support. Because they love and have great investment in their children, wanting to have them actualize their potential. The relationship isn't adversarial with the child, it's adversarial with an ideology which doesn't seem to take proper account of teen development, other medical and mental health conditions, peer and social influences. In this case we're convinced that the young person is gay and that influence of someone this young person prizes and idolizes as an object for first love has resulted in the expressed trans wish. But this sort of context is not considered, and hormones are offered within a first appointment, with the surgical trajectory being 3 months later to initiate, with the 3 months being waiting list, ie adminstrative, not anything further. I think the way things are done are better elsewhere according to protocols that don't seem followed here abouts.
  • There's no point in raking over the same stuff. It's striking though, np, that you keep digging up transphobic stuff from the internet or wherever. Odd, isn't it?
  • If families are convinced that their teen is transgender, they will generally facilitate and support.

    This is not the lived experience of many transgender. Heck, it's not the lived experience of a lot of folks with any sort of non-conformity to gender norms. At the Old Ship we had fairly lengthy thread on the lengths parents would go to "cure" their gay kids. I'm not sure a general assumption of "facilitate[ing]" kids who don't act according to their "proper" gender roles can just be made.
  • Crœsos wrote: »
    If families are convinced that their teen is transgender, they will generally facilitate and support.

    This is not the lived experience of many transgender. Heck, it's not the lived experience of a lot of folks with any sort of non-conformity to gender norms.

    This. A *lot* of LGBTQ folks I know received somewhere in the range of "no support" to "outright hostility" from their families. Some, thankfully, were loved and supported to be who they are. But it's a long way from "they will generally facilitate and support."
  • I have read the study in question, and the parents who responded did, on the whole, have the attitude that there was nothing wrong with being transgender, but their kid wasn't it - because they'd never shown any signs before that point, and they could see clear influences from peers and/or internet and/or their child's other difficulties. Many of them could see their child as gay or lesbian (and had seen that previously, and been fine with it, just not that their child had anything to indicate they were transgender).

    My take on that is that there are different kinds of parents of children who are gay, lesbian, or transgender.
    Those that are fine with it and assume their child is right whatever they say.
    Those that are fine with it but check their child is not saying it for a reason that's not actually true.
    And those that are determined not to be fine with it - those parents wouldn't be investigating the issues and talking to other parents who are generally a liberal bunch - they'd be forbidding it, refusing to talk about it or do any research, and saying NOT IN MY HOUSE and NEVER DARKEN MY DOOR AGAIN.

    Saying that some people are transgender but this particular set of teens aren't isn't transphobic. It's just cautious, and parents are right to be cautious.
  • Yes, but the Rapid Onset stuff came out of an anti-trans milieu. It seems science-ish, but may well help roll back trans rights. True, there is nothing wrong with being cautious, but then in the UK, I don't see clinics rushing anywhere, especially as there are long hold-ups in seeking treatment.
  • chukovsky wrote: »
    I have read the study in question, and the parents who responded did, on the whole, have the attitude that there was nothing wrong with being transgender, but their kid wasn't it - because they'd never shown any signs before that point, and they could see clear influences from peers and/or internet and/or their child's other difficulties. Many of them could see their child as gay or lesbian (and had seen that previously, and been fine with it, just not that their child had anything to indicate they were transgender).

    My take on that is that there are different kinds of parents of children who are gay, lesbian, or transgender.
    Those that are fine with it and assume their child is right whatever they say.
    Those that are fine with it but check their child is not saying it for a reason that's not actually true.
    And those that are determined not to be fine with it - those parents wouldn't be investigating the issues and talking to other parents who are generally a liberal bunch - they'd be forbidding it, refusing to talk about it or do any research, and saying NOT IN MY HOUSE and NEVER DARKEN MY DOOR AGAIN.

    Saying that some people are transgender but this particular set of teens aren't isn't transphobic. It's just cautious, and parents are right to be cautious.

    Nice summary. Those that are fine with it but check their child is not saying it for a reason that's not actually true. is about where we are.
  • in the UK, I don't see clinics rushing anywhere, especially as there are long hold-ups in seeking treatment.

    There was a doctor in the UK recently struck off - and then convicted of illegal prescribing - for running an unlicensed clinic. Their web page suggests they will prescribe after a single phone or Skype consultation with a child. It's £75, if you're interested. They have a fairly strong incentive to diagnose and prescribe, under their kind of model - they don't get money if they don't advertise the issue as a problem to be treated, and a prescription keeps the customers coming back.

    It is true that the NHS services are generally rightly cautious (we are talking about children's long term health, sexual functioning, and fertility here) but outside the NHS it seems to be the Wild West.

    In my understanding the ROGD issue mainly came out of the massive increase in girls who had shown no signs of gender dysphoria in childhood, coming forward for treatment in adolescence. The sex disparity is a particular worry. That's not anti-trans - it's just cautious. Again, we're talking about children's long term health, sexual functioning, and fertility.

  • Of course, ROGD came out of an anti-trans milieu. Read the stuff above, esp by Curiosity killed. Rapid Onset Parental Transphobia, borrowed from Leaf.
  • Read the stuff above, esp by Curiosity killed. Rapid Onset Parental Transphobia, borrowed from Leaf.

    I will try to but it's kind of hard to find an individual post in a multi-page thread; I have read a lot elsewhere on this and I have read the original PLoS article.

    The definition of ROGD is that an adolescent shows signs of gender dysphoria who would not have met the criteria when younger. The paper does not speak to the prevalence of this condition (maybe only 1 teen in the world meets the criteria) or its causes (it mentions them, but can't draw firm conclusions).

    But the fact remains that among the adolescents in the paper there ARE those that meet the criteria for ROGD. They would not have met the diagnostic criteria for gender dysphoria when younger. Some tried to edit their past (literally) and some admitted (to others than parents) to lying about what they had thought and felt when they were younger, and to seeking out appropriate wording to get a diagnosis.
    But the criteria for gender dysphoria include signs that can be observable by others and the adolescents in the study did not have these observable signs when younger. Therefore, by definition, they meet the criteria for ROGD.

    You may argue, of course, that the criteria for gender dysphoria (they are in the paper, you can check them out) in children are wrong, and it should be retrospectively diagnosable on signs that are non-observable - that's your prerogative, though it would be pretty hard to objectively diagnose on that basis - but those are what they are, at the moment.

  • The Littman study has attracted a lot of criticism over its methodology. For example, she recruited informants from well-known transphobic websites, and she gave questionnaires to parents, and not to trans youths themselves. You might as well ask on a white supremacist forum, if black people have any foibles.

    In fact, DSM-5 talks about late onset GD, see for example, this, "others (trans youth), do not report any signs of childhood GD ... parents express surprise because they did not see signs of GD in childhood."

    The APA has this, "while some children express feelings and behaviours relating to GD at 4 years or younger, many may not express feelings and behaviours until puberty or much later."

    So is Littman claiming to have found a new type of GD? It seems odd that it's reported in DSM-5.

    (GD = gender dysphoria).
  • APA = American Psychiatric Association.
  • In fact, Julia Serano describes late onset in relation to herself. In her book, "Whipping Girl", she describes the confusing feelings she had about sex/gender, which she couldn't make sense of as a child. But at puberty, things began to coalesce and make sense, and she began to identify as trans. This book was written over ten years ago. She is a biologist, and author. So how is late onset a new discovery?
  • RussRuss Deckhand, Styx
    Of course, ROGD came out of an anti-trans milieu.

    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?
  • Russ wrote: »
    Of course, ROGD came out of an anti-trans milieu.

    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?

    They show their peer reviewed evidence base.
  • DafydDafyd Shipmate
    Russ wrote: »
    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?
    They could start by avoiding the word 'contagion'. The choice of metaphor is pejorative.

  • Russ wrote: »
    Of course, ROGD came out of an anti-trans milieu.

    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?

    Go beyond speculation, and present some evidence. Asking parents who subscribe to anti-trans websites, what they think, is not really it. It's farcical that the article in question didn't question the youths themselves.
  • Dafyd wrote: »
    Russ wrote: »
    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?
    They could start by avoiding the word 'contagion'. The choice of metaphor is pejorative.

    "Contagion" is a common word used to describe clusters of a mental health issue found in individuals who have been in contact with each other or who have read or watched material that promotes the thought processes associated with that disorder. It has a specific, clinical meaning.

    See for example

    Anorexia and social contagion
    https://journals.sagepub.com/doi/full/10.1177/0004867413502092

    Suicidal thoughts and social contagion
    https://edition.cnn.com/2018/06/09/health/suicide-contagion-explainer/index.html

    Mood and contagion
    https://www.medicalnewstoday.com/articles/319509.php
  • I seem to remember that the notion of contagion was wheeled out in relation to gays and lesbians. The reason that more gays were coming out, was that innocent children were being contaminated by other gays. In fact, I think you can still see the idea haunting the pages of homophobic writers.

    In relation to trans identity, it raises the interesting question as to whether you can change your gender voluntarily and long term.
  • If you Google ROGD, you will find a ton of conservative and Christian groups, using it to argue that trans is fake, and children need to be re-educated back to being non-trans or gender conforming. Trump approves! But the point is, the article itself is bad science.
  • DafydDafyd Shipmate
    edited November 2018
    chukovsky wrote: »
    Dafyd wrote: »
    They could start by avoiding the word 'contagion'. The choice of metaphor is pejorative.
    "Contagion" is a common word used to describe clusters of a mental health issue found in individuals who have been in contact with each other or who have read or watched material that promotes the thought processes associated with that disorder.
    Nobody thinks that anorexia or suicidal ideation are sane solutions to mental health problems for anybody. Nobody would claim to believe that anorexia was acceptable if it had no sudden onset or had been a feature of someone's life since early childhood. Anorexia and suicidal ideation are themselves mental health problems. Living as the gender one does not identify with may cause problems, but living as the gender one identifies oneself as is in that case not a problem but a solution.

  • BoogieBoogie Shipmate
    edited November 2018
    @Dafyd said -
    Living as the gender one does not identify with may cause problems, but living as the gender one identifies oneself as is in that case not a problem but a solution.

    Yes.

    Surely the ‘late onset’ would be due to societal pressures to say nothing - just like many people come out as gay when they can be untrue to themselves no longer.

    The ‘late onset’ could happen at any age. My friend ‘came out’ as transgender aged 56. But he knew he was in in wrong body from when he was a very young child. He told his grandma, who he lived with, and was told - in no uncertain terms - to never mention it again, as if it were shameful.
  • Yes, there are plenty of older people who transition, for example the Wachowski sisters, and for UK readers, Kellie Maloney, the boxing promoter. How much older people suppressed their trans identity in early life, I don't know, I should think many felt confused, and that it was unthinkable. And God wouldn't like it.

    Sudden onset in itself isn't particularly controversial, and has been discussed for years, but for the transphobes, it is linked with contagion, and "She saw it on the internet".
  • edited November 2018
    The situation is entirely different with adolescents. They are not adults. They are extensively influenced by others and they are trying to sort out their place in the world, and all sorts of things related to identity. Confirming a sudden expression of gender dysphoria is not appropriate, and it is not inappropriate for parents and health providers to ask many questions, some of which will be skeptical and force discussion of it. The problem we're having is the opposite: that health care providers are not doing their jobs of assessment, rather, confirming without assessment and without confirming the developmental course of the expression.

    You misunderstand and misrepresent social contagion.
  • Confirming without assessment sounds bizarre. If they don't assess, how do they know what they are dealing with?
  • DoublethinkDoublethink Shipmate, Purgatory Host
    The situation is entirely different with adolescents. They are not adults. They are extensively influenced by others and they are trying to sort out their place in the world, and all sorts of things related to identity. Confirming a sudden expression of gender dysphoria is not appropriate, and it is not inappropriate for parents and health providers to ask many questions, some of which will be skeptical and force discussion of it. The problem we're having is the opposite: that health care providers are not doing their jobs of assessment, rather, confirming without assessment and without confirming the developmental course of the expression.

    You misunderstand and misrepresent social contagion.

    Isn’t this almost identical to the “it’s just a phase” debates around homosexuality ?

    Adolescence is the obvious time for this to happen, because both sex and gender become much more obvious during puberty.
  • IkkyuIkkyu Shipmate Posts: 19
    In the support group for parents of transgender youth I attend. It has been the experience that there are two populations. Those kids that start showing signs when they were very young. And those that come out when teenagers. Of those two groups contrary to my expectations, the younger ones were more likely to change their gender expression when they get older, but the ones that started later almost never do. Again this is not a scientific study just anecdotal evidence. But it definitely goes against the idea that the teenagers are just "following a trend". In the case of my Son he has been consistent for almost 3 years now. And nobody rushed him into anything. My experience is that everyone's path to transition is considered personal and nobody is pressured. No transition is expected to be the same. Hormones or surgery are seen as personal decisions that not all who transition follow in the same way. And some people chose to not use hormones or do surgery at all. And if there is any pressure is usually in the direction of waiting. Or against the idea of transitioning at all usually by non supportive family members.
    The best remedy for skeptics is to actually meet with the families of transgender youth.
    One thing you will learn is that we are not all the same, we come from all sorts of political and religious backgrounds, what we share is the desire to support our kids.
    I was very alarmed when it was leaked that the Trump administration plans to "define" gender non conforming people out of existence. Something that would not only affect the transgender community but the intersex community as well.
    But my Son is not a "trend" he exists, and his inner experience of gender is valid and
    should not be used as a political football.
  • RussRuss Deckhand, Styx
    KarlLB wrote: »
    Russ wrote: »
    Of course, ROGD came out of an anti-trans milieu.

    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?

    They show their peer reviewed evidence base.

    You have a peer-reviewed evidence base for your every belief about how the world works ?

    Your life has taught you nothing that you have not verified by a search of the scientific literature ?

    Are you for real ?
  • Most young people
    The situation is entirely different with adolescents. They are not adults. They are extensively influenced by others and they are trying to sort out their place in the world, and all sorts of things related to identity. Confirming a sudden expression of gender dysphoria is not appropriate, and it is not inappropriate for parents and health providers to ask many questions, some of which will be skeptical and force discussion of it. The problem we're having is the opposite: that health care providers are not doing their jobs of assessment, rather, confirming without assessment and without confirming the developmental course of the expression.

    You misunderstand and misrepresent social contagion.

    Isn’t this almost identical to the “it’s just a phase” debates around homosexuality ?

    Adolescence is the obvious time for this to happen, because both sex and gender become much more obvious during puberty.
    Consider medical intervention- surgery and medications. The permanency of bodily modification and hormonal. Makes taking more care is required.
  • DoublethinkDoublethink Shipmate, Purgatory Host
    edited November 2018
    Consider the mental health implications of denying people’s sense of themselves - have you seen the stats on the rates of attempted suicide ?
  • KarlLBKarlLB Shipmate
    edited November 2018
    Russ wrote: »
    KarlLB wrote: »
    Russ wrote: »
    Of course, ROGD came out of an anti-trans milieu.

    So how in your world does someone who holds a dispassionate belief that "social contagion" describes a real psychological phenomenon express that belief without being branded a hatemonger ?

    They show their peer reviewed evidence base.

    You have a peer-reviewed evidence base for your every belief about how the world works ?

    Your life has taught you nothing that you have not verified by a search of the scientific literature ?

    Are you for real ?

    If people are going to go around telling other people they know more about what's going on in those peoples' own heads than those people do themselves then they had better come armed with good evidence for it.
  • RussRuss Deckhand, Styx
    If people are going to go around telling other people they know more about what's going on in those peoples' own heads than those people do themselves then they had better come armed with good evidence for it.

    Wanting evidence is entirely reasonable.

    My view of the world is that it is rich and complex enough to include both "knowledge from the inside" that is very difficult for anybody other than the subject to really know and "knowledge from the outside" that it is very difficult for the subject himself/herself to really know.

    If someone has gender dysphoria, then the primary evidence will be internal and knowable only to themselves. What is knowable to others will be only secondary evidence - observable patterns of behaviour more typical of the other gender over a period of time.

    Being influenced by the presence or absence of such secondary evidence is reasonable.

    It is conceivable that there are psychological conditions that would cause someone to claim to have gender dysphoria when that is not the case. I'm not expert enough to know what those conditions are, but it seems likely that the presence or absence of evidence for that would be more knowable externally.

    The other point to make here is that your statement seems very reasonable when applied to adults. (No-one would doubt without evidence the personal experience claimed by anyone on this thread).

    But it's more difficult when children are involved.

    If your child says they need an ice cream, you don't need a peer-reviewed paper before telling them no.

    And more difficult again when we're talking about young people in transition from childhood to adulthood.

  • KarlLBKarlLB Shipmate
    edited November 2018
    Comparing wanting an ice-cream to a strong sense of gender identity - I'm really not sure where you can go from there.

    I mean, wow. Just... Wow.
  • Hence the triple requirement observed by some professionals, that the child or adolescent is consistent, persistent and insistent on their gender identity.

    Like saying no to an ice-cream? It's frightening to think that some kids might be faced with that mind-set.
  • Hang on, what is the actual argument here?

    The NHS does not permit irreversible changes to a child's physical body as treatment for gender dysphoria until the child reaches 17. Source.

    Which suggests that a.) the NHS agrees with Russ and NP_NP's concern about children not knowing their own mind, and also b.) Russ and NP_NP are arguing against a strawman, unless things are different in the US and Canada.
  • Well, that has gone on for the whole thread, I don't know whether it's about straw men, or variations in professional practice. The idea that you could waltz into an NHS clinic, and demand hormones, and/or surgery, is farcical, but maybe it happens elsewhere.
  • RicardusRicardus Shipmate
    edited November 2018
    On reflection, 'children not knowing their own mind' sounds a bit flippant.

    I suppose the question is how many minors who receive some kind of reversible intervention for gender dysphoria on the NHS don't in fact continue with this intervention once they reach adulthood.

    From this NHS site, it seems that, for the majority of prepubescent children who are referred for gender dysphoria - for whom (I assume) the treatment is basically counselling - the dysphoria does not in fact persist into adolescence, whereas adolescents who are referred are more likely to continue to request treatment into adulthood. (I'm not sure whether this means 'more likely than not' or 'more likely than those who are referred before puberty'.)

    Which suggests to me that the NHS approach is right and sensible and this is all a moral panic.
  • There has been an on going moral panic about trans, and the tabloids, for example, love sensationalized stories about it. Also some conservatives and Christians seek to undermine the whole notion of trans identity, plus those feminists who seem angry about trans women - so there is quite a mixture going on. Of course, trans people and parents of trans kids, get on with life, and many professionals are respectful and caring. Ikkyu's posts are a good example of this sanity.
  • edited November 2018
    Ricardus wrote: »
    Hang on, what is the actual argument here?

    The NHS does not permit irreversible changes to a child's physical body as treatment for gender dysphoria until the child reaches 17. Source.

    Which suggests that a.) the NHS agrees with Russ and NP_NP's concern about children not knowing their own mind, and also b.) Russ and NP_NP are arguing against a strawman, unless things are different in the US and Canada.

    I think we established this earlier in this thread. Medical and hospital care is publicly funded, with psychosocial care very spotty. And all health care is provincially organized not national. Our experience is that hormone appt to start on injections was offered by a social worker within the first appt at the gender clinic, that the social worker would arrange an appt with the physician in the community. The gender clinic refers out to fee for service physicians in the community. They have no doctors themselves. The counselling in the gender clinic organizes the changing. That's their role as they define it. It looks life pure advocacy. No-one does thorough assessing. Its been nightmarish to have a wish expressed that is immediately validated in non-credible ways.

    The family in our case decided to hear counselling from psychologists. Which is fee paid by family and extended family at $220 per hour. Which has been very expensive. The contents is between the psychologists and young person. Who also organized a psychological assessment and actually reviewed past medical and mental health records. Something the gender clinic didn't.

    The psychologists don't do the anti things you imagine. Which is also a strawman frankly. They're working through things in the careful way we'd expect and this may be what you get in the UK. But it doesn't happen here.

    The young person in our case may continue to transition. Everyone is okay with that but not if rushed.
  • Ricardus wrote: »
    From this NHS site, it seems that, for the majority of prepubescent children who are referred for gender dysphoria - for whom (I assume) the treatment is basically counselling - the dysphoria does not in fact persist into adolescence, whereas adolescents who are referred are more likely to continue to request treatment into adulthood. (I'm not sure whether this means 'more likely than not' or 'more likely than those who are referred before puberty'.)

    The WPATH Standards of Care document gives some useful perspective on this -- they note the absence of formal prospective studies but also cite a follow up study where of 70 adolescents diagnosed with GD in early adolescence all of them went on to seek reassignment (starting with hormones) in later life.

    The situation described by NP seems inconsistent with both international and generally accepted Canadian standards of care -- see e.g. recommended procedures published by Sherbourne Health Centre in Toronto (in 2009, so now almost 10 years ago) based on their fairly extensive experience treating trans clients.
  • edited November 2018
    As far as I can tell, more monied and populous provinces fund more things. Again health care is provincial not national. Something insured in one province isn't in others with great service uneveness. The Canada Health Act dictates core federal-provincial cost-shared things. Things provinces have to do to get federal dollars for health care. Our research indicates that surgery and services by doctors and surgeons are covered mostly. With everything else differing greatly. Psychosocial care is whatever the province has prioritized. My cousin has discussed the problems with MLAs (member of legislative assembly) and regulatory colleges. Very very fraught. Things are on the right track now. With, as noted, the young person living as the other gender, with pacing of irreversible decisions. Parents and young persons should not have pay 1000s out of pocket. What about those with no ability too pay or extended family to help fund? Canadian Medicare is actually not very comprehensive.

    Let me add that it is absolutely not anti-trans. Much as it is simpler to mislabel nuances as one thing or another. This young person simply needs care which resembles what the international and national standards are. Not instant promotion of a perspective. Glad to understand that there are proper care standards being actually followed elsewhere.
  • Our experience is that hormone appt to start on injections was offered by a social worker within the first appt at the gender clinic,

    What hormones are we talking about here?

    The only hormones offered by the NHS to transgender adolescents are puberty blockers, i.e. hormones that will delay the development of secondary sexual characteristics while the adolescent works out their identity.

    If Canadian doctors are offering cross-sex hormones to adolescents, i.e. hormones that will physically turn them into the other sex, then I agree there is a problem.
  • Russ wrote: »
    If someone has gender dysphoria, then the primary evidence will be internal and knowable only to themselves. What is knowable to others will be only secondary evidence - observable patterns of behaviour more typical of the other gender over a period of time.

    Being influenced by the presence or absence of such secondary evidence is reasonable.

    I find it interesting that we still live in an era where people can pretend that they've never heard of The Closet.
    Russ wrote: »
    It is conceivable that there are psychological conditions that would cause someone to claim to have gender dysphoria when that is not the case. I'm not expert enough to know what those conditions are, but it seems likely that the presence or absence of evidence for that would be more knowable externally.

    What about someone who has gender dysphoria but denies it to certain people, like parents who have control over their lives? Is that kind of situation more knowable internally or externally?
  • In any case, the external evidence seems to be, counter-intuitively, that gender dysphoria is more likely to be persistent if it presents during or after puberty, rather than before.

    So if a trans teenager didn't seem to exhibit dysphoria before puberty, it's not necessary to posit horrible parents who forced them into the closet, it may just be that they genuinely didn't experience dysphoria then.
  • OhherOhher Shipmate
    I freely confess that, having read through this thread, I feel little more enlightened than when I began. Roughly 50 years ago, while working at a temp job between acting gigs, I was approached by a co-worker who was transitioning from male to female, and she wanted my advice about make-up and to be taught skills in applying it.

    I was a 20-something naif, but recalled that I myself had done internal "thought experiments" about being male rather than female, and about having been a bit of a tomboy (a phrase I've come to hate), and about having interests and hobbies and career goals then (during my 1950s childhood) deemed "masculine," which at various points made me wonder about my "femininity," etc. So for this young man to have undertaken what was then a very unusual and time-consuming and expensive and potentially risky and etc. etc.
    endeavor seemed at least superficially understandable to my naive self.

    My efforts to teach her make-up application were relatively short-lived, as I got cast in some show and left the temp job. But the encounter changed something in me: I became far more conscious of how hard I have always worked during my life (mostly to absolutely no effect) to present myself foremost as a person rather than as a "girl" or a "woman." It's also how I try to understand individual students of mine, and colleagues, and other posters on this forum.

    I can't claim any expertise or knowledge beyond my own quite limited experience, but I strongly suspect that there'd be less dysphoria about a great many issues, including gender, if we could all somehow un-link our understanding of assorted human traits, abilities, and activities from our understanding of gender (and I suspect, with all humility, that we know a great deal less about all these issues than we like to imagine). When I used occasionally to fantasize (as I entered puberty, quite early, as it happens) about being a boy, it wasn't because I wanted to have a boy's body; it's that I wanted experiences and opportunities that my culture deemed appropriate only for boys. That's an entirely different problem (though not at all uncommon) than what faced my former coworker. It wasn't about what women had that he-becoming-she lacked; it was all about who he-becoming-she truly was. She once described her inner state to me as having been forcibly assigned to an extremely poorly-thought-out Witness Protection Program placement, whose parameters, rather than protecting her, placed her in constant danger of failure, exposure, and assorted kinds of social and sexual doom.

    Once sexuality -- that is, entering into the stage of life where sexual expression and sexual activity become real and pressing needs -- this can only become even more complex and more jarring and disorienting.
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