This is frequently claimed but is untrue, or at the very least highly uncertain. The studies most often referenced have serious methodological errors, including inconsistent definitions of dysphoria (owing partially to problems with the Gender Identity Disorder diagnostic criteria in the DSM-IV that have since been fixed with the DSM-5) and desistance (in some cases counting anyone who didn't follow up with the clinic conducting the research as having desisted) https://www.gdaworkinggroup.com/desistance-articles-and-crit...

Julia Serano has also written extensively on this topic with much depth and nuance, at least in my opinion: https://juliaserano.medium.com/detransition-desistance-and-d...

I stand by my claim. The online echo chambers that children, including my own, seek out very much push the ideology that any claim to be male, female, non-binary or whatever must be accepted at face value. And that the person who is making the claim should have the right to any treatment that they wish, up to and including surgery.

As for criticism of the research that exists, I agree that it isn't very good. But then again, most research in the social sciences isn't very good. See the Replication Crisis. Or as we used to say, news at 11.

I can understand some caution around the latter part of this quote, given how traumatic, invasive, and costly surgery can be. It is a defensible and reasonable position that there should be _some_ barrier-to-entry to such major decisions (especially for children), even while there's also a simultaneous reasonable concern that such barriers will be used to prevent access to folks who genuinely do need, want, and would benefit from it.

But how can anyone _possibly_ deny the first part? How could anyone contradict an individual who states their own gender - on what grounds can you claim to know how someone feels about themselves better than they themself do? Even the position of "they are confused" or "this is a phase that will pass" or "they have been pressured into that belief" doesn't hold water - until that phase passes, that person's gender, their self-image, _is_ whatever that phase dictates. That doesn't make the current situation any less true. If you told someone "I like broccoli" and they responded "that's just a phase, you'll grow out of liking broccoli soon", your response would, presumably be "...so? I like broccoli _now_, what does your guess about the future have anything to do with it?"

Does your position on "accepting gender at face value" change if the statement "I am male" is replaced with "I see myself as male"? Are you more comfortable accepting the fact that someone's self-image can change over time, rather than imagining that gender is some abstract immutable inherent property?

How do you define denying the first part?

According to my child's world view, I need to ask them every day what their pronouns are today. And any accidental slip-ups on any adult's part are a demonstration of transphobia, which justifies a raised voice and lecture.

While I'm perfectly OK with making an attempt to treat people as they wish to be treated, at what point does the inconvenience and stress that your constant demands make on others become an unreasonable ask of them? (Which is a question that every parent of teenagers winds up asking at some point, for some reason...)

I agree that their request is unreasonable, and I'm sorry for the stress it's causing you. I can't really justify their behavior on a rational basis (teens, right?). And obviously I don't know your child, and I don't know you, but as a trans person who went through a similar phase, maybe consider what they might be thinking if you want to understand why they might be behaving like this?

For one thing, they almost certainly know your opinions about the persistence of trans identity and online echo chambers of gender identity. If (real if) you're hostile to the idea that they could really be trans, it's possible they feel hostile to the idea that you could really be making a good faith best effort to support them, which is what this sounds like to me: defensiveness. I had a very similar dynamic with my parents for several years. We came out of it understanding each other a lot better, but it was certainly rough in the thick of it. I really hope you can find a way to resolve the tension.

True, you don't know me.

When my child came out as pan, a few days later we had arranged for a trip to an old friend of mine who is a trans-woman, a lesbian, and who had a non-binary friend who was staying with her.

I regret the fact that you had a difficult relationship with your parents. I've seen that story play out. However I'm pretty confident that I'm not actually transphobic. My concern is not that I don't want a child who is trans, my concern is about what is best for my child's long-term well-being.

It’s one thing to be supportive and empathetic. It’s another thing to bow down to worship your child and let them run the show.

The trans issue has risen to a point where society must face it and figure out the bigger questions of how can we accommodate them and yet balance and find natural limits. We are so fucking far away from that point. And we will get there eventually.

I agree with the parent comment saying the trans issue is way over sampled and is or has become some kinda trend. It just is. Clearly their child showcases the main point of children know nothing when the child mis-understands what true transphobia is versus a childlike ignorance of parroting a concept they just heard about. Why is that? Well it never changes from generation to generation. If you have kids at some point they learn about attention and how to use it.

It’s kinda like personal preferences. Is it transphobic to say you are only attracted to the opposite sex and would never date or consider a trans person in a romantic relationship? Nope. But it’s a sure fired way to keep eyeballs on the screen and people in their rigid political groups.

Like this parent (although I will be more brutal) I could give two shits if they felt they were a trex or were a girl or a boy. I don’t care. What matters is that I raise a kind hearted, compassionate human being who understands the world is not your friend. And can find their grit and true will when they need it. There’s book loads more to this but boiled down I’m doing my best to not raise an inconsiderate asshole. Because they must be held to account and told when they are in fact acting like an inconsiderate asshole.

Sorry to say it that harshly, but this is basically shutting down any discussion.

To what end?

Being a teenager is really confusing to begin with, and the last thing children need is more ways to categorize and divide people into clumps.

When your kid's demands are as simple as "hey support my identity, which requires nothing but thinking slightly more about the words you use" how could they not be frustrated when their parent can't even clear that low bar.

I can imagine thousands of reasons why teenagers would lie, and maybe they'll come up with new pronouns just to annoy you. Because that's what kids do, they constantly test the limits of acceptable behavior and the limits of your patience.

That said, I agree with you that people can choose what gender they feel like and others should accept it as an opinion. But trying to force others to change their behavior to accommodate your opinion very quickly becomes unreasonable.

So gender is fine, but pronouns are already a slippery slope.

Do you believe a horny teenage guy would be willing to lie and say he identifies as female, if that means he gets to see all of his female classmates naked?

It's a tradeoff between people living out their believes and the inconvenience that this causes for others.

No, I don't. Living out that type of switch for any length of time is an enormous investment, which will change the way your peers view you forever. It is worthwhile if you're actually trans, but anyone else would be so much better off just browsing the internet.

That said, I also think single-gender spaces are in need of an re-think. Same-sex locker rooms inherently assume that people of the same gender can't be attracted to one another, which is simply not the case. So what's the point?

Same sex locker rooms don't only assume people of same gender are not attracted to each other, but also that women are disproportionally exposed to potential sexual abuse from men than the other way around. Protecting women from men specifically is very central to the idea.

What "switch" are you talking about? The trans-rights movement frowns on requiring trans people to make any sort of "switch" beyond a mere declaration. The whole concept of self-identification is that a man need do nothing more than declare that he's now a woman, and he should promptly have access to spaces and resources reserved for women, such as girls' scholarships, women's bathrooms, women's shelters, women's sports teams and athletics, women's prisons, women's healthcare, women's dating websites, etc. Requiring any sort of physical transition is said to be a violation of trans people's human rights, and thus men-- biological males with penises-- should be allowed access to these spaces by simply "checking a box".

Getting self-identification enacted in laws is a primary goal of the most prominent and powerful trans rights lobbies:

https://www.pinknews.co.uk/2020/09/22/gender-recognition-act...

Unless someone really really commits, it's going to be terribly obvious who is acting in bad faith.

Do you know of any examples when this became a problem in practice?

- Lesbian dating sites are facing an influx of men-- biological men with penises-- who have declared that they are lesbian trans-women, and are angry when they don't get any attention from the females on the site. This has become a significant controversy in these communities, because apparently many lesbians on lesbian dating sites are attracted exclusively to other females. Now, I'm sure some of these guys actually are earnest trans-gendered women, who are honestly and in good faith seeking to fully transition. But others are just incels trying a new strategy.

- The English and Canadian prison systems are currently dealing with the ramifications of allowing men into women's prisons-- biological men with penises who declare they are women, and demand to be placed into women's prisons. In many cases these guys have assaulted women in prison. These cases are easily googleable.

- 18 male candidates from the The Force for Mexico party registered as women for this year's municipal elections in Tlaxcala, in order to get around quotas requiring equal numbers of female candidates. These are men, just straight up men, who declared themselves women just for the registration, and defended by trans rights activists saying that self-identification must be respected with no questions.

- This guy: http://www.daniellemuscato.com/. This is a biological male with a penis who has no intention of transitioning (he has a medical excuse it seems). In legal trouble and homeless at times, he demands to be let into women's shelters and placed in detention with women. He works diligently and successfully to folks critical of him banned from twitter.

Jessica Yaniv (I know, an easy target, but he's a huge influence in Canada).

Etc.

Easily implemented for newly built places, can be retrofitted to some, hard to retrofit for some.

But make it a new standard and let time solve the rest.

Any bathroom wouldn't be able to accommodate everyone. For these exception there can be single cabin room or something else.

There are a lot of bathrooms for both sexes, mostly in places where space is limited. But having segregated bathrooms is in no way a problem anywhere and I think many people are happy with that.

Also, I agree that any bathroom won't accommodate everyone. But no current bathroom does that either.

For unisex purposes it depends on the bathroom design surely.

People have this idea you have some semi-public space because people might see each other in a state of undress.

But almost all westernised bathrooms contain a bunch of toilet stalls.

If everyone is going into a toilet stall to do their business - standing or sitting - then the only shared space is for washing hands or preening in front of a mirror. And if that's an issue, optionally put that in the stall too.

If security is a problem - many toilet stalls have limited doors/walls around them - then make it secure. This effort would benefit everyone.

Then humans - whatever their persuasion - could simply do their business in peace and get on with their life.

Granted, I really appreciate urinals and I feel like they might be a casualty of switching over to unisex bathrooms in a lot of cases.

I doubt that's coming anytime soon. Would be big dumb and have no real support

Your example is way off because they are not equal processing tasks obviously and resources may not be mostly idle you just made that all up

And even if there is an inefficiency or inequality that doesn't mean the answer is unisex bathrooms I could come up with an equally contrived example for how inefficient that is

When I'm out at the theatre with my partner - we don't go back to our seats until both of us have taken care of business - I'd be happy to accept a bit of a personal delay in order to speed up the process overall (and I'd be even happier if an appropriate amount of urinals still existed - I don't know what that ratio is, maybe a quarter of the floor space or so, but eliminating them would likely make restrooms less pleasant for everyone).

Intelligent building would forecast demographics and optimize for the future I guess if you really just want "max efficiency" I assume this is already being done to an extent, but changing things already built sounds expensive af for little to no value in my opinion.

As for the headline "Teenager finds way to push parental buttons: this never-before-seen act is the fault of liberals" yes, can confirm that toddlers start practicing early.

Back in my high school days, we had some bathing events and also shared sauna. One could either voluntary use the nude beach, or walk a bit and go to an outdoor pool with proper changing rooms and dressed people.

I think the split was roughly 50/50 and there also wasn't much gender skew.

But that was a time before smartphones. When people still walked over to each other's house to hang out.

> [I am opposed to the situation that] any claim to be male, female, non-binary or whatever must be accepted at face value

That is exactly what GP was implying - that their self-image does _not_ have to be accepted.

Would you be for puberty blockers so that puberty can be delayed until 18 and automatic sex transformations be paused until the person can make a decision which way they want to go?

An open conversation and a working plan for what they want to do later in life is a good thing. I'm not opposed to hormone therapy as an interim measure. But I'm opposed to catering to teenage whims that aren't thought through very well, or discussed well, or which are driven by a desire to be part of a popular group, because I've seen the results. Confusion and self-hate and self-destruction can happen as a result of not being able to express yourself, but they can also happen as a result of too much unrestrained emancipation for a teenager, who doesn't understand the consequences. I'm not even speaking about trans issues here, just about teenage decisions in general. They're not fully rational people. I wasn't, either.

Think of the concepts of "citizen", "resident", "immigrant", "ex-pat", "DREAMer", etc - all terms related to where someone lives and what set of laws applies to them. Regardless of how the person feels, the label isn't just for their own sake. Someone can be a citizen and an immigrant if they are naturalized, saying someone is a resident implies (but not definitely) that they are not a citizen, ex-pats are assumed to be temporarily in the place where they reside.

Labelling trans women as women is a lossy translation that ignores a lot of societal edge cases.

Saying someone is a cancer surviving resident doesn't add anything to my knowledge of their medical history or which laws apply to them, but resident vs ex-pat tells me a lot.

There's no debate I'm aware of about lowering the age for getting a tattoo, or drinking, or acting in porn, or other things which are fine for adults, but which we don't permit 12 year olds to do.

A lot of us remember similar mistakes from their own teenage years. I had a short phase where I thought I was gay, because my classmates were starting to date girls but I had a close guy friend and wasn't very interested in girls. Then I looked it up, found some resources clearly explaining that's not what being gay is, and walked away more secure in my identity. If someone had told me that I couldn't be wrong, because nobody knows how I feel better than I do, I would probably have come out and then been confused and insecure for years.

2. None of this is even remotely new, Im not sure where you're getting that impression from. Germany had an entire institute dedicated to studying trans people at the turn of the 20th century [1]. I'd agree that for a variety of (usually discriminatory and religious) reasons it hasn't been well studied, but trans people certainly arent new.

[0] https://journals.sagepub.com/doi/full/10.1177/24702897188036...

[1]https://en.wikipedia.org/wiki/Institut_f%C3%BCr_Sexualwissen...

2. Transgender is not new. But the broader public debate about the distinction between sex and gender is recent.

Your specific exposure to the public "debate" is recent, sure. But just because you hadn't heard of it before the heritage foundation spent millions of dollars to insure you did didn't mean it wasn't happening.

Surely, if we're trying to group people by biological sex, we'd use chromosomes and ternary logic: male / female / intersex.

You won't easily find support for that on hacker news =)

Like yeah, Im aware HN (as a population) hates women, and GSM in general, but somehow im always surprised by how much yall do.

[0] https://en.wikipedia.org/wiki/Marianne_Legato

You shouldn't believe me you should believe science. I'm not arguing any of that go read about it yourself.

Some people claim to be cats. The argument is fairly leaking too. You might argue it is different for gender and to a degree that is true. Doesn't But this argument is pretty leaking too.

Because people lie about themselves all the time. Especially teenagers. We don't take every claim made by teenagers about their feeling as true on face value. We know they're practicing how to deceive people as part of growing up.

I removed that part as I agree it wasn't relevant.

> As for criticism of the research that exists, I agree that it isn't very good.

Unfortunately it's so poor that I judge it as being insufficient to use to form an opinion on this issue. It's much worse than the replication crisis at large, it's not clear that their methods prove what they claim in the first place if you look at their work. The pages I linked go into greater depth about why this is a difficult question to study and what the existing research gets wrong.

> The online echo chambers that children, including my own, seek out very much push the ideology that any claim to be male, female, non-binary or whatever must be accepted at face value.

That's as may be, but I suggest you read the WPATH standards of care if you're interested in what the medical community in general thinks about the medical treatment of trans people, including kids. It's a little out of date (2012), but if you can't find a knowledgeable medical professional nearby it's pretty much the gold standard, and is very well supported by evidence: https://www.wpath.org/publications/soc In particular, adolescents seem much less likely to desist than younger children.

In not saying that applies to all cases, but definitely a good number of them among young people, especially girls.

It wouldn't be easy to prove something like that, because you're claiming the causation is inverted. You can't very well construct a controlled study out of people's social connections or gender identity.

I don't think either of us can do more than an educated guess here.

It seems rather obvious that something like social contagion is going on, similar to anorexia. There may be cases with other causes, but a lot of them at the moment are probably social contagion.

If you think about it, onset of puberty is when the bodies of kids undergo drastic changes, and it is normal that they struggle to come to terms with it. Maybe worse for girls because their bodies change in more obvious sexual ways.

So they are in a vulnerable state where their bodies feel wrong until they have adjusted to their "new world".

I don't find it surprising that they are vulnerable to people telling them the reason their body feels wrong is because they are really trans, and they desperately grasp for an offered cure.

That is just me thinking, not "medical research", mind you. However, I think parental common sense is underrated when it comes to such issues. Too much expert bullshit has been injected into child rearing over the centuries.

Could you link to this research? This is a fraught topic that includes fraudulent studies and claims like this mean little without links.

From what I have heard this does not, however, lead me to believe there's an epidemic of kids receiving medical intervention in support of this, who don't "really mean it". As best I can tell it just means puberty is weird and confusing sometimes, but that usually resolves itself (at least, more or less) after a bit, which should surprise no-one. I doubt many cases that are merely confusion or uncertainty or "experimenting" or whatever, reach the point of even having a conversation with a doctor about it. I could be wrong about that, but nothing I've heard has me worried about The Children. Suicide rates do, but not that.

What would be productive is allowing kids to use different pronouns, allowing them to dress themselves the way they wish and allowing them to seek affirmative care and affirmative communities -- so that they can explore their own gender identity without feeling like they need to commit hard or lean in against opposition that tells them they're not really trans.

To the extent that gender identity can be influenced by social norms, allowing kids to identify their own genders is a way of allowing them to safely experiment in that space without invasive surgeries that they might regret. But if everything becomes policing whether or not someone really is trans, if everything involves policing even minor interventions like puberty blockers, then of course kids who suspect they might be trans are going to think that surgery is the only way that they'll be accepted or feel comfortable -- because that's what "gender-critical" groups are telling them, they're telling them that having a certain body is a barrier to their identity.

For some trans people, exploring gender is a process. Allowing people to feel safe and accepted during that process decreases the risk of rash decisions. And accepting them regardless of whether or not they pass for their gender decreases social pressure that might exist telling them they need to medically transition to be valid.

It's not surprising that mocking gender fluidity, over-emphasizing physical attributes in gender identity, and restricting low-impact interventions like puberty blockers might make uncertain kids feel like they need to hard-commit to medically transitioning. It's not surprising that trans kids and trans-questioning kids would be alienated by that environment, and that they might be less willing to openly air their doubts and fears or seek external advice.

The debate is not about whether somebody can use a pronoun. It’s whether everyone else is compelled to use it as well. It’s the difference between positive and negative rights - whether you have the right to compel others to behave a certain way vs whether you have the right to behave a certain way yourself. Legally compelled speech creates a real Pandora’s box.

I think you should feel good for being respectful and for using whatever terms people prefer, but punishing people for not doing so seems wrong minded

That's not really what I was getting at, what I was getting at is that creating an environment where people refuse to use proper pronouns or provide even basic accommodation for trans kids is going to make them more interested in medically transitioning, not less.

If you're a kid, and you suspect you might be a girl, and everyone around you is refusing to use pronouns because you don't look like a girl... it wouldn't be unbelievable for that situation to increase your risk of body dysphoria, because everyone around you is telling you you'll never be a girl until you look enough like one.

It can be someone's right to avoid referring to people by their proper pronouns, but I don't believe them if they turn around and say they're doing it to protect the kids from rash decisions about transitioning. Making kids feel safer and more accepted is how you protect them from rash decisions. Making them feel like you respect them and their identity is how you encourage them to seek outside advice and to be open about their doubts about their own gender.

> if people are genuinely worried about invasive surgery, the policing of trans identity is counterproductive to addressing that concern.

Your theory is that being accommodating on the first request makes more extreme requests less likely. An alternative theory is that bending over backwards to the first request makes such requests feel OK, and therefore makes more extreme requests more likely.

Do you have any research indicating that one theory is more likely to be true than the other?

Affirmative care does drastically and pretty irrefutably reduce the risk of suicide in trans/gender-questioning youth, but that's not exactly what you're asking about, you're asking specifically about whether affirmation and respect will decrease regrets about future transitioning. With trans kids, that's tricky to get data on today, because we kind of have to wait for them to get older to find out if they have regrets.

However, this philosophy is consistent with how we approach many other topics with kids. There's a reason why psychologists offer guarantees of confidentiality, because we've learned that when people don't feel safe talking about an issue they're having, they don't talk about it. This is also the philosophy behind ending the war on drugs, it's the philosophy behind modern approaches to sex education. We are focused on management and education, not repression.

We can also point back towards the debates about gay conversion therapy and look at some of those stats. Gay identity can follow a similar trajectory to trans identity; not everyone who thinks they're gay as a kid identifies as gay when they're older, and vice-versa. Discovering a sexual orientation can be a deeply confusing process. However, we have generally accepted that affirmative counseling for children who are experiencing distress over their sexual orientation is more helpful than conversion therapy or locking down the conversation. It is likely that trans children will have similar experiences.

Trans kids will not stop questioning their gender identity just because they're told to. But if that questioning is happening in complete isolation, then how are they supposed to make educated decisions about any of this? In particular, a child who is wondering what they would feel like using girl/boy pronouns may simply burn with curiosity, rather than trying out the identity and genuinely discovering whether or not it fits them.

As a somewhat over-simplistic analogy, a child who is convinced that they want to play the piano might take lessons for a while and then decide that they don't like playing the piano. Or they might decide that they love piano, and they might go out and buy their own keyboard. Either outcome is fine. But regardless of what they choose, the early lessons will have better-equipped them to make that decision.

No, that is NOT what I'm asking about.

What I'm asking for data on is whether efforts to accommodate teens in their requests is more likely to lead to them being satisfied with what they have received, or more likely to make more extreme requests.

The specific example is whether accommodations such as offering teens a choice of pronouns, along with messages about accepting their transgender nature, whatever that might be, makes the teens more or less likely to seek gender reassignment surgery.

Then I'm a little bit confused at your question. I suppose my prior is that acceptance of trans identity will probably lead to more people coming out and more people seeking gender reassignment surgery. I don't know that for certain (again, we don't really have studies about this in the long term yet), but again, we can look at other situations (gay rights, acceptance of left-handedness, ADHD, etc...) and based on how those movements have gone, it's pretty reasonable to conclude that the more people feel comfortable expressing their gender identity, the more people will decide to express their gender identity, including (sometimes) through surgery.

However, that is a meaningless thing to worry about unless you believe that gender reassignment surgery is inherently bad, which... it's not. We don't care whether gender reassignment surgeries become more common, we care about people making mistakes and regretting their surgeries. So the only statistics worth measuring here are the outcomes of people who choose to have surgery or choose to avoid surgery. We want to know whether as adults they feel they made the right choice.

Lowering the number of surgeries is not a metric we should be optimizing for. Improving outcomes and avoiding post-surgery regret is the metric we care about.

I guess to answer your specific question, I suspect that acceptance of transgender identities will probably lead to more people coming out as trans, and will probably lead to more surgery. But that has nothing to do with the question of whether or not affirmation is good for kids and whether it helps them make more educated decisions about their identity in the future. Having more trans-identifying people isn't a bad outcome unless those people are unhappy with their identity.

> The specific example is whether accommodations such as offering teens a choice of pronouns, along with messages about accepting their transgender nature, whatever that might be, makes the teens more or less likely to seek gender reassignment surgery.

So I don't understand why this is a question that anyone anywhere would care about, unless your insinuation is that your goal is to minimize the number of transgender people overall.

Do you care if your kid has regrets about the decisions they end up making about their body once they reach adulthood? Or do you care whether your kid is trans? Because those two concerns are completely orthogonal to each other.

"That's not really what I was getting at, what I was getting at is that creating an environment where people refuse to use proper pronouns or provide even basic accommodation for trans kids is going to make them more interested in medically transitioning, not less."

I don't know whether that statement is correct. But my strong suspicion is that it is the opposite of the truth. That the more we encourage the idea of transitioning, the more interest we create in all forms of transitioning.

Moving on, you ask:

"Do you care if your kid has regrets about the decisions they end up making about their body once they reach adulthood? Or do you care whether your kid is trans? Because those two concerns are completely orthogonal to each other."

The answer is that I care whether my kid will come to have regrets. I don't actually care whether they are trans. I care about whether they are happy.

It is my belief that medical interventions in teenage years are likely to work out poorly for future happiness. I wish I could say that this is an informed belief, but after attempting to inform myself I concluded that good information is not actually available. Still, since that is my belief, I believe that increased odds of a medical intervention implies increased odds of a bad outcome.

I don't care about legalism and I'm not going to get into gotcha debates about, "well technically you said".

My intent behind that statement would be more accurate to say: non-affirming environments force children and young-adults to make extreme decisions without the benefit of experimentation or counseling over those decisions. In that environment, it is more likely that they will regret the choices they make, because they will never get an opportunity to try out those choices in a limited capacity beforehand. This seems to me to be an obviously logical, reasonable statement: people who have less experience living as a trans person are less equipped to make weighty decisions about their future life. People who have less experience in any area of their life are less equipped to make weighty decisions about that area.

If that seems like a different argument to you than what I said before, then I apologize for being confusing, clumsy, and imprecise, and I'll happily concede one internet-point. But beyond that I'm not really interested in those kinds of fights.

> The answer is that I care whether my kid will come to have regrets. I don't actually care whether they are trans. I care about whether they are happy.

In which case, the only studies that will be helpful are the ones that measure regret, not rate of surgeries. Unfortunately those studies are limited. Bear in mind that post-puberty regret and regret over waiting on transitioning are also possible outcomes here. Both medically transitioning and waiting to transition or avoiding puberty blockers/hormones can have negative outcomes, which is why I emphasize kids being able to get more life experience being trans before they make that choice.

While long-term studies on transitioning are limited, there is at least pretty strong evidence that affirmative care reduces suicide rates in trans youth[0], so it does seem to have some measurable positive outcomes.

[0]: https://www.thetrevorproject.org/2020/01/29/research-brief-g...

And tendentious language, such as calling simple things like not giving detentions for a boy arriving to school in a skirt or a girl declaring she wants to be known as Pete "bending over backwards", really only weakens your argument.

If you object, or can't keep up, you'll be labelled a transphobe.

Here's a sample, linked from the website of Stonewall UK, a prominent trans rights organization:

https://www.mypronouns.org/how

I don't understand how people are so upset about this. Is learning someone's correct pronouns more difficult than learning a preferred nickname? If somebody comes into work and announces that they've gotten married and they have a different last name now, is that a major inconvenience to people? I had professors in college who wanted me to call them prof, and some who wanted me to call them doctor, and some who wanted me to call them Mrs/Ms/Mr. It's fine, you learn their preferences and you do it.

Transphobia isn't manifested in messing up someone's pronouns or getting a tiny bit behind on something, or accidentally calling someone the wrong thing. When people start to get suspicious of transphobia is when they see someone acting like using a pronoun is a giant imposition rather than very simple sign of respect.

Seriously, who the heck cares if someone wants to use a different pronoun? I don't have any validation criteria for that. Heck, if you want me to alternate pronouns every other day of the week, I'll do my best to accommodate that and I'll respond respectfully if I mess up and I'm corrected.

I just don't see what the big deal is here. We have so many different inconsistent rules in modern society about how to politely refer to other people, asking people's pronouns doesn't seem much more inconvenient to me.

If your professor wants to be called "prof" or "Dr.", it's probably because they're a professor or a doctor.

But a personalized pronoun is like someone informing you that they identify as a doctor, even though they have no degree, and you must therefore address them as Dr.

This makes no more sense than when someone says they identify as a non-binary pan-sexual gender-fabulist (yes, I know such people), and you're now required to memorize their customized pronouns.

Now, to your point, I used to work with a trans woman who was very obviously a biological male, but also very obviously identifying as a female in gender. She wore dresses and feminine hair styles. Her demand for female pronouns made perfect sense, and her overt appearance and behavior made it easy for everyone to remember her self identification. I have no problem with that.

But I'm probably not going to put much effort into remembering anything beyond the traditional binary pronouns. Pick one of those and I'll stick to it, but if you expect me to call you xe/xim, you'll likely be disappointed.

I don't personally run requests like this through an internal filter to figure out whether or not I agree with them or whether they make sense to me. To your point of titles:

> But a personalized pronoun is like someone informing you that they identify as a doctor, even though they have no degree, and you must therefore address them as Dr.

I don't think I've ever looked up someone's PHD after they asked me to call them doctor. I just do it, it's no skin off of my back. If I find out that they're not a doctor later, I might think that's kind of weird, but I'm probably not going to fight them over it.

Same if someone says they got married, or if they're getting married and keeping their last name, or if someone gives me a pronunciation of their name that doesn't match phonetically with how it's spelled. I don't really know that I have a validation criteria for any of those things, I don't think I've ever needed one.

I guess I can theoretically think of examples where it would be an issue, but I've never personally encountered them, and I don't think xe/xim rises to that level. Memorizing xe/xim isn't any harder to me than memorizing how a name is pronounced.

I don't understand how people are so upset about people disliking it when others respond coercively, threaten legal action, cause job loss, or enact excommunication from society (if you're a celebrity) when somebody demands that you call them something unconventional in the grander scheme of societal norms.

I don't think it's all that abnormal, at all, for a grand majority to push back on a vocal, disruptive, abusive, coercive, entitled group of activists sprinkled throughout the world who represent a slightly larger group of otherwise peaceful, passive people who have embraced a chosen (or inert) identity (or fad, for many) that flies in the face of society as a whole.

Disclaimer: this next paragraph is wholly and entirely satirical, and I, with full sincerity, do not intend to take any of the actions portrayed in the following example:

Dan, if you don't remember that I like my coffee with milk and agave nectar tomorrow, I'm unfortunately going to have you lose your job. Sorry man. That's just how I feel. You must remember, or I will continue to lose respect for you. I'm not going to just leave you alone and get over the fact that you won't remember -- I'm going to use social media to destroy your life and complicate your relationships at work, with your friends, family, and revel in any other damage I can do because you didn't remember the way I like my coffee. You must be my friend, but if you forget my coffee preference once, you're fully subject to my verbal and emotional abuse.

See how that works? This is the reality. And people wouldn't be calling this out in droves if the news headlines, TV show skits mocking it, the endless reports & anecdotes of people's lives destroyed, etc. didn't already prove this phenomenon. Irrefutable. And it has to stop dominating everyone's minds. It is psychological torture on an unimaginable scale, to hold most of society hostage to an unmerited stigma for the sake of "respect" demanded of it. And what good is respect if it is not earned by demonstrating positive intent and action in everyday conversation?

Activists on this front would do well to understand this, lest they continually fail in their mission to create a unified and equal society. Animosity, labels, and threats endorsed -- by proxy -- by the media, government institutions, and major corporations are the last thing that will unify people.

It's really not, as far as I've seen? At least not in the spaces where I'm active.

If you came into work with me and started to call me George, and refused to call me Daniel, yeah, you might face consequences at work for that. If it became a really serious problem, you might get fired, partially just out of the confusion of why this was such a big issue for you. I'm a little more tolerant of stuff like this, I'm not sure I care if people use the wrong name for me, but I don't advise going around and trying it, you're probably going to run into issues. And I have definitely met adults and professors who would openly reprimand someone for using their wrong title.

But you're not going to get thrown into jail for using someone's pronouns incorrectly, and you're certainly not going to get cancelled because you messed up one time. To the extent you are followed around by aggressive activists who are berating you for small errors, you can safely ignore them, society as a whole and the trans community as a whole doesn't think that way.

That's not to say that purity spirals and cancellation isn't a thing, it's not to say that people don't get overzealous about stuff. And certainly, Twitter is gonna Twitter. But Twitter represents maybe 20% of the population. I think you're going a little overboard with this characterization.

BUT... let's assume for a second that you're right. Let's assume that you are facing stigmatization for using the wrong pronouns, let's assume that enforcement is out of control and people are just getting canceled left and right for simple mistakes. We'll assume for the rest of this comment that literally everything you've said is accurate.

> I don't understand how people are so upset about people disliking it when others respond coercively, threaten legal action, cause job loss, or enact excommunication from society (if you're a celebrity) when somebody demands that you call them something unconventional in the grander scheme of societal norms.

What you are describing is the reality that trans people have faced for generations. Come out, get fired. Come out, get disowned by your family. Get shunned by society. Have politicians call you a menace, get told that you're dangerous to have around kids. Get evicted from properties, get used as a talking point. Have entire books written about how there's something wrong with your brain, that there's something wrong with you. Get attacked in prisons, get constantly accused everywhere you go that you are a fraud. Forget about having your online life ruined, have your regular life ruined. Get harassed as you're walking down the street, get thrown out of your church. Get told that you're a symptom of a decaying society.

Do you understand why some members of that group might end up having a short fuse about being misgendered? Do you understand why they might start to get worried about transphobia, why they might start to read into incorrect pronoun usage, or get a little bit paranoid sometimes?

What percentage of the US was openly disappointed that the Supreme Court ruled that sex discrimination laws applied to LGBTQ+ people? Look around you at the laws states are passing right now. Transphobia in the US is alive and well, and its agenda is actively being pursued today.

That is why this stuff dominates people's minds. Because the trans community understands better than almost anyone else in this country what it actually means to be cancelled by society, and they recognize a vocal group of Americans who are not just refusing to use pronouns, but that are trying to demonize them and erase them from society.

----

Now, you are not obligated to pay attention to militant, bad faith, or unreasonable activists. Those people are a minority, you don't need to feel bad about ignoring them. And no reasonable trans person is going to get mad at you for accidentally messing up a pronoun.

You are also not legally obligated to use anyone's pronouns. You might get fired or disinvited from some social groups, but if that's a big fear then you can vote to repeal fire-at-will laws. I can't control what a company does or who people associate with, I can't override someone else's freedom of association. In any case, you should not be losing sleep over whether you're going to get arrested for misgendering someone.

But it is utterly disingenuous to argue that there's a completely new, novel plague of cancellations over trans people. That plague always existed, and in the past it was even worse. It just affected different people than you.

The biggest difference we're actually seeing today is that more of society is realizing that refusing to accommodate trans people even in extremely trivial matters is kind of a jerk move. What we are seeing as cisgender people when we watch someone get cancelled is a very tiny portion of what many trans people have been living with throughout the majority of American history.

So if the backlash people have against anti-trans rhetoric really is terrifying, or you really do feel that people are on a hair-trigger to cancel each other, then pass some equal rights legislation and maybe everyone will be less on edge. On the same thread that people are openly complaining that trans women are "erasing the identity of biological women", at the same time that states are literally banning affirmative care for kids, you have to understand why some trans people and activists are a little bit reserved and prickly about this stuff at the moment.

Anecdotally, pretty much every trans space I participate in is usually full of people trying to be themselves without getting fired, disowned, or murdered. There is nary a mention of going into women's or men's spaces without passing first AND some pressing need where a public bathroom cant be avoided. The fact that so much focus in this discussion is on use-cases which most people agree aren't practical already paints it in a suspicious light.

The image painted here is very much giving the impression that bad faith activists are the primary worry of society rather than most trans people trying to figure out if they have the right to exist in the society in the first place.

With attention being drawn to us yet again by a conservative party trying to distract its base from its own policy failures, it is hard to have this cyclical discussion again and again without getting exhausted. At least every time this hits the mainstream it feels like there is a little progress.

Yeah, we read the article -- where it was portrayed as over-zealous and at least somewhat discredited.

https://www.stonewall.org.uk/about-us/news/international-pro...

B) I, OTOH, was commenting about Stonewall, pointing out that it seemed a crappy source. As such, quoting a known reputable source's judgement of them seems far more prudent than the primary source itself. They're not likely to say "We're a crappy source", are they?

(Heeey, I think I may finally have figured out Wikipedia's obsession with explicitly secondary sources.)

If someone required me to chant "Chocolate is god" whenever I enter their home, and my refusal to do so is a punishable / jailable offense, then that is a massive breach of my own rights to control my own speech.

I would probably choose to no longer spend time with those people if they felt they could compell (or more accurately, coerce) me to speak a certain way.

The same applies to identity, given that immediate obvious biological traits are present that can be used to infer a person's identity, and if asked to refer to them as something different, to respect that as long as the request is as respectful as me asking someone to do me a small favor.

Anything beyond that is toxic, purely from an emotional/verbal abuse lens.

Nope. It's a constraint on where you can go. You come into my home, then you follow my rules.

At that point, it all boils down to control on either side. One side is demanding control of one's speech (in one's own home, in this example, let's be specific). On the other side, they are demanding respect for one's right to think and speak freely without being compelled by complete strangers, and in the case of Canada, by the government.

Just as I am free not to participate in a religion and all of its chants and sayings, I am also free not to participate in the demands of a fellow human who uses personal rules and boundaries in excess to exert control over others. It's really no different than someone 50 years ago screeching "you will call me sir," -- in fact, I would argue a good portion of Leftists would absolutely flip their shit if they learned someone's father demanded their children call them "sir".

"What gives?", they'd ask. In that situation, there's an authority figure using that as a way to teach his children respect in the context of an authority/subordinate relationship, yet something about it still seems silly, especially if the father was using it as a way to strong-arm his children leading to a poorer relationship later.

In a nearly identical way, some (not all) in the trans community, especially in the public sphere, exert that same control by strong-arming their way into gaining respect from complete strangers they never earned it from, and without overt and obvious physical traits to denote one's gender falling into 1 of 2 major buckets by deduction.

"Don't guess what I am, know what I am," and guessing wrong is minus 3 points on the relationship building scale. Nice way to start! It could have been much simpler. For those who are more forgiving of those mistakes and ask politely for others to call them a certain way -- that would make it more reasonable; and I would venture to say that the majority in this community are that way. The only other issue now is the sheer complexity of remembering 50+ genders and growing.

Many people can barely remember others' names after asking 3 times, much less N number of possible genders.

"Don't take yourself too seriously" never had a better moment to shine. The world would be so much different if everyone treated those genders as something faddish or silly, where one's job, reputation, standing with friends, and even criminal status aren't hinging on a few mistakes not remembering others' preferred pronouns, especially for public figures and celebrities. God forbid they mess up or setup boundaries against more angry/coercive types. The same goes for employers or anyone else refusing employment or service to members of the trans community. That also is a real shame.

What good is a society not built on grace, rather than punishment, for something so frivolous as pronouns?

I'm a male, and I've been called "she" by accident (and even jokingly) too many times to count. All of those people still have jobs and good standing in society because I didn't take to social media to mount a campaign against them.

I'm proud of that. :) Though, it didn't take much for me to brush it off, because that's what good people do. Turning it into a harmless joke only evolved the interactions into something memorable that left both parties feeling seen and respected.

Is someone asking you to use their name a small favor or common societal expectation?

Also, since when is pronoun use punishable? Who is talking about jail time? People are just asking for respect, that shouldn't be too much to ask.

If everytime you see someone, you call them a rude name, and that person tells everyone you're rude, who is in the wrong?

We are not talking about that. Is more like a request to address somebody as his majesty or excellency.

https://www.cbc.ca/cbcdocspov/features/canadas-gender-identi...

And note that the pronouns subject to misgendering include the "personal pronouns" such as ze/zir that are now being pushed by trans rights activists:

https://www.mypronouns.org/how

> In the Criminal Code, which does not reference pronouns, Cossman says misusing pronouns alone would not constitute a criminal act.

https://www.cbc.ca/cbcdocspov/features/canadas-gender-identi...

> If someone refused to use a preferred pronoun — and it was determined to constitute discrimination or harassment — could that potentially result in jail time?

> It is possible, Brown says, through a process that would start with a complaint and progress to a proceeding before a human rights tribunal.

Sure sounds like "potential" to me, no matter how unlikely its proponents claim that will be.

And any talk of tribunals always makes my ears perk up, as it should anyone who values representative democracy.

This is the solution to your problem; and, if you were continually offensive to those people, one you may be forced to enact - by their rejection of your presence. However, if you do choose to interact with them, or choose to engage in activities where you will interact with them (during your work duties, for example) - that's the social contract you're going to have to adhere to if you want to continue doing so. You wouldn't argue that you should be able to go around verbally assaulting people without consequence because that would be an infringement to your right to free speech (which has always been limited, by the way; like it or not - you can't shout fire in a crowded theatre), would you?

I will caveat that I believe people who are opposed to the gender pronoun salad should also have the right to share that publicly, and in the event a person who subscribes to that way of life stumbles upon those public comments would benefit most by live-and-let-live, and simply write off or ignore those individuals if they feel upset.

Unfortunately every single permutation within intersectionality, whether "normative" or not, are going to face mild disagreement or prejudice towards their own ideologies.

A humble response is one that lives beyond it, rather than consuming all of one's time fighting it in the name of justice, IMHO. Seeking perfect insulation from disagreement is unachievable in society without also severely marginalizing a few groups at any given moment.

That is, unless there is a clear sign that said prejudice is on track to grow rapidly in the direction of genocide or overt societal exclusion and/or the belief that reeducation is necessary. All of these are unacceptable.

Though we are witnessing this being done against normative groups en masse in companies and public institutions today, unfortunately. It appears that most are reaching a breaking point and pushing back, and those who do represent many different races, creeds, and backgrounds. It's encouraging to see.

What do you mean by this? In what circumstances do you think it's acceptable to make these comments? What qualifies as "stumbling upon"? Do you mean to include group interactions in non-dedicated forums of discussion? Personal interactions? Should neither party be permitted to raise objection? Why should either party be expected to simply leave the discussion without contributing?

> That is, unless there is a clear sign that said prejudice is on track to grow rapidly in the direction of genocide or overt societal exclusion and/or the belief that reeducation is necessary. All of these are unacceptable.

Who judges this and how are they chosen to do so?

Excellent questions, and ones that are complicated to answer in any truly objective sense. The measuring stick I would maybe use to judge an appropriate context would be the same as how we would maybe treat a particular interest or political stance.

Does it feel appropriate to minimize someone else's political views to their face in a casual group setting? Probably not.

Does it feel appropriate to share a political rant in one's workplace chat that may have deeply personal implications? Maybe not. But if it did happen, could the offended party forgive the person who shared? That'd be favorable.

Does it feel appropriate to share the same political rant with a close friend? Sure, why not? Family? Definitely, if you're on good terms.

How about on Facebook? Twitter? Sure -- a point of disagreement is a few scroll wheel clicks away from passing over it, if a cool, measured response can't be mustered.

We are surrounded with opposition daily in various forms. The measure of our character is judged by how we choose to handle those moments. Sometimes walking away is a more mature response, because it acknowledges that the person is capable of thriving despite their opposition. It indicates that their ego is in their own control, not swayed by any insult that passively comes their way.

In the event you have a persistent harasser, it's time to either respond in kind, or get help from someone with the power to stop such harassment, but a single passive statement of belief or opinion shared is hardly even close to classifying as harassment.

> Who judges this and how are they chosen to do so?

Another tricky one, and very difficult to qualify.

If I had to choose, I might say the military if I've entrusted them to have intelligence data and a general pulse of potential threats within or outside a nation. Maybe that trust is misplaced? Who then would I turn to? The media? Would the media faithfully represent the issue in an unbiased manner? They've done very well to shatter that trust, as a collective institution.

Who then? Citizen journalists and average people recording and sharing video footage of evidence of mistreatment, but shared en masse? Reports of in the hundreds? Thousands? That'd be a good indicator that something's amiss.

Parents approaching their school boards en masse across the country to confront Critical Race Theory's damaging effects on school-aged children leading to fundamentally racist views against white people? That's a pretty good indicator something's wrong, especially if there hadn't been a past history of malicious / nefarious confrontations of the same sort, to where the recent recordings and reports of this happening are objectively novel situations within a larger period of time.

Despite those reports, there still would need to be a fairly unbiased judge of the broader situation, and one (or many) who could act decisively in enough time to prevent catastrophe should a threatening scenario for any given race or group arise.

It's the same sort of question as "did the Allies act soon enough against Nazi Germany's genocide?" or "did anyone act soon enough or... at all, against the Bolsheviks?"

Well, people finally acted, but was it enough? Or was the potential disaster they prevented grander than what had already been committed?

I couldn't confidently say there is anyone on Earth who is qualified to answer that question outside of God Himself.

It sort of is, though: someone's use of a pronoun only exists to the extent that others refer to them that way. My pronouns for myself are I/me/mine. Your avoidance of the pronouns I prefer denies me the "use" of those pronouns. I can't use them without your help.

Not disagreeing about the positive/negative rights characterization. And bigger picture: you're right that this really is about respect. Many people want to demand (even if not compel) more attention to mutual respect; many others want to use disrespectfulness as an indicator of their independence, because they view that as a more important value.

It's their identity, they're asking you to identify them a particular way.

Are they asking you to expend a small amount of effort to mentally adjust how to refer to them? Yes. Have people been changing nicknames over their lives for probably hundreds or thousands of years? Also yes.

But you ask someone to use a different pronoun and suddenly it's just too much.

Great contribution.

The sad thing is that while this is only a conversation on the internet, there are people out there passing laws affecting actual humans with the same amount of actual exposure to those humans and based entirely on their own imagined discomfort.

What if I asked to be addressed as "Sir"? Would it matter if I were nobility, or a nobody just trying to assert dominance? Or if you hated me and thought I was the opposite of a gentleman? But what if I thought of myself as a perfect gentlemen? Are you bound by my self perception?

Ridiculous is a relative term. If I think a request is ridiculous, am I free to ignore it?

It may indeed be. I likely don't have the time or energy to correctly address people who insist on being called they/them, or xe/xem. I have enough trouble remembering people's names.

Or would it be an implicit acceptance of the presumptions implied?

Would that not matter since it's their identity?

Forget nicknames, how would these people feel if somebody just said "Hey I'm going to call you Arnold now, because you fit my mental image of Arnold." Wildly inappropriate thing to do?

If you want to go and impose whatever pronoun you want on someone based on how they look, don't act shocked when you get called out for being a dick to them.

I've not seen someone suffer negative consequences for calling someone else the wrong real name. I've seen instances of negative consequences for someone using the wrong pronoun though.

Or is it because deliberately going out of your way to call people the wrong name to make a political point isn't a thing that anyone does, so nobody has needed a rule to make them knock it off?

You know, in being subtle like that, I fear you might not be making your point clearly enough for the others.

I don't know how anyone could look at the swath of laws introduced throughout 2020-2021 in both the US and in the UK and actually believe that people are not trying to police trans identity.

> by loudly insisting that any kind of socially non-normative gender expression should be seen as tantamount to and ipso facto equated with some sort of trans identity.

I mean, no. One of the good side-effects of allowing people to be more comfortable with gender fluidity is reducing stereotypes about what men and women need to look like and how they need to act. It means less telling women that something is wrong with them if they inhabit traditional male roles or have certain body types.

This is helpful not only for trans people, but also for non-conforming cis people. The less that people are freaking out over somebody calling themselves a girl if they don't look a certain way, the better things are for everyone who is not inhabiting a traditional gender role, whether they be cis or trans.

> Need I point out how this policing may be harmful to non-heteronormatively-expressing folks?

No, you don't need to. As I pointed out above, this policing isn't happening, and breaking down social norms about gender expression creates safe spaces for non-heteronormatively expressing people, regardless of whether or not they identify as trans.

An advantage of separating concepts like gender, sex, and presentation is that non-conforming cis people can feel more comfortable saying, "my appearance/interests do not make me less of a woman/man."

The idea that trans people are telling girls who like sports that they have to be men just so fundamentally misunderstands what the trans community actually believes about sex and gender. Trans people largely believe the opposite of what you say, they are pushing back against the idea that you can be "prescribed" an innate gender-identity by society.

Also, why is it that you refer to people who advocate for the validity of the trans experience as "trans activists" but insist on using the term "gender critical" to describe those who advocate for the position that the trans experience is invalid? Would not a more appropriate term be "anti-trans activists"? Is the resemblance to the "pro-choice/pro-life" argument - i.e. using a euphemism to avoid saying what the position is descriptively and clearly - purposeful?

While some people with highly traditionalist views might indeed believe this, many gender critical folks do not. Trans identity can definitely be valid, but so can cis identity. And it's definitely wrong to conflate any and all non-normative gender expression or presentation with some kind of all-encompassing "trans experience", at least in the strict identity sense.

Teenagers explore their identity in a number of vectors. I have always been strongly opposed to parentally imposed career choices and gender falls into this same category except there is some genetic predisposition that will carry on bodily changes unless proactive intervention is undertaken.

Frankly, transgender youth who seek these treatments generally suffer from clinical mental health disorders - including anxiety, depression, and suicidal ideation. These carry a significant risk of long-term suffering and anguish - not to mention the obvious fact that suicide is far too common in this population.

The risks of treatment are well studied and well known - the drugs used have existed for decades. They absolutely do not have to be completely safe and free of long term side effects - and even then the risk present is incredibly low - if what it does is keep them from committing suicide because of the suffering they endure as their bodies slowly turn into what they don't want to be. Surely you can imagine the distress that would cause?

The studies and metastudies and International Endocrine Society metareviews and treatment protocol recommendations are there and the vast majority of them say that you do less harm by providing blockers than you do by withholding them - do your own googling.

> the question is one of the benefits outweighing the risks

Naturally, and this is the essence of the "safety and efficacy" goal that is at the heart of our medical regulatory framework.

> Frankly, transgender youth who seek these treatments generally suffer from clinical mental health disorders

I absolutely agree. That makes the subject a difficult one to study, and all the more important to devote resources to that study, and to warrant great care before we have good data, which we don't yet.

> the drugs used have existed for decades

Yes they have, and we have decades of data on the negative side effects.

> do your own googling

Ok. Here's a big one:

https://www.pinknews.co.uk/2020/01/23/puberty-blockers-decre...

Apparently Pink News forgot to actually read this study, a careful reading of which reveals the following:

- The percentage of people who ideated and planned suicide (but did not attempt it) was nearly the same between those with and without puberty blockers (55.6% vs 58.2%).

- The percentage of people who attempted suicide was higher for those who had blockers (24.4% vs 21.5%).

- The percentage of people who attempted suicide and were hospitalised was nearly double for those who had blockers (45.5% vs 22.8%).

I see similarly shoddy treatment of data in many other ostensibly pro-intervention studies.

Perhaps you know of some other, higher quality work I could look at?

Surgical and cross-hormonal therapies are, by most nationally recognised and implemented standards of care, reserved until the patient reaches at least 16 years of age. Pubertal suppression is used as a method of reducing harm and is widely associated with improved mental health outcomes.

> Perhaps you know of some other, higher quality work I could look at?

Yes, I do. It's the same one covered by the PinkNews article you cited. A "careful" reading is insufficient. A careful, statistically literate reading is required. Such a reading of the study shows that the data do support the conclusion. The "contradictions" you cite are derived from statistically insignificant correlations. Please read up on P-value and the necessity of corrections in multi-variate analysis.

The claimed reduction effect with P 0.001/multivariate corrected is total lifetime suicidality in individuals with a history of suicidal ideation, who wanted pubertal suppression and received it. Absolutely none of the "contradictions" you cite are claimed and the study isn't powerful enough to give realistic results for any of them.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/

Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation

Pediatrics. 2020 Feb; 145(2): e20191725. doi: 10.1542/peds.2019-1725

See also Erratum, perhaps the rephrasing of the conclusion there will be helpful for you - https://pubmed.ncbi.nlm.nih.gov/31974216/

Now, this is certainly valid criticism of the study (or rather, the study and the data upon which the study was based): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169497/

Please, in the future, try to criticise studies like this. I certainly don't agree with many of Bigg's points but they do raise the right questions. More data is certainly needed - but that doesn't mean that the proposed treatment is necessarily wrong. That remains a clinical decision with this as but a small input factor.

Those standards of care are transphobic and a violation of trans children's human rights, according to trans rights groups. Policies that seek any kind of age limits are universally attacked by trans activists.

For example, observe the storm around Tavistock in the UK, which has for years aggressively pushed children into transition surgeries and hormone treatments, and censored and persecuted internal dissenters and wistleblowers with accusations of transphobia.

Last year's High Court ruling that Tavistock must limit these treatment to children over 16 was attacked by trans activists. Here's Mermaids:

"It’s frankly a potential catastrophe for trans young people across the country and it cannot be exaggerated the impact that this might have, not only on the population of trans young people that require hormone blockers, but it may potentially open the floodgates towards other questions around bodily autonomy and who has the right to govern their own body."

And in a recent example from the US, in response to South Dakota's effort to limit surgeries and hormonal treatments to kids older than 16, the Trevor Project said, "[these bills] not only contradict reality and majority medical opinion in the United States — they would also put young lives in jeopardy".

Regarding the study, you're looking at the wrong one. The one cited at the Pink News link is here:

https://pediatrics.aappublications.org/content/145/2/e201917...

No, there's no p-value fuckery going on here (and yes, I understand p-values; I worked at a medical device company analysing statistics from human trials.) This is just bad analysis. And I see bad analysis and bad data everywhere I look within this admittedly fraught subject.

Thanks for the other material though, I'll take a look.

So do what you'd do when your kid is rebelling against their religion or curfew or your selection of their college major. Talk about it and ask what's up. Express your own views, respectfully. Listen.

More and more women as coming out as trans instead of lesbian, and the 'lesbian until graduation' phenomenon was well known for decades before this.

The general populace has a very shallow understanding of the distinction between gender vs sex. The academic/popular liberal community makes no attempt to clarify the distinctions and it leads to further confused middle/high schoolers.

I don't think this study is perfect by any means, especially as the data is coming from parents of said teenage girls, but it's a place to start.

[1] https://www.youtube.com/watch?v=pnc_KvWkiHw&t=3324s

Oh, and of course, the methodology was soundly criticised and contextualised in the same journal; imagine that. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424477/

> The level of evidence produced by the Dr. Littman’s study cannot generate a new diagnostic criterion relative to the time of presentation of the demands of medical and social gender affirmation.

Surprise.

It's also the start and end of anyone replicating those results. This is very misleading and equivalent to linking the now debunked paper saying vaccines cause autism then telling readers to go look for more research.

For those in the back, trans people are the gender they say they are and the last people you should be asking for their opinion on a person's identity are their unsupportive parents. [0] https://journals.plos.org/plosone/article?id=10.1371/journal...

Edit: I just noticed the original poster already converted this into a longform post, so the "reader app" version isn't really necessary https://liminalwarmth.com/the-hard-thing-about-hard-things-m...

This avoids a lot of dysphoria-provoking secondary sexual characteristics from progressing, and also avoids accidentally "transing" a cisgender teenager.

Nobody hesitates to give puberty blockers to cisgender teenagers, for other medical reasons. I knew a young girl who had to have puberty blockers because she had a precocious puberty and it was literally destroying her young body -- she was not old enough physically or mentally to be able to deal with it.

However, for whatever reason, there is a huge backlash against giving it to transgender teenagers, despite it representing the best and ultimate choice in self-determination -- "Take these for a few years and then when you are 18 you can decide which puberty you want to go through". It leaves room for the individual to decide. If the person decides against it before then, they can stop and puberty immediately resumes as normal.

When the suicide rates are as high as they are for transgender people, and there is the option of halting the things causing the suicidal feelings, the dysphoria, all of the physical and emotional and societal pain. Halting an onslaught of pain that is utterly soul destroying, and just giving them more time to make a choice and more of an informed decision, how can there be any empathically-cogent argument against that?

I’d guess they’d be significant but that’s just a guess.

AMAB patients have less penile tissue for vaginoplasty. They have other options though. I don't think anyone has studied mature penile size in AMAB patients who decided to go through male puberty. Few do.

And people insist that these drugs are harmless?

"The primary risks of pubertal suppression in gender dysphoric youth treated with GnRH agonists include adverse effects on bone mineralization, compromised fertility, and unknown effects on brain development."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290172

"GnRHa therapy prevents maturation of primary oocytes and spermatogonia and may preclude gamete maturation, and currently there are no proven methods to preserve fertility in early pubertal transgender adolescents."

https://pubmed.ncbi.nlm.nih.gov/31319416/

I'd imagine you take the position that a child seeking this care is always confused. Could this be mistaken? Your argument would be void, if so.

Further, the quotes you make from the studies you cite are misleadingly cherry-picked - the studies themselves do not support the conclusion you imply they do. They are both calls for further research - they are not studies which draw any conclusions about the risk/benefit trade-offs of treatment and they do not state that treatment should be withheld.

> "The primary risks of pubertal suppression in gender dysphoric youth treated with GnRH agonists include adverse effects on bone mineralization, compromised fertility, and unknown effects on brain development." -https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290172

No one denies this. Again, it comes down to benefits of treatment versus risks of no treatment.

> "GnRHa therapy prevents maturation of primary oocytes and spermatogonia and may preclude gamete maturation, and currently there are no proven methods to preserve fertility in early pubertal transgender adolescents." - https://pubmed.ncbi.nlm.nih.gov/31319416/

Same here.

Surely a patient and doctor have the right to decide to risk infertility or a lack of bone density later in life in order to prevent severe mental anguish and potential suicide now? Would you rather demand the child continue to suffer so that they can have, according to you - as though it were your decision for whatever creepy reason, the best chance of making more children they may not even want or strong bones they may not even use on account of having committed suicide before reaching adulthood?

A child who insists that he is no longer a male (or never was) is definitely confused.

If that same child insists that he's black, even though both of his biological parents are white, would you take him at his word or save him from getting Dolezal'ed by an unforgiving woke mob?

Children don't make good decisions. Their brains are literally missing the hardware until about age 25. [1] We don't allow them to make permanent changes that they might regret.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621648/

Circular, self-reinforcing, argument. Invalid.

> If that same child insists that he's black, even though both of his biological parents are white, would you take him at his word or save him from getting Dolezal'ed by an unforgiving woke mob?

Non-sequitur. Dismissed. Child still in need of psychological treatment.

> Children don't make good decisions. Their brains are literally missing the hardware until about age 25. [1] We don't allow them to make permanent changes that they might regret.

Sure we do. All the time. We allow them to grow up - that's rather permanent. You're not upset about that. Of course, it just so happens to be something you don't personally disagree with, unlike the topic of discussion.

There isn't a moral equivalence between interfering in the process and allowing nature to run its course.

Argument from naturality. The moral equivalence arises from the context and circumstance - not on whether one chooses to interfere or not.

Inaction doesn't require justification unless action is obligatory.

The decision to help a child mutilate himself is never obligatory (or even justifiable).

"The primary risks of pubertal suppression in gender dysphoric youth treated with GnRH agonists include adverse effects on bone mineralization, compromised fertility, and unknown effects on brain development."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290172

"GnRHa therapy prevents maturation of primary oocytes and spermatogonia and may preclude gamete maturation, and currently there are no proven methods to preserve fertility in early pubertal transgender adolescents."

https://pubmed.ncbi.nlm.nih.gov/31319416/

The 1st paper said fertility may be compromised "if puberty is suppressed at an early stage and the patient completes phenotypic transition with the use of cross-sex hormones". Not if they decide not to transition. And cross sex hormones can compromise fertility on their own. The 2nd paper said "There is no substantiated evidence that GnRHa treatment for CPP impairs reproductive function or reduces fertility." Because those patients don't take cross sex hormones when they stop the blockers.

Unknown effects on brain development means no known effects. The only study mentioned found no significant detrimental effects.

Possible long-term side effects of puberty blockers Lower bone density. To protect against this, we work to make sure every patient gets enough exercise, calcium and vitamin D, which can help keep bones healthy and strong. We also closely monitor patients’ bone density. Delayed growth plate closure, leading to slightly taller adult height. Less development of genital tissue, which may limit options for gender affirming surgery (bottom surgery) later in life. Other possible long-term side effects that are not yet known.

https://www.stlouischildrens.org/conditions-treatments/trans...

I leave it to the reader to determine whether they think having to take vitamin supplement counts as a significant side-effects. I would note, however, that it is also important to put these side effects in context. The contraceptive pill, for instance, also has reduced bone density as a possible side-effect.

My reading of the research also does not indicate that it is majorly lacking. Medical research is written in a very conservative manner. Researchers avoid making claims beyond the limits of their research. This can look like doubt or uncertainty when it is not.

My experience as a Ph.D. researchers is exactly this.

> This can look like doubt or uncertainty when it is not.

No, it is absolutely real uncertainty. The difference between knowing a topic and knowing something about it is vast, and in the space is sophistry.

> How can there be any emphatically-cogent argument…?

Because drugging little kids should be a last resort. Using big words doesn't change the need to be extremely cautious in doing something as serious as blocking puberty.

Has anything changed in the last 10 or 20 years?

Why does this affect as many youths as it does today?

No doubt there was unhappiness with one's identity in the past, but I doubt it was at the level it is today. And, in addition, I doubt it's at the same elevated level in all countries. In other words, we can ask 30 or 40 year olds, did you as a kid feel unhappy with your identity as much as today's youth feel about their identities but couldn't wouldn't express it?

Is it kids leading the change, is it kids following societal trends, is it other, what is it?

Labeling - There's one specific example I'm aware of: Girls interested more in "boy" things than "girl" things were once called a "tomboy", but were still accepted as a girl, just a girl with different interests. Nowadays that same kid would be described as transgender and encouraged to transition.

Yes. We as a society have become dramatically more accepting of gay and trans people.

Gay marriage is a reasonable proxy. Back in 2008, and even a relatively liberal state like California passed a proposition to ban gay marriage. Today popular opinion supports gay marriage. Not just popular opinion in California, or nationwide, but even popular opinion nationwide AMONG REPUBLICANS.

This is why the parents that I know today with children identifying as trans are figuring out how to best support and help their children. The parents of trans people that I knew a few years back wound up becoming homeless as teenagers because of the reactions of their parents. A typical such reaction having been, "You are murdering my son!"

This won't be accurate for a few reasons.

First, there are certainly people in denial about these feelings. A society that is more hostile to trans people will yield a society that has more trans people denying their true identity. That should be obvious. Sometimes that denial is only outward which could result on them lying on a poll. Sometimes that denial will even be to themselves which means they couldn't be truthful on a poll.

If you have spent time around young children you have probably learned that it is difficult to understand a feeling without being able to name that feeling. Similarly it is possible for people to be experiencing gender dysmorphia without realizing that it is specifically gender dysmorphia. I have heard trans people talk about having a general lack of comfort in their body or just the sense that they were somehow wrong that they couldn't explain until they later in life realized they are trans.

Also trans people tragically have a shorter average life span due to increased rates of violence and suicide. Simply measuring the percentage of 40 years isn't going to be comparable to a percentage of 15 year olds because many of those 15 year olds sadly won't live to see 40.

“The proportion of mental health–related emergency department visits among adolescents aged 12–17 years increased 31 percent in 2020 compared with the same period in 2019, the report said. Visits for suspected suicide attempts among girls aged 12-17 then jumped 50 percent from February to March 2021 compared to the same period in 2019. The increase among boys the same age over the same period was just 3.7 percent.“

This makes your theory conveniently unfalsifiable.

https://www.amazon.com/Irreversible-Damage-Transgender-Seduc...

[1] https://4w.pub/social-media-trends-indicate-rise-in-gender-d...

Culture seems to be going through a convulsion of sorts and it is taking an enormous toll on our young girls. They do seem to grow out of it, but the phenomenon is real.

This isn't actually a thing. Certain factions who would prefer trans people cease to exist push this idea that kids are on this hot new meme of getting their bits flipped before reaching the age of consent, but it is simply not a thing. No top surgery, either.

It just isn't a thing. It's a wild fantasy. The only thing kids can go on are puberty blockers. These are well-tested and their effects known and understood through their use for other medical concerns.

The most common type of surgery is breast. In the USA, double mastectomies on children are legal, and have been performed on patients as young as 13. As for gender dysphoria itself, according to some surveys the frequency of teenage biological girls diagnosed with the disorder has risen by a factor of 40 in recent years.

For sources on both of those facts, as well as more background on this topic, I recommend https://www.webmd.com/children/news/20210427/transition-ther....

It seemed to imply the 40x increase was in rapid onset gender dysphoria. But ROGD isn't a recognized diagnosis even now. Never mind 2006. A single researcher published a single paper proposing it in 2018. They relied on the assumption teenagers tell their parents everything. And they selected for parents who refused to accept their children coming out as trans.[1]

The article also claimed 100% of a small study population proceeding to transition after puberty blockers contradicts the claim puberty blockers give children more time to decide before transitioning. But doctors don't hand out puberty blockers randomly of course.

[1] https://www.youtube.com/watch?v=pnc_KvWkiHw&t=3324s

I knew several women in college who had the procedure done before college to avoid familial cancer risk or back problems.

It's borderline misleading to say that mastectomies "happen", and then link it with an unrelated number for diagnoses of gender dysphoria.

It's also misleading to represent the growth of a tiny number relatively. A few dozen cases grew to a few hundred. That's completely normal and what happens with any novel diagnosis that was barely accepted even just 10 years ago.

The situation re: M2F is genuinely more challenging, and one has to balance a variety of factors pushing for earlier, not just later intervention.

> Certain factions who would prefer trans people cease to exist

I don't think this is fair. When we're talking about people this young, concerns about later desistance are very real. Expressing such concerns is in no way equal to preferring that these people "cease to exist".

Mastectomies leave scars and can have complications. And you seem to ignore the psychological and social aspects of going through opposite gender puberty.

After psychological counselling, not just on a child's whim, but still.

We've had exactly your point in the public discourse: "that's FUD, no surgery for minors is planned", but the wording in the draft law was clear, and proponents were unwilling to get rid of it, even though it would have made the law's passage much, much more likely.

What I do know is there's tons more bills trying (sometimes successfully) to block consenting adults and older kids with parental permission from even basic stuff like counseling or blockers. That seems way more dangerous than the fraction of a percent of kids who change their mind later being able to go through with a transition they'll regret.

They can also go on testosterone injections here in the UK, not sure about US.

[1] https://www.nhs.uk/conditions/gender-dysphoria/treatment/

> The only thing kids can go on are puberty blockers.

So instead of specifying gender reassignment surgery, they should have something more broad, like well-meaning medical interventions. It seems like the heart of their statement is true and that these medical interventions on children can backfire.

Except... people don't perform gender reassignment surgery on children just going through puberty.

Once female beauty was commoditized, and you could literally purchase an upgrade to parts you were born with. Entire cosmetic and plastic surgery industry benefited from marketing and promoting this model of beauty. The unforeseen consequence was that men started fetishizing these upgrades themselves.

As some men hyper focus on female body parts anyway. It was a way to exploit psychological tendencies for profit.

I guess the counter remedy would be to promote female beauty as the whole, and not some collection of body parts.

SRS/GRS is not recommended for pubescent children by anyone. At that age only hormone blockers are on the table, definitely not permanent surgery.

EDIT

Posting a reference backing up my claim since I'm getting downvoted:

https://www.politifact.com/factchecks/2021/mar/05/viral-imag...

| Professional organizations such as the Endocrine Society recommend against puberty blockers for children who have not reached puberty, and recommend that patients be at least 16 years old before beginning hormone treatments for feminization or masculinization of the body. The last step in transitioning to another gender, gender reassignment surgery, is only available to those 18 and older in the United States.

But the post that you're replying to, in general, holds up. "Gender reassignment surgery is typically only available to those 18 and older in the United States." https://www.politifact.com/factchecks/2021/mar/05/viral-imag...

I was editing my comment with that exact link when you posted.

Double mastectomy is practiced, at least:

https://jamanetwork.com/journals/jamapediatrics/article-abst...

It seems like an oddly small number to obsess over, especially considering over 8,000 non-trans teenagers between 13 and 19 receive breast augmentations each year.

From your link:

| the mean (SD) age was 19 (2.5) years for postsurgical participants and 17 (2.5) years for nonsurgical participants

Surgical patients would be the ones who are in the most danger of suicide or self-harm or for whom nonsurgical (hormone) treatment is not an option.

Also,

| Self-reported regret was near 0.

Here is the document that the report refers to as the standard for care for transgender patients:

https://s3.amazonaws.com/amo_hub_content/Association140/file...

You'll want to look at Section VI: . Assessment and Treatment of Children and Adolescents with Gender Dysphoria.

Are we talking about a top operation, or a bottom one? Do mastectomies count as gender reassignment, or only if genitals are involved?

Because if you include top surgery, then https://wng.org/roundups/state-mandates-payment-for-children... says that where I live in California it is legal, and insurance must pay for it.

You're going to have to come up with a better source.

https://jamanetwork.com/journals/jamapediatrics/article-abst...

But it links to http://www.insurance.ca.gov/0250-insurers/0300-insurers/0200... which is the actual decision posted on an official California government website. It confirms what I said.

Sometimes people lie on the internet.

And quite often, when they lie, they do so by omission or by inaccurately summarizing facts.

In any case, the two points in this thread are in agreement. Top surgery is "typically only available to those 18 or older," as 'john-radio wrote. In atypical cases, it is available to those under 18, and it requires a doctor to a) decide that it's necessary and b) consciously go against WPATH recommendations when doing so. The legal opinion here is that an insurer may not come up with a rule that says that doctors may never decide that it's the right thing to do for a particular patient, because that's a decision a doctor is allowed to make.

My child is smart enough to look for a doctor that is known to have evaluated cases on a "case by case basis" to provide the surgery that they want. As for how to find said doctor, if anyone in their online social network finds one, that information will be shared. In fact I would happily take an even money bet that my child would have no problem laying their hands on the name of such a doctor within 24 hours.

What do you think that specific clinical situation was in those situations?

I think this isn't solved by education, it is caused by it and consequently the peer pressure among pupils.

The reason is probably not that trans-people are discriminated against. That is very unlikely.

Why?

There are simply more disabled people than trans people and they are getting far less attention, right?

How is that hard to say?

One comes from the American Psychological Association, called the DSM and another comes from the World Health Organization called the ICD.

https://www.apa.org/monitor/2009/10/icd-dsm

For example, “discomfort” in gender dysphoria is a scientific term that implies a level of suffering on par with the “discomfort” one would feel immediately after a major surgery, during the recovery phase, except this discomfort is chronic.

Scientifically, people experiencing gender dysphoria are considered to be in a state of chronic suffering for which there is a medical treatment, called gender affirming care.

Not all gender affirming care results in gender reassignment.

I certainly remember as a teen being unhappy with the constraints gender put on me in social situations but that certainly doesn't mean I'm trans.

Unfortunately, politics keeps interfering with the word choices of scientists.