Friday, 7 April 2023

Transgender wars

Transgender wars


I'm a member of an email group for psychiatrists in Australia and New Zealand called Auspsyc. In 2020, there began a vigorous debate triggered by legislation in Victoria which affects psychiatrists who work there.

Change or Suppression (Conversion) Practices Prohibition Act 2021, which passed into law, criminalises attempts to convert gays into being straight, and also attempts to dissuade people from gender transition. This is threatening to psychiatrists, especially adolescent psychiatrists who might see patients with gender dysphoria.


Another part of the Act concerns the possibility of the complainant's identity being anonymous.
 

Understandably, a number of psychiatrists were horrified that, after about 15 years of training, they might find themselves in a situation where they face a jail sentence of 10 years for basically doing their job.

Meanwhile, whereas Victoria was essentially criminalising counselling, another story has been playing out in the United Kingdom.

The Tavistock Institute of Human Relations is a well respected centre for psychotherapy in London. In 2009, Tavistock and Portman Trust’s Gender Identity Development Service (GIDS) was established to treat people with gender dysphoria, or discomfort with the gender they had been born into. 

What Went Wrong at the Tavistock Clinic for Trans Teenagers?  Special Report from The Times (June 17th, 2022).

It led to an  independent review run by Dr Hilary Cass. The Cass Review. Following this review, GIDS was closed down.


Talking trans: Adolescents, gender transition and the conversations we need to have. A nuanced article in The Age by Michael Bachelard,  November 25, 2023

Keira Bell

Keira Bell, who began taking puberty blockers when she was 16, then medically transitioned and had surgery to remove her breasts as an adult. She later regretted this.

She sued the clinic, arguing she had been too young to consent to treatment as a teenager. The court agreed but this ruling was overturned on appeal in 2021.


Bell v Tavistock case and appeal.

The matter of 'detransitioners' is complicated by research of uncertain reliability. In general, trans-activists tend to say detransition is very rare and a distraction from their campaign of trans liberation. Detransitioners, on the other hand say that trans regret and detransition are common.


A survey of 203 people who detransitioned.



A video-blog reply to this article by Cari Stella, who detransitioned.


DETRANS: The Dangers of Gender-Affirming Care. A short documentary. Oct 25, 2023


The number of people presenting at clinics for gender dysphoria have rocketed over the last few years. The sex ratio has also changed from being more male than female to a lot more female.





A chart of children referred to GIDS, the Tavistock and Portman Trust’s Gender Identity Development Service clinic in northwest London. Overall case numbers had risen – from just 72 in 2009-10 to 1,807 in 2016-17 – but there was something more puzzling. Female referrals, once a fraction of males, now made up 70 per cent: from 32 to 1,265. The number of teenage girls with gender dysphoria (ie profound discomfort with their biological sex) had risen by 5,000% in 7 years.

How the Transgender Movement Happened. An interview with Dr Miriam Grossman, a child and adolescent psychiatrist. About 1 hour. 

The Society for Evidence-Based Gender Medicine is praised by some and vilified by others. Either way, it’s making waves.


Areas of dispute around transgender politics

  1. The medical management of teenagers with gender dysphoria
  2. Conflict over access by M2F (Male to Female) trans people into protected women's spaces
  3. Splitting in organisations triggered by transgender politics

1) The medical management of teenagers with gender dysphoria


The matters discussed above concern medical practices, and whether they are being carried out appropriately, particularly with young people who may or may not be old enough to adequately provide consent. As seen in the graphs above, this particularly concerns teenage girls seeking F2M transition, many of whom can be thought of as lying on an autistic spectrum. Before the upswing in medical intervention, many of these girls would have become butch lesbians. 

Supporters of medical transition for teenagers are often driven by fear of suicide. The evidence that medical transition reduces the risk suicide is by no means conclusive. E.g.:

'The present findings, although preliminary, suggest that social gender transition is not associated with mental health status in children and adolescents, at least in the short term.'

Youth Gender-Transition Treatment Not Tied to Lower Suicide Deaths in Finland 

Such treatment for adolescents with gender dysphoria was also not linked to lower psychiatric treatment needs, according to preliminary findings from an analysis of Finnish health data. Benjamin Ryan. 14 Oct 2023

Many of these gay teenage girls on the spectrum do not do particularly well when they go through transition. There are high rates of detransition.






Paper for the Australian Family Law profession. Belle Lane. This is an extensive and comprehensive review of the issues by a barrister in family law. 


Dr Dianna Kenny's rebuttal of ABC Four Corner's recent program "Blocked".

British mental healthcare responses to adult homosexuality and gender non-conforming children at the turn of the twenty-first century, by Prof David Pilgrim. A serious academic paper. It cautions against the anachronistic tendency to conflate the short-lived, and now defunct, experiment of aversion therapy for homosexuality with more recent defences of exploratory psychotherapy, wrongly called 'conversion therapy' for gender dysphoria in young people. 

The New York Times’s coverage of trans medicine is getting better, but problems remain.

'The New York Times has published a new investigative report on the pediatric gender clinic at Washington University in St. Louis, home of case-manager-turned-whistleblower Jamie Reed. Last February, Reed alleged in The Free Press that her former clinic was harming adolescents with invasive and unnecessary treatments. “What’s happening to children,” she said, “is medically and morally appalling.”

Return of the Grown-ups. A report of a conference of SEGM in New York, October 2023.

"If there’s one sentence I hope every attendee of the Society for Evidence Based Gender Medicine’s conference last week took to heart, it’s this:

No treatment with such low-quality evidence can be described as evidence-based, life-saving, and/or medically necessary.

A few key takeaways from the conference, and things most people there did agree on:

  • Parents always need to be involved in their children’s treatment.
  • There is no one approach to treating gender dysphoria.
  • We need to see the whole person, not just gender.
  • The chain of trust has been broken, between patients and clinicians, between clinicians and their membership organizations.
  • A therapist can affirm a client without “affirming” a gender identity.
  • We don’t need a new model of treatment; we already know how therapy and psychological support works.
  • We definitely need new and better guidelines, and no one knows how to get that done quickly in this country."
Part of the concern of psychiatrists is that there has been a conflation of the ideas of counselling and psychotherapy to help a young person with gender dysphoria, and the idea of 'conversion therapy' which has been made illegal in some jurisdictions, and threatens therapists with severe penalties.

A paper 'Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy' by Roberto D’Angelo, addresses this. J Med Ethics November 18, 2023.

ABSTRACT Opinion is divided about the certainty of the evidence base for gender-affirming medical interventions in youth. Proponents claim that these treatments are well supported, while critics claim the poor-quality evidence base warrants extreme caution. Psychotherapy is one of the only available alternatives to the gender- affirming approach. Discussion of the treatment of gender dysphoria in young people is generally framed in terms of two binary approaches: affirmation or conversion. Psychotherapy/exploratory therapy offers a treatment option that lies outside this binary, although it is mistakenly conflated with conversion therapies. Psychotherapy does not impose restrictive gender stereotypes, as is sometimes claimed, but critically examines them. It empowers young people to develop creative solutions to their difficulties and promotes agency and autonomy. Importantly, an exploratory psychotherapeutic process can help to clarify whether gender dysphoria is a carrier for other psychological or social problems that may not be immediately apparent. Psychotherapy can therefore make a significant contribution to the optimal, ethical care of gender- dysphoric young people by ensuring that patients make appropriate, informed decisions about medical interventions which carry risks of harm and have a contested evidence base.

As Kids, They Thought They Were Trans. They No Longer Do. NY Times, 2nd February 2024.

The WPATH Files: Pseudoscientific surgical and hormonal experiments on children, adolescents, and vulnerable adults March 4, 2024.  Newly leaked files from within the leading global transgender healthcare body have revealed that the clinicians who shape how “gender medicine” is regulated and practiced around the world consistently violate medical ethics and informed consent. The files, which were leaked from within the World Professional Association for Transgender Health (WPATH), were published by the US-based think tank Environmental Progress.

Trans, Racist & Woke: How Psychology Went MAD

After the closure of the Tavistock’s Gender Identity Service, many people have been left wondering how such institutional medical abuse of children could possibly have happened, and be allowed to happen for so long. How could some of the extremes of gender ideology and critical race theory be adopted by professionals who are supposed to be able to discern sanity from madness?

‘How Psychology Went Mad’ -- looks at the impact of ideology on psychotherapy, psychology, and psychiatry. It charts the development of the ‘talking cure’ and how this has become corrupted by far-left dogma and identity politics. In an era of increased censorship, political correctness, and infringements of freedom of speech, how can a profession based on being able to talk freely survive?

In this documentary, Amy Gallagher, describes her own experience of authoritarian ideology interfering with her own psychotherapy training and interviews those who have also spoken up about similar concerns. 

The gender-affirming model of care is incompatible with competent, ethical medical practice.
Andrew Amos. Australasian Psychiatry March 19, 2024.  

The assumption that there is no pathology involved in the development of gender diversity is a necessary precondition for the unquestioning affirmation of self-reported gender identity. Cases where psychosis is the undeniable cause of gender diversity demonstrate this assumption is categorically false. To protect this false assumption, gender-affirming guidelines forbid the application of the core psychiatric competencies of phenomenology and psychopathology to the assessment of gender diversity. They substitute the political goal of expanding personal liberty for the evidence-based medicine processes of clinical reasoning, rendering them incompatible with competent, ethical medical practice.

Why the Tavistock gender identity clinic was forced to shut ... and what happens next  The Guardian 31 Mar 2024, by Hannah Barnes.

The clinic at the heart of a heated national debate formally closes this weekend. The journalist who told the inside story of its practice reflects on those it leaves behind.

Hilary Cass Says U.S. Doctors Are ‘Out of Date’ on Youth Gender Medicine NY Times, May 13, 2024

Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. 

What Are We Doing to Children? The U.K. finally puts the brakes on gender medicine. By Theodore Dalrymple. He is a retired prison psychiatrist who writes widely.

Why I Hope the Supreme Court Upholds the Ban on Child Transition 

Jamie Reed became the first whistleblower from a youth gender clinic in the United States to come forward, raising the alarm about the dangers of paediatric gender transition in The Free Press. (4/12/2024)

Even though she is a progressive lesbian “to the left of Bernie Sanders,” Reed is supporting the Republican-led ban. She is also the executive director of the LGBT Courage Coalition, a movement of lesbians and gay men opposed to paediatric gender transitions.


2) Conflict over access by M2F (Male to Female) trans people into protected women's spaces



The second area of conflict concerns tension between natal male transgender people, and women who feel that their protected spaces (women's sports, bathrooms, prisons, rape centres, etc) are being invaded. This conflict has played out in many public altercations in which trans-activists have attacked prominent feminists. There are many instances where the trans-activists have successfully cancelled speakers, or people who are in public positions in universities and elsewhere. The term TERF means trans-exclusionary radical feminist. It is a term of abuse aimed at women the trans-activists claim are trans-phobic.

Here are some examples.

Kathleen Stock



Kathleen Stock is a philosopher who was hounded out of her job at Sussex University by trans-activists.

Various Youtubes here

The problem with ‘trans women are women’ by Kathleen Stock. More of her writing on Unherd.

J. K. Rowling


J. K. Rowling is the famous author of the Harry Potter novels. She has spoken about trans-gender issues and has been a target of some attacks by trans-activists. Her views are summarised here.

A podcast called "The Witch Trials of J.K. Rowling", is interesting.


J.K. Rowling Writes about Her Reasons for Speaking out on Sex and Gender Issues. A précis of the views she expresses in the podcast.


Julie Bindell

Twenty years a Terf. 'In 2004, I wrote a piece for the Guardian that changed everything'.


Posie Parker

Aka Kellie-Jay Keen-Minshull is a speaker for the group Standing for Women. Often her speaking engagements have been attacked by trans-activists. An event in Auckland led to violence towards her.







Isla Bryson case concerns Isla Bryson, a 31-year-old Scottish transgender M2F person from Clydebank, Dunbartonshire, who was convicted in January 2023 of the rapes of two women committed prior to Bryson's gender transition.

The case caused controversy after Bryson was remanded to a women's prison to await sentence.




“Trans” by Helen Joyce is a timely exploration of gender identity ideology and its far-reaching impact on society. Through rigorous research and compelling narratives, Joyce delves into how redefining gender affects laws, policies, education, sports, medical protocols, and the media. This book is an essential read for anyone seeking to understand the complexities and implications of one of the most contentious issues of our era.

3) Splitting in organisations triggered by transgender politics



Splitting is a defence mechanism that involves viewing people, situations, or events in black and white terms, without any shades of gray. This can lead to a person idealizing one person or group while demonizing another, without any attempt to reconcile their differing views or beliefs. Splitting can be especially prevalent in situations involving heated debates or disputes, where emotions run high and people feel strongly about their positions.

In relation to transgender debates, splitting can manifest in several ways. For example, some people may view all transgender individuals as either victims or villains, without considering the complexities of their individual experiences. This can lead to a lack of empathy or understanding for those who have different viewpoints or experiences.

Similarly, cancel culture can be seen as a form of splitting, where individuals or groups are quickly and harshly judged based on one aspect of their beliefs or behavior. Cancel culture often does not allow for dialogue or understanding, and instead relies on extreme reactions to perceived offences.

Many organisations have been split by transgender politics. Here are some examples.


The Australian Greens

Victorian Liberal Party

Gay organisations. 
What should trans pride look like? by Simon Fanshawe, a founder of Stonewall

The Royal College of Psychiatrists. 

The American Psychiatric Association

Universities

Schools
It should not be controversial for parents to be involved in their child's decisions.
Today the UK Government published its draft guidance for teachers on how best to support gender-questioning pupils. The proposals look both eminently sensible and guaranteed to cause total panic.

Sport

Breastfeeding support groups

Melbourne Comedy Festival



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