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I got into an argument on JK Rowling recently. That was mildly annoying, but then it shifted to transgender stuff in general, and the puberty blocker discussion in particular was very vexing to me. I just genuinely don't know how anyone can be okay with the idea, especially now that we know way more about it than we did 10 years ago. The dismissal of the Cass Review on the part of the pro-trans side has increasingly looked like the stereotypical right winger doing mental somersaults to any science they dislike. But I have some questions on it, there were some things I didn't have great answers to.
What are the actual requirements for getting prescribed puberty blockers? The pro-trans tribe insists that it is a very rigorous process involving thorough checking of gender dysphoria, and it's not commonly done, despite being a readily available tool in the toolbox of clinical practice. I do not believe this after examples I have seen, but I have nothing to cite.
Is there any actual scientific evidence in favor of social contagion playing any part in transgenderism? The pro-trans tribe claims that social contagion plays no role, and to me, it's trivially true that social contagion plays an astounding part, as well as fetishism and abuse, and autism. I have no idea how many kids genuinely become gender dysphoric due to genetics, if there are any at all. And if there are any, I certainly don't think that it's a given that they need puberty blockers. How the hell did that become the default? But anyway, has The Science turned up anything on social contagion?
Are there any actually valid critiques of the Cass Review? Pro-trans tribe will cite the Yale Law retort, then when I point out the responses to it, either holes are poked in them or they just go back to their priors that the Cass Review was methodologically bad, done by a transphobe, misinterpreted studies, and went against the scientific consensus and ruined its own credibility. Actually, they say the same about the recent HHS Report. Please show me if there are any published valid critiques of the Cass Review besides the Yale thing.
What are the probabilities of serious consequences from puberty blockers? I brought up infertility, and the pro-trans tribe claimed that it's actually a very low chance and that it's not anyone's business anyway because not everyone wants to have kids. The latter half of that is completely inane when we're talking about life changing decisions for a demographic that cannot consent, but the former, I don't know. Do puberty blockers cause the infertility, the loss of ability to orgasm, and the complete lack of penis tissue with which to create a neovagina, or is it the ensuing hormones that do this?
Sadly, none of this will do anything to convince anyone on either side anyway. There's really no way out of this hole that has been created. Sometimes, I kind of hate this world. I really thought "don't give minors seriously debilitating life changing pills to solve a solely mental disorder" was an easy hill to stand on, but the fighting was just as vicious as anything else with the gender issue.
Edited to be slightly less angry.
The criteria for a gender dysphoria diagnosis is that you're "consistent, persistent, and insistent" about it, I think I even they even give a specific time period of exhibiting *sistence, and if memory serves, it's something like a few months. I'll try to look it up, and get back to you.
Sorry for the harsh words, but this is just a lie. Gender clinicians will say themselves, when they think you're not listening, that the issue shouldn't be medicalized, and it's just about patient autonomy and free expression. Many detransitioners say they got prescriptions after a session or two. There was a sting operation were a girl got it after 9 minutes on the phone.
And malpractice aside, like I said the official criteria is that you say you're trans and don't change your mind about it for a few months, I might be missing something, but I don't see much opportunity for rigor here.
It hasn't been properly studied yet to my knowledge as, until recently, the hypothesis was treated as an insane conspiracy theory.
Not to my knowledge, but I'm biased.
The deadly cocktail is blockers + opposite sex hormones, that basically clinches infertility and/or anorgasmia. Either one of those without the other is recoverable to some extent. There's a whole section on puberty blockers in the Cass Review, and from what I recall reversibility on healthy, normally developing children has never been studied.
@oats_son
This has been a bit frustrating to look up. While the phrase “Insistent, persistent, and consistent” does appear here and there, as though it is quoting someone, I can't seem to locate the original source. The first time I heard it must have been during one of the 7 zillion hours of trans / anti-trans confenrences I've watched, but my best effort attempt, of writing a script for downloating auto-subtitles from my playlists and grepping for the keywords, has yielded no match.
For what it's worth, the "few month" period seems to come from the DSM-5, and the diagnostic criterion seems to match the sentiment behind the 3-word phrase, so maybe it's a summary of that , rather than a direct quote.
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Ironically, reversibility was among the conditions that were being studied among the eight "transgender mouse" studies which the Trump administration cancelled funding for.
I kinda wish they had already studied it before prescribing them to children and explicitly marketing them as reversible. You can point out the irony, I guess, but it's hard to pin that on Trump.
Also, if an animal trial is enough for you, we already have a study on sheep that shows a fairly big impact on brain development.
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Yes, I guess I already knew it was a lie. Healthcare professionals can't look inside your brain for you, so they have to rely on what you say. It's extremely easy to get antidepressants if you say you've lost interest in doing your schoolwork, you have heightened anxiety, and you have bleak thoughts involving self harm. The script is different for different mental issues, but it's a script all the same. I don't know how you convince someone of that, but generally, anyone who argues this with you already has their mind made up.
It is deeply frustrating that such an intense issue is so stagnant on the research front (not to mention actually discourages wrongthink). If medicine didn't overextend into territory it didn't fully understand yet, none of this would have happened and I wouldn't get into these soul-destroying arguments. I think science didn't have much to do with the decision to do all this in the first place, so it's very frustrating when pro-trans advocates say to me that clinicians know a lot about medicine and can properly judge in individual cases whether it's worth it or not, so we should just trust them. It sounds so noble.
I am just wondering if trans advocates have any leg to stand on with regards to dismissing the review entirely. Do they have any official published critiques at all they're drawing from? Or is it a blue-tribe-wide vibe that they all feel? It's disturbing to see so many people actually in the field express such things if it's all vibes.
Are there any studies on this that you know of? How did you find this out? Too bad it's both that are required or it would be easier to argue this.
Sadly, I must refer you back to the "it hasn't been properly studied" point above. "No conclusions can be drawn" is basically a constant refrain in the Cass Review.
I think the first time I heard about it was with the case of Jazz Jennings, the rest is connecting the dots from what gender clinicians say themselves. From another post of mine:
One note: I did adjust my position somewhat since writing it. Recently I've seen an interview with a guy that had hypogonadism, basically the opposite of precocious puberty, where his body didn't want to trigger normal development. Apparently doctors managed to get him mostly up to speed where he now looks and acts (the lack of puberty also affected his psychology) like a normal bloke, so from this I figure it's not as bad as I thought. I keep promising myself I'll look into the literature on his condition, since if it describes what happens when it's untreated, that should give a non-politicized answer to the question of what happens due to puberty blockers, but I haven't found the time / motivation to do so yet.
I've also know of at least one detrans woman who managed to get pregnant post-testosterone (I think there are even non-detrans females that gave birth while constantly taking hormones). This is all in contrast to the blockers+hormones case, where I see gender clinicians themselves getting nervous, trying to adjust time-tables, and hacking around the issue, as per the quote above.
Sorry if it's conjecture, but I don't think anyone has actual data on this (or they do, but keep it secret, which wouldn't be surprising either at this point).
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