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A good write-up on a detransition study by the PI (Well, it's a cogent write-up, on its own; I didn't check if it was faithful to the study.)
They subtyped detransition into "Detransitioning with regret," 'Identity evolutions," "Transition ambivalence,' and "Interrupted gender transitions." The biggest surprise to me was the last subtype, since the others were pretty much what you'd expect. (Or, at least, what I'd expected.)
The write-up has a lot of tables and graphs, so block quotes aren't very effective.
To paraphrase the author, this is higher quality information than we had, previously, but the study can't tell us how to use that information... So, how would a utilitarian interpret this? Or a deontologist, virtue ethicist, contractualist, contractarianist, etc?
There are a couple of perplexing things here. First, and most pedantically, the mention of "external barriers" implies the possible or likely existence of "internal barriers." What would that be? Not yet reconciling yourself to the fact that your trans? What If a person has never thought they were trans? Is this just "internalized" something something. This is one of my biggest epistemic problems with the Trans people and the Woke people; they posit to understand everyone's true, latent motivations better than the individuals do. They're saying the can read the 'true' mind inside my mind and, furthermore, that their generalizations in this recursive mind reading are broadly applicable to society. "Everyone has, to some extent, internalized racism. They may not know it, however." Wow. What an assertion.
Second, if "external barriers" like discrimination, limited "access" to gender-affirming care, and (the very non-specific) lack of support cause a person to totally halt their transition, am I allowed to question their commitment in the first place? If I have a strongly head opinion on any issue, I'm probably going to try persevere even in the face of resistance and lack of support. I can understand the healthcare argument where a cancer patient, for instance, fails because they're just too weak. But the whole thing about transitioning is that there are no maladies in the body, just a desire to change it.
If we open the aperture to say that "emotional strength" is required to transition and that the actions of others can damage a person's "emotional strength" and, furthermore, that this is a valid reason for interrupting or quitting a course of action then how in the actual hell is anyone ever responsible for anything?. If "It made me feel bad so I quit" is acknowledged as "valid" then every deadbeat dad is forever absolved, every addict in recovery who relapses is a saint, every smash-and-grab thief is an understandable hardship case.
I do not think it is hyperbolic to say that much of society rests on the idea that everyone will, at multiple points in their lives, feel bad but that good behavior is still required even with the reality of negative emotional states. By medicalizing this "experience" (as the report explicitly does), we're opening pandora's box to the medicalizing of subjective emotional states. As I've written before:
My pitch regarding subsidies for transition is that every citizen should be entitled from birth to a finite "morphological freedom budget", calculated to cover gender reassignment plus detransition. A trans person can cash it in to transition (with just enough left over to detransition if they change their mind); an ordinary person can use the money on whatever other elective plastic surgery they want. But once you're out you're out, and further expenses are on you.
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For example:
Sure. I mean, you are also allowed to question the sexual identity of a celibate closet gay in Kabul, or the faith of a Christian in Tehran who does not try to preach the gospel to the locals.
For most people, a faith, gender or sexual identity is not their whole utility function. There is probably a trans person somewhere who would emigrate to Somalia if that was the only country where they could transition, or be willing to murder people for their wallets if that was the only way they could affort HRT. But almost all people have more complex utility functions, where trade-offs exist.
Physics determines part of how easy or difficult maxxing certain terms in one's utility function is. If visiting the Moon was as easy as taking a tram, you can bet I would visit the Moon, and if changing your sex was as easy as picking another option in a drop-down menu before going to sleep, I would certainly experiment with being a woman. But giving the constraints of physics, both of these things have significant tradeoffs, so I am very unlikely to gaze at Earth or grow tits.
But on top of that, societies can incentivize or disincentivize the maxxing of certain terms of one's utility function ("self-actualization"). I like to eat licorice sometimes, but if my society places it on Schedule I, I will not spend half my paycheck on getting some from the darknet. Likewise, if the penalty for the possession of redhead porn was death, that would definitely affect my porn habits. Or if the government decided that unlimited vanilla ice cream was a Basic Human Right and heavily subsidized its sale, that would likely lead to me changing my ice cream habits.
If your model of mental health services is that they will give people whatever will make them feel better, then I totally agree that no society could afford this. "Doc, I am a bit down, but I think a {new dress|adventure holiday|blowjob|fancy dinner|MMORPG item} would cheer me up" - "Sure, let me just write you a voucher for that".
In the real world, the mental health services do not work like that. Feel free to visit a psychiatric hospital sometimes and check. Engaging with mental health services because you feel bad is like using a life buoy because you are wet. Either system is designed to keep you alive, not ensure your comfort. Unless you are wet to the point which we call "drowning", or feeling bad to the point we call "clinically depressed", your best option very likely does not involve these emergency nets.
Trans issues are a strange exception to all sorts of the usual bureaucracy/hangups/etc. One visit, 45 minutes-hour max, possibly even a virtual consult to get HRT through planned parenthood. Then there's the whole sports debacle, bathrooms, pronouns have kind of faded but they were fireable offense for many years, 'cotton ceiling' discourse... et cetera.
Most mental health services do not work like that. Western societies made an exception for one subset and nobody seems to know why.
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There were people who checked and the results look a lot closer to his model than what you call "the real world".
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