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Unfortunately like basically every pro and anti trans study, it wasn't really a good one. Their model for psychiatric health is, I'm not even kidding, how much you see a mental health professional. It might be a decent proxy in some ways, but it has very obvious issues. A schizophrenic living on the streets untouched is considered more mentally sound than a middle class student going to a therapist because of "anxiety".
This doesn't necessarily show how mentally healthy you are, it shows how willing you are to engage with the healthcare industry.
That we've selected for a group that seeks out, uses medical care and sticks to it (this is way less common than you might expect, tons of people won't even stick to life saving meds) should suggest a rather heightened rate of psychiatric medical care as well by default, they're the people who actually go use medical care to begin with! No treatment/after treatment comparisons can't get away from this selection effect, people who stick with treatments are the types of people who stick with treatments and use medical care. Even before and after comparisons are flawed. You could see reasons increased rates both from negative results (more problems) and positive results (more trust in healthcare).
Social science sucks. At best this obvious flaw in study design not being cared about is lazy, at worst it's because they're retarded and didn't even think about possible selection effects like most social scientists don't.
This would be a reasonable-ish criticism in the US (and even there "yeah, I know it's not perfect, but it's not bad enough to dismiss the findings"), but in a country with a robust public healthcare and welfare system, the dynamics are completely different. The homeless schizophrenic is far more likely to get treatment than the middle class student trying to get treatment for "anxiety", because the state doesn't have unlimited money, and will triage people.
It definitely lowers it. You can't claim they don't engage with the healthcare system, if they already signed up for gender dysphoria treatment, and are just waiting for it.
We've been allowing an exponential increase in transgender medical interventions, including for children, on the basis of even poorer quality studies claiming they improve mental health outcomes. This study, at the very least, serves as evidence against the pro-trans studies who use similarly flawed methods, except they have no controls, and use way smaller sample sizes. If you want to reject it, there's no reason to take any pro-trans study seriously, and we'd have to admit we're performing massive, dangerous, interventions on children, with absolutely no evidence they help at all.
Robust public healthcare still doesn't mean that people engage in it equally. Especially because you can't make the comparison with the US like that when healthcare in the US for the poor is essentially free for them too! The poor schizo is gonna get all their costs covered by Medicare. So the US is not actually as different as you think.
And the schizo example is just a more obvious way it fails. Again like I said there's an issue in healthcare about how many people won't even take prescribed medicine that they literally have covered by insurance. Tons of people just don't use the resources available to them.
This is just a reading problem, I said that they are selected for being the types to use healthcare. People who engage in voluntary healthcare for years are the types of people who engage in voluntary healthcare.
Yep, that's why I said "unfortunately like basically every pro and anti trans study, it wasn't really a good one.". Social science being low quality is basically the default.
This makes the assumption that the default should be that government bans people's choices unless it's "proven" to help. Why can't the default be that government stays out of what people, including children and their parents, want to do with their lives?
But the comparison in the study takes two groups who, by your argument, are likely to engage in voluntary healthcare. The only difference you can potentially point to is how likely they are to stick to a treatment. Also keep in mind that the effect size you're trying to explain away this way is pretty big. Big enough that I'd think the idea should be backed by evidence itself
This isn't a social science paper, and these issues are pretty common in other fields as well.
It's an extremely unpopular idea. There's a reason why trans activists don't even bring it up.
Not nearly the same rate. It's also not the only issue. Because the Finnish youth on treatment were also being monitored every 3-6 months during checkups, there's also going to be a higher rate of any possible flags being noticed and referred compared to a group who doesn't get monitored by doctors 4x a year. So it's not even just measuring willingness to use healthcare, but also measuring "do people who see doctors regularly get referred to other doctors more?" This is a known issue called surveillance bias.
So yeah, I assume all things equal that a group seeing psychiatric checkups 4x a week, especially voluntarily doing so, are going to have more psychiatric treatments elsewhere.
The effect size is pretty massive sure, but that doesn't mean much. Why should I assume the selection effect of "people likely to utilize healthcare are likely to utilize healthcare" is itself small?
It's actually pretty popular that parents, not government, makes the choices about parenting. Parents can even do things like get their children permanently circumcised, there's a growing movement against requiring childhood vaccines, and in general parents can refuse medical care for their children unless it's directly and immediately endangering the life of the child for US laws. While that might not be the case for some other western nations, I believe the US way is superior to more restrictive and less free countries.
Where are you getting the 3-6 month number from? I see no indication of it in the paper. I can imagine this being a problem if the relevant comparison was to the controls only, but you're comparing two subgroups of people already interacting with the medical system due to gender dysphoria.
Because both groups are already utilizing healthcare, for one. Also, when you criticize a study as "lazy or retarded" the possible bias should be big enough to wipe away or invert the finding, and I think it's reasonable to ask for some backing on how likely that is given the numbers at hand.
Not really. Even on the trans issue itself, the very same people who defend these treatments as being "between the child, parents, and their doctor" will routinely defend institutions hiding a child's transition from their parents.
The US has medical licensing bodies, that take away licences from doctors that prescribe or carry out unproven treatments. It also has a system in place that prevents people (adults!) from voluntarily buying the drugs for themselves that they want. I'm not sure about what the US laws say on the matter, but I don't think they would take kindly for parents getting a hold of prescription drugs, and giving them to their children, on the basis of nothing more than their personal belief it will make them better. I'm not proposing anything different here.
The implication of your idea would be that we'd get rid of this system, or at least make it entirely voluntary, which would be hugely controversial. I'm pretty sure it would be only popular with hardcore libertarians.
Medical checkups for the hormone treatments and getting new prescriptions.
The controls here are not people actively engaging with the healthcare system over several years, as you can tell by the fact that they are controls not receiving ongoing treatment.
Ok let's look at this specific topic, here's a poll from South Carolina which asked
~71% responded should not! Even the republican respondents were a large majority opposing state intervention against parental decision making. This makes sense, the left leaning side are pro trans and the right leaning side is typically in favor of small government. Traditional conservatives typically say "get the fuck away government regulators"
Ok, but this isn't based on your knowledge of the Finnish system, and you don't know for a fact that the pre-intervention group isn't also getting checked up regularly, right?
Yeah, I know. But the finding is based on the raw comparison to the controls, it's based on comparing each of the subgroups (pre- and post-intervention) to the controls. For your objection to be valid, the pre- group would have to be as unlikely to interact with the medical system as the general population. Which would be weird, given that they already entered the system asking for help with dysphoria.
Ok, fair enough, there are apperently similar results for the other side of my question as well. That said, there's also the rest of my argument. For this to be indicative of a general principle being applied, we'd need to see similar support for changing the medical licensing and prescription systems to being purely advisory at most. I doubt that's a very popular idea.
Unless the Finnish system is unique and just prescribes medicine for years without any followup needed, I can say pretty confidently that they are receiving constant checkups.
For what? They aren't receiving a treatment then so what checks up would they be having?
Now hold up, read that again. They can not be both pre and post system.
That's not true. Plenty of people believe in greater medical autonomy under the condition that it is conducted under medical supervision. Now this does change with one major factor, insurance. It is the bill payer who will demand things be "necessary" after all, regardless of beliefs in autonomy. But if someone pays their own way, why not? It actually helps people to ignore the traditional system, like tons of people are losing weight thanks to Cremieux teaching them how to bypass the extremely expensive and often overly gatekept requirements for glp-1s.
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