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I said two months ago I would reply to a comment about this study on the mental health effects of gender transition. I have only now managed to find the time, so I'm going to post my reply as a top-level comment lest it get buried. You can find the previous discussion here.
To be honest, some of the statistical manipulation seems dubious, but that's above my pay grade, so I'm going to assume the study was conducted in good faith with no shenanigans.
In short, the study finds that, contrary to assumptions that transitioning should improve mental health, the share of people needing mental health treatment rises drastically after transition. Anti-trans people conclude that this means transition actually worsens mental health, and, hence, people should not be allowed to transition.
There's some nitpicking to be done here, for example, maybe the patients already needed mental health treatment and just found out they needed it at the same time as they found out they're transgender, or that just seeing a mental health professional regularly doesn't necessarily mean that your mental health is worse than it used to be.
But my fundamental objection is to the conclusion that no one should be allowed to transition. Suppose the anti-trans side is completely correct on the facts, that transitioning did, in fact, directly worsen the mental health of many or even most patients. There are still some patients who are better off. There are countless anecdotal reports online of people who are happier after transitioning. The most you can conclude is that the criteria for who should transition need to be changed. (If I'm interpreting the data right, the likelihood of needing mental health treatment after transitioning was higher in those born later, consistent with the rapid-onset gender dysphoria (ROGD)/social contagion hypothesis.) But if you care about people's happiness, some people should still be supported in transitioning.
Obviously if you believe all trans people are delusional and object to transition and treating people as their stated gender regardless of the effect on their mental health, this does not apply to you. But in that case the study isn't an argument you can use.
Speaking of ROGD, its rhetorical use by anti-trans people is a peculiar example of a self-contradictory motte-and-bailey: usually the bailey is a stronger version of the motte, and thus necessarily consistent with it, but here the bailey ("all trans people are delusional and none of them are their stated gender") contradicts the motte ("some trans people with a specific presentation – primarily adolescent girls – are not actually their stated gender") because the latter presupposes that some trans people are, in fact, their stated gender. If you believe all trans people are delusional, why do you care about the specific etiology of the transness of a specific subgroup of trans people? The treatment, whichever you prefer, should be the same.
I consider myself pro-trans, but I believe ROGD/social contagion may well be a real thing. If you agree about the possibility of social contagion, you should try to minimize the attention trans people receive, yet anti-trans activists have been the main publicists of transness for about a decade now – trans people really entered the mainstream with the North Carolina "bathroom bill". It used to be that you would only find information about transness if you went looking for it because you were questioning your gender, but now that trans people are everywhere (thanks to anti-trans activists), you get impressionable young people who were not predisposed to questioning their gender hearing about it and joining in for the standard reasons impressionable young people join trends. (Cf. media coverage of school shootings encouraging more school shootings – a common argument among anti-gun-control people.)
Neither of those argument doesn't work. There are 3 groups in the study:
The conclusion isn't based on just comparing trans people to controls It's based on how theie mental health deteriorated after transition. I also remember the author of the interview saying all students get a regular (yearly?) mental health assesment in Finland.
I agree that this study is not enough to conclude that, but I don't I've seen anyone say "this study clearly shows that no one should transition". Instead, it is a rebuttal to the pro trans narrative that claims they are able to accurately diagnose dysphoria, and that these interventions not only help, but are medically necessary. This conversation has a long running context, where the pro-trans side was deliberately misleading people and attacking skeptics for years, so I don't think it's right to try and portray them as saying "well, we just think there's a non-zero number of people who might benefit from this"
The kind of people who say "no one should transition" don't so much believe some one "isn't their stated gender", they question the very concept of gender. I think it's a strong argument, "gender" is effectively a religious belief. Specifically it seems that it's a secular version of the belief in a soul, and I think it's fair to say that this is not a valid basis for a medical intervention
I also don't see the contradiction. You can say "no one should transition", and "this social contagions seems to be affecting mostly adolescent girls". I see no presupposition of validity of other people's gender dysphoria.
Gender-as-distinct-from-sex is either of nonsense or actively reifying stereotypes, take your pick. Souls are more coherent than strict self-ID gender. That sounds harsh, but for those following along at home, play this out for a minute. If your gender has no connection to the outside world, it's just your internal experience and label for yourself that you definitionally can't be wrong about, then there's absolutely zero reason for anybody to ever treat anybody else differently based upon their gender. There's no reason for gendered spaces or activities or anything at all, and so since the outside world has no reason to care, poof! Bye, gender. Trying to hold onto it is going to just wrap around into it not mattering or build up inconsistencies and nonsense. So for gender to be A Thing about which We Should Care, it has to have some ties to the outside world. Being distinct from sex, we're already ruling out biology. So that leaves social/cultural factors, which are not innate, not inherent, and indeed we see them vary by culture. So we should care about a bundle of traits and properties a particular culture has decided go together - that is a stereotype!
If women are people who X and only X, then let's just deal with X directly rather than lay an extra category on top. If women are people who X and Y, then baby you've got a
stewstereotype going! If women are people who call themselves women and nothing else, then we've no reason at all to care. Once you take the biology out of the gender, you have nothing left that anybody can or should care about but social and cultural baggage, and so by clinging to it and impressing how important it all is to you, you're just strengthening your cultural stereotypes and calling 'em sacred. Quit it.The '90s had the right idea. Boys can wear dresses and have tea parties, girls can play with monster trucks and hit one another with sticks, etc and so on, and none of those things make them not boys or not girls. Let the words refer to the biological reality underneath that is true and correct in 99+% of cases, invent special terms for the outliers if you must, drop the social/cultural barriers, and just let people do their thing. There's no reason for all the hassle, and it can't and won't get anybody any more freedom anyway.
You want to take hormones and are otherwise okay with opening the gates on letting people put stuff in their bodies if they feel like it, go for it. You want to wear 'gender inappropriate clothing' and are otherwise okay with a general lack of expected dressing standards, go for it. You want elective/cosmetic surgery so that your body is more pleasant for you and are otherwise okay with people having other such surgeries, go for it. Do What You Want, up to the limit of what you think society should allow in general, because you are not a special case. You cannot be a special case, because there is nothing special underneath. You're just a boy or a girl who wants to do an activity which is not gated by gender.
IMO trying to completely separate gender from its biological aspect is partly cope for the fact that transition is an imperfect technology and not everybody ends up passing, and no surgery can make you have the reproductive functionality of the opposite sex yet.
Most trans people desperately want to be the opposite sex on a biological level and a trans woman being allowed to wear dresses because boys can dress however they want won’t help with the fact that her hips are too narrow and she hates having stubble and that having a penis means most men will be uninterested in dating her, and that she won’t be able to have a normal sex life regardless, or have children the normal way, etc.
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