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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.)
I highly doubt you're arguing in good faith here.
Not sure who you're talking to, but that isn't the modal "anti-trans" view, and I doubt anyone has that strawman view on this forum. Sure, many trans people are delusional (the ones who merely declare they want to be treated as the other sex aren't, but the modern line that they are and always have been another sex is just obviously false). But adults are free to pursue happiness in their own way, including transitioning, and it's no big deal for me to be polite and play along with their preferences most of the time.
I suspect you know that most people's main objection is to forcing the rest of society to play along. That includes:
This is a hilariously absurd take. You're just shit-stirring.
It applies to me. All transgenders are wrong about a very obvious and easily verifiable fact. That is, literally, the definition of transgender. They confront proof of this wrongness every time they take a shower or use the toilet- hopefully, multiple times a day. They are, in other words, delusional, and playing along for the sake of their mental health is not actually any sort of obligation, except perhaps occasionally for actual mental health professionals, and not for the sake of increasing their comfort with their delusion but only for that of getting at and treating the underlying issues.
Now there are many lumped into the category of transgender who believe themselves to be something other than male and female, who identify as 'queer' or 'nonbinary'. I don't know what these categories are because these categories are not real, and while these people are wrong they're wrong about metaphysics- claiming to be something that isn't real on nonexistent philosophical grounds isn't falsifiable, it can't be delusional. But these people are not transgenders proper.
This stance does not, incidentally, actually determine whether people should be banned from transition. Not least, transition is sufficiently difficult to define as to make that hard.
I don’t understand what’s the delusion? The vast majority of trans people are acutely aware of the reality of their biological sex, otherwise they would not be taking hormones and having surgery.
Being trans is about wanting to be the opposite sex, or at least being distressed by your own biological sex and sexual characteristics. What are they wrong about?
It’s like thinking overweight people who take GLP-1 antagonists are delusional about thinking they’re actually skinny. That seems… completely backwards? There’s anorexic people who take Ozempic but the delusion is thinking they’re being fat - the equivalent would be a cis woman taking estrogen because she has a delusion that she’s biologically male. A trans woman is 100% correct about not being biologically female, which is why she’d want medical interventions instead of doing nothing!
There’s an ontological debate over the definition of the words “woman” and “man” and the whole gender vs sex kerfuffle, and some activists’ definition of “woman” is circular to the point of uselessness, but that’s a separate issue and more of a debate around values, not facts.
The delusion is in insisting that wanting to be something is exactly the same thing as being that something, which is obviously ridiculous. Honestly you are starting to sound wilfully ignorant which makes me think you are trans-identified yourself, because consistently denying reality and pretending not to understand things that have been explained to you ad nauseam is a key characteristic of trans-identified people and their allies.
But I'll bite and explain once more. According to mainstream gender ideology:
To apply this analogy, it would be like thinking that overweight people become skinny merely by expressing the desire to become skinny. And moreover, not only are they now skinny (even though they are objectively still fat), they have retroactively always been skinny, and if you deny this, you are a bigot and you will get banned for misweighting a stunning and brave transskinny person.
The fact that nobody actually thinks like this when it comes to fat people shows how ridiculous gender ideology is.
And sure, there is a type of trans person who actually tries to transition. They will take cross sex hormones, change out their wardrobe, change their behavior, and so on. Those people have at least some valid claim to be treated as the opposite sex. But importantly, gender ideology doesn't require anyone to do anything like that (claiming someone needs to transitions to be “valid” as a transgender makes you truscum which is practically as bad as being a TERF) and even if you go through all that trouble, obviously it doesn't change who you were before your transition, although gender ideologues will insist that who you were in the past depends entirely on what you identify as today.
My understanding of the matter is more:
The premise that gender is merely a separate thing from sex was used as a foot in the door twenty years ago. No modern gender ideologue operates on the basis that biological sex is real and important today.
If you disagree, I will ask you the same thing as I asked Rae: go ahead edit the fact that Imane Khelif is male and that Elliot Page is female into their respective Wikipedia pages. If you manage to do that, I will concede that gender ideologues in the real world separate sex from gender identity.
Sure, that's what gender ideologues believe, but why shouldn't it be? Especially if they use their false claim to get special privileges, like Imane Khelif falsely claiming to be a woman to compete in the women's boxing tournament.
Again, that's perfectly reasonable up to the point where they make false claims to access resources they shouldn't have access to. The analogy fails because people with embarassing skin conditions or missing limbs don't generally claim to have flawless complexions or complete bodies.
The closest case I can think of is someone like Oscar Pistorius who is a sprinter with artifical legs who was eventually banned from competing against natural humans because he had an advantage over regular athletes. If we can ban Pistorius from men's sports, why can't we ban Khelif from women's sports?
Imane Khelif isn't even trans! By all accounts, she has a vagina and was raised as a girl, and she and her entire family have believed she is female her whole life. Even if she does have XY chromosomes (not confirmed), a hundred years ago we wouldn't have even known that and no one would have questioned her womanhood.
Whether Khelif is trans or has a vagina really depends on which definition you use, but let's talk about something more interesting:
I'm willing to believe that Khelif and her family assumed her female until puberty, but after that, they must have noticed something was up.
I find it hard to believe that even in a relatively poor country like Algeria, a teenage girl can go through puberty without ever menstruating or developing secondary sexual characteristics like breasts and hips, and nobody questions it or takes her to the doctor. Algeria is a poor country, but they're not that primitive. And even primitive peoples understand the basics of male and female anatomy pretty well.
And then of course there were all the failed sex tests: first by the IBA, and then by a private doctor in France in 2023, which Khelif later admitted confirmed he has male genetics and male typical testosterone levels.
Note that his was before the 2024 Olympics, when it became known that he had failed the IBA tests, but the results of his private tests weren't public knowledge yet. The IOC and various useful idiots spread the lie that the IBA results had been falsified by evil Russians. Khelif knew this wasn't true, because his own private results confirmed the IBA tests, but he never spoke up. This seems calculated.
Then later, in 2025, Khelif tried to participate in the boxing championship held in the UK, organized by World Boxing, the Western organization that was created to replace the IBA. They also required a sex test, which Khelif refused to take, despite being desparate to compete (he even sued the organization to force admission without doing the test, but lost). Why would a person who legitimately believes himself to be female refuse to take a sex test designed to confirm that fact?
So it's clear at this point Khelif knows he's genetically male, and that therefore he will never pass any test designed to screen out genetic males. He probably knew this at the 2024 Olympics, too, because he had already failed the IBA tests and had them confirmed by his own doctor. He was intentionally witholding that information.
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Photos from the Olympics clearly show Khelif being carried on their coach's shoulders and their coach's hands touching Khelif's bare skin. In theocratic MENA countries it's a big no-no for a man to touch the bare skin of a woman who isn't his wife (many women won't even shake hands with a man when meeting him). The coach definitely knew.
Strange, given Khelif has admitted it.
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Sure, I'll happily keep my mouth shut about that should I ever encounter an obviously trans person in real life (by the way, that's another claim I've seen: 'you do know trans people, hundreds of them, you've met them, they're all around you'. Er, no.)
But when someone starts in about "how about we all share our pronouns?" or the likes and makes it about "let's not embarrass trans people by relying on visual identification where they don't pass, let's all share our pronouns so we're not outing anyone, even though we are in fact outing people" (and I'll admit that's often or mostly the allies, or some other branch of the LGBT+++ movement, not the trans people themselves doing it), then they make it about "I am clearly pretending to be something I'm not and demanding you openly accede to that verbally". If you're going to demand I say out loud "yes, Sally is a girl" then I reserve the right to say out loud "We all know Sally used to be John". I'm willing to exchange courtesy for courtesy and live-and-let-live, but not if I'm asked (or strongly encouraged) to participate in the pretence.
I did see an example in my own work life of someone firing off emails with their pronouns in the signature line, I don't know if this was something mandated by where they worked (because it was a couple of different people in the same organisation doing it) but thankfully that seems to have died a natural death. If you can't tell by my obviously female name what gender I present as, and we're never going to meet face-to-face, and you don't need to know my gender/sex/number of limbs, then why make a big deal out of it? I did not need to know that Susie was going by "she/her" in order to send back the completed form as requested per your last.
My mum argued that pronouns can be helpful, not for the purposes of trans inclusivity, but because sometimes she gets emails from people from foreign countries and isn't sure if their forename is a boy's or girl's name.
I pointed out that we used to have a perfectly effective means of solving this problem: Mr./Mrs./Ms. This seems like a great example of jugaad ethics.
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Also, the euphemistic "should" in "should keep that to yourself" is playing the part of a motte. I have no problem with the idea that it's just as impolite to point out that a transwoman looks ridiculous as it is to call attention to somebody's missing arm (although I would hope the transwoman had someone in their life who was honest with them). The actual bailey is "you MUST keep that to yourself, or you are a declared Enemy and we will publicly advocate for doxxing you, getting you fired, and (in the UK, at least) jailing you".
I agree. Part of the problem with the skin condition analogy is that the issue doesn't normally come up in ordinary life. The way you address a person isn't normally based on whether the person has clear skin. By contrast, you normally call a person "sir" or "ma'am" based on whether they are male or female. Similarly, people don't use a particular locker room based on whether or not they have a skin condition.
I think A better analogy would be if people with serious skin conditions were given access to special resources, for example more convenient parking spaces during the summer months so that they wouldn't have to spend as much time walking outdoors. And if a person with perfectly healthy skin was permitted to identify as having a skin condition and take advantage of this special access. And if anyone who complained about the situation (or who didn't go along with pretending that the person had a skin condition) were ostracized.
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That’s my understanding as well. Maybe @MartianNight and @hydroacetylene don’t believe in the gender/sex distinction but it’s central to the mainstream trans viewpoint and it’s either a straw man or a misinterpretation to interpret “x was always a man” as “x is and always was biologically male”.
Progressives will be very sensitive about language and avoid explicitly calling a trans man a biological female, but they aren’t (completely) denying reality, they’ll just use euphemisms and softer language (like AFAB/AMAB, “presenting as female at the time”). If you don’t have hold the sex/gender distinction it’s easy to think it’s complete nonsensical absurdity and that they’re saying a man can will himself into having a uterus, as opposed to having this nebulously defined conception of the inner self as a woman.
There is no gender/sex distinction. Famously, Matt Walsh asked “what is a woman?”. Self ID doesn’t get you there because unless you have a platonic form there is no way one can in fact identify as a woman (what is someone identifying with if there is no form). So the only possible coherence is to look at the platonic form of a female and see if women maps onto it.
But then trans folks are basically claiming that doing certain activities are the defining form of being a woman (again if there is any coherence to trans ideology — one could say there are many ways to be a woman but trans people need there to be a platonic form). And by doing so, by saying “women are X, Y, and Z” trans folks are basically telling a bunch of females that they actually aren’t a woman (unlike the trans “woman” who is male). That is patently ridiculous. No, the woman who was born with women’s characteristics shouldn’t be told she isnt a woman by a confused man. Being a woman (based on sex) is easily defined and generally has worked for society for ages; yes there are extreme edge cases but far fewer than if the trans incoherence was adopted.
So even if you take the weak form of trans claims, they still fall apart into incoherent delusions since the only way to make any sense of gender is by tying it in to sex and therefore breaking the alleged binary.
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No it's not, and I've already pointed you to enough examples that I now believe you are being completely disingenuous the way all gender ideologues are always completely disingenuous.
If gender ideologues embraced the sex/gender distinction, Wikipedia's Elliot Page article would start with: "Elliot Page is a female actor who identifies as a man"
And Wikipedia's Imane Khelif article would start with "Imane Khelif is an intersex male suffering from 5AR2D who identifies as a woman..."
The Khelif article literally contains the false claim that "Khelif was born female" and for months contained the completely unsubstantiated sentence "false claims that she was a male circulated online": while these claims did circulate online, they were factually true, and this is still not acknowledged, though the sentence has been modified by replacing "male" with "man" which is still a lie since Khelif is a man in the trivial meaning of the word.
There is no "sensitivity" or "soft language" here. There is just a complete denial of objective reality. And it's not an oversight: this was one of the most-viewed articles of 2025. Many people tried to correct the "born female" and "false claims" phrasing; these people were all overruled by the gender activists that watch these articles like hawks and police the language carefully with the intent to maximally deceive the public.
If you disagree and you think the statement "Khelif was born female" was not meant to deceive the reader into thinking Khelif was born female (when in fact Khelif was born male) I would love to read your argument to that effect. But stop your bullshit about me not “believing” in a gender/sex distinction that obviously real world gender ideologues don't believe in either, considering that they're always intentionally conflating gender with sex, and never plainly state the sex of transgender/intersex people.
Intersex is a whole other kettle of fish, and I have sympathy there. But it's been hijacked as the "hit me now with the child in my arms" by the trans activists in order to go "well ackshully chromosomes aren't enough or assignment at birth isn't enough because what about this case and this case and this case of intersex people? checkmate, bigot!"
Someone with Klinefelter Syndrome is not the same as someone with functional sexual characteristics and two X chromosomes now declaring that they are the same as XY male for all intents and purposes. So what if I'm getting pregnant, I am the father of this child not the mother!
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