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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.
One problem is that when considering the effect of an intervention, this is basically an apples-to-oranges-to-licorice comparison.
The gold standard for determining the effect of an intervention would be a randomized controlled trial (RCT). Take a patient and then prescribe them either a puberty blocker or a placebo, so that neither you nor they know what they got, and then follow up on the outcome years later.
Obviously this is hard to do for ethical reasons. But anything else risks simply measuring confounders. Perhaps the people opting for intervention simply had a higher trust in their medical system, and consequently were also more likely to seek psychiatric help with other problems. Or a million other things.
This is not my experience. The anti-trans side believes very strongly in their conception of gender, hence all the bathroom bans. Someone who actually rejected the concept of gender might preach some kind of pansexuality where you simply do not care what kind of sex bit your partners have. They might reject the very concept of straight and gay couples because There Is No Gender, Man.
By contrast, the people most offended by trans people believe very strongly in the existence of gender, they just happen to think that it is identical to sex-assigned-at-birth.
This is a weird framing. I wouldn't say I believe in gender, but think it's identical to sex (not "sex-assigned-at-birth", just "sex"). I would say that, of the two, sex is the only thing that actually exists. No one actually has a "gender identity" (hell, no one can even provide a cogent, non-circular definition of what "gender identity" even is), but even if they did, it's a bad idea to design public policies around unfalsifiable claims people make about their own inner experiences. "Gender identity" meets this description, "sex" does not, ergo "sex" is a good basis on which to design public policies and "gender identity" is not.
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