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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 think trans people can be largely divided into two groups:
People who had an affinity for the other sex from the time they were toddlers onward. A boy who prefers dolls and dresses to cars, etc. to the point of everyone around them knowing that this toddler is behaving like the opposite sex in a somewhat obsessive way. These people I have a lot of sympathy for, even if I disagree that this means that they are the opposite sex. Dr. Kenneth Zucker mostly treated this group, and in his clinical research about 80-90% went on to become normal gay men after puberty, with the remainder going through some sort of transition in adulthood. I honestly believe most have some kind of hormonal thing, maybe their mothers took estrogen during pregnancy, maybe some other endocrine disrupter got them early on. I still think the best thing is to wait and see if the desire to transition subsides after going through natal-sex puberty, but if the only group that transitioned was this group, as adults, then I would have few qualms for transition as a medical practice.
Unfortunately, there is the second group. Mostly consists of adolescents who for various reasons started thinking that transitioning will benefit them. The RODG group. The Autogynophelia group. Autistic girls who always felt something was off but never could put it into words. ETC. There might be some hormonal issues, but most of the time it's a social contagion of some kind. For this group, transitioning is probably the worst thing for them to do. It's a harsh medical intervention for something that will typically go away after puberty and therapy. Unfortunately, this group is the largest group getting medically transitioned and contains pretty much every transperson I know IRL.
I don't think any trans person is their desired gender, but that doesn't mean that they are delusional. It really is their desired gender. It's just that desiring a gender doesn't make them that gender.
Agreeing with your point about adolescents, honestly I never understood the argument for delaying puberty. That's one of the crucial times of sex differentiation where someone is really developing into a mature man or woman, from hormones to physical changes to all the rest of it. How in the world can someone say "they don't feel like a male" when they're not done developing all the way? I don't see how it's helpful to delay this process to, I guess, "give them time to figure it out". You're literally denying them information and the opportunity for self-discovery. For a lot of people, puberty just sucks, but that doesn't mean they're transgender.
The steelman is that the internal experience of puberty is supposed to be extremely unpleasant for trans people, and the later stages makes later transition much harder.
The 'very unpleasant' bit is more obvious for FtMs -- menses isn't fun for anyone and I'd assume it feels worse if the whole 'this is an alien thing rolling in my belly' sensation never goes away, breasts have obvious social impact and also just kinda suck from back pain and bras perspective to the point, and even in the modern day there's an absolute fuck-ton of social threat stuff a lot of young women suddenly get thrown at them. But the guy side isn't great, either: acne, cracking voice, more acne, your junk getting a mind of its own, and a lot of the things that make up for it for normal guys are actively unappealing for MtFs.
The transition bit is... the ugly paradox. Trans people really don't like to think about how it can be harder for some people to pass, no matter how much effort they put into it, but it's a thing, they know it's a thing, and there's a lot of tactical decision-making about how it's a thing. Both as a "I wish I had" moment, because a lot of trans activists only transitioned later in life, and because a there's a variety of pragmatic effects downstream of transition by physics and by law. The MtF who's six-foot-six, has a prominent Adam's apple, body hair everywhere, and enough upper arm strength to bench press a swimming team is going to have a lot more expensive, painful, longer-lasting surgical intervention just to pass to someone with poor gender recognition from thirty feet away. An FtM who has to get bras special-ordered and spent five years with the habits downstream of that isn't going to mode-switch into how cis guys act quickly, if ever.
The theory was that if someone's staying consistent in gender presentation for a year or two, you could be a lot more confident that they're not going to desist and get them to an age range where knowing consent is more realistic.
I think the trans movement badly over-corrected here, both in how early they started using puberty blockers (to the point where it made healthy life after transition more difficult), how long they used them, and by neglecting the amount of information people do pick up from early puberty. But while the former has a lot of problems downstream of bad practices by advocacy groups and active obfuscation by doctors of negative results, the latter is a more reasonable mistake. The numbers, even by social conservative expectations, had youth desistance just pretty damned rare. That was figmentary -- until 2020ish, prepuberty gender weirdness just wasn't be recorded much at all -- but it wasn't just hopes and dreams, either.
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I think the part you don't understand about the argument - because it's hidden, even from the arguers themselves - is that the argument rests on a fundamental belief in dualism. That is, that a person has a soul that is some gender or another, which is only accessible to the person's mind and, as such, they are whatever gender that they believe they are. This form of argument was taken from the successful fight for gay marriage around the late 00s/early 10s, where it was deemed that gay people were "born that way," and as such, e.g. someone who comes out as gay after years of enthusiastic heterosexual sex that they didn't regret was always gay from the moment of birth to now. This, of course, also rested on a fundamental belief in dualism.
This is also why one common trans activist point of agreement is that babies can be trans before they're even verbal, which can be detected by their parents carefully observing their behaviors, a la facilitated communication. Interestingly, the belief in dualism and maximum autonomy also results in push for what seem like the complete opposite, that someone can change their gender at will, since their gender is entirely and only determined by the person's opinion.
So when a prepubescent person is confused about their gender identity, this isn't the result of them simply not having enough experience in life, or of them not having knowledge of what being a man or woman is like, or of them having been exposed constantly to social messaging about transness; it's necessarily only the result of their eternal soul expressing themselves in the truest, most genuine, real form. As such, denying them the ability to get on puberty blockers in order to transition their biology before their actual sex's puberty causes biological changes to them is cruelty. Furthermore, if they actually go through their natural puberty, they might believe that they "grew out" of their innate transness, which means one less trans person than there otherwise would have been, which is one of many forms that "trans genocide" takes place.
How often does this happen?
No, the concern is that (1) being treated as the wrong gender is extremely unpleasant, and the sooner it ends, the better, and (2) transitioning later will make it more difficult to pass. I don't think trans people think people deciding they're cis after all is bad in any way. Some might believe it never happens, but for those who accept that it does, I don't think they consider it "trans genocide". Claims of "trans genocide" focus on alleged actual killings of trans people.
They do not. Consider a representative example, which claims that bathroom bills, laws requiring people to compete in sports corresponding to their sex and elevated risk of suicide for trans people are all part of the "trans genocide" currently ongoing in the US.
Or consider the Wikipedia page about the concept (of course it has a Wikipedia page). Opening paragraph:
By their own admission, trans activists consider the "erasure" of trans people (i.e. failing to affirm them and refer to them by the names and pronouns they wish to be addressed by; refusing to make every other character in a teen drama trans) and "discrimination" against them (i.e. demanding that they be housed in the prisons and hospitals corresponding to their sex; lesbians refusing to have sex with male people who "identify as" women) to be examples of "genocide". They also consider the elevated risk of suicide trans people face as an example of "genocide" i.e. the transgender genocide might be the world's first self-administered genocide. Sui-genocide? Geno-suicide?
Some countries make a gender recognition cert conditional on having undergone bottom surgery. This argument is sort of ridiculous because a) no one is forcing you to cut your dick off: if changing the sex on your birth cert is that important to you, that's a you problem; and b) unlike ethnicity, trans identification isn't hereditary.
You'll note that there's a bit of a Morton's fork here, as elsewhere in the article they claim that banning bottom surgery for minors constitutes "genocide". If you stop a trans person getting bottom surgery, that's genocide. If you say that a trans person can change the sex marker on their driver's license only if they get bottom surgery (in order to weed out bad actors), that's also genocide. As near as I can tell it, transgender genocide is just when you don't let trans people do exactly what they want 100% of the time.
Elsewhere in the article, there's a map of the US showing which states have banned gender-affirming care. You'll notice that this has absolutely nothing to do with "actual killings of trans people". The page argues that these laws meet certain criteria mentioned in the United Nations definition of genocide, as they "[cause] serious bodily or mental harm to members of the group; deliberately [inflict] on the group conditions of life calculated to bring about its physical destruction in whole or in part". But this is assuming the conclusion: a major reason for these bans is because of researchers like Hilary Cass investigating and learning that the evidence base for the efficacy of these interventions is appallingly weak and poor quality. This whole discussion was started by you pointing out that some children's mental health worsens after they undergo gender-affirming care. If this is true in general, it implies that legalising gender-affirming care for minors constitutes "transgender genocide"!
In other words, if people stop identifying as trans, there will be no trans people left and hence trans people will have been (metaphorically) exterminated. (Note the popular slogan "death before detransition".) Again – absolutely nothing to do with "actual killings of trans people". If everyone stopped identifying as trans tomorrow, there would be no trans people left, without anyone actually having been killed. Nobody identifies as a mod or a rocker anymore, and yet it would be absurd to claim that mods or rockers have been "genocided".
There you go. When they talk about "transgender genocide", they are not talking about trans people being murdered.
I could go on and fisk the rest of the article in detail, but I think I've made my point. Only a small portion of the Wikipedia article about "transgender genocide" concerns itself with trans people actually being murdered.* The rest of it is just complaining about trans people being made to use the public facilities concordant with their sex, not being permitted to compete in opposite-sex sporting events, certain trans people no longer identifying as trans, medical bodies hitting pause on gender-affirming care for minors and so on. When you hear "transgender genocide", instead of thinking "trans people being murdered in their hundreds" you should hear "trans people being inconvenienced or failing to get exactly what they want, in any way".
Between this and Gaza, I'm starting to think the word "genocide" will need to be retired pretty soon.
*The article is 15,451 words long. "Murder" appears 15 times, "kill" 13 times, "violence" 38 times, "death" 9 times and so on.
I dislike the "trans genocide" terminology, but I'm kind of stuck on a better word that doesn't minimize the concerns. Attempts to extinguish belief systems by any means necessary up to and including forced conversion and outlawing specific rites are a well-attested historical phenomenon which seems like it'd make a better analogy, but I don't believe that idea has a more specific name than the somewhat broader umbrella of "religious persecution".
Well, at least you're acknowledging that a new religious movement is what trans is.
"Genocide" is obviously the wrong word because genocide means targeting an ethnic group for extermination, and trans people aren't an ethnic group. Over time, a religious order can become a distinct ethnic group provided they only marry each other (you'd be amazed how often I have to explain to people that the Holocaust was not an example of religious persecution, as the Nazis targeted anyone of the Jewish ethnicity, regardless of whether they were practising or were even aware of their heritage), but I don't get the impression that this description is likely to apply to trans people any time soon. Sure, members of the Blue Tribe tend to endorse gender ideology and tend to intermarry, but most people who endorse gender ideology are not themselves trans. And as a result of the medical interventions they've undergone, trans people are disproportionately likely to be unable to have children anyway.
If (as you more or less concede) taking HRT and puberty blockers is more akin to a holy sacrament than anything we think of as medical care in the ordinary sense of the term, and if top/bottom surgery are more similar to elective surgical procedures done as part of induction into a tribe (analogous to circumcision or FGM), then in my eyes this strengthens rather than weakens the case for banning these interventions for children. If communion wafers wreaked the changes on children's bodies that HRT does, I'd be in favour of banning them too. Many jurisdictions already ban FGM for teenage girls. I'm aware that this practice is closely affiliated with certain strands of the Islamic faith and hence trying to prevent it could be thought of as "religious persecution": I just don't care. Religion or no, you shouldn't cut off bits of teenage girls' genitals when not medically indicated, and a pluralistic society has to drawn the line somewhere. I haven't been circumcised, but if circumcision were to be banned outright in all Western countries I'd be delighted. I'm sure there would be much waiting and gnashing of teeth from these countries' Muslim and Jewish communities, but this is one case where even an outspoken philosemite such as myself would say "tough".
Not exactly, but I do concede that it's a belief system - and as a liberal atheist I believe belief systems should get the same kinds of legal protection whether or not they're grounded in supernatural beliefs, as historical belief systems tended to be. Persecuting Daoists or Buddhists for their beliefs continues to be wrong even if we're simply talking about their moral or philosophical beliefs rather than anything properly theological. I feel the same logic should apply to Transgenderism - and Vegetarianism, and Effective Altruism, etc.
I wholeheartedly agree - about FGM, male circumcision, and medical transition for children. Physical alterations to children has always been the one point where I diverge from the progressive consensus re: trans issues, though it puts me into quite a lonely place politically - my belief is that in an ideal world, children should be allowed to socially transition, but barred from making permanent changes to their bodies just yet, and this is something both sides view as unacceptable from opposite directions.
(Now, mind, I do think that there's something of the isolated demand for rigor to the scrutiny applied to transitioning children. There are a lot of other alterations to children's bodies that are currently kosher, from getting a girl's ears pierced to so-called-"corrective" genital surgery on intersex infants. I tend not to find that much common ground with a lot of anti-child-transition campaigners due to them not caring about those things, never mind their views on adult transition, which are rarely congruent with mine. But I'm leaving this as a parenthetical here, insofar as given your stated position on circumcision I think you might actually be ideologically consistent on this kind of stuff.)
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Technically, "persecution against any identifiable group or collectivity on political, racial, national, ethnic, cultural, religious, gender as defined [to include only male and female], or other grounds that are universally recognized as impermissible under international law" (defined as "intentional and severe deprivation of fundamental rights contrary to international law by reason of identity") does count as a crime against humanity, even though in common parlance it does not sound so weighty.
There should really a better way to encapsulate the specific idea "people are trying to make there not be any Xs anymore" as distinct from just "people are systematically mistreating Xs"; many groups are persecuted without their enemies' aim being to extinguish the relevant identity altogether. Trivially, that UN definition you quote conceives of itself as applying to gender-based "persecution", and it would be… surprising for any government to set itself the goal of actually erasing women from the Earth (even in the non-murder-based sense of trying to forcibly transition all women into trans men), so they can't intend that "persecute" should be understood as implying an intent to destroy.
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Both the Substack article and the Wikipedia article seem to be suggesting that all this is merely the prelude to mass killings, along the lines of the ten stages of genocide. The Wikipedia article, being a page on a wiki, is admittedly less coherent.
And you'll notice that hypothetical mass killings of trans people are very much not actual killings of trans people.
I don't even concede that there are hypothetical mass killings. If criticism of a group (even based on malicious falsehoods) is a prelude to them being mass killed, then Kiwi Farms users are about to be genocided. So is everyone on The Motte.
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Who knows? Doesn't matter, according to the "born this way" metaphysics of homosexuality.
They focus on that, certainly, but focus doesn't mean exclusivity. Another common claim of "trans genocide" is that any microaggression against a trans person could be the marginal straw-that-broke-the-camel's-back that pushes them to suicide (which is famously common among trans people). And certainly, yet another is the but-for reduction of trans people by not allowing youths to transition. Which is why, e.g. pushes against "Drag Queen Story Hour" and similar activities have been labeled as part of "trans genocide" - the reasoning being that, if you don't normalize subversive gender expression like that among children, there will likely be at least some of them who would have discovered their innate transness but never did to due to not encountering such subversions, which reduces the population of trans people.
It doesn't make sense to complain about some bad thing your opponents caused if it never actually happens. I find it most implausible that someone should have "years of enthusiastic heterosexual sex that they didn't regret" and then come out as gay.
With all due respect, this suggests to me that you don't actually understand the other side very well. Trans activists, drag queens, and associated people draw a very clear distinction between trans women and drag queens. It is mostly anti-trans people who conflate the two.
Who's complaining? Please point out to me where in my:
implies in any way that this is a bad thing or that I'm complaining about it.
With all due respect, this suggests to me that you haven't actually spoken to people on your "side" (an aside: what an ugly word to use in this sort of conversation). I'm basing this on actual conversations I had with actual trans activists who I was on the same "side" as all the way through around early 2020s. I used to be an intersectional feminist (still a feminist today, just not that kind) who was very much on the entire "break down all social norms and queer everything" train (heh) up to that point and know for a fact that, yes, trans activists do draw a very clear distinction between trans women and drag queens, but they certainly see the normalization of the latter as a good tool for normalizing the former, via attacking heteronormativity and opening up people's minds to the possibilities of human expression and sexuality and etc. that are being suppressed by our current oppressive system. My comment did not, in any way, conflate trans women with drag queens, nor did my comment imply such as a base assumption.
The tone of the entire paragraph certainly suggests that you disagree with what you have dubbed "dualism".
If you don't mind sharing, what made you change your mind?
I'll have to concede on this, as I am not personally involved in activist circles and am not privy to this kind of strategizing.
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