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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.
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.
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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