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PaperclipPerfector  3d ago (text post)   13409 thread views

Culture War Roundup for the week of June 22, 2026

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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.)

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.

Neither of those argument doesn't work. There are 3 groups in the study:

  • people with dysphoria pre- some form of transition (blockers, hormones, surgeries)
  • people with dysphoria post- transition
  • people without dysphoria as controls

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.

But my fundamental objection is to the conclusion that no one should be allowed to transition.

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"

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.

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.

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".

That's the certainly the impression I got from people citing the study, even if none of them said so explicitly. Do you agree some people 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"

I am not the pro-trans side; I am one person on this website. You are arguing with my claim that some trans would benefit from, and should be allowed to, transition.

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

A simple concept of "gender" that avoids any metaphysical or spiritual claims is that "my gender is 'woman'" means "I want to be treated, in most social situations, as you would treat the average person with XX chromosomes (however you refer to such a person)". I realize this is not the version typically advocated, but I am not the typical pro-trans advocate.

That's the certainly the impression I got from people citing the study, even if none of them said a@so explicitly.

You might be picking up correctly what their opinion is, but not their justification for it. It's particularly strange you claim that it has something to do with the study, when they don't say anything of that sort explicitly.

Do you agree some people should transition?

Depends what exactly you mean. There are scenarios where I believe people should be allowed to transition if they want to, but I don't think they should. But either way my opinion is not based on that study, nor am I using it the study to back that particular opinion.

I am not the pro-trans side;

I think that if you're going criticize the arguments people are making, you should take the context in which they are made, and what they're responding to, into account.

A simple concept of "gender" that avoids any metaphysical or spiritual claims is that "my gender is 'woman'" means "I want to be treated, in most social situations, as you would treat the average person with XX chromosomes (however you refer to such a person)". I realize this is not the version typically advocated, but I am not the typical pro-trans advocate.

If "gender" is just a desire for being treated that way, than clearly that desire exists, but then people who say "no one should transition" aren't saying "X isn't their stated gender", which would have to mean "they don't actually have that desire", they're saying they're refusing to fulfill it.

You might be picking up correctly what their opinion is, but not their justification for it. It's particularly strange you claim that it has something to do with the study, when they don't say anything of that sort explicitly.

Here I said trans people are happier if they are allowed to transition and get treated as their preferred gender, and that therefore they should be allowed to transition and get treated as their preferred gender, and someone pointed to the study to rebut my claim.

If "gender" is just a desire for being treated that way, than clearly that desire exists, but then people who say "no one should transition" aren't saying "X isn't their stated gender", which would have to mean "they don't actually have that desire", they're saying they're refusing to fulfill it.

Yes, the terminology would have to be adjusted. Other than that, do you agree that that view of gender is reasonable?

Here I said trans people are happier if they are allowed to transition and get treated as their preferred gender, and that therefore they should be allowed to transition and get treated as their preferred gender, and someone pointed to the study to rebut my claim.

You made a general empirical (which you emphasized yourself) claim, and the study was used to refute it. It was not used to make a normative claim applicable to everyone, including the most exceptional cases.

Yes, the terminology would have to be adjusted. Other than that, do you agree that that view of gender is reasonable?

Reasonable in what sense? In a descriptive one, in that there indeed are people who have such a preference? Sure. Or reasonable in a prescriptive sense, in that adopting such view of gender, and doing everything in your power to fulfill such desires would somehow be good for society? No, I disagree with that.

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