Very few people "grow out" of their gender dysphoria - a critical review of the "Steensma" study. [1235 words]
(created by Chaoticcylinder on 2021 Aug 21 Sat 7:49:42 GMT)
= Summary = Many attempts have been made in the past to determine what percentage of transgender people grow out (“desist”) of gender dysphoria. Previous studies have been flawed and usually had a low sample size and a very loose definition of “transgender”. Many people who “desisted” were simply gender non-conforming. The Steensma study (Steensma, et al. 2013) is the strongest study conducted on transgender desistance yet. Its strengths were having a larger sample size (127) than many others, and followed the participants long term. The Steensma study, while better than others, was still incredibly flawed. Its sample size was still not sufficient for reliability in such a variable topic, it used an old diagnostic manual for gender dysphoria, assumed all who didn’t respond to the study had desisted, many of the participants were subthreshold for gender dysphoria and the authors failed to adjust for certain factors, making the study misinterpreted by those who didn’t read very far in. The Steensma study is often misinterpreted by transphobes trying to push an argument against transgender treatment such as hormone therapy and puberty blockers. Assessing what percentage of transgender people desisted was not the study’s intention, but rather what factors make desistance and persistence more or less likely. Upon removing nonresponders and those who were subthreshold for gender dysphoria, the persistence rate significantly increases, making a strong argument FOR transgender treatment. For natal boys, the desistance rate went from 70.89% to 8.7%, and for natal girls it went from 50% to 20.69% (mean: 14.7%). Incorrectly claiming that most people grow out of their dysphoria is incredibly dangerous and discourages people from acquiring the medical treatment that they require. Introduction There have been many attempts to determine and calculate the percentage of those with gender dysphoria who “grew out” or desisted from their dysphoria. Many of these former studies had various methodological flaws and very loosely defined transgenderism and many were not actually transgender in these studies. Furthermore, many had small sample sizes and weren’t necessarily reliable sources of information to extrapolate to the whole transgender community. These studies fail to adjust for confounding factors or provide significant information. Many used outdated diagnostic criteria for gender dysphoria which ended up lumping transgender individuals in with gender non-conforming individuals such as effeminate boys or masculine girls. The Steensma study is the first study to actually provide significant information on confounding factors, had a larger than usual sample size (albeit still not substantial to reliably make a conclusion) and followed the participants long term. It is the closest thing to a “reliable” study on desistance or persistence of gender dysphoria. However, regardless of its strengths, it is still commonly misinterpreted, misrepresented and fails to state the results upon removing certain factors associated with desistance and persistence from the data set. Many people incorrectly assume that the study is about the percentage of transgender people who desist, but rather, it is a study on factors contributing to predicting whether an individual will desist or persist. Misrepresentation The Steensma study is often misrepresented, misinterpreted or taken out of context. Many transphobes have incorrectly cited this study as “evidence” that transgender people will usually desist in their gender dysphoria, without considering the actual study intent. The goal of the study was to evaluate factors associated with desistance and persistence, which many people ignore and wrongly assume that it just means that a majority of transgender people will desist. That is not the case, but rather, that transgender people who did not meet the threshold for gender dysphoria were more likely to desist. Misrepresenting a study in this way is incredibly dangerous. It spreads misinformation without any regard for accuracy and makes people doubt themselves or be afraid to transition out of fear of regretting it, even if such is unlikely for them given they meet the attributes which contribute to a high likelihood of persistence. Those who DO persist are incredibly unlikely to regret gender affirming treatment (USTS, 2015). The misrepresentation of the study by those in opposition to gender affirming healthcare is incredibly dangerous and disregards the results that conflict with the agenda they are trying to push with the help of a study they are taking out of context. Methodological Flaws The Steensma study suffered from having various methodological flaws making it unreliable to make a strong conclusion from. It had a small sample size, had many confounding factors (which, due to a small sample size, makes adjustment very difficult and unreliable), mostly assessed those who did not meet the threshold for gender dysphoria and assumed that all who did not respond to the follow-up had desisted. This is problematic because you cannot make such bold assumptions in science, and it is extremely difficult to determine whether other factors are at play. Nonresponders may have not been present when required to respond to the followup survey, simply not been inclined to respond, may have died, may have moved to another country or simply not wished to return to that specific clinic and may have seeked treatment elsewhere either outside of the Netherlands or from alternative treatment methods such as nonprescribed hormones or puberty blockers, which is not exceptionally rare within transgender communities (Rotondi, et al. 2013). “As the Amsterdam clinic is the only gender identity service in the Netherlands where psychological and medical treatment is offered to adolescents with GD, we assumed that for the 80 adolescents (56 boys and 24 girls), who did not return to the clinic, that their GD had desisted, and that they no longer had a desire for gender reassignment.” Adjusting for Methodological Flaws The study calculated the desistance rate for all participants and made various assumptions. Upon removing those who did not respond to the followup survey and those who did not meet the threshold for gender dysphoria, the desistance rates significantly decreased. I calculated the sample size after removing the percentage of each group who did not meet the threshold and then subtracted the amount of nonresponders to find the new percentage. The desistance rate for natal boys went from 70.89% to 8.7%, and for natal girls it went from 50% to 20.69% (mean: 14.7%). 21 persisters upon removing subthreshold, 22 desisters upon removing subthreshold. 2 desisters upon removing nonresponders (8.7% desistance rate for boys). 23 persisters upon removing subthreshold, 14 desisters upon removing subthreshold. 6 desisters upon removing nonresponders (20.69% desistance rate for natal girls). Glossary Steensma: Thomas Steensma is the author of what I am critiquing. Transgender: Those whose gender identity is separate from their natal sex. Desistance: When a transgender individual “grows out” of being transgender. Gender Dysphoria: Severe discomfort associated with being perceived as a gender that an individual does not identify as. Resources Steensma, T. D., McGuire, J. K., Kreukels, B. P. C., Beekman, A. J., & Cohen-Kettenis, P. T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: A quantitative follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(6), 582–590. https://doi.org/10.1016/j.jaac.2013.03.016 Tannehill, B. (2017, January 1). The End of the Desistance Myth. HuffPost. https://www.huffpost.com/entry/the-end-of-the-desistance_b_8903690. James, Sandy E., Herman, Jody, Keisling, Mara, Mottet, Lisa, and Anafi, Ma’ayan. 2015 U.S. Transgender Survey (USTS). Inter-university Consortium for Political and Social Research
I'm back. [854 words]
(created by Chaoticcylinder on 2021 Aug 18 Wed 3:45:16 GMT)
Hi there! I used to be an administrator for this wiki, and was known for my productivity with edits, administrative work on the wiki and the discord in addition to 2 essay-sized blog posts whereby I analyzed two topics, provided my thoughts and critiques of them. Why did you leave? In the MOGAI community, I encountered somebody. She was somebody with whom I strongly disagreed on almost all of their views, although I had strong feelings for her. I bit my lip on the issues I disagreed with her on, and let her extreme ideas manifest without ever criticising them. Her absurd, unsubstantiated beliefs began to seem normal, and I even began to sympathise with them. This was analogous to the normalisation of extremism we saw with Donald Trump. Eventually, I even began to hold some of the beliefs they held and wasn't thinking as critically about the topics. I began to adhere to communist ideology, became more critical of certain identities, began to appeal to anecdotes as an argument against MOGAI people and even became a transmedicalist. During the later days in this community, I began to troll the "tucutes'' on the LGBTA Wiki discord, which I founded with Simon. I abused my power, but regardless of my disdain for those who disagreed with me on the server, I still felt a bit bad for said abuse. I confessed to my change in ideology and promptly left the server. I even stayed around for a few days on an alt account and continued trolling. What happened to me and where was I? During my time away from the LGBTA Wiki, I began to spend more time with the individual I was discussing. They began to wither away at my mental health, and I eventually cut contact with them after an argument following them lashing out at me over a bit of a meltdown that I had. Following cutting contact, my mental health began to improve significantly. I still held the same positions I was indoctrinated into. I began to feel better about myself, more confident and had fewer mood swings. I felt more confident in my beliefs and thought for myself more. Something that I may not have mentioned during my time in the LGBTA Wiki was that I was a vegetarian (now vegan). I eventually joined a vegan discord server and was convinced to go vegan after learning of cruelty existing in the egg and dairy industry. The more I learned about how bad animal agriculture is for the planet, humanity and the animals, the worse I felt about the state of the planet and people's dietary habits. I decided to become a vegan activist and began spending hours every day discussing the topic with people, and actually met a few people who used neopronouns. I valued the community more than some views I still wasn't very sure about and felt guilty for having, and thus I chose to stay silent about my disagreements with their identity and their usage of pronouns. The same effect that I experienced with the individual who indoctrinated me occurred with these individuals, and I began to become more sympathetic to marginalized identities. Eventually, a transmedicalist joined the server and attacked various people who used neopronouns. I mentioned (paraphrasing) "I think you need to have gender dysphoria to be trans, but jesus, that guy was a huge asshole. I don't get why transmedicalists have to express their opinions so staunchly without any regard for simple respect, as much as I do agree with their views). I was challenged on this by somebody in the chat, and as this server was much more of a debate sphere, I was given the environment to discuss my views, argue for them and argue against my opponent critically. I realised that the actual arguments for MY position on transmedicalism was quite weak, and that none of the points could be actually substantiated. I began to question my values. Following the discussion, I tried to formalise my argument with propositional logic. I realised that I could not substantiate any of my arguments, and as somebody with a strong dedication to truth and science, I conceded on the position. I no longer adhere to a transmedicalist position. Am I any different? Yes. I am now a vegan activist, somebody with an actual dedication to science and somebody who takes topics more seriously. I now spend hours every day doing things more productive, such as researching, reading academic papers, debating, advocating and doing schoolwork. I no longer play video games, and I am a much more proactive individual than I was a year ago. Will I stay on the LGBTA Wiki? I will not be active on the LGBTA Wiki, but as someone who regularly writes essays, I will probably post some of my writings to my blog on this server. Thank you, and I apologise to anybody who I have offended in the past on the discord or on other communities.
MOGAI Discourse; a critical analysis. [1240 words]
(created by Chaoticcylinder on 2020 Jun 26 Fri 6:27:01 GMT)
MOGAI is an all-inclusive acronym for the LGBT+ community standing for Marginalized Orientations, Genders and Intersex. This acronym has a lot of controversy, and is targetted with many accusations of being a community of people turning the queer community into a 'trend'. Here we will be doing a critical analysis of the acronym, and whether or not it is helpful. Glossary MOGAI - Marginalized Orientations, Genders and Intersex Queer - Any form of LGBTQ+ identity LGBTQ+ - Lesbian, gay, bisexual, transgender, queer and more. Cisgender - Someone who strictly identifies as the gender they were assigned at birth. Straight - Someone who is attracted to the opposite gender. Cishet - Someone who is both straight and cisgender. Gay - Someone attracted to the same gender. Lesbian - A woman who is attracted to the same gender. Bisexual - Someone attracted to two or more genders. Trans - Someone who does not identify as the gender they were assigned at birth. Non-binary - Someone who does not strictly identify as either a man or a woman. Pan - Someone attracted to all genders. Allo - Someone who is able to experience attraction, the opposite of asexual or aromantic. Micro-labels - Labels to describe small details in ones identity. Anxiegender - A gender affected by anxiety. Exclusion - Leaving certain things or people out of a group, in this case the LGBTQ+ community. Cupioromantic - Someone who does not experience romantic attraction but still desires a romantic relationship. Trixensexual - Someone who is exclusively attracted to women and non-binary people. Marginalized - When a group or person is treated as a lesser or insignificant. Arguments for the MOGAI Acronym MOGAI is shadowed with many accusations of glorifying oppression and the discrimination the queer community faces for the sake of being apart of a trend, but is it a trend? Why is MOGAI helpful? Less clunky If you were to have an a letter for everyone in the LGBTQ+ acronym without leaving anybody out, you would have LGBTQIAPKCDEFHJMNORSUVWXYZ2 which is riddled with flaws, being too long, being hard to memorize, and in general sounding ridiculous. MOGAI is a 5 letter, short and all inclusive acronym. All inclusive MOGAI represents all people who diverge from the societal norm of being cisgender, straight and allo in 5 letters without 'prioritizing' other orientations, and treating everyone with equality and respect. Validates obscure identities The acronym MOGAI does not exclude anybody, and in 5 letters accounts for trans people, non-binary people, gay people, lesbians, bi people, pan people, the list can go on but for the sake of brevity we shall stop there. Arguments Against the MOGAI Acronym MOGAI is shadowed with many accusations of glorifying oppression and the discrimination the queer community faces for the sake of being apart of a trend, but is it a trend? Why could MOGAI be harmful? Coining "unnecessary" labels MOGAI has a reputation of coining obscure micro-labels for the slightest difference in orientation or gender, which to some may seem ridiculous and unnecessary; potentially harming the cause for equal rights by confusing people outside of the LGBT+ community. These unnecessary labels are sometimes called offensive as to some they may seem ridiculous, for example in the case of Anxiegender, a term that describes any form of gender identity affected by anxiety, which can be seen as a glorification of anxiety, in my personal eyes it is not, but rather a term to more accurately describe certain people's experiences. Allows cishets into the community The acronym is accused of letting everyone into the community, but this argument is inherently exclusionary because it implies that obscure identities do not deviate from the societal norm of being straight, cisgender and allo which is a completely opinion based argument. Glorification of mental illness Many times you can see MOGAI blogs glorifying mental illnesses, such as in the case of the depression pride flag or misophonia pride flag, which may make mental illness look like a cool and quirky trend, which is damaging to society as a whole because of the brutal mortality rates and risks of mental illness. Discussion The discourse has many arguments, most very similar to eachother but this blog post has stored some of the main ones, now I shall be giving my personal opinion on the matter. "Allowing cishets into the community" The whole point of MOGAI is marginalized orientations, genders and intersex. If an orientation or gender is not marginalized, it is not a MOGAI identity, and the claim that some of the more obscure identities are merely opinion based and inherently exclusionary. Micro-labels Micro-labels are a form of jargon to connect with other members of the queer community to easily express and explain ones personal experiences; for example, someone interested in flags may know what a canton, hoist, fimbriation, bordure or fess is but in a normal conversation these words would not be used as communication is a two way street, and if the other person fails to understand you, you have failed to communicate a point. For example, a cupioromantic trixensexual person may not tell people upon meeting for the first time that they are a cupioromantic trixensexual person because they are very obscure, unknown terms, instead these labels may just be summarised with the term "bisexual". Glorification of mental illness I think the glorification of mental illness is a fucked up thing to do, as someone diagnosed with depression, anxiety, OCD and a potential eating disorder I am repulsed by the depression pride flag. However, I believe this to be the fault of the creator and people who make these flags rather then MOGAI as a whole, because 4chan claimed in 2017 that the LGBTQ+ community was adding a P for 'pedosexual' does that mean it was true? No, the P stands for pansexual. Conclusion I personally see no problem with MOGAI, though other peoples opinions may differ, and I believe that people have the right to define their orientation or gender how they please rather then letting other people speak for them. A reader may disagree with the points I make, but at the end of the day, just be kind to each other, rather then responding with hostility to what you disagree with, engage in a healthy discussion or debate. Resources https://beyond-mogai-pride-flags.tumblr.com/post/620406935004512256/misophoniac-flag https://beyond-mogai-pride-flags.tumblr.com/post/158036134050/depression-flag#notes https://www.snopes.com/fact-check/lgbtp-adding-letter/
The Desistance Myth [398 words]
(created by Chaoticcylinder on 2020 Jun 17 Wed 5:10:58 GMT)
The Desistance Myth The desistance argument is a common narrative used in attempt to oppose any form of medical or social transition. One of the most cited studies is the Steensma study of 2013. Steensma Steensma surveyed 127 adolescents, of which 80 participants ‘desisted’ in their gender dysphoria (62.99%) Flaws in the methodology of the study This study suffers from several methodological flaws making this study very unreliable. Baseless assumptions "As the Amsterdam clinic is the only gender identity service in the Netherlands where psychological and medical treatment is offered to adolescents with GD, we assumed that for the 80 adolescents (56 boys and 24 girls), who did not return to the clinic, that their GD had desisted, and that they no longer had a desire for gender reassignment." (583) The problem with measuring this way is that these adolescents could have died, moved to a different country, decided to speak to a different doctor or not medically transition. Not all individuals with gender dysphoria desire to medically transition for many reasons, as in trans men not wanting to go on testosterone to keep a singing voice. Instead of counting the children who failed to go to the clinic again, you cut them out of your statistics. "All 47 persisters participated in the study. Of the 80 desisters, 46 adolescents sent back the questioners." (584) They contacted the 80 desisters, of which only 46 responded, making 34 of these desisters invalid and not part of the actual statistics. The actual sample size is now 93, which brings the desistance rate down to approximately 49.4% (46 desisters, 47 persisters). Many of the children surveyed did not meet the criteria for gender dysphoria Many of the desisters did not meet the threshold for gender dysphoria. 91.3% of male persisters were diagnosed with gender dysphoria. 95.8% of female persisters were diagnosed with gender dysphoria. 60% of male desisters were not diagnosed with gender dysphoria. 41.7% of female desisters were not diagnosed with gender dysphoria. Conclusion Other studies also suffer from similar flaws in their method of surveying, this study completely goes against the scientific method and bases its evidence on bad statistics. It is safe to say that the studies available to us are of poor quality and more research needs to be done. Glossary GD: Gender Dysphoria GID: Gender Identity Disorder (now known as Gender Dysphoria) Resources Steensma, Thomas, et al. Factors Associated With Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study. NEW RESEARCH, June. 2013, https://www.docdroid.net/hY664Sc/steensma2013-pdf