Why Sweden is changing its gender transition policy for children and young people

Written By: - Date published: 8:15 am, March 18th, 2022 - 105 comments
Categories: child welfare, gender, health - Tags: , ,

Guest Post by Standardista Molly

In the last couple of weeks, Sweden has joined a small, but growing number of countries that have changed their policies regarding medical gender transition for children.

As inhabitants of a developed country with access to medical care, we often hold a high degree of trust in our political and institutional systems to collate, assess evidence, make decisions and implement policies based on evidential data and best practice.

As adults – particularly as adults who participate on political blogs, we know that trust is sometimes misplaced, and other factors interfere with the best outcomes.

There are protocols and safeguards regarding medical intervention that we assume. For children in particular, who may respond to adult tested medication in unknown ways, I believe it is important that specific studies regarding long-term use of puberty blockers, and cross-sex hormones are undertaken before it is considered a standard response to gender dysphoria or gender incongruence. However, it seems that long-term studies have not been consulted even in regards to adult use, and drugs are being used off-label as standard treatment of gender dysphoria or incongruence in children and young people.

WPATH is the World Professional Association for Transgender Health, and their guidelines are used to create health policies for treatment all over the world along with reference to the Yogyakarta Principles. But are their guidelines evidenced based? In another post, I will outline and provide links as to why I don’t believe that to be the case. But as the transitioning of children and young people is occurring – within NZ as well – and advocacy is strong for medical treatment for this demographic, I will focus on this discussion point for now in a series of posts, until all aspects I can think of have been identified and suitably linked to resources.

You can choose to ignore these posts, or sit back and get (un)comfortable.

Adults in Sweden are unable to get reproductive sterilisation surgery until the age of 25 as this decision is considered irreversible, and so unable to be cognitively understood in terms of impact and consequences until the brain has completed development.

However, this consideration of brain development is not mentioned when discussing gender reassignment surgery. There is reference to suicidal risks, and assumptions that medication and surgery will alleviate those risks even though there is no evidence to back up either of those assumptions. Assumptions both, because no evidence is provided regarding the suicidal risk.

The origin of the changed Swedish policy can be traced back to 2018, as the Guardian reported:

In the autumn of 2018, the Social Democrat-led government, under pressure from the gay, lesbian and transgender group RFSL, proposed a new law which would reduce the minimum age for sex reassignment medical care from 18 to 15, remove all need for parental consent, and allow children as young as 12 to change their legal gender.

The introduction of this bill was followed by a May 2019 article authored by Professor Christopher Gillberg et al from the University of Gothenburg that was published in the Svenska Dagbladet, number three in daily newspaper circulation.

Titled “Gender reassignment of children is a big experiment“, I cannot find the full translation but the article is unequivocal in its starting paragraph:

In Sweden – and in several other countries – a rapidly growing experimental activity with children has been going on for a few years. Hundreds of children in our country are exposed every year to “treatment” with hormones and then with genital mutilation, completely without there being anything that could even be compared to a reasonable basis in terms of science or proven experience. The children are generally not included in any ethically tested scientific studies. It is not uncommon for treatment to be carried out against the wishes of the parents of the minors.

The Guardian article above continues:

Uppdrag Granskning, an investigative TV programme, followed up with a documentary profiling a former trans man, Sametti, who regretted her irreversible treatment.

After being interviewed on Uppdrag Granskning, Sweden’s health minister, Lena Hallengren, asked the programme to include a text addendum to remind viewers that it had been her predecessor, and not her, who had drafted the controversial law.

On 20 December, the Swedish Agency for Health Technology Assessment, which the government had asked to review the scientific research into the recent surge in teenagers reporting gender dysphoria, reported that there was very little research either into the reason for the increase or the risks or benefits of hormone treatment and surgery.

Link to this first episode, and the follow up episodes can be found below. I would assume that the publication of the article, and the broadcast of this documentary, widened the public knowledge of existing standards of care, and helped initiate and broaden the public discussion. I recommend that anyone interested watch all three episodes, that were broadcast in Sweden over a two year period. As you watch medical professionals at the Karolinksa clinic, equivocate and obfuscate, you begin to understand the failure of these staff to ensure that evidential data existed before creating treatment protocols, and more devastatingly, that they have treated hundreds of children with this approach.

At the same time, Filter magazine profiled the case of Jennifer Ring, a 32-year-old trans woman who hanged herself four years after her surgery. An expert on psychosis who was shown her medical journal by her father, Avi Ring, was quoted as saying that she had shown clear signs of psychosis at the time she first sought treatment for gender dysphoria.

Indeed, the first clinic she approached refused to treat her, citing signs of schizotypal symptoms and lack of a history of gender dysphoria. But the team at Karolinska went ahead. “Karolinska don’t stop anyone; virtually 100% get sex reassignment,” says Ring.

A series of reviews and assessments culminated in the release of new Swedish guidelines for the treatment of gender dysphoric children and young people on 22 February 2022 published by National Board of Health and Welfare (NBHW).

The original Swedish document can be found here (PDF). Sans the language skills, I’ll refer to the Society for Evidence Based Gender Medicine (SEGM) website for the relevant points:

Key Changes in the Updated Guidelines

Following a comprehensive review of evidence, the NBHW concluded that the evidence base for hormonal interventions for gender-dysphoric youth is of low quality, and that hormonal treatments may carry risks. NBHW also concluded that the evidence for pediatric transition comes from studies where the population was markedly different from the cases presenting for care today. In addition, NBHW noted increasing reports of detransition and transition-related regret among youth who transitioned in recent years.

The recommendations and reasons are comprehensive enough to warrant a series of posts by themselves, so follow the SEGM link to read.

It may be enlightening to compare the draft WPATH Standards of Care 8 recommendations (the updated WPATH guidelines due to be released this year), against the NBHW update which used evidential data:

The optimal resolution of this topic, is hampered by the continued absence of evidenced based articles in media, and circumvented public discussion.

Sweden was performing gender-reassignment surgery that ensured infertility on young people at ages they were unable to access infertility surgeries. Now they are not.

Of particular interest is the fact that once the public discussion began in 2019, referrals to Swedish gender clinics dropped by 65% and have continued to decline.

The other topics I hope to discuss on child and youth transition include:

  • Exploration of the new demographics presenting as gender dysphoric – eg. ROGD, autistic youth and the consideration of co-morbidities and the universal approach of affirmative care for all presentations.
  • A look at the distinct presentation of young female to male transitioning.
  • A look at the distinct presentation of young male to female transitioning.
  • A consideration of the role of the internet, social media (particularly Tumblr), and self-diagnosis.
  • Relating the stories of detransitioners, in regards to both transition and detransition.
  • Further exploration of notion of consent in regards to children and young people, and how well informed they can be when long-term data is not available.
  • The impact on families and relationships, when exploratory care is deemed abusive by internet advice, and/or medical professionsals.

Although, even this limited topic requires a number of posts, feel free to add your comments and suggestions below.

Uppdrag granskning (Mission Investigate) – Trans Train – Series (youtube)

Episode 1 – (1 hr) The increase of teenage girls with gender dysphoria worry parents and health care staff in several countries – because of the lack of research on the new group of patients. What if the irreversible decision to undergo a gender correction is a mistake?

Episode 2 – (1 hr) Swedish politicians argue that fifteen-year-olds with gender dysforia should be allowed to undergo gender reassignment surgery without consent from their parents. Otherwise ​they are at great risk of committing suicide. But is this really true? Mission investigate continues to investigate transgender health care and explore the arguments from politicians.

Episode 3 ( 14:30 min) – A brief update in December 2022, which includes a statement from a prominent Swedish transwoman – Aleksa Lundberg – that featured in Episode 2.

105 comments on “Why Sweden is changing its gender transition policy for children and young people ”

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  1. weka 1
    18 March 2022 at 8:00 am

    Mod note: there is an expectation here that commenters will not use tone or language that has the effect of excluding others (see policy) including trans people and gender critical people. How this relates to The Standard’s robust debate ethic can be tricky, but my general advice is to think about who might be reading your comment and how they might be able to take part in the discussion.

    One guideline is to not use terms like genital mutilation for transition surgery. This term is in a quote in the post, I don’t know if it’s a google translation issue or if the professor intended that, but it’s language that negatively impacts on some people, so please don’t use it.

    You also cannot use terf as a pejorative here. https://terfisaslur.com

    it’s fine to ask questions about any of this if you are unsure.

  2. Blazer 2
    18 March 2022 at 9:08 am

    Good to see common sense making an appearance.

    This at least shows who has driven this tragic policy.

    'In the autumn of 2018, the Social Democrat-led government, under pressure from the gay, lesbian and transgender group RFSL, proposed a new law which would reduce the minimum age for sex reassignment medical care from 18 to 15, remove all need for parental consent, and allow children as young as 12 to change their legal gender.'

    The other big issue is how easy it is for whatever reason to 'identify' as a different gender these days and the problems that result.

    Supposedly this development is driven by…older men.

    Never seen any real evidence of that,myself.

    • Sabine 2.1
      18 March 2022 at 9:27 am

      Like this elder man…..President-ElectMarci Bowers, MD

      https://en.wikipedia.org/wiki/Marci_Bowers

      Marci Bowers is a Transwoman. And after a very public failure of a vaginoplasty on Jazz Jennings on live TV courtesy of TLC – this surgery needed four follow up surgeries, gave an interview with Abigail Shrier where they stated that maybe Puberty blockers aren't all that considering that they prevent the development of penis and testes and thus as in the case with Jazz Jennings will actually not leave enough tissue to 'build' a thing loosly resembling a vagina.

      you will find this article here because you for sure won't find it in the news https://bariweiss.substack.com/p/top-trans-doctors-blow-the-whistle?s=r

      btw, Jazz Jennings is now about 300 pounds heavy, his mother has life on telly threatened to 'dilate' her child – which is the insertion of a dildo into the opening that is mimicking the 'vagina canal' to keep depth (aka sexual assault on her child), just in case one day a bloke will want penetrate Jazz in an effort to have sex. Never mind that Jazz never even had an orgasm, as that bodily function too was stunted with the use of puberty blockers. If you want to go down that rabbit hole its on Youtube, together with all the other little Transgirls who are on their way to happiness and an inverted penis.

      But if you can't see the older men, it is maybe due to them wearing woman costume.

      • Psycho Milt 2.1.1
        18 March 2022 at 11:02 am

        Future historians will boggle at what was done to this boy in the name of entertainment (and homophobia).

        • Sabine 2.1.1.1
          18 March 2022 at 11:11 am

          Worst thing is this child may never was gay maybe bi or heterosexual with a penchant for glitter or playing with the glitter stuff of their sister to get affection/attention from mum.

          But this is being replicated on boys and girls the western world over in the name of kindness and affirmation. I wonder for whom the kindness and affirmation is. Follow the money would be my advise.

        • weka 2.1.1.2
          18 March 2022 at 11:29 am

          any why the left enabled it.

        • weka 2.1.1.3
          18 March 2022 at 11:42 am

          there's an additional issue here for progressives, and it's the extent to which parts of the left act as if science is god, especially medicine. I know from a range of different conversations that there are people who are intolerant of suggestions that doctors can be arseholes or malicious or negligent or driven by their own agenda.

          Whereas I've been involved in and/or following women's health issues for over 30 years and have seen just how badly mainstream medicine can get it wrong (true also for and about alternative medicine). Many of the issues around medical culture for trans/NB/detrans people are similar to what women have gone through.

          eg understanding how big pharma has failed women in multiple ways, it's alarming to see lefties implying or outright saying that hormonal treatments are benign. It's like women's history doesn't exist.

          And it's not a coincidence that GCF is largely driven by second wave feminists who were the Cartwright Enquiry generation (not just in NZ). The older ones saw all the bullshit around the sexual revolution and how it impacted negatively on women, then the fights around reproductive rights and health, birth practices, breast implants, not pathologising menopause, etc, then the backlash against feminism in the 90s. It's almost like women have some underlying shared experience that has informed out politics for a long, long time.

          Those women have kids, nieces/nephews, grandchildren. I have zero doubt that if we been allowed a wide ranging public conversation about the issues, we'd now have services for GNC kids that covered all the issues, not just the affirmation model. No Debate has been extraordinarily successful, and the left's complicity in that won't stand up to history either.

          • SPC 2.1.1.3.1
            18 March 2022 at 12:14 pm

            You might want to note one of the older/second generation? names on this list as per the Cartwright enquiry.

            https://www.parliament.nz/resource/en-NZ/53SCGA_EVI_115653_GA20227/28f5558b4088b0184212a4af25bb40146146cf19

          • roblogic 2.1.1.3.2
            18 March 2022 at 7:06 pm

            Re: "science is god"

            One thing that really bugs me as a Christian who has read widely on the intersection of science and religion, and received a lot of flak for arguing in favour of Bible in Schools, is that now those same flak-shooters have turned around and dumbly accepted the edicts of gender ideology and its clearly religious claims to the existence of a gendered soul separate from physical reality. And similar hypocrisy around transitioning vs conversion therapy, free speech vs lies about biological sex.

            Just goes to show that science denial is not the exclusive domain of the "religious right". We have reached a weird cultural moment where several forces have combined (narcissistic individualism +social media +cosmetic surgery +technocracy +adolescent angst…) to form a constellation of self reinforcing toxic beliefs, i.e. the identity cult, that is firmly on the Left.

            • roblogic 2.1.1.3.2.1
              18 March 2022 at 7:25 pm

              My sincere reply to an obnoxious doctor, who refused to countenance a second opinion on the matter:

              "& you fail to respect others lived experience, identity, and values unless they are one of your approved groups."

            • Psycho Milt 2.1.1.3.2.2
              18 March 2022 at 8:33 pm

              Absolutely. Turns out these gender evangelists have no problem with religion being taught in schools, just as long as it's theirs. Let them remove the beam from their own eye first.

            • Molly 2.1.1.3.2.3
              18 March 2022 at 11:28 pm

              While I understand your Christian beliefs, I support the secular school system, which does include religious tolerance teaching.

              However, I am consistent with my stance, as like you, there are components of the current gender ideology that is disconnected from material reality and evidence, and should not be taught as fact in schools.

              While self-expression, and identity exploration is expected and a natural part of maturation, some of the inclusions are inappropriate and gaslighting for children. The referrals to student privacy, and deliberately withheld transition knowledge from parents and families has a red flag all over it. The assumption of harm from non-validation, rather than from inappropriate investigation or treatment is likely to cause more harm than protection. Villifying concerned parents, removes from young people one of the most reliable sources of comfort and support. It should not be done lightly.

          • Psycho Milt 2.1.1.3.3
            18 March 2022 at 8:43 pm

            For my money, there's a huge difference between "science is the best means we have of understanding physical reality" and "You're wrong because doctors [who share my opinions] say this load of old cobblers reflects physical reality." The medical profession is as subject to ambition, greed, malice, lack of empathy etc as any other human endeavour.

            I hadn't previously seen that letter SPC linked to – wonderful to see so many great feminists' names on it.

            • roblogic 2.1.1.3.3.1
              18 March 2022 at 10:01 pm

              The discourse is awash with moral outrage and philosophical/theological pronouncements. And a distinct lack of evidence

    • weka 2.2
      18 March 2022 at 11:00 am

      The other big issue is how easy it is for whatever reason to 'identify' as a different gender these days and the problems that result.

      I don't see a problem with the identifying, except where it impacts negatively on others through law and policy and culture. If someone wants to identify as a wolf, have at it. If someone insists that other people refer to them as a wolf, that's a problem. If governments start putting animal self-ID into law, the census, policy etc, that''s a problem

      (yes there are people who identify as animals).

      That's different from people who are gender non-conforming and who need protection in society from bigotry and prejudice. This is still a very real issue for trans, NB, and gender non-conforming people.

    • swordfish 2.3
      18 March 2022 at 8:57 pm

      .

      Supposedly this development is driven by…older men.

      Never seen any real evidence of that,myself.

      Don't know about the demographics driving it … but in terms of who supports the trans agenda … polls within various Anglosphere Countries suggest women are more supportive than men by quite a margin … with older men the least supportive on most questions.

      [Which isn’t to suggest, I hasten to add, that women are highly supportive of the trans agenda … depends on which aspect they’re asked about … on some important facets a plurality, even a majority of women are opposed … but the point is men are almost always clearly more opposed / less supportive than women regardless of facet]

    • roblogic 2.4
      18 March 2022 at 9:06 pm

      "Never seen any real evidence of that,myself."

      There are anecdotal claims that a large proportion of the trans activist lobby is driven by autogynephilic males who get off on misogyny and gaslighting women. (this whole thread is chock full of eye opening stuff)

      https://twitter.com/_CryMiaRiver/status/1442210451119493122?s=20&t=uFZRd4VZk4vgiXKLsv3OTA

  3. Researchkiwi 3
    18 March 2022 at 10:20 am

    Great post, I wholeheartedly agree. Note that there is a part 4 to Trans Train, focusing on detrimental effects of puberty blockers on teens. Link her: https://www.svtplay.se/video/33358590/uppdrag-granskning/mission-investigate-trans-children-avsnitt-1

    Also the interim Cass Report has just been published in the UK which also shows the paucity of evidence for this treatment, plus Finland recently reviewed ethics of and evidence for gender-affirming healthcare for youth and has since scaled back medicalisation on gender questioning youth, finding evidence of social contagion and poor outcomes of medicalisation in young people. https://segm.org/Finland_deviates_from_WPATH_prioritizing_psychotherapy_no_surgery_for_minors

    So it's not just Sweden that has concerns over the treatment of young people with gender dysphoria or alternative gender identities.

    Interesting how these developments do not seem to have been noticed by NZ media yet though.

    • Molly 3.1
      18 March 2022 at 11:22 am

      Thanks for the link to Episode 4. I had watched it previously, and appreciate you filling in the gaps..

      A harrowing situation for young Leo and the family. What I found particularly telling across the series was the filmed responses of the clinic staff and directors. Often contradicting themselves, unable to provide evidence of safety, and lack of follow-up care.

      The direct scrutiny regarding the quality of care allowed the failures to be clearly seen.

  4. SPC 4
    18 March 2022 at 11:31 am

    France was the first country worldwide to remove transgenderism from its list of mental illnesses and in 2016 allowed change in gender status (via court decision) without medical change.

    Gay and transgender activists have welcomed a new French law that lets transgender people change their legal status without having to be sterilised.

    The activist group ILGA-Europe called it "clear progress" that "another European country has dispensed with the shameful practice of sterilisation"

    But it regretted that trans people in France will still have to get a court to recognise their gender change.

    https://www.bbc.com/news/world-europe-37653459

    France has passed a new law criminalising the use of so-called "conversion therapy" to attempt to change the sexual orientation or gender identity of LGBTQ people.

    https://www.bbc.com/news/world-europe-60145970

    There is however concern about the impact of medical intervention.

    About fifty psychologists/psychiatrists, doctors, and intellectuals speak out against the “ideological hold on children’s bodies” made in the name of the emancipation of the “transgender child.”

    Associated with the Observatory of ideological discourses on children and teenagers, a collective of childcare professionals and researchers (doctors, psychiatrists, psychoanalysts, lawyers, magistrates, teachers of the National Education, philosophers, sociologists, etc.), some fifty professionals are protesting against the idea of “self-determination” of the child which they believe legitimizes a sharp increase in requests for sex change, particularly among teenagers.

    We can no longer remain silent about what appears to us as a serious societal shift committed in the name of the emancipation of the “transgender child” (one who declares that he or she was not born in the “right body”). On the argument that “feelings” equal truth, radical rhetoric has legitimized the requests for sex change. But it is at the price of a lifelong medical and even surgical treatment (removal of breasts or testicles) on children or teenagers’ bodies. It is this phenomenon and its strong media impact that concerns us and not the choices of transgender adults.

    https://genspect.org/france-says-non-to-gender-ideology/

    The National Academy of Medicine in France has issued a press release in which it cautions medical practitioners that the growing cases of transgender identity in young people are often socially-mediated and that great caution in treatment is needed. The Academy draws attention to the fact that hormonal and surgical treatments carry health risks and have permanent effects, and that it is not possible to distinguish a durable trans identity from a passing phase of an adolescent's development.

    The National Academy of Medicine draws the medical community’s attention to the growing demand for care in the context of transgender identity in children and adolescents, and recommends the following:

    • Children and adolescents expressing a desire to transition, as well as their families, should receive extended psychological support;
    • Should the desire to transition persist, the decision to treat with puberty blockers or cross sex-hormones must be considered carefully and within the framework of multidisciplinary consultations;
    • Medical studies should include clinical information specifically adapted for informing and guiding young people and their families;
    • Continued research into both, clinical and biological, as well as ethical aspects of this matter, still lacking in France, is needed;
    • Parents addressing their children’s questions about transgender identity or associated distress should remain vigilant regarding the addictive role of excessive engagement with social media, which is both harmful to the psychological development of young people and is responsible for a very significant part of the growing sense of gender incongruence.

    https://segm.org/France-cautions-regarding-puberty-blockers-and-cross-sex-hormones-for-youth

  5. Jan Rivers 5
    18 March 2022 at 12:18 pm

    Thank you so much Standardista Molly for posting this information. Of course this issue is highly relevant to New Zealand too. Our treatment guidelines are already more extreme that even those of WPATH in 2012 version 7 and they will remain more extreme than the refreshed version 8 due shortly even though that organisation operates essentially from the position that 'you are transgender if you say you are' .

    However the Conversion Practices Prohibition legislation will effectively embed the current affirmative only treatment into our schools, counselling services, GP surgeries and hospitals by threat of imprisonment even as other countries are retreating rapidly. The new legislation will give a free pass to any Rainbow Youth or Inside Out operative, teacher or counsellor who implants in the mind of a vulnerable confused child or young person "do you think you could be trans?" Meanwhile it will constrain the operating guidelines for registered medical staff to operate within a law that demands that they must never encourage “an individual to believe that their [] gender identity, or gender expression needs changing because it is a defect or disorder”. This loaded language ignores that reality gender identity is unstable with most research showing desistance in children and young people and from detransitioners strong evidence that their belief was based in homophobia and other kinds of maladaptive thinking.

    I am not a lawyer but these are my conclusions from a very careful reading of the law and the associated documentation and attending and watching many of the the Select Committee submissions. https://genspect.org/nzs-conversion-practices-prohibition-law-a-wolf-in-wolfs-clothing/ In Australian states where similar legislation has been passed there is mounting evidence that counsellors and others are backing away from taking on gender questioning patients because of the danger that they will be criminalised.

    • Molly 5.1
      18 March 2022 at 12:45 pm

      Great article, Jan. Thanks for the link, and the introduction to another great local resource. (If you wanted to co-ordinate with writing posts on this topic – just give a heads up via comments, and I'll ask TS to send through my email. I'll admit freely that the calibre of that article is much higher than my post today).

      One commenter recently advised me to leave the "rabbit hole", and immersing myself in the impact of unquestioned gender ideology demands, often feels that way. So, I decided to just author a specific and limited post, regarding children and young people, but that too is a vast area to cover, so further limited it to Sweden's new policy that was drafted after long overdue evidence review.

      The legislation changes, and the non-debate is both horrifying and fascinating to witness.

      The lack of intellectual curiosity or engagement is notable.

      • Jan Rivers 5.1.1
        18 March 2022 at 3:08 pm

        Very keen to get in touch. It's a great post you have put up, well researched and really solid. And a lot of work. Look forward to hearing from you.

        Also with anyone else here who may have capacity to focus on these issues. There are two or three interesting projects underway in New Zealand. We have lost two important battles BDMRR and the Converstion Practices Inclusion of gender identity and gender ideology, but the war to stop children being sterilised is very much underway. Even though it now appears to be a long haul

    • Psycho Milt 5.2
      18 March 2022 at 8:52 pm

      Thank you for your own work on this Jan, it has the academic rigour that's sorely missing from the advice the govt took on various pieces of legislation related to this subject.

  6. Anker 6
    18 March 2022 at 12:43 pm
    • Thank you Molly and thanks to The Standard. This is one of the few places in NZ, that the issues and effects of gender ideology are reported. Any view that challenges their ideology are shut down cancelled or are just not reported.

    it will be interesting to see what happens to the NZ public when they realise that they have had the wool pulled over them and were fooled and gas lighted when the were just trying to be progressive and kind

  7. SPC 7
    18 March 2022 at 1:21 pm

    Who are we? How do we find out? What is it to find our authentic selves? What can we learn from the history and philosophy of authenticity?

    [overlong and unexplained copypasta deleted]

    https://www.youtube.com/watch?v=0FrdGMjUD1U

    • SPC 7.1
      18 March 2022 at 2:33 pm

      The unexplained copy and paste was part of the brief synopsis provided by the creator, as a brief outline of the opine of the philosophers covered, in more depth, in the You Tube video.

      • weka 7.1.1
        18 March 2022 at 3:27 pm

        yes, I'm just not sure what it is doing under this post because you didn't say.

        • SPC 7.1.1.1
          18 March 2022 at 4:32 pm

          Gender identity comes under the orbit of authenticity.

          • Molly 7.1.1.1.1
            18 March 2022 at 4:40 pm

            That's probably another series of posts in itself.

            I can understand the link, but tried to make this post specifically about the medical response to children and young people presenting with gender dysphoria or gender incongruence, and how that response has come about.

            Sweden was interesting in that there has been a series of broadcasts, and public opinion pieces that opened up the public discussion, which in turn led to a review of the medical literature and data.

            Their conclusion, was emphatic, that the use of medical interventions was not clinically supported, and should only be used in particular cases linked to research after a multi-disciplinary team had agreed.

            The table above shows the difference between the Swedish review of evidence, and the upcoming guidance of WPATH, which advocates for medicalisation of even younger children than what was happening previously.

          • Jan Rivers 7.1.1.1.2
            18 March 2022 at 5:54 pm

            Too right. I become my real self, by transcending my actual self to become someone else. It's a recipe for a mental health nightmare. Plus all the friends, relatives, colleagues have to go along with a pretended self.

  8. Dennis Frank 8
    18 March 2022 at 2:28 pm

    Good that you're exploring the nuances of this issue, Molly. My interest lies primarily in the interface between identity & civil rights, and my empathy has always inclined me towards consideration of the experience of victims.

    So the obvious point to make for us here in Aotearoa is that the testimony of victims must be included in media reports. Given our cultural tradition of bias against hearing controversial opinions from children, this will be a substantial hurdle for our media to jump over. Support groups for child victims will be essential and I'm inclined to feel that other victims would be ideal members of those – but ask them re that.

    Those groups would provide a counterpoint to peer pressure kids encounter at school or with friends. Sexual experimentation is normal but context can shift it across boundaries and harm can result. Toxic social ecosystems abound.

    Professional help & guidance ought to be informed by a diversity of childhood experience to avoid paternalism! I'd also like to see a focus on the rights of children included in their education. This is particularly relevant to kids from broken homes, or kids experiencing an identity crisis in families with harsh or warped parents.

    • weka 8.1
      18 March 2022 at 3:28 pm

      who are the victims you are thinking about here? (it's not quite clear)

      • Dennis Frank 8.1.1
        18 March 2022 at 3:30 pm

        Mainly those you folk have discussed in recent times. But my framing is general because I lack involvement & can really only see the situation in terms of ethics, principles and rights.

        • weka 8.1.1.1
          18 March 2022 at 3:34 pm

          sorry, I still don't know what you mean. Are you talking about detrans kids? Or kids wanting to transition? Children who've been damaged by the affirmation model? Children who've been damaged by lack of access to services? We talk about all of that.

          • Dennis Frank 8.1.1.1.1
            18 March 2022 at 3:44 pm

            Well, as someone who was brought up to be a victim as a child (by a vindictive father addicted to punishment as constant methodology), I tend to see victims as those harmed by abusers.

            I'm aware of the cultural fashion trend for some self-indulgent types to martyr themselves into victim identities (the poor-me syndrome) but I usually ignore such pretensions. The test of authenticity is actual harm done to victims by others. So whichever of your categories covers those harmed by malevolent people, I'm referring to them…

            • Molly 8.1.1.1.1.1
              18 March 2022 at 4:33 pm

              Hi Dennis,

              From my perspective, the victims of harm are children and young people who are medicalised without clinical justification or data, parents and families that are told that this treatment is best practice, without being told of the full consequences or downsides (because they don't have the data) making informed consent a charade, professionals who are advised to do "affirmative health care" rather than appropriate and comprehensive health care, under fear of prosecution or exclusion.

              Of them all, the most egregious harm is to young people.

              All expected safeguarding protocols seem to have been abandoned in favour of meeting advocacy demands. Adults who can objectively care for, assess and treat young people have been coerced into viewing any alternative to affirmative care as discriminatory and hateful.

              To resolve this situation, we must be able to discuss openly.

              Essentially, has the decision for the "affirmative health care" model been based on evidential data, or advocacy claims?

              If it proves to be the latter (as Netherland, France, Finland and now Sweden have concluded), the policy needs to be reviewed as soon as possible.

              • Dennis Frank …
                18 March 2022 at 4:40 pm

                Yeah, Molly, that makes sense. Seems like lack of protocols to protect victims is a design flaw. I take your point re parents being led down the garden path by inappropriate advice.

                From a cultural perspective, political action emanates from shared concerns & networking – therefore the situation calls for a lobby group to rectify it. If one doesn't exist, concerned folk have the opportunity to organise one…

                • Molly …
                  18 March 2022 at 5:10 pm

                  "From a cultural perspective, political action emanates from shared concerns & networking – therefore the situation calls for a lobby group to rectify it. If one doesn't exist, concerned folk have the opportunity to organise one…"

                  The most interesting aspect of looking into the impact of legislative change – which is separate to allowing people to live with dignity and the right to self-expression – is how it follows a similar pattern to what has occurred in other countries in terms of what legislation gets changed or introduced and when. The No Debate stance, for a country that prides itself on democracy is also adhered to by media, and pundits without overt signalling.

                  I've had to overcome my aversion to social media in order to keep up with the discussions, and find links to source articles and other information that is not relayed on what I would term progressive or mainstream media.

                  It is indicative that Speak up for Women was continually referred to as a hate group, not only by media in NZ but by politicians:

                  Dr Kerekere in a self-congratulatory display, that make a mockery of the consultation process:

                  "Reading your materials is always…. um… always interesting. because I would say as a general rule, if you don't want to be accused of transphobic, perhaps don't say transphobic things."

                  https://www.facebook.com/watch/?v=1165246557298273

                  Speak up for Women was provided a platform by the Free Speech Union of all organisations.

                  Where is the intellectual curiosity, and robust discussion skills of the left?

                  And we can get a glimpse of how this has come about by viewing Denton's document, compiled by the Thomas Reuter Foundation.

                  James Kirkup wrote an article for the Spectator in 2019,

                  https://www.spectator.co.uk/article/the-document-that-reveals-the-remarkable-tactics-of-trans-lobbyists

                  And a copy of the document itself can be found here:

                  https://www.iglyo.com/wp-content/uploads/2019/11/IGLYO_v3-1.pdf

                  It then becomes apparent that usual campaign methods have already been anticipated and subverted. I think you will find those last two links informative.

  9. Visubversa 9
    18 March 2022 at 4:18 pm

    This is what we are teaching Primary School children. Quotes from "Relationships and Sexuality Education – Years 1 to 8" put out by the Ministry of Education.

    "In science, ākonga can: • consider how biological sex has been constructed and measured over time and what this means in relation to people who have variations in sex characteristics • consider variations in puberty, including the role of hormone blockers • explore the role of genetics in constructing debates about gender and sexuality • challenge gender stereotypes about careers in science • identify famous male and female scientists and their contributions • explore what “male” and “female” mean in relation to various living things, for example, plants, sea creatures, and fungi."

    and

    Schools are encouraged to question gender stereotypes and assumptions about sexuality, including: • gender norms • gender binaries • gender stereotypes • sex norms, for example, the assumption that sex characteristics at birth are always male or female.

    Why primary children should be instructed about the 40 or so syndromes that make up the medical conditions known as Differences of Sex Development is beyond me. Perhaps because these medical conditions have been weaponised by trans rights activists to bolster their assertion that sex is a spectrum, and to provide a physiological basis for their psychological conditions.

    Children are also presented with Gender Ideology as if it were an established fact – whereas there is the same amount of evidence for the existence of a separate and immutable Gender Identity that supersedes biological reality, as there is for the existence of an Immortal Soul.

    https://health.tki.org.nz/content/download/2956/26630/version/3/file/RSE+Guide+y1-8.pdf

    [link added]

    • Sabine 9.1
      18 March 2022 at 4:28 pm

      We want adults in the future that will not question anything, or very little and only in approved and regulated ways. We want the adults of tomorrow to practise positive affirmation only and every time. This movement is so insidious as it is top down rather then the other way round. It is lawmakers that get to decide what children learn. And obviously when lawmakers want children to learn and believe that sex can be changed, that someone is what one feels, that there a no differences between male and female, and that plastic surgery will fix any issue you may mentally have then lawmakers will make laws that force and facilitate that type of teaching. Parents and consent and science and physical reality be damned?

      That may be a reason?

      • SPC 9.1.1
        18 March 2022 at 4:52 pm

        Originally the concept of gender equality was used by feminist groups in their campaign for access to education and career opportunity. The distinction between equality and no difference between genders has developed since then.

        This and acceptance of individual sovereignty over sexuality (within public law – same sex marriages) has now led to some license over how people identify.

        That there is diversity between those of each biological sex and the common humanity of those of either gender has given this credence.

        But real world evidence suggests that there is need for caution when younger people undertake medical intervention.

    • roblogic 9.2
      18 March 2022 at 5:41 pm

      Ani O'Brien submitted an OIA to many schools which got a few peoples backs up. Not sure why… unless they are trying to hide something or feel insecure in their beliefs.

      And today she published a piece at the Platform identifying that yes there is indeed a hidden curriculum and an ideological pressure group offering training and material to schools. Funny as I thought religious teaching was supposed to run outside of school hours, not be run by the teachers, and not be compulsory for the kids.

      To many twitterati this is totally cool and those who object are some kind of horrible bigots. Because apparently it is now vitally important to tell kids there are 100 genders and whatever fantasies they dream up in their little heads should be affirmed and validated by everyone they meet.

      Seems a weird thing to be telling children who are still forming their identity based on many factors not just what the school tells them. And getting them to figure out their sexuality at such a young age makes me wonder why safeguarding is not front and centre of this material.

      It's an exercise in gaslighting and telling lies about the sex binary. And it looks dangerously close to undermining some important safeguards that children (especially girls) need to identify potential predators.

      • Molly 9.2.1
        18 March 2022 at 6:03 pm

        Was just reading the comments on that thread. So much for intelligent discussion.

        I haven't had time to comprehensively look at all the information on school curriculum and guidelines, and the MoE redirects searches to outside organisations for further information.

        One such, is Inside Out. Reading their advice for transgender students, in regards to their rights (and what they can demand) is a advanced lesson in semantics.

        Legal Rights in Schools (pdf)

        https://www.insideout.org.nz/wp-content/uploads/2021/11/Legal-Rights-at-School.pdf

        There is a conflict here between single-sex spaces and rights to privacy for transgender students.

        I am a rainbow young person, but not everyone at my school knows. Can my school ‘out’ me without my consent? No. Any move by a school to out you without your consent would be a breach of your privacy. This includes ‘outing’ you to other students’ families, such as when going on a school overnight trip. Under the Privacy Act 2020, personal information about a student cannot be disclosed by a school (with a few exceptions, which are highly unlikely in situations regarding respecting rainbow students’ privacy). You can make a complaint about a breach of your privacy to the Office of the Privacy Commissioner.

        I’m going to school camp. Can I sleep in a tent or cabin with students of my affirmed gender? There are no legal rules or requirements that would prevent your school from allowing you to sleep in a tent or cabin with other students of your affirmed gender.

        Once again, this topic is one worthy of a series in itself.

        • roblogic 9.2.1.1
          18 March 2022 at 6:19 pm

          I skimmed a couple of InsideOUT pamphlets. AFAICT there is no mention of who the authors are or their professional backgrounds (if any). There are lot of lengthy and tedious explanations of why it is so important for schools to get on board with all this identity stuff. Reads like the essays of a sociology major, not an educator or an expert in child developmental psychology, or even a person with a slight background in rigorous science.

          And yet this ideological pablum is expected to be uncritically swallowed by teaching staff and the school community?

          • Tabletennis 9.2.1.1.1
            19 March 2022 at 3:23 pm

            the staff profile of InsideOut is on their website, non are health care workers or knowledgeable on child develop or medical ethics or child education. But they do have a rich variation of pronouns.

            Their booklet ‘Making schools safer for trans and gender diverse youth’ is the pretend that trans and transing is like becoming “happy forever after”.
            It not hard to find contradiction in their list of new terminology. Don’t try to find lesbian or gay in that list, it isn’t there.
            Edited, among others, by Ahi Wi-hongi Tabby Besley and Elizabeth Kerekere.

  10. barry 10
    18 March 2022 at 5:02 pm

    The question of risks of treatment of teenagers vs non-treatment is complicated. There are many examples of non-binary children committing suicide with and without treatment. It is a shame that there is no research to support either option. Randomly switching rules based on political prejudice doesn't seem ideal.

    Ideally everything would happen with parental consent, but there are also plenty of examples where the parents will make decisions that are damaging for a child (e.g. conversion therapy). I would say that there are some teenagers that I would trust to make their own choices.

    I don't know anyone who has had such treatment as a teenager, but I know more than one person who was very unhappy as a teenager and experienced relief when they could transition as an adult. I don't have an answer, but when confronted by an individual pressing case, I am frustrated when lawmakers get in the way.

    • Molly 10.1
      18 March 2022 at 5:13 pm

      "There are many examples of non-binary children committing suicide with and without treatment."

      I'm going to ask you to provide link to evidential data for this claim, because it is the use of this claim that tends to shut down discussion, and sources are vitally important so we can assess appropriately.

      Ideally everything would happen with parental consent, but there are also plenty of examples where the parents will make decisions that are damaging for a child (e.g. conversion therapy). I would say that there are some teenagers that I would trust to make their own choices.
      Gillick competence, which is often cited, related to contraceptive medication, which as every woman knows is almost immediately ineffective if you cease taking the pill. Many contraceptive interventions are fully reversible. The medication and surgeries offered for gender dysphoria are not only prescribed off label, but have no clinical data to support the ‘fully reversible’ accolade that they have been given, nor the data available to actually allow informed consent.

      I don’t know anyone who has had such treatment as a teenager, but I know more than one person who was very unhappy as a teenager and experienced relief when they could transition as an adult. I don’t have an answer, but when confronted by an individual pressing case, I am frustrated when lawmakers get in the way.
      That’s human nature and empathy.
      But we should demand for all those presenting, including those who persist with gender dysphoria into adulthood, high quality and well evidenced care.

      It seems apparent this is not the case at the moment.

        • Molly 10.1.1.1
          18 March 2022 at 5:49 pm

          That is a survey report, which is not reliable in terms of objectivity and clinical assessment.

          Problems with this kind of evidence:

          • Respondents have varying measures of suicidal intentions, actions and thoughts.
          • People who present with gender dysphoria will often have co-morbidities and trauma alongside that presentation. The question is then, is the suicidal aspect solely related to gender dysphoria, may it be a culmination of the whole, or related to a completely separate condition?
          • Suicidal ideation has been a component of many transgender internet information sources as well as repeated in transgender organisations, despite the usual reluctance to refer to suicide in other aspects of health care in regards to known proliferation of those thoughts in communities. Has this constant repetition in terms of transgender health inflated the reference to suicide, or more worryingly, the incidence of suicide in this demographic?
          • Suicide threats as a form of control and manipulation is well known. How do we determine the difference between suicide threats as an advocacy tool, a response to a denial of services, and one that is fully grounded in gender dysphoria without comprehensive evaluation?

          Episode 2 of the Trans Train documentary discusses such surveys above and is worth watching to understand more fully. I'll link here to the final minutes of the episode where Professor Danutta Wasserman, Psychiatry and Suicidology expert, outlines her assessment:

          https://youtu.be/73-mLwWIgwU?t=2848

          • barry 10.1.1.1.1
            18 March 2022 at 7:39 pm

            Of course there are problems with such surveys, but they are all we have. At some stage we have to take people at their word.

            It would almost be surprising if misfits weren't sometimes suicidal. There are also cases of people committing suicide after transition.

            My point is that there is little evidence one way or the other. Some people might be harmed by medical intervention and some might be helped. The law should be based on evidence, and if there is no evidence of increased harm then why do we need to have a law prohibiting it.

            18 year olds can vote, get pregnant and have children or abortions, join armies and fight wars, get tattoos and piercings, etc. Lots of things that will affect their future. Why do we not trust them to make decisions on this aspect of their bodily autonomy?

            • weka 10.1.1.1.1.1
              18 March 2022 at 7:48 pm

              Do you think 18year old women should be able to choose to have a hysterectomy?

              • barry …
                18 March 2022 at 7:52 pm

                I am not going to tell her that she can't.

                • roblogic …
                  18 March 2022 at 8:30 pm

                  Patients who are obsessed with getting their limbs amputated, or suffer from anorexia, are treated for a psychological condition and receive counselling to try to help them to accept themselves. Maybe that is a better way than damaging surgery that removes natural function and healthy body parts.

                • weka …
                  18 March 2022 at 8:34 pm

                  I wasn’t asking what you would say I was asking you what you think the law and public policy should be.

            • Molly 10.1.1.1.1.2
              18 March 2022 at 10:46 pm

              Bad evidence is not good enough to base irreversible medications and surgeries on.

              If you consider that the brain development continues till 25, then it should give pause to what is knowingly consented to.

              You make a couple of leaps in your comment:

              1. That information is available to permit informed consent. We know that this is not the case, In fact many sources continue to state that puberty blockers are completely reversible. We know this to be untrue. Lack of evidence does not equate to lack of harm. There are indications that the cumulative harm could be quite significant. As the transwoman in Episode 2 and 3 above said, if she had access to the data she had been shown during the making of the documentary, then she would likely have not gone through transition, but lived as an effeminate gay man.

              2. You also seem to have forgotten, that despite the supposed sophistication and technical ability of young people, they are still maturing and learning and investigating their own identities. They are at a stage in life when they are brimful of passion, certainty and uncompromising. We should wholeheartedly support this stage in their lives, and should also wholeheartedly ensure that they reach the next stage intact, without irreversible harm. That is the role of the adults in their lives.

              "18 year olds can vote, get pregnant and have children or abortions, join armies and fight wars, get tattoos and piercings, etc. Lots of things that will affect their future. Why do we not trust them to make decisions on this aspect of their bodily autonomy?"

              Because it is not the role of medical professionals to provide medication and surgery on demand, particularly without evidential data to ensure safety and long-term benefits. No other supposedly non-medical condition, can demand such expensive life-long treatment options on demand. In a health system that is already resource limited, this option should be of the highest calibre of treatment. It appears to be a result of concerted advocacy only.

              The comparisons you have made are not analogous. They are reversible, for the most part and have natural consequences that can be worked through and overcome. The treatments on offer have permanent impacts. We can support gender dysphoric young people in other ways, and if they persist into adulthood, they can make the choice then regarding treatment that will most likely result in lifelong medication needs, and medication effects, infertility, lack of sexual function and enjoyment and what that will mean for intimate relationships.

              It's apparent that you haven't taken time out to really read through the links and watch the programmes. It might be of worth for you to do so.

              Children can insist they are right. Adults can still say No when it is appropriate.

            • Sabine 10.1.1.1.1.3
              18 March 2022 at 10:55 pm

              Because a 10 year old who is being put on puperty blockers, followed with wrong sex hormones and in the case of girls have their breasts removed well before they are a 18 are not able to make an informed decision.

              Maybe also a kid that was socially transitioned by their parents due to them playing with the wrong sex toys, i.e. blue truck vs pink frilly frock may not be able to state at 9 or 10 that they actually feel like they are what they are rather then what everyone thought they are, and thus would like to not have puperty blockers injected.

              Maybe also kids are not little adults.

              So why don't we wait will all that jazz and keep kids kids fully intact without any medication what so ever, no social transitioning and just have these kids grow into adulthood so that then they can take a decision about their bodies and their self identity as an adult.

              And in the meantime we offer them copious amounts of counselling rather then sending them down a path to live long medication and maybe the regret about the loss of their sexual functions and their loss to reproduction.

            • Jan Rivers 10.1.1.1.1.4
              19 March 2022 at 1:38 pm

              The issue in answer to your question is that puberty blockers continue inexorably to cross sex hormones and the combination leads to inevitable sterility and other sreious problems. Is it OK for kids to leave adolesce with levels of bone density more akin to a 60 year old and nevery having had puberty with its important role in emotional maturation as well as surgery that leads to loss of sexual function. Since many of these kids are the most likely to become gay or lebsian adults their emerging sexuality is being suppressed as a result often of their, their peers or sometimes event their parents homophobia.

              One of the issues that has been spotted for girls and young women is that many don't want to be women.

              When researchers at Auckland University asked eight year olds whether they were boy girl or something in between (thus seeding in children the neo-religous belief in gender identity these were the results:

              2.7% (n=64) of females identified as either a boy or mostly a boy compared with 0.5% (n=13) of males who identified as either a girl or mostly a girl.
              • 22% (n=531) of females identified between genders compared with 6% (n=151) of males.
              • 3.4% (n=81) of females were unsure about their gender compared with 1.7% (n=43) of males.

              Astoundingly there is no discussion of what these large differences between boys and girls might represent. But to many the obvious speculation is that eight year olds have already recognised the limits to, and harder lives of those persons in society who act within a female gender identity. Or perhaps they have themselves experienced these limits. /sarc

              Moreover the counting ourselves survey https://countingourselves.nz/wp-content/uploads/2020/01/Counting-Ourselves_Report-Dec-19-Online.pdf reports that full 50% of 'transmen' had when asked "Since the age of 13, has anyone tried to have sex with you against your will?" Again there is no discussion of whether these attempts and the high level of rape and sexual assaults also reported took place before the young women had adopted a cross sex identification.

        • Molly 10.1.1.2
          19 March 2022 at 11:53 am

          Just looking into this study in more depth this morning, and noted this:

          "POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose."

          Despite it being defensible, surely that fact that the lead author is a trans- identified female is important for transparency?

          https://casetext.com/case/toomey-v-arizona-1

          A list of their other papers can be found here:

          https://www.semanticscholar.org/author/Russell-B.-Toomey/4027877

          I only looked at several on the first page, but Toomey seems to use surveys and focus groups exclusively, and doesn't acknowledge that limitation very well in analysis. (I do acknowledge I am not an analytical scholar though).

    • Jan Rivers 10.2
      18 March 2022 at 6:02 pm

      A senior clinician at WPATH takes issue with this idea. See https://genspect.org/leeper-edwards-support-doesnt-always-mean-medical-interventions/ She is quoted as saying

      "

      “As far as I know, there are no studies that say that if we don’t start these kids immediately on hormones when they say they want them that they are going to commit suicide. So that is misguided. “
      Dr. Laura Edwards-Leeper

      as does an Oxford professor see https://www.transgendertrend.com/suicide-by-trans-identified-children-in-england-and-wales/

      It appears that when corrected for co-morbid mental health conditions there is no evidence that children who have gender issues are more suicidal. To the extent that they are it could well be because the trans lobby tells them that they will. All the time!!!

      Fnally young people who have counselling do at least as well as those offered hormones and moreover they do not become lifelong patients.

  11. Anker 11
    18 March 2022 at 5:31 pm

    Barry, the issue of suicide is often brought up I understand when parents are unsure about medical transitioning. "Better to have an alive trans child, than lose your child".

    Where else in medicine or other life situations are people told "if you don't do …..then your child/wife/husband/sister mother will end their life

    And there is a lot of research that refutes the suicide stats.

  12. roblogic 12
    18 March 2022 at 6:07 pm

    Another useful resource is the website FullyInformed.nz ; it focuses on puberty blockers and the dubious medical advice given to gender dysphoric patients & their families. (He also tweets at @fullyinformednz)

    The number of adolescents, particularly girls, presenting with gender dysphoria has risen exponentially in NZ and other countries since around 2010. Treating gender dysphoric adolescents with puberty blockers has become a "freely" available treatment option in New Zealand.

    • Molly 12.1
      18 March 2022 at 6:17 pm

      @roblogic.

      I suspect we are synchronised in our internet browsing today. smiley

      • roblogic 12.1.1
        18 March 2022 at 6:30 pm

        Have been dabbling in this odd topic for a while. Got me blocked by quite a few lefties who are otherwise quite reasonable. But unfortunately they see red when this particular topic is raised, and refuse to acknowledge any problems.

        There are so many dimensions — it's a large topic with multiple impacts, but framed in the language of victimhood to neutralise criticism. Luckily there are enough obnoxious/annoying/cantakerously critical people around that cannot in good conscience let lies prevail, children be endangered, and women's rights be trampled.

      • roblogic 12.2.1
        18 March 2022 at 8:23 pm

        Interesting. He writes in the NZ Medical Journal:

        Decision making through the time of adolescence may not be equivalent to that in older people and may possibly respond to social context to a greater extent.7,14,31–32 Given that gender identity may alter or evolve over time, the therapeutic pathways which were developed for older transgender subjects may need revision for the teenage population.21,33 Transgender youth are at a higher risk for poor psychosocial health than their non-transgender peers. Numerous studies have found that transgender youth have a higher prevalence of behavioural and emotional problems, including anxiety, depression, self-harm and suicide than is expected in the general population.21,34–37 Access to psychosocial services is therefore crucial for providing holistic and comprehensive care for these individuals.33 In general, published studies discuss the recognised satisfactory outcomes for teenagers and adults in transgender programmes but do not provide data on people who might be counselled to defer transition, or who stop or are intermittently compliant on hormone therapy. Further, it is important to be aware that at present, developmental trajectories for transgender youth are not yet well understood due to the lack of robust research,

    • RedLogix 12.3
      18 March 2022 at 9:58 pm

      Thanks for this graph rob. I think mentioned something like this a while back so I'm pleased to see a solid reference. The remarkable leap in numbers around 2012-4 truly beggars the imagination.

      My bet for the root cause – this was when social media truly took off

      • Molly 12.3.1
        18 March 2022 at 10:50 pm

        I agree. There are multiple references to Tumblr in transition and detransition posts, and the demographic there is mainly young women, which is the same demographic that has seemingly appeared out of nowhere.

        We know from the Facebook whistleblower that the internal research on young woman was that social media use was increasing, and correlated to increasing incidence of self harm.

        It's another post, I'll try to put together with links. The male to female population seems to be entirely distinct, and while comfortable with cross-sex hormones, less likely to take a surgical route.

        • Sabine 12.3.1.1
          18 March 2022 at 11:02 pm

          Not sure if the MtF is less likely to indulge in surgery, but i think it is more cosmetic in nature. i.e. feminizing surgery, trachea shave, breast implants, chin shave…..after all many of these guys are heterosexual and they might like their penises. Some 85 – 90 % are fully intact. How much their own sexuality is reasoning for transitioning is also not much discussed, Autogynophiles come to mind.

          vs the girls

          Who probably simply don't want to grow up a female in a world that still neither values females, nor offer them respect, dignity and basic humanity. Never mind the other issues of trauma, sexual abuse, and fwiw, also simply earning power. Men earn more, if you want a hysterectomy at 18 you just need to declare yourself trans etc etc. I can see a girl with mental issues and social issues look at that path and don't find it too hard all things considered. I at 13 would have seriously considered and probably gone that way to be honest. To some extend i am glad this did not exist during my childhood years.

          • Molly 12.3.1.1.1
            18 March 2022 at 11:12 pm

            I was thinking more of the genital reassignment surgery, rather than cosmetic, so I think on that you may be right.

            I also was an uncomfortable, non-conforming, slight Asperger's teenager. With access to the internet, I have little doubt that I would have been at least tempted to investigate gender identity. I have heard many other women, for their own reasons, say the same with sincerity. They are also sincerely grateful that they were able to reconcile with their female bodies.

    • arkie 12.4
      18 March 2022 at 11:03 pm

      An interesting comparison is the graph of the incidence of left-handedness over time:

      So over the 20th century there was a dramatic increase, what answers could we draw?

      …historically, people who are not right-handed have often been made to use their right hand for writing, handling cutlery, and various occupational tasks. As a consequence, a proportion of otherwise left-handed or ambidextrous people has become right-handed, while possibly also a number of left-handed people have become ambidextrous through this enforcing. The rate of enforced right-handedness varies between cultures, but has typically shown a decline over recent decades: in many countries, proportions of left-handers have increased with time, probably because society has become more tolerant of variation.

      https://www.nature.com/articles/s41598-018-37423-8

      Not some much that there is necessarily more left-handedness, but that when things like the education system stop enforcing right-handedness, the left-handed can be themselves.

      • Molly 12.4.1
        18 March 2022 at 11:15 pm

        Analogies are good for explaining, but they are not evidence.

        Yes, the incidence of left-handedness notably increased after it's sinister aspect was lost, but that doesn't prove that the increase in gender identity is due to the cultural acceptance. It is a possible reason, which requires investigation to confirm.

        It may also be only part of the reason.

        Have you no intellectual curiosity to investigate other reasons or contributions as well? I do.

        • arkie 12.4.1.1
          18 March 2022 at 11:47 pm

          Analogies are good for explaining, but they are not evidence.

          Did I say it was evidence? It’s a somewhat parallel situation, and increased acceptance could play a part, and I said as much (as well as linked to a scientific paper on it). I would also say that when a state moves to legally accept something like say, homosexuality, the incidence of it may seem to appear to have increased exponentially too.

          Have you no intellectual curiosity to investigate other reasons or contributions as well?

          That’s an uncalled for and strange inference. Who are you to say I haven’t?

          • Molly 12.4.1.1.1
            19 March 2022 at 8:20 am

            You posted a graph in response to roblogics graph about the increase in incidence of gender dysphoria, with two brief sentences that I took (perhaps mistakenly) as inference that you saw this as the main reason for the increase.

            Depending on how many sources you have read, this statistically interesting rise in gender dysphoria is often attributed solely to the current climate of cultural acceptance by gender identity advocates. That assumption should rightly be tested to see if it is true.

            "Have you no intellectual curiosity to investigate other reasons or contributions as well?

            That’s an uncalled for and strange inference. Who are you to say I haven’t?"

            I didn't say that you hadn't, I asked if you had considered some other contributing factors. It was a question.

            If you have considered other factors, it'd be good to discuss.

          • Anker 12.4.1.1.2
            19 March 2022 at 11:27 am
            • Arkie, what we know is there has been a significant (some estimates 4000%) increase in teen girls presenting at gender clinics, wanting to transition. If this increase was all down to more social acceptance, we would see more women in their30’s, 40’s, 50,s etc presenting as trans. This hasn’t happened. Your theory and attempt to liken the increase in young women wanting to transition is flawed.

            btw way Molly asked you a question about whether you had intellectual curiosity she didn’t make a statement about that. It is a reasonable question, given all the work she has put into researching this (as have many women including Weka, Sabine and Jan Rivers).

      • weka 12.4.2
        19 March 2022 at 9:47 am

        Not some much that there is necessarily more left-handedness, but that when things like the education system stop enforcing right-handedness, the left-handed can be themselves.

        I completely agree. I'd like to see society change so that gender non-conforming people are free to be how they are without having to jump through medical and surgical hoops. I'd like women to be able to be who they are, gender conforming and non-gender conforming, and that includes having their own politics and social experiences.

        In the context of this post especially, I really want for young lesbians to be able to be themselves, and young girls and women, so they aren't pressured into feeling that being female is somehow bad that that being male is better, or they aren't sexually harassed or shown a future where being male is better. Then we'd have less detransition tragedies, bu also we'd just have girls becoming women in an affirming and supportive way to be themselves.

        I have no problem within that if some of those people want to be the opposite gender identity. But I'm wondering what you meant with your comparison with left handedness and if you understood just how much socialisation and peer pressure there is for young women to not be young women.

        • arkie 12.4.2.1
          19 March 2022 at 10:31 am

          But I'm wondering what you meant with your comparison with left handedness

          The comparison is mostly about the graph, more than what it is measuring exactly. We should always be cautious in attributing the reasons why, as they can be multitudinous, but we should also be cautious about our interpretation of the perceived statistical increase as well, they too could have many reasons, one of which, like left-handedness, could be about the increased acceptance, by society, and by law, of those who are different from the norm.

          Young women definitely have it tough. Society as a whole seems to have endless opinions about what young women/femmes should or shouldn't be doing; studying STEM, going into trades, getting married or not, having kids or not, how much clothing they must be wearing to prove their virtue, etc etc. There are those who find that societal pressure to be a undue burden and in desperation seek freedom from these conflicting expectations. This is a consequence of our patriarchal society that feels it must condemn or chastise people, but women especially, for making their own decisions about their lives and bodies. Dismantling the patriarchy is of paramount importance, for young women, for young people, for our society as a whole.

  13. Anker 13
    18 March 2022 at 7:23 pm

    Roblogic 100%

  14. Sabine 14
    18 March 2022 at 9:52 pm

    Ad Thailand to your list that changed age for sexual re-assignment surgery – no words on any other medication though.

    https://www.telegraph.co.uk/news/worldnews/1583808/Thai-government-bans-ladyboys-castration.html

  15. Molly 15
    19 March 2022 at 8:37 am

    Addendum: Hormone therapy for gender dysphoria – children and young people

    https://www.sbu.se/342

    Although the paper is in Swedish and you are limited to Google Translate, you can look at the tables regarding:

    1. Literature search (pdf):

    https://www.sbu.se/contentassets/4062b596a35c4e1383405766b7365076/bilaga-1-litteratursokning.pdf

    2. Excluded studies with a high risk of bias (pdf):

    https://www.sbu.se/contentassets/4062b596a35c4e1383405766b7365076/bilaga-2-exkluderade-studier-med-hog-risk-for-bias.pdf

    3. Table of included studies (pdf):

    https://www.sbu.se/contentassets/4062b596a35c4e1383405766b7365076/bilaga-3-tabellverk-over-inkluderade-studier.pdf

  16. Mark 16
    19 March 2022 at 4:16 pm

    What on earth has the subject of this article got to do with what is still purportedly a left wing site.

    This is about a medical matter

    • SPC 16.1
      19 March 2022 at 5:02 pm

      Why would you care, you're not left wing.

    • Molly 16.2
      19 March 2022 at 6:14 pm

      Reading and comprehension a difficulty?

      It's OK. Feel free to ignore.

    • Shanreagh 16.3
      19 March 2022 at 8:55 pm

      So left wing people are not supposed to be concerned about current issues?

      What a weird thought.

      Or are you one of those people who will try to argue that unless a topic has a left and right frame of reference it does not exist as reasonable topic for discussion.

      I bet I am right in one thing though……that you are one who is a cut & run person. Drop a bomb and away. no

    • Anker 16.4
      20 March 2022 at 12:07 pm

      Mark, it might seem from this post that we are focussing on a medical issue. But the medical transition of young people is part of the wider issue of gender ideology which has arisen out of the works out of Judith Butler and Gayle Rubin.

      This ideology posits that there is such a thing as a gender identity, which of course people are entitled to believe. Some of the proponants of this ideology believe that this gender identity trumps biological sex. Some believe that biological sex is a contruct.

      The proponants of this ideology have been able to infiltrate the public service, the media and political parties. This has resulted in legislative changes that has propelled this ideology into law. A recent example has been the self id aspect of the BMDRR bill.

      One of the most concerning things about this ideology is the tactics it uses to shut debate down. This is why the Standard has become a place where gender critical or rather pro reality people can share information

  17. Sabine 17
    20 March 2022 at 10:57 am

    this makes for interesting reading, Sweden again.

    https://twitter.com/NaistenOsa/status/1504423668373467139/photo/1

    Pic three, last line is the most important bit in this account.

    and in other news TRA's cancelled an event because the conversation could have not been kind and affirmative enough.

    https://twitter.com/HJoyceGender/status/1505208925146304516

    • Molly 17.1
      20 March 2022 at 12:30 pm

      Yes, (yet another) unbelievable example of how NoDebate is implemented, regardless of platform or situation.

      Archived copy here:

      https://archive.is/2022.03.19-153443/https://www.telegraph.co.uk/news/2022/03/19/great-ormond-street-cancels-trainee-doctor-conference-trans/

      Susie Green, whose influential charity provided the neopronouns discussed a few days ago is unequivocal on this approach:

      Also cancelled was Stephanie Davies-Arai, the director of Transgender Trend, a gender-critical website for parents, after two separate dossiers of allegations were sent to organisers by a trainee doctor and Mermaids, the child trans charity.

      In her intervention, Susie Green, the chief executive of Mermaids who was due to speak alongside Ms Davies-Arai and other charities on a panel about support for trans youth, told organisers that Mermaids “cannot be a part of a conference that gives a platform to Transgender Trend, regardless of whether their work is in the public domain or not”.

      She went on to tell NHS staff in an email that "in addition to Transgender Trend, I would suggest that CAMHS (child and adolescent mental health services) stay clear of anyone involved with anti-trans pseudo-medical platforms that have been set up with the sole intention of attacking trans people (especially trans youth) and their healthcare."

      Trying to find original source re Leo and Karolinska Institute. Will post when I do, thanks.

      • Sabine 17.1.1
        20 March 2022 at 12:36 pm

        Yes, i just saw that. They also cancelled the Person who wrote the Cass Report. And a few others.

        It is the line in the Maya Forstater trial that stuck : don't argue with her as she come prepared (paraphrased by me).

        But on the other hand all of the de-platformed could meet up and do the same zoom meeting but open attendance. Let everyone who would want to join join. Don't wait to be given a platform, create one. I would join to be honest, heck i would toss a coin to the witches to get in.

    • Molly 17.2
      20 March 2022 at 12:52 pm

      I used Google Translate to convert Swedish article to English:

      Original article – https://www.svt.se/nyheter/granskning/ug/uppdrag-granskning-avslojar-flera-barn-har-fatt-skador-i-transvarden

      Google translated – https://www-svt-se.translate.goog/nyheter/granskning/ug/uppdrag-granskning-avslojar-flera-barn-har-fatt-skador-i-transvarden?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en-US&_x_tr_pto=wapp

      Leo is ten years old when he tells his parents that he is a boy – and eleven when the doctors at Astrid Lindgren's children's hospital start giving him so-called stop hormones, which pause his puberty.

      His mother Natalie says that Leo has previously injured himself and isolated himself at home. After starting treatment, he feels better, but soon it changes.

      – He felt so bad that he tried to commit suicide on several occasions. We did not understand, we thought our child would feel better from the treatment, says Natalie.

      Over time, Leo also begins to complain of back pain.

      – When we asked from time to time how it felt in the back, he said "I have pain all the time"…

      ..

      In the last five years, about 440 children with sex dysphoria have received stop hormones. It should provide time for reflection before deciding on any treatment with estrogen or testosterone, which causes permanent changes in the body.

      But according to chief physician and pediatric endocrinologist Ricard Nergårdh, who treats children with gender dysphoria, the stop hormones can also affect the patient.

      – It's chemical castration. It can affect mental state in a way that you did not think and did not want. It is very important that the patient and the patient's family are well informed about it.

      According to Richard Nergårdh, treatment for two years is usually stated as a "reasonable" time to minimize the risk of side effects. Bone and bone density should also be monitored and checked regularly.

      Deviation report is delayed

      In Leo's case, it will take 4.5 years before he is sent for an X-ray. His parents are finally contacted by Astrid Lindgren's children's hospital, who says that they have seen abnormalities on Leo's skeleton….

      …Assignment review takes part in documentation about other children who have had serious side effects from hormone treatments, where the treatment has been discontinued. One child has a suspected liver effect, another is diagnosed with reduced bone density after two years. A third has had a severe deterioration in mental state.

      The responsible manager at Karolinska University Hospital does not know that a total of 13 children who have been treated for gender dysphoria in Stockholm have received care injuries.

      How can you not know that? Is not that your responsibility?

      – We are two different units. The children's hospital handles the pediatric part – the investigation and psychiatric follow-up is on the KID team, says Svante Norgren.

      • Molly 17.2.1
        20 March 2022 at 1:02 pm

        Another report in English about Karolinska Institute reporting itself for Leo's 'care'.

        https://ovarit.com/o/GenderCritical/68332/sweden-s-health-and-social-care-inspectorate-is-performing-further-investigation

        ASSIGNMENT INVESTIGATION · Natalie's son Leo has been injured in trans care. Karolinska Hospital has now registered themselves for their care of Leo. The background is Assignment review revealing that several young people have received serious injuries from treatment in trans care. – I am happy and relieved that the care now acknowledges that they have done wrong, says Leo's mother Natalie.

        Leo was only eleven years old when the medical treatment with stop hormones was started. The idea was to stop puberty because Leo, a born girl, identifies as a boy. Just over four years after the treatment was started, it was discovered that he suffered from osteoporosis and vertebral changes, he has stayed in the plant and has back and hip pain.

        Only after four and a half years, when Leo finally complained daily of pain, was the skeleton checked. At that time, no checks on bone density had been made during the years he was treated with stop hormones. A treatment that has known risks and according to experts should not last longer than a couple of years.

        Continued risk of incorrect treatment In November last year, Uppdrag's review revealed that Leo and at least twelve other children had side effects and were injured by hormone treatments in trans care at Karolinska University Hospital.

        After the report, the hospital has made its own investigation of the Leo case. They now state that he and other children have been exposed to the risk of "serious care injury" and that there is a continued risk of incorrect treatment. In the report, the hospital states that they have not had any routines for checking bone density and that the family "has not received sufficient and clear information about known side effects of the treatment"

        They also state that there are a number of shortcomings that can affect and harm children who are treated in trans care. On the one hand, the scientific basis is weak, which means that it is not possible to know whether the treatment is useful or safe. On the one hand, care is divided between two care providers, which complicates overall responsibility for investigation, diagnosis and follow-up of side effects.

        Was not caught by the care In addition, the hospital writes that "it is clear that the diagnosis of gender dysphoria is not static" and that it happens that patients no longer want to undergo gender correction after the stop hormones have been released.

        In the investigation, a doctor writes that Leo should not have received the treatment from the beginning, because they did not take into account psychiatric problems, suicide attempts and that he himself expressed hesitation, which was not captured by the care.

      • Molly 17.2.2
        20 March 2022 at 1:06 pm

        Second article on that link has gender clinic using the threat of child removal:

        ASSIGNMENT REVIEW · When Rasmus' 12-year-old children came out as trans, the health service wanted to start hormone treatment. Due to the risk of irreversible damage to his child, Rasmus said no. He was then reported to the social services. Assignment review has been in contact with several families who have been exposed to the same thing. It was a couple of years ago that Rasmus when 12-year-old children, born as a boy, came out as a trance and identified themselves as a girl.

        The gender identity clinic where the child received care wanted to start treatment with stop hormones, but Rasmus was hesitant.

        • I wanted to know what stop hormones were, what kind of medicine it is. Then I realized quite quickly that there were irreversible, ie irreversible, aspects of this. My child could risk becoming sterile, says Rasmus.

        Some time into the treatment, Rasmus abruptly said no to his children continuing to receive stop hormones – and was reported to the social services.

        The head of operations at the gender identity clinic informed Rasmus that they judged that his refusal could "be to the detriment of the young person through increased anxiety and anxiety about the future".

        Several cases of reports of unrest SVT has been in contact with several families who have experienced the same thing; when they oppose medication, they have been reported worried. A family was deprived of their child for a short time because they said no to stop hormones.

        • Sabine 17.2.2.1
          20 March 2022 at 1:16 pm

          It is this weird government supported child experimentation/abuse. Including the health care sector and mental health care sector (a lot of this happens on he public dime), education ('sex ed for toddlers), and compliance of adults enforced via work place 'values' and enforcement of these value, coupled with a few saccharine tv shows who 'fashion' wash this abuse, and use of the police to take care of resisters. Coupled that with the ongoing de-humanising of women as something that can't be without words to describe itself, and we are back in the victorian times were everyone but men were humans and women and children were chattel.

          • Molly 17.2.2.1.1
            20 March 2022 at 2:11 pm

            Women raising concerns are definitely being treated differently to men raising the same concerns, even as those concerns are ignored.

            I feel as if women's rights have almost melted away in the neon glare of the rainbow, and that is powered by all the co-opted institutions and governments who are dazzled by the pretty colours.

            How this situation is not of concern to everyone is an indication of how tribal some seem to be.

            • Sabine 17.2.2.1.1.1
              20 March 2022 at 2:34 pm

              I think it goes further then mere tribalism, but the mysoginy on the left is the same as on the right, someone said: left men want women to be public property and right men want them to be private property and i agree.

              I have always understood my 'rights' to be 'mine' until someone takes them away ditto for human rights. We have these rights because we agree to give these rights to each other, another one of our social contract thingies.

              And now seemingly we are happy to take away rights from women and children – all children – in favor of an ideology that is very very harmful to women and children. And it is government, and academia driven and i would like to understand why. Capitalism and the mining of bodily spareparts of women and the womb rental market are one thing. But surely there must be more too it.

              But generally i think this escalated to this point now because many don't have an issue putting women back into their place, and many don't seem to have an issue with physical child abuse (never mind the emotional and mental distressed caused), and even less seem to care about the long term effects. Kindness i guess. Everyone just trying or pretending to be kind. It does not affect them after all.

    • Jan Rivers 17.3
      20 March 2022 at 11:13 pm

      This article is a series of tweets about the way that Diversity and Inclusion policies by a leader at the Guardian Susanna Rustin https://threadreaderapp.com/user/SusannaRustin

      Another journal article published over the weekend is Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults and it outlines the poor quality of evidence for gender medicine for children.

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