Gender Studies I

[MissThundercat]

which could mean the standards work to prevent transition regret, right?

Swing and a miss.

Research, things I actually linked to, show the few (0.8%) cases of regret come from pervasive societal discrimination and family maltreatment.

https://drive.google.com/file/d/18iU...ew?usp=sharing

[Slap Shot]

"And what that "Bob" dude did for me was protected me for 35+ years. He ran marathons to get me out of harm's way. He got a job at Sam's Club because he knew a supervisor there would understand and be supportive when Amber Marie could take over. He brought me to Holland because help would be here, including people who were just like me. He took us out of church in Muskegon because that place did not treat trans people kindly. He warmed up to Alicia and Donna at Tyson because they understood. He befriended the HR manager at Tyson to ensure I would be protected for the most part. He kept going back to Grand Rapids for solace because 5 particular women saw something was up and Bob was never happy. And those 5 women, not knowing what else to do or ever having been introduced to this before, stayed with Bob until he could get the help I needed.

And Bob, as I was learning to stand up, walk around, stretch my legs, and get ready to face the world, stayed with me until the team at Out On the Lakeshore and Gender SAFE could take me in and give me the help I needed. He was elated when the teams at Grace Episcopal and PFLAG joined the ranks of support for me. And in the time between November 2017 and March 2018, Bob stayed nearby in case I needed anything else. But on March 13, 2018, Bob knew it was just about time for him and I to completely part ways. He was in the room at Out On the Lakeshore the day I was approved for hormones, as I excitedly shared the news with the entire OOTL Community Center Team. And he smiled. He knew the next day, he would fade to gray and disappear completely. On March 14, 2018, he and I walked to the CVS counter at Target, we grabbed my hormones, and we left for home. We walked up the stairs to my apartment, and knowing he would be gone in a few minutes, said "let's do this." He observed as I took my first dose of Spiro and applied the patch of Estradiol. As I sat in a dining chair, feeling a sense of relief that the journey was over, Bob completely faded out, knowing his work here and his time here were done, proud of me and knowing I'd be working wonders soon!"- written by me, 7/20/2020

Most every poster has seen the change and marked improvement in my life since I started hormonal transition (I take estradiol valerate injection). I received an added bump when I had my breast augmentation. My Instagram shows all this. On the Internet, there is a picture of Trumpet and I at the 2010 Regionals in Grand Rapids. I've come a long way since then.

But at this point, there's no convincing someone who's mind is made up. Let the bigot post 90 minute videos to his Facebook page of him sitting in his truck complaining how the world is changing and he doesn't like it. The rest of us are going for pancakes and coffee.

And uh... surgery? I already dropped $6175 for my breasts. University of Michigan wants about $60,000 for confirmation, and I'll need several bills paid while I'm recovering from surgery and not working. Venmo and PayPal available upon request.

Thank you for sharing, Amber.

[dxmnkd316]

Swing and a miss.

Research, things I actually linked to, show the few (0.8%) cases of regret come from pervasive societal discrimination and family maltreatment.

https://drive.google.com/file/d/18iU...ew?usp=sharing

Right, but his point is that you can't prove something doesn't work by absence of the thing it's trying to remove.

Think of a filter. You want the filter to remove particles. If it does work, the expectation is they won't be in the water coming out of the filter. However, if you only test the water coming out of the filter, you can't tell if it's working or not. The particles may not exist in the first place. You would need to test the water coming into the filter and coming out.

So in this case, the question is whether those cases of regret did or did not exist BEFORE these rules were in place. I'm guessing that data doesn't exist because the rules have been in place for so long. (I can't actually read the google docs right now since my company blocks all google docs, drives, etc.)

All of that being said, perhaps it's time we remove the rules or pilot their removal. Because if they are effective and helping filter those cases out, perhaps there's a value there. Because it's not like you can just go back - that money is gone. The balance of course is not putting up too many barriers for someone to match their identity to their body. I think it's probably important to have both.

I don't know where to draw that line nor is it my decision. Because how different is this to someone wanting an abortion and forcing them to get a transvaginal ultrasound and look at their baby's face? Which I'm vehemently opposed to. So I'm really of two minds on this.



Edit: I think the bottom line is, they aren't going to let someone go through highly invasive surgery with GA without a need. On the other hand... we have that cat lady. So who knows.

[MissThundercat]

Right, but his point is that you can't prove something doesn't work by absence of the thing it's trying to remove.

Think of a filter. You want the filter to remove particles. If it does work, the expectation is they won't be in the water coming out of the filter. However, if you only test the water coming out of the filter, you can't tell if it's working or not. The particles may not exist in the first place. You would need to test the water coming into the filter and coming out.

So in this case, the question is whether those cases of regret did or did not exist BEFORE these rules were in place. I'm guessing that data doesn't exist because the rules have been in place for so long. (I can't actually read the google docs right now since my company blocks all google docs, drives, etc.)

All of that being said, perhaps it's time we remove the rules or pilot their removal. Because if they are effective and helping filter those cases out, perhaps there's a value there. Because it's not like you can just go back - that money is gone. The balance of course is not putting up too many barriers for someone to match their identity to their body. I think it's probably important to have both.

I don't know where to draw that line nor is it my decision. Because how different is this to someone wanting an abortion and forcing them to get a transvaginal ultrasound and look at their baby's face? Which I'm vehemently opposed to. So I'm really of two minds on this.



Edit: I think the bottom line is, they aren't going to let someone go through highly invasive surgery with GA without a need. On the other hand... we have that cat lady. So who knows.

The TL;DR of the Google doc is this: a tiny percentage of those who experience "transition regret" actually regret it for medical reasons (this is not what they had in mind). Early research is promising: Mt. Sinai found 45% of patients were ready for surgical transition in a patient-centered model vs. 13% of those on WPATH standards. However, further research needs to be done and pilot programs need to be evaluated. And informed consent is not "I want surgery" and BOOM, surgery/hormones are granted. It is a long and detailed discussion of the risks involved vs. the benefits, then asking the patient "after hearing all that, do you still want to do it?"

[Fishman'81]

The TL;DR of the Google doc is this: a tiny percentage of those who experience "transition regret" actually regret it for medical reasons (this is not what they had in mind). Early research is promising: Mt. Sinai found 45% of patients were ready for surgical transition in a patient-centered model vs. 13% of those on WPATH standards. However, further research needs to be done and pilot programs need to be evaluated. And informed consent is not "I want surgery" and BOOM, surgery/hormones are granted. It is a long and detailed discussion of the risks involved vs. the benefits, then asking the patient "after hearing all that, do you still want to do it?"

FWIW, I completely accept the description of your own experience, and I absolutely support you in your journey to getting where you need to be.

What seems to have been lost in the fray here was my original point: simply choosing a gender on a given day, and via what agenda that particular day might obtain, is problematic in a broad social sense... I certainly stand by my assertion that certain cis (yeah, I said that!) men will abuse that privilege on occasion. I'm old enough to have seen that sort of thing many times.

Yet, as I've already stated, you are committed, and not an opportunist. You are walking the walk.

I'm gonna give this thing a rest; some people on this thread will have to look for another pinata. But I certainly wish you happiness.

[BassAle]

Right, but his point is that you can't prove something doesn't work by absence of the thing it's trying to remove.

Think of a filter. You want the filter to remove particles. If it does work, the expectation is they won't be in the water coming out of the filter. However, if you only test the water coming out of the filter, you can't tell if it's working or not. The particles may not exist in the first place. You would need to test the water coming into the filter and coming out.

So in this case, the question is whether those cases of regret did or did not exist BEFORE these rules were in place. I'm guessing that data doesn't exist because the rules have been in place for so long. (I can't actually read the google docs right now since my company blocks all google docs, drives, etc.)

All of that being said, perhaps it's time we remove the rules or pilot their removal. Because if they are effective and helping filter those cases out, perhaps there's a value there. Because it's not like you can just go back - that money is gone. The balance of course is not putting up too many barriers for someone to match their identity to their body. I think it's probably important to have both.

I don't know where to draw that line nor is it my decision. Because how different is this to someone wanting an abortion and forcing them to get a transvaginal ultrasound and look at their baby's face? Which I'm vehemently opposed to. So I'm really of two minds on this.



Edit: I think the bottom line is, they aren't going to let someone go through highly invasive surgery with GA without a need. On the other hand... we have that cat lady. So who knows.

this is exactly what I was getting at.

Do we know how many regrets the current standard of care filters out? Are there so few because those standards are in place? Or are they overburdening?

Research about the causes of the current small number of cases of regret does not tell us anything about the cases of regret that didn’t happen because of the rigorous screening process. We would need control data to compare to.

I think you’re off base on the abortion comparison though. Those laws are pushed by politicians, not doctors. In this case I would guess the current standards have been developed by medical professionals as an attempt to prevent harm to the patient.

[MissThundercat]

41% attempted suicide rate. Hormones/surgery are lifesaving.

Access to mental health care is a problem in our community. Standards say you need letters, but what happens if you can't afford a therapist, or there are no affirming therapists within a 50 mile radius of you (the case for a lot of us in Jesusland)?

Chasing letters is stressful and burdensome and can drive the actual suicide rate up. I have a friend who's been out and on HRT for over 10 years; her letters keep getting rejected by U of M. Informed consent would have meant she'd have had surgery years ago.

The WPATH Standards of Care treats being trans as a pathology (a disease) and the current Standards show you have to prove you're "trans enough" to meet someone else's standards. Also, current standards show you have to have extreme dysphoria to get the HRT; for many of us, it was not dysphoria, but the idea it could be so much better. By WPATH standard, I don't meet the guidelines.

[Kepler]

WPATH Standards of Care 7. These standards were in place to prevent so-called "transition regret," but few people actually regret transition regret. More people reverse their transition due to societal pressure/family maltreatment than anything else.

So it's the usual intimidation, like all the anti-abortion derp.

Can we please just deport the Christians? They basically cause all the problems at this point.

And they'd be so much happier in a theocracy like Iran.

[Fishman'81]

So it's the usual intimidation, like all the anti-abortion derp.

Can we please just deport the Christians? They basically cause all the problems at this point.

And they'd be so much happier in a theocracy like Iran.

Probably my favorite post of yours, although it's a chip-shot.

[BassAle]

41% attempted suicide rate. Hormones/surgery are lifesaving.

Access to mental health care is a problem in our community. Standards say you need letters, but what happens if you can't afford a therapist, or there are no affirming therapists within a 50 mile radius of you (the case for a lot of us in Jesusland)?

Chasing letters is stressful and burdensome and can drive the actual suicide rate up. I have a friend who's been out and on HRT for over 10 years; her letters keep getting rejected by U of M. Informed consent would have meant she'd have had surgery years ago.

The WPATH Standards of Care treats being trans as a pathology (a disease) and the current Standards show you have to prove you're "trans enough" to meet someone else's standards. Also, current standards show you have to have extreme dysphoria to get the HRT; for many of us, it was not dysphoria, but the idea it could be so much better. By WPATH standard, I don't meet the guidelines.

We should live in a world where people get the healthcare they need without regard to the cost. It is unfortunate that money is one of the primary filters preventing people from getting lifesaving treatment, which hormone replacement therapy and confirmation surgery clearly are.

It sounds like the standards need updating, I don’t have the experience or knowledge you do in this regard. However, what I DO know is data. I’ve spent the last 17 years of my life working in a world renowned biomedical research laboratory. A large percentage of my time over the last two years has been collaborating with an investigator studying behavior, and behavior “abnormalities” (including addiction, depression, and ADHD) with the goal of discovering the neurological pathways involved (this is basic, not applied research).

All I can say is that the current ultra low “regret” rates do not prove the current standards are unnecessary. They could work very well, in which case the rates would be higher without them. Or they could be totally overburdening, and the rates would be super low even without them. The truth is probably somewhere in between and you would need a carefully controlled study to determine where the truth likely lies. This is clearly worth studying, because the default will be to err on the side of “caution”, which is currently seen as preventing irreversible harm done by a surgery the patient regrets. In reality, as you well know, there is considerable harm done by placing nearly insurmountable barriers for those that do need the treatment. Unfortunately there is also a bit of covering the surgeons *** — they don’t want to be sued by someone that regrets the surgery or the family of someone that commits suicide after confirmation surgery so they have an incentive to err on the side of excluding too many rather than let one slip through.

TL;DR this needs research and the NIH should fund it.

[dxmnkd316]

TL;DR this needs research and the NIH should fund it.

Good post. But this line sums it up nicely.

[BassAle]

We just brought on a new high school intern, who _really_ wanted to work in the behavioral research group. (In addition to pre-doctoral and post doctoral fellowships, we have a pretty great high school internship program — especially in the summer when in non pandemic times we bring in high school and college undergraduate students from all over the country and put them up in a historic oceanfront mansion that we own).

this student is just coming out as a trans man, and only just beginning this journey. We want to make certain he feels welcomed and safe. I can’t even imagine what it’s like.

[MinnesotaNorthStar]

So it's the usual intimidation, like all the anti-abortion derp.

Can we please just deport the Christians? They basically cause all the problems at this point.

And they'd be so much happier in a theocracy like Iran.

Christianity is simply the excuse they use, the Democratic People's Republic of Korea sounds like a better fit.

[Kepler]

Christianity is simply the excuse they use, the Democratic People's Republic of Korea sounds like a better fit.

Authoritarianism has always fit hand in glove with Christianity, though. It is an especially fecund Petri dish for right wing intolerance and aggression.

[LynahFan]

Authoritarianism has always fit hand in glove with Christianity, though. It is an especially fecund Petri dish for right wing intolerance and aggression.

...wrapped in an impenetrable cloak of self-righteousness that prevents any introspection whatsoever.