The harm that has been done is criminal, and we need accountability. A mental health crisis is happening in this world and there is no age of consent for it to take control. Doctor's oath "To Do No Harm" is meaningless because that is all they are doing to these confused children. Supporting the outcome and not the reason is lunacy. How has this evil cults' lies continued to be supported? What has caused our once rational, educated, and highly respected people in our community to become suddenly irrational and stupid? I just do not understand.
We still need to acknowledge that for some patients these so-called sex change surgeries are largely successful, in that years down the road they are not reporting regret. This is most likely the case for those with lifelong gender dysphoria, not those who have fallen victim to a social craze. These unfortunate people have a mental health disorder, and aren't celebrating their gender confusion, seeking attention or trying redefine biological sex. They are in the category of patients who were once diagnosed as "transsexuals," and the idea of surgically modifying their bodies isn't new. Such surgeries have been performed over the last 100 years, and in these older patients with long term dysphoria, surgical intervention is much more likely to produce the desired outcome. Of course no one can actually change their sex, so these are cosmetic alterations, and these patients understand that. Whether insurance should cover all, if any, of the cost is another question. I assume that most of us here wouldn't be in favor of it.
We were not able as a society in our expert, professional, doctorial, ranks to just say No. That men cannot be women and women cannot be men, they all lied, and even some parents bought into it as the experts said it was possible. Look at us now, look at these kids now. Sane people knew cross sex hormones and surgeries used to become the opposite sex of what you are would obviously be a total disaster, here we are. These Gods to these people, these experts, well of course cannot be wrong, so, course correction is going to be an absolute mess.
Meanwhile my daughter is beared and breastless, teaching children in Colorado. Jesus please protect those children and everyone around her as she spreads these satanic lies.
Psychologically and morally healthy societies do not permit its members to mutilate and sterilize each other in the name of good intentions or "individual rights". Certainly not for profit, and especially not when it's facilitating the impersonation of the opposite sex out in society. Being permissive about it seemed like the right call. Our modern biotech made it (somewhat) possible, and we're all about "individual rights", tolerating antisocial deviancy, and soothing suffering these days. We have since learned that it was not the right call, there are too many unintended consequences, and it simply cannot be allowed to continue.
Thank-you for this excellent essay and links to studies. I agree that confused adults deserve proper psychotherapy for gender confusion and hatred of their bodies.
I think gender confusion is actually a myth, perpetrated by social media and trans activists, who have in turn captured teachers, those in higher education and college campuses, so-called medical professionals who should know better, certain churches and millions of regular people in the be-kind movement. These confused adults deserve better. My adult “non-binary” daughter deserves better.
I don’t think it’s a coincidence that the Pritzker family has donated hundreds of millions of dollars in the last 13 years or so to universities and medical institutions specifically to push gender ideology. They went along for the money, and the Pritzker family did it to affirm their own agenda. I would be curious to know how many of our children were groomed either in college or in a therapist’s office.
Thank you for this excellent compilation of studies: transition is not good, evidence-based or ethical healthcare at *any* age.
To the admirable warriors at Genspect, DIAG, Do No Harm, etc, a sincere thank you for all you do, but please, please, put this succinct message out there more prominently.
I think the language was a very intentional part of pushing this agenda . What this actually is ;elective non -medically necessary castration , mastectomies , plastic surgeries & drugs being prescribed off-label in a dangerous and reckless way .
Absolutely correct. I'm glad to see that more people seem to be seeing this now rather than defending transgenderism for adults in an attempt to appear "reasonable".
But it IS reasonable to acknowledge a mental health diagnosis that has existed over the decades, and is not related to the transgender craze. It is also important to distinguish between adults and children in assessing the right to consent to any medical procedure. We can't lump all gender-confused people into one category. The reality is more nuanced than that.
This isn't a medical procedure, any more than cutting off healthy arms or legs is a medical procedure. We don't allow people to consent to that, and we shouldn't. It's not about age, it's about "what is the human body and the human being designed for?" If you can't answer that question correctly, you don't have a foundation to determine what is and isn't right to do to a human body. Attempting to change sex, or gender, or whatever you may call it, goes against reality itself, therefore it isn't good for anyone.
We are talking about surgeries and hormonal treatments that are controversial, for sure, but who are you to say they should be banned? I personally know someone who did benefit from gender surgeries, and I would NEVER say that shouldn't have been an option for her. I do get your point about healthy body parts, and in the case of an arm or leg it would be difficult for anyone to function without them. But the human body is designed for more than one purpose, and the reproductive parts aren't essential for basic body function. Women who cut off their breasts (much as I find the idea abhorrent), aren't making their bodies dysfunctional, and what they do with their boobs isn't my business. It isn't your business either.
Who am I? I'm no one, but I seek to understand and speak truth. I don't think your friend did benefit from his surgery, in the true sense. He may "feel" happier, perhaps, but he didn't benefit because benefit comes from truth. He was further affirmed in his delusion; he was not helped.
As for reproductive parts, human beings are not disjointed collections of pieces. We're a whole. You cannot harm a part without harming the whole. Certainly, you don't need your reproductive organs to live, but they are central to who we are as people. I believe that God created us in his image, and an integral part of that is that he created us male and female. You don't seem to believe that, which is fine, but that's why, if you pardon me being blunt, you can't understand the weight of this.
Women who cut off their breasts are very much making their bodies dysfunctional. They cannot feed a baby, to name just one thing.
It is definitely my business, because this is a sickness that is plaguing our society. The people who fall for it are the victims of lies. They are not helped by us saying nothing. I see so many confused, lost young people trapped in this because they are told it's fine. It's not. Many detransitioners are out there speaking to the horrible harms that were done to them, including those who had their procedures as adults.
You are no one to be telling others what to believe or how to live their lives. Yes, of course it's best if patients can learn to accept their biological sex, but sometimes they don't, which is why my friend most certainly did benefit from surgery. I am referring to a mental illness here, one that has been recognized since the beginning of psychiatry. I'm not talking about the ROGD cases involving those who have been caught up in the current transgender craze. For these patients with long term gender dysphoria, the treatment may involve making physical changes to the body to help the individual "pass" as the opposite sex. As I've said, this kind of treatment has been going on over the last century, and it is controversial. But it isn't for you or anyone else to decide how these patients should be treated.
"You are no one to be telling others what to believe or how to live their lives." But you are?
Agreed that it's a mental illness (really, a spiritual sickness), which is precisely why the treatment should not be to mutilate bodies to affirm it.
"But it isn't for you or anyone else to decide how these patients should be treated." -excluding yourself, and those who agree that they should get cross-sex hormones and surgery, it appears.
I agree with the general line of ethical reasoning in this article and think we should continue to talk about the upper age limit for "gender" medicalization procedures. There are a couple of technical issues with the authors' comments on research design and statistics.
It is possible to conduct "double blind" research when we are handing the research participants a pill, but pills or injections that have early effects or side effects will tell the user that they are taking the treatment, not the placebo. In that case, they and their assigned investigators are no longer "blinded." An example of how this can happen is with SSRI drugs for treatment of depression. Drug companies can claim that they used a double blinded research design, but these drugs have significant side effects for a substantial percentage of people who take them, and the side effects are apparent immediately. In the case of testosterone injections, women's bodies start to show the effects soon after initiating treatment, and if the dosage is high enough, masculinization can develop within a couple of months.
Most medical research includes control (comparison) groups but is not blinded. An example is research on treatments for breast cancer. Participants might be randomly assigned to a radiation group, a chemotherapy group and a surgery only group, then are told which one before they receive the treatment. In a lot of medical research it is not ethical to use a control group to rule out placebo effects (like an inert pill in drug testing), if the participants in the study have a condition that needs active treatment. "Treatment as usual" rather than a no-treatment control group is often used as the standard of comparison for an experimental treatment.
A second issue is that we actually do not know yet if GAC or any kind of social or medical transition increases risk of suicide for people who are "trans identified" or struggling with gender distress. We do have evidence in the articles listed by the authors that medical transition procedures do not prevent suicide with 100 per cent effectiveness in that population. We do not, however, know if the suicide rate would have been even higher if the people being studied had not transitioned.
"From 107 583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery. "
Gender-affirming surgery.. is associated with increased risk of mental health issues.
Thank you for offering this link. I have read the abstract previously but have not read the full text version of the article. I think this is a valuable study, which tells us that, on the average, people who have undergone "gender surgeries" have higher risk than control groups of reporting the mental health symptoms they list.
The main weakness with this type of research, although it is worth doing, is that we do not have random assignment of patients into the surgery versus non-surgery groups. The problem here is that people who undergo surgery versus some kind of conservative treatment or none at all may differ from each other prior to the treatments, and those differences may influence what treatments they receive. For example, patients who are referred for spine surgery tend to have more severe symptoms and/or anatomical problems than those who are referred to less invasive treatments. In addition, surgeons vary in how conservative they are in their individual practices. The latter problem is less of an issue in studies that include large numbers of surgeons, like the one above, but the size of study does not correct for lack of random assignment of patients to surgery versus other treatments.
An additional problem with much of the "gender" research is that the authors often tell us that patients in the treatment group were matched (compared with) other people based on "gender." In some studies this turns out to mean that males who identify as girls or women are matched with girls and women rather than boys and men. The investigators should match members of the treatment groups with same sex people and make it clear that this was their methodology. This is critical when researching mental health issues because many psychiatric diagnoses are sex-linked. Suicide is very strongly sex linked, with males generally being more likely than females to actually try to kill themselves and to be successful. Females are much more likely than males generally to exhibit "suicidality," including talk about suicide, claiming histories of "suicide attempts" that often times required no need for medical treatment, and engaging in non-lethal self harm with various levels of suicidal intent. Again, I don't know to what extent the investigators in the study you linked took these sex differences into account.
To be clear about my own position, I think it is entirely possible that young people and/or adults may develop more mental health problems after "gender" surgeries, either because the surgeries were not effective in alleviating their pre-existing mental disorders, because the surgeries made them worse, or because the disorders became worse in the treated population for reasons unrelated to the surgeries.
The problem with the identity issue is that academics incline to accept the self designation in the first place. Nonetheless, given this disadvantage, the study still concludes: "From 107 583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery." That's incredibly disturbing, given the claim that gender medicine is "life saving."
Indeed, studies of this type have shown quite clearly that "gender surgery" is not a panacea that prevents suicide in higher risk groups. It is ridiculous for "gender" clinicians to claim that it does. Surgery is not an appropriate treatment for any mental health condition, although cosmetic surgeries do provide at least a temporary improvement in peoples' self-image if the outcome is what the patient wanted. In the case of people who seek "gender surgeries," however, the pre-existing mental health issues are likely to be related to factors other than how the person looks.
To obtain informed consent for GAC or any alternative approach to medicalization, people should be told that puberty blockers, hormones, and/or surgeries will probably not lead to improvement in any mental health problem they have, with the possible exception of "gender dysphoria" specifically. They should also be told, especially male patients, that the odds of them finding a romantic partner will be reduced if they medically transition, which is a major factor in most peoples' life satisfaction.
The authors did not define what is meant by "gender," so I don't know if they are talking about biological sex. Even when the term "sex" is used, the researchers often use it in the same way they use "gender," i.e., referring to the patients' self image.
Again, the main problem is that there is probably not random assignment of patients to cohorts. Random assignment usually requires that it was planned prior to doing any treatments, and the study we are discussing is a retroactive chart review. We do not know if there were differences to begin with between people who had surgery and those who did not. For example, people who push for surgery might be more mentally disturbed than those who do not.
Much of the pro-gender medicine research relies on surveys completed while patients are still experiencing a placebo effect in the "honeymoon" phase following surgery.
The strength of the study is that it does not rely on recollection or bias but sorts individuals according to their medical diagnosis and presumably the gender designation in their records for placing in cohort categories.
Another strength of the study is that it follows patients for a decade. Many studies look only at the immediate aftermath of surgery or a few months. In order to achieve the longer perspective needed to determine actual outcomes, the researchers pulled national data from TriNetX database, which contains data from over 100 million patients, looking at clinical outcomes for age 18 and older Americans (adults, as under consideration in this Pitt article.
Their definition of gender relied on the International Classification of Diseases, Tenth Revision [ICD-10] F64). The findings, based on diagnosis, show that-- contrary to the claim that gender medicine prevents mental health issues leading to suicide, patients' mental health is not improved. Using that guidance, though not perfect, provided internal consistency following the actual treatments carried out in order to assess long-term surgical outcomes. "By leveraging ICD-10 codes, we provide a more accurate representation of patient demographics and clinical outcomes, minimizing recall and reporting biases that often limit survey-based research." Other gold standard long-term research reaches similar conclusions.
I have not been successful in purchasing this article from the publisher. It looks like it requires ordering by a library, if one is not a member of a professional or institutional group on the publisher's list. I might still try to order it through a library, but will probably wait a while and see if anybody else reviews it. Thanks again, Faith for bringing it to my attention.
Thanks Faith, for your careful attention to the research and for your dialogue with me about this particular piece of it. I will look through my downloads and see if I already purchased this article, otherwise I will do so and will get back to you.
I appreciate your perspective on the technical challenges of the research and statistics. But without clear and concise evidence that doctors are a) not doing harm merely for profit and b) that the (faulty) claims they hide behind to justify their actions are rigorously tested and proven accurate, they are merely conducting an experiment on humanity, often targeting neurodivergent individuals at a disproportional rate. The first precept of medicine should be the divining rod that guides their trajectory: “first, do no harm.” Anything less is ideologically driven, not scientifically sound.
I completely agree with your statement. I also will continue to point out errors in peoples' interpretations of research results, in a good faith effort to differentiate truth from misunderstandings and biases in stated conclusions. I happen to have some training in research design whereas most people have not, and feel a responsibility to offer an informed opinion.
With that kind of experience, you could write something much more powerfully concise than I have here. And I truly hope you do. It can be very confusing to a layperson to sort and navigate data like this. And that’s what most parents are up against. It’s easy for a professional to present a biased opinion and support it with faulty research as though it were far more thorough or accurate than it truly is. What is that quote… “statistics don’t lie, but liars use statistics…” Something like that. It’s easy to manipulate the data when others don’t know how to sort it out for themselves. Thank you for the feedback and critique. I truly appreciate it.
Colin Wright, Leor Sapir, and others have written about the defects in the outcome research on "gender affirmative care" with respect to suicide rates. Hilary Cass in the UK and Riittakerttu Kaltiala of Finland have offered opinions that "trans" identified adolescents commit suicide at higher rates than same aged kids in the general population, but also said that these children in their national health services have multiple mental disorders with known elevated suicide rates. The little data that we have suggests that kids identified as "gender" patients may have suicide rates that are 5-7 times higher than the rates of same aged peers in the general population, which could be accounted for by their comorbid mental disorders, such as depression and autism. We do not have any good data that clarifies whether "trans" identification alone is associated with elevated suicide rates before or after any kind of treatment.
We have no reliable data that shows a decline in completed suicides in "trans" identified people following any aspect of "gender affirmative care."
I’m so glad you mentioned young adults and adults.
There are so many who were brainwashed in HS & college with COVID isolation exacerbating the issue. We need to reach & teach those individuals. They need competent, healing therapy. They seriously need de-programming.
I am so angry that despite all this mountain of evidence and huge numbers of mutilated kids and adults, no one has successfully been able to sue any of these fucking clinics and doctors. Most of them continue profiting from this madness, completely unbothered and undeterred.
I woke up seriously angry this morning as well...and my son is no longer caught up in it (after 4 years or so of injections). I hate that 'f' word but really appreciate it in this context! But I do believe their day of reckoning is coming....I'm just having a hard time waiting, because although my son has stopped the hormones he is still poisoning his body with other things that aren't much better for him. The devil is real!
I’m sorry, and I completely understand. It’s frustrating how slowly justice moves, and it’s difficult to watch someone you love poison themselves, even if it’s only a little bit at a time.
I think you're right, AFT, but so heartbroken for the many young adults (including two of my own children) that have already been caught up in this and made irreversible "medical" changes.
I hear you. And I’m so sorry. I know how much it hurts. But I have to believe that God has plans to use our children’s suffering for a greater good that we can’t yet see or comprehend. They are not their bodies, and this life is just a temporal experience.
I totally agree with you....and you know my son stopped the whole trans thing about a year ago now, and I thought things would be better, and they are because at least he's no longer believing that lie, but he still does not work, he vapes and drinks sodas all day (that we buy for him to avoid the backlash if we didn't). It's just ALL WRONG! I KNOW that we are soon going to witness the hand of God move like He has never moved before...it's just really hard continuing to do things I feel I shouldn't but doing them because I fear the outcome if I didn't. :(
This may be an unpopular opinion, but perhaps you might encourage him to consume more natural versions of those substances. Start with Hansen’s natural soda, and move towards homemade second brew (bottled/carbonated by fermentation) kombucha or ginger beer made with a fermented ginger bug. I bottle both and they are very carbonated, even more than soda, and very satisfying as a soda replacement. (I haven’t had soda in years and I used to drink it daily, too!) And if he wants cannabis, it would be better to buy a dry herb vaporizer and consume the flower that way rather than as an oil. Some cartridges have been found to contain a number of contaminates, including fentanyl, as well as heavy metals. Alternatively, a sublingual tincture made from whole flowers is a more healthful alternative. I don’t want to assume too much, but he is likely medicating the suffering in his mind in denial of what he’s done to himself. And that may help him to face it and integrate his shadow with his conscious mind in time, but it won’t be helpful if he gives himself cancer. Thank God he isn’t medicalizing anymore! That’s a huge win!!!
It's mind boggling that the cross sex sterilizing hormones prescribed to my vulnerble son with autistic traits at 19 on his first visit to Planned Parenthood is not worthy of criminal prosecution. In four years, he has deteriorated mentally and physically. No one at any age should be harmed by unethical damaging drugs and barbaric surgeries.
Same. The UK doctors prescribed testosterone to my 19 year old daughter (with high-functioning ADHD & autistic traits) on her very first visit to the gender clinic. She is now nearly 21 and is a very long way away from home studying at college.🥲. Dear God, please help us all. 🙏.
The harm that has been done is criminal, and we need accountability. A mental health crisis is happening in this world and there is no age of consent for it to take control. Doctor's oath "To Do No Harm" is meaningless because that is all they are doing to these confused children. Supporting the outcome and not the reason is lunacy. How has this evil cults' lies continued to be supported? What has caused our once rational, educated, and highly respected people in our community to become suddenly irrational and stupid? I just do not understand.
We still need to acknowledge that for some patients these so-called sex change surgeries are largely successful, in that years down the road they are not reporting regret. This is most likely the case for those with lifelong gender dysphoria, not those who have fallen victim to a social craze. These unfortunate people have a mental health disorder, and aren't celebrating their gender confusion, seeking attention or trying redefine biological sex. They are in the category of patients who were once diagnosed as "transsexuals," and the idea of surgically modifying their bodies isn't new. Such surgeries have been performed over the last 100 years, and in these older patients with long term dysphoria, surgical intervention is much more likely to produce the desired outcome. Of course no one can actually change their sex, so these are cosmetic alterations, and these patients understand that. Whether insurance should cover all, if any, of the cost is another question. I assume that most of us here wouldn't be in favor of it.
We were not able as a society in our expert, professional, doctorial, ranks to just say No. That men cannot be women and women cannot be men, they all lied, and even some parents bought into it as the experts said it was possible. Look at us now, look at these kids now. Sane people knew cross sex hormones and surgeries used to become the opposite sex of what you are would obviously be a total disaster, here we are. These Gods to these people, these experts, well of course cannot be wrong, so, course correction is going to be an absolute mess.
Meanwhile my daughter is beared and breastless, teaching children in Colorado. Jesus please protect those children and everyone around her as she spreads these satanic lies.
🥲🙏
Psychologically and morally healthy societies do not permit its members to mutilate and sterilize each other in the name of good intentions or "individual rights". Certainly not for profit, and especially not when it's facilitating the impersonation of the opposite sex out in society. Being permissive about it seemed like the right call. Our modern biotech made it (somewhat) possible, and we're all about "individual rights", tolerating antisocial deviancy, and soothing suffering these days. We have since learned that it was not the right call, there are too many unintended consequences, and it simply cannot be allowed to continue.
Thank-you for this excellent essay and links to studies. I agree that confused adults deserve proper psychotherapy for gender confusion and hatred of their bodies.
I think gender confusion is actually a myth, perpetrated by social media and trans activists, who have in turn captured teachers, those in higher education and college campuses, so-called medical professionals who should know better, certain churches and millions of regular people in the be-kind movement. These confused adults deserve better. My adult “non-binary” daughter deserves better.
A myth? Gender confusion isn't a myth. The question is what is causing the confusion.
I don’t think it’s a coincidence that the Pritzker family has donated hundreds of millions of dollars in the last 13 years or so to universities and medical institutions specifically to push gender ideology. They went along for the money, and the Pritzker family did it to affirm their own agenda. I would be curious to know how many of our children were groomed either in college or in a therapist’s office.
🥲
Yes, here is one of the beneficiaries of the Pritzker agenda. Sickening.
https://www.uvic.ca/research/transchair/support/JP/index.php
Yes. This.
Thank you for this excellent compilation of studies: transition is not good, evidence-based or ethical healthcare at *any* age.
To the admirable warriors at Genspect, DIAG, Do No Harm, etc, a sincere thank you for all you do, but please, please, put this succinct message out there more prominently.
Thanks for this well-argued, well-cited piece. I've saved it in my bookmarks and subscribed to your Substack.
Thank you, Jenny. I appreciate the support. ❤️
I think the language was a very intentional part of pushing this agenda . What this actually is ;elective non -medically necessary castration , mastectomies , plastic surgeries & drugs being prescribed off-label in a dangerous and reckless way .
🥲
Absolutely correct. I'm glad to see that more people seem to be seeing this now rather than defending transgenderism for adults in an attempt to appear "reasonable".
But it IS reasonable to acknowledge a mental health diagnosis that has existed over the decades, and is not related to the transgender craze. It is also important to distinguish between adults and children in assessing the right to consent to any medical procedure. We can't lump all gender-confused people into one category. The reality is more nuanced than that.
This isn't a medical procedure, any more than cutting off healthy arms or legs is a medical procedure. We don't allow people to consent to that, and we shouldn't. It's not about age, it's about "what is the human body and the human being designed for?" If you can't answer that question correctly, you don't have a foundation to determine what is and isn't right to do to a human body. Attempting to change sex, or gender, or whatever you may call it, goes against reality itself, therefore it isn't good for anyone.
We are talking about surgeries and hormonal treatments that are controversial, for sure, but who are you to say they should be banned? I personally know someone who did benefit from gender surgeries, and I would NEVER say that shouldn't have been an option for her. I do get your point about healthy body parts, and in the case of an arm or leg it would be difficult for anyone to function without them. But the human body is designed for more than one purpose, and the reproductive parts aren't essential for basic body function. Women who cut off their breasts (much as I find the idea abhorrent), aren't making their bodies dysfunctional, and what they do with their boobs isn't my business. It isn't your business either.
Who am I? I'm no one, but I seek to understand and speak truth. I don't think your friend did benefit from his surgery, in the true sense. He may "feel" happier, perhaps, but he didn't benefit because benefit comes from truth. He was further affirmed in his delusion; he was not helped.
As for reproductive parts, human beings are not disjointed collections of pieces. We're a whole. You cannot harm a part without harming the whole. Certainly, you don't need your reproductive organs to live, but they are central to who we are as people. I believe that God created us in his image, and an integral part of that is that he created us male and female. You don't seem to believe that, which is fine, but that's why, if you pardon me being blunt, you can't understand the weight of this.
Women who cut off their breasts are very much making their bodies dysfunctional. They cannot feed a baby, to name just one thing.
It is definitely my business, because this is a sickness that is plaguing our society. The people who fall for it are the victims of lies. They are not helped by us saying nothing. I see so many confused, lost young people trapped in this because they are told it's fine. It's not. Many detransitioners are out there speaking to the horrible harms that were done to them, including those who had their procedures as adults.
You are no one to be telling others what to believe or how to live their lives. Yes, of course it's best if patients can learn to accept their biological sex, but sometimes they don't, which is why my friend most certainly did benefit from surgery. I am referring to a mental illness here, one that has been recognized since the beginning of psychiatry. I'm not talking about the ROGD cases involving those who have been caught up in the current transgender craze. For these patients with long term gender dysphoria, the treatment may involve making physical changes to the body to help the individual "pass" as the opposite sex. As I've said, this kind of treatment has been going on over the last century, and it is controversial. But it isn't for you or anyone else to decide how these patients should be treated.
"You are no one to be telling others what to believe or how to live their lives." But you are?
Agreed that it's a mental illness (really, a spiritual sickness), which is precisely why the treatment should not be to mutilate bodies to affirm it.
"But it isn't for you or anyone else to decide how these patients should be treated." -excluding yourself, and those who agree that they should get cross-sex hormones and surgery, it appears.
I agree with the general line of ethical reasoning in this article and think we should continue to talk about the upper age limit for "gender" medicalization procedures. There are a couple of technical issues with the authors' comments on research design and statistics.
It is possible to conduct "double blind" research when we are handing the research participants a pill, but pills or injections that have early effects or side effects will tell the user that they are taking the treatment, not the placebo. In that case, they and their assigned investigators are no longer "blinded." An example of how this can happen is with SSRI drugs for treatment of depression. Drug companies can claim that they used a double blinded research design, but these drugs have significant side effects for a substantial percentage of people who take them, and the side effects are apparent immediately. In the case of testosterone injections, women's bodies start to show the effects soon after initiating treatment, and if the dosage is high enough, masculinization can develop within a couple of months.
Most medical research includes control (comparison) groups but is not blinded. An example is research on treatments for breast cancer. Participants might be randomly assigned to a radiation group, a chemotherapy group and a surgery only group, then are told which one before they receive the treatment. In a lot of medical research it is not ethical to use a control group to rule out placebo effects (like an inert pill in drug testing), if the participants in the study have a condition that needs active treatment. "Treatment as usual" rather than a no-treatment control group is often used as the standard of comparison for an experimental treatment.
A second issue is that we actually do not know yet if GAC or any kind of social or medical transition increases risk of suicide for people who are "trans identified" or struggling with gender distress. We do have evidence in the articles listed by the authors that medical transition procedures do not prevent suicide with 100 per cent effectiveness in that population. We do not, however, know if the suicide rate would have been even higher if the people being studied had not transitioned.
Gender Surgery Increases Suicide Rates April 2025
From the Study Conclusion:
"From 107 583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery. "
Gender-affirming surgery.. is associated with increased risk of mental health issues.
https://academic.oup.com/jsm/article-abstract/22/4/645/8042063?login=false
Thank you for offering this link. I have read the abstract previously but have not read the full text version of the article. I think this is a valuable study, which tells us that, on the average, people who have undergone "gender surgeries" have higher risk than control groups of reporting the mental health symptoms they list.
The main weakness with this type of research, although it is worth doing, is that we do not have random assignment of patients into the surgery versus non-surgery groups. The problem here is that people who undergo surgery versus some kind of conservative treatment or none at all may differ from each other prior to the treatments, and those differences may influence what treatments they receive. For example, patients who are referred for spine surgery tend to have more severe symptoms and/or anatomical problems than those who are referred to less invasive treatments. In addition, surgeons vary in how conservative they are in their individual practices. The latter problem is less of an issue in studies that include large numbers of surgeons, like the one above, but the size of study does not correct for lack of random assignment of patients to surgery versus other treatments.
An additional problem with much of the "gender" research is that the authors often tell us that patients in the treatment group were matched (compared with) other people based on "gender." In some studies this turns out to mean that males who identify as girls or women are matched with girls and women rather than boys and men. The investigators should match members of the treatment groups with same sex people and make it clear that this was their methodology. This is critical when researching mental health issues because many psychiatric diagnoses are sex-linked. Suicide is very strongly sex linked, with males generally being more likely than females to actually try to kill themselves and to be successful. Females are much more likely than males generally to exhibit "suicidality," including talk about suicide, claiming histories of "suicide attempts" that often times required no need for medical treatment, and engaging in non-lethal self harm with various levels of suicidal intent. Again, I don't know to what extent the investigators in the study you linked took these sex differences into account.
To be clear about my own position, I think it is entirely possible that young people and/or adults may develop more mental health problems after "gender" surgeries, either because the surgeries were not effective in alleviating their pre-existing mental disorders, because the surgeries made them worse, or because the disorders became worse in the treated population for reasons unrelated to the surgeries.
The problem with the identity issue is that academics incline to accept the self designation in the first place. Nonetheless, given this disadvantage, the study still concludes: "From 107 583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery." That's incredibly disturbing, given the claim that gender medicine is "life saving."
Indeed, studies of this type have shown quite clearly that "gender surgery" is not a panacea that prevents suicide in higher risk groups. It is ridiculous for "gender" clinicians to claim that it does. Surgery is not an appropriate treatment for any mental health condition, although cosmetic surgeries do provide at least a temporary improvement in peoples' self-image if the outcome is what the patient wanted. In the case of people who seek "gender surgeries," however, the pre-existing mental health issues are likely to be related to factors other than how the person looks.
To obtain informed consent for GAC or any alternative approach to medicalization, people should be told that puberty blockers, hormones, and/or surgeries will probably not lead to improvement in any mental health problem they have, with the possible exception of "gender dysphoria" specifically. They should also be told, especially male patients, that the odds of them finding a romantic partner will be reduced if they medically transition, which is a major factor in most peoples' life satisfaction.
"Cohorts A-D included patients with or without surgery, and Cohorts E-F allowed for gender comparison among those with surgery.
The authors did not define what is meant by "gender," so I don't know if they are talking about biological sex. Even when the term "sex" is used, the researchers often use it in the same way they use "gender," i.e., referring to the patients' self image.
Again, the main problem is that there is probably not random assignment of patients to cohorts. Random assignment usually requires that it was planned prior to doing any treatments, and the study we are discussing is a retroactive chart review. We do not know if there were differences to begin with between people who had surgery and those who did not. For example, people who push for surgery might be more mentally disturbed than those who do not.
Much of the pro-gender medicine research relies on surveys completed while patients are still experiencing a placebo effect in the "honeymoon" phase following surgery.
The strength of the study is that it does not rely on recollection or bias but sorts individuals according to their medical diagnosis and presumably the gender designation in their records for placing in cohort categories.
Another strength of the study is that it follows patients for a decade. Many studies look only at the immediate aftermath of surgery or a few months. In order to achieve the longer perspective needed to determine actual outcomes, the researchers pulled national data from TriNetX database, which contains data from over 100 million patients, looking at clinical outcomes for age 18 and older Americans (adults, as under consideration in this Pitt article.
Their definition of gender relied on the International Classification of Diseases, Tenth Revision [ICD-10] F64). The findings, based on diagnosis, show that-- contrary to the claim that gender medicine prevents mental health issues leading to suicide, patients' mental health is not improved. Using that guidance, though not perfect, provided internal consistency following the actual treatments carried out in order to assess long-term surgical outcomes. "By leveraging ICD-10 codes, we provide a more accurate representation of patient demographics and clinical outcomes, minimizing recall and reporting biases that often limit survey-based research." Other gold standard long-term research reaches similar conclusions.
I have not been successful in purchasing this article from the publisher. It looks like it requires ordering by a library, if one is not a member of a professional or institutional group on the publisher's list. I might still try to order it through a library, but will probably wait a while and see if anybody else reviews it. Thanks again, Faith for bringing it to my attention.
Thanks Faith, for your careful attention to the research and for your dialogue with me about this particular piece of it. I will look through my downloads and see if I already purchased this article, otherwise I will do so and will get back to you.
I appreciate your perspective on the technical challenges of the research and statistics. But without clear and concise evidence that doctors are a) not doing harm merely for profit and b) that the (faulty) claims they hide behind to justify their actions are rigorously tested and proven accurate, they are merely conducting an experiment on humanity, often targeting neurodivergent individuals at a disproportional rate. The first precept of medicine should be the divining rod that guides their trajectory: “first, do no harm.” Anything less is ideologically driven, not scientifically sound.
I completely agree with your statement. I also will continue to point out errors in peoples' interpretations of research results, in a good faith effort to differentiate truth from misunderstandings and biases in stated conclusions. I happen to have some training in research design whereas most people have not, and feel a responsibility to offer an informed opinion.
With that kind of experience, you could write something much more powerfully concise than I have here. And I truly hope you do. It can be very confusing to a layperson to sort and navigate data like this. And that’s what most parents are up against. It’s easy for a professional to present a biased opinion and support it with faulty research as though it were far more thorough or accurate than it truly is. What is that quote… “statistics don’t lie, but liars use statistics…” Something like that. It’s easy to manipulate the data when others don’t know how to sort it out for themselves. Thank you for the feedback and critique. I truly appreciate it.
I'm sorry I didn't respond to this post sooner.
Colin Wright, Leor Sapir, and others have written about the defects in the outcome research on "gender affirmative care" with respect to suicide rates. Hilary Cass in the UK and Riittakerttu Kaltiala of Finland have offered opinions that "trans" identified adolescents commit suicide at higher rates than same aged kids in the general population, but also said that these children in their national health services have multiple mental disorders with known elevated suicide rates. The little data that we have suggests that kids identified as "gender" patients may have suicide rates that are 5-7 times higher than the rates of same aged peers in the general population, which could be accounted for by their comorbid mental disorders, such as depression and autism. We do not have any good data that clarifies whether "trans" identification alone is associated with elevated suicide rates before or after any kind of treatment.
We have no reliable data that shows a decline in completed suicides in "trans" identified people following any aspect of "gender affirmative care."
I’m so glad you mentioned young adults and adults.
There are so many who were brainwashed in HS & college with COVID isolation exacerbating the issue. We need to reach & teach those individuals. They need competent, healing therapy. They seriously need de-programming.
Exactly. My daughter’s ‘trans pains’ nightmare started during Covid isolation… 🥲
I am so angry that despite all this mountain of evidence and huge numbers of mutilated kids and adults, no one has successfully been able to sue any of these fucking clinics and doctors. Most of them continue profiting from this madness, completely unbothered and undeterred.
I woke up seriously angry this morning as well...and my son is no longer caught up in it (after 4 years or so of injections). I hate that 'f' word but really appreciate it in this context! But I do believe their day of reckoning is coming....I'm just having a hard time waiting, because although my son has stopped the hormones he is still poisoning his body with other things that aren't much better for him. The devil is real!
I’m sorry, and I completely understand. It’s frustrating how slowly justice moves, and it’s difficult to watch someone you love poison themselves, even if it’s only a little bit at a time.
Their day of reckoning is coming. Don’t lose faith, it will happen.
🙏🙏🙏
I think you're right, AFT, but so heartbroken for the many young adults (including two of my own children) that have already been caught up in this and made irreversible "medical" changes.
🥲🙏
I hear you. And I’m so sorry. I know how much it hurts. But I have to believe that God has plans to use our children’s suffering for a greater good that we can’t yet see or comprehend. They are not their bodies, and this life is just a temporal experience.
I totally agree with you....and you know my son stopped the whole trans thing about a year ago now, and I thought things would be better, and they are because at least he's no longer believing that lie, but he still does not work, he vapes and drinks sodas all day (that we buy for him to avoid the backlash if we didn't). It's just ALL WRONG! I KNOW that we are soon going to witness the hand of God move like He has never moved before...it's just really hard continuing to do things I feel I shouldn't but doing them because I fear the outcome if I didn't. :(
This may be an unpopular opinion, but perhaps you might encourage him to consume more natural versions of those substances. Start with Hansen’s natural soda, and move towards homemade second brew (bottled/carbonated by fermentation) kombucha or ginger beer made with a fermented ginger bug. I bottle both and they are very carbonated, even more than soda, and very satisfying as a soda replacement. (I haven’t had soda in years and I used to drink it daily, too!) And if he wants cannabis, it would be better to buy a dry herb vaporizer and consume the flower that way rather than as an oil. Some cartridges have been found to contain a number of contaminates, including fentanyl, as well as heavy metals. Alternatively, a sublingual tincture made from whole flowers is a more healthful alternative. I don’t want to assume too much, but he is likely medicating the suffering in his mind in denial of what he’s done to himself. And that may help him to face it and integrate his shadow with his conscious mind in time, but it won’t be helpful if he gives himself cancer. Thank God he isn’t medicalizing anymore! That’s a huge win!!!
kombucha has many benefits besides, as it's fermented
Exactly: "Medical ethics and scientific standards don’t expire on one’s 18th birthday." Thank you for this article.
It's mind boggling that the cross sex sterilizing hormones prescribed to my vulnerble son with autistic traits at 19 on his first visit to Planned Parenthood is not worthy of criminal prosecution. In four years, he has deteriorated mentally and physically. No one at any age should be harmed by unethical damaging drugs and barbaric surgeries.
Same. The UK doctors prescribed testosterone to my 19 year old daughter (with high-functioning ADHD & autistic traits) on her very first visit to the gender clinic. She is now nearly 21 and is a very long way away from home studying at college.🥲. Dear God, please help us all. 🙏.