Friday, April 26, 2019

Transgender health

Nature has an article about a larger than usual European study on the on-going health and effects of transgender treatment.   It certainly supports the criticism that hormonal treatments have been readily offered without knowing the long term consequences.   Look at this, for example:
In 2017, the NIH launched a prospective study of 400 transgender adolescents. It will be the first study to examine the effects of drugs that block puberty until a teenager’s body and mind is mature enough to begin cross-sex hormone treatment.

Questions of how — and when — to allow transgender youth to transition medically and socially are among the stickiest in the field.
I hadn't heard of this surprising figure before, either:
Mental health tends to rank highly among health concerns, along with HIV. According to some studies, 25% of transgender women and 56% of African American transgender women in the United States are living with HIV, although this estimate could be high because it is based on people seeking treatment.
This is such a complicated area....

12 comments:

not trampis said...

well knock me over with a feather. A person who is a male but thinks they are a female ( or vica versa) have mental health problems.

I am tonally shocked

TimT said...

I am not quite sure what 'tonally shocked' means but perhaps it's what happens when you listen to too much death metal...? ;)

Mayan said...

Well, if a group of people are pushed to the margins of society, vilified in countless newspapers and blogs, and treated badly, then this is exactly what is likely to happen. Of course, to the conservative mind, watching poor outcomes due to the consequences of knuckle-dragging conservative ideology, is reason to double down on the knuckled dragging.

Still, what the literature is clear on is that outcomes are better when people can live their lives as they see fit, even if not perfect. Arguing that people should be stopped from doing that is akin to arguing against seat belts, because people still experience harm from car crashes despite wearing seatbelts. Perhaps more accurately, one could specify crashes caused by other parties driving while drunk, after which the drunkards screech abuse at the injured parties, and demand that they be stopped from wearing seatbelts because they have been injured ... largely because of drunk drivers.

Steve said...

Mayan, I am somewhat interested in your take on a point I've made before: accepting that there have always been some transgender folk around, they did often have ways of stoically dealing with it either with or without the consent or knowledge of society more broadly. Such as women who secretly lived as a man, or those other societies that accepted a "third sex" and may have given a specific cross-gender role to boys/men to accommodate that.

In other words, they coped without hormonal or surgical intervention - and that would have had one clear benefit of avoiding what most doctors suspect will be some adverse effects of long term hormonal intervention.

I can guess the likely general tone of your response - but to me, it seems peculiar that the advent of the possibility of body changing hormonal and surgical treatment has led to an apparent intensification of the claimed psychological suffering of those who believe they are(or just are, if you will) transgender. I suspect that this has happened in one other case too - IVF. Couples who had an infertility problem previously would often adopt and make the best of it: you did not used to hear of the intensity of grief to couples that discovering infertility seems to routinely involve now. I'm sure it was always upsetting - but was everyone just more stoic about everything prior to (say) 1960?

I for one am not very comfortable with this - that a medical "advance" is oddly the cause for greater apparent psychological suffering than the situation before the advance was available, which leads to treatment being given before its consequences are properly understood.

Steve said...

Oh - I have another example, and one which you might find harder to criticise: the rise in plastic surgery. Now that breast enlargement is routinely available, not to mention nosejobs, face lifts and "labiapasty", you have thousands of (mainly women) apparently developing enough "self esteem" issues that will pay for unnecessary surgery, encouraged by the profit making interests of the profession, of course.

This is not good. The surgery, arguably, creates its own perceived need. At least in many cases of plastic surgery (breast implants excepted), it is pretty clear that there will not be any unintended adverse, life limiting medical outcomes, unlike the case with hormonal treatment for transgender.

Mayan said...

The precautionary principle taken to extremes?

I think you give yourself away when you valorize those who have lived "in secret", "stoically dealing with it", and "stoically dealing with it either with or without the consent or knowledge of society more broadly". This is the same bullshit that, for example, gays and lesbians had to live with. Or various religious minorities. It is hypocrisy to say you're fine with the existence of other people while also demanding that they live in a way amounts to self-erasure from society.

Hormones and surgery are not new. If they were were going to be catatrophic, that would have shown by now. Instead, we're seeing people live their lives contentedly, and grow to old age. Your arguments there are the sort of nonsense one hears from antivaxers. It is sad.

I do understand why trans, and also intersex, people are such a threat to conservatives, and inspire such passion among them: their existence is a refutation of the basic assumptions held by so many about humanity. Sure, those assumptions cover the overwhelming majority of people, but not all. They were an understandable first approximation of reality, but time and experience has shown them to be wanting. Yet, still some cling to them, in the same way that free market extremists and Marxists cling to their dogma.

My reason for countering such nonsense is clear, but quite why you should care to raise it is somewhat of a mystery. You're not such a culture warrior on other issues, yet this seems to have put a bee in your bonnet.

Steve said...

Hi Mayan,

* have never disputed intersex exists and such persons may well want and warrant surgery or other medical intervention (when they know what they want, not have an assignment done for them as a baby.)

* I did not mean to imply that all should transgender should live out of sight to make the rest of us feel not uncomfortable - in fact,I was implying by reference to tribal societies and their "third sex" idea that modern societies could perhaps accommodate something similar. Not sure that I would give them any special status as shamans, though.

* the question of hormonal treatment is an important one when the increasing inclination is to start it very early in life. You appear to ignore the point of the Nature article - that they are only now doing the studies on the ongoing health of people starting early. If a guy at age 40 or 50 wants to transition via hormones, well that's a risk they chose themselves, after years of contemplation. Funny, but I don't trust the judgement of young teenagers in quite the same way.

* The topic interests me a lot because it deals with a very vexed topic of how humans understand themselves and where the dividing line lies between accommodating unusual convictions (lob off a limb to someone with an obsession that they'd be happier without a leg?) and encouraging them to find another way to deal with their perception.

* Because it's a matter of psychology, it's also almost certainly one that may be subject to social contagion and medical fashion that is informed by more than the strictly medical. The remarkable increase in teenage women presenting as transgender after the high media profile of transgender people in the last decade is very suspiciously a good example of the former.

Mayan said...

Social contagion? The same nonsense used about gays in the past. There is nothing new under the dark sun of conservative paranoia, and the wilful wallowing in misinformation.

Steve said...

Mayan, you will not be convinced of this at all, I know, but just because conservative understanding of the experience of homosexuality is now well recognised as (in many cases) wrong-headed, it does not necessarily follow that skeptical views of aspects of the current medical and community views on transgender issue are similarly motivated.

There's no point in pointing you to cases of parents with teenage girls who think that the claim that they are transgender is doubtful given their direct knowledge of the girl's behaviour and statements from birth: you will always assume that they can't be the liberals they claim to be.

This basically makes you impossible to debate these issues with.



Mayan said...

You could try to educate yourself, such as with the links made by a poster here: https://www.reddit.com/r/australia/comments/bh3zmk/murdoch_rags_once_again_fearmongering_about_trans/

If you said you wanted to murder trans people, you would be more respectable and honest than when you flop about, alternating between:
* concern trolling
* moral panic-mongering about gender whisperers
* wanting people to suffer stoically and in hiding
* recommending that people be forced to suffer (with the high suicide rate that entails - a real, concrete danger versus your abstract concern trolling) even though treatment is available and effective
* trafficking in contempt toward people who weren't able to avail themselves of treatment at an early age (which of course you wouldn't permit)
* wanting people to be forced into a third category of people, which one can be sure is not equal (just like apartheid, segregation, forcing people to wear gold stars, etc.) ; and
* perpetuating crass caricatures.

So, I'm impossible to debate with? Good. That means that I won't hide, cower, and erase myself just to placate your now discredited and factually inaccurate world-view of humanity.

Steve said...

One of your more irritating habits on this topic is to exaggerate what I am saying or implying. As well as insisting that only one side is influenced by an ideological/cultural view that they don't recognise in themselves.

As you may have noticed, I post about anything that interests me and treat this as a on line quasi diary which others may read, or not, at their choice. (Few do). I do not know anything about your personal situation, apart from I think you said on Catallaxy you were/are intersex in some way. But in any event, I don't post things on the topic just to annoy you.

GMB said...

Completely ridiculous Mayan. Who do you think these surgeons are? They are people with knives. They are not magicians. They cannot take a man and make him a woman. All they can do is mutilate the man with their gruesome tools and get paid a kings ransom for doing so. The mutilated man is no less confused. Because you haven't solved any problems you've just cut him up. So of course there will massive suicides and unhappiness.