Monday, September 03, 2018

Transgender research wars, continued...

I've mentioned the 4thwavenow website before [it's subtitled "A community of parents & others concerned about the medicalization of gender-atypical youth and rapid-onset gender dysphoria (ROGD)"], and how transgender activists hate it.  Now Science reports on a researcher who did surveys with parents from that and similar sites, only to be condemned for, you know, investigating what a lot of concerned parents were claiming:
Controversy is exploding around a paper published earlier this month in PLOS ONE by a public health expert at Brown University describing reports by parents that their children suddenly experienced unease with the gender they were assigned at birth; the paper calls the condition “rapid onset gender dysphoria” (ROGD). The paper, by physician-scientist Lisa Littman, is drawing fierce criticism from transgender advocates, who call it antitransgender because it suggests that some cases of gender dysphoria may be “socially contagious.” They say the paper has serious methodological flaws, noting that Littman interviewed only parents, not the young people themselves, and recruited from websites frequented by parents who were concerned about their children’s apparently sudden gender transitions. Meanwhile, the reactions of Brown and the journal are being assailed by critics who accuse them of caving to political pressure.

On Monday, PLOS ONE announced it is conducting a postpublication investigation of the study’s methodology and analysis. “This is not about suppressing academic freedom or scientific research. This is about the scientific content itself—whether there is anything that needs to be looked into or corrected,” PLOS ONE Editor-in-Chief Joerg Heber in San Francisco, California, told ScienceInsider in an interview yesterday.

Also on Monday, Brown officials removed the university’s press release highlighting the paper from its website. On Tuesday, Bess Marcus, dean of Brown’s School of Public Health, wrote in an open statement that the university acted “in light of questions raised about research design and data collection related to the study.” She added that people in the Brown community have raised concerns that the study’s conclusions “could be used to discredit efforts to support transgender youth and invalidate the perspectives of members of the transgender community.”
 Another researcher says there is no denying the upswing in sudden onset transexuals, though:
But Ray Blanchard, a professor of psychiatry at the University of Toronto in Canada who worked for 15 years in a gender identity clinic that screened candidates for sex reassignment surgery, says the paper points to a clear phenomenon: a new subgroup of adolescents, mainly women, with gender dysphoria and no behavioral signs of such dysphoria during childhood.

“Many clinicians in North America and elsewhere have been seeing such patients,” Blanchard, who worked with adults, wrote in an email, “and it has been speculated that this subgroup is one reason for the predominance of adolescent females now being seen in North America and elsewhere (Aitken et al., 2015). No one can deny the clinical reality,” he wrote, that the documented increase in adolescent girls being referred to clinics for gender dysphoria is being augmented by those with no history of the condition in childhood.

In the study, Littman acknowledged its limitations, describing it as a starting point. “Like all first descriptive studies, additional studies will be needed to replicate the findings,” she wrote. She told ScienceInsider that in upcoming research she plans to recruit parent-teen pairs in cases where the teenager experienced ROGD that later resolved.


Jason Soon said...

Off topic but I know how fond you are of Tim Wilson

Steve said...

Oh I saw that alright.

I've been meaning to post that one of the slightly interesting things about the leadership spill was that Timbo stuck strongly to Turnbull. (Not sure if he then voted for Bishop in the first round of the final leadership vote.)

Which makes me suspect he's gone more to the centre than I anticipated, given his history.

He continual selfie self promotion makes me sure he thinks of himself as PM material. He's like a gay Andrew Peacock, I think; all preening show and little substance.

TimT said...

This is one of those issues where both sides are absolutely crackers. Transgender research wars, I mean, not Tim Wilson related stuff.

Mayan said...

As lamentable as some of the shriller voices might have been, they had a point. Surveying the parents of trans people, who have a predisposition to detest trans people about whether their kids being trans was a shock is akin to asking any group of people whether their biases are correct.

It's more than a classic case of a drunk searching under a light post. Rather, it is akin to a sober individual searching under a light post in daylight, then deciding to publish results that contribute no knowledge other than that those who detest trans people detest trans people.

Do I have to say anything more about Blanchard? He boasted that he went to Johns Hopkins with the explicit intention of closing their trans project. Now, after dodgy papers, he isn't published anywhere other than in religious magazines.

What I have some qualms with are well-intentioned parents transitioning their barely school aged kids. Yes, most trans people knew at that age they were trans, but if one reads the results from Monash, if that continues into puberty, then the odds are extremely high that the person really is trans and will benefit from treatment.

Steve said...

Mayan, you're shooting from the hip, and I would bet have not read the actual paper. It is open about its limitations, respectful in tone, and tries to address the "well, they would say that, wouldn't they?" dismissal that is one way to show complete disinterest in what parents have to say about their experience with their children and clinicians.

Rather than shoot the messenger, is Blanchard wrong in his claim that there has been a sudden surge in teenage women claiming they are transgender? He is a co-author of the paper cited that quotes numbers - pretty hard to get wrong, unless you're going to argue about sample error or something. Well, go ahead and show that he's wrong.

The Littman paper cites other examples of social contagion of problems or a psychological nature - it is entirely reasonable to question whether social contagion accounts for the odd trend that Blanchard claims.

Steve said...

And what about this paper by some Scandinavians, Mayan, indicating that the very thing Littman is researching by talking to parents, is something that really needs addressing:

"Increasing numbers of adolescents are seeking treatment at gender identity services in Western countries. An increasingly accepted treatment model that includes puberty suppression with gonadotropin-releasing hormone analogs starting during the early stages of puberty, cross-sex hormonal treatment starting at ~16 years of age and possibly surgical treatments in legal adulthood, is often indicated for adolescents with childhood gender dysphoria (GD) that intensifies during puberty. However, virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity. Consolidation of identity development is a central developmental goal of adolescence, but we still do not know enough about how gender identity and gender variance actually evolve. Treatment-seeking adolescents with GD present with considerable psychiatric comorbidity. There is little research on how GD and/or transgender identity are associated with completion of developmental tasks of adolescence."

Mayan said...

Consider, if you will, a cohort of people who grow up in homes in which it is simply unacceptable to be gay or trans, and yet some people are. Now consider that we live in a world with the internet, where instead of simply killing themselves, or spending years lost and distressed, people are able to connect with others in the same situation as themselves, share information, and find support. It is not at all shocking that those people will find each other.

What will be a shock is the reaction of their parents who are not open to the reality that some people are gay and some (much smaller number) are trans. Given that most of their offspring will try to keep quiet, not mention this to their parents, then it will appear as a sudden onset to the parents.

As to the fact that more people are publicly coming out as trans, that is not a surprise at all, just as the increase in the number of people who came out as gay in the past generation is not a surprised. When you realise that you can have a life, and not be murdered in the street because of who you are, then yes, you are likely to be more open about your identity, and so seek to lead a satisfying life.

As for Blanchard, his entire life has been a mission to delete trans people from society. No doubt, there are still people who cleave to the flat earth theory, but their past errors now mean they are restricted to fringe journals and magazines.

There is a curiosity in all this. We live in a culture where people are generally opposed to the notion of 'designer babies', genetically edited to their parents requirements, yet we pander to just that same expectation, even narcissism, when we allow intersex infants to be modified without watching to see how they develop, causing untold misery along the way. It's less acceptable now, but god bothering parents still send their kids to pray away the gay camps, which don't work, unless you count an increased suicide rate as a way of enforcing parental expectations. So much of the comment at the websites through which repondants were recruited is lamentations at not having the offspring they wanted. Life is filled with disappointments, many originating in the first question asked by parents about their child, even before its health.

The research from Monash, combined with that from elsewhere shows that the model of treating likely trans people in their teens with puberty delaying drugs and therapy is the best model.

If you really want to pursue objection of "but brains continue developing until the mid 20s", why not apply that objection consistently? Instead it is brought out overwhelmingly by those who perceive that they are on the losing side of a moral panic they themselves have started.

Steve said...

Mayan: you seem to continually assume that the parents who have commented at the 4thwavenow site (being the only one of its type I have read) are all god bothering conservatives with a natural predisposition to hate transgender. In fact, I am sure that the person who started the blog (and I think from memory at least some other parents who have commented there) say they are from an (American) liberal background and are not motivated by religious objection to transgender or gay people.

You have one theory as to why "sudden onset gender dysphoria" only seems like a thing; parents of teenagers who say they GD doubt the theory. Research like Littman's might help clarify the matter, but transgender activists do not want the research done because no one is ever meant to doubt the account of someone who claims they have GD, regardless of the circumstances.

I think the intersex and religious camps to pray gay away are very different issues.