I did watch the Four Corners episode last night on youth transgender controversy, and then read some of the (what's left of) Twitter responses - mostly by people upset that it was too soft on the "anti gender affirming" side.
I did get the feeling that the psychologist Dianna Kenny didn't exactly come across as trustworthy (or perhaps I should say - sufficiently objective); but then again, nor did I get any great feeling of objectivity from virtually all of the doctors, psychiatrists and psychologists on the pro-gender affirming care side. I got the distinct impression that there is a serious disinclination by them to discuss or acknowledge in detail the step back from the use of puberty blockers in children in many European countries, for example.
The thing is, though, all of us can Google terms like "transgender detransition" and find many articles from the last couple of years in legitimate journals from experts explaining that detransition rates are not well understood, and they are very relevant to the question of treatment of minors with puberty blockers and hormones.
I don't think the show did a good explanation of this - instead just quoting Kenny's claim that there's an "explosion" of detransitioners, and putting one with a Youtube channel on the show.
I guess it is a difficult field in which to find people willing to go on television and present a case that there is a legitimate debate, and that some hide behind "evidence based approach" as if the important stuff is basically settled, when everyone with common sense knows that psychology and psychiatry are some of the most difficult areas in which to get solid evidence such that treatments and approaches won't change over time. (True, the head of the Queensland clinic acknowledged that there is a vigorous debate which they will always pay attention; but it still felt like his subtext was "but this doesn't mean we're doing anything wrong at the moment.")
I did read the accompanying ABC article that went with the show. It did seem to have a weird spin. A transgender teen took their life, but we are left with no details as to *why*, only the implication that they didn't get the appropriate ('gender-affirming') care in time. So, no other issues with depression, family break up, nothing like that? Nothing else that could be a significant causative factor?
ReplyDeleteOr their attempt to put down a Westmead Hospital finding that up to 22 per cent of people who seek gender-affirming care eventually desist - and then give a figure of about 9.2 per cent, almost as if that is negligible. Almost TEN PER CENT of people seeking this sort of care eventually detransition but it's nothing to be concerned about WHAT.
It is the same old problem. When an issue becomes politized it becomes very difficult to sort fact from fiction. I don't have much faith in the diagnoses of psychologists and psychiatrists because they have to rely on self reports and it is easy to present as someone having gender dysphoria. Thanks for nothing internet! The experiments of Szasz and Rosenhan, and those programs like How Mad Are You, illustrate the huge problem those disciplines face in diagnosis. I trust they don't just rely on the patient and seek out observations from parents, family, and friends.
ReplyDeletePeople who argue for evidence based approach must think we are mugs. Look at Ioannidis' and McCloskey's damning analyses of biomedicine. Error rates are very high and it often takes years if not decades to determine the truth.
My impression is that in other areas of medicine doctors would not proceed with treatment unless it has been subject to much more rigourous analysis than is currently being used to justify transitioning.
The ABC has come under attack for being too soft on the transphobes. Can't win in this public debate.
ReplyDeletehttps://www.news.com.au/lifestyle/health/mental-health/its-exhausting-four-corners-criticised-for-the-way-it-balanced-its-gender-distress-story/news-story/cbed5d0fe952d50412a699199699641d
At least one more WHAT moment from that link, John: "You’ve failed to understand that puberty blockers are essential for cis kids." (Quote from Natalie Feliks). Puberty blockers are essential for not just trans kids but 'cis' kids now???
ReplyDelete