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Ms. Pain-y Br-oken @PennyOaken
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Since we're on a common thread of Latin, science, and transgender people,

Let's examine "rara avis in terris nigroque simillima cygno", a metaphor from Juvenal's 2nd century /Satires/. "As rare a bird in the earth as a black swan".
When the line was written, black swans were unknown to Juvenal's culture.

It was a polite and poetic manner of speaking to say, "No such thing".
Much later, the "New World", the lands of the Western Hemisphere, were encountered by European explorers, for whom Juvenal's works were part of their literary canon.

Here, black swans *do* exist.
So in our intellectual tradition, the saying about the Existence of Black Swans,

was *converted* from "No Such Entity Exists",

to a caution about *presuming* "No Such Entity Exists".
en.wikipedia.org/wiki/Black_swa… is the Wikipedia article about the theory, but it mainly goes in depth describing a particular modern statistician's expoundment on how to apply it to stock trading. That doesn't explain what it means for our purposes.
A paper was recently "published" that asserted that there exists a phenomenon, among young people, which the author used the label "Rapid Onset Gender Dysphoria" for.
The paper has been criticised for its research methodology by others.

I want to criticise the philosophy behind the choices of the author, the choices she made in assembling her paper.
The term, "Rapid Onset Gender Dysphoria", before the publication of this paper, was used in a context where it signified the belief, by the person who asserted its existence, that the Gender Dysphoria being presented by the patient, was professed for cultural cache.
i.e., the person saying "This is ROGD!" was saying that the presentation of Gender Dysphoria was not a sincere expression of the patient's actual perception of gender.
The abstract says:

"The purpose of this study was to document and explore these observations and describe the resulting presentation of gender dysphoria, which is inconsistent with existing research literature."
"ROGD appears to represent an entity that is distinct from the gender dysphoria observed in individuals who have previously been described as transgender."

It asserts that the presentations of GD in "ROGD" cases studied are inconsistent with the DSM-V, basically.
There's a problem, there.

The study has been criticised for

//not actually clinically studying any of the patients//.

How does the author *know* that the GD symptoms the patients present with, vary from published literature?

The author //asked the patients' parents//.
The parents were recruited from forums where they had gathered for the express purpose of discussion and political organisation over their shared value,

and that shared value?

Is that //their children aren't transgender//, diagnosis or not.
The common explanation on these forums is that their children were culturally converted or pressured by peers into identifying as transgender and seeking medical diagnoses, for the cultural cache of the identity.
The paper repeats this hypothesis, without describing explicitly the supposed *motive* -- the cultural cache -- leaving that for another explanation.

The paper just wants to establish that "ROGD" /exists as a credible phenomenon/.
Here's the problem, in the Philosophy of Science, with that choice:

It treats transgender people, as if they were Black Swans.

It presumes that transgender people don't exist until one that exactly meets the criteria described prior in literature is presented.
It presumes that the person presenting cannot /be/ transgender until and unless they meet the exact criteria described in prior literature.
That's not only at odds with the standards of care of modern medicine, it's at odds with the standards of science.
In order for a study like this to be medically ethical, it would need, /at minimum/,

direct observation and characterisation of patients in a studied population,

identification BY CLINICIANS of a phenomenon IN THE PATIENTS of GD presentation variant from that in the literature,
and metaliterature studies performed to determine whether or not this observed variance was due to a deficit in the *literature*, whether it was due to a deficit in *prior evaluation techniques*.

These are things that need to be controlled for, FIRST.
What happened instead:
In addition, IF the phenomenon WERE found to be due to cultural pressures on presenting patients to seek medical treatment for GD (despite not "authentically" or sincerely experiencing clinically significant dysphoria as regards their gender) --
That would be something that clinicians should be evaluating for *already*.

Is the patient sincere? Is there a reason to doubt the patient's sincerity in presentation? Are there other clinical explanations for the patient's behaviour? Are they necessarily mutually exclusive or
- can they be comorbid conditions?

Practicing Clinicians have a /fiduciary duty/ to put the best interests of their patients before their own, which means treating them as individuals, and not treating them as RESEARCH SUBJECTS without their express approval.

AND
If you are conducting research on a subject to determine whether or not they are part of a population,

it's IMPERATIVE that the subject NOT KNOW THAT YOU ARE TRYING TO DETERMINE THAT THEY ARE OR ARE NOT PART OF THE POPULATION
Every single one of these parents, every single one of these GD presenting kids,

ALL KNEW THAT THE PARENTS WERE CLAIMING THEIR KIDS WERE INSINCERE
---- another scientific body made a statement earlier that "ROGD" doesn't exist.

They were persuaded to retract that statement. The rationale used was that they were "pressured" into making the statement.

But here's the thing:
The phenomenon described in this paper, "Rapid Onset Gender Dysphoria" --

the paper doesn't *prove* it exists.

It doesn't *disprove* it exists.

BUT THE METHODS AND PRESUMPTIONS AND CHOICES WERE SO BAD,

THAT NEITHER CAN ANYONE ELSE EVER PROVE OR DISPROVE IT.
2018 Aug 16;13(8):e0202330. doi: 10.1371/journal.pone.0202330. eCollection 2018. Littman L; Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports.

IS A POISON PILL THAT PREVENTS USEFUL STUDY OF THE SUBJECT IN THE FUTURE.
Because of the CHOICE to use the term "Rapid Onset Gender Dysphoria", which described behaviour of /parents/, but characterised it as bad-faith /patients/,
The publication of the Littman paper has *damaged* the ability of FUTURE potential patients to invest good faith in the medical profession's fiduciary duties to put THEIR interests first, BEFORE the interests of adjacent parties (i.e. their parents).
Why would any at-risk patient in a stigmatised population, be moved to invest faith in medical care providers in general, when they can SEE and VERIFY that there exist CLINICIANS who treat them as study subjects FIRST and put their parents' interests FIRST?
Black Swan Theory.

1: The Event is a surprise to the observer.
2: The Event has a major effect.
3: The Event is rationalised by the observer in hindsight (observer bias).

Every scientist knows this bias, is trained to minimise it, to control for it.

Lisa Littman didn't.
Further? If there *is* a deficit in the described literature, in the standards for GD, if there are patients with sincere presentation of a variant or a comorbid related syndrome?

This paper sabotages future research in that area.
And all this, because a researcher chose to write a document describing an entity which she *presumed* the existence of, before *verifying* the non-existence of the necessary exclusion of that entity.

She made a Black Swan error.
End of thread. 乌
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