So many proposed anti-#trans bills contain text stating something along the lines of "most #transgender adolescents will grow up to be cisgender, so they should not be given gender-affirming medical interventions."

Let's break down the problems with this false statement 🧵 (1/6)
First, the literature they're referencing is about children who have not yet reached puberty (eg Steensma et al. JAACAP 2013). Medical interventions are not offered until trans youth reach adolescence, at which point it's rare for trans youth to later identify as cisgender (2/6)
Second, many children in these longitudinal studies may have gone back in the closet when they were exposed to more stigma. In studies before 2000. the "persistence" rate was 2-9%. After 2000, as stigma improved, it changed to 12-39%. (3/6)
Third, these studies included many kids who were referred to gender clinics but didn't meet criteria for "gender identity disorder" - the diagnosis used at the time of these studies. Many were likely cisgender tomboys or boys with feminine interests (dolls, etc.) (4/6)
Fourth, of children who met gender identity disorder (GID) criteria, 55% "persisted" in identifying as trans. But those with GID could be cisgender at T0, as the criteria are largely based on gender role rather than gender identity (gender dysphoria in DSM-5 changed this) (5/6)
The number of ways in which "most transgender kids grow up to be cisgender without medical intervention" is not true makes it extremely frustrating to see this kind of misinformation come up in policy debates. I often don't even know where to start. (6/6)
More on the epidemiology of transgender youth and these questions is available in our textbook (chapter 2).
jackturban.com/textbook

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More from @jack_turban

13 Jan
A new book about #trans youth from The Wall Street Journal's @AbigailShrier has some truly disturbing recommendations.

Page 215: She recommends parents isolate their trans children by sending them to live on horse farms with no internet, hoping that will make them cisgender.
She asserts that children whose parents isolated them in this way all "desisted" from identifying as #transgender.

If a parent sends their kid to a horse farm with no internet to try to make them cisgender, it's not surprising that the kid's going to go back in the closet.
These practices are cruel gender identity conversion therapies, and they've been labelled unethical & dangerous by The American Medical Association, The American Academy of Pediatrics, The American Psychiatric Association, and The American Academy of Child & Adolescent Psychiatry
Read 4 tweets
15 Dec 20
The misinformation about #trans youth and #mentalhealth in this piece from @TheEconomist is astounding. Thread (1/9) Image
They cite that most adolescents who start pubertal suppression (PS) go on to take gender-affirming hormones. This isn't evidence PS made them trans. It's evidence they were trans to begin with & the clinic wasn't giving PS to kids who would later identify as cisgender (2/9) Image
Courts are not experts on informed consent for minors. Psychiatrists and pediatricians are. Policy statements from The American Academy of Pediatrics and The American Academy of Child & Adolescent Psychiatry make it clear that they disagree with the court's decision (3/9) Image
Read 9 tweets
25 Oct 20
I'm a gay physician-scientist with Harvard and Yale training, and I research #LGBTQ health. Amy Coney Barrett's confirmation next week likely means more LGBTQ people like me will die early. Here's why (a thread) 🧵(1/8) #medtwitter #SCOTUS
Difference-in-differences analyses show that marriage equality results in fewer suicide attempts among sexual minority youth. (2/8)
jamanetwork.com/journals/jamap…
Barett's writings indicate she would jump at an opportunity to overturn Obergefell v Hodges (SCOTUS marriage equality decision). Other conservative justices have already been hinting at their intent to do so. (3/8)
nbcnews.com/feature/nbc-ou…
Read 8 tweets
17 Aug 20
I just read the authors note, introduction, and chapter 1 of @AbigailShrier's new book about #trans youth. I'll continue to update as I make progress, but here are the inaccuracies I've found so far. Image
First, according to the "author's note," Shrier did not interview any of the trans adolescents themselves for the book, only their parents. She changes story details so that the adolescents themselves will not be able to recognize themselves and point out any flaws in the stories Image
Shrier claims "in most cases-nearly 70%-gender dysphoria resolves." This is not true. The studies referenced used the old diagnosis of "gender identity disorder (GID)," not gender dysphoria. One can meet GID criteria and be cisgender; DSM-5 gender dysphoria diagnosis changed this
Read 5 tweets
14 Apr 20
Some reasons having a psychiatry resident as your doctor on a #COVID19 unit may not be so bad: a #medtwitter thread.

1. A psychiatry resident already completed a medicine internship. They’ve done this before, and they’re supervised by an internal medicine attending. Image
We are expecting a surge in PTSD from people being in the ICU and from invasive procedures. Psychiatry residents are more likely to work to prevent this, recognize it, and treat it.
Many coronavirus patients will experience delirium: a reversible syndrome in which you forget where you are and may even hallucinate. Psychiatry residents know how to recognize and treat this (it’s often missed).
Read 7 tweets

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