#Trans people who accessed gender-affirming hormones during adolescence had lower odds of adverse mental health outcomes, including suicidality, when compared to those who didn't access hormones until adulthood. (2/6)
All age groups that accessed gender-affirming hormones (during early adolescence, during late adolescence, and during adulthood) had better mental health outcomes than those who desired but weren't able to access gender-affirming hormones. (3/6)
A large number of #trans people who desired gender-affirming hormones (41%) were unable to ever access them, highlighting that we desperately need more clinicians trained in providing competent care for transgender and gender diverse people. (4/6)
We adjusted for a wide range of potential confounders, including family support for gender identity, exposure to gender identity conversion efforts, demographic variables, K-12 harassment based on gender identity, and access to pubertal suppression. (5/6)
These results argue against legislative attempts to restrict access to gender-affirming medical care for #trans adolescents. Such legislation is also opposed by all relevant major medical organizations, including The American Medical Association. (6/6) jamanetwork.com/journals/jama/β¦
Letβs talk about βcomplex #PTSD.β Have you learned about it but donβt understand it? Thatβs because itβs controversial! But a useful construct in my opinion. #medtwitter#psychtwitter π§΅
Classic PTSD can occur after one big life threatening event (think a car crash). Common symptoms include nightmares, flashbacks, startling more easily, and avoiding things that remind you of the trauma.
In 1992, Harvard psychiatrist Dr. Judith Herman proposed the concept of complex PTSD (CPTSD) as a distinct syndrome that can occur when people have repeated prolonged trauma (for example, chronic exposure to domestic violence or childhood abuse)
Republicans cite βscienceβ as why they oppose the #EqualityAct - a bill that would extend federal civil rights protections to all #LGBTQ Americans.
Rigorous research has shown that #trans antidiscrimination laws result in a decrease in suicidality. States that implemented these laws saw a 39% drop in suicidality among #trans people. pubmed.ncbi.nlm.nih.gov/32374362/
Adolescent suicidality dropped in states that passed marriage equality, likely due to broad societal impact that improved social climates and subsequently mental health pubmed.ncbi.nlm.nih.gov/28241285/
In summary: 13.1% of currently identified #trans people report that they detransitioned at some point in their lives. Most (82.5%) report that detransition was driven by at least one external factor (e.g., harassment, stigma, etc.) #detrans π§΅
A minority (15.9%) reported that detransition was driven by at least one internal factor (e.g., fluctuation in or uncertainty regarding gender identity). Clinicians should be aware of potential factors - internal and external - that may drive detransition. Examples:
The high number of #trans folks reporting a history of detransition highlights that some who detransition will transition again in the future. Folks should also keep in mind that external factors (societal stigma) can drive internal factors (doubt regarding gender identity).
As a @Harvard undergrad, I read an @AnnCoulter book and was struck by this line:
"Liberals can't have #gay marriage and evolution. For that we would need survival of the most fabulous."
Turns out she's wrong, but it took my whole evolutionary bio class to learn why (1/2) #LGBTQ
My favorite reconciliation of male homosexuality & evolution comes from studies suggesting it is an X-linked trait. For XY folks, it makes them gay, but for XX folks it makes them more fecund (i.e. fertile). This results in a stable but low % of gays in the population over time
It turns out there's a lot of homosexuality in nature. But things are complicated. Dolphins have 50% same-sex pairings. Male albatross are promiscuous, so females have lifelong pairings.
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
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 𧡠(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)