Leor Sapir Profile picture
Oct 18 4 tweets 2 min read
1/ Actually this study is enough. It inadvertently supports the theory that childhood social transition is iatrogenic. How else would you square it with the eleven previous persistence studies on children (who were not socially transitioned) that found 61-88% desistance?
2/ In her report, Dr. Hilary Cass warned that social transition is likely to be "not a neutral act" but an active psychosocial intervention for this very reason.

Steensma et al (2013) also mentions child social transition as a risk factor of gender dysphoria persistence.
3/ We should thank Olson/Caraballo for reminding us of an obvious fact: children are impressionable, and when adults (parents, teachers) reinforce the belief that they are "assigned" the wrong sex, they are less likely to come to terms with their body.

#SchoolToClinicPipeline
Point of clarification on language: when activists say "clinicians should never steer a young person toward a cisgender outcome," this is code for "clinicians should never help children and teenagers feel comfortable in their own bodies." Call me insane, but I think they should.

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More from @LeorSapir

Oct 19
Sorry John Oliver (@iamjohnoliver), but your claim that it’s the right, not the left, that has made “trans rights” (read: replacing sex with “gender identity” in those few areas of life where sex distinctions matter) into a national issue, is absurd.

🧵
During the Obama years trans activists inside state and fed governments, in major legal advocacy groups, and on the federal bench began exploiting a complex and opaque administrative process to advance gender self-ID in health and ed policy.
How many Republicans at the state or federal level were proposing “anti-trans” bills in 2010, when the federal Department of Education used a “Dear Colleague” letter to define “bullying” as “sexual harassment,” and the latter as harassment based on “gender identity”?
Read 11 tweets
Oct 14
1/ "[W]hen clinicians integrate the notion of essential gender into their efforts to respond to trans children, their therapeutic efforts change significantly. With essential gender in mind they are likely to be less psychologically minded...
2/ and less thorough in their consideration of the cost-benefit ratio of invasive interventions and of research that might militate against their impulses to intervene. To be sure, they are trying to be respectful of and responsive to children's stated wishes.
3/ But it seems that beyond that, when child patients talk about their gender, their belief in its reality seems to distract the clinician from the fact that we cannot listen to children in the same way that we listen to adults."
Read 4 tweets
Oct 12
1/ On @TheProblem, Chase Strangio (@chasestrangio) of @ACLU said: "there are no medical interventions on prepubertal children, period."

A fact check.
2/ Strangio is right that puberty blockers are typically given at Tanner Stage II, meaning at the onset of puberty. Whether those receiving these drugs should be classified as children or adolescence is another question.
3/ More importantly, because Strangio also said that it's necessary to support "children" (meaning, I assume, prepubertal children) in their trans ID, the truth of his claim about medical interventions depends on whether this "support" constitutes medical intervention.
Read 14 tweets
Oct 11
1/ Dr. James Cantor (@JamesCantorPhD), an expert with deep knowledge of the research and with his own peer-reviewed publications on medical gender transition in minors, is willing to debate any medical professional who supports the "gender affirming" approach.
2/ He's willing to do so on the platform and with the moderator of his adversary's choosing.

Any takers? @jack_turban @DrScottHadland @AmerAcadPeds @marcibdoc etc.

Feel free to tag any other pro-"affirming" doc/researcher, and please retweet to get the word out!
If I was a medical professional working in this field of practice who claimed that the affirmative model is settled science, I would absolutely jump at the opportunity to publicly discredit an "affirming" skeptic like Dr. Cantor.
Read 5 tweets
Oct 10
1/ Cancer has an objective and scientifically demonstrable basis in biology. Gender dysphoria doesn’t. Cancer will lead to death if untreated. There’s no evidence that gender dysphoria will, or that hormonal interventions will reduce the chance of suicide among teens at risk.
2/ The Olson study @Esqueer_ cites is one critics of the affirmative approach should know. 11 previous studies on childhood GD all found that the vast majority desist. Olson is the only one to have found otherwise. What changed? The kids in her study were socially transitioned.
2.5/ Note: among the studies prior to Olson’s, the one that found the highest persistence rate (Steensma 2013), at 29.1%, was the one in which the children were partly or fully socially transitioned.
Read 9 tweets
Oct 10
1/ @BillboardChris has asked @DrScottHadland to have a respectful, substantive conversation about the quality of the evidence behind hormonal interventions for youth with gender related distress. Science-based medicine requires such conversations.
2/ There are MDs and gender dysphoria researchers who agree with Chris, and peer reviewed studies that cast serious doubt on the belief that these interventions are medically necessary.

Scott, thank you for engaging. Listening to opposing views does not mean agreeing with them.
3/ I hope this conversation takes place, and would be happy to take part in it if it does. Countries with a more progressive track record on LGBT rights have done systematic reviews and rejected the affirmative approach (without banning hormones altogether).
Read 7 tweets

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