Leor Sapir Profile picture
Nov 15 23 tweets 4 min read
The claim that "gender affirming" puberty blockers, cross-sex hormones, and surgeries are "medically necessary" and (or rather because) "life-saving" doesn't stand up to minimal scrutiny.

A 🧵
According to a common claim, 41% of "transgender youth" are at serious risk of suicide if not socially and medically "affirmed." We all know the mantra: "you can either have a live son or a dead daughter."
The Human Rights Campaign: "More than half of transgender male teens who participated in the survey reported attempting suicide in their lifetime, while 29.9 percent of transgender female teens said they attempted suicide."

If activists are right that "trans kids" have always existed and the skyrocketing numbers of trans self-ID and gender dysphoria diagnosis are purely because of growing social acceptance, we should expect to see, under a more hostile/non-GAC society,...
alarming levels of teen suicide or serious suicidal attempt. Anything less than serious attempt (e.g., self-harm as cry for help/attention) would presumably not be enough to justify the risks/costs of GAC.
According to data published recently by Reuters and collected by Komodo Health, there were 142,882 new diagnoses of youth gender dysphoria added between 2017 and 2021. Because this is based on insurance claims, it's probably an undercount. Let's assume 150,000.
The number of diagnoses has grown by 20% every year since 2017, and 80% between 2020-2021 (Komodo). There is no reason to assume that the numbers have maxed out. Indeed, 2.1% of Gen Z now self-ID as trans (Gallup), and if even half are dysphoric, that means 630k.
41% of 630,000 = 258,300. That means roughly 260k of Gen Z who have experienced serious suicidal attempt or have committed suicide during their teen years, all on account of "unaffirmed" gender identity. Since this cohort reached adolescence about a decade ago,...
and since trans activists assume that levels of trans-ID among Gen Z reveal the "normal" state of things under an accepting society, we can extrapolate and say that we'd expect to see 260k teen suicides per decade under a non-GAC regime--all due to "unaffirmed" gender.
According to CDC data, between 2000 and 2010, within the age cohort of 15-19, there were 13 suicides per 100k among males (per year) and 4 suicides per 100k among females. Assuming this age group totaled 20m, this averages to 2,600 male suicides and 800 female suicides per year.
In other words, the number of relevant suicidal events before GAC became widely available is roughly ONE EIGHTH (3.4k/yr vs. 26k/yr) what we would expect to see if trans activists were right about the natural occurrence of transgender ID and the "life saving" necessity of GAC.
And this is assuming, to repeat, that every single teen suicide or serious attempted suicide before GAC was because of unaffirmed gender identity--a wildly implausible assumption.
So how do we make sense of such a senseless mantra as "affirm or suicide"? Let's take a step back and apply some common sense--something sorely lacking in much of our scientific community at the moment.
Gender dysphoria and transgender identity give teenagers in a state of confusion or distress a mental schema to make sense of what they're experiencing. For most (if not all) these kids, we are not observing, but rather creating, their "solution" to what is a natural problem.
Step one: set the expectation that feeling very uncomfortable in one's body is a unique experience, something that only you, oh precious child, and a few other magical "gender creative" kids, are experiencing.
Step two: inform said teens that, fortunately, this a "problem" with a technological "solution."

Step three: emphasize to them that no one should have to go through this, and that they have a "right," a claim of justice, not to go through it.
An Ivy League grad from a prominent political family might experience severe anxiety/depression at the prospect of not becoming US president. The thought might even make him suicidal.

The rest of us go about our business unconcerned that we'll never end up in the White House.
The Greek philosophers (and Rousseau, of all people) understood this point well: the key to happiness is to bring your desires ("needs") within the scope of what you can reasonably satisfy. Happiness as well as freedom meant the taming of human desire.
The modern conception of freedom after Hobbes is based on the unleashing of desire and the redefining of justice ("rights") to mean the limitless pursuit of its satisfaction. Freedom = joyless pursuit of joy. Technological progress is both the expression and engine of this idea.
If you tell teens who fear puberty and don't want to be sexually objectified that they can technologically opt-out of the experience, and then you put (or threaten to put) their gender drugs out of reach, you are creating the very distress you are trying to resolve.
To paraphrase John Stuart Mill, you are mistaking the doing of your own hands as the work of nature, and then appealing to "nature" ("trans kids are born that way") as justification for your doing. This is not "gender ideology." It's simple, and all too predictable, human folly.
I encourage fact checkers to check my math and assumptions.
Fact-checking myself: the Reuters number was 121,882, not 142,882. That said, rounding up to 150 is still reasonable, and none of this affects the basic conclusion.

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More from @LeorSapir

Nov 17
Non-binary, which seems to be the most common way for youth to opt-in to LGBTQ+, is not an “identity” in the sense of the word used in mainstream trans advocacy. That’s because according to queer theory, the intellectual home of NB, gender is a “performance.” 1/5
Judith Butler, godmother of QT, has called the notion of a true gender self, an inner sense of gender capable of authentic outward expression, a “regulatory fiction.” 2/5
NB is a performance whose purpose is to “trouble” gender (understood as a social system), meaning a political performance.

What makes a person “binary” is not some innate and immutable trait. No one is born M or F, according to QT. One’s ID as M or F = conformity. 3/5
Read 7 tweets
Nov 14
Setting aside the second sentence of this article, NYT seems to have taken another baby step toward investigative (as opposed to affirmative) journalism.

A few highlights...

They Paused Puberty, but Is There a Cost? nytimes.com/2022/11/14/hea…
"As the number of adolescents who identify as transgender grows, drugs known as puberty blockers have become the first line of intervention for the youngest ones seeking medical treatment."

"First line of treatment." Interesting. @AmerAcadPeds and @AAPPres: any comments?
NYT is finally acknowledging that other countries are pulling back from puberty blockers. If only the Times had mentioned the systematic reviews of evidence these countries have done, and the fact that the AAP and other American medical orgs have not done them.
Read 8 tweets
Nov 4
IMPORTANT UPDATE in light of Dr. Aron Janssen’s statement the other day claiming that the Dutch clinic proves the “best data” and that most American clinics are following the Dutch model. I showed in a thread yesterday why that claim is likely false.

Here’s more evidence 🧵
One of the central criticisms of studies purporting to show that hormonal interventions (to use Jack Turban’s language) “result in” better mental health is selection bias.
Eligibility for hormones in the Dutch study was predicated upon stable mental health and absence of major psychological “counter-indications” (co-morbidities). Presence of these was regarded as cause for more psychotherapy before blockers/CSH are administered.
Read 14 tweets
Nov 3
In his testimony in favor of "gender affirming care" before the Florida board of medicine, Dr. Aron Janssen (@LGBTDoc) was asked why Europe has taken a more "conservative" approach than we have.

A quick fact check thread:
Janssen: "The best data that we have, and the best longitudinal data that we have about transgender youth, comes primarily out of the Dutch clinic... That's the prevailing model that most American clinics have based their care upon."

One of those Dutch researchers disagrees.
Dr. Thomas Steensma of the Amsterdam University Medical Center said in 2021 that "the rest of the world is blindly adopting our research."

Read 12 tweets
Nov 2
Remarkable that in her reporting on “gender affirming care” for @TeenVogue, @brittneymac15 cites the Tordoff study (!) in support of her claim that the protocol is supported by research. The study showed NO improvement in mental health from hormones. Read the study!
I just can’t fathom how lazy journalism has become, particularly on this issue. If reporters can’t be bothered to do the minimum due diligence and read the studies they cite, they shouldn’t be trusted as reliable sources of information. It’s that simple.
@brittneymac15: if you have *any* concern for the truth, you’ll read this by @jessesingal

Read 4 tweets
Oct 25

4 days after my fact-check of @jack_turban's article reviewing studies in @PsychToday came out, Psych Today issued a correction to Turban's article (or asked Turban to do so).


The new version is here: psychologytoday.com/us/blog/politi…
4 corrections were issued, along with 2 stealth edits:

* Kaltiala et al 2020: hormones are "not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria." BTW--this sentence is in the abstract, not buried in the article.
As I mentioned in my fact-check, Kaltiala herself emphasized to me that their study should not be used to claim that hormones reduce suicidality. That is a stronger caveat than the one Turban now acknowledges.
Read 16 tweets

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