Thread by @LeorSapir

I'm reposting my thread on the dubious origins of the American gender-affirmative model for anyone who wants it unrolled with the corrected Olson names. 🧵

The founders of the affirmative model wrote: "We... acknowledge that the majority of gender-nonconforming children presenting for clinical care related to gender dysphoria are desisters unlikely to mature into transgender individuals."

5 years later, a young, inexperienced pediatric psychiatrist named Jason Rafferty wrote a document that would become the basis for the @AmerAcadPeds's position, as well as that of other medical orgs and, through their endorsements, state & federal policymakers.

According to Rafferty, "children who are prepubertal and assert an identity of TGD [transgender and gender diverse] know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender and benefit from...

the same level of social acceptance. This developmental approach to gender affirmation is in contrast to the outdated approach in which a child’s gender-diverse assertions are held as 'possibly true' until an arbitrary age... when they can be considered valid."

In other words, Rafferty and the AAP took a position explicitly at odds with that of the clinicians who promoted the affirmative approach in 2013.

Rafferty provides a single citation in support of this departure: K. Olson et al., "Gender Cognition in Transgender Children," 2015.

The Olson 2015 study was about gender self-perception in kids ages 5 to 12. The study claims to have found that, when matched with their same-gender-identity "cisgender" peers, "transgender children" show indistinguishable and consistent levels of gender self-cognition.

In other words, a 5 yr-old boy who identifies as a girl has the same subjective self-perception of girlhood (defined, of course, through stereotypes) as a 5 yr-old girl.

journals.sagepub.com/doi/abs/10.117…

This study is purely about subjective self-perception. The author's underlying and never-argued-for assumption is that a consistent subjective self-perception of "girl" *is* what makes one a girl. You may agree with this assumption, but it's ideology, not science.

But here's the crucial part: Olson et al. note that the use of the "early gender cognition" test for predicting persistence "remains a provocative possibility, though one that would need substantially more testing before the [implicit association test] could be used in this way."

In other words, the AAP's and the American medical establishment's position on childhood social transition rests *in its entirety* on a single study whose authors explicitly say that it CANNOT be used in the way the AAP has used it.

And, of course, as @JamesCantorPhD has shown, Rafferty misrepresented sources when advocating against "watchful waiting" (the sources counseled "watchful waiting") and omitted all existing studies on rates of desistance/persistence in prepubertal GD.

pubmed.ncbi.nlm.nih.gov/31838960/

There simply is no other way to say it: a small group of ideological/activist clinicians, operating with the imprimatur of prestigious medical organizations, have lied to their colleagues, policymakers, and the general public.