Thread by @RoisinMichaux

New thread for @ZUCKERKJ at @genspect #GenspectBiggerPicture. Really starting to feel like a medical congress now. 1/

Zucker talking about why and how gender identity disorder got into the DSM-3. 2/
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Key reasons why kids were turning up at his Toronto clinic back in the day:
Feelings of dysphoria
Social ostracism
Mental health probs
Family dynamics
Parents worried about kid being gay 3/
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@ZUCKERKJ lists a bunch of follow up studies on persistence and desistance in children - the studies all had laughably low numbers (as low as 4). 4/
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@ZUCKERKJ went on a mission to find out who came uP with the term "watchful waiting" because he didn't know what it really meant - and realised it was he himself in an editorial! lol 5/
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This is what we know, from these small studies, about the persistence of gender dysphoria in kids, says @ZUCKERKJ - his own Toronto study showed about 12% in both females and males. 6/
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Very similar findings on sexual orientation at different sites - a very high percentage of boys with dysphoria when younger turned out to be same-sex attracted. "Some people hate these follow-up studies," because of diff methods, lost-to-follow-up... 7/

But some argued, says Biggs, that anyone who desisted was not trans to begin with (the No True Scotsman argument). He shows figures for persisters; 88 and desisters: 280. Of the desisters, 60% had a strong gender dysphoria diagnosis. 8/ #GenspectBiggerPicture

This showed that there were plenty of gender dysphoric kids who ended up desisting. Social transition wasn't a thing back then. 9/
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@ZUCKERKJ shows a picture from Jazz Jennings' book: "I have a girl's brain in a boy's body." 10/
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He shows graphs that he claims demonstrates that social transition is a *predictor* of persistence. "In 2006 we started to see kids in the clinic who had already socially transitioned." He compared them to those who had not socially transitioned. 11/
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Suggest there are correlates of social transition (social class, age etc but that's a story for another day). Says Tavistock in 2012-2016 was seeing kids who had already socially transitioned (86% for boys!), some very young.
12/ #GenspectBiggerPicture

Which therapeutic approach should be taken to reduce gender dysphoria? Watchful waiting, social transition, psycho-education or psychotherapy? @ZUCKERKJ says none should be privileged over any other and no *outcome* should be privileged over others. 13/

Parents jsut need to know what the odds are of one approach over another - where it will go. But to decide on the optimal approach, we need many other different kinds of data, says @ZUCKERKJ. /End
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