Eliza Mondegreen Profile picture
May 6 14 tweets 3 min read Twitter logo Read on Twitter
The shift from 'gender dysphoria' to 'gender incongruence' seemed to me at first to be primarily about normalizing an ever-widening range of body modifications... 🧵
But watching the discouraging data about patient mental health outcomes—data that researchers and clinicians refuse to translate into evidence that transition works or doesn't work—roll in, it occurs to me that incongruence triumphed over dysphoria for other reasons.
Incongruence's flexibility is attractive, of course. But incongruence also makes no promises that transition will improve mental health, whereas treatments for gender *dysphoria* really ought to improve patients' quality of life overall.
Unfortunately, that doesn't seem to be happening.

genspect.org/dont-stop-beli…
Much more convenient for clinicians to be able to say:

We treated the patient's gender incongruence so it doesn't matter if the patient got worse on every other count. Xie didn't want breasts, we removed xir breasts, the treatment was a success!
This shift was well underway at last week's EPATH conference in Killarney, Ireland. Researchers presented findings that were often devastating to the claims that 'gender-affirming care' is effective and life-saving. Then declined to draw any conclusions.
GIDS presented research showing that adolescent patients experienced a rise in self harm and deterioration of social-communication skills six months *after* initiating ‘gender-affirming’ treatment...
A Swedish researcher had the misfortune to find that “youth with gender dysphoria diagnoses face persisting mental health challenges after initiation of treatment with puberty blockers and gender-affirming hormones,” including increased psychiatric hospitalization...
She said she was “really concerned about how results will be interpreted,” since “as you all know, there are improved mental health outcomes following puberty blockers and gender-affirming hormones.”

As we all know!
“Gender-affirming treatment is supposed to alleviate gender dysphoria,” she reiterated. “It would be a good thing if it alleviated other mental health challenges but even if mental health challenges persist, that doesn’t mean it’s not the right treatment for gender dysphoria.”
In response, a prominent Dutch researcher mused: “What should we use as an outcome measure? Mental health needs? What if you ask the kids: are you happy with the treatment and they say, ‘yes, we are happy’?”
This is a sharp diminishment of the grand claims made at previous WPATH/EPATH/USPATH conferences where it was even suggested that treating gender dysphoria could even alleviate symptoms of autism. transgendertrend.com/stonewall-auti…
For years, the associations pushing transition have argued that the data will vindicate their bold experiments in human development and endocrine function. But the data is coming in and it's not living up to expectations.
So clinicians and researchers must pivot, fast. 'Gender incongruence' lets clinicians off the hook for bad outcomes. It lets researchers dismiss alarming findings. "We weren't treating *that.*"

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More from @elizamondegreen

May 4
So I went undercover to last week's meeting of the European Professional Association for Transgender Health. Here's what I saw... 🧵
Compared to WPATH, EPATH looks almost reasonable. But WPATH—which celebrates eunuchs and wants to 'help' patients who claim to have multiple personalities decide which irreversible surgeries to get, when those ‘personalities’ disagree—is hard to top.
Rising media scrutiny of 'gender-affirming care' forced clinicians at EPATH acknowledge a few open questions, even though they continue to insist the benefits outweigh the (still unknown) risks.
Read 34 tweets
Apr 17
Something that's on my mind for heart-wrenching personal reasons:

Having a trans-identified person in your life is meant to bind you to a certain perspective on trans issues.
If you have a loved one who identifies as trans, then you must agree that sterilizing gender-confused kids is great & men in women's sports is great & Dylan Mulvaney has been a woman for 365+ days and counting, & anything else—no matter your reasons—is a heinous betrayal.
When a loved one converts, everyone in that person’s life is supposed to convert. Suddenly, whatever I once believed, whatever I once said, should not only go unsaid but unbelieved.
Read 17 tweets
Apr 15
A friend of mine is visiting Madison and I feel so intensely homesick for it. I lived there for so long and then moved away with next to no notice (last minute academic contract for my partner at the time) and no real goodbye. Image
Image
But I also feel nostalgic for a place that doesn't exist now the way it existed then. I moved away in 2017 and for me it feels like a snowglobe on a shelf, preserved from the madness that infected everywhere I lived after that but that seeped into that place, too.
Read 6 tweets
Apr 2
One of my goals in writing about gender is to bring context back. Over 90% of cosmetic surgeries performed in the US in 2019 were performed on women. That's context for all the double mastectomies sought in the name of gender 'authenticity.'
Mental health of adolescent girls tanked starting around 2013. That's context for the spike in trans identity among adolescent girls starting around 2013.
Adolescent girls often express distress through mortifying their bodies. We can see that clearly when we're talking about cutting or self-starvation. That's context for transgender identity and the pursuit of interventions that punish and discipline the body, too.
Read 5 tweets
Apr 2
I would put it more provocatively and say this is one of the places language like "gestator" and "uterus-haver" was always leading: the dissolution of human bonds and invisibilization of human trafficking of women and children.
theguardian.com/commentisfree/…
"Gestator," "vulva-owner," "menstruator": these are all transactional terms that slice the female body into markets. A "menstruator" is anyone who buys certain sanitary products. A "vulva-owner" is type of sexual experience, a porn category.
A "cervix-haver" is a consumer of certain medical screenings. A "gestator" can "incubate" a baby that will be sold across the world--or just across class lines closer to home.
Read 4 tweets

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