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Florence Ashley Profile picture
@ButNotTheCity
Feb 5 • 10 tweets • 3 min read • Read on X
With the Alberta government announcing a ban on gender-affirming care until 16 years old, let’s take a minute to correct some misinformation.

A thread.🧵
“High quality evidence doesn’t support gender-affirming care.”

‘High quality evidence’ is a technical term that essentially just means ’no randomized controlled trials.’ RCTs are not scientifically feasible for trans youth care and would be unethical:

tandfonline.com/doi/full/10.10…
The evidence-base for gender-affirming care is quite robust and is at least as good at the evidence base for comparable interventions like abortion and birth control.

For an overview of available studies (a few years outdated), see page 144 onwards: florenceashley.com/uploads/1/2/4/…
“Over 80% of kids grow out of being trans.”

That claim is based on old, poor-quality studies that included tons of kids who never claimed to be trans. More recent, better studies suggest that only around 2.5% have ‘grown out of it’ after 5 years:

publications.aap.org/pediatrics/art…
“Kids falsely believe that they are trans because of social contagion.”

There is no evidence for that claim. For a careful explanation of why the claim is completely unsupported by evidence: florenceashley.com/uploads/1/2/4/…
Studies of trans youth using clinical data have also failed to find any evidence of epidemic or large-scale social contagion:

sciencedirect.com/science/articl…
“We need a years-long diagnostic process to make sure kids are ‘truly’ trans before they transition.”

There is no evidence that gender assessments fare any better than self-report at predicting future outcomes, as we explain in our recent review:

psycnet.apa.org/fulltext/2024-…
“Gender-exploratory therapy can help identify the trauma that made these kids gender dysphoric.”

GET is difficult to distinguish from classic conversion therapy, which also begins from the premise that ‘trauma’ makes people LGBTQ:

journals.sagepub.com/doi/10.1177/17…
Since conversion therapy is known to be harmful, we have reasons to believe that GET would be as well. Self-directed exploration is good. Forced exploration rooted in suspicion towards trans identities isn’t.

It’s also worth noting that conversion therapy is illegal in Canada.
Let me know if there’s any more myths you want me to discuss and give peer-reviewed resources on!

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More from @ButNotTheCity

Florence Ashley Profile picture
Jul 3, 2023
🚨This is not a drill!🚨 After years in the making, my paper on GI is finally out in MIND, one of the most prestigious philosophy journals in the world, of all places.

⬇️Why this is the most important paper on gender you’ll read this week, a thread:🧵

academic.oup.com/mind/advance-a…
First things first, here’s where you can read it for free:

And here’s where you can listen to an audio version: https://t.co/CccAe5iPXrflorenceashley.com/uploads/1/2/4/…
podcasters.spotify.com/pod/show/flore…
The paper explains how people get a gender identity. It doesn’t explain what gender identity is per se, but it explains where it comes from and what it is built on.

So if anyone asks you to define gender identity as a gotcha’ you can send them the paper.
Read 35 tweets
Florence Ashley Profile picture
Jun 14, 2023
The level of evidence that someone requires to justify a medical practice is strongly if not directly correlated with how they intuitively feel about it. If they dislike it or are skeptical it, the threshold is higher. If they like it, the threshold is lower.
That’s why so many people criticize the evidence base for gender-affirming care but not other things. They think it unnatural, icky, or evil so they require higher quality evidence that is difficult if not impossible to muster.
If probed, they find all sorts of excuses why the medical practices they like are okay despite having worse evidence. But mostly they rely on not being probed and just coasting on double standards.
Read 5 tweets
Florence Ashley Profile picture
Jun 14, 2023
I’d add a small but important nuance. GRADE would classify it as low quality evidence but low does not equate unproven or unsupported.

For one, GRADE doesn’t recognize “proof,” it only recognizes degrees of evidence. For two, it’s “low” quality evidence not “insufficient.”
It’s an important distinction. If GRADE meant to suggest that nothing should be done without moderate or high quality evidence, there would be no point distinguishing low and very low quality evidence.
Nor would it make much sense to allow the rare (and I mean *rare*) observational studies being bumped up to moderate quality given that they’re theoretically completely different in terms of ability to discern causality—a difference of kind not degree.
Read 5 tweets
Florence Ashley Profile picture
Jun 14, 2023
Richard Green, one of the people that gay rights groups allied with to remove homosexuality from the DSM, openly promoted conversion therapy for trans people all the way until his death in 2019. He used the collaboration to deflect criticisms of his transphobia.
His deeply homophobic “Sissy Boy Project” helped legitimate decades upon decades of conversion therapy on trans & cis gay kids. Sure he claimed conversion therapy was to prevent kids from growing up trans, but it was still being broadly applied to gender non-conforming kids.
The UCLA gender clinic were just a fantastic bunch. People like religious homophobe George Rekers who put kids through conversion practices for decade before being disgraced for paying men for sex.
Read 5 tweets
Florence Ashley Profile picture
Jun 13, 2023
You’d think Designated Survivor’s plot lines are a bit far fetched until you realize they’re inspired from real events. 😫
The True Believers plot line seems to be based on CSA, a far-right white supremacist group that plotted to overthrow the federal government back in the late 80s.
But unlike the white South African scientist who came to the US engage in racial bioterrorism, the real Wouter Basson was actively helped by the US government and its scientists for his mass murders in South Africa.
Read 4 tweets
Florence Ashley Profile picture
Jun 5, 2023
My hot take of the day is that the birth of applied trans studies is the best thing to have happened to trans cultural studies – for lack of a better term, which is to say the trans studies that finds itself most at home in TSQ – since its own emergence.
Ian Khara Ellasante in “Dear Trans Studies, Can You Do Love?” and Kadji Amin in “Whither Trans Studies?” both astutely noted just how devoid of trans life much of trans cultural studies has become.
The abstraction of ‘trans-’ as crossing might be an appealing way to secure the disciplinary space of trans studies but it makes it far too easy to ignore the trans lives behind trans studies.
Read 11 tweets

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