More shenanigans!

You may have noticed that the World Health Organization (WHO) is planning to release guidance on "the health of trans and gender diverse people," but have you noticed the dodgy timing?

who.int/news/item/18-1… The announcement above was on the 18th of December. They are soliciting public comment from now until the 7th of January.

Friends in Europe tell me that the Christmas holidays there extend past the day, until the 12th night. Nobody opens their PC. That's January 6.

Interesting.

A doctor friend of mine shared an idea that I think has great merit: detransitioners can file complaints against their gender doctors not in court (they can do that as well, but that's a hard road) but with that doctor's medical board. You can be anonymous
fsmb.org/contact-a-stat… One complaint is unlikely to "bring down" a doctor, but we are creating a paper trail. Unlike lawsuits, the person filing the complaint can remain anonymous (in every state I know of - I haven't checked the process in all 50 states). The board will investigate, there are rules...

Parents of trans-identified kids: please take this as an opportunity to look inward. A therapist is not going to fix this. Even if you could arrange a heart-to-heart convo with a detransitioner, that's not going to fix this.

You have to think "how did we get here?" I'm not saying that this is your fault!

Yes, many aspects of "trans" seem like a cult. Still, nobody has ever gotten a cult member to leave their cult by telling them they are in a cult. Humans don't work like that.

For teens and young adults, that goes double.

@helenlewis came out with a good but frustrating article in The Atlantic all of 3 days ago, here's a link to an archived version:
archive.md/FthDI Frustration #1, Helen inadvertently reminds me that the name of my rejected "Pediatrics Perspective" for the journal Pediatrics was called "Far From Settled Science: a Call for Caution in the Care of Gender Dysphoric Youth."

Yeah, it was sent to gender doctors for "peer review."

#AAP2022 had nothing about gatekeeping access to powerful controlled substances with irreversible effects, it was all affirmation and celebration.

#Tweetiatricians please read:

https://twitter.com/kcmiller1225/status/1579894797632155648

Our last speaker @moladinsky runs the gender clinic at the University of Alabama. She just described a suicide as “boldly stepping in front of a truck.” She repeated the word boldly.

I, I can’t even. . .

Glorifying suicide is unprofessional and dangerous.

🧵: Back in February I participated in a webinar about free speech, hosted by the Harvard Business School Club of New York. It was called “Misinformation and Hate Speech: Who Gets To Decide?”
hbscny.org/events/registe… There were multiple speakers, including Nadine Strossen, the former President of the ACLU (I would add - back when it was pro free speech, from 1991-2008) and Lisa Littman MD (@LisaLittman1).

It was three years ago that @LisaLittman1 published her seminal work on adolescent onset gender dysphoria, a new phenomena not previously described in the scientific literature. In honor of her work, @genspect has declared August 16 to be #RogdAwarenessDay #RogdAwarenessDay

I recently had a conversation with a pediatric psychiatrist about a troubled 12 yr old who has been self harming via cutting for more than a year. As we were discussing the case, the psychiatrist tells me that the girl has expressed discomfort with her gender. (1/4) I responded “Of course - she's a stressed out 12 yr old girl in Portland in 2021, it's not surprising she would want a get out of girl card, but that makes me wonder if there's a history of sexual abuse."  (2/4)

An "all inclusive feminist" shared an article with me, to educate me about detransitioners. I read it when it came out last December, but let's take a look, shall we?

nbcnews.com/feature/nbc-ou… It starts by suggesting that major media outlets are exaggerating the number and significance of detransitioners, "fueling misconceptions about the gender transition process."

"“The media are conjuring up a panic about trans lives." says Lui Asquith, who works for Mermaids:

I recently re-read a super useful article about how adults can respond to children who express gender dysphoria. It's from 2012, by David Schwartz Ph.D. and it's called "Listening to Children Imagining Gender: Observing the Inflation of an Idea."

tandfonline.com/doi/full/10.10… I'm not the first person to admire this article, but I've just got to share a few lines because they really spoke to me as a pediatrician.

I spend my days advising parents on the sometimes confusing behavior of their children. A line I use a lot is "kids do what works."

Why am I speaking up? Partly because I can, and as @amandapalmer says "If you can, you must."

Most pediatricians see gender as a difficult and fraught topic, and it just feels safe to just refer any kids with gender dysphoria to the gender clinic. They're the experts, right? But over at the gender clinic, they aren't exploring the patient's history, looking for ACE's. They aren't getting into comorbid conditions, like ADHD and ASD. They are starting with affirmation and moving briskly into transition.

And the medical risks are real, for that path

11 days ago I submitted a Letter to the Editor of the New York Times, in response to an opinion piece by that prolific psychiatric resident who can not be @'d because he has blocked me.

It was titled "What South Dakota Doesn't Get About Transgender Children."

(thread: 1/8) (2/8) It's safe to say at this point that I'm not getting my concerns aired on the august pages of the gray lady. I was told I'd hear back in a week; I've waited that plus 4.

So, I will share my letter with all of you!

To the Editor:

I've been around long enough to see . . .

Advice from an experienced pediatrician about interacting with your ROGD teen:
-remain calm! It's hard when things get scary, but you need to be the adult in the situation.
-don't try to change your teen's mind. When has anyone ever changed someone's mind with facts? Not often. That said, you don't need to just go along to get along. If you have deeply held doubts that hormones and surgery are going to make your teen happy in the long run, it's perfectly reasonable to say so.
It's OK to say that the idea of surgery is scary to you.

A few years ago I was a typical liberal, edging towards full hippy (🌻side note: the hippies were right about almost everything 🌺 ;-) I read @kdrum and @joshmarshall. I studied #permaculture. When I heard about “bathroom bills” in North Carolina, I thought “Oh those bigoted folks over there, they’re all worked up about nothing!” I casually conflated transgender rights with gay rights.

What has really struck me in conversations with and observations of doctors providing puberty blockers and cross-gender hormones to gender dysphoric youth is their utter conviction that they are saving lives.

"Would you rather have a dead daughter, or a live son?" At a talk at #AAP19, Katherine Greenberg MD, who's on the speaker's bureau for Merck, said that trans youth denied treatment have "8 times" the risk of suicide. Sounds terrible!

In this article: medpagetoday.com/meetingcoverag…

Kevin Wang MD says suicide attempts are 9 to 10x higher.