How is this not a scandal?
The revelation in this Tavistock study – that “blockers” and hormone-switches don’t fix the psychological misery – is shocking and scandalous.
Alleviating psychological symptoms is the basis for the treatment and the PR for it and the marketing angle for it and the political justification of it. It’s the tool the pro-trans fanatics grab to beat skeptics over the head with. It’s the whole thing.
It’s up there with the Tuskegee experiment or thalidomide.
Or spraying DDT on school children at lunch to demonstrate it was safe.
I am, of course, shocked that freezing a child in an anomalous, neither-male-nor-female, neither-adult-nor-child state doesn’t help resolve psychological issues around one’s body.
“I hate my body because I don’t fit in with the other boys.” “Well, how about we make you the only 17-year-old boy in your school without body hair, whose voice hasn’t cracked yet, and whose penis and testicles are underdeveloped? That ought to solve it.”
OR
“I hate my body because I don’t fit in with the other girls.” “No problem, we’ll just make you the only 17-year-old girl in your school to not have her period, or develop breasts. Then you surely won’t have any social anxiety.”
FOLLOWED BY:
“Hmm, that might not be so good.”
“No problem, we can always just ‘unfreeze’ you, and then you can be the only university student going through puberty!”
“That seems not so great. Don’t people find that distressing?”
“Uh… it’s uh… hard to say. I can say that we’ve never had any reports that it was a problem.”
“Oh, good. Out of how many people?”
“Erm… well.. you see… ”
At which point Pretentious Git, QC, charges in to call the child a transphobe. And… scene.
What those analogies lack I think is what may be called the Gratitude Factor: none of those patients or subjects begged for it, cried with joy when they got it, hugged the person who gave it, and for at least a while swore up and down that it was good, they were better, and they were so, so grateful. It wouldn’t need to be all the teens; it wouldn’t need to be completely sincere or spontaneous; it wouldn’t need to be long term; and it wouldn’t need to be objectively true. It only has to be convincing enough that people in a ‘helping’ profession become convinced they have indeed helped some children.
And then this conviction snowballs into ignoring the need for scientific verification. My guess is that it’s the same damn process you get with alternative medicine. A few outright con artists and frauds are swamped by a lot of True Believers who may cut some corners or make a mistake, but their heart is in the right place and they have such splendid stories to tell about how they made a difference in the lives of children.
And once that crap gets into mainstream medical centers — it’s been verified and established. Doesn’t matter if it’s homeopathy or puberty blockers, black salve or cross-sex hormones. The Gratitude Factor is very, very seductive and convincing, giving heavy weight to glowing self-reports and jumping lightly over the negativity and dissatisfaction which only shows up in a controlled study and objective research.
Sastra, that’s a very good point.
For all that I mock them, I really don’t have any doubt that these doctors are sincerely and utterly convinced that they’re doing the right thing, and that it would be monstrously cruel to deny a young person who is crying and begging for help the thing that they believe will help them.
And I certainly wouldn’t have any magic words or plans of action for such a child, beyond explaining that yes, it’s terrible that you feel this way, I want you to feel better, but there’s considerable doubt whether this will be the solution that you think it is, and let’s try something less drastic and consequential like therapy. It reminds me how Kevin K. used to demand that we all tell him what he was supposed to say to his trans child, as if the correctness of our arguments depended on a particular child finding them emotionally satisfying.
So yeah, it’s a dilemma I’m sure. But sometimes when you’re a professional, you have to deliver the news that you have no good solution. I can’t count how many clients or potential clients have been displeased to be told that yes, I know you’re upset at this situation, but filing a lawsuit over it isn’t going to accomplish anything other than making me a lot of money. (Or, conversely, fighting this lawsuit instead of settling.) You can be pissed at me for saying so, and you can be pissed at “the system” for not being the way you think it should be, but that’s the reality and that’s what I base my advice on, not what makes you feel good or makes me money. So while I can empathize with these doctors, I don’t excuse. (And I don’t take you to be excusing them either, Sastra — it remains a good point that these people aren’t villains, certainly not in their own minds and probably not at all.)
Sastra’s description is familiar to me, because it’s what I see in educational “research”. Self-reports, followed by no improvement (and sometimes a decline) in test results or other means of assessing knowledge, but the student reports that they learned more by this method, and they are really, really happy. They liked learning this way. It felt good. And they know so much!
Everyone ignores the objective measures…everyone means well, and educators genuinely want to educate, so they read these articles (actually, we are always encouraged to just read the abstracts, save time we could put to redesigning all our classes), and implement the changes. Sometimes they do notice that they are not getting good results; much of the time, they only notice those kids that do well (many of whom would do well no matter what, who were doing well before you implemented the change).
Politics does a lot of the same thing.
Isn’t there also some research showing that high scores on teaching evaluations are not correlated with any metric of student learning, but are inversely correlated with the amount of work assigned?
Screechy, that’s sort of an interesting thing to me, because one thing that became evident pretty quickly when I started teaching is that it is difficult to know what any test/essay/assignment or other method of assessment is actually measuring. I think part of the problem comes down to assessing what learning really means. Is it stuffing your head full of memorized facts? Knowing all the answers on a true/false test, even the tricky ones?
Personally, I think the main thing is how you can process the information. Take those facts stuffed into your head and move them around into different relationships to discover things. Figure out how a new piece of information relates to other things you already know, seemingly unrelated. Being able to understand the difference between fact and fiction, fantasy and reality. Problem is, those things can be damn hard to measure. I utilize a variety of different methods in my classes, and I discover that the students seem to walk into my classes as a blank slate, not even able to do simple things like multiply a number by 1 without a calculator or understand that if you give five choices on a multiple choice test, and ask which are one of the top three of something, the answer cannot be all of the above.
I have not been impressed with educational research. They start with assumptions that have little justification, and their conclusions frequently don’t match their results. I’ve seen some cases where they actually recognize that their results don’t support their hypothesis, and they go ahead and conclude that they do support anyway. Which is what the abstract will say, which seems to be all anyone reads (except me; I’m a rebel and I like research and statistics, so I will read what they really did, how they did it – usually a seriously flawed design – and what they really found).
Another example: Freudianism.
@Screechy Monkey #4
I agree that many of the specialists providing “care” to “trans teens” sincerely believe in the cause, but I’d be willing to bet there are also some self-aware peddlers of snake oil among their ranks. A few years back, when there was much less mainstream criticism of underage transition in the UK, a private-practice doctor by the name of Helen Webberley got in trouble for prescribing puberty blockers and cross-sex hormones to thousands of children. Some of these children were below the legal age for this “treatment”; others had been deemed poor candidates for transition by the NHS. Webberley and her husband, also a doctor, routinely prescribed blockers/hormones after a single one-hour teleconsultation, charging £150 per session. Back-of-envelope calculations suggest they were taking in hundreds of thousands per year. Now, perhaps they thought they were doing some kind of good, but I suspect that first and foremost, they were riding the gravy train as far as they could. (Eventually they rode it all the way to Spain, where they set up shop after having their prescribing rights pulled in Ol’ Bliney.)
#3 Screechy
Minor quibble: puberty blockers certainly do create an anomalous body state, but the person is still male or female, just an underdeveloped one. Which, yes, is hardly going to alleviate the person’s distress. It seems to me that that would merely replace one source of distress (“I find my maleness / femaleness repellent, I want to stop it”) with a new source (“I am physically anomalous amongst my peers, remaining childlike as they become adult”).
It is no wonder that 43 of 44 went on with the transition procedure. Far from being a ‘breathing space’, puberty blockers would seem to induce more of an axiety-riddled ‘hyperventilation space’ in which a person that already had body issues now has body issues with added stress. If they were contemplating transitioning before, puberty blockers would seem only to add urgency to this desire.
Holms #10
Getting the kid on puberty blockers is “closing the sale” on selling the kid down the trans pipeline. Other people have brought up that once on puberty blockers, the sunk cost bias is also a factor.
Ophelia:
Another example: drug addiction.
The whole thing reminds me of nothing so much as that. Always chasing the dragon, the addict finds that joy is transient. Eventually the fix is only sufficient to provide relief, and then not even that. A greater high must be found. Is this not the pattern we see play out? They begin with superficial changes in fashion, then binding, then comes a name change and a declaration of trans-ness, then onward to medical interventions, which themselves get progressively more extreme. And each of those steps along the way seems like it’s The Thing that will finally bring them happiness. But it doesn’t, because it’s a cycle of addiction.
When I read this, I thought you were going in a different direction. I thought you were going to talk about the “treatment” for substance abuse, which in the U.S. is basically sending people to a 12-step program. A nice place in Malibu or some similar place if you’re rich, otherwise you can go drink bad coffee in a church basement. Anyone questioning the effectiveness of this “treatment” method, or asking for reliable data, or suggesting the medical establishment explore alternatives, is denounced as someone who WANTS ADDICTS TO DIE. Oh, and of course YOU DON’T KNOW WHAT YOU’RE TALKING ABOUT because we must privilege the experiences of addicts who believe that AA “saved” them over trivial things like evidence.
Well, there’s that, and you’re absolutely right. I’ve had conversations with people who’ve gone through “the program”, and it’s like talking to the Saved. Which is not surprising, given the (at best quasi)religious nature of AA. Last time I did, I dropped the topic quickly, since I was at a wedding reception and didn’t feel like bringing everyone down by being a Socratic asshole.
‘They begin with superficial changes in fashion, then binding, then comes a name change and a declaration of trans-ness, then onward to medical interventions, which themselves get progressively more extreme.’
Some people have pointed out that a lot of these kids are dedicated gamers, and this reflects the progress of playing a video game as you ‘level up’ through accumulating skill and seniority.
There’s a lot in life that follows a leveling system: school, work, social standing, team sports, chess, etc. Progress is per se a process of tiered accumulation. While the comparison works to some degree between in-game leveling and transing, I’m not fond of analogies that apply too widely.
What study?
Allison Bailey’s tweet doesn’t link to a study.
Ophelia’s post doesn’t link to a study.
“I have this study that shows transgender people are all mentally ill, but I won’t let you see it.”
I’m reminded of Joseph McCarthy: “I have this list of communists in the state department, but I won’t let you see it.”
Well, Sam, if you weren’t just doing a drive-by cheap shot, you might have realized that this post is one of many discussing the Tavistock ruling.
Then you might have looked up the High Court’s ruling (here, I’ll spare you the effort) and read it, including the discussion at paras. 56-59, but also elsewhere.
But you didn’t do that, and I’m betting you won’t read it and respond now, let alone apologize, because you got your cheap McCarthy comparison in and are probably off to high-five some pals about how you really told those TERFs.
And Tavistock’s own study (reported here and discussed just a couple of posts back, which conveniently “wasn’t ready” in time for the High Court case.
Here you go:
https://www.bbc.co.uk/news/uk-55282113
https://www.medrxiv.org/content/10.1101/2020.12.01.20241653v1?fbclid=IwAR2nM32LPUtEYQ6zEmGofoHz3h6KibXQ_pAWVPIKBRwGSdQWJq-ok8Ncg70
Three seconds’ work, but I did know where to look.