#2017. 2021. and all the almosts in between and beyond

[starsonmarsy]

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[panicroomsammy]

I just saw some takes on “queer coding” that make me want to scream so I am going to post (part of) a paper I’m writing on queer coding in Supernatural that some of my mutuals encouraged me to post when I talked about it a few days ago. Tl;dr is that queer coding is a negative thing done by othering and/or vilifying a character - this is undisputed in academia and if you use the phrase “queer coded” to mean otherwise you are misusing the phrase.

Fandom has a long-lasting tradition of reading queerness into works of fiction – dating back to the original airing of Star Trek in the 1960s. Supernatural’s fandom has been no different. The show has, in fact, influenced the fandom subculture as a whole more than any other individual TV show this century – though to explore this in detail is beyond the scope of this paper.

The popular queer readings by fans largely center around the intensely macho elder brother, Dean Winchester. While the character’s overperformance of masculinity may lend itself to such readings, it is important to note that he is not traditionally queer coded at all. The vast majority of the traditional queer coding which goes on in the show instead applies to the more sensitive younger brother, Sam Winchester. The extent to which fans refuse to engage with this queer coding is what this section of the paper sets out to explain.

I propose that this reluctance stems from the fact that queer coding is negative. Characters are queer coded through Othering – a process by which they are shown to be different from their communities and from the heroes. The use of this in queer coding is well established – “all the analyzed [queer coded] characters somehow fitting the form of an outcast” (Svobodová, 2022) exemplifies queer coded characters as outcasts. There is also the theme of “monsters as the Other, representing queer people” (Mudry, 2022) and that “[queer coded] characters are meant to symbolise everything that is bad. In the process, they also become the Other,” (Veera, 2023). Queerness and monstrosity are linked through the process of queer coding, and this link makes queerness villainous. Historically this has been used to discourage deviant behavior and encourage conformity to the norm.

The way that this Othering is almost always part of the process of setting up a character as a villain is well established by scholarship that has focused on queer coding broadly (“queer-coded characters are almost always villains,” (Kim, 2017), “most of these [queer coded] characters are villains,” (Brown, 2021)). While many queer people have become fans of villains in response to seeing representation in them as the Other, villains or the monstrous do not appeal to everyone, and queer people are no exception.

While this may very well be a matter of preference, preferences do not form in a vacuum and, especially in the context of politically fraught topics such as queerness, are often indicative of deeper political issues. Even those who are Othered may recoil at unpalatable representations of the Other in fiction. In The Big, the Bad, and the Queer: Analysing the Queer-Coded Villain in Selected Disney Films, it is stated that “Seeing villains that behave in particular, perceivably queer ways creates “a psychological association” between ‘queer’ and ‘evil’ in the minds of children.”” This psychological association has been created through decades of queer coded villains in media and applies to present day characters that exhibit traditionally queer coded monstrous traits. The negative perception of queer coded and monstrous characters can apply to queer people as well as straight people.

Sam Winchester is a traditionally queer coded character. His arc over the first four seasons focuses on him having supernatural abilities that work to Other him. In the world of hunters – those who hunt supernatural beings – all supernatural beings are considered to be evil and are indiscriminately killed. Sam is one of these hunters, as are his family – his brother Dean and his father John. The development of his supernatural abilities over these seasons Others him in relation to his community and his family. The narrative positioning of such abilities as evil also work to position him as an anti-hero in a traditional queer coded villain role.

The show focuses on themes of the monstrous in its monster of the week format, broader plot arcs, and in relation to its main characters. This is often done by paralleling Sam with the monster of the week, done with the werewolf Madison in Heart (2.17) and the rugaru Jack in Metamorphosis (4.4). These parallels further work to place Sam in the role of the monstrous, even while working to humanize the monster of the week.

Queer people who have internalized the messages of queer coded characters as “everything that is bad” from other queer coded media are likely to dislike characters that are queer coded and may wish to distance their own queerness from such portrayals.

[peachjagiya]

My Taekook timeline thoughts

Idea from @blue703.

I'mma try this. Let me preface by saying I'm baby Army, coming up to a year. I pick stuff up fast and I have ADHD so I hyperfixate and deep dive but there's definitely stuff I don't know/am still trying to figure out. I ALSO got exposed to a lot of rumour and speculation without much foundation early on so I'm trying to remove that from my thinking.

2013-2014

Tae is instrumental in bringing Jungkook out of himself. They're CLEARLY close. Initial puppy love vibes.

2014-2015

This always feels to me that the attraction is strongest/most obvious on Jungkook's side. I don't think it's one-sided but Jungkook wears his heart in his EYES and Taehyung finds it easier to centre himself, perhaps. 2015-2017

Jungkook is what, 18-20 at this point, Taehyung 20-22? (my maths is appalling. I think that's right) and they seem to have exactly the kind of relationship that two young guys figuring themselves out have ie; DRAMATIC.

Sweet and clingy and lots of eyes and touching. Doesn't seem beyond the realms of possibility that kissing/whatever might have occurred. They're young and besotted. But it also seems to be a time of some pretty intense down moments like whatever the heck happened around Tokyo.

If you think about the Inkigayo video where JK seems a little bit stroppy with Tae for not being there sooner - well, devolve his emotional maturity by 6 or 7 years. I know people say JK doesn't like when he's not getting attention and it's supported by some clips, I feel. Like the slight drama with Bogum. I can imagine this combined with scary queer feelings combined with *SPECULATION INCOMING* being seperated on camera*, against their natural instinct to be close, would create a pressure cooker of Feels which would only ever come out in drama.

Also: Stigma is released in this time, Namjoon says Tae has his own story about it. I have wondered if Stigma might have been related to HYYH but I don't think the storyline bled into the songs, did they? Please correct me if I'm wrong there.

*side note: Dispatch threat to reveal a same sex couple then Dispatch suddenly getting BTS exclusives is an intriguing theory but I think even if it's nonsense or about a different group, I imagine it would create nervous ripples throughout various agencies? Maybe seperating Taekook was precaution? I don't know. Just a thought.

2018

It's well known JK and Tae were having some of their worst times during 2018 and disbandment talks. What intrigues me is that Jin says JK isolated himself and didn't talk to the members.

But Yoongi sends Tae and JK the supportive text message and Tae says he and JK read the messages together and cried. JK is isolated and not talking to other members but he's with Tae at this point? Interesting.

(I don't know if anyone else gets this but there seems to be a kind of implied "Well except V" in a lot of these stories. JK in his 2023 Sirius interview "I didn't really get a chance to see the members this year." and yet he's with Tae on a number of confirmed occasions and maybe other unconfirmed? Almost like Tae is aside from the collective members when it comes to JK.)

I feel like intentions might have been set here and some kind of commitment made, though I'm not sure it's a "together" commitment. Just an undetermined milestone of things getting much heavier than they were. An admission, a mutual understanding, a commitment to stop the drama... I don't know.

2019-2021

Golden Disk Awards 2020. Grammys 2020. Atomix. That's all. :)

Oh I suppose we have BTS: ITS1 filmed in 2020 and as we all know, Tae and JK have been awkward for a while and the only way Jungkook wants to be near Tae is if Jimin tricks him into going. 🙄

They just seem real sweet and close these years. No particular dramas between the two of them are cropping up for me, correct me if I'm wrong. JK has his tattooist nonsense which just feels like a silly storm in a dumb teacup. Still being seperated and forced to pretend they barely like each other in lives but that's just Bighit Streisand Effecting themselves. 😇

If not 2018 then something in here feels like it might have been the actual commitment.

2022 onwards

Demonstrable time spent together. Confirmed private time where JK hangs out with Tae's friends. Unconfirmed time too. WHATEVER WAS IN THE WATER FOR DREAM PREMIERE. Obviously Jennie weirdness in late '22, early '23 but that feels so much like a press stunt that I just J-Hope side eye it.

I once looked up if there was any telltale signs of fanservice when I was newborn army and so confused. A lot of the response was just "if it looks gay, it's fanservice." LOL but one person replied, paraphrased, "Disregard stages, photoshoots, some of the promotional lives, anything under direct agency management. Consider whether they actually interact privately where nobody is." and I feel like that kind of sums up Taekook since 2022 when BTS are on hiatus and they're still in each other's orbit.

2023

If they're not a couple, they're in love and don't know it. That's a joke. Don't come for me.

Lets see what 2024 onwards brings!

[ukrfeminism]

The number of women dying during pregnancy or soon after childbirth has reached its highest level in almost 20 years, according to new data. Experts have described the figures as “very worrying”.

How many women are dying?

Between 2020 and 2022, 293 women in the UK died during pregnancy or within 42 days of the end of their pregnancy. With 21 deaths classified as coincidental, 272 in 2,028,543 pregnancies resulted in a maternal death rate of 13.41 per 100,000.

This is a steep rise from the 8.79 deaths per 100,000 pregnancies in 2017 to 2019, the most recent three-year period with complete data. The death rate has increased to levels not seen since 2003 to 2005.

Where have the figures come from?

The data comes from MBRRACE-UK, which conducts surveillance and investigates the causes of maternal deaths, stillbirths and infant deaths as part of the national Maternal, Newborn and Infant Clinical Outcome Review Programme (MNI-CORP).

MNI-CORP aims to improve patient outcomes and is funded by NHS England, the Welsh government, the health and social care division of the Scottish government, the Northern Ireland Department of Health, and the states of Jersey, Guernsey, and the Isle of Man.

Why are so many women dying during or just after childbirth?

The main cause of death was thrombosis and thromboembolism, or blood clots in the veins.

The second most common cause was Covid-19. But even when deaths due to Covid were excluded, the maternal death rate for 2020 to 2022 – 11.54 per 100,000 pregnancies – remained higher than the rate for 2017 to 2019.

Heart disease and deaths related to poor mental health were also common, according to a review of the data by the Guardian.

Why is the mortality rate increasing?

The researchers behind the data project, led by Oxford Population Health’s national perinatal epidemiology unit at the University of Oxford, highlight several issues.

They say maternity systems in the UK are under pressure but also point to pre-pregnancy health and the need to tackle conditions such as obesity, as well as critical actions to work towards more inclusive and personalised care during pregnancy.

Is there any good news?

Not really. The maternal death rate among black women decreased slightly compared with 2019 to 2021, but they remain three times more likely to die compared with white women. Asian women are twice as likely to die during pregnancy or soon after compared with white women.

Are there other factors aside from health?

Absolutely. Women living in the most deprived areas of the UK have a maternal death rate more than twice that of women living in the least deprived areas.

Persisting ethnic and socioeconomic inequalities show the UK must think beyond maternity care to address the “underlying structures” that impact health before, during and after pregnancy, such as housing, education and access to healthy environments, said Dr Nicola Vousden, co-chair of the women’s health specialist interest group for the Faculty of Public Health.

Are deaths during pregnancy only increasing in the UK?

No. Maternal death rates are rising in many countries, yet this alarming trend has not been seriously addressed by governments and healthcare systems worldwide.

Rates have doubled in the US over the last two decades, with deaths highest among black mothers, a study in Journal of the American Medical Association found. Indigenous women had the greatest increase.

It is difficult to compare precise death rates between countries because the data is not uniform. But other countries seeing substantial rises in rates include Venezuela, Cyprus, Greece, Mauritius, Puerto Rico, Belize, and the Dominican Republic.

What can be done to reverse the trend?

Urgent action is needed to bolster the quality of maternal healthcare, ensure it is accessible to all, and repair the damage inflicted by the pandemic on women’s healthcare services more generally.

Clea Harmer, the chief executive of bereavement charity Sands, said improving maternity safety also needs to be at the top of the UK’s agenda.

The government said it was committed to ensuring all women received safe and compassionate care from maternity services, regardless of their ethnicity, location or economic status.

Anneliese Dodds, the shadow women and equalities secretary, said Labour would seek to reverse the “deeply concerning” maternal mortality figures by training thousands more midwives and health visitors and incentivising continuity of care for women during pregnancy.

NHS England said it had made “significant improvements” to maternity services but acknowledged “further action” was needed. It has introduced maternal medical networks and specialist centres to improve the identification of potentially fatal medical conditions in pregnancy.

[waitmyturtles]

Now that I’m a couple weeks back from my huge overseas trip, I’m very much back into my Old GMMTV Challenge Project (which, admittedly, has expanded WELL beyond the original three classic BLs that @absolutebl recommended to watch way back, when many of us were talking about old BL frameworks and tropes earlier this year!). Here’s an update:

1) The end of Love Sick Season 2 is incredibly near, and while, yes, there are many problematic factors to this show -- I think the show’s SHEER LENGTH allowed it to do a LOT with the characters and script that I’m frankly surprised by. It’s delved into allyship, into sexual exploration and revelation (on all the ends of the spectrum), into all the interesting shades of acceptance and casual homophobia among a group of teenage men, and now I see at the end of the show that we’ll (hopefully) get an exploration into acceptance of queer relationships by families, which is always my jam. 

I’ll save most of this for my post-watch analytical write-up, but I think for at least this show, to explore EVERYTHING the script got into -- the show needed this length. The writing wasn’t crisp and concise enough to really dig into things à la this wonderful era of GMMTV writing that we’re in NOW. But, I AM surprised by how far this script has gone without being ENTIRELY, 100% problematic. It’s a really good and fascinating watch, and I’m glad I dug into it for the history.

2) Next up will be Make It Right and Make It Right 2, which I originally thought would be my vehicle for learning more about the early high school pulps and getting familiar with pre-GMMTV Ohm Pawat. But I’ve also now been convinced by the wonderful @bengiyo to delve specifically into the works of the prolific New Siwaj, to learn about his focus on the queer male experience, and how he either successfully (or unsuccessfully) (or both, simultaneously) gets his messages across. I haven’t been watching his current works (Between Us, ABAAB), but surprisingly -- he’s a screenwriter on Double Savage, which for now seems very het. But now I wouldn’t be surprised if, à la 10 Years Ticket, we get a queer storyline in the show at some point. 

3) Speaking of Double Savage (which I am seriously enjoying -- I already highly recommend it), I’m watching Perth Tanapon for the first time (I didn’t watch Never Let Me Go, and I’m not sure that I will, yet, unless finishing out Double Savage makes me get into a Perth rabbithole). But anyway, I know that Dangerous Romance with PerthChimon is on its way, so I figured -- if Perth is paired with Ohm as brothers in DS -- that I should know about early PerthSaint, as Perth and Ohm had almost the same exact trajectory into GMMTV from their very youthful years in BL.

With that, and considering the new New Siwaj focus: I’m going to add Love By Chance to the list. (But I’m NOT adding the second season.) And it’ll be my first MAME show, and likely something that I feel like I SHOULD watch before watching TharnType later this year.

4) So here’s my newly jujjed list, and I’m fixing some errors for chronology here as well from past lists. I think with what I’ve watched so far -- Bad Buddy, ATOTS, The Eclipse, KinnPorsche, and Moonlight Chicken -- that I’ve already filled holes in this chronology, but I think this list gets me straight on the history I need to know.

If anyone has suggestions on watch order or other essential/necessary/historic/significant shows to watch, I am ALWAYS OPEN to feedback!

1) Make It Right (2016) 2) Make It Right 2 (2017) 3) Love By Chance (2018) 4) Kiss Me Again: PeteKao cuts (2018) 5) He’s Coming To Me (2019) 6) Dark Blue Kiss (2019) 7) TharnType (2019) 8) Theory of Love (2019) 9) Until We Meet Again (2019-2020) 10) 2gether (2020) 11) Still 2gether (2020) 12) ITSAY (2020) 13) I Promised You the Moon (2021) 14) Not Me (2021-2022) 15) My School President (2022-2023)

I can’t wait to finish Love Sick this week and get my write-up going, aaahhh!

[religion-is-a-mental-illness]

Published: Apr 5, 2023

Prisha Mosley was 17 when she was first given testosterone in a clinic in North Carolina, after she had declared to her parents that she was a boy. She had struggled through her teen years with anorexia and depression after a sexual assault. Luka Hein had both breasts removed as a 16-year-old in Nebraska. Chloe Cole, in California, was a year younger when she had her double mastectomy. She had been on testosterone and puberty-blocking drugs since 13, also after a sexual assault.

All three girls were experiencing “gender dysphoria”, a feeling of intense discomfort with their own sexed bodies. Once a rare diagnosis, it has exploded over the past decade. In England and Wales the number of teenagers seeking treatment at the Gender Identity Development Service (gids), the main clinic treating dysphoria, has risen 17-fold since 2011-12 (see chart 1). An analysis by Reuters, a news agency, based on data from Komodo, a health-technology firm, estimated that more than 42,000 American children and teenagers were diagnosed in 2021—three times the count in 2017. Other rich countries, from Australia to Sweden, have also experienced rapid increases.

As the caseload has grown, so has a method of treatment, pioneered in the Netherlands, now known as “gender-affirming care”. It involves acknowledging patients’ feelings about a mismatch between their body and their sense of self and, after a psychological assessment, offering some of them a combination of puberty-blocking drugs, opposite-sex hormones and sometimes surgery to try to ease their discomfort. Komodo’s data suggest around 5,000 teenagers were prescribed puberty-blockers or cross-sex hormones in America in 2021, double the number in 2017.

Dysphoria furoria

The treatment is controversial. In many countries, but in America most of all, it has become yet another front in the culture wars. Many on the left caricature critics of gender-affirming care as callously disregarding extreme distress and even suicides among adolescents with gender dysphoria in their determination to “erase” trans people. Zealots on the right, meanwhile, accuse doctors of being so hell-bent on promoting gender transitions that they “groom” vulnerable teenagers—a term usually applied to paedophiles. In October supporters and critics of gender-affirming care held rival, rowdy protests outside a meeting of the American Academy of Paediatrics. Several American states, such as Florida and Utah, have passed laws banning gender-affirming care in children. Joe Biden, America’s president, has described such laws as “close to sinful”.

Almost all America’s medical authorities support gender-affirming care. But those in Britain, Finland, France, Norway and Sweden, while supporting talking therapy as a first step, have misgivings about the pharmacological and surgical elements of the treatment. A Finnish review, published in 2020, concluded that gender reassignment in children is “experimental” and that treatment should seldom proceed beyond talking therapy. Swedish authorities found that the risks of physical interventions “currently outweigh the possible benefits” and should only be offered in “exceptional cases”. In Britain a review led by Hilary Cass, a paediatrician, found that gender-affirming care had developed without “some of the normal quality controls that are typically applied when new or innovative treatments are introduced”. In 2022 France’s National Academy of Medicine advised doctors to proceed with drugs and surgery only with “great medical caution” and “the greatest reserve”.

There is no question that many children and parents are desperate to get help with gender dysphoria. Some consider the physical elements of gender-affirming care to have been life-saving treatments. But the fact that some patients are harmed is not in doubt either. Ms Mosley, Ms Hein and Ms Cole are all “detransitioners”: they have changed their minds and no longer wish to be seen as male. All three bitterly regret the irreversible effects of their treatment and are angry at doctors who, they say, rushed them into it. Ms Cole considers herself to have been “butchered by institutions we all thought we could trust”.

The transitioning of teenagers has its roots in a treatment protocol developed in the Netherlands in the 1980s and 1990s. It is built on three pillars: puberty-blockers (formally known as gnrh antagonists), cross-sex hormones and surgery. The goal was to alter the patient’s body to more closely match their sense of cross-sex identity, and thereby relieve their mental anguish. A pair of papers published in 2011 and 2014 by Annelou de Vries, one of the Dutch protocol’s pioneers, reported on the experiences of some of the first patients. They concluded that symptoms of depression decreased among patients taking puberty-blockers, and that gender dysphoria “resolved” and psychological functioning “steadily improved” after cross-sex hormones and surgery.

Transition ignition

Puberty-blockers do what their name suggests. The idea is that suspending unwanted sexual development can give patients time to think about their dysphoria, and whether or not they wish to pursue more drastic interventions. The same family of drugs is used to treat “central precocious puberty”, in which puberty begins very early. Some countries also use them to chemically castrate sex offenders. As with many other medicines used in children, the use of puberty-blockers in gender medicine is “off-label”, meaning that they do not have regulatory approval for that purpose.

Patients who decide to proceed with their transition are then prescribed cross-sex hormones. Males will see the development of breasts and alterations to how fat is stored on the body. Giving testosterone to females boosts muscle growth and causes irreversible changes such as deepening the voice, altering the bone structure of the face and the growth of facial hair.

Under the original Dutch protocol, surgery was permitted only after a patient turned 18, although as the cases of Ms Cole and Ms Hein show, in some places mastectomies occur at a younger age. Male patients can have artificial breasts implanted. More elaborate procedures, in which females have a simulated penis built from a tube of skin harvested from the forearm or the thigh, or males have an artificial vagina made in a “penile inversion”, are performed extremely rarely on minors.

In 2020 the National Institute for Health and Care Excellence (nice), a British body which reviews the scientific underpinnings of medical treatments, looked at the case for puberty-blockers and cross-sex hormones. The academic evidence it found was weak, discouraging and in some cases contradictory. The studies suggest puberty-blockers had little impact on patients. Cross-sex hormones may improve mental health, but the certainty of that finding was low, and nice warned of the unknown risks of lasting side-effects.

For both classes of drug, nice assessed the quality of the papers it analysed as “very low”, its poorest rating. Some studies reported results but made no effort to analyse them for statistical significance. Cross-sex hormones are a lifelong treatment, yet follow-up was short, ranging from one to six years. Most studies followed only a single set of patients, who were given the drugs, instead of comparing them with another set who were not. Without such a “control group”, researchers cannot tell whether anything that happened to the patients in the studies was down to the drugs, to other treatments the patients might be receiving (such as counselling or antidepressants), or to some other, unrelated third factor.

The upshot is that it is hard to know whether any of the supposed effects reported in the studies, whether positive or negative, are actually real. Reviews in Finland and Sweden came to similar conclusions. As the Swedish one put it, “The scientific base is not sufficient to assess…puberty-inhibiting or gender-opposite hormone treatment” in children.

Two American professional bodies, the Endocrine Society (es) and the World Professional Association for Transgender Health (wpath) have also reviewed the science underpinning adolescent transitions. But es’s review did not set out to look at whether gender-affirming care helped resolve gender dysphoria or improve mental health by any measure. It focused instead on side-effects, for which it found only weak evidence. This omission, says Gordon Guyatt of McMaster University, makes the review “fundamentally flawed”. wpath, for its part, did look at the psychological effects of blockers and hormones. It found scant, low-quality evidence. Despite these findings, both groups continue to recommend physical treatments for gender dysphoria, and insist that their reviews and the resulting guidelines are sound.

One justification for puberty-blockers is that they “buy time” for children to decide whether to proceed with cross-sex hormones or not. But the data available so far from clinics suggest that almost all decide to go ahead. A Dutch paper published in October concluded that 98% of adolescents prescribed blockers decide to proceed to cross-sex hormones. Similarly high numbers have been reported elsewhere.

The reassuring interpretation is that blockers are being prescribed very precisely, given only to those whose dysphoria is deep-rooted and unlikely to ease. The troubling one is that puberty-blockers lock at least some children in to further treatment. “Time to Think”, a new book about gids by a British journalist, Hannah Barnes, cites British medical workers concerned by the latter possibility. They say patients received blockers after cursory and shallow examinations.

The Dutch researchers weigh both explanations. “It is likely that most people starting [puberty-blockers] experience sustained gender dysphoria,” they write. But, “One cannot exclude the possibility that starting [puberty-blockers] in itself makes adolescents more likely to continue medical transition.”

Perhaps the biggest question is how many of those given drugs and surgery eventually change their minds and “detransition”, having reconciled themselves with their biological sex. Those who do often face fresh anguish as they come to terms with permanent and visible alterations to their bodies.

Once again, good data are scarce. One problem is that those who abandon a transition are likely to stop talking to their doctors, and so disappear from the figures. The estimates that do exist vary by an order of magnitude or more. Some studies have reported detransition rates as low as 1%. But three papers published in 2021 and 2022, which looked at patients in Britain and in America’s armed forces, found that between 7% and 30% of them stopped treatment within a few years.

The original Dutch studies published in 2011 and 2014 were longitudinal—that is, they followed the same group of patients throughout their treatment. Yet three recent critiques published in the Journal of Sex & Marital Therapy nonetheless find fault with the studies’ data.

One of the new studies’ concerns is the small size of the original samples. The 2011 paper looked at 70 patients. But the outcome of treatment was only known for between 32 and 55 of them (the exact number depends on the specific measure). And even then, the final assessment of outcomes occurred around 18 months after surgery—a very short timeframe for a treatment whose effects will last a lifetime. (The first patient, “FG”, was followed for longer. In 2011, when in his mid-30s, researchers reported his feelings of “shame about his genital appearance” and of “inadequacy in sexual matters”. A decade later though, things had improved, and FG had a steady girlfriend.)

The critiques also suggest that the finding that gender dysphoria improved with treatment may have been an artefact of how the participants were assessed. Before treatment, female patients were asked to agree or disagree with such statements as, “Every time someone treats me like a girl I feel hurt.” This established their desire to be seen as male. After blockers, hormones and surgery the same individuals were asked questions on a scale originally developed for those born male. It offered statements such as, “Every time someone treats me like a boy I feel hurt.” Naturally, patients who preferred to be seen as male disagreed. In effect, the yardstick was changed in a way that might be seen as making positive outcomes more likely.

Finally, the original studies seem to have inadvertently cherry-picked patients for whom the treatment was most effective. The researchers started with 111 adolescents, but excluded those whose treatment with puberty-blockers did not progress well. Of the remaining 70, others were omitted from the final findings because they did not return questionnaires, or explicitly refused to do so, or dropped out of care or, in one case, died of complications from genital surgery. The data may therefore exclude precisely those patients who were harmed by or dissatisfied with their treatment.

In a rebuttal published in the same journal, Dr de Vries insists that the original papers found a significant improvement in gender dysphoria, the condition the protocol was designed to treat. She concedes that the switching of assessment scales is “not ideal” but says this does not imply the studies’ results were “’falsely’ measured”. In response to worries about the relatively short follow-up, she noted that a study reporting longer-term outcomes is due “in the upcoming years”.

What is more, whatever the merits of the Dutch team’s original research, the patients passing through modern clinics are strikingly different from those assessed in their papers. Twenty years ago the majority of patients were pre-pubescent boys; in recent years teenage girls have come to dominate (see chart 2). The findings of older research may not apply to today’s patients.

The Dutch team’s approach was deliberately conservative. Patients had to have suffered from gender dysphoria since before puberty. Many of today’s patients say they began to suffer from dysphoria as teenagers. The Dutch protocol excludes those with mental-health problems from receiving treatment. But 70% or more of the young people seeking treatment suffer from mental-health problems, according to three recent papers looking at patients in America, Australia and Finland.

Despite the protocol’s caution, says Will Malone of the Society for Evidence-Based Gender Medicine, an international group of concerned clinicians, the reality is often the reverse, especially in America, with mental-health issues becoming a reason to proceed with transitions, rather than to stop them. “We are now told that if we don’t address young people’s mental-health problems caused by dysphoria with transition, they will kill themselves.”

Gender agenda

The original Dutch protocol emphasises the need for careful screening and assessments, as do official guidelines in most countries. But whatever the guidance, there are persistent allegations that it is not being followed in practice. “I had one 15-minute appointment before I was given testosterone,” says Ms Mosley. Many American patients contacted by The Economist reported similarly brief examinations.

The possibility that many teenagers presenting as trans could instead be gay has long been discussed. The Dutch study of 2011 found that 97% of the participants were attracted either to their own sex or to both sexes. In 2019 a group of doctors who resigned from gids told the Times, a British newspaper, of their worries about homophobia in some patients and parents. They worried that, by turning children into simulacra of the opposite sex, the clinic was, in effect, providing a new type of “conversion therapy” for gay children.

Both within America and without, whatever the loudmouths may claim, the vast majority of practitioners are simply trying to ease the genuine suffering of adolescents afflicted by gender dysphoria. But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics.

European medical systems have not concluded that it is always wrong for an adolescent to transition. They are not trying to erase distressed patients. They have simply determined that more research and data are needed before physical treatments for gender dysphoria can become routine. Further research could, conceivably, lead to guidelines similar to those already in use by American medical bodies. But that is another way of saying that it is impossible to justify the current recommendations about gender-affirming care based on the existing data. 

[ Via: https://archive.is/oeQ6F ]

[ahelpfulpeach]

cat introduction (and reintroduction(and re-reintroduction...)) help???

SO I'm throwing out some feelers here because my partner (Jay) and I are a little... at a loss. This is gonna be long in order to explain everything under the cut, but the tl;dr is:

We have 4 cats(all spayed/neutered): Thomas(M almost 7), Corvo(M 5.5), Juno(F almost 3), and Jester (F 1.5)

Thomas and Corvo were living with me (and for a few months, my dad, while Jay and I got a new apartment where everyone would fit), Juno and Jester were living with Jay

We moved everyone in together into the new apartment just before Halloween 2022

Introductions were going fairly smoothly (doing the whole quarantine and slowly edging up to hanging out together thing over a couple weeks), but Corvo needed to be shaved because he was very matted

Thomas had BAD nonrecognition aggression which we think triggered fear with the girls.

He has since gotten back to normal with Corvo, but continues to be fearful of the girls despite reintroducing everyone

We've already tried/are already trying: Feliway, Gabapentin (prescribed by vet), vet visit, door feeding, treats together, playing together, fun things that only happen when they're together, brushing them with the same brushes, using Corvo as a scent conduit, swapping rooms, catnip, endless interactive toys, puzzle treat toys, so many litter boxes and water bowls and hidey-holes and cat towers and pathways, etc etc etc

So. Help?

Details under the cut

Okay so, the longer version with anything I can possibly think of that might be useful.

Thomas and Corvo:

I got Thomas in college in mid 2016 as a kitten. He lived with me, my roommates, and one of my roommate's cats (Toni, 2ish year old male). He had no issues with any of this. He also had to spend breaks with either my family and my childhood cat (Angel, older female) and dog (Taylor, older female), or my roommate's family and HIS childhood cat (Pablo, older male).

I got Corvo after moving in late 2017, also as a kitten, and he and Thomas were introduced well and got along just fine. Again, they had to spend some breaks at my family's home and spent some time with Angel and Taylor. No real issues beyond some discomfort of being moved around and having to deal with new places.

Moved again 2018 and my new roomie had a dog and a cat (Male, roughly their age?). No real issues with either.

Another move in 2019, no new animals.

Another move to live with my dad 2020-2022. Taylor and Angel were back in the picture. I lived with them full time through 2020, then spent a lot of my time going between my dad's home and Jay's (who lived in another state) up until I moved in with her full time in April/May of 2022

Basically all this to say that both Thomas and Corvo have moved several times and had to be introduced to new people, new cats, and new animals in general over and over and have always been able to handle it with minimal issues. Corvo was always a little more willing to buddy up with other critters, but Thomas was never fearful or aggressive. Generally just acknowledged their existence.

Thomas has in the past had some issues with non-recognition aggression after vet visits for him and Corvo, but it never lasted more than a few hours.

Thomas has always shown a little more anxiety about changes, but again, nothing so bad as right now. That said, he's settled into the apartment itself fine at this point. He's confident and curious and wants to be with people... so long as the girls are not involved.

Juno and Jester:

Jay got Juno back at the end of 2020, when she was about 8 months old.

Aside from coming to her parents' for Xmas and being in the general proximity of her childhood cat(Female, scaredy cat) and dog (male, 3ish?), Juno didn't interact with other animals until we got Jester in summer of 2021

Juno took a little while to get adjusted to Jester, but the two of them are now wonderfully bonded.

Juno had an autoimmune issue that caused us to have to remove all of her teeth in early/mid October of 2022. Not exactly ideal timing, as we had already planned a move for later that month.

Both of

The initial situation:

We got a new apartment to move into at the end of October 2022. Two bedrooms so we could handle quarantining the cats better. Ahead of time we put in Feliway spray and diffusers for a solid week.

I had to drive Thomas and Corvo down from my dad's home for a full day, but the cats were essentially introduced to the new environment at the same time. There were more objects with the girls' scents on them as most of the furniture was Jay's, but I brought all the boy's beds and towers and scratchers and toys to get their scent in the new place too.

Everyone got set up with their home bases and we got to work introducing everyone. Feeding on opposite sides of the doors, more Feliway, swapping objects, swapping rooms, rubbing everyone with a towel and brushes to get scents mixed, sniffing and playing under the doors or through cracked doorways, etc. Slowly ramping things up

Juno was the most grumpy about the situation at first, which is more or less what we expected, given that she'd just had surgery and had had the most time as a single cat. She was standoffish and hissy and slappy, but would still exist in the room with everyone. Everyone else seemed to have gotten to the point of acceptance with one another.

The Haircut and Reintroduction:

As mentioned, Corvo needed his mats shaved out because my father is old and did not keep up with his grooming. This wound up happening mid November 2022.

We knew to expect some issues with everyone not recognizing him at first, since he'd smell weird and look weird, but by golly the poor little guy was OSTRACIZED.

Thomas reacted the most violently, chasing him down and attacking him upon first seeing him, and not wanting to be anywhere near him. The girls were less upset but still untrusting.

However, at this same time, Juno decided she was done playing hard-to-get with Thomas, and wanted to be buddies. Thomas, who was already freaked out, did not like this, and responded with hissing, slapping, and running away.

While we were busy reintroducing Corvo to the crew, the girls (and later Corvo once he was interacting in person again) decided Thomas' running away was just a great game and continuously chased him. Everyone seemed pretty into the idea of chasing Thomas every time he made an appearance, which did not help his fear.

Despite our best efforts, no amount of playing everyone out ahead of being together seemed to really detract from their interest in chasing him. At least the girls and Corvo were getting along once again.

Finally though, we got to a point where Thomas and Corvo could be together and play and chase each other like normal. This took pretty much the entire rest of November and into December, however.

Re-re-introduction (ongoing):

So, that brings us to the status quo we've been living in since early December.

We completely separated Thomas and the girls again in late November to restart the introduction process. Door feeding, swapping rooms, etc. Corvo is able to be out and about all the time because he's the only valid child he gets along with everyone.

The only times the girls and Thomas are together are during entirely supervised and guided play times. We have to be very involved to keep the girls from trying to pounce on Thomas. Any time that that has happened, Thomas has gotten very upset and run away and hidden.

We can't really feed them together because the boys eat slowly and the girls are gluttons who inhale their food instantly.

But yes we have multiple daily play times together with every distraction we can think of.

Yes we have Feliway. No, I have no idea if it's doing anything.

Outside of those interactions, we have either the girls or Thomas out in the main area of the apartment with us and Corvo, and the other in the bedroom or office.

In December both Jay and I were sick for most of the month, so unfortunately we were not as consistent with our playtimes with the cats during that month.

Also in December we got Thomas over to our vet to be checked out. He got a clean bill of health and a prescription of Gabapentin to chill him out.

The gabapentin helps (he's able to exist in the girls' proximity and even play with toys or approach them to sniff them), but he's still clearly uncomfortable. Even while drugged, he hides at the slightest provocation, hisses and slaps at the girls when the approach him (usually), or walk past him, or move slightly too close to him, or react to him sticking his entire nose in their anus. You get it.

So at this point, a solid month and a half into our more intensive re-introduction and two and a half months into the reintroduction at all, and 3 and half months into them all living together, we're... struggling. It seems like we've hit a plateau with what we can accomplish. We can't have the cats out together without strict supervision, which is taxing on us, because the girls want to pounce on Thomas, and Thomas is still reacting to their general EXISTENCE with fear. He's not at a point where he could tolerate them trying to play with him like that, and we don't want what minor progress we've been able to make taken away.

That said, we're pretty sure the more realistic thing is to desensitize Thomas to the girls than to try to get the girls to ignore him completely. But we just. Don't know how to do that, as what we've already been doing doesn't seem to be creating any more progress.

We have Feliway dispensers in every single room in the multicat flavor. I want to emphasize we live in a two bedroom apartment. This is MORE than enough for coverage.

We have cat trees in every room. And scratchers. And hidey holes. And beds. And water bowls. And toys. And windows. And litter boxes. There is no shortage of resources for these guys. And we've done our best to create multiple pathways for everyone wherever we can. It's not always possible, there's not always room, but we try.

We have specific meal times. We can't feed them together because the girls will finish first and try to eat the boys' food cuz they are empty pits, but everyone is fed at the same time and they eat on opposite sides of the doors.

We play with them all together at least twice a day for at least 20 minutes or so a pop, which is sometimes all we can manage since we both work full time and it's a two person job to handle all four at once. We can't get them out together while we're both gone, it's just not possible, and we also need time to do the other general household things we need to do and REST.

I dunno. We're just at a bit of a loss. Please feel free to reply or message with any questions, I know this is a jumbled mess.

[oswlld]

Eight (8) Shows to Get to Know Me

tagged by @talays-portkey ♥ ty for tagging me and having me walk down memory lane for the past few days (spent too much time in all the tags microdosing on my upbringing)

DISCLAIMER: i wanted to showcase defining eras in my life/made an impact in a substantial way; i’m also recommending an ep to watch with each one, which isn’t part of the tag format but imma do it

--

i. LOST (2004-2010)

this was my whole world for my entire hs existence and into my early college years. half of the shows listed here stems from my first love of the ensemble cast, their interwoven yet clandestine storylines, and the mystery box. at my first sdcc, half of the cast was present when they debuted p1 of the series finale (you’d think i was dead the whole time fksfsk;lv)

the jessi special: The Constant (04x05)

ii. Fringe (2008-2013)

yes, i faithfully followed jj abrams into another insane show. i think it actually altered my brain chemistry, rewired something in me, devoured a piece of me. once LOST was over and Fringe brought in the alternate universe, i dove in head first and never resurfaced

the jessi special: Making Angels (04x11)

iii. Doctor Who (2005-Present)

i think it was technically winter 2010 when i started binging this show because s6 was my first time catching it live (was young and naïve, i caught it on bbca lol) ive been on hellsite for almost two years at the time and fully became a fandom blog, so it was inevitable i would love this series. i think it was the first show i made gifs/edits for???

the jessi special: The Doctor’s Wife (06x04)

iv. Lizzie Bennet Diaries (2012-2013)

oh look, my dna makeup shifts again. i actually started watching this show the week leading up to Darcy Day and can still vividly remember the migraines from binging 8-10min eps times 60ish worth of content. this show got me into writing my first fic, running an rp blog, creating instrumental playlists, making a DWxLBD blog, AND eventually flying my ass back to CA to meet the cast and beloved mutuals at VidCon

the jessi special: A New Buddy (ep56)

v. Orphan Black (2013-2017)

happy international women’s day to this show and this show only! i think of all the shows listed here, this is the first time since LOST i caught all the eps in real time from the very beginning. this was filling the hole Fringe was about to carve deep in me. but if you cut me open, you will find the beth-shaped hole that nothing/no one has been able to fill and likely will never fill til the end of time

the jessi special: The Collapse of Nature (04x01)

vi. Shadowhunters (2016-2019)

im willing to admit that the reason i got into this show was because of the wedding kiss haha i saw the clip, signed the adoption papers on the spot, and went on to write a 100K+ wip series. admittedly, i confess that this was a DNF and never finished the last season... i abandoned my boy.gif

the jessi special: Of Men and Angels (01x06)

vii. Sense8 (2015-2018)

a show about eight children than i gave birth to, that i raised on my own, that i will defend on my death bed and beyond??? that show sense8?? yes that show sense8. fun fact, when they did the screening of the finale in Chicago, the cast ended up sitting three rows behind me in the theater and i could hear them talking in between scenes the entire evening. wish i could bottle that feeling up

the jessi special: I Have No Room in My Heart for Hate (02x07)

viii. Bad Buddy (2021-2022)

and we finally made it to the current decade! its nov 2021, im fresh off leaving my previous job and still getting situated in my new position, yet this show was a siren calling to me in the dark mist of my life. i ended up saving the binge watching for the week of my bday and my whole life shifted again. it must have been so alarming on the outside, seeing me go from making 1-2 edits a month to 1-2 edits a day for almost THREE MONTHS. the fact that i still cont to avg two edits/week since then... oy lol

the jessi special: Ep10 (shocked pikachu.jpg)

and ill also throw some honorable mentions too: Chuck, The Good Place, Vice Versa, Twenty Five Twenty One, Once Upon a Time, and Elementary

--

now tagging @pranink, @icouldhyperfixatehim, @noxclara, @curious-earth (no pressure tho!)

[kaitlin-murphy]

"After John James Audubon (American Woodsman)" 2021.

Vintage posters, Franklinia alatamaha seeds, cotton, antique frame, plywood, plexi, glue, hardware, vintage lumber, iron oxide stain, light-reactive sound device, 1950s sound recordings of Vermivora bachmanii, vintage darning egg, vintage needle and spools, Sturnus vulgaris skull, wool socks knitted by Bobby Wilcox, original wallpaper digitally designed using copyright free historic images, printed by SpoonFlower Inc, self-published zine.

I was invited by Goucher College Curator and Director of Exhibitions Alex Ebstein to create this installation for the "Rediscovering Goucher's Lost Museum" exhibition in fall 2021. Documentation photos generously made by Vivian Marie Doering @vivianmariephoto on Instagram.

Artist Statement:

“On the whole, the task of turning Audubon’s original images into marketable engravings proved to be an extremely labor-intensive process that relied, almost immediately, on the work of dozens of artisans, often working directly under Audubon’s ever-critical eye. But the work process went well beyond the engraver’s shop. Unseen and unheralded others likewise made a critical contribution to the project: the papermakers who produced the huge, high-quality sheets Audubon required; the copper smelters who turned raw ore into clean ingots; the miners who extracted the ore from the earth in the first place; and so forth, back through all the prior steps of production. In that sense, The Birds of America was not just an extensive work of art, not just an example of the sole genius of the lone, struggling artist. It was, rather, an ambitious business venture that relied on a complex labor process and an extensive supply chain, an enterprise in which the artist became not just the designer of the work, but the administrative manager of dozens of people, many of whom could be called artists in their own right, and a marketer to prospective customers, many of whom he had to track down wherever he could find them, on both sides of a very wide ocean.”

--Gregory Nobles, John James Audubon: The Nature of the American Woodsman, 2017. p103

Beyond the ‘supply chain’ of compensated workers existed a backdrop of the truly Unseen and Unheralded – the enslaved Black people whose supportive labor was violently coerced; and the work of Maria Martin, an ‘artist in [her] own right’ whose labor was given, and taken, freely due to her faith and her standing as an unmarried, white woman in the Antebellum South. Utilizing the exquisite Martin-Audubon collaborative painting, "Bachman's Warbler", as a jumping-off point, this installation is a visual exploration of the cultural and structural scaffolding that made such erasure possible during that era, as well as two examples of natural history showcased by the painting that have been lost and found - the now extinct Bachman's Warbler (Vermivora bachmanii) for which this painting and a few short sound recordings are our best documentation of the species' existence, and Franklin Tree (Franklinia alatamaha) a species native to the southeastern US that narrowly avoided utter extinction thanks to the collectors John and William Bartram, and that now exists in scattered cultivation across the country.

This project is not meant as a wholesale ‘cancel’ of John James Audubon or early American naturalists – whose work, at times disturbingly tainted by prevailing beliefs and customs, nevertheless paved the way for the scientific fields of biology and ecology today. This installation is, rather, an acknowledgment of the conflicted entanglements between history, nature, people, race, gender, ideology, belief, imagery, and power.

Collections are essentially a grandiose form of appropriation, recontextualizing objects for myriad purposes. This installation plays with two traditions: collections and appropriation, by appropriating and recontextualizing Audubon’s work, as well as other historical illustrations from various collections, and using metaphor and allegory as tools to tell the story. It would not have been made possible without the help, labor, and/or support of many unseen and unheralded, including the anonymous archivists at the Internet Archive, New York Public Library Digital Collections, and Cornell’s Macaulay Library, collectors on Ebay, Etsy, Facebook Marketplace, and Bazaar in Hamden, the production team at Spoonflower, and most especially Alex Ebstein, Bobby Wilcox, Seth Adelsberger, Denise Wilcox, Patti Murphy, Wyatt Hersey, Jenny Rieke and Oona McKay.

[romualddem]

Permeation

Agnieszka Brzeżańska, Judith Hamann

@ MOS, Gorzów Sep 13—Oct 20, 2024 sound performance by Judith Hamann: Oct 19, 2024 at 6 pm

Permeation juxtaposes the recent paintings and sculptures of Agnieszka Brzeżańska with the sound installation and drawings by Judith Hamann. The joint exhibition of two interdisciplinary artists, who use a variety of methods and approaches in their work, subjecting the surrounding world to sensitive observation and listening, creates a space for experience and joint contemplation of the immediate future.

Agnieszka Brzeżańska uses a variety of media, focusing on the relationship between living beings and other entities inhabiting the Earth. In what appear to be abstract images, her search is for the representation of that which remains beyond the boundaries of anthropocentric reality. Biomorphic shapes represent extraterrestrial bodies, lost, non-existent or imagined entities. Brzeżanska works with a precise, formal shorthand, which can be seen in compositions built from almost a single line—delicately swirling, forming regular circles like ripples on the water, or spreading out in many directions.

Disorderly thoughts/forms, phantoms smiling mysteriously, or perhaps representations of nature, which, according to Agnieszka Brzeżańska, is in principle favourable to all beings? The artist’s ceramic sculptures from recent years seem to capture her interests and fascinations in both form and meaning. The collection of candelabra-like objects with organic shapes (Metaphor of Everything, 2017) is presented as an installation and serves as a symbolic element in the exhibition. Set on mirrors and equipped with candles that are lit during the visit, the figure- like plants enhance the polysensory dimension of the exhibition, while inviting a more intimate contact with the art.

The intangible element that fills the exhibition space is sound, present in the form of Judith Hamann’s audiospheric installation. The composition, based on field recordings, is only a small part of Hamann’s wider research-performative practice, which is rooted in experiments with the instrument and the non-human voice. Hamann refers to the many audible and perceptible properties of sound as a living medium that not only accompanies humans but is above all an intrinsic part of nature. In addition to the auditory form, the exhibition presents an excerpt from the series Paper Membranes (2020/24), for which Judith Hamann uses the technique of frottage, treated as a performative action akin to field recording. She imagines landscapes, interior and exterior spaces as ‘recordings’ made up of the surface of a wall, the trunk of a tree or the texture of a stone. These become part of a single trace, a recording of an impossible-potential landscape.

Agnieszka Brzeżańska (born in Gdańsk) studied at the Academy of Fine Arts in Gdańsk and Warsaw in Prof. Stefan Gierowski’s Painting Studio, and at the Tokyo University of Fine Arts and Music. Her work includes paintings, drawings, photography, film, ceramics and other media. Brzeżanska draws on various registers of knowledge, from physics and philosophy to systems of cognition marginalised by modern science, such as alchemy, parapsychology, esotericism, indigenous knowledge or matriarchal traditions. Since 2016, she has been organising Flow/Przepływ, an artist residency on the Vistula River, together with Ewa Cieplewska. She has presented her works in many solo exhibitions, most recently including ‘Incantations and Ancestors’, Willa Polonia Gallery in Busko-Zdrój (2023), ‘Ancestors’, BWA Warszawa (2023), ‘So Remember The Liquid Ground’, eastcontemporary in Milan (2021), ‘World National Park’, Królikarnia, The Xawery Dunikowski Museum of Sculpture — a division of the National Museum in Warsaw (2019), Gdansk City Gallery (2018). She took part in the 10th Berlin Biennale for Contemporary Art (2018). She collaborates with the BWA Warszawa gallery in Warsaw and the Nanzuka gallery in Tokyo. She lives and works in Warsaw.

Judith Hamann (born in Naarm/Melbourne, Australia) is a composer, performer and sound art maker. They are described as an “extraordinary Australian cellist” (the Guardian) who “destroys the fiction of the musician who lives and works outside conventional parameters and puts in its place a series of compositions that are fundamentally humane” (WIRE). Hamann’s work encompasses performance, improvisation, electro-acoustic composition, field recording, electronics, site specific generative work, and micro-tonal systems in a deeply considered process based, or even ‘nomadic’ approach to creative practice. Hamann explores acts of shaking and humming as formal and intimate encounters; explores ‘collapse’ as a generative, imagined surface; and considers the ‘demystification’ of bodies, both human and non-human, in the context of instrumental practice and the pedagogy of colonial heritage. They have performed at festivals such as Tectonics (Glasgow, Athens, etc.), UnSound (NYC), Sonic Acts (Amsterdam), Maerzmusik (Berlin), CTM (Berlin), Biennale Musica — The International Festival of Contemporary Music (Venice), Tokyo Experimental Festival (Tokyo), and AURAL (Mexico). Hamann enjoys thinking and working with other artists which includes Marja Ahti, Joshua Bonnetta, Pascale Criton, Charles Curtis, Sarah Hennies, Yvette Janine Jackson, and Anike Joyce Sadiq. Their music was released on labels including Blank Forms, Black Truffle, Another Timbre, and Longform Editions. They hold a Doctor of Musical Arts from UC San Diego. Judith Hamann lives and works in Berlin.

Text by Romuald Demidenko Contemporary Art Library

[fabioperes]

Why Some North Korean Defectors Want to Go Back Nearly 34,000 North Koreans have defected to South Korea since figures were first collected in 1998. While the number of new arrivals dropped to a trickle in recent years due to strict Covid controls in North Korea and China, they are almost certain to start rising again now that border constraints are easing. For many, the journey is arduous. Since the border between the two Koreas is one of the most militarized in the world, almost all defectors first flee to China until they can gather enough money to reach a third country, such as Thailand. Then they can apply for asylum in South Korea, which grants them citizenship after a security screening. Their resettlement should in theory be easier because they’re moving to a country with a common language, culture and traditions. But North Korea’s decades of isolation and lack of uncensored information has caused a wide rift with South Korea. Once North Koreans arrive, South Korea offers an initial settlement funding of 9 million won ($6,900), vocational training and subsidies for employers for hiring defectors. Many live near each other in blocks of inexpensive apartments, oftentimes the so-called 25-square-meter “rental apartments” provided by the government. When the support runs out, they must provide for themselves — often leading to grim outcomes. The unemployment rate for defectors is about twice the national average. Many older defectors retain a northern Korean accent, making them stand out each time they speak. Others bear scars such as psychological trauma or physical problems such as lung damage from digging for coal in unsafe mines with no protective equipment. Nearly 90% of defectors in Seoul said they’ve had trouble settling into their new homes after a decade, according to a 2022 study from the Seoul Institute. North Korean defectors between 2017 and 2021 experienced suicidal impulses more than double the rate of South Korea population, which is already among the highest in the world, according to a survey from the Seoul Institute. In some cases, leaving could prove fatal for family members who don’t flee. Lee, who defected to South Korea in 2017, and only gave her surname due to safety concerns, could only afford to bring one of her sons with her. When the North Korean authorities found out about her defection, they beat her oldest son to death. “I am so lonely,” Lee said. “I want to go back and die there — South Korea is as suffocating as the North.” -------- Like this video? Subscribe: http://www.youtube.com/Bloomberg?sub_confirmation=1 Become a Quicktake Member for exclusive perks: http://www.youtube.com/bloomberg/join Bloomberg Originals offers bold takes for curious minds on today’s biggest topics. Hosted by experts covering stories you haven’t seen and viewpoints you haven’t heard, you’ll discover cinematic, data-led shows that investigate the intersection of business and culture. Exploring every angle of climate change, technology, finance, sports and beyond, Bloomberg Originals is business as you’ve never seen it. Subscribe for business news, but not as you've known it: exclusive interviews, fascinating profiles, data-driven analysis, and the latest in tech innovation from around the world. Visit our partner channel Bloomberg Quicktake for global news and insight in an instant. via YouTube https://www.youtube.com/watch?v=PmmKNGMI9F8

[gone-fish-mode]

introduction

last updated: 10 / 21 / 24

about me

howdy! and welcome to my otherkin blog. i am amadeus and i am a 21 year old aromantic lesbian. i use he/she only, no they/them. i like and follow from @actualamadeus .

i've had this blog since august 2023, but i've known i was alterhuman since 2017. i did not activley identify with any of the labels until late 2020 / early 2021.

i enjoy lots of things but am not really active in fandom spaces. i enjoy hiking, backpacking, camping, kayaking, bone hunting, antiquing, and crocheting! i collect bones, type writers, antique books, and labradorite.

i generally try to avoid getting too close with those below 18, however my account is SFW and i am willing to chat with almost anyone!

my anon asks and dms are always open. i can be pretty skittish sometimes and have trouble responding, but i do really appreciate every attempt to reach out.

feel free to send any questions in the ask box ! i am an open book and willing to chat or answer questions or give advice.

'types

gillman psycological otherkin

alien satellotype otherkin [ orbits gillman 'type ]

gargoyle other heart

stitch [ lilo and stitch ] fictionkin

This blog is mainly about my gillman type, since it is the most prominent. It's the only one I have any sort of shift for, although I will make the occasional post about my others.

despite technically being fictionkin, i have no desire to align myself with that community or interact with the fandom. i will gladly speak about it if asked, but i really just want to sit with it and have fun with it on my own.

byf / dni / bos

i block freely and casually.

i will not interact with anyone who supports, harbors, or condones an identity or a space for an identity that is harmful towards anyone, be it physically, emotionally, or otherwise.

i am anti-censorship, but believe we should be critical of the media we consume.

i will not tolerate policing labels. i support all good faith identities.

i am not a discourse blog. none of these things will come up in any post. at the most extreme i will reblog something reporting physical nonhumans or good-faith ID's within the otherkin community.

tags

i do not plan to post any triggering content, however if you follow me and there is something you'd like tagged, let me know. I will do it without a second question.

#blub blub: posts that have my own words!

#fish mode is best mode: posts that are directly about my kin experience or posts by others that i heavily relate to.

#blub answers: asks that i've answered!

#blub asks: asks that i send

#blub stars: posts that make me kick my flippers with joy

visual credits/hoard

"flesh between my jaws" user box: @stranger-from-beyond

"the asset" mood board: @yourfavoritemenace

"transseamonster / transspecies sea monster" flag: @rwuffles

*not requested by me

"gillman" cage design: @mons7errr

"gillman/amphibian man" kin flags: @eddie-the-silver-fox

"gillman" otherkin flag: @crazy-iwascrazyonce1

"gillman" mood board: @gone-fish-mode

"gillman" mood board: @your-ace-fluffy-neighbour

"gargoyle" other heart flag: @crazy-iwascrazyonce1

"from afar" user box: @stranger-from-beyond

[theultimatefan]

NLL Names Kurt Hunzeker Executive Vice President of Commercial Operations

The National Lacrosse League (@NLL), the largest and most successful professional lacrosse property in the world, today announced industry veteran Kurt Hunzeker has been named to the newly created position of Executive Vice President of Commercial Operations. Hunzeker brings more than 20 years of executive sales, marketing, and brand building to the NLL, most recently as Vice President, Minor League Business Operations for Major League Baseball. He will report directly to NLL Commissioner Brett Frood and will begin his work this week.

“The National Lacrosse League is enjoying a post-pandemic rebirth on and off the field, as evidenced by our rise in attendance and revenue, media exposure and the expansion of partnership programs by our teams,” Commissioner Frood said. “Kurt has the perfect blend of creative and practical business experience to help us capitalize on this next vital phase of enterprise growth. His experience with disruptive properties like the XFL’s St. Louis BattleHawks, and with emerging businesses like MiLB, provide the right mix to help shape and grow the NLL business and promotional platforms like never before.”

“I look at the NLL as a property that has exactly what brands and consumers want—fast paced excitement, great athletes, a growing fan base, a solid ownership structure, and great media partners in ESPN and TSN—and I am looking forward to helping the League realize its business and brand potential beyond what exists today,” Hunzeker said. “The industry has heard about the emerging growth of lacrosse as a sport, now it’s time for the NLL to push the narrative to an even wider audience, while continuing to engage and develop that stronger base of fans who have enjoyed the NLL for years.”

Hunzeker joins the NLL after overseeing all business-driving and revenue-generating functions of MLB’s restructured player development system and its 120 MiLB teams since 2021, including: national commercial sales and partnership activation, marketing and communications, content strategy and creation, media production and multimedia platforms, community relations and fan engagement, ticketing strategy, licensed consumer products, and ecommerce. He also authored the initial five-year business strategy and activation plan for MiLB’s new centralized business fully integrated within MLB, and generated the most commercial revenue in MiLB’s 122-year history in 2022.

It was Hunzeker’s second successful stint in baseball, having served as Vice President, Marketing Strategy and Research for Minor League Baseball from January 2015 to June 2019 where he built, enacted and measured the go-to-market corporate partnership and fan engagement strategies, focused on brand amplification, consumer acquisition, and unprecedented revenue growth for MiLB’s national commercial sales and marketing enterprise representing all 160 MiLB communities at the time. He led the creation of MiLB Copa de la Diversión™ (the “Fun Cup”), and designed and implemented MiLB’s 10-year strategic marketing plan in 2017, including its first-ever national campaign, MiLB It’s Fun to Be a Fan®, amplifying all 160 MiLB Clubs’ fan recruitment and engagement efforts.

Between his time at MiLB and MLB, Kurt was President of the St. Louis BattleHawks of the XFL, leading the team to landmark growth for the startup league before it was shut down due to the pandemic. The BattleHawks were the XFL’s leader in almost all business categories, surpassing all sales, social media and marketing goals by as much as 97% before the league shutdown. That success also included the signing of a record 12 Founding Partnerships, including national brands with deep, local market connections such as Anheuser-Busch InBev, Centene and McDonald’s.

The St. Louis native and University of Missouri graduate was also Senior Director, Brand Marketing for the Rawlings Sporting Goods Company for four years before MiLB, where he managed the global brand marketing and media buying efforts for the iconic sports brand, focusing on creating engagement platforms targeting next-level players, coaches and parents to maximize brand awareness, drive purchase intent and generate revenues with high potential consumers worldwide.

[bluemoonmetaverse]

How To Buy Metaverse Land: A Step-by-Step Guide

The metaverse gained more popularity than ever this past year as we experienced a transition into a new era of digital connectivity in 2022, especially with Facebook officially changing to “Meta” in October 2021. The main idea of the metaverse lies in creating an entirely immersive replica of our existing reality without any physical boundaries meaning the potential of this new digital universe is almost beyond comprehension!

Decentraland staged its first metaverse land sale before the end of December 2017, selling individual acres for about $20. The cost of the parcels rose to $6000 towards the end of 2021, and by the middle of 2022, prices had more than doubled to about $15,000. It’s these unprecedented spikes in value that has major players flocking to invest.

Interest in Metaverse Real Estate has risen higher after multiple celebrities have purchased digital land. In 2021, a purchase of $450,000 was made for the land adjacent to Snoop Dogg's virtual home, allowing the owner to become digital neighbors with the hip-hop icon.  In this article, we will delve into the specifics of why the value of metaverse land is growing and shed light on how you can invest in digital real estate as well.

An Understanding of the Metaverse Land

With the Metaverse gaining so much traction, it’s natural to wonder how to capitalize on it. You should understand that metaverse land works similarly to physical land. There are many different areas more suited for particular businesses; farmland, residential land, commercial land with high foot traffic, etc. With metaverse land, you should focus on your business goals.  For example, Snoop Dogg’s Snoopverse would be a good place to buy a plot of land to sell hip hop oriented NFTs or avatars.

The Metaverse enables gamers or users to run applications that let them create avatars that are either identical to or superior to them. These avatars can interact socially, work, and make money from investments. These users can then buy Metaverse land to build gaming centers, online shops, and art galleries; the possibilities are endless. Essentially, the Metaverse provides a connection between the virtual and physical worlds.

How Can One Purchase Land in the Bluemoon Metaverse?

You must first acquire cryptocurrencies if you wish to purchase virtual real estate. For instance, if you're thinking about purchasing land in the Bluemoon Metaverse, you might need to first acquire Ether (Ethereum) or MANA.

Currently, metaverse platforms have some of the best-developed and well-organized real-world infrastructures, which new owners are free to alter as they see fit. Land can be purchased directly from owners or investors. Follow these steps to learn how to purchase metaverse land.

Step 1: Choose a Metaverse Platform

The success of your investment is significantly impacted by the platform you select for your metaverse land. It all depends on what you want to do with the land you acquire, but be aware that there are a variety of possibilities available. For example, the Bluemoon Metaverse enables businesses to enter the Metaverse with their own digital worlds for a variety of uses spanning from entertainment, finance, healthcare, and more.

Step 2: Create Your NFT or Cryptocurrency Wallet

A wallet where you can access your cryptocurrency is necessary. Before choosing, you must confirm that the cryptocurrency is compatible with the platform where you intend to buy your Metaverse land. The Bluemoon Metaverse eases this process by allowing its users to shift their assets across networks with a few simple clicks using multi-chain compatibility.

Step 3: Connect Your Wallet to the Metaverse

Each metaverse platform has a different registration procedure. You will link your wallet after initially creating an account. It takes just a few clicks to link your wallet, and you may install browser add-ons that take care of the integration for you.

Step 4: Purchase cryptocurrency and add it to your digital wallet

Cryptocurrency can be bought via online markets like Binance. Make sure you have enough ETH or MANA in your wallet to make your desired investment whenever you are ready to explore, bid, or buy.  Inside Bluemoon’s Metaverse, users can display their NFTs while automatically listing these NFTs on multiple NFT Marketplaces, including the Bluemoon Marketplace. This allows visitors to buy NFTs on a single platform.

Future of Investing in the Metaverse

In the long term, the vitality of virtual real estate will depend on the future of the Metaverse itself. Several wealthy and influential companies, from Facebook to Microsoft, are betting big that it will be the next evolution of the internet. If the Metaverse can become as essential to business and society as the internet has become, digital real estate will become a progressively more profitable asset.

From large corporations to personal brands and influencers, people love the opportunity the internet gives them to create followings and build new products and services. The Metaverse might be the next big thing, but much more immersive than its predecessors, like social media. This likely points to a promising future for the virtual real estate market. Now that you have a basic understanding of how to buy Metaverse land do your research and choose the investment that best suits you.

[medley-med]

How to Address Patient Concerns about Telemedicine?

Between 2017 and 2023, the telemedicine market is expected to rise by 16.8%. Because of its cost-effectiveness and ease of access to healthcare services. In the United States, it is used by more than half of hospitals and almost one million Americans. While there are numerous advantages to telemedicine, there are also some legitimate concerns. The good news is that having a strategy can help you conquer your fears.

How to Address Patient Concerns about Telehealth Apps?

Telehealth is not a new concept: an article published in The Lancet in 1879 urged for the use of the telephone to reduce the number of unnecessary office visits. The magazine Science and Invention highlighted it in 1925 when it featured a physician diagnosing their patient via the radio on the cover.  

Telehealth has advanced far beyond anything anyone could have envisioned a century ago, thanks to current advances in information technology and the rise of industry 4.0. Doctors may now communicate with their patients via video chat, monitor them remotely via IoT, and access all their medical records with a single click. Furthermore, the usage of telemedicine solutions has risen as a result of COVID-19 and the accompanying shutdown.  

It is predicted that more than 1 billion virtual healthcare contacts will occur by 2023. Telehealth visits increased by 50% in March of 2021 alone.

What Is the State of Telehealth Right Now?

According to a poll conducted by Software Advice, patients are already interested in telemedicine. Telemedicine Platform, a subset of telehealth, piqued the attention of nearly three out of every four responders. If 2021 taught us anything about healthcare, it was the significance of embracing digitalization and telemedicine.  

As the globe sank into dread and uncertainty at the start of 2020, the Indian people were quickly confined to their homes for the better part of the year. This has been a nightmare for people with significant illnesses and chronic disorders, as the epidemic has put unprecedented demand on healthcare systems around the world, including in India.

Following the epidemic of the Coronavirus, the Indian government issued new telemedicine guidelines to assist patients and healthcare professionals by delivering medical services to the Indian people.

Patients who have used telemedicine identified several advantages, which should come as no surprise.

·      High-quality care: on par with, if not better than, face-to-face encounters

·      Eliminating the need for travel and allowing patients to see a doctor from the convenience of their own homes

·      The opportunity to see a doctor quickly and avoid waiting

·      Reduced expenses

Telemedicine saved rural patients, especially those without easy access to efficient forms of transportation, the time and effort of arranging transportation to and from their appointments. This is why rural hospitals have embraced telemedicine more than urban or suburban hospitals.

Telehealth: Issues and Concerns

The majority of problems fall into one of two categories: those relating to treatment quality and those connected to procedure technology. These misgivings may hinder the adoption of telehealth, which is why healthcare providers must address them to encourage its growth.

Medical Treatment of High Quality

The most widespread belief is that obtaining virtual consultations will not provide the same level of care as receiving in-person treatment. The in-person engagement and relationship developed with the physician is a vital component of medical consultation for many people. This should come as no surprise, as studies have shown that efficient communication between patients and their doctors has a significant impact on health outcomes.

Furthermore, it improves patient satisfaction and participation in their therapy, as well as provides much-needed support and comfort to patients at tough moments. While synchronous telemedicine is good for check-ups and consultations, asynchronous telehealth can be beneficial when consumers wish to ask their doctors’ rapid questions and both are performed by MedleyMed. Remote monitoring can not only eliminate many of the limitations of synchronous telehealth, but it can also be a great alternative for monitoring people with chronic illnesses like diabetes and heart disease.

[old-school-butch]

I highly recommend subscribing to the Economist btw. But they will let you have access to a few free articles a month anyway, and there are a couple more on trans issues in this edition. https://www.economist.com/briefing/2023/04/05/the-evidence-to-support-medicalised-gender-transitions-in-adolescents-is-worryingly-weak

PRISHA MOSLEY was 17 when she was first given testosterone in a clinic in North Carolina, after she had declared to her parents that she was a boy. She had struggled through her teen years with anorexia and depression after a sexual assault. Luka Hein had both breasts removed as a 16-year-old in Nebraska. Chloe Cole, in California, was a year younger when she had her double mastectomy. She had been on testosterone and puberty-blocking drugs since 13, also after a sexual assault. 

All three girls were experiencing “gender dysphoria”, a feeling of intense discomfort with their own sexed bodies. Once a rare diagnosis, it has exploded over the past decade. In England and Wales the number of teenagers seeking treatment at the Gender Identity Development Service (GIDS), the main clinic treating dysphoria, has risen 17-fold since 2011-12 (see chart 1). An analysis by Reuters, a news agency, based on data from Komodo, a health-technology firm, estimated that more than 42,000 American children and teenagers were diagnosed in 2021—three times the count in 2017. Other rich countries, from Australia to Sweden, have also experienced rapid increases.

As the caseload has grown, so has a method of treatment, pioneered in the Netherlands, now known as “gender-affirming care”. It involves acknowledging patients’ feelings about a mismatch between their body and their sense of self and, after a psychological assessment, offering some of them a combination of puberty-blocking drugs, opposite-sex hormones and sometimes surgery to try to ease their discomfort. Komodo’s data suggest around 5,000 teenagers were prescribed puberty-blockers or cross-sex hormones in America in 2021, double the number in 2017.

Dysphoria furoria

The treatment is controversial. In many countries, but in America most of all, it has become yet another front in the culture wars. Many on the left caricature critics of gender-affirming care as callously disregarding extreme distress and even suicides among adolescents with gender dysphoria in their determination to “erase” trans people. Zealots on the right, meanwhile, accuse doctors of being so hell-bent on promoting gender transitions that they “groom” vulnerable teenagers—a term usually applied to paedophiles. In October supporters and critics of gender-affirming care held rival, rowdy protests outside a meeting of the American Academy of Paediatrics. Several American states, such as Florida and Utah, have passed laws banning gender-affirming care in children. Joe Biden, America’s president, has described such laws as “close to sinful”.

Almost all America’s medical authorities support gender-affirming care. But those in Britain, Finland, France, Norway and Sweden, while supporting talking therapy as a first step, have misgivings about the pharmacological and surgical elements of the treatment. A Finnish review, published in 2020, concluded that gender reassignment in children is “experimental” and that treatment should seldom proceed beyond talking therapy. Swedish authorities found that the risks of physical interventions “currently outweigh the possible benefits” and should only be offered in “exceptional cases”. In Britain a review led by Hilary Cass, a paediatrician, found that gender-affirming care had developed without “some of the normal quality controls that are typically applied when new or innovative treatments are introduced”. In 2022 France’s National Academy of Medicine advised doctors to proceed with drugs and surgery only with “great medical caution” and “the greatest reserve”.

There is no question that many children and parents are desperate to get help with gender dysphoria. Some consider the physical elements of gender-affirming care to have been life-saving treatments. But the fact that some patients are harmed is not in doubt either. Ms Mosley, Ms Hein and Ms Cole are all “detransitioners”: they have changed their minds and no longer wish to be seen as male. All three bitterly regret the irreversible effects of their treatment and are angry at doctors who, they say, rushed them into it. Ms Cole considers herself to have been “butchered by institutions we all thought we could trust”.

The transitioning of teenagers has its roots in a treatment protocol developed in the Netherlands in the 1980s and 1990s. It is built on three pillars: puberty-blockers (formally known as GnRH antagonists), cross-sex hormones and surgery. The goal was to alter the patient��s body to more closely match their sense of cross-sex identity, and thereby relieve their mental anguish. A pair of papers published in 2011 and 2014 by Annelou de Vries, one of the Dutch protocol’s pioneers, reported on the experiences of some of the first patients. They concluded that symptoms of depression decreased among patients taking puberty-blockers, and that gender dysphoria “resolved” and psychological functioning “steadily improved” after cross-sex hormones and surgery.

Transition ignition

Puberty-blockers do what their name suggests. The idea is that suspending unwanted sexual development can give patients time to think about their dysphoria, and whether or not they wish to pursue more drastic interventions. The same family of drugs is used to treat “central precocious puberty”, in which puberty begins very early. Some countries also use them to chemically castrate sex offenders. As with many other medicines used in children, the use of puberty-blockers in gender medicine is “off-label”, meaning that they do not have regulatory approval for that purpose.

Patients who decide to proceed with their transition are then prescribed cross-sex hormones. Males will see the development of breasts and alterations to how fat is stored on the body. Giving testosterone to females boosts muscle growth and causes irreversible changes such as deepening the voice, altering the bone structure of the face and the growth of facial hair.

Under the original Dutch protocol, surgery was permitted only after a patient turned 18, although as the cases of Ms Cole and Ms Hein show, in some places mastectomies occur at a younger age. Male patients can have artificial breasts implanted. More elaborate procedures, in which females have a simulated penis built from a tube of skin harvested from the forearm or the thigh, or males have an artificial vagina made in a “penile inversion”, are performed extremely rarely on minors.

In 2020 the National Institute for Health and Care Excellence (NICE), a British body which reviews the scientific underpinnings of medical treatments, looked at the case for puberty-blockers and cross-sex hormones. The academic evidence it found was weak, discouraging and in some cases contradictory. The studies suggest puberty-blockers had little impact on patients. Cross-sex hormones may improve mental health, but the certainty of that finding was low, and NICE warned of the unknown risks of lasting side-effects.

For both classes of drug, NICE assessed the quality of the papers it analysed as “very low”, its poorest rating. Some studies reported results but made no effort to analyse them for statistical significance. Cross-sex hormones are a lifelong treatment, yet follow-up was short, ranging from one to six years. Most studies followed only a single set of patients, who were given the drugs, instead of comparing them with another set who were not. Without such a “control group”, researchers cannot tell whether anything that happened to the patients in the studies was down to the drugs, to other treatments the patients might be receiving (such as counselling or antidepressants), or to some other, unrelated third factor.

The upshot is that it is hard to know whether any of the supposed effects reported in the studies, whether positive or negative, are actually real. Reviews in Finland and Sweden came to similar conclusions. As the Swedish one put it, “The scientific base is not sufficient to assess…puberty-inhibiting or gender-opposite hormone treatment” in children.

Two American professional bodies, the Endocrine Society (es) and the World Professional Association for Transgender Health (wpath) have also reviewed the science underpinning adolescent transitions. But ES’s review did not set out to look at whether gender-affirming care helped resolve gender dysphoria or improve mental health by any measure. It focused instead on side-effects, for which it found only weak evidence. This omission, says Gordon Guyatt of McMaster University, makes the review “fundamentally flawed”. WPATH, for its part, did look at the psychological effects of blockers and hormones. It found scant, low-quality evidence. Despite these findings, both groups continue to recommend physical treatments for gender dysphoria, and insist that their reviews and the resulting guidelines are sound.

One justification for puberty-blockers is that they “buy time” for children to decide whether to proceed with cross-sex hormones or not. But the data available so far from clinics suggest that almost all decide to go ahead. A Dutch paper published in October concluded that 98% of adolescents prescribed blockers decide to proceed to cross-sex hormones. Similarly high numbers have been reported elsewhere.

The reassuring interpretation is that blockers are being prescribed very precisely, given only to those whose dysphoria is deep-rooted and unlikely to ease. The troubling one is that puberty-blockers lock at least some children in to further treatment. “Time to Think”, a new book about gids by a British journalist, Hannah Barnes, cites British medical workers concerned by the latter possibility. They say patients received blockers after cursory and shallow examinations.

The Dutch researchers weigh both explanations. “It is likely that most people starting [puberty-blockers] experience sustained gender dysphoria,” they write. But, “One cannot exclude the possibility that starting [puberty-blockers] in itself makes adolescents more likely to continue medical transition.”

Perhaps the biggest question is how many of those given drugs and surgery eventually change their minds and “detransition”, having reconciled themselves with their biological sex. Those who do often face fresh anguish as they come to terms with permanent and visible alterations to their bodies.

Once again, good data are scarce. One problem is that those who abandon a transition are likely to stop talking to their doctors, and so disappear from the figures. The estimates that do exist vary by an order of magnitude or more. Some studies have reported detransition rates as low as 1%. But three papers published in 2021 and 2022, which looked at patients in Britain and in America’s armed forces, found that between 7% and 30% of them stopped treatment within a few years.

The original Dutch studies published in 2011 and 2014 were longitudinal—that is, they followed the same group of patients throughout their treatment. Yet three recent critiques published in the Journal of Sex & Marital Therapy nonetheless find fault with the studies’ data.

One of the new studies’ concerns is the small size of the original samples. The 2011 paper looked at 70 patients. But the outcome of treatment was only known for between 32 and 55 of them (the exact number depends on the specific measure). And even then, the final assessment of outcomes occurred around 18 months after surgery—a very short timeframe for a treatment whose effects will last a lifetime. (The first patient, “FG”, was followed for longer. In 2011, when in his mid-30s, researchers reported his feelings of “shame about his genital appearance” and of “inadequacy in sexual matters”. A decade later though, things had improved, and FG had a steady girlfriend.)

The critiques also suggest that the finding that gender dysphoria improved with treatment may have been an artefact of how the participants were assessed. Before treatment, female patients were asked to agree or disagree with such statements as, “Every time someone treats me like a girl I feel hurt.” This established their desire to be seen as male. After blockers, hormones and surgery the same individuals were asked questions on a scale originally developed for those born male. It offered statements such as, “Every time someone treats me like a boy I feel hurt.” Naturally, patients who preferred to be seen as male disagreed. In effect, the yardstick was changed in a way that might be seen as making positive outcomes more likely.

Finally, the original studies seem to have inadvertently cherry-picked patients for whom the treatment was most effective. The researchers started with 111 adolescents, but excluded those whose treatment with puberty-blockers did not progress well. Of the remaining 70, others were omitted from the final findings because they did not return questionnaires, or explicitly refused to do so, or dropped out of care or, in one case, died of complications from genital surgery. The data may therefore exclude precisely those patients who were harmed by or dissatisfied with their treatment.

In a rebuttal published in the same journal, Dr de Vries insists that the original papers found a significant improvement in gender dysphoria, the condition the protocol was designed to treat. She concedes that the switching of assessment scales is “not ideal” but says this does not imply the studies’ results were “’falsely’ measured”. In response to worries about the relatively short follow-up, she noted that a study reporting longer-term outcomes is due “in the upcoming years”.

Newer longitudinal studies have been published since, but they have drawbacks, too. One published in January in the New England Journal of Medicine by Diane Chen of Northwestern University and colleagues looked at teenagers after two years of cross-sex hormone treatment. Although participants did typically report improvements in their mental health, they were small—generally single-digit increases on a scale that runs from 0 to 100. The study lacked a control group. Two of the 315 patients committed suicide.

What is more, whatever the merits of the Dutch team’s original research, the patients passing through modern clinics are strikingly different from those assessed in their papers. Twenty years ago the majority of patients were pre-pubescent boys; in recent years teenage girls have come to dominate (see chart 2). The findings of older research may not apply to today’s patients.

The Dutch team’s approach was deliberately conservative. Patients had to have suffered from gender dysphoria since before puberty. Many of today’s patients say they began to suffer from dysphoria as teenagers. The Dutch protocol excludes those with mental-health problems from receiving treatment. But 70% or more of the young people seeking treatment suffer from mental-health problems, according to three recent papers looking at patients in America, Australia and Finland.

Despite the protocol’s caution, says Will Malone of the Society for Evidence-Based Gender Medicine, an international group of concerned clinicians, the reality is often the reverse, especially in America, with mental-health issues becoming a reason to proceed with transitions, rather than to stop them. “We are now told that if we don’t address young people’s mental-health problems caused by dysphoria with transition, they will kill themselves.”

Gender agenda

The original Dutch protocol emphasises the need for careful screening and assessments, as do official guidelines in most countries. But whatever the guidance, there are persistent allegations that it is not being followed in practice. “I had one 15-minute appointment before I was given testosterone,” says Ms Mosley. Many American patients contacted by The Economist reported similarly brief examinations.

The possibility that many teenagers presenting as trans could instead be gay has long been discussed. The Dutch study of 2011 found that 97% of the participants were attracted either to their own sex or to both sexes. In 2019 a group of doctors who resigned from GIDS told the Times, a British newspaper, of their worries about homophobia in some patients and parents. They worried that, by turning children into simulacra of the opposite sex, the clinic was, in effect, providing a new type of “conversion therapy” for gay children.

Both within America and without, whatever the loudmouths may claim, the vast majority of practitioners are simply trying to ease the genuine suffering of adolescents afflicted by gender dysphoria. But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics.

European medical systems have not concluded that it is always wrong for an adolescent to transition. They are not trying to erase distressed patients. They have simply determined that more research and data are needed before physical treatments for gender dysphoria can become routine. Further research could, conceivably, lead to guidelines similar to those already in use by American medical bodies. But that is another way of saying that it is impossible to justify the current recommendations about gender-affirming care based on the existing data.

Anyone have a full version of this they can send me?