#No Evidence for Gender Affirmation

[thearbourist]

Children Are Bring Harmed - The Lack of Ethics in "Gender Affirming" Medicine

If you are violating one of the principles of human medicine – first do no harm – it may be wise to reconsider your position on ‘gender-affirming treatment’ regardless of how lucrative it is. “Children are being harmed. Young people are being harmed.  In many ways, this story is not new. From snake oil to thalidomide, from lobotomies to opioids, medicine has a long history of fake cures and…

[religion-is-a-mental-illness]

By: SEGM

Published: Aug 13, 2023

Near-zero regret” findings among adults suffer from a critical risk of bias and have low applicability to youth

Recent research published in JAMA Surgery evaluated satisfaction and regret among individuals who had undergone chest masculinizing mastectomy at the University of Michigan hospital. The average patient age at the time of mastectomy was 27 years; no patients who were under age 18 were allowed to participate in the study.

The participants reported high levels of satisfaction and low levels of regret at an average of 3.6 years following mastectomy. The study authors lauded the “overwhelmingly low levels of regret following gender-affirming surgery,” and framed their findings as in conflict with the “increasing legislative interest in regulating gender-affirming surgery,” referring to current legislative attempts to restrict or ban “gender-affirming” procedures for minors. Another group of authors provided an invited commentary on the paper, reinforcing the view held by the study authors, and asserting the presence of a “double standard:” “gender-affirming” mastectomies have come under undue scrutiny by states’ legislators, while other surgical procedures with higher regret rates do not appear to concern legislative bodies.

The study suffers from serious methodological limitations, which render the findings of high levels of long-term satisfaction with mastectomy among adults at a "critical risk of bias"—the lowest rating according to the Risk of Bias (ROBINS-I) analysis. ROBINS-I is used to assess non-randomized studies for methodological bias. The "critical risk of bias" rating signals that the results reported by the study may substantially deviate from the truth. The results also suffer from low applicability to the central issue the study and the invited commentary sought to address, which was whether legislative attempts to regulate “gender-affirming” surgeries are warranted in minors. Unfortunately, these highly questionable findings are misrepresented as certain and highly positive by both the study authors and the invited commentators, several of whom have significant conflicts of interest.

Below, we provide a detailed explanation of the key methodological issues in the study which render its claims untrustworthy and not applicable to the patient population at the center of the debate: youth undergoing gender reassignment. We also comment on the alarming trend: several prestigious scientific journals appear to have deviated from their previously high standards for scholarly work and instead have become vehicles for promoting poor-quality research, seemingly to influence judicial policy decisions rather than advance scientific understanding. We conclude with recommendations about how journal editors can restore the integrity of scientific debate and raise the bar on the quality of published studies in the field of gender medicine.

[ For in-depth analysis, see: https://segm.org/long-term-regret-satisfaction-mastectomy-critical-appraisal ]

SEGM Take-Aways

Although this study reports extremely high rates of satisfaction and low regret, the timeframe in which these outcomes were assessed is insufficient—just 3.6 years post-mastectomy on average. The sample is also highly skewed: 50% of the participants had mastectomies in the last 3.6 of the 30 years. This skewing of the length of time since surgery is expected, given the sharp rise in the number of people (especially adolescents and young adults) identifying as transgender and undergoing chest masculinization mastectomy. It is also a short time in which to assess regret, particularly since one quarter of study participants were younger than age 23 at time of surgery and the median age of first birth in the US is 30 years.

The conclusion of high satisfaction/low regret suffers from a critical risk of bias due to the high non-participation rate, important differences between participants and non-participants, and lack of control group. Problematically, the authors misuse the (critically-biased) results from adults to argue against regulations for irreversible body alternations for minors and do so with a decidedly politicized spin.

The only intellectually honest commentary is that we do not have good knowledge of the likely rates of detransition and regret following chest masculinization mastectomy, nor do we know how many people experience regret but remain transitioned. There is an urgent need for quality research in this area. Previously, detransition and regret rates were considered to be low: they may have indeed been low due to the much more rigorous screenings, or the results may have been biased by the notoriously high dropout rates that plague “regret” research. Regardless, there is now growing evidence of much higher rates of medical detransition.

A recent study from a comprehensive U.S. dataset with no loss to follow-up revealed a 36% medical detransition rate among females within just 4 years of starting hormonal transition. At least two recent studies suggest that average time to regret among recently-transitioned females is about 3-5 years, but there is a wide range. Much less is known about detransition among those who undergo surgery. A growing number of detransitioners now express regret associated with the loss of breastfeeding ability, with one case study detailing breastfeeding grief experienced some 15 years post-mastectomy.

The study and invited commentary exemplify three problematic trends that plague studies emerging from the gender clinics: problematic conflicts of interest of the authors; leveraging scientific journals to disguise politically-motivated pieces as quality research; and a conflicted stance by the gender medicine establishment on surgery for minors. We expand on each briefly below.

Conflicts of interest of study authors and commentators 

The significant conflicts of interest of the gender clinicians who study and report on the outcomes of “gender-affirming” interventions cannot be overlooked. These clinicians are conflicted financially, since their practices specialize in “gender-affirming” interventions, as well as intellectually. While conflicts of interest among experts are common, such experts should still attempt to be balanced in their discussions and should acknowledge and reflect on their conflicts of interest.

The interpretations of the data in the study is neither rigorous nor balanced, and both the study and the invited commentary have a decidedly political spin. Further, the invited politicized commentary does not disclose that at least one of the authors is a key expert witness opposing states’ efforts to regulate “gender-affirming” surgeries for minors. This role alone precludes the ability to provide a balanced commentary.

There is a fundamental problem with research emerging from gender clinic settings. The same clinicians provide gender-transitioning treatments to individual patients in their practice; serve as primary investigators and custodians of data used in research informing population health policies; and increasingly, provide paid expert witness testimony in courts defending the unrestricted availability of hormonal and surgical interventions for minors.

As a result, such clinicians cannot express nuanced perspectives. Since any balanced statements may be used against them in a court of law when they serve as expert witnesses, they must resort to the lowest common denominator of the "winner-takes-all" adversarial approach. Such an approach does not tolerate nuance. Unfortunately, this approach contributes to the erosion of the quality of the published work in the arena of gender medicine and accelerates loss of trust about the integrity of the scientific process.

Misuse of scientific publications to promote politically-motivated articles disguised as scientific research

That prestigious medical journals now serve as platforms for promoting misleading, politically motivated research that aims to apply a veneer of misplaced confidence in  highly invasive, irreversible treatment should worry everyone committed to evidence-based medicine and the integrity of science. Moreover, it impairs our ability to accurately assess and improve the long-term health outcomes of the rapidly growing numbers of gender-diverse and gender-distressed youths.

This is not the first time that a JAMA has been used as a platform for positioning advocacy for “gender-affirming” care as scientific research. In 2022, JAMA Pediatrics published a study that assessed bodily happiness in a group of subjects aged 14-24 three months after chest masculinization mastectomy. Despite the very short follow up and dropout rate of 13%, the authors argued that their findings supported the premise that there was no evidence to suggest that young age should delay surgery. They also asserted that their research would help dispel the misconception that such surgeries are experimental. The editorial commissioned to bolster the authors claims was descriptively titled, “Top surgery in adolescents and young adults-effective and medically necessary.”

Another troubling trend is the misuse of statistical tools to reframe research findings that contradict the author's own position. For example, a well-known study that claimed that access to puberty blockers reduce the risk of suicide disregarded the fact that individuals reporting use of puberty blockers use had twice as many recent serious suicide attempts as their peers who did not use puberty blockers. Like the finding cited above, the doubling of suicide attempts was not statistically significant due to a small underpowered sample—but the magnitude of the effect was striking and should have tempered the authors’ enthusiastic conclusion that puberty blockers prevent suicides. Another recent gender clinic study, widely and positively covered by major media outlets, claimed that puberty blockers and cross-sex hormones led to plummeting rate of depression—even though the rate of depression among youth taking those medications remained demonstrably unchanged. More information about problems with research originating from gender clinics is detailed in this recent analysis.

Gender medicine’s stance on pediatric surgery

More generally, the gender medicine establishment is in a curious state of internal conflict about its stance on “gender-affirming” surgeries for minors.  On the one hand, it has become common for advocates of “gender-affirmation” of minors to insist that surgeries for minors are not performed and anyone who suggests otherwise is spreading “scientific misinformation” and “science denialism.”  On the other hand, gender clinicians publish mastectomy outcomes for minors in major medical journals, and laud surgeries for minors as “effective and medically necessary.” It is not uncommon for these opposing claims to be made by the same group of researchers and clinicians, as they test various arguments, searching for the "angle" that is most likely to convince judges and juries--and public at large--that scrutiny of the practice of pediatric transitions, which is increasingly occurring in European countries, is not warranted in the United States.

Notably, none of the European countries that are enacting severe restrictions on the use of puberty blockers or cross-sex hormones for minors have ever allowed surgeries for youth under 18. That the U.S. gender affirmation professionals continue to fight regulation of these problematic procedures speaks volumes about how far the U.S. healthcare has drifted when it comes to "gender affirmation" of minors.

Final thoughts

While it is challenging to determine how best to reduce the temperature of the highly politicized nature of the debate in gender medicine, the editors of scientific journals can begin to restore balance by recognizing how far the field has drifted from the standards of quality scientific research, and begin to expand their circle of peer-reviewers to those with diverse views. Inviting those concerned with the state of gender medicine (and not just the practices’ advocates) into the peer-review and commentary process is the first essential step to improve the quality of research published in the field of gender medicine.

--

--

==

The activists are predictably - and consistent with the superficiality of their own ideology - upset that anyone should look below the surface. It seems to be more troubling that anyone would notice the shoddiness of the research, than that the research is shoddy.

If this is supposed to be "healthcare," you would think that they would want the best healthcare, and be more alarmed at the misrepresentations of the study, than by people finding those misrepresentations.

Could it be that this is ideological rather than medical? 🤔

The conflicts of interest and funding sources alone are remarkable.

[icelogged]

i’m going to be alone again september <3 and i have to stay alive until november because im finally getting legal aid for [redacted] sooooo i think i’ll make it into 2024 ! i hope to see you all there :3 <3

[pyjamaenzel]

got an ask that I legitimately can't tell if it's trolling or not. Poe's Law.

fictional character may be a war criminal but god forbid I make a joke insinuating he might be a transphobe!

I'm wheezing. there are so many layers here.

-the fact that if you spend 5 seconds googling ER character model datamining you find out that it's false (this is the one thing that would make me say it's deliberate trolling except!! People are this stupid.)

-the idea that having a binary trans person as a lackey means Notorious Pompous Arse With Superiority Complex considers them Valid

-the idea that knowing about the existence of binary trans people is the same as knowing about non-binary people

-the fact that I got this intensely pedantic response to a silly comic I made about pedantry.

If this is a joke, congrats anon I love you you are the funniest person on this website. masterfully crafted. you have distilled tumblr down to its essence.

[frogeyedape]

Fact check: where the fuck did these numbers come from. See

Overall, 25 099 patients (52.3%) were aged 19 to 30 years, 10 476 (21.8%) were aged 31 to 40, and 3678 (7.7%) were aged 12 to 18 years. When stratified by the type of procedure performed, breast and chest procedures made up a greater percentage of the surgical interventions in younger patients, while genital surgical procedures were greater in older patients.

3215 patients (87.4%) aged 12 to 18 years underwent GAS and had breast or chest procedures

405 patients (11.0%) aged 12 to 18 years underwent genital surgery.

Above quotes are for data collected for 2016-2020.

The followup study (which i believe op references) addresses the gap in cisgender affirming care vs trans & gender diverse (TGD) affirming care:

Gender-affirming health care aims to align an individual’s physical gender expression with their intrinsic gender identity. An example is breast reduction for cisgender males with gynecomastia. Recently, there have been increased legislative efforts restricting gender-affirming health care specifically for transgender and gender diverse (TGD) people.1 Proponents of these efforts express concerns that TGD minors may be too commonly using gender-affirming surgical procedures. Given stringent clinical standards for gender-affirming care,2,3 use of gender-affirming surgical procedures by TGD minors is expected to be low. However, there are limited national data; while 1 study provided national estimates, it did not capture minors under the age of 12 years and did not exclude procedures with clinical justifications outside of gender affirmation.4 Therefore, using a national dataset, we evaluated the extent to which TGD minors and adults received gender-affirming surgical procedures in 2019. Additionally, in line with a recent publication from bioethicists to acknowledge that gender-affirming care is used by people of all genders,5 we provide a novel characterization of the relative use of 1 gender-affirming surgery—breast reductions—by TGD and cisgender populations.

Note the following quote is for a single year in the US, 2019.

The rate of undergoing a gender-affirming surgery with a TGD-related diagnosis was 5.3 per 100 000 total adults compared with 2.1 per 100 000 minors aged 15 to 17 years, 0.1 per 100 000 minors aged 13 to 14 years, and 0 procedures among minors aged 12 years or younger (Figure 1). Of gender-affirming surgical procedures identified among adults and minors, 1591 of 2664 (59.7%) and 82 of 85 (96.4%) were chest-related procedures, respectively. Of the 636 breast reductions among cisgender male and TGD adults, 507 (80%) were performed on cisgender males. Of the 151 breast reductions among cisgender male minors and TGD minors, 146 (97%) were performed on cisgender male minors (Figure 2).

Fact check: there were 151 breast reductions in (insured) minors in the US in 2019, of which 146 (97%) were for cisgender male people. Among minors, the only surgeries identified as for gender affirming care specifically, 82 of 85 (96.4%) were chest-related procedures.

Furthermore (and supporting op's point):

In this cross-sectional study of a national insured population in 2019, there were no gender-affirming procedures conducted on TGD minors aged 12 years and younger, and procedures on TGD minors older than 12 were rare and almost entirely chest-related procedures. Additionally, when considering breast reductions among cisgender males and TGD people—a surgery that can be considered gender-affirming among both populations—most were performed on cisgender males. Thus, these findings suggest that concerns around high rates of gender-affirming surgery use, specifically among TGD minors, may be unwarranted. Low use by TGD people likely reflects adherence to stringent standards of gender-affirming care.2,3

When you look up gender affirming surgery it says 'a broad range of procedures that help transgender and non-binary people transition to their gender identity'.

Seems 97% had the same procedure.

[lavendulaconminatio]

Synopsis: The Cass Review on transgender care has been crucial in the UK, leading to the cessation of prescribing puberty blockers outside of research protocols. However, in the U.S., where the gender-affirming care model is standard, Cass's four-year investigation and final report have been ignored. The newly released Cass Review on transgender care for young people has been pivotal in the UK, where the prescription of puberty blocking drugs outside of research protocols has now ceased. The review concluded that the evidence on use of puberty blockers and hormones for children and teens experiencing gender related distress is wholly inadequate and called for a more holistic approach to care. Parents and their children are being misled in clinics all over the country. There is no evidence that giving puberty blockers followed by hormones and surgery is lifesaving care and there is mounting evidence that the harms outweigh the advantages. ...I'm already hearing from the boards of directors and trustees of some hospital systems who are starting to get nervous about what they've permitted. So I think that's going to accelerate change within American healthcare.

[probablyasocialecologist]

The study itself is titled, “Long-Term Regret and Satisfaction With Decision Following Gender-Affirming Mastectomy,” and sought to study the rate of regret and satisfaction after 2 years or more following gender affirming top surgery. The study’s results were stunning - in 139 surgery patients, the median regret score was 0/100 and the median satisfaction score was 5/5 with similar means as well. In other words… regret was virtually nonexistent in the study among post-op transgender people. In fact, the regret was so low that many statistical techniques would not even work due to the uniformity of the numbers: In this cross-sectional survey study of participants who underwent gender-affirming mastectomy 2.0 to 23.6 years ago, respondents had a high level of satisfaction with their decision and low rates of decisional regret. The median Satisfaction With Decision score was 5 on a 5-point scale, and the median decisional regret score was 0 on a 100-point scale. This extremely low level of regret and dissatisfaction and lack of variance in scores impeded the ability to determine meaningful associations among these results, clinical outcomes, and demographic information. The numbers are in line with many other studies on satisfaction among transgender people. Detransition rates, for instance, have been pegged at somewhere between 1-3%, with transgender youth seeing very low detransition rates. Surgery regret is in line with at least 27 other studies that show a pooled regret rate of around 1% - compare this to regret rates from things like knee surgery, which can be as high as 30%. Gender affirming care appears to be extremely well tolerated with very low instances of regret when compared to other medically necessary care.

[...]

The intense conservative backlash, to the point of disputing reputable scientific journals, likely stems from the fact that reduced regret rates weaken a central narrative these figures have championed in legal and legislative spaces. Over the past three years, anti-trans entities have showcased political detransitioners, reminiscent of the ex-gay campaigns from the 1990s and 2000s, to argue that regrets over gender transition and detransition are widespread. Some have even asserted detransition rates of up to 80%, a claim that has been broadly debunked. Yet, research consistently struggles to find substantial evidence supporting this narrative. The rarity of detransition and regret is underscored by Florida's inability to enlist a single resident to bear witness against a lawsuit challenging the state's ban on gender-affirming care.

[thearbourist]

Differences Between "Gender Affirming Care" and Evidence Based Medicine.

TL:DR – The column on the left is activist dogma that has been pushed into the medical system.  The column on the right is what proper evidence based care looks like.

[religion-is-a-mental-illness]

By: SEGM

Published: Jun 11, 2023

A new peer-reviewed article, “Transition Regret and Detransition: Meaning and Uncertainties,” published in the Archives of Sexual Behavior, reviews clinical and research issues related to transition regret and detransition. The article emphasizes that “although recent data have shed light on a complex range of experiences that lead people to detransition, research remains very much in its infancy,” and there is currently “no guidance on best practices for clinicians involved in their care.”   

The author, Dr. Jorgensen, notes that the term “detransition” can hold a wide array of possible meanings for transgender-identifying people, detransitioners, and researchers, leading to inconsistencies in its usage. Although regret and detransition overlap in many people, not everyone who regrets their transition takes steps to detransition and conversely, not all of those who detransition regret their transition. Proponents of the “gender-affirming care” model typically focus on the latter group who are driven to detransition by external forces such as discrimination, lack of support from family and friends, or difficulty accessing health care. Euphemisms such as “gender-identity journey” and “dynamic desires for gender-affirming medical interventions” have been used to describe this process.

But the author highlights studies and personal testimonies of detransitioners who do deeply regret their transition, mourn the physical changes made to their bodies, and feel betrayed by the clinicians and medical institutions that offered hormones and surgery as antidotes to their gender confusion and distress. For this group of young people, internal factors such as “worsening mental health or the realization that gender dysphoria was a maladaptive response to trauma, misogyny, internalized homophobia, or pressure from social media and online communities,” were the primary drivers of their decision to detransition.

As the author highlights, a consistent theme in studies and personal testimonies of detransitioners is that there are major gaps in the quality and accessibility of medical and mental healthcare: “Many detransitioners reported not feeling properly informed about health implications of treatments before undergoing them (Gribble et al., 2023; Littman, 2021; Pullen Sansfaçon et al., 2023; Vandenbussche, 2022). Likewise, many felt that they did not receive sufficient exploration of preexisting psychological and emotional problems and continued to struggle post-transition when they realized gender transition was not a panacea (Littman, 2021; Pullen Sansfaçon et al., 2023; Respaut et al., 2022; Sanders et al., 2023; Vandenbussche, 2022). Despite ongoing medical needs, most patients did not maintain contact with their gender clinic during their detransition.” Detransitioners report wanting more information about how to safely stop hormonal therapies and surgical reversal or restorative options, but few clinicians are sufficiently knowledgeable about these issues to manage their care.

The author notes that our ability to predict who will be helped by transition-related medical interventions and who will be harmed by them is limited and we currently have no idea how many of the young people transitioning today will eventually come to regret their decision: “no one is systematically tracking how many young people regret transition or, for that matter, how many are helped by it.” However, the increasing number of detransitioners publicly sharing their experiences suggest that historical studies citing low rates of regret are no longer applicable. Moreover, these studies suffered serious methodological flaws that would tend to underestimate the true rates of regret including high rates of attrition and narrow definitions of regret.

More recent studies that have included the current case mix of predominantly adolescent-onset gender dysphoria suggest that up to 30% of those who undergo medical transition may discontinue it within only a few years (Roberts et al., 2022). It is likely that a number of them will experience significant regret over lost opportunities and permanent physical changes.

So how did we get here?

The author suggests that less restrictive eligibility criteria for accessing transition-related medical interventions under the gender-affirmation and informed consent models, coupled with the rapid rise of adolescents and young adults presenting to gender clinics, many of whom suffer from complex mental health problems and neurodiversity, has important implications for the incidence of transition regret and detransition. Under these models of care, standard processes of differential diagnosis and clinical assessment are seen as “burdensome, intrusive, and impinging on patient autonomy.”  Moreover, the author points out that hormonal therapies and surgery are now conceptualized as a “means of realizing fundamental aspects of personal identity or ‘embodiment goals,’ in contrast to conventional medical care, which is pursued with the objective of treating an underlying illness or injury to restore health and functioning.” 

Furthermore, adolescents and young adults might not be mature enough to appreciate the long-term consequences of their decisions about the irreversible medical interventions used to achieve “embodiment goals,” and/or their capacity to give informed consent may be limited by comorbid mental health problems or neurodevelopmental challenges. Additionally, “feelings of profound grief about lost opportunities and negative repercussions of transition might not be fully captured by framing the emotional experience in terms of regret” because “regret is an emotion that is unique in its relation to personal agency (Zeelenberg & Pieters, 2007), but the exercise of personal agency in the transition process might have been limited for people who began transition as minors, whose decision-making capacity was compromised by mental illness, or who were not fully informed of known and potential adverse health implications.” 

The author offers some suggestions for how detransition may be prevented and inappropriate transitions avoided:

Improving the process of informed consent.

Prioritizing treatment of co-occurring social, developmental and psychological problems.

Using precise language about medical interventions.

Helping young people expand their understanding of what it means to be a man or woman.

Being transparent about the quality of evidence supporting medical interventions and the uncertainty about long-term harms.

The author ends by emphasizing that when clinical cases are complicated by a lack of knowledge about the natural trajectory of the condition and a paucity of evidence supporting treatment options, “minimizing iatrogenic harm requires application of cautious, thoughtful clinical judgement, meticulous examination of the data that are available, as well as a willingness to change practice in the face of new evidence.”

Jorgensen calls on the gender medicine community to “commit to conducting robust research, challenging fundamental assumptions, scrutinizing their practice patterns, and embracing debate.”

--

Read more about the phenomenon of detransition:

Boyd I, Hackett T, Bewley S. Care of Transgender Patients: A General Practice Quality Improvement Approach. Healthcare. 2022; 10(1):121. https://doi.org/10.3390/healthcare10010121

D’Angelo, R. (2020). The man I am trying to be is not me. The International Journal of Psychoanalysis, 101(5), 951–970. https://doi.org/10.1080/00207578.2020.1810049

Entwistle, K. (2020). Debate: Reality check – Detransitioner’s testimonies require us to rethink gender dysphoria. Child and Adolescent Mental Health, camh.12380. https://doi.org/10.1111/camh.12380

Expósito-Campos, P. (2021). A Typology of Gender Detransition and Its Implications for Healthcare Providers. Journal of Sex & Marital Therapy. https://www.tandfonline.com/doi/abs/10.1080/0092623X.2020.1869126

Hall, R., Mitchell, L., & Sachdeva, J. (2021). Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: Retrospective case-note review. BJPsych Open, 7(6), e184. https://doi.org/10.1192/bjo.2021.1022

Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-021-02163-w

Marchiano, L. (2021). Gender detransition: A case study. Journal of Analytical Psychology, 66(4), 813–832. https://doi.org/10.1111/1468-5922.12711

Roberts, C. M., Klein, D. A., Adirim, T. A., Schvey, N. A., & Hisle-Gorman, E. (2022). Continuation of Gender-affirming Hormones Among Transgender Adolescents and Adults. The Journal of Clinical Endocrinology & Metabolism, 107(9), e3937–e3943. https://doi.org/10.1210/clinem/dgac251

Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality, 20. https://doi.org/10.1080/00918369.2021.1919479

==

Genderists often say things like "detransition/regret is rare" and "detransition is only due to discrimination." These run in the opposite direction to genderist assertions, as this means "detransition/regret due to discrimination is rare."

Most of the numbers they cite are either poorly sourced as mentioned above, or worse, from the days of "watchful waiting," where transition only came at the end of a comprehensive care process; a completely different model.

Not only is it dishonest, given they regard watchful waiting, or anything else as "harmful" and "gatekeeping," but the low regret rate actually supports that more cautious, thoughtful process.

And besides, claiming to know the success rate under the "affirming"/"informed consent" models is itself dishonest too. Detransitioners are not going to rush back to the same doctors who facilitated their mistake. Especially in a climate where they'll be blamed or vilified.

[bugpill]

If I see any more misinformation about Kamala Harris to dissuade people from voting I will explode.

1. She did a lot of work as a prosecutor to dismantle the system. When she was DA in San Francisco she was labeled as being “soft on crime” which she in turn claimed was “smart on crime”. Harris made a program called Back on Track so that low-level nonviolent drug offenders could enroll in school rather than doing jail time. She has believe and continues to believe that supporting people prevents crime far better than criminalizing people.

Yes, she put people behind bars. I know she called herself the “Top Cop” and I fucking hate that. However, the number of people who served time in jail was significantly reduced due to her program. She’s not a saint, but she tried to reduce harm as much as she could in her position. Since then, she’s called for even more action in terms of legalizing marijuana and I believe recently fully endorsed it publicly.

2. She is not transphobic. Harris backed the state of California when it tried to deny gender-affirmation surgery to a trans prisoner, but as attorney general, she could not deny the state’s Department of Corrections as a client of hers. Essentially, she had no say in the denial of surgery herself, as she had to represent the department’s interests over her own. Once she realized what they were doing, Harris actually worked behind the scenes to get that very policy changed so that any inmate who needs that care could get it. Additionally, she has lead efforts to put an end to gay and transgender “panic” defenses in criminal trials.

3. Kamala Harris is Black. For some reason, people like to say that she isn’t, and that she’s Indian and pretending to be black… for what reason? Depends on who’s telling the lie to begin with. Kamala Harris is Black and South Asian. Her father, Donald Harris, is a Black man who was born in Jamaica. Her mother, Shyamala Gopalan, was born in India. Speculating about her race with so much evidence towards the contrary is so wrong. If anyone tells you shit about this, just send them her whitehouse.gov biography.

4. Harris (reportedly) has different opinions than Biden on Palestine. Whether or not she makes a clear stance against Israel, I don’t know. That hasn’t happened yet, but I’ll remain hopeful until further notice. She reportedly tried to push Biden towards “a policy on Gaza that was both more humane and in alignment with international law” but wasn’t listened to. The only reason why this is one of my points is that I’ve seen a lot of people stating that she is totally behind every decision and stance Biden made as president, which isn’t necessarily true. I don’t want to give her credit for being pro-Palestine if she isn’t, just to be clear. That is not what I’m trying to do here.

I desperately want her to stand for a free Palestine. I cannot make the promise that this will happen. All I can hope for is that her policy will be less harmful than Trump’s- who wants Israel to “finish the job” and promises to “throw (pro-Palestinian protestors) out of the country”.

Conclusion: the fact of the matter is that people make shit up all of the time. Sometimes it’s propaganda they accidentally absorb, sometimes it’s deliberate misinformation. People often take rumors as facts, and we need to be more vigilant about it. What I know is that some people will do anything for you to not vote tor Kamala Harris, when in reality she’s our only hope here.

Is Harris my favorite person ever? Absolutely not. Does she share my exact views and opinions? Nope. Would I rather vote for someone who more aligns with my personal views? Yes.

Is voting for Harris the only way to stop Donald Trump and Project 2025? Yes.

Disclaimer for the blog: To be 100% transparent, this is only my (Fanya’s) opinions. Although this is a shared blog, I cannot claim that my stance and my voice speaks for everybody involved in this blog. Some members are not American. Some may have different takes. All I know is that all of us are anti-Trump. Don’t go after my friends if you have beef with what I’m saying. I’m trying my best here.

[starksnarks]

lol i made a comment on an instagram reel and i used the phrase "people with uteruses" and somehow it's gotten a few thousand likes and about 20 transphobes being like women?? you mean women?????? someone with a uterus is always a woman??????????? in the comment replies

[elierlick]

Yet another report found that the Cass Review was dangerously flawed. The Integrity Project at Yale concluded the review "obscures key findings, misrepresents its own data, and is rife with misapplications of the scientific method."

From the new report: "The Review also subverts widely accepted processes for development of clinical recommendations and repeats spurious, debunked claims about transgender identity and gender dysphoria. These errors conflict with well-established norms of clinical research and evidence-based healthcare. Further, these errors raise serious concern about the scientific integrity of critical elements of the report’s process and recommendations."

Read the full report here: https://law.yale.edu/yls-today/news/report-addresses-key-issues-legal-battles-over-gender-affirming-health-care

[telumendils]

i really want to emphasize the fact that many of these recent bills aimed at denying trans minors gender-affirming care have special exceptions built in to allow for nonessential surgeries on intersex children. they want to make sure doctors can continue pressuring parents into putting their intersex kids through procedures that have no evidence of benefits and are well known to cause harm (cw on these articles for discussions of intersex medical abuse/trauma).

these bills are not designed to protect children, they're designed to eradicate sex and gender diversity. they want to force both trans and intersex people into their binary little boxes and it will do immense harm to both groups.

[batboyblog]

I'm seeing a worrying amount of idiots on tumblr dot com push that "Kamala hates trans women" and I am losing my mind at how they are pushing it, constantly, saying she is a proven transmisogynist, despite it being a complete lie and her actively working behind the scenes to help trans women in prison. Is there like, sources that could help debunk this shit because I'm at my wits end as these people scream and cry and vomit trying to get biden to drop out but then are like "eghhhh still don't wanna vote for a transphobic cop..." when she's NEITHER-

Isn't the internet wonderful? first rule NEVER examine your priors! ALWAYS! hang onto whatever the first hot take you had on a subject to THE DEATH!

"Kamala is Transphobic!" over here in reality

past that trans and LGBT rights groups have been quick to endorse her like

Advocates for Trans Equality

Human Rights Campaign

just today 1,100 LGBT celebrities, lawmakers and leaders endorsed her

“The intersection on the issue of reproductive care and trans care, and the ability of families to be able to have care for their children and their families, is really, again, an intersection around attacks that are on an identity,” -Vice-President Harris, 2023

any ways the root of the idea she's transphobic comes from one case in 2015. Two inmates in the California State Prison system sued to get GRS, which as inmates would have been covered by the Prison system. It's worth noting here, both women got what they wanted, one was paroled and got the surgery covered by California Medicare while the other serving a life sentence was ultimately covered by the prison system.

Two things are important to bear in mind here, 1. Part of the job of California Attorneys General is to defend the state when it is sued, thats the job, 2. It seems early on in the case Harris was not personally aware of it, about 1,000 lawyers work in the Cali AG's office and so the AG cannot be personally aware of every case, and check this quote from the Lambda Legal lawyer handling the case:

“The California AG’s office shifted its handling of these cases significantly after now-Sen. Harris took over,” Renn said. “Initially there was language in briefing for the state that glaringly misunderstood the medical necessity of transition-related medical care and was patently offensive. But then, there was a dramatic change, which seems to have gone along with important policy shifts.”

Link

in 2019 Harris talked about the case and working after it was settled to change the policy of the California State Prison system

"When that case came up, I had clients, and one of them was the California Department of Corrections. It was their policy. When I learned about what they were doing, behind the scenes, I got them to change the policy," Harris said.

"I commit to you that always in these systems there are going to be these things that these agencies do. And I will commit myself, as I always have, to dealing with it," Harris said.

Any ways Harris can consistently spoken out for and supported Trans people, banned the hateful Trans panic defense when she was AG, in the Senate supported the Equality Act, during her 2020 campaign for President she drew attention to the hate crimes against black trans women while holding herself accountable for the 2015 case. As Vice-President she drew fire voicing support for Dylan Mulvaney during the hellish Bud Light backlash. Her Husband Doug was tapped to host the first ever White House Trans Day of Remembrance

basically you're looking at a great ally who clearly supports trans rights, who was involved in a case, which involved two people who got the surgeries they were looking for paid for by the State of California, close to 10 years ago now, there's evidence that both she moved the case in a better direction when she took over it and also that she changed the polices of the state to before more gender affirming.

[charliejaneanders]

Some have already admitted that KOSA will be used to censor LGBTQ content, especially that which relates to gender-affirming care. 29 Armed with cherry-picked and selectively interpreted studies associating trans content with “anxiety, depression . . . and suicidal behavior,” an ambitious attorney general will claim that “evidence-informed medical information” 30 requires that platforms prohibit minors from viewing such content under KOSA’s duty of care.

They're claiming that KOSA has been fixed. It hasn't been. Please read this detailed explanation of what's wrong with the current version of the bill and then CALL YOUR REPS.