#group policy editor

[wemlygust]

Somebody has probably already said this, so feel free to ignore if so, but if you have Windows 10 Professional (I think it won't work with Windows Home because iirc that won't let you access the group policy editor), then: Type "group policy" into the windows search box and pick the Group Policy Editor. Go to Computer Configuration > Administrative Tools > Windows Components > OneDrive Double click on the options in the OneDrive policy folder and enable or disable them like in the screenshot here or otherwise as you please. The Group Policy Editor also lets you disable such things as Edge Browser (beware though that some of the edge options *might* fuck with xbox game pass for pc if you use that) or forced restarts for updates. Just go to the corresponding Windows Components folder and look through the options. Though for updates, make sure you don't accidentally cut yourself off from security updates entirely and end up out of date. I like to have them auto-download, but not notify me or auto-reboot, so I just install them when I see the little "shut down and install updates" option when I was going to shut down or reboot the computer anyway.

(yes it is completely stupid that Windows doesn't just let us uninstall crap, and that you can't do this with Windows Home, and etc. Still less annoying than Linux though.) Anyway, if you change Group Policy options, try to note down or remember that you have done so / what the original settings were. The changes are very easy to reverse if you need/want to later, but you've gotta remember what you changed in the first place, and if you change a lot that can get surprisingly hard to do. If you plan to change a lot, it's safest to just change a few things at a time, so you can make extra sure you don't accidentally break something you want (e.g. xbox game pass for pc) without knowing how to undo whatever broke it. I have not personally been this cautious about it at all but I assume some people are more patient than me, probably.

[d-e-w-p]

I am attempting to disable windows 11 on my new laptop and.

Lord. Oh dear lord the tech issues

[tsvai]

it is so incredibly irritating that in the year of our lord 2023 microsoft still doesn't provide native way to toggle windows key functionality

u have group policy edits which require a restart, or editing ur registry (which can be dicey and also requires a restart).

then there's third party software but that either also edits your registry, or entails something like autohotkey, which some online games consider cheating software and may even take steps to try to detect if it's running on your system lmao.

tears out hair

[tetranymous]

Heya, did you figure out ReVanced patching on PC already? It's indeed possible although a bit more complex

Afraid I haven't had a chance to look into it yet (uni's been keeping me very busy) but other than Firefox's ram management issues and not being able to turn off autoplay, I'm probably better off sticking with PWA, since I can achieve the ad-free and remove unwanted elements with ublock origin and being able to use shinigami eyes on mobile is very nice. Hopefully someday someone will port xkit over to mobile Firefox and I'll be good (although if it's on revanced I'll absolutely reconsider! :) ).

In youtube's case newpipe isn't very stable, but if I get fed up with it I'll probably switch to piped (includes sponsorblock). But I'm absolutely still willing to give revanced a shot if it doesn't also rely on android 8 things like the patcher does (I'm stuck on 7 for the foreseeable future and seemingly everything cuts its support below 8 or it does run but assumes you have 6+ gigs of ram to throw at it :/ ).

How complex are we talking though? On a scale of using a command line to downloading an entire development studio and compiling and eventually debugging someone else's code.

[mckitterick]

you can also use Group Policy Editor to turn it off. access the Local Group Policy Editor by typing gpedit.msc in the command prompt, then press Enter

go to User Configuration > Administrative Templates > Windows Components > Windows Copilot. in the right pane, double-click "Turn off Windows Copilot" to Enable the setting (which turns off the AI spyware)

Literal definition of spyware:

Also From Microsoft’s own FAQ: "Note that Recall does not perform content moderation. It will not hide information such as passwords or financial account numbers. 🤡

[padawanduck]

btw if you recently updated your windows computer and got the AI assistant Copilot against your will you can completely disable it thru the Group Policy Editor or Registry editor, rather than just hiding it in the taskbar settings

[sudoscience]

I'm so fucking tired of Windows' built-in adware.

[redgoldsparks]

An Open Letter to Our Publishers from Authors Against Book Bans

If you are an author, illustrator, editor, translator, publisher, literary agent, or in any other way involved in the making of books, I highly recommend you join Authors Against Book Bans. With over 3000+ members and chapters in almost every state in the US, AABB is mobilizing to defend our freedoms to read, write, and publish through this current wave of censorship and targeting of diverse stories and authors.

Full text of the letter is below the cut:

An Open Letter to Our Publishers from Authors Against Book Bans

With the election of the Trump administration and its policies as embodied in Project 2025, we authors have deep concerns about how our publishers will be operating and how publishers will advocate for and protect authors. Trump's agenda explicitly calls for the criminalization of authors, teachers, librarians, and publishing professionals with consequences including, “imprison[ment],” and being “classed as registered sex offenders” (Pg 4, Project 2025). For authors who are not citizens, this could also result in deportation. This promises to be a pro-censorship, pro-book-banning administration, and the successful implementation of its policies will require willing compliance of America's institutions, including its corporations.

The freedom to write is as important as the freedom to read. We have been heartened by many publishers' willingness to engage in legal and legislative pathways to fight book banning, and want to be sure that you will double-down on your fight during this consequential time.

This past week, AABB held open forums with authors from all genres and age levels to better understand author concerns and needs. While this may not be a complete list due to the rapid turnaround, we know we have a short time before January to prepare for what is to come, and we want to start this conversation sooner rather than later.

As authors, we need you to:

Continue to acquire and promote books by LGBTQIA+ and BIPOC voices. We are concerned that these voices under particular attack will be silenced or discouraged, directly and/or indirectly.

Be unequivocal in your support of LGBTQIA+ and BIPOC authors. We need to know that no author will be asked to “tone down” or erase elements in their books to please potential censors or to avoid being targeted by unjust laws in certain states. Authors need to know that we can continue to speak our truths in our works and remarks.

Guarantee the safety and confidentiality of all personal information that exists in your portals, or that has been shared for book promotion. We need publishers to refuse to provide lists of:

Authors or staff they know to be immigrants, Muslims, individuals with backgrounds from Iraq, Iran, Libya, Somalia, Sudan, Syria, Yemen, Gaza et al (targeted under Trump's promise to expand the “Muslim ban”)*

(*a correction: we noted that authors from Muslim majority nations should be protected and listed Gaza, but should have listed the entire nation of Palestine and included Lebanon. We will ensure this is included in the future. Our apologies.)

All books by queer or trans authors, or that include queer or trans characters or content

Authors and their citizenship, birthplace, and/or other personal information

Books that reference diversity, equity, inclusion, sexual orientation, gender identity, racism, privilege, or “critical race theory” etc as defined or listed on page 4 of Project 2025

Refuse to provide “ratings” of books that goes beyond the current industry standard categorization of books by age group.

Resist requests for authors to sign contractual language for appearances that impinges upon our free speech in ways including but not limited to: written or spoken language, personal expenditures, personal advocacy.

Provide security in states or locations where an author may be under threat or has received threats. If an author is arrested for discussing their book in a public space, we need you to promise to provide legal aid. We need clear industry standards regarding author security and direct contact information for security and legal needs.

Stand against the blanket weaponization of “pornography,” “obscenity,” “triggering,” and “inappropriate” as they have been used in widespread book bans to target anything with queer content, sex, or references to racism, bigotry, misogyny, abortion, etc. Project 2025 states that people who produce or distribute anything deemed “pornographic” should be jailed, though it does not define pornographic, nor does it seem to adhere to the SCOTUS standard of pornography.

Ensure the freedom of every author to use the terms targeted on pages 4-5 of Project 2025 (which include but are not limited to: sexual orientation and gender identity, diversity, equity, and inclusion, gender, gender equality, gender equity, gender awareness, gender-sensitive, abortion, reproductive health, reproductive rights, etc) freely in their works. We need to know you will continue to send LGBTQIA+ and BIPOC authors to schools, libraries, and festivals funded in whole or in part by federal grants.

Provide training on author safety and emergency contacts for situations when an author feels unsafe.

Be more aggressive and more public in fighting book bans and censorship at local, state, and the national level.

We approach all these needs with the assumption of your support, and we will be vigilant to make sure that any divergence on these crucial points will be noted and protested. It's imperative that publishers, like authors, do not obey in advance. We must be aligned against policies that promote censorship, book bans, and the criminalization of storytelling. We look forward to working together with you and with all the other organizations fighting for our fundamental freedoms to read and to write.

Sincerely, Authors Against Book Bans

[mckitterick]

Geek Uninstaller works great to remove garbage you don't want on your PC: X

Group Policy Editor (gpedit.msc) is your best tool for configuring how every aspect of your machine works, but it's no longer included in Home Editions of Windows, so you'll need to download it from a reputable source (I've been able to find safe distributions regularly, but don't want to link just in case - always do your research before downloading anything)

you'll probably have to reinstall Group Policy Editor and remove some programs over and over after major updates, but at least these two give you control over your computer

for my phone, I needed to download management software onto my PC to uninstall garbage and spyware from my phone, and it can be scary deleting apps whose names you don't recognize, but at least the one I use asks "You sure about that?" for system programs, and you can look up the file names to make sure your device will keep working after uninstall

I don't know about Apple devices, but I'm sure white-hats have developed ways to help you out if that's your thing

the fact that we need to go to these lengths just to use our tech without worrying about surveillance and data theft is pure enshittification, and I wish we could all just ditch these enshittified OSes and switch to Linux, but if so few people feel confident about using these personal-control programs and snap-ins, Linux is an unrealistically large leap

Initially planned for release in June, the launch of Recall was delayed to address these security concerns. Microsoft now plans to roll out the feature to Windows Insiders testers in October.

Remember that new Windows 11 privacy-violating feature that freaked everyone out a few months ago? The screen-recording gizmo that watches everything you do, including logins with passwords, then records those screens to a database? Then uses "AI" to interpret what it's recorded, so you somebody can search it?

Everyone thought Microsoft had heard the backlash and cancelled the project. Nope.

It's baaaaaaaack... and coming to a Windows 11 PC near you next month, October 2024.

[probablyasocialecologist]

Across the US, people speaking out on behalf of Palestinian human rights and against Israeli war crimes, apartheid policies, and settler-colonial expansion that have been unfolding over nearly eight decades are facing a wave of McCarthyite backlash directly targeting their future careers and livelihoods. Students at other prominent universities have faced the same: the leaders of Harvard University student groups were doxxed and smeared for signing a statement also expressing solidarity with the Palestinian people. Their names and faces were plastered on a mobile billboard truck that roamed around campus for days, and a “College Terror List” circulated online accusing them of antisemitism. Several also lost job offers. A Berkeley law professor published an op-ed in the Wall Street Journal imploring legal employers not to hire his own students and smearing them as antisemitic. [This piece was originally commissioned by an editor at The Guardian, who asked me to write about the wave of retaliation and censorship of political expression in solidarity with Palestinians that we’ve seen in the past two weeks. Amid my work as an attorney on some of the resulting cases, I carved out some time to write the following. Minutes before it was supposed to be published, the head of the opinion desk wrote me an email that they were unable to run the piece. When I called her for an explanation she had none, and blamed an unnamed higher-up. That a piece on censorship would get killed in this way—without explanation, but plainly in the interest of political suppression—is, beyond the irony of the matter, a grave indictment of the media response to this critical moment in history.]

[beatrice-otter]

The President and the Police

It is curious to me that people who are (rightly) outraged at the police being sent against the college protestors and want to reflect that in their voting in the next election are focusing on the office that has zero power over the police, and not the offices that actually control the police. (This is especially aggravating because we've been talking about the police a lot over the last four years, and so if people actually wanted to change things you would think they would have figured out basic things like "who controls the police.")

The President does not and never has controlled the police. Anywhere in the US. Policing is a local matter. The vast majority of law enforcement is done by the city police (employed and governed by the city), county sheriffs and their deputies (employed by the county), and state police (employed and governed by the state). The laws and regulations and policies are made at the local level. So are hiring decisions! If you want to change things--and God knows the police are corrupt and violent and bigoted and awful, and DESPERATELY need to be changed--you can't do it through which presidential candidate you vote for (or don't vote for). You do it by voting for your local elected officials: town mayor and city councilmen (or whatever the exact positions are in your area), your county sheriff, and your state representatives. And then following up by doing things like attending city council meetings and raising the question of police reform--and talking to your neighbors and people in your community and building a coalition of people to work on alternatives to the police and convincing people to try some of them. If you live in a city that has a protest that the cops have been called to, please call your city government and complain. It won't magically change things but it'll be a little bit of pressure in the right direction.

The President does have some control over Federal law enforcement, but that's the FBI, DEA, ICE, and other more specialized groups (like the military police and Fish and Wildlife enforcement officers). And God knows that they could desperately use reform as well! ICE in particular should be abolished. So yeah, your vote for President will affect those organizations. (Trump, of course, loves ICE and wants to expand its powers and reach.)

But if you are rightly concerned by police response to the protests, and want to use your vote to do something about it, you need to be thinking locally.

And good news! Local elections have far fewer people voting in them, so it's actually much easier to affect things at a local level than it is to affect national affairs.

I know this, because I've seen it happen in my community. I am a supporter of an immigrant rights group in my community, and a while back our little local police department hired a guy who had been fired for racism by the biggest city in the region. This is extremely common; most trained and experienced police would much rather work in larger cities which pay better. So a lot of small towns and county sheriff's departments have trouble getting "qualified" people who want to work there, and regularly hire cops who are only willing to move to rural areas because they've been fired for cause and no larger police department will touch them.

But in this specific case, the local immigrant support group was watching, saw he'd been hired, and swung into action. They encouraged their members to call the city council, and go to city council meetings, and write letters to the editor, and after a couple of months of this the city council conceded and got rid of the guy. If you get a group of people together to make a concerted effort, you can make a difference in the policing in your local community.

But the President can't do jack about it. So don't blame him, blame the people who actually hire, train, and write the policies for the police. Who are all local people living in your area!

[writingquestionsanswered]

PSA // Questions Requiring My Ideas

Just a quick reminder that I'm not going to answer questions that require me to come up with ideas for your story. I know it can be so frustrating when you're in the thick of your story's plot and things aren't making sense... it would be amazing to have someone who can say, "do this, this, and this," but unless you want to pay a writing coach or a developmental editor, you're going to have to roll up your sleeves like the rest of us and do the hard work of figuring it out. And I knowwwwww how much that stinks sometimes. Believe me, I've been there a million times.

Here are some things that have helped me get through it:

1 - Take A Step Back - Sometimes, even a day or two away from your WIP will help you see it with fresh eyes and get ideas flowing again. For me, if I'm away from my WIP for a few days, it starts nagging at me when I'm doing monotonous things like cleaning or driving. That's when I have sudden epiphanies that fill in plot holes or solve my biggest story problems.

2 - Talk It Through with a Friend - Whether it's a writing friend, your bestie, a family member, the toddler you babysit once a week, your dog or cat, or your favorite plushie, sometimes just talking out loud about your story while someone else listens (or "listens") can help you work through story problems and come up with ideas that you're otherwise struggling with. And... to be honest, I have been known to do some really weird sh*t when I'm in this mode, like pretend I'm talking about my process with this WIP to a group of fans at a book signing, or pretending I'm being interviewed on a podcast or radio show... I don't know what it is about talking this stuff out, but it can make a big difference.

3 - Plot Your Story Out Using a Different Structure Template - I'm a big fan of using story structure templates as interpretive guides for plotting. While I don't recommend boxing yourself in, and feeling like you're stuck following a particular template exactly, I do think story structure templates can be a really helpful way to get an overview of your story's working parts. And sometimes, taking your story and plotting it out against a different structure template just for fun (not necessarily to rework it) can help jog things loose that are stuck. And since it's absolutely okay to combine templates or use little bits of ones that work wherever and however they work for your story, you may find that you just borrow whatever worked from that template and graft it onto your existing structure. Again, whatever works best for the story. My post Creating a Detailed Story Outline has some templates to check out.

More than anything else, just keep at it and try not to get frustrated. Plotting is an absolute bear, but it's hard, and it's supposed to be hard. Anyone who says they sit down and have a perfect, flawless plot fall out of their heads fully formed is not being completely honest. Good plots take a lot of work, and sometimes it's like those shape sorters we played with as babies... you can spend weeks or even months trying to put a square peg in a round hole and not understand why it's not fitting. Then, one day it just CLICKS, and you suddenly see the shapes for what they are, and know how to make everything fit together.

Keep at it! ♥

•••••••••••••••••••••••••••••••••

I’ve been writing seriously for over 30 years and love to share what I’ve learned. Have a writing question? My inbox is always open!

♦ Questions that violate my ask policies will be deleted! ♦ Please see my master list of top posts before asking ♦ Learn more about WQA here

[hotsuqueen]

I just got a new laptop last week and learned the hard way that group policy editing did not come with my version of Windows 11 :'''')

I had to edit the registry to disable online search and Copilot.

I got a laptop with Windows 11 for an IT course so I can get certified, and doing the first time device set-up for it made me want to commit unspeakable violence

Windows 11 should not exist, no one should use it for any reason, it puts ads in the file explorer and has made it so file searches are also web searches and this cannot be turned off except through registry editing. Whoever is responsible for those decisions should be killed, full stop.

Switch to linux, it's free and it's good.

[a-very-tired-jew]

Media Manipulation, Bias, Cooperation and its impact

Media manipulation, misinformation, and propaganda are part of conflicts world wide. Every country, government, NGO, and agency engages in these tactics in some way. There is a story to be told from a certain perspective that pushes an agenda. What we, as the consumer of such media, have to do is determine if we're being fed a biased perspective and/or outright lies that we can then parse through. The current I/P war has seen a huge influx of misinformation and propaganda from social media and traditional news sources. The former is expected as we are in the era of influencers and algorithms. However, traditional sources, such as the AP or WashingtonPost, have long been an issue when it comes to coverage of Israel and Palestine.

Matti Friedman wrote about this a decade ago in an article for the Atlantic titled What The Media Gets Wrong About Israel.

Friedman is a former journalist for the AP and throughout their piece details the biased reporting that they witnessed firsthand, the association with terrorist groups, the influence of terrorists on reporting, and the outright corrupt nature of an organization that touts itself as a bastion of good journalism. From the article:

------------------------------------------------------------------------------

Most consumers of the Israel story don’t understand how the story is manufactured. But Hamas does. Since assuming power in Gaza in 2007, the Islamic Resistance Movement has come to understand that many reporters are committed to a narrative wherein Israelis are oppressors and Palestinians passive victims with reasonable goals, and are uninterested in contradictory information. Recognizing this, certain Hamas spokesmen have taken to confiding to Western journalists, including some I know personally, that the group is in fact a secretly pragmatic outfit with bellicose rhetoric, and journalists—eager to believe the confession, and sometimes unwilling to credit locals with the smarts necessary to deceive them—have taken it as a scoop instead of as spin.

During my time at the AP, we helped Hamas get this point across with a school of reporting that might be classified as “Surprising Signs of Moderation” (a direct precursor to the “Muslim Brotherhood Is Actually Liberal” school that enjoyed a brief vogue in Egypt). In one of my favorite stories, “More Tolerant Hamas” (December 11, 2011), reporters quoted a Hamas spokesman informing readers that the movement’s policy was that “we are not going to dictate anything to anyone,” and another Hamas leader saying the movement had “learned it needs to be more tolerant of others.” Around the same time, I was informed by the bureau’s senior editors that our Palestinian reporter in Gaza couldn’t possibly provide critical coverage of Hamas because doing so would put him in danger.

Hamas is aided in its manipulation of the media by the old reportorial belief, a kind of reflex, according to which reporters shouldn’t mention the existence of reporters. In a conflict like ours, this ends up requiring considerable exertions: So many photographers cover protests in Israel and the Palestinian territories, for example, that one of the challenges for anyone taking pictures is keeping colleagues out of the frame. That the other photographers are as important to the story as Palestinian protesters or Israeli soldiers—this does not seem to be considered.

....

When Hamas’s leaders surveyed their assets before this summer’s round of fighting, they knew that among those assets was the international press. The AP staff in Gaza City would witness a rocket launch right beside their office, endangering reporters and other civilians nearby—and the AP wouldn’t report it, not even in AP articles about Israeli claims that Hamas was launching rockets from residential areas. (This happened.) Hamas fighters would burst into the AP’s Gaza bureau and threaten the staff—and the AP wouldn’t report it. (This also happened.) Cameramen waiting outside Shifa Hospital in Gaza City would film the arrival of civilian casualties and then, at a signal from an official, turn off their cameras when wounded and dead fighters came in, helping Hamas maintain the illusion that only civilians were dying. (This too happened; the information comes from multiple sources with firsthand knowledge of these incidents.)

Colford, the AP spokesman, confirmed that armed militants entered the AP’s Gaza office in the early days of the war to complain about a photo showing the location of a rocket launch, though he said that Hamas claimed that the men “did not represent the group.” The AP “does not report many interactions with militias, armies, thugs or governments,” he wrote. “These incidents are part of the challenge of getting out the news—and not themselves news.”

------------------------------------------------------------------------------

Back in 2021 the IDF destroyed the AP's building because Hamas was using it as a base as well. The AP denied all knowledge of Hamas being in the building, except Friedman and other journalists had previously established that there was a relationship between the terrorists and news outfit. The insistence on denying Hamas's actions for fear of reprisal and to continue the "moral failure" narrative is part of AP's m.o. This standard of avoidance regarding Hamas's actions, couching them in a comparison of "Hamas is bad, but look how much worse Israel is!", justify, or even reduce the horrid nature of them has been part of the formula for years. It explains why we see so many of the major news sources tell the same story in the same manner when it comes to this area. Talking about Hamas, PIJ, and other groups and their bad actions is taboo. Another quote from earlier in the article stands out that highlights this rhetoric. "In these circles, in my experience, a distaste for Israel has come to be something between an acceptable prejudice and a prerequisite for entry. I don’t mean a critical approach to Israeli policies or to the ham-fisted government currently in charge in this country, but a belief that to some extent the Jews of Israel are a symbol of the world’s ills, particularly those connected to nationalism, militarism, colonialism, and racism—an idea quickly becoming one of the central elements of the “progressive” Western zeitgeist, spreading from the European left to American college campuses and intellectuals, including journalists."

Many of us have talked about the antisemitism that is baked into most cultures, and a Jewish journalist documented through their own experiences how that is an inherent part of a "trusted" international news source. The fact that it was/is "in vogue" to paint Israel and its actions as the "moral failing of Jews" and hold them responsible for all the "evils" of the region while handling terrorist groups with kid gloves is abhorrent. It's antisemitic and a continuation of age old conspiracies. Every decade we say this is an issue, and every decade you forget or brush it aside.

[facingthenorthwind]

Don't get involved with Wookieepedia

We all know Wookieepedia — it’s the Star Wars wiki, and an invaluable resource for fic writers everywhere. I’m not telling you not to look at Wookieepedia, but I do need to warn you not to get involved with the community. If you do want to edit it, then never join the discord or get involved with the forums (Senate Hall). It’s a cesspit of bigotry, and you cannot change it.

I tried. Along with a very well-known and vocal user named Immi Thrax, we tried to push back against misogyny and queerphobia. We thought we succeeded. You might have seen supposed “progress” on Wook: the addition of pronouns in the infobox, the addition of an anti-discrimination policy and an apology from the male wook admins for historical abuse towards marginalised editors. We did this. We, along with a small group of queer women and nonbinary editors, badgered the admins to write that apology for months, spoon-feeding them the things they needed to address and telling them that the early piss-weak drafts were unacceptable. We demanded infobox pronouns. We demanded an anti-discrimination policy and worked with them to add a glossary. 

And then they ran us off the website.

We had a side server specifically for women and nonbinary people, with a few channels that also contained men we trusted. A woman (who was voted in as an admin after Immi) took screenshots from this private server and then posted them publicly. The screenshots were taken completely out of context and misrepresented their contents. The woman who took the screenshots deleted messages in them to make us look worse. They slandered us and put us in danger, because Immi has been targeted by dangerous corners of the internet before (which they were well aware of), and we were terrified we would be doxxed. All of the men approved of this, forced Immi to resign, and spread blatant lies about us. Wook users attacked us, and it was deemed perfectly acceptable to do so.

When I wrote the initial forum post about sexism and misogyny on the website, Master Fredcerique, one of the admins, told me that he was in fear of losing his job during 2021 because of discord screenshot leaks, and that "Safety for everyone was of utmost importance" to him, hence requesting I not provide usernames for my examples of bigotry. It is clear that Immi, myself and others in those screenshots do not count in this 'everyone'. I wonder why he wanted to protect the perpetrators of misogyny but was happy to endanger women!

As a result of this horrific breach of trust and privacy, every single queer woman and almost every nonbinary wook editor has left the site. We were too radical, and they had to destroy us. Sure, a woman did this, but I don’t think it’s an accident that a cishet woman who self-describes as a Republican in Florida forced the two loud leftist lesbians off the site. And the men approved of everything she’s done and contributed to it. One (1) man (notably not an admin) stood up for us, and he was banned for doing it. 

So don’t join wook. If you do edit, don't trust anyone. Have every single conversation about wook in public, where people can never take your words out of context. Do not participate in DMs, group chats or any wook-related servers, including the official one. Marginalised editors' very existence is a disruption to the status quo of Wookieepedia, and there is every possibility you will be seen as a threat, even if you are not initially treated as one.

[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.

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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.