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religion-is-a-mental-illness · 1 month ago

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By: Leor Sapir

Published: Dec 5, 2024

An astonishing moment took place yesterday at the Supreme Court during oral arguments in U.S. v. Skrmetti, the case that challenges Tennessee’s ban on pediatric sex “change” procedures. Chase Strangio, the American Civil Liberties Union’s attorney, admitted to Justice Samuel Alito that the narrative around the risk of suicide in transgender-identified youth is false.

Before Alito and Strangio’s exchange, Justice Sonia Sotomayor had asked U.S. Solicitor General Elizabeth Prelogar about minors with gender dysphoria who “attempt suicide.” Prelogar responded that the “rates of suicide”—not “attempts,” but actual death by suicide—in that population “are striking.” Given the government’s support for puberty blockers and cross-sex hormones as treatments for gender dysphoric youth, the clear implication of Prelogar’s remarks was that such interventions are known to prevent these tragic and, in her view, common events.

JUSTICE SOTOMAYOR: Some—some children suffer incredibly with gender dysphoria, don’t they? GENERAL PRELOGAR: Yes. It’s a very serious medical condition. JUSTICE SOTOMAYOR: I think some attempt suicide? GENERAL PRELOGAR: Yes. The rates of suicide are—are striking—

This claim—that rates of suicide among gender-dysphoric young people are high—constitutes the trans suicide myth.

When it was Strangio’s turn, Justice Alito asked, “Do you maintain that the procedures and medications in question reduce the risk of suicide?” The transgender-identifying attorney responded:

MR. STRANGIO: I do, Justice Alito, maintain that the medications in question reduce the risk of depression, anxiety, and suicidality, which are all indicators of potential suicide.

Note that Alito asked about suicide, and Strangio answered about suicidality—the latter of which refers to thoughts of or intent to attempt suicide. Though suicide would be preceded by suicidality, research does not show that suicidality is a reliable predictor of suicide. According to the Centers for Disease Control and Prevention, in 2022, for every one person who committed suicide, 270 people “seriously thought about suicide” and 33 attempted it.

Strangio’s pivot to suicidality is a standard tactic of gender medicine activists in public debates. They exploit public ignorance about the difference between suicidality—thinking about suicide, attempting suicide, using gestures of self-harm as a cry for help or as a form of emotional manipulation—and actual death by suicide.

Unfortunately for Strangio, Justice Alito had done his homework. Citing the U.K.’s Cass Review, Alito observed that “there is no evidence that gender-affirmative treatments reduce suicide.”

Then came Strangio’s remarkable concession:

MR. STRANGIO: What I think that is referring to is there is no evidence in some—in the studies that this treatment reduces completed suicide. And the reason for that is completed suicide, thankfully and admittedly, is rare and we’re talking about a very small population of individuals with studies that don’t necessarily have completed suicides within them. However, there are multiple studies, long-term longitudinal studies that do show that there is a reduction in—in suicidality . . .

Here, the ACLU’s star attorney on trans issues seems to be at odds with Solicitor General Prelogar, who had said that the “rates” of “suicide” among gender-dysphoric youth were “striking.” Strangio admits, under oath, that suicide is actually “rare,” and that the research purporting to demonstrate benefits from hormones concerns suicidality, not suicide. Strangio’s use of “admittedly” is also striking, as it suggests the attorney is aware that claims about suicide prevention through sex “change” are false.

Strangio’s claim that the evidence shows these treatments reduce suicidality is also false. Some studies claim to find that, but existing systematic reviews of evidence have concluded that these claims are not credible due to methodological problems in the research. The Cass Review explicitly cites “major methodological problems” as a reason to be skeptical of studies claiming that “gender-affirming care” reduces “suicidality.” I suspect that Strangio knows this, as well.

None of this means that we shouldn’t take suicidal attempts or ideation seriously. Of course we should. But to equate these behaviors with completed suicide and to use that equivalence as a justification for harmful and experimental treatments on vulnerable adolescents is extremely irresponsible.

It’s hard to exaggerate the importance of Strangio’s concessions yesterday. Transgender activists and their media allies, gender clinicians, and Democrats have consistently and emphatically told the public that suicide is a serious risk for transgender-identified youth and that “gender-affirming care” is necessary to mitigate that risk.

Strangio’s ACLU itself has said this on many occasions, as I previously reported. The ACLU of Wisconsin, for instance, issued a press release in 2023, stating: “Research shows it [denying youth access to ‘gender-affirming care’] contributes to… suicide. On the contrary, transgender youth whose families support their gender identity have a 52% decrease in suicidal thoughts [and] a 48% decrease in suicide attempts.” The following year, the ACLU of South Carolina quoted a physician who said, “Gender-affirming care is life-saving suicide prevention care.”

More egregiously, clinicians have used the suicide threat to cajole parents into agreeing to irreversible medical interventions that can potentially leave their kids sterile, sexually dysfunctional, disfigured, and with lifelong impacts on bone and cardiovascular health. “Would you rather have a dead daughter or a live transgender son?” they ask the parents, sometimes in front of the child.

Crucially, the risk these activists invoke is suicide, not suicidality. Parents are asked to weigh the amputation of their daughters’ breasts or the sterilization of their sons against losing their kids to suicide—any parent’s worst nightmare. If the risk in question were suicidality, that would likely change their calculus.

Consider, as a representative example of activists’ claims, these remarks by Diane Ehrensaft, a San Francisco-based psychologist and pioneer of the “gender-affirming” approach in the United States, in her 2016 book, The Gender Creative Child:

Time and again I watch youth weigh keeping their fertility options open against postponing obtaining their true gender identity, and time and again I watch the decision to affirm their gender and forgo fertility win out. Can a thirteen-year-old truly know that? Yes, I think so, in the same way that a thirteen-year-old is capable of making a choice that will save their life even if it means losing a limb or living with one kidney. We could say, “Well, yes, but that’s a matter of life and death.” So is this for many gender creative youth—to affirm their gender or face crushing despair.

The existing research on the link between gender-related distress and suicide undermines this claim. It includes four findings: first, individuals who identify as transgender or experience distress associated with their sex are at higher risk of suicide than age-matched controls. Second, however, that risk, though elevated, is quite low, as Strangio now concedes. (For example, the suicide rate among youths referred to the U.K.’s Gender Identity Development Service between 2010 and 2020 was 0.03 percent.) Third, the elevated risk is best explained by psychiatric comorbidities, which are extremely common in this population and hypothesized to contribute to transgender identification in youth. Fourth, adults who undergo full “gender reassignment” remain at elevated risk for suicide relative to matched controls even years after their procedures.

Suicide, in other words, is a complex problem that requires nuance and understanding. Suicide-prevention experts have long argued that talking about suicide in the way that Strangio and the ACLU have done is irresponsible: suicide is a socially contagious behavior, and telling youth in distress that it is the expected response to their problems can encourage the very behavior these activists purportedly want to prevent.

In 2017, major LGBT rights organizations partnered with suicide prevention experts and groups to produce a guideline for how to discuss suicide in this population. Among their recommendations:

DON’T attribute a suicide death to a single factor (such as bullying or discrimination) or say that a specific anti-LGBT law or policy will “cause” suicide. Suicide deaths are almost always the result of multiple overlapping causes, including mental health issues that might not have been recognized or treated. Linking suicide directly to external factors like bullying, discrimination or anti-LGBT laws can normalize suicide by suggesting that it is a natural reaction to such experiences or laws. It can also increase suicide risk by leading at-risk individuals to identify with the experiences of those who have died by suicide.

I have since come to learn—through a source close to the movement with contacts at the ACLU—that suicide researchers supportive of LGBT rights are deeply concerned with how transgender activists like Strangio have bullied advocacy group leaders and manipulated the suicide issue to serve their own personal agendas. Strangio and other transgender activists are continuously undermining public trust in the ability of these groups to generate or endorse credible suicide prevention guidelines.

But the narrative is too politically useful for many of these activists to abandon. Shorn of any ability to persuade the public of their incoherent ideas about sex and gender, and unconcerned that their practices violate centuries of accumulated knowledge about healthy child development, transgender activists need the suicide narrative to be true—or at least believable. How else can they get parents to submit their kids to the cult of the scalpel and syringe?

#Leor Sapir #trans or suicide #suicide #suicidality #suicide ideation #Chase Strangio #ACLU #gender ideology #queer theory #gender identity ideology #affirm or suicide #gender affirmation #gender affirming care #gender affirming healthcare #Cass review #Cass report #suicide narrative #religion is a mental illness

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