Suicide Shock & Study Correction

Transgender activists often claim if the “affirmative care model” is not followed the mental health of those suffering from gender dysphoria will worsen and increase the likelihood of suicide.

Parents are shocked into action when told by health professionals that puberty blockers and cross sex hormones, and eventually “gender affirming surgery” may be the only way to prevent their children from committing suicide. Starting them on a medicalized pathway from their “sex assigned at birth” to the sex they now identify with is the most beneficial and humane course of action, parents are instructed.

[Please view this post which rebuts the “assigned at birth” fiction]

In 2019 one of the few major studies on this issue released its findings. The study analyzed health records of 2,679 Swedes diagnosed with gender dysphoria between 2005 and 2015 to determine whether hormonal or surgical treatments improved their mental health over time.  This was one of the first longitudinal studies done about the efficacy of cross-sex hormonal therapy and sex reassignment surgery. And the largest population study to date. Plus it was done in perhaps the most Trans-friendly country on the planet, Sweden.

The original study conducted by a researcher from the Karolinska Institute in Sweden and a researcher from the Yale School of Public Health was published in the American Journal of Psychiatry in 2019. (The Karolinska Institute is the same institute that awards the Nobel Prize in Medicine and in May advised its hospital to stop hormone treatments and surgery for young people under 18!) The study concluded that “Transgender individuals who undergo gender-affirming surgery are significantly less likely to seek mental health treatment for depression and anxiety disorders or attempt suicide in the years following the procedure.”

Still from the perspective of the “affirmers” the results were decidedly mixed.

We learned two things from this study.

The main finding of the study was that hormonal transition showed no signs of mental health improvement for “gender incongruent” patients. This “no improvement” finding was largely ignored by the news media and trans-activists.

Administering cross-sex hormones to gender confused folk did not improve their mental health.

But the 2019 study did show that gender affirming surgery improved the mental health of those in the study. Patients from 2005-2015 who underwent surgical procedures to assist their transition to the opposite sex showed an overall 8 percent improvement.

This was widely reported as evidence that the “affirmative care model” works!

You may think an 8% improvement for those who underwent radical irreversible surgery is not a lot to “hang one’s hat on.” But this result was widely used to denounce Gender Critical viewpoints like mine as anti-science. (read on)

Study Correction

That was then. This is now. (as of August 2020)

After criticism for the study’s flawed methodology, the American Journal of Psychiatry was forced to retract those findings. What was the flawed methodology? For starters: No control group! The researchers looked at a large group of transgender patients over a 10 year period, making it a good longitudinal study. But they failed to compare those results with a control group of transgender patients who had not undergone body altering surgery. Once that was done the rather small 8 percent improvement evaporated.

“the results [of the reanalysis] demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts” - AJP correction

Surgery did not improve psychological well-being. It did not decrease suicide attempts relative to those transgender patients who went the non-surgical route. (Remember this is a study of Swedish patients in the most trans-friendly country on Earth so blaming unaccepting social factors as a cause for continued distress doesn’t work.)

Hormones & mutilating surgery did not improve outcomes for transgender patients!

Here’s a link to the correction. And here is an assessment by the Society For Evidence-Based Gender Medicine (SEGM) an international group of over 100 clinicians and researchers. Their assessment is worth your careful attention. For those of you interested in the details of the flawed methodology make sure you click on the “click here for more” link in the section labeled “Vigorous Debate Leads to Correction of Key Finding.”

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So, after the retraction how did the media respond?

Crickets….

Journalists, like scientists can be biased too.

But sadly parents are still being pressured by pediatricians, gender clinics and Trans-activists into accepting a single medicalized pathway if they want to prevent their kids from committing suicide.

In my research this past year I’ve noticed parents and confused young people hear the following statement all the time from social media influencers and medical professionals:

“Do you want a live “son” or a dead daughter?

That will cause any parent to sit up and take notice! But that is a bald assertion with no evidence to support it. Yes, there is a much higher incidence of suicide among this population but that is because they are psychologically troubled to begin with. Social transitioning, hormones and surgery doesn’t change that reality. My recommendation to parents is get non-affirming treatment and “hold your ground.” Your children and teens are confused.

You’ll meet some of those parents in my next post. They are distraught over the advice they and their children have been given by health care providers.

Obviously, it’s hard to know whether the flaws of the above study were just human error or whether the scientists involved desired a preferred outcome. If you read the end of my last post you’ll find one of our top Psychiatrists admitting that when it comes to questions about “Sex and sexual behavior” many scientists who view humans as infinitely malleable would rather not look too hard for empirical evidence to back up their claims. Ideology drives some of them, just like the activists.

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If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend a book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]

Collaborating With Madness

You may think my last post finished a bit overheated. “Stop the Madness!” Unfortunately, I don’t think so. And neither does Paul McHugh, former Chair of Psychiatry at Johns Hopkins Medical School and psychiatrist-in-chief at Johns Hopkins Hospital. (McHugh just turned 90 and is still kicking.)

The following quotes by McHugh come from his article “Surgical Sex,” in First Things, November 2004. The editor of the New Atlantis called McHugh “the most important American psychiatrist of the last half-century.”  Recent comments from McHugh reveal he still isn’t persuaded by today’s “Gender Science.”

When the practice of sex-change surgery first emerged back in the early 1970s, I would often remind its advocating psychiatrists that with other patients, alcoholics in particular, they would quote the Serenity Prayer, “God, give me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Where did they get the idea that our sexual identity (“gender” was the term they preferred) as men or women was in the category of things that could be changed?

“Advocating psychiatrists” encouraged him to meet with male to female sex-change patients (almost exclusively male back then) but he remained unconvinced. “Their psychological leanings seemed more like those of men than of women,” he said. After becoming psychiatrist-in-chief at John’s Hopkins Hospital in 1975 he decided to test advocate claims by studying two areas.

  1. Did sex-change surgery resolve patient psychological problems?
  2. Were male infants with deformed and/or ambiguous genitalia who were surgically “transformed” into females and raised as “girls” settling into the sexual identity chosen for them?
These claims had generated the opinion in psychiatric circles that one’s “sex” and one’s “gender” were distinct matters, sex being genetically and hormonally determined from conception, while gender was culturally shaped by the actions of family and others during childhood.

The first question was relatively easy given that one research member at Hopkins, Jon Meyer, was developing a follow-up protocol for sex-change patients at Hopkins and was compiling data.

He found that most of the patients he tracked down some years after their surgery were contented with what they had done and that only a few regretted it. But in every other respect, they were little changed in their psychological condition. They had much the same problems with relationships, work, and emotions as before. The hope that they would emerge now from their emotional difficulties to flourish psychologically had not been fulfilled.
With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.

***

Dr. Meyer concluded they were dealing with two distinct groups of men.

  1. Conflicted and guilt-ridden homosexual men seeking sex-change to resolve conflict.
  2. Heterosexual (and some bisexual) males who were sexually aroused by cross-dressing as females. (A disorder Canadian researchers later categorized as “autogynephilia.”)

Dr. McHugh decided not to collaborate with a mental disorder and stopped prescribing sex-change operations for adults at Hopkins in 1976. (In 2016 the hospital announced that it would start performing sex reassignment procedures again.)

***

The second claim made by advocates, “that sexual identity was a matter of cultural conditioning rather than something fundamental to the human constitution” was also studied.

Those born with malformed, sexually ambiguous genitalia and severe phallic defects were surgically “transformed” at Hopkins and given “female-like genitalia.” When doctors said to parents this must be done promptly “because a child’s sexual identity settles in by age two or three,” most parents consented and after surgery began raising the children as “girls.” They were told sexual identity would “conform to environmental conditioning” “without much travail.”

Did it? Was the all important question.

McHugh asked the advocates of sex-change surgery to provide solid empirical evidence that the changes worked. A resident psychiatrist William Reiner was tasked with doing a systematic follow-up of these children.

According to McHugh, the results here were even more startling than in Meyer’s work.

But before we take a look at what Dr. McHugh discovered from the research evidence by Dr. Reiner, let’s first define a term.

***

You may wonder why I use the word ideology so much? Like when I write the phrase, Gender Ideology. Let me clarify what I mean by the word. Ideology is not in and of itself a bad word but a more palatable way of expressing the same concept is worldview.

All of us operate at the level of worldview. This means we bring to every decision, conscious or unconscious, a collection of ideas, perceptions, and values held by a particular group of people in a particular time and place. We don’t decide afresh each time a question arises and a decision or evaluation needs to be made, that would be time-prohibitive & exhausting, rather we fall back on a pre-conceived understanding of the world, and ourselves in that world. These understandings are gleaned from personal analysis, true, but mostly they come from the cultural environment we grew up in. They come as a gift from others. They are the accumulated wisdom our family, church, school, town and country taught us about the good life and how best to live it. Think of them as “glasses behind the eyes” through which we perceive the world and how we ought to behave in that world. These basic viewpoint assumptions for the most part remain unquestioned until we are forced, often uncomfortably, to reconsider them.

The important question is one of Truth and Falsity. Is your worldview basically true or false? And if false is it collaborating with madness?

Today’s Gender Ideology is doing just that. The male female binary is basic. It’s fundamental. Confusion on this point is not progressive, it’s delusional.

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How did this happen? Well, we’ve experienced a revolution in how the self is understood, that’s how.

The best way to describe the modern view of the self would be to say that by the late nineteenth-century there was a dramatic “inward turn” facilitated by a movement known as Romanticism. Poets, like Wordsworth, Shelly, & Blake, philosophers like Rousseau placed the inner psychological life of the individual at the heart of what it means to be a self.

Then the ideas of Marx, Nietzsche, Darwin, and Freud became part of the intuitions of Western culture. All are important because they call in question the idea of human nature. No longer are we created in the image of God as male and female and therefore have an intrinsic transcendent worth.

***

Here’s one non-Christian assumption we hear a lot today. Humans are infinitely malleable. For example, with today’s Gender Ideology one’s biological constitution is as much a malleable artifact as one’s dress. Dr. McHugh addresses that ideological bias below as it relates to sex.

Which brings me to another popular assumption today, thanks mostly to Sigmund Freud. We now tend to think of sex as identity. After Freud the idea of sex as an act was changed to the idea of sex as intrinsically determinative of personal identity. Those feelings that uniquely define us are really at bottom sexual. Prior to Freud few people thought of identity in those terms and even though hardly any psychiatrist turns to Freud’s rather comprehensive worldview today, his basic idea of sex as identity remains the standard belief of so many in the Western world.

You are your sexual desires.

In the past our identity was largely based on our family history, our clan, our ethnic group, our religious community, or our particular vocation. No one would have thought about sex as identity or sexual orientation as our most important characteristic . But today our identity, recognition, and belonging are now deeply connected to the sexual desires we have and the manner in which we express them.

This is a profoundly new cultural development.

Gender Ideology rejects the idea that we are God-created embodied beings with a given nature. Isn’t this the oldest temptation? In the Biblical origins story, Eve was tempted by the serpent to taste the forbidden fruit so she could be like God, knowing good and evil. You might say, what does the temptation to grasp for knowledge or the desire to be like God have to do with the rejection of embodiment? Ideas, knowledge are invisible. God is Spirit. You can’t see an idea. And Spirit or spirits are not embodied. But humans have bodies that are visible. Perhaps wanting to change, or transcend our fundamental nature, grasping for something not given to us, is the most basic temptation. The fatal conceit inspired by the Serpent. At root it is a rejection of how we were created, and a dissatisfaction with God’s wise design. Gender Ideology fundamentally rejects that design.

We were given bodies by God, mediated through our parents, because we were meant to have them. We will never transcend that design. No matter how hard we try. And why would we want to?

Classic Christianity, echoed in our Creeds, teaches us that today, sitting at the right hand of the Father, is the second Person of the Trinity with a human body.

Now meditate on that for a moment. If true, what does that say about God’s view of humanity, and our embodied life?

Instead of “grasping for God-likeness” as the human protagonists in the original story did, God extended himself to become likes us, an embodied being. And suffered bodily death on our behalf.

Philippians 2:5–11 (ESV): Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. Therefore God has highly exalted him and bestowed on him the name that is above every name, so that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father.


Could there be any greater love than this?

We embodied creatures are exceptionally special to our Creator. Christians know this, or at least they should, more than any other religious pilgrim on planet Earth. The embodiment (incarnation) of the Second Person of the Triune God and the resurrection and ascension of His body and the Truth those doctrines teach is Christianity’s unique contribution to World Religion.

But in contrast Gender Ideology believes that our bodies don’t matter. Only our internal disposition, our invisible desires count as real and reveal our most authentic self. This is a rejection of Christianity’s most fundamental tenets. As Christians we are called to fight as Jesus would fight for God’s body affirming worldview! Body & Soul are designed to be an integrated whole. Also….

In the beginning God made us male and female. To those who have ears to hear. Hear.

***

Now back to McHugh’s assessment of Dr. Reiner’s research into the nature or nurture question and the startling results of that study. How were little boys born with ambiguous or deformed genitalia who were surgically given “vaginas” and raised as “girls” actually doing? When parents were told sexual identity would “conform to environmental conditioning” “without much travail” did that in fact happen?

Reiner concluded from this work that the sexual identity followed the genetic constitution. Male-type tendencies (vigorous play, sexual arousal by females, and physical aggressiveness) followed the testosterone-rich intrauterine fetal development of the people he studied, regardless of efforts to socialize them as females after birth. Having looked at the Reiner and Meyer studies, we in the Johns Hopkins Psychiatry Department eventually concluded that human sexual identity is mostly built into our constitution by the genes we inherit and the embryogenesis we undergo. Male hormones sexualize the brain and the mind. Sexual dysphoria—a sense of disquiet in one’s sexual role—naturally occurs amongst those rare males who are raised as females in an effort to correct an infantile genital structural problem.

Gender Ideologues constantly refer to the findings of science to back up their claims when in fact those claims are more about worldview than empirical science. Also, it must be acknowledged, medical professionals can be committed to an ideology just like anyone else.

Dr. McHugh recognizes ideology at work in the medical profession today:

I think the issue of sex-change for males is no longer one in which much can be said for the other side. But I have learned from the experience that the toughest challenge is trying to gain agreement to seek empirical evidence for opinions about sex and sexual behavior, even when the opinions seem on their face unreasonable. One might expect that those who claim that sexual identity has no biological or physical basis would bring forth more evidence to persuade others. But as I’ve learned, there is a deep prejudice in favor of the idea that nature is totally malleable.

Without any fixed position on what is given in human nature, any manipulation of it can be defended as legitimate. A practice that appears to give people what they want—and what some of them are prepared to clamor for—turns out to be difficult to combat with ordinary professional experience and wisdom. Even controlled trials or careful follow-up studies to ensure that the practice itself is not damaging are often resisted and the results rejected.

I have witnessed a great deal of damage from sex-reassignment. The children transformed from their male constitution into female roles suffered prolonged distress and misery as they sensed their natural attitudes. Their parents usually lived with guilt over their decisions—second-guessing themselves and somewhat ashamed of the fabrication, both surgical and social, they had imposed on their sons. As for the adults who came to us claiming to have discovered their “true” sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it.

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If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend a book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]