Treatment Harm in Gender Medicine

A recent article from the Journal of Sex and Marital Therapy, Iatrogenic Harm in Gender Medicine,1“iatrogenic” – relating to illness caused by medical examination or treatment. clarifies the risks of Transgenderism.

The author wants us to consider “the increasing number of young detransitioners.”

Published June 19,2023. Author Sarah C. J. Jorgensen.

ABSTRACT
Although transition regret and detransition are often dismissed as rare, the increasing number of young detransitioners who have come forward in recent years to publicly share their experiences suggests that there are cracks in the gender-affirmation model of care that can no longer be ignored. In this commentary, I argue that the medical community must find ways to have more open discussions and commit to research and clinical collaboration so that regret and detransition really are vanishingly rare outcomes. Moving forward, we must recognize detransitioners as survivors of iatrogenic harm and provide them with the personalized medicine and supports they require.

Many proponents of youth gender transition downplay regret as vanishingly rare (Astor, Citation2023; Coleman et al., Citation2022; McNamara, Lepore, & Alstott, Citation2022; Respaut, Terhune, & Conlin, Citation2022), and it’s easy to understand why: if young people can be mistaken about their gender identity and regret their decision to transition, then the diagnostic approach endorsed by many gender-affirming clinicians, which is based upon the premise that young people “know who they are,” (Ehrensaft, Citation2016, p.114) and adults should “[follow] their lead” (Ehrensaft, Citation2016, p. 54), is clearly failing some patients. The processes of differential diagnosis and clinical assessment that clinicians perform in all other patient encounters have been recast as unnecessary “gatekeeping” under the gender-affirming care model (Amengual, Kunstman, Lloyd, Janssen, & Wescott, Citation2022; Ashley, Citation2019; Cass, Citation2022). Many detransitioners report not receiving sufficient exploration of psychological and emotional problems before being offered hormones or surgery (Gribble, Bewley, & Dahlen, Citation2023; Littman, Citation2021; Pullen Sansfaçon et al., Citation2023; Vandenbussche, Citation2022). “Minority stress,” (i.e., the theory that external forces, such as sigma and discrimination related to gender non-conformity, are the drivers of co-occurring mental health problems) is often evoked to explain away self-harm, depression, anxiety, eating disorders, and even autism (Coleman et al., Citation2022; Kingsbury, Hammond, Johnstone, & Colman, Citation2022; Rood et al., Citation2016; Turban & van Schalkwyk, Citation2018), despite evidence demonstrating high rates of mental illness and neurodiversity before the onset of gender-incongruence 

Source: Taylor & Francis Online


Companion Post

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Kids With Early Smartphone Use Have Worse Mental Health

New global study from Sapien Labs finds consistent links, stronger for girls

Recent Jon Haidt substack dives into the results.

For parents who resisted, or who plan to resist, a new report may encourage many more parents to join you: Sapien Labs, which runs an ongoing global survey of mental health with nearly a million participants so far, released a “Rapid Report” today on a question they added in January asking young adults (those between ages 18 and 24): “At what age did you get your own smartphone or tablet (e.g. iPad) with Internet access that you could carry with you?”  When they plot the age of first smartphone on the X axis against their extensive set of questions about mental health on the Y axis, they find a consistent pattern: the younger the age of getting the first smartphone, the worse the mental health that the young adult reports today. This is true in all the regions studied (the survey is offered in English, Spanish, French, German, Portuguese, Arabic, Hindi, and Swahili), and the relationships are consistently stronger for women.

It didn’t use to be this way…..before smartphones and social media.

There is a well-known finding in happiness research that, across nearly all nations, happiness or well-being forms a U-shaped curve across the lifespan (See Rauch, 2018). Young adults and people in their 60s and 70s are happier than those in middle age. But that may be changing, especially for women, as Gen Z (born in and after 1996) enters young adulthood. You can see the sudden collapse of young adult mental health in some of our previous posts on this Substack. For example, Figure 1 shows that up until 2011, young Canadian women were the most likely to report having excellent or very good mental health. By 2015 they were the least likely, and the decline in their self-reported mental health accelerated after that, while it changed very little for older women. (The same pattern holds for Canadian men, but to a lesser degree.)

Check out the details here. And read his advice to parents, schools, & legislators on how to move forward.


“Crypto Connection by Frederico Clapis” by Dave Pearce (London) is licensed under CC BY-NC-ND 2.0.

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Parents Before ‘Friends’

White Robes Not Enough

“Governments are called upon to protect citizens from harmful practices in all other industries; we don’t carve out exceptions for a profession just because its members wear white robes.”

Leor Sapir responds to a gender-affirming pediatrician and dad who derides recent legislative restrictions on pediatric sex changes.

Click Tweet to read full response.

Where does “burden of proof” lie? See excellent comment below.

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