“The affirm-or-suicide mantra has become the central strategy of contemporary transgender activism, and at times it would seem that activists have little else in their rhetorical arsenal.” So writes Leor Sapir, a fellow of the Manhattan Institute.
“337:365 – the lips, the teeth, the tip of the tongue” by cavale is licensed under CC BY-NC-ND 2.0.
We are constantly told that the Gender-Affirming approach is “life-saving.”
Transgender Assistant Secretary for Health and Human Services Rachel Levine used the same word to justify the federal government’s support for “gender affirming” interventions. Neither Levine nor President Biden, who has given his own imprimatur to the controversial practice, seemed to care much that Europe’s most progressive welfare states have been moving in the opposite direction, placing strict limitations on the use of puberty blockers to treat adolescents in distress presumably because of their “gender.” Scandinavians are not indifferent to teen suicide. Rather, they have examined the evidence behind the affirm-or-suicide claim and have found it wanting.
Despite the unwaveringly confident manner in which these claims are often asserted, there is no good evidence that failing to “affirm” minors in their “gender identity” will increase the likelihood of them committing suicide. As I discuss below, that claim is based on a small handful of deeply flawed studies that, at most, find loose correlations between “affirming” interventions and improved mental health. Some find no reduction of suicide at all, and a new study claims to find that puberty blockers actually increase the risk of suicide.
Not only is the empirical basis for the affirm-or-suicide mantra shoddy at best, but its dissemination is also profoundly irresponsible. Such extreme rhetoric limits our ability to better understand and respond to mental health problems in vulnerable youth, and may itself contribute to the real and documented phenomenon of “suicide contagion.”
Source: Leor Sapir
Sapir gives us a thorough rundown of the current science on gender-dysphoria and suicide. And calls on the Activists to stop the moral panic-mongering.
Hyperbolic rhetoric about suicide rates may do more to increase suicide than prevent it.
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.
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 outcomesfor 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.”
***
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.
***
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 Daughterswas named a “best book” by The Economist and The Times of London. [2020, 2021]
