The first rule of transgender identity club is we don’t talk about transgender identity.
Actually, that’s a lie. The first rule of transgender identity club is to talk about transgender identity as much as we possibly can, as long as it’s in an affirmative fashion. The second rule of transgender identity club is to hound and attempt to destroy the careers and lives of those who don’t abide by the first rule.
Now, it’s easy to understand why advocates want to do this. Putting aside the long history of troubled lives, we’ve had the recent spate of child suicides, in whose tragic final words we find explicit calls for a different world where their wishes would be acted upon. Yes, sometimes people have hidden behind suicide prevention as a way of silencing their voices. Yes, there is horrendous discrimination and exclusion throughout their lives. Behind this political traction, however, advocates all too frequently throw evidence to the wind. Why is trans advocacy research so bad – and does this state of affairs even act in the interests of those it claims to help?
Self-appointed (trans)spokeswoman Paris Lees writes for Vice in a piece which could be presented to a first-year undergraduate in what mistakes not to make in research methods. She confidently quotes “research” stating most trans people “got the memo at the age of five” about their identity. Take a cursory look at the ‘research’ she links, incidentally by another trans person, and the credibility falls to pieces: the data was gathered from a forum poll by the website Crossdressers.com. A forum poll! That’s what academic research has descended to!
Let’s run through the obvious flaws. The first rule of Research Club is to at least make an attempt to control the group you are selecting for: in a forum poll like this, the respondents are self-selecting and self-define as a of different identities. The ability to opt in excludes a range of bystanders, and this puts aside the fact members of such a site will be more committed than most to any such identity. The poll asks adults to reflect back on their lives and decide, post hoc, when they realised they were trans. Anyone who knows the first thing about research on memory knows you can’t accurately remember what happened last week, never mind up to thirty years ago.
“If we also know that 94% of people who walk into gender identity clinics are adults, that means, although the figure is accelerating, only 6% of trans children are currently being identified,” Lees continues. Spot the logical fallacy. Even if we accept the ‘research’ mentioned above as fact, it doesn’t necessarily suggest everyone who believes they may be trans when they were a childwill go on to identify as transgender later in life. Paris obviously has a problem with data, so are there any more reliable – or highbrow – sources which do a better job?
Vox presents itself as a website for the well-informed which looks to explain the world. Its problem is that it suffers from a bad case of publication bias: it quotes studies it agrees with and never looks too closely at its own priors. It confidently quotes psychological research revealing children who strongly identify as trans perform almost identically to their chosen gender in Implicit Association Tests, and references interesting research on whether transgenderism has a biological basis. My response to this is simple: so what? People who hold strong beliefs also identify strongly with those beliefs implicitly; that is, after all, exactly what we’d expect from a “strongly-held belief”! If you’re going to be advocating starting to transition at an early age, then the real test is whether those beliefs hold over time, and whether it’s beneficial for their psychological state.
Can we find this out? Kennedy argues we ought not even to try, claiming there are ethical issues in interviewing children, problems with collecting data (ha!) because people realise their identity at different times, and because the sample would be biased towards those who were ‘apparent’. Translated, that means owt. The last objection is unusual, because if anything those who are apparent appear to me to be the ones most convinced about their identity. The study regarding implicit association mentioned above specifically interviews this type of ‘trans’ child, and is no doubt better than the obfuscation from Kennedy.
It isn’t a completely bleak picture. Some academics have tried to do better. It may have a small sample size, and an unfortunate dropout rate, but this sort of study [which?] at least tries to answer the relevant question when we treat people. Some people may criticise it on the grounds it focuses specifically on those diagnosed as gender dysmorphic; but again, if anything these folk are likely to be more committed than the average. Almost half of those who completed the study reported they no longer believed they were trans.
Does this matter though? Paris quotes another study which looks at young people who started transitioning with puberty blockers who went on to take reassignment surgery and claims all the psychological distress and the suicide rates to go with it desisted. Again, this study has some unusual characteristics* in that it only surveys people who transition one year after the surgery was complete. Believing you’re in a much better psychological state after going through major surgery and medical treatment isn’t exactly unusual; I don’t think I need to explain the placebo effect to anyone.
What would give us a more accurate picture is to measure their state over a longer period of time. Lo and behold, we have another study which tries to do this, finding suicide rates, psychiatric disorders, and general impatient care are still more prevalent for these people. Of course, a lot of this is to do with the exclusion a lot of people face after treatment, but to pretend transitioning is going to solve all the psychological distress and other issues in life is simply a lie. You could say all this doesn’t matter, because treatment to halt puberty is reversible. I abide by a weird, somewhat old-fashioned principle the first rule of Medicine Club is to refrain from dispensing treatment which isn’t necessary. The study explicitly doesn’t pass any comment on the medical effects of puberty suppression, and I’m not scientifically trained enough to pass any real comment on it.
I do have a passing interest in psychology, and what is interesting about the press release for the study is it completely neglects to mention those involved in the study went through a number of psychological treatments. With the extremely high co-morbidity of psychological disorders amongst young people who identify as trans, it isn’t surprising this sort of treatment goes a long way to improving their reported quality of life. We know, at least with some confidence, that these therapies work. What we don’t know is whether facilitating transition as soon as possible is either a true expression of people’s identities, or whether it even helps the majority of people once they do. We ought to pause for thought before we commit ourselves to massively expanding the creation of transition treatments. Evidence I‘ve seen suggests there is no long term harm, but then we said the same thing about SSRI treatments, and the scepticism around them years down the line is starting to fester.
There’s an irony when Kennedy takes a swipe with the slur ‘TERF’ where she claims they believe trans people “exist as the result of pressure from patriarchal male psychiatrists to become stereotypical females”, and thereby the supposed TERFs erase their identity. She casts disdain on a lot of the past research into trans identity from the psychiatry profession because they seek the “prevention” or “elimination” of what is judged socially unacceptable gender-transgressive behaviour.”*
Far be it from me to quote Brendan O’Neill. Brendan O’Neill is a dickhead. He lives for the thrill of the #hottake rather than to inform. It’s hard though, to escape the truth behind his fuckwittery on the issue of trans politics . With advocates like Kennedy and Lees it’s difficult to escape the idea they are trying to impose their own political identities on children, with scant regard for the truth. Trans children, trans adults, parents, and those wrestling with the clusterfuck which is gender need the facts rather than what is considered in advocacy circles to be socially acceptable or transgressive behaviour. Culture war posturing helps no-one and hurts everyone. First, Paris, do no harm.
*Are such high levels of support weird? This goes completely against most reports of peoples experiences of discrimination when they transition. This could be another reason for the very positive results of the study. Sweden is also a highly pro-trans nation.
“Families were supportive of the transitioning process: 95% of mothers, 80% of fathers, and 87% of siblings. Most (79%) young adults reported having 3 ormorefriends,were satisfiedwiththeir male (82%) and female peers (88%), and almost all (95%) had received support from friends regarding their gender reassignment. After their GRS, many participants (89%) reported having been never or seldom called names or harassed. The majority (71%) had experienced social transitioning as easy”
*Also from Kennedys study, testimonies to illustrate trans identity. It may just be me, but if anyone is trying to shoehorn them into an identity it’s her.
It was also evident that their perceptions of gender identities soon appear to maketransgender children feel different from those around them.“The earliest indication that something was unusual was that I had an interestin stereotypically male things. I wanted to drive a train when I grew up (agefour) and I was obsessed with trains and how they worked.”
“Somehow I knew that what I felt was simply not acceptable – and I wasfrequently told ‘boys don’t do that’”.“feeling ecstatic about going to a party as a fairy, but then feeling so low atbeing told it was sissy and had to go as cowboy.”