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Detransitioning

  • 26-11-2019 7:38am
    #1
    Registered Users Posts: 512 ✭✭✭


    Detransitioning....the reversal of transgender identification or gender transition.
    Is sex change regret real...Many studies have shown the majority of kids cease to feel transgender when they get older.
    Is this just a reversal of a mistake or all part of a persons personal growth?


Comments

  • Registered Users Posts: 68,317 ✭✭✭✭seamus


    The number of people who detransition is relatively small, and the data around it is sparse.

    Some studies assert that a large number of people who detransition, transition again later on.

    Studies into motivations also suggest that the number of detransitioners who "change their mind", is very small. The majority do it because living as their birth gender is socially and economically easier than living as their gender identity.

    It's still a wide open area, but the indicators are that more supports are needed for people with GD, for people who transition, but also for other gender identities such as non-binary, etc.

    Medical professionals are still very uneducated on the whole topic, which makes it very difficult for individuals with GD to get the correct guidance on making the right choices for them.


  • Registered Users Posts: 512 ✭✭✭dvdman1


    Maybe more Mental health screening and psychotherapy needs to be required prior to any body modification...its seems there isnt enough in place with the increasing rates of interventions such as surgery.
    The fact that a lot of kids and teens seem to grow out of it when they become adults means they avoid all the surgery.


  • Registered Users Posts: 68,317 ✭✭✭✭seamus


    Perhaps, the data still isn't there though. One US study found that "regret" rates for surgery was just 0.3%, which is incredibly low. For comparison, the "regret" rates for plastic surgery is anywhere between 30% and 60%

    Being transgender also doesn't require surgery. It's an optional step that some choose to take.

    Arguably there's a strong case for all elective cosmetic surgeries to require some level of counselling or "expectation setting" beforehand.

    However, there is a line to walk. Statistically, people who transition surgically report a better quality of life and better mental health than before their surgery. If you place barriers in front of their ability to access treatment, even well-intentioned ones, then you risk having the opposite effect to what you were trying to achieve.


  • Registered Users Posts: 512 ✭✭✭dvdman1


    seamus wrote: »
    Perhaps, the data still isn't there though. One US study found that "regret" rates for surgery was just 0.3%, which is incredibly low. For comparison, the "regret" rates for plastic surgery is anywhere between 30% and 60%

    Being transgender also doesn't require surgery. It's an optional step that some choose to take.

    Arguably there's a strong case for all elective cosmetic surgeries to require some level of counselling or "expectation setting" beforehand.

    However, there is a line to walk. Statistically, people who transition surgically report a better quality of life and better mental health than before their surgery. If you place barriers in front of their ability to access treatment, even well-intentioned ones, then you risk having the opposite effect to what you were trying to achieve.

    Would you consider Mental health screening and psychotherapy a barrier?
    I think a stepback approach is needed here as were talking about a persons life, medium term fixes can have lifetime consequences.

    Reports seem to suggest improved quality of life but like all studies this can be missleading. No follow up studies are carried out beyond 10 years after transition, the data is taken just after and doesnt follow beyond.
    More research is needed in this area to shape the medical responce and policy. Places like the US opt for surgery as this area of medical procedure is becoming lucrative.


  • Registered Users Posts: 68,317 ✭✭✭✭seamus


    dvdman1 wrote: »
    Would you consider Mental health screening and psychotherapy a barrier?
    All professional intervention is a barrier.

    Having to go to the GP to get a prescription for antibiotics, is a barrier to treatment. Having to go to a chemist is a barrier to treatment. Having to pay for them, is a barrier to treatment.

    These are necessary barriers though. By ensuring some level of oversight, you are attempting to ensure that they aren't used carelessly and cause wider public health issues.

    Imagine we said, for example, that anyone who was to be prescribed antibiotics, would from now on have to see a pharmacologist and undergo a full blood screening before being allowed to get them.

    What would happen? Would we ensure more hygiene around antibiotic prescriptions? Sure. It would be a huge boost in the fight against antibiotic resistance. What else would happen? People would stop going to the doctor. Stop getting antibiotics when they need them. Too much hassle, too much expense. Then they end up in hospital when it turns to sepsis, and die of preventable diseases.

    Or they'll purchase them illegally; online, imported from the north, from Moore St., whatever. And the wrong drugs or bad drugs, will kill people.

    So in the fight to make things better, you can make things worse.

    This is why the barriers to access any treatment need to balance the wider interests of public health against the needs of the individual. Create arbitrary hoops that patients have to jump through to access treatment, and people will die.

    There is in general no wider public health issue with transitioning. There is no risk to society when someone transitions, or when a lot of people transition.

    Thus the barriers need to reflect this, and what you're trying to achieve. You're trying to ensure that someone is making an informed choice for themelves. You're trying to ensure that someone is of sound mind. You're using known data to guide the person on the treatment course that has the best statistical outcome for their age, health and condition.

    You don't need comprehensive mental health screening and psychotherapy to do that. No more than someone who goes for liposuction or breast augmentation.
    What you need is informed medical professionals and proscribed protocols to follow, which are based on the outcomes data.

    The lack of any ten-year studies simply shows a need for ten year studies. Initial outcomes are good, five-year outcomes are good. So let's do the 10-year studies and then react on the basis of the data we do have rather than trying to make clinical guidelines based on guesswork.

    After all, you could have the ten year data but decide that "caution is needed because nobody has looked at 15-year data".


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  • Registered Users Posts: 512 ✭✭✭dvdman1


    seamus wrote: »
    All professional intervention is a barrier.

    Having to go to the GP to get a prescription for antibiotics, is a barrier to treatment. Having to go to a chemist is a barrier to treatment. Having to pay for them, is a barrier to treatment.

    These are necessary barriers though. By ensuring some level of oversight, you are attempting to ensure that they aren't used carelessly and cause wider public health issues.

    Imagine we said, for example, that anyone who was to be prescribed antibiotics, would from now on have to see a pharmacologist and undergo a full blood screening before being allowed to get them.

    What would happen? Would we ensure more hygiene around antibiotic prescriptions? Sure. It would be a huge boost in the fight against antibiotic resistance. What else would happen? People would stop going to the doctor. Stop getting antibiotics when they need them. Too much hassle, too much expense. Then they end up in hospital when it turns to sepsis, and die of preventable diseases.

    Or they'll purchase them illegally; online, imported from the north, from Moore St., whatever. And the wrong drugs or bad drugs, will kill people.

    So in the fight to make things better, you can make things worse.

    This is why the barriers to access any treatment need to balance the wider interests of public health against the needs of the individual. Create arbitrary hoops that patients have to jump through to access treatment, and people will die.

    There is in general no wider public health issue with transitioning. There is no risk to society when someone transitions, or when a lot of people transition.

    Thus the barriers need to reflect this, and what you're trying to achieve. You're trying to ensure that someone is making an informed choice for themelves. You're trying to ensure that someone is of sound mind. You're using known data to guide the person on the treatment course that has the best statistical outcome for their age, health and condition.

    You don't need comprehensive mental health screening and psychotherapy to do that. No more than someone who goes for liposuction or breast augmentation.
    What you need is informed medical professionals and proscribed protocols to follow, which are based on the outcomes data.

    The lack of any ten-year studies simply shows a need for ten year studies. Initial outcomes are good, five-year outcomes are good. So let's do the 10-year studies and then react on the basis of the data we do have rather than trying to make clinical guidelines based on guesswork.

    After all, you could have the ten year data but decide that "caution is needed because nobody has looked at 15-year data".

    Its not just about causing wider public health concerns, proper mental screening may save a person from suicide especially in cases of detransitioning which can be very difficult.
    The issue here is you only see transitioning as the course of treatment.
    Mental health screening is also a course of treatment, your analogy of seeing a dr to get some medicine is completly off as in this case, the act of talking to a psychotherapist is the line of treatment in itself.

    By denying scientific biology and reality it doesnt solve the real problem..with your logic transracial people should be able, without psychiatric evaluation be allowed to colour there skin permanently.
    Trans species should be allowed to get surgery and get tails or implants regardless of there mental state.... as an evaluation would be a barrier? All these forms deny reality... ...psychiatry frequently sight that, to really solve this people need to make peace with reality and accept themselves.
    .


  • Registered Users Posts: 254 ✭✭Freedive Ireland


    dvdman1 wrote: »

    By denying scientific biology and reality it doesnt solve the real problem...

    But there isn't always a scientific biological reality! People are born intersex, that's fact. Ie. with both sex organs, that being the case isn't therefore possible that people are born with one sex organ and feel like they are the opposite gender?
    It's not black and white, it's grey. Biological reality is that biology isn't perfect each and every time, welcome to being human.


  • Registered Users Posts: 68,317 ✭✭✭✭seamus


    dvdman1 wrote: »
    By denying scientific biology and reality it doesnt solve the real problem..with your logic transracial people should be able, without psychiatric evaluation be allowed to colour there skin permanently.
    Trans species should be allowed to get surgery and get tails or implants regardless of there mental state.... as an evaluation would be a barrier? All these forms deny reality... ...psychiatry frequently sight that, to really solve this people need to make peace with reality and accept themselves.
    .
    I never said that there should be no barriers, that's why my entire post was a discussion on why barriers should exist, but balanced against what's necessary. The minimum amount of barriers to maximise the number of people who get necessary treatment, not the maximum amount of barriers to minimise mistakes.

    And to take your point; optimal outcomes are not about getting closer to biological "normalness" or perfection. They're about achieving the state which the patient is happiest with and has the highest quality of life.

    The typical question is whether people with BID should have their limbs removed to make them happy. That's similar to your "attaching tails" question. And the obvious answer is that if such surgery was the most effective way to achieve an optimal outcome for the individual, then we should at least allow it to happen and should facilitate it if such oversight is reasonably necessary.

    It doesn't make any sense to force people to be miserable with their own bodies if we have reasonable evidence that making a change will relieve their misery.


  • Registered Users Posts: 512 ✭✭✭dvdman1


    But there isn't always a scientific biological reality! People are born intersex, that's fact. Ie. with both sex organs, that being the case isn't therefore possible that people are born with one sex organ and feel like they are the opposite gender?
    It's not black and white, it's grey. Biological reality is that biology isn't perfect each and every time, welcome to being human.

    Yes i agree its not black and white in cases such as hermaphrodites.... there are people who are not just XX and XY, but rather, there is a range of chromosome complements, hormone balances, and phenotypic variations.
    I was specifically addressing people who deny XX or XY as there birth biology.


  • Registered Users Posts: 698 ✭✭✭SuperRabbit


    I think you didn't spot Freedrive's point. If biological sex is not simple or binary, why would our brains, our minds, our consciousness, be simple and binary? Why would the mind's gender always match a person's chromosomes when the various parts of a person's body don't always match their chromosomes?

    Not to ask too many questions, but why deny someone's lived experience, why not just believe them when, as Seamus said: It doesn't make any sense to force people to be miserable with their own bodies if we have reasonable evidence that making a change will relieve their misery.


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  • Moderators, Category Moderators, Entertainment Moderators, Science, Health & Environment Moderators, Regional East Moderators Posts: 18,174 CMod ✭✭✭✭The Black Oil


    Just so happens that BBC File on 4 covered this recently. https://www.bbc.co.uk/sounds/play/m000bmy9

    Social isolation came up as being key.


  • Registered Users Posts: 1,586 ✭✭✭victor8600


    dvdman1 wrote: »
    I was specifically addressing people who deny XX or XY as there birth biology.

    You are not addressing anything. Your OP is faulty. You said "many studies" yet provided no links. When you were told a specific number in "One US study found that "regret" rates for surgery was just 0.3%, which is incredibly low" you chose not to comment.

    The OP is just a feeble trolling attempt.


  • Registered Users Posts: 512 ✭✭✭dvdman1


    victor8600 wrote: »
    You are not addressing anything. Your OP is faulty. You said "many studies" yet provided no links. When you were told a specific number in "One US study found that "regret" rates for surgery was just 0.3%, which is incredibly low" you chose not to comment.

    The OP is just a feeble trolling attempt.

    I though this was a discussion platform, calling people trolls and feeble for an oposing view is a bit much.

    Some reading for you to catch up on:

    Endocrinology Adult and Pediatric: Reproductive Endocrinology 2013

    Nelson Essentials of Pediatrics E-Book 2014

    Dulcan's Textbook of Child and Adolescent Psychiatry, 2nd Edition

    Gender dysphoria in childhood. International Review of Psychiatry.


  • Registered Users Posts: 698 ✭✭✭SuperRabbit


    Hi DVDman, that last study was interesting, thank you for sharing. I have saved it and I think it might be useful for essays in the future :)

    Reading that study must have really put your mind at ease that transgender children and teenagers are doing the right thing in seeking to socially transition and take puberty blockers before turning 18 and going on the waiting list. After all, the study says most children "whose GD desists" do so before puberty anyway, and puberty blockers are completely reversible.


  • Registered Users Posts: 512 ✭✭✭dvdman1


    Hi DVDman, that last study was interesting, thank you for sharing. I have saved it and I think it might be useful for essays in the future :)

    Reading that study must have really put your mind at ease that transgender children and teenagers are doing the right thing in seeking to socially transition and take puberty blockers before turning 18 and going on the waiting list. After all, the study says most children "whose GD desists" do so before puberty anyway, and puberty blockers are completely reversible.


    Clinical practice is currently under review and debate, the article is part of this debate and doesn't refer to any fact based conclusions that your claiming it did.
    It describes different approaches and interventions and psychosexual development at various ages.


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