For most transgender people, transitioning is one of the greatest experiences of their lives. For others, it deforms into crippling regret. KC Miller is one of them.
The NSW public clinic Westmead takes a more cautious response which leads Transcend to not even list them on their site - they don't want caution and child safeguarding they just want affirm affirm affirm with no concern for the health risks https://transcend.org.au/medical/
All three countries that have conducted systematic reviews of the evidence (Sweden, Finland, England) have stopped transitioning kids. The evidence base in favour of transitioning kids is extremely poor. The British Medical Journal outlines the poor evidence recently here: https://www.bmj.com/content/380/bmj.p382. Your colleague Geraldine Doogue recently talked to the author of Time to Think covering the Tavistock gender service downfall - it's only a matter of time before we have the same situation in Australia because all our gender services are doing exactly the same thing - there is no scientific support for affirmation only and the risks of puberty blockers and cross sex hormones are huge. The staff that work at these gender clinics are now all firmly not looking at the evidence, they truly believe they are doing the right thing. The ones that doubt leave the service, leaving only true believers. https://www.abc.net.au/radionational/programs/saturdayextra/time-to-think/102020686
I know, because my teen went to the Qld gender clinic. They did not ever, not once, outline any risks to health from binders or cross sex hormones. She eventually desisted. She's just a gay autistic kid who was almost trans because no clinicians are brave enough to speak out (yet).
Each time someone criticises the current state of affirmation only health care we're called transphobes and discussion is shut down. Yes, there are awful conservative right wing people who are taking advantage of this to agitate their culture wars. But there are also many left-wing people like myself who just want people to look at the science and evidence and to build care guidelines based on evidence. At the moment guidelines like AusPATH look only at affirmation sources. They ignore evidence that is counter to their mission.
You needed some stats on suicide in there. An important paper from the UK (Biggs 2022 https://link.springer.com/article/10.1007/s10508-022-02287-7 ) has shown that in a decade there were 4 suicides of minors connected with the Tavistock GIDS children's gender clinic in a total of about 30,000 patient years, or analysed by numbers of patients, 4 suicides out of 15,000 patients. That clinic itself acknowledged that suicide was rare. This rate is apparently higher than normal, but probably no higher than for those with anxiety and depression that these kids also have. As you can see this is nowhere near the numbers touted by transgender activists and medical "professionals" who want to scare parents into letting their children transition. There is also no good evidence at all that transitioning actually reduces the risk of suicide. Studies on adult transitioned people show that suicide is a significant cause of death. And yet transition was supposed to prevent that?
All the claims like 40% or 50% or 80% of gender dysphoric youth will attempt suicide or think about suicide if not transitioned seems to be derived from poor quality online surveys. These are taken by a load of people who are politically driven to exaggerate their plight and push the cause of transgender medicine that they so passionately believe in. But transitioning does not usually solve their underlying psychological problems and seemingly does little to prevent suicide. For more info and stats on this, see https://www.transgendertrend.com/the-suicide-myth/ and https://statsforgender.org/suicide/
Josh you seem to think that "most" people who come out as trans "ARE trans". I don't believe in this "true trans" idea - I think that there are just people who will transition and don't regret it, and people who transition and will regret it. I think you vastly underestimate the numbers who will regret. We are seeing an exponential growth in young women deciding they don't want to be women. We should be asking why, not just giving them hormones. It often seems to take 7-10 years for them to realise they have made a mistake. In another decade there will be large numbers of detransitioners, just as there are large numbers of transitioners now. And there will be many with regret just maintaining transition because going back is too hard.
The medical industry supporting this and transitioning children without asking why they feel this way, is sick at its core. This is happening in Australia too. Bring on the court cases. I want those buggers bankrupted.
A few psychiatry notes that come up in this interview:
It is not uncommon to simply ask a psychiatric patient a question and treat their answer as definitive, even in cases where that has serious implications. If the patient is being assessed for intent to harm oneself or others, the doctor will ask the patient directly “are you thinking about hurting yourself?”, or another similarly direct question. If the patient says no, the clinician has the latitude to seek out additional information to the extent that he or she sees fit. In some cases, there is little or no further investigation, which can seem pretty reasonable at times if you consider how many dubious psych consults there are. Whether this should be the practice when discussing serious medical interventions on children is obviously a separate question.
Regarding suicide, I was taught (in my Australian medical school, among other places) not to use the phrase “committed” is it implies a sort of stigma (because one commits crimes) and suicidal ideation should be destigmatized (which is a whole conversation). Another verboten phrase is “successful” suicide, for more obvious reasons. “Died by suicide” is considered more appropriate.
Hi Josh, thanks so much for continuing to talk about htis topic. The numbers of kids being transitioned in Australia is also shocking, we just don't hear about it much. Just look at the stats Dianna Kenny has gotten from FOI requests - you can see Victoria is way way out of step with the rest of the country. https://www.diannakenny.com.au/k-blog/item/20-number-of-children-enrolled-receiving-puberty-blockade-and-cross-sex-hormones-in-five-gender-clinics-in-australia-2014-2021.html
The NSW public clinic Westmead takes a more cautious response which leads Transcend to not even list them on their site - they don't want caution and child safeguarding they just want affirm affirm affirm with no concern for the health risks https://transcend.org.au/medical/
All three countries that have conducted systematic reviews of the evidence (Sweden, Finland, England) have stopped transitioning kids. The evidence base in favour of transitioning kids is extremely poor. The British Medical Journal outlines the poor evidence recently here: https://www.bmj.com/content/380/bmj.p382. Your colleague Geraldine Doogue recently talked to the author of Time to Think covering the Tavistock gender service downfall - it's only a matter of time before we have the same situation in Australia because all our gender services are doing exactly the same thing - there is no scientific support for affirmation only and the risks of puberty blockers and cross sex hormones are huge. The staff that work at these gender clinics are now all firmly not looking at the evidence, they truly believe they are doing the right thing. The ones that doubt leave the service, leaving only true believers. https://www.abc.net.au/radionational/programs/saturdayextra/time-to-think/102020686
I know, because my teen went to the Qld gender clinic. They did not ever, not once, outline any risks to health from binders or cross sex hormones. She eventually desisted. She's just a gay autistic kid who was almost trans because no clinicians are brave enough to speak out (yet).
Each time someone criticises the current state of affirmation only health care we're called transphobes and discussion is shut down. Yes, there are awful conservative right wing people who are taking advantage of this to agitate their culture wars. But there are also many left-wing people like myself who just want people to look at the science and evidence and to build care guidelines based on evidence. At the moment guidelines like AusPATH look only at affirmation sources. They ignore evidence that is counter to their mission.
Josh thank you for having the conversation.
You needed some stats on suicide in there. An important paper from the UK (Biggs 2022 https://link.springer.com/article/10.1007/s10508-022-02287-7 ) has shown that in a decade there were 4 suicides of minors connected with the Tavistock GIDS children's gender clinic in a total of about 30,000 patient years, or analysed by numbers of patients, 4 suicides out of 15,000 patients. That clinic itself acknowledged that suicide was rare. This rate is apparently higher than normal, but probably no higher than for those with anxiety and depression that these kids also have. As you can see this is nowhere near the numbers touted by transgender activists and medical "professionals" who want to scare parents into letting their children transition. There is also no good evidence at all that transitioning actually reduces the risk of suicide. Studies on adult transitioned people show that suicide is a significant cause of death. And yet transition was supposed to prevent that?
All the claims like 40% or 50% or 80% of gender dysphoric youth will attempt suicide or think about suicide if not transitioned seems to be derived from poor quality online surveys. These are taken by a load of people who are politically driven to exaggerate their plight and push the cause of transgender medicine that they so passionately believe in. But transitioning does not usually solve their underlying psychological problems and seemingly does little to prevent suicide. For more info and stats on this, see https://www.transgendertrend.com/the-suicide-myth/ and https://statsforgender.org/suicide/
Josh you seem to think that "most" people who come out as trans "ARE trans". I don't believe in this "true trans" idea - I think that there are just people who will transition and don't regret it, and people who transition and will regret it. I think you vastly underestimate the numbers who will regret. We are seeing an exponential growth in young women deciding they don't want to be women. We should be asking why, not just giving them hormones. It often seems to take 7-10 years for them to realise they have made a mistake. In another decade there will be large numbers of detransitioners, just as there are large numbers of transitioners now. And there will be many with regret just maintaining transition because going back is too hard.
The medical industry supporting this and transitioning children without asking why they feel this way, is sick at its core. This is happening in Australia too. Bring on the court cases. I want those buggers bankrupted.
A few psychiatry notes that come up in this interview:
It is not uncommon to simply ask a psychiatric patient a question and treat their answer as definitive, even in cases where that has serious implications. If the patient is being assessed for intent to harm oneself or others, the doctor will ask the patient directly “are you thinking about hurting yourself?”, or another similarly direct question. If the patient says no, the clinician has the latitude to seek out additional information to the extent that he or she sees fit. In some cases, there is little or no further investigation, which can seem pretty reasonable at times if you consider how many dubious psych consults there are. Whether this should be the practice when discussing serious medical interventions on children is obviously a separate question.
Regarding suicide, I was taught (in my Australian medical school, among other places) not to use the phrase “committed” is it implies a sort of stigma (because one commits crimes) and suicidal ideation should be destigmatized (which is a whole conversation). Another verboten phrase is “successful” suicide, for more obvious reasons. “Died by suicide” is considered more appropriate.
Does it mean that I have dyslexia if I had to read this title 4-5 times before it didn’t say “The Transgender Killer who wasn’t”?
Traditionally shat-upon communities = TSUC (tee-suck). Let’s make it happen!