Professor WGA and Friends Guide to Science - How to counter the TransEthics, TransLifeLife and hack writers in the Rat King

[Wallace]

Fair enough. Here's a rather long piece discussing the junk science of the transgender movement, along with where the money is coming from. Spoiler alert: it's the pharma companies who make money off of kids transitioning.

The modern transgender movement is an astroturf tiger. It is not grassroots, it is not organic, and it serves the purposes of no one beyond homophobes and pharmaceutical companies. It is a menace, it has hollowed out the LGBT community, it threatens women’s legal gains for the past hundred years, and it is going to destroy people’s lives. An entire generation of gender non-conforming children that may have otherwise grown up gay are going to grow up to be brain damaged, weakened eunuchs with a medical malpractice lawyer on retainer. This ‘movement’ needs to end before that happens. The LGBT community needs to wake up and start talking back to the fox in the hen house.

 

[melty]

Fair enough. Here's a rather long piece discussing the junk science of the transgender movement, along with where the money is coming from. Spoiler alert: it's the pharma companies who make money off of kids transitioning.

Wow. This is long, but well worth the read, and possibly one of the best articles I've ever read. Not just for it's extensive summary of everything discussed here and the much-needed addition of where the heck all the funding for this movement came from, but it's one of the rare pieces of journalism that gives a peek at how the world may work.

 

[Wallace]

Just putting this link here so I don't lose it later.

Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports

Purpose
In on-line forums, parents have been reporting that their children are experiencing what is described here as “rapid-onset gender dysphoria,” appearing for the first time during puberty or even after its completion. The onset of gender dysphoria seemed to occur in the context of belonging to a peer group where one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same timeframe. Parents also report that their children exhibited an increase in social media/internet use prior to disclosure of a transgender identity. The purpose of this study was to document and explore these observations and describe the resulting presentation of gender dysphoria, which is inconsistent with existing research literature.

Methods
Recruitment information with a link to a 90-question survey, consisting of multiple-choice, Likert-type and open-ended questions, was placed on three websites where parents had reported rapid onsets of gender dysphoria. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. Data were collected anonymously via SurveyMonkey. Quantitative findings are presented as frequencies, percentages, ranges, means and/or medians. Open-ended responses from two questions were targeted for qualitative analysis of themes.

Results
There were 256 parent-completed surveys that met study criteria. The adolescent and young adult (AYA) children described were predominantly female sex at birth (82.8%) with a mean age of 16.4 years. Forty-one percent of the AYAs had expressed a non-heterosexual sexual orientation before identifying as transgender. Many (62.5%) of the AYAs had been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to the onset of their gender dysphoria (range of the number of pre-existing diagnoses 0–7). In 36.8% of the friendship groups described, the majority of the members became transgender-identified. The most likely outcomes were that AYA mental well-being and parent-child relationships became worse since AYAs “came out”. AYAs expressed a range of behaviors that included: expressing distrust of non-transgender people (22.7%); stopping spending time with non-transgender friends (25.0%); trying to isolate themselves from their families (49.4%), and only trusting information about gender dysphoria from transgender sources (46.6%).

Conclusion
Rapid-onset gender dysphoria (ROGD) describes a phenomenon where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood. ROGD appears to represent an entity that is distinct from the gender dysphoria observed in individuals who have previously been described as transgender. The worsening of mental well-being and parent-child relationships and behaviors that isolate AYAs from their parents, families, non-transgender friends and mainstream sources of information are particularly concerning. More research is needed to better understand this phenomenon, its implications and scope.

 

[wylfım]

Only very tangentially related to points brought up before, but interesting nonetheless. Attached is a (very long) study on sexual behaviors and conditioning. I haven't read through it yet, but I want to note that it shows that sexual preferences can be conditioned (in mice at least) to go against innate biological instincts (in this case the smell of cadaverine, rotting corpses). Essentially, letting people troon out can produce positive feedback loops that reinforce their conviction that they truly are a troon. Apply this principle beyond transsexuals and you get into more controversial waters, but I'll let you make those conclusions yourself...

 

[Wallace]

Putting this one here too.

Gender Dysphoria in Children

American College of Pediatricians – November 2018

ABSTRACT: Gender dysphoria (GD) of childhood describes a psychological condition in which children experience a marked incongruence between their experienced gender and the gender associated with their biological sex. When this occurs in the pre-pubertal child, GD resolves in the vast majority of patients by late adolescence. Currently there is a vigorous, albeit suppressed, debate among physicians, therapists, and academics regarding what is fast becoming the new treatment standard for GD in children. This new paradigm is rooted in the assumption that GD is innate, and involves pubertal suppression with gonadotropin releasing hormone (GnRH) agonists followed by the use of cross-sex hormones—a combination that results in the sterility of minors. A review of the current literature suggests that this protocol is founded upon an unscientific gender ideology, lacks an evidence base, and violates the long-standing ethical principle of “First do no harm.”

This is a lot more than just an opinion piece, it's a position statement. The target audience is policy-makers, people who decide how to act when they get cases like this.

 

[Wallace]

The Brain Will Go to Amazing, Sometimes Scary Lengths to Preserve Its Self-Constructed Narrative

The fact that you feel in control of your life—at, really, any given moment—is, according to Will Storr writing in Aeon, an illusion painted by a brilliant brain struggling to make sense of the world. According to psychologists, it's your emotions that are always—or almost always, at any rate—in charge.

Storr writes:

"We think we’re captained by the part of us that’s self-conscious – the bit that we experience as our own living ‘me’, that collision of sense, memory and internal monologue at the centre of which sits the ‘I’. Yet there’s a silent, unconscious ‘I’ to which we have no access. It communicates with emotions, wordlessly coaxing us this way and that with its ceaseless blooms of disgust and fear and desire. It influences everything we think and do.

Exactly how much influence does this self have over our behaviour? Experts disagree. Some say its control is total: that the voice that speaks in the privacy of our heads might seem like it’s in charge, but really it’s just a babbling spin doctor, making excuses for the misdeeds of its boss. Others claim that our rational selves can play an executive role under certain, limited circumstances – but not much more than that. Either way, most of the time we feel that we’re autonomous only because the voice in our heads narrates all our actions, explaining why we’re doing what we’re doing at any given moment, even though it actually has no idea."

In his long feature, Storr examines the power of the brain's ability to spin tales that obscure this truth, a process called “confabulation.” For most of us, these narratives give order to a largely chaotic world, an existence without clearly defined goals or purpose or meaning. Though confabulations are most severe in people with certain neurological disorders, such as Alzheimer's or amnesia, the tendency to fictionalize our own pasts is one shared by all people, says Psychology Today.

For most people, the narrative gives them special importance and explains their experiences, says Storr. It's the story of your life, as written by you—the just-so story of how you managed to get here from there.

The problem is, it's not necessarily true. And sometimes, writes Storr, this writing and rewriting of history has a dark side. In the case of John Pridmore, a British criminal who turned to God after he nearly killed a man, writes Storr: “It seemed as though the brain would do almost anything to maintain its feeling of control, even if that meant turning our selves and the plot of our lives inside out and upside down.”

Pridmore convinced himself that he was smarter than everyone to justify being a criminal tough guy. Later, he convinced himself that he was redeemed by God, when he decided to leave his criminal life, and became a preacher who expounded on redemption. Basically, whatever he did, he told himself a story about why he was right to do it.

This is just one example of the brain's ability to spin and re-spin a most immaculate yarn. What's amazing—and a little bit scary—is how that special skill can allow a person to self-justify nearly any course of action.

Here's a direct link to Storr's article, if you don't want to give the Guardian a click.

Also: anecdotal but relevant:

 

[Positron]

Gender-affirming hormone in children and adolescents
25 Feb 2019
by Carl Heneghan, Editor in Chief BMJ EBM, Professor of EBM, University of Oxford
and Tom Jefferson, Senior Associate Tutor University of Oxford, Visiting Professor Institute of Health & Society, Faculty of Medicine, Newcastle University

Key points: (whole text under spoiler at the end of this post)

• Evidence suggests that children will change their minds as they age: approximately ¾ of pre-pubescent children attending gender identity clinics will not want to change their gender once puberty starts
• Most studies involving children given GnRH anatgonists and / or cross-sex hormones suffer from lack of control groups and blinding.
• Stopping LH and FSH and testosterone secretion (with GnRH anatgonists) suspends maturation of fetal and neonatal germ cells leading to a loss of fertility.
• Three additional concerns have been raised that GnRH antagoists (paywalled article)
  • Young people are left in a state of ‘developmental limbo’ without secondary sexual characteristics that might consolidate gender identity;
  • Use is likely to threaten the maturation of the adolescent mind
  • Puberty blockers are being used in the context of profound scientific ignorance.
• Spine bone mineral density scores fell during puberty suppression with GnRH antagonist for transgender adolescent "females" and did not increase following estrogen treatment.
• There are concerns that estrogen worsens the triglyceride profiles of boys (while increasing HDL, which is good), and that testosterone increases both the systolic and the diastolic blood pressure among girls.

Spoiler: Full Text

Gender-affirming hormone in children and adolescents
Posted on 25th February 2019

How big a problem is gender dysphoria?
Prevalence estimates suggest male-to-female cases outnumber female-to-male cases, with 1 per 10,000 males and 1 per 27,000 females affected by gender dysphoria. These rates qualify for orphan designation status (defined by the European Union as one that affects less than 5 in 10,000 of the general population).

We know higher rates are observed in Western Europe and America, but the exact prevalence is difficult to estimate because the number of children and adolescents referred to services is still rising. As an example, UK referrals to the national Gender Identity Development Service (GIDs) has risen exponentially since 2011.


Reference: Referrals to UK GID services: Assessment and support of children and adolescents with gender dysphoria. Arch Dis Child 2018;103:631–6. doi:10.1136/archdischild-2018-314992

Treatments options for Gender Dysphoria
The World Professional Association for Transgender Health (WPATH) Guidelines, on the clinical care of transgender adolescent, set out three stages of gender-affirming interventions with progressive levels of irreversibility:

• Stage 1, puberty suppression
• Stage 2, gender-affirming hormones
• Stage 3, gender-affirming surgery

Guidelines require puberty to have begun (Tanner stage 2, when pubic hair and breast buds appear) before any intervention is agreed. This is because gender dysphoria may resolve once puberty begins. In 2008 the Endocrine Society approved puberty blockers for transgender adolescents as young as 12 years old.

To find the evidence for treatment options we first searched for systematic reviews. We used PubMed Clinical Queries to search for the reviews (see here). We found two up to date reviews with overlapping trial results:

• Hormonal Treatment in Young People With Gender Dysphoria: A Systematic Review.
• Gender-affirming hormones and surgery in transgender children and adolescents.

There are other reviews you might want to take a look at, such as The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review, and aSystematic Review of the Effects of Hormone Therapy on Psychological Functioning and Quality of Life in Transgender Individuals. We focused on the latest reviews in children and adolescents that reported a range of clinical outcome to inform decision making.

The first review Hormonal Treatment in Young People With Gender Dysphoria, searched Medline, Embase, and PubMed to June 10, 2017, and assessed risk of bias using a modified version of the Quality in Prognosis Studies, and published a protocol registered at PROSPERO (identifier CRD42017056670). The second, Hormonal Treatment in Young People With Gender Dysphoria, searched MedLine and Embase, included studies when the mean or median age of the sample was below 18 years, reported information on the limitations of each study and set out research recommendations.

Together these reviews included 16 studies with 1,132 participants (transgender males n=615 (54%); transgender females 419 (37%) and 86 (7.6%) control subjects reported in two studies Burke (2016) and Staphorsius (2015). Controls were not matched for important confounders, which means caution should be applied to any conclusions. We found no randomized controlled trials or controlled trials. See our evidence sheet for a summary of the 16 trials:

Stage 1, Puberty suppression treatments

Gonadotrophin-releasing hormone agonists (GnRHa) acts on GnRH receptors to suppress gonadotropin release. It can lower sex hormone levels by 95% in both sexes. In females GnRHa reduces the secretion of LH and FSH; in males, it shuts down gonadal testosterone production. For this reason, they are often referred to as puberty blockers. Stopping LH and FSH and testosterone secretion suspends maturation of fetal and neonatal germ cells leading to a loss of fertility. Little is known about its safety profile in the context of gender dysphoria: use is based largely on effects of treatment of central precocious puberty.

The clinically used GnRH agonists are available in the following formulations:

• Short-acting injection: buserelin, histrelin, leuprorelin, triptorelin
• A long-acting depot injection or injected pellet: leuprorelin, triptorelin
• Injected implant: buserelin, goserelin, leuprorelin
• Surgically implanted pellet: histrelin, leuprorelin
• Nasal spray: buserelin, nafarelin

Evidence suggests that children will change their minds as they age: approximately ¾ of pre-pubescent children attending gender identity clinics will not want to change their gender once puberty starts. A prospective study of 77 gender dysphoric children (59 boys, 18 girls; mean age 8.4 years, range 5–12 years) referred to one clinic found that after 3.4 years of follow-up 27% (12 boys and nine girls) remained gender dysphoric.

We found ten studies that analysed the effects of puberty blockers: the median age of starting in transgender males in these trials was 15.0 years (median range 13.5 to 15.8 years), and in females, the median age was 15.1 years (range 13.6 to 16.5 years). See evidence sheet:

Vlot 2017reported the lowest median age in boys of 13.5 years; Schagen 2016, funded by an unrestricted grant from Ferring the makers of the study drug triptorelin, reported a median age of 13.6 years in transgender females for starting treatment. Six studies were funded by industry: 4 received funding from Ferring (Delemarre-van de Waal, Staphorsius (2015), Schagen 2016 and Hannema 2017).

The denominators in all of these ten studies are tiny and mostly from retrospective case reports or small case series. Many are done in single clinics and lack long term longitudinal outcomes on the effects (both benefits and harms) of puberty blockers. It also hard to disentangle effects from the use of gender affirming hormones. We found four studies reporting on the use of GnHRa alone: Schagen 2016 (n=128 ); Staphorsius (2015) (n=85); Costa 2015 (n=201) and Delemarre-van de Waal 2006 (n= 21).

Schagen 2016 studied the effects of Triptorelin in gender dysphoric adolescents and reported treatment did require adjusting because of insufficient suppression. They concluded further studies should evaluate whether the effects on height and body composition can be reversed during subsequent GAH treatment. Costa 2015reported that global functioning after psychological support and puberty suppression was improved. Delemarre-van de Waal reported GnRHa treatment appeared to be important for the management of gender identity in transsexual adolescents. Finally, Staphorsius (2015), determined whether the performance on the Tower of London task cognitive task was altered with GnRHa and found no significant effects on task scores.

Problems within these studies, however, make it difficult to assess whether early pubertal changes regress under GnRHa treatment and whether prolonged puberty suppression is safe. For example, there is a lack of controls, and in one study that included controls, these were inadequate as relatives and friends of the participants were asked to participate, serving as age-matched controls. A lack of blinding was also problematic One study (Costa 2015) that focused on a measure of psychosocial well-being highlighted that getting older has previously been positively associated with maturity and well-being (see Getting older, getting better? Personal strivings and psychological maturity across the life span.)

An Archive of Diseases in Childhood letter referred to GnRHa treatment as a momentous step in the dark. And set out three main concerns: 1) young people are left in a state of ‘developmental limbo’ without secondary sexual characteristics that might consolidate gender identity; 2) use is likely to threaten the maturation of the adolescent mind, and 3) puberty blockers are being used in the context of profound scientific ignorance.

Stage 2, Gender-affirming cross-sex hormone hormones (CSHs)

Oestrogens and testosterone induce masculine or feminine physical characteristics, and SHOULD ONLY BE taken in the context of medical supervision to monitor risks (e.g., polycythaemia in transgender males, venous thromboembolism in transgender females).

For transgender females, oestrogen therapy alone is often insufficient to produce the desired feminising effects. Other treatments are therefore used in an off label manner. For example spironolactone, an aldosterone antagonist with weak oestrogenic properties is commonly used to support oestrogen therapy – off label. Cyproterone acetate has progestational and antiandrogenic properties, but it can lead to hepatic toxicity including jaundice, hepatitis. Hepatic failure has also been reported (fatalities reported, usually after several months, at dosages of 100 mg and above).

Specific effects of gender affirming hormones

Psychological effects

Young transgender people may have mental health problems, including anxiety, and suicidal ideation. De Vries 2014 (n =55 transgender adolescents) assessed gender dysphoria, body satisfaction, at baseline, puberty suppression, and in adulthood. De Vries 2011 reported on the original cohort (n=70) that showed that emotional problems and depressive symptoms decreased, while general functioning improved significantly during puberty suppression. High levels of bias with study participation mean the results should be treated with caution. The study found a decrease in gender dysphoria after surgery. However, it was not possible to disentangle the psychological benefits of hormone treatments from surgical interventions.

Cognitive and brain-related effects

Neuroimaging studies suggest CSHs affect brain structure and circuitries, ventricular volume and thickness, hypothalamic neuroplasticity, and functional connectivity. One study, Burke (2016) (n=62) investigated GAHs and brain function in adolescents, reported that testosterone therapy in transgender males (n=21 mean age 16.1) was associated with altered cognitive processes, as assessed by the mental rotation task (MRT), a measure of visuospatial working memory that elicits cognitive sex differences. The study concluded that transgender males have atypical sexual differentiation of brain areas involved in visuospatial cognitive functioning.

Bone development

Klink 2015 found that lumbar spine bone mineral density scores fell during puberty suppression with GnRHa for transgender adolescent females but did not increase following oestrogen treatment. Endocrine Society Guidelines state monitoring BMD parameters in transgender adolescents is recommended both prior to and during gender-affirming hormonal treatment.

Haematological variables

Testosterone therapies stimulate erythropoiesis. Increases in haemoglobin and haematocrit are an anticipated physiological response. Jarin 2017 (n =116) reported that testosterone therapy in transgender males (n=72) was associated with significant elevations in mean haemoglobin and haematocrit. Tack 2016 reported haemoglobin and haematocrit concentration variables increased but stabilised at six months. In transgender adolescent females estradiol. Olson-Kennedy 2018 report a significant decline in Hb concentrations after a 2-year course of estradiol.

Cardiovascular Health

Tack 2016; Jarin 2017 report no changes in LDL or triglycerides in the short term for transgender adolescent males. Olson-Kennedy 2018 report significant increases in triglyceride concentrations and HDL after two years of oestrogen treatment. None of the studies showed significant changes in mean total cholesterol concentrations. Olson-Kennedy 2018 report elevations in systolic and diastolic blood pressure with testosterone treatment after two years. Jarin 2017 reports no change in BP at six months. Jarin 2017, Olson-Kennedy 2018 and Tack 2016 report no changes in HbA, glucose, or insulin.

Conclusions

There are significant problems with how the evidence for Gender-affirming cross-sex hormone has been collected and analysed that prevents definitive conclusions to be drawn. Similar to puberty blockers, the evidence is limited by small sample sizes; retrospective methods, loss of considerable numbers of patients in follow-up. The majority of studies also lack a control group (only two studies used controls). Interventions have heterogeneous treatment regimes complicating comparisons between studies. Also adherence to the interventions are either not reported or at best inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding, and many effects can be explained by regression to the mean.

The development of these interventions should, therefore, occur in the context of research. Treatments for under 18 gender dysphoric children and adolescents remain largely experimental. There are a large number of unanswered questions that include the age at start, reversibility; adverse events, long term effects on mental health, quality of life, bone mineral density, osteoporosis in later life and cognition. We wonder whether off label use is appropriate and justified for drugs such as spironolactone which can cause substantial harms, including death. We are also ignorant of the long-term safety profiles of the different GAH regimens. The current evidence base does not support informed decision making and safe practice.

---
Carl Heneghan
Editor in Chief BMJ EBM, Professor of EBM, University of Oxford

Tom Jefferson
Senior Associate Tutor University of Oxford
Visiting Professor Institute of Health & Society, Faculty of Medicine, Newcastle University

Competing interests

This evidence review was performed as part of a BBC Panorama documentary: Trans Kids: Why Medicine Matters, release date: 27 February 2019.

Carl has received expenses and fees for his media work including from BBC Inside Health. He holds grant funding from the NIHR, the NIHR School of Primary Care Research, The NIHR Oxford BRC and the WHO. He has also received income from the publication of a series of toolkit books. CEBM jointly runs the EvidenceLiveConference with the BMJ and the Overdiagnosis Conference with some international partners which are based on a non-profit model. Full disclosure here. Tom received a fee for this work. Tom’s other disclosure is here

 

[Sinner's Sandwich]

Stopping LH and FSH and testosterone secretion suspends maturation of fetal and neonatal germ cells leading to a loss of fertility.

Interesting that they didn't mention the prevention of sexual maturity in males (stunted sex organs, no development of libido) and all the problems testosterone overdose/gnrh agonist cause for female bodies . It seems sexual health isn't a concern and/or this topic isn't trans friendly enough.

 

[Wallace]

Signaling virtuous victimhood as indicators of Dark Triad personalities.

We investigate the consequences and predictors of emitting signals of victimhood and virtue. In our first three studies, we show that the virtuous victim signal can facilitate nonreciprocal resource transfer from others to the signaler. Next, we develop and validate a victim signaling scale that we combine with an established measure of virtue signaling to operationalize the virtuous victim construct. We show that individuals with Dark Triad traits—Machiavellianism, Narcissism, Psychopathy—more frequently signal virtuous victimhood, controlling for demographic and socioeconomic variables that are commonly associated with victimization in Western societies. In Study 5, we show that a specific dimension of Machiavellianism—amoral manipulation—and a form of narcissism that reflects a person’s belief in their superior prosociality predict more frequent virtuous victim signaling. Studies 3, 4, and 6 test our hypothesis that the frequency of emitting virtuous victim signal predicts a person’s willingness to engage in and endorse ethically questionable behaviors, such as lying to earn a bonus, intention to purchase counterfeit products and moral judgments of counterfeiters, and making exaggerated claims about being harmed in an organizational context.

Behind a paywall, but it's nice to get some confirmation of what we already suspected.