Transitions and Detransitions
This article talks about detransitioning.
Detransitioners: 55% say clinicians didn’t give adequate evaluation before gender transition
This does not surprise me because:
* The American medical system is designed for efficiency, not best care, so it rushes through almost everything. This has predictably poor results, especially on informed consent.
* Not a lot of doctors or counselors really understand sex/gender variation to begin with. So unless you are fortunate enough to find caregivers who are highly rated by the trans community, you are likely to receive mediocre or bad care. And there aren't nearly enough good ones to cover everyone in need.
That said, I feel that everyone has a right to as much or as little information about their body, their mind, their condition(s), and their care options as they want; and to make a free choice of the best available option(s) without any outside pressure or consequences. Because when they don't get that, the outcomes tend to be bad.
Also, all the options for coping with gender dysphoria have pros and cons. Hormones can be hard on the body, most sex-related surgeries have complications, and both are expensive. Counseling sometimes makes matters worse. Ignoring the problem often does too. Picking a best, or even least-worst, option depends a lot on individual details.
These can change over a person's lifetime. It's not necessarily bad to make a choice, and then decide later you'd rather do something different. That's what freedom is all about. People need to make their own choices, including mistakes. All we can do is try to ensure they have as much information and freedom available as possible.
The results of a recent study suggest that some clinicians might be failing to explore other causes when treating gender dysphoria.
This could be because:
* They are rushed. Most of the system is now. This is difficult or impossible to fix in context of the society we have.
* The client is freaked out and wants to rush in hopes of feeling less horrible. This doesn't actually work well with sex/gender issues, which are often murky and complicated. Don't speed in the fog on a winding road, folks. Even if you feel like you're being chased by monsters.
* They don't know any better. Gender scholars and medical doctors usually aren't the same people, and the medical industry's training for gendercare is often lacking. They many not know what else could explain the same symptoms, let alone how to distinguish among multiple possibilities. They often aren't particularly good at diagnosis even with physical complaints unless it's quite obvious.
* They may be following clinical recommendations that are flawed or just plain wrong. There's a sort of liberal branch that really does recommend rushing and condemns all efforts at questioning or examination as transphobia. I don't see that helping anyone.
* They may be obligated to follow the guidelines of their organization regardless of personal knowledge or ethics. This is increasingly common as choices are restricted in general. You don't get what you need; you get what someone else tells you that you should have.
So if you're questioning your sex/gender, you're just going to have to take responsibility for your own journey. Other people may or may not offer to help, and if they do, may or may not be able to do so competently. Shop around, explore widely, and take care of yourself first.
A recent study aimed to better understand the experiences of detransititioners. Detransitioners are people who, typically, had gender dysphoria, pursued transition through medication or surgery, and then either stopped taking medication or had surgery to reverse a prior transition.
Well, there's a glaring issue: detransitioning is about reverting to the earlier gender presentation. A person might do that without changing their medical regimen. They might change their regimen because they had bad side effects of medication and/or surgery for which this was the best solution, and not change their current gender presentation. Or they might change both the regimen and the presentation.
There's nothing wrong with detransitioning if you decide that it's not helpful and not worth whatever risks or hassles are entailed in maintaining your current gender presentation. You have a right to change your mind, or your body. It doesn't mean you're dumb. It might mean you didn't have all the information you needed earlier. Even with good information in advance, that can't tell you what it's like to live after transition. You just have to make your best guess. In this regard it's no different than any other major life decision, like picking a college and dropping out because it doesn't teach what you want to learn, or marrying someone and divorcing them because you don't fit after all, or taking a job and quitting it due to burnout. It's your body, your mind, your life. Just do your best and don't 'should' on yourself.
Although the study has multiple limitations, the results suggest that some clinicians might be failing to explore co-morbidities and the greater context within which gender dysphoria can emerge.
Likely so. It'd be nice if we had a system that gave people more time and more mental care and more medical information and more agency. Good luck squeezing any of that out of the pennypinchers.
As these populations have grown, their demographics have been changing, too. In the mid-2000s, the majority of adolescents who sought treatment for gender dysphoria were natal males. But over the past decade or so, that sex-ratio has decidedly flipped, with far more natal females seeking treatment and many deciding to transition. The exact reasons for these changes remain unclear.
I'd check the changing flow of chemical contaminants, as well as social shifts. There are a LOT of "hormone mimicking chemicals" in the environment. It's not just affecting humans, some other species are showing wide swings in sex/gender. Not to mention the poor frogs with extra limbs. 0_o
What is also missing in the research literature on gender dysphoria and transition is comprehensive data on a particular subpopulation: detransitioners — people who had gender dysphoria, pursued transition through medication or surgery, and then either stopped taking medication or had surgery to reverse a prior transition, or both.
There's nowhere near enough research in general. But I can't blame transfolk for avoiding it when so many have had bad experiences with authorities. The other side of the problem is a lack of funding and interest in a niche population that already isn't well liked. Perfect storm.
Detransitioning is a controversial subject. Some transgender rights advocates argue that media reports often exaggerate the prevalence of detransitioners, and that such overestimates risk fueling transphobia, delegitimizing the transgender experience,
Well it's not helped by sweeping it under the rug. Covering up detransitioning is just as much erasure as gatekeeping is.
and discouraging young people with gender dysphoria from pursuing transitioning, which is beneficial for many people.
See above, all the options have drawbacks, sometimes serious ones. Making the wrong choice can kill people. Surgical complications can be lethal, gender dysphoria is one of several conditions where not treating it has a high risk of suicide, and being trans is a good way to get murdered. So people should think very carefully about their options before making a decision, and it's a good idea to try less-risky approaches first.
But the reality is there’s hardly any empirical data on detransitioners or the size of their population. This lack of research is concerning to some medical professionals who feel that, amid the fast-rising rates of transitions and referrals to gender clinics, some young people might not be receiving sufficient, comprehensive medical evaluations and guidance.
With a lack of research, nobody has hard data. That's a problem. We should know, for instance, what is the percentage of crippling or fatal complications with hormones or each different type of surgery, what is the percentage of people who stop feeling gender dysphoria after each type of treatment, what are the comparable risks of suicide down each path, etc. Without hard numbers, we're all guessing to a degree that is inadvisable in high-risk situations.
What’s more, most respondents did not inform their clinicians after they had detransitioned, suggesting that the total number of detransitioners could be underestimated.
Well, duh. The medical industry has a piss-poor reputation in meeting the needs of sex/gender variant clients. People who are already displeased with its performance are unlikely to seek more care -- or do anything else liable to attract unwanted attention. Especially since the industry sucks at taking no for an answer.
The survey results included:
Encouraging factors: Social media and online communities were reported as the top influencing factors in leading respondents to believe that transitioning would help them.
See above re: the need for statistics. Hard facts are good at counterbalancing opinions.
I would suggest that trans websites and other facilities endeavor to represent as many voices as possible. I think this is unlikely as they tend to encourage transition and can be downright hostile about detransitioning. That's not exactly helping people figure out their identity in the murk.
Pressure to transition: 37% of respondents, most of whom were natal females, reported feeling pressured to transition. In open-ended answers, the respondents wrote statements like:
“My gender therapist acted like it [transition] was a panacea for everything.”
“[My] [d]octor pushed drugs and surgery at every visit.”
“I was dating a trans woman and she framed our relationship in a way that was contingent on my being trans.”
“A couple of later trans friends kept insisting that I needed to stop delaying things.”
So that's two clusters, one difficult to fix, one somewhat easier.
1) Clinicians should never pressure clients. It is not their job to decide anything unless the client says, "I don't know, you're the expect, use your best judgment." Otherwise they should present options with pros and cons and let the client decide. "Evidence-based," "best practices," "in similar cases we recommend," and solid statistics can all help clients make good decisions. But the training aims at clinicians pressuring or forcing clients to do what is convenient or profitable for the clinician (or the insurance company, or the institution) so that's what we get. Fixing this requires repairing a fundamentally broken system.
2) Friends, relatives, etc. should never pressure other people about sex/gender decisions. It can be tempting to do so, but this is consistently harmful. We can discourage this by highlighting how it is harmful, and including recommendations to respect agency in tipsheets for friends and family. Especially transfolk should damn well know better. You didn't like it when people pestered you, did you? Then don't do it to anyone else.
Come on, people, if it's not your crotch it's not your choice. This is not a complicated concept.
Reasons for transitioning: The most common reasons for transitioning included statements like:
“I wanted others to perceive me as the target gender.”
“I thought transitioning was my only option to feel better.”
“My body felt wrong to me the way it was.”
Those are all sound reasons, although ideally, people should have the most information to make the best decision.
Reasons for detransitioning: The most common reason for detransitioning was that the respondent’s “personal definition of male and female changed and they became comfortable identifying with their natal sex (60.0%).” Meanwhile, 23% of respondents reported discrimination as a reason for detransitioning.
Here again we have two clusters.
1) Some people just plain outgrow their sex/gender/orientation. It's not rare. It's not restricted to this context. It can be uncomfortable and costly, but sometimes that's just life. All you can do is make the best choice with the information you have at the time.
2) Being trans, or seen as trans, can definitely get you killed. Some people decide they would prefer to be uncomfortable than dead. This is extremely unfortunate, but it is not irrational nor a mistake. It's just making the best of society's shitty situation.
Most respondents (55%) felt that their pre-transition medical evaluation was inadequate. Additionally, 65.3% said their clinicians did not explore whether their desire to transition might be related to trauma or a mental health condition. That could be cause for concern, considering that 38% of respondents reported that one of the reasons they detransitioned was “discovering that something specific like trauma or a mental health condition caused their gender dysphoria,” as the study noted.
This is a very sticky point because:
1) The medical industry is rushed and fixing this would be difficult if not impossible.
2) The mental industry is even worse than the physical one, woefully inadequate and out of reach for many who need it. Even if other options than transitioning exist, they are prevailingly inaccessible. Fixing this will also be difficult if not impossible.
3) Worst of all, and there is no getting around this, we have different groups of people presenting with the same or similar symptoms, each of whom is likely to be harmed by things the other group needs. Transfolk need ready access to gender alignment care, and are easily harmed by questioning their identity or gatekeeping their access. People with other complaints, such as sex/gender trauma, need help examining their condition to identify what it is and what would help; and are easily harmed by getting railroaded into sex/gender change.
4) And on this note, traumatagender is a thing, which happens when your trauma takes your sex/gender/orientation and shoves it in a blender and leans on frappe. Even with the best help, unscrambling that can be impossible. But it's not impossible to talk about; we had a character like this in my high school gaming group, which was very interesting. Come on "experts" ... if I can do it at 16 without even knowing how roleplay worked yet, surely some of you can figure it out. Trauma breaks things, and among the things it can break are sex, gender, and orientation. If you can manage nothing else, at least mention that much, sometimes it helps.
However, we do have one area within easy reach to work on: we can try to make society and sex/gender conceptualizations more flexible. This will simultaneously make it easier for people to figure out what theirs is, and provide more wiggle room so that fewer people get pushed into transition as the only way to feel comfortable in their own skin.
Research on children with gender dysphoria shows that the condition tends to resolve itself over time for about 85% of people. It is not exactly clear why. But the process, called “desistance,” might be a byproduct of getting older, or it could be due to the fact that many people who present with gender dysphoria, especially young people, ultimately turn out to be gay, lesbian, or bisexual, and many eventually come to peace with that identity.
This number is something everyone should get when approaching sex/gender care.
However, I have to wonder if that comes from quickie questionnaires or lifelong cohort studies. That is, if 85% grow into some other identity, is that subsequent identity stable or do they outgrow that too? And if the latter, do they decide they're trans after all or something else yet again? That's important, because it's easy to imagine some people giving up on transgender identity because it's too risky, expensive, or otherwise troublesome -- but they might not be able to stay away. Homosexuals sometimes have that back-and-forth motion too.
In the recent study, for example, 23% of respondents reported that “internalized homophobia and difficulty accepting oneself as lesbian, gay, or bisexual” was a reason for transitioning.
That's a lot. Clearly it would be desirable for people to know this figure and to consider their sexual orientation before deciding whether to transition. But if you ask someone who's already angsting over their gender identity to examine the also-fraught topic of sexual orientation, this is not likely to go over well unless they are particularly open-minded.
Again, the option most in reach is to work on making society more inclusive of many identities so fewer people will feel confused, offended, or panicky about these topics.
“What would have helped me is being able to access women’s community, specifically lesbian community. I needed access to diverse female role-models and mentors, especially other butch women.”
That sounds like a good thing to have in general, more diverse role models and more community
“This means caring about people who have been helped by transition and people who have been harmed by transition; people who had underlying conditions causing their gender dysphoria and people who did not; people whose gender dysphoria persisted and people whose gender dysphoria resolved,” Littman told Big Think.
And don't forget those of us who just don't find the available options worth the risk, expense, or bother. I'm no less genderqueer because I've chosen to stick with the body I have rather than hack around with modifications that, based on my personality, wouldn't be particularly useful; and based on my body and the crapsack industries, downright dangerous. On a planet with nearly 8 billion people, I'm probably not even the only morphlocked shapeshifter muttering, "Fuck it, I've worn worse."
Although transitioning helps many people, Littman said that some cases of gender dysphoria require clinicians to take a more nuanced and comprehensive approach. “Failing to explore co-morbidities and the context in which the gender dysphoria emerged puts patients at risk of harm from misdiagnosis, delayed diagnosis, and receiving the wrong treatment for their distress.”
Consider in particular that co-morbidity means having more than one problem at the same time. Fixing one might make the other(s) better, the same, or worse. So you need to know what they all are, what the options for treating each might be, and how those options could interact. The health industries are shit at making those predictions, and even with physical complaints, are often left with a trial-and-error scramble to find some combination of therapies that improve the overall quality of life rather than just one-up-one-down. So good luck sorting that out in the murk of sex/gender issues sprawled over body, mind, and spirit with the assistance of several dozen microexperts none of whom are good at more than one narrow aspect.
Yeah, I'll be over here popping the hood on culture and hitting it with a wrench again. At least that I can budge a little sometimes. Maybe it needs more kyoot fanfic of transfolk. A few decades of Kirk/Spock has done wonders for gay rights.
Detransitioners: 55% say clinicians didn’t give adequate evaluation before gender transition
This does not surprise me because:
* The American medical system is designed for efficiency, not best care, so it rushes through almost everything. This has predictably poor results, especially on informed consent.
* Not a lot of doctors or counselors really understand sex/gender variation to begin with. So unless you are fortunate enough to find caregivers who are highly rated by the trans community, you are likely to receive mediocre or bad care. And there aren't nearly enough good ones to cover everyone in need.
That said, I feel that everyone has a right to as much or as little information about their body, their mind, their condition(s), and their care options as they want; and to make a free choice of the best available option(s) without any outside pressure or consequences. Because when they don't get that, the outcomes tend to be bad.
Also, all the options for coping with gender dysphoria have pros and cons. Hormones can be hard on the body, most sex-related surgeries have complications, and both are expensive. Counseling sometimes makes matters worse. Ignoring the problem often does too. Picking a best, or even least-worst, option depends a lot on individual details.
These can change over a person's lifetime. It's not necessarily bad to make a choice, and then decide later you'd rather do something different. That's what freedom is all about. People need to make their own choices, including mistakes. All we can do is try to ensure they have as much information and freedom available as possible.
The results of a recent study suggest that some clinicians might be failing to explore other causes when treating gender dysphoria.
This could be because:
* They are rushed. Most of the system is now. This is difficult or impossible to fix in context of the society we have.
* The client is freaked out and wants to rush in hopes of feeling less horrible. This doesn't actually work well with sex/gender issues, which are often murky and complicated. Don't speed in the fog on a winding road, folks. Even if you feel like you're being chased by monsters.
* They don't know any better. Gender scholars and medical doctors usually aren't the same people, and the medical industry's training for gendercare is often lacking. They many not know what else could explain the same symptoms, let alone how to distinguish among multiple possibilities. They often aren't particularly good at diagnosis even with physical complaints unless it's quite obvious.
* They may be following clinical recommendations that are flawed or just plain wrong. There's a sort of liberal branch that really does recommend rushing and condemns all efforts at questioning or examination as transphobia. I don't see that helping anyone.
* They may be obligated to follow the guidelines of their organization regardless of personal knowledge or ethics. This is increasingly common as choices are restricted in general. You don't get what you need; you get what someone else tells you that you should have.
So if you're questioning your sex/gender, you're just going to have to take responsibility for your own journey. Other people may or may not offer to help, and if they do, may or may not be able to do so competently. Shop around, explore widely, and take care of yourself first.
A recent study aimed to better understand the experiences of detransititioners. Detransitioners are people who, typically, had gender dysphoria, pursued transition through medication or surgery, and then either stopped taking medication or had surgery to reverse a prior transition.
Well, there's a glaring issue: detransitioning is about reverting to the earlier gender presentation. A person might do that without changing their medical regimen. They might change their regimen because they had bad side effects of medication and/or surgery for which this was the best solution, and not change their current gender presentation. Or they might change both the regimen and the presentation.
There's nothing wrong with detransitioning if you decide that it's not helpful and not worth whatever risks or hassles are entailed in maintaining your current gender presentation. You have a right to change your mind, or your body. It doesn't mean you're dumb. It might mean you didn't have all the information you needed earlier. Even with good information in advance, that can't tell you what it's like to live after transition. You just have to make your best guess. In this regard it's no different than any other major life decision, like picking a college and dropping out because it doesn't teach what you want to learn, or marrying someone and divorcing them because you don't fit after all, or taking a job and quitting it due to burnout. It's your body, your mind, your life. Just do your best and don't 'should' on yourself.
Although the study has multiple limitations, the results suggest that some clinicians might be failing to explore co-morbidities and the greater context within which gender dysphoria can emerge.
Likely so. It'd be nice if we had a system that gave people more time and more mental care and more medical information and more agency. Good luck squeezing any of that out of the pennypinchers.
As these populations have grown, their demographics have been changing, too. In the mid-2000s, the majority of adolescents who sought treatment for gender dysphoria were natal males. But over the past decade or so, that sex-ratio has decidedly flipped, with far more natal females seeking treatment and many deciding to transition. The exact reasons for these changes remain unclear.
I'd check the changing flow of chemical contaminants, as well as social shifts. There are a LOT of "hormone mimicking chemicals" in the environment. It's not just affecting humans, some other species are showing wide swings in sex/gender. Not to mention the poor frogs with extra limbs. 0_o
What is also missing in the research literature on gender dysphoria and transition is comprehensive data on a particular subpopulation: detransitioners — people who had gender dysphoria, pursued transition through medication or surgery, and then either stopped taking medication or had surgery to reverse a prior transition, or both.
There's nowhere near enough research in general. But I can't blame transfolk for avoiding it when so many have had bad experiences with authorities. The other side of the problem is a lack of funding and interest in a niche population that already isn't well liked. Perfect storm.
Detransitioning is a controversial subject. Some transgender rights advocates argue that media reports often exaggerate the prevalence of detransitioners, and that such overestimates risk fueling transphobia, delegitimizing the transgender experience,
Well it's not helped by sweeping it under the rug. Covering up detransitioning is just as much erasure as gatekeeping is.
and discouraging young people with gender dysphoria from pursuing transitioning, which is beneficial for many people.
See above, all the options have drawbacks, sometimes serious ones. Making the wrong choice can kill people. Surgical complications can be lethal, gender dysphoria is one of several conditions where not treating it has a high risk of suicide, and being trans is a good way to get murdered. So people should think very carefully about their options before making a decision, and it's a good idea to try less-risky approaches first.
But the reality is there’s hardly any empirical data on detransitioners or the size of their population. This lack of research is concerning to some medical professionals who feel that, amid the fast-rising rates of transitions and referrals to gender clinics, some young people might not be receiving sufficient, comprehensive medical evaluations and guidance.
With a lack of research, nobody has hard data. That's a problem. We should know, for instance, what is the percentage of crippling or fatal complications with hormones or each different type of surgery, what is the percentage of people who stop feeling gender dysphoria after each type of treatment, what are the comparable risks of suicide down each path, etc. Without hard numbers, we're all guessing to a degree that is inadvisable in high-risk situations.
What’s more, most respondents did not inform their clinicians after they had detransitioned, suggesting that the total number of detransitioners could be underestimated.
Well, duh. The medical industry has a piss-poor reputation in meeting the needs of sex/gender variant clients. People who are already displeased with its performance are unlikely to seek more care -- or do anything else liable to attract unwanted attention. Especially since the industry sucks at taking no for an answer.
The survey results included:
Encouraging factors: Social media and online communities were reported as the top influencing factors in leading respondents to believe that transitioning would help them.
See above re: the need for statistics. Hard facts are good at counterbalancing opinions.
I would suggest that trans websites and other facilities endeavor to represent as many voices as possible. I think this is unlikely as they tend to encourage transition and can be downright hostile about detransitioning. That's not exactly helping people figure out their identity in the murk.
Pressure to transition: 37% of respondents, most of whom were natal females, reported feeling pressured to transition. In open-ended answers, the respondents wrote statements like:
“My gender therapist acted like it [transition] was a panacea for everything.”
“[My] [d]octor pushed drugs and surgery at every visit.”
“I was dating a trans woman and she framed our relationship in a way that was contingent on my being trans.”
“A couple of later trans friends kept insisting that I needed to stop delaying things.”
So that's two clusters, one difficult to fix, one somewhat easier.
1) Clinicians should never pressure clients. It is not their job to decide anything unless the client says, "I don't know, you're the expect, use your best judgment." Otherwise they should present options with pros and cons and let the client decide. "Evidence-based," "best practices," "in similar cases we recommend," and solid statistics can all help clients make good decisions. But the training aims at clinicians pressuring or forcing clients to do what is convenient or profitable for the clinician (or the insurance company, or the institution) so that's what we get. Fixing this requires repairing a fundamentally broken system.
2) Friends, relatives, etc. should never pressure other people about sex/gender decisions. It can be tempting to do so, but this is consistently harmful. We can discourage this by highlighting how it is harmful, and including recommendations to respect agency in tipsheets for friends and family. Especially transfolk should damn well know better. You didn't like it when people pestered you, did you? Then don't do it to anyone else.
Come on, people, if it's not your crotch it's not your choice. This is not a complicated concept.
Reasons for transitioning: The most common reasons for transitioning included statements like:
“I wanted others to perceive me as the target gender.”
“I thought transitioning was my only option to feel better.”
“My body felt wrong to me the way it was.”
Those are all sound reasons, although ideally, people should have the most information to make the best decision.
Reasons for detransitioning: The most common reason for detransitioning was that the respondent’s “personal definition of male and female changed and they became comfortable identifying with their natal sex (60.0%).” Meanwhile, 23% of respondents reported discrimination as a reason for detransitioning.
Here again we have two clusters.
1) Some people just plain outgrow their sex/gender/orientation. It's not rare. It's not restricted to this context. It can be uncomfortable and costly, but sometimes that's just life. All you can do is make the best choice with the information you have at the time.
2) Being trans, or seen as trans, can definitely get you killed. Some people decide they would prefer to be uncomfortable than dead. This is extremely unfortunate, but it is not irrational nor a mistake. It's just making the best of society's shitty situation.
Most respondents (55%) felt that their pre-transition medical evaluation was inadequate. Additionally, 65.3% said their clinicians did not explore whether their desire to transition might be related to trauma or a mental health condition. That could be cause for concern, considering that 38% of respondents reported that one of the reasons they detransitioned was “discovering that something specific like trauma or a mental health condition caused their gender dysphoria,” as the study noted.
This is a very sticky point because:
1) The medical industry is rushed and fixing this would be difficult if not impossible.
2) The mental industry is even worse than the physical one, woefully inadequate and out of reach for many who need it. Even if other options than transitioning exist, they are prevailingly inaccessible. Fixing this will also be difficult if not impossible.
3) Worst of all, and there is no getting around this, we have different groups of people presenting with the same or similar symptoms, each of whom is likely to be harmed by things the other group needs. Transfolk need ready access to gender alignment care, and are easily harmed by questioning their identity or gatekeeping their access. People with other complaints, such as sex/gender trauma, need help examining their condition to identify what it is and what would help; and are easily harmed by getting railroaded into sex/gender change.
4) And on this note, traumatagender is a thing, which happens when your trauma takes your sex/gender/orientation and shoves it in a blender and leans on frappe. Even with the best help, unscrambling that can be impossible. But it's not impossible to talk about; we had a character like this in my high school gaming group, which was very interesting. Come on "experts" ... if I can do it at 16 without even knowing how roleplay worked yet, surely some of you can figure it out. Trauma breaks things, and among the things it can break are sex, gender, and orientation. If you can manage nothing else, at least mention that much, sometimes it helps.
However, we do have one area within easy reach to work on: we can try to make society and sex/gender conceptualizations more flexible. This will simultaneously make it easier for people to figure out what theirs is, and provide more wiggle room so that fewer people get pushed into transition as the only way to feel comfortable in their own skin.
Research on children with gender dysphoria shows that the condition tends to resolve itself over time for about 85% of people. It is not exactly clear why. But the process, called “desistance,” might be a byproduct of getting older, or it could be due to the fact that many people who present with gender dysphoria, especially young people, ultimately turn out to be gay, lesbian, or bisexual, and many eventually come to peace with that identity.
This number is something everyone should get when approaching sex/gender care.
However, I have to wonder if that comes from quickie questionnaires or lifelong cohort studies. That is, if 85% grow into some other identity, is that subsequent identity stable or do they outgrow that too? And if the latter, do they decide they're trans after all or something else yet again? That's important, because it's easy to imagine some people giving up on transgender identity because it's too risky, expensive, or otherwise troublesome -- but they might not be able to stay away. Homosexuals sometimes have that back-and-forth motion too.
In the recent study, for example, 23% of respondents reported that “internalized homophobia and difficulty accepting oneself as lesbian, gay, or bisexual” was a reason for transitioning.
That's a lot. Clearly it would be desirable for people to know this figure and to consider their sexual orientation before deciding whether to transition. But if you ask someone who's already angsting over their gender identity to examine the also-fraught topic of sexual orientation, this is not likely to go over well unless they are particularly open-minded.
Again, the option most in reach is to work on making society more inclusive of many identities so fewer people will feel confused, offended, or panicky about these topics.
“What would have helped me is being able to access women’s community, specifically lesbian community. I needed access to diverse female role-models and mentors, especially other butch women.”
That sounds like a good thing to have in general, more diverse role models and more community
“This means caring about people who have been helped by transition and people who have been harmed by transition; people who had underlying conditions causing their gender dysphoria and people who did not; people whose gender dysphoria persisted and people whose gender dysphoria resolved,” Littman told Big Think.
And don't forget those of us who just don't find the available options worth the risk, expense, or bother. I'm no less genderqueer because I've chosen to stick with the body I have rather than hack around with modifications that, based on my personality, wouldn't be particularly useful; and based on my body and the crapsack industries, downright dangerous. On a planet with nearly 8 billion people, I'm probably not even the only morphlocked shapeshifter muttering, "Fuck it, I've worn worse."
Although transitioning helps many people, Littman said that some cases of gender dysphoria require clinicians to take a more nuanced and comprehensive approach. “Failing to explore co-morbidities and the context in which the gender dysphoria emerged puts patients at risk of harm from misdiagnosis, delayed diagnosis, and receiving the wrong treatment for their distress.”
Consider in particular that co-morbidity means having more than one problem at the same time. Fixing one might make the other(s) better, the same, or worse. So you need to know what they all are, what the options for treating each might be, and how those options could interact. The health industries are shit at making those predictions, and even with physical complaints, are often left with a trial-and-error scramble to find some combination of therapies that improve the overall quality of life rather than just one-up-one-down. So good luck sorting that out in the murk of sex/gender issues sprawled over body, mind, and spirit with the assistance of several dozen microexperts none of whom are good at more than one narrow aspect.
Yeah, I'll be over here popping the hood on culture and hitting it with a wrench again. At least that I can budge a little sometimes. Maybe it needs more kyoot fanfic of transfolk. A few decades of Kirk/Spock has done wonders for gay rights.