Gender Affirming Care Does Not Save Lives
here are the facts about “gender affirming” children
First of all, what are we talking about? What is Gender Affirming Care? We here about it in the news and in popular culture a lot but it seems like a nebulous term open to wide interpretation. Let’s begin with a definition.
Gender Affirming Care — A Definition
CBC Kids News provides the following definition: Gender-affirming care is health care that supports a patient’s gender identity and expression. Gender-affirming care for trans and non-binary people can include counselling, puberty blockers, hormone therapy and surgeries.
Verbeek et al in the Canadian Journal of Psychiatry provide the following definition: Gender Affirming Care is defined as inclusive of interpersonal, psychosocial, and medical interventions that affirm one's gender.
Rukhsana Sukhan’s definition :: Gender Affirming Care includes social, psychological, medical and surgical interventions in support of the way a person feels about their reproductive class. It includes pronouns and name change and people affirming those, it includes hormone therapy and it also includes body modification surgery. Gender Affirming Care involves a complete submission to the patient’s will and whim and it involves dispensing with the medical assessment model of differential diagnoses. Gender Affirming Care demands clinicians dispense with all they know about trauma care, DBT + suicidal threats, personality disorders, as well as dissociative disorders and follow the patient’s desire to modify themselves to become the opposite sex.
I’m going to take some time out of my Lupron + Puberty writing project to write you a cheat sheet of important facts you can use to have rational and reality-based discussions with the Martin Piper’s of this world. The lie must be crushed — gender affirming care does not reduce suicide deaths, in fact if anything it increases the propensity to commit suicide because of the profound regret related to irreversible body modification and the associated surgical complications. Also, correlation is not causation and many transgender individuals have pre-existing psychiatric conditions, so it would be difficult to discern cause of suicidality.
Note the studies are limited by the study design and statistical processes the researchers applied. Activist journalists frequently misinterpret study results to promote their sensationalistic narrative. When you cut through the fear based rhetoric with fact, when you ask pointed specific questions of your gender affirmationists interlocutor, you force them back to fact. A lie that is repeated often enough becomes truth — knowledge is for cutting up these lies. Equip yourself.
Here are the facts about gender affirming care
1. Finland, Sweden and UK have severely scaled back their Gender Affirming Care programs after systematic reviews reveal low evidence and after sloppy and reckless application of the Dutch Protocol. Dr. Riittakerttu Kaltiala, top pediatric gender specialist in Finland, and the one who pushed for a review of Gender Affirming Care in that country, had this to say about the suicide prophylaxis narrative:
The popular “transition or suicide” narrative used by activists to push back against state reform efforts is, in Kaltiala’s words, “purposeful disinformation, and spreading it is irresponsible.”
Dr. Hillary Cass, UK Pediatrician, wrote the following in her independent review of the Tavistock Clinic:
Evidence on the appropriate management of children and young people with gender incongruence and dysphoria is inconclusive both nationally and internationally.
The Swedish Health Authority provided the following reason for rolling back Gender Affirming Care:
… little is known about the effects of these treatments over the long term and “the risks outweigh the benefits currently.”
2. The Dutch, who pioneered gender affirming care for children, have always taken a more cautious approach, have always offered psychotherapy as an adjunct therapy, have carefully controlled for psychiatric profiles, and have engaged in watchful waiting with young patients. Furthermore, responsible clinicians have begun publicly denouncing the irresponsible use of suicide to force parents to transition their kids. Dr. Annelou de Vries, a member of the clinical team that developed the Dutch Protocol, asks the following question about Gender Affirming Care, aren’t we intervening medically in a developing body where we don’t know the results of those interventions?
3. Canadian gender medicine pioneer Dr. Susan Bradley regrets prescribing puberty blockers.
Blocking the sexual development of children is a highly authoritarian intervention. Children … can’t understand the impact of impaired sexual functioning. We are roughly 10 years into this large-scale experiment and already we have reports on issues with cognitive development, bone mineral density, and fertility. All the up-to-date evidence shows that puberty blockers are neither safe nor reversible.
4. “Puberty Blockers” aka GnRH analogues aren’t approved for treatment of GD or gender confused kids anywhere in the world and never will be, the evidence does not support its use as a treatment for gender dysphoria. As mentioned above, the UK, Finland, and Sweden have each conducted systematic reviews of their program and the evidence supporting GAC as a measure to relieve suicidality and improve mental health outcomes — these three countries have as a result scaled back their pediatric GAC programs, and restricted the prescribing of puberty blockers to pediatric patients. Dr. Riittakerttu Kaltiala of Finland testified in Florida at the hearings to banning gender affirming care for children. Finland was amongst the first countries to adopt the Dutch Protocol. According to the New York Times,
Arguing in favor of restrictions, Dr. Riittakerttu Kaltiala, a professor of adolescent psychiatry at Tampere University in Finland, testified about leading the youth gender program in that country since 2011. The vast majority of her patients were assigned female at birth and began experiencing distress about their gender identity later in adolescence, she said. And many of her patients with co-occurring psychological issues were not helped by the treatments, she said. In 2020, Finland began limiting puberty blocking and hormonal treatments for minors, prescribing them only to adolescents with clear diagnoses of gender dysphoria and expanding the availability of talk therapy.
“This is really my sincere understanding: that the evidence is lousy,” Dr. Kaltiala told the board.
5. GnRHa are certainly contraindicated for kids with severe psychiatric distress and high ACE scores — the plasma surge of sex hormones following administration could produce dangerous reactions in children with pre-existing psychiatric and behavioural disorders. All non-activist (ie valid and reliable) medical literature on Lupron and other GnRHa medications stipulate this contraindication and highlight this adverse reaction. In fact the literature highlights extreme caution in prescribing GnRH analogues to kids because of the developmental risks and the known potency of this hormone blocker. Disturbing a child’s pituitary gland with an exogenous hormone agonist is not a minor treatment and it will have irreversible effects clinicians cannot predict. It violates every principle we know about medical science to promote such an invasive and harmful treatment for psychological distress in children that will desist with growth and development!
6. Gender affirming care is not appropriate suicide care or prophylaxis — destroying sex-based categorization of human society will not alleviate the suicidality of individuals who feel dissociated from their reproductive class and identify as the opposite sex, that’s silly reasoning not serious public health or epidemiological reasoning. Ice cream does not cause rape and gender identity does not cause suicide. Yes rapes may be higher when ice production + sales are higher, it does not infer cause. Similarly, yes the suicide rates for children + youth who identify as transgender are higher than for non-transgender children + youth, this does not infer cause. Correlation is not causation.
Gender Affirmationists will likely quote this recent study by Denmark about Transgender Identity and Suicide rates — this retrospective cohort study simply reports the suicidality of those who identity as the opposite sex, it does not tell us anything about cause + effect, it reports a trend of people who are dissociated from their bodies. The conclusion of the paper itself calls for more gender neutral bathrooms + locker rooms, without any evidence to support these measures as truly suicide prophylactic — this seems to be the main purpose of this study — to keep the fear narrative alive in the public mind as more and more clinicians and parents and detransitioners challenge the reigning narrative that GAC is suicide prophylaxis.
Here is a very solid thread written by Leo Sapir of The Manhattan Institute about GAC and suicidality and systematic reviews and evidence based medicine and what it all means. I urge you to be polite (not snarky) + curious + ask questions, and to reject all hyperbolic narratives and attempts to rage farm you with half truths + sensationalistic headlines. I urge you to learn what you need to in order to understand for yourself what’s going on and what is at stake. It really is your duty as a human to know as much about humanity and society as you can to make inform choices in your life — you do not live in a vacuum, you live in a connected human society. Please start giving a sh1t and please start doing it like a grown up.
The oppositional tactic that we are calling The Gender Wars is creating pockets of intensity and violence and hatred. Also, do you think the kids want to see parents and teachers waging war like they are currently? You are hurting them by this War of the Roses battle. Please pause and look at the facts and let’s all work together to find solutions.