The Experiences of Gender Diverse and Trans Children and Youth Considering and Initiating Medical Interventions in Canadian Gender-Affirming Speciality Clinics

The Experiences of Gender Diverse and Trans Children and Youth Considering and Initiating Medical Interventions in Canadian Gender-Affirming Speciality Clinics

Published in: International Journal of Transgenderism.  August 30, 2019.  Authors: Annie Pullen SansfaçonJulia Temple-NewhookFrank Suerich-GulickStephen FederMargaret L. LawsonJennifer Ducharme

A new study confirming what we've seen in so many others: youth undergoing social and medical transition experience improved self esteem and mental health, and do NOT regret transition. 

Find more about affirmative care for trans and gender nonbinary youth at our site:

www.gdaworkinggroup.com

And follow us on Facebook for regular updates:

@gdaffirmative

“Young people felt positively overall about the care they had received and the medical interventions they had undergone, with many recounting an improvement in their well-being since starting care. Most commonly shared frustrations concerned delays in accessing interventions due to clinic waiting lists or treatment protocols. Some youth described unwanted medication side-effects and others said they had questioned their transition trajectory at certain moments in the past, but none regretted their choice to undergo the interventions…”

“The results suggest that trans youth and gender diverse children are benefiting from medical gender-affirming care they receive at specialty clinics, providing valuable insight into their decision-making processes in seeking care and specific interventions. Providers might consider adjusting aspects of treatment protocols (such as age restrictions, puberty stage, or mental health assessments) or applying them on a more flexible, case-by-case basis to reduce barriers to access...”

“The sometimes difficult and protracted personal and family processes youth underwent before or while accessing gender-affirming care provide insight into the sense of determination and at times extreme urgency many youth expressed in their quest for medical interventions…” 

“Overall, medical interventions, whether in the form of hormone blockers, hormone therapy or surgery appear to be very positive in the lives of trans youth who participated in our study, even for those who reported side effects. They experienced improved general happiness or well-being and reported feeling that their body was better aligned with their gender identity…”

https://www.tandfonline.com/doi/full/10.1080/15532739.2019.1652129?fbclid=IwAR1hwwpo5qpMuVruHNJ9Uj2DX9x_E8GLlxxpFUs0WF8kPVO_NPO3TBI50t0&

 

Homophobia, Conversion Therapy, and Care Models for Trans Youth: Defending the Gender Affirmative Approach

Homophobia, conversion therapy, and care models for trans youth: defending the gender-affirmative approach

Author: Florence Ashley. Published September, 2019. 

A good article discussing affirming care for trans youth, why it is so essential, and how disaffirming and conversion/reparative approaches have far worse outcomes for these vulnerable individuals. 

Find more on affirming care at our website:

www.gdaworkinggroup.com

And follow us on Facebook for regular updates:

@gdaffirmative

“In recent years, opponents of the gender-affirmative approach to trans youth have argued that it bears homophobic roots and may be tantamount to conversion therapy. This argument is mistaken. In this article, I first argue that there is no evidence that social and/or medical transition is motivated by homophobia. Contrary to the critique’s tacit premise, many if not most trans people are LGBQ following transition. Furthermore, despite social progress in the last decade, transphobia remains more common than homophobia. Second, the gender-affirmative approach is fundamentally dissimilar to conversion therapy, unlike clinical approaches that oppose affirmation and seek to prevent transition. The comparison to conversion therapy relies on a superficial understanding of sexual orientation, such that a change of label (e.g. straight, bisexual, gay, lesbian) is equivalent to a change of sexual orientation even without changes to the targets of sexual attraction. By contextualizing conversion therapy in relation to trans youth care, I show that, on the contrary, conversion therapy has long focused on preventing transgender youth from growing up trans.”

https://www.tandfonline.com/doi/full/10.1080/19361653.2019.1665610

 

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study

Published in: American Journal of Psychiatry. October 4, 2019. Authors: Richard Bränström, Ph.D., John E Pachankis, Ph.D.

Yet another study documenting what we already know: transgender people who receive affirming care show dramatic improvement, especially when compared to those in disaffirming environments.

Find more research about affirmative care for trans and non-binary individuals at our website:

www.gdaworkinggroup.com

And follow us on Facebook for updates:

@gdaffirmative

“Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98).”

https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2019.19010080

The AusPATH [Australian Professional Association for Trans Health] Position Statement on "Rapid Onset Gender Dysphoria" (ROGD)

Published September 30, 2019. Shared here in its’ entirety.

“The Australian Professional Association for Trans Health (AusPATH) was established in 2009 and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.

“The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). Therefore, “ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings1.

“AusPATH affirms the rigorous processes by which diagnoses are developed and applied. These academic and clinical processes operate within professional medical organisations, and are developed by expert working groups of  scientists, clinicians, and stakeholders over long periods of time, with high levels of scientific scrutiny of the evidence-based literature. “ROGD” does not meet this standard, and therefore is not recognised by AusPATH.

“Whilst many have a clear picture of their gender from a very early age, for others the journey towards understanding their gender is more prolonged. The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves.

“AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship. All TGDNB people are deserving of gender-affirmative, evidence-based care that is underpinned by contemporary, adequately endorsed and community engaged standards of care and clinical guidelines.

“AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender. AusPATH supports affirmative responses to young people whereby self-reported gender is respected, and young people are able to safely explore their gender and expression without judgment, pathologisation or predetermined outcome. AusPATH urges caution in the use of any term that has the potential to invalidate a person’s gender.

  1. WPATH (World Professional Association for Transgender Health) position on “Rapid-Onset Gender Dysphoria (ROGD)”4 September 2018

https://auspath.org/advocacy/?fbclid=IwAR3GN9E6NmvTyZNx-LcCIgW1mg5zpkE8UgpUaFYweTFBawgMS023DFTgtfI

A Viral Fake News Story Linked Trans Health Care to 'Thousands' of Deaths

A Viral Fake News Story Linked Trans Health Care to ‘Thousands’ of Deaths

Hormone blockers used by some transgender people have multiple uses, including treating prostate cancer in terminally ill patients.

To be clear: Lupron has been widely used in thousands of trans youth, and members of the Gender Dysphoria Affirmative Working Group are NOT AWARE OF ANY DEATHS attributable to Lupron use in trans and gender noxnbinary youth.

As people may have already seen, an ultra conservative Catholic website (Lifesite News) spread misleading news that some 6,300 deaths over 40 years were attributed to leuprolide acetate (Lupron), a medication also used as a puberty blocker in trans youth. Articles and other information released about this issue minimized or did not mention that Lupron is commonly used in palliative care for long-term and terminally ill cancer patients, and instead implied that this medication has been widely killing transgender youth. Multiple conservative outlets further distributed this story (including Breitbart and Daily Wire). We have become aware that parent groups have reported this article (and similar ones reflecting the same misinformation) being sent by "well meaning" relatives to parents of trans youth. We also are concerned that this issue will be used as a ‘talking point’ in other venues like school board meetings and such by those opposed to policies supporting trans youth.

Thus far only one article in mainstream journalism outlet has debunked this misleading press. The "good" article is linked below.

Sadly, we all may be obligated to push back against the further discrimination, hatred, and transphobia only encouraged by these stories. We encourage you to remember that affirmative care - including puberty blockers such as Lupron - have been demonstrated to have vastly improved outcomes for trans youth including dramatic decreases in depression, anxiety, substance use, school dropout, obesity, smoking rates, suicidal ideation and gestures.

“A recent article published by Catholic news outlet LifeSiteNews alleged that the drugs used to treat gender dysphoria in some transgender children are linked to “thousands” of deaths.

“The story went viral on right-wing news websites such as the Christian Postand the Daily Wire. According to CrowdTangle, a social media metric platform, these posts — including shares by Daily Wire founder Ben Shapiroand commentator Matt Walsh— are currently some of the top performing LGBTQ-related content on Facebook and Twitter.

“The problem is: the “thousands” of people who die while taking these drugs are likely the terminally ill cancer patients who receive hormone blockers to fight hormone-sensitive cancers, like prostate cancer, according to experts.”

https://www.nbcnews.com/feature/nbc-out/viral-fake-news-story-linked-trans-healthcare-thousands-deaths-n1059831

Trevor Project National Survey on LGBTQ Youth

The Trevor Project National Survey on LGBTQ Youth. Much of the data here touches on the relationship between rejection and depression, anxiety, and suicide; conversion therapy and attempts by outsiders to change their gender identity and/or sexual orientation; and the impact of the current political climate on mental health. This all makes a strong case for the importance of affirmative care and supportive environments. Find the extended report at the link below.

“This is our first wide-ranging report from a cross-sectional national survey of LGBTQ youth across the United States. With over 34,000 respondents, it is the largest survey of LGBTQ youth mental health ever conducted and provides a critical understanding of the experiences impacting their lives.

“This ground-breaking survey provides new insights into the challenges that LGBTQ youth across the country face every day, including suicide, feeling sad or hopeless, discrimination, physical threats and exposure to conversion therapy.

“The data provides a sobering look at how far we still have to go to protect LGBTQ young lives. But the survey also reveals the resilience and diversity of LGBTQ youth and provides guidance on what can be done to enable them to survive and thrive. Among some of the key findings of the report from LGBTQ youth in the survey:

“39% of LGBTQ youthseriously considered attempting suicide in the past twelve months, with more than half of transgender and non-binary youth having seriously considered

“71% of LGBTQ youthreported feeling sad or hopeless for at least two weeks in the past year

“Less than half of LGBTQ respondentswere out to an adult at school, with youth much less likely to disclose their gender identity than sexual orientation

“2 in 3 LGBTQ youthreported that someone tried to convince them to change their sexual orientation or gender identity, with youth who have undergone conversion therapy more than twice as likely to attempt suicide as those who did not

“71% of LGBTQ youthin our study reported discrimination due to either their sexual orientation or gender identity

“58% of transgender and non-binary youthreported being discouraged from using a bathroom that corresponds to their gender identity

“76% of LGBTQ youthfelt that the recent political climate impacted their mental health or sense of self

“87% of LGBTQ youthsaid it was important to them to reach out to a crisis intervention organization that focuses on LGBTQ youth and 98%said a safe space social networking site for LGBTQ youth would be valuable to them.”

https://www.thetrevorproject.org/wp-content/uploads/2019/06/The-Trevor-Project-National-Survey-Results-2019.pdf

Guidelines to Support Transgender and Gender Expansive Students

The New York City Department of Education guidelines to support Transgender and Gender Expansive Students, which might be a resource for people in other localities.

“These guidelines set forth protocol and describe best practices for supporting transgender and gender expansive students. These guidelines apply to New York City Department of Education (DOE) school-based and central staff. “

“Schools must be proactive in creating a culture and practices that respect and value all students and foster understanding of gender identity and expression within the school community. Creating such an inclusive culture will greatly affect what research shows: that transgender and gender expansive students are at higher risk for being marginalized, victimized, or bullied. An inclusive environment will mitigate the bias, misunderstanding, and/or a lack of knowledge about transgender and gender expansive student’s experiences.”

“Every student is unique and these guidelines do not anticipate every situation that may occur. Schools must assess the needs of each student on an individual basis to ensure that they support all students.”

https://www.schools.nyc.gov/school-life/policies-for-all/guidelines-on-gender/guidelines-to-support-transgender-and-gender-expansive-students

OUT Health and Wellness Transgender 'conversion therapy' associated with 'severe psychological distress'

Transgender 'conversion therapy' associated with 'severe psychological distress'

A study in JAMA Psychiatry is one of the first to highlight the psychological impact of efforts to change a trans person’s gender identity.

A new large-scale study linking conversion therapy - an approach founded on disaffirming a person’s self-identified gender or sexual orientation - is directly link to a sharp increase in suicidal ideation and attempts.

Find more about the benefits of affirmative care, and the risks of disaffirming approaches, at our website:

www.gdaworkinggroup.com

And follow us on Facebook for regular updates:

@gdaffirmative

“Exposure to "conversion therapy" — efforts by a secular or religious professional to change a transgender person’s gender identity — is associated with thoughts of and attempts at suicide, according to a study published Wednesday in the journal JAMA Psychiatry…”

“…But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“…Turban said that previous reports showing the negative effects of conversion therapy, also known as “ex-gay therapy” or “reparative therapy,” have focused on efforts to change a person’s sexual orientation…”

“But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“"The term 'conversion therapy' is a misnomer,” Keuroghlian noted. “It suggests that conversion efforts are a legitimate therapeutic practice, even though we are finding that this practice is associated with significantly increased risk of harm, including serious psychological distress and potentially fatal suicide attempts.””

https://www.nbcnews.com/feature/nbc-out/transgender-conversion-therapy-associated-severe-psychological-distress-n1052416

Presentation by the WPATH Standards of Care 8 Child Chapter Working Group

On September 7, 2019, members of the Standards of Care Version 8 - Child Chapter Working Group delivered a presentation at the US Professional Association of Transgender Health conference in Washington DC. This presentation outlined a significant move toward far more affirming philosophies of care, which will appear in the upcoming SOC V8.

Find more information on Affirmative Care for transgender and gender noxnbinary youth and adolescents at our website: www.gdaworkinggroup.com

And follow us on Facebook for regular updates: @gdaffirmative

As reported by community rapporteur Lotus Đào, and Dr. Asa Radix, Co-Chair of the SOC8 Review Committee, member of the Board of Directors of the World Professional Association of Transgender Health and the US Professional Association of Transgender Health:

On September 7th, 2019, members of the WPATH Standards of Care 8.0 Child Chapter Working Group presented on "Prepubescent Gender Diversity: Complexities and Recommendations." Presenters opened by sharing the working group's process and naming the complexity of working within a global context in an specialty with few expertise. Following a brief research summary, presenters established a foundation of child gender diversity as an expected aspect of general human diversity, rather than a pathology.

Furthermore, gender identity should not be conflated with gender expression. In fact, research indicates that many young children exhibiting extensive gender expansive behavior while feeling cohesive with their gender identity are likely to evolve to be gay or queer by adolescence, not transgender. In addition, gender identity is sometimes static, and sometimes fluid. Some children know from a very young age who they are and their gender identity is static throughout their lifetime. For other children, their gender identity may change over time. Presenters encouraged providers and community members to practice respect and sensitivity in honoring children where they are at and releasing the cultured need to predict a child's gender identity and presentation. In regards to the mental health provider's role in working with gender expansive children, presenters emphasized that gender expansive children should not be required to be in therapy. However, guidance from mental health providers are often helpful, especially if there are external stressors (family, school, region) or the child is interested in medical treatment.

The presenters provided recommendations for providers around advocacy, including educating and supporting gender diversity is expected and not pathological; acknowledging and addressing privilege and frequent intentional and/or unintentional negating of gender diverse experience; working in partnership with schools and childcare programs to sensitive educational providers to importance of gender affirmative practices to promote curricula; and more.

Presenters shared a much anticipated report of the SOC 8 Core Competency Recommendations, which are not finalized, including compenents on Training/Credentials, Gender Development, Child/Family Mental Health, Assessment, Therapuetic Interventions, Autism and Gender, Research Knowledge and Continuing Education. Ultimately, presenters urged attendees to promote gender literacy with gender expansive children, including identifying oppressive and violent environmental messaging around gender and critically examine whether or not it is authentic. Furthermore, presenters recommended providers to not fixate on pathology or force "transgender" onto gender expansive children, but to incorporate "play" and "fun" as important aspects of working with children.

Statement from Brown University School of Public Health Faculty Members Committed to LGBTQI Affirmative Health Research

We at the Gender Dysphoria Affirmative Working Group wish to thank these distinguished faculty from Brown University School of Public Health for openly and directly speaking out to the Rapid Onset Gender Dysphoria ‘controversy’. We respect and appreciate their commitments to scientific honesty and rigor, to creating an environment of compassion and openness, to the necessity to include members of the trans and gender nonbinary community in all work done about the trans and nonbinary community, and to the health and wellbeing of trans and gender nonbinary people worldwide.

https://www.optionsri.org/post/a-letter-on-rapid-onset-gender-dysphoria?fbclid=IwAR3CDdGEy2s067VEjS9_Sa75gWyKWf4lnEs6Su-EHNsjXYJfXRJ3PmKOJHo

A few notable quotes:

“… [W]e write this letter as individual scientists and educators—who benefit from academic freedom—to publicly acknowledge the health-related harms and consequences of a lobby that seeks to undermine the legitimacy of transgender experiences. We also write this letter to state and underscore our commitment to uplift transgender and gender diverse communities through our research, scholarship, teaching, and service.”

“…The ROGD lobby has worked to undermine the experiences and identities of transgender and gender diverse individuals, with the potential for dire health consequences.”

“The ROGD lobby is also threatening transgender individuals’ rights via healthcare practice and public policy.”

“It is well-documented that being affirmed in one’s gender identity yields mental health benefits. Thus, we are committed to creating a safe and gender-affirming educational space for our students, staff, and fellow faculty of all genders, gender expressions, and sexual orientations.” 

“We also recognize that research is best conducted withnot onmembers of the population of interest. Thus, we are committed to carrying out our research in accordance with best practices for community-engaged research.”

“We also recognize the importance of having research agendas developed and implemented bytransgender and gender diverse communities. Thus, we are committed to building a pipeline of transgender students, fostering an environment where transgender and gender diverse students can thrive, and mentoring and training future generations of transgender and gender diverse researchers.

“Finally, an essential responsibility of learned communities is to contribute to social good by amplifying the voices of vulnerable populations. Thus, we affirm our unwavering commitment to transgender and gender diverse communities and the highest standards of ethical, rigorous, and affirming research and practice.”

We encourage the Brown University School of Public Health and Brown University as a whole to issue similar statements in the near future. 

Scientific American: Stop Using Phony Science to Justify Transphobia

An important overview and piece advocating for inclusivity from the prominent scientific journal Scientific American.

Published: June 13, 2019. Author Simón(e) D Sun.

“While this is a small overview, the science is clear and conclusive: sex is not binary, transgender people are real. It is time that we acknowledge this. Defining a person’s sex identity using decontextualized “facts” is unscientific and dehumanizing. The trans experience provides essential insights into the science of sex and scientifically demonstrates that uncommon and atypical phenomena are vital for a successful living system. Even the scientific endeavor itself is quantifiably better when it is more inclusive and diverse. So, no matter what a pundit, politician or internet troll may say, trans people are an indispensable part of our living reality.”

https://blogs.scientificamerican.com/voices/stop-using-phony-science-to-justify-transphobia/?fbclid=IwAR1ldAXMA8U8YMKN6HJw6eHNqKmpRMXfH8G2cbtkzx6JP4w2iwrV09dDNRs

Counterpoint: Pediatric gender care is safe and necessary

While not research, this is a well written piece, concisely outlining the issues and why evidence-based, affirmative care for trans and gender nonbinary youth is safe and effective, and the current standard of care.

Published in: Star Tribune. June 25, 2019. Authors: KATHLEEN MILLER , MARLA EISENBERG , AMY GOWER AND G. NIC RIDER.

"Transgender and nonbinary youths experience persistent and significant distress when forced to conform to the gender they were assigned at birth. They face substantial health disparities, with higher rates of depression, suicide attempts, substance use, bullying and unprotected sexual encounters than their cisgender (i.e., not transgender) peers. However, research shows that these health outcomes are related to stigma, rather than the simple fact of being transgender or nonbinary. This is a subtle, but critical, distinction: Negative health outcomes are not intrinsic to being trans and nonbinary. Rather, daily experiences of discrimination and harassment lead to poor health outcomes..."

"The medical and research community supports gender affirming medical care as a powerful tool to improve the lives of children and adolescents who are transgender or nonbinary. There is ample and growing evidence that children and adolescents have better health outcomes when they are supported in their gender, which includes access to medical interventions when appropriate. As clinicians and pediatric researchers, we firmly support expanding access to gender affirming care for youth."

http://m.startribune.com/counterpoint-pediatric-gender-care-is-safe-and-necessary/511804792/?fbclid=IwAR0KqZCmu9H8RiUQyTQVVjBDKzlqb5_UjPutRB1CflsVs3AmNhisXrMKG2g

Getting Your Health Care Covered: a Guide for Transgender People

Not research, but a resource that could be quite useful in helping people access care… and we know that the ability to access care has a dramatic and positive effect on outcomes.

"Getting your insurance to cover the health care you need can be difficult. The good news is that it should be getting easier. Many insurance plans have gotten rid of exclusions that single out transgender people, and trans people are protected from public and private insurance discrimination under federal law and state laws, including in Medicaid and Medicare."

"But some insurance plans still make it hard to get coverage for transition-related health care, especially surgical care. "

"The most important thing to remember is that your insurance should cover transition-related care. However, you may need to show your insurance company why the treatment you need is medically necessary for you, with letters from your health care providers."

"If you are denied coverage or if your plan has an exclusion, you may also need to explain to your insurance company or employer why it is illegal discrimination to exclude medically necessary transition-related care."

"Use this guide to help you navigate the coverage process."

https://transequality.org/health-coverage-guide?fbclid=IwAR0AzX8f9kkSsK3ClNYdWBiL204Q5Ladsn-mZgkvgyF-8GLkhsUbJpsObSs

Trans teens face higher sexual assault risk when schools restrict bathrooms

Unfortunately the full study itself is behind a paywall, but summaries are available from many news sources online.

Original Study Publisher: Pediatrics. May 2019. Authors: Gabriel R. Murchison, Madina Agénor, Sari L. Reisner, Ryan J. Watson.

“Transgender adolescents may be less likely to be sexually assaulted when they can use school bathrooms and locker rooms that match their gender identity rather than their sex assigned at birth, a U.S. survey suggests.” 

“The survey of 3,673 trans and nonbinary teens in American middle schools and high schools found that more than one in four reported being sexually assaulted in the previous 12 months.'“

“When schools required students to use bathrooms and locker rooms based on their sex assigned at birth, transgender boys - who identify as male but are labeled female on their birth certificates - were 26 percent more likely to experience sexual assault.”

“And transgender girls - who identify as female but were assigned male at birth - had more than twice the assault risk when they had to use restrooms and locker rooms for boys.”

“… the results add to the evidence suggesting that failure to support trans and nonbinary youth can endanger both their physical and mental health, Rosenthal and Ehrensaft write.”

“' ‘Transgender youth who express their gender identity but are required to use facilities matching their genitalia are not only at risk for verbal and physical harassment, including sexual abuse, but, not surprisingly, some will avoid using restrooms altogether, resulting in increased risk for inadequate fluid intake, urinary retention, urinary tract infections, impacted bowels, and school avoidance,’ they write.”

Summary from Reuters: https://www.reuters.com/article/us-health-youth-transgender/trans-teens-face-higher-sexual-assault-risk-when-schools-restrict-bathrooms-idUSKCN1SC1LR

Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”

Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”

Another critique outlining the central flaws in the only study allegedly documenting “Rapid-Onset Gender Dysphoria”.

Published in: Archives of Sexual Behavior. April 22, 2019. Author: Arjee Javellana Restar

“Conclusion: A common error in reports of descriptive studies is overstepping the study design and data (Grimes & Schulz, 2002) and Littman’s (2018) paper, for reasons described in this critique, is an example of this fundamental error. Littman’s methodological flaws in the conceptualization and design of the study illustrate the importance of and need for more rigorous survey design and data analysis in descriptive studies. In the context of research with transgender people, who have historically been subjected to pathologizing research, flawed methodologies that lead to tenuous conclusions can have serious implications. While most science has limitations, researchers studying in the field of transgender health should strive to design their studies with appropriate, non-stigmatizing, and non-pathologizing research aims and methods that are grounded in the lived perspectives and experiences of transgender populations.”

https://link.springer.com/article/10.1007/s10508-019-1453-2

Thinking an ethics of gender exploration: Against delaying transition for transgender and gender creative youth

Thinking an ethics of gender exploration: Against delaying transition for transgender and gender creative youth

Published in: Clinical Child Psychology and Psychiatry. April 10, 2019. Author: Florence Ashley.

Youth explore their genders – both theirs and those of others. Exploration is not only a vessel of discovery and understanding but also of creation. Centring the notion of gender exploration, this article inquires into the ethical issues surrounding care for transgender youth. Arguing that exploration is best seen not as a precondition to transition-related care but as a process that can operate through transitioning, the article concludes that the gender-affirmative approach to trans youth care best fosters youth’s capacity for healthy exploration. Unbounded social transition and ready access to puberty blockers ought to be treated as the default option, and support should be offered to parents who may have difficulty accepting their youth.

https://journals.sagepub.com/doi/full/10.1177/1359104519836462?fbclid=IwAR1losmnMXz9LFNbc-O8JHNaEYThVZe3sEThhqq0hKy8TPeE2idGv0FyCag

What Gender Affirmative Therapy is and is not

While not a research study, this piece is a thoughtful and straightforward overview of affirmative therapy for trans youth.

Author: Meg-John Barker. Published March 18, 2019.

Two years on from 2017 when it began, we’re still in the midst of a moral panic about trans. Daily news stories across all sections of the media continue to spread myths and misinformation about trans people. It’s hard to even imagine the extent of the damage caused to trans people living our lives in this culture of hatred and denial of our basic existence and human rights, particularly young people who are growing up in this climate.

One topic which comes round frequently in this moral panic is the help and support given to people – particularly young people – who are gender diverse, or exploring their gender. Claims are often made that people are pressured to go down particular roots, for example that anybody who questions their gender is pressured to come out at trans, or that everyone is quickly pushed down a particular pathway of medical treatment and surgeries.

I was recently asked to put together a factsheet about what Gender Affirmative Therapy – or Gender Affirmative Practice in general – actually looks like: to put the record straight about what therapists, activists, and other practitioners in this area are actually doing – and inviting others to do. Here it is. You can download the pdf, or read the whole thing below that.

https://www.rewriting-the-rules.com/gender/what-gender-affirmative-therapy-is-and-is-not/?fbclid=IwAR3RTx4RpveJuNIchj4Kzk-Noer-UP3zlkcW1uVHfTwyqUL96HR0yfn1awg

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The Gender Dysphoria Affirmative Working Group would like to thank Saturday Night Live and actor Don Cheadle for their clear and visible statement in support of trans and gender nonbinary youth... some of the most vulnerable in our world today.

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The award-winning actor offers support for transgender kids and takes a slap at Donald Trump.

SNL.jpeg

By Carla Baranauckas

“Award-winning actor Don Cheadle had more than laughs on his mind when he hosted “Saturday Night Live” this weekend. And he made that clear with some of his wardrobe choices.”

“When he introduced Gary Clark Jr., the show’s musical guest, Cheadle wore a T-shirt that said, “Protect Trans Kids.” “ 

https://www.huffpost.com/entry/don-cheadle-fashion-statements-snl_n_5c6933e3e4b05c889d20071b?utm_medium=facebook&ncid=fcbklnkushpmg00000063&utm_campaign=hp_fb_pages&utm_source=main_fb&fbclid=IwAR0thfObhPBjBt4cjMummkjmqCDNtncDshtxTDbz7W9q02aCyTwN0goVui8

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

The 2018 Australian SOC for Trans and Gender Diverse Children and Adults... a very strongly affirming document based on the latest research making clear that affirmative treatment approaches - in which the youth's identity is respected and supported, where the youth are provided the freedom and safety to explore their gender without judgment - yield much happier and better adjusted youth and young adults. It also makes clear that disaffirming approaches are unethical and may cause harm.

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

Authors: M.M. Telfer, M.A. Tollit, C.C. Pace, & K.C. Pang.   2018.  

“Being trans or gender diverse is now largely viewed as part of the natural spectrum of human diversity. It is, however, frequently accompanied by significant gender dysphoria (GD), which is characterised by the distress that arises from incongruence between a person’s gender identity and their sex assigned at birth. It is well recognised that trans and gender diverse individuals are at increased risk of harm because of discrimination, social exclusion, bullying, physical assault and even homicide. Serious psychiatric morbidity is seen in children and adolescents. A study of the mental health of trans young people living in Australia found very high rates of ever being diagnosed with depression (74.6%), anxiety (72.2%), post-traumatic stress disorder (25.1%), a personality disorder (20.1%), psychosis (16.2%) or an eating disorder (22.7%). Furthermore 79.7% reported ever self-harming and 48.1% ever attempting suicide.”

 

“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.”

 

“Understanding and using a person’s preferred name and pronouns is vital to the provision of affirming and respectful care of trans children and adolescents.  Providing an environment that demonstrates inclusiveness and respect for diversity is essential... Some children or adolescents may request use of a preferred name or pronoun only in certain circumstances, such as when their parents are, or are not, present in the room. This is important to respect and enact to enable optimal patient-clinician engagement, and ensure confidentiality and patient safety.”

 

“Avoiding harm is an important ethical consideration for health professionals when considering different options for medical and surgical intervention. Withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including increasing depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications.” 

 

“In the past, psychological practices attempting to change a person’s gender identity to be more aligned with their sex assigned at birth were used.  Such practices, typically known as conversion or reparative therapies, lack efficacy, are considered unethical and may cause lasting damage to a child or adolescent’s social and emotional health and wellbeing.”

 

https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf

 

Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada

We know from other studies that approximately 40% of trans and gender nonbinary identified people attempt suicide at some point in the lifespan, a number shockingly high. While the study below is not specifically about youth, the same factors apply.

Published in: BMC Public Health. 2015. Authors: Greta R. Bauer, Ayden I. Scheim, Jake Pyne, Robb Travers, Rebecca Hammond.

“Large effect sizes were observed… suggesting that interventions to increase social inclusion and access to medical transition, and to reduce transphobia, have the potential to contribute to substantial reductions in the extremely high prevalences of suicide ideation and attempts within trans populations. Such interventions at the population level may require policy change.”

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1867-2