Academic Freedom and Cancel Culture

[smallcleanrat]

Someone needs to calmly educate me on something. I have a biology advanced degree. Never was that good at genetics but I do recall that XX was female and XY was male. I realize there are rare aberration of this, but biology would suggest that XX supports a female designation of gender and XY supports a male designation. Now, what you decide is your gender identity is apparently much more fluid. Someone? Anyone? Honest confusion here.

That's what we learn in high school biology, yes. But just as with high school physics, the truth is actually much more nuanced. Someone with XX chromosomes can have gonads, and someone with XY can have ovaries. That's because biological sex isn't just chromosomally-determined. We know that various gene activations are also important in sex-differentiation, notably SRY, DMRT1, and FOXL2. Then there are all the secondary sex characteristics (like your genitalia) which develop from the interaction of your genes with your hormones, your environment, etc. We also have to remember that chromosomal sex attributes are actually averages and correlations of those attributes; as with any distribution, there are outliers--but if you look at the distribution of attributes like height, muscle mass, bone density, etc., you'll actually find that the two distributions mostly overlap (this is particularly important when talking about segregated sports, which are intrinsically stupid anyway but hey).

+1

How do you typically get from an XX zygote to an adult woman, or from an XY zygote to an adult man? A lot of developmental pathways involving genes, hormones, and the environment.

There are also people who are neither XX nor XY.

And people who develop both male and female genitalia exist too (if you want to talk biology apart from the brain).

[Parasaurolophus]

Another common critique: how studies define desistance (i.e. no longer expressing a desire to live as the opposite gender). Apparently, one of these frequently cited studies classified participants who did not respond to follow-up questionnaires/interviews as 'desisting' for some reason?

Oh.Em. Gee. 0_o

[ergative]

Someone needs to calmly educate me on something. I have a biology advanced degree. Never was that good at genetics but I do recall that XX was female and XY was male. I realize there are rare aberration of this, but biology would suggest that XX supports a female designation of gender and XY supports a male designation. Now, what you decide is your gender identity is apparently much more fluid. Someone? Anyone? Honest confusion here.

That's what we learn in high school biology, yes. But just as with high school physics, the truth is actually much more nuanced. Someone with XX chromosomes can have gonads, and someone with XY can have ovaries. That's because biological sex isn't just chromosomally-determined. We know that various gene activations are also important in sex-differentiation, notably SRY, DMRT1, and FOXL2. Then there are all the secondary sex characteristics (like your genitalia) which develop from the interaction of your genes with your hormones, your environment, etc. We also have to remember that chromosomal sex attributes are actually averages and correlations of those attributes; as with any distribution, there are outliers--but if you look at the distribution of attributes like height, muscle mass, bone density, etc., you'll actually find that the two distributions mostly overlap (this is particularly important when talking about segregated sports, which are intrinsically stupid anyway but hey).

+1

How do you typically get from an XX zygote to an adult woman, or from an XY zygote to an adult man? A lot of developmental pathways involving genes, hormones, and the environment.

There are also people who are neither XX nor XY.

And people who develop both male and female genitalia exist too (if you want to talk biology apart from the brain).

The proportion of people who are intersex is 1.7%, roughly the same as the proportion of people who are redheads.* On the one hand, I like comparing hair color to other types of bigotry, because the classic way we explain why bigotry is bad to children is to say 'wouldn't it be stupid if we discriminated on the basis of hair color?'  But on the other hand, apparently some people dislike redheads? Especially in the UK there's some completely bonkers anti-redhead bias. So I guess any random physical characteristic is fair game for discrimination, because people suck.

Anyway: in the same way it's stupid to force people with red hair to dye their hair to conform to some societal standard of 'not-red', it's stupid to force people who don't match gender binary to conform to gender binary.

*Some quick googling has revealed that this claim is disputed, but it seens to be disputed for reasons like 'Klinefelter syndrome (XXY chromosmes) don't count'. For the purposes of our discussion, which is about the limits of XX=female/XY=male, I'd argue that Klinefelter syndrome--or indeed any situation that departs from straightforward 1:1 mappings between chromosomes and gender assigned at birth--is fully relevant.

[marshwiggle]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

Like in many issues, there will be groups, such as some religious groups, who will argue that transitioning is always wrong. On the other hand, there will be activists who argue that anyone who shows any interest in transitioning should be supported in that and not discouraged in any way.

Both of these groups have a particular bias and neither can be counted on to clearly investigate and report claims that do not support their narrative.

This is like in discussions of sex work. There are people lobbying for it to be legalized, and accepted like any other profession. On the other hand, there are people who lobby for it to be heavily sanctioned due to the high number of sex workers who are victims of trafficking or are exploited due to substance abuse.  The true picture of what sex work is like will include some amounts of what both groups describe. The reason that academics need to be impartial in matters like this is that public policy needs objective, reliable data on the situation which clarifies how many people fit each group, and especially if there need to be distinctions made between the two groups.

There are people who transitioned  in the past and some time later are happy with their decision.
There are people who transitioned  in the past and some time later regret their decision.

If society truly cares about people, then it is essential to get as clear an understanding as possible about both groups, in order to advise people so that people most likely to benefit may do so and people most likely to regret it will be helped to find more appropriate treatment for situation.

[smallcleanrat]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

.....

If society truly cares about people, then it is essential to get as clear an understanding as possible about both groups, in order to advise people so that people most likely to benefit may do so and people most likely to regret it will be helped to find more appropriate treatment for situation.

Yes, I certainly agree with this. And this seems to be the impetus driving much of this research: how best to identify who will be helped by which types of intervention. But is this aim being served by saying "85% of people who initially wanted to transition but didn't turned out to have been better off" as if the research is clear-cut and settled? How is that being scientifically or morally responsible?

Your initial comment wasn't "It's important to understand how to identify who is actually going to be helped by transitioning before proceeding with the transitioning process."

ETA: On re-reading your posts, I can see this was your implication even if you didn't say it directly. But by pulling out the 85% statistic, it still seems that you're implying that in most cases of boys wanting to transition it would have been the wrong decision. Not all, but most.

The message I got from reading your post was "Most people who say they want to transition would have been harmed if they had actually gone through with it" or at least "Most people who say they want to transition ended up identifying with their birth gender later in life" implying in most cases it is better not to transition (or at least to delay). And you refer to "research" without citation or context.

And when discussing the cases in which people either ceased their transitioning process or expressed regret, it's extremely important to attempt to understand the whys. People like to cite these cases to say, "See how awful it is to indulge these people, you're actually hurting them in the long run" while failing to mention that sometimes people don't continue due to difficulty accessing adequate medical care and sometimes people regret transitioning due to social backlash.

People also like to note that trans people have higher rates of depression and suicide than the general population as evidence that being trans itself is harmful to the individual. As if social rejection and bigotry couldn't possibly have anything to do with it.

[smallcleanrat]

Like in many issues, there will be groups, such as some religious groups, who will argue that transitioning is always wrong. On the other hand, there will be activists who argue that anyone who shows any interest in transitioning should be supported in that and not discouraged in any way.

Both of these groups have a particular bias and neither can be counted on to clearly investigate and report claims that do not support their narrative.

While I haven't exhaustively verified the validity of the critique points I mentioned, they are verifiable by reading the methods of the published studies. From what I have read, the critiques are worth keeping in mind when reading secondary reporting of this literature.

As with research results, dismissing a critique because you think the source is biased is not as productive towards the aim of increasing knowledge as evaluating the critique on its own terms.

[marshwiggle]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

.....

If society truly cares about people, then it is essential to get as clear an understanding as possible about both groups, in order to advise people so that people most likely to benefit may do so and people most likely to regret it will be helped to find more appropriate treatment for situation.

Yes, I certainly agree with this. And this seems to be the impetus driving much of this research: how best to identify who will be helped by which types of intervention. But is this aim being served by saying "85% of people who initially wanted to transition but didn't turned out to have been better off" as if the research is clear-cut and settled? How is that being scientifically or morally responsible?

Whether the proportion is 85% or 20% (or whatver) isn't the issue. The issue is that since there are some people who are happy and some who aren't, the most honest and caring thing to do is acknowledge both groups exist and try to learn as much as possible about both of them so that we can recognize which group any given person most likely falls into to give them the help that they need.

Your initial comment wasn't "It's important to understand how to identify who is actually going to be helped by transitioning before proceeding with the transitioning process."

The message I got from reading your post was "Most people who say they want to transition would have been harmed if they had actually gone through with it" or at least "Most people who say they want to transition ended up identifying with their birth gender later in life" implying in most cases it is better not to transition (or at least to delay). And you refer to "research" without citation or context.

I can't recall exactly, but two books related to this topic are "Galileo's Middle Finger" and "Irreversible Damage". That statistic may have been in one or the other.
I believe it came from research by Kenneth Zucker, but I'm not entirely certain.

And when discussing the cases in which people either ceased their transitioning process or expressed regret, it's extremely important to attempt to understand the whys. People like to cite these cases to say, "See how awful it is to indulge these people, you're actually hurting them in the long run" while failing to mention that sometimes people don't continue due to difficulty accessing adequate medical care and sometimes people regret transitioning due to social backlash.

People also like to note that trans people have higher rates of depression and suicide than the general population as evidence that being trans itself is harmful to the individual. As if social rejection and bigotry couldn't possibly have anything to do with it.

The research (again, I believe, Zucker's) indicated that gender dysphoria had a lot of comorbidites for anxiety, depression, etc. Also for girls, autism plays a big part. The suggestion is not that "being trans itself is harmful to the individual", but rather that people who are struggling with various mental health issues and looking for solutions may latch onto gender identity as a possible solution. This would make sense if the people who regret their transition found that it did not provide the resolution they hoped.
(To be clear: This is not to say that all gender dysphoria is due to mental health struggles; it is to say that people with intense struggles may be desperate enough to grasp at anything that might help, and that's why professionals need to be diligent about carefully examining what is really going on to suggest appropriate treatment.)

[ciao_yall]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

I think we are all in agreement in this aspect. Still, pointing to one person who regretted it reminds us that "the plural of anecdote is not data."

[marshwiggle]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

I think we are all in agreement in this aspect. Still, pointing to one person who regretted it reminds us that "the plural of anecdote is not data."

Considerin g both 60 Minutes Australia and the BBC have done documentaries on detransitioning, there are probably a few more than one.

[smallcleanrat]

Kenneth Zucker's work could be a whole thread in itself, and I'd need to do more of a deep dive to discuss his research analytically.

But I'm questioning how the actual percentages don't matter when discussing the question of whether and when transitioning will be harmful vs. beneficial.

The actual numbers of people who regret transitioning doesn't matter so long as it's non-zero?

Say 80% of patients given Treatment X show worse outcomes than patients given Treatment Y (or no treatment at all). That's not going to influence future research or clinical decision-making any differently than if 80% of patients given Treatment X show better outcomes?

A majority of patients transitioning later suffering because of the decision indicates a massive problem in identifying when hormones or surgery is the appropriate intervention. A majority of patients with beneficial outcomes indicates the validity of the treatment, while still acknowledging that it isn't the best option for everyone and further research with the aim of better screening is warranted.

And my comment about the rates of depression etc. in trans people wasn't about you specifically. It was an example of how people will take the results of a study, slap an interpretation onto it that may or may not be accurate, and then think that because the numbers are a fact then so is their interpretation. Often, I read reports of studies in which the article indicates or outright states an interpretation that the authors of the study themselves never put forward.

I'm also questioning the frequency of doctors recklessly signing off on treatment without a thorough evaluation of a patient's individual case or discussion of alternatives. It's been my impression that it's not a quick and easy process, but I honestly don't know how true that is generally.

[ciao_yall]

Again, I'm not claiming to be anything close to an expert on this subject, but I think the issue is complex, not clear-cut. And I personally haven't seen sufficient evidence to feel confident saying, "It's just a phase. They'll grow out of it." That can also do a great deal of harm to an individual.

The point is not that everyone will "grow out of it". But given the lifelong consequences of transitioning, it is scientifically irresponsible to just overlook all reports of people who regret the decision and avoid trying to find out who and how common they are, and it is morally irresponsible to not try to clearly identify the people who will potentially benefit from transition and those who likely will regret it.

I think we are all in agreement in this aspect. Still, pointing to one person who regretted it reminds us that "the plural of anecdote is not data."

Considerin g both 60 Minutes Australia and the BBC have done documentaries on detransitioning, there are probably a few more than one.

Dog bites man?

[ciao_yall]

Let's also consider that yes, it will be stressful to live as a transgendered person, especially if they don't easily "pass."

Still, they may decide that the stresses of living in their AAB gender are worse than the stresses of living as transgendered person.

And, they may decide later that one stress is worse than they had realized.

Doesn't mean transitioning, or not transitioning, is ever 100% the right or wrong decision for everyone.

[Parasaurolophus]

There was an excellent Current Affairs piece on this particular moral panic back in April. Of particular relevance, I think, is this paragraph:

A 2018 survey of practitioners who offer gender affirmation surgeries revealed very few reports of regret. 22,724 patents that had been treated by the surgeons. Only 62 patients had ever reported regret about their gender transition or sought detransition care. 22 of those 62 did report that their gender identity had changed, but another 17 reported that social factors (difficulty in relationships and a lack of family support) had led to the regret, meaning that a good portion of the regrets that do occur come about because we live in a transphobic society. The surgeons had only had to perform 38 detransition procedures in total. A UK study found that out of 3398 patients it studied in an NHS gender identity clinic, only 16 (less than half a percent) reported "transition-related regret or detransitioned."

Let's let that sink in. In the first instance, we have a regret rate of .27%. And a significant percentage of those (27%!) appears to be due entirely to external factors--being rejected by one's family and social circle. So the actual number of internally-driven regrets is more like 45, or .2%.  In the second instance, you've got a regret-rate of .47%.

That's so tiny. If you presented me with a coronavirus vaccine with those odds of adverse effects, I'd take it in a heartbeat. Oh, wait...

[marshwiggle]

A majority of patients transitioning later suffering because of the decision indicates a massive problem in identifying when hormones or surgery is the appropriate intervention. A majority of patients with beneficial outcomes indicates the validity of the treatment, while still acknowledging that it isn't the best option for everyone and further research with the aim of better screening is warranted.

Yes. This is precisely the point.

I'm also questioning the frequency of doctors recklessly signing off on treatment without a thorough evaluation of a patient's individual case or discussion of alternatives. It's been my impression that it's not a quick and easy process, but I honestly don't know how true that is generally.

My understanding is that this used to be the case, but trans activists have pushed to make "support" of transition the virtually automatic decision, and professionals who are more cautious get labelled "transphobic".

(I believe there have been reports of clinics prescribing puberty-blockers without even having an interview with the patient.)

[Wahoo Redux]

Mind your own business, Marshy.  It is not your place to decide what is good for other people.