Academic Freedom and Cancel Culture

[marshwiggle]

If accuracy of statistics doesn't matter, accuracy of anecdata doesn't matter, and consideration of alternate explanations for the statistics and anecdata doesn't matter, what does matter?

OK, here's a paper by Dr. Lisa Littman, whose work is referenced in "Irreversible Differences".

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners

One telling quotation from the abstract:

The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned.

[jimbogumbo]

If accuracy of statistics doesn't matter, accuracy of anecdata doesn't matter, and consideration of alternate explanations for the statistics and anecdata doesn't matter, what does matter?

OK, here's a paper by Dr. Lisa Littman, whose work is referenced in "Irreversible Differences".

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners

One telling quotation from the abstract:

The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned.

The critique of this paper is devastating. Not only is the study prescriptive, the recruited parents were ONLY from among those who visited three websites which support Littman's position. Worse from a clinical standpoint is she had parents use DSM criteria to "evaluate" their child's psychiatric state post surgery.

[smallcleanrat]

If accuracy of statistics doesn't matter, accuracy of anecdata doesn't matter, and consideration of alternate explanations for the statistics and anecdata doesn't matter, what does matter?

OK, here's a paper by Dr. Lisa Littman, whose work is referenced in "Irreversible Differences".

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners

One telling quotation from the abstract:

The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned.

The critique of this paper is devastating. Not only is the study prescriptive, the recruited parents were ONLY from among those who visited three websites which support Littman's position. Worse from a clinical standpoint is she had parents use DSM criteria to "evaluate" their child's psychiatric state post surgery.

Yes, this study [ETA: Littman's studies, not this specific one] had the same problem as many of the anecdotes in the Irreversible Differences book in placing parental assessments in pride of place.

"Scientific responsibility" is not supported by handwaving away critiques on methodology with some generic statement like "Oh, of course people will criticize any study that doesn't fit their ideology-driven narrative."

Not every unpopular opinion is unpopular due to "cancel culture." Not every critique of unpopular opinions which are a target of "cancel culture" is purely reactionary and ideologically based.

Sometimes an unpopular opinion is unpopular because it is based on shoddy scholarship. Refusal to engage with specific critiques of your work (questionable methodology, conclusions which overreach available evidence, refusal to acknowledge studies with results that contradict yours, refusal to consider alternative interpretations of available data, etc...) is a mark of intellectual cowardice. If you really want to champion free inquiry and academic integrity, you should be able to defend your work beyond snarky comments ("Well, I'm sorry the facts don't support your PC narrative.") or playing the martyr ("I dared to ask questions. I dared to speak the truth. And for refusing to compromise my integrity by bowing to ideological orthodoxy, I was viciously attacked.")

And...absolutely nothing further to say about the NHS document you accused of mandating hormones and surgery in response to an adolescent invoking the "magic words" of acute mental distress? Did you even read the document past the point you quoted? Or did you just see the "Preventing people from dying prematurely" blurb and fill in the details with your imagination?

I read that thing point-by-point (twice!) trying to understand your point of view because I took you at your word that you gave a damn about "scientific and moral responsibility." Why do you care so little about 1) ACCURATELY representing the studies and documents you cite to support your claims and 2) the QUALITY of your sources?

You keep going back to the Irreversible Differences book despite indications of the author's personal bias and superficial understanding of the topic she's writing about. Even her cherry-picked anecdotal examples don't clearly support her claims. Why do you trust her ability to vet sources and accurately report on the contents of research studies?

[smallcleanrat]

If accuracy of statistics doesn't matter, accuracy of anecdata doesn't matter, and consideration of alternate explanations for the statistics and anecdata doesn't matter, what does matter?

OK, here's a paper by Dr. Lisa Littman, whose work is referenced in "Irreversible Differences".

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners

One telling quotation from the abstract:

The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned.

This isn't an answer to the question I posed.

You keep quoting statistical claims while you previously said the actual numbers don't matter. The fact that you keep emphasizing studies with claims that a majority of minors who receive specific treatments suggest you do care about the actual numbers.

And is it worth pointing out that this study population is not comprised of "people who wanted to transition" (which was the population you were initially focused on) but the subset of people who detransitioned. And 55% of these indicated inadequate support from medical professionals, which is even lower than your previous claim that 85% of boys wanting transition changed their mind later?

And that even if we accept this study at face value and make the stretch that the experiences of these 100 individuals can be taken as representative of the general population of transgender people (or the general population of desistors), you still have a long way to go to demonstrate that 1) the problem is so widespread it is the norm rather than the exception and that 2) the problem originates from government issued mandates and not individual doctors or clinics.



You keep ignoring studies other people reference which show a high rate of positive outcomes. Why? Why are only the studies you mention informative?

Every time someone raises an issue with a study you cite, you just throw out another stat, without any indication you've actually read the paper beyond the abstract. You don't address the actual critique and defend the paper you previously cited. You just move on to another one.

Are you just going to keep citing a different study every time someone points out an issue with the previous one, in the hopes that eventually you'll mention one that isn't terrible?

What then?

This particular one is an internet survey of 100 people. How much weight do you give it in the context of all the other published studies investigating treatment outcomes?

If someone can link you to the results of an internet survey of 100 people in which the majority felt they were given good support and careful evaluation and felt positive about the effects of treatment, would it make an impression on you at all?

If someone can link you to the results of an internet survey of 100 people who were told they could not access hormone therapy until they were at least 18 years old, and the majority of those surveyed felt they had been harmed by being forced to delay this treatment until after experiencing the long-term effects of puberty, would this carry any weight with you?

[marshwiggle]

And that even if we accept this study at face value and make the stretch that the experiences of these 100 individuals can be taken as representative of the general population of transgender people (or the general population of desistors), you still have a long way to go to demonstrate that 1) the problem is so widespread it is the norm rather than the exception and that 2) the problem originates from government issued mandates and not individual doctors or clinics.

First of all, I have no issue with adults choosing to transition.

Second, I do not remotely suggest that the 100 people in this study represent the norm for people who transition. They are, by defintion, people who regret the decision. (In fact, in the dataset, 3 were people who retransitioned, after detransitioning, so even those were people who ultimately decided transition was better.)

There are lots of procedures which people undergo which are supposed to be permanent, but which some portion of people later regret. (Tatoos and vasectomies come to mind immediately.) If *adults make the informed choice and then regret it, it's on them. However, if adults allow minors to make that choice, which some of them later regret, then the adults bear responsibility for the choice.

(*In the study listed, all of the transitioners were adults. If adults made this choice and then regretted it, it's likely that some proportion of minors making this decision will also later regret it, unless somehow they are getting significantly better counselling than the adults, which is unlikely.)

When tatoos became trendy, a few years later tatoo removals started to become more popular as some people decided that tatoos had become a liability. It makes sense that the "trendiness" made some people jump on the bandwagon with less thought then they would have taken otherwise.

With tatoo removal and vasectomy reversal, if they are succesful, then the individual is restored to pretty much their former self. However, surgical transitions, if "reversed" will not come close to original, and even hormonal treatment has effects that do not completely disappear when the hormones are stopped. This is profoundly more true for children who go on puberty blockers, since all kinds of development is altered (including brain development.)

[smallcleanrat]

You quoted from the study, called the quote "telling" and left it there. You didn't explain exactly what you thought this specific study was telling, so I went back to your previous claims on this thread (of which there are many).

You're still dodging and ignoring the vast majority of responses people have made to your claims and interpretations.

I considered trying to direct your attention back to other posters taking issue with your overblown or unsupported claims on the risks of treatments or your claims about the prevalence of poor treatment outcomes, but there seems to be no point.

You still won't respond to my comment on your claims about the NHS guidelines, and I find that telling.

[marshwiggle]

I considered trying to direct your attention back to other posters taking issue with your overblown or unsupported claims on the risks of treatments or your claims about the prevalence of poor treatment outcomes, but there seems to be no point.

At the risk of failing to answer arguments again, I realize that I'm not sure what specific claims I'm making (whether supported by evidence or not) that you take issue with.

It seems to me that your argument is some combination of

• Any instances of "buyer's remorse" among people who transition are vanishingly rare.
• Any instances of "buyer's remorse" among people who transition are unlikely to be because of social factors (such as those related to "cancel culture", which is why it came up in this thread) leading parents and/or medical professionals to be over-zealous in suggesting or supporting transition.
  

Is that correct, or is there something else which I've missed? Does one of those predominate?

[onthefringe]

Marswiggle, you routinely seem to ignore responses that you can't (or don't want to) pick apart. Upthread I specifically pushed back on

• Your claim that identifying as trans is due to a social contagion
• Your claim that cross culture suicide rates could somehow be used to estimate the fraction of teens who are trans
• Your apparent belief that use of puberty blockers in teens is somehow more harmful than forcing trans youth to go through the wrong puberty simply because you can find evidence of a comparatively small number of people who choose at some point to detransition

Thoughts?

[smallcleanrat]

I considered trying to direct your attention back to other posters taking issue with your overblown or unsupported claims on the risks of treatments or your claims about the prevalence of poor treatment outcomes, but there seems to be no point.

At the risk of failing to answer arguments again, I realize that I'm not sure what specific claims I'm making (whether supported by evidence or not) that you take issue with.

It seems to me that your argument is some combination of

• Any instances of "buyer's remorse" among people who transition are vanishingly rare.
• Any instances of "buyer's remorse" among people who transition are unlikely to be because of social factors (such as those related to "cancel culture", which is why it came up in this thread) leading parents and/or medical professionals to be over-zealous in suggesting or supporting transition.
  

Is that correct, or is there something else which I've missed? Does one of those predominate?

Is there something you've missed? Are you serious?

I wasn't even making a definitive statement about either of those things.

I haven't decided whether it's worth the energy to summarize the things you've said with which I take issue.

For now, I'll simply reiterate the issue I had with your post about the NHS recommendations:
1) You posted a link to a document describing a specific set of NHS guidelines.
2) You made a specific claim about what those guidelines entailed.
3) Your claim is directly contradicted by the text of said document.
4) This discrepancy is mentioned in a reply to your post.
5) You are asked to comment on this discrepancy. You are asked whether you even read the document you cited.
6) *crickets*

[marshwiggle]

Marswiggle, you routinely seem to ignore responses that you can't (or don't want to) pick apart. Upthread I specifically pushed back on

• Your claim that identifying as trans is due to a social contagion
• Your claim that cross culture suicide rates could somehow be used to estimate the fraction of teens who are trans
• Your apparent belief that use of puberty blockers in teens is somehow more harmful than forcing trans youth to go through the wrong puberty simply because you can find evidence of a comparatively small number of people who choose at some point to detransition

Thoughts?

All of these are incorrect.

• There is evidence that some people  identifying as trans is due to a social contagion. (In particular, young girls, especially with autism.)
• Cross culture suicide rates could place an upper bound on the suicide rate of teens who are trans
• The use of puberty blockers in teens is more harmful than forcing trans youth to go through the wrong normal puberty if they are one of the people who choose at some point to detransition

With any medical procedure, no matter how many people it helps, there are some who are worse off after. One of the important parts of getting approval for treatments is trying to identify specifically who is likely to be harmed by the treatment. It would disastrous and immoral to refuse to do that research. In fact, part of the value of that is so that the treatment can be restricted to those most likely to benefit.

Given that some people regret their transition, it would be similarly irresponsible to avoid trying to objectively determine

• what proportion of people who transition later regret it
• what (if any) characteristics identify those who are most likely to regret it so they can get advice that is more appropriate for them

A big part of our debate here is precisely caused by the fact that this kind of objective research is lacking.

[Parasaurolophus]

Given that some people regret their transition, it would be similarly irresponsible to avoid trying to objectively determine

• what proportion of people who transition later regret it
• what (if any) characteristics identify those who are most likely to regret it so they can get advice that is more appropriate for them

A big part of our debate here is precisely caused by the fact that this kind of objective research is lacking.

So something like this:

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...

[smallcleanrat]

At this point, I'm struggling to believe this isn't simple trolling.

In the off chance it isn't...marshwiggle, I don't know if saying it now will make it any clearer than the last half dozen times I said it, but my biggest issue with your claims is the way you bang on about objectivity and scientific responsibility while simultaneously showing no concern for either.



Your post about the NHS guidelines was either a failure of reading comprehension or a failure of honesty. Rather than own up to either (or demonstrate that I'm the one in the wrong), you just keep posting as though nothing happened. You still do. This does not give the impression of someone who values what's true.

How could you possibly have been unclear as to what my issue was with your claim about the NHS guidelines?



People have pointed out reasons to question the validity of the data or the interpretations of the studies you cite, which you either ignore or say don't matter.

You keep claiming that "objective research" into risks vs. benefits of various treatment decisions is lacking, despite the existence of many publications on the subject. Did you look at the list of references on the NHS document? identifying key factors relevant to making treatment recommendations/decisions with the best chance of success is an active area of research.

If you want to make the argument that none of this qualifies as "objective" research and it's all driven by capitulation to ideology and activism, you need to do better at showing your work.

Are you only going to be satisfied that the medical establishment has done its due diligence when the number of youths experiencing negative treatment outcomes is ZERO? Is that a realistic expectation for any medical intervention?

And involving teens in the decision-making process regarding their own medical care is not new nor is it the same as insisting a teen's self-diagnosis and demand for a specific treatment modality to be the final word on the matter.

[secundem_artem]

Jeezus am ever bored with this discussion.  It's endless noodling around these kinds of issues that elects people like Trump.  Nobody cares where you want to pee.

[mamselle]

Well, the boring bits are the parts where people just keep hammering on about their own viewpoint without listening to others' commentary or trying to take it on board.

To wit, SCRat, muchos kudos for trying, but the horse you're trying to lead to the waterhole has a firehose in mind, and he's looking for it out in the desert where there are no firehoses. And he doesn't want to visit the Stata Center, where there is a firehose to drink from, because it's not in the desert.

You may just have to let this horse wander off, he's deliberately not getting it, just to create the kind of boring atmosphere that 2_artem is bewailing. Some horses like to be both thirsty and boring.

------------
So, back to the OP's original topic....There's an interesting summary of the issues as of Nov 1, here, which I don't think has been cited yet:

   https://www.newyorker.com/magazine/2021/11/01/the-power-of-dave-chappelles-comedy-netflix-the-closer

Go to it.

M.

[smallcleanrat]

Jeezus am ever bored with this discussion.  It's endless noodling around these kinds of issues that elects people like Trump.  Nobody cares where you want to pee.

Wtf?