Friday, June 30, 2017

Another psychiatrist putting superstition over science and claiming the reverse

Dr. Rick Fitzgibbons
Richard Fitzgibbons, MD at a Franciscan University event
Dr. Rick Fitzgibbons writes: “The Transgender Agenda vs. the Science.” Needless to say that is not published in the New England Journal of Medicine. Furthermore, while Fitgibbons claims to be a psychiatrist he is not board certified by the American Board of Psychiatry and Neurology. The piece appears in The Catholic Thing. Ordinarily I would ignore it except for the fact that the author claims to be a psychiatrist. The expectation is that he knows something. He does not.

The only “transgender agenda” that I am aware of is to be treated fairly and like human beings. It's not all that complicated. The science overwhelmingly supports gender affirmation to relieve the symptoms of gender dysphoria. So, in other words: What the hell are you talking about?

Let us wade into the assertions:
This … increases the risk of psychological and physical/surgical harm to young people. It completely ignores the medical and psychological literature on the serious risk factors associated with enabling youth to identify with a sex other than their biological sex determined by the genes in every cell of their bodies.
Really? What literature is he referring to? This gets so tedious as we revisit Drs. McHugh and Mayer:
Their 2016 research paper, “Sexuality and Gender: Findings from the Biological, Psychological and Social Sciences,” is an exhaustive review of the scientific literature concerning gender identity and sexual orientation. They examined over 500 scientific articles. Both doctors concur that neither sexual orientation nor gender identity is innate or immutable (no one is born gay or transgender, and both are fluid). Additionally, both doctors find no evidence to support encouraging children to identify as transgender.
The article was “published” to a pretentious conservative Christian blog. It was not peer reviewed. Literature reviews are designed for selective observation to confirm a preexisting opinion. Their post is also at odds with their own professional organizations and McHugh is an admitted defender of the faith.
Dr. Paul Hruz, a pediatric endocrinologist and an associate professor of cell biology and physiology at Washington University School of Medicine, St. Louis, led a 2017 research study, “Growing Pains: Problems With Puberty Suppression in Treating Gender Dysphoria,” that raises serious questions about the current treatment of children with gender dysphoria.
Same blog. Not peer reviewed and at odds with the Endocrine Society, his professional organization. None of these people have experience working with gender dysphoric children.
Dr. Kenneth Zucker, author and clinical psychologist, is another important, internationally recognized scholar on gender dysphoria who would be a valuable member of a presidential commission on the appropriate, safe treatment approach for these young people. He has worked for thirty years in this field and has written numerous papers in peer-reviewed journals on the origins and treatment of the many psychological conflicts in parents and in youth that give rise to transgender attractions. He is the co-author of Gender Identity Disorder in Children.
Kenneth Zucker is a well-respected Canadian psychologist and sexologist. He is not a crackpot. However, about 35 years ago Zucker embraced what we would call reparative therapy for transgender people. The intent was to conform gender to biological sex. That was the prevailing view of treatment at the APA until only a few years ago. The objective was to prevent children from being transgender in the hope that they would conform. It does not work and the result is a substantial amount of self-harm. Zucker has also been inconsistent (at times agreeing with gender affirmation), his clinic was shut down and he is now highly controversial.
Two of the more important studies that should be discussed address the results of transsexual surgery. A 2015 study found that 180 transsexual teenagers (106 female-to-male; 74 male-to-female) had a twofold to threefold increase in risk of psychiatric disorders, including depression, anxiety, suicidal ideation, suicide attempts, self-harm without lethal intent, and both inpatient and outpatient mental health treatment compared to a control group (Reisner, S.L., et al., 2015).
That would be Sari L. Reisner who is a trans man. He is an Assistant Professor of Pediatrics at Harvard Medical School and Boston Children’s Hospital, with a secondary appointment as Assistant Professor in the Department of Epidemiology at Harvard T.H. Chan School of Public Health. He is also an Affiliated Research Scientist at The Fenway Institute at Fenway Health where he is a pediatric gender dysphoria scholar.

Reisner is quite prolific and without a cite it's hard to tell which paper he is referring to. However, Reisner has written: Comprehensive transgender healthcare: the gender affirming clinical and public health model of Fenway Health which contradicts Fitsgibbons' claims. We know that trans kids have psychiatric health problems. We also know that those are relieved with, as Reisner confirms, gender affirmation. The alternative is the self-harm that Reisner notes.
The largest study of post-surgical transexuals was an analysis of over 300 people in Sweden over the past thirty years The study demonstrated that persons after sex reassignment, have considerably higher risks for mortality, suicidal behavior, and psychiatric morbidity than the general population (Dheine, C., et al. 2011).
Some of these people had gender affirming surgery 36 years ago. The mean is probably 18 years ago. I have an email exchange with one of the authors of that study and she attributes the suicidal behavior to the minority stress model. Were Dr. Fitgibbons board certified he might know that.

Given the outlet, it is obvious that Dr. Fitzgibbons is trying to conform medicine to the teachings of the Catholic Church. Those teachings have been authored by men who are theologians, not scientists. Some are based on Bronze Age texts. Faith is one thing. Science is another. They should not be mingled together.

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