Wednesday, August 12, 2020

"Ex-Gay" Woman Opines "Why a Generation of Girls Is Fleeing Womanhood"

“If you agree that parental consent is not gratuitous then this entire narrative falls apart.”
Jean C. Lloyd
This is the closest I can come to an image of Jean C. Lloyd. This is from her appearance in a film produced by the Church's Courage Ministry.
The ex-gay woman is Jean C. Lloyd and the outlet is none other that Witherspoon Institute's pretentious blog. For starters, a generation of girls is not fleeing womanhood but Ms. Lloyd is; a) obsessed with transgender people (presumably in defense of the faith) and; b) incurious which makes her particularly susceptible to confirmation bias.

Ms. Lloyd has some difficulty in differentiating fact from opinion:
Abigail Shrier’s new book is an outstanding investigative report on the diagnostic craze of rapid onset gender dysphoria that has swept over adolescent girls in the past decade. It is an invaluable resource for parents, educators, church and community leaders, and anyone else who cares about the well-being of young women.
Abigail Shrier's book is the product of research that was so significantly corrected by the publishing journal as to make it meaningless. I am informed, off the record, that there was considerable debate among the editors about retracting rather than correcting junk science.

I am referring of course to Lisa Littman's misadventure with what she called rapid onset gender dysphoria. Littman's problem is that her subjects were limited to anonymous mothers culled from mostly anonymous anti-trans blogs. She did not study any of the teen girls who were supposedly influenced to become transgender.

Eventually editors issued a correction to Lisa Littman's study. The journal, Plos-One, published a correction notice, a formal comment, an apology and the revised paper.

Furthermore, there is no study which confirms that rapid onset gender dysphoria actually exists. Littman conceded that rapid onset gender dysphoria is not a formal diagnosis. Anything is possible but the idea that “a generation of girls” has been affected is ridiculous.
[Shrier's] decision to write on transgender issues has introduced her to the abuse heaped on those who inquire more deeply into the popular trans narrative. As an opinion writer, she initially passed on telling this story, trusting someone else would. Yet when she received an e-mail from a mother desperate to get the word out about her beloved daughter identifying as trans “out of the blue,” she couldn’t get it out of her head. Shrier began meticulously researching, conducting almost 200 interviews and consulting with dozens of affected families.
The above contradicts the narrative she provided to a couple of folks from the Heritage Foundation:
My book jumps off from the work of public health researcher Lisa Littman at Brown University, who found that all of a sudden adolescent girls, a demographic that had never experienced gender dysphoria, the severe discomfort in one’s biological sex, had never experienced this in any real numbers, all of a sudden had become the predominant demographic.

Not only were teenage girls suddenly dominating the phenomenon, but these were girls with no childhood history. Typically gender dysphoria began in early childhood.

So she noticed that this was a giant epidemic and it was peculiar.
It is abundantly obvious from the quote that Shrier either did not read or did not understand the correction made to Littman's study. Perhaps she did not care because it interfered with her goal of writing a book to make some money.
This book is not about transgender adults, nor is it shaped by a particular faith perspective. Rather, it is an investigative report on the diagnostic craze of “gender dysphoria” that has swept over adolescent girls in the past decade.
It is not much of an “investigative report” if it mischaracterizes a study (Littman's) while ignoring a mountain of contrary evidence from the likes of the American Academy of Pediatrics.
Shrier uses the term “craze” in its technical sociological sense, referring to “a cultural enthusiasm that can spread” like a contagion. As she reminds us, numerous maladies have affected and been passed on by adolescent females throughout history, such as the eating disorders that plagued my generation. While these young women are dealing with genuine distress, their “self-diagnosis” is as influenced by others as it is erroneous, and the prescribed cure can take the form of “self-harm.”
“Girls,” when not used in the pejorative, are minors. Lloyd has also used the term “adolescents” who are minors as well. If they exist, what have parents done? The first thing that any responsible parent would do is to get a competent diagnosis from a qualified professional.
Transgenderism is the latest manifestation of this phenomenon. As Shrier points out, only eight years ago, there was no clinical literature on females ages eleven to twenty-one suffering from gender dysphoria. None. Now, there are exponential increases in the number of girls who suddenly discover that they’ve been “born in the wrong body,” although they exhibited no hint of gender dysphoria before adolescence. In the space of one year, 2016–2017, “the number of gender surgeries for natal females in the U.S. quadrupled.” Currently, 70 percent of “sex-change” surgeries are performed on women. Shrier dared to ask the question: “What’s ailing these girls?” This book details her search for an answer.
Shrier is wrong in stating that there was no clinical literature eight years ago. Ms. Lloyd lacked sufficient curiosity to review the data. Here is a very small sampling of literature prior to 2012 (in order of search results):
All of the above were published more than eight years ago.

I used a start date filter of 2001 and there are hundreds of peer-reviewed articles regarding transgender youth. Furthermore, the first edition of WPATH's Standards of Care was published in 1979 and it included guidelines for treating trans kids.

In the above quoted material Ms Lloyd writes: “In the space of one year, 2016–2017, 'the number of gender surgeries for natal females in the U.S. quadrupled.'” I assume that she is quoting Shrier.

I cannot find a matching statistic in any of the literature. Furthermore, Lloyd and Shrier have both stated that this is about children and adolescents for whom surgical interventions are irrelevant.

That also leaves out Shrier's “self-diagnosed” proposition because two psychological referrals are required to obtain genital surgery.

Many young women are also eliminated because of the real life experience requirement (candidates for genital surgery must live life as their gender for at least a year while undergoing intensive counseling).

Ms. Lloyd did not consider any of these realities. I love this part:
Although regular Public Discourse readers are likely to be knowledgeable about transgender issues in general, this book—with its specific focus on girls and young women—is still well worth your time. Do not miss it.
Most readers of Witherspoon Institute's blog will be the most tragically misinformed people on the planet regarding LGBTQ issues. They get their science from the Vatican. Gay people are said to be “objectively disordered.” Teachings on transgender matters are based primarily on scripture.
Chapter by chapter, Shrier introduces the major players involved in this complex drama, highlighting the parents, professionals, young trans social media “influencers,” and those who push radical gender ideology in school settings. Who knew that teachers’ associations were voting to allow minors to leave campus to access cross-sex hormones without parental consent?
“Gender ideology” is a tell. Only conservative Christians use the term. Gender is not an ideology or doctrine. Obsessive Catholicism is an ideology based upon religious dogma. Dogmatists accept, as incontrovertible truth, religious doctrine regardless of evidence to the contrary and without considering the viewpoints of others.

Furthermore, teachers' associations have no say in healthcare public policy. Minors require parental consent for hormone treatments.
Pro-affirmation therapists articulate their views of adolescent gender identity declarations as unquestionable and inviolable, arguing that the only response should be agreement and support.
The above is just Christian rhetoric. The issues involved are far more complex. It starts with a diagnosis which includes the presence of gender dysphoria and its severity. Children do not transition because of therapists. They are inexorably drawn to transition as a means of getting some relief from their condition.

Moreover, it is not a matter of agreement or disagreement. According to an enormous amount of clinical data, a child in distress from gender dysphoria should be permitted to transition if that is what they are determined to do. The American Academy of Pediatrics summarized much of this research in its clinical practice guidelines recommending gender-affirming care.

Attempts to talk a kid out of gender dysphoria are pointless. It amounts to gender identity conversion therapy and it is very toxic. It puts the child at severe risk for self-harm.
…psychologist Kenneth Zucker explains that social transition is not a “risk-free” and “nothing to lose” step, as it is commonly portrayed, but rather an “experiment in nurture.” Psychotherapist Lisa Marchiano explains the fascinating concept of “symptom pools,” which are defined as “lists of culturally acceptable ways of manifesting distress that lead to recognized diagnoses.” As humans, she observes, we are drawn to “prescribed narratives,” seeking to explain our troubles in ways that others will recognize, because that will make it more likely for us to “receive care and attention.”
Dr. Zucker is correct. Transitioning is not risk-free. So what? According to most of the experts the greater risk is self-harm.

Lisa Marchiano is pretty sane and reasonable but out of her depth and possibly influenced by religion. Marchiano has a master's degree is social work. She wrote about rapid onset gender dysphoria a year prior to Littman. Her paper seems rather esoteric to me but I am not qualified to judge. Most of her references are to material that is not peer-reviewed and not published to academic journals.
Shrier’s research thoroughly demonstrates how differently transgender medicine operates from any other area of medicine. Patients are essentially placed in the driver’s seat, prescribing their own treatments. The doctor’s role is simply to affirm and enable patients’ access to the medicine chest and surgical procedures of their choosing. For instance, one Canadian plastic surgeon, Hugh McClean, readily admits on his website that “for us, the diagnosis is made by the patient, not the doctor.” Since 2019, McClean has conducted well over 1,000 “masculinizing mastectomies” for women as young as sixteen.
I will start with the surgeon. I don't know how the website was located when his name is misspelled. It is “Dr. Hugh McLean” (one “c”). Dr. McClean does not do genital surgery. His specialty is top surgery which is less demanding and more reversible:
For us, the diagnosis of breast dysphoria is made by the patient, not the doctor, in the same way that a patient seeking breast enlargement is the one who diagnoses her own breasts as being too small. Therefore, the responsibility of the surgeon is to assure that the client is aware of the nature and purpose of the proposed procedure, its alternatives, limitations and potential consequences including risks and complications. This process is called "informed consent". When we are reasonably certain that your information is adequate to allow you to decide whether or not to have the surgery, then we can agree to do it for you.
Shrier also devotes an entire chapter to the perspectives of medically transitioned transgender adults. Scott Newgent, who has publicly acknowledged he is “Blake” in the book, speaks frankly about the benefits he feels he gained from testosterone. However, his arm is permanently handicapped from being sourced for his phalloplasty … He has become one of the most impassioned warriors in the battle to protect children from medical transitioning before they have the adult capacity to consent.
Let me cut to the chase. According to WPATH:
Genital surgery should not be carried out until (i) patients reach the legal age of majority to give consent for medical procedures in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity. The age threshold should be seen as a minimum criterion and not an indication in and of itself for active intervention.
I agree. Blake agrees. Most doctors agree. Children should not be candidates for gender-confirming surgery. Parents should withhold consent.
Critically, Shrier amplifies the voices of the rapidly growing number of “desisters” and “detransitioners”—voices that are regularly denied, suppressed, and shunned by their former communities of trans-identified individuals.
No one gives a crap whether someone detransitions or desists. They become the object of opprobrium when they shill for religious groups claiming that no one should transition. Their experience is not applicable to to anyone else. Walt Heyer comes to mind. He had surgery about 40 years ago.

Moreover, there is no way for Shrier to quantify desisters in order to claim that there is a “rapidly growing number.” Research indicates that desistance rates are minuscule. The data suggests that the percentage of desisters is minuscule.

The reason for there being few desisters is the progression of treatment. Only the most severely affected children ever transition (about 25% of those experiencing discomfort).

These kids are in continuous care by qualified clinicians. As they enter puberty they might receive puberty blockers. This is predicated on obtaining significant relief from having transitioned.

In late teens they might receive gander-affirming hormones. Trans youth experience a great deal of ridicule. Receiving hormones means that they and their doctors are in agreement that the relief from transitioning outweighs being the target of derision.

Most transgender people do not receive gender-confirmation surgery due to the cost. The psychological review process and the real life experience are reasonable indicators of motivation. Satisfaction with gender confirmation surgery is extremely high.

A 2019 study out of Holland concludes that “Current studies indicate that quality of life improves after sex reassignment surgery.” Five years earlier the same researchers found that only 1.8% of patients were dissatisfied (presumably a function of aesthetics).

To be fair, there is a paucity of studies of female-to-male patients. Anecdotally, they much prefer top surgery to binding which is inherently unhealthy. Genital surgery is seemingly rare for transgender men. Perhaps that is because it is cost-prohibitive.

Returning to Ms. Lloyd's narrative:
Psychologist and well-known researcher Ray Blanchard points out that there is “there is no apparent way to record a detransitioned patient for clinical or research purposes.” Trans activists don’t want people to know that detransitioners exist, but they do, and their numbers are growing. A subreddit web forum for detransitioners to discuss their experiences now has over 7,000 members.
Blanchard is correct which is why I said that it would be impossible for Shrier to responsibly claim that there is “rapidly growing number” of desisters. The second part of that paragraph is conspiracy theory. No one is upset if people detransition (usually because of family pressure).

In the same paragraph where Lloyd quotes Blanchard saying, essentially, that there is no way to record detransitioners Lloyd claims that “their numbers are growing.” She has no way of knowing that. Subreddit membership numbers are entirely meaningless. Abigail Shrier has no way of knowing percentages of detransitioners.

Forgive my skepticism:
According to the young people that Shrier interviewed, if a girl comes out as lesbian, she gets a status demotion. But if she comes out as trans, she gets an immediate promotion.
Neither Abigail Shrier nor Jean C. Lloyd appreciate just how difficult life is for a transgender person, male or female. Furthermore, it does not make sense that people not experiencing gender incongruence would transition. It makes even less sense to suggest that the underlying condition of transgender people is contagious or subject to social influence.

There is also an issue with Shrier's sampling. Her book is not research. It has not been subjected to peer-review. Why would Shrier have more success in finding a representative sample than Lisa Littman had? Littman is an accomplished academic and she failed in that regard.

Lloyd is not terribly discerning:
What will this “upgrade” to transgender cost a girl? Only her name; her natural voice, which will be permanently altered even if she one day gets off testosterone; her breasts, with their erogenous capacity and ability to breastfeed; and perhaps her ability to bear children at all. These are lifelong sacrifices, doled out on an “informed consent” basis to girls too young to legally get tattoos.
If a “girl” is to young to get a tattoo then she is too young to get transition medications without parental consent. I have to believe that parents do not provide that consent without consulting with qualified clinicians whose first task is a diagnosis.

If you agree that parental consent is not gratuitous then this entire narrative falls apart.
Later on:
According to Sasha Ayad, who works exclusively with gender-dysphoric adolescents, many of her clients are unsure they want to be boys, they only know they don’t want to be girls.
Sasha Ayad is most certainly unqualified to treat adolescents with gender dysphoria. She has neither the training nor experience to do so. I also believe that she is rather stupid but that's just my opinion.

From absurd to arrogantly preposterous:
Cause for Hope

But Shrier does not leave us without hope. She encourages detransitioners as they settle back into themselves, as well as those questioning whether to start the journey home, that wholeness can be found again. She shares wisdom that will benefit all parents, including the recommendations to “reintroduce privacy to the home.”
Shrier hasn't the skills, training or experience, to render advice to anyone regarding their sexuality. She has no “wisdom” to share in that regard.
My advice to parents remains the same
  1. Find a qualified and board-certified clinician to evaluate your child; someone who has experience in this area.
  2. Find another qualified clinician to render a second opinion.
The Christian right has tried to scare people away from qualified doctors. They claim that a qualified doctor will invariably cause a child to be transgender.

Nothing could be further from the truth! I communicate with enough of these people to know that they care deeply about kids. They have no agenda other than using their best medical judgment.

The Christian right will imply that they have an economic incentive. Lloyd does just that. That's just another helping of BS. The Christian right will do anything to prevent someone from becoming transgender because their existence creates a conflict with scripture.

Jean C. Lloyd's outlet is the blog of Witherspoon Institute. The president of Witherspoon, Luis E. Tellez, is a celibate Opus Dei numerary. The blog is edited by Ryan T. Anderson who is a dedicated and vigorous defender of the faith (who happens to lie all the time).

All of these people, including Jean Lloyd, are lacking in integrity. They are placing a faith-based belief system ahead of evidence-based medical science. I don't know what Abigail Shrier's agenda is. Perhaps it is just to make money. There is nothing wrong with that. Nevertheless, her agenda is certainly not about the best interests of children and adolescents.

Disclaimer: I have not read Shrier's book. I would not want her to profit by as much as a nickel off of her transphobic treatise.

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