Wednesday, September 9, 2020

What the Hell is "Gender Dystopia?"

D. Paul Sullins
Rev. D. Paul Sullins of Ruth Institute
Circa 2018 image via YouTube
An email Wednesday from anti-LGBTQ hate group, Ruth Institute, brings renewed attention to a dishonest September blog post titled: American Journal of Psychiatry Corrects Pro-Transgender Surgery Study. The primary author is Rev. D. Paul Sullins.

I have written about the subject correction before. In sum:
…the conclusion that “the longitudinal association between gender-affirming surgery and lower use of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them” is too strong.
In other words, just because someone wants the surgery doesn't mean that someone should receive the surgery.

Orthodox Catholics have a serious problem with transgender people. Mark Regnerus has written about this study. So has Ryan T. Anderson. Now it's Sullins' turn.

Sullins is perhaps best known for publishing anti-LGBTQ “research” to vanity journals in the Third World with scant peer-review processes. Sullins is a married priest who retired from a professorship at Catholic University to take a position at Ruth Institute.

According to Sullins:
We’re pleased that the American Journal of Psychiatry has issued a rare public correction of serious errors in a study promoting so-called gender-reassignment surgery it published last October.
The article did not “promote” gender confirmation surgery. It confirmed that the procedure improves the quality of life. This conclusion is consistent with numerous other studies.

The following is a very small sample:
Sullins continues:
The Journal now acknowledges that, contrary to what was reported earlier, the study does not show that those undergoing such surgery had improved mental health. Specifically, it does not show that these patients were less likely to suffer from mood-anxiety disorders, based on reports of fewer hospitalizations or less use of prescription drugs.
The correction actually says:
… the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison.
Aside from being contrary to a large body of peer-reviewed research, Sullins fails to mention:
  • This was a study of Swedish individuals. The requirements for the surgery in the United States are far more stringent. Candidates require two behavioral health referrals and must have a minimum of one year “real life experience” (living as their gender).
  • Mental health was evaluated in 2015 rather than longitudinally as a span from surgery. That produces an inherent contradiction. Two people would have vastly different mental health if one had surgery in 2006 and another in 2015.
  • The study did not adjust for age. People who have surgery early in life tend to have better outcomes than people who have surgery later in life.
  • The study did not consider changes in diagnostic criteria over the study period (2006 to 2015).
Sullins is a bent researcher but he does know (far better than I) how to evaluate research. He doesn't raise any of these issues. Among his observations is this:
The authors of the study sought to generate (in their words) support for policies that ensure coverage of gender-affirming treatments,” ignoring many elements of the data that invalidated this conclusion. In fact, an earlier, more rigorous, study of the same data had shown that the risk of suicide following sex reassignment surgery was over 10 times that of the general population.
Sullins does not cite what study he is referring to. My guess is another study out of Sweden which evaluated surgical recipients who had the procedure between 1973 and 2003. Yup. People who had gender affirming surgery 47 years ago and probably later in life had their problems.

In fact conditions for the subjects who had the surgery most recently (2003) were vastly different from what they are today, 17 years later. The conclusions of that study were that transgender people required better counseling after surgery. Sullins is suggesting that the conclusion was to eliminate the surgery.

The dishonesty continues:
For what’s called the Transgender movement, science is frequently distorted in the service of ideology. The results can be catastrophic for individuals and their families.

Pre-teen patients are often subjected to treatment to get them to assume the physical characteristics of the opposite sex. Dr. Sullins charged: “Instead of helping them to feel comfortable with the bodies they have, those suffering from gender dystopia are treated with hormones and surgery to get them to resemble the bodies they do not have.
Ruth Institute fails to cite any research to support the claim of “catastrophic” consequences. Nor do they point out supposed flaws in any other research. Furthermore, yet another religious conservative is promoting “ideology” bullshit.

As for pre-teen patients, some (perhaps most) are prepubescent. Some are post-pubescent and might be receiving puberty blockers. None are likely to be receiving cross-sex hormones and none are candidates for surgery.

Those who are receiving puberty blockers do so to prevent the development of secondary sex characteristics which are difficult or impossible to reverse and can cause considerable distress. A trans boy does not want to develop female breasts. Puberty blockers are fully reversible according to the Endocrine Society.
Suppressing puberty is fully reversible, and it gives individuals experiencing gender incongruence more time to explore their options and to live out their gender identity before they undergo hormone or surgical treatment. Research has found puberty suppression in this population improves psychological functioning. Blocking pubertal hormones early in puberty also prevents a teenager from developing irreversible secondary sex characteristics, such as facial hair and breast growth.
This is rich:
“Based on multiple scholarly complaints, the Journal had the integrity to reexamine the study and issue a correction,” Sullins remarked. “We wish everyone dealing with these studies showed the same willingness to view the matter objectively and admit mistakes.”
Sullins should follow his own statement. The suggestion that Sullins views science “objectively” is ludicrous. He publishes articles intended to conform science to Church teachings. Moreover, he does not publish to journals with the intellectual heft to request a correction.

If you think that either Ruth Institute or Paul Sullins is interested in the well-being of gender-diverse people you would be wrong. Their only interest is to support the teachings of the Catholic Church.

Belief systems are based on faith. Science is supposed to be based on evidence. Sullins attempts to merge the two with predictable results.

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