usa

With a name sounding more like something out of a sci-fi film, the US National Institutes of Health in partnership with former medical leaders of transgender industry group WPATH (World Professional Association for Transgender Health) have formed “TransNet”, a research consortium merging commercial, academic, and government interests in data collection, funding, and regulation of the medicalization of gender. The project aims to set the groundwork for the mainstreaming of transgender medical care by conducting research that supports the practice.

Recent Obama administration changes to Medicare/VA/IRS regulations allow for taxpayer subsidized cosmetic breast implants, facelifts, genital re-shaping and off-label drugs as treatment for transgender individuals. These patients seek to alleviate distress caused by possessing what they believe are innate psychological or mental traits related to the reproductive biology of the opposite sex. The goal of the treatments is an attempt to create the appearance that their bodies are the opposite sex: the sex the patient believes is congruent with their experienced personality traits. But such interventions (and beliefs) have no established scientific rationale. While there is indeed a political will behind performing these treatments, a very profitable medical/psychiatric/therapeutic industry to accommodate them, and an increasing number of patients demanding the treatments, there is an absence of science to support them.

Self-diagnosed consumer-driven “pathology” that mainly afflicts objectively healthy patients seeking off-label care has been a boon for providers and suppliers such as cosmetic surgeons, pharmaceutical companies, rogue physicians and gate-keeping therapists but there comes a point- say, when government bureaucrats become involved, that certain boxes need to be checked and forms filled out.

None of the only fifty or so “sex-change” surgeons worldwide that provide genital reconfiguring for this population accept Medicare reimbursed clients. And why would they? Their specialty has thrived as an underground economy. Their procedures are incredibly risky with high rates of complication. Long-term outcomes are, objectively, poor. Yet their clients will pay through the ear, and sign waivers to boot, and are lined up on waiting lists.

You would think surgeons would be clamoring to get aboard this gravy train but they aren’t. New York State and Massachusetts provider networks have been aggressively recruiting surgical providers for over a year since their states’ Medicaid began covering these procedures, to no avail. The only surgical group that stepped up in California when the Department of Corrections mandated the high-profile state-funded surgery for incarcerated murderer Jeffrey “Michelle” Norsworthy was Brownstein and Crane, whose practice specializes in bilateral mastectomies for healthy genetic females who believe their personalities are in conflict with their secondary sex characteristics.

The mainstreaming of medical body modification for those who clamor to look like members of the other sex has outpaced the usual steps that precede any generic medical care: basic scientific research. While authorities in medicine, government, and the highest courts have jumped on an opportunity to “correct” those who struggle at conforming to social sex-roles (not coincidentally rolling-back decades of gains made by the women’s liberation movement), they did so using the aegis of WPATH, the World Professional Association of Transgender Health, a transgender industry lobbying group comprised of two groups: those who seek such body modification and those who make a good income providing it.

WPATH had never based their suggested practices on any scientific study, which was unnecessary to represent the interests of their two codependent groups of constituents. The American Psychiatric Association however, who invented the pathology of Gender Identity in the first place, lurched awake in 2008 after thirty years of slumber and decided that maybe now was the time for some follow up to their Diagnostic and Statistical Manual GID (Gender Identity Disorder)/ GD (Gender Dysphoria) diagnosis. Some sort of data or guidelines related to the care of this population would be appropriate, in light of the explosion of numbers of patients now presenting with this diagnosis. WPATH, whose last transgender “Standards of Care” had been issued in 2001, realized that they needed to start presenting themselves as an evidence-based authority. They publicly resolved to create new, updated, plausibly authoritative Standards, this time including research citations.

But there was no science. The WPATH board was infested by grifters such as Randi Ettner,PhD who specializes in pseudoscientific “energy” and “body meridian” psychology and her husband Frederic who runs a family practice for anti-vaxxers and sponsors testosterone mills (“Low T?”) for men desiring rejuvenation.

In 2009 two mainstream doctors, both providers to transgender clients, saw the pseudoscientific writing on the wall and attempted to stay the inevitable WPATH disaster. They collaborated to produce a document pointedly suggesting evidence-based revisions to the WPATH standards of care. These physicians were Dr. Jamie Feldman, a family practitioner specializing in transgender care and doctorate of anthropology and associate professor at University of Minnesota and Dr. Joshua Safer, an endocrinologist and associate professor at Boston University.

Their paper: “Feldman, J., & Safer, J. (2009). Hormone therapy in adults: Suggested revisions to the sixth version of the standards of care.” was cited 22 times in the eventual 7th edition WPATH standards of care [PDF].

Despite the efforts of Feldman and Safer, the APA announced they rejected WPATH Standards due to the overall lack of scientific research supporting them, and would begin the long process of formulating their own evidence-based recommended treatment guidelines. The APA issued press releases to calm the resulting panic in the transgender patient population. They affirmed APA support of the Gender Identity diagnosis and their intent to continue authorizing medical body modification services to those so afflicted. “The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups.” 

Doctors Jamie Feldman and Joshua Safer are at the helm of the new NIH TransNet project.

Project Goals at the initial TransNet meeting, “TransNet: Developing a Research Agenda in Transgender Health and Medicine”, which was held this May in Washington DC, included:

“1) further develop a productive transgender health and medicine research consortium that would become a national forum for an evolving comprehensive research agenda in transgender health, as well as a mechanism for interdisciplinary collaboration in research on cross-sex hormone therapies, surgical interventions, STI/HIV prevention, and trans-appropriate primary and mental health care; 2) develop new research methodologies effective in conducting clinical research with transgender people, a stigmatized, vulnerable, and underserved population; 3) develop and use of standardized approaches to data collection, management, and analysis across a variety of clinical and non-clinical settings; and 4) incorporate community engagement in the research process within the structure and function of the consortium, including transgender community advisory representatives, LGBT community health centers, and community engagement procedures throughout the research process.”

Project Number: 1R13HD084267-01 Contact PI / Project Leader: FELDMAN, JAMIE
Title: TRANSNET: DEVELOPING A RESEARCH AGENDA IN TRANSGENDER HEALTH AND MEDICINE

http://projectreporter.nih.gov/project_info_details.cfm?aid=8922636&icde=25266267

One of the interesting implications of the TransNet project is the development of a National Institutes of Health “national database of transgender persons”. From the Daily Free Press:

“Members of the NIH are hoping to develop a national database of transgender people to see what trends appear from different types of intervention. “They want to know what kind of things we could be learning over the next five or ten years depending on how much money is available for research, and the purpose of this conference is to set that strategy and create some priorities for NIH,” [Dr. Joshua Safer] said.”

Such a database has been a long-running goal for Dr. Safer, author of “Out of the Shadows: It is Time to Mainstream Treatment for Transgender Patients (2008)”.

Safer created one himself at Boston Medical Center but due to HIPAA regulations patients were required to give informed consent to being listed in the registry:

“[O]ur work includes the development of a Transgender Health Registry at BMC.  All transgender-identified individuals who have had hormone therapy or other transgender health care management at Boston Medical Center (BMC) who give consent to participate will have their name, date of birth, and medical record number recorded in a registry. By compiling a list of those treated here at BMC, researchers (approved by the Institutional Review Board) will be able to access more complete data when studying the long term effects of hormonal treatment and/or other aspects of care.  It is our hope that by establishing the first BMC registry of Transgender Health, we will be able to better serve individuals who identify as transgender within our community both now and in the future.” [sic]

The coming TransNet national database of transgender people, operating and funded by the National Institutes of Health under the authority of the Department of Health and Human Services, using standardized and regulated data collection, promises to be the most vast and comprehensive pool of research subjects ever studied in the history of the medical industry practice of treating gender.

night-view-from-space

Gavin Grimm

Gavin Grimm

U.S. District Court Judge Robert Doumar rejected the Obama administration’s attempts to eliminate Title IX sex-based protections for women and girls and replace them with social stereotypes based on sex. The ruling came in the case of Gavin Grimm, a sixteen year old girl who believes that people have inborn mental characteristics based on sex, and that she has the personality of a sperm-producing individual. Individuals with this belief system call themselves “Transgender” and consider what they believe to be a mis-match between personality and reproductive biology to be a psychiatric condition.

Grimm believes her personality is one of a biological male, and that therefore she is a male with a female body. She would like to express this belief by using the urinals along with the males in the public restrooms at her school. Transgender adherents also believe that individuals who have personality traits “innate” to the opposite sex should be made to use facilities of the opposite sex that are normally sex-segregated for the protection and privacy of women (locker rooms, sports teams, sleeping quarters, showers, hospital bed assignments, etc.)

The Obama administration also believes in the concept of mental sex, and has attempted to bypass the legislature and judiciary by pushing guidelines through their Department of Education, OSHA, Department of Labor, EEOC, and Justice Department removing sex-based protections for women and girls under Title IX and replacing them with protections for “mental sex”, or “reproductive personality”, or “gender identity”.

The ACLU, with the backing of Obama’s Justice Department filed a lawsuit against Gavin Grimm’s school district, claiming that Title IX sex-based protections should be overridden by the concept of sex-based personality. Specifically they assert that students whose personality does not “match” their reproductive status should use areas of public nudity along with those of the opposite sex. Grimm’s school district sought to accommodate her sex-stereotype beliefs by offering her use of private unisex facilities in several locations throughout the school, but she claims segregating any facilities based on sex discriminates against her self-concept and belief that her brain is reproductively male.

This is at least the second federal ruling that rejects Obama administration attempts to strip Title IX protections from women and girls in order to establish federal guidelines on sex-based personality characteristics.

Here Gavin explains why she believes she is a sperm producing male individual, rather than an egg producing female individual:

“When I was little, I didn’t think of myself as a boy or a girl. I thought of myself as a kid who did what I wanted. When I started school, though, that gender divide became more apparent. I noticed that boys didn’t want to play with me. I had a best friend in elementary school, and one day he just said, “Hey, we can’t hang out any more.” When I asked why, he said, “’Cause you’re a girl.” I was indignant. “What are you talking about?” I asked. “What does that even mean?”

I never, ever, in a million years envisioned myself growing up to be a woman. I don’t think I thought of any alternatives, but I knew for sure that I was not going to grow up and be a woman. When puberty hit, my biggest struggle was not only feeling betrayed by my body, but also the increasing pressure to become a little lady.

It was around this age that my leg hair started growing in — and I did not want to shave it. I loved having leg hair; I thought it was cool! But, my classmates didn’t agree. My mother, of course, put a lot of pressure on me — because I was “blossoming into a young woman” and all that — to conform to feminine archetypes. That caused a lot of conflict in my family relationships. I was a very volatile, angry kid in that time period.

But, I didn’t give up; I just continued refusing to shave or wear dresses. I gravitated towards boys’ clothes. It started slowly: Oh, here’s one Pokémon shirt because I love Pokémon. Soon, I was only shopping in the boys’ section. My mother (and I want to make it very clear that she has come a very, very long way) is Christian. She had a lot of problems with homosexuality, and she perceived me to be a homosexual female because I was very masculine in how I acted and dressed. At one point, she came to me and said, “You’re so angry, and I know why.” I said, “Wait, you do?” And, she said, “You’re a lesbian.”

I was about 11 or 12 at the time. And, I knew I liked girls, but I’d never, ever, ever identified with the term “lesbian” — calling yourself a lesbian means asserting yourself as a woman, and I didn’t want to do that. I wanted to live in that gray area where I didn’t have to say that I was anything. So, the conflict started again. Apparently, being a lesbian doesn’t excuse you from shaving your legs.”

Transgender Flag: Blue is for boys, Pink is for girls

Transgender Flag: Blue is for boys, Pink is for girls

“My rights are being dismissed for his rights”

Southern New Hampshire Medical Center in Nashua, targeted by Laughton

Southern New Hampshire Medical Center in Nashua, targeted by Laughton

From the Union Leader:

 “By KIMBERLY HOUGHTON


Union Leader Correspondent

March 12. 2015 11:45AM

NASHUA — Stacie Laughton, the state’s first openly transgender legislator who was elected to the House of Representatives and then withdrew her candidacy days later, said Thursday that she is the person responsible for calling in a hoax bomb threat at a local hospital.

After spending two weeks receiving treatment at a Vermont hospital for bipolar disorder, Laughton walked into the Nashua Police Department at noon on Thursday and turned herself in on a warrant for the Feb. 27 incident.

“I have had a mental illness my whole life, and I guess this was my worst break with it. I was untreated for a long time, and I didn’t have medication,” Laughton told the New Hampshire Union Leader, adding she is very remorseful for her actions.

Laughton said she was not in the right frame of mind when she called in a bomb threat to Southern New Hampshire Medical Center around 8:30 a.m. on Feb. 27. Laughton, who also suffers from post-traumatic stress disorder, described feelings of extreme impulsivity when she made the phone call.

“I wasn’t trying to hurt anyone, and it was totally out of character for me. I have put a lot behind me, and I never thought I would do this in a million years,” she said.

Laughton is expected to be charged with a felony for calling in a fake bomb threat, which prompted a systematic search of the hospital by local authorities and hospital security.”

MORE: Read the rest of this entry »

CPL_ad_113014

GLBT and liberal media pundits scrambled today to refute an ad sponsored by the right-wing Child Protection League group, but found themselves unable to produce a single point of contention. The paid ads were published in multiple Minnesota newspapers (Star Tribune, St. Cloud Times, Duluth News Tribune, among others) yesterday and claimed that the proposed transgender policy for student athletes will:

 

  1. Allow boys and young men to compete against girls and young women for limited slots on female sports team rosters.

 

  1. Allow boys and young men to compete “as females” on girls and young women’s sports teams based on nothing but declared “gender feelings”.

 

  1. Allow boys and young men to access girls and young women’s school showers and locker rooms previously sex-segregated to protect the privacy of girls and young women from vulnerability in areas of public nudity.

 

Unfortunately for transgender advocates, all of the claims in the ads are true. These are exactly the desired effects of the proposed policy.  In fact, these are the outcomes the proposed policy is designed to achieve. Multiple liberal news outlets and writers are calling the right-wing ads “misleading” but not a single one has produced a statement outlining why. Because they can’t.

Media Matters calls the ads “misleading” (six times), and “false”, but fails to explain why, instead calling the ads “hurtful” (to the feelings of males), “based in ignorance” (although they don’t explain why), and “fear-based” (of what, they do not say). The total lack of rebuttal is remarkable… unless you read the policy, which actually does allow male students to do all the things the ad states.

 OutFront Minnesota, the GLBT lobbying group accuses the ads of “spreading misinformation and fear” but offers no correction or rebuttal (because there isn’t one). Instead they frame the ads as “attacking transgender youth”. Presumably they mean transgender MALE youth, because forcing transgender FEMALES to compete against male-bodied persons -or to choose between their transgender identification and their participation in female sports- is the result of this policy. The policy under debate broadens rights for males only, and decreases the rights of all females, including those who identify as “transgender”.

Pink News, no rebuttal. Because there isn’t one.

The so-called “LGBT Sports Coalition”, a nebulous Nike, Inc. funded organization “composed of thirty organizations and individuals” helmed by transgender “male lesbian” and ESPN reporter Christina (Chris) Kahrl was quoted in the New York Daily News calling the ads “controversial” “hateful” “fear-mongering” and “pushing out false facts” but again failed to present a rebuttal to the accurate claims made in the ad.

You can read some of the disgustingly anti-lesbian and hideously sexist output of the Nike-funded ESPN journalist and “male lesbian” Kahrl’s group here: http://www.outsports.com/2014/11/12/7197635/tina-hillman-shot-put-iowa-state

(Quote: “athletes like Venus and Serena Williams, Brittney Greiner and Layshia Clarendon have blazed their own trails, finding success and stardom by simply expressing themselves and their creativity with every thread of clothing they wear.

Stereotype dictates that shot putters be massive, masculine athletes – something out of a Hans and Frans sketch. The women in the sport are overweight, wear short, “butch” haircuts and have sweatpants permanently attached to their hips.”)

Ugh! Homophobic and sexist! What are you thinking ESPN and Nike?!

NBC Sports writer Aaron Gleeman wrote that the ads were “misleading, bigoted” on Twitter but was unable to articulate why. I asked him myself. Several transgender activists responded that biological sex should be determined by hormone usage, but medication is not a factor, or even mentioned in the proposed juvenile athlete policy. Which I guess means that even transgenders reject this policy. And why would trans activists think it would be a good idea for kids to be pressured to take unnecessary medication as a qualification to play school sports? One transgender activist even tried to convince me that sexually dimorphic reproduction in mammals, including humans, is a myth. Oh my!

Lesbians and Feminists obviously don’t support the anti-gay and anti-woman agenda of the right wing, but we can certainly spot a sexist, lesbophobic policy designed to infringe on the rights of girls and young women when we see one. One designed to erode the rights of female student athletes, including females who “identify as transgender” (Title IX already allows female athletes to compete in male sports if they qualify, regardless of “gender feels”). This policy does nothing but restrict their right to compete.

Lesbians and Feminists and those who support us can also spot the Nike-funded ESPN-style sexism of a policy that limits participation in women’s sports by adherence to what is now apparently about to be state-sanctioned sex stereotypes.

It seems the simple solution – and one that is fair for females as well as males- is to prohibit discrimination against transgender student athletes who wish to compete in sports. That is to say, for example, that males who “identify as” transgender should not be kicked off of the football team because they have long hair or paint their nails or believe that folks have a “mental gender”. Female athletes should not be forced off female teams because they reject the female “sex role”. Not only is that a progressive, feminist view, but it allows all students to compete equally and fairly. Including the female ones.

.

surgery

 

Less than 50 physicians worldwide are willing to provide transgender surgical “sex reassignment” or “sex change” procedures, and as the few existing practitioners retire, no one is replacing them.  Modern cosmetic and reconstructive surgeons at large are opting not to do these procedures, even when they are state mandated and funded.

Now, insurers are struggling to fulfill state mandates covering transgender surgical procedures for men that are excluded for women based on sex discrimination. Transgender state medical mandates pushed by lobbyists insist that procedures such as breast implants and “face lifts” are medically necessary for men who wish to look more like women, while denying coverage for those same procedures to actual women. Transgender advocates have successfully lobbied for such government provided “care” on the grounds that without such procedures men may become depressed or abuse alcohol or other substances, and that such men have a state-protected right to avoid being mocked or socially ostracized for their appearance. Males must declare a “transgender identity” to receive coverage.

From the Boston Herald:

 

Insurers unsure on transgender care

Meanwhile patients unable to find docs for procedures

Thursday, October 30, 2014

Marie Szaniszlo

 

 Four months after the state Division of Insurance put health plans on notice that denying medically necessary treatment to transgender people is prohibited sex discrimination, insurers are still grappling with what constitutes medical necessity, and patients are struggling to find doctors who’ll treat them.

In a state world-renowned for its medical talent, no Massachusetts physician performs genital gender reassignment surgery, said Elizabeth M. Murphy of the Massachusetts Association of Health Plans.

“We were concerned people were having to go all over the country for this surgery,” Dr. Joel Rubenstein of Harvard Pilgrim Health Care said yesterday at a Division of Insurance informational session. “We’re hopeful somebody would step up to put together the surgical piece so it could all be in one place.”

Under state law, health plans are required to develop evidence-based medical necessity guidelines for such procedures.

“We are determined to … not exclude treatment for this condition,” Rubenstein said.

On the other hand, he said, Harvard Pilgrim does not want to approve procedures such as facial feminization for transgender people if those procedures would be considered merely cosmetic for other people.

“If we cover them for transgender patients, we would be being reverse-discriminatory,” said Dr. Robert Nierman, medical director at Tufts Health Plan.

But Ruben Hopwood of Fenway Health said facial feminization is not about wanting a “cuter nose.” A transgender person’s appearance is more likely to be the difference between getting a job or not getting one, and walking down the street unafraid or being attacked, Hopwood said.

Getting the proper treatment also can save money that might otherwise be spent on treatment for alcohol or substance abuse or depression, said Pam Klein, a nurse at Boston Health Care for the Homeless.

 

[bolding by me-GM]

 

 Dr. Sherman Leis hugs a child whose healthy reproductive system and genitals were surgically removed at the age of 16 [Philadelphia Inquirer]


Dr. Sherman Leis hugs a child whose healthy reproductive system and genitals were surgically removed at the age of 16 [Philadelphia Inquirer]

In the UK, Children as young as three years of age are now being admitted to state medical clinics for “corrective treatment” of sex-role noncompliance, with the aim of upholding social norms of gender and to prevent the development of “visibly transgendered” adults. Such treatments involve administration of drugs which halt normal child development (“Puberty Blockers”) followed by the lifetime administration of cross-sex hormones, resulting in sterilization. In the US, the first federally-funded state eugenics program in over thirty years will be launched in Oregon on October 1, 2014, specifically targeting pre-pubertal children deemed by parents and providers to be “transgender”. Surgeons now routinely perform complete “Sexual Reassignment Surgeries”: removing the genitals and reproductive systems of children as young as sixteen.

 

The following are excerpts from an interview featured in this month’s issue of LGBT Health Journal, discussing the “Current Practice and Future Possibilities” of sterilized transgender children:

 

Dr. Eyler: So there are treatments for trans adults who want to become parents. Would the two of you like to discuss the needs of transgender youth, particularly children who may not complete pubertal development in the natal sex, and possibilities for future fertility for them?

Dr. Pang: My experience has been only with postpubertal individuals. The youngest transgender person whom I have treated was 22 years old, so I do not have any experience with children who are either early postpubertal or prepubertal. I think that more transgender young people are becoming interested in potentially being parents. Last year, I was contacted by the mother of a transgender teenager, a 15-year-old transgender son. Her son is interested in fertility preservation; they had questions so I explained to them what it would involve. The technologies that I have to offer are useful only for postpubertal youth, such as someone his age, but I am sure that you, Anderson, might have ideas about how to help prepubertal children.

Dr. Clark: In the trans community, more and more trans youth are being treated at younger ages, such as at Dr. Norman Spack’s clinic at Children’s Hospital in Boston. Some gender variant children are treated with puberty suspending medications, GnRH analogs, similar to the treatment of children who are experiencing precocious puberty. This keeps them from going through the full puberty of the birth sex, spares them from developing secondary sex characteristics that are misaligned with their psychological gender, and gives them some time to mature.

Dr. Eyler: Cognitively and emotionally.

Dr. Clark: Yes, to be able to decide, when they get older, whether they want to medically transition. Some gender variant children are not actually transsexual or transgender as such, and will eventually decide to stop treatment and experience the puberty of the birth sex. Others, with the support of their parents and clinical team, find that they need cross-sex hormone treatments to proceed with the puberty that is aligned with their gender.

The Endocrine Society Guidelines1 support puberty-suppressing treatment beginning as early as Tanner (sexual maturity rating) stage 2, so this can precede significant hormonal and sexual development. Some adolescents, therefore, don’t develop the ability to produce viable gametes (eggs and sperm). Adolescent trans girls may lose fertility from estrogen treatment, even if they developed the ability to produce sperm before this was started. When they reach the age of majority, trans youth may also proceed with gender-affirming surgery that includes removal of the gonads.

For children and young adolescents, it is often the parents who are thinking about future reproductive capacity, because they would like the possibility of grandchildren, and because they are looking after the future interests of their children. When I speak at community conferences, they often come to ask about reproductive options for their children.

Dr. Eyler: Yes, and as a biologist, you are prepared to discuss the significance of the gametes not maturing and what future reproduction might involve.

Dr. Clark: Yes. The most applicable research has been performed on behalf of children who are treated for cancer and are rendered infertile. The Society for the Preservation of Fertility focuses on the needs of both postpubertal and prepubertal youth who may experience sterility from cancer treatments.

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