September 25, 2016
By Dr. Kelly Winters, Ph.D., member of the International Advisory Panel for the World Professional Association for Transgender Health (WPATH) Standards of Care:
WPATH: clarify and correct the childhood “desistance” myth statement in the SOC7
WPATH: Issue a public policy statement discrediting the practice of gender-conversion psychotherapies that is consistent with the SOC7
APA: clarify and correct the childhood “desistance” myth statement in the DSM-5
APA: remove “Transvestic Disorder” category from the DSM-5
WHO: initiate substantive conversation on converging the Adult/Adolescent Gender Incongruence categories in the proposed ICD-11 with the childhood category to refute the historical stereotype of childhood gender “confusion” and practice of gender conversion psychotherapies
US Dept. of HHS: align transition related categories in ICD-10-CM to ICD-11 in 2018
US Dept. of HHS/CMS: issue a National Coverage Determination for surgical transition care that is recognized as medically necessary by US and international medical authorities
From here: https://gidreform.wordpress.com/2016/09/19/gender-madness-in-psycho-politics-transgender-children-under-fire/
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|
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.
November 11, 2014
We’ve all seen the television shows and news reports on “Transgender Children”. They all state that “Nothing permanent is being done to children before the age of consent! Oh gosh no!”
Here’s a typical example of this rhetoric from yesterday’s Irish Examiner:
“Young children don’t need treatment yet,” explains Lacey. “They can make a social transition at home and at school. But older children may need hormone suppressors to delay puberty for a while. This gives them and their families breathing space to decide what’s best for the future.”
Hormone suppressors ((known as anti-androgens) delay the development of breasts, facial hair and other secondary sex characteristics. Males who identify as female take anti-androgens to block testosterone while females identifying as male take anti-androgens to block oestrogen.
“These suppressors are 100% reversible,” says Lacey. “Young people resume puberty if they stop taking them.”
The article continues:
“Prescribing cross-sex hormones is taken more seriously than hormone blockers. Teenagers must have socially transitioned and be aged over 16 to qualify.
“We have to be sure it’s the right thing to do,” explains Dr Brinkmann. “Cross-sex hormones have irreversible effects on fertility. There’s no going back.”
Guidelines from various pro-gender lobbying and medical groups back up this claim. The Endocrine Society states that no child under the age of sixteen should ever be administered cross-sex hormones by physicians under “parental consent” for the purpose of physically disguising the reproductive sex of the child to promote gender conformity. Even WPATH, the powerful pharmaceutical-industry funded transgender lobbying group acknowledges that decades of research show the majority of children who claim a “cross-sex identity” do not mature into transgender adults if left untreated, and in fact many grow up to be well-adjusted lesbian and gay adults. WPATH also states that children under sixteen should not be given cross-sex hormones which cause permanent changes (including sterilization). None of the “transgender children” clinics in the Netherlands, which pioneered the practice, have ever administered cross-sex hormones to children under sixteen. In the UK, parents who desire to have their children placed on puberty blockers (which paralyze the pituitary gland) must meet strict guidelines and be entered into a government research protocol. Cross-sex hormones are not administered prior to the age of sixteen. In Australia, a court order is required to provide “blockers” in an attempt to formalize oversight of these practices and protect children from abuse.
In the United States, however, it is coming to light that “transgender children” physicians, (that is, the doctors who have been championing and pioneering this practice without oversight), have been “going rogue” since the very start, ignoring all research and guidelines and pushing the limits of what the human bodies of these gender-nonconforming children are medically able to endure.
Last month, in a program specifically addressed to medical students, Dr. Johanna Olson, director of the LA Children’s Hospital transgender children clinic, admitted that she has been “skipping the blockers” and placing children as young as twelve directly on cross-sex hormones, starting with her very first patient. Read the rest of this entry »
Sheila Jeffreys “looks more than a bit like a man. She’s about four shots of testosterone away from passing as one”. When men review ‘Gender Hurts’
June 12, 2014
Two new reviews of ‘Gender Hurts’ today, both from men, one of whom has actually read the book.
The first is from Dallas Denny, who previously campaigned with Jamison Green, the President of WPATH (World Professional Association for Transgender Health, a medical lobby funded by the pharmaceutical industry) in an attempt to censor the publication of this book BEFORE IT HAD EVEN BEEN AUTHORED.
Denny opines in today’s first offering:
“[Managing Director of Books Jeremy North of Routledge Press] suggested we could review the book after it was published. And now I’m doing just that. Or, rather, I expect I will, if ever I can bring myself to read it. What follows is not a thorough review, but an impression based on a lookover of Gender Hurts.
Interestingly, the page count of Jeffreys’ book is almost the same as Raymond’s; at 189 pages it weighs in just four pages longer than Raymond’s 185.”
Aah, yes, the page count. And what of the paper quality? How much does the book weigh? Does it have that “new book smell”? What was the cost of the shipping freight?
Angry men should never feel obliged to read a woman’s words before forming strong opinions about them, and subsequently publishing those very important opinions. All that female-impersonator Denny needs to do is look at the book cover to conclude that Jeffreys “adopts a lesbian uniform that makes her look more than a bit like a man. She’s about four shots of testosterone away from passing as one.” How can men possibly take the time to read the books they are reviewing when the author is lesbian, and fails to adopt a distinctly sexay laydee wardrobe requirement?
Read more of Denny’s devastatingly insightful review of a book he has not read here:
Today’s second review is by another man, who in this case claims to have actually read the book he is reviewing. In a New Statesman piece Tim R. Johnston generously offers that feminists have the right to critique males but “that critique must come from a place of established respect.” Jeffreys has dismally failed to respect men in her feminist text, says Johnston. LOL!
“The entire text is a striking example of how not to criticise a group [men] of which you are not a member.” Insensitive, man-hating feminist dyke! In one succinct sentence Mr. Johnston places Jeffreys’ text into the entire canon of the history of the Women’s Liberation movement, on which he claims to be an authority: “The book is poorly researched and argued, and is not a meaningful contribution to feminist theory.” Oh, Okay bro.
Johnston suggests that women abandon women’s liberation and release ourselves from our “attachment to our sex”; By doing so (Stupid cunts! Why haven’t we thought of this ourselves!) we will..something… something …something.
“When we abandon our attachment to either sex or gender identity we can more clearly see the experiences we share and let those experiences form the basis of a coalition.” Okay bro.
The important thing is that men who take pleasure in sex-roles should be prioritized over the actual violence and subjugation of women.
“Trans women [men] may identify as women, but they are not women because they do not have the lived history of having been born and raised as women. Identity cannot replace or change your history of living as one of two biological sexes. Feminists have good reason to be attached to this foundation. Women are violently persecuted because of their sex, and the methods of that persecution, methods like rape and forced reproduction, often involve female anatomy. Uniting in this shared history is an important foundation for feminist consciousness raising and solidarity.
Many [male] people ground their politics in gender identity, describing how this identity is a persistent aspect of their experience. Cisgender people [women] must realise that a [male] woman did not become a woman after transitioning, [he] has always been a woman, and because [he] is a woman [he] deserves access to women-only spaces. Certainly not all [male] people identify as having always been one gender, but focusing on gender identity over biological or assigned sex is an important way to ensure that [male] identities are not discredited, ignored, or marginalised.”
Jeffreys’ work, which is not meaningful to male feminism, discredits, ignores, and marginalizes male feelings and the access to women that males deserve. Oh gosh no!
Okay thanks guys! Thanks for clearing up the whole female oppression thing! Problem solved (for you)!
October 24, 2013
The following is a list written by a detransitioning woman outlining the missing factors in the care they were provided by medical practitioners, advocates, and the trans-supportive community at large.
Much lip service is paid in transgender political lobbying around the difficulties in accessing “care” for transgender people. Yet this “care” is profoundly, singularly directed towards modalities that proscribe misogynist, heteronormative, and indeed transphobic(!) adherence to sex-based gender roles and the pathologization and medicalization of sex-role nonconformity.
Increasingly, this narrow focus of “care” is being directed towards children as young as 18 months old who are being diagnosed as medically disabled and “gender defective” and are celebrated as such for their “bravery” in the face of developmental sex-role deformity by the mainstream LGBT community as if they were contestants in a queer “special gender olympics” version of Toddlers and Tiaras.
What of the individuals like Nathan Verhelst for whom such treatments abysmally fail to diagnose or cure? What treatments are available for gender dysphoric individuals for whom cross-hormone and cosmetic surgical options are medically contraindicated? What “care” is available for those many individuals suffering after “transition”?
When Joel Nowak of Retransition.Org contacted WPATH (the premier medical lobbying group for transgender psychiatric and medical care) regarding resources and information for those who need to discontinue cross-sex hormones for various reasons they were told that WPATH had “no idea”. NO IDEA. “That is a very good question” he was advised. This organization has presented itself as the worldwide cutting-edge authority in medical and therapeutic treatment for transgender individuals for decades, and is recognized as such by legal and medical and governmental agencies globally. Yet they had “no idea” how to advise transgender medical consumers on how to safely desist cross-sex hormone therapy, and “no idea” where to refer such transgender persons.
While continually citing the suicidality, morbidity and psychiatric and medical emergency of gender dysphoria, the carers and advocates for transgender persons- including those of the highest professional, therapeutic, academic, political and activist standing- have decided that care should be confined to those who can (and want to) medically and psychologically tolerate gender normative “treatment” and all other transgenders who suffer from sex or gender dysphoria can literally be damned.
Transgenders who medically detransition, or whose dysphoria is uncured after “treatment” – and the percentage is large- are not only completely rejected from care but are shunned, and even attacked by those claiming to promote care for sex and gender dysphoric (transgender) persons. Supportive medical and therapeutic care for these particular transgenders is considered non-imperative as their distress is deemed inconsequential and their experiences and outcomes disposable.
Below is the list provided by a detransitioning woman (now negotiating medical and social de-transition without care or support, because none exists) listing the elements that she identifies as missing in her pre-transition care.
Sadly, this woman has been subjected to a barrage of harassment and intimidation by individuals (also identifying themselves as transgender) who want to silence any sex or gender dysphoric individuals who share information on gaps in existing care for transgender people.
Anyone who is genuinely concerned about providing care for transgender individuals – perhaps especially families struggling with “transgender children”- would do well to take note of the items on this list.
From her post:
“As someone who views transsexualism as a medical condition, I believe everyone should exhaust other alternatives and transition only as a last resort. That is what I did. The thing is, I didn’t have the resources to utilize that I could envision in a better world. Transition was the best option at the time for me, but I can think of a lot of things that would have allowed me to make a better decision. Some of these things are:
– Knowledge of the existence of detransition
– Realistic, accurate, and honest information about detransition
– Visibility of detransitioned folks sharing their story
– Information on alternative options for dealing with dysphoria such as meditation and exercises to re-align my self of self with my body
– Knowledge of radical feminism
– Knowledge of how trauma can influence one’s sense of self
– Trained, knowledgeable support for my trauma
– Someone to guide me into addressing my trauma, instead of letting me go through therapy thinking it really didn’t affect me in any significant way
– Better role models to look up to who exemplify living confidently as a gender non-conforming woman
– More accurate information on the effects of testosterone
– Honest discussion on the mental effects of testosterone
– Parental support in being gay
– Parental acceptance of my being gender non-conforming
– Better support by non-parental figures in being gay and gender non-conforming
– Knowledge of how deeply misogyny can affect females
– Acknowledgement and information about internalized misogyny within the FTM spectrum
“Last resort” is a misleading phrase here. I think virtually all trans folks are in a compromised position where better resources could be available, but are not. Detransition has been entirely taboo to talk about anywhere. It has been dismissed by trans folks and framed as cautionary bullshit coming from transphobic people. That one aspect alone puts anyone considering transition at a significant disadvantage if they are ignorant of the possibility of detransition.
Am I against transition altogether? Until these sorts of support and resources are available to the majority trans people, that question does not apply. We do not live in a world where these things are prerequisite to transition, so how could anyone know if transition would still be necessary if better support and resources were available? Sexual trauma is completely ignored as an influence of transsexuality by most therapists in an effort to be “PC”, and that is appalling.”
Read the rest of her post and more of her thoughts here: http://twentythreetimes.tumblr.com/
[Bolding by me not the author- GM]
The American Psychiatric Association (APA) has never issued any resource documents, treatment guidelines, or position statements on transgenderism since they inserted transgenderism as a pathological diagnosis into their DSM following the de-pathologization of homosexuality over thirty years ago.
Although the diagnosis of Gender Identity Disorder was created by the APA and the practice of medicalizing social sex roles is largely carried out on the authority of the APA’s professional membership, up until this point the psychiatric establishment has deferred to WPATH (World Professional Association for Transgender Health).
WPATH guidelines for psychiatric/medical/surgical “treatment” of “gender” have never been based on any research or study into the treatments they advocate. Instead, the guidelines were created by those interested in making a living off the burgeoning gender treatment market. As the practice of genderiam explodes in popularity (some clinics showing a doubling of business ANNUALLY) tension between the APA and WPATH has grown.
In April 2011 the APA formed a Task Force to evaluate transgenderism and issue recommendations for the formation of the APA’s own treatment guidelines and resources, which would remove APA members from practicing under WPATH guidelines and introduce professional standards based on actual medical research. WPATH responded to APA concerns (and the impending breach in WPATH authority) by attempting for the first time to attach research citations to the most recent version of their treatment guidelines (version 7), issued in September 2011. [PDF here: http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf%5D
As expected, the updated WPATH standards of care guide offered no pretense of objectivity or professionalism and reads as more of a genderist political manifesto. Citations attached were cherry-picked to support the WPATH political platform, many attached haphazardly. Indeed, WPATH 7 even uses previous (scientifically unsupported) versions of it’s own guidelines as a citation supporting the new ones! Kind of a big no-no. WPATH’s badly implemented strategy to introduce citations was inadequate to halt the momentum of the APA Task Force’s move to break from WPATH’s authority.
The APA Task Force issued their findings Monday in the 28 page “Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder” that you can access as either HTML or downloadable PDF here:
Here are a few random excerpts followed by the Task Force recommendations: