Throughout the western world, so-called gender affirmative therapy for minors (puberty blocker followed by cross-sex hormones and surgery) has long been the subject of heavy criticism from doctors and experts, some of whom regret having prescribed it, pointing out its dangerousness and ineffectivenessSomeone said that in the future we will talk about it as one of the biggest scandals in the history of medicine, comparable to the use of lobotomy on 50,000 psychiatric patients in the USA in the middle of the last century. After the UK, Sweden and the whole of the Great North, Australia, there are curbs on trans-treatment for minors also in the USAwhere new research shows that affirmative therapy does not improve -nay, worsens- the psychological and physical state of treated minors and where the first lawsuits by young detransitioners against the doctors who prescribed them these 'therapies' and even against the AAP, the American Paediatricians Associationwhich probably for this very reason decided to postpone the publication of a book on paediatric transitions in order to have time to revise their guidelines. E in Italy? Nothing at all, apart from the contrary stance by the Italian Psychoanalytic Society and the lively debate that has opened up in the society of cognitive-behavioural psychotherapists. At the moment no critical signals from the Paediatrics and Endocrinology societies, who have indeed expressed their support for affirmative therapy (apart from a few individual stances to the contrary): see here e here. Nothing is known about the number of minors treated or the protocols actually applied. The hope is that the news coming out of the USA today will be the cue for the opening of a critical reflection, particularly among pediatri Italians.
Those who detransition or desist from transitioning feel better than before when they took cross-sex hormones or declared themselves trans: better well-being and also less gender dysphoria.
This was found by one studio mentioned by Bernard Lane on Gender Clinic News conducted by researcher Lisa Littman together with the psychotherapist Stella O'Malley, to the detransitioner Helena Kerschner and the sexologist J Michael Bailey and published in Archives of Sexual Behavior.
The study was carried out on a sample of 71 American women and 7 men aged between 18 and 33. The young people - who had identified in the opposite sex for 5 years- have experienced a net improvement of their psychological health after stopping treatment or renouncing their transgender identity. Given the controversial topic, only recently have detransitioners become visible and this is the first study on the subject.
In the study, all the males and most of the females had taken cross-sex hormones (testosterone for females, oestrogen for males) and almost a third of the females had had a double mastectomy, while a small number had also had their uterus and ovaries removed, a rather significant investment in their new identity in terms of time and medical protocols. The rethinking occurred more out of inner issues -reflections, change in the definition of male and female as well as realising that they are more comfortable in their birth sex- than by external factors, such as discrimination.
Another determining factor was having mistaken mental health problems and trauma for gender dysphoria. It is interesting that just over half of the group has stated that they recognise themselves as having rapid onset gender dysphoria (RODG) with onset during or after puberty. ROGD, first described by Littman, describes theinternational epidemic since 2010 among groups of socially influenced adolescents - especially girls - who suddenly embrace trans identities. But this is a hypothesis that activists are trying hard to discredit.
Among the key points of the paper is the fact that most of those who took cross-sex hormones obtained them through a rapid informed consent. Two-thirds of the sample felt they had not been adequately informed about the risks and long-term consequences. Almost half of the women stated that they were exclusively attracted to women and for many it was the desire to escape abuse and sexualisation. More than a third of the group stated that most friends identified themselves as trans, indeed it was common to tease those who were not. Before the transition the psychiatric diagnoses most common had been depression (63%), attention deficit disorder (24%), eating disorder (23%), obsessive compulsive disorder (18%), post-traumatic stress disorder (15%), bipolar disorder (12%), trichotillomania (10%), autism spectrum disorder (9%). Many had traumatic experiences during childhood such as abuse in the family. Most of the sample have liberal political views and support gay marriage and trans rights.
The authors state that the results of the study are necessarily provisional and therefore acknowledge the limitations of the research. It cannot yet be demonstrated how common detransition or 'desistance' is or whether the group examined was particularly at risk. Imperfect research, however, is better than none, and the authors believe that a follow-up of patients, a practice that currently has no course in the US.
Meanwhile, from ainvestigation by Benjamin Ryan on The New York Sun we learn that two detransitioners sued their doctors, Jason Rafferty and Michelle Forcier, and also the AAP, American Society of Paediatrics, for negligence. One of them, Isabelle Ayala, 20 years old (top photo) survivor of sexual abuse with a long history of depression, ADHD, self-harm, attempted suicides, was 14 years old when she started the transition protocol and is now regretting it. Doctor Rafferty had told her mother that not prescribing testosterone might lead the girl to the suicide. Unfortunately After only eight months of treatment Ayala attempted suicide and was hospitalised. Ayala's lawsuit, part of a growing litigation movement, could shed light on why such an important academy as paediatrics supported the affirmation model in spite of growing criticism especially in Europe. It is no coincidence that after the investigation the AAP decided to delay the release of a book on paediatric transitions 'due to a review of the guidelines'.
The clay-footed giant of the transitions business is beginning to crumble.