Serious LGBT Thread

Isuckatgaming

Isuckatgaming

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PilotBland said:
it's basically having to revolve your life around some creepy old fuck to show to his friends if you're unlucky, lucky if he's closeted and he'll call you to fuck whenever he's in town

you're luckier if he's from out of town but most old dudes are stingy from that 'SUGAR BABY' allowance so they'll be demanding as fuck
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You sound experienced in this matter
 
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surra

surra

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Chadwick said:
What are you a fuckin trans expert?
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yep this is a certified

Credit to DGunner for some sources and inspiration for the title. I scoured hundreds of reddit posts, blog posts and news articles to get all this information.

I've been collecting dozens of scientific research and news articles on trans people for some time now, but I just realized that it was selfish to not share this research with others. All credit to the scientists!

I'm going to be using the terminology GCS (gender confirming surgery) for the post. Common synonyms are SRS, GRS. A warning that many of the studies use the terminology 'transsexual'.

Why Trans People Are Suicidal/Depressed: Society
  1. Being validated with the correct name, pronouns and documentation is associated with drops in suicide/depression [1] [2] [17] and delegitimization is associated with rises in suicide [9] [19]
  2. Friend, social and familial support is associated with drastic reductions in suicidal ideation and depression [2] [3] [4] [5] [6] [17] [18]
  3. Gender-based violence is a factor that contributes to suicide [7] [10] [11]
  4. Internalized transphobia is sometimes a factor that contributes or leads to suicide [12]
  5. And seeking religious treatment is not effective, and actually increases the rate of suicide [13]
  6. Discrimination is generally linked with higher suicide rates [8] [17] [18], and can cause mental disorders [14], which are further connected to suicide [15]
  7. The kicker: After controlling for minority stress (discrimination) and access to healthcare (a proxy for poverty, and a measure of the ability to transition), trans people have a mental health quality of life similar to that of the general population [16]
[1] When trans youth are allowed to use their actual name, depression and suicide drops
[2] Having a supportive family reduced suicide rates by 57% and access to legal documentation reflecting ones gender reduces suicide rate by 44%
[3] Parental support is associated with a 93% reduction in suicide attempts
[4] The ability to transition, along with family and social acceptance, are the largest factors reducing suicide risk among trans people.
[5] Social support is a suicide protective factor
[6] Familial support is associated with a better psychological and overall quality of life, and support from friends is associated with ab better quality of life in all other aspects
[7] Individuals targeted on the basis gender have the highest risk for attempting suicide, Being physically attacked is associated with suicidal ideation and behavior.
[8] Homelessness, lower income, discrimination, violence, lack of treatment (all of which have higher prevelancy among trans ppl) are contributing factors to suicide
[9] Restricing teens to the bathroom of their assigned sex increases suicide rates
[10] Gender-based victimization of transgender individuals is associated with suicide
[11] Gender-related abuse is a significant psychiatric health problem that affects the suicide rate
[12] Internalized transphobia is a factor in some suicides
[13] Seeking religious/spiritual treatment increases likelihood of committing suicide
[14] Discrimination as a cause of PTSD
[15] The connection between PTSD and suicide
[16] After controlling for minority stress and medical care, trans people have similar QOL (including mental health)
[17] Social support, reduced transphobia & discrimination, having personal identification with the correct name and pronouns, and transitioning all significantly reduce suicide rates
[18] A literature review that finds considerable support for the idea that social support reduces suicide and discrimination increases it among trans individuals [19] College transgender students are at a higher risk for suicide and suicide attempts when they are denied access to bathrooms and gender-appropiate housing

The Benefits of Transition - Debunking Some Myths
The scientific consensus is clear. Transitioning is the only scientifically-supported method of ameliorating gender dysphoria. (I'll be lumping together HRT, SRS and other treatments for this, but if anyone has any problems or wants me to, I can attempt to separate them). This is not to say that any one surgery is going to solve all of your problems, because as shown above, society has a significant impact on the well-being of transgender individuals.

I'll go into detail about the misinterpreted studies in a minute.

  1. Transition is associated with lower suicide ideation, attempts and rates [1] [2] [3] [4] [5] [6]
  2. Transition is associated with a lower rate of depression [7] [8] [9] [10]
  3. Transition is associated with improved anxiety, stress and distress levels [8] [9] [10] [11] [12] [13] [14]
  4. Transition is associated with a higher quality of life [9] [15] [16] [17] [18]
  5. Individuals undergoing transition are satisfied with their results
  6. The regret rate of various transition procedures is very low [20] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] [37], ranging from 0% [24] to 0.6% [25] [26] to 2.2% [23], and has been decreasing with time [23] and are similar to that of other common surgeries [35]
  7. Undergoing transition increases sex satisfaction [37] [38] [39] [40] [41]
  8. Transition increases general mental health, reduces psychopathology and psychiatric disorders and symptoms [10] [13] [16] [21] [32] [36]
  9. Transition is safe and has little long-term side effects [42] [43] [44] [45] [46] This review summarizes the benefits of transition from the research
[1] Transition vastly reduces risks of suicide attempts, and the farther along in transition someone is the lower that risk gets.
[2] Survey found that 70% were more satisfied after transition, 74% had better mental health, 63% had decreased self harming, and 63% had less suicidal ideation
[3] Rate of suicide attempts dropped dramatically from 29.3 percent to 5.1 percent after receiving medical and surgical treatment among Dutch patients treated from 1986-2001.
[4] “In a cross-sectional study of 141 transgender patients, Kuiper and Cohen-Kittenis found that after medical intervention and treatments, suicide fell from 19 percent to zero percent in transgender men and from 24 percent to 6 percent in transgender women.” Additionally, none of the patients regretted their decision to undergo GCS
[5] A 2013 study of 433 trans people in Canada found that 27% of those who hadn’t begun transitioning had attempted suicide in the past year, but this dropped to 1% for those who were finished transitioning.
[6] Studies show that there is ...a little more than 1% of suicides among operated subjects. The empirical research does not confirm the opinion that suicide is strongly associated with surgical transformation
[7] Hormone treatment decreases depression by 10x
[8] Most individuals had average scores on mood, satisfaction, depression and anxiety tests in a hostile environment after SRS
[9] The research shows that hormone therapy reduces depression and anxiety to normal ranges, and is associated with a significant increase in the quality of life
[10] Treated patients have less stress, anxiety, depression, psychological symptoms, etc
[11] CHT decreases anxiety, depression and distress
[12] CHT is an effective treatment for anxiety problems
[13] SCL-90 scores (a test that measures anxiety, distress and hostility) resembled that of the general population after the initiation of hormone therapy
[14] Transition is associated with a drop in stress levels, reaching stress levels within normal values
[15] Hormonal therapy was significantly associated with a higher quality of life
[16] Gender-affirming hormone therapy is a safe and effective way to improve quality of life and mental health outcomes for transgender adolescents
[17] Undergoing CHT increased quality of life for all transgender people
[18] Transition is associated with an increased quality of life and a high satisfaction rate
[19] Satisfaction is 97% among trans men and 87% among trans women for gender confirming surgery in the 1990s before the advancement of the procedure
[20] Trans individuals were overwhelmingly happy with their GCS results, said that GCS greatly improved the quality of their lives. None reported outright regret, and only a few expressed occasional regret
[21] Patients had fewer psychological problems and interpersonal difficulties and a increased life satisfaction
[22] Transition is successful at increasing body satisfaction and improving body image, which may alleviate eating disorders
[23] Regret was about 2.2% and there was a significant decline of regrets over the time period.
[24] More than 90% were satisfied, and no one reported regret after GCS
[25] Only 0.6% of transwomen and 0.3% of transmen who underwent gonadectomy were identified as experiencing regret.
[26] Out of 162 trans adults, only one reported that she would choose not to transition again, and another had some regrets but would choose to transition again, which yields a 0.6% regret rate
[27] Out of 62 trans people who had undergone surgery, one woman said she occasionally regretted it, and continued to live as a woman
[28] A study of 50 trans women who had received genital reconstruction found that only two felt regret sometimes
[29] None were consistently regretful, and 6% felt regret sometimes
[30] Studies show that there is less than 1% of regrets
[31] None of the patients regretted their surgery
[32] 1.6% of patients regretted their surgery and patients improved on 13 out of 14 mental health indicators
[33] None of the patients experienced doubts about undergoing surgery
[34] Among female-to-male transsexuals after SRS, i.e., in men, no regrets were reported in the author's sample, and in the literature they amount to less than 1%. Among male-to- female transsexuals after SRS, i.e., in women, regrets are reported in 1-1.5%
[35] Regret rates are similar to/better than that of gastric bypass/banding surgery [36] A review of the literature: levels of psychopathology and psychiatric disorders improve with medical intervention and often reach normative values. Schizophrenia and bipolar have prevalences equal to that of the general population.
[37] Trans men experience a better sex life after SRS and do not regret the surgery
[38] Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication.
[39] "Sexual experience was considered to have improved by 83.3% of the patients, and became more frequent for 64.7% of the patients."
[40] 80% report improvement in sexuality
[41] "Based on the available literature, transsexuals appear to have adequate sexual functioning and/or high rates of sexual satisfaction following SRS"
[42] Finds that there are little to no long-term side effects of transitioning
[43] Transgender men did not experience important side effects such as cardiovascular events, hormone-related cancers, or osteoporosis
[44] Hormone therapy is safe with medical supervision. There was no increase in mortality or cancer prevalance
[45] The only side effect of hormone therapy is current ethinyl estradiol use (which is not commonly used anymore), causing an increase in cardiovascular risk of death
[46] Mortality was not different from the general population and observed mortality was not linked with hormone therapy

The most common study I’ve seen cited about transitioning is the Williams Institute suicide report: https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf. The most common claim drawn from this report is that ‘transitioning increases suicide’. This is not only contradicted by all of the other research, but not supported by the report itself:

Table 5 is on page 8. It has lifetime suicide rates for people who don't want, want or have had each transition-related procedure. For example, the lifetime suicide rate for people who do not want counseling is 29%, people who want is 39% and have had it is 44%. The most important thing to note is that this is the LIFETIME SUICIDE RATE. This means that a trans person who attempts suicide previous to their transition still counts after they transitioned. So, this absolutely does not support the claim that the suicide rate increases after transition. Here is a plausible explanation for why the lifetime suicide rate is higher for those who transition: the people who have the worst gender dysphoria, the most depression (and thus suicide) before transitioning are going to be more focused on transitioning as fast as possible. People who have milder gender dysphoria can afford to wait longer. People who have transitioned are also likely older, meaning they have a longer expanse of life to go through; more suicide attempts.

Another possible (similar) explanation is given in the report itself:

Significantly higher prevalence of lifetime suicide attempts was found among respondents who were classified as trans women (MTF) and trans men (FTM), based on their primary self-identifications. Since trans women and trans men are the groups within the overall transgender population most likely to need surgical care for transition, this may help to explain the high prevalence of lifetime suicide attempts we found among respondents who said they have had transition-related surgical procedures, compared to those who said they did not want transition-related surgery. Comparably high, or higher, prevalence of suicide attempts were found among respondents who said that they someday wanted FTM genital surgery, hysterectomy, or phalloplasty, suggesting that desiring transition-related health care services and procedures but not yet having them may exacerbate respondents’ distress at the incongruence between their gender identity and physical appearance. It is also possible that elevated prevalence of lifetime suicide attempts may be due to distress related to barriers to obtaining transitionrelated health care, such as a lack of insurance coverage, inability to afford the procedures, or lack of access to providers.

They even clarify that one can't draw that conclusion from the report:

As has been noted, the NTDS instrument did not include questions about the timing of suicide attempts relative to transition, and thus we were unable to determine whether suicidal behavior is significantly reduced following transition-related surgeries, as some clinical studies have suggested (Dixen et al., 1984; De Cuypere et al., 2006).

They later state that more research is necessary on the timing of suicide increases and decreases

First, more research is needed into the timing of suicide attempts in relation to age and gender transition status. In regard to timing of suicide attempts and gender transition, some surveys and clinical studies have found that transgender people are at an elevated risk for suicide attempt during gender transition, while rates of suicide attempts decrease after gender transition (Whittle et al., 2007; DeCuypere et al., 2006; Transgender Equality Network Ireland, 2012). Further research is clearly needed on the occurrence of all aspects of self-harm behavior, including suicidal ideation, suicide attempts and non-suicidal self-injury, in relation to gender transition and barriers to transition

Another common miscitation is the Karolinska Institute study.

Not only does the report not state what transphobe want it to, the study’s lead author has clarified her opinion on transitioning and transgender people and attempted to dissuade misinterpretation.

A common argument is that this study shows that transition increases suicide or that transition is ineffective

From the conclusion:

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.

This part is cited to show that ‘transition increases suicide’. But these claims are entirely ignorant of what the study says. The study did not measure the change in suicide attempts/behavior before and after surgery, it only compared transgender people who had had GCS to the general population and concluded that they had a higher rate of suicidal behavior. This is, as before, a result of discrimination, transphobia, stigma, barriers in access to healthcare and lack of social support. Like the primary author says:

The aim of trans medical interventions is to bring a trans person’s body more inline with their gender identity, resulting in the measurable diminishment of their gender dysphoria. However trans people as a group also experience significant social oppression in the form of bullying, abuse, rape and hate crimes. Medical transition alone won’t resolve the effects of crushing social oppression: social anxiety, depression and posttraumatic stress

What we’ve found is that treatment models which ignore the effect of cultural oppression and outright hate aren’t enough. We need to understand that our treatment models must be responsive to not only gender dysphoria, but the effects of anti-trans hate as well. That’s what improved care means.

Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

Of course one surgery isn’t going to solve all of trans people’s problems. Systemic oppression isn’t washed away with only medical treatment. It’s something that has to be addressed at the societal level. Anti-trans activists use this portion to claim that ‘sex reassignment’ isn’t effective at improving well-being, but that isn’t what the study means:

People who misuse the study always omit the fact that the study clearly states that it is not an evaluation of gender dysphoria treatment. If we look at the literature, we find that several recent studies conclude that WPATH Standards of Care compliant treatment decrease gender dysphoria and improves mental health.

And TERFs and “Rad Fems” often use the study to claim that trans women are men because of the sections on ‘criminality’. Dhejne states:

The individual in the image who is making claims about trans criminality, specifically rape likelihood, is misrepresenting the study findings. The study as a whole covers the period between 1973 and 2003. If one divides the cohort into two groups, 1973 to 1988 and 1989 to 2003, one observes that for the latter group (1989 – 2003), differences in mortality, suicide attempts and crime disappear. This means that for the 1989 to 2003 group, we did not find a male pattern of criminality.

As to the criminality metric itself, we were measuring and comparing the total number of convictions, not conviction type. We were not saying that cisgender males are convicted of crimes associated with marginalization and poverty. We didn’t control for that and we were certainly not saying that we found that trans women were a rape risk. What we were saying was that for the 1973 to 1988 cohort group and the cisgender male group, both experienced similar rates of convictions. As I said, this pattern is not observed in the 1989 to 2003 cohort group.

The difference we observed between the 1989 to 2003 cohort and the control group is that the trans cohort group accessed more mental health care, which is appropriate given the level of ongoing discrimination the group faces. What the data tells us is that things are getting measurably better and the issues we found affecting the 1973 to 1988 cohort group likely reflects a time when trans health and psychological care was less effective and social stigma was far worse.

She further answers questions about transgender people in her 2017 AMA on /r/science for Trans Week of Science

Here is some additional information about transgender prisoners that indicates that 1 in 1250 prisoners are trans, well below the 0.6% population figure.

Another commonly miscited study is the 2004 British study that supposedly determines that gender confirmation surgery is ineffective. The study in reference is an update to a 1997 study and found that the newly published research on GCS was of low quality (only two studies had a control group and a dropout rate of less than 50%). And requiring double-blind controlled studies is unethical and impossible for research on GCS

Trans Youth
Myth #1: Kids Will Change Their Minds / The Desistance Myth
The desistance myth is one of the most frustrating arguments made against transgender children. It's all based off of some research that has some significant methodological flaws. Many of the individuals included in the studies did not identify as transgender (two studies had 90% of the participants identify as their assigned sex), some studies concluded that a respondent had desisted if they did not follow up (Steensma 2011 and Steensma 2013), and many included very small sample sizes. (All from this book and this study). There is more recent research indicating that more than 96% of children diagnosed with gender dysphoria continue to identify as transgender as adults. Even the flawed research indicates something far lower than the commonly repeated trope of 80-85%: Steensma 2013 (critiqued above) reports 16%. Wallien and Cohen-Kettenis 2008 and Ristori and Steensma 2016 have multiple weaknesses that render their conclusions useless, and Steensma 2010 is also flawed. This great study goes over numerous critiques of 4 main ‘desistance’ studies, and this one. A sort of review on the topic of trans children goes over the problems with desistance studies, goes over the research supporting affirmative care and the problems created when parents are not supportive

There are specific criteria to be diagnosed with gender dysphoria as a child.

The American Psychological Association's guidelines state:

The gender affirmative model supports identity exploration and development without an a priori goal of any particular gender identity or expression. Practitioners of the gender affirmative model do not push children in any direction, rather, they listen to children and, with the help of parents, translate what the child is communicating about their gender identity and expression. They work toward improving gender health, where a child is able to live in the gender that feels most authentic to the child and can express gender without fear of rejection.

There is a large body of researching indicating that gender identity is formed by the age of 3-5, possibly as early as 18 months, and that transgender children know what gender is, what they are identifying as and think of themselves as their gender identity:

Gender identity of transgender youth is deeply held and not the result of confusion. Transgender children view themselves as their expressed gender and are similar to cisgender children of their gender identity. (A more readable article). Transgender children develop similarly

Transgender teens that undergo gender reassignment do not62807-0/abstract) experience regret. And transgender children that underwent puberty suppression had decreased emotional and behavioral problems and increased general functioning, and all continued on to undergo hormone therapy

Transgender children endorse gender stereotypes less and see violations of gender stereotypes as more acceptable (Take THAT TERFs)

Myth #2: Kids "Are Rushed" Into Transition
This myth is based off of the faulty assumption that transgender youth under the age of 12 get some or any form of gender confirming surgery or hormone therapy. This is simply untrue. Common headlines like “4 year old youngest sex change” are masked in false claims and conflate social transition with surgery and hormones. The standard age for hormone therapy is 16 (Endocrine Society, Family court lawyers indicate that hormone therapy is typically attained at age 16, and the NHS recommends starting at 16 years of age). Research into ages of teens that being hormone therapy indicated a median age of 17.9 and 17.3 ranging from 13.3 to 22.3 years at one clinic and another clinic in Holland had mean age of initation of 16.4-16.7, with minimum ages ranging from 13.9-14.9. The typical minimum for GCS is 18 years of age (WPATH page 60, Unicare, and the ICD-10) and the lowest reported case is Kim Petras at 16. For chest reconstructive surgery, the mean age of surgery was 17.2, and only 3 patients were under 16 years of age.

Kids simply aren’t being rushed into transitioning.

Myth #3: Puberty blockers are harmful
This just simply isn't supported by the evidence. They are safe and not harmful to bone growth, and don't affect greater brain function. The few negative effects of puberty blockers do not change children's minds. Puberty blockers are also easily and permanently reversible, and this has happened successfully in the past before . No clinically significant effects on physiologic parameters were noted.

Both the Endocrine Society and WPATH recommend puberty suppression for transgender children.

Important evidence to consider is the evidence of the efficacy and safety of puberty blockers to treat children with precocious puberty. GnRH is safe in children with precocious puberty. There is no negative impact on bone mineral density or reproductive function and the treatment did not cause or aggravate obesity. Two years after therapy, bone mineral density and BMD scores for bone age and chronological age were normal, and percentage body fat reached normative values one year after treatment. Menstrual pattern was normal, BMD was normal after treatment, and hormonal values, ovarian and uterine dimensions were normal after treatment.. Long-term leuprorelin treatment had no effect on reproductive function. There is little to no evidence of long-term changes resulting from GnRH agonists. Psychosocial problems are improved with puberty blockers, as well as a reduction in loneliness and behavioral problems. Treatment has no effect on BMI

There is significant evidence that puberty blockers can improve children’s quality of life and in some cases, save children’s lives

A common argument about puberty blockers comes from TERFs and “GC” types, and sometimes from the right-wing (oh wait I already talked about them ) is that puberty blockers cause infertility. There is no risk of fertility from puberty blockers. If a child goes directly from puberty blockers to hormone therapy without going through ‘normal puberty’, that’s when it causes infertility. Puberty blockers themself cannot cause infertility.

Spack, however, is quick to point out that there is no risk of infertility from the hormone-blocking treatment alone. Infertility only comes when the hormone-blocking treatment is paired with Stage 2, the use of opposite-sex hormones. And so, Spack says, hormone blockers should really be seen simply as a treatment that gives families more time to think about what to do.

Trans youth are overwhelmingly given the option for fertility preservation when switching from puberty blockers to hormones

Myth #4: There is no need to transition
Gender dysphoria has been documented to harm mental health and create psychological distress. Social transition has been shown to ameliorate this distress and normalize mental health outcomes:

Well-being (of transgender children after puberty suppression) was similar to or better than same-age young adults from the general population.

Early transition virtually eliminates these higher rates of depression and low self-worth

Transition dramatically improves mental health among trans kids

Olson found that kids that transition have no elevation in depression and slight elevation in anxiety.

The younger one transitions, the fewer problems one will have

Adolescents who have gender confirmation surgery alleviate gender dysphoria and function psychologically and socially well, none having regrets

(TODO: Find Olson's new study that showed her previous research was flawed due to using parental data on child mental health and actually finds that anxiety is equivalent to that of the general population)

If any links are broken, I have any typos or any incorrect statements, please notify me in the comments. If a full article is inaccessible, use outline.com and if a full study/research article is inaccessible, use sci-hub.tw. If you have studies to add or further information, feel free to chime in in the comments and I’ll add it to the post. If there are any topics you think I should cover, please ask.


MOMENT
 
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