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Autistic girls seeking answers ‘are seizing on sex change’

I mean shit, the whole topic of the thread is transgendered people and how to address their needs, particularly in light of a comorbidity of autism.
Well, first I'd say we need to figure out if actual gender dysphoria is comorbid with autism... or whether a lack of appropriate therapy for autism is driving a bad diagnosis of dysphoria. That seems like a good place to start, rather than just assuming that any minor who complains that they are uncomfortable with their sexed bodies must be dysphoric and therefore should immediately be given puberty blockers and set on a pathway to irreversible medical transition. But you know, that would require you to think beyond your own personal conceptions and desires, and consider the overall impact on other people - especially children.

From this perspective genital, gonad, and gamete sex at birth is not even topical!
It's topical when the treatment for the assumed dysphoria is a process that results in sterilization and permanent medicalization!

The discussion hinges entirely on the question of brain sex, whether someone can be brain/genital discordant in the first place, and what that implies about the treatment of humans in the context of society.
Brain sex... as in the chromosomal basis of the cells in the brain? Now we're right back at a biological position. I presume that you're actually talking about the entirely hypothetical speculation that there are "girl brains" and "boy brains" that somehow have something to do with the social gender role that people gravitate to but it's magically embedded in... some mystical process within the brain... because you believe it must be the case.

I'm sure that the magical ephemeral soul of your brain cased by [some imagined process] can also totally explain your dysphoria regarding your body that is not "represented by any biology seen in any human being (or for that matter any mammal) ever born."

So... woo and magic.

Things waxed scientific when we got into the rats nest that is biogical sexual dimorphism and it's systemic causes, which may go either way regardless of genotype.
Uhh... what now? Are you legitimately claiming that it's just the roll of the dice on whether an XY pairing produces a human with small motile gametes or a human with large immobile gametes? It could go either way?

At issue here is that Emily seems to think that one of the members of this forum is not a "woman". I want to know, then, what basic requirements for this definition are of "womanhood", and thus shove a scenario in Emily's face wherein a "trans" person born with a penis would qualify, thus invalidating and disproving their contention that nobody born with a penis can be a woman.
Emily's position is that many of the members of this forum are not female, and that probably a lot of members of this forum don't conform to the socially constructed narrative of gender roles and gendered expectations that we associate with "woman/feminine" and "man/masculine".

I mean, really, I think a whole lot of members on this forum aren't women. Lots of them are men.

Rather, I think you are bent because I don't think that your dysphoria actually for really reals makes you indistinguishable from a female of the species. Or whatever it is that you identify as.
 
You still have yet to justify your contention that they are "actually male". You keep insisting that "sex" is a real thing without ever actually figuring out what it is.

So, you say that someone with their brain in a 100% "female" body is not female. That they are "male". Well then sex is, by that measure, purely a function of brain development, which I keep pointing out, may in fact be "fully female". Which would actually make that person fully and non-discordantly female.

So which is it? Is it the vagina or the brain? I contend that it is the brain, that having a "female brain" or whatever you would like to call it, exposed to estrogen, is about as necessary as it gets for being a woman.

This is so woo I don't even know where to begin. Sex is about gametes. This is true for every fucking sexed-animal on the planet. You're the one assuming something contrary to every bit of biology we know about reproductive species. So... I don't even know what to say.

You are conflating contexts of "sex". You are dancing between those contexts as if they aren't different. You are insisting that we discuss gametes in the context of whether we allow trans people to seek treatment for their condition.

Gametes are not at all pertinent to the discussion, if we are talking about behavior, neurology, and brain/body discordance.

You keep trying really hard to not answer the question, especially given the break neck speed of science in general, of what procedure would make someone female, what procedure would make someone a "woman".

Here you claim sex is the gametes in this post right here.so I ask again,

if someone born with a penis now produces eggs,ndoes that make them female? Does that make them a woman?

You instead insist that they are still "male". So what is it? Is it the gametes or the fucking brain?!?
 
You still have yet to justify your contention that they are "actually male". You keep insisting that "sex" is a real thing without ever actually figuring out what it is.

So, you say that someone with their brain in a 100% "female" body is not female. That they are "male". Well then sex is, by that measure, purely a function of brain development, which I keep pointing out, may in fact be "fully female". Which would actually make that person fully and non-discordantly female.

So which is it? Is it the vagina or the brain? I contend that it is the brain, that having a "female brain" or whatever you would like to call it, exposed to estrogen, is about as necessary as it gets for being a woman.

This is so woo I don't even know where to begin. Sex is about gametes. This is true for every fucking sexed-animal on the planet. You're the one assuming something contrary to every bit of biology we know about reproductive species. So... I don't even know what to say.

You are conflating contexts of "sex". You are dancing between those contexts as if they aren't different. You are insisting that we discuss gametes in the context of whether we allow trans people to seek treatment for their condition.

Gametes are not at all pertinent to the discussion, if we are talking about behavior, neurology, and brain/body discordance.

You keep trying really hard to not answer the question, especially given the break neck speed of science in general, of what procedure would make someone female, what procedure would make someone a "woman".

Here you claim sex is the gametes in this post right here.so I ask again,

if someone born with a penis now produces eggs,ndoes that make them female? Does that make them a woman?

You instead insist that they are still "male". So what is it? Is it the gametes or the fucking brain?!?

Learn to read, and use some common sense.
When that happens, then I will very likely change my view. At the moment, however, that's not a possibility. I mean, at some point in the future when (if) humans can magically implant their brains into giraffes, I'll also have to change my view on what a giraffe is as well as what a human is. I'll get back to you then.

And regardless of your oft-repeated claim to a "female brain", that's not a thing. I'm sure it makes you feel better to believe so... but you are simply incorrect. The brain is "sexed" in the sense that the cells of the brain carry the chromosomal markers of their biological sex. There is a region of the brain that shows significant sex-differentiation... but it's associated with sexual attraction and orientation, not with gender identity. It is, in fact, a part of the brain that shows significant similarities between straight females and gay males, as well as between lesbian females and straight males. It doesn't give any information with respect to how a person identifies.

So at the end of the day, you seem to be basing your ire and your size 7 font burst on the assumption that a hypothetical sci-fi medical process might someday be real and the assumption that brains are gendered as opposed to being sexed.
 
You are conflating contexts of "sex". You are dancing between those contexts as if they aren't different. You are insisting that we discuss gametes in the context of whether we allow trans people to seek treatment for their condition.

Gametes are not at all pertinent to the discussion, if we are talking about behavior, neurology, and brain/body discordance.

You keep trying really hard to not answer the question, especially given the break neck speed of science in general, of what procedure would make someone female, what procedure would make someone a "woman".

Here you claim sex is the gametes in this post right here.so I ask again,

if someone born with a penis now produces eggs,ndoes that make them female? Does that make them a woman?

You instead insist that they are still "male". So what is it? Is it the gametes or the fucking brain?!?

Learn to read, and use some common sense.
When that happens, then I will very likely change my view. At the moment, however, that's not a possibility. I mean, at some point in the future when (if) humans can magically implant their brains into giraffes, I'll also have to change my view on what a giraffe is as well as what a human is. I'll get back to you then.

And regardless of your oft-repeated claim to a "female brain", that's not a thing. I'm sure it makes you feel better to believe so... but you are simply incorrect. The brain is "sexed" in the sense that the cells of the brain carry the chromosomal markers of their biological sex. There is a region of the brain that shows significant sex-differentiation... but it's associated with sexual attraction and orientation, not with gender identity. It is, in fact, a part of the brain that shows significant similarities between straight females and gay males, as well as between lesbian females and straight males. It doesn't give any information with respect to how a person identifies.

So at the end of the day, you seem to be basing your ire and your size 7 font burst on the assumption that a hypothetical sci-fi medical process might someday be real and the assumption that brains are gendered as opposed to being sexed.

So, all I'm hearing here is an outpouring of cowardice at answering the question.

You keep insisting that brains are not sexed. On what do you base this outlandish claim? Because I can absolutely point to cases as described in https://www.healio.com/news/endocrinology/20120325/easing-transitions-with-gender-assignment indicate that large portions of people born forcibly cross-assigned, much larger percentages than express as trans within society (roughly commensurate, in fact, with the percentage difference between socially expressed trans ideologies seen in common society vs the percentages expressed within non-conforming segments: .2%-1% vs 10%) transition toward their chromosomal gender identity. This implies a brain differentiation not just of sexuality but of sex ideation. So you are absolutely wrong.

Your argument dies there. Brains are sexed as much as they are sexualized.
 
So, all I'm hearing here is an outpouring of cowardice at answering the question.
I answered the question in the quote below that. It's the same answer I gave you the first time you asked me whether a completely imaginary sci-fi future state would change my mind, before you felt the need to yell at me. I have LITERALLY answered your question already.

You keep insisting that brains are not sexed. On what do you base this outlandish claim? Because I can absolutely point to cases as described in https://www.healio.com/news/endocrinology/20120325/easing-transitions-with-gender-assignment indicate that large portions of people born forcibly cross-assigned, much larger percentages than express as trans within society (roughly commensurate, in fact, with the percentage difference between socially expressed trans ideologies seen in common society vs the percentages expressed within non-conforming segments: .2%-1% vs 10%) transition toward their chromosomal gender identity. This implies a brain differentiation not just of sexuality but of sex ideation. So you are absolutely wrong.

Your argument dies there. Brains are sexed as much as they are sexualized.

That is the strangest counter argument I think I've run across.

You're taking very rare cases of DSD... in which the chosen sex at birth is not necessarily that which aligns with their chromosomal sex... and later in their development, they drift toward identifying as their chromosomal sex rather than the cross-sex selection made for them at birth.

And somehow, in your mind... this translates to being support for transgender people who do not have a DSD somehow actually having a "gendered" brain consistent with the body of the opposite sex? And you're conflating sex and gender while you're doing it.

Neurosexism: the myth that men and women have different brains
The Myth Of The Gendered Brain
Is the Brain Gendered? A Q&A with Harvard's Catherine Dulac
Don’t Fall For Neuro-Nonsense about Gendered Brains
 
You failed to actually read the numbers to understand the implication.

People born with a complete immunity to testosterone who have lived their entire lives "as a woman" have a 1000% greater probability of expressing trans ideation than someone born XX but otherwise the same.

This implies the reality of a neural predisposition towards gender identity. For those who are impacted by testosterone, this goes up to 25%, which is, well, 25000% more likely to transition.

The existence of the fact that these biases are so much stronger demands the existence of a part of the brain coded to "know" what gender, what sex, to expect of the body around it.

But sure. Pretend that it's "all in their heads". But then, if it is, then a person born with a penis already has everything they need to feel all the necessary realities of being a woman except the estrogen* because as I keep pointing out having eggs a uterus and a vagina are not necessities of being a woman.

Edit: *and the estrogen is easy enough to provide
 
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You failed to actually read the numbers to understand the implication.

People born with a complete immunity to testosterone who have lived their entire lives "as a woman" have a 1000% greater probability of expressing trans ideation than someone born XX but otherwise the same.

This implies the reality of a neural predisposition towards gender identity. For those who are impacted by testosterone, this goes up to 25%, which is, well, 25000% more likely to transition.

The existence of the fact that these biases are so much stronger demands the existence of a part of the brain coded to "know" what gender, what sex, to expect of the body around it.

But sure. Pretend that it's "all in their heads". But then, if it is, then a person born with a penis already has everything they need to feel all the necessary realities of being a woman except the estrogen* because as I keep pointing out having eggs a uterus and a vagina are not necessities of being a woman.

Edit: *and the estrogen is easy enough to provide

It suggests nothing at all about gender identity. It suggests some correlation between chromosomal sex with respect to people with DSD identifying as the sex that they chromosomally are.

It doesn't, however, give any information whatsoever about a person who is NOT intersex, and is in all respects chromosomally and reproductively sex A "identifying" as sex B.

Unless you can produce something that actually demonstrates a material and meaningful, non-pseudoscientific, result indicating that the brains of perfectly normally male-bodied people who identify as women actually have brains that are more like women than like men... you're still working on woo and faith.

Beyond that, I think there's even more onus involved when your claim is that your identity is something never before seen in nature. I eagerly await an explanation for how that has a neurological cause that makes even a teensy bit of sense.
 
You failed to actually read the numbers to understand the implication.

People born with a complete immunity to testosterone who have lived their entire lives "as a woman" have a 1000% greater probability of expressing trans ideation than someone born XX but otherwise the same.

This implies the reality of a neural predisposition towards gender identity. For those who are impacted by testosterone, this goes up to 25%, which is, well, 25000% more likely to transition.

The existence of the fact that these biases are so much stronger demands the existence of a part of the brain coded to "know" what gender, what sex, to expect of the body around it.

But sure. Pretend that it's "all in their heads". But then, if it is, then a person born with a penis already has everything they need to feel all the necessary realities of being a woman except the estrogen* because as I keep pointing out having eggs a uterus and a vagina are not necessities of being a woman.

Edit: *and the estrogen is easy enough to provide

It suggests nothing at all about gender identity. It suggests some correlation between chromosomal sex with respect to people with DSD identifying as the sex that they chromosomally are.
This quote: "It suggests nothing about gender identity..."
Also this quote: "it suggests a correlation between chromosomal sex and gender identity".

Because identifying as a given "sex" is "gender identity".

Cognative dissonance at it's finest.
It doesn't, however, give any information whatsoever about a person who is NOT intersex, and is in all respects chromosomally and reproductively sex A "identifying" as sex B.
It means that there is a genetic correlation to identity regardless of what the person is told, regardless of what hormones someone has been exposed to. You hand-wave that away because ???.
Unless you can <kick a ball between a moving goalposts...>
LOLNO. Get bent. I have demonstrated evidence for a biological basis for neurological sex. You can put your fingers in your ears and scream that you don't like it one bit, but that's your problem, not mine.
Beyond that, I think there's even more onus involved when your claim is that your identity is something never before seen in nature. I eagerly await an explanation for how that has a neurological cause that makes even a teensy bit of sense.
No. There really isn't. Because here's the thing...

If there is no neurological sex (if your contention is true), then it must be the case that all it takes for someone to be meaningfully "woman" is to socialize with women as their peer group and be exposed to estrogen rather than testosterone: trans women are then meaningfully women.

If there is a neurological sex (if your contention is wrong), then it must be the case that not only are transwomen women, but that they are born that way: trans women are meaningfully women and it is even more awful to force them through the wrong puberty.
 
If there is no neurological sex (if your contention is true), then it must be the case that all it takes for someone to be meaningfully "woman" is to socialize with women as their peer group and be exposed to estrogen rather than testosterone: trans women are then meaningfully women.

If there is a neurological sex (if your contention is wrong), then it must be the case that not only are transwomen women, but that they are born that way: trans women are meaningfully women and it is even more awful to force them through the wrong puberty.

Alternatively... biological sex influences the experiences that people have, and this neural plasticity produces differences. Additionally, hormones DO affect the brain.

What you're arguing, however, is that there's some innate brain sex that is distinct and separate from biological sex... and that for some people this special "brain sex" makes them fundamentally as much of their "brain sex" as a person who is biologically that sex.

In clearer terms... You're arguing that there is some innate from infancy "male brain" that exists with zero connection to the body, and is not affected by the chromosomal make-up of the person in question, and remains resistant to the hormones to which it is exposed in fetal and pubertal development. And that this "male brain" is so strong a force, that it overrides the female body in some people, as well as the female experience of having a female body and the experience of being a female in society... in such a way that this person is fundamentally "male" as much as a person who has a male body and experiences is.

Do you also argue that people who identify as otherkin have some a fully or partially non-human brain?
 
Just thinking about natal males now, what if there are roughly two kinds of transgenderisms?

One type would be very instinctual in their feeling and behavior as women and the other would be sort of detached and fixated on the idea of being a woman.

That is radically different and if someone was being dishonest they could use the example of one type to suggest that the other type was not valid. But I think that both kinds likely exist and are valid.
 
If there is no neurological sex (if your contention is true), then it must be the case that all it takes for someone to be meaningfully "woman" is to socialize with women as their peer group and be exposed to estrogen rather than testosterone: trans women are then meaningfully women.

If there is a neurological sex (if your contention is wrong), then it must be the case that not only are transwomen women, but that they are born that way: trans women are meaningfully women and it is even more awful to force them through the wrong puberty.

Alternatively... biological sex influences the experiences that people have
Except when it doesn't... say for fucking trans people, or for instance, those with reconstructioms following an at birth DSD diagnosis...
, and this neural plasticity produces differences. Additionally, hormones DO affect the brain.
Except that the hormones DO NOT directly affect the brain development, especially at the epochs of life we are talking about. It's more a game of "mouse trap", where one thing impacts another and so on until a result happens. Spoilers here, though: half the time the reaction in the game never makes it to the end point, and the basket never comes down. Biology is a lot more reliable, but nothing is perfect. As evidenced by the facts of the DSD population.
What you're arguing, however, is that there's some innate brain sex that is distinct and separate from biological sex...
No, I'm arguing that both are biological. Because neural development is just as biological as gonad development.
and that for some people this special "brain sex" makes them fundamentally as much of their "brain sex" as a person who is biologically that sex.
If there is a brain sex, it has biological roots. Period. They are both "biological". The question at play here is which biological entity has more meaning to how we interact with people. My contention is that we interact with "who someone is", not with "what is in their pants" 99.99% of the time.
In clearer terms... You're arguing that there is some innate from infancy "male brain" that exists with zero connection to the body,
Again, no. I'm arguing that while the body significantly impacts probabilities as a function of prenatal hormonal exposure and then a practically goldbergian process of chemical potentials, that the steps between "DHT" and "brain formation" are vulnerable, and in .42-2% of the population have fallen victim to such vulnerabilities of the process to being waylaid by chance.
and is not affected by the chromosomal make-up of the person in question
No, I'm arguing that the linkage is probabilistic, not absolute. Do you even know what probabilistic means? I'm starting to doubt. I've used it several times now.
and remains resistant to the hormones to which it is exposed in fetal and pubertal development.
Not resistant. Just not deterministically influenced by hormones at the stage of the process where the actual structure happens.
And that this "male brain" is so strong a force, that it overrides the female body in some people
Again, you fail completely and utterly here. "The body" (genitals) doesn't get "overridden" because the brain is not the genital. They are separate and distinct structures formed by very different processes.
, as well as the female experience of having a female body and the experience of being a female in society...
Sorry, no. Trans children do not have a "female body' to the extent it matters except to the extent that it creates difficulties or eases those difficulties with regards to how they pee. They don't have breasts. They don't 'lack' an adam's apple any more than their peers. Provided they are allowed to interact as a girl with other girls, present as a girl, learn how to be a girl, a trans girl prior to puberty will have the same experience any other girl does, except for the slight detail that she can write her name in the snow*.
in such a way that this person is fundamentally "male" as much as a person who has a male body and experiences is.
You put WAY too much importance on what is between someone's legs. I didn't know what my dick was capable of doing until I was 16. I didn't care about it. It didn't determine how I acted. What determined how I acted was my brain, how it was socialized, and how I assumed I ought act as a function of my innate neurological biases.
Do you also argue that people who identify as otherkin have some a fully or partially non-human brain?
Nope. I assume that they have the right to their own identity though, and that their socialization in their peer group is just as significant to who they are as your socialization in your peer group.

There is definitely a phenomena wherein some segment of humans identify, unbidden, as something along the lines of "otherkin". They did this long before the internet ever existed, before even the written word, and there is absolutely some biological basis for neural predispositioning towards that end.

It doesn't mean they are, strictly speaking non-human, but it does imply there is more going on here. To go back to your schizophrenia example, while schizophrenia does not speak to the reality of the voices someone hears in a universal sense, it absolutely implies that there is a neurological phenomena driving these similar outcomes.

Edit: *and after I wrote this, I realized another important facet about growing up a trans girl: they will also be molested, harassed, and raped to the same extent their cis peers are too. Because it's not like predators, assuming that the child's privacy is protected by their parents, will know until it's too late for the victim regardless, and it will suck just as bad. Potentially worse.
 
Emily - you're not even using the term "gender dysphoria" properly. Dysphoria is the anxiety associated with having the outward appearance/presentation not match with the internal. There is no such thing as 'determining if someone REALLY has gender dysphoria - if they say they do, they do." What you are attempting to question is whether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young).

Secondly, you CANNOT put puberty blockers anywhere NEAR the same class as transition medications. They simply are not the same. Puberty blockers are a short term situations and once they are not longer taken, the individual will enter puberty without lasting effect. One may choose to begin transitional medications straight from PB and those MAY have lasting/permanent effects, but don't always.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.
 
Emily - you're not even using the term "gender dysphoria" properly. Dysphoria is the anxiety associated with having the outward appearance/presentation not match with the internal. There is no such thing as 'determining if someone REALLY has gender dysphoria - if they say they do, they do." What you are attempting to question is whether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young).

Secondly, you CANNOT put puberty blockers anywhere NEAR the same class as transition medications. They simply are not the same. Puberty blockers are a short term situations and once they are not longer taken, the individual will enter puberty without lasting effect. One may choose to begin transitional medications straight from PB and those MAY have lasting/permanent effects, but don't always.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.

To be fair, HRT will, absolutely, have lasting and permanent effects, generally moreso for the testosterone-seekers than the estrogen-seekers.

The thing about that, though, is that that's usually what they are going for anyway.
 
interesting clip from Ibram Kendi, which I think makes sense:

https://twitter.com/robbysoave/status/1357772964247306242

There should be a way to gently figure out the reasons why a girl like his daughter would make such a statement - without putting a thumb on the scale either way.

The easiest way to solve these problems is, in my particular opinion, to not actually press assumptions of gender on your children and let them come to their own conclusions on the matter.

As it is, my husband and I are totally planning a big gender reveal party where the reveal is something along the lines of "LOL, we have no idea and what is in their pants is none of your business!"

Our goal, if kids are in the cards, is to let them make their own damn decisions about who they are, what toys/peers to play with, and to protect their privacy from those who would foist their assumptions on them.
 
Just thinking about natal males now, what if there are roughly two kinds of transgenderisms?

One type would be very instinctual in their feeling and behavior as women and the other would be sort of detached and fixated on the idea of being a woman.
That hypothesis has been put forth, and at least some research supports it. Many transgender people and activists reject it outright though.
 
Emily - you're not even using the term "gender dysphoria" properly. Dysphoria is the anxiety associated with having the outward appearance/presentation not match with the internal. There is no such thing as 'determining if someone REALLY has gender dysphoria - if they say they do, they do." What you are attempting to question is whether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young).
Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?

Secondly, you CANNOT put puberty blockers anywhere NEAR the same class as transition medications. They simply are not the same. Puberty blockers are a short term situations and once they are not longer taken, the individual will enter puberty without lasting effect. One may choose to begin transitional medications straight from PB and those MAY have lasting/permanent effects, but don't always.
Puberty blockers do have long-term effects, even if taken for a relatively short time. In both male and female children, bone density fails to accrete while puberty is blocked, as that increase in density occurs as part of puberty. Once removed from blockers, that density increase doesn't occur at the same rate, and the long-term effect is lower bone density. The most commonly used blocker for females is Lupron. I had to take Lupron prior to a surgery once, as an adult. My doctor was extremely clear that he wanted me to take it for no more than three months, because of the risk to bone density and other potential long-term complications. Another side effect of puberty blockers is that they also block the cognitive maturation that would be needed to make an informed decision in the first place. I suppose if you only took cross-sex hormones for a couple of weeks, one might consider that "reversible". But once facial hair is triggered to grow by testosterone, those follicles don't disappear. Once breast tissue forms due to estrogen, they don't just evaporate.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.
Sure. That's the point though - those other conditions are NOT being treated.
 
Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?
All of them, effectively.
If you don't like what A Doctor is telling you, search for a more compatible diagnosis, treatment, or threshold.
The internet has made this wonderfully easy. Used to be, you just needed money.
 
Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?
You are not anyone's doctor.

And thank goodness for that, as apparently you would try to argue with your patients when they describe themselves as anxious about something.
 
Emily - you're not even using the term "gender dysphoria" properly. Dysphoria is the anxiety associated with having the outward appearance/presentation not match with the internal. There is no such thing as 'determining if someone REALLY has gender dysphoria - if they say they do, they do." What you are attempting to question is whether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young).

Secondly, you CANNOT put puberty blockers anywhere NEAR the same class as transition medications. They simply are not the same. Puberty blockers are a short term situations and once they are not longer taken, the individual will enter puberty without lasting effect. One may choose to begin transitional medications straight from PB and those MAY have lasting/permanent effects, but don't always.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.

To be fair, HRT will, absolutely, have lasting and permanent effects, generally moreso for the testosterone-seekers than the estrogen-seekers.

The thing about that, though, is that that's usually what they are going for anyway.

It's not guaranteed to have lasting effects if someone decides to stop taking it, but it CAN and typically does. But you are absolutely correct, that is what they're going for. However, I agree it may not be the best course for someone young suffering with OTHER comorbidities that CAN influence cognitive function (eating disorder, ADD, Bipolar Disorder, etc).
 
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