Sanity in the UK?

[Jarhyn]

For FTMs who detransition and are attracted to men, the issue of their permanently lower voice has got to a be serious hurdle in the dating market.

For me, and I think I am normal straight guy, it is (and would have been when I was dating age) an instant hyper deal breaker seeing even an otherwise very attractive woman with a teenage boy's or adult male's voice. It is nothing that I can control, but some part of my brain goes nope.

I am being an honest asshole here because no one else is.

For MTF who transition, and are attracted to men, the issue of their permanently lower voice has got to be a serious hurdle in the dating market.

I am sure it would be quite a deal breaker seeing an otherwise very attractive woman with a teenage boy's or even adult male's voice.

<Edited>, and while I believe it honest, you aren't at all on mark for having any kind of point. I can't imagine how you don't see this, all the people who actually want to transition with blockers because they don't want to suffer exactly the fate you just described.

And you are using this argument of a vanishing minority to deny the majority exactly the experience you bemoan for this poor hypothetical transitioner: the right to the body of their desired gender puberty.

 

[krypton iodine sulfur]

Their ass.

Maybe, but it kind of feels like she's pulling on talking points I've encountered frequently before.

It is true that good data is hard to come by with this issue. There are so many complicating factors. But this 80% figure, in particular, feels like it pulls from a handful of studies (Blanchard and Steensma come to mind) which wouldn't likely translate to the current scenario for various reasons, most notably diagnostic criteria being a) changed and b) more rigidly applied in proper treatment protocols. Other comments feel like familiar talking points (e.g. notes of ROGD). So I guess I am curious where this research is coming from because I suspect it is not her ass.

The 80% is mostly from this study:
https://www.sciencedirect.com/science/article/abs/pii/S0890856713001871
Roughly the same rate has been found in other studies over the years, but they were all much smaller.

I can't read it since it's behind a paywall. I have no idea if it cites an 80% desistance rate; however, I would strongly caution against assuming that the numbers are indicative of who would be recommended or eligible for HRT in youth.

 

[krypton iodine sulfur]

In countries where puberty blockers are given to essentially any child that identifies themselves as being dysphoric, 90% to 95% move on to cross-sex hormones. In countries where puberty blockers are not given to children under 18, 80% of those who present with self-identified dysphoria stop being dysphoric after they begin a natural puberty.

I think you're crossing numbers. Studies indicating high desistance rates have typically been looking at a broader or different age range from the age at which puberty blockers would be typically used and younger than cross sex hormones would be used. In older studies, outdated diagnostic criteria were applied, and in a number of cases there was little to no differentiation between children who were gender non-conforming in some capacity, and children who actually meet the criteria for an incongruence of gender/ gender dysphoria diagnosis. Your supposition simply isn't realistic or indicated by evidence.

 

[Emily Lake]

For FTMs who detransition and are attracted to men, the issue of their permanently lower voice has got to a be serious hurdle in the dating market.

I'd imagine that the facial hair is at least as big a hurdle.

For me, and I think I am normal straight guy, it is (and would have been when I was dating age) an instant hyper deal breaker seeing even an otherwise very attractive woman with a teenage boy's or adult male's voice. It is nothing that I can control, but some part of my brain goes nope.

I am being an honest asshole here because no one else is.

I don't think you're being an asshole. I think you're heterosexual, and are attracted to the biological sex of female, as well as being attracted to the general secondary characteristics of females. A difference in voice is one of those secondary characteristics. I don't think it's any more assholish than not being attracted to women with very small breasts, or with narrow hips. On the other side of things, I don't think it's any different from a woman only being attracted to tall men, or men with really deep voices, or men with thick chest hair.

 

[Emily Lake]

The 80% is mostly from this study:
https://www.sciencedirect.com/science/article/abs/pii/S0890856713001871
Roughly the same rate has been found in other studies over the years, but they were all much smaller.

I can't read it since it's behind a paywall. I have no idea if it cites an 80% desistance rate; however, I would strongly caution against assuming that the numbers are indicative of who would be recommended or eligible for HRT in youth.

I doubt it's uniform across the globe, and if good evaluations and guidelines are in place, I have a lot less concern about it.

One of the issues seen with Tavistock (as well as some gender centers in the US), is that they've taken an approach of "affirmation only", and have taken the position than any questioning of whether the person is actually clinically dysphoric is seen as being equivalent to conversion therapy. Pair this with a strong push toward social and legal self-identification without the need for a diagnosis, and it presents a risk to children.

Without the freedom to dig in to the causes of the apparent dysphoria, the therapist cannot effectively identify whether the dysphoria is genuine and persistent, or whether it's a side effect of a different issue. Lots of autistic children, especially girls, feel very disconnected from their bodies to start with, and this is amplified when sexuality enters the picture, because they don't tend to have the same bonding and attraction patterns that other children do. It's fairly easy for a child with mild autism to infer that their trouble connecting with others is because they're "in the wrong body". When therapists reinforce that, you end up with autistic children not getting the occupational therapy that they need in order to form connections and navigate the social herd. Similarly, a lot of apparent gender dysphoria is a result of childhood sexual abuse, where the child subconsciously interprets their body to be the traitor, and has an emotional unexamined assumption that if they had been a different sex, the abuse wouldn't have occurred. By failing to investigate that underlying cause, the therapist does a disservice to the child.

I end up wanting a divergent solution: Either have self-id without a medical diagnosis and do not provide blockers to children under 16... Or require a well-investigated medical diagnosis and treatment and provide blockers to those children who pass the rigorous screening.


I'm not super supportive of self-id alone for legal recognition... but there are different drivers for my concerns there, which have nothing to do with the effect on kids. That's more of a case of protecting against potential abuse.

 

[krypton iodine sulfur]

One of the issues seen with Tavistock (as well as some gender centers in the US), is that they've taken an approach of "affirmation only", and have taken the position than any questioning of whether the person is actually clinically dysphoric is seen as being equivalent to conversion therapy. Pair this with a strong push toward social and legal self-identification without the need for a diagnosis, and it presents a risk to children.

Without the freedom to dig in to the causes of the apparent dysphoria, the therapist cannot effectively identify whether the dysphoria is genuine and persistent, or whether it's a side effect of a different issue.

I don't know why 'affirmation only' is in quotation marks. If you're talking about the gender affirmative model of treatment, then you are wrong. That model was designed to reduce some of the psychosocial pressures on children to help therapists and clinicians reach a more accurate diagnosis. It's not designed to turn a blind eye to any complicating factors in a diagnosis or to conflate gender non-conformity with gender dysphoria.

Or require a well-investigated medical diagnosis and treatment and provide blockers to those children who pass the rigorous screening.

Part of the point of the blockers is to allow time for that diagnosis. Doctors can't guarantee the timelines for when children will be referred for treatment. If they don't see the patient until they are thirteen, then most likely that youth has already entered or is entering Tanner stage 3, possibly stage 4 where irreversible or only surgically reversible changes are taking place.

 

[Emily Lake]

One of the issues seen with Tavistock (as well as some gender centers in the US), is that they've taken an approach of "affirmation only", and have taken the position than any questioning of whether the person is actually clinically dysphoric is seen as being equivalent to conversion therapy. Pair this with a strong push toward social and legal self-identification without the need for a diagnosis, and it presents a risk to children.

Without the freedom to dig in to the causes of the apparent dysphoria, the therapist cannot effectively identify whether the dysphoria is genuine and persistent, or whether it's a side effect of a different issue.

I don't know why 'affirmation only' is in quotation marks. If you're talking about the gender affirmative model of treatment, then you are wrong. That model was designed to reduce some of the psychosocial pressures on children to help therapists and clinicians reach a more accurate diagnosis. It's not designed to turn a blind eye to any complicating factors in a diagnosis or to conflate gender non-conformity with gender dysphoria.

It's in quotations because while it's not "only" on paper, it has been in practice. Tavistock, for example, heavily discouraged any questioning of gender identity in any way at all - in ways that impeded therapists accurately evaluating their patients. It ended up causing a large number of psychologists to resign in the last couple of years.

You're correct in what the model is designed to do... but it isn't being applied as designed in a great many cases. That's part of why the high court came to the ruling it did. It didn't outright ban the use of puberty blockers, but it does now require a court order for them to be prescribed. Tavistock has been playing fast and loose and not doing their duty to ensure that they are acting in the best long-term interest of the children.

 

[krypton iodine sulfur]

One of the issues seen with Tavistock (as well as some gender centers in the US), is that they've taken an approach of "affirmation only", and have taken the position than any questioning of whether the person is actually clinically dysphoric is seen as being equivalent to conversion therapy. Pair this with a strong push toward social and legal self-identification without the need for a diagnosis, and it presents a risk to children.

Without the freedom to dig in to the causes of the apparent dysphoria, the therapist cannot effectively identify whether the dysphoria is genuine and persistent, or whether it's a side effect of a different issue.

I don't know why 'affirmation only' is in quotation marks. If you're talking about the gender affirmative model of treatment, then you are wrong. That model was designed to reduce some of the psychosocial pressures on children to help therapists and clinicians reach a more accurate diagnosis. It's not designed to turn a blind eye to any complicating factors in a diagnosis or to conflate gender non-conformity with gender dysphoria.

It's in quotations because while it's not "only" on paper, it has been in practice. Tavistock, for example, heavily discouraged any questioning of gender identity in any way at all - in ways that impeded therapists accurately evaluating their patients. It ended up causing a large number of psychologists to resign in the last couple of years.

You're correct in what the model is designed to do... but it isn't being applied as designed in a great many cases. That's part of why the high court came to the ruling it did. It didn't outright ban the use of puberty blockers, but it does now require a court order for them to be prescribed. Tavistock has been playing fast and loose and not doing their duty to ensure that they are acting in the best long-term interest of the children.

This conversation would be much easier if you could differentiate between what is generally applicable and specific concerns with the Tavistock clinic. If I'm being honest, I don't really have the energy to untangle the clusterfuck of shit you're mashing together.

 

[Emily Lake]

This conversation would be much easier if you could differentiate between what is generally applicable and specific concerns with the Tavistock clinic. If I'm being honest, I don't really have the energy to untangle the clusterfuck of shit you're mashing together.

Sorry for being unclear.

Tavistock is one of the more egregious clinics... but there are many other clinics that are adopting their approach. That causes me general concern over potential harm to children.

I want a responsible approach that recognizes that there are risks to children of getting the diagnosis wrong - that applies to both false negatives and false positives.