Michael Laidlaw and friends still misunderstand the basics of affirming care for trans youth

I’ve previously covered Dr. Michael K. Laidlaw et al.’s (2019) remarkable feat of fitting so many inaccuracies and distortions about trans youth treatments into an eight-paragraph letter to the editor in the Journal of Clinical Endocrinology & Metabolism, it took several thousand words to dissect these errors thoroughly. These included:

  • Claims that gender-affirming medical care causes “sexual dysfunction”, without acknowledgment that untreated gender dysphoria can itself be a significant source of sexual dysfunction and gender-affirming care is associated with improvements in sexual function.
  • Asserting that youth with untreated gender dysphoria are “healthy”, omitting any recognition of the many severe comorbidities that can accompany these.
  • Asserting the existence of new “rapid onset” form of gender dysphoria developing “suddenly” in teenagers through “social contagion”, supported by a single study that examined only parental reports and perceptions without including a single transgender, gender-nonconforming, or gender dysphoric youth.
  • Incorrectly claiming that all transgender adolescents who take puberty blockers will continue on to take cross-sex hormones as well.
  • And the utterly groundless assertion that use of puberty blockers induces persistence of adolescent gender dysphoria that would supposedly otherwise remit spontaneously.

As it turns out, that last item appears to be a persistent point of confusion for Laidlaw and his coauthors. In their letter to the editor, Laidlaw et al. stated that most “children” would “outgrow” their gender dysphoria “by adulthood”, inaccurately suggesting that adulthood rather than the onset of adolescence is the point at which gender dysphoria is observed to persist or desist. This is not the case: statistics about “desistance”, which are themselves often questionable and highly variable, are about whether or not childhood gender dysphoria persists beyond the onset of adolescence. Past that point, these dysphoric youth are unlikely to experience spontaneous remission of their dysphoria upon reaching adulthood – but Laidlaw et al.’s misrepresentation makes it seem as though this is the case. This is an attempt to provide a pretext for the continued denial of medically necessary care to gender-dysphoric adolescents, based on the false belief that it will simply go away within a few years and any affirming care would be unnecessary and inappropriate. Continue reading “Michael Laidlaw and friends still misunderstand the basics of affirming care for trans youth”

Gender-affirming chest reconstruction surgery is highly effective for nonbinary patients

Even in the context of transgender identities and gender-affirming care and medical treatments, gender norms and stereotypes received from a cissexist society can still be uncomfortably prevalent, and this is particularly visible in the hostility with which nonbinary people trans people are often met. From within trans communities, “transmedicalist” factions often argue that the authenticity of one’s transness is defined by one’s desire and willingness to undergo certain gender-affirming medical interventions; from outside, “gender-critical” trolls characterize being nonbinary as merely adopting a superficial identity for the sake of distinguishing oneself as “special” or “different”, while wider society often has little awareness of the possibility and reality of genders outside the female/male binary at all.

None of these notions reflect the reality of nonbinary trans people’s lives – and one instance in which this becomes particularly clear is in nonbinary trans people’s pursuit of gender-affirming surgeries. Continue reading “Gender-affirming chest reconstruction surgery is highly effective for nonbinary patients”

A measured look at lactation and breastfeeding by trans women

While public awareness of transness and visibility of trans people have grown substantially in recent years, many people are still unaware of some of the particular details of the medical process of transitioning. For instance, trans women have described occasionally encountering individuals who are wholly unaware of what our breasts are made of; these people often assume that trans women’s breasts are always created by breast augmentation surgery. In reality, hormone therapy with antiandrogens and estrogen (and sometimes progesterone or other progestins) is sufficient to produce the development of breasts – not merely the appearance of breasts, but actual breast tissue histologically identical to that seen in cis women, along with the accompanying anatomical structures (Phillips et al., 2014).

And one of the least-understood aspects of trans women’s breasts is their capacity for lactation and nursing infants. Continue reading “A measured look at lactation and breastfeeding by trans women”

“Hey, where’s my Gender Analysis?”

Greetings, programs! You might have noticed that the blog looks a little different, doesn’t have a lot of its content, is kind of hideous, is located at an entirely new domain… Okay, it’s not even the same blog. Here’s the scoop: At Gender Analysis, we relied on hosting from a provider that turned out not to be as reliable as we thought. Whoops. But don’t be alarmed! We’re restoring from backups over the next few days, and Gender Analysis as you know it will be resurrected in its totality. While that process is underway, we’re using rapidonsetgenderdysphoria.com (which we somehow managed to grab before anyone else thought to!) as a temporary holding area for new Gender Analysis content. In the meantime, if you’re looking for material that’s currently offline during this transition, you can find a complete archival copy of genderanalysis.net at the Internet Archive. So please stand by, and we’ll return to your regularly scheduled programming shortly.

Analytically yours,

The Gender Analysis Team