What the media gets wrong about UK gatekeeping and detransitioners

[Lonemathsytoothbrushthief]

I have to vent about this. I won't post the related articles because we all know what these news pieces look like by now. The BBC, sky news, all the usual suspects made some stories about the supposedly high numbers of actually cis people(this is always assumed, despite the existence of trans detransitioners) detransitioning after accessing gender clinics, and the blame is being pinned on not enough gatekeeping in the NHS.

Why is this wrong? Well for a start, I have yet to see someone tell me how it's the NHS, with longer waiting lists and more difficulty accessing trans healthcare than any of the private clinics or ways of self medicating via foreign markets for hormones, which would be responsible for all of these detransitioners. Next up, the articles routinely(as has been the case with literally every round of scaremongering) bring up that these detransitioners are disproportionately mentally ill and autistic, as a way to imply that gatekeeping should stop such people from transitioning in the first place. Simultaneously, we have a nurse trying to bring a court case to say under 18s can't consent to puberty blockers, and guess what? There's an autistic kid in the mix. Again and again, people use disability to fuel assumptions about lack of agency, as if disabled people don't have our own thoughts, desires and yes, gender identities and sexualities.

What I would like just one of these reports to look into is how medical gatekeeping works for trans and disabled people. We have a system which is far from informed consent even if there are seemingly many who will say it's not that bad because trans people need time to be secure in their identities. I have heard of trans people being delayed hormones and surgeries which they want because of suicide attempts, and mental health histories, while those with "a clean bill of health" encounter no such problems. This does NOT prevent detransitioners. This attacks  the health of trans people in the UK as a whole, because how are we to navigate a health system which treats any further issue as a reason to delay life saving trans healthcare? How can we accept a fundamentally ableist system for treating a demographic which is, largely due to our environment, disproportionately disabled? And why do trans people who aren't proudly disabled still treat waiting times, gatekeeping and the need for a "clean bill of health", mental or otherwise, as a necessity or even praise them for the time to think?

[Skittles87]

Thanks for posting this. I recently read a couple of mainstream news articles about detransitioners that seemed very iffy, but as a cis person without detailed knowledge of the issue, I wasn't sure why. This clarifies things a lot.

 

The thing that bothers me most is when they don't report numbers at all. When you look at the actual figures for detransitioning, they're pretty small (and they don't take account of people who still identify as trans or non-binary but decide they don't want medical intervention). But I remember one article, I think it was in The Telegraph, that implied huge numbers were detransitioning. When I looked up the actual figures I was surprised at how low they were.

[Lonemathsytoothbrushthief]

5 minutes ago, Skittles87 said:

Thanks for posting this. I recently read a couple of mainstream news articles about detransitioners that seemed very iffy, but as a cis person without detailed knowledge of the issue, I wasn't sure why. This clarifies things a lot.

 

The thing that bothers me most is when they don't report numbers at all. When you look at the actual figures for detransitioning, they're pretty small (and they don't take account of people who still identify as trans or non-binary but decide they don't want medical intervention). But I remember one article, I think it was in The Telegraph, that implied huge numbers were detransitioning. When I looked up the actual figures I was surprised at how low they were.

They base this on a number of questionable studies which concluded that the majority of people attending gender clinics detransition. The most typical flaws in these studies are: poor definitions of transitioning, the idea that someone possibly fits the criteria for gender dysphoria being equated with gender clinics diagnosing them as such(sometimes people fit the criteria but obviously don't plan to socially transition to be seen as another gender), poor definitions of detransitioners for example that those who stopped attending a gender clinic count as detransitioners without long term followup, or that detransitioners can be assumed to be cis, neglecting any followup on their overall life situation and environment which may influence how safe it was for them to transition.

 

But yeah, the numbers are extremely small. Especially when we're talking people who accessed any medical treatments whatsoever - I know of a youtube channel centred on detransition with four detransitioners, where about three of them didn't even touch hormones. So when people fearmonger about how much detransitioners are harmed, they're often using detransitioners who never did anything but ask for different name and pronouns as evidence.

[Lonemathsytoothbrushthief]

Another point is that even if the numbers of detransitioners grow larger, this is only a problem if you see trans bodies as inherently unattractive, unappealing, deserving of discrimination. After all, transphobes LOVE to tell trans people how we should be able to accept our bodies as they are, when we consider medical transition. But when a cis person accidentally transitions, they are allowed to feel distressed, traumatised and pressure is put on the medical system to change? What is this ridiculous double standard?

[iff]

I  read The Gender Games by Juno Dawson (one of the funniest but a very touching, interesting and a really eye opening read). She states that one gender clinician in London, Dr Stuart Lorimer as having had 15 patients cease hormone treatment out of 4,000 who have had hormone treatment. That is 0.375 percent, which is miniscule. 

 

With the tories in charge, they seem to be giving a voice to transphobic. One of their ministers in opposing grc reform showed how she had absolutely no knowledge about grc forms (either juno dawson or Paris Lees had great takedown on twitter of why she was so incorrect) 

[Skycaptain]

Unfortunately anything to do with sex sells, and these sort of sensationalist articles generate viewers. 

It's to be expected that there will be a small number of people who, having gone to gender clinics, change their minds for various reasons. People with an agenda will jump on this sort of thing for their own purposes, most of which is a degree of "why is this treatment available for free when I'm waiting for my own treatment". Same as people jumping on the "A lot of people who have gender identity issues are also diagnosed as being on the Autistic Spectrum," bandwagon. Last year some in the British media were trying to suggest that transgender was a trend in the Autistic community. 

[Anthracite_Impreza]

The disabled aren't allowed opinions, we aren't allowed autonomy and feelings and needs. We are disabled, and thus too broken to think for ourselves, especially we weird, scary autistics. Our opinions and needs are to be dismissed cos we don't know anything about ourselves or the world.

[Karst]

I think that one issue here is that people are eager to label anything that doesn't help their specific problems as wasteful spending.

[Calligraphette_Coe]

8 hours ago, Lonemathsytoothbrushthief said:

I have to vent about this. I won't post the related articles because we all know what these news pieces look like by now. The BBC, sky news, all the usual suspects made some stories about the supposedly high numbers of actually cis people(this is always assumed, despite the existence of trans detransitioners) detransitioning after accessing gender clinics, and the blame is being pinned on not enough gatekeeping in the NHS.

 

It's always the same old thing with certain media outlets who pander to a conservative population: pick something you don't like, find out the problems, drum up outrage and look for blame. It doesn't matter if they get it right or are even objective as long as Truth, Justice and Everything Morally Wonderful rides in to save the day. It was the same way with homosexuality in the 70s, when practititioners and APA finally reached consensus that that is just how reality is. My god, the practititioners before the Great Enlightenment used to want to institutionalize homosexuals and subject them to electroshock to 'cure' them.

 

Same errors, different era, different outgroup-- only the script hasn't changed.

 

I so wish I could roll back the clock and start at 20 again to become a biochemist and a genetic engineer using CRISPR/CAS9 to usher in a new era of HRT and transmedicine. I can't see blockheaded approaches used now surviving in some kind of enlightened treatment  ear of societal acceptance of something that happens and has happened in ages past to be allowed to exist on in a fog of ignorance and prejudice. 

 

 

[Calligraphette_Coe]

Just curious, do _any_ of these journalists _or_ the people about whom they write who have detransitioned say even _once_, "Yeah, there _are_ people for whom surgery and hormones work and we should be happy for them"? Sorry to say it, but I get the impression that it's like ex-smokers being militant. And that's not even a good comparison, because smoking has been proven to harm everyone in some way or another and nicotine is addictive as hell, quite likely one of the most addictive substances known. Apologies for all the underscores, I just think in superlatives sometimes and feel a need to convey those spots where I do. Sort of like being intellectually breathy-- but dammit, I've seen too many people struggle with this like I struggle with this and we can't all be wrong all the time.

[Karst]

12 minutes ago, Calligraphette_Coe said:

Just curious, do _any_ of these journalists _or_ the people about whom they write who have detransitioned say even _once_, "Yeah, there _are_ people for whom surgery and hormones work and we should be happy for them"? Sorry to say it, but I get the impression that it's like ex-smokers being militant. And that's not even a good comparison, because smoking has been proven to harm everyone in some way or another and nicotine is addictive as hell, quite likely one of the most addictive substances known. Apologies for all the underscores, I just think in superlatives sometimes and feel a need to convey those spots where I do. Sort of like being intellectually breathy-- but dammit, I've seen too many people struggle with this like I struggle with this and we can't all be wrong all the time.

I think there's a general tendency for people to assume that if something was bad for them personally, it must be bad for everyone else.

[Lonemathsytoothbrushthief]

4 minutes ago, Calligraphette_Coe said:

Just curious, do _any_ of these journalists _or_ the people about whom they write who have detransitioned say even _once_, "Yeah, there _are_ people for whom surgery and hormones work and we should be happy for them"? Sorry to say it, but I get the impression that it's like ex-smokers being militant. And that's not even a good comparison, because smoking has been proven to harm everyone in some way or another and nicotine is addictive as hell, quite likely one of the most addictive substances known. Apologies for all the underscores, I just think in superlatives sometimes and feel a need to convey those spots where I do. Sort of like being intellectually breathy-- but dammit, I've seen too many people struggle with this like I struggle with this and we can't all be wrong all the time.

I've got to be honest the journalists in britain are not invested in researching or presenting the facts of their clickbait stories at all right now, so far as I can tell they don't bother to find detransitioners who actually went on hormones like 95% of the time. But I've watched channels of detransitioners who DID go on them and such, and there are a few who are fairly happy with their bodies, what's most bizarre is when some of them are like yeah I'm glad I had surgery I don't mind if people aren't sure if I'm a woman and STILL, still say we need the gatekeeping. At the same time even the most well researched stories about how long the waiting lists are for trans people here seem to have waiting times at least half of what they are in some areas, or else neglect to mention that the waiting lists reported are basically for a first appointment to try and get a gender dysphoria diagnosis and not actual hormones, which take another few years, so it seems very well calculated to always frame detransitioners as an important part of the narrative - as if that isn't bizarre in a country where some gender clinics' waiting lists literally aren't moving any more. Somehow we need more gatekeeping, even when the gate is rusted shut completely???

 

I should also point out that someone should maybe point out to transphobes that trying to claim trans people are autistic and then remove their bodily autonomy is grounded in a history of conversion therapy practiced on both lgbt+ and autistic kids. Coincidence much?

[Guest]

1 hour ago, Lonemathsytoothbrushthief said:

I've got to be honest the journalists in britain are not invested in researching or presenting the facts of their clickbait stories at all right now, so far as I can tell they don't bother to find detransitioners who actually went on hormones like 95% of the time. But I've watched channels of detransitioners who DID go on them and such, and there are a few who are fairly happy with their bodies, what's most bizarre is when some of them are like yeah I'm glad I had surgery I don't mind if people aren't sure if I'm a woman and STILL, still say we need the gatekeeping. At the same time even the most well researched stories about how long the waiting lists are for trans people here seem to have waiting times at least half of what they are in some areas, or else neglect to mention that the waiting lists reported are basically for a first appointment to try and get a gender dysphoria diagnosis and not actual hormones, which take another few years, so it seems very well calculated to always frame detransitioners as an important part of the narrative - as if that isn't bizarre in a country where some gender clinics' waiting lists literally aren't moving any more. Somehow we need more gatekeeping, even when the gate is rusted shut completely???

 

I should also point out that someone should maybe point out to transphobes that trying to claim trans people are autistic and then remove their bodily autonomy is grounded in a history of conversion therapy practiced on both lgbt+ and autistic kids. Coincidence much?

The gatekeeping is hella annoying for sure. People shouldn't have to wait so long but I do think measures need to be taken. I believe gender dysphoria needs to be throughly explored. A therapist needs to talk to them about past experiences and anything that could possibly influence transition other than actual gender dysphoria. Trauma, internalized misogyny, being gay, body dysmorphia, even fetishizition.  That was the check list I went through my head when I spent my year questioning. A through explorion of feelings can help them cement their medical decisions and what they need. You need to be 100% sure when transitioning. I can completely understand why therapists would be uncomfortable giving a person the go for HRT after only a few sessions and not feeling like they have a grasp on the full picture. It is a little complicated on both ends, especially when that trans person needs the treament. I believe it should be up to the patient to decide what they need medical wise though. To me a therapist would just be doing the job of the therapist and nothing more. 

 

Medical stuffz is scawy : P

[Lonemathsytoothbrushthief]

8 hours ago, KrysLost said:

The gatekeeping is hella annoying for sure. People shouldn't have to wait so long but I do think measures need to be taken. I believe gender dysphoria needs to be throughly explored. A therapist needs to talk to them about past experiences and anything that could possibly influence transition other than actual gender dysphoria. Trauma, internalized misogyny, being gay, body dysmorphia, even fetishizition.  That was the check list I went through my head when I spent my year questioning. A through explorion of feelings can help them cement their medical decisions and what they need. You need to be 100% sure when transitioning. I can completely understand why therapists would be uncomfortable giving a person the go for HRT after only a few sessions and not feeling like they have a grasp on the full picture. It is a little complicated on both ends, especially when that trans person needs the treament. I believe it should be up to the patient to decide what they need medical wise though. To me a therapist would just be doing the job of the therapist and nothing more. 

 

Medical stuffz is scawy : P

Heads up, when you've already had abusive people question your gender this whole "thorough examination" of why someone thinks they're trans can be triggering. Cue me dissociating and possibly shutting down. The way we assume people are not capable of asking for therapy for trauma in this one area is an extension of the history of transphobia and how it's assumed that you must separate out the disabled people from people who want to transition.

If we didn't have medical gatekeeping, people wouldn't be hiding their symptoms of trauma and mental illness and personality disorders etc, they could actually ask for help which right now always has the veiled threat of what if they won't let me transition. The very point where you say it should be up to the patient contradicts the entirety of medical gatekeeping...

[Guest]

29 minutes ago, Lonemathsytoothbrushthief said:

Heads up, when you've already had abusive people question your gender this whole "thorough examination" of why someone thinks they're trans can be triggering. Cue me dissociating and possibly shutting down. The way we assume people are not capable of asking for therapy for trauma in this one area is an extension of the history of transphobia and how it's assumed that you must separate out the disabled people from people who want to transition.

If we didn't have medical gatekeeping, people wouldn't be hiding their symptoms of trauma and mental illness and personality disorders etc, they could actually ask for help which right now always has the veiled threat of what if they won't let me transition. The very point where you say it should be up to the patient contradicts the entirety of medical gatekeeping...

Eh I knew I'd miss something in this discussion. 

[PoeciMeta]

Hey, it's fair I guess. People don't want to spend money on creeps. Look, we're even autistic. I know, right? Ah, I guess at least we're not completely useless if we can entertain.

[Karst]

I think that some of these "gatekeepers" have genuinely good intentions, but end up doing more harm than good.  They want to keep people from rushing into major decisions, but they delay those who are really in need.  It doesn't help that some of them have limited experience with the community that they're trying to help.