The title of this substack is misleading and unfortunate because, as the essay shows, “regret” is too simplistic a concept to convey the questions we should be asking.
Nice point but I think the entire Cass Study debate is suspect from fundamental conditions.
It is trivially easy to concoct control groups for such studies - psychotherapy plus placebo, psychotherapy plus chemistry; watchful wait plus placebo, watchful wait plus chemistry, watchful wait plus psychotherapy.
Unfortunately the outcome will never be conclusive because the ___inputs are not definable___ Children cannot self-diagnose period, and adults who are delusional cannot self diagnose because they are delusional. That is really lost on everyone. Delusional people don’t know they are delusional.
There is no clinical test which can tell the difference between delusion and non-delusion for anything relating to gender, since gender is a linguistic, not a medical term.
As to distress, is no clinical way to define the difference between puberty anxiety and genital dysmorphic distress and sex delusion.
In other words you cannot tell if a boy is distressed for having to become a man at puberty, distressed for having male genitals, or distressed for having a delusion of being female, or distressed for being gay, or any number of sex related distressed issues for male children, at puberty. It’s ludicrous.
If you cannot separate the conditions, then what exactly does a given “control” set of outcomes prove ?
Since 90-95% of such children snap out of it (I was one) through puberty, and there is no definitive way to find children who don’t, you have a serious ethical problem irrespective of normal study control groups.
The probability that you will give a distressed child damaging and unnecessary treatment is 90-95%. For the remaining 5-10%, remember the net adult rate of clinical-level trans distress is 0.3% of the population, and those demanding chemistry or surgery is 5% of that 0.015% of the population. No clinical treatment or experimental treatment would be allowed to exist where the probability of harm is 90-95% with the remaining 5% having unverifiable benefit.
That means that assuming 100% of the distressed children are gay, fewer than 1 in a hundred may require clinical support as an adult but even that is suspect - most adult trans only identified later in life often after their 40’s, with marriage and children, as heterosexuals.
The only ethical research is identifying what therapy helps a majority of distressed children become happy gay adults - and seeing if there may be any link - completely unknown - between distress at puberty and adult trans. In general, there isn’t from what I’ve read.
Because to sound like a broken record, opposite-sex trans is a delusion - either that you have an opposite sex possession, or the wrong genitals.
You do not comply with delusions to resolve distress (“I am a bird, I am Jesus Christ, someone controls my thoughts”) you can only help people accommodate the stress from being delusional and how it interferes with normal life.
This article has a few problems. The section on the lack of control groups in research published by gender clinics is one that deserves a response. The author challenges the claim that use of control groups is unethical in the study of medical transitions. In fact, one kind of control group that is often unethical in medical research is the use of a "no treatment control group." Whether the patient's condition is physical, psychiatric or both, if lack of treatment causes the condition to become worse, remain the same, or result in prolonged suffering, patients should in many cases not be advised or encouraged to forego treatment for purposes of research. In cancer research, for example, the groups of subjects typically are assigned to differing treatments, such as radiation versus chemotherapy, but are not placed in a no-treatment group. When the patient's condition is not life threatening or progressive and the suffering is not significant, a no-treatment control group may be more feasible.
It is not clear what kinds of control groups should or shouldn't be used in research on medical transitioning. Dr. Cass proposed in her Review that the UK go ahead with clinical trials that test at least some of the processes currently included in medical transitioning, and it will be interesting to watch what unfolds from her recommendations.
“View the original version of this article in Dutch: Transspijt is mogelijk 33%” - transspijt is the word translated
the Dutch word spijt could be literally translated as “regret” as in “het spijt me” - “I regret” or “I am sorry”
But the deeper feeling of the Dutch is to have a mix of sorrow, regret, and … grieving.
One regrets a tattoo, or buying a Tesla.
One grieves for a death.
Granted Trans use “deadname” the idea grief is apt.
The Dutch spijt and English spite are not related though pronounced almost identically.
The title of this substack is misleading and unfortunate because, as the essay shows, “regret” is too simplistic a concept to convey the questions we should be asking.
Nice point but I think the entire Cass Study debate is suspect from fundamental conditions.
It is trivially easy to concoct control groups for such studies - psychotherapy plus placebo, psychotherapy plus chemistry; watchful wait plus placebo, watchful wait plus chemistry, watchful wait plus psychotherapy.
Unfortunately the outcome will never be conclusive because the ___inputs are not definable___ Children cannot self-diagnose period, and adults who are delusional cannot self diagnose because they are delusional. That is really lost on everyone. Delusional people don’t know they are delusional.
There is no clinical test which can tell the difference between delusion and non-delusion for anything relating to gender, since gender is a linguistic, not a medical term.
As to distress, is no clinical way to define the difference between puberty anxiety and genital dysmorphic distress and sex delusion.
In other words you cannot tell if a boy is distressed for having to become a man at puberty, distressed for having male genitals, or distressed for having a delusion of being female, or distressed for being gay, or any number of sex related distressed issues for male children, at puberty. It’s ludicrous.
If you cannot separate the conditions, then what exactly does a given “control” set of outcomes prove ?
Since 90-95% of such children snap out of it (I was one) through puberty, and there is no definitive way to find children who don’t, you have a serious ethical problem irrespective of normal study control groups.
The probability that you will give a distressed child damaging and unnecessary treatment is 90-95%. For the remaining 5-10%, remember the net adult rate of clinical-level trans distress is 0.3% of the population, and those demanding chemistry or surgery is 5% of that 0.015% of the population. No clinical treatment or experimental treatment would be allowed to exist where the probability of harm is 90-95% with the remaining 5% having unverifiable benefit.
That means that assuming 100% of the distressed children are gay, fewer than 1 in a hundred may require clinical support as an adult but even that is suspect - most adult trans only identified later in life often after their 40’s, with marriage and children, as heterosexuals.
The only ethical research is identifying what therapy helps a majority of distressed children become happy gay adults - and seeing if there may be any link - completely unknown - between distress at puberty and adult trans. In general, there isn’t from what I’ve read.
Because to sound like a broken record, opposite-sex trans is a delusion - either that you have an opposite sex possession, or the wrong genitals.
You do not comply with delusions to resolve distress (“I am a bird, I am Jesus Christ, someone controls my thoughts”) you can only help people accommodate the stress from being delusional and how it interferes with normal life.
This article has a few problems. The section on the lack of control groups in research published by gender clinics is one that deserves a response. The author challenges the claim that use of control groups is unethical in the study of medical transitions. In fact, one kind of control group that is often unethical in medical research is the use of a "no treatment control group." Whether the patient's condition is physical, psychiatric or both, if lack of treatment causes the condition to become worse, remain the same, or result in prolonged suffering, patients should in many cases not be advised or encouraged to forego treatment for purposes of research. In cancer research, for example, the groups of subjects typically are assigned to differing treatments, such as radiation versus chemotherapy, but are not placed in a no-treatment group. When the patient's condition is not life threatening or progressive and the suffering is not significant, a no-treatment control group may be more feasible.
It is not clear what kinds of control groups should or shouldn't be used in research on medical transitioning. Dr. Cass proposed in her Review that the UK go ahead with clinical trials that test at least some of the processes currently included in medical transitioning, and it will be interesting to watch what unfolds from her recommendations.