The Truth About Trans Medicine - Christina Buttons

The discussion, featuring Christina, centers on the controversial topic of gender-affirming care, particularly for youth. Christina criticizes U.S. medical organizations for endorsing these treatments without robust evidence, contrasting this with more cautious approaches in Europe. She highlights the role of autism and psychiatric conditions in the rising numbers of youth identifying as trans and stresses the lack of long-term data on the safety and efficacy of treatments like puberty blockers. Christina advocates for a more evidence-based, cautious approach, emphasizing the need for accurate information and the dangers of conflating gender nonconformity with gender dysphoria.

• Many doctors endorsing gender-affirming care view themselves as civil rights heroes.
• They believe they are continuing the legacy of the gay rights movement.
• There is an irony in this belief as it may be harming mostly gay children.

"A lot of the doctors that have signed on and endorsed gender affirming care believe that they are civil rights heroes. They're taking on after the gay rights movement."

• Many doctors see themselves as fighting for civil rights by endorsing gender-affirming care.

"Yeah, because they're actually hurting mostly gay kids."

• The irony lies in the potential harm to gay children, contradicting the civil rights hero narrative.

• Regret in detransition cases typically takes 4 to 8 years to manifest.
• There is a lack of accurate information provided to individuals about their condition.
• Misinformation is prevalent, leading to misguided decisions.

"What we see with detransition is that it typically takes between four to eight years for regret to occur. People are not receiving accurate information about their condition. They're lying to people."

• Regret takes years to surface, and misinformation is a significant issue.

• UK has made progress in rolling back extreme trans ideology in medicine and education.
• US medical organizations have not aligned their guidelines with systematic evidence reviews.
• European countries have found that risks of youth transition outweigh benefits and have prioritized psychotherapy over puberty blockers.

"US based medical organizations have so far refused to align their guidelines with the best available evidence provided by systematic evidence reviews, which many European countries have done."

• US medical guidelines are not aligned with evidence reviews, unlike Europe.

"They've significantly rolled back and halted the use of puberty blockers and are prioritizing psychotherapy now as a first line treatment for youth who are experiencing any kind of gender related distress."

• European countries are prioritizing psychotherapy over medical interventions for gender-related distress.

• UK's National Health Service releases annual referral data, highlighting a significant increase in youth referrals to gender identity services.
• US lacks a national health service and comprehensive data on pediatric gender clinics.
• The gender-affirming model of care originated in the US and is widely endorsed despite lacking sound evidence.

"The first year available, they had in 2009, there were about 78 youth referrals to the gender identity service. And as of the latest review, for probably the year 2023 to 2024, it was over 9000."

• UK data shows an exponential increase in youth referrals to gender identity services.

"We don't have any data on the over 100 pediatric gender clinics in the United States."

• There is a lack of comprehensive data on pediatric gender clinics in the US.

• US medical organizations engage in circular referencing, relying on each other for endorsements without sound evidence.
• This practice inflates the perceived legitimacy of gender-affirming care guidelines.
• Systematic evidence reviews are the pinnacle of evidence-based medicine, but US guidelines do not align with these reviews.

"There's a number of national, regional medical organizations that relied on the endorsements from those medical organizations."

• Circular referencing among medical organizations inflates perceived legitimacy without sound evidence.

"Systematic evidence reviews represent the pinnacle of evidence-based medicine and sort of the hierarchy, the pyramid of evidence."

• Systematic evidence reviews are the highest standard in evidence-based medicine.

• There are financial incentives for doctors to perform trans-based surgeries.
• Some doctors genuinely believe they are doing the right thing by endorsing gender-affirming care.

"You can earn far more from doing trans based surgeries than you can from doing regular surgery."

• Financial incentives exist for performing trans-based surgeries.

"I think that a lot of the doctors that have signed on and endorsed gender affirming care believe that they are civil rights heroes."

• Many doctors believe they are making a positive civil rights impact.

• A significant percentage of children identifying as trans have moderate to severe autistic traits.
• Autism is highly overrepresented in the cohort of children with gender dysphoria.

"The study you are referring to is a 2018 study of kids that found 35% had moderate to severe autistic traits."

• A notable percentage of trans-identifying children have moderate to severe autistic traits.

"As many as 47% had an autism diagnosis. They're highly over represented in the cohort."

• Autism is highly overrepresented among children with gender dysphoria.

• There is no long-term data on the safety and efficacy of puberty blockers and other medications used in gender-affirming care.
• The lack of long-term data is a significant reason for the rollback of such treatments in the UK.

"There's absolutely no long term data on the safety and efficacy of any of these medications."

• The absence of long-term data on puberty blockers and other medications is a critical issue.

• Several lawsuits from detransitioners are underway in the US.
• Successful lawsuits could potentially lead to rollbacks similar to those seen in the UK.

"There's a number underway. There's, I think, at least like, 14 cases, lawsuits underway from detransitioners."

• Multiple lawsuits from detransitioners are currently in progress.

"A lot of times, medical scandals and things of this nature end with lawsuits."

• Legal actions often lead to significant changes in medical practices.

• The recovered memory movement occurred in the late 1980s and 1990s.
• Therapists believed patients had repressed memories of significant trauma causing their current issues.
• Vulnerable patients were highly suggestible, leading to implanted false memories, often involving incest.
• This resulted in destroyed families and wrongful imprisonments based on pseudoscience.
• The movement ended with lawsuits from patients against therapists for ruining lives with junk science.

"The recovered memory movement took place in sort of like the late eighties and nineties. And it came from therapists had this idea that people possessed these repressed memories of significant trauma that could explain, you know, why their adult patients were coming into their office."

• Explanation: The movement was based on the idea that repressed traumatic memories explained adult patients' issues.

"They were just highly suggestible. So therapists would end up implanting false memories in them, and they would become convinced a lot of times they had to do with incest with family members."

• Explanation: Vulnerable patients were convinced of false memories, often involving family members.

"The recovered memory movement ended with lawsuits from the patients who sued their therapist for basically ruining their lives and their family lives based on absolute junk science."

• Explanation: The movement concluded with patients suing therapists for the damage caused by pseudoscientific practices.

• Focus on debunking unfounded scientific claims about innate gender identity and gender-affirming care.
• Claims presented as sound science lack empirical evidence.
• Gender pseudoscience parallels other historical medical scandals.

"Gender pseudoscience is unfounded scientific claims about innate gender identity and medical claims about the gender affirming model of care that are presented as sound science. But in fact, I are not supported by any empirical evidence."

• Explanation: Gender pseudoscience involves unsubstantiated scientific claims lacking empirical support.

• Similar to the opioid crisis, where pharmaceutical companies pushed non-addictive claims without real studies.
• Gender clinics have proliferated similarly to pill mills, driven by patient demand rather than medical necessity.

"It's not even just the medical organizations and the doctors. It's academia, it's research institutions, it's the Biden administration, it's activist organizations, like gay and civil rights organizations, mainstream media. They're all sort of complicit in promoting this particular narrative that gender affirming care is life saving, medically necessary, evidence based."

• Explanation: Various institutions and organizations promote gender-affirming care as necessary and evidence-based.

"Former medical scandals, I sometimes liken it to like the opioid crisis that we saw. It was these pharmaceutical companies who took a study, or even, you know, it wasn't even a real study, but they used that to say that their particular new brand of opioid wasn't addictive at all."

• Explanation: The opioid crisis involved false claims about non-addictive opioids, similar to gender pseudoscience.

"There were virtually none, like 15 years ago. Now there's at least 100 pediatric gender clinics and probably over 900 clinics that will prescribe medical interventions for the purposes of gender affirming care."

• Explanation: The rapid increase in gender clinics parallels the proliferation of pill mills during the opioid crisis.

• Disguised as a social justice issue, often linked to the gay rights movement.
• Mainstream media portrays opposition as religious conservatism, polarizing the issue.
• Critics, even those with liberal views, are labeled as bigots or transphobes.

"Because it's sort of disguised in this couched in social justice framework. People think it's sort of a continuation of the gay rights movement."

• Explanation: The current scandal is framed as a social justice issue, linked to the gay rights movement.

"Mainstream media sort of portrays it as, you know, something that only religious conservatives would oppose."

• Explanation: Media portrays opposition as a conservative stance, polarizing the issue.

• Christina relates to detransitioners due to her troubled teenage years with similar issues.
• Believes many young people are misdiagnosing their distress as gender identity issues.
• Concerned that the medical community is not exploring other factors contributing to distress.

"I came into this after reading detransitioner stories and finding so many similarities. I mean, it was like kind of reading my own journal or diary when I read their stories."

• Explanation: Christina's personal experiences resonate with the stories of detransitioners.

"I think that a lot of young people are encountering these narratives online and attributing symptoms that they may be experiencing from other things to a trans identity."

• Explanation: Young people may misattribute their distress to gender identity issues due to online narratives.

• Medical community often immediately affirms self-diagnosed gender identity without differential diagnosis.
• This approach is unique to gender medicine and not seen in other medical fields.

"There's no other area of medicine where the doctor relies on the patient's self diagnosis and then immediately affirms it and immediately refers them for medical interventions."

• Explanation: Unlike other medical fields, gender medicine often immediately affirms self-diagnosed identities.

"A lot of doctors now are just immediately affirming this self diagnosis."

• Explanation: Doctors are increasingly affirming self-diagnosed gender identities without further investigation.

• Considered the current standard of care.
• Fear of being labeled transphobic or facing professional repercussions.

"It's considered the standard of care currently. That's what the gender affirming model."

• Explanation: The gender-affirming model is the current standard, leading to immediate affirmation of self-diagnoses.

• Autism in girls often goes undiagnosed until adulthood, with a historical bias viewing autism as a predominantly male disorder.
• Diagnostic criteria and screening tools were traditionally created with boys in mind, contributing to underdiagnosis in girls.
• Girls tend to mask their autistic traits better and are more socially motivated, which can lead to their autism being overlooked.
• The consolidation of Asperger's into Autism Spectrum Disorder in 2013 has led to high-functioning autistic females going undetected.
• Puberty is a challenging time for autistic girls, leading to social difficulties and an inward search for explanations of their differences.
• High rates of gender nonconformity in the autistic population can lead to misinterpretation of autistic traits as gender dysphoria.
• Medical organizations have broadened the definition of being transgender, conflating it with common gender nonconformity, which can be confusing for autistic individuals.

"For a long time, autism was sort of conceptualized as, like, a boy's disorder because they believed that there were about, like, four to five males to every one female would get diagnosed."

• Historical bias in autism diagnosis viewing it predominantly as a male disorder.

"There are a lot of diagnostic criteria and screening tools that were sort of created with boys in mind."

• Diagnostic tools were designed primarily for boys, leading to underdiagnosis in girls.

"Girls are also more socially motivated, and they're better at camouflaging their traits."

• Girls' social motivations and ability to camouflage traits contribute to their autism being overlooked.

"With the removal of that, I think we're seeing a lot of what we call, like, high functioning autistic females who are going flying under the radar, going undetected."

• The removal of Asperger's has led to high-functioning autistic females being undetected.

"Puberty, it's very difficult. That's when social things start becoming a lot more important and friendships start becoming a lot more important."

• Puberty is a challenging period for autistic girls, exacerbating social difficulties.

"We have very high rates of gender nonconformity in the autistic population."

• High rates of gender nonconformity in autistic individuals can lead to misinterpretation as gender dysphoria.

"Medical organizations and scientific organizations have broadened what it means to be transgender, and they have conflated a trans identity with common gender nonconformity."

• Broadened definitions of transgender identity by medical organizations contribute to confusion.

• Despite increased awareness of autism, it often remains undiagnosed in girls due to masking and differences in presentation.
• Activism has influenced autism organizations, leading to support for gender-affirming care even for autistic individuals with intellectual delays.
• The quality of studies supporting gender-affirming care is low, with short-term follow-ups and methodological flaws.
• Detransition typically occurs between four to eight years after transitioning, but mainstream media often downplays these experiences.

"You'd think that somebody would be sitting opposite a girl who's profoundly distressed, especially a psychiatrist, and they'd be like, well, this girl is clearly autistic."

• Increased awareness of autism should lead to better diagnosis, but it often does not.

"A lot of autism orgs have totally capitulated to activists and they're completely on board with gender affirming care."

• Activism has influenced autism organizations to support gender-affirming care.

"They also are getting psychotherapy at the same time. So it's a very, very poor, poor quality studies that show some kind of, like, short term benefit."

• Studies supporting gender-affirming care are of low quality with short-term follow-ups.

"What we see with detransition is that it typically takes between four to eight years for regret to occur."

• Detransition often occurs years after transitioning, highlighting the long-term challenges.

• Parents face distress when their child is diagnosed with gender dysphoria and pressured into transitioning.
• Evidence supporting the efficacy of gender-affirming care is weak, with short-term benefits and poor-quality studies.
• Mainstream media often downplays the experiences of detransitioners, citing studies on low regret rates from different cohorts.
• The concept of sunk cost fallacy and the power imbalance between doctors and patients contribute to continued transitions despite potential regrets.

"I can't imagine the distress of a parent whose child is struggling with life."

• Parental distress in dealing with a child's gender dysphoria diagnosis.

"All they have is very short term follow ups and low quality studies that show maybe there's like a short term benefit in improving their mood."

• Evidence supporting gender-affirming care is based on low-quality studies with short-term benefits.

"It's just terrible the way detransition is talked about in the mainstream media, because it's mostly to downplay, diminish their experiences."

• Mainstream media often downplays the experiences of detransitioners.

"There is a bit of, like, a sunk cost fallacy that I think."

• The concept of sunk cost fallacy contributes to continued transitions despite potential regrets.

"People are not receiving accurate information about their condition. Their doctors are lying to them."

• Patients are not provided with accurate information about gender dysphoria and its high rate of desistance.

• Discussion on stigma surrounding psychiatric disorders versus biological disorders.
• Comparison of societal reactions to conditions like skin cancer and psychiatric conditions.
• Exploration of how stigma drives misinformation and activism.

"Do you think that one of the reasons that people are being lied to is there is a stigma around saying that something is a psychiatric disorder in a way that there isn't about a biological disorder?"

• Inquiry about whether stigma around psychiatric disorders contributes to misinformation.

• Activists’ efforts to de-emphasize gender dysphoria and promote innate gender identity.
• The pursuit of civil rights protections through the concept of immutable traits.
• Lack of empirical evidence supporting a biological basis for gender identity.

"What's driving this is activists have worked really hard to de emphasize the importance of gender dysphoria, and now they've moved on to innate gender identity."

• Activists aim to shift focus from gender dysphoria to innate gender identity for civil rights protections.

"There is no empirical evidence to support a biological basis for gender identity."

• Statement on the lack of scientific evidence for a biological basis of gender identity.

• Proposal to view transgender identity as a lifestyle choice.
• Emphasis on the importance of informed consent and accurate information.
• Distinction between medically necessary procedures and cosmetic elective procedures.

"What I'd like to work towards is conceptualizing transgender person as a lifestyle choice."

• Suggestion to view transgender identity as a lifestyle choice.

"I just don't want people being misled about the nature of their condition."

• Emphasis on the need for accurate information regarding transgender identity.

• Importance of empathy and respect when discussing transgender issues.
• Criticism of demeaning and toxic discussions online.
• Recognition of the struggle for identity and belonging among transgender individuals.

"I don't like the way that people are demeaned transgender people."

• Criticism of demeaning discussions about transgender people.

"Transgender people are people first and foremost, just like us, but they're struggling to reconcile fundamental human needs of identity and belonging."

• Emphasis on the shared human struggle for identity and belonging.

• Discussion on the political and cultural dimensions of the transgender debate.
• Role of prominent figures and journalists in shaping the conversation.
• Criticism of the media's failure to provide objective information.

"I strongly believe that we have the evidence and the arguments and the moral high ground and we need to lead with that."

• Belief in the importance of evidence-based arguments in the debate.

"Journalists have just basically been acting as activist mouthpieces."

• Criticism of journalists for acting as activists rather than providing objective information.

• Personal journey from being a social justice warrior to questioning mainstream narratives.
• Realization of the lack of objectivity in mainstream media.
• Motivation to become a journalist to provide accurate information.

"I trusted the mainstream media when they told me that we were experiencing a racism pandemic."

• Initial trust in mainstream media narratives.

"I eventually came to my senses and realized that something wasn't right with this narrative."

• Realization of the flaws in mainstream media narratives.

• Discussion on the media's role in spreading misinformation about gender-affirming care.
• Criticism of stock phrases used by media outlets to promote certain narratives.
• Importance of accurate and evidence-based information.

"CNN.com will use, and it's in dozens and dozens of articles, even in an article they were writing about the recent cast review, they inserted it stating that gender affirming care is medically necessary and evidence based."

• Criticism of media outlets for using stock phrases to promote narratives.

• Mention of parallels between trans activism and the neurodiversity movement.
• Recognition of both positive and problematic aspects of the neurodiversity movement.
• Suggestion to discuss autism more in relation to these issues.

"There's a lot of actual parallels going on between trans activism and sort of the neurodiversity movement."

• Identification of parallels between trans activism and the neurodiversity movement.

"Neurodiversity definitely has positives about it, but there are a lot of problems going on there, too."

• Acknowledgment of both positive and problematic aspects of the neurodiversity movement.