Linkage

Wow. This is mindblowing.

For some transgender people, hormone replacement therapy (HRT) is “an ontological necessity for a livable life” (Fondén, 2020, p. 29). Some trans people engage in do-it-yourself (DIY) HRT (aka “DIYers”) because of care barriers, including medication costs, difficulty accessing healthcare providers, and mistrust in professionalized medical systems. Although DIY HRT is often framed as highly risky, we analyzed in-depth interviews with 36 U.S. DIYers to understand how they themselves perceived their goals, challenges, and risk mitigation using the Liberatory Harm Reduction and lay expertise frameworks. Participants emphasized experiences of transphobia within medical spaces. In contrast, participants characterized DIY HRT as a community-driven, accessible, and empowering practice. Through self-organized online forums and mutual aid, DIYers constructed adaptive health-promoting practices that challenge biomedical conceptualizations of risk and affirm trans agency.

A really comprehensive roundup:

In 2018, a physician and researcher named Lisa Littman published a paper in the journal PLOS One describing what she termed “rapid-onset gender dysphoria” (ROGD). She hypothesized that some young people—particularly those assigned female at birth—might claim a transgender identity after increasing their social media use or befriending trans peers. According to this perspective, online platforms supposedly “infect” teenagers with the idea that they are trans, creating clusters of youth who suddenly identify in new ways.

From the moment Littman’s paper appeared, researchers and advocacy groups criticized its methodology. Littman’s survey collected responses solely from parents recruited on three websites openly skeptical or critical of medical care for trans youth. These anti-trans or “trans-skeptical” forums—4thWaveNow, Transgender Trend, and Youth Trans Critical Professionals—advertised Littman’s survey to parents who already believed their child’s trans identity was misguided. Unsurprisingly, 76.5% of respondents felt their child was “incorrect” in identifying as transgender.

Critics also pointed out that the youth themselves were never surveyed. Parents who participated were asked to diagnose their children with gender dysphoria (a clinical term referring to distress due to a mismatch between one’s internal sense of gender and assigned sex at birth), even though most parents do not have training in psychology or medicine.

[…]

Although Littman’s original 2018 article used the term ROGD, many discussions in conservative blogs and online groups substituted or conflated it with “transgender social contagion.” This idea claims that trans identity spreads from teen to teen like a virus—an online trend rather than a real expression of self.

While the ROGD paper didn’t use the “social contagion” phrase outright, it alluded to the concept through references to “peer influence” and social media immersion. Almost immediately, these concepts were embraced by anti-trans activists, policymakers, and media personalities. The theory gave them a sort of “scientific” veneer to argue that trans kids are just “confused.” As a result, many now simply refer to both ROGD and “transgender social contagion” interchangeably, even though they are (at least in Littman’s framing) slightly different.

Over the last four days, the bizarre Cybertruck fire outside a Trump hotel in Las Vegas has run from comical interlude to possible terrorist incident to tragic suicide of another veteran of America’s forever wars. Each of these descriptions still captures an important part of the story. As I noted yesterday, while Matthew Livelsberger appears to have had a series of combustible and likely abusive relationships going back many years he also appears to have suffered from PTSD and possibly a traumatic brain injury since returning from a tour of duty in 2019. (I’m tentative on the spousal abuse front only because for now the direct evidence for that that I’m aware of comes only from the friend of his ex-wife.) But at least for the moment there is a pretty striking lack of attention to the political motives he expressed in at least two documents or what I guess we might call minifestos that investigators found on his iPhone.

Those documents denounce Democrats and demand they be “purged” from Washington, by violence if necessary, and express the hope that his own death will serve as a kind of bell clap for a national rebirth of masculinity under the leadership of Donald Trump, Elon Musk and Bobby Kennedy Jr.

Did you miss that stuff?

Yeah, me too!

Most headlines I’d seen in the news report only that he warned of national decline and bore “no ill will toward Mr. Trump,” in the words of one of the investigators. That gloss on Donald Trump is, shall we say, a bit of an understatement, as you can see in these excerpts.

For activist Raquel Willis, co-founder of the Gender Liberation Movement alongside Eliel Cruz, the fight for trans rights and universal bodily autonomy has to move past the visibility era to be truly impactful.

“This idea of simply using visibility as a means to bring about the kind of culture and society that’s going to receive trans folks with the respects that we deserve is over,” she told PinkNews, “and so we have to be thinking in new ways about how to protect ourselves, our voices, our histories and our brilliance without relying on a lot of the institutions that have really pushed the visibility vehicle.”

[…]

For many, access to abortion and gender affirming care might be thought of as different social issues impacting distinctly different groups of people; things to campaign for separately but not together. This line of thinking is similar to how trans rights and women’s rights more widely are often framed by the right-wing press as in direct contrast with one another when instead they are not opposites sides of a coin but rather intricately intertwined.

New York Democrat Alexandria Ocasio-Cortez noted this in response to Mace’s bathroom ban, telling reporters in November that such restrictions endanger “all women and girls” because “people are going to want to check their private parts in suspecting who is trans and who is cis”.

“The idea that Nancy Mace wants little girls and women to drop trou in front of, who, an investigator, because she wants to suspect and point fingers at who she thinks is trans is disgusting. It is disgusting. And frankly, all it does is allow these Republicans to go around and bully any woman who isn’t wearing a skirt because they think she might not look woman enough,” AOC added.

The intersectionality between the two issues hence sits at the very core of the GLM’s mission because “many of the same forces and entities that are targeting access to abortion are also targeting access to gender affirming care”, Willis said.

Cruz explained: “In the United States, legal precedents are being used to try to pass one another. So these connections are already there in terms […] of those who are making these attacks and for us it was important to marry the different groups of people that people may not necessarily talk about in the same ways.

“Really bringing those connections together in a very intentional way.” 

Greenfield sites are not the solution for housing affordability, even if it’s an easier political sell than increasing density in existing neighborhoods. Housing needs to work for nondrivers, whether that’s people like me who can’t drive, people who can’t afford to drive, young people or older adults (on average, Americans will spend the last seven to 10 years of their lives being unable to drive). When driving isn't an option for so many people, building more car-dependent communities isn't a solution.

When I see advertisements for greenfield developments, especially ones that are built with “new urbanist” ideals, I think back to my year in North Carolina. Southern Village wasn’t just an exurban housing development: The “Village” featured a town square with an organic grocery store, a small gym, and even a restaurant or two. But it definitely wasn’t possible to get everything you needed without leaving, and leaving meant navigating the highway.

For people who can drive, being able to reduce their driving trips because there’s a cute coffee shop nearby might feel great, but for people who can’t drive like me, places like Southern Village feel more like a desert island than the intended suburban paradise. Without enough transit, and often with only a highway shoulder connecting the development with all the other places a person might need to go, these places necessarily exclude people who are physically or financially unable to drive. Because, sometimes, you need more than a coffee shop or a cute grocery store.

Fully diluted valuation is an estimate so flawed that even publishing it should be considered journalistic malpractice. It is calculated by taking the current going price for a crypto token on an exchange and multiplying it by the total number of tokens that may ever exist for that cryptocurrency. To use $TRUMP as an example, people are currently trading these coins for around $53 apiece. There are 200 million of them in circulation, which puts the token’s (already highly questionable, as I explain in a moment) “market cap” at around $10.7 billion. Eventually, over a period of three years (assuming Trump does not lose interest or change the parameters of the deal), 1 billion tokens are set to be released. It is this supply — three years from now — that is being multiplied by the current price of the tokens to achieve estimates in the several tens of billions for how much Trump’s “net worth” has increased, as though it can be safely assumed that not only will the price remain stable over the next three years, but that there is another more than $40 billion that is guaranteed to just materialize.

This is not to downplay the extent to which Trump is grifting his devotees and those crypto traders looking to make a buck on memecoin speculation. But it is important that we accurately report on his cons and do not contribute to misleading crypto hype for the sake of large numbers.

After years of struggle, UK parents successfully lobbied the NHS to start prescribing gender-affirming medical treatments for minors under 16 in 2011. Their success, however, was short-lived.

In April, NHS England released the findings of a four-year inquiry into GIDS led by Dr. Hilary Cass, a pediatrician with no experience treating adolescents with gender dysphoria. On the recommendation of the Cass Review, which was highly critical of adolescent medical transition, the NHS services in England, Wales and Scotland have stopped prescribing puberty blockers for gender dysphoria. The British government also banned private clinics from prescribing them, at least temporarily.

Though there is much more evidence now to support gender-affirming care than in 2008, there is also a much stronger anti-trans movement seeking to discredit and ban such care.

British media coverage has given that movement a big boost in recent years, turning the spotlight away from the realities that trans kids and their families are facing, and pumping out stories nitpicking at the strength of the expanding evidence base for gender-affirming care. Its coverage of the Cass Review followed suit.

US media, unsurprisingly, gave less coverage to the British review, but most of the in-depth coverage followed British media’s model. Underlying this coverage are questionable claims by people with no experience treating minors with gender dysphoria, and double standards regarding the evidence for medical and alternative treatments.

I emphatically reject the author's opinion that "it’s not ridiculous to suggest, for example, that a randomized trial of puberty blockers would be a good idea." (Why not a randomised trial of ambulances? We'll send half of emergency callers an Uber instead.) But he's certainly thorough, and excepts like this are astounding.

The Cass review was an interesting juxtaposition. Some of the scientific arguments were very reasonable, and the York team generally did a decent job with the systematic reviews that informed the document. However, the review itself often positioned bizarre theories about gender dysphoria alongside data and evidence. I’ve recounted quite a few examples of this during my pieces, but I thought I’d share one more that I found recently:

“Research commentators recommend more investigation into consumption of online pornography and gender dysphoria is needed. Some researchers (Nadrowski, 2023) suggest that exploration with gender-questioning youth should include consideration of their engagement with pornographic content.” (Cass review, page 110)

This paragraph suggests that porn can potentially turn children trans. If you look up the reference, it is to this opinion piece from a psychiatrist. The paper itself contains no data connecting gender dysphoria to pornography, but basically argues that teen girls may view porn and become so disgusted with being women that they choose to instead become men. The paper also notes that “Girls affected by autism might be at higher risk because of their reduced mentalization capacities.”, although it does not provide any evidence that this is true.

The author of this opinion piece is a psychiatric trainee who lists their affiliation as Therapy First. Therapy First is an explicitly anti-medication group which campaigns to prevent children from being given hormones or puberty blockers for gender dysphoria - instead, they recommend psychotherapy as the first and in many cases only option. This is not evidence. It’s barely even an opinion. There is no reasonable excuse for the Cass review having included such a completely bizarre and unsubstantiated theory, especially without noting that it is entirely unsupported by even the most vague of evidence.

Seriously: would you test the effectiveness of chemotherapy by giving a control group of cancer sufferers saline water? I mean, assuming you're not a raving lunatic who insists that cancer is a fashionable lifestyle choice spread by social contagion on TikTok?

The absence of RCTs studying the impact of gender-affirming care on the mental health and well-being of transgender adolescents does not imply that these interventions are insufficiently supported by evidence. Although RCTs are considered high-quality evidence because of their ability to control for unmeasured confounders, the impossibility of masking which participants receive gender-affirming interventions and the differential impact of unmasking on adherence, withdrawal, response bias, and generalizability compromises the value of RCTs for adolescent gender-affirming care. RCTs are methodologically inappropriate for studying the relationship between gender-affirming interventions and mental health. These methodological considerations compound the serious ethical concerns raised by RCTs in adolescent transgender healthcare. Given the limitations of RCTs, complementary and well-designed observational studies offer more reliable scientific evidence than RCTs and should be considered of sufficient quality to guide clinical practice and policymaking. Adolescent trans healthcare is on solid footing.

a periodic reminder that these places exist:

• https://genderdysphoria.fyi/
• https://diyhrt.wiki/
• https://diyhrt.info/
• https://hrtcafe.net/
• https://transharmreduction.org/
• https://transfemscience.org/
• https://gtrr.artemislena.eu/
• https://diyhrt.market/transfem-hrt-guide
• https://www.reddit.com/r/estrogel/wiki/

and places like these:

• https://diyhrt.market/
• https://www.unitedpharmacies-uk.md

and some country specific things (please recommend more):

• https://genderkit.org.uk/

feel free to boost, and reply with other useful links for #trans people