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solarbird(This is the other one that wouldn't crosspost for unknown reasons yay. Don't know why.)
This is the one I'm posting because I want to reference it in a Fascism Watch, because it has data from what happens if you don't let trans people transition. In particular, the person I was talking to was going on about irreversible damage from puberty blockers (not real) and that there are no long-term studies on puberty blocker effects. That last one's extra not true, and they moved the goalposts when provided with examples of 25-year-studies and 40 years of clinical use, declaring all of that "not long term."
In part, they claimed that there were vanishingly few cases of precocious puberty so studies of those cases weren't enough to matter and didn't count. I started by calculating the numbers. Spoiler: it is not vanishingly small.
They also posted an undersourced graph showing as many as 11 hysterectomies a year nationally supposedly for gender identity reasons. I took that as 100% real, then went into what happens when trans people are not allowed to transition, and drew a comparison. Spoiler: it's mass death.
Details under the fold.
First, let me drop in what I was researching when I saw that things were exploding.
I looked up the pre-COVID19 rate of precocious puberty, in Europe (Denmark in particular, because I found it first), the US, and China. They were within a range, looked like 0.12-0.20 percent. These numbers indicated cases significant enough to trigger medical notice and intervention. 1-2 out of every 1000 people is another way to put it.
In the US, that'd be… hm, CDC says about 15,000,000 people in the right age range, so picking in the middle range of reported incidence (again, pre-COVID), that's right about 24,000 cases a year. Nationally in the US.
(I'm excluding post-COVID data because I saw studies showing rates soaring after COVID. This is both unsurprising and a real yikes, because it shows the kind of impact COVID has as an endocrine disrupter, in addition to being a circulatory and neural disrupter. It is bad shit. So I'm sticking with pre-COVID baseline.)
Since these drugs are overwhelmingly considered both effective and low-risk, puberty delaying medication is generally prescribed. But let's go with half that number. 12,000 a year.
It's a small number, but not what I'd call vanishingly small. And certainly larger than that chart you just pasted in showing up to 11 under-18 gender-confirming surgeries in a year.
I think the numbers are enough to show the … relative commonality of this treatment, at least when compared to "vanishingly small." It seems to me with that kind of caseload since the 1980s we'd be seeing more long-term effects, since you're worried about long-term risk. But we haven't.
But let's talk about long-term anyway, and about something that's been lost in this discussion - quite intentionally, from the side of the anti-trans/fundamentalist politicians and activists. A couple of times, studies have been referenced, some which are considered medically long-term - 25 years given a return-to-baseline time of one year. But since I also know that 25 years isn't an acceptably long for you, and you very rarely get studies longer than that on what is legitimately a niche condition, I'm going to ask a different question.
And that question is: What's being left aside?
What's being left on the side is the very important question of what happens when trans kids don't get treatment?
This is a comparison, right? Most cancer drugs, as you know, are incredibly dangerous and poisonous. Most of them will shorten your life dramatically - if you don't have cancer.
But if you have cancer, and they work, which they generally do, they make your life longer. Often, decades longer.
It's a tradeoff, as many things medical tend to be.
So let's take that 25 years. 25 years later, there's no evidence of medically significant issues. The right likes to talk about bone density, and that's pretty much not meaningful, but let's say it is. Let's say early-onset osteoporosis is a thing at, say, year 30, but so far nobody's noticed.
So what happens after 30 years when a trans kid doesn't get treatment? When they're beaten back down, forced to comply with fundamentalist/conservative gender roles, all that. What happens 25, 30 years later, at age, oh, 40?
Mostly, they're dead.
That's what happens. Dead. Dead, dead, dead, dead, dead, dead, dead. They are
DEAD.
Before all of this, before trans-supportive health care become more available, the average lifespan of a trans person was THIRTY FIVE. That's from surveys and studies I read in the early 2000s. I don't have them at the tips of my fingers. But they were the data then available and reflected the era before treatment.
Sure, that number was dragged down a lot by youth suicide, and if you want to pretend that doesn't matter then it's longer. But even then it's lowered a lot by young adult suicide and lots, and I do mean lots, of destructive behaviour and "self-medication" that destroys the livers, kidneys, and so on of the people who do make it longer.
That's the alternative we're talking about here. The medical alternative.
Unsupported-by-evidence early-onset osteoporosis and possibly some other complications, oorrrrrrr…. miserable, then dead.
And here's the thing. Here's why the movement that wants to "eradicate" trans people likes to ignore and override that. I'm pretty sure you can see where this is going:
Death is what they want.
It's what they've always wanted for all queer people of all flavours, but in particular, they want it for trans people, including kids.
As this was ramping up, some years ago, a trans-friendly journalist went to… I think it was Mumsnet (because fuck you algorithm) but it could've been Kiwifa*rms (see previous) and asked members raging against trans people and for bathroom bans what they thought trans people should do, particularly once their bans are in place - as they are in Florida, now. She got absolutely massive response.
There were a couple of small percentage answers. Something like 8% said special / single-occupant bathrooms. Something like 10% said use bathrooms only at home, severely restricting the ability of trans people to have jobs, go to school, and so on. Those might be reversed, it doesn't matter..
But 80% - I remember that number very well - said trans people should all die.
Now sure, that's an anti-trans activist environment. They're particularly far out there.
But they're also the ones churning out all this disinformation, they're the motivated base, they're the ones setting the policy because even Republicans who really don't care one way or the other when push comes to shove know who is buttering their bread and what makes them turn out to vote, and they're perfectly happy to sacrifice a few faggots along the way for a favourable result.
So to get back to medical efficacy and the inevitable tradeoffs of long-term medication, it's always important to remember what the actual options long-term outcomes. And what they are here is:
A: Speculative but unstudied and therefore possible early bone atrophy in middle-age, along with similar other long-term fitness issues, or
B: DEATH. On average, by age 35.
Because B was the reality.
Since everyone dies, we could call it "55% reduction in lifespan." That's softer, less stark. Of course, it ignores the brutally abusive lives trans people experience without being allowed medical care, it ignores quality of life issues - and not in favour of outcome A, believe me.
So that's the actual choice here. Not the "it's fine they'll grow out of it" vs "bad things might happen later" they sell you.
When (non-evangelical fundamentalist) health-care professions tell you this is lifesaving care, this is what they mean.
They call it life-saving because it is.
That's what they're taking away. But again - only from trans people! It can all still be forced upon IS people, and it can all be used freely for cisgendered children - again, all of it. Every single one of these bills carves out massive exemptions for cis kids. They're not banning any of this in general. They're only banning it for the queers.
But. As per your chart, there were…. as many as 11 gender-confirming surgeries a year for trans people under 18. How many for cisgendered kids? I don't know.
What do we do with that?
Like I said before, I'm not slamming the door on it. If it's medically necessary in the opinion of medical doctors and parents, and the trans youth is also onboard? I see that as their call.
But let's say we decide it's not. What do we do?
Do we add additional delays and roadblocks specifically to surgeries? Additional requirements, extra verifications, make it take longer? With a count of eleven - from your data - it's hard to see how much more we can winnow that down.
Do we just ban it? That'd get the numbers to zero, at some real harm to some small number of trans teens.
Or instead, do we ban all youth trans-supportive health care and make it a felony? Do we ban even social transition for under-18s? Do we ban all mention of LGBT people in schools, and declare a lot of it obscene and therefore illegal, and sometimes a sex offense?
That last one is what the Republican Party is doing.
It's not all they're doing - just this week more Republican states banned all or virtually all trans health care for adults, and they're quite upfront in their agenda to do that everywhere. "Eradication," as one of their own put it at the last CPAC, is the goal. Kids are just the wedge.
Is that what we do if we're worried about those 11 surgeries a year?
I don't think so. As a genuine reaction, I think that's insane - unless it's an excuse, and not the cause.
If this wasn't just the nose under the tent, if this wasn't just the fear factor intended to let them destroy everyone not adequately gender compliant, they wouldn't already be moving in the whole head and shoulders, and we wouldn't have threads of people seeking help fleeing entire states. We wouldn't have adult trans health care being completely blocked.
We wouldn't have Target having to pull LGBT merchandise in response to violent threats against staff, either.
But it is what we have. We do have their radio and internet talking heads going on day after day about trans (and in some cases LGBT people in general) being a sickness that must be eradicated, the same way they were talking about "homosexuals" in the 90s. We wouldn't have both trans and IS people being banned from washrooms. We wouldn't have "don't say gay" being instituted in several Republican states, and being used to ban any mention of LGBT people in schools up through graduation. We wouldn't have pride parades being banned by new laws declaring drag an obscenity.
But again, we do.
And that should be all you need to know about what's really happening here.
From your chart, at peak, eleven (11) kids received gender-supportive surgery in a year.
More states than that - all Republican, of course - have moved to make all trans people as illegal as they can, and continue to do so.
They're addressing what they see as a problem, all right. It's just not the problem you think it is. The "problem" is queer existence.
That's the "problem" they're addressing.
This is the one I'm posting because I want to reference it in a Fascism Watch, because it has data from what happens if you don't let trans people transition. In particular, the person I was talking to was going on about irreversible damage from puberty blockers (not real) and that there are no long-term studies on puberty blocker effects. That last one's extra not true, and they moved the goalposts when provided with examples of 25-year-studies and 40 years of clinical use, declaring all of that "not long term."
In part, they claimed that there were vanishingly few cases of precocious puberty so studies of those cases weren't enough to matter and didn't count. I started by calculating the numbers. Spoiler: it is not vanishingly small.
They also posted an undersourced graph showing as many as 11 hysterectomies a year nationally supposedly for gender identity reasons. I took that as 100% real, then went into what happens when trans people are not allowed to transition, and drew a comparison. Spoiler: it's mass death.
Details under the fold.
First, let me drop in what I was researching when I saw that things were exploding.
I looked up the pre-COVID19 rate of precocious puberty, in Europe (Denmark in particular, because I found it first), the US, and China. They were within a range, looked like 0.12-0.20 percent. These numbers indicated cases significant enough to trigger medical notice and intervention. 1-2 out of every 1000 people is another way to put it.
In the US, that'd be… hm, CDC says about 15,000,000 people in the right age range, so picking in the middle range of reported incidence (again, pre-COVID), that's right about 24,000 cases a year. Nationally in the US.
(I'm excluding post-COVID data because I saw studies showing rates soaring after COVID. This is both unsurprising and a real yikes, because it shows the kind of impact COVID has as an endocrine disrupter, in addition to being a circulatory and neural disrupter. It is bad shit. So I'm sticking with pre-COVID baseline.)
Since these drugs are overwhelmingly considered both effective and low-risk, puberty delaying medication is generally prescribed. But let's go with half that number. 12,000 a year.
It's a small number, but not what I'd call vanishingly small. And certainly larger than that chart you just pasted in showing up to 11 under-18 gender-confirming surgeries in a year.
I think the numbers are enough to show the … relative commonality of this treatment, at least when compared to "vanishingly small." It seems to me with that kind of caseload since the 1980s we'd be seeing more long-term effects, since you're worried about long-term risk. But we haven't.
But let's talk about long-term anyway, and about something that's been lost in this discussion - quite intentionally, from the side of the anti-trans/fundamentalist politicians and activists. A couple of times, studies have been referenced, some which are considered medically long-term - 25 years given a return-to-baseline time of one year. But since I also know that 25 years isn't an acceptably long for you, and you very rarely get studies longer than that on what is legitimately a niche condition, I'm going to ask a different question.
And that question is: What's being left aside?
What's being left on the side is the very important question of what happens when trans kids don't get treatment?
This is a comparison, right? Most cancer drugs, as you know, are incredibly dangerous and poisonous. Most of them will shorten your life dramatically - if you don't have cancer.
But if you have cancer, and they work, which they generally do, they make your life longer. Often, decades longer.
It's a tradeoff, as many things medical tend to be.
So let's take that 25 years. 25 years later, there's no evidence of medically significant issues. The right likes to talk about bone density, and that's pretty much not meaningful, but let's say it is. Let's say early-onset osteoporosis is a thing at, say, year 30, but so far nobody's noticed.
So what happens after 30 years when a trans kid doesn't get treatment? When they're beaten back down, forced to comply with fundamentalist/conservative gender roles, all that. What happens 25, 30 years later, at age, oh, 40?
Mostly, they're dead.
That's what happens. Dead. Dead, dead, dead, dead, dead, dead, dead. They are
DEAD.
Before all of this, before trans-supportive health care become more available, the average lifespan of a trans person was THIRTY FIVE. That's from surveys and studies I read in the early 2000s. I don't have them at the tips of my fingers. But they were the data then available and reflected the era before treatment.
Sure, that number was dragged down a lot by youth suicide, and if you want to pretend that doesn't matter then it's longer. But even then it's lowered a lot by young adult suicide and lots, and I do mean lots, of destructive behaviour and "self-medication" that destroys the livers, kidneys, and so on of the people who do make it longer.
That's the alternative we're talking about here. The medical alternative.
Unsupported-by-evidence early-onset osteoporosis and possibly some other complications, oorrrrrrr…. miserable, then dead.
And here's the thing. Here's why the movement that wants to "eradicate" trans people likes to ignore and override that. I'm pretty sure you can see where this is going:
Death is what they want.
It's what they've always wanted for all queer people of all flavours, but in particular, they want it for trans people, including kids.
As this was ramping up, some years ago, a trans-friendly journalist went to… I think it was Mumsnet (because fuck you algorithm) but it could've been Kiwifa*rms (see previous) and asked members raging against trans people and for bathroom bans what they thought trans people should do, particularly once their bans are in place - as they are in Florida, now. She got absolutely massive response.
There were a couple of small percentage answers. Something like 8% said special / single-occupant bathrooms. Something like 10% said use bathrooms only at home, severely restricting the ability of trans people to have jobs, go to school, and so on. Those might be reversed, it doesn't matter..
But 80% - I remember that number very well - said trans people should all die.
Now sure, that's an anti-trans activist environment. They're particularly far out there.
But they're also the ones churning out all this disinformation, they're the motivated base, they're the ones setting the policy because even Republicans who really don't care one way or the other when push comes to shove know who is buttering their bread and what makes them turn out to vote, and they're perfectly happy to sacrifice a few faggots along the way for a favourable result.
So to get back to medical efficacy and the inevitable tradeoffs of long-term medication, it's always important to remember what the actual options long-term outcomes. And what they are here is:
A: Speculative but unstudied and therefore possible early bone atrophy in middle-age, along with similar other long-term fitness issues, or
B: DEATH. On average, by age 35.
Because B was the reality.
Since everyone dies, we could call it "55% reduction in lifespan." That's softer, less stark. Of course, it ignores the brutally abusive lives trans people experience without being allowed medical care, it ignores quality of life issues - and not in favour of outcome A, believe me.
So that's the actual choice here. Not the "it's fine they'll grow out of it" vs "bad things might happen later" they sell you.
When (non-evangelical fundamentalist) health-care professions tell you this is lifesaving care, this is what they mean.
They call it life-saving because it is.
That's what they're taking away. But again - only from trans people! It can all still be forced upon IS people, and it can all be used freely for cisgendered children - again, all of it. Every single one of these bills carves out massive exemptions for cis kids. They're not banning any of this in general. They're only banning it for the queers.
But. As per your chart, there were…. as many as 11 gender-confirming surgeries a year for trans people under 18. How many for cisgendered kids? I don't know.
What do we do with that?
Like I said before, I'm not slamming the door on it. If it's medically necessary in the opinion of medical doctors and parents, and the trans youth is also onboard? I see that as their call.
But let's say we decide it's not. What do we do?
Do we add additional delays and roadblocks specifically to surgeries? Additional requirements, extra verifications, make it take longer? With a count of eleven - from your data - it's hard to see how much more we can winnow that down.
Do we just ban it? That'd get the numbers to zero, at some real harm to some small number of trans teens.
Or instead, do we ban all youth trans-supportive health care and make it a felony? Do we ban even social transition for under-18s? Do we ban all mention of LGBT people in schools, and declare a lot of it obscene and therefore illegal, and sometimes a sex offense?
That last one is what the Republican Party is doing.
It's not all they're doing - just this week more Republican states banned all or virtually all trans health care for adults, and they're quite upfront in their agenda to do that everywhere. "Eradication," as one of their own put it at the last CPAC, is the goal. Kids are just the wedge.
Is that what we do if we're worried about those 11 surgeries a year?
I don't think so. As a genuine reaction, I think that's insane - unless it's an excuse, and not the cause.
If this wasn't just the nose under the tent, if this wasn't just the fear factor intended to let them destroy everyone not adequately gender compliant, they wouldn't already be moving in the whole head and shoulders, and we wouldn't have threads of people seeking help fleeing entire states. We wouldn't have adult trans health care being completely blocked.
We wouldn't have Target having to pull LGBT merchandise in response to violent threats against staff, either.
But it is what we have. We do have their radio and internet talking heads going on day after day about trans (and in some cases LGBT people in general) being a sickness that must be eradicated, the same way they were talking about "homosexuals" in the 90s. We wouldn't have both trans and IS people being banned from washrooms. We wouldn't have "don't say gay" being instituted in several Republican states, and being used to ban any mention of LGBT people in schools up through graduation. We wouldn't have pride parades being banned by new laws declaring drag an obscenity.
But again, we do.
And that should be all you need to know about what's really happening here.
From your chart, at peak, eleven (11) kids received gender-supportive surgery in a year.
More states than that - all Republican, of course - have moved to make all trans people as illegal as they can, and continue to do so.
They're addressing what they see as a problem, all right. It's just not the problem you think it is. The "problem" is queer existence.
That's the "problem" they're addressing.
