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Great piece! This is why I get grumpy at people who just gesticulate towards 'research' in support of ideology instead of demonstrating the logic. It is just anti-trans propaganda. Talk to any parent of a child who is transgender and you'll learn that gender identity usually emerges around the age of 3 and cannot be influenced by parents or anyone else.

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About 3/4 of the way through the article:

|Of course, there are also some parts which are just completely unsupported. The essay states:

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|“However, many therapists were reluctant to be involved in the care of detransitioners due to fears that they would be accused of performing conversion therapy if they deviated from the affirmative approach (Griffin et al., 2021)”

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|But Griffin et al 2021 is not a survey of therapists involved in the care of transgender people - it is an opinion/perspective piece from a psychiatric journal. There’s no information at all suggesting that therapists are “reluctant to be involved in the care of detransitioners”. There are currently clinics in the world that explicitly advocate against transition, so the statement isn’t just unsupported, it’s overtly false.

The last sentence does not seem valid. The quoted claim says there are "many therapists... reluctant to be involved in the care of detransitioners due to fears". There could be therapists who want to help trans patients and detransitioners, but fear social and career repercussions from the latter. The existence of anti-transition clinics does not mean that they will get hired there, or want to work there.

Maybe the contradicted claim didn't make it into the quote?

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As someone who is not well versed on this issue I appreciate the info herein. But I do have one problem that's a little off topic. You say:

"Cross-sectional studies are, by definition, not really evidence of one thing following another, because you’re just asking people about stuff at a single point in time."

Why? If you are having a trial where the defendant is pleading self-defense asking about the sequence of events that took place is surely relevant to the evidence? If you are trying to discover the origin of a virus surely asking people about the sequence of events is relevant to the evidence? Why does asking these questions at 'single point in time' render them not evidence?

Please keep I mind I am not disputing the reliability of such evidence, but rather your claim that they are not evidence "by definition". This strikes me as rather extraordinary.

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Good to see you go through the references step by step to show how shaky the paper is. The referencing appears impressive on first glance and it takes work to see if it holds water. Also liked the discussion that all areas of medicine have risks. You note the paper that got retracted due to ethical concerns. It is likely a bad paper, but it got retracted on a technicality that was inconsistently applied by the journal in a way that appears to me to be highly unethical and was based on pressure from activists. You're using its retraction as evidence that is bad research, which I don't think is fair, though it might be bad research on the substance. Speaks to how highly politicised the field is. I also agree with another comment that citing that there are anti-transition clinics does not make the argument that therapists may be reluctant to provide care for detransistioners overtly false. You could argue it is not supported by evidence. Considering how much vicious and unethical behaviour there has been in this field from people from all sides, it's not hard to believe that people would be reluctant to support detransistioners if you know people who may have sway on your career strongly hold opposing views. But it would be great to have good research so we could judge the extent it may be a problem.

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Is "metal lego" in the spine supposed to be "metal goo"?

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Nope! It's just a hyperbolic description of the treatment, which is fixed pieces of metal.

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