The spectre
At the Critic an anonymous psychiatrist writes:
When a child identifies as trans, the spectre of suicide is frequently raised by campaigners — sometimes in a highly manipulative and unethical form. A talk by philosopher Kathleen Stock at the Oxford Union in May was interrupted by an activist glueing her hands to the floor. She wore a T-shirt stating, “No more dead trans kids”. Parents are told that unless they immediately “socially transition” their child — i.e., refer to them as members of the opposite sex, and present them as such to everyone else — their child is highly likely to self-harm.
Perhaps the most egregious form this claim takes is that unless a child is swiftly medicalised, first with puberty-blockers and then cross-sex hormones to cause their body to develop towards the “right” sex, the risk of suicide is hugely elevated. This emotional blackmail is expressed in the activist catchphrase, “Better a live daughter than a dead son”. Susie Green, former chief executive of the trans lobby group Mermaids, has described medicalisation of gender-distressed young people as “literally lifesaving”.
Thus many parents hasten to say yes to hormones and surgery.
This hurried, medicalised approach is entirely at odds with what mental-health practitioners know about assessing and managing suicide risk. The majority of patients who are suicidal are depressed, anxious, psychotic or experiencing ongoing trauma such as bullying, domestic violence or abuse. They feel hopeless and ashamed. Patients try to “carry on as normal” and hide their despair from those around them. Frequently they avoid acknowledging, even to themselves, that they are having serious mental health problems.
It’s complicated difficult stuff, so the best people to deal with it are not ideology-addled nitwits on social media.
There is, thankfully, no evidence to support the idea that having a trans identification in itself leads to a higher risk of suicide. Being gender non-conforming can cause so-called “minority stress”, and people who identify as trans often suffer from mental-health conditions that are related to self-harm and suicidality. The website of the main NHS child gender clinic, GIDS, says that “suicidality in young people attending the GIDS is similar to that of young people referred to child and adolescent mental health services”.
However, a young person who hears repeatedly that they are at risk, if they are denied social transition, puberty blockers or cross-sex hormones, may come to believe this claim.
But if the result is that they get to ruin their bodies in order to pretend to be the other sex then that’s a win, right?
Every child who experiences gender distress deserves high-quality, evidence-based care. They do not deserve to be treated as rhetorical devices by campaigners and politicians who wish to forward a political agenda. They seem to have lost sight of the harm they are doing to this very vulnerable group.
It’s for the greater good, which is creating more and more and more trans people.
Is it just me, or is “affirmation” the opposite of evidence-based care?
No, Mike, it’s not just you.
Affirmations are a well-used and well regarded tool in psychology. I used them extensively in the past and will still do so on a rare occasion.
When my partner and I first began to live together some 16 years ago, one morning she asked me if I took my phone into the bathroom as she could hear me talking.
I had suffered under an internal voice that kept telling me how bad I was, that I was useless, that no one cared about me and I’d never amount to a hill of beans. Through a lot of work on myself, including group work and psychodrama, I came to understand this internal voice and how I was undermining myself. The voice was loudest in the morning, in the shower before I would set off for my new day. Self sabotage and undermining was my expert subject in the game of life.
I began to talk to myself, out loud, as I showered, self affirmation statements, statements of self love and worth, and statements of how much I meant to others and they to me. And it worked. The negative was driven out, the positive arrived and life became better. So much better. These days, I may only do this a few times a year, but the tool is always there, ready to be used if needed.
And because it worked for me, in a good way, I can see how easy it also would be for someone else to have that internal dialogue about hating themselves, hating their body, and desperately wanting to be cured. If I was 55 years younger and immersed in yoof culture like tik tok and snapchat, I too could have had the internal discussion that would lead to body modification, drugs, and transitioning.
Affirmation is a powerful psychological tool, but like all tools (nuclear power or nuclear bombs) it needs to be applied with rigour and care for the outcome.
If all the above sounds a bit like New Age babbling, yeah, I thought so too, but if you can avoid the crystal rubbers, the mantra chantas, and the spirit guides, it is a very effective tool.
When I was depressed and suicidal, no one “affirmed” my beliefs about myself. I was told to use affirmations in the way the Rev did (which isn’t the same as what ‘gender affirming care’ is doing). I tried. I’m pleased it worked for him, but it just made me more depressed, because it felt silly, and because I knew what I was saying was lies. (It may not have been; I may not have been a worthless pile of pond scum, but I felt like it was lies, no, I knew it was lies).
But that wasn’t about others affirming a delusion. It was about me affirming my worth. I sucked at it then, I suck at it now, and I could not with a straight face call a male bodied person ‘she’. I’m not that good an actor.
Interesting insight. Thank you for sharing this.
We seem to be dealing with the “nuclear bomb” version of this psychological tool. These desperate people are being told that affirmation needs to be paired with drastic body modification. The self-defeating, self destructive internal voice is being catered to and appeased, not talked off the ledge. The social contagion aspect turns the phenomenon into a patient driven one, with sufferers demanding the “true path” to what they’ve been told will make them better. At the same time, the watchfull waiting approach which would leave them intact and, if successful, happier in their own, uncut skin, is condemned by activists as “conversion therapy.” The activist path is encouraging sufferers to listen to the inner voice telling them to jump into the lifelong, medicalized “journey” to a place they can never reach.
A major twist on this weaponized “affirmation” approach is that the entire rest of the world is supposed to join in with the “affirmation.” It is no longer an internal dialogue, but a play in which we’re all expected to read our scripted lines and follow the blocking that the reified, empowered and enthroned “gender identity” demands. Everyone else is supposed to go along with the fiction that yes, these people have actually changed sex. We are unwittingly and unwillingly pressed into being a part of their “therapy.” Failure to comply results in our punishment as cruel monters out to cause “harm” and “suffering” to these people who have become, at the same time, our wards and our masters. We are to dance to the tune chosen by these marginalized, vulnerable dictators, whose zealous supporters can have us cancelled and fired for using the “wrong” words.
And whatever is happening with, or done to genuinely dysphoric individuals, the “affirmation approach” has in turn been appropriated by fetishistic AGP males in order to demand access to female only spaces. And this appropriation goes farther still. The therapeutic language, along with Self-ID, become tools to be used by predators and cheats who might not even be dysphoric or AGP at all, but who see and seize an opportunity they can exploit. Trans activists, having failed to acknowledge the threat that Self-ID represents to women’s spaces perforce defend predators when they defend the “right” of TiMs to access those spaces. Because there is no way for women to distinguish between “harmless” TiMs and run-of-the-mill male predators, trans activists have effectively taken the predators under their wing so as not to weaken their own supposed claim to women’s spaces. If a few women suffer as collateral damage from predators who take advantage of the opening that TiMs have made, oh well. It’s all a part of “validation” and “affirmation.” We all have our parts to play, though we don’t all have a choice in the matter. Some of us are stars, some of us are only extras.
That all of these different, conflicting groups get lumped together under the “trans umbrella” within the even broader, forced-teamed LGBTQetc. “community” makes responding difficult, as opposing the boundary-breaking behaviour of males who claim to be trans is trumpeted as an “attack” on the “entire LGBTQ community,” even when it’s really just an attempt to protect women from creepy males. In the ultimate reductio ad absurdum, we have the bizarre, unexpected spectacle of lesbians defending their same-sex attraction and association against genderist “lady dick lesbians” being turned outcast for “attacking” the very community of which they are ostensibly charter members. To paraphrase the promulgators and aplogists of “TWAW,” The L is right there in the name! But like some sort of activist auto-immune disorder, the “community” turns on part of its own body, giving the lie to the loudly asserted claim that there is “No Conflict” between women’s rights and trans “rights.” A little “affirmation” goes a long way.
In the treatment of childhood gender dysphoria, the “gender affirming” model is still the norm in the US and Canada. That’s what “affirmation” refers to in this context.
What it comes down to it that a child’s self-declared “gender identity” is affirmed from the get go.
This model assumes that “gender identity” (as the term is used by TRAs) is real, that children “know who they are,” and that to challenge the patient’s identification, or to explore it in depth without affirming (or denying) it, amounts to conversion therapy. It also tends to assume that any mental health problems a child presents with will be fixed by transition.
This is the treatment model that uses puberty blockers and “gender affirming” mastectomies.
The evidence for the use of default “affirmation,” puberty blockers, and the rest of it is very weak.
SEGM reports on one recent study here:
https://segm.org/current-concerns-gender-affirming-therapy-adolescents
See also: the interim Cass Report on the UK’s Tavistock clinic (which used the affirmation model,) and Sweden’s Karolinska Clinic’s comprehensive review of pertinent studies.
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