Fact Check: Fact Check: 216 Instances Of Factual Errors Found In Right-Wing "WPATH Files" Document

In response to the WPATH files being dropped, transgender activist Erin Reed made a response, fact checking the claims made in the editorial of the original document, written by Mia Hughes. Reed claims that there are 216 “instances of factual inaccuracies, erroneous citations, misinterpretations of what is “leaked,” and purposeful omissions contradicting the authors central editorialized claims.”

The introduction is spent discrediting the organizations involved as “right wing” and “anti trans.” Reed alleges that the quick rate at which the files were spread was a “coordinated and organized embargo campaign, leaving those in support of care with scant time to review the voluminous documents and respond.”

The first claim that Reed alleges to be false is the claim that the Beyond WPATH declaration was signed by many people who were not doctors, pointing out signatures with occupations such as “DJ” and “yoga instructor” as well as comments like “concerned parent.” The original document does not claim that all signatures were from doctors, with the exact quote stating that it was “now signed by over 2,000 concerned individuals, many of whom are clinicians working with gender diverse young people.” (bold text mine). Nowhere does it imply that only doctors were able to sign it, it simply acknowledges that many people who signed the petition were doctors. One important thing to note is that the creator of the petition, Dr. Joseph Burgo, alleges that the petition was hijacked by trans activists adding fake signatures. (timestamp: 16 min)

Here is a screenshot of the top signers of the petition. Highlighted are all medical professionals.

Note that one of the signers, Stephen B. Levine, was a former president of WPATH who left due to the organization becoming less evidence based and more focused on activists.

Next, Reed criticizes the quality of the citations, stating, "When addressing supposedly "scientific" citations, the report's performance is equally lacking." One example given is an article from The Guardian from 2004, and another being “a conservative site called "The New Atlantis, " Upon visiting the link to the New Atlantis’s “about” page, they explicitly state they are a nonpartisan organization. That being said, other sources do allege this particular publication is right wing. However, this attempt to frame any opposing source as "right wing" or "conservative" is a significant part of Reed's argument on why the information is unreliable.

Reed accuses many of the studies cited to be misrepresented. One study cited in the WPATH files is a Swedish study which is quoted as finding, “rates of completed suicide post-surgical transition to be greatly elevated over the general population.”

Reed links to an article from a site called Trans Advocate, which contains an interview with the author of the Swedish study on how her work has been misinterpreted. In this article, the study is quoted as saying, “no inferences can be drawn as to the effectiveness of sex reassignment as a treatment for transsexualism. In other words, the results should not be interpreted such as sex reassignment per se increases morbidity and mortality.” The study does not conclude that sex reassignment surgery works, but there is also no reason to suggest it causes people to be more suicidal than they were pre-transition. Hughes does imply that suicide risk can increase after transition in cases where certain mental health conditions such as BPD are left untreated, and the patient comes to regret transition later, but this is not cited as scientific fact (42).

On the page before the Swedish study is referenced (42), Hughes discusses the mental health issues commonly found in trans-identified youth and how those issues may account for the higher rate of suicidality. Reed fails to acknowledge the Amsterdam study that concluded “the suicide risk in transgender people is higher than in the general population and seems to occur at every stage of transitioning.” While some parts of the Swedish study may have been misinterpreted, there are other studies with similar findings. The point is not that suicidality increases after transition, but rather that there is little evidence to suggest that transition has a long-term benefit on a person's other mental health issues.

Reed links to three studies disputing both the 2009 study and the Swedish study, implying that all of this “much newer research from peer-reviewed articles,” completely invalidates the findings of the other studies. The first study that Reed gives as a rebuttal does not actually come to the conclusion that there is a “substantial improvement in the quality of life for transgender individuals.” This 2017 study concludes that, “Our results show that transgender women generally have a lower QoL compared to the general population. GRS leads to an improvement in general well-being as a trend but over the long-term, QoL decreases slightly in line with that of the comparison group.” Basically, it claims that quality of life increases shortly after surgery, but later declines after about 5 years. They acknowledge that this is the case in the general population as well, and they state that there is still little consensus on trans identified people’s quality of life.

The second study Reed cites looks at the quality of life of patients who have received phalloplasties. Only 32 patients were part of this study, and they found that “88% of our patients were very satisfied with the aesthetic result, 75% have had sex after surgery, and 72% were very satisfied with sexual function after GAS. Eighty-one percent had a strong improvement of QOL, and 91% would undergo the same treatment again.” However, there is more evidence that phalloplasty is a dangerous procedure, and Reed fails to acknowledge any of those studies, such as this study of 1731 phalloplasty patients, finding that the "Overall complication rate was high at 76.5%"

The third study was a survey of 27,715 trans identified adults from 2015. The introduction of the study admits that “Mental health effects of gender-affirming surgery thus remain controversial.” In this survey, only 25% of participants had undergone surgery. This study was only a secondary analysis of these survey responses, comparing results of those who did not undergo surgery with those who had.

Reed implies that the 2% fatality rate of the vaginoplasty performed on males who had previously been on puberty blockers is irrelevant because the death “occurred from a wound infection, a potential complication for any surgery.” Hughes acknowledges that the patient died of necrotizing fasciitis, (19) and the case report that Reed links states that the patient, “developed septic shock and multiple organ failure on the basis of an extended-spectrum β-lactamase-producing Escherichia coli. A severe progression of the necrotizing fasciitis was lethal, despite repeated surgical debridement, intravenous antibiotic use, and supportive care at the intensive care unit.” The study that Reed then links to prove this treatment is successful contains extremely graphic images detailing the surgery without any warning. This does not discredit the study, but for that reason I cannot really look at it.

Reed attempts to debunk the accusation that those who took puberty blockers cannot orgasm, by alluding to there being two studies disproving this. However, it appears that Reed linked the same study twice within this quote, "To ensure factual accuracy, studies have shown that those who took puberty blockers are capable of orgasm" Only the abstract is available to me for this study. Because this study is behind a paywall, it is difficult for me to verify Reed’s claims about their results. The study is a survey of group of 31 primary total laparoscopic intestinal vaginoplasty patients, and is a survey about general quality of life one year after the surgery. It states that the group was “relatively young,” and states that the, “median age at time of surgery = 19.1 years, range = 18.3–45.0.” However, it gives no indication of when the patients began transition. It does imply that patients were on "Puberty-suppressing hormonal treatment”, but does not make any mention of when the patients started puberty blockers. Marci Bowers, head of WPATH, has explicitly stated that “I’m unaware of an individual claiming ability to orgasm when they were blocked at Tanner Stage 2.” Tanner Stage 2 is around the age of 11. It is possible these patients began blockers later on, but that evidence is not available to me either way. Another important thing to note is that the conclusion of the second study states, “This group of relatively young transgender women reported satisfactory functional and esthetic results of the neovagina and a good quality of life, despite low Female Sexual Function Index scores.” (bold text mine) “The mean Female Sexual Function Index total score of sexually active transgender women was 26.0 ± 6.8.”

This study is a survey relying on patients to self report their satisfaction, and Hughes does acknowledge the flaws of self reported studies on page 33, stating that measurable studies showed less positive results than surveys. Many of the studies Reed cites as rebuttals rely on self report.

Finally, Reed criticizes the idea that gender dysphoric youth would eventually desist post-puberty. One of the links provided as evidence against this claim leads to another article of Reed's. The criticism of Kenneth Zucker's research from the 90s appears to be that it classifies children with "gender identity disorder" as those who are simply gender non-conforming. The article uses this graphic to illustrate the difference between gender identity disorder and the current DSM-5 diagnosis of gender dysphoria, implying that the latter has stricter requirements.

Reed dismisses any correlation between social transition and desistance rates and accuses Hughes of implying that, “social transition prevents this “natural” desistance, a hypothesis that has not been validated.” While there may have been some flaws in Zunker's original study, this massive difference between then and now certainly raises questions on how the impact of social transition affects a child.

In the next section, Reed claims that the “leaked material” is frequently misrepresented, yet only provides three examples of this occurring. It does appear that Hughes left out the part about the orgasm in the first example, which would have been important context to include (28). In the second example, Reed accuses Hughes of leaving out the fact that it was a detransitioner who used the phrase “gender journey” and not a clinician. In reality, Hughes does not specify who said this, simply stating “There is talk about detransition being just another step in a patient’s “gender journey.” (31) However, we only have the clinicians word to go off to prove that the patient used that phrase, and there is evidence of another clinician pushing patients to identify with their language. This doctor decided to label a patient as “eunuch identified,” despite him not claiming that label himself (51). The third example of a misrepresentation consists of a patient developing a hepatic adenoma (liver mass) after taking testosterone. Reed is correct that hepatic adenomas are benign and that they are linked to both contraceptives and hormones. However, Reed accuses the document of leaving out the fact that the patient was on both oral contraceptives and testosterone. Hughes does in fact state that the patient was on norethindrone acetate, which is a contraceptive. In the WPATH document, the doctor specifically suspects that the hormones are the cause of the liver masses as opposed to the contraceptive.

Reed alleges that Stella O’Malley and Genspect “teased a young trans girl testifying in front of a school board.” The linked tweet reads: “US-UTAH: 11 yr old “Alison” came out as trans at 8 after having a vision of wearing a long white dress in a field. Dad says his “daughter” must be “validated in who she is” & allowed to use girls spaces bc many trans-identified people consider suicide.”

Overall, Reed’s fact checking only provides a few examples, nowhere near the 216 claimed.  Many of the studies linked as rebuttals do not come to the same conclusions as Reed implies. In my opinion, it appears that Reed did not expect the audience of this article to go and read the WPATH files for themselves, or for that matter, even check the links thoroughly. The few good points that are made here do not discredit the entirety of the report, and Reed fails to address the main claims in the report; such as WPATH members admitting that children do not have the capacity to consent, their disregard of proper scientific protocol, the experimental approach to healthcare, disregard of patients' other mental health issues, and lack of ethics.

If anyone wants to add things to this or expand on anything, please feel free to do so. There were a couple sections where my understanding was a bit limited, such as the limitations of the trans youth desistance study, and the puberty blockers/vaginoplasty study.

Edit: Moving this disclaimer down here because a TRA quit reading immediately after they saw this. I would like to acknowledge that I am not a doctor or any type of medical professional (neither is Reed) and some scientific studies may be difficult for me to interpret.

Edit 2: Removed the part about the New Atlantis because I have seen mixed info on it's political leanings.

Your phone just cracked. It fell off the table, it bounced off a wall, or it was just a classic case of wrong place, wrong time and was crushed under something weighty. Either way, there is no saving it, and you are left with the only option of buying a new phone. Here, your friends chime in, urging you to buy the latest iPhone. No matter that an Android is cheaper, has the same features and is less likely to meet the same fate as your previous phone. Your friends make their voices louder, more demanding, and you finally succumb and buy an iPhone. Congratulations, you are now a victim of herd mentality.

Disclaimer- this article has no intentions to slander Apple products, regardless of the authors’ personal views.

So, what is herd mentality?

Herd mentality, according to wikipedia, is a mentality that describes how people can be influenced by their peers to adopt certain behaviors on a largely emotional, rather than rational, basis. People usually ignore their own feelings in this process, and make different decisions than they would have individually.

When in Rome, be a Roman

Humans have always been social creatures. To fit in with the rest of the group and be accepted, social conformity was the norm. Thus, ’herd mentality’ was born. It was first coined by Gabriel Tarde and Gustave Le Bo in the 19th century. This herd mentality led to the process of groupthink, where members of a group pushed aside their own dissenting opinions just to have the appearance of unanimity.

This conformity can be something as simple as applauding when the other audience applauds, or something as problematic as bullying somebody just because everybody else bullies them.

Why do we follow the crowd?

To be plain and simple, it's comfortable. You don’t stand alone and you won’t be singled out. You have the comfort of the masses around you. There’s no pressure to be actively individualistic, you can just swim with the current.

In society, we are also encouraged to be ‘normal’ and fit in with everyone else. Those who don’t comply with the majority are shunned as outcasts. Therefore, to be liked and accepted in society, most people suppress their individuality and change aspects of themselves, adjusting to norms dictated by others.

It is also assumed that walking the road more travelled leads to higher rates of success, because hey, everybody else succeeded, didn’t they? But this is a misconception, other than in select few exceptions. Most people think that this is an easy short-cut, and try to get the best of both worlds. But success and comfort rarely go together. To succeed, one must go through the mortifying ordeal of actively being themselves and defending their opinion, which just isn't possible when they are part of the crowd.

In India

A perfect example of herd mentality, and a very relevant issue in society, is the Indian education system, and the stigma that surrounds it. A huge chunk of the population prioritizes the science stream and ostracizes those who choose the arts. It’s assumed that "smart" kids take up science and the "stupid" kids take up arts.

While we were having this discussion, we wondered why this was. The first thing that one of us mentioned was how science was relatively more rooted in logic, and perhaps due to this, people leaned towards science. But one of us argued that our culture was rife with superstitious beliefs, so it didn’t make much sense.

The most common reason that children are pushed into the science stream, and encouraged to become doctors and engineers, is that it pays well. These two professions, in general, lead to financial stability. Here, herd mentality comes into the picture- the people blindly believe that only engineering or medical professions will pay well, without doing actual research. There are plenty of other fields that can sustain your average nuclear family just fine. But this is food for thought that traditional Indian households find hard to digest. This is probably because, in such traditional Indian households, the men are usually expected to be the financial providers, and there is a certain comfort in having a stable 9 to 5 job, like a desk job. Of course, there is stable work to be had in any field, but herd mentality has played its role once again in spreading misinformation, and family members claim that financial stability is to be had only in the engineering/medical field.

Arguably, the cut off percentages for the differing streams is also to blame. The science cut off is much higher than for the art streams, and thus it is assumed that “smart” students opt for science, while the “stupid” students have no other option but to go to arts, as they couldn’t clear the science cut off. This leads to the notion that those who take up science are inherently smarter than arts students, which prompts the typical Indian family to force their child to opt for science.

This herd mentality extends to the students themselves- we often see science students dismissing arts students, claiming that they “have it easy” as they are in arts. This stereotype also feeds into the bragging culture. People would prefer to brag about their child who is studying in science, as it is also a subtle way to show that their child is “smart”.

Blind Justice

Another relevant problem would be the reaction of the masses in protest against the controversial CAA bill passed in early 2019. Thousands gathered on the streets, demanding both the CAA and NRC bills to be scrapped. However, when some of the protestors were interviewed by news agents, most didn’t even know the full forms of CAA (Citizenship Amendment Act) and NRC (National Register of Citizens). Yet they appeared in the masses, calling for justice. Others did away with the farce of justice entirely and stated that they showed merely up because their leaders told them to.

A more benign instance of herd mentality is showcased on social media, particularly Instagram. Whenever a human rights issue goes viral, for instance, the Black Lives Matter movement and the genocide in Palestine, there is a barrage of sympathy that is poured through Instagram stories and ‘black squares’. But these stories and black squares, while acts of solidarity, aren’t ones that are particularly helpful, and are generally used by ‘influencers’ more as tools of performative activism. Where does herd mentality fit into this? People put up these shows of support because everybody else is doing it, and they want to fit in, and want their sympathy to be seen. The ‘thoughts and prayers’ message has the same qualities. Instead, why not put up links to petitions and fundraisers, or donate?

To be sheep or to not be sheep

But even if we are aware of herd mentality, can we be truly immune to it? It’s simply not possible. A lot of times, we are forced to follow the ‘herd’, either because of lack of other options, or fear of repercussions. At the same time, one must also think for themselves, and approach each situation rationally. The most logical thing to do would be to find a balance between the two. At the end of the day, we must ask ourselves if we can use this mentality for good, but really are there sides to being human?

N.B. university students decry tuition increase as classes move online

A number of Maritime universities have indicated their classes will be primarily held online for the foreseeable future. In some cases, that’s resulting in higher tuition for students, who are wondering why they’re being asked to pay more, if they’re not even on-campus.

The post-secondary school year is going to look a lot different for many students and faculty across the Maritimes.

COVID-19 has forced many classes to move from campus to computer, and University of New Brunswick student union President Sean MacKenzie believes the quality of education will suffer.

“You don’t have that ability to get that hands on experience if you’re in a field that may require that,” says MacKenzie. “If that’s where your strength of learning is that hands on experience, it could impact.”

The students’ union doesn’t believe they should have to pay as much for that, let alone more.

But tuition is expected to go up by 2% this year at UNB.

“I don’t really think its right to have students have to absorb the burden of the financial struggles of the university right now, especially when we’re all experiencing our own financial struggles,” says MacKenzie.

UNB says the increase is ‘tied to a multi-year agreement with the province of New Brunswick’. 

In an interview with CTV News last week, UNB’s Vice President Academic says he doesn’t believe the quality of education will suffer.

“We’ve gone out to each of our faculties and asked them, based on their knowledge and what’s best for their programs, what would work best for their students,” says George MacLean. “So it’s going to be a blend, it’s going to be a mixed system of in-person and remote teaching.”

There will still be students on campus, and research activities will continue, there just won’t be as many. But lots will be online and that transition costs money.

“There’s a large amount that’s needed for personnel and technology to be able to deliver programs remotely,” says MacLean. “Imagine, for instance, a wet lab. That means that students who aren’t here need to have a lab kit at their home to be able to interact remotely with their instructors. That’s an expensive option.”

Mount Allison University is also increasing tuition by 4.5% for Canadian students.

Thousands of students at UNB and Mount Allison have signed petitions asking for the universities to reconsider.

MacKenzie says he’s heard from many students who support the move to online learning, saying they understand it’s for the health and safety of the campus community. But he’s still hopeful UNB will reconsider the tuition increase. 

from CTV News - Atlantic https://ift.tt/2CLCWSK