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fox-steward · 3 months

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hi, your blog is incredibly interesting- i genuinely didn't realise there was a not conservative side of the gender critical sphere. i've been on testosterone for about 7 months now, so far this has been making me feel more like myself. personally I am not thinking about 'gender' but rather what i want to look and sound like- this has been working better than the whole 'gender is a feeling' thing..which is definitely a theory! If its okay to ask, what are your thoughts on medical transition?

i think medical transition is, broadly, very harmful.

it harms the individual: disrupts natural hormone cycles, negatively impacts cardiovascular health, negatively impacts reproductive functioning, creates an artifice which the individual comes to rely on to "feel like themself," thereby severing that person from true authenticity, necessitating the person remain a lifelong medical patient to keep all effects of hormones, subjecting the person to unnecessary risk of surgery, including death. it costs a lot of money and time that you don't actually have to spend. there is no evidence it correlates with mental health improvement, and it is my opinion that by focusing on transition, people do not attend to the areas of their lives that actually need and would benefit from attention and intervention.

it harms the group: gays and lesbians are disproportionately impacted by medical transition; gender non-conformity (which homosexuality is a form of) has become pathologized; now young lesbians and gays are not only growing up in a culture dominated by heterosexuality and rife with homophobia, they also have to navigate the pervasive message that they might benefit from transition. when i was a kid i was told by adults that i was "trying to be a man," that real women are not lesbians, and eventually i agreed with them. that gender non-conformity is seen as a precursor to "trans identification" only makes this worse--it's like, you get the "what, are you trying to be a man >:( ??!!" but also, "what, are you trying to be a man <=D ??!!" messaging. and what chance do we stand against attacks from all sides?

it is harmful to all women: look around at misogyny--devaluing women's opinions as vapid or lesser, assuming women are weak and fickle, dismissing women's perspectives and ideas, preying on women and girls sexually, seeing women as one-dimensional vessels for the transformation of the men around them--of COURSE girls don't "feel like a woman" these days, who would? instead of looking at the way society treats women and the disidentification it is producing among youth as the blazing alarm that it is, trans culture has wedged itself between women and liberation with the suggestion that "maybe you're not a woman if you don't feel like one?" never minding that "feeling like one" generally means liking being objectified, belittled, seen as weak, ignored, simultaneously not being taken seriously but being blamed for things. not only does this derail the actually important conversation about misogyny, but it leaves women and girls vulnerable to the predation of medical transition, which as i mentioned above, is harmful physically, emotionally, socially, and financially.

also, i would argue there are actually no conservative "gender critical" people. conservatives tend to reject gender non-conformity and embrace traditional gender roles; ain't no way to be critical of gender while holding central traditional gender roles. conservatives may be "trans critical," but they're not actually "gender critical." trans ideology has a lot in common with conservatives when it comes to gender, actually. both reinforce traditional gender stereotypes; how different is "i'm masculine and fit in more with boys than girls, so i must really be a man" from "i'm not a man, so i can't act masculinely, i must act femininely" really? they are threads of the same rope and that rope holds us prisoner, it doesn't free us. true gender non-conformity is being female but realizing that your masculine nature doesn't change anything about you (trans ideology), nor does it need to change itself (conservative ideology).

i know you didn't ask for this part, but you're here in my inbox, so here you go: doesn't it strike you as strange that it's taking synthetic medical intervention to make you "feel like yourself?" is the route to authenticity really via the path of cosmetic surgery and synthetic hormones?

it's either intellectually dishonest or intellectually lazy to stop at you're just "thinking about...how you want to look and sound." WHY do you want to look masculinized and have a deeper voice? there is a zero-percent chance the answer to that question is entirely separate from how those traits get you treated in society. and that's the impact of misogyny. and please don't misunderstand this as me suggesting you should not be masculine--i just don't think you have to subject yourself to the harms of medical transition in order to BE masculine.

and i say this as someone who took these steps, who masculinized with a mastectomy and many years of testosterone. i get that there are certain advantages to appearing as a man in society despite being a woman, but largely these are individual advantages for ME that come at the expense of WOMEN. thinking i'm a man, men take me more seriously; this impacts women by reinforcing the idea that men deserve consideration when women's voices don't, and it means that i don't have to advocate for women to be taken seriously because I don't personally need it; it runs the risk of making me complacent to this phenomenon, convincing me that surely women are exaggerating when they share their experiences because i don't have such a hard time of things, all the men are nice to me. see how pernicious it is?

because i'm 5'10", skinny, and with a flat chest, many people think i'm a man when i'm running. this means i can run at night, with headphones in, in new places--all basically without fear. the stories other women tell me make it clear this isn't the case for them. some women i know don't run outside anymore at all because of how men treat them, sexualize them, harass them, prey on them. so i get that it is a clear advantage to appear as a man sometimes; this is one thing i'm actually really grateful for. but it is not worth the damage i did to my body, it isn't worth the sense of alienation i sometimes feel from women, a sense i also felt with men, even when i was pretending to be "one of them," it isn't worth the money and time and effort i spent trying to convincingly imitate men that i could have spent on things that would actually nurture me and my life.

"gender is a feeling" certainly is a theory, but so is "transition makes me more myself," and one is about as good as the other.

we are not alive to simply take our thoughts and feelings at face value! interrogate your feelings and your ideas! we live in a culture and none of us are immune to that. something something unexamined life.

best of luck, i'm rooting for you.

#gender critical #detransition #radfem #radical feminism #detrans #asked #answered #transgender #anonymous #anon

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mossymossman · 2 months

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Nimona is great; here's why:

Nimona made me cry for a lot of reasons. Hearing the story of queerness portrayed in such an elegant way hit me hard. But I also think Nimona is one of those movies that can be enjoyed by all sorts of people. Nimona tells a story of isolation, of feeling rejected. Oddly enough, feeling alone is a pretty universal experience. So tons of people can relate, not just queer/neurodivergent people. This is important for representation. A story should be able to reach all sorts of people. Of course, you don't need to relate to every single character in order to enjoy a movie. Empathy is great.

Nimona is also a big step forward in terms of letting PG movies involve more adult topics. Children's media often shies away from "Difficult" topics. I found that most media is either for younger kids or teenagers; there aren't a lot of shows speaking to those tween years. Turning Red was the first movie that felt like it was made for tweens. Nimona also feels like it was made for tweens. Nimona contained themes of suicide. With the growing rise of poor mental health among youth, I think that representation is more important than ever. Even the representation of mental health issues. I remember when I was 10-13 and dealing with suicidal ideation. I was so young when I dealt with that. That made me feel so alone; in my mind, "Kids don't get suicidal! That only happens to teenagers!" But there I was. I think Nimona would have helped the younger me. Kids are often depicted as unable to struggle with poor mental health. "Kids can't be depressed! Kids can't be really struggling." Unfortunately, that isn't the case. Nimona is a 'kid' with trauma, suicidal thoughts, and other mental health issues. Nimona gives kids like little me a way to not feel alone.

TLDR: Nimona is great; every movie should take notes from Nimona. Be like Nimona

#nimona #nimona movie #nimona netflix #queer representation #queer rep in media #representation matters #representation #mental health rep #mental health awareness

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mysteroads · 1 month

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World Building Post-War MHA, aka:

How Mr. Compress survives, thrives, steals all of AFO's money, and gives a big ol' "Fuck You!" to the heroes by doing a better job at saving people... All while staying classy. 😉

tltr: Mr. Compress steals AFO's money, creates a non-profit, names it all after the League to remind everyone why it's important and also to thumb his nose at the heroes.

So, mostly for my own edification, I started wondering what a Post-War MHA world would look like, and since MHA is a dystopia, how people would go about fixing the problems.

So, MHA dystopia can be described as: "Questioning the root of systemic issues brought about by a society grown both compliant *and* reliant on the protection of superheroes-- who have been elevated to celebrity/godlike status while ignoring 'Heroes' inherent humanity and all the flaws that come with being human-- while ignoring their own responsibilities as humans to help each other."

There's a reoccurring theme of Bystander Syndrome. Regular people growing compliant and being unwilling to step up to help their fellow man. Well, Post-War, I'm betting that's going to change, and that's where our boy Atsuhiro Sako can come in.

We all know Mr. Compress is going to survive. I really hope more members of the League do as well, but we know Atsuhiro Sako's going to make it. More than that, he's going jump headlong into making damn sure the past doesn't repeat itself, even if that means playing nice with the heroes (for awhile). There's going to be some sort of Villain Rehab program, or even a pardon/parole for the surviving LoV member(s). Sako's going to to be the perfect little ex-villain right up until his exit paperwork is processed.

And, since he was 1} in Tomura's inner circle, 2} he's clever enough to get Garaki to talk to him, and 3} he's an excellent thief... I'm going to assume he's smart enough to get the info he needs to access enough of AFO's accounts. 💸💸💸 And even if he's not, he's savvy enough to find the money somewhere.

I see Atsuhiro at the head of a Non-Profit Organization with several subsidiaries dedicated to different problems. Furthermore, as a unashamed former villain, I can see him naming the whole thing after the League... just to spite the heroes and remind everyone why he's doing what he's doing.😈 It's what his friends would've wanted.

The League for the Lost, and it's subsidiaries (colored for funsies):

Dabi’s Fire, for the campaign against domestic abuse and protection for the abused.

Himiko’s Hope, assistance for so-called villainous and other maligned quirks, with a special emphasis on blood quirks and others with unique dietary requirements.

Spinner’s Stories, support for mutation quirks and heteromorphs.

Jin’s Friends, for free access to mental health resources.

Big Sis’s House, safe spaces for queer youth and adults.

Tomura’s Soldiers, for the war against the trafficking of children with powerful quirks.

Honestly, this is probably the best way for the problems to be solved, and the best way to put AFO's ill gotten gains to good use. I mean, the money is there! It's going to be found eventually. Might as well use it to do whatever they can do to prevent a problem before it happens! And what better way to keep the memory of the League of Villains alive, get civilians involved in helping each other, and provide a warning for future generations-- than to put their names on Japan's biggest non-profit?

And, if he manages to piss off the old-school heroes and cops, while attracting the new generations, then that's just a bonus. 😎

If you made it this far, you are a most excellent person, a ✨gem✨ among readers!💖 And I want to hear from you! All... probably two, maybe three?... of you! What would you like to see from Post-War MHA? How would you fix the problems? Who from the LoV do you think's going to survive, and what are they going to do with themselves in the new world?

#I wrote a fic #now I'm gonna explain my though process #mwhahahaha #mha post canon #my hero academia #sako atsuhiro #mr compress #my writing #Rain on Wisteria #We're Dead but We've been Worse!#my hero academia fanfic #post canon fix it #fanfiction #what if #world building #boko no hero academia #bnha

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offender42085 · 1 year

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Post 927

Jacob Allen Barber, Oklahoma inmate 2007100. born 1997, incarceration intake 01/06/2023 at age 25, Sentenced to life without the possibility of parole.

Murder

In January 2023, a 25-year-old man convicted of killing his father was sentenced to spend the rest of his life in prison.

Cleveland County District Judge Michael Tupper followed a jury’s recommendation and sentenced Jacob Allen Barber, 25, to life without the possibility of parole as punishment for killing Glenn Barber, 48.

Glenn Barber, his father, was the former youth pastor at First Moore Baptist Church.

Tupper called the case “a real tragedy.”

“The jury has clearly spoken in this case,” he said. “They had an option of doing something less in this case given the evidence they heard, and they were quite deliberate in this sentence.”

A jury in September 2022 found Barber guilty of stabbing his father to death in the summer of 2019. He was arrested near Sanger, Texas, and brought back to the Cleveland County Detention Center.

Court records indicated the father and son “argued daily and had a volatile relationship.”

“The suspect has been to several mental institutions but refuses to take his prescribed medication,” a detective wrote in a court affidavit.

After a 7-day trial, jurors voted unanimously to recommended a sentence of life without the possibility of parole and a $10,000 fine.

The trial was delayed several times due to the pandemic and for mental health evaluations. Much of the testimony during the trial centered on Barber’s mental state.

But lead prosecutor Abby Nathan argued Barber’s actions were premeditated.

“It is important to show the circumstances and the manner of this homicide,” she told jurors. “It is our duty and honor to the jury to do so.”

Two family members attended the hearing Friday but neither addressed the court.

The defendant also declined to speak.

“We know that there isn’t anything that anyone can do to change what happened, but we believe that the collaboration between the different agencies to bring justice for the victim, Glen Barber, honors Mr. Barber’s memory,” Nathan said in a statement following the hearing.

“During the trial there was one commonality among the testimonies of Mr. Barber’s family and friends. They all said he was an incredible person. We hope to honor and remember Mr. Glen Barber in that way, as the incredible person he was.”

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victorysp · 12 days

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Spanish State Visit to Netherlands - Day 2

Queen Máxima and Queen Letizia start the day at LAB6, a centre in Amsterdam Nieuw-West where cultural, sporting and other activities are organised by and for young people aged 12 to 23. They speak with young people and youth workers from Ara Cora, El Mazouni Coaching, @ease and similar organisations about the importance of easily accessible walk-in centres for young people’s mental health. Walk-in centres give young people a place where they feel welcome and where support is available for anyone who is struggling. Queen Máxima and Queen Letizia will be given a tour of LAB6 to see the activities offered to young people. Queen Máxima is the honorary chair of Stichting MIND Us, an organisation that promotes mental health among young people. April 18, 2024.

�� Gtres

#dutch royal family #queen máxima #queen letizia #spanish royal family #spanish state visit to netherlands

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bfpnola · 2 years

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Why Imagination is Vital

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Copied excerpt from the transcript:

With these systems of systems corrupting our humanity, compounded by the psychological manipulations of the social media era, and with a general consensus that we’re hurtling towards a horrible future, how do we break free? I believe it starts with a recognition of the importance of imagination.

We’re not going to be liberated by techno-hopium, by green consumerism, or by politicians. We can't wait for governments and we can’t do this on our own. We are a social species. The only way we get free is together. But one of the first steps is the cultivation of our imagination. Imagination is an essential skill we must all work to foster. Things can change for the better, and they can change very quickly. Imagination is central to empathy, to creating better lives, to envisioning and then enacting a positive future. We cannot let this most critical tool languish.

First and foremost, because imagination is vital to our health.Particularly our mental health. In our brains, we have a pair of seahorse-looking blobs called the hippocampus, and it is the HQ of our imagination. Among the hormones it receives, the hippocampus is particularly vulnerable to cortisol, the stress hormone. Cortisol is the hormone responsible for fight or flight and can be very useful, but in high doses, such as in late-stage capitalism, cortisol can damage our hippocampal cells, reducing the hippocampus’s size and volume and setting off a deleterious cycle of events. The more damaged the hippocampus, the more stressfully and pessimistically you experience reality, which results in even more damage to the hippocampus, and on and on. Capitalism is a mental illness generator; the policies and structures it upholds serves to weave stress, trauma, alienation, inequality, inadequacy, and anxiety throughout the social tapestry. The worse things get, the worse things look, and it becomes harder to imagine a way out.

You’ve heard of capitalism killing our imaginations, now get ready for climate change killing our imaginations. Global CO2 concentrations are currently at around 413 parts per million, and they're projected to reach 1,000 ppm by the year 2100. Researchers estimate that such a concentration would reduce human cognitive ability by 21%. Even the 660 ppm by 2100 goal put forward by the Paris Climate Agreement would put us at a 15% decline in cognitive ability.

But the greatest imagination killer alongside climate change and capitalism, embedded in capitalism, emerging from capitalism, whatever, is the contemporary education system. Or rather, “contemporary” “education” system. Little has diverted from the damaging Prussian Model of the 18th and 19th centuries. While imagination seems to come more easily for children, it has been banished to their domain exclusively and, through the school system, suppressed, removed, redirected, or re-educated as they age. Many children these days don’t have an outside to play in, where they could create their own worlds and games and stories, but such freedom to roam is vital for their psychological well-being. When youth liberation advocates argue for the freedom of children from the domination of schools and parents, it is with the understanding that freedom, and especially freedom to play, which children are being robbed of more and more, is as essential for their potential development as learning to speak or walk. Without it, we’re left with stunted and traumatized adults. Free, spontaneous, and unstructured play teaches social skills, cooperation, creativity, resilience, and conflict resolution, and in my view, it should be a robust and well-incorporated element of our organizing. I believe we should play-pretend about the future to explore different possibilities and then bring them to life. But it’s hard for many adults to engage with play. I get it. School has done a number on people to devalue, undermine, manipulate, and drain our imaginations in order to maintain order and conformity. The education system is globally competitive at this point, and in an effort for colonized countries to keep up with the demanding standards of the so-called first world, they must recreate the standard of sickness corroding our societies and our planet. Imagine if we actually committed to the project of learning. Imagine if we discarded its antithesis. Imagine if we availed learning to all, and refused to restrict it to one set time in one set place in one’s life. Imagine if children were actually able to learn and to direct their learning and develop their skills and passions and selves in a dynamic, diverse, and delightful environment. Imagine if we nurtured whole persons, rather than limiting them to the confines of profit and hierarchy.

For this task of revitalizing our imaginations, I believe nature can and should guide us. After all, the environment we evolved in cultivated our imaginations in the first place. When we speak of peas in a pod, when we speak of running like the wind, when we speak of the bravery of a lion, when we ask “How deep is your love?” It’s like the ocean. Because human creativity, human language, human thought, is tied to the natural world. The separation we maintain with it now is artificial and in many cases detrimental to our wellbeing. The war against nature waged by industrial colonial capitalism is a war against ourselves and an affront to our imaginations. Imagination needs diversity to feed it, but monocultures, monopolies, and other monotonies strip us of that diversity. When we can draw from a palette of possibilities, marked in our memories, we’re able to muse from the magnificent muse of the natural world. So if you want to spark your imagination, start by getting your hands dirty. Literally, soil is about as diverse as it gets.

We can further inspire and energize ourselves with the power of art and the stories it can tell. Humans are storytellers and we cannot afford to underestimate the power of stories. Whether we hitch ourselves to God’s plan, Elon Musk’s vision, Solarpunk, or Desert by Anonymous, narratives shape our lives, our identities, our perceptions, and our actions. Stories may be inaccurate, incomplete, immature, or intransigent, but they are potent. Facts are not enough to change hearts and minds. But stories can. The way I see it, we cannot cede the domain of imagination, of narratives, of stories, to dystopia. There may be constraints on the future, but we should not assume that such restraints require the special brand of “pragmatism” put forth by certain capitulators to the status quo. In fact, with limitations come opportunities. Haiku poetry may be limited to 5-7-5 syllables, but so much beauty has come out of it over the centuries. The same can be said for the stories we can generate from present conditions and future possibilities. Stories that can bring the future to life and help people let go of the past. Stories we can distribute and popularize over a wide, wide variety of media. Stories that inspire boldness and brilliance in community action to aim for a world we can thrive in together.

This video has been inspired by and built upon the book “From What Is to What If” by Rob Hopkins. While I have my critiques of some of the constraints that underline the author’s line of thinking, I highly recommend y’all give it a read. It’s chock full of examples, studies, and case studies that can provide inspiration in this journey.One of the concepts that Rob Hopkins has generated that I want us to reflect upon is The Imagination Sundial, which I’d like to borrow from and push a bit further. The model is split into four sections: space, place, practices, and pacts.

Space involves creating, well, space. Carving out mental and emotional space and time to imagine more, do more and act more. Connecting with others to share burdens and care, whether alloparental care, group meditation, peer support, or reading discussions. The Space Section cannot be divorced from other elements of the Imagination Sundial. Part of creating space must involve organizing to gain power over and minimize the monopoly of work on our time and energy.

Place involves creating and transforming places that can allow us to bring together our imaginations, organize collectively, and implement the worlds we want to see, like food forest permablitzes, street art events, squats and occupations, block meetings, maker spaces, libraries of things, skillshares, and even virtual collaborations.

Practices involve connecting us with each other and changing our frame of possibilities. International solidarity allows us to come together and share stories and case studies of what’s possible for everyday people committed to change. We can be inspired by and learn from the strategies and tactics of liberatory projects from Brazil to Mexico to India to Kurdistan. “Yes And, What if?” practices allow us to exercise our imagination and engage our hands and minds in the process of making the future.

Pacts are about making agreements to get things done. Our projects should not suffocate in isolation but should strive to thrive in the company. Worker cooperatives, housing cooperatives, farming cooperatives, unschooling cooperatives, alloparenting networks, student unions, tenant unions, workers unions, abolitionist movements, permaculture movements, mutual aid projects, artist collectives, especifist units, neighbourhood assemblies, and more can and should convene, confederate, and catalyze action. I’ve spoken in the past about permablitzes, but I can see that style of one-day or weekend focused event action being directed elsewhere too.

These future blitzes can, for example, create what Jason Roberts called “Better Blocks.” Over one weekend, Roberts and a group of others transformed an abandoned block in Dallas into a vibrant block with sidewalk gardens, bike paths, outdoor seating, historic lights, and more. Guerilla bottom-up place-making, as he calls it, helps people execute the changes they want to see in the places they inhabit. Communities are able to come together, imagine collectively, and tell their stories about their environment and their future.

Conclusion: We seem to face insurmountable challenges, but as we rethink the stories we’ve been told and forge new ones, with a renewed sense of resilient imagination, I believe we’ll find many new paths to overcome our obstacles. Imagination is a fundamental component of our humanity; we just need to cultivate it. We can create what-if spaces for why-not action, and we can do it today.

Peace.

#video #youtube #andrewism #resources #reaux speaks #imagination #bipoc #educational equity #anti capitalism #socialism #anarchism #communism #health #permaculture #solarpunk #intersectional environmentalism #community #Youtube

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cv02-lside · 1 month

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The Harmful Sexualization of Teenage Girls in Media

For many years, there has been a concerning trend in media where teenage girls are often depicted in sexually provocative ways. This objectification not only demeans these young women but also perpetuates dangerous attitudes towards them. It is important to understand why this idealization exists and its horrible effects on society, particularly vulnerable adolescent girls.

The sexualization of teenage girls in media can be traced back to several factors. Firstly, some industries exploit youth culture for commercial gain, using suggestive imagery to attract attention and boost sales.

Secondly, certain media platforms may prioritize sensationalism over responsible reporting, leading to the normalization of such content. Moreover, there is a worrying prevalence of adult males who hold positions of power in the entertainment industry and use their influence to promote this disturbing trend.

The consequences of sexualizing teenage girls extend beyond mere "aesthetics". By presenting these young women as objects for male gratification, society reinforces damaging gender stereotypes and contributes to a culture that trivializes consent and completely disregards personal boundaries! Furthermore, research suggests that exposure to hypersexualized images can lead to body image issues among mostly female viewers, potentially resulting in eating disorders or other mental health concerns. (Puberty dysphoria, girls wondering why they don't look like the alluring/grown up image of what they see in media) Additionally, it fosters an environment where predatory behavior towards minors becomes normalized and even encouraged.

Another alarming aspect of the sexualization of teenage girls in media is its connection to child pornography and human trafficking. Predators often use online platforms to share illicit and illegal content featuring underage individuals, further victimizing them and contributing to a cycle of abuse. Tragically, many victims are lured into these situations due to poverty or manipulation by those seeking to profit from their exploitation. The production and distribution of such materials not only violate basic human rights but also create a demand for more vulnerable young people to be part of this horrific thing.

Imagine a young girl growing up surrounded by images that tell her she's nothing more than an object to be admired and desired and to be used/rated. She sees herself reflected in the media as someone whose worth is measured solely by her physical appearance, stripped of agency or autonomy. As she navigates this confusing landscape, she becomes increasingly vulnerable to predators who seek to exploit her innocence for their own twisted desires.This isn't just about numbers or statistics; it's about real lives shattered by a society that prioritizes male pleasure over human safety. It's about broken dreams and stolen futures, all because we continue to perpetuate harmful stereotypes that reduce women to mere playthings for men's power and control. We must challenge the status quo and demand better representation in our media, one that celebrates strength, intelligence, and individuality instead of reducing them to sexual objects.

#feminsim #femme #feminine #teenagers #rant post #ranting #rant #personal rant #writers on tumblr #tumblr problems #microblog #poets on tumblr #blog #tumblr stuff #essay #social justice #social media

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clansbeforetime · 9 months

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Ranks and Jobs

In the three clans around the Baobab, there are different jobs sabers can do, depending on their stage of life and the training they decide to go through! Let’s do a little overview of what those roles and jobs look like together…

Cub [0-6 moons]: Cubs are the youngest members of a clan, cared for by the monarchs (and in the case of SunClan, by their family) and kept mostly confined to the nursery until they are big enough to walk around by themselves, at which time they are free to explore the camp, but never the territory beyond. Not until they become apprentices! The main duties of a cub are listening to your elders, learning about your clan's history, meeting all your clanmates, and growing your saber-teeth, of course! It’s also a good time to look around at all the different adult jobs you could have when you grow, to start getting an idea of what you want to be when you grow up! But don’t worry, we don’t rush here, you’ll have plenty of time to figure it out, and you can always change your mind!

Hunter’s Apprentice [6-12 moons]: Ah, apprenticehood. Something every saber looks back on fondly, when they first started working towards being the fierce cat they are today. It’s at six moons old (or roughly thereabouts, in TuskClan) that a saber is acknowledged as officially training for their future. In BevyClan, this is the time where a young saber is assigned a Mentor who will guide them through their training. In TuskClan, this is when a Batch receives their group name and builds their first real nest together. In SunClan, this is the time when family members begin to take you out to train. A truly exciting time, all-around! Hunter’s apprentices train first and foremost on their namesake: Hunting. How to hunt the prey in your territory in the most effective way possible. They also learn the basics of self-defense and emergency healing.

Hunter: Once graduated from a Hunter’s Apprentice, the next steps in life are up to the individual. Many choose to stop training at the Hunter level, and instead pursue individualized hobbies, such as craft-making, den-keeping, and other activities, alongside keeping their clan well-fed and happy! A hunter can be a hunter all their life, but should they decide to change specialties, they would need to undergo separate training, for each of the three other ranks among the clans…

Guardians are tasked with protecting their clan, and learn their clan’s preferred way of battle, honing their techniques until they are considered a dangerous enemy to any who would call their clan a foe. They are tasked with watching the borders and protecting hunting parties from adversaries, as well as other predators that make their home on clan territory. Training to become a guardian takes 8 moons, though many say they train for their entire lives to be the best guardian they can be.

Healers are in charge of keeping their clan healthy. This can take shape in many different ways, from mental health, physical injury treatment, chronic illness management, and so many others! Healers main tasks include caring for the sick and injured, keeping the clan stocked with medicinal herbs, and studying to discover new ways to keep their clan healthy. Healer training takes 12 moons, though like guardians, healing is a constantly practiced specialty.

Monarchs are the glue that binds a clan together, taking on what many say is the most important of tasks: rearing the young. It comes in many forms, from caring for pregnant and nursing sabers, to teaching cubs developmental skills, and instilling clan values and culture in the youth. They have a bank of knowledge that comes from moons of experience, and 12 moons of around the clock training is required to make being a monarch your full-time career.

When it comes to leadership, there are three positions that sabers can take:

Elders are the most senior members of a clan, who have put in the time and are now retired from their day-to-day duties of their youth. Now, they act as council to the clan and leaders, guiding the newer generations as they were by elders before. Elders have earned respect from each of their clan members by dedicating their lives to their clan, and their rest is definitely well-earned!

Deputies are leaders-in-training, chosen for whichever qualities a clan values most via a vote any time the position is found empty. Their day-to-day tasks can vary depending on what their leader needs the most assistance with, though typical duties include advising clanmates on interpersonal issues and organizing hunting and border patrols for the day.

Leaders are the faces of their clans, chosen to represent everything a clan values and holds dear to them. They run the camp and advise their clanmembers on a day-to-day, and are responsible for diplomacy with their neighbors. If clans decide to go to war, a leader’s yes is necessary after discussions are had. Leaders serve their clan for their entire life, or until they retire if they choose to do so.

#discord warrior cat roleplay #wcrp #sabertooth tiger #discord rp #discord wcrp #sabertooth cat #discord warrior cat rp #clansbeforetime #warrior cats #clans before time #lore

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estellaestella · 2 years

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Freed from masculinity: How Timothée Chalamet made me believe in the new man

Aline Laurent Mayard. 10/12/2022. ESSAYS AND PAPERS

Article about this Essay :

Fascinated by the Franco-American actor Timothée Chalamet, whom she has observed closely since his performance in Call Me By Your Name , Aline Laurent-Mayard analyzes what "Chalamania" (name given to the excessive enthusiasm of a of youth for the actor) engenders new ways of looking at masculinity. From the attitude of Timothée Chalamet in an interview to his uninhibited dresscode on the red carpets, the journalist and author takes us, with Libérés de masculinité, how Timothée Chalamet made me believe in the new man , in an exciting odyssey of masculinities in the realm of pop culture. Maintenance.

How did your obsession with Timothée Chalamet come about?

I have a hard time with the term “obsession”, but let's say that I became very interested in Timothée Chalamet after seeing Call Me By Your Name . Inside, he's an excellent actor, filmed with great sensitivity, a sort of fragile, vulnerable eroticism. After the film, like many people, I started looking for information about it on the Internet. I thought he had something quite unusual. He was young, jovial, he looked humble. One of the reasons for his success, I think, is his likeability. Journalists say it's a pleasure to interview him, fans are thrilled because he always makes time for them, on the red carpet and on the street.

How does this behavior renew masculinity?

Kindness is not a valued quality in a man, because it is perceived as feminine. For women feelings, care, listening, and for men efficiency, rationality, performance. We have been inculcated with the idea that the feminine and the masculine are opposed, impervious, and that the masculine is superior to the feminine. So, if women manage to go into the realm of what is perceived as masculine, it is much less conceivable for men to go into the realm of the "feminine" - because in fact, they would go down the social ladder. . Few men are therefore ultimately built on values such as kindness. Some very well-known figures did it, like Tom Hanks or Keanu Reeves, but it was not perceived as something sexy.

Until now, it was rather the bad boys who embodied the height of sexyness, as you analyze in your book...

Yes, the bad boys demonstrate how kindness is not valued, and how badness is! As I dug into the subject of bad boys, I realized how much we've learned that it's sexy for men to abuse women. However, when we accept that a guy speaks badly to us, or simply does not open up, it can lead to many other things, including violence and murder - in his latest book Reinventing Love, Mona Chollet has also conducted a rather staggering study on all these women who are passionate about murderers. Valuing kindness is for me a necessary step to reach a new phase of our society. We cannot hope that society will change and that men will be less violent if we continue to accept that they are so in our imaginations, and therefore in fiction, and if we do not put forward the men who propose reverse. It's important to open up imaginations because, after having deconstructed certain things, we now have to build new ones.

As such, is Timothée Chalamet a special case, or is he the figurehead of a new generation?

He is not the only one. Among the very well-known personalities and especially among young people, there is also Tom Holland ( Editor's note: actor, seen in Spiderman) and Harry Styles ( Editor's note: singer, ex-member of the group One Direction ), whom I quote a lot in my book . All three are part of a new approach to masculinity, kindness and vulnerability. Harry Styles is a lot into sartorial staging, he talks a lot about his mental health, he's an ally of feminist and LGBT causes. Its slogan is “ Treat people with kindness”. Tom Holland, he stages his relationship with his girlfriend Zendaya in a very egalitarian way; he laughs at being smaller than her, he supports her a lot in her work. This says something about the evolution of our society, that it is these three young men who are talking about them at the moment, to the detriment of bad boys who seem to have disappeared from the landscape.

These three representatives of a revival of masculinity are still cisgender, white, able-bodied and heterosexual men...

Yes. In the book, I am talking about all the other people like them who have not necessarily reached their level of success because they are queer or not white, but who also adopt this type of attitude. If I haven't found an equivalent of these three personalities in France, you just have to walk down the street to see that something is happening. We see it by the proliferation of skirts or nail polish on people who seem to be masculine. And then, when we speak with teenagers, we also see this evolution. We feel that the patriarchy is beginning to crack.

Freed from masculinity, how Timothée Chalamet made me believe in the new man , by Aline Laurent-Mayard (JC Lattès), 240 pages, 19 euros

#timothee chalamet #masculinity #new man #harry styles #tom holland #spiderman #keanu reeves #tom hanks #jimmy stewart

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religion-is-a-mental-illness · 2 months

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By: SEGM

Published: Feb 23, 2024

The finding of low suicide rates and no evidence of benefits of gender reassignment continues to challenge the practice of youth transitions

Summary

A recent study published in BMJ Mental Health, All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019, analyzed overall mortality and suicide mortality among gender-referred young people in Finland over a 25-year time span (n=2,083; median age 19 years; median follow-up 5.7 years). The study defined young people as those referred to gender services under the age of 23.

The study found that suicide among young people <23 ("youth") seeking gender services in Finland is an unusual event (0.3%, or 0.51 per 1,000 person-years). Further, in comparing gender-referred youth to a cohort of matched controls (n=16,643), the study found no convincing evidence that gender-referred youth have statistically significantly higher suicide rates as compared to the general population, after controlling for psychiatric needs. The study also did not detect a statistically significant association between gender reassignment and the risk of suicide. The study did, however, find a statistically significant relationship between a high rate of co-occurring mental health difficulties and increased suicide. The authors concluded that "it is of utmost importance to identify and appropriately treat mental disorders in adolescents experiencing GD [gender dysphoria] to prevent suicide, while also noting that "the risk of suicide-related to transgender identity and/or GD per se may have been overestimated."

This paper has important strengths and limitations. Its conclusions should be examined in the context of the preceding research from the Finnish team on the psychological needs of the recent cohort of youth presenting with gender dysphoria. An earlier study (also a registry study with no loss to follow-up), Have the psychiatric needs of people seeking gender reassignment changed as their numbers increase?, concluded that the level of psychopathology among gender-dysphoric youth has increased in recent years, but found no evidence that medical gender reassignment resolved psychiatric morbidity in young people experiencing gender-related distress.

In order to put the strengths and weaknesses of this latest research from Finland in context, we start by discussing the critical role the Finnish researchers played in highlighting problems with the practice of medical transition of adolescents. We then briefly expand on the most recent paper from the Finnish research team. We conclude with SEGM take-aways.

Background

Finland was the first country in the West to raise concerns about the practice of gender reassignment of minors. Finland opened its gender services for minors in January 2011, the same year as the first of two seminal Dutch papers—the paper focused on the outcomes of puberty blockers (de Vries et al., 2011)—was published. However, after the first few years of initiating youth gender transitions, Finnish clinicians began to sound the alarm. In their descriptively-titled 2015 paper, Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development, they observed that the majority of gender-dysphoric youth presenting for care were female, exhibited "severe psychopathology and considerable challenges in the adolescent development," and suffered from "wider identity confusion." The researchers cautioned that the concept of medical gender transition for this cohort was at odds with the principles of adolescent development.

In the majority of the applicants, gender dysphoria presented in the context of wider identity confusion, severe psychopathology and considerable challenges in the adolescent development. At this point it is not possible to predict how gender dysphoria in this group will develop: will gender dysphoria in these adolescents cease with the resolution of wider developmental problems, or perhaps consolidate later into transsexual identity, with the completion of the developmental tasks of adolescence.

The Finnish researchers continued to provide gender-transition services to youth, while continuing to note the increasing prevalence of gender-related distress in youth and the emerging role of social influence:

… GD appears more common than it was 5 years earlier among Finnish junior high school students. It remains to be seen whether this signifies a vastly increased need for SR services. Adolescents’ identity experiences are shaped by the surrounding society and extensive media coverage of topics related to transgender identity, GD, and gender reassignment, [which] may have an influence on how adolescents perceive themselves and their developmental distress.

By 2020, the Finnish researchers were in the position to evaluate treatment outcomes. While their 2020 paper is frequently quoted by proponents of youth gender transition as an illustration of success (during treatment with hormones, there was a reduction in visits related to depression, anxiety, suicidal ideation, and self-harm), the Finnish researchers themselves arrived at a much more nuanced conclusion with troubling implications. They reported that youth with significant mental health and functional problems at baseline not only failed to improve their functioning after they started hormones, but many got worse:

If the adolescents diagnosed with transsexualism had had difficulties at school/work as during the gender identity assessment, they mainly continued to have difficulties during the real-life phase. Only a minority moved from progressing with difficulties to progressing normatively, and equally many deteriorated during follow-up.

The focus on objective functioning—participation in school or employment, relationships with peers, romantic involvement, and gaining independence—were key outcome measures in the 2020 Finnish study. These measures of functioning are proxies for overall adolescent development. The Finnish researchers noted that gender transition does not appear to facilitate adolescent development in many gender-dysphoric youth, and indeed may exert a negative effect.

The data in the 2020 paper, along with a systematic review of evidence, led the Finnish Health Authority agency COHERE to issue updated recommendations for treating gender-dysphoric youth. These updated guidelines stipulated that psychosocial support and, if necessary, gender-explorative therapy was to be the first line of treatment, while hormone treatments were restricted to very few cases. In Finland, surgery was never allowed for youth under age 18.

While the Finnish research team published a number of other important research papers between 2015 and 2023, the two papers discussed above (Kaltiala-Heino et al., 2015 and Kaltiala et al., 2020) had arguably been the most groundbreaking papers from the Finnish gender research team—until this 2024 paper in the BMJ Mental Health.

Suicide Mortality in Gender-Dysphoric Youth: What Do We Know?

One of the strongest stated rationales for gender transition in youth is the aim to prevent suicides. The notion that suicides are common in gender-dysphoric youth, and that medical gender transition prevents this tragic outcome, is exemplified by the phrase “would you rather have a dead daughter or a living son?”

In February 2024, a new key paper, All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019 by the Finnish team was published in BMJ Mental Health. The paper posed three important questions (quoted directly from the paper below):

Do the all-cause and suicide mortalities of gender-referred adolescents differ from those of matched control populations?

Are any observed differences in mortality between gender-referred adolescents and matched controls explained by psychiatric morbidity?

What is the impact of GR [gender reassignment] on mortality among gender-referred adolescents?

In response to the first question specific to suicides, the researchers found that among <23-year-olds referred to the gender clinic between 1996 and 2019, 0.3% died by suicide, corresponding to 0.51 per 1,000 person-years. While this rate was about 4 times higher than the rate observed in the population of non-gender-dysphoric peers (0.12 per 1,000 person-years), the researchers found that once specialty psychiatric visits were controlled for, the difference between suicide rates in gender-referred adolescents and the general population was no longer statistically significant. In response to the second question, the study found that having 101+ psychiatric visits was a statistically significant predictor of suicide.

In response to the third question, the researchers were unable to find evidence that gender reassignment reduced suicide. When the gender-referred group was separated into “gender-reassigned (GR+)” and “not gender-reassigned (GR-),” and each group was compared to the general population (after controlling for the number of psychiatric visits as a proxy for psychiatric comorbidities), neither group's suicide rates differed from the general population in a statistically significant way. The researchers concluded that these results did “not support the claims that GR is necessary in order to prevent suicide.”

The paper has important strengths and limitations.

Strengths:

Objective and robust measure of suicide rates. The paper’s report of 0.51 per 1000 person-years, based on 13,602 person-years (with a median follow-up of about 6 years) represents one of the most robust measures of suicide in gender-dysphoric youth to date. Suicides should not be confused with “suicidality,” a related but distinctly different measure. Suicidality refers to a wide range of behaviors from thoughts about suicide and non-suicidal self-harm, to serious suicide attempts; it is usually assessed by self-report; it typically excludes actual suicides; and it is considered a less robust and reliable outcome. The large sample (over 2,000 cases of gender-referred youth) provides a high degree of confidence in the size of the estimate and strongly signals that suicide is an unusual event for gender-referred adolescents in Finland, regardless of their gender transition status.

Control for severe psychiatric comorbidities. Because psychiatric illness remains a key predictor of suicide, it is essential to isolate the extent to which gender dysphoria itself contributes to suicide risk in transgender-identified youth. The paper’s use of a proxy measure for severe psychiatric comorbidity allowed for a more reliable estimate of the effect of gender dysphoria on suicide (which was found to not be statistically significant). However, the chosen method of controlling for psychiatric comorbidities has important limitations, which we discuss below.

Isolated the effect of gender reassignment on suicides. One of the ongoing criticisms of the existing data on suicide is the inability to determine whether medical gender reassignment has a positive, negative, or neutral effect on suicides. This is because suicide is reported for gender-dysphoric patients without accounting for whether or not the patient was treated. The Finnish researchers controlled for treatment status by splitting the sample of gender-referred adolescents into “transitioned” vs “not transitioned” and comparing their suicide rates to the general population of matched peers. The paper concluded no effect of transition on suicides due to a lack of statistical significance. Our discussion in the "SEGM take-away" section below discusses the limitations of exclusively relying on statistical significance when too few events are observed, but we ultimately agree with the authors' conclusions.

No loss to follow-up. The paper used linked national health registries, which assured that all the assessed individuals were accounted for, with effectively no loss to follow-up (only those who left the country would be missing from the national register data). In contrast, most research in this field suffers from substantial loss to follow-up, ranging from 20% to 60%. Loss to follow-up can often mask negative outcomes, as patients disillusioned in their care or struggling with functioning are less likely to engage in follow-up research.

While this paper represents one of the most robust efforts to date to answer essential questions about the relationship between gender dysphoria and suicide, and the impact of gender transition on suicide, it also has important limitations. The most salient ones (some of which are recognized by the authors) are outlined below:

Limitations:

Relatively short-term follow-up. While the registry spans 25 years, the median follow-up time is under 6 years. Since the elevated morbidity and mortality in adult studies emerge after the 10-year mark, it is unlikely that the paper accurately reflects the long-term picture on adverse outcomes. Given the “honeymoon period” associated with gender transitions and the young age of current study participants, it is likely that the positive outcomes of the transition have been “frontloaded” and thus accounted for by the results, while the negative outcomes—including both the possibility of regret and the negative effect of prolonged exposure to cross-sex hormones—may not have been yet incurred and are not captured by the data. With longer follow-ups, the results could substantially change. However, this is a limitation of the field rather than the limitation of the study itself. Youth only began to present for gender reassessment in high numbers in recent years, which has contributed to the median follow-up of only about 6 years.

Too few events for a subgroup analysis. The welcome news that there were few suicides among the gender-dysphoric youth (n=7) comes with a scientific disadvantage that these numbers are too small for well-powered statistical analysis. For example, the study’s first two research questions led the researchers to compare 7 suicide events among gender-referred youth to 13 suicides in the matched control population. The analysis to inform questions about which independent variables (e.g., level of psychiatric comorbidity, transition status, sex, etc.) have an effect on suicide is necessarily limited by these small numbers. The small number of suicides is a welcome limitation.

Imperfect control for co-occurring mental illness. To assess the level of co-occurring psychiatric conditions, the researchers relied on the count of psychiatric visits to tertiary care. However, this approach does suffer from limitations. While the frequency of psychiatric visits is an indicator of severe psychiatric disease (the authors explain that in Finland, only severe psychiatric illness is treated at a tertiary level), it is an imprecise measure of psychiatric morbidity. For example, 1 psychiatric hospitalization, 1 outpatient consult for severe and persistent mental illness such as schizophrenia, and 1 visit related to depression would all count as "1 visit" but would signal different levels of psychiatric needs. At the same time, disorders such as anxiety may not be captured at all, if such less severe conditions are addressed at a lower level of care in the Finnish healthcare system. Further, while the researchers controlled for birth year, it does not appear that the number of psychiatric visits was annualized; instead, it was summed across the entire timespan. This risks underestimating the burden of psychiatric illness for most recently referred youth, who are presenting with large numbers in recent years with significant mental health comorbidities, but who have shorter psychiatric histories (fewer total visits).

The authors observe that "experiencing GD [gender dysphoria] significant enough to seek GR [gender reassignment] appears to not be associated with increased suicide mortality, but suicides appear to be explained by psychiatric morbidities." They further note that "when psychiatric treatment history is considered, GD significant enough to result in contact with specialized gender identity services during adolescence does not appear to be predictive of all-cause or suicide mortality. Psychiatric morbidities are also common in this population. Therefore, the risk of suicide-related to transgender identity and/or GD per se may have been overestimated." Consistent with these observations, the authors finish with the clinical implication of the “utmost importance to identify and appropriately treat mental disorders in adolescents experiencing GD to prevent suicide” and recommended that “accurate information is provided to professionals” regarding this important topic.

The current study's conclusions must also be examined in the context of earlier Finnish research. As mentioned above, another recent study from Finland, also relying on the registry data with no loss to follow-up, examined the psychiatric needs of gender-referred individuals in Finland. The study concluded that gender referrals at ever-younger ages are on the increase, with an increasing burden of co-occurring psychiatric problems. The authors examined the effects of gender transition on psychiatric needs, with the hope of seeing that gender reassignment, combined with reduced stigma and prejudice in society, would alleviate psychiatric comorbidities. Instead, the analysis showed that “manifold psychiatric needs persist regardless of medical GR [gender reassignment].” The authors noted that this conclusion from Finland is consistent with a recent US study, which also had no loss to follow-up.

SEGM Take-Away

The results of the study should be interpreted in the context of the unique characteristics of Finland's transgender-identifying population (e.g., the reportedly low rates of substance use in Finland, in contrast to the high reported rate in the US), Finland's recent strides in having significantly reduced suicide rates in the country overall, and Finland's unique, high-quality healthcare system, which contributes to superior health outcomes for the Finnish population. At the same time, several important aspects of the Finnish results are nonetheless likely generalizable to other Western countries, as the trend of high numbers of young people presenting to specialty services with a wish to medicalize their recent-onset transgender identity appears to be ubiquitous in the West.

The recent Finnish study confirms the earlier finding from the UK that suicides remain uncommon events in gender-dysphoric youth, regardless of gender transition status. It also confirms the finding from an earlier international study on suicidality (a related concept) that while the frequency of such events is elevated in gender-dysphoric young people compared with the general population of youth, it is comparable to youth referred for other mental health problems but not gender dysphoria. The Finnish study's results suggest that the clinical management of gender-dysphoric young people should focus on the management of comorbid psychiatric conditions, which are a well-known risk factor for suicides. This conclusion is consistent with prior research, which consistently shows that psychiatric comorbidities are highly prevalent in gender-dysphoric youth, typically predating the diagnosis of gender dysphoria.

Some proponents of youth gender transitions may argue that while the effect of gender reassignment on suicide reported by the study was not statistically significant, it was nonetheless clinically meaningful. The study reported that youth who were gender-transitioned had a lower risk of suicide over time (adjusted hazard ratio, 0.8; 95% confidence interval 0.2 to 4.0; p-value = 0.8) compared to the general population, while youth who were gender-referred but did not undergo transition had a higher risk (adjusted hazard ratio, 3.2; 95% confidence interval 1.0 to 10.2; p-value, 0.05). Some have suggested that this signals that gender transition decreases suicide risk, and that this finding deserves careful consideration despite the lack of statistical significance, which could be explained by a small sample with insufficient power. In the past, SEGM itself made an argument that statistical significance alone should not be relied upon, and that some results can be not statistically significant, yet clinically meaningful.

Our analysis of suicidality data in the Bränström & Pachankis 2020 study is a case in point. Originally, the study concluded that hormones did not lead to improvement in mental health of gender-referred individuals but claimed that gender-affirming surgeries did result in a benefit. After the study's publication, the analysis was found to have had significant problems, and the data were subsequently re-analyzed using a more rigorous statistical method. After the re-analysis, the earlier finding of benefits had to be corrected, stating, "the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison." In examining the re-analyzed data, SEGM noted that not only was the original conclusion of suicide attempt reductions nullified, but the re-analyzed data showed nearly twice as many serious suicide attempts in the "gender-dysphoric and surgically-transitioned" group relative to the risk-matched "gender-dysphoric but not surgically-transitioned" group. While this difference was not statistically significant, we argued that it was nonetheless clinically meaningful, and that the lack of statistical significance was likely due to lack of power from too few recorded suicide attempts.

For the reasons outlined above, we will engage with the question, does the Finnish data show that gender transition reduces suicides—even if the results were not statistically significant?

Does the Finnish Study Show That Gender Transition Reduces Suicides?

Statistical significance is a double-edged sword. On the one hand, statistical significance testing is an objective method that separates the "signal" from the "noise" of random error in a dataset, so that random effects are not mistaken for a likely true effect (also known as Type I error). On the other hand, it is possible to wrongly dismiss a real effect because it failed to reach statistical significance, for example, due to a small sample (known as Type II error). For this reason, besides looking at statistical significance, one should examine the direction, magnitude, and precision of effect estimates (i.e., confidence intervals), as well as the overall sample size. It is possible to come to a conclusion that a non-statistically significant result is still clinically meaningful and informative.

Below we explain why the Finnish results do not suggest that gender transition reduced suicides. In fact, had the results been statistically significant, we would still assert that one could not draw the conclusion that Finnish data provided reliable evidence that gender transitions reduced suicides. This is because we believe the adjustment for psychiatric illness, which is one of the strongest predictors of suicide, did not fully account for the burden of psychiatric comorbidity, and that this limitation disproportionately affected the "gender-referred but not reassigned" (GR-) group's comparison to the general population, leading to a possible overestimate of the point estimate for the adjusted hazard ratio.

Because the researchers chose to rely on the total count of psychiatric visits to specialty tertiary care centers as their control variable, the analysis remained vulnerable to confounding due to psychiatric illness, as we explained in the limitation section above. This limitation is particularly relevant to the discussion at hand because the assignment to "gender-referred but not reassigned" (GR-) vs. "gender-referred and reassigned" (GR+) groups was non-random. Individuals with a higher degree of psychiatric comorbidity, and, thus, a higher baseline suicide risk, were less likely to be approved for transition by the centralized Gender Identity Services (GIS), and, thus, more likely to "end up" in the GR- group, as the quote from the earlier 2023 Finnish study suggests:

Proceeding to medical GR [gender reassignment] interventions was not independent of psychiatric treatment needs prior to contacting GIS. Those who proceeded to medical GR presented less commonly with needs for specialist-level psychiatric treatment before contacting GIS and after the index date.

Given the well-established fact that recent gender-referred youths suffer from high rates of co-occurring mental illness, the inability to fully control for psychiatric comorbidity would likely disproportionately affect the GR-group's comparison to the general population, affecting the adjusted hazard ratios calculations.

Of course, the lack of statistical significance is another strong reason not to over-interpret the difference in the point estimates in the adjusted hazard ratios between the GR+ and the GR- groups. The confidence intervals for adjusted hazard ratios for suicide between GR- and GR+ (compared to controls) were 1.0 - 10.2 and 0.2 - 4.0, respectively. In other words, among gender-referred young people who underwent medical reassignment (GR+), the rate of suicide was anywhere from 80% lower to 4 times higher than matched controls, after accounting for psychiatric comorbidity, whereas among gender-referred young people who did not undergo medical reassignment (GR-), the rate of suicide was the same as or up to 10 times higher than matched controls. The uncertainty around the estimates was due to the (thankfully) small number of suicides in both groups.

Perhaps most importantly, debating whether these non-statistically significant study results can still be interpreted to mean that gender reassignment reduced suicides misses the biggest point of the study: the low absolute risk of suicide in the population of gender dysphoric youth. Because this absolute base risk is low, any further treatment-associated reductions in the risk are naturally limited and must be considered in the context of the harms of the same treatment, as we explain below. (To clarify, the explanation below is based on a thought experiment, as the researchers did not share the raw numbers due to patient privacy reasons.)

Let's assume that 6 of the 7 recorded suicides in the Finnish study occurred in the GR- (un-reassigned) group (6/1287=0.47%), and only 1 of the 7 suicides occurred in the GR+ (reassigned) group (1/796=0.13%); this is the most generous assumption the current data affords. Although one could claim that suicides were reduced nearly 4-fold (from 0.47% to 0.13%), the absolute suicide risk was reduced by less than 1 percentage point (0.47%-0.13%=0.34%)*. This example emphasizes the need to always consider the absolute, rather than relative risk. Reliance on relative risk reduction can lead to an overly optimistic (and often misleading) assessment of a treatment's efficacy.

Further, any reductions in the risk of suicide from gender reassignment, which are limited by the ceiling of less than 1% as we demonstrate above, must then be weighed against the risk of treatment-associated harms. For example, every child treated according to the recommendations by the Endocrine Society (i.e., starting puberty blockade at Tanner stage 2 and followed with cross-sex hormones) is expected to be infertile or sterile, and significant unanswered questions remain about bone and brain development. Past studies of transgender-identified adults found significantly shortened lifespans and elevated morbidity among transitioned individuals, including significant cardiovascular risks. A number of other risks emerge saliently only after the 10-year mark, which is several years later than the study's average follow-up of 6 years. While the Number Needed to Treat (NNT) to avoid an adverse outcome such as suicide is impossible to calculate from the current study, given the hypothetical best-case-scenario example above, the relationship between the NNT (number needed to treat) and the NNR (number needed to harm) is unlikely to be favorable, even if gender transitions did reduce suicides—which the study failed to conclude.

Finally, trading off benefits and harm involves patient and parent (in the case of minors) value judgments about how much harm (and what type) a patient would accept in return for a benefit. Quality systematic research into patient values and preferences in this space has not been conducted.

In constructing Table 1 below to summarize what's known about the absolute risk of suicide in gender-referred youth, we noted that the highest rates of suicides were reported in instances where every young person was treated with hormones. That neither the current study nor several other studies to date have been able to demonstrate that gender transition reduces suicide or serious suicide attempts adds to the concern that the suicide narrative has been inappropriately used to promote medical gender transitions of youth.

We would like to conclude our discussion of the Finnish study with a recent quote from Dr. Erica Anderson, the former President of USPATH: “If gender-affirming medicines could not provide sufficient relief to the adolescents so treated and reduce their suicidality, should such patients have received hormones at all?"

We would like to add one more important question: How should the treatment outcomes be measured? The medical community must come to a consensus on what the primary treatment target is. The goal of suicide reduction, which has long been asserted by the many proponents of youth gender transitions, appears to be a flawed measure. At the same time, a mere achievement of satisfying appearance results, as suggested by the new "gender incongruence" ICD diagnosis, is also a questionable measure, especially given what we know about ongoing adolescent development.The Finnish researchers have long asserted the treatment target should be on the improvements in functioning (both short- and long-term).

These critical questions must be urgently debated by the professionals who deeply care about helping gender-dysphoric youth. The answer to these questions will have a direct impact on which treatments—hormones and surgery, or watchful waiting and psychotherapy—will become the standard of care for the rapidly growing numbers of gender-dysphoric youth in the 21st century.

The primary manipulation used by activists and activist-clinicians to manipulate both parents and kids is, unsurprisingly, a lie.

#SEGM #Society for Evidence Based Gender Medicine #gender ideology #gender identity ideology #queer theory #medical scandal #medical malpractice #medical corruption #suicide #trans or suicide #suicide narrative #affirm or suicide #religion is a mental illness

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