I have a new-ish post up at Genspect on the Dutch protocol and reports on a longitudinal study following teenage patients into their thirties:
The Dutch said they were interested in whether patients who transitioned as children and teens experienced changes in gender identity, sexual orientation, and desire for children of their own over time. Researchers asked whether patients continued to identify as “binary trans” or whether their identities were now more “fluid.” They found that 18% of children and 31% of teens experienced “multiple attenuations” of their gender identity over time. “Multiple attenuations” conveniently lumps trans/nonbinary identification together with detransition so that there are no detransition numbers to point to. This allowed researchers to report cheerily on the profusion of gender identities their patients had adopted over the years, from “elf” to “fairy” to “friendly non-intimidating woman,” while burying the uncomfortable reality that some patients detransitioned, too.
On the question of sexual orientation, many patients reported changes over the study period. At the outset, the patients were almost exclusively same-sex attracted. But after undergoing puberty suppression, cross-sex hormones, and other interventions, a sizable share of female patients and a subset of male patients reported a change in sexual orientation.
Of the patients researchers actually managed to follow up with, more than one in four (27%) said they regretted that gender transition had rendered them infertile. A further 11% said they weren’t sure how they felt about the loss of their fertility. Fifty-six percent of patients said that they now wanted children, with many expressing that their desires had changed since they themselves were children; 21% of patients said they were simply too young to understand the consequences when they embarked on medical transition as preteens or young teenagers.
And now, years later, surrounded by evidence of regret and harm, the Dutch clinicians joked that they’re “not really interested in prediction.” One researcher said “I can predict how I’ll feel in one minute—still nervous!—but I cannot predict how I will feel tomorrow.” The audience laughed.
But it’s not funny. This is an adult in a conference room joking that she has no idea how she’ll feel tomorrow—after all, anything could happen between now and then!—to gloss over evidence that distressed children and teens can’t consent to sign away the rest of their lives.
At a conference that so often devolved into sheer insanity—like endorsing ‘gender-affirming care’ for eunuchs and people who claim multiple personalities—this particular WPATH session was restrained and reasonable-sounding. That’s why it was so chilling.
All around the world, gender clinicians look to the Dutch. And the Dutch have no idea what they’re doing and they never did and they never will. Circumstances outside of their control are forcing them to talk about regret and detransition and all they can come up with is: “Respecting someone’s autonomy also includes that the person has the right to make a decision which they may later regret.”
If these clinicians were talking about regretted tattoos, I’d agree. But they’re talking about irreversible interventions with lifelong consequences that they carried out on minors under the banner of medicine.
Of course, such clinicians would rather talk about patient autonomy than medical responsibility. Of course, they refuse to translate “some patients changed their minds later/experienced multiple attenuations of their gender” (autonomy framework) into “we harmed patients” (medical responsibility framework).
As a physician, this is a difficult article to read. I’m smashing my head against the wall trying to figure out where “first, do no harm” went.
What happened to “First, do no harm”?