The Guardian was once teased for its typos - hence the friendly knickname 'Grauniad' as used in the late 20th century. Affection for a once great newspaper has evaporated. Those typos, instead of being spelling errors, have become egregious inaccuracies. The Guardian, in print and on-line, is now notorious for its corrupted and incompetent journalism - its much limited readership residing in an echo chamber.
Society has gone from rightly criticizing "pray the gay away" to embracing the far more damaging "trans the gay away". At least pray-the-gay-away didn't involve bodily mutilation and could be abandoned at will without the lifelong physical scars.
Even a non-psychologist who follows rebuttals of the disinformation and lies put out by transactivists, knows that this research quoted in The Guardian is worthless: or at least meaningless in isolation from other, all too scanty, followups of "gender reassignment" surgery, made over longer periods.
I cannot readily quote sources, but know that detransitioners reverse their decisions from typically between one to ten years following such surgery: ie after the one-year period of this study ended -- and during which satisfaction tends to be at its highest. Until the first surgery is no longer "enough", and / or the body dysmorphia focus has shifted, and / or the strain of imposter syndrome has taken its toll...
All of us know that any TRA suicide stats for so-called "trans" kids, are wildly exaggerated to suit their special pleading. With a suicide rate typically presented as "19 times worse" than distressed children generally pre-transition -- when (in various studies) it's actually very marginally (if at all) worse than other kids with the same range of mental health issues. These often stem from emotional and/or physical abuse and neglect, and/or sexual abuse, and/or autism, and/or homophobic bullying. And particularly for girls, from puberty itself: from the assorted horrors of becoming a woman.
None of the resulting mental health problems (anxiety, depression, eating disorders etc) are considered by TRAs to be worthy of investigation or treatment, demonised as "conversion therapy" -- because "gender dysphoria" is assumed to cause them all. But gender dysphoria is much more likely to be the RESULT, than the cause...
And far from dropping after transition, the suicide rate in one longterm study rocketed up to 19 times HIGHER than its pre-transition rate, over ten years.
The NYTs just yesterday also had a "news" article with much the same aim about the Va. Gov. pardoning the Loudon County parent whose daughter was sexually asualted in school without ever revealing that any of it was about anything except "anti-trans-rights" and the Gov. "starting his campaign push by courting "the far right". Certainly not about the school board lying to parents, their insane "gender" policies, and the TWO, 2! preventable sexual assualts that took place IN LOUDON PUBLIC SCHOOLS. Terribly biased, ILL-informative reporting, in the NYTs.--- "The Paper of Record" --- Shameful.
It's a bloody record review so review the damned record. When is a record reviewer ever before commenting on the artist's personal views. It's pathetic and childish. All great publicity for Murphy.
It is good that you have looked at Tordoff et al., 2022 in greater detail. However, you should know that several much more comprehensive teardowns exist already. The first is the magnum opus: "Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite" (https://jessesingal.substack.com/p/researchers-found-puberty-blockers).
The second is a research paper published in early 2023, called "The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed" (https://doi.org/10.1080/0092623X.2022.2150346). I will quote the section where they criticize the Tordoff paper in full: "The spin of Tordoff et al. (2022) is dramatic. This study claimed that puberty blockers and “gender-affirming” hormones produced a 60% reduction in depression after only one year. However, this conclusion is in stark contrast to the raw data: at baseline, 59% of the yet-to-be treated patients had moderate to severe depression; by the end of the study at 12 months, 56% were still moderately to severely depressed, despite receiving hormone treatment (Supplementary material of eTable 3 Tordoff et al., 2022). This unchanged rate of depression became an “observed 60% lower odds of depression” via a methodology that inferred the “improvement” in the treated cases from the reported “worsening” in the untreated cases. Indeed, the untreated cases in the study had depression rates of 86% by the end of the study period (n = 7), compared to 56% of the treated cases (n = 57), seemingly supporting the conclusion that treatment with hormones alleviates depression.
"However, by basing their conclusion about the relative success of the “treated” on the finding of lack of success among the “untreated” cases, the researchers failed to consider that they lost an astounding 80% of their “untreated” cohort by the end of the study (28 of 35); in contrast, over 80% of the “treated” cohort (57 of 69) remained enrolled. The high dropout rate in “untreated” subjects makes intuitive sense: the study took place in a gender clinic setting, the primary purpose of which is provision of gender transition services. Youth whose distress was ameliorated without the use of hormones would have little reason to stay enrolled in the clinic and participate in the ongoing research. However, what this also suggests is that the highest functioning “untreated” youth dropped out of the study. Thus, the entire conclusion that because “untreated” cases faired so poorly on measures of depression, anxiety, or suicidality, it must be that hormones given to the “treated” cases “worked,” is invalid. There are other problems in the study, including the fact that the use of psychiatric medications was not accounted for in the analysis. The university was aware of the problems with this research but chose to remain silent because the study’s optimistic conclusions were so well received by national news media outlets (Rantz, 2022)."
The Tordoff paper is also discussed in a magisterial takedown of yet another highly cited paper, that of Chen et al., 2023. This appeared in a Reddit thread, which has now become "viral" by the standards of viral among medical researchers. It appears here: https://www.reddit.com/r/medicine/comments/15hhliu/the_chen_2023_paper_raises_serious_concerns_about/. I would request readers to read this in full, because it is written by an experienced ABPN Board Certified Child and Adolescent Psychiatrist, with a deep knowledge of the practice and the research, something that is apparent when you go through the detailed observations.
The Tordoff critique appears as follows: "Tordoff 2022 was an observational cohort study of 104 teens, with 7 on some kind of hormonal treatment for gender dysphoria at the beginning of the study and 69 being on such treatment by the end. The authors measured depression on the PHQ-9 scale at 3, 6, and 12 months, and reported "60% lower odds of depression and 73% lower odds of suicidality among youths who had initiated PBs or GAHs compared with youths who had not." This paper is widely cited as evidence for GAH, but the problem is that the treatment group did not actually improve. The authors are making a statistical argument that relies on the "no treatment" group getting worse. This would be bad enough by itself, but the deeper problem is that the apparent worsening of the non-GAH group can be explained by dropout effects. There were 35 teens not on GAH at the end of the study, but only 7 completed the final depression scale.
"The data in eTable 3 of the supplement is helpful. At the beginning the 7 teens on GAH and the 93 not on GAH have similar scores: 57-59% meeting depression criteria and 43-45% positive for self-harming or suicidal thoughts. There is some evidence of a temporary benefit from GAH at 3 months, when the 43 GAH teens were at 56% and 28% for depression and suicidality respectively, and the 38 non-GAH teens at 76% and 58%. At 6 months the 59 GAH teens and 24 non-GAH teens are both around 56-58% and 42-46% for depression and suicidality. At 12 months there appears to be a stark worsening of the non-GAH group, with 86% meeting both depression and suicidality criteria. However, this is because 6/7 = 86% [have left the study] and there are only 7 subjects reporting data out of the 35 not on GAH from the original 104 subject cohort. The actual depression rate for the GAH group remains stable around 56% throughout the study, and the rate of suicidality actually worsens from Month 3 to Month 12.
"We cannot assume that the remaining 7 are representative of the entire untreated 35. I suspect teens dropped out of this study because their gender dysphoria improved in its natural course, as many adolescent symptoms, identities and other concerns do. However, even if you disagree with me on this point, the question you have to ask about the Tordoff study is why these 7 teens would go to a gender clinic for a year and not receive GAH. Whatever the reason was, it makes them non-representative of gender dysphoric teens at a gender clinic."
The Tordoff study is a turd of a "research" paper that would not have passed even through the editorial desk of any editor who understands the basics of the scientific process or possesses the mere basics of statistical knowledge. But then, zombie ideas die hard; they just shamble along, ready to infect a new cohort of gullible journalists at the earliest opportunity.
The Reddit post is not only a takedown of Tordoff 2022 or Chen 2023, but a more general takedown on the "state-of-the-art" when it comes to gender medicine research: "I am not unaware of how fraught and politicized this topic has become, but the time has come to admit that we, even the moderates like me, were wrong. When a teenager is distressed by their gender or gendered traits, altering their body with hormones does not help their distress. I suspect, but cannot yet prove, that the gender affirming model is actively harmful, and this is why these gender studies do not have the same methodological problem of large placebo effect size that plagues so much research in psychiatry. When I do in depth chart reviews of suicidal twenty-something trans adults on my inpatient unit, I often see a pattern of a teenager who was uncomfortable with their body, "affirmed" in the belief that they were born in the wrong body (which is an idea that, whether right or wrong, is much harder to cope with than merely accepting that you are a masculine woman, or that you must learn to cope with disliking a specific aspect of your body), and their mental health gets worse and worse the more gender affirming treatments they receive. First, they are uncomfortable being traditionally feminine, then they feel "fake" after a social transition and masculine haircut, then they take testosterone and feel extremely depressed about "being a man with breasts," then they have their breasts removed and feel suicidal about not having a penis. The belief that "there is something wrong with my body" is a cognitive distortion that has been affirmed instead of Socratically questioned with CBT, and the iatrogenic harm can be extreme.
"If we say we care about trans kids, that must mean caring about them enough to hold their treatments to the same standard of evidence we use for everything else. No one thinks that the way we "care about Alzheimer's patients" is allowing Biogen to have free rein marketing Aduhelm. The entire edifice of modern medical science is premised on the idea that we cannot assume we are helping people merely because we have good intentions and a good theory. If researchers from Harvard and UCSF could follow over 300 affirmed trans teens for 2 years, measure them with dozens of scales, and publish what they did, then the notion that GAH is helpful should be considered dubious until proven otherwise. Proving a negative is always tricky, but if half a dozen elite researchers scour my house looking for a cat and can't find one, then it is reasonable to conclude no cat exists. And it may no longer reasonable to consider the medicalization of vulnerable teenagers due to a theory that this cat might exist despite our best efforts to find it."
In addition, the Dutch study (deVries, Steensma, et al, 2014) was funded by Ferring Pharma, which produces a puberty blocking drug. In a later followup recently the same researchers lost 50% to follow up, and found that many of those they found were calling themselves some other identity such as non-binary, rather than an identity opposite their natal sex. The study started out with 70 and 15 dropped out. Can we assumed they had gone through enough actual puberty to then desist from cross-sex ideation. DeVries reportedly shrugged her shoulders at a recent professional meeting and invented "gender incongruent" as a term to explain their "journey will never be over." Meanwhile, Alexander L and Ritchie Herron talk about the urination problems and the complications of trying to replace the testosterone that castration robbed from them through injections or patches, which give the penile material inserted inside them (so-called "vaginoplasty") to become stiff like in an erection.
This is covered as well, very engagingly, in Miriam Grossman's newly published book "Lost In Trans Nation" which I highly recommend. I am listening to the audio version.
Excellent analysis of current research on the impact of puberty blockers. I do love calmly considered and informative writing on serious issues which this is. Thanks Kathryn!
Excellent article. The Guardian is totally dysfunctional. I have peaked many people since I was peaked (in January 2021) but Guardian-reading friends are the least-informed around anything to do with gender ideology. They still defend Stonewall and Eddy Izzard, and they know nothing about the fetishists, paedos, cross-dressers and porn addicts now rebranded as trans. When you do tell them stuff, they say things like "problems on both sides".
Wow, utterly breathtaking in its awfulness. Audacious in its corruption. At times I wonder: How can such things be? Hard to know which is worse, the "science" or the "journalism".
nice job. the logic behind these studys is the same used by multi millionaires and $billion corporations to evade income taxes in the US: add several layers of unnecessary complexity and most wont spend the effort to find the truth.
the uncanny part is every gender biz stat, study and claim suffers the same flaw: bogus information followed by a campaign style headline that misrepresents the data
The Guardian was once teased for its typos - hence the friendly knickname 'Grauniad' as used in the late 20th century. Affection for a once great newspaper has evaporated. Those typos, instead of being spelling errors, have become egregious inaccuracies. The Guardian, in print and on-line, is now notorious for its corrupted and incompetent journalism - its much limited readership residing in an echo chamber.
This is bloody marvellous, agreed with every word! Thank you Kathryn
Society has gone from rightly criticizing "pray the gay away" to embracing the far more damaging "trans the gay away". At least pray-the-gay-away didn't involve bodily mutilation and could be abandoned at will without the lifelong physical scars.
Fantastic username, btw.
Even a non-psychologist who follows rebuttals of the disinformation and lies put out by transactivists, knows that this research quoted in The Guardian is worthless: or at least meaningless in isolation from other, all too scanty, followups of "gender reassignment" surgery, made over longer periods.
I cannot readily quote sources, but know that detransitioners reverse their decisions from typically between one to ten years following such surgery: ie after the one-year period of this study ended -- and during which satisfaction tends to be at its highest. Until the first surgery is no longer "enough", and / or the body dysmorphia focus has shifted, and / or the strain of imposter syndrome has taken its toll...
All of us know that any TRA suicide stats for so-called "trans" kids, are wildly exaggerated to suit their special pleading. With a suicide rate typically presented as "19 times worse" than distressed children generally pre-transition -- when (in various studies) it's actually very marginally (if at all) worse than other kids with the same range of mental health issues. These often stem from emotional and/or physical abuse and neglect, and/or sexual abuse, and/or autism, and/or homophobic bullying. And particularly for girls, from puberty itself: from the assorted horrors of becoming a woman.
None of the resulting mental health problems (anxiety, depression, eating disorders etc) are considered by TRAs to be worthy of investigation or treatment, demonised as "conversion therapy" -- because "gender dysphoria" is assumed to cause them all. But gender dysphoria is much more likely to be the RESULT, than the cause...
And far from dropping after transition, the suicide rate in one longterm study rocketed up to 19 times HIGHER than its pre-transition rate, over ten years.
The NYTs just yesterday also had a "news" article with much the same aim about the Va. Gov. pardoning the Loudon County parent whose daughter was sexually asualted in school without ever revealing that any of it was about anything except "anti-trans-rights" and the Gov. "starting his campaign push by courting "the far right". Certainly not about the school board lying to parents, their insane "gender" policies, and the TWO, 2! preventable sexual assualts that took place IN LOUDON PUBLIC SCHOOLS. Terribly biased, ILL-informative reporting, in the NYTs.--- "The Paper of Record" --- Shameful.
It's a bloody record review so review the damned record. When is a record reviewer ever before commenting on the artist's personal views. It's pathetic and childish. All great publicity for Murphy.
It is good that you have looked at Tordoff et al., 2022 in greater detail. However, you should know that several much more comprehensive teardowns exist already. The first is the magnum opus: "Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite" (https://jessesingal.substack.com/p/researchers-found-puberty-blockers).
The second is a research paper published in early 2023, called "The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed" (https://doi.org/10.1080/0092623X.2022.2150346). I will quote the section where they criticize the Tordoff paper in full: "The spin of Tordoff et al. (2022) is dramatic. This study claimed that puberty blockers and “gender-affirming” hormones produced a 60% reduction in depression after only one year. However, this conclusion is in stark contrast to the raw data: at baseline, 59% of the yet-to-be treated patients had moderate to severe depression; by the end of the study at 12 months, 56% were still moderately to severely depressed, despite receiving hormone treatment (Supplementary material of eTable 3 Tordoff et al., 2022). This unchanged rate of depression became an “observed 60% lower odds of depression” via a methodology that inferred the “improvement” in the treated cases from the reported “worsening” in the untreated cases. Indeed, the untreated cases in the study had depression rates of 86% by the end of the study period (n = 7), compared to 56% of the treated cases (n = 57), seemingly supporting the conclusion that treatment with hormones alleviates depression.
"However, by basing their conclusion about the relative success of the “treated” on the finding of lack of success among the “untreated” cases, the researchers failed to consider that they lost an astounding 80% of their “untreated” cohort by the end of the study (28 of 35); in contrast, over 80% of the “treated” cohort (57 of 69) remained enrolled. The high dropout rate in “untreated” subjects makes intuitive sense: the study took place in a gender clinic setting, the primary purpose of which is provision of gender transition services. Youth whose distress was ameliorated without the use of hormones would have little reason to stay enrolled in the clinic and participate in the ongoing research. However, what this also suggests is that the highest functioning “untreated” youth dropped out of the study. Thus, the entire conclusion that because “untreated” cases faired so poorly on measures of depression, anxiety, or suicidality, it must be that hormones given to the “treated” cases “worked,” is invalid. There are other problems in the study, including the fact that the use of psychiatric medications was not accounted for in the analysis. The university was aware of the problems with this research but chose to remain silent because the study’s optimistic conclusions were so well received by national news media outlets (Rantz, 2022)."
The Tordoff paper is also discussed in a magisterial takedown of yet another highly cited paper, that of Chen et al., 2023. This appeared in a Reddit thread, which has now become "viral" by the standards of viral among medical researchers. It appears here: https://www.reddit.com/r/medicine/comments/15hhliu/the_chen_2023_paper_raises_serious_concerns_about/. I would request readers to read this in full, because it is written by an experienced ABPN Board Certified Child and Adolescent Psychiatrist, with a deep knowledge of the practice and the research, something that is apparent when you go through the detailed observations.
The Tordoff critique appears as follows: "Tordoff 2022 was an observational cohort study of 104 teens, with 7 on some kind of hormonal treatment for gender dysphoria at the beginning of the study and 69 being on such treatment by the end. The authors measured depression on the PHQ-9 scale at 3, 6, and 12 months, and reported "60% lower odds of depression and 73% lower odds of suicidality among youths who had initiated PBs or GAHs compared with youths who had not." This paper is widely cited as evidence for GAH, but the problem is that the treatment group did not actually improve. The authors are making a statistical argument that relies on the "no treatment" group getting worse. This would be bad enough by itself, but the deeper problem is that the apparent worsening of the non-GAH group can be explained by dropout effects. There were 35 teens not on GAH at the end of the study, but only 7 completed the final depression scale.
"The data in eTable 3 of the supplement is helpful. At the beginning the 7 teens on GAH and the 93 not on GAH have similar scores: 57-59% meeting depression criteria and 43-45% positive for self-harming or suicidal thoughts. There is some evidence of a temporary benefit from GAH at 3 months, when the 43 GAH teens were at 56% and 28% for depression and suicidality respectively, and the 38 non-GAH teens at 76% and 58%. At 6 months the 59 GAH teens and 24 non-GAH teens are both around 56-58% and 42-46% for depression and suicidality. At 12 months there appears to be a stark worsening of the non-GAH group, with 86% meeting both depression and suicidality criteria. However, this is because 6/7 = 86% [have left the study] and there are only 7 subjects reporting data out of the 35 not on GAH from the original 104 subject cohort. The actual depression rate for the GAH group remains stable around 56% throughout the study, and the rate of suicidality actually worsens from Month 3 to Month 12.
"We cannot assume that the remaining 7 are representative of the entire untreated 35. I suspect teens dropped out of this study because their gender dysphoria improved in its natural course, as many adolescent symptoms, identities and other concerns do. However, even if you disagree with me on this point, the question you have to ask about the Tordoff study is why these 7 teens would go to a gender clinic for a year and not receive GAH. Whatever the reason was, it makes them non-representative of gender dysphoric teens at a gender clinic."
The Tordoff study is a turd of a "research" paper that would not have passed even through the editorial desk of any editor who understands the basics of the scientific process or possesses the mere basics of statistical knowledge. But then, zombie ideas die hard; they just shamble along, ready to infect a new cohort of gullible journalists at the earliest opportunity.
The Reddit post is not only a takedown of Tordoff 2022 or Chen 2023, but a more general takedown on the "state-of-the-art" when it comes to gender medicine research: "I am not unaware of how fraught and politicized this topic has become, but the time has come to admit that we, even the moderates like me, were wrong. When a teenager is distressed by their gender or gendered traits, altering their body with hormones does not help their distress. I suspect, but cannot yet prove, that the gender affirming model is actively harmful, and this is why these gender studies do not have the same methodological problem of large placebo effect size that plagues so much research in psychiatry. When I do in depth chart reviews of suicidal twenty-something trans adults on my inpatient unit, I often see a pattern of a teenager who was uncomfortable with their body, "affirmed" in the belief that they were born in the wrong body (which is an idea that, whether right or wrong, is much harder to cope with than merely accepting that you are a masculine woman, or that you must learn to cope with disliking a specific aspect of your body), and their mental health gets worse and worse the more gender affirming treatments they receive. First, they are uncomfortable being traditionally feminine, then they feel "fake" after a social transition and masculine haircut, then they take testosterone and feel extremely depressed about "being a man with breasts," then they have their breasts removed and feel suicidal about not having a penis. The belief that "there is something wrong with my body" is a cognitive distortion that has been affirmed instead of Socratically questioned with CBT, and the iatrogenic harm can be extreme.
"If we say we care about trans kids, that must mean caring about them enough to hold their treatments to the same standard of evidence we use for everything else. No one thinks that the way we "care about Alzheimer's patients" is allowing Biogen to have free rein marketing Aduhelm. The entire edifice of modern medical science is premised on the idea that we cannot assume we are helping people merely because we have good intentions and a good theory. If researchers from Harvard and UCSF could follow over 300 affirmed trans teens for 2 years, measure them with dozens of scales, and publish what they did, then the notion that GAH is helpful should be considered dubious until proven otherwise. Proving a negative is always tricky, but if half a dozen elite researchers scour my house looking for a cat and can't find one, then it is reasonable to conclude no cat exists. And it may no longer reasonable to consider the medicalization of vulnerable teenagers due to a theory that this cat might exist despite our best efforts to find it."
It defies logic that we would ever tell someone they are born in the wrong body instead of telling them they are perfectly fine as they are.
In 2023 we tell vulnerable people they need medicating and mutilating to fit into society and we call this progress????
Brava/Bravo ML - sterling stuff 👏👏👏👏👏
In addition, the Dutch study (deVries, Steensma, et al, 2014) was funded by Ferring Pharma, which produces a puberty blocking drug. In a later followup recently the same researchers lost 50% to follow up, and found that many of those they found were calling themselves some other identity such as non-binary, rather than an identity opposite their natal sex. The study started out with 70 and 15 dropped out. Can we assumed they had gone through enough actual puberty to then desist from cross-sex ideation. DeVries reportedly shrugged her shoulders at a recent professional meeting and invented "gender incongruent" as a term to explain their "journey will never be over." Meanwhile, Alexander L and Ritchie Herron talk about the urination problems and the complications of trying to replace the testosterone that castration robbed from them through injections or patches, which give the penile material inserted inside them (so-called "vaginoplasty") to become stiff like in an erection.
https://www.youtube.com/watch?v=kw7a8eioa1w&t=3320s
Excellent re-analysis! Well done!
Thanks for this marvellous piece.
I’ll report later on a sneaked out recording of a Guardian editorial meeting- very interesting!
Dusty
Now posted
https://dustymasterson.substack.com/p/the-stepford-wives
The crappy Guardian and its acolytes should be thoroughly ashamed of themselves! Absolutely despicable propaganda!! I've got The Arsehole now!!!! 😡😡
Is that the new name for the Guardian 😂
Dusty
Very good.
This is covered as well, very engagingly, in Miriam Grossman's newly published book "Lost In Trans Nation" which I highly recommend. I am listening to the audio version.
Thanks, TT as it happens I have just bought that - though I have a serious reading backlog at present!!
Dusty
Same - I have a pile unread too. But read this one first!
OK thanks, Tess, will do :)
Dusty
Excellent analysis of current research on the impact of puberty blockers. I do love calmly considered and informative writing on serious issues which this is. Thanks Kathryn!
Excellent article. The Guardian is totally dysfunctional. I have peaked many people since I was peaked (in January 2021) but Guardian-reading friends are the least-informed around anything to do with gender ideology. They still defend Stonewall and Eddy Izzard, and they know nothing about the fetishists, paedos, cross-dressers and porn addicts now rebranded as trans. When you do tell them stuff, they say things like "problems on both sides".
Wow, utterly breathtaking in its awfulness. Audacious in its corruption. At times I wonder: How can such things be? Hard to know which is worse, the "science" or the "journalism".
nice job. the logic behind these studys is the same used by multi millionaires and $billion corporations to evade income taxes in the US: add several layers of unnecessary complexity and most wont spend the effort to find the truth.
the uncanny part is every gender biz stat, study and claim suffers the same flaw: bogus information followed by a campaign style headline that misrepresents the data