I’ve written many times about the “detransition myth”, the oft-repeated and thoroughly debunked claim that most trans kids who go through medical transition then change their minds. The short version: anti-trans groups tell you that 80% of trans kids detransition; the actual numbers show that 80% of gender non-conforming kids aren’t trans. Those kids aren’t given any medical treatment whatsoever.

It doesn’t stop the bullshit, unfortunately. The weekend papers were full of it once again this week, prioritising scaremongering nonsense from anonymous “concerned parents” over actual facts.

Wouldn’t it be great if the newspapers had some real numbers to work with?

Over the weekend, the various medical experts that comprise the World Professional Association for Transgender Health (WPATH) had a conference. This is important, because it’s the WPATH guidelines that (eventually) inform the healthcare trans people are given. They’re a serious bunch.

One presentation analysed detransition rates in the Nottingham gender clinic, a very large provider of trans-related assessment, counselling and healthcare. Of the 303 trans kids studied, how many do you think detransitioned?

It should be easy. If there’s an 80% detransition rate, you’d expect to see 242 people detransitioning.

The actual number?

One.

From the study:

Only one person of the 303 reviewed made a detransition (0.33%). They later transitioned again.

There were two other detransitioners, but they withdrew before ever attending the clinic. But even if you take them into account, the real world detransition rate was 0.99%.

The “why” is as interesting as the “how many”. Detransition wasn’t because the patients realised they weren’t trans. The patients said they couldn’t continue because their families were unsupportive: things were just too difficult.

Unlike the newspapers, I’m going to point out the flaws in the numbers I’m using to make my point. It was a study over one year, it’s just one gender clinic, and over time you’d expect more people to revert to their original gender presentation because as I’m the first to admit, this shit is hard. Forums are full of stories of people who came out and attempted transition only to retreat because their lives were so spectacularly shit due to lack of familial acceptance and the prejudice of others. Eventually they re-transition, but it’s often many years later.

I would expect the actual numbers over a longer period to be higher than 0.99%.

However, the numbers do correlate with others: the numbers from private trans health providers, many of whom can’t name a single case of permanent detransition; the surgical regret rate of 2% among gender confirmation surgery patients (that’s the kind of regret rate many surgeons can only dream of. It’s much higher among, say, cosmetic surgery providers); the many studies that show trans kids with supportive families living happier lives and the ones with unsupportive families living miserable ones.

One of the reasons detransition rates are so low is because we already have a cruel but effective way of weeding out people who aren’t serious or who aren’t strong enough to cope. It’s called the NHS. The system is so overloaded and waiting lists are so long that the supposed “fast tracking” you read about in the papers is a process that can take two or three years just to get to an initial assessment, with another couple of years of assessments.

What’s fast about that?

Law.com:

Dozens of companies, including Microsoft Corp., Google Inc. and The Coca-Cola Co., pushed back against recent attempts by the Trump administration to reduce protections for transgender people under federal civil rights laws. They instead stressed the importance of equality in a public statement released Thursday.

The 56 companies include major financial institutions, tech companies and retail giants, among other household names, such as JPMorgan Chase & Co., Deutsche Bank, IBM Corp. and American Airlines.

It’s notable that Twitter and Facebook are on the list: their support doesn’t seem to extend to doing anything about the widespread, vicious abuse of trans people on their services.

Still, it’s good to see such important organisations making such public support – although in the long term, we’ll see it as a “well, of course they did” thing because despite what you might read online, the science is firmly on our side.

It’s hard to see many positives to the Trump administration’s war on trans people, but one little bit of sunlight is the horrified response from the scientific community.

At the time of writing some 1,642 scientists, including 8 Nobel laureates, have written an open letter to politicians about Trump’s anti-trans plans. The list includes “Biologists, Geneticists, Psychologists, Anthropologists, Physicians, Neuroscientists, Social Scientists, Biochemists, [and] Mental Health Service Providers”.

They are not a lunatic fringe. More:

Scientific American: The Trump Administration’s Proposed “Redefinition” of Gender Is Scientifically Absurd
Nature: US proposal for defining gender has no basis in science
Wired: Trump’s plan to redefine gender makes no scientific sense
The Union of Concerned Scientists: Trump Administration Proposal on Gender is Discrimination, Not Science
Center for Biological Diversity: Statement on Reported Trump Memo Targeting Transgender People
STAT: Scientists see a problem with Trump plan on defining sex: biology
STAT: CDC’s Redfield on Trump’s transgender proposal: Stigma is ‘not in the interest of public health’
New Yorker: The Trump administration’s plan to redefine gender recalls an earlier rejection of science
TIME: The Idea of a ‘DNA Test’ for Transgender People Is Part of a Long, Dark History
TIME: If the Government Redefines Gender to Exclude Trans People, It Could Worsen an Urgent Public Health Crisis
NYT: Anatomy does not determine gender, experts say
The Scientist: Trump Administration’s Definitions of Sex Defy Science
Mashable: The Trump administration says there are two sexes. The science says they’re wrong
Psychology Today: Trump administration’s definition of gender is not science
Healio: Rolling back transgender protections would endanger patients, experts say
Washington Post: The Trump administration is trying to tell people they aren’t who they are
Washington Post: Powerful gay rights groups excluded trans people for decades — leaving them vulnerable to Trump’s attack
Kaiser Health News: Defining A Person’s Sex At Birth And Making It Unchangeable Would Be ‘An Insult To Science,’ Biologists Say
Truthout: Right-wing fantasies about gender are killing trans people
Esquire: Trump’s new attack on transgender people is another sign it’s about the cruelty itself
Philly.com: With lie-filled ‘nationalist’ war on caravan, transgender people, Trump moves US toward tyranny

It’s interesting to compare the UK and the US. In the US, the politicians are scaremongering about trans people and the press is largely pro-science. In the UK, the politicians are largely pro-science and the press is doing the scaremongering.

Two years ago today, I began coming out as trans. I say “began” because while the initial announcement is an event, it’s merely the beginning of a process. I come out all over again every time I walk out the door, every time I pick up the phone, every time I meet someone new.

Not everybody chooses to come out. On a forum I frequent, one trans woman has decided not to come out. She fears losing her relationship with her family, fears her ex making it hard to see her kids, works in an environment where she has reason to believe coming out would cost her her job.

“It really feels like a step too far,” she says, “especially with attitudes towards trans people being what they are in the UK at the minute. I’m not sure I could take the abuse if it came.”

Her decision is the opposite of mine: better to live a miserable life than to lose family, friends, job and everything else. And for her it’s clearly the right decision.

I can understand that. In very many ways the last two years have been the worst two years of my life. They’ve definitely been the hardest. I lost my marriage, moved out of the family home and see much less of my children. I lost most of my friends and have had many close relationships stretched to breaking point. Maybe beyond breaking point. I spend two hours a week getting stubble torn from my face in an ultimately futile attempt to make me appear more feminine, my face sore and swollen for days afterwards, while the hormones that make me feel better have made me put on so much weight I can’t bear to see myself in photographs. People stare, and talk about me. Some days I’m so sad I can’t function. I have no doubts that I’ll die alone.

I was asked the other day: was it worth it?

And I honestly can’t answer that, because I don’t feel it was a choice. I didn’t come out because I wanted to. I came out because I had to. I’m certain that if I hadn’t, I wouldn’t be here. And sometimes I wish I’d taken that option instead.

Don’t worry. I’m fine. I have good friends now, reasons to be cheerful. But sometimes I think we need to stop fixing a smile for just a little while and say: you know what? Being trans is incredibly, unbelievably shit sometimes. I’m amazed that so few people detransition (that is, go back to living in the gender they were assigned at birth): to be looked at and often stared at every time you go anywhere, to be constantly misgendered, to be attacked by politicians and pundits, to see a body you didn’t want in the mirror, to spend a significant amount of your time feeling scared… who would choose that?

I chose that. But it wasn’t really a choice.

There’s a superb column in the New York Times by Thomas Page McBee about something I’ve been thinking about for a while: the problem of visible trans people in the media.

Very few of the people who so enthusiastically celebrated our stories of “finally being ourselves” showed up at the rallies that took place across the country, in the wake of news that the Trump administration aims to define us out of existence. And even as trans people on television are increasingly beamed into living rooms across the country, we’re also seeing an uptick of violence against the most marginalized members of our community.

McBee argues that while we’ve never been more visible than we are today, we’re still seen by most as mysterious others, not friends and neighbours. And when there’s a backlash to our sudden media profile not just “from conservatives or the ignorant and uninformed” but also in the form of “decades-old talking points from women calling themselves feminists”, it makes our lives even harder.

The triumph you see on television only happens if there is a welcoming world to greet us on the other side. This past week, for me, raised the question once again: Is there?

…the didactic, often body-focused framing of those stories and the gender-war timing of that visibility has also rendered us into symbols, metaphors, pawns and boogeymen.

That’s how I feel about it.

The current obsession with us isn’t helping. We’re facing incredibly dangerous threats to our human rights (and in the US, our healthcare); instead, the papers run with tales of how everybody’s upset about an offensive Caitlyn Jenner hallowe’en costume. Believe me, most of us don’t give a shit. Similarly the well-intentioned but wrong-headed use of the world “menstruators” by The Guardian in a piece about women’s reproductive health: it was a clumsy attempt to include trans men (people assigned female at birth who now live as men) but was instantly portrayed as the sinister trans lobby perverting language to erase women.

To use the Scots phrase, it wisny us.

I don’t give a shit. I’m too busy filling out yet more documents about my name change over a year since it actually changed, trying to persuade Equifax that no, I haven’t been a victim of fraud, I’ve just changed my name. I’m too busy trying to solve the problem with my prescription where the doc prescribed a hormone the NHS won’t pay for and I can’t afford to source privately. I’m too busy wondering whether I’ll get yelled at when I go for a piss. I’m too busy working to pay for the electrolysis that often leaves my face bleeding and swollen for days afterwards.

I don’t recognise the caricature of trans people I see in the newspapers, discussed on TV, shared on social media. I know quite a lot of trans people now (as the joke goes, everybody assumes you know every other trans person, and that’s not true, but then they mention Natalie and Katharine and of course you know them), and none of us are spending any time whatsoever fussing about language, worrying about stupid hallowe’en costumes or trying to destabilise the very fabric of society. We’re just doing what you’re doing: trying to get on with our lives.

But there’s a narrative, and once you notice it you see it everywhere. Trans people as dangerous, intolerant others, a sinister force to be resisted by all right-thinking people. It’d be laughable if it weren’t causing real-life misery for trans people.

As I’ve said before, there are so few of us the Girl Guides could totally take us in a fight. There are no trans MPs, MSPs or MEPs in the UK, no trans people with weekly newspaper columns, no trans judges or trans newspaper editors or trans talk show hosts or trans bosses of FTSE 100 companies.

The coverage of us, the obsessive coverage of our supposed threat to all that’s right and good, is massively disproportionate and completely unrepresentative. Of course it is. Almost all of the coverage is about us, but without us.

Again and again I see stories purporting to be about what trans people are like, what trans people think, what trans people want. Number of trans people spoken to: none.

Here’s my reality, over and above the usual stuff: working, trying to be good for my kids. It’s getting stared at everywhere you go. It’s being afraid to use a toilet. It’s being tired of correcting people about your name. It’s about being called the big man when you’re sitting there in a nice dress. It’s clothes that don’t quite fit, no matter how hard you try. It’s taking a deep breath every time you open a door. It’s scraping off the gel from your nails and making sure there isn’t a trace at your child’s birthday party for fear of what the other parents may think. It’s asking your friends if the gig they’re inviting you to is going to be safe for you. It’s seeing a photo of yourself when you thought you looked quite nice and realising you’re a laughing stock.

It’s shit.

I just want a quiet life: I’d much rather spend my time thinking about guitars and girls, not gender politics. But to be trans right now is to be a very visible foot soldier in a war other people are fighting.

McBee again:

But reducing trans people into a symbolic vanguard is not only dehumanizing — it’s dangerous. True progress happens when all of us are released from the realm of “other” — which means allowing trans people to captain our own stories, where we can depict ourselves as fully fleshed-out people: not just brothers, mothers, neighbors and friends, but also reflections of an aspect of humanity as old as time. We’re not metaphors; we’re who you would have been if you’d been born trans.

I can’t put it better than that. We’re who you would have been if you’d been born trans.

This, from Reddit, made me laugh.

I’m going to a wedding today, my first one as me. The reception is fancy dress, and I’m going as Velma from Scooby-Doo. Jinkies!

There have been a lot of pro-science pieces in the aftermath of the Trump anti-trans memo, and while none of the science bits will be new to readers of this blog it’s still heartening to see mainstream media outlets battling misinformation from a man who actively courted LGBT voters before embarking on a campaign of cruelty against transgender people.

I like the cut of Wired’s jib.

Basically no scientist who knows anything about this stuff subscribes to the idea of the strict “gender binary” anymore.

The article is a good primer on the basic science.

a lot can happen on the road from embryogenesis to personhood. Sometimes the fusion of egg and sperm goes differently. People can be XXX, XXY, or XYY with no physiological indications. People can have some XX cells and some XY cells. Sometimes a person can be XX but have “male” physiognomy, or the other way ’round. Sometimes, to the tune of one in a hundred, a baby is born with genitalia that people in the room can’t agree on.

Trump’s memo isn’t about science, of course. It’s an attempt to rouse the supporters for the mid-term elections by picking on one of the few groups it’s still safe to pick on: a group that unlike the wider LGB community has no political power and precious little media clout.

There’s nothing remotely scientific about Trump’s so-called science. It’s science in the same way that some people call creationism a science, an attempt to reject the world as it actually is in favour of the world some bigots would like to see.

I’ve posted this before, but Scientific American reposted it today in light of the Trump memo.

Determination of biological sex is staggeringly complex, involving not only anatomy but an intricate choreography of genetic and chemical factors that unfolds over time. Intersex individuals—those for whom sexual development follows an atypical trajectory—are characterized by a diverse range of conditions, such as 5-alpha reductase deficiency. A small cross section of these conditions and the pathways they follow is shown here. In an additional layer of complexity, the gender with which a person identifies does not always align with the sex they* are assigned at birth, and they may not be wholly male or female. The more we learn about sex and gender, the more these attributes appear to exist on a spectrum.