Big Data

The 2015 Transgender Survey

Last week, I described the foundational Dutch Studies, whose flamboyant defects have recently been exposed, somewhat belatedly. My plan for this week was to bring you more of these artifacts: deeply flawed studies anointed by WPATH as evidence in favor of gender medicine.

The next study on my hit list was the 2015 Transgender Survey, published by the National Center for Transgender Equality. I’d heard it was the source of the ‘data’ used to persuade therapists, school counselors and parents that kids who weren’t fast-tracked to ‘affirming care’ would probably kill themselves. Having been four times catechised on the living-son/dead-daughter binary — ‘celebrate the transition or bury the child’ — I’ve had this study on my radar for awhile now.

Jesse Singal has identified some major weaknesses, the worst of which are probably these:

• It’s an anonymous online survey, so there is no way to sort out respondents who don’t meet the criteria (e.g., trans-identified, age 18 and above)

• The purveyors of the survey offered monetary incentive in the form of a sweepstakes entry to every respondent, which might tend to incentivize repeat participation.

The total number of responses it drew—more than 27,000— was huge and impressive. If a high quality survey instrument returned that much data, it might do a lot of good.

It needs to be said that any research conducted by an interested party, be it an advocacy group like the National Center for Transgender Equality or a political opponent, is burdened by a tendency to produce data helpful to the mission the authors are paid to advance. For this reason, neutral scientists (a phrase that should be redundant but isn’t) have been urging ‘systematic evidence reviews’ of gender medicine for a long time. That process involves examining every study ever conducted on a given question, disregarding the abstract and the editorial conclusions, and considering only the methodology and the raw data that were returned. A study can’t be excluded for having yielded a disfavored result, but it can and must be excluded if there’s meaningful bias built into its design or execution.

As you may know, wherever a systematic evidence review of youth gender medicine has been completed, it’s led to severe restrictions on puberty blockers and added safeguarding for adolescent patients; because that’s where all of the objective data seem to lead.

Knowing this survey, like so many others embraced by WPATH, was flawed, I read through the published report looking for more examples to prove we should just ignore it.

Yes, the 2015 Transgender Survey is of technically low quality for the reasons Jesse pointed out. Still, I came away convinced it merits attention for a different reason.

The survey’s proponents were professional transgender advocates seeking to describe the experience of trans-identifying adults in America. Here are some of their findings:

• Unemployment among respondents was three times the national rate, while poverty was double the national rate.

• Only 16% of respondents owned a home, compared to 63% in the US population.

• 30% of respondents had experienced homelessness in their lifetimes; 12% had been homeless in the previous year.

• 40% said they’d attempted suicide — nearly nine times the rate (4.6%) in the US population, and 82% had “seriously considered suicide” at some point in their lives.

• 39% were experiencing “serious psychological distress” at the time of the survey.

• 29% had used illegal substances in the previous month.

• Trans-identifying men were HIV-positive at a level ten times higher than the general population; and for those who were black, the multiplier was more than twenty.

• 19% of the respondents had performed ‘some type of sex work’ either for money, food, or a place to sleep.

This is a devastating depiction of lives being suffered in agony. Also, it recalls the Dutch researchers’ assessment of their first adult cohort back in 1989. I don’t know if that picture was quite as bleak as this one, but it was not a rosy finding of self-actualization through gender reassignment: quite the opposite.

The disappointing outcomes observed by the Dutch researchers back then were given to argue in favor of the experimental adolescent protocol that came next.

The hypothesis: maybe these adults would be doing better if they could pass more convincingly as their target sex. If that’s true, we should see better outcomes if we can just rearrange and sterilize them younger.

Which of course they did, killing one patient as they went, losing a few more to hormone-induced illness, with still more lost to follow-up. Counting only the few ‘success’ stories that were left, the Dutch clinicians published a sunny tale of short-term patient satisfaction using survey instruments that couldn’t even logically measure what they were said to measure. (See last week’s post.)

It’s a little bit deja vu, right?

A year after the 2015 Transgender Survey was conducted, I entered Genderland at my daughter’s invitation. Soon I would receive my first stern admonishment from a virtual stranger, to choose the living son or else.

After all these years and all that digging in the information rabbit hole, only this week did I realize these people expected me to nominate my daughter for initiation into a club whose membership benefits were known to include: some homelessness, some sex work for food or money, chronic unemployment, a potential drug habit, the occasional mental health crisis, and a persistent wish to die.

Um, can we take some time to think it over?

Seven years later, I’m glad I can at least say we did that: we thought it over, in a non-linear, emotionally exhausting, not very cathartic but maybe incrementally helpful way. I’m not glad the safest course of action was ultimately determined to be a therapeutic residential school in another state. I struggle to grasp how a grandiose ideology of narcissism so unmoored from material reality could gain control over civic life so easily and so completely that a stable, high-functioning family such as ours could be literally and cognitively displaced, for wanting to think it through.

I keep expecting every post will bring me closer to an understanding of how it happened, and keeps on happening. I’m not like the well-prepared trial lawyer who only asks a question she already knows the answer to. I’m asking questions I can’t fully believe I have to ask. You know?