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

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By: Christina Buttons

Published: Feb 21, 2024

The Arizona Mirror published an article earlier this month titled "The latest GOP anti-trans strategy: Requiring ‘detransition’ services," arguing that legislation aimed at providing healthcare and insurance coverage for detransitioners is unnecessary—it is merely a tactic by Republicans to hassle people who currently identify as transgender. The article was republished under the same title in the Phoenix New Times.

The article focuses on an Arizona senate bill that would make the pathway of detransition easier for those who are struggling to get the healthcare they need. Currently, there are no billing codes for detransitioning, nor is there anything resembling a standard of care for this growing population. Additionally, some insurance companies explicitly exclude gender-reversal procedures.

But you wouldn’t learn any of this from reading the Arizona Mirror. It appears that the author, Gloria Gomez, only writes about the bill in an attempt to discredit it. The articles’ premise is that detransitioners face no difficulties in accessing healthcare and this bill is merely a scheme designed to inconvenience people who currently identify as transgender.

Gomez does not speak to a single detransitioner, opting instead to quote gender activists who argue the bill is “unnecessary” and not a “real issue” because detransitioners’ “medical needs are already covered by insurance.”

The first half of this article will debunk these misleading claims and clarify the purpose and necessity of detransition healthcare bills, offering a new contribution to the discourse. The latter half will counter several common misleading claims about detransition and "gender-affirming care" made by Gomez. For those familiar with my work, I often address these claims, so some of the content may be drawn from earlier writings.

Gomez quotes two representatives from the Human Rights Campaign (HRC), the largest LGBTQ political lobbying organization in the United States, which received $50 million in donations in 2023. The HRC regularly protests the New York Times' coverage of detransitioners and the inadequacies of the "gender affirming" model of care.

Misleading Claim #1: Detransitioners’ medical needs are “already covered by health insurance”

An emailed statement by Cathryn Oakley, the senior director of legal policy for the Human Rights Campaign (HRC) said:

“This bill is an unnecessary and gratuitous excuse to talk about detransition in an effort to shift the focus from the actual health care that transgender people receive, which is supported by every mainstream American medical health organization, to the care of a very small number of folks whose medical needs are already covered by health insurance.”

For many detransitioners, this is false.

There is significant variability among insurance policies regarding what is covered, leading to disparities in access to care. While some insurers may cover detransition care under certain conditions, others may not, deeming the care not medically necessary.

Had Gomez done any research she’d know some insurance companies explicitly exclude detransition healthcare—like Capital Blue, which has a stipulation in its plans stating gender-reversal surgery is “considered not medically necessary and, therefore, not covered.”

[ Capital Blue ]

…or United Healthcare Community Plan, which excludes “reversal of genital surgery or reversal of surgery to revise secondary sex characteristics.”

[ United Health Community Plan ]

Others evaluate on a case-by-case basis (California Health & Wellness) or if certain criteria are met (Wellmark), and thankfully, some health insurance companies do cover detransition healthcare (Aetna). These are just a few examples and by no means an exhaustive list. I plan to conduct a much larger overview of insurance providers’ coverage of detransition care in a future investigative article.

Misleading Claim #2: Detransitioners receive the same care as those seeking to transition

Bridget Sharpe, the director of HRC's Arizona branch, who responded to the Arizona Mirror's request for comment, said:

“The care for people who detransition is the same as the care for transgender people. Any medical service that affirms someone’s gender includes someone who decides to detransition. If they decide to detransition they are affirming their gender.”

This is not accurate.

Under the current system, when someone transitions, they receive a diagnosis code indicating gender dysphoria. When someone detransitions, they no longer meet the criteria for a gender dysphoria diagnosis. Without a specific diagnosis like gender dysphoria to justify “medical necessity,” obtaining coverage for detransition procedures can be complicated, demonstrating the need for legislation that ensures detransition is covered.

Legislation like SB 1511, which mandates that doctors, health care institutions, or any other licensed health care providers in Arizona offering gender transition procedures must also provide gender detransition procedures. Furthermore, if an insurance policy covers gender transition, it will be required to "provide or pay" for detransition procedures.

A third provision aims to collect information on how many people are requesting detransition procedures by requiring insurance companies to submit a report. Currently, there is no method for tracking detransition, so we don't know how many people are detransitioning.

Gathering more data on detransitioners would aid in the process of acquiring new billing codes from coding authorities. Nine months ago, FAIR in Medicine submitted an application to the Centers for Disease Control and Prevention (CDC) for International Classification of Disease (ICD) diagnosis codes specific to detransition. This application is currently under review. The process to review and approve new ICD diagnosis codes can take over a year and involves several steps, including gathering data, public comment, and revision.

The absence of dedicated medical billing codes for detransition procedures creates a significant barrier for healthcare providers seeking reimbursement for these services. Consequently, they may resort to using inaccurate billing codes.

In practice, healthcare professionals apply their discretion to navigate these challenges. For example, a detransitioned woman who underwent a hysterectomy as part of her transgender experience might be classified similarly to a postmenopausal woman for the purposes of accessing hormone replacement therapy.

An important article by Drs. Aida Cerundolo and Carrie Mendoza on detransition billing codes highlights a case like this: A woman named Katie began taking testosterone at 19, underwent a double mastectomy at 20, and had a hysterectomy at 24. Shortly after, she realized transitioning was a mistake.

Now at 25, Katie is experiencing early menopause and has had significant difficulty obtaining the correct hormone dosage. Even after numerous phone calls, she was prescribed estrogen at a dose typically given to males seeking to become transgender women, which was not suitable for her needs. For obvious reasons, this is not a sustainable solution. We need detransition billing codes.

Misleading Claim #3: Detransition healthcare is not a “real issue”

The director of HRC's Arizona branch, Bridget Sharpe, continued her statement by saying:

Instead of resolving a real issue, Sharpe said, the Republican legislation instead seeks to weaponize detransitioning against transgender health care.

It is insulting to dismiss detransitioners’ healthcare needs as not a “real issue.”

Had Gomez interviewed any detransitioners or reviewed research on them, she would understand that many encounter challenges in finding information on detransition or healthcare professionals equipped to address their specific needs.

A 2021 international survey of 237 detransitioners found the support available to detransitioners to meet their medical needs is currently inadequate.

49% seek accurate information on stopping or changing hormonal treatment.

24% require assistance for complications from surgeries or hormonal treatments.

15% need information on and access to reversal surgeries or procedures.

7% provided other responses not listed, such as the need for tests to assess current reproductive health, information on the long-term effects of cross-sex hormones, the health consequences of undergoing a full hysterectomy, and issues related to pain from chest binding.

My preliminary survey of 94 detransitioners and desisters (pending publication) revealed that 72% of those seeking medical assistance faced significant challenges, and 78% of those who sought insurance coverage for detransition services had difficulty accessing it.

I've interviewed several detransitioners who have had immense difficulty in getting insurance coverage for detransition-related needs. One male detransitioner had to wait a full year to have his breast implants removed. Others have turned to crowdfunding to finance their detransition-related procedures.

However, one detransitioner I recently spoke with had no issues in getting insurance coverage for breast reconstruction surgery, which I believe is due to a growing awareness of detransitioners' needs in the last year.

Activist-journalism

In the last decade, influential activist organizations, including HRC, GLAAD, ACLU, and SPLC, have collaborated closely to shape the narrative on transgender issues. They provide news outlets with a range of media reference guides, stylebooks, fact sheets, and other resources, equipping mainstream journalists—most of whom are not well-informed on the debate surrounding youth medical transition—with the materials needed to present a biased perspective and label any valid concerns as bigotry. This approach effectively transforms journalists into activists.

Activists rely on propaganda tactics like the illusory truth effect—the tendency for people to believe things that are false after repeated exposure. This strategy of creating a semblance of public agreement benefits from the support of progressive platforms like the Arizona Mirror, which claims to be “an independent, nonprofit news organization” yet serves as an example of political activism masquerading as journalism. Their reporting standards neglect objectivity and thorough research, delivering a skewed narrative that deceives the public.

It seems ironic that progressives who champion “healthcare for all” would try to undermine bills aimed at ensuring a vulnerable group has access to healthcare. And like Pamela Paul pointed out in her recent New York Times op-ed, “These are people who were once the trans-identified kids that so many organizations say they’re trying to protect.”

Activist organizations frequently ignore or downplay the experiences of individuals who have detransitioned, despite these being the same individuals they pledge to support. This neglect is a significant departure from their stated principles. For many, a transgender identity is not a lifelong experience — they need support too.

Additional reading:

Misleading Claim #4: Detransition is rare

Gomez states that people who detransition "represent an extreme minority of the transgender experience." To support this statement, she cites the U.S. Transgender Survey of 2015, which is a deeply flawed sample consisting primarily of older adults who transitioned under a medical model vastly different from the current gender-affirmation model concerning youth and young adults.

The study included only those who identified as transgender at the time they took the survey, which, by definition, excludes detransitioners. Gomez overlooks more recent, robust, and representative studies that challenge the notion that detransition is rare, such as a 2022 comprehensive review of medical records that found 30% of teens and young adults discontinued cross-sex hormones after 4 years.

A 2021 study found that 75% of detransitioners did not inform their doctors about their decision to detransition. The rate of detransition remains unknown and is difficult to track, partly due to the absence of specific medical billing codes for detransition procedures.

Misleading Claim #5: Youth medical transition is backed by major medical organizations

Gomez relies on an appeal to authority fallacy by stating that puberty blockers and cross-sex hormones for minors are “backed by major medical associations as safe and necessary for the well-being of transgender people.” But these US-based medical organizations are not basing their recommendations on the best available evidence.

Systematic evidence reviews—widely recognized as the gold standard in evidence-based medicine (EBM)—have found that the risks of youth medical transition outweigh any purported benefits.

Public health agencies in Finland, Sweden, England, Denmark and soon Norway have aligned their guidelines with systematic evidence reviews, and have adopted a far more restrictive and cautious approach, one that prioritizes psychotherapy.

Medical authorities in several other countries including France, Ireland, Italy, the Netherlands, Australia, and New Zealand, have begun expressing concerns or are in the process of reevaluating their stance on transitioning minors.

US-based medical organizations in favor of youth medical transition have not aligned their guidelines with systematic evidence reviews, actively resisting such calls for many years. However, just last year, the American Academy of Pediatrics (AAP) finally announced it will be conducting its own systematic evidence review.

The unfortunate reality is that a small, ideologically-motivated group of individuals in charge of US-based medical organizations are acting as political entities that represent specific interest groups and invest heavily in lobbying.

Last year, international experts publicly weighed in on the American debate over "gender-affirming care" for the first time. 21 leading experts on pediatric gender medicine from eight countries wrote a letter expressing disagreement with US-based medical organizations over the treatment of gender dysphoria in youth, urging them to align their recommendations with unbiased evidence “rather than exaggerating the benefits and minimizing the risks.”

Dr. Gordon Guyatt, a clinical epidemiologist at McMaster University and founder of the evidence-based medicine (EBM) movement, who is a highly respected figure in the field of medical research methods and evidence evaluation, has stated that the current guidelines in the US for managing gender dysphoria in adolescents are "untrustworthy" and should not be considered evidence-based.

Guyatt adds that the guidelines fail to offer cautious and conditional recommendations appropriate for the low-quality evidence, highlighting that European policies are ”much more aligned with the evidence than are the Americans.”

Misleading Claim #6: Bills aimed at safeguarding youth and vulnerable adults are “anti trans”

Gomez refers to detransitioner Chloe Cole, who transitioned as a minor and spoke in favor of SB 1511, as “a frequent supporter of anti trans legislation.”

Activists and activist-journalists rely heavily on the label “anti-trans,” a strategy referred to as poisoning the well. By branding anyone or anything critical of youth medical transition as motivated by bigotry, they skew the audience’s perception, making them less receptive to other viewpoints.

Legislation aimed at protecting youth (and sometimes vulnerable young adults with psychiatric comorbidities) from a reckless model of care is not “anti-trans,” it is pro-safeguarding. Gender activists have spent years lobbying to remove these protective measures, which they call “gatekeeping.”

Many states that have placed restrictions on medical transition services have not included provisions for detransition or gender-reversal procedures, which is why some are doing so now. Earlier this month, the Tennessee House filed a bill requiring gender clinics to perform detransition procedures.

Do No Harm, an organization dedicated to scientific integrity and ethics in medicine, introduced model legislation last year called the Detransitioner Bill of Rights, which has already been used in several states.

Misleading Claim #7: Republicans are the sole proponents of age restrictions on medical transition services

Throughout the article, Gomez repeatedly identifies Republican lawmakers as proponents of "anti-trans legislation," stating, "far-right politicians have latched onto detransitioners to justify their calls to curtail gender-affirming care."

This perspective overlooks the broader context and the international consensus among European countries, arguably more progressive than the United States, that have drastically scaled back on youth medical transition. It also ignores the bipartisan support that opposition to youth transition policies is now receiving in the United States, as groups of Democrats in four states (Louisiana, Maine, New Hampshire, and Texas) have voted against them.

There's also a new organization called Democrats for an Informed Approach to Gender (DIAG), which seeks to organize initiatives for left-leaning individuals that oppose youth transition. Additionally, organizations like Genspect, the Society for Evidence-Based Gender Medicine (SEGM), the LGBT Courage Coalition, the Gender Dysphoria Alliance, and others are non-partisan but primarily consist of healthcare professionals and researchers who identify as liberal or left-leaning, or at least did at some point in time.

Age restrictions on youth medical transition reflect broader public opinion across the political spectrum. A 2023 Washington Post-KFF poll found a majority of adults (nearly 7 out of 10) oppose allowing children aged 10 to 14 access to puberty-blocking drugs, and a similar majority (6 out of 10) opposes cross-sex hormones for 15- to 17-year-olds.

It's regrettable that legislative intervention has become necessary, but as medical organizations continue to let ideologues dictate policies and silence more moderate voices within the profession, lawmakers are left with little choice but to step in.

If you haven't already spotted the moral-religious overtones in this ideology, I don't know what more to show you.

The people who insist that "Gender Affirming Treatment" is "healthcare" and "not about you, it's about us and our survival," also want you to believe that care for detransitioners is all about them and attacking them. The narcissism and sociopathy are completely off the charts.

What they're actually afraid of is the scale of this medical scandal. At present, there's no insurance coverage, no billing codes, and limited doctor accountability, which will change as lawsuits proceed. Activists can claim that detransition is "rare" because the medical system doesn't track it. Detransitioners frequently do not return to the same doctor-activist who drugged or carved them up in the first place and are forced to simply "make do." Legal coverage of detransition isn't just a recognition of the phenomenon of detransition and the flaws of simply "affirming" everyone but will also reveal in fine grain detail the extent of it, in a way activists will be unable to continue lie about.

Meanwhile...

#Christina Buttons #detrans #detransition #gender ideology #gender identity ideology #queer theory #medical corruption #medical malpractice #medical scandal #gender affirming care #gender affirming healthcare #gender affirmation #affirmation model #religion is a mental illness

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