Rex Kerr
3 min readMar 1, 2023

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That makes sense, but if we go back to the beginning--the 97% "never have any regrets" claim you made--this is presumably predicated on the mental health care making this distinction properly in advance.

Rather than stressing that number, why don't you stress the high quality of the mental care that is (presumably) received that underlies (again, presumably) the low rates of regret?

There are multiple different false narratives that need countering, and actual issues that need exploration, and "97% never have any regrets" is both difficult to support (especially the "never" part) and doesn't address really any of the issues very well.

False narrative 1: trans identity doesn't exist. 97% doesn't help with that, because the hypothesis is that vulnerable people can be manipulated into adopting a self-harming identity. Given the existence of cults as a model for getting people to adopt a self-harming identity (as a cult-member), this requires some argument or evidence; you can't just laugh it off. Careful probing by mental health officials is pretty good evidence. (Note: the narrative here is that it's all manipulation, which is much easier to shoot down than that there is ever manipulation. If you wanted to make a strong case that manipulation is basically unheard-of, then you would need stats like 97%+, but because the premise is that the people are deluded, reported regret is not a good metric--cult members tend not to report regret until they're out.)

False narrative 2: people who get gender affirming care (surgery or hormones--the narratives differ a bit on each) overwhelmingly regret it. 97% somewhat helps with that, if the methodology is good. The transgender survey has good coverage but poor methodology for answering that question: you state yourself that it's intended for people who identify as trans. Other studies have poor coverage for what the accusers are probably thinking of (i.e. probably not the Amsterdam gender identity clinic) but some have good methodology. Regret rates are relevant, but there is no harm in going into enough detail to cover the variability because explaining that variability gives a stronger argument against harmful legislation than does a number-with-exceptions where if anyone calls you on it you have to do damage control.

False narrative 3: people get or are pressured to get major interventions on little more than a whim. 97% doesn't help with that either, though this narrative has trouble standing on its own without false narrative 2.

Issue actually needing investigation: as it becomes easier to get gender affirming care, and there is a larger and more vocal community who supports trans identity, are we continuing to adequately figure out who is confused? From the 1970s through 2015, the Dutch result is yes: you can see the impact of the decreasing stigma (presumably--cause hasn't been determined here) in the huge increase in numbers, and you can see the more-people-are-probably-just-confused phenomenon in the huge decrease in the fraction who visit who go on to start hormone therapy (90% to 65%). With this level of pre-selection (presumably with "intensive mental health care" as you say), the progression beyond that point remains stable: same fraction go on to get surgery, same level of satisfaction. But the social acceptability, visibility, and trendiness (in some groups) are all still rapidly changing. "97%" makes it sound like we don't even need to keep looking. But if you widen the accessibility, you now have a population that wasn't well-sampled before--those who are more socially sensitive, those with lesser dysphoria, etc.--so you can't necessarily expect that previous results will extrapolate. Your best indication that they will for a while is that the results are really stable despite previous changes in population--but they're not that stable.

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Rex Kerr
Rex Kerr

Written by Rex Kerr

One who rejoices when everything is made as simple as possible, but no simpler. Sayer of things that may be wrong, but not so bad that they're not even wrong.

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