Opinion Sexuality

Dispelling two myths of trans hormone therapy

Last month, the Lethbridge Herald, ran a letter to the editor, titled “Bill C-8 will limit help for children with gender issues”.

Last month, the Lethbridge Herald, ran a letter to the editor, titled “Bill C-8 will limit help for children with gender issues”. It was written by Sascha Kramps, coordinator of community services at Edenbridge Family Services.

Edenbridge provides ongoing supports and services to children and adults with developmental disabilities, support for those who require assistance with their independence, and individuals with mental health challenges. Intriguingly, their mission statement includes this sentence:

Edenbridge Family Services Inc. is dedicated to providing services to those in need regardless of race, color, religion, national origin, gender, sexual orientation, age, income or disability.

But that’s kind of tangential.

Bill C-8, which held its first reading on 9 March 2020, will criminalize the following actions related to conversion therapy, once passed:

  • Causing a person to undergo conversion therapy against the person’s will
  • Causing a child to undergo conversion therapy
  • Doing anything that removes a child from Canada to undergo conversion therapy outside Canada
  • Advertising an offer to provide conversion therapy
  • Receiving a financial or other material benefit from providing conversion therapy.

Conversion therapy is a collective term that refers to various practices aimed at changing a person’s sexual orientation or gender identity, including shaming, emotional trauma, and physical pain, by associating those negative experiences with their LGBTQ identities.

Fundamentally, Bill C-8 is about making conversion therapy illegal in Canada, recognizing that it harms LGBTQ people.

Sascha Kramps’s letter opposes the bill, at least from a trans treatment perspective. This isn’t surprising, as Sascha has a history of transphobic comments online.

For example, on 6 January 2020, she commented on a Change.or petition called “Stop RBC from supporting radical sex education in schools”.

Last year, she left a comment on a post called “Letter Sent to PFLAG Vancouver Regarding Their Trans Protest Against Feminist Meghan Murphy: Some LGBT Community Members Support Her Right to Speak” at the transphobic website The Homoarchy. The article has since been removed. Full disclosure: Colin McKenna, the chapter lead of PFLAG Vancouver is a friend of mine, and we went to high school together.

In a comment last May on a Patreon post entitled, “The Transgender Takeover of Female Sports”, she said, “This infuriates me.”

Her letter uses two common myths that transphobic people use to justify their transphobia and oppose initiatives that protect trans rights. As a parent of 3 trans youth—and as a queer man myself—I felt it important to dispel these two myths.

Myth 1: 85% of trans kids choose to be straight after therapy

The problem with desistance research is that it’s terribly flawed.

First, a diagnosis of gender identity disorder was less stringent than that of gender dysphoria in the DSM-V. This means that these desistance studies included large numbers of children who wouldn’t have met the more stringent criteria if they sought diagnosis today.

Second, these desistance studies weren’t studying gender identity. Some of the participants in the studies were children whose parents were worried about their gender expression (boys wearing dresses, for example).

Third, some studies classified all study dropouts as desisters, whether they actually desisted or not.

Finally, the more popular studies cited for desistance statistics never studied desistance, but rather predictors of persistence. Also, those who ended up labelled as desisters were more likely to indicate–when asked if they were a boy or a girl—that they wished they were the “opposite” sex. Those who indicated they were the other sex were less likely to desist.

Take a 2013 study by Thomas Steensma, a researcher and clinician at the Center of Expertise on Gender Dysphoria in Amsterdam. In this study, Steensma and his team examined 127 adolescents who had displayed various gender dysphoria as children. They found that 80 of the participants had desisted by 16 years old. That works out to 63% of kids who apparently stopped being transgender.

However, 28 of those 80 who had been classified as desisters simply had not sent back their questionnaires. 38 of the original participants didn’t meet all the criteria of an official diagnosis. And the desisters tended, when asked if they were or a boy or girl, to indicate that they wished that they were the “opposite” sex, while the persisters tended to indicate that they actually were the opposite sex.

As well, Steensma’s study was never designed to measure desistance; it was designed to measure persistence, which it did.

Myth 2: Hormone therapy leads to sterility

Sascha Kramps cites Michael Laidlaw—an endocrinologist who is no longer ABIM-certified but is certified with NBPAS—well-known for his own transphobia and his crusade to stop hormone therapy. According to Kramps, Laidlaw claims that hormone therapy leads to sterility.

I mean, that makes sense. If a trans male takes GnRH analogs, for example, then of course his body isn’t going to ovulate. That’s kind of the point. If a trans female is on estrogen therapy, then her testosterone levels will drop, potentially affecting sperm generation.

Like I said, that makes sense. But I anticipate most trans men don’t actually want to have their period every month, let alone get pregnant. Perhaps some do, but I imagine for others, this can accentuate gender dysphoria, which is why they’re using hormone therapy in the first place.

Granted, this seems to be reversible, at least for some people. A 2017 Belgian study, for instance, found that cortical follicle distribution in trans men, even after over a year of testosterone treatment, was normal.

Even so, fertility is not the only outcome of hormone therapy. It also alleviates gender dysphoria and improves psychological functioning (such as body image, global functioning, depression, anxiety, and emotional and behavioural problems). As well, it results in the well-being (social and professional functioning, quality of life, life satisfaction, and happiness) of trans people to be similar to or better than same age people from the general population.

In the second sentence of Kramps’ letter, she states, “Bill C-8, the Conversion Therapy Ban, limits opportunities for children to receive thorough psychological care.”

What Kramps fails to address in her letter is that there is little evidence that conversion therapy provides psychological care, let alone thorough care.

The APA established a task force in 2007 to review all the research to date on conversion therapy’s efficacy. The task force concluded that there was very little methodologically sound research on the effects of conversion therapy, and the scientifically valid research that did exist indicated “that it is unlikely that individuals will be able to reduce same-sex attractions or increase other-sex sexual attractions through” conversion therapy.

On the other hand, not participating in conversion therapy means someone doesn’t have to endure being told that they’re not actually gay, that they can be the sexual orientation their parents assigned to them at birth. It means someone doesn’t have to endure being told that they’re not actually the gender they identify with, that they can be the gender their parents assigned to them at birth. That alone can improve one’s mental health.

I never had to undergo conversion therapy, thankfully. However, I have had, as a queer man, my sexual orientation repressed. All my life, I’ve been told I was straight: by my family, by my church, by the society I live in. I accepted it, and for decades repressed my queerness. I’m only starting to come to terms with it now.

Luckily for me, I’m in a relationship with someone I’m sexually attracted to, so my mental health hasn’t suffered greatly. I can only imagine what it must be like for someone who is completely gay to have to live as straight or someone who is trans having to live as cis.

How anyone could defend the forcing of those scenarios as beneficial, especially someone who herself is lesbian and who thinks “praying the gay away is garbage”, dumbfounds me.

Update (21 April 2020): The Lethbridge Herald removed the letter to the editor from their website. Here is a copy:

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By Kim Siever

Kim Siever is an independent queer journalist based in Lethbridge, Alberta. He writes daily news articles, focusing on politics and labour.

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