<p>claremarie, the third article you posted was very interesting. I also read the full-length feature on the same subject that appeared in the Guardian the next day. Here are a few things I noticed:</p>
<ol>
<li><p>The authors of the study cited in the headline claimed that previous studies on the same topic had restricted sample sizes and poor methodologies, making their results misleading. They, in turn, provided no description of their sample size or methodology, making it impossible to review or fact-check their work. As far as I can tell, it hasn’t been published anywhere. On the other hand, WPATH writes that “*n over 80 qualitatively different case studies and reviews from 12 countries, it has been demonstrated during the last 30 years that the treatment that includes the whole process of gender reassignment is effective”, and provides citations for these studies. ([page</a> 3](<a href=“http://www.wpath.org/documents/Med%20Nec%20on%202008%20Letterhead.pdf]page”>http://www.wpath.org/documents/Med%20Nec%20on%202008%20Letterhead.pdf)) While the Arif study only involved trans women and only examined the results of vaginoplasty (which is just one component in an extensive transition process), these reviews included trans women and men, and considered multiple aspects of transitioning. So I’m skeptical about one review that claims to invalidate all this research. Maybe you can link me to Arif’s actual data?</p></li>
<li><p>Like I said, I also read the full-length feature profiling trans women, and men who had previously identified as trans women, who regretted vaginoplasty. Oddly enough, the first person profiled in the article identified as a transsexual woman and didn’t regret vaginoplasty per se; her unhappiness was due to the decision to “de-transition” after joining an evangelical church, and it was that decision that had caused problems for her. Others in the article regretted poor medical and psychiatric care before and after surgery, withholding information from the therapists who referred them to surgeons, or isolating themselves from sources of support in the trans community. None of them suggest, and nothing in the article indicates, that there are not people who are really transsexual and genuinely do benefit from hormones and surgery. In fact, one of them was profiled in the article.</p></li>
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<p>See also [this</a> letter](<a href=“404 Page Not Found | Transgender Support and Advice | United Kingdom Transgender Resources | Academic Reviews Medical Care Treatment and Research Data Base | UK Support | Crossdresser | Transvestite | Transsexual | Help and Advice | Transgender Venue Guide | Transgender News”>404 Page Not Found | Transgender Support and Advice | United Kingdom Transgender Resources | Academic Reviews Medical Care Treatment and Research Data Base | UK Support | Crossdresser | Transvestite | Transsexual | Help and Advice | Transgender Venue Guide | Transgender News) from the author of the article, who writes:</p>
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<p>The point of the piece is not to demonstrate that gender dysphoria is a “delusion”, as you put it, or that trans people are mentally ill or frauds – but that sometimes there are problems in the ways it’s diagnosed and treated, especially when patients have other emotional or social problems. So, uh, when people are misdiagnosed while underlying issues go untreated, they come to regret it? That’s neither headline-worthy nor an argument “against” transsexuality.</p>
<p>I should add that when gender therapy is done right, it neither blindly acquiesces to a person’s desires, nor forces them into medical procedures that they don’t want. Therapists who’ve worked with many trans patients are more likely to know what signs to look for and what questions to ask, and to ensure meaningful support throughout the transition process. Unfortunately, some people can’t find a local, affordable therapist who’s experienced with trans issues, and some don’t feel that they can trust therapists enough to be fully honest in sessions. Not without reason – the mental health community has a history of perpetuating bizarre myths and profoundly messed-up standards regarding trans people, and many still view them as gatekeepers, not as allies.</p>
<p>The article also focuses on the health care system in the U.K., where the process of attaining surgery is AFAIK pretty different from in the U.S. You might be interested to read the [Standards</a> of Care](<a href=“http://wpath.org/Documents2/socv6.pdf]Standards”>http://wpath.org/Documents2/socv6.pdf) for the treatment of trans patients, which most therapists and surgeons here adhere to. As a prerequisite for top surgery, my surgeon required a letter from a therapist attesting that I’d been in therapy for a certain period of time (in my case, eleven months) and had lived full-time as a man for more than a year. The endocrinologist who prescribes my testosterone required a similar letter. Not that there aren’t problems with the SoC – they make the process of transitioning longer and more expensive, turn identities into diagnoses in a way that many trans people resent, and in some cases restrict treatment for people who really need it. But for all their faults, they do make it pretty damn hard to do anything irreversible unless you and your therapist are sure it’s the right choice at the right time.</p>
<p>So that’s my reaction – and again, I’d love to read that review if you have a link to it. I haven’t had a chance to read the other articles in detail, because I have to sleep at some point and it might as well be now…</p>