Talk:Gender dysphoria

Bachmann et al.

This source (Bachmann et al. 2024) has been used to support the following claim:

A recent study in Germany found that more than half of young people aged 5-24 across every age subgroup diagnosed with "gender identity disorder" no longer had the diagnosis after five years. Specifically, the persistence rate was 27.3% in 15- to 19-year-old females and 49.7% in 20- to 24-year-old males.

The source is a "Kurzmitteilung" (a short summary as opposed to a full research article) of a study on insurance data from the German Bundesländer, published only a few days ago.

The relevant parts of the source are, from the Ergebnisse section:

In der Längsschnittkohorte (n = 7 885, 47,1 % 20- bis 24-jährig, 37,7 % männlich) wiesen nach fünf Jahren insgesamt nur noch 36,4 % eine gesicherte F64-Diagnose auf, eine Diagnosepersistenz < 50 % zeigte sich in allen Altersgruppen (27,3 % [15- bis 19-jährige Frauen] bis 49,7 % [20- bis 24-jährige Männer]).

and from the Diskussion section:

Die diagnostische Persistenz von unter 50 % in allen Altersgruppen im 5-Jahres-Follow-up entspricht der Literatur und spiegelt vermutlich die Fluidität des Konzepts „Geschlechtsidentität“ im Kindes- und Jugendalter wider (5), kann aber auch als Hinweis auf die Notwendigkeit eines umfassenden, standardisierten diagnostischen Vorgehens interpretiert werden (www.cass.independent-review.uk/publications/final-report).

The authors stress the fact that they have not (for obvious reasons) investigated whether the diagnoses were "valid", and their conclusion is that more work needs to be done to investigate whether the reaults from their initial study hold true, and what the reasons may be for the low persistence of diagnoses. They also conclude that offering various treatment options for gender identity disorder is crucial.

I strongly believe that the source can't be used for the sweeping claim it was used to support, and I am curious why that particular bit of the study was used, and not the bit where the authors show that there is a robust increasing trend in gender dysphoria diagnoses, or the conclusion that it is important to offer a range of gender affirming treatments. But above all, I don't think a primary source consisting of a short summary of research on which insurance codes are used in German health care data is useful as a source. --bonadea contributions talk 09:35, 15 June 2024 (UTC)

Just FYI, it’s very likely the data in this paper isnt particularly meaningful. It is about diagnostic persistence in the German medical system which requires associated billing events over time. I.e. somebody who is diagnosed with GD but parents don’t let them transition (and as such, there is no ongoing billing events occurring) are counted as desistors in this paper. As are people who delay their transition. Insurance billing events are not a good way of measuring persistence of GD or transgender identity. Zenomonoz (talk) 01:37, 16 June 2024 (UTC)

Guillamon et.al (source 23)

The information under “symptoms” for this source comes from the intro/abstract of this paper and references Blanchard’s typology, which has been discredited. The information also contradicts the previous paragraph which states sexual orientation does not impact GD. Wren Armstrong (talk) 18:27, 17 October 2024 (UTC)

Is this correct?

About this paragraph in the introduction, does this correctly describe the stances of the referenced sources?

Some researchers and transgender people argue for the declassification of the condition because they say the diagnosis pathologizes gender variance and reinforces the binary model of gender. However, this declassification could carry implications for healthcare accessibility, as HRT and gender-affirming surgery could be deemed cosmetic by insurance providers, as opposed to medically necessary treatment, thereby affecting coverage.

Are they really calling for the declassification of gender dysphoria or the declassification of free self identification? As gender dysphoria has lots of severe symptoms right? So it is unclear to me how anyone can argue that symptoms should be declassified? Is enough context given here? Are they maybe arguing this out of questioning whether the symptoms are caused by the dysphoria or by environmental factors (discrimination)? I can only really think of possible arguments to declassify gender dysphoria that would indeed lead to "implications" stated in the second sentence, that it would deemed cosmetic.

So to wrap up a bit, it is not clear to me what exactly the first sentence here means with "declassification", is it an emotional argument out of activism, or is there some solid logic here? If there is solid logic, I don't see it. Wallby (talk) 15:55, 27 October 2024 (UTC)

This looks like a fair summary of the existing sources, although one is old and the other is tertiary so I imagine more nuanced coverage of both stances probably exists.

• From Britannica:

  Critics have argued that GD diagnoses continue a long-standing history of pathologizing oppressed peoples. Some argue that the diagnosis stigmatizes groups that are simply expressing variation, not pathology. Critics suggest that the diagnosis individualizes a broad cultural and social phenomenon and reinforces a binary mode of gender.

• From ThinkProgress:

  On the other hand, insurance companies have been more willing to cover the expenses associated with transition under this language, because treatment for a disorder is considered medically necessary, rather than cosmetic.

Hope this helps. –RoxySaunders 🏳️‍⚧️ (talk • stalk) 17:24, 27 October 2024 (UTC)

I can't speak for others, but if it helps you conceptualize the "anti-" argument, I offer the following clumsy analogy: I was born with a rare birth mark that spells out "Kick Me". I'm depressed because everyone keeps kicking me. I go to the doctor to get it removed. He says I have kick-me sad-brain disorder. He gives me antidepressants and says not to let it bother me as much when people kick me. I turn to leave. He kicks me. –RoxySaunders 🏳️‍⚧️ (talk • stalk) 17:34, 27 October 2024 (UTC)

The first quote doesn't seem to establish declassification.

It only the seems to claim that the formulation and/or application of the current diagnosis allegedly leads to reductionisticly or even entirely wrongly labelling people with a variation-question with a pathological label (second sentence from first quote), and seems to claim that before mentioned of the current diagnosis seems to lack neutrality/objectivity, specifically failing to detect (binary) gender stereotypes.

So is it then correct that declassification is argued for? Wallby (talk) 18:09, 27 October 2024 (UTC)

With "before mentioned" I meant "the formulation and/or application" again, not sure if there is a more compact/clear way to write that without repeating that entirely. Wallby (talk) 18:11, 27 October 2024 (UTC)