Wednesday, June 05, 2013

Walt Heyer's Distortions - Subtle And Significant

I think I have already made it fairly clear that I think the "ex-Trans" narratives are largely nonsense, and in particular that Walt Heyer is filled with internal inconsistency that speaks volumes to the conditions that are involved.

Heyer is particularly vocal on his blog that he thinks that GRS and other treatments for transsexuals should not be available.  He regularly tries to cite various medical papers as supporting his position.  However, he does this by engaging in a semantic sleight of hand act that deserves to be examined and called out.

The pattern of Heyer's arguments is largely along the following lines:

- Find a paper which talks about transsexuals which addresses some aspect of transsexualism
- Infer that the paper supports his contention that being transsexual is a result of untreated trauma or other condition
- Conclude that this is justification for eliminating access to current treatment methods such as GRS

Consider the following post from May:  Sex Change Transitioning May Become Obsolete

This particular post is concerning for a couple of reasons.  First, Heyer appears to be republishing an e-mail from some anonymous physician.  In general, I find "anonymous authority" sources like this to be suspect at best.  If this physician has real insights into these issues which would suggest at the very least ethical failures on the part of the treatment community, then why are they not raising these issues in a forum where they can be discussed fully, with the engagement of that physician as well as other stakeholders?

However, let's go a little further, shall we?  Heyer's anonymous authority makes the following claims regarding what this paper shows:

Dear Walt, this just came out electronically ahead of print 1 week ago, It demonstrates that the main factor in the brain that is responsible for brain growth and changes of the brain in those with GID:
1) Parallels the same brain neurochemistry and neurophysiology that is known to underpin various mental disorders in general
2) Is directly the result of the way transsexuals are treated mainly in traumas and psychological abuse

I can't pick and choose the objectivity of the facts. I now need to present you the objective findings that neurochemistry and the neurophysiology of GID brains demonstrates that the brain is indeed changeable and that there is substantial evidence that GID brains are the result of psychological trauma and that the changes are the changes seen in those with an array of psychiatric disorders.
Wait a second.  Papers like this seldom make such clear causal declarations.  Sadly, I don't have the full text of the paper at my disposal right now, just the abstract as published on PubMed which reads as follows:

Gender Identity Disorder (GID) is characterized by a strong and persistent cross-gender identification that affects different aspects of behavior. Brain-derived neurotrophic factor (BDNF) plays a critical role in neurodevelopment and neuroplasticity. Altered BDNF-signaling is thought to contribute to the pathogenesis of psychiatric disordersand is related to traumatic life events. To examine serum BDNF levels, we compared one group of DSM-IV GID patients (n = 45) and one healthy control group (n = 66). Serum BDNF levels were significantly decreased in GID patients (p = 0.013). This data support the hypothesis that the reduction found in serum BDNF levels in GID patients may be related to the psychological abuse that transsexuals are exposed during their life. [Emphasis Added]
Ah, welcome to the typical bit of sleight of hand that takes place in how Heyer (or his allies) interpret these things.

According to Heyer, the correlation is that someone who is transsexual is transsexual as a result of psychological trauma.  Yet, the abstract of the paper uses very different language which does not draw a causal relationship between BDNF levels and the condition of being transsexual.  Instead, the last statement merely refers to transsexuals experiencing psychological abuse during their lives.

These are not logically equivalent statements.  Heyer is claiming a direct causal relationship between someone being traumatized and that person being transsexual.  In contrast, it's fairly clear from the abstract that the paper is talking about a correlation between someone being transsexual and being exposed to trauma.

The distinction here is that the paper is NOT asserting that trauma causes transsexualism, where Heyer and his anonymous authority clearly are.

I have a number of problems with this.

First, Heyer and his allies are twisting the objective data.  Claiming a causal connection when what we actually have is a correlation is extremely weak logic.

Second, it is entirely possible that the condition of being transsexual may in fact be traumatic in its own right.  In other words, one would expect to see some evidence of clinical trauma in transsexuals simply because of the consequences of their condition.  For example, it is a fairly common aspect of the narrative of transsexuals to have found their first puberty to be a horrifying experience.

Third, the language of the abstract is clear in pointing out that transsexuals are subject to a great deal of discrimination simply because they are transsexual.  This can be extremely traumatic in the long term, and would also play into the development of consistent symptoms.

Putting the cart before the horse is fundamentally lousy logic.  However, this kind of logic is often used by the propagandists to justify their positions.  Were this the first time on Heyer's blog that I have seen this kind of semantic twisting of facts, I might be willing to view it as an isolated incident and possibly a misunderstanding.  Sadly it isn't.

Back in April, he went on quite a bender citing research papers to justify his claims that transsexuals are "made, not born", and further Heyer likes to assert that regrets from GRS treatment are directly related to the high rates of suicide among transgender people.

Transsexuals (a.k.a. Gender Imposters) Have A 51% Higher Rate Of Death

In this tirade, Heyer uses more or less the same tactics repeatedly to bolster his claims regarding transsexualism.

We know from the 2013 Rome study (4) and the 2009 Japan study (5) that transgenders are no different genetically than normal males. So then the suggestion that the surgery is surgically correcting the body to fix a gender defect is completely false.
I went and reviewed the abstracts of these two studies.  Again, Heyer is making an inference which the study abstracts certainly do not seem to support.  In both cases, the studies find that the transsexuals in the sample sets do not exhibit any significant chromosomal abnormalities in the regions that are currently understood to be related to sexual differentiation.

Okay.  That is an interesting finding.  However, it does not tell us what Heyer claims it does.  We know that genes are but one part of the picture when it comes to development.  A good example is the known genetic mutations related to breast cancers.  Those do not carry a guarantee that the individual will develop breast cancer, but rather an increased risk of it happening.  This is a consequence of the fact that genes do not exist as absolutes.  Instead, they are part of a much more complex process that goes on in the body.  The expression of individual genes as specific attributes is highly variable.

I will grant Heyer this much - we DO NOT know the causes of transsexualism.  There is a growing body of evidence that points to a set of physiological causes.  That said, we do not know how it is that the condition actually arises.  This is true of a lot of conditions - we do not know what causes schizophrenia or bipolar disorder to develop either.  That doesn't mean that they aren't legitimate conditions.
We have additional evidence in a Swedish review of 324 transgenders over 30 years which found “higher risk for mortality” for people who underwent the surgery:
Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behavior, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group. (2)
Again, we have another situation here where he is twisting the situation quite a lot.  The part of the quote above that is in italics comes from the abstract of the paper.   Heyer goes on to interpret this as if the problem is GRS itself:
The studies show kids and adults are dying and are committing suicide. We are told that gender changing is a complete success when the research studies suggest changing genders is much more a slow death sentence and no one gives a rip. 
Argh.  There is an enormous issue with Heyer's reasoning here.  He is essentially arguing that treating someone's gender dysphoria with a known effective treatment should not be done.  The study itself is correctly pointing that there is often more to the picture that needs to be treated in conjunction with the gender dysphoria.

Once again, I'm going to turn to the WPATH SOC v7 document which reads:

Clients presenting with gender dysphoria may struggle with a range of mental health concerns (Gómez-Gil, Trilla, Salamero, Godás, & Valdés, 2009; Murad et al., 2010) whether related or unrelated to what is often a long history of gender dysphoria and/or chronic minority stress. Possible concerns include anxiety, depression, self-harm, a history of abuse and neglect, compulsivity, substance abuse, sexual concerns, personality disorders, eating disorders, psychotic disorders, and autistic spectrum disorders (Bockting et al., 2006; Nuttbrock et al., 2010; Robinow, 2009). Mental health professionals should screen for these and other mental health concerns and incorporate the identified concerns into the overall treatment plan. These concerns can be significant sources of distress and, if left untreated, can complicate the process of gender identity exploration and resolution of gender dysphoria (Bockting et al., 2006; Fraser, 2009a; Lev, 2009). Addressing these concerns can greatly facilitate the resolution of gender dysphoria, possible changes in gender role, the making of informed decisions about medical interventions, and improvements in quality of life. [WPATH SOCv7 P. 24-25]

In other words, transition when there are additional mental health concerns is more complex.  Further, that even when the Gender Dysphoria issues have been dealt with that there may be a need for ongoing treatment plans to be in play.  While GRS does address the issues of Gender Dysphoria itself, it does not address day to day living problems such as the discrimination that transsexuals can face.

Again, Heyer has conveniently twisted things around to suit his agenda.  The blunt reality is that the studies do not show what he is claiming, but rather typically show a much more nuanced and subtle picture.

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