We have a condition with one known, effective treatment. We estimate that treatment is effective, conservatively, in 97-99% of patients. The condition is also highly stigmatized, so many patients who need it don't access it or stop treatment due to stigma.
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In this situation, what would improve healthcare for these patients? A) Destigmatizing the condition and treatment so more patients who need it get it. B) Focus attention on 1-3% for whom the treatment is not effective, try to reduce the number to zero.
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It's A, guys. It's A. I know how tough it must be for detransitioners to have hope for a medical treatment and be in the number of people for whom it didn't work. But, this is very normal, in medicine. It's disappointing. It's tough. These folks deserve support, and empathy.
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However, they should not be allowed to harm patients who need this effective and highly stigmatized treatment. That's not evidence based medicine. That's transphobic stigma and moral panic.
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When the evidence changes doctors opinions will change. So will mine. If a wave of AFAB detransitioners ever finally materializes IN THE DATA, we'll listen. But there is no current support for the belief that a main issue in trans medical care is too much ineffective treatment.
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Replying to @e_urq
Can you really not see that wave, it’s already clearly happening
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Replying to @saturnalea
No support for it in the data. I'll believe in it when it's more than anecdotes, and not a moment before.
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Replying to @e_urq
Setting aside detrans experiences as anecdotes too rare to care about is cruel & shortsighted. All detrans stories show where we can do better for any patient dx’d with dysphoria.
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Replying to @saturnalea
It's not about caring, it's about comparing apples to apples. All treatments have failure rates. The data determine which treatments are likely to be helpful, not compassion for those with a poor experience. Trans care should be held to the same standards of other medicine.
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Replying to @e_urq
Considering that we are seeing cases like these, and considering we are making irreversible changes based on a model that is still not flawless, it should be held to a higher standard. Why is it a problem when detrans people demand more scrutiny into this model? We want better.
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It's a problem when trans medical care is held to a standard that no other treatment in the world is subject to. False postives exist in all medicine, as do negative outcomes and treatment-resistant cases.
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Replying to @e_urq @saturnalea
When you ask whether a treatment is safe and effective, you base it on the total statistical picture, not on making sure the rare negative outcomes never happen.
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