Reikalingas tikrovės patikrinimas: Detransicionierių liudijimai atskleidžia dezinformaciją apie medicinines intervencijas

Diskusija: realybės patikra – detranzicionierių liudijimai verčia permąstyti lytinę disforiją

Authors
Kirsty Entwistle
Journal
Child and Adolescent Mental Health
Year
2021

Summary

In this short debate piece, Kirsty Entwistle, a clinical psychologist who had worked at England's NHS youth gender service in Leeds, backs Butler and Hutchinson's call for detransition research. She argues that stories detransitioners have shared online show decisions about puberty blockers (drugs that pause puberty), hormones and surgery being made on misleading information about how well they work and whether they are needed. She calls for long-term tracking of everyone treated by NHS and private clinics, for non-medical treatments for gender distress, and for a close look at the systems that shaped current practice. The piece raised concerns that were later examined by England's official evidence reviews and the Cass Review, an independent review of youth gender services. But it is opinion based on personal stories and gives no figures on how common these problems are.

Key findings

  • Straipsnis yra dviejų puslapių atsakymas į Butler ir Hutchinson 2020 m. raginimą tirti ir teikti paslaugas žmonėms, nutraukiantiems ar atšaukiantiems tranziciją.
  • Jame pažymima augančioji detranzicionierių grupė, daugelis paauglių ir ankstyvos pilnametystės, kurie dalijasi savo patirtimi viešose internetinėse erdvėse, nes jiems nėra specializuotų paslaugų.
  • Autorė teigia, kad ilgalaikis, organizuotas visų NHS ir privačiose klinikose medicininį gydymą gavusių žmonių stebėjimas yra būtinas.
  • Ji teigia, kad sprendimai dėl medicininio lyties sukeltos kančios gydymo buvo grindžiami klaidinančia informacija apie tai, kaip gerai jis veikia ir ar jo reikia.
  • Ji sako, kad detranzicionierių istorijos rodo, jog nemedicininio lyties sukeltos kančios gydymo labai reikia.
  • Ji ragina atidžiai ištirti politines ir organizacines sistemas, lėmusias dabartinę praktiką, kad jauni žmonės negautų jiems nereikalingo medicininio gydymo.

Abstract

Butler and Hutchinson's clarion call (Butler and Hutchinson, 2020) for empirical research on desistance and detransition deserves careful consideration. It formally documents the needs of the emerging cohort of detransitioners, many of whom are in their teens and early twenties. In the absence of specialist services, some detransitioners have been sharing their experiences in public forums. The anecdotal reports by detransitioners indicate that systematic long-term follow-up of those who have been prescribed medical interventions by NHS and private clinics is essential to understanding the gestalt. Decision-making on the basis of misinformation on the effectiveness and necessity of medical interventions for gender dysphoria is a problem, and detransitioners indicate that nonmedical interventions for gender dysphoria are sorely needed. Analysis of the political and organisational systems that have brought us to the current situation is required in order to prevent more young people from being prescribed unnecessary medical interventions for gender dysphoria.

Conclusion

Detransitioners' testimonies reveal that decision-making about medical interventions for gender dysphoria has been based on misinformation regarding effectiveness and necessity. Systematic long-term follow-up of individuals prescribed medical interventions is essential, nonmedical interventions for gender dysphoria are sorely needed, and analysis of the political and organisational systems that led to the current situation is required to prevent more young people from being prescribed unnecessary medical interventions.