AmericanNazbro posted:
Is there any drug I can take to give me an erection permanently? Thank you.

anime

jools posted:
Also obviously theres no evidence. its not like the pre-transition suicide rate is Over 20% and much much higher than the post-transition suicide rate

http://www.guardian.co.uk/society/2004/jul/30/health.mentalhealth

There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian Weekend tomorrow.

The review of more than 100 international medical studies of post-operative transsexuals by the University of Birmingham's aggressive research intelligence facility (Arif) found no robust scientific evidence that gender reassignment surgery is clinically effective.

The Guardian asked Arif to conduct the review after speaking to several people who regret changing gender or believe that the medical care they received failed to prepare them for their new lives. They explain why they are unhappy with their sex change and how they cope with the consequences in the Weekend magazine tomorrow (July 31).

Chris Hyde, the director of Arif, said: "There is a huge uncertainty over whether changing someone's sex is a good or a bad thing. While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there's still a large number of people who have the surgery but remain traumatised - often to the point of committing suicide."

Arif, which advises the NHS in the West Midlands about the evidence base of healthcare treatments, found that most of the medical research on gender reassignment was poorly designed, which skewed the results to suggest that sex change operations are beneficial.

Its review warns that the results of many gender reassignment studies are unsound because researchers lost track of more than half of the participants. For example, in a five-year study of 727 post-operative transsexuals published last year, 495 people dropped out for unknown reasons. Dr Hyde said the high drop out rate could reflect high levels of dissatisfaction or even suicide among post-operative transsexuals. He called for the causes of their deaths to be tracked to provide more evidence.

Dr Hyde said: "The bottom line is that although it's clear that some people do well with gender reassignment surgery, the available research does little to reassure about how many patients do badly and, if so, how badly."

There are around 5,000 post-operative transsexuals in the UK, according to the transgender pressure group Press for Change (PFC). It is estimated that up to 400 sex changes will be performed this year on the NHS and privately. Each operation costs the NHS around £3,000, while private patients pay upwards of £8,000 for surgery.

Christine Burns, of PFC, said the campaign group's research suggested that the vast majority of transsexual people enjoyed much happier lives following surgery.

Ms Burns added that the greatest flaws in medical literature about gender reassignment were in those studies unsympathetic to transsexual people. For example, one study was based on a survey of seven transsexual prostitutes interviewed in one gay bar in Chicago.

She said: "The fact that research is badly constructed isn't a poor reflection on transpeople, but on the people we should be able to trust for our care. If they "lose" half the patients they ought to be able to track the question is why? As we've repeatedly pointed out ourselves there is really no difficulty in getting transpeople to come forward and cooperate in research that is properly constructed and conceived with people's true well-being in mind."

Research from the US and Holland suggests that up to a fifth of patients regret changing sex. A 1998 review by the Research and Development Directorate of the NHS Executive found attempted suicide rates of up to 18% noted in some medical studies of gender reassignment.

Andrew McCulloch, chief executive of the Mental Health Foundation, has written to the mental health minister, Rosie Winterton, requesting a "thorough assessment" of the long-term effects of sex change operations. He wants the National Institute for Clinical Excellence, which decides what treatments should be available on the NHS, to draw up guidelines on gender reassignment.

Transgender psychiatrists, who assess whether patients should change sex, agree that more scientific research is needed. But Kevan Wylie, chairman of the Royal College of Psychiatrists' working party on gender identity disorders, said that all of his patients' lives have drastically improved following gender reassignment surgery.

Dr Wylie added that it was difficult to conduct research on the outcome of gender reassignment, or to compare its effects with alternative treatments, because transsexualism was such a "rare experience". Urological surgeon James Bellringer, who has performed more than 200 sex changes over the past four years, claimed that trying to carry out research that involves studying a control group of transsexual patients who were denied hormones and surgery would be unethical.

Mr Bellringer, who works at the main NHS gender identity clinic at Charing Cross hospital in west London, said: "I don't think that any research that denied transsexual patients treatment would get past an ethics committee. There's no other treatment that works. You either have an operation or suffer a miserable life. A fifth of those who don't get treatment commit suicide."

gruntstein posted:
im not sure what point you're making, but the point is simply that the benefit, if any, from this mode of therapy is totally insignificant, which is not surprising because it's the only form of mental illness in which the method of treatment is to accept the patient's delusions and construct reality around them

wow. read some foucault, newb

deadken posted:

gruntstein posted:
im not sure what point you're making, but the point is simply that the benefit, if any, from this mode of therapy is totally insignificant, which is not surprising because it's the only form of mental illness in which the method of treatment is to accept the patient's delusions and construct reality around them

wow. read some foucault, newb

i could but then i realized that i prefer to read things that are written in human grammar

DR posted:

gruntstein posted:
woo a 20% suicide attempt rate vs. an 18% attempt rate, certainly this was worth castrating the patient, destroying most of their family relationships and turning them into an unemployable social pariah. no regiment of therapy and pills could have had such a statistically invisible result, but the important thing is we not feel like bigots and just do the Proper thing which is to baselessly tell the mentally ill that happiness will come from destroying their sex organs and dropping ten thousand dollars to become a crude approximation of their prima facie absurd delusion.

the problem is that if you read the review most dissatisfaction likely due to the quality of surgery/complications, not that it had been performed at all. and the majority of studies don't show any significant rates of dissatisfaction, especially the modern ones, where surgical techniques have improved.

moreover, the one study featured in the review that has any sort of control (people operated on without delay vs people experiencing a significant wait for surgery) showed better functioning for the people who had surgery early (higher rate of employment, better sex life, more active social life). in fact, post-operative transsexuals showed better functioning in most studies.

additionally, another study from cambridge, of around 400 trans women, suggested that most post-operative detransitions (around 2%) were due to persistent nonacceptance from family and friends.

and one final point, some of the studies were conducted in an environment bereft of the rigorous psychological evaluation and real life experience requirements practiced today as a matter of course in many areas.

your uncited study that told you what you wanted to hear is very interesting but i prefer the comprehensive review of dozens of studies conducted by the biggest newspaper in britain

DR posted:
further, the other review doesn't make the claim that gender reassignment is ineffective, just that it's difficult to ascertain empirically whether it is effective or not.

edit: oh cool, it also suggests that people with worse results are more likely to stay in contact with doctors, which can bias the results of studies. how unsurprising.

actually it suggests that people with worse results can give up and drop out of studies and/or commit suicide at much higher rates.

gruntstein posted:
im not sure what point you're making, but the point is simply that the benefit, if any, from this mode of therapy is totally insignificant, which is not surprising because it's the only form of mental illness in which the method of treatment is to accept the patient's delusions and construct reality around them

you pretty obviously dont have any clue what you're talking about, but ok, let's assume for a second that gender dysphoria is a "delusion" instead of a normal response to the imposition of cultural binaries on human expression. the common therapeutic approach to delusion is to reconstruct it, not tear it down - best practices focus on the happiness and social functioning of the patient, not the logical inconsistencies between their thoughts and those providing treatment.

gruntstein posted:
it shouldn't be terribly difficult to ascertain its effectiveness if it were, no? maybe the fact that dozens of studies on this topic were at best inconclusive is in evidence of the idea that maybe other methods should be tested and for the time being it is unethical to encourage the mentally ill to castrate themselves and enter a physical and social reality that only further entrenches their depression, bipolar disorder, and general wretchedness

well, the dozens of studies on this subject had a) small sample sizes and were b) not controlled. they were heavily reliant on case studies. the review notes that this isn't necessarily an obstacle, so long as researchers can demonstrate that the sample they end up with is representative. the problems with this are that again, people with poor results are more likely to remain in contact with doctors than those that don't, and as pointed out by Christine Burns in the Guardian article, the way these studies are performed is often disrespectful to the participants, disinclining them to further participation. so actually it's quite difficult to determine its effectiveness.

further, the evidence that it "reinforces" depression, bipolar disorder et al is even more sparing. where are you getting that from?

gruntstein posted:
actually it suggests that people with worse results can give up and drop out of studies and/or commit suicide at much higher rates.

Have you actually read anything other than the guardian article?

DR posted:

gruntstein posted:
actually it suggests that people with worse results can give up and drop out of studies and/or commit suicide at much higher rates.

Have you actually read anything other than the guardian article?

idk did you read the guardian article? your failed interpretation of what it wrote suggests that you did not


HI. swampman here. Im going to send this thing to the thing! bye

Edited by swampman (Dec. 5, 2011 02:17:08)

gruntstein posted:

DR posted:

gruntstein posted:
actually it suggests that people with worse results can give up and drop out of studies and/or commit suicide at much higher rates.

Have you actually read anything other than the guardian article?

idk did you read the guardian article? your failed interpretation of what it wrote suggests that you did not

i did, yes. and then i read the evidence it was based on, which should be standard practice for anyone thinking critically about a newspaper article concerning a medical or scientific issue.

i'm afraid you're simply mistaken if you believe that the modern way of dealing with peoples' mental illnesses are to accept and justify them,

just relays such a deep and willful ignorance that i couldnt resist Press The Button for the 1st time of my illustrious mod career. Thanks for 5ing and subscribing.

swampman posted:
Just so im not accused of putting someone into the peenalty box because i cant handle the truth about cats and dogs

i'm afraid you're simply mistaken if you believe that the modern way of dealing with peoples' mental illnesses are to accept and justify them,

just relays such a deep and willful ignorance that i couldnt resist Press The Button for the 1st time of my illustrious mod career. Thanks for 5ing and subscribing.

Nice arguemen.t im sure other ppl have been convinced, as have i