No, You Can’t Substitute Therapy for Hormones

I try to keep an eye on the world of transphobia, and, as an autistic person, I was particularly drawn to a Daily Wire (a right wing, transphobic website with dubious connections to truth created by Ben Shapiro) article on how autistic adolescents were helped with psychotherapy and no medical intervention, based on a recent study. Even writing this sentence, an astute reader will notice problems. But, I went beyond that and actually read the study.

Needless to say, I’ll be talking about transphobia and ableism. This is your content warning, if you’re not in a place where you want to deal with this stuff. You honestly don’t need to — there are enough of us who do, and your health is important.

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“Facts” Without Knowledge: How Many Trans Women Have HIV?

If you are active in trans advocacy, you’ve seen various estimates for HIV in trans women: 42% (CDC)! 14% (Also CDC)! 24–28% (Baral, et. al.)!

I suspect none of these are right, and I think all over-estimate HIV prevalence among trans women. I recognize that’s a minority position — advocacy groups who depend on public health funding like to tout high numbers, as do HIV outreach organizations trying to convince trans women of the risk they may have of contracting HIV, much like the oft-cited, but wrong, 35-year-old estimate for the average life expectancy of Black trans women).

Certainly, Black trans women are at too-high of risk for violence (anyone who attends a US-based Transgender Day of Remembrance event will be struck by the number of Black trans people who are murdered each year — far outnumbering the white faces), and it’s a real problem. But we can make this point without incorrect statistics that also serve to discourage Black trans women from transitioning and living as who they are.

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Researching Trans Bodies…Without Trans Bodies

Transgender people have never had a great relationship with medical care. Most trans people have stories about being mistreated while obtaining medical care — not just for trans-related healthcare, but also for general healthcare. It’s not unusual to be refused treatment by transphobic doctors, to be misgendered and dead-named by providers, to experience the biases the medical profession has against sex workers (whether or not we’re a sex worker), and to be subject to assumptions (without necessarily any evidence) about what gender we really are.

Sometimes the problem is intrinsic in the way medicine sees trans bodies and the research that enlightens the medical world.

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What Does Transgender Research Really Say?

The UK news organization, Daily Mail, reported that seeing trans people on TV caused young people to seek out medical transition.

Except, no, the actual research didn’t.

First, let me link to what I’m talking about:

Science reporting is notoriously awful (ironically the linked paper also mentions the Daily Mail’s bad reporting of another science issue, the false link between the MMR and autism that destroyed public confidence in vaccines). There isn’t a simple reason for this, but it is worth looking at.

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