Friday, March 23, 2018

In High Places

More and more trans people are being appointed to high government positions, President Obama had about a dozen trans people in key government positions and a trans women has just been appointed to a Pennsylvania cabinet position.
Levine becomes PA’s first trans cabinet member
Philadelphia Gay News.
By Kristen Demilio 
March 21, 2018

The Pennsylvania Senate this week confirmed Dr. Rachel Levine, along with three other women, to cabinet-level positions, making Levine the commonwealth’s first-ever transgender individual to reach this level of government.

Levine, who was already serving as Pennsylvania’s Physician General — also a first for the trans community — was appointed Secretary of Health, joining the appointments of Department of Human Services Secretary Teresa Miller, Department of Drug and Alcohol Programs Secretary Jennifer Smith and Insurance Commissioner Jessica Altman.

As Physician General, Levine initiated the effort to establish opioid-prescribing guidelines in Pennsylvania. She also has led an LGBT workgroup on behalf of the governor’s office to promote fair and inclusive access to healthcare.

Levine, who specializes in pediatrics and psychiatry, “is firm in her stance, but professional and gentle in her delivery,” said Dane Menkin, clinical operations director of the Mazzoni Center and a member of the workgroup. “She takes issues that could spark conflict and de-escalates them.”
Hmm… I am a little surprised to see her appointment because the Senate is controlled by the Republicans while the governor is a Democrat.

The classes went very good, I didn’t finished the slide set in my presentation but I left them with a pdf copy of the PowerPoint. I might see them again at the March For Our Lives rally tomorrow in Hartford, they will get extra credit for attending the rally.

I’ve Been Taken In…

It seems like yesterday’s post might not have been on the up and up, according to Cristan Williams at the Transadvocate the author of the Slate article didn’t report the conclusion of the research accurately.
Slate wants you to be concerned that, “A Disproportionate Number of Autistic Youth Are Transgender.” Here’s why that concern is BS.

Cited are the following papers:
  • Gender identity disorder in a girl with autism —a case report, 1997
  • A 2017 Atlantic article that itself cites a 2010 paper titled, Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents
  • A 2016 paper titled, Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature that predominately considers a pre-2013 dataset.
In fact, the 2016 study warns researchers that:
Notably, 1 study explored the link between the DSM-IV diagnosis GID and ASD in a clinical sample of children and adolescents using the more comprehensive Diagnostic Interview for Social and Communication Disorders (DISCO), a semistructured 2- to 4-hour interview. This study identified 1 child (of 52 with GID) who also met criteria for ASD according to the DISCO… In conclusion, current research has not established an overrepresentation of GD among those with ASD or the converse.
Yup, this is the paper that Slate cites as an example of supporting that:
A.) There is a consensus that “gender-dysphoric youth are more likely to be autistic than would be expected based on autism rates in the general population”; and,
B.) “This co-occurrence has implications for the treatment of both gender dysphoria and autism in young people”
The Slate article states, “Research on this phenomenon goes back to at least the 1990s, when the first case study of an autistic child with gender dysphoria (then called gender identity disorder) was published. As studies investigating the co-occurrence (or correlation) between gender dysphoria and autism spectrum disorder (ASD) have trickled in, there is a growing consensus in the medical community that the two do co-occur at disproportionate rates.”
Consider the following from a 2018 paper published in the Journal of the American Academy of Child & Adolescent Psychiatry:
More recently, growing attention has been paid to a putative relation between gender dysphoria (GD) and autism spectrum disorder (ASD). This concept has become particularly popular in the lay press. Some individuals have gone so far as to suggest that transgender identity is a result of underlying psychopathology, with ASD being one example. These conclusions are not supported by extant research, and practicing child and adolescent psychiatrists should be aware of the literature on this topic and its limitations.
This paper is titled, “Gender Dysphoria” and Autism Spectrum Disorder: Is the Link Real?

As this paper correctly notes, the idea that Autism and GD share a link has, “become particularly popular in the lay press.” If you care to see how these misconceptions are used as propaganda, check out the way this misconception is used on this ex-trans site, a site that recently helped publish an ex-trans booklet targeting schools and school children. Click here to see the 100s of news articles on google fretting over the link between autism and being trans.
So I guess I was suckered in to reporting the Slate article.

What I do see is that many of trans children have been misdiagnosed with ADHD and other spectrum disorders; that many time when a child socially transitions all misdiagnosed symptoms disappear and the child begins living a normal life.

She ends the article with…
While it’s possible there is, in fact, a link between autism and being trans, the reality is that we do not have evidence to substantiate that hypothesis. Until we have clear data that substantiates the claims Slate and others regularly make, we need to remain agnostic to such claims, no matter how often these claims are made. While there are certainly autistic people who have gender dysphoria (just like there are autistic people who are GNC or gay) this reality doesn’t mean that being GNC, gay, or GD is any more likely than the general population to be autistic.

Thursday, March 22, 2018

Is There A Link?

Or is it because the dysphoria mimics many of the symptoms of ADHD or Autism? It is because therapists only look for the oblivious and don’t probe deeper?
A Disproportionate Number of Autistic Youth Are Transgender. Why?
By Evan Urquhart
March 21, 2018

Gender specialists first noticed decades ago that a large number of people who seek treatment for gender dysphoria also seemed to have autistic traits. Research on this phenomenon goes back to at least the 1990s, when the first case study of an autistic child with gender dysphoria (then called gender identity disorder) was published. As studies investigating the co-occurrence (or correlation) between gender dysphoria and autism spectrum disorder (ASD) have trickled in, there is a growing consensus in the medical community that the two do co-occur at disproportionate rates. This consensus is based on numerous studies reporting that gender-dysphoric youth are more likely to be autistic than would be expected based on autism rates in the general population. (This may also hold true for adults, although the research on adults is sparser.) This co-occurrence has implications for the treatment of both gender dysphoria and autism in young people, and hints at a connection between the biological causes of both transgender identity and ASD.

“We have enough evidence, across multiple studies internationally, to say that autism is more common in gender-diverse youth than in the general population,” said John Strang, a neuropsychologist and founder of the Gender and Autism Program at Children’s National Health System in Washington. Strang authored a 2014 analysis that found that more than 5 percent of autistic youth sampled for his study also displayed some level of desire to be the other gender, according to parental reports. (He cautioned that it’s too soon to say what the exact percentage in the overall population may be.) Another widely referenced study found that 7.8 percent of young people being treated for gender dysphoria at a clinic in Amsterdam had a confirmed diagnosis of ASD.

These studies seem to support the hypothesis that transgender identities are rooted in biology, especially when combined with other studies pointing to a strong heritable component of transgender identity. A biological basis for transgender identity is still highly contested, although the science has been pointing toward that explanation for several years. Researchers believe that autism itself is highly heritable, so a link between autism and gender identity could even provide some direction for researchers hunting for genes associated with transgender identity.
Two things, first we cannot get hung up on a biological component of gender dysphoria, there might be many other reason for GD besides biological causes. Also we cannot say that the two are linked; there are many autistic children who are not trans.
On the other hand, it’s possible that autism is overrepresented among trans youth because autistic people are less concerned with social norms and less likely to bow to social pressures that keep other trans people from coming out. Our ability to study gender dysphoria and diversity is limited by the fact that there are such strong social pressures, starting in early childhood, to conform to gendered expectations. There’s no way of knowing how many people hide their transgender identity, so we can’t know for sure whether studies of openly transgender people are representing the full picture at this time.
It can be as simple as asking questions about their gender identity.
One practical outcome of this research is that clinicians are recommending that autistic youth should be screened for gender dysphoria—and that clinics that work with gender-dysphoric youth should screen clients for autism as well. Young people who are found to have both need individualized, compassionate care, and they and their families also need to know that they are not alone. Strang cautioned that ASD should not be viewed as a negative for transgender people, because the ability to ignore social pressure can be very freeing for this group: “Autistic people may be more bold and individualistic, less swayed by social expectations. Some of the front-line leaders of the trans rights movement have been trans and autistic—and there’s a beautiful focus, for many of them, on being themselves and not bending to social expectations of what others expect them to be.”
The other thing we have to be aware of comorbidity.

We cannot block a child’s transition just because they’re autistic or if they have any other medical or mental illness. The governing factor should be can they make an informed consent to transition.

Update: 7:55 PM
The TransAdvocte reports that this article if flawed... Tomorrow post will look at her reserach.

I Have Said…

…That human rights should not be subject to a popular vote.
Anchorage voters to decide on anti-transgender "bathroom" law pushed by far-right extremists
Voters in Anchorage, Alaska are deciding the fate of an anti-transgender “bathroom” initiative in the city’s first vote-by-mail election (ballots are due by Election Day, Tuesday, April 3).
By Brendan Joel Kelley
March 21, 2018

Proposition 1, on the ballot due to the signature-gathering efforts of the far-right anti-LGBT Alaska Family Council (AFC), would overturn some protections enshrined by the Anchorage Assembly’s (the city’s legislative body) 2015 nondiscrimination law, and require city-owned changing facilities and restrooms to be designated for persons of the same sex listed on their birth certificate. The current nondiscrimination law being targeted by the Alaska Family Council and its allies entitles people to use bathrooms, locker rooms and dressing rooms that are “consistent with their gender identity.”

Anchorage, which last year elected the state’s first two openly gay politicians, Christopher Constant and Felix Rivera, to the municipal assembly, has a long history with anti-LGBT culture wars, and the Alaska Family Council, led by its director Jim Minnery, has been the tip of the spear in attempts to deny LGBT equality over the last decade.

Minnery and the Alaska Family Council, with support from the national anti-LGBT hate group Alliance Defending Freedom (of which Minnery’s cousin Tom was once chairman), led the campaign against Anchorage’s Proposition 5 in 2012, which would have added sexual orientation and transgender identity to the city’s civil rights code. The initiative failed after an ugly campaign against it that included anti-transgender cartoon ads former Governor Tony Knowles described as “intentionally stigmatizing” and “dehumanizing.”
Much like in the 2012 campaign, Minnery and the Alaska Family Council are relying on scare tactics like the debunked “bathroom predator” myth to convince Anchorage residents to vote yes on the initiative.
What gets me is that these so called “Family” organizations don’t even blink an eye to lying, creating hate and fear. I don’t know about you but these are not family values, family values are love and acceptance.

Let us hope that love wins out over hate.

This morning I am up at the Legislative Office Building at an “Action” to support the nomination to Chief Justice of the Connecticut Supreme Court.

When Justice McDonald was appointed to the Supreme Court his vote in Senate and House was almost unanimous now it is split right down party lines.

The question is what has changed?

The Republicans claim it was his vote about the death penalty* but other judges who ruled the same as Justice McDonald were not grilled on their ruling.

The Republicans claim that he looked researched the law on issues that were not brought up before the court during the trail but the Republicans never questioned any other of the justices during their re-nominating hearings. So why was it an issue with McDonald?

The Republicans claim it is because of a proposed bill he introduced to add more oversite of church funds but that was not an issue when he was voted to the Supreme Court, why is it an issue now?

Is it because he is a personal friend of the governor?

Is it because he is gay?

Is it because conservative money is pouring into the state?

*Back when the legislature voted to repeal the death penalty, the convicts on death row sued saying it was unfair that those convicted before the legislation passed the law still faced the death sentence. Four out of the seven justices agreed.

Wednesday, March 21, 2018

Have You Attended A Trans Support Group?

It seems like support groups have a love them, hate them with the community. There’re some trans people who swear by them and another group of people hate them and wouldn’t set foot in them.
Support group offers window into how Las Vegas treats its transgender residents
Nevada Independent
By Jackie Valley
March 18th, 2018

The circle of chairs just keeps getting larger.

First, it’s only a man and woman sitting on a couch. But then someone takes a chair across the circle. Then another. And another. By the time Blue Montana takes a seat and introduces himself, 13 people surround him. Some are strangers. Some are friends. But in this room — with its dark purple walls, lime-green lockers and orange-tinted floors — Montana wants all to feel welcome and, more importantly, comfortable to be themselves. So his introduction comes with an invitation to do just that:

“My pronouns are he/him,” Montana tells the group. “This week so far was good.”

The introductions continue in that pattern.

 “My name is T. I don’t have a pronoun right now. I think I had a good week.”

“I’m Harper. Female pronouns. My week has been terrible.”

“My name is Geneva. Pronouns she and her. Last week was pretty crappy, and I’d rather not talk about it.”
This is common in support groups, the check-in.

It is just basic peer support group procedure, it give everyone a chance to speak-up. Many times after the check-in the group will go back and ask a member to expand more on their opening comments. Some support groups are more social than support, they have trips out to dinner, movies, or the theaters. But even those trips can be supportive by getting their member out in the public to build up courage for its members.

I used to visit every support group in the state to talk about the gender inclusive non-discrimination bill so I got to know many trans people in the state and also see how their group operates. I still attend two support groups regularly now so much for support but more socially. I see many friends at the meetings. It is also the reason I attend Fantasia Fair, not for the workshops but more for the social aspect.

I am also the treasurer for Connecticut Outreach Society because I saw too many times the treasurer left the group and it was hard to track them down to sign over the bank account to another member so I became the treasurer.

You All Have Seen Those Hateful Comments…

About XY and XX chromosomes or about our anatomy between our legs; well that is 1950s thinking, we have come a long ways since then to understand gender.
Scientists uncover 20 genes linked to being transgender – supporting claims the condition has a physical basis
  • US researchers tested 14 female-to-male and 16 male-to-female patients
  • The latest findings point towards transgender identity having a physical basis
  • Dr Ricki Lewis, a geneticist, said: 'It lends legitimacy, if that needs to be added, that transgender is not a choice but a way of being'

The Daily Mail
By Colin Fernandez Science Correspondent
18 March 2018

Scientists have uncovered 20 genes linked to being transgender – supporting claims that the condition has a physical basis.

Researchers believe the gene variations may contribute to people identifying with the opposite sex.

Critics of transgender identity say the condition is ‘all in the mind’, and transgender people have a psychological problem rather than a medical one. But by highlighting genetic mutations that affect brain development, the latest findings point towards transgender identity having a physical basis.
‘The most promising of these include variants of genes involved in neurologic development and sex hormones.’

Dr Ricki Lewis, a geneticist, said: ‘These are highly reputable folks going about this exactly the right way, searching the genomes of transgender people to highlight which genes they have variants in. It lends legitimacy, if that needs to be added, that transgender is not a choice but a way of being.'
Then there is this article…
What Role Do Sex Chromosomes Play In Transgender People's Identities?
Quora , Contributor
Match 19, 2018

What role do sex chromosomes play in the identities of transgender people? originally appeared on Quora: the place to gain and share knowledge, empowering people to learn from others and better understand the world.
Answer by Sai Janani Ganesan, Postdoctoral Scholar at UCSF, on Quora:
Biological gender and gender identity are two very distinct concepts. Biological gender or sex refers to the anatomy and physiology of a human body, whereas gender identity is influenced by a multitude of factors, most of which we don’t fully understand.

Biological sex is purely determined by the choice of sexual differentiation pathway, which is guided by genes on the sex chromosomes (though not exclusively, for example: WNT4 on chromosome 1). Testis-determining factor (TDF) or sex determining gene Y (SRY) located on the Y chromosome is one such gene. SRY is largely responsible for testis formation. It is not the only gene, and a variety of pathways and proteins are involved in this process of sex differentiation, some even located in the autosomal regions, but SRY is… special.

The sex determining gene Y (SRY) was identified in the 1980s by Peter Goodfellow’s group [2]. Goodfellow’s group and others performed a series of experiments to demonstrate the role of the gene. In one such study, they looked at the genetic information of individuals who were anatomically female and had both XY chromosomes, and individuals who were anatomically male with XX chromosomes [3][4]. They found the SRY gene in an X chromosome in fifty cases of anatomically male with XX chromosomes. In one of the anatomically female case with XY chromosomes, they found a single nucleotide mutation in the SRY gene, that translated to a single amino acid change (from methionine to isoleucine), thus disrupting the testes development process. A single amino acid change from methionine to isoleucine in the SRY gene can cause an embryo with XY sex chromosomes to develop as a female. It is not difficult to imagine that such de novo mutations can also play a role in gender identity. In another study in 1991, they were able to transform female mice embryo to male (anatomically and behaviorally) by simply inserting one single SRY gene [5].
The thing to remember is that there may be many reasons why we are trans and just because you don’t have one medical indicator doesn’t mean you’re not trans. There is only one sure thing that indicates if you are trans or not and it is you. You are the final judge if you are trans.