Is being trans a social fad among teenagers? 

As a trans person, I can say for a fact that the worst part of this "culture war" is that we can't talk freely about the complexities, and that the underlying compassion for individuals themselves is utterly lost. The gender critical campaigns have reduced things down so far that it's now not about how do we appropriately give support to people, but instead about basic rights to personal freedom and being able to participate within society. Faced with extreme threats to survival, it is normal for humans to drop nuance, and so those opposed to trans people get to say "look at those crazy trans people, ignoring science/safety/etc". And there's strong history of trans people strawmen being created by GCs and widely publicised as real, further stoking hatred. Trans people want to talk about things seriously and openly. We've always existed, and don't pose any kind of new danger to anyone - indeed, many of the gender critical arguments are misogynistic in basis ("protecting innocent girls"), and there's a documented rise in transphobia and of cis women getting harassed for "not looking feminine enough to be a real woman". Core to Sabine's argument is that this is an area of science & healthcare, and not something for petty fights, political wins, and media sensationalism. And frankly, most trans people absolutely agree - we just want to go about our lives with the same dignity as anyone else.

Regardless of the science, can we just be kind to each other? Asking for a friend. She’s not here to ask anymore.

"It Takes All Kinds" is what my mother used to say when asked about people who spoke/acted/behaved differently. The beauty of this line is that it encourages, even insists on tolerance but doesn't require that you actually understand every divergent branch of humanity. Sure, its important to try but its OK not to as long as you are tolerant and respectful.

".....have you ever seen a normal person? I haven't." Well said Sabine.

"if you want to be a girl you join the physics club" GODDAMN she is dropping bombs just because she can

I have real empathy for people who feel they got the wrong body parts. If I was born with a female body, retaining everything else I know about myself as a red blooded American man, I don’t know if I could deal with it. Especially when family and society just thinks your crazy, and when surgery is risky, and kids will bully you on top of your already difficult circumstances. I’m sure there are fakers, some people fake cancer. But nobody bullies you when you say you have stage four melanoma.

I'm a little late to the game here as i just saw this video. One important factor that was completely ignored when discussing the psychological satisfaction of recipients of treatment is the fact that systemic hatred of trans people is a common thread before, during, and after treatment. Of course someone is going to be depressed if they are constantly inundated by an endless barrage of hate! As a trans woman who transitioned 20 years ago i can definitively say that transitioning made me happier and more satisfied with my life but the world's hatred continues to drag me down.

“If you want to be a girl, you join the physics club!” 😂 I love this

A wise man once said "Mumsnet is not a valid journal of science"

I'm a trans guy who transitioned as an adult (18): I've been out and living as a guy for 3 years now and have been on hrt for a few months. I read through many of the other comments, and I'd like to add on to them and address a topic I saw a bit underepresented: the medical diagnosis of gender dysphoria. The modern sociological consensus is that you do NOT need to have dysphoria to be trans, and you may have dysphoria about a body part but that doesn't necessarily indicate you are trans. Dysphoria is a mental reaction to feeling a discrepancy between how your body is and how you expect it to be/feel like it should be. Since everyone processes certain traumas differently, not every trans person actually experiences dysphoria to the same level. At the same time, treating dysphoria doesn't actually treat depression, anxiety, or any other mental health problem an individual could've developed due to the trauma of being trans. Going to a therapist and getting treated for those is just as crucial as receiving medical transition care...unfortunately many trans people I know assumed all their problems would disappear upon starting hrt, and although they are happy with their changes, hormones obviously don't make depression go away. So even just from my experience and from extensive talks with my psychiatrist, I am not at all surprised that studies found that mental health of patients medically transitioning did not significantly improve, because medical transition is not a "cure to depression", it just helps to alleviate dysphoria and make someone feel more comfortable in society. I should note here that I don't study medicine, and I think we should leave it up to medical professionals and the patient to thoroughly evaluate the best course of care for each individual. I understand how someone not diagnosed with dysphoria wanting to medically transition can be a difficult situation, and I am not smart enough in this topic to resolve such issues. I advocate strongly for thorough medical evaluation before commiting to any sort of gender care, but I don't think it is as simple as "HRT is a perfect solution" or "HRT is bad for everyone". I really do think this should be evaluated on a person-to-person basis and best left up to the psychiatrist, GP, and the patient without government intervention (anymore than the government intervenes in other medical issues, that is)

In my experience, transgender women tend to be less likely to come out due to societal pressures. They tend to pass less frequently and are more strongly argued against in the media's eye. Most trans arguments in the media seem to feature transwomen and women's spaces whereas the transmen side is less critiqued in the same way. This may offput transwomen from coming out in fear of social stigma

i am someone who came out as trans to my family when i was 13, and was able start feminizing hormones with the support of my family and doctors just before i turned 15. i'm not exactly happy or content with my life as it is now, and as the past 4 years of HRT have progressed, i've actually started to identify less and less with the gender i came out as. however, i don't say this to say i regret transitioning. i'm actually extremely grateful my unhappiness has nothing to do with my gender identity now, because even after all the ways i've changed (and i've been through a LOT of personal changes), my conviction that i am not the gender i was assigned at birth has never faltered, nor has my belief that feminizing hormones are the right choice for me. maybe now i don't identify as fully female, but i've always seen myself as a "fem" person, and HRT absolutely does its part in sparing me from the gender dysphoria i would be feeling if i still wasn't aligned with that. from my perspective, gender is too sensationalized. sex serves a simple biological purpose, but humans are the only species that have had the intellectual agency to establish genders, and for some reason we think they're this law of nature that is dangerous to interact or play with. in the end, the goal is to live in alignment with the person you see your best self as, which is more realistically about gender expression than gender itself. of course, as someone who has remained happy with their transition since starting as a minor, i don't think minors should be restricted from transitioning. however, in order to mitigate the potential harm of young people being dissatisfied with their choice to make permanent changes to their bodies, i think a degree of medical "gatekeeping" is important, which i certainly faced. though, i also think a less gender-enforced society would alleviate the some of the pressure impressionable teenagers experience to chain themselves to certain identities. it's just hard to get good data for this stuff.

In the Netherlands the ratio of girls and boys waiting for gender affirming care seems to have balanced out again. In any case, the requirements in the Netherlands to receive this care are pretty strict, it is not a procedure you can just get on a whim. Also people are closely monitored both before and after transition to check their well-being and see if any mistakes have been made in the assessment. Ultimately it is about people actually transitioning not people that may entertain the thought for a while.

I’m sure this topic won’t be controversial at all. Good luck, anyone venturing into the comments!

The problem with no control group is understandable since essentially a control group would demand a group of teens getting placebo instead of blockers or gender affirming care, we do control groups with many illnesses and symptoms but those are larger than 0.5% of the population. There's no getting around the need for controlled study but its going to be difficult to achieve, its gonna take time.

Like so many senselessly politicized issues, this is one that requires the wisdom of Solomon. As we are not Solomon, perhaps we should leave this to the children, their parents, and qualified mental and medical professionals while the rest of us butt out!

My scepticism of the "they're doing it because it's popular" doesn't come from any "agenda" but as a gay man in my fifties I've heard it all before about me. People haven't let go of the "it's a choice" libel still as if anyone would choose to have every Tom Dick and Harry know better than you what you are going through. I have known 2 trans people and both transitioned as adults.

"have you ever seen a normal human being" 😂😂

It's like being taught to wear your shoes on the wrong feet. Everyone tells you to do as they say, but it hurts too much.

11:30 "If you want to be a girl, you join the physics club." Ha! Ha! I love you, Sabine!

23:33 _"you can switch a pen from one hand to the other and back within a few seconds and without lasting consequences; puberty blockers and hormone therapy are not as easy to undo"_ I'd say the left-handedness analogy is pretty solid from another perspective that you didn't mention, though: Forcing left-handed kids to use their right hand for stuff like writing causes long-term damage -- they tend to develop weird learning and speech disorders. And forcing trans kids to act out their assigned gender has similarly been shown to cause long-term damage. They can't simply "suck it up" and act right-handed/cisgender without lasting negative consequences.

"Have you ever seen a normal human? I haven't." Thank goodness for you. ❤

One thing that I've heard about the case of Sweden "rolling back" is that the country has been at the forefront of gender-affirming care with much easier access to treatments, including surgery for younger people, than most other places in the world. That was from a documentary on the "rollback" on French TV a year or two ago, a state owned channel if I remember correctly (seen as left-leaning if anyone wonders why it would matter). What I gathered is that after some highly mediatized cases of people regretting their decisions to switch genders with medical assistance at a younger age there has been a backlash against somewhat zealous use of these therapies, but it's still rather more accessible and common than in many other western countries. I wanted to say this because in the video it seems like the countries who go back on these treatments may have completely changed their course but in my understanding and memory of it it's more of a case of three steps forward and one step back.

Great video Sabine. Small observation. When I was a child, there was no common term to be used. So if I had known I was transgender when I was 5, I sure wouldn't know the word was transgender. That was the 60s. Today, we have a lot of kids able to better understand themselves, there isn't more of us, there is just more of us that understand what makes us uncomfortable.

Wait.... Why are references exclusive to patreon ??? Shouldn't it be under the description and not under paywall or am i the crazy one here ?????

16:00 this may be a dumb question, but wouldn’t you expect to see little change with puberty blockers? the point of taking them is to delay a change that might otherwise cause distress. (not getting worse) does not equate to (getting better.) otherwise thank you for a relatively balanced and in depth look at this stuff, it’s important.

I am glad many comments have been made here, especially from people who have lived these experiences, as to the many, many confounding factors which I feel were not included in Sabine's presented analysis. Anything even approaching the societal, let alone socially constructed itself, is going to have multitude intersections to account for, any of which will be received by different people in different ways. As briefly chortled, correlation is not causation, and underwhelming results of treatments cannot be expected to be comprehensive of what pressures are at play. As mentioned, at the very least, these treatments on whole reduce harm, are one less thing to be as worried over, and I feel that release of pressure is worth erring on the side of proactivity, until such time as it would ever be found that these treatments would be significant detriments.

As the parent of a chromosomaly intersex child, I really wish we could just teach our children to accept their whole selves without worrying so much about who is a boy or girl and whether their body matches a definition of either. While your anatomy may define your biological sex and increase the odds of certain personality traits, it doesn't have to define who you are. My child is who they are and their anatomy isn't at odds with the reality of what they will grow to view as their identity. There is nothing wrong with either their feelings on the subject, or with their body.

I have a young relative who insisted on transitioning; I think their parents took the best route, they let them use whatever pronoun or name they wanted; but to start medical transition they had to attend therapy to manage their depression and anxiety. Within a year they decided to keep the new name and pronoun, but hold off on the medical transition for now. I think accepting and understanding had a huge impact on their mental health, and letting them know they don't have to confirm into traditional gender roles had a huge impact.

it makes perfect sense that puberty blockers wouldn't improve the mental health of the people on them. Puberty blockers aren't doing anything to make it better, they are just preveting things from getting worse. Which is also obvious when you take into account that the mental health of the people who were untreated declined, because for them the problem was getting worse.

I personally dont care about it that much, its a form of body modification and everyone should have that right once reaching a certain age. If it helps your self image and/or is something that a person wants for themselves they should be allowed. I myself dont understand gender identity or its importance, perhaps thats because I myself just don't care what labels I am stuck with because I just am what I am. Ones identity and physicality are both part of them and you don't have much agency in either, even one's identity is influenced by things that they cant control whether external or internal. I myself went through puberty really late and I am well below the average in height, I am somewhat androgenous though my biological sex is still obvious. None of that mattered to me though because why should I care what my body is like? I just do what I do and am what I am, it doesn't really need a label and no one else needs to understand me but out of pure laziness the answer I put when asked my gender is male but id rather just not have to be asked a question that is pointless to me.

I'd like to hear the directly from the trans teen in person rather than listen to the opinion of someone who is not trans. Its very telling when the subject of all these debates and controversy are the ones given the smallest voice.

I don't think this should be portrayed as a "both sides are crazy". You got popular american conservative figures calling for "eradication of Transgenderism", popular figure Posie Parker (supported by JK Rowling) being backed by Nazi saluting fascists in Australia. There are no popular figures saying some polar cruel opposite - the unified message of everyone else is respecting trans people and ensuring adequate healthcare. It frustrates me when respecting people and targeted discrimination is portrayed as equal and opposite.

Would be nice to compare the life satisfaction (over the lifetime) of those who received an early treatment and those who did it only later in life.

I am trans and I think that going through puberty clears up the uncertainty about ones gender for a lot of people so by halting puberty you are creating a self fulfilling prophecy. The problem is that we don't know who is "really" trans and who isn't so it doesn't matter what you do you will cause harm to someone.

"And leave the toilet seat up" -lol I'm actually a rare form of male that pees sitting down. I hate splashage.

I'm a trans man from the UK who came out at 15 and started seeing a psychologist so he could refer me to a gender clinic. I had to fight a lot to get that referral, it came over 18 months later, then I was on the wait list at the gender clinic for about 1 year after that. Even then, I didn't get a prescription for hormones until I had just turned 19. So I started my transition as a teen, but I didn't medically transition until 19. A lot of people think teens are just walking into the doctor's office and coming out with prescriptions. In the UK at least, it's far from that. It's a long, arduous process with lots of therapy and they try to 'prove' you're not trans which either makes you realise you aren't or it reinforces that you are. This made me very depressed at the time, feeling like I was not being heard or accepted, but at 23 now I can see they were doing that for my benefit so I didn't make a mistake transitioning. I've personally known a handful of girls/women who came out as trans but then returned to identifying as female before medically transitioning, but no males doing this, so I wasn't surprised by the data showing increased numbers for females coming out as trans. We all know young girls often struggle with mental health and self-image issues, exacerabated by social media. Tiktok especially, because if you engage with one trans video, it will show you 10 more and you get sucked into a rabbit hole that can 'trick' you into thinking you're trans, when really you're just at a vulnerable point in your relationship with yourself. I think, as you said, a lot of these studies are hard to draw strong conclusions from, I think in the next 10 years we will have a lot more concrete data. But will that be too late to show people trans people are normal people and prevent harmful legislature being introduced? I guess we will find out...

I am sick to death of people talking about it. Thanks for adding to the pile. I am trans, I live out my life in peace and don't bother others. I just want to be left to get on with things without going on twitter and seeing me being painted as a predator or a groomer, to walk down the street without seeing angry faces of people with preconceived beliefs about me based on what they have seen in this culture war. I am especially bored of the allies who think that activism is boycotting a video game or telling me what words I can or can't use to talk about myself. I am super sick of people who claim they are being cancelled, usually super rich celebrities who will never have to worry for anything in their lives.

Substitute “common” for “normal.” You can’t say you’ve never seen a common person. Commonly, they’re everywhere

The only RELIABLY-GOOD advice I can think of: if you don't want people to be miserable, then don't torment them.

This is a hell of a lot better than watching a bunch of stupid debates on this issue. Great work.

One thing that you didn't touch one was how forcing a transperson to go through a Puberty that mismatches their gender has huge consequences as an adult. Often increasing the costs of Transition by a large percentage due to having to pay for surgeries to erase secondary characteristics that mismatch the gender. ALSO, esp for Transwomen. If we don't get on blockers, we will often grow to be bigger than cisgender women. Something that is completely irreversible with any surgery.

Have I ever seen a normal person? Not on this channel! lol. Thank you for sharing your sane, balanced and objective viewpoint and for summarising the confusing state of society.

I was born in 1958. I wouldn't have told anyone that I was the wrong sex when I was a teenager for anything in the universe. I just kept my mouth shut and drank and took drugs, tried to unalive myself multiple times and wished I had the courage to do it right. Abject misery was my life. At the age of 35, in 1993, I was living in San Diego,(rather than North Carolina), and finally got the courage to come out and transition. It was like coming alive. Soaring out of hell to take part in life....finally! I never regretted it for a second.-weezi-🙏💖🙏🌄

My father grew up unacceptably left-handed in decidedly non-progressive 1930/40's Belfast, and in his case the result of forced right-handed writing was a terrible stutter that took a decade of renewed left-handed writing (as an adult) to rectify - so not quite as easily fixed as swapping hands, though he definitely wished it had been so

Puberty blockers not "improving" the state of affairs is rather expected, when you account for the previously reported discomfort with existing gendered characteristics. What they do is prevent things from getting worse. As you may image, for a trans person to go through the puberty that doesn't fit their gender, well it could be nightmarish. So they avoid that, therefore them 'not working' is them actually working, by producing exactly the intended result (keeping things at relatively the same level and not letting them worsen).

"...grow testicles, and leave the toilet seats up" 😂😂😂😂😂😂😂😂

"And leave the toilet seat up" Bhahaha. I may have spit coffee at my computer screen!

As a response to why there are more AFAB people identifying as trans in proportion to AMABs in adolescence, I would make the argument that since AFAB people start puberty earlier than AMABs, they have more time to figure out what characteristics about their body are bothering them and why. I also believe that it is still somewhat more stigmatized for AMAB people to be trans, or identify as LGBTQ+ (see current political discourse of AMAB trans and queer people being groomers, and media villanization dating back to the 80's). For these reasons, I believe that the amount of AMAB trans adolescents will eventually come closer to, or meet the number of AFAB adolescents.

I speak as a trans woman who transitioned at my late 20’s in Brazil. And I did it despite the statistics pointing Brazil as the most violent country towards trans women, we call it trans-feminicide, often with regards of cruelty and excess violence. I had always been like this, but the fear was part of my social structure. Gender dysphoria is real, and it can go on for a lifetime, I didn’t know what it was but the angst was always there lurking from the shadows, I studied psychology, I traveled, moved around, did therapy for years getting to know myself and building the courage to take the first steps towards transition, it’s been 4 years, I feel way much better about myself, despite the cultural and societal consequences. I believe it would have been much better if I could have transitioned in my late teens, I hope more studies can be taken and we have it scientifically right, so young trans people can have a better life.

As per Sabine's presentation, one thing is clear. There is clearly an dearth of reliable and significant scientific and psychological studies that can offer definitive insight, conclusions or recommendations. This should especially be heeded with considered caution in the case of young children and their parents assenting to transitions. Adults, though also lacking the benefit credible, in-depth studies, obviously have free rein to make such will decisions for themselves. It is a very sensitive, difficult and challenging subject of our society's epoch and will require more time to land on terra firma. We must, in the interim, be respectful, patient and tolerant.

I just found your channel, and this is exactly what I was looking for! In a world with incredibly heavy and extreme subjectivity (in the sense that people tend to go to the extremes of their opinions (very exaggerated example, but like saying “I adore chocolate” and “I despise chocolate”)) this channel definitely presents a more objective approach than most, showing many different investigations, what points in them are valid or invalid, and many points of view too. You’re amazing!

I think looking at "reduction of suicidal tendencies" betrays an error in approach. Noone wants to block puberty for the sake of blocking puberty. It isn't even done for alleviation of current problems. It's preventative. A child who's already suicidal due to gender identity issues... isn't going to be made less suicidal by preventing an incongruent puberty. Puberty blockers are just saving them from further stressors, such as development of divergent anatomy, the onset of certain processes, and facial/body hair growth. Puberty blockers are a panic button to buy time for the child to "figure out" their gender stuff, and externally to the child... puberty blockers are a compromise. Now allow me to elaborate on that. blocking puberty is not the best option for anyone. Puberty is this crossroads. Regardless of what thinking the child needs to do, or what they've already figured out, puberty is an imminent question. At it's core, there are three choices: A, Do nothing. B, Block puberty. C, assisted puberty (provision and management of hormones through puberty, more aligned to the child's sense of gender). with 'A', that is the standard we've had for a long while for many, and it's the default for anyone who slips through the net, and it's also the starting state for these children. You do nothing, incongruent puberty progresses, not every trans child grows up, those that do often having body issues. I'm blase about describing this because it's just the experience for most trans adults right now. Ask them, they'll let you know what A has been like for them. C is practically just a theoretical approach. it is, when sensationalised, the story the american right wing will spin, the "horrors of doctors transing our children". On a more grounded, reasonable perspective.. it is gender affirming care tailored towards, and likely designed to mimic the pubertal progression of hormones, and in this theoretical situation, would result in the child going through puberty simultaneously to their peers, in a manner more congruent with their gender. please note i'm not talking about ethical questions yet, just the process of each approach, what it results in. B, is temporary. a stopgap. continuing B for too long is extremely inadvisable. Eventually, you either have to go on HRT, or allow your endogenous pubertal development. So why B? well, I already listed issues that happen with A. As for C, you get questions of the child's capability to decide for themselves, of the level of confidence in that decision, you also have the parents/guardians rights, views, and biases to consider. A child that is adamant on transition, with parents who refuse the child's desire to pursue option C, would usually pursue option A. However, with option B available, puberty blockers, a manner of harm minimisation can occur. B can allow for the decision on seeking hormonal transition to be deferred to such a time as either the parents have softened their position, or the child has sufficiently developed and grown so as to be more removed from the decisions of the parents, and be able to more thoroughly advocate for themselves - that is, the patient is now considered capable of making this medical decision for themselves. Trans patients seek puberty blockers because it's the lesser of two evils. If, as is one selling point, they needed more time to think on it, and they decide that transition isn't for them, they just stop taking blockers, and resume puberty. The other direction this goes, it's all the other possibilities combined, they continue puberty blockers. This is true if they're "undecided", or if the entire time they know with little doubt, they want to pursue HRT and a more congruent puberty. And it's all well and good criticising puberty blockers, espousing their dangers, negligible "benefits", etc. But they do one thing - block the progression of puberty. And when the choices that are effectively given to that child are an incongruent puberty, or the absence of one.. you're not really giving them much choice. The young trans woman is likely going to pick puberty blockers despite all the concerns, because holding off masculine puberty until she can access feminising hormones is the most she can do to avoid the horror she 'knows' is coming, a body moving ever further away from the kind of body she feels she should have. No matter the cost, the puberty blockers will stave off the outcome she absolutely *doesn't* want. I know this is contentious, but I would argue that the goal should be as little time on puberty blockers as possible. That as soon as that child has confidence in the direction their care should take, effort should be made to either allow puberty to take place, or provide care to assist in the chosen puberty - it is the best way to minimise the harm blockers *could* do, minimise the harm a delayed puberty causes, and also allows for the development of the child in a more healthy manner, rather than keeping them in what is little more than a holding pattern. Delaying the care of a child with obvious and persistent desire to transition should definitely be questioned as an approach to trans healthcare. Especially if hormone blockers are so questionable as an alternative. It's not the child doing this to themselves. It's not even the doctor, they've guidelines to follow. It's the politics. I implore anyone who gets through this wall of text, talk to a trans person. Don't take the words of politicians, or even science communicators, as they are. Hear what *we* say our problems are, how are lives have been, learn the good, the bad, and the ugly of us. Understand us as people, and perhaps hear our insights as to how we would have liked things to go when we were children, and please, factor that into your understanding and perspectives of trans people, of trans healthcare. Should transgender teens transition? They're already going to be transitioning from child to adult, experiencing the chaos of hormone changes. You have the opportunity to give them the opportunity to actually choose. Don't let your own fears cloud your judgement on how best to address the situation.

"The control group members who did not receive care had worse mental health outcomes and by the end there were only 7 people left in this group" - this is the problem with control group studies in this group. Who would put themselves into the control group? It would mean denying yourself and sticking withthat despite knowing an alternative exists

I think we should let trans people, their parents, and their doctors decide. Why this is any of the public’s business is beyond me. They’re a small enough demographic that addressing this issue like it’s a problem legitimizes the current culture wars that are actively dehumanizing and harming trans people.

I think I love her thought process so much, that opening statement of asking for the facts summarized is how I feel everything they start arguing.

I will never understand why people think that it's better for a trans person to be attacked until they "admit defeat" and "return to normal" instead of just making them feel comfortable in their own skin, even if the person trying to make them comfortable with who they are doesn't believe that the trans person is truly the gender they transition to.

I think regarding the change in proportion of FTM vs MTF binary transgender people, it's important to note that the social pressures on trans people of these genders are not equal. Trans men who underwent female puberty, for example, have a lot easier time passing as male after hormone therapy than trans men in similar circumstances do passing as women. And much of the culture war in America specifically latches onto the idea that trans women are just men in dresses hoping to assault cis women and 'trick' heterosexual men. Trans men are far more invisible- there's less violence at risk for living as a trans man at the moment.

The information from studies in this video is woefully inadequate and at points entirely misleading. She admits herself that all the studies she used for research were small and she did not use many studies at all. Why she did this I don't know because there are many larger studies from which you could draw far more informed and solid conclusions, a good start but it feels like she just stopped researching after forming her first opinions on the matter. And the misleading part is the bit about some kids thinking they're trans because they're friends are trans. This is outright misinformation. Kids suddenly thinking that they're trans because they have trans friends is otherwise known as Rapid Onset Gender Dysphoria ( as she says) and it is complete and utter shit. This theory has been rejected by the medical community, thoroughly debunked, and the doctor who came up with it disgraced. Her saying that this is still medically debated is false. The matter has been settled by the doctors that specialise in gender dysphoria and transgender healthcare and while there are indeed other members of the medical community trying to desperately find evidence for ROGD, they are not experts and their research does not pass peer reviews by the experts. Saying that a trans child might be trans just because they have a trans friend or see lots of trans people on SM is like saying that a gay child is only gay because they have a gay friends or see gay people on SM. Trans or gay is not something that can be influenced, if that were true, there would be no trans children and no gay because the majority of their peers, the majority of any people around them will not be trans. It's a ridiculous, already proven false theory and it is very concerning that it's being presented here as part of a balanced discussion on trans issues

I was raised in a *very* sheltered and rural Christian area by a devoutly religious family. I had almost no understanding or exposure to LGBT concepts until I was an adult and moved away from home. I started getting yelled at by adult teachers for “not acting like a boy should” in kindergarten. I instinctively knew I had to hide it from my family because they had the same Christian hate in their hearts that we’re seeing so much of today. My internal sense of gender has never changed, I just learned what it meant and sought medical help as an adult. Most of us know we’re not cis when we’re very very young, but wasn’t allowed to even know that concept existed. The kicker is that my entire adult life was spent terribly depressed, but for me it wasn’t even so much an identity/dysphoria issue. Turns out that all my brain needed to function properly was corrected hormones and the depression literally just vanished.

An important thing to remember is that often times any sort of these studies would be _unethical_ to perform with an untreated control group.

I am a transwoman and I think this video has a lot of nuanced discussion about the topic. As a lover a science I would also like to see better studies done on the subject but I think the prospect of creating a control group for these studies is difficult. You'd have to have someone with gender dysphoria and then have them not transition. Antidotally, I can say that this has gone poorly for some of my peers. When there was a control group in that study that fact that it shrank so much should be indicative. My lived experience has been that my mental health has declined while not seeking treatment. It shouldn't be surprising that the control groups mental health gets worse while the other group either stays the same or makes modest gains. I think there is another topic being left out of the conversation all together. I think we all need to agree on a few foundational things to have a good faith investigation about transgender people. Firstly, I think we need to agree that we are real (was pointed out in the video) and have the right to exist as citizens with the same rights as everyone else. The political problem we have in the US right now is that we can't agree on that. This makes it hard to have good faith research on trans people. It also makes these studies difficult to carry out. How do account for these existential problems that many trans people face? I can say that can take a toll on your mental health. Unless we can reduce that as an external factor or we can account for it I feel like studies will be difficult to carry out. Just my thoughts :)

I really respect how true scientists can have the ability to look at polarizing and sensitive issues with nuance and care. It's so normal for people to pick a side, defend it, and never question anything they believe. I feel like this has helped me take a more compassionate and nuanced perspective on the matter. Thank you.

Sabine, your objectivity and depth of thought--and yes, even your bone-dry humor--on this painfully sensitive topic are a breath of fresh air.

Having worked at a general hospital that's had a trans reference center for decades, it was easy to see that, up until 2015 when I left, in adult patients detransition rates were low and reported quality of life improvement was high. Local data was overwhelming. And it was a lenghty process, too. Screening to greenlight surgical procedures took 2 years. You had to be openly living as the target gender for that period, and you had to control for conditions that could complicate your diagnostics. Psychiatric and psychological care was provided, and every single professional had to agree and sign it in order for you to get the medical approval for permanent procedures. I can't see this being any different for children (in fact Pediatrics is usually way way stricter than this). TDLR: If your protocol is strict, there's no excuse not to provide care.

The suggestion that children “decide to be trans” because they hear so much about it is not grounded in any facts yet is stated as such. Very damning and unworthy of a science educator. You have to prove this is happening, but puberty blockers and surgery isn’t something you get into like a tattoo. It’s insane and so tonedeaf.

as a trans woman, for me and many other trans people i know, hormone therapy is an attempt to survive and not commit suicide more than anything else. It makes sense that mental health would not become much better, as many people socially transition at the same time as hrt, which is incredibly difficult. when i was more visibly transgender, i would frequently be called slurs, be stared at, and was ostracized because of it. hormone replacement therapy has helped me not be as noticeable, and makes life a little easier. but i still struggle with the way people see me because of my transition and life is by no means easy.

I expect that trans men used to be under counted. I'm 62 and a trans man who was assigned female at birth (AFAB). My male identity was clear to me before kindergarten. I thought I was alone. I knew trans women but never met a trans man. In my 30s, I started meeting many women, my age and older, who also had "gender identity issues." These women never referred to themselves as trans men. Instead, they talked about the horror, physical discomfort, and trauma of being in the wrong body. These women would never have been counted in a survey or come out publicly. This is how I discovered I wasn't alone in the world. I attended a large women's spiritual retreat where I confided that I struggle with gender identity issues. The facilitator confessed that they too had these struggles. Then the room was filled with choruses of "me too." It was a transformative moment. The community became a safe place to talk about identity and even the very elderly would discuss their male identities. I don't remember any of these individuals coming out publicly, but given that there is more acceptance today, I hope that they will.

As an adult trans person who has grown up away from social media or even the trans conversation (my family is conservative and religious) transitioning in my late 20s has been a boon on my mental health and general quality of life. But I assume that is because the people I live with accept me and respect my identity. I think studying trans people's mental health is complicated because we are a small minority and our well-being is very dependent on how those around us (family, colleagues, government) treat us. That is why I suspect proving HRT does any good is complicated, it is only a small part of what being a healthy and happy trans person is. On top of that, many trans people forgo hormones and operations completely and focus on the social part of their transition. So, I do not think focusing on hormonal therapy is a good way of studying whether transitioning is a good thing. I guess we will have to wait and see for more studies to come in.

“We DON’T leave the toilet seat up you ALWAYS leave it down!” - Rorschach

My main take away from this is that larger more conclusive studies do need to be done. As she mentioned multiple time throughout the video, the sample sizes were very small. Its very difficult to draw any conclusions from what limited size there is of these studies. I will admit that I might have a bias myself, being trans and friends with several other trans people as well, but i will share my thoughts regardless and am open to fair and helpful criticism. I have not yet begun any type of medical transition yet because, as she mentioned, american healthcare system, but i do know people who have and from my observations of them as people they seem far happier and more comfortable with themselves. This is very anecdotal of course and likely doesnt represent all cases, but from what ive seen, people who do undergo medical transition seem to be a lot more confident and ive had some very surreal conversations with them about how they feel now versus how they felt before treatment and the consensus among them seems to be that their lives have greatly improved. Interestingly enough, most of them are ftm or non-binary so i think that that is something worth having a larger study done on. Of course this is all my opinions and what ive observed in other people close to me and doesn't necessarily reflect how other trans people might feel or the effects of treatment. I do greatly appreciate your videos and am always astonished and grateful for the way you present only facts and never try to bash on any community, even when result, like the ones mentioned here, don't completely align with what is often believed by most people among said community. I honestly cant wait for more studies to be done on this topic to see what results are valuable, what changes, and what new conclusions can be drawn. Keep up the great work!

meanwhile, once they stopped performing actual exorcisms on left handed people, "are teenagers becoming left handed as a fad?"

As a university professor, I have had more than one student over the years suddenly changing the first name to something suggesting the opposite gender. They usually are in their lower twenties and I'm rather confident they have made up their mind by now. They are just starting their transition, so their appearance and behavior sometimes sends mixed signals as to their gender, which can lead to awkward interactions. It is therefore a special challenge to treat these students in such a way as not to make their transition even more difficult then it already is. It seems to me that being aware of their struggle is the first step to improve their situation, and correct information and honest discussion helps with that. In this sense: thanks, Sabine, for this valuable contribution.

it seems like this video really likes to say "evidence is inconclusive so trans people shouldn't have healthcare" but the status quo is a position so you can't escape responsibility for this either

As a self acclaimed fish. I find this highly offensive.

It’s worth pointing out that the irreversible damage goes both ways. People are more likely to give inaction and status quo a free pass but that’s a bias. Trans kids going through the wrong puberty is also irreversible. You don’t actually have to prove no one takes blockers that shouldn’t have, you have to prove that a majority of cases are false positives.

Writing as a transwoman now aged 79 having had SRS in 2004 at the age of 60, I feel compelled to add my comments. I first encountered gender dysphoria at the age of 5, but of course, did not understand it at that time. I recall leaving school at 16 & not having a clue about what the adult world was about & TBH I don't think that I could have transitioned then even if circumstances were available, which they were not. It wasn't until I was 57/8 that I was finally able to transition, much to the surprise of my family. So, over the last 20 years or so, I have attended hundreds of trans functions & met probably over 1000 trans people, some of which are my closest friends. What I need to explain to you & readers is that "transgender" is a very imprecise term. In this regard I was refer people to The Harry Benjamin scale of Gender Dysphoria which categorises transgender people into basically 6 levels. So for male to female level 1 might be a man who dresses as a woman once a month, level 2 might be someone who dresses once a week, level 3 might be someone who dresses once a day, etc onto level 6 which is basically someone who feels that they must have SRS (sex reassignment surgery) & nothing else will do. So, in my experience, of those 1000 people I've talked to I estimate that only 40 or so were level 6, i.e. 4% which is quite low in my opinion. I must also add that nearly all the people that I have come across at least over the age of 30, & some well into their 80's. I cannot recall talking to any teenagers, but my advice to them & their parents is to meet up with older trans people, because we are the real experts on this subject. I actually think that the internet has been responsible for causing confusion to young minds who are unable to put things in concept. Hope this helps!!

I always thought "normal" people just meant people who don't have any rare or highly uncommon characteristics or traits for the environments they are in.

Puberty blockers have existed and been used since the 1980s, but there is "no longitudinal analysis" on their effects?

I have a trans son (female to male). Our experience is that he displayed completely female until puberty, began having doubts around age 13, and told us he was trans as he turned 16. We insisted "no you aren't" and resisted any kind of change or treatment for two years - lots of discussion, prayer (we were evangelical christians back then), therapy, etc. For TWO YEARS the only thing that changed was that his mental state got steadily worse. Eventually we had to make a choice - either insist on our way of seeing him, and potentially lose him one way or another, or yield to some level of transition and see what happens. He went on Testosterone, and then had top surgery. That was three years ago. The other mental problems faded away, he is back to being the basically happy and positive person he was as a child. I've learned never to think we know what the future holds, but as of right now I have no reason to believe it was the wrong decision. I understand the lack of scientifically reliable studies, so I'm sure there will be other experiences out there, but from our experience I would put the fad/social contagion theory to bed, along with the grooming theory. From my own perspective, the current move in legislatures across the U.S. against trans care, in fact against every aspect of trans existence, is mainly about right-wing self-righteousness and culture wars and has very little if anything to do with concern for the health of anyone. As a father I don't think I need their help.

Would you post your citations somewhere without a paywall, please?

Thank you, very valuable overview of the studies about the phenomena.

What I've learned is that psychologists learned that a person's gender identity appears to form or become apparent to that person by the age of 4 y.o. I forget how this was determined, only by asking adults and/or observing kids. Adapting a way I heard it described was that it is a bit like being left-handed. You just know without having to be told or reminded that you are left-handed instead of right-handed and you don't have to be told every day which type of handedness you are.

Personally, HRT has made me feel great about my body and enjoy being alive and having sex. It didnt magically undo my depression, anxiety, and ADHD, but with my body disphoria conquered I have more time and energy to work through those. HRT has definitely saved my life, I might have just stopped eating, drinking, or sleeping after highschool and died of starvation if I didn't have this option. It was awful, and I'm so much happier now.

I am transgender, yes, and the amount of red tape and social stigma I have to get through in order to receive gender affirming care makes me highly skeptical about the idea of this being a "fad". Would have to be one masochistic fad - I wonder if cis people realize how hard it actually is to start treatment. All of these safeguards put in place to hypothetically protect some fraction of a fraction of a population from making the wrong decision seems to me like it's creating much more suffering by denying care to people who need it, for sometimes an excessively long time. But that's just anecdote, and I am a hurt person, so take it with a big grain of salt.

About the puberty blockers not being better for teenagers mental health: teenagers tend to not have very good mental health regarless imagine being trans and on blockers on top of that, yeah... they're not gonna feel amazing.

1:06 A note from an intersex person. I was never told explicitly until recently why I took hormones because we are feared by the same people that tear transgender people. We make up (about) 5.6 MILLION People. The US is massive so this is barely a percent, but we're the size of some countries. The US also has limited regulations on if doctors have to report, or get in trouble for not reporting intersex children and often change their exterior to match what was predicted. Even though intersex individuals might not come up in conversations as much as other groups, they are a big part of the population like, imagine the whole population of a small country or a major city. That's around 5.6 million people in the United States alone! It's super important to remember that every single person, no matter how common or rare their experience might seem, deserves to be recognized and respected. The fact that intersex people are here and part of our world adds so much to our understanding of human diversity. It really challenges the simple boxes we often try to put sex and gender into.

Trans people are still rare where I live, but the few I've met have been very nice and seemed happy.

In this case doesn't "a control group" imply that we would have to deny potentially life-saving care to an enormous number of people for a very long time? There seems to be a good reason why that kind of research is less common in medicine.

I was definitely the victim of a culture where I could be pretty sure I was trans subconsciously but learned that you don't talk about being one in polite society. I had to hide it and it was this big shameful thing until I was an adult and felt as though I were 'permitted' to live my life, but in the process I felt as though I couldn't get the care I needed as a teen to just make the change. I wouldn't have had any hesitation in it if I had received the proper education but the dialogue on the subject is pretty backwards a lot of the time and I grew up with a distorted view of what a transexual was - nobody knew one in my circles and the media of it in the 90's and 2000's was as grotesque in retrospect as you can imagine. These days some of the media that is coming out is unthinkable to me as something that would have aired in my childhood explaining, "some people are born one way and feel another, and it's okay". But they are everywhere now so there are no doubt a ton more youths asking a lot of questions. I have a couple of friends who weren't sure about their gender and had to feel it out with hormones, and a ton of friends who are permanently, proudly trans even though we kinda feel like we "missed the boat" on having the puberty we actually wanted. So do you completely take away the opportunity for the ones who really knew, and wanted it? Growing up it wasn't even an option for me. In fact if you talked about that kind of stuff you were more or less announcing your intention to be shunned or bashed. It's definitely a rainbow of experiences, but we should listen to the ones who 'know' now that the word is out. Edit: By the way, I agree that there is not enough data about transgender studies in general. I have always been very frustrated by the small sample groups in these studies because it's not wise to say one-size-fits-all with this stuff to begin with. I guess as always it's hard to get funding, lol

God, the deadpan delivery of humor always gets me.

Sabine A few aspects of this video stand out to me. Re: ROGD, the Littman paper that initially advanced the idea was not just 'heavily criticized', but retracted. Therefore, it would be more accurate summarize the state of the data as 'there is no evidence of this' rather than the more generous 'there is evidence, but it's pretty bad' that you opted for. Additionally, the study recruited survey respondents from websites like Mumsnet, which is notoriously anti-trans, and ROGD was a common belief among mumsnet posters before it was given name by Littman. The study could very well just be describing people colluding to create a narrative or transphobic parents from whom their children hid everything until the last possible moment. Re: Jesse Singal, while what Jesse points out in this specific instance may or may not be true (idk), Singal has been criticized for himself being misrepresentative of evidence in a way that is persistently biased against transgender people. It's, to say the least, a red flag to see his name included in a video like this. I'm not accusing you or anybody on your staff of being anti-trans or misrepresenting anything, but it does seem like a few careless slip ups found their way into this video.

Sabine - I can't emphasize enough how important to me, and how much I appreciate, your ability to analyze and present a fair, balanced, and non-biased summation of the different topics you delve into. I was watching a you-tube video just yesterday where someone else was trying to do just that, and not succeeding very well - bias tends to shine through even the best efforts. I remember remarking to my wife that "Sabine would have presented a more balanced view of this". Of all the people I trust to present the truth, (and that's a damn tiny list) you are at the top - and to me you're a national treasure. Thanks for your efforts, and please keep up the good work. I feel really, really bad about people who don't feel right about the body they are born into, I can't imagine what a nightmare that would be, And I am also disheartened and angry about people who dismiss their feelings, or are cruel and non-inclusive in their dealings with these unfortunate folks. I hope we can put more resources into studying the problem as soon as possible, and do what we can to help them, and to create an environment where they are accepted and loved, the way we all deserve to be.

This title could have been from the Onion News Network.

I'm a 32 year old trans man. I didn't know what being transgender is as a teenager. I was just a depressed, suicidal mess. If I had known back then what I know now, I would have transitioned as a teenager, it just wasn't an option yet available.

The gender ratio shift could be explained in many other ways - it's hard to compare the violence and hatred "failed men" face in society to anything. By that i mean people who were expected to be straight men (gay men, transgender women), who did not comply with societies expectations. The physical and emotional violence that comes with that from peers and family is unparalleled. I'm not saying people assigned female at birth who transition don't face difficulties, just that they are different, and currently less immediately severe. It's much easier to be "non binary" if you were born AFAB because feminism already fought for women's right to be gender non conforming. Any sign of gender deviancy from AMAB people is mostly met with ridicule and like i said violence.

I appreciate all your science-education. I'd like to point out that most of the people I know who were forced to be right handed against their nature found it to be very traumatic. It seems, it's not so simple, easy and side-effect-free to be constantly forced switch a pen from the preferred hand to the non-dominant one as one might think. Are there any studies about that? Even collections of leanings from therapists? What would this say about people raised as their assigned gender rather than their preferred gender? As a non-binary person who grew up in a transphobic, anti-queer ultra-orthodox enclave, I can say it wasn't really enjoyable.

I am a right handed writer who started out as a left hander, nowadays enjoy practice writing back with the left and able to write with both hands equally well. Have to agree that gender role change is a much more complex activity than switching back hands for tasks like writing and throwing a ball

It seems odd to consider people who voluntarily stop puberty blockers as the control group for those who don't. If they stopped voluntarily, they likely decided that they don't need them, and thus are a poor proxy for those who want the blockers but can't get them. The difference is obviously gonna be smaller.

A complaint about statistics: If you _know_ you don't know the true rate of trans folks in the population, there's no reason to believe you know anything about the true distribution at all (in fact all we know for sure is this is not the true distribution!) Many marginalized groups are suppressed diferentially, so we should not expect that the suppressed distribution resembles the true distribution in any way. Young boys and young girls are subject to wildly different social forces, there's no reason to believe there should be any kind of invariance of proportions as those social forces shift.