A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children

ABSTRACT

Background: It has been widely suggested that over 80% of transgender children will come to identify as cisgender (i.e., desist) as they mature, with the assumption that for this 80%, the trans identity was a temporary “phase.” This statistic is used as the scientific rationale for discouraging social transition for pre-pubertal children. This article is a critical commentary on the limitations of this research and a caution against using these studies to develop care recommendations for gender-nonconforming children.

Methods: A critical review methodology is employed to systematically interpret four frequently-cited studies that sought to document identity outcomes for gender-nonconforming children (often referred to as “desistance” research).

Results: Methodological, theoretical, ethical, and interpretive concerns regarding four “desistance” studies are presented. The authors clarify the historical and clinical contexts within which these studies were conducted to deconstruct assumptions in interpretations of the results. The discussion makes distinctions between the specific evidence provided by these studies versus the assumptions that have shaped recommendations for care. The affirmative model is presented as a way to move away from the question of, “How should children's gender identities develop over time?” toward a more useful question: “How should children best be supported as their gender identity develops?”

Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities.     

Does Taves reconsider experience enough? A critical commentary on religious experience reconsidered

Three problems beset Ann Taves' thought-provoking book. The first is her failure to recognize that her focus on “experiences deemed religious” makes just as many metaphysical claims as does the focus on “religious experiences” that she seeks to replace. Second, her building-block definition of religion drops her into the middle of controversies over the nature of religion, rather than rescuing her from them. Third, her approach embodies a peculiarly North American cultural ambiguity about religion: on the one hand, it contains an abstract democratic affirmation of the importance of studying people's beliefs and practices on their own terms; on the other hand, it pairs to this a concrete sense of horror at what those beliefs and practices actually are.     

Confirmation and justification. A commentary on Shogenji’s measure

So far no known measure of confirmation of a hypothesis by evidence has satisfied a minimal requirement concerning thresholds of acceptance. In contrast, Shogenji’s new measure of justification (Shogenji, Synthese, this number 2009) does the trick. As we show, it is ordinally equivalent to the most general measure which satisfies this requirement. We further demonstrate that this general measure resolves the problem of the irrelevant conjunction. Finally, we spell out some implications of the general measure for the Conjunction Effect; in particular we give an example in which the effect occurs in a larger domain, according to Shogenji justification, than Carnap’s measure of confirmation would have led one to expect.     

The octopus and the child—Another perspective on American culture: A commentary on Stearns

Stearns argues that, in the twentieth century, American parents increasingly treated their children as frail and vulnerable. But the parental protectiveness that he describes is only one part of the story. Some American parents did hover over their children; others ignored, neglected, or abused them. Some did shore up their suspect self-esteem; others trusted in their strength and sturdiness and even demanded a new toughness and competitiveness. American culture is more complicated and contested than Stearns allows.     

Human dignity and technology: A study and commentary∗

Several contradictory definitions were provided for evolution. It was viewed as progress or as local adaptation, as widening or as exploiting of transformation perspectives, as emergence of non‐historical patterns or as history of Life.

The conflicting views of evolution can be reconciled by taking the rival terms as different moments, or phases, of a single process. The first phase is form creation, the second is form selection. Progress and adaptation, widening and reduction of perspectives, emergence and history orderly mark the two successive phases.

Dynamic Structuralism and Darwinism differ in the preferential emphasis they put, respectively, in the first or in the second phase. According to structuralists, mere history does not depict a process: nothing can happen outside a frame, without a grid of meanings. A chance event, a non‐intelligible event is not a fact. A set of generative principles, of rules of form, is required both to produce evolution and to make it understandable.

By entrusting innovation to chance the Darwinian historical view is essentially pessimistic. Any small step forward can only be achieved at a price of innumerable sacrifices, and only the very few survive. In the dynamic structuralist view, forms (e.g. the mild “splash” by D'Arcy Thompson) emerge spontaneously and immediately, with no need of countless failures. They express concealed potentialities, explore the varied inventory of Nature, and do not result from the meaningless trouble of history.     

Carson Strong's “positive killing and the irreversibly unconscious patient”: A commentary

There is general agreement that death of the entire brain results in death of the person, and that such a condition can exist in a body which is still technically “alive.”1,2 Dr. Strong additionally contends that in cases of irreversible coma, since cognitive abilities characteristic of the person are no longer manifest and cannot be expected to reappear, such an individual no longer has the “right to life” and somatic death can be initiated by “positive killing.” This, the author claims, can be considered a logical and morally acceptable extension of the conceptual framework now in force for dealing with cases of isolated brain death.     

How to play the flute: A commentary on Dreyfus's “Intelligence without representation”

Phenomenology and the Cognitive Sciences -     

Why did Tiger Woods shoot 82? A commentary on

In a recent article, Toner and Moran (2015) argued that athletes need to pay conscious attention to body movements, and that an external focus of attention would not be effective for continued improvement at the elite level. Their arguments appear to be based on misunderstandings of the attentional focus literature. In this commentary, I clarify that adopting an external focus does not imply that performers are not aware of their body movements. Rather, an external focus (i.e., focusing attention of the intended movement effect) refers to the preparation of movement execution. I maintain that an external focus is necessary to optimize performance and learning at any level of performance.     

The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender non-conforming children” by Temple Newhook et al. (2018)

ABSTRACT

Temple Newhook et al. (2018) provide a critique of recent follow-up studies of children referred to specialized gender identity clinics, organized around rates of persistence and desistance. The critical gaze of Temple Newhook et al. examined three primary issues: (1) the terms persistence and desistance in their own right; (2) methodology of the follow-up studies and interpretation of the data; and (3) ethical matters. In this response, I interrogate the critique of Temple Newhook et al. (2018).     

Does the philosophy of medicine exist? A commentary on Caplan

Caplan has argued that the philosophy of medicine does not exist. Although I will not deny the points he makes, I will argue that the philosophy of medicine has characteristics of a developing field with the potential to meet all of Caplan's criteria. The argument is based on Dewey's established views on logical development for a field of inquiry, as well as pointing out how other criteria Caplan imposes can be fulfilled.The U.S. Government right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged.     

How critical is “critical thinking”?

Before criticism is justified, an account of the applicable criteria should be given. This task concerns first of all the well-known logical principles of identity, contradiction and the excluded middle. They connect critical thinking to the conceptual element of rationality and to the normed nature of logical thinking, manifest in logically sound (norm-conformative) thinking and antinormative thinking—briefly also accounting for the dialectical tradition. An analysis of these principles requires an understanding of the uniqueness of, and coherence between, the logical and non-logical aspects in the light of contraries like logical-illogical, polite-impolite and frugal-wasteful. It also questions the idea of autonomy and examines the switch from principles to values. When a school of thought does not accept all the logical principles, the criteria for scientific thinking are challenged, for example in intuitionistic logic which rejects the universal validity of the principle of the excluded middle. It is then argued that the principle of sufficient reason and that of the excluded antinomy points at a more than logical foundation for critical thinking and ultimately calls for a non-reductionist ontology.     

A place for nouns and a place for verbs? A critical review of neurocognitive data on grammatical-class effects

It is generally held that noun processing is specifically sub-served by temporal areas, while the neural underpinnings of verb processing are located in the frontal lobe. However, this view is now challenged by a significant body of evidence accumulated over the years. Moreover, the results obtained so far on the neural implementation of noun and verb processing appear to be quite inconsistent. The present review briefly describes and critically re-considers the anatomo-correlative, neuroimaging, MEG, TMS and cortical stimulation studies on nouns and verbs with the aim of assessing the consistency of their results, particularly within techniques. The paper also addresses the question as to whether the inconsistency of the data could be due to the variety of the tasks used. However, it emerged that neither the different investigation techniques used nor the different cognitive tasks employed fully explain the variability of the data. In the final section we thus suggest that the main reason for the emergence of inconsistent data in this field is that the cerebral circuits underlying noun and verb processing are not spatially segregated, at least for the spatial resolution currently used in most neuroimaging studies.     

A remark on tucker and Messick's “points of view” analysis

It is shown that to combine readings from points of view configurations as assumed in Tucker and Messick's model is not to combine configurations in any simple way. Both empirical and logical consequences of the disparity are discussed.     

The three-systems-model of fear and emotion—A critical examination

The ‘Three-Systems-Model’ of fear and emotion (Lang, 1968; Rachman. 1978b) is reviewed and discussed. The paper is centered on four topics relevant to such a view of fear; The definitional focus; Measurement and quantification of components; Implications for etiology; Implications for treatment of phobias. Definitional problems with the radical operationalist view implied by the Tree-Systems-Model are identified and discussed. In addition problems with measurement and quantification of the various components are discussed. Implications for etiology of phobic fears are noted. Finally, it is suggested that treatment methods be individually tailored to the particular component response-profile displayed by each patient, and that the identification of such a profile is included in standard behavioral diagnosis procedures when fear is clinically assessed.     

“Intelligence and Civilisation”: A Ludwig Mond lecture delivered at the University of Manchester on 23rd October 1936 by Godfrey H. Thomson. A reprinting with background and commentary

Here we reprint, and provide background and a commentary on, a recently-rediscovered lecture by Godfrey H. Thomson entitled, “Intelligence and civilisation.” It was delivered at the University of Manchester, UK, on 23rd October, 1936, printed in 1937 in the short-lived Journal of the University of Manchester and as a pamphlet in Edinburgh. It was one in the series of lectures supported by the industrialist and philanthropist Ludwig Mond. The lecture is unusually valuable in that it places the theory, testing and practical application of intelligence against the background of the rise of fascism and its threat to civilisation. The lecture is a candid and accessible ‘confession and contemplation'; the frank thoughts of a person committed to, but critical of, intelligence testing and theory, but convinced of the power and place of intelligence differences in people's lives and in civilisation. It comes at an important time for Thomson, with regard to three of his major achievements: his Moray House Test series, the Scottish Mental Survey of 1932 (and the Northumbrian testing exercise that preceded it), and the preparation of his book The Factorial Analysis of Human Ability. The understanding of the lecture is enhanced by recently-discovered archive materials on Thomson and his circle. ([Thomson, G.H. (1937a). Intelligence and civilisation: A Ludwig Mond lecture delivered at the University of Manchester on October 23rd, 1936. Journal of the University of Manchester, 1, 18–38], from the Ludwig Mond lecture).