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.     

The Effect of PTSD Symptom Change on Suicidal Ideation in a Combined Military and Civilian Sample Engaged in Cognitive Processing Therapy

In light of the well-established relationship between posttraumatic stress disorder (PTSD) and suicidal ideation (SI), there has been a push for treatments that simultaneously improve symptoms of PTSD and decrease SI. Using data from a randomized controlled hybrid implementation-effectiveness trial, the current study investigated the effectiveness of Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2016) on PTSD and SI. The patient sample (N = 188) was diverse in military and veteran status, gender, and comorbidity, and 73% of the sample endorsed SI at one or more points during CPT. Participants demonstrated significant improvement in SI over the course of CPT. Multilevel growth curve modeling revealed a significant association between PTSD symptom change and change in SI. Results from cross-lagged multilevel regressions indicated that PTSD symptoms predicted SI in the next session, yet SI in a given session did not predict PTSD symptoms in the next session. Potentially relevant clinical factors (i.e., military status, gender, depression diagnosis, baseline SI, study consultation condition) were not associated with the relationship between PTSD symptoms and SI. These results add to the burgeoning literature suggesting that evidence-based treatments for PTSD, like CPT, reduce suicidality in a range of individuals with PTSD, and that this reduction is predicted by improvements in PTSD symptoms.     

Linking Executive Function and Peer Problems from Early Childhood Through Middle Adolescence

Peer interactions and executive function play central roles in the development of healthy children, as peer problems have been indicative of lower cognitive competencies such as self-regulatory behavior and poor executive function has been indicative of problem behaviors and social dysfunction. However, few studies have focused on the relation between peer interactions and executive function and the underlying mechanisms that may create this link. Using a national sample (n?=?1164, 48.6 % female) from the Study of Early Child Care and Youth Development (SECCYD), we analyzed executive function and peer problems (including victimization and rejection) across three waves within each domain (executive function or peer problems), beginning in early childhood and ending in middle adolescence. Executive function was measured as a multi-method, multi-informant composite including reports from parents on the Children’s Behavior Questionnaire and Child Behavior Checklist and child’s performance on behavioral tasks including the Continuous Performance Task, Woodcock-Johnson, Tower of Hanoi, Operation Span Task, Stroop, and Tower of London. Peer problems were measured as a multi-informant composite including self, teacher, and afterschool caregiver reports on multiple peer-relationship scales. Using a cross-lagged design, our Structural Equation Modeling findings suggested that experiencing peer problems contributed to lower executive function later in childhood and better executive function reduced the likelihood of experiencing peer problems later in childhood and middle adolescence, although these relations weakened as a child moves into adolescence. The results highlight that peer relationships are involved in the development of strengths and deficits in executive function and vice versa.     

SCIENCE EDUCATION AND MORAL EDUCATION

Abstract. Both science and ethics are embedded in cultural traditions where truths are shared through education; both need competent critics educated within such traditions. Education in both ought to be directed although moral education demands levels of responsible agency that science education does not. Evolutionary science often carries an implicit or explicit understanding of who and what humans are, one which may not be coherent with the implicit or explicit human self-understanding in moral education. The latter in turn may not be coherent with classical human self-understandings. Moral education may enlighten and elevate the human nature that has evolved biologically.     

Statistical versus clinical significance in research with the MMPI

Some of the contradictions in psychological research may be attributable to failure to distinguish statistical from clinical significance. 82 articles in which the MMPI was the research instrument were analyzed to see how often the results reported as significant were in fact large enough to warrant such a conclusion. Articles were classified as to whether or not the clinical interpretations were consistent with the statistical results. Excluding articles in which data were insufficient to reach an independent conclusion, 54.90% of the articles presented conclusions of clinical significance that were not supported by the data, while 45.10% reported clinical results that were supported by the data.     

Evidence for a difference in syntactic knowledge between skilled and less skilled adult readers

In two experiments, we investigated the relationship between reading ability and linguistic knowledge in adults. The results from Experiment 1 showed that good comprehenders performed more accurately than average comprehenders in a syntactic-judgment task that required them to decide whether pairs of words served the same grammatical function in sentences. By contrast, the reader groups performed similarly when required to make semantic judgments about whether pairs of words were related in meaning. In Experiment 2, individuals were classified according to comprehension level and reading speed. Good comprehenders again performed more accurately than average comprehenders in the syntactic task but not the semantic task. We argued that differences in form-class knowledge could be associated with corresponding differences in syntacticprocessing efficiency, and thus with variation in reading-comprehension skill generally.     

Haptic perception of texture gradients

To pick up 3-D aspects of pictures is arguably the most difficult problem concerning tactile pictorial perception by the blind. The aim of the experiments reported was to examine the potential utility of texture gradients in this context. Since there is no theoretical basis for predicting absolute values of 3-D properties from 2-D patterns read by the finger pads, the abilities of participants to perceive gradients lying between known maxima and minima were assessed. Experiment 1 involved blindfolded sighted participants making verbal magnitude estimations of texture-gradient magnitudes corresponding to plane surfaces at different slants. In experiment 2 the participants' task was to orient a surface at a slant corresponding to the texture gradients depicted tactually, and experiment 3 required early-blind participants to attempt the same task. The results revealed that participants can scale the magnitudes of texture gradients with high precision and that they can also accurately produce surface slants from depictions, providing the extreme conditions are clearly defined and there are opportunities for learning. Texture gradients appear as informative to the blind as they do to the sighted. To what extent these data can be generalised to other gradients and textures or to other projections of 3-D scenes remains to be investigated.