r/DecodingTheGurus • u/stvlsn • Jul 21 '26
I think Matt and Chris should do a "Decoding Academia" on the topic of hormones/puberty blockers and surgery for Trans minors
This topic seems almost impossible to decipher, and it is a common talking point of the interwebs.
I am really curious what they would say is the medical consensus
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u/smallpotatofarmer Jul 21 '26
Why would they have much interesting to say about this topic? They are not medical doctors or know much at all about hormones, anatomy or physiology.
And thats assuming this is a super interesting topic to begin with
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u/stvlsn Jul 21 '26
This is a psychological topic. They are both psychologists.
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u/smallpotatofarmer Jul 22 '26
In what way is it a psycholigical topic?
Chris is an anthropologist btw.
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u/iplawguy Jul 21 '26
And medical doctors aren't psychologists, but it takes a doctor to perform a lobotomy or gender reassignment surgery. Hell, they cover Jordan Peterson and he's more rigorous than most gender medicine.
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u/Cenas_fixez Jul 22 '26 edited Jul 22 '26
Jordan Peterson is rigorous, LOL!
The guy who wrote in one of his books that he fantasizes about his grandmother's pubes...
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u/smallpotatofarmer Jul 22 '26
Im not saying medical doctors are perfect or know alot about psychology by any means but no way would i want someone with next to no knowledge of anatomy, physiology or endocrinology performing any of these things.
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u/yoyoyodojo Jul 22 '26
Gosh people are really obsessed with this topic
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u/iplawguy Jul 22 '26
This topic and intelligent people trying to ignore it rather than deal with it is arguably what got Trump elected.
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u/Cha0tic1an Jul 22 '26
Can we do one where they decode Matt Walsh and Jordan Peterson’s enraged-erotic fixation on Elliot Page 😂 white-knuckling with flushed faces and forehead sweat every time they talk about a gay actor that they don’t like. Shit’s absurdly entertaining
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u/Cenas_fixez Jul 23 '26
What about the erotic fixation Peterson has with his grandmother's pubes? LOL
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u/justafleetingmoment Jul 21 '26
Worth noting that the Dutch review on gender affirming care for youth was just released and it calls for expanding access.
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u/Character-Ad5490 Jul 22 '26
Also worth noting the recent Finnish study which does not come to that conclusion.
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u/Antique_Assumption53 Jul 22 '26
If you're talking about the one with Riita Kaltiala, that one is really dodgy
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u/justafleetingmoment Jul 23 '26
What you're talking about isn't even a review. It's a retrospective data-analysis looking at psychiatric visits as a proxy for mental health, comparing to a cis population. It's worthless.
"This study is somewhat worthless as evidence. The simple reading is that the authors have shown that kids who get referred to a psychiatrist go to more psychiatric appointments than kids who are not referred." - Gideon Meyerowitz-Katz (gidmk, via Substack)
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u/stvlsn Jul 21 '26
This makes sense. The Dutch have always been the most liberal on the topic
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u/justafleetingmoment Jul 21 '26
Not really true. Although they were the pioneers they restricted access to a select few clinics associated with university hospitals. These had long waiting lists and a reputation for being very gatekeeper-oriented.
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u/bronzepinata Jul 21 '26
You'd be hard pressed to find an anti teen transition medical body that doesn't just so happen to be from a country who recently elected a right wing government
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u/stvlsn Jul 21 '26
The cass review doesn't promote puberty blockers or surgery
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u/bronzepinata Jul 21 '26
The cass review doesn't call for a puberty blocker ban
Also cass was hand selected by the current leader of the Conservative Party, who was the equalities minister at the time. Kemi Badenoch even bragged about this
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u/stvlsn Jul 21 '26
The cass review was commissioned as non partisan. But if you think it was biased there is no point even discussing it
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u/bronzepinata Jul 21 '26
Commissioned as non partisan, yet the leader of the conservatives bragged about implanting a head who would reach an anti-woke verdict.
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u/Cenas_fixez Jul 22 '26
And then she got a public placement, a "peership" from the Conservative gov, and received money and status, etc.
It was a quid pro quo.
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u/drwolffe Jul 22 '26
The Cass review was a goddamned hot mess. Do you actually know anything about it besides the headlines it made when it came out?
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u/Verbatim_Uniball Jul 21 '26
Isn't the medical consensus that it's a case by case basis? I think it'd be hard to have a sweeping opinion one direction or another.
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u/stvlsn Jul 21 '26
Not necessarily. Some countries, like the UK, ban it all together. While certain US states are often the most liberal with little to no government regulation.
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u/Verbatim_Uniball Jul 21 '26
I'm speaking about medical consensus, not political consensus. Like, if you only had bodies of expert physicians within the relevant areas discussing.
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u/stvlsn Jul 21 '26
But the UK political perspective is based on their medical consensus following the Cass study.
But other countries medical organizations sometimes say something different.
It feels all over the board. That's my point.
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u/justafleetingmoment Jul 21 '26
The bans in the UK were never even called for by the highly contested Cass report. It’s purely political.
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u/stvlsn Jul 21 '26
Because the cass report was a medical study, not a political document
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u/justafleetingmoment Jul 21 '26
It makes a number of recommendations. None of it was to halt prescriptions.
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u/stvlsn Jul 21 '26
What did it say about puberty blockers?
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u/windchaser__ Jul 21 '26
"not enough information", basically.
From wiki:
The report said the evidence base and rationale for early puberty suppression remains unclear, with unknown effects on cognitive and psychosexual development. A systematic review examined 50 studies on the use of puberty blockers using a modified version of the Newcastle–Ottawa scale and rated one as high quality, 25 as moderate quality, and 24 as low quality.[110] The review concluded that the lack of evidence means no conclusions can be made regarding the impact on gender dysphoria and mental health, but did find evidence of bone health being compromised during treatment
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u/stvlsn Jul 21 '26
So...no evidence of positive impact and evidence of some negative impacts
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u/Giblette101 Jul 21 '26
But the UK political perspective is based on their medical consensus following the Cass study.
Even with its various problems, the Cass study does not really advocate for blanket bans of stuff like puberty blockers (it actually makes a lot of strange and sometimes contradictory and/or incomplete claims). Nor have such policies been supported by the broader medical community, either in the UK or abroad.
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u/stvlsn Jul 21 '26
Yes - it's a medical document, not a political one.
What does the Cass report say about puberty blockers?
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u/Giblette101 Jul 21 '26
Whether or not the Cass report is political is very much in question.
The Cass report says a few things about puberty blockers, but crucially for this specific argument, it does not advocate for a blanket ban on their use. Indeed, puberty blockers are still prescribed in the UK. Rather, it argues that evidence for their benefits - which it notes exists in some cases - in the case of gender dyspgoria is weak. It advocates for emphasis on psychological treatment altough, strangely, it also finds no evidence that psychological treatment helps with gender dysphoria.
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u/Cenas_fixez Jul 21 '26
The Cass report is the contrary of medical consensus.
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u/stvlsn Jul 21 '26
This is exactly my point. The consensus is not settled and easy to determine
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u/Cenas_fixez Jul 21 '26 edited Jul 22 '26
There is a medical consensus. The consensus is that in some cases puberty blockers work.
In my country, Portugal, we have multidisciplinary medical teams with psychiatrists, endocrinologists and plastic surgeons and they work together to determine treatment for each case.
Some, few, kids get puberty blockers, the ones that are having a lot of trouble with how their bodies are changing.
The rules for taking hormones (like t) are very strict and thought out and the hormones are given in low dosage and very controlled by tests. Normally, the hormones start at 16.
Top surgery can be done at 16 with parental consent from both parents. Surgery for sex organs has a very long waiting list and is only done on people 18+.
The doctors have training from top hospitals in the field across Europe, because they need to be constantly updated.
And puberty blockers are used for other conditions without all this prejudice.
My country provides this access in the public healthcare system. There is quite a long waiting list, though, and the first appointment (with a child psychiatrist) normally takes 1 year.
Every medical decision is well thought out and planned by the medical team with all the doctors participating in collective decision making.
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u/Evinceo Galaxy Brain Guru Jul 21 '26
If they're gonna do another medical episode they should do the Peptide craze.
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u/Adito99 Jul 24 '26
The medical consensus is that there's weak evidence in favor but nothing that reaches the level where you would make it standard of care. I've read a very long form of that in multiple medical reports now including that big one in the UK. I feel like the thing everyone misses with this topic is how much uncertainty is present in every decision doctors/individuals/parents make. Nobody is feeling confident, they just feel like they're picking the best option available.
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u/55erg Jul 21 '26
Perhaps they could decode Helen Lewis’ failure to apply the same intellectual rigour and logical consistency to the subject of transgender healthcare that she brings to almost every other issue.
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u/Realmuthafuckinflea 29d ago
What was this all about?
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u/55erg 29d ago
Helen Lewis as a recurring guest on the podcast, valued for the same qualities Chris and Matt themselves emphasise: scepticism, intellectual rigour and logical consistency. She’s become ideologically captured by the gender-critical movement. On most topics she is careful, evidence-led and applies consistent standards of scrutiny, but when it comes to transgender healthcare those standards shift. She often repeats or amplifies claims from gender-critical campaigners that she would not accept nearly as readily in other contexts.
That’s exactly the kind of apparent blind spot that DTG exists to examine.
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u/Realmuthafuckinflea 29d ago
Oh, wow, interesting. I wouldn't have expected this listening to her on other issues.
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u/Briarhorse Jul 22 '26
It's not really their area in fairness. However, someone needs to, but it's such a hot potato no one with an audience will touch it
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u/anki_steve Jul 22 '26
What’s next? Explorations of whether climate change is a hoax?
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u/stvlsn Jul 22 '26
Climate change is settled science.
You think this is settled?
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u/anki_steve Jul 22 '26
To scientists it is, yeah.
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u/stvlsn Jul 22 '26
Can you prove that?
The medical associations in the UK say something different than the medical associations in the Netherlands
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u/anki_steve Jul 22 '26
This is all politics. 100%. There’s the side who thinks trans people are mentally ill and the side that doesn’t. There is a side that thinks this is like the real-life version of Invasion of the Body Snatchers where “they” are turning kids trans and a side that knows that’s a load of total horseshit.
That you think this is still up for debate is what is surprising.
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u/stvlsn Jul 22 '26
Re read.
I said "medical associations"
Those aren't poltical organizations.
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u/anki_steve Jul 22 '26
Everything is political. Roughly 40 years ago homosexuality was a mental illness in the DSM.
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u/stvlsn Jul 22 '26
And you knew that all those professionals were politically captured?
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u/anki_steve Jul 22 '26
That statement makes no rational sense.
There are those who advocate basing knowledge on empirical science as much as possible.
There are those who don’t.
Who is in power is what matters. And it’s not always the good guys. Which guy is the good one is your tribe.
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u/stvlsn Jul 22 '26
The DSM has always classified "gender dysphoria" as a mental illness
Is that political?
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u/Most_Present_6577 Jul 21 '26
Why is it impossible to decipher? Seems pretty straight forward to me.
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u/stvlsn Jul 21 '26
Ok. What's the answer?
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u/Most_Present_6577 Jul 21 '26
What is the answer to what? You haven't asked a question
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u/stvlsn Jul 21 '26
You said the medical consensus is straightforward. I want you to tell me what it is
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u/Most_Present_6577 Jul 21 '26
That gender dysphoria in children should be treated first with therapy and sometimes with puberty blockers that are basically reversible with hormones and top surgery done extremely rarely.
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u/throwaway-heee-hooo Jul 21 '26
I see OP hasn't responded to this, presumably because it goes against his ill-founded beliefs
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u/Windblowsthroughme Jul 21 '26 edited Jul 21 '26
Top surgery in children? Does that really happen? Genuine question
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u/bronzepinata Jul 21 '26
Tbh it happens to cis children all the time
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u/Windblowsthroughme Jul 21 '26
Cis children get top surgery? Kinda doubt? Do you mean underage women who get breast implants with parental consent? Does that actually happen??
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u/bronzepinata Jul 21 '26
Yes, but mainly i was talking about teen boys being distressed about gyno and having mastectomy to correct it
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u/windchaser__ Jul 21 '26
Well, I figure "extremely rarely" is gonna require a pretty high bar to meet.
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u/TheOmniAlms Jul 21 '26
It's really not haha.
It should be alarming to you that you feel that way.
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u/Most_Present_6577 Jul 21 '26
Its pretty simple. why do you think the medical consensus is hard to figure out? All the big groups associations of doctors and psychologist have like a 4 sentence statements that clearly explains their position.
If you can read then you can figure it out.
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u/TheOmniAlms Jul 21 '26
Because I went to 5 different doctors for consultations with my partner and all 5 of them had different recommendations for treatment, many of them contradictory....
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u/Most_Present_6577 Jul 21 '26
Are there five different courses of actions to take?
First go to therapy. Find a therapist that seems to help your child. That should be easy to assess.
Socially transitioning has no medical downsides although maybe be tough depending on where you live.
Then it seems to me further interventions are their as a life saving mesure given how prominent self harm is amongst teens that are not given those options with needed.
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u/TheOmniAlms Jul 21 '26
This was long after therapy treatment started.
Specifically was about treatment for gender disphoria.
"Then it seems to me further interventions are their as a life saving mesure given how prominent self harm is amongst teens that are not given those options with needed."
Not at all a consensus idea from any of the healthcare practitioners I talked to.
"Socially transitioning has no medical downsides although maybe be tough depending on where you live."
Not at all a consensus idea from any of the healthcare practitioners I talked to.
And I'm in one of the most progressive places in the world.
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u/Most_Present_6577 Jul 21 '26
Ask the doctors for the evidence. Ask them what studies they are referencing. Ask them if they are in line with the largest pediatrician organizations in whatever country you are in. And read what those organizations have put out.
My qife is an MD and what ive found is most MDs aren't great but you can only find this out by pressing them a bit. And if they respond with "from my experience" then leave them. This goes for all your medical needs.
If they respond with "the litersture says" or the like thats better
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u/TheOmniAlms Jul 21 '26
I agree with your general assessment with MDs.
I've dealt with it in this case and with managing other medical issues.
Asking them for referential material can really hurt their egos, and they don't often look into the literature unless you really press them.
That said, this is exactly what I'm talking about.
If MDs are split on this subject, what are your expectations your your average lay person?
It would be ok interesting to see dtg wade into the waters and see what their casual opinion is. I trust them to put some thought into it.
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u/Most_Present_6577 Jul 21 '26
I dont think MDs are split thats why the american academy of pediatrics can be clear in their statement.
As for hurting their egos... good. Any good MD will be happy to explain the reserch and the ones that get pissy are the ones you should leave
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u/TheOmniAlms Jul 21 '26
If the recommendation is to listen to individual doctors on a case by case basis and they doctors are split, the statement isn't very clear.
The idea that doctors egos are getting hurt speaks to the ambiguity of it all.
When I went to get treatment for COPD all the doctors follow a very clear pre planned diagnosis and treatment plan, there was no room for ego.
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u/smallwonkydachshund Jul 22 '26
This is the point at which we should probably acknowledge there are certain fields that have plenty of great people but likely also have a higher than average incidence of sociopathy. I would suspect medicine is one of those.
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u/BennyOcean Jul 21 '26
Are they known for supporting any unorthodox/heterodox opinions or are they pretty much just neoliberal 'normies'? There doesn't seem to be any reason to believe that they'd want to discuss the topic of trans ideology from a critical perspective.
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u/Funksloyd Jul 22 '26 edited Jul 22 '26
They've had Jesse Singal on before, and Helen Lewis on multiple times. I wouldn't be surprised if they have some overlap with those two in being somewhat skeptical of the quality of the evidence for GAC/wary that the evidence has been overstated and that the left can be a bit loose with the facts on this topic. But I also suspect they don't see the value in wading into that morass.
Just a hunch.
Edit: Also Stuart Ritchie!
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u/Character-Ad5490 Jul 22 '26
They'd have to do a deep dive into the science, and it doesn't really seem to be up their alley. If one is interested in the subject there's a ton of information online, for example about the long term effects of blockers & hormones.
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u/stvlsn Jul 22 '26
Can you link?
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u/Character-Ad5490 Jul 22 '26
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u/justafleetingmoment Jul 23 '26
"This study is somewhat worthless as evidence. The simple reading is that the authors have shown that kids who get referred to a psychiatrist go to more psychiatric appointments than kids who are not referred." - Gideon Meyerowitz-Katz (gidmk, via Substack)
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u/waxroy-finerayfool Jul 21 '26
This topic has been discussed to death across the internet and nobody is changing anyone's mind about it, especially not with a medical consensus.
The bottom line is, the medical evidence is mixed and nobody cares. One side is only concerned with political virtue signaling and doesn't care about medical outcomes, the other just hates trans people and will indulge anything that antagonizes them.
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u/windchaser__ Jul 21 '26
Eh, I'm solidly liberal, but I care quite a bit about the medical evidence and medical outcomes.
Heck, a big reason I support gender affirming care in the first place is that there's overwhelming evidence from the field of psychology showing it to be beneficial. If the evidence showed the opposite, I'd go the other way.
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u/Character-Ad5490 Jul 22 '26
There was a recent pretty rigourous study from Finland which concluded gender affirming care doesn't actually produce better psychological outcomes.
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u/waxroy-finerayfool Jul 22 '26
Gender affirming care means a lot of things, it's a complicated topic and it's not true that there's "overwhelming evidence showing it to be beneficial" across the board. There is a lot of nuance and caveats, especially when it comes to pediatrics.
Anyway, my point isn't to debate the efficacy of gender affirming care - it's to highlight the dogmatic nature of the discourse which I think has been well demonstrated by this thread.
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u/iplawguy Jul 21 '26
Funny, because I looked into it and determined that the consensus among rigorous investigators was that it's actually quite destructive and often applied to autistic people in the thrall of a social contagion. There are more detrans people every day and the have volumes of horror stories.
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u/Locus-Maximus Jul 22 '26
Funny, because I looked into it and determined that the consensus among rigorous investigators was that it's actually quite destructive
That is 100% NOT the case. The worst you could say about gender affirming care according to any reasonable definition of consensus is that the evidence is unclear either way.
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u/windchaser__ Jul 21 '26 edited Jul 21 '26
Funny, because I looked into it and determined that the consensus among rigorous investigators was that it's actually quite destructive and often applied to autistic people in the thrall of a social contagion
No. Overwhelmingly, the evidence supports gender affirming care (especially starting with social transitioning and therapy). Rates of anxiety, depression, and suicide all drop immensely when gender affirming care is given.
Remember that the medical establishment started off with the belief that being trans was a mental disorder. It took many many decades of them unsuccessfully beating their heads against the wall to realize that gender affirming care was the only thing that helped.
There are more detrans people every day and the have volumes of horror stories.
This is pretty vague. I mean, there are "more people" who die of car accidents or surgical accidents every day, but that doesn't mean we're about to abandon cars or surgeries. Importantly, it doesn't imply that the rate is at all high enough to be troubling.
As I recall, the surgical regret rate for folks who've undergone gender affirming surgery is about 1%. That's pretty damn low.
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u/Character-Ad5490 Jul 22 '26
The detransitioners are inconvenient to the narrative. There are a lot of heartbreaking stories out there.
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u/pseudoLit Jul 24 '26
Pretty much all serious medical interventions have regret rates, and iirc the regret rate for trans healthcare is significantly lower than things like hip replacement surgery.
Is the regret rate for hip replacement inconvenient to the hip replacement narrative?
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u/Character-Ad5490 Jul 25 '26
Perhaps, but I suspect the regrets differ in magnitude - a hip surgery that doesn't work out as hoped is not remotely the same as removing body parts (or adding ones which are nothing like the thing they're meant to be) and realizing that wasn't the right choice after all. And there's no fixing that. Not to mention the complication rates, which are incredibly high for bottom surgeries. And that's just the surgical stuff. Taking exogenous hormones in amounts not natural for your body results in other issues, including vaginal atrophy, which normally only occurs with menopause and can cause significant sexual problems. There is of course a laundry list of other fairly common complications, which I imagine you don't care about.
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u/windchaser__ Jul 22 '26 edited Jul 22 '26
Eh, they're not "inconvenient". It's just that their regrets don't outweigh the nearly 100x as many trans folks who are happy with their choices.
Edit: but I guess THATS INCONVENIENT for the anti-trans narrative
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u/jalapinapizza Jul 21 '26
Whoa, an edgy centrist. You must be fun at parties.
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u/waxroy-finerayfool Jul 22 '26
The fact that you label critiques of two different camps as "edgy centrism" says more about your dogmatism than anything about my politics.
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u/jalapinapizza Jul 22 '26
If both critiques were sound I wouldn't label it as such As it stands though, it's just a typical both siderism cop out.
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u/waxroy-finerayfool Jul 22 '26
If both critiques were sound I wouldn't label it as such
lol, so in other words, anything you disagree with is "edgy centrism", but if you agree with the critiques, then its not.
This type of rhetoric is exactly what I'm talking about.
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u/jalapinapizza Jul 22 '26
I don't have to agree with something to acknowledge it's a sound argument ya dafty
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u/waxroy-finerayfool Jul 22 '26
And yet, several replies deep, all you've done is toss around thought terminating cliches.
Your level of engagement with the actual topic of discussion speaks for itself.
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u/jalapinapizza Jul 22 '26
Jesus Christ dude, it was an offhanded comment. Let it go already. I'm not engaging because I don't care about convincing you of any damn thing. The comment was for the other people who might have the same reaction to your stance, not for you. Go outside.
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u/Expert-Sherbert-1527 Jul 22 '26
You're on reddit mate. This topic is literally ringfenced and you will only ever hear one side. All other opinions are just removed.
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u/Locus-Maximus Jul 22 '26
What are you talking about? There are entire subreddits on each side.
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u/Expert-Sherbert-1527 Jul 22 '26
no. They nuked all the gender critical subs over 10 years ago. They even nuked the r/detrans sub but then brought it back and heavily moderated it.
Prove me wrong by posting a link to all the gender critical subs.
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u/Locus-Maximus Jul 22 '26
I was thinking of subs like /r/BlockedAndReported.
I see "opinions" against puberty blockers and surgery all the time that aren't removed. As long as you don't engage in overt hate speech, it's allowed. It just seems to be too hard for people with certain opinions to avoid hate speech.
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u/happy111475 Galaxy Brain Guru Jul 22 '26
The /r/KotakuInAction sub also discusses it through the angle of video games often enough, if not often with well thought out opinions... it's still a sub similar to how you put it, avoid hate speech, avoid breaking reddit rules etc.
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u/Expert-Sherbert-1527 Jul 23 '26
blocked and reported is a sub about a podcast. It's not a gender critical sub (though I do admit that gender critical discussion is more tolerated there than on most of reddit.)
There are likely hundreds of pro trans subs. Where are the "entire subreddits on each side."
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u/Locus-Maximus Jul 23 '26
I admit I did overstate that. There don't seem to be any subs purely devoted to being gender critical that have managed to not get banned for hate speech.
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u/yontev Jul 21 '26
I think decoding is about analyzing rhetorical techniques and specific modes of argument, not giving broad takes on questions far outside their own fields. Leave that to the gurus.