ABSTRACT The American Academy of Pediatrics (AAP) recently published a policy statement: Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.
Although almost all clinics and pro-fessional associations in the world use what’s called the watchful waiting approach to helping gender diverse (GD) children, the AAP statement instead rejected that consensus, endorsing gender affirmation as the only acceptable approach.
Remarkably, not only did the AAP statement fail to include any of the actual outcomes literature on such cases, but it also misrepresented the contents of its citations, which repeatedly said the very opposite of what AAP attributed to them.
The AAP statement was also remarkable in what it left out—namely, the actual outcomes research on GD children. In total, there have been 11 follow-up studies of GD children, of which AAP cited one (Wallien & Cohen-Kettenis, 2008), doing so without actually mentioning the out-come data it contained.
The literature on outcomes was neither reviewed, summarized, nor subjected to meta-analysis to be considered in the aggregate—It was merely disappeared.
As they make clear, every follow-up study of GD children, without exception, found the same thing: Over puberty, the majority of GD children cease to want to transition.
With regard to gender identity, AAP wrote: “[C]onversion” or “reparative” treatment models are used to prevent children and adolescents from identifying as transgender or to dissuade them from exhibiting gender-diverse expressions. ...
Reparative pproaches have been proven to be not only unsuccessful but also deleterious and are considered outside the mainstream of traditional medical practice.
AAP’s claims struck me as odd because there are no studies of conversion therapy for gender identity. Studies of conversion therapy have been limited to sexual orientation, and, moreover, to the sexual orientation of adults, not to gender identity and not of children in any case.
I started checking AAP’s citations for that, and these sources too pertained only to sexual orientation, not gender identity (specifics below). What AAP’s sources did repeatedly emphasize was that:
A. Sexual orientation of adults is unaffected by conversion therapy and any other [known] intervention; B. Gender dysphoria in childhood before puberty desists in the majority of cases, becoming (cis-gendered) homosexuality in adulthood, again regardless of any [known] intervention; and
作者開始檢查 AAP的引用，這些來源也只與性取向有關，而不是性別認同（具體如下）。 AAP 的消息來源反復強調的是： A. 成人的性取向不受扭轉療法和任何其他 [已知] 干預的影響； B. 在大多數情況下，青春期前兒童的性別焦慮最終會停止，成年後成為（順性別的）同性戀，不管任何[已知的]干預；和 C. 在青春期後持續存在的性別不安往往會持續存在。
That is, in the context of GD children, it simply makes no sense to refer to externally induced “conversion”: The majority of children “convert” to cisgender or “desist” from transgender regardless of any attempt to change them.
“Conversion” only makes sense with regard to adult sexual orientation because (unlike childhood gender identity), adult homosexuality never or nearly never spontaneously changes to heterosexuality.
Although gender identity and sexual orientation may often be analogous and discussed together with regard to social or political values and to civil rights, they are nonetheless distinct—with distinct origins, needs, and responses to medical and mental health care choices.
補翻一小段 AAP divided clinical approaches into three types—conversion therapy, watchful waiting, and gender affirmation. It rejected the first two and endorsed gender affirmation as the only acceptable alternative. Most readers will likely be familiar already with attempts to use conver sion therapy to change sexual orientation.
google機翻潤飾之摘譯
The American Academy of Pediatrics (AAP) recently published a policy statement: Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.
美國兒科學會 ( AAP）最近發表了一份政策聲明：〈為跨性別及多元性別的兒童和青少年提供全面的照顧與支持〉。儘管世界上幾乎所有診所和專業協會都使用所謂的「觀察等待」來幫助多元性別 (GD) 兒童，但 AAP 的聲明卻拒絕接受這項共識，反而認可「性別肯認療法」是唯一可接受的方法。
“[C]onversion” or “reparative” treatment models are used to prevent children and adolescents from identifying as transgender or to dissuade them from exhibiting gender-diverse expressions. ...
B. Gender dysphoria in childhood before puberty desists in the majority of cases, becoming (cis-gendered) homosexuality in adulthood, again regardless of any [known] intervention; and
A. 成人的性取向不受扭轉療法和任何其他 [已知] 干預的影響；
B. 在大多數情況下，青春期前兒童的性別焦慮最終會停止，成年後成為（順性別的）同性戀，不管任何[已知的]干預；和
C. 在青春期後持續存在的性別不安往往會持續存在。
1.AAP引用美國兒童和青少年精神病學學會（AACAP）的實踐指南，該指南僅針對性取向，說明不該對同性戀實施扭轉治療，而AAP把針對性取向的研究擴張到性別認同上。實際上AACAP認為跨性別相關研究還不夠多，認為還是該持續觀察到成年
3.第三份研究根本沒有提到扭轉療法，而是認為可以把荷爾蒙治療的年齡從18下修到16歲，而12歲可以先用青春期阻斷劑來延長青少年探索時間
4.第四份研究討論同性戀從DSM除病化，而娘娘腔和tomboy被劃入DSM中的歷史，跟扭轉治療無關，作者表示他不懂AAP幹嘛引這個
作者認為「觀察等待」才是目前幫助多元性別 (GD) 兒童的合理且有依據的方法，肯認治療沒有研究支持，任何對同性戀（性取向）的研究，不能直接套用在性別認同上，性取向與性別認同從本質上就不同。AAP這種誤讀甚至扭曲原意的做法不可取。
感謝兩個月前提供論文的chick6108旅人（噗），之所以過了兩個月才想要翻譯這篇文章，是因為看到偷偷說出現的HP討論區之為什麼要封殺JK羅琳，挺跨方的論點實在太荒謬了，而且作為一個HP原作粉，我對他們取消羅琳非常憤怒
更別提他後來簡直仇女的種種發言
該文最後有說明：這些等位基因的變異在順性別的個體中也存在，把這些研究的發現解釋為造成跨性別的突變基因是不恰當的。
他引的文章：
這就跟「邪惡的基因」一樣，不是絕對
但C8的扭轉是指：一個醫生看診時，患者說他喜歡同性，他可能是跨性別（另一個性別），醫生說沒有你只是普通的同性戀→這是在扭轉他跨性別認同的治療；又或是醫生診斷出患者只是因為壓力或其他精神疾病，導致有變性欲（後發）而非原生變性欲，於是建議患者治療精神疾病→你這是在扭轉他跨性別認同！
就作者看到的那些文獻，扭轉治療是針對成人同性戀（因為成人同性戀的性向很少出現自發性改變，才需要強行扭轉），但AAP認為扭轉治療也被施行在小孩子身上，而這裡的扭轉治療與我們一般認知的電擊、吃藥、厭惡治療等不太一樣，很可能就單純是指告訴孩子他並不是跨性別（事實上很多孩子確實不是），作者再進一步闡述，針對孩子討論扭轉治療是沒有意義的，因為孩子的性別認同很可能會自發性地改變，無論有沒有經過扭轉治療，這與成人同性戀完全不同
作者同時指出目前的醫學共識，對性別不安的兒童應該要觀察並等待他探索自己的性別認同
AAP divided clinical approaches into three types—conversion therapy, watchful waiting, and gender affirmation. It rejected the first two and endorsed gender affirmation as the only acceptable alternative. Most readers will likely be familiar already with attempts to use conver sion therapy to change sexual orientation.
Correlation當cause兩篇，一篇是不管品質好壞的文章都搜集來統整的review，最後一篇是個案。所謂最後一個是個案，意思是資料不足/沒有對照組/數量不足，只是單純的個案描述(case report)。
沒有研究價值的垃圾。如果有其他旅人想進行學術交流的話也可以等他們提出！
從那個網頁的敘述中也能看出，目前還沒有找到性別認同是天生的證據，因為順性別也會有相似的基因，所以跨性別天生論在目前的研究上根本站不住腳
但旅人的核實結果比我以為的還扯，沒想到原本的研究參考性就很不足了嗎……好扯……