More and more, concern trolls are hijacking the discussion about transgender people in society. A concern troll is a person who participates in a debate posing as an actual or potential ally who simply has some concerns they need answered before they will ally themselves with a cause. In reality they are a critic, or flat out someone who wishes harm upon the transgender community. The ultimate goal of concern troll is usually to keep transgender people marginalized, mistreated and without legal protections.
The best that can be said of these concern trolls is that they have a very limited playbook. Never fear, though! As a community service, here are the key phrases and ideas that will help you spot them immediately.
1. Concern Troll says, "Transgender people often regret..."
Any time the subject of regret comes up in the media, it's usually in the context of denying transgender people affirming care, or preventing them from transitioning. Because concern troll is very worried about the well being of transgender people, and doesn't want them to rush into anything. Really.
The reality is that the existing guidelines for the treatment of transgender people are designed to prevent people from rushing into transition already, and follow a conservative timeline in order to prevent misdiagnoses. As a result virtually every modern study puts regret below 2 percent. In some other recent longitudinal studies, none of the subjects expressed regret over medically transitioning. When people cited in anecdotes do have regrets, it is mostly because of lack of acceptance, or poor surgical outcomes.
In short, concern troll is more worried about the 1 percent of transgender people who MIGHT not benefit from transition, at the expense of the 99 percent who will.
2. Concern Troll says, "What if society completely accepted gender variance? Then we wouldn't have to..."
This line of thinking usually finishes with "give transgender people medical care," or "need laws protecting transgender people." The entire concept is asinine at many levels.
First, the idea of culturally abolishing the concept of gender is about as likely as humanity abolishing the concept of money.
Next, the idea that we should aim for a perfect society rather than have a system of laws that takes into account how humans have historically harmed each other isn't aiming for utopia. It is snake oil sold by rich, heterosexual white male Christian libertarians who like the fact that being a rich, heterosexual white male Christian is a position of unrivaled privilege.
Beyond that, concern troll ignores the reality of being transgender. They deliberately conflate gender identity, gender expression and ignore the nature of dysphoria in order to sow doubt with readers. They push the notion that if transgender people (well, transgender women, concern troll ignores transgender men) could just put on 50's vintage house dress and flounce around without fear of harassment (and that's a huge assumption to begin with), then we wouldn't have to give those people any medical care.
This completely ignores the reality that transgender people have to look at ourselves in a mirror. Increasing societal acceptance of gender non-conformance does NOTHING to alleviate dysphoria. Minority stress (social pressure and isolation) and dysphoria are two entirely separate concepts.
Why does concern troll say these things? Because it's good to be the king.
3. Concern Troll says, "80 percent of children with cross gender identification desist..."
This comes from a Danish study. However, the actual study doesn't support this conclusion. First, it didn't discriminate between gender non-conforming children and those with insistent, consistent and persistent cross gender identification. Basically, the boys who liked playing with "My Little Pony" and sparkly dresses got lumped in with the ones who announce at 18 months they're a girl, and keep it up for years.
The Danish study also lost track of a lot of the kids enrolled in it, and counted all the children they could not account for as "desisters." The American Psychological Association states that, "this research runs a strong risk of inflating estimates of the number of youth who do not persist with a TGNC identity."
The biggest proponent of the 80 percent narrative, Dr. Kenneth Zucker, pushed the idea that coercive behavior modification therapy could be used on children to change their sexual orientation for decades. Now that changing sexual orientation is passé, he's selling the same snake oil as a "cure" for transgender children. As a result of concerns over whether his "treatments" are ethical, Dr. Zucker's own clinic has forbidden him from taking on new patients.
More recent research has shown that transgender children, and not ones who are simply gender non-conforming, have a gender identity that is as consistent as that of cisgender children. Children who identify more intensely with a gender different than sex assigned at birth are more likely to persist in this gender identification into adolescence and that when gender dysphoria persists through childhood and intensifies into adolescence, the likelihood of long‐term TGNC identification increases.
There is also a growing body of evidence that practices like Zucker's are actively harmful (Hill et al., 2010; Pyne, 2014; Travers et al., 2012; Wallace & Russell, 2013), and that supporting transgender children leads to better mental health outcomes. As a result, there are fewer and fewer professionals who promote rejection of a child and their interests.
When it comes to adolescents, even proponents of the 80 percent figure (like Zucker) admit that if an adolescent has across gender identification, it is very unlikely to ever change.
So why does concern troll keep bringing up the 80 percent figure? Because concern troll wants transgender people back in deep dark safe closet.
4. Concern Troll says, "Dr. Paul McHugh of Johns Hopkins..."
Let's establish who and what Dr. McHugh is. Dr. Paul McHugh is an ultra-Conservative Catholic who blames gays for the church's sexual abuse scandal, believes sexual orientation is a choice and would rather let an 11-year-old girl raped by a relative die rather than have an abortion. He was part of the campaign that led to the murder of abortion provider Dr. George Tiller in 2009.
When he was put in charge of the gender clinic Johns Hopkins in the 1975, by his own admission he intended from beginning to close it. The "study" he did was designed from the start to facilitate his goal. The study itself was pure nonsense, full of non-reproducible results, punishing patients for having jobs that were "too masculine," or having been married to a woman at some point in their lives. McHugh has made it clear he finds cultural acceptance of transgender people unacceptable.
As a result, no reputable researcher will cite his "study," and was not considered credible by any professional medical or mental health organization when developing guidelines for the treatment of transgender individuals.
Why does concern troll bring up Paul McHugh? Because concern troll hopes you won't Google Dr. McHugh.
5. Concern Troll says, "We don't know the long term effects of puberty blockers on children..."
The drug used to block puberty in children, Leuprorelin has been approved for this purpose since 1989. It just hasn't been used on transgender kids. So yes, we don't know what it does 40 years down the road. But then again, by the same standard, we don't know the effects of a lot of drugs 40 years down the road either.
However, the most recent study on the effects of Leuprorelin, on transgender children show considerable benefit so far. The study found that the children who had used blockers, "were no longer experiencing mental health consequences related to gender dysphoria, their quality of life and happiness levels were on par with their non-transgender peers and none expressed any regret about delaying puberty or transitioning." A new, $5.7 million dollar, 5-year large-scale study has just been launched to settle this matter.
So why does concern troll show so much concern? Because concern troll is afraid happy, healthy, beautiful transgender people will convince others that transgender people aren't so scary after all.
6. Concern Troll says, "The 2011 Swedish study..."
Whenever a concern troll brings up Dr. Dehjne's study, they try to use it to prove that transgender people commit suicide at a really high rate. Or that they're just as criminal as men. Or that health care for transgender people is ineffective and should be discontinued. In fact, all of these are either gross representations of the actual findings of the study. Let's take them one by one.
So what does the study say about transgender people and suicide? It's higher, but only statistically so for those who transitioned before 1989. Afterwards, there's no statistically significant difference between transgender people and the general population.
What does it say about criminal convictions? It says the same thing, no statistically significant different for those who transitioned after 1989.
What does it say about the efficacy of health care for transgender people? It says the study shouldn't be used to make any judgments about the efficacy of transgender health care, because there is no control group, and that the consensus is health care is beneficial.
So what does the study ACTUALLY recommend? Transgender people need better follow up care after surgery.
So why does concern troll bring this up? Because concern troll hopes no one will read the actual study.
7. Concern Troll says, "What if people didn't have to be transgender?"
The line of thinking here always goes the same way. Transgender people suffer from suicidality, depression, drug abuse, homelessness, unemployment, etc... far more than the general population. If they weren't transgender anymore, then these bad things would go away, right? Wong. This is effectively no different than asking someone, "Have you tried not being gay?"
For most transgender people, the answer is of course we tried not being transgender, and it nearly killed us. As bad as things are after coming out, it's still better than the closet where we were. That's why we came out in the first place.
It is rare for a concern troll to offer any ideas on how one might choose not to be transgender, or what sorts of credible therapists might help someone become "not transgender."
What concern troll leaves out is that no such treatment exists.
The world's leading body on transgender health care (WPATH) states: "Treatment aimed at trying to change a person's gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success, particularly in the long term. Such treatment is no longer considered ethical."
When the concern troll is cornered and forced to recommend something specific, it's the same pray-away-the-gay organizations that failed so miserably at making people "not gay."
So why does concern troll ask this? Because concern troll is sad no one like pray-away-the-gay anymore. Maybe work this time with trans, though.
8. Concern Troll says, "The quality of studies on transgender people are poor..."
Medical studies on transgender people have two very difficult hurdles. The first is being double blind. There's really no placebo for hormones and surgery. It's not as if you can perform gender reassignment surgery on someone without them noticing it. People don't wake up one morning and say, "Whoa! When did I get a vagina?"
The second issue is control groups. There is an accepted body of evidence that transition related health care is beneficial, and that denying it carries a strong risk. In order for a study to happen, and especially if there are human subjects involved, it has to be approved and monitored by an ethics review board.
Conducting a study where you deny necessary medical care to people, and there is evidence that denying it will dramatically and unnecessarily increase the risk of suicide and mortality will never make it past an ethics board (IRB).
Beyond that, there's a strong chance the control group will "cheat" by finding medical services outside the study if they're desperate enough.
The last time someone got a transgender surgical study with a control group through an IRB was 25 years ago. This study found that the group receiving treatment did significantly better than the control group.
Concern trolls are well aware of this, and also well aware that most people won't examine their question further.
So why does concern troll say this? Because they know that no one will be allowed to conduct a study that will meet their impossible requirements.
9. Concern Troll says, "Transgender is really a sexual disorder."
There's a small group of people promoting the discredited theory that all transgender women are either self-hating homosexual men, or heterosexual men with an out of control fetish (known as Blanchard's Autogynephilic Theory).
The only people who actually promote this theory are purveyors of reparative therapy, anti-LGBT hate groups, some small circles of anti-transgender radical feminists and a small cluster of people who have invested their professional reputations in promoting the idea. When concern trolls bring this up, they try to not sound anti-transgender, claiming that even though transgender people are perverts and sexual deviants, they don't hold anything against them morally. They claim they're just interested in "spreading the truth," and that they oppose discrimination against the people they just called sexual deviants.
The problem is, these concern trolls are more than happy to let hate groups use their pet theory to argue for discrimination, and even encourage members of the hate groups on their own bulletin boards. One of the primary promoters of this narrative, J. Michael Bailey, even offered free copies of his book to a group whose sole purpose is opposition to legal protections for transgender people. They also go online to troll transgender people and humiliate them.
So why does concern troll say this? Because calling gay men pedophiles has failed. Maybe work on trans people this time.
10. Concern Troll says, "We give health care to transgender people, and bad things still happen."
This is perhaps the easiest to debunk. We've already established that the overwhelming body of research shows that transgender health care and acceptance is beneficial. This is accepted as a truism by every major medical and mental health organization in America. However, a lifetime of prejudice, harassment and discrimination both leaves scars, and follows you around even after you have transitioned.
What the concern troll says is akin to asking why we give prosthetic legs to people, when they're still going to walk with a limp anyway.
Because it's better than the alternative of doing nothing, and it's the best option we have now.
So why does concern troll say this? Because concern troll assumes you won't think.
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