Cherry Picking is Not Science

Dr. Dana Bevan Dismantles the anti-trans “report” by Mayer and McHugh

By Dana J. Bevan, Ph.D.

Part I

It is hard to know where to begin in reviewing the transgender part of this article so I will do an overview now with Part II later. The article is important because it could form the basis for anti-transgender amicus briefs in the current bathroom discrimination cases. McHugh has written several previous amicus briefs seeking to influence court cases.

The article pretends to review the scientific research about being transgender but nothing could be further from the truth. Mayer and McHugh (M&M) cherrypick the science that they include, do not include relevant science and make judgments based on their biases. We will examine their overall conclusions in this blog post with more detail later.

First their conclusion about the biological basis of being transgender:

The hypothesis that gender identity is an innate, fixed property of human beings that is independent of biological sex — that a person might be “a man trapped in a woman’s body” or “a woman trapped in a man’s body” — is not supported by scientific evidence. Studies comparing the brain structures of transgender and non-transgender individuals have demonstrated weak correlations between brain structure and cross-gender identification. These correlations do not provide any evidence for a neurobiological basis for cross-gender identification.

Science has come a long way from the old “nature versus nurture” false dichotomy that an “innate fixed property” terminology would have us believe is one of two possibilities. Science now recognizes several factors that influence gender behavior. In the case of being transgender several factors seem to be involved: genetic predispositions, epigenetic blocking of genetic expression, early learning about gender and cultural construction of gender behavior categories. The introspective experiences they cite about being trapped in the wrong body cannot objectively be confirmed by science, that is why I rely primarily on behavior. All we really know is that the observable behavior of transgender people is in a gender behavior category that is incongruent with the one they were assigned at birth. Biological correlates of being transgender do not have to resemble the biology of the opposite sex, although many do show this. All they have to do to show that being transgender involves biology is different from that usually associated with a person’s birth sex.

There are a host of biological studies which do indicate that transgender physiology and anatomy is more like the opposite birth sex but M&M do not cite these studies, which I have done in my previous blog posts. They are either ignorant of the biology or deliberately constructing a biased case. I can suspect but do not know exactly what is going on in their heads; I can only make judgments based on their behavior. But whatever they are thinking, they do not accurately reflect the evidence.

The next conclusion which cites the recent Williams Institute is a nearly correct replay of the results of that study:

According to a recent estimate, about 0.6% of U.S. adults identify as a gender that does not correspond to their biological sex.

The authors of this paper fail to cite the Lynn Conway series of studies which show that the lower statistical bound for just trans women is at least 1% based on behavior, not survey data. The Conway studies clearly provide better scientific evidence than the Williams studies which are based on rehashing survey data that was collected for other purposes (e.g. smoking incidence). Other surveys have produced even higher frequencies. The most recent Williams study was a rehash of a CDC survey using questionable statistical procedures, relying on census and other data to project the number of transgender people rather than measure them. Acknowledging these non-standard procedures, statistics in the Williams Institute study for ages 18-25 indicate that the frequency is closer to .7%. This estimate should be closer to the actual biological frequency because younger people are less likely to hold their transgender behavior as a secret because the subculture of young people in the U.S. is more accepting. Previous Williams’s studies indicated .3 and then .35% so with .7% they are getting closer to Conway’s estimate made 12-15 years ago. I am ignoring the psychobabble of “gender identity” as opposed to “gender” for now.

Their conclusion about transsexual genital plastic surgery:

Compared to the general population, adults who have undergone sex-reassignment surgery continue to have a higher risk of experiencing poor mental health outcomes. One study found that, compared to controls, sex-reassigned individuals were about 5 times more likely to attempt suicide and about 19 times more likely to die by suicide.

In their conclusion, the M&M boys did not quote the overall conclusion of the larger study (Murad) from which the data was drawn which said that:

Pooling data across studies showed that, after receiving sex-reassignment procedures, 80% of patients reported improvement in gender dysphoria, 78% reported improvement in psychological symptoms, and 80% reported improvement in quality of life.

Their conclusion about GPS was based only on a smaller group in the larger study. The general consensus about transsexual transition and GPS is that transsexuals still need counseling help to deal with residual social problems.

Their conclusion about whether transgender children become transgender adults:

Children are a special case when addressing transgender issues. Only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood.

This conclusion is based on the clinical notes of Zucker who claimed that only 3 of 26 transgender kids continued to be transgender. Would you deny that you admit you were transgender in later childhood if it meant going to back to Zucker’s clinic (which has subsequently been closed down for inappropriate treatment approaches)? There are better attempts at longitudinal studies but they have serious flaws. In one study over half of the 10-year-old transgender children responded to a follow up examination at age 20 years old. If you were 20 years old would you return, given the possible rejection for being associated with being transgender? All of the attempts at longitudinal studies, so far, have had problems principally because they used transgender children who were taken to gender clinics. One estimate was that 40% of children in clinics typically have mental health problems in addition to being transgender. Clinical studies are often misleading because of selection bias.

The next conclusion involves treatment of transgender children and adolescents:

There is little scientific evidence for the therapeutic value of interventions that delay puberty or modify the secondary sex characteristics of adolescents, although some children may have improved psychological well-being if they are encouraged and supported in their cross-gender identification. There is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender…. We are concerned by the increasing tendency toward encouraging children with gender identity issues to transition to their preferred gender through medical and then surgical procedures.

M&M embed two straw man arguments and an ad hominem attack in this conclusion. I am sure that none of the clinicians who help these children and adolescents would say that they have enough data to make definitive, statistically significant scientific conclusions. Such treatments only started about 8 years ago on a pilot basis and the number of children involved is still very small. The clinicians do say that the treatments look promising so far but longitudinal and larger studies are needed to be totally sure. The other straw man is that the clinicians do not encourage being transgender but instead do all they can to be sure that the treatments are appropriate. They are scrupulous to be sure that no one is forced to be transgender if they are uncomfortable with such behavior. This is a clear slur on the clinicians that help these children and adolescents.

Finally, the authors seem to encourage future scientific studies:

There is a clear need for more research in these areas.

Now what do you suppose will be the effect on research funding of this and other papers which question the legitimacy of being transgender? One might conclude from their writings, including this paper, that research on being transgender is useless because the phenomena is not real and based on a pathological delusion. This is particularly true of many U.S. legislators that already rely on anti-transgender arguments to act as “red meat” for their constituents who fear/hate transgender people or changes in the culture.

To be continued in Part 2.

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Category: Transgender Body & Soul, Transgender Community News