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#14826134
Drlee wrote:I have not heard this but I am not surprised by it. Without any evidence here are some thoughts.

It could be that people suffering gender dysphoria seek out the military in an attempt to suppress their feelings. Where better to "butch up" than in the military. So this having failed, the person seeks the gender reassignment they were fearing for so long.


It could also be that the military life and its overtly male culture contrasted with the current US zeitgeist leads to seeking to abandon male gender in protest against that culture. What is the most "anti-military" action? How about abandoning manhood in favor of womanhood? And one could see female to male reassignment in the same light; joining behavior rather than protesting. My suspicion is that the overwhelming majority of these GID cases are male to female.

Then there is the possibility that the male soldier, traumatized by the stresses of combat (or even just military life) escapes in the most irrevocable way ever.

I have another thought about male to female adult gender reassignment. Could it be that the person transitioning rejects homosexuality and finds transgenderism a way to have sex with men without being "gay".

Thanks for the reply, Drlee. I know that you are an epidemiologist and interested in military/veteran affairs, so I was hoping that you had perhaps heard something that would confirm these results.

I agree that self selection into the military is a possible explanation for this, although that doesn't explain the high rates of co-morbidity.

I'm wary of psycho-dynamic explanations as a basis for illnesses (assuming you agree that GID is an illness), because they lack sound evidence as to the mechanism of conscious or subconscious thought causing chronic or long term debilitating symptoms and they have been proven wrong again and again. Historically, illnesses have only ever moved out of the category of psychosomatic/psychogenic illness, as we've become more advanced in measuring organic/physical changes in the body. Still, to this day, in the absence of measurable biomarkers, we have a tendency to default to psycho-dynamic explanations, especially, but not only, if the condition involves changes in behaviour. For instance, people who have non-epileptic seizures will have a good chance of being told by their neurologist that they had some trauma in childhood which causes them to subconsciously induce these seizures, even if the patient is not aware of any trauma (if you are interested, see here for partial transcripts of such consultations under 3.2.1 Psychological explanations). At the most basic level, these explanations are problematic because they are not falsifiable and don't even require evidence for the triggering event(s), as it can be subconscious. They are only restricted by the creativity and imagination of the person coming up with them.

As for stress, it's implicated in lots of illnesses, which probably shouldn't be surprising since steroids are involved in such as variety of biological pathways. As you no doubt know, steroids as a medication have also been shown to have a profoundly positive effect on several autoimmune diseases, although unfortunately their side effects prevent long-term use in most cases. Hence, I think all types of stress, psychological and physical, should be a major focus of research on a molecular level for us. The concepts of vulnerability and resilience to stress have been around for some time now and I am keen to see sound evidence for this and for its causes. This is particularly pertinent for the military, as it's hard to imagine a more objectively stressful experience than that of soldiers on active duty, including mental stress, physical exhaustion and potential environmental stressors such as toxins.

Drlee wrote:I am deeply skeptical of childhood gender reassingment. Even of the diagnosis at at all. I am also skeptical of adult transgenderism. Or at least the relative ease with which we allow this odd behavior.

From an epidemiological standpoint, the highly technical explanation for my concerns goes something like this: There is something rotten in Denmark and it ain't the fish".

I think we had a conversation about this before, so you probably know that I share your skepticism. However, I'm quite confident that GD/transgenderism exists and that it can cause profound suffering.

Interestingly, there has been research recently showing overlap with ASD: see this Spectrum article under Diagnostic overlap. The article alarmingly uses the term "Autism identity", so Autism is one of the next candidates that identity politics will try to capture. There is also this presentation from the Autism-Europe International Congress last year. Here are two graphs from the presentation. TD means "traditionally developing", i.e. the control group.

Study 2
Hypothesis: Individuals with ASD would demonstrate higher levels of gender-dysphoric traits (GDT) compared to TD individuals.

Image

As a side note, there is also overlap with non-heterosexual orientation.

Study 1
Hypothesis: Individuals with ASD would report lower rates of heterosexuality and higher rates of homosexuality, bisexuality and asexuality across all three domains of sexual orientation: sexual attractions, sexual contacts and sexual identity.

Image
Caveat: I haven't looked at the research mentioned in the Spectrum article in detail and the presentation from which I've taken the above graphs is based on convenience samples. So this is not necessarily conclusive, but I believe is at least worth a closer look.
#14826169
Thank you for that Kaiserschmarrm. Excellent post.

I'm wary of psycho-dynamic explanations as a basis for illnesses (assuming you agree that GID is an illness), because they lack sound evidence as to the mechanism of conscious or subconscious thought causing chronic or long term debilitating symptoms and they have been proven wrong again and again. Historically, illnesses have only ever moved out of the category of psychosomatic/psychogenic illness, as we've become more advanced in measuring organic/physical changes in the body.


I completely agree with this. Our tendency to quickly offer psycho-dynamic explanations is disturbing and I think it is often intellectually lazy....Much easier than doing the work. It is also dissatisfying to the patient I would imagine.

I think we had a conversation about this before, so you probably know that I share your skepticism. However, I'm quite confident that GD/transgenderism exists and that it can cause profound suffering.


I completely agree. For others reading this I believe you join me in my suspicion that gender reassignment surgery 'may' not be the only treatment option for this illness (I use that term deliberately) though it is being 'pushed' pretty hard these days. This is all the more true when we see young children medically transitioning. I am deeply suspicious of this to say the least.

I am going to look into your references. They are very good and demand more time to digest them.

A quick comment about the stresses of military life. It is true that soldiers, particularly combat soldiers, are under a great deal of stress. I share with you the conviction that the manifestations of this stress are biochemical in even more profound ways than what we routinely acknowledge now.

An unscientific personal antidote.

After I retired from the Army and worked in a stressful consulting job for awhile, I decided to take some time off and "relax". This did not go well for me. I am quite certain that the chemical changes I underwent as I lowered my decades old high stress levels virtually overnight were profound. I would liken it to something like benzodiazepine withdrawal. I was really quite ill for some time. My doctor(s) performed the usual battery of tests, ranging from a complete cardiac work up to more esoteric tests like a sleep deprived EEG. Gar nichts. Finally I ran into an internist who was not so quick to dismiss my symptoms as psychosomatic. She encouraged me to increase my stress levels and then try to bring myself down more slowly. (If you want to know how I did this I can PM you rather than talk about it here.) Anyway. She succeeded where others failed. So you can see that I am very much interested in what you posted.
#14826261
@Kaiserschmarrn @Drlee
I just want to let you know how refreshing it is to see people who can take realistic looks at these issues. I see too much about what "science and medicine knows" and too little about what they don't know. Lowering their pedestal could lead to some wonderful things.
On a side note, the connections with ASD and sexuality I find as belonging to political thinking, based upon not looking into it deeply. ASD would indicate a lack of association with the real world, would it not, and therefore has no real indication of how it relates to non ASD and sexuality?

Edit: I admit your discussion is over my head and am just trying to get some clarification.

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