Some notes on desistance research

Epistemic status: To make sure I got this post right, I asked Michael Bailey for comments. I edited my initial draft based on his feedback, and he agrees completely with this version.

Also, I guess this post means that the followup that I promised for my last post will have to wait a bit.

“Desistance”, in the context of research by Zucker et al, refers to a very specific phenomenon. The topic is still an open research area, so it is difficult to say anything for sure. However, desistance research specifically applies to early-onset gender dysphoria, which is strongly associated with gender nonconformity. The association with gender-nonconformity makes it easy to assume that highly GNC kids will eventually turn out transgender, but in practice they are usually observed to outgrow this and end up happy with their sex. This specifically is the phenomenon that is covered in desistance research. Not much is known about why they are so strongly correlated, but some researchers believe that the gender-nonconformity can be a reflection of the dysphoria, and that encouraging it may cause the dysphoria to persist. This specific pattern of desistance is observed only for early-onset gender dysphoria, and it likely relies on specific characteristics of the dysphoria that are not seen in other forms. As a result, there is little a priori reason to expect it to generalize to other forms of gender dysphoria, unless these forms of gender dysphoria also have specific characteristics that would imply a high likelihood of desistance.

In particular, desistance research does not apply to autogynephilic gender dysphoria. Not much is known about the specifics that distinguishes dysphoric autogynephiles from non-dysphoric ones, but equivalent phenomena to desistance have not been consistently observed for them (and is unlikely to ever be observed, even if it does exist, as properly identifying and evaluating autogynephiles in the relevant period is very difficult). Autogynephilic gender dysphoria has, however, been observed to disappear in some cases, but this is not a consistent and reliable phenomenon in the same way that desistance from gender nonconformity seems to be.

The research also does not apply directly to “rapid-onset gender dysphoria”. There is currently no research on the desistance rates of ROGD. However, if the model that rapid-onset gender dysphoria is to a large degree caused by social contagion is true, then this creates a large possibility for desistance under the right circumstances, as the gender dysphoria is not purely due to permanent characteristics of the person in question, but instead also due to mutable social environment. If the social contagion model is incorrect, there is very little reason to expect desistance to happen. There is almost no research on the validity of the social contagion model for rapid-onset gender dysphoria, but there are many anecdotes that make it seem somewhat plausible.

The specific ways that desistance might work in early-onset gender dysphorics also means that if children who *could* desist instead go on to transition, they will likely not experience regret from transition, but will instead simply not desist. This has a number of implications. It means that the harm of transition will be limited to the problems associated with being a transgender person rather than a gay person, rather than implying regret and future detransition. However, it also means that if someone who could’ve desisted ends up transitioning, it becomes easy for people to mistakenly think that the transition was a huge success because the patient is very happy with the outcomes, when actually the patient could have been just as happy if they didn’t transition. And lastly, it also implies that interventions which do not permit unlearning gender-nonconformity and atypical gender identity – for example ones where gender-nonconformity is highly encouraged – might very well prevent desistance.

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