Bad stat of the month: Trans regret

I don’t want to do this. I want to be a happy trans. I don’t like being negative, and I don’t like singling out people. I’ve held back for years. Unfortunately, people keep putting in hours, months, years of work producing these bad statistics, and then advocating questionable policies based on them. This latest one could be really damaging. It’s about trans regret, and it comes from a British grad student named Maeve Regan:

The recent Trans Mental Health Study was the largest study of its kind ever undertaken in Europe, with almost 900 respondents. The study asked specifically about individuals’ feelings of regret following social and/or medical transition. These are the results:

In terms of social changes made during transition (coming out to friends and family, changing name, living full or part time in a gender not assigned at birth), 34% of respondents had minimal regrets and 9% had significant regrets. A small majority, 53% had no regrets.

Specific regrets given included: not having the body they had wanted from birth, not transitioning earlier, losing friends and family, and the impact of transition on others.

In terms of physical changes made during transition (resulting from hormone therapy and surgical interventions), the vast majority, 86%, had no regrets. Of the remainder, 10% had minor regrets and 2% had major regrets.

The specific regrets given include complications relating to surgery (especially loss of sensitivity), and the choice of surgeon (if surgery resulted in complications or required revisions and repairs).

Regan, who identifies herself as “cisgendered (not trans),” wrote the above as part of a summary of findings of the Trans Mental Health Study, for which she was “part of the Advisory Board.” [Edited to add]: She concludes, “It is clear from the actual reported regrets, along with the conclusions that transition is associated with a broad range of positive indicators, that most cases of regret around transition are not related to being a different gender to the one assigned at birth, or undergoing transition, but rather due to poor surgical outcomes, social stigma and huge barriers to medical care.”

In other words, trans people never regret transitioning. We only regret the way we’re treated, or the way the surgery turns out.

This statistic was used in an online discussion where I brought up trans regret. [Edited]: One of Regan’s co-authors, Jay McNeil, wrote, “we found that where people did have regrets, they were largely related to their experiences of how they were treated rather than the choices they’d made around their bodies. Where people felt like de-transitioning it was mainly because they lacked support to cope wit the social stigma and losses.”

How are these percentages bad statistics? They are taken from a non-representative sample and generalized to all transgender people in the United Kingdom. Specifically, this survey was collected using the ubiquitous “snowball” method:

Participants were encouraged to take part mainly through a process of snowballing. Trans support groups, online forums and mailing lists with UK members were contacted and given information about the study and asked to share the survey as widely as possible. Other equality and health groups, and professional networks with potential links to the trans population (e.g. LGBT networks; professionals whose work might bring them into contact with trans people) were also contacted and asked to distribute information about the survey. The survey spread primarily through word-of-mouth, and the researchers attended a number of trans groups in person to discuss the project and encourage participation. The survey was open for approximately 3 months (mid-April 2012 to mid-July 2012), during which time reminders were posted online, and the survey continued to be publicised.

The problem is that “trans people” are typically defined by whether they intend to transition. Regretters by definition withdraw that intent to transition, and are thus considered by many to be “not really trans.” Some regretters, like non-transitioners, accept that classification and affirm, “I guess I wasn’t trans after all.” Others may still consider themselves trans, but not want to hang around with the happy transitioning crowd. Would you?

Regretters who don’t believe they’re trans wouldn’t take a “trans mental health survey.” Regretters who are alienated from “the trans community” might not know about such a survey, and might not want to fill one out if they did know about it. So this survey is highly unlikely to have received responses from any serious regretters. That’s not evidence that regretters don’t exist, it’s evidence of bad sampling.

These numbers could be really damaging because they give a false impression that regret doesn’t exist. That could set up any number of trans people for serious disappointment down the road. Of course, with this “no true Scotsman” (ahem) reasoning, the authors may never find out.

As I said, this snowball method is all over the place. I don’t want to single out the authors of this study for doing what practically every other trans researcher is doing. I felt bad for focusing on Emilia Dunham for publishing a bunch of unfounded generalizations back in 2011. But you need to start somewhere. And the conclusions that Regan draws are bad, bad, bad.

I get the feeling that Regan and the other authors of the Trans Mental Health study are kind, caring people, and want to help all trans people. I think if they looked into the eyes of a regretter and saw the disappointment and frustration that I’ve seen, they would care about them too, and stop this denial. I wonder if they will ever allow themselves to do it.

“Gender identity” in the Violence Against Women Act

Recently, I got some messages asking me to press for transgender and lesbian, gay and bisexual inclusion in the Violence Against Women Act, a law that sunsets regularly but has just been reauthorized by Congress. The action alerts also talked about “gender identity,” and the definition that came to mind is this one from GLAAD, which is echoed in other definitions around the country: “One’s internal, personal sense of being a man or a woman (or a boy or a girl).”

I was concerned about the use of “gender identity” in this bill. Being white and middle-class I’m at relatively low risk, but there are other trans people from all ethnic and economic backgrounds who occasionally go out in public presenting as women, with male bodies unmodified by hormone or surgical treatment, and without a strong belief that we are women. We may be seen by others as women, as trans people or as gay men. We may be targeted for sexual assault, stalking or other violent actions based on those perceptions. A law that is based on the “internal sense” definition of gender identity would fail to protect us.

Today I took a closer look and discovered that this fight actually is relevant to people like me. The Violence Against Women Act, originally passed in 1994, provided grants for nonprofits and government agencies to run programs aimed at preventing violence against women and providing support for women who are victims of domestic and sexual violence.

The expanded version of the law passed by the Senate last year, but rejected by the House of Representatives, and then passed this week by both houses of Congress, includes new protections that weren’t in the original bill. Overall, it includes “dating violence” and “stalking” as eligible categories of violence in addition to “domestic violence” and “sexual assault.” It also includes provisions for “men, women, and youth in correctional and detention settings.”

One part that relates to transgender and LGB victims is the definition of “underserved populations.” There are grants for organizations working with underserved populations.

UNDERSERVED POPULATIONS.—The term “underserved populations” means populations who face barriers in accessing and using victim services, and includes populations underserved because of geographic location, religion, sexual orientation, gender identity, underserved racial and ethnic populations, populations underserved because of special needs (such as language barriers, disabilities, alienage status, or age), and any other population determined to be underserved by the Attorney General or by the Secretary of Health and Human Services, as appropriate.

Another section expands the Omnibus Crime Control and Safe Streets Act of 1968 to include support for the following:

developing, enlarging, or strengthening programs and projects to provide services and responses targeting male and female victims of domestic violence, dating violence, sexual assault, or stalking, whose ability to access traditional services and responses is affected by their sexual orientation or gender identity, as defined in section 249(c) of title 4 18, United States Code

In section 249(c) of the hate crimes law is where we actually get a legal definition of “gender identity,” and it turns out to be very different from that given by organizations like GLAAD:

the term ‘gender identity’ means actual or perceived gender-related characteristics

This definition is much broader than the “internal sense” definitions, but does a better job of delineating the class of victims who are underserved, and who are often actually denied services when people perceive them as “queers” or “trannies,” with no knowledge of their internal sense of gender.

The people who refuse to investigate or prosecute crimes against transgender people don’t give a rat’s ass what internal, personal sense of gender those transgender people have. If I (or someone like me who’s black or Mexican) get bashed and a cop won’t write it up, telling the cop that I really don’t have an internal, personal sense that I’m a woman isn’t going to get me any better treatment. That’s probably why the definition in the hate crimes law didn’t reference a sense of gender, and why this expanded Violence Against Women Act doesn’t either.

A final note: in the spirit of the Delhi protesters who said “Don’t tell your daughters to stay at home, instead teach your sons to behave,” I like this program in the new Violence Against Women Act:

ENGAGING MEN AS LEADERS AND ROLE MODELS.—To develop, maintain or enhance programs that work with men to prevent domestic violence, dating violence, sexual assault, and stalking by helping men to serve as role models and social influencers of other men and youth at the individual, school, community or statewide levels.