Byng et al. (2018) present a distorted picture of transgender identity and affirming care

This month, Richard Byng, Susan Bewley, Damian Clifford, and Margaret McCartney published a response letter to the article “Trans health needs more and better services: increasing capacity, expertise, and integration” in BMJ (Byng et al., 2018). Their response offers a number of questionable implications and an overall hostile approach to transgender-affirming care generally. These insinuations merit a response, and raise the question of why this material is being published in BMJ.

Byng et al. invoke the supposedly worrying trend of more adolescent and adult AFABs seeking evaluation for gender dysphoria:

However, the article does not question the steep rise in referrals, especially of girls, to gender identity clinics (GICs) nor concern itself with potential harms of self-diagnosis and prescribing, or medical over-diagnosis and over-treatment.

This “trend”, often cited by those who express a concern that these youth may not be genuinely trans, has in fact not been shown to be a new or concerning issue at all. Fluctuations in the sex ratios of those presenting for transition treatment have been known to occur around the world for decades, with many areas showing a predominance of AFABs over AMABs. 

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About Zinnia Jones

My work focuses on insights to be found across transgender healthcare, public health, psychiatry, and history of medicine, integrating these many perspectives and guided by the lived experiences of trans people. I live in Orlando with my family, and work mainly in technical writing.
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