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Affirmation improves outcomes for Trans people

There is an overwhelming & growing evidence trans lives are improved via affirmation, access to medical care, and freedom from discrimination



Pictured are Elijah, a Black transgender model, advocate, & LA Blade columnist Rose Montoya (Photo by Rosalynne Montoya)

By Brynn Tannehill | FAIRFAX COUNTY, Va. – There is an overwhelming and still growing body of evidence that trans lives are improved via affirmation, access to medical care, and freedom from discrimination. The latest piece of which came from a large sample study (n = 11,914) of trans people between the ages of 11 and 24 using data collected by The Trevor Project and published in the Journal of Adolescent Health

This study found that almost half of the cohort wanted access to Gender Affirming Hormone Therapy (GAHT) but were unable to access it. It also found that the depression was significantly lower among those with access to GAHT. Most importantly, GAHT was also correlated with a 40% reduction in reported suicide attempts by youth under 18. Other recent studies, including one with an even larger sample (n = 20,619), found that access to GAHT in trans youth significantly improved mental wellbeing. Other qualitative studies have shown that deliberately withholding GAHT can cause intense distress

Similarly, there is a body of evidence that access to surgical care reduces distress and improves outcomes, both for trans masculine and trans feminine individuals. In 2018, Cornell University conducted a comprehensive lit review of studies from 1991 to 2017 on the effects of transition on well-being. They showed that 93% found positive results, 7% had mixed or null outcomes, and none found a negative effect. 

Similarly, a comprehensive review of studies on surgical regret rates found that only 1% of trans people regretted gender affirming surgery. This meta-study also found that the most common reasons for regret were being mistreated after transition, followed by poor surgical outcomes. Overall, this 1% figure is extremely low compared to the 14% regret rate among the general population for all surgeries (based on a meta-study of 889 prior studies on general surgical regret).   

Another key component of reducing risk for trans people (and trans youth in particular) is affirmation and support. One 2016 study showed that mental health among pre-pubertal trans youth who were supported by their parents was statistically no different than their cisgender peers. Another study of young trans feminine adults found that having supportive mothers reduced the probability of having suicidal ideation by 63%.  Another study of young trans people in Ontario found that having affirming parents dramatically improved mental health and reduced suicidal thoughts.

Conversely, lack of support by parents is associated with greater risk of suicide attempts, low self-esteem, and homelessness. Putting trans people in conversion therapy is particularly deadly. A 2020 study of trans adults who had been subjected to conversion therapy as youth found that the victims had double the lifetime risk of suicide attempts, regardless of whether the conversion therapy was religious or secular. 

No reputable organizations, articles, Journals, doctors, or medical health professionals provide evidence for the efficacy of conversion therapy on trans people. Major professional organizations such as the American Medical Association, American Psychiatric Association, American Academy of Pediatrics, and the American Psychological Association universally oppose conversion therapy efforts on transgender people because there’s no evidence for their efficacy, and there’s clear evidence of harm.

Trans people suffer from poorer mental health outcomes in great part due to stigma, discrimination, violence, shame, negative media portrayals, and a cluster of other factors collectively known as minority stress. There is clear evidence to suggest that affirmation by friends and family greatly reduces these factors. So does access to medical care, which allows trans people to both “pass” as cisgender (and stop being treated in public as transgender), and for their mental self-image to more closely match their physical body. 

The counter arguments to this are politically, ideologically, and religiously driven based on cherry-picked evidence, deliberate misinterpretation of studies, false appeals to authority, glaring omissions of counterfactual information, and false assumptions. No better recent example of this can be found than a recent Washington Times article by Tim Constantine. He makes the claim that because trans people have worse mental outcomes than the public, they should be shamed, discriminated against, and denied health care until they get some unspecified conversion therapy and go back into the closet.

Among the many errors, falsehoods, and omissions used in support of this conclusion:

  • He claims that transgender people are trans because they have greater psychological comorbidities (depression, anxiety, etc…). However, this ignores that the evidence shows that shame, stigma and discrimination result in transgender people being mistreated, and suffering high rates of PTSD. Constantine ignores the rule that correlation is not causation. The same logic would lead to a belief that John McCain was a POW because he had PTSD, and not the other way around. This is an example of the questionable cause logical fallacy.
  • He cites Paul McHugh as an “expert” on trans issues, without noting that he’s 90 years old, retired, has never written a journal article on trans people, has not worked clinically in decades, and is a radical Catholic anti-abortion and anti-LGBT activist who promotes conversion therapy. Nor does Constantine mention that McHugh’s own university has repudiated his work years ago. This is the logical fallacy known as an appeal to false authority.
  • He cites the Diagnostic and Statistical Manual (DSM) to claim that Gender Dysphoria is a mental illness, to imply that all transgender people are mentally ill. Constantine deliberately omitted several things that counter this conclusion, including the American Psychiatric Association’s (the body responsible for writing the DSM) own admonition in the DSM that, “Gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.” In other words, a trans person who has transitioned and isn’t in distress over it anymore, isn’t de facto mentally ill, or even have a diagnosable condition. The article also ignores that the ICD-11 (International Classification of Diseases 11th Revision, published by the World Health Organization) removed gender identity disorder from its list of mental illnesses in 2019, and placed “gender incongruence” under sexual health. All in all, these are lies of omission.
  • Constantine cites the American College of Pediatrics as an authority on transgender health. First, he wrongly attributes their hate group designation to the defunct ThinkProgress (the Southern Poverty Law Center designated ACP as an anti-LGBT hate group in 2015). The article omits the fact that ACP is not an actual medical organization (like the American Academy of Pediatrics), but a small group of religiously conservative individuals masquerading as a medical organization to promote conversion therapy, oppose LGBTQ people adopting children, and attempting to link homosexuality with pedophilia. Again, Constantine has made an appeal to a false authority, while omitting crucial information about the authority he cites.
  • He refences the “Swedish study” to cast doubt on the efficacy of treatment and acceptance. Constantine omits many things about this, the most important of which is that it literally says in the study itself that, “It does not, however, address whether sex reassignment is an effective treatment or not,” because there was no control group. The Times article also omits the fact that the lead author of the study (Dr. Cecilia Dhejne) has gone on record stating her article can’t be used in exactly the way Constantine used it. He also omitted the fact that the 2011 study found no statistical difference in suicide rates between the public and people who transitioned after 1989.
  • Constantine implies that 70-80% of all transgender youth spontaneously stop being transgender. This is a misrepresentation of the literature, which in and of itself is flawed. “Desistance” as a theory was only meant to apply to pre-pubertal children, and it was developed in a period where a child who had any gender atypical interests or behaviors was regarded as trans under the old DSM-IV. Even the man who developed the desistance theory in the 1990’s (Kenneth Zucker) supported puberty blockers for trans youth who were still dysphoric at puberty, because he recognized they were highly unlikely to desist. 
  • He implies that conversion therapy is the best option, without a shred of evidence that it works (because there isn’t any), while ignoring the science showing that it does great harm. The government of Canada came to the same conclusion, and voted unanimously in Parliament and the House of Lords to ban the practice on LGBT people, virtually without exception.

The entire thesis of this article is that transgender people should only be marginally tolerated, and definitely-not accepted.  This lack of acceptance is for their own good of course. He provides no actual evidence that simply conversion therapy and stigmatizing trans people into the closet is what’s best for them based on the false assumption that closeted trans people have better outcomes than people that come out. Of course, we don’t collect data on completely closeted people.

Opposition to trans people is based on multiple burden of proof fallacies, also known as Russell’s Teapot. The burden of proof person making empirically unfalsifiable claims, rather than shifting the burden of disproof to others. Anti-trans campaigners claim that people who stay closeted are better off, and it can’t be falsified because they’re in the closet. They claim that conversion therapy is better, but don’t have any actual data to support this. 

They claim that the best thing for trans people and society is to not treat them as the gender with which they identify but can provide no evidence that making people miserable enough to go back in the closet improves their mental health. This is a bit like the 19th Century idea that if you simply threw enough buckets of cold water on people in a tiny cell, they would eventually regain their sanity. 

The evidence they do provide is based on cherry picking, gaping omissions, unfalsifiable assumptions, appeals to false authority, deliberately confusing cause and effect, and conclusions that violate Occam’s Razor (which postulates that of two competing theories, the simpler explanation of an entity is to be preferred.)

So, which hypothesis seems more likely to be the correct one:

a) Accepting and affirming trans people leads to better outcomes, based the advice of all the major medical and mental health professional organizations and decades of peer reviewed evidence? Or 

b) Conversion therapy and stigma to push trans people into the closet makes them happier, based the beliefs of religious individuals with no real qualifications using no direct evidence whatsoever.


Brynn Tannehill is a senior analyst at a Washington D.C. area think-tank, and is the author of “American Fascism: How the GOP is Subverting Democracy.”

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“Just Vote” is not a strategy

The GOP found out long ago that keeping their based terrified and angry was the key to victory: Democrats need to learn to use it as well



Los Angeles Blade graphic

By Eric Tannehill | FAIRFAX COUNTY, Va. – When the Supreme Court overturned Roe v. Wade, it sent waves of dismay through the LGBT community. Clarence Thomas’ concurrence made it clear that he wants to overturn Obergefell (marriage) and Lawrence v. Texas (sodomy laws).

Already, Texas Attorney General Ken Paxton has called upon the Supreme Court to overturn Lawrence, and sources tell The Blade that the Alliance Defending Freedom is gearing up challenges to Obergefell in the conservative 5th and 11th Circuits. Even if these challenges fail at the Supreme Court on the first try, the Circuit Courts are likely to issue injunctions that make life miserable for years for LGBT people.

It’s unclear whether the Supreme Court would overturn these rulings. In the Dobbs v. Jackson abortion decision by Alito, he claims that this case is different because it involves human life. On the other hand, the tests for constitutionality created by Alito in Dobbs clearly indicate that Obergefell and Lawrence would fail if brought before him, and should be struck down. Alito very clearly and deliberately left a road map for how to make arguments that ensure these seminal LGBT rights cases are overturned.

The Democratic response to Roe, reassuring the LGBT community, has achieved exactly the opposite: people are terrified and hopeless. Singing “God Bless America,” reading poems, making outraged statements, proposing bills that haven’t a prayer of becoming law, and doing yoga is about all that Democratic leaders have been able to offer the people who put them in office. 

Nancy Pelosi Criticizes ‘Hypocrisy’ Of Supreme Court Overturning Roe v. Wade:

Every proposed solution that might actually work has been shot down. The White House has unilaterally rejected expanding the court or providing abortions on federal land. Manchin and Sinema refuse to budge on the filibuster. No one dares speak about malicious compliance or the legitimacy of a court where most of the justices were put in place by Republicans who lost the popular vote. Meanwhile, Republicans are gleefully planning how they can abuse the system to prosecute women who flee to other states, or people who provide abortifacient drugs by mail.

The singular message Democrats are providing is, “give us money and vote for us, and maybe something good will happen.”

The singular message Democrats are providing is, “give us money and vote for us, and maybe something good will happen.” Vote is not a strategy. Nor is the Democratic base stupid: we know damn well that there is a +7 lean towards the GOP in the Senate, meaning that Democrats must win the national vote by an average of 7 points every year to even have a 50-50 shot of controlling the Senate.

We know that lifetime appointments to the bench mean that the GOP will control SCOTUS for decades. “Just vote” is not a strategy, just like hope is not a plan. But it is patronizing.

This is a complete failure of leadership. Democrats must state explicitly what they will do, and how they will do it, to protect the people voting for them from an increasingly fascist GOP that wants to remake America in its white, Christian, heterosexual image.

We are facing a queer apocalypse, and we’re getting tips on perfecting your “downward dog” and emails begging for money so they can keep doing what they’re doing: which is effectively nothing besides passing legislation that will never see the light of day in the Senate. (The Equality Act, anyone?)

There’s a glimmer of hope: congressional generic ballot polling after the Dobbs v. Jackson decision shows a strong shift towards Democrats, and that the ruling made Democrats much more likely to vote. However, without a clearly enumerated plan and messaging, this is just a blip in our collective short term political memory.

Between now and the election Democratic ads and messaging need to highlight every woman who dies, or nearly so, because of the Dobbs decision. Ads with interviews with women left in screaming bloody agony for hours while a priest and lawyers bicker over whether this is covered by “life of the mother” exceptions.

Women denied lifesaving chemotherapy or forced to carry a pregnancy that could kill them. Women forced to carry a rape to term, and then share custody with their assailant. Make the messaging as brutal as possible: remind voters every day that a vote for Republicans is a vote to torture or kill women.

The GOP found out long ago that keeping their based terrified and angry was the key to victory: Democrats need to learn to use it as well.

The GOP found out long ago that keeping their based terrified and angry was the key to victory

They also need to be explicit in what they are going to do if they somehow manage to retain the House and Senate: namely they will end the filibuster and enshrine Roe v. Wade as federal law.

They need to explicitly spell out how they will use the power given them to prevent SCOTUS from allowing gerrymandered red states from eliminating marriage equality and throwing LGBT people in jail for having consensual sex in the privacy of their own homes. 

Democrats need to stop over-promising and under delivering. The public knows damned well what cannot be accomplished as long as the filibuster is in place, or SCOTUS dominated by conservative ideologues.

The Roberts Court, April 23, 2021 Seated from left to right: Justices Samuel A. Alito, Jr. and Clarence Thomas, Chief Justice John G. Roberts, Jr., and Justices Stephen G. Breyer and Sonia Sotomayor Standing from left to right: Justices Brett M. Kavanaugh, Elena Kagan, Neil M. Gorsuch, and Amy Coney Barrett.
Photograph by Fred Schilling, Collection of the Supreme Court of the United States

Failing to do these things will produce even worse outcomes: namely people giving up hope of solutions from within the system, ceasing to vote, and attempting to take matters into their own hands out of a sense of hopelessness and rage.

Viable plans create hope. Scared, desperate angry people do stupid things if they do not have both hope and a plan.

It’s President Biden’s responsibility as a leader to map out that plan unambiguously, while Democrats need to make certain everyone knows what the consequences of failure are. 


Eric Tannehill is a twenty-something queer activist and university student.

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WeHo ignores data on LASD in latest budget proposal

LASD misled city council on its contract & on crime rates, on June 27, the city will discuss rewarding them with a $1 million budget increase



Los Angeles Sheriff’s deputies back down protesters at LA Pride (Sean Carmitchel).

By Nika Soon-Shiong | WEST HOLLYWOOD – West Hollywood’s Public Safety Commission passed a motion to reallocate $3.2 million from the annual sheriff’s contract to much needed social services.

In exchange for recovering two out of 249 stolen phones, the council will discuss a $1,030,000 contract increase to support training for undercover sting operations. Zero cell phones were recovered from dimly lit, noisy nightclubs in the sting operations so far. The $22.15 million LASD contract will soak up one fifth of the city’s budget.  

One out of every five calls to the WeHo sheriff’s department is to address homelessness. An unprecedented campaign to reallocate dollars from LASD to social services has been supported by the 17th president of the NAACP, founder of CalEITC4Me, former mayors, and more.

As one resident shared in the outpour of public comments to the June 6 City Council meeting, “We need less money for cops, and more money for things like mental health, social services, and unarmed security.”The commenter said they’d witnessed armed LASD officers sitting around in their cruiser, not attending to a deceased elderly neighbor’s body and instead waiting for the coroner’s office to handle the situation.

The commenter also said they personally experienced being met with armed LASD officers just to report that their identity had been stolen. “I had to ask two [officers] to come to my unit and stare at my modem,” the commenter said. “All of this is such a waste! There is no reason to send highly paid and trained soldiers to do the type of work that a low-level bureaucrat could do.”

Let’s put the sheriff and social services budgets into perspective with two examples: the cost for an 18 month-guaranteed income pilot for LGBTQ+ residents versus three days of law enforcement at the city’s Pride events. 

WeHo announced a guaranteed income pilot delivering $1,000 per month to elderly LGBTQ+ residents. After a legal debate over the program’s discrimination against straight people, applications will re-open late June. Over a year after the pilot was announced, only 25 people will be selected. 

There was little debate around spending even more than the total guaranteed income payments for the LASD to patrol Pride. As one ACLU SoCal lawyer shared to City Council:

“Pride was, and still is, a protest. Instead, WeHo made Pride into a parade for the sheriff… The department is openly bamboozling you, the city, and other contract cities. We can all see it.”

Other commenters matched this sentiment, reflecting that voters are ready for change:

“Rainbow-wrapped cars do nothing for the community,” said one commenter. “WeHo filled Pride with deputy gangs,” said another.”

LA City controller candidate Kenneth Mejia’s historic lead in the recent primary demonstrates the demand for common-sense budgets backed by clearly communicated and transparent data. So far, Mejia has won almost double the votes of an established, career politician of 35 years, and has nearly the same vote tallies as the leading mayoral candidates, using a platform of financial education.

Sheriff & Protective Services Budgeted for: $22,155,636. Social Services budgeted for $6,5557,492
From 2022-23 West Hollywood Budget Breakdown.

It’s been a year since the city asked the WeHo sheriff to audit the department’s own performance. This summer, the city will spend $500,000 for an external auditing firm to audit the sheriff’s audit. The plan to “audit the audit” starkly reveals the level of trust this department has earned. 

It’s true that WeHo residents are not feeling safe. A community study showed that, in 2013, only 43% of residents felt very safe. A robust sheriff presence was the primary solution offered. Five years later, in 2018, even fewer felt very safe: only 26%.

It’s also true that there is no correlation between the rising costs of the sheriff contract and crime reduction. Who gave us this data? The sheriff’s department itself.  

Let’s remember that reducing the LASD contract does not even imply there will be fewer officers in WeHo. According to the LA County CEO, the LASD hired or promoted 1,900 new employees during the “hiring freeze” and is not prevented from assigning deputies to contract cities.

A group of Los Angeles Sheriff's Deputies stand in a crosswalk in West Hollywood. One of them is holding a bottle of water.
Los Angeles Sheriff’s Department Deputies at LA Pride in West Hollywood (Sean Carmitchel).

In Denver, a Support Team Assisted Response (STAR) Program sent mental health clinicians, paramedics, or emergency medical technicians to respond to low-risk calls coming into the 911 system. Most of the 15.6 million calls to the STAR team did not involve a safety concern or weapon.

The program reduced crime by 34%. We can let an alternative emergency response team take similar calls in WeHo, where each single LASD deputy could pay for three social service or mental health workers. For the cost of one officer, we could buy new iPhone 13s for each resident who was pickpocketed, and still have 109 phones left over at City Hall.

The $3.2 million LASD contract reduction could quadruple the number of unarmed Block by Block Security Ambassadors to 110 people. There could be a Block by Block Security Ambassador on every corner of the two square mile city.

Investing taxpayer dollars into the gigantic LASD bureaucracy has never been an effective solution to address homelessness or crime. Direct cash programs reduce crime. Alternative emergency response teams reduce crime. 

Perhaps this doesn’t matter when perception trumps reality. We have a chance to change both and set an example for other contract cities by investing in more effective –– and fiscally responsible –– solutions to public safety. 

There’s an ongoing petition for the city to reallocate $3.2 million from LASD to social services. 

The public has from June 23rd onwards to submit written public comments before the city’s budget is finalized at the June 27th City Council meeting.


Nika Soon-Shiong is the Public Safety Commissioner for the City of West Hollywood.

Additionally she is the Founder @fund4gi, Director @ComptonPledge, Board Chair @onefairwage and a PhD Candidate @UniofOxford


The preceding article was previously published by Knock LA and is republished by permission.

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To Biden: No Pride in detention of Transgender, queer communities

Jennicet Gutiérrez declines to attend White House Pride event



LGBTQ+ immigrant rights activists participate in the Queens Pride parade in Jackson Heights, N.Y., on June 5, 2022. (Photo courtesy of Emilio Vicente)

Editor’s note: This is the letter that Jennicet Gutiérrez sent to the White House in response to the invitation she received to attend its Pride Month celebration.

June 13, 2022

Dear President Biden and Dr. Biden,

I received your invitation to the White House Pride Celebration on June 15, 2022, and with a clear conscience I am letting you know that I will not be attending this event. There should be no White House celebration when Trans and queer communities are suffering and being detained by your administration. There is no pride in detention. 

At the start of your administration you pledged to protect LGBTQ+ people worldwide, but it’s a commitment that you have failed to uphold at home. 

Almost a year ago, while you were holding a Pride reception, Trans and queer immigrant leaders from across the nation marched to the White House, demanding the release of trans people, people living with HIV, and any medical condition, from detention centers across the country. We are still seeking justice for Victoria Arellano, Roxsana Hernández, and Johana Medina, trans women who died because of the negligence of Immigration and Customs Enforcement (ICE). 

Our members across the country are marching and protesting this Pride Month with the same demand of ending the violence and killings of Trans people. There have been over two million deportations since you took office, setting you up to be the next deporter-in-chief. Your administration has used Title 42 as an excuse to deport immigrants seeking a better future, most of them Black and brown people and including Trans and queer immigrants, even as your administration is relaxing requirements for people traveling to the United States. More than 32 states have drafted bills that would criminalize trans youth and their families for providing life affirming healthcare. Transgender people and children are under attack by the same white supremacist forces that are plaguing our nation and we haven’t seen your administration’s response be enough in the face of these attacks.

The reality is that as this celebration is taking place, Trans people currently in ICE custody will be in unsafe conditions. You could easily stop their suffering by instructing the Department of Homeland Security to implement a policy of liberating Trans people, people living with HIV and other medical conditions, as well as other vulnerable people.

Ending Trans detention and using your executive powers to protect LGBTQ people would have a greater impact on our community and would save many lives rather than hosting an event to deliver a well-crafted speech with broken promises.


Jennicet Eva Gutiérrez

13 de julio del 2022

Estimados presidente Biden y Dr. Biden, 

Recibí su invitación a la Celebración del Orgullo de la Casa Blanca el 15 de junio de 2022 y con la conciencia clara les hago saber que no asistiré a este evento. No debería haber celebración de Orgullo en la Casa Blanca cuando las comunidades trans y queer están sufriendo y siendo detenidas por su misma administración. No hay orgullo en la detención. 

Al comienzo de su administración, se comprometió a proteger a las personas LGBTQ + en todo el mundo, pero es un compromiso que no ha podido mantener en casa. 

Hace casi un año, mientras celebraban una recepción de Orgullo, líderes inmigrantes trans y queer de todo el país marcharon a la Casa Blanca, exigiendo la liberación de las personas trans, las personas que viven con el VIH y cualquier condición médica, de los centros de detención de todo el país. Todavía estamos buscando justicia para Victoria Arellano, Roxsana Hernández y Johana Medina, mujeres trans que murieron debido a la negligencia del Servicio de Inmigración y Control de Aduanas (ICE).

Nuestros miembros en todo el país están marchando y protestando este mes del orgullo con la misma demanda de poner fin a la violencia y los asesinatos de personas trans. Ha habido más de dos millones de deportaciones desde que asumió el cargo, lo que lo prepara para ser el próximo jefe-de-deportaciones. Su administración ha utilizado el Título 42 como una excusa para deportar a los inmigrantes que buscan un futuro mejor, la mayoría de ellxs personas Negras y personas de color, e incluyendo a inmigrantes trans y queer, mientras su administración está relajando los requisitos para las personas que viajan a los Estados Unidos. Además, más de treinta y dos estados han redactado proyectos de ley que criminalizan a los jóvenes trans y sus familias por proporcionarles atención médica que afirma su género y salvan sus vidas. Las personas transgénero y los niños están siendo atacados por las mismas fuerzas supremacistas blancas que están plagando nuestra nación y no hemos visto que la respuesta de su administración es suficiente frente a estos ataques.

La realidad es que a medida que se lleva a cabo esta celebración, personas trans actualmente bajo custodia de ICE estarán en condiciones inseguras y peligrosas. Usted podría parar fácilmente su sufrimiento instruyendo al Departamento de Seguridad Nacional para que implemente una política de liberación de personas trans, personas que viven con VIH y otras condiciones médicas, así como otras personas vulnerables. 

Poner fin a la detención trans y usar sus poderes ejecutivos para proteger a las personas LGBTQ tendría un mayor impacto en nuestra comunidad y salvaría muchas vidas en lugar de organizar una celebración de Orgullo para pronunciar un discurso bien elaborado con promesas incumplidas.


Jennicet Eva Gutiérrez

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