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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

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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.

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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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Jimmy Biblarz: Representation matters, why I’m running for LA City Council

Jimmy Biblarz is a candidate for LA City Council to represent District 5 which runs from Bel-Air, through Palms, and east to Hancock Park

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Photo courtesy of Jimmy Biblarz

By Jimmy Biblarz | BEVERLY GROVE – Angelenos routinely list homelessness and housing affordability as their top concerns. As a candidate for Los Angeles City Council’s Fifth District, I’ve heard the concerns of worried and frustrated residents and the impact both have had on their lives. They want real solutions to these seemingly intractable issues.  

Housing affordability has shaped my life. When I was 12, my family was evicted from our apartment and we moved all over the city due to housing costs. Compounding this was growing up gay under the cloud of Prop. 8, which temporarily enshrined state-sanctioned marriage as between a man or a woman. The scars from this confluence of events are very much still with me. 

People don’t usually associate the LGBTQ+ community with homelessness and housing affordability. But by every measure, the LGBTQ+ community fares far worse than the general population. According to Williams Institute research, up to 40% of homeless youth identify as LGBTQ+. Half of all trans people experiencing homelessness nationally live in California, with Los Angeles city having the highest number, per the National Coalition to End Homelessness. LGBTQ+ folks are 15% more likely to be poor than their hetero and cisgender counterparts, especially queer people of color. Fewer than 50% of LGBTQ+ people own their homes, compared to 70% for non-LGBTQ+ people. And we know that LGBTQ+ still experience discrimination in the housing market; housing providers are less likely to respond to rental and mortgage inquiries from same-sex couples are more likely to charge same-sex couples higher rents.

This is why representation matters. Amidst calls for more permanent supportive housing, shelter beds, or tiny homes, the LGBTQ+ story is too often missed, especially trans voices. Temporary congregate shelters are poor fits for LGBTQ+ folks, typically offering few LGBTQ+-specific medical or mental health services, and often feeling quite unsafe to gender and sexuality minorities. That’s why queer people are much more likely to experience unsheltered homelessness, living on the streets, versus other forms of homelessness (“doubling up” with friends or family, living in a car). We need leaders who see issues through a queer lens.

Los Angeles has long been a haven for queer young people. That is a point of pride for our city. We must do everything we can to ensure it stays one. We must bring permanent supportive housing online with the urgency this crisis demands, by streamlining plan approvals and the location siting process, and supporting master lease agreements. And we must ensure new supportive housing includes the slate of medical and mental health services LGBTQ+ people need. Perhaps above all, we must invest in methodical and sustained street engagement teams led by well-compensated and highly trained experts with specific knowledge of the issues LGBTQ+ folks face. 

We need to elect leaders who are serious about new housing in LA, especially in the high-opportunity and job-rich areas of Council District 5 where I’m running. My plan focuses on building diverse, low-cost housing along under-utilized commercial transit corridors in high-opportunity areas in CD-5 (like Robertson, Westwood, Melrose, and L.A. Cienega) and holding developers’ feet to the fire on affordability requirements in market-rate units. Simultaneously, we must ensure wages rise in tandem with L.A.’s cost of living via indexed minimum wage increases that exceed increases in cost of living and investments in high-quality, unionized, green jobs. There is a growing gulf between real wages and the cost of housing. If we don’t act to reverse this trend, more and more LGBTQ+ people will be priced out of LA, and our thriving LGBTQ+ communities will disappear. 

With Ron Galperin’s departure, Mike Bonin’s retirement, and Mitch O’Farrell’s re-election far from a sure thing, we are at risk of losing LGBTQ+ representation on the Los Angeles City Council. Los Angeles has had nearly uninterrupted LGBTQ+ representation on the City Council since Joel Wachs was first elected in 1971, save a brief period in the mid-2000s. Come November, the nation’s second largest region could have no LGBTQ+ representation in the city or the county.  

Los Angeles needs LGBTQ+ leaders who understand the issues our community faces everyday. Queer people understand the importance of politics acutely; we can’t afford backsliding in representation, especially given the proliferation of anti-LGBTQ+ laws across the country, and growing hate in our own city. 

My life experience makes me uniquely qualified to meet this moment. I understand the major issues facing Angelenos because I’ve lived it. But it’s about more than my city council race. What’s at stake is a true representative democracy—a city that reflects its citizens. I urge all LGBTQ+ Angelenos to get informed, get involved and vote by June 7th. Our voice matters and we’ve come too far to let it slip away. 

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Jimmy Biblarz is a candidate for City Council in District 5, which runs from Bel-Air, through Palms, and east to Hancock Park, bordering most of West Hollywood.

Born and raised in West LA, Jimmy is an educator, policy expert, and housing advocate. Shaped by his own experience with housing insecurity and eviction, Jimmy centers empathy and compassion in his approach to the homelessness and housing crisis.

Jimmy attended K-12 LAUSD schools in the district, was at Harvard for college, graduate school, and law school and is now a professor at UCLA Law School. He lives with his partner Harry, in Beverly Grove. 

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Why I’m Running: Lindsey Horvath

Lindsey Horvath is a candidate for the seat representing Los Angeles County’s 3rd supervisorial district on the County Board of Supervisors

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Courtesy of Lindsey Horvath

WEST HOLLYWOOD – My career is defined by tackling the hardest problems, building diverse coalitions, and delivering results for my community. I’m running to be the next Los Angeles County Supervisor from the 3rd District because I have the determination and experience to make a difference for the people who need it most.

Right now, working families are struggling to keep up with a crush of compounding crises. We need Los Angeles County to step up and protect workers’ rights while creating a thriving local economy. We need sustainable, supportive housing and services for the people living on our streets and community-focused public safety services that keep us all safe. We need our government to work for us. 

I’m ready to use my experience leading the region on issues like homelessness, public safety, transportation, and economic development to put Los Angeles County back to work for the people. Throughout my career as a public servant, I have scored victories for my community on advancing the rights of women and LGBTQ+ people, as well as creating age-friendly, sustainable neighborhoods, and I’m just getting started. 

Of all the candidates, I bring a proven record of bridge-building, community engagement, and innovative problem-solving on the local level. Like many Angelenos, I am a renter, a millennial, and someone who directly faces the needs of working people. My experience and connections at the local level have delivered opportunities to serve in statewide and national leadership roles. 

I am the only candidate with relevant, current experience at the local level who has the community connections to implement real, on-the-ground, culturally-competent solutions to our District’s most urgent challenges. I’m currently working within County leadership to implement solutions to our homelessness and housing crises as well as our broken criminal justice system, to improve our health and quality of life through enhanced social programs, and to help Los Angeles transition towards a sustainable, clean energy future. 

I’m also the only candidate who has direct experience navigating the LA County Sheriff’s Department to implement real and lasting change. This includes my work to clear the backlog of untested rape kit evidence and to hold the Sheriff and the Department accountable.

As Mayor during the pandemic, I worked with businesses and employees to keep businesses safely open and to improve working conditions. The unique, diverse coalition of support we’ve developed reflects the diversity of our region, and makes our campaign uniquely positioned to connect with ALL communities throughout the district.

As a municipal official for 15 years, I took action to keep our communities healthy for all of our residents by fighting for investment in public safety services, preserving and building more affordable housing, improving public transit by bringing Metro rail to our District ahead of schedule, and finding solutions to care for and house our growing unhoused population.

We need leaders who know how to deliver for our communities. I’ve done this not just in West Hollywood but as Past President of the California Contract Cities; Board Member for the National League of Cities (NLC); Past President of Women in Municipal Government (WIMG) for the National League of Cities; Chair of the Liability Trust Fund Claims Board & Oversight Committee; and Executive Committee Member and Legislative & Regulatory Chair for Clean Power Alliance of Southern California.

Combating homelessness is a top priority for me. My leadership in the City of West Hollywood has produced an intersectional approach to solving homelessness – including housing, services, and community safety – that has delivered results. In addition to inclusionary housing, I have championed the production of transitional, supportive, and long-term affordable housing solutions. I also initiated the City’s request to have dedicated LASD Mental Evaluation Teams (MET), which combine a clinically-trained social worker with a public safety professional to respond to relevant calls.

We need to establish teams to meet people where they are with the relevant support they need, including mental health services, addiction recovery, and job training, instead of leaving them to face the additional challenges of navigating the endless bureaucratic process alone. We must invest in solutions that take into account the root causes of homelessness, rather than wastefully spending more public dollars without solving the foundational problems.

We also need to take immediate action to transform Los Angeles into a leading clean energy county. Climate change is an issue that requires bold action, which is why I supported the adoption of net-zero policy goals to set my community on the path to becoming a zero-carbon city, and I will work with cities and neighborhoods to do the same across Los Angeles County.
Throughout my career, I’ve worked to bring people together to find solutions to the toughest local problems. I’m ready to put my skills to work for people of District 3 so that we can build a Los Angeles that works for everyone.

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Lindsey Horvath is a candidate for the seat representing Los Angeles County’s 3rd supervisorial district on the County Board of Supervisors. She currently is an elected member of the City of West Hollywood City Council.

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Regarding Chappelle being attacked

“It seems that every time something like this happens, we remove another block from the wall that separates from anarchy and mob rule”

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Courtesy of Netflix

By Julia Scotti | WHITING, Nj. – Regarding Chappelle, in the past I’ve made no secret about my feelings for Chappelle, so I won’t rehash them again. This essay is about him being attacked on stage last night and to a lesser extent, what happened to Chris Rock at the Oscars.

Comedy is one of the last bastions for truly Free Speech. Ask any comic if they feel the same way and I would bet that they would agree. One of the reasons people come to see us is that comedians often reflect what the audience is feeling but dares not say aloud. Sometimes it is risky, but we hope that if we present it in a humorous, absurd way, you will see what we see.

In general, most comedians will adhere to the unwritten rule of “Not Punching Down,” that is, not picking on those who can’t fight back. Chappelle, of course, violates this rule constantly. In fact just after the attack, he joking referred to his attacker as a trans-man.

Now I’m sure that his lame attempt at humor was an effort to try to diffuse the tension onstage and return to normal. But joking or not, there are some in that audience who will believe that their idol was indeed attacked by a deranged Trans man. I don’t know if the attacker was or wasn’t. I don’t care and neither should Chappelle. What I do care about though is this seeming trend toward violent response when someone is unhappy with the comedians’ words.

It pains me to have to defend this guy (Chappelle), but there is a bigger issue here. What does it say about us as a nation when our only response to being dissatisfied with the outcome of an event is to resort to violence? If an election doesn’t turn out the way we want? Storm the Capitol. Unhappy with certain people trying to pass laws guaranteeing equality? Ridicule them, intimidate them and threaten their families until they acquiesce to your way of thinking. If a comedian says something you don’t like, goad them into responding to your heckles until you can record it and become a social media star, or worse, attack them onstage.

I don’t know what Chappelle’s attacker’s motivation was. I understand that he got quite a beat down from the security people at the venue. 

Take a step back from the news and try to see us from a different perspective. Through my lens at least, it seems that every time something like this happens, we remove another block from the wall that separates from anarchy and mob rule. It’s sad, really. Very, very sad.

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Julia Scotti is a nationally known beloved Trans comedian, actor, and fan favorite of America’s Got Talent audiences around the world.

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