"How to ruin Sex Research" article by JM Bailey

[MCParent]

Seems relevant to the board, perhaps in particular the "feeling attacked" thread....

How to Ruin Sex Research

Thoughts, all?

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[WisNeuro]

I read/skimmed it, I'm bookmarking it for a more thorough read. Did you want to discuss the editorial in general, or larger issues? Lots of ways to comment and very easy ways that it could get turned into an SPF thread, so I'll let you lead

 

[PsyDr]

Pretty much elementary school science class: Science should try to efficiently communicate. Science should explore ideas even if they are distressing. Science should use science to evaluate if an idea is wrong. Science should question anything it wants using science.

I wonder if the geologist or cartographer professional associations have to deal with people who are upset by spherical earth maps, and dinosaur fossils, and whatever.

I read it. Lots of good points. I think we have let elements of the culture of offense infect some science.

This echoes of the elevator lingerie joke issue (last year?) in which an old guy told a joke that someone took offense to and that someone got a professional group to blast the old guy for it.
.

That entire thing was that Richard Lebow, from Kings College, got in an elevator at a conference, and when a kind person in the elevator asked what floor he wished to go to, he replied something like "women' lingerie department". Which is a stupid dad joke. People kinda laughed. Simona Sharoni was on the elevator and filed a formal complaint with the professional organization.


https://www.washingtonpost.com/opin...ory.html?noredirect=on&utm_term=.258c04925db5

 

[cara susanna]

I thought that this was an interesting point:

The politically acceptable way to refer to phenomena recently called “transgender” seems to change weekly (e.g., Steinmetz, 2014a, b; Transgender terms and labels, n.d.). Changes occur not because of scientific discovery or scientific consensus. Rather, they usually occur because activists say terminology must change, in order to reduce offense.

I'm not a sex researcher but I run into a lot of this in online communities, where you see people being called "TERF" or accused of transphobia/non-inclusivity on a regular basis.

 

[erg923]

The thing I don’t get is that she was just in the presence of it....it’s not like he was even talking to her, or about her.

 

[futureapppsy2]

My impression from what I know of Bailey’s work is that he is a bit TERF-ish, whereby he seems to operate under the theory that trans women are the result of sexual desire (either gay men looking to attract men or autogynesexual men), which doesn’t account for the general positive mental health outcomes we see with hormone therapy alone, plus sexual reassignment surgery and social transition, especially when someone is treated as the gender they identify as. Plus, research suggests that treating trans children as the gender they identify as almost eliminates the mental health disparities between trans and cis/gender-conforming children, which is remarkable. I agree with his points about how we need to research questions and disseminate the answers regardless of whether or not they are politically correct, but much of what I read from this reads kind of like someone taking offense to people finding issues with his theories of gender dysphoria and sexual orientation. Not to mention, theories can indeed be harmful—see the empirically tested theories that you could positively punish (in this case, beating) the femininity—and thus potentially the homosexuality—out of your male children.

 

[MCParent]

The thing I don’t get is that she was just in the presence of it....it’s not like he was even talking to her, or about her.

If I saw someone make an openly sexual remark to someone in an elevator, I would report it. I don't see why it would have to be directed at her. I don't see the offense in the actual comment that was made, though.

 

[Sanman]

If I saw someone make an openly sexual remark to someone in an elevator, I would report it. I don't see why it would have to be directed at her. I don't see the offense in the actual comment that was made, though.

Offensive or not, I am appalled that a professional association feels the need to address conduct outside of the confines of a professional conference room in a public elevator. Whatever happened to free speech? So no one in that organization can ever tell a joke anywhere?

What I learned from that entire issue...don't wear a name tag.

 

[futureapppsy2]

Can we get back to the topic of Bailey (and his letter), please? Super curious to hear your thoughts...

 

[MCParent]

Can we get back to the topic of Bailey (and his letter), please? Super curious to hear your thoughts...

The idea that all transwomen are autogyophilic is bizarre, I agree that Bailey comes across as TERFy. But it’s also completely true that much of psych is being pushed out of real striving for scientific approaches.

 

[MCParent]

Offensive or not, I am appalled that a professional association feels the need to address conduct outside of the confines of a professional conference room in a public elevator. Whatever happened to free speech? So no one in that organization can ever tell a joke anywhere?

What I learned from that entire issue...don't wear a name tag.

I said I meant in the case of a totally sexist/offensive remark that is unambiguous. I think I was pretty clear I did not mean a joke, even a bad one.

 

[cara susanna]

Yeah, I did a quick Google Scholar search on the autogynephilia theory (I feel like I'm spelling that wrong) after reading this and it seems controversial for a reason.

 

[futureapppsy2]

The idea that all transmen are autogyophilic is bizarre, I agree that Bailey comes across as TERFy. But it’s also completely true that much of psych is being pushed out of real striving for scientific approaches.

Just to clarify, Bailey holds that trans *women* (MTF) are either autogynephilliac or gay men. As far as I can find, trans men (FTM) are non-existant in his theory.

 

[Ollie123]

I agree the article itself comes across a little self-serving and lacks some introspection regarding legitimate critiques of his own work.

I do think scientists have a responsibility to think through the public health impact of how they frame their work. I do not believe that he (and many others) necessarily do a great job of this and trend a bit more towards sensationalism than I think is wise or responsible. It bolsters their career, but I do not think it is optimal behavior. When it comes to laboratory research or clinical trials work, making bold statements from a single sample is very rarely justifiable. That said...there is a fine line. They are still a far cry from news organizations. I am not suggesting anyone should suppress results. I am suggesting that if I discovered tomorrow that cigarette smoking was in fact, not related to lung cancer in a particular subpopulation...I'd be damn careful how I phrase it and have about a bajillion "We need to replicate this before believing it" lines. This hurts my career and makes me less likely to grab headlines. I still think its the right thing to do.

That said, his broader point I wholeheartedly agree with. This is a political topic, but it doesn't mean we should politicize the science. Use the science for political arguments...sure. Use political beliefs to motivate us to study certain topics? Maybe. If its done rigorously, I have no issue with it. His discussion of working with Sylla was perfect. Everyone worked together and learned something. This is the ideal. If you think I'm wrong, shut up and show me the data because otherwise you are just wasting mine and everyone else's time. Or critique it. Legitimate scientific critiques are fine and appreciated. Maybe I missed something in my study design. Great! I'll fix it and we can make the next one better. There is a wide chasm between "I think your study is bad because you didn't include covariate X and its important for reason Y" and "I think your study is bad because I find your results offensive to my world view."

I do worry the latter is becoming more prevalent. Which is ironic, given the push is often coming from sects that have traditionally been extremely pro-science (progressive, highly-educated, etc.).

I wasn't there, but if his description of the event is accurate, Milford seems like a tool and were I in charge would likely not be welcome back at the conference. Disagree strongly with a speaker? Fabulous. Arrange a debate/panel/symposium on the topic for next year. This is how grown-up scientists behave. And these events are invariably the best-attended events at every conference I have been to.

 

[MCParent]

Just to clarify, Bailey holds that trans *women* (MTF) are either autogynephilliac or gay men. As far as I can find, trans men (FTM) are non-existant in his theory.

Oops, typing while walking. Fixed.

 

[deleted343839]

The idea that all transwomen are autogyophilic is bizarre

That isn't the claim, though you could argue that he overvalues this phenomenon.

As far as I can find, trans men (FTM) are non-existant in his theory.

To be fair, he doesn't have an obligation to study trans men. That he doesn't study this population doesn't mean he considers them "non-existent." I know someone who mainly studies trans men and I would never make the assumption that they "erase" trans women or whatever. Trans men are probably less well represented in the literature in general, though this may be changing.

Fun fact: I met Michael Bailey once at a drag show.

 

[futureapppsy2]

That isn't the claim, though you could argue that he overvalues this phenomenon.



To be fair, he doesn't have an obligation to study trans men. That he doesn't study this population doesn't mean he considers them "non-existent." I know someone who mainly studies trans men and I would never make the assumption that they "erase" trans women or whatever. Trans men are probably less well represented in the literature in general, though this may be changing.

Fun fact: I met Michael Bailey once at a drag show.

Not saying he doesn’t think they exist, just saying that his theory of transgender origin doesn’t necessarily translate to trans men, which is arguably a considerable shortcoming of it as a causative model of transness.

 

[deleted343839]

Not saying he doesn’t think they exist, just saying that his theory of transgender origin doesn’t necessarily translate to trans men, which is arguably a considerable shortcoming of it as a causative model of transness.

Are there actually people who think that a single model can or should explain all transgender phenomena? Good lord, I'd like a dose of that confidence.

 

[Fan_of_Meehl]

Seems relevant to the board, perhaps in particular the "feeling attacked" thread....

How to Ruin Sex Research

Thoughts, all?

We need more sex research. We need more research into 'controversial' areas in psychology in general.

 

[futureapppsy2]

Are there actually people who think that a single model can or should explain all transgender phenomena? Good lord, I'd like a dose of that confidence.

Well, according to Bailey’s writings, all trans women are either a) gay men who become women to attract men or b) autogynephillic men, so he does hold that he has a complete model of (MTF) trans-ness. There are other models of trans development that are much more strongly supported by evidence (as well as developmental biology), and honestly Bailey’s model strikes me as akin to the old theories that homosexuality is the result of boys not having feminine behaviors “taught” out of them. It’s not just as Bailey’s model is not 100% explainatory, it’s that it’s not supported by a pretty substantial body of both basic and applied research.

 

[deleted343839]

It’s not just as Bailey’s model is not 100% explainatory, it’s that it’s not supported by a pretty substantial body of both basic and applied research.

I'm no Bailey apologist. I think his editorial was self-serving and tunnel visioned. However, I am sympathetic to the idea that it is politically expedient to keep our narratives about sexuality and gender "clean" and ignore the more complicated realities. Bailey is not the only person who has studied autogynephilia and autoandrophilia or their relationship to sexual orientation and gender identity. There is a big difference between saying that Bailey overemphasizes/overvalues the role of autogynephilia (which I believe to be true) and saying that the model doesn't describe any forms of transgender experience. In the same vein, while the "born this way" narrative of sexual orientation has been very politically successful, it's overly simplistic and runs counter to how some people describe their experience of developing different sexual attractions in adulthood. Scientists are afraid to touch these issues, and for good reasons. And that's a shame.

 

[Fan_of_Meehl]

Who 'owns' the concept of gender identity or roles? I think it might best be discussed and resolved at the level of the individual client and their therapist. I am concerned about the encroaching tyranny of this top-down process of the 'experts' telling us what we must do in our consulting rooms.

 

[Fan_of_Meehl]

I think that Roseanne Cash is even a better songwriter than her father, but I am still dragging my knuckles...



The lyrics are brilliant.

 

[futureapppsy2]

Who 'owns' the concept of gender identity or roles? I think it might best be discussed and resolved at the level of the individual client and their therapist. I am concerned about the encroaching tyranny of this top-down process of the 'experts' telling us what we must do in our consulting rooms.

You mean the people who conduct empirical research to determine what leads to the best outcomes for people with gender dysphoria? It’s like how dare those researchers tell us that conversion therapy for gay people is iatrogenic based on extensive research.

 

[Fan_of_Meehl]

You mean the people who conduct empirical research to determine what leads to the best outcomes for people with gender dysphoria? It’s like how dare those researchers tell us that conversion therapy for gay people is iatrogenic based on extensive research.

I take your point. And it's a good one. At the level of the statistical/empirical concepts being applied to the level of the individual of the consulting room. No offense intended. And I think this is a cool and important discussion.

 

[Fan_of_Meehl]

Who here is advocating for 'conversion therapy for gay people'? I think you may be executing a straw person.

 

[Fan_of_Meehl]

The evidence is hardly in for 'what works' in terms of helping our clients who present with gender dysphoria. Moreover, I don't even discern a coherent theoretical model of 'what's wrong' or 'what is the pathology' here.

 

[Fan_of_Meehl]

You mean the people who conduct empirical research to determine what leads to the best outcomes for people with gender dysphoria? It’s like how dare those researchers tell us that conversion therapy for gay people is iatrogenic based on extensive research.

What does lead to 'the best outcomes' for people with gender dysphoria?

 

[Fan_of_Meehl]

In my clinical experience, those who present with 'gender dysphoria' are typically narcissistic and demanding that the world bend and cater to their opinions, needs, and demands. Now, I'll get 'flamed' (poetically) for saying it, but it's the truth. Typically, their difficulties have little or nothing to do with the gender issue itself, but their narcissism. Delete/scald/obliterate this post, but it won't cancel out the truth.

 

[futureapppsy2]

In my clinical experience, those who present with 'gender dysphoria' are typically narcissistic and demanding that the world bend and cater to their opinions, needs, and demands. Now, I'll get 'flamed' (poetically) for saying it, but it's the truth. Typically, their difficulties have little or nothing to do with the gender issue itself, but their narcissism. Delete/scald/obliterate this post, but it won't cancel out the truth.

Interesting observation. I’d be interested (legitimately!) in data on this. Off-hand, I’d wonder if this could be reactive defensenwss, which we do sometimes see in traditionally marginalized groups, but we need solid data.

As for best outcomes, we see consistently that treating gender dysphoric people as the gender they identify as leads to better outcomes across the lifespan. Is it a panacea? No, but it does significantly help, especially in trans children. I have some citations on this I can pull.

 

[Fan_of_Meehl]

Sure. Is there any 'non-anecdotal' methodologically sound research literature that honestly addresses the issue/question?

 

[Fan_of_Meehl]

Clinical experience ('anecdotes') trump politically/ideologically motivated discourse, in my experience.

 

[Fan_of_Meehl]

Interesting observation. I’d be interested (legitimately!) in data on this. Off-hand, I’d wonder if this could be reactive defensenwss, which we do sometimes see in traditionally marginalized groups, but we need solid data.

As for best outcomes, we see consistently that treating gender dysphoric people as the gender they identify as leads to better outcomes across the lifespan. Is it a panacea? No, but it does significantly help, especially in trans children. I have some citations on this I can pull.

Pull literature all you want. Adopting an 'I am a victim and the world is against me so why try' mentality is inherently dysfunctional.

 

[Fan_of_Meehl]

No one here (even me) has articulated a position against supporting transgender adults/children/zygotes in their gender expression, by the way.

 

[LadyHalcyon]

Interesting observation. I’d be interested (legitimately!) in data on this. Off-hand, I’d wonder if this could be reactive defensenwss, which we do sometimes see in traditionally marginalized groups, but we need solid data.

As for best outcomes, we see consistently that treating gender dysphoric people as the gender they identify as leads to better outcomes across the lifespan. Is it a panacea? No, but it does significantly help, especially in trans children. I have some citations on this I can pull.

I actually see it more often linked with a borderline presentation and a lack of a coherent and unified identity. There is actually research that supports this. I have also tested children as young as 6 who identified as a different gender. In fact, I remember one case where the parents said their son wanted to be a girl since the age of 2 or 3. I gave him an IQ test and he performed below our expectations. My supervisor suggested we give him another test (PPVT) but have him choose his name and gender prior to the administration. He performed significantly higher. I think gender dysohoria is complicated; for some it may represent more of a borderline presentation but for others it might not. That is why I am a huge advocate of psychological testing prior to gender reassignment surgery because if it is a borderline presentation for that individual then there is the potential for the surgery to cause harm.

 

[Fan_of_Meehl]

Interesting observation. I’d be interested (legitimately!) in data on this. Off-hand, I’d wonder if this could be reactive defensenwss, which we do sometimes see in traditionally marginalized groups, but we need solid data.

As for best outcomes, we see consistently that treating gender dysphoric people as the gender they identify as leads to better outcomes across the lifespan. Is it a panacea? No, but it does significantly help, especially in trans children. I have some citations on this I can pull.

I'll tell them all about my cis-gender, white-male, patriarchal, colonizing guilt and see if that reduces their symptoms and improves their relationships and interpersonal functioning. Where are the studies in support of this approach? Is this a religion?

 

[LadyHalcyon]

Pull literature all you want. Adopting an 'I am a victim and the world is against me so why try' mentality is inherently dysfunctional.

I was just reviewing a few studies I had and one of the studies stated the most frequent PD associated with Gender Identity Disorder was Narcissistic PD. Very interesting.

 

[Fan_of_Meehl]

I was just reviewing a few studies I had and one of the studies stated the most frequent PD associated with Gender Identity Disorder was Narcissistic PD. Very interesting.

This is an interesting finding. Thanks for sharing it. Not sure what it means. I don't have an agenda beyond actually being truthful (and not lying) to my patients and helping them live better lives.

 

[Fan_of_Meehl]

If we have one 'prime directive' as psychotherapists...it is not (knowingly) lying to our patients.

 

[foreverbull]

I'm speaking very generally, here; this is complicated. I agree with the author to some extent (the underlying theme) that if you don't agree with the research, continue to do more research and change the methodology/improve the methodology--the best rebuttal being research to counter research.

Having said that, research with problematic bias in the first place can be what folks remember, even if it isn't generalizable and is cherry-picked data. While we talk about the pitfalls in research methodology and generalizability in our grad programs, the public doesn't necessarily remember the rebuttals and later research.

I'm not sure where this author falls in his views, but it sounds like his research hinges on autogynephilia. Makes me wonder how or why he came up with this theory, but I'd have to look at his research to comment more specifically.

I'm not a person who sees these issues in black-and-white because I think people can take things to extremes either way. I've seen people go out of their way to act insensitively and/or go into research with an extremely conservatively-biased agenda (meant to be "evidence" against equal rights for different groups), and folks who felt so offended by the discussion of self harm that they demanded a trigger warning during a training for peer support students who were volunteering to help students in crisis. I do think there is a shift culturally that is highlighting these issues of discourse.

Science can be helpful in both bringing up these issues and sharpening methodologies, as well as highlighting underlying bias/ulterior motives. It's important to take bias into consideration because we tend to think science is the last word. I became a bit jaded about the nature of research and "truth" when I saw the magic you can perform via data imputation when you have missing values in your data set.

I’ve perused the outcomes research for transition in the literature and it leads to better outcomes by far for adults with gender dysphoria. While there is some fluidity in adolescence and childhood, for most children who consistently identify as the opposite gender and have a clear pattern of gender dysphoria, the gender dysphoria will persist into adulthood. I’ve worked with many trans-identifying adolescents and adults (pre- and post- transition) and I’ve rarely seen the “narcissism” that @Fan_of_Meehl mentions, but I’m thinking that relates to personality disorder comorbidity. Things do get tricky when folks see themselves as completely genderqueer (no sense of male or female, but both or neither) and then want to pursue surgery but not hormones, etc., but our mindset in the field just hasn’t caught up with it all the way because gray areas are scary for psychologists.

Anecdotally, I worked with a trans woman pre-transition who regularly dreamed of being a woman, felt “at home” and comfortable in women’s clothing (not sexually/fetishized), and was not sexually attracted to men (identified as asexual) so that doesn’t seem to support this author’s theory, from what has been discussed so far in this thread, unless I’m misunderstanding a piece of his theory.

 

[LadyHalcyon]

This is an interesting finding. Thanks for sharing it. Not sure what it means. I don't have an agenda beyond actually being truthful (and not lying) to my patients and helping them live better lives.

Not surprisingly much of the research is contradictory: "Understanding these disorders contributes to clarification of GID nosology. Some scholars classified GID as a part of borderline personality disorder (BPD) (10 to 13). For example, Murray has suggested that GID in men is a presentation of character structure matched with Kernberg’s criteria for borderline personality organization. Transsexualism is even considered as a subset of borderline personality disorder (10). Seikowski et al. opposed to the correlation between GID and borderline personality disorder, regarding GID as a separate disorder, which may sometimes show borderline personality disorder symptoms (14)."

Here is a link to the study. It is also important to note this research was conducted in Iran.

Edited to add: Also, I question their use of the MCMI II as it tends to overpathologize and the combination of Narcissistic and Histrionic elevations can actually be indicative of resiliency.

The frequency of personality disorders in patients with gender identity disorder

 

[futureapppsy2]

If we have one 'prime directive' as psychotherapists...it is not (knowingly) lying to our patients.

It’s not lying to say that transition or gender-affirmation is protective in people with well-established GID, though—its very much evidence-based. Again, there’s issues of comorbidity and sorting out GID from gender non-conformity, especially in children, but I’m confused by your assertions that there’s no clear benefits to gender affirmative or transition, when there’s a very strong body of literature that supports this.

I also think there are cautions about looking at pathology in trans adults, especially in somewhere like Iran, and trying to generalize it to making gender dysphoria a pathology. We know that we see higher rates of many pathologies in GLB people, but those rates decrease with greater social acceptance—same as with trans people—which seems to suggest that something like minority stress may be contributing in large parts to the higher rates.

 

[foreverbull]

Just as a reminder, Gender Identity Disorder doesn’t exist in the DSM-5. It’s simply Gender Dysphoria.

 

[Fan_of_Meehl]

I have no implied or expressed (behaviorally) bias against my clients expressing their gender identity in any form that they choose. It is my responsibility to explore, with them, the consequences of their behavior. They are the ultimate judge, however. I don't think we disagree.

 

[LadyHalcyon]

The current cultural zeitgeist also seems to have implications. I work with adolescents and adults and over the past five years I have noticed most of my adolescent patients identify as transgender, bisexual, pansexual etc. I do not think this is necessarily symptomatic of gender dysphoria and gender fluidity clearly does not equal gender dysphoria, but I am interested to see future research in this area.

 

[Fan_of_Meehl]

The current cultural zeitgeist also seems to have implications. I work with adolescents and adults and over the past five years I have noticed most of my adolescent patients identify as transgender, bisexual, pansexual etc. I do not think this is necessarily symptomatic of gender dysphoria and gender fluidity clearly does not equal gender dysphoria, but I am interested to see future research in this area.

I think we should all carefully explore the implications and effects of this with our individual clients and strive to help them (without bias) find their own way with respect to sexual orientation or gender-reassignment (or gender 'affirming') surgery.

 

[foreverbull]

The current cultural zeitgeist also seems to have implications. I work with adolescents and adults and over the past five years I have noticed most of my adolescent patients identify as transgender, bisexual, pansexual etc. I do not think this is necessarily symptomatic of gender dysphoria and gender fluidity clearly does not equal gender dysphoria, but I am interested to see future research in this area.

There are trends; amongst some groups of adolescents it’s now seen as “cool” to identify this way (I worked at an adolescent residential treatment program and eating disordered behaviors and identifying as trans were hip for a second and spread quickly). Taking time to slowly explore all angles and not moving too quickly can help differentiate between a phase and a deep underlying dysphoria. With the phase kids, they just explored the trans identity harmlessly for a little while (“tried it on,” so to speak and asked others to call them by particular pronouns/names) and then their interest waned and they moved on, while another subset with true dysphoria held firm to the identity and understanding of themselves.

 

[Fan_of_Meehl]

I was just contacted by an apparent authority of this board, stating that I was in violation of some principles. This is amazing.

 

[Fan_of_Meehl]

There are trends; amongst some groups of adolescents it’s now seen as “cool” to identify this way (I worked at an adolescent residential treatment program and eating disordered behaviors and identifying as trans were hip for a second and spread quickly). Taking time to slowly explore all angles and not moving too quickly can help differentiate between a phase and a deep underlying dysphoria. With the phase kids, they just explored the trans identity harmlessly for a little while (“tried it on,” so to speak and asked others to call them by particular pronouns/names) and then their interest waned and they moved on, while another subset with true dysphoria held firm to the identity and understanding of themselves.

Have fun with a 'discussion' where a civil, intelligent, respectful opposition is banned due to disagreement.

 

[LadyHalcyon]

There are trends; amongst some groups of adolescents it’s now seen as “cool” to identify this way (I worked at an adolescent residential treatment program and eating disordered behaviors and identifying as trans were hip for a second and spread quickly). Taking time to slowly explore all angles and not moving too quickly can help differentiate between a phase and a deep underlying dysphoria. With the phase kids, they just explored the trans identity harmlessly for a little while (“tried it on,” so to speak and asked others to call them by particular pronouns/names) and then their interest waned and they moved on, while another subset with true dysphoria held firm to the identity and understanding of themselves.

Yes, this has also been my experience (albeit very limited). I have only worked with one client diagnosed with Gender Dysphoria but they had a different presentation than the adolescents I work with now. The former's gender dysphoric feelings emerged in early childhood and were also more persistent/consistent.