The critiques also suggest that the finding that gender dysphoria improved with treatment may have been an artefact of how the participants were assessed. Before treatment, female patients were asked to agree or disagree with such statements as, “Every time someone treats me like a girl I feel hurt.” This established their desire to be seen as male. After blockers, hormones and surgery the same individuals were asked questions on a scale originally developed for those born male. It offered statements such as, “Every time someone treats me like a boy I feel hurt.” Naturally, patients who preferred to be seen as male disagreed. In effect, the yardstick was changed in a way that might be seen as making positive outcomes more likely.

Finally, the original studies seem to have inadvertently cherry-picked patients for whom the treatment was most effective. The researchers started with 111 adolescents, but excluded those whose treatment with puberty-blockers did not progress well. Of the remaining 70, others were omitted from the final findings because they did not return questionnaires, or explicitly refused to do so, or dropped out of care or, in one case, died of complications from genital surgery. The data may therefore exclude precisely those patients who were harmed by or dissatisfied with their treatment.

[The upshot of all this is that gender transitioning is experimental and unfounded in solid scientific data. That’s even more true for adolescents. The Economist does its best to sneer at those who oppose such practices as ideologues, but the question should be why the medical industry adopted these therapies and surgeries without convincing scientific data in the first place. — Ed]