it's about social contagion and the entire reason for pronouns is trans and trans adjacent inclusion specifically because now the idea of assuming gender is considered rude and bigoted



almost nobody 40 or over lists anything, the very few that do will have the standard she/her



30-40 majority still don't have pronouns listed, the 20%ish that do will have a good mix of she/her they/them she/they etc but still lean heavily on the standard one


under 30 it's just the wild wild west

there's not something in the water that is making more she/theys and trans and gender fluid peopel



the rate has more than doubled in the past decade and we're still too early to have data on where these people will stand as adults

social contagion is real so much so that if you were sexually abused as a child by another male, you are significantly more likely to come out as gay yourself, furthermore, those same people are themselves more likely to sexually abuse a child as well once they are adults

Agreed, and I'd fully expect this is what happens now in the vast majority of cases.

I wouldn't want to try to gauge this with my limited knowledge, but this is possible.

The dating app results are certainly what I, and I assume most (all?) of us expected - no surprise there. But this is getting into a much, much bigger subject. Are people really concerned if kids come out as gay or choose different pronouns and later figure out that isn't what they want/who they are? I know I'm not. I'd think the concern is kids trying to undergo surgery, for example, due merely to "social contagion". That's what I remain unconvinced is actually happening, and a higher number of young people changing pronouns isn't all that compelling to make me believe otherwise.

What diagnostic code is associated with the administration of testosterone into a woman who is “transitioning?”

I honestly believe you are lying on purpose. There is plenty of evidence of groups of teenage girls in the same social circle announcing they are trans at the same time. Stop lying.

You may find it bizarre, but it’s a real thing. Eating disorders, cutting behaviors, and teen suicides have occurred as social contagions. And, they are more prevalent in young females based on personality traits, however, you do see this in boys too.
No one is saying that’s the only thing, but, to ignore that it occurs is irresponsible.

This reminds me of all the parents who, before I see their child, will tell me to be careful because the kid will lie about some things or not want to talk about some topics. Like, do these parents think that doctors somehow just fully trust every word a teenager (or any patient of any age, really) says? I was a teen once myself, I've gotten training in how to interact with them, and I have a lot of experience dealing with them. I take very little any patient says at face value. Do we think I'm unique?

Just because you have to put a diagnostic code down for billing purposes does not mean the patient actually has mental illness. CPT codes don't determine reality.

Just answer the question, man. And we’re not talking CPT code, that’s billing, we’re talking ICD-10.

Sorry, I'm still waking up. Just because you put down an ICD-10 code to be able to bill a CPT code doesn't mean the patient actually has a mental disorder. You already posted an ICD-10 code -- should I doubt you?

So you’re refusing to answer the question. Probably because answering it does not fit your agenda.

As I’ve already answered the question, maybe now you’d like to avoid answering the question, what is body dysmorphic disorder? Why is it in the DSM if it’s not a mental illness?

I answered where your question was going. If you want to play games trying to string the conversation along, I'm not interested. You can just make the point you want to make.

I never said that body dysmorphic disorder or gender dysphoria are not mental illnesses. What I said, and what the vast majority of psychiatrists and psychologists believe, is that being transgender is not a mental illness.

Bro, you are refusing to answer. It’s a simple question. What is the diagnosis affixed to a transgender person?
And, if you’re “not saying BDD is not a mental illness,” then you must agree that it is and if trans are diagnosed with BDD, how are they then not mentally ill?
The amount of mental gymnastics you are engaging is impressive.

There's no diagnosis attached to being transgender as being transgender is not a medical nor psychiatric problem. To give a drug or other medical procedure, we must put some diagnosis down. I will just trust that you have the correct diagnosis code and I'm really not sure why you want me to repeat it. However, putting down a diagnosis in order to be able to bill for the work doesn't mean the patient actually has a medical diagnosis. Is this unclear?

Anyway, I feel like this is the third time or so that I've said the exact same thing. Unless there's something new to add, I don't intend to repeat it again.

So you’re saying medical providers routinely lie in the medical record when they affix a diagnosis of BDD when ordering treatments associated with gender affirming care? I would think that is fraud. So, providers throughout the land are putting their licenses at risk on a daily basis? Why not, then, use a different billing code then?

Yes, the US healthcare system is quite messed up. We have to put the codes that the insurance companies have agreed we can use. Doing what's best for our patients sometimes means playing a game with insurance. I doubt any doctor in the US would be surprised by this in general, even if not as applied to the specific situation.

Also, I'm not saying that many of these patients don't have gender dysphoria which justifies the use of hormones. Being trans itself is not the mental disorder.

The lengths you will go to to avoid admitting you’re wrong is impressive. What’s funny, though, is everyone reading this thread will see how you were asked a direct question multiple times and refused to answer it. That does not bode well for your credibility.

Actually, I don't find you very credible in your exchange with Gangsta. Your reliance on a social contagion as the explanation for a medical condition is well beyond your expertise as either a internist or actor and does not follow any medical guidelines in existence. A social contagion is,at best, an anomaly.

CPT codes are never to be confused with medical diagnostics, as directly stated in their own guidelines. Very few civil cases even fewer criminal cases have ever succeeded for fraudulently using these codes and most of those have been for over-coding a procedure (ie, claiming it is more complex). Putting a CPT code in for treatment billing doesn't create any liability to the provider for making said diagnosis.

So it’s ok to accept social contagion as an anomaly, but intersex cannot be an anomaly of the binary gender classification that has been and continues to be scientific fact?

Not even sure what you think you're trying to salvage at this point.

I’m not the one needing to salvage anything. I’ve proven my points beyond all doubts, provided facts and evidence, and not refused to answer a single question, which is far more than can be said about others here.

Diagnostics are extremely important. They not only justify why you’re doing an intervention, they help communicate to others what is going on. I’ll give you an example; I had a young “man” in my office receiving testosterone injections. Very uncommon for an early 20s male to need testosterone. It happens. But it’s rare. Then, I saw under the patient’s problem list and saw Body Dysmorphic Disorder and immediately understood that this patient did not have some sort of endocrinological problem. By the way, that diagnosis was placed in the chart by, wait for it…….a psychiatrist!

It's just the fact that we don't physically assault kids who are not cis and straight as much as we used to. When you remove the violence required to keep the binary illusion alive then people are free to act how they want.

Language always changes with the young. Once you get older you are set in your ways and to hear different words is jarring. I will never get used to hearing "they" when "he" or "she" is what I grew up with as the proper usage. That doesn't mean I don't understand why things are changing or why someone would want to use "they". That older people don't use "they" as much as younger people is irrelevant to this conversation.

They is plural and is not used to refer to an individual when the gender is known.