Several Problems Press

CC:
Sen. Matthew Canavan (LNP—QLD)
Sen. Pauline Hanson (ONP—QLD)
Sen. Susan McDonald (LNP—QLD)
Sen. Gerard Rennick (LNP—QLD)
Sen. Amanda Stoker (LNP—QLD)

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Dear Senator Roberts,

I hope this letter finds you appropriately well.

I write with reference to your Motion No. 1114, considered by the Senate Tuesday 15 June 2021, which was not carried. The other recipients of this letter are included because they are Senators from Queensland who voted “aye.” As a resident of Queensland who is enrolled to vote, and therefore as your — and their — constituent, I am doing my civic duty and providing you with informed feedback.

As it was your motion, I assume it was drafted either by you or by someone with whom you are professionally associated. I have a few suggestions and points of issue for the next time you take legislative action on this topic. From the text of your motion —

there is an alarming trend that teenage girls, with no history of GD, have become the largest group seeking treatment.

s (a)(i)

First. Some percentage of these people — statistically, an overwhelming majority of them — are not girls. The decision to classify them all as “girls” regardless is an act of misgendering which could easily have been avoided.

Second. The ratio of trans women to trans men in adulthood is approximately 1:1; however, female-assigned children who don’t conform to their assigned gender have historically been underrepresented at gender clinics, partly because people who appear to be women are taken less seriously in general, and partly because gender nonconformity is less pathologised in “girls” than in “boys” (Urquhart, 2017). It is not reasonable to describe the referral of more trans boys as “alarming” when it represents a regression toward the mean (Ashley & Baril, 2018).

Third. “Not having a recorded history of a condition until you seek treatment for it” describes the vast majority of all interactions with the medical system; one doesn’t go to the doctor for a complaint until one has that complaint. The framing used in the motion implies a very unusual understanding of human psychology.

in the United States of America, girls requesting gender reassignment surgery in 2016-17 rose 400%.

s (a)(ii)

First. Again, some percentage of these people are not girls and this section of the motion misgenders them.

Second. The claim being made here is extracted from Abigail Shrier’s Irreversible Damage, which cites the American Society of Plastic Surgeons (2018) as the source. Per the fine print, the ASPS’ numbers are not their raw survey data, but instead a “projection” from it. The “projection” appears to be done in a methodologically flawed way which means that the “projections” in question do not necessarily bear, and in fact may necessarily not bear, any actual resemblance to reality (Brown, 2017).

Third. It is likely, however, that there would indeed have been a rise in treatment uptake in 2016-2017 — because it was still within the first couple of years after the US Medicare system dropped its blanket denial of public healthcare coverage for any transition therapies whatsoever (Cha, 2014).

This would extremely obviously be material to any discussion of year-on-year increases in therapeutic uptake, especially given that cost is statistically a significant barrier to gender therapies (Sineath et al., 2015), while transgender people are disproportionately impoverished, unemployed, uninsured, and denied medically necessary procedures when they are insured (James et al., 2016). Omitting this necessary context does not lend itself to a charitable interpretation of the motives of the party responsible.

in the United Kingdom, girls presenting with GD in the last 10 years rose 4000%

s (a)(iii)

This statistic is presumably derived from its most common primary source, the UK High Court of Justice’s finding (Sharp et al., 2020) in Quincy Bell & Mrs A v. The Tavistock and Portman NHS Foundation Trust, known in brief as Bell v. Tavistock.

First. The parameter to which the “4,000%” figure corresponds is the rise in referrals to the National Health Service (NHS) Gender Identity Development Service, which provides counselling and, where appropriate, transition care for people who are referred with transition-related distress.

This means that the phrase “presenting with” is inaccurate — it implies that the parameter which has risen by 4,000% is the number of under-18s who think they might be trans. However, that quantity (which is unknown) is not linked 1:1 to the quantity of referrals to the Tavistock, because the Tavistock does not allow self-referral by a patient or their family (NHS Gender Identity Development Service, 2021).

What has actually risen by 4,000% is the number of under-18s who have gender-related distress that a medical professional considers sufficiently severe and credible to warrant referral to a specialist. However, this is inconvenient for the “kids being brainwashed into transition” narrative presented by this framing — because it also requires the brainwashing of a group of generally highly educated and well-informed professionals who are liable to face serious legal and reputational consequences if they are insufficiently careful.

Second. This framing implies that a dramatic difference over time is inherently cause for suspicion. This implication is baseless. The percentage of the world population who are naturally left-handed is approx. 10% (Hardyck & Petrinovich, 1977); where and when left-handed people have faced social suppression and abuse, the percentage of people who report left-handedness is less than 1% (Shimizu & Endo, 1983).

Trans people and their families have historically faced an extraordinary number of social, ideological, informational and organisational obstacles to accessing transition care even when it theoretically exists, meaning that historically they have not gotten to the point where data like referral counts would even indicate their existence. It does not create a legitimate basis for suspicion to observe that if you stop dramatically under-counting how many trans people there are, the number of trans people you count dramatically increases (Hoffman, 2016).

Australia’s Royal Children’s Hospital indicates referrals have grown from 1 every two years to 104 patients in 2014.

s (a)(iv)

Many of the same points in the previous section are applicable here, with the following additions —

First. This is framed as in such a way as to suggest that this growth in referrals was rapid and unexpected. In fact, it happened over the course of eleven years (Telfer et al., 2015).

Second. Approximately 1 in every 200 adults is trans, according to US data (Flores et al., 2016), which both I and the author of the motion clearly agree is applicable here. In 2014, the reference year, the population of Greater Melbourne was c. 4,440,000 (Australian Bureau of Statistics, 2015), and likely around 18% of them were children under 15 years of age (Australian Bureau of Statistics, 2012). Extrapolating from those figures, there should be, at a very conservative estimate, c. 4,000 trans kids under 15 in Greater Melbourne in any given year.

This estimate is conservative because there are obviously kids above 15 but under 18, and because survey data suggests the rate of trans identity among current adults is socially suppressed, and the rate of trans identity among kids is actually approximately twice the reference value used above (Clark et al., 2014). What this establishes is that, compared to what it notionally should have been at minimum, the RCH Gender Service’s patient population in 2014 was worryingly small.

Sweden’s leading gender clinic has ended treatment of minors with hormonal drugs due to safety concerns, citing cancer and infertility.

s (b)(i)

This references a public statement (Gauffin & Norgren, 2021) from Astrid Lindgren Children’s Hospital in Solna, Sweden, affiliated with Karolinska University Hospital and the Karolinska Institute.

The medical risks which Lindgren Hospital names in its statement include, according to the translation I consulted (“Society for Evidence-based Gender Medicine,” 2021), “cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis.” It neglects to mention that many of these risks are associated with gender-affirming therapy for the same reasons and to the same degree that those risks are, themselves, gendered.

For instance, thanks to testosterone, trans men are more likely to develop heart disease than cis women — the same is true among cis men, for the same reason (Endocrine Society, 2015). Thanks to estrogen and progesterone, trans women are more likely to develop breast cancer and thrombosis than cis men — the same is true among cis women, for the same reason (Cavalieri et al., 2006; Filardo, 2018). The risk of breast cancer among trans women in general is lower than among cis women in general (de Blok et al., 2019), and the risk of thrombosis is higher or lower depending on the specific formulation used (Goodman, 2021).

The extraordinarily vague way in which the risks are stated also lends itself to misleading conclusions about how they come about. If someone took puberty-suppressing medications for a very long time, they would likely develop osteoporosis — in much the same way that if I were to swallow the rest of this month’s refill of ADHD medication in one go, I would probably die. There is no meaningful risk of osteoporosis arising from normal use of puberty blockers in the context of gender-affirming care (Heger et al., 1999).

Moreover, the reason puberty-suppressing medication can cause osteoporosis if taken for extraordinarily long periods is because it blocks sex hormones, and low levels of sex hormones are the most important factor in the development of osteoporosis (Sinnesael et al., 2013) — meaning that actually administering cross-sex hormones relieves the risk entirely.

Finally, an argument to fertility seems deeply unsuitable here. The same argument can be made about chemotherapy for cancer (Cancer Council Victoria, 2021), anti-seizure drugs for epilepsy (Sukumaran, Sarma & Thomas, 2010), and even common off-the-shelf medications like ibuprofen (Leverrier-Penna et al., 2018; Kristensen et al., 2018). It is understood that the benefit these medications provide to quality of life, and indeed often continuation of life, is sufficient to warrant their use regardless. The same is unambiguously true of gender-affirming treatment (Cornell University, 2021); therefore one is obliged ethically to take the same position.

As a side note, the Institute’s public statement effective 1 April notes the Bell v. Tavistock decision cited above as an essential component of its own decision — but fails to note that the Court reversed the relevant part of its decision in the month prior to the Institute’s policy change taking effect (Parsons, 2021). This does not inspire confidence that the most current information is being used either by the Institute or by Australian politicians relying on its conclusions.

suicide mortality rate for transgendered people is 20 times higher than comparable peers

s (b)(ii)

First. “Transgendered” has now been out-of-date and offensive terminology for at least a decade (Herman, 2011), and is explicitly excluded by relevant style guides (Lopez, 2015). That raises questions about how this editorial decision was made — among politicians, an occupational group known specifically for having to perform sensitivity to public opinion, it would be extraordinary if it were accidental.

Second. This is a relatively common canard based on a widely circulated study by Dhejne et al. (2011). As when the Australian Christian Lobby’s Lyle Shelton tried this approach (Kõlves, 2016), the implied or explicit argument is invariably that transgender people’s increased suicidality is caused by transition-related medical interventions themselves.

However, this is unambiguously not in fact the case. The factors in suicidality among trans people have been identified, and include discrimination, hostility, post-traumatic stress, prejudice, shame, social anxiety, and stigma (Haas et al., 2011; Marshall et al., 2015; Pandya, 2015; Skerrett et al., 2015; Williams & Dhejne, 2015).

To suggest that suicidality in trans people indicates we should further restrict their access to treatment known to relieve it is, optimistically, a misunderstanding that beggars belief. Out of a desire not to be hurtful, I have opted not to detail the pessimistic view.

the ‘wait and see’ method as the first choice

s (c)(i)

“Wait and see” is already the first choice. Under the current international clinical standard, published by the Endocrine Society in 2017, unless there are exceptionally medically compelling reasons to begin earlier, it is not part of normal practice to initiate hormone treatment before 16 years of age (Hembree et al., 2017). Prolonging puberty suppression treatment for much longer than that would lend itself to the side effects which the motion’s author professes to wish to avoid. Failing to provide puberty suppression treatment would lead to a currently permanent and irreversible decline in the efficacy of later transition, which could not in fact be ethically justified.

Given that puberty suppression has no effects other than shifting the time at which the normal puberty process begins and proceeds, the suggestion that it represents a departure from “wait and see” is not a coherent one.

evidence shows between 70—90% of young people’s dysphoria resolves itself by puberty

s (c)(i)

This is an often-mentioned, rarely-sourced factoid. It is rarely sourced because it is bunk.

It is based on a cluster of studies, primarily Steensma et al. (2011) but also a number of others that are similarly constructed (Winters, 2014), which between them appear to boast an impressive array of methodological flaws (Temple Newhook et al., 2018), including:

• assuming that any and all children who could not be located for follow-up — nearly half of the study population — must have desisted, a level of assumptive confidence seen in virtually no other research whatsoever (Ford, 2017);
• not bothering to distinguish between children who are comfortable in their assigned gender but are perceived as gender-nonconforming, and children who are actually consistently, persistently, and insistently trans (Tannehill, 2017);
• treating subjects who didn’t transition by follow-up as desisters even if they’d never presented as trans in the first place (Winters, 2016).

An argument which relies on studies with these flaws as a source of supporting information is not an argument that is well-sourced, well-supported, or well-informed.

a comprehensive therapeutic pathway since a large percentage of these children have pre-existing mental health issues, and not a medical pathway

s (c)(ii)

First. The pre-existing mental health issues in question are most commonly major depressive disorder and similar conditions (Meybodi et al., 2014); i.e., they are not, as this framing implies, issues which are regarded as impairing the capacity to give informed consent.

Second. The pre-existing mental health issues in question are reliably and consistently relieved by transition (Cole et al., 1997). As previously stated, framing them as a reason to bar access to transition care does not reflect reality.

Third. A mental health therapeutic pathway which was non-medical would necessarily also exclude psychiatric care, which is a medical specialty (Gaebel et al., 2010). There is no evidence to suggest that any intervention other than transition reliably relieves gender dysphoria, but the suggestion that such a hypothetical intervention should not include “a medical pathway” does not, even in that hypothetical universe, reflect an intention to ensure that the distress of trans people is relieved.

experimental and unproven medical treatments of irreversible puberty blockers and sex hormone treatments, and […] irreversible transgender surgery

s (d)(i) et seq.

First. Given that sex hormones are an extremely basic part of medicine and are widely and trivially known not to be experimental, this is presumably a revival of the claim that puberty blockers are experimental, which is false (Giordano & Holm, 2020). They are used “off-label,” that is, for a purpose different for the purpose for which they are licensed. This practice is ubiquitous in all paediatric healthcare because many medications which are unequivocally necessary for juvenile patients have only been tested on adults and are therefore only licensed for use in adults (Cuzzolin et al., 2003; Magalhães et al., 2015; Balan et al., 2018). Off-label prescribing in paediatrics is endorsed by the relevant peak bodies for this precise reason (Sharma et al., 2016).

Second. It is factually untrue that puberty blockers are irreversible. They are fully reversible (Murchison et al., 2016). Hormone replacement therapy and sex reassignment surgery have aspects that are irreversible — because of course they do, that’s the point. The idea that the irreversibility of gender-affirming pharmacotherapy and and surgery should be a bar to its use is fundamentally dependent on the assumption that there are no trans kids, that later in life they will invariably “snap back.” There is no evidence to suggest that.

Third. It is factually untrue that either puberty suppression or gender-affirming hormones are unproven. Both puberty blockers (Alegria, 2016; Mahfouda et al., 2017; Rafferty et al., 2018; etc., etc.) and gender-affirming hormones (Newfield et al., 2006; Johansson et al., 2009; Byne et al., 2012; etc., etc.) have a long prescription history and body of literature demonstrating that they are thoroughly safe and effective. To assert otherwise is either to be ignorant of the professional consensus, or to knowingly contradict it in order to advance political ends. Out of politeness, I will refrain from asserting which.

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I, and most likely the vast majority of your other constituents, expect that when our Senators vote on real-world issues, they will inform their votes with real-world facts, which they have more than sufficient resources to do. Your choice to move this motion and your co-addressees’ choice to support it presents two alternatives:

1. You and/or they were not acquainted with the facts (disappointing);
2. You and/or they were acquainted with the facts but chose to ignore them for the sake of political advancement and power (disgusting).

It would be most gratifying to believe that you will do better in future.

Cordially yours,
Isabelle Moreton

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Urquhart, E. (2017, September 13). Why are trans youth clinics seeing an uptick in trans boys?. Slate.

Williams, C., & Dhejne, C. (2015, November). Fact check: Study shows transition makes trans people suicidal. The TransAdvocate.

Winters, K. (2014, February 25). Methodological questions in childhood gender identity ‘desistance’ research. GID Reform Advocates.

Winters, K. (2016, July 26). Media misinformation about trans youth: The persistent 80% desistance myth. GID Reform Advocates.

Factors affecting individual propensity to crime include:

• adverse childhood experiences (Reavis et al., 2013), including
  • chronic parental conflict (Loeber & Stouthamer-Loeber, 1986);
  • family breakdown (Schuerman & Kobrin, 1986);
• lack of access to education (Lochner & Moretti, 2004);
• poverty (Anser et al., 2020), both
  • living in absolute poverty (Dong et al., 2020) and
  • living below the country-specific poverty line (Imran et al., 2018);
• reduced informal social control in an area, including:
  • exclusion of demographic groups from civic life (Sampson et al., 1997).
• substance addiction (Rafaiee et al., 2013);
• unemployment (Anser et al., 2020), which is linked to property crime specifically (NZ Ministry of Justice, 2009).

Policy actions we could take to reduce crime, therefore, might include:

• increasing access to addiction treatment programs (McCollister & French, 2003);
• increasing access to psychological and psychiatric healthcare (Wen et al., 2017);
• increasing unemployment benefits (Melick, 2003; Mesters et al., 2015) from their current c. 50% of the Henderson poverty line (Melbourne Institute, 2021) to a point at or above it;
• making education, all the way up to tertiary vocational and academic education, more accessible (Nordin, 2017);
• reducing the price of accessing healthcare services (Anser et al., 2020).

Things that do not appear likely to help, or appear likely to make things worse, include:

• high arrest rates (Brown, 1978);
• “zero-tolerance” policing (Braga et al., 2015);
• imprisoning more people (Harding et al., 2019);
• locking them up for longer (Hoel & Gelb, 2008).

References

Anser, M.K., Yousaf, Z., Nassani, A.A., Alotaibi, S.M., Kabbani, A., & Zaman, K. (2020, June 5). Dynamic linkages between poverty, inequality, crime, and social expenditures in a panel of 16 countries: Two-step GMM estimates. Journal of Economic Structures, 9, 43. doi:10.1186/s40008-020-00220-6.

Braga, A.A., Welsh, B.C., & Schnell, C. (2015, June 4). Can policing disorder reduce crime? A systematic review and meta-analysis. Journal of Research in Crime and Delinquency, 52(4), 567-588. doi:10.1177/0022427815576576.

Britt, C.L. (1994, January). Crime and unemployment among youths in the United States, 1958-1990: A time series analysis. American Journal of Economics and Sociology, 53(1), 99-109.

Brown, D.W. (1978, December). Arrest rates and crime rates: When does a tipping effect occur?. Social Forces, 57(2), 671-682. doi:10.2307/2577689.

Dong, B., Egger, P.H., & Guo, Y. (2020, May 18). Is poverty the mother of crime? Evidence from homicide rates in China?. PLoS One, 15(5), e0233034. doi:10.1371/journal.pone.0233034.

Harding, D.J., Morenoff, J.D., Nguyen, A.P., Bushway, S.D., & Binswanger, I.A. (2019, May 13). A natural experiment study of the effects of imprisonment on violence in the community. Nature Human Behaviour, 3, 671-677. doi:10.1038/s41562-019-0604-8.

Hoel, A., & Gelb, K. (2008, August). Sentencing matters: Mandatory sentencing. Victorian State Government Sentencing Advisory Council.

Imran, M., Hosen, M., & Chowdhury, M.A.F. (2018, September 25). Does poverty lead to crime? Evidence from the United States of America. International Journal of Social Economics, 45(10), 1424-1438. doi:10.1108/IJSE-04-2017-0167.

Lochner, L., & Moretti, E. (2004, March). The effect of education on crime: Evidence from prison inmates, arrests, and self-reports. American Economic Review, 94(1), 155-189.

Loeber, R., & Stouthamer-Loeber, M. (1986). Family factors as correlates and predictors of juvenile conduct problems and delinquency (pp. 29—149). In M. Tonry & N. Morris (Eds.), Crime and justice: An annual review of research (vol. 7). University of Chicago Press.

McCollister, K.E., & French, M.T. (2003, December). The relative contribution of outcome domains in the total economic benefit of addiction interventions: A review of first findings. Addiction, 98(12), 1647-1659. doi:10.1111/j.1360-0443.2003.00541.x.

Melbourne Institute (2021, April). Poverty lines: Australia — December quarter 2020. University of Melbourne.

Melick, M.D. (2003, April). The relationship between crime and unemployment. Park Place Economist, 11(1), 13.

Mesters, G., van der Geest, V., & Bijleveld, C. (2015, June 17). Crime, employment and social welfare: An individual-level study on disadvantaged males. Journal of Quantitative Criminology, 32, 159-190. doi:10.1007/s10940-015-9258-5.

New Zealand Ministry of Justice (2009, March). Strategic policy brief: Social risk factors for involvement in crime.

Nordin, M. (2017, May 19). Does eligibility for tertiary education affect crime rates? Quasi-experimental evidence. Journal of Quantitative Criminology, 34, 805-829. doi:10.1007/s10940-017-9355-8.

Rafaiee, R., Olyaee, S., & Sargolzaiee, A. (2013, December 22). The relationship between the type of crime and drugs in addicted prisoners in Zahedan central prison. International Journal of High Risk Behaviors, 2(3), 139-140. doi:10.5182/ijhrba.13977.

Reavis, J.A., Looman, J., Franco, K.A., & Rojas, B. (2013, Spring). Adverse childhood experiences and adult criminality: How long must we live before we possess our own lives?. Permanente Journal, 17(2), 44-48. doi:10.7812/TPP/12-072.

Sampson, R.J., Raudenbush, S.W., & Earls, F. (1997, August 15). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science, 277(5328), 918-924. doi:10.1126/science.277.5328.918.

Schuerman, L., & Kobrin, S. (1986). Community careers in crime. Communities and Crime, 8, 67-100.

Weatherburn, D. (2001, February). Contemporary issues in crime and justice: What causes crime?. Crime and Justice Bulletin, 54. New South Wales Bureau of Crime Statistics and Research.

Wen, H., Hockenberry, J.M., & Cummings, J.R. (2017, October). The effect of Medicaid expansion on crime reduction: Evidence from HIFA-waiver expansions. Journal of Public Economics, 154, 67-94. doi:10.1016/j.jpubeco.2017.09.001.

This is an explainer for this Tweet. The context is Australian politics. The audience for whom this explainer is intended consists of (i) international readers and (ii) Australians who have not had the chance to peruse all the media coverage on the relative issue.

This post contains —

1. a glossary
2. a summary of the background preceding this story
3. an explanation of the immediate context of the Tweet
4. other information relating to the Tweet
5. a list of references to which the in-text citations point

Glossary

ABC — the Australian Broadcasting Corporation, Australia’s state broadcaster.

ADM — the abbreviation signifying the Royal Australian Navy rank of Admiral.

AFP — the Australian Federal Police, Australia’s federal law enforcement agency.

Chief of the Defence Force — the head of the Australian Defence Force (ADF), the entity comprising the military forces of Australia. The Australian Army and Royal Australian Navy are components of the ADF.

CPL — the abbreviation signifying the Australian Army rank of Corporal.

MBA — Master’s in Business Administration, an academic degree.

MG — the postnominal letters denoting a recipient of the Medal for Gallantry, the third-highest award for gallantry in the Australian system.

NXT — Nick Xenophon Team, the name used from 2013 to 2018 by the party currently known as Centre Alliance.

RAN — Royal Australian Navy.

SA — South Australia.

SC — the postnominal letters denoting a Senior Counsel, a class of senior lawyer in a number of Commonwealth realms including Australia.

SGT — the abbreviation signifying the Australian Army rank of Sergeant.

VC — the postnominal letters denoting a recipient of the Victoria Cross for Australia, the highest honour in the Australian system.

Background

The person to whom this is referring is Corporal (ret.) Ben Roberts-Smith vc mg. CPL Roberts-Smith received his MG in 2006 and his VC in 2011.

In October 2013, Roberts-Smith left the Army to study an MBA at the University of Queensland.

In April 2015 (20 months prior to graduation), Roberts-Smith was appointed deputy General Manager of Seven Queensland (Law, 2015), a major regional television network operated by conservative (Gillies, 2020) media corporation Seven West Media. In July, he was promoted to General Manager (Christensen, 2015).

In October 2017, the Sydney Morning Herald reported that, according to the relevant patrol report, Roberts-Smith had hunted down and shot an unarmed Afghan teenager who had acted as a spotter for the Ṭālibān (McKenzie, 2017). In an oral account to the Australian War Memorial, Roberts-Smith reported the incident as “two armed insurgents,” and when called on it, claimed to have remembered incorrectly (Masters, 2017).

In November 2017, a contractor allegedly acting on Roberts-Smith’s instructions sent anonymous emails to the Australian Federal Police, to then-Senator Nick Xenophon (NXT—SA), and to Andrew Burrell, editor of the ultra-conservative national daily The Australian. The emails claimed that a soldier who was preparing to deliver adverse information about Roberts-Smith to the Brereton Inquiry (investigating Australian war crimes) was at grave risk of committing a massacre of civilians in Perth (McKenzie et al., 2021). The soldier in question was swatted, but nothing was turned up — which didn’t stop The Australian from running a story which could be read to imply that it had been (Burrell, 2017).

In a subsequent interview with The Australian, Roberts-Smith described Chris Masters’ revelation of his alleged killing of an unarmed Afghan teenager as “un-Australian.” he further accused Masters of sullying the memory of SGT Matthew Locke, who had joined Roberts-Smith on his, for lack of a better word, hunting trip, and who had been killed in action a year prior (Dalton & Callinan, 2017). Dan Oakes of the ABC responded that it wasn’t ‘un-Australian’ to investigate the actions of special forces in Afghanistan and that “we should be worried when legitimate questions about what is done in our name, to an impoverished people on the other side of the world, are deflected with accusations of disloyalty” (Oakes, 2017).

In June 2018, a soldier who served with Roberts-Smith and was due to testify to the Brereton Inquiry into Australian war crimes in Afghanistan received a letter threatening to kill him if he did not recant (McKenzie & Masters, 2018). While the AFP investigation into the matter quickly ended, The Age published allegations in 2021 that Roberts-Smith sent the letter (McKenzie et al., 2021).

Through July and August 2018, a joint investigation by the ABC and Nine, the parent company of The Age and the Sydney Morning Herald, reported that Roberts-Smith was under investigation by an inquiry into the conduct of the Australian special forces in Afghanistan, and publicised allegations of Roberts-Smith’s involvement in at least six unlawful killings (Oakes, 2018; Whitbourn, 2018), bullying of other soldiers, and domestic violence after returning to Australia (McKenzie et al., 2018). Roberts-Smith has now sued for defamation, to which Nine has responded by noting that its allegations are “substantially true” (Whitbourn, 2018).

One of the killings in question involves an unarmed, handcuffed Afghan man, Ali Jan, being kicked off a cliff by an Australian soldier, severely injuring him, and then being shot in order to “put him out of his misery” (Masters & McKenzie, 2018).

In September 2020, Sandy Dawson SC, representing Nine, told the Federal Court of Australia that the AFP have an eyewitness account and other evidence that implicates Roberts-Smith in war crimes in Afghanistan (Knaus, 2020).

In November 2020, it became public that Roberts-Smith had received an AU$1.9 million loan from Kerry Stokes, Chairman of Seven West Media and member of the board of the Australian War Memorial, and that he was using the money to fund his ongoing defamation claim (Aston, 2020). Stokes is perceived to have a conflict of interest and is under pressure to stand down as an AWM board member (Galloway, 2020), but has not yet done so.

Immediate context

In early April 2021, it became apparent that Roberts-Smith had buried a pink plastic children’s lunchbox in his backyard containing USB drives which held classified media, images and videos.

• The Age reports the existence of photos which show an Australian soldier drinking beer from the prosthetic leg of an Afghan fighter who CPL Roberts-Smith had allegedly illegally executed on Easter Sunday 2009 (McKenzie et al., 2021).
  
• Photos published by The Age show a man killed by CPL Roberts-Smith’s patrol team with challenge coins placed on his eyes bearing the emblems of the Special Air Service Regiment (SASR) and Roberts-Smith’s unit, 2 Squadron SASR (McKenzie et al., op. cit.).
  
• Photos published by The Age show CPL Roberts-Smith smiling and encouraging a soldier in a Ku Klux Klan outfit burning a cross in September 2012 (McKenzie et al., 2021).
  
• According to ADM Chris Barrie, RAN, former Chief of the Defence Force, the classified content in question includes credible evidence of Roberts-Smith’s involvement in the desecration of a corpse (Galloway, 2021).

Regardless, it appears that Seven West Media will keep Roberts-Smith onboard and will continue to fund his defence (Down, 2021).

Other information

The format of the Tweet is a parody of William Carlos Williams’ poem “This is just to say” (1934), a format enjoying some currency in the Australian leftist community at the time it was made.

References

Aston, J. (2020, November 15). Ben Roberts-Smith owes Kerry Stokes $1.9m. Australian Financial Review. Retrieved 12 April 2021.

Burrell, A. (2017, November 10). Australian Defence Force inquiry into SAS ‘gun smuggling’. The Australian. Retrieved 12 April 2021.

Christensen, N. (2015, July 2). Seven West Media promotes VC recipient Ben Roberts-Smith to GM Queensland office. Mumbrella. Retrieved 12 April 2021.

Dalton, T., & Callinan, R. (2017, October 21). VC hero Ben Roberts-Smith: I did nothing wrong in Afghanistan. The Australian. Retrieved 12 April 2021.

Down, R. (2021, April 12). War hero Ben Roberts-Smith hits back at bombshell report. The Australian. Retrieved 12 April 2021.

Galloway, A. (2020, November 25). ‘Discredited’: Former War Memorial historian calls for Kerry Stokes to stand down. The Age. Retrieved 12 April 2021.

Galloway, A. (2021, April 12). Seven stands by senior executive Ben Roberts-Smith over new evidence he attempted to cover up alleged crimes. The Age. Retrieved 12 April 2021.

Gillies, R. (2020, November 30). The effect of right-wing bias in Australia’s media. Independent Australia. Retrieved 12 April 2021.

Knaus, C. (2020, September 1). Australian police told Ben Roberts-Smith they had witnesses to alleged Afghanistan war crimes, court hears. The Guardian. Retrieved 12 April 2021.

Law, J. (2015, April 24). Ben Roberts-Smith takes on new battle: Managing a TV network. news.com.au. Retrieved 12 April 2021.

Masters, C. (2017). No front line: Australia’s special forces at war in Afghanistan. Allen & Unwin.

Masters, C., & McKenzie, N. (2018, June 9). Special forces rookie ‘blooded’ by executing an unarmed man. The Age. Retrieved 12 April 2021.

McKenzie, N. (2017, October 19). The fog of war and politics leads to controversy over Afghan war mission. Sydney Morning Herald. Retrieved 12 April 2021.

McKenzie, N., & Masters, C. (2018, September 23). Fresh threat to SAS soldiers assisting war crimes inquiry. The Age. Retrieved 12 April 2021.

McKenzie, N., & Masters, C. (2020, May 7). Ben Roberts-Smith may face war crimes charges after AFP probe. The Age. Retrieved 12 April 2021.

McKenzie, N., Wroe, D., & Masters, C. (2018, August 10). Beneath the bravery of our most decorated soldier. Sydney Morning Herald. Retrieved 12 April 2021.

McKenzie, N., Masters, C., & Tozer, J. (2021, April 11). Buried evidence and threats: How Ben Roberts-Smith tried to cover up his alleged crimes. The Age. Retrieved 12 April 2021.

Oakes, D. (2017, October 26). It’s not ‘un-Australian’ to investigate the actions of special forces in Afghanistan. ABC News. Retrieved 12 April 2021.

Oakes, D. (2018, June 10). Death in Darwan. ABC News. Retrieved 12 April 2021.

Whitbourn, M. (2018, October 19). Fairfax defends Ben Roberts-Smith defamation claim. Sydney Morning Herald. Retrieved 12 April 2021.

This post was copied from my Facebook. It was originally written in 2021, but will be updated and iterated as new evidence comes to light, or for style, or for any other reason.

29 March — 4 April is World Autism Awareness Week. April is Autism Acceptance Month.

Approximately 1 in 40 people are autistic (Mozes, 2018). That’s about

• 64,000 people in Brisbane (population of the Hills District plus Albany Creek, Brendale, Bridgeman Downs, Bunya, Eatons Hill and McDowall)
• 129,600 Queenslanders (fewer people than Toowoomba, more than Mackay — if we were a city, we would be the 7th most populous city in Queensland).
• 644,100 Australians (fewer people than the Gold Coast—Tweed Heads area; more people than Newcastle, NSW — if we were a city, we would be the 7th most populous city in Australia).
• 196.4 million people worldwide (fewer people than Nigeria, more than Bangladesh — if we were a country, we would be the 8th largest in the world, comfortably outnumbering Russia, Mexico, Japan, Germany, France, the UK, Italy, the Republic of Korea, and Spain, among others).

Here are some things I think the community would like people to be aware of.

First: The opposite of “autistic” isn’t “normal”.

The term that strictly means “not autistic” is “allistic”. The longer-used, better-known term is “neurotypical”; however, this is actually the opposite of “neurodivergent,” and the neurotypical—neurodivergent axis is wider than autism alone; for example, people with bipolar disorder are neurodivergent.

Second: Please use IFL, not PFL.

When talking about people and their identities, identity-first language (IFL) places the identity first in the sentence: “an autistic person.” Person-first language (PFL) places the person first in the sentence: “a person with autism.” Allistic people tend to prefer PFL because many allistic people perceive ‘autistic’ as being an inherently negative word.Many autistic people don’t share that view, however, and feel that saying “a person with autism” is like saying “a person with tallness”. While identity-only language (“an autist[ic]”) is still considered offensive when used by people outside the community, just like e.g. “the gays” or “a transgender,” the autistic community in general tends to prefer IFL to PFL; “an autistic person,” not “a person with autism.” (Brown, 2011)

Third: Asperger syndrome doesn’t exist any more.

The primary reference for psychiatric diagnoses is the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). When the fifth edition (the DSM-5) was released in 2013, Asperger’s syndrome was abolished and folded into autism spectrum disorder.

There are a couple of reasons that Asperger is no longer a diagnosis: it’s an early diagnostic construct that doesn’t necessarily keep up with the modern understanding of autism (Szatmari, 2000; Sanders, 2009), and it’s not clear that there’s much benefit distinguishing it from other autism diagnoses such as PDD-NOS (Klin & Volkmar, 2003).

There’s also debate over whether it’s appropriate to have a condition named after Johann “Hans” Asperger. He didn’t come up with the condition himself; it was described and formalised by Lorna Wing in 1976 (Guiding Pathways, 2018), based on the work of Asperger, who by then had passed away. In addition, Asperger syndrome as it was understood in the modern day didn’t have all that much to do with Asperger’s original work (Hippler & Klicpera, 2003).

More worryingly, Professor Asperger voluntarily cooperated with the Nazi client government in Austria; he was a member of the Austrian fascist party, the Fatherland Front, he joined them in openly supporting the Nazis’ racist policies (Czech, 2018), and he knowingly allowed his patients to be subjected to unethical and inhumane experimentation followed by involuntary euthanasia (Baron-Cohen, 2018). Many autistic people questioned the necessity of naming a condition after such a man.

Fourth: The leading therapy for autism, applied behaviour analysis, is ineffective and unethical.

For some children it definitely does not work (Howlin et al., 2009), and there is, in fact, generally no high-quality evidence that it works at all (Matson, 2005; Rao et al., 2007; Reichow et al., 2018).

There are also ethical concerns. ABA includes the use of “aversives” such as electric shocks, slapping and shouting (Løvaas, 1987). This is a carry-over from the practice of involuntary “conversion therapy” of queer and transgender individuals, which is now illegal in a number of developed countries and jurisdictions, including Queensland (Remington, 2020). The creator of ABA was also a co-creator of conversion therapy (Rekers & Løvaas, 1974), which in the case of the study cited led to the death of the subject (Bronstein & Joseph, 2011).

It has been claimed that use of aversives has reduced over time (Spreat, 2012), but as of 2014, experts in ABA were still describing ABA provider training as including the “principles of punishment,” including electric shocks, which were not banned until 2020 (“FDA takes rare step,” 2020). Even without considering aversives, the stated end goal of ABA is to create an autistic child who is “indistinguishable from their peers” (Therapist Neurodiversity Collective, 2019), placing all the onus on the child to become “normal,” when their peers are equally capable of undertaking the arguably far easier task of simply accepting them as they are (DeVita-Raeburn, 2016).

Fifth: Autism Speaks is a hate group.

Autism Speaks is the largest autism advocacy organisation in the United States, known for, e.g., creating the popular blue puzzle piece symbol and the Light It Up Blue Campaign. However, dozens of other disability advocacy organisations have condemned it (Ne’eman, 2009). There are a number of reasons this is the case:

Of the revenue it receives, Autism Speaks spends less on its actual work and more on executive salaries than other comparable organisations (Podkul, 2014).

Autism Speaks is responsible for the creation of the 2006 film Autism Every Day, which portrayed autistic people primarily as tragic burdens on their parents (“An autistic speaks,” 2007), used deceptive and manipulative framing in order to do so (Stanton, 2006), and treated autistic children as responsible for persistent murderous and suicidal urges experienced by their parents; those urges were framed as reasonable, which may have led to the death of at least one child in the week after the film’s release (Perry, 2014).

Autism Speaks has a record of taking legal action to suppress comment by autistic people who disagree with it (Biever, 2008).

Autism Speaks systematically excludes autistic people from its board of directors (Baronets, 2017).

The autistic community in general tends to support other advocacy organisations, the most prominent of which is the Autistic Self-Advocacy Network (ASAN). In addition, the blue puzzle piece of Autism Speaks has acquired a negative connotation; ASAN and most others prefer the “neurodiverse community” rainbow infinity symbol.

Sixth: The “empathy gap” is two-way.

The legend is that autistic people generally don’t understand or care about the feelings of others. However, this isn’t the case; on the contrary, the weight of scientific evidence is that autistic people are *more* empathetic than their allistic counterparts (Smith, 2009). There’s an intuitive way to test this: ask an autistic friend if they enjoy cringe comedy.

Autistic people’s ability to conform is heightened further by the fact that we have to do so in order to survive. This is further substantiated by the fact that autistic people raised as girls, who are subject to gender-specific increased pressure to conform, are much less likely to be diagnosed with autism than their male counterparts precisely because of their ability to perform in accordance with societal expectations (Bazelon, 2007).

In addition, repeated evidence has shown that at least part of the communication problem is that allistic people do not instinctively understand, and aren’t under any pressure to understand, how autistic people think or feel (Sheppard et al., 2015; Heasman & Gillespie, 2017; Milton, 2018).This is further substantiated by studies into ABA, as previously mentioned; by and large, the cases where ABA is reported to “work” are cases in which the parent has also actively undergone training to accept their child’s behaviours and meet them where they’re at, rather than placing the full responsibility on the child to become “normal” (Sofronoff et al., 2004).

To summarise, while there is relatively little scientific evidence that autistic people don’t understand allistic people, there is plenty of evidence for the other way around.

Here are the key takeaways:

1. Non-autistic people are “allistic,” not “normal.”
2. It’s “autistic people,” not “people with autism.”
3. Asperger syndrome is dead and Asperger was a Nazi.
4. ABA is conversion therapy and is unethical.
5. Autism Speaks doesn’t care about autistic people.
6. Autistic people have empathy; allistic people need to, too.

References

An autistic speaks about Autism Speaks (2007, May 20). Daily Kos. Retrieved 2 April 2021.

Baron-Cohen, S. (2018, May 8). The truth about Hans Asperger’s Nazi collusion. Nature, 557, 305-306. doi:10.1038/d41586-018-05112-1. Retrieved 2 April 2021.

Baronets, A. (2017, August 26). Why I boycott Autism Speaks, and you should too. Medium. Retrieved 2 April 2021.

Bazelon, E. (2007, August 5). What autistic girls are made of. New York Times Magazine. Retrieved 2 April 2021.

Biever, C. (2008, January 30). Voices of autism ‘silenced’ by charity. NewScientist. Retrieved 2 April 2021.

Bronstein, S., & Joseph, J. (2011, June 10). Therapy to change ‘feminine’ boy created a troubled man, family says. CNN. Retrieved 2 April 2021.

Brown, L.X.Z. (2011, August 4). The significance of semantics: Person-first language — why it matters. Autistic Hoya. Retrieved 2 April 2021.

Czech, H. (2018, April 19). Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna. Molecular Autism, 9, 29. doi:10.1186/s13229-018-0208-6. Retrieved 2 April 2021.

DeVita-Raeburn, E. (2016, August 10). The controversy over autism’s most common therapy. Spectrum News. Retrieved 2 April 2021.

FDA takes rare step to ban electrical stimulation devices for self-injurious or aggressive behaviour (2020, March 4). US Food and Drug Administration. Retrieved 2 April 2021.

Guiding Pathways (2018, January 24). What is Asperger’s syndrome. Retrieved 2 April 2021.

Heasman, B., & Gillespie, A. (2017, July 7). Perspective-taking is two-sided: Misunderstandings between people with Asperger’s syndrome and their family members. Autism, 22(6), 740-750. doi:10.1177/1362361317708287. Retrieved 2 April 2021.

Hippler, K., & Klicpera, C. (2003, February 28). A retrospective analysis of the clinical case records of ‘autistic psychopaths’ diagnosed by Hans Asperger and his team at the University Children’s Hospital, Vienna. Philosophical Transactions of the Royal Society B, 358(1430), 291-301. doi:10.1098/rstb.2002.1197. Retrieved 2 April 2021.

Howlin, P., Magiati, I., Charman, T., & MacLean, W.E. (2009, January 1). Systematic review of early intensive behavioral interventions for children with autism. American Journal of Intellectual and Developmental Disorders, 114(1), 23-41. doi:10.1352/2009.114:23-41. Retrieved 2 April 2021.

Klin, A., & Volkmar, F.R. (2003, January). Asperger syndrome: diagnosis and external validity. Child and Adolescent Psychiatric Clinics of North America, 12(1), 1-13. doi:10.1016/S1056-4993(02)00052-4. Retrieved 2 April 2021.

Løvaas, O.I. (1987, February). Behavioural treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3-9. doi:10.1037//0022-006x.55.1.3. Retrieved 2 April 2021.

Matson, J.L. (2007, March—April). Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in learning based interventions. Research in Developmental Disabilities, 28(2), 207-218. doi:10.1016/j.ridd.2005.07.006. Retrieved 2 April 2021.

Milton, D. (2018, March 2). The double empathy problem. National Autistic Society. Retrieved 2 April 2021.

Mozes, A. (2018, November 26). Report: Autism rate rises to 1 in 40 children. WebMD. Retrieved 2 April 2021.

Ne’eman, A. (2009, October 7). Disability community condemns Autism Speaks. Autistic Self Advocacy Network. Retrieved 2 April 2021.

Perry, D.M. (2014, November 10). Why London McCabe’s death matters. CNN. Retrieved 2 April 2021.

Podkul, A. (2014, June 17). Understanding the puzzle of Autism Speaks. Philanthropy Daily. Retrieved 2 April 2021.

Rao, P.A., Beidel, D.C., & Murray, M.J. (2007, July 20). Social skills interventions for children with Asperger’s syndrome or high-functioning autism: A review and recommendations. Journal of Autism and Developmental Disorders, 38, 353-361. doi:10.1007/s10803-007-0402-4. Retrieved 2 April 2021.

Reichow, B., Hume, K., Barton, E.E., & Boyd, B.A. (2018, May 9). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 5, CD009260. doi:10.1002/14651858.CD009260.pub3. Retrieved 2 April 2021.

Rekers, G.A., & Løvaas, O.I. (1974, Summer). Behavioral treatment of deviant sex-role behaviors in a male child. Journal of Applied Behavior Analysis, 7(2), 173-190. doi:10.1901/jaba.1974.7-173. Retrieved 2 April 2021.

Remington, C. (2020, October 14). Conversion therapy banned in Queensland. HealthLegal. Retrieved 2 April 2021.

Sanders, J.L. (2009, June 23). Qualitative or quantitative differences between Asperger’s disorder and autism? Historical considerations. Journal of Autism and Developmental Disorders, 39, 1560. doi:10.1007/s10803-009-0798-0. Retrieved 2 April 2021.

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