site banner

Culture War Roundup for the week of June 3, 2024

This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.

Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.

We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:

  • Shaming.

  • Attempting to 'build consensus' or enforce ideological conformity.

  • Making sweeping generalizations to vilify a group you dislike.

  • Recruiting for a cause.

  • Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.

In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:

  • Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.

  • Be as precise and charitable as you can. Don't paraphrase unflatteringly.

  • Don't imply that someone said something they did not say, even if you think it follows from what they said.

  • Write like everyone is reading and you want them to be included in the discussion.

On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.

8
Jump in the discussion.

No email address required.

I am saying that you cannot separate one issue from the others.

Ok then that has nothing to do with the origin of the whole argument, which was:

This is not some new thing we just came up with. We already had this conversation as a society and decided the answer was, your kids, your choices, until you are literally about to kill them, then maybe we will stop you. Let's not open that can of worms because that truce is there for a reason.

Like I said there is no such truce at the moment, and according to what you're saying now, one is not even being offered, so I reject this entire line of argument.

But in any case, I said I agree with you there no?

Have you? Like I said you're constantly reframing what I said to make an answer more convenient for you, rather than answering what I already said. I don't see you saying "yes, let us abolish the system where medicine is only available through prescription" you're haggling over details like which drug should be more available to whom - precisely what I said I'm not interested in doing.

As long as you're in favor of there being a system where authority is used as a safeguard for people using medicine, I want that authority to safeguard a segment of the public that is vulnerable, impressionable, and currently neglected.

Then become a doctor or scientist and write papers about it.

My talents were never in academic pursuits, so my time is far better spent financially supporting doctors and scientists who are writing papers about, and critiquing the utter state of transgender care. You may have heard of a certain doctor Hillary Cass recently, and like her there are many others. As far as I can tell anyone whoever bothered doing a systemic review of the state of evidence came to a similar conclusion as she did, including a review commissioned by WPATH itself, which they promptly decided to bury.

Because now we have just circled all the way back to the beginning, where they claim it is scientifically valid (and you say they are wrong) and back around we go.

They can claim what they want, and I can expose their lies. This is my right as a member of the public.

in almost all the instances you are talking about the parents, child and doctor are all agreed.

I do not grant that. The child is too impressionable and ignorant to make an informed decision on the subject, and from personal experience, most parents are intimidated to agree by activist doctors, abusing their authority. This is why I am in favor of taking that authority away from them.

Well you can deal with that by talking to them

Cool, but I'm not worried about myself, or my family. As the saying goes "we live in a society". You just put on a long spiel about how it's completely fine and nothing new for trans advocates to go around changing the culture, including the opinion of judges. This is what I am doing as well, so please do not stand in my way, as you said you won't stand in case of JWs and trans advocates.

What I don't think is ok is pretending this is some brand new thing that we let people's ideologies inform what harmful things they choose for their children and then demand this is the one we stop at. We have already done that for hundreds of years. This isn't anything new.

I agree. From ovariotomies, lobotomies, apotemnophilia, to giving the human growth hormone to short boys / synthetic estrogen to tall girls in order to "normalize" their height, you're right that scandals like this aren't new, but they are pretty rare, and should be treated as the aberration that they are.

Finally I still submit that assuming the doctors are operating in good faith and trying to help not harm, they are less morally wrong than someone who is trying to harm. They may still need to be sanctioned and perhaps even commit a crime, but that is why we separate negligent homicide and manslaughter from first degree homicide, or even first degree homicide from 2nd degree. The intentions of a person have an impact on how moral their actions are perceived to be.

Agree to disagree, I suppose. Especially when it comes to doctors, now that I think about it. They hold a position of trust from the public, so they have an extra duty to make sure their work is done in service of their patients, rather than their sensibilities, or their fanciful ideologies. This is what the WPATH practitioners are in blatant disregard of, they get together at their conferences, and mock the very idea of their approach being wrong, or anyone who brings substantial criticism against them. They refuse debate, and use their political connections to shut down conversations. I don't care if this all comes from "good intentions", the "good intentions" only make the whole thing more horrifying.

The child in question may suffer equal harm, but the level of harm is not the only component of moral judgement for anyone outside of hard consequentialists.

Again, nothing I said relies on consequentialism.

I do not grant that. The child is too impressionable and ignorant to make an informed decision on the subject, and from personal experience, most parents are intimidated to agree by activist doctors, abusing their authority. This is why I am in favor of taking that authority away from them.

This is a fully generalizable argument against anybody deciding anything. If your government and culture provides incentives and pressure to get married and have kids does that mean you can't make an informed decision so every one is abusive? I submit the answer is no. But I point out your argument is basically the one used by strands of feminism, that all marriage is unwilling, that all sex is rape because women exist in a world where men are bigger and stronger and more powerful than them. I reject that that from them and I reject it from you. We are the captain of our own ships. Doctors have no power and authority over parents that those parents themselves do not allow. And I note it also applies to priests and any authority who doesn't have legal authority. Like I say fully generalizable and ends up saying that none of us can actually make our own choices where someone else has some kind of pressure to exert. Which given as you say we exist in a society, is almost everyone.

I reject that premise entirely. You do not have to do what a doctor tells you, you can get a second opinion or a third, you can research yourself. This is not the middle ages. Just as with David Bowie, they have no power over you! Stop denying people their agency.

This is a fully generalizable argument against anybody deciding anything.

No, U. There's a spectrum between agency and coercion, I'm arguing that what the GAC doctors are doing is falling on the coercive side of the spectrum. If you wish to disagree about my assessment, that's fair game, but you're saying I'm denying the very possibility of someone having agency. This implies a strict binary (or hell, unary) worldview, where no shades of grey exist. It is you, therefore that is making a fully generalizable argument for the total invalidity of the concepts of manipulation and pressure. I wouldn't even mind, if you actually believed that, but as usual, I'm pretty sure you're only deploying this argument strategically. But I dunno man, surprise me. Show me your #MeToo era posts defending Harvey Weinstein.

You do not have to do what a doctor tells you, you can get a second opinion or a third

Why yes, if you don't like Dr. Freeman's opinion on the necessity of you getting a lobotomy, you can get a second opinion from Dr. Watts, and if you don't like his opinion either, you can always talk to Dr. Moniz.

Your right to get a second opinion does not absolve doctors from acting in an ethical way. The whole point of there being a licencing system to begin with, is so that people don't have to constantly keep "caveat emptor" in their mind, when they go visit a doctor. Now, if you want to argue for the total abolition of the licensing system (and no, "ho hum, I am not against relaxing the licensing a little" does not count), the conversation can progress, but as long as there is licensing, ethical rules must apply.

Sure,but where you started out was where the doctors were actually advocating for what they believed was the best solution, but were wrong. That isn't an ethical problem.

If a doctor is recommending something they know to be harmful, i've already said they should be dealt with however their local area prefers.

But a doctor who is trying to do their best and is wrong, should be advocating for what they think is in the patients best interest. And the patient or parent can accept that or not. If they are being lied to that is different, but the situation we are discussing is one where they don't lie, they themselves are wrong, but well intentioned.

Otherwise we wouldn't have been talking about whether intentionally doing harm was worse than trying to help but doing harm anyway remember?

This is why the first time round, i was trying to understand your actual position, because you kind of keep equivocating between these doctors are well intentioned and these doctors know they are wrong. And so your arguments keep criss-crossing over that point. You initially talk about them as if they are well intentioned but incorrect, but then your arguments assume they are lying, pushy assholes. But someone who is genuinely well intentioned and actively trying to get the best outcome for the patient is highly unlikely to be a lying pushy asshole (most doctors in my experience are distinctly not Gregory House M.D.)

My arguments are based on us talking about people who are genuinely well intentioned. A good person who is wrong is highly unlikely to lie to a patient about treatment because from his perspective he doesn't have to. The facts are on his side. This is the best option.

Sure,but where you started out was where the doctors were actually advocating for what they believed was the best solution, but were wrong. That isn't an ethical problem.

What are you talking about? Of course it is. Lobotomists thought lobotomies were the best solution, ovariotomists thought ovariotomies were the best solution, etc., etc., etc. None of that absolves them of the violation of ethics they comitted.

If a doctor is recommending something they know to be harmful, i've already said they should be dealt with however their local area prefers.

There is, again, pages upon pages of various ethical guidelines that medical practitioners have to follow, they usually don't get to circumvent them with "I think this will yield the best results". Why do you want transgender care to be handled differently?

My arguments are based on us talking about people who are genuinely well intentioned. A good person who is wrong is highly unlikely to lie to a patient about treatment because from his perspective he doesn't have to.

Yes, so are mine. There is a certain type of "genuinely good intentions" that are used to justify lying, and sometime much, much worse. This is the entire basis of me calling some types of well-intentioned behavior just as bad as ill-intentioned behavior, and transgender care would be a very salient example. They have been caught lying in public and in private, and they have been doing so systemically. They do have good intentions though.

By the way - please stick to a single subject, and limit yourself to advocating only for things you actually believe. We've went from the abstract topic of judging well-intentioned behavior just as bad as ill-intentioned bahvior, to the ins and outs of transgender care, and back again. Nothing we talked about in the middle was necessary to reach this point, and it comes off as throwing spaghetti at the wall.

This is a discussion and a conversation, not a debate being scored. It goes where it goes that's the beauty of this format. So no, I won't stick to a single point, any more than you have. You don't get to set the rules in a conversation. That is not how this works. If I go on a tangent you don't want to talk about, just don't follow me down that path. Neither of ys get yo control what the other says, just what we do.

Do you have examples of where you think doctors have lied to their patients (or the parents of their parients) in this frame?

Doctors who lobotomized patients when that was the prevailing medical consensus were not themselves behaving unethically at the time. This is critical because it one of the reasons I am not a progressive. The most ethical doctor in the world who looked at all the reearch and thought, sounds like this is exactly what my patient needs is not being unethical. He is just wrong and ignorant. A doctor who did it today, knowing better would be unethical.

If we discover tomorrow that heart transplants are slowly destroying the planet, that doesn't mean heart surgeons were unethical to do it.

Lets say for the sake of argument you are correct that doctors themselves are being hoodwinked by WPATH. But that doesn't mean Dr Smith who is following the guidelines (but had no hand in writing them) is being unethical himself. Being unethical requires (ironically) informed decision making.

This is a discussion and a conversation, not a debate being scored.

Never said otherwise. I just don't like when points are left unfinished. I try to respond to your questions, so please respond to mine before moving on.

And while tangents are not my favorite thing, but more or less acceptable, the appealing to principles that you do not actually hold, while using the first person plural is not.

Do you have examples of where you think doctors have lied to their patients (or the parents of their parients) in this frame?

Sure, the claim that puberty blockers are fully reversible is a straight-up lie. So was the claim that minors are required to undergo a thorough diagnostic process before they are prescribed hormones or surgeries. "Would you rather have a dead daughter or a happy son" is not a lie per-se, since it's not making a claim, but it is heavily implying something they knew for a fact that was exaggerated.

The most ethical doctor in the world who looked at all the reearch and thought, sounds like this is exactly what my patient needs is not being unethical.

What about the doctor who didn't really look at all the research, possibly because what he's prescribing is new and exciting, and there isn't even all that much research to begin with, but he's still convinced that what he's prescribing is what the patient needs? How about a doctor that commissioned research to prove he's right, but buried the results when he didn't like them, but is still convinced future research will vindicate him?

But that doesn't mean Dr Smith who is following the guidelines (but had no hand in writing them) is being unethical himself. Being unethical requires (ironically) informed decision making.

I'd say he has some responsibility to look into the subject himself. The WPATH is a self-declared authority, they have no special knowledge here, and a trained clinician should be able to pick up on the nonsense (which they tend to do, once they actually look at it). If nothing else, when parents express doubts, he has an obligation to state the level of his actual knowledge, and not oversell his confidence. That said, I kind of agree. Do like they did at Nurenberg, the chain of responsibility starts at the top, and is being progressively diminished as your work your way down.

But note that this is separate from the question of whether it is possible to be well-intentioned but unethical. I assign the biggest culpability to WPATH, but I maintain that they are well-intentioned.