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Yet Another Part Of the WPATH Saga
Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care
You may have heard about the controversy around the latest Standards Of Care removing the age minimums for various transgender care procedures. What I didn't make clear in that post was this wasn't about the difference between SOC7 and SOC8, the removal took place between different versions of the SOC8 itself. Shortly after the original guidelines were published, a correction notice was issued, and WPATH republished the SOC with the minimum ages removed (among other changes). Curiously the current version of the notice says the original version was published by mistake, and contains no details about the text that was changed.
The now unsealed documents show that this was the result of pressure from none other than Admiral Rachel Levine:
Another quote from the article says that "we have made changes as to how the minimal ages are presented in the documents", but this wasn't just a simple change in presentation, all age limits, other than for phalloplasty, are gone, and replaced with procedural steps the patient should go through. They claim this makes the standards more restrictive, but in my opinion that's contradicted by the statements from admiral Levine.
Jesse Singal also points out standards were supposed to be determined by the "Delphi process":
This process was violated according to SOC contributors themselves:
So between the "correction notice" shenanigans, and outright admission that rules were broken to push through that particular change, it seems like a pretty slam-dunk case for the Biden administration putting political pressure to loosen criteria for transgender care for minors.
I never liked the Bare Link Repository, but I'm starting to miss it...
Another batch of documents from Boe v. Marshall shines light on the buried systemic review commissioned by WPATH
Some time after the Cass Review was published, news started going around that WPATH was sitting on a systemic review that they comissioned to back up the SOC8, but refused to have published, because they didn't like the results. The recently released documents reveal the circumstances around it.
Only read the summary so far, and will be making my way through the evidence in the coming days. This is probably the most damning document I've seen so far. I mean, publication bias / burying results you don't like is par for the course for academia, but you have to admire the sheer gall of demanding that unfavorable research be buried, as well as forcing a disclaimer that you had no influence on it.
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Levine is trans herself, which... well, in theory means first-hand experience, but leaves a lot to be skeptical about professional focus.
Combined with the laughably bad Surgeon General’s Advisory on Firearm Violence, it does seem like a lot of progressive groups are trying to stripmine any remaining institutional trust.
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P.S.: "Gender Critical" Twitter in uproar over apparent purge
This is too small for a top level post, but I wanted to write it down for the sake of posterity: Several accounts have reported a ban and unfollow wave, including receipts for Twitter HQ taking out the banhammers.
No direct evidence for any connection with the events from the top level post, but the timing sure is interesting, and given what we know from the Twitter Files, it wouldn't be at all surprising if these 2 things were connected.
Update: This turned out to be a bit of a nothingburger. Within 24 hours, followers, and suspended accounts were reinstated, according to some of the people that were originally complaining.
Intervention by Elon? Rogue moderators getting CTRL+Zeed? A fluke / false conspiracy theory? We may never know!
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This all just feels like moving deck chairs on the titanic. If being trans is real and we can indeed reliably detect it then all of this is pointless. If it's not then deciding what age to do the surgeries is the least of our issues. I don't see how there can be some middle road where we are confident it's real and detectable and yet should move cautiously.
I've started to use religious terms around transgender ideology, since I think they're the most accurate ones to describe what I see as a metaphysical belief system, or a "folk religion." If there can be a more widespread understanding of this ideology as similar to a folk religion, I think the decisions around treatments and surgeries (acts of faith) become easier for pundits/politicians/voters to articulate and decide where the guardrails should be.
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Plenty of disorders are detectable, but not perfectly. False positives are common across a range of medical tests. Short of a gene that can be identified and predicts trans status with 100% accuracy, there's nothing irrational about saying something exists but we have to be careful about treating it because we could be wrong.
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There's a few problems here. For one, I don't think people at he forefront of the trans movement are even using the same framework as you are, where it's a diagnosable disorder that should be treated - see my previous WPATH post. Secondly, they're not really making any claims about detectability, because that would allow us to resolve the matter in a simple blinded test, and I don't think it would come out well for the pro-trans side.
Now, I believe (and think I have enough examples to back it up) this "medicalized narrative" has absolutely been used to persuade the broader public. Even as they were avoiding making specific claims about detectability, they were speaking with enough confidence that the detectability felt implied, and this is why this conversation is not pointless. Most people know children are developing, go through phases, and are generally more malleable, so recommending irreversible treatments will at the very least give people pause. This is why this is such a big part of the conversation, it highlits the tensions and contradictions in the discourse.
Another thing is that I don't think the story is so much about the state of Trans Science, as it is about the political pressure on science. The pro-trans side claims the anti-trans are playing dirty by passing bills limiting transgender care for children, they claim this should be left to the doctors. As it turns out, they're putting substantial political pressure themselves to force "the science" to say what they want it to say, except they do it covertly.
This is core to the progressive playbook.
Simplified American democracy can be thought of as "You think A, I think B - let's vote on it." Our dispute resolution mechanism is voting plus individual level protections (the constitution) and then courts for reviewing the decision even after its made. Throw on top a lot of procedural shenanigans as a mechanism to slow or disrupt a process, but not to truly alter the game. It gets down to voting, often multiple times over time.
The progressive playbook is "Let's not vote on this." Instead, it's "Let's shoehorn this into something we've already voted on and, simultaneously, push a narrative than any disagreement with subject X is actually a disagreement with already universally agreed upon subject Y (ie that thing on which we've already voted)" Primarily this takes the form of injecting everything into the 1964 Civil Rights acts (or one of its many updates over the decades). Why? Because no one is going to come out and say "I'm against civil rights." All the progressives have to do is say "everything is civil rights" which they do routinely.
And this, as you state, is exactly why WPATH has tried to science-ify and launder what is actually a very niche ideological debate. If "science" says all of this trans stuff is "healthcare" then they can make the argument "this is about healthcare, not about out trans stuff" while simultaneously making outrageous claims like "people against us want to hurt children."
This is also how "abortion" is no longer primarily about "killing babies vs not killing babies" but about drafting off of 1960s-1970s era women's rights ("her body, her choice") and (again) healthcare infused "reproductive health."
And this is what truly disturbs those on the right about progressives. It isn't the issue / ideology stuff - you can have crazy ideas all you want, and you can have them away from me. If enough people really do agree with you, we can all vote on it. But when you keep hacking and re-hacking the system to effectively circumvent all of the laws and norms that have been developed to deal with disagreement since the founding of the republic, it really doesn't look like you don't care about things like the constitution anymore - you just want to have it YOUR way, all others be literally damned and exiled. And it's stupid because all of those laws and norms are there for really good reasons like preventing tyranny and resisting highly emotional social movements. It's funny to me when I hear progressives say things like "Donald Trump will end democracy" because it demonstrates they don't really understand how the three branches of government work and interact. But, then again, if the institutions go the way the progressives want then, yes, a sufficiently motivated demagogue would have the instruments at hand to end democracy in America as we know it.
It has always been framed this way. Pro-choice advocates have been framing it mostly in terms of women's lib since they stopped framing it mostly in terms of eugenics. The emphasis on 'healthcare' has always been in the background, I think it's just increased progressive neuroticism that brought it to the fore.
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I think this glosses over a lot of what the limits of democratic control should be. This itself is a political choice - hairdressing is licensed in some jurisdictions, but not others. What sorts of trades a bank can make with its own book is a political question, and our current consensus developed post GFC which led to the Basel frameworks.
The populist theory appears to be that any change which is salient is grounds for the choice to be declared political and the subject of debate. This is self-fulfilling IMO, because nearly any issue can be made politically divise simply by inciting our leaders to act divisive about it. See: vaccines, plastic bags at grocers, transgender healthcare.
Our discourse is increasingly driven by crackpots and populists, and that's how you end up with the Phillipine Courts causing blindness in children.
The populist framing is going to do severe long term damage to our politics, our health, and our planet.
Retvrn to elite worship.
We're ..... already here.
No, it isn't elites in the sense of Aristocrats or Philosopher-Kings the way a lot of reactionaries would like. It's elites of culture - Hollywood, sports figures, quasi political public figures (talking heads), and pretty much anyone who can find a way to capture 1mm+ eyeballs one way or another.
Now, you might respond "No,no,no by elite I mean people with, you know, demonstrated skill and capability!" Well, it's turtles all the way down. One man's skill is another man's luck, just look at the recent thread on the stock market. Also, if you think the most meritocratic are the ones who naturally progress to the top of large organizations, I've got a Google and United States Army certified bridge to sell you.
The entire idea of "replace bad elites with good elites" fails because having any elites in the American system allows for co-opting of the system. Bernie Bro's will talk about the moneyed elite buying elections, MAGA types will talk about the Deep State bureaucracy elites stealing elections. They're both wrong in a factual sense (which is, you know, the most important one) but they're both leaning on an elite-vs-people ontology as the primary engine for deteriorating social and economic conditions. This is because it's such a simple and compelling narrative and has worked hundreds of times all of the world. "THEY are fucking you over!" Is politicking in a nutshell. There's a reason we call it Red Tribe vs Blue Tribe on this website.
Elites should be less socially relevant to people. I've written about this before but a huge part of Trumps appeal is that a lot of his base viscerally, deeply sees Trump as one of their own. They feel like they can reach out and touch him. Flashback to early in the 2016 election cycle and we were, then, headed towards Hillary Clinton vs Jeb Bush. That's an election that feels awful because neither candidate is
not a lizard person grown in the Epstein cyborg bunkerparticularly personable. But I wonder if it would've been one of the more substantive elections in recent history. "Hey, both of us have the personality of a damp phonebook ... I guess we to have to talk about the issues!" That turns into elites with high political / technical salience getting their shot at leadership, instead of those with high social salience. President Mitch McConnell? Never in today's world ... but I have a suspicion the Founding Fathers would've looked at him and said, "That's your fucking guy!""Elite worship" as you term it is a very fancy version of parasocial relationships with strangers. I can't think of an argument for why a deeply committed parasocial relationship is ever a good thing. Instead, strengthen actual in person social relationships. But at the level beyond your own family (which, for any healthy adult, will always be their number one social relationship). But don't extend it to strangers, which just turns into you creating conceptions of reality that already fit your pre-defined values system. I'd say, draw the demarcation point at people you see semi-regularly and know the names of. People who might greet you on the street. Put politicians right after those folks in terms of relative social importance. I want my relative prioritization of my relationship with Steve, the retired Army Colonel at my regular bar, to be far more important that my perceived relationship with Biden/Trump/Kevin Sorbo.
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I call first dibs on defining "elite".
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Reverse this and I think the populist position becomes a lot more compelling. In other words, deciding what to exclude from politics is a political choice. Taking an element of life and saying 'I don't care what any of you think, we're doing it this way and we always will' is pretty much the most direct exercise of power one can imagine.
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Huh? You think transgender health is divisive only because politicians acted divisive about it? I think that's a pretty bad example. If anything politicians are playing catchup with the popular sentiment, and the whole thing only ever became a topic in public debate, because the elites were working so relentlessly on imposing it on the public.
Or are saying the opposite, these issues wouldn't be divisive if people wouldn't feel divided about them, and incite politicians to act accordingly? Isn't that just a round about way of saying "the issue is, in fact, politically divisive"?
Who's elites, yours or mine?
If you think having a unified legitimate elite is such a great idea, why don't you reject yours and endorse mine as legitimate?
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Yeah, I think there's a pretty critical underlying value disagreement. Even were a choir of angels to descend from heaven with a device that could guarantee not only whether a specific person was trans, but even whether they'd be happier to transition or not, I don't think social conservatives and the pro-trans side would be able to agree even in the most convenient world.
And in the world we're in, it's looking increasingly like that magical device might change from 'yes' to 'no' for a single person over time in some cases, which is pretty far from convenient. Social conservatives reject the framework that this change reflects internalization of transphobia or the harsher limits of later transition (usually, I think, in favor of seeing it as 'puberty naturally solving the discomfort'), but even accepting it doesn't actually change the value conflict: social conservatives absolutely will bit the bullet in favor of distress for a couple years to avoid sizable surgical interventions, even well outside of the trans sphere.
Yeah, half of the transhumanists balk when I point it out, but transhumanism really is at the core of the issue.
But even then I think I disagree there's no compromise to be had. I think even a decent chunk of conservatives could tolerate people going full-cyborg when they're adults, it's insisting that it's necessary for children that crosses the line.
And then it doesn't help that this is combined with all sorts of demands to rearrenge the social order.
I think the more critical part is the extent that social conservative (and other non-progressive) interests are being cordoned off, even in red states or outside of state interests. I don't yet agree with FCFromSSC's thesis that multiculturalist approaches are fundamentally doomed, but they're very clearly not something anyone with serious power is willing to accept.
It's demonstrably possible make the argument for people's right to make medical decisions or talk up the right to freedom in education, while wanting to ban homeschooling or require medical procedures, because that's become The Accepted Position, but it's little more than multi-culturalism-for-me.
On the silver lining side, the broader movement is in the process of eating itself alive over other contradictions, so the lack of interest in accepting more minimal takes has its costs. Hell, I don't think the transhumanist part will survive, because no small portion of the pro-trans not-actually-trans-themselves world hates transhumanism-as-practiced; cfe the various reactions to VR or weight loss drugs or AI or yada yada.
But that's a pretty shitty silver lining, and the movement can be incoherent longer than you can stay solvent.
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The children thing is weird, and like most things I think we have a pretty good handle on it by "do what you want after 18, before then, NO. Having big time drugs or surgery before then is a large mistake currently because it is irreversible, if that isn't the case in the future it will obviate this entire problem. If a child or adult can be one sex at 9 am and another at 10 am why would anyone care about any of this anymore?
Except we don't actually have that handle on it. Trans activists explicitly claim that these interventions for children are medically necessary, and care providers privately share tips with each other on how to wear down reluctant parents' resistance.
I can grant that the issue goes both ways, as there are also more conservative parents that want to ban it for everyone, but I'm regularly surprised at people's assumption that this issue is currently being handled the same way as tattoos or cosmetic surgery.
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There is multiple popular theories under which it makes sense. The simplest and most common on the left is that trans is real, but there is no reliable way to detect it except through introspection by the person itself. And introspection is hard, and even harder if you're young, so it's better to set up at least some safeguards to make sure that people really get to think things through. This is also why there used to be rules like "try to life like a woman for 3 years and if you still like it, we can talk about that bottom surgery". In fact this used to be the dominant theory, and it's a pity that it got replaced by the current insanity, even though I don't entirely agree with it either it's just much, much less destructive.
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I don't think there is necessarily a link between "trans being real" (which I assume means some people having hormonal or brain imbalances that mean they will never feel comfortable being identified as their birth sex) and being reliably able to identify it in young malleable children.
It's very realistic to me that it could be a real phenomenon but the malleability of young minds means it cannot be reliably diagnosed before a certain sexual/cognitive threshold.
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You're right. It's incoherent.
But the very fact you cite - that so much ground has been ceded without working out the central issue - is what implies that it isn't pointless.
Once half a generation has been indoctrinated and enough people have essentially circumcised themselves or their children and must stick with the tribe or be stuck in some liminal zone cursing their illness or credulity it becomes harder to roll back.
If society is giving concessions now to this stuff, it won't be less likely to do so when people finally throw up their hands and admit theres no there there. Or rather, it'll never get to that point.
They're running out the clock. Every moment where some unflattering thing can be hidden is another moment to lock in gains.
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You could say the same about abortion: there are plenty of mutually incompatible theories of when it might be appropriate, but most people are okay with some sort of gradient. I don't have strong opinions on how real transness is, but I feel like if it's real and necessary, it's less an unjust limitation on liberty to restrict surgery from children than from everyone; likewise, if it's fake, it's still better that independent adults do it than dependent children.
It's not a coherent way to intellectually approach the world, but it's a politically feasible and useful one.
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