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Notes -
I think the difference in medicine is specifically that the people using the service are generally in no position to understand the issues involved. Most people don’t have even a high school understanding of human biology. They don’t understand enough to know if something is dangerous or not. What most people end up doing is treating medicine like they would have treated witchcraft 800 years ago— the guy in funny clothes told me I have to eat/drink this or let him do this thing to me. They don’t have any expertise or experience to say “hey wait, is this really a good idea?”
With things like swimming pools or other sports or activities, a person is in a bit better shape in making a good decision because they know what they’re looking at. If my kid wants to go swimming, I know whether he has that skill, I know whether he’s going to a pool or a river or lake, I can therefore have a reasonable assessment of the risks. If he wants to play football, I’ve seen enough football to know it’s a rough sport with a fair number of injuries. Alcohol is again something people know enough about to make reasonable decisions about. They know it can be addictive they know it impairs judgement and coordination and they have probably seen a drunk uncle or two.
As far as the agency I’d use — most states already have medical boards with all kinds of record keeping, requirements to keep up with the field through continuing education hours, requirements for the facilities, requirements for outcomes. Every state already has this, you have to have a state medical license to practice medicine (and a similar thing for pharmacies) in any given state. I don’t see a problem with adding a check that you’re not giving out opioids or adderall at 2σ above the normal base rate and having someone check up if you are. If every child coming to your psychiatrist practice is being diagnosed with gender dysphoria, then there’s very likely a problem, just like if you’re giving every single person coming to your clinic adderall or OxyContin.
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