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Culture War Roundup for the week of August 26, 2024

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The basic idea behind trans ideology is that sometimes you get a person, a trans woman, who is born as a guy. Despite this, they feel a strong desire to modify their body to have breasts and a vagina. When they modify their body in this way, they become much happier - it is one of the most successful medical interventions, on that axis.

Hi! I was skipping a lot of the conversation you started, because I didn't want to contribute to the "explain yourself now, trans person" dogpile, but my ears perked up at that one.

My understanding is that this view is pretty outdated. WPATH seems to outright reject it, and to only use it cynically as a foot-in-the-door thing in countries with lower trans acceptance. They hold that it's all about "authenticity" and self-expression, and that doctor's empashis needs to be on removing barriers, and on patient autonomy. They don't even think it's about transitioning from man to woman, or the other way around, and are happily endorsing "non-binary" surgeries.

Would you say they are out of line, or is it that you're more old-school and no longer representative of the community?

I think a lot of trans women genuinely fall into the older, classic model like me. It's really hard to say if it represents the actual community, because there's some loud voices that want to make the newest ideology the only one, but I do think there's a lot of people like me, and still are, even if we're no longer the majority within the trans community. I think there's a lot more of us than you'd guess, simply because we tend to be quiet: we already got what we want, as long as we don't draw attention to ourselves.

I have a bit of trouble taking someone seriously as a "trans woman" if they just want to self-identify, don't have dysphoria, and aren't even taking HRT, but... I'm asking people who don't believe I'm a woman to call me "she/her" anyway, so I'm at least fine with names and pronouns even there.

If we accept the idea that I want to have a cis-woman looking body despite not being born with one, it doesn't really surprise me that some people might want "non-binary" mixes. I don't really understand the category well myself, though. I think a lot of non-binary is much more about abolishing gender roles entirely - most cis women I meet who identify as "non-binary" just seem unhappy with society's concept of "female", or are viewing that concept through a fairly narrow lens. All that said, if you're actually going out and getting surgery, I'm going to take you seriously.

It's really hard to say if it represents the actual community, because there's some loud voices that want to make the newest ideology the only one, but I do think there's a lot of people like me, and still are, even if we're no longer the majority within the trans community. I think there's a lot more of us than you'd guess

Well, my guess was roughly what you're describing. I saw a pretty big generational difference in the trans community, and figured the more old school view is probably still strongly represented, but trended on it's way out I was wondering if an insider's view was different.

But my problem here is that this isn't a question of numbers and loudness, but one of position. Ten thousand reasonable trans women, who aren't bothering anyone, and just want to live their life, will easily be outweighed by a single Dr. Ren Massey simply by virtue of him being a doctor, and being in the position of training other doctors.

I have a bit of trouble taking someone seriously as a "trans woman" if they just want to self-identify, don't have dysphoria, and aren't even taking HRT

Well, if I understood the new approach to the issue, it's less about being trans without dysphoria and HRT, and more about taking HRT without dysphoria. The way you described it, HRT / pronouns / gender affirming care generally is something we do, because it's the best way to alleviate suffering. I'm not into causing unnecessary suffering, so I can go along with that, but the new view on this matter seems to be that there might not be any suffering involved to begin with, so this is where my patience starts to wear thin - I didn't sign up to be a part of anyone's grand project of self-expression.

most cis women I meet who identify as "non-binary" just seem unhappy with society's concept of "female", or are viewing that concept through a fairly narrow lens. All that said, if you're actually going out and getting surgery, I'm going to take you seriously.

That's interesting, because that's the opposite of my instincts. As long as it's about "roles" it's no skin off my nose, it's when doctors encourage body modification to express one's non-binariness that I'm starting to think that things are getting out of hand, and we need to put a stop to it.

it's when doctors encourage body modification to express one's non-binariness that I'm starting to think that things are getting out of hand, and we need to put a stop to it.

That feels a bit oddly phased. Presumably it is the patient who is expressing a desire for this, and going through a fairly lengthy bureaucratic process - especially for anything non-binary. I don't think there's a bunch of doctors out there going "have you considered transition?" I would indeed find it super creepy for one's personal doctor to be offering recommendations like that unless the patient is listing off dysphoria symptoms.

That said, if someone knowingly undergoes surgery, and this routinely makes those people happier, I don't see any reason to stop it. I support people doing other forms of cosmetic surgery, getting tattoos, etc.. My general understanding is that very few people regret these surgeries, partly because there is still generally a lengthy bureaucratic process weeding out anyone doing this on a whim. If it makes them happy, why not?

That feels a bit oddly phased. Presumably it is the patient who is expressing a desire for this

I see nothing odd about it. A few years back there was a story about a patient who went to a psychologist, and expressed a desire to be blind (and, if you're curious how it ended, the psychologist did oblige), it's still the doctor's job to discourage rather than encourage it, in my opinion.

and going through a fairly lengthy bureaucratic process - especially for anything non-binary

The process is neither lengthy nor particularly bureaucratic.

I don't think there's a bunch of doctors out there going "have you considered transition?"

The issue I brought up is that there are doctors explicitly advocating for removing all guardrails, including age, history of mental illness, and even the incidence of gender dysphoria. The response that they're (probably, maybe) not going out of their way to sell transition, does not alleviate my fears stemming from the issue I brought up.

That said, if someone knowingly undergoes surgery, and this routinely makes those people happier, I don't see any reason to stop it.

Well, you originally made it sound like it's a question of best medical practice. If diagnosis doesn't enter into it, and we're just fulfilling people's arbitrary desires, hoping it will make them happy, it would appear the original argument is invalid.

In any case the reason that I see to stop it, is that young people are not known for their good judgment, so I don't think we should be letting minors undergo irreversible procedures on the basis of their sayso.

There's also an argument for limiting access even for adults, but if we can't agree on minors, I don't we'll get far regarding adults.

My general understanding is that very few people regret these surgeries, partly because there is still generally a lengthy bureaucratic process weeding out anyone doing this on a whim.

I'm not talking only about surgeries, but about the whole "gender affirming care" package (blockers, hormones, surgaries). Further, my entire point is that specific doctors, and organizations like WPATH are explicitly working towards abolishing any such process, wherever it exists. If the reason why you're not worried about people undergoing these procedures is that there are safeguards in place, then I think the biggest worldwide association of gender care providers arguing to abolish them should be a bigger deal to you.

In any case what you said is inaccurate. Until recently you could get all of these things, with zero questioning, and few bureaucratic hurdles, even as a minor. In response some jurisdictions decided to clamp down on the practice, and impose age limits through legislative action. In other places, this was done through medical oversight institutions finding little to no evidence for the effectiveness of the practice. But there are still many jurisdictions that did not regulate the practice, and even doubled down on making it even more accessible.