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I've read the Skrmetti case and the amicus brief, and I really hope the petitioners fail.
That said, I'd bet money that the amicus brief (an inherently one sided argument) is broadly accurate in its claims, and is far closer to ground truth that the current US medical consensus. IMO the APA, AMA, and WPATH are completely out to lunch with regard to gender care, peddling harmful anti-science bullshit. I think trans insanity is waning slowly but surely, but the remedies proposed in Skrmetti set a precedent I don't like on principle. And principles are occasionally bitter pills to swallow, otherwise they're not principles.
If Skrmetti prevails (and I think it will), the effect will be a long standing precedent in case law that legislatures can eschew a medical consensus. Science will be decided in the courtroom; then the legislature. Granted, I think the US scientific consensus is wrong in this case, but I'm hewing to my principles, which sucks big fat amputated cock in this case. I want doctors, not legislators, to determine medical care. I don't want legislators deciding if mifepristone is safe, if my doctor/psychiatrist can prescribe me therapeutic ketamine, testosterone, MDMA, a lethal dose of whatever if I'm terminal, etc.
I loath safteyism, and won't clutch my pears and "think of the children" because other avenues of justice are available, namely torts. Suing doctors for negligence will change medical standards without opening a wider door permanent legislative intrusion. Torts have worked before. Anyone remember when fake tits were (erroneously, in retrospect) deemed unsafe for a period in the 90's? (In re Dow Corning Corp, 1996).
The Alabama amicus brief gives a good argument that the medical consensus in this case rests wholly on advocacy and not on science. It demonstrates WPATH as an advocacy-first organization that actively suppresses conflicting or even ambivalent research, and therefore any "consensus" based on its recommendation ought to be suspect--especially given the general climate where medical researchers not part of WPATH also voluntarily suppress research contrary to that org's guidelines.
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Completely aligned. The current medical standards are hogwash, Skrmetti will likely prevail, and yet I am not satisfied by that outcome. Wrong tool for the job, second and third order effects worse than the cure. This is just How Things Are Done These Days, apparently. I want to get off Mr Bones' Wild Ride.
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While I think Tennessee would love to have the legal question ride on whether these particular procedures are Good or not, that question only really comes up after resolving several others first: what level of sex-based classifications raise heightened scrutiny under the 14th amendment, whether trans-related classifications count as sex-based classifications, if these trans-related procedures count, what level of scrutiny that all rolls out into, and only then whether the procedures are Good or Not.
There's a lot of ways to punt, on either direction, about the underlying validity of these processes and procedures, and especially given the makeup of the court right now, I would not be very confident that they will not punt to some extent.
Meanwhile, the rule that legislatures can overrule medical consensus is pretty-well-established, no matter what happens. See matters like right-to-try laws, or the entire existence of the DEA. Even if SCOTUS jumps whole-heartedly in favor of trans rights on the matter, the questions presented here are solely about sex discrimination; the case does not argue a right to specific medical practices in general.
((I'm also separately very skeptical of the negligence/malpractice route as 'better', from either direction. Malpractice and negligence lawsuits have wonky rules and impacts: doctors have good reason to practice extremely defensively even where they may eventually win the case, and can avoid liability for pretty bad behavior so long as it falls within certain standards.))
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An improvement over the current state of affairs, where it is decided by the moral fads of unaccountable administrative bodies.
If we must be the toys of power, let it at least be power that has a chance to feel the consequences of mistakes.
Thats why having principles sucks. It will be an improvement in this one case. But the expansion of legislative caprice can be broadly interpreted for a long time. There are equally useful alternative toys of power to exact justice. Torts maintain a comparatively narrower scope, and stay within the realm of liability.
We signed a death warrant on Science the moment we thought it could be a "neutral" way of resolving political disputes. The instant that idea was entertained Science was doomed to either go the Olson Kennedy route, where scientists themselves abandon the scientific process in pursuit of their political agenda, or to be brought to heel by another institution with political power (and I agree with the other poster, that it's better to have politics be done by a transparently political institution, than under the guise of "neutrality").
For you to get what you want, we'd need to take science out of politics.
What's sad is that had it been kept out of hot political issues, it could still be useful to validate our answers to these questions once they are no longer politically hot. Now that it's balls deep into political issues, even old mistakes will have to be maintained or memory holed because previous examples of Science being wrong are going to be used as examples of why today's Science could be wrong, and we can't have that!
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In the absence of a shared religion or culture you need something. Seemed like a smart idea at the time.
Yeah, I can't judge, I cosigned it too back then.
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In 2017 Oren Cass published an a great article on the problem of "policy based evidence making" in my favorite magazine, National Affairs. Part of the thesis was a call against government expansion, which won't be the case if Skrmetti prevails. Unlike policy, science gets mugged by reality in comparatively short time spans. I'm confident that "gender science" won't hold for a hundredth as long as the precedence Skrmetti will establish. Moreover, it would broaden the scope of legislative intrusion. Imagine a scientific consensus emerges that natal males playing female contact sports poses statistically significant injury risk. An ideological legislature could dismiss that, and instead pursue their own policy, ethical, or ideological goals. The same principles are in play.
Science remains the best way to find out what is true, all else being equal. No passenger would be tempted to troubleshoot a high-flying faulty airliner by the legislative process; to defer to a representative for the best way to perform life saving surgery.
https://www.nationalaffairs.com/publications/detail/policy-based-evidence-making
No one arguing against Skrimetti actually wants to stop government expansion. What they want, as the Alabama brief eloquently argues, is to have political controversies be resolved by unelected, supposedly scientific bodies like the FDA, or the alphabet soup of medical associations.
If you actually want a government that does not interfere in science, you need to roll back the entire regulatory state. Otherwise the supposedly neutral institutions will simply become a political faction, and science will go out the window anyway (which is exactly what happened).
Well, first you'll have to explain what's so bad about that. Unless I'm missing something Skrimetti is just about banning / age limits on gender medicine. I don't see how it's qualitatively different from banning heroin or other recreational drugs.
And if these controversies are settled through scientific institutions, all that will happen is that political factions will use underhanded means to take them over, and produce shoddy science that serves their political goals. Which, I repeat, is exactly what happened. The WPATH and Olson Kennedy did not fall from a coconut tree, as they say.
I think I've been pretty clear that entire reason I'm against Skrmetti prevailing has noting - whatsoever - to do with banning flawed gender medicine. The precedent it sets can be argued in favor of the next Bad Thing(tm). Just sue the current bad thing for torts.
What I'm asking is what precedent is it setting? As far as I can tell it's nothing new. Are bans on surrogacy some "dangerous precedent"?
Again, if that's what you're going for you shouldn't be arguing against Skrimetti, you should be arguing for the total abolishing of the regulatory state.
As I stated, legislators can eschew medical/expert consensus for anything they please. Imagine the scientific consensus states that natal males in womens contact sports poses an injury risk. Well, Srkmetti would provide precedent that elected representatives can ignore that consensus. Is mifepristone safe? Thats now up for legislators to decide on their own. Does MDMA provide a therapeutic benefit to veterans with PTSD? Etc.
No, I want both internal and external experts to study things without their findings being handwaved away by politicians with an ideological agenda. Or course in this scenario, I don't trust the APA, AMA, and WPATH view on gender medicine. But experts will be mugged by reality far faster than case law. The cass report led to a reversal in the UK; science slowed down gender medicine in the Nordic countries. It takes far too long to get bunk science out of the legal system because the legal system is unscientific; relies on case law (eg bite mark analysis). In general, trust experts more than politicians because experts are responsible for the modern world.
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I don't think this is as good of an example as you think given how Boeing has been doing lately. Someone gets mugged by reality alright, but it doesn't have to be the scientist or the people who give him money. And until you have a way to close the loop, they can keep being insane for long enough to destroy your society.
Science is good at figuring out precise models of the natural world, it is absolutely terrible at making decisions about the results of those models, or itself.
The modern world being so complex you need layers upon layers of experts to even understand problems is the story the managerial class tells about why it should rule, but that's only a story. We could be doing other things, with other tradeoffs.
I think what did the most damage to this story in recent times is Elon Musk. I think that's what they hated most about him, before the Twitter purchase.
The managerial class had evaluated the question and decided that while electric cars were a cute idea, they were not a realistic replacement for ICE cars. It also concluded that space exploration was just too expensive and that it should just be about launching drones to increase the prestige of institutional Science, and as a way to transfer more ressources to contractors so embedded in the US government they're practically an arm of it.
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