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It's because it's both natural and we have a long track record of that path working.
It's a very difficult problem to come up with an alternative pathway that leads to physically and mentally healthy humans at our current level of tech. Unconstrained thinking is probably not a good idea when it comes to complex biological and psychological changes.
It becomes even more absurd to even attempt this in the name of people with disordered relations to their own body, when puberty itself may help resolve that disordered relationship.
Maybe people's intuitions that living their values will make them happy are just wrong. Maybe this is especially true for a group that is prone to a bunch of other mental disorders.
...
We can't exactly take it for granted that mentally ill people are holding values that will actually make them happy , or that they have a reasonable understanding of the risk they're taking on (especially when faced with dubious information from medical practitioners)or have reasonable expectations for these treatments.
Or hell, that their stated euphoria and relief will be lasting.
Society is entitled to say no. My doctor won't give me SARMs for some reason.
Discussions like this make you feel the void left by any natural law or common understanding of virtue.
I did stress that I'm playing Devil's
AdvocateDoctor. I don't want puberty blockers, if I had the misfortune of having a child who desired them, I would do almost anything in my power to dissuade them. I'm not in the business of prescribing them either, I'm not a psychiatrist for kids and teenagers. In fact, the UK is cracking down on even the relatively few (compared to the US) "legitimate" gender transitioning clinics.That being said: Natural law is bullshit. There is no coherent collection of principles that the term usefully refers to. Most adherents ignore the literal meaning and embrace a gazillion unprincipled exceptions. The closest it has to a working definition is status-quo bias.
Even teleological definitions have absurd conclusions. Is the meaning of life to maximize entropy? It is, if the outcome of a process defines its purpose.
Even mild exposure to different cultures and their associated values will tell you that beyond a small core (often contentious itself) there's no "common understanding of virtue".
Even simple sounding ideas, like "don't murder, or steal from your neighbors" will have people arguing ad-nauseum what counts murder or stealing or even a neighbor.
If I pity people who want to be the opposite of the sex they were at birth, then I pity people who genuinely believe in natural law or "objective" morality even more.
One of them is a matter of personal values. The other is basing your moral foundations on wishful thinking.
I'm a moral relativist and a moral chauvinist. I know my values are just as valid (or not) as anyone else's. I also happen to think they're better, with the implicit understanding that to use such a comparative term necessarily needs an observer by whose light it is better or worse (me). Anyone who has convinced themselves that there's objective grounding to their morality, well, I don't want to have what they're smoking.
Quite a few gynecologists and many endocrinologists would be out of a job if the outcome of human hormones acting as they would always had the desired outcome.
I don't contest that the overwhelming majority of people are neutral or slightly positive towards puberty, assuming they even cared to reflect on it.
I would be the last person to disagree about the limits of modern science, engineering and medicine. I also think we should be improving our tech (and we are).
On the other hand, constraining thinking to only that which is known to be possible is... a choice.
You might have gotten away with it a thousand years back, when the lives you and your grandpa lived were nigh interchangeable. That's not the case today, we're living in a scifi novel with reality's rather lax attitude towards plausibility.
And it might not. The rate of desistance with puberty is not 100%. A non-zero number of people will find themselves still wanting to transition, and face even greater hardship for even less change.
I'm for reflecting on whether or not that risk is worth taking, from the perspective of someone who has to:
They need to add up the benefits and risks themselves.
I do not hold happiness as the only terminal value, nor do most people. If they disagree, then they're welcome to start a fent habit.
Whether doing something will make a person happier, either in the short-term, in the long term, or just on average, is far from the only consideration when making a choice.
There are plenty of people who are just depressed, so we wouldn't be out of a job.
Mental illnesses are not made equal.
Someone who had an overwhelming desire to fly and tried to do so might have been better off in an insane asylum if they were born in the 1700s.
Today, they might be a hang-glider hobbyist, a pilot, an astronaut.
Did the people who jumped off cliffs or the Eiffel Tower with inadequate parachutes or mechanical contraptions count as mentally ill or suicidal? Not by most definitions I've heard of. They would still have been "better off" if society had caged them, or at least lived longer. Yet today, we soar.
Your argument argues, just as strongly, for doing our level best to present reliable information to patients. You could also force doctors to present information that better represented reality, on the pain of liability. You could have people be grilled by a different doctor or some other Authoritative Individual who had to be convinced that the patient understood the risks and benefits. This is already common practice in psychiatry, at least where I work. Things like detention under the Mental Health Act or forced treatment require multiple people uninvolved with the original case to sign off. This isn't trivially gamed either, I've seen the headaches my bosses get went they're trying to put these in place without unimpeachable evidence.
Death, be it ours, or that of the universe, doesn't mean temporary endeavors are worthless. At least not to me.
Even in the short term, the hedonic treadmill goes brrr. I'd love to win the lottery, even if a year later my happiness would have regressed to near baseline levels.
You should try a different doctor. Some are more flexible. If I had a patient who understood the risks and benefits, and I wasn't violating laws (because I wish to keep my license, my own moral proclivities aside), then I'd prescribe them.
There are many things that would nice if they were real. You know, a benevolent Creator, objective morality, a pill that changes your gender with no consequences.
Sometimes, you're shit out of luck. Sometimes you can make something just as good. Sometimes you pick the lesser evil out of available options while working on making better ones.
If you have a god-shaped hole, in a universe that doesn't have a god, make one yourself from applying linear algebra to {the majority of text Mankind has written}. If you can't become the opposite sex today, maybe settle for the terrible ersatź substitute.
All I say is maybe.
Hooo buddy, have I got some news to break to you about natural science. People debate conceptual primitives and what "counts" as them all the bloody time. I presume that you pity people who genuinely believe in natural physical law or "objective" reality, too?
These sentences contradict one another and result in something that is conceptually incoherent.
Ontology is a matter of convenience. All models are flawed, some models are useful. If there are two different models of reality that output the same results for all ranges of possible inputs, then choosing between them is a matter of convenience. If, for some reason, it became relevant, you could then worry about which one had the lowest Kolmogorov complexity or something.
Objective reality is a very useful concept to have, even if establishing it is likely unreachable. I can happily concede that the universe might be a cosmic dream, that this could be a simulation, that I'm perhaps a brain in a vat or a Boltzmann brain while happily acting as if this reality is shared, stable and predictable. The ability to compartmentalize or hold multiple levels of abstraction in your head when necessary can be handy.
There is certainly far more evidence for consistent and universal laws of physics than there is for objective and universal morality. Physicists can predict the outcome of systems spanning dozens of orders of magnitude within the limits of experimental error. Philosophers are lucky if they can get their buddy reading Kant in the cafeteria to agree with them.
1 to 4 establish the relativism. 5-7 explain why that's not a barrier for me preferring my morality over all others, as I believe that it both needs no justification beyond personal preference and that there isn't any more deep-seated justification for anyone's morality.
In other words: "Because there's no objective standard, all moralities are equally ungrounded. However, from my subjective viewpoint, I find my own morality preferable, and therefore I advocate for it." I avoid claiming objective superiority while still asserting subjective preference and a desire for propagation.
Please, do tell me me how these two concepts are impossible to reconcile. I think I just did that, so there's an existence proof for you. I would be much obliged if you also established reasons for there being an "objective" morality, or a reason why I should prefer that of someone else's over myself.
If you somehow succeed, I will either concede the point, or disappear into a gibbering mess of congealing brain matter from the cognitive dissonance I expect to experience.
...and yet, you must pity people who actually believe it, right?
Let's start with, "What does this sentence mean?" What does it mean for values to be "just as valid (or not)"? You seem to have not touched on this at all in your latest comment.
The same way I pity someone with a bad haircut. It's not a big deal, or a lot of pity.
It means precisely that from any imagined objective standpoint (which I argue doesn't exist for morality), no set of values has a greater claim to inherent correctness or truth than any other. They are "equally valid" in the sense that they are all subjective constructs, arising from individuals or cultures. They are "equally (or not)" valid because the very concept of objective validation is moot here â they are all equally ungrounded in objective truth. Think of it like favourite colours: saying my favourite colour (blue) is "just as valid" as yours (red) means neither has an objective claim to being the 'correct' favourite colour; the concept doesn't apply.
This lack of objective grounding doesn't prevent me, as a subject, from having preferences. I prefer my moral framework. I find it more consistent, more conducive to the kind of world I want to live in, etc. That's the chauvinism. But it's a preference asserted without the illusion of objective backing. It's saying "I prefer blue and think others should too because I find it aesthetically superior," not "Blue is objectively the best colour according to the laws of the universe."
Not that I feel like this point requires elaboration, I strongly expect that if you had an actual way to show me up as incoherent, you'd have produced it by now.
Why not? Why the difference?
This is just restating that you think values are subjective, not telling me what you think it means for such subjective values to be "valid" or not... or multiple values to be "equally valid".
Precisely as I expected. You have absolutely no explanation of what your own sentence meant; only what it did not mean. Your sentence lacked any semantic content and was incoherent in your view. Once one tries to include any semantic content in it, it contradicts the prior sentence. It's extremely bad form to use sentences that you sneakily think are incoherent.
[EDIT: Let's change the syntax to make it clear. Suppose you had said, "I know my values are just as blurf (or not) as everyone else's." Suppose I inquired as to what you meant by values being blurf or not, or multiple values being equally blurf. It's not really helpful to say that there is nothing objective about blurf. It still simply fails to tell me anything about what blurf actually means.]
Of course, if I proceeded with your attitude, I'd say that I strongly expect that if you had an actual way to make your own statements coherent/consistent in your view, you'd have produced it by now.
You're just wasting my time, and have been for a while.
I've explained my stance, that moral views are just as inherently subjective as opinions on favorite colors. That's it.
Precisely as expected. You do not have a way of making your own statements coherent/consistent in your view, which is why you haven't done so. Now you're just throwing a hilarious Internet Shit Fit for having gotten called out on it. (About three comments! That's "for a while"! Mucho Internet Shit Fit...)
It is actually you who has wasted all of our time, by making incoherent statements and then refusing to engage in reasoned discourse about them. All you have to do is explain the meaning of your sentences. This should be extremely easy, since your position is so simple, straightforward, and obviously true... so much so that you pity anyone who doesn't agree with you and think that they're smoking wildly crazy stuff. Why can't they understand your extremely simple position? ...perhaps it's because you can't even be bothered to make it coherent.
EDIT:
You dropped this bit.
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I know. You just run into places in these discussions where you're clearly in need of a common touchstone, even if we can't get back.
True. But, practically, internal dissension seems more relevant than the inability to get the entire human race to agree. Nobody in America is overly bothered by the fact that Saudis have a different moral code.
Although the balance has shifted with how connected we are.
This is the majority of philosophers btw. I personally don't take a strong stance on metaethics (another way to put it is that I'm too lazy to read enough to formulate one and always puts it off) but that always gives me pause here. What many people find very unintuitive is the consensus position.
It doesn't disprove the "narrow is the path and few find it" argument if even otherwise healthy people have issues that require correction imo. Seems like it does the opposite.
The standard for any treatment (or social convention for that matter) has never been that it's 100% successful.
I actually think that's part of the problem: society is constantly being overturned in the name of smaller and smaller minorities until we hit one where the tradeoffs for doing so are actually serious and visible.
The situation before the general pullback, where public cachet was redistributed to a small number of people who would likely be even smaller given healthy puberty, combined with credulous diagnosing and taboos against "conversion therapy" seems totally backwards.
I meant it in the broader sense. I suppose what the Greeks would call eudaimonia and now philosophers translate as "human flourishing", to avoid exactly these problems.
And I suppose that's a coherent personal position. However, society clearly has certain standards for medical treatment.
Yes, it would be better if everyone was given accurate information on blockers. But that's not the only medical ethic. It seems like we have some pretty high standards for things like amputations which is precisely why exuberant claims were made about the necessity of transition to save a child's life. Even my opponents have implicitly yielded the point: the goal is not short-term gender euphoria in exchange for things we know tend to give people meaning like the ability to experience sexual pleasure and have children or not suffer side-effects from cross-sex hormones.
It's to literally save lives and improve human flourishing. It is not like your own personal decision to spend $3 on a lottery ticket (which costs you almost nothing and doesn't require any medical professional to be complicit).
Maybe that's what I see myself as doing, but for society.
The arguments against a lot of TRA claims and medical practices to help them are usually on pragmatic grounds.
I've done my best to explore what drives philosophers to endorse objective morality, and found all their arguments lacking. It would help if the people who believed in objective morality could agree with each other on what it looked like, but alas.
I belong to the most oppressed minority of all,
gamers, individuals. It doesn't get any smaller than that.I also strongly value personal liberty. It's far from my only consideration, but it is a powerful one. The same arguments, namely paternalism, thinking that you can't allow such far-fetched thinking, would also restrict me.
I'm willing to support people in their quest for personal liberty, even if I think they're misguided, for the same reason that you want the right to free speech to cover heinous kinds as well. Nobody needs to have speech that's popular and favored protected by law.
Society isn't actually a monolithic entity (I'm not claiming that you're saying this, you appear to appreciate nuance). It's made of individuals, and some of them, like medical professionals or regulators, have disproportionate influence.
As the former, if not the latter, I consider it my duty to explain my views. At the absolute very least, I'm painfully self-consistent, and many of my opponents (the average philosopher, for example) aren't. There's plenty of vagueness and moral gray in that field, let alone when it becomes political.
It is certainly not consistent. As @RovScam helpfully illustrates in his own comment, it is trivial to consider an isomorphic example where almost nobody would consider it their business to interfere if the patient, their parents and the treating physicians were all on board.
Modus ponens, modus tollens. I've addressed the specific example of elective limb amputation before. To summarize, if the person was otherwise sane (or at least had capacity), couldn't be dissuaded despite plenty of effort, found a surgeon willing to help, and could afford it, then I see that as entirely fine. I wouldn't like to pay for it with my taxes, there are better things to waste them on.
Young teens make many life changing decisions with uncertain payoffs. Opting for a less conventional field of scholarship might be one.
"We know that leaving school at 11 and then tilling the fields leads to a satisfying and happy life, why bother with the stress and expense of uni".
If someone is busy sacrificing their ability to party with friends in high school in exchange for grinding for med school, what of it? They'd definitely be getting more sexual pleasure in the short term, and likely have more kids if they didn't have to finish residency.
The issue is that the people you're trying to look out for vehemently disagree on what counts as human flourishing. They certainly don't appreciate your attempts to dictate what they should choose, even if you good intentions.
If money is the biggest factor, then I have little objection to saying such procedures shouldn't be paid for by the public, any more than breast implants or a boob job typically are. I say typically for a reason, because someone who had a mastectomy for cancer might qualify.
The core of this is that meme:
"I consent." Says a distressed young child. "I consent." Says their worried but loving parents, and some doctor making sure they're ticking the consent boxes. "I don't-" Says someone whose consent seems entirely unnecessary to me, at least when they're not paying for this.
As a matter of such longstanding custom or clear law that it can easily be said to be "society's" position.
If we lived in a libertarian world where people were expected to take on all of the costs of a procedure and balance the risks themselves I think your personal take would be coherent for society to adopt.
In practice, neither of those things may be the case. Society collectively pays for a bunch of services and we insist on rigorous epistemic and ethical standards even when people might willingly take the risk. Even the people arguing for the specific case we're discussing pay deference to that expectation.
I think this status quo has a lot to recommend it but, even if I could be convinced it should change, I'd like to know why this topic (given how I feel about the object-level issue) should motivate that change.
tl;dr: They can have it when I have the same easy access to steroids.
The consequences of majoring in programming right now with AI is unclear. The consequences of lopping of your limb are.
We seem to think that matters, which is why one involves far more ethical requirements.
I'm not sure they actually do though?
The argument for gender affirming care has always been that it will reduce things like suicide rates and suicide ideation and the comorbidities associated with trans identification and thus it functions as medicine, as it's commonly understood. The controversy is about whether gender affirming care achieves some broad definition of human flourishing but the general goal it should be achieving if it is effective medicine (and a brief, heroin-like moment of bliss doesn't count) doesn't seem to be controversial.
The whole emotional blackmail line of "dead son or live daughter" has this assumption built in.
If it turns out that the evidence isn't good for this then their case falls apart by its own standards.
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