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naraburns  nihil supernum  1yr ago (text post)   35347 thread views

Culture War Roundup for the week of April 3, 2023

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an unverified twitter account claiming to be the child in question is saying, despite all the facts in the article being correct, that they don't place the same emotional valence or cause and effect on it that the mother in the story does

First, there are no verified accounts on Twitter any more. The legacy policy required that accounts be "authentic"; the new policy requires that accounts be "non-deceptive", but in no way actually checks that.

Second, they don't claim that "all the facts in the article [are] correct". From the article:

Within a semester, Casey went from all As and Bs to a report card dotted with Ds and Fs.

From the thread:

The article mentions that my grades dropped from A’s and B’s to D’s and F’s in a semester. This is a completely exaggerated statement. My grades were on a steady decline since 2020 due to unrelated mental health concerns.

From the article:

Caroline assumed counseling at the center would help Casey sort things out. But in retrospect, she says, what the psychologist at the center did was solidify the idea that Casey needed medical intervention for his gender distress.

From the thread:

I was in counseling with the Washington University transgender care center in which I was treated amazingly by my counselor. She was a friend to me and offered a great amount of support. This was taken away when my mom revoked consent for the Supprelin.

The article doesn't make any effort to determine that the effect of counseling was, if the counselor recommended or encouraged medical intervention, just repeats Caroline's opinion. It leaves an unchallenged implication; the kid denying it is meaningful.

They especially and annoyingly split hairs in that they admit the doctors said trans teens kill themselves without treatment, but the doctors never said they would specifically. See, totally no longer pressuring the parent!

Is there a way to give informed consent here that isn't pressure under this rubric? Hey, if you don't get this shot, you're much more likely to die of COVID, but we're not pressuring you, right? Doctors are supposed to explain risks and benefits to the patient for any procedure; how can they provide information without "pressuring" someone?

Is there a way to give informed consent here that isn't pressure under this rubric? Hey, if you don't get this shot, you're much more likely to die of COVID, but we're not pressuring you, right? Doctors are supposed to explain risks and benefits to the patient for any procedure; how can they provide information without "pressuring" someone?

By providing dry info. X% of people with your condition day within Y days, Z% of people who take this treatment have a A% chance of living to age B.

I guarantee you that the doctors did not do that in this case.

I guarantee you that the doctors did not do that in this case.

I'm not a doctor, and I'm certainly not an expert in communicating with people. But is that how doctors communicate in other circumstances? Does a doctor who notices that you smoke simply provide dry info and leave it at that? From what I can tell, standards around informed consent focus on whether or not information has been provided in a legible way to the patient or caregiver, not on the fastidious maintenance of strict neutrality.

I don't know how this was presented, and neither do you. But it's a stretch to say that it was presented meaningfully differently from how other medical procedures are offered, i.e., it reflects the standard of care in medicine generally. And if your issue is with the standards for informed consent, why tie it to a controversial set of procedures where the public, at least, absolutely does not agree about the risks and benefits?

In short, the dialogue looks like this to me:

A: Caroline was unethically pressured into approving puberty blockers for her child.

B: It looks like that pressure took the form of explaining risks and benefits.

A: Anything going beyond a bare recitation of the facts is undue pressure.

B: That's a standard that medicine, in general, does not meet.

It looks like either you're holding gender-nonconforming medical interventions to a uniquely high standard, or you're expressing a general issue you have with medical-ethical standards in an unnecessarily controversial manner.

I don't know how this was presented, and neither do you

I do know it wasn't presented in the way I described, because if you plug in the relevant numbers you will not get anything that can be seen as pressuring the parents into having their child take blockers.

It looks like either you're holding gender-nonconforming medical interventions to a uniquely high standard

You originally claimed it is not possible for a doctor to give information about a medicine, so the patient can give informed consent, without pressuring them into taking it. You can't criticize me for holding blockers to a higher standard, when all I did was give an example you asked for.

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