This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
I agree that Tordoff et al.'s work is of lesser quality, and that there simply doesn't exist gold-standard evidence on this issue. I find Turban et al.'s work more convincing.
To be clear, we're talking about puberty blockers, which "are falsely claimed to cause infertility and to be irreversible, despite no substantiated evidence".
The WPATH standards, which are on the radical side of global medical opinion (Scandinavian rules, as @arjin_ferman points out, are much more restrictive) emphasize social transition, then possibly puberty blockers, then possibly cross-sex hormones, then possibly surgery. To the extent that it looks like this standard of care isn't being followed, those reports are themselves untrustworthy.
If you're upset about something going on in the world, it behooves you to make sure you're clear on what's actually going on.
While your response is ok in the context of raggedy's bombastic claim, I'd like to caution that this "falsely claimed without evidence" business is itself rather bombastic. What they most likely mean by that ist that there is no evidence blockers directly, permanently, and reliably cause infertility. What they most likely don't mean by it is that there is no evidence for any impact on fertility.
Right off the bat, we are talking about a drug that is also used for chemical castration, so it would be wild if it didn't have at least a temporary impact on fertility. Secondly there's the question of when the puberty blocking is started, if you block puberty at or before stage Tanner II, where by WPATH's Marci Bowers' own admission even your ability to orgasm is seriously impeded, would that have no impact on fertility? Various gender clinics are quite cautious on that:
I found another paper that seems to have a more sober tone, and even your Lancet article seems to have resulted in a lot less bombastic follow-up, but SciHub not being what it used to be, I couldn't verify what exactly they said.
EDIT: Originally I thought they meant "irreversibly cause infertility", but I just noticed that the reversibility claim is made separately from the claims about fertility:
That's just an outright lie. There is no way to bring a person back on their original development trajectory after they have been affected by blockers. Neither the article, nor the paper cited under "no substantial evidence" link addresses the reversibility of the effects puberty blockers have on a person.
I want to emphasise that it's shaping up to be a European, not just a Scandinavian thing. The UK also restricted their standards, the French National Academy of Medicine issued a statement urging caution, and the Belgian Center for Evidence-Based Medicine is throwing heavy shade at the state of research as well.
Maybe this is what you meant by "on the radical side" but it's worth noting that after publishing the original version of the SOC, that various researchers actually signed on to, they immediately issued a correction removing the minimal ages for gender affirming procedures. There's a whole bunch of other controversies resulting from the latest SOC which, personally, put the credibility of the entire organization in question, but that's not related to your point.
Keep in mind that the reports that these reports are untrustworthy, are themselves untrustworthy. The people who were originally casting doubt at Reed's story are now claiming she/journalists committed HIPPA violations by providing evidence.
Well, yes, in a very literal sense, there's no such thing as an action without consequences in the most general sense, but the drugs do not appear to be horribly dangerous in the general sense, which is why they're used for kids who are going through puberty at the wrong time.
For scale, I'd point out that we regularly perform surgery on healthy adolescents, as well as on infants, sometimes in ways that make them very definitely infertile, but despite considerable activism, this hasn't become nearly as much of a major issue, likely because these things are done to make children more gender-conforming, as opposed to less.
The level of concern about potential bone-density impacts, for example, seems disproportionate compared to the way we disregard much more serious issues when no one involved is gender-nonconforming.
Reed's claims are pretty straightforward: the standards of care that the clinic was supposedly following were flagrantly violated. This should be, in theory, simple to resolve, modulo medical privacy issues. The fact that people who were at the clinic says that their experience doesn't match what she reported seems at least somewhat relevant.
There's plenty of medical procedures that you can go through, that even if they make their mark, it will be hard to spot years down the line. If I catch a particularly nasty bug, and the doctor gives me antibiotics, chances are no one will be able to tell I took them after I recover. That's what most people mean by "not permanent" and "reversible". Puberty blockers are not that, and it's not a case of being strictly literal to point it out.
This is shifting the goal posts. You can't accuse people of "falsely claiming with no evidence" that they're irreversible and can cause infertility, only to switch to "aside from their permanent impact on the development trajectory, they don't seem to have that many side effects".
The former is a cosmetic surgery, which we make clear from the start, so the patients and their parents can actually make an informed decision. I'm also pretty sure it's effects are less serious than blockers (and if not, then it's also insane that this is allowed).
The latter is barbaric, and one of the reasons arguments from authority ring hollow to me.
Deliberately and permanently altering a development trajectory again shows that the drug has very serious and permanent effects. Taking it at a time when the kid is supposed to go through puberty means they will miss out on important stages of development. It's insane to me that academic journals have the balls to call that reversible.
You seem to be painting a picture that "lower bone density" just means living a mostly normal life, with maybe an increased risk of braking a leg, or something. While that's relatively accurate when you're young, things start getting a lot more serious by the time you hit your 30's, when you might start feeling the effects of early onset osteoporosis.
Contrary to your claim that gender medicine is met with disproportionate scrutiny, the truth is the opposite. We turn a blind eye to serious side effects of gender medicine, which we would never allow in other cases.
The fact that Reed said all her claims are documented and verifying them is a question of a simple subpoena, while the other side is screaming about HIPPA is even more relevant.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link