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The more I've thought about the concept of disease and disability, the more I've become convinced that there isn't actually a good philosophical grounding for talking about variation and difference in normative terms.
To take just one example, being left-handed is a variation that occurs in a minority of humans. Is it an "unfortunate mutation" or a "normal variation"?
Does it matter that it occurs in 10% of people? If being left-handed had instead occured only in 0.01% of people would it then be correct to say something like, "Humans are a bipedal, right-handed species"?
We can be descriptive and speak in generalities, but in a lot of cases I don't think we have a sound basis to say something like, "A human body should work this way, but yours is working wrong."
I think if we're being as pedantic as possible, the best you could say is something like, "Your body works in way X, most people's body works in way Y, but with a surgery Z we can make your body work in way Y as well."
Normal doesn't mean "accounts for all cases". There is little doubt that those with very unusual disabilities or those that put substantial effort into mimicking the opposite sex are not normal. And that can be fine, people don't have to be normal. Abnormal doesn't even strictly mean bad. I do not understand this impulse some have to destroy the concept of normal to spare obvious outliers the small pain of accepting the obvious truth that they are not normal. Or at least the reasoning that does make sense for this impulse is very uncharitable.
Sure, being left handed can be abnormal. It is either a, very slightly, unfortunate mutation or maybe a, very slightly, fortunate mutation in some rare cases like fighting or tennis where it can throw your opponent offguard. No one is surprised when a tennis couch says "normally when the ball is here and your opponent is here you'd expect it to come back in so and so way, but with a lefty so and so". These sexual mutations are much more straightforwardly unfortunate as they carry practically no benefit and quite a bit of downside.
In some cases sure, but being sterile is very clearly not how the body is supposed to work. The purpose of the reproductive system is to produce offspring, if it can't do that then it is defective. Being defective is about as dead center of a sound basis for declaring something not working correctly as I can imagine. If you can't rule this as abnormal then I question what you actually think normal could possibly mean.
Normal has a purpose, it lets us treat special cases as special cases and suspend normal treatment as necessary. Which is, possibly uncharitably, what I think is behind this whole shell game. You want trans people to be treated not just as normal, but as normal for their desired sex. Those of us objecting to this want to be able to treat trans people as abnormal members of their natal sex. And I think we have tremendously better reasons to do so. I think you want what you want for laudably empathetic reasons, you see them as suffering and that they deeply want to be treated as normal members of the opposite sex. But this violence you're doing to the concept of normal to try and force them to fit is ridiculous and cannot stand. It is wrong to enforce an incoherent worldview, even if done out if empathy. It can't even stand in its own legs, the norm of cis female needs to exist in order for trans women to even emulate it.
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I mean, if we're going to question the concept of disease and disability why start there? Seems "convenient" to start on an edge case that most people would acknowledge (presumably because there's other factors at play that prevent one assuming that variation is disability - e.g. almost no impact on what we consider right and healthy functioning)
Seems like this easily collapses into a general challenge to the idea of health as a normative category.
So what about people born without an arm? Or many other actually painful congenital conditions? How do we know that's "unhealthy" or a "disability"? Do we just not? Is there no normative sheen to any of this?
I think this leads to strange places that are at least out of step with most people's intuitions.
If it doesn't, then I don't see how this point isn't subject to the same critique being made of this concept of gender: it's a deliberate attempt to occlude the fact of a generally accepted category by using edge cases.
You made a big leap from left-handedness to missing limb, which is commonly accepted as a disability, and ignored all of the in-between.
What about something like autism spectrum disorders? A mild case of autism can be beneficial; how many technological and scientific advances do we owe to people who had autistic obsessions in engineering, physics, programming, etc.? Some autistic people see “normies” as the dysfunctional ones and are able to be very successful and productive in the right environment - but there’s a point where it becomes entirely a disability. Where do you draw the line?
Yes, it was deliberate.
Thats my point: OP criticized the very idea of normative categories due to biological deviations but conveniently picks one deviation that most people would now argue falls outside of the category of "disability" (because such people fall within the normative category of "healthy").
It seems to me that even in his attempt to "problematize" such categories he's trying to leverage their assumptions. Presumably because arguing that "health" as such is a meaningless category is a fringe position.
It's only a "leap" once I accept that there is such a thing as health and it doesn't exclude certain minor deviations but excludes larger ones. On the category skeptical view who is to say?
I want to push him to apply his logic consistently, to cases intuitively considered less thorny.
If he doesn't see this as a problem then I refer back to my OPs final paragraph.
I think the mistake is viewing categories as “real” things that exist outside of your mind. Categories aren’t “real”, they’re a fuzzy concept that humans invented. This doesn’t mean that they’re meaningless; they’re an abstraction through which to compress tons of information about a subject, allowing you to make decisions more effectively. Every category is like this, from species to planets to sandwiches to chairs.
So if you ask is “X a disease”, you should be aware that disease isn’t a thing that objectively exists outside of human interpretation. Most cases are clearcut so this doesn’t matter, but occasionally you do have ambiguities, like sickle cell traits which offer resistance against malaria at the cost of other health complications - it’s a disease in the western world, but in some African countries it can literally save your life.
So, if categories do carve reality at the joints sometimes, how does this square with:
You're providing one potential grounding and justification of categories - they are tied to important things that are truth-apt. Why is that not enough for grounding, when OP's own examples seem to quite clearly show implicit use of "meaningful" categories?
I think OP is being inconsistently nihilist. He should either pay the full price of nihilism or accept that he's right there with the rest of us and can't just blithely dismiss categories via edge cases to avoid inconvenient exclusions.
Put it another way: can I use OP's argument to dismiss, I dunno, flesh-eating bacteria as a disease? If not, why not? How does the above argument not prove too much?
I don't see how that helps OP. First of all, it's debatable what's objective or not (or what we mean by it). Morality is widely considered objective by ethicists and is even more subject to this criticism.
For another: why does "disease" need to exist outside of humanity? Isn't it enough that OP seems quite clearly able to see that "left-handedness" is only weakly (or not at all) within the disease camp but flesh-eating bacteria would be? Why did he not leverage a more intuitively absurd example? If they know they can't, why do they think they can just dismiss categories when they're quite clearly guiding him?
I don’t agree with OP’s blanket dismissal of categories. “Disease” is a very useful category, my argument is simply to recognise that humans have a tendency to ask “is X a disease” when the real question actually is “should X be cured”, and focusing on whether X is a “really” a disease or not is pointless.
Flesh-eating bacteria neatly fit into the category of “disease”. But, is having sickle cell traits a disease? Is having parasitic worms a disease? You might scoff at the latter - but there’s potential evidence that over-sanitation and elimination of parasites is what is causing the huge spike in auto-immune conditions in the west. So it’s important to ask the real questions, which is “should we cure X”, or “how do we manage X”, not “is X a disease”.
Fair enough. TBF it's unclear how far OP will take it themselves.
The term "disease" has normative implications. The implication that it should be cured is built into debating whether something is a disease.
It's really the same discussion.
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