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PaperclipPerfector  1yr ago (text post)   27509 thread views

Culture War Roundup for the week of November 6, 2023

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What's wrong with "ban until they're 18"?

The canonical answer is "it works worse with age". I don't know how accurate that is, though it certainly seems plausible to me that delays will result in worse patient outcomes among those who do transition.

What precedent is it setting?

I'm not aware of any medical interventions that are banned even when the patient wants them, and their guardian approves it, and a doctor recommends it, but which are allowed once the patient reaches the age of majority.

It's not like we're living in an ancap utopia, the establishment even cracked down on the use of prescribed ivermectin.

Yes, and that was bad. I would prefer fewer things like that, not more things like that.

The canonical answer is "it works worse with age". I don't know how accurate that is, though it certainly seems plausible to me that delays will result in worse patient outcomes among those who do transition.

How is it plausible that a mastectomy works better when you're 14 than when you're 18?

If you're referring to puberty blockers only, other than accuracy of "works worse with age" (which is indeed under question), there's also the issue with diagnosis. Even if the treatment worked as advertised, there's a fundamental question of whether we can actually tell "trans kids" apart from "non-trans kids".

Yes, and that was bad. I would prefer fewer things like that, not more things like that.

But it happened, the precedent is already set.

patient wants them, and their guardian approves it, and a doctor recommends it

There's a massive question mark under each of these components. The patients in question are minors, respectfully, they don't know what the hell they want. Some guardians approve it, but many have their arm twisted into it by dishonest statistics about risk of suicide. Doctors also mostly wash their hands of the responsibility, your family doctor, endocrinologist, even a run-of-the-mill psychologist and psychiatrist will say "I don't know anything about this gender stuff, go to a gender specialist", and the "gender specialist" ends up being a crank who believes in "gender angles".

Why is it beyond the pale to regulate an industry that functions this way?

What on earth are “gender angles”??

It comes from Dr. Dianne Ehrensaft, one of my favorite characters in this entire saga. She first came to prominence during the Satanic Panic that OP mentioned, not satisfied of only having it on her track record, she decided to jump on the gender bandwagon. I originally heard the term without further explanation, in a video from some trans-care conference, so I had to look it up. Luckily it is now used in academic literature:

Chapter 1, “From Gender Identity Creativity to Gender Identity Creativity: The Liberation of Gender-Nonconforming Children and Youth,” written by clinical and developmental psychologist Diane Ehrensaft, presents the story of the still ongoing liberation of gendernonconforming children from the realms of pathologization and provides glimpses into a new gender-creative world, where gender ghosts (i.e., “internalized thoughts, attitudes, feelings, beliefs, experiences that draw us toward culturally arbitrated binary gender boxes and make us anxious when we or anyone else strays from those boxes,” p. 22) can be and will be replaced by gender angels (“internalized thoughts, attitudes, feelings, beliefs, experiences that allow us to be gender creative and live or accept others living outside of culturally defined binary gender boxes,”

You might also be interested in other terms she promoted like "gender minotaur", "gender Prius", "gender Tesla", "gender smoothie", or "gender Tootsie Roll Pop".

The patients in question are minors, respectfully, they don't know what the hell they want.

And then when they turn 18 they become legal adults, famous for making good decisions that align with their long-term interests.

Some guardians approve it, but many have their arm twisted into it by dishonest statistics about risk of suicide. Doctors also mostly wash their hands of the responsibility...

Yeah this is pretty terrible, and the "the statistics on how things actually tend to go in practice are shit to begin with and then further obscured by biased parties on all sides" bit means that it's very hard to make a well-informed decision here. Such is life in an environment of imperfect and sometimes hostile information, but it still sucks.

Why is it beyond the pale to regulate an industry that functions this way?

I don't think it's beyond the pale, I just expect that the costs of regulation here, as it is likely to be implemented in practice, exceed the benefits. I don't actually think it's a good thing that a bunch of teenagers feel like they're trapped in the wrong body and that their best shot at happiness is major medical interventions, I just expect that any attempts by our current regulatory apparatus to curb the problem will cause horrible "unanticipated" problems.

If you have some statistics that show that, actually, regulation here is likely to prevent X0,000 unnecessary surgeries per year, which in turn will prevent Y,000 specific negative aftereffects, I might change my mind on that. But my impression as of now is that this is a small enough problem, and regulation a large and inexact enough hammer, that it's not worth it.

And then when they turn 18 they become legal adults, famous for making good decisions that align with their long-term interests.

You're not wrong, adult detransitioners are quite bitter about people going "you made your decision when you were 18+? Well, fuck you then, I guess!". I'd be happy with banning the practice from mainstream medicine entirely, if this is what you're offering, but what I offer is a compromise.

Such is life in an environment of imperfect and sometimes hostile information, but it still sucks.

No, it's not, actually. An environment of imperfect information is one where everybody gets to make their case, and everybody gets to make their decision, not one where one side gets to pretend they're The Science, and hound all skeptics and dissidents.

If you have some statistics that show that, actually, regulation here is likely to prevent X0,000 unnecessary surgeries per year, which in turn will prevent Y,000 specific negative aftereffects, I might change my mind on that.

Yeah, there are statistics that show the dstience rate was above 80%, before activists took over the field. Do you have any statistics to show any of these surgeries are necessary to begin with?

But my impression as of now is that this is a small enough problem

Tuskagee was a spit in the bucket compared to what's happening, not to mention George Floyd, or MeToo. If you can link to making that s sort of argument about these cases, I'll believe that you actually made this argument in good faith.

Tuskagee was a spit in the bucket compared to what's happening, not to mention George Floyd, or MeToo. If you can link to making that s sort of argument about these cases, I'll believe that you actually made this argument in good faith.

Huh, apparently reddit is more of a tire fire than I thought, because I definitely made the "what exactly do you hope to accomplish, how does what's currently going on accomplish that, and are there any downsides to normalizing looting unrelated businesses and homes in response to injustice" point during the 2020 riots. But apparently it's been memory-holed. IIRC it was my second most downvoted comment ever.

I've got quite a lot of "measures to contain covid have costs as well as benefits, and I've seen no evidence that the benefits exceed the costs and quite a bit of evidence of the reverse" of you're interested in that.

Honestly though, you will probably not have much success modeling me as "on your side" or "against your side" - I would like to grill, and I object to moral busibodies who get between me and my grill with their schemes to make society better. And I especially object when those schemes aim to solve tiny problems that affect a few thousand people in a country of hundreds of millions, or when those schemes obviously won't help with the problem they're supposedly trying to solve, or when the cure is clearly worse than the disease.

Honestly though, you will probably not have much success modeling me as "on your side" or "against your side"

That's no fun, how am I supposed to dunk on you then?

I would like to grill, and I object to moral busibodies who get between me and my grill with their schemes to make society better.

I can sympathize. I still have a libertarian temperament, even I don't think modelling people as free-floating atoms is either accurate, or something to aim for.

And I especially object when those schemes aim to solve tiny problems that affect a few thousand people in a country of hundreds of millions

I think this is the part I object to the most. While your response to BLM was laudable, it doesn't exactly touch on what I was trying to get from you. BLM was objectionable regardless of whether the way the police treated black people was a big problem or not. It's exactly the idea that things that don't affect a large enough proportion of the population shouldn't be talked about, or have any action taken to stop them, that I have a problem with. You could probably justify several genocides on the grounds that the targeted ethnicity was tiny compared to the global population.

or when those schemes obviously won't help with the problem they're supposedly trying to solve, or when the cure is clearly worse than the disease.

These are fine arguments to bring up, but obviously I disagree they apply in this case.

How is it plausible that a mastectomy works better when you're 14 than when you're 18?

The idea is that it’s far easier for a person who transitions at 14 to pass as the gender of their choice than it is for a person who transitions at 18, especially for MTFs. I don’t think they’re actually wrong about this. At 14, most boys and girls are still fairly androgynous; by 18, most boys are clearly young men: tall, prominent jaw line, Adam’s apple, facial hair, muscular structure, etc. If a gender dysphoric boy wants to transition and pass as a girl, puberty blockers at as young an age as possible are his best shot. The same holds true for girls but in reverse.

Cool, but how is it plausible that a mastectomy works better when you're 14 than when you're 18? You are aware this is a thing that is actually being done?

The same holds true for girls but in reverse.

Not really. You can take testosterone when you're a full-grown adult, and you'll pass pretty well. And like I said in the other comment, to the extent this helps trans people, it hurts people who decide to detransition.

A mastectomy specifically? I assume there’s no medical benefit to doing it earlier (though maybe it heals better the younger you do it?). I imagine the proponents of that procedure are solely focused on the psychological benefits—reducing the “trauma” of seeing your body change in ways you don’t want it to. They probably also don’t consider detransitioning to be a real future concern, so why not just get it over with?

That’s the best I can come up with; I’m not actually in favor of such things myself.

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