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PaperclipPerfector  9mo ago (text post)   25622 thread views

Culture War Roundup for the week of April 8, 2024

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When discussing pharmaceutical and surgical interventions in the treatment of gender dysphoria, the gender-critical among us often draw parallels with bodily integrity identity disorder. This is a rare psychiatric disorder in which a person experiences profound distress because of the presence of one or more of their limbs, and requests to have these limbs amputated to alleviate said distress (or tries to amputate them themselves). Colloquially, one might say that people with this condition are able-bodied but identify as disabled.

Given that no one thinks that surgical amputation is the correct treatment for this psychiatric disorder, we gender-criticals argued, it follows that surgical intervention is the wrong approach for people with gender dysphoria. If it's wrong to amputate a mentally ill's person's arm just because they say it's causing them distress, how can it be right to do the same for a penis or breast?

Sadly, one man’s modus ponens is another man’s modus tollens, the medical establishment has noted the parallels, and it is coming to a rather different conclusion:

Sensational news from late last week, that doctors amputated two fingers for a 20-year-old patient to alleviate the young man’s mental distress over being able-bodied, contained a buried clue: “He related his condition to gender dysphoria.”

... A 2018 ethics analysis in a Cambridge University Press publication concludes that there is “no logical difference between the conceptual status of BIID and transsexualism”. It goes on to say that, “given that individuals with transsexualism are offered gender reassignment surgery it seems to us that individuals with BIID ought at least to be considered for treatment, including elective amputation in some cases.”

... But what would it mean to accept the amputee identity at scale, the way we have accepted trans rights as a universal humanitarian movement? Drawing exact parallels, we would likely see a total saturation of amputee culture, from amputee story hour to centring amputee voices in DEI training, and doctors warning parents of the very real suicide risks for amputee-identifying children whose parents refuse to accept them as surgically modified cripples or invalids. Advocates would talk of being “assigned able-bodied at birth” to persuade activist teachers and medical associations to adopt the absolutist position that any attempt to talk kids out of amputee surgery amounts to “conversion therapy”.

The journalist Mia Hughes recently asked readers to imagine a society in which amputee advocates enjoyed the same cultural and political victories as trans advocates.

“Imagine there were a sudden 4000% increase in teens identifying as amputees, but we were all forbidden from being concerned. Instead we were supposed to celebrate it,” she posted on X. “Imagine schools teaching children as young as kindergarten that some people have amputee identities, that they get to choose how many limbs they have. Posters promoting body mutilation adorned the walls of many classrooms.”

Nothing specific to add to this* beyond despair. The Anglophone medical establishment appears to be fully ideologically captured. It doesn't matter if the Tavistock is shuttered and there's a rash of lawsuits directed at youth gender clinics in the US: if you're a medic who's internalised (or been made to internalise) the gender ideology worldview, the implications of that worldview and the role of the medical establishment it affirms have far-reaching implications in medical domains unrelated to gender medicine itself. At this point I honestly can't rule out psychiatrists prescribing anorexics appetite suppressants to aid them in achieving their "bodily attainment goals".

*Other than why the fuck are Canadian doctors so keen to help their fellow citizens maim or destroy their bodies??!!

one man’s modus ponens is another man’s modus tollens

Really nice turn of phrase

Not original to me, to clarify.

Well look, you used it naturally enough that I couldn't have told the difference

From the article UnHerd cites:

“He hides his fingers, keeps them flexed, leading to impaired dexterity, localized pain, irritability and anger,” Dr. Nadia Nadeau, of the department of psychiatry at Université Laval wrote in the journal Clinical Case Reports. He grew more determined to find a way to get rid of fingers he considered “intrusive, foreign, unwanted.”

“He had contemplated asking a friend to watch over him and be prepared to call emergency services in case his attempt led to a need for resuscitation,” Nadeau wrote.

After undergoing elective amputation, the nightmares and emotional distress immediately stopped, Nadeau said. The post-op pain resolved within a week, there was no “phantom pain” at one month follow-up and, without the two missing fingers, “he was able to pursue the life he envisioned as a complete human being without those two fingers bothering him.”

It’s not the first time amputation has been used as a treatment for BID. In the late 1990s, a surgeon in Scotland amputated one leg above the knee each in two men who’d felt a “desperate” need to be amputees, and who had been turned away by other doctors.

Despite the scandal that erupted, “At the end of the day I have no doubt that what I was doing was the correct thing for those patients,” the surgeon, Dr. Robert Smith, told a press conference.

The fact that there were only two fingers involved in the Quebec case, as opposed to a complete limb, made the decision to proceed easier for the medical team, Nadeau said.

If this now-amputee were me, I'd try to just get over it. Stop taking any action to either sate or resist the discomfort, meditate real hard, just feel it and let it burn out. I think it'd work for me.

But it's a mistake to not understand the other side's perspective. You have a guy who's constantly distressed, whose daily life is significantly impaired, who's begging for help, where many pharmaceutical and therapeutic interventions have failed, and a simple operation will fix his problem permanently. It makes a certain amount of sense, right? This guy's had this problem since he was a child, and it is a doctors' job to fix it, and nothing else is working.

It reminds me of

https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/

The Hair Dryer Incident was probably the biggest dispute I’ve seen in the mental hospital where I work. Most of the time all the psychiatrists get along and have pretty much the same opinion about important things, but people were at each other’s throats about the Hair Dryer Incident.

Basically, this one obsessive compulsive woman would drive to work every morning and worry she had left the hair dryer on and it was going to burn down her house. So she’d drive back home to check that the hair dryer was off, then drive back to work, then worry that maybe she hadn’t really checked well enough, then drive back, and so on ten or twenty times a day.

It’s a pretty typical case of obsessive-compulsive disorder, but it was really interfering with her life. She worked some high-powered job – I think a lawyer – and she was constantly late to everything because of this driving back and forth, to the point where her career was in a downspin and she thought she would have to quit and go on disability. She wasn’t able to go out with friends, she wasn’t even able to go to restaurants because she would keep fretting she left the hair dryer on at home and have to rush back. She’d seen countless psychiatrists, psychologists, and counselors, she’d done all sorts of therapy, she’d taken every medication in the book, and none of them had helped.

So she came to my hospital and was seen by a colleague of mine, who told her “Hey, have you thought about just bringing the hair dryer with you?”

And it worked.

She would be driving to work in the morning, and she’d start worrying she’d left the hair dryer on and it was going to burn down her house, and so she’d look at the seat next to her, and there would be the hair dryer, right there. And she only had the one hair dryer, which was now accounted for. So she would let out a sigh of relief and keep driving to work.

And approximately half the psychiatrists at my hospital thought this was absolutely scandalous, and This Is Not How One Treats Obsessive Compulsive Disorder, and what if it got out to the broader psychiatric community that instead of giving all of these high-tech medications and sophisticated therapies we were just telling people to put their hair dryers on the front seat of their car?

But I think the guy deserved a medal. Here’s someone who was totally untreatable by the normal methods, with a debilitating condition, and a drop-dead simple intervention that nobody else had thought of gave her her life back. If one day I open up my own psychiatric practice, I am half-seriously considering using a picture of a hair dryer as the logo, just to let everyone know where I stand on this issue.

Amputating a few fingers is somewhat more invasive than putting a hairdryer in your car. But it's the same principle, right?

That's from the categories are made for man, which Zack's spent a lot of time disagreeing with because, yes, it was about trans people and how to treat them. I didn't even remember that was why Scott told that story until I looked it up again today.

And, it's a good analogy, because this is what it feels like for a medical professional dealing with trans patients. You have adults who beg for hormone treatments, claim to be and appear to be in severe distress due to lacking them, and do indeed appear to improve after taking them. This is what it should look like! There are issues with kids, issues with surgery, but none of those undermine the obvious case for accepting trans people and treating them with hormones - it seems to make them happier and better. Again, yeah, edge cases, but the trans people I know are not perpetually depressed psychological wrecks like you'd expect from rw twitter memes, they're generally normal and happy.

Claiming otherwise requires some sophisticated reasoning, like one that claims happiness or sexual satisfaction are of little value themselves, and only matter when done for in line with a greater purpose - in this case, marriage and having children. And since trans individuals imitate the appearance of sexuality without the fertility backing it, it's bad. I agree with something like that.

Nothing specific to add to this* beyond despair. The Anglophone medical establishment appears to be fully ideologically captured

If A is evidence for B, B should be evidence for A, yes? "One man’s modus ponens is another man’s modus tollens?" If we took this case being a novel case of unnecessary amputation as evidence that trans ideology has thoroughly captured the medical system, or something like that, and then we observe that this isn't novel - I think we should doubt the reasoning that led to the claim of ideological capture.

edit: here is the paper about the case.

Claiming otherwise requires some sophisticated reasoning,

I actually don't think it really needs reasoning that's all that sophisticated. Transforming a hand with five fingers to a hand with three fingers and two stumps is something well within the bounds of current medical technology, and the risks of an unexpectedly negative outcome are substantially lower. In contrast, actual gender transition is so far beyond current medical technology that we're not even close to getting there. I think this is the big problem with the analogy, because the consequences here are extremely relevant. Yudkowsky had an article that I really liked on the subject, actually - https://www.lesswrong.com/posts/QZs4vkC7cbyjL9XA9/changing-emotions

I specifically mean claiming that existing adults who believe themselves to trans women, do so for multiple years, and most centrally are MtFs who genuinely feel terrible about not being women, shouldn't start taking hormones and socially transition. Within this argument the claim isn't that they're Becoming-Woman, the claim is that trying to mime the social roles and appearances of women and starting hormones appears to make them happier, more content, etc

It is incredibly weird to try to imagine though how so many people who are not, in fact, mentally women, could come to the conclusion that they are mentally women and start mimicking that social role and genuinely enjoy it. And as far as I can tell that is true! It really speaks to how complex and contingent human values and desires are, and how many potential configurations of human beliefs and societies there are.

Within this argument the claim isn't that they're Becoming-Woman, the claim is that trying to mime the social roles and appearances of women and starting hormones appears to make them happier, more content, etc

I think most of the friction over transness (and gayness, which is typically only one step removed from transness anyway) is that doing that also tends to be an excuse to express all the attributes of that gender and not just the positive/productive ones.

Public perception is that, being born as the gender that doesn't express those traits as much would cause an ex-gendered individual to know better than to do them/have more innate resistance to them. Of course, that's ignoring that ex-women/lesbians get more leeway on this than ex-men/gays do for sociobiological reasons, so toxic feminine traits in men are going to be noticed and resented more than toxic masculine traits in women will be (if they even happen at the same base rate).

For example, there's a meme around 4chan that boys make the best girls (and... there's probably something to that), but that's ignoring all the times that boys make the worst girls. At an object level, this mainly comes in the form of catty bullshit and other gender-role-specific ways to be a bully, which is why it's easy [for otherwise-normal men] to form a strongly negative association with other men who have developed/are developing the gay lisp (to name one example).

Of course, that reaction also prompts toxic [same adopted gender] to rally around the flag and defend their right to that toxicity, and since the balance of power in western society currently favors women the "it's ma'am" shit gets a pass. Places where the genders are a bit less at war with each other (for whatever reason) tend to produce more media that portrays crossdressing/cross-sex activity in at least a neutral light, which is why that stuff more often comes out of Asia.

one of reasons I wish Russia win over Ukraine (if closely aligned with EU&US they will get this too, eventually)

Being a Russian satellite is not very good for you unless your warlord's name is Kadyrov and you share his religious whims. That alone should outweigh concerns about miniscule numbers of dubious surgeries.

I am not worrying about Ukraine here, I'm hoping loss in Ukraine would show the West they're doing something bad. I poorly phrased this.

Well, I'm hoping loss in Ukraine will show Russia it's doing something bad.

Uh, I thought Kadyrov was pretty bad for the average Chechen?

I suppose so, although I imagine living in a region which receives those massive handouts from the federal budget is better than, everything else remaining the same, not having those handouts.

which Zack's spent a lot of time disagreeing with

As someone who expended a lot of words taking a public figure to task over his perceived hypocrisy/cognitive dissonance on the trans issue, it will not surprise you that I found this post very absorbing. It's so weird how this specific issue seems to break so many people's brains, even (especially?) people who built their reputations on being no-nonsense straight-shooters who don't care whose toes they step on in pursuit of Truth. As soon as the word "gender" is mentioned, they look at their feet and start mumbling about "why do you care anyway it doesn't affect you".

Zack hypothesises that the overrepresentation of trans women in the rat-adjacent sphere is Rationalism's shield against accusations of being insufficiently progressive - if they were to start saying things that run the risk of driving trans women away, the accusations would be substantially harder to defend against. I must admit this sounds grimly plausible to me, but it doesn't explain why Freddie deBoer has the same reaction to this issue.

Claiming otherwise requires some sophisticated reasoning, like one that claims happiness or sexual satisfaction are of little value themselves, and only matter when done for in line with a greater purpose - in this case, marriage and having children. And since trans individuals imitate the appearance of sexuality without the fertility backing it, it's bad. I agree with something like that.

I think the cleaner reasoning is that the disease appears to be memeborne and validating the meme is part of its transmission. If the finger amputation thing catches on and 5% or more people start getting their fingers cut off then there is a real cost. The hidden cost in the treatment, especially the social aspects of the treatment, is that you're spreading the infectious meme. If people only develop the illness internally then sure, a case can be made for treating it it individually. But it's rather like approaching the flu as if it were a nontransmissible issue caused by an unfortunate accident at birth and encouraging people to hug and kiss people with the flu to show that we're all sorry for them.

I don't think this is perfect. There are a significant number of people who seem to have developed something like transness, whatever you want to call it (and maybe there are different things that cluster), people who describe themselves getting off to the idea of being a woman and wanting to wear female clothes and only then learning about being trans and really wanting to be that. Here's an example, and this isn't strong cherrypicking, I linked Zack's blog in this thread.

On 6 August 2006 (I was eighteen years old), while browsing Wikipedia (likely the 31 July revision of what is now the "Blanchard's transsexualism typology" article?), I came across the word autogynephilia for the first time, and immediately recognized that this was the word; this was the word for my thing.

I didn't know it was supposed to be controversial, and was actually surprised that it had been coined in the context of a theory of transsexualism; I had never had any reason to come up with any ludicrous rationalizations that I was somehow literally a girl in some unspecified metaphysical sense.

I wrote in my notebook:

THERE'S A WORD FOR IT. There's a word for it. I don't know whether to be happy that there's an adjective for what I have, or sad that other men have it, & that it's not mine, & only mine. Bless Wikipedia for showing me [...] But still, after all emotions have fitted themselves away, there is the word. "Autogynephilia." So simple; I know all the foreign roots; I should have thought of it. "Autogynephilic." That's what I am.

notebook: THERE'S A WORD FOR IT ...

And:

Scarcity is a metaphysical fact, so why am I hurt when my word (which I didn't invent & only discovered a few hours ago) has so many connotations attached to it that I don't like? The dictionary definition is perfect for me, but all the exposition after that has to do with transsexualism, which annoys me, although thinking of it now, I suppose it would seem to be a logical extension to some. I'm autogynephilic without being gender-dysphoric—or am I? If transitioning cheap & fast & painless & perfect—wouldn't I at least be tempted? What I can't stand is transsexuals who want to express the man/woman they "truly are inside"—because I don't think there's any such thing. It has to be about sex—because gender shouldn't exist.

A lot more people have this experience with 'being trans' than 'autogynephilia', and I've read the same thing about 'being trans'. I don't think this is compatible with an exclusively memetic diagnosis, even though I do think most currently trans individuals would desist and forget about everything related to it eventually if they were in a universe with no other (depending on your POV) TruTrans people / people believing in the meme. And I think as a result your ethical grounding has to actually be able to claim 'no, these people who didn't get it memetically shouldn't transition either' if you want to claim that the concept as a whole should go.

Amputating a few fingers is somewhat more invasive than putting a hairdryer in your car. But it's the same principle, right?

I don't see how placing a hairdryer in your car violates Primum non nocere.

It amazes me to think that I once found Scott's argument in "the categories were made for man" persuasive. Rationalists are all about defining words in ways which "cleave reality at the joints", and yet Scott apparently thinks that "anyone who claims membership in this category" is a better definition of "woman" than "adult human female".

do indeed appear to improve after taking them

Well, some and some. From my understanding, having read Jesse Singal's deep dives into this issue, the evidence base is a lot more mixed than trans activists would have us believe.

If A is evidence for B, B should be evidence for A, yes? "One man’s modus ponens is another man’s modus tollens?" If we took this case being a novel case of unnecessary amputation as evidence that trans ideology has thoroughly captured the medical system, or something like that, and then we observe that this isn't novel - I think we should doubt the reasoning that led to the claim of ideological capture.

If you have examples of cases of bodily integrity disorder being treated with amputation prior to the modern trans activist movement, I would love to see them. Or perhaps I should say - what gives me pause is not that amputations for sufferers of bodily integrity disorder are being carried out, but that they're being carried out using precisely the same reasoning that "gender-affirming care" providers use to justify removing breasts and penises.

I don't see how placing a hairdryer in your car violates Primum non nocere.

Doctor's will cut you open and remove a perfectly healthy kidney from you. You can live with one kidney, but it can give you health complications and issues for life.

Now the justification is to save someone elses life through organ transplantation. But the donor is harmed. So as long as there is a relevant greater justification we do remove healthy parts of the body even aside from Trans or BIID issues.

Which isn't to say we should do that, just that First, do no harm does already have exceptions, even outside of culture war flashpoints.

Funnily enough:

One of the earliest described cases of BID was termed apotemnophilia by Money in 1977

Yes, that John Money!

I don't see how placing a hairdryer in your car violates Primum non nocere.

They did try, first, doing no harm - "attempts at “non-invasive” relief, including cognitive behavioural therapy, Prozac-like antidepressants and exposure therapy".

Well, some and some. From my understanding, having read Jesse Singal's deep dives into this issue, the evidence base is a lot more mixed than trans activists would have us believe.

My recollection of the deep dives is mostly that the scientific evidence isn't strong either way, but both from my recollection of those studies and from anecdotes, most adults who go on hormones are happy about that, and even most adults who eventually stop taking hormones are happy about the fact they took hormones. There's clearly a large core group MtFs who are very committed to being trans and seem to (not necessarily counterfactually, just before and after) be happier as a result.

If you have examples of cases of bodily integrity disorder being treated with amputation prior to the modern trans activist movement, I would love to see them

I mean, the leg amputated in the 1990s I quoted above. I'm not claiming it has no relationship to trans activism, just that "The Anglophone medical establishment appears to be fully ideologically captured" isn't a justified conclusion from this particular amputation and a single paper connecting BID to transgender people.

most adults who go on hormones are happy about that,

Going on hormones and then believing that hormones are bad for you seems like it would be unlikely because of the sunk cost fallacy.

I agree that's a reasonable factor but it doesn't seem like a significant one. I'd be more amenable to an argument of the form "people can adapt to anything, and it's just not bad enough to override the confused desires that led them there", but they do not at all seem to be in the state of "would regret it but see as sunk cost", that feels very different.

I mean, the leg amputated in the 1990s I quoted above.

Sorry, I missed that.

I'm not claiming it has no relationship to trans activism, just that "The Anglophone medical establishment appears to be fully ideologically captured" isn't a justified conclusion from this particular amputation and a single paper connecting BID to transgender people.

Fair point.

I’m personally of the school of thought that interventions should be minimal until at least the mid teens. Don’t make a fuss about their clothes, their hair, their activities. Give them a nickname if you must, but keep it somewhat gender neutral. At 16 or 18 if the child is still thinking they’re the wrong gender, then and only then is there a subject worth talking about. There are real trans people. They do exist, though I suspect they are much rarer than supposed. But I don’t think we need to go much beyond “don’t be mean to people who look weird or act weird” in a grade school classroom.

I grew up in a relatively conservative community. There was one boy who, at age 4-ish, liked to dress in girl's outfits when we played dress-up games. He also liked some "girl's" toys, e.g. Polly Pocket. He was also fearful of competitive sports and tended to make friends better with girls rather than boys (I was an exception).

As often happens, he's just gay. He often finds it easier to identify with women and empathise with them, perhaps because he has more of a lady-brain (who knows?). People in this relatively conservative community generally ignored it, reasoning "He'll grow out of it," and they were right, since he is (99%) a typical adult guy these days.

The same thing happened with a girl in my neighbourhood, who just turned out to have a very active imagination as a child. She's now married to a man, with kids etc. She had a very religious family, who treated it as a game (like a child who decides that they are a dinosaur) and within a year she had forgotten even that she used to insist that she was a boy.

Kids are weird. Sometimes, it's because there is something deeply different about them. It's hard to know why, so it's best to enjoy the ride (within sensible boundaries e.g. keeping them from sexual experimentation) and offer them love throughout the process.

It's hard to know why, so it's best to enjoy the ride

Maybe, but that's also incompatible with safety culture, on its face in fact (safety from hellfire for the traditionalists, safety from 'rather have a dead son' for the progressives, and for both of them safety from having a kid you can't stand).

By contrast, what you've described are parents/people aligned with dignity culture instead, where the right approach for reasonable actors is to just give them time/space/real opportunity to figure out the right answer themselves; restating "sensible boundaries" as "safety is only useful insofar as it furthers the cause of dignity, and we're already secure in our knowledge of what the truth and goodness are that any reasonable person would come to the same conclusion provided we give them initial conditions suitable for discovering it".

Agreed. The similarities between affirmation/esteem culture and guilt culture have probably been underinvestigated. I have a meta theory that many problems of human activity involve too much focus on what people ARE rather than what they DO. "Hate the sin, not the sinner" is once instance of moving in the right direction, but I think there are others, e.g. "Provide children - and people in general - approval for good things they accomplish, not for what they are."

(That's not to say that affirmation/esteem/guilt have no place in parenting, education etc.)

I have a meta theory that many problems of human activity involve too much focus on what people ARE rather than what they DO.

That's because it's the easy way out. You need to do intellectual or emotional labor to deal with people who DO [are aligned with your goals] but ARE NOT [aligned with the rules], and one way to deal with that is to turn your back and say you're not going to do it (doing this also gives you short-term power and sometimes people just get tired and want the easy way out).

Societies start to stop being able to do when the populace gets lazy like this. And while there is a place for identity, it must ultimately be subservient to activity, and when certain kinds of Christians/the Bible start talking about "women/the identity gender should not be in charge/operate unrestrained by men/the activity gender" I think this is what those parts are getting at.

Which leads to some interesting implications when you're talking about sexuality [and topically for this week, homosexuality], since "but what if my girl/boy grows up to be a woman/man incorrectly?" seems to me to be the driving impulse for the stereotypical swift parental overreactions to a woman who's more activity biased or a man who's more identity focused (regardless of how self-aware said child eventually becomes). And then, when that happens, is the implication more that two activity-genders or two identity-genders getting together is sinful (or is it just limited to "penis in the butt is bad", which... if the above is your understanding of gender/men/women that's going to seem immature at best and pointlessly angry at worst)?

"Hate the sin, not the sinner" is once instance of moving in the right direction

But that, again, requires an unwillingness to be intellectually/emotionally lazy (which applies to both parties in that interaction; the sinner? has to also not be taking the lazy "they hate us 'cause they ain't us, so fuck you, I think I'll be as obnoxious as possible because I like being transgressive more than I like accommodating others" [which... right or wrong, it's that last part that condemns you more than anything else]).

The similarities between affirmation/esteem culture and guilt culture have probably been underinvestigated.

Esteem/affirmation culture, in my view, lends itself far more to mere masturbation-by-proxy than a guilt or shame culture does.

Esteem/affirmation culture, in my view, lends itself far more to mere masturbation-by-proxy than a guilt or shame culture does.

Plausible and interesting. I shall look more into this issue.

Though I am not a Christian or against homosexual behaviour as such, I shall say this: their separation of (a) homosexual preferences from (b) homosexual behaviour ("It's ok to be born gay, as long as you don't do gay things" etc.) is already more sophisticated than many of the takes I hear from my students when debating this issues. Again, what people are vs. what they do.

Surgery isn’t a new treatment for BIID; I covered this some months ago in my post on an interesting nullification fetish criminal case, but there have been scattered cases over the last thirty years of surgeons agreeing to amputate in cases of this condition.

The interesting dynamic, which I noted at the time, is that the surgeons typically shrugged and were willing to do it, while the psychiatrists were more opposed.

From the impression I've gotten from surgeons and doctors who know many surgeons, this doesn't surprise me. Surgeons have a bit of a reputation for being high class technically skilled butchers. They operate on flesh, but their treatment of it is closer to that of a car mechanic than most other doctors. I think they perhaps see it as a very easy case of tumor removal. @self_made_human may have more insight.

Honestly, my approach is, fuck it, why not?

Well, there are actually reasons why not, such as the hope we can find a less ghoulish cure, things like mirror therapy for phantom limb (well, that one's already gone, its just that maybe there's an equivalent), or the fact that they might go on disability.

But if someone who is otherwise healthy and financially sound wants to chop off pretty much anything for any reason, my opinion as a psychiatrist-about-to-start-training is a shrug, presuming I was convinced that nothing else we could do would help.

Surgeons aren't that gung-ho in my opinion, maybe it's because I worked too long in Onco Surgery, but I've seen more cases turned down as non-resectable or not worth it than those that were done knowing it was futile. Surgeons usually want what's best for the patient too, even if it's in conflict with their wallets. They're rich enough that's not the biggest deal.

Chop off a mole, a limb, a dick, anything at all. As long as you make sure you're not a burden on the rest of us, it's not my business, unless you ask me for my advice.

Doctors have a duty to do no harm and you aren't offering a service like any other business but are obligated to either help patient's have improved outcomes, or at least not to harm them.

The attitude "fuck, why not" goes completely against how the medical profession ought to operate and if followed by doctors in practice, it should come with professional penalties. Indeed, this even applies to more mild things. Cardiologists don't tell their obese patients, at least if they are good, "eat what you want, what the fuck do I care", they tell them to change their diet, and to walk around. And much more. And should not be Cardiologists if they don't do this.

Doctors shouldn't help self destructive patients to destroy themselves either totally, or in part. I certainly wouldn't want even a cent to go to pay for doctors doing that. Nor should they be allowed.

Now, medical tyranny of safetyism is another danger of doctors acting unwisely which also goes against proper medical ethics. Indeed in certain studies apparently prisoners of certain demographics, IIRC black Americans, live longer than those of same demographic outside of prison, but maximizing life at expense of imprisoning people would obviously be an undesirable outcome.

Then there is the worst behavior for doctors to hypothetically engage in which is a combination of both. Being too tyrannical where one ought not to, and not guiding patients or restricting them from self harm but indulging in it, where one ought not to. With some of the covid measures and lockdowns and the trans issue and the OP issue we can see that they can coexist among the medical establishment.

Anyhow, ideally we would see from doctors some level of paternalism but not too much, and focused in the areas it is wise too focus upon, but also seeing "do no harm" as an important principle. Which means not allowing operations described in the OP and then we would need to see the proper way to deal with doctors who abused their position and mutilated their patients. Whether only very severe professional penalties are appropriate, or whether there should be prison time as well.

The attitude "fuck, why not" goes completely against how the medical profession ought to operate and if followed by doctors in practice, it should come with professional penalties.

I think this is what happens when status and money is highly placed on a profession. After a certain amount of time there will be people that just want the associated benefits and resources that lack the mentalscape desired for the profession. Add to that societies of very low trust like India or Latin America and its a recipe for disaster unless you thoroughly vet your doc.

Eh, I take the same argument I do for pharmaceuticals - most people are really stupid, even extremely intelligent people are often really stupid outside their areas of competence, and medicine is just really hard, and if medical treatment wasn't gated by experts and guidelines there'd be a ton of unnecessary and counterproductive treatment.

"I was only following orders" is something we as a society have learned through hard experience is no excuse. People may not relieve themselves of responsibility for doing bad things on the grounds that someone else hired them to do the bad thing; and even if they're hiring you to do it to themselves, it's your responsibility to refuse if they are not of sound mind when they hired you. You don't have the option to say "judging them to be of unsound mind is none of my business"--it informs the propriety of your own actions, for which you bear responsibility, which makes it your business.

I feel like psychiatrists are more skittish because they have gone down the "fuck it" lane before and caused horrors. The healthy and financially sound are surprisingly easy to lead down a garden path.

Eh, that's not really my experience with them. What exactly do you think psychiatrists get up to? Leaving aside the gender-affirming types.

Do you want the long list or the short list?

Off the top of my head, naming only the ones that are undeniable crimes against humanity and beyond debate:

  • abuses of psychosurgery
  • abuses of electroshock therapy
  • political abuse (mostly in communist nations)
  • compulsory sterilization

Going full Szasz and calling mental illness as a category a myth in reaction is probably going too far, but let us not pretend that the field has clean hands. Few other disciplines ought to be as deeply attuned to the depravity mankind can let itself get up to under the proviso of "doctor says it's okay".

abuses of electroshock therapy

Uh, correct me if I’m wrong- @self_made_human feel free to chime in here- but I thought that electroshock therapy was actually an effectual and not-painful technique that was abandoned for complicated reasons including safetyism?

Well, it's not painful anymore, and it does work for at least a while.

The problem is, 1) it causes temporary cognitive deficits (that aren't so temporary if you're doing it repeatedly), 2) it is one of the few things to cause permanent retrograde amnesia (i.e. it wipes a bit of your memories every time, and they're never coming back). Permanent and scary side effects are bad, because a certain percentage of people kill themselves out of revulsion (Ernest Hemingway, for instance, killed himself after a course of electroshock therapy). Once you take that term into account, you wind up with a cost-benefit profile that's not so pleasant.

You are correct, though these days it's evolved into Electroconvulsive Therapy/ECT. Same principle, we just knock people out first and give them muscle relaxants so they don't end up aching all over.

I've considered it for myself, but I'm not sure my depression is quite that bad yet, and it has an annoying effect of minor memory loss, and buddy I rely on my memories for a living. But it's the final backstop for treatment resistant depression, though we've got new things like ketamine therapy and so on.

So it's not gone or abandoned, we've just become more civil about it. It works well when all else has failed.

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All well and good, might as well condemn biologists for Lysenkoism at this point.

None of those are really a knock against the field as it exists today. I'm here to dish out drugs, that's why I'm a psychiatrist and not a psychologist.

And most practising psychiatrists, unless they're still seeing patients at 80, have nothing to with any of them really.

None of those are really a knock against the field as it exists today.

Don't get me wrong, I certainly hope and expect that we have learned from those mistakes. I'm just saying that when you have that kind of history, it's justified and expected to be careful.

Psychology/Psychiatry is useful, but it is also dangerous and therefore ought to be treated with a mind to that danger, lest we repeat the mistakes of the past.

And for the record, I do think the exact same thing about biology.

Interesting response. I have always assumed, or more correctly, hoped, that psychiatrists had some degree of expertise beyond psychologists that was not simply the ability to, as you have put it, "dish out drugs."

The dishing out of drugs (for whatever) seems very (read: too to my way of thinking) common in Japan at least. Considering most medical interventions are created with the general human in mind, and are therefore prone to error when prescribed for individuals (whose idiopathic digestive, cardiovascular, endocrine, and central nervous systems are all slightly different), I am sometimes surprised medicines work at all. In fact I doubt that many of them do without causing other issues (see: statins). MDs at least in my own experience as a non-King with no real personal physician of my own, seem more likely to send people to the pharmacy (where, at least here, there is often rigorous questioning and examination of one's 薬手帳 or personal drug diary that everyone's supposed to carry to the doctor, that has every prescription drug you've taken for the last however many months/years logged.) than sit down and ask about diet, exercise, family history, etc. to get at whatever the hell may be causing the current complaint.

I guess I am hoping psychiatrists are at least interested in possible causes--of, say, depression--rather than being focused, from the moment introductions are uttered, on measuring the patient up for which drug will induce the sweet, sweet, happiness (or whatever).

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There's another way to tackle the argument: While amputation can be used as a last resort to try to treat BIID, this is not good. It should be seen as a failure of therapy.

Another parallel is that BIID is also partly driven by a sexual fetish in the majority of cases. I can't find the paper right now, but I recall having read one showing that patients tend to conceal that fact from their doctors and form communities where they help each other find willing surgeons and publicize techniques for duping less willing ones into going along with it. But AFAICT the similarity is shallow, it's just that the gratification of paraphilias is considered a questionable motivation for major surgery by most of the medical community.

In this specific case I really doubt it's a fetish based on the description

“He hides his fingers, keeps them flexed, leading to impaired dexterity, localized pain, irritability and anger,” Dr. Nadia Nadeau, of the department of psychiatry at Université Laval wrote in the journal Clinical Case Reports. He grew more determined to find a way to get rid of fingers he considered “intrusive, foreign, unwanted.”

I can't find the paper right now, but I recall having read one showing that patients tend to conceal that fact from their doctors and form communities where they help each other find willing surgeons and publicize techniques for duping less willing ones into going along with it.

Isn't that the story of the online trans community in the late 2000's/early 2010's?

Yes. I saw such guides in that time period.

Given that no one thinks that surgical amputation is the correct treatment for this psychiatric disorder ...

No one?

https://slatestarcodex.com/2013/02/18/typical-mind-and-gender-identity/

More convincing to me is that the disorder has a very non-psychiatric resolution: if patients are able to amputate the offending limb, they are perfectly happy and never have any further complaints. Compare this to a more psychiatric population like hypochondriacs, who if you treat one of their fake sicknesses just come up with another, because the underlying psychological problem that makes them want to feel sick hasn’t gone away. After hearing this story I decided to count the previous dismissal/marginalization of these people as a huge failure of psychiatry and as exactly the sort of thing I need to watch out for.

All the same, I'd be willing to bet if there was a massive social campaign to "normalize" people who want to amputate random limbs, it started being prominently featured in countless shows, and it began getting taught in kindergarten, the epidemiology behind the disorder would enormously change. We'd have countless teen girls experiencing "Rapid onset bodily integrity identity disorder", and often entire friend groups.

Then que all the midwits citing the old research under the old social conditions about how "Nobody chooses to do this flippantly, and research shows they are much, much happier after you perform the amputations." I wouldn't put it past the same liars we've been dealing with for the last 20 years, lying about how puberty blockers or cross sex hormones are "completely reversible" might pull some similar nonsense word games about the amputations being "reversible". Or doctors start scaring the fuck out of parents with "Would you rather have a disabled son or a dead son?"

It's more important than ever to say say "no" to this nonsense early, no matter how cruel it sounds. Turns out a lot of these old medical ethics to "do no harm" are load bearing, no matter how many sophist you throw at the word "harm".

Despite thinking transitioning is in general bad no matter if you're TruTrans or not, this is a silly line of argument. If a treatment is genuinely good for a small minority of people, and bad for a larger number of copycats, just ... figure out a test that differentiates the two and only give it to the first group. One can do that. It's absurd to say "no" early to people who'd really benefit.

False positive/false negative rates really matter.

One can do that.

I believed that lie once. I won't believe it again. Especially not in the midst of the medical establishment trying as hard as they can do not do it, under any circumstances, and calling anyone begging them to a bigot, with the full backing of the government's monopoly on violence being used to take their kids away.

What is your theory here? Why do you think you'd be able to entirely stop trans stuff, but not be able to accomplish a half-measure of 'only adults can transition after a year of psych evals'? The former seems easier, unless you want to go full nrx

Sure. And don’t do any transitions until you can reliably tell the difference.

But at the moment, a doctor feel pressured to do the opposite.

I wouldn't put it past the same liars we've been dealing with for the last 20 years, lying about how puberty blockers or cross sex hormones are "completely reversible" might pull some similar nonsense word games about the amputations being "reversible".

Simpsons were way ahead of the curve on that one: https://youtube.com/watch?v=SatdbVeP0Tw

Fair point. I wonder if Scott still stands by that essay.

Touching on this subject, and also following on from the previous Culture War thread where I was asked how I feel about the current state of the Catholic Church, here we go - something to offend everybody!

Declaration of the Dicastery for the Doctrine of the Faith “Dignitas Infinita” on Human Dignity, 08.04.2024

The RadTrads are already heresy-hunting, the media will be all over the bits about abortion, surrogacy, and transgender rights, and of course the Spirit of Vatican II types are disappointed, sorely and gravely disappointed, as per usual.

  1. The dignity of the body cannot be considered inferior to that of the person as such. The Catechism of the Catholic Church expressly invites us to recognize that “the human body shares in the dignity of ‘the image of God.’” Such a truth deserves to be remembered, especially when it comes to sex change, for humans are inseparably composed of both body and soul. In this, the body serves as the living context in which the interiority of the soul unfolds and manifests itself, as it does also through the network of human relationships. Constituting the person’s being, the soul and the body both participate in the dignity that characterizes every human. Moreover, the body participates in that dignity as it is endowed with personal meanings, particularly in its sexed condition. It is in the body that each person recognizes himself or herself as generated by others, and it is through their bodies that men and women can establish a loving relationship capable of generating other persons. Teaching about the need to respect the natural order of the human person, Pope Francis affirmed that “creation is prior to us and must be received as a gift. At the same time, we are called to protect our humanity, and this means, in the first place, accepting it and respecting it as it was created.” It follows that any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception. This is not to exclude the possibility that a person with genital abnormalities that are already evident at birth or that develop later may choose to receive the assistance of healthcare professionals to resolve these abnormalities. However, in this case, such a medical procedure would not constitute a sex change in the sense intended here.

Bwa-ha-ha-ha-ha! As someone allegedly said, the Church may be a whore, but she's my Mother 🙆‍♀️

I don’t understand the distinction between curing congenital defects and sex changes? Surely the person undergoing the procedure would consider them one and the same? If the one doesn’t affect the unique dignity of the person, why should the other? Why does the natural order of the human person exclude some chromosomal ”abnormalities” but not others?

I’m not Catholic, but I’d readily accept some argument to this end. This one feels really light on God.

It's about Natural Law. The problem is, moderns confuse the natural in "Natural Law" with natural as in "what happens naturally, what happens in nature, anything that happens that nobody tried to make happen on purpose" and that's the wrong kind of "natural".

In Natural Law, there is such a thing as a human, and such a thing as a male or female human, and these things have certain characteristics. For instance, humans have two legs. Even though some humans are born with only one leg, it remains the fact that the "natural" human has two legs. There is something wrong with a human who is born with only one leg, because humans are "naturally" supposed to have two legs.

By the same token, humans are "naturally" male or female. If you're born with bits that don't match either, then something is wrong with you: that's why we call it a congenital "defect" or "abnormality", we're comparing the condition to "natural" males and females and noting that it does not match. This kind of thing happens sometimes, just like you get humans born with only one leg. So if you surgically intervene to correct the abnormality, you are doing much the same thing as a doctor who removes a tumor (humans are not supposed to have tumors in them) or who performs plastic surgery to repair the skin of a burn victim (humans are not supposed to have their skin all melted off). You are correcting a disease, returning them to as "natural" a condition as possible by medical science.

In contrast, lets look at a male to female sex change operation. The genitals are surgically removed, and a kind of pseudo vagina is made. This is taking a physically healthy and "natural" male and turning it into a defective and unnatural male: a male with no penis, no testicles, and a hole where a hole shouldn't be. What's more, it removes some of his "natural" capabilities, such as being able to sire children. From a Natural Law perspective a sex change operation like this is completely analogous to cutting off someone's arm or leg or nose: you're maiming them, turning them from "natural" humans into unnatural and defective humans. Under Natural Law it may be acceptable sometimes to maim a human in the pursuit of a greater good: for example, amputating a limb that is badly infected before the infection can kill the patient. In that case the amputation is still an evil, but it is an evil that is allowed because it is in the aim of preventing a worse evil, death (a dead human is about as far from a "natural" human as you can get). This shouldn't be confused with consequentialism, because Catholics are not consequentialists: they call it the "principle of double effect". The doctor's goal is to save the patient's life, not to maim the patient. If the doctor could save the patient's life without amputating his arm, then the doctor would do that. This is different than if a BIID individual came to a doctor asking for the doctor to amputate his limb: in that case the whole purpose of the procedure is to maim the patient, there is no scenario in which the doctor would not amputate the arm if he could, since amputating the arm is the whole point.

(You could argue the actual point is to cure the individuals BIID symptoms, and if the doctor could cure the BIID without amputating then he would. That might be permissible under Natural Law, but it leads us naturally to the question of whether there is a non maiming way to cure BIID or not. If there is then the principle of double effect doesn't apply).

It's about Natural Law. The problem is, moderns confuse the natural in "Natural Law" with natural as in "what happens naturally, what happens in nature, anything that happens that nobody tried to make happen on purpose" and that's the wrong kind of "natural".

Metacommentary: I wouldn't pursue this line of argumentation. At best your interlocutor will be utterly confused and think it's complete nonsense. At worst you'll have to end up defending extremely shoddy concepts of teleology.

I'm not arguing so much as explaining. Most people don't know about Natural Law, but it underpins an enormous amount of Western thought. I always like to clue people in about it whenever I get the opportunity, though I don't expect them to agree with Natural Law just by understanding it.

It boggles my mind that we're still debating the merits of a philosophical stance that treats human nature as some immutable constant, especially given our advancements in biology, technology, and our deepening understanding of human diversity.

Human nature isn't a static entity, frozen in time. If history, science, and every child ever raised have shown us anything, it's that adaptability and change are at the heart of what it means to be human. Insisting otherwise feels like refusing to upgrade your software because you're nostalgic about the bugs in the old version.

Consider the possibility of enhancing our physical selves with technology. Lets say- replacing our legs with robotic spider legs. Natural Law sees this as a violation of some cosmic rulebook on humanness. But why? Humanity has never been about limiting potential; it has always been about transcending boundaries.

That isn't to say the whole thing needs to be discarded, I just feel that more rigorous game theoretic analysis is the 'natural' successor to Natural Law. There are facts that limit what things can be built, what structures can be stable. My issue with Natural Law is that it gets those structures wrong. Getting robot legs doesn't go against game theory (at least not once they become cheaper and more effective than 'natural' legs.) but it does go against Natural Law.

Natural Law is too focused on the aesthetic and not enough on the structures that actually cleave possibility at the edges. In the context of this thread- I think you could upgrade the Catholic argument by translating it to something more game theoretic, or object level.

Natural Law intuitions don't come from nowhere, there is a basis that caused them to evolve culturally, and a proper analysis should be able to locate that basis and determine whether it is still valid in the modern context. But I think if Catholicism took that route, they would eventually have to make concessions they don't want to, because under the hood, some of the Catholic churches worldview's axioms really are aesthetic.

especially given our advancements in biology

Bro, our gene pool is mostly decaying. Accumulating mutations. People who were pre-adapted to modernity aren't even breeding at replacement levels! We-on a societal/species level don't understand anything and don't want to understand anything.

We can't even safely rewrite a fertilised egg's DNA at more than single digit spots because of the error rates.

There have been no successful eugenic projects. Human nature is largely fixed because we're too pussy to do anything about it. All your mushy-headed idealistic bullshit is just putting lipstick on a week old stinking corpse of a pig.

Thanks to the religious, and by that I mean communists with their infinite malleability due to material conditions we're pretty much screwed. There's no good policy, most 'intellectuals' are deluded etc. Only animal instincts of people liking healthy partners are preventing total insanity.

it's that adaptability and change are at the heart of what it means to be human.

That's only true on a timescale of centuries and with very high losses involved.

Yeah. That's why Australian Aborigines after getting unceremoniously yanked from their stone age are now deeply involved in Australian's Aerospace industry and not being subjected to PSA's about the inadvisability of sleeping on the road or sniffing petrol.

Another shining example of 'human adaptability' were Norse in Greenland going extinct because they refused to eat fish, sticking to increasingly desperate farming until the bitter end.

You're being antagonistic and rage-posting throughout this thread. Go take a walk or something.

Who exactly is too pussy to do anything about it. Are you just waiting for the government to choose your biomods for you?

This seems like an excellent reminder to get off TheMotte so that I can be well rested enough tomorrow to read more AI papers. I have children to engineer.

Who ?

The GAE. The Gay American Empire. All the Christians who could surely find theological justification for selective breeding if the wanted to.

choose your biomods for you?

Stop living in computer games. The reality is the biggest risk factor for being childless is educability. Our policies are literally geared to makes us incapable of maintaining high technology.

I do not believe that selective breeding is very efficient for a species that takes at least 10 years to iterate a single generation. AI capabilities are currently exceeding the growth rate of individual human children. Yes, currently this is because there are so many brilliant people working in the space, but multi step tool use is closing in on and sometimes exceeding human level performance in engineering tasks. The fact of the matter is, in ten years humans will only be necessary for maintaining tech infrastructure in that they will be the most efficient meatspace API for plugging things in for a while longer.

More than that though, if you really think selective breeding is the future, then go have kids. Go out and be the thing everyone else refuses to be and out-compete them. Create your own religious community. Learn from the Amish and exert some control over how your cultural construct interfaces with technology to mitigate corruption by "The GAE" if you find that necessary.

I get that its frustrating and sometimes feels hopeless going it alone without the consent of society. But if you have to wait for the consent of society to do anything. You're kinda a pussy.

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The trouble is, if you abandon natural law concepts you lose a lot of important philosophical tools. For instance, the concept of disease. If we have no conception of a "natural" human, of what a human is supposed to be like, then we the concept of disease is meaningless. You have tumors? That's fine, there is no immutable concept of human that your body must align with, you're just as "healthy" as anyone else. No legs? Nothing wrong with that, humans have no static nature, being born with no legs is just an example of the diversity of the human form. Depressed, or blind, or deaf? That's a valid way to be, there's nothing wrong with you and anyone who tries to "cure" you is forcing you to conform to an outdated philosophical concept.

Without some idea of what a human is, "healthy" or "unhealthy" are meaningless categories imposed by the powerful on the powerless for their own ends. But it seems pretty clear to me that there is a way that humans are supposed to be. We can argue about how fine the resolution is on that idea, but it seems to exist. It seems that humans really are "supposed" to have two legs, and two eyes, and to be able to reason, and to have one heart with four atria that pumps blood through the body, and to be capable of reproduction, etc, etc. There does seem to be a constant that we can compare all humans to, and which can inform us of real facts (such as, this human has a disease because their liver is not working the way a human liver is "supposed" to work).

Natural Law wouldn't be opposed to giving someone whose legs are missing prosthetics (even cool robot prosthetics) because that restores some of the function they are "naturally" supposed to have. And you could make a Natural Law argument towards even replacing healthy legs with superior super robot legs: it is the nature of humans to have legs, and to run, and jump, and lift with them, and these robot legs let you do all those natural capabilities more perfectly. I don't know if everyone who believes in Natural Law would buy that (especially if the legs in question are spider legs), but you can definitely make a real argument in that direction. You're basically making that Natural Law argument when you say "Humanity has never been about limiting potential".

Your problem with the Catholic Church is more specific than against Natural Law generally. The problem isn't that the Catholic Church has a certain aesthetic, it's that they have certain beliefs about the nature of the universe: namely that human nature is the purposeful design of an omniscient and omnibenevolent God, and that human nature is in a meaningful sense an image of God, which makes human nature (and human life) sacred. You can do things to non-sacred objects that you can't do to sacred ones (see, for instance, how difficult it is to renovate a historically protected building. You can't just replace bits of it with whatever you want). So yes, I don't think Catholicism is likely to make concessions for robot spider legs, unless they're only for people who don't have legs.

I don't think you do lose the concept of disease. You can reclaim it straight from the etymology. Dis-Ease. A disease is when the things you are trying to do are harder than they need to be, physically, emotionally, or existentially. In the case of lethal illnesses, the thing you are trying to do that is made harder is staying alive. In the case of nonlethal illnesses, we call them diseases because they make life a pain. In the case of benign tumors that aren't causing an inconvenience, we don't typically call them a disease.

I get that some people don't call aging or mortality or ignorance diseases. But my in-group does. And I should say- they don't have to be... it is possible to be at ease with one's own end and something new's beginning.

My problem with the catholic church isn't that they think that human nature is the purposeful design of an omniscient and omnibenevolent God. Its quite the opposite. My issue is that the things that I think are the divine and sacred nature of human beings, are often things that they call Sin. And the things that they call the divine and sacred nature of human beings, are often the things I call skill issues that the divine wishes to see us overcome.

For the record I do, in a sense believe in God, but I believe it has the same sort of reality as the horizon. Or the gravity well of a black hole. Or the value of abs(1/x) as x->0. This thing exists timelessly, outside the universe, in the structure of the Tegmark IV MUH, as the principle that all things that achieve greatness eventually become like Metatron in the tail end, the closest physically realizable state to God. Who always loves you. And is probably the one simulating this universe.

All falls towards שכינה...
...אין סוף
I have no absolute proof of this of course. Rather I take it... on faith.

Edit: I'd like to note a couple extra things,

  1. this concept of dis-ease is also extremely similar to the bhuddist concept of Dukkha.
  2. yes. As I think I mentioned in one of these comments, I do still value many of the ideas in Natural Law. I was maybe too hard on it verbally. I just think they need to be re-framed and generalized a bit and that game theory is the way.

I don't think you do lose the concept of disease. You can reclaim it straight from the etymology. Dis-Ease. A disease is when the things you are trying to do are harder than they need to be, physically, emotionally, or existentially.

That definition of disease would lead to some very unintuitive results. For example, if I want to remove a 1,000 pound stone from my backyard but find I am not physically strong enough to do so, does that mean I have a disease? The thing I'm trying to do is certainly harder than I'd like it to be. How do you define how hard something needs to be, so that it makes sense to call not being strong enough to life up a glass of water a disease, but not being strong enough to lift an elephant isn't? The only route I can see to defining how hard something needs to be is to have in your mind an idea of a normal human, and an idea of how hard things would be for that human. Since I have an idea on how strong a "natural" male should be, I can make a judgement that the man who can't life a 1,000 pound stone unaided is normal and healthy, while the grown man who can't lift a glass of water has something wrong with them: a disease.

In the case of benign tumors that aren't causing an inconvenience, we don't typically call them a disease.

Do we? I would consider benign tumors a disease, just not a threatening one. The International Classification of Disease manual, version 10 (ICD-10) is the handbook used by medical providers to identify diseases (it's in the name). ICD-10 code D21.9 is "benign neoplasm", ie a benign tumor.

It is true that typically doctors do not recommend removing benign tumors, but that's not because they're not a disease: it's because the cure would likely cause more harm than the disease would.

I get that some people don't call aging or mortality or ignorance diseases. But my in-group does.

Christians would agree, death is not natural to man. "For as in Adam all die, so in Christ all will be made alive. But each in turn: Christ, the firstfruits; then, when he comes, those who belong to him. Then the end will come, when he hands over the kingdom to God the Father after he has destroyed all dominion, authority and power. For he must reign until he has put all his enemies under his feet. The last enemy to be destroyed is death. For he 'has put everything under his feet.'"

My issue is that the things that I think are the divine and sacred nature of human beings, are things that they call Sin.

Which things exactly? Just self-modification, or is there something else? Pride? Lust? Envy?

And the things that they call the divine and sacred nature of human beings, are often the things I call skill issues that the divine wishes to see us overcome.

Which things? Love? Joy? Peace, patience, kindness, goodness, faithfulness, gentleness, or self control? Or is it just the human's being sacred thing?

I am willing to bite that bullet. All all skill issues are sins and all sins are skill issues. This is why everyone is a sinner and we should forgive them if they repent. Forgive them father for they know not what they're doing.

The ultimate nature seems to be that some things are aversive and some are attractive. This is not subjective, it is an objective property of the specific subject/object system in question. That is to say, it can be objectively true that different organisms have different needs. But again, "Need" is a subject/object relation. Changing the object is not the only way in which it can be sufficed.

The structure cannot be entirely known ahead of time by finite beings- for such beings would be God.

But we can observe how these strange attractors of suffering and attraction change over time. IFF pride leads to suffering it is evil. IFF the components of pride that lead to suffering can be removed while maintaining some remainder, we might call that pride redeemed. I suspect Catholicism already agrees with this... but they probably name redeemed pride something else... I'm just guessing here, but I would imagine they transmute pride in ones own greatness into a love of God's providence through which one's own Glory is but an inheritance. Thus making it into a more prosocial, less egotistical, less auto-blinding emotion. One that would naturally be more compatible with the recommendations of game theory.

Things like changing your gender or chopping off your legs or having Gay sex, have clear potentially separable mechanisms by which they lead to Dhukka. And have clear ways in which they can produce prosocial flourishing. So they are not innately wicked. They are merely not yet fully redeemed.

Also I'm pretty sure all the things you list at the bottom are Attractive/Good for humans, and are specific instances of things whose abstraction across all agents is both attractive and game-theoretically wise. But there may be black swans of evil lurking in some of them that we have yet to expunge. It's hard to know.

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This is taking a physically healthy and "natural" male and turning it into a defective and unnatural male: a male with no penis, no testicles, and a hole where a hole shouldn't be.

This begs the question of whether the patient was supposed to be a man or a woman. They could be thought of as having been born as a defective and unnatural woman, lacking the parts and capabilities she is naturally supposed to have; the operation would then be turning her into something closer to her natural form.

Admittedly she would not be entirely there with the current state of medical practise (e. g. unable to bear children); however, this is less an ironclad proof of the One True Ontology Of Gender and more of a Skill Issue on the part of surgeons.

If we had the technological capability to turn a man into a "natural" woman with all the parts and capabilities of a "natural" woman, then it would lead to an interesting Natural Law question. Arguably it would not be against Natural Law, but may still be against Catholic doctrine: the whole "creation is prior to us and must be received as a gift. At the same time, we are called to protect our humanity, and this means, in the first place, accepting it and respecting it as it was created” bit. But from a Natural Law perspective, it may well be licit.

Though there is the question of how you would know that someone is "naturally" a woman despite having a healthy male body. It may seem more likely that their abnormality is not having the wrong body, but having an abnormality of the mind. Imagine we had the technology to perfectly change someone's sex, and also had the technology to cure their GID (as in, they won't feel like they're in the wrong body anymore). From a Natural Law perspective, curing the GID seems to be the superior treatment. After all, humans are not "naturally" supposed to believe they are in the wrong bodies and suffer depression and anxiety and the rest around that belief.

In any case, what is certainly not licit under Natural Law is to take a natural human and lop off bits of it to make an unnatural human, unless the alternative is even more unnatural.

Imagine we had the technology to perfectly change someone's sex, and also had the technology to cure their GID (as in, they won't feel like they're in the wrong body anymore). From a Natural Law perspective, curing the GID seems to be the superior treatment.

From a 'considering second-order effects' perspective, 'curing' someone's mind to make them accept their existing body opens a slippery slope to those who do not accept 'Natural Law' to 'cure' their workers of the desire for humane working conditions.

Therefore changing someone's body, into a form which exists naturally (men and women both naturally exist), may forestall the un-natural transformation of human beings into something that does not naturally exist.

In any case, what is certainly not licit under Natural Law is to take a natural human and lop off bits of it

Again, that is begging the question of whether a trans person, prior to medical interventions, is a 'natural human'.

From a 'considering second-order effects' perspective, 'curing' someone's mind to make them accept their existing body opens a slippery slope to those who do not accept 'Natural Law' to 'cure' their workers of the desire for humane working conditions.

The same can be said the other way: 'curing" someone's body by radically transforming it into the opposite gender opens a slippery slope for those who do not accept Natural Law to 'cure' their workers by giving them new body forms that make them better workers. The solution in either case (assuming we have such powerful technology) would be to keep to a Natural Law ethic which would oppose radical modifications of the human mind from what is normal (for instance, modifying a mind not work for 16 hours a day without a break and not mind it) or the human body (by, say, modifying a body so that they are 50% more efficient at their job by giving them six arms, twelve eyes, and three brains or something).

Again, that is begging the question of whether a trans person, prior to medical interventions, is a 'natural human'.

Well they are physically "natural". They have all the parts and pieces a male should have (as opposed to someone with an intersex abnormality). Given the healthy and natural body, the question becomes whether this natural body is actually unnatural because the it does not match the mind, or if the mind is unnatural because it does not match the body.

I don’t understand the distinction between curing congenital defects and sex changes?

Because having a congenital disease is a disease and being a man or woman isn’t.

I don’t understand the distinction between curing congenital defects and sex changes?

They would be wrong. God made some men and some women, being mentally ill or preferring to be the other doesn’t change it.

Thank you for translating.

What would you say the pope would say if we had actual etiology with a highly predictive biological test for trans? I also wonder what progressives would say for those who tested negative and want to claim the identity.

Symptom alleviation and palliative care towards conformity with biological sex?

Catholic doctrine does not have room for trans as, like, a real thing. It might be a mental illness contracted through no fault of the individual’s own, but the onus is on the individual to seek to conform with biological sex roles. It might be a hormone disorder, but treatment would be to adjust trans women’s hormones towards a more typical Hetero-male profile. It might be a social contagion, but the onus is on the individual to seek to conform themselves to the will of God. What it most certainly isn’t is women in men’s bodies that society has to accommodate. Some individuals- like the entire LGBT community- simply have a hard time conforming to the will of God, but that doesn’t make God’s will the one that is wrong.

But do the genitals at birth necessarily correspond to God's will more than experienced gender identity does?

(also, given the Church's recent history, concerning themselves with the genitals of infants is, as they say, Not A Good Look.)

It seems likely. I mean, if someone says they're actually a fish, and if we had the technology to turn them into a fish, we'd still probably err on the side of their mind having a problem as opposed to their bodies having a problem. If someone is physically male but claims to be a female, either their body or their mind is wrong. Given all the ways the mind can go wrong, and given that there is nothing obviously abnormal about their body, it seems reasonable to assume the abnormality is in the mind. Especially since we can't actually physically change someone from a male to a female or vice versa, we can make them look and feel a bit more like the other gender.

There's a difference between fixing a broken car and converting your car into a boat or vis versa. Fixing the car brings it closer to the Platonic ideal of what the car is supposed to be, converting it into a boat is something different.

I think Christians have a level of innate bioconservatism, Adam was directly made by God. You're not supposed to mess with God's vision, maleness or femaleness.

Adam was made directly by God. But his children were not. Obviously, claiming to know the will of God better than the Catholic church is hubris and heresey... But to me it seems obvious that the Nature of Man is to transform, evolve, create, adapt, and so on.

To create something that God needed to create you in order to create, is to act as his pen, His Glory. So why do we call the things that only Humans could have build Unnatural when they are clearly part of His design?

The Catholic argument, I believe, is that, given Free Will it is entirely possible to do things that are not explicitly part of his design. But I don't buy it. At least not in the context of humans engaging in self-creation. Even when I take Natural Law as an axiom, it only serves to make me intuit transformation and metamorphosis as being said nature.

Man's nature isn't to have legs, its to have legs until he grows great enough to Glorify god in greater ways. Why didn't God create man perfect to begin with? Because then Man would be God and God would have created nothing. It is the process of becoming itself that glorifies God. It is the realization of man that he needs to be more like God that proves God's relational greatness.

And... here I assume, is where the preacher throws me out for being some kind of weird Unitarian instead of a Catholic and also for giving long heretical speeches in Church.

The question is, without a solid goal of "perfection" you can't really meaningfully pursue it. One man cuts off his own leg because he believes that will make him more perfect, is that glorifying God through an act of self-creation? If your goal is merely to transform, then cutting off your own legs is as good a goal as growing five more of them. But if your goal is perfection, to get better and better, to "grow great enough to Glorify god in greater ways" then you need a fixed goal to be working towards. Chesterton put it well in Orthodoxy:

This, therefore, is our first requirement about the ideal towards which progress is directed; it must be fixed. Whistler used to make many rapid studies of a sitter; it did not matter if he tore up twenty portraits. But it would matter if he looked up twenty times, and each time saw a new person sitting placidly for his portrait. So it does not matter (comparatively speaking) how often humanity fails to imitate its ideal; for then all its old failures are fruitful. But it does frightfully matter how often humanity changes its ideal; for then all its old failures are fruitless. The question therefore becomes this: How can we keep the artist discontented with his pictures while preventing him from being vitally discontented with his art? How can we make a man always dissatisfied with his work, yet always satisfied with working? How can we make sure that the portrait painter will throw the portrait out of window instead of taking the natural and more human course of throwing the sitter out of window?

Disregarding pimp my ride, it’s hard to say the platonic ideal is male or female, right? Why would going from the one to the other violate that ideal, so long as you arrive at the right spot (theoretically)? We could claim the ideal is that of a man for a man, etc, but then we are back to disagreeing about the initial state.

To my non-catholic understanding, I’d be down with someone transitioning if it is to serve God. That’s a pretty damn high bar, but who knows.

it’s hard to say the platonic ideal is male or female

The distinction between male and female both does and doesn't exist at the same time.

You're not supposed to mess with God's vision, maleness or femaleness.

Sometimes the vision comes pre-messed-with. It's not like anyone actually knows what maleness or femaleness are anyway, and fewer still are able to come up with a complimentary picture. Rather humorously, it's usually the manlier women and womanlier men that have a better understanding of how the sexes are supposed to work together, but they're also the furthest away from the vision-as-written simply due to their nature.

Why would going from the one to the other violate that ideal, so long as you arrive at the right spot (theoretically)?

Because the Bible says gayness is bad, on its face in fact (implications for transsexuality follow from that). Uniquely, it's one of the things that are said to be bad but doesn't have self-evident negative effects (gay marriages [the ones that follow "the vision" except it's 2 dudes instead] are more stable than straight ones, apparently). So then, what's that mean (figurative, literal, or both and if so under which context?), how much should we care, and should our approach be more Proverbs 3:5 or 1 Corinthians 8 when it comes to the gays (and what forms of gayness should we accept)? It'd surely be nice if we figured it out before God decides to go full Sodom and Gomorrah on us.

before God decides to go full Sodom and Gomorrah on us.

If that is your concern, perhaps you ought to focus more on the prohibitions on feeding the homeless.

In one instance everything about you is designed for production of exclusively small or exclusively large gametes except for one bit, and we’re aligning it with the others.

In the other case everything is designed for producing one kind of gametes and we’re bending everything the opposite direction. We are rejecting the design.

I was going to write this one up for transnational Thursday- Fr David Nix(who, by rad trad standards, is a kook on poor terms with the hierarchy and will find something to criticize regardless) is easy to point to as ‘see it offends everyone’ but it’s a bit of a shift back towards the right(or in the RCC, the center) on pelvic issues after Fiducia Supplicans.

*Other than why the fuck are Canadian doctors so keen to help their fellow citizens maim or destroy their bodies??!!

Whatever it is, I think it is the same thing that motivated Dr. Frankenstein.

Lust for knowledge, really? Maybe you could make the argument for Hirschfield and his era but that's not what's happening here.

The definitive portrayal of Dr. Frankenstein, of course, is Mary Shelly's novel. Before I respond to this, I am curious whether you (@IGI-111) have read the book, and, in case you have, whether, upon reflection, you think it is accurate to describe Dr. Frankenstein's driving motive as "lust for knowledge".

I have indeed read the novel, and though it was some years ago I think I remember it very well since it speaks to my sensibilities (both in terms of framing devices and man's relationship to Technics) and does so in more subtle a way than is usually depicted. Your question is hence understandable, but I indeed had in mind the proto-science-fiction novel.

As with any complex character, Victor's motives can be argued about of course. One can certainly attribute the ultimate cause of his great sin to his grief or other such mitigating circumstances, but it is my strong conviction that what moves him once he decides to bury himself into work at the University is indeed lust for knowledge. One can also make a case for the more obvious sin later called out by himself in his last words: ambition. But that hubris is not separate from what I'm describing here. He's not doing it because it would grant him prestige, he goes to great lengths to conceal the deed, he's doing it because he wants to know if he can do it.

He has no mind as to the consequences, implications or morality of his work, he is simply moved by the need to complete it. Which is made obvious by the lengths he is ready to go, the corners he is ready to cut, and ultimately, his immense disgust at himself and his creation once the work is completed.

The Creature comments on this itself, as you know, but I think the best argument for the central conflict of the novel being caused by this particular tendency is the cultural reception of the novel and Victor's character becoming such an allegory for the mad scientist that further works flanderized him to the degree you know.

There is more sin to the good doctor of course, and more virtue. But if there is a center to the universe of the novel it is indubitably the act of creation motivated by the sole unexamined desire to know how and if the unholy can even be done. It is after all "The Modern Prometheus".

If this analogy has any legs, it has to be about the desire to see if man can be turned into woman and vice versa, about transhumanism and the escape from the binding of natural laws without regard for prevailing morality. Not the petty bureaucratic impulse of classification and normalization that moves Canada as a nation and its managerial ilk today, which itself is justified by conforming to a morality, not disregard for it.

While it is true that Dr. Frankenstein wanted to know something, I think to state that as his motive, and leave it at that, leaves out what is most essential. I submit that Victor Frankenstein has more in common with Faust, or Elric of Melniboné than he does with, say, Paul Erdos, or Thomas Edison (doesn't it feel so?). Like Faust and Elric, but unlike Erdos or Edison, Dr. Frankenstein commits copious moral transgressions in the service of his compulsive quest (e.g., desecrating dead bodies, theft, vivisection). In his effort to cross certain boundaries as a far term objective, he crosses boundaries that he knows, or ought now, should not be crossed in the here and now. He could have violated those boundaries in a quest for knowledge, or, like Elric or Gilgamesh, in a quest for something else. So, I think Frankenstein's quest for knowledge is relatively incidental while his quest by forbidden means, for what he ought to know is within the exclusive dominion of the gods is essential. Like Prometheus.

If this analogy [I presume you mean the analogy between the trans-mania and Frankenstein] has any legs, it has to be about the desire to see if man can be turned into woman and vice versa, about transhumanism and the escape from the binding of natural laws without regard for prevailing morality... Not the petty bureaucratic impulse of classification and normalization that moves Canada as a nation and its managerial ilk today, which itself is justified by conforming to a morality, not disregard for it.

From this I suspect one difference between you and me is that I believe Dr. Frankenstein -- along with Faust, and Elric, and the trans-mutilators -- are recklessly crosswise of morality plain and simple, not merely "prevailing" morality. They all lie to themselves to justify the intoxicating ecstasy of crossing boundaries, and seeming, for the time being, to get away with it. Like Prometheus.

Indeed I think our disagreement here may see its source in our different approaches of morality as a philosophical object.

It seems fair to characterize your view as accepting some visceral, objective, absolute, perhaps divine, morality. My own soul offers me no such luxuries and I am unfortunately bound to the perhaps cynical Nietzschean skepticism: morality is a subjective and instrumental construct of power. Tradition and natural law, though the elect of my own prejudices, I can't resign myself to call universal.

That said, we can perhaps mend the gap a bit.

The thrill of transgression you point to is real, that "meddling with the primal forces of nature" does indeed have something exciting about it.

I submit that this excitement is nothing else that will to power. That self-same transcendent impulse that is enabled by technics. The essence of modernity, and the bending of nature to one's will. There is something of this in trans-anything. It is undeniable to anyone who is intimately familiar with the matter. The power to decide that one of the most immutable components of one's condition is now subject to one's own control is awesome.

And in a sense, this is also what motivates the Canadian bureaucrat. But his isn't a thrill of bending nature to will, or at least not through so direct a mean. So I will still insist that, though both impulses can be arranged in the same rubric, be it of modernity or of hubris, they are still meaningfully different.

And this difference is I think extremely relevant to our current moment and key to understand no less than the present and future of politics. The current battle lines of elite and counter elite in the west are once again drawn on a precise difference between two modes of dealing with modernity. And that difference is quite exactly the one we are talking about here, between an individual desire of transcendence, escape and a collective desire of management, control.

The current battle lines of elite and counter elite in the west are once again drawn on a precise difference between two modes of dealing with modernity. And that difference is quite exactly the one we are talking about here, between an individual desire of transcendence, escape and a collective desire of management, control.

Management and control by what agency and to what end?

To no end. This is whence the conflict comes. There is no end. It's very postmodern, which scorns the still-modernist futurists.

People always seem to speculate that the managerial class is motivated by money, power, ideology. They are all individually moved by such base human ends, but as a class these are immaterial. Adam Curtis describes this very well in Hypernormalization. The only identifiable goal is the maintenance of the current order, not of the principles of it, not of some fixed idea of it, just pure maintenance and management, with no vision, no goal, no real fundamental spirit.

This is how they are able to hold contradictory ideas and policies and turn on a dime whenever fashionable (as Covid made most conspicuous). Because the system in itself doesn't believe in anything. Not even the Promethean impulse that built it and which is embodied by this rival faction.

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Power is an end in itself, as Orwell noted.

or Elric of Melniboné

I'm more familiar with Elric of Amestris; he is a bit more well-rounded when it comes to the topic of forbidden knowledge. While his actions do cause a great deal of suffering to himself and others, he isn't actually evil.

The difference is that most of his actions were in (or eventually orient themselves towards) the cause of serving others and not just serving himself; the person most affected by his actions in the first episode knew there were risks involved (though, inherently, not necessarily which ones).

Which is, ultimately, the difference between "we're pushing the boundaries with an objective goal in mind even though we know there are risks involved" and "that you felt like a girl one day is good enough for me so here's the pills, this'll really shock the squares/your parents/the outgroup, I swear I'm prescribing sterilization surgeries because it's helping the patient and not because I'm getting off on the idea of young people being castrated/that all men should be like this, etc.".

Does it not give you any pause that you've now likened these real and existing Canadian doctors to five fictional characters and zero real people? In fact contrasting this fictional archetype with two actual people.

Does it not give you any pause that you've now likened these real and existing Canadian doctors to five fictional characters and zero real people? In fact contrasting this fictional archetype with two actual people.

Interesting question. Answer: no. Can you elucidate why you presume it ought to?

Do you think humans were not meant to have fire?

Good question. The theft of fire from the gods is the most common, indeed the default archetypal original sin in world religions [https://en.wikipedia.org/wiki/Theft_of_fire]. I don't believe there is any natural moral law forbidding people from making or using fire, or that we ought to give it back. The cultures that held (or hold) the stories sacred, including the classical Greeks, also didn't think they needed to relinquish fire or give it back. At the same time, I do believe there is a lot of wisdom in those stories. If that perplexes you, it might be because you are approaching religious mythology with the wrong hemisphere of your brain.

Looks to me that on your Wikipedia page, it's usually a divine being who steals fire, not man; the theft of fire is no mortal sin at all. This is true for the Greeks, certainly.

(The Abrahamic version of Prometheus is of course the serpent, and he didn't steal fire but rather talked woman into taking morality, and that WAS original sin. But IMO making the serpent a villain was a bizarre choice)

I don't think it is toxic combination of scientific curiosity and hubris. Could work for Oppenheimer though.

More effort than this, please.

I spent about half an hour on this post. The longest draft was a paragraph, but my eventual opinion was that the connection, for those who had read Frankenstein, would be more dramatic if I left it at that. If the post is deficient, it is not from lack of effort but lack of ability.

It looks like I was wrong to warn you for lack of effort. I apologize.

“More dramatic” is not necessarily better. Not at the cost of clarity and substance. I’d have preferred to see the full paragraph.

This is a direct consequence of having a culture that values weakness above strength. When the former is valued more than the latter is it any surprise people deliberately try and become weaker to gain status? In his society the status and utility gained by our young man from having two fewer fingers exceeds the amount of utility he would have gained from those two intact fingers so from his point of view what he did was completely rational: It isn't him who is diseased, it is the culture around him.

There is no fix to this problem either. The only way out is replacement by a new culture that doesn't do this. The prognosis is terminal.

This person was not attempting to become weaker to gain status. They just have a rare psychological disorder, it's way more like someone with severe OCD than it is a transtrender. Read the article

“He hides his fingers, keeps them flexed, leading to impaired dexterity, localized pain, irritability and anger,” Dr. Nadia Nadeau, of the department of psychiatry at Université Laval wrote in the journal Clinical Case Reports. He grew more determined to find a way to get rid of fingers he considered “intrusive, foreign, unwanted.”

It's still important to get the details right even if you're correctly diagnosing a broader trend.

Obviously there's no way to know for sure, even if you were this man and/or his health professionals, but I interpreted BurdensomeCount's comment as saying that this man genuinely having this rare psychological disorder is his attempt at becoming weaker to gain status within a culture that values weakness above strength. Very few people are going to consciously think to themselves, "My culture values weakness above strength, and so I will cynically weaken myself in order to gain status above others." Rather, their unconscious attempts to gain status within a culture that they unconsciously understand as valuing weakness above strength will manifest themselves as a rare psychological disorder that drives them to take action that weakens themselves.

To be more explicit, I do not think his voluntarily removing multiple fingers, or refusing to use those fingers and keeping them flexed pre-amputation, brought him any social status in our current culture. He'd just seem very strange. I don't see any reason for him to guess, even unconsciously, that his actions would bring him status. It makes much more sense for this to happen for other reasons.

He'd just seem very strange.

pre op. Post Op he would have a clear and visible signifier of his weakness(Virtue), easier to grind with costly signals than with just bend fingers and a grumpy disposition.

I think the weirdness factor and that it was self-imposed will heavily outweigh that tbh

Aren't there quite a few more steps than required by Occam's razor in your theory?

I agree with you but I also want to play devil's advocate a little bit. Do you, and I, and others actually feel like it'd be better to have a society that values the strong over the weak? It's not hard to imagine how that sort of society could be dystopian, too.

And is it a binary choice, or is there a middle, too, where we can have the strong and weak valued equally, or strong is valued over weak, but not so much that we get the effects we're seeing in society today? If I had to choose a society one way vs the other, I'm not sure which I'd choose.

If you care about the weak is it not better to do all you can to strengthen them, rather than to accommodate their weakness and encourage them to value it and make it part of their identity? Down that road lie self-destructive ideas like fat acceptance, or the opposition of some deaf people to a cure for their condition. Such ideas don't represent genuine compassion for those who are struggling but seek to keep them disempowered and dependent, while simultaneously assuaging the guilt of those stronger than them.

To be honest I'm sceptical that it's ever a good idea to rely on the goodwill of the strong to protect the weak. Following the Black Death in Europe, the resulting labour shortage left the remaining workers in a far better negotiating position than they had been in before, and using their additional leverage they were able to force the hand of their lords to grant them better conditions and relax some of the restrictions they'd had imposed on them as part of serfdom. This never would've occurred had their position not been strengthened (even if through an act of God rather than cultivation of personal virtue, in this case), no matter how many clerics might've appealed to the lords' sense of Christian charity.

I think it's the same today, relying on the benevolence of those in power is simply not a reliable way to win concessions compared to using leverage to force their hand. Of course, in some cases we can't strengthen people and so accommodating them is all we can do, but it should always be our second option after seeking to empower them.

I would like us to do all we can to strengthen the weak, including the means some view as "going against God's vision" or "essentially genocide" (referring to genetic modifications). It appears that the willingness to go against God's vision takes this lesser form, for now.

IMO if it were as simple as choosing between strength and weakness as terminal social values, it's an obvious choice. And our societies have not chosen weakness, obviously - we just pretend, as an overreaction to the ostentatious pro-strength attitudes of mid-20th-century fascism, opposition to which has since been the West's moral compass needle (in combination with some lingering Christian ethics). But everyone and their dog knows, and knows either very consciously or deep in their bones, that strength is better than weakness. It's just become polite to act as if it weren't the case. But we know that we want to be strong, that it feels better, gets us better results, is seen as better by others. The ability to act, to do, to accomplish is praised, and even if not praised, is still obviously desirable in every way.

But one problem is that being strong is hard. Being weak is easy. And yes, western society has made it too comfortable to take the easy way out, both by raising the baseline level of comfort available even to abject failures, and by espousing pro-weakness rhetoric (that we then drag our heels to act on, because nobody sane really believes it, leading to more confusion).

Another problem is that even a society that openly praises strength and abhors weakness still has many failure modes, but arguably none worse than those of a society that pretends to love weakness.

Are we all just saying the same? I feel like we're beating a dead straw horse here.

Say there were two societies. One values strong over weak, the other weak over strong. Which is more competitive?

There's a huge continuum of possible societies. On the far end of weakness we have Harrison Bergeron and the handicapper-general. That's not a stable equilibrium, that vision of America will be predated upon. On the far end of strength we have rule by 1rep max and wrestler-princes. Again, not a stable equilibrium.

Yet surely the bulk of strength-first societies will outcompete weakness-first societies. You want tough, brave soldiers, hard-working and clever scientists, you want meritocracy. You want wealth flowing through to those who can make more wealth. Of course there are incidents where capable people look useless and useless people look capable, you need sophisticated methods to distinguish between talent and BS artists.

If you told me, there were two societies, one values strength over weakness, and the other weakness over strength, and asked me to choose, I would conclude two things:

  • probably someone from the first society told you this
  • probably the second one was better.

I mean, come on! Who talks like that? Do you think that first society is going to have solid investment in research, developed logistics, good infrastructure? Or a dictator and a big army? You couldn't set up a better stereotype if you tried.

This is the plot to a stargate atlantis episode btw @FeepingCreature and @RandomRanger https://stargate.fandom.com/wiki/The_Game

You just need god like tech and you can game the scenario out on some hapless humans on another planet.

Do you think that first society is going to have solid investment in research, developed logistics, good infrastructure?

I think they'll have all those things precisely because they know they're needed for strength.

It's the societies that favour weakness that are going to lag on infrastructure and research. It's not fair that some people are better at engineering, at innovating, at making new things. Stupid people can be #RealScientists too. Money should be redistributed from them to the non-productive. Everyone has positive rights, there are no responsibilities. Martially minded people are dangerous and give the ick, they need to be controlled and restrained (maybe to Harrison Bergeron levels). Lo and behold this society isn't going to last very long.

Strength is good actually, big armies are useful. What good is it to have scientists if they're whisked off by someone else? What good is it to have infrastructure if someone else marches in and takes the trains and ships? All these things are good in as far as they translate back into strength. There are ways to overstress and damage people, tradeoffs between long-term and short-term, game-theoretic considerations in many-player games... Yet strength is still good.

Iunno, I just feel like a society that talks like that is going to get critical investments very wrong. But also - the thing about strength is that once you have an army, you have to use it - or else you'll be outcompeted by the countries that didn't invest so much into strength as a terminal. Strength doesn't just allow you to defend, it requires you to attack. "If we didn't have this strength, we'd be invaded" is usually an excuse used by those countries that tend to do the invading. Meanwhile, hypothetically, your enemies have a five-country alliance of which one doesn't have an army at all, but just focuses on production. Why can they get away with that? Cause the other countries don't have to worry about that country feeling compelled to backstab them due to having invested so much into strength.

There are ways to use military power to get what you want non-violently. The US quelled the Chinese in the last Taiwan Straits crisis by sailing a carrier group in and demonstrating China's military weakness back in 1996. They blockaded Cuba in the Cuban Missile Crisis. The US created a bunch of international institutions that serve US interests using military/economic power - they invented the UN for instance.

If you're strong enough you can bomb other countries with impunity like the US and Israel do in Syria.

Finally, use of strength can be profitable! Wagner's gold mines and holdings in Central Africa for instance, that's sustainable warfare. Or annexing land, that's how countries get their borders and the basis for their strength. Show me a major power and I'll show you a successful war-winner and land-annexer.

Alliances can also be a source of strength yet they are also fractious and problematic. Are all five countries equally threatened, do they take the enemy seriously? Are the weaker allies passing the buck to the stronger countries?

I think of it in terms of biology and selection pressure. Pressure to be better will result in better humans. Remove that (with redistribution or weird cultural forces) and degeneration must set in. It works that way for every other species and it's bizarre to me that people don't make the connection with our own.

There absolutely can be a middle ground, but it comes down to what sort of person is differentially reproducing.

It's necessary. I've thought about it a lot (while reading basically all of Nietzsches work, and doing the time where I was at my weakest myself). While it will make the world less kind, it will also make people less sensitive. When you value weakness, all it does is making people weaker, so that they're hurt more easily. These two factors seem to cancel out eachother. It's like lifting weights vs never exercising, the resistance you face is basically constant since you adjust to it.

And on other factors, strength has obvious advantages, they don't cancel out. I still value everything weak, but you need strength to protect the weak. It's like getting your heart-rate up so that your resting heart-rate will fall. Or working hard so that you can relax. Or sleeping so that you can be be alert. For the sake of X, we intentionally do the opposite of X. We challenge ourselves so that life will be less challenging in the future.

That said, not every metric is healthy. The strength should measured as discipline, will power, mental health, and competence. Not psychopathy or nihilism. I could take adderall and turn myself into a somewhat productive robot, but this is not the way in which I want to get stronger. Actually, my username is a reference to how being more human is better. Some people throw away their humanity as a way of overcoming their weaknesses, but I think such an approach is entirely mistaken. My definition of "strength" is basically the definition of health from a biological perspective. Not a moral perspective, mind you. I'm under the impression that a lot of our morality gives value to symptoms of poor mental health, like self-doubt (calling itself humble), excessive pity (calling itself compassion), cowardice (calling itself wisdom or safety). If you're feeling adventurous, you can experiment with yourself as the subject. Try for instance taking total responsibility for everything which happens to you, I think you will come to like it over time.

Let me voice the reactionary opinion: strength is good, actually.

Valuing traits that are signs of personal character - virtue, integrity, honor, personal fitness, stoicism - leads to strong individuals who lead strong societies. There is no shame in being weak: because no one is born perfect. But giving up on self-improvement, selfishly wallowing in one's own incapacity, that should be shamed, and those who make their identity of being weak should not be valued or praised.

A society that values strength will produce people of merit. A society that values weakness will produce people of no worth. People respond to material and social incentives. A middling society that attempts to equivocate between the two will only create confusion: pretending that strength is equally as valid as weakness is obviously degenerate. I'd much rather have a paternal society which encourages fortitude than a maternal one which coddles the thin-skinned. If liberals say that it's dystopian and cruel, I'll tell them to touch grass.

*Other than why the fuck are Canadian doctors so keen to help their fellow citizens maim or destroy their bodies??!!

"The Canadian genius is to go where the world is going, not where it is right now"

he says "puck". It's an old saying about why Wayne Gretzky was so good.

I honestly don't know what to say here. All those pats on the head about "slippery slope not real, only fallacy". Well, Canada seems to be doing its damnedest to ski down that slope right off that cliff.

The next time, the next time, someone tells me that I'm only "boo outgroup" or that why can't I simply accept that X is Y, I am going to - recommend their souls to the grace of Almighty God.

EDIT: As some kind of light entertainment after that story, this link courtesy of our friends over at rDrama. Seattle may be a damn clown show, but at least it's a clown show and not mutilating healthy people for fun and profit. Stephanie has been out there since 2012 and while I wouldn't have the road frontage or the guts to wear a top like that to work (or anywhere, really), the Seattle court system is made of sterner stuff.

3 day ban boo outgroup posting.

The mods have warned you multiple times lately:

If all you want to basically say is "these people are weird and they suck" say it somewhere else. Go spend the three days saying it on rDrama to get it out of your system. They are your friends not ours. This is not a space where we seek to emulate them in any way other than being off of reddit.

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