ArjinFerman
Tinfoil Gigachad
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User ID: 626
ArjinFerman
Tinfoil Gigachad
26d ago
Well, I've long argued that transgenderism is just a facet of transhumanism (much to tje chagrin of self_made_human), but that's beside the point. The SBM people weren't defending it on transhumanist grounds.
Is Science-Based Medicine opposed to the likes of elective plastic surgery? I think there's a great deal of difference between "opposing patient autonomy" in the sense of being against allowing patients too much discretion to pick quack treatments that they can cure them of a particular ailment, vs "opposing patient autonomy" in the sense of being against patients undergoing elective procedures for reasons other than medical need, but whose efficacy to do the things they physically achieve is not in scientific doubt.
Sure, I can concede the difference, but transgender care gets dinged either way. The signed-but-not-read statement says it's "medically necessary", activists say it's "life-saving", "do you want a happy little girl, or a dead little boy?", etc. What do you think is the drama around these systematic reviews, if it isn't about showing that they're ineffective treatments.
This is quack medicine, no two ways about it.
ArjinFerman
Tinfoil Gigachad
26d ago
in the US, the absolute number of black and white murderers is about the same and the percentage of people logged as black is somewhere over 10%, it's basically a wash between black women and white men
...why would you say any of these things as though they favored your point?
Evidence Based Medicine, Science Based Medicine... I just want Based Medicine
In 2021 the Society for Evidence-Based Gender Medicine (SEGM) contracted McMaster University to do a series of systematic reviews of gender medicine, and what better place than McMaster, home to Dr. Gordon Guyatt, the father of Evidence Based Medicine himself? For quite a while the working relationship seems to have indeed been working, perhaps not completely without a hitch as Dr. Guyatt will later tell us, but 3 systematic reviews, assessing the evidence for puberty blockers, cross-sex hormones, and bilateral mastectomies, have been published earlier this year. Their results are consistent with all other systematic reviews published to date: the evidence for various forms of gender affirming care is of low to very low quality.
In February 2025 The BMJ published an article titled Medical journal editors must resist CDC order and anti-gender ideology. This was a response to the much-criticized Trump CTRL+F grant cuts, dataset changes, and orders for CDC scientists to remove themselves from studies that so much as mention "gender" or any other 2SLGBTQIA+ related terminology. The BMJ swears up and down that such terms are "medically relevant" and therefore "evidence based", and so the Trump administration has no place in dictating how science is conducted.
One of the responses to the article praises the BMJ for it's "anti-gender ideology" stance, but declares that this is just an empty gesture, as the journal has published the studies sponsored by SEGM, which has been designated as an "anti-LGBT hate group" by the SPLC. On top of that, Dr. Guyatt and his staff faced direct activist pressure of various sorts.
In August, McMaster University published a stetement about their systematic reviews, expressing concern that their studies are being misused to pass policy which takes away autonomy from the patient, something that goes against the principles of Evidence Based Medicine, as they understand it. They announced that they will not be working with SEGM anymore, and that they will be donating Egale Canada to help fund their efforts to prevent gender affirming care bans.
Following the publishing of the statement, there is now an open letter demanding an apology, and a retraction of the SEGM-funded studies.
...A renowned institution, a respected leader, some activist pressure, and a repudiation of their previous work: a story that we're quite familiar with by now... or is it?
Earlier this week Dr. Guyatt was interviewed on the Beyond Gender podcast about his work with SEGM and his statement about the systematic reviews. Throughout the conversation it becomes clear that there is no evidence-based argument against SEGM and their work, rather it's a disagreement of values. As already noted in the his statement, Dr. Guyatt holds patient autonomy in extremely high regard, and his main issue is with his work being used to justify blanket bans. This mirrors the shift in the discourse that I talked about before. Not being able to argue that The Science Is Settled, activists have to retreat to a more defensible position and settled on autonomy with a sprinkling of Trust The Experts, although they're kind of trying to have it both ways...
During the interview Dr. Guyatt is asked how he would define "medical necessity", at first he's confused, and then rejects the very concept outright, which is interesting in the light of the following exchange taking place at the end of the episode:
Mia Hughes: Someone very recently said that the very fact that you have signed this statement that says (...) "this is medically necessary"...
Gordon Guyatt: WHAT?! How ridiculous! We never said anything... I told you that I would never use the term "medically necessary", I would never use it. The fact that you said I used it is completely wrong.
MH: Well then, I will fact-check myself...
(...)
GG: Yeah, see if you can find "medically necessary" in my statement. I would have to jump off a bridge if I said that.
(Co-host asks another question to prevent dead-air)
MH: I did fact-check myself this is your statement:
We will no longer accept funding from SEGM. As recommended by community advocates, we have also personally made a donation to Egale Canada’s legal and justice work, noting their litigation efforts aimed at preventing the denial of medically necessary care for gender-diverse youth.
GG: Okay... that was not my paragraph, and I didn't read carefully...
Narrator: To date, Dr. Guyatt has not yet jumped off a bridge. He noticed no irony in the contrast between his complaint about his studies, that to date he still stands behind, being used to justify policy he disagrees with, and his downplaying of how his signature, on a statement he vehemently disagrees with, could be used.
Credit to Mia Hughes, not just for the interview, but for already collecting most of the links.
Ok, some extra thoughts.
This isn't the first time we got a politically charged statement from a suppesedly neutral political institution. Off the top of my head there was the AMA declaring gun violence to be a public health crisis, or similar statements from the American College of Physicians, complete with a trendy hashtag, and of course, who can forget "Racism is an ongoing public health crisis"? This is, however, the first time someone from any of these institutions was publically cross-examined, and the results were devastating. Do the other statements have better backing? I personally doubt it, we can always quibble about it and construct elaborate "steelmen", but it doesn't matter. My opinion is that all these statements should be rejected by default, and and treated as political, and not based on science or their understanding of the public good, at least until similar cross-examinations take place.
This also touches on Trump's dreaded funding cuts. We've had a number of people here complaining about them, claiming that Trump should have used a more precise approach. It can't be done. Any presumption-of-innocence approach would yield no significant outcome, as institutions could hire activists faster than you could get them fired. If you want people to stop cheering as he torches your institutions, do something to save them yourself. Show people that they're self-correcting and can be trusted by the public, and if they aren't then make them become self-correcting.
Finally, on a different topic, it's interesting to compare Guyatt's autonomy-valuing approach to the results of other people's non-autonomy-respecting approaches. Though I'm Rat-adjacent, I've never been a proper Rat. Rather, I hail from the "Skeptic" community - Sagan, James Randi, those sorts of people. Randi himself, and many of his followers, spent a lot of their time debunking evidence-free treatments, often calling for their banning and/or strict regulation. One of them, Dr Steven Novella, even formulated a broader criticism of the entire Evidence Based Medicine framework, and founded his own blog Science Based Medicine blog in response. The issue he and his collegues identified, is that EBM can be hacked as it focuses too much on clinical trials, rather than the entirety of evidence, and prior plausibility. For the curious here's his introduction post explaining their approach, and here's a post series about some spat about cancer treatments which provides a more specific example (and extra links outlining the differences between the approaches).
Given the direct contrast to EBM, and the opposition to patient autonomy when the treatment is not grounded in sound science, what do you think would be their response to the transgender care phenomenon? Oh, that's right, a complete caving to the trans activists in violation of all their principles. Credit where credit is due, I suppose, AJ Eckart, the pro-trans author they hired after dropping Harriet Hall, has been awfully quiet ever since the Cass Review dropped, so someone must have decided they backed the wrong horse.
The sad conclusion of all this seems to be: the romantic notion that Science™ can be trusted as a process seems to completely wrong. Science is only as a good as the people doing, and the people doing it at the moment don't seem much good. If a conflict between their scientific principles, and their political principles arises, scientists seem to reliably choose politics.
ArjinFerman
Tinfoil Gigachad
26d ago
and with intent to, or knowing or having reason to know,1 such activity would likely, derail, disable, or wreck a mass transportation vehicle used, operated, or employed by a mass transportation provider;
This makes it sound like it has to be more than just a murder on a transportation system? Although I guess the earlier point says "any person who is on property described". I'm going to take a wild guess and say the defense is going to be about whether the law applies, rather than guilt/innocence.
ArjinFerman
Tinfoil Gigachad
26d ago
What would be the justification for making this a federal matter?
They literally abandoned her and followed the killer out of the bus. Two people from the front of the bus later come over to help her, but the ones closest to her just noped out.
ArjinFerman
Tinfoil Gigachad
26d ago
Would be hard to pull off with people sharing "George Floyd vs. Iryna Zarutska search result hits" memes.
ArjinFerman
Tinfoil Gigachad
26d ago
It sure would have been nice to hear all these sorts of justifications for why things ain't quite so bad as they appear, oh I don't know, 5 years ago...
ArjinFerman
Tinfoil Gigachad
27d ago
Based.
Also, you did approximately nothing all winter.
ArjinFerman
Tinfoil Gigachad
27d ago
It does, you pointed it out yourself.
ArjinFerman
Tinfoil Gigachad
27d ago
So does "pseudoscience".
This number includes social science major
Where are you getting that from? This would be a rather unconventional use of "STEM". Not saying you're wrong, but finding out would require a lot more clicking into his link, than I can do right now.
The irony of this is that the whole idea of a "nation" is an over-inclusion:
I'm not seeing it. "Overinclusion" was a shorthand for the latter part of the following statement:
But I think by far the bigger threat is a government that excludes people who indisputably share my creed, versus a government that would try and promote another creed.
The direct analogy to that would be a multiethnic empire promoting one ethnic group to the detriment of others, not one that attempts to merge multiple groups into a single one.
General rule: people have the right to allocate the use of their excludable property
We were talking about the creedal nation, you explicitly said you would have said creed enforced by the government, why the sudden switch to basic property rights?
Sorry, I meant that your description of my views was accurate.
Lol, ok. I had a whole paragraph ready to go, in case you meant that, but somehow convinced myself it's not possible.
If you'd be ok with importing a sizeable portion of Muslims without being able to force them to attend Church, how is that not a straightforward example of excluding allies (the few Christians sprinkled in) being to the advantage of the creedal nation? We've seen the deterioration of social cohesion that results from this, what is supposed to be the upside?
More importantly, how is it even a creedal nation if you don't exclude other creeds, and abandon the mechanism of enforcing your creed that you put forward yourself?
If it's true that my beliefs are beneficial, then that truth is asymmetric. Also some beliefs contain the sub-belief that they're guaranteed to be beneficial if [and sometimes only if] they're true. So long as I'm confident in the meta-belief that I'm maximising personal benefit, those beliefs have an asymmetric power over me (so long as they're true.)
Ok. My point was that something can be true and beneficial, and lose to the false and detrimental. Even the false/detrimental thing ultimately collapses, and you get to claim some metaphysical victory, the costs of letting it happen would be enormous, and that this kind of complecancy is not what I'd typically associate with Catholicism.
If the deal was that I have to listen without objection to other people using preferred pronouns, and only when I'm in a trans person's house, I think that would be more than reasonable.
ArjinFerman
Tinfoil Gigachad
28d ago
If you came to this country and wanted to stay there and assimilate, would you go to Sunni or Shiite mosque?
Which ones are telling me my people should go extinct?
ArjinFerman
Tinfoil Gigachad
28d ago
Did you read the rest of my comment? I'm not using "violence" in a pejorative sense here, I'm using it because within the linguistic resources of English it is the most general word available, unless I am very much mistaken.
Yeah, I know. This is exactly how "taxation is theft is used", and yet it was dubbed "the worst argument in the world". I haven't kept track of names and dates, but I'm pretty sure there's a strong overlap between people agreeing with Scott's "worst argument in the world", and proponents of "immigration enforcement is violence".
ArjinFerman
Tinfoil Gigachad
28d ago
purely American creation
That's a bit far. I think they'd fit right into Europe.
ArjinFerman
Tinfoil Gigachad
28d ago
Isn't using men with guns to do something part of the standard definition of violence? How do illegal immigrants get removed from the country?
"Worst argument in the world" people, when someone wants to have borders....
Now overlap a net immigration chart on that. And then add an immigration / GDP chart of the US for comparison, and added effect.
ArjinFerman
Tinfoil Gigachad
29d ago
Ah ok, that's what you mean. Yeah, I think I agree that this is a plausible mechanism for improving the economy via immigration. The problem is that it can have a similar effect on other institutions, and therefore it's not clear it's worth the cost. Also, I think the modal immigration enjoyer would self-immolate before willingly describing the mechanism with this level of clarity and honesty.
ArjinFerman
Tinfoil Gigachad
29d ago
Right. Does that get solved by airdropping a million Syrians somehow?
ArjinFerman
Tinfoil Gigachad
29d ago
That's hardly the question. The question is, had they been able to attract immigrants, would they have done better? The answer is clearly yes
...yeah, because to attract migrants you need to be doing better to begin with. How is that relevant for the discussion?
ArjinFerman
Tinfoil Gigachad
29d ago
Please, I am begging you, tell me with a straight face that the poor economic outcomes of the communist block was due to not accepting enough migrants.
This assumes the primary objective of the SBM people is to defend transgender care, rather than their actually stated one of informing the piblic about which medical treatments are scientifically backed.
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