grendel-khan
i'm sorry, but it's more complicated than that
Housing Poster. Series index here.
User ID: 197
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
I think this proves too much.
Consider bariatric surgery on an obese patient. It's elective, and it has risks and benefits. It's shown to cut the risk of cardiovascular events like heart attacks and strokes in half. If your doctors tells you, look, we can't tell you that you will die of a heart attack, but people who don't get this surgery die of heart attacks all the time, so no pressure, it's your decision whether you want to have a heart attack, we have no idea if that'll happen, at least we can't tell you whether it'll happen or not because the regulators won't let us, so you can choose anything you like, and please sign here that we totally didn't pressure you about anything like telling you that you'd have a heart attack.
If you think that puberty blockers don't actually reduce the risk of suicide, then that's a real objection, a matter of fact, and someone is right and someone is wrong.
But in the world where puberty blockers do significantly reduce the risk of suicide in teenagers with gender dysphoria, what's the right thing to do? Not tell their parents about it? Informed consent is complicated, but communicating the risks and benefits of an elective procedure has to be part of it.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Okay, that's fair! So, to be clear, this is a question of fact, and if the best estimate we currently have says that puberty blockers are, in particular circumstances, linked to a lower risk of suicide, then you wouldn't have an objection?
they have no evidence that it reduces the risk
I'm aware of Turban et al. (2020) and Tordoff et al. (2022). Note that as of 2018, a literature review concluded that "the psychosocial effects of gender-affirming hormones in transgender youth have not yet been adequately assessed". So at that point, the right thing to tell patients and parents would be different. But it looks like you can reasonably say that puberty blockers are indicated in certain circumstances, and not using them carries an increased risk.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Even in 2020 we can see how the election became very close at one point during the night, until Biden's mysterious surge.
This is not, and was not, mysterious. It was heavily predicted before the election (Reuters, CNN, NBC, Fox), the explanation (Democrats are more likely to vote by mail, mail-in ballots are counted later) was straightforward, and the only reason this is even a thing is that it was one in a series of Trump's attempts to avoid facing up to his loss.
It's Morning in California. Rather, it's Morning in the legislative season, a time when big ideas seem possible, before they disappear into a swamp of obscure pitfalls and shenaniganry. Here's my understanding of the current roster of big housing bills this year, and the threats and potential involved. See also Alfred Twu's very detailed writeup (PDF).
(Part of an ongoing series on housing, mostly in California, also at theschism.)
Some common themes:
- CEQA, the California version of NEPA, is a problem, and though it's right up there with Prop 13 as a Third Rail in California politics, many of the housing bills this year center around exempting projects from CEQA, especially after a particularly egregious use to block student housing because the students themselves would constitute an environmental impact. (I'm reminded of SourceWatch's very cursed Precautionary Principle chart.)
- Last year's AB 2011 was a particularly big deal, not because of its contents, but because Assemblymember Wicks (previously seen here) managed to get the carpenters' union on board. The Building Trades have been adamant in their demands (basically, require that workers on streamlined projects attended a particular union training program), which the YIMBYs consider a dealbreaker. The compromise in AB 2011 was to provide various benefits to any worker on those projects, and to give preferences to graduates of union apprenticeship programs. There's a huge difference in California politics between "the unions oppose" and "the unions are divided". This mainly applies to SB 423, but the model will likely be tried in plenty of other bills.
The major bills:
- AB 68 (CA YIMBY), the Housing and Climate Solutions Act. (Not to be confused with 2019's AB 68, part of the push to legalize ADUs). This will likely be a two-year bill, but it's a mass upzoning in the vein of SB 827 and SB 50. Those bills failed, so the YIMBYs are taking a different tack: this is a collaboration between California YIMBY and the Nature Conservancy, as it would not only make it easier to build in cities, it would make it harder to build in the wilderness, under the Gain/Maintain/Sustain rubric outlined here. Details are still in flux, but Livable California is furious. Much of how this goes will depend on how labor gets on board.
- SB 423 (CA YIMBY), an extension of 2017's SB 35 (previously seen here). The original SB 35 streamlined approvals (including CEQA exemptions) for general plan-compliant projects in cities behind on their housing goals. It was a compromise, which got the Building Trades on board: all-subsidized projects could pay prevailing wage, but market-rate projects had to use "Skilled and Trained" labor, which is extremely scarce. As a result, the only SB 35 projects completed as of this point are subsidized. SB 423 would apply AB 2011-style labor standards to all projects and indefinitely extend the streamlining. The intra-labor fight has been intense. The carpenters are supporting in droves; the remaining trades are stopping just shy of calling them scabs.
- SB 4, a revival of 2020's SB 899, which would allow churches and nonprofit schools to build housing on their land. This is enormously popular, and was killed for unclear reasons last time. There's been some remarkable cross-pollination with SB 423 at the Capitol, with religious leaders supporting SB 423 and the carpenters supporting SB 4.
- AB 309 (CA YIMBY), a revival of AB 2053, which would take the first steps in establishing a statewide social housing agency.
- AB 1630 would exempt student housing within a thousand feet of a school from CEQA, as well as from a variety of building standards such as floor-area ratios, parking minimums, density limits, and height limits under forty feet. This is a direct response to the Berkeley ruling earlier this year.
These bills will of course change going forward, and some will certainly fail to advance, but this is the state of things at the top of the year.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Generally speaking, it would be a strange coincidence if the Biden campaign's malfeasance matched up so impressively well with the media's red-mirage predictions, and had the opposite effect you'd expect on the eventual results, which were much better for Trump than pre-election polling would indicate.
More specifically, this doesn't appear to have happened; the Trump campaign fundraised on that idea, but didn't appear willing to make the same bold claims in actual court.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Okay, but why do you think that "poll watchers were removed", since the only claims to that effect came from incompetent Trump followers who then recanted?
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
I agree that Tordoff et al.'s work is of lesser quality, and that there simply doesn't exist gold-standard evidence on this issue. I find Turban et al.'s work more convincing.
This is the quality of the evidence base on which doctors are sterilizing children and making lifelong medical patients out of them.
To be clear, we're talking about puberty blockers, which "are falsely claimed to cause infertility and to be irreversible, despite no substantiated evidence".
The WPATH standards, which are on the radical side of global medical opinion (Scandinavian rules, as @arjin_ferman points out, are much more restrictive) emphasize social transition, then possibly puberty blockers, then possibly cross-sex hormones, then possibly surgery. To the extent that it looks like this standard of care isn't being followed, those reports are themselves untrustworthy.
If you're upset about something going on in the world, it behooves you to make sure you're clear on what's actually going on.
an unverified twitter account claiming to be the child in question is saying, despite all the facts in the article being correct, that they don't place the same emotional valence or cause and effect on it that the mother in the story does
First, there are no verified accounts on Twitter any more. The legacy policy required that accounts be "authentic"; the new policy requires that accounts be "non-deceptive", but in no way actually checks that.
Second, they don't claim that "all the facts in the article [are] correct". From the article:
Within a semester, Casey went from all As and Bs to a report card dotted with Ds and Fs.
From the thread:
The article mentions that my grades dropped from A’s and B’s to D’s and F’s in a semester. This is a completely exaggerated statement. My grades were on a steady decline since 2020 due to unrelated mental health concerns.
From the article:
Caroline assumed counseling at the center would help Casey sort things out. But in retrospect, she says, what the psychologist at the center did was solidify the idea that Casey needed medical intervention for his gender distress.
From the thread:
I was in counseling with the Washington University transgender care center in which I was treated amazingly by my counselor. She was a friend to me and offered a great amount of support. This was taken away when my mom revoked consent for the Supprelin.
The article doesn't make any effort to determine that the effect of counseling was, if the counselor recommended or encouraged medical intervention, just repeats Caroline's opinion. It leaves an unchallenged implication; the kid denying it is meaningful.
They especially and annoyingly split hairs in that they admit the doctors said trans teens kill themselves without treatment, but the doctors never said they would specifically. See, totally no longer pressuring the parent!
Is there a way to give informed consent here that isn't pressure under this rubric? Hey, if you don't get this shot, you're much more likely to die of COVID, but we're not pressuring you, right? Doctors are supposed to explain risks and benefits to the patient for any procedure; how can they provide information without "pressuring" someone?
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
See also, previous discussion about more/better police. (This was mid-2020, when the issue was particularly salient.) Another thing that came up was Jill Leovy's Ghettoside (review/summary here), which argues that black Americans are particularly subject to simultaneous over- and under-policing, where the cops hassle and intimidate them for minor infractions but allow murders to go unsolved.
Darrell Owens in The Discourse Lounge, "YIMBYs Triumph In California". (Part of a migratory series on housing, mostly in California, also at theschism.)
This wasn't supposed to be a big year in the Legislature. It's an election year, which means excuses and cowardice and small-c conservatism. It's why there was no SB 827 or SB 50, no mass-upzoning bill. But it was a surprisingly successful year in the Legislature for the YIMBYs, maybe even more so than last year. The governor has yet to sign these, but he's expected to. California has no pocket veto, so if he takes no action, they become law at the end of September.
First, the bills that didn't make it.
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AB 2053 (California Social Housing Act) would have established a state agency to "produce and preserve mixed-income homes that are union built, sustainable, collectively owned, affordable for all income levels, and are financially self-sustaining". It would also have provided a mechanism for the state to engage in counter-cyclical construction when it's cheap and jobs are scarce. It made it through the Assembly, but failed to advance from Senate Governance and Finance by one vote. More here from Alex Lee, the author.
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AB 2656, which isn't exactly major, but would have outlawed CEQA shenanigans as seen in the 469 Stevenson case in San Francisco by interpreting them as a denial under the Housing Accountability Act. It passed its committees and the Assembly, but disappeared in the Senate Appropriations black hole. This indicates just how much of a third-rail any sort of CEQA reform is.
-
SB 917 (Seamless Transit Transformation Act) passed its votes with near unanimity, but Assembly Appropriations spiked it for unclear reasons. It would have placed a timeline on the harmonization of the more than twenty transit agencies in the Bay Area, covering wayfinding and real-time transit data, establishing free transfers, multi-agency passes, and planning a unified regional network. Streetsblog opines that it will still have a significant impact.
And the major bills that did.
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AB 2011 (Affordable Housing and High Road Jobs Act) allows residential development on commercial sites; as a compromise, it doesn't require union labor, but it does require preference be given to apprenticeship programs. This got the Carpenters' Union on board, though not the broader Trades Union. It requires a certain proportion of subsidized units, and comes with minsterial approval, which means its projects are exempt from CEQA. It could make 1.6-2.4 million more units feasible statewide.
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SB 6 (Middle Class Housing Act), similar to AB 2011, also allows housing in commercial zones without specific subsidized percentages, but requires union labor and does not provide ministerial approval. Here's a comparison of the two bills.
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AB 2097 (Parking reform), a reboot of last year's AB 1401, which was lost in Appropriations. There have been some amendments; cities can argue (using a "preponderance of evidence") that they really need parking, unless twenty percent of the housing is set aside for low-income, elderly, or disabled people, or students, or the project is twenty units or smaller.
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SB 886 (CEQA exemption for student housing) is a CEQA reform that actually did pass; it exempts (certain) student housing projects. This doesn't directly address the UC Berkeley enrollment mess, but it does address one of the underlying causes, which was the city of Berkeley's blocking of student housing.
Matt Yglesias is very excited:
I think it’s possible that California is going to substantially improve its housing situation over the next decade / The key isn’t any one of the bills that’s passed or any specific action taken by the governor or the AG, it’s that they now seem to have a durable political coalition in place that wants to see more homes built and keeps taking new swings at it.
This is something that Owens covers as well. Until now, the Trades have blocked any housing reform which didn't require union labor. But AB 2011 passed without the Trades' approval; the Carpenters' unions (along with public employee unions, teacher unions, and the SEIU) showed up and advocated for the bill. There is now a path to major reform that doesn't require the Trades. Much is possible that previously wasn't.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Seriously, how did we get a system that is so self defeating?
Remember that feeling. Hold on to it. One thing I've learned from working in this space is that the systems are always stupider and more vile than you think.
One thing that helps is to remember that at this point, a society that builds is not in living memory for any but the very oldest of Americans.
"And some things that should not have been forgotten were lost. History became legend. Legend became myth. And for two and a half generations, the builder's mindset passed out of all knowledge.”
The YIMBYs are envisioning a wonderfully abundant future, and at the same time, doing a lot of Slow Boring of Hard Boards. In practice, the tip of the spear involves showing up at community meetings to politely ask your local officials to knock it off, or calling your legislator to politely ask them to take your local officials' toys away, or to pore over your city's state-mandated reports and politely tell the state that the city is lying. Roughly none of it looks like Punching The Bad People. (There's an excellent, unfortunately Patreon-only, episode of "The War on Cars" interviewing Matthew Lewis that covers a lot of this.)
Sometimes there are wins, and they're worth celebrating. My city's downtown is replacing a closed donut shop with a small apartment building with ground-floor retail. It's only a few stories tall, but it has a cool roof deck, and it'll make our downtown a little nicer. It's only possible because AB 2097 says the city can't require fifteen parking spaces, which would make the project unconstructible. It's not loud, it's not huge, but it's something. And piling up more and more of those will eventually matter.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
I think it's worth trying to empathize with these people. Consider this previous discussion on some comments by Matthew Cortland, where he vociferously argues against the concept of QALYs, because as a disabled person, QALYs value his life less than that of someone who isn't disabled.
On the one hand, it is devastating to be told that you're not an entire person, even in an accounting sense.
On the other, when you're doing a utilitarianism, either you're going to count disabled people less than non-disabled ones, or you're going to see nothing wrong with deafening someone, or blinding them, and so on.
grendel-khan
i'm sorry, but it's more complicated than that
6mo ago
"I come back to you now, at the turn of the tide." Or at least, the turn of the legislative season. Some life changes have led to Less Posting, as I've had to focus on more meatspace matters. But the legislative roundup is worth doing. Here's my understanding and my take on the 2022-2023 California legislative season as it relates to housing. (See also Alfred Twu's very detailed writeup (PDF).)
(Part of an ongoing series on housing, mostly in California. Also at /r/theschism.)
This has largely been a successful year. While the YIMBYs didn't get everything they wanted, they got a lot of it, and they are very happy. The major wins:
- SB 423 (CA YIMBY), an extension of 2017's SB 35 (previously seen here). It also adds a special timeline just for San Francisco, which means that most development there will be by-right by spring of 2024. (That piece is from Annie Fryman, former legislative aide to Senator Scott Wiener and the author of the original SB 35.) The AB 2011-style labor provisions were a success. Expect to see more in this vein going forward.
- SB 4 (CA YIMBY), a revival of 2020's SB 899, which would allow churches and nonprofit schools to build housing on their land.
- AB 1633 (CA YIMBY), very mild CEQA reform which nevertheless faced stiff opposition from everyone from environmental to trade groups, because it meant less leverage. Chris Elmendorf has a good thread noting that most bills trade one set of constraints for another. For example, SB 423 trades local discretion for union labor and subsidized housing requirements. (Shades of pretextual planning, here.) This just gets rid of something bad, period, close to how AB 2097, which got rid of parking requirements, did. I've been asked how close we are to actually solving the problem; to the extent that it's solved, it will be because of bills like this.
- AB 835 (CA YIMBY), which would direct the State Fire Marshal to develop standards for single-stairway buildings. This is one of those technical reforms that is showing up in a variety of places; here's a policy brief.
The major losses:
- AB 68 (CA YIMBY), the Housing and Climate Solutions Act. As predicted, it's a two-year bill, so expect to see it in next year's roundup. It's a mass upzoning in the vein of SB 827 and SB 50, but the details are yet to be hashed out.
- AB 309 (CA YIMBY), a revival of AB 2053, which would take the first steps in establishing a statewide social housing agency. It was vetoed by the Governor, citing costs.
Note that while the Governor's veto can theoretically be overriden by a two-thirds vote, that hasn't happened since 1980. Also vetoed despite passing the Legislature: SB 58, psychedelics decriminalization (veto message) and SB 403, banning caste discrimination (veto message).
There's some speculation that Governor Newsom is trying to avoid signing anything that would look bad during a Presidential run. Hot take: "Californians suffering so their governor can finish 4th in New Hampshire, they have more in common with Florida than they think".
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Thanks! I'd previously seen the difference between the Swedish model and WPATH recommendations, and kinda dead-ended there, because I'm not a researcher, just a layman trying to do my homework. (For example, I don't know how you could ethically do an RCT on puberty blockers in children and adolescents.)
I do notice that the NICE report excludes Turban et al. (the strongest evidence I'm aware of that puberty blockers reduce the risk of suicide) with the explanation "Intervention – data for GnRH analogues not reported separately from other interventions". (I don't understand why the criteria were set to exclude nearly every study.) On page 19 and following, it relies entirely on de Vries et al. (2011), which is a prospective study of seventy people, to conclude that "This study provides very low certainty evidence that treatment with GnRH analogues, before starting gender-affirming hormones, may reduce depression." So, in plain terms, it looks promising, but we don't have enough information to have a strong opinion.
It looks like the state of evidence is different now than it was in 2018. These questions are, generally speaking, answerable, and it looks like the best information we have indicates that puberty blockers reduce the risk of suicide in adolescents with gender dysphoria. Perhaps a good use of time would be to develop better diagnostic tools so that dysphoric adolescents who will likely not pursue transition aren't offered puberty blockers, and those who likely will, are.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Hey, cool! I'm flattered; thanks, everyone. A few updates on this year's housing bills, as a thank-you.
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AB 2097 (Parking reform) was signed by the Governor, and will take effect at the beginning of 2023. Governor's statement here.
- I attended some developer conferences, and was surprised that financiers will now be requiring parking, though at a considerably lower ratio than cities have been. (0.75-1.2 stalls per unit for market-rate developers; 0.5-0.75 for subsidized; contrast with 2.5-4.5 for cities' requirements.)
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AB 2011 (Affordable Housing and High Road Jobs Act), SB 6 (Middle Class Housing Act), SB 886 (CEQA exemption for student housing) were all signed on Housing Bill Day; around forty bills in total. Every California YIMBY priority bill that made it through policy committees was signed by the Governor.
- SB 922 (CEQA exemptions for non-car transportation), on the subject of CEQA reform, extended and expanded CEQA exemptions for pedestrian, bike, and transit infrastructure.
Here's Alfred Twu's annual infographic. It's definitely the biggest year so far for the YIMBYs in California.
Thank you for providing context; I really should have included the depth of housing problems at Berkeley (see page 10 and following). About a tenth of students were homeless at some point, though this mostly took the form of couchsurfing. (This matches up with how homelessness works; it's mostly temporary, and people only wind up on the street when they've exhausted their social networks.)
I'd also point out that the University predates the city; the city is there because of the University, which makes claims that the University is ruining the City, in a way, confused.
On another topic, I'm really skeptical about the university's plan to put a homeless shelter right next to a student dorm in the proposed People's Park development.
On the one hand, the homeless people are there in the area around the University already; they're just outdoors. On the other, I absolutely see what you mean. This is a hell of a compromise; more than half of the space will still be a park (an actual park, this time), and there will be more homeless/formerly-homeless people living on the site after the project is complete. It's a testament to just how ideologically committed the left-NIMBYs are that none of these concessions even registered. The maximalist position, I think, would have been an enormous mega-dorm covering the entire footprint of the site, and that's nowhere on the radar.
Perhaps the university is simply planning to build the dorm first and then drop the homeless shelter idea once the dorm is already fait accompli.
I don't think they're insincere, but ironically, the level of protesting has made this outcome considerably more likely. Supportive housing development, like any publicly-funded housing, involves a "layer cake" of various overlapping funding sources and deadlines, a byzantine array of mutually near-contradictory requirements, and so on. (Previously discussed here.) Any disruption or delay can trash the whole process.
grendel-khan
i'm sorry, but it's more complicated than that
2mo ago
In a sense, this is sad, but in another sense, it's probably good for me.
If I had to predict which service was going to become a walled garden, I wouldn't have picked Twitter. Is this enshittification?
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
The host of the podcast retweets groups of vandals who slash car tyres and smash people's headlights.
The Tyre Extinguishers, so far as I can tell, encourage people to deflate tires, as shown in the linked thread. I'm not saying that Aaron Naparstek has never retweeted a violent extremist, but he's not doing so here. If he has, let me know.
I'm not very public facing, I'm moderate in my approach but radical in my goals, and I absolutely disavow violent extremism.
There is, however, violence involved here. The arms race making vehicles larger and taller means that every life saved by an SUV costs four lives outside of the vehicle. Pedestrian deaths are steeply rising after falling for decades. I think that's worth caring about as well.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
I found some magnificent explorables; I don't remember where I got the link from, but this is a breakdown of a how a mechanical watch works, and it is amazing.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Doesn't this prove too much? Attempting to destroy gay or lesbian communities seems bad in the same way; aren't they also "(largely) voluntarily sterile"?
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
There is no way to bring a person back on their original development trajectory after they have been affected by blockers.
Well, yes, in a very literal sense, there's no such thing as an action without consequences in the most general sense, but the drugs do not appear to be horribly dangerous in the general sense, which is why they're used for kids who are going through puberty at the wrong time.
For scale, I'd point out that we regularly perform surgery on healthy adolescents, as well as on infants, sometimes in ways that make them very definitely infertile, but despite considerable activism, this hasn't become nearly as much of a major issue, likely because these things are done to make children more gender-conforming, as opposed to less.
The level of concern about potential bone-density impacts, for example, seems disproportionate compared to the way we disregard much more serious issues when no one involved is gender-nonconforming.
Keep in mind that the reports that these reports are untrustworthy, are themselves untrustworthy.
Reed's claims are pretty straightforward: the standards of care that the clinic was supposedly following were flagrantly violated. This should be, in theory, simple to resolve, modulo medical privacy issues. The fact that people who were at the clinic says that their experience doesn't match what she reported seems at least somewhat relevant.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
It genuinely worries me that this is the strength of the evidence base on which doctors are heavily implying to parents, "Give your kid this drug or they will kill themselves."
And here, we're back to the beginning. While it matters what the right thing to do is given the pitiful state of the evidence we have (Scott just posted about people dying from an overabundance of caution), I firmly agree that I'd much, much rather know whether the use of puberty blockers in certain instances prevent suicide than not know.
As it stands now, we're either endangering a lot of kids' mental health and very lives, or we're performing nontrivial medical procedures on them that, while not "sterilizing children and making lifelong medical patients of them", aren't actually necessary. I think the evidence leans more toward the former, you think the latter, but the confidence interval is disconcertingly wide.
She may yet prove a liar, but Hannah Barnes, chronicler of the Tavistock's implosion, considers Reed's story basically plausible.
Maybe we're doing Reference Class Tennis here, but the thing this reminds me of is people making outlandish claims about Planned Parenthood, i.e., that they're coercing women into getting abortions so they can sell the parts on the black market, which turn out not to be nearly as spicy as originally reported.
Mainly it looks like you're citing violations of WPATH's standards. You'd think the solution would be to enforce the agreed-on standards, not essentially ban this class treatment altogether. The solution to Kermit Gosnell, for example, wasn't to shut down Planned Parenthood, because performing a service badly doesn't mean that the service shouldn't be provided.
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
Why is it ethical to RCT every other medication before it gets approval?
You're right; I'm not sure what I was thinking. I guess you'd enter adolescents with gender dysphoria into a study, and either give them puberty blockers or a placebo, would be hard to keep secret from the patients. But I'm reminded of AIDS patients desperately trying to beat the blinding system in the AZT trials. ("There were also stories of patients from the 12 centers where the study was conducted pooling their pills, to better the chances that they would get at least some of the drug rather than just placebos.") And a story I can't find right now about a teenager who stole HRT from their mother back in the sixties or seventies.
My concern is less that people are ignoring the evidence we have (as you point out, the best we have is an uncontrolled retrospective study), and more that the people fighting the use of puberty blockers in teenagers have no interest in answering these questions. I see this in the pre-emptive excuse-making; if we did do an RCT and puberty blockers saved lives, maybe the whole thing is still social contagion?
Finally, there being a positive signal in the literature that blockers may reduce suicide risk does not justify scaring the parents into allowing blockers for their kids. Far more confidence is needed to make such statements ethically.
And here we're back to the beginning. If you say, "a massive uncontrolled retrospective study found that kids who present with the symptoms your kid is presenting with were less likely to commit suicide when given this treatment", are you "scaring the parents into allowing blockers for their kids"?
grendel-khan
i'm sorry, but it's more complicated than that
1yr ago
I guarantee you that the doctors did not do that in this case.
I'm not a doctor, and I'm certainly not an expert in communicating with people. But is that how doctors communicate in other circumstances? Does a doctor who notices that you smoke simply provide dry info and leave it at that? From what I can tell, standards around informed consent focus on whether or not information has been provided in a legible way to the patient or caregiver, not on the fastidious maintenance of strict neutrality.
I don't know how this was presented, and neither do you. But it's a stretch to say that it was presented meaningfully differently from how other medical procedures are offered, i.e., it reflects the standard of care in medicine generally. And if your issue is with the standards for informed consent, why tie it to a controversial set of procedures where the public, at least, absolutely does not agree about the risks and benefits?
In short, the dialogue looks like this to me:
A: Caroline was unethically pressured into approving puberty blockers for her child.
B: It looks like that pressure took the form of explaining risks and benefits.
A: Anything going beyond a bare recitation of the facts is undue pressure.
B: That's a standard that medicine, in general, does not meet.
It looks like either you're holding gender-nonconforming medical interventions to a uniquely high standard, or you're expressing a general issue you have with medical-ethical standards in an unnecessarily controversial manner.
NBC Bay Area, "Protests continue as large walls surround People's Park in Berkeley". (Part of an ongoing series on housing, mostly in California. Also at theschism.)
(Notes on browsing: some of these links are soft-paywalled; prepend
archive.todayor12ft.ioto circumvent if you run into trouble. Nitter is dead and Twitter doesn't allow logged-out browsing; replacetwitter.comwithtwiiit.comand try repeatedly to see entire threads, but anonymous browsing of Twitter is gradually going away, alas.)I've covered historic laundromats and sacred parking lots, but what about a historic homeless encampment?
In 1969, some Berkeley locals attempted to make a vacant University-owned lot into a "power to the people" park. The University decided to make it into a soccer field and evicted them a month later. Later that day, at a rally on the Arab-Israeli conflict, the Berkeley student President suggested that the thousands of people there either "take the park" or "go down to the park" (accounts differ), later saying that he'd never intended to precipitate a riot. The crowd grew to about six thousand people and fought police, who killed one student and blinded another.
The park has stayed as it was since then. UC Berkeley has attempted to develop it, first into a soccer field, then in the 1990s into a volleyball court (made unusable by protests), then in the 2010s in an unclear way which involved a protester falling out of a tree they were sleeping in, and most recently starting in 2018, into student housing with a historical monument and permanent supportive housing for currently homeless people.
The status quo involves police being called to the park roughly every six hours on average as of 2018, colorful incidents like a woman force-feeding meth to a two year old, and three people dying there within a six-month span. (There are forty to fifty residents at a given time.) The general vibe from students matches up.
The 2018 plan started having public meetings in 2020; when construction fencing was built in 2021, protesters tore it down; a group calling itself "Defend People's Park" occupied it and posted letters about how an attempt to develop the site is "gentrification", the university could develop "other existing properties", the proposed nonprofit developer for the supportive housing has donors which include "the Home Depot Foundation, a company that profits off construction", and so on.
Legal struggles are related to the 2022 lawsuit to use CEQA to cap enrollment at Berkeley and a lawsuit using CEQA to claim that student noise is an environmental impact. In the summer of 2022, SB 886 exempted student housing (with caveats and tradeoffs) from CEQA, and AB 1307 explicitly exempted unamplified voices from CEQA consideration. The site has been one of about 350 locally-designated "Berkeley Landmarks" (one for every three hundred and forty Berkeleyans) since 1984, but was added to the National Register of Historic Places that summer as well in an effort to dissuade development. (The National Trust sent a letter in support of that student-noise lawsuit.) Amid all this, RCD, the nonprofit developer attached for the supportive housing, left the project, citing delays and uncertainty. The State Supreme Court agreed to hear the case in the summer of 2023, but the case may be moot in light of AB 1307. The university says yes, and "Make UC a Good Neighbor" says no. Search here for S279242 for updates.
And that brings us to this January. On the night of the fourth, police cleared the park in preparation for construction, putting up a wall of shipping containers which they covered in barbed wire the next week to prevent people from climbing them.
Local opponents of the project take the position that "Building housing should not require a militarized police state", which seems to indicate support for a kind of heckler's veto. And, of course, it should be built "somewhere else". (This meme, basically.) Kian Goh, professor of urban planning at UCLA: "So, do places of historical and present political struggle not matter at all to yimbys? Or do they just not matter as much as new housing?".
Construction appears to be proceeding, after more than fifty years of stasis. Noah Smith attempts to steelman the NIMBYs, but I don't find it convincing. I'm sure the people who cheered burning down subsidized housing in Minneapolis saw themselves as heroes, but that doesn't make them any less wrong.
As a postscript, the City Council member representing the district of Berkeley including People's Park is Rigel Robinson, who entered office at 22 as the youngest ever councilmember, and was generally expected to be the next mayor. He abruptly resigned on the ninth, ending what had been a promising political career, likely due to death threats stuck to his front door. The Mayor of Berkeley wrote a supportive opinion piece; a fellow councilmember wrote a similar letter. On the other hand, a sitting councilmember in neighboring Emeryville retweeted "Sure sounds like going YIMBY ruined it for him. Here's to running more real estate vultures out in 2024 🥂". People are polarized about this. It's made the news.
I'm going to nutpick one of the comments from an article on his resignation, as a treat.
If only people could live inside a world-level political symbol. Current plans for construction at the site are here.
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