sodiummuffin
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User ID: 420
In my opinion, there is definitely enough research out there by now that you can confidently release something like a Cass Report without anything new.
The CASS report predominantly based its conclusions on the lack of high-quality research, a point it reiterates often, not on high-quality affirmative evidence against treatment. There is some such evidence - for instance see this Reddit comment I wrote about puberty blockers and the indications that they both lock children onto the transgender pathway and permanently damage brain development - but like all evidence on the issue it isn't very good. In the absence of evidence that a treatment is safe and effective, the burden is traditionally on those advocating for the treatment to prove that it is. However, even aside from new studies actually providing information, "gender-affirming care" now has both established practice and a political ideology behind it, so abolishing it in any sort of permanent and widespread way seems likely to require more evidence. Without new evidence you might see some governments abolish or discourage it specifically for children, but others will continue to feed a fraction of every new generation into the trans pipeline and even places that get rid of it could easily flip back in a generation. The medical consensus turning against it would be a much more effective and stable solution, and something like a high-quality randomized control trial showing gender transition failing to outperform the control group would be a big step in that direction.
If anything "lack of high-quality research" understates the case. There is not a single randomized control study of gender transition, in either children or adults. It's incredibly easy for non-RCTs to give false results even if you do a reasonably good job, and most don't do even that. Read through something like Scott's Alcoholics Anonymous post or his ivermectin post and imagine how much worse it would be if only the non-RCT subset of the studies he looks at were available. That's why fields like nutrition, where long-term randomized control trials are impractical, are so terrible despite far more quantity and quality of research than a small field like gender dysphoria.
As an example, here's an excerpt from the Cass Report I've looked into previously:
The systematic review on interventions to suppress puberty (Taylor et al: Puberty suppression) provides an update to the NICE review (2020a). It identified 50 studies looking at different aspects of gender-related, psychosocial, physiological and cognitive outcomes of puberty suppression. Quality was assessed on a standardised scale. There was one high quality study, 25 moderate quality studies and 24 low quality studies. The low quality studies were excluded from the synthesis of results.
Here is the meta-study being cited, the classification into high/moderate/low quality was not done by the Cass Report but by the meta-study. Note that many of the studies only looked at physical outcomes like "is puberty suppressed". At the time trans activists complained about the CASS report excluding a lot of studies, but among other things that includes studies that only investigated whether puberty blockers stop puberty and made no attempt to investigate whether stopping puberty provided any psychological benefit. This is the single supposed "high-quality" study. It isn't a randomized control study, it compares patients who have been given puberty blockers to ones who just started the assessment process. (It also compares to a "cisgender comparison group", such comparisons tend to be even more worthless.) Among other potential problems, this means the results are very plausibly just regression to the mean or benefits from the other mental-health care provided. If you think the parents of children with worse self-reported "internalizing, suicidality, and peer relations" are more likely to seek treatment than the parents of children who are currently doing fine, which the study itself shows, then improvement over time is the expected result even if you don't do anything. Plus they did do other things, it specifically mentions "the care provided in the present study also involved the offering of appropriate mental health care". It also mentions that the "control" group has an average age of 14.5 years and the treatment group 16.8 years. And that's the only "high-quality" study the meta-study could find on puberty blockers, here are the reasons given for why it considered the other studies to be even worse.
sodiummuffin
10mo ago
Well, the fact that is the one quote always cited to make that argument certainly makes it seem like an outlier. And even it only says that they are not "purely white" since they are supposedly darker in complexion. That doesn't seem like a quote from a society where "French people aren't members of the white race" was a mainstream view, and indeed that wouldn't make sense with how people interpreted laws and rules explicitly referring to "White" people. It seems like him drawing a novel distinction between the different white races based on skin-tone to argue some of them are more white.
sodiummuffin
10mo ago
As I said:
The main trick they pull is to define "whiteness" as not being discriminated against or "othered", point out that the Irish were discriminated against, and thus define them as not white. But the actual historical people who did the discriminating did not define white people that way, they both considered Irish to be a subcategory of white people and also discriminated against them.
sodiummuffin
10mo ago
The Irish and the Lithuanians and the Jews were definitely not white when they first got off the boats.
The Irish/Jews/etc. were considered white, the idea that they weren't is a psuedo-historical myth advanced by certain activist historians like Noel Ignatiev. The main trick they pull is to define "whiteness" as not being discriminated against or "othered", point out that the Irish were discriminated against, and thus define them as not white. But the actual historical people who did the discriminating did not define white people that way, they both considered Irish to be a subcategory of white people and also discriminated against them. Being white was of real legal and social relevance, and groups such as the Irish were unquestionably included in that category.
The Volokh Conspiracy: Sorry, but the Irish were always ‘white’ (and so were Italians, Jews and so on)
Here are some objective tests as to whether a group was historically considered “white” in the United States: Were members of the group allowed to go to “whites-only” schools in the South, or otherwise partake of the advantages that accrued to whites under Jim Crow? Were they ever segregated in schools by law, anywhere in the United States, such that “whites” went to one school, and the group in question was relegated to another? When laws banned interracial marriage in many states (not just in the South), if a white Anglo-Saxon wanted to marry a member of the group, would that have been against the law? Some labor unions restricted their membership to whites. Did such unions exclude members of the group in question? Were members of the group ever entirely excluded from being able to immigrate to the United States, or face special bans or restrictions in becoming citizens?
If you use such objective tests, you find that Irish, Jews, Italians and other white ethnics were indeed considered white by law and by custom (as in the case of labor unions). Indeed, some lighter-skinned African Americans of mixed heritage “passed” as white by claiming they were of Arab descent and that explained their relative swarthiness, showing that Arab Americans, another group whose “whiteness” has been questioned, were considered white. By contrast, persons of African, Asian, Mexican and Native American descent faced various degrees of exclusion from public schools and labor unions, bans on marriage and direct restrictions on immigration and citizenship.
sodiummuffin
10mo ago
The second frames Zelensky as a conduit for his people's will. ... The average age of the fighting man is over 40.
What's with the way people use this point? Ukraine is engaging in a deliberate policy of recruiting older people because they don't want to kill off their younger generation. The minimum age for conscription was 27 until they lowered it to 25 in 2024. This is bad enough when people are using it make some "Ukraine is running out of manpower" point, which true or false is not supported by them recruiting people of the ages they are deliberately trying to recruit. However it seems even more ill-suited to make your current argument: if it's a mistaken policy, then it is one that if anything panders too hard towards the will of the people.
sodiummuffin
11mo ago
the developers deny its authenticity
By "don't believe everything you read on the internet" they were presumably referring to the false rumors not the true ones. Like the "unskippable gay sex scene" rumor started by Saudi Arabian sites based on it being rejected by the government of Saudi Arabia. Of course in reality the scene is both part of a very optional romance and is (like every cutscene) skippable even if you've chosen that romance route. I'm not sure if the "unskippable" part was from bad machine translation of the Saudi sites or something else.
sodiummuffin
11mo ago
Because it was a plan created by a group of non-Trump Republicans and contained elements that he disagreed with, some of which were mined for political attacks by those claiming it was his plan. That doesn't mean that he disagrees with everything in it - both Trump and the authors are Republicans, so naturally they have overlap in policy. Nor does it mean that Trump considers people radioactive and unhireable for contributing to it, once again they are Republicans and agree on many things. It just means that people quoting from it as "Trump's plan" were being dishonest, an honest critic could have either quoted Agenda 47 instead or made predictions about his actions without claiming they were from Trump's published plan. I don't think this is ordinarily a concept people have difficulty with, activist groups and think-tanks publish proposals that have partial overlap with politician's actual plans all the time.
I'm guessing the very fact that it wasn't his plan contributed to the focus on it. For anything in Agenda 47 he could just say "yeah that's my plan, it's great!". Whereas the fact that Project 2025 wasn't actually his plan meant that he denied it, which looks weaker and like he has something to hide.
sodiummuffin
11mo ago
"Six million people were killed in Nazi concentration camps during the second world war, as well as millions of others because they were Polish, disabled, gay or belonged to another ethnic group".
"Millions of others" - other than what? Other than the 6 million jews referrred to in the first part of the sentence. This is a statement that only makes sense precicely because the speaker is not a holocaust denier and thinks it goes without saying that the 6 million refers to the jewish victims and then on top of that there were "millions of others" who were instead killed for being "Polish, disabled, gay or belonged to another ethnic group".
That's just how people talk. It doesn't reflect anything besides the fact that the sensitive nature of the subject matter means some people on Twitter are combing through statements like these in order to complain because someone said "six million" instead of "six million jews". Similarly with the others, when someone says "all those who were murdered just for being who they were" it's because she wants to emphasize that aspect of the motive, not because she doesn't think jews were targeted.
sodiummuffin
11mo ago
Scott knew the truth about HBD all along, but his public position was still in compliance with HBD denial.
No it wasn't. In 2017 he wrote The Atomic Bomb Considered As Hungarian High School Science Fair Project, as well as this post that was probably the most explicit pre-AstralCodexTen:
Learning To Love Scientific Consensus:
Even things about genetic psychological differences between population groups are less bold and maverick-y than their proponents like to think. The relevant surveys I know trying to elicit scientific consensus (1, 2, 3) all find that, when asked anonymously, most scientists think these differences explain about 25% – 50% of variance.
I hate to bring that up, because it’ll probably start a flame war in the comments, but I think it’s important as a sign of exactly how hard it is to politicize science. Global warming skeptics talk about how maybe the scientific consensus on global warming is false because climatologists face political pressure to bias their results in favor of the theory. But scientists studying these areas face much more political pressure, and as long as you give the surveys anonymously they’re happy to express horrendously taboo opinions. This is about the strongest evidence in favor of the consensus on global warming – and scientific consensus in general – that I could imagine.
Coincidentally that post also addresses your point. Even with something as taboo and suprressed as HBD, you can anonymously survey experts in the field and get overwhelming support. That doesn't translate into "institutions" being automatically trustworthy, something like a public statement by a university or an article in the New York Times has little in common with an anonymous survey of experts. But I don't think he ever said otherwise. He's posted about how media outlets rarely outright lie and prefer misleading people in other ways, but that isn't the same as saying they're generally trustworthy.
I harp on RCTs because most of the time I read non-RCTs (in fields like healthcare and sociology with complicated and frequently opaque mechanisms) they end up utterly failing to adequately compensate for their disadvantages. Though of course this is a biased sample, I'm generally not reading studies on obvious and non-controversial subjects. It's always stuff like "we controlled for X" where X is whatever arbitrary handful of factors the authors thought of (leaving whatever residue is left as the "effect", or conversely erasing the effect with Everest controls), or "we matched with a non-random pseudo control group" (like the puberty blockers study I discussed) where we're supposed to trust how well matched they really are and there's often obvious differences between the groups. It is with good reason that in applications like clinical trials where RCTs are possible, they are considered the "gold standard" and are often required for approval by organizations like the FDA.
It's bad enough that I think anyone trying to argue the contrary needs to very specifically justify why the non-RCTs in the case in question actually work, not vaguely gesture at the fact that sometimes we can gather adequate evidence without RCTs. Otherwise I think it is very easy for people, including medical professionals, to assume that (for instance) just because 50 studies on puberty blockers have been conducted and they have become established clinical practice we now know whether they are better or worse than nothing. Sorry, 5-HTTLPR and depression had 450 studies and turned out to be completely fake, you need the very highest quality of studies to know whether the thing you're talking about is even real. There are of course plenty of ways to mess up RCTs too, the replication crisis is filled with them, but my impression whenever I see RCTs on a subject compared with non-RCTs (as in Scott's posts I linked in the prior post) is of a huge and often unbridgeable difference in baseline reliability. Sometimes conducting RCTs really is impossible (and in those cases I expect our understanding of the issue to be much worse) but if they're possible then conducting a high-quality RCT is going to be my go-to recommendation for both understanding the issue and creating evidence compelling enough that it can potentially convince others.
What do HIV and parachutes have in common? A much clearer mechanism of action. With gender dysphoria what we instead have is the murky waters of people creating narratives about their own subjective experiences based on whatever memes their culture has lying around, something people are terrible at doing accurately. Such introspection provides a wide range of insights: miracle supplements or faith-healing producing amazing boosts in well-being, subconscious reasons for your problems accessible through dream-analysis, neurasthensia, suppressed memories, etc. So yes, I'm sure you can make the case for HIV without a RCT, but that case would have to focus specifically on evidence particular to that case, my default without such evidence is to be skeptical of non-RCTs and look for the many ways they can go wrong.
By the way, based on you posting this in reply to someone else I think you mistook his posts for mine.
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