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I have a very smart friend who is also a talented decoupler, who could easily be a very quality contributer here if dealing with Culture War issues didn't make him bleed from the eyes. He is literally the only person I know whose Facebook posts about politics did not make me lose respect for him. Over the years, we have had a number of conversations about contentious CW topics that flirted with the border of Adversarial Collaboration, long detailed discussions handled with fairness, civility, and mutual respect.
Until the topic of student loan forgiveness came up. That discussion was unusually heated. He seemed almost frantic, heated about PPP loan forgiveness hypocrites and just not giving the expected degree of decoupled consideration for arguments about how the loan forgiveness was an overall terrible policy. He seemed personally invested, felt personally attacked, in a way he hadn't in conversations about abortion or gun control.
The thing is, my friend is a teacher. Education is a big factor in his identity. He has taught maybe a thousand students who might benefit from the forgiveness plan. Attacks on that plan are an attack on his class identity. Politics is the mind-killer, and it is a sad fact that a rationalist's Art is most likely to abandon him when he needs it most (or, rather, he will fail the Art). And so my arguments sparked an uncontrolled emotional response that was missing from other, less identity-laden topics.
The second thing is, I've been on the other side of that coin, back when we had our multi-day deep dive into the gun control literature. Gun control hits me emotionally as an attack on my class identity. When I hear a gun control proposal, before I hear a single specific detail or spend a second considering merits, some lizard part of my brain interprets it as "Fuck you, your father, your father's father, and your father's father's father". (Does the word "father" still mean anything to you?) I've begged off having spontaneous discussions about it in person, even with close family, because I don't want to spike myself into rage and other unpleasant feelings. During that deep dive, my excellent friend was so calm, fair and rational that he overrode that concern, and I ended up learning a lot and having a great time.
And I'm thinking about this now, because I notice a similar reaction to the trans discussion downthread. The idea that my children might be brainwashed into taking evolutionarily self-destructive choices, and I can't even attempt to oppose it without facing the full wrath of the modern State, kindles a pre-rational, animal panic/fury response. I find myself getting heated to an unusual degree just thinking about it. I don't think I'm particularly "anti-trans". I was willing to be accepting two decades ago, when I first learned it was even a thing. But something about the thought that the phenomenon might hit my kids triggers an atavistic survival instinct. That reaction doesn't trigger when I consider my son dressing like David Bowie, or my daughter playing sports. It doesn't happen when a peer goes trans. It triggers at the thought of one of the two corporeal incarnations of my DNA and memes getting sucked into a fraught psychological memeplex, and particularly at the thought of them being medically sterilized.
Imagine an alternate world where any time a kid expressed suicidal ideation, government employees would firmly nudge them towards euthanasia, and would jail you as a parent for protesting. That's roughly the level of emotional hit - some part of me considers this an existential threat.
But what are the odds? 0.3%? That's not that much worse than the odds of childhood cancer, or other kind of unexpected death that a healthy mind doesn't overmuch worry about, and deals with gracefully if it comes. But now it's apparently something more like nearly 2%? That hits me in the Papa-Bear-Who-Wants-Grandkids-In-Space-Forever. And it seems very likely that a lot of that is social contagion or could otherwise be wildly reduced with a minimal degree of skepticism towards youth fads.
So, two points. One, I think it might behoove activist types (assuming we're not in pure conflict theory) to try to notice when one of their pushes is hitting this sort of reaction and figure out a path to undermine or alleviate it.
Secondly, a question for the community: What gets you fiercely activated, beyond what you can rationally justify? What CW issues feels like molten hot war to the hilt, where your instincts fight to throw aside all reason and charity? Any thoughts about why?
I don’t know if it’s naïve, but I’ve always sort of assumed that transition is something which gets recommended after years of therapy where someone is consistently exhibiting being gender dysphoric.
I’m curious because I think this is a key point where left assumptions and right assumptions tend to diverge. Left assumption: you talk about gender dysphoria with a therapist and they evaluate you for a long time to make sure it’s actually there and is affecting your life in a severe way before recommending any life altering treatments. Right assumption: any old kid reads something online about gender fluidity, experiments with the idea for a short phase, the doctor algorithm says, dysphoric, boom here’s some hormones to take.
Idk which one it looks more like in reality.
Like, I think it’s fine that people transition, but I also know it’s easy to basically trick psychologists until I get prescribed Adderal. Right? So ideally transition would be there but you’d have to spend a huge amount of time and commitment to get anybody to open up the door where it’s locked up at.
That feels to me like a place where some common ground can be found? But maybe I’m also naïve there too, lol.
This is part of a bigger suspicion that all of our problems are solvable by understanding that there are fractions of truth claims in what both sides tend to offer, but it’s very unpopular to say so because we immediately perceive the other side as the worst consequences of their way of thinking rather than looking for where there is a bit of truth in what they say.
Hospital in Canada:
I suppose if the hospital's "Gender Pathways Service" is already prescribing puberty blockers so freely that there's no requirement for diagnosis beyond the child or child's parent getting a referral by saying something about transgenderism to the family doctor, giving them before the first appointment saves time. While doing so based on 0 appointments is obviously unusual, quite a few of the anecdotes I've heard mention prescriptions after the 1st appointment. The way you describe it used to be much more standard, I remember trans-activists complaining about previous requirements like living for 6-months to a year as the opposite gender, but doesn't seem common anymore.
It's possible they justify this with the argument that puberty blockers are much less significant than opposite-sex hormones and are just "giving the child time to choose" or some such thing, but that seems heavily contradicted by the evidence. For one it amounts to much the same decision: 97% of children put on puberty blockers go on to take hormones (page 38), but around 60%-90% of trans children who aren't given any intervention (the previously standard "watchful waiting" approach) grow up to not be trans. For another puberty blockers themselves, particularly when used to avert puberty entirely rather than delay precocious-puberty a couple years, are serious business. We know about them impacting bone density based on the use with precocious-puberty, but we also have reason to believe they impact brain development but have zero research on what that impact is in humans. The best I've found is this study on sheep. A concern mentioned by the NHS's independent review:
Given how the medical system is normally so obsessed with the precautionary principle (like the FDA shutting down early unapproved COVID testing) it seems crazy that something as significant as preventing puberty entirely has become standard practice based on no more than the same drugs previously being approved to delay precocious puberty. There's a severe lack of research on even the safety/side-effects of using those drugs that way, let alone a randomized control trial of effectiveness indicating it actually performs better as a treatment of trans-identifying children than doing nothing.
Broadly, I don't necessarily disagree, but surely got to be careful with selection effects here, and the direction of causation. It would seem likely that the kids who felt 'strongest' about their dysphoria would want to go on blockers immediately and those who weren't so sure watch and wait, and further that those kids who felt strongly would be more likely to persist in transition. Which is to say, it isn't that blockers make it more likely to continue transition, but that people more likely to continue transition take blockers.
The selection effects wouldn't be that straightforward because the second link is to a meta-study of studies by clinics on outcomes for all the children they diagnosed with gender dysphoria, none of whom were given puberty blockers. There unfortunately aren't many studies like that and the children in question were diagnosed before use of puberty-blockers became widespread.
Now, that definitely raises its own serious problems in comparing the two groups. In particular, the number of children diagnosed with gender dysphoria since those studies has risen enormously. At the recently-closed Tavistock/Gender Identity Development Service clinic in the UK, the NHS's only gender clinic for children, referrals rose from 94 in 2010 to 2,519 in 2018. So there's not a lot of reason to believe those diagnosed with gender dysphoria in the earlier studies included in that meta-study are representative of more than a small fraction of those diagnosed today. But it seems difficult to justify that those diagnosed with gender dysphoria before the increase would be more prone to desistance under a watchful-waiting approach than those who seemingly wouldn't have been diagnosed if they were born a decade earlier. It's possible to construct a narrative like that - I've heard arguments that the ability to diagnose gender dysphoria has become more accurate, or that the desisters would be better-off as trans but were forced back into the closet by a transphobic society. But it certainly doesn't seem safe to assume, let alone prescribing puberty-blockers based on that assumption.
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I just have to repeat that. Because the usual excuses I see made are that the doctors that screen these patients are just that damned good at their job. 100% success rate at identifying which pre-pubescents need puberty blockers. Nothing at all to do with the puberty blockers actually prolonging or increasing dysphoria.
But when the doctor hasn't even seen them yet, shifting the goalpost to "Yeah, I guess only kids that really want puberty blockers take puberty blockers" seem... weak? And inconsistent with everything everyone who's ever had any proximity to any children what so ever knows about this little thing called a "phase".
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Lol, yeah that’s pretty wild.
I stand very corrected.
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