site banner

Culture War Roundup for the week of October 24, 2022

This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.

Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.

We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:

  • Shaming.

  • Attempting to 'build consensus' or enforce ideological conformity.

  • Making sweeping generalizations to vilify a group you dislike.

  • Recruiting for a cause.

  • Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.

In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:

  • Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.

  • Be as precise and charitable as you can. Don't paraphrase unflatteringly.

  • Don't imply that someone said something they did not say, even if you think it follows from what they said.

  • Write like everyone is reading and you want them to be included in the discussion.

On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.

20
Jump in the discussion.

No email address required.

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.

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.

“Given the distress that can be associated with Gender Dysphoria, we have also included information on puberty blockers that can be started prior to their initial appointment. We have included a Lupron Depot® Information sheet.”

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".