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Today, Jesse Singal wrote an opinion for the New York Times where he argued that Trump defunding youth gender research was a bad thing, despite the terrible research coming out of that part of science. He thinks that reform is in order, not slash-and-burn practices. 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. Certainly, funding bad actors makes no sense, but to me, reform is little gain, and even a good new study must follow around minors that have gone through the unethical transgender science grinder.
It reminds me of an (unpopular) opinion Trace shared the other day on Twitter regarding the axing of funds for museums and libraries. Even if anthropology is 99% leftist, well, the institutions belong to those who show up, so right wingers just need to get in there and fix it themselves. While I appreciated that stance as it related to conservative law organizations, and as it related to Twitter when left-wingers were leaving the site en masse, I find it pretty distasteful to give up anthropology to positive feedback loops, and let our history become a mockery when it is within one's power to just raze it.
Deus Ex took a look at this perspective. Spoilers for Deus Ex:General Carter, after the UNATCO plot is exposed, decides to stay within the organization, because institutions are only as good as the people that comprise them. Later in the game, you see him in the Vandenburg compound. He has given up on his idea of reform and joined the resistance.
I'm going to guess most of this forum disagrees with Trace and Jesse on this matter in pretty much the same way that I do. Can you name any areas in government or other organizations where you do agree with them?
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:
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.
You're overstating the importance of randomized controlled trials (RCTs) in medical research.
As a famous parody of your point, this 2003 study found that no RCTs had been done of parachute use when jumping out of airplanes and concluded that there is insufficient evidence to conclude that parachutes are effective. As a follow up, this 2018 study did implement a RCT for parachute use when jumping from airplanes and concluded that parachutes do not in fact prevent injury. (Participants jumped from an airplane on the ground.)
Less facetiously, we have no RCTs demonstrating that HIV causes AIDs, but we can still be pretty confident about the link between the virus and the disease. Recognizing this relationship has led to a lot of good medical progress both for the populationis affected by AIDs and those not affected by AIDs (by for example keeping HIV out of blood transfusions to prevent the spread of AIDs).
I happen to also be skeptical of the benefits of transition. But your explanation of the science is not good here and at best leading you to the "right belief for the wrong reason".
I am far too used to people using the parachute idea as justification to not do RCTs in places where an RCT would clearly be best practice. Most recently, involving COVID restrictions, which are assumed to work because "physics" or whatever but never get tested. We don't apply such flimsy reasoning elsewhere. Designer drugs have to go through trials despite being physics telling you they should work because they interact with the target molecule in models. If you can do an RCT, and choose not to, you better have a good reason to do so, and parachutes isn't a good enough reason.
Early parachute designs were actually tested. Nobody took the claims of their inventors at face value, they wanted evidence that they work, so their inventors tested them either personally or with objects/animals. That's why we don't need additional RCTs for the concept of parachutes, even though you could do one using animals. If they were invented for the first time tomorrow, you'd probably want to do something like an RCT:
Take 20 crash test dummies.
Randomly assign 10 to use the parachute, and 10 to not.
Simulate identical falls for all 20.
Hand the dummies to a blinded team of engineers who assess damage
Compare the results statistically to see if the safety intervention reduced injuries
I think it depends. To me, in anything science, RCT is the gold standard. There are workarounds that can be used when doing RCT is unethical due to the danger to the control group or in some cases the data is impossible to gather. In those cases other methods can work, though I generally take them to be low value and require a lot more of them done under lots of conditions before I accept the results.
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