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PaperclipPerfector  5d ago (text post)   20299 thread views

Culture War Roundup for the week of May 26, 2025

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I got into an argument on JK Rowling recently. That was mildly annoying, but then it shifted to transgender stuff in general, and the puberty blocker discussion in particular was very vexing to me. I just genuinely don't know how anyone can be okay with the idea, especially now that we know way more about it than we did 10 years ago. The dismissal of the Cass Review on the part of the pro-trans side has increasingly looked like the stereotypical right winger doing mental somersaults to any science they dislike. But I have some questions on it, there were some things I didn't have great answers to.

  1. What are the actual requirements for getting prescribed puberty blockers? The pro-trans tribe insists that it is a very rigorous process involving thorough checking of gender dysphoria, and it's not commonly done, despite being a readily available tool in the toolbox of clinical practice. I do not believe this after examples I have seen, but I have nothing to cite.

  2. Is there any actual scientific evidence in favor of social contagion playing any part in transgenderism? The pro-trans tribe claims that social contagion plays no role, and to me, it's trivially true that social contagion plays an astounding part, as well as fetishism and abuse, and autism. I have no idea how many kids genuinely become gender dysphoric due to genetics, if there are any at all. And if there are any, I certainly don't think that it's a given that they need puberty blockers. How the hell did that become the default? But anyway, has The Science turned up anything on social contagion?

  3. Are there any actually valid critiques of the Cass Review? Pro-trans tribe will cite the Yale Law retort, then when I point out the responses to it, either holes are poked in them or they just go back to their priors that the Cass Review was methodologically bad, done by a transphobe, misinterpreted studies, and went against the scientific consensus and ruined its own credibility. Actually, they say the same about the recent HHS Report. Please show me if there are any published valid critiques of the Cass Review besides the Yale thing.

  4. What are the probabilities of serious consequences from puberty blockers? I brought up infertility, and the pro-trans tribe claimed that it's actually a very low chance and that it's not anyone's business anyway because not everyone wants to have kids. The latter half of that is completely inane when we're talking about life changing decisions for a demographic that cannot consent, but the former, I don't know. Do puberty blockers cause the infertility, the loss of ability to orgasm, and the complete lack of penis tissue with which to create a neovagina, or is it the ensuing hormones that do this?

Sadly, none of this will do anything to convince anyone on either side anyway. There's really no way out of this hole that has been created. Sometimes, I kind of hate this world. I really thought "don't give minors seriously debilitating life changing pills to solve a solely mental disorder" was an easy hill to stand on, but the fighting was just as vicious as anything else with the gender issue.

Edited to be slightly less angry.

There's really no way out of this hole that has been created.

Basically everything I have read about transgenderism is ridiculous. Neovaginas, dilators, the fetishes, the entire ideology, like there is no way its true. There is no way it makes these people happy, these people are not going to be happy. They are destroying themselves. The kids parents are destroying them. Why stop them? Why argue to save them? Just let them destroy themselves. Let them destroy their children. These people are my out group, they believe almost every other thing I hate about my society, and they are destroying themselves. Why stop them?

The kids parents are destroying them. Why stop them?

This is probably a smaller issue now that the opposition to trans became more prominent, but many parents were Milgram Experiment-ed into it. The point is to give them enough info that they realize they don't have to listen to the dude in the labcoat.

I think it is worth noting that on all of this discussion about blockers, blockers are supposed to be the compromise position that was suggested to placate those concerned about youth gender medicine.

You could just let them take cross-sex hormones instead. Hormones are pretty good at what they do in relatively short order, I have seen many examples of people taking hormones for ~3yrs and along with a haircut, passing well. It works the other direction too, all of the physical changes can also be reversed in short order if you desist and let your gonads get back to work producing your natural sex hormones. When you take E or T, it makes your gonads stop, temporarily, producing hormones, because your body doesn't seem to care which hormone you have, as long as you have a sufficient amount of it coursing through you it's satisfied.

If a trans woman hasn't had an orchiectomy, she can get off hormones and father children within 3 months or so. Same goes for trans men getting off T and getting pregnant.

Kid still goes through puberty, won't have to worry about bone density, won't have to worry about IQ loss, etc. Can reverse it later by stopping them whenever.

all of the physical changes can also be reversed in short order if you desist [...] Can reverse it later by stopping them whenever.

Voice breaking and breast development won't be reversed just to name two. That physical changes aren't reversible is pretty much the entire basis for puberty blockers. If physical changes were reversible the kids with gender misidentification could develop without interference until they were 18, or any age thereafter, then decide they weren't happy with their body and change it without any issue.

I want to add on that this kind of thinking seems to only occur around the trans-osphere. Nobody thinks that the 5'0 weakling with the weak chin can become a gigchad by taking some extra testosterone. At best he'll get bigger muscles (and smaller balls). Women and men around the world want bigger tits and dicks respectively, but the tits require surgery which produces ugly Frankenboobs and we still haven't cracked dick embiggening. But we tell trans identifying people that yep, with a little medicine, a bit of routine surgery and a ctrl-H to switch M and F in their paperwork they can slide into a whole other body. It comes over as somewhere between wishcasting and denial of reality.

Oh, hey there. Are you ever responding to that Jaime Reed thing you started?

I think it is worth noting that on all of this discussion about blockers, blockers are supposed to be the compromise position that was suggested to placate those concerned about youth gender medicine.

You could just let them take cross-sex hormones instead.

Is the idea here that you should default to giving children any medicine they ask for, or is it just some special case for hormones?

Is there any actual scientific evidence in favor of social contagion playing any part in transgenderism? The pro-trans tribe claims that social contagion plays no role, and to me, it's trivially true that social contagion plays an astounding part, as well as fetishism and abuse, and autism. I have no idea how many kids genuinely become gender dysphoric due to genetics, if there are any at all. And if there are any, I certainly don't think that it's a given that they need puberty blockers. How the hell did that become the default? But anyway, has The Science turned up anything on social contagion

The problem with empirics here is that the whole phenomenon is unfalsifiable. I think that many trans people are indeed experiencing something whether it's sociogenic or a physical ailment because they are doing a lot of costly harm to themselves to a degree that makes no sense if they aren't actually suffering. But there just isn't really a way to tell if a kid is going through a phase or has this more real thing assuming there is a real thing. Even the prospective trans person themselves can't know if what they're experiencing is what other trans people are experiencing. It's all guessing all the way down.

I think if a kid has been secluded from all transgender related concepts, but still displays gender dysphoria (which you can confirm by asking if it is actually gender dysphoria or the kid is mistakenly wanting to be the other gender for some other reason), then that's decent evidence that the kid is transgender. What should be done about this (allowing social transition, or puberty blockers, or even more extreme measures) is still unclear though.

I think that is evidence but not proof. "I'm the opposite sex actually" is not so conceptually foreign to normal experience that I wouldn't expect it to come about as a normal error spontaneously occasionally. "the position of the stars mean something to or ordinary lives" is a false conclusion arrived at by multiple civilizations.

Now, maybe having that error and it getting ingrained deeply enough just is gender dysphoria and star believer would also spontaneously appear at some base rate and further the best thing to do about this is let them buy crystals and get gaudy piercing to their heart's content. But if that's the case then it does sound like something we ought to be able to talk a rational person out of, and should probably try pretty hard to given the severity of the costs associated with transitioning. Finally granting all of that falls on the side of letting them transition anyways being the best for them, this being a disorder caused by an idea it would be exactly the kind of thing we'd worry about social contagion on. It becoming a fixation may be a much lower bar than it being spontaneously arrived at and then affirming it as a normal thing widely seems like a pretty big mistake.

Then there is the other possible conclusion. If It's caused by some kind of physical thing and would show up not only separated from the concept of transgenderism but in some kind of Truman show style total separation from the opposite sex. This would be very strong evidence indeed and some kind of model where we can do a brain scan and very accurately predict transgendered identification would be strong evidence. But then I'd want the transition gate kept on those grounds.

Yeah I agree it is not proof, but it can be good enough evidence.

but still displays gender dysphoria (which you can confirm by asking if it is actually gender dysphoria or the kid is mistakenly wanting to be the other gender for some other reason)

Huh? How do you ask "is this actually gender dysphoria" to someone who hasn't heard of the concept?

You ask the kid why they think what they are thinking. For eg. if a girl tells you she wants to be a boy, you can ask her why and eliminate non gender dysphoric reasons like "she wants to play football which only boys get to play".

I kinda know what you mean, but I think there are limits to the method. Stella O'Malley, one of the most prominent anti-trans activists out there, had what could would probably fall under "gender dysphoria" from your definition. Plot twist: she's happily cis, and a mother of two children nowadays, and the experience of getting over the discomfort is part of the motivation for her activism.

Yeah, I agree. I am not saying to necessarily take any decisions even if you suspect it is likely gender dysphoria. You could engage in waitfull watching.

Yeah but the issue with transgenderism is that 'gender dysphoria' is the phenomenon that can actually be described, everything else is conjecture and preferred ways of treating that issue based on differing ideologies.

It can be described but I'm not sure everyone is talking about the same thing when they use the term.

I certainly don't think that it's a given that they need puberty blockers.

The ultimate pro-puberty-blocker argument is that if treatment is not provided children will commit suicide. Last time I looked at this (mid-pandemic), there were no randomly controlled trials on suicide rates in trans children under different treatment regimens. If you looked at the effect sizes of the few existing small Scandinavian studies about the effectiveness of different transitioning methods on suicide rates, it looked like social transition had about the same effect size as medical transition.

I'm generally in favor of doing more RCTs on children whose parents consent (and on pregnant women). There are so many medical questions that we don't have answers to because medical ethics has raised the standards for informed consent higher than is reasonable.

then when I point out the responses to it

This response to the Cass review was particularly hilarious: a paper written by two lawyers attempting to dispute the "evidentiary standards" of the Cass review, which manages to misinterpret the Cass review as well as misquote two of the scientific meta-analyses used by the Cass review. If that's the highest quality of argument they can put forward (in NEJM of all places!), then I'm going to guess that the actual "evidentiary standards" in support of their position are quite weak.

(And indeed, the Cass review is up front about there being no RCTs available for use.)

Your Jesse Singal link seems to be broken.

Thank you. Should be fixed, but might be paywalled. The title of the article is "If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes", written on Mar 11, 2025.

Presumably it's meant to go here (NB: partially paywalled). I don't know what all the extra crap in RR's link does but presumably some part of it requires a cookie you (and I) don't have or something.

Yup. Thank you.

I know two trans women.

One transitioned in her late twenties, and gets stared at wherever she goes. Anyone can instantly tell that she’s trans from her voice and appearance, she’ll need to spend a lot of money on surgery to look remotely female, and she’s at the risk of being hate-crimed just from walking in the wrong area. She doesn’t behave very femininely, perhaps from nearly 30 years of growing up as male.

The other went on puberty blockers as a teenager, she has a normal female voice, and wherever she goes, the average person just sees a normal woman. She didn’t have to spend a single dime on facial feminisation surgery, and also seems to have fairly standard straight female sexuality (no complaints about anorgasmia) as opposed to the weird fetishistic oversexualised behaviour some later transitioners have.

Without going into any studies or the difficulty of distinguishing persistence vs desistance rates, it’s unarguable that early transitioners just fit in better in society and have less chance of being perceived as “freaks” in public based on their appearance. I don’t know if that quality of life upgrade is taken into account in any studies, but that’s enough for me to support them in a broad strokes fashion, even if I don’t necessarily agree with all the details of the modern clinical practices.

What you are saying is true, but incomplete. If someone were certain to transition, it is unarguably true that it is better for them to begin pre-puberty and be in the puberty blockers -> transition pipeline. But the important word there is if.

That is because, if someone can be happy in the body they were born in, it is also unarguably true that they be so, rather than transition at any age. Your second trans friend is certainly in a better position than your first, but even so, she has had major, irreversible chemical intervention and surgery, which has left her infertile, and unable to participate in traditional family formation. She will be on medication for the rest of her life. and, of course, even as a trans woman who passes well, she will still be subject to social stigma in some form or another for being trans. Her marriage pool, for example, will be tiny.

So the real question is: what proportion of those who transition as children would have -if prevented- either transitioned later or lived a miserable life as their birth sex? That's a counterfactual, so we can't know for sure. But, if that number is lower than 90% (so 10% would have been satisfied to live as their birth sex) , then that's a false positive rate that is probably not justifiable. However, desistance studies indicate that number could be as low as 20%. I think it plausible that there are psychological interventions that could bring that number into the low single digit percentages.

How would you feel if there were a 4 in 5 chance that your trans friend could have lived happily as a normal man?

What you are saying is true, but incomplete. If someone were certain to transition, it is unarguably true that it is better for them to begin pre-puberty and be in the puberty blockers -> transition pipeline. But the important word there is if.

To pick a nit, that's nit necessarily true. It might turn out that early puberty blockade causes issues later on (say, early onset osteoporosis and/or dementia) that the patient might in hindsight decide weren't worth the benefits of better looks while young.

That's another "if" on my part, of course, but just wanted to point out it's not unarguable.

Historical eunuchs who were castrated pre-puberty had remarkably increased lifespans (and that’s with no sex hormones, having estrogen in your system would decrease the odds of osteoporosis), so if there’s major health issues arising from puberty blockers, it would be a side effect of the particular medications, not of blocking puberty itself.

There’s also a difference between the compromise protocol of “go on puberty blockers until age 16, then start estrogen/testosterone”, and “start HRT ASAP to go through cross-sex puberty at a normal age”. The whole point of the former was to let the minor have time to decide if they want to transition or not, but that seems to have been lost in the debate.

Ok, but did historic eunuchs actually have increased lifespans or did they have higher lifespans than the low baselines of premodern societies? The latter could easily be explained by court bureaucrats having higher life expectancies than either conventional elites who need to risk childbirth and combat or commoners who, well, farming is ludicrously dangerous even today?

Here’s a LessWrong article that goes in depth about this slightly bizarre topic. It’s pretty much certain that castration makes you less likely to die from infectious diseases, cardiovascular disease, and (obviously) testicular and prostate cancer, and the benefits decrease the later it’s done.

Historical eunuchs who were castrated pre-puberty had remarkably increased lifespans (and that’s with no sex hormones, having estrogen in your system would decrease the odds of osteoporosis),

On one hand - good point, I think I was researching eunuchs at some point for a point of comparison, and came to similar conclusions. OTOH, bone density problems seem to be acknowledged by all the studies, and I've seen "what's up with all the canes" posts on trans forums. There's also questions of cancer risks, ovarian cysts, etc. etc. I don't know if the question has a simple answer.

The whole point of the former was to let the minor have time to decide if they want to transition or not, but that seems to have been lost in the debate.

Not quite. The original rationale for puberty blockers was passing, "time to choose" was a marketing strategy. It has been lost to debate when the reversibility of blockers became dubious / indefensible.

I’ve never heard “what’s up with all the canes” despite being pretty active in trans communities (I actually don’t know anybody that uses a cane or crutch), although I’m seeing that canes are popular in the broader American queer community for some reason? I do know that various disorders are more common among trans people (e.g. endometriosis, PCOS in FtMs, EDS in general) but they’re not related to puberty blockers. Delaying puberty for too long without any sex hormones is bad for bone health, that’s for sure.

Not quite. The original rationale for puberty blockers was passing, "time to choose" was a marketing strategy. It has been lost to debate when the reversibility of blockers became dubious / indefensible.

To have the best chance of passing, you should skip the 2 years of puberty blocker and just go straight into opposite-sex HRT. Once you are on estrogen or testosterone, you’re not at a higher risk of osteoporosis than cis women/men respectively, and it’s conceivable your risk could actually be lower than someone who goes through menopause. Trans women that are on only puberty blockers for a while will actually grow taller and have a barrel-like chest (the classic eunuch physique), even if they avoid masculinisation.

I’ve never heard “what’s up with all the canes” despite being pretty active in trans communities (I actually don’t know anybody that uses a cane or crutch), although I’m seeing that canes are popular in the broader American queer community for some reason?

I'm confused. By the time you reach the end of the sentence, you seem to confirm what I've said. I suppose what you mean is that the queer community in your locality has not been affected by that particular thing?

To have the best chance of passing, you should skip the 2 years of puberty blocker and just go straight into opposite-sex HRT.

I will, once again, have to comb through the 7 zillion hours of podcasts I listened to for a source, but I solemnly swear that the original rationale for puberty blockers was passing. Even if, after some experimentation, it turned out that you get better results with just going directly to hormones, I swear that this was the original rationale, as per the Dutch researchers who kicked off the trend. This will probably take longer than the other search, but I'm planting a flag here, and I will also get back to you once I found it, or have tapped out.

I accept your nit, but barring any massive unforseen consequence (e.g. common early onset alzheimers) I don't think it changes the calculus much. If you told me I had to be a trans woman, I would choose to be a pre-pubescent transitioner ten times out of ten.

I think I'd take some weird looks over having to walk with a cane before I even turn 30

no complaints about anorgasmia

You have specific detailed knowledge of their ability to orgasm? Other than myself and my wife I don't specifically know if anyone else can or cannot orgasm.

It's the same reason bodybuilders who take Gear can't get the airplane up.

Wait, really? I thought the whole point was to fly to exotic locations.

More plates = more dates dudes asking you about your training regimen

(no complaints about anorgasmia)

How would you even go about complaining about missing something you have no concept of? Orgasm is a pretty distinct thing with no real equivalence to anything you may experience earlier.

Here's a comment from then WPATH president.

“I’m unaware of an individual claiming ability to orgasm when they were blocked at Tanner 2.” Tanner stage 2 is the beginning of puberty. It can be as young as nine in girls.

I meant that she doesn’t have anorgasmia (having started puberty blockers at 14 or 15 IIRC). But in any case you can delay the puberty blockers until tanner stage 3 or 4, or use local testosterone gel on specific areas.

I know adult cis women who never had an orgasm and that are quite unhappy about it. From a cursory search it’s around 10% of women? It’s pretty easy to talk and read about it and feel like you’re missing out.

I know adult cis women who never had an orgasm and that are quite unhappy about it.

What, not even these Womanizer/Satisfyer pressure wave vibes can get them off? From what I've heard, they usually work so well the experience is almost clinical in its efficiency.

Without going into any studies or the difficulty of distinguishing persistence vs desistance rates, it’s unarguable that early transitioners just fit in better in society and have less chance of being perceived as “freaks” in public based on their appearance.

That is the genuine problem for which I do have sympathy. However, the extreme cases around transgender issues and the activist rhetoric about "not owing anyone femininity" (which seems to translate to "keeping your feminine penis and testicles and your beard") make it difficult to maintain that sympathy, as well as the push for "so this means that nine year olds should be started on the transition path because of course every child who has concerns and problems around facing into puberty is trans and not at all perhaps suffering from different anxieties and problems that need to be addressed by therapy but don't mean telling them 'it's because you're really a girl or a boy, not a boy or a girl'".

Jesse Singal gets absolutely slaughtered on Bluesky for being a Nazi fascist supporter of trans genocide for being a conventional liberal who is positive on socially liberal issues but has concerns around the whole transitioning of kids and expressed such qualms. It's a genuine question of "when should you start medical - which means puberty blockers and hormones - transitioning versus social transitioning", because going too early does involve other problems later on, but if you are not 100% behind "this never happens and if it does, it's a good thing" then you are a trans genocider.

Anxiety around starting puberty does not need therapy, though. People have had it since time immemorial. It needs talking with the same sex parent. It does not need to be taken as a serious objection.

It does not need to be taken as a serious objection.

But the well-meaning (to be as charitable as I can) jump on it as indicating dysphoria which means "this child is trans" and then we get the "if not allowed to transition, they will commit suicide"

Puberty and Gender Incongruence
• There can be huge psychological stress: self-harm/suicidal ideation due to incongruence between the developing body and internal feelings and body image; e.g. periods/breasts developing or facial hair/deepening voice etc...
• Additional stressors of bullying and possible family rejection
• Young people often disclose around this age, as their bodies are developing and feeling ‘different’ to the way they feel inside. This can lead to co-occurring mental health difficulties, with suicidal ideation and self-harm (Mayock et al. 2009; McNeill et al., 2013). Eating disorders with over/under eating and also young people not wanting to use the bathroom.

and schools doing things like hiding from parents that their child is socially transitioning on the rationale that "parents not supporting their trans child is abuse", though that seems to be changing at least as far as official policy is concerned due to protests and backlash:

Communicating With Families
It is still important for schools to maintain positive communication and working relationships with family members. A consortium of LGBTQ advocacy groups and educational associations produced a guide for Colorado educators that includes the following advice about working with families:

“When contacting parents or guardians of a transgender or gender nonconforming student, school personnel should use the student’s legal name and the pronoun corresponding to the student’s gender assigned at birth unless the student, parents, and or guardian has indicated otherwise... In some cases, notifying parents of the student carries risk, such as being kicked out of the home or experiencing rejection from their family. Prior to notification of the family, school staff should work closely with the student and consider the health, well-being, and safety of the student.”

Detailed guidance from the Massachusetts Department of Education also offers helpful considerations in communicating with families, particularly when a student is the target of bullying and harassment:

“School officials should use their discretion in discussing the incident and avoid sharing information that might endanger the mental or physical health and safety of the student. Where the student has not disclosed his or her sexual orientation or gender identity, expression, to his or her parents and the student believes he or she may be at risk if it is disclosed, to the extent possible, discussion should focus on facts regarding the student's involvement as a target or aggressor and on safety planning, not on information that reveals the actual or perceived gender identity or sexual orientation of the student. As in all bullying incidents, school officials should offer resources and support to the student and family.”

Sure, I was taught that if I needed to talk about puberty I could go to my parents or maybe grandparents, but to only ask my doctor straightforward physical health questions and to not bother teachers, coaches, etc with such things at all.

This seems normal politeness and boundaries and not new-style paranoia to me(after all, it would never have occurred to my parents that doctors could turn me trans- it was simply assumed that anxiety about new feelings was impolite to discuss with them). My parents did, in fact, brush off my discomfort with starting puberty and I turned out fine. The need for conversion therapy wasn’t anticipatable-seeming and it did, in any case, work.

What are the actual requirements for getting prescribed puberty blockers?

I think there's a lot of clinical discretion so it varies. I remember reading news articles about some prescribing them after a single appointment that you could try to look up, and here's an extreme example in Canada from a couple years back, where the "Gender Pathways Service" advises family doctors on prescribing them before a single appointment with a specialist:

“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.”

Children’s Hospital, London, Ontario.

If they're willing to do that presumably they are also willing to hand them out readily themselves.

What are the probabilities of serious consequences from puberty blockers?

Copy-pasting the last comment I wrote regarding the state of the evidence for puberty blockers:

Puberty blockers both lock children onto the transgender pathway (making them largely equivalent to prescribing HRT in actual outcome) and have very serious and poorly-studied medical consequences of their own, including potential damage to brain development. In children the "watchful waiting" approach used to be standard, meaning the children were not given any "gender-affirming" medical or social intervention, just treatment for whatever other psychological issues they had. Did they continue to want to transition into adulthood or did their gender dysphoria desist on its own? Some studies on this were conducted, and according to this meta-study and this blog post the desistence rates they found ranged from 61% to 98%. If you just add the figures from the studies listed in the linked study it would be an overall desistence rate of 85%, or 80% for the studies listed in the linked blog post. By contrast 97% of children put on puberty blockers go on to take hormones (page 38). The lack of any randomized control study makes it difficult to be sure, but this seems indicative of a very strong "lock-in" effect.

The lock-in from social transition also seems very strong even for children not on puberty blockers (and may be a large part of the lock-in associated with puberty blockers), with this study finding the persistence rate of "binary transgender identity" to be 94% 5 years after social transition. The study mentions that persistence was less common for children that were transitioned before the age of 6, which significantly affects the results because they were 124 of the 317 children in their study, but still 90.3% compared to 96.4% for those 6 or older. 5 years isn't really long enough to know long-term desistence of course, but the explosion in rates is recent enough that it would be difficult to do much longer.

Meanwhile regarding the side-effects of puberty-blockers themselves there is very little high-quality evidence (e.g. randomized control trials in humans that track the things you want them to track), and essentially none for using them to avert puberty entirely rather than stop precocious-puberty for a few years. But this randomized study in sheep seems to indicate permanent damage to brain development:

The long-term spatial memory performance of GnRHa-Recovery rams remained reduced (P < 0.05, 1.5-fold slower) after discontinuation of GnRHa, compared to Controls. This result suggests that the time at which puberty normally occurs may represent a critical period of hippocampal plasticity. Perturbing normal hippocampal formation in this peripubertal period may also have long lasting effects on other brain areas and aspects of cognitive function.

In humans the best we have seems to be this study in which a 3-year course of puberty blockers in girls with precocious puberty is associated with a 7-point reduction in IQ from what they scored before beginning the puberty blockers. However without a randomized control trial and/or a longer-term followup it is difficult to know if this is meaningful, which is why I mentioned the sheep study first.

The NHS's independent review mentions a similar concern:

A further concern is that adolescent sex hormone surges may trigger the opening of a critical period for experience-dependent rewiring of neural circuits underlying executive function (i.e. maturation of the part of the brain concerned with planning, decision making and judgement). If this is the case, brain maturation may be temporarily or permanently disrupted by puberty blockers, which could have significant impact on the ability to make complex risk-laden decisions, as well as possible longer-term neuropsychological consequences. To date, there has been very limited research on the short-, medium- or longer-term impact of puberty blockers on neurocognitive development.

This all seems completely backwards and the opposite of the precautionary principle. A treatment as far-reaching and poorly-understood as preventing puberty should not be adopted as standard practice without conducting the research required to know if it is safe and effective. It should not be critics of the treatment looking through sheep studies and comparing desistence rates between different studies to find indications that it causes brain damage and treats gender dysphoria worse than doing nothing. It should be advocates having to do randomized control trials showing it actually improves outcomes relative to no treatment and that the damage to brain/bones/etc. is minor enough to be worth it. (In the U.S. it doesn't have to pass FDA approval because it's an off-label usage of drugs approved for precocious puberty. Unsurprisingly the trials conducted for that have little relevance to the way it is used for gender dysphoria, and frankly seem pretty questionable even for precocious puberty.) Instead it might be difficult or impossible to get ethics approval for such a study, since you're denying a now-standard treatment, particularly if you actually do it properly by advising your control group to not socially transition either. Since Sweden, Finland, Norway and the UK have in recent years advised against most or all usage of puberty blockers to treat gender dysphoria, hopefully someone in one of those countries will be able to conduct a proper randomized control trial?

It’s tough, but I don’t think RCTs are possible. Despite obviously how helpful they would be. They require you to randomize treatment, and not only is blinding difficult or impossible, at its core for an RCT to even occur you need parents and teen subjects BOTH who are willing to give up the choice entirely to chance! That is, if you’re assigned to a transition group or not, neither the parent nor child can have a veto, or it ruins makes random assignment useless. I don’t know anyone who would be comfortable doing that, do you?

That's why I suggest doing them in one of the countries that no longer recommends puberty-blockers - the choice would be between a 50% shot at blockers as part of the study or a ~0% shot as part of the general public. Theoretically some could go doctor-shopping internationally, but hopefully not enough to ruin the study. An unblinded RCT would still be a huge step up from the evidence we have now.

the choice would be between a 50% shot at blockers

This will never happen, even if tried, these days you can get your bathtub Estradiol from Discord weirdoes (shout out to Keffals) or straight from India/China. A determined teen with a 50% legit chance would definitely supliment themselves to ensure their chosen outcome.

In humans the best we have seems to be this study in which a 3-year course of puberty blockers in girls with precocious puberty is associated with a 7-point reduction in IQ from what they scored before beginning the puberty blockers.

I think that would be hard to disentangle from "are there associated problems with precocious puberty that affect the brain?" since presumably the IQ tests happened before the precocious puberty set in which is when the puberty blockers would be needed. I think that if the wiring for when puberty should begin is so mistimed, it wouldn't be surprising if other problems came to the fore as well.

If the cause can be traced to the hypothalamus or pituitary, the cause is considered central. Other names for this type are complete or true precocious puberty.

Causes of central precocious puberty can include:

  • hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH)
  • Langerhans cell histiocytosis
  • McCune–Albright syndrome

Central precocious puberty can also be caused by brain tumors, infection (most commonly tuberculous meningitis, especially in developing countries), trauma, hydrocephalus, and Angelman syndrome. Precocious puberty is associated with advancement in bone age, which leads to early fusion of epiphyses, thus resulting in reduced final height and short stature.

Those sorts of concerns are why I emphasized the sheep RCT more despite it being in sheep. Unfortunately this is the state of the evidence regarding puberty blockers.

Though regarding your specific suggestion the IQ test was conducted as part of the puberty-blockers study, so they would already have some symptoms of precocious puberty. The study actually speculates that the early puberty was boosting performance relative to other children the same age and the drop was the result of stopping it (which is itself a concerning idea regarding using puberty blockers to stop puberty entirely):

The results on IQ measurements in children with precocious puberty showed elevated scores, with higher verbal than performance scores, and this was interpreted as a possible effect of sex steroids, especially on the left hemisphere (4, 30). The initial total IQ score in this group was not different from normal—comparable with the data of Xhrouet-Heinrichs et al. (4)—and a decrease of about 7 points was observed during the treatment period. Although significant, doubts exist about the clinical relevance of this decrease. One hypothesis for the decrease in verbal IQ scores is that withdrawal of exposure of the brain to sex steroids brings the child back into a more age-appropriate IQ range. The lower verbal scores in this group, which was in contrast to results in girls with central precocious puberty, could be explained by the adoption status of the children; as in other children from foreign backgrounds, it is known that verbal intelligence is lower than in children born in their own country. In primary school, mathematics, which is part of verbal IQ, was problematic in adopted children, especially in boys. The authors concluded that a deficient development of visual–spatial organization and, to a lesser extent, poorer concentration, may be due to the lower achievements in mathematics rather than to intelligence or fluency.

Who knows if this is meaningful at all though, it's speculative and sounds pretty dubious to me.

It's hard to know, since clearly suffering from precocious puberty means a problem with the entire system so the effects of that on the brain are going to be hard to tease out from "and then we put them on blockers".

How well sheep studies relate to humans is also hard to know, who was the last sheep to attend Harvard?

The study actually speculates that the early puberty was boosting performance relative to other children the same age

I can definitely tell you this is true, girls get their puberty relatively earlier than their age-peer boys and act/behave more mature, from that you get more conscientiousness and a whole slew of other brain alterations.

Top quality comment, you put a lot of work into this. Yes, during my argument, it was seriously proposed that there wasn't any real difference in health outcomes between the usage of blockers for precocious puberty and the usage of blockers for gender affirming care purposes, since you're blocking puberty either way. I actually didn't know that that's the actual medical reasoning, that's insane. Blocking puberty to get it to happen at the right time is a much different case than blocking puberty from happening at the right time. The advocates should be the ones doing the work, and things would not have progressed this far if they were. There also would not be nearly so many advocates in that case.

That's the argument that annoys me in the same way as when "but intersex people!" is used. A case where puberty is gone wrong and needs medical intervention to be halted is not the same thing as normal puberty, in the same way as a syndrome where there is an intersex condition is not the same thing as normal development of primary and secondary sexual characteristics.

it's trivially true that social contagion plays an astounding part, as well as fetishism and abuse, and autism

I don't have any hard numbers to give you here, but one of the strongest pieces of evidence for me personally about transness mot being an inherent part of who you are is the autism->hyper-sexualized autogynephilia pipeline. Specifically a certain field of technology that I have closely followed for about 30 years is the biggest source of evidence for this: video game emulator development. Emulator developers aren't inherently always destined to be trannies, but the more talented they are the more likely they are to be a tranny (and/or a furry and/or all sorts of paraphilias generally).

Name the lead devs of a successful emulator (i.e. high accuracy and/or amazing performance) and in 80% of cases I can find lurid details of their weird fetishes for you. Off the top of my head Byuu/Near (SNES amongst others), Endrift (GBA amongst others), and the guy who made MelonDS (can't be bothered to look him up) are all trannies. Basically everyone on the Dolphin (Gamecube/Wii emulator) team are notorious sexual deviants. One of the only devs of a successful emulator I can't find anything about is SourMesen (dev of Mesen, a great NES emulator). He seems smart enough to not get involved in personal drama on the internet at least.

And this goes beyond just emulation, the sortsof people who get hyper into low level coding/hardware/hacking stuff tend to be deviants too, emulator devs just seem to be one of the most purely distilled examples of this tendency.

My experience with these sorts of people has probably been the strongest blocker for me accepting the trans lobby's claims regarding the nature of transness, potentially even a stronger blocker than my religious beliefs. Their claims just don't match with a much more obvious connection to me: turbo-autism leading to sexual devisncy including AGP.

As a funny add-on: a photo of core Rust (programming language) contributors celebrating the 10th anniversary of the language launch: https://blog.rust-lang.org/2025/05/15/Rust-1.87.0/

I have observed the same thing and I also think that the trans phenomenon is clearly one of social contagion, but I think your particular argument is very weak, practically self-defeating. Autism is generally understood to be an in-born condition of biological/genetic origin, and transgender activists would typically argue that they're the same way. A correlation between these conditions is exactly the kind of thing they'd predict.

It's much clearer to observe the spread of trans stuff through a community, how insular and tight-knit communities wind up disproportionately transgender through cultish dynamics and the memetic equivalent of the founder effect.

The problem is they are doing one of the single most strongly male-coded things in existence, up there with working on boilers etc. That the best people in a field that is essentially 100% male (I've literally never heard of any female emulator devs despite following the scene for decades) would claim they're actually female in their brains is the strongest evidence against it being real that I can imagine.

Edit: When I tried to search Google for female emulator developers the only relevant result I got was for a tranny working on Dolphin that committed suicide. I'd be surprised if the female:male ratio that have even written a simple CHIP-8 emulator, let alone something more complicated and technical, is more than 1:100000

I mean ‘taking agency to reinvent yourself rather than going along with societal expectations’ is also very male coded.

but the fighting was just as vicious as anything else with the gender issue.

I'm shocked that you'd expect anything else.
This issue is derived from instinctual gender politics; follow the money.

It is to the advantage of old women that two things be true:

  • Young women are as ugly as old women, to eliminate their competitive advantage
  • Men are as much good little worker bees as possible with as little demand for pregnancy-causing sex as possible (castration is a proven method to achieve this; ask the Chinese about their eunuchs and the Arabs about their slaves)

Furthermore, old women have significantly more sociopolitical power than they did 50 years ago compared to everyone else.

So, what do we see? We see old women pushing hard on "encourage young women to destroy their sexual appeal to young men", for when attractive women are scarcer, men pay more[1] for inferior sex. Additionally, we see pushes for "the only safe man is a man who is either uninterested in sex with women, or if still interested in women, unable to cause real harm to them"[2].

Encouraging homosexuality, then transgenderism, is the way that is done- the end result of both is a social token that old women can hold up about Fighting Oppression(tm), and less competition. The fact that it destroys young men and women is not a concern to biological dead-ends (a fact said old women are extremely resentful of), forming a perfect moral hazard.

Is there any actual scientific evidence in favor of social contagion playing any part in transgenderism?

Other than Noticing it's always the mom? The more female-dominated the profession is, the more obsessed with transgenderism it is- I think this is the reason why.

This is [one way] women sexually abuse children. Men don't really understand it and aren't equipped to fight it (the conditions of reality- that being without them, women don't eat- haven't forced them to evolve a defense against this; now that automation has made it so women are on equal footing with men, these problems emerge), but the motive and the result, at the end of the day, is abusive[3].

Now, that all having been said, is transgenderism a real thing? I think so (ask the older pre-Third Wave Feminism examples about it), and puberty blockers/hormones might be our best response for that condition at this time. But much like our other "best answers" that psychology has given us listed downthread, it's also extremely destructive, and it's complicated by the institutions responsible for identifying it all being dominated by the gender most likely to abuse children in this way.

There's really no way out of this hole that has been created.

There is, and it's being followed. Because the faction currently pushing for puberty blockers and transgenderism to be a solution to everything is also the only one that the concept of "consent" serves (per the above: punishing men for sex with younger women that they actually want = more power for older women), sanctioning any woman who speaks of transgenderism to anyone under the age of "consent" is only fair... which is why laws are, though slowly and clumsily (re: Don't Say Gay), moving in that direction.

[1] Instincts are just brute force, and can't adjust for men having anything better to do- these days, men have plenty of other options, so the [sexual] market shortfall is hidden.

[2] The fact this (one or more of "sexual herbivorism", effeminate homosexuality, chemical interference) generally makes them worse at harming hostile men is not something women need to care about- if all their tribe's men are killed in war because they were unable or unwilling to dominate their own women, they still have inherent value to enemy men and will generally be treated well. Women even have instincts for accepting being carried off; they don't have a similar instinct for making sure their sons or daughters grow up to be attractive (men do, to a point).

[3] "But they enjoyed it/it actually had a positive outcome" is an excuse men use when they use their social station to abuse children, but not one we accept from them. Why should we accept it from women?

Psychology itself isn’t that rigorous, and especially if you’re dealing entirely with self-reported phenomena, it’s not particularly good at skepticism. If I go complaining of feeling sad for several weeks I can get diagnosed with depression. If you go in claiming to lose stuff a lot (whatever you personally consider “a lot”) you can get diagnosed with ADHD. As such I tend to be skeptical of trans diagnosis simply from my experience of being diagnosed adhd — it took ten minutes and I didn’t even go in seeking a diagnosis.

Which also becomes a problem when the symptoms of these disorders are known. People want to be diagnosed, and with helpful checklists, they know what to say to get that. Kids who want to be trans know what to say to the shrink before the first session. And there’s a good chance that a psychiatrist isn’t going to look into whether the person is lying or exaggerating symptoms. There are no fake symptoms that people think are true of trans people but aren’t.

As far as social contagion, I think it’s just like anything else. Most teens crave acceptance and if you’re vulnerable, being told that some trait is desirable they’ll at least fake it to fit in or be cool. And there are examples all over TikTok of kids faking all kinds of mental illnesses up to and including having multiple personalities. It seems like it would be weird if this is the one illness nobody fakes, especially when much of our culture celebrates it as the cool disorder.

As such I tend to be skeptical of trans diagnosis simply from my experience of being diagnosed adhd — it took ten minutes and I didn’t even go in seeking a diagnosis.

Really? I thought it was very hard to get an ADHD diagnosis, especially as an adult.

Really? I thought it was very hard to get an ADHD diagnosis, especially as an adult.

Massively depends on the country in question. I've been trying to get ADHD medication for over 2 years in Eastern Europe with no success so far.

There are two perverse inscentive to get you slapped with ADHD, get you out the door faster and kickbacks for prescriptions (which are apparently 100% legal)

And that isn’t true for a population that will need lots of surgery, hormones for life, and lots of follow up care? I mean, if anything, those same incentives are more present in trans populations who spend thousands on medical treatments overa decade.

In the US, it definitely isn’t.

I think the most important parts of a social contagion are that it's self-replicating, and that it contains some form of error correction to prevent its core payload from mutating beyond all recognition. In my opinion there is one obvious existing social contagion, Christianity. The primary function of Christianity is to perpetuate itself through evangelism. It also has error-checking capability to prevent its core payload (the holy trinity, etc) from mutating too much, but beyond that it adapts to fit in every culture and every corner of the world. Note that this isn't true of most other religions - many don't even want to perpetuate themselves beyond their own original culture. I think it's also reasonable to argue that wokeness a social contagion, since conversion through guilt-tripping seems to be a major component of the woke doctrine. However, the woke doctrine itself is not very well-preserved as wokeness reproduces itself, since wokeness is not a formal religion. Different woke people can have radically different beliefs, much more so than different sects of christianity, which still agree on 99% of their doctrine. I would argue that JK Rowling herself is part of woke culture - she is a radical feminist who believes in male privilege, and votes left on basically every issue other than transgenderism. Most of her criticisms of transgenderism are based on woke identity politics (women need safe spaces, men are evil raping oppressors, blah blah)

But I think transgenderism itself is fairly inert. People do decide to transition by witnessing other people transitioning, true. But there isn't always an ideological component. Some people just want to change their physiological sex characteristics to the extent possible. Imagine the counterfactual, that nobody wanted to change their biological sex. That would be pretty weird if everyone just happened to be totally satisfied with the results of a coinflip at their conception. People want to change all kinds of things about themselves, why not sex as well? I think a world where everyone was fine with their biological sex would actually require a mental gender identity. Somehow the brain would have to be adapted to prefer being in a body with the correct biological sex characteristics.

So the question is whether our observations of approximately 1% of people choosing to mess around with their physiological sex characteristics is more consistent with a social contagion containing that goal, or with some people just inherently wanting to do that, and social restrictions being lifted in the last few decades.

It’s not ideological for the kids involved. But it is a way for ostracized kids to find some measure of acceptance and even celebration as they decide to transition. Which would feel better to a boy who doesn’t fit in at all with the other boys? Grow up to be a lonely male incel hikkimori, doomed for life, or be trans female and find some measure of acceptance by wider society, a new, somewhat trendy identity. People choose all kinds of identities that don’t fit them perfectly for the purpose of fitting in. Goths, various fandoms, music scenes, sports, you name it. Humans are social animals that naturally want to be high in the social hierarchy. It’s not really that weird to think that if there’s social capital in being trans there would be kids willing to at least socially transition. The alternative is being an outcast.

I dislike the phrase "social contagion", which assumes that being trans is a negative and it's bad for it to spread. This negative connotation is, I think, what causes people to deny the obvious when they might not if the question were phrased differently. Is dyeing your hair a "social contagion"? Tattoos? The latest slang, the latest fashion? People will trivially be more likely adopt all these things if they know they're on the table, and even more so if they're popular. "People will be more likely to develop a desire to change genders if they know it's a commonly-done thing" is common sense, and I don't think "the pro-trans tribe" would deny it if the name people used for it wasn't something which implies it's a nefarious process that needs to be halted.

(Mind you, I do think we use puberty blockers on minors too cavalierly. But Rowling is not a good champion for that narrow, sensible point when she is clearly against social transition, and all forms of adult transition, as well.)

I dislike the phrase "social contagion", which assumes that being trans is a negative and it's bad for it to spread.

I think the phrase came into being due to the recent increase in female-to-male identification, where up till then it had been majority male-to-female transition:

Earlier this year, a team of NHS researchers was asked to investigate why there has been such a huge rise in the number of adolescent biological girls seeking referrals to gender clinics.

The figures alone do seem remarkable.

According to a study commissioned by NHS England, 10 years ago there were just under 250 referrals, most of them boys, to the Gender Identity Development Service (Gids), run by the Tavistock and Portman NHS foundation trust in London.

Last year, there were more than 5,000, which was twice the number in the previous year. And the largest group, about two-thirds, now consisted of “birth-registered females first presenting in adolescence with gender-related distress”, the report said.

And increasingly younger women, and teenage girls being vulnerable to precisely this sort of social contagion (see conversion disorders and examples of mass hysteria spreading amongst teen girl populations in enclosed or tightly knit social circles). The Loudun possessions is perhaps the most well-known example of such an outbreak, in a convent in the 17th century.

An article about a movie from 2015 about a fictional incident quotes the film-maker as inspired thusly:

The idea for the film, documentary maker Morley explains, "came to me over a decade ago, when a friend and I ended up in bursts of hysterical laughter on the phone.

"I ended up making a short film, called The Madness of the Dance, about mass hysteria, or mass psychogenic illness, as it's now known.

"It's documented in medieval times and there was an outbreak in Salem, New England, which helped lead to the famous witch trials of the 17th Century.

"They are usually confined to same-sex institutions such as convents, schools or army barracks - and it is overwhelmingly a female phenomenon.

"Most recently they seem to break out in schools, and there have been cases all over the world - from Mexico to Sri Lanka to the West Bank.

"That idea of female collectivity, of what can happen amongst a close-knit group of girls or women, is fascinating to me.

"I found that while there are set patterns that are used to identify a mass psychogenic outbreak, medics can't yet entirely understand the physical symptoms. It's steeped in mystery.

"There's a theory that they are to do with unconsciously admiring another person with symptoms and this is how the disorder spreads, or that it's triggered by a stressful event.

"That gave me the whole idea for The Falling."

I think you misunderstood my post. I do not deny that there is a social spread of transgender. That's obvious. I object to the phrase "social contagion" because it implies that this spread is a bad thing we ought to stop, as opposed to a value-neutral - or even beneficial! - social trend like any other. I object to it for the same reason I might have objected, decades ago, to "there is a satanic plot to corrupt children into playing Dungeons & Dragons". Doubtless there were indeed marketing experts working very hard to convince more children to play Dungeons & Dragons! That is not in doubt! But playing Dungeons & Dragons isn't witchcraft and being transgender isn't a horrible disease, therefore the one is not satanic corruption and the other is not contagion. They're just neat activities propagating through populations that find them to be fun ways to spend their lives.

Are we really going to pretend that the lifetime outcome changes of taking drugs that massively and irreversibly alter your body and playing a tabletop RPG are anywhere near the same?

What's next, you're going to argue that methheads are just trying to have fun?

But Rowling is not a good champion for that narrow, sensible point when she is clearly against social transition, and all forms of adult transition, as well.

Is she? Maybe she is now, after the campaigns against her by such as Gretchen Felker-Martin but it started out with what to me was the mild and reasonable position of "hey, maybe people with penises should not be in the same spaces as people who have been hurt by people with penises" and then it all exploded.

So if you're going to be called a fascist genocidal TERF and you have more money than God, why not lean into it and go "okay, I really don't agree with this stuff"?

I don't necessarily mean that she thinks social transitioning minors should be against the law, or that she wants all adult trans people rounded up in the streets. But it seems pretty clear that she's, like, not in favor. All else being equal she would rather there be fewer trans people in the world; she wouldn't want any children of hers to transition; etc. I think it's fair to describe this as being "against" social transition & adult medical transition even if she's tolerant of them despite her disapproval.

I would assume practically everyone would wish there were fewer trans people in the world, same as they'd wish there were fewer people with any unfortunate condition. Having your body disagree with you is worse than not having that be the case.

Not all trans people find that their body "disagrees" with them, and even those who do often celebrate their transness, eg this popular quote.

That's an incredible cope and makes a mockery of the claims that trans people need recognition and support or will face risks of mental health and suicide. In the counterfactual world where they were cis they could have found meaning is better ways. You can justify practically any bad thing with this framing. Should we praise and no prevent child abuse because it allows one to overcome it? Cripple children so that they invent new modes of locomotion? Genuinely absurd.

I'm sorry but "you don't need dysphoria to be trans" is an extremely mainstream position among leftists.

And it remains a silly thing to believe while also demanding resources and concessions from the rest of society. If there is nothing to the claim but a preference, an extreme form of self crippling tattoo, then we are certainly not giving minors access to it, we are certainly not bending over backwards to allow people with a sports league preference, we are certainly not paying for this tattoo with a substantial amount of my tax dollars. I believe enough in freedom of form that people should be allowed to whatever they want to their own bodies but if what they're doing is for preference they owe it to the rest of us not to do harm in their pursuits.

I dislike the phrase "social contagion", which assumes that being trans is a negative and it's bad for it to spread.

You have this backward, I think--the phrase social contagion emerges from the conclusion, not the other way around. The phrase "social contagion" refers specifically to the vector for an illness. If we accept the "mental illness" model of psychology, then mental illness that spreads via social exposure is a "social contagion." To the best of my understanding, it is pretty well established that e.g. eating disorders exhibit social contagion. So, apparently, does suicide.

If gender dysphoria isn't an illness, then it's not a social contagion. But also: if gender dysphoria isn't an illness, then there's not really any good argument that insurance companies should be required to pay for treatment. (I know Scott Alexander has written about this, though to the best of my recollection he tends to be a bit allergic to drawing the obvious conclusions on trans issues, possibly because of his geographic bubble.) So gender dysphoria ends up in this weird superposition where trans advocates want it treated as an illness when that means they get money, but definitely not treated as an illness in any other context.

There are a variety of definitions out there for "mental illness" but the usual one is something like "a psychological condition that interferes with participation or satisfaction in ordinary, every day life." The standard goal of treatment is to eliminate that interference, but the sociological angle is that "ordinary, every day life" is a culturally constructed and often moving target. So yeah--dying your hair or getting a tattoo could indeed be a matter of "social contagion" if it interfered with everyday life--people who engage in extreme body modifications that make them mostly unemployable, for example, can probably even now be fairly described as suffering from a mental illness, possibly acquired through social contagion. But the more serious we are about pluralism, the harder it is to say what "ordinary, every day life" entails.

I don't think "the pro-trans tribe" would deny it if the name people used for it wasn't something which implies it's a nefarious process that needs to be halted.

The people who think transsexuality is (or is at least substantially) a matter of social contagion are generally agreed that it's a nefarious process that needs to be halted. Which, if it is a mental illness, seems like a fair assessment. Again, if it's not an illness, then related treatment is purely aesthetic, and very few people think health insurance or national health programs should cover body aesthetics (even when looking prettier seems likely to e.g. alleviate your depression).

But Rowling is not a good champion for that narrow, sensible point when she is clearly against social transition, and all forms of adult transition, as well.

Do you have a source for this? My understanding has long been that Rowling is totally fine with neopronouns, social transition, etc., and is indeed quite supportive of trans ideology in almost every context, far more so than e.g. a religious conservative. Rowling just doesn't think males should be permitted to compete against females in athletics, or placed in prison with them, or allowed into female-only shelters, or the like. Basically she has the classically feminist view that males, as a class, are dangerous to females, as a class, in ways that warrant giving certain unique recognition and advantages to females, which transsexuals born male are not; whether they are individually harmless is irrelevant to their continued membership in the suspect class. But if a male wants to put on some womanface and call himself Tina, Rowling seems happy to "yaass queen" him--just so long as he doesn't go flashing his penis in the girls' locker room.

If gender dysphoria isn't an illness, then it's not a social contagion. But also: if gender dysphoria isn't an illness, then there's not really any good argument that insurance companies should be required to pay for treatment.

I think the conventional way to thread that needle is that you can be transgender without having gender dysphoria (ie you have no morbidly negative feelings about your current gender, you just get gender euphoria from a switch). Thus, the spread of transgender itself is not the spread of a contagious illness; gender dysphoria simply develops organically in people who had become trans in the positive sense beforehand. If smoking becomes popular in a given population, lung cancer will rise, but "lung cancer is a social contagion" would be a rather odd way to put it; ditto "bone fractures are a social contagion" for a population that's gotten really into mountain-climbing lately.

That being said, if push comes to shove I think we should just bite the bullet that gender dysphoria isn't an illness. We just pretend it is because the government has yet to implement a decent UBI, so we unconvincingly pretend a transition budget is a natural part of healthcare. Perhaps we could see about creating separate transition grants, decoupled from health insurance? This is all pretty far out of the Overton Window, so we're stuck with the kludge. Still, internally, the trans movement takes it as implicit that you understand that much - that "transgender is a mental illness" is a convenient fiction for browbeating the government into giving money it wouldn't otherwise give, and shouldn't be taken as axiomatic in any other context.

But if a male wants to put on some womanface and call himself Tina, Rowling seems happy to "yaass queen" him

Sorry to reverse-uno you, but I'd like a source on that. I've never, ever seen Rowling say it's good to let minors transition or refer to a MTF as a woman. My read is, she might be socially liberal enough, in the true sense of the word, to tolerate social transition as a "live and let live" kind of deal, but she is still clearly against it in the sense that it wouldn't exist in her concept of an ideal world and she'd be very put off if any friends of hers transitioned.

Sorry to reverse-uno you, but I'd like a source on that.

...have you even bothered to look?

Here is Rowling's essay on the matter, published five years ago. Just one excerpt:

I want to be very clear here: I know transition will be a solution for some gender dysphoric people . . . Again and again I’ve been told to ‘just meet some trans people.’ I have: in addition to a few younger people, who were all adorable, I happen to know a self-described transsexual woman who’s older than I am and wonderful. Although she’s open about her past as a gay man, I’ve always found it hard to think of her as anything other than a woman, and I believe (and certainly hope) she’s completely happy to have transitioned.

This is a direct refutation of your "read" on Rowling, which you apparently never bothered to check. I would be very interested in a response from you detailing how you are now revising your priors, especially in connection with the credibility you will afford in the future to the sources of your misinformation on Rowling.

This is a direct refutation of your "read" on Rowling

No it isn't. I read the essay long ago, and it is entirely congruent with my read of Rowling as willing to tolerate transition in certain narrow cases, but not actually in favor of it. Even assuming Rowling is telling the truth about this trans woman she "happens to know" (has she come forward and offered comment? I wonder if we're talking about a friend of many years as opposed to someone she's met once at a friend of a friend's baby shower), the essay only makes room for transition as a "solution for some gender dysphoric people", not a life choice people are free to make for any reason. She explicitly endorses the view that "candidates for sex reassignment" should go through "a long and rigorous process of evaluation", which is to say, that some adults who want to transition shouldn't be allowed to.

Moreover, she only seems to even care about medical transition. "A man who intends to have no surgery and take no hormones may now secure himself a Gender Recognition Certificate and be a woman in the sight of the law", she writes, as if that were inherently beyond the pale. I'm sorry but those just aren't the words of someone who approves of social transition for anyone, let alone for minors. Granted, it's possible to approve of social transition without thinking it should be recognized by law - but someone who held that idiosyncratic view still wouldn't start that sentence with "a man".

And again it's not that I want to crucify her for this or anything, she's entitled to her views. But it makes her a poor champion for the specific cause of "all else aside, puberty blockers are medically hazardous", a case which would be better made by someone who enthusiastically endorsed social transition, and indeed a theoretical risk-free perfectly-reversible sex-change procedure, while cautioning that we should be much more careful about the medical implications of the imperfect options that exist today.

A man who intends to have no surgery and take no hormones may now secure himself a Gender Recognition Certificate and be a woman in the sight of the law", she writes, as if that were inherently beyond the pale.

Well, uh, yeah? Guy who is functionally a guy but gets off on having people call him "ma'am" and getting into women's spaces so he can parade around with his dick on show is beyond the pale. That includes "yes I've now been convicted of violent rape but I suddenly discovered my inner femininity so please put me in the women's jail not the men's jail" specimens.

There may well be "I call myself legally a woman but I'm functionally still a man" types who don't cause any harm or intend to do so, but they seem to be rare specimens. The "my legal identity is a woman but I'm a straight guy who has penis in vagina sex with women" on the other hand, do cause waves even if they maintain that their intentions were pure.

Let’s back up a second. Should we be using male or female pronouns with you? How do you identify?

I’m very neutral, like non-binary, although I don’t like that word. I’m legally female. But I have facial hair. I have a penis. I have no breasts. I don’t have a feminine voice. I don’t wear makeup or dress up like a female. So imagine you’re a grocery store [clerk] and you’re bagging my groceries and you say, “Excuse me, sir . . . ” I mean, am I supposed to be offended? That’d be ridiculous. How would this person know? But technically, for legal terms, I am she/her. I put "female" on my driver’s license. But I’ve had to struggle my whole life fitting into traditional society.

...Have you considered just changing clothes in a stall or wearing a bathing suit?

It’s not for me to adapt to society at this point. Even if it’s the polite thing to do or you want me to or there’s a controversy or whatever, if nobody else is using a shower curtain or nobody else is using a swimsuit, it’s illegal to try and make me do it. Technically, and from all perspectives, I am female, and everybody agrees with that. We’re all on equal grounds under the law.

Disapprove of my attitudes, that's your right, but if I'm in a women's changing room I don't want this guy walking around with his dingle-dangle out even if he has legal papers that he's a Real Woman.

Disapprove of my attitudes, that's your right

And it's yours to disapprove of mine! But no one with your or Rowling's attitudes can be said to be in favor of transition, which is what I sought to prove. At best they are extremely narrow transmedicalists.

You said that she's against it, not that she's unsupportive.

This is a direct refutation of your "read" on Rowling

No it isn't.

Remarkable how quickly you drop to a motte-and-bailey doctrine here. Here is what you said, emphasis added:

she is clearly against social transition, and all forms of adult transition, as well

Based on her own words, this is clearly false. Then, when I tried to correct you, you doubled down and asked me to be the one bringing evidence, instead of you. So I brought the evidence, and your response was to simply withdraw to a motte:

it is entirely congruent with my read of Rowling as willing to tolerate transition in certain narrow cases, but not actually in favor of it

I no longer regard you as engaging honestly in this conversation, so I guess that's the end of it.

I don't know what to tell you. I think it's perfectly possible to be against something while tolerating it. For example, I would describe myself as "against religion", but I tolerate religious people, and I am willing to allow that for some people, they're probably happier for being religious than they would otherwise be. Nothing you have shown me disproves the idea that Rowling is against transition in this sense. And you certainly haven't proven her to be in favor of it in the sense that I argued would be necessary for a fitting advocate of the narrow puberty-blockers issue, which was my core point, not whatever semantic games about what it means to be "against" something.

If you want to totally evacuate the concept of Gender Dysphoria from this conversation, which I still feel is relevant and important, fair enough, but then the thing this becomes most analogous to is drug use, which, yes, is socially contagious and massively detrimental to your health. And sure enough, we don't let kids do drugs. Hell in theory we don't even let adults.

Now if we put the medicalism back in, having GD fucking sucks balls and I wouldn't wish that on my worst enemy. Anything that would actually generate that in more people is positively evil, regardless of the mechanism.

which assumes that being trans is a negative and it's bad for it to spread.

No matter which way you slice it, medical transition will have negative effects on your health. Few people would consider it a good idea to do it for cosmetic reasons, and even fewer parents would let their children do it for such a reason. This is why the possibility of the desire to transition being spread socially needs to be denied, and reasons for urgency (like suicide risk) need to be invented.

Well, see my parenthetical. I think we should tell 90% of trans minors "great, go ahead and transition socially, but you'll have to wait until you're of age for medical transition", and only medicalize the minority who have proper "will claw at their growing breasts with their bare nails if not allowed to get rid of them" dysmorphia.

and only medicalize the minority who have proper "will claw at their growing breasts with their bare nails if not allowed to get rid of them" dysmorphia.

One turn of the screw later, everyone who's been exposed to the trans meme will claw at their growing breasts with their bare nails if not allowed to get rid of them because they're told that that will get them what they want. The measure becomes the target. Then what?

I contend that what they want is to be taken seriously as their chosen gender, and a lot of trans teens who currently seek medicalization do so because they think it will improve their chances of that. If the two were successfully decoupled, far fewer would want it.

they want is to be taken seriously as their chosen gender

The problem is we've told these people it's possible to choose your gender or for your gender to be wrong wrt your sex. The whole idea is a memetic hazard. They aren't tomboys, twinks they are suddenly in the wrong body. That's the problem.

I'm sure a non negligible number would have been "fine" with being a slightly-gender nonconforming version of the same gender instead of being sold the bill of goods for "choosing your gender"

You are, again, assuming the conclusion. I happen to think the world is considerably better for having trans people in it, and that most people are happier transitioning than they would have been in a counterfactual world where they didn't. (Not because it was written on their soul in golden ink from birth that they were the opposite gender; just because gender transition is a fun thing to do with your life and imbues the transitioner with a welcome sense of purpose and fulfillment, like any other arbitrary self-improvement project.) It's a memetic something but I reject the term "hazard". I think it's a boon to human flourishing, and it needs to spread harder, so long as we can decouple it from dangerous medical procedures. We're halfway there. "Transmedicalists" are already viewed with suspicion by mainstream gender theory; "you can be trans even if you don't get surgery or hormones" is a very widespread meme which is looked on approvingly. Push it all the way to "at least if you're a minor, it's better to be the non-medicalized kind of trans" and you're golden.

It's a [transitioning] memetic something but I reject the term "hazard". I think it's a boon to human flourishing, and it needs to spread harder, so long as we can decouple it from dangerous medical procedures.

You are ignoring the fact that for many, many trans people, transitioning is inextricably coupled with "dangerous medical procedures". That is, its impossible to decouple the dangerous medical procedures, from the sense of purpose and fulfillment that a completed gender transition gives; that sense of purpose is fulfilled by those dangerous medical procedures.

I happen to think the world is considerably better for having trans people in it, and that most people are happier transitioning than they would have been in a counterfactual world where they didn't. (Not because it was written on their soul in golden ink from birth that they were the opposite gender; just because gender transition is a fun thing to do with your life and imbues the transitioner with a welcome sense of purpose and fulfillment, like any other arbitrary self-improvement project.)

And here is the crux of the issue. What if I believe that transitioning is not a good thing, and people who transition actually feel worse than they would be in the counterfactual world where they didn't transition? How do we resolve this tension? The only way is to actually analyze the relative happiness levels of transitioners, how and when they transition, and the relative psychological profiles of transitioners and trans people (those who don't transition) in general; in other words, medicalize the issue. And if we do this type of analysis, at best the benefits of transitioning, both for minors and adults, become unclear and murky. At worst, gender transitioning actually seems to make the quality of life for people to be worse; it appears that it actually causes harm in the transitioner - the evidence for which the commentators in this forum have showed to you at length.

A heroin habit is also a fun thing to do, that imbues the junky with a sense of purpose and fulfillment -- I don't happen to agree that this should be illegal, but glorifying it is clearly not great for society. (or, objectively, the users)

Except most trans teens seem to not want to be taken seriously as their chosen gender, they seem to want to be something other than their real gender- that’s basically the conclusion of Irreversible Damage. These trans folks are not attempting great conformity with the roles of their chosen gender.

"Their chosen gender" needn't be "traditional binary male or female". The point is that it's the social aspect they're primarily interested in, not really the surgery.

What other gender? I don’t understand what they’re conforming to?

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Are you suggesting that society should ditch any notion of gender and accept every way of gender presentation so that passing is no longer necessary? How likely do you think that would be?

Assuming of course, that social transition itself is not a negative. Either to the person transitioning or society itself.

What are the probabilities of serious consequences from puberty blockers? I brought up infertility, and the pro-trans tribe claimed that it's actually a very low chance and that it's not anyone's business anyway because not everyone wants to have kids. The latter half of that is completely inane when we're talking about life changing decisions for a demographic that cannot consent, but the former, I don't know. Do puberty blockers cause the infertility, the loss of ability to orgasm, and the complete lack of penis tissue with which to create a neovagina, or is it the ensuing hormones that do this?

People don't brig up enough the very real side effects and increased chance of getting cancer with any sex hormone alteration, (ball cancer, if they are still there, various ovary related shenanigans in women)

There's bone marrow issues too, I mean it's really not a surprise that fucking with your endocrine system to that degree causes a whole lot of issues. You need only look at what menopausal women have to deal with going through something that humans evolved to do for millenia.

What are the actual requirements for getting prescribed puberty blockers?

Under US federal law, you can get prescribed something off-label just because your doctor thought it sounded good, so long as the drug was approved (and doesn't fall under DEA et all). I have a breakdown of WPATH's conventions over time here, but there's no requirement that a doctor doing trans-related care even be aware of WPATH, nevermind commit to it, and even those that run with WPATH tend to pick-and-choose from v7 and v8 if they aren't from one of the big gender clinics.

Most actual enforcement is predicted to fall under what insurance companies are willing to cover (except the ACA requires all covered plans include gender care) or what doctors expect to fear from civil lawsuits (except these are an absolute mess and no one has a good idea what the actual fallout will be under law today, and the interstate nature of how those lawsuits will shake out is going to make things even messier).

What are the probabilities of serious consequences from puberty blockers?

Physical consequences seems to depend very heavily on both when the drugs are first provided, and how long they're used. The 'precocious puberty' problem that a lot of the scientific data is based around relatively short-duration (1-2 years) use, where you maybe see a little bit of difference in bone health or adult height at the margins. What data we have from non-gender non-pre-normal-puberty use shows controllable bone health issues, but that control is dependent on use of estradiol or estrogen (in women), which is unlikely to be used for gender therapy in transmen.

Mental, people on puberty blockers are a lot more likely to (continue to) transition.

Both puberty blockers and hormone therapy are linked to certain types of cancers, to such a point where transmen not intended to have (biological) children are were once encouraged to have a hysterectomy by their late thirties (WPATH v8 limits this to cases with a family history or other risk factors). The actual incidence and impact is pretty low, though, and it's migrated through so many intermediates (therapy links to PCOS which links to endo cancer which links yada yada).

But the big question is the uncomfortable one of whether puberty blockers cause long-term sexual nonfunction, the infamous "never have an orgasm". Studies on this matter give more uncertainty, and Bowers' model seems... confused or at least simplified-for-normies (do you want to go on national television and have a conversation about childhood sexuality? Because I don't want to even think about it too hard), but the contours of those studies leave cause to be more cautious rather than less.

My gutcheck is that these issues will exist for those who undergo puberty blockers very early, for a long period, and then don't transition have at least reduced sexual drive; I don't think Bowers claim should be taken literally, but I do think there's a lot to be cautious about Tanner 2 or even early Tanner 3 start dates.

I really thought "don't give minors seriously debilitating life changing pills to solve a solely mental disorder" was an easy hill to stand on, but the fighting was just as vicious as anything else with the gender issue.

If we had a drug that perfectly cured severe schizophrenia, for example, with the side effect of reduced sexual functioning, would you consider it impermissible to provide to those who wanted it? Or is the objection about what the mental disorder is, first? And, from the other direction, early social gender transition has shown a pretty strong link to later transition (and I'm willing to bet not solely correlative). Would social transition be acceptable if the people in question waited until they were 20 to undergo chemical or surgical intervention?

I'm not going to claim that the answers should be clear, but I'm generally very skeptical of advocacy that doesn't leave space for anyone on the opposing side to be merely wrong or merely have different values.

What are the actual requirements for getting prescribed puberty blockers?

The criteria for a gender dysphoria diagnosis is that you're "consistent, persistent, and insistent" about it, I think I even they even give a specific time period of exhibiting *sistence, and if memory serves, it's something like a few months. I'll try to look it up, and get back to you.

The pro-trans tribe insists that it is a very rigorous process involving thorough checking of gender dysphoria

Sorry for the harsh words, but this is just a lie. Gender clinicians will say themselves, when they think you're not listening, that the issue shouldn't be medicalized, and it's just about patient autonomy and free expression. Many detransitioners say they got prescriptions after a session or two. There was a sting operation were a girl got it after 9 minutes on the phone.

And malpractice aside, like I said the official criteria is that you say you're trans and don't change your mind about it for a few months, I might be missing something, but I don't see much opportunity for rigor here.

Is there any actual scientific evidence in favor of social contagion playing any part in transgenderism?

It hasn't been properly studied yet to my knowledge as, until recently, the hypothesis was treated as an insane conspiracy theory.

Are there any actually valid critiques of the Cass Review?

Not to my knowledge, but I'm biased.

What are the probabilities of serious consequences from puberty blockers?

The deadly cocktail is blockers + opposite sex hormones, that basically clinches infertility and/or anorgasmia. Either one of those without the other is recoverable to some extent. There's a whole section on puberty blockers in the Cass Review, and from what I recall reversibility on healthy, normally developing children has never been studied.

The criteria for a gender dysphoria diagnosis is that you're "consistent, persistent, and insistent" about it, I think I even they even give a specific time period of exhibiting *sistence, and if memory serves, it's something like a few months. I'll try to look it up, and get back to you.

@oats_son

This has been a bit frustrating to look up. While the phrase “Insistent, persistent, and consistent” does appear here and there, as though it is quoting someone, I can't seem to locate the original source. The first time I heard it must have been during one of the 7 zillion hours of trans / anti-trans confenrences I've watched, but my best effort attempt, of writing a script for downloating auto-subtitles from my playlists and grepping for the keywords, has yielded no match.

For what it's worth, the "few month" period seems to come from the DSM-5, and the diagnostic criterion seems to match the sentiment behind the 3-word phrase, so maybe it's a summary of that , rather than a direct quote.

Ironically, reversibility was among the conditions that were being studied among the eight "transgender mouse" studies which the Trump administration cancelled funding for.

I kinda wish they had already studied it before prescribing them to children and explicitly marketing them as reversible. You can point out the irony, I guess, but it's hard to pin that on Trump.

Also, if an animal trial is enough for you, we already have a study on sheep that shows a fairly big impact on brain development.

Sorry for the harsh words, but this is just a lie.

Yes, I guess I already knew it was a lie. Healthcare professionals can't look inside your brain for you, so they have to rely on what you say. It's extremely easy to get antidepressants if you say you've lost interest in doing your schoolwork, you have heightened anxiety, and you have bleak thoughts involving self harm. The script is different for different mental issues, but it's a script all the same. I don't know how you convince someone of that, but generally, anyone who argues this with you already has their mind made up.

It hasn't been properly studied yet to my knowledge as, until recently, the hypothesis was treated as an insane conspiracy theory.

It is deeply frustrating that such an intense issue is so stagnant on the research front (not to mention actually discourages wrongthink). If medicine didn't overextend into territory it didn't fully understand yet, none of this would have happened and I wouldn't get into these soul-destroying arguments. I think science didn't have much to do with the decision to do all this in the first place, so it's very frustrating when pro-trans advocates say to me that clinicians know a lot about medicine and can properly judge in individual cases whether it's worth it or not, so we should just trust them. It sounds so noble.

Not to my knowledge, but I'm biased.

I am just wondering if trans advocates have any leg to stand on with regards to dismissing the review entirely. Do they have any official published critiques at all they're drawing from? Or is it a blue-tribe-wide vibe that they all feel? It's disturbing to see so many people actually in the field express such things if it's all vibes.

The deadly cocktail is blockers + opposite sex hormones, that basically clinches infertility and/or anorgasmia

Are there any studies on this that you know of? How did you find this out? Too bad it's both that are required or it would be easier to argue this.

Are there any studies on this that you know of?

Sadly, I must refer you back to the "it hasn't been properly studied" point above. "No conclusions can be drawn" is basically a constant refrain in the Cass Review.

How did you find this out?

I think the first time I heard about it was with the case of Jazz Jennings, the rest is connecting the dots from what gender clinicians say themselves. From another post of mine:

But when gender care providers themselves tell me that "puberty blockers are reversible (asterisk)", the asterisk being you can't stay on them too long, or that if you start them too early you're never going to have an orgasm, when celebrity cases like Jazz Jennings say they don't regret going on blockers, but the downside was "there wasn't enough tissue to work with when it came to the surgery" (and also don't know what an orgasm is), when the industry comes up with procedures like sigmoid vaginoplasties or zero depth vaginoplasties to either hack around or throw up their hands about the issue, can we say that there are good reasons to suspect some of the changes may be irreversible?

One note: I did adjust my position somewhat since writing it. Recently I've seen an interview with a guy that had hypogonadism, basically the opposite of precocious puberty, where his body didn't want to trigger normal development. Apparently doctors managed to get him mostly up to speed where he now looks and acts (the lack of puberty also affected his psychology) like a normal bloke, so from this I figure it's not as bad as I thought. I keep promising myself I'll look into the literature on his condition, since if it describes what happens when it's untreated, that should give a non-politicized answer to the question of what happens due to puberty blockers, but I haven't found the time / motivation to do so yet.

I've also know of at least one detrans woman who managed to get pregnant post-testosterone (I think there are even non-detrans females that gave birth while constantly taking hormones). This is all in contrast to the blockers+hormones case, where I see gender clinicians themselves getting nervous, trying to adjust time-tables, and hacking around the issue, as per the quote above.

Sorry if it's conjecture, but I don't think anyone has actual data on this (or they do, but keep it secret, which wouldn't be surprising either at this point).

Look like puberty blockers were prescribed for trans reasons to about 1400 kids in 2021, with that number increasing by about 200 kids / year. Puberty blockers were additionally prescribed to about 20,000 kids in 2021 for central precocious puberty (puberty starting before age 8 for girls or age 9 for boys).

As a point of comparison, about 3100 teens between the ages of 12 and 19 died in car crashes in 2021.

Is there a reason you think that puberty blockers, specifically, are a big problem?

You don’t see the difference between random accidents and intentional mutilation of children for an incoherent ideology?

I do see the difference, but moral panics over "think of the children" have a history of having the reactions be cures that are worse than the disease, and I see no particular reason to think that this time is different. Do you have a reason to think that this time is different?

This is a gigantic own goal that's more likely to be seen as akin to lobotomies 50 years down the line than anything else. It's close to unprecedented in human history to issue major invasive surgeries which barely even impact the longterm suicidal incidence and just shrug and call it self-expression

... I don't think puberty blockers are as damaging as lobotomies, and also puberty blockers in the context of gender affirming care are like 10x less frequent than lobotomies were at the peak of that craze. I think people 50 years from now (assuming the world of 50 years from now substantially resembles the world of today) will probably think of it similar to how we think about high schoolers smoking or using tanning beds (i.e "basically not at all").

There were about 40,000 lobotomies ever in the United States over the course of decades and there are about 1.5 million Trans people in the United states. Even if only 10% of them are pursuing surgical correction/puberty blockers, that doesn't really line up. Lobotomies were likely more damaging case-by-case, but a 30%~ suicide rate indicates that there is no particular happiness coming from gender confirmation.

Most of the 1.5 million trans people in the US are not minors, and the fraction of the trans minors who go on puberty blockers is about 3%, not "only 10%". Unless you're talking about what they do once they reach adulthood, but if you want to forbid adults from doing things they want to do with their bodies, trying to add regulations around what kids can do probably won't help.

Moral panics when they're about extremely rare events like satanic cannibals are one thing. We're talking about the ascendant ideology which is extremely entrenched and uses the organs of government to do things like force parents to give up their children if they don't subscribe radical political/philosophical views. Moral panics are designed to counter things like this, and I'm glad America in particular has a habit of doing so.

I don't think the once-ascendant ideology is particularly entrenched anymore. The anti-woke/anti-trans movement at this point feels very similar to the way the atheism community felt in the 2012 era, as they ran out of defensible causes and started to turn to indefensible causes and on each other. Had they packed up and gone home once their original goals were met (e.g. no prayer in schools) I think the world would be a happier place.

Well it's a reaction to such a "think of the children" moral panic that went too far, for one.

It sure is. But to bastardize Mickens, responding to a moral panic with a second moral panic in the opposite direction is like asking Godzilla to prevent Mega-Godzilla from terrorizing Japan. THIS DOES NOT LEAD TO RISING PROPERTY VALUES IN TOKYO.

Is there a reason you think that puberty blockers, specifically, are a big problem?

Yeah, they alter the normal development of a healthy child. This is not the case with precocious puberty, so the comparison is not valid.

Rephrasing - is it a big enough problem that the disease of having ~1k kids/year go on puberty blockers is worse than the "cure" that would be implemented by the political apparatus would be? Being realistic about what historical political "solutions" have looked like.

What do you think the political solution would look like? AFAIK no other society has had to deal with trans

Lots of societies have had to deal with some folly of youth causing some number of kids to ruin their lives in one way or another in their quest for status and acceptance. In ancient Rome, kids seeking social status joined gladiatorial schools, and many of those kids ended up crippled or dying. In Victorian England, girls wore incredibly tight corsets which caused reduced lung capacity, skeletal deformations, and abdominal muscle weakness, which led to lots of health problems (including much higher chances of miscarriage or death in childbirth).

Just because something is a problem doesn't mean a political solution exists. The politician's fallacy ("We must do something. This is something. Therefore we must do this") is frequently cited as a fallacy due to the third line, but the first line is often also wrong - we don't actually have to try to solve every problem.

I think the use of puberty blockers is a problem of small enough scale and low enough severity that it's probably better to just let it ride.

Ok, what do you think a political solution looks like? My guess is, at most, a planned parenthood doctor gets railroaded for gender affirming care every other year or so, and this may or may not have a chilling effect on adolescent specialized medicine but that was all activists anyways.

Or loses a malpractice suit when they do malpractice, yeah. Again, 40k kids a year start "gender affirming care", only 1k of those 40k start puberty blockers. I really don't think puberty blockers warrant special attention here.

I really don't think puberty blockers warrant special attention here.

Sure, the rest of gender affirming care is dubious too, and needs just as much attention as puberty blockers.

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Would you give a license to kill 5 people per year to a known sociopath? It's less people than those that die by lightning strike, even if he maxxes out the limit. That's basically how I see the issue, even if the consequences are less severe than death.

I also don't see any problems with implementing the political apparatus. We already have it, it's just asleep at the wheel.

Me personally? No. If the US government had given a single known sociopath a license to kill 5 people, though, trying to get them to change that decision would not be a very high priority for me.

Damn. Well, personally I'd either campaign to put him, and the person that gave him the license in prison, or I'd shoot the mofo myself.

Yes, because it is a harm being deliberately inflicted on minors by the medical establishment that has permanent horrible consequences like infertility, plus generally being considered freaks for the rest of their lives. There's a reason that despite the low occurrence of incidents, people care about the Catholic Church having members of the clergy molest children and then shuffle them around without being prosecuted. Teens getting into car accidents, or kids dying in pool accidents are problems that are hard to solve, but deliberate actions from officials in respected establishments based on strategies are much easier. That goes for the Catholic Church, that goes for doctors, that goes for police department policies on restraint with chokeholds. Thanks for posting some statistics.

At its core, this is about fundamental values differences. I think trannies should be sent to gender-conformity camp and learn to embrace the way God made them. Pro-trans people think that gender is some ontological thing that can only be arrived at after deconstructing the concept. You presumably fall somewhere in the middle.

From that light, it’s not really about the state of the scientific evidence. I know there are male, female, and deformed, and you can find out which you are by dropping your pants and looking down. Trans activists know that gender is an ontological state which can only be understood by deconstruction. Neither of these beliefs can be proven by controlled experiment.

Pro-trans people think that gender is some ontological thing

Well I'm pro trans and I don't believe that at all. I'm a nihilistic hedonist, and I think people should be allowed to do whatever they want with their own bodies. I want to liberate the west from yolk of middle eastern morality. I think people who believe in god are mentally ill deranged barbarians, but I would never advocate for them to be sent to camps.

Pro-trans people vary wildly, of course many of them do believe in an ontological concept of gender and reject that biological sex exists. But to me scientific evidence is very important.

I'm a nihilistic hedonist, and I think people should be allowed to do whatever they want with their own bodies

Show me your anti-COVID-vaxx mandate posts, please.

I made plenty of them, not on this forum but on plenty of my suspended reddit accounts. I also think antivaxxers are incorrect, but vaxx mandates are regarded even from a purely practical standpoint. If a really serious virus came along, nobody would have to be forced to get the vaccine. But even if it were airborne ebola I would defend the rights of people to make their own choices.

I'm like you in that I don't consider transgenderness valid at all, but I cannot really take that stance in the areas that I argue in. If they're going to wield studies and science to justify these horrible actions, someone else has to do the same to fight back against their worst excesses. I think I've made my peace with adults deciding to take hormones and wear the wrong clothing and try embarrassingly to talk like the opposite sex, though I resent having to pretend they are what they are pretending to be. But something like puberty blockers must be viciously fought in every place it pops up.

Again, it’s not a scientific belief. Really it’s not a belief about science on either side, it’s a belief about ontology.

The correct rhetorical move is to point this out while holding on to the Cass report. What is a Woman did a pretty good job of showing the lack of sciencey-ness to trans beliefs amongst the proles; that’s the tack to take moreso than getting into the muck about the side effects of puberty blockers unless you, yourself, happen to be a doctor.

Thankfully, I am not a doctor. I appreciate the rhetorical suggestion. I don't know how much I can take it, though, because these are my friends and I try not to overly offend my friends (or anyone, I guess). Like Sonya from Crime and Punishment, I have recently realized that no matter how I conduct myself, I will never be able to totally avoid offending people.

...and the puberty blocker discussion in particular was very vexing to me. I just genuinely don't know how anyone can be okay with the idea, especially now that we know way more about it than we did 10 years ago.

I'm basically pro-puberty blocker in principle, and my reasoning is as follows:

  • Adults should, broadly speaking, be allowed to make their own decisions regarding their bodies, including physically transitioning.

  • Whether a trans person begins to physical transition before or after adolescense seems to have a big effect on how effectively they'll eventually pass as the opposite sex.

  • I'm quite uncomfortable with non-adults making permanent, irreversible alterations to their body.

  • Therefore, if someone has made clear they want to transition and there's a way for someone to reach adulthood (or get closer to it) while preserving the best chance of passing as the opposite sex, I would be in favour of it. Puberty blockers seem to be a reasonable solution to this problem.

In practice of course things quickly get messy and I don't know what the ideal criteria should be for getting blockers prescribed nor what the trade-off is between possible side-effects and potential benefit. I leave that to people more invested in the topic.

A big wrench in this reasoning is often when puberty blockers would be most effective are on underdeveloped kids, their brains aren't yet fully formed, lord knows boys mature mentally slower than girls, also often the pro-transnes is either pushed by parents ( mothers ) or other adults in the room who are supposed to be the experts. For those cases it's like an inverse tiger moms situation. Unless the kid has 'ran away from its guardians', the adults in their lives are a major influence on their own conception of gender/sex and the immutability of such or not.

Your comment is very confusing, you say you're pro-puberty blocker and list your reasoning, and then every one of your reasons contradicts themselves.

"Adults should be allowed to make their own decisions regarding their body." We're talking about puberty blockers which by definition have to be proscribed to non-adults.

"I'm uncomfortable with non-adults making permanent, irreversible alterations to their body" it seems to me there's fair evidence that puberty blocker's side effects do exactly this.

Puberty blockers cause permanent brain development problems as well as stunting sexual maturity at what tanner stage 2? They aren't harmless.

They aren't harmless.

I didn't say they were.

Do you not see that puberty blockers themselves are permanent, irreversible alterations to the body more than puberty itself is? What kind of evidence would you need to see to believe that?

I assume what you mean is that puberty blockers are more of a deviation from the standard path of physical development than going through puberty itself is (I'd be quite confused otherwise; it's hard to think of any process or operation that actually causes more changes to the human body than puberty).

I'm not really clued into the exact nature of the side effects of puberty blockers, but that doesn't change my argument. It's up to the clinician to weigh the harms of putting a child on puberty blockers vs the potential benefit to their future mental wellbeing of potentially allowing them to transition more effectively.

I am impressed that you are the first person to reply to this post on a forum filled to the brim with chuds.

Permanent, irreversible alterations to the body are not bad things inherently. You need to lose your baby teeth to grow adult teeth. Losing your baby teeth is a permanent, irreversible alteration to the body. Puberty is as well, but it leads to the things that are needed to continue the human race, which is important to biology. Messing with this process has a high chance of creating broken fucked up humans.

As I said in my original post, puberty blockers can cause permanent loss of fertility and permanent loss of orgasm. Jazz Jennings is the example I have seen people bring up, where both of these outcomes took effect. They also cause bone density loss. There are probably a lot of other things they do that I don't know about, or that nobody knows about, since this is all new and good studies likely haven't had the time to be created. Kids cannot consent to getting sterilized in the traditional way. Why should they be able to consent in this circuitous way? Why should such serious consequences be undertaken when simple psychotherapy can produce similar results without any of it, according to the HHS report? How am I supposed to trust the clinician has good cost-benefit analysis here when these possibilites are on the table and the medical community has made serious missteps before, such as their taking seriously Dissociative Identity Disorder (now seemingly on its way back) or, famously, performing lobotomies for hysteria? And it's all in service of making them pass better as the opposite sex as an adult when I don't even agree that that's a valid goal for anyone to undertake.

And it's all in service of making them pass better as the opposite sex as an adult when I don't even agree that that's a valid goal for anyone to undertake.

Well this is the actual crux of our disagreement, in that I believe that physical transition can be a helpful approach for a certain small number of people. Everything else you've brought up is downstream of that - i.e. I can't imagine you'd be particularly animated about potential side effects like infertility if we were discussing some other procedure designed to achieve what you'd consider a valid outcome.

Brain development problems in the range of 8-10 IQ points. (More than half a standard deviation).

Woah, that’s stunning. So we need puberty for brain development to reach its full potential?

Yes. I if you have an hour or so to kill, I recommend this interview with a man who suffered from hypogonadism as a kid. He reports it had a quite profound impact on his psychology.

I mean… yeah, duh?

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