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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.
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.
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?
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.
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.
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 particularly rich because so much of the justification for puberty blockers and minor transition has been a "You can have a live daughter or a dead (suicide) son!" fear mongering which turns out to have been based flawed/non-existent studies.
... and that's bad, right? You see how the "think of the children" argument shut down critical thinking in this case?
The happens every time. Saying "think of the children" to mandate certain medical treatments does not go well. Saying "think of the children" to ban those same medical treatments will also probably not go well. Most puberty blockers don't go to trans kids, and most trans kids don't use puberty blockers, so the second-order harms of a bad policy here are likely to be larger than the primary benefits.
That leaves the door open for a good policy of course. Ha ha ha.
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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.
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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.
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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.
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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.
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.
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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.
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