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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?
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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