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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.
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.)
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.
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.
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.
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.
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.
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