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Is Science-Based Medicine opposed to the likes of elective plastic surgery? I think there's a great deal of difference between "opposing patient autonomy" in the sense of being against allowing patients too much discretion to pick quack treatments that they can cure them of a particular ailment, vs "opposing patient autonomy" in the sense of being against patients undergoing elective procedures for reasons other than medical need, but whose efficacy to do the things they physically achieve is not in scientific doubt. Mastectomy's ability to reduce or remove somebody's breasts is pretty settled at the empirical level. A defense of gender-affirming care on the basis of autonomy has nothing to do with the "I should be allowed to heal my cancer with snake oil if I think that will work best" kind of autonomy. It's about the broader kind of bodily autonomy - "it is my right to have my breasts reduced much as it is my right to get my ears pierced" - and I don't see why SBM would have anything to say about that, good or bad. It's a moral question, not a scientific one.
Sure, I can concede the difference, but transgender care gets dinged either way. The signed-but-not-read statement says it's "medically necessary", activists say it's "life-saving", "do you want a happy little girl, or a dead little boy?", etc. What do you think is the drama around these systematic reviews, if it isn't about showing that they're ineffective treatments.
This is quack medicine, no two ways about it.
Well, that standard party line for transgender care gets dinged. I, for one, am strongly pro-transgender-care myself, but I consider that position a subset of my broader transhumanism, and therefore I think that disingenuously wedging gender reassignment in particular into the Overton window through spurious "medically necessary" rationales was one-step-forward-two-steps-back.
Well, I've long argued that transgenderism is just a facet of transhumanism (much to tje chagrin of self_made_human), but that's beside the point. The SBM people weren't defending it on transhumanist grounds.
I would find it difficult to imagine a comprehensive transhumanism that doesn't implicitly include transgenderism. From some years back I remember "morphological freedom" as a transhumanist talking point, and there's no particular way to cash that out that doesn't validate transgenderism. If one of one's goals is complete personal and bodily autonomy, well, you get transgenderism thrown in for free.
I don't think I agree with this position as a normative good, but it is an intellectually consistent one, in a way that I think some of the transgenderism arguments today are not. Morphological freedom also includes, for instance, transracialism for free, even though progressive orthodoxy validates transgenderism but not transracialism.
Perhaps a transhumanist might argue that morphological freedom and individual autonomy extends to the right to make your physical body anything you desire, including everything from sexual organs to skin colour to species, but does not confer a right to be included in any particular community you desire? So an elective community of people identifying as natal-woman or natal-black or what have you might still have the right to constitute itself as such, and forbid transgender or transracial people from joining it. If I imagine a transhumanist utopia, I could imagine a group like that existing in something like the Culture; though I also suspect that in a realistic liberal-transhumanist context, that group would be a tiny minority of weird people, tolerated but largely ignored by most of society, in which transhumanism and radical morphological freedom has dissolved most such concerns or identities.
Yes and no. You get one of the material objects that the trans advocates want for free but they make wider ontological claims. i.e. "men should be allowed to have gender reassignment surgery and be feminine men" is something morphological freedom would endorse but trans activists may not.
Wouldn't they? Isn't that a textbook example of queering the gender binary?
There are a lot of different mutually exclusive factions that make up the trans coalition. You might have transwomen who demand to be considered ontologically categorized the same as natal females support a cisman wearing a dress to queer the gender binary but would strongly object to any insinuation that they were doing basically the same thing. Morphological freedom alone can't explain this conflict, you need additional axioms.
To be sure there are people who call themselves trans who might fully endorse and live by this maximally vague morphological framework, but I'd argue they are a vast minority, especially among vocal activists.
I'd argue that vocal activists themselves are a tiny minority. My anecdotal experience has been that most trans people on the street find this academic language strange and alienating, and do not themselves have a very well-developed concept of gender identity. Like most people, they kludge it together out of a slurry of experiences and half-remembered concepts received from others.
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