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naraburns  nihil supernum  1yr ago (text post)   32161 thread views

Culture War Roundup for the week of January 23, 2023

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Sanderson: I simply support an institution that wants to kill them

That's the thing that annoys me the most. The trans activists who shout that their enemies want to literally kill them. That they're being genocided. Tha the Trans Day of Remembrance is some sort of Holocaust memorial. When the murder rate of trans people is about the same as that for women, and the murders are often of sex workers (a profession already risky even for cis people) or might have been for other reasons (e.g. drug deals gone wrong). When they are getting more and more protection, support, laws, even the damn flag being shoehorned into the Pride flag.

"No no no if you don't tell us we're fantastic and give out puberty blockers, hormones, and surgery on the bare word of anyone who walks in and goes 'I want that' then it's genocide, literally a genocide!"

The trick is that when pressed, they say they're talking about suicide rates, and thus making a veiled threat to kill themselves. As a reminder, this is archetypal abuser behavior.

they say they're talking about suicide rates,

Perhaps a bit uncharitably, I personally am not convinced that suicide rates alone are worth high levels of sympathy. I suppose sometimes, but as you mention that is complicated by social contagions. Should we end euthanasia protocols to improve suicide rates? Personally not convinced. Does the fate of the Jeffrey Epsteins [citation needed] and Adolf Hitlers of this world suggest we should change government policies to make their specific lives better? No. Just no.

More to the point, I would find the whole mental illness thing more sympathetic if their wounds weren’t mostly self inflicted.

Even the suicide rates thing is cherry-picked, though suicidality seems to be high (see the report from which the original 41% rate was taken).

There's a new survey by an LGBT youth project which bumps the rate up even higher - 45-50%. But while the headlines are all about discrimination being the driver, when you read the stories they say that even in progressive states rates are high. And that it's considered rather than "attempted" suicide:

States where lawmakers have aggressively pursued anti-trans legislation, including Texas and Arkansas, have extraordinarily high levels of suicide risk, though the rates are nearly as high in some progressive states, including New York, California and Oregon.

In California, the most populous state, which recently passed a law to protect trans youth, 44% of LGBTQ+ youth considered suicide and 14% attempted suicide, the survey found; for trans and non-binary respondents, the findings were worse, with 54% considering and 19% attempting suicide. And 70% of LGBTQ+ youth in the state said they had experienced discrimination, with 62% saying they were not able to access mental health care.

The rates of trans and nonbinary youth who seriously considered suicide were similar in the next largest states, at 56% in Texas; 54% in Florida; 50% in New York; 54% in Pennsylvania; 51% in Illinois; 54% in Ohio; 55% in Georgia; 53% in North Carolina; and 52% in Michigan. And 16-20% of trans and non-binary youth reported attempting suicide across these states. A majority also said they wanted, but did not receive care.

Even in California there are high rates of suicidal ideation? Why, it's almost as if there's something going on there that's not just about transphobes... maybe there's the whole co-morbidities thing of anxiety and depression... no, that can't be it, it's down to TERFs and J.K. Rowling alone!

For comparison with the general teenage population:

Results from the 2019 Youth Behavioral Risk Factor Surveillance System show that 18.8% of high school students seriously considered attempting suicide and 8.9% actually attempted suicide.

So nearly twice as high for LGBT/trans teens especially if BIPOC (Alaskan natives have shockingly high rates) and poor.

If a depressed person said if you deny us medication or therapy then more depressed people will kill themselves, is this making a veiled threat or recognizing (what they see to be) factual truth?

The game design perspective is an interesting lens to take to this. People are 100% in control of whether or not they threaten to kill themselves. If this yields any advantage the meta will develop to always threaten to kill yourself.

If they are suffering from a mental illness, arguably they are not 100% in control of their actions or words.

If they are suffering from a mental illness, they should get help and support. But that does not mean that they are not 'really' mentally ill, they're perfectly fine and if we don't accept that they are too a unicorn with wings we are driving them to suicide.

No, but if the treatment were that we pretended to accept them, then that is something to consider. We might still say no depending on the cost of such acceptance but to make that decision we have to know the costs and the benefits and if one of the benefits is that fewer people kills themselves then we should take that into account.

Again, that doesn't mean we must do it, because the costs might outweigh saving some lives.

I don't like the "not in control of their actions" idea. Someone with a mental illness doesn't have an entirely separate process intruding on their thoughts - they're taking actions with the same complex network of neurological processes (that aren't understood too well), just either there's some biochemical defect (autoimmune-induced schizophrenia?), or some other social/environmental factor, causing parts of it to be slightly off. And that doesn't seem like 'loss of control'. The 'person' is still 'in control of their actions' (which really is a tautological statement), the actions are just ... bad.

... as an illustration that doesn't have that much resemblance to real mental illness, say the same kind of mental defect gives one person an obsession with collecting baseball cards and another person an obsession with eating rocks. One might say 'the person isn't in control of their actions, they have to eat rocks'. But one wouldn't say that of someone who really likes collecting baseball cards!

If we're going to entirely remove their agency why should we take their argumentation seriously at all?

Not being 100% in control does not mean they lack all agency. For example when carrying out an assessment on patients when I used to be involved in social care, we would minimize what choices they lost. A person who would spend all their money on QVC items would have their finances handled by a social worker but they could still make all other decisions. Mental competence is generally not all or nothing in that perspective.

If these patients threatened to kill themselves if you denied them some reasonably removed choice would you take that as a meaningful argument that the choice should not have been removed? My point is either they're agentic enough that their aims in making the claims weighed more than their handicap or it didn't. If they did then that overwhelms the clause against deceptive self interest. If they did not then we shouldn't take their threats any more seriously than someone in Chicago who threatens to end their life if they don't get to talk to Putin about their Russian royal blood.

Remember though the claim is person X saying if you don't allow Y the likelihood of trans people killing themselves goes up. The person making that argument may not themselves be trans.

So if Bob says hey, if you take Linda's ability to buy QVC knick-knacks from her she might kill herself AND I think Bob is correct then yes I might have to rethink my strategy. Because being dead is (generally) worse than having zero money. So perhaps now I allow Linda to spend some money on QVC or I try to get the channel removed in her home and evaluate how that affects her suicidal ideation. If my job is to get the best outcome for Linda, then Linda being dead is a failure and Linda being zonked out on Thorazine for the rest of her life is a failure. Linda spending 30% of her money on QVC is probably worse than her spending 0% (unless she is buying Zorbeez, those things were great!) but it is better than her being dead etc.

If Bob is wrong then I'm fine, but I can't necessarily tell that. Now if we assume Bob also suffers from the same issue as Linda, that doesn't mean he is wrong about her suicide risk. He might be trying to trick me because he thinks it might be precedent for him getting access to QVC back or he might have more insight because he suffers the same way. But you can't I think just ASSUME he is acting in bad faith. Is his claim plausible? Is it plausible that people suffering from dysphoria who aren't transitioned may kill themselves in greater numbers? And the answer appears to be yes, that is plausible. It's not that I think that it is plausible BECAUSE of Bob, he is just a vector for that information.

If he said, If you don't transition people they run the risk of turning into balloons and floating into space, I would say. Well I think I am ok taking that risk, thanks Bob.

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Then it would follow that they can't be afforded 100% agency.

Indeed. But can anyone? Let's say being suicidally depressed gives you 70% agency. You can make most choices but in a depressive episode, society may try and override your choice to kill yourself (if it can) by treating you whether you choose to or not. It will then discharge you, offer you therapy or drugs and so on.

If dysphoria does lead to increased levels of suicide then the same response would be to..forcibly transition people whether they want it or not? Remember when we believe people do not have agency due to mental illness, we generally act to treat their illness whether they want that treatment or not at that moment.

So, there is another kind of dysphoria that I think is probably a closer metaphor, Body Integrity Identity Disorder, in which people feel like they have too many limbs, and desire to cut one off. If someone presenting that dysphoria says "I want to cut off my arms, and you have to tell me it's a great idea and I'm stunning and brave, but also pretend forever that I never had any arms in the first place, or I will become so inconsolably distraught that I might kill myself"... would you go grab a hacksaw and fire up the gaslights? Or would you think that maybe this person shouldn't be allowed to make that kind of decision for themselves, and they need to be forced to get some regular therapy and evaluation by sane doctors?

would you go grab a hacksaw and fire up the gaslights? Or would you think that maybe this person shouldn't be allowed to make that kind of decision for themselves, and they need to be forced to get some regular therapy and evaluation by sane doctors?

That depends, have they started to try and hack off their own limbs with a rusty hacksaw? Then assuming we can't actually treat the mental part of the disorder, then yes surgically removing their limbs so at least they survive the procedure might be the best option. Our options aren't necessarily magical cure, let them chop limbs off, chops limbs off for them, lock them up forever. It might only be, let them chop limbs off, chops limbs off for them, lock them up forever, at which point limb lopping might be best.

For trans people who are suicidal there does not appear to be a pill that will fix it. The treatment is making the outside "match" the mental internal state because we cannot reliably change the mental internal state (and even if we could, are they the same person? or are we just killing that version of them?). I know a person with bipolar disorder who refuses to take medication for this reason, because the person they are on medication is to their natural state not them, it is some stranger who thinks sluggishly and brokenly. I don't know what the correct option is there.

So imperfect, even shoddy transitioning may be the best option actually available.

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If a depressed person said if you deny us medication or therapy then more depressed people will kill themselves, is this making a veiled threat or recognizing (what they see to be) factual truth?

Unironically, I think it's valid as their interpretation of factual truth if and only if they acknowledge that they're mentally ill. Because without that acknowledgment, then they maintain agency for their actions, and their decision to commit suicide is entirely on their own moral ledger. People who aren't mentally ill can get mad that other people are making them unhappy, but crossing the rhetorical line from unhappiness to suicide is just an abusive tactic in that context.

Does it change the argument if I ( a non depressed person) say that I think depressed people are more likely to kill themselves if denied treatment?

There definitely is some kind of line where threats of suicide can be used abusively I agree, but I think in most examples like this it is being used as a guilt trip which can be (but is not necessarily) abusive. I guilt my kids into doing stuff all the time, because it is one of the social tools at our disposal. When it crosses the line into abusive is hard to define I think.

Does it change the argument if I ( a non depressed person) say that I think depressed people are more likely to kill themselves if denied treatment?

Again... this is okay if and only if we agree that depressed people are mentally ill.

There definitely is some kind of line where threats of suicide can be used abusively I agree, but I think in most examples like this it is being used as a guilt trip which can be (but is not necessarily) abusive. I guilt my kids into doing stuff all the time

If you tell your kids that you'll kill yourself if they don't eat their vegetables or whatever, you'd be way over the line into abuse. If you observe to them dispassionately that you are statistically more likely to kill yourself if they don't eat their vegetables, you haven't salvaged the situation. It isn't the guilt trip that (necessarily) puts you over the line, it's threatening suicide.

If you tell your kids that you'll kill yourself if they don't eat their vegetables or whatever, you'd be way over the line into abuse. If you observe to them dispassionately that you are statistically more likely to kill yourself if they don't eat their vegetables, you haven't salvaged the situation. It isn't the guilt trip that (necessarily) puts you over the line, it's threatening suicide.

Right because eating vegetables and suicide are not linked (I assume!). But depression and suicide are. If I tell them "If you don't eat your vegetables I will be disappointed you have chosen not to eat healthily" I am guilting them with a reasonable outcome on my behalf. If they were doing something that actually would increase my risk of death, then it becomes once more reasonable. Don't pretend to throw your brother off the roof, you'll give me a heart attack perhaps?

Don't pretend to throw your brother off the roof, you'll give me a heart attack perhaps?

No sale. This only works because "you'll give me a heart attack" is a figure of speech. "Don't pretend to throw your brother off the roof or I'll kill myself" speaks for itself.

It's a bad example true, but remember the speaker in the original is not saying they will kill themselves, but that others might. So maybe this one is closer:

If my son is a truck driver and wants to call out to play Call of Duty and I say, if you don't deliver that shipment of widgets, the widget factory will shut down and people will lose their jobs, some might starve and some might even commit suicide. I am not going to hurt anyone or myself, I am predicting the potential consequences of his actions. I might be making those consequences up to guilt him, or they may be true or I may be exaggerating them for effect. But we can't tell which without knowing about the widget factory and the financial situation in the town etc. Whether I am correct in guilting him depends on the accuracy of my prediction. If I work at the widget factory myself, that might mean that I am either knowledgeable enough to know it is one delayed delivery from bankruptcy OR guilting him because my bonus depends on being able to de-widget the widgetiser.

But you can't tell which, whether I am doing it for personal gain or to protect the town (or both!),

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A heart attack is involuntary. What makes it a threat is that you are going to act if they don't do as you demand. The fact you are pinning actions you are going to take to hurt yourself on them makes it more abusive.

Again though remember the original example was about other people hurting themselves. So maybe we're losing it in analogies.

If I say stopping medication to bipolar people increases the risk of bipolar people killing themselves. That can be either true or false. Whether I am bipolar doesn't change anything about what those other people do. If I say I will kill myself if you stop that medication, then that is a different type of statement.

If my son is a truck driver and wants to call out to play Call of Duty and I say, if you don't deliver that shipment of widgets, the widget factory will shut down and people will lose their jobs, some might starve and some might even commit suicide, I am not going to hurt anyone or myself, I am pointing out the potential consequences of his actions. I might be making those consequences up to guilt him, or they may be true or I may be exaggerating them for effect. But we can't tell which without knowing about the widget factory and the financial situation in the town etc.

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I don’t think that jk Rowling is arguing that trans people should be denied treatment but asserting that everyone else isn’t required to acknowledge the trans person’s chosen gender. This isn’t the same thing

Agreed, but if being recognized as their new gender is part of treatment (as surgical transition as a treatment would imply) then we have a question of how much of a responsibility does society (and/or individuals within that society) have to go along with it.

Treatment for what, though? Doesn't this logically require agreeing that transgender people are mentally ill?

Sure, and? I understand many people might disagree, but I only have to make my own arguments not theirs.

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I have a few issues with this comparison. First, the thing we'd be treating is the depression, with medications and therapies designed to fix the undesirable internal state. Secondly, the state of depression treatment is, AIUI, not really where we'd like it to be in terms of scientific reliability, and that's still a much better situation that the fraught nightmare of running experiments on trans people. And third, my issue is not with "access to treatment and therapy" (for adults, at least), but with epistemic demands on other people. If a depressed person demands that we validate their belief that everyone hates them for being smarter than the rest of us, and if we fail to validate that belief they might kill themselves... that is toxic AF. That's emotional blackmail. That's either despicably insincere, or something to have that person committed over. The worst response would be enabling that person in their toxic, abusive behavior.

If someone is suicidal, there are ways to seek help that aren't virulently anti-social, and empathy is not a blank check.

Wasn't there some controversy about SSRIs being no better then a placebo recently?

Anyway, if you make good on your threat, there's no contradiction between the two.

Note they aren't saying they will kill themselves but that other non-medicated depressives will due to still being depressed.

Also hypocritical given all of the left-media's critiques of things like 13 Reasons Why for encouraging a suicide contagion amongst kids by framing it as this grand operatic act.

Meanwhile, activists across the spectrum are actively placing this idea in the heads of vulnerable teens* and parents as a way to either emotionally blackmail the latter or convince the former their position is even more fragile (so they can do the emotional blackmailing themselves or be alienated from their parents).

Of course, if and when a kid does kill themselves and cites this as a reason it'll be plastered everywhere like Matthew Sheppard with calls for "life-saving care" and it'll be years before anyone dares to do any counter fact-checking, let alone suggest the media is had any role to play.

From a moral perspective this situation has nothing to recommend it. From a strategic vantage? Brilliant.

* Lots of comorbidities with "trans" stuff.

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