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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?
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.
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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!
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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.
I think you're too stuck on whether this is technically a threat or not. the metaphor to interpersonal threats of self harm is just a metaphor. There are two components to the objection I think people are making here. One is that the ask on the trans camp isn't for us to give them some neutral treatment, it's to validate truth claims that many of us find would make liars of us. And the practice used to demand these truth claims be validated is not argument but claims of harm, and not even just harm but self inflicted harm which to many people is a completely different category of harm that you don't seem to ever acknowledge as different. When you combine these things together you create a dynamic where reality gets defined by whichever group is most willing to harm itself to get its way. This is a dynamic that many of us viscerally reject, we cannot operate society this way. So in the end we're not really willing to weigh the 'costs' here because the costs are effectively infinite or the entirety of society breaking down. It genuinely matters more what is true than whether people will harm themselves if faced with reality.
Which is I think definitely is a reasonable objection to be clear.
My view is one of a bureaucrat, at societal level decisions, for example people smoke themselves to death or drink themselves to death and you still need to try and stop it happening as a government even though they are in some views responsible for their own problems. While balancing peoples rights to eat and inhale things. If you peel off self inflicted harms, it includes everything from weight to speeding, but that doesn't stop us putting in speed bumps and mandating better calorie labelling on food.
So society already operates in order to try and reduce self-inflicted harms while not removing freedoms entirely.
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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?
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.
This entire debate is more radioactive than Godzilla because it's not just about Bill says he is a Real Woman. If Bill tries cutting off his own arms and therefore surgically removing his arms and giving him prostheses is the best thing for Bill, it doesn't affect my life. But what we have is the equivalent of Bill not alone demanding you cut off his arms and give him prostheses, then everyone has to at least pretend they believe prostheses are the exact same thing as having arms. It's Bill barging into events and claiming that if he can't compete in snooker matches (insert sport of your choice that needs good motor control) against professional players, then it is discrimination and the rules must be changed. By the bye, didn't we go through this already with Oscar Pistorius? Rather an unfortunate example, I agree, but the same debates over "does he have an unfair advantage?" took place.
It's Bill saying that unless we all agree that chopping off your arms is a sane, normal, healthy activity, we are ableists and amputationphobes and that a law to protect him and those like him must be passed. It's amputee activists creating cute cartoons to kids that hey, maybe they too might be like Bill and this is how you get the doctors to agree.
Right that is why we are keeping the discussion contained to specific areas. Just to be clear, just because I don't think that saying not doing x is not abusive does not mean I think we have to actually do x. There might be a lot of other reasons not to.
If it were true that chopping off someones arms was the best option for them but it cost a billion dollars I'd still be saying sorry Bill, even with the risk of you killing yourself by self-surgery the cost/benefit ratio just doesn't work out.
My point is simply that if you are observing an impact of doing or not doing x that isn't on its own abusive behavior. You aren't yourself threatening to commit suicide. I think if it were, "If we discontinue all treatment for depressed people it is likely suicides will increase" that is most likely an uncontroversial statement, even if it were being said by an anti-depression activist.
Likewise a trans person saying if you don't accept us/allow transition/whatever could mean additional trans people killing themselves is if true something to take into account. It might still not be worth it, depending on the costs (both financial and social) but it isn't in and of itself abusive. It's not a threat because they can't actually control what all other trans people do.
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I'd be more amenable to that if it seemed like therapeutic solutions had actually been tried and found wanting. Instead, it seems like therapeutic solutions have been deemed mean and politically incorrect, and not tried. And I get the metaphor with bipolar, but bringing this back to the original point, I am not responsible for someone else's behavior. If Kanye West doesn't want to take his meds, then he gets to deal with the consequences of his unhinged behavior. If you really want to transition, go for it. If you want to surgically turn yourself into a cat, or an orc, have fun! But when you threaten self-harm if I don't buy into your delusional framework, you're either too ill to get to make those decisions for yourself (and need to be committed and treated for general suicidal ideation separate from your gender issues), or you're an abusive piece of shit.
Again though largely, they are not themselves threatening to commit suicide themselves. They are saying if you do X or don't do Y, it increases the likelihood of some trans people committing suicide. Whether the person saying that is or is not trans themselves does not have any bearing on the truth of that statement.
If they say if you don't do X I specifically will kill myself then that is a different statement.
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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.
Again... this is okay if and only if we agree that depressed people are mentally ill.
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?
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!),
This is stupid. It's telling that this sort of achingly awkward construction is the best you're able to come up with after many attempts. It's fine to tell him that he's going to cause privation and misery by shirking, I suppose. Invoking suicide is a rhetorical record-scratch moment where you immediately sound like you've gone off the deep end. It adds nothing, you'd never include it, and it makes your statement less compelling rather than more if you do, because it sounds so transparently manipulative and irrelevant to the point.
That's fair I think, none of the analogies away from mental health have been great. I think those still stand however.
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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.
I think what offends, at least to me, about this line of argumentation is that it implicitly incentivizes committing suicide. It's a kind of brinksmanship of slave morality. It has the same kind of energy of forums that hear about a mass shooting and are, often not even secretly, hoping for it to be their kin slaughtered by the hated outsider. It's this ugly race to the bottom of grievance where instead of groups showing how excellent they are everyone is slavishly hoping for their ingroup to come out as pathetic and worthy of sympathy as possible. It's an impulse I recognize in the worst parts of myself. And if this is the impulse that gets my ingroup what it wants why not indulge it?
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Yeah that got a bit too abstracted.
The problem is, you are 100% correct imo, the idea that better treatment of trans people will reduce the risk of their suicide is not inherently abusive, and it's a fairly standard part of risk management re the mentally ill. Which is why it became such a popular talking point. But then you had trans people lobbying for their community with it. And when trans people started lobbying with that talking point the potential for abuse increased by orders of magnitude, because when you lobby for the community you belong to, anything which affects your community necessarily affects you.
And a percentage of trans people, like a percentage of the rest of the world, are manipulative abusers who saw a superweapon - by ramping up the emotion and playing on their fear, they could make their community (many of whom are on hormones, never mind their default mental state) feel like they were being viciously persecuted and driven to suicide. Then even if someone points out that they are a sociopath manipulating everyone, they can discredit them as a transphobe trying to kill trans people.
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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.
Sure, and... that was my point at the root of this whole comment tree, going back to my comment five levels up.
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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.
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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.
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