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Uh, sure? I don't think any proponent of gender affirming care seriously believes that there is dispositive evidence that it is harmful but that we should support it anyway for reasons of autonomy. Guyatt doesn't.
Then again, one can frame it about the difference between conclusions the data permit as compared to conclusions the data compel. I'm sure this plays into it.
In what way is the belief "disease is caused by bad humors" dispositively proven to be harmful in a way that gender affirming care isn't?
Sure he does, unless you think he doesn't believe that inducing infertility, wrecking the endocrine system, etc., isn't hamrful.
Come on man. It's fine to say "I'm right about it", it's just silly to say "I'm so right about it that the other side is like phlogiston".
Get off it.
I'm not sure "inducing infertility" is a problem -- consenting adults can get their tubes tied.
As for the rest, I'd assume it's balanced against the putative mental health issues that come with untreated dysphoria. Just like many treatments have negative aspects, you have to assess the entire thing.
FWIW, I don't even disagree with you here, if you want to fight someone over it online I'm sure you can find someone on reddit to take the other side.
Isn't that literally what you did when you dimissed hydroacetylene point about viewpoint discrimination in therapy by pointing out that medical professionals discriminate against viewpoints like "disease is caused by bad humors" and "disease is caused by spiritual rot"?
The restrictions medical professionals put on adults wanting to do this are much stricter than the ones placed on children wanting to do it as part of gender affirming care.
Except Guyatt's own research shows that there isn't really evidence that treating gender dysphoria helps anyone.
It's just an example. My argument is that your view of the medical profession is rather rosy.
That was an example to demonstrate the principle at work -- namely that viewpoint discrimination is intrinsically part of professional licensure. It wasn't some specific example.
I'm not too sure about that, but I don't think it's worth litigating at this point in the thread. At the least, the point remains that an adult can have (e.g.) her tubes tied.
There isn't evidence, and so in its absence the establishment chose to believe something that wasn't forbidden to them by the research.
There's a famous Scott piece on the different epistemic burdens people put when faced with assessing things they do and don't want to believe. In the former it's "not excluded by the evidence" and in the latter it's "not mandated by the evidence".
Obviously we both agree those beliefs were largely wrong, so what is left to debate here?
If you can draw a direct comparison without it being a specific example, I don't understand what you're getting upset at me for.
If there are stronger restrictions in place, than I don't see how the point stands.
How is it "not forbidden to them by the research" in any sense that doesn't also absolve the "bad humors" or "spiritual decay" theory? Given the negative effects of the hormonal and surgical interventions in question, and the dispositive evidence for positive outcomes, what can possibly justify they're doing?
In this case we can write "mandated by evidence" right off the bat. As for "not excluded by evidence", most things banned by licensing organizations aren't "excluded by evidence". Just take a look at the drama Scott got into around Ivermectin, there aren't studies categorically proving it cannot work, just studies showing lack of evidence for it working. That's standard fare in science, even "bad humors" and "spiritual decay" aren't "excluded by evidence" in the sense you seem to be using the term.
Epistemology, I guess. What constitutes "mandated by evidence" and "not excluded by evidence". Also, whether or not the medical profession actually follows the lofty standards you claim it does.
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