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My pitch regarding subsidies for transition is that every citizen should be entitled from birth to a finite "morphological freedom budget", calculated to cover gender reassignment plus detransition. A trans person can cash it in to transition (with just enough left over to detransition if they change their mind); an ordinary person can use the money on whatever other elective plastic surgery they want. But once you're out you're out, and further expenses are on you.
Circling back to this: I think what I find so infuriating about this framing is how the claimed purpose of gender-affirming care as life-saving healthcare is being more and more openly discarded, and yet the people who characterised it as such are refusing to acknowledge this, or in some cases (not necessarily yours) denying that they ever so characterised it to begin with.
Medical care is meant to exceed some floor of safety and efficacy, in accordance with primum non nocere. If the government pays for treatments for cancer, they should not also pay for treatments which cause cancer. If the government pays for antidepressants, they should not also pay for things which make people more depressed.
But by allotting everyone a set pot of money which can be used for gender-affirming care or reversing the effects of gender-affirming care so far as is practicable, the government would essentially be abdicating the responsibility of expressing an opinion on whether these treatments are effective medical treatments or not. "You can do this, and if you change your mind you can undo it later, and we'll foot the bill either way" sounds pretty far removed from evidence-based medicine as I understand it. The government might pay to remove someone's malignant tumour, but I can't imagine they'd ever pay to put a malignant tumour back inside; they might pay for treatment for PTSD, but they'd be unlikely to pay to retraumatise someone whose PTSD has been cured. If gender-affirming care is lifesaving treatment, it stands to reason that the government footing the bill for reversing a successful gender-affirming care procedure would be as unthinkable as their paying to reverse a successful course of chemotherapy. But framing it like this (in which you can spend money on the thing itself or the thing to undo the first thing) sounds tantamount to an admission that "gender-affirming care" never had anything to do with relieving trans people of their psychic distress (and thereby preventing them from committing suicide), and was only ever about a desire to modify the body for aesthetic reasons.
But I know you also think it's perfectly legitimate for doctors to lie to the parents of trans-identifying children and knowingly misrepresent the state of the evidence in this field provided the medics in question have a principled attitude to bodily autonomy, so I don't even know what to say to you. When I say "gender-affirming care isn't lifesaving treatment", you reply "yes, and?"; when I say "but lots of advocates for access to gender-affirming care consistently characterised it as life-saving treatment for years", you reply "yes, and?"; when I say "it's not reasonable to assume these advocates were honestly mistaken about the evidentiary basis for their claims that gender-affirming care is life-saving treatment, so the only reasonable conclusion is that they were consistently, knowingly lying, for years", you reply "yes, and?" I keep hoping that at some point you'll either deny my accusations, or own up to them and acknowledge that they were wrong: instead you just keep copping to them, but deny that anyone involved did anything wrong by so doing.
I would've thought it a no-brainer, the idea that a medic's personal philosophical attitude towards bodily autonomy should not override his duty of care to his patients or his responsibility to be informed about the medical state of the art – but apparently not. I would've thought "I support the right of individuals to pharmaceutically and surgically modify their bodies as they see fit because of a principled attitude towards bodily autonomy – but acknowledge that aesthetic modification of one's body may not be an effective treatment for grave psychic distress, and it is dishonest and unprofessional for medics or activists to assert that it is" would be a no-brainer – but apparently not. Trans activists just seem to have a wholly different conception of the standards of behaviour they expect medical practitioners to adhere to than I do.
If trans activists were upfront and said "some people want to surgically modify their bodies for aesthetic reasons, and they should be allowed to" – I mean, I appreciate it's a harder sell, but at least it's honest. "... and the taxpayer should pick up the bill" is a harder sell still, but it remains honest. But instead they adopted this approach wherein they decided to knowingly mislead the public in general (and confused, scared parents of deeply distressed children in particular) with false claims about the efficacy of gender-affirming care in preventing suicide, urged and coerced medics to parrot these false claims – and then they have the gall to wonder why people are suspicious of them and think they might have ulterior motives?
For years, Chase Strangio of the ACLU characterised gender-affirming care as lifesaving medical treatment. Before the Supreme Court, under oath, Strangio admitted that there's no persuasive evidence that gender-affirming care has any impact on the rates of suicide among gender dysphoric children. Do you see how it's only logical for me to assume that everything Strangio says going forward is a barefaced lie? Do you see how Strangio has completely undermined public trust, not just in themself, but in the ACLU and the broader trans activist coalition?
You're expecting a creature who knows naught but naked will to power to apologize for the way that it is? That denial is still an exercise of that, by the way- "yes, and?" is better phrased as "bitch, you ain't gonna do shit about it". They may have lost, but you (and reality) are still too weak to hold them to account.
I don't expect contrition from bugs when they appear in my pantry, and as a consequence my opinion that it is wrong of them to be there doesn't matter- only my ability to physically remove them does.
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Jesus Christ man, how about these people just go to a goddamn psychiatrist and leave the rest of us the hell alone for once?
In what world does what I'm suggesting inconvenience non-trans people in any way? It's literally free money, distributed indiscriminately to all citizens.
(I guess you may be assuming that it would require a tax hike to implement, but I don't think so. I suspect it would pay for itself relative to the status quo by eliminating the need for a complicated diagnosis and insurance claim process; even if it doesn't, I would be very happy to reduce funding to some other over-bloated area of government to this end, while leaving overall budget the same. And in any event we aren't talking huge numbers. Counting $20k per person as a rough estimate, we're talking a maximum of what, seven billion dollars nationwide? That is a drop in the yearly Federal budget, and it would be a lifetime allocation, not yearly. Moreover a majority of people would never use their 20k, so a vast percentage of the money would be repossessed by the US gov at no loss.)
How will the market for cosmetic surgery be affected by subsidizing it for literally everyone? How will society and culture be affected by subsidizing cosmetic surgery for literally everyone? You don't know, you haven't given it a second thought. You're a progressive pulling brand new "freedoms" out of your ass that coincidentally boil down to giving other people's money to one of your pet identity groups. Bringing women who want tit jobs or whatever along for the ride is just a sop you're willing to throw in.
After all, it's free money once you take it from other people. What about the overhead, inevitable creep, and probable activist reactions, someone downthread asks? Well golly those would form a fully generalized argument against massive government spending on non-critical issues, and since those can't possibly exist I guess you don't have to answer any of the questions.
Utterly parodical.
I absolutely do not give a single shit about transgender people. I think they should all get psychiatric treatment to stop thinking they're things they're not and get the fuck out of the public sphere. I resent every political force that has behaved as if this bizarre niche sexual practice is entitled to anything but my scorn, and I think the progressive civil rights mantle has been nothing but degraded by trying to extend it to obvious mentally ill fetish bullshit.
In short, I think we're just enemies.
It isn't. I am a genuine transhumanist and I do in fact support transgender people as a special case of my broader principle of supporting people's desire to alter themselves however they damn well want.
Sure they can. But if we decide that they do and we should just have very small government, then there's not much point in talking about the politics of gender transition on its own merits. I have strong opinions on "if there are charitable government subsidies for various things, should gender transition be one of those things" but I have neither expertise on, nor particular desire to discuss, the viability of that "if". It is, quite literally, a different question.
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The cynical rejoinder is that free money is never free. Firstly it ends up taking a huge amount of time and effort and bureaucracy to collect the money, organise its distribution, and police its usage.
But that's only the start. Soon activists will begin to protest that rich people who can pay for their own cosmetic surgery get 20k of taxpayer money, while trans people who will commit suicide without high-quality gender-affirming care get the same amount. The prices for these operations will change as the cosmetic surgeons soak up the extra funds available. It will end up in the same place as UK national insurance - means-tested to hell and back, too small to satisfy the people who want/need it and far too expensive for the people who pay for it and will never receive it.
Rather, we could just say 'No. Your morphology is your own affair. If it matters to you so much, save up and spend your own money on it'. I'm not sure how in practice your pitch appeals to those who are net taxpayers and think that transness is an unfortunate delusion.
I take the point re: the general swampy Moloch-spiral of any new government scheme - but that's a fully general argument against introducing new forms of government spending, orthogonal to the innate value of the proposal. A conversation on government bloat qua government bloat is not really the conversation I was looking to have; the policy was meant as more of a "here's how I think a sensibly run state would do it" deal than an electoral suggestion.
Well, that's where the one-size-fits-all nature of the policy comes in. As discussed in the tangent with FttG, I'd be happy expanding the scope of the policy such that it encompasses subsidies for forms of self-improvement that Red Tribers might be interested in just as well as pro-trans progressives, such as gym memberships. Besides, in the mid-to-long term, I expect genuinely attractive self-mod options not related to gender to become more and more available and popular; one (wo)man's sex surgery budget would be another man's cyborg-implant budget. Though again, I wasn't really thinking of it in terms of how to "sell" it to a partially hostile nation, just describing how I think a state populated by what I'd call reasonable people ought to do it.
I almost went on a tongue-in-cheek tangent about the fact that rationally, a random cisgender taxpayer can't be sure he or she won't have a gender epiphany in twenty years, and spending a few extra dollars in taxes on supporting the policy would therefore be insurance of sorts. I suppose that actually does raise the serious alternative option of introducing straight-up private-sector "trans insurance" separate from health insurance. Plausibly, enough affluent Blues would buy it as a virtue signal to meet demand, without touching the wallets of anyone who objects.
I don't love that option, because it bakes in gender exceptionalism, whereas an important part of my morpho-freedom-budget idea is that it would serve as a slow lead-in for broader societal acceptance of transhumanism (within which I hope and expect today's gender specific "trans movement" to ultimately dissolve). But it would probably work better than the healthcare kludge we have right now, and would presumably be more acceptable to gender-criticals, as they could keep on buying their health insurance without funding transitions.
Fair enough, if you’re interested in a ‘wouldn’t it be cool if’ conversation. I’m most interested in sensory and mobility stuff - giving more senses and mobility seems to be basically a pure win with very little social upheaval required.
On the practical level, the strong tendency towards bloat means that any such measure would need to be catering to a very strong need that I regard as legitimate and hasn’t been solved any other way, but that’s another conversation.
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What about those of us who aren't weirdos, can we just take the money and spend on a nice house, a couple cars, and retiring early?
One of the more facile arguments made by trans activists is that lots of banal things cis people do all the time technically fall under the domain of "gender-affirming": building muscle mass, getting hair transplants, whatever. The cost of a single penectomy or vaginoplasty would probably cover a lifetime's gym membership and a return trip to Turkey.
The reason it's a facile argument is because the reason I do strength training is because I want to be stronger, more attractive and to make sad head voice quiet, not because I want to more "fully embody my masculine gender identity" or whatever. But it's not like I'd object if my gym membership was subsidised by the taxpayer. I could even imagine a hypothetical world in which such a policy represented a public saving in the long run, if paying for people's gym memberships made them more likely to exercise and in turn less likely to suffer from cardiac disease and obesity-related illnesses. Maybe the lower BMIs, improved muscle tones and higher sex drives that would result from a higher proportion of the population exercising regularly would even improve fertility rates. But my gym membership costs me less than €40 a month, which according to ChatGPT is pretty typical: I find it hard to imagine the monetary expense is a leading factor in why so many people are sedentary.
It's funny to imagine a world in which @WandererintheWilderness's nonsensical policy is put into practice and used to pay for penectomies, phalloplasties and gym memberships. Improving the inclusive genetic fitness of one large demographic while sterilising another, under the exact same policy.
Not as a rational cost-benefit thing, but I think a government subsidy could plausibly manipulate significant numbers into taking advantage of the opportunity, due to the human tendency to not want to "miss out" on a free lunch. Think of all the people who stuff themselves at buffets on free snacks they'd never touch if they had to pay for them, even for cheap. If people were told "you have [X] thousand dollars in the bank, they're yours, but they'll revert to the government unless you spend them on one of gym, hair-dyes, plastic surgery, etc." I think that would in fact increase demand for each of those items as people rush to get what's 'theirs'.
And I don't think it's fair to call my proposed policy "nonsensical" even as you grant that it might be net-positive and that you might like to take advantage of it yourself if it was on the table! Unorthodox, yes; implausible in the short term; but hardly nonsensical.
Well, the point I was making was that I think a positive side effect of such a policy might be that it encourages more people to become fit and healthy, which would pay down dividends in terms of public health expenditure and improved fertility rates. A policy which enables mentally ill people to chop perfectly healthy tissue and organs off of themselves at the taxpayers' expense (and then attempt to reverse the damage as much as possible several years down the line, likewise at the taxpayers' expense) does strike me as nonsensical, even if such a policy was sufficiently broadly-worded as to also include paying for members of the public to become more fit and healthy.
Put simply: would I support a policy of publicly subsidised gender-affirming care and detransition procedures at the taxpayers' expense (option 1)? No, I think that's silly and dumb, in much the same way as publicly subsidised boob jobs and lip fillers would be (in fact, much of the time we would be talking about literally the same procedures). Would I support such a policy if it also included publicly subsidised gym memberships (option 2)? Again, no, but it would be silly not to take advantage of it if it was already in place. Would I support a policy of publicly subsidised gym membership (perhaps under the use-it-or-lose-it model you describe)? Yes, I could be persuaded that such a policy passes a cost-benefit analysis, in a way I simply couldn't with option 1.
"The government will pay for you to chop off pieces of your own body, and will then pay for you to restore them years later after you've decided it was a bad idea" sounds like a conservative parody of wasteful public expenditure, analogous to a self-licking ice cream cone or paying people to dig holes in the ground then fill them up again. It would be exactly as nonsensical as paying people to get fit and healthy and also paying for them to sit on their couches eating ice cream.
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Why on earth would this be a good idea? I would never want to vote for anyone's "morphological freedom." This is an extremely alien thing to Western civilization you're arguing.
Do you oppose "morphological freedom," or just this idea for making subsidies for transition more palatable?
Both!
Why oppose "morphological freedom?"
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If you want to work hard, earn money, and then use it to irrevocably damage your body and future prospects, well, I'm a libertarian and I can somewhat get behind that. If you want to euphemistically throw in that word "freedom", which is being used here to mean that I should pay taxes so you can do that for free, hell to the fucking no.
Tell that to the person who proposed it.
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