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naraburns  nihil supernum  1yr ago (text post)   32768 thread views

Culture War Roundup for the week of February 20, 2023

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Jesse Singal gets gaslit

Also, a more neutral take: https://elizamondegreen.substack.com/p/about-that-twitter-shitstorm-affirmationnot

Brief recap:

  1. NYT shifts its coverage of medical concerns for trans issues from 100% supporting transition in all cases to a more questioning stance, particularly with minors

  2. An open letter is sent to NYT laying out "serious concerns with editorial bias" in response to this shift

  3. Jonathan Chait posts a critical response to the open letter at New York Magazine (no relation to NYT)

  4. Chait gets dragged on twitter for being anti-trans, with a highlighted passage

  5. Jesse Singal posts in support of Chait, showing the highlighted passage is directly in accordance with WPATH guidelines and explains what it means

  6. E. Kale Edmiston, a trans man, posts in response that he, Edmiston, wrote the WPATH guidelines posted by Singal, and that Singal is misinterpreting them

  7. Liberal media pundits and reporters pile on, when Singal defends the straightforward interpretation, demanding that Signal accept Edmiston's (frankly bizarre) interpretation of the quoted passage

  8. Singal has done his homework and contacts several other WPATH authors, who all confirm Singal's interpretation of the passage and reject Edmiston's

  9. Eventually this reaches Scott Leibowitz, overall head of the WPATH guidelines document, who says that Edmiston definitely did not write the highlighted passage, and later severely admonishes this lying and false attribution from within academia

  10. Singal performs several victory laps on Twitter, demanding from the media pundits and reporters the apologies and corrections they had demanded from him

Good guys: Jesse Singal, Jonathan Chait, Scott Leibowitz

Bad guys: E. Kale Edmiston, Madeline Leung Coleman (NYMag editor), Michael Hobbes, Jeet Heer, Marisa Kasabas (MSNBC Columnist), David Perry, Eric Vilas-Boas (Vulture staffer), Miles Klee, Siva Vaidhyanathan

The most interesting, dire, and relevant info is from Eliza Mondegreen, linked near the top. Apparently there is a wink/nod system with the WPATH Standards of Care document, where the words are written a certain way because they must be, but they are interpreted much differently.

She concludes:

Theory and practice—the Standards of Care and what actually happens in the exam room—have nothing to do with one another. Everything in the Standards of Care that sounds cautious and responsible comes with an understanding that’s supposed to go unspoken: We don’t really mean it. We just need to say this. If a patient shows up with serious comorbidities, of course we have to say that they must undergo a “comprehensive” “assessment” and that the clinician must remain open to the possibility that the patient might not really have gender dysphoria and maybe shouldn’t really transition. But you know how important the work we all do is.

In other words, the Standards of Care are a lie that everyone involved in gender medicine pretends to believe. When reporters like Singal and Chait try to hold gender clinicians to WPATH standards (something I think is worth doing, by the way!), savvy clinicians will respond: Yes, of course we “assess” patients very carefully, what do you think this is, the Wild West?

Among other, more obvious mistakes, Edmiston’s most grievous error was not pretending to believe the lie.

EDITS: Signal, Single, Liebowitz. added Cast of Characters, Eliza Mondegreen quote

I honestly just decided I’ll be a bigot and have worked out that trans people don’t exists. Realistically I think there’s an incredibly small percent of the population that some hormone thing went wrong and really have gender confusion.

It feels a lot like anorexia. Where Scott just wrote a piece about how it wasn’t common in society until one case got publicized and now you have an epidemic of anorexia and the same process has occurred in multiple societies. Or like one mass shooting leads to multiple Maas shooting.

So it’s part of the culture war I get no interest in reading the nuances of. It’s like trying to debate caring about a cult of Scientology.

It is exactly like anorexia, and it's also exactly like Dennis Avner aka Stalking Cat.

Dysphoria is a disorder, treating the disorder should be mutually exclusive with affirmation. Yes, anorexics are too skinny, no they don't need to lose more weight. No, Dennis is not a tiger. No, men cannot become women, nor should they try, and neither can women become men. I've always been partial to the homosexual/AGP split to explain transsexual men, mostly because it pattern matches to the personal encounters I've had with them, but I have no idea what causes women to become transsexual. At this point I don't care why they are the way they are.

I have no patience for acceptance or affirmation, and my patience for simple tolerance shrinks every time I hear of stuff like this. It's a social contagion, an infohazard, and just like you shouldn't publicize and glamorize suicides, you shouldn't publicize or glamorize transsexuals.

you shouldn't publicize and glamorize suicides, you shouldn't publicize or glamorize transsexuals

Suicides and transsexuals are a good start, but if we were to rank order a list behaviors that shouldn't be glamorized or publicized those wouldn't be 1 or 2 on my list, though they'd probably make the top ten.

So it’s part of the culture war I get no interest in reading the nuances of. It’s like trying to debate caring about a cult of Scientology.

Too bad it cannot stay a niche like scientology,. It's not like scientologists are demanding we use their lingo in everyday parlance.

There was a time up until probably the early 2000s when Scientology was a large part of the culture war, in particular regarding several legal battles between the church and it's detractors. They really were attacking anyone discussing Xenu, and both openly and covertly threatening their detractors. There are some pretty serious allegations against them.

I don't think Scientology is the best example here.

Maas

Mass-shootings As A Service. If you believe these are partially a social contagion caused by hysterical media coverage, then this is sort of true.

deleted

Paging Scott to include this in the next Bay Area House Party article.

You can always shoot yourself! Be the change you want to see!

I think — love to the good ones like Scott — almost all of psychiatry is basically a pseudoscience dressed up as medical science. There’s just not the same level of skepticism and rigor behind the diagnosis and it’s not even something that most of them seem worried about.

The DSM defines various illnesses abut there are problems here. First, everything is based on self reported symptoms. This is not how a science-based medical diagnosis should work, especially now that anyone can simply Google and find out what to report. How does a doctor know you have the symptoms? You tell him, and he believes you. If you report losing your keys “often” and that you can’t pay attention in lectures, you have ADHD— with no checks to see if you actually have more trouble than anyone else of the same age. Second, most of the disorders are simply defined as symptom clusters, none of which are something objectively testable even if you wanted to. It’s a mess.

Add in that doctors caring for mental health quite often aren’t skeptical about anything their patients tell them, and it’s simply a patient wring their own diagnosis through the auspices of a doctor who will believe anything and use that to give you what you want.

The DSM defines various illnesses abut there are problems here. First, everything is based on self reported symptoms. This is not how a science-based medical diagnosis should work, especially now that anyone can simply Google and find out what to report.

I'm not sure this is a tenable position.

If you actually dig deep into the philosophy of disease and disorder in medicine, it's actually very hard to robustly define what an "illness" is, and there are actually lots of cases where the collection of symptoms is more valuable to doctors than the specific cause of what is going wrong in a person.

Consider over-the-counter medicine, which often just treats symptoms like fever, runny nose, or pain. Sure, it might be helpful to know the exact variety of flu or cold virus I'm dealing with, but researching and treating each of them individually would be costly for society, and it far more resource efficient to say, "Use what you can get at the supermarket to deal with the worst symptoms, and if you sickness gets bad enough, then go to the doctor for more specific medicine."

The process of constructing a definition of a "healthy human body" is a partially social one, and has points that are debatable. What's our cut-off for "unhealthy"? Is every measurable trait of the human body that correlates to shorter lifespan, or greater physical or mental distress automatically "unhealthy"? I'm sure I don't need to explain why that would be unworkable - but one example is that would have us saying that being tall is "unhealthy" since men tend to be taller than women, and tend to live shorter lives than women. But these kinds of questions pop up over and over in medicine, and the current medical consensus of what counts as a "disease" and what is merely a normal variation of human traits is going to be highly dependent on what treatments exist, what kind of measurements we can take, and past precedence.

The DSM is very clear in its introduction about the model it uses when thinking about mental disorders. It more or less acknowledges that the diagnostic categories are more practical than ontologically rigorous. They're telling the doctor, "In the past, when we've had patients that report issues x, y and z, we've generally found medicines a, b and c seem to help those patients in controlled studies." They're not telling doctors, "A patient reporting issues x, y and z, has a definitely 'real' disease A, which is mechanistically and reliably caused by b, c and d."

Last time this came up, I gave a variety of DSM listings which were objective. They had symptoms with specific lab tests, or obvious external evidence. If one ends up eating sand regularly, that’s pica; no self-reporting is needed.

There are steelmen for subjective diagnoses like depression, too! My cousin tried to kill himself after his father’s death. He got committed for it, because that’s pretty good evidence that something is going on in his head.

Psychiatry is not limited to gender affirmation and Ritalin. You’re building a case that doctors “will believe anything” based on how many “seem worried” about meta-level concerns for their field. This is compatible with credulous doctors. It also fits with doctors as drug shills for Big Pharma, or as political fifth columnists. Or maybe you just don’t talk about the Scientific Method with lots of psychiatrists, I dunno.

How much of psychiatry do you think is real?

There are steelmen for subjective diagnoses like depression, too! My cousin tried to kill himself after his father’s death. He got committed for it, because that’s pretty good evidence that something is going on in his head.

Is it? I mean, the judgment that suicide is bad or an inappropriate response is itself, a moral and cultural one. The Indian women who threw themselves on their husband's pyres were not crazy - they were doing exactly as their morality and culture prescribed. Suicide right now is considered immoral, so we act to prevent people from doing it... sometimes. I understand it's back in fashion in Canada, and doctors will not only do nothing to stop you from asking for euthanasia, they'll give you a button to do it with.

Items eaten include earth, paper, chalk, feces, glass, paper and other nonfood items.

Huh, but what about paper?

I think getting a full, accurate picture of someone's mind would have to basically involve spying on them without their knowledge to observe how they act. As someone who did see a psychiatrist for ASD (and got medicated), I think it helped overall, though I've been off medication for years and I have a hard time remembering what we did other than chat weekly. But thinking back on it, I think there were patterns of my behavior and other things I never really told him, and I wonder how that would have affected the diagnosis and his approach--but then, I also feel like he told me that I didn't have to talk about everything, or at least, he never pressured me to.

Realistically I think there’s an incredibly small percent of the population that some hormone thing went wrong and really have gender confusion.

I mean the base idea here is that Gender Dysphoria is definitely a real thing that exists.

Meanwhile the whole trans movement is more about 'how does society decide that these people should be treated and what is appropriate in regards to them' then it's far more a matter of conjecture and debate.

It’s basically a subtype of body dysmorphia. How do we treat that? Surgery is contra indicated, that should give you some idea

Doesn't this imply that surgery would not help those with body dysmorphia (perhaps they might still feel the dysmorphia even after alteration), ergo, it wouldn't help trans people? But you could probably find trans people for whom surgery really did wonders for their mental well-being, i.e., it "cured" the dysphoria.

IIRC suicide rates remain static for trans people who undergo surgery - in other words no change in mood. Dysphoria would just move to some other aspect of themselves, like whack a mole.

Hard to disentangle the second order effects arising from trans surgery not being actually that great though -- is the gender-swap in and of itself making the people feel better, or is it the power arising from providing a locus of control over society and its denizens, or the feeling of putting one over on everyone?

Ironically a magical trans-sex pill wouldn't really provide these ancilliary benefits, and therefore might work less well at alleviating the discomfort -- it would be interesting to compare satisfaction between the "Bruce Jenner middle aged AGP dude" and the new crop who blocked their puberty and are directionally closer in appearance to their ideal, once they hit their 30s or so.

The trans movement is also about "what does it mean to be trans," and "what traits make you trans," "is it morally and/or socially good/high-status to be trans," and "is it beneficial for a person to be trans" and other questions that are not just about how other people interact with/treat trans people.

Though Scott stresses repeatedly, that anorexia or anything else is not "less real" even if the underlying cause is 100% social and 0% biological. Do you think mass shootings don't exist? Of course not. An anorexic girl will still be anorexic and is in danger to hunger herself to death.

This is a bit weird to truly wrap ones head around. Lets take demonic possession. Deciding that there are no demons (or maybe very few) is a valid position. But there is a difference between A) this isn't real, possessed people are faking it, and B) the brains predictive engine is very good in simulating, and the individual experience/qualia is suffering under demonic influence.

I think the answer is ‘so what if it’s real that some people feel like women trapped in men’s bodies. Society doesn’t owe comfort to weirdos.’

I think your phrasing may come across as unduly harsh, but I'd agree with an amplified version. Society doesn't owe comfort to anyone. Comfort is something to seek and give on an individual basis, and generally isn't owed, with some exceptions, as within a family context.

It…kind of does, though. See the ADA, special ed, prison reform. Any number of other times society accepts some cost to mitigate harm for a disadvantaged group.

The question is how much.

100% Most conservatives also agree, but, stereotypically, see it as the church helping widows and orphans.

We are a rich society, and I think that behooves us to help the less fortunate. The trick is how much, and doing it in a way that doesn't encourage too much becoming an 'unfortunate'. I think that's a really complex topic, and one, unfortunately that seems hard to talk about.

E.g. I think having decent unemployment insurance and welfare is a net social good, reduces stress, making people more willing to change jobs, and even reducing crime (as you have more to lose). OTOH, it of course incentivizes people who could work, but just don't, which parasitizes society. I don't think you can have the one side without some of the other, and the key to good policy is finding the balance, and ways decrease the bad effects in ways that don't decrease the good effects more.

Like @The_Nybbler said, I think that the ADA was a huge mistake. Well intentioned, yes, but a mistake nonetheless. We can't reasonably try to build all of society to conform to the needs of a small minority of people.

I’ll defend it on veil-of-ignorance grounds, I guess. I don’t have strong feelings now, but I would want to have those accommodations if I were wheelchair bound or whatever. And unlike gender we have the expectation that it could happen to us. That makes it a hedge against breaking your leg or getting paralyzed.

I’m not sure that’s literally how the ADA got traction. There was a good dose of political pressure from the beneficiaries, as with women’s suffrage or race relations. But it was enough to get some outsiders saying “these people are right; it doesn’t matter that they can’t beat me in a fight.”

Point is, sometimes society does extend charity. Maybe pronoun usage, or making insurance cover hormone therapy, is too far. But it’s not unthinkable.

I’ll defend it on veil-of-ignorance grounds, I guess

I'll attack them on veil-of-ignorance grounds: Even if I ended up in a disadvantaged position myself, I'd rather be born into a society with functional institutions for the average person, than into a society that gives me more handouts, but results in massive barriers for getting anything done.

All of those are errors. The ADA is the second reason we can't build anything (NEPA being the first). Special ed ends up consuming a large percentage, sometimes a majority, of education resources trying to educate the uneducable -- and in worse forms it sometimes ends up ruining education for the rest.

Deciding that there are no demons (or maybe very few) is a valid position.

Not only that, but convincing others that there aren't actually very many demons and the are probably not currently in the thrall of one seems likely to decrease the number of apparent demonic possessions. In contrast, saying that demonic possession is common, shouldn't be judged, and needs a flag to support brave people of possession seems likely to increase apparent demonic possession above ambient levels.

Well, I think that still could mean that the best way to help reduce the number of people suffering such conditions is to not publicize and normalize it so much.

Rather than saying they don't exist, it would be more accurate and productive to say that they have a mental illness. Like with people with anorexia. It exists, it can cause suffering, it's complicated and hard to solve rather than just "made up" in a way that a five year old pretending to be a cowboy is. But it exists within the realm of psychology, and therefore effective treatments will also be within the realm of psychology: therapy and medications. And it is socially irresponsible to enable the behavior and reinforce the illness, even though sympathy may be appropriate as it is for most mental illnesses.

But it exists within the realm of psychology, and therefore effective treatments will also be within the realm of psychology: therapy and medications.

I don't think the conclusion follows.

I, like many men, have a similar problem to transgender folks: I'm Dwayne Johnson in the body of a 40+ computer programmer. The solution is squats, deadlifts, bench press, road work and clean eating, not therapy and medication. Body transformation >> body acceptance, at least in this particular case where body transformation has so many other benefits. And it's pretty easy to reverse the transformation and go back to dad bod if desired.

The principle that "what starts in psychology stays in psychology" seems to be false.

Now in the transgender case it's trickier because body transformation doesn't work very well and it seems like the desire for body transformation is often far less permanent than the transformation itself. But that is fundamentally a question of cost/benefit analysis (and I think the modern world is getting it wrong).

Abstract principles like what you describe don't help. If we had a 100% perfect and reversible gender transition, there would be no reason not to let people try on an opposite gender body just for fun.

I'm Dwayne Johnson in the body of a 40+ computer programmer. The solution is squats, deadlifts, bench press, road work and clean eating, not therapy and medication.

You forgot steroids.

EDIT:

(I'd like to add that without the steroids, he'd probably look half as muscular, which would still be rather impressive in the context of our sedentary society )

I dunno why the rock is always the go-to example of steroids overuse. He's 6'4 and 260 pounds. This is really tall. Using the cube law of scaling, this is the same as a 5'7 man who weighs 178, which is not so unreasonable. Even Joe Rogan is 15 pounds heavier at about the same height.

He did three different professions (football, wrestling, acting) all notorious for steroid use. He's noticeably more muscular than he was at 30.

People who use steroids think he's almost certainly using based on the way he looks. Discussions on nattyornot is almost unanimous.

Going by FFMI he is is borderline, but I think it's safe to assume he's on something.

This is more correct than cubic scaling when comparing individual people rather than across animals. This is why both FFMI and BMI use a square in the denominator despite the fact that the third power has been proposed for more than a century now. Tall people are not just linearly scaled up short people. A square simply describes the observed variation better. Using a square law The rock is the equivalent of a 202 pound, 5'7" guy, very lean, at 50 years old.

It's not clear to me what the reference to Joe Rogan is here. He is not nearly as lean, and I think is open about using exogenous anabolics in the form of "TRT" and HGH.

I don't know where the line is between use and overuse. But the Rock is visibly, obviously cycling a stack of anabolic steroids.

don't think the conclusion follows.

Okay yeah, you're right, and my statement was worded too strongly. It does not follow with logical certaintly that psychological issues must be solved solely within psychology, and there are plenty of counterexamples. But it should be the first thing to try. Plenty of "trans" people have other psychological issues and comorbidities that cause distress, and the trans thing is a red herring, a panacea they've been sold to solve all of their problems. And if they transition those issues still exist but now their one panacea has been tried and they think their problems will never go away. and they have a mutilated body.

And even for someone with actual gender dysphoria as their primary problem. Maaaybe it's an objective desire, analogous to your body building issue, where they inherently wish they had a certain body type, and getting that body type solves their issue. But maybe it's relative: grass is greener. Maybe part of their brain perpetually and irrationally insists that they are ugly and disgusting despite being perfectly health and attractive (a lot of teenage girls have body image issues like this). They just don't want their current body, whatever it happens to be. And no matter what it changes to, that part of their brain doesn't stop telling them that they're disgusting, because it's broken in some psychological way, not actually grounded in their physical body. Transitioning will not help with this latter case, and will in fact make it worse (and does, when this happens in real life).

Yes, if we had a 100% perfect and reversible gender transition, then there would be a lower cost to just trying it and seeing if it works, so I would have much fewer objections to moving it earlier on the list of things to try. (There are still potential social issues, like letting creeps and rapists into women's safe spaces, or having people lie about their original sex to sexual partners who care about their partner's origins not just their current body, but those are a separate issue, and don't apply to good-faith actors who are genuinely seeking help.) But given the irreversible and mutilating brutality of current transition technology, I think it should be an absolute last resort after all interventions and even non-intervention have been attempted and the only alternative is suicide. Maybe in a few decades if technology has advanced we can reconsider transitioning as a viable treatment mechanism. Not today.

body transformation doesn't work very well

Do you mean the transformation itself is poor or that transformation is a poor treatment for the illness?

In your fantasy future where

100% perfect and reversible gender transition

Is possible and available, would you expect this to cure the dysphoric cohort?

My suspicion is that other symptoms would emerge. Are anorexics cured / happy once they reach their weight loss goals?

Do you mean the transformation itself is poor or that transformation is a poor treatment for the illness?

I'm not the person you're responding to but I think the answer to both questions is yes. There's no way to enable trans women to get pregnant, neovaginas are a laughably poor substitute for the real thing (functionally and visually), facial feminization surgery only goes so far (especially if the recipient has already completed puberty). On the trans men side of things, no amount of testosterone will enable any trans man from achieving the muscle mass and bone density of the average cis man, and you can't ejaculate with a neopenis.

In answer to the second question, there was a study conducted in Sweden which found that undergoing gender reassignment surgery did not significantly improve the recipient's likelihood of committing suicide. Obviously beware the man of one study (one obvious potential confounder: a trans person even considering undergoing said procedure is probably in far greater distress and hence proneness to suicide than a trans person who isn't considering it), but anyone presenting medical transition as a silver bullet is either ignorant or deceitful.

I, like many men, have a similar problem to transgender folks: I'm Dwayne Johnson in the body of a 40+ computer programmer. The solution is squats, deadlifts, bench press, road work and clean eating, not therapy and medication. Body transformation >> body acceptance, at least in this particular case where body transformation has so many other benefits. And it's pretty easy to reverse the transformation and go back to dad bod if desired.

That sounds like therapy.

Like, talk therapy involves lifestyle changes all the time. It can be an important component of treatment. This is still, 'what starts in psychology stays in psychology'.

I, like many men, have a similar problem to transgender folks: I'm Dwayne Johnson in the body of a 40+ computer programmer.

If those things are actually similar, that blows up the entirety of trans discourse into atoms.

If "I'm a woman stuck in a man's body" is just a more dramatic way of saying "I wish I was a woman", there's no good reason to concede any of the demands of the trans community. Not the bathrooms, not avoiding "misgendering", not women's sports, or women's prisons. You can wish all you want, why should anyone care?

You can wish all you want, why should anyone care?

People should care because it's good for us to care about one another.

Rather, you can wish all you want, but why should anyone bear the costs of your wishes?

This is, for me, a recurrent political challenge as an American, because I end up stuck between the bifurcated "standard positions" constantly. I object to abortion but I value doctor-patient confidentiality, so as long as I don't know it's happening, I don't think I have much to say about abortion--but if you want to spend tax dollars making it affordable, accessible, etc. then I have a problem. If a man wants to dress in lipstick and ballgowns, enjoy! But if he wants to police my language and my thinking by making implausible demands concerning his pronouns, he can fuck right off.

The law is at its most ethically plausible when it is mediating conflicts between important interests. Modern welfare states, however, are substantially modern manipulation states, deploying government coercion not to mediate legitimate conflicts but to thumb the scales in furtherance of questionable aims. People think it's not good enough for the state to merely abolish segregation laws; they think states must proactively "integrate" communities, even over the objections of historically oppressed minorities. People think it's not good enough for the state to decriminalize activities; they want the state to subsidize those activities. This, I think, actively erodes the care that we should quite naturally feel toward the other humans in our lives. I should care if my friend wishes to have a different body; if the technology existed to actually change them into what they want to be, I'd be all for it!

But I wouldn't pick up the tab for it, and should not be required to pick up the tab through insurance pooling or taxation--any more than I should be required to pick up the tab for their wished-for sports car.

object to abortion but I value doctor-patient confidentiality, so as long as I don't know it's happening, I don't think I have much to say about abortion...

I've never found the confidentiality argument from Roe persuasive, and I don't think the legal system ever did either. Any coherent principle that treatments are exclusively between doctors and patients has to skip over that Roe was never found to legalize medical marijuana or euthanasia, both of which we've punished patients and doctors for in the past.

I think there are reasonable arguments in either direction, but a hard libertarian view of the doctor-patient relationship seems only to be referenced as a rhetorical cudgel rather than a principled argument.

I think there are reasonable arguments in either direction, but a hard libertarian view of the doctor-patient relationship seems only to be referenced as a rhetorical cudgel rather than a principled argument.

Well, it was used as a throwaway example in this case, but since it is apparently all anyone wants to talk about...

My substantive position on abortion is that it should not be legal except in cases of rape, incest, or to save the life of the mother. But because I am not against abortion in all cases, I have created an enforcement problem for myself. How should doctors confirm rape/incest/etc.? This creates a potentially perverse incentive for women to lie to their medical providers about what happened, and about things that may require doctors to report to law enforcement. Sending a man to prison for a rape he did not commit strictly because you do not want to have his baby is morally repugnant, of course, but people have, and will, lie for far less.

Consequently, my resort to doctor-patient privilege is less of a "hard libertarian" view than it is an attempt to balance all competing interests and think of a policy that raises the fewest serious problems. If I were the tyrant in charge of such things, then, I would forbid the advertising of abortion services and spend no public resources enabling abortions. But I would also not criminalize the provision or acceptance of abortion services. There are obviously other details I'd have to iron out re: deliberate murder of the unborn, and really I'd like to see abortions that do happen limited to very early in any given pregnancy. But the real point of saying all this is just to further illustrate how wildly outside the realm of remote possibility my views are. Absolutely no one cares what I think on the matter; my views give too much to their outgroup, pretty much no matter who their outgroup is.

How should doctors confirm rape/incest/etc.?

The difficult to diagnose ones are crimes so perhaps use conviction of the perpetrator if we were organized enough to have trials within 9 months.

An alternate method is to have an abortion court where the woman makes her case and an interested party for the rights if the baby make their case and an impartial jury decides. Burn the records afterward, sealing stopped being trustworthy too long ago.

People should care because it's good for us to care about one another.

Rather, you can wish all you want, but why should anyone bear the costs of your wishes?

Nope. I'm sorry, I'm just one man, and there's millions of human tragedies unfolding every day. I don't have that many fucks to give away, if I actually cared for everyone I'd be a nervous wreck. I'm actually happier to pick up the tab for someone's fanciful wish, than to be forced to care for it. You're Dwayne Johnson stuck in a dadbod? Here, have a gym subsidy, or something. You want a sports league for guys who wish they were women? Why the hell not, knock yourself out. You want me to care? Why? Who are you anyway, and why did you follow my daughter into the locker room?

I object to abortion but I value doctor-patient confidentiality

It's off topic, but I don't get that argument. Doctor-patient confidentiality is not absolute. We let doctors handle pretty hard drugs, but my understanding is that if a doctor starts prescribing hard drugs for the explicit purpose of getting their patients to trip balls, they're getting locked up. Doctor-patient confidentiality would get even more disregarded when the lives of third parties were involved. I don't think a doctor is allowed to say "I have just the thing for your condition! Here's a prescription for carrying out an assassination!"

Nope. I'm sorry, I'm just one man, and there's millions of human tragedies unfolding every day.

That's fine, but it's probably worth noticing that this is not what you said. What you said was:

...why should anyone care?

This is meaningfully distinct. "Why should anyone care about that" is very different from "I have no reason to care about that." I quite agree that you have no reason to care what some rando wishes, or even what a great many randos wish. Some dude in a dress follows your daughter into the locker room, well, you have great reason to care about your daughter's comfort, and no reason at all to make that a lower priority than his comfort. But noticing that you don't have any reason to care, while important, is not the same as saying that no one should care.

Doctor-patient confidentiality is not absolute.

I didn't say that it was, but as you note, it was just a side point to illustrate my frustration with the polarization of certain arguments.

This is meaningfully distinct. "Why should anyone care about that" is very different from "I have no reason to care about that." I quite agree that you have no reason to care what some rando wishes, or even what a great many randos wish. Some dude in a dress follows your daughter into the locker room, well, you have great reason to care about your daughter's comfort, and no reason at all to make that a lower priority than his comfort. But noticing that you don't have any reason to care, while important, is not the same as saying that no one should care.

I'm having issues explaining what I'm driving at. No, they're not distinct, it's not just about me. The "traditional" way to talk about a gender dysphoria, it's that it's an extremely rare psychological condition causing people a lot of distress over the sex they're born with. If this is what we're going with, fine, I do see a reason why society should care, the same way we should care about schizophrenics, phobics, bipolars, etc. tikimixologist said it's somehow similar to wanting to be more fit, if they're qualitatively similar, then yeah, I'm sorry I don't see why anyone should care. You can want all you want, please give me a good reason for anyone to care. If "people should care because it's good for us to care about one another", that sets the bar for caring so low, we'd all be curled in a fetal position, and sobbing all the time from all the caring we're doing for everyone else.

You are being excessively literal in a way which is the scourge of rationalists.

"Why should anyone care" means "why should people other than the ones central to the situation care", not literally "why should any human being care".

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This is just debating the meaning of the word exist. Sherlock Holmes does not exist, because he is made up fictional character. On the other hand Sherlock Holmes does exist as a made up fictional character with his own books, movies and TV shows and centuries long impact on culture.

So in the end I think you and OP want to convey the same thing. Trans people exist as a social construct, as a manifestation of certain cultural process. Of course you can debate impact trans people have on culture and so forth, but OP does not think it merits deeper discussion about the nature of trans as a real category. Another analogy would be debating existence of God - it is one thing to accept it as a social construct and studying impact of this cultural meme on real history. And it is another thing to seriously debate true nature of god as if he is real in the same sense as you are real and if he is one person or three persons in reality etc. This could be considered a category error given that many people have premise that god does not exist in that way.

I feel it's perfectly valid to say that Gender Dysphoria exists as a medical diagnosis and yet trans people exist as a social construct aimed at addressing/ameliorating said social construct.

I feel it's perfectly valid to say that Gender Dysphoria exists as a medical diagnosis and yet trans people exist as a social construct aimed at addressing/ameliorating said social construct.

I agree. To use another analogy: "Bob thinks he is Jesus Christ" can be grounds for valid medical diagnosis of "personality dysphoria" or whatnot. However debating the nature of Jesus Christ in this context is useless.

Are Jesus Bob and his disciples going to insist we call him Lord and accept his divinity?

The popcorn tastes unusually good this week.

So...guilty until proven innocent? This has never happened before.

Low-stakes crisis like this is the outcome of having a huge creative and intellectual-elite class, abundance, and economic prosperity and geopolitical stability. Twitter is the prefect medium for this. It will get much worse. Who's funding all of this. It's being funded by an endless supply of substack $, subscriber $. It's coming from somewhere. Like with Google we know they make money from advertisers buying ads, but who is is funding all this culture war?

I suspect that for the causes the right favors it's more grassroots (apparently a good chunk of the funding for the last North American right-wing protest came from the US even though it didn't occur there- admitting that doesn't help anyone involved, of course) and for the causes the left favors it's a lot more organized.

[Assume left and right are just sides of the aisle for the following].

The right-wing party doesn't listen to its voters as much as the left-wing party does partially because the people the State wants to target disproportionately exist on the right (and right-wing parties aren't immune to this when they form government), so they can't be as centralized for legibility reasons WRT the State. Substack's model of "Stripe doesn't serve Substack directly" helps them significantly in this regard- Patreon isn't as useful for the more interesting parts but not all parts need to be interesting.

For the causes the left favors? The grassroots movement for them haven't been nearly as strong- mainly because they have less middle (a double helping of "they're the State so they're necessarily against it" and "their civil religion currently happens to align with its elimination"), so it's organized backing by the strongest foreign corporation that owns the American means of production along with domestic corporations through both official State and deep State (in the "adopt the [anti-middle-class/right] religion, or we stop inviting you to the WEF dinner parties and start working against you" sense) pressure.

Twitter is the prefect medium for this. It will get much worse.

And now you know why left-wingers are apoplectic about the fact they no longer directly control Twitter; I think they believe (correctly?) that they've lost Twitter as command and control for their human botnet like they made heavy use of in 2020 WRT coordinating riots and general disease hysteria unless they manage to neutralize him and state power is all they have to do that (left-wing people aren't Starlink or Tesla customers). Remember, the only people who stopped using Twitter when he bought it were the religious, and religion alone is clearly not enough (which the relative failure of Gab and Truth Social should have made clear before the Left tried and failed with Mastodon).

And now you know why left-wingers are apoplectic about the fact they no longer directly control Twitter; I think they believe (correctly?) that they've lost Twitter as command and control for their human botnet like they did in 2020 WRT coordinating riots and general disease hysteria unless they manage to neutralize him and state power is all they have

This is why I'm still slumped that elites let Elon buy twitter. Top billionaire elites could have easily pooled their money together to buy it. Disney alone is worth $190 billion but just $40 billion for a major organ of propaganda is almost a good deal. Maybe they are hoping he runs it to the ground and then buy it back cheap, but why take that risk?

I think you give elites too much credit.

Or perhaps too much class interest. If you wouldn’t expect a small town of proles to coordinate for something, you shouldn’t expect a few billionaires to agree on it.

Look at how tenuous the chain of events has to be—all the risk of buying a business, and less obvious, legible upside. Adding more conspirators just makes the C/B worse as more potential competing interests get skin in the game.

I think it pours some water on some of these 'grand theories' that suggest collusion between powerful entities

Top billionaire elites could have easily pooled their money together to buy it.

No. Only Musk could do it.

Most billionaires aren't actually that rich. They wouldn't be able to come up with enough money.

And of the ones that are, most of them aren't American (and the US would absolutely not let a foreign buyer get their hands on the Voice of America Twitter- Musk is US citizen enough for the government to offload its space program onto his company).

And of the ones that are, most of them work for technology companies that directly compete with Twitter (anti-trust law in the US is a dead letter these days, but if anything could get them to wake up it would be that- Musk isn't that kind of tech billionaire).

The thing that bothers me is that Musk is the only citizen in the US to whom its Constitution meaningfully applies, and has it in ways people meme about. There is a reason it was supposed to be for all citizens and this is it.

He purchased the First Amendment (he owns Twitter).

He purchased the Second Amendment (he owns a private fleet of ICBMs).

He purchased the Fourth Amendment (he owns a functionally-unjammable communications network).

If the country melts down sufficiently to allow a Caesar there's a very good argument to be made that these powers are sufficient to give him a crown.

If that happens, the furries (that also happen to be a good chunk of his staff, though not necessarily intentionally) will have been responsible for putting the Musk dynasty in charge of the entire world and the flag of the future will be a pawprint softly caressing a human face forever.

he owns a private fleet of ICBMs

Last I heard, it's a lot harder to get a working warhead on a rocket these days than it is to get the rocket.

Anything is a "warhead" at sufficient velocity.

Surely there's some non-nuclear explosives that are "good enough" to stick on a rocket...

Any larger corporation could have done a much richer stock for stock swap, it didn't have to be cash only.

Wait, furries? I'd ask where do they come in, but it sounds like the setup to a really gross punchline.

I'd ask where do they come in

The guy employs a lot of smart technical people.

That group just happens to disproportionately be furries.

That's it. History tends to have a sense of humor, so clearly this is the way it's going to go. Musky husky uwu

(left-wing people aren't Starlink or Tesla customers)

Lots of left-wing people are Tesla customers. But they're not going to stop buying Teslas. Left wing consumer "boycotts" almost never actually work, they're a sort of theater where a left-wing organization declares they'll boycott and left-wingers either at the principal or at some middleman pretend to be scared of the boycott and cave in. For instance, Twitter lost advertising because the ad agencies (middlemen) are controlled by leftists, not because consumers were actually going to punish companies for advertising on Twitter.

left-wing people are Tesla customers

Sure, but that suggests that they're not quite true believers in the Left's civil religion and are more likely (though of course that isn't guaranteed) to switch sides/be skeptics when the chips are down; at some point they had to encounter the cognitive dissonance between its two luxury beliefs: being "save the environment" and "Elon man bad" and they chose the answer that was closer to reality (rejecting moralism while still working towards a goal they share happens to currently be right of center).

Or they picked the inherently right-wing answer of "the value proposition is actually really good with my usecases" and considered that it aligns with a left-wing luxury belief either as a bonus or something they priced in as having value unto itself.

(Alternately: there are no true Scotsmen, but some Scots are more Scottish than others.)

Among other, more obvious mistakes, Edmiston’s most grievous error was not pretending to believe the lie.

This is something that has seemed obviously true to me for a while, but of course you can't prove it unless you are deeply inside the system. You express concerns about children being casually, almost instantly, referred for "gender affirming care" up to and including surgery, and clinicians and trans activists say "Don't be ridiculous, of course we don't think doctors should just write blank prescriptions everyone's needs are carefully assessed they get a comprehensive evaluation it's all very cautious and evidence-based blah blah blah..."

Every bit of anecdotal evidence I have ever read - but it's still anecdotal! - is that in practice a trans-identifying kid will be "confirmed" as trans basically on their say-so. I've never actually heard of a doctor at one of these clinics saying, "Well, actually, have you considered you might not be trans? Let's work on some of your other mental health issues and then revisit this."

I'd love to find out I am wrong, that the typical clinician is in fact cautious about going along with every child who presents as "trans" and pursues other avenues of care first. But I have yet to see any evidence that this happens... anywhere. Rather, it seems increasingly like anything other than immediate and unreserved validation of any child who presents as trans is treated as transphobic and life-threatening.

Jesse Singal does the lord's work, and he has two problems.

The first is that his work is very wonky. Like, he does deep dives into statistics, he actually reads the charts in the papers cited (and mis-cited) by activists, and points out all the errors, but it's not something easily summarizable if you really want to have an understanding of what he's saying. All his opponents see is "There goes Jesse Singal, known transphobe, obsessively bullying a marginalized community again." Who actually reads and parses his work in detail?

I'll admit while this whole thing was happening on Twitter, I didn't quite get the back and forth the first few times until I finally sighed, dug in, and reread the entire comment chain to figure out who said who said who said what about what when. And I'm fairly current on the issues, reasonably intelligent, and sympathetic to Singal. Meanwhile, everyone else is just posting dunks and high fives and "yikes!" And even after this fairly comprehensive vindication of Singal, I doubt a single person on the other side actually had their mind changed or their priors shifted an iota. What I have seen in response has been a lot of tepid "Well, obviously it's a very complex topic mumble mumble but jeez why does Jesse Singal care so much anyway?"

Which brings me to my second point: Jesse Singal does himself no favors fighting these things out on Twitter. I get it - I understand his mindset. "People are lying about me on the Internet! People are saying I said things I clearly did not say! They're also wrong about the facts! They're saying things that aren't true, just read this damn paper right here that proves it!"

He cannot shake the conviction that if he yells this often and loudly enough, he will make them see. And he won't. Ever. So he ends up looking like deranged Reply Guy who is obsessed with this topic and wants to fight everybody. Meanwhile, his enemies, who don't actually care whether he's right or not, only that he's on the wrong side, see that they can keep winding him up by saying "Look at Jesse Singal being transphobic again."

Every bit of anecdotal evidence I have ever read - but it's still anecdotal! - is that in practice a trans-identifying kid will be "confirmed" as trans basically on their say-so. I've never actually heard of a doctor at one of these clinics saying, "Well, actually, have you considered you might not be trans? Let's work on some of your other mental health issues and then revisit this."

I mean, a clinic in Canada was shut down over doing exactly this. To the activist, that's "conversion therapy", and they will end your career over it. To add insult to injury, the accusation which finally did get the Canadian clinic shut down turned out to be about a different doctor entirely. But the activist worked with what they had.

Coincidentally, Jesse Singal did the breakthrough reporting on that case too, including showing the person allegedly victimized by a doctor a photo of the doctor activist were attacking, to which the alleged victim responded that it wasn't the man who victimized him.

He cannot shake the conviction that if he yells this often and loudly enough, he will make them see. And he won't. Ever. So he ends up looking like deranged Reply Guy who is obsessed with this topic and wants to fight everybody. Meanwhile, his enemies, who don't actually care whether he's right or not, only that he's on the wrong side, see that they can keep winding him up by saying "Look at Jesse Singal being transphobic again."

I wonder at this. Jesse has been working this beat too long, and seen too much of the inmates running the asylum for that. The problem is that he can't escape the cultural framework of D's good, R's bad. It is literally unthinkable to him that D's might be the baddies on this one. That as a party and a cultural force they are responsible for the mutilation and sterilization of countless children. It's too large an atrocity for him to even consider on his side's hands. And even if all the evidence, all the personal experience, says so, there must still be some way that R's are actually still the baddies.

It's unclear what his end game is. Maybe he doesn't have one. Maybe he doesn't hope for any change, and is just a reporter working his beat.

It is literally unthinkable to him that D's might be the baddies on this one

From my perspective, one that I imagine is quite similar to Singal's, the D's aren't the 'baddies' for three central reasons.

Firstly, for the average Democrat this is simply not an important issue. I could name literally hundreds of issues that are of greater significance than the trans debate, even for the average Democratic legislator I strongly suspect that the issue does not really occupy their thoughts very often. When was the last time Congress debated the issue? In state Houses and Senates it comes up more but even then only on occasion. The point is that this is an issue whose prominence on the internet and in vaguely left-wing popular culture is completely out of proportion to its prominence in partisan politics, and in fact its actual importance.

Secondly, where it does crop up in partisan politics its generally in the form of anti-discrimination bills, or culture war fluff like sports, rather than the specifics of transgender medical care; indeed, in general medical practices are not something directly intervened upon by politicians, so the issue is fairly left to the non-partisan regulatory state and independent medical bodies, and it's surely best that way. Even if you think the current state of affairs is unacceptable, I doubt that we'd be much better off with state or Congressional Republicans managing medical practices.

Finally, the Republicans are hardly any better. Singal is good because unlike most commentators on transgender issues (on the sceptical side) he doesn't come across as a deranged culture warrior with an axe to grind, which unfortunately seems to be the case for most Republicans.

Firstly, for the average Democrat this is simply not an important issue.

Literally every single democrat on my street has one or more pride flags flying way out into the road so nobody can miss it. Some of them replaced the old version with the "progress pride" thing last year, while others just fly both. Half of them have "in this house we believe trans women are women" signs up.

I am not going to believe you that they do not care about this when it seems to have eclipsed race as the number one thing to signal party loyalty and make ominous threats to dissenters over.

Wait what, aren't you German? Where do you live? Kreuzberg? shudder

Haha this was a terrible name to pick, wasn't it.

Not sure if you know this, but Bernd is a stereotypical German boomer name. It is also what anons are called on the German chans.

Yeah, it was a reference to an old krautchan thing. Talk about dating yourself: may as well put up a "get off my lawn!" sign at this point.

Firstly, for the average Democrat this is simply not an important issue. I

What's the average Democrat's response to Republicans' attempt to stop it? "Oh, that's not an important issue, go ahead, no I won't cancel you"? Maybe, but I suspect not.

I don't think the average Democrat engages in much cancelling, or tries to While certainly they (and I) would oppose some (most?) of the measures Republicans introduce here and there, it still wouldn't, I think, stand as a great priority.

Average Democrats are not relevant to the conversation. It's activists and the leadership that decide on which course is taken, and they definitely do coordinate cancelation campaigns. They're also pushing through the trans ideology throughout the education system, legislature, etc.

There are things I'd also put in the category of "I'm against it, but it's not important". I prefer lower taxes to hiflgher taxes, less bureaucracy to more, etc. Normally these sort of issues would be ripe for a compromise, if you give me control over "unimportant" cultural issues, I'll give you pretty much anything you want. Does that sound like a good deal to you? Is there any evidence average Democrats would go for it? If not, it is simply not true that the issue is not important for them.

leadership

I meant leadership as well.

legislature

Where?

Does that sound like a good deal to you?

Well it would have to be within reason, but in very broad terms yes I would make social policy concessions for economic policy returns.

Where?

Throughout the western world. In Europe there's a bunch of self-ID laws being pushed, often covertly without public debate. Same for blue states in the US, though over there they are balanced by red state legislatures.

Well it would have to be within reason

Yes, obviously it would have to be within reason on both sides. So if Democrats are so open to such a compromise, doesn't it seem strange to you they haven't offered one in all those years? Could it be an indication that the issue is more important to th then you claim?

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Hear that whistling? It’s the sound of goalposts receding into the distance.

That as a party and a cultural force they are responsible for the mutilation and sterilization of countless children.

What's the average Democrat's response to Republicans' attempt to stop it?

They were definitely talking about normies rather than (just) activists.

The second part was added as a bonus to show his argument would fail on his own terms.

Your post is a perfect example of what I'm talking about. You agree that this trans pandemic is out of control and damaging people. You agree that Dems are asleep at the wheel, or facilitating it.

And yet when Republicans do what they can to try to stop it, suddenly they become the baddies. Because it's "culture war fluff" to keep rapist out of women's spaces. Or it's discrimination to ban the dangerous and unregulated mutilation and sterilization of children.

So you create this situation where you acknowledge the problem, your "side" broadly sits on it's hands or encourages it, and you claim the only people trying to stop it are the bad guys. Because, for whatever reason, even when Republicans are addressing the problems you admit are problems, and are trying to stop the things you admit should probably be stopped, it's just unthinkable to you.

Also, it's a preposterous framing that "in general medical practices are not something directly intervened upon by politicians". The FDA regulates what drugs we are allowed to take. Dangerous or inhumane medical procedures do get banned by governments, like lobotomies. This learned helplessness towards the medical community going off the rails with respect to trans treatments is bonkers. As is the vitriol even people who acknowledge it's a problem direct at anyone who attempts to fix it.

The FDA regulates what drugs we are allowed to take.

Yes, but that's not a partisan affair. The FDA should take whatever action they deem appropriate on transgender care and they don't need politicians to weigh in on the specifics of the decision. Politicians determine the broad remit of the FDA, they don't interfere with its functioning on specific issues.

You agree that this trans pandemic is out of control

I wouldn't go that far, certainly. As for 'asleep at the wheel', it's a question of prioritisation. Political capital and legislative time are finite, and I'd much rather politicians focused on any number of other issues than making ad hoc adjustments to the state of transgender medical care.

the FDA is partisan, acts in partisan ways, and is filled with people who consider themselves Democrats and with political donations to Democrat or more "leftward" orgs signifying their allegiances

"the admin state is a nonpartisan affair" is not a defensible position in 2023

additionally, claiming a political entity created through politics which acts on the politic on behalf of the politic isn't "political" is absurd

"political" is absurd

I didn't say it wasn't political, I said that it wasn't partisan.

In any case, simply because most people at the FDA will be Democrats that doesn't mean one can automatically conclude every decision they make on specific approval of specific treatments will be part of some partisan agenda.

"the admin state is a nonpartisan affair"

I think this is actually broadly true. Undeniably, Democrats are overrepresented significantly in civil service work, but the administrative state opposition that it was frequently claimed Trump would encounter never materialised.

why would "every action taken" have to be "necessarily" part of "some partisan agenda" in order for the FDA to be not "nonpartisan"?

nor did I say that was the only reason to conclude the FDA was partisan

we went from you broadly labeling the FDA as "a nonpartisan affair" to now moving the discussion to defending that every decision taken is part of a partisan agenda

this is silly

"Well, actually, have you considered you might not be trans? Let's work on some of your other mental health issues and then revisit this."

One of the most sensible things that Jordan Peterson said recently was pointing out that body dysmorphia is normal among women with mental health issues. So, if society links body dysmorphia closely to transgenderism and doctors put zero inquiry into whether the dysmorphia is symptomatic of the woman's other mental health problems, then overdiagnosis of transgenderism among women will result.

Anecdotally, detransitioning does seem to be more common among ex-transmen than ex-transwomen, but I don't have stats. The common pattern seems to be "Autistic or otherwise unusual woman develops depression/social anxiety/socialising issues as an adolescent, starts transitioning, maybe develops dysmorphia AGAIN (now wanting to be a woman) and detransitions, often with permanent or long-lasting damage to her body." Both before and after she started transitioning, the real problem was her socialisation and mental health challenges, not that she was in the wrong body. You can't solve such issues with surgery, but that is the impression that many such women are getting.

Anecdotally, detransitioning does seem to be more common among ex-transmen than ex-transwomen

Completely spurious reasoning but I feel like a lot of this would be down to transmen having more to lose by opting to be a male and thereby losing out on 'the sisterhood'/social connections versus low-status men essentially going from nobody giving a fuck to a built-in social network when they opt to transition. I also feel like men are more likely to actually achieve something approaching what they want out of the transition, whilst in my own experience of Transmen there's a lot of very garbled logic about essentially wanting to be a top 1% guy to experience those perceived advantages without realizing they're renouncing female privilege and moving onto... petite feminine male non-privilege.

petite feminine male non-privilege.

Especially not good if they are interested in men, especially long-term relationships. AFAIK, it's hard enough for gay men to find committed partners, and even worse if you're playing in a crowded field (feminine gay men).

The rather brutally honest evaluation of this I've seen is that they don't realise before transitioning that being a short guy with wide hips and no muscles is not going to do them much good.

It's like the geographic cure for dealing with problems - "if I just start afresh someplace nobody knows me, it will all work out better". For some people, be it FTM or MTF, transitioning will fix their problems. For others, swapping genders is not going to fix their depression or loneliness or other problems.

detransitioning does seem to be more common among ex-transmen than ex-transwomen, but I don't have stats

According to this article, the number of subscribers to /r/detrans has risen from a few hundred to 44,000 in the space of five years. Allowing that not every subscriber is a detransitioner themselves, it's still a striking increase.

Absolute numbers aren’t exactly the best here, given that pro-trans awareness has also skyrocketed in that time. It’s also compatible with boring subreddit life cycles. Or even dramatic ones, like a flood of activists looking for rage bait.

It also…doesn’t address the gender ratio question at all.

given that pro-trans awareness has also skyrocketed in that time.

Are trans people really substantially more visible now than they were in February 2018? Back then we already had Caitlyn Jenner, Jazz Jennings, Laverne Cox, Sophie, the Wachowskis. The Danish Girl came out in 2014.

It also…doesn’t address the gender ratio question at all.

Yeah I know, I just happened to have encountered a statistic pertaining to detransitioning this week so I thought I'd mention it.

And even after this fairly comprehensive vindication of Singal, I doubt a single person on the other side actually had their mind changed or their priors shifted an iota.

This is something that's never going to happen, largely because of Kayfabe politics. I don't think we're going to see activists on this give up a single inch. And I mean...I do think objectively there's room to give given up, right? I think it's OK to say that it's bad if there's no assessment done and that shouldn't happen. I think that's giving up an inch. And that's in line with what Singal's argument is for what should happen, is high-quality individualized care.

It's possible maybe this could become a new windmill for me to tilt at, and maybe I'm wrong, but I feel it strongly. I don't think they can give up a single inch. Because an inch isn't an inch. It's actually a mile.

I do think there's an underlying question that's being ignored here. Can exposure to Progressive/Academic models of sex, gender and power or at least, the popularized crude forms, result in Gender Dysphoria or something approaching such? Not universally, of course. But are there people susceptible to this in a way, where exposure to these things might result in significant mental and emotional trauma?

Because I'll be blunt. If we're talking about a recommendation for support or therapy, largely speaking I do think this is the road it's going down more often than not. And if that's the case, if this is something that we should be aware of....then maybe the good guys are not always the good guys. Maybe there needs to be some level of care, or safeguards or whatever put in place. Maybe the world is more complicated than babyfaces and heels, of good guys and bad guys, of white and black.

I do think there's an underlying question that's being ignored here. Can exposure to Progressive/Academic models of sex, gender and power or at least, the popularized crude forms, result in Gender Dysphoria or something approaching such? Not universally, of course. But are there people susceptible to this in a way, where exposure to these things might result in significant mental and emotional trauma?

My contention is that this is where a majority of contemporary homosexuality comes from, never mind gender dysphoria.

It's not that leftist memes swept away bigotry and now everyone's out of the closet and able to be their authentic selves without fear of ostracism / lynching; no, buddy, you just got memed, tricked, into reneging against your genetic imperatives by a slick "mere exposure" advertising campaign.

I wholeheartedly disagree - in fact, I think that the existence of the closet and a reason for gay people to stay in it actually increases the prevalence of gay people in society. Homosexuality is partially heritable, and when gay people have to perform heterosexuality they will often end up having more children, thus reducing or negating the penalty to reproductive fitness imposed by homosexuality. It's another one of those paradoxical outcomes where increasing suppression of homosexuality actually creates more homosexuality in the population.

Do you have any actual evidence for that belief?

My understanding is that estimates of the rate of full blown homosexuality have remained roughly stable since as far back as the Kinsey report. It's true that bisexual identification has gone up in younger generations, but I suspect this is largely a matter of signaling and doesn't necessarily translate to a proportionally increased rate of homosexual intimacy.

I've never actually heard of a doctor at one of these clinics saying, "Well, actually, have you considered you might not be trans? Let's work on some of your other mental health issues and then revisit this."

I'd love to find out I am wrong...

While it's nowhere near as common as the early 00s (where "spend six months figuring yourself out" was the WPATH recommendation), and most of the more cautious stories are from more Red Tribe areas, there are still some times where this does happen, both for legitimate reasons and for sometimes overcautious ones. The current keyword is "mental readiness", but it seems to change every couple years and I'd expect that to continue.

((The flip side is that the last twenty years of political everything about this means that people build tools to work around it, so the people who most worry about are going to gravitate to the shrinks who advertise about questioning the least. Which isn't the same as the people who most need to be questioned, but thanks to BPD and psychosis has at least a little overlap.))

I think the pendulum overcorrected, but there's reasons you'll still see gatekeeping mentioned in trans-heavy spaces, and it's not just exaggeration or memory.

The reason he keeps doing it is because he thinks these people are on his side and just mistaken. He has an unshakable prior that there must actually be some genuine truth to the trans question and there are just a few bad apples and bad bits of science that need to be cleaned up. He truly believes the emperor is wearing clothes and he just needs to find the right light spectrum that everyone else must be looking through to see it and can't tell that all the other people telling him his methods are a ridiculous insult to the emperor because he's obviously wearing clothes are lying to him.

Completely agreed. But I, for one, find him vindicated and gloriously so. So there's that.

Jesus Christ.

I wish Twitter wasn’t taken seriously as The Public Square. This is depressingly stupid. Why would someone make easily falsifiable claims about an organization’s stance and about his role in it?

  1. because he expects no one with standing to call him out

  2. because he expects anyone who does to be absolutely dogpiled by this cesspool of a website

Wrong on 1), right on 2), I guess.

I despise that this objective question—“does the WPATH say such-and-such?” Or perhaps “is the WPATH guideline reasonable?”—is getting settled by shitslinging and victory laps. Perhaps I was foolish to think it could be anything else.

I look forward to seeing what our resident BAR contributor has to say on the issue.

I wish Twitter wasn’t taken seriously as The Public Square. This is depressingly stupid. Why would someone make easily falsifiable claims about an organization’s stance and about his role in it?

because ultimately there a little consequences. twitter is probably the most free speech site on the planet (Musk had nothing to do with this, it's just part of the platform) if your bar for "free speech on the internet" isn't "lets me spam slurs all day long" and so when people can spread something false information, it'll be harder for people to shout correct information louder.

Why would someone make easily falsifiable claims about an organization’s stance and about his role in it?

Because he wants to run for Congress?

No, but seriously, because a non-zero number of people will not bother to either check the claim themselves, or believe the people who did because they are already affectively aligned with the position the falsehood is supporting. Also, it's much, much easier to sling bullshit than it is to fight back against it, and so in the long-run the bullshitting side is going to get something to slip past the filters, or just convince people through the "if there's smoke, there's fire" method of shifting the Overton window.

This twitter dude sounds like a compulsive liar / fantasist. I don't think they can help themselves and they say the most absurd unbelievable shit and I think most of the time the people around them either enjoy the stories or tolerate it so they don't usually get meaningful pushback.

Really, that's the part that I tentatively describe as "gaslighting" (hate the term). One questionable "dude" makes an absurd claim, and the rest of Twitter NPC falls in line. When any neutral reader would accept Jesse's straightforward interpretation.

I'm honestly shocked Leibowitz had the bravery and integrity to do that. He must have been under tremendous pressure to join the pile-on and hand his authority to the gaslighters. Good on him, but I hope he won't be purged for it.

But I went to WPATH. There were whole sessions devoted to transitioning people with every imaginable comorbidity—like patients presenting with ‘multiple personalities’ who disagree about what irreversible interventions ‘they’ want to pursue

Holy shit, I didn't realize it was quite that bad. Only a decade ago the "multiple personality" thing was recognized as larping social contagion, and now it's back to being treated seriously?

I guess this shouldn't be surprising after the castration fetish forum member writing the wpath guidelines, but the gell-mann amnesia is hard to shake off.

I'm honestly shocked Leibowitz had the bravery and integrity to do that. He must have been under tremendous pressure to join the pile-on and hand his authority to the gaslighters. Good on him, but I hope he won't be purged for it.

My model of Leibowitz, pending specific updates, is the same as for NYT editors I've explained here. Actual top managers do not want any «Cathedral» to grow underneath their feet. He doesn't necessarily care about the object level conflict. He may even be more sympathetic to the radical side. But he runs this thing. He's the boss, the alpha of the pack. You use the correct word – hand his authority. It was a direct challenge to him: hey boss, we wanna eat this dude, give us the greenlight OK? Just keep silent about this pesky lil detail we made up that compromises the reputation of your organization, we'll take care of everything. Just sit this one out... Had he agreed, he'd have recognized them as decision makers. And then it would have been as bad as any cancellation, for all his power and status would have become nominal, a shell at the mob's beck and call.

Before long they'd have started to casually refer to more unhinged opinions he did not endorse – what's the harm, the old man's a bit out of the loop (heh) but his heart's in the right place, he's gonna see our point when he gets to it, why bother him. His own assistants would have begun signing documents without his authorisation (realistically they already do, but only when believing he does intend them to do so) – assuming he'd find it too stressful to retract, and would instead escape to routine work, to conferences, to personal affairs... And then a younger alpha, an informal leader, having built a coalition of energetic strivers, would have gratefully received the reins.

Power balance in institutions is surprisingly dependent on such archaic chimp instincts. Do not give your boss the impression you want to make him your bitch unless you're ready to strike.

There's this recurring phenomenon in psychology of fad illnesses that have gigantic spikes in diagnoses for diseases that are real but normally extremely rare. And typically specifically spikes of teenage girls.

Trans has clearly been going through the motions but it's bigger culturally than MPD or anorexia ever were and at this point I think it might be self sustaining.

Appeal to historical patterns is a lot more compelling when it’s not immediately followed by “and this time will be different.”

I was there when trans was this obscure thing nobody gave a shit about, I can tell how different things are now from first hand experience.

I don't fucking know what's gonna happen. The other fads I know of didn't have a political movement attached.

But if there's no level of social contagion involved here I'd like to know how you explain the 1000% growths. Because so far it's the only compelling explanation I've found and the only answer people claiming otherwise have given me is insults and dismissals of official statistics as lies.

It’s not that there can’t be a social contagion involved. I have no doubt that the movement has picked up trend chasers, disaffected youth, hypochondriacs, whatever. How many? I don’t know, I haven’t looked at detransition stats lately, but that’d be a good lower bound. I definitely wouldn’t pick number of Reddit subscribers, especially due to the attached political movement.

I’m objecting to the anorexia comparison for a different reason. You’ve observed that both trans and anorexia have the trappings of a fad. But trans doesn’t seem to be hitting the expected lifecycle. This suggests two options.

If trans is a fad, then like anorexia, it should be expected to wane. If trans isn’t going to fade away, then it perhaps it isn’t like anorexia in other ways.

Instead, you’ve picked from both options. It’s like anorexia (contagious, not “real”, should be stigmatized) except when it isn’t (politicized, expected to self-sustain).

Only a decade ago the "multiple personality" thing was recognized as larping social contagion, and now it's back to being treated seriously?

Scott Alexander has written about this, I feel pretty certain. Tulpas (intentional creation of additional personality) and victims (unintentional multiple personalities) seem to be real phenomena, if rarer than claimed.

I'm pretty sure that 200 years from now we will regard contemporary psychology and pyschiatry the same way we regard galenic medicine today.

Scott Alexander has written about this, I feel pretty certain.

Yes he has

Wow, Freddie was going off in the comments.

We've had some recent discussion here, too. I think Singal's motioning around the modern "plural/multiplicity" thing, which is still weird, but it's a different sort of problem than the more classical DID/MPD "is this a giant trauma reaction, or are shrinks training people into it" (and, perhaps more importantly, doesn't have the 'large memory gap' symptom that a lot of DID fakers abused).

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