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Notes -
Jesse Singal gets gaslit
Also, a more neutral take: https://elizamondegreen.substack.com/p/about-that-twitter-shitstorm-affirmationnot
Brief recap:
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
An open letter is sent to NYT laying out "serious concerns with editorial bias" in response to this shift
Jonathan Chait posts a critical response to the open letter at New York Magazine (no relation to NYT)
Chait gets dragged on twitter for being anti-trans, with a highlighted passage
Jesse Singal posts in support of Chait, showing the highlighted passage is directly in accordance with WPATH guidelines and explains what it means
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
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
Singal has done his homework and contacts several other WPATH authors, who all confirm Singal's interpretation of the passage and reject Edmiston's
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
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:
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.
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.
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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.
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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.
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You can always shoot yourself! Be the change you want to see!
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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.
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."
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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?
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.
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Huh, but what about paper?
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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.
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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.
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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.
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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.
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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.
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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.
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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 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.
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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.
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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.
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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.
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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.
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.
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.
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I don't know where the line is between use and overuse. But the Rock is visibly, obviously cycling a stack of anabolic steroids.
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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.
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Do you mean the transformation itself is poor or that transformation is a poor treatment for the illness?
In your fantasy future where
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?
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.
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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'.
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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?
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.
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.
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.
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.
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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?
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!"
That's fine, but it's probably worth noticing that this is not what you said. What you said was:
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 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.
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.
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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 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?
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