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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.

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".

More comments

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?