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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, 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.