This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
When discussing pharmaceutical and surgical interventions in the treatment of gender dysphoria, the gender-critical among us often draw parallels with bodily integrity identity disorder. This is a rare psychiatric disorder in which a person experiences profound distress because of the presence of one or more of their limbs, and requests to have these limbs amputated to alleviate said distress (or tries to amputate them themselves). Colloquially, one might say that people with this condition are able-bodied but identify as disabled.
Given that no one thinks that surgical amputation is the correct treatment for this psychiatric disorder, we gender-criticals argued, it follows that surgical intervention is the wrong approach for people with gender dysphoria. If it's wrong to amputate a mentally ill's person's arm just because they say it's causing them distress, how can it be right to do the same for a penis or breast?
Sadly, one man’s modus ponens is another man’s modus tollens, the medical establishment has noted the parallels, and it is coming to a rather different conclusion:
Nothing specific to add to this* beyond despair. The Anglophone medical establishment appears to be fully ideologically captured. It doesn't matter if the Tavistock is shuttered and there's a rash of lawsuits directed at youth gender clinics in the US: if you're a medic who's internalised (or been made to internalise) the gender ideology worldview, the implications of that worldview and the role of the medical establishment it affirms have far-reaching implications in medical domains unrelated to gender medicine itself. At this point I honestly can't rule out psychiatrists prescribing anorexics appetite suppressants to aid them in achieving their "bodily attainment goals".
*Other than why the fuck are Canadian doctors so keen to help their fellow citizens maim or destroy their bodies??!!
Surgery isn’t a new treatment for BIID; I covered this some months ago in my post on an interesting nullification fetish criminal case, but there have been scattered cases over the last thirty years of surgeons agreeing to amputate in cases of this condition.
The interesting dynamic, which I noted at the time, is that the surgeons typically shrugged and were willing to do it, while the psychiatrists were more opposed.
From the impression I've gotten from surgeons and doctors who know many surgeons, this doesn't surprise me. Surgeons have a bit of a reputation for being high class technically skilled butchers. They operate on flesh, but their treatment of it is closer to that of a car mechanic than most other doctors. I think they perhaps see it as a very easy case of tumor removal. @self_made_human may have more insight.
Honestly, my approach is, fuck it, why not?
Well, there are actually reasons why not, such as the hope we can find a less ghoulish cure, things like mirror therapy for phantom limb (well, that one's already gone, its just that maybe there's an equivalent), or the fact that they might go on disability.
But if someone who is otherwise healthy and financially sound wants to chop off pretty much anything for any reason, my opinion as a psychiatrist-about-to-start-training is a shrug, presuming I was convinced that nothing else we could do would help.
Surgeons aren't that gung-ho in my opinion, maybe it's because I worked too long in Onco Surgery, but I've seen more cases turned down as non-resectable or not worth it than those that were done knowing it was futile. Surgeons usually want what's best for the patient too, even if it's in conflict with their wallets. They're rich enough that's not the biggest deal.
Chop off a mole, a limb, a dick, anything at all. As long as you make sure you're not a burden on the rest of us, it's not my business, unless you ask me for my advice.
"I was only following orders" is something we as a society have learned through hard experience is no excuse. People may not relieve themselves of responsibility for doing bad things on the grounds that someone else hired them to do the bad thing; and even if they're hiring you to do it to themselves, it's your responsibility to refuse if they are not of sound mind when they hired you. You don't have the option to say "judging them to be of unsound mind is none of my business"--it informs the propriety of your own actions, for which you bear responsibility, which makes it your business.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link