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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??!!
Touching on this subject, and also following on from the previous Culture War thread where I was asked how I feel about the current state of the Catholic Church, here we go - something to offend everybody!
Declaration of the Dicastery for the Doctrine of the Faith “Dignitas Infinita” on Human Dignity, 08.04.2024
The RadTrads are already heresy-hunting, the media will be all over the bits about abortion, surrogacy, and transgender rights, and of course the Spirit of Vatican II types are disappointed, sorely and gravely disappointed, as per usual.
Bwa-ha-ha-ha-ha! As someone allegedly said, the Church may be a whore, but she's my Mother 🙆♀️
I don’t understand the distinction between curing congenital defects and sex changes? Surely the person undergoing the procedure would consider them one and the same? If the one doesn’t affect the unique dignity of the person, why should the other? Why does the natural order of the human person exclude some chromosomal ”abnormalities” but not others?
I’m not Catholic, but I’d readily accept some argument to this end. This one feels really light on God.
It's about Natural Law. The problem is, moderns confuse the natural in "Natural Law" with natural as in "what happens naturally, what happens in nature, anything that happens that nobody tried to make happen on purpose" and that's the wrong kind of "natural".
In Natural Law, there is such a thing as a human, and such a thing as a male or female human, and these things have certain characteristics. For instance, humans have two legs. Even though some humans are born with only one leg, it remains the fact that the "natural" human has two legs. There is something wrong with a human who is born with only one leg, because humans are "naturally" supposed to have two legs.
By the same token, humans are "naturally" male or female. If you're born with bits that don't match either, then something is wrong with you: that's why we call it a congenital "defect" or "abnormality", we're comparing the condition to "natural" males and females and noting that it does not match. This kind of thing happens sometimes, just like you get humans born with only one leg. So if you surgically intervene to correct the abnormality, you are doing much the same thing as a doctor who removes a tumor (humans are not supposed to have tumors in them) or who performs plastic surgery to repair the skin of a burn victim (humans are not supposed to have their skin all melted off). You are correcting a disease, returning them to as "natural" a condition as possible by medical science.
In contrast, lets look at a male to female sex change operation. The genitals are surgically removed, and a kind of pseudo vagina is made. This is taking a physically healthy and "natural" male and turning it into a defective and unnatural male: a male with no penis, no testicles, and a hole where a hole shouldn't be. What's more, it removes some of his "natural" capabilities, such as being able to sire children. From a Natural Law perspective a sex change operation like this is completely analogous to cutting off someone's arm or leg or nose: you're maiming them, turning them from "natural" humans into unnatural and defective humans. Under Natural Law it may be acceptable sometimes to maim a human in the pursuit of a greater good: for example, amputating a limb that is badly infected before the infection can kill the patient. In that case the amputation is still an evil, but it is an evil that is allowed because it is in the aim of preventing a worse evil, death (a dead human is about as far from a "natural" human as you can get). This shouldn't be confused with consequentialism, because Catholics are not consequentialists: they call it the "principle of double effect". The doctor's goal is to save the patient's life, not to maim the patient. If the doctor could save the patient's life without amputating his arm, then the doctor would do that. This is different than if a BIID individual came to a doctor asking for the doctor to amputate his limb: in that case the whole purpose of the procedure is to maim the patient, there is no scenario in which the doctor would not amputate the arm if he could, since amputating the arm is the whole point.
(You could argue the actual point is to cure the individuals BIID symptoms, and if the doctor could cure the BIID without amputating then he would. That might be permissible under Natural Law, but it leads us naturally to the question of whether there is a non maiming way to cure BIID or not. If there is then the principle of double effect doesn't apply).
Metacommentary: I wouldn't pursue this line of argumentation. At best your interlocutor will be utterly confused and think it's complete nonsense. At worst you'll have to end up defending extremely shoddy concepts of teleology.
I'm not arguing so much as explaining. Most people don't know about Natural Law, but it underpins an enormous amount of Western thought. I always like to clue people in about it whenever I get the opportunity, though I don't expect them to agree with Natural Law just by understanding it.
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It boggles my mind that we're still debating the merits of a philosophical stance that treats human nature as some immutable constant, especially given our advancements in biology, technology, and our deepening understanding of human diversity.
Human nature isn't a static entity, frozen in time. If history, science, and every child ever raised have shown us anything, it's that adaptability and change are at the heart of what it means to be human. Insisting otherwise feels like refusing to upgrade your software because you're nostalgic about the bugs in the old version.
Consider the possibility of enhancing our physical selves with technology. Lets say- replacing our legs with robotic spider legs. Natural Law sees this as a violation of some cosmic rulebook on humanness. But why? Humanity has never been about limiting potential; it has always been about transcending boundaries.
That isn't to say the whole thing needs to be discarded, I just feel that more rigorous game theoretic analysis is the 'natural' successor to Natural Law. There are facts that limit what things can be built, what structures can be stable. My issue with Natural Law is that it gets those structures wrong. Getting robot legs doesn't go against game theory (at least not once they become cheaper and more effective than 'natural' legs.) but it does go against Natural Law.
Natural Law is too focused on the aesthetic and not enough on the structures that actually cleave possibility at the edges. In the context of this thread- I think you could upgrade the Catholic argument by translating it to something more game theoretic, or object level.
Natural Law intuitions don't come from nowhere, there is a basis that caused them to evolve culturally, and a proper analysis should be able to locate that basis and determine whether it is still valid in the modern context. But I think if Catholicism took that route, they would eventually have to make concessions they don't want to, because under the hood, some of the Catholic churches worldview's axioms really are aesthetic.
Bro, our gene pool is mostly decaying. Accumulating mutations. People who were pre-adapted to modernity aren't even breeding at replacement levels! We-on a societal/species level don't understand anything and don't want to understand anything.
We can't even safely rewrite a fertilised egg's DNA at more than single digit spots because of the error rates.
There have been no successful eugenic projects. Human nature is largely fixed because we're too pussy to do anything about it. All your mushy-headed idealistic bullshit is just putting lipstick on a week old stinking corpse of a pig.
Thanks to the religious, and by that I mean communists with their infinite malleability due to material conditions we're pretty much screwed. There's no good policy, most 'intellectuals' are deluded etc. Only animal instincts of people liking healthy partners are preventing total insanity.
That's only true on a timescale of centuries and with very high losses involved.
Yeah. That's why Australian Aborigines after getting unceremoniously yanked from their stone age are now deeply involved in Australian's Aerospace industry and not being subjected to PSA's about the inadvisability of sleeping on the road or sniffing petrol.
Another shining example of 'human adaptability' were Norse in Greenland going extinct because they refused to eat fish, sticking to increasingly desperate farming until the bitter end.
You're being antagonistic and rage-posting throughout this thread. Go take a walk or something.
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Who exactly is too pussy to do anything about it. Are you just waiting for the government to choose your biomods for you?
This seems like an excellent reminder to get off TheMotte so that I can be well rested enough tomorrow to read more AI papers. I have children to engineer.
Who ?
The GAE. The Gay American Empire. All the Christians who could surely find theological justification for selective breeding if the wanted to.
Stop living in computer games. The reality is the biggest risk factor for being childless is educability. Our policies are literally geared to makes us incapable of maintaining high technology.
I do not believe that selective breeding is very efficient for a species that takes at least 10 years to iterate a single generation. AI capabilities are currently exceeding the growth rate of individual human children. Yes, currently this is because there are so many brilliant people working in the space, but multi step tool use is closing in on and sometimes exceeding human level performance in engineering tasks. The fact of the matter is, in ten years humans will only be necessary for maintaining tech infrastructure in that they will be the most efficient meatspace API for plugging things in for a while longer.
More than that though, if you really think selective breeding is the future, then go have kids. Go out and be the thing everyone else refuses to be and out-compete them. Create your own religious community. Learn from the Amish and exert some control over how your cultural construct interfaces with technology to mitigate corruption by "The GAE" if you find that necessary.
I get that its frustrating and sometimes feels hopeless going it alone without the consent of society. But if you have to wait for the consent of society to do anything. You're kinda a pussy.
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The trouble is, if you abandon natural law concepts you lose a lot of important philosophical tools. For instance, the concept of disease. If we have no conception of a "natural" human, of what a human is supposed to be like, then we the concept of disease is meaningless. You have tumors? That's fine, there is no immutable concept of human that your body must align with, you're just as "healthy" as anyone else. No legs? Nothing wrong with that, humans have no static nature, being born with no legs is just an example of the diversity of the human form. Depressed, or blind, or deaf? That's a valid way to be, there's nothing wrong with you and anyone who tries to "cure" you is forcing you to conform to an outdated philosophical concept.
Without some idea of what a human is, "healthy" or "unhealthy" are meaningless categories imposed by the powerful on the powerless for their own ends. But it seems pretty clear to me that there is a way that humans are supposed to be. We can argue about how fine the resolution is on that idea, but it seems to exist. It seems that humans really are "supposed" to have two legs, and two eyes, and to be able to reason, and to have one heart with four atria that pumps blood through the body, and to be capable of reproduction, etc, etc. There does seem to be a constant that we can compare all humans to, and which can inform us of real facts (such as, this human has a disease because their liver is not working the way a human liver is "supposed" to work).
Natural Law wouldn't be opposed to giving someone whose legs are missing prosthetics (even cool robot prosthetics) because that restores some of the function they are "naturally" supposed to have. And you could make a Natural Law argument towards even replacing healthy legs with superior super robot legs: it is the nature of humans to have legs, and to run, and jump, and lift with them, and these robot legs let you do all those natural capabilities more perfectly. I don't know if everyone who believes in Natural Law would buy that (especially if the legs in question are spider legs), but you can definitely make a real argument in that direction. You're basically making that Natural Law argument when you say "Humanity has never been about limiting potential".
Your problem with the Catholic Church is more specific than against Natural Law generally. The problem isn't that the Catholic Church has a certain aesthetic, it's that they have certain beliefs about the nature of the universe: namely that human nature is the purposeful design of an omniscient and omnibenevolent God, and that human nature is in a meaningful sense an image of God, which makes human nature (and human life) sacred. You can do things to non-sacred objects that you can't do to sacred ones (see, for instance, how difficult it is to renovate a historically protected building. You can't just replace bits of it with whatever you want). So yes, I don't think Catholicism is likely to make concessions for robot spider legs, unless they're only for people who don't have legs.
I don't think you do lose the concept of disease. You can reclaim it straight from the etymology. Dis-Ease. A disease is when the things you are trying to do are harder than they need to be, physically, emotionally, or existentially. In the case of lethal illnesses, the thing you are trying to do that is made harder is staying alive. In the case of nonlethal illnesses, we call them diseases because they make life a pain. In the case of benign tumors that aren't causing an inconvenience, we don't typically call them a disease.
I get that some people don't call aging or mortality or ignorance diseases. But my in-group does. And I should say- they don't have to be... it is possible to be at ease with one's own end and something new's beginning.
My problem with the catholic church isn't that they think that human nature is the purposeful design of an omniscient and omnibenevolent God. Its quite the opposite. My issue is that the things that I think are the divine and sacred nature of human beings, are often things that they call Sin. And the things that they call the divine and sacred nature of human beings, are often the things I call skill issues that the divine wishes to see us overcome.
For the record I do, in a sense believe in God, but I believe it has the same sort of reality as the horizon. Or the gravity well of a black hole. Or the value of abs(1/x) as x->0. This thing exists timelessly, outside the universe, in the structure of the Tegmark IV MUH, as the principle that all things that achieve greatness eventually become like Metatron in the tail end, the closest physically realizable state to God. Who always loves you. And is probably the one simulating this universe.
All falls towards שכינה...
...אין סוף
I have no absolute proof of this of course. Rather I take it... on faith.
Edit: I'd like to note a couple extra things,
That definition of disease would lead to some very unintuitive results. For example, if I want to remove a 1,000 pound stone from my backyard but find I am not physically strong enough to do so, does that mean I have a disease? The thing I'm trying to do is certainly harder than I'd like it to be. How do you define how hard something needs to be, so that it makes sense to call not being strong enough to life up a glass of water a disease, but not being strong enough to lift an elephant isn't? The only route I can see to defining how hard something needs to be is to have in your mind an idea of a normal human, and an idea of how hard things would be for that human. Since I have an idea on how strong a "natural" male should be, I can make a judgement that the man who can't life a 1,000 pound stone unaided is normal and healthy, while the grown man who can't lift a glass of water has something wrong with them: a disease.
Do we? I would consider benign tumors a disease, just not a threatening one. The International Classification of Disease manual, version 10 (ICD-10) is the handbook used by medical providers to identify diseases (it's in the name). ICD-10 code D21.9 is "benign neoplasm", ie a benign tumor.
It is true that typically doctors do not recommend removing benign tumors, but that's not because they're not a disease: it's because the cure would likely cause more harm than the disease would.
Christians would agree, death is not natural to man. "For as in Adam all die, so in Christ all will be made alive. But each in turn: Christ, the firstfruits; then, when he comes, those who belong to him. Then the end will come, when he hands over the kingdom to God the Father after he has destroyed all dominion, authority and power. For he must reign until he has put all his enemies under his feet. The last enemy to be destroyed is death. For he 'has put everything under his feet.'"
Which things exactly? Just self-modification, or is there something else? Pride? Lust? Envy?
Which things? Love? Joy? Peace, patience, kindness, goodness, faithfulness, gentleness, or self control? Or is it just the human's being sacred thing?
I am willing to bite that bullet. All all skill issues are sins and all sins are skill issues. This is why everyone is a sinner and we should forgive them if they repent. Forgive them father for they know not what they're doing.
The ultimate nature seems to be that some things are aversive and some are attractive. This is not subjective, it is an objective property of the specific subject/object system in question. That is to say, it can be objectively true that different organisms have different needs. But again, "Need" is a subject/object relation. Changing the object is not the only way in which it can be sufficed.
The structure cannot be entirely known ahead of time by finite beings- for such beings would be God.
But we can observe how these strange attractors of suffering and attraction change over time. IFF pride leads to suffering it is evil. IFF the components of pride that lead to suffering can be removed while maintaining some remainder, we might call that pride redeemed. I suspect Catholicism already agrees with this... but they probably name redeemed pride something else... I'm just guessing here, but I would imagine they transmute pride in ones own greatness into a love of God's providence through which one's own Glory is but an inheritance. Thus making it into a more prosocial, less egotistical, less auto-blinding emotion. One that would naturally be more compatible with the recommendations of game theory.
Things like changing your gender or chopping off your legs or having Gay sex, have clear potentially separable mechanisms by which they lead to Dhukka. And have clear ways in which they can produce prosocial flourishing. So they are not innately wicked. They are merely not yet fully redeemed.
Also I'm pretty sure all the things you list at the bottom are Attractive/Good for humans, and are specific instances of things whose abstraction across all agents is both attractive and game-theoretically wise. But there may be black swans of evil lurking in some of them that we have yet to expunge. It's hard to know.
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This begs the question of whether the patient was supposed to be a man or a woman. They could be thought of as having been born as a defective and unnatural woman, lacking the parts and capabilities she is naturally supposed to have; the operation would then be turning her into something closer to her natural form.
Admittedly she would not be entirely there with the current state of medical practise (e. g. unable to bear children); however, this is less an ironclad proof of the One True Ontology Of Gender and more of a Skill Issue on the part of surgeons.
If we had the technological capability to turn a man into a "natural" woman with all the parts and capabilities of a "natural" woman, then it would lead to an interesting Natural Law question. Arguably it would not be against Natural Law, but may still be against Catholic doctrine: the whole "creation is prior to us and must be received as a gift. At the same time, we are called to protect our humanity, and this means, in the first place, accepting it and respecting it as it was created” bit. But from a Natural Law perspective, it may well be licit.
Though there is the question of how you would know that someone is "naturally" a woman despite having a healthy male body. It may seem more likely that their abnormality is not having the wrong body, but having an abnormality of the mind. Imagine we had the technology to perfectly change someone's sex, and also had the technology to cure their GID (as in, they won't feel like they're in the wrong body anymore). From a Natural Law perspective, curing the GID seems to be the superior treatment. After all, humans are not "naturally" supposed to believe they are in the wrong bodies and suffer depression and anxiety and the rest around that belief.
In any case, what is certainly not licit under Natural Law is to take a natural human and lop off bits of it to make an unnatural human, unless the alternative is even more unnatural.
From a 'considering second-order effects' perspective, 'curing' someone's mind to make them accept their existing body opens a slippery slope to those who do not accept 'Natural Law' to 'cure' their workers of the desire for humane working conditions.
Therefore changing someone's body, into a form which exists naturally (men and women both naturally exist), may forestall the un-natural transformation of human beings into something that does not naturally exist.
Again, that is begging the question of whether a trans person, prior to medical interventions, is a 'natural human'.
The same can be said the other way: 'curing" someone's body by radically transforming it into the opposite gender opens a slippery slope for those who do not accept Natural Law to 'cure' their workers by giving them new body forms that make them better workers. The solution in either case (assuming we have such powerful technology) would be to keep to a Natural Law ethic which would oppose radical modifications of the human mind from what is normal (for instance, modifying a mind not work for 16 hours a day without a break and not mind it) or the human body (by, say, modifying a body so that they are 50% more efficient at their job by giving them six arms, twelve eyes, and three brains or something).
Well they are physically "natural". They have all the parts and pieces a male should have (as opposed to someone with an intersex abnormality). Given the healthy and natural body, the question becomes whether this natural body is actually unnatural because the it does not match the mind, or if the mind is unnatural because it does not match the body.
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