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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??!!
From the article UnHerd cites:
If this now-amputee were me, I'd try to just get over it. Stop taking any action to either sate or resist the discomfort, meditate real hard, just feel it and let it burn out. I think it'd work for me.
But it's a mistake to not understand the other side's perspective. You have a guy who's constantly distressed, whose daily life is significantly impaired, who's begging for help, where many pharmaceutical and therapeutic interventions have failed, and a simple operation will fix his problem permanently. It makes a certain amount of sense, right? This guy's had this problem since he was a child, and it is a doctors' job to fix it, and nothing else is working.
It reminds me of
https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/
Amputating a few fingers is somewhat more invasive than putting a hairdryer in your car. But it's the same principle, right?
That's from the categories are made for man, which Zack's spent a lot of time disagreeing with because, yes, it was about trans people and how to treat them. I didn't even remember that was why Scott told that story until I looked it up again today.
And, it's a good analogy, because this is what it feels like for a medical professional dealing with trans patients. You have adults who beg for hormone treatments, claim to be and appear to be in severe distress due to lacking them, and do indeed appear to improve after taking them. This is what it should look like! There are issues with kids, issues with surgery, but none of those undermine the obvious case for accepting trans people and treating them with hormones - it seems to make them happier and better. Again, yeah, edge cases, but the trans people I know are not perpetually depressed psychological wrecks like you'd expect from rw twitter memes, they're generally normal and happy.
Claiming otherwise requires some sophisticated reasoning, like one that claims happiness or sexual satisfaction are of little value themselves, and only matter when done for in line with a greater purpose - in this case, marriage and having children. And since trans individuals imitate the appearance of sexuality without the fertility backing it, it's bad. I agree with something like that.
If A is evidence for B,
B should be evidence forA, yes? "One man’s modus ponens is another man’s modus tollens?" If we took this case being a novel case of unnecessary amputation as evidence that trans ideology has thoroughly captured the medical system, or something like that, and then we observe that this isn't novel - I think we should doubt the reasoning that led to the claim of ideological capture.edit: here is the paper about the case.
I actually don't think it really needs reasoning that's all that sophisticated. Transforming a hand with five fingers to a hand with three fingers and two stumps is something well within the bounds of current medical technology, and the risks of an unexpectedly negative outcome are substantially lower. In contrast, actual gender transition is so far beyond current medical technology that we're not even close to getting there. I think this is the big problem with the analogy, because the consequences here are extremely relevant. Yudkowsky had an article that I really liked on the subject, actually - https://www.lesswrong.com/posts/QZs4vkC7cbyjL9XA9/changing-emotions
I specifically mean claiming that existing adults who believe themselves to trans women, do so for multiple years, and most centrally are MtFs who genuinely feel terrible about not being women, shouldn't start taking hormones and socially transition. Within this argument the claim isn't that they're Becoming-Woman, the claim is that trying to mime the social roles and appearances of women and starting hormones appears to make them happier, more content, etc
It is incredibly weird to try to imagine though how so many people who are not, in fact, mentally women, could come to the conclusion that they are mentally women and start mimicking that social role and genuinely enjoy it. And as far as I can tell that is true! It really speaks to how complex and contingent human values and desires are, and how many potential configurations of human beliefs and societies there are.
I think most of the friction over transness (and gayness, which is typically only one step removed from transness anyway) is that doing that also tends to be an excuse to express all the attributes of that gender and not just the positive/productive ones.
Public perception is that, being born as the gender that doesn't express those traits as much would cause an ex-gendered individual to know better than to do them/have more innate resistance to them. Of course, that's ignoring that ex-women/lesbians get more leeway on this than ex-men/gays do for sociobiological reasons, so toxic feminine traits in men are going to be noticed and resented more than toxic masculine traits in women will be (if they even happen at the same base rate).
For example, there's a meme around 4chan that boys make the best girls (and... there's probably something to that), but that's ignoring all the times that boys make the worst girls. At an object level, this mainly comes in the form of catty bullshit and other gender-role-specific ways to be a bully, which is why it's easy [for otherwise-normal men] to form a strongly negative association with other men who have developed/are developing the gay lisp (to name one example).
Of course, that reaction also prompts toxic [same adopted gender] to rally around the flag and defend their right to that toxicity, and since the balance of power in western society currently favors women the "it's ma'am" shit gets a pass. Places where the genders are a bit less at war with each other (for whatever reason) tend to produce more media that portrays crossdressing/cross-sex activity in at least a neutral light, which is why that stuff more often comes out of Asia.
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