Let's re-think South Carolina ban on gender-affirming care

[libre]

First off, we're talking about kids with GD.

Agreed.

Many kids with severe GD do NOT end up trans.

I agree that having gender dysphoria and being transgender is not the same thing.
I however object to the notion that a trans person has to go through a puberty that they don't want to definitively prove if they are trans or not, that is dangerous. Only the person themselves can identify their gender.

is allowed to go thru puberty without drugs,

Your word choice here strikes me as very strange.
All children are legally allowed to go through their cisgender puberty.
However the bans that you support do not allow children to go through their natural puberty, it forces children to go through that puberty.

 

[icehorse]

Well, we're agreeing on some things, and that's good!

However the bans that you support do not allow children to go through their natural puberty, it forces children to go through that puberty.

But here I find your word choice strange:

Nature forces life stages on us all. But "forces" seems a strange word to use here. I guess nature forces us to get taller, and age and die, and that's just the way life is, right?

With that said, you are correct.

Now IF (and it's a huge, huge, huge IF), doctors could - with 100% accuracy - determine which pre-puberty, GD kids would definitely end up wanting to transition, then I wouldn't be such a persistent critic of GAC. But doctors don't have that predictive capability.

To be clear, I understand that IF we somehow knew for sure that a specific kid would never want to be anything other than trans, that starting GAC early has advantages. I get that.

But we have to weigh those advantages against the disadvantages of maiming some GD kids who would end up changing their minds about being trans. Do you get that?

 

[fantome profane]

Now IF (and it's a huge, huge, huge IF), doctors could - with 100% accuracy ...

But how does this compare with any other medical treatment or procedure? With any medical treatment there is a small possibility of making things worse, even a possibility of killing the patient. There is no such thing as 100% guarantee for anything. But we compare the risks and rewards and make an informed decision. That includes the risk of the treatment, and the risks of no treatment. And you want to deny that there are any risks of non-treatment, there are.

 

[libre]

Nature forces life stages on us all.

It was that way in the past, but it is no longer the case, because we've found a way to stop and change which puberty people go through.
And this ban takes those options away, condemning many to irreversible changes against their will that causes harm.

 

[libre]

But we have to weigh those advantages against the disadvantages of maiming some GD kids who would end up changing their minds about being trans.

Referring to GAC as maiming is absurd.
It is healthcare, not a wound. This stigmatizing language is not productive and it's promoted and catches on from anti-trans groups.

 

[icehorse]

Referring to GAC as maiming is absurd.
It is healthcare, not a wound. This stigmatizing language is not productive and it's promoted and catches on from anti-trans groups.

Context is important here. If you subject a kid that is not trans to GAC, you are maiming that kid.

 

[Evangelicalhumanist]

Nature forces life stages on us all. But "forces" seems a strange word to use here. I guess nature forces us to get taller, and age and die, and that's just the way life is, right?

Until we learned something about medicine and surgery, nature forced us to die early of all sorts of things. And then we learned how to prevent that, to our great benefit. Should we give all that up, and let nature have her way?

 

[icehorse]

But how does this compare with any other medical treatment or procedure? With any medical treatment there is a small possibility of making things worse, even a possibility of killing the patient. There is no such thing as 100% guarantee for anything. But we compare the risks and rewards and make an informed decision. That includes the risk of the treatment, and the risks of no treatment. And you want to deny that there are any risks of non-treatment, there are.

It was that way in the past, but it is no longer the case, because we've found a way to stop and change which puberty people go through.
And this ban takes those options away, condemning many to irreversible changes against their will that causes harm.

So how do you do the ethical / moral math here? If we use GAC there are upsides and downsides:

- upside: kids who want to transition get better results
- downside: kids who end up not wanting to transition get maimed.

How do you propose weighing those two outcomes?

 

[icehorse]

Until we learned something about medicine and surgery, nature forced us to die early of all sorts of things. And then we learned how to prevent that, to our great benefit. Should we give all that up, and let nature have her way?

Come on man. We're talking about dangerous alterations of healthy bodies to treat a mental condition.

 

[libre]

So dangerous that the patients are 97% satisfied with the results!!

 

[icehorse]

So dangerous that the patients are 97% satisfied with the results!!

several points:

1 - lack of long term data
2 - you're not factoring in the non-trans GD kids

So try to put yourself in the following scenario: You're a kid with severe GD. Adults convince you to do GAC, which you do. It's IRREVERSIBLE. You're still not happy. But you're also trapped by the decision adults put you up to. You might well lie, to others and to yourself. This is something like the sunk cost fallacy.

That's why truly long term studies are needed. For many situations regret doesn't come up for years or decades.

 

[fantome profane]

get maimed

You lecture about having a "good faith conversation", and then use language like this. You do not discuss in good faith, you use disgusting bigoted loaded language.


But that will not stop me from answering what is a simple question with an obvious answer. You do the "ethical math" the same way you do it with any other medical decision, you weigh the risks of the treatment with the rewards, and the risks of non-treatment as well.

 

[libre]

Adults convince you to do GAC, which you do.

Outside of a few incidents of abuse and malpractice, no children are being encouraged to go through GAC if they don't want to.
The idea that there are children being put up to GAC on an institutional level or and not being 'allowed' the option to go through their cisgender puberty is not based in fact.

As for your assertions about the dangerousness of GAC and the stigmatizing language you use, once again, I defer to the pediatric society of my country over your non-doctor opinion.

 

[icehorse]

You lecture about having a "good faith conversation", and then use language like this. You do not discuss in good faith, you use disgusting bigoted loaded language.


But that will not stop me from answering what is a simple question with an obvious answer. You do the "ethical math" the same way you do it with any other medical decision, you weigh the risks of the treatment with the rewards, and the risks of non-treatment as well.

GAC maims, that's the reality. It makes some GD kids feel better mentally, but it still maims their bodies. To deny that is dishonest.

==

Ok, progress on the ethical math.. what are the risks of non-treatment? As you think about answering that question, keep in mind that there are no studies that provide high quality evidence that GAC is more effective than talk therapy only.

 

[icehorse]

Outside of a few incidents of abuse and malpractice, no children are being encouraged to go through GAC if they don't want to.
The idea that there are children being put up to GAC on an institutional level or and not being 'allowed' the option to go through their cisgender puberty is not based in fact.

Do you think the kid spontaneously arrives at the idea that there are drugs to stop puberty? Do you think these kids really understand what puberty is, other than it's making them severely sad?

 

[icehorse]

As for your assertions about the dangerousness of GAC and the stigmatizing language you use, once again, I defer to the pediatric society of my country over your non-doctor opinion.

GAC maims, that's the reality. It makes some GD kids feel better mentally, but it still maims their bodies. To deny that is dishonest.

 

[ADigitalArtist]

I don't engage with people couching their transphobic content in 'think of the children' anymore so I've mostly stayed away from this and similar threads. Since the whole first page was waiting for that one person to arrive.

But I do want to comment on this.

I'm not talking about any individual. I'm talking about medicine.

Which is why careful screening is necessary. If a anatomical male is found to have a woman's brain, what is to be done, change the brain, change the body, change the lifestyle/presentation, or do nothing?

Don't councilors have PET, fMRI, or CAT?

Do no ham. Maximize well-being.

Pink brains and blue brains have not been established to exist. So far every study which has found large structural difference between female and male brains were not natal, but after nurture both environmental interest in cultural habits and subjects of men and women, (e.g. men and women are socialized to engage in certain types of play and learning) as well as post hormone influence. So far every study which has found structural differences between male and female brains did not extend to the majority within the testing pool (e.g. not all men had specific structural differences associated with 'male' brain and visa versa for women.)

This is important because it's part of a wider dialogue about how nature vs nurture operates as a blind talking point, and in reality there is no clear white line between the two. And when nature vs nurture gets politicized, it's almost always to the detriment of a minority trying to find a magic pill to excuse who they are as 'natural' to an unbelieving audience.

But just like how there is no such thing as a 'gay gene' because homosexuality is infinitely more complex than a single gene, there's probably not going to be anything as easy for trans (and those of us who aren't trans but who have very masculinized or feminized bodies outside our natal sex) as 'your brain looks like this therefore that's your gender.' And that's okay. There's no specific place you can point to in the brain for an autistic diagnosis either, but that doesn't mean autism cannot be diagnosed and treated without a PET, fMRI or CAT. The same is true for gender dysphoria, being trans, etc.

 

[icehorse]

I don't engage with people couching their transphobic content in 'think of the children' anymore so I've mostly stayed away from this and similar threads.

Hypothetically, a person criticizing GAC could consider this sentence a sort of loop hole way to slander posters, which is counter to forum rules. Or did I get that wrong?

 

[fantome profane]

Ok, progress on the ethical math.. what are the risks of non-treatment? As you think about answering that question, keep in mind that there are no studies that provide high quality evidence that GAC is more effective than talk therapy only.

You are missing the point. And it is the same point that I have literally been making for years now on this board.

It is not up to me to access the risks of treatment or non-treatment. This is up to either the patient or the guardian of the patient. No different, absolutely no different, than any other medical decision. But you care deeply about this one because of your obvious anti-trans bias.

 

[icehorse]

You are missing the point. And it is the same point that I have literally been making for years now on this board.

It is not up to me to access the risks of treatment or non-treatment. This is up to either the patient or the guardian of the patient. No different, absolutely no different, than any other medical decision. But you care deeply about this one because of your obvious anti-trans bias.

I'm opposed to GAC as it currently stands. Many top doctors around the world agree with this stance. This is NOT an anti-trans stance.

So, to reiterate, I'm simply reporting on what top doctors are saying.

As far as what's up to you... well we're all here - voluntarily - on a debate forum. We debate extremely consequential topics across all areas of life. Do you think that this topic is somehow less debate-able than all the other topics we debate?