Ohio Governor's Transgender Decision

[9-10ths_Penguin]

Did you even glance at the links I provided?

My guess is not, so it appears as though your mind is made up regardless of what facts you might be presented with.

The idea that you've presented facts is... overly generous.

I will ask you the same question I asked jay: Do you think that researchers must use control groups while they are researching and establishing medical protocols??

Of course not.

Is your suggestion that there are no studies with control groups that support gender-affirming care?

I ask because while I'm not willing to treat your arguments as fact, I'm willing to have reasonable discussions around the issue of what the heck is wrong with anti-trans people.

In that light, one topic I'm willing to discuss with you is how you could end up arguing this mistaken position. Are you just ignorant of the research, or are you misrepresenting it wilfully?

 

[icehorse]

See

Randomized-controlled trials are methodologically​

inappropriate in adolescent transgender healthcare​

??

 

[icehorse]

The idea that you've presented facts is... overly generous.


Of course not.

Is your suggestion that there are no studies with control groups that support gender-affirming care?

I ask because while I'm not willing to treat your arguments as fact, I'm willing to have reasonable discussions around the issue of what the heck is wrong with anti-trans people.

In that light, one topic I'm willing to discuss with you is how you could end up arguing this mistaken position. Are you just ignorant of the research, or are you misrepresenting it wilfully?

Being as it's the holidays, I'll continue to assume you're debating in good faith.

First, you still haven't answered the question about control goups.

Second, there are a lot of studies, as my links show. But the problem is that they all produced evidence of low quality. As my links show.

 

[flowerpower]

I don't think government should dabble, in general And I'm sort of middle of the road when it comes to how big government should be, I'm probably slightly left leaning. But I think that when it comes to public safety, the government ought to have oversight. Of course they should enlist the best experts they can.

Call me paranoid, but I'm not sure that I even trust the so-called "experts" employed by governments anymore.

I'm all for small government - I think they should only meddle by ensuring that people's basic human needs are met; so not much more than a slight tweaking of socio-economic policy.

I think government overreach and nannystatism takes place when more abstract and obscure social issues are addressed.

Someone called this governor's move "gutsy" - sounds accurate. The reason why the transgender stuff is so controversial is because I don't know if it's been clearly established whether it is a genuine medical issue or not - and being able to obtain basic healthcare ought to be considered a basic human need in a decent society.

I mean - is being transgender a medical issue or a choice of lifestyle that is enhanced by certain medical procedures? I'm not convinced that it can be both. And, if it is a medical issue, the jury seems to be out in terms of whether it's actually helpful or healthy to endorse specific approaches to treating the issue - that then overlaps the issue with it being framed as a more abstract, obscure social issue rather than something that actually deals with basic human rights and needs.

A lot of people seem to think this issue is a cut and dry "human rights / civil rights vs bigotry" type of deal - I really don't think that it is; I think it's a lot more complicated than that. And thus, why it's been so controversial for nearly a decade now.

 

[McBell]

??

From the linked article:

This article argues that RCTs are methodologically inappropriate for evaluating the impact of gender-affirming care on mental health outcomes among adolescents. The article is divided into three sections that (1) survey why and when RCTs are valued as a study design, (2) explain why RCTs are insufficiently methodologically robust for studying the impact of gender-affirming care on mental health among trans adolescents, and (3) discuss how complementary and well-crafted observational studies are an appropriate alternative basis for clinical practice and policymaking. Our arguments supplement ethical concerns regarding the lack of equipoise for RCTs in adolescent trans healthcare given the numerous studies associating adolescent gender-affirming interventions with improved mental health (Achille et al., Citation2020; Allen et al., Citation2019; Costa et al., Citation2015; Deutsch et al., Citation2016; de Vries et al., Citation2014, Citation2011; Foster Skewis et al., Citation2021; Freedman, Citation1987; Grannis et al., Citation2021; Green et al., Citation2022; Kuper et al., Citation2020; Sorbara et al., Citation2020; Tordoff, Wanta, et al., Citation2022; Tan et al., Citation2022; Turban et al., Citation2020, Citation2022).​

 

[Subduction Zone]

It's a good thing that he did this.
It's harmful to block this care, and I'm not for a moment under the illusion that the Republican's will stop at barring the practice for children.

That one governor may have seen the light, but most will not have or will value their political careers more than they value the lives of trans people.

 

[McBell]

From the linked article:

This article argues that RCTs are methodologically inappropriate for evaluating the impact of gender-affirming care on mental health outcomes among adolescents. The article is divided into three sections that (1) survey why and when RCTs are valued as a study design, (2) explain why RCTs are insufficiently methodologically robust for studying the impact of gender-affirming care on mental health among trans adolescents, and (3) discuss how complementary and well-crafted observational studies are an appropriate alternative basis for clinical practice and policymaking. Our arguments supplement ethical concerns regarding the lack of equipoise for RCTs in adolescent trans healthcare given the numerous studies associating adolescent gender-affirming interventions with improved mental health (Achille et al., Citation2020; Allen et al., Citation2019; Costa et al., Citation2015; Deutsch et al., Citation2016; de Vries et al., Citation2014, Citation2011; Foster Skewis et al., Citation2021; Freedman, Citation1987; Grannis et al., Citation2021; Green et al., Citation2022; Kuper et al., Citation2020; Sorbara et al., Citation2020; Tordoff, Wanta, et al., Citation2022; Tan et al., Citation2022; Turban et al., Citation2020, Citation2022).​

More from the linked article:

Conclusion​

The absence of RCTs studying the impact of gender-affirming care on the mental health and well-being of transgender adolescents does not imply that these interventions are insufficiently supported by evidence. Although RCTs are considered high-quality evidence because of their ability to control for unmeasured confounders, the impossibility of masking which participants receive gender-affirming interventions and the differential impact of unmasking on adherence, withdrawal, response bias, and generalizability compromises the value of RCTs for adolescent gender-affirming care. RCTs are methodologically inappropriate for studying the relationship between gender-affirming interventions and mental health. These methodological considerations compound the serious ethical concerns raised by RCTs in adolescent transgender healthcare. Given the limitations of RCTs, complementary and well-designed observational studies offer more reliable scientific evidence than RCTs and should be considered of sufficient quality to guide clinical practice and policymaking. Adolescent trans healthcare is on solid footing.​

 

[icehorse]

See

Randomized-controlled trials are methodologically​

inappropriate in adolescent transgender healthcare​

Sorry, I missed the link.

From the article:

Because physiological changes are the primary purpose of gender-affirming care, meaningful effects on psychological well-being and quality of life are not expected until unmasking occurs.

I thought that mental health (e.g. reduction of suicidal thoughts), was the primary purpose of GAC?

I think the quoted sentence is making a huge assumption, that being that questioning whether altering physiological changes are even appropriate, seems to be off the table.

In other words, your link seems to be saying - more or less - "if we assume GD youths need to see physiological changes in order to be happy...".

I do not think any such assumption is valid.

 

[Shadow Wolf]

Why?

Why? Probably because those decisions can only ethically and rightly be made between a patient and care providers. The state does political things and politics belongs in healthcare like water on a grease fire.

 

[Shadow Wolf]

I think the quoted sentence is making a huge assumption, that being that questioning whether altering physiological changes are even appropriate seems to be off the table.

Only a huge assumption if you recently learned about it and consistently dismiss peer reviewed data from various medical organizations.

 

[Subduction Zone]

Only a huge assumption if you recently learned about it and consistently dismiss peer reviewed data from various medical organizations.

Hah! Peer review does not matter if it goes against my religious beliefs!!

Sadly I see that reaction far too often.

 

[Shaul]

Why? Probably because those decisions can only ethically and rightly be made between a patient and care providers. The state does political things and politics belongs in healthcare like water on a grease fire.

The act of legislating cannot be divorced from impacting the realm of medicine. I don't think you have considered the entire consequences of your position.

 

[Subduction Zone]

The act of legislating cannot be divorced from impacting the realm of medicine. I don't think you have considered the entire consequences of your position.

Why do you say that? First, please note that almost no medical procedure is guaranteed to work 100%. Also a little background, there is strong medical evidence that shows being trans is a real medical condition. The brain of a trans person works differently than the brain of a cis person of the same sex. And please note, "sex" refers to what one's chromosomes say, gender is how one expresses one's sexuality.

Also the governor here is not proposing allowing surgery for minors. This allows minors to grow as the sex that their mind tells them that they are. This prevents the poor transwoman who has the gif of "It is man" happening. If she was allowed to transition early she would not look like a man. The brain and the body do not always agree and if it is anything that makes us human it is our minds. If transspecies organ donation was possible no one would think that giving a human a chimp heart would turn him or her into a chimp. And at the same time if one could transplant a chimp brain into a human body no one would argue that that was a human.

 

[Shadow Wolf]

The act of legislating cannot be divorced from impacting the realm of medicine. I don't think you have considered the entire consequences of your position.

Yeah, actually I did have to correct someone and point out the words I used because it was assumed I went with a problematic term.
You can actually largely split the two, especially when it comes to being in the office. And when the state does need to get involved it is definitely best for science and medicine to take the lead.

 

[Shaul]

Yeah, actually I did have to correct someone and point out the words I used because it was assumed I went with a problematic term.
You can actually largely split the two, especially when it comes to being in the office. And when the state does need to get involved it is definitely best for science and medicine to take the lead.

So no government funding of any medical procedures. Goodbye Medicare and abortion providers. Oh, and forget about government sponsored vaccinations or help during pandemics. And no prohibition on dubious "medical procedures". Hello female genital mutilations. The government has no business legislating about decisions between a "doctor" and a patient, right?

 

[libre]

So no government funding of any medical procedures.

Are we really to believe that you can't tell the ethical difference between the government criminalizing medical treatments and paying for medical treatments?

 

[Shadow Wolf]

So no government funding of any medical procedures. Goodbye Medicare and abortion providers. Oh, and forget about government sponsored vaccinations or help during pandemics. And no prohibition on dubious "medical procedures". Hello female genital mutilations. The government has no business legislating about decisions between a "doctor" and a patient, right?

That's not making decisions for people, and clearly misrepresenting what I said. "Hello female genital mutilations"? "No business"? Because, yeah, ya know, when I said "when the state gets involved it's best for science and medicine to take the lead" meams EXACTLY what you are attempting to twist my post into.
Think you can twist things like that with my mom's van so I can get these motormount bolts back in?

 

[Shaul]

That's not making decisions for people, and clearly misrepresenting what I said. "Hello female genital mutilations"? "No business"? Because, yeah, ya know, when I said "when the state gets involved it's best for science and medicine to take the lead" meams EXACTLY what you are attempting to twist my post into.
Think you can twist things like that with my mom's van so I can get these motormount bolts back in?

What you wrote, to which I replied "Why?", was; "Good. The state should stay out of deciding medical care for others." Everything in my post #95 is within that scope. I didn't twist anything. You are simply trying to squirm out of the consequences of your own words.

 

[Shaul]

Are we really to believe that you can't tell the ethical difference between the government criminalizing medical treatments and paying for medical treatments?

I'm not the one arguing that the government has no business legislating about medical treatments. That was someone else.

 

[Subduction Zone]

What you wrote, to which I replied "Why?", was; "Good. The state should stay out of deciding medical care for others." Everything in my post #95 is within that scope. I didn't twist anything. You are simply trying to squirm out of the consequences of your own words.

Being excessively literal is not a winning tactic in a debate.