a_chap
When the world came apart, where were you?
I don't know about workable, enforceable or desirable but it seems to me future historians will conclude that threads about trans' issues was finally the way that Urban75 ceased to be a community.
Is this woman a transphobe?
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I don't know about workable, enforceable or desirable but it seems to me future historians will conclude that threads about trans' issues was finally the way that Urban75 ceased to be a community.
littlebabyjesus
one of Maxwell's demons
Maybe I was wrong to think this was a place these disagreements could be aired. Probably was wrong.
I'll sign off by leaving this here. I would normally quote from it but won't as that would just be asking for more debate. It's quite long but imho it's worth the read and could be of interest, to see this considered perspective if nothing else. It's a piece by the psychoanalyst who resigned as a governor of the Tavistock clinic.
Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs
I'll sign off by leaving this here. I would normally quote from it but won't as that would just be asking for more debate. It's quite long but imho it's worth the read and could be of interest, to see this considered perspective if nothing else. It's a piece by the psychoanalyst who resigned as a governor of the Tavistock clinic.
Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs
Border Reiver
Active Member
Always worth reading a view from the minority. Does not make it more valid than the vast majority.
Even a dogmatic Freudian with no clinical experience of treating trans kids, who has no published work on trans people, done no formal research into trans people and who just so happens to have a book coming out outlining his evidence free theories of how to cure gender dysphoric kids with the power of his mighty psycho-analysing skills. And who seems to support Zucker's attempts at conversion therapy which I outlined earlier in the thread - although even Zucker supprts medical transition when gender dysphoria persists into adolescence.
I think articles like this are one of the most depressing aspects of this debate. There's so much of it which doesn't tell the whole story, or ignores inconvenient facts or sometimes just tells bare faced lies. None of the people he cites have any expertise in the field, other than Zucker who he conveniently cherry picks. So many people are setting themselves up as experts on trans kids when half of them have barely ever even spoken to a trans kid and people are accepting it because what they say chimes with their personal hunches about trans people. It would take an essay of equal length to point out the inaccuracies, omissions and obvious biases in that piece by Evans, and I'm not even sure there's any point anymore. What I do know however, is that if they do manage to stop all treatments for trans kids in the UK, these kids will not be thanking all of you who supported it a decade or so later. They will be filled with burning hatred for the rest of their lives over the insistence that people's evidence free pet theories about gender identity superceded their lived experience and understanding of themselves. And if you want to see a taste of that read Ky Schevers and some of the others from the first wave of detransitioners who have subsequently retransitioned - which incidentally is exactly what you'd expect if you read any of the evidence about the experiences of detransitioners: Ky Schevers – Medium
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8ball
Decolonise colons!
That ‘like’ wasn’t laughing at the post btw - I think it’s a good point. I’m far less conversant with Jung than Freud tbf (aside from knowing Jordan Peterson talks about the former a lot).
What concerns me about that article is that it makes a lot of claims with no reference to the kind sources I’d tend to look for (when making claims about studies and science - I’m not talking about links to interviews with fellow-travellers) , and there are exactly no comments below it addressing those claims. It is all cheerleading (well, 90% cheerleading and 10% rank transphobia). Maybe one could point to the source and say perhaps some people are disengaging with the cesspool , but I suspect there is more to the story and Quilette’s modding might not be as “all about the freespeech” as is claimed.
I’ve gone on too long, anything further should be in a different place than here.
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Border Reiver
Active Member
The subsequent sentence shows there was a note of irony missing from your quote of part of the comment.
Puberty blockers have been confirmed to be ethical and lawful by a subsequent case at the High Court. No current treatment has been affected and the only question now is whether a child can consent to puberty blockers while their parent opposes them. A very narrow point still being appealed.
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I will say this. There are no ‘experts’, other than trans people on their lived experience. There are only theories about what causes some people to experience their physical body as at odds with their psychological perception of themselves.
The idea that gender is an ‘essence’ that exists as something separate to biological sex, something that should be discovered by an individual during life rather than ‘assigned’ at birth, is an explanation but it is not a fact. And it cannot be proven or disproven by science. Any more than the idea put forward in the article that littlebabyjesus linked to, that gender dysphoria is linked to the traumatic separation from the primary caregiver (mother). These are psychological theories which are not amenable to scientific proof.
Leaving aside the theoretical explanations of why some people experience gender dysphoria, you can try and use the scientific method to measure whether one medical treatment is better than another. The outcome measure usually a proxy for psychological distress (suicide attempts, or self reported episodes of suicidal ideation). These kinds of measures are fraught with difficulty, and biases within the method, but are the best that science can do. The often low powered studies that exist, provide equivocal evidence overall for medical intervention.
What is a fact is that medicine cannot change a persons biological sex, except at the most crude hormonal and anatomical level. Sex differences between males and females are pervasive genetically, through to physiologically, and anatomically (and not just secondary sex characteristics- everything from skeletal muscle type, bone density, kidney volume distribution, etc pretty much every part of the body has sex based differences), to clinically (much if not most pathology and diseases have sex-biases and present differently).
Even a pre pubertal biological female, given puberty blockers, then testosterone, having their breast tissue surgically removed and a ‘penis’ surgically created out of tissue from other body regions, does not ‘become’ a male medically. And the person has of course been made infertile and will have lifelong sexual dysfunction, and may well also have physical side effects of the medical and surgical treatments (such as osteoporosis, growth retardation, significant scarring etc).
Maybe for some people the modification of the body like this is the best way to treat the psychological distress. Maybe for others, psychological therapy without medical intervention would be best. We just don’t yet know what works best for most yet.
We do know that adolescents (people aged between 10 and 19 years) are already undergoing a period of physical sexual maturation and psychological adaptation. This has long been recognised as a challenging time psychologically for many. We also know that the brain is changing rapidly, and adolescence is a time of differing risk assessment of likely outcomes of behaviours to adults, and heightened vulnerability to risk behaviour. Delaying these processes using puberty blockers will of course effect a young persons physical, psychological, neuro developmental, and psychosexual development.
These are enormously complex decisions. For adults, let alone children. Medicine must be very careful when deciding whether to act. The omission of action can of course also harm, but first, first, do no harm.
Border Reiver
Active Member
The problem is that harm can be done both by offering treatment and by withholding treatment. The adage "First do no harm" is not an active part of modern medical ethics which recognises any intervention or lack of intervention can have desired and undesired consequences.
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Border Reiver
Active Member
As a social construct, gender may correlate with biological sex but is not caused by it. All identities are negotiated between the person and the society. That is what "construction" means. This applies to all identities, nationality, occupational, sexuality, group membership, etc, not just gender.
And herein is the complication too, because like all social constructs, they exist in terms of social practices as well as personal affect. Whether you use a social representation theoretical approach, a discourse analytical approach, a psychosocial approach, a social identity approach or any other way of understanding the psycho-social interface, you have to include the two-way nature of the construction, both the agentic and the socially determined.
I think as far as these medical matters are concerned, it's sensible for laypeople to take the view of the majority of experts. I'm getting a bit of a "vaccines cause autism" vibe about all this. Cautious scientific uncertainty is not an excuse for a free for all.
We can't have this debate because it's too damaging. Also, you lot are just like those idiotic vaccine sceptics. I am very wise and kind.
Debate what you like. I don't have any problem with eg. posting the Marcus Evans piece, but it would be responsible to give us proper background on it.
You're the one smearing the 'other side'! You've been doing it for the whole thread!And good grief. The whole petty your side, my side thing again and on tricky scientific questions. What has happened to this place?
Even sly gendercritters who aren't even real feminists?
Good article by Owen Jones here, warning about the similarities between transphobia and homophobia
owenjones84.medium.com
Transphobia was always going to end up as crude, old-fashioned homophobia
Why does anyone want to be a parent, with all the stress, exhaustion, and often thankless turmoil it can entail? A simple answer is a very…
Indeed they're dreadful. Individually. Posey Parker is one of the worst individuals, and I recognise that it wouldn't be fair to lump say Julie Bindel in with her, while recognising the problems with the latter.
littlebabyjesus
one of Maxwell's demons
He is a psychoanalyst who was a governor of the Tavistock but resigned a couple of years ago. The article is an explanation from him of why he resigned. I gave that bare bones background and nothing more as I didn't want to get involved in a new raft of discussion. 'It's complicated' would be my summary of the ethics of medical treatment for young people with gender dysphoria. This article I think gives insight into some of that complication. I don't necessarily buy all of his psychoanalytical ideas about GD - just as an endocrinologist is likely to see everything as a hormone problem, so a psychoanalyst is likely to see everything as a problem rooted in Freudian ideas about attachment - but I also didn't particularly see the need for me to signpost that.
Normally, as I said, I would quote a couple of bits to show why I was linking to it. The idea that it's not responsible to post it without adding more is weird, though. Are these dangerous ideas or something?
teuchter
je suis teuchter
Reading these threads on here and making an attempt to understand them is the closest I feel I'll ever get to understanding the parts of this issue that involve different views from the ones that I generally have access to in "real" life. It's the closest I'll ever get to finding answers to questions that I remain unwilling to ask.
8ball
Decolonise colons!
Let me know if I’m misreading anything, but taking it on face value, no, medicine does not work quite like this.
It works by assessing a balance of risks and harms, and having been harmed by a couple of life saving operations in the past, I’m pretty grateful that it works this way.
You are misunderstanding. The four pillars of medical ethics remain: Beneficence (doing good), Non-maleficence (to do no harm), Autonomy (giving the patient the freedom to choose freely, where they are able), Justice (ensuring fairness).
Non-maleficence, or "given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good” is still considered the first pillar to consider. In fact, in much of surgery and medicine, it is better to do nothing than something and watchful waiting and conservative treatment is often considered prudent and wise. Risk/benefit discussion is one way in which the pillars of medical ethics of beneficence and non-maleficence are considered, and links to capacitous consent and autonomy in patient discussions. I’m afraid to suggest that non-maleficence is no longer relevant to medical ethics is just incorrect.
8ball
Decolonise colons!
I didn’t do that, it seems you didn’t understand my post. Also, risking doing more harm than good is something that happens all the time, depending on an assessment of severity and likelihood of risk.
Right now I’m waiting for another operation, the decision of when to operate is based on their assessment of when the aneurysm becomes more likely to kill me than the operation (I forget the precise period of time this calculation is based on). This is a clear case of “risking doing more harm than good”. Where taking the risk is judged favourable, it is taken (I’m assuming matters of consent to be obvious).
Omg do you have a brain aneurysm?! I’ve just (literally week before last) had neurosurgery for an 8mm left sided ICA aneurysm that was stretching my left optic nerve and causing visual changes. Scary stuff. Good luck xx
8ball
Decolonise colons!
Shit. Hope you’re doing ok.
No, I have an ascending aortic aneurysm. Has been stable for a long time, kind of sits at the size they’d usually operate but since it’s not changing I just get an annual dose of rads from the CT scanner. So far, so good...
Border Reiver
Active Member
It requires context. His views are held by a tiny minority of clinicians and by no real medical authority.
bimble
floofy
Maybe not all that tiny really, if he's telling the truth about how one fifth of the staff at the Tavistock GIDS service grouped together to announce that they too had 'grave ethical concerns' about the service that their own workplace was providing?
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