Prevalence of Gender Ideology and the Placebo Effect

Is the nearly vertical upward spike in reported cases of gender transition due, in part, to the placebo effect? Leor Sapir Reports at City Journal,  "The Placebo Is the Point: A new paper highlights the fundamental bias in the world of “gender-affirming” research."

A paper published last month in the Archives of Sexual Behavior makes an important point about the environment in which “gender-affirming” drugs and surgeries are offered to minors. Positive outcomes from hormonal interventions, argues psychiatrist Alison Clayton, the article’s author, may be attributable to placebo effects generated by clinical encounters and the social context in which they take place, rather than to the underlying psychotropic effects of the drugs themselves.

Clayton’s basic intuition makes sense. If you take a teenager in emotional distress and tell her that drug X will solve her problems, while treatment Y will make them worse, and then bring her to a clinical setting where medical professionals repeat that message, it should come as no surprise that the teenager experiences emotional relief when you give her X, or distress when you give her Y—regardless of the psychotropic effects of X. The patient may regard the giving of X symbolically as adults listening to her and empathizing with her inner turmoil. “The ‘Hawthorne effect,’” writes Clayton, “describes the phenomenon where clinical trial patients’ improvements may occur because they are being observed and given special attention. A patient who is part of a study, receiving special attention, and with motivated clinicians, who are invested in the benefits of the treatment under study, is likely to have higher expectations of therapeutic benefits.”

It is indeed the case that promoters of “gender-affirming care” have created what Clayton calls “a perfect storm for the placebo effect.” In the left-of-center media, puberty-blockers, cross-sex hormones and (less frequently) surgeries are hailed as “medically necessary” and suicide-preventing measures for teens in distress, supposedly over having been wrongly “assigned” their sex at birth. Skeptics of these interventions are denounced as cruel deniers of life-saving medicine to youth at high risk of suicide. Meantime, alternatives to drugs and surgeries (e.g., psychotherapy) are denigrated as harmful “conversion therapy,” setting the stage for a nocebo (harmful) effect on those who receive psychotherapy but not drugs.

From the viewpoint of those who have become intensely interested in treating dysphoria medically (rather than the "watch and see" method), many have uttered the phrase "Munchausen syndrome by proxy," which is "a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick."

 Biologist Colin Wright has been observing various parent groups. His observations give credence to that concern.

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Jordan Peterson: The Danger of Obsessing About Yourself

Jordan Peterson had a long and intense discussion with writer Helen Joyce about transgender ideology. It is a well-worth listening to the entire episode, including the discussions of social contagion, the reasons girls reject their own bodies, the disrespect shown to older women (by younger women) and the pervasive role of narcisism. Peterson, who has worked as a clinical psychologist, offers this advice for people who suffer from social anxiety. From my personal anecdotal experience, I think this is spot on and important to note:

Helen Joyce: And alongside that, that you must choose your identity off a list of dozens, and sometimes hundreds, that require the most intense, constant rumination and self-examination. I mean, I was talking to somebody just yesterday--who was telling me that who has this check sheet for how do I feel? ... But you were meant to be thinking all the time, like, how am I feeling right now? And it was, you know, on a scale of one to 10, how happy am I? This is all a terribly bad idea.

Jordan Peterson: Well, it's clearly bad. One of the things I learned when I was treating people who were socially anxious, I had a lot of anxious people in my, in my clinical practice, which is hardly surprising because that that's the kind of suffering that requires people to seek clinical intervention. Socially anxious people, when they go into a new social situation, think obsessively about how others are thinking about them. Yes. And so then they become self conscious often about bodily issues. But not only that, they might become self conscious about their lack of conversational ability, and the fact that they're not very interesting, and the fact that they're being evaluated by other people, it's a litany of obsessive thoughts. And you can, you might say, well, you can train people to stop thinking about themselves. But you can't stop people from thinking about something by telling them to stop thinking about something. But what you can train people to do is to think more about other people. And so one of the techniques that I used in my practice was okay, now, when you go into a social situation next time, like we'd go through the niceties of introducing yourself and making sure they knew your name, and get that ritualized, so that it was practiced and expert and therefore not a source of anxiety. But the next thing is, your job is to make the other person that you're talking to as comfortable as possible, to pay as much attention to them. And so we know that the more you think about yourself--this is literally true--there is no difference between thinking about yourself, and being miserable. They load on the same statistical axis. And so these kids that are constantly being tormented by 150 identities, that's a front not of freedom, but of utter chaos. And then asked to constantly reflect on their own state of emotional well being and happiness is the surest route to the kind of misery that's going to open them up to psychogenic epidemics. The clinical data on that are clear.

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The Biggest Dangers of Tribes

What should you make of the fact that you are passionate about your position on an issue?

Is that passion justified by real world facts and a careful and conscious cost/benefit analysis? Or did unconsciously adopt your position as a result of becoming a member of a tribe? Did social pressures and desires nullify your intellectual defenses to bullshit, allowing rickety beliefs to find a welcoming space in your head? Did you aggressively attack your new position, making sure that it is solid? Or did it slip in like the trojan horse after your sentries became completely distracted by their cravings to be liked (and not disliked) by others? After all, because called "inappropriate" "misguided," "a tool for the [bad people]" or "racist" hurts, especially when done in public arenas. Those slings and arrows take a toll and they have put Americas institutions at great risk. It takes a special person to be able to shake off those accusations and stay true your need to hyper-scrutinize all issues, especially your own position on those issues.

It takes courage and strength to constantly attack your own ideas and it needs to be constant because truth-seeking is never-ending work. And it's not enough to try as hard as you can to be skeptical of your own ideas, because we are blind to the problems with our own thought process.

We know this for sure, based on the work of many scientists who have studied the confirmation bias, including Jonathan Haidt:

Morality binds and blinds. It binds us into ideological teams that fight each other as though the fate of the world depended on our side winning each battle. It blinds us to the fact that each team is composed of good people who have something important to say.

From The Righteous Mind: Why Good People Are Divided by Politics and Religion.

You can't cure this problem alone. You need to expose yourself to viewpoints you find distasteful or even odious. That is the only solution because the confirmation bias is that strong. You cannot see the problem as long as you are clinging only to your favorite sources of information. You need quit being a coward and engage with people and ideas that challenge you. You need to visit websites and read books that you would rather not. That is your only chance to test your ideas, identify those that work and don't work. This need to constantly expose your thoughts to the marketplace of ideas was described with precision by John Stuart Mill (and see here). Recently, Jonathan Rauch has taken a deep dive on this challenge in his excellent book, The Constitution of Knowledge.

There will be many who read this who say "I'm not concerned because I am immune to both dumb things and the pressures of tribes." They are wrong to be complacent for two reasons.

Reason One: People think they are immune because they feel certain that they have things right. They feel this way even though ALL OF US change our opinions over time. We are guaranteed to change our views in the future just as we have in the past, but we don't remember how much we change over time.  We simply sit there smug and certain that we've got things figured out at each present moment. What is that feeling of certainty worth? Nothing, as explained by Robert Burton, in his book, On Being Certain.

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Gender Ideology: Colin Wright Offers a Case Study

How does one explain "the sudden and dramatic rise in the number of children being referred to gender clinics for gender dysphoria—the experience of distress caused by a perceived mismatch between one’s biological sex and “gender identity.”

Biologist Colin Wright followed one recent case on the Facebook Group, “Trans People and the Allies Who Support Them” Facebook Group.? Here's a great recipe if you would like to confuse and abuse a young child.

[This sudden and dramatic rise of such cases] is likely due to the equally sudden rise of a radical new ideology—gender ideology—which is a set of beliefs asserting that whether someone is a man/boy or woman/girl is entirely rooted in one’s subjective “gender identity” as opposed to one’s objective biological sex. In practice, “gender identity” reflects an individual’s affinity to, or rejection of, masculine and/or feminine stereotypes.

This truly radical reconceptualization of what it means to be a man, woman, boy, or girl, does not come without equally radical and harmful consequences. The harm results from the fact that the completely natural and common tendency of some individuals of each sex to exhibit gender nonconforming personalities and behavior is now being incorrectly interpreted as being transgender—a psychological condition that requires treatment.

The current standard of care is called “gender-affirming therapy,” which is the practice of immediately accepting and accommodating a child’s new identity without question or exploration of causal factors. Initially this often means participating in the child’s social transition, which can involve calling the child by a new name, using new pronouns, and allowing them access to spaces (e.g. bathrooms) that “match” their claimed identity. Following social transition, the next step often involves taking puberty blockers to halt further body development, and then cross-sex hormones and surgical interventions such as double mastectomies (removal of breasts) in girls, or orchiectomies (removal of testicles) in boys.

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