Substitution as a Lazy Narrative-Preserving Technique (Using Gays Against Groomers as an Example)

What are the policy positions of Gays Against Groomers? Many people won’t know because corporate media on the left (I checked the NYT and WaPo) refuse to mention the organization. I recently asked someone who considers herself to be on the political left. She cringed and responded by saying that it sounds like a Republican or conservative group and that there is no grooming going on in America’s schools.

That seems like an answer to the question, but it isn’t. What just happened is subtle, but it is critically important. The person I was talking to completely failed to answer my question. Her answer illustrates Daniel Kahneman’s principle of “substitution,” which he discussed at length in Thinking, Fast and Slow (2011).

[W]hen faced with a difficult question, we often answer an easier one instead, usually without noticing the substitution.

(p. 12).

In my experience, this is a go-to technique in the culture war conversations. Quite often, when people are asked factual questions about a person or organization they don’t like (or they assume they don’t like), they will substitute an easy question for the more difficult question of detailing the facts. The substituted easy question will often be something like “Do you like this person/organization,” even though that was clearly not the question asked. As Kahneman describes, the new simple question will be unconsciously inserted. With the new simple question substituted in, the answer is also simple. In culture war discussions, it often takes the form of an ad hominem attack. Consider this example:

Q: “What are the policy position of [a particular person/group]?”

This is a factual question that should either be “I don’t know” or it should be a listing of the policy positions of the person/group. If the is about an organization and the answer is anything other than “I don’t know,” it should fairly track the “About Us” page of the website the person or organization.

However, the hard question is often unconsciously brushed to the side and a new easy question is inserted. In my example, if the person thinks they don’t like the person or organization, they could be expected to substitute in a new simple question like this:

“Do you like [the person or group] and what detrimental things can your emotionally generate (e.g., what deplorable person/affiliation/ad hominem label can you reflexively pull out) to express your emotions?”

For people politically on the Left, the answer will often be something like: “That [person/group] is like Hitler, Republicans, Satan, etc.

On this topic of Substitution, here is another excerpt from Kahneman book (p. 101):

The idea of substitution came up early in my work with Amos [Tversky], and it was the core of what became the heuristics and biases approach. We asked ourselves how people manage to make judgments of probability without knowing precisely what probability is. We concluded that people must somehow simplify that impossible task, and we set out to find how they do it. Our answer was that when called upon to judge probability, people actually judge something else and believe they have judged probability. System 1 often makes this move when faced with difficult target questions, if the an¬swer to a related and easier heuristic question comes readily to mind.
Consider the questions listed in the left-hand column of Table 1.

These are difficult questions, and before you can produce a reasoned answer to any of them you must deal with other difficult issues. What is the meaning of happiness? What are the likely political developments in the next six months? What are the standard sentences for other financial crimes? How strong is the competition that the candidate faces? What other environmental or other causes should be considered? Dealing with these questions seriously is completely impractical. But you are not limited to perfectly reasoned answers to questions. There is a heuristic alternative to careful reasoning, which sometimes works fairly well and sometimes leads to serious errors.

[More . . . ]

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The Unwillingness of Many Pro-Transgender Parents to Come to Grips With What They Have Done to Their Children

Journalist Helen Joyce does a deep dive on the capture of organizations by activists and why pro-transgender ideology has become a fight to the death for many parents who have advocated for the surgical mutilation and sterilization of their own children.

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How Gender Ideology Escaped the Lab to Become a Treatment Protocol

How did such a flimsy theory become an on-the-ground preferred treatment for so many health care providers? How did it come to be that so many highly trained doctors will surgically remove healthy body tissue of teenagers or inject them with cross-sex hormones, thus making them infertile? Dr. Stephen Levine, a clinical professor of psychiatry at Case Western Reserve University, explains at Public:

[A] vast chasm that exists between affirmative care doctors who believe that medical interventions should be the first line of treatment for people suffering from gender dysphoria and those like Levine who remain committed to the Hippocratic Oath to first do no harm.

“It’s been for over 2,500 years that we in medicine, we have said we do not remove healthy tissues, and we do not alter the physiology of the body,” he explains, adding that there is no data to suggest that a child who undergoes medical transition can grow up to have a full, happy, accomplished life. “It’s a belief system…and beliefs are not what parents want from doctors. They want to know what the facts are, and part of the facts is the uncertainty of outcome.”

Given that existing long-term data indicate that the “suicide rates of adult transsexuals are much higher than the suicide rate of the general population, not slightly higher, much higher,” Dr. Levine is horrified by doctors who perpetuate the transition-or-suicide narrative as a way to coerce parents into consenting to their child’s transition... A principle of medical ethics is that interventions need to be based on science, and Dr. Levine argues that the evidence for pediatric medical transition is “pretty lousy.”

The entire child sex change experiment is based on a single “innovative experiment” conducted in a Dutch gender clinic. Dr. Levine explains that innovative experiments are how medicine advances. Someone has an idea, tests it out on a tiny patient group, and if the results are promising, that justifies a more controlled study.

“The innovative experiment with patients demands that we repeat and we refine the method to establish the facts,” he said, explaining that this didn’t happen with the puberty blockers experiment.

The original Dutch study began with 197 children, but 86 were ruled out for reasons of mental disturbance. Of the remaining 111, 41 parents refused to allow their children to take part. Of the remaining 70, only 55 were entered into the final reports, and the researchers only had psychological data on 32 of the 55. There was no control group, and no long-term follow-up, as well as other serious methodological flaws. There was one attempt at replication, conducted at the Tavistock gender clinic in London, and it failed to produce the same supposedly positive result.

But Dr. Levine says the Dutch experiment “escaped the lab,” and rapidly spread into general medical practice via a process called “runaway diffusion,” which is when the medical world mistakes a small innovative experiment for proven practice and a potentially harmful treatment becomes widespread medical practice...

When asked what advice he would give to a teenager seeking medical transition, Dr. Levine replied that he says to the young person, “I know that the most important thing about you is that you’re a human being, and you think the most important thing about you is that you’re a trans person.” He seeks to help his young patients understand that anything that is true about human beings is also going to be true about them, including uncertainty, ambivalence, and the influence of the past on their current identity. And above all, he tells them, “Don’t make your parents the enemy.”

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Transgender Medicine, British Approach versus American. Bari Weiss interviews BBC reporter Hannah Barnes. Topic: On what Tavistock’s closure means for youth gender care around the world. Excerpt:

BW: When you look at your reporting from a ten-thousand-foot view, do you think what happened at Tavistock is a unique scandal, or do you think the real scandal is how normalized this kind of medicalized treatment among young people has become?

HB: These are professional people who’ve dedicated their working lives to helping young people, and what they were saying boils down to: this is not good clinical practice. This isn’t how we’ve ever practiced in other places we’ve worked. Somehow, because this is a gender clinic, the same questions that we would ask normally were not welcome...

So, I’m going to start with my understated Britishness by saying that I avoid using the word scandal because we don’t know yet what the scale might be because we just don’t have the data. We know that some people have been harmed and we know that some people have been helped, and we just don’t know the numbers either way. But what I think is really striking is that people who worked in the clinic, who did those assessments, who made those referrals, fear they have played a part in a huge medical scandal. So I’m just going to start with that caveat. What I would say is that, yes, we have a different healthcare system here in the UK than the U.S., but the evidence base is the same wherever young people live in the world, and the evidence base is weak. No one has been able to replicate the findings of the Dutch team that pioneered this approach. Now, those studies have come under much more scrutiny, and those findings themselves are not strong. And yet that is the basis, really, for gender-affirming medical care in young people in its entirety. So, is what happened at the Tavistock clinic happening elsewhere? Absolutely. . . . This area of healthcare has avoided any of the normal scrutiny one would expect, particularly when dealing with children and with a drug that’s being used off-label. The questions and scrutiny that would normally apply from healthcare commissioners, from politicians, from society, and from the media, they just weren’t asked. And I think that’s what’s gone wrong. Collectively, there has been this fear that if you questioned the standard of care here, that you’re somehow questioning the patient population. We wouldn’t have some great cancer hospital applying treatments which haven’t gone through clinical trials and don’t appear to have any evidence of them working. That’s not attacking people with cancer. That’s attacking the system. It’s really strange that any scrutiny is seen as hateful when actually the reverse is true. Because if gender clinics and society and medicine can get this right, then care will be better both for patients who will thrive as trans adults, and for those for whom it won’t be the right pathway. It’s going to be better for everybody.

BW: Here in the U.S., this feels like a very partisan issue. I don’t think it actually is, but I think it feels that way to a lot of people. Hannah, why is this topic and conversation so important?

HB: It’s important because they’re children. It’s the rest of their lives, and adults need to protect children. Absolutely trans people face real transphobia and bigotry. But actually, the current system isn’t serving trans people very well. The adults need to come back into the room. It’s the job of adults to say no, and that’s not saying no to every one of these young people, because it’s more complicated than that. There is a lot of nuance and there’s this real desire for certainty, like “ban puberty blockers or everyone has them.” But the welfare of children is everybody’s responsibility. The judge of a civilized society is how we protect the most vulnerable.

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