The Problem with the Transgender Affirmative Care Standard

This is an excerpt from a review  of Abigail Shier's book Irreversible Damage by Dr. Harriet Hall, from a section called, "The customer is always right."

A new “affirmative care” standard of mental health care has been adopted by nearly every medical accrediting organization. The American Psychological Association guidelines go much further than respecting and supporting trans identities; they mandate that therapists adopt gender ideology themselves. Therapists must accept and affirm the patient’s self-diagnosis. Shrier likens this to telling an anorexic teen “If you think you are fat, then you are. Let’s talk about liposuction and weight-loss programs”. She asks whether a standard guided less by biology than by political correctness is in the best interests of the patient.

We don’t provide affirmative care for anorexia. We don’t say “Yes, you are fat” and offer to help them reduce their weight even more. Part of a therapist’s role is to question a patient’s self-assessment.

Dr. Hall emphasizes that she is open to current treatments, but only where the patient needs them:
I support hormones and gender surgeries for adults who will benefit from them. I care about the welfare of these adolescent girls and it bothers me that some of them may be unduly influenced and take irreversible steps they will later regret.

Dr. Hall concludes:

[Abigail Shrier's book] will undoubtedly be criticized just as Lisa Littman’s study was. Yes, it’s full of anecdotes and horror stories, and we know the plural of anecdote is not data, but Shrier looked diligently for good scientific studies and didn’t find much. And that’s the problem. We desperately need good science, and it’s not likely to happen in the current political climate. Anyone who addresses this subject can expect to be attacked by activists. Is ROGD a legitimate category? We don’t know, since the necessary controlled studies have not been done. I fully expect Shrier to be called a transphobe and to be vilified for harming transgender people, and I’m sure I will be labeled a transphobe just for reviewing her book.

She brings up some alarming facts that desperately need to be looked into. The incidence of teen gender dysphoria is rising and appears to be linked to internet influences and social peer groups. The number of people identifying as lesbians is dropping. Therapists are accepting patients’ self-diagnoses unquestioningly, and irreversible treatments are being offered without therapist involvement. We know at least some of these patients will desist and detransition, and we have no way to predict which ones. Children are being instructed in how to lie to parents and doctors to coerce them into providing the treatments they want. Families are being destroyed.

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The Many Types of Gametes

Along with our ramped up search for UFO's, shouldn't we invest $ to document all of the intersex gametes? Gametes that are neither sperm nor egg? It appalls me that colonizing doctors keep pompously "assigning" labels of "egg" and "sperm" to gametes.

I'm reacting tongue-in-cheek to Colin Wright's collection of some of the prominent recent claims that there are allegedly more than two sexes and that "sex is a spectrum." Most surprising is the recent claim in a formerly respectable magazine, Scientific American. Wright's collection is worth a quick tour - click the image below.  Read it and weep.

What are gametes and why are they relevant to this discussion?

Gametes are an organism's reproductive cells, also referred to as sex cells. In species that produce two morphologically distinct types of gametes, and in which each individual produces only one type, a female is any individual that produces the larger type of gamete—called an ovum— and a male produces the smaller tadpole-like type—called a sperm.
It's rather amazing what one can do when one boldly separates the concept of gametes from the concept of sex. These days, it's a way for someone to claim victimization, to gain the warmth of a deluded tribe and to get a lot of attention. Here's why that conceptual move fails. 

In this hard-fought conceptual game, the Woke team prefers to categorize people by their feelings and intuition in terms of numerous "genders," ignoring that the traditional way of categorizing people into male and female, men and women, has deep biological roots related to the propagation of the species.  Using sex organs and games as the basis to categorize individuals as male or female is not an arbitration division. In fact, we divide every other mammalian organism into one of two sexes, male and female, based on the types of the type of gamete that organism produces. That division works virtually every time we encounter a mammal. Dividing humans into male and female is easy and intuitive, based on simple observation of sex organs. There is no need for a doctor to "assign" the sex of a newborn baby. With extremely rare exceptions (2 out of 10,000), that determination is purely scientific.

But we now have increasing numbers of people and organizations declaring that there are more than two sexes. It's a classic case of making shit up.

I'll close with this quote by a being that happened to look like an egg:

"When I use a word," Humpty Dumpty said, in rather a scornful tone, "it means just what I choose it to mean—neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master—that's all."

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The Great Power of False Media Narratives

The false story about the motives of the Pulse Nightclub murderer is alive and well, despite indisputable evidence that he was attempting to kill people, not LGBT people. Legacy media and politicians cling to the false narrative and we simply must assume (at this point) that they know that their story is false. However, their false story is powerful. It serves as effective cheap signaling and it moves people to anger, including people who should know better. The Pulse story is merely one example of a common phenomenon today. The story itself serves as the foundation for a "truth," upon which cherry-picked factoids, most of them easily disproved, make everyone in one's tribe feel the righteous anger. Again, Pulse is one example of many. We could substitute dozens of commonly exchanged "truths" for Pulse. That is what much too often serves as "news" in the year 2021. Glenn Greenwald elaborates.

Whatever Mateen's motives were, the horror and tragedy of the extinguishing of forty-nine innocent lives at PULSE on June 12, 2016, remains the same. But this enduring falsehood — which continues to deceive many well-meaning people through this very day, long past the point that it has been definitively debunked — is damaging for so many reasons.

Lying about what happened dishonors Mateen's victims. It harms the cause of LGBT equality, which does not need lies and fabrications to be a just movement. It obscures how often U.S. violence in the Muslim world causes "blowback” — to use the CIA's term — by motivating others to bring violence to the U.S. as retaliation and deterrence for violence against innocent Muslims. And a major reason for the completely unjust prosecution of Noor Salman was to appease understandable demands within the Orlando LGBT community for someone to be punished, but mob justice rarely produces anything benevolent.

No matter how noble the intent, journalism — and activism — becomes corrupted if it knowingly supports falsehoods. That the PULSE massacre was an act of anti-LGBT hatred is a fiction. Unless you are a neocon, there is no such thing as a "noble lie.” It is way past time for politicians and activist groups to stop disseminating this one.

Seeing that this completely false story still has legs (referring to the murderer's motives, not the murders themselves which certainly happened), I am reminded of Daniel Kahneman's discussion of the power of narratives in his book, Thinking, Fast and Slow. Kahneman indicates that we crave consistency in our explanations, not completeness, and this craving leads to overconfidence. We are profligate generators of flimsy explanations and we are "rarely stumped." As a result, poor evidence can make a great story (p. 209). Also, we often believe primarily because our friends believe. Our confidence in our beliefs are preposterous but necessary given our limited cognitive horsepower. That said, once we have our story down pat, it becomes easy to repeat and our confidence in telling that story grows, even if untrue. Confidence results from cognitive ease and coherence, but confidence does not equal truth (p. 238).

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The Under-Appreciated Thin Veneer of Civilization

I recommend this high-energy thoughtful and challenging conversation between Jordan Peterson and Bari Weiss. Do I need to say that I don't agree with everything mentioned during this long conversation? These days, apparently so. There is so much that is honest and good about this open-ended exchange, where these two strong personalities challenge each other and (contrary to the current U.S. zeitgeist) appreciate each other for these challenges.

Here is one of my favorite parts. Those who are steeped in Wokeness so often want to tear everything down, every aspect of the system, all institutions, assuming that there is something good on the other side that will simply organically bloom. This approach is reminding me of fundamentalist libertarianism and fundamentalist conservatives: many of whom believe that great things will simply happen if we just get government out of the way. As though our institutions, which we have crafted over decades and centuries, are not doing Herculaneum work to (imperfectly) set up curbs and guard rails to give us necessary structure to allow human flourishing. I see our (imperfect and always evolving) institutions much like I see traffic laws. Sometimes these institutions seem arbitrary, but they serve to allow people to interact with each other, often in helpful ways that is captured by the definition of "institution" offered by economist Doug North: “humanly devised constraints that shape human interaction." For North, Institutions not bounded by brick and mortar (or by particular people), but by two kinds of constraints: formal and informal. Together, these constraints comprise what John Drobak and North call “the rules of the game.”

[From Julio Faundez, “Douglas North’s Theory of Institutions: Lessons for Law and Development,Hague Journal on the Rule of Law, October 2016, 8(2), p 373.]

We need a set of basic laws in order to move to the next step, to better things, sometimes to almost-magic seeming levels of complexity. Institutions allow this, but destroyed institutions invite (actually, demand) socio-economic collapse. Society's basic rules (promulgated through our institutions) also remind me of the axioms of geometry. Why assume the truth of axioms? Because if you don't, we can't do geometry!

The tear-it down Woke mentality does not offer any meaningful vision of what is on the other side of tearing it down. There is no real-work path being offered to get from the chaos they preach to anything worth having. These youngsters, many of them from a coddled generation, offer no specifics, only cheap-signaling promises that things will somehow be better. For background on this rather sharp accusation of "coddling," see herehere, here, here and here. Today's young adults have not suffered like many people from prior generations who have seen social-economic collapse. They haven't suffered like many first generation immigrants to the U.S., most of whom are not buying Woke ideology, not for one second. The empty of promises of Woke ideologists remind me of the promises of religious fundamentalists who promise "heaven. The realist in me fills in these empty promises of Woke advocates with things like CHAZ/CHOP (see here, for example) and Evergreen State College. Until I see specifics that convince me otherwise, these two things exemplify the Woke end game.

That is the context for the following excerpt. I have edited only for false starts and to tidy up. The content has not been changed:

Jordan Peterson There is a concern for the dispossessed, and that's what gives the radicals the moral high ground so often. "We're concerned for the dispossessed, aren't you?" It's like, "Well, yes, as a matter of fact, we are." The wielders of these ideas start out with a moral advantage, but the evidence seems to suggest that the very systems they're attempting to tear down are, in fact, the best antidote to the problems that they're laying out. So then the question pops up again: So if that's the case, why the hell is there so much force behind these ideas? What's driving them? And it's associated with that laughter at the thought of violent bloody revolution,

Bari Weiss Because we're so removed from violent bloody revolution. That's why. It's a luxury to flirt with these ideas. Let's just take an example, I'm not wearing long sleeves. You could see my collarbone, I could walk down the street here with my wife and go get a falafel at the end of the street and not be stoned to death. Okay, that's the reality. That's a miracle.

Jordan Peterson That is that's what divides people is whether or not they know that's a miracle.

Bari Weiss Yes. And if you are so removed from the truth of that miracle, and from gratitude for everyone and every idea, every piece of scaffolding that allows for that to be that my reality, then you will have the foolishness. But it's really the luxury in the decadence to flirt with ideas about doing away with it. I am so curious about why certain people feel in their bones, how thin the veneer of civilization is and why other people are so nonchalant about it. I feel like it's a logical question, but I don't know it. v Jordan Peterson I don't know either. When I was in graduate school, I was obsessed with the finitude of life and with mortality and death. I mean, I wake up every morning and think there's no time. Get to it now! I had friends who I would say were more well-adjusted than me. That's certainly part of it. Like they were more emotionally stable, technically speaking, less prone to depression and anxiety. So that's part of that. It was that those ideas never entered the theater of their imagination. Right? They just weren't a set of existential problems for them. For me, it's always been Paramount.

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