Should minors be able to receive the set of treatments which fall under the heading, "Gender affirming care"?
A couple of days ago, a friend of mine sent me this video of a speech by Representative Shawn Thierry on the House floor of the Texas legislature. The Texas legislature has been working on legislation to ban gender-affirming care for minors.
Thierry represents a district, the 146th, which covers part of Houston. She is a woman and a Democrat, and refers to herself in the speech as a person of color. An urban Democratic woman of color in the Illinois legislature would be all but guaranteed to support extending medical treatment for gender affirming care to minors, but Thierry explains in her speech why she opposes it.
If you have time, and are willing to listen to her speech, I invite you to do so. You may or may not agree with her conclusion, but in my estimation, she comes across as authentic, caring, and tries to root her views in fact and science. She states she has reached her views on this fraught topic out of concern for the well-being of children. I believe her.
To understand where she stands on questions of gender affirming care, it might be helpful to contrast her stance with that of the United States Conference of Catholic Bishops (USCCB). The conference's Committee on Doctrine released a doctrinal note this past March which provides guidance to Catholic health care organizations regarding whether gender affirming care is permissible. As one might expect of such a document, it roots itself in papal and other authoritative teaching to reach its conclusion, which is: it forbids "attempts to alter the fundamental order and finality of the body and to replace it with something else". Thus, no surgical sex changes, no puberty blockers, no medical treatments geared toward changing the gender of one's birth.
Based on what Thierry says in her speech, her stance is different. She doesn't oppose adults pursuing gender affirming care. But she has serious concerns about subjecting minors to these treatments, as the health risks and consequences aren't well-understood, and there are some studies which raise red flags.
In her speech, Thierry references that some countries in Western Europe which formerly led the way on gender affirming care for minors, now are pulling back and reassessing the risks to teens and children. By contrast, mainstream medical associations in the United States, including the American Medical Association (AMA) continue to recommend gender affirming care as being beneficial to patients, including minors. For example, one study reports:
The results showed that youth who received gender-affirming medications—including puberty blockers and gender-affirming hormones—had a 60% lower odds of moderate or severe depression and 73% lower odds of suicidality over those first 12 months, compared with youth who did not get such medications.
Among the youths who didn’t start puberty blockers or gender-affirming hormones, “depressive symptoms and suicidality were two-fold to three-fold higher than baseline levels at three and six months of follow-up, respectively,” wrote the authors, led by Diana M. Tordoff, MPH, a pre-doctoral research fellow in the Department of Epidemiology at University of Washington in Seattle.
I am honestly perplexed by these varying and, in at least some cases, conflicting sets of guidance and views. I don't want children to suffer. But in seeking to help them avoid suffering, I also don't want to endanger their health and well-being.
I fear the politics swirling around this issue do not help people think through the issues. Thierry references threats she has received as a result of her opposition to gender affirming care for minors. JK Rowling, the celebrated author of the Harry Potter series, has also received many threats for suggesting there should be limits to being able to define one's gender.
And if you take the time to read the USCCB's doctrinal note, you might reach the same conclusion I did: the doctrinal reasoning needs to be supplemented by much more pastoral concern for the anguish felt by teens and adults whose minds and bodies apparently are not completely aligned.
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ReplyDeleteEdited for length and typos:
ReplyDeleteIn my view, gender dysphoria is not a moral or legal problem to be prayed or legislated away. It is a medical problem. As such, the ONLY people parents should be listening to are medical experts who can give them whatever info is available, which seems pretty thin even without the interference of clergy and politicians.
I'm not sure that laws need to be made to protect children from treatment for gender euphoria. In a cursory search of several pediatric hospitals in the US that offer treatment services for children with gender dysphoria, I was unable to find any that offered hormone or surgical options to minors.
JK Rowling is getting threats because she is perceived by some as a TERF (trans exclusive radical feminist). Her comments have been aimed at adult trans men and women. Including her in discussions of treating children for gender dysphoria muddies the water.
"In my view, gender dysphoria is not a moral or legal problem to be prayed or legislated away. It is a medical problem. As such, the ONLY people parents should be listening to are medical experts who can give them whatever info is available"
DeleteI would say it has a medical dimension and a legal dimension. The Catholic church, and presumably many other people and entities, would also insist it has a moral dimension. And surely it also has a psychological dimension. And a sociological dimension, insofar as it impacts families, especially when the subjects are minors. I don't think we can exclude any of these aspects or stakeholders from consideration.
Jean wrote, regarding JK Rowling: "Including her in discussions of treating children for gender dysphoria muddies the water."
DeleteI mentioned her because she has experienced similar threats from LGBTQ ideologues as Thierry. You're right that the goons haven't gone after Rowling specifically because of her views on gender affirming care for minors. I could have made that clearer in the post.
"In a cursory search of several pediatric hospitals in the US that offer treatment services for children with gender dysphoria, I was unable to find any that offered hormone or surgical options to minors."
DeleteFYI - in the State of Illinois, it seems that treatment is required to be available to people age 16 and older. This is one feature of the governor's and legislature's wish to position Illinois as a "magnet destination" for this, as well as for abortion and other medical treatments that are hot-button social issues, in contrast to other, more restrictive nearby states.
That said: I haven't figured out yet whether a 16 year old in Illinois must have parental consent. It appears that at least some health care treatment centers require it, but I haven't been able to figure out yet whether that is a legal requirement.
Yes, medical facilities sometimes impose additional requirements that go beyond state requirements. Before Prop 3, which guarantees abortion in the Mich constitution, minors had to have parental consent for abortions. While it is unclear where parental consent regs stand since Prop 3, the abortion clinics I monitor are still requiring written parental consent to perform abortions.
DeleteSure, there is a psychological aspect to gender dysphoria. I guess I was thinking that medical care included psych evaluation.
DeleteWhat is the sociological aspect and whom do you see as the stakeholders? I guess I look at permanent surgical gender reassignment as something society has a stake in. Thinking about lobotomy, which turned out to be quackery and that society had an obligation to put the kibosh on. But most trans people don't opt for genital surgery.
The Church of course sees a moral aspect in everything. I respect Catholic clergy in their roles as counselors, advisers, encouragers, and interpreters of sacred teaching. They need to get out of the biz of holding the sacraments over the heads of lawmakers and judges for not making Catholic teaching the law of the land.
I am in basic agreement with Jean.
ReplyDeleteOn Twitter, Rod Dreher linked to Representative Shawn Thierry's speech a couple of days ago, and I watched it. I was impressed by her, but I don't approve of legislatures banning medical treatments approved by the major US medical organizations because they, as politicians, have even heartfelt doubts about them. From what I have read, some medical authorities in European countries are "pulling back" and reassessing puberty blockers and hormone treatments. However, this is a far cry from banning all such treatments. South Dakota has passed a law that would force youths undergoing treatments to "detransition," and other states are flirting with similar proposals. What are parents supposed to do when the government demands they must abandon the medical treatment they have chosen for their minor children?
By the way, I don't remember why I subscribed to Rod Dreher's Twitter feed, but the more I read him, the less respect I have for him.
Dreher has driven around the bend and over a cliff, imo. His stories about his buddy with a wife that needs repeated exorcism is pretty much beyond the pale. It looks like a case of spousal abuse to me. Wife needs psychiatric help, but husband tells her she's possessed to keep her under control.
DeleteI had forgotten about Dreher until this week. I read somewhere that he is now living in Hungary. So this is the second time this week I think it must be fake news, but… Since he hasn’t entered my mind for years I hadn’t realized that it sounds as though he’s gone off the deep end. Wouldn’t surprise me though. I thought he had removed himself from the world and was living in some kind of Orthodox community down south somewhere. The Benedict option - wasn’t that the name of his book?
DeleteYeah, I think Dreher jumped the shark. How many times has he re- invented himself?
DeleteRaymond Oliver Dreher Jr.
Delete(born February 14, 1967), known as Rod Dreher, is an American writer and editor living in a self-imposed exile in Budapest, Hungary. He was a columnist with The American Conservative for 12 years, ending in March 2023, and remains an editor-at-large there.
https://en.wikipedia.org › wiki › Ro...
Rod Dreher - Wikipedia
In skimming the whole wiki article I learned that he and his wife are divorcing. Apparently living in an orthodox community of likeminded Orthodox families with the same values about marriage etc, didn’t work for them. So he might as well live in Hungary since he’s apparently lost his family.
DeleteDavid wrote, regarding Rod Dreher: "the more I read him, the less respect I have for him"
DeleteI experienced the same thing, a number of years ago now. He's frequently interesting, but too much content I consider toxic (in particular regarding LGBTQ topics).
"From what I have read, some medical authorities in European countries are "pulling back" and reassessing puberty blockers and hormone treatments. However, this is a far cry from banning all such treatments."
DeleteYes, I agree.
FWIW, here is where I am: I share Thierry's concerns. At the same time, a blanket ban strikes me as too ham-fisted - too much of a one-size-fits-all approach. There should be some room for prudential judgment. Perhaps a general ban, with some room for exceptions? At a bare minimum, the exception should require parental consent. (Although even that gets complicated quickly; some parents are likely to consent when treatment isn't warranted, while others are likely to withhold consent when treatment is warranted. Parenthood is hard as hell.) Perhaps parental consent accompanied by a diagnosis and/or recommendation from an accredited child psychologist that the child is at risk of suicide or other really bad outcomes without treatment.
Gender therapy appears to be going the route of no-fault divorce. Initially the notion was simple, divorce without hassle and no one will be hurt. In real life that doesn't happen very often. One of more people, usually the children get hurt. So, we have to face the complex issues involved in divorce.
ReplyDeleteGender therapy started with the notion that simply giving the person the gender they want will solve the problem. The initial research supported that conclusion because the therapist-researchers took a lot of care in selecting their patients, including whether or not parents and significant others supported the move (a key factor). However, the all-is-well conclusion has not stood up as the therapy has moved on to more iffy cases dealt with by non-researchers who are not as careful about all the circumstances.
The situation appears to me to be different depending upon whether the person is an adult or child. Adults should be able to make their own medical decisions at the same age they can make other major decisions. Some people who are against gender therapy think the people should not be able to alter their gender under after age 25.
However, in the case of children we are now evolving toward medical and legal practice that allows and even encourages minors to make these choices despite the non-cooperation of their parents. Effectively it means that the children are divorcing their parents. I think everyone should be concerned about that development.
Do you have evidence that minors are getting gender reassignment surgery or hormone therapy without parental consent?
DeleteWhen I google the issue of hormone replacement therapy or gender assignment surgery for minors without parents, consent, all I have found is a rather sensational article from Fox News about Spain. I would ask Jack Rakosky to explain why he says that "in the case of children we are now evolving toward medical and legal practice that allows and even encourages minors to make these choices despite the non-cooperation of their parents."
DeleteI am aware that there is some argument that when schools become aware that students openly consider themselves transgender in class, teachers should inform parents if they believe the parents do not know. (I think it is a bad idea.) But I am unaware of any trend in the United States to encourage and enable would-be trans youths to obtain any kind of medical treatment involving drugs or surgery.
We have a lot of situations where medical professionals and other professionals have to deal with adolescents who feel they cannot talk about their problems with their parents (sexual activity, being gay, gender dysphoria).
DeleteSometimes these professionals may agree with the adolescent that their parents are a problem. That brings about the possibility of labeling the parents as neglectful, emotionally abusive, and ultimately depriving them of custody.
The problem is that foster care systems probably don’t do as well as the average parent and may even function as poorly as dysfunctional parents.
It takes a village to raise a child. Most parents and most bureaucratic systems turn out to be poor villages.
Our churches have the potential to be villages, but on most of these issues they are more part of the problem rather than part of the solution. Perhaps if Catholicism becomes a church that walks with people, young people might discover they have a village to help them.
Jack, you seem to be speaking in generalities about "a lot of situations" that lead to the "possibility" that doctors could terminate parental rights.
DeleteIt seems to me that the nice Christian people who are making laws prohibiting care that they have no expertise to judge are putting way more children in danger of being thrown into the foster care system.
I am not aware of situations where minors are getting surgery or medication without parental consent.
DeleteWhat seems more of a possibility is where children or teens start identifying in school as the other gender, with names or pronouns, and the parents are unaware. Most likely because the kid doesn't want to have a difficult conversation with the parents. I don't think the school has the right to keep that from the parents. A school counselor could help facilitate the conversation with the kid's family.
"The problem is that foster care systems probably don’t do as well as the average parent and may even function as poorly as dysfunctional parents."
DeleteBut it seems highly unlikely that children of "average" parents wind up in foster-care. According to one site I checked, the most frequent reasons children are placed in foster care are neglect, abuse, drug addiction, incarceration, illness, and death (all on the part of the parents). I have heard numerous stories about youths suffering terribly in foster care, but I am not at all prepared to conclude they would have been better off remaining with their birth parents.
Also, we also do not have any evidence, even anecdotal, that it is in any way common for authorities to place minors in foster care who insist on transitioning but parents won't permit it. Also, there is always the possibility that when children and their parents disagree, it is the parents who are behaving badly, e.g., mocking the child, condemning him or her because of religious beliefs, and so on. I do not have any personal knowledge of what happens between trans children and their disapproving parents, but I am well aware of many cases of parents discovering their children are gay or lesbian and treating them harshly, up to and including banishing them. Transgender children are subject to the same animus (often religiously motivated) as gays and lesbians.
A great many LGBT minors who don't want their parents to know of their sexual orientation or gender identity are perfectly justified in feeling that way.
I agree that it is unlikely for children or teens to end up in foster care without actual neglect, abuse, etc. I think what is driving those fears are things that the governor and some legislators of Texas have actually said. Of course it is political posturing and chest thumping. Doesn't mean though that they wouldn't try and make an example of some unfortunate family.
DeleteMy children no longer are minors, but for me, it hasn't been that long ago that they were teens. I'd like to think I'd be sympathetic to my teen-age kids if it came to light that one of them is experiencing gender dysphoria. I wouldn't condemn them for religious reasons (or any other reasons - I'm not about condemnation).
DeleteStill, I would be disinclined to provide approval for one of my minor children to have surgery, or receive puberty blockers or hormone therapy, or any other medical treatment intended to help them physically transition. I would do that out of concern for their health. It's been stated several times in these comments - and by Thierry in the original post - that the long-term effects of these treatments are not well-understood.
If they require counseling, of course I would support that.
Once they have reached the age of majority, they could decide what they want to do. To be sure, if they need financial help from me to pay for treatments, then - I might still be a stakeholder in their decision.
As I say, I would like to think I would continue to love them, regardless of what they do.
It's an academic exercise for me to imagine what I'd do if my 40-something sons were still teenagers and came out as trans. Like Jim said, I'd be sympathetic and continue to love them, no matter what. But inwardly I'd be thinking, " Hello! I'm the person who changed your diapers like 5000 times. You're telling me I didn't see what I saw?"
DeleteI honestly don’t know enough nor understand enough about the transgender phenomenon to form anything but a very unsure opinion. I had never heard of it until about three years ago. Adults should be allowed to do what they want. But I am hesitant about surgery for minors though. Hormones can be stopped. Surgery is hard to reverse.
ReplyDeleteI'm with you, Anne. I don't have the foggiest idea. I'm wary of legislation, though. I don't think politicians have the depth to hold forth and decide on these cases.
DeleteTo me, the problem is making physical changes based on subjective reports and desires of children. I think they do have import because I have never had such thoughts and would never have asked for such a thing. I don't think media or fads would convince me otherwise. But I just don't know.
I never heard of it either, until fairly recently. To be sure, there were a couple of widely publicized cases early on, but I thought they were probably anomalies or outliers.
DeleteIt seems likely that the studies which are often quoted as proving that gender affirming care is beneficial are based on relatively small statistical samples. Because the incidence of gender dysphoria is relatively uncommon, despite all the hype.
A caveat with regard to hormone treatment; it isn't risk free, and is life long if the person wants to maintain the desired changes.
It used to be that hormone replacement was routinely prescribed for women experiencing menopausal symptoms. But a large study indicated that there was a significant increase in cancer among those who used hormone therapy for extended periods. Now doctors are much less likely to recommend it. We honestly don't know what the effects of lifelong hormonal treatment are.
First, it is difficult to think of any medical treatment that is completely risk free. It occasionally happens that young people die from tonsillectomies, for example, or from having wisdom teeth removed.
DeleteSecond, for those of us fortunate enough not to have experienced gender dysphoria, it is easy to imagine it is trivial or whimsical—certainly not serous enough to warrant any medical treatment, let alone hormones or surgery.
But gender dysphoria when not treated can be very serious indeed, leading to anxiety, depression, social isolation, alcoholism, drug addiction, eating disorders, self-harm, and possibly even suicide.
It seems to me that a reasonable approach would be to require psychotherapy of some reasonable duration as the first step in treatment for minors, strictly outlined criteria for puberty blockers and hormones, and a prohibition on surgery (until age 18).
It's important to remember that what is driving legislatures to dictate bans on medical treatment is right-wing hostility to "wokism" and a surge in anti-LGBTQ animus.
Yup. It’s political. Transgenderism is the new boogeyman. Your suggested approach is reasonable.
DeletePoliticians trying to micromanage medical practice, what could possibly go wrong? Especially the Dunning Kruger graduates we have for politicians right now. Not every problem has a political solution. Not every problem has a medical solution either, so I agree with David that psychotherapy would be a good first step for minors experiencing gender dysphoria ( I am not talking about conversion therapy, which is basically brainwashing someone).
DeleteWould be nice if governors, congress people, etc. would concentrate on things which are actually in their purview.
Writer Jan Morris transitioned in 1964. She died at 94 of heart disease. Christine Jorgensen transitioned in the early 1950s and died at 62 of bladder and lung cancer. There just isn't enough info available to know whether female hormones affect biologically male bodies in the same way as female bodies. Since HRT is related to cancers of the breast and female reproductive organs, it may be that biological men run fewer risks because they don't have those parts.
DeleteI would hope that Catholics who want to meddle with current standards of care for trans people would contemplate Acts 8:26-40, about the baptism of the eunuch. Eunuchs were considered sexually problematic people at time, and yet acceptance and baptism were freely offered.
ReplyDeleteThe Church has a long long history of embracing weirdos of all sorts--alcoholics, the retarded, people with speech impediments, lepers, loose women, those acting crazy, and many of us here.
I would also hope that, in addition to listening to politicians who make persuasive points, Catholics, especially clergy, talk to the parents of children with gender euphoria so the understand how care for these children proceeds and what those parents are up against.
Imagine the impact it would have if a priest, deacon, or bishop said, "I want to better understand your family."
Gender dysphoria. Stupid autocorrect.
DeleteWe know it was autocorrupt, Jean.
DeleteIf you believe science cannot yet explain certain sexual and gender proclivities, how can you can condemn them as confused or immature?
ReplyDeleteThat said, I understand that we all get flummoxed, offended, or even frightened by certain things that other people do, say, or think.
The crux of the matter to me is how far we're willing to go to pass laws to criminalize certain behaviors and treatments, or whether to allow a certain amount of discrimination against those who go against certain "norms."
Jack, I think that's a good summary.
ReplyDelete"f you believe science cannot yet explain certain sexual and gender proclivities, how can you condemn them as confused or immature."
ReplyDeleteI am describing these people as confused and immature, and I am not condemning these people. Indeed, I affirmed that I am supporting them in their confusion and their immaturity. I think most of them would agree that they don't really know whom they are.
I would not describe their experiences as proclivities since I don't know how much their genetics, the unfolding of those genetics in interaction with the environment, and their early social and psychological experiences contributed to these experiences.
Again their experiences are what they are, we should simply accompany them nor try to make them into our images of what they should be or allow others to make them into their images of what they think they should be.
The fundamental bottom line for me is that to impose oneself on others as the norm for what they should be is idolatry. It is imposing our image on someone uniquely made to the image an likeness of God.
Again their experiences are what they are, and we should respect them. We should not try to put them into cultural war categories of either the right or the left.
Thanks, Anne, for your beautiful description of the many and varied journeys that people take in their early years. We can listen. We can support people when they feel alone. But in many cases we have to let time and experience sort things out.
ReplyDeleteI also agree that therapy can be just as much a problem as a solution.
ReplyDeleteI don't see any comments here as unkind, but certainly incurious about how LGBTQ people live their lives. Most comments seem focused on how to deal with LGBTQ individuals should they make themselves known. Nobody here sees themselves as judgmental about LGBTQ people, but some feel that they have a stake in prohibiting certain behaviors or treatments.
ReplyDeleteThe words "supportive" and "accompany" crop up a lot but without any clear explanation of what that looks like.
For instance, a teenage boy who's been in the parish since birth begins dressing as a girl. What does support and accompaniment look like for that family? How is support and accompaniment going to play out with parishioners who are unsettled or angry by the behavior and want the kid to "grow up"? Is the goal to get the kid to conform? To explain that certain modes of dress will not be tolerated? To provide instruction on the immutability of gender? To set the kid to leave the Church if behavior doesn't change by a certain time? To get the parents condoning cross-dressing to rethink their position? To get the family to leave?
I'd like to think that people wouldn't be so negative toward the teen and family - although I am sure there will be some stupidity.
DeleteAbout 95% of the teens in our parish don't come to mass very often as it is, so it would be rare for a trans teen to come to our parish.
If it happened, and the family stopped to chat with me after mass, I'd hope I could treat the teen like anyone else, with the same dignity and respect that everyone is entitled to. I certainly wouldn't start ranting at him/her that s/he is a horrible sinner who is going to burn in hell and whose parents are failures. Maybe there are Christian churches like that somewhere, but I wouldn't belong to one of those.
If a family approached me about counseling, I would try to get them a referral to someone who is qualified to counsel and who specializes in family counseling.
If they want spiritual advice, I would do my best. For this particular situation, I don't know how good that would be.
My guess is that a transitioning teen who attends Mass several times a year and presents for Communion would be an ongoing source of tension to the parish, and that clergy might be sad but mostly relieved to have that individual, and possibly the whole family, leave.
DeleteIf anybody has seen this work in a manner that illustrates "accompaniment," I'd be heartened to hear it.
"I have seen many young people adopt different identities during the teen years and even well beyond. The macho jock friend of one son who ended up starting a non- profit to help local homeless. The Goth girl on a high school team i was involved with as a volunteer with piercings and black lipstick and black everything who ends up a more than totally conventional Martha Stewart subscriber. The college kids who experimented with a bisexual lifestyle before choosing one preference and committing to a life partner."
ReplyDeleteYeah - people I knew in high school and then lost touch with, express surprise that I've ended up where I have. I wouldn't have been been pegged back then as a potential future cleric. Looking at myself (which is hard to do objectively), I think I have changed - and as Jack noted, have matured - but in some important ways I am still the same person now that I was then. Different, but also the same.
The original post was related to legislation banning certain kinds of physical gender affirming care. Do we agree or disagree ? Or?
ReplyDeleteI can’t really address the issue of how Catholic parishes should react to a transgender person in the community. I attend EC parishes where their sign (found in front of most EC parishes) - “The Episcopal Church Welcomes You” - means what it says. All are welcome. Those who would be traumatized by openly gay or transgender individuals left the EC years ago. I know of several EC parishes in the DC metro area with gay priests and lesbian priests. I don’t personally know of a transgender priest around here, but I imagine that there are some transgender parishioners. One comment I read recently by a transgender person was along the lines of why is this such a huge deal? We are less than 1% of the population and few Americans have ever known a transgender person personally and we’re no threat to you or your family. I think that the EC attitude that All are Welcome is a good idea as long as it’s sincerely meant. In the EC parishes I’ve been to, it is sincerely meant. This is obviously more problematic in RC parishes.
"The original post was related to legislation banning certain kinds of physical gender affirming care. Do we agree or disagree ? Or?"
DeleteI support gender-affirming care for minors. I am assuming a certain preliminary level of exploration and counseling to make sure the would-be trans person is clearly experiencing true gender dysphoria (which I take to be a very real phenomenon) and not looking to transitioning as a solution to anxiety or depression that might otherwise be alleviated. (To perhaps oversimplify, I would define gender dysphoria as a strong, persistent conviction that the person is one gender and their body does not match.) I would support puberty blockers and hormones for minors if a trusted medical authority considered them to be in the best interest of the young person, with real caution that drugs and hormones are administered strictly on a case-by-case basis, and not as a routine, standard, one-size-fits-all treatment. If at all possible, I would hope this could be done with parental consent and support, but in extreme cases where parents are hostile to treatment, I would hope a minor would have an additional option. I have seen too many cases of gay people coming out to their parents and being rejected by their families to believe that parents will always make the right decisions. I would not support surgery for minors (which I understand to be pretty much the law of the land in the USA as things stand).
I would like to see these issues handled by medical practitioners and experts and not have politicians passing the kind of legislation we are seeing lately. There is currently a hysteria about gender issues that will only make for bad laws.
I see the position of the Catholic Church as fundamentally "anti-trans," since philosophically Catholic doctrine states categorically that a person is either a male or female, one's assigned sex is to be accepted, and (presumably) the goal of any therapy or other intervention should be directed toward making persons with gender dysphoria live according to their assigned sex. Catholics widely ignore Humanae Vitae, and ultimately if HV is wrong, other Catholic sexual pronouncements are questionable. One would hope the Catholic Church does not try to impose its teachings in a secular society.
As a quick postscript, I would add that the Catholic exclusion of women from the priesthood is an indicator (in my humble opinion) that Catholic doctrine regarding gender is questionable.
DeleteI've only briefly encountered two people who were transgender among the many people (thousands?) I've met. If that is representative of the statistics, it is certainly true that it isn't important enough to legislate. I think we need legislation regarding income inequality, workers' rights, climate change, universal medical care, lobbyists, corruption, immigration, the overgrown defense budget. This sex and gender stuff is a distraction. Republican politicians do their moralistic posturing and fearmongering. Democratic politicians do counter-posturing on this because it covers up their fecklessness. I am inclined to ignore this "problem".
DeleteJim, few people who knew me as a teen or college kid or into my 30s would believe that I had gone from Young Republican vigorously campaigning for GOP candidates to a squishy lib who favors a European socialist-capitalist style democracy. That I had gone from a fanatical pro- lifer complete with stickers on my car windows to a pro-choice (NOT pro-abortion) who believes that no religion has a right to impose its religiously based views on ALL Americans. That someone who was predicted to become a nun by several people ( it’s true - and I did think seriously about that) ended up as an Episcopalian.
ReplyDeleteThis is in the legislatures because the medical professionals have failed to limit gender therapy to a small number of people who deeply and likely permanently experience themselves as being of the opposite sex.
ReplyDeleteI reviewed this in an early post: https://newgathering.blogspot.com/2022/10/gender-therapy-and-gender-assessment.html
Early on the Europeans who started this limited their adult cases to people who had undergone a thorough assessment which allowed them to select cases that would be highly successful. (that is those I have identified as category #2 in the above comment)
As their successes became public, including some celebrities, and word spread in the media, naturally people became attracted to gender reassignment as a solution to their life's problems. (my category #3)
Eventually under pressure from medical professionals and successful transitions the medical profession abandoned automatic psychiatric assessments for adults.
The NYT article I reviewed dealt with the fight about whether or not adolescents should have a psychiatric assessment. The successful transitions (my category #4 above) and medical professionals who wanted more cases (my category #5) argued in favor of abandoning extensive psychiatric evaluations. My opinions about this whole area are at the end of that post.
I don't think we should demonize right wing legislators for getting into this issue when there are deeply committed professionals who are concerned that there is insufficient assessment and we may be providing this therapy to people who might be harmed by it.
"I don't think we should demonize right wing legislators for getting into this issue when there are deeply committed professionals who are concerned that there is insufficient assessment and we may be providing this therapy to people who might be harmed by it.
DeleteI would just point out that the right-wing legislators involving themselves in this matter are not siding with the more cautious professionals who are concerned that there is "insufficient assessment" of minors before they are prescribed puberty blockers or hormones. Right wing-legislators are banning this kind of medical treatment for minors altogether.
If there is insufficient assessment before treatment, the solution is to require sufficient assessment. Prohibiting all treatment to protect some who might be harmed guarantees the harm of all the others who would benefit.
"Prohibiting all treatment to protect some who might be harmed guarantees the harm of all the others who would benefit."
DeleteAs I mentioned in a previous comment, a blanket prohibition is too one-size-fits-all. This is a long-standing critique of (genuine) conservatives when it comes to government regulation. There are still a few genuine conservatives here and there who are as skeptical of right-wing regulation as they are of liberal regulation.
DeSantis signs Florida ban on transgender treatment for minors
ReplyDeleteMay 17 (Reuters) - Florida Governor Ron DeSantis on Wednesday signed into law a bill that bans gender-affirming medical care such as puberty blockers or hormone therapy for transgender youth, and also enacts obstacles for adults to access treatment.
Taking effect in the third most populous U.S. state, the law escalates a Republican political strategy to pursue bills restricting transgender rights. More than 500 bills affecting LGBTQ matters have been proposed across the country and at least 48 have been enacted, according to the Human Rights Campaign.
Such bills were once mostly limited to regulating changing rooms and women's sports but have expanded to limiting healthcare access even for transgender adults. In some cases legislation has sought to charge parents and doctors with child abuse if they provide treatment to transgender youth.
"This will permanently outlaw the mutilation of minors," DeSantis said at a bill-signing ceremony in Tampa.
"I mean they're trying to do sex change operations on minors, giving them puberty blockers and doing things that are irreversible to them," the Republican governor said.
Surgery for minors is exceedingly rare and only occurs after extensive monitoring by multiple medical professionals.
A group of parents of transgender children immediately challenged the law, filing an emergency request in federal court to block its implementation.
DeSantis, who is expected to launch a bid for the 2024 Republican presidential nomination next week, has staked part of his political future on cultural issues surrounding LGBTQ rights.
In addition to Florida, at least 14 other states have banned treatments for transgender youth, although many face legal challenges in the courts.
Many Republican supporters of the bills distrust the prevailing medical consensus, which endorses gender-affirming care and in some cases considers it life-saving. Instead, opponents of transgender healthcare claim it is dangerous and experimental, with some labeling the measures as chemical castration or child abuse.
The World Professional Association for Transgender Health (WPATH) criticized passage of the bill, saying it interfered with the doctor-patient relationship.
"Florida's bill has created a chilling effect on the medical community by inserting politics into health care," Marci Bowers, the association's president, said in a statement.
The Florida law, known as Senate Bill 254, requires transgender adults to obtain written consent on a form adopted by the Board of Medicine and Board of Osteopathic Medicine - two oversight boards whose members are appointed by the governor and have already taken steps to restrict transgender care under DeSantis.
In addition, the new law, which takes effect immediately, grants state courts jurisdiction in child custody battles over transgender minors when a Florida parent opposes treatment that is being pursued under an out-of-state parent.
DeSantis also signed into law a so-called "bathroom bill" requiring all restrooms or locker rooms at public facilities to be used exclusively for people based on their gender assigned at birth.
Regarding "bathroom bills," I see a lot of trans men (female to male) on TikTok, and the only way one would know they are trans is because they say so. They are convincingly masculine, usually with some kind of facial hair (full beard, goatee, or mustache) and frequently are well toned or even muscular. One such young man on TikTok recently asked, "Do they really want me in women's restrooms?"
DeleteThese bills are basically meant to hassle people so they'll conform, isolate themselves, or move to a different state.
DeleteSomebody out here in the cornfield posts memes on the community page all the time freaking out about drag queen story hour ("The question is not what drag queens are doing at libraries but why drag queens seek out audiences of children?").
None of the area libraries has ever suggested or discussed having drag queens read to kids. But good to keep fear whipped up just in case woke-ass liberals like me and Raber start agitating for it.
Ironically, she belongs to the non-denom church whose youth pastor went to prison for child porn. She also runs a kid's laser tag biz. Yesiree, keep them little boys away from glitter and on wholesome activities like shooting each other.
Those bills are primarily intended to keep the MAGA base fearful, and voting for the extremists who fan the fears in order to hold on to their political power positions.
DeleteFYI - Texas also will most likely see a law signed by its governor in the coming days, banning surgery, puberty blockers and hormone treatments for minors.
DeleteBtw, appeals to a "medical consensus" on the safety of these treatments will carry little or weight with conservatives, for a number of reasons:
ReplyDelete* They don't believe the consensus exists; it is manifest that some European medical authorities are hitting the pause button on these treatments while their US counterparts continue to insist that there is no need to worry, nothing to see here, all will be well.
* Conservatives don't trust the CDC and other medical and scientific government agencies, especially during Democratic presidencies. This conservative distrust of the federal government as an objective and neutral medical and scientific arbiter has been growing for many years, fueled by abortion, Obamacare and COVID-19.
* The claims are promoted by mainstream media which themselves are intensely distrusted by many conservatives
How to penetrate the miasma of distrust and arrive at broadly accepted truth and facts, is one of the great social challenges of our time.
Well, I don’t trust NR or Fox or conservative media in general, so I looked elsewhere. But Jim is right about this. It seems that as the numbers of cases have skyrocketed in Europe also, some countries, like Sweden, are pausing. Others, like Spain, are going the other way.
DeleteBut dragging Obamacare and abortion into this discussion is a bit of a non-sequiter. Irrelevant. After all, normally the MAGA types ( they aren’t conservatives as conservatives were once defined) have no use at all for anything European countries do or say. Suddenly they are turning to European countries to validate their ideas? They are dead wrong about COVID, as any review of the disease, hospitalization and mortality data show - red states/counties had far higher rates of all these Covid measures, but MAGA folk are not actually interested in reality. . And the greatest numbers of beneficiaries of Obamacare also reside in red states/ counties.
https://www.france24.com/en/live-news/20230208-sweden-puts-brakes-on-treatments-for-trans-minors
https://www.euronews.com/next/2023/02/16/as-spain-advances-trans-rights-sweden-backtracks-on-gender-affirming-treatments-for-teens
"normally the MAGA types ( they aren’t conservatives as conservatives were once defined) have no use at all for anything European countries do or say. Suddenly they are turning to European countries to validate their ideas?"
DeleteAgree about MAGA types not being genuine conservatives in many ways. And agree that one isn't likely to find consistency or even coherence in their views.
I think the view of many folks on the right - and this is not solely the province of MAGA types - is that Democrats have succeeded in politicizing government health policymaking, and are following the same playbook when it comes to medical treatments for trans persons. During Obamacare, it was (and still is) bulldozing through conscience objections. Those may not be important for progressives, but they are very important for many Americans, especially religious Americans. For abortion, it was (and still is) subsidizing abortions, domestically and abroad, and seeking to define abortion as "health care".
For COVID, you are right that the disease ravaged persons in both red and blue states. The anger on the right is not around mortality or hospitalizations; it is around shutting down economic activity and shutting down education for 1-2 years. Both are pretty defensible positions - especially the impact on children's education. Many people see themselves as victimized by heavy-handed COVID policies.
As you note: when it comes to this question of gender affirming care for minors, the policy tables are flipped somewhat: at least in red states like Florida (and many others), the heavy hand of government regulation is preventing parents from doing what they may wish for their children.
As for myself: I'm not such a libertarian that I object to any/all government regulation. I think government regulation is necessary - including regulations for medical treatments and medications. What the right set of policies is on this question of gender affirming care for minors is, I truly don't know. As Thierry noted in the video I linked to in the original post, people on both sides of the partisan divide want what is best for children. Perhaps that commonality may lead to a rational policy, once we get through all the regulatory and legislative sausage-making.
The UK was forced to close its sole clinic for youth suffering from gender dysphoria after a series of revelations and scandals. This BBC article has more. The UK is not banning gender affirming care for minors. But in effect it is admitting that its former policy was a failure which apparently harmed some patients, and is now revamping its policies with additional safeguards (and, I believe more restrictions).
Deletehttps://www.bbc.com/news/uk-62335665
DeleteI would recommend to others to read the year-old article you link to and decide for themselves whether there are any lessons to be learned about the current debate regarding the care for transgender youth. (I don't think so.) Among the "revelations and scandals" was the fact that this sole clinic of its kind had a two-year waiting list. I would not say that the UK is "admitting that its former policy was a failure." Exactly what was its former policy, anyway? (Of course, any policy that results in a two-year waiting list cannot be considered a success. But was the treatment protocol the problem? It's not at all clear.)
There is a very, very long AP special report titled Youth in Transition that appears very informative and and trustworthy, but it is far too long to read. The intro to Part 3 does have the following quote: "An overhaul of medical care for transgender minors is exacerbating bottlenecks in England, Reuters found, leaving thousands of patients in limbo and adding to years-long treatment delays. The crisis comes amid a broader debate on appropriate care for rising numbers of teens seeking help in Europe and the United States.' So if accurate, it looks like the "reforms" mentioned in the BBC article are making the situation worse.
I think the whole lesson for me is that right-wing presidential candidates (like DeSantis) and legislators should not be taking control even where medical experts disagree. Nobody is going to convince me they are acting in the interest of children, even if many well-meaning and sincere parents are concerned about the US medical establishment's approach to transgender care.
I think my post
Deletehttps://newgathering.blogspot.com/2022/10/gender-therapy-and-gender-assessment.html
is still the best on the issue of transgender therapy for minors.
The author however focuses upon the internal battle among therapists as to whether or not clinicians should accept a child/adolescent's desire for gender transition at face value or have an extensive assessment of contributing factors before engaging in any form of transition. A good presentation of the need for better assessment is contained in this WAPO article by two gender transition therapists who stress the importance of assessment.
The therapists advocating for better assessment came under intense pressure from their colleagues who said that we should basically accept the minor’s assessment of their case. Some of those colleagues were therapists who had in fact themselves transitioned. (However, some who had were on the side of better assessment). The articles do not mention it, but I suspect many of their colleagues were simply physicians out to make a buck because of the increasing numbers of people categorizing themselves as experiencing gender dysphoria.
In the United States and Canada, meanwhile, two dueling approaches to therapy for young children, before they reached puberty, were vying for supremacy. One in California emphasized a social approach that encourage transition before any medical interventions were made. They found this was successful In Canada, another social approach went the opposite way, encouraging parents to deprive their boys who expressed feminine interestsof opportunities to do so. They found this was successful in keeping birth gender identity, however some of the males ended up being gay.
Since gender identity of the increasing numbers of people expressing interest in gender transition appears from the data to be very flexible, I am inclined to say that unlike the situation in which people consistently experience themselves as the opposite sex there is no medical necessity for intervention.
I think physicians would be wise to keep out of these unnecessary medical interventions rather than treating them as something like cosmetic surgery. I think the medical profession in the US has dropped the ball on this issue. If a child of mind were experiencing symptoms of gender dysphoria, I would wait a long time and be sure that there was no possibility that it would go away before consulting with a physician whom I would try to vet to be very sure they intervened only when there was no alternative.
Incidentally the gender transition activists got the Canadian government to shut down that center (its head later received a settlement for defamation). So while activists may protest about government shutting down the medical opportunity for transition, they have been very willing to shut down interventions that might eliminate the need for transition.
Deletein red states like Florida (and many others), the heavy hand of government regulation is preventing parents from doing what they may wish for their children.
DeleteWhat their heavy hand is doing goes well beyond the very small group for whom gender dysphoria is an issue. Interference with private medical concerns is at the heart of his abortion law too.
DeSantis and friends are shutting down freedom of speech, freedom of thought even, especially in the educational system, all the way up through college level. During Covid he ordered the people in charge of keeping track of illness, hospitalization and deaths to stop making the data public. When a woman who had been doing that job refused to hide the numbers, she was fired. The states surgeon general manipulated the data to make it appear that heart complications in young men were far more common than the reality. DeSantis refused to disclose his vaccination status, so observers assumed that he had been vaccinated. But was too chicken to admit it to the fanatics in his base.
Professors at the universities were muzzled - prevented from giving their opinions about Covid dangers/mitigation/ vaccine safety strategies in public testimonies. Protections for college level educators’ freedom of thought on all the culture war issues are being dismantled, including tenure. Now the laughably named “Moms for Liberty” are getting books banned throughout the public school system. The principal of a charter school using the classical educational curriculum that Hillsdale College created was forced to resign because the middle school art unit had a slide of Michelangelo’s David which one mother deemed pornographic. Ironically, Hillsdale p, as conservative and Libertarian as they get, announced that this school would not be offered a new subscription for next year because of this. I guess Hillsdale is more truly in favor of some freedoms than the DeSantis regime. When the legislature passed his revised abortion bill (6 weeks) - no popular vote - the sentiment supporting almost total bans on abortion had changed- polls indicate that the majority of Floridians are not in favor of such a strict limit - he signed it late at night, near midnight without press or others around to publicize it. He goes after dissenters to silence them in a manner worthy of the Catholic Church during its worst heretic hunting periods. And then there’s his war on Disney. Well, in Hobby Lobby the SC decided that private corporations could have first amendment religious freedom rights just like people when it comes to destroying individual religious rights of their employees, so now Disney can be presumed to have the same first amendment free speech rights as people. Of course, at the same time these ‘freedom” politicians have destroyed the religious freedom rights of millions by imposing their religiously based views of abortion on all in their jurisdictions, pushing for national legislation.
I don't think that we should decide whether we are for or against something based on the Trump or Desantis position of the issue. Even a broken clock is correct twice a day. That just automatically makes every issue a partisan and/or culture war issue.
Delete"I would recommend to others to read the year-old article you link to and decide for themselves whether there are any lessons to be learned about the current debate regarding the care for transgender youth. (I don't think so.) Among the "revelations and scandals" was the fact that this sole clinic of its kind had a two-year waiting list. I would not say that the UK is "admitting that its former policy was a failure." Exactly what was its former policy, anyway? (Of course, any policy that results in a two-year waiting list cannot be considered a success. But was the treatment protocol the problem? It's not at all clear.)"
DeleteYes, among the problems identified with Tavistock was the long waiting list. And that is the problem that Reuters chose to highlight. But the BBC article also mentions other issues. See this BBC article, linked to in the first one I mentioned, for more some more details of issues beyond waiting lists:
https://www.bbc.com/news/health-51806962
For some concerns about clinical practice in the treatment of transitioning minors on this side of the pond, see this article from a whistleblower who worked for several years at the Washington University Transgender Center at Children's Hospital.
Deletehttps://www.thefp.com/p/i-thought-i-was-saving-trans-kids
If I am not mistaken, this article has been pretty influential among conservative activists who are pushing the sort of legislation signed in Florida, and about to be signed in Texas.
FWIW, this hit my mailbox today as an enewsletter: Andrew Sullivan coming out swinging against queer theorists. He's approaching the question from the point of view of a gay man.
Deletehttps://andrewsullivan.substack.com/p/the-queers-versus-the-homosexuals-cfd?utm_source=substack&utm_medium=email
A couple of comments after reading the linked articles. I used to think that the term "queer" in reference to someone's sexuality was a rude word, similar to an ethnic slur; that the terms lesbian or gay were the preferred way to refer to someone who is attracted to the same sex. But it seems that "queer" is now the self description of some, but not all, in that category. Also I had thought that being lesbian or gay (or bi) was a separate category from being trans. Now it seems that the terms are blurred by the catch- all acronym LBGTQ+, and in fact some lesbian or gay people feel that they ate being erased or subsumed by the trans movement.
Delete"ate" should read "are", above.
DeleteAndrew Sullivan is very disturbed about the development of gender theory and well he might be.
DeleteThe successful acceptance of gay marriage is largely due to the fact that many people, including myself discovered that gay people are essentially ordinary people. In college one of my best friends went through the process of coming to terms with his attraction to other males. It was not something that he chose for himself. As a professional I worked regularly with a gay person who talked about his “significant other” in much the same terms of any guy talks about his wife. If it looks like a marriage, talks like a marriage and walks like a marriage, they must be married! As Andrew mentions gays come in all sizes and shapes, just like everyone else, not some rare species found in gay bars. Gay marriage did not result from gay pride marches but from the willingness of gays to be open and honest in a normal way that appealed to the average person.
The queer movement seems to pride itself in taking down all assumptions above sex, gender, race, age, etc. It seems to want to make itself disturbing to the almost everyone. It seems to me to be an elitist movement that looks down on everyone. In regard to children, it seems to be preaching that a child as a person can be anything that it wants, essentially that children are no different than adults. While we have an enormous amount of cultural variety across the human species, I don’t think that everyone can make themselves over just because they want to be different.
Sullivan is so disturbed about gender theory that I cancelled his newsletter. Like Trump and Desantis, I think the less attention paid to the gender theorists the better.
Unfortunately one can’t ignore what DeSantis and trump say and do. One of them might become President again and attempt to find a way to exert their authoritarian will on the entire country.
DeleteOh, for heaven's sakes. I am no longer thin or cute, I am less awkward socially, I am a better knitter, and I don't smoke cigarettes or drink booze anymore. Those are things that age, info, and practice have taken care of.
ReplyDeleteBut I still deal with clinical depression. That's a permanent mental defect, not a phase. It occasionally requires treatment when it gets bad and the little tricks I've learned fail to push it back.
And gender dysphoria is not a phase of immaturity or confusion, or people would not be opting for radical treatments decades after they first noticed it.
Could some kids decide to pretend to have it to get attention? Sure. Should doctors take a conservative approach to treatment that causes permanent bodily alteration with kids? Of course.
But not all mental conditions are in our heads.
So: Has this discussion clarified anything for anyone?
ReplyDeleteMy takeaways:
1. Society has an interest in protecting all people, minors or not, from irreversible trans treatment without appropriate screening and counseling. A graduated transition process over a period of years probably serves people best. That has generally been the treatment approach since the 1950s.
2. Doctors and hospitals should be required to carefully track trans patients to gauge long-term health risks. There needs to be an international pool of info about outcomes of treatment, psychological, hormonal, and surgical.
3. Legislators need to understand that gender dysphoria is a rare but legitimate medical condition that should not be treated as a moral or immaturity problem.
4. The LGBTQ+ movement is not monolithic. It includes internal fractures along age, socioeconomic, and political lines. There are level heads and nuts in the mix, just as there are in any organization. The media tends to throw the nuttier elements into higher relief and to maximize the conflict. We need to be careful about making generalizations about non-heterosexuals based on this info.
5. Some churches may be equipped and prepared to extend support and Christ's love to trans people. The RCC is probably not one if them.
Thanks for the discussion.
This is addressed to Jim about some comments he wrote yesterday.
ReplyDeleteFor COVID, you are right that the disease ravaged persons in both red and blue states
Jim, you are ducking the reality and presenting a distorted both- sides argument. Yes, both red and blue states were “ravaged”, but the toll in red states was much, much higher than in blue states. The mortality rate in Arizona was twice that of its neighbor, California. The toll in sunny Florida was about 50% higher than in sunny California. My brother and his wife in Arizona were both very seriously ill with Covid - for weeks. My sister in law’s brother in Arizona died of it. All of these relatives are/were MAGA. The toll in red states was consistently higher than blue states, statistically significantly higher by a good bit. Even at the county level the death toll was much higher in counties that trump won than in those that Biden won. False or distorted equivalencies are not something I expected from you.
I wrote a whole lot more about the irrational hysteria that has been pushed on a lot of gullible folk by right wing media about the untrustworthy government and medical establishment. I won’t bore with you all of it. I will point out that Sweden’s economic performance was no better than ours or other European countries even though they didn’t lock down, and the mortality rate was quite a bit higher than others. During the first year of Covid Swedens economy tanked - worse than most other European countries and with a much higher mortality rate. It improved once the vaccines were available.
The Covid mortality rate in the US was15th highest in the world, exceeded only by a few Eastern European countries, including Hungary. It was way, way higher than other developed countries, and higher than many less developed countries. Not surprising, because the right-wing fear mongers resulted in the US being #65 in percent of population vaccinated.
The schools decisions were made when we still had no idea about how contagious Covid would be among children. I don’t know where schools might have been closed for 2 years. In LA county which had schools closed longer than most places, they were closed for 3 months of 2020, and 6 months of 2021. Same in the Bay Area. They reopened in March. The first vaccines were available there in January. And, as I recall, most teachers pushed to keep schools virtual. When that ended they wanted masks. Older teachers especially knew that they were more likely to have a serious illness from Covid than most others. Even after the vaccine was available, a lot of people, especially in red states refused to be vaccinated because of the conspiracy theories promoted by the right wing media. Of course, the same people didn’t want masks. So they had a lot more deaths than would have occurred if they had been a bit more rational.
I finally read all of the articles linked to by Jim and Jack. Like Katherine I have been confused by all the terms now used and all the letters. I am still confused. Especially about what Queer means and the implications made by Sullivan. Like Jim I found the articles to be disturbing, I remain convinced that medical interventions should be postponed until someone is at least 18, or older. Hopefully as adults making their own decisions. (Kids take so long to grow up these days that maybe 21 would be better). Gays and lesbians who self-identify as teens don’t undergo radical and sometimes irreversible medical interventions as trans people do.
ReplyDeleteJean wrote
And gender dysphoria is not a phase of immaturity or confusion, or people would not be opting for radical treatments decades after they first noticed it.
Decades - yes. When they are adults, but when they are still children, depending on how one defines children? Pre-pubescent? Teenagers? Pre-school? I confess to having been a bit horrified when reading about some parents who decided that their four year old was really a boy because she had told them that she wanted to be a boy. She wanted to wear jeans, not dresses. She liked playing with toy cars and trucks. So they started planning for hormones, puberty blockers etc, cut her hair like a boy, allowed her to wear jeans and boy t-shirts etc. , allowed her to chose a boy’s name, and told her that when she got older she could be a real boy. They informed her pre-school that their four year old was transgender. An extreme case probably but it does raise an important question. Was she really transgender or were her parents taking a few things she said or did and creating an identity for her? When I was a little girl I was a «tomboy». I preferred wearing jeans or shorts most of the time. I was the only girl on the street who would climb trees like the boys. I wasn’t big on playing dolls. But I did like a fancy dress for Christmas. So if the four year old never liked to wear dresses, and I did occasionally, does that really mean she’s transgender and not a Tom- boy?
Ok.I’m done.
I guess I’m not ( done). I was on the fence when this discussion started. To be honest, it’s not something I’ve paid close attention to. I didn’t actually disagree with DeSantis wanting to keep k- 3 without discussions of sexuality except perhaps having a book like Tommy has Two Daddies, as my grandson’s good friend and classmate does ( two dads). Just giving the general idea that families come in different configurations. But then he expanded the ban on books and discussions about homosexuality, transgender etc through 12th grade, and now teachers are caught in the crossfire. In this country most kids know about the variations in sexuality by 6 th grade. So it’s just him playing dictator again to attract the far right wing voters. He isn’t stopping with banning treatment for trans kids. He ven wants adults to have to be approved for treatment by two review boards whose members he appointed. So DeSantis has gone too far. Again.
DeleteI had been concerned about the reports of a significantly higher suicide rate among transgender kids, compared to the average. The information in the articles indicates that most kids who were treated in England usually had multiple other issues that raise suicide rates, and that 1/3 were on the autism spectrum. Kids on the autism spectrum have high suicide rates - so is the risk high because of being transgender or because of autism or something else, or a combination? Suicide rates among adolescent girls have skyrocketed in recent years even though most are heterosexual. The experts on teen suicide aren’t sure why.
Finally, I felt that the pauses in Sweden, Finland and France are significant. Sweden has treated transgender kids longer than pretty much anyone. They have had more time to see outcomes and patterns. All three of those countries are highly progressive - yet they are concerned. The UK has called a halt for now.
In this country, apparently, the numbers of treatment centers was only half dozen just a few years ago. Now there are more than 100. I can’t help but think that this explosive growth isn’t largely due to the money that flows in to these centers. The other countries don’t have healthcare systems predicated on profit. The US healthcare system is all about profit. Follow the money and it’s easy to see why the US healthcare costs range from four to eight times higher than other developed countries. Their systems aren’t profit based. Ours is - including clinics that ID and treat transgender kids.
I was going to try to write something about the word queer, but as it turns out, the Wikipedia article is quite good, so here it is below. I have divided it into three sections for my purposes.
ReplyDeleteQueer is an umbrella term for people who are not heterosexual or are not cisgender.
[1] Originally meaning 'strange' or 'peculiar', queer came to be used pejoratively against those with same-sex desires or relationships in the late 19th century.
[2] Beginning in the late 1980s, queer activists, such as the members of Queer Nation, began to reclaim the word as a deliberately provocative and politically radical alternative to the more assimilationist branches of the LGBT community.
[3] In the 21st century, queer became increasingly used to describe a broad spectrum of non-normative sexual or gender identities and politics. Academic disciplines such as queer theory and queer studies share a general opposition to binarism, normativity, and a perceived lack of intersectionality, some of them only tangentially connected to the LGBT movement. Queer arts, queer cultural groups, and queer political groups are examples of modern expressions of queer identities.
Critics of the use of the term include members of the LGBT community who associate the term more with its colloquial, derogatory usage, those who wish to dissociate themselves from queer radicalism, and those who see it as amorphous and trendy. Queer is sometimes expanded to include any non-normative sexuality, including cisgender queer heterosexuality, although some LGBTQ people view this use of the term as appropriation.
In my opinion, when (or if) an "ordinary" gay person (say, Pete Buttigieg) uses the term queer, it is more in the 1980s sense, somewhat in the way black people use a variant of the n-word amongst themselves. What Andrew Sullivan is talking about is a phenomenon that no doubt is very real, but takes place among pointy-headed intellectuals.
As I see it, a person's sex as "assigned at birth" is almost always correct, because it is a matter of biology and anatomy. (This excludes cases of genetic anomalies.) One's gender is a matter of how one self-identifies. If a person feels he is a man somehow trapped in a woman's body, his sex is male but his gender (or gender identity) is female. I believe the people Andrew Sullivan so strongly opposes would not make a distinction between biological sex and gender. That is why (for them at least) the question "What is a woman?" is so difficult. They would say that someone who self-identifies as a woman is a woman. I am happy to say a trans woman is a woman for basically all practical purposes. But I would say she is a trans woman, not a biological woman.
I will be interesting to see how DeSantis's "bathroom bills" fare, because the trans men that I see on TikTok are very masculine appearing. Is someone going to try to bar them from men's rooms or force them into women's bathrooms? I would have no problem in any ordinary social situation as accepting them as men. On the other hand, I would not want to run into Kaitlyn Jenner in the men's room (or anywhere else, actually).
I just noticed that Queer Eye for the Straight Guy is in the top ten shows on Netflix currently. This use or aspect of queer is most definitely not what Andrew Sullivan is talking about in The Queers Versus The Homosexuals. In the TV show, it is basically a synonym for gay male. Likewise, the various versions of Queer as Folk are about "ordinary" gay men and lesbians, not radical ideologues. So the word queer has a number of rather different meanings.
DeleteAbout trans women, I would have no problem calling them trans women, or using their preferred pronouns. But I would have a problem calling them women, full stop. Where it gets crazy is saying things like "pregnant people" or "menstruating people", implying that men do these things too. You have to be a biological woman to have these biological functions. You can fool nature some of the time. But not all of the time.
DeleteDavid, thank you for educating us on the nuances of Queer, and on the pro side of gender affirming treatments, especially for adults. I have had little knowledge of everything involved, all the complexities and I will now be open to learning more.
DeleteI have some problems with those who charge that particular people (say, medical people running gender treatment clinics) are in it for the money. It is a rare person indeed who works for a living who cannot be said to be doing their job for money. If there is a great increase in gender dysphoria, we hope and expect qualified professionals to open enough additional clinics to deal with it. I remember once during eye surgery (when I was lightly sedated but not asleep) hearing my surgeon talk business with someone assisting him in the operating room. Doctors very often are businessmen, and that doesn't generally make them bad doctors.
ReplyDeleteA large component of sex change procedures amounts to plastic surgery which is elective and sometimes the result of obsession. Apparently, there are surgeons who will do anything for money. I can only think of the grotesque transformation of singer Michael Jackson which included a race change. That said, I'm not about to advocate legislating away plastic surgery. I just think it's highly questionable in some cases.
DeleteDavid, I’m not referring to the dedication of the medical staff, but to the profit making corporations that own hospitals, clinics, labs, and all the very expensive medications Americans need. It is a truism these days that many many unnecessary tests and procedures are performed in the US. Some is due to fear of malpractice litigation in our tort happy culture and some is due to the old fashioned American greed known as excess profits. Over-testing and over-treatment are big topics of discussion these days. Many doctors own the labs where imaging, bloodwork, etc are done. At the same time, people with stingy health insurance plans often can’t get insurance companies to pay for expensive tests and treatments that definitely are needed. Our healthcare system has been totally distorted by the greed from privatization.
DeleteDoes the dramatic rise in diagnoses of gender dysphoria reflect a real phenomenon? Why such a dramatic increase in such a short period of time? I have no doubt that many cases are real. But I get a bit suspicious when there is a such a huge jump in cases in a very short time - especially when it involves diagnoses that can’t be confirmed through scans or blood tests but which require extensive and very expensive intervention - years of psychological therapy, psychiatric drugs, lifetime hormone therapy, puberty blockers, extensive and very expensive surgery. It seems that when it comes to this particular diagnosis, one that involves serious and often irreversible medical intervention, with no or few long term studies on outcomes (hormones were prescribed for peri-menopausal and menopausal women - aggressively pushed on them - for many years before the cancer link was detected) that going slowly and carefully with young people who are not even fully physically mature may be the prudent course. Maybe stick with therapy alone, combined with anti- depressants and anti- anxiety meds as needed, until adulthood.
Our medical system has been deformed by becoming beholden to corporate profits. And how many young people these days become doctors primarily to help people? I know young MDs - a niece, and the children of friends - who finished their residencies and began their first year of practice with salaries running $300-350k in their first year, buying their first homes for well over $1 million. They are all specialists. Primary care docs are the lowest paid, most subject to midnight calls from patients etc, and few med students are now choosing primary care. With the abortion situation these days, and fear of prosecution for treating miscarriages, many are no longer choosing OB-Gyn specialties either. I know two young couples pretty well who are BOTH doctors - together earning around $650-700,000/year right after finishing their residency. They often have huge loans. One friend of mine told her son (my son’s college roommate) that she was worried about his huge loan for med school - his response - “Don’t worry mom, once I’m in practice I will have it paid off in about three years”. His MD wife is the daughter of two physicians- both specialists also. The three young MD couples I know well have all bought their first homes during the last two years - paying well over $1 million for them. I think many medical interventions and new physicians these days may also be as, or more, more motivated by $$ than the welfare of the patients.
Last year around this time I bent over to lift a laundry basket and when I stood up, I couldn’t put any weight on my right leg without terrible pain. Walking was torture. So a trip to the orthopedist. He took X-rays and diagnosed degenerative disc disease - adult scoliosis. He prescribed physical therapy and an MRI. I asked if an MRI was really necessary. No, he said, it’s up to you. I didn’t get it, I did a half dozen sessions of PT, continued the exercises at home, and have been fine. An unnecessary test that would have generated $$ for the testing center.
Anne, glad the PT helped you! Also glad there was some "wiggle room", that the orthopedist left it up to you if you wanted to do the MRI. Sometimes the insurance companies make you jump through hoops to get even necessary tests approved. I've found Medicare pretty easy to work with when it comes to things like that.
DeleteAbout our medical system skewing things toward maximizing profit, I just read an article saying that pediatricians on average make 25%. less than their adult physician counterparts. So that's another specialty where there are likely to be shortages.
DeleteKatherine, Medicare is way better than the private company insurance my husband’s very small company could afford for its ~30-35 employees. We really do need Medicare for all in some form in this country.
DeleteAbout 5 years ago I had a really painful episode with my left knee. X- rays showed “medium” arthritis. But it was so painful that walking was very difficult. Possible - unlike with the back - but very, very painful. That orthopedist gave me a shot of cortisone, telling me that it would wear off after a while, could not be used too often because of potential damage to cartilage, but would help me to get through some sessions of PT. It did wear off eventually. But I did the PT and followed his suggestion to walk a lot, because movement lubricates the joints, which I have done. An average of 2-2 1/2 miles most days since then. My knee has been fine ever since. So if your doc prescribes PT after you are “recovered” from your surgery, my advice is to do it. It really helped me with my knee and with the back. I’m a believer!
I research all my healthcare issues thoroughly, looking for studies in peer reviewed medical journals especially. I probably collected links to about 100 studies when I was diagnosed with breast cancer in 2021. I really did not want to take the aromatase therapy meds that are prescribed for breast cancer patients for five years after surgery along with radiation- it is the standard of care. The meds have a lot of unpleasant side effects, as well as some that might be worse than discomfort, such as osteoporosis. My mother had that, and when she was about the age I am now, she broke her leg in 17 places. She fell, but the docs said that she might have broken her leg when taking a small step out of my sisters front door, not from the fall - that the break might have caused the fall. I found several studies from different countries that advanced the idea that these meds might be over- treatment for older breast cancer patients ( 70 years+) with very small, non-agressive tumors, as I had. I did five sessions of radiation. But I felt that quality of life as I approached 80 was important and I declined the medication. I hope I made the right decision! Time will tell. I told my Hopkins oncologist that I didn’t want the meds and cited the studies. She told me that the meds are the standard of care, noted in my record so I can’t sue them I suppose, if the cancer comes back. She also told me that it was a reasonable risk- benefit ratio for me, given my concerns about quality of life. I got a second opinion from a non-Hopkins affiliated oncologist also. She strongly supported my decision, while repeating the standard of care stuff. I’ve read a lot about unnecessary testing and over treatment so I do my homework before agreeing to every test or treatment.
Anne, I have also heard that about the aromatase inhibitors. I have also observed some people who did the full five years, that they became quite stoop-shouldered, which seems like it indicates that it affects the spine.
DeleteI am doing PT three times a week until the middle of June (I was kidding K that PT is my social life). My biggest problem is getting up from chairs and furniture because I am restricted from putting weight on the surgical knee if it is bent.
A long time to put up with it all, but hopefully a big improvement in your quality of life!
DeleteAt the time of Obamacare my extremely conservative Republican podiatrist told me what was wrong with health care costs and what had to be fixed:
Delete1. Physicians are too greedy. We got into the problem of for- profit insurance companies because the nonprofit insurance companies were not dealing with greedy physicians.
2. Profit hungry insurance companies. I would add profit hungry corporate providers including most of the nonprofits who plow their “profits” into facilities and investment funds.
3. Lawyers making money on malpractice lawsuits. He said this will be difficult because it cannot be solved by caps because people who have been dreadfully wronged deserve their compensation. I would add that part of this problem is that the medical profession does not regulate its professionals.
Given the extremely high costs and poor outcomes, the American healthcare system is riddled with people who are getting rich at the cost of quality care for our people.
Off- topic to Jim. Although you haven’t yet accepted that the majority of Americans, including in red states, oppose the draconian bans on abortion implemented by fiat in states that didn’t provide an opportunity for people to vote on them, it seems that the GOP has gotten the message, DeSantis is suddenly keeping quiet on the subject. His six week ban was rubber stamped by the legislature (no popular vote), but by then he was realizing that it could come back to bite him. He signed the bill privately - no photo ops - close to midnight. And no longer talks much about it. Now it seems that the GOP. has decided to pivot and support a 12 week window for abortion. They now refer to themselves as in the mainstream. Well, probably. After all, before Dobbs, 85% of abortions were done before 8 weeks and around 93% by 12 weeks, - - - without legal coercion. The extremists on the left don’t like it, but most Americans, including me, would be satisfied that this is a decent compromise. However, exceptions for rape, incest and saving the life of the mother after the 12 weeks should be included.
ReplyDeletehttps://www.washingtonpost.com/politics/2023/05/20/republicans-deploy-new-playbook-abortion-bans-citing-political-backlash/
Yeah, Nebraska has endured much drama over LB 574! They finally settled on 12 weeks, which seems like something people will accept.
DeleteHi Anne - actually, I've been aware for quite some time that the pro-life position is not a political winner in most of the country. I've probably blogged about it here once or twice, or at least mentioned it in passing.
DeleteI think 12 weeks is politically viable in red-but-not-reddest-of-the-red states, like Florida. If that turns out to be where much of the country as a whole settles, and the political temperature gets turned down on abortion, as apparently is the case in Europe, then perhaps that is not the worst possible outcome. I confess I wouldn't have guessed that Republicans would lead us to that settlement, but there are many things in life that I fail to predict correctly.
In purple and blue states, it seems likely that what is politically viable is more or less what was in place while Roe was still in force. Or worse.
Jim, I would love to see this limit. It’s what I have supported all along. Casey was the decision that opened the door to extremism on the other side. Fortunately third trimester abortions have always been extremely rare- even 2nd are rare. As noted previously, more than 92% of abortions were done by 12 weeks without using the heavy hand of extremist legal fiats. When late abortions have occurred it’s usually been to save the mother or the tragic cases where it’s been determined that the fetus has an uncorrectable condition that is incompatible with life such as when imaging shows no brain or testing shows a rare genetic condition. Most women who learn this are heartbroken but will choose to terminate rather than carry to term.
DeleteI have never believed that most anti- abortion politicians take that position out of genuine principles. They don’t have many principles on anything. I believe that most (Pence may be an exception) take that position in order to be elected. They are wholly about gaining and keeping power and they learned years ago that a good way to do that was to enlist evangelicals and conservative Catholics active in the pro-life movement and cynically use them for their own purposes. The ONLY reason the GOP has pivoted is because they realize that their extreme positions and laws are not what people want. They havé realized that they could risk their careers if they didn’t change their tune.
I see that the Nebraska bill does include the needed exceptions for rape, incest and the life of the mother.
A rare genetic condition that is incompatible with life. Not a more common one like Down Syndrome which is compatible with life.
DeleteRe: DeSantis and the 6 week ban: I don't know a lot about his personal views. But everything he does seems to be about pushing the culture-war envelope. Florida would not be on my list of reddest-of-red states which I mentioned in my previous comment, even though they are geographically part of the Confederacy. It wasn't that long ago that Florida was electing Democrats to statewide positions. I think, politically, it's more like Ohio than Alabama. I guess DeSantis's presidential campaign strategy is: veer right on culture war issues during the primary season, perhaps to peel away Trump's Evangelical base. Then tack to the center during the general election.
DeleteFlorida seems to have become blood red in recent years. All about the culture wars a long with the rise in open racism that trump made acceptable. They are edging real close to Alabama. The NAACP just issued a travel warning to African Americans about the now open hostility towards Blacks, combined with the new no permit for concealed carry and stand your ground laws. which seem precariously close to legalizing shooting people if you feel “threatened”,. It seems it’s mostly white guys with guns who feel threatened by any disagreement with a black guy. Or maybe just go ahead and shoot because the 16 year old kid who rang the doorbell of the wrong house is black. His defense is stand your ground too. He felt threatened because the boy at the door was black. Shoot first and ask questions later.
DeletePS to Jim. The Florida Panhandle, including the Capitol, Tallahassee, is known as LA. Like in California. Except that it stands for Lower Alabama. Florida IS more Alabama than Ohio. But with JD Vance in Congress now, who knows what is happening in Ohio.
DeleteSo my younger son and family are catching a red-eye flight to Orlando tonight. They're taking the kids to Disney World. I said something about Disney and DeSantis previously. He said, "Who's DeSantis?" Sometimes ignorance is bliss.
DeleteIf he’s a Republican I sure I hope he educates himself before the primaries. And votes for whomever seems closest to being rational. Asa Hutchinson? Who is currently polling in single digits. We have gone to Florida for decades for vacations. Sanibel Island is very close to my heart, a place where we made some of our best family memories. I doubt we will ever go to Florida again unless some kind of decency returns to its politics, especially backing off its suppression of freedoms, especially speech, and academic freedom, and the heightened atmosphere of racism. Unfortunately my Jamaican d-I-law’s family lives there.
DeleteI don't actually know if he's registered in a political party, maybe independent. He leans more "none of the above", and rarely talks about politics. The other son is more politically engaged; switched to Democrat last general election.
DeleteNo problems with racism etc. But Sanibel still isn’t open for business really. It’s still recovering from Hurricane Ian last September. It was pretty well devastated. Most places expect to reopen in September or October. Politically the island is purple, in a deep red county. I just hate the idea of contributing a single penny in taxes - on condo rentals,, restaurants, car rental etc - to the state of Florida! We love Hawaii but it’s so far away compared to Sanibel. I hope your son and his family have a good time at Disney World. We took our kids a couple of times and had a great time. But it’s so much more expensive now! Memorial Day weekend will be crowded, though not as bad as thanksgiving, Easter, and Christmas.
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