The post above shares a journal article from "Annals of Plastic Surgery" Trends in "top surgery', CPT codes used by plastic surgeons. There are multiple codes the surgeons can choose from.
Jesse Singal has been cautiously walking back some of his earlier "I'm one of the good reasonable guys" statements about how "some" kids absolutely benefit from gender affirming care and how it's always great for adults who really want it. He says now "oh I just didn't know how bad the science actually was" but at the time he was very invested in kicking stronger critics in the teeth in order to better position himself as the Voice of Reason who was not a transphobic bigot like Them Over There (Them Over There being mostly women and some gay men).
I don’t think this is fair to Jesse. I think he really believed Laura Edwards-Leeper’s schtick back in 2018, having confidence that nice, Harvard-affiliated physicians surely wouldn’t give children sex lobotomies without any good evidence. Like we all did, or at least I did, as an institutionalist & optimist. But like many of us, he’s come to see the lies & chicanery that evil (or deluded) people are capable of when they’re convinced that their snake oil will cure you or your kid.
I was at Genspect last fall & met Jesse & even sat with him for almost a whole day. I asked him point blank if he had changed his mind & he said, yes absolutely. We should cheer on people who review the evidence & change their opinions accordingly! 🥳
I was very surprised to recently hear Jesse say some of his thoughts on adult gender medicine are changing since he's realizing how weak those studies are. Has he talked more about how this shift in thinking happened because I have so many questions! Did he just take all the adult studies at face value all this time and never do any of his deep dives like he's done with the child and adolescent studies? If that's the case, I'd really like to hear his thoughts on why he didn't look at the adult studies for so long even after he saw time and again how bad the youth studies were. I want to know not to criticize him, but to understand him, because I think that kind of insight would be helpful for approaching conversations with everyone in a more thoughtful way.
Lots of critics of PGM assume the adult evidence is sound! I think it's partly that they just don't want to go there — want to be able to be the reasonable person and say "But with consenting adults it's fine." Speaking for myself at least. Of course the difference between children and adults is still relevant, but this becomes less of a feel-good, live-and-let-live thing to say when you realize their consent is misinformed.
This thread is grossly unfair to Jesse Singal. Before Singal came along, was anyone else critiquing youth gender medicine in major mainstream publications whose readership was fully captured by the gender identity hoax? If Singal has changed his views and is now more critical of the trans establishment, that's a sign of intellectual integrity.
Critiques by feminist women were absolutely shut out of mainstream publications, that’s true. Part of Jesse’s entre into those publications came via stragetically placed kicks in the teeth of feminist critics to signal that he was acceptable, not a “bigot” like those awful women. He and Katie continually offer up those kicks pretty freely on BARpod and not even strategically: just for laffs.
If your view of this media landscape is that it all makes Jesse Singal a hero, well, okay. I’m not stopping you from tying his scarf to your jousting lance. I just have watched it all unfold and felt otherwise.
Two things - first, on Jesse Singal, if he was wrong before, there is nothing wrong with pointing that out. I can understand the frustration of those who have been arguing against these things for many years and felt undermined. However, I have tremendous respect for someone who is willing to admit they were wrong and have since changed their position. Thus, if he openly admits that he was wrong, I think that’s great!
Second. On this article, UB has made so many good points but I will discuss just one, the burden of proof. “Extraordinary claims require extraordinary proof.” The claim that someone was born with -or acquired at a young age - a condition whereby they must chemically and surgically alter their body to appear the opposite sex in ways that will have serious, irreversible effects from sterilization to sexual dysfunction to the need to rely on synthetic hormones for life, not to mention all the likely health impacts such as likelihood of incontinence and bowel issues, increased chance of stroke, heart attack, cancer, etc., in order to ever have a reasonably happy or peaceful existence is EXTRAORDINARY. It requires extraordinary proof and, to date, there is none.
When the entire premise of the need for treatment is based on an unfalsifiable claim, how do we even prove it? I think the best we can do is to limit these “treatments” to adults who can understand the risks AND not lie to those adults that this is medically necessary. We have no way of knowing that these interventions are medically necessary. We should not cover these “treatments” with health insurance either. Rather, like any cosmetic treatments, people who can afford them and think they may benefit and understand all the risks and lack of proof of benefit, are free to do what they want on their own dime.
Examples? This is the first I've heard that Jesse got into The Atlantic and other similar publications through "stragetically placed kicks in the teeth of feminist critics to signal that he was acceptable, not a 'bigot' like those awful women."
He has done it repeatedly: talked about gender affirming care OF COURSE being necessary and life saving for some kids and only meanie weanies think otherwise; OF COURSE preferred pronouns are just decent and only meanie weanies think otherwise; OF COURSE adults should be given access to this medically necessary care and it’s nobody’s business and only meanie weanies think otherwise.
Who has been in the opposite corner of all of those positions since the late 70s? It’s been a central part of Jesse Singal’s self-positioning that’s he not a bigoted anti-trans extremist like the bad prudey old radfems. Have you only become aware of him recently?
I've been following Singal for quite a while now. I'm familiar with the criticism he receives from Team Trans. Until I read the comments here, though, I wasn't aware he had critics on the other side. That's why I'm inquiring about it. I wish I'd known about this a few weeks ago when Blocked and Reported had an "ask us anything" edition of their Substack. I'm interested in how he'd respond.
I wouldn't say he has organized "critics". It's not like radfems are writing publications demanding he never be published again, TRA style. I want to be clear about that because so often the framing is "oh yes, all the crazies hate me, that just shows you what a reasonable soul I am". There is absolutely no equivalence, no radfems are organizing posses to get him (or ever have done so).
I am saying I and other women have noticed that he used criticizing feminist women as a shield for himself: "I am criticizing trans stuff, yes, but not like the Bad Mean Women of Terflandia". And then as it gets safer to say more critical stuff he's just sort of edged his way along into the terrain they were on the whole time, without EVER crediting them or saying "oh actually, they were right all along and it was sort of shitty of me to cast so many aspersions on them in order to clear a little pathway of respectability for myself."
None of us are organizing flying monkey brigades about this. We just see it and give it a blue-pencilly look.
I also don't believe this article fully on the whole adult thing. I think the benefits are likely inconsistent on adults and may not outweigh the considerable risks and societal issues, but the idea that the treatments has not benefited a single adult seems to lack credibility, and in any case, the "underlying theory" being bunk doesn't mean the treatment doesn't work. Chinese gave sick people tea based on underlying medicine theories that were wrong, but coincidentally germ theory says you cure many illnesses with clean, boiled water, so the treatment worked better then placebo regardless. Similarly, I am willing to believe for some people the treatment improves quality of life for some reason or another, tho whether it's enough people to justify the expense and risks of offering it and the people it fails is a fair question.another example is that many people had incorrect underlying theories about why limes cured scurvy, but their instinct was right: vitamin c in limes cures scurvy.
I assume there is some number of people that transition has provided genuine relief for, even with its costs, for the basic reason than I'm very uncomfortable making hard all or nothing statements (extreme all or nothing thinking is a big part of how we got into this mess to start with). But even in those cases, I have to wonder if there still could have been a better way, one without the harms and risks. To borrow from your examples of how certain treatments (limes for scurvy) worked without people knowing why, things can work but there are still better options. For example, smoking/nicotine suppresses appetite and many people find it helps them control their weight. Obesity can cause a lot of health problems but we wouldn't want to settle on smoking being the only or best treatment for a person no matter how well it works for them or if some people can happily smoke their whole lives without experiencing its serious complications.
Yeah, children and adults are two separate things. Children first of all don't have the capacity to make those kinds of decisions, and also have not fully matured into who they will be.
I have to admit that while I've looked at quite a bit of literature on adolescents, have never seen any literature on adults. I have though read a few accounts by adults, both male and female, who transitioned in adulthood, typically in their mid 20s, and were living satisfied lives after transitioning. The common threads I saw for all of them were that they had been dysphoric since childhood, they had given it a good go at conforming to the gendered expectations of their sex through adolescence, upon entering early adulthood they were still trying to give it a go, but to no avail, they sought counseling, not with a gender councilor, reflected quite a bit, and decided to transition, went to a gender clinic of some sort, where they went through quite a bit of gatekeeping and transitioned. Notable that they all were cognizant of and accepted social norms, were committed to adhere to those norms, and just wanted to get on with their life. And they are.
And I'm also aware of the grotesque crap you can see on X.
So yeah, I think it actually can work for some adults. Seems to be related to how well adjusted they are besides their dysphoria, and along with that if they have professional or career goals, that is they are not obsessed with their sex and gender.
Don't know anything, offhand, about his "true trans essence", but kind of think he's a bit of a fraud and a grifter. He had asked for feedback for his "I'm Writing Another Book" -- "about the United States’ youth gender medicine debate" -- but didn't even acknowledge my email to him on the topic:
Jesse: "I’ve always understood gender to mostly be something that is imposed on you."
Steersman: "Arguably that's something of a serious if common misperception that tends to cause no end of problems. Try thinking that 'gender' refers to or encompasses BOTH personalities AND personality types. The same way that there is, for example, BOTH the personality type 'introvert' AND people who actually are introverted to a greater or lesser extent."
But what really kind of chapped my hide was his dismissal of Jonathan Stewart's more or less coherent endorsement of gender as a spectrum of personality types and behaviours. Though Singal does have some valid criticisms of Stewart who seems to be conflating sex and gender -- lotta that goin' round these days:
Jon Stewart's performance as critiqued by Jesse and Katie in the BAR episode your reference was absolutely deranged. Even if he did mention at some point that gender is a spectrum, and Jesse may have dismissed that the point of that episode was to point out the garbage that Stewart and Oliver were spewing about "gender medicine", how they were openly promoting the lies of the GAC crowd, and how much of a shit show Stewart and Oliver's own research staff, who writes their material, are.
Jesse and Katie's typical modus operandi is dive into crazy and not well reported media reporting, often occurring on the internet, can be. This episode was just that. It just happened to be about two talk show hosts who thought they could lecture their audience about the virtues of GAC, and Jesse and Katie basically took them down.
I DID say that Singal had some valid criticisms. But point taken -- I quite agree that Stewart's (mis)understanding of sex and gender is a large part of the problem.
In particular, Stewart, along with too many others, seems to "think" that "male" and "female" encompass the "behavioral, cultural, or psychological traits" that are typically associated with one sex or the other, and that are more reasonably the defining criteria for the entirely separate category of "gender":
Much of the transgender clusterfuck -- excuse my French -- turns on the conflation of sex and gender, and on a general reluctance to define exactly what is meant by each of those terms. Hence my falling back on the strict biological definitions for the sexes as the only defensible "line in the sand".
But Singal did have a nice summary of that problem in his preliminary review of Byrne's "Trouble With Gender: Sex Facts, Gender Fictions" -- even if that book is rather badly flawed in many ways:
JS: "... but the fact of the matter is that our national conversation about sex and gender and gender identity is completely hamstrung by dumb and incoherent language games. Some of the biggest and most influential players in this space often refuse to even define their terms, let alone use them consistently, or to even try to make clear exactly what they’re arguing when they argue. .... I do think the present, extremely sorry state of philosophy when it comes to sex and gender can be partly explained by the contagious allergy to debate and discussion of difficult subjects that has been contracted by so many thinkers and activists, especially younger ones. "
Sadly, UB is more or less in that same boat of "refusing to define their terms" -- not quite sure how she thinks that workable laws around women's rights can be created without them.
But you might have some interest in a Substack post by "Eliza Mondegreen", in particular my conversation with Hippiesq -- another NYC lawyer, and mother of a dysphoric teenager -- who endorses that same definition for gender, even if we're "quibbling" over the definition for sex itself. Of particular note:
Hippiesq: "Sorry to go on and on, but, like you, I think the definition of 'gender' is a big part of the problem here. .... I guess [gender] could be hundreds of different intersecting spectrums ... One might fall well into the masculine zone of some of these little spectrums, towards the middle for others, and more towards the feminine on others ..."
> "But Cass doubled down on this sketchy claim when interviewed by the New York Times in May: 'There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access …' ...."
In other news, American Pediatric Society affirms that there are children who "absolutely benefit" from a steady diet of cake and ice cream devoid of any meat, potatoes, and vegetables. Details at 11 ... 🙄🙂
Barking mad. Hardly much better than the demented premises of those "gender doctors" who "think" that a child who exhibits some "gender non-conformance", some sex atypical personality traits should have their genitalia mangled -- trans-mogrified -- into some Frankensteinian resemblance of those characteristic of the other sex.
Absolutely monstrous. Medical scandal and crime of the century. Bunch of "doctors" should lose their licenses if not be strung up by their nuts and left to twist in the wind -- figuratively speaking of course ...
There is no definition of gender that justifies the actions being taken in the name of gender. We will eventually win if we just keep demanding that they define gender.
Kind of depends on what actions you have in mind, on what you mean by the term "gender", and which "they" you're referring to.
But it doesn't help much when you -- and far too many others -- insist that the only definition for "gender" is as a "grammatical class", and flat-out reject more scientifically tenable definitions for the term such as this one from Merriam-Webster:
MW: "gender: 2b) the behavioral, cultural, or psychological traits typically associated with one sex"
Whole concept of gender is a bit of a dog's breakfast, and it is maybe moot whether the idea is much better than phrenology or Chinese fortune cookies for categorizing personality types. But there is, in fact, a great deal of solid evidence that there are significant differences, by sex, in those "behavioural, cultural, or psychological traits typically associated with one sex" or the other. Sexual dimorphism writ large:
You might also have some interest in my post on the "A Multidimensional Gender Spectrum" which attempts to put the concept on a more scientific footing, and which more or less starts off from that MW definition:
I expect "we" are more likely to "win" if we have "steelmanned" the concept. And have shown thereby that many of "their" claims -- like "born in the wrong body" and "change your genitalia, change your sex (act now! offer ends soon! 🙄) " -- are so much incoherent and quite unscientific twaddle, at best.
After reading Andrew Doyle's piece a few days ago on take over of dictionaries by activists, I'm a little leery about using dictionary definitions these days. Although that one seems not to be controversial.
While largely synonym for sex while I've been alive, and from what I can see before that, not so clear cut, at least in western society these days. I have to admit that I find the general kerfuffle a bit puzzling, as during my teenage years and through my 20s it seemed that we were getting a lot more accommodating to the idea that the member of one sex could behave in ways previously associated with the other sex in terms of interests and activities, displayed emotions, etc. Dress got a lot more androgenous, at least in professional attire and recreational attire. I guess I didn't they pay attention until more recently, when gender stereotypes have seemed to become more pronounced, especially with respect to behavior. And gender identity has become this huge thing, mostly for younger people (like below 30). Are people really thinking that much about gender? I guess so, but why?
So it's probably useless to try to define it by categories. Maybe not even worry about it, and just base everything on sex.
Or, be completely objective about it, and just classify it as:
- Man=male
- Woman=female
-Transman=female that presents like a man, including through modification''
- Transwoman=male that presents as a woman including through modification
- Non-binary=could be male or female, but hard to tell
Spaces (restrooms, shelters, prisons, etc) are by sex. For spaces that are used by trans or nonbinary, there are unisex spaces
Sports are by sex and sex only.
Other than that, live your life, no discrimination.
Though you might post a link or two yourself -- as all the Substack veterans say, "sharing is caring" ... 😉🙂
But as evidence of the rot that transgenderism has wrought -- so to speak -- you might take a gander at the Merriam-Webster definitions for "male" and "female" as he only gave one for "female":
"male: 1b) having a gender identity that is the opposite of female"
"female: 1b) having a gender identity that is the opposite of male"
The "Circular Definitions R Us" crowd.
But it's kind of necessary to have some "authoritative source" stipulate the definitions in play -- otherwise they're kind of useless: anyone can play. You might have some interest in an essay by a philosopher of science on the topic of definitions in general:
If anyone had suggested 10 years ago that one day a quasi-religious scarification cult that valorizes child sacrifice would become our - "new normal" - I would have thought them daft. Amazing!
Yes, gender medicine is the University of Phoenix of medicines. The burden is not on us to be like "I will show you scientifically that these lying shady fucks lie like fuck all the time", we can just cut to the chase and say: look at these lying shady fucks lying all the time, they are obviously up to SHENANIGANS.
But also -- we know that if high quality large cohort studies are done of outcomes among young people, they absolutely will show catastrophic results. We should agitate for those studies being done and we should absolutely point to the terrible evidence base for the interventions that are being done, all the time, right now.
Good point, but I'm not calling for RCTs on humans because I think the treatment is unethical. In theory there might be a compromise here -- ban PGM except in the context of RCT -- but I'm not sure any trustworthy doctors at this point would agree to administer the treatment to kids.
I dread the chicanery that gender doctors would engage in trying to rig the study, hide info, delay reporting results, mislead the media. Trans-ID subjects would be peer-pressured to tell researchers they were happy. Control group kids would be pressured to drop out or claim misery. Etc.
Would be a reasonable course, however going to be dawn challenging, at least in US due to the balkanization of health care delivery and medical records, which would make it difficult to put together a subject roster for a retrospective study. Much more feasible in a European country like UK with a national health service,or a country like Germany with at least a national insurance system that can track individual use of meduca
medical system. Apparently Cass was rebuffed when trying to gain access to records for adult services having to do with gender affirming care, which would have allowed some level of retrospective analysis of those that had entered as adolescents and then moved into adulthood. Maybe that will get done. There was a recent paper out of Germany which looked at essentially resistance. Found over 60%, just by looking at diagnostic codes in records. So assuming same record system would indicate codes for people that had received medical procedures for gender issues, and they could be contacted and agree to interview to examine long term outcomes, there is an opportunity.
Yes, Chen et Al 2023 for instance, with its missing 6/8 protocol outcomes.
And yes, the placebo/nocebo effects are really hard to sort out when you've got young people and their communities being falsely told they'll commit suicide unless given medical or social transition.
The latest Alabama docs show that SEGM really got under the skin of WPATH and for that I’m down w EBM …From James Cantor’s Alabama court report “The document’s introduction includes a list of adversaries and obstacles which “Eli”
felt were attacking trans health care, including “academics and scientists who are naturally
skeptical” and “continuing pressure in health care to provide evidence-based care.” It is
impossible to exaggerate the fatal importance of Eli’s categorization of scientific skepticism and
evidence-based medicine as a problem rather than the goal. An objective observer would
perceive SOC-8 to be under attack from evidence-based care exactly because SOC-8 does not
embody evidence-based care, although WPATH and other advocates of medicalized transition
assert that it does. As I have detailed in my initial report and in this supplemental report,
multiple, substantial portions of SOC-8 are constructed based on exactly the anecdotal,
ambiguous, subjective, and insufficient features that evidence-based medicine rejects as
What I don't understand is how you could convince people or legislatures to ban the procedure _withouut_ using ebm and lots of studies. You can preach to the choir all you want, but do you ever think California or new York would be persuaded to discontinue their gender clinics unless the evidence was overwhelming that the treatments didn't work? Saying the belief in transcendent gender is bunk is too "wishy washy" to convince anyone who isn't already stridently anti trans or easily open to persuasion on the topic. And the supreme court would not be interested in making a procedure illegal nationwide unless a law came up about the issue; nor would it make it illegal in other countries. The odds of a law making gender medicine illegal nationwide getting 60 votes in the senate in the next twenty years seems exceedingly remote compared to doctors simply realizing the treatment doesn't work or medical authorities realizing this and punishing doctors who disagree , but the latter path simply requires evidence, not "vibes". (As a follow up, the states could and would challenge a national law, asserting that in state medical practices are not a federal matter, and they might win this challenge, so no matter what, you have to convince liberal states to discontinue this on their own accord; and simply saying the whole thing is bunk alone isn't going to convince them.
The burden of persuasion for such an invasive treatment should be on gender doctors. New Yorkers will realize that once they find out about the gender doctors' turpitude.
It doesn't really matter what the burden should be, the bar for upending established treatments, even insanely stupid ones, is usually conclusive evidence they don't work. That's just the unfortunate reality based on how we've thwarted other dead end science.
Spot on as usual, and a treasure trove of references to support what you say, again as usual...again, thank you!
"For years I’d litigated against a scammy for-profit college, which entailed interviewing and deposing many of its workers. The gender clinic ex-employee reminded me of them. Suddenly I started drawing connections between gender medicine and other predatory industries. That’s the perspective that drives many of my posts here."
Predatory is right. I'm not sure trans rights activists, the often used term, is the right description, as the question is what constitutes "rights". Trans medicalization industry? It's an industry.
Excellent piece, Unyielding Bicyclist.
If there were not billable codes for these procedures, these procedures would be rare.
https://x.com/statsforgender/status/1814339917104730299
The post above shares a journal article from "Annals of Plastic Surgery" Trends in "top surgery', CPT codes used by plastic surgeons. There are multiple codes the surgeons can choose from.
Jesse Singal has been cautiously walking back some of his earlier "I'm one of the good reasonable guys" statements about how "some" kids absolutely benefit from gender affirming care and how it's always great for adults who really want it. He says now "oh I just didn't know how bad the science actually was" but at the time he was very invested in kicking stronger critics in the teeth in order to better position himself as the Voice of Reason who was not a transphobic bigot like Them Over There (Them Over There being mostly women and some gay men).
I don’t think this is fair to Jesse. I think he really believed Laura Edwards-Leeper’s schtick back in 2018, having confidence that nice, Harvard-affiliated physicians surely wouldn’t give children sex lobotomies without any good evidence. Like we all did, or at least I did, as an institutionalist & optimist. But like many of us, he’s come to see the lies & chicanery that evil (or deluded) people are capable of when they’re convinced that their snake oil will cure you or your kid.
I was at Genspect last fall & met Jesse & even sat with him for almost a whole day. I asked him point blank if he had changed his mind & he said, yes absolutely. We should cheer on people who review the evidence & change their opinions accordingly! 🥳
I can see your point but his smug dismissals along the way of the (mostly women) who were right all along gripes my soul.
I was very surprised to recently hear Jesse say some of his thoughts on adult gender medicine are changing since he's realizing how weak those studies are. Has he talked more about how this shift in thinking happened because I have so many questions! Did he just take all the adult studies at face value all this time and never do any of his deep dives like he's done with the child and adolescent studies? If that's the case, I'd really like to hear his thoughts on why he didn't look at the adult studies for so long even after he saw time and again how bad the youth studies were. I want to know not to criticize him, but to understand him, because I think that kind of insight would be helpful for approaching conversations with everyone in a more thoughtful way.
Lots of critics of PGM assume the adult evidence is sound! I think it's partly that they just don't want to go there — want to be able to be the reasonable person and say "But with consenting adults it's fine." Speaking for myself at least. Of course the difference between children and adults is still relevant, but this becomes less of a feel-good, live-and-let-live thing to say when you realize their consent is misinformed.
Definitely agree with the Jesse comment. His earlier writings pandered to the gender clinicians.
Examples?
I admit to being unfair about Jesse. I am thinking of some of his earlier writings.
And the notion that some people benefit from transition.
I don't doubt there are adults who are happy about their changed bodies.
It's not ethical to put children, teens, even young adults, through medical transition.
People may be happy--but they would have been just fine without these drastic interventions.
I agree with Christina: https://x.com/buttonslives/status/1816838359525843213
This thread is grossly unfair to Jesse Singal. Before Singal came along, was anyone else critiquing youth gender medicine in major mainstream publications whose readership was fully captured by the gender identity hoax? If Singal has changed his views and is now more critical of the trans establishment, that's a sign of intellectual integrity.
Critiques by feminist women were absolutely shut out of mainstream publications, that’s true. Part of Jesse’s entre into those publications came via stragetically placed kicks in the teeth of feminist critics to signal that he was acceptable, not a “bigot” like those awful women. He and Katie continually offer up those kicks pretty freely on BARpod and not even strategically: just for laffs.
If your view of this media landscape is that it all makes Jesse Singal a hero, well, okay. I’m not stopping you from tying his scarf to your jousting lance. I just have watched it all unfold and felt otherwise.
Two things - first, on Jesse Singal, if he was wrong before, there is nothing wrong with pointing that out. I can understand the frustration of those who have been arguing against these things for many years and felt undermined. However, I have tremendous respect for someone who is willing to admit they were wrong and have since changed their position. Thus, if he openly admits that he was wrong, I think that’s great!
Second. On this article, UB has made so many good points but I will discuss just one, the burden of proof. “Extraordinary claims require extraordinary proof.” The claim that someone was born with -or acquired at a young age - a condition whereby they must chemically and surgically alter their body to appear the opposite sex in ways that will have serious, irreversible effects from sterilization to sexual dysfunction to the need to rely on synthetic hormones for life, not to mention all the likely health impacts such as likelihood of incontinence and bowel issues, increased chance of stroke, heart attack, cancer, etc., in order to ever have a reasonably happy or peaceful existence is EXTRAORDINARY. It requires extraordinary proof and, to date, there is none.
When the entire premise of the need for treatment is based on an unfalsifiable claim, how do we even prove it? I think the best we can do is to limit these “treatments” to adults who can understand the risks AND not lie to those adults that this is medically necessary. We have no way of knowing that these interventions are medically necessary. We should not cover these “treatments” with health insurance either. Rather, like any cosmetic treatments, people who can afford them and think they may benefit and understand all the risks and lack of proof of benefit, are free to do what they want on their own dime.
Examples? This is the first I've heard that Jesse got into The Atlantic and other similar publications through "stragetically placed kicks in the teeth of feminist critics to signal that he was acceptable, not a 'bigot' like those awful women."
Who are the women in question?
How did Jesse kick the in the teeth, so to speak?
He has done it repeatedly: talked about gender affirming care OF COURSE being necessary and life saving for some kids and only meanie weanies think otherwise; OF COURSE preferred pronouns are just decent and only meanie weanies think otherwise; OF COURSE adults should be given access to this medically necessary care and it’s nobody’s business and only meanie weanies think otherwise.
Who has been in the opposite corner of all of those positions since the late 70s? It’s been a central part of Jesse Singal’s self-positioning that’s he not a bigoted anti-trans extremist like the bad prudey old radfems. Have you only become aware of him recently?
I've been following Singal for quite a while now. I'm familiar with the criticism he receives from Team Trans. Until I read the comments here, though, I wasn't aware he had critics on the other side. That's why I'm inquiring about it. I wish I'd known about this a few weeks ago when Blocked and Reported had an "ask us anything" edition of their Substack. I'm interested in how he'd respond.
I wouldn't say he has organized "critics". It's not like radfems are writing publications demanding he never be published again, TRA style. I want to be clear about that because so often the framing is "oh yes, all the crazies hate me, that just shows you what a reasonable soul I am". There is absolutely no equivalence, no radfems are organizing posses to get him (or ever have done so).
I am saying I and other women have noticed that he used criticizing feminist women as a shield for himself: "I am criticizing trans stuff, yes, but not like the Bad Mean Women of Terflandia". And then as it gets safer to say more critical stuff he's just sort of edged his way along into the terrain they were on the whole time, without EVER crediting them or saying "oh actually, they were right all along and it was sort of shitty of me to cast so many aspersions on them in order to clear a little pathway of respectability for myself."
None of us are organizing flying monkey brigades about this. We just see it and give it a blue-pencilly look.
I also don't believe this article fully on the whole adult thing. I think the benefits are likely inconsistent on adults and may not outweigh the considerable risks and societal issues, but the idea that the treatments has not benefited a single adult seems to lack credibility, and in any case, the "underlying theory" being bunk doesn't mean the treatment doesn't work. Chinese gave sick people tea based on underlying medicine theories that were wrong, but coincidentally germ theory says you cure many illnesses with clean, boiled water, so the treatment worked better then placebo regardless. Similarly, I am willing to believe for some people the treatment improves quality of life for some reason or another, tho whether it's enough people to justify the expense and risks of offering it and the people it fails is a fair question.another example is that many people had incorrect underlying theories about why limes cured scurvy, but their instinct was right: vitamin c in limes cures scurvy.
I assume there is some number of people that transition has provided genuine relief for, even with its costs, for the basic reason than I'm very uncomfortable making hard all or nothing statements (extreme all or nothing thinking is a big part of how we got into this mess to start with). But even in those cases, I have to wonder if there still could have been a better way, one without the harms and risks. To borrow from your examples of how certain treatments (limes for scurvy) worked without people knowing why, things can work but there are still better options. For example, smoking/nicotine suppresses appetite and many people find it helps them control their weight. Obesity can cause a lot of health problems but we wouldn't want to settle on smoking being the only or best treatment for a person no matter how well it works for them or if some people can happily smoke their whole lives without experiencing its serious complications.
Yeah, children and adults are two separate things. Children first of all don't have the capacity to make those kinds of decisions, and also have not fully matured into who they will be.
I have to admit that while I've looked at quite a bit of literature on adolescents, have never seen any literature on adults. I have though read a few accounts by adults, both male and female, who transitioned in adulthood, typically in their mid 20s, and were living satisfied lives after transitioning. The common threads I saw for all of them were that they had been dysphoric since childhood, they had given it a good go at conforming to the gendered expectations of their sex through adolescence, upon entering early adulthood they were still trying to give it a go, but to no avail, they sought counseling, not with a gender councilor, reflected quite a bit, and decided to transition, went to a gender clinic of some sort, where they went through quite a bit of gatekeeping and transitioned. Notable that they all were cognizant of and accepted social norms, were committed to adhere to those norms, and just wanted to get on with their life. And they are.
And I'm also aware of the grotesque crap you can see on X.
So yeah, I think it actually can work for some adults. Seems to be related to how well adjusted they are besides their dysphoria, and along with that if they have professional or career goals, that is they are not obsessed with their sex and gender.
And then there are total loons.
which article?
People tried to tell him, he fell into the true trans essence mistake.
Don't know anything, offhand, about his "true trans essence", but kind of think he's a bit of a fraud and a grifter. He had asked for feedback for his "I'm Writing Another Book" -- "about the United States’ youth gender medicine debate" -- but didn't even acknowledge my email to him on the topic:
https://jessesingal.substack.com/p/im-writing-another-book
And not terribly impressed that he's put many of his posts -- and comments -- behind a paywall, this one in particular, and my comment thereon:
https://jessesingal.substack.com/p/the-traditional-liberal-concept-of/comment/20956987
Jesse: "I’ve always understood gender to mostly be something that is imposed on you."
Steersman: "Arguably that's something of a serious if common misperception that tends to cause no end of problems. Try thinking that 'gender' refers to or encompasses BOTH personalities AND personality types. The same way that there is, for example, BOTH the personality type 'introvert' AND people who actually are introverted to a greater or lesser extent."
But what really kind of chapped my hide was his dismissal of Jonathan Stewart's more or less coherent endorsement of gender as a spectrum of personality types and behaviours. Though Singal does have some valid criticisms of Stewart who seems to be conflating sex and gender -- lotta that goin' round these days:
https://www.blockedandreported.org/p/episode-138-jon-stewart-and-john
Jon Stewart's performance as critiqued by Jesse and Katie in the BAR episode your reference was absolutely deranged. Even if he did mention at some point that gender is a spectrum, and Jesse may have dismissed that the point of that episode was to point out the garbage that Stewart and Oliver were spewing about "gender medicine", how they were openly promoting the lies of the GAC crowd, and how much of a shit show Stewart and Oliver's own research staff, who writes their material, are.
Jesse and Katie's typical modus operandi is dive into crazy and not well reported media reporting, often occurring on the internet, can be. This episode was just that. It just happened to be about two talk show hosts who thought they could lecture their audience about the virtues of GAC, and Jesse and Katie basically took them down.
I DID say that Singal had some valid criticisms. But point taken -- I quite agree that Stewart's (mis)understanding of sex and gender is a large part of the problem.
In particular, Stewart, along with too many others, seems to "think" that "male" and "female" encompass the "behavioral, cultural, or psychological traits" that are typically associated with one sex or the other, and that are more reasonably the defining criteria for the entirely separate category of "gender":
https://www.merriam-webster.com/dictionary/gender#usage-1
Much of the transgender clusterfuck -- excuse my French -- turns on the conflation of sex and gender, and on a general reluctance to define exactly what is meant by each of those terms. Hence my falling back on the strict biological definitions for the sexes as the only defensible "line in the sand".
But Singal did have a nice summary of that problem in his preliminary review of Byrne's "Trouble With Gender: Sex Facts, Gender Fictions" -- even if that book is rather badly flawed in many ways:
JS: "... but the fact of the matter is that our national conversation about sex and gender and gender identity is completely hamstrung by dumb and incoherent language games. Some of the biggest and most influential players in this space often refuse to even define their terms, let alone use them consistently, or to even try to make clear exactly what they’re arguing when they argue. .... I do think the present, extremely sorry state of philosophy when it comes to sex and gender can be partly explained by the contagious allergy to debate and discussion of difficult subjects that has been contracted by so many thinkers and activists, especially younger ones. "
https://jessesingal.substack.com/p/win-a-copy-of-trouble-with-gender
Sadly, UB is more or less in that same boat of "refusing to define their terms" -- not quite sure how she thinks that workable laws around women's rights can be created without them.
But you might have some interest in a Substack post by "Eliza Mondegreen", in particular my conversation with Hippiesq -- another NYC lawyer, and mother of a dysphoric teenager -- who endorses that same definition for gender, even if we're "quibbling" over the definition for sex itself. Of particular note:
Hippiesq: "Sorry to go on and on, but, like you, I think the definition of 'gender' is a big part of the problem here. .... I guess [gender] could be hundreds of different intersecting spectrums ... One might fall well into the masculine zone of some of these little spectrums, towards the middle for others, and more towards the feminine on others ..."
https://elizamondegreen.substack.com/p/lies-darn-lies-and-journalism-with/comment/63147198
If we can't agree on what words mean then we haven't a hope in hell of resolving issues that turn on them.
> "But Cass doubled down on this sketchy claim when interviewed by the New York Times in May: 'There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access …' ...."
In other news, American Pediatric Society affirms that there are children who "absolutely benefit" from a steady diet of cake and ice cream devoid of any meat, potatoes, and vegetables. Details at 11 ... 🙄🙂
Barking mad. Hardly much better than the demented premises of those "gender doctors" who "think" that a child who exhibits some "gender non-conformance", some sex atypical personality traits should have their genitalia mangled -- trans-mogrified -- into some Frankensteinian resemblance of those characteristic of the other sex.
Absolutely monstrous. Medical scandal and crime of the century. Bunch of "doctors" should lose their licenses if not be strung up by their nuts and left to twist in the wind -- figuratively speaking of course ...
There is no definition of gender that justifies the actions being taken in the name of gender. We will eventually win if we just keep demanding that they define gender.
Kind of depends on what actions you have in mind, on what you mean by the term "gender", and which "they" you're referring to.
But it doesn't help much when you -- and far too many others -- insist that the only definition for "gender" is as a "grammatical class", and flat-out reject more scientifically tenable definitions for the term such as this one from Merriam-Webster:
MW: "gender: 2b) the behavioral, cultural, or psychological traits typically associated with one sex"
https://www.merriam-webster.com/dictionary/gender#usage-1
Whole concept of gender is a bit of a dog's breakfast, and it is maybe moot whether the idea is much better than phrenology or Chinese fortune cookies for categorizing personality types. But there is, in fact, a great deal of solid evidence that there are significant differences, by sex, in those "behavioural, cultural, or psychological traits typically associated with one sex" or the other. Sexual dimorphism writ large:
https://en.wikipedia.org/wiki/Sexual_dimorphism
https://www.realityslaststand.com/p/yes-male-mammals-tend-to-be-larger
https://4thwavenow.com/2019/08/19/no-child-is-born-in-the-wrong-body-and-other-thoughts-on-the-concept-of-gender-identity/
You might also have some interest in my post on the "A Multidimensional Gender Spectrum" which attempts to put the concept on a more scientific footing, and which more or less starts off from that MW definition:
https://humanuseofhumanbeings.substack.com/p/a-multi-dimensional-gender-spectrum
I expect "we" are more likely to "win" if we have "steelmanned" the concept. And have shown thereby that many of "their" claims -- like "born in the wrong body" and "change your genitalia, change your sex (act now! offer ends soon! 🙄) " -- are so much incoherent and quite unscientific twaddle, at best.
After reading Andrew Doyle's piece a few days ago on take over of dictionaries by activists, I'm a little leery about using dictionary definitions these days. Although that one seems not to be controversial.
While largely synonym for sex while I've been alive, and from what I can see before that, not so clear cut, at least in western society these days. I have to admit that I find the general kerfuffle a bit puzzling, as during my teenage years and through my 20s it seemed that we were getting a lot more accommodating to the idea that the member of one sex could behave in ways previously associated with the other sex in terms of interests and activities, displayed emotions, etc. Dress got a lot more androgenous, at least in professional attire and recreational attire. I guess I didn't they pay attention until more recently, when gender stereotypes have seemed to become more pronounced, especially with respect to behavior. And gender identity has become this huge thing, mostly for younger people (like below 30). Are people really thinking that much about gender? I guess so, but why?
So it's probably useless to try to define it by categories. Maybe not even worry about it, and just base everything on sex.
Or, be completely objective about it, and just classify it as:
- Man=male
- Woman=female
-Transman=female that presents like a man, including through modification''
- Transwoman=male that presents as a woman including through modification
- Non-binary=could be male or female, but hard to tell
Spaces (restrooms, shelters, prisons, etc) are by sex. For spaces that are used by trans or nonbinary, there are unisex spaces
Sports are by sex and sex only.
Other than that, live your life, no discrimination.
Easy
Thanks for the heads-up about Doyle:
https://andrewdoyle.substack.com/p/the-activist-takeover-of-online-dictionaries
Though you might post a link or two yourself -- as all the Substack veterans say, "sharing is caring" ... 😉🙂
But as evidence of the rot that transgenderism has wrought -- so to speak -- you might take a gander at the Merriam-Webster definitions for "male" and "female" as he only gave one for "female":
https://www.merriam-webster.com/dictionary/male
https://www.merriam-webster.com/dictionary/female
"male: 1b) having a gender identity that is the opposite of female"
"female: 1b) having a gender identity that is the opposite of male"
The "Circular Definitions R Us" crowd.
But it's kind of necessary to have some "authoritative source" stipulate the definitions in play -- otherwise they're kind of useless: anyone can play. You might have some interest in an essay by a philosopher of science on the topic of definitions in general:
https://www.sfu.ca/~swartz/definitions.htm#part5
If anyone had suggested 10 years ago that one day a quasi-religious scarification cult that valorizes child sacrifice would become our - "new normal" - I would have thought them daft. Amazing!
why not both?
Yes, gender medicine is the University of Phoenix of medicines. The burden is not on us to be like "I will show you scientifically that these lying shady fucks lie like fuck all the time", we can just cut to the chase and say: look at these lying shady fucks lying all the time, they are obviously up to SHENANIGANS.
But also -- we know that if high quality large cohort studies are done of outcomes among young people, they absolutely will show catastrophic results. We should agitate for those studies being done and we should absolutely point to the terrible evidence base for the interventions that are being done, all the time, right now.
Good point, but I'm not calling for RCTs on humans because I think the treatment is unethical. In theory there might be a compromise here -- ban PGM except in the context of RCT -- but I'm not sure any trustworthy doctors at this point would agree to administer the treatment to kids.
I dread the chicanery that gender doctors would engage in trying to rig the study, hide info, delay reporting results, mislead the media. Trans-ID subjects would be peer-pressured to tell researchers they were happy. Control group kids would be pressured to drop out or claim misery. Etc.
Oh agreed totally about RCTs
No prospective studies, agreed that would be unethical to get new young people in the pipeline
I mean well designed follow up studies on big cohorts who already were subjected to this “care”
How are their outcomes? How are their general morbidity rates compared to peers of their age?
Also maybe we'd seek to understand and delineate what trans actually is, why it's increasing and how malleable children are to media grooming?
Would be a reasonable course, however going to be dawn challenging, at least in US due to the balkanization of health care delivery and medical records, which would make it difficult to put together a subject roster for a retrospective study. Much more feasible in a European country like UK with a national health service,or a country like Germany with at least a national insurance system that can track individual use of meduca
medical system. Apparently Cass was rebuffed when trying to gain access to records for adult services having to do with gender affirming care, which would have allowed some level of retrospective analysis of those that had entered as adolescents and then moved into adulthood. Maybe that will get done. There was a recent paper out of Germany which looked at essentially resistance. Found over 60%, just by looking at diagnostic codes in records. So assuming same record system would indicate codes for people that had received medical procedures for gender issues, and they could be contacted and agree to interview to examine long term outcomes, there is an opportunity.
Yes, Chen et Al 2023 for instance, with its missing 6/8 protocol outcomes.
And yes, the placebo/nocebo effects are really hard to sort out when you've got young people and their communities being falsely told they'll commit suicide unless given medical or social transition.
The latest Alabama docs show that SEGM really got under the skin of WPATH and for that I’m down w EBM …From James Cantor’s Alabama court report “The document’s introduction includes a list of adversaries and obstacles which “Eli”
felt were attacking trans health care, including “academics and scientists who are naturally
skeptical” and “continuing pressure in health care to provide evidence-based care.” It is
impossible to exaggerate the fatal importance of Eli’s categorization of scientific skepticism and
evidence-based medicine as a problem rather than the goal. An objective observer would
perceive SOC-8 to be under attack from evidence-based care exactly because SOC-8 does not
embody evidence-based care, although WPATH and other advocates of medicalized transition
assert that it does. As I have detailed in my initial report and in this supplemental report,
multiple, substantial portions of SOC-8 are constructed based on exactly the anecdotal,
ambiguous, subjective, and insufficient features that evidence-based medicine rejects as
unreliable, and is designed to replace.
Wow, brilliant writing!
What I don't understand is how you could convince people or legislatures to ban the procedure _withouut_ using ebm and lots of studies. You can preach to the choir all you want, but do you ever think California or new York would be persuaded to discontinue their gender clinics unless the evidence was overwhelming that the treatments didn't work? Saying the belief in transcendent gender is bunk is too "wishy washy" to convince anyone who isn't already stridently anti trans or easily open to persuasion on the topic. And the supreme court would not be interested in making a procedure illegal nationwide unless a law came up about the issue; nor would it make it illegal in other countries. The odds of a law making gender medicine illegal nationwide getting 60 votes in the senate in the next twenty years seems exceedingly remote compared to doctors simply realizing the treatment doesn't work or medical authorities realizing this and punishing doctors who disagree , but the latter path simply requires evidence, not "vibes". (As a follow up, the states could and would challenge a national law, asserting that in state medical practices are not a federal matter, and they might win this challenge, so no matter what, you have to convince liberal states to discontinue this on their own accord; and simply saying the whole thing is bunk alone isn't going to convince them.
The burden of persuasion for such an invasive treatment should be on gender doctors. New Yorkers will realize that once they find out about the gender doctors' turpitude.
Doctors who look at this carefully also are getting shocked at what's being done in their name. They've misplaced their trust.
It doesn't really matter what the burden should be, the bar for upending established treatments, even insanely stupid ones, is usually conclusive evidence they don't work. That's just the unfortunate reality based on how we've thwarted other dead end science.
Check out the es 2009 guidelines? Also Hembree et Al!
They don’t take them down with science, they take them down with courage to stand up to and face down bullies.
Just like in every other context.
It’s not really about science, it’s about bravery.
Thank you!
Spot on as usual, and a treasure trove of references to support what you say, again as usual...again, thank you!
"For years I’d litigated against a scammy for-profit college, which entailed interviewing and deposing many of its workers. The gender clinic ex-employee reminded me of them. Suddenly I started drawing connections between gender medicine and other predatory industries. That’s the perspective that drives many of my posts here."
Predatory is right. I'm not sure trans rights activists, the often used term, is the right description, as the question is what constitutes "rights". Trans medicalization industry? It's an industry.
Very interesting perspective. Thanks