Netherlands Puberty Blocker Review Comes to Opposite Conclusion, Dismisses Cass Review

I hope that in "taking account the potential benefits, risks and uncertainties of all available options" you are including the wider impact on the people around the trans person and on the laws and social contracts we all expect to support us?

This is not just about what might make trans people feel better, but also whether that creates a fair demand on the people who have to accomodate it, especially women who are the ones being expected to play along with woman-identifying males in our spaces and under our name.

So the meaning is derived from one sex needing different services to the other sex because of their sex? So when you said this

It's not necessarily about sexism per se, it's about gendered categories. I don't see how we can ever completely eliminate those, because - (as gender critical philosophy persistently reminds us)- of the salience of human reproductive roles. As long as we have a society that recognises and gives any meaning/ recognition to these categories/ roles, there will be people who feel that they are in the wrong one.

in an earlier post, you were talking about people’s need for different facilities or services because of their sex and that there will be some people who feel they need the services for the opposite sex?

I am finding it hard to imagine that the ECHR recognising that sex matters sometimes is a reason for someone’s feeling of gender distress. Can you explain more precisely what you mean and what is a gendered category?

No, you are underestimating me.

That's understandable.

You may not have been here very long to read what I have said in the past. An advanced search may be illuminating.

It is probably worth looking at my posts a year or two back now as I've largely given up delving into the nuances of why this is being done to women, preferring instead to focus on the injustice of it being done to women at all. Because no matter what the very good reason someone might have for it, it is still an injustice being done to women.

So I would gently suggest you are a little arrogant to asume pepople have not thought about this as much as you have, rather than considering whether people have in fact thought about it more than you for much longer than you and are talking to you ahead of you on a path of thought that they much further along than you.

I am saying:

1. It doesn't matter whether it's a complex phenomenom or (as I actually believe) a symptom with many different root causes, the male person's belief that they are a woman is still either (a) correct, because being "a woman" turns out to be a mental phenomenom not a physical one and most critically for this to work we can objectively observe it in everyone who claims to be a woman rgardless of their sex and no one who does not, or (b) incorrect, in which case regardless of the cause it is a delusion.

and also

2. Whether it is a delusion or a new "real" defintion of a woman, the fact of female people still exists, the things that happen to us because we are female still exist. So even if (a) were to be true and we have found a "real" mental commonality between trans women and female people who identify as women, it is still a choice whether to make this the definition of "woman" and so take the reality of the female body, the history of female exploitation, abuse and margialistion because of our bodies and the social and physical conseuences we still face today off the table when it comes to being a "woman". It is still a choice to decide none of that matters but this inner new commonality of mind does, not just enough to name it as a newly understood feature of humanity that oten, but not always sits alongside womanhood but to name it as womanhood and in so doing unname the female half of humanity altogether.

And that is what I find offensive and degrading. Not just a defintion of womanhood that is based on sterotypes (although let's face it, we all know that and homophobia is almost certainly what is really behind this), but the idea that the entire female half of the species needs redefining to accomodate men's feelings of identity at all.

I understand that is your position. However, the point is that uncertainty about a treatment does not automatically mean that withholding it is risk-free or preferable. The question is a comparative one: what approach best supports young people experiencing significant distress, taking into account the potential benefits, risks, and uncertainties of all available options.

The issue is not whether psychological care should be offered—it should be—but whether it is appropriate to assume that psychological intervention alone will resolve the distress for everyone.

No. The issue is whether it's ever appropriate to experiment on children with unproven physical treatments, instead of providing only psychological treatments.

I don't think the choice is as simple as "psychological treatment versus physical treatment". Psychological support is an important part of care for anyone experiencing distress, including people with gender dysphoria. But the question clinicians have to consider is what approach best addresses the source of that distress for each individual.

For some people, psychological support may be sufficient. For others, distress may persist despite psychological approaches, and clinicians may consider other interventions. The issue is not whether psychological care should be offered—it should be—but whether it is appropriate to assume that psychological intervention alone will resolve the distress for everyone.

Nobody is suggesting that treatment should be withheld. The question is whether the treatment (for the psychological condition of gender dysphoria) should be psychological or physical.

Gotta dash, but this is the post I really look forward to you replying to @Sunnibee

It is also potentially irresponsible not to provide appropriate treatment where someone is experiencing significant distress and where untreated symptoms may have serious consequences. The fact that long-term evidence is incomplete does not automatically mean that withholding treatment is the safer option; it means clinicians have to weigh the potential benefits and risks of all available approaches.

The question is not simply "are there uncertainties?"—there are uncertainties in many areas of medicine. The question is how those uncertainties compare with the harms of leaving a condition untreated and what approach best supports the individual patient.

It strikes me as massively irresponsible to put young people on treatments where the longterm impacts are not known, especially for an issue that barely existed 15 or 20 years ago, and which appears to be psychological.

I'm not talking about any specific stereotypical meaning attached to being male or female. I'm talking about the act of recognising and giving meaning to something - the process by which societies recognise categories and give them social significance.

So for example - the EHRC guidance recognises sex-based categories as relevant to how some services should be organised. That is a social meaning attached to a category, not a claim that men and women must conform to particular stereotypes.

it's not that a 'man' thinks he's in the wrong category because 'he can't get pregnant', it's that society gives recognition and meaning to the concepts of 'male'/'female' based on biological differences

Please describe one or more of these meanings. I can’t think of any which aren’t stereotypes.

I think the disagreement here is that you are assuming the only way someone can experience gender is through stereotypes about how men and women think, behave, or present. I would gently challenge that assumption. Gender incongruence is a complex psychological phenomenon, and reducing it to a single explanation risks overlooking the diversity and complexity of people's actual experiences.

He didn't say "all" though did he?

He said based on his experience, this is what the proportions seem to be.

Whereas you appear to be saying that based on your feeling that this can't be right, this can't be right. And you expect this has equal weight and authority.

The phrase "believes he's a woman" already assumes that the person's experience is merely a mistaken belief rather than a complex psychological phenomenon.

They are the same thing.

THEY ARE THE SAME THING.

Either 1:
He is a woman, which means there is really, in an objectively measureable way, something in him that is also present in all other women and all other trans women but not in men or trans men AND society has decided that this "thing" is the true source of womanhood rather than a female body,

or 2:
He is not a woman but very sincerely believes himself to be.

If the latter is true, then this is a delusion. The reason for it does not change that. It does not become any more true because there is a (hypothetical) organic reason he believes this rather than a social one.

If there were to be a complex psychological phenomenon that caused humans to believe they could fly, this would stil be a deluiosn. They would not in any way be more able to fly than someone who merely has a mistaken belief.

No, it is an argument from evidence that is bolstered by authority.

Quite. Stereotypes for me but not for thee.

Expertise is relevant, but it does not make someone's conclusions immune from scrutiny.

People can have considerable clinical experience and still make claims that require challenge, particularly when those claims extend beyond their direct observations to an entire group of people and have potentially harmful real world consequences.

To say "Dr Hakeem has treated many patients, therefore his generalisation about all trans people must be true", is an appeal to authority rather than an argument.

It is asking whether the conclusion being drawn is proportionate to the evidence.

Well, unless you have better evidence, I'll stick with the conclusions of someone who is highly qualified and works in the field.

On what basis can a man be said to be a woman because of how he feels that is not applying sterotypes about women to the entire group of women?

I personally find the assumption that women all have the same way of thinking and feeling, and that it is this inner feeling that makes us women rather than simply our bodies incredibly offensive and degrading, and it undeniably is having real world consequences for women.

Why is this somehow ok just because now it's trans people stereotyping everyone else?

Dr Az Hakeem is promoting harmful stereotypes about trans people.

He is a consultant psychiatrist with over twenty years experience of treating gender dysphoria. What are your qualifications to contradict him?

This isn't about dismissing an uncomfortable claim because it is unpleasant. It is about whether a claim is accurate and whether the way it is framed is justified. I have no problem acknowledging that trans people are not a completely homogeneous group and that some people who seek gender-related care may have a range of motivations or experiences.

Criticising a generalisation because it risks reinforcing harmful stereotypes is not the same thing as saying "don't discuss difficult topics". It is asking whether the conclusion being drawn is proportionate to the evidence.

Blanchard's typology is a contested theory and does not provide a straightforward basis for making claims about all trans people. His samples were drawn from people attending specialist services in a particular time and place; they were not representative samples of the wider trans population, either then or now.

No one is saying that if your kid likes princess dresses they are trans.

A bold claim. The below has been a popular resource in schools through this period.

We wouldn’t give chemo to someone who thought they might have cancer but it couldn’t be proved.

That's a good analogy @InfoSecInTheCity I'll remember it!

The Napoleon analogy doesn't really fit because it treats gender dysphoria as a belief disorder. The phrase "believes he's a woman" already assumes that the person's experience is merely a mistaken belief rather than a complex psychological phenomenon. Gender dysphoria is not understood clinically as simply a false belief that someone is a different person.

A person with gender dysphoria can understand and be aware of the physical characteristics of their body while still experiencing significant distress related to their sex. Recognising that distress and treating it appropriately is not the same thing as affirming a delusion.