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

@Sunnibee

This is a good article about a similar condition to gender dysphoria - Body integrity identity disorder (BIID) or body integrity dysphoria.

https://www.theatlantic.com/magazine/archive/2000/12/a-new-way-to-be-mad/304671/

Archived here: https://archive.is/OsvZ6

The people who suffer from this condition often feel that they have a limb which doesn't belong to them, or that there is something else wrong with one or more of their body parts. This sounds very similar to your description of gender dysphoria being focused on healthy and normal body parts.

The article also makes the comparison with gender dysphoria.

I think you are conflating two different things.

Saying someone experiences their body as incongruent is a description of their subjective experience.

In order to experience this a person doesn't need to believe that there is a biological defect in their body, or that their anatomy is objectively abnormal. A trans person may well fully recognise and acknowledge that there is nothing objectively "wrong" about their body, but yet they still experience profound incongruence.

So "delusion" isn't quite the right word for it. Clinically, a delusion is a fixed false belief. Gender dysphoria doesn't depend on holding a false belief about one's anatomy; it describes a subjective psychological experience of distress or incongruence. Whether that experience has one explanation or another is a separate debate, but simply experiencing incongruence is not, in itself, a delusion

One doesn't need to have some concept of the reality of gender to have sex dysphoria existing

Right exactly! That's what I'm trying to say.

A common mistake is to assume that, in order to experience dysphoria, someone must first adopt a particular theory of gender, but that isn't the case at all. A person can experience dysphoria regarding of their theories about gender and sex. Young children often experience dysphoria before they have any sophisticated ideas about gender identity, gender roles, or philosophy. The distress appears as an immediate, embodied sense that something is wrong about their sexed body or being treated as a member of that sex category. It isn’t reasoned into existence.

Where I think your argument becomes confused is in two ways.

First, you move from “the brain generates the experience” to “the brain is getting reality wrong.” Those aren’t the same thing. People often misunderstand trans people as being "deluded" about their bodies, but that isn’t generally what’s being described. Trans people are not under the illusion that they have different sexual anatomy. They know what their bodies are. The distress isn’t caused by a false belief about their anatomy; it’s caused by the fact that their anatomy is experienced as profoundly wrong or incongruent.

More fundamentally, contending that gender isn't "real" highlights another misunderstanding. No one is suggesting that gender is an independent object in the world. Gender identity is simply the language given to describe a psychological experience.
While gender identity itself isn't a "thing" the psychological experience of it is real. This is true of any psychological experience. Pain isn’t an independently existing entity. Hunger isn’t. Our sense of body ownership isn’t. They’re subjective experiences generated by the brain, but they’re nonetheless real features of human experience.

@Sunnibee

This is a good article about a similar condition to gender dysphoria - Body integrity identity disorder (BIID) or body integrity dysphoria.

https://www.theatlantic.com/magazine/archive/2000/12/a-new-way-to-be-mad/304671/

Archived here: https://archive.is/OsvZ6

The people who suffer from this condition often feel that they have a limb which doesn't belong to them, or that there is something else wrong with one or more of their body parts. This sounds very similar to your description of gender dysphoria being focused on healthy and normal body parts.

The article also makes the comparison with gender dysphoria.

The distress isn’t caused by a false belief about their anatomy; it’s caused by the fact that their anatomy is experienced as profoundly wrong or incongruent.

And this is the delusion. The feeling that there is something wrong about or incongruent about their body, when in fact there is absolutely nothing wrong with it.

This is an interesting X thread:

https://x.com/wontsomeonethi2/status/2069800467811459454

The poster is a developmental psychologist who says she has spoken to Cass and that Cass knows that these children are not 'true trans'.

One doesn't need to have some concept of the reality of gender to have sex dysphoria existing

Right exactly! That's what I'm trying to say.

A common mistake is to assume that, in order to experience dysphoria, someone must first adopt a particular theory of gender, but that isn't the case at all. A person can experience dysphoria regarding of their theories about gender and sex. Young children often experience dysphoria before they have any sophisticated ideas about gender identity, gender roles, or philosophy. The distress appears as an immediate, embodied sense that something is wrong about their sexed body or being treated as a member of that sex category. It isn’t reasoned into existence.

Where I think your argument becomes confused is in two ways.

First, you move from “the brain generates the experience” to “the brain is getting reality wrong.” Those aren’t the same thing. People often misunderstand trans people as being "deluded" about their bodies, but that isn’t generally what’s being described. Trans people are not under the illusion that they have different sexual anatomy. They know what their bodies are. The distress isn’t caused by a false belief about their anatomy; it’s caused by the fact that their anatomy is experienced as profoundly wrong or incongruent.

More fundamentally, contending that gender isn't "real" highlights another misunderstanding. No one is suggesting that gender is an independent object in the world. Gender identity is simply the language given to describe a psychological experience.
While gender identity itself isn't a "thing" the psychological experience of it is real. This is true of any psychological experience. Pain isn’t an independently existing entity. Hunger isn’t. Our sense of body ownership isn’t. They’re subjective experiences generated by the brain, but they’re nonetheless real features of human experience.

One doesn't need to have some concept of the reality of gender to have sex dysphoria existing. Brains get stuff wrong. Anorexia doesn't have an underlying reality of people having an independently existing mind-BMI, the mind is just stuck in a dangerous rut where its perceptions and reality wildly diverge.

It’s difficult to point to one study that proves the cause of gender dysphoria—psychological conditions rarely have that kind of evidence. My view comes from the broader body of clinical literature and patient accounts.

Taken together, they point away from the idea that gender incongruence is simply the internalisation of gender stereotypes or social expectations.

For example:

• Many trans people grow up in families with very traditional views about sex and gender, where being trans is actively discouraged or rejected. Yet their gender incongruence persists despite those social pressures.
• Many trans people have interests, personalities and behaviours that are typical of their natal sex, yet still experience profound gender incongruence.
• There are masculine trans women and feminine trans men, which is difficult to reconcile with the idea that transition is simply a desire to conform to gender stereotypes.
• Some trans people explicitly reject gender stereotypes, gender as a construct and hold sex-realist views, yet their gender incongruence persists.

If gender incongruence were fundamentally caused by internalising gender stereotypes, we would expect trans people to hold more rigid stereotypes than everyone else. In fact, the evidence points in the opposite direction: transgender children tend to endorse gender stereotypes less strongly and are more accepting of gender non-conformity than their cisgender peers (eg Olson, K. R., & Enright, E. A. (2018). Do transgender children (gender) stereotype less than their peers and siblings? Developmental Science, 21(4), e12606. https://doi.org/10.1111/desc.1260

Most importantly, the detailed accounts of persistent gender dysphoria simply don’t read as “I believed boys should do X and girls should do Y.” They are far more consistently described / characterised as a deeply embodied experience of incongruence with one’s sexed body. Whatever its ultimate cause, that experience appears to involve how the brain perceives and represents the body, not merely internalised beliefs about gender roles.

None of this proves a single cause of gender dysphoria. But it does make the hypothesis that it is fundamentally caused by internalised gender stereotypes an inadequate and entirely unconvincing explanation of the body of evidence.

It’s difficult to point to one study that proves the cause of gender dysphoria—psychological conditions rarely have that kind of evidence. My view comes from the broader body of clinical literature and patient accounts.

Taken together, they point away from the idea that gender incongruence is simply the internalisation of gender stereotypes or social expectations.

For example:

• Many trans people grow up in families with very traditional views about sex and gender, where being trans is actively discouraged or rejected. Yet their gender incongruence persists despite those social pressures.
• Many trans people have interests, personalities and behaviours that are typical of their natal sex, yet still experience profound gender incongruence.
• There are masculine trans women and feminine trans men, which is difficult to reconcile with the idea that transition is simply a desire to conform to gender stereotypes.
• Some trans people explicitly reject gender stereotypes, gender as a construct and hold sex-realist views, yet their gender incongruence persists.

If gender incongruence were fundamentally caused by internalising gender stereotypes, we would expect trans people to hold more rigid stereotypes than everyone else. In fact, the evidence points in the opposite direction: transgender children tend to endorse gender stereotypes less strongly and are more accepting of gender non-conformity than their cisgender peers (eg Olson, K. R., & Enright, E. A. (2018). Do transgender children (gender) stereotype less than their peers and siblings? Developmental Science, 21(4), e12606. https://doi.org/10.1111/desc.1260

Most importantly, the detailed accounts of persistent gender dysphoria simply don’t read as “I believed boys should do X and girls should do Y.” They are far more consistently described / characterised as a deeply embodied experience of incongruence with one’s sexed body. Whatever its ultimate cause, that experience appears to involve how the brain perceives and represents the body, not merely internalised beliefs about gender roles.

None of this proves a single cause of gender dysphoria. But it does make the hypothesis that it is fundamentally caused by internalised gender stereotypes an inadequate and entirely unconvincing explanation of the body of evidence.

Which is no justification at all.

Well quite, "Jo" doesn't justify it at all.

In Cass's argument "Jo" justifies the trial of PBs because otherwise the parents will buy Lupron for their child on the dark web.

Well quite, "Jo" doesn't justify it at all. "Jo"s story has shades of David Reimer and that didn't have a happy ending.

Is that how you see Cass?

A world where it seems that we cannot trust anyone who has any sort of finger in the gender-affirming care pie.

Any luck with that clinical literature that shows that social factors don't adequately explain gender incongruence in some people? Preferably something fairly recent where modern psychological treatments have been used intensively within a neutral, exploratory approach rather than in a gender-affirming framework.

A world where fictional and wildly unrealistic stories are invented and then presented as if they were meaningful examples of kids with gender dysphoria in policy debates?

Welcome to our world

I agree that it's a figment of her imagination and unrealistic. But How does this case justify the trial? Surely it would be the opposite? If this were really the kind of thing going on..?

I agree that it's a figment of her imagination and unrealistic. But How does this case justify the trial? Surely it would be the opposite? If this were really the kind of thing going on..?

I agree that it's a figment of her imagination and unrealistic. But How does this case justify the trial? Surely it would be the opposite? If this were really the kind of thing going on..?

I suppose it is technically possible to get all the way to the end of Primary school without realising that if you have a penis that makes you a boy.

I don't believe that it is possible even with brainwashing by transactivist parents. The fictional "Jo" is a figment of Baroness Cass's imagination. She says it was based on what she has been told by parents who have transed their children but I suspect she is exaggerating to support her argument in favour of the PB trial. In any case parents who "trans" a two year old child are hardly going to be reliable sources as they are so invested in their child being "trans".

I suppose it is technically possible to get all the way to the end of Primary school without realising that if you have a penis that makes you a boy.

I don't believe that it is possible even with brainwashing by transactivist parents. The fictional "Jo" is a figment of Baroness Cass's imagination. She says it was based on what she has been told by parents who have transed their children but I suspect she is exaggerating to support her argument in favour of the PB trial. In any case parents who "trans" a two year old child are hardly going to be reliable sources as they are so invested in their child being "trans".