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

I didn't say it was 'stupid'. Why do you think Cass's example is stupid?

Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

Next post:
We don't have the scientific understanding to explain why some people have gender dysphoria

You are all over the shop @Sunnibee

Maybe I just don't understand how you have presented it. This is nonsensical- although of course I don't believe Cass wrote it. "He is not even that elusive creature the 'truly trans' child with the magical internal feeling."

What is it that you want me to comment on?

I agree that assessment processes should have robust safeguarding procedures to ensure parents aren't pushing this on a child because they have FDA or some such.

Thank you for your productive engagement ,

Gender' only exists in social contexts because it is predicated on how people perceive and attribute certain characteristics based on one's sex.
Yes
The problem is not one's sex - but one's feelings about it based on what one thinks is expected because of it.

I don't think that's quite right.
These feelings aren’t caused by what someone thinks is expected of their sex. Gender dysphoria isn’t about believing “boys should like football” or “girls should wear pink.”
It's a deep-seated, embodied sense that one’s body or sex category is wrong. The distress isn’t produced by stereotypes; it’s about the body/ sex itself.

A child may hate the colour pink, prefer football to netball, and have no interest whatsoever in conventionally feminine things. Yet every day they may still beg to wear a pink dress and play netball—not because they enjoy those things, but because doing so allows them to be recognised by others as the girl they feel themselves to be. The pink dress isn’t the cause of the dysphoria; it’s an attempt to alleviate it.

So yes we could eliminate the idea that certain colours or sports are for boys and girls (and we definitely should because gender stereotypes suck). But there’s no reason to think that eliminating those stereotypes would eliminate gender dysphoria, because those stereotypes weren’t what caused it in the first place.

There is, however, a more philosophically interesting argument. If sex categories themselves had absolutely no social meaning or consequence, perhaps gender dysphoria would disappear because there would be no meaningful category in which to feel misplaced. I can see the logic in that.

Even then, though, people would still have different bodies, and many people with gender dysphoria experience profound distress about those physical characteristics themselves. And in any case, the premise is entirely hypothetical. Sex categories exist because human beings are sexually dimorphic. Those biological differences have significant social consequences—for example, only some people become pregnant. It isn’t realistic to imagine a society that simply doesn’t notice or attach any significance to those differences.

So no, I don’t think it’s accurate to say that gender dysphoria can be “cured” by abolishing gender stereotypes. Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

Pointing out inconsistences is productive.

This is what Cass wrote about 'Jo'. You said Jo was a stupid example. Why is it stupid?

“There was considerable discomfort in the House and more widely on social media about my account of ‘Jo’, a biologically male child who was socially transitioned to a girl at 2½ and presented at around 10-11 afraid to go to secondary school for fear of being ‘outed’, later retreating to their bedroom and developing weak bones due to inactivity. ‘Jo’ is not a specific case, but represents a group of similar children being seen in the new services, and previously at the Tavistock. Although social transition is usually later (from 4 onwards), I was told during the Review about children who had been transitioned at Jo’s age and younger. “I have been asked why safeguarding procedures would not have been initiated when ‘Jo’ was a toddler, but these children are frequently living in stealth (i.e. those around them do not know their biological sex) and do not come to medical attention until much later as puberty looms. A male child who has socially transitioned at 4 and presents at 11 will have next to no recollection of being a boy. They are not making a decision to be a girl – by that time they just believe themselves to be a girl and have no frame of reference to think differently. Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if they had not been socially transitioned at that very early stage.”

Gender' only exists in social contexts because it is predicated on how people perceive and attribute certain characteristics based on one's sex.
Yes
The problem is not one's sex - but one's feelings about it based on what one thinks is expected because of it.

I don't think that's quite right.
These feelings aren’t caused by what someone thinks is expected of their sex. Gender dysphoria isn’t about believing “boys should like football” or “girls should wear pink.”
It's a deep-seated, embodied sense that one’s body or sex category is wrong. The distress isn’t produced by stereotypes; it’s about the body/ sex itself.

A child may hate the colour pink, prefer football to netball, and have no interest whatsoever in conventionally feminine things. Yet every day they may still beg to wear a pink dress and play netball—not because they enjoy those things, but because doing so allows them to be recognised by others as the girl they feel themselves to be. The pink dress isn’t the cause of the dysphoria; it’s an attempt to alleviate it.

So yes we could eliminate the idea that certain colours or sports are for boys and girls (and we definitely should because gender stereotypes suck). But there’s no reason to think that eliminating those stereotypes would eliminate gender dysphoria, because those stereotypes weren’t what caused it in the first place.

There is, however, a more philosophically interesting argument. If sex categories themselves had absolutely no social meaning or consequence, perhaps gender dysphoria would disappear because there would be no meaningful category in which to feel misplaced. I can see the logic in that.

Even then, though, people would still have different bodies, and many people with gender dysphoria experience profound distress about those physical characteristics themselves. And in any case, the premise is entirely hypothetical. Sex categories exist because human beings are sexually dimorphic. Those biological differences have significant social consequences—for example, only some people become pregnant. It isn’t realistic to imagine a society that simply doesn’t notice or attach any significance to those differences.

So no, I don’t think it’s accurate to say that gender dysphoria can be “cured” by abolishing gender stereotypes. Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

Gender' only exists in social contexts because it is predicated on how people perceive and attribute certain characteristics based on one's sex.
Yes
The problem is not one's sex - but one's feelings about it based on what one thinks is expected because of it.

I don't think that's quite right.
These feelings aren’t caused by what someone thinks is expected of their sex. Gender dysphoria isn’t about believing “boys should like football” or “girls should wear pink.”
It's a deep-seated, embodied sense that one’s body or sex category is wrong. The distress isn’t produced by stereotypes; it’s about the body/ sex itself.

A child may hate the colour pink, prefer football to netball, and have no interest whatsoever in conventionally feminine things. Yet every day they may still beg to wear a pink dress and play netball—not because they enjoy those things, but because doing so allows them to be recognised by others as the girl they feel themselves to be. The pink dress isn’t the cause of the dysphoria; it’s an attempt to alleviate it.

So yes we could eliminate the idea that certain colours or sports are for boys and girls (and we definitely should because gender stereotypes suck). But there’s no reason to think that eliminating those stereotypes would eliminate gender dysphoria, because those stereotypes weren’t what caused it in the first place.

There is, however, a more philosophically interesting argument. If sex categories themselves had absolutely no social meaning or consequence, perhaps gender dysphoria would disappear because there would be no meaningful category in which to feel misplaced. I can see the logic in that.

Even then, though, people would still have different bodies, and many people with gender dysphoria experience profound distress about those physical characteristics themselves. And in any case, the premise is entirely hypothetical. Sex categories exist because human beings are sexually dimorphic. Those biological differences have significant social consequences—for example, only some people become pregnant. It isn’t realistic to imagine a society that simply doesn’t notice or attach any significance to those differences.

So no, I don’t think it’s accurate to say that gender dysphoria can be “cured” by abolishing gender stereotypes. Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

I explained in an earlier post how I've heard people talk about how their feelings of distress about their body were exactly the same when they were suffering from the distress of anorexia, as when they then went on to labelling those feelings as 'gender dysphoria'. The distress and discomfort had the same depth and intensity.

The only difference between the two was the language/symbolism and the 'solutions' surrounding those two episodes of distress. One was housed in the language of food control and restriction and the other housed in the language of 'gender' and the solution was to suppress bodily processes through use of drugs and the elimination of certain body parts through surgery.

Throughout history people have utilised the terms of whatever the faddish condition of the day was - in order to express their distress. In Victorian times young women would be prone to fainting, and there was a widespread condition in which young women ( mainly) would become bed-ridden and unable to use their legs. Anorexia was unknown in Japan until it was introduced by American/Western agencies; and 'gender dysphoria' in children was simply not a thing until reatively recently here. I know this because I was a teacher and it just wasn't a thing - even 15 years ago. After covid there was a rapidly growing trend for young people in schools to develop Tourette's Syndrome.

We can all give examples, though, of how we struggled with our developing selves as children and how we became aware of sex based stereotypes and expectations ( and how we felt about them). Struggle with self and social expectations is in the very nature of growing up and navigating the social world.

We also know that many boys ( for whom certain forms of expression are still particularly frowned upon) start cross dressing in childhood. This is often in secret, and it is usually accompanied by strong, awakening sexual feelings and responses. Many cross dressing men have discussed this and how this habit developed ,and some have even described what the emotional motivation for cross dressing was. Many of these boys, who go on to be men, don't have particularly 'feminine' interests or preferences but they do have a compulsion to wear the clothes of the opposite sex and to fantasise about being girls or women ( as you suggest).

There used to be an organisation for Cross dressing men ( and their wives) called 'The Beaumont Society' ( originally 'Full Personality Expression') - in which men could meet up with other men at weekends and indulge freely in their cross sex imaginings - while their wives sought solace in the company of each other.This society, formed in the 1960's, is now a full on trans organisation in which the men involved now refer to themselves as women. Many have now taken what was a secret or P/T practice or habit full time and have declared trans identities. Men like Debbie Hayton have written about this, and he tells of how he even went on to have the 'full' surgery. He's still married to his wife and has children. This grouping of men now forms the bulk of male transitioners ....and many have re-invented their past to suggest that they " always knew they were trans from childhood".

Trying to block male puberty is an attempt to help a boy pass more easily as a girl and then as a woman. Something that many of these men have longed for.

You’re grouping together several very different phenomena and treating them as though they’re all manifestations of the same underlying process. But that’s the point under dispute, not something you’ve established. The fact that people with anorexia, gender dysphoria, or other conditions all experience profound distress doesn’t mean that distress has the same cause or that it should be understood or treated in the same way. The fact that different conditions can produce equally profound distress doesn’t show they’re the same condition. To argue that they are, you’d need evidence that the underlying causes are the same, not just that the subjective intensity of the distress is similar

I explained how several young women I have spoken with described their own conditions and experiences of having both anorexia and then 'gender dysphoria'. They themselves realised, on reflection ( after the hormones, drugs and surgeries) that they were the exact same set of feelings about their developing bodies but being expressed through different frameworks. 'Gender' is just one of the most recent lenses through which to view distress.

Children have always had 'gender' imposed on them by parents and society to greater or lesser degrees - except it wasn't referred to in those terms in times past.

You’re grouping together several very different phenomena and treating them as though they’re all manifestations of the same underlying process. But that’s the point under dispute, not something you’ve established. The fact that people with anorexia, gender dysphoria, or other conditions all experience profound distress doesn’t mean that distress has the same cause or that it should be understood or treated in the same way. The fact that different conditions can produce equally profound distress doesn’t show they’re the same condition. To argue that they are, you’d need evidence that the underlying causes are the same, not just that the subjective intensity of the distress is similar

There may well be people whose experiences are best understood that way, and those cases deserve to be taken seriously. But you can’t generalise from a subset of cases to the whole. The fact that some people later conclude their dysphoria reflected another underlying issue doesn’t show that this is what gender dysphoria is in general. The vast majority of trans people do not describe their experience as anorexia-like distress simply reframed through a different cultural lens

'Perception' is the underlying issue ( which is psychological and emotional) not one's body. Gender is perception.

You are missing my point that conditions originating in the mind ( psychological) have always been housed and shaped in the clothing and terms of different theories of mind or psychology - throughout time.

You can't seem to step outside of the gender framework in order to view it with any objectivity.

@Sunnibee This involves how the brain perceives, represents and experiences the body—not simply beliefs about gendered social roles or expectations.

Do you accept that this incongruence in children might in some cases arise because of the beliefs about gendered social roles or expectations of their primary caregivers, and the influence those may have on the child's perceptions of their own body?

You’re assuming the underlying condition is the same in every case and that only the cultural framing changes. But that’s exactly what needs to be demonstrated. The question is: what is the underlying psychological condition, and how do we identify and explain it? Simply saying that distress is expressed through different cultural frameworks doesn’t show that anorexia, conversion disorder, gender dysphoria and other conditions are all manifestations of the same thing.

I'm not committed to a “gender framework” as an explanation in itself. I’m trying to describe a specific psychological experience: a persistent, distressing sense of incongruence between one’s experienced self and one’s sexed body. This involves how the brain perceives, represents and experiences the body—not simply beliefs about gendered social roles or expectations

Yes. I would agree that social expectations and the attitudes of caregivers can influence how children understand themselves and their bodies. Children are shaped by their environments. it is plausible that in some cases these social / caregiving attitudes can cause a child gender related distress. The question is not whether social factors ever play a role; it’s whether they adequately explain the persistent, embodied experiences of gender incrongruebce reported by some people. That requires looking at the individual experience rather than assuming one cause applies to everyone.

You’re assuming the underlying condition is the same in every case and that only the cultural framing changes. But that’s exactly what needs to be demonstrated. The question is: what is the underlying psychological condition, and how do we identify and explain it? Simply saying that distress is expressed through different cultural frameworks doesn’t show that anorexia, conversion disorder, gender dysphoria and other conditions are all manifestations of the same thing.

I'm not committed to a “gender framework” as an explanation in itself. I’m trying to describe a specific psychological experience: a persistent, distressing sense of incongruence between one’s experienced self and one’s sexed body. This involves how the brain perceives, represents and experiences the body—not simply beliefs about gendered social roles or expectations

@Sunnibee The question is not whether social factors ever play a role; it’s whether they adequately explain the persistent, embodied experiences of gender incrongruebce reported by some people.

Do you think that we have convincing evidence that for some people this is not an adequate explanation? Given that a therapist can only explore the patient's childhood through the patient's own recollections and, in some cases, those of the very caregivers who might have contributed to the incongruence.

Absolutely. To me it's very clear from the clinical literature and patient accounts that this is not at all an adequate explanation in many cases. We have a gender critical, sex realist trans person on this thread. His gender incongruence persists despite his very fixed immersion in sex realist perspectives and rejection of gender stereotypes