Canada - Judge delays double mastectomy

[Dimpsey]

Saw this on twitter and thought I would share: vancouversun.com/news/b-c-supreme-court-judge-orders-surgeon-to-deny-trans-teens-mastectomy-wish?utm_term=Autofeed&utm_medium=Social&utm_source=Twitter#Echobox=1604974077

Mother of the child asking the surgeons to provide evidence of the protocol they have followed to demonstrate that the operation is in the child's best interests.

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back. All the information is freely available, anyone is free to take it or leave it.

But that's the answer we always get - "I'm not telling you" - and what informs my opinion.

So round we go again.

@MadBadDaddy

I'm sorry if it sounds melodramatic to put it that way, but this thread is chock a block with comments that boil down to exactly that.

You are imputing bad faith where none exists, exactly as you did for the mother in this OP. Several posters have clarified exact what is meant and it is not that.

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back.

You can do as you wish but I never understand why posters drop in, make sweeping statements about 'you all believe x' and then refuse to clarify or engage. I made quite a detailed reply upthread, you could explain how you disagree or, if not, we have common ground.

All the information is freely available, anyone is free to take it or leave it.

Lots of charities which puppet to speak for tran people use the things you say it is not to describe being trans. Many trans people disagree with those as many feminists think they are sexist and derivative. It shouldn't surprise any trans person to hear that the issue is a source of debate.

My larger concern is that children are being denied appropriate treatment b/c of loud and often ignorant campaigning.

Access to GIDS has been slowing down for years- nothing to do with campaigning, it is about the rapid increase in demand. The recent attention provoked by opposition to the proposed GRA reforms has prompted the government to increase resources where previously they ignored it.

Campaigning for women and children's rights is not the cause of insufficient funding. Appropriate MH treatment before SRS is considered is not harmful to Trans people. A great many posters on here are much more informed than you think.

Leave it to the pros, but not the pros that question affirmation only and have published a sexologists analysis of gender identity.

There's legions of pros who are called ignorant, prejudiced, judgemental and far worse. Most of the posters here have read what they have to say and reached their own conclusions about why it's such a mystery to be suppressed with coy "I don't knows". There's also testimony from partners and parents here who actually do know.

Any way. Let's find out what the protocol for healthy breast removal in this case is as I expect it's little more than signing away liability.

sadly, as par for the course, there it is,

Still, there was some acknowledgement at the very least, that this cohort of teenagers may be different. But it was minimised.

I share that concern, which isn't difficult to glean from my comments on this thread. My larger concern is that children are being denied appropriate treatment b/c of loud and often ignorant campaigning.

I feel that when MBD expresses concern that these children and teens are not getting the appropriate treatment, it means that it should be affirmation only. Because they feel that was what would have worked for them.

I too would be interested MadBadDaddy, did you have a double mastectomy at 17 too?

Do you honestly believe that irreversible operation is appropriate for every teenaged girl who now identifies as trans? (ie. the teenaged girls with a motivation that may very well be very different to your motivation was decades ago. Therefore, NOT THE SAME) or do you believe, like many parents on this thread, that better care may NOT simply be affirmative only treatment but treatment on multiple levels with affirmative treatment only at the end. As advocated by experts who have decades of experience in treating transpeople that are being shut down by some activists who only want these patients to be affirmed only, and who are very loud and often ignorant themselves.

There are quite a growing number of transpeople who believe that medicalising children and teens is wrong. Do you believe them when they explain why?

Do you understand that teenaged girls are researching this for themselves with the assistance from lobby groups and presenting self diagnosed selves to doctors repeating what the lobby groups tell them to say to get affirmative only treatment? Do you actually not see that this is problematic? That is why there is a growing concern amongst high profile transpeople, particularly transmen. It is NOT just feminists who are concerned although, it is always portrayed as 'loud and often ignorant campaigning.'

So, to be clear. Do you believe that other transpeople campaigning to stop the medicalising of children and teens are also ignorant?

All the information is freely available, anyone is free to take it or leave it.

If you haven't noticed, this information is changing monthly as clinicians and unbiased experts clarify that lobby groups who had control of disseminating this information have overstepped their remit and have spread many ideas that are harmful to the health of transpeople, particularly children.

So, really, we are left with old and out of date information and the new information seems to be hugely ambiguous.

I for one am finding it hard to differentiate my response to double mastectomies in teenage girls from my response to fgm in five year old girls. Just because the older girls are asking for surgery doesn't make it right to enable it.

I have read Hibo Wardere's book on her experience of FGM. She says that she asked to be "cut", though admittedly she didn't understand what it meant beforehand. The two are directly comparable. They both involve unnecessary cutting off of healthy body parts in children. Both often cause long term reliance on medical support which would not otherwise be necessary. Both are done to meet a cultural expectation of what a woman should be. In both cases, I simply don't believe that children are capable of understanding the full implications of the decision.

My stance is quite simple, tbh. No permanent physical changes to the body of any child, unless necessary due to a physical illness. So no to FGM, medical transition, tattoos.

@Winesalot

Thank you for your minimal acknowledgement of my minimal acknowledgement.

I'm not seeing much in your last post that I haven't covered at least to some degree. Believe it or not, I've attempted to make my points as succinctly as I could, but its obvious that they were not clear enough.
I've made it clear at several points that i am not some oracle and that there is plenty of discussion to be had, but the denial has to end. I see my place in all this as similar to a ward nurse being asked for their input into a new hospital design.

I don't believe that "affirmative care' is the uncompromising bogey-man that you seem to think, but at the same time if there are ways of 'gaming' the system to bypass any safeguards then that is certainly a problem, as it would be anywhere I am more in tune with the situation in the UK and not Canada though, and trans healthcare here is long, slow and cautious.

I don't think any 'side' has a monopoly on ignorance or dogma. Ex-porn stars and comfortable middle class physics teachers don't speak for all of us on all matters, but probably like to think they do. They have an image to uphold, after all.

The 'changing information' is more of a marketing problem, and less of a medical issue. I'm not saying that this makes it insignificant, and more could be done, but i don't think it would ever be enough for some people.

um...because trans children do exist, and deserve the treatment they receive from dedicated professionals. To deny them treatment is cruel.

We're not all Keira Bell, y'know.

MadBadDaddy, if you can give us a certain way of distinguishing the "trans children" from the "Kiera Bells" then please do so.

Otherwise, since the treatment is not medically necessary, we must refrain from performing unnecessary, irreversible surgery on children.

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back.

MBD, why would describing what trans actually means to you, end up creating problems for yourself?

@PearPickingPorky

um...because trans children do exist, and deserve the treatment they receive from dedicated professionals. To deny them treatment is cruel.

We're not all Keira Bell, y'know.

MadBadDaddy, if you can give us a certain way of distinguishing the "trans children" from the "Kiera Bells" then please do so.

Otherwise, since the treatment is not medically necessary, we must refrain from performing unnecessary, irreversible surgery on children.

this in a nutshell!

Ex-porn stars and comfortable middle class physics teachers don't speak for all of us on all matters

Way to minimise other voices. There are plenty of other transpeople talking about this other than Buck and Debbie Hayton. I think you probably know that.

My point is that this is not just feminists expressing concern. But obviously you have no respect for any person who does from how you just wiped away part of your community's concern.

I don't believe that "affirmative care' is the uncompromising bogey-man that you seem to think

Perhaps you should do some reading about the new bill proposed in Canada at the moment. Have you listened to the clinicians who are discussing this issue from decades of experience who are also expressing concern? Across the world, not just in the UK?

Perhaps you might explain what your understanding of 'affirmative only' treatment entails?

For instance, do you believe that unbiased exploration of other mental health issues can be done without it being considered 'conversion therapy'?

What happens if that treatment results in someone no longer identifying as trans but has significantly better mental health?

I see my place in all this as similar to a ward nurse being asked for their input into a new hospital design.

No, it’s similar to a nurse being asked “What is a nurse?”

If you knew when you were 6, it can’t be that complicated.

That said, if I knew from around the age of 6 that I was trans (despite having literally no words for any of it) and, by the time i left my teens, that it was never truly going to go away, then I also know that there will always be other children like me, and they shouldn't have to go through the blind torment and distress that i did.

You didn't know that. You believed it, and it turns out to have been true, so far.

But you're guilty of result-oriented thinking. The result turning out the way you thought does not prove your decision was correct, or would be correct next time.

Poker and other games talk about this fallacy. If you made a decision on the assumption that you're going to draw an ace, and it turned out you did draw the ace, it does not mean that you made the right decision.

Here's an excerpt from some investment article base on the subject I found with a quick Google:

In assessing a prior move, technically the question one ought to answer is along the lines of: “Given all the information I had at the time, was my decision the right one? If I made my decision in each of the universes I could have been living in at the time, with each containing different hidden past events and different unknowable future events, what would the result have been in each? If I assess all of the decisions I could have made and all the universes I could have been living in, and set the appropriate probabilities, which decision on average has the best outcome — with ‘best’ up for me to define as I see fit?”

Unfortunately, employing such a technique is often impossible, not to mention difficult. So instead, it is common to perform the shortcut that psychologist Daniel Kahneman terms “attribute substitution.” When trying to assess the wisdom of a prior decision, rather than attempting to answer the difficult set of nested questions laid out above, we lazily choose to answer an easier one: “How did it work out when I did it last time?”

Poker players play multiple games - they cannot afford to base their future plays on "how did it turn out last time". That is not the factor. It's probabilities. How likely was it to draw the ace versus something else? Would there have been a better-average-outcome play?

You don't get another play at your life, but you're betting other people's lives on how your play turned out.

Your place in this thread is not a professional engagement about a workplace. It is entirely motivated by a personal belief that parents should not be able to protect their children from harmful medical practice. You leapt straight to smearing them as possible abusers on no evidence as a method of discrediting a parents motives.
And smearing posters as prejudiced for being pleased that the parents are able to see the evidence based decision making for their child's proposed surgery as a result of this court order. That is surely the bare minimum of reasonable expectations.

When did a nurses job become smearing and bullying parents to comply? Is it in the degree syllabus?

I see my place in all this as similar to a ward nurse being asked for their input into a new hospital design.

You see your place in all this as similar to an expert professional being consulted on a subject directly related to their professional expertise? I'm sorry, but who is consulting you? And what is your professional knowledge of child development? Or child safeguarding? Or the evaluation of clinical treatment outcomes? Or psychiatry? Or the law? Or any relevant field? You're pontificating on a forum, as are the rest of us, but at least some people here do have relevant expertise.

If you were being consulted by anyone here, your role would be similar to that of a patient representative in a PPI consultation, not a clinical expert, but you wouldn't be suitable even for that - you don't even have expertise on being a trans child, given the clear evidence of different etiologies of transness, particularly between people who initially present with gender issues as adults, and "trans children", and the evidence from clinicians that many adult transitioners have unconsciously edited their memories of their their childhood and early adult life to conform to a specific narrative.

It's not clear at all that the opinions of trans-identifying adults have any role to play in shaping the treatment of "trans children" and if they were to be consulted, then the testimonials of adults who identified as the opposite sex as children and then ceased to identify in this way should be given equal weight. Ultimately the outcomes for children who have actually been through this treatment are the most important evidence to consider, but there's a strange dearth of data there.

"And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that..."

"That said, if I knew from around the age of 6 that I was trans (despite having literally no words for any of it)"

It's impossible to argue when the key 'problem' in need of a solution has no definition. There is no 'there' there. It's like insisting at a tennis match that the little yellow ball, which both players and spectators can see, is not the ball, but the ball which must be played with is instead some invisible 'thing' which only you can perceive. How are we meant to play?

I find it telling when trans activists claim that critics think that trans 'doesn't exist'. The closest thing I've ever heard to someone saying that trans 'doesn't exist' are trans activists' own insistence that being trans has nothing to do with gender dysphoria, stereotypes, a preferred aesthetic or dress sense, a sense of alienation or of being somehow special compared to others of one's natal sex (you know, those mere sheep who just looove the strictures and limitations imposed by gender stereotypes), and nothing to do with fetish or paraphilias (recalling that transvestitism is classified as being under the trans 'umbrella' by Stonewall), etc. etc.

@Datun

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back.

MBD, why would describing what trans actually means to you, end up creating problems for yourself?

Pfft... see above

Ever seen that footage of the antelope brought down by a pack of komodo dragons?

Everything I've said on this thread could be reduced to a couple of words: "Trans exists" and this would still be too much for some of you, who will reflexively dismiss everything I say so as to continue to enjoy their unchallenged conceit that lived experiences like mine are nothing more than a political statement or a glorified delusion, and who will continue to be as guilty as they think I am of seeking to harm children's lives in the name of helping them.

The debate is toxic.

You haven’t told us anything. Please just outline what you mean by transgender, what it meant to you as a 6 yr old and how it has affected your lived experience. @MadBadDaddy

A different context but a case asking whether a child's beliefs should be overruled in a medical context.

www.google.com/amp/s/www.dailymail.co.uk/news/article-8935567/amp/Judge-rules-Jehovahs-Witness-15-blood-transfusion-save-life.html

The judge, who needed to make an urgent ruling, is suggesting that historic prescedents should be reviewed. In summary they suggest under 16 and a child does not have a say. 16-17 and their views are taken into account. Full consent is 18. Gender decisions seem to be out of line with consent in other medical areas.

(And yes UK will be different from Canada, but courts in all countries will be coming accross these issues.)

The debate is toxic.

What debate? There is no debate.

You've admitted that if you actually describe what trans means to you, it will give you tremendous problems as it would, presumably, be seen in a negative light.

You said you known what it is, you've always known it, but you won't describe it, because it has to remain a secret.

You want it to remain a secret from everyone, can't describe it, say it really doesn't mean what an awful lot of other people who are trans says it means, and still expect us to think you're the font of all knowledge about everything transgender!

Every time I engage with you, or Renata, or jj, the restrictions you all place on your accountability get tighter and tighter, and your answers get more and more daft.

And then you all contradict each other!

pediatrics.aappublications.org/content/146/4/e2020010611

Seems that research promoting affirmation is not as robust as it should be.

@gardenbird48

You haven’t told us anything. Please just outline what you mean by transgender, what it meant to you as a 6 yr old and how it has affected your lived experience. *@MadBadDaddy*

I've told you plenty, whether you want to hear it is up to you. And I've tried several times to excuse myself as some sort of trans oracle, but does anyone listen? And by 'toxic debate' I refer to the wider debate, not merely this skirmish

sigh but OK (grabs spotlight)... As a 6 year old boy in the 1970s I started feeling like I wanted to be a girl. That is the beginning, the middle, and end of it. I knew it was something I could never, ever tell anyone else.

The feeling would come and go like a tide, phasing to extremes over weeks or even months, but always returning no matter how far away it seemed to go at times. It made me nervous, secretive, sneaky, introspective, calculating, detached and alienated. If I ever saw a cool girl at school or on TV or wherever, I never knew if I wanted to be with her, or be her. I never felt like I fit in with "the lads" or "the girls", as much as I wanted to. The chemistry was just not right. Luckily I came of age in the late 80s which was a good time to bend one's gender and dispense with labels. I've been a proud flag-flying freak ever since, but did eventually learn how to blend in and fool everyone for a fair while before my life collapsed and I came out and the world didn't end and I'm much happier as a result, even if i just go by what other people tell me. I appreciate my story may or may not be entirely typical but that is just a problem of belonging to such a tiny demographic - there is little that is 'typical'.

That's it. Feel free to pull this to bits and laugh in my face.

But girls are as diverse as 50 percent of the billions in the planet as are boys. so what part of being a girl did you want to be ?

@MadBadDaddy

I have no wish to pull you or your story to bits. If you will permit, it seems that what you are saying is that your being trans is based on a strong and enduring feeling. Okay.

I can believe that you have that feeling, and that it is very important to you - so much that it defines you in some if not many ways.

However I don't think that having such a feeling, or claiming to have such a feeling (as may be the case for some people, particularly children, who may be feeling confused about puberty etc.) - can ever be a good reason for medically unnecessary surgical and endocrinal interventions. I will accept that adults may choose to do what they may with their bodies, if they think it will help to relieve distress, but I will never accept that this can be appropriate for a child or adolescent.