"Biological sex is a multidimensional variable with various components" - Thread 2

[MissScarletInTheBallroom]

The last thread ended with Tandora attempting to sidestep the question about what she would say if her daughter had been raped by a trans woman in a female only space and no longer believed that trans women should be in female only spaces as a consequence.

Her last reply was along the lines of, "The same thing I would say if she had been bullied by a green person at school and said she no longer wanted to go to school with green people."

@Tandora can we have a serious answer?

Apparently so, that or self exclude from health care. Tandora has outlined this position before on previous threads.

@Tandora your opinion seems to be that some trans identified male doctors might knowingly sexually assault a female patient who had requested same sex intimate care?

It seems very transphobic to me. Apparently @tandora believes males with a trans identity would knowingly cause trauma to women by claiming to be female and treating women who had asked for single sex care.

Doesn't it just.

It also shows that even though Tandora is apparently advocating for throwing safeguarding totally out the window, the position that Tandora argues from in fact gives weight to the arguments for safeguarding.

It identifies as evidence.

But identity isn’t a thing when it comes to being trans? I’m not sure even @Tandorais keeping up.

The intellectually disabled adult is an interesting comparator.
Although they may have a "mental age of 10" and it is not fair to their dignity or conducive to their happiness to expect them to cope in the same way as a person with an adult mind, we don't therefore say that dignity and respect requires us to see them and treat them exactly like a 10 year old.
And we don't force actual 10 year olds to share their spaces with them and to believe or pretend that there is no real difference between that person and a 10 year old child. And we recognise that having an adult body means that the person is in some ways an adult as well as "mentally 10" and that this may have implications for what is appropriate.
To be quite clear, I am not:implying that transness is a mental disability or anything of that kind. The comparison is that it is a similar situation of mismatch between something in the brain (or wherever) and something in the body. The thing in the brain can be real enough and have very serious implications for the individual concerned, but society's response, if it is to be wise as well as compassionate, has to take account of the whole picture, not just part of it.

You dont link to any studies, Tandora, because it is easy to critique them. The recruitment method for this particular study, like many others, leave a lot to be desired. It does not improve the accuracy of a poor study to combine the results with any number ( in this case 3) of other poorly designed small studies. All involve biased recruitment and this one with fairly low engagement from their clinical populations.

@Tandora
I see the subject of defining sex is still going. Would like to finish the conversation where we left off in the last part of this thread. I've copied the conversation chain below.

We covered one context of a doctor assuming sex, and there was mention that it could result in a mistake, but there wasn't any clarification as to how sex would be verified after a mistake. You can see how the conversation ended abruptly.

How would sex be verified after an incorrect assumption?

(edited to fix formatting)

Fidgetbreak:
Hi Tandora , Forgive me for not having read every post yet, it's a very long thread. Also a very interesting one. I'm genuinely curious about your perspective. Have a small question that might help me understand things better. How would you determine if a person is male or female?

Tandora:
sorry I did miss this.
How would we determine whether someone is male or female? Well firstly it would depend on the context - in which context were you thinking?

Fidgetbreak:
I was thinking generally. To pick something more specific, perhaps, in the context of seeing a doctor? Maybe you could mention some contexts where it could differ as well?

Tandora:
In the context of seeing a doctor, the doctor would assume the sex of the person by looking at them. There would be social cues - how they were dressed, their name, as well as cues related to physiological features associated with either sex. There is usually also a market on the medical record designating whether the person is 'f' or 'm'.

crazysnakess:
How does a doctor decide what contraception to suggest?

Tandora:
Based on what reproductive anatomy the person had, which they would deduce based on their perception of the person's sex.

crazysnakess:
But how does the doctor know? How do they know what sex it is that they are perceiving?

Tandora:
I answered that above. Sometimes they may be wrong of course which would involve a conversation between the doctor and the patient.

BackToLurk:
So if a transwoman, whose ‘transness’ was based on how they felt, but whose reproductive anatomy was entirely male, went to the GP what type of contraception would be appropriate?

Tandora:
They would require condoms or a vasectomy.

cloudyblueglass:
Because….?

Tandora:
Because they have a penis and testes.

cloudyblueglass:
And they are objectively….,what sex?

Tandora:
It depends what you mean by "sex". And that's what this thread was about.

Skirting around the question, always twirling, twirling, twirling.

Social norms haven’t just come out of a meaningless void though, have they? They evolved as a reaction to the real, experienced behaviour of men, as a class, towards women. They are a reaction to the real threat men (as a class) pose to women.

whether that threat is mainly due to the effects of testosterone on the male body (which is entirely due to chromosomes) or just opportunism as men realise their bigger average size enables them to impose their will on women, is a subject of debate. But that threat is very real.

Tandora:
sorry I did miss this.
How would we determine whether someone is male or female? Well firstly it would depend on the context - in which context were you thinking?

This is where it all ends for me. The definition of sex is irrespective of context. There are two sexes and they are defined by which types of gametes a body currently makes, or made, or will make, or would make in the absence of medical problems or DSDs. That's it, it's not dependent on context. This is just a distraction, it falls at first principles.

As I’ve said before, if there were firm evidence for a biological reason behind trans, it would have 100% made it into the diagnostic criteria. But it hasn’t.

For example, with onset of confusion and dementia in the elderly, especially women, they’re checked for UTIs and even hypothyroidism. (A gp once told me she admitted an elderly woman to hospital with severe dementia where she was screened for hypothyroidism and that was what it was. Started thyroxine and recovered.)

there so much money in the area of transgender research and yet it’s still not proven there’s any sort of medical test to diagnose it.

it’s a subjective diagnosis. In the category of mental health. Which most people self diagnose these days.

No. That was not the scenario in any way shape or form.

I stated repeatedly that a patient has every right of course to refuse care from a doctor that makes them uncomfortable.

The pp then asked if she should say to the doctor “I want a female doctor, and you are male”.

I responded that she (pp) was completely able to assert her boundaries and request a new Dr, without the need to make personal “observations” about someone else’s body/ person.

So what reason should the patient give for not wanting treatment from Dr Upton, if she is not allowed to point out that Dr Upton is male?

"I would be more comfortable with a different doctor".

@Tandora so you are doubling down on your assertion that some trans identified male doctors might knowingly sexually assault a female patient who had requested same sex intimate care?

Otherwise why would they present themselves to administer said intimate care to a female patient who had already explicitly requested same sex intimate care.

Of course all studies have their limitations - this applies to every area of science/ medicine, and it applies especially when you are dealing with rare populations and exploring something as complex as genetics and the biological underpinnings of mental processes. However, we work with the data/ material we have and try to make the best use of it. (This study fyi has much better power than most twin studies and has been peer reviewed and published in a high ranking scientific journal). Even so, my understanding of transness does not derive from one study published a few weeks ago, it derives from years and years of study: original research, as well as reading literatures across multiple disciplines.

I often link to studies in these conversations. However, you are correct that I prefer to actually reason through the points and explain them, rather than post endless links to individual studies.
The reasons for this are several: First, there is not one single study that I can point you to that will definitively 'prove' to you that being trans is a real and legitimate thing - this seems to be what people expect and of course it doesn't exist.
Second people don't read the studies, if they do, they glance at them and make illiterate assumptions about what they say based on reading one line, and
Third, because people then get bogged down in trying to point out all the limitations and flaws with one particular study, which is beside the real point of the conversation, which is to try to challenge people on their misunderstandings and prejudices about trans people.

who had already explicitly requested same sex intimate care

That wasn't part of the scenario we were discussing.

Why can't people read?

Makes you wonder why people bother to conduct and publish studies, no?
There are very few published studies that on their own "settle" science. Scientist's conduct work, publish their results, discuss with other scientists (who also publish) and eventually out of all this published and discussed data a scientific consensus forms, and for sex this consensus is very clear and has been very clear for a long time. Sex is binary and it is evolution's way of increasing genetic variability so natural selection can get to work. This is the consensus no matter how many science outreach officers at third rate universities or "I'm a biology teacher listen to me" experts on social media blather on about it being so much more complex.

But this person has already asked for a female doctor. And they've been sent a male doctor who pretends to be female, and you're now putting all the emotional labour on this patient, who may be very ill, to advocate for herself and say, "Not that one, a different female doctor."

This is grossly unfair, unprofessional, and incompatible with providing ethical and patient centred care.

A much better solution would be for male doctors such as Beth Upton to find a female colleague and say, "Can you take this patient? She's requested a female doctor."

I could have sworn that particular point had already been covered. If it wasn't explicit, it was implicit in the context of the discussion however so this is just another clear deflection.

I think everyone here would agree with me that the scenario presented took as a given that the female patient had requested her intimate health care be provided by a same sex doctor.

So in that scenario where a female patient has already requested same sex intimate health care (for her not life threatening at all, non emergency, perhaps even regularly scheduled appointment - just in case it isn't explicit enough for you already), a trans identified male doctor presenting themselves to administer said intimate health care knowing the patient had requested sex care intimate health care, would be knowingly committing sexual assault... yes?

As an aside, Dr Upton has stated in court that he would indeed present himself in the given scenario above and said the patient would need to further be able to advocate for themselves and say to him at that point again "I'd prefer another doctor" (or whatever form of words you'd like this hypothetical female patient to use), further stating that he would see that as transphobia and possibly an act of aggression from the patient. What do you think of that?

Are you aware that in that scenario, and by simply saying "I'd prefer another doctor" as politely as you like, a doctor like Dr Upton could feasibly have health care withheld from the patient at that hospital? I'd be interested in what you think of that too?

As always, women are expected to be the ‘support humans’

Nope there is no scientific consensus that sex is a strictly singular, objective, fixed and binary measure.
Actually the science shows that sex is a really complex, multi-variable process of development, which produces a whole range of complex minority variations.

It most certainly was part of the discussion.

Happy to go find the quotes if you’d like?

You can repeat that claim until the cows come home it's still wrong.
Among biologists, and I mean the ones who actually know what they are talking about, Winston, Dawkins, Nuesslein-Vollhard, Hilton, Wright, gazillions of others with careers, millions of £ or $ in research funding and large research groups nobody believes sex to be anything else than binary. Variation that don't produce a new type of gamete don't challenge the binary model of sex.