Helen Joyce - why gender medicine isn’t science…

[Justme56]

https://www.thehelenjoyce.com/p/why-gender-medicine-isnt-science

“Actually that’s not quite right, because there isn’t any requirement to perform your gender, just to state it. Nothing further than the statement is required of the person making it: it’s other people who have to do the work by believing that statement — that is, by “affirming” that gender. The expression “gender self-identification” is a misnomer — it’s not something you have to do, beyond proclamation, it’s a demand that other people affirm you as being the gender you state yourself to be. Opening the door marked F or M is a way of declaring your gender identity.

There’s no place for other people’s judgment, indeed no role at all for other people except as supporting actors or appreciative audience. No room for them to say they don’t fancy joining in the performance, or to be a critic and say it’s not a very good performance. They’re not allowed to say: “OK, you say you’re a woman, that you’re living as a woman or have a female gender identity, but you don’t seem very female to me.”

In the UK -
Age eighteen & over = adult
Age under eighteen = child

These are the legal definitions. Children age 16 or 17 are deemed to have competence to consent to medical treatment. Children under 16 may have competence to consent to medical treatment if they have sufficient maturity i.e. "Gillick competence". Alternatively a parent may consent to medical treatment on the child's behalf.

Has anyone got that Interruptaron meme to hand?

Rather than play pigeon chess with an increasingly rude and desperate TRA, those of us in the mood for an interesting conversation could return to the more congenial and articulate subject of Helen Joyce?

And chatGPT premium, it’s an expensive hobby for some people.

I liked Helen going into the Greek theory of the humours.

Interestingly enough - we sometimes mention Iran's policy of transing the gay away, but the Shia clerics over there have created a theological justification for it. As I understand it, they say that there's the soul and the body, and the soul has precedence, so if the two are misaligned (e.g. we interpret a gay man to be a female soul in a male body) it is permissible to fix the body to restore alignment.

If you strip out the religious language about souls, and replace it with something like "identity", it's oddly familiar.

Err it wasn't banned as in still available under trial conditions as proven upthread.

Children already on these dangerous drug regimes have been allowed to continue, however, they are currently not prescribed to new clients. The ethics of a PB trial are currently being discussed.

There is no formal trial underway in Britain.

I particularly liked this bit. I've never seen a decent TRA answer to the question:

When you finally see the gulf between what people outside the gender ritual think people inside the gender ritual are talking about, and what they are actually talking about, it makes the physical interventions even more monstrous. If what the clinics are selling is validation — and if Miley Cyrus and Liam Hemsworth can be “queer” in their utterly traditional white wedding — then why do the clinics give people drugs and surgeries? Why can’t they just say to their patients what they claim to believe: that women can have penises, men can get pregnant, trans women are women, trans men are men and non-binary identities are valid, and it’s transphobic to think you need to do anything to your body to validate your identity? Why do they stop the “wrong puberty” and cut off the penises and breasts? What even could “gender-affirming care” mean, when all that having a gender identity means is saying you have that gender identity?

Agree:

"I think you can see where I’m going with this: gender medicine isn’t medicine, because nobody knows what it is to have a healthily functioning gender. I suppose someone working in the field would say that it’s “not suffering from gender dysphoria”, but that’s just a fancy way of saying “not suffering distress about something undefined” — and note too that people in the field insist that there is nothing wrong with being trans, it’s a natural variant, which is odd when the way they think people end up deciding that they are trans is generally that they suffer distress about this undefined thing called gender. And without knowing what it is to have a healthy gender, or gender identity, it’s not possible to say what it means to have a malfunctioning one, what might have caused that, and how it can be treated."

I think this is an interesting point.

There seem to be two competing diagnoses.

1. The wrong body diagnosis - there is a right way to be a gender, and some people have the wrong gender for their body - but that is not defined. There is no way to know whether somebody has the 'wrong' gender, and any attempts to define this would stray into sexism and homophobia, and also, presumably not align with people's own perceptions of their gender.

2. Dysphoria - but that is a mental health condition, and there may be many ways to treat it. Given that it isn't possible to change sex, the most obvious first course of action would be to resolve the dysphoria.

There is a third way to look at it, that it's just a personal matter and adults can do what they want with their bodies, and that (within reason) they should be able to present as they want without discrimination. However, that no more needs to be available on the NHS than a nose piercing.

Nothing to say about Marci Bowers' reverse ferret then?

That's Marci Bowers, ex-president of WPATH.

Why is it super important to mess with children’s bodies in the name of gender is a jolly good question

Couldn't find the unicorn but I found a pigeon.

What even could “gender-affirming care” mean, when all that having a gender identity means is saying you have that gender identity?

I think that Stonewall et al have done just as much as Abigail Shrier to suggest that 'there is no there there'.

'Affirmation only' cannot be a credible justification for medical treatment.

Duration is not the same. For precocious puberty, the drugs might be used for 2 or 3 years, though doctors will aim to limit it as much as possible. The child will then go through puberty at the normal age and hopefully his or her reproductive function will not be affected.

Children with gender related issues may take the drugs for longer - puberty itself can last up to five years - and as these are the crucial years for developing reproductive capacity it will almost inevitably be impaired, as will other important things such as brain development. Cass observed that a very high proportion of those starting on puberty blockers progressed to cross-sex hormones.

Off label use of medicine is justified in some cases but not all, and the criticism is not that the medication is being used off label, but that it’s actively harmful when used to treat gender questioning children.

And, once again, precocious puberty and gender dysphoria are completely different things that should be entirely decoupled in these discussions.

Thanks for the link, HJ being her usual eloquent self. More people need to start listening to what she and others are saying. Personally I think gender medicine, like gender studies, is a pile of useless made up bollocks, it's just the amount of harm gender medicine is doing is horrific.

I love this and haven’t seen it before!

I started off willing to engage in the ‘wider discussion’ on a couple of threads because I could see how it related to the topic at hand. I have only now caught that the same ‘wider related points’ are being recycled on every thread, derailing the specifics of each thread.

It all comes down to what it means to 'have a gender' or to have a 'gender identity'. And also how 'gender' is related to the physical body.

Nobody seems to be able to define what it is to 'have a gender' or a 'gender identity, but there are several contradictory answers from the genderists regarding the relationship with the physical body. These seem to be quite different for children and adults.

For children, and particularly adolescents, the expectation is that they will seek treatment at a gender clinic to halt their puberty and eventually have opposite sex hormones and other medical interventions. The public are led to believe that this treatment is essential or they will kill themselves.

For adults, the trans cheerleaders find it quite acceptable for a trans-identified male to say that he intends to have no treatment at all, that he loves his 'lady dick' but he insists that he should still be treated 'as a woman' which means mainly being allowed into women's toilets and changing rooms and other women-only spaces.

So if it's acceptable for a trans-identified adult to have no medical treatment, then surely we shouldn't be giving any of this treatment to children.

So if it's acceptable for a trans-identified adult to have no medical treatment, then surely we shouldn't be giving any of this treatment to children.

Absolutely, and the difference is glaring.

The one thing I'd add is that trans-identified females are much more likely to go down the surgical route, and get celebrated and affirmed for doing so. The male cohort don't seem to be nearly as keen on amputating healthy body parts, and there's little social pressure on them to do it.

Funny that.

Yes, despite their insistence that it's only gender that matters, not sex, there does seem to be a split along sex lines regarding treatment.

Women and children encouraged to go down the medical/surgical route, while adult males keep their lady dicks intact, slap on a bit of lippy and insist on using the ladies'.

I can't claim credit! I love the image too.

Yes, that particular poster has nothing to offer. Sophistry and insults can't hide the fact that he knows very little and understands even less. He's just embarrassing himself.

There’s no reason to give out gender affirming treatments on the NHS. It’s as unreasonable a use of public money as giving out full facelifts to people who are devastated at how they are aging.

You can fund your own exotic surgeries as an adult, I think you should be free to do that. But just like no one around you will actually think you are 25 again after a face lift, no one will think you have changed sex after a double mastectomy.

You can’t have a face lift and change your age on your birth certificate, I don’t think you should chop bits off your body and change your sex on it either.

But I do think people should have autonomy over their own bodies, they can fund it themselves, if they think it will make them happy, just like having a tummy tuck, or some other appearance based surgery.
But it has nothing to do with the rest of society, we shouldn’t be compelled to enter into the charade that anything has actually changed.

Not sure about that. It sounds easy, but changing bodies isn't like changing clothes. If anything goes wrong (and it often does), even if the individuals savings or medical insurance covered the first procedure, is it going to cover everything else? Where will the hospital beds come from, the nurses and support staff? States license some medicines and not others after cost-benefit analysis. Surely surgical procedures should have the same scrutiny. Particularly in a country like the UK where the National Health Service will end up footing the bill for anything that goes wrong.

There are already significant burdens put on health systems by people who go abroad and get, for instance, tummy tucks on the cheap. Gender is about fantasies and lies first and foremost, but the aesthetic surgery industry is also about making money and abandoning responsibility.

The NHS won't amputate your limbs if you think they shouldn't be there, and a surgeon was stopped from doing such operations on people with Body integrity identity disorder (BIID). Gender dysphoria seems like a very similar condition, but focusing on the sex characteristics of the body, so nobody should be doing those operations either.

This is a good article (from 2000!) which notes the similarity between these two conditions.

A New Way to Be Mad - The Atlantic

Why does anybody have a facelift though? Or a tummy tuck? Or boob jobs? Or Botox? Or fillers?

It’s all dissatisfaction with your body. You pay and go private for care, and any following issues are resolved by the NHS if it’s causing physical difficulties. You could argue Katie Price should not have surgery either. And no one should have cheap dental veneers in turkey,

How is any gender surgery different?

Ive known people with body dysmorphia (which is what I knew it as) and they spent thousands and thousands on surgery and still felt suicidal. I don’t see gender surgery as different.

You should be free to make unwise decisions for yourself. You can pay for them yourself, and it’s just a private matter for the individual, my issue is tax payers paying for it, and then everyone pretending it makes any difference to who you actually are.

I class gender reassignment surgery as vanity plastic surgery, and that’s fine IMO, just don’t drag everybody you meet into your issues with your body.

I think that ethically the difference is that, at least in the UK, any cosmetic surgery that would lead to the long term health issues caused by 'bottom surgery' would be banned. The only comparison I can think of is FGM, or BIID as discussed in the article posted by OldCrone above.

The only way that it can be legal is if there is a medical justification - so you come back to the same question.

It is very odd that any aesthetic intervention, not just surgery, but also using sunbeds, that ends up being a burden on the state either because follow-on medical care has to be paid for or because people render themselves unable to work, is legal.

I appreciate that it is not possible to stop people going abroad and paying people to operate on them in - for instance - Turkey or Thailand or Bulgaria. But maybe it should be made clear that they will have to pay for any follow-on care that is needed.

Yes, vaginoplasty and phalloplasty seem to be an absolute waste of time, essentially functionless and causing nothing but long term suffering. Probably more problematic than a random amputation. I don’t know how they are acceptable surgeries. I don’t know how the first surgeon got anyone to agree to stand in an operating theatre with them and carry it out.

Less so the other surgeries, mastectomy, hysterectomy, orchidectomy, facial feminising surgery, the Adams Apple one…

I will think about it more, I just really feel strongly that people are allowed to make unwise decisions for themselves.