The misogyny thread right. Another woman beaten up by men for having the gall to speak up. Such a charming movement.

https://www.nationalreview.com/news/riley-gaines-assaulted-by-trans-activists-at-san-francisco-state-university/

Meanwhile questions being asked about whether maybe it’s best not to do irreversible damage to teen girls.

https://www.economist.com/briefing/2023/04/05/the-evidence-to-support-medicalised-gender-transitions-in-adolescents-is-worryingly-weak

http://press.psprings.co.uk/bmj/february/transgender.pdf

It’s ok though, as long as people like Dylan Mulvaney can cosplay at ‘day 365 of being a girl’ and earn a killing for it.

Really trying not to both sides this, but the use of individual instances to go "see, this is what they're really like" is mostly a distraction.

Could easily grab pics from the Melbourne rally of pp's security grabbing a woman by the throat.

Anyhoo. I keep wanting to respond in here, but find it frankly distressing.

Knight wrote:

Meanwhile questions being asked about whether maybe it’s best not to do irreversible damage to teen girls. https://www.economist.com/briefing/2023/04/05/the-evidence-to-support-medicalised-gender-transitions-in-adolescents-is-worryingly-weak http://press.psprings.co.uk/bmj/february/transgender.pdf 

I guess the first thing to note there is that those questions are being asked in mainstream medical journals (and have been for sometime). The question of "is this treatment safe?" is a mainstay of pretty much all medical research, and it would be actively worrying if such questions weren't being asked.

When talking about "irreversible damage to young girls" (and it's worth contemplating why you're seemingly unconcerned with damage to young boys) there are two things you're querying here really. One is surgery, the other is hormones.

Let's start with surgery first as it's the easiest to discuss. It is, inarguably "irreversible", and so you would expect and hope that safeguards are in place.  As mentioned before, in the UK at least, you can't get any sort of surgery until you're at least 18 years old. So, whilst you could make the case that it's irreversible harm if that individual is to then change their mind, it's harm to young women, but not "young girls".  It is an informed decision by an adult with respect to what they choose to do to their bodies, and as such is no different from any other kind of cosmetic surgery. (You can, of course, debate whether or not cosmetic surgery is, in itself, deeply problematic but that's not the case you're making.)

So, we need not worry about surgery any more (or less) than we do about other paid cosmetic changes to people's bodies.

Which brings us to hormones.  This is much trickier. As mentioned when I talked about the Tavistock, there have been concerns about how rapidly some children have accessed hormones of one sort or another - usually with a view to delaying puberty altogether. Even at its peak, the use of hormones in children was relatively rare, if only because access was very difficult to obtain.  The wait for Gender Identity clinics is extraordinary in this country, and the vast majority of kids are adults by the time they get there. (This is only exacerbated by the imminent closure of the Tavistock.) 

So, even as the number of kids querying their gender increases, there's little reason to anticipate a raft of children adopting treatment. (Though I'll come back to a couple of caveats later.)

The issues with hormones are two fold really. Firstly - what are the associated risks, and then secondly - what are the real benefits? Beyond that - what's the evidence for either?

To which the answer, of course, is we don;t yet know for sure.  That's what the BMJ paper is all about. What it doesn't labour (because it presumes its audience is well aware) is that answering "what are the long term effects of puberty blockers given childhood?" is always going to be massively challenging to answer - because to do so needs you to give large numbers o children those hormones, and then track them for the rest of their lives. (Whilst ideally also giving a placebo to a similar number, something that simply isn't possible for a medication with such obvious physical effects.)  As such the evidence base is always going to be unclear.

We know being trans increases an individual's risk of suicide, but we're less clear on whether helping them physically transition entirely resolves this - particularly in a world that loudly refuses to accept them as their new gender. Every person who "solves" the trans issue by saying "we just need a separate category for trans women" has failed to appreciate the chief concern (at least from a medical perspective).  There is evidence suggesting transition does help, but we don't have the sheer numbers needed, and nor (beyond simple fatality rate) do we have a readily measured metric. 

Which is where we get into medicine's dirty secret.  Loads of stuff doesn't have much evidence. In fact, only about 10% of medical treatments have high quality evidence based on the GRADE criteria quoted in the BMJ article, and more than half have either low or very low quality evidence. So puberty blockers are sitting pretty firmly alongside the vast majority of medical treatments in terms of evidence base.  (Again, this doesn't mean that there's no evidence at all, simply that this evidence doesn't fulfill the gold standard.)  Of course, you might argue that we shouldn't do anything at all until we've hit gold for everything, but often achieving that level of quality requires you to be offering the treatment - so it's a catch 22.

Luckily the hormones used aren't completely alien to us - we've used all of the hormones to assist with various other problems for many years, so we know in broad terms what the effects are. We just don't know the specifics of using them for this person, for this reason, at this time.

There's often a retort that we shouldn't be giving hormones to fundamentally change people at all, unless there's some sort of life saving problem.  That we certainly shouldn't be giving anything that changes who and what you naturally are.

Except, of course, we do that all the time - especially in women.  We give hormones to teenagers pretty often - because we don't want them to get pregnant, or we want to stop their acne, or simply delay their period when they're on holiday. Different hormones, sure, but this is, arguably, a fundamental push against their nature as "women" - after all many opponents of trans will cite the ability to bear children as one of the attributes - yet we routinely take this away at the request of individuals for whom it is inconvenient or distressing.

At the other end of life women spend 1/3 of their lives menopausal, another physical transition not dissimilar to puberty in that it's a hormonal change eliciting a series of physical and psychological changes which some (but not all) find unwelcome. Again we will give hormones to delay - indefinitely - this entirely normal transition, at the request of any woman who finds this distressing. Indeed the very people who tend to get furious about the use of hormones to delay/prevent transition at puberty are often the same people who get angry that not enough is done to promote hormones for women who wish to delay/prevent transition at menopause.  

So, in summary, the evidence base for hormone use in trans people is not yet at a gold standard, and likely won't be for a very long time. However it's rarely used, what evidence we do have suggests the benefits probably outweigh the risks, and it is simply the latest in a long line of hormonal treatments aimed at altering normal physiology in women in order to suit both their personal preferences, and to arguably allow the rest of society to get away with not making better steps to accommodate women's natural changes. (Now there's a topic for a misogyny discussion...)  

Oh, I said I'd come back to poor access limiting the number of children getting hormone treatment.  This is true, of course, except that there are now many families who are going to private treatment clinics outside the UK to access hormone blockers. This is a concern from my perspective. When someone is eventually seen via the NHS GIDS service they are usually offered counselling, and encouraged to explore various elements of their gender identity. It may not work as well as it should, but there are a fair few protections in place.  Some of these other routes aren't as cautious - and so the systematic de-funding and running down of gender clinics in reaction to the whole anti-trans debate has had the weird effect of arguably increasing the numbers of well meaning middle class parents rushing their kids to get treatment by any means necessary because the system no longer really supports them...  (The NHS clinics also offer things like sperm/egg storage to preserve fertility, an option not offered by most private providers except at vast expense, and only for as long as you keep paying them...)

For what it's worth, my personal opinion is that we shouldn't be giving any hormonal treatments to kids unless they are able to make that decision themselves - which sadly means in many cases missing the boat for getting in before puberty, despite the obvious advantages to a trans child of doing so. Some trans people would disagree strongly with that, others wouldn't - but for me the ethical issues stem from those incapable of making that decision themselves.  

Finally (honest), all of the above is irrelevant, really, to the wider debate.  How we do, or do not, go about "treating", or at least mitigating, the physical experience of trans people doesn't affect the wider point that trans people exist, and are deserving of recognition and respect. It's clear from some of your posts that you're struggling fundamentally with that concept (the "365 day cosplay" pretty much nails it), and I'd suggest that's where you need to start before you even begin looking at the more nuanced questions.

tin_robot wrote:

Knight wrote:

Meanwhile questions being asked about whether maybe it’s best not to do irreversible damage to teen girls. https://www.economist.com/briefing/2023/04/05/the-evidence-to-support-medicalised-gender-transitions-in-adolescents-is-worryingly-weak http://press.psprings.co.uk/bmj/february/transgender.pdf 

I guess the first thing to note there is that those questions are being asked in mainstream medical journals (and have been for sometime). The question of "is this treatment safe?" is a mainstay of pretty much all medical research, and it would be actively worrying if such questions weren't being asked.

When talking about "irreversible damage to young girls" (and it's worth contemplating why you're seemingly unconcerned with damage to young boys) there are two things you're querying here really. One is surgery, the other is hormones.

Let's start with surgery first as it's the easiest to discuss. It is, inarguably "irreversible", and so you would expect and hope that safeguards are in place.  As mentioned before, in the UK at least, you can't get any sort of surgery until you're at least 18 years old. So, whilst you could make the case that it's irreversible harm if that individual is to then change their mind, it's harm to young women, but not "young girls".  It is an informed decision by an adult with respect to what they choose to do to their bodies, and as such is no different from any other kind of cosmetic surgery. (You can, of course, debate whether or not cosmetic surgery is, in itself, deeply problematic but that's not the case you're making.)

So, we need not worry about surgery any more (or less) than we do about other paid cosmetic changes to people's bodies.

Which brings us to hormones.  This is much trickier. As mentioned when I talked about the Tavistock, there have been concerns about how rapidly some children have accessed hormones of one sort or another - usually with a view to delaying puberty altogether. Even at its peak, the use of hormones in children was relatively rare, if only because access was very difficult to obtain.  The wait for Gender Identity clinics is extraordinary in this country, and the vast majority of kids are adults by the time they get there. (This is only exacerbated by the imminent closure of the Tavistock.) 

So, even as the number of kids querying their gender increases, there's little reason to anticipate a raft of children adopting treatment. (Though I'll come back to a couple of caveats later.)

The issues with hormones are two fold really. Firstly - what are the associated risks, and then secondly - what are the real benefits? Beyond that - what's the evidence for either?

To which the answer, of course, is we don;t yet know for sure.  That's what the BMJ paper is all about. What it doesn't labour (because it presumes its audience is well aware) is that answering "what are the long term effects of puberty blockers given childhood?" is always going to be massively challenging to answer - because to do so needs you to give large numbers o children those hormones, and then track them for the rest of their lives. (Whilst ideally also giving a placebo to a similar number, something that simply isn't possible for a medication with such obvious physical effects.)  As such the evidence base is always going to be unclear.

We know being trans increases an individual's risk of suicide, but we're less clear on whether helping them physically transition entirely resolves this - particularly in a world that loudly refuses to accept them as their new gender. Every person who "solves" the trans issue by saying "we just need a separate category for trans women" has failed to appreciate the chief concern (at least from a medical perspective).  There is evidence suggesting transition does help, but we don't have the sheer numbers needed, and nor (beyond simple fatality rate) do we have a readily measured metric. 

Which is where we get into medicine's dirty secret.  Loads of stuff doesn't have much evidence. In fact, only about 10% of medical treatments have high quality evidence based on the GRADE criteria quoted in the BMJ article, and more than half have either low or very low quality evidence. So puberty blockers are sitting pretty firmly alongside the vast majority of medical treatments in terms of evidence base.  (Again, this doesn't mean that there's no evidence at all, simply that this evidence doesn't fulfill the gold standard.)  Of course, you might argue that we shouldn't do anything at all until we've hit gold for everything, but often achieving that level of quality requires you to be offering the treatment - so it's a catch 22.

Luckily the hormones used aren't completely alien to us - we've used all of the hormones to assist with various other problems for many years, so we know in broad terms what the effects are. We just don't know the specifics of using them for this person, for this reason, at this time.

There's often a retort that we shouldn't be giving hormones to fundamentally change people at all, unless there's some sort of life saving problem.  That we certainly shouldn't be giving anything that changes who and what you naturally are.

Except, of course, we do that all the time - especially in women.  We give hormones to teenagers pretty often - because we don't want them to get pregnant, or we want to stop their acne, or simply delay their period when they're on holiday. Different hormones, sure, but this is, arguably, a fundamental push against their nature as "women" - after all many opponents of trans will cite the ability to bear children as one of the attributes - yet we routinely take this away at the request of individuals for whom it is inconvenient or distressing.

At the other end of life women spend 1/3 of their lives menopausal, another physical transition not dissimilar to puberty in that it's a hormonal change eliciting a series of physical and psychological changes which some (but not all) find unwelcome. Again we will give hormones to delay - indefinitely - this entirely normal transition, at the request of any woman who finds this distressing. Indeed the very people who tend to get furious about the use of hormones to delay/prevent transition at puberty are often the same people who get angry that not enough is done to promote hormones for women who wish to delay/prevent transition at menopause.  

So, in summary, the evidence base for hormone use in trans people is not yet at a gold standard, and likely won't be for a very long time. However it's rarely used, what evidence we do have suggests the benefits probably outweigh the risks, and it is simply the latest in a long line of hormonal treatments aimed at altering normal physiology in women in order to suit both their personal preferences, and to arguably allow the rest of society to get away with not making better steps to accommodate women's natural changes. (Now there's a topic for a misogyny discussion...)  

Oh, I said I'd come back to poor access limiting the number of children getting hormone treatment.  This is true, of course, except that there are now many families who are going to private treatment clinics outside the UK to access hormone blockers. This is a concern from my perspective. When someone is eventually seen via the NHS GIDS service they are usually offered counselling, and encouraged to explore various elements of their gender identity. It may not work as well as it should, but there are a fair few protections in place.  Some of these other routes aren't as cautious - and so the systematic de-funding and running down of gender clinics in reaction to the whole anti-trans debate has had the weird effect of arguably increasing the numbers of well meaning middle class parents rushing their kids to get treatment by any means necessary because the system no longer really supports them...  (The NHS clinics also offer things like sperm/egg storage to preserve fertility, an option not offered by most private providers except at vast expense, and only for as long as you keep paying them...)

For what it's worth, my personal opinion is that we shouldn't be giving any hormonal treatments to kids unless they are able to make that decision themselves - which sadly means in many cases missing the boat for getting in before puberty, despite the obvious advantages to a trans child of doing so. Some trans people would disagree strongly with that, others wouldn't - but for me the ethical issues stem from those incapable of making that decision themselves.  

Finally (honest), all of the above is irrelevant, really, to the wider debate.  How we do, or do not, go about "treating", or at least mitigating, the physical experience of trans people doesn't affect the wider point that trans people exist, and are deserving of recognition and respect. It's clear from some of your posts that you're struggling fundamentally with that concept (the "365 day cosplay" pretty much nails it), and I'd suggest that's where you need to start before you even begin looking at the more nuanced questions.

Re: study of hormones / puberty blockers, it is a fair point to ask knights question. I assumed he doesn't mean medical journals. I asked, years ago, ITT about hormones, and Dante iirc just shut it down. They're puberty BLOCKERS, no hormones. Mermaids etc say it's ok ERGO PLATO no harm involv d yeah?

Knight isn't making a statement about medical research. He's criticising th blind faith acceptance of one side of the debate.

To most people, this is a "which camp are you in" issue, which is deplorable. Eg to the anti trans ppl it's now "look Sweden started first but not have stopped". But it's not clear what they stopped or dialed back is based on acienc and data as opposed to a political backlash.

Baby in tow, so read the "I assumed" bit into every subsequent imputation of knights motives ya?

AFAIK no trans ppl ITT (maybe one queer one gender fluid), so I'm talking to ppl ITT, and I'm remembering an actual conversation with a few ppl, yrs ago, about puberty blockers, specifically Dante, where my impression is he simply didn't want to know anything other than puberty blockers, first of all, aren't hormone therapy, and secondly, perfectly safe. No study cited, no cognizance of the r cency of treatments making assessments difficult, labelling skeptics transphobic (maybe misquoting here a bit but that's the vibe I got)

No dig at trans ppl who I agree are the real victims of this toxic debate, and the camps thing. It's good to ask questions. It's good to question mermaids. It's good to listen to a wide variety of views, and assess. At least, that's how I go about my life. That's how I checked my own prejudices and stopped thinking toilets or women's officers in the CLP are an issue. That's how I held on to my belief that trans women who had testosterone competing Vs women who had no testosterone is unfair and is a threat to women's sport, for example. Lots of guff in this debate, but equally guff to handwave everything away.

Yeah it doesn't apply to you, or Tin. But it does apply to many. Adkm for one.

New Contra on this (and by this I mean The Trans) is a solid watch.

Link abbreved due to YT not working for peeps: youtube.com/watch?v=EmT0i0xG6zg

Yup, Pornography, Right Wing Women and Intercourse are basically spoilers of modern debate points. Dworkin herself was super complicated and she’d almost certainly be Queen Terf nowadays, but she’s also an example of going full War against the Smug chin-stroking Reasoned Debate types.

Long-time listeners may remember
https://www.polygon.com/23814201/feminist-frequency-shutting-down-anita-sarkeesian

It's probably been edged forward as much as feasible considering they're still mostly made by male nerds for male nerds. 

The thing I remember about those vids is the long, long lists of the various roles women have played in games over the years. Especially kidnap victim. In the latest Mario, Peach still gets kidnapped and forced into a wedding with Bowser, Mario saves her and proposes himself but then it ends with her deciding she doesn't want to marry either of them and flouncing off. Which is a sort of progress.

Mario got that Bowser good.

Pretty pissed off.

Diluted Dante wrote:

I'm delighted the cunt is being fucked off and I hope he can only ever get games in for clubs in the arse end of nowhere.

Even at those bottom clubs - imagine him togging out for your team. Imagine being a player at those clubs.

Didnt this happen with another player?  There was a similar issue with some rugby players in Ireland where I think they got avoided criminal charges but the evidence that came out still showed them to be awful humans. I think they ended up going to some french club or something.