I can’t help but roll my eyes at mindless euphemisms like “attacking trans people.”
There are very serious issues involving trans people with no easy answers. Like allowing minors access to irreversible treatments. Like women’s sports. Like the safety of women only spaces.
I bring this up because on so many questions like these, the progressive reaction is to shut down any discussion and isolate themselves from exposure to any ideas different from their own.
It doesn’t work. And it doesn’t help anyone.
And maybe this has something to do with why Facebook is migrating to a “Community Notes” model.
Is it not possible that ‘attacking trans people’ is both (sometimes) a euphemism for criticism of maximalist positions and (at other times) a perfectly normal term that designates approximately what ‘attacking x’ generally means? There is such a thing as an unsubstantive and utterly unpleasant insult explicitly motivated by the fact that its target is trans. Many trans people say that there are many such, and one does not need to believe everything that trans people say (surely with the result of inconsistency!) to think that the evidence they present is not wholly concocted.
Others may misidentify respectable, good, or correct arguments as ‘attacks’ in narrower senses, but that no more makes the underlying categories meaningless than the misapplication of such descriptions as ‘true’, ‘valid’, ‘scientifically established’, or ‘by definition’. I have no general pithy answer to what one should do about the sorts of attack I have described, but I venture that it is reasonable to talk or attempt to do something about them. What term would you prefer?
I think that it would help if you were to suggest a term people who don’t want to ‘shut down discussion about related topics all together’ should use. Otherwise, the effect (although perhaps not the intention) of deprecating the term ‘attacks on trans people’ is that the sort of discussion you admit is possible theoretically will be impossible for want of a suitable term to designate the sorts of attacks it concerns.
I can't help but roll my eyes at "serious issues" you know in most states these anti trans laws were passes targeting handfuls of children in each state, sometimes a single child. But oh yes that's a serious issue for sure right now
This is a cheap political gotcha accompanied by a litany of unevidenced and vague allegations against a political out-group (which "particular group"? On what basis do you assert that "some AI somewhere" is involved, and why would that matter? Not to mention the tired "dog whistle" cliche) and a demand for self-censorship.
You've also made a bold claim about the relevant statistics without any kind of citation.
My understanding is that a higher standard of discourse is expected on HN.
But aside from that meta point: your argument seems to rest on the idea that your ideological opponents would prefer for cisgender teenage boys to be able to get mastectomies when they exhibit unwanted breast growth. But the source your interlocutor found suggests that the "breast reductions in teenage boys" you're talking about are in fact dominantly performed on transgender teenage boys (i.e., people your ideological opponents would consider "teenage girls"). So the intended gotcha doesn't even work; you haven't identified any kind of inconsistency in the position or potential for a "self-own".
While the page is obviously not unbiased about the benefits of this surgery, you can infer from the number of patients included in just one study that it’s very common. Yet this particular irreversible surgery performed on children does not seem to be causing a moral panic.
The broader point, which I think you’ve not picked up on, is that most people are fine with gender affirming care for children as long as the children are cis - which is arguably a double standard.
>you can infer from the number of patients included in just one study that it’s very common
No, I don't think I can infer any such thing. The original claim was that "everything else is completely and totally marginal by comparison in the US." The Reuters article cites hundreds of mastectomies on trans-male-identifying patients per year. The existence of a study on 145 mastectomies on cis-male-identifying patients does not establish the claim.
>The broader point, which I think you’ve not picked up on, is that most people are fine with gender affirming care for children as long as the children are cis - which is arguably a double standard.
I understand exactly what the point was. I just didn't think it was established. Absent a baseline statistic, the Reuters article suggested a different conclusion. Claims phrased with language like "completely and totally marginal by comparison" should be evidenced.
The way to do that would have been with a citation, such as from Wikipedia:
> According to the American Society of Plastic Surgeons, breast reduction surgeries to correct gynecomastia are fairly common but has been a recent decline. In 2020, there were over 18,000 procedures of this type performed in the United States which is down 11% compared to in 2019.
But for those who object to such surgeries on trans-identifying minors, I doubt that they would characterize such a surgery in a cis individual as "gender affirming care" anyway.
Thanks for digging up the statistic, but seems to confirm that bsder was correct about the relative numbers.
>I doubt that they would characterize such a surgery in a cis individual as "gender affirming care" anyway.
Right, but they don't characterize it that way purely because the individual is cis. The typical reason for these surgeries is that many boys and men feel uncomfortable having large breasts (even though this is not particularly abnormal in biological terms or a dangerous medical condition). So it is 'gender affirming care' in a pretty literal sense. The person feels that their body conflicts with their gender identity, and the surgery removes or lessens the discrepancy.
My point was that the breathless hyperbole about "gender affirming" surgery is actually in direct opposition to "traditional male stereotype" of the same group--thus invalidating that the concern is a genuine issue rather than political rhetoric.
As to whether teenage boys should be getting that surgery? That's .. more complicated. Should one that lost 100+ pounds to be healthier be able to get that surgery? Probably. How big should the growth be before it becomes "medical"? Don't know.
This is why stuff like this should be left to doctors who actually understand the circumstances of the patient.
> thus invalidating that the concern is a genuine issue rather than political rhetoric.
You didn't invalidate the concern at all and just if anything bolstered it. One reason why people voted for Trump (I wouldn't vote for him myself) is that any discussion on these topics gets called a phobia or an ism.
> Should one that lost 100+ pounds to be healthier be able to get that surgery?
If they're an adult, they can do what they like.
> This is why stuff like this should be left to doctors who actually understand the circumstances of the patient.
Just because someone is a doctor does not mean they have an unquestionable moral or ethical compass, there are good doctors and bad doctors. When homosexuality was illegal in the UK, doctors would chemically castrate gay men.
Calling a legitimate argument a "dog whistle" is a classic tactic OP is talking about which is used to shut down discussion. Just debate the merit of what he's saying rather than try to label him as an enemy.
Breast reduction for children IS in fact irreversible. It causes huge scars and trying to get breast augmentation later is not actually restoring their body to its natural state. It is definitely something that is controversial. Also putting children on hormones is within scope of this conversation and DOES happen.
There are lots of people who detransition and regret their decision. Children who have been sterilized for life and have permanent scars. It's completely valid to have discussions about whether kids should be able to make these decisions (they shouldn't).
You are repeating the talking point without including the number:
The number of those kinds of surgeries people claim to be "oh so concerned" about is in the low double digits--generally low single digits--normally zero in a year.
When you get to some medical procedure that incredibly rare, the medical indications are generally really, really unique and should be left to doctors. (breast implants in girls are simply not done until 18+ unless cancer is involved, for example).
Despite what people seem to think, doctors don't just do this stuff randomly (at least in the US). They can and will lose their license for doing this kind of thing unless they follow established guidelines. And all those guidelines dictate that this kind of stuff is simply not done until after 18 unless there are incredibly extenuating medical circumstances.
> Breast reduction for children IS in fact irreversible. It causes huge scars and trying to get breast augmentation later is not actually restoring their body to its natural state.
I have yet to meet a girl or woman who had breast reduction and regretted it. See: Soleil Moon Frye, for example. She had genuine health issues. And, even still, she had to fight with her doctors to get it done at 16 rather than wait until 18.
> Children who have been sterilized for life and have permanent scars.
Cite examples. I suspect vastly more children have been sterilized for life from circumcision complications than from any other gender surgery.
> ...These drugs, known as GnRH agonists, suppress the release of the sex hormones testosterone and estrogen. The U.S. Food and Drug Administration has approved the drugs to treat prostate cancer, endometriosis and central precocious puberty, but not gender dysphoria. Their off-label use in gender-affirming care, while legal, lacks the support of clinical trials to establish their safety for such treatment. ... Over the last five years, there were at least 4,780 adolescents who started on puberty blockers and had a prior gender dysphoria diagnosis...
And more than that for hormone treatment:
> At least 14,726 minors started hormone treatment with a prior gender dysphoria diagnosis from 2017 through 2021, according to the Komodo analysis.
And far more than "low double digits--generally low single digits--normally zero" for surgeries:
> In the three years ending in 2021, at least 776 mastectomies were performed in the United States on patients ages 13 to 17 with a gender dysphoria diagnosis, according to Komodo’s data analysis of insurance claims. This tally does not include procedures that were paid for out of pocket.
(And also does not include cisgender patients without gender dysphoria but with unwanted breast growth.)
I would just like to say the discussion under your comment is exactly the kind of productive discussion citing papers and statistics I want to see more of.
Too many progressives want to terminate such discussions by censoring any dissenting opinions and attacking any kind of disagreement as bigotry.
> The number of those kinds of surgeries people claim to be "oh so concerned" about is in the low double digits--generally low single digits--normally zero in a year.
> Among the 209 adolescents who underwent gender-affirming mastectomy, only two expressed regret.
> In our cohort, two patients (0.95%) expressed regret; one inquired about reversal surgery, but neither had undergone reversal surgery within follow-up periods of 3.7 years and 6.5 years.
Note the followups are into post-teenage years and most are very satisfied.
> Gender-affirming mastectomy, also known as “top surgery,” is the most prevalent surgery requested when considering all transgender adolescents, whereas “bottom surgery,” which affects genitalia and fertility, is relatively more complex and mostly performed after age 18.
As far as I can see, this is a medical system that is being very conservative (especially involving irreversible effects on fertility), involving parents/guardians at all stages, and prefers therapy first, hormones second, and surgery only as a very final choice. And note this level of conservatism in a system in Northern California--which is likely to be the most accepting of such medical actions.
So, if you are advocating that this should not be the case, understand that you are directly attempting to legislate the complex relationship between parent and teenager as well as both of them communicating with a medical professional for something which evidentially is a neutral to positive outcome for 98+% of the patients involved.
What right do YOU think you have to enter into that conversation at all?
> Our study has several limitations. First, its retrospective design meant we were unable to measure patient satisfaction and quality-of-life outcomes. Complications and any mention of regret were obtained from provider notes, which may be variable, and thus both may be under-reported. In addition, although an integrated health care system allows for continuity of care, some members may have transferred care or changed their insurance status and thus, subsequent complications, or reversal operations, would not have been captured. Next, our study was conducted at KPNC in an insured cohort of individuals with access to gender-affirming medical and surgical care. Therefore, our outcomes may not be representative of the general population, many of whom lack similar access to care. Finally, the time to develop postoperative regret and/or dissatisfaction remains unknown and may be difficult to discern.
You state that "the followups are into post-teenage years and most are very satisfied", but the authors were very explicit about not being able to determine this due to the study design.
The authors also report that:
> The median age at the time of referral was 16 years (IQR=2) and ranged from 12-17 years. Patients had a median post-operative follow-up length of 2.1 years (IQR 1.69).
Which implies that for many patients, the follow-up would have been within their teenage years.
Not only that, but the number of kids on hormone blockers is in the thousands (and increasing a lot every year). It's claimed that their effects are reversible but that is false, they lead to sterilization if the timing is wrong.
I appreciate the study links, but it makes it really hard to take you seriously when you claim trans kids are not allowed to “exist”. That’s extreme hyperbole, as if they’re still alive they obviously exist.
If you don't allow for proper treatment like social transitioning and puberty blockers, they can't be themselves and therefore they can't exist.
Next to this there's also risk of those kids committing suicide because they can't get proper treatment, which is only getting worse with all the anti-trans laws. See https://www.nature.com/articles/s41562-024-01979-5.epdf
>According to this way more recent study they are totally reversible: And this one says the same:
I see nothing in your links that supports those conclusions. The second one at least asserts that recipients overwhelmingly don't want to reverse the effects, but this too is a complex topic (see e.g. https://slatestarcodex.com/2018/09/08/acc-entry-should-trans... ).
Also, the link you're responding to isn't a "study", but rather a position document from the NHS (UK national healthcare).
You can either force a trans kid to develop the wrong kind of secondary sex characteristics. With all trauma and painful corrective procedures that will follow later in life, or you can let them take a pill a day which will halt it until they're old enough to make that decision. That really doesn't seem difficult to me.
> Also, the link you're responding to isn't a "study", but rather a position document from the NHS
I know but it's still based on the cass report, which claims to be a study.
> As far as I can tell, you linked to abstracts for a paywalled academic papers.
Just scroll down, no paywall.
> The point is about the objective fact of what the kids want. Your moral judgement of what should be done as a result, is irrelevant to that.
This has nothing to do with my moral judgment. If a kid gets diagnosed with gender-dysphoria, they should get proper treatment. Social transition in combination with puberty blockers are the known effective treatment.
Not sure about the US, but here gender-dysphoria in children has to be diagnosed by a team of professionals that aren't allowed to steer them in any way.
Disputed by the disingenuous. Notice who they always exclude from the restrictions from those "dangerous drugs"? Cis children. Magically that 0.01% of the population faces absolutely zero issues.
> > Whether and under what circumstances trans women have no advantage over cos women is a highly complex question.
> Again, not really, except for all the misinformation online. If trans woman have such an high advantage, why haven't they dominated the Olympics for the last 20 years?
Not really sure why you specify 20 years, but I'm too lazy to go through the history of IOC positions to figure out the one 20 years ago.
Because looking at the current one already provides the answer.
The IOC doesn't take the position that it is a simple topic.
The wording in https://olympics.com/ioc/human-rights/fairness-inclusion-non... (and click through) is quite clear that they see a tension between inclusion along the axis of sexual identity and a continuation (or successor) or male/female category split.
Where is your actual evidence puberty blockers are reversible? They are male. Their reproductive systems are organized around creating sperm not eggs. HRT does not change a male into a female. There are myriad aspects of biology that still makes them male and confers all such advantages in athletics. This is just reality.
There are very serious issues involving trans people with no easy answers. Like allowing minors access to irreversible treatments. Like women’s sports. Like the safety of women only spaces.
I bring this up because on so many questions like these, the progressive reaction is to shut down any discussion and isolate themselves from exposure to any ideas different from their own.
It doesn’t work. And it doesn’t help anyone.
And maybe this has something to do with why Facebook is migrating to a “Community Notes” model.