That's a very good question. It leads me on to another: Should our thinking be binary or should it not or both?
I ask that because I inhabit the medical model which is very binary, as I think it implicit in my previous posts. Moreover, legally we live in a binary world. Individuals must have a designated sex in most jurisdictions which is a binary choice.
On the other side is the fact that people are not binary. Quite apart from those who identify as non-binary gender, all of us have a range of traits and attributes that may be commonly associated with one gender or the other. Even if we have a strong sense of gender identity which is cis- most of us are fairly fluid these days in terms of traditional gender roles.
That's a very good question. It leads me on to another: Should our thinking be binary or should it not or both?
On the other side is the fact that people are not binary. Quite apart from those who identify as non-binary gender, all of us have a range of traits and attributes that may be commonly associated with one gender or the other. Even if we have a strong sense of gender identity which is cis- most of us are fairly fluid these days in terms of traditional gender roles.
Which makes me question what you meant in your (very educational) post up-thread by 'brains being male profile due to the effect of testosterone'.
If I were to try to list the traits and characteristics that make one 'male ' or 'female' I pretty soon realise I'm in the territory of social expectations and conditioning. And misogyny too.
That's a very good question. It leads me on to another: Should our thinking be binary or should it not or both?
On the other side is the fact that people are not binary. Quite apart from those who identify as non-binary gender, all of us have a range of traits and attributes that may be commonly associated with one gender or the other. Even if we have a strong sense of gender identity which is cis- most of us are fairly fluid these days in terms of traditional gender roles.
Which makes me question what you meant in your (very educational) post up-thread by 'brains being male profile due to the effect of testosterone'.
If I were to try to list the traits and characteristics that make one 'male ' or 'female' I pretty soon realise I'm in the territory of social expectations and conditioning. And misogyny too.
Indeed.
The science on sex differences in brains is mixed. I am confident that hormones affect brain development. That implies sex differences but they have been very hard to nail down. Things like functional MRI studies have been done but with mixed results. And given that brains are incredibly plastic, even if you find differences they may be an effect of social phenomena rather than intrinsic biology.
However, there are biological females who *feel* they are male, despite being socialised as female their whole lives. That implies that there are biological factors for gender identity independent of socialisation.
I looked up a Nature article on brain differences between the sexes the other day which bemoaned how often the conclusions of neuroscience studies were subject to pre-existing biases from the territory of social expectations and indeed misogyny.
Hence it is hugely problematic. But that does not change my view that it is totally plausible that there is a biological explanation for the experience of being Transgender. However, we have to acknowledge that it is a very complex question and being able to seperate out sex from gender, biology from social expectations, nature from nuture is challenging. And - and - we are talking about real human persons here so we must tread lightly. Which I hope I have managed to do.
The conclusion, @Marvin the Martian wrote put it so well, I am going to steal it:
I don’t think such an explanation would detract from the lived experience or treatment of transgender people in the least, quite the reverse in fact, I think it would provide firm evidence to confirm and legitimise it. Perhaps that evidence shouldn’t be needed in an ideal world, but that’s not the world in which we live.
However, we have to acknowledge that it is a very complex question and being able to seperate out sex from gender, biology from social expectations, nature from nuture is challenging.
And, we should also be asking whether we need to separate out different influences on how someone sees themselves. If someone sees themselves as a gender different from that assigned at birth, does it really matter how much of that self-identity is a result of biology or how much is a result of early childhood experience?
That's a very good question. It leads me on to another: Should our thinking be binary or should it not or both?
I ask that because I inhabit the medical model which is very binary, as I think it implicit in my previous posts. Moreover, legally we live in a binary world. Individuals must have a designated sex in most jurisdictions which is a binary choice.
On the other side is the fact that people are not binary. Quite apart from those who identify as non-binary gender, all of us have a range of traits and attributes that may be commonly associated with one gender or the other. Even if we have a strong sense of gender identity which is cis- most of us are fairly fluid these days in terms of traditional gender roles.
Hmmm....
Well, that depends what you mean by "people are..."
Splitting humans in to people that can impregnate and people who can be impregnated is a pretty binary division. With the exception of the various intersex conditions, sex is binary, and a model of binary sex, with a small number of "errors" describes people well.
But just because one thing about humans is binary doesn't mean that other things have to be. Sex is real, and is (mostly) binary. A society that wants to perpetuate itself needs to arrange itself around some sort of stable framework that includes lots of male-female sex, otherwise you don't get more people. We are the inheritors of generations of social conditioning that separates roles and expectations based on whether you're the sort of person who can get pregnant or not.
So I think the fact that the social conditioning has been so binary is likely to do a good job at obscuring whatever gender is, if gender actually exists as a thing at all. Are people who identify as cis actually people who have a strong sense of gender that aligns with their genitals, or are they just people that have a sense of gender that is not sufficiently opposed to their biology to make going along with the societal defaults intolerable?
I don't think it matters at all for the social questions of how society should treat trans people, but I think it's an interesting question.
A number of research studies have investigated biological factors that could potentially contribute to transgender identity, but results often contradict each other. Interpretation of etiological studies of transgender identity can be misunderstood and/or misused by media, politicians, and care providers, placing transgender people at risk. We question the utility of etiological studies in clinical care, given that transgender identity is not pathological. When etiological studies are undertaken, we recommend new, inclusive designs for a rigorous and compassionate approach to scientific practice in the service of transgender communities and the providers who serve them.
I'm reminded that Western societies and institutions don't have a great track record in relation to the pathologisation of feelings and behaviour that fall outside traditional Western norms.
Splitting humans in to people that can impregnate and people who can be impregnated is a pretty binary division. With the exception of the various intersex conditions, sex is binary, and a model of binary sex, with a small number of "errors" describes people well.
Also, there are the exceptions of people who are infertile - and, there are a lot of those people in older age groups (as well as children). And, does someone who is physically capable of impregnating someone but has no desire to do so (eg: because they're gay) count as someone who "can" or not? Likewise with those who can be impregnated.
The more exceptions there are then the less useful a binary division is.
And when you put epigenetics into the mix, it seems that 'social phenomena' can actually affect 'biology'.
In my family when someone mentions epigenetics, that's a signal to put the kettle on as you're in for a long haul. All I can offer (several teas later) is that humanity is probably the most complex thing in the galaxy and that almost any simplification is going to be reductive. I think we have to just try and get more comfortable with the idea that clear cut answers and human beings very seldom mix.
Medically it matters because biological sex affects which diseases you might get. But in other contexts the differences are rarely relevant.
Defining gender on the basis of one's role in reproduction only really works when society focuses on reproduction.
@pease's point about the utility of etiological studies is well made. Medical science does not have a very good record here - especially in how such studies have been used.
I have suffered from depression all my adult life. Most days I have an existential crisis - by which I mean I want to sit in a corner and stop existing. It passes in a few minutes, and I'm OK.
When I was a medical student there was still some talk about exogenous and endogenous depression. I have good risk factors for both. I had a complex childhood - some of which I've relayed here. I have a strong family history with my maternal grandfather being treated for depression in the 60s and 70s and my father having bipolar, amongst other things.
Ultimately though, it's irrelevant. My brain chemistry is just a little fucked most of the time. Who cares which causes have led to that fact? Because of mental health stigma, sometimes it's easier to have so-called exogenous depression because that's allowed but endogenous just means you're weak. In case you haven't worked it out yet, this division is total bollocks.
Now, I want to be careful with the parallel because not being cis- is not pathology. But the same applies: the experience is real. Conversely, I stand by the bit above that as well as being intellectually interesting, a biological explanation could help. It shouldn't be like that. We should just believe trans and non binary people when they tell us who they are.
And when you put epigenetics into the mix, it seems that 'social phenomena' can actually affect 'biology'.
In my family when someone mentions epigenetics, that's a signal to put the kettle on as you're in for a long haul. All I can offer (several teas later) is that humanity is probably the most complex thing in the galaxy and that almost any simplification is going to be reductive. I think we have to just try and get more comfortable with the idea that clear cut answers and human beings very seldom mix.
Wonderful description. Epigentics is lots of fun. There's a strain of mice in which you can alter the fur colour of the offspring by changing the diet of the mother during pregnancy!
Human persons are very complicated. I am a medical professional and a molecular biologist who believes that often the most important things about us are nothing to do with our biology.
I think the fundamental fear that drives that, is the fear one’s children may not be able to have children of their own.
Which must be a fairly recent phenomena given that until relatively recently a big percentage of children in western countries died in childhood, during childbirth or as adults before they could reproduce. There can't have been much expectation for parents that any given child would survive and reproduce.
Epigenetics may be fun with the colour of mice but it can also be scary. In the BMJ recently (27 July) there was an article citing evidence that adverse environmental conditions affecting a baby, and even before birth, such as heat stress, drought, malnutrition etc increases the the risk of the child growing up to have educational underperformance, anxiety and depression, ADHD, 'diminished self-regulation' etc.
From which one could postulate a mechanism that results in the perpetuation through generations of factors that are associated with poverty in terms of life outcomes.
Epigenetics may be fun with the colour of mice but it can also be scary. In the BMJ recently (27 July) there was an article citing evidence that adverse environmental conditions affecting a baby, and even before birth, such as heat stress, drought, malnutrition etc increases the the risk of the child growing up to have educational underperformance, anxiety and depression, ADHD, 'diminished self-regulation' etc.
From which one could postulate a mechanism that results in the perpetuation through generations of factors that are associated with poverty in terms of life outcomes.
Indeed. But it is extremely complicated and we are only beginning to scratch the surface of any of this so we should be extremely cautious about drawing any conclusions. Extremely.
If anyone is interested, I can do a basic explanation of epigenetics (probably) within the character limit?
No, I’m asking exactly what I asked. I don’t think that trans ontology need rely on the notion that “gender identity is by definition a mental construct.” One could believe that one’s true, inner gender is A, while one’s body is sex B, and also believe that their gender A is objectively real, gleaned from reality rather than imposed on it, without any existentialism at all—say for instance that one’s soul/spirit is gender A in a sex B body.
Trans people include those who identify their gender as non-binary, agender, and various other descriptors. Observation says that whatever gender is, it's significantly less binary than biological sex. A lot of older ways of thinking about transgender issues are very binary, and those don't seem to fit the data.
Which isn't too surprising, given the primacy, in Western cultures, of binary ways of thinking about the world ("binary opposition").
Again, one could believe this ("that one’s true, inner gender is A, while one’s body is sex B," etc.). One is not constrained to believe this. It's one way among others that someone who believes in philosophical essentialism (vs existentialism) might believe about such matters. The question of whether gender is or is not ultimately, on a metaphysical level, binary or not is still a philosophical question. (One could (note the word "could"--not "must") also argue that gender is ultimately binary, but that within Creation, all things (including humans) experience gender as a polarity rather than being absolutely one or the other. Or possibly multiple genders of different aspects of any given entity/object within creation, so for example the acetaminophen bottle on the desk next to me could be masculine in one aspect, feminine in another, etc., while the tablets inside it could have other aspects, the label on the bottle, etc. Ditto for rocks, trees, animals, angels, and humans. But this again is on a philosophical and metaphysical level.)
I see in the above a tendency towards conceiving the issue in binary terms - do you think this reflects the general extent to which our thinking is (predominantly) Western, or maybe that it emerges (more specifically) from an essentialist perspective?
In my case, it’s connected to a belief in philosophical essentialism, rather than existentialism, certainly. If it is true, and Western or other groups of beliefs reflect this, then good. But to me the primary matter is whether or not something is true, not the region of the world that believes it.
I want to pick up on something AFZ said up-thread; 'there are biological females who *feel* they are male..'
I want to ask, if I'm allowed (as I have no lived experience of this), whether such a person might also *feel* that they are *not female* and whether, in some individuals, only one of these two *feelings* might be experienced. Also similarly in the case of a 'biological male'?
PS, AFZ : another thread for epigenetics could be very interesting.
I think the fundamental fear that drives that, is the fear one’s children may not be able to have children of their own.
Which must be a fairly recent phenomena given that until relatively recently a big percentage of children in western countries died in childhood, during childbirth or as adults before they could reproduce. There can't have been much expectation for parents that any given child would survive and reproduce.
And, does someone who is physically capable of impregnating someone but has no desire to do so (eg: because they're gay) count as someone who "can" or not? Likewise with those who can be impregnated.
Can, of course, because the issue, in the mediaeval sense, is whether you can do the deed, and not whether you'll like it. And because rape exists.
@alienfromzog notes that this differentiation only really works when society focuses on reproduction. Until very recently, that is exactly what our societies did. The cultural imperative to focus on reproduction is still present in significant fractions of our contemporary society. I don't think you can ignore that.
Conversely, I stand by the bit above that as well as being intellectually interesting, a biological explanation could help. It shouldn't be like that. We should just believe trans and non binary people when they tell us who they are.
All the difficult issues arise because it's not just about "believing trans people when they tell us who they are". So a trans man says that he is a man. OK. We believe him, we assume that he is giving an honest description of the way he sees himself.
But does it automatically follow that the divisions that we choose to use for sporting competitions should be "people who identify as men" and "people who identify as women"? Does it automatically follow that modesty taboos about changing in public should have to do with how you identify, or to do with what your body looks like?
In a cisgender binary world, where sex = gender = presentation, you don't have to think too hard about whether some activity is separated by sex or gender, because they're the same thing. You can reasonably think about whether the activity needs any kind of separation at all, but you don't need to think too hard about exactly why you think men and women need to be separated.
Now that everyone is aware that trans people exist, there isn't just one obvious way to group people. And if you look at, for example, the set of reasons to have a separate changing room for men and for women, some of the reasons correlate with gender, and some of the reasons correlate with external biology. And so I think well-meaning people of good faith can come to different conclusions depending on which aspects they emphasize.
I think the fundamental fear that drives that, is the fear one’s children may not be able to have children of their own.
I don't really think that this can explain all or even most of the reactions to this and similar issues. Fundamentally we live in a society with a very dyadic understanding of gender which is policed and self-policed in all sorts of subtle ways; For parents it's partly anxiety that our children won't fit in or that their gender expressions can reflect on and undermine our own performance of gender. More broadly that any expression of gender that is outside the limits set by society is in itself seen as a threat as it questions the entire system.
However, we have to acknowledge that it is a very complex question and being able to seperate out sex from gender, biology from social expectations, nature from nuture is challenging.
And, we should also be asking whether we need to separate out different influences on how someone sees themselves. If someone sees themselves as a gender different from that assigned at birth, does it really matter how much of that self-identity is a result of biology or how much is a result of early childhood experience?
There are challenges here which both @pease and @alienfromzog have covered off very thoroughly. But that said I get worried whenever I see the “it doesn’t really matter” argument because it sometimes seems to come from a place that is deeply resistant to society fully understanding transgenderism and I think that ultimately does a lot of damage. There are aspects of trans and nonbinary experience where I think if you understand the experience then the etiology becomes obvious, at least to the extent of understanding that there is no remotely plausible way that nurture could be part of that etiology. Which leaves some form of nature. And so conversely deliberate agnosticism about etiology translates into willed ignorance about trans and nonbinary experience.
I’m sorry that’s a little cryptic but it’s as much as I want to say on the Internet.
However, we have to acknowledge that it is a very complex question and being able to seperate out sex from gender, biology from social expectations, nature from nuture is challenging.
And, we should also be asking whether we need to separate out different influences on how someone sees themselves. If someone sees themselves as a gender different from that assigned at birth, does it really matter how much of that self-identity is a result of biology or how much is a result of early childhood experience?
There are challenges here which both @pease and @alienfromzog have covered off very thoroughly. But that said I get worried whenever I see the “it doesn’t really matter” argument because it sometimes seems to come from a place that is deeply resistant to society fully understanding transgenderism and I think that ultimately does a lot of damage. There are aspects of trans and nonbinary experience where I think if you understand the experience then the etiology becomes obvious, at least to the extent of understanding that there is no remotely plausible way that nurture could be part of that etiology. Which leaves some form of nature. And so conversely deliberate agnosticism about etiology translates into willed ignorance about trans and nonbinary experience.
I’m sorry that’s a little cryptic but it’s as much as I want to say on the Internet.
But, I think there's a difference between etiology and experience. People can explain their experience without needing to be able to understand how they came to be who they are. I'd guess very few of us understand how we came to have fundamental characteristics of our identity - I can explain my experience of being a (mad) scientist, but why I'm good at analytical skills is a mystery; I can talk about memories of primary school completing maths tasks and asking for more challenging work while practically the whole of the rest of the class had their hands up waiting for help, but I don't know why I was so much better at maths than others in my class. Would anyone actually demand to know why I'm good at maths and physical sciences, or just accept my experience of being good at maths and physical sciences?
My point was whether an emphasis on etiology can overshadow, or even deny, experience. If someone says their experience of their gender differs from what was assigned at birth, then why shouldn't that statement of their own experience be sufficient? Why should we be focussing on the reasons why they don't experience their gender in the way it was assigned at birth?
I'm not denying the value of etiology. Many people may want to at least try to understand who they are, and etiology could be part of that. The useful summary AFZ gave earlier about the different ways X and Y chromosomes work, and importantly how sometimes that creates differences in external characteristics, is something that shows how biology can lead to some forms of non-binary/transgender identity and should open our minds to the possibility of other ways that people can experience gender that we don't understand, and possibly will never understand. I think it's important to help people out of binary thinking, and such summaries help with that.
But, while not denying value in etiology I'd want to emphasise experience.
In my opinion there is too much weight given in many of the discussions about trans healthcare which downplay the individual, in a way that would be unacceptable in other medical ethics contexts. Cass to me seems to have fallen into a hole of promoting poorly argued bioethics and the British government seems to have decided that it is authoritative.
Sorry, it's taken me a couple of days, but I wanted to respond to this specifically.
As I mentioned in an earlier post, the so-called Four=Principles Approach has been very widely used in medical ethics for half a century. It is not the only approach but at a guess, I would say it is the most commonly used. It has its limitations, of course, but as a basis for understanding the ethics of medical interventions, it is a really good starting point.
Essentially what we are saying is that the individual gets to decide what they want. Medicine should be beneficial and should not cause harm. And finally, we should treat all individuals fairly.
In the 21st century, much of the discussion of medical ethics has focused only on autonomy. There's a good argument for that focus. I cannot remember who first articulated the following argument, sorry, but it's a good one: 1. Human beings are entitled to autonomy
2. Illness compromises an individual's autonomy and stops them doing things and being what they want to be.
3. Therefore the purpose of medical interventions is to restore as much as possible that autonomy.
However, the converse is also true and many feel that autonomy has been taken too far to the exclusion of other principles. It is fairly well established that autonomy is not unlimited in ethical frameworks in that a patient may not demand a treatment from a doctor if the clinician believes said treatment to be harmful or not beneficial. That is also well established in English law.
I think all doctors can tell stories of the pressure created by patients demanding treatments that he/she does not think appropriate for that patient.
The issues, of course get much more complex when we are talking about minors.
The concept here is Competence, Competence is the ability and right of an individual to make autonomous decisions about their own care. Adults are assumed to be competent unless they are demonstrated not to. Competence is defined in the ability to understand the relevant information, retain it long enough to weigh the benefits and risks and make a decision. It is decision-specific. An individual may be competent for one decision but not another, depending on the complexity of the issues involved.
Gillick Competence is the legal term used for assessing the ability of minors to make decisions. The name comes from a landmark case in the High Court. This says that a child of any age (in theory) may be competent to make decisions about their medical care if they are of sufficient maturity to understand the risks and benefits. If they are not Gillick Competent, then normally the person with Parental Responsibility will give consent on their behalf, This is my daily life. Yesterday I took consent for three different operations, the patients were aged 1-4 and in each case, the parents signed the consent form.
Probably something like 99 times out of 100, it is totally appropriate that the parents give consent for a child. They are the patient's advocate and guardian. However, there are clearly examples of parents who do not act in the best interests of the child and hence there are legal processes to deal with this. I have been involved in cases where social services were involved because the parents would not consent to a procedure that the child really needed and was coming to harm because it had not yet happened.
Around DSD, there are some very complex discussions. Particularly around genital operations. The big discussion is around timing. There are advantages to performing surgery earlier which means long before the child is able to contribute to the discussion. Hence there is an argument for delaying surgery until the child is able to understand the risks and benefits and contribute to the discussion. The problem with this is that outcomes are not always as good if treatment is delayed. These cases are very tricky and are always discussed in the hospital ethics committee and may even involve legal proceedings. This is entirely appropriate. Generally, we are talking about invasive, irreversible interventions. I want to be clear that these are very difficult decisions in some cases. There are legal restrictions as well.
It seems to me, that Cass is putting puberty-blockers in the same category. To me, that is a category error. You can see the trap though. A child with gender dysphoria will get the most benefit from puberty blockers if they are started at around 11-14 (depending on the child) but they will not be a fully-autonomous adult until they are 18, at which point they will not benefit from such a treatment as it's too late.
As noted, the usual arguments about autonomy, beneficence, non-maleficence and justice would permit the use of puberty blockers. Autonomy: The patient and their family choose to have this treatment. There is a clear beneficial aim of the treatment with (limited) evidence that it will work. There are risks but no clear reason to think the risk of harm out-weighs the benefits. Justice says we should treat all groups (including Trans young people!) fairly.
In my view, Cass is denying autonomy on the basis of deciding that the beneficence is unproven and the risk of maleficence high. Therefore it ends up with a position that is also unjust.
That's just my opinion. Again, this is why I have such a problem with Cass. There is a discussion to be had here but Cass has reached a definitive position when a definitive position is not justified by the evidence.
I see in the above a tendency towards conceiving the issue in binary terms - do you think this reflects the general extent to which our thinking is (predominantly) Western, or maybe that it emerges (more specifically) from an essentialist perspective?
In my case, it’s connected to a belief in philosophical essentialism, rather than existentialism, certainly. If it is true, and Western or other groups of beliefs reflect this, then good. But to me the primary matter is whether or not something is true, not the region of the world that believes it.
Ah.
In my understanding, essentialism is no more "true" or "false" than existentialism - they are both perspectives or systems for thinking about the world. It is possible to believe that one or other is better, according to some criteria, but not that one is truer.
That smirking fucker Streeting is doubling down on transphobia today, pushing a permanent ban on puberty blockers for trans kids across the UK while crying crocodile tears about how much he cares about trans people. Then his Shadow Shit Stain on the Underpants of Humanity stands up, agrees with him, and dog-whistles about "protecting children".
This should probably be a hell thread where Streeting can get the rusty pitchforking he so richly deserves but I shall leave that to the discretion of the mods.
It always strikes me, they are approaching transgender from a political point of view, not a medical one. It seems amazing that this sleight of hand goes through, although I think some doctors are critical. Of course, the right wing, with zero knowledge or experience in this field, celebrate.
There's the implication that referrals for puberty blockers and gender affirming hormones were (a) commonplace and (b) offered instead of psychological and social support, when in reality neither of those things were true.
It also treats the Cass report as having far more weight and legitimacy than is justified.
It also quotes purveyors of anti-trans prejudice as authorities without identifying that that's what they are and gives very poor context for how increasingly discredited the Cass Review is internationally. You wouldn't know from the poor context given in this article that the recent French review rejects Cass's approach or that reviews in Australia have rejected what she says or the full extent to which medical professional bodies in America have rejected her approach or the scholarly criticism of what she's done and how it's been used. Meanwhile the article also doesn't tell you about the heavily abusive situation in Finland and that the main culprit there was involved in the Cass Review.
So pretty poor all round and the article is not own voice.
I can't stress enough to everyone how bad ALL the UK legacy media (with very very few exceptions) has become on this issue. If you don't go to the very few trans journalists who manage to keep writing, you will get platforms absolutely swamped with misinformation and prejudice dressed up as quality journalism but actually sticking their thumbs in the scale for people who want to erase trans people from public life, persecute them and stop them transitioning and treating that as a respectable point of view.
I have watched it happen over the space of eight years and watched bodies I thought couldn't get corrupted in this way to persecute a minority get corrupted right in front of my eyes.
On the academic front Dr Ruth Pearce maintains a resource page here with comments from medical professionals
the Review has been extensively criticised by trans community organisations, medical practitioners, plus scholars working in fields including transgender medicine, epidemiology, neuroscience, psychology, women’s studies, feminist theory, and gender studies. They have highlighted problems with the Cass Review that include substandard and inconsistent use of evidence, non-evidenced claims, unethical recommendations, overt prejudice, pathologisation, and the intentional exclusion of service users and trans healthcare experts from the Review process.
This post provides a round-up of links to written commentary and evidence regarding problems with the Cass Review, plus quotes pulled from each. In light of these, I believe that it would be extremely harmful to implement the Review’s findings in full
Dr Pearce and Dr Cal Horton co-authored a piece in Scientific American about the problems with the Cass Review. They are published own voice scholars
I honestly want to say some very bad words about Wes Streeting and the cowardly numpties up here in Scotland who've taken the path of least resistance but it would be unprintable - Labour and the SNP furthering the far-right scapegoating of a tiny harmless minority for votes. It's a horrifying thing.
If we ever wonder what we would have done in the 1930s when eugenics was all the rage even in left wing circles and 'scientific' racism was still widely respectable, wonder no more. It's what we're doing now to stand by trans people or not stand by them because we are steeping our brains in prejudiced media about them which makes it easy for governments to attack them - thinking it will win brownie points with populists and an increasingly irresponsible media.
Also if folk genuinely want to know whether something is transphobic then looking at what trans and non binary people are saying is a good place to start.
And Evan Urquhart is an American journalist but because British attacks on trans people are notorious he carries a fair bit of UK news on Assigned Media
Absolutely right. I think the BMA review of Cass continues but even if it concludes (as it should) that Cass is deeply flawed, the damage is already done.
I’ve already messaged my MP but I want to go further.
Is the UK's official fucking-over of trans kids more blatant than the new US president saying in his inaugural address: “As of today, it will henceforth be the official policy of the United States government that there are only two genders: male and female" and announcing an executive order removing many supports and protections for transgender people in the US?
As I live in neither country (but in a country that currently has broad protections for trans people, which conservatives are eager to remove, and are looking at both the US and the UK for examples of how to do so), I'm interested in how the government approaches to trans people under the UK Labour government and the new US Republican administration compare with each other? What do people here think? What are trans writers and activists in both countries saying?
Well currently trans identity is recognised in legislation - and it cannot simply be removed by decree. There is public transphobic discourse, but unravelling protections would be a difficult undertaking for the government, and I suspect is not big priority for them. This is one of the laws pertaining to this. This is Stonewall’s summary of the current UK situation - obviously they are lobbying group but I do think it’s a reasonable summary.
People like Gemma Stone and Lee Hurley and Sasha Baker are also good follows on Bluesky
Lots of trans folk were early adopters of Bluesky because of the situation on Twitter and because the moderation and blocking tools there are relatively good ( though not perfect)
So it's a very good place to find out what trans people say.
The UK government has continued to sustain and take anti-trans measures since the election of Labour
They continue to prevent Scotland implementing self-ID which our parliament voted for. They are, like the Conservatives, using an oppressive mechanism that denies Scottish democracy- Section 35 - to stop our law coming into effect.
And they have kept and gone further than the badly flawed and harmful Cass Review on healthcare for trans youth - continuing and extending a puberty blocker ban which harms young people.
The Cass Review also apparently just got thoroughly slated in the prestigious New England Journal of Medicine- which I was planning to post about but I've just got the article and want to read it first. Its findings were also rejected in France in their recent review. There's another recent academic article in the Journal of Adolescent Health - 'Emotional Health of Transgender Youth 24 Months After Initiating Gender-Affirming Hormone Therapy' which also appears to contradict Cass's approach.
I'm not an expert on presidential executive orders so can't properly evaluate the American situation though US trans people there that I've seen comment think the general situation looks extremely bad - fascists are in power and they are one of the fascist's most targeted groups. In the UK trans people I read expect things to get worse and for adult health care to be increasingly assaulted.
I should add that Stonewall are seen as poor allies who failed utterly over the Cass Review by a lot of trans people I follow who do not think they speak for them. They may have done good things in the past but aren't rated well now.
Nicola Sturgeon did an interview with Glad community radio in her constituency and spoke up for trans people and against misogyny. What a contrast she is with the current SNP leadership and even more with Streeting and Starmer. It's so disheartening to have lost her from front line politics at a time where this brand of intolerance is embraced by so many, but people like her still exist.
Interviewer So critics in your own party and elsewhere say that you allowed the issue of gender politics to dominate quite a lot of your time in in government and that that time could have been better used in other areas health, transport, education, etc.. What's your response to that?
Nicola Sturgeon I think it is bunkum. You know, if you if you were to go and do an analysis of the time spent on different issues as First minister, you would find that the time I spent on gender politics and I'll come back to minute in a minute to what people mean by that, but the time I spent on it would have been infinitesimal. If by gender politics, people including promoting, you know, gender equality, you know, making sure women got a fair crack at the whip, making sure women were properly represented in my cabinet, that we were, you know, encouraging and pushing companies to make sure women were properly represented on their boards or making sure that we were tackling misogyny and sexism. I will never apologise for trying to do that because sexism, misogyny, the many ways in which women don't get the same opportunities as men is one of the biggest challenges we should take on as a society.
If people are talking about trying to deliver greater dignity and respect for that tiny, tiny, tiny proportion of the population who are trans. I didn't spend much time quantitatively on that. But do I regret trying to reduce stigma and discrimination and trauma and heartache for that tiny number of people in our society? No, because one of the things that burns passionately in me is a belief in, you know, equality, a hatred of discrimination and prejudice and, you know, it often strikes me not, of course, not everybody I'm talking about, only some people, but some of my loudest critics on that issue are the ones who don't talk about anything else other than that issue, rather than me doing that. So I think people should sometimes take a step back and maybe ask themselves if what they're reflecting onto me is something in their own sense of the world.
There's a very interesting case going through a tribunal at the moment. I feel like the outcome of this will tell us a lot about where we are as a nation with this - I've been very worried and concerned by recent indicators.
It's already told us a lot - the case has been the subject of vile comment in the Scottish press, the person who brought it is an avowed Donald Trump fan and the judge permitted misgendering in court.
If people previously could have made the excuse that they were bamboozled by The Guardian and didn't realise they were standing with fascists to persecute a minority, they can't now.
I feel the same way as Barnabas- standing against it is a moral obligation and it's one that our current governments have failed. I include the post-Nicola SNP in that because they failed on Cass and haven't defended trans people from its ill effects.
The Cass Review was thoroughly condemned recently as the bad piece of work it is, in the New England Journal of Medicine (something you'd never know from the vast majority of the media who pushed and lauded it - now it's coming unstuck internationally and at a scholarly level they're not interested). AFZ was right about it - the NEJM makes similar criticisms to the ones he raised on this thread.
So much blame belongs to our media who drove this moral panic. It's really sobering.
Comments
I ask that because I inhabit the medical model which is very binary, as I think it implicit in my previous posts. Moreover, legally we live in a binary world. Individuals must have a designated sex in most jurisdictions which is a binary choice.
On the other side is the fact that people are not binary. Quite apart from those who identify as non-binary gender, all of us have a range of traits and attributes that may be commonly associated with one gender or the other. Even if we have a strong sense of gender identity which is cis- most of us are fairly fluid these days in terms of traditional gender roles.
Hmmm....
Which makes me question what you meant in your (very educational) post up-thread by 'brains being male profile due to the effect of testosterone'.
If I were to try to list the traits and characteristics that make one 'male ' or 'female' I pretty soon realise I'm in the territory of social expectations and conditioning. And misogyny too.
Indeed.
The science on sex differences in brains is mixed. I am confident that hormones affect brain development. That implies sex differences but they have been very hard to nail down. Things like functional MRI studies have been done but with mixed results. And given that brains are incredibly plastic, even if you find differences they may be an effect of social phenomena rather than intrinsic biology.
However, there are biological females who *feel* they are male, despite being socialised as female their whole lives. That implies that there are biological factors for gender identity independent of socialisation.
I looked up a Nature article on brain differences between the sexes the other day which bemoaned how often the conclusions of neuroscience studies were subject to pre-existing biases from the territory of social expectations and indeed misogyny.
Hence it is hugely problematic. But that does not change my view that it is totally plausible that there is a biological explanation for the experience of being Transgender. However, we have to acknowledge that it is a very complex question and being able to seperate out sex from gender, biology from social expectations, nature from nuture is challenging. And - and - we are talking about real human persons here so we must tread lightly. Which I hope I have managed to do.
The conclusion, @Marvin the Martian wrote put it so well, I am going to steal it:
I don’t think such an explanation would detract from the lived experience or treatment of transgender people in the least, quite the reverse in fact, I think it would provide firm evidence to confirm and legitimise it. Perhaps that evidence shouldn’t be needed in an ideal world, but that’s not the world in which we live.
AFZ
Well, that depends what you mean by "people are..."
Splitting humans in to people that can impregnate and people who can be impregnated is a pretty binary division. With the exception of the various intersex conditions, sex is binary, and a model of binary sex, with a small number of "errors" describes people well.
But just because one thing about humans is binary doesn't mean that other things have to be. Sex is real, and is (mostly) binary. A society that wants to perpetuate itself needs to arrange itself around some sort of stable framework that includes lots of male-female sex, otherwise you don't get more people. We are the inheritors of generations of social conditioning that separates roles and expectations based on whether you're the sort of person who can get pregnant or not.
So I think the fact that the social conditioning has been so binary is likely to do a good job at obscuring whatever gender is, if gender actually exists as a thing at all. Are people who identify as cis actually people who have a strong sense of gender that aligns with their genitals, or are they just people that have a sense of gender that is not sufficiently opposed to their biology to make going along with the societal defaults intolerable?
I don't think it matters at all for the social questions of how society should treat trans people, but I think it's an interesting question.
I'm reminded that Western societies and institutions don't have a great track record in relation to the pathologisation of feelings and behaviour that fall outside traditional Western norms.
The more exceptions there are then the less useful a binary division is.
In my family when someone mentions epigenetics, that's a signal to put the kettle on as you're in for a long haul. All I can offer (several teas later) is that humanity is probably the most complex thing in the galaxy and that almost any simplification is going to be reductive. I think we have to just try and get more comfortable with the idea that clear cut answers and human beings very seldom mix.
Medically it matters because biological sex affects which diseases you might get. But in other contexts the differences are rarely relevant.
Defining gender on the basis of one's role in reproduction only really works when society focuses on reproduction.
@pease's point about the utility of etiological studies is well made. Medical science does not have a very good record here - especially in how such studies have been used.
I have suffered from depression all my adult life. Most days I have an existential crisis - by which I mean I want to sit in a corner and stop existing. It passes in a few minutes, and I'm OK.
When I was a medical student there was still some talk about exogenous and endogenous depression. I have good risk factors for both. I had a complex childhood - some of which I've relayed here. I have a strong family history with my maternal grandfather being treated for depression in the 60s and 70s and my father having bipolar, amongst other things.
Ultimately though, it's irrelevant. My brain chemistry is just a little fucked most of the time. Who cares which causes have led to that fact? Because of mental health stigma, sometimes it's easier to have so-called exogenous depression because that's allowed but endogenous just means you're weak. In case you haven't worked it out yet, this division is total bollocks.
Now, I want to be careful with the parallel because not being cis- is not pathology. But the same applies: the experience is real. Conversely, I stand by the bit above that as well as being intellectually interesting, a biological explanation could help. It shouldn't be like that. We should just believe trans and non binary people when they tell us who they are.
AFZ
Wonderful description. Epigentics is lots of fun. There's a strain of mice in which you can alter the fur colour of the offspring by changing the diet of the mother during pregnancy!
Human persons are very complicated. I am a medical professional and a molecular biologist who believes that often the most important things about us are nothing to do with our biology.
AFZ
Which must be a fairly recent phenomena given that until relatively recently a big percentage of children in western countries died in childhood, during childbirth or as adults before they could reproduce. There can't have been much expectation for parents that any given child would survive and reproduce.
From which one could postulate a mechanism that results in the perpetuation through generations of factors that are associated with poverty in terms of life outcomes.
Indeed. But it is extremely complicated and we are only beginning to scratch the surface of any of this so we should be extremely cautious about drawing any conclusions. Extremely.
If anyone is interested, I can do a basic explanation of epigenetics (probably) within the character limit?
AFZ
In my case, it’s connected to a belief in philosophical essentialism, rather than existentialism, certainly. If it is true, and Western or other groups of beliefs reflect this, then good. But to me the primary matter is whether or not something is true, not the region of the world that believes it.
I want to ask, if I'm allowed (as I have no lived experience of this), whether such a person might also *feel* that they are *not female* and whether, in some individuals, only one of these two *feelings* might be experienced. Also similarly in the case of a 'biological male'?
PS, AFZ : another thread for epigenetics could be very interesting.
I don't feel male, I am male. As far as I hear from trans men, they don't feel that they are male, they have a deep knowledge that they are male.
I don't think I've ever met anyone who is non-binary.
That’s one of the reasons why they had so many.
Can, of course, because the issue, in the mediaeval sense, is whether you can do the deed, and not whether you'll like it. And because rape exists.
@alienfromzog notes that this differentiation only really works when society focuses on reproduction. Until very recently, that is exactly what our societies did. The cultural imperative to focus on reproduction is still present in significant fractions of our contemporary society. I don't think you can ignore that.
All the difficult issues arise because it's not just about "believing trans people when they tell us who they are". So a trans man says that he is a man. OK. We believe him, we assume that he is giving an honest description of the way he sees himself.
But does it automatically follow that the divisions that we choose to use for sporting competitions should be "people who identify as men" and "people who identify as women"? Does it automatically follow that modesty taboos about changing in public should have to do with how you identify, or to do with what your body looks like?
In a cisgender binary world, where sex = gender = presentation, you don't have to think too hard about whether some activity is separated by sex or gender, because they're the same thing. You can reasonably think about whether the activity needs any kind of separation at all, but you don't need to think too hard about exactly why you think men and women need to be separated.
Now that everyone is aware that trans people exist, there isn't just one obvious way to group people. And if you look at, for example, the set of reasons to have a separate changing room for men and for women, some of the reasons correlate with gender, and some of the reasons correlate with external biology. And so I think well-meaning people of good faith can come to different conclusions depending on which aspects they emphasize.
I don't really think that this can explain all or even most of the reactions to this and similar issues. Fundamentally we live in a society with a very dyadic understanding of gender which is policed and self-policed in all sorts of subtle ways; For parents it's partly anxiety that our children won't fit in or that their gender expressions can reflect on and undermine our own performance of gender. More broadly that any expression of gender that is outside the limits set by society is in itself seen as a threat as it questions the entire system.
There are challenges here which both @pease and @alienfromzog have covered off very thoroughly. But that said I get worried whenever I see the “it doesn’t really matter” argument because it sometimes seems to come from a place that is deeply resistant to society fully understanding transgenderism and I think that ultimately does a lot of damage. There are aspects of trans and nonbinary experience where I think if you understand the experience then the etiology becomes obvious, at least to the extent of understanding that there is no remotely plausible way that nurture could be part of that etiology. Which leaves some form of nature. And so conversely deliberate agnosticism about etiology translates into willed ignorance about trans and nonbinary experience.
I’m sorry that’s a little cryptic but it’s as much as I want to say on the Internet.
I don't think that cryptic at all.
My point was whether an emphasis on etiology can overshadow, or even deny, experience. If someone says their experience of their gender differs from what was assigned at birth, then why shouldn't that statement of their own experience be sufficient? Why should we be focussing on the reasons why they don't experience their gender in the way it was assigned at birth?
I'm not denying the value of etiology. Many people may want to at least try to understand who they are, and etiology could be part of that. The useful summary AFZ gave earlier about the different ways X and Y chromosomes work, and importantly how sometimes that creates differences in external characteristics, is something that shows how biology can lead to some forms of non-binary/transgender identity and should open our minds to the possibility of other ways that people can experience gender that we don't understand, and possibly will never understand. I think it's important to help people out of binary thinking, and such summaries help with that.
But, while not denying value in etiology I'd want to emphasise experience.
Sorry, it's taken me a couple of days, but I wanted to respond to this specifically.
As I mentioned in an earlier post, the so-called Four=Principles Approach has been very widely used in medical ethics for half a century. It is not the only approach but at a guess, I would say it is the most commonly used. It has its limitations, of course, but as a basis for understanding the ethics of medical interventions, it is a really good starting point.
Essentially what we are saying is that the individual gets to decide what they want. Medicine should be beneficial and should not cause harm. And finally, we should treat all individuals fairly.
In the 21st century, much of the discussion of medical ethics has focused only on autonomy. There's a good argument for that focus. I cannot remember who first articulated the following argument, sorry, but it's a good one:
1. Human beings are entitled to autonomy
2. Illness compromises an individual's autonomy and stops them doing things and being what they want to be.
3. Therefore the purpose of medical interventions is to restore as much as possible that autonomy.
However, the converse is also true and many feel that autonomy has been taken too far to the exclusion of other principles. It is fairly well established that autonomy is not unlimited in ethical frameworks in that a patient may not demand a treatment from a doctor if the clinician believes said treatment to be harmful or not beneficial. That is also well established in English law.
I think all doctors can tell stories of the pressure created by patients demanding treatments that he/she does not think appropriate for that patient.
The issues, of course get much more complex when we are talking about minors.
The concept here is Competence, Competence is the ability and right of an individual to make autonomous decisions about their own care. Adults are assumed to be competent unless they are demonstrated not to. Competence is defined in the ability to understand the relevant information, retain it long enough to weigh the benefits and risks and make a decision. It is decision-specific. An individual may be competent for one decision but not another, depending on the complexity of the issues involved.
Gillick Competence is the legal term used for assessing the ability of minors to make decisions. The name comes from a landmark case in the High Court. This says that a child of any age (in theory) may be competent to make decisions about their medical care if they are of sufficient maturity to understand the risks and benefits. If they are not Gillick Competent, then normally the person with Parental Responsibility will give consent on their behalf, This is my daily life. Yesterday I took consent for three different operations, the patients were aged 1-4 and in each case, the parents signed the consent form.
Probably something like 99 times out of 100, it is totally appropriate that the parents give consent for a child. They are the patient's advocate and guardian. However, there are clearly examples of parents who do not act in the best interests of the child and hence there are legal processes to deal with this. I have been involved in cases where social services were involved because the parents would not consent to a procedure that the child really needed and was coming to harm because it had not yet happened.
Around DSD, there are some very complex discussions. Particularly around genital operations. The big discussion is around timing. There are advantages to performing surgery earlier which means long before the child is able to contribute to the discussion. Hence there is an argument for delaying surgery until the child is able to understand the risks and benefits and contribute to the discussion. The problem with this is that outcomes are not always as good if treatment is delayed. These cases are very tricky and are always discussed in the hospital ethics committee and may even involve legal proceedings. This is entirely appropriate. Generally, we are talking about invasive, irreversible interventions. I want to be clear that these are very difficult decisions in some cases. There are legal restrictions as well.
It seems to me, that Cass is putting puberty-blockers in the same category. To me, that is a category error. You can see the trap though. A child with gender dysphoria will get the most benefit from puberty blockers if they are started at around 11-14 (depending on the child) but they will not be a fully-autonomous adult until they are 18, at which point they will not benefit from such a treatment as it's too late.
As noted, the usual arguments about autonomy, beneficence, non-maleficence and justice would permit the use of puberty blockers. Autonomy: The patient and their family choose to have this treatment. There is a clear beneficial aim of the treatment with (limited) evidence that it will work. There are risks but no clear reason to think the risk of harm out-weighs the benefits. Justice says we should treat all groups (including Trans young people!) fairly.
In my view, Cass is denying autonomy on the basis of deciding that the beneficence is unproven and the risk of maleficence high. Therefore it ends up with a position that is also unjust.
That's just my opinion. Again, this is why I have such a problem with Cass. There is a discussion to be had here but Cass has reached a definitive position when a definitive position is not justified by the evidence.
AFZ
Is “nature” exclusively biological, or does it include spiritual/metaphysical as well?
In my understanding, essentialism is no more "true" or "false" than existentialism - they are both perspectives or systems for thinking about the world. It is possible to believe that one or other is better, according to some criteria, but not that one is truer.
In relation to transgender ontology, I suggest having a look at this article from The Conversation: What is essentialism? And how does it shape attitudes to transgender people and sexual diversity?
It illustrates what appear to be fundamental problems with trying to reach a transgender ontology from an essentialist perspective.
Doublethink, Temporary Epiphanies Hosting
Doublethink, Temporary Epiphanies Hosting
As long as it’s okay with Pease, but I’m thinking about the essentialism/existentialism issue in itself, not relating to trans issues specifically…
This should probably be a hell thread where Streeting can get the rusty pitchforking he so richly deserves but I shall leave that to the discretion of the mods.
https://www.bbc.co.uk/news/articles/clyd2qe5kkjo
There's the implication that referrals for puberty blockers and gender affirming hormones were (a) commonplace and (b) offered instead of psychological and social support, when in reality neither of those things were true.
It also treats the Cass report as having far more weight and legitimacy than is justified.
It also quotes purveyors of anti-trans prejudice as authorities without identifying that that's what they are and gives very poor context for how increasingly discredited the Cass Review is internationally. You wouldn't know from the poor context given in this article that the recent French review rejects Cass's approach or that reviews in Australia have rejected what she says or the full extent to which medical professional bodies in America have rejected her approach or the scholarly criticism of what she's done and how it's been used. Meanwhile the article also doesn't tell you about the heavily abusive situation in Finland and that the main culprit there was involved in the Cass Review.
So pretty poor all round and the article is not own voice.
I can't stress enough to everyone how bad ALL the UK legacy media (with very very few exceptions) has become on this issue. If you don't go to the very few trans journalists who manage to keep writing, you will get platforms absolutely swamped with misinformation and prejudice dressed up as quality journalism but actually sticking their thumbs in the scale for people who want to erase trans people from public life, persecute them and stop them transitioning and treating that as a respectable point of view.
I have watched it happen over the space of eight years and watched bodies I thought couldn't get corrupted in this way to persecute a minority get corrupted right in front of my eyes.
On the academic front Dr Ruth Pearce maintains a resource page here with comments from medical professionals
https://ruthpearce.net/2024/04/16/whats-wrong-with-the-cass-review-a-round-up-of-commentary-and-evidence/
Dr Pearce and Dr Cal Horton co-authored a piece in Scientific American about the problems with the Cass Review. They are published own voice scholars
https://www.scientificamerican.com/article/the-u-k-s-cass-review-badly-fails-trans-children/
I honestly want to say some very bad words about Wes Streeting and the cowardly numpties up here in Scotland who've taken the path of least resistance but it would be unprintable - Labour and the SNP furthering the far-right scapegoating of a tiny harmless minority for votes. It's a horrifying thing.
If we ever wonder what we would have done in the 1930s when eugenics was all the rage even in left wing circles and 'scientific' racism was still widely respectable, wonder no more. It's what we're doing now to stand by trans people or not stand by them because we are steeping our brains in prejudiced media about them which makes it easy for governments to attack them - thinking it will win brownie points with populists and an increasingly irresponsible media.
This is one of the main UK sites
https://transwrites.world/
Sasha Baker is a good shout too
https://www.thebureauinvestigates.com/profile/sashabaker/
'What the trans!' also do podcasts if you prefer podcasts but I've linked to their opinion pieces here
https://whatthetrans.com/author/what-the-trans/
And Evan Urquhart is an American journalist but because British attacks on trans people are notorious he carries a fair bit of UK news on Assigned Media
https://www.assignedmedia.org/about-assigned
Stories on Puberty blockers here
https://www.assignedmedia.org/search?q=Puberty blockers
Absolutely right. I think the BMA review of Cass continues but even if it concludes (as it should) that Cass is deeply flawed, the damage is already done.
I’ve already messaged my MP but I want to go further.
Meanwhile, across the Atlantic ….
https://www.erininthemorning.com/p/81-democrats-voted-to-pull-care-from?utm_source=post-banner&utm_medium=web&utm_campaign=posts-open-in-app&triedRedirect=true
As I live in neither country (but in a country that currently has broad protections for trans people, which conservatives are eager to remove, and are looking at both the US and the UK for examples of how to do so), I'm interested in how the government approaches to trans people under the UK Labour government and the new US Republican administration compare with each other? What do people here think? What are trans writers and activists in both countries saying?
For the US my go to is https://www.assignedmedia.org/
And Evan Urquhart's personal account on Bluesky is
https://bsky.app/profile/evanurquhart.bsky.social
But you need to be signed into view
For the UK
https://transwrites.world/
People like Gemma Stone and Lee Hurley and Sasha Baker are also good follows on Bluesky
Lots of trans folk were early adopters of Bluesky because of the situation on Twitter and because the moderation and blocking tools there are relatively good ( though not perfect)
So it's a very good place to find out what trans people say.
The UK government has continued to sustain and take anti-trans measures since the election of Labour
They continue to prevent Scotland implementing self-ID which our parliament voted for. They are, like the Conservatives, using an oppressive mechanism that denies Scottish democracy- Section 35 - to stop our law coming into effect.
And they have kept and gone further than the badly flawed and harmful Cass Review on healthcare for trans youth - continuing and extending a puberty blocker ban which harms young people.
The Cass Review also apparently just got thoroughly slated in the prestigious New England Journal of Medicine- which I was planning to post about but I've just got the article and want to read it first. Its findings were also rejected in France in their recent review. There's another recent academic article in the Journal of Adolescent Health - 'Emotional Health of Transgender Youth 24 Months After Initiating Gender-Affirming Hormone Therapy' which also appears to contradict Cass's approach.
I'm not an expert on presidential executive orders so can't properly evaluate the American situation though US trans people there that I've seen comment think the general situation looks extremely bad - fascists are in power and they are one of the fascist's most targeted groups. In the UK trans people I read expect things to get worse and for adult health care to be increasingly assaulted.
I should add that Stonewall are seen as poor allies who failed utterly over the Cass Review by a lot of trans people I follow who do not think they speak for them. They may have done good things in the past but aren't rated well now.
I fear it’s heading that way in the USA and have concerns about political trends in Europe. Reminds me of Niemoller.
“They came for the trans ….”
https://www.mixcloud.com/GladRadio/southside-democracy-03/
https://www.bbc.co.uk/news/articles/c5ydnxy5019o
If people previously could have made the excuse that they were bamboozled by The Guardian and didn't realise they were standing with fascists to persecute a minority, they can't now.
I feel the same way as Barnabas- standing against it is a moral obligation and it's one that our current governments have failed. I include the post-Nicola SNP in that because they failed on Cass and haven't defended trans people from its ill effects.
The Cass Review was thoroughly condemned recently as the bad piece of work it is, in the New England Journal of Medicine (something you'd never know from the vast majority of the media who pushed and lauded it - now it's coming unstuck internationally and at a scholarly level they're not interested). AFZ was right about it - the NEJM makes similar criticisms to the ones he raised on this thread.
So much blame belongs to our media who drove this moral panic. It's really sobering.