[brandon272]

I am well aware of the current concerns around the incentives that exist in the medical industry when it comes to the treatment of gender dysphoric people. Some of it we should absolutely be concerned about, particularly when it comes to treatment of children.

Where the current public discourse on these issues goes off the rails is that we conclude that, because these concerns around improper incentives and improper treatment exists, or because there are some issues around social influence of children on social media, that "gender dysphoria" broadly is either not real or not a legitimate problem that people deal with.

> If someone was too short, or too tall, or thought they were black (even though they were unambiguously white)

If someone was 5'8" and underwent leg-lengthening therapy to become 6'1", would we not call that person "tall", or would we jump through strange mental hoops to justify antagonizing them based on their genetic makeup?

> Until a mind reading machine exists

Again, the problem here is that you are concluding that unless you can rationalize and validate someone else's thought process or mental condition through the lens of your own experience, then their experience is irrelevant to you, not real, and that they are worthy of mockery and derision instead of respect and consideration.

We don't need a mind reading machine to understand what gender dysphoria is, because gender dysphoric people tell us what they are thinking and feeling, not to mention they tend to know what will reduce their feelings of dysphoria.

[chlodwig]

We don't need a mind reading machine to understand what gender dysphoria is, because gender dysphoric people tell us what they are thinking and feeling

It's not this simple. For one, lots of people are all kinds of confused. There are people who think they are dysphoric, transition, then realize they totally messed up. There are people who say, "I went through a period when I was a kid where I was a tom-boy or told my parents I was the other sex -- thank goodness this kind of ideology wasn't around then because I could have been trannsed. I'm perfectly happy in my biological sex right now." If you read a lot of stories they aren't necessarily "dysphoric" they just think it will benefit them someway to transition, in the same way a weightlifter who goes on steroids is not "dysphoric" about his body, he just might think he is happier to be muscled up.

And we also have people who later admit that they lied about the nature gender identity in order to get sex change drugs and trans people who admit there is substantial political pressure to make their personal testimonials about gender identity conform to a certain script: https://nymag.com/intelligencer/article/trans-rights-biologi... https://www.nplusonemag.com/issue-30/essays/on-liking-women/

Because we do not actually have the technology to turn a man into a female (or vice versa), I think the most honest and best course is to tell that person, "Sorry, you are not a woman, and the surgery you are asking for will not actually get you want you want. Cross-dressing and wearing lipstick does not make you a woman. But if you learn to accept who you are, you can live a happy life." To be convinced that this common sense approach is not the best approach, I would need very strong evidence -- at minimum multiple randomized controlled trials by honest researchers.

[brandon272]

> There are people who think they are dysphoric, transition, then realize they totally messed up.

Some people start businesses, it doesn't go well, they then realized they messed up and totally regret it. Does this mean that all entrepreneurship should be banned?

The logical failure in your argument is that you are saying that because there are problems with current approaches to transgender care, that gender dysphoria is not real and does not need to be taken seriously or treated or accommodated.

> I think the most honest and best course is to tell that person, "Sorry, you are not a woman, and the surgery you are asking for will not actually get you want you want. Cross-dressing and wearing lipstick does not make you a woman. But if you learn to accept who you are, you can live a happy life."

There is zero evidence that your "common sense approach" works at all, and there is zero evidence that reparative or conversion therapy works at all for those with legitimate gender dysphoria.

[chlodwig]

There is zero evidence that your "common sense approach" works at all, and there is zero evidence that reparative or conversion therapy works at all for those with legitimate gender dysphoria.

Clinical psychologists Kenneth Zucker's work in getting the majority of his patients over their dysphoria is "evidence" that reparative therapy works -- https://www.thecut.com/2016/02/fight-over-trans-kids-got-a-r...

Every random comment on Reddit that "I suffered from dysphoria and then started lifting and doing masculine things and got completely over it" is evidence that reparative therapy works.

It's not gold standard evidence, it's not proof-beyond-a-reasonable doubt, but it is evidence. But the "evidence" for "affirmation" and "medical transition" do not meet this gold standard either.

With medicine, the burden of proof is on the person doing the intervention. "First do no harm." Social transition and medical transition are both MAJOR interventions, the burden of proof is on the proponents. "You have to give people this drug, no we have never done a controlled clinical trial on it, but you have no evidence that NOT giving them the treatment works." What? You need to do a RCT before promoting a new treatment as the standard of care. "Affirmation" has never proved itself in an RCT so "Sorry, you are a man" should be the default.

[brandon272]

> Clinical psychologists Kenneth Zucker's work in getting the majority of his patients over their dysphoria is "evidence" that reparative therapy works

You are conflating social trends among young people to identify as gender non-confirming for social clout, with adults who have intractable gender dysphoria. It is disingenuous to point to children who were likely not genuinely gender dysphoric to begin with, claim that they were 'cured' and conclude that this solution is then viable for all people with gender dysphoria. There is an incredible amount of nuance to the situation that you are simply ignoring.

One of two things is true:

1) You genuinely do not understand the 'separation of concerns' when it comes to these issues surround gender, biological sex and gender dysphoria, current social trends, and sensational political headlines.

2) You are being intentionally misleading.

I'm going to assume you are arguing in good faith and that #1 is true. In that case, I recommend you take a step back and try to recalibrate your understanding of the issue. I don't know the best way to accomplish that - maybe do some research and read some stories of transgender people published prior to 2015 before it became the political fight du jour.

>Every random comment on Reddit that "I suffered from dysphoria and then started lifting and doing masculine things and got completely over it" is evidence that reparative therapy works.

You've gone from demanding randomized controlled trials to referring to random comments from anonymous users on Reddit about how lifting weights cures gender dysphoria?

I think it's safe to say that the conversation has gone off the rails, although maybe that happened a few replies ago.

[chlodwig]

You are conflating social trends among young people to identify as gender non-confirming for social clout, with adults who have intractable gender dysphoria.

It's not just me who is conflating them, the official medical establishment doesn't treat children much differently these days. Zucker was canceled, "watchful waiting" or "reparative therapy" is officially condemned by the APA. "Intractable gender dysphoria" is not something that can be reliably or objectively diagnosed a priori. A relative of mine who has transitioned their son, partly based on medical advice, partly on the advice of adult trans friends, seems to repeating arguments about it being a fixed property and affirmative care being the only approach. Now, I personally do not think this boy has dysphoria at all, he sees a perfectly normal boy to me, he just liked Elsa and princess dresses as a kid because Elsa is a super-stimuli character. But that's not what the medical people say.

You can't separate the kids and adults issue because the most powerful activists who are making policy and getting people canceled are not making a proper distinction themselves.

You can't separate the kids and adults issue because there was a direct road from redefining the words "man" and "woman" to the medical "experts" like Diane Ehrensaft, cited by NPR and NY Times telling parents to not tell their four-year-old things like: "you have a penis, you can never grow up to be a woman or get pregnant, you will grow up to be a man, you are a boy."

It's not the sensationalist headlines that is making me freak about this, it's seeing my own relatives sending a little boy down the path where "continuity of care" ( https://www.youtube.com/watch?v=v0V0PXrezHM ) will lead to having his penis cut off like Jazz Jennings -- https://malcolmrichardclark.substack.com/p/the-truth-about-j... https://x.com/SJWilliams123/status/1654534161015635973

I don't know the best way to accomplish that - maybe do some research and read some stories of transgender people published prior to 2015 before it became the political fight du jour.

I have, but you need to re-calibrate your understand for the recent situation. The people who transitioning now are not exhibiting the same types of life stories as those who did thirty years ago. It seems like a different phenomena, and I am much more concerned with the phenomena now, when if afflicts so many people, including parents I know who are transitioning their kids, than I am about the phenomena 30 years ago.

You've gone from demanding randomized controlled trials to referring to random comments from anonymous users on Reddit about how lifting weights cures gender dysphoria?

Yes, once you have anecdotal evidence of something working on a n=1 approach, the thing to do is expand it to an n=many RCT. That hasn't been done. It should have been done. Also, comments on niche subreddits inhabited by relatively normal people are some of the best anecdotal evidence you can find. Anecdotes from friend groups are limited in their own way. Popular memoirs and newspaper stories are both highly selected and filtered by publishers for preferred narratives, and the person writing them understands that a lot is at stake and they have to be careful about how they narrate their story. Random commenters on niche forums have much less incentive to lie (this doesn't apply to big forums where people will lie to get rise out of people, and the comments that reach visibility are selected).