Trans women are not women (Part 8)

[Ziggurat]

I have no reason to believe Planned Parenthood's approach to prescribing hormone therapy is inappropriate. Do you?

Do you have any reason to believe that it is appropriate? I don't think you actually do.

It seems a lot of begging the question that some intense psychoanalysis or longer-term therapy is necessary before prescribing these drugs responsibly.

Uh, no. There's no begging the question involved. It should be obvious. ANY medical treatment with significant and permanent consequences should be considered quite seriously before it is performed. You should not do surgery without a confident diagnosis, and that goes for a lot of medications as well. And people are very bad at self-diagnosis.

What planned parenthood describes sounds like a fairly quick medical exam in which the patient and clinician talk about what problems the patient is experiencing and what medical solutions exist, followed by a script for medicine as appropriate. What's the problem?

The problem is that this isn't enough to actually determine what's appropriate.

Children are trickier because of the generally understood rule that children are kinda stupid. More politely, they have less capacity than adults. That does not mean they are totally incompetent to make their own medical decisions, but are more reliant on the guidance of professionals and guardians to help them make the best possible decisions.

The problem is they keep getting bad guidance from the "professionals". You demonstrated that quite well with the whole "puberty blockers are reversible" claim that fell apart under scrutiny.

This gets a bit trickier when the assumption that parents always have their children's best interests in mind often fails.

You don't seem to consider the possibility that the "professionals" might not have their children's best interests in mind. Or that parents who encourage kids to transition don't either.

 

[theprestige]

Normalizing secrets kept by children from their parents is Grooming 101.

The thing is, parents are the proper authority to see to their children's interests. Overriding their authority is something that should only ever be done with demonstrably good reason. How many school teachers and administrators actually have the resources, training, or even the personality to properly determine when a child's parents should be taken out of the loop?

Yet there is a push to make taking parents out of the loop the default educational policy. Who's more likely to be grooming the child for a life of sexual abuse? The parents who want to be kept informed of their child's education and thinking about human sexuality? Or the educator who's pushing to keep them in the dark?

 

[TurkeysGhost]

Normalizing secrets kept by children from their parents is Grooming 101.

The thing is, parents are the proper authority to see to their children's interests. Overriding their authority is something that should only ever be done with demonstrably good reason. How many school teachers and administrators actually have the resources, training, or even the personality to properly determine when a child's parents should be taken out of the loop?

Yet there is a push to make taking parents out of the loop the default educational policy. Who's more likely to be grooming the child for a life of sexual abuse? The parents who want to be kept informed of their child's education and thinking about human sexuality? Or the educator who's pushing to keep them in the dark?

Not sure where teachers came into this, my comments were about teens consenting to medical treatment without parental consent. But whatever it takes to ram the "Groomer" smear into the narrative.

Do you think laws that allow for teen children to consent to vaccinations against their parent's wishes are being "groomed"? What about a 16 year old that get an abortion or birth control against their parent's wishes? These kinds of conflicts are very common.

 

[Rolfe]

One of the links I posted yesterday concerned parents of a teenage girl who had a history of quite severe mental illness. They supported her throughout, took her to multiple psychology and counselling appointments, and tried to do whatever they could for her. Throughout, no matter how stressful the circumstances, the counsellors had no fault to find with them as parents and always included the parents in discussions about their daughter's treatment. Never were her demands treated as sacrosanct, or the daughter unconditionally supported to defy her parents.

Until she suddenly declared she was "really a boy" after falling in with a new friendship group, every single one of whom declared themselves to be trans within a window of a few weeks. When they took her to a gender therapy consultation, citing her previous psychological history and their belief that the trans identity was part of the whole mental health issue and influenced by peer-group contagion, they were shut out of the process by a therapist who would consider no other possibility but that their daughter was "really their son" and should be started on testosterone at the earliest opportunity. When they refused permission for their minor daughter to have this treatment it was prescribed anyway. The parents were subjected to vilification and abuse for being "transphobic", and the girl was deferred to in her every demand.

This is not good medicine.

 

[Meadmaker]

Do you really not understand why personal anecdotes are not that useful? They're inherently unfalsifiable. It's often impossible to know if the facts being relayed are truthful, either through bias or through intentional dishonesty.

I started to type, "I see your point, but...." and then realized that wasn't the right answer, because your point isn't relevant.

EC posted a personal anecdote of her niece, at the time her nephew, if memory serves, walking into a doctor's office at 16 and, without any reference from mental health professionals and without knowledge of her parents, receiving a prescription for opposite sex hormones.

You know that there are places where that can happen today, and you applaud that it can happen. You like it that way and you are against efforts to stop it.

So, instead of saying, "Yeah. Good on her for doing it." you make it sound like somehow you doubt it and cast doubt on EC's believability. Even if that particular anecdote is inaccurate because of intentional or unintentional reasons, it makes no difference at all. You know that situations like that do in fact occur, and you know that you want them to occur. What's the point of this whole "personal anecdote" sidetrack?

I have no reason to believe Planned Parenthood's approach to prescribing hormone therapy is inappropriate. Do you? It seems a lot of begging the question that some intense psychoanalysis or longer-term therapy is necessary before prescribing these drugs responsibly.

In my opinion, prescribing these drugs without psychoanalysis or some form of mental health evaluation is not a responsible way of prescribing these drugs.

And of course you add "intense" or "longer term", because distorting other people's opinion is your standard modus operandi.

And I am not begging the question. I'm stating an opinion. There is a difference. In the post you are referring to, I didn't make any argument supporting that opinion, i just stated it.

Elsewhere, I have made arguments about it, and in doing so, did not beg any questions there, either.

What planned parenthood describes sounds like a fairly quick medical exam in which the patient and clinician talk about what problems the patient is experiencing and what medical solutions exist, followed by a script for medicine as appropriate. What's the problem?

That is exactly what they are doing, although the assertion of "as appropriate" is actually contentious. It should be "as appropriate in the opinion of the patient and/or physician". Saying it is actually appropriate seems almost like begging the question. (Unless, you just mean "appropriate in your opinion")

 

[TurkeysGhost]

I started to type, "I see your point, but...." and then realized that wasn't the right answer, because your point isn't relevant.

EC posted a personal anecdote of her niece, at the time her nephew, if memory serves, walking into a doctor's office at 16 and, without any reference from mental health professionals and without knowledge of her parents, receiving a prescription for opposite sex hormones.

You know that there are places where that can happen today, and you applaud that it can happen. You like it that way and you are against efforts to stop it.

So, instead of saying, "Yeah. Good on her for doing it." you make it sound like somehow you doubt it and cast doubt on EC's believability. Even if that particular anecdote is inaccurate because of intentional or unintentional reasons, it makes no difference at all. You know that situations like that do in fact occur, and you know that you want them to occur. What's the point of this whole "personal anecdote" sidetrack?

16 strikes me as an age where children, generally speaking, can be trusted to make their own medical decisions. Where exactly that line is is hard to say, but 16 seems over it in my opinion.

What exactly is the point of this horror story? Let's take it at face value. Are we supposed to be aghast that a near adult can receive medical care without the parent's permission? This is well trod ground when it comes to other "controversial" medical treatments related to sexual health, abortion, and mental health in which parents and children find themselves in stark disagreement about what constitutes their child's best interests. I'm no more going to worry about this than I am when some kid decides they don't want to needlessly suffer to comply with their parent's weird religious requirements or social hangups.

It would be better if kids didn't feel the need to sneak around to get mental health care, birth control, abortions, STD treatment and prevention, vaccinations, trans-affirming care, and so on, but they don't get to pick their nutbag parents.

I would caution parents of late teens that they are risking permanently estranging their soon to be adult children by acting like this. A parent of a 16 year old is looking at the rapid end of their parental control and probably should get used to their children making their own decisions.

In my opinion, prescribing these drugs without psychoanalysis or some form of mental health evaluation is not a responsible way of prescribing these drugs.

And of course you add "intense" or "longer term", because distorting other people's opinion is your standard modus operandi.

And I am not begging the question. I'm stating an opinion. There is a difference. In the post you are referring to, I didn't make any argument supporting that opinion, i just stated it.

Elsewhere, I have made arguments about it, and in doing so, did not beg any questions there, either.

Seems these clinicians disagree with that opinion.

That is exactly what they are doing, although the assertion of "as appropriate" is actually contentious. It should be "as appropriate in the opinion of the patient and/or physician". Saying it is actually appropriate seems almost like begging the question. (Unless, you just mean "appropriate in your opinion")

"As appropriate" means at the discretion of a professional medical clinician, consistent with their training, best practices, and their ethical obligations. Ya know, just like any other time they prescribe any kind of medicine or treatment. Didn't think this needed to be spelled out.

 

[Ziggurat]

"As appropriate" means at the discretion of a professional medical clinician, consistent with their training, best practices, and their ethical obligations.

And what are the best practices?

I have yet to hear anyone describe how clinicians, especially at a place like Planned Parenthood which isn't actually specialized in this sort of thing, actually make a determination of who is and isn't a good candidate for medical intervention. Nobody can actually say on what basis people are approved or, just as importantly, denied. As far as I can tell, there really are no standards, and "best practices" basically means do what the patient asks for.

This is not an environment in which clinicians should be trusted, especially not trusted more than parents. Clinicians do not actually have more of an interest in the welfare of the child than parents, and I do not place any faith in their track record.

Ya know, just like any other time they prescribe any kind of medicine or treatment.

Except it's not like any kind of medicine or treatment. First off, unlike most treatments, many of these involve actively degrading the health of an otherwise healthy body, in ways that are often permanent and irreversible. Second, other treatments generally require much better diagnoses than is required here.

Didn't think this needed to be spelled out.

Ditto.

 

[Meadmaker]

16 strikes me as an age where children, generally speaking, can be trusted to make their own medical decisions. Where exactly that line is is hard to say, but 16 seems over it in my opinion.

Ok. So now we have your opinion on the subject on record. Good.

I disagree with you. We can go into why if that's something that interests you. I basically agree with what Ziggurat posted earlier on the subject, and with the policy adopted in Sweden recently.

What exactly is the point of this horror story?

The point of that horror story was, very specifically, to refute the inaccurate claim made in this post:

What a strange fantasy world you've presented in which people seeking out care for gender dysphoria aren't routinely receiving lots of mental health counseling and professional guidance.

ETA: For more on Sweden: https://genderreport.ca/the-swedish-u-turn-on-gender-transitioning/

 

[Emily's Cat]

It's sex-denying hormone care, not sex-affirming hormone care. Testosterone supplements for men with low testosterone, or estrogen for women going through menopause, is sex-affirming. If you're giving sex hormones for the opposite sex, that's not affirmation, that's denial.

Which, if that's what an adult really needs because of severe dysphoria, then sure, go for it. But let's not lie about what it is.

Thanks, I like your version better.

Agreed, I think it's a fairly accurate observation.

 

[Meadmaker]

I've thought about one of my other questions, which I said I was unsure about. That was the question about schools, parents, and transgender kids.

After some thought, I have decided that the policy ought to be that counselors employed by school districts, or other district staff, should not be required to inform parents about transgender issues, including school treatment (i.e. calling their son "Jill" if that's what he wants. I am specifically NOT referring to medical treatment, which generally isn't performed by schools) They also should not be prohibited from informing parents.

In other words, maybe we don't need a rule that defines how people can talk to each other. Use some judgement. Admittedly, people often use bad judgement, including parents, and including school personnel. So it goes. You can't fix everything. I think allowing discretion is best.

 

[Emily's Cat]

So is birth control.

"Biological processes are sacred and should not be interfered with" is an argument I've seen many times, but is not one that generally ends with good results for women who want to exercise any reproductive autonomy. Such biological essentialism arguments are probably more at home with fundamental religious ideology than any feminist line of thought.

What are your thoughts on someone who identifies as vulcan, and wants to have a prescription for large amounts of drugs with sulfonamides so their blood turns green?

Do you support that affirmation as well?

 

[TurkeysGhost]

Ok. So now we have your opinion on the subject on record. Good.

I disagree with you. We can go into why if that's something that interests you. I basically agree with what Ziggurat posted earlier on the subject, and with the policy adopted in Sweden recently.




The point of that horror story was, very specifically, to refute the inaccurate claim made in this post:




ETA: For more on Sweden: https://genderreport.ca/the-swedish-u-turn-on-gender-transitioning/

You understand that receiving a script for hormones is not a one-time affair. Prescriptions have to be renewed and there's a continuing doctor-patient relationship to monitor progress and make additional recommendations, as needed, for the treatment of dysphoria.

A patient on hormone therapy still complaining of dysphoria would likely be recommended mental health services in addition to the hormone therapy. Whether or not patients can get expensive mental health counseling care in a country with privatized health care is probably a very relevant question in the context of a Planned Parenthood clinic. Often doctors in this country have to do the best they can with limited resources.

The notion that these medical interventions are being advised flippantly is simply untrue.

 

[Ziggurat]

You understand that receiving a script for hormones is not a one-time affair. Prescriptions have to be renewed and there's a continuing doctor-patient relationship to monitor progress and make additional recommendations, as needed, for the treatment of dysphoria.

A patient on hormone therapy still complaining of dysphoria would likely be recommended mental health services in addition to the hormone therapy.

The notion that these medical interventions are being advised flippantly is simply untrue.

This is a really odd argument. What makes you think that patients are going to confide all their problems with their doctor? What makes you think that patients are even going to understand all their problems? And even if mental health services are recommended, what makes you think every patient will actually carry through with obtaining such services?

 

[Emily's Cat]

I've thought about one of my other questions, which I said I was unsure about. That was the question about schools, parents, and transgender kids.

After some thought, I have decided that the policy ought to be that counselors employed by school districts, or other district staff, should not be required to inform parents about transgender issues, including school treatment (i.e. calling their son "Jill" if that's what he wants. I am specifically NOT referring to medical treatment.) They also should not be prohibited from informing parents.

In other words, maybe we don't need a rule that defines how people can talk to each other. Use some judgement. Admittedly, people often use bad judgement, including parents, and including school personnel. So it goes. You can't fix everything. I think allowing discretion is best. I

If things were working the way we would like them to, I would agree with you.

The problem is that schools are actively teaching gender ideology, indoctrinating children to believe that they can choose what sex they want to be, telling them that it's safe and normal for children to switch sexes, and creating confusion among them. Keeping it secret from parents reinforces that distrust of parents across the board and entrenches this ideology.

 

[TurkeysGhost]

If things were working the way we would like them to, I would agree with you.

The problem is that schools are actively teaching gender ideology, indoctrinating children to believe that they can choose what sex they want to be, telling them that it's safe and normal for children to switch sexes, and creating confusion among them. Keeping it secret from parents reinforces that distrust of parents across the board and entrenches this ideology.

It's wild how successful this hate mongering propaganda has been. It's only a matter of time before some Facebook poisoned boomer goes off and murders a teacher or shoots up Disneyland or whatever in order to fight back against the "groomers".

 

[Emily's Cat]

You understand that receiving a script for hormones is not a one-time affair. Prescriptions have to be renewed and there's a continuing doctor-patient relationship to monitor progress and make additional recommendations, as needed, for the treatment of dysphoria.

A patient on hormone therapy still complaining of dysphoria would likely be recommended mental health services in addition to the hormone therapy. Whether or not patients can get expensive mental health counseling care in a country with privatized health care is probably a very relevant question in the context of a Planned Parenthood clinic. Often doctors in this country have to do the best they can with limited resources.

The notion that these medical interventions are being advised flippantly is simply untrue.

You are wrong. This is what you assume ought to be happening, but it isn't what is actually happening.

 

[Ziggurat]

It's wild how successful this hate mongering propaganda has been.

This isn't actually an argument that she's wrong.

It's only a matter of time before some Facebook poisoned boomer goes off and murders a teacher or shoots up Disneyland or whatever in order to fight back against the "groomers".

Hypothetical claims about what might happen (but hasn't) are not an argument for suppressing one side of a debate.

 

[Paul2]

You understand that receiving a script for hormones is not a one-time affair. Prescriptions have to be renewed and there's a continuing doctor-patient relationship to monitor progress and make additional recommendations, as needed, for the treatment of dysphoria.

A patient on hormone therapy still complaining of dysphoria would likely be recommended mental health services in addition to the hormone therapy. Whether or not patients can get expensive mental health counseling care in a country with privatized health care is probably a very relevant question in the context of a Planned Parenthood clinic. Often doctors in this country have to do the best they can with limited resources.

The notion that these medical interventions are being advised flippantly is simply untrue.

The primary issue with the Planned Parenthood situation was more how the *initial* decision to transition, take hormones, etc. is made. That careful attention over a period of time for monitoring hormone therapy is possible after initially prescribing hormone treatment merely on the patient's request. The discussion as outlined by Planned Parenthood is not designed, as far as I can see, to allow for denying, or even delaying, the patient's request.

 

[TurkeysGhost]

The discussion as outlined by Planned Parenthood is not designed, as far as I can see, to allow for denying, or even delaying, the patient's request.

What does this even mean? Nobody is forcing a doctor to write a script they feel is inappropriate.

 

[Paul2]

What does this even mean? Nobody is forcing a doctor to write a script they feel is inappropriate.

It means there is no point in the process - as it seems to me, and I am not a medical doctor - at which the clinician decides whether transitioning is advisable. When PP says, "Discuss your transition goals," that presents as accepting that the patient will transition without any clinical review of the decision to transition.