Gender confusion

[Josh]

Less restrictive alternatives would be things like increased psychological evaluations required before surgical alternatives are employed, increased waiting times, examination of the current standards of care, and so forth. And these issues are more appropriately addressed within the medical community than by state legislators acting due to prejudice or public opinion.

In other words, exactly what was the consensus in the medical community and the standard of care in the 1990s.

Ken, any guesses as to why that all changed?

[Ken]

So we are talking about in the neighborhood of 2-3 children per year. Who are not dead mind you. They simply regret or are dissatisfied with a decision that they, themselves made.

So it actually is happening, but it doesn't matter. I have some questions.
1. How many who undergo sexual reassignment surgery commit suicide because they regret or are dissatisfied with the results? They most certainly are dead. "Simply regret or are dissatisfied" seems an understatement severely lacking in empathy.
2. Should children age 13-17 (or younger) be empowered to make decisions of such permanent significance, when they are restricted on the basis of age from making other decisions or engaging in other activities that are far less consequential?
3. How many actually make these decisions themselves, without pressure from counselors, peers, groomers, or other influence?

Regarding #1: Do you know the answer? I don't. The data I cited was only the number that had expressed dissatisfaction. It said nothing about suicides.

Regarding #2: What is your threshold for children and their parents making life-altering decisions? Dropping of school is a life-altering decision. Should children be able to make that decision before age 18? Should their parents be able to decide to withdraw them from school at age 16 or age 13 or 14 like the Amish do? What about marriage? Should marriage be allowed under the age of 18? That is pretty permanent and life-altering. Many states allow marriage at age 16. Even Baptism is a life-altering decision. At what age does your church consider children to be mature enough to make that life-altering decision?

Remember we are talking about a JOINT decision by both parents and children when it comes to trangender care. This is not solely the child's decision. Parents are involved or should be. I would generally oppose allowing children to make this decisions on their own without parental involvement unless they have gone through the legal process of emancipation. That isn't necessarily what the law says, but it is my personal opinion.

Regarding #3. No one makes decisions in a vacuum. Is a 14 year old Amish child who decides to stop attending school at age 14 making that decision in a vacuum? Or is he subject to peer pressure from his family and church? The actual job of psychologists is to screen children and make sure that their decisions are their own and not the result of peer pressure. If a psychologist cannot do this or does it poorly then they are engaging in malpractice and should be removed from the profession.

[Ken]

Less restrictive alternatives would be things like increased psychological evaluations required before surgical alternatives are employed, increased waiting times, examination of the current standards of care, and so forth. And these issues are more appropriately addressed within the medical community than by state legislators acting due to prejudice or public opinion.

In other words, exactly what was the consensus in the medical community and the standard of care in the 1990s.

Ken, any guesses as to why that all changed?

I'm not an expert on how standards of care have evolved in the past 30 years in this area. If they are getting out too far over their skis then the profession needs to dial things back. Malpractice lawsuits is how that often happens. But again, that is something for the professional boards to address, not state legislators.

If there are large numbers of children who have been ill-served by the medical profession then we will see lots of lawsuits and know it is a problem. If it is mostly fantasy then we won't.

[Josh]

So, in Ken's universe, chopping off completely normal, functional body organs, like a cosmetic double mastectomy...

... is equivalent to Amish people sending their children to 8th grade education, or a young person choosing to be baptised before age 18.

OK Ken.

Ya know, you can always go and get a GED. Or you can choose to go college. Or you can decide you don't like your church and convert to another faith, or choose to become an atheist.

But you can't restore perfectly normal body parts that have been amputated.

[Josh]

Less restrictive alternatives would be things like increased psychological evaluations required before surgical alternatives are employed, increased waiting times, examination of the current standards of care, and so forth. And these issues are more appropriately addressed within the medical community than by state legislators acting due to prejudice or public opinion.

In other words, exactly what was the consensus in the medical community and the standard of care in the 1990s.

Ken, any guesses as to why that all changed?

I'm not an expert on how standards of care have evolved in the past 30 years in this area. If they are getting out too far over their skis then the profession needs to dial things back. Malpractice lawsuits is how that often happens.

Indeed, Ken, you most certainly are not an expert about this at all. There are no safeguards in place anymore before someone who claims to be transsexual engages in permanent courses of action like taking hormones or getting permanent surgery. There used to be: it used to be that someone needed a referral from a psychiatrist, which was later downgraded to any medical provider; now such a thing is not needed at all. Likewise, it used to be a transsexual person was expected to live as the opposite sex for a year before starting hormones. That requirement, too, was removed. The only thing necessary now is that the transsexual person simply says "I want to do this" and then it is required that they be allowed to do so.

There is no room for "malpractice lawsuits"; quite the opposite. A provider could be subject to a lawsuit for refusing to do so or for requiring additional referrals such as a psychiatric one.

But again, that is something for the professional boards to address, not state legislators.

OK, Ken, can you explain to us why the professional boards have made such a radical shift in this area?

[Ken]

So, in Ken's universe, chopping off completely normal, functional body organs, like a cosmetic double mastectomy...

... is equivalent to Amish people sending their children to 8th grade education, or a young person choosing to be baptised before age 18.

OK Ken.

I would, in fact, argue that whether or not one's education ends at 8th grade or with a college degree has a MUCH MORE consequential effect on the course of their life than whether or not than the purely cosmetic question of whether or not they have large or small breasts.

[ohio jones]

So we are talking about in the neighborhood of 2-3 children per year. Who are not dead mind you. They simply regret or are dissatisfied with a decision that they, themselves made.

So it actually is happening, but it doesn't matter. I have some questions.
1. How many who undergo sexual reassignment surgery commit suicide because they regret or are dissatisfied with the results? They most certainly are dead. "Simply regret or are dissatisfied" seems an understatement severely lacking in empathy.
2. Should children age 13-17 (or younger) be empowered to make decisions of such permanent significance, when they are restricted on the basis of age from making other decisions or engaging in other activities that are far less consequential?
3. How many actually make these decisions themselves, without pressure from counselors, peers, groomers, or other influence?

Regarding #1: Do you know the answer? I don't. The data I cited was only the number that had expressed dissatisfaction. It said nothing about suicides.

Regarding #2: What is your threshold for children and their parents making life-altering decisions? Dropping of school is a life-altering decision. Should children be able to make that decision before age 18? Should their parents be able to decide to withdraw them from school at age 16 or age 13 or 14 like the Amish do? What about marriage? Should marriage be allowed under the age of 18? That is pretty permanent and life-altering. Many states allow marriage at age 16. Even Baptism is a life-altering decision. At what age does your church consider children to be mature enough to make that life-altering decision?

Remember we are talking about a JOINT decision by both parents and children when it comes to trangender care. This is not solely the child's decision. Parents are involved or should be. I would generally oppose allowing children to make this decisions on their own without parental involvement unless they have gone through the legal process of emancipation. That isn't necessarily what the law says, but it is my personal opinion.

Regarding #3. No one makes decisions in a vacuum. Is a 14 year old Amish child who decides to stop attending school at age 14 making that decision in a vacuum? Or is he subject to peer pressure from his family and church? The actual job of psychologists is to screen children and make sure that their decisions are their own and not the result of peer pressure. If a psychologist cannot do this or does it poorly then they are engaging in malpractice and should be removed from the profession.

Well, you're the one who said they aren't dead. Yet in some cases they are. If regret is worth quantifying, it should include both the living and the dead.

And again, you're the one who said "they themselves made" the decision, yet now it's a decision made jointly with the parents. Unless a psychologist is involved, apparently?

As far as the threshold for making life-altering decisions, why should the age for gender reassignment (you're citing data as young as age 13 and asking where's the problem!) be lower than that for other major decisions? We are talking about more than purely cosmetic surgery.

[Ken]

Well, you're the one who said they aren't dead. Yet in some cases they are. If regret is worth quantifying, it should include both the living and the dead.

And again, you're the one who said "they themselves made" the decision, yet now it's a decision made jointly with the parents. Unless a psychologist is involved, apparently?

As far as the threshold for making life-altering decisions, why should the age for gender reassignment (you're citing data as young as age 13 and asking where's the problem!) be lower than that for other major decisions? We are talking about more than purely cosmetic surgery.

It was a survey (or collection of 20+ surveys) so I'm assuming that dead people aren't answering. If you really want to know the answer you'll have to dig I guess.

We are playing semantic games here. In every case of a transgender minor child it should be the child making the decision that they are transgender. They typically need their parents consent to ACT on that decision by pursuing any sort of medical care. I expect there are unusual cases where the parents and child are at odds and medical treatment proceeds. I don't know how common those are. I would definitely hope there are no instances of a parent pushing medical intervention that the child does not want. That would be tantamount to child abuse or Munchhausen by Proxy. And it would be the professional obligation of psychologists to catch that sort of thing. If they don't they would be engaging in malpractice.

As for your third question about what age children should be able to make decisions? That is what parents are for. To help them. Parents constantly make decisions for their children about other medical issues, where to live, what school to attend, what church to attend, etc. This is a BIG decision if we are talking about surgery (which is very rare in minors as the numbers upstream suggest). But I don't have a good answer for you as to what age is too young for parents and children to make the decision together. I expect each child is different.

[Sliceitup]

Sliceitup, you seem to act like you are some kind of "expert" on "intersex" people (a term that zero of the CAIS or other such people I have personally known have accepted for themselves). Why are you so obsessed with this?

Why am I obsessed with this? First, as background, I have ADHD and as a result I tend to go on intense deep dives into certain subjects.

I guess I’ll start using the term “people with DSD” so as to be more respectful. Thank you for that information. I don’t claim to be an expert. I hope I haven’t come across that way.

DSD has been an interest of mine from the time I knew it existed. It didn’t seem to fit with what I had been told about the world and sex/gender. When Semenya’s case happened I read more about it. And then I read the book “Sporting Gender” which I highly recommend (I think the author is Joanna Harper, but don’t quote me.) Then I read a few of Alice Dregers books.

The existence of DSD kind of blew up my understanding of gender/sex. And I know that many do not think there’s a connection to transgender people, but I see some very big connections.

Maybe I seem obsessed with it because I often bring it up during discussions. But I’m not doing that in order to score a point. I just genuinely want to know peoples opinions on it. I genuinely am interested in how people reconcile DSD with an absolute view of male and female gender.

I once had a discussion with someone on Facebook about the topic. We ended up taking our conversation to direct messages and had a very long but fruitful discussion about it. And in the end we both understood each others positions and why/how we felt that way. We still didn’t come out on the same side of the issue. We weren’t shouting at each other on line but it felt like we each learned something from that conversation.

[Josh]

So, in Ken's universe, chopping off completely normal, functional body organs, like a cosmetic double mastectomy...

... is equivalent to Amish people sending their children to 8th grade education, or a young person choosing to be baptised before age 18.

OK Ken.

I would, in fact, argue that whether or not one's education ends at 8th grade or with a college degree has a MUCH MORE consequential effect on the course of their life than whether or not than the purely cosmetic question of whether or not they have large or small breasts.

... Ken, a cosmetic double mastectomy is not about being "large" or "small". It is the complete removal of perfectly functional human organs that can never be replaced or undone. When a woman has to undergo one because of cancer it is a huge deal, a very serious surgery, with many possible complications, and it is impossible to ever nurse a baby after undergoing this.

I'm sorry, but whether someone goes to 8th grade in an Amish school (which is an excellent education) vs. 12th grade in a public school (many of which are failing and produce students with 0% proficiency in math and reading) is not a permanent, life-altering decision.

Or, actually, maybe it is. Many students would do much better in an Amish school than in a public school. Amish schools are producing excellent results. Public schools aren't.

But in any case, that's irrelevant to the question of whether a 13 year old should be getting a double mastectomy for no reason other than cosmetic reasons.