Hacker News Reader

Comment by toofy | Hacker News Reader

We currently have a massive chunk of society who are losing their collective minds about people engaging in the very early iterations of transhumanism—transgender folks.

I still regularly encounter people who are spitting angry against transgender folks and then later in the conversation will completely unironically talk about how much they love the cyberpunk genre.

Not many of them realize they would be the weird cultists in the background of the story holding signs preaching about unnatural technology.

View on HN

I really don't feel that's a fair comparison.

The transgender community needs to stop pushing the notion that it's healthy and desirable; it's not - it's a devastating hormonal/fertility disorder.

We can't even look into the extent to which the androgenisation of humanity is the consequence of the pollutants that we've introduced into the environment.

Now, comparing this to trans-humanist body mods - how many of those result in sterility?

The changes that trans-humans want are intended to extend the capabilities of the human; but a sex change leaves an individual in a physically compromised super-position of the body that they were born with, and the body that fits the mind.

> trans people make body modifications that don't prioritize my values (fertility)

Doesn't seem like a very strong argument that it doesn't fit into the cyberpunk ethos. Modifying your body for reasons you care about seems very cyberpunk, and exactly the sort of thing that other people would have moral qualms over, especially if they don't share your values. Certainly the technology could be improved for people who do care about fertility, but, well, newer, improved versions of body modification technology is also very cyberpunk.

A disingenuously paraphrasing quote?

Sure thing.

But I'm not espousing my values, but values vital to the continuation of life.

Values that have been around for thousands of millions of years.

Perhaps there's the potential for this to change, but it'll just be fertility in another form.

The human race isn’t in an immediate danger of dying out for lack of babies. People are allowed to and do take many actions with a risk of sterilization. For goodness sake’s people get vasectomies and their tubes tied. This can’t be about fertility or else you should be out campaigning against the pill, condoms, and just plain old normal drinking. Also do you imagine grafting electronics, really progress of any kind to be free of risks? Honestly, I’m sort of anti cyberpunk, because that sort of body modification is on a whole different level of risk

I can assure you, my only concern here is inate fertility - (idiocracy aside) I don't give a shit about people deciding not to have children.

As for the danger, population collapse is often precipitous - and by the time you notice it, is very hard to roll back.

And it's not just our species impacted by the changes.

Ok, so are you also against birth control and or opt in sterilization, otherwise your position is inconsistent and I don’t claim morals are logic, but they should at least be consistent.

Oh also since we’re on a technicality forum. Trans hormones don’t necessarily cause permanent sterilization. Plenty of trans people have children

Citation for plenty needed.

https://www.tandfonline.com/doi/full/10.1080/15295192.2020.1...

> Of the adult trans population, between 25% and 49% of individuals are believed to be parents (Dierckx, Motmans, Mortelmans, & T’sjoen, 2016)

Parenthood doesn't imply fertility. From that link:

> Trans parents may form their families in a range of ways, including through biological parenthood, step-parenthood, adoption, fostering, and assisted reproduction, with an increasing number of options available to trans people wishing to become parents.

So what? Human societies have always and everywhere included multiple modes of parenthood. I don't understand this obsession with personal biological reproduction. That's not how human societies work. Adoption, fostering, etc are an important part of social sustainability and always have been.

The original assertion was about fertility:

> Trans hormones don’t necessarily cause permanent sterilization. Plenty of trans people have children

I was just pointing out that the evidence provided with the 25% number doesn't really speak to fertility, but rather all the possible ways of having children.

That was much higher than I had expected.

Me too, but I suppose being trans doesn't eliminate all the other aspects of human behaviour and psychology, including the desire to have or care for children.

I don’t think there is great science on this but here’s a paper focusing on tactics to preserve fertility https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626312/. It gives rates as high as 100% for mtf fertility (and as low as 25). And I may have missed it, but doesn’t seem to for trans men. Stories of trans men pausing hormones to have a kid are anecdotally pretty common though

Population collapse is likely not going to come from too many people becoming steralized (I mean what percentages are we talk g about here, there would have to be a massive growth to even make a measurable dent into populations). Typical population collapse in biological systems comes from overpopulation that cannot be sustained by the ecosystem, which results in the sudden collapse. When we talk about the survival of the human race people not having children are likely a net positive, but somehow I get the impression that's not really what your opposition to gender conversion is about

> Population collapse is likely not going to come from too many people becoming steralized

And if it did, it would probably be from something like pollution/climate change, not a tiny minority of trans people.

> But I'm not espousing my values, but values vital to the continuation of life.

> Values that have been around for thousands of millions of years.

I could make the same arguments about modern therapeutics for asthma and short-sightedness being againsts millions of years of nature.

>"But I'm not espousing my values, but values vital to the continuation of life."

There are no self-grounding values. You cannot objectively justify why fertility is the overriding value here, rather than, say, fairness, liberty or anything else. So yes, you are absolutely espousing your values. If you want to make an argument, make it, don't pretend it's self-evident.

Not all of your ancestors had lives that were free or fair, but every last one of them was fertile.

Humans are a communal species, our cultures and psychology include behaviour that sacrifices our own personal reproductive chances in favour of the survival of the group, or simply deprecates personal reproduction as a priority. It’s genetic propagation by proxy, and it’s called kin selection or genetic altruism in the literature. A member of society can contribute to the survival and propagation of that society in many ways, propagating the group genome, and that doesn’t have to include through personal reproduction.

We have all benefited from the contributions made by members of past generations that didn’t reproduce, but their genes live on through their relatives that did reproduce. If all we care about is survival of the species, the best thing for all of us is that trans people get the help and support they need to leave the healthiest and most fulfilling lives possible, so that they can maximally contribute to society. I think that’s an overly reductive attitude, but that’s one way of thinking about it.

This argument is disingenuous: not only your direct ancestors contributed to your existence. You are also dependent on all of the aunties and uncles, and other members of the community around your direct line that contributed to their survival.

No it's not; most of those people also reproduced. It's like Covid - think of the R number.

Every one of them also had kidneys, but that's not an objective argument for the pre-eminent moral value of kidneys.

There is an inescapable choice in choosing the grounds from which to reason out to an ethical conclusion - there is no self-evident starting point, hence the riotous confusion of moral philosophy over the last two millennia.

If you go back far enough, no they didn't.

Kidneys evolved, mutative replication remains the source of life.

There are lots of conditions of the possibility of life - biological, physical, chemical - but the real point is that there is no incontestable reason to think that the conditions of the possibility of life are the pre-eminent source of moral value. Kant argued from the conditions of the possibility of understanding to moral conclusions. Sarte reasons from the conditions of the possibility of existential personality to morality. Rawls reasons from the conditions of the possibility of morality to morality. My point is, lots of people make this move, in a much more sophisticated way than you, and none is obviously better than the other - or indeed any other form of moral argument. There is no self-grounding foundation from which to reason about morality. What incontrovertible reason can you give for starting from the conditions of the possibility of life, or indeed one particular condition, rather than any other place? You can't.

What of people who were fertile but didn’t have children, through choice, medical reasons, death etc? Surely a person who is fertile but doesn’t have a child for any reason has the same net impact on the growth of population as an unfertile person (trans or not)?

Sure, but some causes of infertility are correlated and persistent.

If I'm exposed to poisons in the air or water, it's likely to happen to others as well - especially if it's at levels where it's not immediately noticed.

Many other causes of effective infertility are unlikely to impact entire groups of people across long periods of time.

who cares though? species have come and gone, and will continue too

if you died and then a millisecond after a chicxulub scale asteroid obliterated all mammalian life (again), who would be there to care about fucking fertility or propagation of the species??

the point is we don't have to be limited to biological mandates -- that's what transhumanism is about. moralizing it is just wasted and you clearly don't understand what it's about.

instead you decide to whinge about trans people being mentally ill. please

Where did I say that they were mentally ill?

(Misremembering other people's arguments is a poor strategy in a technical forum.)

And regardless of what transhumanism as a whole is about, it will always be about continuation of sapience and its evolution through time.

Biological or otherwise.

> The transgender community needs to stop pushing the notion that it's healthy and desirable; it's not - it's a devastating hormonal/fertility disorder.

what exactly is your word for unhealthy and undesirable? you are clearly referring to dysphoria. i don't know if you realized, but the DSM has changed in recent years.

No mention of mental illness there, but you already knew that.

sorry, you just disagree with them being happy even if it makes them infertile.

classic intellectually dishonest HN concern troll

The classical consumerist hedonist mentality : if they are happy then who can say anything about that ?

Well it seems you're the one trolling here.

If you deny the right to people to have opinions and judgments based on their beliefs about anything they wish, you're doing worse than you complain about.

He's actually putting words in my mouth again; I really have no problem with people having a sex change.

Acceptance was a vital social step, but promotion crosses a line for me - and there are severe deleterious consequences are ignored and dismissed by the community.

I think in general the answer is to let kids be themselves and not to judge them for it; give them a say in their clothes and toys - and do not punish them for their selection.

i am not denying any right, i have neither authority nor power. we all have equal right to comment and disagree.

though you are right, i am kinda a hedonist. do you mourn for me, or lament the condition I would bring upon civilization, right before chicxulub blows us up? haha.

don't worry, i have no power offline either.

If you stopped acting in bad faith, looking for some gotcha, for one single second, you'd realize that by "unhealthly" they were referring to the effects of hormone treatments, which clearly have significant effects and side effects on the physical body.

People literally do hormone treatments to solve things like pattern baldness. If you're concerned about unhealthy hormone treatments you should probably start with the stuff that's far more common. Finasteride is used for both hair loss as well as hormone therapy for transgender people.

That was meant to say 'misrepresenting' (the phone said 'misre...ing' since the complete word didn't fit on the screen.

Cyberpunk != transhumanism

Is an amputee cyberpunk?

Yeah if your replacing it with something better for you

There are a million things more dangerous to the continuation of the human race than a few people willingly becoming sterile to solve other issues with their body. For decades we were shoving lead into gasoline and poisoning an entire generation for the sake of more money, for example. And the 'androgenization of humanity' seems like some nonsense, considering there's zero data or otherwise to back that up.

> a few people willingly becoming sterile to solve other issues with their body.

Most of the controversy around trans issues that I've seen would not exist if this was the only dimension to it.

Most of the controversy around trans issues is made up nonsense being pushed by a propaganda machine pining to politicize an entire group of people. The same group of people that have turned towards trying to harass gay, lesbian etc individuals because they know they can harness a certain virulent part of their base to harass and antagonize people.

how convenient. relegating any concern for the modern trans movement to pure malevolence. I guess it makes it easier for you.

By all means, if you think you can come up with any issues or concerns that don't involve the typical political talking points then please, do so.

Citation needed.

I mean you're quite frankly arguing with a straw man, and being vague with the word "healthy", no trans community is advocating that taking opposite hormones is physically healthy.

They push for it because that's the only viable option for them to appear as the opposite gender which helps them mentally.

Although it is funny you're in a way talking about how men are turning into femboy meme.

You mention sterility. As a thought experiment, what if the science was perfected that you could change gender perfectly (ala The Culture novels). Would you still feel the same way about it?

I think if you could undergo a perfect and reversible sex change operation as easily as changing your clothes, it would become simply a matter of fashion - but with that kind of technology, changing your sex would be one of the least interesting things you could do, and new controversies would arise: for example, is it ethical to modify your body to look exactly like someone else’s body? And how far can you go with body modification before it stretches credulity to identify as a human, and what does that mean for the concept of human rights?

Personally I think that would fantastic and fun. Who wouldn’t want to see what life is like on the other side?

95 to 99% of the population...

But if there was no real downside in terms of social stigma, and it was totally reversible? You don’t think most people would want to switch just out of curiosity?

Grow a hollow in a vat and insert the brain?

It'd be prohibitively expensive for most, but why not?

It was free in the culture novels. So, the problem is with the fact we can't do it properly yet?

Also, you mentioned environmental factors, is that thinking based on a paper or similar?

Everything was free in the Culture novels; more interestingly, gender swapping was a built-in biological function that one could activate by willpower alone, and hold in a part-way state, even allowing two people to get each other pregnant concurrently.

https://scholar.google.co.nz/scholar?q=endocrine+disruptors+...

Oh, so the reason conservatives are concerned about the birth rate is so they have ammo against gay, trans, and women on the pill. Got it. I was wondering why an issue that won't be a major concern until after 2100 was becoming popular.

Putting aside the debate and controversy around transgender folks, if I just step back and think about the act itself, it is truly an incredible act of will over self... redefining yourself, redefining your relationship to society, acting so strongly against the defaults of your life... I'm not sure I could do it.

As an act of tremendous will over self I genuinely respect it.

One can exercise tremendous change over ones self, but one cannot redefine ones relationship with society since relationships aren't one-way. That's always going to be a potential source of friction.

Sounds like a religious conversion to me.

Especially those that require body modification, such as Jewish and Islam's adult circumcision.

I think a lot of people have a hard time with the idea that you could believe something enough to actually change the direction of your life in response to that belief. It raises a lot of uncomfortable feelings to see someone do that.

I think a big fraction of the anti-transgender movement is not against adults modifying their bodies, but against a) children modifying their bodies, b) persons with modified bodies claiming to be the opposite gender thanks to their modifications (or indeed, before any modification). They probably would have much less of a problem with an adult replacing one of their eyes with an x-ray camera or whatever.

I wish that were the case - but it’s a significantly smaller fraction than it needs to be.

The largest fraction of the anti-transgender movement is clearly the American conservative Christian right, who has completely chosen to ignore human rights in favour of Old Testament values.

(Source: I’m transgender, and I’m terrified what’s going on in the USA.)

The fraction of people who want to prevent children transitioning or claiming youre a different gender, versus people against general body mods, is smaller than it needs to be? That might be a really good point if true.

Transitioning for small children is literally just wearing different clothing.

When they get a bit older, at most they can extremely rarely (due to people pushing against it, even though it reduces suicide rates and saves lives!) get puberty blockers.

Those can then be stopped with minimal consequences if they decide that's not something they wanna do. What is actually cruel is FORCING kids to undergo their AGAB puberty against their will.

We know they are safe, we know they save lives. The vast majority of uses for puberty blockers are still cis children that have early puberty.

> undergo their AGAB puberty against their will

It's also weird mental gymnastics like this that people are pushing against. For anyone who is not familiar with the acronym, AGAB means "Assigned Gender At Birth", and is push back against the fact that we broadly lump all people into either the male / female camp when they are born. It can be useful when talking about gender norms, etc – which are discussions worth having. But when you start to move into the region of "biological sex is unimportant" it takes on an entirely different slant.

"AGAB puberty" is an oxymoronic statement. If the gender was merely "assigned" to them, then why is their body naturally going through puberty in a certain direction. It's not their AGAB, it's their biological sex. We are not saying "this is a boy" and then giving them testosterone when they hit 12 so that they match their "assigned" gender. Their body is the body of a boy which naturally produces (much) more testosterone (and other obvious hormonal and physical differences) than that of what we broadly call a girl.

Nobody is FORCING anything – that is just something our bodies do naturally because we are a sexually reproducing species of mammal so our DNA causes us to split broadly into male and female.

> We are not saying "this is a boy" and then giving them testosterone when they hit 12 so that they match their "assigned" gender.

That's literally what happens, especially to inter people, though.

And sometimes even done for cis people if their natural hormone levels are too low, or rather their parents and doctors deem them too low (the child is never asked).

We literally do not give 99% of the population any sort of hormonal treatment in order to ensure they match their "assigned gender". For the overwhelming majority of people we say "wow this looks like a boy" and that person ends up a boy with no intervention and no gender identity issues.

Yes, there are intersex people and they are a special case that need to be handled differently than the rest of the population. And just "assigning" a gender to those people like we've been doing for most of medical history is probably not the right move. But the vast majority of trans people are not even intersex so injecting that into a conversation about trans issues is just muddying the waters.

When we do intervene, yes, of course the child is never asked. As far as I'm aware there isn't any medication/intervention we give to children where we ask for their permission. Because they are children. One of the main reasons we distinguish between children and adults in our society is because we have decided that children do not have the mental maturity to make such decisions of large import, so we place that responsibility on parents/guardians/doctors/etc.

What do you mean "of course"?

Children have a right to take part in their own medical decisions as early as 7 years old, and teens make the majority of the decisions themselves after 14yo.

If teens can get tattoos (16+), can drink alcohol (16+), can work part time jobs (14+), under conditions (12+) and can get jail time (14+), then they can just as well make at least part of their own medical decisions.

Delaying permanent changes to a point in time where they can decide for themselves is the perfect solution if teens want to make such a decision, as long as it's safe (which even the cass review admits has been proven safe for AMAB people)

> Children have a right to take part in their own medical decisions as early as 7 years old

Where is this right enshrined?

> and teens make the majority of the decisions themselves after 14yo

Do you have a source for this claim? Where in particular is this the case? You say 14 but then most of the examples you give about choices with long-term consequences are at 16, since I wouldn't really include part-time jobs (not really a major life decision to bus tables or whatever) and jail time at 14 is the exception not the rule. We default to not putting 14 year olds in jail because again, we assume children are not entirely culpable for their actions at that age. Jail is reserved for particularly egregious infractions that we otherwise don't have a better social response for.

> Delaying permanent changes to a point in time where they can decide for themselves is the perfect solution

Right but isn't part of maturing going through puberty? If we block puberty, what is the point at which you can decide for yourself? Where do you draw the line?

Denying puberty blockers, which are easily produced, known to be acceptably safe, and can prevent physical changes, is forcing teens through a harmful puberty against their will.

Allowing puberty blockers, allows children to make uninformed decisions with lasting and harmful consequences to their own body and future. That's why this issue has went to various courts, ascending the hierarchy, in England where it has been found illegal, legal etc. See https://en.wikipedia.org/wiki/Bell_v_Tavistock and think how Keira Bell is likely to feel about your simplistic "it is safe" comments.

It is a complex issue and perfectly OK to be on one side or the other - what's not OK is pretending that only one side is right and the other is evil and abandoning all nuance - that seems to be the trans activist way tho.

It’s a bit silly that you’ve essentially written here “abandoning all nuance is bad, that’s what the other side does!”

This is ironic of course, since you’ve ignored the nuance that the Keira Bell case was specifically regarding the ability of children under the age of 16 to consent to this treatment themselves. It does not question the lawfulness of the treatment or guidance itself, and it has been clearly established that parents or guardians can give consent. I have absolute sympathy with Keira Bell and the struggles she has gone through, but it seems clear we should want to avoid using the legal system to intervene in clinical decision making to the greatest extent possible.

For the record though, I disagree with you - I don’t think it’s a particularly complex issue. It has certainly been ratcheted into a hot-button culture-war topic by quite a lot of ignorance and deliberate muddying of the waters though, which can have the effect of making things seem more complex than they really are. You’ve just done this yourself—even if unintentionally—in your comment.

How have they ignored the nuance of the Keira Bell case?

> It does not question the lawfulness of the treatment or guidance itself

Nobody is saying it does. The nuance is in fact what people are talking about. Many advocates for the trans community argue that under-16s should be able to choose such treatments for themselves without parental consent/oversight. The other side argues that trans issues should not be treated any differently than anything else, where generally children have limited say in medical interventions applied to them and that the responsibility is ultimately the parents'.

Just checking you know that Kiera Bell lost.

Given as they linked the wikipedia article, it seems likely they are aware. Just because she lost on appeal does not detract from the parent's point, which is that clearly these things are not harmless otherwise there probably wouldn't be such a court case.

Why link to wikipedia and not the court judgments?

Almost no healthcare is harmless. Anyone can sue for almost anything, there's a low threshold to bring a case. Notably she didn't sue for a personal injury case because she knows she would have lost that - she was strongly advised by her doctor not to proceed, but she ignored that advice and went ahead anyway. She was over 16 at the time, and capacitous, and so she got the treatment that she asked for.

Puberty blockers aren’t known to be safe. The FDA just issued a new series of warnings on blockers in the last month due to the severe side-effects being experienced by children on them, including brain swelling and vision loss: https://abcnews4.com/amp/news/nation-world/fda-warns-puberty...

That's besides the point the parent is making.

Nobody is FORCING anything – that is just something our bodies do naturally

This is just a silly semantic game. Our bodies naturally do a lot of things that in some cases we’d prefer they not do. They love growing babies, or tumours, or falling apart in uncountable ways.

Withholding access to an available and desired medical treatment is broadly equivalent to forcing a patient to experience the effects of whatever the treatment is intending to prevent.

We are just far more likely to use the explicit term “forcing” in cases where that treatment is being withheld for ideological reasons - such as abortions or puberty inhibitors.

> Nobody is FORCING anything

Well except Texas law makers

Idk what the effect of taking blockers for 3 years and then realizing its a mistake would be. Do you experience puberty for the same duration, to the same extent? If youre male, are you going to be shorter for instance?

Regarding clothing, maybe its just wrong to emphasize gender in the first place? I think a lot of people are cool with kids doing whatever, its just weird when the people around them start really reaffirming the decisions made by someone we dont trust to have autonomy in most things.

Maybe transgendered people have some biological or psychological drive thats distinct and not related to the people around them, but if I were around this rhetoric as a kid I can very easily see how it could have wrecked me, considering how I dealt with the subject of gender from pre to late teens. Maybe itd be a worthy price, Im skeptical but trying to make sense of it

> Idk what the effect of taking blockers for 3 years and then realizing its a mistake would be. Do you experience puberty for the same duration, to the same extent? If youre male, are you going to be shorter for instance?

There's no negative effects, as long as you only delay it for a few years (e.g. 10-13) and not too long (you should have entered some puberty around 16, or things get complicated).

As soon as you'll stop, your natural puberty starts, with the same duration and effects it'd have normally.

Puberty blockers are actually an off-label use when used for trans people. Puberty blockers are originally used for cis kids who enter puberty too early, and this use is far far more common than the use for trans kids.

So if they're safe to use on cis kids to delay transition, they're definitely safe for the trans usage as well.

I don't think it's a one-dimensional line with pro/anti modification. For example, if you were against people integrating weapons into their bodies or upward-facing eyes into their feet for looking up skirts, that wouldn't make you anti-transhuman.

Right. But being able to live as your authentic self is a good thing, unlike your examples. Opposing good modifications is anti-transhumanist.

Idk, first the focus on body modifications in the context of what a transhumanist is is a bummer, I always thought imoroved thinking made more sense as the initial goal. And second, how do you determine what is someones authentic self, if theyre pursuing that or if theyre taking advantage of body mods to be pervy or manipulative or do xyz bad thing. Its entirely subjective. Not to say there arent solutions to separate safe mods from unsafe, just that the authentic self feels like too fuzzy a thing to use sincerely, at least I see it as some bundling of your personal values that could be cancerous as far as I know :)

I'm a furry. Does "being a (cuddly) werewolf" count as a weapon?

Fun example. Or does getting a giant ass, big fake breasts, filled lips, etc. get counted in the same lot? It's definitely funky, in terms of the ethics surrounding it. You could see it as buying into negative (in the sense that they're not equal) biological biases and taking advantage of them. Such a fun lens to consider funky cultural stuff.

I think if transhumans with augmentations wanted to compete with humans in sports, or if parents wanted to give their children irreversible experimental augmentations, you would find very similar concerns.

Parents aren't giving their children any irreversible modifications though, that's not even legal.

All that's done is pausing puberty until the children are old enough to legally consent to changes, if they do want them. If they do not, puberty can be resumed at any time without any harm (puberty blockers are used significantly more often on cis kids whose puberty started too early than on trans kids).

No child is taking any hormone medication or getting any surgery to transition. Actually, hormones and surgery are frequently given to cis kids who are close to the line to inter, to better align them with their AGAB. But in trans healthcare,this is not a thing.

Usually at 14 or 16 trans teenagers can choose to take hormones, but still, no surgeries below the age of 18 for trans children.

The only surgeries parents can do to children legally are circumcision in cis children and heavy genital modification in inter children to pretend they're not inter.

It is in fact legal, and does in fact happen. Three examples found with three minutes googling[1][2][3], plus an article identifying 51 mastectomy approvals for under-18s[4] in Scotland alone.

Are these just isolated cases performed by overzealous doctors? No, WPATH's current guidelines allow for mastectomies at age 16, and the latest Standards of Care draft[5] calls for reducing this to 15.

What about the safety and reversibility of puberty blockers? We don't know. See this letter[6] arising from the Cass Review outlining the evidence gap. The current approach to treating gender dysphoria is a slow-motion trainwreck medical scandal. I strongly recommend reading the Cass Review interim report[7] which outlines the numerous ways in which gender-dysphoric children are being failed by current treatment models.

[1] https://thevelvetchronicle.com/double-mastectomy-at-15-detra...

[2] https://www.newyorker.com/magazine/2013/03/18/about-a-boy-2

[3] https://mercatornet.com/chloe-cole-gender-transition/80073/

[4] https://www.thetimes.co.uk/article/scottish-doctors-approved...

[5] https://www.wpath.org/media/cms/Documents/SOC%20v8/SOC8%20Ch...

[6] https://cass.independent-review.uk/wp-content/uploads/2022/0...

[7] https://cass.independent-review.uk/publications/interim-repo...

> under-18s

> children

There’s a major difference between those terms. 16-year-olds are definitely not children anymore. They can get tattoos, piercings, get a driving license, drink alcohol, enter into contracts, and get jail time if they commit a crime.

And cis and inter children at that age can also commit to bodily changing surgeries, e.g. mastectomy for children with gynecomastia is common and legal.

The only legal form of body modification for children below that age are circumcision, which should absolutely not be legal, and surgeries for inter children, which shouldn’t be legal either.

How come you consider teenagers making decisions for themselves a risk, but parents letting doctors mutilate the genitals of newborn children is something you entirely ignore? That’s what we should worry about.

Then there’s the argument regarding puberty blockers, where you’re citing the cass review, which has to be seen in critical light in general. Puberty blockers, when used for cis children, have been well reviewed and approved in wide studies, with lots of evidence proving their safety. There is no evidence gap there – if they’re safe to delay puberty in cis children, they’re just as safe for the same purpose in trans children.

I sure hope you’re right, but the point is that we just don’t know. Reviews of that evidence have determined it to be low quality:

https://www.bbc.com/news/health-56601386.amp

Read Cass for more details.

I also 110% oppose circumcision.

The fact that the consensus differs so heavily between countries where this topic has become a political issue, and countries where it’s not yet become one (e.g., Germany), leads me to suspect these sources are biased.

This applies especially to british sources on this topic. The NHS and BBC have become heavily influenced by the Tories in recent years, so I’ll have to question your sources.

Anti-trans campaigners misunderstand what's meant by "low quality evidence". It just means we don't yet have double blind randomised control trials of certain treatments. But that's to be expected: trans children are rare, we don't put anyone on puberty blockers without very good reason, and withholding PBs is not a neutral act. So running RCTs on this population group is very difficult.

See also masks: we're pretty sure that masks work, but the evidence for masking is low quality.

Anti-trans campaigners also misrepresent the Cass review. The review has said that taivstock (currently the only provider of specialist care to trans children) isn't very good. (Trans children and their families also say that the tavistock is pretty awful). They then say that this proves the anti-trans argument that no gender affirming care should be provided to trans children. But what Cass has said is that care should be taken out of tavistock and new given to new centres across England who will initiate care and then GPs can be allowed to continue that care -- this is a big expansion of gender affirming care for children, and trans people welcome it. It's what people have been asking for for years.

Cass does have some weird anti-trans aspects, but it's certainly not the win that anti-trans campaigners are claiming. And this is a core feature of UK anti-trans campaigning: they're fundamentally dishonest about everything all the time. You should always read the sources they're citing, because they always misrepresent those sources.

> Anti-trans campaigners misunderstand what's meant by "low quality evidence". It just means we don't yet have double blind randomised control trials of certain treatments.

No it doesn’t. The problems run far deeper. Read the interim report, pages 18-19[1]:

> 1.24. A lack of a conceptual agreement about the meaning of gender dysphoria hampers research, as well as NHS clinical service provision.

> 1.25. There has not been routine and consistent data collection within GIDS, which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service.

> 1.26. Internationally as well as nationally, longer-term follow-up data on children and young people who have been seen by gender identity services is limited, including for those who have received physical interventions; who were transferred to adult services and/or accessed private services; or who desisted, experienced regret or detransitioned.

> 1.27. There has been research on the short-term mental health outcomes and physical side effects of puberty blockers for this cohort, but very limited research on the sexual, cognitive or broader developmental outcomes.

This is not about a lack of rigorously designed experiments. This is about very basic gaps in definitions, data collection, and followup. This is not a case of “we did some research and it’s basically fine but the science police won’t acknowledge the result because we didn’t fill the form out correctly”. We fundamentally do not have the evidence.

Additionally, the new UK regional centers are not an expansion of gender-affirming care, they are an expansion of care, period. The presumption of gender affirmation was explicitly criticized, and in the forthcoming service model there is a requirement to deal with the whole clinical presentation.

None of this has any bearing on being “pro-trans” or “anti-trans”. It is about uplifting treatment for gender dysphoria to the same standards of evidence-based medicine that we expect for any other clinical issue.

I agree, sources are frequently misrepresented.

[1] https://cass.independent-review.uk/wp-content/uploads/2022/0...

> No it doesn’t

Yes it does. You not knowing what GRADE is or how it works but insisting that you are well informed is a great example of the problem with these discussions. You dump a load of ill-informed mangled sources into a thread, and now I have to spend a few hours explaining how you're misrepresenting the sources.

> Additionally, the new UK regional centers are not an expansion of gender-affirming care, they are an expansion of care, period. The presumption of gender affirmation was explicitly criticized, and in the forthcoming service model there is a requirement to deal with the whole clinical presentation.

I've read the service specification for the new centres. (Have you?) It's an expansion of gender affirming care, and there's no way to spin it otherwise. There will be more clinics treating more children in a more timely way. More children will have access to puberty blockers. What's that if it's not an expansion of service?

> None of this has any bearing on being “pro-trans” or “anti-trans”.

All the information you've posted to this thread so far is sourced to anti-trans organisations. At least be honest about it. You are anti-trans, you post anti-trans disinformation from anti-trans links.

I mean, you're making the same three claims as if they're magic gotchas but you don't understand what you're saying.

1) Care at tavistock is bad

Yes, everyone agrees, that's why people are pleased that Cass recommends the NHS continues its long established plan to remove care from Tavi.

2) There's no evidence

There's plenty of evidence. It doesn't come from tavi, but that's because they provide so little care it's not possible to use their patients as experimental subjects. We have lots of evidence from other countries and other patient cohorts

3) Cass says...

Mostly you're misunderstanding what Cass says, or you're relying on the single source that agrees with you and ignoring international scientific and medical opinion.

4) The new centres are providing less gender affirming care than tavi

The vast majority of children attending tavi got no care at all because they were on a waiting list and then aged out of children's services. But even if they got treatment at tavi the vast majority got no meds at all but psycho-social advice. The new centres will be doing this too, but with more children and with smaller waiting lists and the shared care agreements with GPs will be clearer.

I keep mentioning Cass because it is a breath of fresh air in this bitterly polarised subject area, compared to news sources. It is level-headed and compassionate, and I encourage you to try reading it, if you can excuse its Britishness.

I've read it, but its arguments are still at odds with what's done based on it.

e.g., the Cass Review explicitly says "The rationale for use of puberty blockers at Tanner Stage 2 of development was based on data that demonstrated that children, particularly birth-registered boys who had early gender incongruence, were unlikely to desist once they reached early puberty" and only recommends reviewing puberty blockers for AFAB people.

Yet your comments and british politics instead call for ending the use of puberty blockers for everyone, including AMAB people (and the recent tavistock case actually accomplished that).

Most of the other issues the report finds are entirely local to the UK, due to the way healthcare systems differ heavily between countries, and can't be applied elsewhere.

I'll be entirely honest, the british system is an absolute mess and needs to be entirely rebuilt (and any british trans person is going to agree), but just stopping all care entirely for years until a new system exists is the worst possible option, and one that's going to cost countless lives.

This is untrue. Puberty blockers have been in use for trans children for over 40 years now, we have lots of evidence of benefit and lots of evidence that there's not much harm.

We don't have randomised controlled trials, but if you don't know why we don't have those maybe you should refrain from commenting until you understand the topic a bit more.

What about detransitioners? Most of those kids grew into adults that have been ruined for life. Knowing this, the risk of giving these drugs to kids to outright block their puberty is just too immense. Not to mention the underage surgeries some of them receive.

> What about detransitioners?

Detransitioners are a tragic case, but they amount of detransitioners compared to all trans people is smaller than the amount of trans people compared to the rest of the population.

If taking detransitioners into account is the primary priority of trans healthcare for you, then trans people should be an equal or larger priority in overall healthcare as well.

> Not to mention the underage surgeries some of them receive.

That's something that's questionable, but it's not that simple either. Cis people doing surgery against gynecomastia is the majority of underage surgeries of this type.

> to outright block their puberty

It's just paused. It continues as if nothing had happened the moment you stop, with no risk to the patient. Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable.

If the Cass Review, a paper that was commissioned to find a way to reject healthcare for trans people, argues it's safe, you can trust it is safe.

> Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable.

I've read the Interim Report, it asserts neither of these points.

the Cass Review explicitly says "The rationale for use of puberty blockers at Tanner Stage 2 of development was based on data that demonstrated that children, particularly birth-registered boys who had early gender incongruence, were unlikely to desist once they reached early puberty" and only recommends reviewing puberty blockers for AFAB people.

Your quote misses out the part of the sentence immediately following:

"this rationale does not necessarily apply to later-presenting young people, including the predominant referral group of birth-registered girls"

The group referred to here is defined by being later-presenting. Female is only a subset of this.

Also, Cass is just describing the rationale, not endorsing it. This is implied by the paragraph immediately following, where she discusses the paucity of data regarding potential negative effects of puberty blockers on brain maturation:

"A further concern is that adolescent sex hormone surges may trigger the opening of a critical period for experience-dependent rewiring of neural circuits underlying executive function (i.e. maturation of the part of the brain concerned with planning, decision making and judgement). If this is the case, brain maturation may be temporarily or permanently disrupted by puberty blockers, which could have significant impact on the ability to make complex risk-laden decisions, as well as possible longer-term neuropsychological consequences. To date, there has been very limited research on the short-, medium- or longer-term impact of puberty-blockers on neurocognitive development."

> and only recommends reviewing puberty blockers for AFAB people

Cass does not make this recommendation.

Cyberpunk as a genre generally depicts as a technologically advanced dystopia. One can find the setting interesting but not desirable, just as people find post-apocalyptic zombie plagues fascinating but wouldn’t actually want to experience it.

That's arguing with bad faith and framing the argument incorrectly IMO. Nobody is " against trans " people, whatever that means. Many are against children joining that lifestyle, which may result in irreparable harm to the child.

As an adult, I am on androgen replacement therapy but I am also very careful with it, regularly checking my labs to make sure I don't torch my liver in the process. I can make informed decisions about it because I've read the research and understand the risks. A child or even a teenager doesn't understand the risks of taking hormones. Not fully anyway, as the brain doesn't fully develop until 25 or so.

> Nobody is " against trans " people, whatever that means.

Have you ever been on twitter? It will take you a couple of minutes to find people who think that's unnatural, sinful, should be forbidden, they're mentally ill, they're sexual predators by default. I know there are some more moderate ideas, but people completely against do exist.

You're putting in the same bag many complaints, some of which irrational and unproven (sexual predators) and some valid arguments, rooted in philosophical or religious beliefs (unnatural, mental illness).

Moreover, everyone knows twitter is not exactly the place with the healthiest representative sample of mankind...

The claim wasn't that it was a common, healthy, or well researched opinion. Just that it exists, unlike what the parent wrote.

> . Nobody is " against trans " people, whatever that means

What it means is “actively seeking to eliminate trans people, including by the simple expedient of killing them by means such as prohibiting care that is proven to greatly reduce suicidality in, especially, young trans people.”

And lots of people—indeed, entire state governments in the US—are “against trans people”.

> “actively seeking to eliminate trans people,

Put it such extreme and dishonest way, reducing sugar in food it an attempt to eliminate obese people... No , the attribute is not the object.

> indeed, entire state governments in the US—are “against trans people”.

So you deny the rights of a community of people to decide what they deem legal or illegal ? All this for the personal benefit of a (literal) couple of people ?

Should they also be carried in Ferraris to their treatment place?

> So you deny the rights of a community of people to decide what they deem legal or illegal ?

That’s irrelevant. Whether a community has a right to pass laws based on the fact that they are against trans people is not the issue. Whether people are. manifestly against trans people is the issue (and they very clearly are.)

> So you deny the rights of a community of people to decide what they deem legal or illegal ? All this for the personal benefit of a (literal) couple of people ?

I hate to invoke Godwin, but just because a society decides to outlaw belonging to a certain minority doesn't make it right. The NSDAP's Anti-Jew laws were also passed in parliament, but still those laws were very obviously wrong.

>So you deny the rights of a community of people to decide what they deem legal or illegal ? All this for the personal benefit of a (literal) couple of people

By that logic if said community is for incest, pedophilia and extremely violent and barbarian punishment, the country has to allow it?

Many societies over the course of history have decided that slavery should be legal. Some still do today. I absolutely deny those communities' moral right to this decision (though I can't do much about the practical right).

> That's arguing with bad faith and framing the argument incorrectly IMO. Nobody is " against trans " people

I don't know how you can say that unironically when places like my current state (Texas) have been doing everything in their power to be against trans people. These lifestyle arguments remind me a lot of the exact same stuff people said about anyone gay, that they thought it caused irreparable harm and spread disease.

Some aspects of subcultures within people who identify as gay end up spreading disease, in certain contexts. Why is monkeypox so prevalent now? Did the virus decide to hop continents?

So I'm going to call it, you are using textbook neonazi argumentation. Never admitting that you are actually ideologically opposed to certain people (LGBT, black, brown...) but making up bogus "medical" arguments.

The reason why monkeypox is so prevalent right now is because the way it spreads isn't limited to gay sex, despite what the mangled messaging around says. It spreads by any sort of close contact (including bedding and clothing), and there have been many straight individuals turned away from testing because they weren't deemed 'at risk' despite them having all of the classical signs of monkeypox. So it ends up spreading among crowds like swingers and what not most publicly, while privately it spreads among the more traditional crowds that end up not getting tested.

Going through natal puberty causes irreparable harm to children.

> I still regularly encounter people who are spitting angry against transgender folks

Would those people still be angry at transgender people if they went in the bathrooms (and other sex segregated spaces) they used to go into and didn't complain about being called using their original names, sex and pronouns? I expect the most they'd get in that case is nose wrinkling in disgust.

They would be just as angry in that situation. Have you seen how trans masculine people get treated?

The bathroom laws forbid them from going into the male bathroom (because they're AFAB), bit if they go into the female bathroom while looking like a bodybuilder, they'll also have the cops called on them.

Bathrooms were never sex segregated, and that's not the point of these laws either: the goal of these laws is to make it so uncomfortable to be visibly trans, that it becomes impossible.

That's why this usually goes hand in hand with bans on even teaching about the existence of LGBT people in schools, the goal is eradication.

>I still regularly encounter people who are spitting angry against transgender folks and then later in the conversation will completely unironically talk about how much they love the cyberpunk genre.

There is a difference between messing with your body and augmenting it. Transhumanists generally believe in augmenting the human body with cybernetic parts, not changing the body's internal chemistry.

Then how do you explain common transhumanist ideas like nootropics and biohacking? I think the line you've drawn is a bit arbitrary.

Indeed, I don't think the issue is with the use of chemicals or not.

But about, as the parent pointed, improvement. Even in a transhumanist society, someone with eyes on its feet or a mechanical arm without any usefulness would be regarded as stupid or mentally ill.

Not all modifications are good &/or transhumanists.

>I think the line you've drawn is a bit arbitrary.

On second thought, what I should have said was "transhumanists focus on improving the human body". Transitioning may improve your mental health (debatably) but it does not improve your physiological capabilities, and in case of MTF transition arguably worsens your body (bone density, muscle mass, fat distribution and so on)

Reply on news.ycombinator.com