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Comment by longcommonname | Hacker News Reader

More research should be done around detransitioners. Doctors need to evaluate the whole patient and in the case of informed consent they should confirm that the patient is aware of all the potential changes.

That being said, gate keeping what I do with my body is wrong. I knew all the potential side effects when I transitioned. I read the wpath in full. I was comfortable with all the risks.

This type of critical judgment of children's health care is needed and I hope the doctors are being more rigorous than what the author suggests.

I feel terrible for the girls who made a decision they regret and lost parts of their body that made them happy. Their doctors, and parents failed them. I am also happy that so many people were able to successfully transition.

The timing of the article is concerning with so many states trying to withhold life saving care I worry that the nuance of this article will be lost.

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Gatekeeping is one of the central aspects of modern medicine. Maybe a hundred years ago, when we had a free country and you could buy heroin over the counter, there was nobody gatekeeping what you did to your own body. But now we’ve corrected a pretty long way in the other direction.

In principle I think consenting adults should be able to do whatever they want with their own bodies, but consent needs to be informed and the person needs to be mentally capable of consent. You need some degree of gatekeeping just to reach that bar. And this is going to be an even bigger concern with children.

> heroin over the counter, there was nobody gatekeeping

I wasn't there, though I have learned that generally the local pharmacy would do the gate-keeping. Now the local pharmacy does what the computer says to do based on whatever regulations were input by the back office.

The local pharmacy at that time didn't look anything like its current counterpart. Let's not forget that the 1920s was the start of the "Soda Fountain Pharmacy" thanks to prohibition, so I wouldn't put much stock into the quality of professional pharmacology at the time. It would be decades before regulation caught up.

The local pharmacists, unfortunately, used to be perfectly happy to make addicts of people.

There was a huge decline in morphine addiction simply by requiring that products containing morphine be labeled as such.

The local pharmacy has very, very strong financial incentives to sell you morphine all the time -- just not enough to kill you.

I don't know why you'd trust them any more than a drug dealer, and historical anecdotes about opium addicts suggest it's a valid comparison.

> This type of critical judgment of children's health care is needed and I hope the doctors are being more rigorous than what the author suggests.

If you look critically at the research papers being published on these topics as a means to champion it, your hopes will be dashed.

Children do stupid things. Gate keeping them from touching a flame or walking off a balcony or any other experience they have no concept of is what parents do. It is to indoctrinate until children learns their own way and that generally happens once they understand the world better.

If we let children do as they do because it was their body then where would we be as responsible parents.

I hate the idea of making a kid take a test of knowledge on what transitioning entails before starting or going through some other form of gatekeeping, but my gut tells me that only people who are enthusiastic about the process and all of the nitty gritty details should be candidates for medical transitioning.

What's missing from this post is a sense of timescale and the steps taken throughout a patient's journey. There was no mention of patients publicly presenting as their preferred gender as a first step towards transitioning, prior to any medical intervention; I'm not sure if that's a red flag or if I just have outdated knowledge on treatment practices. I understood that the doctors seemed to be improvising with the treatment of patients, but the inconsistencies between patients' treatment weren't highlighted.

If a seventeen year old bio female comes to a 40 year old doctor and is prescribed chemicals that alter her genitalia for life, it is “gate keeping” to prosecute or regulate said doctor.

However, if a seventeen year old decides to have sex with a 40 year old, we would find it morally reprehensible and all agree that she could not consent to use her body that way.

I don’t know how to rectify these two commonly held beliefs.

>I don’t know how to rectify these two commonly held beliefs.

In the former case the doctors conflicts of interest don't seem so strong, in the latter case the doctors conflict of interest is overwhelmingly self-evident, so there is much higher risk of the doctor consciously working against his patients interests when the patient is still a minor in a major power differential.

One causes sterilisation, one causes pregnancy, western society is specifically very very against 17 year olds being pregnant and are anti-natalist and sex-negative more broadly.

The second case does not refer to a doctor. Was there an edit?

Nah I misread

there is no doctor in the second case. the wokemind is just a big ball of hypocrisy

The age of consent is 16 in most states. WTF are you talking about?

Isn't it obvious? Legalize MAPs.

I'm curious whether earlier accommodations or therapy can ease the pressure to move forward with surgical transition, and thus reduce the number of people who feel regret for their decision.

That said, I'm not sure these articles are intended to improve treatment options. Rather, the goal seems to be eliminating transgender care altogether.

How old were you when you transitioned?

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