It always seems strange to me when a transgender adult, such as Admiral Rachel Levine, advocates so strongly for youths to have access to gender medical treatments. Levine has two children, which obviously wouldn't be possible if [she] had started puberty blockers and had genital surgery before becoming an adult. Levine didn't transition until age 54 or so.
Why do adults want minors to be cut off from ever being able to have intimacy or parenthood experiences that they have enjoyed?
Because, as narcissists, people like Levine wish they looked more like women, and believe they would look better had they the opportunity to have transitioned earlier themselves.
They want “trans kids” to look more like the opposite sex, which they believe requires transitioning as young as possible. They don’t care if such children never have children of their own (they can adopt). They don’t care if they regret mastectomies (they have more plastic surgery).
And I’m pretty sure Levine has publicly expressed that he’s happy to have had his kids and only transitioned later. But he’s perfectly happy to have boys never get to experience what he did. Not just not having kids (not everyone wants them) but never even the joy of the activity that can lead to kids. A nasty piece of work.
I wonder if it is because being a tiny minority and having to cope for so long thinking they were the only one that they are doing two things: advocating for others so that others do not have to suffer (which is great), and maybe subconsciously still feeling alone and wanting more trans folks so they do not feel alone.
A good hypothesis. Like.most readers here I don't support youth transition or indoctrination but I do think it's important to understand our "enemies" as much as possible.
Yes. I also think their own experience was traumatic enough that they are reluctant to consider that, while trans kids definitely want to transition, other kids who are NOT trans may want to transition for very different reasons (and will suffer real harm if they do so, since they actually aren't trans).
What concerns me is that gender/body dysphoria is just part of puberty. Show me an adolescent who thinks their rapidly changing body is wonderful. I’ll wait. How does the affirming model of care handle this? I remember feeling envious of boys because they didn’t have periods, and because instead of adding fat, they tended to grow taller and develop muscle. If there had been TikTok in the ‘70’s, would it have occurred to me that I was a boy trapped in a girl’s body?
My research suggests that adolescent and young adult females are responding to common developmental pressures and seeking to fulfill basic developmental tasks through trans identification. This is not the same thing as being in any sense ‘born in the wrong body.’ Until recently, researchers, clinicians, and parents understood something a lot like gender dysphoria to be a normal stage of adolescent development for teenage girls. Simply put, it is hard to grow up female. It can be hard to accept the changes to one’s body—like menstruation and breast development—and the way society responds to those changes. There have always been girls and young women who sought a way out of the developmental challenges puberty posed. They took off-ramps like anorexia or cutting. Today, trans identity is a super highway promising an escape from the discomfort of female adolescence.
Many of the young females I see in online trans communities are seeking an explanation for the distress they feel over their changing bodies. They often struggle with questions of identity. They may not know how to fit in with their peers. They are looking for a place to belong, a sense of direction in life, a purpose or cause to devote themselves to, and recognition for their uniqueness and for the changes they undergo as they move from childhood toward adulthood. They are also often looking for a scapegoat for difficulties in life. The belief that one is transgender offers a clear scapegoat: the female body itself, which can be disciplined into compliance with the new identity regime, much the way the anorexic disciplines her body through starvation. A transgender identity can be especially appealing when healthier developmental pathways are blocked, for whatever reason: because the whole world locked down during a pandemic, because a young person has too few friends and opportunities in real life, or a too-compliant personality, or because mental health difficulties and neurocognitive differences interfere with her ability to build a compelling life offline.
I think that concern is shared by a lot of people, including me. Add to that the fact that sexual stereotyping appears to be getting stronger today. I was a very unfeminine child, who is now a very unfeminine woman; when I was a teen, the worst outcome had I believed the stereotypes would have been convincing myself that I was a butch lesbian - and how much actual harm (apart from the inevitable heart bruises most of us obtain as we figure out relationships) would that have caused me? Experimenting with same-sex attraction isn't even remotely the same as making permanent physical alterations to your body!
And then there are the kids who are rejecting their body as a result of trauma, such as sexual assault. That's yet another can of worms.
Kids don't understand that old saw "Wherever you go, there you are," and can mistakenly believe that changing their body is a solution to issues that actually have nothing to do with their body. Adults can also make that mistake, but more lived experience means they are less likely to. The "traditional" trans person was a man in his 40s who wanted to transition to female; it's a mistake to think that what we know about that demographic is automatically applicable to a 13 year boy, let alone a 13 year old girl.
I worked last summer in an environment that had a lot of middle school kids, and each week there were a couple of kids who were experimenting with gender. 100% natal females and they had a uniform—baggy flannel shirts, jeans, looked like they had cut their own hair with poultry shears. It was a mix of cosplay and being 13–nothing is more fun than calling out some clueless old lady who mistakenly uses the wrong pronouns! It felt like a typical teen thing to do—find something that drives your parents and other adults a little crazy. Harmless if nobody does any more than play along with them until they get bored and move to the next thing. I have no idea how many of these kids push for hormonal therapy—my sense with this group was that it was a fun thing to do but as far as I know nobody was on meds.
There are some people (not saying that Levine is one of them) who might be very attracted to the idea of a legal adult with body of someone who hasn't gone through puberty. There's also the castration fetishists. Again, not saying that Levine is one of them.
Some members of WPATH have been involved with the Eunuch Archive "a long-standing forum which hosts nearly 10,000 fictional pornography stories of an extreme sadomasochistic nature. As previously reported by Reduxx, many of these stories feature a theme of the rape, castration, torture, and killing of children — specifically little boys."
Sorry, but this is not the smoking gun you think it is. The degree that members of WPATH are "involved with" that forum is to have them as subjects of a study, with their informed consent. Same as you'd have with men who frequent gay bars or people who are part of a BDSM subculture. It is a paraphalia that exists and deserves study, and I don't see any evidence that those papers are advocating for "Eunuch" as sexual identity that people should be encouraged to choose. And in particular, there's zero evidence here that WPATH members are pursuing a paraphalia-based desire to emasculate children.
There are plenty of non-moral panic explanations as to the problematic way that "gender-affirming care" has played out.
I felt neutral about trans issues before. I was expecting more discussions about adults not getting discriminated against in housing and at workplace, since everybody there was an adult. However, that wasn't something they focused on, they had an overwhelming interest in discussing transing children. And the person I accompanied was gushing about how hormones made him feel like teenager girls, and made him to go through a lot of emotions, etc. He also showed obvious pedophilic interests, that's why I dissociated from him and started to pay attention to the trans movement.
I believe MTF is "Male to female" i.e. XY chromosomes (sex = male) and presenting as female. Usually referred to as transwomen.
AGP, with a bit of googling, appears to be autogynephilia - the theory, I think, being that the reason that _some_ XY people transition may be a sexual desire to be female.
Yes, but more specifically, the autogynephile is the target of his own attraction, so he needs to be absolutely convinced of his attractiveness — to himself— as a woman, and to have the idea reinforced by the public. The young boys whose puberty is blocked (this requires parental stewardship, sometimes driven by stated homophobia) are likely proto-gay men who will find their adult romantic prospects severely curtailed if they lack male genitals. These, in my view, are probably the patients most harmed by ‘affirmative care,’ and that is saying a lot.
I don’t have a source at the ready, but there is a relationship between opposite-sex presentation in childhood and same-sex attraction in adulthood. Dr. Michael Bailey devotes a chapter to this in The Man Who Would Be Queen, and I think he finds the link to be even stronger in effeminate boys than in tomboyish girls. Regardless, they should not lose their genitals.
Ugh, I had a feeling Levine was REALLY BAD NEWS and now it’s confirmed.
Not that the age limits that Levine removed really matter.The gender clinics aren’t even bothering to follow WPATH standards anymore. They’re so busy batting away anything remotely in the way of fast tracking children that having Levine help dismantle standards is simply a cherry on top.
Now that the Supreme Court is considering the constitutionality of banning this form of “medicine,” can they stop this insanity?
Every last advocate in the realm of trans politics is proving to be untrustworthy. I think most truly believe they’re on the side of the angels and the ends thus justify the means.
I started off cheering for Jazz Jennings a decade ago. By now, I’m so disillusioned at the means that I’m also skeptical of the ends, including gender medicine for young adults.
Blanket bans for children and no Medicaid payments for this stuff as adults would be a good start. The reason a blanket ban for children is necessary is because it's irreversible damage that damages development include possibly the brain. In addition, sexual dysfunction, sterilization and bone loss occurs. For women, there is no reason why they should ever do this as children because they can start taking hormones later if they wish. Changing their voice irreversibly when they're confused girls is disgusting. Personally, I think it's a mental disorder and social construct and dragging kids into conversion therapy and convincing them they can be another sex is perverted and cruel.
I don’t disagree on the merits, but as Jesse likes to say, it’s complicated. I really don’t want the government in the business of banning surgeries of any kind, especially ones with this much culture war fuel. Who decides which surgeries are OK? Don’t assume it will always be your people who get the final say.
Should goat gland transplants be legal and covered by insurance? Because that’s the kind of “care” this is. Back in the 1920s Dr Brinkley had a great business doing this. Patients desiring virility flocked to his practice. They demanded it.
Likewise, some believed removing ovaries cured all sorts of illnesses—women demanded it. Went to legislators to ensure access when some experts tried to end them because of myriad bad outcomes.
These events, and more, can be found in a book called Sex, Science, Self by Bob Ostertag.
I believe people should be allowed to do stupid things to their bodies if they want. With minors it’s more complicated, but in general I think that government is the least qualified of all options to make that call.
I don't think people should have board certified doctors amputating their limbs or removing their genitalia because they want it. Medical practice should be evidence based, not consumer driven.
The only reason lawmakers are getting involved at all is because the medical trade organizations (AMA, APA, etc) are allowing their members to do these things. They are refusing to do systematic reviews (like the Cass Review in the UK). In European countries with centralized health systems they are following the science and reducing these practices--because their studies show the harms clearly outweigh the benefits.
The goat glads transplants and the ovary removals did end in part because the AMA decided to expel any members who did them.
I'd be happy to see that happen in this case, but at the moment, legislation is the tool at hand.
Sorry I must disagree. Blanket bans may be the only way to stop this. Anything less leaves the door open to more medical harm.
To object to banning this medieval cruelty is like saying, well, okay, maybe some people *really need* goat gland transplants to feel more virile, so we’ll allow them when the doctor prescribes it. (I’m not making up the goat gland surgeries, look up Dr Brinkley.)
But yes when I was a normie I felt similarly. Just not any more.
My doubts about blanket bans revolve more around whether they will actually be effective. As long as the culture supports the narrative that youth gender medicine is “life-saving care,” frightened parents will continue to affirm and travel thousands of miles to a blue state for blockers and hormones for their kids. Blanket bans on under-18 treatment harden the determination of some young people to medicalize on their 18th birthday.
I don’t say this lightly. I understood the desperation of parents during the year my child identified as trans. He was already 18 so a ban would not have stopped him. (What did sway him? Getting mostly offline. Developing mastery at a job. Learning a new instrument.)
Even a majority of the moderates and normies among my students are on board with most of the trans agenda. They don’t want to be known as bigots. There may be a good bit of preference falsification, as evidenced by some nods when I’ve stated that I think social influences are leading some to medicalize who might be better off in their unaltered bodies. But then again, I’ve only rarely said this to students because I’m scared of cancellation (I’m in a nontenurable position in WGSS).
Yes, people will continue to go to Thailand for surgeries no matter what.
But I think adding friction to the process is good. I think it would still reduce the amount of harm.
As to the political and cultural battles, these things have shifted before. Gay marriage suddenly became acceptable. The Satanic Panic suddenly receded (leaving plenty of wreckage, including those who still believe it). Belief in the efficacy of this stuff could change--but I'm no activist so I don't have any particular strategies.
And yes, I'm not using my real name here because I'm concerned about being cancelled by my nice liberal friends.
I also have my doubts about blanket bans. A better legislative solution would be to lengthen the statute of limitations for medical malpractice lawsuits.
Unfortunately, medical malpractice is a hard case to make, and can happen only after permanent damage has been done.
Another possible tactic is to end insurance coverage for all of it, just as cosmetic surgeries aren’t covered. That would be difficult given Obamacare rules, but perhaps Congress could do it (I’m no expert). Having to self finance the surgery would dramatically cut the numbers.
The 10-year statute of limitations imposed by the Missouri legislature shut down the youth gender clinic in St. Louis! You’re quite right about the difficulty of the cases - elsewhere in this thread you referenced the lawyer for detransitioners who was recently on Gender - A Wider Lens. That episode is worth a listen!
Legal liability is a powerful disincentive for MDs, as well as providers of malpractice insurance. It really blunted the recovered memory movement in the 90s. Also, as I recall, a gender clinic in Missouri cited a change in the law on medical malpractice (not sure of the specifics, maybe longer statutes of limitation) as a reason for discontinuing care.
I can’t recall exactly what interview it was, but it was argued that all it would take would be one judgment with a large award to really change the playing field.
I hope you’re correct! But one of the worst practitioners of recovered memory was able to keep his license and he kept practicing in Montana for years after the lawsuits.
And recovered memory has made a comeback, albeit in slightly different form, as trauma-informed therapy.
The Supreme Court has no power by which to ban any form of medicine, even something like this. There are definitely areas where the courts may be called to intervene, but health care policy are legislative questions. There are a lot of non controversial limits on permanent bodily changes or health care decisions. Most states do not allow individuals under 18 to get a tattoo shout parental consent, or cosmetic surgery, for instance. If tomorrow, the state of New York decided to get rid of any age limits on getting a tattoo, there is no grounds to sue the state legislature because it’s a bad idea.
Some of the more egregious and hair raising laws - such as the trans sanctuary laws for minors in California - where the state would not return runaways to parents if the kid says it’s because the parent won’t permit gender affirming care - will likely get thrown out by lower courts, as it violates centuries of common law on parental rights and existing federal laws.
Of course. Isn’t the question before the court whether or not such bans are unconstitutional? If they rule no, then states will be able to set those rules. If they rule yes, that it’s unconstitutional to ban such medical practice under the 14th amendment, then no bans will stand.
I’m hoping they rule no, such state bans are not unconstitutional, but are like other state laws you mention. That keeps the door open for state legislatures to pass more laws restricting these practices.
Agreed. I don’t see how the court could rule that such bans are unconstitutional. It would be very much not in line with its own recent decisions, a running theme of which is “Congress, do your job” and “this literally is not our decision to make.” Unfortunately, the laws in red states, like Alabama, will lead Blue States to up the ante in the opposite direction. Before we know it, nullification surgery will become the new civil rights fight of our time, until the next thing. The one silver lining is that as the blue states get more ridiculous, the gap between the evidence and rhetoric will grow even wider. I imagine at some point this will be like the Satanic Panic, #metoo excesses, and the worst of MSNBC Russiagate coverage - there will be attempt to memory hole it, and a lot of people who should lose credibility will someone come through it unscathed.
The Supremes took this court on the basis of a dispute over whether the Equal Protection Clause. They chose not to go for a similar case where substantive due process liberty was also at stake. I’m not a constitutional scholar but have read a decent amount on the 14th amendment (thank you, Martha Nussbaum) and I think this is significant. Dobbs already left substantive due process heavily wounded. Choosing to tackle it here might open a can of worms about state regulations applying to trans adults.
I can imagine SCOTUS will have something to say about the extent to which transgender people should be considered a protected class. That’s the direction EP points, in my decidedly non-lawyerly opinion.
Bostock held that sex as a protected characteristic could be used in a “but-for” analysis to claim rights for gay and trans people: “but for” sex, Aimee Stephens would not have been fired from her funeral home job for dressing in women’s clothes as a trans woman. But that ruling signaled narrow applicability - and when the Biden administration and advocates claim otherwise by saying Title IX was addressed in Bostock, they are trying to buffalo us.
Bostock was also decided on the basis of Equal Protection. This new case could mean the court is looking to signal whether the EPC extends beyond the parameters of Bostock.
Don't you think the decision to appeal the Tennessee case to SCOTUS was, ah, courageous? This is the court that struck down Roe, for crying out loud, so it's hard for me to think it would rule in a more progressive way on youth gender stuff.
Bostock hardly came out as anyone expected, but I imagine this case will come out in line with Dobbs, where abortion was left to the politician branches of government- specifically state governments and Congress. It most likely will “open a can of worms about state regulations applying to trans adults” and trans children, and it will be messy, but thats how democracies and the public square are supposed to work. The current status quo can’t hold. The science is weak across the board, and there are a lot of competing legitimate interests. Ultimately, a national modus vivendi will develop, and it will probably be much more conservative, more in line with Western Europe.
It's very significant. Equal Protection is a high bar to clear. These laws should have survived a Rational Basis review. And evidence like this further bolsters that the entire US SOC is a house of cards.
Except that the WPATH standards are not legally binding, they are suggestions.
WPATH is a lobbying group pretending to be a medical expert organization.
All their standards of care are essentially marketing mechanisms: “see, all these activists agree that this care is appropriate, so, really trans medicine makes sense” when it has zero relationship to the ethic of “doing no harm.”
Levine made clear here that any age limits would lead to opponents demanding more age limits, so let’s do away with them all. Rips off the facade that such standards have any meaning at all.
I’m not claiming they are legally binding. But they make an argument available to a plaintiff’s attorney. When SOC8 was changed at the last minute, one of reasons proffered was that they would expose MDs to legal liability. Now we also see a political motive, but I wouldn’t say that they have no legal significance.
Detransitioner lawsuits, as far as I know, have not been able to refer to WPATH standards not being followed. It’s complicated, I don’t understand all of it, and the lawsuits are trying different approaches. Genspect had a lawyer on the podcast discussing this. I’m not a lawyer, so I could be wrong!
"Levine made clear here that any age limits would lead to opponents demanding more age limits, so let’s do away with them all. Rips off the facade that such standards have any meaning at all."
Is that the reasoning?
I assumed it was the opposite - that they were going to lower the age guidelines a bit, and didn't want them publicized because that would lead to backlash as people complained about the lower age limits.
Jesse - do you have information either way as to the reasoning here?
"She like [sic] the SOC-8 very much but she was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth and maybe adults too. Apparently the situation in the USA is terrible and she and the Biden administration worried that having ages in the document will make matters worse."
My interpretation is that Levine thought that having no age limits was a more defensible political position. Levine's request shows that the discussions over "age limits" are political, not based on evidence or tested standards.
I will hope (I have no legal expertise) that the reason they took the case was to see if they could ensure such bans would stand. I mean, most of the justices are Catholic. They must see some potential here to cut such challenges off? But I know nothing!
Hell. Just hell. I don't even remember whose law it is, but the more consequential something is for social policy, the more it will be manipulated to conform with a group's goals. And that, my friends, is how science goes to hell.
Why is it that, when government is deeply involved in a field - “public” health, “public” safety, “public” education - people are still surprised when it becomes politicized?
I don't think this will answer your question, but the issue for me turns on just /how/ politicized it will be, leading to how /much/ the issue will be obfuscated, manipulated, played up or down, become the subject to lies of omission and of commission, subject to little white lies and whoppers, blended into a panoply of acts of dishonesty and fabrication. And once it's well-cooked, how much will the product be forced on the public and dominate policy? Crap. Why bother with vast conspiracies when we're surrounded by banal, little conspiracists?
The health and welfare of American children are being sacrificed for a social ideology. The American lefts empathy has been used against them to support the perverse ideology that is willing to harm kids to support potential gender dysphoric kids at all costs. It’s unethical and immoral.
This is actually stunning. I imagine the Free Press will run an article on this, but if major outlets don't report on this, I will actually be quite flabbergasted as this is truly newsworthy information.
The only reason not to run it would be concerns over how it would impact the Biden campaign (a la Dan Froomkin arguments).
It's so surreal to have all these nasty details come out about trans medicine. If I wasn't living through it and just read it in a history book, I'd think it was exaggerated.
And of course Delphi process is the lowest reliability of medical evidence. Expert opinion, compared to systematic reviews, the most reliable and best practices. Wpath commissioned some systematic reviews and then ignored them.
I hope the supreme court wakes up! This should not be political. That's why the Cass review said these kids were let down!
The ideologues who’ve made policy on youth gender medicine in the AAP want to avoid lawsuits that would be easier to win if doctors were shown to have violated standards of care. No standards? No basis for a lawsuit!
As Jesse and Leor Sapir noted on Twitter, the AAP and/or Levine wished to remove provisions that could influence legislation in the states.
Perhaps most of all, the people making policy at AAP - such as Jason Rafferty, the very young doctor who wrote the AAP statement on affirmative care for children - believe they’re on a life-saving mission. They can’t retreat because they’ve personally staked so much on it: their career, reputation, self-image.
So, I feel like everyone in this thread is reading the quotes that Jesse cites a little differently from me. (Or maybe I’m misreading the comments?) To me, it seems very clear that Levine is against the age limits because they look bad from a public relations perspective. This quote seems pretty clear:
“[Levine’s Chief of Staff] is confident, based on the rhetoric she is hearing in DC, and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care.”
In other words, Levine (and probably other figure in HHS) knew it was a really unpopular look to release standards that embrace things like sex reassignment surgery for minors. Those standards would cause a firestorm, possibly discredit WPaths standards with some groups, and give GOP state legislators stronger ground to argue that ‘the medical community isn’t protecting kids so we have to.’ Levine presumably either didn’t want to push WPath to raise its age guidance, or didn’t think she could do so successfully, so she asked them to bury that part of their recommendations. This is a clear public relations move. It’s definitely bad to have public officials telling medical groups to just hide the parts of their recommendations that the public won’t like - because it makes it harder for the public to judge those recommendations.
But some people on here seem to be reading this as if Levine was upset because she thought that WPATH was doing too much to limit GAC for children at younger ages. Like she thought that WPATH just wasn’t being radical enough. And the info we have doesn’t really support that.
Again, maybe I’m misreading other people’s comments. But let’s make sure that we’re scandalized by the thing that actually happened, which appears to be a public official trying to prevent WPATH from releasing a portion of their guidelines that would instantly be very popular.
The future is dim. As a culture we’ve crossed into evil territory, where it’s acceptable to exchange lives and human wellbeing for politics. And this is to ensure, even force, the re-election of the nominal good guy.
If they don’t care about kids enough to knowingly harm them, to destroy sex and true love and romance from their lives, and only for gender politics to push a campaign policy? How long before some chemical gives everyone cancer with these norms in place? Some broken fix that wins votes but harms voters, and can be hidden by this vast tapestry of lies and censorship the Democrats hide behind?
The one and only experience I have with the Delphi method was pretty mind-blowing. My experience was with the local catholic church and their desire to yet again remodel a lovely church in order to meet ever-changing liturgical standards. In that case, it felt like a predetermined solution was arrived at through a consensus process that felt like coercion.
It always seems strange to me when a transgender adult, such as Admiral Rachel Levine, advocates so strongly for youths to have access to gender medical treatments. Levine has two children, which obviously wouldn't be possible if [she] had started puberty blockers and had genital surgery before becoming an adult. Levine didn't transition until age 54 or so.
Why do adults want minors to be cut off from ever being able to have intimacy or parenthood experiences that they have enjoyed?
Because, as narcissists, people like Levine wish they looked more like women, and believe they would look better had they the opportunity to have transitioned earlier themselves.
They want “trans kids” to look more like the opposite sex, which they believe requires transitioning as young as possible. They don’t care if such children never have children of their own (they can adopt). They don’t care if they regret mastectomies (they have more plastic surgery).
I won’t have you sully the name of Babylon Bee’s Man of the Year so flippantly.
There is a strong sexual fantasy element from some older AGPs about young boys being feminized and even castrated.
And I’m pretty sure Levine has publicly expressed that he’s happy to have had his kids and only transitioned later. But he’s perfectly happy to have boys never get to experience what he did. Not just not having kids (not everyone wants them) but never even the joy of the activity that can lead to kids. A nasty piece of work.
Thank you for being a sex realist and using the male pronoun when referring to Richard Levine.
I wonder if it is because being a tiny minority and having to cope for so long thinking they were the only one that they are doing two things: advocating for others so that others do not have to suffer (which is great), and maybe subconsciously still feeling alone and wanting more trans folks so they do not feel alone.
A good hypothesis. Like.most readers here I don't support youth transition or indoctrination but I do think it's important to understand our "enemies" as much as possible.
Yes. I also think their own experience was traumatic enough that they are reluctant to consider that, while trans kids definitely want to transition, other kids who are NOT trans may want to transition for very different reasons (and will suffer real harm if they do so, since they actually aren't trans).
What concerns me is that gender/body dysphoria is just part of puberty. Show me an adolescent who thinks their rapidly changing body is wonderful. I’ll wait. How does the affirming model of care handle this? I remember feeling envious of boys because they didn’t have periods, and because instead of adding fat, they tended to grow taller and develop muscle. If there had been TikTok in the ‘70’s, would it have occurred to me that I was a boy trapped in a girl’s body?
This is gender researcher Eliza Mondegreen's take on the female side of the trans phenomenon:
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My research suggests that adolescent and young adult females are responding to common developmental pressures and seeking to fulfill basic developmental tasks through trans identification. This is not the same thing as being in any sense ‘born in the wrong body.’ Until recently, researchers, clinicians, and parents understood something a lot like gender dysphoria to be a normal stage of adolescent development for teenage girls. Simply put, it is hard to grow up female. It can be hard to accept the changes to one’s body—like menstruation and breast development—and the way society responds to those changes. There have always been girls and young women who sought a way out of the developmental challenges puberty posed. They took off-ramps like anorexia or cutting. Today, trans identity is a super highway promising an escape from the discomfort of female adolescence.
Many of the young females I see in online trans communities are seeking an explanation for the distress they feel over their changing bodies. They often struggle with questions of identity. They may not know how to fit in with their peers. They are looking for a place to belong, a sense of direction in life, a purpose or cause to devote themselves to, and recognition for their uniqueness and for the changes they undergo as they move from childhood toward adulthood. They are also often looking for a scapegoat for difficulties in life. The belief that one is transgender offers a clear scapegoat: the female body itself, which can be disciplined into compliance with the new identity regime, much the way the anorexic disciplines her body through starvation. A transgender identity can be especially appealing when healthier developmental pathways are blocked, for whatever reason: because the whole world locked down during a pandemic, because a young person has too few friends and opportunities in real life, or a too-compliant personality, or because mental health difficulties and neurocognitive differences interfere with her ability to build a compelling life offline.
https://elizamondegreen.substack.com/p/my-testimony-for-quebecs-comite-de
I think that concern is shared by a lot of people, including me. Add to that the fact that sexual stereotyping appears to be getting stronger today. I was a very unfeminine child, who is now a very unfeminine woman; when I was a teen, the worst outcome had I believed the stereotypes would have been convincing myself that I was a butch lesbian - and how much actual harm (apart from the inevitable heart bruises most of us obtain as we figure out relationships) would that have caused me? Experimenting with same-sex attraction isn't even remotely the same as making permanent physical alterations to your body!
And then there are the kids who are rejecting their body as a result of trauma, such as sexual assault. That's yet another can of worms.
Kids don't understand that old saw "Wherever you go, there you are," and can mistakenly believe that changing their body is a solution to issues that actually have nothing to do with their body. Adults can also make that mistake, but more lived experience means they are less likely to. The "traditional" trans person was a man in his 40s who wanted to transition to female; it's a mistake to think that what we know about that demographic is automatically applicable to a 13 year boy, let alone a 13 year old girl.
I worked last summer in an environment that had a lot of middle school kids, and each week there were a couple of kids who were experimenting with gender. 100% natal females and they had a uniform—baggy flannel shirts, jeans, looked like they had cut their own hair with poultry shears. It was a mix of cosplay and being 13–nothing is more fun than calling out some clueless old lady who mistakenly uses the wrong pronouns! It felt like a typical teen thing to do—find something that drives your parents and other adults a little crazy. Harmless if nobody does any more than play along with them until they get bored and move to the next thing. I have no idea how many of these kids push for hormonal therapy—my sense with this group was that it was a fun thing to do but as far as I know nobody was on meds.
I’ve been making the case that people, with some success, have essentially pathologized puberty.
Andrew Sullivan has largely gone ‘round the twist, and I mostly roll my eyes at him, but he thinks people have pathologized gay kids.
I don’t see how that also isn’t a pertinent concern. No one has be able to explain away that it isn’t a non-zero chance.
There are some people (not saying that Levine is one of them) who might be very attracted to the idea of a legal adult with body of someone who hasn't gone through puberty. There's also the castration fetishists. Again, not saying that Levine is one of them.
Some members of WPATH have been involved with the Eunuch Archive "a long-standing forum which hosts nearly 10,000 fictional pornography stories of an extreme sadomasochistic nature. As previously reported by Reduxx, many of these stories feature a theme of the rape, castration, torture, and killing of children — specifically little boys."
https://reduxx.info/academics-involved-with-top-transgender-health-authority-publish-paper-on-choosing-castration/
Sorry, but this is not the smoking gun you think it is. The degree that members of WPATH are "involved with" that forum is to have them as subjects of a study, with their informed consent. Same as you'd have with men who frequent gay bars or people who are part of a BDSM subculture. It is a paraphalia that exists and deserves study, and I don't see any evidence that those papers are advocating for "Eunuch" as sexual identity that people should be encouraged to choose. And in particular, there's zero evidence here that WPATH members are pursuing a paraphalia-based desire to emasculate children.
There are plenty of non-moral panic explanations as to the problematic way that "gender-affirming care" has played out.
Can you say more about this? How did they convince you?
I felt neutral about trans issues before. I was expecting more discussions about adults not getting discriminated against in housing and at workplace, since everybody there was an adult. However, that wasn't something they focused on, they had an overwhelming interest in discussing transing children. And the person I accompanied was gushing about how hormones made him feel like teenager girls, and made him to go through a lot of emotions, etc. He also showed obvious pedophilic interests, that's why I dissociated from him and started to pay attention to the trans movement.
That’s illuminating, thank you.
What is MTF? What is AGP?
I believe MTF is "Male to female" i.e. XY chromosomes (sex = male) and presenting as female. Usually referred to as transwomen.
AGP, with a bit of googling, appears to be autogynephilia - the theory, I think, being that the reason that _some_ XY people transition may be a sexual desire to be female.
Yes, but more specifically, the autogynephile is the target of his own attraction, so he needs to be absolutely convinced of his attractiveness — to himself— as a woman, and to have the idea reinforced by the public. The young boys whose puberty is blocked (this requires parental stewardship, sometimes driven by stated homophobia) are likely proto-gay men who will find their adult romantic prospects severely curtailed if they lack male genitals. These, in my view, are probably the patients most harmed by ‘affirmative care,’ and that is saying a lot.
"the autogynephile is the target of his own attraction, so he needs to be absolutely convinced of his attractiveness — to himself— as a woman"
So, like Buffalo Bill in Silence of the Lambs.
I don't know about "likely" (what kind of numbers does that mean) but the evidence suggests it's certainly non-zero.
I don’t have a source at the ready, but there is a relationship between opposite-sex presentation in childhood and same-sex attraction in adulthood. Dr. Michael Bailey devotes a chapter to this in The Man Who Would Be Queen, and I think he finds the link to be even stronger in effeminate boys than in tomboyish girls. Regardless, they should not lose their genitals.
MTF = male-to-female transsexual. It's older lingo (1990s).
AGP = Autogynephilia. https://pubmed.ncbi.nlm.nih.gov/22005209/
Great reporting. Thank you. And fuck these people.
I hope Jesse or Helen gets some opportunities to write about this in major publications. This is insanely scandalous, right?
The piece I am working on is for a major publication and is also about WPATH. Fingers crossed!
God bless
Yes, please.
The WPATH tapes contain a wealth of information. If you do not have 30 hours to spare, I wrote a 4-pager that I hope is published soon.
Can't wait to read it!
It is on PITT Substack. It is called Physiological Plausibility.
This matter is on the front page of NYT now.
https://www.nytimes.com/2024/06/25/health/transgender-minors-surgeries.html
Ugh, I had a feeling Levine was REALLY BAD NEWS and now it’s confirmed.
Not that the age limits that Levine removed really matter.The gender clinics aren’t even bothering to follow WPATH standards anymore. They’re so busy batting away anything remotely in the way of fast tracking children that having Levine help dismantle standards is simply a cherry on top.
Now that the Supreme Court is considering the constitutionality of banning this form of “medicine,” can they stop this insanity?
Every last advocate in the realm of trans politics is proving to be untrustworthy. I think most truly believe they’re on the side of the angels and the ends thus justify the means.
I started off cheering for Jazz Jennings a decade ago. By now, I’m so disillusioned at the means that I’m also skeptical of the ends, including gender medicine for young adults.
Blanket bans are also a terrible solution imho (but leaving Rachel Levine open to enormous lawsuits seems appropriate and potentially cathartic)
Blanket bans for children and no Medicaid payments for this stuff as adults would be a good start. The reason a blanket ban for children is necessary is because it's irreversible damage that damages development include possibly the brain. In addition, sexual dysfunction, sterilization and bone loss occurs. For women, there is no reason why they should ever do this as children because they can start taking hormones later if they wish. Changing their voice irreversibly when they're confused girls is disgusting. Personally, I think it's a mental disorder and social construct and dragging kids into conversion therapy and convincing them they can be another sex is perverted and cruel.
I don’t disagree on the merits, but as Jesse likes to say, it’s complicated. I really don’t want the government in the business of banning surgeries of any kind, especially ones with this much culture war fuel. Who decides which surgeries are OK? Don’t assume it will always be your people who get the final say.
Should goat gland transplants be legal and covered by insurance? Because that’s the kind of “care” this is. Back in the 1920s Dr Brinkley had a great business doing this. Patients desiring virility flocked to his practice. They demanded it.
Likewise, some believed removing ovaries cured all sorts of illnesses—women demanded it. Went to legislators to ensure access when some experts tried to end them because of myriad bad outcomes.
These events, and more, can be found in a book called Sex, Science, Self by Bob Ostertag.
I believe people should be allowed to do stupid things to their bodies if they want. With minors it’s more complicated, but in general I think that government is the least qualified of all options to make that call.
I don't think people should have board certified doctors amputating their limbs or removing their genitalia because they want it. Medical practice should be evidence based, not consumer driven.
The only reason lawmakers are getting involved at all is because the medical trade organizations (AMA, APA, etc) are allowing their members to do these things. They are refusing to do systematic reviews (like the Cass Review in the UK). In European countries with centralized health systems they are following the science and reducing these practices--because their studies show the harms clearly outweigh the benefits.
The goat glads transplants and the ovary removals did end in part because the AMA decided to expel any members who did them.
I'd be happy to see that happen in this case, but at the moment, legislation is the tool at hand.
This issue is indeed, complicated, something the moral panic-driven "gender-critical" crowd is as blind to as the "gender-affirming care" folks.
Sorry I must disagree. Blanket bans may be the only way to stop this. Anything less leaves the door open to more medical harm.
To object to banning this medieval cruelty is like saying, well, okay, maybe some people *really need* goat gland transplants to feel more virile, so we’ll allow them when the doctor prescribes it. (I’m not making up the goat gland surgeries, look up Dr Brinkley.)
But yes when I was a normie I felt similarly. Just not any more.
My doubts about blanket bans revolve more around whether they will actually be effective. As long as the culture supports the narrative that youth gender medicine is “life-saving care,” frightened parents will continue to affirm and travel thousands of miles to a blue state for blockers and hormones for their kids. Blanket bans on under-18 treatment harden the determination of some young people to medicalize on their 18th birthday.
I don’t say this lightly. I understood the desperation of parents during the year my child identified as trans. He was already 18 so a ban would not have stopped him. (What did sway him? Getting mostly offline. Developing mastery at a job. Learning a new instrument.)
Even a majority of the moderates and normies among my students are on board with most of the trans agenda. They don’t want to be known as bigots. There may be a good bit of preference falsification, as evidenced by some nods when I’ve stated that I think social influences are leading some to medicalize who might be better off in their unaltered bodies. But then again, I’ve only rarely said this to students because I’m scared of cancellation (I’m in a nontenurable position in WGSS).
Yes, people will continue to go to Thailand for surgeries no matter what.
But I think adding friction to the process is good. I think it would still reduce the amount of harm.
As to the political and cultural battles, these things have shifted before. Gay marriage suddenly became acceptable. The Satanic Panic suddenly receded (leaving plenty of wreckage, including those who still believe it). Belief in the efficacy of this stuff could change--but I'm no activist so I don't have any particular strategies.
And yes, I'm not using my real name here because I'm concerned about being cancelled by my nice liberal friends.
I also have my doubts about blanket bans. A better legislative solution would be to lengthen the statute of limitations for medical malpractice lawsuits.
Unfortunately, medical malpractice is a hard case to make, and can happen only after permanent damage has been done.
Another possible tactic is to end insurance coverage for all of it, just as cosmetic surgeries aren’t covered. That would be difficult given Obamacare rules, but perhaps Congress could do it (I’m no expert). Having to self finance the surgery would dramatically cut the numbers.
The 10-year statute of limitations imposed by the Missouri legislature shut down the youth gender clinic in St. Louis! You’re quite right about the difficulty of the cases - elsewhere in this thread you referenced the lawyer for detransitioners who was recently on Gender - A Wider Lens. That episode is worth a listen!
Legal liability is a powerful disincentive for MDs, as well as providers of malpractice insurance. It really blunted the recovered memory movement in the 90s. Also, as I recall, a gender clinic in Missouri cited a change in the law on medical malpractice (not sure of the specifics, maybe longer statutes of limitation) as a reason for discontinuing care.
I can’t recall exactly what interview it was, but it was argued that all it would take would be one judgment with a large award to really change the playing field.
I hope you’re correct! But one of the worst practitioners of recovered memory was able to keep his license and he kept practicing in Montana for years after the lawsuits.
And recovered memory has made a comeback, albeit in slightly different form, as trauma-informed therapy.
Such battles require many weapons, it seems.
The Supreme Court has no power by which to ban any form of medicine, even something like this. There are definitely areas where the courts may be called to intervene, but health care policy are legislative questions. There are a lot of non controversial limits on permanent bodily changes or health care decisions. Most states do not allow individuals under 18 to get a tattoo shout parental consent, or cosmetic surgery, for instance. If tomorrow, the state of New York decided to get rid of any age limits on getting a tattoo, there is no grounds to sue the state legislature because it’s a bad idea.
Some of the more egregious and hair raising laws - such as the trans sanctuary laws for minors in California - where the state would not return runaways to parents if the kid says it’s because the parent won’t permit gender affirming care - will likely get thrown out by lower courts, as it violates centuries of common law on parental rights and existing federal laws.
Of course. Isn’t the question before the court whether or not such bans are unconstitutional? If they rule no, then states will be able to set those rules. If they rule yes, that it’s unconstitutional to ban such medical practice under the 14th amendment, then no bans will stand.
I’m hoping they rule no, such state bans are not unconstitutional, but are like other state laws you mention. That keeps the door open for state legislatures to pass more laws restricting these practices.
Agreed. I don’t see how the court could rule that such bans are unconstitutional. It would be very much not in line with its own recent decisions, a running theme of which is “Congress, do your job” and “this literally is not our decision to make.” Unfortunately, the laws in red states, like Alabama, will lead Blue States to up the ante in the opposite direction. Before we know it, nullification surgery will become the new civil rights fight of our time, until the next thing. The one silver lining is that as the blue states get more ridiculous, the gap between the evidence and rhetoric will grow even wider. I imagine at some point this will be like the Satanic Panic, #metoo excesses, and the worst of MSNBC Russiagate coverage - there will be attempt to memory hole it, and a lot of people who should lose credibility will someone come through it unscathed.
The Supremes took this court on the basis of a dispute over whether the Equal Protection Clause. They chose not to go for a similar case where substantive due process liberty was also at stake. I’m not a constitutional scholar but have read a decent amount on the 14th amendment (thank you, Martha Nussbaum) and I think this is significant. Dobbs already left substantive due process heavily wounded. Choosing to tackle it here might open a can of worms about state regulations applying to trans adults.
I can imagine SCOTUS will have something to say about the extent to which transgender people should be considered a protected class. That’s the direction EP points, in my decidedly non-lawyerly opinion.
Bostock held that sex as a protected characteristic could be used in a “but-for” analysis to claim rights for gay and trans people: “but for” sex, Aimee Stephens would not have been fired from her funeral home job for dressing in women’s clothes as a trans woman. But that ruling signaled narrow applicability - and when the Biden administration and advocates claim otherwise by saying Title IX was addressed in Bostock, they are trying to buffalo us.
Bostock was also decided on the basis of Equal Protection. This new case could mean the court is looking to signal whether the EPC extends beyond the parameters of Bostock.
Don't you think the decision to appeal the Tennessee case to SCOTUS was, ah, courageous? This is the court that struck down Roe, for crying out loud, so it's hard for me to think it would rule in a more progressive way on youth gender stuff.
Bostock hardly came out as anyone expected, but I imagine this case will come out in line with Dobbs, where abortion was left to the politician branches of government- specifically state governments and Congress. It most likely will “open a can of worms about state regulations applying to trans adults” and trans children, and it will be messy, but thats how democracies and the public square are supposed to work. The current status quo can’t hold. The science is weak across the board, and there are a lot of competing legitimate interests. Ultimately, a national modus vivendi will develop, and it will probably be much more conservative, more in line with Western Europe.
It's very significant. Equal Protection is a high bar to clear. These laws should have survived a Rational Basis review. And evidence like this further bolsters that the entire US SOC is a house of cards.
A
Alaaa
The age limits could matter, because they open the clinics to legal liability if they don’t follow the supposed standard of care.
Except that the WPATH standards are not legally binding, they are suggestions.
WPATH is a lobbying group pretending to be a medical expert organization.
All their standards of care are essentially marketing mechanisms: “see, all these activists agree that this care is appropriate, so, really trans medicine makes sense” when it has zero relationship to the ethic of “doing no harm.”
Levine made clear here that any age limits would lead to opponents demanding more age limits, so let’s do away with them all. Rips off the facade that such standards have any meaning at all.
I’m not claiming they are legally binding. But they make an argument available to a plaintiff’s attorney. When SOC8 was changed at the last minute, one of reasons proffered was that they would expose MDs to legal liability. Now we also see a political motive, but I wouldn’t say that they have no legal significance.
Detransitioner lawsuits, as far as I know, have not been able to refer to WPATH standards not being followed. It’s complicated, I don’t understand all of it, and the lawsuits are trying different approaches. Genspect had a lawyer on the podcast discussing this. I’m not a lawyer, so I could be wrong!
Not a lawyer either. It’s a question I would want to hear put to a lawyer.
"Levine made clear here that any age limits would lead to opponents demanding more age limits, so let’s do away with them all. Rips off the facade that such standards have any meaning at all."
Is that the reasoning?
I assumed it was the opposite - that they were going to lower the age guidelines a bit, and didn't want them publicized because that would lead to backlash as people complained about the lower age limits.
Jesse - do you have information either way as to the reasoning here?
"She like [sic] the SOC-8 very much but she was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth and maybe adults too. Apparently the situation in the USA is terrible and she and the Biden administration worried that having ages in the document will make matters worse."
My interpretation is that Levine thought that having no age limits was a more defensible political position. Levine's request shows that the discussions over "age limits" are political, not based on evidence or tested standards.
But I could be wrong!
If the ages would affect access for adults, then that suggests backlash by exposing the ages (as being too young).
I don’t think SCOTUS will ban this. I’m prepared to be wrong, I’m just not sure I see the constitutional case.
I will hope (I have no legal expertise) that the reason they took the case was to see if they could ensure such bans would stand. I mean, most of the justices are Catholic. They must see some potential here to cut such challenges off? But I know nothing!
Could these people kindly stop making right wing paranoid fever dreams come true
Hell. Just hell. I don't even remember whose law it is, but the more consequential something is for social policy, the more it will be manipulated to conform with a group's goals. And that, my friends, is how science goes to hell.
Why is it that, when government is deeply involved in a field - “public” health, “public” safety, “public” education - people are still surprised when it becomes politicized?
I don't think this will answer your question, but the issue for me turns on just /how/ politicized it will be, leading to how /much/ the issue will be obfuscated, manipulated, played up or down, become the subject to lies of omission and of commission, subject to little white lies and whoppers, blended into a panoply of acts of dishonesty and fabrication. And once it's well-cooked, how much will the product be forced on the public and dominate policy? Crap. Why bother with vast conspiracies when we're surrounded by banal, little conspiracists?
The health and welfare of American children are being sacrificed for a social ideology. The American lefts empathy has been used against them to support the perverse ideology that is willing to harm kids to support potential gender dysphoric kids at all costs. It’s unethical and immoral.
This is actually stunning. I imagine the Free Press will run an article on this, but if major outlets don't report on this, I will actually be quite flabbergasted as this is truly newsworthy information.
The only reason not to run it would be concerns over how it would impact the Biden campaign (a la Dan Froomkin arguments).
I’d bet money that mainstream outlets won’t run this.
I will be very, very surprised if they do.
eta: yes, I’m surprised!
I, too, am shocked that the nytimes bit on this:
https://www.nytimes.com/2024/06/25/health/transgender-minors-surgeries.html
Wow-- good for them. I am truly shocked.
I am normally very pessimistic about the mainstream media. But this is so crazy that I think at least one outlet will bite (wsj?).
I guess if NYPost gets to it first it will become radioactive. Which is probably the most likely result...
Azeen Ghorayshi just wrote it for NYT. Lots of people hate her so she's probably a trustworthy journalist.
It's so surreal to have all these nasty details come out about trans medicine. If I wasn't living through it and just read it in a history book, I'd think it was exaggerated.
And of course Delphi process is the lowest reliability of medical evidence. Expert opinion, compared to systematic reviews, the most reliable and best practices. Wpath commissioned some systematic reviews and then ignored them.
I hope the supreme court wakes up! This should not be political. That's why the Cass review said these kids were let down!
I don’t understand why AAP would be so interested in getting the age limits for trans care procedures removed.
The ideologues who’ve made policy on youth gender medicine in the AAP want to avoid lawsuits that would be easier to win if doctors were shown to have violated standards of care. No standards? No basis for a lawsuit!
As Jesse and Leor Sapir noted on Twitter, the AAP and/or Levine wished to remove provisions that could influence legislation in the states.
Perhaps most of all, the people making policy at AAP - such as Jason Rafferty, the very young doctor who wrote the AAP statement on affirmative care for children - believe they’re on a life-saving mission. They can’t retreat because they’ve personally staked so much on it: their career, reputation, self-image.
So, I feel like everyone in this thread is reading the quotes that Jesse cites a little differently from me. (Or maybe I’m misreading the comments?) To me, it seems very clear that Levine is against the age limits because they look bad from a public relations perspective. This quote seems pretty clear:
“[Levine’s Chief of Staff] is confident, based on the rhetoric she is hearing in DC, and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care.”
In other words, Levine (and probably other figure in HHS) knew it was a really unpopular look to release standards that embrace things like sex reassignment surgery for minors. Those standards would cause a firestorm, possibly discredit WPaths standards with some groups, and give GOP state legislators stronger ground to argue that ‘the medical community isn’t protecting kids so we have to.’ Levine presumably either didn’t want to push WPath to raise its age guidance, or didn’t think she could do so successfully, so she asked them to bury that part of their recommendations. This is a clear public relations move. It’s definitely bad to have public officials telling medical groups to just hide the parts of their recommendations that the public won’t like - because it makes it harder for the public to judge those recommendations.
But some people on here seem to be reading this as if Levine was upset because she thought that WPATH was doing too much to limit GAC for children at younger ages. Like she thought that WPATH just wasn’t being radical enough. And the info we have doesn’t really support that.
Again, maybe I’m misreading other people’s comments. But let’s make sure that we’re scandalized by the thing that actually happened, which appears to be a public official trying to prevent WPATH from releasing a portion of their guidelines that would instantly be very popular.
That's my reading as well
The future is dim. As a culture we’ve crossed into evil territory, where it’s acceptable to exchange lives and human wellbeing for politics. And this is to ensure, even force, the re-election of the nominal good guy.
If they don’t care about kids enough to knowingly harm them, to destroy sex and true love and romance from their lives, and only for gender politics to push a campaign policy? How long before some chemical gives everyone cancer with these norms in place? Some broken fix that wins votes but harms voters, and can be hidden by this vast tapestry of lies and censorship the Democrats hide behind?
Great investigative reporting by Jesse, as always.
The one and only experience I have with the Delphi method was pretty mind-blowing. My experience was with the local catholic church and their desire to yet again remodel a lovely church in order to meet ever-changing liturgical standards. In that case, it felt like a predetermined solution was arrived at through a consensus process that felt like coercion.
It's called gobsat in medicine and was discarded in the 90s because evidence based medicine is better for patients.
Good old boys sitting around a table.
Ivan florez discusses guideline requirements in a talk from and evidence based medicine conference run by SEGM and it's on the segm YouTube channel.
Concerned about blanket bans? Take a look at Corinna Cohn's thoughtful and nuanced discussion about why they might be necessary.
https://twitter.com/heterodorx/status/1805587756086591521
Cohn had bottom surgery when he was 19 and has been challenging the spread of procedures to younger and younger people.
Thanks for reporting on this. None of this is even remotely surprising. I hope we can blow the lid on the entire pediatric gender scandal soon.