When Your Epistemic Bubble Pops (Unlocked)

The perils of relying on in-group evidentiary standards

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Because I was so focused on one very frustrating and inaccurate article about the December High Court ruling that will make it more difficult for teenagers in England and Wales to get puberty blockers, I haven’t written much about the ruling itself. And now I want to use it to make a broader point about how insular communities work.

One thing that’s interesting about Bell v. Tavistock (PDF) is just how little evidence the defendant, the Tavistock and Portman NHS Foundation Trust, was able to muster in defense of its practice of prescribing blockers to kids under 16.

The word ‘surprising’ comes up three times in the ruling, all in the context of the judges’ befuddlement that Tavistock couldn’t mount a better case:

We note here that we find it surprising that such data was not collated in previous years given the young age of the patient group, the experimental nature of the treatment and the profound impact that it has. 

Again, we have found this lack of data analysis – and the apparent lack of investigation of this issue - surprising. 

We find it surprising that GIDS did not obtain full data showing the figures and the proportion of those on puberty blockers who remain within GIDS and move on to crosssex hormones.

Elsewhere, the judges note the “lack of a firm evidence base for their use [which] is evident from the very limited published material as to the effectiveness of the treatment, however it is measured” and “the lack of published research” on blockers.

This would all come as news to anyone ensconced in the mainstream progressive discussion about transgender youth and puberty blockers. There it is a settled fact that this medicine is safe, effective, and fully reversible. By the normal standards of medical science, none of these three claims has been fully proven. And yet within many progressive communities, you can get in a bit of trouble for openly expressing skepticism about puberty blockers, or even for just asking questions about them. (For example, the Foreign Policy article described the High Court’s relative skepticism about puberty blockers as an “unprecedented juridical attack on the LGBT community in the U.K.” and the judge’s motivations as ‘eliminationist.’)

It’s interesting what happens when the epistemic bubble pops, though. You can spend years such inside a bubble, convincing yourself and your friends both that a certain thing is true and that you all have a moral imperative to believe it is true, only to find that outside your bubble people are treating it with the same skepticism they would most other novel claims.

I bet it’s the case that the more hot-button an issue is, the stronger the epistemic bubble dynamics, and the less internal critique and careful cultivation of evidence goes on within those bubbles. If you’re in an epistemic bubble in which it is vital, for the sake of your in-group status, to profess belief in X, then you are going to accept just about any evidence for X, no matter how weak, because people are quite poor at decoupling “disbelief in evidence for X” from “disbelief in X” — if you deny the validity of the evidence, that is often seen as denying the validity of the claim. (Which is silly, because it’s perfectly reasonable to say, “I think X is true, but this particular evidence suffers from the following weaknesses. If we want to convince others X is true, we should rely on stronger evidence.”) If none of the available evidence is sturdy enough to withstand the environment outside the bubble, then within the bubble weak evidence will pile up instead and be treated as dispositive. 

Police abolition is a good example of this. It is a popular idea in relatively insulated elite spaces, and in those spaces certain stock responses to common questions are accepted as strong, knockdown arguments. But those responses do not come across as compelling to the rest of us, who are very opposed to police abolition. In another post, for example, I mentioned a New York Times column from June arguing that yes, police abolitionists really do want to literally abolish the police (sometimes people claim this is just an expression, not meant to be taken literally).

“What about rape?,” wrote the author of that piece. “The current approach hasn’t ended it. In fact most rapists never see the inside of a courtroom. Two-thirds of people who experience sexual violence never report it to anyone.” But of course this isn’t a remotely adequate response to the question of how society would handle rapists in the absence of police. Or outside the bubble it isn’t, at least. To be in the bubble is to be socialized in a certain way, which includes training on what responses to offer to what arguments — but often without that important step of asking, How would people outside the bubble respond to this?

Or take this snippet from a piece published on LEVEL, a Medium publication: 

Some people may ask, “Does this mean that I can never call the cops if my life is in serious danger?” Abolition does not center that question. Instead, abolition challenges us to ask, “Why do we have no other well-resourced options?” and pushes us to creatively consider how we can grow, build, and try other avenues to reduce harm.

If abolition “does not center that question,” it might be because the truthful answer to said question is “No, under police abolition there is no one to call if your life is in serious danger, unless you’re in a wealthy area with private security forces, or unless you live in some as-yet-undiscovered utopia where people have figured out some other alternative.” Which is not really a credible response to a pretty obvious question. If you’re in the bubble, though, it is seen as an acceptable answer, and people might question your dedication to the cause if you point out how thin it is.

Both these pieces show what happens when the epistemic bubble pops. Both authors are writing for a general audience who might, they hope, be swayed toward police abolition, and yet both rely on arguments that are inevitably going to fall flat when normies catch wind of them. Such are the risks of spending too much time in epistemic bubbles.

Back to puberty blockers: Many of the catch phrases about how they are reversible, they are life-saving, and so on, aren’t quite matched by the evidence. I say this as someone who has gone on-record, over and over and over, as saying I think well-diagnosed kids with severe gender dysphoria should go on blockers. I think that because I think the overall balance of evidence points in that direction. But there are certainly risks and tradeoffs and unknowns. To say, in a pat way, “Of course puberty blockers help! And they’re reversible, anyway,” is to ignore a lot of intricate but important detail, such as the fact the most commonly cited research supporting the use of blockers comes from a clinical environment very different from what’s (likely) going on in much of the U.S. today; the question of ‘reversibility’ means one thing in the context of commencing one’s natural puberty after a delay and another in the context of instead starting a partial cross-sex puberty; another study showed no short-term psychological benefits to going on blockers (though also not much to worry about, either); yet another key study that appeared to show a correlation between being denied access to puberty blockers and suicidality does some serious overclaiming (I’m going to save that for another day); and so on. The research on this does not tell a clear and straightforward story. 

Unless you’re in the bubble! In the bubble, this is a settled issue and the only thing to do is to try to spread the word that Science Has Proven puberty blockers are lifesaving for trans kids, and to criticize anyone who says otherwise, because only a transphobe could be against such a well-established scientific consensus.

This works on Twitter, to a point, at least among progressives who don’t want to be tarred as bigots or bigot-adjacent. But, again, outside the bubble things are different. The judges in Tavistock v. Bell looked at the evidence and scrunched their eyebrows (Britishly) and said, “Huh… This is it?” And there’s a useful lesson here, because people trapped in epistemic bubbles sometimes lose the plot a little. The Iron Law is powerful: It’s tempting to fall into the pattern of satisfying validation that comes from nurturing one’s status within the in-group rather than working toward improving the in-group’s prospects in the broader world, which is a much more fraught task — and a task that might sometimes entail saying to your bubble-buddies, “You know, that evidence you’re presenting is pretty weak; we can do better.”

Of course, in a better world we wouldn’t be confined to bubbles and would be open to changing our minds altogether, but that’s a whole other story.

Questions? Comments? Ideas for how we should decorate our own epistemic bubble to make it as cozy as possible? I’m at singalminded@gmail.com or on Twitter at @jessesingal. The lead image, of bubbles in front of water and some buildings, comes via Joshua Reddekopp on Unsplash.