U.K Politics: Revenge of the Truss.

[karaddin]

I literally just answered that, you have a bunch of criteria which can include size, strength and what hormone your endocrine system is primarily running on. You know, the parts that are actually relevant to dividing people up for fairness.

Unless your attachment to sex is some mystical thing that isn't actually the part that's relevant.

[karaddin]

Or, of course, if your actual goal is to exclude trans people for no reason you can actually justify. Then it's a great thing to grab onto.

[Heartofice]

Just now, karaddin said:

I literally just answered that, you have a bunch of criteria which can include size, strength and what hormone your endocrine system is primarily running on. You know, the parts that are actually relevant to dividing people up for fairness.

Unless your attachment to sex is some mystical thing that isn't actually the part that's relevant.

Except that because some people think sex is not real we now have double rapists and sex criminals in female prisons ( or we did until Sturgeon realised how wrong she was) and transwomen in female competitions beating biological women. 
 

So the whole ideology is completely flawed. 

[karaddin]

See there you go again. There are already rapists in women's prison because small numbers of cis women are rapists. Unless you're advocating for removing all sexual offenders from women's prisons, you're not addressing that. And if you are advocating for that, any trans woman offender can and should be treated the same way the cis woman rapist is.

Can't help but notice you're not answering what trans care you actually support. Or detailing what factors are actually relevant.

[Heartofice]

29 minutes ago, karaddin said:

See there you go again. There are already rapists in women's prison because small numbers of cis women are rapists.

No. 
There are zero cis women in UK prisons convicted of rape because in UK law women cannot commit the act of rape. Rape in UK law is the act of using your penis without the other persons consent. Now I really do wish you would stop this bafflingly stupid argument. Again this is another point where sex is relevant. 
 

29 minutes ago, karaddin said:

Can't help but notice you're not answering what trans care you actually support. Or detailing what factors are actually relevant.

In answer to your previous post:

Quote

Do you support trans kids getting to socially transition with no medical treatment at all? 

Yes I do, however it should be part of a holistic and supported approach by professionals, and gender dysmorphic feelings should be questioned and not automatically affirmed. 

 

57 minutes ago, karaddin said:

Trans teens having access to the reversible treatment - puberty blockers - to delay the irreversible changes in puberty? Who do you think gets to gatekeep this treatment?

I think this question is pretty unclear actually. The prescription of puberty blockers should be on the advice of professionals and probably only in limited cases. It really isn't clear that puberty blockers have no long lasting effects. The NHS has changed their guidelines to reflect the fact that little is known about the long term side effects:
https://www.nhs.uk/conditions/gender-dysphoria/treatment/
 

Quote

Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.

Although GIDS advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be.

It's also not known whether hormone blockers affect the development of the teenage brain or children's bones. Side effects may also include hot flushes, fatigue and mood alterations.

 

Quote

Do we get to be called by our names and pronouns or is it fine to act like bigotry is a religious belief and people can call us whatever they like?

As I've said before, using requested pronouns is common courtesy and should be standard practice. 

 

Quote

Do adult trans people get access to hormone therapy? Surgical intervention? What level of gatekeeping should this have compared to the functionally none required for many other procedures which simply require informed consent - a standard that's very important in medical treatment.

Yes and it should be part of a long term holistic approach to helping people with gender dysphoria feel more comfortable.

So here is the thing, I think I am pretty representative of a lot of people in the UK in this regard. I am supportive of trans peoples rights to live their lives in the gender they identify as, and to make their lives as comfortable as possible. This has been pretty much a unchallenged point by most people here for decades. However that doesn't mean that I don't think there are incoherent beliefs at the very heart of this new wave of gender activism that actually does genuine trans people a disservice, and I also think that transitioning should be part of a long term medically supervised approach to helping individuals. 

I don't think there is anything especially controversial about that, nor do I think it is in anyway transphobic.
 

[Raja]

This melon thinks gender dysmorphic feelings aren't questioned by medical professionals & clinicians - this is complete nonsense

Completely uninformed takes, over and over again.

 

[Heartofice]

Just now, Raja said:

This melon thinks gender dysmorphic feelings aren't questioned by medical professionals & clinicians - this is complete nonsense

Completely uninformed takes, over and over again.

 

Have you looked up the Tavistock lately?

[Heartofice]

https://www.theguardian.com/commentisfree/2022/mar/20/observer-view-cass-review-gender-identity-services-young-people

 

Quote

The review, led by the distinguished paediatrician and former president of the Royal College of Paediatrics and Child Health Dr Hilary Cass, has published its interim report. Its findings echo concerns already flagged by the courts, the Care Quality Commission, and, as the Observer has reported over the years, several NHS whistleblowers.

 

The report highlights a profound lack of evidence and medical consensus about the best approach to treating gender dysphoria in children. Yet the NHS’s specialist Gender Identity Development Service (GIDS) takes a child’s expressed gender identity as the starting point for treatment. This “affirmative approach” leaves little space for exploration of the potential relationship between their dysphoria and neurodiversity or psychosocial needs, including those arising from childhood trauma or internalised hostility to same-sex attraction. GIDS has compounded this lack of evidence with its own failure to track patient outcomes.

 

[karaddin]

On puberty blockers - doing nothing isn't the status quo, you'd pick the (at worst) unknown risk compared to a guaranteed harm by proceeding through puberty. I'd give fucking anything to reverse mine.

"Part of a long term holistic approach" still leaves a hell of a lot of ambiguity, it covers the entire gamut from prompt treatment in consultation with a general practitioner all the way through to making it so hard to access it functions as a closed gate.

I have to check in with my doctor and have semi regular blood tests, but years on that's all I need. Earlier on I did need mental health assistance, but I got that on my own with a completely different provider. The psych assessment did not help, in fact by positioning it as gate keeping it actually makes it less helpful by making your access to treatment conditional on their approval, which discourages honesty in favor of telling them what they want to hear. And in a lot of cases what they wanted to hear is that you'd get surgery as soon as possible and try fit in as a conforming heterosexual. Being given access to care alongside accessing the treatment you need is far more effective at promoting honesty and introspection, gate keeping does the opposite of it's (good faith) intended point.

The problem with positioning the small number of sincere detransitioners as a barrier to everyone else getting care is... Well exactly that. You're putting far more weight on a small percentage of the people accessing care being harmed by that care than you are the overwhelming majority being harmed by not receiving that care. And that's ignoring that a lot of detransitioners do it because of other people making their life a nightmare, not because they weren't actually trans.

[karaddin]

And I have no idea how genuine therapy in conjunction with an affirmative approach precludes exploring your mental state and your gender. That's literally how I did it with the counselor that was separate from the gate keeping. Obviously you're not going to jump immediately to medical intention in a kid while they figure themselves out, the entire point of puberty blockers is to buy time to work through it all.

[Raja]

This is such a strange country

[Heartofice]

10 minutes ago, karaddin said:

The problem with positioning the small number of sincere detransitioners as a barrier to everyone else getting care is... Well exactly that. You're putting far more weight on a small percentage of the people accessing care being harmed by that care than you are the overwhelming majority being harmed by not receiving that care.

Why is it zero sum? Why should taking care to give the correct treatment be a controversial approach? 
 

Quote

And that's ignoring that a lot of detransitioners do it because of other people making their life a nightmare, not because they weren't actually trans.

It's also true that there are detransitioners that do it because they regret it such as the as of Keira Bell:


https://www.bbc.co.uk/news/health-51676020

 

Quote

he was referred to the Tavistock GIDS clinic at the age of 16. She said after three one-hour-long appointments she was prescribed puberty blockers, which delay the development of signs of puberty, like periods or facial hair.

She felt there wasn't enough investigation or therapy before she reached that stage.

"I should have been challenged on the proposals or the claims that I was making for myself," she said. "And I think that would have made a big difference as well. If I was just challenged on the things I was saying."

I have a daughter and I sure as shit hope that if one day she comes and says she is confused about her gender identity she is given thoughtful and careful treatment, not put on an unchallenged path towards permanent medical changes and infertility. 

[karaddin]

Referring to sincere detransitioners and saying many are due to social pressures is already accepting some are genuine, I'm not sure why you're trying to act like I denied they exist. 

It's zero sum if you use the existence of detransitioners to discourage/unreasonably restrict access to treatment, thus putting one group above the other. There are regrets for other surgeries, but as long as informed consent is being followed at some point we get to take responsibility for our bodies - the good and the bad.

I really don't see the issue with a prompt prescription for puberty blockers for someone where the changes of puberty are urgent, once again the point is to buy time. I certainly wouldn't want surgical intervention in that case, but blockers to minimize the impact of puberty while receiving further care to help you work through things is in line with their purpose.

[Heartofice]

2 minutes ago, karaddin said:

 

I really don't see the issue with a prompt prescription for puberty blockers for someone where the changes of puberty are urgent

Possibly because the NHS says the long term effects are not known?

[Raja]

From the review quoted in that guardian article ( by the way, helps to actually read the report in question as opposed to article published)

Quote

When children and young people are able to access the service, there is often a sense of frustration with what several describe as the “gatekeeping” medical model and a “clinician lottery”. This can feel like a series of barriers and hurdles designed to add to, rather than alleviate, distress. Most children and young people seeking help do not see themselves as having a medical condition; yet to achieve their desired intervention they need to engage with clinical services and receive a medical diagnosis of gender dysphoria. By the time they are seen in the GIDS clinic, they may feel very certain of their gender identity and be anxious to start hormone treatment as quickly as possible. However, they can then face a period of what can seem like intrusive, repetitive and unnecessary questioning. Some feel that this undermines their autonomy and right to self-determination.

Sounds like an 'unchallenged path', doesn't it?

 

[Heartofice]

1 minute ago, Raja said:

From the review quoted in that guardian article ( by the way, helps to actually read the report in question as opposed to article published)

Sounds like an 'unchallenged path', doesn't it?

 

Like this report:

https://cass.independent-review.uk/wp-content/uploads/2022/03/Cass-Review-Interim-Report-Final-Web-Accessible.pdf

Quote

1.14. Primary and secondary care staff have told us that they feel under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters.

Quote

From the point of entry to GIDS there appears to be predominantly an affirmative, non-exploratory approach, often driven by child and parent expectations and the extent of social transition that has developed due to the delay in service provision.

Quote

4.20. Some secondary care providers told us that their training and professional standards dictate that when working with a child or young person they should be taking a mental health approach to formulating a differential diagnosis of the child or young person’s problems. However, they are afraid of the consequences of doing so in relation to gender distress because of the pressure to take a purely affirmative approach. Some clinicians feel that they are not supported by their professional body on this matter.

 

[karaddin]

8 minutes ago, Heartofice said:

Possibly because the NHS says the long term effects are not known?

A short stint isn't long term use, but regardless drug testing is a very complicated and separate conversation. Trans care impacts a very small number of people and typically the pharma companies don't tend to do targeted testing for a small demographic like this so "long term effects are unknown" is a lot more common than the phrase would make you think.

There are also major ethical issues, the risk of harm to a foetus results in a fuckload of drugs not being tested and approved for use during pregnancy. To do a proper study on this would require a control group who were being given a placebo that would not actually delay their puberty, directly harming the control group - that's typically a no no when you're dealing with a drug that has already been studied as safe and approved for use in a wider demographic already. 

If there was a major risk the drug wouldn't be used to delay precocious puberty, so the small risk is judged to be safer than the guaranteed harm to trans people of going through the wrong puberty.

Off label uses for drugs also frequently have issues around a lack of rigorous formal studies being performed, but we continue using those for a bunch of different things. Epilepsy, anti depressants, and blood pressure medications are used for migraine treatment for example despite that not being an on label use for most of them. Puberty blockers are much better than some of those in terms of identified adverse effects.

[Derfel Cadarn]

1 hour ago, Heartofice said:

No. 
There are zero cis women in UK prisons convicted of rape because in UK law women cannot commit the act of rape. Rape in UK law is the act of using your penis without the other persons consent. Now I really do wish you would stop this bafflingly stupid argument. Again this is another point where sex is relevant. 
 

In answer to your previous post:

Yes I do, however it should be part of a holistic and supported approach by professionals, and gender dysmorphic feelings should be questioned and not automatically affirmed. 

 

I think this question is pretty unclear actually. The prescription of puberty blockers should be on the advice of professionals and probably only in limited cases. It really isn't clear that puberty blockers have no long lasting effects. The NHS has changed their guidelines to reflect the fact that little is known about the long term side effects:
https://www.nhs.uk/conditions/gender-dysphoria/treatment/
 

 

As I've said before, using requested pronouns is common courtesy and should be standard practice. 

 

Yes and it should be part of a long term holistic approach to helping people with gender dysphoria feel more comfortable.

So here is the thing, I think I am pretty representative of a lot of people in the UK in this regard. I am supportive of trans peoples rights to live their lives in the gender they identify as, and to make their lives as comfortable as possible. This has been pretty much a unchallenged point by most people here for decades. However that doesn't mean that I don't think there are incoherent beliefs at the very heart of this new wave of gender activism that actually does genuine trans people a disservice, and I also think that transitioning should be part of a long term medically supervised approach to helping individuals. 

I don't think there is anything especially controversial about that, nor do I think it is in anyway transphobic.
 

Scotland replaced thr commonlaw of rape (and other sexual offences) with the Sexual Offences Act. So the older crimes would only be used for historical offences pre-dating the new legislation. 
So the ‘new’ equivelent of common law rape does cover cis women.

 

Edited February 18 by Derfel Cadarn

[Heartofice]

5 minutes ago, Derfel Cadarn said:

Scotland replaced thr commonlaw of rape (and other sexual offences) with the Sexual Offences Act. So the older crimes would only be used for historical offences pre-dating the new legislation. 
So the ‘new’ equivelent of common law rape does cover cis women.

 

Did that remove the requirement of use of penis without consent?

https://www.healthscotland.scot/health-topics/gender-based-violence/rape-and-sexual-assault

The Sexual Offences (Scotland) Act 2009 defines rape as 'penetration of the vagina, anus or mouth of another person by the penis without consent'. The offence covers surgically constructed genitalia, for example as a result of gender reassignment surgery.

 

[Derfel Cadarn]

1 minute ago, Heartofice said:

Did that remove the requirement of use of penis without consent?

https://www.healthscotland.scot/health-topics/gender-based-violence/rape-and-sexual-assault

The Sexual Offences (Scotland) Act 2009 defines rape as 'penetration of the vagina, anus or mouth of another person by the penis without consent'. The offence covers surgically constructed genitalia, for example as a result of gender reassignment surgery.

 

There are subsections to cover any form of penetration.