For John, BLUF: As people become more and more protective of their own truth, including quashing other views, we become less and less free citizens, exercising our rights thereof. Nothing to see here; just move along.
From The Old Gray Lady, by Opinion Columnist David Brooks, April 18, 2024.
Here is the lede plus one:
Hilary Cass is the kind of hero the world needs today. She has entered one of the most toxic debates in our culture: how the medical community should respond to the growing numbers of young people who seek gender transition through medical treatments, including puberty blockers and hormone therapies. This month, after more than three years of research, Cass, a pediatrician, produced a report, commissioned by the National Health Service in England, that is remarkable for its empathy for people on all sides of this issue, for its humility in the face of complex social trends we don’t understand and for its intellectual integrity as we try to figure out which treatments actually work to serve those patients who are in distress. With incredible courage, she shows that careful scholarship can cut through debates that have been marked by vituperation and intimidation and possibly reset them on more rational grounds.I see this article as having two main issues.Cass, a past president of Britain’s Royal College of Pediatrics and Child Health, is clear about the mission of her report: “This review is not about defining what it means to be trans, nor is it about undermining the validity of trans identities, challenging the right of people to express themselves or rolling back on people’s rights to health care. It is about what the health care approach should be, and how best to help the growing number of children and young people who are looking for support from the N.H.S. in relation to their gender identity.”
This issue begins with a mystery. For reasons that are not clear, the number of adolescents who have sought to medically change their sex has been skyrocketing in recent years, though the overall number remains very small. For reasons that are also not clear, adolescents who were assigned female at birth are driving this trend, whereas before the late 2000s, it was mostly adolescents who were assigned male at birth who sought these treatments.
Doctors and researchers have proposed various theories to try to explain these trends. One is that greater social acceptance of trans people has enabled people to seek these therapies. Another is that teenagers are being influenced by the popularity of searching and experimenting around identity. A third is that the rise of teen mental health issues may be contributing to gender dysphoria. In her report, Cass is skeptical of broad generalizations in the absence of clear evidence; these are individual children and adolescents who take their own routes to who they are.
Some activists and medical practitioners on the left have come to see the surge in requests for medical transitioning as a piece of the new civil rights issue of our time — offering recognition to people of all gender identities. Transition through medical interventions was embraced by providers in the United States and Europe after a pair of small Dutch studies showed that such treatment improved patients’ well-being. But a 2022 Reuters investigation found that some American clinics were quite aggressive with treatment: None of the 18 U.S. clinics that Reuters looked at performed long assessments on their patients, and some prescribed puberty blockers on the first visit.
Unfortunately, some researchers who questioned the Dutch approach were viciously attacked. This year, Sallie Baxendale, a professor of clinical neuropsychology at the University College London, published a review of studies looking at the impact of puberty blockers on brain development and concluded that “critical questions” about the therapy remain unanswered. She was immediately attacked. She recently told The Guardian, “I’ve been accused of being an anti-trans activist, and that now comes up on Google and is never going to go away.”
One issue is transgenderism. I think Dr Cass is right to suggest go slow for gender dysphoria for young people. If you are 23 or older I figure you are mature enough to make your own choices. Before then it is child abuse. (I would have said 21, but my co-host this morning said the age was 25 for full brain development. She is a teacher of special needs children and a member of our School Committee.)
But, at another level transgenderism is abusive of those who are not. Some day in the future this might not be true, but today it just throws more of a burden on women who are cis-women. To sustain our population they, today, must produce 2.1 children. In this generation my Middle Brother and Wife have one, my Youngest Brother and Wife three and Martha and myself three. Seven. Divided by 3 is 2.33. We produced a surplus. For my kids, three, two and four. Nine. Divided by three is 3.0. A surplus. But, if my Daughter had been transgender, then two and four, for six, divided by thee and you get 2.0. Someone else has to make up that deficiency. Do the work others won't (can’t). Which is why we need immigration, since they can do the work female US Citizens can’t or won’t. Don’t blame me. Blame nature and nature’s God.
As for the point, about scientific research, I think that we are in a period where it is not respected. I liked the mention of British philosopher and mathematician William Kingdon Clifford. Columnist Brooks throws shade at Republicans in this arena, but I think that is too narrow a view. Look at COVID-19. Any research that flowed differently from the views of Dr Anthony Fauci or Dr Birx was suppressed. Look at either the Great Barrington Declaration or Ivermectin. Or Mr Berliner, formerly of NPR. We need more dialogue, more people challenging the conventional wisdom. This morning I had a Democratic State Rep, at the end of a televised interview, asked me, given my views, why I am a Republican. I took that as a genuine complement. A diversity of views and an openness to discuss them is important to our progress as a society.
Hat tip to my Middle Brother.
Regards — Cliff
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