All appreciation to the person who put together this report, which is a lot of work that I would never have been able to do myself, but let me highlight some points of partial disagreement:
*The Hippocratic Oath has been revised many times, and is no longer the standard. Predictably, many medical schools (including mine in Australia) use …
All appreciation to the person who put together this report, which is a lot of work that I would never have been able to do myself, but let me highlight some points of partial disagreement:
*The Hippocratic Oath has been revised many times, and is no longer the standard. Predictably, many medical schools (including mine in Australia) use non-Hippocratic oaths now, some derived from the WHO, which are starting to include language about "equity" and "racial justice", etc. etc. "Do No Harm" was never a legally binding commitment, but it is no longer even an implicit expectation. So saying that something "violates the Hippocratic Oath" sounds like a bold shot across the bow of medical professionals but it really isn't.
*I liked the way she pulled in historical medical scandals, but there are others. There absolutely is precedent for doing invasive, dangerous procedures without having or even trying to gather evidence within the memory of people living today. For example, failed back surgery syndrome (it used to be common to operate on people's spines just because they had back pain with no other neurological problems), stents for asymptomatic coronary vascular disease, etc. And you can go bigger; the entire COVID response (certainly a Shellenberger favorite) shows many of the same flaws.
*Regret rate is not a good measure of success, because it essentially cedes the ground that what matters is the patient's subjective experience, as explained by the patient and recorded by the physician in most cases, both with their respective biases. The regret rate for opioid prescription is also pretty low, but that doesn't mean we don't have an opioid epidemic.
*There is nothing special about transgender medicine, and turning to the rest of the medical profession to fix it is not in itself a solution. Medical societies are clubs. They have always been ruled by social forces rather than evidence. The quality of science and the beneficence of medicine emanates from individuals, not from the structure of medical societies. They are all vulnerable to takeover, and all of them show the same pathologies. Part of the reason there has been so much resistance to the transgender story is that it may illuminate other fraudulent areas of medicine. And the real medicine is mixed with the fraud. That's the thing about "rot" (a term particularly favored by Bari Weiss to describe failing institutions). Rotten wood is still wood. There are pediatricians at the AAP who are practicing real pediatrics and doing real science. They are side by side with the ones who aren't, and individual doctors may fall into both categories some of the time. That's what makes rot so difficult to find and eliminate. Many doctors are probably afraid that if the rot is cut out, huge swaths of medicine may have to go with it, and that they may be personally harmed. Justifiably afraid, I would say.
Also, I just can't agree that there is no such thing as a transgender person. To conclude that, you have to either say that there is no difference between the brains of men and women, or that the process that decides those differences literally never goes wrong. I find both of those propositions unsupportable.
You can convince me that most of the people being medicalized have other issues, sure, but that doesn't mean trans can't exist.
All appreciation to the person who put together this report, which is a lot of work that I would never have been able to do myself, but let me highlight some points of partial disagreement:
*The Hippocratic Oath has been revised many times, and is no longer the standard. Predictably, many medical schools (including mine in Australia) use non-Hippocratic oaths now, some derived from the WHO, which are starting to include language about "equity" and "racial justice", etc. etc. "Do No Harm" was never a legally binding commitment, but it is no longer even an implicit expectation. So saying that something "violates the Hippocratic Oath" sounds like a bold shot across the bow of medical professionals but it really isn't.
*I liked the way she pulled in historical medical scandals, but there are others. There absolutely is precedent for doing invasive, dangerous procedures without having or even trying to gather evidence within the memory of people living today. For example, failed back surgery syndrome (it used to be common to operate on people's spines just because they had back pain with no other neurological problems), stents for asymptomatic coronary vascular disease, etc. And you can go bigger; the entire COVID response (certainly a Shellenberger favorite) shows many of the same flaws.
*Regret rate is not a good measure of success, because it essentially cedes the ground that what matters is the patient's subjective experience, as explained by the patient and recorded by the physician in most cases, both with their respective biases. The regret rate for opioid prescription is also pretty low, but that doesn't mean we don't have an opioid epidemic.
*There is nothing special about transgender medicine, and turning to the rest of the medical profession to fix it is not in itself a solution. Medical societies are clubs. They have always been ruled by social forces rather than evidence. The quality of science and the beneficence of medicine emanates from individuals, not from the structure of medical societies. They are all vulnerable to takeover, and all of them show the same pathologies. Part of the reason there has been so much resistance to the transgender story is that it may illuminate other fraudulent areas of medicine. And the real medicine is mixed with the fraud. That's the thing about "rot" (a term particularly favored by Bari Weiss to describe failing institutions). Rotten wood is still wood. There are pediatricians at the AAP who are practicing real pediatrics and doing real science. They are side by side with the ones who aren't, and individual doctors may fall into both categories some of the time. That's what makes rot so difficult to find and eliminate. Many doctors are probably afraid that if the rot is cut out, huge swaths of medicine may have to go with it, and that they may be personally harmed. Justifiably afraid, I would say.
Also, I just can't agree that there is no such thing as a transgender person. To conclude that, you have to either say that there is no difference between the brains of men and women, or that the process that decides those differences literally never goes wrong. I find both of those propositions unsupportable.
You can convince me that most of the people being medicalized have other issues, sure, but that doesn't mean trans can't exist.