I read some of the Michael Schellenberger articles on substack about this, but some of the language could be more neutral. Mia Hughes argues in a similar way sometimes.
The articles constantly referred to 'mistreatment' by doctors. Any hormone treatment was mistreatment.
While that might technically be true it is opinion-infused language that will probably put off some of the people that could otherwise be swayed.
I noticed this, too. Having said that, I concede that playing neutral in this context would be darn near impossible. The more I’ve learned… I mean… how could anyone have stayed neutral on lobotomies? When it becomes clear what it is, what’s being lost, it’s that we’re seeing it for what it is: harm.
Thanks for doing an episode on this shocking medical scandal. Hopefully this will be picked up in larger media outlets as well. The establishment media and politicians have gone so aggressively down the path of affirmation only it will be interesting to see what their response is to this information. If there is any response at all.
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.
This conversation, again, reminded me of how infrequently the rate of self harm and suicide has only increased, after this “treatment” and “affirmation” model has been implemented in the last few decades.
Where were all the children and teens suffering from dysphoria, before the turn of the century?
I know with certainty it existed, but it seems with greater “visibility” and “acceptance”, came far more suffering.
I dipped into the WPATH files (the Hughes report and the files themselves). I think Hughes has a stance of advocacy and opposition that clouds her reporting. For example, one of the text exchanges in the WPATH files cites this article - https://tinyurl.com/8vr2p5pb - which complains that WPATH standards of care for mentally ill patients are *too restrictive*. This would suggest that some of the text exchanges leaked in the WPATH files are among more fringe members, and that the WPATH standards are not being overly influenced by the fringe - but the fringe might not be following the standards.
"First, do no harm" is not a binding legal standard, and modern medical oaths are rather different. In the words of the AAMC (this is pre-2020, mind you): "What they include, from social activism to self-care, would surprise Hippocrates" (https://www.aamc.org/news/solemn-truth-about-medical-oaths)
Being legal is not always ethical. The issue expressed above was that those who are not self-aware of their harmful actions under the presumption of doing good may still be Evil. At one point, sterilizing the mentally ill was considered charitable.
Blissful compassion is certainly not a reasonable defense of surgical conversion therapy on minors, and it would be reasonable for some of the doctors and activists to be targeted for appropriate legal (criminal and civil) action to perhaps cause others lost in doing good to stop and consider next moves. They may still be not self-aware of their harmful behavior but may stop out of self-preservation, much like a sociopath.
This was a great podcast episode, but I don't think we should necessarily turn the other cheek ... just in case they decide to take our cheeks and transplant them to another part of our bodies.
And I would agree that many Western institutions are rotten and likely need to be raised and rebuilt. At least, we can start to depopulate the managerial class.
And the First do not harm! is actually attributed to Thomas Sydenham not Hippocrates. Regardless, it remains a good guiding principle. So is checking that the scene is safe or not pissing into the wind. Cheers.
Yes, ethical considerations and legal ones are not the same.
But even if we were talking about ethical considerations, the avoidance of harm is not a consensus opinion. It might be yours, and it might have merit, but the point I was making is that to try to hold the medical profession to a standard that it does not itself aspire to is not a winning strategy on a rhetorical level.
My point is about how the transgender activists won. They didn't do it by being right, or even by having a good ethical or empirical argument, but they did win to some significant extent.
Also, regarding doctors not being criminally charged: if I am not mistaken, the Canadian law banning conversion therapy is a criminal law. I.e. those people who are caught engaging in “conversion therapy” (loosely described as not affirming transgender people, without hesitation or mediation—and applicable to therapists as well as ordinary people, including family members), will be criminally charged. So why couldn’t doctors be as well, if the societal definition of conversion therapy were to change?
I read some of the Michael Schellenberger articles on substack about this, but some of the language could be more neutral. Mia Hughes argues in a similar way sometimes.
The articles constantly referred to 'mistreatment' by doctors. Any hormone treatment was mistreatment.
While that might technically be true it is opinion-infused language that will probably put off some of the people that could otherwise be swayed.
I noticed this, too. Having said that, I concede that playing neutral in this context would be darn near impossible. The more I’ve learned… I mean… how could anyone have stayed neutral on lobotomies? When it becomes clear what it is, what’s being lost, it’s that we’re seeing it for what it is: harm.
Well, if there is no attempts to be more moderate on this topic one just creates an equally extreme backlash.
The ultimate goal should be toning down the heat and hysteria of all these discussions.
Righteousness does not make things right or just makes the people feel good who get to say "told you so".
Thanks for doing an episode on this shocking medical scandal. Hopefully this will be picked up in larger media outlets as well. The establishment media and politicians have gone so aggressively down the path of affirmation only it will be interesting to see what their response is to this information. If there is any response at all.
I had not heard of her before -- great interview. What a wacky world we live in that has allowed this kind of medicine to be practiced.
First?
Yes
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.
This conversation, again, reminded me of how infrequently the rate of self harm and suicide has only increased, after this “treatment” and “affirmation” model has been implemented in the last few decades.
Where were all the children and teens suffering from dysphoria, before the turn of the century?
I know with certainty it existed, but it seems with greater “visibility” and “acceptance”, came far more suffering.
OMG
I dipped into the WPATH files (the Hughes report and the files themselves). I think Hughes has a stance of advocacy and opposition that clouds her reporting. For example, one of the text exchanges in the WPATH files cites this article - https://tinyurl.com/8vr2p5pb - which complains that WPATH standards of care for mentally ill patients are *too restrictive*. This would suggest that some of the text exchanges leaked in the WPATH files are among more fringe members, and that the WPATH standards are not being overly influenced by the fringe - but the fringe might not be following the standards.
This was a great listen and I would love to talk to Mia about the similarities between this medical scandal & the experiences of people born with DSD (intersex variations), as so many similarities https://differently-normal.com/2021/10/25/the-invention-of-intersex/?preview_id=292&preview_nonce=0d6cea1ac5&preview=true
Do Gooders are actually Evil. They have no insight. First do no harm. Then do good.
"First, do no harm" is not a binding legal standard, and modern medical oaths are rather different. In the words of the AAMC (this is pre-2020, mind you): "What they include, from social activism to self-care, would surprise Hippocrates" (https://www.aamc.org/news/solemn-truth-about-medical-oaths)
Being legal is not always ethical. The issue expressed above was that those who are not self-aware of their harmful actions under the presumption of doing good may still be Evil. At one point, sterilizing the mentally ill was considered charitable.
Blissful compassion is certainly not a reasonable defense of surgical conversion therapy on minors, and it would be reasonable for some of the doctors and activists to be targeted for appropriate legal (criminal and civil) action to perhaps cause others lost in doing good to stop and consider next moves. They may still be not self-aware of their harmful behavior but may stop out of self-preservation, much like a sociopath.
This was a great podcast episode, but I don't think we should necessarily turn the other cheek ... just in case they decide to take our cheeks and transplant them to another part of our bodies.
And I would agree that many Western institutions are rotten and likely need to be raised and rebuilt. At least, we can start to depopulate the managerial class.
And the First do not harm! is actually attributed to Thomas Sydenham not Hippocrates. Regardless, it remains a good guiding principle. So is checking that the scene is safe or not pissing into the wind. Cheers.
Yes, ethical considerations and legal ones are not the same.
But even if we were talking about ethical considerations, the avoidance of harm is not a consensus opinion. It might be yours, and it might have merit, but the point I was making is that to try to hold the medical profession to a standard that it does not itself aspire to is not a winning strategy on a rhetorical level.
The ethics are a whole different conversation.
I guess you win?
My point is about how the transgender activists won. They didn't do it by being right, or even by having a good ethical or empirical argument, but they did win to some significant extent.
This was an AWESOME podcast, my friends. One of the best you’ve done. The sweet spot of salient, informative and human. Bravo!
Also, regarding doctors not being criminally charged: if I am not mistaken, the Canadian law banning conversion therapy is a criminal law. I.e. those people who are caught engaging in “conversion therapy” (loosely described as not affirming transgender people, without hesitation or mediation—and applicable to therapists as well as ordinary people, including family members), will be criminally charged. So why couldn’t doctors be as well, if the societal definition of conversion therapy were to change?
One thing, I thought “Multiple Personality Disorder” (or DID), was debunked ages ago?
DID is still listed in the latest version of the DSM (DSM5-TR) according to Wikipedia.
It is described as controversial but is still currently diagnosed and treated.
That was part of the point she was making