One of the many great divides in our society is between those of us who have a high degree of trust for experts and those who reflexively reject them as either wrong or corrupt or maybe both.
I tend to be in the former group. For the most part, I’m inclined to trust people who have the education, training, experience or background to opine authoritatively on a given subject.
But there’s at least one case where I begin to understand the skepticism of those who don’t trust experts. That area is the treatment of children for gender dysphoria. Treating kids who feel that they were “assigned” the wrong gender with interventions like puberty blocking drugs is endorsed by the American Medical Association, the American Academy of Pediatrics, the American Psychological Association and a couple of dozen other groups in medically related fields.
And yet, that just doesn’t strike me as right. I don’t understand how a kid, before puberty, can know that they should be the other gender. And, to the extent that some of these treatments are irreversible, it doesn’t seem to me that it fits with the overriding principle in the medical profession that treatments should be conservative. First, do no harm.
For my liberal friends, all of my reservations about this can be easily waved aside by simply listing the expert medical professional groups that endorse these treatments. For them, that should simply end the discussion. I don’t know what I’m talking about while they do.
But there’s evidence that these groups have been herded into a rigid pro-intervention stance by politics. Here’s a portion of a very thoughtful piece written by center-right New York Times columnist David French:
Perhaps the single most consequential and rigorous examination of the safety and efficacy of gender-affirming medical interventions is the Cass Review, a comprehensive survey by Dr. Hilary Cass of research on gender-affirming medical treatments for minors. Britain’s National Health Service commissioned the review to make recommendations on how to improve N.H.S. gender identity services and to make sure that children experiencing gender dysphoria experience a “high standard of care.”
Cass described the field of study as “an area of remarkably weak evidence.” Even worse, “the results of studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint.” Her conclusion was sobering: “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”
The report also highlights the way in which the medical community typically takes a cautious approach to new medical interventions. But, as Cass argues, “Quite the reverse happened in the field of gender care for children. Based on a single Dutch study, which suggested that puberty blockers may improve psychological well-being for a narrowly defined group of children with gender incongruence, the practice spread at pace to other countries.”
Yet there can be serious side effects to medical treatments. As the State of Tennessee contended in its brief to the court, “giving girls high doses of testosterone induces severe hyperandrogenism that can cause clitoromegaly, atrophy of the lining of the uterus and vagina, irreversible vocal cord changes, blood-cell disorders and increased risk of heart attack.”
In addition, “giving boys high doses of estrogen induces hyperestrogenemia, leading to a ‘very high risk of’ blood clots and increased risk of tumors, breast cancer, coronary artery disease, cerebrovascular disease, sexual dysfunction and gallstones.”
It is deeply unfortunate that the public debate over gender-affirming care for kids has been tainted by extreme intolerance. Researchers are often frightened to present results at odds with the desires and goals of at least some activists for transgender rights. A scientific consensus achieved through threats and intimidation is no consensus at all.
I’m still inclined to oppose the Tennessee law banning these treatments for minors, which is the subject of the Supreme Court case that prompted French’s column. That’s because this seems to me to be the deeply personal decision of a family, and the government should stay out of it. I may think these families are making a mistake, but it’s not my call.
On the other hand, you can make a case that these treatments amount to child abuse and so the state has a right to intervene. I think there’s enough murkiness on that point to err on the side of parental rights. It’s a little inconsistent for conservatives who are always harping about parental rights to all of a sudden want to override them in this case.
So, I find myself, uneasily, on the side of the transgender activists on this one. But I also understand somewhat better now why so many people are so skeptical of experts.
Yellow Stripes & Dead Armadillos 
And cosmetic surgery could be considered self-abuse. It’s risky and damaging too, but you can’t save people from themselves or get into personal choices. It’s just none of our business. Activists promoting that kind of care need to be careful what they wish for, I guess.
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Right on!
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“But I also understand somewhat better now why so many people are so skeptical of experts.”
On that subject:
GENDER TRANSTION REGRET Deserves A Voice, Says Former Patient
University TURNED DOWN Politically Incorrect Transgender Research
My I WOULD HAVE BEEN A TRANS Story
Too Many Transgender Activists Are SADISTIC BULLIES
MONEY QUOTE: “(T)ransgender activists (AKA the Trantifa) have taken to warping research findings to promote their agenda, censoring all others, and embarking on witch hunts, harassing dissenting scientists for decades of their careers.”
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“I don’t understand how a kid, before puberty, can know that they should be the other gender.”
Perhaps reach out to some families and educate yourself. Stay away from media on the topic, since with such a political issue virtually all media exists to promote a viewpoint. Talk to a real family.
Beware the tactic being actively employed by political groups. The goal is to use the inherent uncertainty of science to undermine scientific conclusions generally, and specifically conclusions that are disliked. The ultimate goal is the replacement of fact and evidence with political opinion.
No matter what any scientific conclusion is, there will be evidence that people put forward to say it’s wrong. Then people with political or personal reasons to dislike the scientific conclusion will glob on to this evidence to feel better about their opinion. And well funded interests will promote this evidence far and wide, not for scientific reasons but for political reasons.
This comes back to the importance of experts, who should be equipped to weigh all the existing evidence and make reasonable conclusions. Where again, anti-experts will glom on to examples of individual corrupt or incorrect experts in attempt to discount expert opinion in general, for political reasons.
“It’s a little inconsistent for conservatives who are always harping about parental rights to all of a sudden want to override them in this case.”
Sure is. These sorts of contradictions are all over the conservative sphere. I predict a response to this comment along the lines of the “but the Democrats!” propaganda technique, but my pointing this out about Cons doesn’t absolve non-Cons from their own issues 🙂
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I agree with your views on science, but then what do you make of French’s point that the science on this point is thin — a lot hanging on one limited Dutch study?
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Why ask me? I’m not educated in this field of study. Ask the American Medical Association, the American Academy of Pediatrics, the American Psychological Association, or the other groups in medically related fields that you mentioned in your post. I don’t know if Dr. Hilary Cass is right or wrong, because I’m not an expert in this field.
I am educated enough to say: The scientific consensus will be wrong sometimes. But in the long run, the scientific process will lead towards truth. If we want it to and let it.
I am also educated enough to say that science could very well exterminate us while it proceeds in uncovering truth. I would not argue against a wholesale slowing down of how our scientific progress is released upon the earth.
This trans issue is only highlighted in this context for political reasons. But there are innumerable previously non-existent technologies and techniques that we only learn are dangerous when it’s far too late. Most of them make rich people richer, so they’re not a major political issue, but trans kids were made into a political wedge issue, so here we are talking about it. At least that impact is limited to the family who made the choice. I never signed up to be the test-dummy for corporate experimentation.
To recap the hypocrisy of Cons, here they are up in arms about how a few children transition gender, but are silent on the many things that are unhealthy and dangerous for all of us. The only science that gets challenged are things that fit their political goals. Cue the “but the Ds!” response.
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That study is methodologically flawed in many ways.
How do you recognize an expert? By listening to other experts say someone else is an expert? Sounds like a circle to me.
Example, hot topic: The experts who were allowed to voice their opinions on what covid was and how to treat it were wrong on almost every aspect of the problem. There were many highly credentialed scientists who were pointing out the weakness and gross politicization of the science very early on. Two examples: Dr. Jay Bhattacharya and Dr. Marty Makary. You can look them up, but they are both highly credentialed internationally recognized experts in their respective fields. They are also both Trump nominees for the Director of NIH and FDA respectively. Both, Bhattacharya particularly, were denigrated and demeaned for the positions on covid and how to address it. They were also both right.
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