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  #101  
Old 10-15-2019, 08:03 AM
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Delaying is not stopping. Kids normally enter puberty at a pretty wide range over several years. The idea is to delay to the end of that wide normal range, not far beyond. A later teen who is confidently stating they want hormonal transition is, as above, unlikely to be changing their mind later.
  #102  
Old 10-15-2019, 08:25 AM
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Originally Posted by Annoyed View Post
What the fuck do you think happens to a pre pubescent male child if you stop him from going through puberty?
Nothing, until hormones are delivered to the bloodstream - either by the child's own gonads ( if the child ultimately decides they are cisgendered) or by artificial means (if the child decides they are transgendered). Puberty-blocking in these cases is not a permanent state of affairs; it just buys a little more time before the child has to commit to shaping their body into a male or female one.

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You think they are going to grow up completely normal, structurally? No.
They will grow up with a body that matches, as closely as possible, the gender they most strongly identify with in their minds. This is not a bad thing.

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What the hell do you think is happening? They are gonna grow up exactly the same as natural? No.
Why do you feel "not natural" is inherently bad?

Why do you feel "not normal" is inherently bad?

What if "not normal/not natural" is required in order for a person to live a happy life instead of being borderline suicidal all the time?
  #103  
Old 10-15-2019, 08:56 AM
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As it happens, CBS Sunday morning aired a segment two days ago about transgendered kids. These are kids who were featured in a piece five years ago, before they hit puberty; this week's piece followed up on them.

Here's the link. That webpage has a transcription of the whole piece, but it's worth watching the video. If you saw these kids in person and didn't know they were transgendered, you'd never have reason to suspect; they appear to be happy, normal, well-adjusted post-pubescent kids.

Anyone looking for a little more understanding of the experience of kids who grow up transgendered might find that piece informative. Annoyed, please take some time to watch it; it might soften your stance a bit.
  #104  
Old 10-15-2019, 08:57 AM
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It's often said that biological physical sex is a social construct just as gender is. That statement is unfortunately often just tossed out there without much elaboration (aside from a gratuitous mention of intersex people) and it often seems to be used to justify a "just go with everyone's gender identity and hey it's not polite to conjecture about the merchandise in anybody's underwear, that should be a taboo topic" viewpoint.

But, yeah, ultimately sex (the biological physical, split off from things like personality and behavior which we call "gender") is social. The easiest working definition of "male" is "if the person in question appeared on a nude beach in front of 1000 non-blind strangers, at least 980 of them would classify them as 'male'". Likewise for "female". Once you start trying to rely on physical data (chromosomes, ownership of a uterus, has a long external protruberant sex organ, prolific hair growth, wide hips, etc) you get into arguments about exceptions and the mindset of the people doing the classifying and the wide range of possible variations etc -- it's easier to treat it as social to begin with, and then establish that there's a predictable and high level of inter-rater correlation and consistency and that, yeah, the overwhelming majority of people are assigned in this manner without any appreciable ambivalence from the assigners.

No one who was born male (using this social definition of 'male' -- 980+ nude beach raters say 'male') knows from firsthand experience that their body should have been female instead. They can only arrive at that conclusion by extrapolation. Even given Julia Serrano's notion of 'brain sex' -- in which the human brain contains a sort of schematic diagram of what the body's morphology ought to be like -- interpreting the resulting feeling of "wrongness" as meaning "oh, my body should have been like theirs" (points to some female people) intrinsically requires some social extrapolation. (And, once again, likewise for female-to-male situations).

This makes it profoundly difficult to sort out what portion of a person's dysphoria is composed of wanting to be perceived and interacted with as people of the other sex are perceived and treated, and what portion is specifically "I don't want this body structure, I want that body structure instead, this one is wrong".

To anyone whose inclination is to say, in response to that, that people with dysphoria should just be sex-expectation rebels and be loud proud gender nonconformists and thereby change how the world treats and regards people of their sex, I would say that, of the two, changing one's own morphology is a shitload easier and can be accomplished in a matter of a few years, whereas the other objective is something that many folks have been attempting over the course of generations and yet there are still rigid and very polarized social notions still in force.

I don't have a physical dysphoria. I have no sense that my brain thinks my body should be a different configuration. Like most people on this planet, I have a tendency to skew my beliefs about other folks' experience so that I expect them to be like me, more so than they actually are. Do I tend to think a lot of trans folks' issues are actually with gender and not with physical sex? Yeah, of course. But that doesn't make me right.

I would never want to make transitioning less available to those who want it. I do see the necessity of establishing a "type of person", socially recognized and spoken of, whose gender is the opposite of what usually goes along with their biological sex. I do think that opens up options for people who might not be the best candidates, in the long run, for surgery and hormones and the rest of what transitioning involves.
  #105  
Old 10-15-2019, 10:47 AM
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I think it's interesting that, on one hand, people are shocked at the idea that a child might know that they are transgender at a young age, but on the other hand have no problem whatsoever pushing gender stereotypes onto them and punishing them if they rebel against those. It's also especially odd given that most of the 'gender norms' are only about a century old; notably in the early part of the 20th century it was normal for all young children to wear dresses (not just girls) and the gender coding of pink and blue were the reverse of what they are now. When you get down to it, color coding babies so that strangers know what their genitals look like is a much weirder practice than listening to what children say about how they fit into gender roles.
  #106  
Old 10-15-2019, 10:59 AM
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Originally Posted by Weedy View Post
So that was me ('swapping genders at will') and I am not skyr, or Aji de Gallina and I have not said anything about surgery or hormones or anything else. I haven't switched or continued anything.
That phrase is commonly used to trivialize the experience of transgender youth. But you're right, I don't think you meant it that way, and I shouldn't have lumped you in with the others, even indirectly. I apologize.

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The thing I wanted to know, since I work with that age group, and it could actually happen, is what I am supposed to do if a child expresses to me that they are a different gender to what I think they look like biologically? 5 years ago, I would have just treated it exactly like them telling me they are a dog (i.e. as pretend play), even if it went on for months. Now I have learnt a little more about trans-gender people (mostly from this message board) and it seems like that is maybe not the best response. I'm OK with not getting an answer to my question but I would rather not be misrepresented.
I'm not an expert on young children, so take this for what it's worth. But I think treating it like pretend play is fine at that age initially (I assume that means you support and encourage imagination, not telling them "quit being silly"). Think of it as helping the child explore what gender means, not making a decision.

If it continues (remember - persistent, consistent, and insistent), then you can involve the parents and determine if a more formal social transition is appropriate.
  #107  
Old 10-15-2019, 11:19 AM
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Originally Posted by Pantastic View Post
I think it's interesting that, on one hand, people are shocked at the idea that a child might know that they are transgender at a young age, but on the other hand have no problem whatsoever pushing gender stereotypes onto them and punishing them if they rebel against those. It's also especially odd given that most of the 'gender norms' are only about a century old; notably in the early part of the 20th century it was normal for all young children to wear dresses (not just girls) and the gender coding of pink and blue were the reverse of what they are now. When you get down to it, color coding babies so that strangers know what their genitals look like is a much weirder practice than listening to what children say about how they fit into gender roles.
But "transgender" does not mean a boy wearing pink or a girls wearing blue. If my wife wears blue, she is not transgender in the sense that word is currently meant.
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  #108  
Old 10-15-2019, 12:06 PM
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look, my whole thing here is someone trying to ascribe gender to a 3-year-old. I'm a guy. when I was 5-6 years old, I was into Strawberry Shortcake dolls.. Why? because they were scented, and I thought that was neat. I didn't play with them or anything. I'm sure my older relatives made cracks about it. But if I had the parents/grandparents the OP describes, they would have tried to funnel me into being gay or trans just because I was a boy who collected dolls for like a little bit.

how about let the kid be and see how it turns out? 'cos it kind of sounds like the people OP is talking about actuall want this kid to be trans.
Yes, I believe that ignoring the familys psychology is very foolish in these situations. I don't believe a child can independently choose these things at 3, outside of the psychology of their parents. If that is the case they all need to be in family therapy.

Toddlers are not competent (by definition). Is it likely that they need to be making decisions as big as that? I tend to see family issues here, not little monarchs who are ordering their universe.
  #109  
Old 10-15-2019, 12:48 PM
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But "transgender" does not mean a boy wearing pink or a girls wearing blue. If my wife wears blue, she is not transgender in the sense that word is currently meant.
Good thing no one said anything remotely like that then, isn't it?
  #110  
Old 10-15-2019, 01:54 PM
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Originally Posted by Annoyed View Post
I find it appalling that parents would consider permanently manipulating their pre-pubescent child’s hormonal levels to effectively stop them from becoming fertile, growing full testicles, full bone structure, and changing their physiology for life.
Puberty blockers DELAY puberty, they don't prevent it. By keeping the kids on blockers until they are of legal age the parents are NOT doing any such thing. In such cases any decision to proceed with gender surgery/hormones/other treatments is made by the legally adult person and NOT the parents.

If the decision is NOT to proceed the blockers are discontinued and NORMAL PUBERTY ensures. The person will achieve normal fertility, "full testicles" (assuming they are male), full bone structure (whatever that means - presumably normal bone structure for their gender), and so forth.

Puberty not occurring until 18 or 20 is actually within the NORMAL range for human beings and can occur naturally with no other side effects. Other than a reduced chance of breast cancer for women (early puberty is associated with a higher risk of that cancer).

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It it’s a sad and disturbing little social experiment going on that I have no doubt will be looked at in the future as a dark time in history.
Or maybe it will be praised as getting people appropriate treatment for a condition no one would willing acquire but that some people suffer from nonetheless.
  #111  
Old 10-15-2019, 02:01 PM
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What the fuck do you think happens to a pre pubescent male child if you stop him from going through puberty? His bone structure. His reproductive organs.

You think they are going to grow up completely normal, structurally? No.
If you use puberty blockers then yes, when they are stopped the child will undergo "full puberty". Delaying puberty does not reduce fertility, does not screw up "bone structure", or reproductive organs in either gender. The kid might end up slightly taller than otherwise, but that's not usually seen as a problem, particularly for men.

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Same with female to male hormones. What the fuck do you think happens if you alter a growing child’s hormones?
Well, THERE's your problem - you don't understand the difference between "hormone blockers" and actual hormones.

NO ONE is putting hormones into these underage kids. There are medications that BLOCK the actions of certain hormones and that is what they are given. Standard procedure is NOT to give hormones until the child is legally an adult and able to make such a decision for themself.

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What the hell do you think is happening? They are gonna grow up exactly the same as natural? No.
By that argument we shouldn't repair harelips, which occur "naturally". Or any other birth defect.

The real test of whether or not a treatment is justified is how the outcome with treatment compares to the outcome without treatment. People who have gender/body dysphoria that isn't treated have ludicrously high rates of suicide and other problems. Preventing death can justify a lot of things that would otherwise be repugnant. It's not about how YOU feel about it, it's about how well people with this condition can function. Their health and well being outweighs your personal squeamishness on the subject.
  #112  
Old 10-15-2019, 02:07 PM
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Well now I'm confused. Gender is something people can swap at will now? I work in daycare and that would never fly at my work, one month we are calling a child 'he' and the next month saying 'she'. Are we behind the times?
Yep. You use a person's preferred pronoun. It can change. There's nothing wrong or Earth shattering a out that, and is the norm where I live.

And some kids don't want to be called either of those. I have a kid who, since around age 3 has said that he sometimes feels like a girl and sometimes feels like a boy. We've been listening to what he says, and talking to him about what that means for him for 3 years now. He is still developing and exploring, but gender is clearly not a black and white subject for him. He identifies as non-binary, and uses the pronouns he or they. Lately, he's been more clear that he's a boy, so we support that. Kids give him a hard time at school for using the boys' bathroom because he has long hair, and many kids insist he's a girl.* That may be part of why he is being more assertive about being a boy, or his view of himself might be changing. Either way, we'll keep supporting him and let him tell us what feels comfortable and right for him.

The rest of this post is not directed to Weedy, but more generally.

There are people who make assumptions on both sides. People who think of themselves as supportive of trans rights are often locked into binary thinking. Like, seeing my kid in certain clothes, and with long hair, they'll ask questions or choose pronouns assuming that he identifies as a girl. It's super complicated though, so asking questions is fine with me. The people I have a problem with are the ones who don't just accept the answers about a person's own identity.

As for whether 3 year olds can know for sure how they identify, I think some can. It's important to think about how gender is socialized into kids. All people start out with some mix of traits and interests and abilities. Almost all of those will be traditionally associated with either male or female gender. Like, being sensitive, nurturing, and a good communicator would be traditionally associated with the feminine, and being strong, stoic, and mechanically inclined are associated with masculinity. For both boys and girls, there is pressure to conform to gender expectations. But research has shown that there are some critical times when these norms are strongly enforced.

A particular researcher has referred to a "halving" process where enormous pressure is applied societally to reject or tremendously de-emphasize the traits etc. that fall on the "wrong" side of the line. The punishment for not confirming can be brutal. For boys, the "halving" (rejecting a great deal of one's self) starts during the preschool and kindergarten years. For girls, the most brutal enforcement occurs in middle school. 3 year olds may not fully understand what is happening, but they most definitely are getting strong messages about what is accepted or not accepted about them, and for boys, this is a time when there is enormous pressure. Kids who can't or won't jettison that part of themselves suffer. (As do the kids who do -- gender norm enforcement hurts everybody.) As a parent, you can see the difference between a kid who is confused and upset about how gender is being applied to them, vs a kid who likes to imagine being the opposite sex sometimes.
  #113  
Old 10-15-2019, 03:01 PM
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Good thing no one said anything remotely like that then, isn't it?
So what was the point in bringing up what color people dress girls and boys in?

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Originally Posted by Broomstick
If you use puberty blockers then yes, when they are stopped the child will undergo "full puberty". Delaying puberty does not reduce fertility, does not screw up "bone structure", or reproductive organs in either gender. The kid might end up slightly taller than otherwise, but that's not usually seen as a problem, particularly for men.
It is not clear that this are correct. There is evidence that puberty blockers do in fact reduce fertility/virility and reduce bone density. In truth, the registries for puberty blockers are in the very early stages of being filled in with data, and so one cannot comment on the long term effects with a great deal of confidence either way. There is not yet a lot of phase IV study to draw from.
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  #114  
Old 10-15-2019, 08:05 PM
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When someone asks to be called a certain name, why is it such a big deal? I don't get it? I mean, you don't freak out when someone says, "Hey, I'm William, call me Bill", right? So why when someone asks for different pronouns do people get so anal?


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So what was the point in bringing up what color people dress girls and boys in?
Especially since it used to be pink for boys, blue for girls. It switched at some point.


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It is not clear that this are correct. There is evidence that puberty blockers do in fact reduce fertility/virility and reduce bone density. In truth, the registries for puberty blockers are in the very early stages of being filled in with data, and so one cannot comment on the long term effects with a great deal of confidence either way. There is not yet a lot of phase IV study to draw from.
I would imagine -- at least I would hope! -- that doctors don't just say, "oh here you go, here are some blockers" at a first meeting. Because there have been reports of some particular blockers causing long term side effects, and they're not just used for trans children. For example -- precocious puberty. You have a kid who starts puberty at age 3 or 4, you want to stop that.

And I would think ANY parent would be concerned about what ANY kind of medication might do to their child's body. Not because they're transphobic, or because they don't want to see their child happy, or succeed, but because they're concerned and want to make sure -- hey, am I going to hear years from now that this drug causes cancer, or heart disease, or whatever?

Hell, I had to go through a year's worth of counseling, between being diagnosed with ADHD, and being prescribed RITALIN. (Granted that was 30 years ago). It wasn't because they wanted me to fail. It was because hey, is this really ADD, or is she just upset because of the new baby?

I don't think a parent worrying somewhat about the drug part -- even if it's just puberty blockers -- makes them bad parents. Just, normal.
  #115  
Old 10-15-2019, 09:15 PM
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Originally Posted by Broomstick View Post
Puberty blockers DELAY puberty, they don't prevent it. By keeping the kids on blockers until they are of legal age the parents are NOT doing any such thing. In such cases any decision to proceed with gender surgery/hormones/other treatments is made by the legally adult person and NOT the parents.

If the decision is NOT to proceed the blockers are discontinued and NORMAL PUBERTY ensures. The person will achieve normal fertility, "full testicles" (assuming they are male), full bone structure (whatever that means - presumably normal bone structure for their gender), and so forth.

Puberty not occurring until 18 or 20 is actually within the NORMAL range for human beings and can occur naturally with no other side effects. Other than a reduced chance of breast cancer for women (early puberty is associated with a higher risk of that cancer).
May we ask for cites for this?

Concerning the age of puberty:

"For girls, puberty usually starts around age 11. But it can start as early as age 6 or 7. For boys, puberty begins around age 12. It can start as early as age 9. Puberty is a process. It occurs for several years. Most girls finish puberty by age 14. Most boys finish puberty at age 15 or 16." (Source) Perhaps puberty not occurring until 18 or 20 happens naturally in some cases, but clearly those are extreme outliers, so it does make sense that some patients or their parents wouldn't be totally sanguine about pushing puberty into that age range by artificial means.

Concerning the effects of puberty blockers, one of the most common is Lupron. "More than 10,000 adverse event reports filed with the FDA reflect the experiences of women who’ve taken Lupron." Among the side effects reported: brittle bones, faulty joints and need for joint replacement at an early age, chronic pain, seizures (sometimes deadly), deteriorating vision, and depression, for starters.

In boys, puberty blockers may be linked to testicular cancer. "Combining our data with that of Feuillan et al. [19], a prevalence of 10% results, which is approximately fourfold the prevalence demonstrated in large young male asymptomatic populations [54]. Albeit the clinical significance of ultrasound imaging for testicular microcalcifications in subjects without any other risk factors for testicular neoplasia is still unclear [54,55], some data suggest a possible association with testicular cancer [56]." (Source)

Also: "Though there is very little scientific evidence relating to the effects of puberty suppression on children with gender dysphoria — and there certainly have been no controlled clinical trials comparing the outcomes of puberty suppression to the outcomes of alternative therapeutic approaches — there are reasons to suspect that the treatments could have negative consequences for neurological development. Scientists at the University of Glasgow recently used puberty-suppressing treatments on sheep, and found that the spatial memory of male sheep was impaired by puberty suppression using GnRH analogues,[117] and that adult sheep that were treated with GnRH analogues near puberty continued to show signs of impaired spatial memory.[118] In a 2015 study of adolescents treated with puberty suppression, the authors claimed that “there are no detrimental effects of [GnRH analogues] on [executive functioning],”[119] but the results of their study were more ambiguous and more suggestive of harm than that summary indicates.[120] (It is also worth noting that the study was conducted on a small number of subjects, which makes the detection of significant differences difficult.)" (Source)

Regarding the particular question of whether the effects of puberty blockers can be reversed: "In addition to the reasons to suspect that puberty suppression may have side effects on physiological and psychological development, the evidence that something like normal puberty will resume for these patients after puberty-suppressing drugs are removed is very weak. This is because there are virtually no published reports, even case studies, of adolescents withdrawing from puberty-suppressing drugs and then resuming the normal pubertal development typical for their sex. ... Because the major studies of puberty suppression have not reported results of patients who have withdrawn from treatment and then resumed the puberty typical of their sex, we also do not know how normally the primary and secondary sex characteristics will develop in adolescents whose puberty has been artificially suppressed beginning at age 12. And so the claim that puberty suppression for adolescents with gender dysphoria is “reversible” is based on speculation, not rigorous analysis of scientific data." (Same source as above.)
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Old 10-15-2019, 09:42 PM
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I'm not sure if you know anything about the main source you quoted or if you just picked the first study that fit your bias. But Paul. McHugh is pretty well known for his strong anti-transgender views, arguing that gender dysphoria doesn't exist. The study in the New Atlantis you cited was not peer reviewed, and neither McHugh nor Mayer specializes in sexuality or LGBTQ health. The entire report contains no original research, and instead represents cherry-picked data selected from other studies that matched their views.

I can find research indicating adverse effects for any drug out there. It's meaningless without a balanced examination of all the data, both pro and con. You know, actual science.
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Old 10-15-2019, 10:40 PM
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I'm not sure if you know anything about the main source you quoted or if you just picked the first study that fit your bias. But Paul. McHugh is pretty well known for his strong anti-transgender views, arguing that gender dysphoria doesn't exist. The study in the New Atlantis you cited was not peer reviewed, and neither McHugh nor Mayer specializes in sexuality or LGBTQ health. The entire report contains no original research, and instead represents cherry-picked data selected from other studies that matched their views.
I quoted four different sources, not one main source. If you have any evidence that the conclusions quoted are not correct, I will be happy to read it.

Regarding the claim that puberty blockers can cause brain damage, here's a commentary on the issue from a peer-reviewed journal. It says the same thing. There are two studies that have found kids taking puberty blockers have lower IQs. The result was statistically significant in one case, not in the other case (narrowly). That, combined with results from research on animals, provides some evidence that the drugs hurt brain function. More research on the question would be nice, but as things stand now, nobody should say that puberty blockers are safe and free from side effects.

Lots more evidence about side effects can be found here.

Quote:
I can find research indicating adverse effects for any drug out there. It's meaningless without a balanced examination of all the data, both pro and con. You know, actual science.
I agree, science is good. Some posts about puberty blockers in this thread have been entirely about the pro and not the con. As noted in the PBS article that I linked to, the FDA is reviewing the evidence for the safety of GnRH antagonists after receiving a massive number of reports of nasty, and sometimes fatal, side effects. If we want to look at pro and con, surely harmful side effects that include death should be mentioned.
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Old 10-15-2019, 11:01 PM
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Bear in mind that the standard here is not that we should be aiming to eschew treatment such as puberty blockers unless we can show conclusively that there's no risk involved. This isn't something where safety should be assessed on the same basis as (say) a cis woman's breast augmentation. Safety must be assessed relative to the considerable risk in doing nothing at all to help people with gender dysphoria, since doing nothing means potentially committing people to either live in the "wrong" body or to live with the result of much less satisfactory post-pubescent transition procedures.

Last edited by Riemann; 10-15-2019 at 11:03 PM.
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Old 10-15-2019, 11:54 PM
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FWIW not very hard to find evidence-based guidelines from the Endocrine Society. First of all it reinforces that early gender incongruence has much fluidity:
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In most children diagnosed with GD/gender incongruence, it did not persist into adolescence. The percentages differed among studies, probably dependent on which version of the DSM clinicians used, the patient’s age, the recruitment criteria, and perhaps cultural factors. However, the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/gender incongruent in adolescence ...

... In individual cases, an early complete social transition may result in a more favorable outcome, but there are currently no criteria to identify the GD/gender-incongruent children to whom this applies. At the present time, clinical experience suggests that persistence of GD/gender incongruence can only be reliably assessed after the first signs of puberty ...
Again, labelling a three year old who expresses gender incongruence as "trans" would most often be premature at best. One can accept a child's non-congruent behaviors and wishes as they are expressed at the time without any judgement while being completely open to the idea that they may or may not change in the future.

Regarding the potential risks of delaying puberty with gonadotropin releasing hormone analogues (GnRH analogs) -
Quote:
... prolonged pubertal suppression using GnRH analogs is reversible and clinicians should inform these individuals that sperm production can be initiated following prolonged gonadotropin suppression. This can be accomplished by spontaneous gonadotropin recovery after cessation of GnRH analogs or by gonadotropin treatment and will probably be associated with physical manifestations of testosterone production, as stated above. Note that there are no data in this population concerning the time required for sufficient spermatogenesis to collect enough sperm for later fertility. In males treated for precocious puberty, spermarche was reported 0.7 to 3 years after cessation of GnRH analogs (69). In adult men with gonadotropin deficiency, sperm are noted in seminal fluid by 6 to 12 months of gonadotropin treatment. ...

... In girls, no studies have reported long-term, adverse effects of pubertal suppression on ovarian function after treatment cessation ...

... Pubertal suppression can expand the diagnostic phase by a long period, giving the subject more time to explore options and to live in the experienced gender before making a decision to proceed with gender-affirming sex hormone treatments and/or surgery, some of which is irreversible (84, 85). Pubertal suppression is fully reversible, enabling full pubertal development in the natal gender, after cessation of treatment, if appropriate. The experience of full endogenous puberty is an undesirable condition for the GD/gender-incongruent individual and may seriously interfere with healthy psychological functioning and well-being. Treating GD/gender-incongruent adolescents entering puberty with GnRH analogs has been shown to improve psychological functioning in several domains (86).

Another reason to start blocking pubertal hormones early in puberty is that the physical outcome is improved compared with initiating physical transition after puberty has been completed (60, 62). Looking like a man or woman when living as the opposite sex creates difficult barriers with enormous life-long disadvantages. We therefore advise starting suppression in early puberty to prevent the irreversible development of undesirable secondary sex characteristics. However, adolescents with GD/gender incongruence should experience the first changes of their endogenous spontaneous puberty, because their emotional reaction to these first physical changes has diagnostic value in establishing the persistence of GD/gender incongruence (85). Thus, Tanner stage 2 is the optimal time to start pubertal suppression. However, pubertal suppression treatment in early puberty will limit the growth of the penis and scrotum, which will have a potential effect on future surgical treatments (87). ...

... The primary risks of pubertal suppression in GD/gender-incongruent adolescents may include adverse effects on bone mineralization (which can theoretically be reversed with sex hormone treatment), compromised fertility if the person subsequently is treated with sex hormones, and unknown effects on brain development. Few data are available on the effect of GnRH analogs on BMD in adolescents with GD/gender incongruence. ... [detailed review follows with the bottom line being some findings of unclear statistical let alone clinical significance] ...

... Currently available data from transgender adolescents support treatment with sex hormones starting at age 16 years (63, 122). However, some patients may incur potential risks by waiting until age 16 years. These include the potential risk to bone health if puberty is suppressed for 6 to 7 years before initiating sex hormones (e.g., if someone reached Tanner stage 2 at age 9-10 years old). Additionally, there may be concerns about inappropriate height and potential harm to mental health (emotional and social isolation) if initiation of secondary sex characteristics must wait until the person has reached 16 years of age. However, only minimal data supporting earlier use of gender-affirming hormones in transgender adolescents currently exist (63). Clearly, long-term studies are needed to determine the optimal age of sex hormone treatment in GD/gender-incongruent adolescents. ...
Bolding mine.

The risks of GnRF analogue treatment are non-zero but small while the harms of allowing puberty to proceed at that point, at an age that a child cannot be reasonably expected to be competent to make a decision of such life-long import, are very sizable.

I'm no expert and haven't done a full literature review ... but these people are experts and have.
  #120  
Old 10-16-2019, 12:38 AM
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Bear in mind that the standard here is not that we should be aiming to eschew treatment such as puberty blockers unless we can show conclusively that there's no risk involved. This isn't something where safety should be assessed on the same basis as (say) a cis woman's breast augmentation. Safety must be assessed relative to the considerable risk in doing nothing at all to help people with gender dysphoria, since doing nothing means potentially committing people to either live in the "wrong" body or to live with the result of much less satisfactory post-pubescent transition procedures.
I don't think anyone's disagreeing here. No drug out there has zero risk or side effect. (Fucking TYLENOL does) You want to make sure it's not going to cause something like cancer, but there's never going to be a non-zero risk for any kind of medical treatment.

But parents will worry, because they're parents, that's all I'M saying.

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  #121  
Old 10-16-2019, 02:53 AM
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May we ask for cites for this?

Concerning the age of puberty:

"For girls, puberty usually starts around age 11. But it can start as early as age 6 or 7. For boys, puberty begins around age 12. It can start as early as age 9. Puberty is a process. It occurs for several years. Most girls finish puberty by age 14. Most boys finish puberty at age 15 or 16." (Source) Perhaps puberty not occurring until 18 or 20 happens naturally in some cases, but clearly those are extreme outliers, so it does make sense that some patients or their parents wouldn't be totally sanguine about pushing puberty into that age range by artificial means.
Those are ages for puberty NOW, not historically.

This article provides some overview - highlights include German researchers providing statistics that around 1860 the average age of puberty onset in girls was 16 years, not 11. In other words, in prior centuries the norm was to start puberty at an age where kids these days are finished and done with the process. Our "normal" is not, in fact, normal when viewed historically.

I don't have time right now to dig up a primary-source research paper on the topic, but a quick google will show you ample information that the average age of puberty dropped by 5 years in the 20th Century and that puberty in the age range of 15-17 was, historically, the norm in many places and eras.

Another problem with tracking the long term effects of puberty blockers is that their use in young transgender people - that is, presumably people who are biologically normal for their birth gender - is relatively new. Other uses involve kids with precocious puberty, which untreated can have its own problems (such as increased risk of cancer over a lifetime), and a subset of kids with things like hormone-secreting tumors who, again, have medical issues that may or may not affect long term outcomes.

So yes, there probably are potentially bad side effects. The same can be said for untreated gender dysphoria. That's why professionals need to be involved in evaluation of the problem and treatment decisions. This is not something DIY.

But also consider that no one is going to be giving puberty blockers to a 3 year old. The only way a kid, say, 8 years old is going to be giving puberty blockers is if they are, in fact, in precocious puberty for which puberty blockers are a long-standing treatment. A transgender kid may be on the blockers fewer years on average than kids with precocious puberty would be, although exact lengths of time depends on the individual.

The fact is we routinely give kids, even young kids, powerful medications for various reasons, all of which can have side effects both short and long term. While certainly puberty-blockers shouldn't be handed out lightly in conjunction with on-going treatment for a problem I don't see where they should be ruled out or viewed as something totally new when, in fact, they aren't. This particular use is new, but the medications are not.
  #122  
Old 10-16-2019, 10:04 AM
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[QUOTE=RickJay;21917845]So what was the point in bringing up what color people dress girls and boys in?

As I said, "I think it's interesting that, on one hand, people are shocked at the idea that a child might know that they are transgender at a young age, but on the other hand have no problem whatsoever pushing gender stereotypes onto them and punishing them if they rebel against those." People seem to feel that the idea that a child might know anything about their gender is absurd (one poster thinks they don't even know he/she at age three), but children are actually bombarded with information about gender and how they fit into it. And a lot of the signals they are sent are very recent inventions and not part of longstanding tradition or 'human nature' like people often like to pretend. The pink/blue genital information color coding serves as a readily identifiable example of this, and is a very historically recent phenomenon.
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Old 10-16-2019, 11:01 AM
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If we magically erased all preconceived / stereotypical notions about differences between the sexes from everyone's heads, there are two likely outcomes:

a) From that point on, we no longer have any beliefs about differences in personality, behavior, priorities, values, or anything else, other than the most fundamental physical structural facts, about how the sexes differ. (And maybe not even particularly polarized notions even about that).

= or =

b) Over time, people make generalizations, which become widely shared because they are relatively consistent generalizations about the sexes, and we once again have a stereotyped notion about what it means to be male (or a boy, or a man) and what it means to be female (or a girl, or a woman).


Someone walked up to my desk 20 minutes ago and asked if I could direct her to the bathroom. Note that I use the pronoun "her". This person did not specify a pronoun choice, nor did this person specify which bathroom was the one being sought. Based on a combination of visible morphological contours, apparent texture of facial skin, hair length and styling, choice of apparel, timbre of voice, and probably a few dozen other things I wasn't entirely consciously aware of, I gendered this person as female and assumed "she", and assumed she was seeking the women's bathroom.

She returned to my desk a couple moments later and said someone else had told her that, no, the bathroom was not on this side (where I had pointed her). The bathroom that is on the corridor on the other side of the building is the men's bathroom. (We have a neutral-gender bathroom on the floor above me). She, or, rather, this person, did not tell me they had been informed that a specific bathroom was "not on this side" but with this additional information I clarified that there was a women's bathroom in the direction I had previously pointed but to get to the men's bathroom one would walk through the kitchen and along the left hand side of the corridor would find it.

Which is to say that relying on a generalization doesn't prohibit adjusting for the possibility of exceptions.

For now -- if not forever in perpetuity -- our world does operate with generalizations which constitute gender. We gender people, we assign them identities in our head without consulting them, based on these generalizations. Toddlers learn about the generalizations (that's specifically when it is acquired) and they may, at that time, decide that they are exceptions.


That could be because they wish to be gendered by other people as the other common identity.

That could be because they perceive themselves as fitting the generalizations associated with the other common identity more accurately than they fit the ones associated with their sex.

(Or, in simpler terms, a toddler may think of themselves in much the way we adults think of a transgender individual, or a toddler may think of themselves more the way we think of sissies and tomboys, people who are gender atypical but still identify as the bio sex that their pediatrician has on their medical record).

We should not impose a belief system on them about what it "means". Let them tell us.
  #124  
Old 10-16-2019, 12:28 PM
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I would imagine -- at least I would hope! -- that doctors don't just say, "oh here you go, here are some blockers" at a first meeting.
Well of course. But there's always bad doctors; look at the opioid epidemic. There ARE examples of doctors being absurdly quick on the trigger in prescribing drugs to kids who declare gender dysphoria, but that's not really my point; the pharma industry as a whole doesn't yet have the full story on long term effects (positive or negative) so we can't say we KNOW what the long term results will be. Use of hormone inhibitors for this indication in relatively new.

For that matter, transgenderism is to some extent new; we assume it's always been with us and there are a number of famous examples, but the number of kids being identified as gender dysphoric now is climbing exponentially, and we do not yet know what the long term "results" of that will be, either. There isn't even any sort of agreement on, say, whether or not kids who identify as trans will change their minds later; you will hear from some people that that even almost never happens, but a few posts ago is a cite that it actually happens a lot. Until the current generation matures to adulthood, we've no clear idea. How often trans kids attempt suicide is a matter of many competing claims but limited clarity. There is no consistency at all from place to place or service provider to provider as to how to help kids dealing with gender dysphoria and there is VERY little investigation into what the comorbidities are.

The long and short of it; anyone who says they KNOW about the science of this is fooling themselves.
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  #125  
Old 10-16-2019, 05:44 PM
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If we magically erased all preconceived / stereotypical notions about differences between the sexes from everyone's heads....
From this and other posts, I get the impression that your model is that gender identity is principally or entirely a social construct. Certainly it is to some degree, but surely the very existence of transgender people strongly implies that there is some degree of sexual dimorphism in the behavioral phenotype. Transgender people assert a gender identity that is in opposition to massive social pressure to adopt a cis identity, historically placing themselves at great risk of persecution and suffering. It’s hard to imagine how this could be a result of social conditioning. It’s surely likely to be a combination of genetics and/or early non-social environmental factors.

Last edited by Riemann; 10-16-2019 at 05:46 PM.
  #126  
Old 10-16-2019, 07:44 PM
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... As I said, "I think it's interesting that, on one hand, people are shocked at the idea that a child might know that they are transgender at a young age, but on the other hand have no problem whatsoever pushing gender stereotypes onto them and punishing them if they rebel against those." ...
Two ends that are, I believe, equally ignorant, and excluding the middle that is most backed by the data that we have.

The data is pretty clear that most gender incongruent younger children will NOT remain so forever ... and that some fewer will. And no one, including the child, knows at that point which kid will be the one whose gender incongruity persists or fades, including the child. One can respect and support where they are at that moment without trying to impose an adult forever identity upon them. Give them the space to explore and come to their own conclusions over the course of childhood, confident that they are loved whatever identities they embrace, plural intended as the chosen identity may change and they need to know that it is okay to be fluid and to be a boy for now and a girl later and maybe back again, no lasting choices need to be made yet, and when it is time we will be here with you, loving you as you make that decision then.
  #127  
Old 10-16-2019, 10:25 PM
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From this and other posts, I get the impression that your model is that gender identity is principally or entirely a social construct. Certainly it is to some degree, but surely the very existence of transgender people strongly implies that there is some degree of sexual dimorphism in the behavioral phenotype. Transgender people assert a gender identity that is in opposition to massive social pressure to adopt a cis identity, historically placing themselves at great risk of persecution and suffering. It’s hard to imagine how this could be a result of social conditioning. It’s surely likely to be a combination of genetics and/or early non-social environmental factors.
I would think the example of David Reimer showed that gender isn't simply a "social construct". You can't force a cis kid to be trans, so people should realize that forcing a trans person to be cis ain't gonna work.

John Money tried to claim that gender roles were purely social -- but the jury's still out on the "nature vs. nurture" deal. Probably a good mix of the two.
  #128  
Old 10-17-2019, 09:21 AM
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If we magically erased all preconceived / stereotypical notions about differences between the sexes from everyone's heads....
From this and other posts, I get the impression that your model is that gender identity is principally or entirely a social construct.
Gender is, by definition, a social construct. Sex is what is biological; gender is what is social. That's the traditional definitive difference between the two terms.


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Certainly it is to some degree, but surely the very existence of transgender people strongly implies that there is some degree of sexual dimorphism in the behavioral phenotype.
A theory the effect that being transgender is biologically based does exist. There is some supportive evidence, but the interpretation of such evidence is very heavily flavored by the politics of the outcome of the interpretation.

At an absolute minimum, though, it remains true that transgender people may exist whose gender variance is not the consequence of anything biologically different in their brains. Using the modern wider definition of "transgender" -- a person whose gender identity is different from the sex they were assigned at birth -- that seems extremely likely, since we're now talking not only of people who feel that the body with which they were born is wrong and needs medical intervention, but also people like me, and people who identify as "nonbinary transgender", and others who do not regard their physical body as in need of any kind of physical alteration. Given that wide range of variation, it is unlikely that a single built-in physical difference at the brain level is responsible for all of that.


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Transgender people assert a gender identity that is in opposition to massive social pressure to adopt a cis identity, historically placing themselves at great risk of persecution and suffering. It’s hard to imagine how this could be a result of social conditioning.
Why? I have no difficulty believing that at all. Our culture has a massively unwelcoming and negative response to gender-atypical people (masculine female people and feminine male people), and that's on top of the social friction of being constantly assumed to be something that one is not (i.e., assumed to be a masculine male if one is male, assumes to be a feminine female if one is female).

One need not "assert" a gender identity in order to slam headlong into persecution and suffering. In the absence of coming out, of defining one's atypical gender identity, one has the limited choice of either faking one's persona so as to fit in among those of the same biological sex (profoundly uncomfortable, severe suffering) or expressing who one is more honestly and being regarded as "wrong" for one's sex.

Transitioning -- or at least presenting as the physical sex that is typically associated with how one actually is inside, instead of as the physical sex one was born as -- is something one does to alleviate the persecution and suffering. It is something that one does in order to more accurately be thought of and to be treated more in accordance with the person that one actually is.

Social conditioning is exactly why the people of the world, at large, behave in such a rigid, sex-polarized and intolerant way. I've seen enough change in how we are regarded during the short course of my own lifetime to convince me that there's no reason or need to posit a built-in biological hatred for feminine males or masculine females.

And if that tolerance were to expand to the point that a feminine male person or a masculine female person were accepted and embraced from birth as a minority, a male girl or female boy or however you want to characterize that, and no longer regarded as 'wrong', just minority, then many more of us would opt to not transition -- in fact transitioning would be limited to those who specifically consider their body to be wrong, and not those who transition in order to be regarded and treated the way the opposite sex is treated, since being recognized and accepted as male girl / female boy would accomplish the latter without transition.




Quote:
It’s surely likely to be a combination of genetics and/or early non-social environmental factors.
* shrug * maybe, maybe not. There could be a genetic or congenital or non-social environmental reason that I have, for a lifetime, been inclined to perceive myself as being one of the girls (proudly), to behave in ways that others view as feminine, to be this way. If so, that has never made me want my body to be biologically female. If the reasons that propel the transitioning people to want to transition is the same difference, it has multiple expressions; if it's a different genetic (etc) difference, we've got multiple phenomena going on and shouldn't assume gender-variant behavior means one and doesn't mean the other. If only the transition-inclined people have a built-in genetic (etc) difference, then the rest of us, those not at odds with our physical morphology, are up against the socialization stuff only, and again, gender-variant behavior in children should not be viewed as indicative of the genetic version when it might be the other phenomenon.


Let's transform society and create space for those of us who don't wish to transition OR fake our identities, and see who still wants to transition. And make sure that those who wish to transition have access to the process without impediment.
  #129  
Old 10-17-2019, 10:00 AM
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Gender is, by definition, a social construct. Sex is what is biological; gender is what is social. That's the traditional definitive difference between the two terms.
Just to dive into a little etymology... not exactly. The terms are being separated into those two definitions now, but that is quite a recent thing - that usage is younger than I am - not a "traditional" thing, and in common English people still use "gender" to just mean "biological sex." Virtually any English dictionary will say "gender" can mean either the things attributed to a sex or can be just synonymous with sex.

The use of "gender" in the sense of distinguishing between sexes dated back to roughly the sixteenth century;; prior to that it generally meant "a group of like things," and is related the the Latin "genus." In the late nineteenth century it came into more common use to replace the word "sex" in usage not related to the erotic sense of "sex." So to almost any English-speaking person a hundred years ago, "gender" meant "sex." The concept of social constructs of gender wasn't really a thing they would have comprehended.

Of course gender also has a grammatical meaning too but that's not pertinent here.

Anyway, that's a nitpick. The rest of your post was very thoughtful and wise.
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  #130  
Old 10-17-2019, 10:47 AM
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AHunter3, not sure where your raising "a single built-in physical difference at the brain level" comes from. Spectrums of outcomes based on biological predispositions of multifactorial origins is usually how we think of complex behavioral phenotypes, not single items.

Be that as it may, how does your model of considering gender as a social construct apply to sexual orientation, which also has a spectrum and many with some fluidity, some clear biological predispositions, but more evidence for persistence from early childhood into adulthood than gender incongruence does?
  #131  
Old 10-17-2019, 11:00 AM
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Both good points, DSeid.

This, I think, needs to be said: the implicit, generally unspoken subtext of the "hey, it's built into the brain, it's biological" argument is "aww gee they can't help it so you have to excuse or forgive them and not hold it against them that they're like this".

And that's an attitude that slides right under my fingernails and pokes me sharply.

Fuck that shit. Why are our identities on trial?

And it's a false dichotomy. There's not "one of me" and outside of that my biology, my personal history, the events in my past that have shaped me, my genetics, etc, that are somehow "not me" but instead are responsible for how I am. Nope, it's all me.

I experienced myself as choosing, affirmatively, to behave in ways that were condemned by others as feminine. I experienced myself as choosing to embrace a sense of self as one of the girls. Now, you could ask "Well, could you have chosen otherwise and still been true to yourself? Could you have chosen otherwise without it being the choice to live a lie?", and I'd say "no". I could not have. But that's what I mean by saying it's a false dichotomy. Who I am and the choices that I have made are not separable things. And I'm not apologizing for any of it, nor crawling into the convenient shadows of some kind of biological-causative absolution as if I needed permission, forgiveness, or anything of the sort.


Having said that, yeah I suppose there's some knee-jerk elements to my reaction to the topic.
  #132  
Old 10-17-2019, 08:53 PM
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Gender is, by definition, a social construct. Sex is what is biological; gender is what is social. That's the traditional definitive difference between the two terms...
No, it's not, unless you buy into assumptions of postmodern social theory that are at odds with reality.

Biological sex is the physical body excluding the brain (to a biologist, part of the somatic phenotype); gender identity is part of your mental state, how you feel and act as a person (part of the behavioral phenotype). Both body and mind are determined by a combination of genetics and environment, with environment subdivided into social and non-social factors.

Now, of course the relative importance of nature vs nurture is a matter of great interest and controversy; but only if you adopt some ludicrous extreme version of the "blank slate" model of human behavior would you assume that there are no genetic factors influencing aspects of our mental state such as gender identity. Just as with all animals, virtually every aspect of what it means to be a human being is some combination of both genetics and environment.

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...At an absolute minimum, though, it remains true that transgender people may exist whose gender variance is not the consequence of anything biologically different in their brains...
Of course. Absolute genetic determinism is just as ludicrous as extreme forms of the "blank slate" model. Both genes and environment. It's not nature or nurture, it's always nature and nurture.

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...Given that wide range of variation, it is unlikely that a single built-in physical difference at the brain level is responsible for all of that..
Who said anything about a single genetic factor? Everything about us, both physically and mentally, is influenced by a huge number of complex genetic factors. The fact that some aspect of phenotype exists in a diverse spectrum is not evidence one way or the other about the relative importance of genetic vs environmental factors.

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Originally Posted by Riemann had said
Transgender people assert a gender identity that is in opposition to massive social pressure to adopt a cis identity, historically placing themselves at great risk of persecution and suffering. It’s hard to imagine how this could be a result of social conditioning.
To which you responded:

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Why? I have no difficulty believing that at all. Our culture has a massively unwelcoming and negative response to gender-atypical people (masculine female people and feminine male people), and that's on top of the social friction of being constantly assumed to be something that one is not (i.e., assumed to be a masculine male if one is male, assumes to be a feminine female if one is female).

One need not "assert" a gender identity in order to slam headlong into persecution and suffering. In the absence of coming out, of defining one's atypical gender identity, one has the limited choice of either faking one's persona so as to fit in among those of the same biological sex (profoundly uncomfortable, severe suffering) or expressing who one is more honestly and being regarded as "wrong" for one's sex.
I'm scratching my head at your reasoning here. What you've laid out is precisely why it's so implausible that being trans is a result of social conditioning. How do you imagine that social persecution would condition kids to adopt an LGBT identity? All the social conditioning I see kids being exposed to pushes them strongly to conform to "traditional" straight-cis-binary stereotypes. If our gender identity were entirely the result of social conditioning, i.e. our minds were infinitely malleable blank slates, why would LGBT people exist at all in a society that has historically rejected and persecuted them? Transgender (or any LGBT or non-binary) kids seem to be rebelling strongly against the social conditioning they are exposed to, historically making their lives far more difficult by doing so. That strongly implies that their identities are not infinitely malleable blank slates, that they cannot be comfortable with the straight-cis-binary identity that social conditioning tries to foist upon everyone from birth. It strongly implies significant contributions to gender identity from genetic factors and/or non-social environmental factors.
  #133  
Old 10-17-2019, 11:28 PM
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No, it's not, unless you buy into assumptions of postmodern social theory that are at odds with reality.

Biological sex is the physical body excluding the brain (to a biologist, part of the somatic phenotype); gender identity is part of your mental state, how you feel and act as a person (part of the behavioral phenotype). Both body and mind are determined by a combination of genetics and environment
possibly. Probably, even. OK I'll give you that.

Quote:
, with environment subdivided into social and non-social factors.

Now, of course the relative importance of nature vs nurture is a matter of great interest and controversy; but only if you adopt some ludicrous extreme version of the "blank slate" model of human behavior would you assume that there are no genetic factors influencing aspects of our mental state such as gender identity.
I am a sociologist-type academic kind of person. I'm not as extreme as what I was taught in college — that absolutely everything is social and nothing is intrinsic, and in fact I find that perspective oppressive — but I lean towards a social explanation first and foremost. Unless I see specific evidence of it, I tend not to assume built-in biological causes for observable differences.

Quote:
Of course. Absolute genetic determinism is just as ludicrous as extreme forms of the "blank slate" model. Both genes and environment. It's not nature or nurture, it's always nature and nurture.
Yeah, that's a good way to put it.



Quote:
What you've laid out is precisely why it's so implausible that being trans is a result of social conditioning. How do you imagine that social persecution would condition kids to adopt an LGBT identity?
You are treating the LGBT people as if they, and they alone, were the socially constructed particles in this interaction. I tend to think of the people constituting their social environment as socially constructed. (Individual variations may exist but when we're speaking of a person's social environment we're dealing with the aggregate, so I think I have stronger case for it). A person is gender-variant. It's the response of their social environment that makes it into a Thing. Otherwise it's of no more concern than being lefthanded in a righthanded-majority world.

Quote:
All the social conditioning I see kids being exposed to pushes them strongly to conform to "traditional" straight-cis-binary stereotypes. If our gender identity were entirely the result of social conditioning, i.e. our minds were infinitely malleable blank slates, why would LGBT people exist at all in a society that has historically rejected and persecuted them?
I've never for a moment believed we were blank slates. I've occasionally believed that the true nature of people is at odds with the oppressively imposed definitions of masculine and feminine, though. The first level of socialized forces acting upon a person tries to shoehorn them into masculinity, if male, or femininity, if female. If that doesn't "take" the next level of socialized forces marginalizes them as wrong and weird and establishes a stereotype about feminine males and masculine females.


I am one. I am a sissy-femme girlish male person.
  #134  
Old 10-18-2019, 12:32 AM
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The risks of GnRF analogue treatment are non-zero but small while the harms of allowing puberty to proceed at that point, at an age that a child cannot be reasonably expected to be competent to make a decision of such life-long import, are very sizable.

I'm no expert and haven't done a full literature review ... but these people are experts and have.
There has been more research brought to light recently. Most significantly, Michael Biggs, a professor at Oxford, has analyzed results from a study done by Gender Identity Development Service (GIDS), the service in NHS focused on treating transgender youth. His full academic write-up of the results can be found here, a summary for the public is here. Concerning the actual effects of puberty blockers on mental health:
It tracks 30 of the children on triptorelin, measuring changes after one year of the drug regime; presumably the remaining 14 subjects had not completed their first year on the drug. The text is sometimes internally inconsistent and occasionally contradicts the tabulated figures, suggesting that the appendix was prepared in haste. But we can summarize those changes that were reported as statistically significant (p-value < .05). Only one change was positive: “according to their parents, the young people experience less internalizing behavioural problems” (as measured by the Child Behavior Checklist). There were three negative changes. “Natal girls showed a significant increase in behavioural and emotional problems”, according to their parents (also from the Child Behavior Checklist, contradicting the only positive result). One dimension of the Health Related Quality of Life scale, completed by parents, “showed a significant decrease in Physical well-being of their child”. What is most disturbing is that “a significant increase was found in the first item ‘I deliberately try to hurt or kill self’” (in the Youth Self Report questionnaire). Astonishingly, the increased risk of self-harm attracted no comment in Carmichael’s report. Given that puberty blockers are prescribed to treat gender dysphoria, it is paradoxical that “the suppression of puberty does not impact positively on the experience of gender dysphoria” (measured by the Body Image Scale).
...
For the children who commenced the blocker, feeling happier and more confident with their gender identity was a dominant theme that emerged during the semi-structured interviews at 6 months. However, the quantitative outcomes for these children at 1 years time suggest that they also continue to report an increase in internalising problems and body dissatisfaction, especially natal girls.
...
Expectations of improvement in functioning and relief of the dysphoria are not as extensive as anticipated, and psychometric indices do not always improve nor does the prevalence of measures of disturbance such as deliberate self harm improve.
So the results show that puberty blockers increased suicidal thoughts by at least one measure and did not consistently help patients with gender dysphoria. This clearly undermines the whole justification for using puberty blockers.
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Old 10-18-2019, 01:11 AM
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I am a sociologist-type academic kind of person. I'm not as extreme as what I was taught in college — that absolutely everything is social and nothing is intrinsic, and in fact I find that perspective oppressive — but I lean towards a social explanation first and foremost. Unless I see specific evidence of it, I tend not to assume built-in biological causes for observable differences...
And acknowledging that you've also said:

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I've never for a moment believed we were blank slates.
Much of modern social science is not science, it's ideologically motivated, and never tested against reality. And nobody has ever proposed a credible explanation of how humans, unlike all other animals including all our ancestors in the tree of life, at some point in evolution mysteriously lost all instinctive behaviors and evolved blank-slate brains without any firmware. I think the only sensible null hypothesis is that both genes and environment are significant contributors to most aspects of what we are, absent strong evidence that one or other dominates.

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You are treating the LGBT people as if they, and they alone, were the socially constructed particles in this interaction...
I'm not sure what you mean by this and the subsequent paragraph, but I'm discussing to what extent gender identity in general is genetically vs socially determined. But it's LGBT people who provide some evidence on the question, because they appear to be examples of gender identities that persist in opposition to strong social conditioning.

Last edited by Riemann; 10-18-2019 at 01:12 AM.
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Old 10-18-2019, 02:20 AM
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That phrase is commonly used to trivialize the experience of transgender youth. But you're right, I don't think you meant it that way, and I shouldn't have lumped you in with the others, even indirectly. I apologize.


I'm not an expert on young children, so take this for what it's worth. But I think treating it like pretend play is fine at that age initially (I assume that means you support and encourage imagination, not telling them "quit being silly"). Think of it as helping the child explore what gender means, not making a decision.

If it continues (remember - persistent, consistent, and insistent), then you can involve the parents and determine if a more formal social transition is appropriate.
Thanks. I guess this 'insistent, persistent, consistent' part is an important part.
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Yep. You use a person's preferred pronoun. It can change. There's nothing wrong or Earth shattering a out that, and is the norm where I live.
Interesting, thanks.
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Old 10-18-2019, 09:02 AM
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There has been more research brought to light recently. ...
I clicked the first link expecting to see some actual research link. Foolish me.

No ITR an individual sociology professor making (verbose) accusations of a cover up by the expert medical bodies is not something I will bother wading through.

There are areas that I will try to be the expert on, areas in which I will do the comprehensive full literature review myself, weighing the complete body of evidence critically, sometimes coming to a different conclusion than expert panels have. This is not one of them.

As more evidence comes in over years of experience the expert medical panels will review the complete body of evidence inclusive of it. I for one will defer to their conclusions over the conspiracy rantings of individual sociology professors. Now and when they revise in the face of new data if they do. YMMV.

Expert panel review and conclusions were shared FWIW. Place the "worth" value of it vs individual rantings where you feel is appropriate.
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Old 10-18-2019, 09:31 AM
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...
I'm not sure what you mean by this and the subsequent paragraph, but I'm discussing to what extent gender identity in general is genetically vs socially determined. But it's LGBT people who provide some evidence on the question, because they appear to be examples of gender identities that persist in opposition to strong social conditioning.
A genetic predisposition towards gender is not like a genetic predisposition towards being tall or having red hair. It (if it exists) is more like a genetic predisposition towards the characteristics that would make one an excellent jet pilot or an exceptional oil painter: nobody in the absence of social learning could ever identify as a "born jet pilot" or "born artist". We learn through social interaction what those things are. None of our paleolithic ancestors thought of themselves as "born jet pilots" because the concept didn't exist.

Hence, LGBTQIetc people do not, in fact, have identities that "persist in opposition to strong social conditioning", or at least that's a misleading way of looking at it; we position ourselves and reach our sense of our own identities against a backdrop of identities discernable to us. Same as cis hetero people.

Certainly the reason that Individual A comes to think of himself as a "him", and as attracted to the people he categorizes as "her" type people, may have built-in biological components. (On the other hand, there may NOT be any such built-in differences setting him apart from Individual B of the same morphological body structure who reaches different self-evaluations; we do not know for sure. But there certainly CAN be).

What we do know for absolute ironclad fact is that for both Individual A and Individual B, the process of identifying is very much a socially immersed one.
  #139  
Old 10-18-2019, 10:38 AM
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A genetic predisposition towards gender is not like a genetic predisposition towards being tall or having red hair. It (if it exists) is more like a genetic predisposition towards the characteristics that would make one an excellent jet pilot or an exceptional oil painter: nobody in the absence of social learning could ever identify as a "born jet pilot" or "born artist". We learn through social interaction what those things are. None of our paleolithic ancestors thought of themselves as "born jet pilots" because the concept didn't exist...
Sure, but in considering the contributions of genetics vs environment this is a really a distinction without a difference. If we say that someone has a genetic predisposition toward some trait, that always requires that we specify a set of environmental conditions in which that trait is manifest. The fact that a trait may be a complex result of many factors, or may be manifest at all only in environmental conditions which did not exist for our ancestors, doesn't mean it can't be genetic. The question is still: among individuals exposed to identical environmental conditions, is there variation in the trait that's attributable to variation in genotype?

Last edited by Riemann; 10-18-2019 at 10:41 AM.
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Old 10-18-2019, 10:42 AM
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For something as complicated as gender identity and sexual attraction pattern (which incorporates not just the either-or of "do you find male people hot or female people hot?" but all the different inclinations and tastes and preferences woven into what is or is not hot, or even what hotness itself is actually like), I don't think there are any two individuals who have been exposed to identical environmental conditions.

You'd have to rewind and replay the entirety of Joan's experience for Jill in order to expose Jill to the identical environmental conditions in which Joan's identity and preferences emerged.
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Old 10-18-2019, 12:56 PM
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For something as complicated as gender identity and sexual attraction pattern....I don't think there are any two individuals who have been exposed to identical environmental conditions.
Of course not. I wasn't suggesting that any two humans actually exist in practice in precisely identical environmental conditions. I was describing the theoretical model for how we think about relative contributions to some effect when many factors are involved.

Think about health outcomes, which are an equally complex result of many factors. In a similar way, no two humans are exposed to precisely the same environmental conditions in terms of lifestyle - nutrition, exercise, exposure to toxins, etc. Does that complexity imply that there cannot be a significant genetic contribution to the probability of (say) getting cancer?

You seem to think that if something is complex, that implies there can't be a significant genetic contribution. That's wrong. If somebody were suggesting absolute genetic determinism, then "it's more complicated than that" would be a valid rebuttal. But that's a straw man, nobody who knows anything about genetics would ever claim that something as complex as human personality is determined completely by genetics. It's genetics and environment. The kind of question we're likely to be asking is whether genetics explains (say) more like 10% or 30% or 50% of the variation in some trait. In that case, the fact that the trait is the complex result of many factors doesn't mean much in itself. It does mean it may be much more difficult to control for those many factors and prove the relationship, but it doesn't imply anything about the size of the genetic contribution.

Last edited by Riemann; 10-18-2019 at 01:01 PM.
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Old 10-18-2019, 01:32 PM
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The related issue here is the question of why you (and many people in the social sciences) seem to think that it's a problem if there is a significant genetic contribution to human behavior, and have an ideological agenda to resist the idea.

Obviously I can see the motivation in some situations. If a trait is something desirable - intelligence is the obvious example - then it's of great concern and has social implications if certain subsets of humans have differing genetic predispositions for the trait.

But gender identity or sexual preference are not aspects of personality where one part of the spectrum is "good" and one part is "bad", except of course to bigots (and that bigotry is all social conditioning). The immense diversity in gender identity is all part of the natural variation in human nature, and it's not clear to me why it's a problem if the genetic contribution is significant.

If gender identity and sexual preference were completely a result of social conditioning, that seems to me far more problematic. For example, it creates a justification for the notion of conversion "therapy". If identity and preference are entirely the result of social conditioning, then in principle social conditioning could change them. Perhaps (with Jeebus' help!) we really could change LGBT people into non-LGBT people. And there isn't any definitive rebuttal to the misguided notion stated in the OP to this thread that a child exploring their gender identity is qualitatively similar to a child fantasizing about being a dog. If our minds are blank slates and genetics doesn't matter at all, then why can't someone really be a dog in the same way that a trans woman really is a woman?

Last edited by Riemann; 10-18-2019 at 01:36 PM.
  #143  
Old 10-18-2019, 03:30 PM
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You seem to think that if something is complex, that implies there can't be a significant genetic contribution.
No, I don't think I believe that or anything like that. **stops to consider for a few beats**

In general, for each and every human behavior, I would say there is always a built-in component (which may consist of not merely one but a whole horde of genetic markers, and also non-genetic built-ins such as factors that are simply intrinsic to being indivdually intelligent social beings or some such thing).

But for many human behaviors, human social learning is involved, which means that what we're seeing is how those intrinsic built-in factors manifest under certain select social circumstances.

I think you're fully with me on that so far. (Correct me if not).

OK, now, here's where I seem to be expressing myself unclearly, and confusingly...

In many cases (or so I am positing for consideration), there's a sort of sensitive dependence on precise social circumstances (to borrow from the world of nonlinear causality in physics) -- where the same built-in factors result in a wide range of resultant behaviors that vary all over the map as a consequence of minor differences in the social experience of the individual in question.

Did that assertion make more sense than my garbled way of saying it previously?

And would you sign on in agreement with it, or do you stand in disagreement with me there?

So, finally, I am asserting that a lot of gender and sexuality identities and expressions are likely to be in that latter category. I only know this anecdotally and from personal experience interpretation, but I'm pretty confident in saying so, nevertheless.



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The related issue here is the question of why you (and many people in the social sciences) seem to think that it's a problem if there is a significant genetic contribution to human behavior, and have an ideological agenda to resist the idea.
Oh, I'm equally opposed to the hard-line social sciences assertion that absolutely all human behavior is the outcome of socialization -- that we have no core nature, that we are born as blank slates and that every observable human behavior is the outcome of what we've been socially exposed to.

And I've compared the arguments that occur between the two extremes to two people arguing how much of the damn swimming pool's volume is due to its length, and how much to its width, and I've often felt like neither side has much understanding of depth. If you catch my drift.


And, to answer the remainder of your question, I don't think I'm very much inclined to adopt a position on something factual in nature just because I like what that position would let me go on to argue if it were indeed true. Quite the opposite. As I've said previously, I think a lot of the impetus to have us all 'believe' that LGBTQ identities and inclinations are built in is exactly that, that people like what they think it lets them go on to say next if it's true: "You can't go around blaming people for being gay or trans if they're born that way, you can't say it's a sin or immoral cuz they can't help it!"

I'll admit that probably prompts a little bit of reactive knee-jerk antipathy on my part, but really I'm aware that yes it could be built-in, or some aspect of it could be at any rate. I don't claim to know. What I do claim is that it doesn't fail to make rational sense that it could be otherwise. It does.

And as I said before, I am uninclined to reach for a "built-in" explanation for a difference as a default belief when I don't know one way or the other.

I'll quote the brilliant Elizabeth Janeway on that one (speaking on the subject of gender differences at the time):

Quote:
Originally Posted by Elizabeth Janeway
If we limit ourselves to what we know for sure about built-in differences between the sexes, all we can say is that their existence is an unresolvable hypothesis. What we can say furthermore is that the workings of society and culture, by themselves, are sufficient to produce the differences between the sexes that we know so well without any need to posit innate differences in the brain, and in my opinion, they have

Quote:
If gender identity and sexual preference were completely a result of social conditioning, that seems to me far more problematic. For example, it creates a justification for the notion of conversion "therapy". If identity and preference are entirely the result of social conditioning, then in principle social conditioning could change them. Perhaps (with Jeebus' help!) we really could change LGBT people into non-LGBT people.
Or vice versa. We could convert all the annoying Christians into Satanists while we're at it.

A theory that all of what's inside our heads is conditioned to be there and that there's no intrinsic factor that prefers something because it's genuinely better (for us personally) also leaves us all with no ability to claim superiority for any of our beliefs, let alone any of our tastes and preferences.

Just as I won't embrace the "built in" theory on the basis of what it will then allow me to go on to say, I wont' dismiss the "socially constructed" theory on the basis of the horrible things it would let someone else go on to say. It's intellectually dishonest either way.

I dismiss both of those theories because I actually think they're both wrong. I think it's all a complex interaction of social and innate factors. The innate factors may or may not differ in a specific polarized way between gay and straight or between trans and cis but that doesn't mean there are no innate factors at work here. Blank slate theories ultimately leave one unable to explain why we seek happiness or avoid pain: if everything's socialized then we'd have to be socialized to consider pain unpleasant, we'd have to be socialized to consider happiness a good thing. And if that were the case, how the hell does socialization occur then? Of what would its rewards and punishments be composed if nothing is intrinsic, if nothing is built in?


Quote:
And there isn't any definitive rebuttal to the misguided notion stated in the OP to this thread that a child exploring their gender identity is qualitatively similar to a child fantasizing about being a dog. If our minds are blank slates and genetics doesn't matter at all, then why can't someone really be a dog in the same way that a trans woman really is a woman?
The OPs question, like the "I identify as an attack helicopter" thing that's been floating around, is mostly a mockery of transgender experiences. But I can give good-faith consideration to an idea tossed out in bad faith.

How would one know that one "is" a dog? One would have to have extrapolated from external observation of what dogs' internal lives are (probably) like and then concluded that one's own internal life is more like that than akin to the internal lives of (other) people. One also has to extrapolate what other people's internal lives are in fact like -- never having been any other person. The difficulty with getting to the internal life of a dog is that they aren't very talkative; I don't find it easy to believe that even the pet owners who "speak for their pets" and think they read their pets' minds really know what the dog feels and thinks and how it imagines things and so forth. But despite all these barriers I suppose it could happen that someone actually has an identity wherein they have more in common, at the fundamental-self level, with dogs than with the rest of the species human.

I'd have a lot of curious and skeptical questions about how this transdog would communicate this sense of identity to me or anyone else though. Hopefully not by trying to hump my leg.

Being transgender is more easily grasped conceptually. It's far easier to accept that someone has realized that their self has more in common with the self of people born of the opposite sex, although yes they have to extrapolate from external observations both of the opposite-sex people AND of others of their own sex in order to derive that sense of understanding of self. But people of our species write and talk and sing about what it is like to be us and that makes it accessible in a way that the inner life of a dog kind of isn't , if you see what I mean.
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Old 10-18-2019, 06:41 PM
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...non-genetic built-ins...
All I can imagine you might mean by this is factors that are not genetic, but are not malleable to social conditioning. That would mean early non-social environmental factors, for example the intrauterine environment. If that's not what you mean, you have to explain what a "non-genetic built-in" is.

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...In many cases...the same built-in factors result in a wide range of resultant behaviors that vary all over the map...I only know this anecdotally and from personal experience interpretation, but I'm pretty confident in saying so, nevertheless.
[My bold] This is simply a claim about the relative size of the contribution of genetics vs social environment to the variance in gender identity. But no, that's really not something anybody could conceivably judge through personal experience, unless you have a close personal relationship with a large number of pairs of identical twins. You observe a lot of subtle variation, sure - but you cannot possibly know its cause. Again, the existence of complexity and extensive variation implies nothing in itself about the size of the contribution from genetics vs environment.

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I'll quote the brilliant Elizabeth Janeway on that one (speaking on the subject of gender differences at the time):

Quote:
Originally Posted by Elizabeth Janeway
If we limit ourselves to what we know for sure about built-in differences between the sexes, all we can say is that their existence is an unresolvable hypothesis. What we can say furthermore is that the workings of society and culture, by themselves, are sufficient to produce the differences between the sexes that we know so well without any need to posit innate differences in the brain, and in my opinion, they have
I'm not sure why you think this is brilliant. It just makes explicit her ideological bias. Why is any genetic contribution an "unresolvable hypothesis" with an apparently arbitrarily high standard of proof, whereas we can assume without evidence that social conditioning is sufficient to explain 100% of the variance?

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...The OPs question, like the "I identify as an attack helicopter" thing that's been floating around, is mostly a mockery of transgender experiences...
Of course, but with the correct non-blank-slate model for brain development there's a straightforward rebuttal to show how this type of slippery slope mockery is nonsense. We can also addresses the scientifically ignorant trope that it's "basic biology" that you can only possibly have a cis gender identity, and that trans people must be fantasists or something. All humans (XX and XY) have virtually identical sets of genes. There's very little on the Y except some high-level triggers that influence the expression of other downstream genes that we all possess (on X or the autosomes) that do the actual construction work. So people of either biological sex possess all the necessary genes to make a brain with a male identity or a female identity, it's just a question of when and if those genes are switched on. So it's perfectly plausible that a significant minority of people could have a male body but some or all aspects of a female brain, or vice versa. But human genes will only ever make a human brain of some kind, they can't possibly make a doggy brain - that requires doggy genes. If someone describes their gender identity as something within the range of human variation - which includes trans and non-binary, of course - that's something objectively true. The fact that the only way to know someone's neuron configuration is to talk to them doesn't make it any less objectively real than their genitalia. But if someone says they have a doggy brain - well, that's not real. That may be the way they feel, and if a furry wants to be treated as a non-human animal, I have no problem respecting that. But they certainly don't really have a doggy brain in the same way that a trans woman has a human woman's brain.

Last edited by Riemann; 10-18-2019 at 06:43 PM.
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