Autistic girls seeking answers ‘are seizing on sex change’

[Playball40]

interesting clip from Ibram Kendi, which I think makes sense:

https://twitter.com/robbysoave/status/1357772964247306242

There should be a way to gently figure out the reasons why a girl like his daughter would make such a statement - without putting a thumb on the scale either way.

The easiest way to solve these problems is, in my particular opinion, to not actually press assumptions of gender on your children and let them come to their own conclusions on the matter.

As it is, my husband and I are totally planning a big gender reveal party where the reveal is something along the lines of "LOL, we have no idea and what is in their pants is none of your business!"

Our goal, if kids are in the cards, is to let them make their own damn decisions about who they are, what toys/peers to play with, and to protect their privacy from those who would foist their assumptions on them.

This is so much easier to do in theory. Still, the culture is moving in the right direction and I hope someday we can stop pigeon holding genders.

 

[Playball40]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?


Puberty blockers do have long-term effects, even if taken for a relatively short time. In both male and female children, bone density fails to accrete while puberty is blocked, as that increase in density occurs as part of puberty. Once removed from blockers, that density increase doesn't occur at the same rate, and the long-term effect is lower bone density. The most commonly used blocker for females is Lupron. I had to take Lupron prior to a surgery once, as an adult. My doctor was extremely clear that he wanted me to take it for no more than three months, because of the risk to bone density and other potential long-term complications. Another side effect of puberty blockers is that they also block the cognitive maturation that would be needed to make an informed decision in the first place. I suppose if you only took cross-sex hormones for a couple of weeks, one might consider that "reversible". But once facial hair is triggered to grow by testosterone, those follicles don't disappear. Once breast tissue forms due to estrogen, they don't just evaporate.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.

Sure. That's the point though - those other conditions are NOT being treated.

You are describing HRT (transition hormones) and not puberty blockers. And any person that would ignore treating an ED is not a doctor as it has the highest mortality rate of ANY MENTAL HEALTH disorder.

 

[Playball40]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?


Puberty blockers do have long-term effects, even if taken for a relatively short time. In both male and female children, bone density fails to accrete while puberty is blocked, as that increase in density occurs as part of puberty. Once removed from blockers, that density increase doesn't occur at the same rate, and the long-term effect is lower bone density. The most commonly used blocker for females is Lupron. I had to take Lupron prior to a surgery once, as an adult. My doctor was extremely clear that he wanted me to take it for no more than three months, because of the risk to bone density and other potential long-term complications. Another side effect of puberty blockers is that they also block the cognitive maturation that would be needed to make an informed decision in the first place. I suppose if you only took cross-sex hormones for a couple of weeks, one might consider that "reversible". But once facial hair is triggered to grow by testosterone, those follicles don't disappear. Once breast tissue forms due to estrogen, they don't just evaporate.

Third, the connection between eating disorders, gender dysphoria and autism is already well-documented. You cannot "treat" one and ignore the other as that's just not how it works. That said, getting someone with an ED medically stable is the first priority - as psychotherapy cannot and will not work on a starving brain.

Sure. That's the point though - those other conditions are NOT being treated.

To date there is not 'clinical' way to diagnose any anxiety. It is diagnosed by symptoms and thoughts. This is the same for gender dysphoria. A doctor can and do diagnose it. I have to ask, would you tell someone suffering from panic attacks that they aren't REALLY anxious? Why would you tell someone with gender dysphoria they aren't REALLY transgender?

 

[Jokodo]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?

Did you read what you were replying to? Here it is again, the last 2/3 of a sentence repeated: "[W]hether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young)." - so the other person you were ostensibly replying to already said that the decision should involve a doctor - just not a judge.

Do you know of other examples of a condition that's diagnosed by judges?

 

[Emily Lake]

You are describing HRT (transition hormones) and not puberty blockers. And any person that would ignore treating an ED is not a doctor as it has the highest mortality rate of ANY MENTAL HEALTH disorder.

Actually, I was describing both. Puberty blockers have effects too - lack of accretion of bone density leading to lower long term density, delay in cognitive maturation.

You're right, anyone who is ignoring the ED is not doing a very good job. What appears to be happening, however, is that clinicians who specialize in gender identity are assuming that the eating disorder is caused by dysphoria, and are moving directly to prescribe puberty blockers and/or cross sex hormones. Those doctors deal with gender identity issues, not with anything else, and they are affirming the dysphoria and are not treating the other issues. They're not even slowing down enough to determine whether the dysphoria is the result of a different problem, and whether addressing that other problem alleviates the dysphoria.

 

[Emily Lake]

To date there is not 'clinical' way to diagnose any anxiety. It is diagnosed by symptoms and thoughts. This is the same for gender dysphoria. A doctor can and do diagnose it. I have to ask, would you tell someone suffering from panic attacks that they aren't REALLY anxious? Why would you tell someone with gender dysphoria they aren't REALLY transgender?

I'm not saying that the anxiety isn't real. But if a person comes in complaining about anxiety because they are fat... I might dig in on their self-perception, especially if they are not overweight. If a person comes in experiencing anxiety and attributes it to being uncomfortable with their sexed body... It seems like it might be a good idea to determine whether their body is the problem in the first place before moving directly to puberty blockers.

 

[Emily Lake]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?

Did you read what you were replying to? Here it is again, the last 2/3 of a sentence repeated: "[W]hether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young)." - so the other person you were ostensibly replying to already said that the decision should involve a doctor - just not a judge.

Do you know of other examples of a condition that's diagnosed by judges?

The judge gets involved only in cases where the patient is a minor, because minors are not considered cognitively capable of giving consent to a medical treatment that has permanent long-term repercussions... and because the doctors have been doing a shitty job.

 

[repoman]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?

Did you read what you were replying to? Here it is again, the last 2/3 of a sentence repeated: "[W]hether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young)." - so the other person you were ostensibly replying to already said that the decision should involve a doctor - just not a judge.

Do you know of other examples of a condition that's diagnosed by judges?

The judge gets involved only in cases where the patient is a minor, because minors are not considered cognitively capable of giving consent to a medical treatment that has permanent long-term repercussions... and because the doctors have been doing a shitty job.

It only takes one doctor to say yes to treatment.

 

[Playball40]

You are describing HRT (transition hormones) and not puberty blockers. And any person that would ignore treating an ED is not a doctor as it has the highest mortality rate of ANY MENTAL HEALTH disorder.

Actually, I was describing both. Puberty blockers have effects too - lack of accretion of bone density leading to lower long term density, delay in cognitive maturation.

You're right, anyone who is ignoring the ED is not doing a very good job. What appears to be happening, however, is that clinicians who specialize in gender identity are assuming that the eating disorder is caused by dysphoria, and are moving directly to prescribe puberty blockers and/or cross sex hormones. Those doctors deal with gender identity issues, not with anything else, and they are affirming the dysphoria and are not treating the other issues. They're not even slowing down enough to determine whether the dysphoria is the result of a different problem, and whether addressing that other problem alleviates the dysphoria.

You do know that anorexia has the EXACT SAME side effects (and is likely to kill you if left untreated). Puberty blockers are a short term solution (with RARE to the point of non-existent, long term issues) but will not get prescribed to a starving body/brain by any reputable doctor, nor should any parent allow it without doing their research. And please don't school me in PB as I've spent the last six+ years dealing with both anorexia, body dysmorphia, anxiety/depression and gender dysphoria with my son. This isn't 'theoretical' for my family or my child.

 

[Emily Lake]

For consideration...

https://www.newsweek.com/we-need-balance-when-it-comes-gender-dysphoric-kids-i-would-know-opinion-1567277

 

[Jokodo]

Are there other conditions that we allow the patient to diagnose, and which a doctor is not allowed to question?

Did you read what you were replying to? Here it is again, the last 2/3 of a sentence repeated: "[W]hether one is transgendered or not and that is not for you or a judge to decided. That is for the individual (with assistance from their doctor and parents if they are young)." - so the other person you were ostensibly replying to already said that the decision should involve a doctor - just not a judge.

Do you know of other examples of a condition that's diagnosed by judges?

The judge gets involved only in cases where the patient is a minor, because minors are not considered cognitively capable of giving consent to a medical treatment that has permanent long-term repercussions... and because the doctors have been doing a shitty job.

I don't think it's generally good ideas to let judges do the job of doctors because activists claim who are not doctors reject the doctors findings because common sense. That's kind of the same logic that leads to things like the anti-vax movement.

 

[Jarhyn]

The judge gets involved only in cases where the patient is a minor, because minors are not considered cognitively capable of giving consent to a medical treatment that has permanent long-term repercussions... and because the doctors have been doing a shitty job.

I don't think it's generally good ideas to let judges do the job of doctors because activists claim who are not doctors reject the doctors findings because common sense. That's kind of the same logic that leads to things like the anti-vax movement.

And then comes the philosophical angle, which for some reason (I can't possibly imagine what that is*...) supports the same conclusions.

This model states that everyone will go through those "permanent, long term reprucussuons" anyway... okay, almost everyone, full Testosterone resistance in the absence of estrogen and cross-sex imposition will not experience puberty, and neither will eunuchs who don't seek or have access to hormones.

Let's take a moment to consider here. It might take some hypotheticals to clear out some of the cultural assumptions that a lot of us are going to make on the subject.

Imagine a world, this one, where tomorrow a terrible virus rips through our species. This virus has the fundamental effect of disabling everyone's ability to produce sex hormones, forever (let's assume the DHT bit in the womb still works, because it's mechanisms are a little different).

Now, *every* puberty requires intervention to start.

Are minors cognitively capable of consenting to this treatment that has permanent long-term reprucussuons? Are we ethically justified rejecting what is now clearly a necessary choice over which treatment they get?

The fact is, nobody who experiences puberty is technically in a position to meaningfully consent to what DOES happen to them, but nowadays they don't even get a choice, and Emily would see that they never do.

I would much rather see people have a choice and a rite of passage than see people denied choice over who they will be as adults. The reality is that most people are just fine with wanting to be a "grown up", and with the help and guidance of those around them may decide how to accomplish that up-growing.


*I lied, it's because models tend to converge on correctness.

 

[Emily Lake]

The fact is, nobody who experiences puberty is technically in a position to meaningfully consent to what DOES happen to them, but nowadays they don't even get a choice, and Emily would see that they never do.

To be fair, Emily also doesn't think that a fetus has the right to decide that they don't want to be born, on the basis of them not having consented to being born. I also think it's ridiculous to think that children have a right to object to their hair color because they didn't consent to being blond. Nor do kids have a leg to stand on when they want to lop off an arm because they didn't consent to being born with two arms.

Nobody "consents" to objective fucking reality. What is, is.

 

[Jarhyn]

The fact is, nobody who experiences puberty is technically in a position to meaningfully consent to what DOES happen to them, but nowadays they don't even get a choice, and Emily would see that they never do.

To be fair, Emily also doesn't think that a fetus has the right to decide that they don't want to be born, on the basis of them not having consented to being born. I also think it's ridiculous to think that children have a right to object to their hair color because they didn't consent to being blond. Nor do kids have a leg to stand on when they want to lop off an arm because they didn't consent to being born with two arms.

Nobody "consents" to objective fucking reality. What is, is.

LOL, but they totally do have such a right. Exercising that right is a huge industry (hair dyes). Not to mention that they are not permanently blocked from changing it at any point.

The fact is, I can always later chop my arm off, once I am an adult. I can't decide to have not grown an adam's apple.

These are not the same situation.

In fact fetuses eventually get the right to decide to not exist, too. Plenty of people make that decision every year.

The question is about timing. All these decisions you foolishly claim people ought not have they DO have and CAN make at any point once they are adults. Puberty? Not so much. The only way to make that decision as a mentally matured individual is to take blockers. And you scream and moan about that, too.