… [Hanging] trans rights on the thin peg of gender identity, a concept clumsily adapted from psychiatry and strongly influenced by both gender studies and the born-this-way tactics of the campaign for marriage equality [was a mistake]. [It] has won us modest gains at the level of social acceptance. But we have largely failed to form a coherent moral account of why someone’s gender identity should justify the actual biological interventions that make up gender-affirming care. If gender really is an all-encompassing structure of social norms that produces the illusion of sex, critics ask, why would the affirmation of someone’s gender identity entail a change to their biology? As a result, advocates have fallen back on the clinical diagnosis of gender dysphoria, known until about a decade ago as gender identity disorder, defined as the distress felt at the incongruence of gender identity and biological sex. The idea that trans people fundamentally suffer from a mental illness has long been used by psychiatrists to decide who “qualifies” for transition-related care and who does not. By insisting on the medical validity of the diagnosis, progressives have reduced the question of justice to a question of who has the appropriate disease. In so doing, they have given the anti-trans movement a powerful tool for systematically pathologizing trans kids.

We will never be able to defend the rights of transgender kids until we understand them purely on their own terms: as full members of society who would like to change their sex. It does not matter where this desire comes from. When the TARL [(trans-agnostic reactionary liberal)] insinuates again and again that the sudden increase of trans-identified youth is “unexplained,” he is trying to bait us into thinking trans rights lie just on the other side of a good explanation. But any model of where trans people “come from” — any at all — is a model that by default calls into question the care of anyone who does not meet its etiological profile. This is as true of the old psychiatric hypothesis that transsexuality resulted from in utero exposure to maternal sex hormones as it is of the well-meaning but misguided search for the genes that “cause” gender incongruence. It is most certainly true of the current model of gender identity as “consistent, insistent, and persistent,” as LGBTQ+ advocates like to say. At best, these theories give us a brief respite from the hail of delegitimizing attacks; they will never save us. We must be prepared to defend the idea that, in principle, everyone should have access to sex-changing medical care, regardless of age, gender identity, social environment, or psychiatric history. This may strike you as a vertiginous task. The good news is that millions of people already believe it.

Archived at https://web.archive.org/web/20240312105306/https://nymag.com/intelligencer/article/trans-rights-biological-sex-gender-judith-butler.html

    • Jordan_U@lemmy.ml
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      8 months ago

      Puberty is irreversible.

      Going through the wrong puberty can (and frequently does) lead to suicide.

      Suicide is also irreversible.

      Puberty blockers allow children to delay puberty so that they can decide which puberty they would like to have.

      • trashgirlfriend@lemmy.world
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        8 months ago

        Cis people love to do polemics about “what if they end up going through the wrong puberty!!!” ignoring that this is literally what you’re forcing trans kids to go through

        • fidodo@lemmy.world
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          8 months ago

          It’s also pretty condescending to assume that the community hasn’t already spent way more time thinking about how to deal with such a complex problem that effects them so much.

          It’s always best to ask questions first before jumping to conclusions.

    • fidodo@lemmy.world
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      8 months ago

      That’s why the first thing they’re given are puberty blockers to give them more time to make such an incredibly important decision. If the permanent effects of being given hormones for the wrong sex is so damaging and severe, it goes both ways. The permanent effects of doing nothing and becoming the wrong gender is just as bad as if you made a mistake and we’re given the wrong hormones.

      I think the policy of delaying it is the right choice. That gives more time to provide mental health treatment and provide as much assurance that they’re making the right choice to live their lives in the body they feel most comfortable in. I assure you, everyone is acutely aware of the repercussions and permanence of making the wrong decision which is why time is prioritized over providing hormone treatment early.

      Conservatives trying to ban all trans care including puberty blockers, and taking away that time I view as equally as bad as forcing a child to take the wrong hormone drugs.

      No offense, but you should ask these questions first before assuming that the community that is so affected by these problems and have spent a ton of time thinking about it and considering options hasn’t already explored the problem in detail already. Your concerns are valid, but you should ask how these problems are being dealt with instead of assuming they aren’t being dealt with.

      • Tarquinn2049@lemmy.world
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        8 months ago

        I agree, hold off puberty until they are sure they want the one that would irreversibly happen without intervention.

      • OurToothbrush@lemmy.ml
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        8 months ago

        Giving every single cis and trans child puberty blockers seems kinda unethical, also what about people who are never self-sufficient? Do they just not get to go through puberty? Isn’t that dangerous?

      • chetradley@lemmy.world
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        8 months ago

        It sounds simple on the surface, but I struggle with weighing the risk of prescribing gender-affirming care to someone who will regret it later in life and forcing someone to endure puberty that they will regret later in life. A strong case can be made that some kids will identify as transgender due to childhood trauma or neurodivergence. It’s also undeniable that there are hundreds of thousands of people who regret going through puberty that doesn’t match their gender. I’d be curious to see statistical data about these groups to truly measure the risks on either side. There’s also an interesting study of neuroanatomy in trans women showing strong similarities to cisgender women. I wonder if this data can be used to help mitigate the potential risks of gender-affirming care?

        • Nikki@lemmy.world
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          8 months ago

          puberty blockers =/= horemone therapy

          they are reversable, and give time for trans kids to sort out any hesitancy towards transition without going through either puberty. so many people think that the idea lf puberty blockers is to give kids e/t when its just to give ghe kids time to discover themselves

          • chetradley@lemmy.world
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            8 months ago

            Do puberty blockers fall under the classification of gender affirming care, or is only hormone therapy and surgery? Perhaps I was incorrect.

            • Nikki@lemmy.world
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              8 months ago

              they can, but arent exclusive to gender affirming care. in most cases, kids arent getting hormone therapy, theyre getting blockers until they get older

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                8 months ago

                Ok that’s what I had assumed, but I might have been vague with my comment. I should have said “the risks of certain types of gender-affirming care”.

                • Nikki@lemmy.world
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                  8 months ago

                  im in the same boat in that case, i just am so hesitant on laws being made. in the wrong hands they will be made to prevent any care (puberty blockers) when its a tiny subset of kids getting hrt in the first place

                  i just dont want anyone to have to go through the wrong puberty like i did, its awful

          • Elsie@lemmy.ml
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            8 months ago

            So question, if in a hypothetical situation someone was on puberty blockers until they were 21, what would happen with their body once they go off them?

          • chetradley@lemmy.world
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            I did, and I find myself largely in agreement with the author. I was citing the article and a linked source when I talked about the rare case of people who regretted transitioning. Was there a specific claim I made that the article refuted? Maybe I missed something?

    • @A_Toasty_Strudel @gAlienLifeform recent study shows that only %1 percent of trans youth detransition and not all of them are detransitioning because they made a mistake. Even between these people who detransition, they are still happy that they got to try and transition. There are lots of studies backing up starting transition early. If I was able to I would have started before going through the wrong puberty and the changes puberty makes are irreversible. Being a trans is not a mental health, they treated it as mental health and didn’t help at all. Why so much stigma around transitioning when the satisfaction for this treatment is one of the highest in any kind of medical procedure?

    • Anamnesis@lemmy.world
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      Defining mental illness is tricky. Typically one important feature of mental illness is personal distress. Given that lots of trans people seem to be distressed about their gender identity, or the sex of their bodies, I don’t see why it’s incorrect to call that distress mental illness. It seems like the problem here is the stigmatization of mental illness in general. Even if being trans was a symptom of mental illness, this doesn’t mean the best way to treat someone who’s trans isn’t gender affirming-care.

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    Well, for good or ill, kids are treated differently because they don’t have the full ability to give meaningful consent. That includes a lot more than medical issues, but it includes medical issues.

    With that standard in place, and it should be, there’s no reason someone being trans should be treated any different than any other major procedures/treatments.

    Now, that’s absolutely only as regards medical issues. And “puberty blockers” are a necessary exception since the dangers of that not being available far outweigh any minor risks from the medication. Any changes that aren’t medical other than that are between the kid, their parents, and their doctors as consultants. The rest of us have no business interfering in that.

    • MetaCubed@lemmy.world
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      The point of the puberty blockers is to allow the child to explore the identity they have chosen without locking them in either way.

      Its not like kids say theyre trans and they get hormones the same day.

      • come out to their parents or guardian
      • go to therapy for months to get diagnosed with dysphoria
      • start puberty blockers for months to literal years, doing counselling/therapy the whole time
      • reach the age that further intervention is allowed,(usually 16-18) they either go forwards with further transition, or
      • stop the puberty blockers and go through a late but otherwise normal puberty.
    • boywar3@lemmy.world
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      Puberty blockers exist to give the option to change more time before puberty does significant alterations to a person.

      Essentially, it buys time for younger trans people to be certain of their choices and minimize the (already remote) possibility of de-transitioning being needed.

      There is also no evidence of any significant negative side-effects from the treatment.

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    8 months ago

    consent must be informed and everyone who undergoes it must be psychologically evaluated. thats a starting point

    • lolcatnip@reddthat.com
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      That in itself doesn’t say what your position in any particular treatment is. A lot of people want to say any medical intervention requires informed consent, as if whatever happens without medical intervention is always fine and doesn’t require consent. Clearly nobody believes that, though, or pediatric medicine as a whole would be illegal.

      What really bothers me is when people demand a higher level of informed consent for gender-affirming care then they do for other medical interventions. That, to me, says their issue is but actually consent, but rather that they have an issue with trans people that they think justifies interfering with strangers’ medical care. I, on the other hand, take a hard line that medical decisions should never be made by politicians, and banning a particular kind of care is absolutely a medical decision that contracts medical best practices.