The recent controversy about the use of so-called puberty blockers concerns another aspect of this same complexity: The Tavistock clinic in London was ordered by higher authorities to restrict the use of puberty blockers that suppress hormones and in this way pause a child’s development of sex-based characteristics, such as breasts. Tavistock was administering these drugs to youngsters between 9 and 16 who appeared not to be able to choose their sexual identity.  

I still don't understand how it makes sense to have a child make such a decision. When I was 9 I thought I was a dinosaur. I bet that if we could, under the current political landscape we would pay huge bucks to pharmaceutical companies to turn millions of 9 year olds to dinosaurs.

A boy or girl dinosaur is the question.

trans dinasour ? /s

Dinoself

Dinothey

I won’t pretend to understand what do people actually feel who really really need that, because I’m not one of them.

But I don’t get how one can justify enabling a person to to switch their gender before the age of consent, or driving license, drinking or voting thresholds. I mean, at least you can stop drinking or voting if you don’t like it, and the age thresholds for those activities are a bit higher than the age of 9.

> But I don’t get how one can justify enabling a person to to switch their gender before the age of consent

IF we didn’t impose gender before the age of consent, there’d be no reason for anyone to switch one before such an age.

OTOH, any logic that can justify the imposition can justify the change.

I’m thinking more along the lines of irreversibility. Reminded me of this recent post here: https://news.ycombinator.com/item?id=34753240

> I’m thinking more along the lines of irreversibility.

Puberty blockers are not, generally, irreversible (or even permanent-but-reversible, simply stopping taking them usually results in puberty), a fact widely recognized and documented in coverage of their use in delaying precocious puberty, long before ideological activists started attacking them based on a mix of anecdote and fiction because they were also used in treatment of trans kids.

That’s true however with the caveat that the treatment duration is often far shorter than with misgendered individuals.

The reality is that there are no long term studies on puberty blockers since in most used cases they are used as an intervention until the underlying medical condition can be resolved including in precocious puberty.

The fact that individuals can be on them for years or even a decade without any significant long term or permanent side effects also isn’t supported by evidence.

I'm not really deep into the topic, so this may be wrong/inaccurate - but I've read that puberty blockers were actually introduced as a way to solve the problem of children having to make life-changing decisions.

A successful HRT becomes much harder after puberty. On the other hand, performing HRT on children is plain unethical, for all the reasons discussed in the rest of this thread. (And btw something the trans community is advocating against - because forced sex reassignment had been standard practice for intersex children for decades. The trans community is demanding to end this practice.)

So to solve this, the idea was to artificially postpone puberty until the person is old enough that they can make a mature, informed decision about the subject.

Of course that logic has its own weak points - e.g. that puberty itself may play a major role in the person finding their identity. So postponing it until the person has settled into an identity would be sort of like trying to outrun your shadow. I'm not sure what the status of science in that regard is though.

I’m not entirely sure that logic works, they aren’t trying to change their “gender” but primarily wanting to change their sex to the best of our current medical ability.

Not quite, they want to change societies perception of themselves and medically transitioning helps that's by changing certain physical traits often used by society/people to guess which sex they are and thus change what societal expectations are placed on their appearance, behavior, and personality. This is called 'passing'.

There's also no drugs approved by the MHRA (the UK FDA equivalent) as "puberty blockers" it's purely off label use of cancer drugs.

What you've done right here is a prime example of rhetoric (whether you realize that or not).

You neither specify what drugs are being allegedly used off label (with nothing to back that claim up either) and suggest they are cancer drugs to invoke fear. Most people when they hear/read "cancer drugs" think chemotherapy drugs (which are very serious business) but not all cancer drugs are chemotherapy drugs.

Since I don't know what drugs you are actually referring to, let's talk a cancer drug (but not a chemotherapy drug) that could be used as a puberty blocker:

Tamoxifen (Brand name Nolvadex) - Used to treat breast cancer.

Note: I have no idea if tamoxifen is used as a puberty blocker, nor do I care to determine that it is. The point I am trying to make is just because something is a "cancer drug" does not mean that it can't be used for other things safely and rationally.

Why is it used to treat breast cancer?

Because it blocks estrogen receptors.

Why is blocking estrogen receptors helpful for treating breast cancer?

Certain types of breast cancer (not all types - cancers, even of within a single type, are not a monolithic disease but actually a constellation of genetically distinct diseases with some commonalities) - ER+ breast cancers in particular - evolve to hijack the hormonal system (primarily estrogen) in aiding its growth and multiplication.

Thus, blocking the cancer's ability to bind to estrogen molecules slows and can stop the growth of breast cancer cells.

Are there side effects to Tamoxifen? Of course, there are (find me a drug that doesn't have side effects): hot flashes vaginal discharge nausea mood swings fatigue depression hair thinning constipation loss of libido dry skin

These side effects are very similar to the signs of menopause because tamoxifen is essentially causing a reversible menopause in those whose bodies have become accustomed to estrogen.

Once more, the point I am trying to make here is not that Tamoxifen, a "cancer drug", can, should or is used as a puberty blocker but that cancer drugs can very plausibly be used for other things.

See breastcancer.org for a concise explanation: [1] https://www.breastcancer.org/treatment/hormonal-therapy/tamo...

See Tamoxifen evolution for a much more technical discussion: [2] https://www.nature.com/articles/s41416-023-02158-5#Sec8

For those paying attention you will invariably also see someone compare puberty blockers to the drugs used to "chemically castrate" sex offenders. This is the exact same rhetorical device and also leverages a very shallow understanding of how the drugs themselves actually work.

I understand that cancer drugs can be used for other things. That makes perfect sense to me. But we are not talking about using cancer drugs for things other than cancer in general, we're talking about using them as puberty blockers.

The use of estrogen-blocking drugs as puberty blockers is not a good idea just because estrogen blocking drugs exist. They were not originally intended for that.

> They were not originally intended for that.

Why is this important? Lots of things find use outside their original purpose. Intent doesn't really matter over function.

To be clear, I was not saying or imply GnRH agonists are estrogen blockers. Or making any claims about GnRH, it's uses or history of use. Or saying tamoxifen would be a good for use a puberty blocker.

I was simply making the point that a drugs origin does not automatically imply something about the safety or the plausibility of it's use in other areas.

I in fact agree with everything rhinoceraptor has said about puberty blockers. It's not new or anything to be panicked about.

This non-issue is be used extremely transparently to stoke a "won't you think of the children" moral panic where trans people and trans kids are being made the punching bags. I'm old enough to remember when essentially all the same talking points were being used to drum up a moral panics about gay/lesbian folks. (I'm not even that old)

That is why I called it rhetoric. I believe the poster I was responding to (RobotToaster) and it seems JoeyBananas are attempting to conflate puberty blockers (and if you read between the lines: trans people) with cancer. It's purpose is not to convey information but to inspire feelings, feelings of fear and unease.

Of course I can't know the posters hearts and I have met folks who genuinely didn't understand the litany of dog whistles and red flags they were shooting off.

It very lame to see yet another well known person (ŽIžek) jump in on it.

It suggests using these drugs as puberty blockers is a "wildcat" application that is not widely accepted

You need to substantiate your claim that off label use is even occuring. But before you get to that:

"These drugs" - what drugs? You've not even demonstrated that you know what drugs are being used as puberty blockers in the UK.

GnRH agonists are not estrogen blockers. And they have decades of history in use for children as puberty blockers, for reasons that have nothing to do with gender, early puberty.

Trans people have a keen idea of their gender identity from a very early age. If it is a human rights violation to force an adult to live opposite their innate gender identity, surely it's a human rights violation to do the same to a child.

The question isn't do trans children really know their gender identity. It's can the person responsible for allowing the transition to happen distinguish whether the child knows they're gender identity doesn't match their sex, or is it just a child being a child. Going through puberty isn't weird just for trans people.

The issue is with regards to false positives.

Parents have legal guardianship over children not because they 100% of the time know the correct decision, but as a compromise between children literally just coming into the world and knowing nothing, and not handing complete self autonomy over to the state.

Neither are human rights violations.

> When I was 9 I thought I was a dinosaur.

This undersells how sinister underage hormone blockers are, because being a dinosaur is not a normal part of human development. identity confusion, especially during puberty, is normal for a significant percentage of people - millions.

Doctors administrating these blockers cross well past malpractice and into evil. If you are permanently altering children - the people we don't let buy cigarettes or alcohol, vote, or drive - without years of therapy first, you deserve jail time.

@dang

Let's see this same energy for circumcision then

I need everyone, EVERYONE, who chooses to use this word to be very careful about how you define it, because most of you are NOT DOING THAT.

And in the process, you end up fueling right-wing idiocy. Because there are presently two working definitions of "woke."

Reasonable people have defined it as "a modern extreme naive liberalism" and that's fine.

But the right basically uses it as "whatever we disagree with," and often pretty much feels like the n-word.

And conflating these two is causing LOTS of problems.

Yup. The right is fuelling the moral panic about trans people while going against abortion rights and contraceptives: https://m.washingtontimes.com/news/2022/jul/21/house-passes-...

> Yup. The right is fuelling the moral panic about trans people

I wouldn't call opposition to performing irreversible gender transition procedures on children "moral panic".

Maybe true. But then that concern about irreversible medical procedures somehow results in a complete ban on educating children on gender identity or sexuality at all: https://www.nbcnews.com/nbc-out/out-politics-and-policy/nati...

When you conjure a national crisis out of a few very rare examples, that puts members of a vulnerable minority group at risk, with the express purpose to frighten your supporters while dividing your adversaries, so that your side can seize power, that's more than just a "moral panic", it's textbook fascist politics.

In the W Bush era it was gays getting married. Terrorists are taking over and gays are gonna shack up and destroy America. Gotta have a foreign and domestic set of enemies to get people riled up about.

But the Overton Window shifted and no one really cares if the gays marry.

Trans people are even fewer than gay people and there may be a number of real, or kinda real, arguments to be had there, such as the wisdom of giving younger kids hormones, or if trans athletes should be allowed to participate in gendered sports leagues. They make a fantastic wedge issue, with the benefit that they're 0.3% of the population -- political footballs, with no chance of actually burning a voting block.

As a (Black) leftie, I really wish the political-internet-left understood this better.

"They want to destroy us!"

No, fam, that's not quite what's happening here. None of them (with power) wake up thinking "trans people are a menace that must be stopped." Now, it may be just as bad - but to them you're just a useful pawn, which requires different tactics from "this is exactly like Nazi Germany."

This is one of those unfortunately effective wedge points that the right exploits. I personally do think that MEDICALLY altering children's growth is an extremely dangerous idea that has to be handled very carefully, and perhaps more carefully than it is now..

..but again, the Right will happily use this tiny point to drive the wedge to say "TRANS IS BAD ALL THE TIME."

> ..but again, the Right will happily use this tiny point to drive the wedge to say "TRANS IS BAD ALL THE TIME."

I have no doubt that folks on the right will exploit that, but I'd also argue that supporting irreversible transition procedures on children, often against the wishes of the parents, is not a tiny point as you callously put it. It's THE point.

Against the wishes of the parents? While I'm not deep into it like that, I'm pretty darn certain that's very much NOT a thing.

(However, I do have therapists in my family, and they do have serious concerns that too many parents are encouraging their kids in this direction)

The liberality of "abortion" and of "gender identity" fundamentally follow from the same misconceptions about sex, so the equivocation is quite warranted.

I kind of like "not asleep" as a definition, but also like the idea that every time you hear those on the right make up their own definition you simply replace it with "Ewok" in order to point out the distinction

We all would do better to live as if disagreement isn't the end of the discussion, but the beginning of a negotiation.

I saw a video of a home inspector who said he leaves fire safety kids' books when he can tell a kid lives in the house, and someone was angry at him about it being 'woke'.

And it is very woke of them, as in being awaken to the opportunity to teach and prevent harm

A lot of political terms are poorly defined, like liberalism. By the traditional economic definition both US parties are liberal.

Personally I'd define woke as the toxic mixture of identity politics and cancel culture. Mark Fisher wrote about an embryonic kind of this in "exiting the vampire castle"

But what I'm saying is different. "Woke" is presently weaponized in an extremely effectively divisive way, e.g. Dave Chappelle's comedy is simultaneously extremely "woke" and also extremely NOT "woke."

You can't do that with e.g. "liberalism" today.

Wokeness = no longer being able to treat marginalized people like shit without consequences.

I'm glad it's here to stay.

Wokeness also informs us that "playing a wizard game makes you a Nazi, and you are literally committing murder".

Being chastised or losing your job is not quite the same as what would result from having literally murdered someone.

Though, this definition apparently does not apply to marginalized women, when they object to males demanding access to women-only spaces.

I won't speak to wokeness as a whole (I think the concept is way too slippery and politically charged), but I find the specific example of providing for puberty blockers for children particularly frightening.

Puberty blockers are not a wild or experimental new drug. They have been to children for decades, for a completely different reason: early puberty.

This does not imply that puberty blockers are an appropriate intervention for children presenting with gender dysphoria though.

I'm inclined to trust medical authorities over the opinions of internet posters.

The health authorities of several European countries have halted the routine use of puberty blockers for gender dysphoric children, due to a lack of evidence that this intervention helps rather than harms.

The health authorities of several US states have done the same. Politicians are not medical experts. I'm not aware of any legitimate medical authority that would agree with this fearmongering.

I wasn't talking about politicians, it is medical experts who have driven this decision in the health authorities I was referring to - e.g. England, Sweden, Finland.

This is from applying an evidence-based medicine approach to this. The political side of things is yet another matter.

> I won’t speak to wokeness as a whole (I think the concept is way too slippery and politically charged), but I find the specific example of providing for puberty blockers for children particularly frightening.

They are safe drugs that have long been used to delay puberty for reasons other than gender dysphoria, and are extremely well-established to be an effective intervention that greatly mitigates the extreme increase in suicidality in trans youth.

Why would it be frightening?

The health authorities of several European countries, including England, Sweden, Finland and France, have halted or severely restricted the routine use of puberty blockers in gender dysphoric youth, due to the lack of evidence that this is actually helping and not harming these patients.

It just seem super weird to me that by the state has deep say in what we do with our bodies.

The whole idea of medicine as only a thing to undo damage, to deal with problems is so old fashioned, so out of touch. It doesnt correspond to what we can do & it seems weird we socially have kind of started catching upnbut legally are still stuck with hundred year norms. There probably should be some limits but letting people play with & experiment with their body chemistry seems a simple enough proposition.

Paul Ford at Wired talking about Mounjaro for weight loss, & more generally the opening the box on self-modification is a glimpse beyond this weird fixation point medicine has been stuck upon. Great read. https://www.wired.com/story/new-drug-switched-off-appetite-m...

My strategy is usually to replace the word "Woke" with the word "Polite." That has served me well, and served me well for decades doing the same for "Politically Correct."

Sometimes for a laugh I'll replace the current moral panic word with a moral panic from an earlier age.

Politeness has nothing to do with cops killing POCs, or systemic repression, or giving hormones to kids.

You don't say slurs and use someone's preferred pronouns out of politeness; 'woke' is about systemic or deeper issues. Maybe the woke crows has bad takes on these issues -- happy to debate each on their merits in other threads -- but it's disingenuous to couch it in terms of simple social graces.

This post reads like a rich white dude who was able to sidestep these deeper issues via a wink and a nod but without actually engaging with the core issues -- which is how these issues continue to persist. Keep getting your STEM salary and be nice.

Reminds me of Marcus Aurelius and the Stoics, who wrote a lot about calming the self, being kind and non-judgemental to others, understanding that they might not be mad at you but at circumstances, etc etc. Meanwhile their entire system ran on institutional slavery and constant subjugation. Yeah they'd crucify people but those Senators sure were polite.

Woke people are some of the least polite people out there. They won't hesitate to label people they have never even met as racist, sexist *-phobes. This type of hyper-aggressive rhetoric is exactly why the woke are so widely loathed, and why wokeism will sooner or later implode under the recognition that it's impossible to be both a nice person and also woke.

People said the same thing about abolitionists, suffragists, anti-segregationists, etc, etc. It's certainly possible that this time will be different, but I wouldn't wager money on it.

Some radical suffragettes were actual terrorists and did their cause no good, quite possibly harm. Female suffrage came about as a result of the Great War, not verbal abuse by radicals.

At any rate, you seem to be agreeing with me but justifying it by claiming these people are on the right side of history. Communists and the Jacobins both thought that, but were both dead wrong. Merely being an abusive radical doesn't mean you're right. These people are clearly on the wrong side of history: they're trying to drag the world backwards to one where everything is decided along racial and gender lines.

As someone who dressed up as Žižek at a Halloween party in my early twenties, I must say the man remains a puzzle to me. Or rather, it remains puzzling to me how he doesn't see the connections between the facets of culture that he criticizes (as in this piece) and the legacy that he defends. He is certainly intelligent enough, but perhaps lacks the courage to dismiss centuries of revolutionary legacy as ultimately vain. This, I think, is the hardest step most secularists have to make in their journey toward Truth.

He gets paid to say things. You know his name because he says famous or controversial things -- so even if he sees the connections, why would he bite?

My own exposure to him was primarily through his early works, which are at least worth reading to get a good grip on his intellectual genealogy. I think his foundational commitment to Hegel is ultimately what prevents him from repudiating Prometheus and revolution, not necessarily the fact that his thoughts are sanctioned by money.