LGBT issues thread (was Supreme Court to hear same-sex marriage cases)

[Grifman]

[Smoove_B]

I'm sure no one saw this coming:

Missouri is the first state to severely restrict gender-affirming care for transgender adults amid a nationwide, GOP-led push to legislate away trans rights.

The state’s Attorney General Andrew Bailey announced an emergency regulation on Thursday that aims to limit access to gender-affirming care for Missourians by setting sweeping new rules for those seeking treatment.

“I will always fight to protect children because gender transition interventions are experimental,” Bailey said in a statement. Science actually supports gender-affirming care, and it’s not experimental.

...

The emergency rule makes it impossible for transgender people of all ages to access gender-affirming care unless they have exhibited a medically documented “long-lasting, persistent and intense” pattern of gender dysphoria for three years. They also have to prove they’ve received “a full psychological or psychiatric assessment” and “15 separate, hourly sessions” of therapy, at least 10 of which must be with the same therapist. This follows several anti-trans lobbyists and lawmakers, who’ve attempted to falsely equate transness with “severe mental illness.”

...

Care is also prohibited if healthcare workers don’t check yearly whether a patient is “experiencing social contagion with respect to the patient’s gender identity.” This is likely based on yet another GOP-spread myth that transness is a trend or craze.

[Grifman]

[GreenGoo]

We don't have to understand it. It concerns the person, their parents (potentially) and their doctor. They need to be as informed as possible and then make the decisions they feel are best for them.

Why is government interfering in peoples' healthcare??

I'm not a libertarian but holy hell.

[gbasden]

We don't have to understand it. It concerns the person, their parents (potentially) and their doctor. They need to be as informed as possible and then make the decisions they feel are best for them.

Why is government interfering in peoples' healthcare??

I'm not a libertarian but holy hell.

Yeah. This. It's complete bullshit.

[noxiousdog]

Are y'all really questioning why the government be involved in minors healthcare?

I mean I assume you want the government involved with those gay reeducation camps. You wouldn't argue that should be between a child, parents, and pastor?

And while I'm sympathetic to a doctor's advice, there are plenty of doctors who will sacrifice ethics for money.

[GreenGoo]

Are y'all really questioning why the government be involved in minors healthcare?

I mean I assume you want the government involved with those gay reeducation camps. You wouldn't argue that should be between a child, parents, and pastor?

And while I'm sympathetic to a doctor's advice, there are plenty of doctors who will sacrifice ethics for money.

Two things. A pastor is not a doctor, and the child presumably wants to change. There's a difference between "you're broken and we're going to fix you against your will" and "we will help you, here are some options, let's discuss"

[noxiousdog]

Sure. There's a difference and I would trust most doctors over most pastors.

But when you're talking about novel treatment, I'm not worried about most, I'm worried about fringe.

[El Guapo]

Obviously this is more politically charged at the moment, but seems like the same principals should apply to transitional medical care as other types of medical care. Seems like there's a proper public oversight role in ensuring core elements like: (1) consent - do they agree to the procedure; and (2) competency - do they understand what the procedure entails and do they have the capacity to make a decision on it. Seems like both get more complicated when minors are involved, especially if the minor is pushing for a procedure and the parents are opposed.

[GreenGoo]

Without unanimous agreement, no surgery.

That seems like a no-brainer.

[Isgrimnur]

Sure. There's a difference and I would trust most doctors over most pastors.

But when you're talking about novel treatment, I'm not worried about most, I'm worried about fringe.

Fringe is going to fringe. We should stop letting fringe be a political weapon to oppress most.

[noxiousdog]

That's the government's job. Protect everybody; not just the ones with access to good doctors.

[Isgrimnur]

I'm fine with there being laws and enforcement against the fringe. I'm not fine with the actions of the fringe being used to shackle the many.

[LawBeefaroni]

Gender care such as mental health and social support
are no-brainers.

Medical and pharmaceutical gender transitions are more problematic IMO.

[Madmarcus]

Without unanimous agreement, no surgery.

That seems like a no-brainer.

Who is part of unanimous? Child and doctor? One parent? Both parents? Do you make a distinction based on age of the child? Do you set different rules for reversible treatments, reversible but with more chance of permanent side effects, and non-reversible?

More or less what LawBeefaroni said while I was typing!

[noxiousdog]

The article asserts, "swedish authorities found that the risks of physical interventions currently outweigh the possible benefits and should only be offered in exceptional cases. In Britain, a paediatrician (sic) found gender-affirming care had developer without "some of the normal quality controls that are typically applied when new or innovative treatments are introduced"

Finnish authorities consider it experimental and France said do it with "great medical caution" (duh)

I would recommend the article. It goes on further to discuss a lot of details and studies.

I completely agree with it's conclusion, "both within America and without, whatever the loudmouths may claim, the vast majority of practitioners are simply trying to eat the genuine suffering of adolescents afflicted by gender dysphoria. But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics."

[noxiousdog]

Without unanimous agreement, no surgery.

That seems like a no-brainer.

Who is part of unanimous? Child and doctor? One parent? Both parents? Do you make a distinction based on age of the child? Do you set different rules for reversible treatments, reversible but with more chance of permanent side effects, and non-reversible?

More or less what LawBeefaroni said while I was typing!

Unanimity when one party can be swapped out as many times as you want for a yes, isn't a fair vote.

[Smoove_B]

But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics."

Also complicating it is that there's a significant number of Americans that are trying to suppress and erase anything that isn't hetero-normative. Allowing doctors the space to help figure these things out doesn't work when you have voters and politicians actively removing their ability to do so.

EDIT: I know this is what you're saying (generally), but it goes beyond politics and science. It's religious fundamentalists that are driving the pressures, applied through politics and science.

[Isgrimnur]

the vast majority of practitioners are simply trying to eat the genuine suffering of adolescents afflicted by gender dysphoria.

I hadn't seen that take before.

[LawBeefaroni]

But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics."

Also complicating it is that there's a significant number of Americans that are trying to suppress and erase anything that isn't hetero-normative. Allowing doctors the space to help figure these things out doesn't work when you have voters and politicians actively removing their ability to do so.

Doesn't make me any more comomfortable circumventing evidence based medicine and minimum safety protocols.

[Kurth]

We don't have to understand it. It concerns the person, their parents (potentially) and their doctor. They need to be as informed as possible and then make the decisions they feel are best for them.

Why is government interfering in peoples' healthcare??

I'm not a libertarian but holy hell.

This is not a sound position.

It’s actually a perfect example of left and right crossover. Now you’re arguing that the government should get the hell out of the healthcare business??? What’s next? Down with Obama Care? Fuck your “Death Boards”? All health care should be dictated by the private market? Etc. etc.

The government (the FDA, for one) plays a key role in regulating health care, and it’s a critical role. Of course the government needs to make sure that medical treatments, including pharmaceutical treatments, for gender alignment, need to be safe, effective and with minimal side effects. Can you even imagine the number of hucksters and scammers who might try to make a buck by selling untested, worthless, potentially dangerous treatments to desperate people and their families? Unanimous consent is not even close to sufficient protection.

Also, as the government takes a bigger and bigger role in providing health insurance, it is responsible for making sure the procedures and treatments it is paying for are efficacious.

[noxiousdog]

the vast majority of practitioners are simply trying to eat the genuine suffering of adolescents afflicted by gender dysphoria.

I hadn't seen that take before.

Nom nom nom

[El Guapo]

But in America in particular the charged atmosphere has made it very difficult to separate the science from the politics."

Also complicating it is that there's a significant number of Americans that are trying to suppress and erase anything that isn't hetero-normative. Allowing doctors the space to help figure these things out doesn't work when you have voters and politicians actively removing their ability to do so.

EDIT: I know this is what you're saying (generally), but it goes beyond politics and science. It's religious fundamentalists that are driving the pressures, applied through politics and science.

This is an incredibly politically frought space now which complicates the efforts to devise the best and most appropriate treatment plans. On the one hand you have very real bigotry and efforts on the right to treat all LGBT sexuality as mental illness (especially as regards trans people and trans care). But you also have people on the left who treat any analysis or discussion on complicated issues here as presumptive bigotry.

[Blackhawk]

On the one hand you have very real bigotry and efforts on the right to treat all LGBT sexuality as mental illness (especially as regards trans people and trans care). But you also have people on the left who treat any analysis or discussion on complicated issues here as presumptive bigotry.

This. It's a minefield to even discuss right now. There are a few genuine questions out there that need real consideration and debate, but honest debate is seen as hate.

[Smoove_B]

What also is being discounted/suppressed is the statements and sentiments being delivered by individuals that went through gender-affirming care. Situations where they specifically note how it saved their life. Write a book about that? That's banned at a school. Want to have a drag queen (and yes i know not all drag queens are LGBTQ+) read books to children? No we can't have that either. It's a coordinated effort to make sure anyone that feels or believes they are not within a very strict boundary should remain hidden and quiet.

It's absolutely a minefield regardless, but when a significant cohort is doing everything they can to eliminate anything related to the topic, it shouldn't be surprising that a similarly motivated group forms in direct opposition to that sentiment.

[GreenGoo]

This is not a sound position.

It’s actually a perfect example of left and right crossover. Now you’re arguing that the government should get the hell out of the healthcare business???

That's simply not true. For one, your government is only tertiarily involved in your healthcare to begin with. Except for medicare/medicaid/veterans, your government is embarassingly absent from the caring for the health of its citizens.

For another, of FUCKING COURSE I don't want government making healthcare decisions. See abortions for an easy example of how the left is not interested in politicians' opinions on things.

This is not a new or unique stance, as you seem to imply it is.

[GreenGoo]

That's the government's job. Protect everybody; not just the ones with access to good doctors.

Start with protecting moms from their unwanted zygotes. We can move forward from there.

[Isgrimnur]

That's the government's job. Protect everybody

It would be nice if they fucking acted like it.

[GreenGoo]

Who is part of unanimous? Child and doctor? One parent? Both parents? Do you make a distinction based on age of the child?

This was crystal clear based on Smoove's post, which I was responding to.

None of those questions are roadblocks. We've answered them before for lots of things.

And you're god damned right I'm changing doctors if my doctor refuses to care for the health and welfare of my child. Geezus. How is that question?

[GreenGoo]

Unanimity when one party can be swapped out as many times as you want for a yes, isn't a fair vote.

Fair to who? Because I think it's incredibly fair to the one person at the center of all this.

[GreenGoo]

This. It's a minefield to even discuss right now. There are a few genuine questions out there that need real consideration and debate, but honest debate is seen as hate.

What frustrates me is that this is a national discussion at all. Why the fuck should strangers have an opinion or worse, a say, in the healthcare of someone else's child. And give me a break about "protecting the child". Protecting them from what? What god made them in the first place?

Every time we cut someone open there are risks. That's not an argument against anything. A consideration? Yes. A roadblock? Wtf?

[El Guapo]

What also is being discounted/suppressed is the statements and sentiments being delivered by individuals that went through gender-affirming care. Situations where they specifically note how it saved their life. Write a book about that? That's banned at a school. Want to have a drag queen (and yes i know not all drag queens are LGBTQ+) read books to children? No we can't have that either. It's a coordinated effort to make sure anyone that feels or believes they are not within a very strict boundary should remain hidden and quiet.

It's absolutely a minefield regardless, but when a significant cohort is doing everything they can to eliminate anything related to the topic, it shouldn't be surprising that a similarly motivated group forms in direct opposition to that sentiment.

Yeah, I agree that it's not surprising. When you listen to a lot of GOP politicians talk about trans issues and how this is all mental illness, I 100% get how any discussion along the lines of "we need to make sure that minors have the competency and capacity to make the decision to get transition procedures that will permanently alter their bodies" as being on that spectrum of bigotry. But that doesn't make the real and sometimes complicated issues involved here go away.

[GreenGoo]

I think this is what pisses me off the most. The absolute arrogance it takes to decide what's right for someone else's child. Like we have some sort of say and stick our noses in between a patient and their doctor and parents.

If everyone involved decides the rewards outweigh the risks, who are we to decide that they don't?

[GreenGoo]

But that doesn't make the real and sometimes complicated issues involved here go away.

Absolutely not. But it doesn't warrant a public decision making process from a public that generally can't be assed to vote, let understand what they are voting for. Somehow public opinion is valuable in complicated fields and new medical procedures? It's garbage.

We've witnessed politics influencing science in both our countries. And not as an ethical backstop either.

[El Guapo]

I think this is what pisses me off the most. The absolute arrogance it takes to decide what's right for someone else's child. Like we have some sort of say and stick our noses in between a patient and their doctor and parents.

If everyone involved decides the rewards outweigh the risks, who are we to decide that they don't?

I don't think that anyone here is arguing for the right to make decisions about the treatment of particular kids. But I think you're acting like everything here is always simple and clear, and I don't think it is. If the parents, kid, and doctor are all in agreement on the appropriate healthcare for a kid, then I think there's general agreement that 99% of the time the government has little role here (other than its general role licensing / approving medicines / treatments).

But as soon as there isn't agreement it gets more complicated. What if a 13 year old wants transition care and their parents refuse their consent? Can the kid sue and get a court order authorizing the care over his parents' objections, or are they SOL until they reach the age of consent? What if one parent consents and the other doesn't? Does a biological divorced parent get any input?

[El Guapo]

But that doesn't make the real and sometimes complicated issues involved here go away.

Absolutely not. But it doesn't warrant a public decision making process from a public that generally can't be assed to vote, let understand what they are voting for. Somehow public opinion is valuable in complicated fields and new medical procedures? It's garbage.

We've witnessed politics influencing science in both our countries. And not as an ethical backstop either.

Welcome to democracy (for as long as it lasts). Idiots get to weigh in on stuff far beyond their expertise all the time.

[GreenGoo]

Welcome to democracy (for as long as it lasts). Idiots get to weigh in on stuff far beyond their expertise all the time.

No one voted on heart surgery. It's not remotely a democratic issue, and that's not addressing the for profit nature of healthcare in your country.

[GreenGoo]

I don't think that anyone here is arguing for the right to make decisions about the treatment of particular kids. But I think you're acting like everything here is always simple and clear, and I don't think it is.

I'm acting like the fact that the GOP is muddying the waters so that the public thinks their opinion has value is a joke.

At no point am I saying it's an easy decision or that it obviously achieves its goals 100% of the time.

What I am saying is shut the fuck up and get out of the way, random people not involved.

[LawBeefaroni]

I think this is what pisses me off the most. The absolute arrogance it takes to decide what's right for someone else's child. Like we have some sort of say and stick our noses in between a patient and their doctor and parents.

I don't think it's about deciding what is right for someone else. It's about avoiding what is potentially harmful. Apply the same evidence based approach that is used to bring a drug to market or approve a chemo therapy. This doesn't require new legislation, just existing laws and the scientific method.

If everyone involved decides the rewards outweigh the risks, who are we to decide that they don't?

Who is everyone? A doctor and a family? What if the medical consensus is against a particular treatment? If a single doctor and a family want to chelate their child to treat autism, that's OK? "Everyone" agrees. Ignore the FDA if a doctor says its OK?

[Blackhawk]

Nobody should be making decisions for anyone else's child.

Except if you're suppressing discussion of information required to make it an informed decision.

Or if your decision is to do things that hurt that child.

Those things need study, discussion, and debate. Once the data is there, it may or may not require some level of government intervention. But right now, study, discussion, and debate are being hindered by both sides.