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

[GreenGoo]

Those things need study, discussion, and debate.

Sure. But not by the general public. The GOP wants their ignorant masses involved because "outrage!" and focused attention on the "other", not for any actual concern for the child. Give me a break. DeSantis would make them illegal if he could.

[GreenGoo]

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.


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?

Great. Why are we involved at all, then?

[Kurth]

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.

This is a fundamentally bad take. The government is deeply involved in healthcare in the United States. Again, look at the power the FDA has to regulate what’s available and not available as treatment options.

What this boils down to is that you just don’t want the government involved when it’s making healthcare decisions you don’t agree with.

[noxiousdog]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

[El Guapo]

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.

No, but voters voted in the governments that created the FDA, created Obamacare, and created all of the other agencies, laws, and regulations that govern healthcare in the United States. They also voted in all the state level officials that are passing good or bad healthcare regulations.

Basically, I'm all for leaving decisions like whether and when to start transition care to as close to the family as possible. But it's unavoidable that the government's going to have a role in making various public policy decisions that will impact the decisions of various families. Among other things, insurance companies are only going to be required to pay for transition care if the government forces them to do so (although some insurance companies will (have?) start to cover that on their own). So whether and when an insurance company (especially Medicaid) will cover transition care is something that for good or for ill our public officials will have a role in, which will in turn greatly impact when and whether a family starts transition care for their child.

[El Guapo]

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.

Well, I suppose I agree that the GOP is stupid and should shut the fuck up.

[Zarathud]

The government should be acting to protect consumers and improve health care, not advance particular political agendas.

The worst part of the MAGA “conservative” agenda is its need to turn everything into a battle against the OTHER. It eliminates all rational policy-making simply to preserve the fragile coalition and hide the utter lack of a Republican plan to do anything but “get back” at the liberals.

[Blackhawk]

Those things need study, discussion, and debate.

Sure. But not by the general public.

We live in a society. Societies have to be able to discuss controversial issues, decide how the society is going to operate going forward, argue, inform each other, spread the word, protest, write letters, decide what's right or wrong and use that to elect leaders who will support those ideals.

[GreenGoo]

I personally don't think so.

Your opinion shouldn't matter.

edit: Neither should mine.

[GreenGoo]

We live in a society.

So what? You don't get a vote in whether I get my tumorous lump removed.

If I haven't been clear, I think that this has been politicized by the GOP for nefarious purposes, and every single one of you is legitimizing that.

Which is absolutely ridiculous and embarrassing.

Dance in the culture war. Why not?

[GreenGoo]

What this boils down to is that you just don’t want the government involved when it’s making healthcare decisions you don’t agree with.

Boil all you want.

[noxiousdog]

I personally don't think so.

Your opinion shouldn't matter.

edit: Neither should mine.

That's ridiculous. We decide all the time about what is reasonable risk for our society and whether to outlaw it.

[El Guapo]

We live in a society.

So what? You don't get a vote in whether I get my tumorous lump removed.

If I haven't been clear, I think that this has been politicized by the GOP for nefarious purposes, and every single one of you is legitimizing that.

Which is absolutely ridiculous and embarrassing.

Dance in the culture war. Why not?

But like...we do get to weigh in on whether you get your tumorous lump removed (at least to the extent that any individual voter gets to weigh in). Well, you're in Canada, so your fellow citizens do anyway. But you're able to get a tumorous lump removed because Canadian voters elected governments that created the current Canadian health system, and which decided that efficacious cancer treatments (like tumor removal) will be paid for and provided through that system. Now there's no powerful pro-cancer lobby (yet!) nor is there much in the way of widespread bigotry or discrimination against cancer patients (yet!) so there's no real controversy around that, but your ability to get that lump removed is absolutely the results of policy decisions made by governments elected by your fellow voters. That was "politicized" the very moment that the Canadian government decided to involve itself in the terms of the provision of health care.

Obviously the provision of gender-affirming care is more controversial at this point and so there's more debate around that than around cancer treatments, which is why Canadians' ability to access gender-affirming care varies significantly by province. Access to that care should probably be expanded and made more uniform, which is only going to come through activism and political movements involving, you guessed it, voters.

Of course the government involvement in health care in the U.S. is less robust than in Canada, but the government here still is very much involved in what treatments are available, at what cost, and the terms under which each person can access them.

So like I get how you want this all to boil down to "let people do what they want and mind your own business", and I agree with that as a principle, but that's not the end of the story once the government is involved (which it very much is!). You'll also note that we've mainly been talking about the provision of care to minors, because that's where things get especially complicated (if an adult wants gender-affirming care, up to and including surgery, and the proposed treatments are not quackery then the case for any regulatory involvement in that decision gets much weaker). And yeah, it 1,000% doesn't help that we have GOP nutballs running around demonizing trans people. But neither does it make the sometimes difficult public policy decisions magically go away.

[Alefroth]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

I think looking at the total number is also very important. This study seems to do a good job of showing that-

https://www.reuters.com/investigates/sp ... outh-data/

If your 1% estimate is correct, that's less than 3 minors that regretted mastectomies last year and less than 1 that regretted other genital surgery.

[geezer]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

Yes, but... it's also important to remember that, absent other treatments (puberty blockers, other hormone interventions, etc.) that some people ALSO want to eliminate from the discussion, putting this decision off until 18 can have very real, very permanent consequences. I think you have to weigh the negative consequences that the other 99% would have by being forced to wait until after puberty, don't you?

[GreenGoo]

<snip>

But only technically. Politicians never voted on individual treatments or not (god, I hope not anyway) and voters never voted for a politician because they would legislate tumour removal.

[El Guapo]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

Yes, but... it's also important to remember that, absent other treatments (puberty blockers, other hormone interventions, etc.) that some people ALSO want to eliminate from the discussion, putting this decision off until 18 can have very real, very permanent consequences. I think you have to weigh the negative consequences that the other 99% would have by being forced to wait until after puberty, don't you?

Absolutely. And I would assume that there are ways to address that 1% without unduly denying access to the other 99%. Those are exactly the kinds of debates that we should be having - how can we provide appropriate care to everyone who needs it while minimizing the (small but non-trivial) instances where things go wrong for one reason or another?

[El Guapo]

<snip>

But only technically. Politicians never voted on individual treatments or not (god, I hope not anyway) and voters never voted for a politician because they would legislate tumour removal.

Obviously it would be practically impossible for voters to vote treatment-by-treatment. But they voted for the politicians who set up the system by which it would be decided what treatments would be provided, and if the results of that system get too out of whack with what current voters want then they'll vote for politicians who will reform the current system.

[GreenGoo]

That's ridiculous. We decide all the time about what is reasonable risk for our society and whether to outlaw it.

Yes. For society. There is zero risk here for society.

Once upon a time you thought stats with tiny outliers were too small to legislate. Now (tiny outliers in) abortion and gender reassignment require government action to stop it.

Why? What's changed?

[GreenGoo]

Obviously it would be practically impossible for voters to vote treatment-by-treatment.

Then why are we discussing this specific treatment in the public forum? Let the experts and stake holders do their thing.

Imagine a young texan going through the nightmare that is figuring out who they are and why their plumbing doesn't match. Now add their parents. And health care providers.

Now add politicians in Florida (driving the narative) and 200 million other uneducated strangers deciding what is right for them.

This is not a political subject. Even if the GOP want it to be. This is a by the book GOP play. Ugh.

[GreenGoo]

how can we provide appropriate care to everyone who needs it while minimizing the (small but non-trivial) instances where things go wrong for one reason or another?

This is insane.

We don't have a national debate on how best to save the endangered blue shrike in North Dakota. And they don't even have autonomy. But here we are deciding appropriate approach for a handful of strangers in unfathomable situations with complex options and a wide range of outcomes.

If we can't trust the doctors (as implied by Nox several times) to do what's best, I sure as fuck am not going to trust the average voter or politician to do it. I don't trust them to even understand it.

[GreenGoo]

Ok, I think I've made my feelings clear. Many of you have as well.

Targeted legislation only for vulnerable minorities for political gain is not my cup of tea. Wafer thin camouflage not withstanding. Let the experts do their thing.

Good luck to the trans population. God speed, etc.

[El Guapo]

Obviously it would be practically impossible for voters to vote treatment-by-treatment.

Then why are we discussing this specific treatment in the public forum? Let the experts and stake holders do their thing.

Imagine a young texan going through the nightmare that is figuring out who they are and why their plumbing doesn't match. Now add their parents. And health care providers.

Now add politicians in Florida (driving the narative) and 200 million other uneducated strangers deciding what is right for them.

This is not a political subject. Even if the GOP want it to be. This is a by the book GOP play. Ugh.

Do you think that if we all collectively stop talking about issues around access to gender affirming care that the GOP will magically stop their activism on this and leave the "experts and stake holders" to make their dispassionate evidence-driven decisions without interference?

You also have to remember that we're working from a place where (not very long ago) gender-affirming care was next to non-existent. This stuff all exists because people pushed for it, and they need to keep pushing for it. That necessarily generates pushback. A lot of that pushback is sheer bigotry, and that stuff needs to be discarded as much as possible. Some of the pushback will raise legitimate issues that need to be accounted for and addressed.

Honestly it's like you think that objective policy experts were created with the big bang and would solve any controversies for everyone if people would shut up and leave them alone.

[YellowKing]

Meanwhile while everyone gets up in arms over this 1%, kids are dying in record numbers from gun violence and nothing is being done. Mission accomplished GOP.

They've normalized the idea that this is not only an issue important enough for the national stage, but important enough for federal involvement. Which is utter nonsense.

[El Guapo]

how can we provide appropriate care to everyone who needs it while minimizing the (small but non-trivial) instances where things go wrong for one reason or another?

This is insane.

We don't have a national debate on how best to save the endangered blue shrike in North Dakota. And they don't even have autonomy. But here we are deciding appropriate approach for a handful of strangers in unfathomable situations with complex options and a wide range of outcomes.

If we can't trust the doctors (as implied by Nox several times) to do what's best, I sure as fuck am not going to trust the average voter or politician to do it. I don't trust them to even understand it.

Sigh. Voters elect governments who set up agencies who address specific issues too small to be addressed in a general election. That includes health care decisions. It also includes agencies that deal with things like how to save endangered species in specific places. Sometimes those agencies will make decisions that make voters mad (rightly or wrongly) which will impact future elections which will in turn impact the agencies. This stuff exists and happens whether you would like it to or not.

[Jaymann]

Obviously it would be practically impossible for voters to vote treatment-by-treatment.

Then why are we discussing this specific treatment in the public forum? Let the experts and stake holders do their thing.

Imagine a young texan going through the nightmare that is figuring out who they are and why their plumbing doesn't match. Now add their parents. And health care providers.

Now add politicians in Florida (driving the narative) and 200 million other uneducated strangers deciding what is right for them.

This is not a political subject. Even if the GOP want it to be. This is a by the book GOP play. Ugh.

Do you think that if we all collectively stop talking about issues around access to gender affirming care that the GOP will magically stop their activism on this and leave the "experts and stake holders" to make their dispassionate evidence-driven decisions without interference?

You also have to remember that we're working from a place where (not very long ago) gender-affirming care was next to non-existent. This stuff all exists because people pushed for it, and they need to keep pushing for it. That necessarily generates pushback. A lot of that pushback is sheer bigotry, and that stuff needs to be discarded as much as possible. Some of the pushback will raise legitimate issues that need to be accounted for and addressed.

Honestly it's like you think that objective policy experts were created with the big bang...

Technically they didn't come along until much later, during the Inflationary Epoch at 10 to the -36 seconds.

[Isgrimnur]

In the beginning the Universe was created. This had made many people very angry and has been widely regarded as a bad move.

[noxiousdog]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

I think looking at the total number is also very important. This study seems to do a good job of showing that-

https://www.reuters.com/investigates/sp ... outh-data/

If your 1% estimate is correct, that's less than 3 minors that regretted mastectomies last year and less than 1 that regretted other genital surgery.

Children who had their genitals cut off.

If this were anything but a liberal vs conservative thing, you'd be outraged.

[Blackhawk]

Children who chose, presumably in a manner that satisfied their parents and doctor, to have their genitals cut off. And of the 99% who didn't regret it, how many might have died had they skipped it?

[Alefroth]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

I think looking at the total number is also very important. This study seems to do a good job of showing that-

https://www.reuters.com/investigates/sp ... outh-data/

If your 1% estimate is correct, that's less than 3 minors that regretted mastectomies last year and less than 1 that regretted other genital surgery.

Children who had their genitals cut off.

If this were anything but a liberal vs conservative thing, you'd be outraged.

If children were forced to have their genitals cut off, I'd be outraged. As it is, not even one minor per year who chooses to have their genitals cut off regrets it.

[Alefroth]

Children who chose, presumably in a manner that satisfied their parents and doctor, to have their genitals cut off. And of the 99% who didn't regret it, how many might have died had they skipped it?

Or lived, but live in torment.

[Victoria Raverna]

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?

Protecting children from making wrong decision that is going to be permanently affect them for the rest of their lives?

You don't trust children to vote or to drive but why you trust them to make decisions that are going to change them permanently?

[gilraen]

Protecting children from making wrong decision that is going to be permanently affect them for the rest of their lives?

Surgery is extremely uncommon before the age of 18. Especially since the numbers listed in the article come from surveying insurance claims - those must be very extreme cases if the shitty US health insurance companies actually approved those surgeries.

[gbasden]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

Yes, but... it's also important to remember that, absent other treatments (puberty blockers, other hormone interventions, etc.) that some people ALSO want to eliminate from the discussion, putting this decision off until 18 can have very real, very permanent consequences. I think you have to weigh the negative consequences that the other 99% would have by being forced to wait until after puberty, don't you?

Absolutely. And I would assume that there are ways to address that 1% without unduly denying access to the other 99%. Those are exactly the kinds of debates that we should be having - how can we provide appropriate care to everyone who needs it while minimizing the (small but non-trivial) instances where things go wrong for one reason or another?

Given the suicide rates for trans and non-binary youth it would seem to me that 1% is absolutely low enough.

In California, the most populous state, which recently passed a law to protect trans youth, 44% of LGBTQ+ youth considered suicide and 14% attempted suicide, the survey found; for trans and non-binary respondents, the findings were worse, with 54% considering and 19% attempting suicide. And 70% of LGBTQ+ youth in the state said they had experienced discrimination, with 62% saying they were not able to access mental health care.

The rates of trans and nonbinary youth who seriously considered suicide were similar in the next largest states, at 56% in Texas; 54% in Florida; 50% in New York; 54% in Pennsylvania; 51% in Illinois; 54% in Ohio; 55% in Georgia; 53% in North Carolina; and 52% in Michigan. And 16-20% of trans and non-binary youth reported attempting suicide across these states. A majority also said they wanted, but did not receive care.

[Blackhawk]

You don't trust children to vote or to drive but why you trust them to make decisions that are going to change them permanently?

Presumably, if they're not old enough to drive, they're having both parents and doctors weigh in on the decision.

[LawBeefaroni]

Protecting children from making wrong decision that is going to be permanently affect them for the rest of their lives?

Surgery is extremely uncommon before the age of 18. Especially since the numbers listed in the article come from surveying insurance claims - those must be very extreme cases if the shitty US health insurance companies actually approved those surgeries.

Approval for elective surgery isn't necessarily based on need or severity. It's often just whether you have more generous plan coverage, which is usually based on your employer sponsor.

[Unagi]

I’m curious if any one here actually has and loves and struggles with, let’s say a 13/14 year old child that actually is talking about gender affirming care?

[El Guapo]

I believe the official rate of people who regret gender transition surgery is 1%. Is that low enough that we should be allowing minors to elect to have that procedure?

I personally don't think so.

Yes, but... it's also important to remember that, absent other treatments (puberty blockers, other hormone interventions, etc.) that some people ALSO want to eliminate from the discussion, putting this decision off until 18 can have very real, very permanent consequences. I think you have to weigh the negative consequences that the other 99% would have by being forced to wait until after puberty, don't you?

Absolutely. And I would assume that there are ways to address that 1% without unduly denying access to the other 99%. Those are exactly the kinds of debates that we should be having - how can we provide appropriate care to everyone who needs it while minimizing the (small but non-trivial) instances where things go wrong for one reason or another?

Given the suicide rates for trans and non-binary youth it would seem to me that 1% is absolutely low enough.

In California, the most populous state, which recently passed a law to protect trans youth, 44% of LGBTQ+ youth considered suicide and 14% attempted suicide, the survey found; for trans and non-binary respondents, the findings were worse, with 54% considering and 19% attempting suicide. And 70% of LGBTQ+ youth in the state said they had experienced discrimination, with 62% saying they were not able to access mental health care.

The rates of trans and nonbinary youth who seriously considered suicide were similar in the next largest states, at 56% in Texas; 54% in Florida; 50% in New York; 54% in Pennsylvania; 51% in Illinois; 54% in Ohio; 55% in Georgia; 53% in North Carolina; and 52% in Michigan. And 16-20% of trans and non-binary youth reported attempting suicide across these states. A majority also said they wanted, but did not receive care.

What's maybe a little bit funny is that I think that GreenGoo and I (probably?) don't disagree much on how the decision-making here should go. The decision-making should in general be made by or as close to the family as possible, and the relevant public policy decisions (e.g., should insurers have to pay for gender-affirming care and if so what procedures and under what circumstances; what to do as to minors if parents disagree with what the child wants or with each other; etc.) should be made as much as possible by objective parties informed by data and the current science, etc. Mainly he seems mad that we are talking about this and that voters get to vote in elections that ultimately connect indirectly to regulatory decisions that matter to families.

But yes, the 1% seems low to me and (at a high level) not a great reason to deny appropriate treatment to the 99%. So the analysis would / should I think focus on how to mitigate that 1% (since presumably that sucks for the families impacted in those cases). But this is where it gets more into the details of current science / analysis that I don't know so well myself.

[noxiousdog]

I’m curious if any one here actually has and loves and struggles with, let’s say a 13/14 year old child that actually is talking about gender affirming care?

Yes. And that's part of the issue.

This is purely anecdotal, but it has a decent sample size as my brother works in a 4000+ student school.

I have two biological female daughters. The elder is now 18. From 13-17 her and her entire friend group were transgender. My younger is turning 15 and is a boy. Most of his friend group are also transgender. Either we have the highest concentration of transgender kids in the world, or there's some confusion going on.

It's totally understandable. We support all of them however we can. Name changes, pronoun changes. Forcing extended family to cooperate. Therapists; etc

My less than average informed opinion is that with the world confronting non-binary gender, they are trying to explore the idea that they aren't gender typical. Ie they don't feel, act, or look like tv/movie/society girls and therefore can't be girls. Yet, there is so little role model for this they still try to exist in a binary world. "I'm not a girl therefore I must be a boy" on top a bit of rebellious "I'm going to shock my parents" and you get this situation

It's 100% guaranteed there are bad doctors out there. My wife's family has had multiple run-ins with dentists who have started procedures and then halfway through tried to upgrade it to a higher priced outcome. I listen to advertisements all the way in to work for testosterone boosters which have no medical basis. It's not that hard to find COVID and vaccine denying doctors if there's a buck involved.

To make my stance clear, I'm fine with gender affirming care up to the point of permanent changes to minors. Puberty blockers I can understand as it's not permanent though, I'd definitely like more research.

Hell, we don't even allow them to get tattoos in some states.

And let's stop with the notion that if we don't let them have gender transition surgery at 16 they are committing suicide. That's a totally false dichotomy. If we get them positive support with therapy and the expectation that they can make an adult decision when they are adults, I'm guessing it would go a long way to helping. Furthermore, I would bet you'd have a really hard time getting the medical community to agree that the best solution for attempted suicide is surgery.

[Smoove_B]

Yeah, I suppose I should state my views clearer here. I'm in no way suggesting we should be routinely performing surgeries on 12 year olds.

As ND noted, access to puberty blockers buys time; it's a temporary solution that (in theory) would allow a minor to work with additional support staff to figure things out.

For non-surgical elements (changing pronouns, clothing, etc...) these are the types of things that IMHO aren't normalized or accepted. They're probably also way more common than a teenager looking for surgery or transitional hormone therapy.

If we get them positive support with therapy and the expectation that they can make an adult decision when they are adults, I'm guessing it would go a long way to helping. Furthermore, I would bet you'd have a really hard time getting the medical community to agree that the best solution for attempted suicide is surgery.

I don't think people are arguing it's surgery or suicide. Instead I think they're arguing that ignoring issues surrounding gender identity and not allowing teenagers the space (through non-surgical/medical) elements to explore their options, it's potentially contributing to increased suicide risk. Seeing how local or state culture pushes back or accepts the LGBTQ+ community overall is what's impacting the suicide rates. Over and over again you'll hear from members in the community how they wish they could have been seen or felt comfortable to do things - particularly with parents or guardians - but instead they were told be heteronormative or else. I know this is branching out from trans issues into the larger umbrella, but it's the same (general) idea.