The costs of trans visibility

Many/most cases isn’t all, you have to either choose if it’s fake or not. Law of excluded middle.

no, I can see an attempt to medicalize normality predicated on very rare actual medical cases.

so yes if your claim is that a tiny number of trans people suffer so greatly from their mismatch with their bodies, it would be reasonable to treat that as a medical issue you might had a point, except currently we are just allowing any trans person to claim they want to modify their body and we have to pay for it.

If we are going by formal deductive inference this concession would completely destroy your argument.

No because first do no harm applies

So in any case when even the smallest shade of doubt exist, it's not medical.

So doing nothing in all cases is infinitely preferable to medicalizing all of them if most aren't medical cases.

That, normatively, according to the first principle of medicine.

Idea would be are you as a physician absolutely certain, willing to bet your life on it, that this person needs medical care?

If the answer isn't "obviously yes" you shouldn't even start thinking about taking the patient in.

That doesn’t even sound remotely true to me. No doubt whatsoever would mean they wouldn’t ever be able to do any treatment. Normally they assess if the symptoms fit a common condition and then go from there. The idea that doctors have to be 100% sure before they act is ludicrous.

Secondly, we’re talking about a logical deduction. Once you accept that there is a medical reality to things like ADHD and Trans, then you are really just talking about disagreements with treatment or the frequency with which certain treatments are administered. You’re not contesting that on its face there are people that have such a medical condition.

No doubt whatsoever that they have a condition that needs treatment !!!

They have to be 100% sure something health wise is off before acting, ofc they can be sure of a diagnosis.

But doctors especially in the USA don't think like that at all anymore.

Fact is treating someone who isn't sick is a lot worse than not treating someone who is sick, you need to err on avoiding the former, that's what "first do no harm" means.

And, given we pay, we can restrict paying only for stuff we are sure about

I think the guidelines I posted itt make everything more than clear.

No I didn't know that. I saw the 2M followers, the content of the tweet, and the fact they ended up in my algo and assumed they were a dailywire type. They have since doubled down and it's some pretty hard narrative crafting.

I mean I put the disclaimer at the beginning of the post. People looked at the story and gave feedback. Instead of being a fact checker I learned something

The reason mods have problems and these topics are "problematic" is because every single politics mod has been miles to the left of obama/clinton. Crossnerd as a choice for politics mod is an all time classic.

Anyways, this is pretty amazing. Kamala went on record to declare tax payers should be providing gender care to detained migrants, including surgery

I’m not trying to be obtuse here but I feel like the way you initially worded it was confusing.

I don’t really get what you’re saying here. Even if someone isn’t Actually Trans (tm) they will still be suffering from some kind of mental health issue that needs treatment if they have debilitating gender dysphoria.

And I’m not medical expert but I doubt that’s how it works or has ever worked.

Doesn't someone have to go through a psych eval to have an operation or receive medication treatments? I'm not being passive-aggressive. I genuinely don't know much about these things.

see this is why you shouldn't post nonsense

because that second one here is very compelling/interesting information

but since it came from you, i genuinely can't rule out that it's from an account which made that video with AI

Not necessarily no, a lot of difference between various healthcare systems though and recently there was pushback at least for minors in most places.

But no cases such as tavistock in the UK show that self identification (hi I am trans and I want meds) was sufficient to get medical treatment even for minors for a while in various places.

GD is a scheduled mental disorder in the DSM because it apparently causes significant distress. However, we know that in most cases, if you leave it alone for a couple of years apart from possibly counselling, it tends to resolve itself and about 90% of those who present with it are simply gay and initially conflicted about that. So medicalising it at an early stage, particularly in any irreversible way, would not be a good idea. Where it persists into later adolescence, you may have a different problem, but you still need to be careful because brain development isn't complete till age 25 (and may never be complete if you start hitting people with artificial hormones).

Here's the question and her old response.

That seems reasonable to me. It is up to the state to provide medical care for people incarcerated by the state. That should include trans people and their unique medical needs.

It looks like the first case of this at the federal level happened in 2023: https://www.aclu-il.org/en/press-release....

depends why they’re in prison, but also, if they are being detained by ICE/border patrol they are ostensibly not citizens of this country and should be kicked out if they are not here legally. so I don’t support that.

still on the other side we have this insane guy saying that kids are just randomly getting their genitals cut off at school which is absolutely insane.

I don't think it really depends WHY someone is being detained by the state. During the period of time in which they are detained, it is the state's responsibility to provide all appropriate medical care. This is absolutely true of ICE as well. That said, focusing this on the parenthetical of ICE detentions and transitions is probably just a red herring, looks like average length of detention here is around 50 days, so what I would imagine would be a fairly long and stringent process almost certainly isn't going to be relevant on those time-scales. Nevertheless, I think it is worth affirming the general principle (that the state is medically responsible for people it detains) even if one can find a presumably rare or non-existent subcase where it sounds somehow bad.

Or they are actually trans but they grow accepting their own bodies which happens more often than some trans activists are willing to admit

I’d have to see what the application is. If they want to transition and the law is that people that transition and have committed extreme violence like rape, murder, attempted murder, CSA will stay in male prisons, then fine. But to move them to female prisons or prisons for trans people that transitioned outside of prison would be bad.

People that commit nonviolent offenses should continue to receive the same trans healthcare as anyone else, so yeah I agree that they should have that taken care of in that instance. I think that getting them to a segregated ward in the prison would be best if they started their transition out of prison.

Not sure how to handle people that transition outside of prison and then commit a violent crime. Probably has to be looked at on a case by case basis.

Immigration wise I gave a caveat of “here illegally” because some people are applying for asylum legitimately in which case we might need to process their claim, and so they should receive healthcare while in detention. I definitely don’t see why we should even consider giving them surgery though, as you said they’re not even here for that long.

I think this is an entirely different issue. The state has a responsibility to provide medical care to people it incarcerates. That isn't more or less true depending on how the state plans to detain trans people.

I don't think their legal status is relevant. A more normal application would be say someone needs diabetes medication. There is a legal requirement that this medical need is provided for whether someone is or is not a citizen, and indeed presumably a lot of people in this category haven't yet had their immigration status even determined yet.

Depending in the medical condition there may be certain cutting edge treatments available that are quite costly and above the minimum standards of care (ie elective in some sense). I don’t believe the state has a duty to provide the most cutting edge medical care to prisoners, simply adequate care would suffice. That would mean hormones and therapy, but not srs, face surgeries, breast augmentation, etc. Not even every trans person has access to those things.

Ok. I’m Canadian, so the whole concept of some people getting better healthcare than others is always a weird one to wrap my head around. I guess I would say it isn’t up to you and I to decide what medical interventions are in the “bottom” tier that subjects of the state get, and which this class doesn’t get. I don’t really know how you draw the line between medication and therapy vs surgeries, but if a line must be drawn I’d rather it be drawn by the medical community.

For what it is worth, my understanding is especially with the private prison complex basic medical care is super shitty for inmates, and even things like continuing the hormones you are already on I’d expect to be an uphill battle half the time.

i actually fact checked that tweet, kamala did indeed say detainees should receive gender reassignment surgery

which is just bonkers that we're giving free cosmetic surgeries out

I mean, certainly for common procedures people probably all get the same standard of care in Canada, but I know for a fact that there are people that are able to afford cutting all types of red tape and accessing cutting edge procedures by flying to another country like the US where they can get all sorts of treatments a normal Canadian doesn't have access to. Secondly, it also allows for there to be innovation in the sense that some surgeons gain a reputation as being a particularly good or cutting edge trans doctor. Should people not be allowed to go to the surgeon that has the most experience in trans healthcare? Should the state be paying for the top of the line neovaginas for their prisoners? Or do you just say that they should receive an adequate neovagina that meets some adequate standard of care?

I'm assuming you're not saying that every prisoner deserves every cutting edge treatment available at the expense of cutting in line of people that haven't committed a crime, as well as their literal tax payer expense?

If true, this incentives people who want free surgery to commit medium level crimes just to get 6-12-18 months in jail and free procedures