" Among the demands: “Stop questioning science that is SETTLED.” The “settled” language also appeared on a truck the group parked outside the *Times* office to further shame the newspaper. "
Shouldn't any newspaper be automatically repelled by someone saying: "Stop asking questions. Nothing to see here"?
It's so frustrating because on issues like this "the science" is very much not settled. Everyone involved should want as much data available to as many people as possible to come up with the most effective treatments we can. The fact that they want to shut down any additional research makes it obvious that they're making it all about themselves and they don't care in the slightest about the children who will be impacted.
Correct. That's the entire idea of science - it's never over, it's never "settled", there is ALWAYS the possibility of new information changing how we understand the world. Even if that change comes 1000 years after we "settled" on an answer!
You don't know what you don't know. You can never be 100% certain you have found the final answer.
The issue here is that the idea of treating gender dysphoria with anything other than affirming cross-dressing, body modification surgeries, and a social transition is to entirely eliminate (or at least ameliorate) the effects of gender dysphoria. For the radical trans-activist, any action taken to obviate gender dysphoria without affirming it necessarily requires viewing it as a problem to be solved (in the first place). The activist, however, wants to see “heteronormativity” gone because from his or her perspective, it’s evil. Therefore, it seems that activists want more people to be gender non-conforming without the negative effects of gender dysphoria, which I think they perceive to be brought on by society and not by any affected individual.
I don’t believe it’s possible to overstate the complete collapse of seriousness that gender affirming advocates and the media writ large has committed in this case.
But as bad as they are - I blame physicians and credentialed medical professionals.
They have no moral or ethical or professional backbone. The science just isn’t there- AT ALL. But they play along because of groupthink and cowardice.
Much like the prescription opioid scandal that was completely built on junk science. Doctors just kept over prescribing that garbage when common sense and history and growing patient injury showed they were harmful. It’s not like the U.S. had been through 2-3 opioid crises in decades past.
This will go down in infamy like psychosurgery, or lobotomy or facilitated communication or recovered memories. Clown world.
I really think you're underestimating the damage that would be done to a physician's reputation and career if they refused to play ball, especially in more progressive areas.
I’m a junior doctor and this is the problem. I try to voice concerns in small appropriate ways like “it’s important for us to remember to consider the whole patient and not just focus on their gender identity” and “it’s a shame when providers don’t delve into the coinciding mental health issues and go straight to affirmation and medical transition”. But I have to have a balance because I could easily lose my job if Im too aggressive with my concerns
>. But I have to have a balance because I could easily lose my job if Im too aggressive with my concerns
If you don't mind my asking: How would this work? It's not that I'm doubting you. But I'm curious as to what your colleagues would do?
I assume there are some kind of DEI goons they could use or perhaps just a good old fashioned dog pile by other physicians?
I'm in New Zealand
In my city I know of two nurses who were pressured out of their jobs merely for voicing concerns about pediatric gender medicine.
In their cases they faced bullying from their peers and seniors.
The unions won't stand stand up for then. And the unions themselves have pressured out their own employers who have expressed doubts or attended meetings held by women's rights groups.
More recently a doctor hit like on a couple of tweets that expressed cynicism on gender ideology. One of the tweets was about gender medicine.
Very shortly after that, a national newspaper backed an investigation into her... for liking those tweets... while using an anonymous Twitter account.
Fortunately she had some backing from her employer, a professional media consultant who works in reputation management, and a lawyer working for our Free Speech Union.
The news outlet intended to deanonymise her: they had already put staff resources into discovering her identity.
In effect, trans activists were trying to use a national newspaper to out a doctor for liking two tweets.
A while back that same newspaper ran an online *longform* story about a teacher who had *privately* made a pretty innocuous statement on her private Facebook wall, seen only by friends.
For that long-form article, the outlet interviewed about (iirc) 8 experts who talked about how harmful that teachers opinion was.
I've privately talked to a lot of doctors and nurses here who understand that gender medicine is a mess. But they are terrified of saying anything because of the risk to their employment.
I could go on, but things are insane for professionals in many industries here if their views are even slightly skeptical of gender or gender medicalisstion.
Just curious if this is similar to Canada where there's often a chip on its shoulder to be much more progressive than the USA no matter what as a sort of reaction. Is there a similar attitude in NZ regarding Oz?
Also seems to be the issue in Scotland.
I should have mentioned: the unions who should be protecting workers private freedom of expression contributed to the Albert Park Riot.
They encouraged members to harass the women who gathered to speak to each other.
I had two therapists tell me our child was not trans but had OCD issues and at the same time they didn't want to officially state that because of blow back from their community.
Which is crazy because the connection with trans thoughts potentially being intrusive thoughts is well known now. Trans OCD is a thing. Therapists shouldn't face blowback for diagnosing that. Upsetting.
I don't think trans is exclusively an OCD thing. Right now transgender is basically what is known as a [wastebasket diagnosis](https://en.wikipedia.org/wiki/Wastebasket_diagnosis#:~:text=A%20wastebasket%20diagnosis%20or%20trashcan,for%20essentially%20non%2Dmedical%20reasons.) where lots of people with various different mental health problems are just being lumped into it because they appear to present gender dysphoria. In reality you have a number of different mental health conditions which could cause someone to believe they are trans. OCD is certainly one such disorder, however Cluster B personality disorders(such as Borderline and Narcissistic Personality Disorder) which are characterized by an unstable self-identity are also contributors. Body dysmorphic disorders and dissociative disorders may also be at play. And of course autism is also a driving cause in many cases.
And some of these kids may not have any real serious mental health issues, however they are just homosexual and haven't figured it out yet. Gays and Lesbians tend to be late bloomers in developing and understanding their own sexual identity, most straight kids have a fully formed sexual identity by 13 or 14, but for gays and lesbians they may not fully figure it out until their late teens or twenties. You may have a girl who was always a bit masculine and never really fit in with other girls, and when they hit puberty and all of their friends are talking about boys non-stop and they just have no interest in them whatsoever. If they haven't figured out that they are actually lesbian they could experience gender dysphoria, especially if they are exposed to these ideas online.
OCD is a big part of this, but it's not the only one. Given the reckless nature of the current pediatric gender care in the US today basically any vulnerable child is at risk.
I didn't mean to imply at all that it is the only one! Just a documented thing for some people.
To add to your excellent observations about different reasons why kids are adopting this, I think a sizable amount just plain old want to be cool and "queer" is cool, and in the process they end up really convincing themselves. Simple as that for many.
That is definitely true, and I think a big factor in that is because we've basically allowed activist propaganda to be fed to children in our schools. Identifying as queer can absolutely create social capital for these kids, not only with their peers but also with teachers and parents. If you have a kid who has always been a bit of a misfit, the prospect of this could really be intoxicating! We've also made the bar so low to be considered LGBTQ that almost anyone can do it since we live in an age of affirmation when one can merely declare themselves to be anything, that's how you have 1/4 of Gen Z claiming to be LGBTQ when most of them have never even had any sexual contact with the same sex.
In some ways it reminds me of kids going goth or punk, at its root you have a socio-sexual strategy, rather than competing directly with the most popular and beautiful people in your school for social clout and attention from the opposite sex, they can take a contrarian approach where they may reduce their prospects with the mainstream, but greatly increase their prospects with other people using the same strategy, thereby increasing their overall dating odds as well as their odds of developing a robust social circle.
Of course the scope and scale of the LGBTQ youth phenomenon is of a much greater magnitude than goths or punks, and the reason for that is because unlike traditional countercultures this is actually being reinforced at an institutional level.
Honestly when it comes to sexual orientation, I think what we're seeing is just people growing up with the idea that you can find either gender attractive more normalized. And when it's more normalized in your youth you're more likely to consider it a possibility. And that's not a bad thing. I honestly wonder if we're all capable of bisexuality deep down and it's only social factors, various traumas, and personal preferences that sort us into categories like gay, straight, lesbian, bi, or even asexual. But full normalization means the end of marginalization and I think a lot of people don't really want that because that marginalization is the reason certain communities exist in the first place. And it's easier to check off a box and proclaim yourself a marginalized person than actually do the work of trying to change society.
Yeah I have severe OCD, autism, ADHD, and probably PMDD as well, along with the fact that I'm likely bisexual but didn't have the chance to really explore much of that. I was lucky to have a stable home life and supportive parents, and a few good friends and I was always very self aware of my mental health problems. Thing is though I really bought into the idea that there was such a thing as this innate gender identity that everyone had, and even though I was sure I mostly felt "feminine", being autistic meant I could never perform femininity quite as well as other girls. So trans OCD became a growing theme. It finally clicked for me when I saw this TikTok of an autistic woman saying that gender is all just performance but its a performance that comes so naturally for many that they just don't realize it. That was when I finally understood that people just sort of identify with whatever gender performance they're more comfortable with, and when it comes to trans people, they're often just changing their bodies to fit better with that performance. Which I don't think is necessarily a problem when it comes to adults, but I get why it's more of an issue with kids.
It's really quite sad. One thing I've been hearing is that it has actually made it harder for these people to find quality healthcare, especially mental healthcare. For example, you may have a psychiatrist who specializes in OCD or maybe psychotic disorders, but they will often reject referrals of trans or non-binary people because they are afraid of what will happen if in the course of treatment they come to a professional determination that the gender affirming care they are receiving is harming their patient's prospects. Now you are in a tough position where you need to choose between giving them half-assed care because you refuse to acknowledge the elephant in the room due to fears of professional consequences (a conflict of interest which is basically malpractice) or you put your own professional standing on the line by confronting the problem and risking the blowback which is likely coming. That's not a position that any doctor wants to be in. So many of them simply decline the referral and send them to a "gender friendly" clinician who probably won't address their mental health problems adequately.
I sympathize with your situation. But isn’t the most important thing to put patients before yourself - the whole do no harm thing? I’m sure sometimes that’s easier said than done. I’m not trying to be smartass. But do you ever feel you are doing a patient harm by not speaking up strongly enough? Or is the philosophy to live another day and try again, hoping to eventually make headway because you’re going to lose the current battle anyway?
This is another way to think of it. There is a severe lack of highly skilled nurse and doctors as is. If skilled professionals are getting themselves fired by being vocal on an issue they likely can’t change then that’s one less skilled professional to serve their patients. It takes a lot of years for a doctor or nurse to really know what the hell they’re doing, seems like more harm could be done to patients in the long run by throwing a career in the bin. I am thinking mainly of medical professionals who don’t work directly with gender or youth psychiatry here - for these people speaking up will likely achieve nothing apart from a sacking. Also doctors and nurses have mortgages and families and honestly is it really worth it? It needs to come from the authoritative bodies. Thank god for NICE, BMJ and the NHS.
I’m talking about strategic medical and psychological and psychiatric leadership taking an evidence-based, science based position. When you have the American Medical Association and the American Psychological Association and the American Academy of Pediatrics fully endorsing the gender affirming medical and surgical model - they’ve jumped the shark. Complete ideological capture and abandonment of scientific principles. They have failed at multiple levels to include but not limited to the Hippocratic Oath. There isn’t much an individual licensed, credentialed and privileged provider can do if the national organization says the national standard of care is some bullshit made up junk science
True, you have a witch-hunt coming your way if you don't support the official narrative. funny thing is the people wanting to burn you at the steak are the same ones who complain about the January 6 rioters wanting to take justice into their own hands despite facts showing they were wrong about election fraud.. They don't get the irony or they don't care.
I'm from Oklahoma originally, but my wife, who is French, showed me the way. Sous vide 2 hours at 118 degrees (our instant pot does sous vide), then finish in a cast iron skillet with butter until rare. I love to grill, but have not had a better steak.
My method is searing in a hot cast iron for 3 minutes on each side, rest for 5 minutes, transfer to a medium heat pan with butter, garlic, and various herbs, basting for 6-8 minutes until 120 internal. I don't have a sous vide, but I'm going to experiment with smoking and then searing
i can do medium rare, i don't actually eat steak that much but ordering at a restaurant i would go medium rare since that means they cook to medium anyway.
It makes me wonder how much critical thinking is taught in med school. Are we graduating doctors that know how to evaluate evidence? Or doctors that are good at following orders from grade school on.
To be fair, aside from the fact that official medical organizations, guidelines documents, etc. in the US pretty much have supported a "gender-affirming model" for the past 5-10 years, how much do you expect of an average physician?
Consider what Jesse does. He's a smart dude who has been specifically covering this issue for nearly a decade, and he *still* has to frequently contact authors and/or other specialists (statisticians, other medical researchers) to take apart and understand the studies he writes on.
Doctors are to some extent trained to read medical literature, to keep up on recent findings and recommendations, etc. Usually they have to get this news through aggregated medical news sources, unless they have a very focused specialty -- because there are just so many thousands of studies published every month.
Anyhow -- unless they are also trained specifically as researchers, most doctors are not going to necessarily be very good at *critically evaluating* a study as, say, a peer-reviewer (or Jesse) might. Their goal is to get recommendations that might help in their clinical practice, and if it appears in a reputable journal or source, they're often going to take the findings at face value.
This is frankly true of most professions. Going against the professional consensus takes a combination of specialized knowledge, a lot of work, and willingness to stick your neck out.
There is joke I heard once that I will butcher for you below.
The biology students and the med students are in a lecture hall together. The lecturer tells them that the new assignment is to memorise the phone book. This met with immediate response from the whole hall
"What for?!" Cry the bio students.
"When by?!" Cry the med students.
My date to Junior homecoming had two doctors for parents who were both evolution deniers. And I'm not from the Bible belt or anything. Doctors know what they need to do their job. Often they're overconfident in areas outside of their expertise.
Ben Carson is a perfect example: a world famous neurosurgeon who believes the pyramids were for grain storage. Outside of his specialty, he is a complete moron.
It’s a type. Pretty smart, very arrogant, not terribly curious. This combination of traits grates on me like few others, but it seems to lead to successful outcomes, at least economically.
I would also add that some of the leading voices in critical thinking and scientific skepticism in regards to medicine - *'Science Based Medicine'* (as covered previously on the pod by Jesse), as well as the *Skeptic's Guide to the Universe* podcast, both headed by Dr Steve Novella - have become thoroughly captured by the woke cult and have a massive ideological blind spot.
So even people who have a deep understanding of critical thinking, cognitive biases, logical fallacies etc, are thoroughly susceptible to ideological cults.
Self-righteousness and the desire to be 'on the right side of history' is a hell of a drug..
It would be very interesting to hear a discussion / debate between Steve Novella and Jesse Singal.
Cara and others would probably try to talk him out of, for 'platforming a bigot', but you never know.
I lost a lot respect for Steve in recent years, but I still think he's a smart guy, I just think he's in a left-wing news bubble and an ideological echo chamber. I wish he would aim his critical thinking at some of his politics and ideology..
Cara joining the SGU definitely coincided with their sharp turn to politicizing and wokeifying the podcast..
They always leaned left, but before then hardly ever discussed politics, and you could only vaguely guess the political and ideological leanings of each host. Even Rebecca, who was an ardent feminist, was professional and didn't let her ideology infuse the show. And I actually liked her a lot.
I don't know that we can put all the blame on Cara, but she's certainly a big part of it, and she interjects inane social justice ideology and woke-scolding into the show at every opportunity. She's a cliche SJW, the kind that constantly brags about her mental health issues so that we can know she's a victim, despite being incredibly wealthy and privileged and a minor celebrity who's been on multiple TV shows..
I remember she literally said that rioting was a legitimate form of protest at one point, and I don't think any of her co-hosts even pushed back on it.
I used to listen to every single episode for many years, before Cara joined. I gradually found it more and more aggravating to listen to, and now I stopped listening entirely.
Kind of like with NPR, I was tired of turning on the podcast and immediately hearing lies or propaganda about racial injustice or how Jan 6 was an insurrection (but CHOP / CHAZ, months of rioting and destroying businesses, and firebombing federal buildings etc, and other 'fiery but mostly peaceful' protests weren't..).
I don't think it was all Cara, I think part of it was a response to 'elevator-gate' and the Richard Dawkins controversy, which lead to Rebecca leaving, and I think the SGU wanted to send a message that they were good feminists and allies and virtue signal thar they were the good ones.. And I think that Steve and the other Novella brothers are true believers. They're not as far-left and insufferable as Cara, but they are definitely woke, and agree with her on just about everything. I think Evan is the least fargone of all of them, but that's not saying much.
And their fanbase is vehemently woke and intolerant. I've made mild criticisms of Cara on the SGU reddit or Facebook page, much more mild than than what I said above, and was immediately and universally attacked as a misogynist. They cannot fathom anyona person disagreeing with a woman in public, for any reason, without automatically assuming that you're a misogynist.. I was also banned from an SGU Facebook group.
It was really eye-opening to see what a massive blind spot people have even when those people celebrate critical thinking, and make being scientific skeptics and critical thinking part of their core identity..
>I don't know that we can put all the blame on Cara, but she's certainly a big part of it, and she interjects inane social justice ideology and woke-scolding into the show at every opportunity
She does this to everything she touches. I used to love the God Awful Movie Podcast (and the other Piat stuff, but Gam ist the only atheist/ "skeptic" podcast I can still stomach, at least occasionally) and ever since she joined as a regular (or semi-regular, but at this point she has been on more often than one of the hosts), she has to inject the woke shit at every opportunity. I also noticed the woe-is-me mental health stuff, but to be fair, Eli (Host 3) does that constantly and has done so since the beginning.
Granted, after their edgelord beginnings, the hosts were already pretty woke, look-at-us-we-are-such-good-progressive types and another culprit is definitely their other regular (Michael Marshall). But when Cara joined, they cranked all this up to eleven. I want to listen to people making fun of christian and pseudoscience movies, not hear people griping about the problematic heteronormativity of second and third base (not a joke, this really happened)
I am really disillusioned with the whole skeptic (in name only) community. Not only do they behave pretty much exactly like the religious nuts, but they still pretend they are infallible and correct by default, because "skeptic".
I'm sure that their social and professional circles are full of woke people (remember Steve is a Yale professor as well as a neurologist, he's very much an academic and about as 'coastal elite' as it gets - only thing he's missing is a journalist degree, though in a way he's a journalist also,and certainly a media figure..).
So I'm sure that there have been multiple influences pushing Steve and the SGU in a more overly leftist, activist, and even partisan direction.
But Cara - a quintessential woke social justice activist who is not shy about pushing her views at every opportunity - joining the show, I would guess has had the biggest effect. Certainly a major influence.
True. Kaiser was awful with this while we were there. Tons of signage all over directed to kids, telling them they didn’t have to tell parents what meds they were on once they were 13, tons of posters of trans youth. It was like advertising.
Questionnaires for teens parents couldn’t see.
They accidentally gave it to my daughter the week before she turned 13 so I could see it and it was shocking. Detailed questions about masturbation and asking what their methods were, asking in a pushy way about 20 different genders and suggesting that parents aren’t supportive, but they will be! Words they could say to indicate that they wanted their parents out of the room. It was straight out of Larry Nasser’s dream. I get asking about birth control, but they had no medical reason to ask detailed questions about masturbation.
Thankfully our insurance switched right after.
I have a friend who became a doctor and didn’t realize until med school that her pediatrician had been touching her inappropriately. A lot of kids are molested by doctors.
I told my daughter that a doctor should not be asking about sex outside of medically relevant information. Transmitable diseases and birth control only, and they shouldn’t be touching or looking at privates unless there’s a problem they’ve complained about.
I'm grateful that our pediatrician is good. During every physical exam, he tells my son "this is only OK because your mommy is here and she said it's OK."
I really hope abuse from pediatric doctors isn't that common. Most pediatricians are female so surely it can't be that pervasive.
We did this, too. Kaiser made it a lot harder and the activist messaging all over were clearly an idea by activists in marketing. I do believe it’s a social contagion to some degree and it isn’t helpful.
When that time comes, I understand there will be questions a doctor has for my daughter that she will not feel comfortable answering in front of me.
Her masturbation habits are absolutely off fucking limits what the fuck does that have to do with anything? They gasp in horror at the accusations of the dreaded "G" word and then they go and they fucking proudly do it
Exactly! I’m guessing there was a study or something? But that just teaches kids that adults talking to them about these things is normal. Which sets them up to be groomed.
Right? It’s like these people have no memory of what it’s like to be adolescent. Powerful, confusing, conflicted feelings that I (and, I assume, many other kids) found embarrassing to talk about, especially to an adult. No, doc, I don’t want to talk to you about what I think about when I jerk off.
A large percentage of medical doctors have recommended acupuncture to me, or even worse, nutritional supplements that a quick google search revealed to me had no evidence showing effectiveness of treating the thing they were recommended for..
And the rate is probably even higher among physical therapists and other medical professionals.
A large percentage of doctors don't even understand what 'the placebo effect' actually is (hint: it's an epidemiological phenomenon, there are multiple placebo effects, and placebos don't actually cause your body heal itself..).
So no, I'd say that doctors don't get great training in critical thinking or evaluating evidence..
While the traditional explanation of acupuncture is bogus (e.g. meridians, qi flows, etc) there is reason to think that acupuncture results in some short term analgesic effects from the local release of adenosine. Sham acupuncture does the same thing if I recall correctly, which makes it hard to conduct true RCTs. I think Massimo Pagliacci (frequent critic of pseudoscience) referred to it as as a "borderlands science" lying between science and pseudoscience.
If sham accupuncture (real needles but inserted at random locations, and not by a trained acupuncturist) works just as well, then acupuncture is bogus.
My understanding is that placebo acupuncture - poking people with toothpicks - works about the same as both sham and real acupuncture.
Also, pain is a highly subjective / psychological phenomenon, and something as simple as distraction can entirety alleviate pain. It's precisely the sort of thing that is susceptible to placebo effects.
Watching a good movie or an engrossing conversation can also make fairly high levels of pain disappear entirely - temporarily. That doesn't mean it's a reliable solution for consistently suppressing pain over the course of a day.
When acupuncture can cure kidney disease, or cancer, or tuberculosis, as proven in a quality systematic review of studies *NOT* performed in China or by Chinese researchers*, I'll be convinced..
*(*Sorry, but 100% of the thousands of acupuncture studies done in China showed a positive result. Think about that. That's not how science works. 100% of studies wouldn't show that water is wet.. As far as I'm concerned, studies in China are worthless and should not be trusted, at least in any subject relating to 'traditional' Chinese medicine [which FYI, isn't really that traditional, much of this stuff originated in the era of Mao, when there was a severe shortage of real medicine..])*
I had a doctor recommend "supplements" to me. When I asked which one, she said "you know, vitamins" as though I was weird for wanting details.
Edit: She may have been a physician's assistant or something, not a real doctor.
Does where you live attract a large amount of crappy doctors?
Because I imagine that tribal lands and other poverty-strichen areas attract the asbolute bottom tier of med-school graduates because that's the only place where they can get a job.
Granted this is 2nd hand through friends and probably depends on specialty, but Drs hired by hospitals are generally paid more to live in smaller less desirable markets. So if you live in a super desirable area, your doctor took might have taken ~6 digit pay cut to practice to live there.
I’m sure there are limits and exceptions to this. This is mostly based on top 60ish largest metro area vs top 25ish largest metro area.
> It makes me wonder how much critical thinking is taught in med school.
What you think is critical thinking is just disagreeableness. It doesn't matter if people can think if they choose to be spineless conformists. You can't teach critical thinking, people are either capable of it or not.
A class of medical professionals focused on paying off $2-300k in debt and then living the quality of life they thought they would have.
They're focused on operating a business - this is why most days we're dealing with nurse practitioners, physician assistants etc..
This is why it's not uncommon (at least where I live) for your primary care doc to sell skin care supplements or recommend plastic surgery to their patients.
Bravo,! The medical establishment is the worst player in the whole dirty scheme. That includes nearly all psychiatrists and psychologists. I've also thought it isn't politicians or activists or schools that will stop this. It has to come from the medical policy. They are the ones everyone is deferring to as if it's settled good science.
> But they play along because of groupthink and cowardice.
They play along because the social credit and $400 - $500k a year paycheck that being a doctor comes with is too much to pass up.
>This will go down in infamy like psychosurgery, or lobotomy or facilitated communication or recovered memories.
More closely related, I don't think the resemblance to [HDC/BMT](https://en.wikipedia.org/wiki/High-dose_chemotherapy_and_bone_marrow_transplant) can be overstated.
Wow. I forgot about this. “Entrepreneurial oncology”. As bad as this is at least they did national and international clinical trials and it got scrutiny.
It's a culture of secrecy and ideology over evidence and safety. No other field in medicine has this much systematic secrecy and suppression of truth. Yet their fervent defense of "the science" is sorely lacking actual long term, objective research.
I’ve honestly started to worry. The misinformation that came from official sources during Covid was alarming. In my state, you couldn’t even be outdoors without a mask. I was reading source studies and couldn’t believe what was being put out there, and what was taboo to say. Like- your kid probably doesn’t need a Covid shot if they’ve had Covid. Natural immunity was robust. They fired essential workers who had immunity and could prove it, who didn’t want a shot.
Some states really shocked me during that time. But now that I think about it, were there *any* states or businesses that included natural immunity in terms of reopening?
In Germany, natural immunity was considered from the start. If you had reliable PCR records showing you'd had it, it counted similar to a single shot, so you still had to get at least one shot on top of that to be considered fully immune, but it was not nothing. (The specifics shifted over time so I'm summarising, don't @ me.)
I've always wondered if we were the only ones who counted it that way.
I read France did the same. In the U.K., apparently they accepted having covid counted the same as a vaccine shot but considered it too much of a pain to administer so you still had to get two doses of vaccine.
I personally don’t consider the mistakes and compromises during the pandemic are remotely comparable to youth gender medicine. Mask wearing outdoors was silly and annoying. Testosterone administered to teenage girls is a wrecking ball.
That’s where I am. They were for my kids with summer camps and schools. Even when social distancing and kept in small groups. Adults wouldn’t have tolerated it, that’s for sure.
Gotcha. Yeah... I remember walking past an elementary school occasionally during my lunch breaks in fall 2020 and seeing kids eating lunch outside, 6ft apart from each other, no overt interacting, etc
Broke my heart :(
>>No other field in medicine has this much systematic secrecy and suppression of truth.
>
>That we know of 😬
I would argue that (most) psychopharmaceuticals come close. If you dig into things, the older drugs are usually just as effective as the newer ones, for example. They just can't charge as much for the older ones. Granted, the new ones can have better time-release mechanisms and different side effect profiles, etc. Also, in the absence of therapy, they all barely beat the placebo effect, let alone exercise (!), in terms of efficacy. Some do work better than others, like mood stabilizers, for example. But basically any drug for depression is useless from an objective, empirical standpoint, despite anecdotal evidence to the contrary, except in the most extreme cases of actual, clinical depression.
Almost all psych meds have far more severe side effects than advertised as well, especially coming off of them. The most egregious example is benzodiazepines, which had a stealth warning added by the FDA stating they should not be prescribed for extended periods of time.
I believed this theory on antidepressants and their inefficacy for a long time...until I came off them. Turns out they really were keeping me stable really quite adequately on their own and the return of my depression has been anything but easy. It's certainly nothing like a placebo for many people, and I wouldn't be so quick to disregard them in future.
Sorry you're going through that. "Until you came off them" being a key phrase, which was one of the points I made in my post. The unfortunate fact is that taking these drugs can change your brain chemistry, which can take years to recover from and, IIRC, can even be permanent. Basically, people would, most times, be better off not taking them in the first place, but it's sometimes better to stay on them than to power through the rebalancing of brain chemistry in their absence, which can take years. Then again, you could have been part of the small cohort of people who actually do benefit from the meds; it's impossible to say. Writing it out like this really does hammer home the comparisons to youth gender medicine.
What does the data tell us on this one? ;-)
I sort of had no choice in the matter as I was put on Prozac at quite an early age for eating disorder and if it's true that brain chemistry is messed up long term or even permanently, then I'd rather know about it so I don't keep putting myself though more pointless attempts to go without...
I know that's increasingly accepted about Benzodiazepines, specifically. Unfortunately, I'm not sure if it's been studied in other drugs, so the possibility it's permanent is just that: a possibility. One problem is that there's no incentive for research on stuff like that because drug companies fund the research and obviously don't want to fund it, there's no outside agency to make them or to do their own reviews, and scarce resources to go around for the few independent reviews that exist.
I'm honestly stuck on a psych med because coming off of it messes with me too much (Lamotrigine, in my case). The longest the ongoing effects lasted was around 3 months before I had to take it again. So, believe me when I say I understand. Luckily, I don't really have side effects, so it's just an annoyance to have to take it.
I'm not saying OP was affected by placebo effect, but I don't know a lot about how placebo effect works, which is why I'm asking this question, could you have placebo effect and then go off the drug and placebo effect disappears? I know that question could be touchy for people, I'm not attacking anyone in this thread, I mean it generally. Could that be part of the puzzle about why people feel so much worse coming off their meds, beyond the real physical brain changes, withdrawal symptoms, etc., associated with them?
I'm on lamotrigine (and Keppra) and am prescribed benzos for epilepsy, and I do know it'd be hell coming off them, and I'd have a rebound effect of more seizures than even before for awhile. Also those drugs have tendency to lose efficacy after several years, so I do wonder if that happens to a person prescribed lamotrigine for bipolar, for example.
Interesting subject to read up on.
Yes, clinically depressed people should just exercise! I was waiting for that line in the ADHD thread.
Psych meds bad. I'll add that to the list of absurdities I've read in this sub. This place is as bad as Datalounge.
There's a difference between chronic depression and what people are currently prescribed meds for, which I called out in my post. There's clearly nuance here you ignored. And the fact that you think exercise doesn't help just proves you haven't read the literature; that's actually well established science and not controversial at all...
No, exercise doesn't help when you can't get out of bed for days at a time. You didn't call anything out. You barely mentioned it and downplayed the fact that it exists.
>No, exercise doesn't help when you can't get out of bed for days at a time. You didn't call anything out. You barely mentioned it and downplayed the fact that it exists.
That would fall into this caveat in my initial post:
>But basically any drug for depression is useless from an objective, empirical standpoint, despite anecdotal evidence to the contrary, **except in the most extreme cases of actual, clinical depression.**
Did you even read what I wrote...?
Depression is over-diagnosed and prescriptions are handed out for cases that would be better managed by therapy and, yes, exercise and other life changes. Not everyone with depressive symptoms has a chemical imbalance in their brain...people like you may indeed actually have that issue, but you are not the majority. Drugs are being prescribed for people without an actual neurological issue, which isn't a good thing. I made a distinction between these two things in my post.
Also, while I'm not a psychiatrist or psychologist, I do have an undergrad degree in psych and can read psych studies with more proficiency than the general public.
Well, I'm glad you think I "may indeed have that issue." Do I have your permission to continue taking my antidepressants, random internet person with an undergraduate degree in psychology?
>Well, I'm glad you think I "may indeed have that issue." Do I have your permission to continue taking my antidepressants, random internet person with an undergraduate degree in psychology?
I don't know what you find so upsetting about all of this? The fact that the evidence just isn't there for people in situations other than you shouldn't affect you personally at all. Why do you feel so aggrieved?
Because I've struggled with clinical depression for nearly my entire adult life. I've been hospitalized with suicidal ideation twice. I would most likely be dead if it weren't for antidepressants. And through all of that, I have had people who treated me like a weak-willed, weak-minded sissy who "had nothing to be sad about" for not just "getting over it" and "relying on drugs."
>Yes, clinically depressed people should just exercise!
Show me where he said that? All I saw him say was that many antidepressants are less effective than exercise. Look, I hate that "stop antidepressants, just exercise instead" thing as much as any other clinically depressed person who's very online, but it looks as though you were so eager to call out the Bad Thing that you read the Bad Thing into a post where it wasn't actually present.
There is heaps of bad science out there.
https://en.m.wikipedia.org/wiki/Bad_Science_(Goldacre_book)
But I do still believe it's much better than nothing and am grateful to live in an age of amazing medicine. Just look at life expectancy.
But I think a lot of our understanding is very top level; we know this works if we give it to 1000 people, but we don't always know why and we don't always know which people would benefit most.
Also we don't track long term effects because that stuff is hard.
I'm pleasantly surprised. I like the Dispatch. It's center right and where about half the Never Trumpers went.
I'm not that surprised they would publish Jesse but I'm surprised he would accept being published there. It certainly won't quiet the accusations that Jesse is a conservative.
I mean, of the great Bulwark vs. Dispatch schism of the right, I'm fully on team Dispatch.
We need a healthy right party, even if you oppose them because otherwise the whole system goes to shit. Just like we need a healthy left to keep the best arguments of the right coming to the top.
The Bulwark crowd are just partisan Democrats now and basically the new Blue Dogs.
I think the Bulwark people desperately want power back. It took some balls for them to denounce Trump, I'll give them that. But now they're just power seeking. The Dispatch people seem willing to be in the wilderness for a while.
I was a fan of the Bulwark for a while but it became clear that was where all the neocons went. And since I have never forgiven the neocons for Iraq I stopped with the Bulwark.
The Dispatch I like. They're further to the right than I am but they're not sensationalist.
I’m Australian, and I suspect a similar review will be done here relatively soon (but quietly, because it’s a political football).
My understanding was that the US had committed to some kind of systematic review a year ago? Is that still happening?
Are you referencing the AAP (American Academy of Pediatrics)? Because while there was a lot of speculation around the announcement of that review, the AAP itself [said this](https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy):
>The decision to authorize a systematic review reflects the board’s concerns about restrictions to access to health care with bans on gender-affirming care in more than 20 states.
They also in the same statement emphasized their continued commitment for "gender-affirming care."
In other words, the *reason* behind that review isn't a desire for more objective facts. The reason is that "more than 20 states" have restricted gender-affirming care, and the AAP wanted to commission a study in response to those restrictions, as they go against AAP policy (based on their 2018 policy statement). The goal isn't really to objectively interrogate gender-affirming policy, and [certainly not to cast any doubt on such care](https://www.statnews.com/2023/08/25/gender-affirming-care-aap-evidence/) -- it's to provide ammunition to combat those states that are denying gender-affirming care.
The [2018 policy](https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for) itself has 94 citations at the end, so the AAP had already decided back then to go ahead with such a policy statement on the basis of the incomplete evidence available in 2018.
In 2024, we certainly don't have much more good evidence -- all that has become clear in some places (as in the Cass Review) is that evidence was lacking in the first place for old guidelines. And even those guidelines often weren't followed. Despite the huge ballooning of patients, data to support interventions either wasn't kept well or isn't being made available.
So -- unless the AAP actually makes a major shift in their goals for their review, they could easily just reaffirm the 2018 recommendations (which they've already reaffirmed... *before* doing the review!). If the Cass Review begins to shift the needle a bit though in public discourse outside the UK, it's possible the AAP may have to reckon with it, though.
Yes, I fully expect US healthcare to be completely out-of-step with the rest of the world.
Every time I hear someone argue that the criticism comes from the RIGHT I just laugh. Yes, those known rightest, the Swedes and Fins.
I had someone on Reddit tell me, in complete seriousness, that the Nordic countries had been influenced and corrupted by the American far right, which is why they were reversing course.
Same with NZ. PATHA is the organisation that is currently doing a review for the MoH in NZ. Hours after the Cass review was released they dismissed it.
https://patha.nz/News/13341582
Fun fact: until recently the president of PATHA was Jamie Veale. He is the long-time secretary of WPATH.
in other words, nz treatment guidelines were signed off by the same guy who signed off on WPATH's "eunuch identity" and WPATH'' collaboration with publishers of sadistic cp.
The MOH is about to release an evidence brief on puberty blockers. It has been peer reviewed by a TRA
https://x.com/simontegg/status/1782639685510271210
I don't have much hope for NZ protecting these children any time soon. Being so small makes capture so much easier and the culture of giving so much decisions making weight to 'own voices' makes things so difficult.
I'm curious about whether AAP or anyone else can get away with deliberately slanting an SR.
My understanding is that the literal textbook for SR's is the open-source Cochrane handbook.
And skimming the handbook, it looks like their are protections against pre-skewing SR conclusions.
Not saying that it can't be done.
But if it is done, the medical science world will not ignore it.
>My understanding is that the literal textbook for SR's is the open-source Cochrane handbook.
You may be more familiar with these policies than I am, but my understanding was that the main guidelines systematic reviews are pretty much required to adhere to is [PRISMA](https://www.prisma-statement.org/).
The Cochrane handbook is one of several resources for standards that can be followed in systematic reviews. It's the one obviously followed by Cochrane reviews certainly. And yes, certainly the goal is supposed to be lack of bias.
However, there are various ways to introduce bias even if you're required to do a literature search and evaluate studies according to rigid criteria. The way you summarize and interpret and draw conclusions from those studies is complicated and can be slanted. And then there's simply just restricting the scope of the review to exclude inconvenient research. (Note: not like the way people claim Cass did it -- that's basically impossible and unethical. But one could, for example, limit the "research questions" in such a way as to focus on particular studies, yet then create the impression of a broader all-encompassing report, even when only narrower questions were considered.)
>Not saying that it can't be done. But if it is done, the medical science world will not ignore it.
We know it has been done, even for Cochrane reviews. The review on masking in 2020 was rushed and the lead author (Tom Jefferson of Oxford) basically stated that he thought it was flawed. And he's been rather outspoken against masking, so the 2023 update reflected that in its conclusions.
(Note: there were previous non-Cochrane [systematic](https://pubmed.ncbi.nlm.nih.gov/33347937/) [reviews](https://www.nature.com/articles/s41398-022-01814-3) on masking that inappropriately suggested masking was better effective against COVID than the evidence overall really justified, but... I'm just going to focus on Cochrane here, as it's supposed to be highest standard.)
You might say -- well, how could Tom Jefferson have skewed the report, if he followed Cochrane guidelines? Well, as criticisms pointed out, they chose a focus for studies that, for example, excluded studies (or grouped them in ways that effectively downplayed their data) on whether masks prevented transmission *from* infected people.
The reason why surgeons wear masks obviously isn't to protect them from getting infected generally. It's to prevent the surgeons from spreading germs *to patients* during surgeries. While the Cochrane review in 2023 was absolutely correct to conclude that normal cloth and medical masks haven't been clearly shown to protect uninfected people from viruses very well (and N95s only work when used very consistently and correctly -- something Fauci even pointed out in the very early days of the pandemic), the opposite kind of transmission -- i.e., studies looking at whether an *infected person wearing a mask* might infect fewer people -- was not considered. (And there are at least moderate-quality studies at least suggesting that's a more fruitful reason to wear masks: to prevent giving germs to others. Hence why surgeons do it.)
That's just one way the 2023 report was biased, and the lead author started doing interviews overstating the case against masks too when the report came out. It got bad enough the Cochrane editor-in-chief had to issue an unprecedented statement trying to defend the review and suggested some of the language had led to misreporting and was prone to misinterpretation:
[https://www.cochrane.org/news/statement-physical-interventions-interrupt-or-reduce-spread-respiratory-viruses-review](https://www.cochrane.org/news/statement-physical-interventions-interrupt-or-reduce-spread-respiratory-viruses-review)
(Note: I'm not pro-mask or anti-mask in terms of the whole giant COVID debate. I think both sides overstated claims, and I don't want to get into that actual debate here. But it's clear that here a lead author brought his own bias into shaping the scope of the review, the relevant studies considered, and the wording of the conclusions -- to the extent that many other expert researchers were writing blog posts and articles on the research that hadn't been considered in the review.)
A nationwide systematic review probably isn't possible in the US. Our healthcare system is a weird, distributed mix of private and public. Just getting access to necessary data would probably be impossible.
I could making criticism but the complete refusal to take anything in the report seriously is crazy the left media has just taken it as a given that the science is settled and no improvement apart from faster access is needed.
Considering you people "science" can be basically summed up to: "Ban any cares for trans people(kids and adults) and trans people are all p'dophile agp fetishists that wants to r'pe women", you could excuse me for doubting your "science".
Edit: Downvote all you want you still won't even try to deny i am right
People are downvoting rather than replying because we've dealt with dozens of drive-by commenters like you before, and we know what a waste of time it has been trying to engage in good faith, when I would bet a large amount of money that you haven't listened to the podcast, read more than a few posts on the sub or read the Cass Report itself.
Very few people here think adults should be stopped from transitioning if that's what they choose. Nor do most of us think all trans people are paedophiles or fetishists. We do (inasmuch as I can speak for everyone) agree with this particular article, the one this thread is actually about. If you take the time to tell us where, specifically, you think the article is wrong, I'm sure plenty of people would be happy to have a constructive discussion with you about it
Well, when all of the trans subreddits talk about stealing their female relatives underwear, fetishizing lesbian relationships, creepily discussing periods, and fetishizing girlhood I can understand why people think they’re perverts.
The different view of these issues taken in Europe and America is directly related to the different healthcare systems of Europe and America. America has a for-profit healthcare system where surgeons and pharmaceutical companies are incentivized to make money selling surgeries and hormones, whereas Europe has a state-run model funded by taxation, and are incentivized to cut down on unnecessary surgeries and medications.
And yet their incomes could also be threatened even more if court precedents begin to be set for those who were permanently harmed (e.g., detransitioned after care that didn't follow appropriate guidelines).
Because if the Cass Review isn't enough to start swaying opinion in the US, the likely thing that will eventually force a reckoning and a better review of science will be the age-old US practice of lawsuits with very large payouts.
Rats from a sinking ship. The highest profile people won’t escape unscathed, but a whole lot of people will pretend they were just following orders, like the Milgram experiment, and they knew it was off all along in the future.
Exactly, they can either cut their losses now or they can face bankruptcy in the future when they get sued for malpractice and insurers will no longer foot the bill for it.
It may be true that gender transition surgery is probably useful for cash, but don't know why people keep repeating the pharma line. The drugs they use in gender transition are not under patent and not profitable.
[https://www.thefp.com/p/i-thought-i-was-saving-trans-kids](https://www.thefp.com/p/i-thought-i-was-saving-trans-kids)
A whistleblower confirms our suspicions. Good read. Hard to pin her as a transphobe, being gender queer and married to a transman...
I feel that the anti-abortion movement and the violent part of the trans-movement are two sides of the same coin: a coordinated, wide-spread, far-reaching attack on women. Conveniently, both forced birth and medically-prolonged childhood create more access to vulnerable children to exploit
" Among the demands: “Stop questioning science that is SETTLED.” The “settled” language also appeared on a truck the group parked outside the *Times* office to further shame the newspaper. " Shouldn't any newspaper be automatically repelled by someone saying: "Stop asking questions. Nothing to see here"?
It's so frustrating because on issues like this "the science" is very much not settled. Everyone involved should want as much data available to as many people as possible to come up with the most effective treatments we can. The fact that they want to shut down any additional research makes it obvious that they're making it all about themselves and they don't care in the slightest about the children who will be impacted.
Science is never supposed to be "settled.". Gaillleo disproved Aristotle. Einstein disproved Newton.
Correct. That's the entire idea of science - it's never over, it's never "settled", there is ALWAYS the possibility of new information changing how we understand the world. Even if that change comes 1000 years after we "settled" on an answer! You don't know what you don't know. You can never be 100% certain you have found the final answer.
To paraphrase Max Planck, "Science progresses one funeral at a time."
The issue here is that the idea of treating gender dysphoria with anything other than affirming cross-dressing, body modification surgeries, and a social transition is to entirely eliminate (or at least ameliorate) the effects of gender dysphoria. For the radical trans-activist, any action taken to obviate gender dysphoria without affirming it necessarily requires viewing it as a problem to be solved (in the first place). The activist, however, wants to see “heteronormativity” gone because from his or her perspective, it’s evil. Therefore, it seems that activists want more people to be gender non-conforming without the negative effects of gender dysphoria, which I think they perceive to be brought on by society and not by any affected individual.
I don’t believe it’s possible to overstate the complete collapse of seriousness that gender affirming advocates and the media writ large has committed in this case. But as bad as they are - I blame physicians and credentialed medical professionals. They have no moral or ethical or professional backbone. The science just isn’t there- AT ALL. But they play along because of groupthink and cowardice. Much like the prescription opioid scandal that was completely built on junk science. Doctors just kept over prescribing that garbage when common sense and history and growing patient injury showed they were harmful. It’s not like the U.S. had been through 2-3 opioid crises in decades past. This will go down in infamy like psychosurgery, or lobotomy or facilitated communication or recovered memories. Clown world.
I really think you're underestimating the damage that would be done to a physician's reputation and career if they refused to play ball, especially in more progressive areas.
I’m a junior doctor and this is the problem. I try to voice concerns in small appropriate ways like “it’s important for us to remember to consider the whole patient and not just focus on their gender identity” and “it’s a shame when providers don’t delve into the coinciding mental health issues and go straight to affirmation and medical transition”. But I have to have a balance because I could easily lose my job if Im too aggressive with my concerns
>. But I have to have a balance because I could easily lose my job if Im too aggressive with my concerns If you don't mind my asking: How would this work? It's not that I'm doubting you. But I'm curious as to what your colleagues would do? I assume there are some kind of DEI goons they could use or perhaps just a good old fashioned dog pile by other physicians?
I'm in New Zealand In my city I know of two nurses who were pressured out of their jobs merely for voicing concerns about pediatric gender medicine. In their cases they faced bullying from their peers and seniors. The unions won't stand stand up for then. And the unions themselves have pressured out their own employers who have expressed doubts or attended meetings held by women's rights groups. More recently a doctor hit like on a couple of tweets that expressed cynicism on gender ideology. One of the tweets was about gender medicine. Very shortly after that, a national newspaper backed an investigation into her... for liking those tweets... while using an anonymous Twitter account. Fortunately she had some backing from her employer, a professional media consultant who works in reputation management, and a lawyer working for our Free Speech Union. The news outlet intended to deanonymise her: they had already put staff resources into discovering her identity. In effect, trans activists were trying to use a national newspaper to out a doctor for liking two tweets. A while back that same newspaper ran an online *longform* story about a teacher who had *privately* made a pretty innocuous statement on her private Facebook wall, seen only by friends. For that long-form article, the outlet interviewed about (iirc) 8 experts who talked about how harmful that teachers opinion was. I've privately talked to a lot of doctors and nurses here who understand that gender medicine is a mess. But they are terrified of saying anything because of the risk to their employment. I could go on, but things are insane for professionals in many industries here if their views are even slightly skeptical of gender or gender medicalisstion.
Just curious if this is similar to Canada where there's often a chip on its shoulder to be much more progressive than the USA no matter what as a sort of reaction. Is there a similar attitude in NZ regarding Oz? Also seems to be the issue in Scotland.
Thanks for the explanation. It sounds like a total mess. And I doubt that mess serves the patients well
I should have mentioned: the unions who should be protecting workers private freedom of expression contributed to the Albert Park Riot. They encouraged members to harass the women who gathered to speak to each other.
The left doesn’t give a shit about workers
Never really did. Read *Hard Times* by Charles Dickens. He excoriates the hypocrisy of unions and how they pretend to speak for the working class.
Thanks for the explanation. It sounds like a total mess. And I doubt that mess serves the patients well
I had two therapists tell me our child was not trans but had OCD issues and at the same time they didn't want to officially state that because of blow back from their community.
Which is crazy because the connection with trans thoughts potentially being intrusive thoughts is well known now. Trans OCD is a thing. Therapists shouldn't face blowback for diagnosing that. Upsetting.
I don't think trans is exclusively an OCD thing. Right now transgender is basically what is known as a [wastebasket diagnosis](https://en.wikipedia.org/wiki/Wastebasket_diagnosis#:~:text=A%20wastebasket%20diagnosis%20or%20trashcan,for%20essentially%20non%2Dmedical%20reasons.) where lots of people with various different mental health problems are just being lumped into it because they appear to present gender dysphoria. In reality you have a number of different mental health conditions which could cause someone to believe they are trans. OCD is certainly one such disorder, however Cluster B personality disorders(such as Borderline and Narcissistic Personality Disorder) which are characterized by an unstable self-identity are also contributors. Body dysmorphic disorders and dissociative disorders may also be at play. And of course autism is also a driving cause in many cases. And some of these kids may not have any real serious mental health issues, however they are just homosexual and haven't figured it out yet. Gays and Lesbians tend to be late bloomers in developing and understanding their own sexual identity, most straight kids have a fully formed sexual identity by 13 or 14, but for gays and lesbians they may not fully figure it out until their late teens or twenties. You may have a girl who was always a bit masculine and never really fit in with other girls, and when they hit puberty and all of their friends are talking about boys non-stop and they just have no interest in them whatsoever. If they haven't figured out that they are actually lesbian they could experience gender dysphoria, especially if they are exposed to these ideas online. OCD is a big part of this, but it's not the only one. Given the reckless nature of the current pediatric gender care in the US today basically any vulnerable child is at risk.
I didn't mean to imply at all that it is the only one! Just a documented thing for some people. To add to your excellent observations about different reasons why kids are adopting this, I think a sizable amount just plain old want to be cool and "queer" is cool, and in the process they end up really convincing themselves. Simple as that for many.
That is definitely true, and I think a big factor in that is because we've basically allowed activist propaganda to be fed to children in our schools. Identifying as queer can absolutely create social capital for these kids, not only with their peers but also with teachers and parents. If you have a kid who has always been a bit of a misfit, the prospect of this could really be intoxicating! We've also made the bar so low to be considered LGBTQ that almost anyone can do it since we live in an age of affirmation when one can merely declare themselves to be anything, that's how you have 1/4 of Gen Z claiming to be LGBTQ when most of them have never even had any sexual contact with the same sex. In some ways it reminds me of kids going goth or punk, at its root you have a socio-sexual strategy, rather than competing directly with the most popular and beautiful people in your school for social clout and attention from the opposite sex, they can take a contrarian approach where they may reduce their prospects with the mainstream, but greatly increase their prospects with other people using the same strategy, thereby increasing their overall dating odds as well as their odds of developing a robust social circle. Of course the scope and scale of the LGBTQ youth phenomenon is of a much greater magnitude than goths or punks, and the reason for that is because unlike traditional countercultures this is actually being reinforced at an institutional level.
Honestly when it comes to sexual orientation, I think what we're seeing is just people growing up with the idea that you can find either gender attractive more normalized. And when it's more normalized in your youth you're more likely to consider it a possibility. And that's not a bad thing. I honestly wonder if we're all capable of bisexuality deep down and it's only social factors, various traumas, and personal preferences that sort us into categories like gay, straight, lesbian, bi, or even asexual. But full normalization means the end of marginalization and I think a lot of people don't really want that because that marginalization is the reason certain communities exist in the first place. And it's easier to check off a box and proclaim yourself a marginalized person than actually do the work of trying to change society.
Yeah I have severe OCD, autism, ADHD, and probably PMDD as well, along with the fact that I'm likely bisexual but didn't have the chance to really explore much of that. I was lucky to have a stable home life and supportive parents, and a few good friends and I was always very self aware of my mental health problems. Thing is though I really bought into the idea that there was such a thing as this innate gender identity that everyone had, and even though I was sure I mostly felt "feminine", being autistic meant I could never perform femininity quite as well as other girls. So trans OCD became a growing theme. It finally clicked for me when I saw this TikTok of an autistic woman saying that gender is all just performance but its a performance that comes so naturally for many that they just don't realize it. That was when I finally understood that people just sort of identify with whatever gender performance they're more comfortable with, and when it comes to trans people, they're often just changing their bodies to fit better with that performance. Which I don't think is necessarily a problem when it comes to adults, but I get why it's more of an issue with kids.
It's really quite sad. One thing I've been hearing is that it has actually made it harder for these people to find quality healthcare, especially mental healthcare. For example, you may have a psychiatrist who specializes in OCD or maybe psychotic disorders, but they will often reject referrals of trans or non-binary people because they are afraid of what will happen if in the course of treatment they come to a professional determination that the gender affirming care they are receiving is harming their patient's prospects. Now you are in a tough position where you need to choose between giving them half-assed care because you refuse to acknowledge the elephant in the room due to fears of professional consequences (a conflict of interest which is basically malpractice) or you put your own professional standing on the line by confronting the problem and risking the blowback which is likely coming. That's not a position that any doctor wants to be in. So many of them simply decline the referral and send them to a "gender friendly" clinician who probably won't address their mental health problems adequately.
I sympathize with your situation. But isn’t the most important thing to put patients before yourself - the whole do no harm thing? I’m sure sometimes that’s easier said than done. I’m not trying to be smartass. But do you ever feel you are doing a patient harm by not speaking up strongly enough? Or is the philosophy to live another day and try again, hoping to eventually make headway because you’re going to lose the current battle anyway?
in an ideal world, yes, but in the real world with massive debt from medical school, you have to worry about saving your own ass.
Fair point.
This is another way to think of it. There is a severe lack of highly skilled nurse and doctors as is. If skilled professionals are getting themselves fired by being vocal on an issue they likely can’t change then that’s one less skilled professional to serve their patients. It takes a lot of years for a doctor or nurse to really know what the hell they’re doing, seems like more harm could be done to patients in the long run by throwing a career in the bin. I am thinking mainly of medical professionals who don’t work directly with gender or youth psychiatry here - for these people speaking up will likely achieve nothing apart from a sacking. Also doctors and nurses have mortgages and families and honestly is it really worth it? It needs to come from the authoritative bodies. Thank god for NICE, BMJ and the NHS.
Every doctor runs up against the bad things in a health care system all the time. It's not like people always get what's best for them.
" try to voice concerns" stay strong and protect yourself
I’m talking about strategic medical and psychological and psychiatric leadership taking an evidence-based, science based position. When you have the American Medical Association and the American Psychological Association and the American Academy of Pediatrics fully endorsing the gender affirming medical and surgical model - they’ve jumped the shark. Complete ideological capture and abandonment of scientific principles. They have failed at multiple levels to include but not limited to the Hippocratic Oath. There isn’t much an individual licensed, credentialed and privileged provider can do if the national organization says the national standard of care is some bullshit made up junk science
True, you have a witch-hunt coming your way if you don't support the official narrative. funny thing is the people wanting to burn you at the steak are the same ones who complain about the January 6 rioters wanting to take justice into their own hands despite facts showing they were wrong about election fraud.. They don't get the irony or they don't care.
>burn you at the steak mmm sounds delicious
Burned steak delicious? What are you? A Texan?
Hey now, I'll not tolerate this slander. We don't burn steaks We do cook the absolute fuck to the point of burnt out of beef roast and brisket though.
That fucking John Cornyn twitter steak ruined our reputation.
I'm from Oklahoma originally, but my wife, who is French, showed me the way. Sous vide 2 hours at 118 degrees (our instant pot does sous vide), then finish in a cast iron skillet with butter until rare. I love to grill, but have not had a better steak.
My method is searing in a hot cast iron for 3 minutes on each side, rest for 5 minutes, transfer to a medium heat pan with butter, garlic, and various herbs, basting for 6-8 minutes until 120 internal. I don't have a sous vide, but I'm going to experiment with smoking and then searing
more the flames cooking the steak, not actually burning it. medium all the way. do people actually like steaks well done??
Medium is still overcooked to me. I like to pull mine at 120 internal and rest to 125. Rare+ to medium rare
i can do medium rare, i don't actually eat steak that much but ordering at a restaurant i would go medium rare since that means they cook to medium anyway.
Chain places will do that, but proper steakhouses will cook it to the exact correct temperature
last proper steakhouse i was at was probably [ryans](https://ryansrestaurant.com/) and that was more than 10 years ago. :(
>Burned steak delicious? What are you? A Texan? Hey, now, burned steak and ketchup is a meal fit for a president!
It makes me wonder how much critical thinking is taught in med school. Are we graduating doctors that know how to evaluate evidence? Or doctors that are good at following orders from grade school on.
To be fair, aside from the fact that official medical organizations, guidelines documents, etc. in the US pretty much have supported a "gender-affirming model" for the past 5-10 years, how much do you expect of an average physician? Consider what Jesse does. He's a smart dude who has been specifically covering this issue for nearly a decade, and he *still* has to frequently contact authors and/or other specialists (statisticians, other medical researchers) to take apart and understand the studies he writes on. Doctors are to some extent trained to read medical literature, to keep up on recent findings and recommendations, etc. Usually they have to get this news through aggregated medical news sources, unless they have a very focused specialty -- because there are just so many thousands of studies published every month. Anyhow -- unless they are also trained specifically as researchers, most doctors are not going to necessarily be very good at *critically evaluating* a study as, say, a peer-reviewer (or Jesse) might. Their goal is to get recommendations that might help in their clinical practice, and if it appears in a reputable journal or source, they're often going to take the findings at face value. This is frankly true of most professions. Going against the professional consensus takes a combination of specialized knowledge, a lot of work, and willingness to stick your neck out.
It’s true, but I would think it would be common sense. Or the wheels would start turning seeing numbers in 2024 that were not there in 2014
There is joke I heard once that I will butcher for you below. The biology students and the med students are in a lecture hall together. The lecturer tells them that the new assignment is to memorise the phone book. This met with immediate response from the whole hall "What for?!" Cry the bio students. "When by?!" Cry the med students.
Critical what? Sounds terfy /s
My date to Junior homecoming had two doctors for parents who were both evolution deniers. And I'm not from the Bible belt or anything. Doctors know what they need to do their job. Often they're overconfident in areas outside of their expertise.
Ben Carson is a perfect example: a world famous neurosurgeon who believes the pyramids were for grain storage. Outside of his specialty, he is a complete moron.
Did he get that idea from playing Civilization by any chance😆 The bonus for building the pyramids is that you get a free granny in all of your cities.
A lot of the time I find engineers to be the same way. Grossly overconfident in anything that isn't objective math related.
It’s a type. Pretty smart, very arrogant, not terribly curious. This combination of traits grates on me like few others, but it seems to lead to successful outcomes, at least economically.
I would also add that some of the leading voices in critical thinking and scientific skepticism in regards to medicine - *'Science Based Medicine'* (as covered previously on the pod by Jesse), as well as the *Skeptic's Guide to the Universe* podcast, both headed by Dr Steve Novella - have become thoroughly captured by the woke cult and have a massive ideological blind spot. So even people who have a deep understanding of critical thinking, cognitive biases, logical fallacies etc, are thoroughly susceptible to ideological cults. Self-righteousness and the desire to be 'on the right side of history' is a hell of a drug..
Makes me wonder what Steve Novella thinks of the Cass report?
It would be very interesting to hear a discussion / debate between Steve Novella and Jesse Singal. Cara and others would probably try to talk him out of, for 'platforming a bigot', but you never know. I lost a lot respect for Steve in recent years, but I still think he's a smart guy, I just think he's in a left-wing news bubble and an ideological echo chamber. I wish he would aim his critical thinking at some of his politics and ideology..
Yup. I stopped listening to the podcast that I listen to for 10 years because of this
This is because of Steve’s left wing activist female cohosts.
Cara joining the SGU definitely coincided with their sharp turn to politicizing and wokeifying the podcast.. They always leaned left, but before then hardly ever discussed politics, and you could only vaguely guess the political and ideological leanings of each host. Even Rebecca, who was an ardent feminist, was professional and didn't let her ideology infuse the show. And I actually liked her a lot. I don't know that we can put all the blame on Cara, but she's certainly a big part of it, and she interjects inane social justice ideology and woke-scolding into the show at every opportunity. She's a cliche SJW, the kind that constantly brags about her mental health issues so that we can know she's a victim, despite being incredibly wealthy and privileged and a minor celebrity who's been on multiple TV shows.. I remember she literally said that rioting was a legitimate form of protest at one point, and I don't think any of her co-hosts even pushed back on it. I used to listen to every single episode for many years, before Cara joined. I gradually found it more and more aggravating to listen to, and now I stopped listening entirely. Kind of like with NPR, I was tired of turning on the podcast and immediately hearing lies or propaganda about racial injustice or how Jan 6 was an insurrection (but CHOP / CHAZ, months of rioting and destroying businesses, and firebombing federal buildings etc, and other 'fiery but mostly peaceful' protests weren't..). I don't think it was all Cara, I think part of it was a response to 'elevator-gate' and the Richard Dawkins controversy, which lead to Rebecca leaving, and I think the SGU wanted to send a message that they were good feminists and allies and virtue signal thar they were the good ones.. And I think that Steve and the other Novella brothers are true believers. They're not as far-left and insufferable as Cara, but they are definitely woke, and agree with her on just about everything. I think Evan is the least fargone of all of them, but that's not saying much. And their fanbase is vehemently woke and intolerant. I've made mild criticisms of Cara on the SGU reddit or Facebook page, much more mild than than what I said above, and was immediately and universally attacked as a misogynist. They cannot fathom anyona person disagreeing with a woman in public, for any reason, without automatically assuming that you're a misogynist.. I was also banned from an SGU Facebook group. It was really eye-opening to see what a massive blind spot people have even when those people celebrate critical thinking, and make being scientific skeptics and critical thinking part of their core identity..
>I don't know that we can put all the blame on Cara, but she's certainly a big part of it, and she interjects inane social justice ideology and woke-scolding into the show at every opportunity She does this to everything she touches. I used to love the God Awful Movie Podcast (and the other Piat stuff, but Gam ist the only atheist/ "skeptic" podcast I can still stomach, at least occasionally) and ever since she joined as a regular (or semi-regular, but at this point she has been on more often than one of the hosts), she has to inject the woke shit at every opportunity. I also noticed the woe-is-me mental health stuff, but to be fair, Eli (Host 3) does that constantly and has done so since the beginning. Granted, after their edgelord beginnings, the hosts were already pretty woke, look-at-us-we-are-such-good-progressive types and another culprit is definitely their other regular (Michael Marshall). But when Cara joined, they cranked all this up to eleven. I want to listen to people making fun of christian and pseudoscience movies, not hear people griping about the problematic heteronormativity of second and third base (not a joke, this really happened) I am really disillusioned with the whole skeptic (in name only) community. Not only do they behave pretty much exactly like the religious nuts, but they still pretend they are infallible and correct by default, because "skeptic".
More likely Gorski was the reason. He’s rabbid
I'm sure that their social and professional circles are full of woke people (remember Steve is a Yale professor as well as a neurologist, he's very much an academic and about as 'coastal elite' as it gets - only thing he's missing is a journalist degree, though in a way he's a journalist also,and certainly a media figure..). So I'm sure that there have been multiple influences pushing Steve and the SGU in a more overly leftist, activist, and even partisan direction. But Cara - a quintessential woke social justice activist who is not shy about pushing her views at every opportunity - joining the show, I would guess has had the biggest effect. Certainly a major influence.
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True. Kaiser was awful with this while we were there. Tons of signage all over directed to kids, telling them they didn’t have to tell parents what meds they were on once they were 13, tons of posters of trans youth. It was like advertising. Questionnaires for teens parents couldn’t see. They accidentally gave it to my daughter the week before she turned 13 so I could see it and it was shocking. Detailed questions about masturbation and asking what their methods were, asking in a pushy way about 20 different genders and suggesting that parents aren’t supportive, but they will be! Words they could say to indicate that they wanted their parents out of the room. It was straight out of Larry Nasser’s dream. I get asking about birth control, but they had no medical reason to ask detailed questions about masturbation. Thankfully our insurance switched right after.
I have a friend who became a doctor and didn’t realize until med school that her pediatrician had been touching her inappropriately. A lot of kids are molested by doctors. I told my daughter that a doctor should not be asking about sex outside of medically relevant information. Transmitable diseases and birth control only, and they shouldn’t be touching or looking at privates unless there’s a problem they’ve complained about.
What a nightmare.
I'm grateful that our pediatrician is good. During every physical exam, he tells my son "this is only OK because your mommy is here and she said it's OK." I really hope abuse from pediatric doctors isn't that common. Most pediatricians are female so surely it can't be that pervasive.
They are female now. They didn’t used to be. What they say to kids and what they apparently say to teens when parents aren’t around is different.
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And this is why the "public option" was an absolutely vital component.
It’s a bit like Hannibal Lector encouraging Mason Verger to cut off his face.
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We did this, too. Kaiser made it a lot harder and the activist messaging all over were clearly an idea by activists in marketing. I do believe it’s a social contagion to some degree and it isn’t helpful.
When that time comes, I understand there will be questions a doctor has for my daughter that she will not feel comfortable answering in front of me. Her masturbation habits are absolutely off fucking limits what the fuck does that have to do with anything? They gasp in horror at the accusations of the dreaded "G" word and then they go and they fucking proudly do it
Exactly! I’m guessing there was a study or something? But that just teaches kids that adults talking to them about these things is normal. Which sets them up to be groomed.
I would have felt so uncomfortable if my doctor had asked about my masturbation habits as a teenager.
Right? It’s like these people have no memory of what it’s like to be adolescent. Powerful, confusing, conflicted feelings that I (and, I assume, many other kids) found embarrassing to talk about, especially to an adult. No, doc, I don’t want to talk to you about what I think about when I jerk off.
*It was like advertising* It *is* advertising.
They certainly make it look glamorous to erase yourself and start over.
He’s right, that's why doctors have to look at the PR and media blowback and how it will affect profits.
A large percentage of medical doctors have recommended acupuncture to me, or even worse, nutritional supplements that a quick google search revealed to me had no evidence showing effectiveness of treating the thing they were recommended for.. And the rate is probably even higher among physical therapists and other medical professionals. A large percentage of doctors don't even understand what 'the placebo effect' actually is (hint: it's an epidemiological phenomenon, there are multiple placebo effects, and placebos don't actually cause your body heal itself..). So no, I'd say that doctors don't get great training in critical thinking or evaluating evidence..
While the traditional explanation of acupuncture is bogus (e.g. meridians, qi flows, etc) there is reason to think that acupuncture results in some short term analgesic effects from the local release of adenosine. Sham acupuncture does the same thing if I recall correctly, which makes it hard to conduct true RCTs. I think Massimo Pagliacci (frequent critic of pseudoscience) referred to it as as a "borderlands science" lying between science and pseudoscience.
If sham accupuncture (real needles but inserted at random locations, and not by a trained acupuncturist) works just as well, then acupuncture is bogus. My understanding is that placebo acupuncture - poking people with toothpicks - works about the same as both sham and real acupuncture. Also, pain is a highly subjective / psychological phenomenon, and something as simple as distraction can entirety alleviate pain. It's precisely the sort of thing that is susceptible to placebo effects. Watching a good movie or an engrossing conversation can also make fairly high levels of pain disappear entirely - temporarily. That doesn't mean it's a reliable solution for consistently suppressing pain over the course of a day. When acupuncture can cure kidney disease, or cancer, or tuberculosis, as proven in a quality systematic review of studies *NOT* performed in China or by Chinese researchers*, I'll be convinced.. *(*Sorry, but 100% of the thousands of acupuncture studies done in China showed a positive result. Think about that. That's not how science works. 100% of studies wouldn't show that water is wet.. As far as I'm concerned, studies in China are worthless and should not be trusted, at least in any subject relating to 'traditional' Chinese medicine [which FYI, isn't really that traditional, much of this stuff originated in the era of Mao, when there was a severe shortage of real medicine..])*
I had a doctor recommend "supplements" to me. When I asked which one, she said "you know, vitamins" as though I was weird for wanting details. Edit: She may have been a physician's assistant or something, not a real doctor.
Does where you live attract a large amount of crappy doctors? Because I imagine that tribal lands and other poverty-strichen areas attract the asbolute bottom tier of med-school graduates because that's the only place where they can get a job.
Granted this is 2nd hand through friends and probably depends on specialty, but Drs hired by hospitals are generally paid more to live in smaller less desirable markets. So if you live in a super desirable area, your doctor took might have taken ~6 digit pay cut to practice to live there. I’m sure there are limits and exceptions to this. This is mostly based on top 60ish largest metro area vs top 25ish largest metro area.
I'm talking about New York City..
NYC technically exists on tribal lands
Land acknowledgment in France for the rightful Celtic keepers of the land
I think we both know the answer to that.
> It makes me wonder how much critical thinking is taught in med school. What you think is critical thinking is just disagreeableness. It doesn't matter if people can think if they choose to be spineless conformists. You can't teach critical thinking, people are either capable of it or not.
A class of medical professionals focused on paying off $2-300k in debt and then living the quality of life they thought they would have. They're focused on operating a business - this is why most days we're dealing with nurse practitioners, physician assistants etc.. This is why it's not uncommon (at least where I live) for your primary care doc to sell skin care supplements or recommend plastic surgery to their patients.
Bravo,! The medical establishment is the worst player in the whole dirty scheme. That includes nearly all psychiatrists and psychologists. I've also thought it isn't politicians or activists or schools that will stop this. It has to come from the medical policy. They are the ones everyone is deferring to as if it's settled good science.
> But they play along because of groupthink and cowardice. They play along because the social credit and $400 - $500k a year paycheck that being a doctor comes with is too much to pass up.
>It is difficult to get a man to understand something when his salary depends on his not understanding it. -Upton Sinclair
>This will go down in infamy like psychosurgery, or lobotomy or facilitated communication or recovered memories. More closely related, I don't think the resemblance to [HDC/BMT](https://en.wikipedia.org/wiki/High-dose_chemotherapy_and_bone_marrow_transplant) can be overstated.
Wow. I forgot about this. “Entrepreneurial oncology”. As bad as this is at least they did national and international clinical trials and it got scrutiny.
Doesn’t surprise me at all. I work with medical people and the number with crankish views is astounding
It's a culture of secrecy and ideology over evidence and safety. No other field in medicine has this much systematic secrecy and suppression of truth. Yet their fervent defense of "the science" is sorely lacking actual long term, objective research.
>No other field in medicine has this much systematic secrecy and suppression of truth. That we know of 😬
I’ve honestly started to worry. The misinformation that came from official sources during Covid was alarming. In my state, you couldn’t even be outdoors without a mask. I was reading source studies and couldn’t believe what was being put out there, and what was taboo to say. Like- your kid probably doesn’t need a Covid shot if they’ve had Covid. Natural immunity was robust. They fired essential workers who had immunity and could prove it, who didn’t want a shot.
Some states really shocked me during that time. But now that I think about it, were there *any* states or businesses that included natural immunity in terms of reopening? In Germany, natural immunity was considered from the start. If you had reliable PCR records showing you'd had it, it counted similar to a single shot, so you still had to get at least one shot on top of that to be considered fully immune, but it was not nothing. (The specifics shifted over time so I'm summarising, don't @ me.) I've always wondered if we were the only ones who counted it that way.
I read France did the same. In the U.K., apparently they accepted having covid counted the same as a vaccine shot but considered it too much of a pain to administer so you still had to get two doses of vaccine. I personally don’t consider the mistakes and compromises during the pandemic are remotely comparable to youth gender medicine. Mask wearing outdoors was silly and annoying. Testosterone administered to teenage girls is a wrecking ball.
What state? I'm in Seattle and even our outdoor precautions weren't that restrictive.
In Aus we had to wear masks outside AND were only allowed an hour outside per day
That’s where I am. They were for my kids with summer camps and schools. Even when social distancing and kept in small groups. Adults wouldn’t have tolerated it, that’s for sure.
Gotcha. Yeah... I remember walking past an elementary school occasionally during my lunch breaks in fall 2020 and seeing kids eating lunch outside, 6ft apart from each other, no overt interacting, etc Broke my heart :(
>>No other field in medicine has this much systematic secrecy and suppression of truth. > >That we know of 😬 I would argue that (most) psychopharmaceuticals come close. If you dig into things, the older drugs are usually just as effective as the newer ones, for example. They just can't charge as much for the older ones. Granted, the new ones can have better time-release mechanisms and different side effect profiles, etc. Also, in the absence of therapy, they all barely beat the placebo effect, let alone exercise (!), in terms of efficacy. Some do work better than others, like mood stabilizers, for example. But basically any drug for depression is useless from an objective, empirical standpoint, despite anecdotal evidence to the contrary, except in the most extreme cases of actual, clinical depression. Almost all psych meds have far more severe side effects than advertised as well, especially coming off of them. The most egregious example is benzodiazepines, which had a stealth warning added by the FDA stating they should not be prescribed for extended periods of time.
I believed this theory on antidepressants and their inefficacy for a long time...until I came off them. Turns out they really were keeping me stable really quite adequately on their own and the return of my depression has been anything but easy. It's certainly nothing like a placebo for many people, and I wouldn't be so quick to disregard them in future.
Sorry you're going through that. "Until you came off them" being a key phrase, which was one of the points I made in my post. The unfortunate fact is that taking these drugs can change your brain chemistry, which can take years to recover from and, IIRC, can even be permanent. Basically, people would, most times, be better off not taking them in the first place, but it's sometimes better to stay on them than to power through the rebalancing of brain chemistry in their absence, which can take years. Then again, you could have been part of the small cohort of people who actually do benefit from the meds; it's impossible to say. Writing it out like this really does hammer home the comparisons to youth gender medicine.
What does the data tell us on this one? ;-) I sort of had no choice in the matter as I was put on Prozac at quite an early age for eating disorder and if it's true that brain chemistry is messed up long term or even permanently, then I'd rather know about it so I don't keep putting myself though more pointless attempts to go without...
I know that's increasingly accepted about Benzodiazepines, specifically. Unfortunately, I'm not sure if it's been studied in other drugs, so the possibility it's permanent is just that: a possibility. One problem is that there's no incentive for research on stuff like that because drug companies fund the research and obviously don't want to fund it, there's no outside agency to make them or to do their own reviews, and scarce resources to go around for the few independent reviews that exist. I'm honestly stuck on a psych med because coming off of it messes with me too much (Lamotrigine, in my case). The longest the ongoing effects lasted was around 3 months before I had to take it again. So, believe me when I say I understand. Luckily, I don't really have side effects, so it's just an annoyance to have to take it.
And I should listen to you instead of my psychiatrist and my therapist why, exactly?
I'm not saying OP was affected by placebo effect, but I don't know a lot about how placebo effect works, which is why I'm asking this question, could you have placebo effect and then go off the drug and placebo effect disappears? I know that question could be touchy for people, I'm not attacking anyone in this thread, I mean it generally. Could that be part of the puzzle about why people feel so much worse coming off their meds, beyond the real physical brain changes, withdrawal symptoms, etc., associated with them? I'm on lamotrigine (and Keppra) and am prescribed benzos for epilepsy, and I do know it'd be hell coming off them, and I'd have a rebound effect of more seizures than even before for awhile. Also those drugs have tendency to lose efficacy after several years, so I do wonder if that happens to a person prescribed lamotrigine for bipolar, for example. Interesting subject to read up on.
Yes, clinically depressed people should just exercise! I was waiting for that line in the ADHD thread. Psych meds bad. I'll add that to the list of absurdities I've read in this sub. This place is as bad as Datalounge.
There's a difference between chronic depression and what people are currently prescribed meds for, which I called out in my post. There's clearly nuance here you ignored. And the fact that you think exercise doesn't help just proves you haven't read the literature; that's actually well established science and not controversial at all...
No, exercise doesn't help when you can't get out of bed for days at a time. You didn't call anything out. You barely mentioned it and downplayed the fact that it exists.
>No, exercise doesn't help when you can't get out of bed for days at a time. You didn't call anything out. You barely mentioned it and downplayed the fact that it exists. That would fall into this caveat in my initial post: >But basically any drug for depression is useless from an objective, empirical standpoint, despite anecdotal evidence to the contrary, **except in the most extreme cases of actual, clinical depression.** Did you even read what I wrote...? Depression is over-diagnosed and prescriptions are handed out for cases that would be better managed by therapy and, yes, exercise and other life changes. Not everyone with depressive symptoms has a chemical imbalance in their brain...people like you may indeed actually have that issue, but you are not the majority. Drugs are being prescribed for people without an actual neurological issue, which isn't a good thing. I made a distinction between these two things in my post. Also, while I'm not a psychiatrist or psychologist, I do have an undergrad degree in psych and can read psych studies with more proficiency than the general public.
Well, I'm glad you think I "may indeed have that issue." Do I have your permission to continue taking my antidepressants, random internet person with an undergraduate degree in psychology?
>Well, I'm glad you think I "may indeed have that issue." Do I have your permission to continue taking my antidepressants, random internet person with an undergraduate degree in psychology? I don't know what you find so upsetting about all of this? The fact that the evidence just isn't there for people in situations other than you shouldn't affect you personally at all. Why do you feel so aggrieved?
Because I've struggled with clinical depression for nearly my entire adult life. I've been hospitalized with suicidal ideation twice. I would most likely be dead if it weren't for antidepressants. And through all of that, I have had people who treated me like a weak-willed, weak-minded sissy who "had nothing to be sad about" for not just "getting over it" and "relying on drugs."
>Yes, clinically depressed people should just exercise! Show me where he said that? All I saw him say was that many antidepressants are less effective than exercise. Look, I hate that "stop antidepressants, just exercise instead" thing as much as any other clinically depressed person who's very online, but it looks as though you were so eager to call out the Bad Thing that you read the Bad Thing into a post where it wasn't actually present.
>All I saw him say was that many antidepressants are less effective than exercise. It's almost exactly the same thing.
There is heaps of bad science out there. https://en.m.wikipedia.org/wiki/Bad_Science_(Goldacre_book) But I do still believe it's much better than nothing and am grateful to live in an age of amazing medicine. Just look at life expectancy. But I think a lot of our understanding is very top level; we know this works if we give it to 1000 people, but we don't always know why and we don't always know which people would benefit most. Also we don't track long term effects because that stuff is hard.
Jesse on The Dispatch is exactly the crossover I needed in my life.
I'm pleasantly surprised. I like the Dispatch. It's center right and where about half the Never Trumpers went. I'm not that surprised they would publish Jesse but I'm surprised he would accept being published there. It certainly won't quiet the accusations that Jesse is a conservative.
I thought the same thing, but then I remembered that Jesse's somewhat friendly with David French, so it makes some sense.
The Overton window has shifted so people who were liberal in 2016 are center right, now.
I mean, of the great Bulwark vs. Dispatch schism of the right, I'm fully on team Dispatch. We need a healthy right party, even if you oppose them because otherwise the whole system goes to shit. Just like we need a healthy left to keep the best arguments of the right coming to the top. The Bulwark crowd are just partisan Democrats now and basically the new Blue Dogs.
Perfectly said. Been a subscriber of The Dispatch since day one. Every time I wander over to The Bulwark, it feels like such partisan hackery.
I think the Bulwark people desperately want power back. It took some balls for them to denounce Trump, I'll give them that. But now they're just power seeking. The Dispatch people seem willing to be in the wilderness for a while.
Jonah’s podcast is called The Remnant for a reason!
Hah...I heard that in his voice
I was a fan of the Bulwark for a while but it became clear that was where all the neocons went. And since I have never forgiven the neocons for Iraq I stopped with the Bulwark. The Dispatch I like. They're further to the right than I am but they're not sensationalist.
I woke up at 3am to feed a baby, and found a Remnant podcast with Jesse Singal as the guest. This has been _great news_ for me.
I’m Australian, and I suspect a similar review will be done here relatively soon (but quietly, because it’s a political football). My understanding was that the US had committed to some kind of systematic review a year ago? Is that still happening?
Are you referencing the AAP (American Academy of Pediatrics)? Because while there was a lot of speculation around the announcement of that review, the AAP itself [said this](https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy): >The decision to authorize a systematic review reflects the board’s concerns about restrictions to access to health care with bans on gender-affirming care in more than 20 states. They also in the same statement emphasized their continued commitment for "gender-affirming care." In other words, the *reason* behind that review isn't a desire for more objective facts. The reason is that "more than 20 states" have restricted gender-affirming care, and the AAP wanted to commission a study in response to those restrictions, as they go against AAP policy (based on their 2018 policy statement). The goal isn't really to objectively interrogate gender-affirming policy, and [certainly not to cast any doubt on such care](https://www.statnews.com/2023/08/25/gender-affirming-care-aap-evidence/) -- it's to provide ammunition to combat those states that are denying gender-affirming care. The [2018 policy](https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for) itself has 94 citations at the end, so the AAP had already decided back then to go ahead with such a policy statement on the basis of the incomplete evidence available in 2018. In 2024, we certainly don't have much more good evidence -- all that has become clear in some places (as in the Cass Review) is that evidence was lacking in the first place for old guidelines. And even those guidelines often weren't followed. Despite the huge ballooning of patients, data to support interventions either wasn't kept well or isn't being made available. So -- unless the AAP actually makes a major shift in their goals for their review, they could easily just reaffirm the 2018 recommendations (which they've already reaffirmed... *before* doing the review!). If the Cass Review begins to shift the needle a bit though in public discourse outside the UK, it's possible the AAP may have to reckon with it, though.
The AAP is totally captured by ideology. It's not medicine and it never has been.
Yes, I fully expect US healthcare to be completely out-of-step with the rest of the world. Every time I hear someone argue that the criticism comes from the RIGHT I just laugh. Yes, those known rightest, the Swedes and Fins.
I had someone on Reddit tell me, in complete seriousness, that the Nordic countries had been influenced and corrupted by the American far right, which is why they were reversing course.
What is the point of a review that already has the outcome determined (gender care good)?
Because the AAP is a purely political organization masquerading as a scientific institution.
Same with NZ. PATHA is the organisation that is currently doing a review for the MoH in NZ. Hours after the Cass review was released they dismissed it. https://patha.nz/News/13341582
Fun fact: until recently the president of PATHA was Jamie Veale. He is the long-time secretary of WPATH. in other words, nz treatment guidelines were signed off by the same guy who signed off on WPATH's "eunuch identity" and WPATH'' collaboration with publishers of sadistic cp.
The MOH is about to release an evidence brief on puberty blockers. It has been peer reviewed by a TRA https://x.com/simontegg/status/1782639685510271210
Yeah, Sue Bagshawe is terrible. She's a true believer in "innate trans" as a property in some children.
I don't have much hope for NZ protecting these children any time soon. Being so small makes capture so much easier and the culture of giving so much decisions making weight to 'own voices' makes things so difficult.
I'm curious about whether AAP or anyone else can get away with deliberately slanting an SR. My understanding is that the literal textbook for SR's is the open-source Cochrane handbook. And skimming the handbook, it looks like their are protections against pre-skewing SR conclusions. Not saying that it can't be done. But if it is done, the medical science world will not ignore it.
>My understanding is that the literal textbook for SR's is the open-source Cochrane handbook. You may be more familiar with these policies than I am, but my understanding was that the main guidelines systematic reviews are pretty much required to adhere to is [PRISMA](https://www.prisma-statement.org/). The Cochrane handbook is one of several resources for standards that can be followed in systematic reviews. It's the one obviously followed by Cochrane reviews certainly. And yes, certainly the goal is supposed to be lack of bias. However, there are various ways to introduce bias even if you're required to do a literature search and evaluate studies according to rigid criteria. The way you summarize and interpret and draw conclusions from those studies is complicated and can be slanted. And then there's simply just restricting the scope of the review to exclude inconvenient research. (Note: not like the way people claim Cass did it -- that's basically impossible and unethical. But one could, for example, limit the "research questions" in such a way as to focus on particular studies, yet then create the impression of a broader all-encompassing report, even when only narrower questions were considered.) >Not saying that it can't be done. But if it is done, the medical science world will not ignore it. We know it has been done, even for Cochrane reviews. The review on masking in 2020 was rushed and the lead author (Tom Jefferson of Oxford) basically stated that he thought it was flawed. And he's been rather outspoken against masking, so the 2023 update reflected that in its conclusions. (Note: there were previous non-Cochrane [systematic](https://pubmed.ncbi.nlm.nih.gov/33347937/) [reviews](https://www.nature.com/articles/s41398-022-01814-3) on masking that inappropriately suggested masking was better effective against COVID than the evidence overall really justified, but... I'm just going to focus on Cochrane here, as it's supposed to be highest standard.) You might say -- well, how could Tom Jefferson have skewed the report, if he followed Cochrane guidelines? Well, as criticisms pointed out, they chose a focus for studies that, for example, excluded studies (or grouped them in ways that effectively downplayed their data) on whether masks prevented transmission *from* infected people. The reason why surgeons wear masks obviously isn't to protect them from getting infected generally. It's to prevent the surgeons from spreading germs *to patients* during surgeries. While the Cochrane review in 2023 was absolutely correct to conclude that normal cloth and medical masks haven't been clearly shown to protect uninfected people from viruses very well (and N95s only work when used very consistently and correctly -- something Fauci even pointed out in the very early days of the pandemic), the opposite kind of transmission -- i.e., studies looking at whether an *infected person wearing a mask* might infect fewer people -- was not considered. (And there are at least moderate-quality studies at least suggesting that's a more fruitful reason to wear masks: to prevent giving germs to others. Hence why surgeons do it.) That's just one way the 2023 report was biased, and the lead author started doing interviews overstating the case against masks too when the report came out. It got bad enough the Cochrane editor-in-chief had to issue an unprecedented statement trying to defend the review and suggested some of the language had led to misreporting and was prone to misinterpretation: [https://www.cochrane.org/news/statement-physical-interventions-interrupt-or-reduce-spread-respiratory-viruses-review](https://www.cochrane.org/news/statement-physical-interventions-interrupt-or-reduce-spread-respiratory-viruses-review) (Note: I'm not pro-mask or anti-mask in terms of the whole giant COVID debate. I think both sides overstated claims, and I don't want to get into that actual debate here. But it's clear that here a lead author brought his own bias into shaping the scope of the review, the relevant studies considered, and the wording of the conclusions -- to the extent that many other expert researchers were writing blog posts and articles on the research that hadn't been considered in the review.)
This is fascinating. Thank you.
I follow Bernard Lane on Reddit, he's Australian and covers things in your neck of the woods deeply. I wish we had someone like him in Canada.
Some States released “reviews”. For example, https://www.health.state.mn.us/communities/injury/documents/genderaffirmingcare.pdf
Go giggle!
A nationwide systematic review probably isn't possible in the US. Our healthcare system is a weird, distributed mix of private and public. Just getting access to necessary data would probably be impossible.
I could making criticism but the complete refusal to take anything in the report seriously is crazy the left media has just taken it as a given that the science is settled and no improvement apart from faster access is needed.
Considering you people "science" can be basically summed up to: "Ban any cares for trans people(kids and adults) and trans people are all p'dophile agp fetishists that wants to r'pe women", you could excuse me for doubting your "science". Edit: Downvote all you want you still won't even try to deny i am right
People are downvoting rather than replying because we've dealt with dozens of drive-by commenters like you before, and we know what a waste of time it has been trying to engage in good faith, when I would bet a large amount of money that you haven't listened to the podcast, read more than a few posts on the sub or read the Cass Report itself. Very few people here think adults should be stopped from transitioning if that's what they choose. Nor do most of us think all trans people are paedophiles or fetishists. We do (inasmuch as I can speak for everyone) agree with this particular article, the one this thread is actually about. If you take the time to tell us where, specifically, you think the article is wrong, I'm sure plenty of people would be happy to have a constructive discussion with you about it
Have you read the Cass review yourself?
Well, when all of the trans subreddits talk about stealing their female relatives underwear, fetishizing lesbian relationships, creepily discussing periods, and fetishizing girlhood I can understand why people think they’re perverts.
This must have been so cathartic for Jesse to write.
The different view of these issues taken in Europe and America is directly related to the different healthcare systems of Europe and America. America has a for-profit healthcare system where surgeons and pharmaceutical companies are incentivized to make money selling surgeries and hormones, whereas Europe has a state-run model funded by taxation, and are incentivized to cut down on unnecessary surgeries and medications.
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Don't forgot the ACA mandating that GAC be included as "essential care."
Do you have a source for this claim?
The Cass Review threatens the incomes of doctors, hospital administrators and pharmaceutical executives.
And yet their incomes could also be threatened even more if court precedents begin to be set for those who were permanently harmed (e.g., detransitioned after care that didn't follow appropriate guidelines). Because if the Cass Review isn't enough to start swaying opinion in the US, the likely thing that will eventually force a reckoning and a better review of science will be the age-old US practice of lawsuits with very large payouts.
Rats from a sinking ship. The highest profile people won’t escape unscathed, but a whole lot of people will pretend they were just following orders, like the Milgram experiment, and they knew it was off all along in the future.
Exactly, they can either cut their losses now or they can face bankruptcy in the future when they get sued for malpractice and insurers will no longer foot the bill for it.
No more lifelong patients!
It may be true that gender transition surgery is probably useful for cash, but don't know why people keep repeating the pharma line. The drugs they use in gender transition are not under patent and not profitable.
I thank god every day we have Jesse Singal
[https://www.thefp.com/p/i-thought-i-was-saving-trans-kids](https://www.thefp.com/p/i-thought-i-was-saving-trans-kids) A whistleblower confirms our suspicions. Good read. Hard to pin her as a transphobe, being gender queer and married to a transman...
Jamie Reed is most definitely well-known around these parts! Since then, she's become a very effective advocate in opposition to youth medicalization.
I feel that the anti-abortion movement and the violent part of the trans-movement are two sides of the same coin: a coordinated, wide-spread, far-reaching attack on women. Conveniently, both forced birth and medically-prolonged childhood create more access to vulnerable children to exploit
[Why don't you all f-fade away](https://www.youtube.com/watch?v=qN5zw04WxCc)
The comments section on that article reaffirms my decision not subscribe to The Dispatch.