Hey, thanks for your insights - totally vibing with your thoughts and concerns about the teleological argument, nothing more to add there. Few additional thoughts:
In invoking the medical argument, it may not be necessary to categorize transgenderism solely as a medical condition to draw conclusions on permissibility or insurance coverage. Recognizing that transgenderism or gender dysphoria can cause significant mental distress for some individuals may suffice. While some may seek medical changes due to cosmetic concerns rather than mental distress, akin to cosmetic interventions typically not covered by insurance, specific cosmetic procedures may be covered in jurisdictions where there's significant psychological distress. For instance, corrective surgeries like pinning protruding ears in children or breast reconstruction post-breast cancer are covered in some geographies.
Invoking the Hippocratic oath, especially in its entirety, may be misleading in this context as many of its principles are pretty much outdated in modern medicine. For instance, the oath's prohibition of interventions like cutting for those with stones conflicts with contemporary surgical practices. Similarly, actions such as abortions and end-of-life care, including assisted dying, contradict traditional teachings of the oath. However, the core principle of 'do no harm' is what you likely refer to. The discussion then hinges on our definition of harm, as you rightly point out. Allowing people to die in extreme agony may constitute far more harm than providing compassionate assistance to terminally ill patients who wish to end their suffering. Medical practice demonstrates that sometimes objective harm must be accepted to safeguard patient autonomy. This principle is widely recognized and enshrined in medical regulations across various jurisdictions.
Ultimately, it seems that the arguments presented are intricately intertwined. Deliberating between the medical and libertarian perspectives is a very common focal point in the realm of medical ethics. Even when a particular medical procedure is deemed safe, effective, and likely to substantially benefit an individual patient, its administration hinges upon the patient's consent. For instance, a Jehovah's Witness would not undergo a blood transfusion against their beliefs, even if it meant facing death otherwise. In most scenarios, autonomy typically outweighs medical considerations. Of course, exceptions exist, particularly in global or public health contexts, where individual liberties may be curtailed for the collective good. Examples include mandates for vaccinations, quarantines, or mass drug application programs, where broader public health concerns supersede individual freedoms.
So perhaps utilizing established medical ethics frameworks could still offer valuable insights into addressing the complexities of transitioning. I resonate with the emphasis on libertarian arguments, evident in other medical domains where even concerns about minors' ability to consent are usually very carefully managed. Applying the ethical and medical rigor of other domains in medicine to transitioning could elevate the quality of care and safeguard individual autonomy.
“There’s no way to give a healthy male a healthy female body, or vice versa. At least not yet.”
This worries me most, as I think many people with strong opinions don’t realize quite how far we are from being able to actually, fully transition medically.
To take an imperfect, but less controversial analogy: If someone wanted desperately to be 10 inches taller, and we could do that, but only at the cost of them being wheelchair-bound for the rest of their lives, I don’t think many would argue that we should cover or endorse that, or allow it for teenagers who are still developing. But if the cost is that their legs will occasionally feel a bit numb, that’s a different consideration altogether. So what cost is acceptable? To me more openness around the tradeoffs, and the evolving capabilities of modern medicine, and thus being able to discuss, if not answer, these questions better, would probably do more to change my mind on the issue of medical transition than anything else.
However, it is still a tragedy to me that children grow up with models of what it means to be male or female that are so limited that they feel incompatible with those roles. Identity is created in “dialogue” with society at large. And our society has made it very hard – for some, nearly impossible – to fit the standard of what it means to be a woman (and, to a lesser degree, what it means to be a man). So of course young people will go to extreme lengths to try to find a way to fit in, make sense of who they are, and find new meaning.
We’ve always been willing to edit our bodies, and those of our children, in order to fit with who we think society wants us to be – they range from fairly benign, like tattoos, piercings and scarification, to potentially crippling or even lethal, tying of feet, elongation of neck (e.g. Kayan), FGM, and circumcision (e.g. Ulwaluko). I think anyone can recognize those things as downstream of culture, while also often very deeply and inextricably tied to people’s identities. And they can see that proper, safe medicine is not a solution as much as it is a way to minimize harm once people have already committed to the procedure.
I sympathize deeply with people who feel like they don’t fit into the world they were born into – that even their bodies are wrong. When that happens, it shouldn’t be the person’s responsibility to take such extreme measures as medical transition is to feel at home. When so many people want medical transition, that’s an indictment of the rest of us (and not just the progressives). We – all of us, but particularly culture shapers – should take far more responsibility for our expectations for others, and not manipulate kids into self-selecting into some camouflaged social-darwinistic/eugenics program aimed at turning all of us into Kardashians. (Oh, irony of ironies!)
Hey, thanks for your insights - totally vibing with your thoughts and concerns about the teleological argument, nothing more to add there. Few additional thoughts:
In invoking the medical argument, it may not be necessary to categorize transgenderism solely as a medical condition to draw conclusions on permissibility or insurance coverage. Recognizing that transgenderism or gender dysphoria can cause significant mental distress for some individuals may suffice. While some may seek medical changes due to cosmetic concerns rather than mental distress, akin to cosmetic interventions typically not covered by insurance, specific cosmetic procedures may be covered in jurisdictions where there's significant psychological distress. For instance, corrective surgeries like pinning protruding ears in children or breast reconstruction post-breast cancer are covered in some geographies.
Invoking the Hippocratic oath, especially in its entirety, may be misleading in this context as many of its principles are pretty much outdated in modern medicine. For instance, the oath's prohibition of interventions like cutting for those with stones conflicts with contemporary surgical practices. Similarly, actions such as abortions and end-of-life care, including assisted dying, contradict traditional teachings of the oath. However, the core principle of 'do no harm' is what you likely refer to. The discussion then hinges on our definition of harm, as you rightly point out. Allowing people to die in extreme agony may constitute far more harm than providing compassionate assistance to terminally ill patients who wish to end their suffering. Medical practice demonstrates that sometimes objective harm must be accepted to safeguard patient autonomy. This principle is widely recognized and enshrined in medical regulations across various jurisdictions.
Ultimately, it seems that the arguments presented are intricately intertwined. Deliberating between the medical and libertarian perspectives is a very common focal point in the realm of medical ethics. Even when a particular medical procedure is deemed safe, effective, and likely to substantially benefit an individual patient, its administration hinges upon the patient's consent. For instance, a Jehovah's Witness would not undergo a blood transfusion against their beliefs, even if it meant facing death otherwise. In most scenarios, autonomy typically outweighs medical considerations. Of course, exceptions exist, particularly in global or public health contexts, where individual liberties may be curtailed for the collective good. Examples include mandates for vaccinations, quarantines, or mass drug application programs, where broader public health concerns supersede individual freedoms.
So perhaps utilizing established medical ethics frameworks could still offer valuable insights into addressing the complexities of transitioning. I resonate with the emphasis on libertarian arguments, evident in other medical domains where even concerns about minors' ability to consent are usually very carefully managed. Applying the ethical and medical rigor of other domains in medicine to transitioning could elevate the quality of care and safeguard individual autonomy.
“There’s no way to give a healthy male a healthy female body, or vice versa. At least not yet.”
This worries me most, as I think many people with strong opinions don’t realize quite how far we are from being able to actually, fully transition medically.
To take an imperfect, but less controversial analogy: If someone wanted desperately to be 10 inches taller, and we could do that, but only at the cost of them being wheelchair-bound for the rest of their lives, I don’t think many would argue that we should cover or endorse that, or allow it for teenagers who are still developing. But if the cost is that their legs will occasionally feel a bit numb, that’s a different consideration altogether. So what cost is acceptable? To me more openness around the tradeoffs, and the evolving capabilities of modern medicine, and thus being able to discuss, if not answer, these questions better, would probably do more to change my mind on the issue of medical transition than anything else.
However, it is still a tragedy to me that children grow up with models of what it means to be male or female that are so limited that they feel incompatible with those roles. Identity is created in “dialogue” with society at large. And our society has made it very hard – for some, nearly impossible – to fit the standard of what it means to be a woman (and, to a lesser degree, what it means to be a man). So of course young people will go to extreme lengths to try to find a way to fit in, make sense of who they are, and find new meaning.
We’ve always been willing to edit our bodies, and those of our children, in order to fit with who we think society wants us to be – they range from fairly benign, like tattoos, piercings and scarification, to potentially crippling or even lethal, tying of feet, elongation of neck (e.g. Kayan), FGM, and circumcision (e.g. Ulwaluko). I think anyone can recognize those things as downstream of culture, while also often very deeply and inextricably tied to people’s identities. And they can see that proper, safe medicine is not a solution as much as it is a way to minimize harm once people have already committed to the procedure.
I sympathize deeply with people who feel like they don’t fit into the world they were born into – that even their bodies are wrong. When that happens, it shouldn’t be the person’s responsibility to take such extreme measures as medical transition is to feel at home. When so many people want medical transition, that’s an indictment of the rest of us (and not just the progressives). We – all of us, but particularly culture shapers – should take far more responsibility for our expectations for others, and not manipulate kids into self-selecting into some camouflaged social-darwinistic/eugenics program aimed at turning all of us into Kardashians. (Oh, irony of ironies!)