Transgender care — shall we follow the science?

Started by JEdwards, April 10, 2024, 07:20:37 PM

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MaddogLutheran

#30
Quote from: DCharlton on April 11, 2024, 12:20:58 PMConversion Therapy has been banned in many states.  It would logically follow that if one were opposed to Conversion Therapy for minors, one would be opposed the Gender Transition Therapy/Surgery for minors. 
You describe my position.  What I've been told is that one works, the other doesn't.  One is harmful, the other is not. That's begging the question, considering much of the evidence now changing the minds of the European medical profession.

Maybe the most visible activists are not representative of the entire movement, but Munchausen by Proxy and other political motivations certainly appear possible in this zeal to grow the trans community.  One could almost describe it as evangelical missionary looking for converts.  Especially the desire to help young people and adults "recognize" they are trans.  This makes me want to scrutinize all of their science, not accepting it at face value.
Sterling Spatz
ELCA pew-sitter

SomeoneWrites

Quote from: MaddogLutheran on April 11, 2024, 12:45:34 PMWhy?  Seriously, why?

Have you ever had clinical pastoral education? 


Quote from: MaddogLutheran on April 11, 2024, 12:45:34 PMI don't have the right to demand anyone else "affirm" any of my beliefs.  Please don't confuse this with being actively hostile.  I'm not going to berate you for being an atheist.  I accept your freedom to believe as you choose.  I don't have to affirm that, any more than you need to affirm my Lutheranism.  This talk of affirmation remains nonsense.

Whup.  No.  I don't choose my beliefs.  I'm convinced of something.  You believe affirmation is nonsense.  You are not convinced.  Maybe eventually you will.  I don't know.  But I'll go back to the above, sit in on some clinical pastoral education discussions, and you may have your mind changed. 

Quote from: MaddogLutheran on April 11, 2024, 12:45:34 PMAs I've stated here before, I am not hostile to recognizing someone's identity preference.  I am happy to use whatever pronouns an individual prefers.  Nobody should get their nose out of joint if such a person's presentation is initially confusing so that I presume their (obvious) sex without other social cues.
If you are using their pronouns, you are affirming it.  That's great!  And you're allowed to make mistakes too.  Most transgender people I've met have been very gracious about the whole thing. 

Quote from: MaddogLutheran on April 11, 2024, 12:45:34 PMIt seems like what most of what is controversial about "gender affirming care" is not gender affirming, it's biological sex modification.  Again, not necessarily a bad thing from my perspective.  As Fr. Hummel write, people should be free to do even dumb things.  Unless someone (not you, Someone) insists I have to pay for it.
Not all gender affirming care is chemicals surgery. 
LCMS raised
LCMS theology major
LCMS sem grad
Atheist

JEdwards

Quote from: John Mundinger on April 11, 2024, 12:19:24 PM
Quote from: JEdwards on April 11, 2024, 11:32:33 AMAn opinion piece with footnotes is still an opinion piece.  As most medical journals do, JAMA organizes the contents of each issue by the type of contribution.  In the same issue, there a separate article listed as a review.  The article you cited is classified as an opinion piece.  It is not standard to describe such articles as "studies."

Technically, it is a review paper, drawing conclusions based on the review of multiple published studies.  It may be the journal's practice of publishing review papers as a "point of view".  But, that is not the same as an "opinion" published on an editorial page.  And, if you disagree with the authors' "opinion", the correct approach to express that disagreement is not to dismiss the review article as an opinion.  Rather, read the same articles that the authors reviewed and point out the discrepancies that you discovered.
You really should stop digging, but since you insist...

The peer review process and the format of a "Viewpoint" piece and a review article are quite different.  The authors of a review paper are expected to describe their process of identifying relevant studies in order to provide some assurance that a balanced summary of original research is provided.  Reviewers will have less tolerance for selective presentation of underlying research.  Authors of a "Viewpoint" get more leeway precisely because it is openly acknowledged to be an opinion piece.  For example, in the same issue as the article you cited, there is an actual review article, "Liver Transplant as a Treatment of Primary and Secondary Hepatic Neoplasms", which includes the following:

METHODS
PubMed, Scopus, and Embase databases, as well as clinical trial information from ClinicalTrials.gov, were searched for articles and data published in English that included the search terms transplantation, liver, cancer, oncology, primary, metastatic, outcomes, graft, and survival. There was no restriction on the date of publication
.

There is nothing remotely like this in the article you cited.

I have already pointed out some of the substantive limitations of the meta-analyses cited in the viewpoint article you cited.  In addition, it is worth noting that one of the authors of the viewpoint article you cited is a plastic surgeon who serves as the medical director of the "Center for Transgender and Gender Expansive Health" at Johns Hopkins University, and she lists "Gender Affirmation Surgery" as an area of expertise.  Interestingly, neither she nor either of her coauthors listed any conflicts of interest associated with the article.

Peace,
Jon

John Mundinger

Quote from: JEdwards on April 11, 2024, 12:57:17 PMMETHODS
PubMed, Scopus, and Embase databases, as well as clinical trial information from ClinicalTrials.gov, were searched for articles and data published in English that included the search terms transplantation, liver, cancer, oncology, primary, metastatic, outcomes, graft, and survival. There was no restriction on the date of publication
.

There is nothing remotely like this in the article you cited.

There is nothing remotely like that in what I posted because it is just the abstract.  Do you have a subscription such that you are able to read the whole article?  I don't. 

Quote from: JEdwards on April 11, 2024, 12:57:17 PMIn addition, it is worth noting that one of the authors of the viewpoint article you cited is a plastic surgeon who serves as the medical director of the "Center for Transgender and Gender Expansive Health" at Johns Hopkins University, and she lists "Gender Affirmation Surgery" as an area of expertise.

Do you have any information to suggest that she is providing anything other than the highest standard of care?
Lifelong Evangelical Lutheran layman

Whoever, then, thinks that he understands the Holy Scriptures, or any part of them, but puts such an interpretation upon them as does not tend to build up this twofold love of God and our neighbour, does not yet understand them as he ought.  St. Augustine

Charles Austin

Mr. Spatz:
Nobody should get their nose out of joint if such a person's presentation is initially confusing so that I presume their (obvious) sex without other social cues.

Me:
News flash! Quite often a person's sex (if you mean gender) is far from obvious.
ELCA PASTOR. Iowa born and raised. And look at this. Here's the old 1960s protestor and critic of our government as virtually the only "love this country" patriot in this forum.

Jim Butler

#35
From the Editor-in-Chief of the British Medical Journal:

https://www.bmj.com/content/385/bmj.q837

Two quotes: "The evidence base for interventions in gender medicine is threadbare, whichever research question you wish to consider—from social transition to hormone treatment."

"Of more than 100 studies examining the role of puberty blockers and hormone treatment for gender transition only two were of passable quality."

Pretty damning stuff.
"Pastor Butler... [is] deaf to the cries of people like me, dismissing our concerns as Satanic scenarios, denouncing our faith and our very existence."--Charles Austin

David Garner

Quote from: SomeoneWrites on April 11, 2024, 12:57:03 PMI don't choose my beliefs.  I'm convinced of something.

I'm not following the difference here.  Are you implying you are compelled to believe as you do, once so convinced?  Because otherwise, you make a choice as to what it is you will believe. Convinced, after all, essentially means being sure of one's belief. Confronted with competing claims or even competing evidence, you must choose which you will follow and which you will not.

I grant we can have all sorts of discussions about the distinctions between free will and materialistic determinism, but I do assume you think humans make their own decisions for the most part and yours are not merely the clanging together of atoms randomly to generate these material things we call "thoughts."  I assume that because if you believed the latter, you would probably not find discussion here fruitful, and more, you'd have no basis to fault anyone here for their own beliefs, since presumably they would also be compelled by nature to believe as they do.
Orthodox Reader and former Lutheran (LCMS and WELS).

JEdwards

Quote from: John Mundinger on April 11, 2024, 01:26:08 PM
Quote from: JEdwards on April 11, 2024, 12:57:17 PMMETHODS
PubMed, Scopus, and Embase databases, as well as clinical trial information from ClinicalTrials.gov, were searched for articles and data published in English that included the search terms transplantation, liver, cancer, oncology, primary, metastatic, outcomes, graft, and survival. There was no restriction on the date of publication
.

There is nothing remotely like this in the article you cited.

There is nothing remotely like that in what I posted because it is just the abstract.  Do you have a subscription such that you are able to read the whole article?
Yes

SomeoneWrites

Quote from: David Garner on April 11, 2024, 01:32:53 PM
Quote from: SomeoneWrites on April 11, 2024, 12:57:03 PMI don't choose my beliefs.  I'm convinced of something.

I'm not following the difference here.  Are you implying you are compelled to believe as you do, once so convinced?  Because otherwise, you make a choice as to what it is you will believe. Convinced, after all, essentially means being sure of one's belief. Confronted with competing claims or even competing evidence, you must choose which you will follow and which you will not.

I grant we can have all sorts of discussions about the distinctions between free will and materialistic determinism, but I do assume you think humans make their own decisions for the most part and yours are not merely the clanging together of atoms randomly to generate these material things we call "thoughts."  I assume that because if you believed the latter, you would probably not find discussion here fruitful, and more, you'd have no basis to fault anyone here for their own beliefs, since presumably they would also be compelled by nature to believe as they do.
There's a lot of nebulous language and definitions involved.  If I can be clear - I do not CHOOSE what I believe.  I am compelled to believe or not believe.  I hope that helps
LCMS raised
LCMS theology major
LCMS sem grad
Atheist

David Garner

Quote from: SomeoneWrites on April 11, 2024, 01:59:21 PM
Quote from: David Garner on April 11, 2024, 01:32:53 PM
Quote from: SomeoneWrites on April 11, 2024, 12:57:03 PMI don't choose my beliefs.  I'm convinced of something.

I'm not following the difference here.  Are you implying you are compelled to believe as you do, once so convinced?  Because otherwise, you make a choice as to what it is you will believe. Convinced, after all, essentially means being sure of one's belief. Confronted with competing claims or even competing evidence, you must choose which you will follow and which you will not.

I grant we can have all sorts of discussions about the distinctions between free will and materialistic determinism, but I do assume you think humans make their own decisions for the most part and yours are not merely the clanging together of atoms randomly to generate these material things we call "thoughts."  I assume that because if you believed the latter, you would probably not find discussion here fruitful, and more, you'd have no basis to fault anyone here for their own beliefs, since presumably they would also be compelled by nature to believe as they do.
There's a lot of nebulous language and definitions involved.  If I can be clear - I do not CHOOSE what I believe.  I am compelled to believe or not believe.  I hope that helps

If that's the case, would you agree that we're all compelled to believe or not believe?

If so, I honestly find it odd that you would ever disagree with anyone (you do so fairly and charitably, so don't take this as an attack on your character).  If we do not choose what we believe, why would anyone be faulted, criticized, etc. for believing something else?  And on what basis would you think they might change their mind?
Orthodox Reader and former Lutheran (LCMS and WELS).

SomeoneWrites

Quote from: David Garner on April 11, 2024, 02:08:09 PMIf that's the case, would you agree that we're all compelled to believe or not believe?

If so, I honestly find it odd that you would ever disagree with anyone (you do so fairly and charitably, so don't take this as an attack on your character).  If we do not choose what we believe, why would anyone be faulted, criticized, etc. for believing something else?  And on what basis would you think they might change their mind?

I think this why I aim for fairness and charity.  I can get frustrated, but I do recognize others are in the same situation.  However, none of this means that minds can't change in certain settings.  This is where evidence comes into play.  Not all evidence is strong.  And sometimes it takes a lot.  Sometimes, it can make people unsure.  And sometimes, when one moves through the cognitive biases and all the other fluff, there can be a genuine change. 
LCMS raised
LCMS theology major
LCMS sem grad
Atheist

MaddogLutheran

#41
Quote from: SomeoneWrites on April 11, 2024, 12:57:03 PMIf you are using their pronouns, you are affirming it.  That's great!  And you're allowed to make mistakes too.  Most transgender people I've met have been very gracious about the whole thing. 

I don't accept your definitions here.  I don't accept you telling me what or how I believe or affirm.  I won't attempt further to describe your belief mechanism, since you are obviously operating under a different set of assumptions.  I would almost call it a narrative, but maybe that is too strong.

As I indicated in my previous, nobody (except the speech police) would care about gender affirming care if it didn't involve:
(1) irreversible physiological changes, especially including fertility, being primarily administered to minors before/during puberty, because puberty is the enemy of gender versus sex
(2) Authoritarianism by some to control how other people speak.  Hence J.K. Rowling's recent public pushback against the Scotland hate crime law.

I wouldn't run afoul of the speech component of that, unlike Rowling.  I absolutely agree that biological men do not belong in women's intimate spaces, because it make some women feel unsafe.  That's what many believe gender affirming is.  I'm out.

Note I probably wouldn't have replied at all if you hadn't tried to tell me what my words meant.  Not interested in interacting with the rest of what you wrote.
Sterling Spatz
ELCA pew-sitter

MaddogLutheran

Quote from: Charles Austin on April 11, 2024, 01:27:10 PMMr. Spatz:
Nobody should get their nose out of joint if such a person's presentation is initially confusing so that I presume their (obvious) sex without other social cues.

Me:
News flash! Quite often a person's sex (if you mean gender) is far from obvious.
Really?  How many times have you gotten that wrong in your life?  I can't say that I ever have.  I guess you're much more worldly if it's happen to you frequently.  Thanks for enlightening me!

There are some men who, because of their physiques, simply cannot pass for a woman.  If "she" isn't wearing a dress, or wearing her hair in an obviously feminine way, it may not be obvious that she's trans.  That cuts both ways.  Given the times we live in, there are probably some normal biological women who might be dressed androgynous and could be confused for a man (or perhaps better described as a boy).
Sterling Spatz
ELCA pew-sitter

SomeoneWrites

Quote from: MaddogLutheran on April 11, 2024, 02:21:38 PM
Quote from: SomeoneWrites on April 11, 2024, 12:57:03 PMIf you are using their pronouns, you are affirming it.  That's great!  And you're allowed to make mistakes too.  Most transgender people I've met have been very gracious about the whole thing. 

I don't accept your definitions here.  I don't accept you telling me what or how I believe or affirm.  I won't attempt further to describe your belief mechanism, since you are obviously operating under a different set of assumptions.  I would almost call it a narrative, but maybe that is too strong.

As I indicated in my previous, nobody (except the speech police) would care about gender affirming care if it didn't involve:
(1) irreversible physiological changes, especially including fertility, being primarily administered to minors before/during puberty, because puberty is the enemy of gender versus sex
(2) Authoritarianism by some to control how other people speak.  Hence J.K. Rowling's recent public pushback against the Scotland hate crime law.

I wouldn't run afoul of the speech component of that, unlike Rowling.  I absolutely agree that biological men do not belong in women's intimate spaces, because it make some women feel unsafe.  That's what many believe gender affirming is.  I'm out

Note I probably wouldn't have replied at all if you hadn't tried to tell me what my words meant.  Not interested in interacting with the rest of what you wrote.


ok.  Thank you for calling people by their preferred pronouns.  That's a great step in the right direction. 
LCMS raised
LCMS theology major
LCMS sem grad
Atheist

MaddogLutheran

Quote from: SomeoneWrites on April 11, 2024, 02:27:25 PMok.  Thank you for calling people by their preferred pronouns.  That's a great step in the right direction.
Your thanks is not required.  Nor your approval.  That's a patronizing thing to say.
Sterling Spatz
ELCA pew-sitter

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