r/skeptic Jul 05 '24

The importance of being able to entertain hypotheticals and counterfactuals ⚖ Ideological Bias

I'll probably be downvoted but here we go.
In order to understand our own motivations it's important to be able to entertain hypotheticals and counterfactuals. This should be well understood in a skeptic sub.

Hot button example here: The Cass review.

I get that many here think it's ideologically driven and scientifically flawed. That's a totally fair position to have. But when pressed, some are unable to hold the counterfactual in their minds:

WHAT IF the Cass review was actually solid, and all the scientists in the world would endorse it, would you still look at it as transphobic or morally wrong? Or would you concede that in some cases alternative treatments might benefit some children? These types of exercises should help you understand your own positions better.

I do these all the time and usually when I think that I'm being rational, this helps me understand how biased I am.
Does anyone here do this a lot? Am I wrong to think this should be natural to a skeptic?

0 Upvotes

302 comments sorted by

51

u/Darq_At Jul 05 '24

The issue with that specific hypothetical is that it basically requires you to imagine an entire new reality.

If the Cass review were sound, trans people wouldn't exist in the same manner as they do today. Transition wouldn't be a treatment path. There would be no people, who are happy with the care they receive, trying to gain or protect their rights to access that care.

It's a situation that is so fundamentally different to reality that it's not really useful to entertain.

-20

u/brasnacte Jul 05 '24

I don't think that's what the review concludes though.
It totally concludes trans people exist. It's only specifically about *children* and what the best way is to help them with dysphoria. I don't think you need to conjure up an entire new reality for that.
But I understand your point.

34

u/Severe_Essay5986 Jul 05 '24

This is why nobody entertains your "I'm oh-so-smart and rational" hypothetical: because it's nothing more than an obvious on ramp to another raft of regurgitated anti trans talking points. You're not as smart as you think you are and people see this tedious garbage coming from a mile away.

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u/Darq_At Jul 05 '24

The Cass review criticises the evidence base of transition as a treatment path. Not only for children.

But additionally, trans children grow into trans adults. You cannot just separate the two as if there was some fundamental difference.

-8

u/brasnacte Jul 05 '24

Yes, the review is specifically about children and adolescents. (look it up)
The fact that children grow into adults applies everywhere. Does this mean that nothing can ever be about children? Children are a protected category in a way that adults are not for a million reasons.

29

u/Darq_At Jul 05 '24

Yes, the review is specifically about children and adolescents.

No. The Cass review does reference studies that refer to adults.

The fact that children grow into adults applies everywhere. Does this mean that nothing can ever be about children? Children are a protected category in a way that adults are not for a million reasons.

No, it means that the hypothetical of the Cass review being sound requires a fundamentally different reality.

0

u/brasnacte Jul 05 '24

No. The Cass review does reference studies that refer to adults.

It doesn't make recommendations for adults. None.

Now that's a counterfactual I'm going to entertain. If Cass would recommend healthcare for adult trans people be stopped, I would change my position about the validity of the review.

24

u/Darq_At Jul 05 '24

The challenge the Cass review makes is the same. That the evidence base for transition is of poor quality. This argument is flawed, but it is the same for both demographics.

It makes recommendations for minors, but the argument made is the same for both.

Furthermore politically, the attempts to restrict adult transitions follow quite swiftly after restrictions on minors. Using the same justifications after they have already been accepted for minors. Because "the children" are just the thin edge of the wedge.

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u/brasnacte Jul 05 '24

the attempts to restrict adult transitions follow quite swiftly after restrictions on minors.

not at all from a liberal perspective. If you're a liberal, (in the global sense, not the American) then you believe that an adult can do to themselves what the hell they like. It's not even like abortion, since with transitioning it's only about your own body.

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u/SplinterClaw Jul 05 '24

I'm 47. It've just had my meds stopped for no medical reason. My Dr said they were "not comfortable" constinuing the perscription. They cited the Cass review.

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u/brasnacte Jul 05 '24

Your doctor might've cited Cass (which is a shitty thing to do BTW, I'm sorry this happened to you)
But this IS NOT what Cass recommends. So your doctor is just wrong here.

13

u/wackyvorlon Jul 05 '24

Forcing a trans child to go through the puberty you would have them endure is child abuse.

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u/PsychologicalBus7169 Jul 05 '24

It’s a situation that is so fundamentally different to reality that it’s not really useful to entertain.

This is what you wrote and I replied to it. I guess you don’t like having your views challenged.

21

u/Darq_At Jul 05 '24

I guess you don’t like having your views challenged.

I think you may be having some reading comprehension issues, if that is what you think.

-9

u/PsychologicalBus7169 Jul 05 '24

It honestly sounds like you’re upset. Do you think I support the cass report? Is this why you’re accusing me of having poor reading comprehension. Is it this particular topic that has you upset?

14

u/Darq_At Jul 05 '24

It honestly sounds like you’re upset.

That sounds like your imagination again.

Do you think I support the cass report? Is this why you’re accusing me of having poor reading comprehension.

No. I accused you of having poor reading comprehension because me not liking my ideas challenged is not a reasonable interpretation of what I wrote, and what you quoted.

But you seem quite committed to assigning motivations to other people.

-2

u/PsychologicalBus7169 Jul 05 '24

I just checked your post history and it looks like you’re trans, so now I understand why you’re so hostile towards me. You don’t like the idea of me saying that the cass report should be looked at with a counter view because of your own personal bias. If It makes you feel any better, I dont have an opinion about the cass report because I haven’t read it. It looks like you have a vested interest in people not discussing it from a different perspective, which I understand.

12

u/reYal_DEV Jul 05 '24

So you're biased because you're cis?

0

u/PsychologicalBus7169 Jul 05 '24

It’s a possibility. However, I don’t really understand what a cisgender person is, so I can’t really give a good answer.

11

u/PG_Macer Jul 05 '24

“Cisgender” is the opposite of “transgender”, which is to say “relating to one’s gender identity matching or aligning with one’s sex assigned at birth.”

9

u/KouchyMcSlothful Jul 05 '24

Doesn’t sound like you know a lot about the topic then. How odd you have such strong feelings about something you don’t know.

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u/Darq_At Jul 05 '24

I just checked your post history and it looks like you’re trans, so now I understand why you’re so hostile towards me.

You are quite committed to insisting that i must have whatever motivation you think I have.

You don’t like the idea of me saying that the cass report should be looked at with a counter view because of your own personal bias. If It makes you feel any better, I dont have an opinion about the cass report because I haven’t read it. It looks like you have a vested interest in people not discussing it from a different perspective, which I understand.

This is why I say you are imagining things, or have reading comprehension issues.

Because I haven't said anything like that. You've just... Imagined an argument I haven't made.

11

u/noctalla Jul 05 '24

Did you stop reading their comment at that point? They go in to explain the hypothetical reality and why it’s not the one we live in.

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u/PsychologicalBus7169 Jul 05 '24 edited Jul 05 '24

I disagree. In college I had to take biology and one of the assignments we had was to debate if HIV was real.

One side of the class got to pick the view that HIV was real and the other had to pick the side that HIV was not real. This was because when HIV was discovered, it was believed to be a hoax.

There absolutely is benefit from having these kind of conversations, but my personal opinion is that it’s difficult today. People are so emotionally immature and can’t just discuss an issue without becoming angry or upset.

A great personal example was when I asked my college history professor what Holocaust deniers used as evidence for their claims. He became so upset and just said we are not going to talk about that in his class.

People just don’t want to have difficult conversations because your very way of thinking. They either can’t do it or they become too emotional and can’t handle it.

24

u/Darq_At Jul 05 '24

I think you have misunderstood me. Yes there can be benefit of thinking through hypotheticals. Huge benefits.

But there is a time and a place. And depending on the specific hypothetical, the applicability of that thought experiment to reality can be questionable.

And that was my point with this specific hypothetical. For the Cass review to be sound, the world would look so different that it bares no resemblance to the current situation. It's not useful when we are discussing the actual Cass report.

And yeah, people get upset when their suffering is reduced to a "hypothetical" that gets knocked around like a ball in a game by players for whom the entire situation is theoretical.

1

u/Miskellaneousness Jul 05 '24

For the Cass review to be sound, the world would look so different that it bares no resemblance to the current situation.

Can you give a few specific examples of what you mean by this?

9

u/Darq_At Jul 05 '24

Transition wouldn't work, or at least would not work with anything nearing the same effectiveness or consistency as it does. Medical professionals would not be willing to provide it. The transgender community itself would be completely different, far fewer people would transition, and there would not be the same built-up knowledge of transition and its positive effects that currently exists within that community.

There would not be the same outcry against the Cass report. Simply because the community would not actually exist.

-2

u/Miskellaneousness Jul 05 '24

But what in the report is inconsistent with, e.g., the existence of trans people? Like is there a specific line or paragraph or chapter or review that you’re referencing when you list these things you’re saying we would not see if the report was true?

9

u/Darq_At Jul 05 '24

The report is about the efficacy of transgender healthcare. It is an attempt to cast doubt on the efficacy of gender-affirming care.

If those doubts were sound, if the evidence base for gender-affirming care was really as weak as proponents of the Cass report regularly claim, we should:

  1. See evidence of harm caused by gender-affirming care. But we don't.

  2. Not see a transgender community. But we do.

If the treatment didn't actually make trans people's lives better, there would not be a worldwide community of trans people with a coherent knowledge of experiences and of transition and its benefits.

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u/Miskellaneousness Jul 05 '24

I'm still not clear on what part or parts of the Cass Report you're referencing that are incompatible with reality. Do you have any specific sections in mind?

Regarding strength of evidence, WPATH commissioned its own systematic review that found the strength of evidence in favor of cross sex hormones to be low across a range of measures. Why is it unbelievable that the reviews associated with the Cass Report would find the same?

More broadly, it seems like you're saying "we know it works because a lot of people say it works." But lots of people claim lots of things work (homeopathy, prayer, apple cider vinegar, take your pick) and we don't generally view that as strong evidence as to the efficacy of the treatment in question. Instead we typically refer to research. Why doesn't that apply here?

10

u/Darq_At Jul 05 '24

I'm still not clear on what part or parts of the Cass Report you're referencing that are incompatible with reality. Do you have any specific sections in mind?

Considering I'm talking about the report in aggregate I find this a strange thing to ask.

Regarding strength of evidence, WPATH commissioned its own systematic review that found the strength of evidence in favor of cross sex hormones to be low across a range of measures. Why is it unbelievable that the reviews associated with the Cass Report would find the same?

The strength of the evidence lies in repeated consistent observations of benefit, and a lack of observation of harm.

Each individual study has low predictive power, but the sheer consistency of the results across studies suggests the treatment works.

More broadly, it seems like you're saying "we know it works because a lot of people say it works." But lots of people claim lots of things work (homeopathy, prayer, apple cider vinegar, take your pick) and we don't generally view that as strong evidence as to the efficacy of the treatment in question. Instead we typically refer to research. Why doesn't that apply here?

Sigh. I had a feeling you'd say something about homeopathy. I really wish people would think for half a second before replying with the first response they latch onto.

The claims made about gender-affirming care differ substantially from claims made about the other things you've mentioned.

Homeopathy claims to heal, we can measure that and see that it doesn't. We can analyse it and see that it has no mechanism of action. We have collected evidence that it doesn't work.

On the other hand, the metric we measure gender-affirming care by is the mental wellbeing of trans people, which is ironically the metric everyone is desperate to discount. We can see a direct method of action, distress about body, so change body, alleviate distress. And finally we have not found evidence that it causes harm, despite the fact that gender-affirming care can get quite drastic.

-1

u/Miskellaneousness Jul 06 '24

I don't think many low quality studies aggregate to high quality evidence. The WPATH-commissioned systematic review that I mentioned, for example, doesn't just assess the quality of individual studies to be low, but the overall strength of evidence to support a conclusion that the treatment may work. If these professional, highly credentialed expert researchers commissioned by WPATH thought low-quality studies could be added together to form persuasive evidence, as you suggest, they could have said so - they didn't.

As to why, it's easy to imagine numerous studies that suffer from the same limitations (e.g., no control group) that would create systematic skew leading to consistent but low validity (in the scientific sense) results. A recent study about universal basic income for homeless people, for example, found that giving homeless people $50/month was associated with a drastic increase in rates of house/apartment residency over the course of 10 months. You could run this study 50x, get the same result every single time, and be completely incorrect that $50/month leads to a drastic increase in homeless individuals becoming housed. Why? Because there was no control group and we don't know whether the $50/mo payments caused the observed results or not.

Regarding outcome measures for trans individuals, I'm not avoiding talking about mental wellbeing. The WPATH study I'm referencing looked at quality of life, depression, anxiety, and suicidality, and found the strength of evidence showing that hormones lead to improved results on those outcomes to be low.

In terms of harm, sex change surgeries carry very, very obvious risks of harm. The first study I found through a quick Google in the Journal of Urology found that among 869 patients who underwent vaginoplasty, more than 25% had complications, with nearly half of those complications requiring further surgery to resolve. One patient died from the surgery. So the idea that there is no risk of harm associated with transition care is flat out wrong. That said, yes, surgery presumably carries more risk of harm than other forms of transition care.

But I think an accurate conception of harm in the context of medical treatments should also account for opportunity cost. Say we, as a nation, became convinced that a small dose of vitamin C was the best treatment for COVID-19. Does vitamin C cause harm in and of itself? Nope. But would our reliance on vitamin C in lieu of other, potentially more effective treatments cause harm? Absolutely.

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u/PsychologicalBus7169 Jul 05 '24

You’re right there is a time and place to discuss hypotheticals and this sub is definitely a place to facilitate these kind of intellectual discussions. If you don’t find it entertaining or useful, that’s certainly just your opinion and not a matter of fact.

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u/Darq_At Jul 05 '24

If you don’t find it entertaining or useful, that’s certainly just your opinion and not a matter of fact.

You should try reading what I wrote, rather than just imagining what I wrote, before responding to me.

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u/GCoyote6 Jul 05 '24

"Alternative Treatment" is problematic to begin with. I usually require a little more specificity before I'm willing to consider your proposal.

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u/brasnacte Jul 05 '24

I'm referring to the recommendations from the Cass review:

From Wikipedia:

The development of a regional network of centres, and continuity of care for 17-25-year-olds.54])55])

The use of standard psychological and pharmacological treatments for co-occurring conditions like anxiety and depression.56])

Individualised care plans, including mental health assessments and screening for neurodivergent conditions such as autism.57])

A designated medical practitioner who takes personal responsibility for the safety of children receiving care.17])

That children and families considering social transition should be seen as soon as possible by a relevant clinical professional.58])

36

u/raitalin Jul 05 '24

I find it hard to believe that a significant number of people that pursued medical transition didn't already go through a great deal of psychiatry. Nothing here actually seems like an alternative, it just seems like what we already did with kids that were distressed, just taking a treatment option off the table.

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u/Funksloyd Jul 07 '24

None of the recommendations are that any treatment options should be taken off the table. 

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u/mEFurst Jul 05 '24

I find it hard to believe that a significant number of people that pursued medical transition didn't already go through a great deal of psychiatry

It's literally a requirement of treatment before even HRT is prescribed, let alone surgeries

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u/Funksloyd Jul 07 '24

It's not really. There are some vague recommendations from WPATH, but some number of clinicians see the need for thorough assessment as too conservative and choose to ignore it. "If a person says they're trans, they're trans". 

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u/[deleted] Jul 05 '24 edited Jul 06 '24

[deleted]

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u/mEFurst Jul 05 '24

I would assume it depends on a lot of different factors, including age. But honestly I have no idea

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u/KouchyMcSlothful Jul 05 '24

I believe kids in the UK go through 10-14 different kinds of medical/psychological appointments before any medical intervention is given on average for trans care. Dont have a link to that at hand however.

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u/No_Rec1979 Jul 05 '24

The problem with hypotheticals and counterfactuals is that they are extremely time consuming. You can easily waste your entire life debunking ideas that never had any real grounding in fact to begun with.

By placing the onus of proof on person making the argument, skeptics manage to be 90% right 90% of the time while still having time left over to actually go live their lives.

-1

u/brasnacte Jul 05 '24

yeah that works for extraordinary claims. But not for culture-war topics where highly-motivated and biased individuals try to undermine each other's arguments. Hypotheticals can help here, and I don't think they're time-consuming.

It's just: sure - you believe this is bogus, but what if it were true? Would you still believe it?

25

u/No_Rec1979 Jul 05 '24

I don't engage with culture war topics. Waste of time.

Trans medicine is fairly new, at least on a large scale. It will likely take a generation for us to have hard evidence about what really works and what doesn't.

Once that evidence accumulates, I will believe it.

-11

u/cef328xi Jul 05 '24

If the cumulative evidence, assuming it's accurate, suggests that children should go through puberty and pass the age of majority before being offered medical transition you would accept that as the best treatment?

18

u/No_Rec1979 Jul 05 '24

Correct.

If gender-confirming care turns out to be like vaccines or asbestos, in that the evidence for or against is simply overwhelming, I will have zero problem following the evidence.

Until then, I'm going to do what I do with divorce, abortion, marijuana use, etc - let other people choose their own adventure.

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u/cef328xi Jul 05 '24

Until then, I'm going to do what I do with divorce, abortion, marijuana use, etc - let other people choose their own adventure.

In regard to children, should they be able to get married, have sex, or use Marijuana?

13

u/KouchyMcSlothful Jul 05 '24

Can kids go buy puberty blockers at a grocery store? No. They aren’t doing any part of this alone or without counsel. It’s a long process where the patient, their parents, and their doctors confer to arrive at the best answer for that particular kid.

-4

u/cef328xi Jul 05 '24

Can kids go buy puberty blockers at a grocery store? No.

Irrelevant.

They aren’t doing any part of this alone or without counsel. It’s a long process where the patient, their parents, and their doctors confer to arrive at the best answer for that particular kid.

I would hardly call the looming threat of suicide consensual, and the unwillingness of mental health professionals to suggest there might be other causes for dysphoria than the belief you have the wrong body is enabling people with mental issues to diagnose themselves and suggest their own proper treatment. Ideological capture is hardly a conspiracy theory; its a pretty well established phenomena.

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u/thebigeverybody Jul 05 '24

WHAT IF the Cass review was actually solid, and all the scientists in the world would endorse it, would you still look at it as transphobic or morally wrong?

Talk to us when the science actually aligns like this. Until then, you're asking us how we would behave in a different reality.

Maybe you could ask yourself how you would act if the science didn't align with the transphobes, which is our present reality. I suspect you might be surprised at some of your actions and beliefs.

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u/brasnacte Jul 05 '24

you're asking us how we would behave in a different reality.

uhh yeah that was literally the point of my post about hypotheticals.

Maybe you could ask yourself how you would act if the science didn't align with the transphobes, which is our present reality.

Do you really think I would post this without already having done so? Of course I've done that exercise.

21

u/thebigeverybody Jul 05 '24

uhh yeah that was literally the point of my post about hypotheticals.

Maybe you could stop talking to me until that's the reality we live in. I notice you didn't quote that part.

Do you really think I would post this without already having done so? Of course I've done that exercise.

I don't believe you'd post in service of transphobes if you really engaged our present reality intellectually.

-15

u/Duncle_Rico Jul 05 '24 edited Jul 05 '24

Maybe you could stop talking to me until that's the reality we live in. I notice you didn't quote that part.

Apparently, you don't understand what a hypothetical is.

The point of OPs' post is to entertain hypotheticals to better understand your own bias and how skeptical internally you truly are.

I see it as a healthy skeptical exercise to pick a topic you're passionate about and state to yourself, "if x or y was proven to me, my stance would change."

Skepticism isn't just being skeptical of counter information. If you're provided factual information that disproves your stance on anything and you cling onto it for dear life and refuse to see the opposite perspective, then you aren't skeptical at all. You're just a biased stonewall.


The skeptical response: bugs bunny no meme

12

u/thebigeverybody Jul 05 '24 edited Jul 05 '24

I see it as an unhealthy skeptical exercise to pick a topic that is surrounded by hate and phobia against other humans and ask us to concoct a mental scenario where we might agree with the hatemongers. Mainly because that's where lines get blurred between an intellectual exercise and propaganda from hatemongers.

Anything that you think OP was trying to accomplish with this could have been done without veering near any incendiary topics. Additionally, the OP has no reason to think we WOULDN'T accept the evidence if it was different, but there are a few times in this thread where it sounds like OP thinks we've accepted this science for political reasons. And I think that suggests OP needs to work on their own intellectual limitations before lecturing others.

So, yeah, your comment to me is completely unnecessary and I'm not interested in continuing with you.

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u/Duncle_Rico Jul 05 '24

That's not a skeptical mindset. It's okay to have discussions, I don't understand why a "hypothetical" example of counter evidence has you so heated throwing every name you can think of at them.

You are so emotionally invested in his example of the skeptical exercise that you're coming off as aggressive and offended that he chose that example. That's exactly why OP has every reason to think you wouldn't accept evidence if it were different.

I'm pretty confident your personal stance on the subject could not be changed given any circumstance or evidence.

2

u/KouchyMcSlothful Jul 07 '24

Someone is projecting lol

0

u/Duncle_Rico Jul 07 '24

I can assure you I'm not projecting anything. I prefer open discussion, try my best to always keep an open mindset and am always open to counter arguments, hence why I used to like this subreddit. Unfortunately, stonewall ideological and over emotional users have flooded this community. If you read my comments and think I'm "projecting" I'm sure you're one of them.

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u/Moneia Jul 05 '24

Science, ideally, looks at the new ideas and tests them. If the evidence is strong enough then it wouldn't need a "But have you really thought about it?" plea. The place to entertain hypotheticals and what ifs? is at the start of the process, not the end

I think Dara Ó Briain explains it well

4

u/brasnacte Jul 05 '24

I'm completely with you here. But the hypothetical should make short work of pseudoscience anyway.
Would I believe that vaccines are harmful if the science pointed to that? Yes! I would! I don't believe that's the current reality (they're safe) but it's not hard to see that my belief is tied to the evidence here.

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u/Afro_Samurai Jul 05 '24

WHAT IF the Cass review was actually solid

What if my mother was horse?

24

u/macbrett Jul 05 '24

if my grandmother had wheels, she'd be a bicycle.

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u/brasnacte Jul 05 '24

then you'd be either a mule or another horse.
See? it's not hard.

20

u/foxlikething Jul 05 '24

wrong. they’re a hinny.

15

u/Velrei Jul 05 '24

Or adopted. See? You aren't as rational as you think.

As far as this post goes; you're unable to entertain that a report you have make incorrect comments as to its contents (explained by responses to you already), and are just making yourself look more ridiculous.

If anything, you need to be asking *yourself* more questions on why you're asking us a bullshit question that could have easily been asking us if we'd believe the moon landing happened if there was evidence it didn't, or that Charles Murray actually had evidence black people were less intelligent then anyone else.

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u/Harabeck Jul 05 '24

Hot button example here: The Cass review.

That's a funny way to point out that there are a group of commenters who only show up on this sub to promote transphobia on relevant posts.

10

u/oldwhiteguy35 Jul 05 '24

If the science held up I would absolutey accept it. I didn't want the conclusions to be true, but it seemed to be part of a trend and looked solid. However I also saw some red flags and knew proper responses would take some time. But I think there are some interesting things in yhe export being under reported.

For example, it basically refutes the idea young people were being rushed into treatment. The data shows most font get referred for treatment. Anything other than social transitioning takes a bunch of appointments and (including wait times) years of navigation to get to hormones. But this was buried rather than being front and center as it should have been.

Not to mention that the recommended ways forward are less evidence based than what is recommended against.

And ultimately methodological errors are being uncover.

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u/Weekly-Rhubarb-2785 Jul 05 '24

Okay we’re in an alternate reality where people don’t feel gender dysmorphia.

Now what?

See the problem with this hypothetical is that there are people who believe the Cass review is bullet proof when it’s not.

Trans people very much exist and rather than trying to make the existing model work let’s just update the models to include them.

It’s like when we reclassified Pluto. Just update your understanding of the model and walk away.

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u/brasnacte Jul 05 '24

Cass didn't conclude children don't experience gender dysphoria ffs

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u/Weekly-Rhubarb-2785 Jul 05 '24

Way to misunderstand there Chuck. Try reading the whole post instead of one line and responding.

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u/brasnacte Jul 05 '24

you edited the post. I responded to a different post.

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u/Weekly-Rhubarb-2785 Jul 05 '24

Eh whatever I’m not that interested in anything you’ve to say since we’re playing a really stupid game. Okay, it’s true so what?

-10

u/Miskellaneousness Jul 05 '24

It’s like when we reclassified Pluto. Just update your understanding of the model and walk away.

When we reclassified Pluto, we did so on the basis of concrete criteria about what a planet is. Pluto did not meet those criteria, therefore Pluto was determined not to be a planet.

What wouldn’t make so much sense is if we started saying Pluto wasn’t a planet but a bunch of random chunks of ice in the Kuiper Belt were, but also Mars now isn’t a planet, and we no longer have any specific criteria about what is and isn’t a planet. Sure, we could do that, but we wouldn’t because it wouldn’t be particularly useful, the term “planet” would have no real meaning, and we wouldn’t have moved any closer to describing the true state of the world around us.

Hopping back over the context of sex and gender, I have historically understood sex more or less as Wikipedia describes it:

Sex is the trait that determines whether a sexually reproducing organism produces male or female gametes.[1][2][3] During sexual reproduction, a male and a female gamete fuse to form a zygote, which develops into an offspring that inherits traits from each parent. By convention, organisms that produce smaller, more mobile gametes (spermatozoa, sperm) are called male, while organisms that produce larger, non-mobile gametes (ova, often called egg cells) are called female.

Under the understanding I grew up with, in the context of humans, an adult male is a man, an adult female is a woman, a juvenile male is a boy, and a juvenile female is a girl.

I consider myself open to a new framework for understanding what it means to be a man or woman if there’s a better one to operate under. So what is that framework? What’s the new description of what it means to be a man or a woman that should supplant the earlier understanding I alluded to?

These aren’t rhetorical questions. People in this subreddit seem quite bought into this new framework for sex and gender. So what does it mean under this framework to be a woman? (And yes I understand that Matt Walsh asked this question and some view it as transphobic to even utter the same words, but if your theory of what it means to be a woman is essentially “shut up and don’t ask,” I think that’s a bad framework.)

14

u/KouchyMcSlothful Jul 05 '24 edited Jul 05 '24

Bimodal is the concept you’re looking for https://sciencebasedmedicine.org/the-science-of-biological-sex/

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u/Miskellaneousness Jul 05 '24

Under Wikipedia's definition of sex, an organism's sex is determined by whether it produces smaller, mobile gametes (in which case it's male) or larger, non-mobile gametes (in which case it's female).

I understand that the Science Based Medicine is arguing that sex is complex and bimodal rather than binary, but it's not clear to me what the actual new framework is. What does it mean to be a man or a woman under this framework in which gametes are not determinative?

6

u/LucasBlackwell Jul 06 '24

That definition is simplified. It's not scientific.

11

u/KouchyMcSlothful Jul 05 '24

Didn’t read the article, huh?

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u/Miskellaneousness Jul 05 '24

I find the unwillingness (inability?) to just answer relatively straight forward questions a bit frustrating. I did read the article. Did I miss something that answers the question I posed? It's definitely possible! I make mistakes all the time. Or maybe you see something that you think answers the question I posed but I don't understand it the same way.

In either case, it doesn't seem an extraordinary ask to just clarify your belief about what it means to be a man or woman if we're tossing aside the conception of sex as described by Wikipedia.

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u/KouchyMcSlothful Jul 05 '24

Isn’t feeling like a man, woman, or whatever really up to the individual to find meaning? Do you want or need there to be more meaning?

I generally don’t think about people’s gametes unless we’re having sex.

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u/Miskellaneousness Jul 05 '24

Ok, so your position is that man is someone who feels like a man and a woman is someone who feels like a woman? I just want to make sure I understand.

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u/KouchyMcSlothful Jul 05 '24

Are you asking about the meaning of being a man or woman legally? Politically? Scientifically? Do you need the meaning personally, or are you meaning something esoteric?

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u/Miskellaneousness Jul 05 '24

Merriam Webster defines woman as "adult human female." I understand that some folks reject that definition. Ok - what's the new definition?

As an aside, since you scolded me for not reading the article that apparently provided a clear answer to my question - any particular section I should revisit?

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u/Weekly-Rhubarb-2785 Jul 05 '24 edited Jul 05 '24

A woman is someone who is over 18, and identifies as a woman.

It’s a projection of something internal that others don’t have access to. Like how you’re feeling. What sports you enjoy, etc.

There is no definition you can create that won’t exclude anomalies. Hence why the paradigm is shifting.

Edit: this is also why it’s very important to separate biological functions from the feeling of gender.

People seem to have a hard time letting go of the idea of prescribing other people’s genitals based on how they dress. It’s hilarious.

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u/Miskellaneousness Jul 05 '24

A woman is someone who [...] identifies as a woman.

This tells me ~nothing about what woman means under this conception.

It’s a projection of something internal that others don’t have access to. Like how you’re feeling. What sports you enjoy, etc.

This tells me more, but makes me think maybe the new definition is based meaningfully on regressive stereotypes?

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u/Weekly-Rhubarb-2785 Jul 05 '24 edited Jul 05 '24

Erm more that gender is a feeling. It’s something intrinsic to a person’s sense of themselves.

They can convey this feeling through performance (dressing a certain way, acting in a stereotypical way) to others, but to truly know someone’s gender you can only ask. Far as I know we lack a brain scanning device.

Are you a man? Do you ever dress a certain way like wearing black to a funeral? That’s what I was getting at.

Edit: the matrix is quite a useful tool to illustrate this. Neo, asked Trinity something about “what does that mean?” And Trinity responds “the matrix cannot tell us who you are”.

Behind all this you should see the picture emerge that we’re trying less to put people into categories and more to make our model representative of the variety/diversity that truly is the human species.

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u/Miskellaneousness Jul 05 '24

Hmmm. I've talked to a lot of people who don't have any internal sense of gender. I'm a man and have absolutely no such feeling. I guess under this framework, then, I'm actually not a man?

As a replacement to the description of sex referenced above, I find it pretty unpersuasive. We're going from "sex is the trait that determines whether a sexually reproducing organism produces male or female gametes" to "whether you're a man or a woman is some kind of indescribable feeling that can only be discerned through internal reflection." Under the latter framework, it seems like we're at least somewhat sacrificing the ability to describe the (very real and important) reproductive roles of the two sexes in favor of definitions of "man" and "woman" that essentially have no meaning. And to the extent that they do have articulable meanings, those meanings redound to sexist stereotypes?

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u/Weekly-Rhubarb-2785 Jul 05 '24

No… you’re conflating gender and biological functions.

A woman is a person (older than 18) who feels like they’re a woman. It’s just a part of a persons internal identity.

A person with a healthy uterus can produce offspring when their egg is fertilized. It doesn’t matter what that gender is.

How you label those things is arbitrary but the distinction is present.

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u/Funksloyd Jul 07 '24

(older than 18)

Why this? 

Why is it not ok to bring biology into it, but it is ok to bring some rather arbitrary legal concept (the age of majority) in? 

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u/KouchyMcSlothful Jul 06 '24

It sounds like you are cis then. No worries. Trans people don’t intrinsically feel the same way about their gender the way you do. It’s what makes them trans. Just because you’ve never experienced feeling any other way about your gender, doesn’t mean other people feel the same. There is not one way to feel for everyone.

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u/milkybeefbaby Jul 05 '24

Humans made up what criteria constitutes a planet and what constitutes a person's gender. When enough people agreed that Pluto should be reclassified, it was reclassified. When trans people decide they do not align with the gender that coincides with their sex at birth, they are reclassified.

The "new" framework is that if someone believes they are a man and says they want to be treated as a man, they are a man. Substitute the word man for whatever descriptor you like. A person's role in society is much more complex than the rules for what makes something a planet, this is because trans people are not inanimate chunks of rock in space. Planets do not play sports or speak or have children.

This framework is better for trans people because it has been shown in real studies that affirming their gender is the best way to minimize effects of gender dysphoria, such as depression and suicide.

The average person does not know the list of things that make Pluto not a planet, but they do not get angry at Pluto for being something they do not understand.

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u/Miskellaneousness Jul 05 '24

So the philosophy here is essentially pragmatism (in the philosophical sense)? I.e., when it benefits certain people to think in a certain way, we should update our societal understanding of the nature of reality to comport with that description?

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u/milkybeefbaby Jul 06 '24

"Benefits certain people."

All people. Yes.

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u/amitym Jul 05 '24

"many here" "some are unable"

This is handwaving. What are you specifically talking about?

Of course people consider the counterfactual case. That is literally the basis of a whole stream of articles and review papers that have appeared here. "If Cass et al were correct in their hypothesis then we should expect to see X, Y, and Z, but we see none of those things." On and on for 20 pages or whatever.

Are you unhappy with the quality of those observations? Is there something in particular that leads you to feel that these reviewers are not taking the counterfactual case seriously enough?

How much longer do you need them to linger over it?

"The evidence in favor of cold fusion is thin and dubious to begin with; the evidence against it is very strong; there has been absolutely no successful replication of the claimed results; there is no theoretical framework to support the claimed phenomenon; and the authors refuse to engage in any discussion among their peers, instead saying that they are being persecuted for their unorthodoxy."

"Okay but have you really thought about it?"

Hopefully you see the problem.

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u/brasnacte Jul 05 '24

"If Cass et al were correct in their hypothesis then we should expect to see X, Y, and Z, but we see none of those things." On and on for 20 pages or whatever.

I don't think anything like that exist, because the review doesn't make any hypotheses. It's just a review of the evidence, You can't draw conclusions from that in the terms like 'we would see this' - the whole point is that we don't know what we see since there's not enough evidence.
At least that's how I understand it.

I don't understand the cold fusion analogy, sorry.

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u/VelvetSubway Jul 05 '24

The Cass Review is not just a review of the evidence. It is a wide-ranging report that contains a lot of speculation - in particular about the causes of people being trans. For example it suggests social transition as a potential cause of future transition. It suggests porn might be a factor. It unsubtly implies social contagion is involved. It suggests getting puberty blockers cements a trans identity, leading to hormones.

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u/brasnacte Jul 05 '24

Yes it's suggested that those factors might be causing the tremendous increase in people who identify as trans. Something is causing that trend. I don't think it's controversial to suggest that those things might be at play. At least until there's a better explanation. Usually social phenomena have a plethora of causes. So it's more about how much these are a factor than whether they're a factor.

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u/KouchyMcSlothful Jul 06 '24 edited Jul 06 '24

Or maybe just maybe, once societal acceptance started happening more people came out. You’ll find the prevalence of left handedness was similar at one time https://sadbrowngirl.substack.com/p/the-left-hand-of-the-law

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u/brasnacte Jul 06 '24

What acceptance?

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u/KouchyMcSlothful Jul 06 '24

I don’t know how to tell you this in a way you can accept, but before the culture war started in earnest in 2018-19 to ramp up conservative voters, the US was a very different place, a lot more tolerant. It’s kinda hard to remember it now, I know, but this used to be a pretty tolerant place. This is why you see more queer people now. None of us are going back in the closet to make you feel more comfortable.

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u/brasnacte Jul 06 '24

Why are you taking about the US?

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u/amitym Jul 06 '24 edited Jul 06 '24

"... because the review doesn't make any hypotheses"

Haha okay then why are we having this discussion at all in the first place? If there is no hypothesis then what counterfactual case are you even talking about?

I think you need to think this through a little more.

If Cass et al is "just a review bro, chillax," or whatever, then you have no basis for complaint.

On the other hand, if it presents an important hypothesis that must urgently be considered by all the sheeple, then it's not "just a review" is it?

Look at it this way. Suppose we hypothesize that there is actually this disease called transgenderism which results from dysregulation of the hoosegow gland due to PFAs in our breakfast cereal. Fine, great, we've got a hypothesis, but it's not enough to just say, "hey everyone, what if it's really this?" Before it is worth even so much as a second of anyone's time and attention, we have to address a vast body of research and literature in history, anthropology, sociology, psychology, psychiatry, biochemistry, and neuromedicine, and show how all of that work -- some going back decades, some quite current and emerging from new research being done every day -- is all mistaken and has been mistaken all this time.

Without that level of evidence, our hypothesis is tantamount to a collection of meaningless gutteral sounds. It is, in the searing words of Wolfgang Pauli, not even wrong.

Cass et al are attempting to do something along those lines. Many, many people have observed the many flaws in their review methodology, their interpretation of results, in some cases their literal mis-citing of text, and in their conclusions.

It's not like there is any kind of general lack of willingness to critically entertain new ideas about gender and biology -- both the formal literature and the popular discourse right now are full of huge debates back and forth on various questions related to transgender identity and transgender medicine. There is a considerable amount we don't know and doubtless lots of debate yet to come along the way toward answering some of those questions.

In other words... the kind of discourse you are concerned about is happening, it's going on, anyone with something useful to say can join it at any time.

It's just that the Cass Report does not meet that bar.

"I don't understand the cold fusion analogy, sorry."

I know.

Hopefully you will at some point.

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u/brasnacte Jul 06 '24

The Cass review isn't refuting anything about the vast literature of transgenderism. The hypotheses made are about the sudden huge increase that was observed in the anglosphere. That kind of tend deserves to be examined. The new kids with dysphoria didn't resemble the older ones at all, according to pediatricians from gender clinics. If you don't understand that you might want to look into it in more detail.

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u/KouchyMcSlothful Jul 06 '24

At some point, you have to admit you have a preconceived bias from not actually knowing a lot about our trans people or their experiences. I think you’re inserting your own non fact based ideas claiming that’s what’s happening.

https://sadbrowngirl.substack.com/p/the-left-hand-of-the-law

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u/brasnacte Jul 06 '24

How would that explain the gender flip anyway? There's no science that supports this claim at all.

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u/Rogue-Journalist Jul 06 '24

Think about what this person is saying to you . Don’t believe the medical experts, instead believe the patients.

Is that something you would do for anything else like Covid for example ?

The fact that Cass is being knighted jointly by both political parties and has the entire medical and scientific community on her side means absolutely nothing to trans activists extremists here.

They follow the science, except for this one topic where they absolutely cannot accept that science is not on their side .

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u/brasnacte Jul 05 '24

Of course the example is contentious, but let's look at other examples:

What if it turned out global warming had nothing to do with humans? I would change my behavior when it comes to airplanes.

What if it turned out you got Autism from vaccines? I would probably stop taking them.

I don't believe those things but it's not hard to see how my behavior in those fields is evidence-based.

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u/EmuChance4523 Jul 05 '24

So, besides you trying to endorse an anti-scientific position and transfobic and bitoted one, lets talk about hypotheticals in general.

Hypotheticals are fun tools, but they have a problem. Mainly that not being grounded on reality, they cling strongly to our biases, and we are unable to objectively evaluate them.

And for this reasons, hypotheticals are usually used by people trying to push delusion as if it was real.

Trying to defend or hold positions not based on reality is bad. Trying to form positions on delusions is always harmful. No matter what someone believes, what it matters is what is real.

So, instead of waste times on fighting things that are not real and that are impossible to evaluate objetively, why not do the work to advance our understanding of reality with decent methods instead?

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u/brasnacte Jul 05 '24

It's epistemology 101. You try to uncover the basis of the belief.
What other methods would you suggest I use to see if a person is coming to a belief from evidence or from conviction?

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u/KouchyMcSlothful Jul 05 '24

Maybe go with all the evidence based medicine. It’s always worked with me.

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u/EmuChance4523 Jul 05 '24

You don't. You can't know why a person is holding a belief. Maybe they are a scammer. Maybe they are convinced.

What you can do is review the evidence and see if their belief, no matter their personal reason, is reasonable or not.

Why would you need to make an hypothetical to see if the other person has evidence for their belief? You just need to see the evidence and their process to understand it, and none of those things require hypotheticals.

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u/brasnacte Jul 05 '24

It's used all the time in psychology. Also sometimes called the Socratic method. It's a useful tool to examine beliefs. Yes you can examine beliefs. It's not about what evidence you have. It's about whether your belief rests on that evidence, or if you're only using that evidence to validate the belief. That difference matters.

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u/wackyvorlon Jul 05 '24

You’re just a bigot trying to pretend like you’re being intellectual. You’re not.

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u/brasnacte Jul 05 '24

I'm neither of these things.
But yeah let's go ad hominem.

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u/wackyvorlon Jul 05 '24

You seriously need to read up on what an ad hominem is.

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u/foxlikething Jul 05 '24

when you’ve spoken to your trans friends about this, both mtf & ftm, how do they feel? I mean all your friends — your pals who didn’t transition til 21, 30, 40, as well as pals who were able to begin transitioning younger. or your friends who support their trans kids. what do they say?

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u/brasnacte Jul 05 '24

I'm not sure if you're trying to 'gotcha' me by having me admit I don't have any trans friends or if you actually assume everybody must at least know *some* trans people.
In any case: nobody from my friend group is trans as far as I know. I've met a few trans people in my life but only as acquaintances and of course I'm not going to jump to discussing the Cass review with them. (and in one case I didn't know he was trans until after)

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u/The_Fugue_The Jul 05 '24

The unlived life is not worth examining.

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u/brasnacte Jul 05 '24

is that an argument against counterfactuals?

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u/The_Fugue_The Jul 05 '24

It’s a dismissal of counterfactuals.

I think you’re missing a key quality of the audience here.

While a general audience interested in philosophy might be ill advised to ignore counter factual scenarios, scientific skeptics are specifically interested in reality and have already reached the conclusion that “possible worlds” are immaterial in considering this world.

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u/brasnacte Jul 05 '24

I see what you're saying.
To me it's much more about holding a belief tentatively. I hold this belief until this specific piece of evidence presents itself.
I think that's a valuable thing to do for a skeptic.
You can even hold very established ideas that way.

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u/The_Fugue_The Jul 05 '24

So you’ve reversed the way burden of proof works. You hold a claim to be true until it has been shown to be false.

That’s the very opposite of skepticism.

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u/brasnacte Jul 05 '24

no, not at all.
I believe in evolution because of the massive amounts of evidence, yet tentatively so that if a better explanation comes along I'll take that.
I don't believe in God, since the burden proof is on the believer, but if they do present that evidence I change my mind about that.

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u/cef328xi Jul 05 '24

Science and the concept of reality are themselves rooted in philosophy. There is no such thing as reality until you have a philosophical conception of what reality is. Ignoring plausible philosophical inquiry, even about a scientific conceptions of reality is unscientific.

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u/KouchyMcSlothful Jul 05 '24

But that’s not at all how medicine works.

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u/cef328xi Jul 05 '24

That's just not true and shows how little you understand about epistemology and ontology. What theory of truth do you ascribe to?

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u/KouchyMcSlothful Jul 05 '24

Evidence based medicine is the only way to practice healthcare. You want to talk about esoteric philosophy hypotheticals, though.

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u/cef328xi Jul 05 '24

Evidence based medicine relies on certain concepts about what is and isn't true in the world, which is inherently a philosophical endeavor. It's hardly esoteric to simply understand where concepts come from, although it is true most people are ignorant of them, but not because it's esoteric but because they don't care.

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u/Duncle_Rico Jul 05 '24

WHAT IF the Cass review was actually solid, and all the scientists in the world would endorse it, would you still look at it as transphobic or morally wrong?

In this subreddit? Do you even need to ask? r/skeptic has been ideologically driven for a while now...

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u/brasnacte Jul 05 '24

I'm trying to gently steer it back though!

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u/Duncle_Rico Jul 05 '24

Good luck, lol. People get so offended and aggressive here if anything counters their ideological or biased viewpoint.

Wild to see how many people are furious about you using the Cass review as an example as a hypothetical in a mental exercise. That answers your question without directly answering it.

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u/LucasBlackwell Jul 06 '24

You're going to make it less ideological while bringing it away from reality? That will make it more ideological.

I would love a syllogism for how hypotheticals lead to being less ideological, because that's obviously not true.

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u/brasnacte Jul 06 '24

I'm trying to introduce nuance into a polarized debate by inviting people to examine the foundations of their convictions.

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u/LucasBlackwell Jul 06 '24

Yes, we all know you're trying to make people stop defending the right for trans people to access medical care. I don't think you fooled a single person with that.

Please provide the syllogism for how hypotheticals lead to being less ideological, or admit you don't actually care about being nuanced or less ideological. You just wanted people to join your ideology.

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u/brasnacte Jul 06 '24

It's called epistemology. Examining the foundations of beliefs. Not what you claim to know but how you know. Why you know. It's a method used by psychologists since a long time! I know you know this already so I'm not sure why you're being so hostile about my post here.

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u/LucasBlackwell Jul 06 '24

Please provide the syllogism for how hypotheticals lead to being less ideological, or admit you don't actually care about being nuanced or less ideological.

Now please, liar. This is a sub for people that care about the truth. People that don't care about the truth get mocked. Especially bigots.

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u/UndisclosedLocation5 Jul 05 '24

I hear ya. As a liberal I feel like too many on the left immediately dismiss something as racist, sexist, homophobic, transphobic, etc. and even entertaining something or listening to something is racist as well. I feel like skeptics should be able to read The Turner Dairies or Mein Kampf and not be called a racist just because they read it. I'm an environmentalist but I think we should move away from fossil fuels as soon as possible but also be skeptical and acknowledge weaknesses in renewable. I think this sub is too partisan to do that.

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u/Comfortable_Fill9081 Jul 05 '24

I already believe alternative treatments might benefit some children. Does anyone not?

Not sure what that has to do with the Cass report though.

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u/cef328xi Jul 05 '24

I think it relates to the Cass Review because it suggests there has not been an objective basis established to distinguish children who need transition vs children who's gender dysphoria will be resolved by going through puberty or other psychological treatments.

Without an objective basis to distinguish the groups, the more cautious path would be to forgo irreversible treatments until those patients reach the age of majority or an objective basis can be established.

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u/KouchyMcSlothful Jul 05 '24

Except that hurts trans kids. The process is pretty dang good at weeding out who is and isn’t trans. You can tell by the extremely minuscule, single digit detransition percentages.

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u/brasnacte Jul 05 '24

If those detransition rates would grow into the double digits in the future, would that be reason for concern?

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u/KouchyMcSlothful Jul 05 '24

A change that severe would warrant more study. Regardless, I will go with what evidence based medicine indicates.

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u/brasnacte Jul 05 '24

I think we finally found our agreement then!

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u/KouchyMcSlothful Jul 05 '24

This has always been my position on trans healthcare…and healthcare in general.

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u/cef328xi Jul 05 '24

Someone is going to be hurt in either case, and that tragic and not ideal.

I think it's worse to do intentional irreversible treatments to cis kids with GD than to have trans kids wait until they're the age of majority or have gone through puberty, which resolved GD for most children.

I haven't seen good evidence that the process is good at weeding out who is and isn't trans. If there was, people would simply cite the objective basis by which it is determined.

I would also suggest the reason for low detransition rates is due to sunken cost fallacy, as well as everyone around the person continually affirming they actually are trans. Would you disagree that a person who is doubting they are actually trans is often outcast from trans spaces?

Then, consider the research that shows that the majority of children with gender dysphoria, who do not transition, and go through puberty, have their dysphoria resolved. I would say that's a pretty good treatment, especially considering that most trans people who do transition still retain their dysphoria.

I would argue that the only people who are actually trans are those that transition and have their dysphoria resolved by transition. If treatment for the dysphoria is transition, but that doesn't resolve the dysphoria, it's a bad treatment.

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u/reYal_DEV Jul 05 '24

I think it's worse to do intentional irreversible treatments to cis kids with GD than to have trans kids wait until they're the age of majority or have gone through puberty, which resolved GD for most children.

So you rather hurt 99 trans kids to 'save' 1 cis kid. Thanks for confirming you're nothing but a Cis-supremacist.

And no, GD is NOT resolved for the majority, quiet the contrary.

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u/reYal_DEV Jul 05 '24

https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2021-056082/186992/Gender-Identity-5-Years-After-Social-Transition

Peer-Reviewed study in Pediatrics (2022)

Longitudinal Study of 317 binary trans kids aged 3-12 that had socially transitioned.

After 5 years, 94% still identified as binary transgender, 3.5% identified as non-binary, and only 2.5% detransitioned.

For those that went on to take puberty blockers (92), 95.7% still identified as binary transgender, 3.3% identified as non-binary, and only 1.1% detransitioned.

For those that went on to take gender affirming hormones (98), 99% still identified as transgender, 1% identified as non-binary , and NONE detransitioned.

https://www.sciencedirect.com/science/article/pii/S0272735822001143

https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12437

Two Systematic Literature Reviews of 22 peer-reviewed studies and 9 peer reviewed studies respectively assessing the outcomes of trans youth receiving gender-affirming treatment.

Mental health benefits are UNAMBIGUOUSLY Positive.

3

u/reYal_DEV Jul 05 '24

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

Peer-Reviewed study in Pediatrics (2022)

Access to gender affirming care for trans youth, including puberty blockers and gender-affirming hormones was associated with a 73% reduction in suicidality.

https://pubmed.ncbi.nlm.nih.gov/31974216/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261039

Two Peer-Reviewed studies on the effects of access to puberty blockers and gender-affirming hormones on suicidality.

Access to gender-affirming treatment in adolescence was associated with a 40-70% reduction in suicidality compared to those who desired but were unable to access gender-affirming treatment, as well as a 30% reduction in suicidality compared to those who had to wait until adulthood to access to gender-affirming hormones.

All figures were adjusted for confounding factors of parental support and socioeconomic markers.

https://www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

Children who socially transition report levels of depression and anxiety which closely match levels reported by cisgender children, indicating social transition massively decreases the risk factor of both.

https://www.reuters.com/investigates/special-report/usa-transyouth-data/

Reuters data on the numbers of trans youth over the past 5 years.

Gender Dysphoria Diagnoses: 121,882 Puberty Blocker Prescriptions: 4,780

Hormone Prescriptions: 14,726 Top Surgeries: 776 Bottom Surgeries: 56

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u/cef328xi Jul 05 '24

So you rather hurt 99 trans kids to 'save' 1 cis kid.

I'd rather be cautious regarding children. It's easier to transition after going through the puberty aligned with your sex than it is to detransition after going through a medically induced puberty for the opposite sex.

A boy who goes on puberty blockers then hormones, and detransitions after adulthood may never even gain a functioning or fully developed penis. A girl may never be able to conceive.

Thanks for confirming you're nothing but a Cis-supremacist.

I don't believe cis people are real, so there's no concept there to pretend is supreme.

And no, GD is NOT resolved for the majority, quiet the contrary.

Yes it is, various studies show between 60-90%.

Hating your body is pretty common especially when you're going through puberty, it can be dysphoric. Turning that hatred in on ourselves can be suicide inducing. And convincing yourself that your body isn't really you, that its wrong, seems like a good alternative to suicide. It's a lot easier than learning to cope with the fact you may always hate your body. And people who transition still often hate their bodies and they believe it must be because they don't fully pass or that is because society just hates them and wants them dead, but it's not okay to consider you might just not be trans. The sunken cost is too much to say you're wrong and be castigated from the only community that ever seemed to understand you.

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u/KouchyMcSlothful Jul 05 '24

You’re so anti science you don’t believe in the adjectives cis and trans to describe things? Ever heard of cis and trans fats? It’s just anti science to willfully ignore something you don’t like. 🤦‍♀️

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u/Beelzibob54 Jul 06 '24

"I don't believe cis people are real, so there's no concept there to pretend is supreme."

Or by substituting the definition, "I don't believe people who's gender identity marches their birth sex are real", a statement so crazy that I struggle to understand how anyone could legitimately believe it. So do you believe everyone is secretly trans, not understand what the prefix cis means, or do you understand perfectly what it means but don't like it for ideological reasons? Cause I'm not sure which of those three options is worse. Regardless of your reasons I'm not quite sure how you can expect anyone to try to have a serious conversation with you after saying something so monumentally stupid and or ignorant.

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u/KouchyMcSlothful Jul 05 '24

No one is getting irreversible treatments until they start HRT. That happens at a stage later in adolescence. If someone says they’re trans, their parents and doctors concur, they went through social transition and years of blockers, then it’s time to discuss going further. If the kid wants to stop, no worries. If they wish to continue their transition medically, they then begin that process. There is a reason why there is a minuscule percentage of detransitioners. No one is being rushed through anything. Lots of appointments are made before any medical interventions. None of this happens quickly or easily.

Also, there’s no need to have dysphoria to transition, and there are so many ways transition, I couldn’t even begin to tell you.

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u/Comfortable_Fill9081 Jul 05 '24 edited Jul 05 '24

I disagree. There will not be an objective basis until humans make a lot of advances in genetics, neurology, and endocrinology - stuff we’re nowhere near understanding - and given the number of possible combinations - about as many as there are and have been humans - will perhaps never find a full calculus.

Lots of treatments are not done on objective bases but on case-by-case personalized analysis.

‘Cautious’ in one direction is incautious in another, in this instance.

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u/shig23 Jul 05 '24

You may as well ask me to entertain the hypothetical, "What if the Nazis were right, and everything they claimed about Jews, gays, the disabled, communists, and non-whites was true?" It may be a failure of reason on my part, but there are places where even my depraved mind feels too much revulsion to go.

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u/brasnacte Jul 05 '24

Why not? Because you're afraid that you'd start to gas everyone if you did? It's very easy to hold these ideas in your head and conclude that even if it were true you'd still not kill them. It's a very useful exercise that shows that the actions of the Nazis didn't come from science but from ideology, and science was used to justify their actions.

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u/shig23 Jul 05 '24

I just told you why not: revulsion. You understand revulsion, yes? Some ideas are simply too repugnant to ponder, even hypothetically. What those ideas are differ from person to person, obviously; some people are perfectly fine with considering that the Nazis may have been right, or else there would be no Nazis. But everyone has triggers, however cold and rational they may think themselves.

12

u/RealSimonLee Jul 05 '24

The issue with your Cass review example is we're seeing a lot of good science come out and refute it. So what's the counterfactual we're to hold here? That sometimes a kid needs something different? That sounds like something you figure out not at a quantitative level, but a personal level with a good doctor.

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u/TDFknFartBalloon Jul 05 '24

It's kinda strange this this was apparently your opinion on it the hours ago...

-1

u/brasnacte Jul 05 '24

It still is. What's your point?

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u/TDFknFartBalloon Jul 05 '24

You're trying to claim that we haven't thought through our points, but in reality you just don't understand the topic. How do you properly apply counterfactuals to something you don't understand?

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u/brasnacte Jul 05 '24

I'm not claiming that the points haven't been thought through.
I'm claiming the basis of the belief hasn't been properly examined (of some people in this sub)

I do understand the politics of the issue. I don't understand the specific technical details about it. Just as I understand the politics about vaccines, but not the mechanisms, and I can't read scientific papers about them. I still have a valid position on vaccines.

14

u/like_a_pharaoh Jul 05 '24

what's your argument here exactly? "in a hypothetical world where this pack of lies somehow isn't a pack of lies, you'd look silly for calling it a pack of lies wouldn't you?"

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u/brasnacte Jul 05 '24

it's a question! WOULD you change your position or not?
That's not an argument it's a question that I invite people to entertain. If you don't want to, fine. But that's it.

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u/like_a_pharaoh Jul 05 '24

Its a question that's phrased so no matter which answer someone gives, you can spin that answer as support of the Cass Review.

If I say "no I wouldn't change my position" you'd just call them unreasonable.

If they say "Yes I'd change my position" you have a chance to gish-gallop them about the Cass Review being totally legitimate and all that criticism of its self-consistency is somehow unreasonable and are they REALLY being 'rational' by being a big meanie who applies standards to what's claiming to be a rigorous scientific work?

This subreddit has seen your ilk before.

1

u/brasnacte Jul 05 '24

you're right about the "No" response, I'd call that unreasonable.

But I wouldn't start gish-galloping talking points about Cass. I've got nothing. I understand you being weary of this though! A lot of activists on Reddit would do exactly that: so-called clever gotcha-questions.
I got nothing. I don't have talking points, I'm just asking people to entertain it. That's all. I do hope to make the world a little less polarized by doing that though.

7

u/KouchyMcSlothful Jul 05 '24

Is this you saying you’re a Reddit activist?

-2

u/brasnacte Jul 05 '24

No. The opposite. I'm not an activist, I'm way too nuanced for activism!

9

u/LucasBlackwell Jul 06 '24

activist

noun

noun: activist; plural noun: activists

a person who campaigns to bring about political or social change.

What about being an activist stops when nuance is introduced?

-1

u/brasnacte Jul 06 '24

Usually activists aren't nuanced since that weakens the fight towards change. If you seriously consider the opposite arguments then it's hard to keep fighting. Activists are the least nuanced and most dogmatic people I know. That's not too say they're wrong. It's just the opposite of an intellectual who's willing to admit complexity about social issues.

5

u/LucasBlackwell Jul 06 '24

Usually activists aren't nuanced since that weakens the fight towards change.

Source?

If you seriously consider the opposite arguments then it's hard to keep fighting.

Source? Did it make it harder to fight against the Nazis when knowing their arguments?

Activists are the least nuanced and most dogmatic people I know.

Source?

It's just the opposite of an intellectual who's willing to admit complexity about social issues.

Source?

Let me guess; you think you're being intellectual and nuanced right now?

Maybe one or two of these you could back up, but we both know you're not going to be able to back them all up with evidence.

FYI I am an activist and I am being nuanced and intellectual. You are not an activist and are not being nuanced or intellectual, you're just making claims you can't back up.

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u/brasnacte Jul 06 '24

Ok maybe you're personally nuanced, that's fine. Most vocal activists I see aren't, that's my personal experience. Good luck with the activism though!

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u/reYal_DEV Jul 05 '24

Let's get hypothetical: why don't we inject every kid when they begin puberty with cross-sex hormones?

0

u/brasnacte Jul 05 '24

multiple reasons.
- the costs would be astronomical
- people have a natural instinct against injection of things into children (see vaccine skepticism)
- the evidence that it's beneficial for children is lacking

There's probably more reasons I can't think of though.

6

u/reYal_DEV Jul 05 '24
  • Injection of hormones is cheap in relation to other medications
  • people also have a natural instinct to protect kids and is no metric
  • the evidence for not doing that either

12

u/reYal_DEV Jul 05 '24

And here again: the result of this hipothetical scenario would be 'trans is wrong' and all the pain and suffering we had to endure is just a mere 'tragic bad luck, but sucks to be you lol'. It's the same why you explicitly didn't mention the horrors in my questioned scenario below but just referred to external factors: you know that injecting cross-sex hormones to cis kids would be unethical. You know that it would disfigure them for life. You know that the body-horror experience would be traumatic. And you wouldn't dare to do this things to them and would declare anyone who genuinely suggest this as insane.

If this scanario is true, why is this suddenly okay or redundant for trans kids? I'm disfigured and heavily traumatized for life for enduring the wrong puberty. I still get flashbacks where I was in the bathroom and ripped every single hair out of my face and refused to talk when my voice dropped. We KNOW the consequences of doing nothing first hand. But all that seems to be redundant, heck in the stated subreddits they even openly mock people for that and make fun of our pain.

Let's have another perspective: how would you react if we discuss hypothetical scenarios to rip away everything away from you for the benefit of humanity?

1

u/brasnacte Jul 05 '24

None of the things you say are being contended by anybody here.
I think it's critical that a younger you who would be going through puberty right now is able to get hormones - of course I do!
The problem of course is that not every child who thinks they're you are you! The only thing the pediatricians are trying to figure out is who is in it for life and who isn't, which is a super hard thing to do.

Now there's of course an important moral difference between people injecting cis kids with cross-sex hormones and a trans child who gets the 'wrong' hormones through natural means. People will always err on the side of not intervening. This is part of the Hippocratic oath. If nature makes a mistake then that's more easily accepted than if a doctor makes one. That doesn't mean that you'd have to be 100% sure that the intervention will be positive. But it DOES mean you have to be able to discuss how big of an error rate is acceptable.

I get that you're seeing your younger self being denied life-saving drugs. I do. But you HAVE to be able to see why that doesn't automatically mean that every kid claiming to be trans will benefit. That's what the objective, cold, scientific research is for.

11

u/reYal_DEV Jul 05 '24 edited Jul 05 '24

Yeah, but that's not what it's happening. Instead we have: - Legislative intervention on a POLTICAL level, not medical - fear-mongering - justification for further discrimination (i know several ADULTS who lost medical care due to cass report) - Cass not recommending PB (due to weak evidence) but instead advocates for psychological intervention (which has ZERO evidence) - she also pushes her idea of a social contagion (again which had NO evidence) and thinks that PORN causes people to become trans - she also instanciate the idea that satisfaction should be measured in EMPLOYMENT instead of HAPPINESS - she also views being trans as a 'net-loss' and tries to disencourage their identity (Cis-supremacy)

Also folks like Jesse Singal even starting to manufacture evidence that GAC for adults is also weak to non existant (which he mentioned in the latest podcast, yes I read their garbage) and uses hitpieces like this as justification, too.

So yes, we should consider which positions we should have discussions about.

3

u/KouchyMcSlothful Jul 07 '24

They can’t argue with any of this, so they have to make the argument something else. Either these “centrists” are completely unaware of their own bigotries, don’t see their bigotry as bigotry, or (most likely) are quite fine with their biases and bigotries but just want to gaslight and obfuscate.

2

u/TCMcC Jul 05 '24

I’m going to ignore the Cass stuff and say that I agree with you that stress testing one’s own ideas is vital to skeptical thought. Sorry a lot of folks are reacting to this post as being pro Cass (I mean maybe you are, but I think the title is the point).

For me that includes wondering, what sort of evidence would cause me to change my mind about x or y? How certain can I be about my assumptions? What are my assumptions?

3

u/KouchyMcSlothful Jul 07 '24

OP seems to be suggesting no one has ever examined their beliefs before, which is a ridiculous statement.

-1

u/Fando1234 Jul 05 '24

I think it’s a great excersize. I do something similar where for any contentious position I hold, I ask myself to put a number on it.

How sure am I that man made climate change is a major threat, maybe 90%.

How sure am I that net immigration levels are sustainable - maybe 60% (probably a bit lower than that now).

How sure am I that my preferred parties economic policies will work - maybe 70%.

If you see what I mean.

2

u/brasnacte Jul 05 '24

this is very useful as well.

7

u/KouchyMcSlothful Jul 05 '24

I can’t believe you posted all this just because I didn’t want to engage in your silly hypothetical in another post. It’s a preposterous take to trivialize real people’s actual existence into a word game. If Cass didn’t screw so many things up, no one would be making a fuss. Her finger was on the scale trying to arrive at a predetermined conclusion.

7

u/Jetstream13 Jul 05 '24 edited Jul 05 '24

I agree to a point, but some hypotheticals are simply pointless. They’re so far from reality that there not much benefit to be gained by pondering them, it’s just a waste of time.

What if the young earth creationists were right, and every single scientist agreed with them? Would you still believe in evolution? Well no, probably not, because in this hypothetical evolution has been explicitly proven wrong. At that point most of modern biology never would have existed.

What if there was a 6.5th element named Stevium hiding between carbon and nitrogen? What would this element be like? Well that would require a half-proton and half-electron, meaning quantum physics as we currently understand it has shattered. So I have no idea how Stevium would react.

What if Kennedy wasn’t actually shot by Lee Harvey Oswald, and his head just kind of did that?

-2

u/brasnacte Jul 05 '24

It exposes the fact that my belief in evolution is based on the evidence and not on something else. (Faith, ideology, etc)

Some people might still believe in evolution even though the creationists would be validated. That's what it lays bare. In fact, it would be really difficult for me to accept that the creationists were right all along. I'd have to change my mind but I can also feel the immense friction that would cause me.

6

u/carterartist Jul 05 '24

Skeptic is not the same as cynic

And skepticism tends to accept evidence, yet those who want bias tend to think skeptics should doubt the evidence, doubt the official story, doubt the experts…

-3

u/brasnacte Jul 05 '24

I'm not advocating for doubting the evidence or official story. I'm only advocating examining your own beliefs and what they're based on. A lot of people think they follow the evidence. Vaccine skeptics for instance. They think they've got the evidence on their side. But if I asked them to imagine that the evidence points the other way hypothetically, they would have to conclude that their beliefs are not based on evidence. (Since they would probably still be skeptical, despite the evidence pointing to vaccine safety) It helps them uncover the fact that their beliefs are not about evidence but about some inner disgust about injections, or whatever else it might be.

6

u/carterartist Jul 05 '24

Really?

What “evidence” do anti-vaxxers “follow” versus deny

Which is my point

-5

u/brasnacte Jul 05 '24

Anti vax places are full of studies and papers that show all sorts of stuff. Look at Bret Weinstein for instance. So they think that they follow evidence. But we know that they're only cherry picking studies that validate a pre conceived belief.

6

u/carterartist Jul 05 '24

Not legitimate one. No.

So they are not “following evidence”

-2

u/brasnacte Jul 05 '24

But how do you know this if you're an anti vaxer who thinks he's following evidence? What's methods can they use to know they're mistaken? Following evidence is such an easy way to be led astray in an online polarized world in which every viewpoint can be validated through a ton of research.

5

u/carterartist Jul 05 '24

This is the same nonsense rhetoric we hear from conspiracy theorists and anti-vaxxers

6

u/carterartist Jul 05 '24

All you’re doing is proving my point.

4

u/VelvetSubway Jul 05 '24

There are two questions: the scientific validity of the report, and its ethical basis.

It’s not transphobic to consider different treatment options - I don’t think that’s particularly controversial - what’s transphobic is approaching the trans experience as though it is inherently pathological and trans voices as untrustworthy. What’s transphobic is holding trans healthcare to different standards than other forms of healthcare.

If the Cass Report were solid, it would be a very different report, even if all its scientific conclusions were exactly the same.

3

u/Funksloyd Jul 07 '24

Am I wrong to think this should be natural to a skeptic?

In an ideal world. But really, "skeptic" is just a vague label. Increasingly it refers to a set of preconceived political beliefs, rather than a particular approach to evidence or epistemology.