Talk:Society for Evidence-Based Gender Medicine

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Evans' trans/psychoanalysis book

That is, "Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults".

So I've got a Google preview of this for a little look (I'm not hunting down a full copy, honestly, and I don't even know how much of this I'll bother to read since I've always been a bit personally avoidant of Freudian tripe). It starts off with a preface that quotes a Daily Mail article and then a foreword that erroneously claims transgender identity was an "entirely hidden phenomenon" that basically emerged in medicine in 1948 (with Harry Benjamin). Even people who know a bit of trans history don't seem to realize that it actually goes as far back as at least 1829 in the modern medical literature (see Johann Baptist Friedreich), but the slightest look into this subject would've at least unearthed Hirschfeld's clinic from the 1910s and 1920s. Anyway, what a great note this book starts off on. Chillpilled (talk) 01:09, 16 November 2023 (UTC)

Came across this: https://www.tandfonline.com/doi/abs/10.1080/00332828.2022.2056378 Chillpilled (talk) 10:42, 19 November 2023 (UTC)

Perhaps more

I ought to even return to the SEGM page. It addresses that they promote undersupported, fringe positions, that they're linked to even fringier entities, that about a third of their advisors are psychoanalysts, and that their treasurer is an executive for a Catholic hospital network which so-morally straight up robs the poor, but it doesn't so much address their key challenges towards affirmative trans medicine (but to be clear — their "alternatives" that look an awful lot like conversion therapy wouldn't meet their own standards for evidence and appear based on their simple prior that "cis > trans").

I would need to formulate how I can do that, and it may take research. One thing is how SEGM exploits the (often unstated) assumption that Europe is more "socially liberal" and so if they take a more "cautious" approach to trans medicine (something which SEGM seems to strategically support but then opposes in favor of an even more conservative option once that goalpost is met), it must mean that "even" social-liberals agree with them. There are a plethora of reasons this is wrong, but a few: European countries are actually significantly more socially conservative than the US policy-wise on some issues such as abortion; some of these governments implemented policy changes amidst a local cultural/political context that had grown more socially conservative immediately prior; some of these decisions involved SEGM and related groups at least indirectly if not directly.

They also point to a lack of "high quality evidence" for affirmative care (I'm even assuming this is true for a second, but an SBM article says the NICE reviews they refer to omitted key studies), but we also find: just 9.9% of medical treatments have "high quality evidence" under the "GRADE system" used. Yet we can still tell that certain things without "high-quality evidence" do work, partly because of the rigidity of the GRADE system. Meeting that bar can actually be impossible for certain treatments due to the simple facts of how they work; others may be unethical to carry out an RCT for. I've considered the approach of Science-Based Medicine (which criticizes this sort of rigidity) versus "evidence based medicine" concerning this question. What are the risk/benefits of assisting a transition? SEGM and co. emphasize "infertility" as "irreversible", which, I'm finding isn't even convincing considering recent methods (e.g. clomid or extended-sperm-search-and-microfreeze). To be fair there could be more documentation about by what means certain aspects of a transition might be reversed, alongside which ones are not completely reversible.

It's a mess of nuances, and untangling it then presenting it in a wiki article is a challenge. Chillpilled (talk) 22:18, 28 December 2023 (UTC)

"European countries are actually significantly more socially conservative than the US policy-wise on some issues such as abortion"

Sadly, this is no longer true since the overturning of Roe v. Wade, with several US states having extremely backwards legislation instead. It's true that traditionally, the US has much more generous term limits when compared to Europe, but given that most abortions occur during the first trimester of pregnancy anyway, this should be balanced with other things, like how abortion is paid for, its access through the territory, constitutional protections, etc.

On transgender issues, there is a rift between Western/Northern Europe on the one hand and Central/Eastern Europe on the other hand, with the former all having legal gender identity change without sterilization nor surgical intervention and the latter usually having much more conservative legislations. In the US, this roughly matches the divide between blue states and red states.

However, even given this division, there are nuances: the UK is notorious as being TERF island, and even Sweden is actually barely better on this topic.

"some of these governments implemented policy changes amidst a local cultural/political context that had grown more socially conservative immediately prior;"

True. On certain issues such as immigration, European right-wing parties have pushed even more to the right, so it isn't surprising that transgender issues are targeted next.

"some of these decisions involved SEGM and related groups at least indirectly if not directly."

Also true. In Europe, SEGM has a certain influence over right-of-center political parties in matters of transgender policy, and is often cited as a reference and as a justification for their proposals.--Monotremous (talk) 10:59, 9 December 2024 (UTC)

Something I didn't know when writing that was the EU countries seem to place more emphasis on precautionary principle, a fact RFK Jr. seems to be exploiting with his own kind of "appeal to Europe" with regards to things like food additives (though I don't know whether he might happen to ultimately be right about those, not familiar with the subject). Chillpilled (talk) 14:29, 9 December 2024 (UTC)

The precautionary principle even has constitutional value in some countries, but above all because Europe is a lot less averse to regulation in general. From a conservative American perspective, any "appeal to Europe" will always be very selective, as by their standards, European ideology heavily leans towards socialism.--Monotremous (talk) 16:04, 9 December 2024 (UTC)