Montana has once again put on hold a new law banning gender-affirming care for trans teens:
Montana’s ban on gender-affirming medical care for transgender minors has been temporarily blocked by the state supreme court on grounds that it is likely to violate the right to privacy enshrined in the state’s constitution.
....Montana’s supreme court justices agreed with the district court judge Jason Marks who put a stop to the ban in September 2023, just days before it came into effect. Marks ruled: “The legislature has no interest … to justify its interference with an individual’s fundamental privacy right to obtain a particular lawful medical procedure from a healthcare provider.”
It's all but impossible to say that anything is "clear" when it comes to this topic, but there are a couple of things that seem pretty close:
- It's pretty well known that a lot of young teens who report gender dysphoria—upwards of 70-80%—will grow out of it on their own within a few years. Since there's a small amount of evidence that puberty blockers and hormone treatments might be damaging in the long run, we should probably use them a good deal more sparingly than we do now.
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- It's equally well known that many teens are very serious about transitioning. It's quite feasible to identify them, and they should be able to start puberty blockers early. Invasive surgery should probably still wait until they're adults, but there might be rare exceptions.
Given this, it's not a good idea to ban GAC, as many red states have done. Ultimately, the state should tread carefully about interfering with medical treatment between consenting parties—especially for political reasons. On the other hand, it's probably also not a good idea to let gender clinics run wild with no firm guidance, as many blue states do.
In other words, no to bans but yes to tighter regulations.
Both sides in this dispute are in thrall to highly contentious activist groups. For red states it's MAGA-style culture warriors. For blue states, it's trans groups that insist the science is settled in favor of medical transitions for any child who wants one. It's pie in the sky to insist that the job of legislators is to resist this kind of pressure, but it is. Red states ought to be crafting good-faith guidelines on gender-affirming care, not throwing red meat to the crowd by casually banning it completely.
That study doesn't actually show that 70-80% of trans youth desist. It conflates trans youth with the much larger population of gender non-conforming youth and queer youth, among others
https://www.erininthemorning.com/p/fact-check-no-a-new-study-does-not?utm_source=publication-search
Recent, high quality, long-term studies actually show that trans youth almost always continue with gender affirming care, and that they are very satisfied with that care.
https://www.erininthemorning.com/p/new-study-trans-youth-satisfied-6
To be fair, the study is quite clear that it’s talking about gender non-contentedness and not gender dysphoria. It’s explained in the very first paragraph even. But for some reason Kevin continues to ignore the distinction and even mislabel his own version of their results graph.
Next Kevin will be suggesting politicians butt out of managing competitive sports, and leave sensitive, difficult decisions about eligibility to the people responsible for running the competitions. Pretty revolutionary stuff to trust the parents and teachers running school district sports to make wise decisions instead of leaving it to the likes of Nancy Mace and Ron DeSantis.
That's Ron De Sanctimonious.
The UK *Labour* government just today banned puberty blockers except in the limited case of a clinical trial. Does that suggest that these treatments are perfectly safe? For anyone, even a teenager who's convinced they need them?
Banned them for trans kids. They can and will continue to be used for cis kids, as they have been for decades.
The ban suggests that the UK government perceives the use of puberty blockers to have undesirable effects. That perception suggests nothing about the real world, since it may be inaccurate.
Your right to interfere with my family’s decisions isn’t up to the limit of “perfectly safe”. I’d it was, I could take your guns, car keys, pool, ORVs and all your junk food to boot.
Parents have extremely wide latitude, for good reason. Why your double standard?
If zero risk of long-term harm were the goal, contact sports for minors would be banned immediately.
I would suggest that guidelines for the treatment of trans kids should be the province of the AMA or other non-political medical body, not of the local legislature.
It would likely need to be some kind of joint commission involving the AMA and APA. But, yes. This should be something experts decide, especially since science may lead them to adjust practices as we learn more.
In 1973 the APA removed the diagnosis of homosexuality from its manual. Eventually the government went along.
They removed it from the Diagnostic and Statistical Manual of *Mental Disorders* (DSM). That does not mean that it stopped being something that they needed to provide input on. Identity, of which gender is a big part in our society, is very much a topic on which the APA could provide useful input.
The APA provided major input by removing it from the DSM.
“the state should tread carefully about interfering with medical treatment between consenting parties”
I agree, but why? The state has an interest in restricting treatments which do harm. The FDA decide which drugs and devices are safe and effective.
I think the prohibition on gender dysphoria treatment is OK. What do I care if someone in distress finds relief in it? But we all see the suicide statistics and we know that some of these folks have other underlying conditions (neurodivergent, depression, Bipolar, etc). If the state or the FDA are suspicious that something is a social contagion (and clearly some do) they are going to regulate the behavior. There’s no real constitutional prohibition.
Maybe we should pass some constitutional amendments one day which put restrictions on the government to do this stuff. Missed opportunities… it’s too late now, I think.
And we all know that liberals and progressives have long loved state regulatory powers. Oops.
"Marks ruled: “The legislature has no interest … to justify its interference with an individual’s fundamental privacy right to obtain a particular lawful medical procedure from a healthcare provider.”"
This doesn't make a lot of sense to me. The legislature can just declare medical procedures they don't like unlawful.
And the individuals in question here are children who aren't considered capable of making their own decisions in many cases. Do they also have a fundamental right to obtain guns?
In this case "lawful" means lawful under federal law. Which supersedes state law.
No one can ever show standing, i.e., that they were harmed by the status quo.
Virtually everyone of the activists seeking to ban affirming care, the pundits and columnists writing about, aren't trans, don't know anyone who is trans, and yet deem themselves fit to determine the course of the lives of thousands of people they don't really know anything about.
Notice the thundering silence about all the myriad other medical treatments minors puberty blockers for cis children with precocious puberty, growth hormones for those who are short, or even plastic surgery to alter their appearance.
My personal fave is that male circumcision is still allowed on infants who
(1) cannot consent,
(2) is irreversible if the infant grows up to be an adult who wishes he still had a foreskin,
(3) has no medical use whatsoever at the time of the procedure (phimosis can't be diagnosed until the child is approaching puberty and even too tight foreskins can almost always be fixed post-puberty with a snip to loose them up),
(4) is often performed by someone who isn't even a medical professional (big side eye to all the mohels out there),
(5) has a 1-2% complication rate (usually "just" infection), and
(6) occasionally ends up with a male adult who had "too much" taken off the top and has to suffer a dysfunctional penis for the rest of his life. (In real horror cases, the child was then raised as a girl against his will and with the government's blessing. Allegedly, this practice has ended, but who knows since the government doesn't keep stats on it?)
And yet... crickets from the Right on preventing parents from seeking this "medical care" for their children.
Yeah, the concern trolling over trans medical care really needs to stop from Kevin. Republicans won, they'll immiserate all the trans people, so Kevin's concerns over children having their genitals violated in some non-circumcisiony way would appear to soon be vanishing. Take the win, Kevin, and STFU about this topic.
Ditto for the thousands of breast augmentations on minors, teeth straightening and whitening and other cosmetic procedures which are OK.
I wish people would just admit that all their "concern" is that they find trans people icky and so they invent special rules just for them.
Though FDA has not approved augmentation under 18, and national Plastic surgeon association only recommends aesthetic augmentation for teens over 18 years old.
And yet thousands of teens get breast augmentation each year, and no one cares.
It's an interesting analogy, but a not so minor difference is that male circumcision has over a thousand years of continuous practice.
What should or should not be legal can't be grounded upon continuous practice alone. That was a long-standing justification for slavery as an "institution."
There is no excuse for the state stepping in to prohibit medical treatment on the grounds that it is in some way "novel." My father had Chronic Fatigue Syndrome before it was medically recognized as a real condition, but because he was a male executive presenting with clear physiological issues, he wasn't told (like many women with the same condition) that it was all in his head, even though Johns Hopkins ran every test they had and couldn't identify the problem. Instead, he ended up with a theory of what was going on, and a series of potential treatments, many of which made things worse, but which eventually gave him a good quality of life for another thirty years.
He didn't have to wait that thirty years for the medical establishment to work things out enough that it might suffice to satisfy state legislators that a treatment to address his suffering was something he was allowed to try.
It's strange that Republicans don't feel a need to regulate when it comes to medical procedures on children until those procedures involve the reproductive system. But let's be very clear: the problem is that Republican politicians don't freak out over the possibility a child might have had an organ transplant, they freak out over a woman possibly having a penis.
Pro-tip: Calling a logical consequence and analogy doesn't make it an analogy. That you chose to refute the argument by relabeling it analogy tells me a) you can't refute the argument, b) you're kind of a dishonest person, and c) you want you want and don't particularly care about care about any amount of harm you do to others, just so long as you get your way.
I wasn't dismissing it b/c it was an analogy. Analogies are an excellent way of making a point. I was pointing out where I felt the comparison left out what I considered a relevant aspect, that circumcision has an extremely long track record, so it's well accepted, and explains why no one complains about it.
this has nothing to do with the validity of surgery or meds for kids.
But I'll keep your pro-tip in mind for future reference!
It's not an analogy, and you well know that. It's saying that if this is your argument, here is what follows, full stop. So either you agree that, say, circumcision should be banned on the strength of your own argument ... or you squirm and say that's no true Scotsman. 'Fess up, even you don't believe the hooey you're spewing, you just don't want to answer the question. Hence, the demeaning downgrade from logical implication to analogy.
This is a political dispute. You don't need standing to participate in it.
"let gender clinics run wild with no firm guidance, as many blue states do."
Citation required.
Apparently, it's impossible in Kevin's world for blue state patients who end up regretting their trans medical care to sue the doctors and hospitals for malpractice.
Kevin, in several posts you've said "medical transitions for any child who wants one". But the truth is: medical transitions for any child with supportive parents, good health insurance, and two or more concurring doctors (psychologist, endocrinologist). Are you using "for any child who wants one" as a shorthand or are you just a troll?
Kevin consistently trots out this strawman and I don't know why. Nobody including activist trans group says every teenager that thinks they want puberty blockers should have them. It's like saying every teenager that thinks they want statins should get them. They can't.
Particularly bad in a case like this where the chart implies a large number of 11-year-olds with untreated gender dysphoria. Other posters have corrected the label; I'd want to see this study start with 7-8 year olds and continue, because I think "freaking out about bodily changes associated with puberty" is what's being tracked here, which is radically distinct from "number of children who went through every step required for gender reassignment and who, after going through everything, now feel gender dysphoria toward their current gender."
Imagine if biological and medical technology progressed to the point where we could all easily change gender back and forth. Would Kevin's concerns vanish? Would that of diehard opponents to gender reassignment? What does that suggest about their actual concerns, respectively?
It feels like Kevin has a problem with trans people. They're just icky in his mind. Why else the endless posts and looking for ways to suggest gender dysphoria is not a real thing. Icky does a lot of heavy lifting here.
The Montana state supreme court's decision parallels what I think the SCOTUS decision ought to look like. The state (or federal government) has no compelling interest in this matter. Or in 14th amendment terms, it has no "rational basis" for such a ban.
Thing is, we've seen SCOTUS stand on its head to interpret law in a way that it likes, and they will probably try to do it with this case.
Drum's claims are that most children who question their gender identity are not transgender. He also notes that the most determined children who question their gender identity are overwhelmingly in fact transgender. His conclusion is that the government should not forbid gender-affirming care, but it should place limits on the doctors who provide such care.
How does somebody as intelligent as Drum not see what a ridiculously bad argument this is. No evidence is given that those children who are questioning their gender identity but are not transgender are receiving any care that they shouldn't. Is he getting that from Fox News? Given his hatred of Fox News presumably not. But the one consistent throughline of the studies of transgender kids, it comes through even in the attempts to create a panic, is how few children resent the care they are given. That simply wouldn't be true if children who are not transgender were receiving treatment in the kind of free way that Drum suggests.
The attack on trans kids seems to directly mirror the attacks on abortion, which is not surprising given the overlap between the two groups. The evidence that clinics rush to treat people who don't need treatment seems to be based on one woman in St Louis who claims to have witnessed it, just as the similar claim with abortion was based on one woman in Illinois who claimed to witness newborns left to die after failed abortions. No outside evidence was provided for either claim. But it is even more ridiculous in the case of the women in St Louis since if she was telling the truth there would be a lot of angry patients who received this treatment. In the abortion case the victims, if they existed, would be dead, and everybody would have an interest in hushing it up. In this case if the woman was telling the truth there should be a lot of angry children and their parents. And there simply is not. There is a small number of people who regret transitioning, but it is much too small a number to suggest that anybody is being pressured into treatment. It is much smaller than the percentage of women who regret abortions, and that is too small a number to justify the idea that women are rushed into having abortions.
What is missing from Drum's argument is any suggestion of why the government should be trusted over doctors and parents to make these decisions.
Re: transition regret - and many (? most? all? I need to find the study) of those who DID regret surgical transition were unhappy with the result and the public/societal reception as a post op trans person. In no ways did it sound like they felt they were NOT trans, just were given (or imagined) rosy outcomes and reality fell short.
Solely on the issue of puberty blockers with regards to GAC, if there were risks involved, then, it wouldn't be right to use them to treat precocious puberty, either.
I thought the whole point of an informed consent was to have an informed consent. No child can obtain PBs without (a) a guardian/parent's consent, (b) a doctor's consent, (c) their own consent.
Governments requiring their consent to use PBs only for one type of treatment -- precocious puberty -- while blocking it for GAC on the claim that PBs are dangerous, is absurd.
👍👍👍👍👍
There you go, all logical and critical thinking. Nice.
I don't think this question is finally settled as a medical question. More studies will appear and eventually the medical community will decide on the correct guidance. It is unavoidable at this intermediate stage that not every kid receives optimal care.
Given this state of affairs I think the question should be left to medical authorities and politicians should stay out of it. British Labor is wrong to meddle in it.
This has been today's flirtation with being anti-trans, not quite there yet but a little closer every day.
"On the other hand, it's probably also not a good idea to let gender clinics run wild with no firm guidance, as many blue states do.
In other words, no to bans but yes to tighter regulations."
This is what is known as a false choice. Evidence please, Kevin.
"It's quite feasible to identify them, and they should be able to start puberty blockers early. "
I'd like to see a reference for this, as I've never seen a claim like this before.
"Since there's a small amount of evidence that puberty blockers and hormone treatments might be damaging in the long run, we should probably use them a good deal more sparingly than we do now."
Hormone treatments after puberty blocking usually causes infertility. That's hardly a minor issue, and IIRC there's a lot of evidence that this happens.
Kevin,
I'm a longtime lurker and I finally had to create an account to comment on your posts regarding trans issues. I live in one of the bluest of blue states, I have more familiarity with how gender-affirming care is provided to minors here than most people who confidently bloviate about the subject, and I can tell you that "gender clinics" are not "running wild."
I'll name names because why the hell not and this is the last time I read your blog anyway: Singal knows what he's doing. He's been looking for a massive scandal that has not materialized for years now, but hey, the scaremongering works, so as long as he keeps going the moral panic will continue to pay off handsomely. Let me repeat that: These massive regret numbers due to this supposed social contagion have not materialized. Not even in blue states. You know that. I know that. The difference is that for some reason, you can't bring yourself to actually admit it.
So that's that for Singal. The British fearmongers are not even worth mentioning, since they all dropped the ridiculous "we're taking away your healthcare... compassionately" mask long ago. But with you and Yglesias... man, I thought you'd have learned something from the Iraq fiasco and would actually spend time understanding what you're talking about when lives are on the line. Thing is, just like with that clusterf***, you're not the one who's going to pay the price for all of you helping the moral panic snowball into what it has become.
Anyhow, this is the end of the line for me. Adieu.
PS. the "trans activists" you keep sneering at are the only reason why trans kids have better support systems nowadays and adults don't have to go through degrading and incredibly ignorant assessments to get some healthcare. Without them, we'd still be stuck on stupid insisting that trans people are either perverts who can't help themselves or deluded "homosexuals" (and that those who say they aren't are simply lying) and healthcare for trans kids would consist mostly of conversion therapy. I also know you know that, because I was around back when Dreger, et al. were concern trolling a very vulnerable, very marginalized population. I just wish you'd have the guts to really look at what's driving you here.