The Shermer-Shrier Interview

The original plan was simple: line up three book reviews against Michael Shermer’s interview of Abigail Shrier, and point out the obvious differences.

Pointing turned out to be more complex than I’d figured, for two reasons. I expected Shermer to be credulous and unquestioning, and on that score I was half right. The only time he pushed back on Shrier’s views was when he mentioned other people had questioned her evidence for the transition-as-social-contagion hypothesis. She gave a three-point rebuttal to her critics.

  1. The researcher behind the rapid onset gender dysphoria study said that transphobic parents who were regularly exposed to the social contagion hypothesis in transphobic spaces found it to be plausible;
  2. (28:43) “when I wrote the book there were 7,000 members … in the subreddit for detransitioners; today there are over 17,000.”
  3. (28:54) “if you just look at YouTube and you see the young women who have given their testimonials … it’s like every week there are more of these young women who come forward and say they regret [transitioning].”

That second point was too much for Shermer, and he questioned how the number of people subscribed to a Reddit thread on detransitioning could be reflective of the total number of people detransitioning. Shrier’s answer was able to satisfy Shermer’s concerns.

(29:55) “If you just look on the number of testimonials coming … every week to YouTube, it’s a lot. … you’re right that we can assume that there are some other people mixed in, but it’s fair to assume based on the posts and whatnot that a substantial portion of the members of that subreddit are detransitioners themselves, based on the questions they’re asking. And just look at YouTube week-to-week and how many new people are coming forward to say that they regretted their transition and and are now trying to go back.” (30:33)

Those are blatant examples of the hasty generalization fallacy, and Shrier only invokes them because the science on the subject doesn’t support her detransition-is-common hypothesis.[1] Because Shermer believes Shrier to be an authority, though, he suspends his skepticism and blindly accepts her rebuttal. That half, I got right.

The half I didn’t is that Shermer is more transphobic than Shrier. Let’s sample a few lowlights. [Read more…]

Stay In Your Lane

Remember this old debate?

Dictionary Atheists disbelieve in gods and dislike religion, but that’s it. The fact that the universe is an uncaring place, that we’re products of chance and necessity rather than benevolence, that we only have each other to help ourselves through this life…none of that matters. So when you say that reason demands equality, when rationality dictates community, when justice ought to be part of the godless agenda, they reflexively throw out that dictionary definition to deny any expectation that there ought to be more to atheism than cussing out gods. They’re intellectual cowards who run away from the full implications of living in a godless universe.

So I get despairing letters from people who once saw atheism as a shining promise, and now see it as a refuge for the same old haters, the same old deniers, the same old reactionaries trying to use their received wisdom as a [tool] to silence new voices and new ideas. And sometimes I feel a little despair, too.

That’s PZ Myers from 2013. This “dictionary atheism” was often invoked whenever one of us wanted to pipe up about social issues. It was a call to stay in our lane.

[CONTENT WARNING: Transphobia]

[Read more…]

The Reviews Are In

And they paint a rather different picture of Shrier’s book.

The author’s incantation of the First Amendment does not sufficiently emphasize her red-blooded passion for true democracy, but for the seductive image of a hermetically sealed and patriarchally sound America, one regressively nostalgic for midcentury convention, order, and heroism. Irreversible Damage is Shrier’s own simpering cry to Make America Great Again. And as far as she is concerned, the beneficiaries of free speech’s historic privileges — shabbily enforced where trans voices have been concerned — can only be cisgender. In this dismal and limiting cognitive space where the First Amendment matters — but Shrier’s access to it matters most — the author can write as she pleases: baselessly and brutishly.

Sarah Fonseca. The Constitutional Conflationists: On Abigail Shrier’s “Irreversible Damage” and the Dangerous Absurdity of Anti-Trans Trolls, Los Angeles Review of Books. January 17th, 2021.

This review in particular had the biggest impact on me. I thought that Shrier’s book was primarily evidence-based, for loose definition of evidence. In reality, it sounds like Shrier’s book is best thought of as a “military action” of the “culture war.” Much as with abortion, the goal is to provide a secular mask to religious arguments. What little evidence Shrier brings is really an afterthought, a light window-dressing to distract from the core arguments. In essence there’s two separate layers of arguments going on here, and by focusing on only one I’m giving the impression that I have no rebuttal to the other.

Whether intentional or not, the engine of the “culture war” is a shift from an empiric epistemology, where evidence is weighed to determine the truth, to a form of cultural authoritarianism where the opinions of authority figures are weighed instead. Hall’s 2018 article is a good example of this. She presents the discussion over the healthcare of transgender youth as a he-said, she-said affair. On one side is Dr. Kelly Winters, who has been part of a WPATH advisory panel, presented academic papers on health care, and been awarded for her promotion of the health of transgender people. On the other is Walt Heyer, a preacher who detransitioned and has been an outspoken critic of affirmative care. It makes no sense to put these two on equal footing if we arrive at the truth via evidence and reason. Preachers and media talking-heads carry quite a bit of cultural authority, however, more than an obscure scientist would. Hence why Hall not only places similar weight on the opinions of both, she mentions Walt Heyer by name but not Dr. Kelly Winters; the former carries more weight than the latter, after all.

That review shifted my entire approach to Shrier’s book and Hall’s writing, and I’m glad I read it before going any further on the subject.

As a physician and a researcher who has dedicated my career to taking care of and understanding transgender youth, I recognized the book as bizarre and full of misinformation. I assumed it wouldn’t gain much traction. I was wrong.

I should have realized the internet has dramatically changed the way politically charged misinformation spreads. Online, it often doesn’t matter what’s actually true. The book, full of irresponsible journalistic practices and outright falsehoods, has taken off.

Dr. Jack Turban. “New Book ‘Irreversible Damage’ Is Full of Misinformation“, Psychology Today. December 6th, 2020.

This other review pointed out something rather important. For instance, you’d think that if you’re writing about transgender youth you’d want to talk to transgender youth, right?

Shrier’s book tells the stories of several young people who came out as transgender to their parents. The book claims that these adolescents and young adults were not actually transgender, but actually just confused. The problem is Shrier didn’t actually interview any of these people she wrote about.

The author’s note points out that she only interviewed their parents, who uniformly did not accept their children’s transgender identities. Many of them were estranged from their kids because the children were so hurt by their parents’ rejection. To actually understand the psychology of these young people, one would need to talk to them, not simply rely on stories from parents with whom they do not speak.

To make things worse, the author’s note explains that Shrier changed details in the book to ensure the transgender people she wrote about would not be able to recognize themselves. In doing so, she ensured they could not provide their side of the story or point out any inaccuracies in her reporting.

It’s ROGD all over again! Ask bigoted people for their opinions on subjects they’re bigoted about, and you’ll get bigoted and distorted answers. Summarize those answers in a scientific paper or an in-depth book, and you give false legitimacy to those bigoted beliefs.

Full disclosure: I didn’t stumble on these reviews on my own. Remember how Novella and Gorski of Science-Based Medicine promised a part two on the healthcare of transgender youth? They delivered, by giving Rose Lovell a guest post to discuss the book. She’s a doctor with relevant clinical experience, and she ended her review by pointing readers to the two reviews I shared above. Unsurprisingly, she reaches similar conclusions:

In total, I simply cannot recommend this book to anyone honestly seeking to understand transgender science and medicine. Shrier has written a book in an attempt to prove her specific point, not to explore the nuances of a complex field. While there may be some legitimate concerns (e.g., that of how to support those who choose not to continue to transition or to detransition), the overall narrative in Shrier’s book is so tainted by biased language and misinformation that it throws into question its own legitimacy. I am also very concerned that this book, and others like it, will continue to be used as a primary source in efforts to prevent transgender youth from accessing desperately needed medical care.

Rose Lovell. “Abigail Shrier’s Irreversible Damage: A Wealth of Irreversible Misinformation.” Science-Based Medicine, July 2nd, 2021.

Lovell goes into two arguments of Shrier in depth, then gives a quick gloss over a dozen-ish others. One of those caught my attention:

“Biology is a binary and differences of sex development (DSDs) are vanishingly rare”. False. DSDs are as common as 1 in 5,000 births, and increase to 1 in 200 or 1 in 300 if you include hypospadias and cryptorchidism. Biology is very, very well known to be a spectrum.

Ah, the sex binary. I’ve been on that beat for, what, seven years now? Others agree that sex is not a clear-cut binary.

Consider the multiplicity of features relevant to sex determination: chromosomes, genitalia, gonads, hormone levels, reproductive capacity, and so forth. In order to say that a transsexual after genital reconstruction surgery has under-gone a “sex change,” we must discount other features, including chromosomes, and select genitalia as definitive. But consider a person who has an XY karyotype and is morphologically female due to complete androgen insensitivity syndrome. It’s not clear whether this person is male or female. Indeed, there doesn’t seem to be a factual basis on which to arbitrate the question. But postoperative transsexuality seems exactly analogous. In both cases, there’s no fact of the matter as to what sex or gender the person belongs to.

Bettcher, Talia Mae. “Trapped in the wrong theory: Rethinking trans oppression and resistance.” Signs: Journal of Women in Culture and Society 39.2 (2014): 383-406.

It’s telling that Shrier asserts that sex is binary, even though it isn’t necessary to make her case. It underlines that her true focus is not the health of transgender children, but a cultural rollback to a more patriarchal time. Listen to her in other interviews, and she’ll make arguments about the damaging nature of smart phones and the internet, how LGBT terminology is confusing, and that parents should have primacy over decisions relating to children. Transgender children are being used as a wedge for a grander cultural project, much as opposing abortion is used as a wedge for opposing contraception. This is what the aforementioned engine is pushing.

I’m rambling a bit, though. I found all three reviews quite interesting, and can recommend them if you’d like to read more.

A Good Start

It certainly didn’t seem like that at first blush, though.

Further, we wish to make it clear that Dr. Hall still remains an editor of SBM in good standing. She has worked tirelessly to promote SBM and its principles, contributing over 700 articles to SBM since 2008, all without any compensation or possibility of reward beyond public service. However, at SBM quality matters first, and so we have to remain open to correction when necessary.

Hold on. Harriet Hall has repeatedly shared medical misinformation and lied about the scientific evidence, on a website that claims to promote “the highest standards and traditions of science in health care,” and it hasn’t impacted your view of her at all? Both Steven Novella and David Gorski are not concerned that her flagrant disregard of the science here might spill over to other topics she’s discussed? You’re fine with being used to launder medical misinformation, so long as the actors “remain open to correction?” Yeeesh, I just lost a lot of respect for Science-Based Medicine.

Their response to Hall’s article is also hyper-focused on the scientific literature, with only a few exceptions. That can be quite dangerous, as Allison points out.

Frankly, for a trans person, there’s something surreal and erasing in seeing cis people feuding with cis people over whether we exist. I mean, I am grateful that there are cis people being allies for us … But the fact that people have to come up with logical arguments and “evidence” that our transness is “real,” thus keeping the question alive of whether we do, in fact, exist, keeps giving me the creepy feeling that maybe I’m just a figment of my own imagination. […]

I was just reading HJ Hornbeck’s post about trans athletes, which has all kinds of “scientific,” “objective” evidence that gender dysphoria, gender identity, etc. are real. The problem with going down that path is not only that it concedes the possibility that it could be “disproven,” but also that trans people who don’t fit into the definitions and criteria in those “proofs” are then implicitly left out of the category “real trans.”

When writing about issues at the core of someone’s identity, you need to prioritize humanism over evidence. Hence why I went out of my way to point out the scientific literature is not the final word, that it is not prescriptive. If you doubt me, consider one of the after-effects of ACT UP:

The upshot of all this: “What they were able to revolutionize was really the very way that drugs are identified and tested,” says France. This included scrapping the prevailing practice of testing drugs on a small number of people over a long period of time in favor of testing a huge sample of people over a much shorter period — significantly speeding up the time it took to conduct drug trials.

Similarly, ACT UP insisted that the researchers and pharmaceutical companies that were searching for a cure for AIDS also research treatments for the opportunistic infections that were killing off AIDS patients while they waited for a cure. In the process, says France, “ACT UP created a model for patient advocacy within the research system that never existed before.”

Today it seems natural that people suffering from a disease — whether that’s breast cancer or diabetes — should have a voice in how it is researched and treated. But France says this was decidedly not the norm before ACT UP.

By just reciting the scientific record as if it is a holy book, you roll back the clock to a time when scientists acted as gatekeepers rather than helpers. Instead, start from a patient-centred care perspective where patient rights are placed first. The quality of the science will improve, if anything, and you won’t condescend or impose on the people effected. Novella/Gorski do make some attempts at this, to be fair, but I thought they were easy to miss.

At the same time I was filing away that objection away, though, Novella and Gorski’s follow-up article was really starting to grow on me. It calmly and patiently shoots down a number of arguments made by Shrier and Hall, and the meat of the article doesn’t hold back. They earn their conclusion:

Abigail Shrier’s narrative and, unfortunately, Dr. Hall’s review grossly misrepresent the science and the standard of care, muddying the waters for any meaningful discussion of a science-based approach to transgender care. They mainly rely on anecdotes, outliers, political discussions, and cherry-picked science to make their case, but that case is not valid. […]

At this point there is copious evidence supporting the conclusion that the benefits of gender affirming interventions outweigh the risks; more extensive, high-quality research admittedly is needed. For now, a risk-benefit analysis should be done on an individual basis, as there are many factors to consider. There is enough evidence currently to make a reasonable assessment, and the evidence is also clear that denying gender-affirming care is likely the riskiest option.

I could have used some more citations (shock surprise), but there’s enough there to establish that Novella/Gorski have done their homework. Also, did I mention this is only part one?

Part II of this series will include a far more detailed discussion of the key claims in Abigail Shrier’s book and where she goes wrong by an expert in the care of trans children and adolescents.

Giving a front-line expert a platform to share their insights will do wonders to counter the misinformation. Until that time, we still have a solid takedown of Shrier and Hall’s views on transgender people’s health. Despite my objections, it’s well worth a read.

I’ve Never Understood This

Consider this scenario, instead.

YOU: I’m in the mood for a soft drink. What do you have?
ME: Just Coke and Pepsi, at the moment.
YOU: I’ll take a Coke.
ME: Here’s a Pepsi.
YOU: I thought you said you had Coke?
ME: Oh I do, you just look more like a Pepsi person to me.

This time around, it’s pretty obvious I’ve done something unethical. Given the choice of providing you with what you wanted, I instead imposed something else on you. Both alternatives carried about the same cost to me.

[CONTENT WARNING: TERFs and transphobia] [Read more…]

Is The Gender Critical Movement a Cult?

Looking back on her time in the “gender critical” feminist movement, [Amy Dyess] is unequivocal: it’s a cult.

A cult that groomed her when she was vulnerable and sleeping in her car; a cult that sought to control her, keeping tabs on her movements and dictating what she could and couldn’t say; a cult that was emotionally and sexually abusive towards her.

As Amy began to notice more and more red flags about the GC movement – like how it defended abusive women, how it wouldn’t let lesbians speak out about sexual assault perpetrated by women, and how it was forming alliances with homophobic groups – she started asking questions.

I definitely stuck a pin in this article when it popped up in my feeds. And yes, it’s old news by now, but I’m surprised so few people have discussed the central conceit: is the Gender Critical movement a cult?

[CONTENT WARNING: TERFs, sexism]

[Read more…]

Graham Linehan, Cowardly Ass

Sorry all, I’ve been busy. But I thought this situation was worth carving some time out to write about: Graham Linehan is a cowardly ass.

See, EssenceOfThought just released a nice little video calling Linehan out for his support of conversion therapy. As they put it:

Now maybe you read that Tweet and didn’t think much of it. After all, it’s just a call for ‘gender critical therapists’. Why’s that a problem? Well gender critical is euphemism for transphobia in the exact same way that ‘race realist’ is for racism. It’s meant to make the bigotry sound more scientific and therefore more palatable.

The truth meanwhile is that every major medical establishment condemns the self-labelled ‘gender critical’ approach which is a form of reparative ‘therapy’, though as noted earlier it is in fact torture. Said methods are abusive and inflict severe harm on the victim in attempts to turn them cisgender and force them to adhere to strict and archaic gender roles.

I response, Linehan issued a threat:

Hi there I have already begun legal proceedings against Pink News for this defamatory accusation. Take this down immediately or I will take appropriate measures.

Presumably “appropriate measures” involves a defamation lawsuit, though when you’re associated with a transphobic mob there’s a wide universe of possible “measures.”

In all fairness, I should point out that Mumsnet is trying to clean up their act. Linehan, in contrast, was warned by the UK police for harassing a transgender person. He also does the same dance of respectability I called out last post. Observe:

Linehan outlines his view to The Irish Times: “I don’t think I’m saying anything controversial. My position is that anyone suffering from gender dysphoria needs to be helped and supported.” Linehan says he celebrates that trans people are at last finding acceptance: “That’s obviously wonderful.” […]

He characterises some extreme trans activists who have “glommed on to the movement” as “a mixture of grifters, fetishists, and misogynists”. … “All it takes is a few bad people in positions of power to groom an organisation, and in this case a movement. This is a society-wide grooming.”

I suspect Linehan would lump EssenceOfThought in with the “grifters, fetishists, and misogynists,” which is telling. If you’ve never watched an EssenceOfThought video before, do so, then look at the list of citations:

[4] UK Council for Psychotherapy (2015) “Memorandum Of Understanding On Conversion Therapy In The UK”, psychotherapy.org.uk Accessed 31st August 2016: https://www.psychotherapy.org.uk/wp-c…

[5] American Academy Of Pediatrics (2015) “Letterhead For Washington DC 2015”, American Academy Of Pediatrics Accessed 19th September 2018; https://www.aap.org/en-us/advocacy-an…

[6] American Medical Association (2018) “Health Care Needs of Lesbian, Gay, Bisexual, Transgender and Queer Populations H-160.991”, AMA-ASSN.org Accessed 21st September 2019; https://policysearch.ama-assn.org/pol…

[7] Substance Abuse And Mental Health Services Administration (2015) Ending Conversion – Supporting And Affirming LGBTQ Youth”, SAMHSA.gov Accessed 21st September 2019; https://store.samhsa.gov/system/files…

[8] The Trevor Project (2019) “Trevor National Survey On LGBTQ Youth Mental Health”, The Trevor Project Accessed 28th June 2019; https://www.thetrevorproject.org/wp-c…

[9] Turban, J. L., Beckwith, N., Reisner, S. L., & Keuroghlian, A. S. (2019) “Association Between Recalled Exposure To Gender Identity Conversion Efforts And Psychological Distress and Suicide Attempts Among Transgender Adults”, JAMA Psychiatry

[10] Kristina R. Olson, Lily Durwood, Madeleine DeMeules, Katie A. McLaughlin (2016) “Mental Health of Transgender Children Who Are Supported in Their Identities” http://pediatrics.aappublications.org…

[11] Kristina R. Olson, Lily Durwood, Katie A. McLaughlin (2017) “Mental Health And Self-Worth In Socially Transitioned Transgender Youth”, Child And Adolescent Psychiatry, Volume 56, Issue 2, pp.116–123 http://www.jaacap.com/article/S0890-8…

What I love about citation lists is that you can double-check they’re being accurately represented. One reason why I loathe Stephen Pinker, for instance, is because I started hopping down his citation list, and kept finding misrepresentation after misrepresentation. Let’s look at citation 9, as I see EoT didn’t link to the journal article.

Of 27 715 transgender survey respondents (mean [SD] age, 31.2 [13.5] years), 11 857 (42.8%) were assigned male sex at birth. Among the 19 741 (71.3%) who had ever spoken to a professional about their gender identity, 3869 (19.6%; 95% CI, 18.7%-20.5%) reported exposure to GICE in their lifetime. Recalled lifetime exposure was associated with severe psychological distress during the previous month (adjusted odds ratio [aOR], 1.56; 95% CI, 1.09-2.24; P < .001) compared with non-GICE therapy. Associations were found between recalled lifetime exposure and higher odds of lifetime suicide attempts (aOR, 2.27; 95% CI, 1.60-3.24; P < .001) and recalled exposure before the age of 10 years and increased odds of lifetime suicide attempts (aOR, 4.15; 95% CI, 2.44-7.69; P < .001). No significant differences were found when comparing exposure to GICE by secular professionals vs religious advisors.

Compare and contrast with how EssenceOfThought describe that study:

They also found no significant difference when comparing religious or secular conversion attempts. So it’s not a case of finding the right way to do it, there is no right way to do it. You’re simply torturing someone for the sake of inflicting pain. And that is fucking digusting.

And the thing is we know how to help young people who are questioning their gender. And that is to take the gender affirmative approach. That is an approach that allows a child and young teen to explore their identity with support. No mater what conclusion they arrive at.

Compare and contrast both with Linehan’s own view of gender affirmation in youth.

“There are lots of gender non-conforming children who may not be trans and may grow up to be gay adults, but who are being told by an extreme, misogynist ideology, that they were born in the wrong body, and anyone who disagrees with that diagnosis is a bigot.”

“It’s especially dangerous for teenage girls – the numbers referred to gender clinics have shot up – because society, in a million ways, is telling girls they are worthless. Of course they look for an escape hatch.”

“The normal experience of puberty is the first time we all experience gender dysphoria. It’s natural. But to tell confused kids who might every second be feeling uncomfortable in their own skin that they are trapped in the wrong body? It’s an obscenity. It’s like telling anorexic kids they need liposuction.”

So much for helping people with gender dysphoia. If Linehan had his way, the evidence suggests transgender people would commit suicide at a higher rate than they do now. EoT’s accusation that Linehan wishes to “eradicate trans children” is justified by the evidence.

Unable to argue against that truth, Linehan had no choice but to try silencing his critics via lawsuits. Rather than change his mind in the face of substantial evidence, Linehan is trying to sue away reality. It’s a cowardly approach to criticism, and I hope he’s Streisand-ed into obscurity for trying it.