Apology for the Priesthood Ban / "March of Dimes Syndrome" / "Mission Creep" / "Spencer's Law"

[Calm]

57 minutes ago, SeekingUnderstanding said:

It baffles me, that SMAC can be as active as he is here and think this. You have never as long as I've been on this board done a "gotcha." You are as faithful as they come in the church. At the same time, you expect honesty, careful speaking, citing of sources, not overstating anything, and most of all you seek understanding FROM ALL SIDES. I'd lend you my moniker since it no longer really fits my persona here, but alas, I can't.

Thank you.  This means a lot.  Sometimes I wonder if I am fooling myself, that I am not trying to do what I think I am trying to do (if others can be mistaken in this way, it makes sense I could be), but reassure myself I am at least putting in the work with providing documentation for most things that need it and for some that don’t.  It is good to have this kind of feedback.

I would not be surprised if a gotcha slipped out on occasion with one of the clumsier, highly aggressive critics (the ones that mock but don’t know much at all and yet think they do), but only likely because they get me annoyed for wasting others’ time and attention as well as their own.  We don’t get too many of those though.

Edited October 11, 2024 by Calm

[smac97]

3 hours ago, SeekingUnderstanding said:

Quote

What are your thoughts on "Conversion Therapy"?  Do you take a similar "it can be overused and misuses, but that doesn't mean it never has a place" tack?  Or are you take a more "black and white thinking" approach to it?

Conversion therapy was accepted practice for decades. Decades.

And now it's not.  At all.  "Black and white," as it were.

Or do you take a similar "it can be overused and misused, but that doesn't mean it never has a place" tack? 

3 hours ago, SeekingUnderstanding said:

See here:

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-whether-conversion-therapy-can-alter-sexual-orientation-without-causing-harm/

If Gender Affirming Care had similarly bad outcomes in all cases, SNIP then I would support bans. 

You are saying "Gender Affirming Care" always had "bad outcomes"?  In "all cases"?

Are you sure about that?

3 hours ago, SeekingUnderstanding said:

However, I know from personal people that I am acquainted with, that gender affirming care, including sex change operations can have an enormously positive impact on their emotional and physical health and well-being.

And adults can make that choice (though many of the bulleted concerns I have about PSTM remain fairly relevant even then).

But the discussion here is about PSTM ("pediatric sex trait modification") procedures.  I think that changes the approach quite a bit.  As Doctor Bell of the Tavistock Clinic put it: 

• "It should be possible, he believes, to manage the distress of a child who is suffering gender dysphoria in a less interventionist way, until he or she is an adult and can make a decision.  'Consent is the issue here, nothing else.'"
• “'They think this is to do with being liberal, rather than with concerns about the care of children. Mermaids and Stonewall [the charities for trans children and LGBTQ+ rights] have made people afraid even of listening to another view.'"
• "'I hate the weaponisation of victimhood, the fact that the fear of being seen to be transphobic now overrides everything.'"
• "The current campaign to ban so-called gay conversion therapy is {} likely to become a Trojan horse for trans activists who will use it to put pressure on any clinician who does not immediately affirm a young person’s statement about their identity, decrying this, too, as a form of 'conversion'."
• "'This is about light and air.  It’s about free thinking, the kind that will result in better outcomes for all young people, whether transgender or not.'"

3 hours ago, SeekingUnderstanding said:

To the extent that any undue pressure exists one way or another exists, it should be promptly addressed and mitigated.

I agree.  I think the other issues also need to be addressed.  

Frankly, I don't see how Informed Consent can be meaningfully "mitigated."  I think this will likely be the core point addressed in litigation, lots and lots of it, in the relatively near future.

3 hours ago, SeekingUnderstanding said:

To the extent that there is a lack of knowledge and understanding of the risks (something that is problematic across all medical fields) this should be improved. But ban? The only people that support outright bans as far as I can tell are religiously motivated ideologues. 

"'I hate the weaponisation of victimhood, the fact that the fear of being seen to be transphobic now overrides everything.'"

Thanks,

-Smac

Edited October 11, 2024 by smac97

[smac97]

33 minutes ago, Calm said:

Quote

I took her comments as more of a "gotcha." 

I don’t do “gotchas” as I have stated before.  

Yet that is how it came across.  Hence the "I took her..." prologue.

33 minutes ago, Calm said:

If something sounds like one, it is because I want to know the reasoning behind it as it seems inconsistent with other things someone says.

Understood.  

33 minutes ago, Calm said:

I am interested in these discussions mostly to examine how people reason and that isn’t always clear from what they say, especially when as stated there appears to be a conflict.  I believe nuances in thinking are very often revealed when apparent conflicts are resolved with more information, either by revealing there is no actual conflict or by showing the conflict is valid but was unrecognized and once recognized can be corrected for a more accurate position…or a combo of the two since things can be complex and both somewhat correct but incomplete and somewhat in conflict.

Got it.

When I say that I quoted Reed's article "primarily because she is a percipient witness," it is weird to see you respond "he fact someone is a percipient witness is not the primary reason you choose them as a reference."

Thanks,

-Smac

Thanks,

[Teancum]

On 10/10/2024 at 2:54 PM, ZealouslyStriving said:

For the crowd here anything falling outside of Judeo-Christian morality is sacrosanct and must not be interfered with.

Huh?!

[SeekingUnderstanding]

38 minutes ago, smac97 said:

You are saying "Gender Affirming Care" always had "bad outcomes"?  In "all cases"?

Are you sure about that?

I assume you misspoke here. Did you mean to ask about conversion therapy? All cases is too broad, since anecdotes mean nothing scientifically. So again I will restate. If after decades of providing gender affirming care, the medical community comes to the conclusion that there is no credible evidence of any benefit to the therapy, and powerful evidence that gender affirming care was almost always extremely harmful, then yes I would support banning it. 

Edited October 11, 2024 by SeekingUnderstanding

[smac97]

3 hours ago, SeekingUnderstanding said:

Quote

Well, maybe it does.  Informed consent alone may end up being an insuperable bar to PSTM.  

How so? Minor's can't consent to anything legally speaking?

I did not say that.  The law governing minors (including parental rights) and medical ethics about this sort of thing are pretty complex, and they do not result in a one-size-fits-all sort approach to a given medical issue.

For example, many states have laws that allow minors to consent to specific types of medical procedures, regardless of their general age or legal status, such as reproductive health services, mental health treatment, substance abuse treatment, STI testing and treatment, etc.

One further complicating issue is the characterization, or re-characterization, of PSTM as being "medically necessary" versus "elective" treatment.  

It's a messy, messy area of the law.

3 hours ago, SeekingUnderstanding said:

I didn't consent to my circumcision.

Presumably, your parents did.

Do you see any material distinction between circumcision (typically for religious, cultural and/or aesthetic, but also some medical, purposes) and "gender affirming" medical treatments involving electively removing healthy body parts of children (such as penectomies and mastectomies) and electively sterilizing children?  If so, what are those distinctions?

3 hours ago, SeekingUnderstanding said:

I didn't consent to my religious upbringing which I view as causing me irreparable harm.

Do you see any material distinction between the legal issues associated with your parents' decisions regarding your "religious upbringing" and the legal issues associated with "gender affirming" medical treatments involving electively removing healthy body parts of children (such as penectomies and mastectomies) and electively sterilizing children?

3 hours ago, SeekingUnderstanding said:

Minor's can't consent to any number of things.

True.  So given that you acknowledge this, do you support or oppose "gender affirming" medical treatments involving electively removing healthy body parts of minors (such as penectomies and mastectomies) and electively sterilizing minors?

3 hours ago, SeekingUnderstanding said:

It seems awfully suspicious to me that this is where the line must be drawn.

I have noted a number of concerning aspects of PSTM:

• Comorbidities. 
• Informed consent. 
• Compromised assessments of the best interests of the child. 
• Irreversibility. 
• Sterilization. 
• Cutting off healthy body parts. 
• Longitudinal studies essentially absent. 
• Lifelong medical regimens. 
• Massive ideological/sociopolitical influences/pressures on medical care. 
• Massive social contagion risks. 
• Massive risk of financial devastation for the individual (and burden on society).

"Informed Consent" is, I think, likely to be where the rubber hits the road in a legal sense.

Can a minor with comorbidities (depression, anxiety, etc.) truly give "informed consent" to PSTM procedures (electively removing healthy body parts of minors (such as penectomies and mastectomies) and electively sterilizing minors)?

Can parents who are being told, essentially, that their options are either PSTM or risk their child commit suicide, truly give "informed consent" to PSTM procedures (electively removing healthy body parts of minors (such as penectomies and mastectomies) and electively sterilizing minors)?

Can a minor truly give "informed consent" to a procedure that is profoundly important and also irreversible?  Can a fifteen-year-old girl truly and competently give informed consent to procedures that will involve the removal of her breasts?  The irreversible elimination of the capacity for any sexual sensation?

Can a minor truly give "informed consent" about being sterilized?  A fifteen-year-old girl may think she will never want to have children.  But are we as a society willing to let her make that decision for all time at fifteen years old?

Can a minor truly give "informed consent" in the absence of substantial longitudinal studies about the long-term effects of PSTM?

Can a minor truly give "informed consent" to PSTM and the attendant lifelong medical regimens often involved?

And so on.

I'm not sure what you mean by "suspicious."  Are you saying these issues do not exist?  Or that they are not that big a deal? 

3 hours ago, SeekingUnderstanding said:

Especially so, since you oppose all gender affirming care from a theological standpoint.

First, I'm largely ambivalent to "gender affirming care" for adults.  They can do what they want with their bodies.  

Second, my objections to "gender affirming care" for adults pertain to the impact on the individual and on society.  Comorbidities need to be addressed.  Informed consent needs to be obtained.  Longitudinal data needs to be collected and impartially evaluated.  Ideological pressures need to be set aside.  Compromised decisionmaking (such as under the threat of suicide) needs to be rectified.

Third, we are not discussing all "gender affirming care" here, but rather such treatments as to minors.

Fourth, from a legal standpoint, I do not categorically oppose gender-affirming care for adults.  You are not stating my position accurately.  Moreover, you are personalizing this to me.  I am not the decisionmaker in this matter.

Do you appreciate the difference?  Do you understand that I can, notwithstanding "theological" perspectives, arrive at a different conclusion about a societal issue based on additional factors (sociological, legal, etc.)?

Thanks,

-Smac

Edited October 11, 2024 by smac97

[smac97]

1 hour ago, SeekingUnderstanding said:

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Quote

 

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A medical procedure can be overused and misused.  That doesn’t mean it never has a place.

What are your thoughts on "Conversion Therapy"?  Do you take a similar "it can be overused and misuses, but that doesn't mean it never has a place" tack?  Or are you take a more "black and white thinking" approach to it?

Conversion therapy was accepted practice for decades. Decades.

See here:

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-whether-conversion-therapy-can-alter-sexual-orientation-without-causing-harm/

If Gender Affirming Care had similarly bad outcomes in all cases, SNIP then I would support bans. 

 

You are saying "Gender Affirming Care" always had "bad outcomes"?  In "all cases"?

Are you sure about that?

I assume you misspoke here.

Yes.  I meant to ask "You are saying 'Conversion Therapy' always had 'bad outcomes'?  In 'all cases'?"

I apologize for the error.

1 hour ago, SeekingUnderstanding said:

Did you mean to ask about conversion therapy? All cases is too broad, since anecdotes mean nothing scientifically.

I agree.  And yet later in your previous post, you state: "I know from personal people that I am acquainted with, that gender affirming care, including sex change operations can have an enormously positive impact on their emotional and physical health and well-being."  

You seem to be relying on anecdotes involving "people that {you are} acquainted with" to formulate a position on PSTM.  I think that can have a place, but I think it is more important to realize that, as you put it, "anecdotes mean nothing scientifically," which is why I think the various issues in my bulleted list need to be evaluated pretty extensively.

1 hour ago, SeekingUnderstanding said:

So again I will restate. If after decades of providing gender affirming care, the medical community comes to the conclusion that there is no credible evidence of any benefit to the therapy, and powerful evidence that gender affirming care was almost always extremely harmful, then yes I would support banning it. 

"{N}o credible evidence of any benefit"?  

"{A}lmost always extremely harmful"?

That is a "scientific" standard in your view?

By this reckoning, Conversion Therapy should be welcomed back with a roar.  I'm reasonably confident that there are ample instances of it being "beneficial" to some folks, or of only being marginally or somewhat "harmful" (not "extremely").

But we seem to agree that extensive longitudinal data and study is necessary before PSTM should be utilized in any widespread manner.  Would you agree with that?  Or am I misunderstanding you?

Thanks,

-Smac

Edited October 11, 2024 by smac97

[Calm]

28 minutes ago, smac97 said:

Can parents who are being told, essentially, that their options are either PMST or risk their child commit suicide, truly give "informed consent"?

Why can’t parents as adults step back and do the research themselves now the internet is available to pretty much everyone who might have access to gender affirming care?  If they can, but don’t, is that on them and not the law?

[smac97]

1 hour ago, SeekingUnderstanding said:

It baffles me, that SMAC can be as active as he is here and think this. You have never as long as I've been on this board done a "gotcha."

Get a grip, please.  I did not accuse her of some sort of moral malfeasance.

1 hour ago, SeekingUnderstanding said:

You are as faithful as they come in the church.

I did not question her faithfulness in the Church.

1 hour ago, SeekingUnderstanding said:

At the same time, you expect honesty, careful speaking, citing of sources, not overstating anything, and most of all you seek understanding FROM ALL SIDES. I'd lend you my moniker since it no longer really fits my persona here, but alas, I can't.

Online communications via text-based message boards can only carry so much nuance. 

For example, your icon shows you smiling with a baby girl.  I assume you are well-loved by family and friends, as am I by my family and friends.  Yet I think you view me, in my capacity as a member and advocate and defender of The Church of Jesus Christ of Latter-day Saints, as an ideological opponent, even an enemy, and speak accordingly.  I perceive you as being relentlessly hostile and suspicious to pretty much anything I say.  You have frequently imputed horrible thoughts and motivations to me which I do not hold.  So your "SeekingUnderstanding" thing has, to me, come across as pretty ironic for a long time.  

As for Calm, I did not impugn her character or decency.  I just told her how one of her comments came across.  She shares her critiques of my comments in similar ways.

If my perception of the "gotcha" was in error, or if commenting on that perception was beyond the pale of civil discourse, then I retract it and apologize.  I didn't think it was that big a deal.

Thanks,

-Smac

[SeekingUnderstanding]

24 minutes ago, smac97 said:

Do you see any material distinction

I see all types of shades of gray to the issue of informed consent. I’m not the one saying it represents an “insuperable bar” to anything. That’s you. 

 

25 minutes ago, smac97 said:

do you support or oppose "gender affirming" medical treatments involving electively removing healthy body parts of minors (such as penectomies and mastectomies) and electively sterilizing minors?

As I’ve stated, I do not support a ban. I do not think an outright ban is supported by the data. I think legal bans should only be considered after lengthy deliberation and support from experts in the field. 
 

I do think judicious caution is warranted. I think that parents and medical professionals should use it in extreme cases and as a last resort. I think there are substantial improvements to be had in this area, but I do not think that’s limited to gender affirming care.  I think they were systemic issues throughout the healthcare System that should be addressed here. 

31 minutes ago, smac97 said:

Do you appreciate the difference?  Do you understand that I can, notwithstanding "theological" perspectives, arrive at a different conclusion about a societal issue based on additional factors (sociological, legal, etc.)?

I do appreciate the difference. However, if you were able to overcome your strong theological opposition to this and provide a purely impartial, rational legal approach to the issue, you would be the extreme exception among people. I, on the other hand, don’t have an ideological perspective on this issue. I want good studies and good data. Until we have such, I am EXTREMELY skeptical of ideological legislatures dipping their toe in to legislate here. I would much rather parents children and their doctors to have options in the absence of such long term data. 

[SeekingUnderstanding]

29 minutes ago, smac97 said:

Online communications via text-based message boards can only carry so much nuance. 

Respectfully, if you can’t correctly read Calm, who is ideologically aligned with you, and one of the nicest and most prolific poster in this board, what hope do you have of engaging with ideological opponents? I am not alone in feeling that you break up thoughts to the point of non-recognizability. You are told this frequently by those you engage with. I have yet again broken my own rule not to engaged with you. So with this feel free to have the last word. 

Edited October 11, 2024 by SeekingUnderstanding

[smac97]

1 hour ago, SeekingUnderstanding said:

Quote

Do you see any material distinction

I see all types of shades of gray to the issue of informed consent. I’m not the one saying it represents an “insuperable bar” to anything. That’s you. 

I think you are not understanding what I meant by referencing "informed consent" as an "insuperable bar" to PSTM ("pediatric sex trait modification") procedures.  Let me be a bit more specific:

1. "Informed consent" is a legal concept, and a very important one as to the nexus between the practice of medicine and the laws and regulations that govern that practice.  It can vary in the particulars from one jurisdiction to another.  However, its broad contours are fairly well-established.

2. PSTM is a relatively new concept.  We as a society have very little experience in and data regarding medical treatments involving electively removing healthy body parts of minors and/or electively sterilizing minors.  The legalities of such things have not been tested much, either by state legislatures or in the court system.  We went from zero treatment centers for children in 2010 to over 100 such centers by, IIRC, 2017.  That is explosive growth. 

3. Longitudinal data for the efficacy of PSTM is overwhelmingly absent.  We really have idea what the long-term effects of PSTM are or will be.

4. In the absence of such longitudinal data, the last 10-14 years have effectively allowed some medical practitioners to perform PSTM procedures and treatments on minors without really understanding the long-term effects.  Also, protocols for addressing comorbidities seem to be all over the place.

5. Given the foregoing, these practitioners and their sponsoring institutions (clinics, hospitals, etc.) are likely to have a really hard time proving that they sought and received "informed consent" from the minors and their parents.  The "informed" part of the consent is just not there.

6. I think we may well see, in the near future, substantial numbers of lawsuits that will test whether "informed consent" was obtained in the thousand and thousands of instances of PMST procedures performed on minors.  If judges and juries start concluding that informed consent was not obtained, then performing irreversible, life-altering medical treatments involving electively removing healthy body parts of minors and/or electively sterilizing minors, and doing so without having first obtaining informed consent, may well result in some pretty staggering monetary judgments.

Imagine a doctor getting sued for accidentally sterilizing a 22-year-old woman.  The damages would likely be enormous.  What is the value of the ability to conceive a child?  What amount of money would sufficiently compensate the young woman because the doctor accidentally deprived her of the ability to conceive and carry a child?

Now imagine a doctor being sued for intentionally sterilizing a 15-year-old girl, doing so without informed consent, doing so while being aware of comorbidities, etc.  The damages could be astronomical.

7. After a few of these lawsuits are filed and settled and/or litigated, and money is paid out, what do you think doctors, hospitals, medical insurance underwriters, malpractice insurance underwriters, state medical boards, state legislatures, etc. are going to do?  I think they will look at these lawsuits, see that informed consent (or, to be more precise, the lack of informed consent) was the legal lynchpin of them, and begin to act accordingly. 

• Doctors may well stop performing these PSTM procedures. 
• Hospitals may well stop allowing these PSTM procedures to be performed in their facilities. 
• Insurance companies may well exclude these PSTM procedures from coverage. 
• Malpractice insurers may well refuse to insure doctors for these PSTM procedures.
• State medical boards and/or legislatures may well prohibit such PSTM procedures outright in their jurisdictions.

8. Some state legislatures have apparently already enacted de jure prohibitions or substantial restrictions on PSTM procedures.  Litigation, centering on informed consent, may well lead to similar de facto prohibitions or substantial restrictions on PSTM procedures.  At least until there is substantial longitudinal data to support/justify PSTM.

9. I find the foregoing proposition (that substantial longitudinal data will support/justify PSTM) to be a pretty dubious proposition, for which I remain fairly skeptical, at least at scale.  From one of the articles I quoted previously (emphases added) :

Quote

Ghorayshi’s question seems to suggest that the debate between Europe and the U.S. is over how much mental-health screening and counseling to offer adolescents before putting them on a medical track. In truth, the European countries have adopted an approach that emphasizes, for most gender dysphoric adolescents, mental health support instead of hormones.

Though she notes the divergence in medical policy in Europe versus the U.S., Ghorayshi doesn’t fully explain the nature of this divergence and understates its extent. True, Europe hasn’t banned hormonal interventions altogether. But if the restrictions now in place in Finland, Sweden, and Denmark (the situation in the U.K. is more complicated) were implemented in U.S. clinics, the majority of American teenagers now being put on the medical track would receive only mental-health support. In Denmark, for instance, the rate of intake-to-medicalization at the country’s centralized gender clinic was 65 percent in 2018. After restrictions were imposed, the rate fell to 6 percent in 2022.

Ghorayshi mentions a Washington Post op-ed from 2021 by two psychologists, Laura Edwards-Leeper and Erica Anderson, who support the early medical-intervention model albeit with guardrails. According to Ghorayshi, Edwards-Leeper and Anderson “warned that American gender clinics were prescribing hormones to some children who needed mental health support first” (my emphasis). But what Edwards-Leeper and Anderson actually argue in their op-ed is that comprehensive mental-health assessment is needed to figure out whether medicalization is appropriate—a subtle but crucial difference. Such assessment is necessary for differential diagnosis and avoidance of unnecessary and potentially harmful medicalization.

Thus, it’s not just that patients referred to the St. Louis clinic were not receiving “mental health support first.” If judged by Scandinavian standards, which are far more in line with the principles of evidence-based medicine, many or most patients at the St. Louis clinics were likely being given drugs they should not have been prescribed at all. While some may believe that current restrictions in Europe are about “trying everything again from scratch,” an equally plausible explanation is that this is the first step in a bigger retrenchment that will result in firm age restrictions. Time will tell.

10. There may well be other "insuperable bars" to the longevity of PSTM in the United States.  My initial assessment pertains to the legal effect of informed consent being absent.  Candidly, this is not really my area of expertise in the law, but the foregoing seems to be well within the realm of possibility.  I briefly worked for a medmal attorney, and he made it clear that lawsuits involving babies were by far the most lucrative type of lawsuit in terms of ROI.  I didn't really like the guy, so I didn't work for him long, but I wouldn't be surprised to see him, and other attorneys like him, be eager to sue doctors and clinics on behalf of plaintiffs who underwent PSTM procedures and later came to regret them.  I think informed consent will be front and center in these lawsuits.

1 hour ago, SeekingUnderstanding said:

As I’ve stated, I do not support a ban. I do not think an outright ban is supported by the data. I think legal bans should only be considered after lengthy deliberation and support from experts in the field.

What are your thoughts about informed consent?

1 hour ago, SeekingUnderstanding said:

I do think judicious caution is warranted. I think that parents and medical professionals should use it in extreme cases and as a last resort.

I have a hard time conceptualizing this arising in the context of a minor.

1 hour ago, SeekingUnderstanding said:

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Especially so, since you oppose all gender affirming care from a theological standpoint.

Do you appreciate the difference?  Do you understand that I can, notwithstanding "theological" perspectives, arrive at a different conclusion about a societal issue based on additional factors (sociological, legal, etc.)?

I do appreciate the difference.

Great.  

Then perhaps the day may come when you will credit me with having that difference as an important part of my worldview.

I disagree with same-sex marriage, and with homosexual behavior, and with sex outside of marriage, "from a theological standpoint."  However, I acknowledge that same-sex marriage is the law of the land, and I find legislatively restricting consensual sexual behavior to be a waste of time (and, for that matter, not really compatible with either my "theological" or secular standpoints).

I can walk as a Latter-day Saint and chew secular gum at the same time.

1 hour ago, SeekingUnderstanding said:

However, if you were able to overcome your strong theological opposition

No.  No.  I will keep my theological views as part of my overall worldview.  No need to "overcome" them.  I keep them in their sphere and element.

1 hour ago, SeekingUnderstanding said:

to this and provide a purely impartial, rational legal approach to the issue, you would be the extreme exception among people.

I think this is patently unreasonable and nothing more than special pleading.  You do not hold yourself to this standard.

1 hour ago, SeekingUnderstanding said:

I, on the other hand, don’t have an ideological perspective on this issue.

Riiiight.

1 hour ago, SeekingUnderstanding said:

I want good studies and good data. Until we have such, I am EXTREMELY skeptical of ideological legislatures dipping their toe in to legislate here. I would much rather parents children and their doctors to have options in the absence of such long term data. 

So you don't care about informed consent?  It's not relevant?

Do you think an adult can give informed consent where we as a society lack - as you put it - "good studies and good data" about the medical procedures in question?

Do you think a minor can given informed consent under those circumstances?

Thanks,

-Smac

Edited October 11, 2024 by smac97

[smac97]

1 hour ago, SeekingUnderstanding said:

Quote

Online communications via text-based message boards can only carry so much nuance. 

Respectfully, if you can’t correctly read Calm,

Physician, heal thyself.

You can't correctly read me, SU.  You regularly impute horrible thoughts and motives to me which I do not hold.  You regularly interpret my comments in the worst possible light.

1 hour ago, SeekingUnderstanding said:

who is ideologically aligned with you,

Meh.  People who share ideological values can still disagree with each other.

And again, please get a grip.  I did not accuse Calm of some sort of moral malfeasance.

1 hour ago, SeekingUnderstanding said:

and one of the nicest and most prolific poster in this board,

I agree that Calm is very nice.  She might also err here and there, or give the impression of doing so.

1 hour ago, SeekingUnderstanding said:

what hope do you have of engaging with ideological opponents?

I have a fairly limited set of expectations of persuading you of much of anything.  I think your hostility to my faith overwhelms your ability to give me anything like the benefit of the doubt, and your regular hostility toward me as a person often tosses basic notions of civility out the window.

Unfortunately, I reciprocate your boorish behavior more often than I should (which, ideally, would be never).  I need to work on that.  Meanwhile, my expectations arising out my interactions with you have more to do with attempting to persuade other readers.

1 hour ago, SeekingUnderstanding said:

I am not alone in feeling that you break up thoughts to the point of non-recognizability.

Shrug.  We all have different writing styles.  

1 hour ago, SeekingUnderstanding said:

You are told this frequently by those you engage with.

And others like my posting style.  So...

1 hour ago, SeekingUnderstanding said:

I have yet again broken my own rule not to engaged with you. So with this feel free to have the last word. 

I find your implacable hostility toward The Church of Jesus Christ of Latter-day Saints to frequently and substantially hinder your capacity to provide meaningful input on the topics under discussion.

I hope that changes some day.

Thanks,

-Smac

Edited October 11, 2024 by smac97

[smac97]

1 hour ago, Calm said:

Quote

Can parents who are being told, essentially, that their options are either PMST or risk their child commit suicide, truly give "informed consent"?

Why can’t parents as adults step back and do the research themselves now the internet is available to pretty much everyone who might have access to gender affirming care?  

Parents can do this.  But that does not excuse the doctor from being obligated to obtain informed consent.

1 hour ago, Calm said:

If they can, but don’t, is that on them and not the law?

No, that is not the law.  Doctors are obligated to seek and obtain informed consent.  Telling parents to "go do research online and then come back and sign a paper saying you are giving 'informed consent'" will not do.

Thanks,

-Smac

[Calm]

1 hour ago, smac97 said:

my perception of the "gotcha" was in error, or if commenting on that perception was beyond the pale of civil discourse, then I retract it and apologize.  I didn't think it was that big a deal.

 

I like to know how I come across.  It is very helpful if the particular words are quoted so I can see where I may need to be clearer.  Or if connections were made between different sections or with another person so I can learn when I need to make it clear there is not a connection, similar to how I try and be clear something is not a rhetorical question, but actually asking for info.

I would prefer to be told immediately if something seems like a gotcha to you as that will save both of us time most likely.  You don’t need to respond to those, probably shouldn’t because if you respond like I am doing a gotcha, it is responding to something I didn’t mean and is a waste of your time and .i won’t want to respond to it.  Just tell me it came out like a gotcha and I will rewrite it.  And you can respond to that.   

Edited October 11, 2024 by Calm

[Calm]

21 minutes ago, smac97 said:

But that does not excuse the doctor from being obligated to obtain informed consent.

Did you like California boy’s idea of having educational training for parents and age appropriate training for children and anyone else involved?

[smac97]

3 minutes ago, Calm said:

Quote

my perception of the "gotcha" was in error, or if commenting on that perception was beyond the pale of civil discourse, then I retract it and apologize.  I didn't think it was that big a deal.

I like to know how I come across.  

Hence my comment about how your post came across.  Why SU is making such a big deal out of it is . . . unknown.

3 minutes ago, Calm said:

It is very helpful if the particular words are quoted so I can see where I may need to be clearer.  Or if connections were made between different sections or with another person so I can learn when I need to make it clear there is not a connection, similar to how I try and be clear something is not a rhetorical question, but actually asking for info.

I would prefer to be told immediately if something seems like a gotcha to you as that will save both of us time most likely.  You don’t need to respond to those, probably shouldn’t because if you respond like I am doing a gotcha, it is responding to something I didn’t mean and is a waste of your time and .i won’t want to respond to it.  Just tell me it came out like a gotcha and I will rewrite it.  And you can respond to that.   

Again, I did not think what you said, and which I perceived as a "gotcha" to be anything approaching a big deal.  And I have retracted and apologized for the observation.  I think that ought to put the matter to rest.

Thanks,

-Smac

[Calm]

1 hour ago, SeekingUnderstanding said:

I think there are substantial improvements to be had in this area, but I do not think that’s limited to gender affirming care.  I think they were systemic issues throughout the healthcare System that should be addressed here. 

Yes, yes, yes

[smac97]

1 minute ago, Calm said:

Quote

But that does not excuse the doctor from being obligated to obtain informed consent.

Did you like California boy’s idea of having educational training for parents and age appropriate training for children and anyone else involved?

I don't know.  I'm not an "informed consent" expert.  We'd need to see the training.

Moreover, my sense is that informed consent may not be possible (or that society can reasonably reach that conclusion).  A 15-year-old girl may well be utterly convinced that she will never want her breasts back, may never want to have children, will be fine with lifelong medical regimens associated with the PSTM procedures, etc., and yet we as a society may say that no amount of information can create informed consent in this context.

Thanks,

-Smac

[Calm]

2 minutes ago, smac97 said:

Why SU is making such a big deal out of it is . . . unknown.

He has figured out it means a lot to me to be a decent communicator.  Don’t know if he knows it’s not a pride thing, though that likely sneaks into it a bit; it is mostly a fundamental need.  Not quite food and water, but next step up on my personal version of Maslow’s hierarchy for me.  He has been paying attention when I have talked about how important being understood is for me and has probably picked up on my cues of when I get invested in something.  I believe this based on our previous interactions.  He comes across as getting me at times when others haven’t, it is pretty rare, I think, that he’s misread me…don’t actually remember it happening but it must since we are both human, lol.  He probably just stays quiet so as not to subject himself to my epic responses trying to clarify a minor point.   Anyway, I think he picks up on my nuances quite a bit.

It isn’t a big deal in and of itself that it came across to you that way, but it is part of me that I don’t do ‘gotcha’ and it does hurt some when longtime posters make assumptions that I am doing something that I have said over time I don’t do rather than presenting it as say “this came across as a gotcha to me, I know you don’t do that, could you clarify here?”  It is more the shock, mild that it is, that someone doesn’t understand me that I thought would/did, at least to that level.  It leaves me feeling lonely to be fully transparent/blunt/wimpy and that is probably why I repeat myself about it in detail on occasion.

[Calm]

31 minutes ago, smac97 said:

my sense is that informed consent may not be possible (or that society can reasonably reach that conclusion).  A 15-year-old girl may well be utterly convinced that she will never want her breasts back, may never want to have children, will be fine with lifelong medical regimens associated with the PSTM procedures, etc., and yet we as a society may say that no amount of information can create informed consent in this context.

I don’t think informed consent of any real value is going to come from a teen.  I think the ability to make such requires experience in making adult level decisions about one’s life and seeing consequences among many other things, like experiencing vulnerability and failure and success and pain and recovery and on and on.  A teenager’s life is a prolonged experiment in trying new things in new ways, preferably with nothing irreversible happening in it, but of course life itself is irreversible until we get to the Atonement.

I don’t see how it is possible for a teen to grok*** what a lifetime consequence means.  I don’t think they can even come close.  Parents and doctors may approach informed consent enough to act on it in my view.  This does not mean the minor’s views should be ignored, but rather those views become one of the major parts of the decision.

***it’s the perfect word for what I mean.  It would be best to read the book for the full context, but here is a very truncated version:

https://en.wikipedia.org/wiki/Grok

Edited October 12, 2024 by Calm

[smac97]

1 hour ago, Calm said:

I don’t think informed consent of any real value is going to come from a teen.  

Then irreversible and life-altering procedures like penectomies, mastectomies, and sterilizations might be better left to adulthood.

1 hour ago, Calm said:

I think the ability to make such requires experience in making adult level decisions about one’s life and seeing consequences among many other things, like experiencing vulnerability and failure and success and pain and recovery and on and on.  A teenager’s life is a prolonged experiment in trying new things in new ways, preferably with nothing irreversible happening in it, but of course life itself is irreversible until we get to the Atonement.

I don’t see how it is possible for a teen to grok*** what a lifetime consequence means.  I don’t think they can even come close.  Parents and doctors may approach informed consent enough to act on it in my view.  

How would parents come by informed consent when we lack meaningful longitudinal data about PSTM procedures?

Doctors, of course, don't count in the equation, since they aren't being asked to consent to such things.

Thanks,

-Smac

Edited October 12, 2024 by smac97

[Peacefully]

On 10/9/2024 at 12:29 PM, smac97 said:

Hoo, boy.  Underneath his name there is a notation: "9.5K."  This is in reference to Teancum's approximately 9,500 posts on this board, the vast majority of which are taken up with criticizing and finding fault with the Church.  

I think Teancum gave the Church an attaboy for its announcement of starting a medical school at BYU.  That was a nice thing to see.  Overwhelmingly, though, the "there is much to criticize about the church" dictum (which you aptly describe as "take every opportunity to criticize the church wherever you can") is the order of the day. 

Abraham Maslow famously said: "I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail."  If one's perspective on the Church is principally defined by implacable hostility and a desire to tear down and find fault (the "hammer"), then pretty much every story about the Church can be construed as a basis for criticism ("as if it were a nail").

And that's really too bad, because although the Church is not perfect.  it is, in my view and experience and estimation, overwhelmingly good in both motivations and behaviors/actions.  I love it a lot.  It deserves nowhere near the endless and relentless faultfinding that Teancum has spent nearly 10,000 posts heaping on it.

Thanks,

-Smac

But isn’t there value in both your and his observations? 

[Peacefully]

3 hours ago, smac97 said:

Physician, heal thyself.

You can't correctly read me, SU.  You regularly impute horrible thoughts and motives to me which I do not hold.  You regularly interpret my comments in the worst possible light.

Meh.  People who share ideological values can still disagree with each other.

And again, please get a grip.  I did not accuse Calm of some sort of moral malfeasance.

I agree that Calm is very nice.  She might also err here and there, or give the impression of doing so.

I have a fairly limited set of expectations of persuading you of much of anything.  I think your hostility to my faith overwhelms your ability to give me anything like the benefit of the doubt, and your regular hostility toward me as a person often tosses basic notions of civility out the window.

Unfortunately, I reciprocate your boorish behavior more often than I should (which, ideally, would be never).  I need to work on that.  Meanwhile, my expectations arising out my interactions with you have more to do with attempting to persuade other readers.

Shrug.  We all have different writing styles.  

And others like my posting style.  So...

I find your implacable hostility toward The Church of Jesus Christ of Latter-day Saints to frequently and substantially hinder your capacity to provide meaningful input on the topics under discussion.

I hope that changes some day.

Thanks,

-Smac

I think that last part was rather harsh. Again, doesn’t SU have as much to give to this board as you do? 

Edited October 12, 2024 by Peacefully

[Peacefully]

3 hours ago, Calm said:

He has figured out it means a lot to me to be a decent communicator.  Don’t know if he knows it’s not a pride thing, though that likely sneaks into it a bit; it is mostly a fundamental need.  Not quite food and water, but next step up on my personal version of Maslow’s hierarchy for me.  He has been paying attention when I have talked about how important being understood is for me and has probably picked up on my cues of when I get invested in something.  I believe this based on our previous interactions.  He comes across as getting me at times when others haven’t, it is pretty rare, I think, that he’s misread me…don’t actually remember it happening but it must since we are both human, lol.  He probably just stays quiet so as not to subject himself to my epic responses trying to clarify a minor point.   Anyway, I think he picks up on my nuances quite a bit.

It isn’t a big deal in and of itself that it came across to you that way, but it is part of me that I don’t do ‘gotcha’ and it does hurt some when longtime posters make assumptions that I am doing something that I have said over time I don’t do rather than presenting it as say “this came across as a gotcha to me, I know you don’t do that, could you clarify here?”  It is more the shock, mild that it is, that someone doesn’t understand me that I thought would/did, at least to that level.  It leaves me feeling lonely to be fully transparent/blunt/wimpy and that is probably why I repeat myself about it in detail on occasion.

It would also be nice if Smac could give a sincere apology instead of brushing it off as no big deal. “If my perception of the "gotcha" was in error, or if commenting on that perception was beyond the pale of civil discourse, then I retract it and apologize.  I didn't think it was that big a deal.”