I wrote about my experience at the European Professional Association for Transgender Health conference for Genspect.
Here’s an excerpt—but please read the whole thing (says every writer ever, I know)!
So many questions aren’t asked, so many presentations end with no questions from the audience at all. Instead, there’s an awkward pause where inquiry and debate should be. It’s as though the questions that should be asked cease to exist. Patients expressed satisfaction six months after undergoing a double mastectomy. But why had patients sought such surgeries? How will patients feel in five years, or 10? Is this medicine or customer service provided under a limited warranty: customer satisfaction guaranteed—for six months?
I want to say there was no human curiosity at EPATH. But that’s not quite true. What there is is more insidious in that it’s harder to see: it’s that for every normal human need and impulse, ‘gender-affirming care’ provides a surrogate.
In place of free-ranging curiosity about what drives patients to seek such drastic interventions, there is a bounded curiosity about how patients identity and what novel “treatment wishes” patients will express in the future.
In the place of self-reflection, clinicians meditate on their “positionality” and “privilege.” One researcher spent nine minutes of a 20-minute presentation pontificating on the impossibility of neutrality.
In place of scientific inquiry, we find ‘multiple ways of knowing.’ A session titled “Transgender adolescents and bone mineral density: Strengthening knowledge from multiple perspectives” enabled researchers to downplay the only measurement of bone density that really matters. Nonetheless, this was one of the few sessions where an attendee dared to ask a hard question: “Is there a threshold of worry [when it comes to bone density of adolescents undergoing puberty suppression]?” After an uncomfortable pause, a British clinician said: “I guess I’d worry more the lower they go,” before bursting into nervous laughter. “In the end, we need the data on fractures to know [how low is too low] and we won’t have that for a while.” Besides, as another clinician helpfully pointed out, “pediatric osteoporosis is also a problem beyond trans health” and no one knows the extent of the effects of (experimental) puberty suppression versus other factors on pediatric osteopenia and osteoporosis.
My sense is that when EPATH attendees think of Genspect, meeting just down the road, they feel misunderstood. Clinicians may feel that they are being accused of not caring about their patients. Of course, most of them do care—very much so. This deeply held sense of being a caring provider lets criticisms bounce off. But care can be misguided. Our best intentions can mislead—and harm. That is what has happened in the field of ‘gender-affirming care.’
What you make of transgender pharmaceutical and surgical interventions comes down to a question of belief. To a believer, the situation looks one way. ‘Gender-affirming care’ is effective, no matter what the evidence says. Believers see “reconstructive chest surgery for transmasculine minors” as “life-saving” and puberty blockers as a “harmless pause button” to save a child from undergoing “non-consensual puberty.” To the nonbelievers—whether they’re lifelong heretics or detransitioners or other recent defectors—the very same situation looks different. We see doctors performing breast amputations on troubled girls, clinicians running a risky experiment that shuts down a child’s pituitary gland, with unknown effects on that child’s cognitive, physical, and psychological development and wellbeing.
I keep turning over Motmans’ words: “We respect everyone’s freedom of speech, but we choose not to listen to it.”
This is a remarkable admission for the president of a professional association, especially when you consider that the speech Motmans and EPATH are “choos[ing] not to listen to” includes mounting evidence of medical harm and regret. The accusations EPATH chooses not to listen to are serious and cut directly at the organization’s stated aims: “To promote mental, physical and social health of transgender people in Europe. To increase the quality of life among transgender people in Europe. To ensure transgender people’s rights for healthy development and well-being.”
This new term, "non-consensual puberty" is so befuddling. What does that even mean? And what kind of world do you have to live in for that to make any sense?
"Don't Stop Believing'" could be the title of your book! I promise I will read the whole thing!