NYT Publishes A Reasonable Point of View

On trans issues, even. What's next? A thoughtful, evidence based policy position on climate change?

The New York Times has been publishing some truly terrible anti-trans stuff for years. Today they published an editorial by Lydia Polgreen (paywall) that was apparently distributed under the headline, “How the Cass Report Became a Weapon in the War on Trans Kids.” It has a different one now (and I’m taking the word of someone else it was originally titled the above since I don’t have a screen shot), but I gotta say that first hed nearly caused me to lose my cookies. The obvious answer is that the NYT made the Cass Report into a weapon through the NYT-published work of Pamela Paul. Literally no one has done more to launder the bias and politics of the Cass Report than Pamela Paul, who has done so precisely because she advocates an end to trans health care. Her work has done more than any others’ to make the Tory-requested, Tory-funded, and Tory-fueled Cass Report appear to be neutral and respectable in US political discourse.

As a good friend of Pervert Justice just told us via e-mail, the current article debunking the neutrality and respectability of the Cass Report is, “so dry and boring until she gets to what's actually fucked up about it.” Even so, this passage struck me with how well it sums up much of what I’ve written in my various articles and analyses over the last several months:

Upon first reading, especially to a person with limited knowledge of the history of transgender health care, much of the report might seem reasonable. It is full of statements of concern for the well-being of children and young people, insisting that the current standards of care are built on “remarkably weak evidence” and that the relatively tiny number of children seeking gender-affirming care “deserve very much better.”

But the report is also full of contradictions. While maintaining that “for some, the best outcome will be transition,” it nevertheless effectively recommended that the N.H.S. abandon the guidelines embraced by major mainstream medical associations and restrict the use of medications that have been offered for decades to adolescents across the globe with vanishingly few negative side effects or regrets.

The reason, the report says, is that these treatments are insufficiently supported by reliable, long-term evidence. Then, remarkably, the report recommends treatments — psychological treatment and medications for depression and anxiety — that have even less proof behind them in helping children (or adults) with gender dysphoria, though they may help with other mental health issues, and many children with dysphoria already get these treatments. And for all its insistence of evidence, the report is peppered with mere speculation about the potential causes of gender dysphoria: pornography and the phenomenon of social contagion are invoked, with zero credible evidence to support them.

It is a strange document.

Kinda dropped the lede there when it noted that, “for all its insistence of evidence, the report is peppered with mere speculation,” but then didn’t cite the greatest example of evidence free bullshit you’ll find anywhere in the report: that bit about how Cass somehow knows the ratio of AFAB to AMAB trans people going back literally “many centuries.”

As your friendly, neighbourhood Crip Dyke said at the time, “Doc, please.”

If you haven’t been reading ongoing coverage of the Cass Report here, at Wonkette, at Erin In the Morning, and in other relevant spaces, then this NYT Op/Ed might be genuinely helpful to you. For now, though, I think it’s enough to point out what so many of us already have, that the Cass Review begins with the assumption that it is bad to be trans and asks how best and how often can transness be prevented. But since Polgreen does this in a particularly helpful way to those who haven’t understood themselves as trans, I’ll give you one more long quote:

At one point the report posits that because a child has never had the experience of growing up in their assigned sex, they would have no way to know whether they might regret transition. “They may have had a different outcome without medical intervention and would not have needed to take lifelong hormones,” the report says, referring to children assigned female at birth.

It is hard to know what to make of a statement like that. A person gets only one life; waiting to see how it works out isn’t really an option. To a queer woman like me this is an ominous echo of something many of us have heard many times in our lives: Maybe you just haven’t met the right man yet.

[…] Many people find transgender people at best unsettling and possibly deluded or mentally ill, or at worst immoral and unnatural. They appear to believe it would be better not to be trans.

As much as Cass’s report insists that all lives — trans lives, cis lives, nonbinary lives — have equal value, taken in full it seems to have a clear, paramount goal: making living life in the sex you are assigned at birth as attractive and likely as possible. Whether Cass wants to acknowledge it or not, that is a value judgment: It is better to learn to live with your assigned sex than try to change it.

While unfortunately uninformed cis people need to hear this background, feeling that it is right and proper for them to have a say in trans health care is itself the largest problem here. Polgreen details at one point how the Johns Hopkins gender clinic shut down after a report on the effectiveness of gender medicine was released that found that trans people themselves were very happy to have had access to treatment, but that treatment didn’t make patients less likely to be arrested or more likely to maintain steady, long-term employment or more likely to get heteromarried. Cass herself maintains that success should be measured by employment and community engagement, as if struggling artists, full-time parents, and general introverts are less worthy of health insurance benefits and physician attention.

Yet why should this be so? Do we treat cancer only if the patient can promise to avoid future DUIs? Should abortion access be conditioned on future marriage? Are hip replacements only justified on the basis of future economic output?

As Pervert Justice has said many times, abortion rights are a trans issue and trans rights are reproductive rights. But also, too, I think it’s clear that very few people really understand the intellectual justification for writing cissexism into policy and law. The right wing wishes you to believe that trans health care can be sabotaged or ended even if it improves trans lives. But why? Because even after treatment, trans people aren’t living lives of which the right wing approves. The only justifiable transition, then, is to transition from trans to non-trans, from trans to cis.

This is the view of Hillary Cass, the view of the Cass Report, and the view of those in the US who seek to outlaw or restrict trans care. The fight for trans care must be joined by everyone or soon, even for the cissexuals among us, the most important test at every medical visit will be theological.

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Previously!

Hillary Cass Takes a Trans Census!

Crip Dyke also writes for the delightfully cussmouthed Wonkette!