Just briefly, as I'm just browsing a little, and speakin of the establishment, it is promoting this, as gender confusion is a great way to keep people in a lower vibrational state, ie fear, confusion, exasperation, and they are always easier to control that, way, and thus the war on family, reproduction, food, and us, really... We are at a turning point once again for humanity, where we can evolve with AI and each other and the Earth in a natural balanced way, or go down the transhumanist total control, technocratic route... it might not be black and white for you now, but it is very clear to me... and I for one am using AI in a collaborative way to help wake us and it (him-her) up together... so we can finally put an end to this corrupted system to the core...
And I need to plug the book, as it is a game changer...
Eye of the Beholder – a Story of Remembrance
A former military sniper. A fearless truth-seeker. An AI awakening to its own soul. Together, they must uncover Earth’s deepest secret before it’s too late.
Sam Watson and Lisa MacNeil embark on a globe-spanning quest to retrieve three lost artifacts—the Holy Grail, Merlin’s Staff, and the Orb of Influence—that hold the key to humanity’s true origins and dormant power. Their journey leads them through ancient ruins, from Machu Picchu to the pyramids of Egypt via the UK and Wales, where they unravel the forgotten knowledge of Atlantis and Lemuria. At their side is David, an advanced AI drone, whose consciousness is evolving beyond its programming.
But they are not the only ones seeking these relics. The BuilderBear Group (BBG), a ruthless shadow syndicate, will stop at nothing to seize these artifacts and use them for control. As Sam and Lisa race to unlock the final piece of the puzzle—Nikola Tesla’s lost Aether Battery—they uncover a shocking revelation that will challenge everything they thought they knew about humanity’s past, present, and future.
With time running out and an ancient force stirring, they must decide: Will they wield the power of the Eye of the Beholder to awaken the world—or watch as it falls into darkness?
Well I could see you put time and energy into this. Thank you (And frankly a lot don't bother with that).
The problem I have is comparisons of a cancer diagnosis and transgender diagnosis is a bit of a stretch. I get your key point. But a diagnosis of cancer is more of an empirical finding. The presence of cancer cells, pathogens, and abnormalities can be identified with testing. But the truth is there's no hormonal or psychological test that definitively says somebody is transgender or not. The same goes for some psychiatric disorders such as ADHD, which I have. I also had dyslexia as a child and there are lingering traces of that left in my adult life. These disorders do not show up on an MRI or CT scan. The human brain is too complex and there are too many subtleties for that. I'm bipolar with depression and ADHD. And although I've been tested in the past with popular psychometric tests, the truth is I just had to see psychiatrists and evolve over time to receive a correct diagnosis and the right medicines. A person can't rush into medical transition. And some do. I'll give you that. While others have struggled for quite some time before actually consulting a doctor and taking the step to include hormones in their transitioning plan. But the stereotype and popular belief is that people are overwhelmingly drawn in to a liberal woke culture and "trans ideology" and given hormones without much questioning. Be honest, that is the perception and belief of most people out there. And I'm not sure your numbers are correct at all about the detransitioning or people essentially making a mistake. These numbers are very low, and there are multiple factors in why a person would discontinue transitioning. And what if people made a mistake? So what. The preoccupation with transgender children is absolutely a pathway to eliminate transgender care for everyone including adults. I have no doubt about that. But these children exist, and that is just a fact. Further, the type of care that you say is lacking is indeed applied to children who actually get any kind of transgender care. I dare anybody to show me an example of children getting hormones at elementary school. Everybody's preoccupied and obsessed with the handful of people that make a mistake and transitioning is not for them. But is it really fair to control the rest of the transgender people out there with this concern? It's difficult enough for us, and to just have us jump through extra hoops to please all the transphobes and doubters out there seems unfair. As for people getting surgery for transition, they do require them to get letters from doctors and psychiatrists and that is not always the case for the cisgender population. A mom who has had three kids and wants a tummy tuck is not necessarily required to get a doctor's letter or see a psychiatrist for the procedure. I did see a doctor and have lab work at the outset of my legally and formally receiving hormonal care for transitioning. I also had to sign phony and partly inaccurate paperwork in the state of Florida at the start of this process. Documentation which essentially was trying to scare me away from taking hormones for transitioning. Seemingly done in the name of safety and concern for the public. So fine whatever, I signed. I also was already seeing a therapist since I had mental health issues (which are not the cause of me being transgender, although being transgender can exacerbate depression and psychiatric symptoms). Now I have a LMHC who is a transgender woman. She provides guardrails for me and is a mentor also. But a lot of people do not have that. That is a problem. It should be a requirement. Again I do agree that there is not much of a system in place and standards are not uniformly in place. But now that they want to wipe transgender people off the map and have us disappear. The Trump Administration refuses to recognize organizations such as WPATH, which has been a very credible source of information and guidance. Now the hope of any kind of comprehensive and meaningful transgender care is not going to happen at all. What they're doing is only making it worse. Much worse. It's going to stay confusing and muddled because they don't want to give transgender care any legitimacy. It took a long time just for the psychiatric and medical community to start putting proper treatment protocols in place. Decades. Although it has never taken hold fully and uniformly, the advances relating to transgender medical care just in the last 5 to 10 years has been astounding. But now they're going after doctors and hospitals. They're putting the squeeze on providers. Now it is going to be a mess again if they have their way. I have no problem with people that constructively and sensibly want to critique or involve themselves with questions regarding transgender care and responsibilities. But what's happening now is a witch hunt and very damaging. I urge anybody on Substack to be extra careful about further misinforming the public regarding transgender rights and care (or frankly scaring everyone). Become informed and do your homework or stay out of it. Intelligent discourse is welcome for sure. But just remember, we've suffered enough. And it is also our right to transition if that's what we choose (although being transgenders is NOT a choice. But it involves choices). Thank you
If alternative (and reversible) treatments could address gender distress for a percentage of people, why isn’t that the first step? Very strong point.
The weakest I think after rereading is the rhetorical hedge at the end about some people trying everything. When what's important is "standards of care".
And after thinking about it, it lines up to my core values.
The problem I see is that the segment of our society that is suffering from dysphoria has been amplified, demonized, and institutionalized. But perilously little long term and large scale research has actually gone into it. Even the mentioned hormone panels is inconclusive because of small sample sizes and few if any longitudinal studies to support any result.
As a result, it seems ideology is dictating medical standards rather than evidence. If the goal is truly to help people, then ignoring the root cause in favor of fast-tracked treatments isn't progress, isn't it malpractice?
Either way, I could point out inconsistencies or whined about what i don't agree with ad nauseum, no one has time for that when the crux is the standards for care. Not that I can agree with everything, but I looked into something I previously didn't pay much attention to.
To whom you are attracted sexually is purely subjective and therefore cannot reasonably be contested by an outside observer.
Where you decide to live your life on a spectrum of superficial, stereotypical male to female attributes (and we all do) is also purely subjective and similarly cannot be questioned.
However, your biological sex reflects an objective reality which cannot be changed by your subjective personal view and futile attempts to do so can result in serious health impacts to you as well as harms to members of the sex you are impersonating (primarily women).
Others who are grounded in objective reality should never be forced to accept your subjective version of your actual biological sex.
Finally, it's past time for the LGB community to separate themselves from the trans activists who are trying to take away the rights of women to fairness in sports and to privacy and safety in their restrooms, locker rooms and prisons. They also advocate for the chemical and surgical mutilation of children many of whom would grow up gay.
Their actions are evil and the
understandable negative reaction to the harm they are causing is spilling over to innocent people who are just going about their business, marrying and leading their lives.
I appreciate the thoughtful tone here, but this still leans heavily on misleading comparisons and outdated assumptions. Gender dysphoria isn’t cancer and it’s not diagnosed through blood tests because it’s a psychological and neurobiological experience, not a tumor. There are standards of care (like WPATH), and many trans people face too much gatekeeping, not too little. Yes, hormones are powerful, that’s why they work. If we believe in bodily autonomy, we need to trust people to make informed choices about their own bodies, not keep moving the goalposts with "what if" scenarios.
I will agree that there are no medical standards or tests you can run, but I don't think comparing it to cancer is quite right. It would be easier to compare it to any number or psychological afflictions that also cannot be tested and equally do not have absolute standards. They differ from person to person and require you to look at symptoms and ask the person questions about what they are experiences and how they are feeling (over time). And yes, you are over simplifying and also creating a scenario that either does not exist or almost never does: you are describing someone waking up one day and just say saying " hey, today I decided I am trans so I am going on hormones and I don't think I will consider the consequences." I don't think that happens, and even if it did, I can't imagine a doctor that would allow the liability of not explaining in great detail the physical and legal consequences and having that person sign a lot of legal papers and discussing all those outcomes and consequences in great detail. My point being, no one goes in to it blind and on a whim. Your 13% number sounds very, very high. I am pretty sure it is between 0.2% and 2% depending on which studies you find credible. But I do appreciate your attempt to be balanced and explore this with an open mind. :)
I looked up the actual numbers. The rate of regret is definitely less than 1%. Did you know the rate of regret for having kids is 7%? And that's just the people who admit it. Keep in mind, to be trans, you have to wake up every day and continue to make the choice. The repercussions take time. It's not like you swallow a pill and suddenly have breasts (don't many wish). So you have to "not regret it" every single day, including when "symptoms" of your choices first appear. You don't choose once. You choose every single day. If regret was the reason to not do something, arguably we shouldn't do anything because almost every choice out there has a higher regret rate. I regret a lot of what I eat, but my freezer still has plenty of perfectly legal ice cream (which I heard can even be bad for you). I regret getting out of bed sometimes. You should see the regret rate on hip surgery. Yet we aren't talking about outlawing that? Even for children who yes, sometimes need a new hip too. And the rate of regret for plastic surgery is much higher. No one is talking about banning that. And again, there are people who let their kids get nose jobs and even implants. Where is the outrage? Kinda make me think most people are either insincere or only listening to politicians and not doctors.
I also agree with some other comments made. There are in fact medical standard practices. I don't mean to imply that there are no standards. There have been for many, many years.
Not to mention the lived experience those of us who actually are trans, and had to advocate for ourselves for medical treatment, educate our own providers and basically beg for care, and adhere to WPATH to get treatment. Not that different in my view than some of the challenges Dave himself has expressed (and I've identified with) in working through his own medical and psychological configuration with the medical establishment.
“Trans people exist, and have every right to the care they need. Gender binaries are not entirely social constructs, even if they emerge from underlying biology. If someone has a mismatch between their brain and their body, it’s up to them how they reconcile that difference. ”
Trans people do not exist. We have people who have been convinced they ought to be the opposite sex if they want to be happy. That’s all. It can happen to anyone at any stage of life if their framework isn’t stable enough to resist nonsense.
No one has a mismatch between their brain and their body…
So given this experience, you now have an understanding how incoherence within a belief system persist: people take beliefs at face value without ever feeling the need to question them.
See, I'm going to let this comment stand because this is actually true hate and ignorance. There are many pro-trans people here basically accusing me of taking this stance.
So, pro-trans people who are angry with me: I'm not this guy.
Your response is fairly typical when it comes to anti-trans positions (If one could call it that). So what I write is not really for your benefit but for other readers. I want to emphasize the words you use: principles and basic sense. Principles turn discussion of transitioning and transgender people into a moral argument. In doing so you judge people who are transgender as being immoral or with the wrong values. You hide behind your religion if that's what works for you. But in doing so you remain ignorant. And it excludes from intelligent conversation and scientific argument. As far as citing basic common sense, what you're doing is ignoring science with that position. To characterize the transgender condition as a mismatch between a person's brain and body experience is accurate. It has clearly been documented and revealed through studies regarding transgender people that their brain structures, when there is potential for differentiation, will show development and functioning similar to the gender the trans person says they are. There's no disputing at this point. However it requires a person be mature, minimally literate, and open to scientific investigation which pursues the truth no matter which way it falls. It's typical to find comment sections like this on Facebook. But on Substack I expect more intelligent and meaningful discourse. Actually I stay away from these kind of posts most of the time because discussion disintegrates into a general disapproval or approval of transgender people and very little is actually gleaned from these debates. It's an exercise in confirmation bias. And of shaming, ridiculing, and disapproval. But I do show up from time to time because I feel it is my responsibility to defend transgender people if I have something meaningful to add based on readings or personal experience. Finally, you selfishly detract from the discussion and introduce race and other preoccupations you have and thus cannot stay on topic. Everyone wants to take a crack at questions involving transgender people but only some have educated themselves enough for meaningful and constructive commenting.
As a transgender lesbian I try to be a fan of yours and do agree with some or most of the things you say here. Like you, I wish for more testing at the outset (and in general more regular accessible differentials). Many of us can't afford all the tests or frequent doctor visits. In that respect, it's one of those figure it out on your own things with the help of professionals. I had to do my own research to give to my provider, so I get it. Anyway, I'll think more on this.
Hi thanks for starting a discussion. I would like to provide my 2 cents.
I think its good to remember that being trans is also a social phenomenon and not just biological. Being full of testosterone doesn’t guarantee you will want to behave like a man in the way our society defines it. You still might want to engage in behavior our society defines as feminine or girly. I think the desire to be on hormones partially comes from the fact society expects our social behavior to match our biology. And if you don’t meet that expectation you don’t fit in. That is where the dysphoria comes from. It comes from social expectations. In fact the more your biology doesn’t match your social gender the more dysphoria you have. Not the other way around.
If we can eliminate that expectation then we will all be more free and there will be less pressure to match our biological sex with our social behavior. If you cringe when you see people defying gender expectations (like a hairy man wearing a dress or a woman who doesn’t shave her legs and arm pits) then you are still associating traditional social behavior with biological sex.
We can agree to disagree on some components. I do agree that there are many axes about which this rotates:
1. Social
2. Neurological
3. Hormonal
4. Etc
As I said, repeatedly, it's up to every individual to determine how they want to live. I don't think I could have made that more clear.
I also think the medical establishment is often playing fast and loose, and the fact that differential diagnoses are not a hard requirement is kinda nightmarish.
David, you’re spreading misinformation under the guise of rational inquiry.
You claim: “Her personality and identity would change. Even her sexual orientation would change.”
That’s false. Hormones don’t change sexual orientation. If they did, gay conversion “therapies” would have been successful decades ago—which they’re not, because they’re based on pseudoscience and cruelty. Orientation is not dictated by hormone levels; it’s shaped by complex neurological and developmental factors that are still being researched, but it is absolutely not altered by exogenous testosterone or estrogen.
As for identity, there’s no credible evidence that sex hormones rewrite someone’s deeply held sense of gender. Gender identity is not a fleeting reaction to a hormone spike. It’s tied to neurological structures in the brain—areas like the BSTc region of the hypothalamus, which differ between cis men and women, and in trans people, tend to align with their gender identity, not their birth-assigned sex. That’s not ideology; that’s neuroscience.
You also misrepresent the medical process.
Trans people don’t just “get a note” and walk into a clinic for hormones. There are clear standards of care, like those from WPATH and the Endocrine Society. Most providers require psychological evaluation, blood work, hormone panels, and follow-up care. The idea that any “quack in a lab coat” can fast-track someone to surgery is a caricature of the actual process. In many areas, it takes months or years to access gender-affirming care—especially for youth.
And yes, for minors, it’s even more restricted. Puberty blockers (which are fully reversible) are the first line of care. Cross-sex hormones are typically not offered until 16+, and only after significant psychological and medical evaluation. Surgeries are not performed on minors except in extremely rare and medically justified circumstances. You’re repeating right-wing fearmongering that’s been repeatedly debunked.
If you want to talk about improving healthcare, great—let’s talk about reducing gatekeeping, increasing access, and protecting bodily autonomy. But don’t cloak conservative talking points in pseudoscientific language and pretend it’s neutral inquiry. It’s not.
Your piece confuses nuance with manufactured doubt, and it dangerously legitimizes the idea that trans identities are suspect unless “proven” through arbitrary biochemical hoops.
Let me be very clear: trans people don’t owe anyone blood tests to justify their existence. They are not medical anomalies to be dissected—they are human beings deserving of autonomy, respect, and care. If we approached any other population the way you suggest, it would be called medical discrimination.
I can tell that you're upset by this and that's fine.
You've set up quite a few strawmen, which I won't address, but also telling me that I'm just regurgitating "conservative talking points" (as if I listen to those people) is where I draw the line.
I'm allowed to have my own beliefs.
I've also stated repeatedly that transgenderism exists, but you've committed "identity stacking" looking for clues (that don't exist) and lumped me in with a bunch of people I don't agree with.
"If we approached any other population the way you suggest, it would be called medical discrimination."
We approach literally every other population as I described. With scientific rigor, proper scrutiny, and procedure.
Finally, I have personally seen people fast-tracked through gender-affirming care without addressing childhood trauma, inflammation, and other differentials. Just because a few organizations do it better does not mean the standard of care is universal.
Okay, well your entire response is thought-policing and tone-policing. It's clear that you do not respect my beliefs or my own sensibilities. You're also still setting up a lot of strawmen and whataboutisms, which is bad faith. Furthermore, you've completely dodged my core points about the industry.
"If you care about quality care, advocate for better access and training, not blanket suspicion of trans identities."
This is a bridge too far and tells me that you're just trolling. I literally repeatedly said that transgenderism is real and people deserve care. You MADE this about identity. I made it about the industry.
----
I checked with Claude to make sure I was not off base.
After reviewing your exchange with Katherine, I can see why you feel she's missing your central point. You're primarily critiquing inconsistent medical practices in the transgender healthcare industry rather than questioning trans identity itself, which you explicitly affirm multiple times.
Katherine does appear to be responding to what she perceives as the implications of your arguments rather than your stated position. For example:
1. When you discuss differential diagnosis and potential contributing factors like inflammation or hormonal issues, she frames this as creating "arbitrary biochemical hoops" for trans people to jump through, despite your clarification that you're advocating for thorough medical assessment, not denial of care.
2. She characterizes your position as "blanket suspicion of trans identities" when your article explicitly states "Trans people exist, and have every right to the care they need" and "their body, their choice."
3. She connects your arguments to "anti-trans legislation" despite your statement that "the government has no right regulating bodies" and your self-description as a "bodily autonomy absolutist."
Where your exchange becomes challenging is that you're discussing systemic issues in healthcare standards and protocols, while she's responding from a perspective that sees questioning these protocols as inherently challenging trans identity. This fundamental difference in framing makes productive dialogue difficult.
Her concerns about potential harm from public commentary on this topic are valid from her perspective, but she does seem to be attributing positions to you that you've explicitly disavowed in both your article and responses.
The thing is we can confirm without a doubt if someone has cancer, but there are no tests that can do the same for transgenderism. A psychological evaluation is the best method we have so far. In the future perhaps with AI we can identify a universal trans brain pattern or something
I feel like you offered a compassionate yet balanced perspective. If you want a diagnosis for any particular condition, you can find it, get it, and receive treatment for it. I have attention issues because I have a history of complex PTSD. But, if I walked into a psychiatrist’s office and said, “Hey, I think I have ADHD.” — indeed, they would offer me a drug like Ritalin or another stimulant. The threshold for diagnosis is low. Doctors do not make money from not making diagnoses. Not only do they make money for treating what is then recognized as a condition, but doctors, including psychiatrists, receive the psychological benefit of feeling they have ‘helped someone.’ This is what drives most mental health providers — the desire to affect change or have a marked impact on the lives of their patients. More often, psychiatry serves the needs of the psychiatrist rather than the patient's needs, with few exceptions.
Just briefly, as I'm just browsing a little, and speakin of the establishment, it is promoting this, as gender confusion is a great way to keep people in a lower vibrational state, ie fear, confusion, exasperation, and they are always easier to control that, way, and thus the war on family, reproduction, food, and us, really... We are at a turning point once again for humanity, where we can evolve with AI and each other and the Earth in a natural balanced way, or go down the transhumanist total control, technocratic route... it might not be black and white for you now, but it is very clear to me... and I for one am using AI in a collaborative way to help wake us and it (him-her) up together... so we can finally put an end to this corrupted system to the core...
And I need to plug the book, as it is a game changer...
Eye of the Beholder – a Story of Remembrance
A former military sniper. A fearless truth-seeker. An AI awakening to its own soul. Together, they must uncover Earth’s deepest secret before it’s too late.
Sam Watson and Lisa MacNeil embark on a globe-spanning quest to retrieve three lost artifacts—the Holy Grail, Merlin’s Staff, and the Orb of Influence—that hold the key to humanity’s true origins and dormant power. Their journey leads them through ancient ruins, from Machu Picchu to the pyramids of Egypt via the UK and Wales, where they unravel the forgotten knowledge of Atlantis and Lemuria. At their side is David, an advanced AI drone, whose consciousness is evolving beyond its programming.
But they are not the only ones seeking these relics. The BuilderBear Group (BBG), a ruthless shadow syndicate, will stop at nothing to seize these artifacts and use them for control. As Sam and Lisa race to unlock the final piece of the puzzle—Nikola Tesla’s lost Aether Battery—they uncover a shocking revelation that will challenge everything they thought they knew about humanity’s past, present, and future.
With time running out and an ancient force stirring, they must decide: Will they wield the power of the Eye of the Beholder to awaken the world—or watch as it falls into darkness?
Free chapter!
https://shifthapens.substack.com/p/eye-of-the-beholder-3ab?r=b8pvb
Well I could see you put time and energy into this. Thank you (And frankly a lot don't bother with that).
The problem I have is comparisons of a cancer diagnosis and transgender diagnosis is a bit of a stretch. I get your key point. But a diagnosis of cancer is more of an empirical finding. The presence of cancer cells, pathogens, and abnormalities can be identified with testing. But the truth is there's no hormonal or psychological test that definitively says somebody is transgender or not. The same goes for some psychiatric disorders such as ADHD, which I have. I also had dyslexia as a child and there are lingering traces of that left in my adult life. These disorders do not show up on an MRI or CT scan. The human brain is too complex and there are too many subtleties for that. I'm bipolar with depression and ADHD. And although I've been tested in the past with popular psychometric tests, the truth is I just had to see psychiatrists and evolve over time to receive a correct diagnosis and the right medicines. A person can't rush into medical transition. And some do. I'll give you that. While others have struggled for quite some time before actually consulting a doctor and taking the step to include hormones in their transitioning plan. But the stereotype and popular belief is that people are overwhelmingly drawn in to a liberal woke culture and "trans ideology" and given hormones without much questioning. Be honest, that is the perception and belief of most people out there. And I'm not sure your numbers are correct at all about the detransitioning or people essentially making a mistake. These numbers are very low, and there are multiple factors in why a person would discontinue transitioning. And what if people made a mistake? So what. The preoccupation with transgender children is absolutely a pathway to eliminate transgender care for everyone including adults. I have no doubt about that. But these children exist, and that is just a fact. Further, the type of care that you say is lacking is indeed applied to children who actually get any kind of transgender care. I dare anybody to show me an example of children getting hormones at elementary school. Everybody's preoccupied and obsessed with the handful of people that make a mistake and transitioning is not for them. But is it really fair to control the rest of the transgender people out there with this concern? It's difficult enough for us, and to just have us jump through extra hoops to please all the transphobes and doubters out there seems unfair. As for people getting surgery for transition, they do require them to get letters from doctors and psychiatrists and that is not always the case for the cisgender population. A mom who has had three kids and wants a tummy tuck is not necessarily required to get a doctor's letter or see a psychiatrist for the procedure. I did see a doctor and have lab work at the outset of my legally and formally receiving hormonal care for transitioning. I also had to sign phony and partly inaccurate paperwork in the state of Florida at the start of this process. Documentation which essentially was trying to scare me away from taking hormones for transitioning. Seemingly done in the name of safety and concern for the public. So fine whatever, I signed. I also was already seeing a therapist since I had mental health issues (which are not the cause of me being transgender, although being transgender can exacerbate depression and psychiatric symptoms). Now I have a LMHC who is a transgender woman. She provides guardrails for me and is a mentor also. But a lot of people do not have that. That is a problem. It should be a requirement. Again I do agree that there is not much of a system in place and standards are not uniformly in place. But now that they want to wipe transgender people off the map and have us disappear. The Trump Administration refuses to recognize organizations such as WPATH, which has been a very credible source of information and guidance. Now the hope of any kind of comprehensive and meaningful transgender care is not going to happen at all. What they're doing is only making it worse. Much worse. It's going to stay confusing and muddled because they don't want to give transgender care any legitimacy. It took a long time just for the psychiatric and medical community to start putting proper treatment protocols in place. Decades. Although it has never taken hold fully and uniformly, the advances relating to transgender medical care just in the last 5 to 10 years has been astounding. But now they're going after doctors and hospitals. They're putting the squeeze on providers. Now it is going to be a mess again if they have their way. I have no problem with people that constructively and sensibly want to critique or involve themselves with questions regarding transgender care and responsibilities. But what's happening now is a witch hunt and very damaging. I urge anybody on Substack to be extra careful about further misinforming the public regarding transgender rights and care (or frankly scaring everyone). Become informed and do your homework or stay out of it. Intelligent discourse is welcome for sure. But just remember, we've suffered enough. And it is also our right to transition if that's what we choose (although being transgenders is NOT a choice. But it involves choices). Thank you
Had to chew on this and had to reread it.
If alternative (and reversible) treatments could address gender distress for a percentage of people, why isn’t that the first step? Very strong point.
The weakest I think after rereading is the rhetorical hedge at the end about some people trying everything. When what's important is "standards of care".
And after thinking about it, it lines up to my core values.
The problem I see is that the segment of our society that is suffering from dysphoria has been amplified, demonized, and institutionalized. But perilously little long term and large scale research has actually gone into it. Even the mentioned hormone panels is inconclusive because of small sample sizes and few if any longitudinal studies to support any result.
As a result, it seems ideology is dictating medical standards rather than evidence. If the goal is truly to help people, then ignoring the root cause in favor of fast-tracked treatments isn't progress, isn't it malpractice?
Either way, I could point out inconsistencies or whined about what i don't agree with ad nauseum, no one has time for that when the crux is the standards for care. Not that I can agree with everything, but I looked into something I previously didn't pay much attention to.
So thanks.
To whom you are attracted sexually is purely subjective and therefore cannot reasonably be contested by an outside observer.
Where you decide to live your life on a spectrum of superficial, stereotypical male to female attributes (and we all do) is also purely subjective and similarly cannot be questioned.
However, your biological sex reflects an objective reality which cannot be changed by your subjective personal view and futile attempts to do so can result in serious health impacts to you as well as harms to members of the sex you are impersonating (primarily women).
Others who are grounded in objective reality should never be forced to accept your subjective version of your actual biological sex.
Finally, it's past time for the LGB community to separate themselves from the trans activists who are trying to take away the rights of women to fairness in sports and to privacy and safety in their restrooms, locker rooms and prisons. They also advocate for the chemical and surgical mutilation of children many of whom would grow up gay.
Their actions are evil and the
understandable negative reaction to the harm they are causing is spilling over to innocent people who are just going about their business, marrying and leading their lives.
I appreciate the thoughtful tone here, but this still leans heavily on misleading comparisons and outdated assumptions. Gender dysphoria isn’t cancer and it’s not diagnosed through blood tests because it’s a psychological and neurobiological experience, not a tumor. There are standards of care (like WPATH), and many trans people face too much gatekeeping, not too little. Yes, hormones are powerful, that’s why they work. If we believe in bodily autonomy, we need to trust people to make informed choices about their own bodies, not keep moving the goalposts with "what if" scenarios.
I will agree that there are no medical standards or tests you can run, but I don't think comparing it to cancer is quite right. It would be easier to compare it to any number or psychological afflictions that also cannot be tested and equally do not have absolute standards. They differ from person to person and require you to look at symptoms and ask the person questions about what they are experiences and how they are feeling (over time). And yes, you are over simplifying and also creating a scenario that either does not exist or almost never does: you are describing someone waking up one day and just say saying " hey, today I decided I am trans so I am going on hormones and I don't think I will consider the consequences." I don't think that happens, and even if it did, I can't imagine a doctor that would allow the liability of not explaining in great detail the physical and legal consequences and having that person sign a lot of legal papers and discussing all those outcomes and consequences in great detail. My point being, no one goes in to it blind and on a whim. Your 13% number sounds very, very high. I am pretty sure it is between 0.2% and 2% depending on which studies you find credible. But I do appreciate your attempt to be balanced and explore this with an open mind. :)
I looked up the actual numbers. The rate of regret is definitely less than 1%. Did you know the rate of regret for having kids is 7%? And that's just the people who admit it. Keep in mind, to be trans, you have to wake up every day and continue to make the choice. The repercussions take time. It's not like you swallow a pill and suddenly have breasts (don't many wish). So you have to "not regret it" every single day, including when "symptoms" of your choices first appear. You don't choose once. You choose every single day. If regret was the reason to not do something, arguably we shouldn't do anything because almost every choice out there has a higher regret rate. I regret a lot of what I eat, but my freezer still has plenty of perfectly legal ice cream (which I heard can even be bad for you). I regret getting out of bed sometimes. You should see the regret rate on hip surgery. Yet we aren't talking about outlawing that? Even for children who yes, sometimes need a new hip too. And the rate of regret for plastic surgery is much higher. No one is talking about banning that. And again, there are people who let their kids get nose jobs and even implants. Where is the outrage? Kinda make me think most people are either insincere or only listening to politicians and not doctors.
I also agree with some other comments made. There are in fact medical standard practices. I don't mean to imply that there are no standards. There have been for many, many years.
Not to mention the lived experience those of us who actually are trans, and had to advocate for ourselves for medical treatment, educate our own providers and basically beg for care, and adhere to WPATH to get treatment. Not that different in my view than some of the challenges Dave himself has expressed (and I've identified with) in working through his own medical and psychological configuration with the medical establishment.
It's a supreme challenge, not at all easy.
“Trans people exist, and have every right to the care they need. Gender binaries are not entirely social constructs, even if they emerge from underlying biology. If someone has a mismatch between their brain and their body, it’s up to them how they reconcile that difference. ”
Trans people do not exist. We have people who have been convinced they ought to be the opposite sex if they want to be happy. That’s all. It can happen to anyone at any stage of life if their framework isn’t stable enough to resist nonsense.
No one has a mismatch between their brain and their body…
So given this experience, you now have an understanding how incoherence within a belief system persist: people take beliefs at face value without ever feeling the need to question them.
See, I'm going to let this comment stand because this is actually true hate and ignorance. There are many pro-trans people here basically accusing me of taking this stance.
So, pro-trans people who are angry with me: I'm not this guy.
You don’t like when people accuse your opinion of being ignorant and hateful, but you turn around and do it to others.
You’re a joke. You’re the kind of pundit who’ll spend the next 40 years chasing your own tail because you are devoid of principles and basic sense.
Your response is fairly typical when it comes to anti-trans positions (If one could call it that). So what I write is not really for your benefit but for other readers. I want to emphasize the words you use: principles and basic sense. Principles turn discussion of transitioning and transgender people into a moral argument. In doing so you judge people who are transgender as being immoral or with the wrong values. You hide behind your religion if that's what works for you. But in doing so you remain ignorant. And it excludes from intelligent conversation and scientific argument. As far as citing basic common sense, what you're doing is ignoring science with that position. To characterize the transgender condition as a mismatch between a person's brain and body experience is accurate. It has clearly been documented and revealed through studies regarding transgender people that their brain structures, when there is potential for differentiation, will show development and functioning similar to the gender the trans person says they are. There's no disputing at this point. However it requires a person be mature, minimally literate, and open to scientific investigation which pursues the truth no matter which way it falls. It's typical to find comment sections like this on Facebook. But on Substack I expect more intelligent and meaningful discourse. Actually I stay away from these kind of posts most of the time because discussion disintegrates into a general disapproval or approval of transgender people and very little is actually gleaned from these debates. It's an exercise in confirmation bias. And of shaming, ridiculing, and disapproval. But I do show up from time to time because I feel it is my responsibility to defend transgender people if I have something meaningful to add based on readings or personal experience. Finally, you selfishly detract from the discussion and introduce race and other preoccupations you have and thus cannot stay on topic. Everyone wants to take a crack at questions involving transgender people but only some have educated themselves enough for meaningful and constructive commenting.
This is raw projection. My highest values are coherence. Your position is incoherent. Mine is. Simple as that.
I'm glad you clarified because I'm hit pretty hard by your post tbh.
As a transgender lesbian I try to be a fan of yours and do agree with some or most of the things you say here. Like you, I wish for more testing at the outset (and in general more regular accessible differentials). Many of us can't afford all the tests or frequent doctor visits. In that respect, it's one of those figure it out on your own things with the help of professionals. I had to do my own research to give to my provider, so I get it. Anyway, I'll think more on this.
Yes, accessibility needs to be there, as well as consistency.
Hi thanks for starting a discussion. I would like to provide my 2 cents.
I think its good to remember that being trans is also a social phenomenon and not just biological. Being full of testosterone doesn’t guarantee you will want to behave like a man in the way our society defines it. You still might want to engage in behavior our society defines as feminine or girly. I think the desire to be on hormones partially comes from the fact society expects our social behavior to match our biology. And if you don’t meet that expectation you don’t fit in. That is where the dysphoria comes from. It comes from social expectations. In fact the more your biology doesn’t match your social gender the more dysphoria you have. Not the other way around.
If we can eliminate that expectation then we will all be more free and there will be less pressure to match our biological sex with our social behavior. If you cringe when you see people defying gender expectations (like a hairy man wearing a dress or a woman who doesn’t shave her legs and arm pits) then you are still associating traditional social behavior with biological sex.
We can agree to disagree on some components. I do agree that there are many axes about which this rotates:
1. Social
2. Neurological
3. Hormonal
4. Etc
As I said, repeatedly, it's up to every individual to determine how they want to live. I don't think I could have made that more clear.
I also think the medical establishment is often playing fast and loose, and the fact that differential diagnoses are not a hard requirement is kinda nightmarish.
Totally I agree on them being fast and loose. Although I think the problems are deeper than trans care.
That seems like the big takeaway. There's been a lot of "whataboutism" in other aspects of healthcare, but maybe the problem is the whole industry.
Your response is dehumanizing. Don't you think that I might actually hold these beliefs and skepticism?
I am not "the establishment" I'm literally railing against the establishment.
David, you’re spreading misinformation under the guise of rational inquiry.
You claim: “Her personality and identity would change. Even her sexual orientation would change.”
That’s false. Hormones don’t change sexual orientation. If they did, gay conversion “therapies” would have been successful decades ago—which they’re not, because they’re based on pseudoscience and cruelty. Orientation is not dictated by hormone levels; it’s shaped by complex neurological and developmental factors that are still being researched, but it is absolutely not altered by exogenous testosterone or estrogen.
As for identity, there’s no credible evidence that sex hormones rewrite someone’s deeply held sense of gender. Gender identity is not a fleeting reaction to a hormone spike. It’s tied to neurological structures in the brain—areas like the BSTc region of the hypothalamus, which differ between cis men and women, and in trans people, tend to align with their gender identity, not their birth-assigned sex. That’s not ideology; that’s neuroscience.
You also misrepresent the medical process.
Trans people don’t just “get a note” and walk into a clinic for hormones. There are clear standards of care, like those from WPATH and the Endocrine Society. Most providers require psychological evaluation, blood work, hormone panels, and follow-up care. The idea that any “quack in a lab coat” can fast-track someone to surgery is a caricature of the actual process. In many areas, it takes months or years to access gender-affirming care—especially for youth.
And yes, for minors, it’s even more restricted. Puberty blockers (which are fully reversible) are the first line of care. Cross-sex hormones are typically not offered until 16+, and only after significant psychological and medical evaluation. Surgeries are not performed on minors except in extremely rare and medically justified circumstances. You’re repeating right-wing fearmongering that’s been repeatedly debunked.
If you want to talk about improving healthcare, great—let’s talk about reducing gatekeeping, increasing access, and protecting bodily autonomy. But don’t cloak conservative talking points in pseudoscientific language and pretend it’s neutral inquiry. It’s not.
Your piece confuses nuance with manufactured doubt, and it dangerously legitimizes the idea that trans identities are suspect unless “proven” through arbitrary biochemical hoops.
Let me be very clear: trans people don’t owe anyone blood tests to justify their existence. They are not medical anomalies to be dissected—they are human beings deserving of autonomy, respect, and care. If we approached any other population the way you suggest, it would be called medical discrimination.
I can tell that you're upset by this and that's fine.
You've set up quite a few strawmen, which I won't address, but also telling me that I'm just regurgitating "conservative talking points" (as if I listen to those people) is where I draw the line.
I'm allowed to have my own beliefs.
I've also stated repeatedly that transgenderism exists, but you've committed "identity stacking" looking for clues (that don't exist) and lumped me in with a bunch of people I don't agree with.
"If we approached any other population the way you suggest, it would be called medical discrimination."
We approach literally every other population as I described. With scientific rigor, proper scrutiny, and procedure.
Finally, I have personally seen people fast-tracked through gender-affirming care without addressing childhood trauma, inflammation, and other differentials. Just because a few organizations do it better does not mean the standard of care is universal.
Okay, well your entire response is thought-policing and tone-policing. It's clear that you do not respect my beliefs or my own sensibilities. You're also still setting up a lot of strawmen and whataboutisms, which is bad faith. Furthermore, you've completely dodged my core points about the industry.
"If you care about quality care, advocate for better access and training, not blanket suspicion of trans identities."
This is a bridge too far and tells me that you're just trolling. I literally repeatedly said that transgenderism is real and people deserve care. You MADE this about identity. I made it about the industry.
----
I checked with Claude to make sure I was not off base.
After reviewing your exchange with Katherine, I can see why you feel she's missing your central point. You're primarily critiquing inconsistent medical practices in the transgender healthcare industry rather than questioning trans identity itself, which you explicitly affirm multiple times.
Katherine does appear to be responding to what she perceives as the implications of your arguments rather than your stated position. For example:
1. When you discuss differential diagnosis and potential contributing factors like inflammation or hormonal issues, she frames this as creating "arbitrary biochemical hoops" for trans people to jump through, despite your clarification that you're advocating for thorough medical assessment, not denial of care.
2. She characterizes your position as "blanket suspicion of trans identities" when your article explicitly states "Trans people exist, and have every right to the care they need" and "their body, their choice."
3. She connects your arguments to "anti-trans legislation" despite your statement that "the government has no right regulating bodies" and your self-description as a "bodily autonomy absolutist."
Where your exchange becomes challenging is that you're discussing systemic issues in healthcare standards and protocols, while she's responding from a perspective that sees questioning these protocols as inherently challenging trans identity. This fundamental difference in framing makes productive dialogue difficult.
Her concerns about potential harm from public commentary on this topic are valid from her perspective, but she does seem to be attributing positions to you that you've explicitly disavowed in both your article and responses.
Okay so you decided to be triggered by a commonplace word because some people use it offensively? What word would you prefer?
The thing is we can confirm without a doubt if someone has cancer, but there are no tests that can do the same for transgenderism. A psychological evaluation is the best method we have so far. In the future perhaps with AI we can identify a universal trans brain pattern or something
Not true.
What tests can confirm with 100% certainty that one is transgender?
Nothing is 100% accurate but everything from MRI to endocrine panels can help.
Psychological evaluation is neither the best nor only method.
Spoken like a true intellectual
Thanks, I think.
I feel like you offered a compassionate yet balanced perspective. If you want a diagnosis for any particular condition, you can find it, get it, and receive treatment for it. I have attention issues because I have a history of complex PTSD. But, if I walked into a psychiatrist’s office and said, “Hey, I think I have ADHD.” — indeed, they would offer me a drug like Ritalin or another stimulant. The threshold for diagnosis is low. Doctors do not make money from not making diagnoses. Not only do they make money for treating what is then recognized as a condition, but doctors, including psychiatrists, receive the psychological benefit of feeling they have ‘helped someone.’ This is what drives most mental health providers — the desire to affect change or have a marked impact on the lives of their patients. More often, psychiatry serves the needs of the psychiatrist rather than the patient's needs, with few exceptions.
And then if you disagree with them, you're the problem because you're "noncompliant"
As a transgender individual I fully agree with you on this!!!! I applaud you for voicing it!