It’s like they put you in a rowboat, and you think you’re going to be happy when you get to the other side. But at some point, you realize you’re never even getting out of the boat.
That’s something Dr. Julia Mason was told by someone who realized too late that transitioning to the other sex wasn’t really possible. Dr. Mason tossed out the remark at the end of a podcast interview last summer, and it’s stuck with me ever since. I’ll come back to this in a minute.
Major events have been coming so fast and furiously since my last essay that I’ve been daunted by the embarrassment of writing prompts. No sooner were the ‘WPATH Files’ released than Britain’s National Health Service imposed a sweeping ban on puberty blockers outside of approved clinical trials. Then yet another tectonic plate shifted when a lawsuit was announced March 14th by sixteen female former collegiate swimmers against the NCAA. The action’s official title reads like poetry to me, even if the punctuation is slightly confounding:
Complaint for Damages, Declaratory, Equitable, and Class Relief and Demand for Jury Trial
I'm not a legal expert, and I haven’t yet read the complaint. That said, the last four words of the title — ‘Demand for Jury Trial’ — feel important.
The thought-stopping slogan of trans-activism is #NoDebate. ‘Jury trial’ means not just #YesDebate but #PublicDebate in a room where lying, obfuscating or otherwise trying to weasel out of what you’ve said and done will come with risks.
The sixteen plaintiff-athletes, as undergraduates, endured a bizarre, sickening psy-ops experiment perpetrated by the NCAA with the full cooperation of the major American universities for whom they competed. To think of their experience of training, suiting up and swimming alongside Will (“Lia”) Thomas as an experiment in the limits of gaslighting would be fair but massively insufficient. I don’t even have the words to do it justice, but I trust the women’s lawyers will, and I’ll be on the edge of my seat when the case comes to trial.
In the meantime, we have this memorable image, which may in the end do more for the plaintiffs, and sentient brains everywhere, than even the most eloquent rhetorical arguments.
Whether the story is about medical experiments on healthy kids, or deviant males grabbing opportunities and spaces reserved for females, or politicians and academics pushing a fringe social theory; each one sends me back to the rowboat metaphor, which really just asks:
‘But have you thought this through? If yes, then you will have formed a prediction about what might await you on the opposite shore. You will need that prediction to fortify your resolve as you begin to row your boat toward the horizon. In other words, your prediction will have to make plausible sense.’
Last Friday’s ‘Gender: A Wider Lens’ podcast featured an interview with Scarlet, a male detransitioner, now about 21, who had sought out professional help as a 13-year-old effeminate gay boy who felt alienated from his rural, conservative family and community. If you haven’t listened to this episode, I urge you to do so, or better yet, watch it on YouTube. It’s heartbreaking, but because Scarlet happens to be exceptionally wise and resilient, it won’t make you miserable.
Scarlet sought, but never received, compassionate therapeutic support. At barely 13, he was instead given androgen blockers and synthetic estrogen, which the ‘experts’ implied would also do the work of therapy. Later, the experts encouraged him to surgically modify his genitals: Scarlet is thankful to have declined that offer.
The hormone treatments would cause significant, lasting harm to Scarlet’s body, health, and spirit, but at barely 13 he had no way to predict that outcome. He chose this path because a doctor told him the drugs would help him feel better about himself. In about 2015, an endocrinologist at a gender clinic assured Scarlet there were ‘tons of trans women’ living happy lives with husbands and adopted children. Privately, he told Scarlet’s mother that her son would likely kill himself if he didn’t choose the medical path. It was thus perfectly plausible for both Scarlet and his mother to predict a better future on the other shore: the prediction was in fact supplied by an expert whose job it was to give truthful guidance.
What about the endocrinologist, though? Had this trained ‘gender-medicine’ expert seen convincing evidence that if a gay boy skipped puberty, he would later get to choose from an array of loving, mentally-healthy heterosexual male partners with whom he could marry and build a family? If so, did the doctor have a theory about how such a storybook romance would navigate the problem of the bride’s ‘unusual’ genitalia?
In the event, Scarlet has encountered only a very different kind of suitor. The detransitioner known as ShapeShifter describes these men using a term Scarlet is too polite to utter: ‘tranny-chaser.’ At 21, Scarlet says he’s already resigning himself to a life without a life partner.
Returning to the endocrinologist, my guess is no: that is, he would feel incentivized not to think it through: better for him to know as little about tranny-chasers as possible. Better, for that matter, not to know about any potential benefits of exploratory therapy, nor about Scarlet’s eventual medical regret and detransition. This incentive structure can be inferred by the lack of patient follow-up that is one hallmark of all ‘gender affirming care,’ especially as it’s practiced in the US.1Here, the financial incentives dangled in front of providers are greater than anywhere else. As of today, the risk/reward tradeoff must still appear favorable to the providers.
I’ve never committed public relations, but I have worked in adjacent departments where the PR team could be overheard. From this I learned at least one useful tip: The sooner you get out in front of a problem, the better. This makes sense in business and in life: whatever you may have done will sound better in your own words than in the words your critics will choose in their efforts to condemn you. Critics will have their say no matter what, but you can defuse their impact by going first, explaining your ‘missteps’ using words like ‘missteps’ instead of, say, ‘crimes.’
Thanks to our common-sense heroes in Britain and elsewhere who have graciously volunteered to go first, America’s offenders can simply follow the open-source global disaster manual that’s being written in real time.
Of course, ‘America’s offenders’ describes a group that would need a very large tent to contain all its constituent members: not just ‘gender-affirming’ surgeons and endocrinologists, but health-insurance companies, advocacy groups, the administrative and DEI staffs of virtually every US college and university, the leadership of every public K-12 teachers’ and counselors’ union, every major medical association, the public broadcasting networks (PBS, NPR), ‘mainstream’ commercial cable news channels (CNN, MSNBC), as well as most local news outlets, every national magazine, virtually all book publishing concerns, the officers of all large publicly-traded companies, and most elected Democrats. (Apologies for any culprits I may have left out.)
Everyone in that bulging tent should at this point be able to see what’s coming. Most will not have to worry about being ‘condemned’ by critics: they will be protected by the plausible claim that their jobs required them to advance certain beliefs that turned out to be wrong. Some people reading this will identify with that claim. They were not the architects of the catastrophe, and they shouldn’t (and won’t) have to answer for the damage.
In a just resolution, the chief architects will, one by one, be required under oath to answer the rowboat prompt, i.e., walk us through the process by which they thought the whole thing through. So for example, the leadership of the American Academy of Pediatrics might be asked: Exactly how did you predict unhappy adolescents would become self-actualized adults as a result of your giving them hybrid, infertile bodies with frail bones and hearts? To whom were those bodies meant to be found irresistible, and what data informed your working assumptions?
We could make a fun party game thinking up rowboat prompts for each of the worst offenders, with special attention payable to the news media, whose silence in the wake of the events of the last ten days is truly jaw-dropping. Their AWOL posture displays an abandonment not just of basic professional ethics, but of any claim to honor, integrity, or even fitness for purpose. Implicit in their disgraceful silence is a message that can only be read as this:
You don’t matter, Scarlet: you can’t be allowed to matter. The athletes suing the NCAA can’t be allowed to matter. However many healthy young bodies and athletic careers will be sacrificed between today and the day we are finally held accountable for the flagrant neglect of our duty to seek facts and inform the public: they can’t matter either. If they did, what would it say about us?
I asked Chris Hayes a version of this question in January, 2023, while offering him some free PR advice about getting out in front of his own problem:
“…why didn’t you report the Keira Bell story? What forces, if any, prevent you from widening your reporting of the trans-kids narrative even as incrementally as the New York Times has done?
“If it’s even a little bit possible that a catastrophic medical scandal looms on the horizon — one that will redound to the huge and wholly preventable benefit of the actual right wing — why not meet it head on, with the strength and resolve of a truth seeker who cares about the victims?”
I didn’t expect him to take that advice, necessarily; but as the symphony of crickets gets louder by the week, I’m starting to think of journalists like him as occupants of their own sad rowboats, looking to the horizon and hoping for some 11th hour reprieve. I can’t imagine where that reprieve would come from, and I doubt they can imagine it, either: they don’t seem to have thought it through. They just keep getting smaller as they drift farther and farther from solid ground.
Fun fact about the optional role of data in public policy: in 1996, an Arkansas Congressman named Jay Dickey proposed what came to be called the Dickey Amendment to a federal omnibus spending bill. His stroke of genius was to de-fund the Centers for Disease Control’s data gathering of gun-related deaths, because all those dead people made the NRA look pretty bad. Dickey’s creative solution: lose the data. No gun-death data = no gun-death problem! Maybe that’s where ‘trans’ activists got the idea not to count their casualties.
I'm going to push back a bit on your comment about the Dickey Amendment. First, my pedantic retort: It did not defund CDC data gathering on gun-related deaths, it merely mandated that the CDC cannot use funds to advocate for gun control. To defend your broader point, congress also reallocated funds that had been previously spent on gun injury research to brain injury research.
The amendment and the reallocation of funds appears to have had a chilling effect on CDC gun research. But what is unclear is whether the chilling effect was the result of uncertainty about how the Dickey Amendment would be interpreted by the courts (as in, does congress really mean no more gun violence research is allowed?) or whether the CDC retraction revealed that what they called “research” was really just advocacy masquerading as science, a practice that should be familiar to readers of this excellent blog.
The events preceding the Dickey Amendment and the CDC response suggest to me that it is that latter; the CDC couldn’t defend the research it funded so decided it should just stop doing research in this area at all. Starting with the response, there was nothing stopping the CDC from testing the boundaries of the Dickey Amendment by continuing to fund gun violence research. In the 90s, gun violence was a major issue and prompted the passage of a great many related laws. Public opinion was squarely behind gun control movements and if there was a time when the CDC might have had popular and political support in this area, the 90s was it. The event that led to the Dickey Amendment was the publishing of a CDC-funded article by Arthur Kellerman in the NEJM, “Gun ownership as a risk factor for homicide in the home.” This article made strong causal claims that were clearly unsupported by the data and revealed that the CDC was willing to fund poor quality research as long as it reached the “right conclusions”. As stated earlier, this suggests that the lack of gun violence research by the CDC since the Dickey Amendment reveals that the CDC was actually doing advocacy, not research.
Read further for a closer look at the Kellerman study.
The Kellerman article makes strong claims about the increased risk of homicide associated with keeping a gun in the home, concluding that “Rather than confer protection, guns kept in the home are associated with an increase in the risk of homicide”. This is a causal statement suggesting that guns increase the risk of homicide in the home. However, the data gathered do not support this claim, raising questions about the motivations of the researchers and the funding organization (the CDC)
To step back, the ideal study in any scientific domain is the randomized controlled trial (RCT) where a group of test subjects are randomly split into two groups, the experimental group and the control group. The experimental group is exposed to the variable or treatment in question (for example, given a medicine being evaluated) and the control is not. The groups are identical in every way (because of the randomization) except for the variable or treatment, so any resulting difference in the groups (for example, how quickly a disease is abated) can be causally linked to the variable or treatment. It is not possible to do a RCT for gun ownership (where we would give guns to random homes and see what happens) so Kellerman does observational research using the case-control method to evaluate risk factors for homicide in the victim’s home. In a case-control study, the researchers start with the outcome and work backwards to try to create an experimental (case) group and a control group. In Kellerman’s study, the researchers tracked homicides (the outcome) in select cities over several years. For each homicide victim identified (the cases), the researchers found an analogous person that was matched to a victim according to sex, race, and age range (the controls). The researchers then surveyed both the cases and controls about risk factors to identify differences between the two groups and generate odds ratios for the outcome. The key finding from the article: A person exposed to guns kept in the home (the risk factor) is 2.7 times more likely (the odds ratio) to experience homicide (the outcome).
More broadly, the article finds the following odds ratios for surveyed risk factors:
Illicit drug use in household 5.7
Home rented 4.4
Previous fight in home 4.4
Lived alone 3.7
Gun(s) kept in home 2.7
Previous arrest in household 2.5
The article could have more strongly made claims like “Renting is associated with an increase in the risk of homicide” or “Illicit drug use is associated with an increase in the risk of homicide” but it did not. The title only mentions guns and the discussion and conclusion of the article focus heavily on guns kept in the home despite the fact that odds ratios were significantly higher for other factors.
But more importantly this research fails to establish a causal connection from guns to homicide that could justify the claims of the researchers. First, it is possible that causation runs in the opposite direction in many cases. That is, people who are at risk of homicide might be more likely to get guns for protection. Secondly, only half of victims died from gunshot wounds, others died from knives, blunt objects, strangling, or other means. By what means does a gun in the house result in the victim being strangled? The article does not say. We can imagine a scenario where the victim attempts to defend themselves with a gun, which causes the assaillant to act more violently and decisively than they otherwise would have, but we don’t know whether the gun kept in the home was involved in the altercation at all. This kind of evaluation is the responsibility of the researchers making causal claims. Thirdly, of the half of victims that were killed by a gun, we do not know how many were killed by a gun kept in the home vs. a gun brought into the home by the assaillant. How did a gun kept in the home increase the odds of a victim being killed by another gun? The article does not say and such speculation suggests that the study missed opportunities for deeper understanding. The bottom line is that this study does not show that having a gun in the house increases one’s risk of homicide; rather, it shows the reverse, that victims of homicide are more likely than non victims to have guns in the home. We can speculate why this might be: people connected to the drug trade and with a history of violence are the kinds of people who might be more inclined to have guns and are also the kinds of people who are more inclined to be murdered because they hang out with other violent people. Regardless, it is incorrect for the article to state such a strong causal conclusion from this data.
The other claim made by the article is that “We found no evidence of a protective benefit from gun ownership in any subgroup, including one restricted to cases of homicide that followed forced entry into the home and another restricted to cases in which resistance was attempted.”. This is tautological and is essentially saying: When we look at cases where the victim was murdered, we do not find that the victim successfully defended themselves. Obviously! The researchers are only looking at cases where the victim was murdered so therefore failed to defend themselves! But further, the study as designed is incapable of evaluating the protective benefit of guns because it only looks for defensive gun uses where the potential victim killed the assailant in the assailant’s own home with a gun. In the vast majority of defensive gun uses, no shot is fired, let alone an attacker killed, so there could be a great many defensive gun uses that go undetected by this study because nobody was killed. Also, this study is sloppy with the phrase “no evidence” which can mean one of two things: either “we have evidence and find no effect” (no positive evidence) or “we have no evidence at all so don’t know if the effect exists”. This study couldn’t possibly detect defensive gun uses so it is in the “no evidence at all” category, but the phrasing used in the study suggests that it is “no positive evidence”. By itself, this might be forgivable because our current scientific language norms are imprecise about the the usage of the phrase “no evidence”, but in the context of the paper as a whole, with unsupported claims and an obsessive focus on gun ownership, it’s hard to not infer intentionality into the sloppiness of language.
This comment is excessively long. I’ll wrap up by saying that Kellerman used weak evidence to make strong causal claims about how gun ownership leads to increased risk of homicide. It is my belief that Kellerman did not do as scientists ought to do, which is to objectively evaluate the data and draw appropriate conclusions. Rather, he started with a conclusion and sought out data to support it. This is not science, it is propaganda.
For a more measured and thorough evaluation of this article, i’ll refer to you David Yamane: https://davidyamane.com/2014/07/18/scrutinizing-claims-about-guns-in-homes-as-a-risk-factor-for-homicide-in-the-home/
From another view, the perspective of the besotted drivers of this cutting edge medicalization is suggested: flying the plane upside down unawares. "What if we were flying upside down? But let’s go further. What if an entire generation was flying upside down–flying through fog and danger, unable to see either ground or sky, and the well-intended adjustments pushed on them by “experts” were just bringing them closer to catastrophe? Reality's Last Stand