02 March 2023

On Not Following the Science

In January of 2023 PBS North Carolina premiered a weekly state legislative affairs program called State Lines. According to its presser, "State Lines will bring context to complex issues facing North Carolinians and provide an open forum for meaningful discussion between experienced political analysts, journalists and elected officials from across the state and political spectrum."

On February 10, panelists included state senator Sydney Batch, state representative Matthew Winslow, Matt Mercer, and Rick Glazier. Rick is a colleague at Campbell University Law School and heads up the law school's Blanchard Community Law Clinic. First up for discussion was North Carolina SB 49, short-named the Parents' Bill of Rights. Of particular concern to moderator Kelly McCullen were the parts of the bill that recognizing a parent's right "to make health care decisions for his or her child." Glazier immediately followed by alluding to two sections of the bill, which provided that,

Except as otherwise provided in this Article or by court order, a health care practitioner shall not provide, solicit, or arrange treatment for a minor child without first obtaining written consent from that minor child's parent.

Except as otherwise provided in this Article or by court order, a health care facility shall not allow treatment to be performed on a minor child in its facility without first obtaining written consent from that minor child's parent.

What possibly could be the problem? You can listen to Glazier's comments yourself beginning at about the 2:18 mark on the recorded version of the program here. In short, he conflates two parts of the bill in support of his claim that it would prohibit teachers from discussing matters of sexual or gender identity or transgender ideation with students. The bill says no such thing. SB 49 will, however, block school districts and administrators from

Prohibit[ing] school employees from notifying a parent about his or her child's mental, emotional, or physical health or well-being or a change in related services or monitoring.

Or,

Encourag[ing] or hav[ing] the effect of encouraging a child to withhold from that child's parent information about his or her mental, emotional, or physical health or well-being or a change in related services or monitoring.

In other words, the bill would give teachers the freedom to bring parents into the discussion of serious issues.

Again, what could be the problem? We find out at the 3:42 mark when Glazier plays the suicide card. In other words, "experts say" that if we don't let trans kids subject themselves to medical treatment, free from parental involvement, they will kill themselves.

This Is No Evidence That This Is True

In Glazier's defense, he may have been relying on an earlier NPR report by Jennifer Evans that purports to cite “research showing that medical transition [e.g., puberty blockers] has clear benefits" to trans kids including reduction in depression and suicidal ideation and attempts. The so-called expert consensus on the need to provide gender-affirming medical (as opposed to psychological) treatment (starting with puberty blockers, followed by hormonal treatments, followed by surgery) is primarily based on a two studies. You can read the more recent one here. What is equally important is the strong critique here. Glazier also failed to mention the side effects of puberty blockers for children experiencing gender dysphoria.

You can see a second study here. And a thorough evaluation here. According to a source I respect, there have been five large systematic literature reviews, and all have concluded that evidence supporting affirming treatments is low to very low quality on the modified GRADE rating system (low is defined as the anticipated outcome is unlikely to be observed).

One might hope that criticism of what passes for recognition of the role of parents in the lives of their children would be dismissed and that SB 49 would quickly become law. (Why more teens than ever (LGBTQ and not) are experiencing depression and thoughts of suicide is a serious issue. The answer, as the New York Times knows, is digital technology.)

Pathologizing the Human Body

Even though there is no firm evidence that puberty blockers reduce suicidal ideation and suicide doesn't mean they don't. It's still possible, one might argue, that some girls traditionally called tomboys and who feel uncomfortable about developing secondary sexual characteristics might be happier in the long run if those developments were suppressed. Ditto for smaller and weaker boys. Possible, but not likely. Go here for an excellent and very recent webinar demonstrating that such treatments have serious--and permanent--side effectsShouldn't these be considered when weighing the putative benefits of such treatment?

More generally, the digitally-enhanced social phenomenon of children identifying as the opposite of their biological sex is part of a larger, cultural phenomenon of pathologizing the human body. And especially the female human body. Much contemporary American medical practice is no longer about promoting the health of the body we have but rather treating our very bodies--half of the psycho-somatic unity that is the human person--as an object of manipulation at will. Paraphrasing Justice Kagan, we're all Gnostics now: our bodies are the prisons of our wills.

It is even more ironic that, as many are coming to believe that embodied human nature does not exist, environmentalists extol the virtues of the pristine and unmanipulated physical world around us. If children are free to begin to suppress their natural bodies without parental approval, one might think that property owners should be free to reshape their land free from government control. If the costs of global warming demand a regime of carbon neutrality, don't the lifetime costs of war against one's body militate in favor of parental involvement in a child's decision to disrupt its natural processes? Do teens really understand the lifetime implications of never being able to begat a child? Of never experiencing orgasm? Or who knows what else because long-term longitudinal studies of a regimen of hormonal treatments have not been undertaken?

Whatever one thinks of SB 49, opposition to any of its elements should be based on fact, not fiction.

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