Bigmouth Strikes Again: Carrie Marshall's blog

Carrie’s books | Carrie’s band

Category: Health

Scare stories and newspaper nonsense

  • Be better

    Science writer Ed Yong’s coverage of COVID was superb, and his reporting of long COVID even more so. In a thoughtful piece for the NYT, he explains how journalists should and could do better: Reporting on Long Covid Taught Me To Be a Better Journalist.

    Covering long Covid solidified my view that science is not the objective, neutral force it is often misconstrued as. It is instead a human endeavor, relentlessly buffeted by our culture, values and politics. As energy-depleting illnesses that disproportionately affect women, long Covid and M.E./C.F.S. are easily belittled by a sexist society that trivializes women’s pain, and a capitalist one that values people according to their productivity. Societal dismissal leads to scientific neglect, and a lack of research becomes fodder for further skepticism.

    …How could so many people feel so thoroughly unrepresented by an industry that purports to give voice to the voiceless?

    As Yong explains, some of the defining characteristics of journalism can make it a powerful enemy of people who are suffering.

    many journalistic norms and biases work against us. Our love of iconoclasts privileges the voices of skeptics, who can profess to be canceled by patient groups, over the voices of patients who are actually suffering. Our fondness for novelty leaves us prone to ignoring chronic conditions that are, by definition, not new.

    …We are not neutral actors, reporting on the world at a remove; we also create that world through our choices, and we must do so with purpose, care and compassion.

  • Ignorance is strength

    The Tory government have confirmed that they intend to ban conversion therapy but not for trans people: according to equalities minister Kemi Badenoch, providing a safe space for kids to explore their feelings about gender rather than mentally torturing them is the real conversion therapy.

    It’s egregious bullshit, of course, but it’s entirely in keeping with Badenoch’s war on trans people, a war she and Liz Truss have been waging for several years now.

    The idea that gender-affirming care is really conversation therapy is a fiction concocted by the evangelicals and parroted widely by their useful idiots. Once again, our politicians are happily dancing to the evangelical right’s tune.

  • An admission

    It’s yet another week in the ongoing demonisation of trans women; former prime minister Liz Truss wants to introduce a member’s bill that would ban healthcare for trans teens and make it illegal for trans women to use women’s spaces, and a bunch of bigoted right-wing shits have made a film mocking trans women in sports. The coverage of both has been dreadful – for example most reports of Truss’s bill use the sense-free dog-whistle “biological males” instead of trans women, while the bigots’ film has been described as a comedy – and in the case of the movie, the coverage has missed a crucial point.

    According to risible bigot Ben Shapiro, the film was not originally intended as a scripted movie. It was supposed to be a documentary. His intention was to get men to join women’s sports teams by claiming they were women, but when the men tried to do that they were told (politely, I assume) to fuck off – because you can’t just join women’s sports teams by claiming to be a woman. As Shapiro has admitted, the men “weren’t willing to go the full distance in terms of, you know, the actual hormone treatments and everything to play in some of the ladies’ leagues.”

    Right-wing bigots in “making shit up to demonise minorities” shocker? This is my surprised face.

    As is so often the case, writer and academic Julia Serano has been talking about this for years: as she wrote in her book Whipping Girl, if changing gender were that simple, that easy, far more people would do it. Actors would do it for roles, criminals would do it to go undercover, reality show contestants would do it for fame, women would do it to escape the glass ceiling and other discrimination, struggling gay or lesbian people would do it for an easier life. And right-wing assholes would do it to get on women’s sports teams.

    The reason they don’t is because deep down, they understand that gender transition is not something anybody does lightly, that hormones have a profound effect on your brain and on your body. To be blunt, they weren’t willing to risk feeling for even a few weeks what many trans people have to feel for years or even decades.

  • Unethical. Unscientific. Unsafe

    The ever-growing waiting times for adult trans healthcare have effectively privatised medicine for trans adults: good luck waiting 25 years or more for a first appointment if you can’t afford a private GP and a life of private prescriptions; shared care, where a private GP prescribes your medicine and your local GP oversees it, is largely banned (so for example it’s been stopped in my bit of Scotland). And now the NHS in England is turning its attention to teenagers. Its new policies are unethical, unscientific and unsafe, and have effectively banned best practice healthcare for trans teens.

    Healthcare will be withheld – a clear human rights violation – if patients don’t agree to be part of research studies – another human rights violation; patients have the right not to be forced into such studies – and private clinicians who provide the care the NHS denies may be investigated by regulators with the threat of withdrawing their licence to practice medicine. The proposed protocols enshrine dangerous and discredited conversion therapy as a preferred course of action instead of providing evidenced and effective treatment we know to be life-enhancing and in some cases life-saving.

    This article by Susie Green goes into the detail.

    What we’re seeing here is healthcare decisions made not by clinicians but by columnists; not by medical experts but by propagandists.

    Green:

    So where did these protocols come from? Who created them? We don’t know and they aren’t telling us. It seems ridiculous that they would ignore WPATH Standards of Care V8, especially when you consider the rigorous work done to ensure that it is based on extensive literature review and contributions, and scrutiny from over 4,000 clinicians worldwide who specialise in transgender healthcare. But with a government hellbent on damaging trans people as a way to distract from their failings, I don’t think it is difficult to work out that NHSE has become a politically manipulated service. And trans people are the ones who are suffering because of it… [the NHS] doesn’t want to improve trans healthcare for children. They want to stop it.

    These new protocols aren’t medical. They’re political.

  • HRT+DNA

    Over at Stained Glass Woman, Doc Impossible has written a fun piece about HRT and what it does regarding DNA.  As ever, the “basic biology” crowd are ignorant about actual biology: the super-short version is that DNA is an instruction book but hormones decide which specific instructions your body will actually follow. Change those hormones and the body changes too, and not just superficially.

    I love this stuff: as in other areas of science, the more we know the more we discover about the sheer complexity, variety and, if faith is your thing, miraculousness of it all. To paraphrase Hamlet: there are more things in heaven and Earth than are understood by social media science deniers.

  • “I no longer feel safe”

    Jane Fae writes in Metro about the UK government’s demonisation of trans women:

    “I no longer feel safe as a transgender woman. I no longer feel included.

    …Did I mention I was angry? Well, yes, that. But also scared; fearful for my future in a country that can contemplate this; and – having seen how vicious, how violent the anti-trans backlash has been in some parts of the world – wondering just where this one stops.”

  • Pain

    I really love Cat Valente’s writing, and her latest essay – Pain Is Not Penance – is a thoughtful piece about pain and our understanding of it. Some of it feels like an exorcism.

    Pain, Valente writes, is something many of us have learnt to believe is a punishment:

    For something you’ve done, something you’ve been, something you failed to do, something you wanted, chose, strove for, resisted, something you couldn’t stop, something you turned away from or turned toward or turned into, something you gave in to, something you saw or didn’t see, something you lost or took or abandoned or wouldn’t let go.

    And that can lead to one of the most dangerous beliefs in our society:

    Pain is payback. You earned this hurt. It didn’t happen to you, you collided with it. It isn’t random, it is your pain, for you, because of you, and if you’d only been better, if only you’d been stronger, if only you’d held on a little longer or let go a little sooner, if only you’d been more, if only you’d been less, if only you’d managed to be Goldilocks’ Own Brand Pristinely Precisely Perfect Fucking Porridge, you wouldn’t be doubled over in the dark right now, burning alive from the inside out.

    I don’t want to spoil the rest of the article. It’s well worth your time.

  • Now they’re closing clinics

    A US health clinic for trans people has closed its doors permanently after the introduction of a state-wide ban on healthcare for trans teens. As Xtra magazine reports, the ban was largely based on wild allegations by a single person, allegations that appear to be largely or completely baseless. But the national press, and the New York Times in particular, doesn’t let the facts get in the way of a good scare story – and those scare stories often end up being used as evidence by the bigots in support of their bans.

    From the article:

    While the bulk of the blame for the clinic’s shuttering lies with the state’s conservative legislature, its closure was also accelerated by a group of anti-trans journalists who presented Reed’s unsubstantiated allegations to a wide audience.

    …[despite the claims being debunked] Reed got a rosy portrayal from New York Times journalist Azeen Ghorayshi. Ghorayshi reported that she couldn’t substantiate most of Reed’s claims, and yet still went on to paint Reed as a brave truth teller in the pages of the paper of record.

    Evan Urquhart in Assigned Media has more, including interviews with the parents of trans teens.

    “We care about the clinic we take our children to. We care that it is providing ethical care. We care that it is following the standards of care. But using the words of this person [Reed] who has been shown to be unethical, to deny healthcare to all these people, just isn’t right. In Missouri, politicians are making health care decisions right now, none of whom are qualified to do so.”

    For too many journalists, this is a game. But for the people losing their healthcare – and the right-wingers have adults in their sights as well as teens – it’s a matter of life and death.

     

  • Fake science, real cash

    The Huffington Post has an interesting exposé of the people making good money from bad takes and pseudoscience: you can make tens of thousands of dollars presenting pseudoscience in the employ of anti-trans religious extremists. And while the article is mainly about the US, the UK gets a look-in too. You may recognise the names here from their very frequent appearances in the UK press.

    The spike in anti-trans legislation means states need even more experts to defend it. And in order to deepen the bench, states have started enlisting academics who aren’t in health care or don’t even primarily research humans. One is a Manchester University professor named Emma Hilton, who mainly studies a particular species of frog and how it offers an understanding of inherited human genetic disorders. Hilton is a founder of a British group, Sex Matters, that advocates for legally segregating spaces by sex. She earned $300 an hour last year defending bans on trans girls playing on girls’ sports teams in Utah and Indiana.

    By way of explaining why she was qualified to weigh in on school sports, she told one court, “I participate keenly in sports at an amateur level, playing netball recreationally.”

    “Our understanding of human biology is in part a result of the study of animal models,” Hilton said in an email. She declined to address the relevance of netball, which is like basketball without dribbling.

    Another is Michael Biggs, an Oxford sociology professor who admitted in court to writing transphobic tweets under the pseudonymous handle @MrHenryWimbush and described himself as a “teenage shitlord [turned] Oxford professor.” “Transphobia is a word created by fascists, and used by cowards, to manipulate morons,” reads one representative post.

    Florida paid Biggs $400 an hour to defend its Medicaid ban.

  • Where’s the rush?

    The London Gender Identity Clinic has just updated its waiting list information: as of July 2023 it was making first appointments for people first referred in July/August 2018, five years ago. With 324 new referrals each month and 55 first appointments offered per month, it’s clear that that five year figure is only going to increase.

    Maths isn’t my strong point. But a service that’s only seeing 20% of new referrals each month is a service that’s adding 80% of new referrals to a waiting list that’s already five years long. So if you’re referred today, your waiting time won’t be measured in months, weeks or even years; it’ll be decades.

    In Scotland, where the population is smaller and we have a different NHS, things are marginally better: the Edinburgh gender service is currently making first appointments for people referred two years ago. However in Glasgow, which covers a much bigger area (and oversees all surgery-related care for Lothian, Tayside and Grampian NHS areas too) and is the largest such clinic in Scotland, the waiting list for adults is around five years, up from four years in late 2022.

    Gender services are not bound by the same Referral To Treatment (RTT) and Treatment Time Guarantees (TTG), which mandate that patients should not have to wait more than 18 weeks between referral and the beginning of treatment. Rather, the care for trans people is best illustrated by a small but telling detail: if you believe that the wait for an appointment is affecting your mental health, NHS Scotland will direct you to a page of mental health resources on the Sandyford website. When you visit the page you’ll see a short, simple message: “The page you requested was removed.”

    One of the reasons that waiting lists are growing (other than the fact that trans healthcare is centralised when most of it could easily be handled by GPs) is because where there are vacancies, as there are in Sandyford, the current viciously anti-trans climate makes vacancies hard to fill: in the case of the Sandyford you don’t just have to brave online abuse but run a gauntlet of bodycam-wearing Christian extremists to get in the front door on some days. And while the wider faults in trans healthcare have been glaringly apparent for many years now, no politician is going to demand the improvements that are so desperately needed when you know exactly how the press and pressure groups would spin it.

    I’d love to live in the fantasy world the bigots describe, where you simply refer yourself to a clinic and have hormones and surgery the same day. It’s much nicer than the reality, in which our healthcare is little more than a link to a web page that doesn’t even exist.