All posts by dentedbluemercedes

The bad faith “debate” about trans human rights

Recently, the National Post published a discussion that I engaged in with Jonathan Kay.

I participated in that because it was an opportunity to provide a counterpoint for readers who don’t often see one. It was a chance to challenge some of the distortions and misinformation that have been circulating about trans people and their legal protections. If you read predominantly far right media right now, you would believe that wealthy, well-funded and all-powerful “TRAs” (trans rights activists) somehow control the government (one popular conspiracy theory claims that it is a pharmaceutical company plot) and are forcing some completely unfounded ideology and social engineering on destitute and helpless schools, governments, churches, workplaces and Canadian society as a whole. So it’s worth it for those readers to encounter a discussion that is rational, measured, and provides a glimpse of the reality outside of their own tunnel vision. I doubt many minds were changed, but at least an effort was made for the sake readers who are either still open to considering information outside the range of their predisposed views, or don’t encounter any better information in their travels.

It was framed as a debate, and debates about trans human rights are always a damned-if-you-do-damned-if-you-don’t proposition. If you participate in a debate, it gives the appearance of legitimacy to the idea that human rights should be debatable, and that opposition to them is an equally valid side. On the other hand, if you don’t, the debate still steamrolls on without you having any voice in it, and not only is your perspective unrepresented, it can even be characterized however your opponent chooses to portray it, without challenge.

It is worth mentioning, however, that the discussion that I had with Jonathan Kay is not “the debate” that gender critical figures are trying to have. I want to be clear that the discussion with Kay, via the Post was conducted in good faith — I don’t want to imply otherwise. The gender critical version of the debate gets framed a specific way, and it’s important to recognize this, and understand why the debate that gender critical speakers are pushing for is one that is inherently flawed and intended to be conducted in bad faith. And forgive me, because I have to generalize here: obviously, not everyone who takes issue with trans people thinks alike, but there are some general similarities, and the debate that most are trying to have has generally developed these relatively consistent rules.

From a gender critical perspective, the debate must be held within certain parameters. This is sometimes accomplished by defining terms at the beginning, but it can just as easily be accomplished by assuming those parameters at the beginning and very consistently and firmly policing anyone who deviates from them, as well as reframing anything that is said to the contrary so that it can be subsumed back into the original parameters.

“Sex ≠ Gender”

The first premise for the GC debate is that sex and gender are two different things. This statement is true, and any misinformed perspective usually begins with a kernel of truth. Sex and gender are two different things, and this is a point that trans folk have long made, when explaining why their anatomy does not define them. But for gender critical speakers, distinguishing sex from gender does the opposite, providing the opportunity to ignore both gender and gender identity, so that trans people can be once again defined according to their genital status (“sex”) at birth.

Gender critical speakers try to claim the moral authority on this point to assert that by extension. when it comes to human rights and accommodations in gendered spaces, physical sex is the only measure that matters. It’s sometimes phrased as though it’s a question of whether “sex is real,” but the intended undertone is that gender and gender identity are not, and are therefore not worthy of consideration. In reality, trans people don’t question whether sex is “real,” but whether one’s biology is their destiny, and whether one’s sex defines absolutely everything about them.

Making physical sex the sole benchmark is somewhat fallacious, given that (at least ideally) we don’t actually see the physical sex of the people we encounter, and instead assume their sex based on their gender presentation — but the folks making that argument are hoping that you don’t think too long on that. This foundation is used a bit duplicitously, though: when the subject of post-operative trans women comes up, the benchmark suddenly moves to chromosomes, socialization or reproductive capability, so that regardless of their apparently all-important anatomy, trans women can still be still essentialized as “males.” Likewise, the argument is made that segregation in gendered spaces is a matter of safety… but when the subject turns to accommodation in general (non-gendered) spaces and fears for safety can no longer be exploited, the imperative to verbally essentialize trans women as “males” (even to the point of harassment and abuse) and consider sex as the only worthy point of consideration is still viewed as being of paramount importance, and uncompromisable. Using “sex” as the one and only measure of value is actually a veiled proxy for considering cis (non-trans) status as the one and only measure of womanhood (it should be noted that gender critical people also abhor the term “cis,” because if the Latin oppositive “cis” is ever accepted as a corollary to “trans,” then it might legitimize the idea that trans people exist — so in gender critical thought, “cis” too must be considered a slur, and the words “normal,” “real,” “natal” or — most often — “biological” should be used instead).

The next extension of that initial premise is that there are only two sexes. This statement is true-ish in an overly general sense, but ignores the complexity of the science on the topic, and fails to consider intersex persons who have established medical conditions which cause developmental variances in their chromosomes, genitals or gonads. Any mention of intersex in the gender critical debate is usually met with a quick twist of pretzel logic to claim that these are merely exceptions that prove the rule, and then proceed once again under the premise that there are only two sexes — thus quickly evading the possibility that trans people (especially those who are compelled to transition between sexes, but not necessarily only them) vary in simply less visible ways than currently recognized intersex conditions, and deserve the same consideration.

Erasing Gender and Identity From Human Rights

The second major premise is that gender should be dismissed as being nothing more than a collection of outdated roles and stereotypes. This is incredibly reductive (deliberately so): gender can include them, but is not only them. Gender is the meaning that we find for ourselves inwardly and how we express it outwardly: this is usually based on our sex, but this meaning can also be chosen antithetically to what is expected based on sex — in short, it’s about who we are and how we decide to present that to the world, whether in accordance with stereotypes, despite them, or regardless of them.

As in the first point, there is a kernel of truth here too, namely, that gender roles and stereotypes are problematic. This is why “gender critical” became the new term preferred by trans-exclusionary feminists (who had previously self-identified as “trans-exclusionary radical feminists,” until they’d heard the acronym “TERF” in anger enough to decide that it should be considered a slur): certainly, there is a lot about gender roles and stereotypes to be critical of. On this point, gender critical thinkers and trans people should theoretically be in agreement, given that the latter challenge, question, traverse and defy those roles and stereotypes more than anyone. But there is duplicity in how gender critical people apply their argument here, too: whenever trans people happen to be in alignment with traditional stereotypes, they’re accused of reinforcing them; but when they challenge or deviate from those stereotypes, they’re mocked for being visibly trans, for how they look, and for visibly failing (by that person’s individual assessment) to meet those same expected stereotypes.

By extension of this second premise, then, gender identity is said to simply not exist, according to gender critical feminism. The collective weight of medical evidence in dealing with trans people says otherwise, but this is quickly dismissed as the medical establishment (at best) humouring trans people out of a misguided sense of sympathy, or (at worst) being in on the “gender ideology” conspiracy to reshape and destroy society. By defining gender identity as mental illness, a delusion, or even a destructive ideology, trans people then become entirely irrelevant to the debate that gender critical people want to have, and it becomes completely appropriate to dismiss them, their life experiences, and their needs from consideration. The gender critical debate, then, is entirely about us, but doesn’t involve us, as they assert that we can’t be trusted to have anything of value to contribute.

These are the starting points of the gender critical “debate,” and they are hallmarks of a debate in bad faith. From these parameters, trans women can only be considered to be “men,” and therefore everything that predatory men do can be ascribed to them, by default.  From these parameters, allowing trans women into a gendered space is automatically phrased as though those spaces are being opened up to “men” — even though that is not what is actually happening. There is no argument that can be made within these parameters that will lead to any acknowledgement that trans people exist, let alone that they should have rights or be accommodated in society in any way. This is by design: the easiest way to win a debate is to control the framing of it, so that it becomes impossible to come to any other conclusion than the one that you had allowed at the outset.

Human rights should not be up for debate in the first place… but when the debate is framed so asymmetrically, it becomes absolutely toxic.

In the discussion that I had with Jonathan Kay, it was on the condition that legitimacy issues (who I am or whether trans women are women, for example) would not be the focus of that dialogue. It is telling that he considered that “not realistic,” because the debate as he’s been hearing it has been taking place within the constraints above, and his thinking remained clearly influenced by these premises.

Many of the apparent “problems” of trans inclusion have already been considered over the past decade or more, and have been in the process of being updated based on real life experience, medical evidence, legal practicalities, and the duty to accommodate in a balanced way that considers context. By changing the parameters of the so-called “debate,” opponents hope to reset this all back to zero in a way that centers fears about trans people, and dismisses the voices of trans folk, solutions that have already been arrived at, nuances that we as a society have already learned to deal with, the context of any given situation, and any evidence that supports inclusion. It is, in a way, a means to reverse everything that has happened in the past several years, simply by insisting that it should be so and denying the validity of anything or anyone that says otherwise. It also provides a reset on language so that those who refuse to accept the existence of trans people have a sometimes-stealth / sometimes-duplicitous language with which they can be hostile, without incurring the wrath of the public at large (although we see from the complaints about infringements on freedom of speech that this doesn’t always work).

The worst part of it all is that the entire bad faith gender critical “debate” threatens to divide feminism against itself at a time when Canadian religious conservatives are attempting to reboot abortion criminalization and American religious conservatives are eagerly awaiting the overturning of Roe v Wade. It allows traditionally misogynistic personalities and organizations — ranging from the Heritage Foundation to Tucker Carlson — to deflectively posture as feminists or allies at a time when the so-called “populist” nationalism they tout is threatening to erase feminist awareness from higher education and push women back toward those very same stifling gender roles and limitations that women are still struggling to break. In the UK, it has even been used to locate and recruit gay and lesbian transphobes in order to turn them against that nation’s primary LGBTQ+ rights advocacy organization, and undercut, defund or even destroy it. Beyond that, it has also managed to turn up some transphobic lesbian, gay and feminist personalities willing to validate religious conservative talking points about “gender ideology,” without realizing that “gender ideology” is veiled code that in many uses also encompasses LGBTQ+ rights, feminism and many other aspects of social justice.

There are so incredibly many things that trans feminism and general feminism can and should agree on, and yet gender critical efforts seem to discard all of that, in order to pretend that the single most important challenge facing women today is whether trans women should be accepted as women. This absolutist, sort-of-fundamentalist and all-consuming focus is as troubling as it is self-defeating.

(This commentary also appears at rabble.ca. Image: Adobe Stock)

The Conscience Chronicles

UPDATE: As this was being readied for posting, the Standing Committee on Private Bills and Private Members’ Public Bills voted to recommend that Bill 207 not move forward in its current form, meaning that the bill will not be proceeding to the floor. I have elected to post this anyway, given the possibility that the proposal might be resurrected and amended at a later date.

At a first casual glance, the stated premise of Alberta’s Bill 207, Conscience Rights (Health Care Providers) Protection Act, might sound reasonable: most people wouldn’t expect medical professionals who object to procedures like abortion to be required to perform them.

In practice, Alberta’s College of Physicians and Surgeons already allows medical professionals to opt out of medical procedures that they have a religious objection to (a status quo that is at times problematic), so long as they provide any referral or direction to comprehensive information needed, ensuring that their patient still receives care in a timely manner. Bill 207 removes the obligation to refer and / or ensure patient care — using the reasoning that providing a referral is sort of like participating in the procedure. Regardless of any urgency or medical appropriateness of care in any given situation, this change allows refusals to increase the time delay to accessing care (regardless of any urgency), put the burden of medical care back on the patient, and be a kind of barrier and discouragement, if not more. Indeed, it can be like making someone start over from scratch. Proponents of the bill say that because medical care is still available elsewhere, it isn’t really being denied, which is technically true… but the time, emotional and informational barriers cannot be discounted.

But while those advancing the bill claim it is only codifying that status quo in law, there are more things that Bill 207 does, many of which have received little attention by media.

The bill extends conscience rights to health care organizations, as well. While religious care organizations have already asserted conscience objections in many ways already, this codifies it in law. It also allows organizations to assert their conscience-based decisions over those of their facilities, staff and resources. By way of example, Covenant Health (Canada’s largest Catholic health care provider) owns 16 health care facilities throughout the province, including two major hospitals in Edmonton; its affiliate Covenant Care owns another seven assisted living and long-term care facilities. In some rural areas of Alberta, all or most facilities are religious-owned.

In short, this moves Alberta down a landscape in which anyone in the chain of service provision — from facility administration to lab technician and pharmacist — can create a roadblock to services, without consequence. This becomes even more concerning when one realizes the potential for administrative staff, clergy or even outside groups to apply pressure to doctors and clinics to deny services that they might not otherwise have initially had objections to.

In fact, by the text of the law, it is left entirely up to the health care provider or religious health care organization to determine if their conscientious beliefs would be infringed, and there really is no appeal process to see if there is some agreeable compromise. No record is kept, leaving no way to follow up to ascertain if the patient has ever received the care they needed or sought. Gathering statistics about patients denied care in order to inspect what consequences the law has had becomes impossible, as demonstrated elsewhere.

By the text of the law, if a regulatory body receives a complaint about denial of care having to do with conscience, the complaint must be discarded (there is a caveat that complaints or portions thereof that are not conscience-related are not discarded). They are not allowed to investigate or question the decision:

5(1)  On receiving a complaint in accordance with section 55(1) of the Health Professions Act, the subject matter of which is a health care provider’s decision not to provide a health care service based on their conscientious beliefs, the complaints director for the regulatory body that received the complaint must immediately

(a) dismiss the complaint, and

(b) provide notice of the dismissal to the complainant.

It also specifies that by law, “a health care provider’s decision to not provide a health care service based on their conscientious beliefs is not to be considered as unprofessional conduct,” and providers and / or organizations are immediately shielded from legal liability.

There is also an amendment to Section 7(1) of the Alberta Human Rights Act, to immediately shield any employee from termination or discrimination based on their conscientious beliefs. This amendment is not restricted in any way to the medical profession, and could conceivably provide a shield for harassment and abuse of one’s co-workers or customers because of one’s religious or conscientious beliefs.

The bill’s proponent, MLA Dan Williams, has promised a number of amendments to Bill 207, but in those proposed changes, none of these points is substantively changed. One of his proposals — to restore a duty to assist “if not providing the health care service would result in an imminent risk of death” — isn’t altogether reassuring about the thought that was put into the bill in the first place… but even with that change, there is no clarification on whether or how the legal shield and barriers to reporting and investigation might be changed in the event of a patient’s death (especially in cases in which it was not thought that there would be an “imminent risk”).

There are many hypothetical situations that one can suggest could arise as a result of this legislation. But this is not uncharted territory. It is very easy to look at places where “conscience” exemptions have been implemented or attempted — or where medical personnel or organizations have attempted to assert their conscience rights — and see how it has affected medical care for patients.

“I was nervous and excited about the consult for my first intrauterine device (IUD) at MedStar Georgetown University Hospital. After a brief conversation, Dr. Case (a pseudonym) asked me to get off the exam table and follow her to her office for a ‘chat.’ But in her office, when the door was safely shut, my excitement slowly started to fade. ‘Well, first things first, this is a Catholic hospital,’ she said in a mock whisper…”

Evann Normandin, writing at Rewire this past May, described what happened to her when hospital policy prevented her from getting an IUD. She left with a referral… and shaming. Although referrals don’t come with the added expense of multiple visits in Alberta, like south of the border, the expense of time and transportation remain, and can pale in comparison to the emotional cost of the refusal itself:

“… On my way out of the labyrinthian building, I scrunched up the unofficial paper in my hand. The ripped edges felt sharp against my skin. In the Uber ride home, after paying transportation to and from my apartment to a world-class hospital and forking over a $50 copay for unsolicited advice about my vagina, I cried…”

At Huffington Post, Ace Ratcliff described her fight with doctors over her need for a hysterectomy:

“My illness’ severity [hypermobile Ehlers-Danlos syndrome] led me to the conclusion early on that childbirth would irreparably damage my already broken body and would never be the right choice for me. My joints dislocate painfully and at random. I have difficulty swallowing food. I bruise like an overripe peach. I faint if I have to stand for too long. Wounds take much longer to heal on me than on a normal human.

“… Somehow, my personal autonomy, my health and my comfort didn’t rate high enough to outrank the desires of my future, then-nonexistent partner. And nothing I said could change my doctors’ minds [about a surgical hysterectomy], not the stories about my frequently dislocating hips, my mom’s complicated pregnancies or the increased rate of miscarriage and preterm labor for EDS patients…”

In another instance, the hospital’s policies would have allowed the removal of a dislodged IUD, but the doctor thought the policies wouldn’t, and refused care. The patient was sent home, limited in her options by her insurance company (not applicable in Alberta, but limits on options can occur because of other factors, such as rural accessibility), and she ultimately had to file suit:

“Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“… It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights…”

Something that Bill 207 does not address at all is any duty of physicians to discuss every option available to a patient. If referring is equated to participating in an objected-to procedure or medication, then one might tacitly assume that providing comprehensive information on that procedure or medication can be denied. Withholding medical information can have serious consequences:

“… a woman was traveling across the Midwest when she developed abdominal pain. She and her husband went to the nearest hospital, where she was diagnosed with a potentially fatal ectopic pregnancy. The doctors recommended immediate surgery to remove the fallopian tube containing the misplaced embryo, a procedure that would reduce by half her future chances of conceiving a child. They failed to mention that a simple injection of Methotrexate could solve the problem, leaving her fertility intact. (In fact, at a secular hospital she found on her smart phone, it subsequently did.) Why the omission? The Catholic hospital where she got diagnosed was subject to the “Ethical and Religious Directives” of the Catholic bishops, which state, “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion…'”

In fact, denial of comprehensive information is a recurring issue when medical conscience exemptions are asserted.

Of course, some of these examples focus on the emotional impact, but that doesn’t mean that there aren’t serious physical consequences potentially at stake:

“After about 10 hours, the patient’s temperature soared to 102 or 103 degrees, Ralph recalled in an interview with Rewire in June, a few months after the incident. Ralph and her team gave the patient medication to induce labor. But Ralph could not administer mifepristone, which the American College of Obstetricians and Gynecologists (ACOG) considers part of the most effective drug regimen for such cases. The Catholic hospital didn’t carry the drug, which is commonly used for medication abortions—a failure Ralph believes was religiously motivated and needlessly prolonged her patient’s labor.

“… For more than 24 hours, the patient labored through painful contractions. She bled heavily, requiring at least one blood transfusion. Her lips and face lost their color. Finally, she delivered a fetus that had no hope of survival…”

The full extent of Bill 207’s reach isn’t understood either, until you realize that “medical provider” covers a wide range, as noted in an Edmonton Journal editorial:

“The list is long and includes emergency, primary and critical care paramedics; midwives, chiropractors, podiatrists, psychologists and psychiatrists; lab, respiratory, ultrasound and X-ray technologists; pharmacists, physiotherapists and physical therapists; opticians and optometrists; dieticians and nutritionists; anesthesiologists, surgeons, and social workers; audiologists, dental professionals and speech-language pathologists…”

The inclusion of pharmacists in that list raises the question about access to birth control, an issue that has already surfaced in Alberta and elsewhere in Canada:

“Joan Chand’oiseau of Calgary recently posted a photo on Facebook of a sign on her physician’s office door that read, ‘Please be informed that the physician on duty today will not prescribe the birth control pill…’”

It also raises questions about access to hormone therapy for trans patients, or the possibility of throwing in a bit of public humiliation for good measure:

“‘Sir, we canceled your prescription because we couldn’t figure out why a man would need female hormones,’ said the voice. ‘You’ll have to have your doctor call us to confirm this is correct because it doesn’t make any sense…'”

Indeed, trans health is just as likely to be impacted as reproductive health, and doesn’t even have to be about transition-related medical concerns. Trans people regularly report what they’ve nicknamed ‘Trans Broken Arm Syndrome‘ — that is, the refusal of care for basic health services just because they’re trans. And it does indeed happen in Canada:

“According to the College of Physicians and Surgeons of Saskatchewan’s charge of unprofessional conduct and the penalty presentation, the incident took place on Jan. 5, 2016, when Anderson saw a patient for “reasons related to bronchitis” — something completely unrelated to the patient’s transition to male from female.”According to the documents, the disciplinary hearing committee found it ‘probable’ that Anderson ‘launched into an unsolicited running commentary’ regarding transitioning. Anderson made statements ‘which were insensitive and unrelated to the reasons for which the patient requested your medical services,’ according to the charges against Anderson…”

It should also be asked what conscience protections might do to protect the still-persistent practices of reparative therapy in Alberta (albeit with coded language). But that aside, denial of basic care is something that all LGBTQ+ people have had to worry about, sometimes even with lethal effect in situations that didn’t initially seem to pose an “imminent risk”:

“Refusing to treat patients can be be deadly, as was the case in 1995, when Tyra Hunter, a transgender woman, lost her life after emergency medical technicians refused to assist her at the scene of a car accident. According to the Center for American Progress, had Hunter received care, her chances of surviving were 86 percent — she should have lived…”

Medical assistance in dying is another area in which medical access is an issue, and in this instance, access is even more seriously limited. It is estimated that the aforementioned Covenant Health (and affiliates) oversee up to 90% of the long-term care beds in parts of Alberta, and regardless of whether long-term care patients are healthy enough to be moved, doing so is sometimes necessary just have questions answered, because of facility policies:

“Covenant Health stated in May of 2016 that it has an ‘ethical and moral opposition to medical assistance in dying’ and that the organization’s ‘unequivocal position to not provide or explicitly refer’ must be recognized. Functionally, this means that any assessment of capacity, any answering of technical questions, and the act of assistance in dying itself would require a transfer away from a Covenant facility.

“… The case of Ian Shearer, an 84-year-old Calgary man living in Vancouver with palliative heart and kidney disease and severe chronic pain, brought attention to how transfers can do harm. Shearer was denied a request for medical assistance in dying from St. Paul’s Hospital, a Catholic facility near where he lived and where he’d been admitted for care. On the day he chose to die, his ambulance was delayed three hours and his medications were withheld to allow him to confirm consent. The ordeal, last August, was described by his daughter as ‘unnecessary… excruciating suffering…'”

Obviously, the out-of-province and out-of-country examples won’t exactly mirror what would happen in Alberta, because of circumstantial differences in things like medical coverage, but what this demonstrates is the extent to which individuals might be willing to abuse a conscience protection, and the twists of logic involved. From the firing of doctors for not adhering to an organization’s conscience policies, to the chilling effect on medical care caused by activism from anti-abortion groups against clinics just for hiring doctors who’ve performed abortions elsewhere in the past, to medical residents who openly vowed to give the wrong medications to specific groups of people, to some some truly backwards beliefs about medical interventions…

“Throughout the conference’s diverse and highly academic presentations, one discernible theme emerged, namely, that “brain death” has been invented to harvest viable organs from still-living people. Only when a person’s heart stops beating and their breathing ceases for a determinate amount of time can it be said that death has truly occurred…”

… the politics surrounding medical conscience exemptions raises a broad range of concerns.

It is likely that Alberta’s Bill 207 would not survive a legal challenge. Indeed, the same day that the bill was introduced in the Alberta Legislature, a similar policy was overturned in the U.S. Likewise, a ruling in Ontario last May affirmed patients’ rights to referrals when care is denied.

But getting there could be another long, legally costly process, with very real human collateral damage caused along the way.

Photo: Adobe Stock

(crossposted to rabble.ca)

“Unthinkable”

American religious conservatives have a problem.

Riding high on their partnerships with the Trump administration and the perception of being political kingmakers, they need to be sure that they will be able to sustain their momentum for years to come. And with the newly-stacked U.S. Supreme Court making the overturn of Roe v Wade a seeming inevitability (as well as putting the overturn of marriage equality within sight), they are now looking for what to do in a “post-Roe” world to retain their energy, power, and dizzying levels of funding. And in the discussions they have about that dilemma, their solution, often, is to work toward a world in which they have made abortion “unthinkable.”

“I’m not suggesting that the proposed laws are unimportant—on the contrary, pass more of them! I only wish to remind us that our goal is to make abortion unthinkable as well as illegal. And that means our work has only just begun…” –  John Stonestreet and Roberto Rivera, Breakpoint

When I speak about American conservatives, of course, I don’t mean to suggest that there is some central plan or hive mind. It doesn’t work that way. Even getting U.S. Evangelicals and Catholic fundamentalists onto the same page can be a challenge sometimes, and the religious nationalist industrial complex is made up of an infinite number of organizations all vying for dollars in the same fundraising pool. But there does seem to be a fairly cohesive and organic process in which talking points filter out and take shape – and “unthinkable” appears to be one such trend in linguistic spin.

The origin of this particular incarnation of the talking point (it has been mused about many times before, but not with this degree of viral spread and consistency) appears to have been January’s Evangelicals for Life conference, in which the senior vice president of Alliance Defending Freedom’s (ADF) U.S. legal division Kristen Waggoner encouraged attendees, using the phrase. Waggoner’s encouragement came about a week after Robin Marty’s Handbook for a Post-Roe America was published, and progressive news outlets were discussing how to respond to the possibility of a patchwork or even nationwide ban on abortion. The possibility that the left might evolve to cope with a changing legal landscape – as far as EFL attendees were concerned – needed to be thought out and prepared for.

So when Ontario Member of Provincial Parliament Sam Oosterhoff tells an anti-abortion rally in Toronto that he pledges to make abortion “unthinkable in our lifetime,” it’s helpful to look at religious conservative media for clues as to what he might mean by that, and where his influences are coming from.

“New Hampshire Right to Life’s position is clear, she said. ‘We would want to put restrictions on abortions and make it unthinkable and illegal…’”Concord Monitor

I could go at some length about how promoters of the sensationalistic and Planned Parenthood -defaming movie Unplanned seized on the phrase during their publicity tour, or how it’s turning up on Fox News, or how it came up during anti-abortion rhetoric pertaining to legislation in New York and Georgia as well as a legal ruling in Louisiana, or how it spread widely enough that even a perceived-left website like Vox gave it oxygen – but that only establishes that there is definitely a narrative. I’d much rather look at what religious conservatives are getting at, when they use the phrase.

“Every answer to why abortion is viewed as still ‘needed’ stems from a deeper-seeded issue which we could be fighting against… we need to combat the issues which give abortion supporters reasons to think it is the better ‘option.’ Abortion needs to stop being an excuse for not addressing the larger issues at hand…” – Paul Collier

If anti-abortion groups wanted to turn their attention toward addressing poverty, it would probably be a welcome development. Sadly, you won’t find a whisper of that, and doing so would probably frighten the megadonors with whom they collaborate to form the Republican / Conservative political base. But getting religious conservatives to speak candidly about specific objectives isn’t always easy. Afraid that too much transparency might allow opponents to organize effectively against them, they often restrict their public musings to dog whistle terms (of which “unthinkable” is arguably one), and stay effectively mum about which political candidates they’ve managed to get nominated as candidates in an election. But in venues seen as relatively safe and exclusive, or from pundits who are seen as less prominent, sometimes you’ll find some elaboration.

One such pundit is The Federalist’s Georgi Boorman, who actually proposed a 6-point plan. Chief among these is to “Improve Reproductive Education” – but you won’t find her making any mention of contraception (elsewhere, Boorman reveals herself to be not a fan of The Pill), condoms or family planning. There’s no direct mention of sex education in schools, either, even though it would clearly be the necessary vehicle for what she has in mind. The “reproductive education” that she speaks of is predominantly “to educate women on the dangers of” abortion (by which she means the usual far right claims about health dangers of the practice), a fetishization of the stages of fetal development, and more fearmongering about the current medical process (i.e. she cites “the horrid conditions of abortionist Kermit Gosnell’s facility” as a typical example… it’s far from it).

The remainder of Georgi Boorman’s suggestions include more criminalization (elsewhere, she openly supports the death sentence for women who abort) and the vague “celebrate life” mantra, as well as increasing support for adoption (“especially cross-racial,” she adds, stealthily riffing on anti-abortion groups’ efforts to portray the procedure as a kind of racist genocide perpetrated by leftists) and – of course – ramping up funding for anti-abortion fake pregnancy centres.

On these points, her proposals are within the purview of those of Abby Johnson, whose own proposals are steeped in proselytizing and expanding anti-abortion pregnancy counseling centers into additional areas that beatify motherhood, but do not provide any hints of information about contraception or family planning (other than, perhaps, the “rhythm method”). But Boorman also adds a notable comment about “support[ing] fatherhood”:

“… what if fathers were asked to step up as parents and providers, instead of being written off as unqualified sperm donors? What if our culture demanded it? … Millions of fathers have been robbed of this opportunity since Roe, and our welfare system has enabled this by disincentivizing marriage and fatherhood obligations. … Instead of affirming mothers’ unilateral decisions by default, we should encourage fathers’ involvement (including marriage)…”

When religious conservatives frame opposition to gay and trans human rights as “protecting marriage,” LGBTQ+ organizations and spokespeople often quip about the hypocrisy in their seeming lack of worry about divorce and cohabitation. But the fact of the matter is that anti- groups have never stopped tilting at those particular windmills, either. An outright ban on divorce is only touted by the most extreme among them, but “disincentivizing” and creating an institutional system that heavily favours marriage come up often, and the idea of restricting divorce or making it difficult retains some level of popularity.

Other religious conservatives are more ambitious. Around the same time that Kristen Waggoner was proposing that abortion be made unthinkable, the Heritage Foundation hosted Sue Ellen Browder, who claims that “the sexual revolution hijacked the women’s movement” to make abortion and contraception priorities. This, too, is not a new argument, but it is gaining new popularity with organizations seeking to keep the money rolling in after an overturn of Roe. And with anti-trans, anti-sex work and anti-porn feminists partnering with religious conservatives like never before, there appears to be a sense that they have an opportunity to co-opt womens’ rights, which can then be used as a shield against accusations of homophobia, Islamophobia and puritanism, while at the same time purging it of reproductive rights advocacy and sex positivity, maintaining a subordinated role for women in administrative areas, and asserting the doctrine of complementarianism (a teaching used both to mandate motherhood as a woman’s integral life goal, and to invalidate LGBTQ+ peoples’ rights to live their lives as they need to).

“The battle against feminism is better fought by women because the public has been convinced that men are not qualified to speak about issues that affect the fairer sex…”John Horvat II

On this point, James V. Schall suggests that religious conservatives need to target the entirety of the sexual revolution: “The path, when spelled out, is a direct line from divorce, contraception, and abortion to single-sex ‘marriage,’ in-vitro fertilization, surrogate motherhood, and designer babies and now to a refusal to continue to increase and multiply with transgenderism, population decline, and, ultimately euthanasia… If we were to eliminate abortion, we must freely stop committing the sins that initiate disordered conceptions… Without this conversion, we will continue on the same path on which we now are traveling…”The Federalist’s Cullen Herout (which, admit it, must be a pseudonym) agrees at least on the point about contraception, saying “… if the goal really is to make abortion unthinkable, that cannot and will not happen without a large-scale shift in our cultural attitude toward human sexuality and contraception…”

So the next time your local political representative muses about making abortion “unthinkable,” it’s only reasonable to press them to elaborate. Because there clearly is more to that statement – and while religious conservatives obviously don’t think in total homogeneity, there’s enough like-mindedness to view this sort of dog whistle with alarm.

The Alberta Advantage was Dependence

In the end, the “Alberta Advantage” was dependence.
And in retrospect, undoing that dependence on the oil industry — a mixture of real and perceived — needed to be the number one priority of the Notley NDP government. When Albertans (even to their own surprise) overthrew the 40-year Progressive Conservative dynasty in 2015, they were hungry for change, and they knew that change was both inevitable and urgent, given the realities of global climate change — something they had been increasingly experiencing (most notably when the third “one-in-a-hundred-year flood” in ten years ate High River and parts of downtown Calgary).
Instead, industry managed to keep the focus on oil development and pipelines, and sucked all of the rest of the political and economic air out of the room.
Of course, Alberta’s energy sector is well-versed in fostering and using the dependence on its jobs and products — whether manipulating gas prices, making punitive and excessive layoffs whenever an administration or policy it doesn’t like is in place, or dangling illusionary carrots, like job creation estimates that factor in a hundredfold of jobs that they imagine might be generated by their project (and which nobody ever follows up on to debunk). In reality, building a pipeline creates merely a small number of regionally-shifting jobs aimed at transporting the longer-term refining jobs out-of-country, but nobody really ever remarks on that, because of how overwhelmed with industry propaganda Albertans are, and their eagerness for what little crumbs industry is willing to toss their way.
Now, the rest of Canada might not be overly sympathetic to Alberta’s plight, right now, because the province has had a pretty good run, riding waves of oil prices over the past few decades to sustained prosperity, while labour markets elsewhere have dwindled, automated, and relocated to other countries. Consequently, Alberta may feel the coming change more acutely than the rest of Canada — but feel it everyone will.
Change is hard. It’s disruptive. And with the level of budgetary dependence on energy royalties and the perceived dependence (thanks to the hard work of neoliberal institutions like the Fraser, CAPP and corporate media) of everyone’s jobs on oil development, Alberta has had four years of reckoning that haven’t really done anything to assuage any of the associated fears that come with that change.
To be fair, that transition was never something that was going to be able to take place in a scant four years.
Additionally, the Notley NDP have tried to break some of that sense of dependence through diversification. It’s something that hasn’t been well-publicized, but it also needed to be more aggressively pursued. And diversification is only one step — job retraining and the economic support and optimism needed to get through it are more critical. Albertans looked to Rachel Notley to lead them into and through a transition, and somewhere along the way, industry convinced the government and the public alike that the transition was yet another pipeline.
Consequently, we find ourselves at a crossroads in which Albertans seem receptive to old, failed conservative policies of austerity and corporate giveaways, regardless of the ethical concerns with a guy who may have broken electoral laws in order to become party leader, and regardless of whether he has surrounded himself with lake-of-fire social conservatives and semi-open white nationalists. It’s why we’ve seen people who’ve never protested before come out to agitate for pipelines, and naively allowed themselves to get hijacked by and aligned with racist wingnuts who’d previously floundered on the fringe for decades. Despite the stereotype of the Albertan redneck, Albertans have always tended toward worrying about the money, and not caring about the social positions that have aligned themselves with it (which is, in a way, even worse).
But here’s the clincher: a pipeline isn’t going to slow or stop the one-in-a-hundred-year floods, or the summer seasons that might soon be renamed “Smoke,” or the fracking-triggered earthquakes. And electing a traditional oil crony is more likely to undo the first steps that Alberta has taken than to make those hard choices. Because the longer Alberta tries to forestall its transition, the more abrupt, disruptive, and devastating that eventual change is going to be.
(crossposted to rabble.ca)

Support Trans Youth, Say Pediatricians

On Monday, the American Academy of Pediatrics (AAP) released a policy statement declaring that “The Academy stands against stigmatization and marginalization of [transgender and gender-diverse (TGD)] youths and emphasizes the need for their acceptance as members of our families, communities, and workforce. A new policy statement, Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescentsuses strengths-based concepts to outline the role of pediatricians in addressing the needs, challenges and resilience of TGD youths and their families.”

The AAP is the largest professional organization of pediatricians in North America, representing over 64,000 members in both primary care and related specialties.The AAP’s recommendations are:

“1. that youth who identify as TGD have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space;

“2. that family-based therapy and support be available to recognize and respond to the emotional and mental health needs of parents, caregivers, and siblings of youth who identify as TGD;

“3. that electronic health records, billing systems, patient-centered notification systems, and clinical research be designed to respect the asserted gender identity of each patient while maintaining confidentiality and avoiding duplicate charts;

“4. that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions;

“5. that provider education, including medical school, residency, and continuing education, integrate core competencies on the emotional and physical health needs and best practices for the care of youth who identify as TGD and their families;

“6. that pediatricians have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression;

“7. that pediatricians have a role in advocating for policies and laws that protect youth who identify as TGD from discrimination and violence;

“8. that the health care workforce protects diversity by offering equal employment opportunities and workplace protections, regardless of gender identity or expression; and

“9. that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as TGD…”

This important statement comes at a time when fearmongering about the acceptance and accommodation of trans youth has reached a fever pitch in the Western world. In the US, fears raised about trans kids in public washrooms continue to constitute an unwarranted panic used to justify attacks on the public school system and teachers unions as much as the kids themselves. In the UK, tabloids have targeted a children’s charity with false claims and called medical access into question, while predominantly anti-trans websites have attempted to portray an increase in trans youth coming out of the closet as a “social contagion.” In Canada, acceptance of trans kids is typically rephrased as “transgender [or even “liberal”] ideology” (it makes it easier to generate alarm when the kids are erased entirely), and used as one of the main objections to age-appropriate sex education (the phrase “gender ideology” has been used by the Vatican for longer, and is also sometimes a dog whistle encompassing any combination of feminism, reproductive freedoms, sex education, and / or LGBTQAI2 rights). Much of this fearmongering has been made possible by flawed or distorted data, such as the often-cited statistic that 84% (or 90, because rounding up sounds better) of trans kids desist (that is, grow out of it, in much the same way people used to view being gay as “just a phase”) — a claim made possible by looking at studies that failed to distinguish kids who actually had a strong and persistent identification with the gender that does not match their birth assignment, from kids who simply experimented with gender (or were even just arbitrarily thought of as gender non-conforming by their parents or doctors).

The AAP statement also comes at a time when Canadian media are starting to jump on a study purporting to show a social contagion-style phenomenon that proponents call Rapid Onset Gender Dysphoria (ROGD). If anything clearly demonstrates why the AAP’s statement this week was necessary, it is the panic over ROGD.

Rapid Onset Gender Dysphoria is not recognized by any medical body, but is rather a theory generated by a group of trans-exclusionary feminists and parents who refuse to accept their kids’ admissions of experiencing gender dysphoria, and instead blame trans awareness and activism for making being trans seem trendy. It is essentially a retooling of the “gays recruit” myth, but it has proven so effective in UK tabloids that British Conservative politician and Equalities Minister Penny Mordaunt is launching an investigation into why the number of kids accessing the medical system has risen from 97 to 2,519 over the past eight years.

[Of course, the answer to that should be obvious. Eight years ago, trans-affirming treatment existed only at major metropolitan centres, few doctors would help trans kids, and finding those who did was hit-and-miss. Eight years ago, human rights protections were tenuous for adults, let alone youth who had much less legal autonomy, and schools were unprepared for accommodating them. Eight years ago, awareness, support options and the assurance of being accepted were much less, but the certainty of opposition was overwhelmingly intimidating. Eight years ago, parents could even have custody of their children taken away if they affirmed and supported them. As the stigma decreased and acceptance increased, people simply started coming out earlier in life. Which means that only now is society beginning to realize the real prevalence of trans* people.]

“Parents have described clusters of gender dysphoria outbreaks…”– the Littman study

But ROGD was given a veneer of legitimacy by a recent “study” that media outlets everywhere eagerly jumped on. I put study in quotation marks, because its methodology was a total mess. It was published in a journal that speeds papers to publication, and then lets you “peer review” them. The study itself acknowledged that its methodology was to take a voluntary survey of visitors to three websites (4thwavenow, Transgender Trend and youthtranscriticalprofessionals, which I will not link to directly), a cursory glance at which would be more than enough to ascertain exist only to discredit trans youth anecdotally and demonize their supporters. The survey didn’t talk to trans kids at all, but rather asked parents if their child’s coming out was sudden (i.e. it can seem to be “rapid onset” when one doesn’t live with it and is unaware of it for years), without prior signs (any trans person can tell you that before coming out, they sometimes go to great lengths to hide it), and were received with any sort of peer or educational support (from which they are assumed to have contracted transgenderism, I guess). The methodology was so flawed that PLOS ONE decided to conduct a “post-publication re-review,” and the researcher’s university withdrew its support almost as quickly as it was published:

“As a research institution, we feel we must ensure that work that is featured on the University website conforms to the highest academic standards. Given the concerns raised about research design and methods, the most responsible course of action was to stop publicizing the work published in this particular instance.  We would have done this regardless of the topic of the article…”

In the end, the only thing that was “rapid onset” was the process from fearmongering to theory (the few months in which the aforementioned three websites grew) and from published “study” to media event (which can be measured in days). National Post and The Globe and Mail should be embarrassed.

In fact, attempts to pass off transphobia and homophobia as science are not new: a discredited 2012 study attempting to prove that parenting by same-sex couples harmed their kids touched off a new wave of anti-LGBTQAI2 junk research, and an astroturf organization calling itself the American College of Pediatricians (identified as a hate group by the Southern Poverty Law Center) has repeatedly tried to pose as an authoritative pediatrics organization in order to fight LGBTQIA2 equality and reproductive rights. But the speed with which ROGD was heralded shows that there is a real appetite for misinformation about trans youth.

So this week’s policy statement by the American Academy of Pediatrics is vital. After years of ongoing research and evidence, the AAP has put its support behind the Gender-Affirmative Care Model (GACM):

“The GACM is best facilitated through the integration of medical, mental health, and social services, including specific resources and supports for parents and families.24 Providers work together to destigmatize gender variance, promote the child’s self-worth, facilitate access to care, educate families, and advocate for safer community spaces where children are free to develop and explore their gender.5 A specialized gender-affirmative therapist, when available, may be an asset in helping children and their families build skills for dealing with gender-based stigma, address symptoms of anxiety or depression, and reinforce the child’s overall resiliency.34,35 There is a limited but growing body of evidence that suggests that using an integrated affirmative model results in young people having fewer mental health concerns whether they ultimately identify as transgender.24,36,37

I have written before about medical accommodations for trans youth, and what is involved:

“It’s important to recognize that the process for trans youth that I’m speaking of is not “sex change” and surgery.  This is often the conclusion that people jump to, but the reality is that newer treatments merely delay puberty until it is certain whether further changes like hormone therapy must be undertaken… typically after age 14…

“Youth transition does not start simply because a child wants to crossdress on occasion or because they like dolls or trucks.  It happens when there is a strong and persistent identification that clearly indicates that there is something deeper than the usual experimentation phase which most kids go through…”

Dr. Norman Spack, who pioneered affirmative treatments, has a TED Talk on how they are scaled to be age-appropriate, and why he came to develop his course of care.  (It should be acknowledged that the policy statement does not specifically embrace Dr. Spack’s treatment, but does stand behind gender-affirmative care, of which his medical process is an example.)

The AAP statement also condemns reparative (or conversion) therapy:

“In contrast, “conversion” or “reparative” treatment models are used to prevent children and adolescents from identifying as transgender or to dissuade them from exhibiting gender-diverse expressions. The Substance Abuse and Mental Health Services Administration has concluded that any therapeutic intervention with the goal of changing a youth’s gender expression or identity is inappropriate.33 Reparative approaches have been proven to be not only unsuccessful38 but also deleterious and are considered outside the mainstream of traditional medical practice.29,3942 The AAP described reparative approaches as “unfair and deceptive.”43 At the time of this writing,* conversion therapy was banned by executive regulation in New York and by legislative statutes in 9 other states as well as the District of Columbia.44

Ontario banned reparative therapy for youth in 2015, noting that kids are often coerced or forced into the treatment by unaccepting parents and churches. This year, reparative therapy for all ages has been coming into question, with legislation being proposed in Nova Scotia, considered in Alberta, passed in the City of Vancouver, and being lobbied for nationwide.

The AAP’s statement mirrors guidelines issued earlier this year by The Canadian Paediatric Society, and are informed by a growing body of evidence that accepting, affirming and supporting trans children and youth leads to better long-term outcomes:

“Many kids who are transgender have chosen a name that is different than the one that they were given at birth,” said author Stephen T. Russell, professor and chair of human development and family science. “We showed that the more contexts or settings where they were able to use their preferred name, the stronger their mental health was…. I’ve been doing research on LGBT youth for almost 20 years now, and even I was surprised by how clear that link was…”

Whether or not the rhetoric subsides, the science is clear.

(Crossposted to Rabble.ca)

Free Speech, When The “Debate” is You (and You’re Not Invited)

There’s a duplicitous game of sleight-of-hand that is taking place in discussions about freedom of speech in academia and the public square.

Here’s how it works: at first, a person fishes for controversy by saying several things that they know will offend people.  If this garners enough attention, then the process recurs organically — say, whenever a politician wants to reference the controversy as a coded dog whistle to their base, or when a teaching assistant replays a recording in class because she thinks the discussion is interesting and challenging.

And the moment the people targeted by that discussion get angry and protest, they’re described not as being upset about the content of what is being said, but rather their protest is reframed as opposing freedom of speech itself.  Whether you see that as accidental or deliberate probably depends on how cynical you are about the whole issue. Continue reading Free Speech, When The “Debate” is You (and You’re Not Invited)