Who Decides for Children?

Yves here. As an adult who has issues with impulse control (after years of being unable to voice anger, I’m now too casual about it), it’s not hard to see the point of view that children are less skilled than adults at emotional regulation and risk assessment (although per my self-disclosure, plenty of adults are lousy at it too) and therefore should have circumscribed realms of action. So it is no surprise that this topic is hopelessly fraught.

By Matt Bruenig. Originally published at his website

One of the meta-questions surrounding the oddly large volume of writing about transgender youth these days is the question of who makes decisions for children.

Liberalism generally endorses the view that people should be able to make decisions for themselves. All of the expository devices of liberal philosophy take rational individuals as the fundamental unit of society and then build from there, generally in the direction of letting people do what they want provided that they do not prevent others from doing what they want.

But children, and adults with severe cognitive deficits, are not fully rational individuals in the sense that liberalism needs someone to be. And so liberalism doesn’t really know what to do with them.

Liberal philosophy wants so badly for societies to avoid taking positions on certain final questions about right and wrong and what constitutes the good life, but it needs to take at least some positions on those questions in order to make decisions for children and other people who cannot decide for themselves.

The default approach to dealing with this problem when it comes to kids is to allocate decision-making to parents and guardians. This allows the society to remain neutral on final questions in the way that liberalism prescribes.

This approach works in a lot of cases, but, in other cases, it generates outcomes many regard as unacceptable. The cases where the outcome is deemed unacceptable take two forms:

  1. A parent making a decision that most consider to be extremely bad.
  2. A parent making a decision that goes against the wishes of their child when the child is sufficiently mature and the decision pertains to a topic that society for one reason or another thinks the child should have a say in.

An example of the first case is a parent deciding against authorizing routine medical care that would prevent their child from dying. In the US, such decisions are frequently overridden by society based on a view that most in society share about a child having an individual right to life. Parents who make this decision typically do so as part of their religious beliefs, which makes society’s decision to override them doubly difficult from a liberal perspective: not only is the society taking a position on a final question but it is doing so against a sincere religious belief.

Another example of the first case is a parent deciding that their child can get a tattoo. Some states allow parents to make that decision. Others override it and do not allow any tattoos until adulthood.

A recent example of the second case can be found in COVID vaccination policy. For young kids, the society generally took the position that parents will decide whether their child is vaccinated, though that decision, like childhood vaccination decisions generally, was often heavily nudged in the direction of doing it by conditioning the receipt of basic services on vaccination.

For older kids, some states in the US have a “mature minor doctrine” that allows children above a certain age who also demonstrate a certain mature cognitive ability to decide to get the vaccine even in the absence of parental consent.

Another example of the second case can be found in abortion policy. Although most states require some kind of parental involvement when it comes to the abortion decision-making of pregnant minors, all but one have some version of a mature minor doctrine that allows pregnant minors to obtain an abortion without parental consent.

There are of course many other cases that fall into these two categories.

There is no general way to determine in what circumstances the society should step in to override a parent or allocate decision-making authority to a child. All of these special rules are fundamentally illiberal in that they are rooted in societal judgments about final questions. Thus, the general principles of liberalism that we tend to rely upon for our public reasoning offers very little guidance.

In the case of gender-affirming care for transgender youth, both sides of the public discourse seem to agree that parental decision-making is not appropriate. But one side thinks it is inappropriate in the sense of case one above, meaning that they think society should override any parent that decides to medically transition their child. And the other side thinks it is inappropriate in sense of case two above, meaning that they think society should allocate decision-making authority about medical transitioning to mature minors.

As noted already, liberalism offers absolutely nothing to help resolve this disagreement. Both positions proceed from divergent answers people have reached on contestable final questions about gender and identity. It’s a necessarily illiberal debate occurring in the context of a liberal society, which leads to a lot of frantic grasping for straws and rhetorical confusion.

The fact that what to do with children is a weak spot of liberal philosophy is also probably why children so frequently become the focal points of various cultural battles. For adults, liberalism has an answer to divergent cultural views: live and let live. For children, this is not really possible. So by focusing the debate on children, you get to fight a cultural battle that would otherwise be waived off as an illiberal grievance that is irrelevant to public policy.

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63 comments

  1. KD

    This is the problem with a lot of libertarian philosophy. Whether it is legalizing gambling or drugs, the brunt of the damage is borne by children when the parent suffers from addiction or compulsive behavior. It doesn’t make sense to traumatize a generation of children in the interests of muh freedom. The State has an interest in the family precisely because children represent the future society.

    1. hunkerdown

      No, the State has an interest in the family precisely because children represent the future State. Peoples do just fine or better without States, which are the agents that create such as muh freedom and other false ideological promises, and then have to play surprised Pikachu and cry “No, not like that”.

      It’s very simple: stop making up myths such as the State and all it contains, and actual, productive, living humans will be better off than those who sacrifice their lived experiences in subordination to property.

    2. Retired Carpenter

      re:This is the problem with a lot of libertarian philosophy
      KD,
      Might you be confusing “liberalism” with “libertarian philosophy”? The new “liberalism” as practiced by the Woke seems to be an insidious form of “authoritarianism” preached in “liberal” terms. Wokism, thy name is legion…
      Retired Carpenter

      1. KD

        I think it is libertarian, non-aggression principle, everyone can do what they want, so long as they don’t coerce or harm their neighbors. I can seek my fulfillment by joining a Bible-based Church and living by the literal teachings of Jesus and you can find fulfillment by medical optimization and performing drag shows at the local library, so long we don’t harm each other or try to coerce the other, its hunkey-dorey.

        Libertarian is “Classical Liberal”–J.S. Mill is the bridge to more social democracy with civil liberties, positive freedom and negative freedom alongside each other. This is “liberal” by late 20th century standards. Now liberals seem to be Reds-Under-the-Bed John Birch Society types except they control the media so their conspiracy theories are “news” and promote warmongering (opposition to Vietnam got the Birchers booted from the “conservative movement”). The Wokesters are just straight up totalitarians as far as I can tell. If we don’t create a one party state and unload political repression and censorship on our political enemies, the Fascists will win (e.g. totalitarians playing the same game but wearing a different jersey).

          1. KD

            A real libertarian can afford their own private island, and anyone infected is probably part of the surplus population driving up tax rates on creative entrepreneurial talent anyways.

      1. KD

        Some children get pulled out of some horrifically abusive conditions, it may not be ideal, but I don’t know how you can just abandon children. . . not talking about the B.S. culture wars stuff.

        1. Han

          The problem is there is a massive amount of abuse of children within the foster care system even after they are removed from parents. Children who come out of foster care have terrible outcomes and often don’t even finish high school. Child Protective Services should offer services to families, but the bar for removing children from the home should be exceedingly high and there should be an automatic investigation of the social worker who authorizes the separation.

  2. Matt Alfalfafield

    What’s missed here is a few things:
    Studies consistently show that gender affirming care leads to the best outcomes for youth (as in, lower rates of depression and suicide).
    Gender affirming care for children mostly involves non-medical interventions like allowing the child to choose their name, pronouns, presentation, etc. For kids nearing adolescence, doctors often prescribe puberty blockers, which have been given to children for decades for a variety of other medical issues without serious side effects. Overall, trans health care for youth buys them time to think and be sure about their decision to transition without making any permanent/long lasting medical interventions such as hormones or surgery.
    Given all this, it’s hard for me to understand the hysteria surrounding this topic.

    1. Yves Smith Post author

      Please provide links. There are clear cut cases of harm.

      https://www.thefp.com/p/i-thought-i-was-saving-trans-kids

      Specifically, one of the drugs used to block puberty in boys is flat out dangerous. From IM Doc based on the practices of the clinic above, which I doubt is an outlier:

      You gave that little boy WHAT? Just bicalutamide (Casodex) – one of the most awful drugs to take I have ever seen in my career. It is an anti androgen drug. Approved for prostate cancer. Feminizes men after just a few doses. Man boobs that never look real. Serious mood swings and rage. Massive loss of muscle mass. Big time fat deposits in all the wrong places that are very difficult to exercise off later. And, my God, the blood clotting and accelerated aging, etc. When given to a healthy developing boy, they will never be going back to normal. And God knows what the “new normal” will be. This is literally demonic. How can a 12 year old be considered able to consent for this?

      And this is from the same people who were the biggest critics of ivermectin.

      The scariest 2 parts though were when she reports the open discussion that one boy was being treated likely as a castration attempt because of his behavior.

      And then of course “we are flying the airplane at the same time we are building it”. That is excusable as an approach when you have a crashing cardiac arrest patient in front of you. That is not even remotely excusable ethically with a confused young kid with a HEALTHY body. But the New York Times assures us that they are following the best evidence. And AOC tells us that they are not actually doing all this to kids. Just ignore all the advertising videos. I guess this is what EBM has become these days. flying an airplane while building it and then covering up/lying about problems. I have myself done literature searches for evidence when asked by parents and grandparents about these procedures. The most kind way to say it is that there is NO credible evidence for any of the claims in kids.

      But these clinics are making tons of money for these universities. Who cares about the futures of these kids when the lucre is rolling in? I find myself whiplashed by the fact that these same people have spent the past several decades lecturing and condescending the Muslim world about mutilating genitals in kids. Oh that these moralizers could spend a few minutes with the two MTF patients in my practice who get to deal with their constantly infected neovaginas all day. The smell, the discharge, the pain, the spotting. The only consolation is they made the choice to do this as adults.

      If an adult wants to do this, go for it. Doing this to kids is absolutely evil. Where there is evil in medicine, there is often a source of lucre. There is enormous truth to Sherlock Holmes quote “When a doctor goes bad, he is the first of criminals.” From the Adventure of the Speckled Band. Always remember that Conan Doyle was a doctor. He produced that statement from experience.

      The hubris of these people is overwhelming. Nemesis is not far behind. Mark my words, this is going to get real ugly for them very soon. The critical mass threshold of damaged kids will soon arrive.

      And further from IM Doc, on the casualness of the diagnosis:

      I was involved in a situation with a xx year old boy last year. Parents were horrified that the gender therapist in CA spent about 2 minutes with him before declaring that he should be transitioned immediately. They did not do it, and now the kid is dating a girl, and getting ready for basketball season.

      They privately talked to the therapist without their son and were called transphobic for questioning her. It was all very simple – the very act of assessment itself is transphobic to the extreme. Assessing these kids puts questions and doubts in their mind. If the child is telling you he is the wrong gender, he is the wrong gender. The end. Questioning a child is evil and will cause pain. Therefore, you just go with what they are telling you. There is no need for a painful assessment.

      I just thought of my boys. One day they are a deer, one day a turtle, one day HeMan. This is really disturbing to me as a parent.

      I thought this may be unusual until talking with colleagues. It turns out this is SOP.

      These cretins and their circular logic will be the death of us all.

      1. MapleLeaf

        Destroying physical bodies instead of adjusting social constructs… neoliberalism has quite the knack for it.

        On issues like these and others, I’m always reminded of the “star-bellied sneeches” of Dr. Seuss.

      2. Susan the other

        Thank you. We might want to consider sending the therapists to a therapist. It has got to be a delusion when someone thinks they know enough to offer advice that precludes better alternatives. It’s just me here but I think a good therapist would manage to convey the great truth that nobody is “happy” and so It should be understood that when it comes to radical treatment a second opinion is important. I’m wondering what the ancients did about this question. They seem to have accepted the differences among people far better than we do. And we have at least come to the level of understanding that everything human is on a “spectrum” of behaviors. It would seem to me that surgery really can’t address the problem at all.

        1. Grumpy Engineer

          Yes. And it’s not just the surgery. It’s also the lifelong administration of synthetic hormones (and hormone suppressants) designed to perpetually keep the body in a state that would never occur naturally. Cease those hormones, and the body will (at least partially) revert to the original biology. I have great difficulty imagining that long-term alteration of the body’s chemistry will be free of harmful side effects.

        2. Sarah Henry

          I wonder if there’s a similar phenomenon at work for therapists and other clinicians with powerful attachments to current “gender-affirming care” models as there was for clinicians who pushed the repressed-memory syndrome idea in the 1980s and 1990s. A cursory look at both moral panics, separated in time by about thirty years, reveals a remarkably similar anatomy.

          If I recall correctly, psychologists played a significant role in pushing into public consciousness the idea that a person can suffer horrific abuse and not remember any of it until the memory is “recovered” later in life, with the help of a suitably credentialed therapist of course. While the repressed-memory idea has been mostly debunked (see Katie Herzog on this topic), some of its proponents’ extreme sensitivity to public criticism and any research contradicting their ideas seems to parallel that of contemporary gender clinicians. Both movements claim as a primary concern the well-being of children or other vulnerable social groups. The absolute confidence of both movements’ adherents as to their own moral superiority stands out as well; after all, who could argue against protecting children from incest or satanic cult abuse, or allowing disturbed teens to access appropriate medical care?

          I’m a bit baffled as to why clinicians as a group seem somewhat vulnerable to the sweep of moral panics like this though…is it about class power, since many are of PMC backgrounds? Access to research funding? More twitter followers? The sense of power that comes from pushing public discourse in one’s personally-preferred direction? I’d love to think that sending these therapists to a therapist would help, but our psychological establishment under neoliberalism seems grossly ill-equipped to handle their issues.

      3. John Zelnicker

        Thank you, Yves, for printing IM Doc’s rant. It’s spot on.

        I have long believed that many parents who think their children want to be a different gender have issues of their own that impair rational consideration of their child’s gender issues, e.g., parents who wanted and expected a son, but got a daughter. The potential intensity of feelings of disappointment, or some emotion like that, can lead, IMHO, to irrational thought or placing far more importance in their child’s fantasizing than it deserves.

        Just asking here, but how many parents have taken an expressed desire and run with it when the child is just exploring themselves and next week they’ll want to be that turtle?

        The first paragraph of IM Doc’s further comment is exactly what I’m talking about, except those parents refused to go along.

      4. clarky90

        They are institutionalizing the sterilization of boy and girl children, who display any girlish, or any boyish attributes.

        When my youngest son was a pre-teen there was a girl in his class named Tiffany. Tiffany only wore boy’s clothes and wore a short back and sides haircut. This was never an issue with anyone (child or adult), that I was aware of. We understood that she was a tomboy. A few years later, in high school, she became a super girly girl……

        People change.

        This irreversible, mass sterilization (neutering) of the innocent, is reminiscent of the horrors of eugenics during the first half of the 20th Century.

        Another Organized Aktion, designed to reduce the human population, and make way for more Lebensraum-(living space) for the Private-Jet-Set and their toys.

        1. Yves Smith Post author

          I only went a bit in and it’s embarrassingly and patently dishonest, starting with the claim the story was held back 2 weeks with a link to the Epoch Times piece which says no such thing. What ET says is that it took 2 weeks from the receipt of the complaint to saddle up with an investigation. That’s not “held back”; that’s lightening speed.

          They also try guilt by association because right wing outlets are the ones amplifying the story. That’s akin to attacks on Glenn Greenwald for appearing on Tucker Carlson, when Glenn is on Tucker because Tucker is the only MSM that will interview Glenn these days.

          The claim that she misgenders her patients, even if true, does nothing to rebut the claims of harm. And that assertion seems based on the barmy presence that anyone who comes into the clinic for a consultation or treatment must be immediately regendered.

          And that may be a function of Free Press editing, not her original text. Let us not forget she is married to a trans man. Note it was also doctors at the clinic who were privately worried about cases of social contagion (particular cases, mind you); the author pointed to a cluster in the clinic and wondered if that could be more of the same. The study cited is not on point because it does not prove or disprove very local trends. Moreover, it covers only 16 states. I have no idea if they are strongly blue or red, which could very well influence reporting.

      5. Steve M

        Can I just make one observation after reading equally spellbinding articles and comments here for a few years?

        Yves, when you regularly rap responders on the head fast but firm just to keep them on the road, I’m tickled enough to almost want to try it myself.

        But when you drop one of these doozies with the heft of IM Doc or other sources (you being one of your better ones) into the middle of the pond and I follow the ripples, why,

        Madame, I believe that you can turn a aircraft carrier around 180 degrees in under 20 minutes and half a mile of surface runway!

        I often pause to marvel at the content and style of this website. This time I paused longer to tell you.

        And thank you.

        1. Yves Smith Post author

          That’s very kind but a lot of credit goes to our mods.

          We have been forced to restrict discussion of trans issues, which I am not happy about, due to the aggression and efforts to thought police on the Internet of some trans advocates. I do not like being forced to step in and escalate with one of them, but this sort of bad faith and argument by attempted character assassination is not on.

          You can see the straw manning above, that when people who have been sympathetic to the trans cause point out that the current maximalist approach is doing harm in a non-trivial proportion of cases, they get smeared as trans-phobic or worse, when the instances of poor outcomes should instead be examined to improve screening and treatment approaches.

          This maximalist stance also risks producing a huge backlash.

          1. Terry Flynn

            Kudos Yves. I like to think I’m “with it” but as I say elsewhere I simply don’t know re a bunch of trans issues….. I’m not afraid to say so.

            I can only begin to understand the fights you and your crew encounter on the issue.

            1. PlutoniumKun

              I think the fact that its impossible to have a reasoned discussion on the topic is very sad. I’ve had the experience with people of just seeing the fences go up when you discuss it. People who are happy to talk all night about politics and society will just clam up when anyone strays off the narrative on trans issues.

              Unfortunately, I think the wrong lessons were learned from previous successful social movements. With gay marriage, for example, there was a long process of developing a consensus within the LGBT community on whether it was the right approach (I’m old enough to remember when many older gay men and lesbians were very anti-gay marriage, seeing it as ‘aping heteronormative behaviour’ as one person I know put it). Once that consensus was reached, then it was easier to reach out to the ‘don’t really know/don’t care’ majority in the population.

              But with trans there has been open bullying of anyone who doesn’t thread the line, and unwillingness to do the hard work of getting everyone on board through persuasion and discussion. The fact that ‘terf’ is now a term of abuse says it all. So much for ‘liberalism’.

    2. semper loquitur

      Here’s a few links for you, since you didn’t bring your own:

      Diana Shaw, USA Debunking Myths About Transgender Murder & Suicide Rates

      https://youtu.be/dhiSjcURSnU

      Suicide rates increase following unnecessary medical interventions, by Diana Shaw

      https://youtu.be/32a828NCoS8

      Did you know Sweden has pulled a 180 on gender “reassignment” “care”?

      Finally, a nice overview of the wealthy and powerful players behind it all:

      What and who is behind Transgender Ideology? – Jennifer B. Bilek

      https://youtu.be/YmrS8q5o1k8

    3. Scylla

      As someone who is trans, the problem, as I see it, is how the liberal set has glorified transgenderism (for lack of a better term), and made it STYLISH. Some of them even virtue signal trans kids, so being trans has become socially incentivized. This is going to create problems as there will be people who regret transitioning, and these people as individuals, along with liberals glorifying everything trans will be used to fuel a reactionary backlash, which no liberals will have to suffer. Everything liberals touch turns to s%@!
      I do have a child that claims to be trans, and I, a trans parent, am deeply skeptical. Without outside influence, trans children exhibit noticeable traits if you pay attention. My kid only exhibits traits sometimes, and none were apparent prior to social media exposure. Liberals and conservatives alike have made it almost impossible to make valid determinations in this sphere because of the politicization of the subject. Due to all of this, I doubt very much I would ever help a child of mine transition because of this. Not sure I would stop them if they found the wherewithal to do it on their own (which shows a level of seriousness I would not feel right opposing). Its tough all the way around. There are idiot parents on both sides of this, but I do not think the state should get involved- in this day and age, that will simply not yield a positive result imo.

  3. Terry Flynn

    Thank you – very important topic. As an “older Gen Xer” I tend to be (and doubly via personal circumstances) “with it” concerning the “LGB” bit of the longer and longer “queer grouping”. However I freely admit my difficulty regarding the “T” bit etc.

    All I can offer are some observations regarding divergence between ADULTS’ perception of children’s pain but especially mental anguish, and the valuations of the kids themselves (who tend to accept far greater impairments to other things in life to avoid mental anguish). In short, adults don’t rate adolescent mental health drops as badly as adolescents themselves. Is this “real” or a “lack of life experience on the part of kids”. Dunno. But it’s definitely not a “happiness bias” (whereby certain age groups naturally use different parts of the numerical scale – plenty of evidence in UK, particularly USA and Australia).

    They were asked for trade offs not numbers. No answers from me but plenty of avenues for research. Declaration of interest – I have done all the stats on at least one major study in this area.

  4. digi_owl

    Based on my own experiences growing up, i have come to the conclusion that only experience is a teacher. Thus when the time comes and interest is shown, “kids” need to get experience in relatively safe circumstances. Because they will seek out those experiences non the less, and place themselves at far more risk by doing so in hiding.

    1. Terry Flynn

      only experience is a teacher

      This is a profound issue that has been at the forefront of health economics for 15+ years for funding in countries like UK, Australia, NZ, and much of the EU. Who/which population subgroup “values” an impaired health state for the purposes of deciding which interventions profits the most “bang for a buck”?

      I have argued that those with maximum experience (often but not exclusively the elderly) should provide the “values” associated with impaired states. It’s definitely controversial however.

      1. digi_owl

        Now you remind me that a Norwegian PM, a trained doctor and leader of the Norwegian labor party, manged to state “that the nation had to stop sewing pillows under people’s arms”. That was pretty much when the neolib encroachment started.

        1. Terry Flynn

          But did everyone in that age group decide this? THAT is my point and what most of the world (including countries that actually USE the policy) don’t understand.

          This goes to the heart of the “universal Healthcare” policy so often advocated here….. WHICH PART OF SOCIETY decides on where the “funding cutoff” falls? We are not talking anecdotes. We’re talking societal decisions.

    1. Janeway

      Don’t see where this article was much about religion per se, but the problems our neoliberal overlords have wrought in society.

      And they are by far and away mostly not religious except in nominal name only.

      1. Alice X

        The article is about who decides what kids are exposed to. Early inculcation into religion, or consumerism, for another example, provides a launching pad for lifetime formations. So that’s why I brought it up.

    2. Terry Flynn

      I try to stick to data but anecdotes and anecdata can be useful and might be here in supporting this point.

      Lots of Brits, Germans, Dutch, French and Spanish when getting winter sun in Gran Canaria (part of the Canary Islands, off Morocco but part of Spain) take their kids to drag shows (starting at 11pm after typically late Spanish dinner) in the most popular resort. These are NOT typically “Guardian reading middle class types”. However they love it. The jokes are frequently “Simpsonsesque” in that the dirty undertone will be appreciated by parents whilst plenty of risqué stuff is still shown to the kids with IMO little objection by parents.

    3. Yves Smith Post author

      When I was in Oz, drag queen shows were seen as adult entertainment and performed in venues that served alcohol. I don’t think even-liberal minded Australians would have been comfortable with kids seeing these perfomances.

      Drag queens were however also accepted in the general public. For instance, during Mardi Gras, I went to Oxford Street, in the heart of gay Sydney, to pick up my laptop from the Apple Store nearby. It was a sunny summer morning, around 11 AM on a Saturday.

      Trundling slowly uphill towards me (Oxford is slightly sloped) was an enormous vintage convertible. A drag queen in full regalia, opera gloves and tiara, was waving to people on the sidewalk and handing out…..something. The yellow sequins on her dress blazed in the hot sunlight.

      She was handing on small printed notecards. At the top was “Sorted?” which is Australian shorthand for “Sorted out”.

      Below was a list of items a proper drag queen might need, with checkmarks by each:

      Artificial eyelashes
      Gown rental
      Waxing
      Wig

      At the bottom was stapled a tiny ziploc of gold glitter.

      It was an ad for the Yellow Pages of Telstra, Australia’s biggest phone company. Needless to say, such a promotion would be inconceivable in America.

      1. Terry Flynn

        Agree that they tended to be “visible” during key elections but completely not otherwise….. However never saw what you witnessed (2009-15). And was in that area regularly due to work there. The drag Queens only appeared at certain bars after certain time on Oxford St. The “Liberal” govt was being very heavy handed during my time there…….

        Got them into right pickle during crackdown on nude beaches and “lewd behaviour” when the only lewd behaviour the police found and arrested was a woman who asking with her husband wanted….. Well……. Anything….. And was visible to a local school….. Oops

  5. David

    As Bruenig essentially says, this reflects a design problem with liberalism: it’s not a bug, it’s a feature. If you start from the individual, and turn every decision into a conflict between what different individuals want and need, then you either decide in favour of the most powerful, or you have an arbitration mechanism such as a court, or both. But this system only works, if it works at all, when all of the participants are rational utility-maximising actors who can reach a consensus, or who will accept an arbitration with good grace. The fact that life isn’t like that accounts for most of the problems of a liberal society.

    So a problem like this can only be conceptualised by liberals as a contest between what the child “wants” and what the parents “want,” or what critics “want.” But children, like certain classes of adults, frequently don’t know what they “want”, or, as you’ll remember if you’ve ever had a child, they change their minds all the time. At some age, children presumably metamorphose into the rational actors of liberal mythology. But how do we know when? Thus the dilemma that the article identifies. But the answer, surely, is to abandon liberalism as a framework of thinking, because this can’t sensibly be treated as a problem of individual rights, but only as a problem that society as a whole will have to find a solution for.

    1. ArvidMartensen

      If you want to control and loot a society, then you allow and encourage atomisation. Then encourage the dominant, hot button issues to be about the personal, through what is given hyped media attention. Moulding society to suit your commercial and political interests. I see the explosion of #MeToo before the 2016 elections as part of this.
      So what you end up with is atomisation – eg I am a young, white, queer and possibly transgender person. This is my core identity. I also have to work 18 hours/day 6 days/week at 3 shitty jobs to survive, but this irrelevant to who I really am.
      There can be no challenge to the ever more entrenched power/wealth structure if nobody even understands it’s possible to be part of a functioning, persevering larger group working to improve living standards methodically and loudly.

      Young people are so malleable and so changeable, changing friends, interests sometimes daily. Prey to every fad Christmas must-have toy and electronic device, they go through agonies of “who am I” as teens, finding safety in being “normal” like their friends.

      But any young person who is different runs a high risk of being shunned and bullied by their peers – the tomboy girl, the quiet and sensitive boy, anyone whose neurobiology makes them more open, more intelligent and more serious than their peers (autists). For them, the answer to “who am I” comes back with answers like “you’re stupid”, “you’re weird” “we don’t want you”. And then these young people desperately search for the answer to why they’re weird, stupid, friendless.

      And suddenly an industry of adult predators come along with a siren song to these confused youngsters – pay us money and we can change your gender and everything will be ok, this is your way out of your terrible pain and confusion of who you are and if you have value.

      And this is what the brave lady speaking out found “The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms“.
      And sadly it will be found eventually that this industry, like all other rapacious industries, has caused irreversible harm to the most vulnerable, and worst of all, for most of their lifetime.

      But the predators will be rich and smug, and will move on to other victims with never a backwards glance. Because the looters have taken away all the citizen protections: independent regulators, an independent press, an affordable legal system, person-centred healthcare, support for families and parents.

  6. jefemt

    As an analog, this brings to mind a very scholarly Law Review article turned into a book,
    Should Trees Have Standing? By Christopher Stone. Am am not a lawyer, and each page is footnoted with reference to cases, findings, to the extent that the majority of each page is footnotes. But it is captivationg!

    Law evolves. Does a non white have rights? A fetus? A minor? A corporation? And no right is sacred… they can be conferred, and removed. Tis a mystery. Great little read, and does have some analogies here.

    I have fewer answers and less certainty every day!

  7. David B Harrison

    Liberalisms greatest failure is to pretend that children are adults. All I have seen around me my whole life is train wrecks caused by adults refusing to raise their children properly. The kids are either spoiled, abused or neglected(or a toxic combination of all three). They have eating disorders, are promiscuous, obese, depressed, violent, airheaded, have body dysmorphia(as evidenced by the tattoos and piercings), materialistic, worship celebrity and wealth, fatalistic, nihilistic, social media addicted, have zero true critical thinking ability, abuse substances, are social darwinistic, this list could go on forever. It has been said that our brain doesn’t fully mature until we are 26. I can attest that I had my head up my butt until I was 24 or so. Children need a proper mix of nurture, discipline, and guidance or they will self destruct. The older generations worship of hedonism has poisoned the younger generations. I used to dwell on my parents child raising defects until I matured out of it. I stopped being a professional victim and realized that they had done a better job raising my sisters and I than 99% of the parents(the younger generations vices I list above I do not practice or have stopped practicing)) . One of the problems that the other parents had was raising their children as status markers instead of human beings. Most of the parents did nothing but throw money at their kids and told them to sink or swim. This lack of nurture, guidance, and discipline has left them shallow, vacuous, and narcissistic( and the neoliberalistic society we live in gleefully exploits them). They are miserable.

    1. digi_owl

      Nah, more like it treats everyone but those at the top as drooling infants.

      That is the basic notion coming out of decades of psychological research.

      1. Terry Flynn

        Agreed. I in the 1970s/80s had FAR more independence and agency than kids kids today. This is a common observation so not just anecdotal.

  8. Kim

    You can’t blame anyone under 16 for following through with such horseshit. Parents who support this are supposed to be mature. By giving permission– unless the kid flees to Newsom’s California to join the future homeless and child prostitutes, are committing genetic suicide and when the mutilated offspring realize the mistake, social and cultural suicide for both child and parents.

  9. lyman alpha blob

    As a parent, I don’t think society at large should overrule parents’ judgment except in rare cases such as when obvious life saving medicine is withheld by parents as noted in the article. I might not like it if a parent wants to allow their young child to have a sex change, but I don’t like it when parents give their kids religious home schooling either, yet I don’t think it should be prohibited. I do think both should be rare, and I suspect that if we really had an more equitable and less fractured society, they would be.

    Kids need good guidance and it should come from the parents or other adult family members if at all possible. My spawn was arguing with me the other day about restrictions on screen time, curfews, etc. and then she wanted a bowl of soup to eat. I suggested she have half a bowl and if she was still hungry, go get more. She insisted on a full bowl since she was really hungry but then predictably got full, didn’t eat it,and threw the rest away.

    I looked at her and said this is why parents set rules for teenagers. They don’t have the judgment yet to even determine how much soup to put in a bowl, much less for more important considerations for getting through life without too much damage. She just looked at me and smiled, so hopefully something is sinking in, however slowly.

    1. Terry Flynn

      As a parent, I don’t think society at large should overrule parents’ judgment except in rare cases such as when obvious life saving medicine is withheld by parents as noted in the article.

      And that is EXACTLY why socialised care won’t work in somewhere with USA values and will be unstable if already implemented somewhere without enough social cohesion. The whole principle is that SOCIETY sets the “cutoff” values. The “system” knows its in trouble and is discussing “exceptions” but this is all work to get EU etc funding.

      Please look up the principles of “extra-welfarism”. It’s the theoretical basis of Healthcare in so many non USA countries. You might be a little disturbed about some of its diktats. 3 score years and ten….. That’s what life expectancy you “deserve”…. From Alan Williams. Look up the “fair innings argument” if you want evidence.

      1. JBird4049

        We do not have socialized healthcare and so people are dying from easily treatable diseases or becoming destitute paying for it. People are considered valuable enough to save because their worth is measured only by their wealth. And yet, our society has been deliberately atomized, stripped of any cohesion from religion, education, clubs, unions, sports and music events, non PMC infested NGOs or charities, functioning governments, art, architecture, and anything else that creates social bonds. Die on the street from poverty or die from death panels. Is there a difference?

        I keep seeing people blaming liberalism. When people complain about the evils of liberalism, I think they should be asked which one? More directly, what makes liberalism, aside from neoliberalism, blameworthy? Classical liberalism main points might be called civil rights particularly freedom of speech and religion, equality under the law, and the right to self government. It was created as a way to have a functioning society by settling disagreements using debate without the whole wars of religion, or rule by kings, or where class determined who got what justice, if any, and acts like death by torture or using torture in questioning was acceptable.

        This the base of the American Declaration of Independence, the Constitution, the Bill of Rights, and representative democracy; the entire philosophical justification for our society comes from the Age of Enlightenment.

        However, liberalism was never meant to replace religion, family, social institutions or be anything other than a way of having a government and society that dictated what you believed, what your position in society was, or what you did because the God-Emperor said so and was going to burn at stake. Or even decide what kind of economy to have. It was meant to protect people from government and from each other and not as a replacement for anything else.

        Somehow, starting with nascent corporations I think, people started to conflate money and corporations as essential parts of liberalism. Perhaps for some the most important part. Then slowly at first, started the process of equating the value of people with money. Just money. Followed with replacing everything with thoughtless misuse of liberal philosophy and denying any restraint or restrictions because it is our right.

        Well, I think that I have a right to eat an entire chocolate cake for every single meal, literally worship cats as my gods, never bathe again, at memorial services denounced the deceased as having had a very close friendship with sheep, and vote for Kamala Harris as president, but all this would be… unwise. Just because I can do something doesn’t mean that I should, but why is this so? It is my right, isn’t it?

        But somehow, too many Americans have replaced religion, morality, ethics, personal responsibility, or even common sense with their rights, and what is worse, the worship of money. It is like people take our liquid modernity and use it to wash away any connections or foundations. If people don’t have any center, it easy for corporations to slide mammon or anything else as a replacement. I sometimes feel like it is not just corporations that are responsible. The security state, maybe, as with Operation Mockingbird. However, blaming liberalism is like blaming Scientism on the scientific method just because some need to use science as a religion. Much like how free market capitalism is treated as received wisdom from the creator. People are always looking to fill that philosophical and metaphysical hole.

        At the end of my disjointed rant, I ask should we get angry at classical liberalism, modern liberalism, or neoliberalism? Who or what is to blame for our collective hollowness?

        Also, if we blame liberalism for our troubles, what should we replace it with? Maybe, instead of blaming liberalism, especially classical liberalism, which seems to be out of fashion with a growing number of our wealthy and credentialed classes, we could stop using it as crutch, but as the tool it was originally supposed to be?

        1. Terry Flynn

          Thank you for another well argued reply. My responses might come across as “liberal friendly” or endorsing “rules”. I don’t. The “extra-welfarist agenda” used in UK, Canada, Aus, NZ and much of EU is repeatedly “tweaking” itself because it is flawed at its base….. Being rooted in neoclassical economics.

          Introduce it according to principles more akin to MMT and other genuinely progressive principles and it will work. You won’t have to get bogged down in these special cases. Just my opinion.

  10. Terry Flynn

    the other side thinks it is inappropriate in sense of case two above, meaning that they think society should allocate decision-making authority about medical transitioning to mature minors.

    As noted already, liberalism offers absolutely nothing to help resolve this disagreement.

    This disagreement regarding who makes decisions is one that I believe is one that will be a hitherto undebated issue regarding “universal Healthcare” in USA. I welcome the moves towards this but in all honesty don’t think it’ll happen…. It necessarily requires too much “socialising of decisionmaking” in a way that repeal of the 2nd amendment wouldn’t pass. The decisionmaking is deliberately unclear in places like EU. WON’T pass in USA.

    In case you want evidence, the “death panels” were originally a reaction to cost-effectiveness decisions (i.e. How decisions are made under universal health care). They’re still terms of abuse.

    1. jsn

      40 years of denigrating Government has led USAians to prefer private Death Panels.

      These private Death Panels have become much more effective and profitable in the ongoing pandemic.

      Attitudes can change, but propaganda is so thick any change is being retarded. As the choice between corporate credibility and one’s life becomes clearer, change will take hold. I agree with you, however, as to how hard it will be for public mindedness to take hold at scale in the polluted US body politic. The mythology of the State will have to erode enough for counter-narratives to take root at some smaller scale and the existing apparatus will do all in its power to prevent that; success of which effort will ensure the ultimate scale of the ultimate fragmentation when it can no longer be prevented will be into tiny shards. Promises to be an interesting decade or so.

  11. Mildred Montana

    Medicine understands little about the human brain. It understands even less about the *developing* human brain. To give drugs of any kind to immature brains is to treat without knowledge of consequences. A possible violation of the Hippocratic oath and most certainly a violation of the Precautionary Principle.

    A nephew of mine had the misfortune to have his “depression” treated (at the age of 16) by a pill-pushing doctor who thought he knew all the answers. My nephew is today (at the age of 50) a high-functioning vegetable but a barely functioning human being. After years of psychotropic-drug therapy, he takes such massive doses of whatever he can get his hands on (OTC, prescription, don’t matter) that he has been hospitalized several times for ODs, which are sometimes construed as suicide attempts.

    On the other hand…many years ago my six-year-old brother decided he wanted a doll for Christmas. Our sensible mother didn’t freak out or run to the nearest child psychologist. Instead she bought him one and didn’t make a big deal of it. Very quickly my brother lost his interest in dolls, became interested in “boy” stuff like Mechano, and grew up to be a heterosexual man with a wife and three kids.

    As painful as it might be for the young teenager who thinks he or she is trans, the medical profession must adopt a policy of “watchful waiting”. Supportive therapy, yes. Drugs and/or hormones, no. Once he or she grows up, maybe. But only then.

    To paraphrase Pink Floyd: “Doctors, leave those kids alone.”

    1. Cocomaan

      This was my favorite post in the thread. Above, the article asks what we should do about and for children.

      The answer is “the kids are alright,” to quote another rock band. Leave them the heck alone, let them grow up.

    2. square coats

      I completely agree with you.

      I will add that there have been numerous studies exploring a phenomenon called “mass social media induced illness (in this article), I think the example receiving the most publicity has been tiktok causing adolescents to develop “functional tic-like behavior” (another article).

      I’m definitely not trying to suggest that transgender identity is an illness, I’m just saying there’s good cause to believe that adolescents (and other age groups) are forming and reforming their own self-understandings partially by trying out emulating their peers or other influential people they observe, so my own take is as Mildred Montana says.

      As far as parental decision making rights are concerned, I do find it interesting that all the particular issues raised in the article are more or less regarding decisions made about children’s health/bodies. lyman alpha blob in a comment above raised the issue of parents making decisions about the sort of education their children receive and there’s some culture warring about this going on currently in the u.s. too.

      I think there are some similarities and also differences between how children’s education vs children’s health are being/have been treated legislatively in the u.s. but I’m not sure I can enumerate them all. Might be a helpful way to get at the overall issue of parental decision making rights further. One big thing is the aspect of irreversability, which several commenters have raised.

      I can see arguments that the effects of particular kinds of education could be considered irreversible, but I also think there’s something qualitatively different about health decisions. Maybe simply that it’s much easier to establish direct cause and effect in the latter case.

      A couple further thoughts… I believe it’s generally frowned on for parents who are licensed doctors to provide various care/procedures to their children, while someone who is a teacher isn’t discouraged from providing homeschooling to their children. But also for example children’s nutrition is generally left up to their parents to determine, and obviously nutrition is a big determiner of health. Just some things this is leading me to ponder.

    3. Carla

      I vote for Mildred Montana for National Mom. In a thread of thoughtful and insightful comments, yours stands out, MM. Thank you. And BTW, “watchful waiting” is a vital part of good parenting overall, IMHO.

  12. Antagonist Muscles

    Since this post is about the autonomy of children and health, let me point out how bitter I am that my mother accompanied me to every doctor appointment I had when I was a child and adolescent. If I had the freedom of having a private conversation with my doctor when I was young, I may have prevented some of the health problems that still plague me to this day.

    If a doctor determines that his adolescent patient is sufficiently competent, that doctor ought to ask the accompanying parent to leave the exam room. My mom is so nosy about my health that she almost certainly would have refused if I requested her to allow me to speak privately to my doctor. I hope doctors wisely use this authority to ask a parent to leave because the young patient may speak quite differently in his mother’s presence.

    Now that I am older and wiser, and my mother is increasingly frail, the converse happens. I accompany her when she has doctor appointments. I now understand that my mom’s persistent beliefs about human health are laughably wrong. It finally dawned on me that she is an utter fool because her inability to comprehend basic communication stretches back to my childhood. Serious well-meaning adults (her doctors and me) have offered her medical advice. She doesn’t want to listen.

  13. Pelham

    Perhaps the state could make a more credible claim to exercise protective powers over children if the state covered a great deal more of the cost of raising kids and providing for their material well-being.

  14. GramSci

    I blame a “Hunger Games” education system that groups kids into narrow, chronological age cohorts, throwing them into competition with other kids who will mature faster or slower, becoming in the process bully or bullied, with all the attendant socially maladaptive conceptions of self and other.

  15. Late Introvert

    I got a little doll for my birthday at age 6 and loved it (I’m male). My two older brothers and all of the neighborhood kids (there were lots on my block) made so much fun of me that I never once played with it. I’ll have to ask my mom if it was her idea. I had forgotten about that.

    Later I worried a lot that I was gay, but that’s because of all the hard-ons at inappropriate times. In my late 20s I moved to SF and one of my roommates had gay porn and I gave it a look. Nope.

    My point is kids should be allowed to figure it out over time, without doctors giving them drugs or god forbid surgery. There are examples of that too, for those who are minimizing this issue. My daughter will be 18 this year and we would have never let a doctor do that to her, even while supporting anything she thinks or feels. She has peers, young women who have decided they aren’t comfortable with their assigned gender, and their parents are supportive without any of this medical malpractice BS.

  16. Late Introvert

    I also want to add that who knows what pollution of our food and water by Big Ag has to do with this issue of gender dystopia.

    1. rob

      I think that is a huge issue. Talk about living in an experimental stage of human development.
      With all the endocrine disruptors in nature now. From the water we drink, and the food we eat, and all the packaging it comes in; we are undertaking an evolutionary experiment of our species.(and all the others too)
      I hear conservatives railing against this latest wave of social upheaval, as if it is just a “trend”, but the flip side is they are always so anti-regulation/pro-corporate; that they will never ask how much of this trend could be contributed to, by pollution in our environment.
      I don’t know; but the timing of the two trends is worth looking into, were we to actually have a functioning society…. but I live in the USA… so no chance of that here.

  17. SES

    As far as I know, it was long understood in clinical practice that the vast majority of gender-questioning children and teens were young lesbians and gays who had difficulties accepting themselves. Given therapy and time, nearly all of them turned out to be self-accepting lesbian and gay young adults.

    Given how I presented as a child, if I were now entering the school system in my province in Canada, I’d quite possibly be nudged into the transition stream by busybody guidance counsellors and social workers. The thought fills me with horror.

    I think the LGB rights NGOs are partly to blame. I’m one of those mossback old gays (I’m 62) who regards gay marriage as “aping heteronormative behaviour,” as PK nicely put it. My partner of 29 years and I would never consider getting married – why do we have to keep symbolically trying to appease our fathers? Anyhow, my guess is that the NGOs had run out of things to push for once they had achieved concrete material progress in terms of LGB rights. Winning gay marriage was the first step in mission creep – a symbolic achievement that added little or nothing in terms of material rights to civil partnerships or common-law relationships. Then what? Disband the NGOs? Yeah, right.

    Many gays and lesbians regard themselves as having been betrayed by what the LGB NGOs have morphed into: organizations promoting an agenda largely driven by straight men with a cross-dressing paraphilia, and that end up essentially promoting “conversion therapy” and sterilization for young, confused, closeted gays and lesbians.

    It’s weird how gender ideology has become the credo quia absurdum of the woke religion. I guess that’s why such a fringe issue has been pushed to centre stage – I mean, if you can get people to believe this stuff …

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