Julie Burchill being nasty again about trans people in The Guardian (in an article since replaced by an apology of the editor) is bad enough, as it might provide cover for bullying but much more worrying is the general disrespect and disdain many trans people receive from their own doctors, as documented in stories shared through Twitter and elsewhere.

Two weeks ago, one of the few doctors providing gender re-assignment outside the NHS, doctor Richard Curtis came under investigation by the General Medical Council, for alleged errors made during gender reassignment, including one alleged wrongful referral for surgery.

For many trans people this investigation looked like yet another attack on the already scarce resources for gender reassignment in the UK, once again focusing on the alleged harm that might have been done to people erroneously under going gender realignment therapies, rather than the everyday difficulties many trans people have with getting the right medical support.

This anger led to the establishment of the TransDocFail hashtag on twitter, started by trans activists Zoe O’Connell and Lib Dem councillor Sarah Brown, asking UK trans patients to relate their experiences with gender reassignment and health care in general. It led to a flood of tweets by trans people, often anonymously describing the problems and bigotry they encounter at their GP or hospital.

The heart of the problem still seems to be the idea that trans people need to be protected from making a potential mistake more than they need to be helped become what they really are, as well as a continuing transphobia amongst some health care workers, not often addressed in the news media. As Sarah Brown is quoted:

“The media are typically invested in presenting a rigid narrative about how trans people interact with medicine. The stories trans people would like to tell, stories of outrageous levels of systemic abuse and transphobia, don’t fit this narrative and so go ignored and unreported. Social media is changing this. The stories trans people have to tell are reaching people who seldom hear them, and people are often appalled by what they hear. We can’t even begin to tackle widespread medical abuse of trans people until there is wider awareness of just how bad it is.”

A related problem is the fact that so often, the only trans stories covered in the media are negative ones, which is something the We Happy Trans project attempts to do something about.

(Originally posted on MetaFilter.)

Health care as a moral issue

Alex talks about medical surveillance technology and the assumptions driving it and how wrong they can be and in the process makes a point that can be applied more generally:

Now, there is obviously some truth to this. Giving up smoking is a really good idea, as is taking your damn pills. But it is also highly problematic. For one thing, it assumes that the problem is non-compliance. In that sense, it transfers your problem from the domain of reality – a physical problem to be solved – into the domain of morality – a statement about good and bad. Rather than being poor, stressed, addicted, etc, the problem is that you are wrong and a bad person. As a rule, this is normatively evil, and of course it only works if the problem is not actually a real problem.

I’ve seen this sort of reasoning play out, or at least this was what it looked like from the outside, in the hospital Sandra stayed in for most of the last two-three years of her life. Sandra was a smoker, had been for decades and while fully aware of the risks, she also was certain that this would not be the thing that killed her and of course she was right… For her, as for many other people, the short term benefits of having a quick fag were more important than the long term health consequences.

Now when she first went into hospital it still have a couple of smoking rooms on the premisses, where both staff (more of whom smoked than you’d expect) and patients could go to. Then one day, in the middle of winter these were closed down because some busybody in higher management decided they don’t belong in a hospital. So now all those patients had to trundle out in the cold to get their fix, which certainly for Sandra didn’t do much for her health.

It’s that sort of attitude where the health health health message has to be driven home, even to people who are in no state to quit smoking, who are dealing with much more immediate problems and need the stress release fags offer. No, people need to be harassed and bullied into doing the right thing, even when it’s inappropriate.

Keep feeling vaccination

As the number of parents who refuse to vaccinate their children grows in the US, so does the number of pediatricians who refuse to treat them. Over at the inevitable comment thread at Metafilter, one pediatrician explains the realities of vaccination and the risk your children run if they’re not vaccinated:

Sometimes I work with families for whom the reality of the morbidity and mortality of these diseases is extremely limited. In my education, I do focus on morbidity because families will not hear that they are putting their children at risk to die. The injuries from these diseases are often more concrete, even minor injuries like the significant scarring of varicella, or persistent airway disease from pertussis. Refusing MMR exposes male children to infertility risk, all children to acquired heart defects. Refusing HiB, even if your child does not die from meningitis, will surely result in acquired neurological, cognitive, vascular, and extremity injury once heroic efforts have saved the child from meningitis death. In the case of HiB, many currently practicing providers lived through the complete horror of internship and residency in children’s hospitals’ meningitis wards where babies were dying all around them that could not be saved. My current attending talks about the weeks when HiB vaccine was, then, introduced and the wards closed up, one by one. And he gets freaking teary-eyed about it, even now. Refusing pneumococcal vaccines like Prevnar opens all of us up for more of the same–the current Prevnar 13, for example, covers for 48% of invasive meningitis.

Families do not believe they are accountable to their own children–that they answer for their scars and acquired disabilities. But they do. Injury from actual vaccine is an incredibly small and fully reported risk. Any parent can go to the CDC site, at any time, and monitor vaccine injury. But the risk of acquiring a preventable childhood disease by refusing to vaccinate is nearly certain in that child’s lifetime. It’s as if a family made the decision to let their infant lay across the backseat, unbuckled, without a carseat, because they decided they would simply just drive very carefully.

My sympathies all lie with the doctors, though I can spare some pity for those parents who, genuinely wanting the best for their children, are taken in by one of the bullshit merchants preying on their fears and insecurities, their greed masqueraded as concern. But vaccination is not new, not controversial and has been used for a long long time, has slain some of the greatest childhood killers: smallpox is gone completely, polio almost, measles in rich countries is an inconvenient childhood disease, nothing to be worried about. That very same success ironically now makes continuing vaccination programmes vulnerable to indifference as parents wonder what the point is, if these disease are gone or under control. But they are still necessary and not vaccinating doesn’t only put your own child at risk, but other people’s children too…

Satoshi Kanazawa is still a massive douche

Having a relatively old blog means you can see certain subjects coming back again and again over the years. One of such is the sheer stupidity and nastiness of Satoshi Kanazawa. In 2006 I posted about his bizarre theory that Asians cannot do science properly, two years later about his masturbatory fantasies of having Ann Coulter in charge of the War on Terror. Today he’s back in the news again for saying that evolution made Black women unattractive, especially to middle aged evolutionary psychologists paid to spout scientificesques excuses for prejudiced bullshit.

Not to long ago the London School of Economics was pilloried for taking money to let one of Khadaffi’s sons study there. Yet I think the LSE should be more ashamed for having Kanazawa on its staff…


In what’s only an aside to his main post, Alex reveals his second thoughts about the slow burn revolution of decentralising technology:

I can’t help thinking, looking at a lot of the growing technology of instant urbanism (suitcase GSM base stations, palletised VSATs, Aggreko gensets, Sun Microsystems containerised data centres…) that a lot of this stuff might actually be a sort of negative toolkit of local optimisations.

RepRap isn’t on that list, but it should be part of this as well. All these technologies take something that you’d normally need a huge industrial complex for, scale them down to were they fit on the back of a lorry and make them independent of the infrastructure that their full scale counterparts depend on, therefore enabling sophisticated technology to be plunked down anywhere in the world without requiring anything but electricity. And even that can be provided independently, by using wind or solar power or diesel generators.

Alex calls it “instant urbanism”, but you could also call it cyberpastoralism: get all the tech benefits of living in the city without having to live in the city. There’s always been a strain of that in science fiction, a longing for the death of the city, for technology to advance to the point where a single household (or at best, a village) could provide everything we now need a global infrastructure for through magic replicator tech. In the fifties it was the flying car and fear of the a-bomb that would bring this about (cf. Simak’s City), in the eighties it was cyberspace and telecommuting and now we’re actually seeing a host of technologies maturing or almost maturing that look a lot like real versions of Star Trek replicators.

Of course even thinking about this for a moment makes you realise this independence is phony. You still need factories to manufacture these “suitcase GSM base stations, palletised VSATs, Aggreko gensets, Sun Microsystems containerised data centres” before they can be used and you still need the raw materials before those magickal RepRap machines can do anything, with everything that implies. All that changes is that people who can afford these toys can pretend to be rugged individualists independent from the rest of society, just like they now can pretend to rough it in the countryside in their expensive 4x4s and brand name survival kits.

In the real world the technologies Alex mentions are meant to be used as quick and dirty stop gaps, to work around the lack of a functioning infrastructure until a more permanent solution can be achieved. But when we see the US Army in all seriousness arguing for diesel generators to power Kandahar indefinately, something has gone wrong. Granted, the alternative of building a proper electricity network and getting power from the Kajaki Dam project and protecting both from the “Taliban” is problematic as well. But the choice for diesel is at heart a political one: it means “Afghanistan” has to buy foreign generators, foreign diesel and keeps the country tied to its donors, much more so than if a proper electricification programme is launched. Going the diesel route means Kandahar electricity production is outsourced to whoever wins the army contract — and the first thing you lose when outsourcing is control.