Stop me if you've heard this one before: "every major medical association endorses gender-affirming care." This factoid is included in just about every article about trans rights... and it makes me extremely nervous. What happens when they stop endorsing it? Appealing to medical authority is a dangerous game.
§ Big Transgender ^
There's a popular misconception that trans people and doctors are natural allies, since we rely on doctors to be able to change our sex. Early anti-trans feminist Janice Raymond even claimed that trans people were created by doctors --- as part of a dastardly plot to abolish Real Women, naturally. These days, transphobes have flipped the script on the conspiracy theory and somehow made it even less plausible: they allege that medical institutions have been "captured" by Big Transgender (also as part of a dastardly plot to abolish Real Women). The way activists confidently proclaim that trans healthcare is endorsed by Major Medical Associations makes me concerned that this mythology has started to spread outside the ranks of the hatemongers.
For most of modern history, doctors have been very hostile to trans people. Their role was not to dispense medicine, but to guard it. Trans people have been using modern medicine to change sex, by hook or by crook, since long before the medical establishment put their stamp of approval on it. As far as I can tell, the only reason this started to change was 1) tireless activism and 2) the evidence was just so overwhelming: they conducted a ton of horrific "research" tormenting children to try to make them un-gay but never succeeded. Doctors went, "okay fine, so we can't torture you normal. I guess we can resort to letting you have what you want (grumble, grumble)."
This brief historical reprieve from medical oppression has, combined with ascendant fascism, created a topsy-turvy world where WPATH, an extremely conservative medical organization once infamous among trans people, gets treated like a pro-trans activist outfit. The US government has targeted them for harassment on this basis. I don't think I can adequately convey just how weird it is for WPATH to be the good guys. Their entire job is (or was) gatekeeping medical treatments. For most of their history there were no trans members. (They have a few now, at least some of whom are outspoken conservatives opposed to trans children's rights.)
§ Premonition ^
What happens when these vaunted Major Medical Associations withdraw their support? Because they will. It's surprising they've held out as long as they have, frankly. Look at how every hospital folded like a leaf when Trump threatened to tighten the pursestrings. And the old creeps are still around! The people who tormented "sissy boys" and kept extensive notes on the fuckability of teenagers1 didn't go anywhere. One guy in Canada lost his abuse factory and that story got spun for the next 100 years as "trans activists went too far"; he's probably looking at illegal images and plotting his revenge at this very moment. We are very lucky that these creeps haven't yet achieved enough power in Major Medical Associations to turn back the clock.
Even in the present, appeals to medical authority are a double-edged sword because the anti-trans movement has made it a priority to generate impressive-sounding pseudoscience. As long as it has a fancy title and a large enough institution at its back, most people will accept it, even if the contents are just paper-thin justifications for anti-trans policies that would have been implemented anyway.
This pseudoscience will continue to proliferate because there's money in it; meanwhile, there's ~0 funding for quality scientific research, and even acknowledging trans people exist is basically illegal. One would expect these conditions to produce a great deal of "evidence" against trans people, and a degradation in the quality of science more generally. It will become increasingly difficult to separate the wheat from the chaff. Left unchecked, they will build a world where medical consensus is firmly against us. Enterprising young hatemongers like SEGM/Genspect have even begun disseminating their materials in continuing medical education classes and medical conferences.
§ Grounding ^
I think we would do well to move away from medical authority and toward moral authority. Bodily autonomy is the most fundamental freedom there is. There is no amount of research that can change this basic fact. We are entitled to change our sex because we are free people, not because 50% + 1 doctors think it will lead to "improved outcomes". Children, likewise, are entitled to live life on their own terms, free of abuse --- especially abuse that attempts to change who they are.
Doctors do a lot of good for the world and we're lucky to have them, but they are not kings. I will still be trans no matter what they decree. My life just plain isn't up to them. It might be tempting to crown experts as a corrective to our monarchy of stupid, but it's the same basic error. No one is more qualified to live your life than you.
Whoever lays his hand on me to govern me is a usurper and a tyrant: I declare him my enemy.
--- PJ