Evan Urquhart

I'm not sure what you mean by "best outcomes." And I'm not sure how you're quantifying that. Do we treat someone with body dysmorphia, or anorexia, or OCD this way? "Oh yes dear, you do look fat. Better lose another 10 pounds." No, we attempt to treat the problem in their psyche.

You seem to be laboring under a common misconception of what mental illness is and isn't. Mental illness isn't when someone has beliefs that seem outrageous or factually wrong. It's about functioning.

An anorexic's functioning doesn't improve if they lose 10 pounds- it gets worse and worse the more weight they lose. Medical science isn't trying to change an anorexic's wrong beliefs into right ones, it's merely seeking to improve their functioning.

A lot of people think that treatment of mental illness is about making people with abnormal beliefs change those beliefs to become normal. But, medicine doesn't care what we believe (thank goodness!) it cares about how we're functioning.

Trans people function poorly when they're forced to conform to their birth-assigned gender and function better after they change gender. So, the job of medical science isn't to judge which beliefs are right, it's just to provide whichever intervention improves functioning.

I would never advocate forcing an adult to conform to anything but the law of the land. Let them live how they want. Children are not mature enough to make these life-altering decisions and doctors should not be helping them "transition."

Personally, I think potentially saving a child's life is more important. Kids shouldn't be denied evidence based treatment for a condition because you're personally uncomfortable with that treatment.

You're right. I'm personally uncomfortable with the fact that a child, not old enough to buy alcohol or vote, can tell adults he needs to be castrated, which is irreversible, and the adults help him do it.