For most trans people, now and historically, a framework of choice doesn't quite fit. Choice doesn't quite fit the intensity of desire to change genders, the pain and failure of trying to force oneself to conform, the lengths people go to to transition, the risks they take.
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Basically, as someone who believes in physical reality and scientific ways of knowing, it's hard not to conclude that an innate physical condition relating to gender dysphoria/discomfort gives rise to the social phenomenon that, in our culture, we call "being transgender".
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And, while I won't go into the evidence on this already long thread, it's perhaps even harder to dismiss the fact that medical interventions are useful and successful for a large number of people who experience gender dysphoria, and that these people rarely experience regret.
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Buying into a scientific/medical framework has strengths and drawbacks. It's not the only useful way to think about or talk about these questions.
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But, in my opinion, it is one of a few useful ways. It's drawbacks shouldn't overshadow its strengths. Medical transition is a gift, and those of us who pursue it need and in fact DESERVE real research, with rigorous standards, to get the best outcomes.
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My wish for the trans community would be to allow ample room for scientific/medical knowledge to inform and improve our lives, while still criticizing science when it goes wrong. /end
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End of conversation
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