GESTIÓN EN SALUD PÚBLICA: BioEdge: ‘Nature’ squarely behind trans rights

domingo, 25 de noviembre de 2018

BioEdge: ‘Nature’ squarely behind trans rights

BioEdge: ‘Nature’ squarely behind trans rights

Bioedge

‘Nature’ squarely behind trans rights

by Michael Cook | 24 Nov 2018 | 1 comment

To no one’s surprise, the Trump Administration takes a dim view of transgender rights. In October a memo of the Department of Health and Human Services (HHS) was leaked to the New York Times which had drafted a definition of gender based on genetics and genitalia.

The Administration’s aim, apparently, is to create a legal framework “on a biological basis that is clear, grounded in science, objective and administrable” for sex-specific government rules and regulations.

This immediately provoked a protest from Nature, the world’s leading science journal. In an editorial, “US proposal for defining gender has no basis in science” Nature argued that the proposal “is a terrible idea that should be killed off. It has no foundation in science and would undo decades of progress on understanding sex — a classification based on internal and external bodily characteristics — and gender, a social construct related to biological differences but also rooted in culture, societal norms and individual behaviour.”

Interestingly, at about the same time, The Economist, not a science journal, but scrupulously researched, socially progressive and no supporter of Trump, published a sceptical review of the transgender controversy. Its concern was principally that a liberal interpretation of trans rights would put women and children at risk. It is far too early to change legislation incorporating a new understanding of the scientific issues, it argued. “The notion that gender and biological sex are entirely separate is new and poorly understood.”

So, might Nature’s blunt assertion that assigning sex based on genetics and genitalia “has no foundation in science” be too categorical? Perhaps what it really means is that the Trump Administration is ignoring an “expert consensus” which regards sex as complicated and gender as a spectrum.

With respect to sex, it references research that as many as 1% of people are intersex. In fact, an even higher figure of 1.7% is often cited in the media, based on a 1993 paper by Anna Fausto-Sterling. Subsequent research by Leonard Saxin 2002 took a more sceptical view, setting the figure at 0.018%. Whatever the real figure is, it seems to be far from an established scientific fact.

With respect to gender, Nature itself (like The Economist) acknowledges that “Some evidence suggests that transgender identity has genetic or hormonal roots, but its exact biological correlates are unclear.” But if the transgender experience is still a mystery to science, isn't the HHS hypothesis still worth keeping on the table?

The idea that an expert consensus constitutes scientific truth is a familiar legacy of the war over climate change. However, as many observers have pointed out, if consensus were the ultimate criterion, the Church was right and Galileo was wrong. Science works through observation, measurement, experiments, and replication. In the case of transgender issues, there is, thus far, very little of any of these.

Ultimately, Nature’s concern is admirable: protecting the dignity of transgender and non-binary people. It views the plans of the HHS as “the latest in a series of proposals that misuse and ignore science and harm marginalized groups as part of a quest to score cheap political points”. But is redefining the way that science works the best way to do ethics?

Sunday, November 25, 2018

With people as wise as former US Vice-President Joe Biden asserting that transgender equality is the “civil rights issue of our time”, it’s no surprise that the world’s leading science journal agrees. In a scathing editorial late last month Nature argued that the Trump Administration’s “proposal for defining gender has no basis in science”.

There is no doubt that many bioethicists would agree with Mr Biden. In fact, a psychotherapist raised a storm in the British media this week with his interpretation of the crisis. It’s just that he took a view 180 degrees opposed to Nature. “In 20 years’ time, I believe we will look back on this folly as one of the darkest periods in the history of modern medicine,” wrote Bob Withers.

Despite trans Twitterstorms twisting and weaving their way across the bioethical landscape, it seems that the science and ethics of transgender issues is far from settled. It’s worthwhile listening to both sides of the debate.