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So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
Lawyers fees and court costs? Fine?
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So I wonder if they would be upset if someone showed up in goth attire or punk or any non-conservative attire (I mean slacks and button down shirt or pencil skirt and blouse or solid color dress). Those would be far more bizarre than showing up in uniform.
I also want to know how it protects everyone. The owner of the business only had to see someone dressed differently today than yesterday and treat her appropriately. You had to actually endure the pressure of becoming who you are meant to be.
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I'm no expert in the field of gender jargon, but it seems obvious to me that when filling in a form (or character sheet), 'gender' should not be followed with:
• male/female
nor
• male/female/other
nor
• male/female/(long-and ever growing-list of other terms)
it should simply say:
• Gender:__________
and let you fill in the blank.
That way, anyone who feels that the choice should be limited to male/female (for some reason) can write 'male' or 'female', and this will in no way prevent anyone else from filling in whichever term they prefer.
Would there be any problem with that?
I think this is a great idea. What you've outlined is how the question of gender which closes with an ostensibly exhaustive list of options forecloses possibility. The process which stabilizes gender categories (whether binary or not) depends, in part, on curbing destabilizing alternatives. Requiring people choose girl or boy, female or male, or woman or man insists that these categories constitute an exhausted, essential human disposition.
I have to admit, I always give the gender question a uncomfortable side-glance when filling out forms: as if there *must* be a category in which I can provide a definitive, objective answer. Even at the doctor's office it seems unnecessarily obligatory: as if the health prescriptions my doctor will proved are contingent on me laying claim to maleness or femaleness.
By leaving the question open, the possibility for "new" gender is made and the previous structure of gender is shown to be destabilized. And any attempt to draft up an exhaustive register of genders becomes immediately threatened by the next "boi," "tomboy," "andro," "Θ," etc inscribed into the blank following Gender.
So would the law be better if it required that the child be on hormone treatment? Are their trans folk that don't take hormone treatment?...
Yes, there are trans folk that don't take hormones. For some people, hormone treatment isn't a necessary or desirable part of transitioning or experiencing oneself as a particular gender.
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I have to admit, I always give the gender question a uncomfortable side-glance when filling out forms: as if there *must* be a category in which I can provide a definitive, objective answer. Even at the doctor's office it seems unnecessarily obligatory: as if the health prescriptions my doctor will proved are contingent on me laying claim to maleness or femaleness.
Actually there are medications that work differently in men and women. While they are not the norm, they do exist. Just like there are medications that work differently for different races. I'm not making this up. There are medications that work better or worse for Asians, blacks, etc. There is enough of a difference between people that this is very important information. To make it even more challenging, there are medications that a man can take that can affect a woman if he exchanges bodily fluids. Again, they aren't the norm but they certainly exist.
It's very important in the medical community to have as close to accurate information as possible. This is where I see a problem because gender is more of a social definition while sex is a more medical one. However, people can change their sex and that's where we run into problems sometimes. I don't know how the surgeries affect people. I just know that I'm a pharmacy technician and I have heard a few counselling sessions over medications and what people need to watch out for. I have seen the pharmacist contact the prescriber over a medication because it was inappropriate for a woman (prostate medication is one) but then we were informed that the patient was transgender. That changes how we do our job. We can't always talk to the patient because the Rx is faxed, e-prescribed, or called in and left as a message.
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There are medically relevant classifications that aren't put on standard forms. There's also the fact that gender/sex is singled out as especially important and important for reasons beyond medicine (at least on forms I've seen). Name, sex, age, SSN, and such are grouped together while things like sexual activity or allergies are pushed elsewhere.
I have to admit, I always give the gender question a uncomfortable side-glance when filling out forms: as if there *must* be a category in which I can provide a definitive, objective answer. Even at the doctor's office it seems unnecessarily obligatory: as if the health prescriptions my doctor will proved are contingent on me laying claim to maleness or femaleness.Actually there are medications that work differently in men and women. While they are not the norm, they do exist. Just like there are medications that work differently for different races. I'm not making this up. There are medications that work better or worse for Asians, blacks, etc. There is enough of a difference between people that this is very important information. To make it even more challenging, there are medications that a man can take that can affect a woman if he exchanges bodily fluids. Again, they aren't the norm but they certainly exist.
You'll forgive me for being incredulous at the vague claim that some medications work differently based on the gender of the patient. I'm not ignorant of medical technology (though this dangerous bodily fluid drug transfer is novel to me, pray tell?). I understand how medical procedures often change depending on the sex classification applied to patients: for example, under the ostensible "do no harm" obligation, doctors alter procedures to preserve the functionality of childbirth/care organs in cis woman (even in cases where it is against her wishes). But this comes out of the collapse of the constellation of gender into womanhood that is implicitly defined as the capacity to give birth. The fact that some women don't want children, or can't give birth to children, makes treatment decisions based off which gendere box is ticked seem premature.
And as you've already pointed out, medications directed at sexed organs in the body don't necessarily correspond with gendered bodies taking the drugs. From this perspective, the necessity of gender assignment to patients falls apart: gender doesn't match up with specific organ composition, and thus requires a more detailed investigation that necessarily desexes prostates, ovaries, uteri, etc. Medical professionals are shamelessly clinging to gender as a diagnoses while simultaneously destabilizing the category: the modern shift in focus to treating prostates and ovaries emerges as a consequence of the irreducibly of gender. (And all this without even mentioning the kind of disciplinary power generated through the shoring up biomedical classifications of day-to-day life).
And what are these racially specific drugs? Though I am willing to entertain the materiality of gender articulated through sex, but I usually have a real hard time buying the grounds for the medicalization of racial categories. Seriously: what are these drugs that work deferentially based on the socially circumscribed racial categories?
And what are these racially specific drugs? Though I am willing to entertain the materiality of gender articulated through sex, I usually have a real hard time buying the grounds for the medicalization of racial categories. Seriously: what are these drugs that work deferentially based on the socially circumscribed racial categories?
Race doesn't have to be biological for race-specific medicines to exist and work. It's historical fact that race has been (still is among some?) considered biology. It's not surprising that there'd be research along these lines. When that research inevitably found differences between the groups, it's plausible that that knowledge could be deployed in medical treatments.
Now I'm not personally aware of any race-based medicines. I've heard that rates of some conditions differ by race, but that's not quite the same.
I believe Bi-Dil is one of the big race sensitive medicines out there (and was reference on a House episode as well from memory).
I believe Bi-Dil is one of the big race sensitive medicines out there (and was reference on a House episode as well from memory).
A close inspection of BiDil’s history, however, shows that the drug is ethnic in name only.... [N]o firm evidence exists that BiDil actually works better or differently in African-Americans than in anyone else. The FDA’s approval of BiDil was based primarily on a clinical trial that enrolled only self-identified African-Americans and did not compare their health outcomes with those of other ethnic or racial groups.
So how did BiDil become tagged as an ethnic drug and the harbinger of a new age of medicine? The story of the drug’s development is a tangled tale of inconclusive studies, regulatory hurdles and commercial motives....
Didn't say it worked, didn't say it didn't. Was merely responding to the post immediately above mine with 'I'm not personally aware of any race-based medicines'.
A couple minutes more google-fu - atenolol reacts differently depending on race.
Note: I'm just trying to show that they exist, as Bob stated upthread...
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So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
I'm liking this Kirkeby fellow.
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I'm liking this Kirkeby fellow.So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
As am I. At least one of our local Senators has a head on his shoulders.
Digital Products Assistant
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So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
High fives for being a force for change! I'm sorry that this "senator" decided that because a trans woman was wearing them, ordinary clothing became "bizarre," but I'm thrilled that you got some justice in the courts.
So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
So, basically, that Senator tried to shame you and make you the villain in front of an entire state... and only made himself look like a jerk.
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I have to admit, I always give the gender question a uncomfortable side-glance when filling out forms: as if there *must* be a category in which I can provide a definitive, objective answer. Even at the doctor's office it seems unnecessarily obligatory: as if the health prescriptions my doctor will proved are contingent on me laying claim to maleness or femaleness.Actually there are medications that work differently in men and women. While they are not the norm, they do exist. Just like there are medications that work differently for different races. I'm not making this up. There are medications that work better or worse for Asians, blacks, etc. There is enough of a difference between people that this is very important information. To make it even more challenging, there are medications that a man can take that can affect a woman if he exchanges bodily fluids. Again, they aren't the norm but they certainly exist.You'll forgive me for being incredulous at the vague claim that some medications work differently based on the gender of the patient. I'm not ignorant of medical technology (though this dangerous bodily fluid drug transfer is novel to me, pray tell?). I understand how medical procedures often change depending on the sex classification applied to patients: for example, under the ostensible "do no harm" obligation, doctors alter procedures to preserve the functionality of childbirth/care organs in cis woman (even in cases where it is against her wishes). But this comes out of the collapse of the constellation of gender into womanhood that is implicitly defined as the capacity to give birth. The fact that some women don't want children, or can't give birth to children, makes treatment decisions based off which gendere box is ticked seem premature.
And as you've already pointed out, medications directed at sexed organs in the body don't necessarily correspond with gendered bodies taking the drugs. From this perspective, the necessity...
According to the FDA, Ambien has different dosages at which it is safe, depending on biological sex.
From that same article, Aspirin is another; in fact, Aspirin even has different effects in healthy biological men than it does in healthy biological women. I didn't even need the article to know that, though; it's covered in the classes necessary to be a nurse at my college and I've overheard surprised classmates talking about it way too many times.
In fact, it's looking like they're beginning to think that the entire idea of drugs affecting both sexes the same is not only wrong, but inherently dangerous.
All I'm doing is showing that not only do these exist, but this is the current thinking in drug testing procedures.
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According to the FDA, Ambien has different dosages at which it is safe, depending on biological sex.
Actually, the FDA had requested that the drug manufactures to set both men and women's dosages to the same low level. But the drug makers elected to only change women's dosages. All this despite the fact that there were both men and women were found to have residual Zolpidem/Abien in their systems on the mornings following taking the drug. Whatever the justification the FDA had for requesting lower doses for both, but only enforcing it for men, it commutes between the scientific facts and the socially organized constellations of gender.
I entertained Bob_Loblaw claim about the medical necessity of binary gender categories, in part because I wanted to flush out the details of the claim (am always excited to learn about new instances where medical science has laid claim to some "truth" about gender), and in part because it was an entertaining red harring. Vague references to specific drug interactions aren't convincing, and they implicitly rest on a claim of biomedical authority over the materiality of gender. Medicine takes up certain physical characteristics of the body (sexed organs, sexed hormones, etc) and articulates them through gender. It is only after we've convinced ourselves that ovaries, prostates, and hormones "make the wo/man," that medical practice organized around gender can proceed. To put another way, these categories aren't vindicated by biomedical science's ability to deferentially prescribe treatments based on gender. Rather, biomedical science depends on stabilizing these categories---sometimes through violent means---before it can deploy gendered technologies.
And like I said earlier, I totally already understand that modern medical practice is already organized around the patient as an essentially gendered subject. This produces the necessity of the closed question of gender and the insisted binary thereof. In fact, this very organization is what makes doctors believe that violent reconstructive surgeries on perfectly healthy intersexed babies is part of their job: in a social world where gender is rendered biologically essential, we see gender enforced through biomedically disciplined erasure of bodily difference.
I guess that's why I really liked Malachi Silverclaw idea: it destablized gender as a category in medical/scientific practice. If the question is left open, then there is no "easy" way to ascribe a gender to a newborn. The contemporary binary enables violent medical practices, but if there is no obvious binary, who is the doctor to go about measuring up infant gentiles for the purposes of (sometimes violent) gender assignment? An open question can be left to the future, and in the future always be revisited for a rewrite.
I agree with a lot of what you are writing, Annabel, but I am curious.
A person is either born with a prostrate, or not. Now, regardless of if that individual is "male" or "not-male" by any social standards, isn't it still medically describable as a person, "Born with a prostrate?" And if this is important to the bodies overall health, the treatment of the body that has a prostrate versus the treatment of the body that does not have a prostrate, wouldn’t this ultimately ensure a division in the practice of medicine among individuals based upon the organs they have, or do not have?
Yes, I think that the presences and character of prostates is a medical description that can be useful for medical practice. The presence or absence of a prostates will divide medical practice, but I don't think that it ought be any difference than how the presence or absence of a pancreas, gallbladder, or wisdom teeth divide medical practice.
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I think one way to understand what Annabel was getting at is that we should say what we mean, rather than collapsing a bunch of different things into sex. For example, if there's a certain medical procedure for people with prostates, then we should talk about it as a medical procedure for people with prostates, rather than as a medical procedure for men. If there's a medical procedure for people with XX chromosomes, then we should talk about it as a medical procedure for people with XX chromosomes, rather than a medical procedure for women. The problem is, collapsing all these different things into the categories of woman and man leads to conflicts when, as is common, someone doesn't fit perfectly into these prescribed categories. Consider the anecdote Bob_Loblaw shared:
I have seen the pharmacist contact the prescriber over a medication because it was inappropriate for a woman (prostate medication is one) but then we were informed that the patient was transgender.
The problem here is that medication inappropriate for a woman is actually medication inappropriate for some women. By saying what is actually meant rather than collapsing everything into one category of sex, we can avoid these issues.
I'm not sure it makes sense in the case presented directly above to place the burden on doctors and pharmacists. This pharmacist was trying to make sure that her patient was not inappropriately prescribed medicine. Mistakes do happen.
It makes more sense that if you know you are biologically a man but look like a woman you tell your pharmacist. The pharmacist is not a mind reader and as has been pointed out sometimes things are not obvious.
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What additional burden is being placed on doctors and pharmacists? If the medication in question was labeled as for people with prostates, how does that place any additional burden on doctors and pharmacists?
you know you are biologically a man but look like a woman
I hope it's not necessary for to me to explain in this thread why that phrasing is problematic.
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I don't think I understand, so I will bow out before I make a fool of myself, or insult someone unintentionally.
I think Vivianne's explanation captures what I was saying pretty well.
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I'm not sure it makes sense in the case presented directly above to place the burden on doctors and pharmacists. This pharmacist was trying to make sure that her patient was not inappropriately prescribed medicine. Mistakes do happen.
It makes more sense that if you know you are biologically a man but look like a woman you tell your pharmacist. The pharmacist is not a mind reader and as has been pointed out sometimes things are not obvious.
There are people who are "biologically" women, and look like women, and have prostates.
Not to put to fine a point on it, but the "biologically/medically" classified categories of gender are unstable, and thus open to challenge. This is made apparent by the fact that there are plenty of people who lay claim to various categories of gender (men and women being two very popular options) while simultaneously not embodying the tidy package of sexed characteristics ascribed as "biological" genders.
According to the FDA, Ambien has different dosages at which it is safe, depending on biological sex.Actually, the FDA had requested that the drug manufactures to set both men and women's dosages to the same low level. But the drug makers elected to only change women's dosages. All this despite the fact that there were both men and women were found to have residual Zolpidem/Abien in their systems on the mornings following taking the drug. Whatever the justification the FDA had for requesting lower doses for both, but only enforcing it for men, it commutes between the scientific facts and the socially organized constellations of gender.
Except they didn't recommend equal dosages for men. The initial recommendation had this to say:
The recommended dose of zolpidem for women should be lowered from 10 mg to 5 mg for immediate-release products (Ambien, Edluar, and Zolpimist) and from 12.5 mg to 6.25 mg for extended-release products (Ambien CR).
Here's the current recommendation:
Also included in the updated label are the dosing recommendations previously stated in FDA’s January 2013 Drug Safety Communication: The recommended initial dose of certain immediate-release zolpidem products (Ambien and Edluar) is 5 mg for women and either 5 mg or 10 mg for men. The recommended initial dose of zolpidem extended-release (Ambien CR) is 6.25 mg for women and either 6.25 or 12.5 mg for men.
They're recommending that women must have a lower dose... but their recommendation for men actually lists two doses. And it's mandated to be on the packaging, which means companies don't have a choice about complying with showing the recommended dosages.
I entertained Bob_Loblaw claim about the medical necessity of binary gender categories, in part because I wanted to flush out the details of the claim (am always excited to learn about new instances where medical science has laid claim to some "truth" about gender), and in part because it was an entertaining red harring. Vague references to specific drug interactions aren't convincing, and they implicitly rest on a claim of biomedical authority over the materiality of gender. Medicine takes up certain physical characteristics of the body (sexed organs, sexed hormones, etc) and articulates them through gender. It is only after we've convinced ourselves that ovaries, prostates, and hormones "make the wo/man," that medical practice organized around gender can proceed. To put another way, these categories aren't vindicated by biomedical science's ability to deferentially prescribe treatments based on gender. Rather, biomedical science depends on stabilizing these categories---sometimes through violent means---before it can deploy gendered technologies.
And like I said earlier, I totally already understand that modern medical practice is already organized around the patient as an essentially gendered subject. This produces the necessity of the closed question of gender and the insisted binary thereof. In fact, this very organization is what makes doctors believe that violent reconstructive surgeries on perfectly healthy intersexed babies is part of their job: in a social world where gender is rendered biologically essential, we see gender enforced through biomedically disciplined erasure of bodily difference.
I guess that's why I really liked Malachi Silverclaw idea: it destablized gender as a category in medical/scientific practice. If the question is left open, then there is no "easy" way to ascribe a gender to a newborn. The contemporary binary enables violent medical practices, but if there is no obvious binary, who is the doctor to go about measuring up infant gentiles for the purposes of (sometimes violent) gender assignment? An open question can be left to the future, and in the future always be revisited for a rewrite.
So, in other words, people who are transgender that want to transition are wrong for wanting to transition to the sex they feel most comfortable as, doctors are wrong for wanting to help them, and the hormone therapies that help people transition are wrong? And this particular field of science, which has always been based on the assumption that sex does not play a part in how drugs are metabolized by the body, is wrong when it finds out that may not necessarily be true and that it adjusts recommendations on some medications (not even the majority by a long shot) to reflect that?
So, do you have any evidence to support this stance? Because I think the people who have already transitioned would love to hear it. And I certainly would love to learn how an entire field of science is wrong on this issue. And I mean scientific evidence; not just conjectures and wild accusations. I want studies.
Edit: If anyone is curious, read the part about hormones and the part about biomedically disciplined erasure of bodily difference in Annabel's post again; those are the entire medical basis for gender reassignment surgery.
What additional burden is being placed on doctors and pharmacists? If the medication in question was labeled as for people with prostrates, how does that place any additional burden on doctors and pharmacists?
you know you are biologically a man but look like a womanI hope it's not necessary for to me to explain in this thread why that phrasing is problematic.
No you don't. Your point here is the whole point. How is labeling medicine "for a man" different from "has a prostate" if you can't tell by looking at someone. After all, you can't see someone's prostate. The pharmacist in question would have had the same problem regardless. "Patient appears to be a woman. Women don't have prostates. Has a mistake been made."
It is much simpler and safer for a patient to self-identify than to leave it up to a doctor/pharmacist's guesswork.
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How is labeling medicine "for a man" different from "has a prostate" if you can't tell by looking at someone. After all, you can't see someone's prostate. The pharmacist in question would have had the same problem regardless. "Patient appears to be a woman. Women don't have prostates. Has a mistake been made."
I don't understand your point. It seems like your scenario is completely analogous to what happened in Bob_Loblaw's story. Which would mean that labeling the medicine as for prostate-havers does not put an additional burden on doctors and pharmacists.
What additional burden is being placed on doctors and pharmacists? If the medication in question was labeled as for people with prostrates, how does that place any additional burden on doctors and pharmacists?
you know you are biologically a man but look like a womanI hope it's not necessary for to me to explain in this thread why that phrasing is problematic.No you don't. Your point here is the whole point. How is labeling medicine "for a man" different from "has a prostate" if you can't tell by looking at someone. After all, you can't see someone's prostate. The pharmacist in question would have had the same problem regardless. "Patient appears to be a woman. Women don't have prostates. Has a mistake been made."
It is much simpler and safer for a patient to self-identify than to leave it up to a doctor/pharmacist's guesswork.
I'm going to say that you're correct on this, in that the patient really should inform the pharmacist of having a prostrate, but beyond that I'm going to side with Vivianne and agree that they shouldn't be defining medicines as male or female.
My use of "biologically male" and "biologically female" is only for ease of communication, not agreement with terms. Vivianne makes a good point as to why that's wrong.
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I've had my gall bladder removed.
I miss it.
I can no longer enjoy cajun food without...unpleasant repurcussions.
I thought the point of the story was that the patient was upset that the pharmacist had to check because of the patients perceived gender identity. Perhaps I misinterpreted the story from your quote and your statement that medicines/treatments should be assigned more specifically based on biology and genetics.
My point was neither biology nor genetics are obviously apparent in some cases so confusion is still possible.
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So, in other words, people who are transgender that want to transition are wrong for wanting to transition to the sex they feel most comfortable as, doctors are wrong for wanting to help them, and the hormone therapies that help people transition are wrong?
I never made this claim. In fact, the structure I laid out with the open-ended question of gender quite obviously opens up the possibility for trans men and women to seek medical care and technologies for the purpose of embodying their gender. Because the "fact" of their bodies isn't prewritten by medical professionals, the opportunity to transition ot the sex they feel most comfortable as isn't foreclosed by a history of (sometimes violent) medically predetermined gender.
And this particular field of science, which has always been based on the assumption that sex does not play a part in how drugs are metabolized by the body, is wrong when it finds out that may not necessarily be true and that it adjusts recommendations on some medications (not even the majority by a long shot) to reflect that?
As I said, sex isn't a stable category. If the question is about the presence or characteristic of COX when aspirin is to be used to treat cardiovascular health, then talk about the presence or characteristic of COX. Sex is being used as an unstable proxy for the actual mechanism of ASA that varies between people (sometimes men and women, though not always).
So, do you have any evidence to support this stance? Because I think the people who have already transitioned would love to hear it. And I certainly would love to learn how an entire field of science is wrong on this issue. And I mean scientific evidence; not just conjectures and wild accusations. I want studies.
Edit: If anyone is curious, read the part about hormones and the part about biomedically disciplined erasure of bodily difference in Annabel's post again; those are the entire medical basis for gender reassignment surgery.
I am not exactly sure what you're specifically talking about, you clipped a rather large and dense quote of mine. While writing this I had in mind people who are intersexed as experiencing medically prescribed violence, though there are many trans men and women who experience this effect too. Ann Fausto-Sterling (Sexing the Body: Gender Politics and the Construction of Sexuality, 2000 and Sex/Gender: Biology in a Social World, 2012) and Suzanne Kessler ("The Medical Construction of Gender" from Lessons from the Intersexed, 1998), are the two researchers that come immediately to mind when I think about these issues, they'd be excellent sources to seek out if you're interested.
I mean, it's worthwhile to note that some trans men and women don't want to undergo all or any forms of medical reassignment. The medical authority that leverages this form bodily desire as the only "legitimate" end goal of transitioning enacts violence against trans people who don't want to seek certain surgical or hormonal treatments.
Yes, there are trans people who seek out medical practices to bring their bodies into closer alignment to their gender, and this is completely fine (and especially fine when they can achieve these goals without disciplining medical surveillance). But the fact that you seem to think this is the only way to embody a particular gender belies a fundamental misunderstanding.
I think I understand, however, Annabel, your statement,
There are people who are "biologically" women, and look like women, and have prostates.I feel complicates the discussion unnecessarily. Because what do you mean by, "Biologically" Women? Do you mean they identify as women, or do you mean they have ovaries and/or a uterus? Isn’t the whole discussion about the nuances of what it means to say someone is a “woman” or is a “man”?
Making a statement such as “…are biologically women…” implies there is no ambiguity.
She may be referring to the Skene's gland, which was recently renamed the female prostrate, or to people who, due to a quirk, are XY but developed as female. Or to a number of other possibilities.
It's not overcomplicating it much because it is actually a real-life phenomenon. And is actually a very good reason as to why labelling medicine as being for men or women is potentially dangerous.
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I think I understand, however, Annabel, your statement,
There are people who are "biologically" women, and look like women, and have prostates.I feel complicates the discussion unnecessarily. Because what do you mean by, "Biologically" Women? Do you mean they identify as women, or do you mean they have ovaries and/or a uterus? Isn’t the whole discussion about the nuances of what it means to say someone is a “woman” or is a “man”?
Making a statement such as “…are biologically women…” implies there is no ambiguity.
Wait, where are we going with this? The question was about prostate. How did the question of ovaries and/or uteri come into the question about medical practice directed at prostates. It's completely possible for someone to have ovaries and a prostate. I mean, this is exactly what I mean when I say that medicalized sex/gender is unstable.
I am exactly questioning (troubling?) the assertion that the concept of a "biological woman" is without ambiguity.
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I thought the point of the story was that the patient was upset that the pharmacist had to check because of the patients perceived gender identity. Perhaps I misinterpreted the story from your quote and your statement that medicines/treatments should be assigned more specifically based on biology and genetics.
My point was neither biology nor genetics are obviously apparent in some cases so confusion is still possible.
Oh, my point wasn't that the patient was or wasn't upset. My point was that the confusion arose out of the equating of man with prostate-haver. Of course, just changing how medicine is labelled won't immediately change how pharmacists and doctors think about these things. This is how we'd get your scenario of the pharmacist wanting clarification to make sure the prostate medicine is intended for the female patient.
But since the confusion arises out of this collapse of men with prostate-havers, the way out of this confusion is to move away from this collapse, even if it takes time for the confusion to dissipate.
disciplining medical surveillance
Michel Foucault much?
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It's prostate. Not prostrate.
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I never made this claim. In fact, the structure I laid out with the open-ended question of gender quite obviously opens up the possibility for trans men and women to seek medical care and technologies for the purpose of embodying their gender. Because the "fact" of their bodies isn't prewritten by medical professionals, the opportunity to transition ot the sex they feel most comfortable as isn't foreclosed by a history of (sometimes violent) medically predetermined gender.
The problem is, the idea that their bodies being a certain sex as prewritten by medical professionals is the entire basis for what led to the rise of gender reassignment surgery. It's basically the assumption that makes the surgery actually considered a sound medical practice within medicine. Because it comes with it a possibility: The mind does not match the body. The mind not matching the body, with the body being a prewritten determination, indicates that something is malfunctioning. And since medical science predicates upon fixing malfunctions within the human body, the idea that the biological sex is prewritten and does not match the mental gender creates a scenario where a correction of the biological body to match the mental gender is an approved course of action and actually considered beneficial to the patient.
The inherent problem with what you're arguing is that it removes the entire basis for gender reassignment surgery to be considered a sound medical practice. Which, given both the cost of it and the opposition, opens the doors to it being banned.
A certain amount of assumption about things being a prewritten determination is necessary within medical science; without it, they would be unable to identify any particular disease and successful treatments, would not be able to identify and correct birth disorders through gene therapy, and would not be able to perform most of the life-saving surgeries they currently are capable of. It also would mean the end of pharmacology, as pharmacology depends upon prewritten determination as to biological results to be able to tell whether or not their drugs are actually having the desired effects during drug testing.
It's also the basis of how vaccines and antibiotics work, as there are known prewritten determinations to how they interact with the body and with diseases. So this might lead to the total collapse of human civilization, given how much of modern civilization depends upon our ability to counter disease.
While I agree with you that the procedure should not be forced upon people, I do disagree that the mental process which leads to it is not necessary. It's the foundation of how medical science operates and there are no alternative cognitive paradigms which exist within the limits of human understanding that could easily replace it.
Instead, I think the problematic areas of it should be refined; instead of assigning a particular sex to a medicine, assign the effects based upon bodily structures that cause the alternative effects. By moving the essential paradigm of prewritten determinations farther towards the specific, we remove a lot of the inherent discrimination, remove a lot of the inherent assumptions, and create a medical basis of adaptability that allows medicine to easily be assigned to those who are outside the old binary assumption where it comes to physical structures. We also preserve the essential prewritten determination paradigm that makes medical science possible.
As I said, sex isn't a stable category. If the question is about the presence or characteristic of COX when aspirin is to be used to treat cardiovascular health, then talk about the presence or characteristic of COX. Sex is being used as an unstable proxy for the actual mechanism of ASA that varies between people (sometimes men and women, though not always).
You have my apology for that challenge. Vivianne and your own post, upon further examination, showed that there is error within it.
I am not exactly sure what you're specifically talking about, you clipped a rather large and dense quote of mine. While writing this I had in mind people who are intersexed as experiencing medically prescribed violence, though there are many trans men and women who experience this effect too.
There's no need to answer the evidence question. I am embarrassed that I asked it. I had misread what you meant, and for that you have my apology.
It's prostate. Not prostrate.
Oops...
We really need an embarrassed smiley on this forum. I could use it!
Though, one of my friends, while looking over my shoulder, snickered and said, "It depends on how hard you kick it."
I think I shall be wearing body armor for the next few days...
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High fives for being a force for change!...So yesterday, the sponsor of the hate bill I fought so hard against this week was asked about it at a Town Hall meeting. This was the discourse:
Hannah Wisser, a freshman physics major at the South Dakota School of Mines & Techonology, asked about the status and reasoning behind Senate Bill 128.
"A recent bill that just went through committee was Senate Bill 128 and this question can either be for Senator (Phil) Jensen or whoever else would like to comment. The bill was directed toward sexual orientation and I was just curious, in case of further bills on the matter, why sexual orientation was under different protection from either race or religion? By that, I mean deserving of less protection from our laws."
Sen. Phil Jensen, R-Rapid City: "Senate Bill 128 simply provided protection for individuals and businesses. A recent example where this bill could have been protective and helpful was Don's Valley Market, which recently paid $60,000 because of a situation with an employee who decided to go transsexual or was transsexual and started showing up in uh, (long pause) rather bizarre clothing. It was found by the employer to be disturbing to customers and fellow employees. This was in Senator (Mark) Kirkeby's district, District 35, and Senator Kirkeby referred to this bill as 'vengeful, hateful and mean,' when in reality, it would have be protective and helpful for this business. It provides equal protection for all people, all individuals regardless of your religious beliefs or your sexual orientation."
Sen. Mark Kirkeby, R-Rapid City: "As much as I want to bite at the apple at the previous speaker, I will certainly not do that. Senate Bill 128 had a full, fair and complete hearing. It died in committee and I'll let it go at that."
For the record, I am that employee who 'decided to go transsexual'. And the 'bizarre clothing' was the store uniform. Also, I'd like to know where the additional $10,000 I supposedly got is.
Thanks Crystal. I'm doing my best to be strong, though his comments truly did rattle me last night. I'm still angry, but able to breathe a little better today. I wish I lived in his district, so I could get the satisfaction of voting against him.
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you have a highly convoluted way of making your point, and as such I cannot easily follow it, I am sorry for making a mistake in trying to understand what you are trying to say. So, you think that there is not, in fact, any person who is "Biologically a woman" who has a prostate, if I understand, because you, in fact, think there is no such thing as "biologically a woman" but only used that statement to make a point about its adsurdity?
I suppose because I'm not a scientific realist, I can safely say I don't think "biologically a woman" means anything until an outline of qualifications are made. This process of outlining is a kind of social practice where the characteristics that designate "biologically" a gender are negotiated. These characteristics are open to question, just like any other social practice. Further, the grounds on which we assert certain "true" categories of gender change as the discussion continues: are we talking about chromosomes, prostates, uteri, brains, hormones, or what?
So we can talk about "biologically a woman," but the term "biological" is only serving to obscure whatever material reality that's being articulated as gender.
Annabel and Vivianne,
I find the approaches you’re taking very interesting, but I was wondering if I might ask you to elaborate a bit. I’m posting off the top of my head, so please feel free to ask me to clarify if I end up being a bit too vague.
I guess I’m most interested in your thoughts on what the ideal solution might be to the cultural muddle of sex and gender, particularly for people who might strongly identify within binaries. That is, if we can decouple gender from sex entirely, what sorts of work can ideas about sex do? Would we want to try to argue whether sex is a matter of gross anatomy, chromosomes, or hormones? I’m thinking in particular of the implications for how we might understand the range of trans* people’s desires, especially those who transition. What does it mean that some people pursue hormone treatment and surgery even though they are not strictly necessary for the experience of being trans or of transition? Is that just the result of the cultural mix-up of sex and gender, or are people onto something when they postulate differences between average neural structures and epigenetic influences? Is there a responsible and meaningful way to acknowledge our embeddedness in discourse when trying to do neuroscience, say, like a more sophisticated version of, “We’re trying to be objective but what we’re looking for and what we can conceive of are limited by the preconceptions we haven’t been able to shake off?”
Perhaps the most concrete example would be how we might think about transgender people who, in MagusJanus’ words, “want to transition to the sex they feel most comfortable as” (emphasis added), or trans people who distinguish more or less sharply between transsexual and transgender.
Also, Annabel, could you go into what you meant about being “willing to entertain the materiality of gender articulated through sex” in a bit more detail? I’m feeling a bit dense that I’m not feeling sure that I know what that entails.
Sigh. One of these days this girl should really get around to reading Judith Butler, at least. :) I’m also open to any other suggested reading people might care to make about the sex and gender mess. I apologize if any of the foregoing seems disingenuous or insulting to anyone reading: that was certainly not my intent.
Brief addendum: I see that while I was composing quite a few other posts have been made; I’m sure some of what I’ve meant to ask has been answered already.
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And what are these racially specific drugs?
When you get into pharmacokinetics, you can and will see some radically different metabolic profiles across different racial groups. Among what we broadly classify as races, you have populations that have population level SNPs for various P450 enzymes in the liver just as an example, that can radically affect the dosage and safety profile of specific drugs. If you under or overexpress Cytochrome P450 3A4 for instance, that has major ramifications for a patient, and it's often useful to consider racial population demographics of certain P450s when giving certain drugs to people in those populations.
Ideally we could sequence a specific patient for this information, but we're not quite there yet (almost at a commercially viable level for that!), so going by "racial" population genetics can be useful.
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The problem is, the idea that their bodies being a certain sex as prewritten by medical professionals is the entire basis for what led to the rise of gender reassignment surgery. It's basically the assumption that makes the surgery actually considered a sound medical practice within medicine. Because it comes with it a possibility: The mind does not match the body. The mind not matching the body, with the body being a prewritten determination, indicates that something is malfunctioning. And since medical science predicates upon fixing malfunctions within the human body, the idea that the biological sex is prewritten and does not match the mental gender creates a scenario where a correction of the biological body to match the mental gender is an approved course of action and actually considered beneficial to the patient.
I think this raises an important point. Whatever the problems with the current establishment, it is the current establishment. Our lives are shaped by it. I'm reminded of the ongoing issue of "gender dysphoria" being in the DSM. Clearly, transgenderism isn't a mental disorder and hence shouldn't be in the DSM. At the same time, this categorization is what makes it possible in the current system for a lot of trans people to receive medical attention, be covered by insurance, etc. Just removing gender dysphoria from the DSM without changing anything else would lead to material harm to a lot of trans people.
I think something similar is happening with this idea of body sex versus brain sex. The idea of a prediscursive body is important in modern western medical science. It informs how transgenderism is considered. We can't excise just that one idea while leaving everything intact without causing harm to a lot of people. At the same time, the idea that all trans people fit a narrow spectrum of experiences, that all trans people desire the same process of medical treatments, hormone therapy, surgery, etc., is false. It excludes a lot of people. We're in a situation without an easy solution because the real world is shitty like that.
What does it mean that some people pursue hormone treatment and surgery even though they are not strictly necessary for the experience of being trans or of transition?
I don't think it really means anything. Hormone treatment and surgery aren't necessary for the experience of being trans, but they are necessary for some people's experience of being trans. There isn't only one way to be trans.
I do think there is something to be said about how the system of making trans people jump through hoops to receive medical treatment has shaped behavior. I was reading something a month or so ago (I believe it was a piece by Julia Serano, but I'm not absolutely certain) about some psychiatrists referring to their trans patients as deceptive and lying. What was happening was that these trans people were presenting themselves so as to try to convince the doctors that they were "truly" trans, that they fit the checklist of things being watched for. That way, they'd be allowed to transition. Their patients were just trying to make their lives livable in the only way made available to them, but the psychiatrists pathologized them for this. Rather than being a problem with a system which forces people to subject themselves to powerless situations, it must be a problem with these individual trans people. That totally makes sense!
The point is, the power within the medical establishment will influence how trans people act. Are people meeting the standards of being a trans person because those standards are accurate, or is it because they are acting that way so that they can receive necessary medical treatment?
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I have to admit, I always give the gender question a uncomfortable side-glance when filling out forms: as if there *must* be a category in which I can provide a definitive, objective answer. Even at the doctor's office it seems unnecessarily obligatory: as if the health prescriptions my doctor will proved are contingent on me laying claim to maleness or femaleness.Actually there are medications that work differently in men and women. While they are not the norm, they do exist. Just like there are medications that work differently for different races. I'm not making this up. There are medications that work better or worse for Asians, blacks, etc. There is enough of a difference between people that this is very important information. To make it even more challenging, there are medications that a man can take that can affect a woman if he exchanges bodily fluids. Again, they aren't the norm but they certainly exist.You'll forgive me for being incredulous at the vague claim that some medications work differently based on the gender of the patient. I'm not ignorant of medical technology (though this dangerous bodily fluid drug transfer is novel to me, pray tell?). I understand how medical procedures often change depending on the sex classification applied to patients: for example, under the ostensible "do no harm" obligation, doctors alter procedures to preserve the functionality of childbirth/care organs in cis woman (even in cases where it is against her wishes). But this comes out of the collapse of the constellation of gender into womanhood that is implicitly defined as the capacity to give birth. The fact that some women don't want children, or can't give birth to children, makes treatment decisions based off which gendere box is ticked seem premature.
And as you've already pointed out, medications directed at sexed organs in the body don't necessarily correspond with gendered bodies taking the drugs. From this perspective, the necessity...
So some medications, like isotretinoin, can cause serious birth defects. There is an involved process to getting the prescription. Women must have a pregnancy test before each prescription and they have 7 days to pick it up otherwise they need a new prescription. Men have longer but they also have a time limit. There can never be refills on this medication. The patient, prescriber, and pharmacy needs to go to a page called Ipledgeprogram.com and answer specific questions. Each prescription is tracked. It can even affect a man's semen which can cause birth defects. It's not as common but it can happen. This is a very potent acne medication.
For medications that work differently based on race, Crestor requires a higher dose for Asians than for other races. They don't metabolize the medication as easily. Some blood pressure medications can be a problem for people with a higher chance of having sickle cell anemia, namely blacks.
Flomax is typically prescribed to men with benign prostatic hyperplasia but it can be prescribed to women for bladder incontinence. The dosing will be different. So it's very important for the doctor and the pharmacist to know why it's being prescribed. Women don't have prostates. A MtF transgender might have a prostate. That's important information to ensure patient safety and medication effectiveness.
More about race: when it comes to bone marrow transplants, it's more likely to be a match when it comes from the same race. One thing that doctors are finding challenging is the increase in mixed race families. They aren't saying that mixing races is a problem. They are saying that we need better ways to deal with the transplant problems.
There aren't a lot of instances where race or sex matter but there are some. Physiologically we are all very similar but there are some minor differences that can really matter.
I want to reiterate something I mentioned before: sex is a scientific/biological term. Gender is a social construct. Medicine does not care about your gender. It can care about your sex. Too often we interchange the terms but they really are separate terms.