Thursday: Hili dialogue

31 thoughts on “Thursday: Hili dialogue”

1. We should notice that this was the 17th Annual Convention for Palestine from which I infer this has been a well placed and sustained yearly pali con for more than a decade. Also, the registration was cheap…sixty bucks for an adult for two days which indicates to me a huge subsidy from somewhere. Yes Jerry, this event starts to explain … no, goes a long way in explaining…how quickly and professionally so many college encampments came about last year. Much like how quickly the uni’s official DEI structures could move smartly and expeditiously in an environment of sincere but scattered and unorganized faculty pushback.

   1. Should have included it above, but on a happier note, there is an essay in today’s Chicago Maroon, the UChicago student newspaper, on the re-opening of Botany Pond and our dear Honey even got some ink! Url is https://chicagomaroon.com/44729/grey-city/photo-essay-a-brief-history-of-the-botany-pond-restoration/

2. Looking for ways to palestinize your campus? Here are some useful, tried-and-true suggestions:

   • Weaponize rape. If they’re indecent (that is, not dressed in a bag), they’re asking for it.
   • Send hundreds of missiles in a sneak attack into the administration buildings.
   • Infirmary or hospital on campus? Hide your rocket launchers and/or hostages there.
   • Need a slogan for a protest sign? Try this one: “We’re not anti-semitic, we’re anti-zionist (wink wink, nudge nudge).”
   • If the attacks all go well, write to the campus newspaper, and whine about how you are victims of genocide.

3. Is this where money that is supposed to go to the actual Palestinians in Gaza is ending up? So US college students are using money intended for the people they supposedly are concerned about?

4. It is often said that medicine is an art as much as a science, and it is true, as the introduction of science into medicine is a relatively recent phenomenon. An under-appreciated effect that this has is that physicians do not have the mindset of a hard scientist, and if they did, they would be poor physicians. I’m sure Dr Novella is a decent neurologist, but he reveals his weaknesses when he tries to pontificate on a matter of science (for example, quoting the American College of Pediatricians, which is a similarly confused body trying to be nice to patients rather than taking a pure science point of view). A degree in physiology and a medical qualification does not make one a biologist, and the reliance on authority begins to fall apart when we argue as to whether we should believe in the authority of a developmental biologist over an evolutionary biologist, when the man in the street can say with complete clarity that there are quite obviously only two sexes. “There are some ideas so absurd that only an intellectual could believe them,” as Orwell said.
   The reason for the existence of sexes is sexual reproduction, which requires two, and only two, sexes. How should a spectrum of sexes evolve when such a simple system already gives all the evolutionary advantages of sexual reproduction over asexual? To try to confuse the picture with associated features (secondary sexual characteristics, hormonal levels, behavioural differences, congenital developmental disorders) is to lose sight of the purpose of sexual reproduction. It’s woolly thinking and it’s wrong.

   1. “that physicians do not have the mindset of a hard scientist,”

      Chris I used to take the above as a given (I dropped out of med school as a student).

      I’ve found in recent years that many doctors indeed DON’T actually have the mindset of a hard scientist. Which surprised me. They’re usually pretty IQ so their grip on analyzing evidence (of whatever nature) is better than average, but what you say is true of more than a few.

      D.A.
      NYC

      1. Ask me how I know!

         1. I always say the best way to lose respect for physicians generally is to teach physiology to pre-meds for 20 years. Should be obvious how I know that.

            1. Contempt of science professors for large classes composed mostly of students hoping to get into Meds (or Dents or Law) is a well-worn trope. We know. The competition is ugly. At the point you are teaching them they aren’t physicians yet. Most never will be. They aren’t even of that elite, yet, who will enrol one day in medical school. Some can learn.

               I should say that I don’t recall any specific teaching on the definition of sex in med school. Nothing contradicted high school biology about gametes. It was just assumed that we all knew about X and Y chromosomes. When we learned about abnormalities in chromosome segregation at meiosis there was never any implication that people conceived as 47,XXY or 45,XO or 47,trisomy 21 were anything other than the sex they appeared to be phenotypically. The SRY gene hadn’t been discovered yet (I don’t think) and, as today, the causes of most cases of ambiguous genitalia were unknown. The syndromes that were recognized were taught in terms of diagnosis and treatment, with no metaphysical arguments as to whether those affected were “really” male or “really” female. Doctors just don’t think that way, which suggests to me that Dr. Novella went off soundings from an inadequate understanding of the underlying biology of the issue. (One of our professors had a patient with complete androgen insensitivity who graciously met with legions of med students over the years to talk about her condition. We were of course aware that she had XY chromosomes but this was relevant only in understanding mechanism, not her as a person.)

               Post-graduate students doing specialty residencies in paediatrics, urology, endocrinology, gynaecology, and medical genetics would have to learn much more detail than we undergrads had to master. It’s entirely likely that a physician specialized in another area would have no coherent intellectual understanding of how to define sex, because it’s not something we ever do except in the delivery room.

               None of this was contentious. There was no obsessing about the distinction between the sexes until trans came along. You treated the patient for what he or she had, meeting him or her where he or she was, and that was about it.

            2. Darn it. Thought I was expressing my lived experience but managed only to employ a well-worn trope.
               Pace, Dr. MacMillan. I am certain that the cream rises.

               I can only speak to courses I have attended or taught, but every compulsory Intro to Biology, Zoology, or Botany, not to mention Physiology or Development, syllabus covers reproductive biology and defines sexes by gamete types. For 45 years at least.

            3. (…although it might not be true any more; I quit teaching in 2014.)

   2. You said, “a degree in physiology and a medical qualification does not make one a biologist”

      But it should. Novella is ideological captured. He knows better.

5. I haven’t read Guy’s article yet, but I intend to.

   I must say that I’m disappointed with Steven Novella – especially his vehement certainty, which is not only rather unscientific, in and of itself, but simply not justified by the facts.

   In fact, what ARE the facts? Although the claim that “sex is a spectrum” could qualify as a paradigm shift, it differs from any paradigm shifts that I’m familiar with in that it is not based on any new evidence. That is, unlike every other paradigm shift, this shift has not been compelled by new scientific discoveries.

   It is, rather, entirely based on a reinterpretation of facts we’ve known forever – e.g., hermaphrodism, intersex conditions, gender dysphoria, overlapping male and female morphologies, clownfish, and so on – and a simultaneous denigration of the significance of another fact we’ve known forever – namely, that there are two and only two types of gametes, with nothing in between.

   Then, this new – and, frankly, somewhat tortured – reinterpretation of existing data has been turned into a litmus test: you either abandon the idea that sex is binary and uncritically adopt the new idea that sex is a spectrum, or you are a transphobic ignoramus.

   PS Is it my imagination, or is Hili getting kind of chonky? Still adorable, of course.

6. Proponents of this crazy idea simply want to reinterpret all the biological facts so as to come up with a rationale for a treatment that they want to provide for ideological or professional reasons that don’t care about biology. You heard this coming through from the live feed of arguments the ACLU and the Justice Dept. presented at the U.S. Supreme Court in Skrmetti yesterday. Some of the Justices seem to get it, some don’t.

   Gametes (and the body plan that makes them) are obviously where it’s at in sex, and this makes it binary. However there are many emotionally and mentally disturbed people coming to doctors who, because of these disturbances, will never have sex with a person of the opposite sex, (and haven’t come to terms with being same-sex attracted.) Some of these people will never have consensual sex with anyone else at all. To them, classifying themselves by what gametes their healthy physical bodies do or will produce seems cruel and uncaring. “I am more than my gametes,” becomes, “Who cares about my gametes?” because those gametes will never be brought into proximity with the opposite ones.

   When the official purpose of sex stopped being procreation of the species and became instead recreation and on-line commerce, gametes became an optional afterthought in sex. This caused no cognitive hiccups for most people but for a few it seems to have unhinged their thinking, and a medical industry based on pop psychology has grown up to feed off them.

   1. +1

   2. I think those who are “transgender” know full well what sex is and what sex they really are, otherwise they wouldn’t try so hard to fake it, to ‘become the other sex’.

      They unfortunately have fallen for “gender ideology”, the most regressive philosophy you can find.

7. Thanks for the link about “How to Make Your Campus Palestinian.”

   Grim reading.

8. This is excellent. Interview with Stephen Kotkin, about …

   Stephen Kotkin on Stalin, Power, and the Art of Biography | Conversations with Tyler Cowen.

   Listening to Kotkin is never wasted time.
   D.A.
   NYC

   1. Listening to CWT is never a waste of time either.

9. Regarding male participation in female sports: one argument that comes up is that sports should be inclusive, and as part of that ethos men who present as female should be allowed to play women’s’ sports so that they can experience the fun of playing. This was recently raised in one of our internal DEI training courses.
   However, there is no restriction keeping men, regardless of self-identification, from playing men’s’ sports. The argument therefore is not that men should be allowed to play in the name of being allowed to play sports, but rather that they should be allowed to compete at a level that allows them to reach a higher level of standing than if they had competed against their own biological sex. I applaud the LPGA decision, and hope for more like it.

   1. +1

      Also: The entire society must (must) actively participate in the self-actualization of trans-sexual people. Therefore, to deny transwomen playing in the women’s division is transphobia. (This is, it seems to me, the position of the activists. Just as they feel quite free to call gay men transphobic bigots if they aren’t attracted to transmen (see Andrew Sullivan on this). The nerve, to feel like you can tell someone who they should be attracted to! Wait! that was exactly the position of the anti-gay lobby for decades.)

   2. As Jim Blilie also said, it is about them being affirmed by others (whether we want to or not.)

10. Jon Guy’s article is disappointing because he misses entirely what Steven Novella was talking about: the development of entire organisms. The mistake is illustrated most clearly in the sentence, “There are exactly two endpoints: ova and sperm.” No, these are not endpoints of bodily development. I am neither an ovum nor a sperm cell.

    Guy also states, “Nonetheless, hermaphrodites are not a third sex. Rather, both male and female merely exist in the same individual.”

    This again misses the point and one cannot win the argument by blithely dismissing it with the word “merely”. The relevant question is, “What sex is that person?” If one cannot say that the person, as a whole, is exactly one of male vs female, then the trans activists win the point that some other terminology is needed to describe unusual people accurately.

    Many people with developmental disorders are legitimate exceptions to a strictly binary classification of whole people based on their sex. The problem is that they are used as a wedge to impose the entire destructive ideology.

    What we need is a definition not of “sex” but of “the sex of an entire organism”, applicable to anyone at any age in any medical condition. That means a definition that completely categorizes every single possible human body without exception, regardless of whether or not said body is fertile, ever has been, or ever can be. It must be sufficiently detailed and encompassing to satisfy a lawyer. That is what is necessary in order to answer societal questions such as, “Which bathroom are they supposed to use?” and, “Can they join the women’s team?”

    1. Simple: if you have external anatomy that correlates with the future ability to make sperm, you are a male. “It’s a boy!” means exactly what the common-sense lay understanding says it does. A penis seen at (or before) birth indicates the present and predicts the future with a high degree of accuracy. The visibly male infant will certainly develop into a man (unless he is castrated), even if he doesn’t ever make spermatozoa. Indeed for many men we will never know if they actually do. What he will never develop into is a woman.

       From an evolutionary view the culmination is production of ova and sperm because these are the agents of heredity and, therefore evolution. You personally might bristle at being called a sperm or an egg but in a sense you are just a fruiting body to support terminal meiosis to make those gametes and conduct them so they can find each other. I wouldn’t have used that phrasing but the sex of the gametes predicted from the anatomy is indeed no more or less than the sex of the organism. How could it be any different? There are developmental disorders that might disqualify some athletes who appeared (and were registered) at birth as girls. There are none I’m aware of that would allow an athlete who appeared (and was registered) at birth as a boy to compete as a girl or woman. Sporting bodies who in good faith want to test for sex without political agenda can be left to figure this out. The job of the state is to write legislation that prevents queer activists from suing them for gender discrimination.

       As for using bathrooms, the most straightforward approach that law enforcement and ordinary judges could use would be to require all individuals to use the bathroom that matched their birth sex, and for legislators to prohibit changes to that registration. It would be unscrupulous, even if not illegal, for a man with 5-ARD to use his female birth certificate to get away with entering a women’s bathroom, especially if he looks masculine enough to make women uncomfortable. If he can’t urinate through his phallus to use a urinal he should use a stall. It’s not our fault that he wasn’t born right.

       This is not difficult to work out for people with medical disorders. The problem comes from trans activists promoting a metaphysical distinction that doesn’t exist except in their own minds. For them, the answer is just, “No.”

       1. “You personally might bristle at being called a sperm or an egg”

          Apparently I was not clear. “There is a range of endpoints depending on lots of developmental variables. I gave CAIS as just one example.” This is clearly talking about physiological development – what the entire developed body is like. “There are exactly two endpoints: ova and sperm.” This then reduces that entire body to one germ cell. Jon and Steven are talking about two completely different kinds of “endpoint”. As a result of this difference in perspective, Jon talked past Steven and did not address his claims. (And CAIS-affected people produce neither ova nor mature sperm, so arrive at neither of Jon’s endpoints.)

          “[T]the sex of the gametes predicted from the anatomy is indeed no more or less than the sex of the organism. How could it be any different?”

          Hermaphrodites, for one example. Imane Khelif for another.

          Yes, the vast majority of people calling themselves “trans” simply deny their obvious sex and should get therapy, not confirmation. (Or a horse-laugh, a la Mencken.) The whole issue regarding the supposed “spectrum” is about different set of people.

    2. “Many people with developmental disorders are legitimate exceptions to a strictly binary classification of whole people based on their sex.”

       “Many” is doing a lot of work there. “Many” other people with developmental disorders such as XXY Kleinfelter syndrome object strenuously to being told they are not entirely male just because they have an extra sex chromosome. Same goes for all other secondary sex differences between males and females: a little variation here or there has nothing to do with whether the whole individual organism is male or female. Saying otherwise seems like a category error.

       Our host is an evolutionary biologist. Sex – defined by anisogamy – evolved long before any secondary sex differences between the ones that make sperm and the ones that make eggs. Lots of animals retain that ancestral state and lack any differences between males and females other than the type of gamete each produces. Well, ok, often females are larger so as to make more eggs (males already makes lots of sperm). In many of them one doesn’t have to guess which is male and which is female because they have transparent body walls and you can look inside and see the sperm or eggs, like checking which fish are in your aquarium.

       Humans (with all their evolved secondary sex traits and other sex differences) are still male or female in the same way all of those other animals are male or female but without secondary sex traits. And that’s because humans retain sexual reproduction for the same reason almost all other animals do (pace a few rotifers): for genetic recombination.

       From that pov it makes zero sense to require a “definition that completely categorizes every single possible human body without exception.” We don’t need such a definition for humans alone. I don’t think of us as nearly so exceptional as that.

       1. That’s why I wrote “many” and not “all”. I do not include XXY people.

          The definition is needed as a basis for legislation. Something that will get picked over and parsed by lawyers.

          (I don’t know how I can be clearer and will not comment further.)

       2. Gordon, I appreciate what you’re saying here. I understand a definition that is all-encompassing could seem helpful. Thanks for articulating that.

          I’m saying such a definition would contradict biological reality in all cases, including hermaphrodites and including Imane Khelif. I think the lawyers you describe are going to have to bend their (or their clients’) views to accommodate that biological reality based on gamete type. Other lawyers (representing women’s sports orgs, or detransitioners, or women in prisons) will help them to bend. I think this is what we have courts for.

          It’s starting to happen at the US Supreme Court right now. The “trans” man Chase Strangio of the ACLU was forced to admit under questioning by the conservative justices that “gender-affirming care” doesn’t reduce the incidence of suicides among distressed minors, despite a decade of claims that puberty blockers and hormones and surgery are “life-saving”. Jesse Singal wrote about another instance today in The Economist (www.economist.com/united-states/2024/12/06/americas-best-known-practitioner-of-youth-gender-medicine-is-being-sued; paywalled, I haven’t read it).

          That second lawsuit is a big deal because it’s filed against Johanna Olson-Kennedy. She runs the largest young gender clinic in the USA. Her ~$10M NIH grant funded work on puberty blockers in “trans” children the results of which she has decided not to publish because the results don’t show benefits and she doesn’t want to contribute to critics of genderism and of the medical mangling of minors by their parents and doctors. Her former patients suing her has the potential to shutter that clinic.

          So I agree some lawyers will want a definition of the two sexes that all capture everyone’s feelings and disorders, but that doesn’t mean such a definition will be needed in the law.

    3. We have a definition of ‘sex’ (or, more precisely, ‘sexes’) that works fine and makes sense for all animals. All. This ontological definition is not in doubt.
       What you are asking is an epistemological question instead: how do we know what sex to assign to individual humans (only, among animals)? I don’t think a single “whole-body definition” is forthcoming (sorry lawyers), nor necessary.
       For purposes of sports, the presence of testicular tissues and their high production rate of androgens, particularly during puberty, is the real issue. External genitalia and affected gender-presentation are irrelevant in that context.
       As for bathrooms, it’s a silly non-issue. There is nothing stopping fully phenotypic and identifying/presenting cis males from entering any women’s bathroom now, except that most would rather not, for whatever reasons.

11. Anthem// Blue Cross/ Blue Shield has already backed down from this policy.

    It really isn’t that different from many insurance company policies that say: Procedure X is only worth 2 days in the hospital. If it takes 3 days, we won’t pay and hospitals can just suck it up.

    (My final comment today!)

    1. The difference with anesthesia is that the bill is between the patient and the anesthesiologist, who is an independent contractor separate from the hospital. If the patient pays in cash and tries to get reimbursed, the patient personally will be out the difference between the bill and what the ins. co. paid. If the doctor accepted assignment and billed the ins. co. himself, then he would be out the difference. In either case the hospital, a faceless corporation of shareholders run by a ruthless CEO is not out any money, only one individual is.

       I am glad that the Blue rescinded it’s policy so quickly after the hue and cry. When our publicly funded government monopsonies make similar cash-saving decisions to limit payment for care, they don’t listen to anyone because they don’t have to. The doctors just have to accept less money and that’s the end of it.

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