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To open, I'm aware many people were offended by my post yesterday. When I made it, I was well aware that was going to happen, but my concerns for what was about to happen to the community (and is literally happening today all over the news media and internet) overshadowed that. It was never my intent to be hurtful, but that was an unfortunate consequence of what I said.
I want to first explain where I'm coming from. I grew up in Lancaster County, PA. I lived literally between two Amish farms in a very rural and conservative farming community. While I've since moved away, I am still friends on Facebook with a multitude of people from there. When I looked at my social media yesterday, it was basically just "lets bash transgender people" in every other thing on there. People were angry, people were frustrated, and the overall opinion was not good.
I exist in a really weird space. I have about 2500 transgender patients in my practice, and I interact with about 15 trans people per day. I've been treating trans people for 9 years. Two times in my career I went without employment rather than abandon my patient population. I care deeply about these people, and I have deeply held beliefs about who they are, and why they deserve respect, acceptance, and love in our country. I've literally dedicated my whole medical career to caring for them. In short, I care very much about my patients, and about the transgender community as a whole. While I am not trans, I spend a lot of time in trans spaces, both online and in the real world, and so I kind of exist right on the border of the transosphere. My social media feed is a weird mixture of pro/anti trans stuff, and I see both sides of the opinion base here. I am outside of the echochamber, I am not in the trans hugbox. While I am commonly dismissed as "you're not trans you can't speak for us", I however can speak for a person who cares deeply about you, and who isn't hugboxed and doesn't exist in an ideological echochamber. I see things that you likely don't encounter much on your feeds, simply because of that. I like this, and I like seeing multiple perspectives as it helps me understand things better. I'm not trans, but I'm as far into the subculture as any cis person is ever going to get.
I subscribe to many polarized subreddits deliberately. /r/democrat and /r/republican, I subscribe to many pro-trans subs, and I also subscribe to anti-trans subs. I do this for a reason. I want to see what people are talking about. I don't want to be in an echo chamber. My primary news sources are Reuters, BBC, and Al-Jazeera as I've found them to be the most neutral things I can find, but I also look at far left and far right media so I can see what people are saying. Basically, I deliberately expose myself to opinions that I don't agree with so I can learn. If you look back at my comment history, you'll literally see me sticking up for trans people in subs like /r/SocialJusticeInAction/ . I actually try and engage with these people in a rational discourse in hopes of getting them to perhaps change their mind about trans people and gain some empathy for them. I usually get downvoted to hell, but I try.
I was a collegiate athlete. I was on the crew team, and I grew up in a family where athletics were really important. My father was a national champion of the decathlon, and I was a competitive athlete in many sports before my collegiate career. When I rowed, my fastest 2k I ever pulled was a 6:15, and at the time I was 6'3 and 220lbs. The closest female time to that on our team was a 6:50 (and that girl dominated all the other girls by a large margin, as she was far taller and stronger than any other girl on the team). I am not transgender, but there is literally no situation in which I could go on HRT (even for a decade) and I would not be able to dominate all of the females on that team, even our strongest tallest girl. Because I went through a male puberty, there is no amount of hormones that could ever make it fair for me to row against them. I know this, and in my chest, I know that me competing against them would be utterly unfair in any situation. My frame, limb length, and other factors of my skeleton would make it such that I would always in all situations have an unfair advantage. Because I know this in my chest, I would feel extreme guilt were I to transition and then just crush female athletes in rowing because I would know that I had an extreme advantage in that sport (and rowing is probably a sport where gender has one of the most extreme differences in ability). Swimming is right up there again due to the same body mechanics.
This is the situation with Lia. She went through a male puberty, and was in peak athletic ability as a swimmer before transition. Even if she is on hormones for 2, 5 or 10 years she will always have a competitive advantage because her body previously went through male puberty. There is literally no physical way in which that can be eliminated, as this is based on her actual skeleton, which has not changed since starting HRT.
So to explain my feelings yesterday, I finish seeing patients, flop onto the couch to rest for a bit, open my phone, and I am literally horrified to see my social media feed just utterly lambasting transgender people as a group because of this one girl's victory. My perspective as a former collegiate athlete, being a large framed human, and as a physician with an expertise in HRT, I know beyond a shadow of a doubt that Lia will always have a competitive advantage that cannot be erased. I therefore reacted as "oh god, this is going to result in things getting even worse for my patients, this is the wrong battle for them to be fighting right now"
Currently, I am acquiring licenses in states all over the USA so that I can continue to provide HRT care to trans people who signed up for my practice during the pandemic. So far this has cost me around $30000, and I still have more to get. I am deeply afraid of having patients in states where it becomes outright illegal to for me to treat them. There is a literal war going on right now in this country on trans people, and to me, Lia is a risk. She adds fuel to the fire of anti-trans rhetoric, and subsequently drums up more support from the unwashed masses to vote for proposals and people who will support anti-trans legislation. I understand that to you, she is a hero. I know this, and I am not trying to tear down your hero.
After locking the thread last night, I experienced a rather strange phenomenon. Despite the thread making it seem like the majority of people were against what I had to say, I received a multitude of private messages in support of it. Many of them stating that they agreed with my perspective, but that they were afraid to speak out because of the retribution they would face. I'll give you just a few examples:
" The reason why sensible trans speak is cos they have sense not to get clobbered by the woke mob. Lol. I’ve got banned from several platforms just for saying X..."
" Your post needed to be said. Too many trans people are being used as a vehicle for ideology even though it only ends up hurting trans people in general. I hate it. "
I received one from a former med student that made me feel truly sad, this student themselves is transgender for context:
" maybe certain communities are like weird, like wanting everyone to be on the same side on certain topics, even though we are all different people with different ideas.Maybe my trans friends just enjoy sharing their opinions and hearing it repeated back to them in a positive light. And they love talking about only just trans political stuff a bunch and I just wanna talk more about the board/card games I play with them.I only bring this up because my new trans friends have recently messaged me directly about something you posted apparently about sports (I honestly only recently check your reddit when it is directly about new medical stuff due to my busy life. And I have surgery shelf next week to worry about) and I'm like thinking "oh no, I gotta say something they agree with or else they may all join together in hating me."Which is a weird feeling now that I think about it because I have multiple cis best friends who have way differing political views than me, and finding that to be okay as long as we all are respected/happy hanging out. "
There is a deep problem in the trans community in that the hugboxing and ideological echochamber transosphere makes it such that people are literally ostracized for having a differing opinion of any kind. This prevents any degree of discourse on any topic, which results in extremism and isolation. People in this situation (any people, of any creed or topic) historically in human history have basically consumed themselves like an ouroboros as the rest of society views them negatively.
Now, the thread itself had an interesting outcome. Despite a pile of comments, the net score of the thread all said and done before I locked it was zero. Literally break even between up and down. The community was heavily divided on it, but I thought that there was one comment in there that I will give the abridged form of that was really the best of all:
It's a question that pits two fundamentally different kinds of fairness against one another. The "yes" side observes that trans women are women, and social fairness and equality therefore demands that their womanhood be recognized, and thus that they be allowed to compete against other women. The "no" side recognizes* that many trans women do have physical characteristics that are extreme within the distribution of female characteristics, which at times can indeed offer a competitive advantage, and thus argue that it is competitively unfair to demand that cis women compete against trans women.
This is effectively the core of the problem. There is no way to reconcile the current situation without being unfair to someone.
As a result, the commenter proposes a complete restructuring of the current gendered system into one based on ability, and to that, I'm not sure that I agree, as it effectively eliminates the possibility of "national champions".
While Lia is the first national champion collegiate trans athlete, she will not be the last. The very nature of competition will always result in the most superior athletes rising to the top. Lia has paved the way for more trans competitors to follow, and it would make sense logically that eventually, all sports in which transgender women could have a competitive advantage they will end up being the top performer in said sport. The commenter does point out that certain sports are currently not gender segregated, simply because there is no competitive benefit.
Chess, darts, billiards, speedcubing, cup stacking, equestrian, e-sports--these are all cases where the competitors gender has no actual bearing on performance. There are probably others as well.
However, it is recognized that in other sports, gender does play a role in competitive advantage, and someone who went through male puberty before transitioning to female would subsequently have an advantage that could never be erased through HRT. That's a rather simple thing to state, and its fairly irrefutable.
In short, the situation is not ever able to be reconciled through fairness to both camps. The solution proposed by the commenter was to dissolve the current system entirely, and this is not something I see happening simply due to the fact that trans people represent 0.3% of the population, and I find it unlikely the rest of the population would ever be in favor of that. Its easy to get lost in trans culture, and forget that for the rest of the world, gender constructs are fairly rigid, core as part of culture, and most people see humans as "men and women". I understand transgender/gender-variant people may not, but they are not the majority, they aren't even more than 1%.
For me personally, I think the most fair possible way of doing things would be to have a completely separate transgender division, but I think this would likely feel unacceptable to transgender people as again, they would not be "fully accepted" as their expressed identity if they were still segregated in this way.
That being said, we can understand that women are women, and transgender and cisgender women are both women, but also understand that transgender women are not cisgender women, and therefore in some situations (such as this) a distinction needs to be made. This distinction is easily understood when it comes to things like childbearing, menstruation, and other immutable characteristics of trans vs cis women, but the perspective that skeletal shape / muscle fiber type / etc are not immutable characteristics seems easily forgotten.
In all honesty, I don't know what the right solution is, but I can say at the very least from my perspective, the current one isn't working, as from my perspective that exists half in and half out of the transosphere, the half outside is literally furious right now about this, and the backlash is going to be terrible. This scares me to my core, as I have never seen such vitriolic speech from non-trans people in my social media in my whole life. To be honest, most of the truly angry and vitriolic speech I see online is typically from the transosphere, and not from Lancaster PA farmers and rednecks. This was truly shocking for me to see, and I was caught off guard by it.
The entire point of my post was to point this out, and the fact that this particular battle is not the one needed to be waged right now when I may lose my ability to literally treat trans people in certain states due to litigation.
Regardless, before I close and open this to general comments I want to make one thing explicitly clear.
I have spent 9 years of my life treating transgender people. I work 60 hours a week treating them, then spend my free time researching better ways to help them. I advocate for them in conservative spaces, and stand up for them when people denigrate them in my presence. I am not a perfect ally. But you will never in a million years find a perfect ally. I am not the hero you deserve, but I am doing my god damn best to help you all as much as I possibly can, day in and day out. If you don't agree with my takes on things, educate me on your opinions, maybe I'll change my own. I have before, but if you continue to lash out and attack those that don't ascribe to your exact belief structure, you will just continue to isolate yourselves into a space where it seems that everyone agrees with you, but in reality, you're in an echo chamber. In order for progress to be made, intelligent discourse needs to happen, minds need to be changed, and usually, moderate ideas need to prevail. That can be frustrating, but keep in mind, what was once a moderate idea "maybe civil unions would be okay for gay people" has now become the societal norm "full gay marriage law nationally in the USA". Steps are made in societal progress slowly and steadily, and being vitriolic to those who are a 50% match to your ideology is not going to result in a societal shift towards your ideology. Empathy, compassion and understanding is always the way forward, even when dealing with people you deeply dislike. If you doubt I walk this path, read my comment history on /r/socialjusticeinaction and see me trying to calmly approach these people in a way they can actually hear and offer them a perspective they may not otherwise have ever considered. It frustrates me deeply to spend my free time doing this and then to be called a TERF like I am somehow on par with real TERFs. If you think I'm a TERF, you've never met a real TERF, as those people are truly vile and you have no concept of the level of hatred and malevolence that they hold for you.
As always, I appreciate those who take the time to help me grow and learn, those who educate me on their differing opinions and those who respectfully engage in civil discourse.
I ask that you all recognize that I'm one man just doing his best to help as many trans people as he can, and even if you don't agree with how I go about that, recognize that I deeply and truly care about transgender people and their rights, happiness, safety, and health. I have dedicated my whole life to this, and so take that into account when you think about calling me a TERF or transphobic or whatever other label you feel like slapping on me, because if you think that's what I am, I have bad news for you about what the gen-pop is thinking right now about Lia's victory and their plans for taking away more of your rights.
I love you guys and gals, I really do, I'm doing my best here. I know you all have a lot of trauma from mistreatment and abuse, especially at the hands of doctors. I understand where the knee jerk response to fight any perceived threat comes from. But I'm not a threat, I'm a guy who really truly wants you to have happy healthy lives, so just...keep that in mind okay? Dr. Powers = Friend and Ally, even if he doesn't agree with literally every tenet of the most possible extreme transosphere views 100% of the time.
Anyway, anyone is welcome to offer thoughts, ideas, or suggestions below as to how we can achieve the following:
- Cisgender athletes are not subjected to unfairness by the inclusion of transgender athletes in sport by the trans athletes having a competitive advantage due to the usage of HRT, or, having experienced a puberty that would convey athletic advantage.
- Transgender athletes are not unfairly excluded from the ability to participate in sport, and that they are able to compete as their self identified gender
- A complete teardown of the current way of separating athletes based on gender is not done (as while this has been proposed, it will literally never ever happen at the highest echelons of sport, and while I understand this could solve the above dilemma, it is extremely unlikely to happen at the national champion/Olympic level. You're welcome to suggest this, but being as the odds of that ever happening in my lifetime are nearly 0, I suggest we focus on ways to amend the current system rather than burn it to the ground and institute one that pleases 0.3% of the population. This is not me being snarky, I just know cis people, and they are currently about at their limit for change right now. Amending the current system is far more likely to be successful.
As an additional 4th idea, I welcome input on actual functional HRT/competition guidelines, as the current IOC guidelines are terrible, and allowing transgender women to compete with testosterone values more than 5 times the cis female maximum is clearly not fair, even if a committee approved it or not. (look it up, I'm not making that up, and any logical person can agree that having a T level quintuple the female max would be unfair) I would love to see the kind of guidelines that transgender people educated on anatomy/physiology/biochemistry would put forth if they were actually truly trying to make things a level playing field.
Thanks for listening.
- Dr. Powers
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