Do you happen to be familiar with Scott's pre-ACX writing, or... anything else about him?
He has, at least for significant stretches of his life, lived in San Francisco- a location with a much higher than average rate of trans people. He's involved in the rationalist and EA communities- likewise, communities with much higher than average rate of trans people. He has dated at least one trans person. One of his most famous essays (https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/) is to convince a bunch of nerds that they should be more accepting of trans people.
None of those things preclude him from being *wrong*, of course, but he's hardly forming "wild hypotheses based on pure speculation."
Sorry, I was directing this towards the comment section, not towards Scott. 100% a bad habit I picked up from other social media sites. Sorry for the confusion!
I've talked to about twenty trans patients, ten trans friends, and the trans partner I dated for several years. What else do you think I should know?
That is - if you were to ask me why I'm straight, I don't think I could, from personal experience alone, give a useful answer like "Well, clearly it's about 40% genetic and 60% non-shared environment, and even with exactly the same genes I might have been attracted to young boys in ancient Sparta" - going off pure personal experience I would probably say something like "Women seem pretty." To get the useful answer I need to know things about science/history/anthropology. Why do you think your gender situation works differently?
Oh! I see the confusion. Sorry, I was directing the comment at this comment section, not at you. That's 100% my bad and a bad habit I got from other social media sites like reddit. Sorry for the confusion, I really liked this post.
But I do think it's different with my gender situation because people aren't culturally expected to be trans. Like, if a man is attracted to men before they know gay people exist, then that's evidence it's at least partially biological, right?
It's some evidence, but even then it's not clear - it could be the sort of thing that is an unexpected byproduct of some cultural influence. I've heard that studies conducted in the middle of the 20th century found that most people said they dream in black-and-white but recent studies found that most people said they dream in color. The explanation I've heard is that the cultural influence of television was affecting how people describe their dreams to researchers, even if they hadn't heard of a cultural trope of how dreams are supposed to look. Conceivably, even a culture that has no discussion of same-sex sexual attraction might have cultural products that frequently produce same-sex sexual attraction in some people, which another culture might lack, so that same-sex sexual attraction could conceivably be entirely driven by culture. (Though I do suspect that there are some biological components as well.)
(Looking at the title I first assumed it would be Russian propaganda, heh.)
The article says that married men and women in those tribes keep having (heterosexual) sex all the time, leaving them no time to even think about masturbation or homosexuality. But what about the rest: teenagers, widows, generally people who do not have a partner at given moment?
Here's what I find remarkable -- if you check wikipedia's History of Homosexuality article https://en.wikipedia.org/wiki/History_of_homosexuality then there's an astonishing blank between "Antiquity" and "Early modernity". There's a couple of paragraphs but it's mostly just a list of evidence-free insinuations that hey, someone famous must have been gay.
Given that homosexuality would have been harshly punished in this period, where are the records of it? Where are all the beheadings? It can't have been that they were _that_ good at not getting caught for fifteen centuries in a row. Even the Spanish Inquisition, which charged 500 people for sodomy, only alleged a handful of cases of _homosexual_ sodomy.
Punishment was also directed toward men. Female homosexuality was something barely acknowledged as possible. Of course, conceiving it in terms of "orientation" rather than behavior is also relatively recent.
~40 years ago, used to have a house mate who worked in William Dements sleep lab around its start at Stanford. Told him of my noticing sometimes dreaming in color and sometimes in B&W. He said Dements' lab had determined that color vs B&W was related to remembering and depth of sleep... lighter sleep led to remembering color dreams while deeper only B&W. Interestingly, the color dreaming nights were correlated to my taking Sudafed before bed (before learning of Sudafed sleep impact). Stopped nighttime Sudafed, stopped remembering color dreams.
My family was not well off, so I first saw a color TV when I was in high school. My entier youth was spent with black-and-white TV (albeit not much of it). I can recall no difference whatsoever in the nature of color in my dreams between youth and young adulthood, nor imagine any difference in how I would describe them.
Counter anecdote: when I was a kid I read a lot of books and rarely watched TV. For a number of years, I recalled my dreams as text descriptions of the events, rather than as sensory input directly
Counter-counter anecdote: I read a lot of books as a kid; my remembrance of dreams comes and as far as I can remember has always come in mainly two categories: vivid sensations (associated with the feeling of vividness), immersive situations where I mostly will the dream into existence around me; and unstructured sparse sensations relating to my previous-day concerns (e.g. flashes of gameplay moments from a video game I played with intense focus very late).
Sorry, my mistake, guess I'm feeling too fighty today.
"Culturally expected" is a complicated term - I think the culture-bound-syndrome perspective is that cultural expectations go from "nobody's ever heard of or considered it" (eg transgender in Arabia 100 years ago), "people have heard of it and know it's a think that happens 1% of the time" (eg transgender in US today), "people have heard of it and know it's pretty common" (eg following cis gender roles today), and "people don't even realize they've heard of it because it's just considered the universal obvious thing (being cis in Arabia 100 years ago). I don't think *anything* is at the far extremes of cultural expectation in modern America, except maybe things like "not being object-sexual".
Lots of people have sex with inanimate objects, that usually just gets lumped together with masturbation. There was a mainstream movie more than twenty years ago: https://www.imdb.com/title/tt0163651/
I think calling people fantasizing about being a girl “gender dysphoria” is an example of a culture-bound effect.
For example (all details changed on account of “that’s private”), I might fantasize about having wings and flying around the clouds. But calling that “dismorphia” or “body dysphoria” says more about how others see my fantasizing than it says about how I feel about it. I have exactly zero trauma about not having wings, but if people would fuss about how sad I must be about my misshapen, wingless body, especially during my childhood, I might.
M Scott Peck, the psychologist who I associate most with runnaway bestsellers (with his book iThe Road Less Traveled from the 1980's) went on to write another book called People of the Lie in which he discusses human evil, and in one chapter actually describes cases of what seemed to him to be demonic possession. As I recall, he puts them forward pretty much straightforwardly. My sense is that there are therapists who encounter these kinds of things and say something like, Yup, More things in Heaven and Earth than are dreamt of in our training programs.
My guess would be that "hard-to-resist impulses to do bizarre/bad/uncharacteristic things" has a large biological component, and "what you attribute the impulses to" is approximately 100% cultural
"Gender dysphoria shares some resemblance to culture-bound illnesses; I would put it around the same level as anorexia."
I agree with this, but I think, given the physical and emotional cost of dysphoria and associated treatment, this implies we should try to *turn the culture knob down* so that we're not steering more people into dysphoria.
In practice, I think this is one of the strongest case for *not* doing awareness campaigns, especially for young kids. Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria.
Yep! I don't think I'm as worried about the spot the "therapy talk dial" is turned to, which is the other very strong awareness/sensitivity campaign. But that might be because one stream of therapy talk is more CBT focused, and thus more skeptical of reifying your passing feelings while the trauma stream is more about introspecting on your feelings and asking "Is this a deep wound that I will struggle to heal?"
I like the Eastern Orthodox framing of some intrusive thoughts/feelings as logismoi, which you don't *need* to incorporate strongly into your sense of self. You can note them, and then choose whether to embrace them or just wave them off.
Whoa! Scott! I think you should be really precise about what you mean here and not vaguely gesture towards endorsing 'unawareness campaigns' for gender dysphoria.
I want to say this without accusing you of transphobia because I don't think you are, or saying you have to be responsible for all readings of your text. But you are basically endorsing the strategic logic of the conservative "anti-groomer" movement. If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal. Heck your theoretical mental health unawareness campaigns involve book burning and cancellations, what would that mean for existing trans adults or the percent of people who will continue to be trans post unawareness campaign? I'm not sure you can do a sort of clinical anti-gender dysphoria awareness campaign without empowering a lot of people who are transphobic and homophobic.
1) I don't think Scott was seriously suggesting a response that extreme, just hypothesizing about a culture as obsessed with "unawareness" campaigns as ours is with awareness campaigns.
2) If (IF!) gender dysphoria is more culture-bound than not, we've got much bigger problems right now than the consequences of possibly empowering transphobes.
>1) I don't think Scott was seriously suggesting a response that extreme, just hypothesizing about a culture as obsessed with "unawareness" campaigns as ours is with awareness campaigns.
And that's fine, but he should be careful about how he talks about it.
Counterpoint: No, he should not be (especially) careful about how he talks about it, because the worldview that says trans stuff is *special* and should be talked about more carefully than suicide or abortion or elections or gangrene is wrong. Lots of things affect people, and we don’t create special rules around how they can be discussed, nor should we.
A basic attempt to be correct and to say what you mean is all that is required.
Suicide and abortion and elections should all be talked about carefully. Gangrene doesn't have the same political connotations. It can be talked about casually.
I'm not saying trans people are special: I'm saying that when people misinterpret well-intentioned comments about trans people it can have disastrous consequences.
About being careful about how he talks about it: I get it, about the dangers of saying things that can be empowering to the transphobes. But I think it's almost always a mistake to keep quiet about your own perceptions and views because they can be weaponized by the wrong side. If the wrong side does pick up on what you said and try to use it, then you have a responsibility to say loudly and often that that is *not* what you meant, and clarify what you did mean. And anyhow, there's already plenty of stuff floating around in the media and cultural soup that can be weaponized, most of which will yield juicier sound bites than Scott's smart little essay.
It's destructive for people with authority to say what they think will make people do what they should, rather than tell to truth an exhort people to do what they should. That's herding, not informing and advising, and people eventually sense what you're up to and began to hate and distrust you. Think about the way the government initially talked about masks -- "No you don't need them" -- because they were concerned about medical staff not having enough. They should have said, yes, masks keep you safer. We are going to transfer most of the supply to medical staff and other essential workers who need it most, so they will be hard to find. Until we can get more on the market, here are some ways to improvise a mask that are better than nothing.
> If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal.
I don't consider myself to be transphobic. Perhaps in the future we will be able to seamlessly transition or alter our bodies without risk or side effects, but until we reach that point I think it is obvious that people who attempt to medically transition are going to endure a very difficult experience.
Modern culture has far too much faith in the medical system. They are better than nothing, but every procedure has enduring costs. I've had a several surgeries and every one has left me with reduced mobility in the joint and nerve damage.
It feels like there's a false choice in the statement "If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal." I think there's a difference between fearing your child will identify as trans vs. fearing your child will become a permanent medical patient from a medical establishment that barely understands what it's doing when it comes to medical care surrounding trans-related questions.
Take 'puberty blockers' as an example. You can't 'pause' puberty any more than you can 'pause' aging. What you can do is SKIP puberty and sexual maturation by messing up endocrine signaling in ways you don't understand. I've heard that some of the kids who get treated never go through puberty and later in life are unable to experience sexual pleasure.
Should an 11-yo be making the decision to take sex off the table for the rest of their life? If they're trans, but got puberty blockers and never developed sexually, maybe they have a bit less dysphoria about their body but they have a lot of anxiety about having mature adult relationships because they never fully sexually developed and therefore can't connect on a pivotal aspect of most relationships. Is it really a decision between that and certain death for large numbers of kids? Call me skeptical, until I see a good meta-analysis of multiple RCTs, with long-term follow-up.
Years ago I read Ending Medical Reversal, www.amazon.com/dp/1421429047/ and a lot of what I hear described sounds like it's ripe for later medical reversal: panics about 'doing something', talk of how the something they're doing 'makes sense' logically, review from medical patients that they're happy with the immediate results of the treatments as justification for treatment efficacy, absence of RCTs and long-term follow-up, medical practice preceding the accumulation of scientific evidence.
I think it's fair to be concerned that your child's treatment will later be realized as a major medical error without linking that concern to their future gender identity.
Yes, that's a different thing. It's possible to say that you will love and accept your child whatever their gender identity but that you are concerned they will be misdiagnosed with gender dysphoria.
However, if you think having gender dysphoria and treating it through gender transition is a really bad life outcome (for many of the reasons you raise about medicalization), and that gender dysphoria is a cultural contagion. The logic of trying to prevent that cultural contagion by limiting trans visibility is hard to resist.
Probably because there's some interaction among the issues at question:
1. Is the incidence of (for lack of a better term) 'transient' gender dysphoria increased by cultural contagion?
2. Do current medical interventions cause long-term/permanent harm to those who eventually detransition/desist?
3. Do current medical interventions cause long-term/permanent harm to those whose trans identity persists?
4. Do cultural attitudes interact with medical decision-making in a way that biases transition and medical interventions with long-term/permanent consequences?
5. What's the ratio of 'transient'/persistent trans identification and medicalization?
If you think, "currently available medical interventions for a 13 yo trans kid generally lead to bad long-term outcomes," you may want the kid to be able to come out and express their gender identity, but still be concerned that this will lead to harmful long-term medical exposure. In that case, you'd want to be an outspoken critic of the current medical system, but encouraging of cultural attitudes.
If you think a majority of those who get medical interventions will likely desist/detransition, you might be opposed to both the medicalization of trans and the cultural attitudes. I'm not sure how to frame this so as to make it less of a false choice, since it doesn't seem we can have a nuanced discussion of the subject. For a lot of issues, it feels like you're either "pro-[whatever]" or you're "[whatever]-phobic/-ist". Sometimes it feels unpopular to be "pro-'I don't have a dog in this fight, but I'd like to take our time gathering evidence for the open questions in this field before making large-scale societal changes, especially those that have potential long-term medical impacts'".
> The logic of trying to prevent that cultural contagion by limiting trans visibility is hard to resist.
I'm not clear on why it should be resisted, in principle. If the causes of gender dysphoria are partly cultural, then anti-awareness campaigns would merely prevent that fraction of the population from developing it for cultural reasons, leaving only the biologically driven gender dysphoric people to receive the prolonged, uncomfortable surgical treatments they need. As long as there's no stigma associated with this condition, what is the problem with this outcome?
You are making a lot of leaps here. I dont see anywhere that supports that Scott "think[s] one of the worst possible life outcomes for your child is that they become trans". I also don't see this echoing any of the "anti-groomer" talking points. In the review of Crazy Like Us, Scott writes, in the Unawareness universe "Secretly the psychiatrists will still treat anybody who comes to them, they’ll just make them swear an oath of secrecy first." So he is clearly not advocating that people should receive treatment. He is only wondering what it would be like if culture didn't promote certain conditions. Thats very very far from the anti-groomer bigotry that casts LGBTQ people as pedophiles and defectives.
No, I think this is hugely loaded and we should be really careful about it. I'm not at all blaming Scott for what the anti-groomer movement does But, if you're suggesting gender dysphoria is largely a cultural contagion, and that maybe we should act to reduce awareness of that cultural contagion, the behavior of the actual movement operating on your theory seems relevant.
Receiving treatment while swearing an oath of secrecy doesn't resolve the problem of trans people being visible in society, not everyone is going to pass and people are going to ask, what happened there?
This strikes me as similar logic to “if you’re questioning biblical science, and the other people questioning biblical science are witches, maybe you should shut up.”
No, in fact, he shouldn’t. He should say what he believes is true rather than being cowed into silence by an argument founded on guilt-by-association. If you have an argument against what he thinks is true, make it; but if all you have to offer is tone policing, your contribution has negative value.
"I'm not sure you can do a sort of clinical anti-gender dysphoria awareness campaign without empowering a lot of people who are transphobic and homophobic."
Interestingly, this doesn't make it a bad idea. Imagine if we could erase anorexia by running an unawareness campaign, but also it would empower the Healthy At Any Size people who say it's perfectly normal to weigh five hundred pounds and die of a heart attack at 40. Would this be bad? Well it depends how many anorexics we avert vs how many morbidly obese people we create. It's not enough to gesture at some possible side effect, you have to actually run the cost-benefit numbers!
>If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal.
I think the trans activists seem to spend a lot of time convincing everyone that absolutely one of the worst things that can happen to people is be trans. They talk incessantly about suicide and abuse and what a struggle it is.
"If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal."
But I do think becoming trans is one of the worst possible life outcomes for my child. Their suicide rates are sky high. I didn't get that from anti-groomer conservatives; I got it from trans activists.
Scott, I'm a fan of your work, but I'd be a little less casual about saying stuff like this. What would a "gender dysphoria unawareness campaign" look like in reality?
I understand you're not saying this out of malice, and I'm not saying you're necessarily wrong, but I think it's important to be careful about how talk about it.
Do you think gender dysphoria awareness advocates should be less casual and more careful as well, are you certain they are all incredibly careful to ensure that each word is chosen with the utmost concern, or do you think that their failure modes are less significant than Scott's?
In the Crazy Like Us review, Scott writes "Secretly the psychiatrists will still treat anybody who comes to them, they’ll just make them swear an oath of secrecy first." So in a world with a "gender dysphoria unawareness campaign" people still get the treatment they ask for.
This was just a quick speculation on Scott's part. I don't see him actually proposing unawareness campaigns as a solution to anything. In fact he concludes "I’m not sure if this culture would have more or less mental illness than our own." So he's not even sure it would work!
As the old saw goes, we’re in a hole, the first step is just to stop digging.
So, for starters, we should relax existing awareness campaigns. Take gender ideology out of middle and high school curricula, stop doing events to raise awareness aimed at young kids—like, say, the “drag queen story hours” that became a culture war flashpoint in the past. (Hopefully admitting that the right was correct about them won’t wound your ego too much.) The movement should probably rebrand away from “protect trans kids”. We can understand that the people leading all of those efforts were well-intentioned and sincere, but also recognize that as it so happens the harm outweighs the benefit, and it’s time to put down the signs and go home.
Finally—what should Scott have really put differently here? His tone strikes me as incredibly careful and well-couched with caveats. To go out on a limb, I don’t think the tone here is your problem at all; rather, it seems like you are very uncomfortable with the implications of his ideas, but unable to present an argument against them, and defaulting to criticizing his tone instead. Consider that the truth might be uncomfortable, and you might have been wrong in the past, and don’t shoot the messenger.
Exactly. The only thing we know for sure at this point is that transsexuality and homosexuality are a behaviour. The rest is speculation. First and foremost, all people who practice any kind of behaviour which does not obviously harm others should be treated with respect. That being said, parents are well within their right to encourage or discourage in their children any kind of (non-harmful) behaviour they wish and here is where we have the problem. Certain movements are working to promote "awareness" of certain behaviours in public schools to other people's children. Imagine if someone suggested that we have should be having Catholic storybook hour in public schools which taught kids that bread can turn into flesh and wine into blood? (something which is not much more fantastical than that a man can turn into a woman)... I think all of us need to learn to be content with having our non-harmful behaviours respected and tolerated by society, but not expect that our behaviours should become part of the public school curriculum...
I disagree with the extension of this logic to sexual orientation. It strikes me as less culture-bound than gender dysphoria—even if, as Scott points out, everything is at least a bit. Also, life outcomes for people who are gay—in terms of e.g. suicide rates or lifetime earnings—are far better for people of nonstandard sexuality than people of nonstandard gender. Differences like these make me think that gender and sexuality are different phenomena to investigate separately. The best approach in one case may not work for the other.
For all that gender is useful to us in terms of giving us a pre-assembled toolkit for identity construction and understanding social roles, it is awfully constrictive and oppressive. Many people are not able to find satisfactory ways to self actualize within the confines it sets, and there are considerable social costs to working outside the boundaries. These discussions about gender ideology are helping to break down those boundaries, to expand the Overton window of gender identity, to work towards a future where everyone is a little bit more free to manifest their individuality.
Moreover, "but think of the children" is a rallying cry that has been used to censor, oppress, and enact very real harms onto queer people and queer communities for a very, very long time and I absolutely will shoot the messenger who starts crowing about that.
Fine, but teach that ideology to YOUR children. Not to mine. I absolutely will shoot messengers who start crowing to my children that they are free to be "shes", "hes" or in betweens because gender is subjective. Biological sex is the only objective truth and the one which should be being exclusively taught in public schools to our children. The rest is ideology and can be taught in the home.
Rather than reducing discussion of gender dysphoria, depression, anorexia etc. to reduce social contagion, could the exact opposite approach work? Public education about how social contagion works and how many popular culture-bound illnesses appear to have a strong social contagion component, as a prophylactic.
I'd really love to see a longitudinal study that showed some children cartoons simply explaining these disorders, and how often they are "just in your head" and that if you don't think you'll get them, you won't, and seeing if these children ended up developing less of these culture-bound illnesses. Beyond the internet culture war argument implications, if this turned out to be an ultra-low cost method to reduce prevalence of depression and anorexia it would be incredibly valuable.
"Oh my God! I just heard about this new mental disorder! And it's well known from social contagion theory that people who hear about new mental disorders are disproportionately likely to acquire those disorders! I'm doomed!"
--Not sarcastic. That's exactly how I predict that would go.
A friend remembered hearing about the dangers of lead paint in the late 70's, but as a kid, that just meant "WHAT? YOU CAN EAT PAINT CHIPS? NEATO, LET"S TRY IT"
It's one level up from that. Jacob is recommending that we expose people to a selection of compelling mind-viruses, and that we pair these with the message: "mind-viruses like these tend to stick in your brain and destroy your life".
Imagine if upon entering med school the students were told: "If you start to think you have a disorder, this wildly increases the chances that you will in fact catch it!" To put it mildly, I do not expect this to decrease medical student syndrome.
By the same token, I do not expect Jacob's recommendation to diminish the spread of mind-viruses.
What if we start telling people that hearing about a disease makes you less likely to think you have it? Call it pathological anpathognosia or something to make it sound really impressive!
That would make for a good novel. A secret organisation dedicated to stamping out knowledge of a religion just to guarantee that the shield of ignorance remains.
I think I'm sympathetic to "telling people gender dysphoria exists is sort of an infohazard if you're not letting them transition, net positive if you are?"
although given how slow our culture is about this this is an argument against telling kids/teens about gender dysphoria
That implies the transition itself is healthy, when it seems distinctly unhealthy due to the lifelong hormone treatments and highly invasive surgeries, which often result in the patient becoming sterile.
Why would you think of it as net positive to be allowed to transition, such that sharing the infohazard itself becomes net positive?
The assumption is that if the transition improves quality of life, then it is healthy. A bit like any psychiatric treatment (anti-psychotic drugs.....).
Right, I get that. Alex seems to be indicating that the "infohazard" part is good if you allow people to transition. I see an infohazard as separate from people who may have "naturally" been trans and were already seeking treatment. The infohazard sounds bad all the way around. Alex's follow up response indicates that they see it as something like "someone may not know they are trans, so allowing that knowledge to exist in general society can provide a path to seeking treatment that would not exist otherwise." I can see the benefit of that, though it's very difficult to weigh that against the problem of an infohazard *causing* orders-of-magnitude more people to believe they are trans and therefore having all of the difficulties that "naturally" trans people have.
So what's your solution? To censor trans people from speaking about their experiences and fighting for their civil rights? To punish them, their friends, and their families if they try to work towards a society more accepting of them?
Go ahead and say the quiet part out loud, Mr. Doolittle.
Assuming that people are either trans or not, what if the full realization of their gender dysphoria actually creates more suffering than the transition can alleviate? Maybe they could have lived their whole lives with a vague discomfort and the occasional thoughts of "Might be nice to be the opposite gender", but when it really hits them, they now experience the stress from knowing exactly what they are dissatisfied about, being misgendered, and wondering if anyone will accept them if they transition. I don't doubt that transition improves quality of life for people who are already suffering from gender dysphoria but it's questionable that it would necessarily improve it for those who *may* experience it but remain blissfully unaware in the mean time.
I can only speak for myself, but as someone who plausibly is trans because of social contagion (was part of a friend group where ~80% of us came out as some flavor of trans over about a 5-year period), I genuinely think my quality of life is as good or better than it would have been otherwise. Being my AGAB has been socially and to a lesser extent physically uncomfortable for as long as I can remember. Drawing attention to that dysphoria was uncomfortable for a few years, but between hormones and not being a teenager anymore, I am literally the most comfortable with my body that I've ever been. Was it the only solution to my problems? Maybe not. Is it better for me than an eating disorder or doing a lot of cocaine? Definitely yes.
I've identified as trans for pretty close to exactly 9 years now. Can't speak to how I'll feel in 9 more, but at the moment I wouldn't change anything about my situation.
I'm glad your life has improved and I hope your experience is typical, but I do find it interesting that you mention 'not being a teenager anymore' because I think that's an important factor in many people's life satisfaction, including my own.
Transition probably improves quality of life over untreated gender dysphoria, but still results in a substantially lower quality of life over not having gender dysphoria, really, not even a little bit, because you never heard of it the way people in pre-1994 Hong Kong never heard of anorexia.
If so, and if gender dysphoria is mostly culture-bound, then knowledge of gender dysphoria is indeed an infohazard that will on average reduce quality of life. Just not as much as it would if we talked a lot about gender dysphoria but didn't allow treatment.
Caveat 1: At present, there is a fairly large support community for transgender individuals; rather less so for other mental illnesses. So it is possible that transition results in a net improvement over quality of life over "I never heard of gender dysphoria, but my depression really sucks and nobody seems to care", because it gains access to that support community.
Caveat 2: All bets are off if we manage to both create a fully tolerant society with no transphobia, and also develop the medical technology for *complete* gender transition, including normal fertility in one's new gender and ideally fully reversible.
> Transition probably improves quality of life over untreated gender dysphoria
Have we done any actual studies on this, though, or are we just guessing?
If we're just guessing, then my guess is that untreated gender dysphoria is usually transient, and that treating it is worse.
And if that's not the case overall, then I think it's probably the case at least for younger and newer cases of gender dysphoria. Starting a kid on the path towards "transitioning" the moment they express a vague wish that they were born the opposite sex is going to ruin the lives of many kids who would otherwise have gotten over this phase on their own.
There have been a number of studies on this, yes, and the numbers for people diagnosed with gender dysphoria who don't get treatment are appallingly bad (double digit suicide rates), while the numbers for post-transition people are significantly worse than for cis people but much less bad.
Of course, every study in this field (as in many fields) is done by a group with strong pre-existing opinions on the issue, so detractors will frequently claim bias - I don't know nearly enough to judge those kinds of claims
Aside from formal health systems, which are vast if under resourced, there are large support networks for a variety of mental illnesses. I'm not sure where you are, but I could probably put you in touch with a local NAMI support group for any number of mental health concerns relatively rapidly.
From my understanding of the OP, culture bound syndromes are caused by the brain noticing various symptoms, and then fitting them into a "narrative" or "theory" that is present in a culture. This then creates a "spiral" effect where they start to notice more and more stuff that fits the theory, exacerbating the illness.
Applying this to gender dysphoria, we have someone who has vague feelings of depression and unhappiness about their life and dysphoria about their body. Because it is available in the memosphere, they lump all these symptoms together into gender dysphoria, and then notice more stuff to be dysphoric about. Then they transition and all the dysphoria goes away or is significantly lessened.
I think where you are coming from is that you are assuming that since those "original" vague feelings of depression and dysphoria were not caused by gender, a gender transition won't fix them. Maybe that's true, but maybe not. Brains are weird. Maybe somehow lumping the "original" symptoms into the gender dysphoria narrative will result in them getting "fixed" by transition. The end result might be someone who is happier on the net.
If this is the case, someone who underwent hormone treatments and surgeries might be happier then someone who never had gender dysphoria, but did have the "original" symptoms that brains sometimes lump together into dysphoria. I don't know, it's highly speculative but most of this field is.
Well or you could just tell them they will be fine in 2 years when they get out of puberty. Or you could give them sugar pills for 2 years. Both of which would probably lead to better total life outcomes (I would bet IDK millions of dollars on this).
Given human history, in an evolutionary aspect, it seems pretty likely that most people want kids. Some people are abhorred by the ideal, just as some people do not like the taste of meat. But mostly veganism is a social thing, not inate.
I'm not convinced most people want kids. I think most people want sex and are willing to raise children if they have them. That would be enough for evolution, which could hardly anticipate the existence of birth control.
"Willing" to rear children is utterly insufficient to the magnitude of the task of parenting. You have to be deeply devoted to the concept of your children, as well as to the individual children involved, to succeed at the job. Your theory would only work for fruitflies or otters, some species that relies on sheer fecundity, and in which the parental investment is relatively modest, rather than a species like ours, which relies on extraordinarily high parental investment -- we routinely spend 45% of our adult working lifespan (~20 of 45 years) looking after our children.
People don't need to be driven towards procreation to be driven towards behavior that tends to cause procreation in a state of nature. Before you come up with evolutionary just-so stories, you have to notice around you there are plenty of people who either do not want children or want significant control over when and how many they have, with the preference being much lower than their total potential. Evolution self-evidently produces creatures with those desires. This is a fact evolution must accommodate, and if your intuitions about what evolution via natural selection must result in contradict that, that's a sign your intuitions are wrong.
That's a terrible argument. The exception does not prove the rule, biologically speaking. That some people get cancer as children does not prove that there is some adaptivity to childhood cancer. It is (one assumes) an unfortunate side-effect of some other mechanism that is adaptive. Similarly, the existence of a minority of individuals who have zero desire to procreate says jack about what evolution may or may not have built into the generic individual in this respect, so it need no better explanation than "shit happens," and natural selection is hardly a universal amd perfect optimizer.
It’s a net positive for the people who have the sort of gender dysphoria that can only be successfully addressed by transition, and otherwise would have been unaware that this was an option.
It’s a net negative for the people who never would have considered transitioning otherwise and would have found some other less invasive means of addressing whatever symptoms made them susceptible to the “gender dysphoria infohazard”. E.g. upper half of the Kinsey scale female adolescents with typical puberty related body image discomfort.
The balance between these two groups is culturally modulated, but in American culture 2023, I suspect there are more of the latter than the former.
-going through puberty and having a sexuality that was not remotely functional and being vaguely dissociated from this and also generally feeling meh
-hearing that gender dysphoria was a thing and as a result of this getting more ~classic dyphoria symptoms and feeling like 'oh fuck I can't live like this"
Having dysfunctional sexuality going through puberty and feeling vaguely dissociated from that is incredibly common in all sorts of people, and something that often gets resolved with time.
Why are you so sure that the counterfactual to receiving classic dysphoria symptoms through contagion is that you live with sexual dysfunction forever rather than growing out of it?
For what it's worth, I've seen transitioning make people I know conspicuously happier for years. It could just be suggestion, but it may be something they really needed.
I've also seen a fair amount from people who said they knew something was wrong, and it took them a long time to find out it was gender dysphoria.
And I've seen interviews with people who detransitioned. (Benjamin Boyce was doing these. I don't know whether he still is.) It's apparently possible for people to be miserable and jump to the conclusion that it might be gender dysphoria when the cause might be something else.
If they're at the point that transition is plausibly the best option, then sure, go ahead. But if the whole dysphoria thing could've been avoided altogether it's a different conversation.
I don't see that dysphoria can be avoided in general, though I agree it also shouldn't be amplified.
If I were running the world, I'd give everyone a year where no one around them cared whether they transitioned or not, just so they can settle their nerves and know what they actually want. This is not feasible.
But wasn't it the whole point of Scott's post? It seems plausible that in not-overdetermined (by hormone imbalance and the like) cases social contagion plays the decisive role, by initiating some kind of feedback loop, which breaks free from normal variance that people ordinarily "grow out of".
"It's apparently possible for people to be miserable and jump to the conclusion that it might be gender dysphoria when the cause might be something else."
Considering that the "something else" might be a condition that really is made worse by one's natal sex, I wonder how much jumping need be involved.
Ehlers-Danlos Syndrome (EDS), a collagen abnormality, provides an instructive example. People with EDS have weaker connective tissues, which keep kicking up their immune system by breaking more, and which can cause some embarrassing cosmetic problems, problems others might have after massive weight loss, only with EDS, you don't have to gain the weight in the first place to have them.
The closest thing to a "cure" for EDS might be androgens. That is, androgens partly compensate for connective-tissue weakness. Androgens help build muscle mass that protect against joint injury, they thicken skin, and so on. Men can suffer from EDS terribly, but overall, the population of men with EDS traits is affected less badly than the population of women. Add in that female fertility is pro-inflammatory, and maybe it's not surprising that the incidence of EDS diagnosis among patients at one gender clinic was measured to be 132 *times* that of the general population (1st reference), with patients with EDS seeking treatment for gender dysphoria being disproportionately born female (89%, 2nd reference), seeking either masculinizing transition or a nonbinary body, with chest masculinization being the most common surgery (58%, 1st reference).
The stereotype is that teen girls' breasts are perky and attractive, that hideously stretch-marked, sagging sacks of flesh are a curse of older womanhood. You don't even have to *want* nice boobs to find growing "granny sacks" instead of "normal breasts" at thelarche embarrassing. The stigma that "granny sacks" are nature's punishment for those who let themselves pork up before slimming down doesn't help. Fat-shaming isn't reserved for the fat to begin with, and appearing formerly-fat is just one more handy excuse for it.
So, EDS can be physically uncomfortable (it isn't always, but it can be), and can make it difficult to conform to notions of what a "normal" body of your sex and youthfulness should look and feel like (not just for women; men with EDS may look and feel "too delicate to be Real Men"). Girls often find the discomfort of EDS worsened by puberty, and the body-horror of puberty dialed up to 11: wishing for a body that's masculinized instead, or to revert to childhood androgyny, seems especially understandable in these circumstances. Add in that androgens can compensate for the underlying defect...
I was diagnosed with EDS in my thirties. I went through female puberty convinced my complaints were either psychosomatic, or a sign that life in general sucks, womanhood sucks, and human sexuality pretty much sucks, too. I was too embarrassed to complain about (what I supposed was really soul-caused) physical suffering to my friends, and too religiously-conservative to transition, but I used to sardonically joke about transitioning. Mightn't God be calling me to transition to manhood and become a monk, some calling that might actually suit me? (Alas, transness is disqualifying for Catholic monastic vows.) I also inferred that the skin signs of EDS were merely evidence that I'd let myself get "fatter than my body could handle", despite not exceeding normal BMI. Maybe a BMI on the high side of normal was just too much for some bodies?... And wasn't "eating too much for your body" gluttony?...
Not "growing out" of "childhood asthma"? Another sign of being "too fat for your body": well-meaning adults reassured me about my asthma in childhood by predicting I'd "grow out of it" (though we now know that's not how asthma works), and everyone knows being a fattie makes asthma worse. Knees already hurt? Not an old lady yet, not an impressive athlete who's "earned" spectacular knee injuries, must just be too fat for your knees! Fatigued? Hey, being fat is tiring! And exactly nobody's surprised when fat girls get painful, heavy periods. Why should a normal BMI rule out being "overweight for you" when other signs of overweight are present? I didn't complain to doctors about my "fat signs", either: I already knew "be thin" was standard advice for such complaints, so why out myself as a delusional whiner?
Since I never got painfully thin, or even model-slim, my guilt never seemed obviously irrational – or even abnormal: teen girls diet. I couldn't manage to abstain from food aggressively enough to achieve typical anorexia, and the horribly-distorted body-image we were taught anorexics have didn't apply to me. I was aware I could count all my ribs, thank you, even as my cellulite dimples remained too numerous to count. Reading through the diagnostic criteria for anorexia as an adult, I went through youthful phases that could have just barely qualified. But not usefully.
My conclusion from all this is that, if going through puberty with EDS induces a desire to transition, the desire is a fairly rational one, and, especially if the EDS goes undiagnosed, transitioning might be the closest thing to symptomatic treatment for EDS that youth – and girls, especially – can convince medical gatekeepers to provide. To jump to the conclusion that transitioning is the solution when "the problem is really EDS" isn't much of a jump. And I have no reason to suppose EDS is unique in this regard. People solve their problems with the tools available to them.
I was thinking of a detransitioner I'd seen interviewed. A substantial part of her apparent gender dysphoria was an eating disorder-- she was hoping that being male would help her lose weight.
"Come, you spirits That tend on mortal thoughts, unsex me here" seems an especially appropriate desire for young women with endometriosis that nobody bothers to check for.
I certainly got the message, growing up, that female fertility was supposed to be uncomfortable, but finding it uncomfortable enough to complain of it, much less be impaired by it, was a sign of wussiness, or of something you must've done (like being too fat) to bring additional discomfort upon yourself. Not surprising that this message might lead young women with unaddressed discomforts they did not bring upon themselves to conclude that womanhood itself was the problem.
I know that's how my ancestresses, half of them who had also asthma, and, according to the genetic counselor, probably EDS as well, thought of it. A female body was kind of a raw deal, but also a raw deal one should pride oneself in enduring without complaint or reduced net productivity.
"The closest thing to a "cure" for EDS might be androgens."
Can you say some more about androgens for EDS. I have an acquaintance who has EDS and is having a terrible time coping with grad school because near the end of her first year into her PHD program she developed chronic fatigue syndrome (exhaustion, malaise, exercise intolerance). She and I have read enough of the literature about Chronic Fatigue Syndrome to know that even the doctors who believe the syndrome is a real thing do not feel optimistic about treatment. Seems there's nothing that helps. So she and I are looking for something evidence-based that's worth trying. Can you send me to any info about androgens helping EDS?
First, even the closest thing to a cure for EDS is still likely to be pretty distant. EDS is managed, not cured, and often, slowing decline of function, not restoring it, is what's feasible. (We're premature geezers!) The best way to "recover" function with EDS is to not lose it in the first place (and some lucky people don't). Secondly, for particular vascular problems, such as in vEDS (vascular EDS), doctors may advise blocking androgens to reduce cardiovascular risk (even if that increases suffering and decreases function: funny how high others rate not-dying over not-suffering).
That said:
Tissue laxity from EDS means joints lack normal protection against hyperextension and injury. Joints' range of motion is too wide for safety. To have EDS is to rely more than others do on muscle to stabilize joints, since other stabilizing tissues aren't much help. Muscle-building therapy helps brace joints from inside out, reducing pain and fatigue. Here's a study on strength training as anabolic EDS therapy:
Exercise intolerance makes physical therapy harder, but usually not impossible. Finding a sweet spot that achieves rehab without triggering the intolerance can be maddening though.
And now, to hormones:
The bulk of research suggesting androgens can protect and strengthen connective tissue isn't done for EDS, but to explain the difference in injury rate between male and female athletes, especially, it seems, for knee injury. Complicating matters, genetically male and genetically female cells don't respond to androgens identically, and sex hormones interact. Transmen might not find androgens as protective against EDS as cismen, but testosterone still reduces range of motion (desirable in EDS) in female Wistar rats (measured with a wee goniometer!):
"I saw a reference on the internet to even low doses of testosterone helping with joint stability- and therefor preventing or slowing joint damage. I brought it up to my doctor tentatively... She agreed readily that this was well known and there were studies to back it up.
"I asked her WHY, in the years she’d been treating me, she NEVER brought this up. She confided that there were Side Effects. I listed the effects I’d seen on my friends who’d been on testosterone for years, and she nodded along. I waited for her to add something more dangerous that might apply to me.
"She had nothing.
"She really believed it was such a sure thing that I would rather have chronic pain and potentially reduced mobility than having a lower voice and some extra hair."
(I would mind if EDS, which has broken so much else, also broke my voice, but then, I sing.)
"Almost exactly 1 year in on low dose testosterone gel and... my pain hasn’t been lower in probably 15 years and I’ve stopped worrying about mobility loss. Every part of my health is improved."
Here's another EDS patient using testosterone shots to enhance physical therapy:
"I have been getting testosterone shots for a couple months now, and I have definitely seen improvements. It has helped me build muscle to support my joints, making physical therapy much more effective."
Some people try to treat EDS with the synthetic anabolic steroids bodybuilders use, apparently sometimes with success, but results seem mixed (some of these steroids apparently damage cartilage, others may not).
EDS can suck you into an overexertion-injury-deconditioning cycle, where attempts to recondition provoke injury that forces even more deconditioning, worsening exercise intolerance. EDS can also monkey with the autonomic system and blood pressure, which may worsen exercise intolerance. Some people find eating extra salt helps with this. Autonomic dysfunction can also – whee! – cause/mimic psychiatric distress:
My heart goes out to your acquaintance. I didn't get an EDS diagnosis (much less pertinent treatment) in time to get my PhD, and, even if I had, could I have managed without having personal assistants (which I couldn't afford) to manage the life stuff so I wouldn't be diverting my limited reserves from academics? (A community that loves you enough to offer assistance gratis, and big enough that members don't burn themselves out from that, would be even better, but realistically, how many grad students get that?) If they don't harm sleep, or worsen underlying dysautonomia, ADHD meds can blunt EDS fatigue, help attend away from EDS discomfort, and generally help anyone be their own manager despite a body that's not cooperating. They're just a band-aid, but sometimes we need band-aids.
Midge, thank you so much for this cornucopia of information! Is there a way I can stay in touch with you in case I have more questions? If you have your ACX responses forwarded to your email, I can just contact you by putting a post here. If not, is there some other way I can reach you? Also, do you know of any good resources on the internet for info about EDS or Chronic Fatigue? A forum like this, populated entirely by smart sensible people would be ideal (but that's a pipe dream I know). Friend would probably be willing to try anything that's evidence-based, but not weird faddish stuff (though of course it's not always possible to separate the wheat from the chaff). Her situation is very difficult: She knew from a young age what she wanted for a career, and is very gifted in the needed skills. Managed to go to a top undergrad program and get into a top grad program -- then a year in began to have chronic fatigue. She is continuing to meet her grad school responsibilities, but has a research advisor who has Asperger's or similar, and truly seems to think of my friend as a very well-built AI who can be trained on the adviser's body of research and thereafter will be quite a useful assistant. Advisor makes appointments with friend, then cancels at last minute or is 90 mins late. Asks friend to do investigate certain obscure ideas, and refuses to have meetings to explain things that are so advanced that even the post-docs in the department do not understand them. I'd like to wring her neck. Meanwhile friend's exercise intolerance is so bad that having to walk 15 mins to a meeting left her exhausted for the whole next day.
I do get ACX responses forwarded to email, and have starred your reply. Hopefully, that means any future replies in this thread won't get lost in my inbox.
Overall, the best online resource for EDS is knowledgeable, patient, and skeptical browsing to trawl for information and see what comes up – DIY research, in other words. Since DIY research competes with academic research for an individual's reserves, friends/family who could help your friend with "presearch" (initial trawling) so she can focus on more wheat, less chaff, and divert less energy away from academics, might help her. The good news is that many with these sorts of chronic illness are bright, sensible people whose bodies have to some degree thwarted their career plans, and so who find research on behalf of someone they've never met welcome mental stimulation. The bad news is that chronic illness can leave people desperate and gullible to quackery, or invested in risky experiments. I've noticed there's a paranoid-but-gullible cognitive style that's particularly attracted to quackery, and understandably common among the chronically ill (who've often been genuinely let down by "the system").
"To respond rapidly to infection or cellular damage, MCs [mast cells] express germline-encoded pattern recognition receptors (PRRs) that recognize unique bacterial, viral, fungal or parasitic components known as pathogen-associated molecular patterns (PAMPs) and host-derived molecules, called damage-associated molecular patterns (DAMPs)" – and the EDS body seems extra-DAMP:
But once the immune system is mobilized, it may not settle down. This reference addresses high-energy trauma, not the accumulation of low-energy traumas common in EDS, but since EDS yields poorer prognosis for tissue recovery, it seems relevant:
"Immune dysfunction is accompanied by a temporal shift in the innate and adaptive immune cells distribution... Recent studies have implicated this dysregulated inflammation in the poor prognosis of polytraumatic injuries"
Mast-cell stabilizers are a fairly popular remedy for EDS-related immune, uh... awkwardness. EDS is not an autoimmune disease, but it's common for EDS bloodwork to read as inconclusive for autoimmunity due to vaguely high inflammatory markers. "Immune derangement" seems the official term for conditions of any sort involving abnormal immune activity.
After that digression, onto other resources:
EDS seems something of a cause célèbre in the UK (at least compared to here), so the NHS's and British charitable trusts' info on EDS tends to be fairly good:
PainScience.com, run by former Science-Based Medicine editor Paul Ingraham, may be the most useful single consumer reference available on pain management and musculoskeletal care. Why do we hurt? How do we make the most of limited resources in seeking relief and rehab? How can we benefit from exercise despite exercise intolerance? (a personal issue for Paul, an athlete who developed exercise intolerance):
Now that I've mentioned ME/CF and advocacy, broaching chronic illness to employers or other gatekeepers (including medical gatekeepers!) takes discretion. If not mentioning it at all, then mysteriously floundering, is causing more disruption than seeking available accommodation would, it's fairer to yourself – and others – to pipe up. But even sympathetic people dislike feeling confused or cozened, and while freeloading off claims to illness seems rarer in fact than in people's imagination, it *is* in most people's imagination, especially regarding "invisible illness":
My strategy is to avoid multiplying labels. When the geneticist diagnosed me with EDS, he added, "And I'll write down you've got fibromyalgia, too."
"No, you will NOT write that down."
"But fibromyalgia is a normal result of EDS."
"Since it's a normal result of EDS, then EDS, not fibromyalgia, is the specific explanation for my problem. I don't want terms famed for vagueness distracting up my chart."
To his credit, he listened. Others with EDS may attach great importance to accumulating labels describing the symptoms of their EDS, but I'm more cynical, especially regarding labels notorious for harming patient credibility:
"For women with non-acute problems and a longer diagnostic journey, the challenge seems to be to hang on to your credibility as a reliable reporter for as long as it takes for the mystery to be unraveled."
"Too many" labels often strike others as incredible. Though so can blaming a bunch of disparate-seeming stuff on one underlying cause. And certain labels invite distrust, whether or not they should.
For example, since both asthma and EDS involve immune abnormality, I'm not surprised weird aftereffects can linger after I've had a cold. If a cold leaves me with slowly-subsiding vestibular neuritis for two years, then "vestibular neuritis" should make my chart, since it's not a common consequence of either EDS or asthma. But, since slowed or incomplete recovery from infection is more generally a common consequence of both, why mention "vestibular neuritis" anywhere off my chart unless dizziness or vertigo first comes up? Even then, "EDS means I don't bounce back quickly from colds. A cold inflamed my inner ear and my balance hasn't recovered yet," is more prosaic and *unifying*, inviting less speculation like, "Last month it was 'EDS', this month it's 'vestibular neuritis'. Always with the excuses, this one. Wonder what medicalized excuse she'll invent next" – though, if I were *inventing* excuses for myself, I hope I'd invent ones less ridiculous than what I've really got! Plus, since the vertigo is nearly gone now, no point in characterizing myself by it. Many would rather not characterize themselves by their permanent conditions, either, but once something interferes with your life enough, it's a characteristic whether or not you admit it.
An old friend of mine ended up switching PhD programs because his PhD advisor disrespected his marriage. The advisor still had the old-fashioned idea that PhD candidates' spouses count only as candidates' support staff, not as human beings who may need support themselves, and remained stubbornly oblivious on this point. Switching was a wrench, but worked out OK for him. I don't know if requesting telemeetings in lieu of unreliably-scheduled walk-in meetings, or a mobility aid for the walks, would work for your friend, but people who *can* walk, just who shouldn't walk *much* for some reason, aren't "cheating" by using motorized aids to get around – and some aids, like electric bikes, wouldn't even "look like cheating". I know an ex-ballerina whose legs are uninjured but who uses a wheelchair now because docs worry else her aorta might explode. The biggest problem with using mobility aids in EDS is ensuring they don't increase deconditioning. (Though, if the alternative is aortic dissection, deconditioning might be the lesser of evils.)
It sounds like "not answering to a flake" might help your friend the most. Though simply *being* chronically ill can invite the judgment that you're pretty flaky yourself, weakening your bargaining position to demand less flakery from others.
To end on a happier note, this is one of those "inspirational young heroes" pieces that name-drops some EDS research centers:
What I'd like is for less social contagion causing people to feel like failures at life if they don't match gender expectations, but I have no idea how that could be done.
I mean not everyone can be above average. IDK some of this I feel like is actually a result of this counterfactual "everyone should be a winner" mentality.
I'm baffled that ordinary adults feel any such thing. I couldn't care less what all the rest of you think men should be like, just like I don't care what you expect from persons with any other of my accidental characteristics -- age, hair color (or more relevantly these days hair volume), weight, fitness, accent, habits. If I don't meet your expectations, that's your problem, not mine. Never felt any different.
I mean, that isn't the same as being an antisocial pain in the ass. I put on a coat and tie when I appear in Court, and I stand at a formal dinner when a lady joins the table, because that's what people expect men to do to show respect, but I don't see that as some constraint on who I am -- the clothes do not make the man -- but rather as me jumping through certain arbitrary ritual hoops to express a respect for the social institutions.
I see it as like a salute in the military. An arbitrary symbol that says "I agree with certain basic constraints on my individual expression for the sake of collective harmony." If men in formal settings were expected to paint themselves blue, wear a feather on their foreheads, and switch from eagle to ostrich at age 65, then I'd do that, too, and not think twice about what it implied about my individual identity (because I think it implies nothing at all).
For what its worth mostly the people I have have known well who were very serious about transitioning, were deeply unhappy with prior trauma, and when they actually had a healthy relationship with the other sex, their desire to transition magically evaporated.
A butch 17 yo woman who likes machines and wearing pants who got abused by a shitty boyfriend will IMO be better off with a good boyfriend who doesn't mind her Tomboyishness, rather than a lifelong struggle against her own biology as she pretends she really "is a man" (whatever that is supposed to mean). Not to mention which, a lot of the time she will just feel better in a few years naturally anyway as almost everyone is happier at 25 than 17.
"Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria."
I haven't seen a sentence I agreed with this much in weeks!
"Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria."
It's a problem, and presumably what's needed is a golden mean-- people can be taught too much sensitivity or too much stoicism.
Yes, I agree. As I kid I had all kinds of quirks. I think my parents did a great job of helping me adapt without making a big deal out of it. I had what might now be called "sensory integration issues" -- had a thing about clothing that was snug or rubbed in a certain way, felt intolerable some how. My parents just got me clothes that were comfortable. Had these awful pity attacks for inanimate objects -- once sobbing about my father's intent to cut the grass because I kept imagining it hurt the grass. My father cut the grass anyhow, and my mother comforted me. Said I wanted to be a soldier when I grew up -- parents listened with interest, did not make a big deal of its being a male occupation and not in line with their politics. Believed til age 6 or so that I could learn to fly if tried really really hard. Jumped off living room chair over & over, flapping my arms super fast. Told my mother that I thought I was making progress -- seemed to take longer to hit the ground. "Good for you," she said. "Keep working on it."
Well put. As a parent I am pretty concerned with authority figures telling my children as they go through puberty that if they feel alienated and uncomfortable with their bodies that they may need to castrate themselves or remove their breasts because gender. I’d much rather focus on being at ease with their bodies as normative.
Pretty much everybody feels alienated and uncomfortable with their bodies around puberty. I worried all the time about having a huge, conspicuous menstrual accident, and of course that's a real possibility when you're a beginner. Guys worry about getting huge conspicuous erections, and that's a real possibility too. I think the adults involved have to tolerate the kids' being uncomfortable (while being on the lookout for kids whio aren't just uncomfortable,but are overwhelmed and starting to fall apart). There are lots of things in life you can't have without passing through a period of suffering and confusion, and sexual maturity is one of them. When I was going through puberty, I don't think I would have been enthused about the prospect of sex change -- I thought boys were gross . But if somebody had said, "oh, honey, you feel ugly and embarrassed about your body? That's a sign you have Puberty Inflammation Disorder. We need to get you some medicine." If they'd said that? I'd have totally bought it, and swallowed the pills.
I never felt alienated and uncomfortable with my body at puberty. Indeed, I was very happy to be shooting up in height, and getting hair in various places, and otherwise clearly evolving towards manhood. (Zits I could do without, however.)
Where I do remember a novel uncomfortableness emerging is from the fact that I became abruptly (it seemed) deeply enamored of the female form. Suddenly, it seemed, girls looked and sounded and smelled wonderful, and by comparison I felt loutish and uncouth, a shambling ape-man with all the poetry of a rusty squalling hydraulic press. I despaired that any of these (newly discovered to me) works of art would find something inherently and attractively pretty about me -- pairing us up would be putting Picasso in an unsquare frame nailed together from creosote railroad ties, an unlikely Banksy.
In retrospect I don't even know if I would wish this away from my pimply 15-year-old self. In despair of being admired for my appearance or gait, I worked hard at good manners, at listening well, at being witty and graceful in my speech, as all of these seemed within my power to achieve and might compensate for my clunky form. In retrospect, I'm glad I put the work in, and I dunno if I would have done it had I thought myself the equal (in inherent attractivity) to the girls.
Well, for what it's worth, I'm not a girl and unlikely to be attracted (physically) to you, but I for one am glad you put the work in. (And not just because of your contribution to ACX, I've also read you in various other places for maybe 15 years.)
>understanding why teen mental health collapsed in the 2010s. In brief, it’s the transition from a play-based childhood involving a lot of risky unsupervised play, which is essential for overcoming fear and fragility, to a phone-based childhood which blocks normal human development by taking time away from sleep, play, and in-person socializing, as well as causing addiction and drowning kids in social comparisons they can’t win.
What if we're in a sensitivity death spiral? I saw a tiktok the other day along the lines of, kids seem to be getting less and less resilient in every generation. Maybe it's not just a matter of overprotective parents. Maybe it's a matter of children of overprotective parents growing up and becoming even *more* overprotective of their own children. Same thing could be happening with teachers too.
Basically, overprotectiveness -> anxious kids -> anxious adults -> even more overprotectiveness
I am shocked both by how much of a baby my 9-11 year old youth athletes are, AND how easy it is to break them out of it.
It is as though a huge percentage of them have never before encountered someone "yes you are hurt, now get up and be a man and stop being a baby".
You do it a few times and suddenly they realize that just because they fell down and scraped their knee, we don't need a 5 minute pity party. They can just get up, be hurt with a scraped knee, and keep playing. So many really seem to feel every pain needs validation by everyone stopping and giving them attention.
Those people were around when I was a kid ~30 years ago. But it was the minority, now it seems like it is all of them until you break the habit.
In any case, I kinda think that your use of "sex-change surgery" should be deprecated if not anathematized. Unless you're going to argue, contrary to standard biological definitions, that penises and vaginas -- or reasonable facsimiles thereof -- constitute the necessary and sufficient conditions for sex category membership 🙂
"Gamete competition, gamete limitation, and the evolution of the two sexes" (Lehtonen & Parker [FRS]):
In my freshman year of college, my roommate, who was a violin major, got crippling tendonitis in her forearm, presumably from suddenly playing the violin vastly more hours of the day. (Eventually she changed majors.) Guess who ALSO got crippling forearm tendonitis, despite no corresponding lifestyle change? Me. I'm like 99% sure this was social contagion, but the tendonitis was real.
FWIW I got forearm tendonitis from typing a lot at a desk made for someone taller than me. When I got a keyboard tray it went away. Point being, if your desk at college was set up differently than your one at home, you might have gotten real tendonitis. Or maybe you had real but mild tendonitis amplified by the social aspect.
Interesting - I had the same experience in reverse - I was unusually tall even as a kid, and my handwriting was always terrible. Hated it. Always felt like I had to scrunch myself up to write at a desk.
Then in HS science classes, suddenly my handwriting was way better! Happened to be most noticeable at... the tall lab desks.
Once in second grade a classmate chipped his tooth while at play during recess. This was like only the second chipped tooth I'd ever heard of.
Later that day during lunchtime, I went up to my teacher and said "I think I chipped my front teeth!" "Nonsense!" came the reply. The teacher knew all about social contagion and its power among susceptible seven-year-olds.
Little did she know how powerful social contagions really were, for indeed I had accidentally chipped my front teeth. Now I understand that it was really the first kid's fault.
Anorexia strikes me as a particularly bad culture-bound mental illness to have, since after patients psychologically recover their metabolisms are frequently still messed up, sometimes forever. Amok damages lots of bystanders, people get killed in kuru-panics etc. etc.
Is there like, a harm-reductive culture-bound mental illness we could import? Hikikomori seems relatively harmless and reversible, if very bleak. "Workaholism" is rather pro-social but doesn't feel like a real mental illness.
As a young American living on the west coast, though admittedly also one who’s deeply in a Japanophile cultural scene, I feel like we’re already working on importing hikikomori-ism. Or maybe the incel identity is already filing that potential-space.
Surely a lot of it is just that video games have gotten more addictive at the same time that it's become easy to obtain an endless supply of them at trivial or zero cost.
Running amok in video games is also a substitute for running amok in real life that wasn't previously available and, again, comes at much lower cost.
Jogging for recreational exercise is a relatively recent phenomenon that's spread like wildfire all over the world since it was labelled in New Zealand in the 1960s. People frequently get into Jogging and its big brother Running because of friends or family who participate. Cardio has very widely accepted health benefits
This is where the mental illness category gets funny. A culture-bound mental illness has to be a way that a distressed individual acts out in a maladaptive way. Otherwise it's just a trend, not an illness. But maybe unhappy Person A jogs in one culture and runs amok in a different culture, but for time and chance.
I had no idea the term jogging was popularized in New Zealand btw. As with culture bound mental illnesses (or trends in general) it apparently occurred sporadically throughout history. The Wikipedia article on jogging includes Roman mosaic of a jogger which looks so modern I thought it was fake:
I picked up cutting socially in my teens (female born in the 90s) as a way to cope with intense feelings, but quit a few years back because it was starting to genuinely fuck up my life. I white knuckled through urges for a couple years before getting into jogging. It acts as both a healthy outlet when I do feel terrible as well as just boosting my overall mood. If I'd been in the more athletic clique in high school instead of the Tumblr kids, I might've skipped the cutting part altogether.
Self-injurious behavior in the form of self-cutting is a fairly culturally universal symptom of mental illness. One might think that one is peculiar to cultural practices, but it seems cross-cultural enough to be primarily a function of human nature.
It's also still fairly taboo to talk about in the US. In my experience people, including people who self-cut, are often surprised to hear about how common it is.
Is self-cutting as widespread historically and in other cultures as it is in the US/West now? My gut feeling is that it used to be a very strong signal for significant mental illness, but has become more culturally relevant and known, and therefore is a much smaller signal for mental illness, in line with Scott's post.
I think the specific of cutting is sort of cultural, but the idea that mental anguish should have a physical signifier is nearly universal. In times of great distress, I have hit myself with a hammer out of what I think are the same urges but a desire to conceal. The knife seemed very appealing in those times. I think the ancients custom of 'rending their garments' or 'sitting in sackcloth and ashes' are rather more reasonable ways to gratify the same impulse. Our society gets an F at dealing with grief, or any emotions that don't immediately payoff for the collective.
Self-cutting is a subtype of parasuicidal self-injurious behavior/self-harm, which is cross-culturally widespread. Self-cutting specifically, especially if you include scratching, is also common cross-culturally, though estimates of frequency have large ranges as you might predict. Rates vary by demographic, but it's found everywhere.
With respect to the US, it's always been fairly prevalent when we've looked. There's been a strong cultural taboo regarding it, so it's one of those things that people tend to be surprised is as common as it is. It's a common response to distress, often characterized as a coping response in the literature.
I have worked a fair amount with people with cluster B personality disorders and a comorbid cognitive disability. Self-cutting and other forms of parasuicidal self-harm is a classic trait you find among people with borderline personality disorder, and my sense (just my sense!) is that a lot of people associate the behavior specifically with people who present borderline symptoms. But that's not really accurate.
Jogging is absolutely a culture bound mental illness. Mass groups of people running in circles burning scarce valuable calories, for most of human history you'd have to be rich and/or a lunatic to do it
Except sports is part of every human society, and as Ivan said, the Romans jogged. The Greeks ran foot races. If a human universal is a mental illness, then what isn't?
Calories are not scarce. We have them in excess. And we are not the only species that burns energy playing when calories are in excess.
If we ever get an economic crisis so severe that the median person is forced to get by on 1500 calories while we wait it out, I'd expect the popularity of jogging to plummet.
I would place it as "sometimes a symptom of muscle dysphoria". As well as anorexia or any other culture-bound disorder that might result in excessive exercise. But people exercise for all kinds of reasons, which sometimes leads to injury, and not all of those reasons are maladaptive. If someone feels tired a lot and is frustrated that they quickly run out of breath, starts exercising more to address that, and develops tendonitis because they didn't stretch enough, that's not a symptom of a mental disorder.
I think your second paragraph implies an interesting follow-up question: is there limited cultural "bandwidth" for culture-bound mental illnesses? If we import new ones will they 'out-compete' the old ones and reduce their prevalence, or will we just end up with anorexic hikikomori?
I get the feeling that school shooters have displaced some older types of bad people, like serial killers. And yet, they probably aren't the same types of individuals.
People were depressed before the 1960s, yet there weren't school shootings. And its not just school shootings, which could be explained by social contagion - its also mothers killing their children and such. People with no prior history of violent behaviour suddenly loose control, and a very high percentage of them are on SSRIs.
Why would you kill random people, particularly children, because you are sad and in despair? Killing people is something you do when you are suffused with rage, or too sociopathic to be able to identify with another human being. Doesn't seem to have anything at all to do with feeling bad about yourself all the time.
I’ve been curious about the wave of anarchist assassinations/bombings that occurred in the 1880’s-1910’s, then petered out. It always struck me that the perpetrators had a similar profile to modern school shooters. Not discounting the impact of SSRIs or other modern influences but it seems plausible that angry young men with few social prospects, regardless of the historical era they live in, will seek out specific and culturally contingent methods to justify acting out revenge fantasies against the societies that have ‘wronged’ them.
Anarchism was a big deal up through about the Spanish Civil War, with a high death toll of assassinated national leaders and figureheads. But unlike Marxism or Fascism, it's largely forgotten today.
Also worth noting that these incidents were often ‘explained’ through the lens of pre-existing moral panics at the time. In Czar Alexander’s case it was ‘this is what happens when we introduce liberal reforms’ while McKinley’s assassination and Sacco & Venzetti were ‘this is because we’re letting in all these non-Anglo immigrants’. Much like ‘first person shooter games caused Columbine’
„Priming“ is one of those soc-psy terms that went up in flames in the reproducibility crisis, IMO rightfully so. People can distinguish between reality and fantasy.
well, "sensitizing" is the verb Scott uses in the post. If you are chill with that term? ;)
Btw: yes, you are right, mostly. Nonetheless, some "priming" was reproducible, if I remember correctly. Just a fun add: Putin and his Russians, Trump, Bernie, Marx, Freud, soc-psy- Wokeists - "people's ability to distinguish between reality and fantasy" seems overrated. Reality and its ability to hit those following the fantasists - and hit them hard - is fine as ever.
"Priming" is a concept in Cognitive Psychology too, and plenty of cognitive priming results still seem to be reliable. I think the sequence is that "priming" was a term coined by cogs and then social psychologists extended it in sily ways, but I wasn't able to verify that quickly.
Priming could be nonsense. I believe it's an extreme form of a reasonable idea-- people do get influenced, but this doesn't mean that the exciting idea that people can be reliably influenced by itty bitty stimuli that they don't notice is a lot less likely.
Perhaps it would be more interesting to see whether or how much people are influenced by overt patriotic displays.
Right. People obviously get primed to do stuff all the time. But what works changes all the time, and people who are good at priming (e.g., rock stars) can make a lot of money off their talent. But even rock stars have a hard time staying on top of the world for more than a few years before turning into nostalgia acts.
The Malcolm Gladwell era priming fad was about marketers hoping that psychologists could invent cheap and enduring scientifically valid ways to prime people into buying the marketers' stuff over and over. Not surprisingly, that kind of priming didn't replicate that well.
This is not to say that priming doesn't exist: Red Bull has managed to prime a lot of people into buying Red Bull. But they've worked awfully hard at it and spent huge amounts of money (e.g., sponsoring winning Formula 1 teams) to get people to buy Red Bull rather than the 100 other brands of energy drinks.
Legal novelist John Grisham sponsored a civil lawsuit against filmmaker Oliver Stone after a boyfriend-girlfriend couple watched Stone's "Natural Born Killers" and then murdered at random friend of Grisham's. Stone eventually came out on top.
There are quite a few apparent examples of "Natural Born Killers" copycat murders:
Well also school shooters have fewer options. A potential school shooter in 1920 could just drop out of school and join the army or become a gangster or whatever. A potential school shooter in 1870 could go west and kill natives and cattle rustlers (or rustle cattle themselves).
Despite society being much bigger and in some sense easier to "lose yourself" in. We are also more trapped than ever. Particularly high schoolers. The 16 year old who hates everybody and everything about their life who for the vast majority of human history likely just disappeared into the wilderness or took up with another tribe/city/whatever, now is going to have the state drag them back to their family in most cases.
This is a good question. Crazy Like Us talks about how old ones die off (there was an earlier anorexia wave which ended, Freud-era "hysteria" is gone, modern PTSD is quite unlike Da Costa syndrome) but now that I think about it, the book doesn't establish or claim that new culture bound illnesses displaced old ones, just that the old ones went away.
I'd been operating under the assumption that distressed people need some way of acting out, and would reach for whatever is "normal", but yes there are a lot of people who have symptoms of multiple mental illnesses so I suppose we could end up with anorexic hikikomori.
Is "hysteria" gone, or do we have other names for it? The phenomenon we refer to as women being "Karens" seems to fit some of the criteria for hysteria. If we're going with a theory of social contagion, it seems very likely that a lot of the specifics could be cultural baggage.
Classic features of hysteria included things like fainting, convulsions, and catatonic states. Individual symptoms get reproduced in other diseases (like TikTok Tourette's) but I think it would be hard to find modern people with the same combined symptom set that was very common in the late 1800s/early 1900s.
Hmm, perhaps my mental image of hysteria comes from later culture? Men telling women to stop acting up because they are "being hysterical" in the 1950s or something.
Just to throw in some more culture-boundedness: mass shootings are somewhat common in the west, but what we don't get is people throwing acid at other people's faces.
Pretty sure that has something to do with how you don't usually have undiluted acid and chemicals casually for sale. The best an average person can do is bleach from Costco, which some people handle without gloves and don't get more than a slight stinging. If you really tried I supposed you can get salon grade hair bleach but that tends to be pasty not good for disfigurement, or you could break into your local uni Chem Lab?
Guns, on the other hand, are very easy to get in the US.
I feel like the means to violence isn't quite as easy to analyse because there's laws that make a huge impact on accessibility. In Australia, the number one form of violence is just punching someone at the back of the skull, usually drunkenly (not easy to be out and about with any kind of weapon - INCREDIBLY easy to get alcohol, it's 18 and up rather than 21 and up).
Everybody has a theory about why school shootings and similar mass killing shootings are so much more numerous today than a half century ago. Trust me, the 1960s and 1970s were not a generally virtuous or restrained era, what with their frequent serial killings, political assassinations, skyjackings, bombings, and muggings—to list five violent crimes that rapidly got worse over the course of those years but now appear to be in decline (as are earlier crime fads such as bank robbery and kidnapping for ransom). Back then, school shootings and the like were just beginning to become a thing in American culture.
Why did school shootings come out of nowhere to turn into a cultural construct, rather like running amok with edged weapons against random passersby was long something that a few (but still too many) men did in some Southeast Asian cultures?
It’s worth considering some alternative timelines that didn’t happen to play out in America. For example, the two worst school atrocities in America appear to have been the 1958 Our Lady of the Angels fire (most likely arson) that killed 95 in Chicago, and the 1927 school bombing in Bath, Mich., that killed 44. (The school fire is remembered locally in Chicago but not nationally, while the bizarre school bombing was largely forgotten until dredged up after Columbine by people looking for something new to say about school shootings.)
I could imagine alternative timelines in which school arsons or school bombings became an American curse rather than school shootings. After all, there are plenty of guys who like setting fires and plenty of others who like blowing stuff up.
For example, bombings became fairly common among radical leftist terrorists at the end of the 1960s. According to Bryan Burroughs, author of Days of Rage:
In a single eighteen-month period during 1971 and 1972 the FBI counted an amazing 2,500 bombings on American soil, almost five a day.
Note that these tended to be smallish bombs set off late at night that mostly broke glass. But antiwar activists did blow up a physicist in the 1970 bombing of Sterling Hall at the U. of Wisconsin-Madison.
School destruction was in the air of popular culture at the time: The 1979 movie Rock ’n’ Roll High School, for instance, ends with the Ramones helping the students blow up and burn down their high school.
But neither school arson nor school bombings became an attention-focusing aspect of American life the way school shootings did.
Why? Was America always fated to have a mass killing shooting problem? Perhaps: America always had a lot of guns. Rifle practice was common in American schools until late in the 20th century. But previous eras didn’t see students getting shot en masse.
One unsatisfying but not implausible theory is that school shootings are just a contingent cultural construct: For most of American history, virtually nobody shot up schools for the same reason that virtually nobody demanded a sex change: Because whoever heard of such a thing? But once a bad idea becomes thinkable, it can sometimes have quite a run among the unhealthy.
For instance, even though there were a few dozen aircraft hijackings in world history before the late 1960s, the concept barely existed in the popular mind. Then, in July 1968, Palestinian terrorists hijacked an Israeli jet and held hostages through forty days of negotiations, finally walking free. This riveted world attention, brought immense publicity to the previously ignored Palestinian nationalist cause, and put the idea in the heads of quite a few jerks that hijacking an airliner would cure whatever ails them.
Soon, skyjackings were a thing. For instance, there were at least ten hijackers who tried to copycat D.B. Cooper. After a few years, airport metal detectors cooled off the trend, and then, hopefully finally, the passengers of Flight 93 deterred most post-9/11 would-be hijackers.
More bizarre examples than skyjackings include castration crazes. The Russian Skoptsy religious sect, which demanded castration of men and mastectomies of women, had about 100,000 members in the early 20th century. Similarly, in the English-speaking world over the past decade, discontented girls demanding top and bottom surgery became a thing.
At least with school shootings, everybody agrees it’s a problem. In contrast, respectable opinion views our new castration cult as a solution.
Isn't respectable opinion right? My understanding of these culture-bound illnesses is that they might only get started because of the ideas floating around in the culture, but once they do get started they're as real as any illness and need to be treated. At the moment, transition is the only real cure for gender dysphoria. Maybe changing our culture's messaging about gender will result in fewer people developing dysphoria in the first place, but once they've developed it it's way too late.
I think you've gotten the concept of "culture bound syndrome" mixed up with the concept of "fad." Culture bound syndromes are not passing fads someone can just shake off, they are genuine illnesses caused by some strange feedback loop between our software and our wetware. Even if the software is where it started, it's entirely possible that the wetware is the only place it can be finished.
I also wouldn't underestimate the perversity of the interaction between human biological systems. It seems entirely plausible that someone might have vague depression-ish symptoms for various reasons, lump all those symptoms together into "gender dysphoria" because that's what's available in our culture, and then have those symptoms be completely cured by surgery, even if the lack of surgery wasn't the original cause of them. Neural pathways are really strange things. It would explain why transition seems to make so many transpeople happy.
I've always been sympathetic to the idea that the emergence of national TV news in the 1960s played a big role[1]. Let's suppose you took your revolver and went to your local school in 1924 and shot 2-3 kids before the nearby adults jumped you and beat you to death. Certainly you would have been big news in that community, people would've talked about it for years. But you wouldn't have been national news, or even international, because to the extent those things even existed they were slow and ponderous ("President Wilson Sets Sail For Paris Peace Conference -- More Details In Six Months"). I'm not saying local tragedy might not make the papers at some distance -- your trial might turn into the Lindbergh kidnapping trial -- but it would be an uncertain thing, and not nearly as immediate and universal as the era of national network TV news, in which a news helicopter can be filming the SWAT team cautiously moving in on you within an hour.
It's certainly not obvious that all school shootings are motivated by a twisted desire for attention, but it also seems no small theme. So...create the audience, and the actor appears, willy nilly.
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[1] That emergence has been argued to have played a major role in the difference between the Vietnam and prior wars.
The invention of videotape and satellite transfer of video is one reason a lot of boomers tend to believe, deep down, that history began with JFK's assassination and the Beatles appearing on the Ed Sullivan show in 1963-1964.
The U. of Texas tower mass shooting in 1966 was one of those early events that was covered vividly on the newly dynamic national television news.
On the other hand, there was only about one copycat crime soon after and then the concept faded away for about a dozen years, a period in which other crime concepts like serial killings and skyjackings took off. The next school mass shooting that made a splash was the "I Don't Like Mondays" one outside San Diego in 1978.
If you are looking for an example of cultural contagion, I've long suspected that Alfred Hitchcock's amazing 1960 movie "Psycho" may have had an impact on the rise of serial killings in the 1960s and 1970s.
No, I don't really believe in cultural contagion, or really in almost any socially-derived motivation for radical decisions by individuals. My go-to theory for any radical decision by an individual is that it is rooted in that individual's psychology, and feeds one of the basic drives -- for money, power, fame (or infamy). And then of course individuals leverage the social shibboleths and doom pr0n of the day by pasting it on top of their boringly quotidian actual motivations. I'm not a criminal, I'm a revolutionary! I'm not sick and twisted in the ordinary way people have been sick and twisted since the Pharoahs, I'm a living symbol of the social changes that you all fear! Et cetera.
I would count them when there's a clear cultural connection to the deficiency or poisoning.
I would count black lung due to the way coal was/is tied to Appalachian identity. From reading the Wiki pages Minamata and Itai-itai seem more like mass industrial accidents, and I wouldn't count something like Bhopal or (going back to Appalachia) C8/PFOA. Reminds me of what Scott wrote years ago in a different review about cassava processing, which is culture-bound knowledge *avoiding* poisoning and that's an inverse situation to culture-induced poisoning.
For deficiencies... if it was due to a cultural dietary restriction, that would definitely count. Not if it's economic or coincidental- even though sailing caused the restriction, I don't think scurvy among sailors would count. If sailors had some weird superstition against citrus, though, that would've counted.
I suspect that some of the deficiency diseases are going to blur the lines between cultural and economic causes. If a culture traditionally uses N foodstuffs, and some critical nutrient is present in only one or two of them, and some economic problem causes those one or two to become less available then it could be that the combination of culture and economics causes the disease.
One weird case: Consider suicide via carbon monoxide poisoning from vehicle exhaust. That suicidal people considered it as an option probably depended on "cultural contagion" - knowledge of the presence of CO in exhaust, and of its toxicity. And it was culturally limited to industrial cultures with internal combustion engine vehicles (possibly also pre-catalytic-converters).
Worth noting that there may be reasons other than cultural for becoming anorexic while living in the US. If you think that at least part of the obesity epidemic, which while worldwide is definitely worse in the US, is due to environmental poisoning especially accumulation of 'something' in the hypothalamus, thyroid or the like, then in such cases of poisoning it is normal for some percentage of the population to have the opposite effect from the poison, instead of inducing obesity inducing severe underweight conditions. Which doesn't entirely explain the psychological impact but it is food for thought. Explained better by the slimemoldtimemold guys. Not sure that I believe it but worth considering.
I've always thought that workaholism is just one symptom of generalized anxiety disorder, mostly based on personal experience of both. On cultural-biological spectrum, GAD is probably at approximately the same point as depression.
> The patient was uncooperative - he was only visiting MDs because the local bishop wouldn’t call in an exorcist until he got a psych exam - and eventually left against medical advice.
I take it you never found out what happened to him?
While this is not the same patient, there are fascinating interviews with Catholic exorcists to be found on youtube which state that in cases where a psychiatrist affirms that the issue is demonic (like the attending doctor here), they have a pretty good success rate at curing the condition.
There was also one quite interesting anecdote where a patient who visited the Bishop for a possession got quite sad when he heard that he was just mentally ill after the examination, as a demonic possession would have at least explained what was wrong with him for him.
The demons here seem like the ants crawling on or under the skin in the other examples.
If your illness is entirely due to some kind of "I believe I am possessed by demons which leads me to feel demon-possession symptoms which makes me believe I am possessed by demons" feedback loop then it seems plausible that an exorcism could break that loop.
The odd thing was that the report of the possessed being treated by the exorcists read extremely similarily, almost verbatim, to Jung recalling how he treated some of his patients with psychoanalysis in Man And His Symbols. Basically they were just doing the same thing with them each day, going through these little rituals without much visual improvement, although some change present, for years, and suddenly the possessed/psychotic stood up, said they were cured, thanked the psychoanalysit/exorcist, said they understood now what happened and they would have never been able to resolve that by themselves, and then went home to never have issues again.
It makes me wonder now, connecting these stories, if maybe exorcism works by the same route as psychoanalysis, by (using their teminology) using the mundane to manipulate the unconscious through the signifying chain to resolve trauma, and if reversed maybe psychoanalysis is some sort of modernised scientified version of exorcism, which would explains why it retains a certain impressive measure of effectivity despite being completely hostile to the scientific method and everything that entails.
"Schizophrenia researchers in Japan in the 60s dealt with a case of a woman who had an alternate personality which claimed to be a fox spirit. They decide what the hell and tried a traditional solution - build it a shrine on the condition it goes away. It went away."
I kept reading and reading waiting for the reference to Morgellon's disease. Yes, you had to get to gender dysphoria, that was a given. And there is at least a mention of chronic lyme. But the two most striking instances of this phenomenon to my mind are the remarkable upsurge in diagnoses (in some quarters of the culture) of different versions of neuro-atypicality, especially autism, and Morgellon's, which makes people sure they are discovering whisps of cotton-like fibers coming out of their body. Still, I don't want to be churlish. This is a great review, especially as half of a diptych with the one on Watters' book.
Autism, ADHD, and whatever we call the opposite of "neurotypical" - neuro-atypical?
I'm old enough to clearly remember before Autism was something anyone really knew about. It existed, and there are clear cases of it, but people generally didn't know or talk about it. Severe cases were known as "mental retardation" and mild cases were...I guess either ignored or people were considered weird somewhere between quirky and antisocial.
>Severe cases were known as "mental retardation" and mild cases were...I guess either ignored or people were considered weird somewhere between quirky and antisocial.
The third option was that their family locked them up in a hospital and didn't talk about it.
Depending on what period you are talking about, a lot of people who would receive a autism spectrum disorder diagnosis today were once diagnosed with childhood schizophrenia and/or intellectual disability (formally "mental retardation"). Diagnostic substitution, along with increased clinician awareness, is the main reason for the appearance of an increase in autism in the public.
Leaving aside low-functioning individuals who are called autistic today and were called retarded in the past, I suspect that high-functioning autism spectrum / Asperger's Personality individuals were less common in the past. I was born in 1958 and don't recall meeting a schoolkid like that until 1973.
Many people who have an autism spectrum disorder have an intellectual disability. In the relatively recent past, the equivalent of an ID/DD diagnosis is all a person with an autism spectrum disorder might receive.
I don't think I ever met a full-blown "Revenge of the Nerds" / "Big Bang Theory"-style nerd until tenth grade in 1973. He'd do things like write all the dates in his history class book report in Base Eight. He got into Caltech but immediately flunked out.
The next year, I got to know a happier, better adjusted nerd, the son of a famous science fiction writer. He explained that computers were making society better and better for people with his type of personality: tomorrow belongs to me was his view.
I remember hearing about Morgellon's in about 2006, but not much since - did it persist or was it a one-time thing, the way vaping-related lung disease was in 2019?
Autism is an interesting one because as long as it's diagnosed in childhood (which I think is still the most common time to get diagnosed?), it seems pretty unlikely to be a case of social contagion in the *kid*. But I wouldn't be surprised if there end up being "outbreaks" of autism where one parent finds out about it and then a bunch of nearby parents also get their kids diagnosed
I was thinking of more late-childhood / adolescent / adult diagnoses, and especially self-diagnosis. I have no doubt that "spectrum" is a fairly decent metaphor human neurodiversity, and "increased awareness" is a good explanation for a lot of these cases of late- and self-diagnosis; but I am dubious about whether they all qualify as a single "condition." It is unquestionably validating for lots of people to discover that when they talk about what it is like to be them, other people say "Yes, me too, and moreover, this has a name and it's listed in the DSM". Probably this is therapeutic in and of itself to some extent, but that it is also culturally determined seems obvious to me.
Autism spectrum disorder isn't a single condition. It's a collection of conditions that are symptomatically similar such they go under the umbrella term. Someone whose ASD is the result of Rett syndrome doesn't have exactly the same thing someone who has fragile X and ASD. You have neurodevelopmental differences that produce patterns of behavior and cognition similar enough that we bracket that and call it ASD.
That is very helpful to know. So it's professionally acknowledged that the commonality is in the family resemblance of manifestations, and not in any ostensible etiology. I'm not sure this awareness has been popularly disseminated, but that's less surprising. Thank you.
Relevant anecdote for once. So I was nineteen years old, first summer working in the sawmill between college and got sent out to replace a length of chain on one of the many chutes that moves sawdust from the mill to the chip pile. Working that day with a guy from West Virginia named Big John. He’s the millwright and I’m the lowly fire watch.
We drive across the shipping yard and he almost runs us straight into a fork lift. I grab my chest and say “Jesus John, I thought we were ghosts there for a second.”
He laughs but gets a distant look in his eye.
We don’t say anything on the rest of the drive out.
We replace the chain. No big deal. He lights a cigarette because no one ever goes through that part of the mill and I have a hose right there anyway. Without preamble he says:
“A ghost touched my honker when I was a young man. Ghosts are very loving creatures. You don’t have to be afraid of ghosts.”
I ask him “what?”
He tells me he worked a year in a logging camp when he was a young man. Him and another guy shared a room. It was summer and super hot so he’d just sleep under a sheet. The ghost would come into his room at night and just hold his honker then leave.
He tells me this over like ten minutes and I start to ask questions about his roommate. No the roommate didn’t have a girlfriend, never said anything about girls, just wanted to hang out with Big John.
I very politely and compassionately suggest to Big John that he was sexually assaulted by his roommate.
He goes, “nah, he was a Presbyterian.”
He goes back to the machine shop. Had to be reminded he told me this later because it was no big deal.
I just sit out there for two hours with my hose. I go back to the lunchroom when my time is up. I try to tell my friend Dude about the story. A guy named TJ overhears and insists that it happened to him too.
At this point I’m sure they’re fucking with me and it’s all an elaborate ruse, and say so. TJ who usually doesn’t care about anything gets really emotional and says he knows what happened.
Then Aaron the apprentice millwright comes in and TJ tells him to tell his story about being molested by a ghost and Aaron just leaves because it’s too much.
Big John, TJ, and Aaron all also had no teeth due to tobacco use and were the only ones with that affliction so in the course of a day I suddenly knew three people with no teeth who believed they were molested by a ghost.
Over the course of two summers I became satisfied they legitimately believed this all happened. This is also why I don’t fully trust any weird experience I ever have no matter how profound.
He was quite religious so he didn’t like to swear. He also yodeled sort of when he talked and everyone I’ve ever met from West Virginia since then says that no one there talks like that, and I just assume that everyone else is from some lame over civilized part of West Virginia.
There are other explanations besides molestation. Erections happen naturally. He could have dreamed it or unconsciously held it himself as part of a dream while in a hypnagogic state. Interesting story though!
True. Sleep paralysis had crossed my mind. The other two did seem a bit more emotional than him and it’s not uncommon for someone with sexual abuse trauma to pretend it was aliens or ghosts instead.
The second and third ones sound like sleep paralysis. There was a famous case in Halifax, NS, where a journalist wrote a column about being raped by a ghost, which was clearly sleep paralysis: couldn't move, happened while waking, ghostly presence, pressure on chest. Just textbook. (Unfortunately I cannot find the full column, but part of it is below). Funnily, he interviewed a theologist about ghosts instead of a sleep expert.
PTSD might be confounded by the fact that war has genuinely gotten more horrible in the modern era - a Roman soldier only had to worry about the guy in front of him trying to stab him, while the modern soldier has to worry about suddenly being exploded by a drone five miles up, or by an artillery unit 20 miles away, or by a cleverly hidden landmine, or... well, there's a lot of things that can suddenly and randomly explode you in modern warfare and I think that would lead to a lot more stress and fear.
I'm not so sure war has gotten more horrible in the modern era. Yes there's artillery now, but there's also things like anaesthetic for wounded soldiers getting amputations.
What I’ve heard of as being potentially the relevant factor that is different in more modern wars is the “anxious wait” where you’re in a combat area but not actively engaged in fighting, but you could still randomly get killed with potentially no warning. The argument goes that this latter wears on the psyche much more than the former.
Think almost a Phobos-Deimos split, the difference between facing a cavalry charge (terror) and patrolling a street in Afghanistan with the constant fear that someone you thought was a random citizen will open fire on you (dread).
Right. The pre-modern soldier might spend many months marching but only one day in actual battle in their whole career. A single day of bad memories is a different prospect to a whole year of them.
Greek city-states in 500 BC tended to fight about one battle each summer that lasted perhaps an hour. So, a respected (and lucky) warrior might see 20 hours of combat in a lifetime from age 18 to 37. In contrast, trench soldiers on the Western Front in WWI might have spent thousands of hours within the reach of sudden death from artillery.
"The battlefield of the logistics soldier lies so heavily entrenched in the realm of the mind - the psychological plane. Unlike our brothers in the combat arms, we rarely go on the offensive. There is no cathartic release for the logistician that an attack can permit an infantryman... Instead, your survival hangs on such random factors as vehicle armour, proximity to a blast, and pure luck. Providence. That is hard to accept. The first move in a convoy fight belongs to the enemy and that is terrifically unsettling. Soon every Toyota that strays too close to your truck resembles a bomb, every colourful kite is a semaphore signal, and every smile from an Afghan pedestrian betrays a sinister secret. Ground convoys extract a continuous toll on the psychological reserves of a logistics unit."
Lieutenant-Colonel John Conrad, What the Thunder Said
Speculation, but there might be a change in perceived levels of control over your fate in war. In the past war took place at shorter ranges, due to the limited range of weapons. You could almost always see your enemy, or at least be in the vicinity of them. But since the mechanisation of war, the range has increased. Today you can be bombed by a plane flying several miles high, blasted by a drone you cannot see or hear, or killed by a missile fired from the other side of a continent.
It is also possible that the way our culture interacts with death and hideous injuries has changed. In the past death was much more a part of daily life, and without modern medical care, people suffered with injuries for longer. Today death has been swept into a corner, and I imagine many people have rarely seen dead bodies or even animals, or had to kill an animal themselves. Medical care means people are generally healthier but also in better shape. Could that mean that when we do experience death and horrific injuries, we are less able to cope with it?
I believe there is a theory that PTSD is actually a result of the compression shock from explosions, but I can't remember where I read this. Might explain the change, though.
Good thinking. I hope you do sometime, you were more fun to read in the Jane Galt days, and maybe a Substack approach would allow you to cut loose a bit. Begging pardon in advance for the presumption, it seemed to me you were having more fun then, too. Naturally with middle age and responsibility and respectability there arise in any pro-social human being constraints...and age brings nuance to one's thinking, too. Plus we all need to pay the mortgage. So not criticizing in the slightest! Just saying it would be a treat to someday read some (more) McMegan dangerously unbound, so to speak.
PTSD was called "shell shock" in WWI. Then the name was changed to "battle fatigue" in WWII and later to PTSD. The concussion aspect of PTSD is now back to being emphasized after all the IEDs in Iraq.
The factor of control also seems relevant. In an ancient battle, the threat comes from a guy with a sword trying to stab you. That sure is scary - but you also have a sword, and if you're good enough with it, you'll likely prevail. You have a chance to impact your fate, secure your survival with your own ability. Conversely, if you're being shelled from beyond the horizon, there's nothing you can do except take cover and hope you don't get hit by shrapnel.
Couldn't most of the protective factors we have for soldiers be PTSD-enhancing? In the Roman era, you were much more likely to die of even minor wounds. In the modern era, you have a much better chance of surviving. But the terror and pain you'd have felt in the course of being wounded, stay with you. I have to expect that modern war is also simply much louder than ancient warfare, and the wounds soldiers can suffer can be much more gruesome because the weapons we use are so much more powerful.
My (non-expert) picture of an ancient war is a lot of men lined up shoulder to shoulder, yelling and screaming, with metal clanking on metal, getting slashed and having arrows sticking out of them or perhaps being trampled, with most of the wounded dying. Armies would stay in the field for only short periods of time due to severe logistical constraints. Battles were often more or less planned one-day events in which two armies would see each other, line up, offer battle, and fight.
My (non-expert) picture of a modern war is men on patrol in unpredictable urban environments or in the field, with explosions and loud sprays of bullets, having entire limbs blown off with no warning, then potentially being rescued from death despite these severe injuries, potentially being in the trenches or in war zones for weeks or months at a time, and fighting not only against other people but potentially also against enormous machines of war. This seems *much* worse to me.
The current war in Ukraine seems especially horrible because of the precision accuracy of 21st Century weaponry. In the past, an optimistic soldier could hope that the other side would simply miss him over and over until he went home, but now it's harder to trust in your luck.
I was thinking the same thing. One of the first instances of biological(also psychological) warfare was flinging corpses at the enemy. You were also at much higher risk of starvation, freezing to death, that kind of thing which are relatively traumatic. Of course there was also decimation where a captured unit would be lined up and every tenth man killed. If that doesn't give number 9 survivors guilt then nothing will.
Modern warfare is all of the romantic movement's complaints about industrialisation honed to a sharp point.
You see, in the old days killing each other was an artisanal, communal affair - carried out in the clean open air and reflecting a generally slower pace of life. Most ancient armies could only campaign for part of the year, and a battle was considered gruelling if it went on longer than a few hours. There were the usual horrors of warfare, yes, but you were at least confronted by the person who wanted to kill you and had the ability to kill them back if you were lucky. Arrows and siege engines (both considered unsporting in how they enabled a person far away to maim or kill someone who could not retaliate) only reached out a few hundred metres at most. And you fought surrounded by comrades, giving both physical and psychological security.
By contrast, modern warfare is stressful, grinding and inhuman. Modern soldiers can be menaced by random death for days, weeks, sometimes even months at a time, sometimes with no rest or respite even when they rotate to the rear. And when death comes, the unfeeling hand of artillery and other heavy ordinance tears human bodies apart in ways that ancient human-powered murder weapons simply cannot accomplish. Even bullets to things to the human body that the ancients would have found obscene - having the insides of someone's head scattered all over you was not a common experience for soldiers before the age of gunpowder.
Worse yet, the need to disperse and take shelter from the sheer destructive power that modern industrialised killing can unleash means that modern warfare is an isolated, atomised experience - the common experience of soldiers across the 20th century has been of small numbers of men fighting murderous, individual battles across a massive front whose convulsions are invisible to them.
This is a good argument. If I may rephrase: Modern warfare has actually *extended* the spectrum of human experience in the direction sheer horror, anxiety and despair. The newfound extreme end of the spectrum may cause an equally newfound experience that we call PTSD.
I have seen a lot of grueling footage of the Ukraine war and agree with your description above.
Or it could be that in the past a very broad cross section of men went to war. However after WWII predominantly young men went to war. After the draft ended, predominantly young men who had neither prospects for college, nor career went to war.
So you're thinking that young people, maybe due to less maturity in some manner, are more prone to PTSD? Or could you elaborate if I'm not catching your meaning?
Multiple factors. Yes younger people, young people not led by older calmer men, not surrounded by older calmer men. Young people who don't have a clear direction in life. Young people who have less family support. Except for those who start out with a military career plan, people who end up in the modern - post draft military end up there because they have no better options.
A couple of other possible reasons why PTSD might have gotten worse since ancient times:
1) Society has gotten more peaceful, leading to a greater disparity between wartime conditions and peacetime ones. If peacetime society were more violent, some level of hyper-vigilance might actually be useful. It's not a disorder if it's adaptive behavior.
2) Some of the symptoms of PTSD used to be more culturally acceptable in other cultures. An ancient Roman who got drunk frequently and/or beat his wife might have been considered an asshole, but not someone that law enforcement or medical professionals needed to do anything about. Nowadays, our culture doesn't see that kind of behavior as benign.
An alternative to 'society has gotten more peaceful' may be 'life has gotten less deadly'. Very few people die of illness at a young age. Kids don't work in industrial or farming jobs where the risk of death or injury is high. Most people's experience with death is the elderly, dying of conditions associated with age.
I think this may play in to more than just PTSD; we've done our best to insulate kids from the reality of life, that there are a number of things they can do that can lead to life-long consequences.
Most people these days have never personally killed an animal for food, whereas probably virtually all males had hunted wild animals or slaughtered farm animals in, say, Roman times.
I talked to the head psychometrician of one of the major wings of the U.S. military about their officer selection test. One of the best predictors of having the right personality for being an officer was enjoying bloodsports like hunting.
A problem I see in this hypothesis is that most young men these days have "hunted" and "killed" thousands of creatures (including rather lifelike humans) in their virtual gaming world by the time they reach adulthood.
One can of course cry "That's different! There's not real blood, only CG blood! Everyone knows it's not real!" (which is what those who strenuously defend video-game violence from the argument that it crosses over to shit like school shootings say all the time). But I'm a little dubious about this distinction vis-a-vis a tolerance for war if the underlying criteria is "enjoys being the cat in a cat-and-mouse game with a deadly outcome." There doesn''t seem much greater lack of that in AD 2023 than AD 202.
What might be very different, though, is the experience of being the mouse -- and *that* may be very relevant to how well you do in warfare, where some days you're the cat, and some days you're the mouse, and often both on the same day. It would seem very plausible that young people today have much less experience of *being hunted* or even being in danger from an intelligence, animal or human, with harmful intent and unbound by rules of fairness.
Even leaving aside the experience of warfare, there were fewer effective social constraints on individual and familial acts of violence in the ancient world. You might easily have had the experience of a family feud or bully or someone you crossed who might decline to take his vengeance in the modern way of courts and lawyers, but instead just find you in a lonely spot and beat or kill you. Family and tribal rivalries in general seem like they could be much more directly dangerous, like rival gangs in south LA today. And of course there were many more actually dangerous animals around, too.
Contra Grossman and the "murder simulator" hypothesis, video games are a very low-resolution simulator of violence. Sight and sound are limited to the screen and ear-safe levels, you don't get a full sensory experience, including effects of heat, cold, pain, exhaustion, etc. They also miss a key component: high stakes, or "skin in the game". Even today in some remote communities, a bad hunt means no protein for your family. When I worked alongside subsistence hunters on their own land, they were able to read the environment in a way that I simply could not. Likewise, people who have grown up in unstable social environments may be able to tell when it's time to leave before a fight breaks out. For the average N. American, there are multiple layers of insulation between "absent-minded mistake" and "dying a horrible death." It's a shock to be suddenly immersed in an environment where small decisions can have life-or-death consequences.
A while ago, I read a semi-convincing case that many cases of PTSD among war veterans might actually be, or at least made much worse by, symptoms of traumatic brain injury, inflicted by detonations of artillery shells, bombs, IEDs and whatever else goes boom on modern battlefields.
Confounded by the fact that if a doctor said that damage to the brain's hardware meant Private Snuffy's brain was not going to will Private Snuffy's body back to the front, Private Snuffy would get rest and treatment. Saying that it was damage to the brain's software that lead to this outcome, would get Private Snuffy a quick trip to the firing squad (or maybe back to the front, if the threat of a firing squad summoned up a bit of extra willpower, but without treatment).
Doctors understood this; officers understood that doctors understood it as well, but most of them didn't actually want to shoot their own men for cowardice, so everyone was highly motivated to agree that yep, it's the exploding shells what did that to poor Snuffy's brain.
I've also seen a David Drake essay about how war is worse because it's more continuous than it used to be. It doesn't stop at night or for planting and harvesting.
It also involves continuous loud noise.
And, as stated, death is more random. Individual courage is less likely to be protective.
Time has also been proposed as a factor. A pre-modern soldier could, under normal circumstances, expect to be in combat for maybe a couple hours on average, and never more than a day as no battle lasted beyond sundown. Further, under most circumstances a pre-modern soldier would receive plenty of warning of an upcoming battle, as baring an ambush or a siege the enemy would always have to approach slowly from the horizon to engage their formation.
In contrast, one month in Flanders in WW1 covered enough time in active danger to equal the entire fighting career of a Roman legionary.
Maybe, but surely being in a siege for months while the city is starving would be pretty much guaranteed to cause PTSD. I am not aware of anywhere that the trauma afterwards is memorialized. Maybe just because it is assumed, or maybe in some way they moved on with their lives, with a capability that we have lost?
I do wonder about the Roman preoccupation with gladiators and other extremely violent sports. Even if less common than our modern interpretation, it's true that they would regularly go watch people die gruesome deaths, for entertainment. Were they simply more comfortable with death and gore than we are? Surely such a society would have less PTSD from witnessing similar acts of violence in other contexts, even if they still had something like PTSD.
"Were they simply more comfortable with death and gore than we are?"
Yes.
Violence to or between animals was extremely common: hunting, slaughtering your farm animals, bullfighting, dogfighting, foxhunting, etc. E.g., in Thackeray's "Vanity Fair," the Oxford-educated son of an aristocratic Church of England prelate has few subjects of conversation other than upcoming dogfights and contests to see which dog can kill the most rats.
I wonder if the incidence of PTSD is as high in the guerilla types. Unlike the American garrisons, they don't generally have to worry about random citizens pulling out a gun, but they do have to worry about drones etc.
Also PTSD is sometimes related to head injuries, modern explosives are probably way more likely to give you head injuries than ancient projectile or hand held weapons...
Not certain if they are more likely. I suppose something exploding will probably generate injuries in more people (with an ancient weapon you can generally only hit one head at a time after all).
How correlated are head injuries and PTSD though? I don't think I've seen any literature on that.
The constant anxiety is one possible difference. I'm also partial to the idea that you had time to decompress after intense battles in the past, where as now you could have mowed down 50 people in an ambush in the middle east then be back in normal, boring suburbia 36 hours later. That's got to mess with your perceptions. At least after World War I they had a couple of weeks on a boat to acclimatize to normalcy.
Well, Scott suggested that most conditions like that are on the spectrum between biology and culture. Or maybe even more complicated than that. Fibro and Long Covid are somewhere there, most likely. My ex had fibro and refused to accept it for a decade or so, and their condition slowly deteriorated to disability. I know a few people who fought long Covid, some succeeded, others got worse. My gut feeling is that it's more biology on average than culture. But I am quite sure that there are some people out there that just need a metaphorical swift kick in the ass and some psych meds to get better. I wish there was a test to figure out the right remedy.
I took the point, as much, to be that some things wouldn't happen without the culture input. Anorexia being one that is fairly strong to consider. In cultures where that is a thing, you have malnourished people showing up. It is clearly physically degenerate.
As such, it isn't that they need a "metaphorical swift kick in the ass." Whatever full set of inputs go into causing it, once here, it is here.
That is, culture bound activity seems to be part of the input to lead to this situation, but it is a very real situation once you are in it. Right?
I think there is a difference between an illness and a manifestation of it (someone else in the comments pointed out something similar). People rarely just randomly get anorexia, it is usually a manifestation of some underlying severe mental struggle. Before anorexia it would likely manifest differently, say, as self-harm, overeating, "hysteria" etc. The manifestations tend to "lock in", of course, and become addictive habits really hard to get out of, though there is a range of interventions that tend to help manage them.
But long covid, fibro and chronic fatigue are a different beast altogether. Most of the time the symptoms are not relieved by psych interventions, trauma therapy or tough love. There is something physiological going on, and I don't think there is a good handle on what it is exactly. The obvious potential culprit, some Mitochondrial Dysfunction has not been shown to be the main issue.
I'm nervous to accept "before ____, it would have manifested as something else." To wit, jealousy and such are clear evidence that knowing how others are will impact how you react to something. And I don't think it is at all controversial to say that jealousy can lead to physical symptoms.
I've also had times where I was cycling and was not at all "dizzy" until someone asked if I was dizzy. At which point I basically fell over trying to take status on whether I was or not. And vertigo/dizziness is clearly a physical thing.
Fully agreed that there is not a good handle on what, exactly, we are looking at.
Fibromyalgia/chronic fatigue is one of the things discussed in Elaine Showalter's "Hystories". I heard of that book via a Holocaust revisionist citing it as evidence that people were hallucinating poison gas attacks between WW1 & the post-WW2 era.
Lindybeige made the point of avoiding the term PTSD in his video, which IMHO was a smart move, because PTSD is a diagnosis with specific criteria. Not all psychological trauma is PTSD, and the instances people like to cite as ancient people traumatized by war, like the blindness of Epizelos, are not symptoms of PTSD.
As someone who has had mild issues with anxiety I can sense that the anxiety exists outside of anything to be anxious about. It’s there and it tries to find a way to manifest itself. I’m assuming this is something similar. The “crazy” exists and will find something to latch on to.
It's possible to be diagnosed with mood and anxiety disorders based entirely on emotions, observable behaviors, and somatic symptoms. The cognitive symptoms - worrying, rumination, catastrophizing, etc. - are just a few of many possible ways to fulfill the criteria. If (simplifying heavily) being in a particular situation triggers tachycardia, sweating, a feeling of lightheadedness, etc., and if I've learned to avoid that situation through, essentially, operant conditioning, then I can meet the criteria for an anxiety disorder without having any conscious thoughts at all.
But the psychotherapeutic constructs of mental disorders *center* the cognitive symptoms. It's just taken for granted that if you have an anxiety disorder, then you worry, and if you have a depressive disorder, then you ruminate and catastrophize. Identifying your maladaptive thought patterns is Step 0 of all the best evidence-based therapies; the fundamental assumption is that bad feelings are caused by wrongthink, and if you correct the wrongthink, the feelings will follow.
If you try to explain to a therapist that you avoid certain situations because you feel anxious but you aren't actually worried *about* anything, you're fully convinced that nothing bad is going to happen, you're actually a pretty optimistic person...they look at you like you grew three heads. They have no idea what to do with that, so they start probing for secret repressed bad thoughts.
I don't know how many other people have had this particular experience, but I suspect the number is not zero. I also feel like someone less stubborn would probably just start agreeing to the leading questions and convince themselves that they actually had all the bad thoughts they were supposed to have. But from my perspective, the whole picture looks inside-out and upside-down.
"I don't know how many other people have had this particular experience, but I suspect the number is not zero."
Avoiding the wrongthink but having the symptoms anyhow? Yep.
Have a therapist look at me like I grew three heads? Nope. Being patronized to because behavioral-health gatekeeper assume that my word that I'm not doing the wrongthink must simply be bogus? Yep. To their credit, some believe me, and even have helpful advice to give on what to do, rather than what to think.
There are some physiological interventions you can try to relieve physiological symptoms associated with stress/tension/negative emotions. DBT workshops do teach some of them often under the banner of "distress tolerance" or "management."
This was my experience with depression as well. My therapist was very insistent on finding the experiences and thoughts I had causing me to be sad and when I insisted that everything was fine except for the depression she thought this just meant I was repressing deeply and needed more therapy. I eventually have up, got put on antidepressants, and all my recurring/compulsive depressive thoughts went away, the physical heaviness and slowness went away, the anhedonia went away..... except for when I forgot to take my meds for several days and relapse. I am now quite skeptical of a lot of therapy-style interventions that confuse the symptom for the cause, because I regret spending years in therapy suffering without making any progress on the problem instead of just trusting myself that the problem was chemical and could be fixed quite simply.
A lot can come from self observation too. It was a revelation to me to find that occasional feelings of doom and gloom in the morning were not linked to either depression or weird premonitions of the world, but to eating sugar before sleep. The sugar low was enough to make me gloomy. Granted this is not "real" depression, my point is, the root cause need not be cognitive, and the root cause need not be something very complicated. It could simply be in the food you eat. BTW ... wasn't that the theme of "Listening to Prozac"?
Doesn't the trope also show up in the Odyssey? I'm almost positive Ulysses is wary of sleeping with Circe less because he's worried about being unfaithful to his wife, and more because he's afraid of, well, you know the drill by now.
Well, i saw the gorilla and counted the right passes and had no prior knowledge, so i must be a superior human right?
However in all my years reading Scott never have I once spotted one of his double thes. Its a life goal of mine. I will snap into enlightenment the moment it happens. One of these days, Scott. you cant quit writing until i get it okay?
Huh, curious that people feel this way. I'm happy that my brain filters out irrelevant junk on the fly without tripping me up, that's system working according to specs as far as I'm concerned.
You're right of course. I think for me it's because I went through an education system heavily based on standardized exams that tested (among others) your ability to nitpick quickly and accurately, and I was good at it and got consistently rewarded for that, which likely conditioned me to feel bad whenever I miss nits, a conditioning that's now maladaptive.
I would say even if the feature of your cognition is in the general case useful, if someone knows enough about it to trick it, repetitively, whenever he wants, for years, mildly kicking yourself is a reasonable response. Thats an adaptive process.
I read an essay, years ago, about the importance of proper grammar and punctuation. At the end, it's revealed that the essay itself is full of grammar and punctuation errors. The experience of reading it kind of "broke" my ability to automatically detect such errors, which is annoying in work settings but nice when I just want to read something. Ever since, I've had to "turn on" my grammar checker in order to catch errors.
You reminded me of how I felt reading Lethem's "The Ecstasy of Influence". Basically, me : Lethem's essay : plagiarism :: you : that essay : grammar and punctuation errors.
Regarding school shootings, I once went through the entirety of https://en.wikipedia.org/wiki/List_of_school_shootings_in_the_United_States_(before_2000) article and it turns out that there were literally zero school shootings before Charles Whitman in 1966. The article lists a lot of shootings _in_ schools, sure, an eight grader accidentally shot a classmate while showing off his new revolver, that kind of stuff, but it took having a brain tumor to come up with an idea of shooting a bunch of schoolchildren to get back at the society. And then twenty-some years of gradually increasing number of copycats to popularize the idea that this is what some people upset at the society do.
I personally find it striking that the US used to have a lot of serial killers in the 70s/80s and now has a lot of mass shootings and no highly publicised serial killers. It could just be reporting bias, (there are still serial killers but they don't get the press the Zodiac killer did?) but it sure feels like the would-be-serial-killers switched to being mass shooters as that became the dominant cultural fear.
The most prolific serial killers in recent times have been medical professionals that killed very ill patients and disguised the murders as natural deaths.
assault weapons aren't really a thing. To the extent that they do exist, they are harder to get now than they used to be. And research has shown approximately no causation (or even correlation) between violence and computer games.
It's interesting how the video game drama refuses to die, whereas the intuitively much more likely culprit - the omnipresent "if it bleeds, it leads" style news - somehow never gets the blame.
If you’re making the narrow point that “AR-15s are not assault rifles because they are not selective fire” and that truly automatic weapons are rare and hard to get, then I agree.
But the thing that the media calls “assault weapons” and are stereotypically used in active shooter crimes are genuinely more common than they used to be and easier to get (they were banned for a period, and they didn’t become the most popular civilian rifle platform until after the ban was lifted).
I could be imagining things but from the inside it sure feels like gun culture has gotten way more “semi-automatic rifle / tacti-cool collector” focused over the last couple decade. In the 90s the prized weapon was a fancy hunting rifle or over-under shotgun, now it’s a tricked out AR with fancy optics and other customizations. I remember “plastic guns” being disdained among the serious gunners in a way that’s been absolutely flipped on its head.
Yes, high capacity semi automatic long guns have been widely available in the U.S. for a long time, but I was intending to object to the idea that they “harder to get” than they used to be, or that they barely exist at all. They are much more common and easier to get than during the “assault weapons ban” days to be sure.
M1 carbines (or indeed any semi-auto long guns) never dominated popular gun culture the way “modern sporting rifles” do now.
M1s that were surplussed to the citizenry violated the NFA (minimum barrel length was originally 18") The government response at that time was to change the SBR definition. Contrast that with today's BATFE which has decided that they'd rather just demand that millions of citizens either relinquish their (previously legal) equpiment or become felons.
You could use the culture-bound disorder argument for mass shootings as a justification to ban "guns that look like AR-15s".
If the cultural image of a mass-shooter is a guy with an AR-15 in a tacticool/Matrix outfit, maybe having to do it with a pistol wouldn't be as appealing to a potential mass shooter.
The “mass shooters always use AR-15s” thing seems to be a comparatively recent meme. Pistols have been used in many mass shootings as well (Columbine, Va Tech, Ft Hood, and Tucson (Gabby Giffords) are a few of the more famous).
All other considerations aside, magically disappearing every pistol would have a much greater impact on murders than semiautomatic rifles - homicide by rifle is something like 2% of total homicides.
They're very much a thing - the term is misleading, but an accurate, easy-to-control semi-automatic rifle with 30+ round magazines is pretty fucking handy if you want to shoot a lot of people.
For example, I can finish a 10-plate dueling tree with my AR in about 5 seconds. Sounds impressive, right? Nope. Did it on the first try. It's really easy.
Doing the same with my 1911 pistol? Goddamn difficult.
Semi-automatic rifles didn't *cause* the rise in mass shootings, but they're for damn sure a part of why the body counts are so high.
I'll just be blatantly racist here for a minute, and say that any mass shooting where injuries>deaths, the shooter is black. If Deaths>injuries, shooter is white.
The confouding factor is military service. Black killers who have military training are very good shots, see the DC Sniper. All Other black people, the joke is they shoot like Eazy-E and can't hit jack-crap.
It's a fun game, try it! Oh, shooting in Houston, 14 injured, one fatality. Let me speculate that the incident was gang-related. Utah, 5 dead, one injured: White People
The information and social and technological safety nets were A LOT looser back in the 1970's and before. There were no cell phones or surveliiance video. It was normal for kids, teenagers to "run away from home" and disappear. People would just up and leave, hard to track them ... that also meant disturbed loners with sketchy pasts could drift from state to state, find a new job/apt/nightlife, without instant questions like, "what was your last job", or, "account for every single second of your life and disclose all your social media posts or we will assume you are a disturbed psychotic sex murderer because you don't have a facebook profile"
TL:dr -- It was Way easier to be a serial killer back then, you could murder dozens of people and even children back then and get away with it for years and years. Until advances in technology changed that and then we suddenly and publicly caught a lot of them at once.
________________
I mean, John Wayne Gacy murdered ~34 young men and teenage boys in mostly in Chicago, in the 70's. Many of them had actually worked for his contracting company, and/or were last seen with him, or said they were going to meet with Gacy to "pick up a paycheck" and were never seen again. Police questioned him several times, but just accepted stories like,
"Yeah, Darrell picked up his check and told me he was gonna split for Ohio, parents were hassling him, kids ya know! What can you do?"
That almost direct quote says volumes about the 70's in partial answer to your question.
BR
My personal favorite tidbit about Gacy and the Chicago PD:
"Oh, those three boy's High School class rings sitting in the candy bowl right by the front door? With, like initials and engraving on them that you cops never thought to look at?
"Well, some kids I hire, they spend all their pay, then ask me to "float" them... one was gonna pawn his class ring, so I had him "pawn" it with me, he knows it'll be here when they can pay me back. Yeah I've did that lotsa times, a few guys never came back to get their rings outta 'hock.' Huh, well kids you know."
One of the big pieces of technology that reduced serial killers was information sharing across police departments. Ted Bundy was able to elude capture for a long time because he killed in different jurisdictions that didn't/couldn't communicate.
The Idaho stabber may have wanted to become a serial killer, but he got caught by all the technological resources the cops have at their disposal these days when they really want to catch a killer.
As an example of how crime doesn't pay anymore if you really piss the cops off, like the Idaho stabber did, who got caught by a combination of security camera video and genomics, a lady I know had her throat slashed by a home invader who stole her smartphone. (She somehow survived.)
Less than 48 hours later, I was driving by the local police station and there was a TV news truck out front and a vaguely familiar-looking TV reporter was climbing out of it. It could have been for anything, but for once I felt with a certainty that it was Good News. "They caught the bastard!" I exulted, and raced home and turned on the TV.
Sure enough, the LAPD had tracked down all the lowlifes he'd called on her phone and told them that if they didn't give this would-be killer up, they were going down on whatever charges it took to put them away. Several of his gang-affiliates squealed that the guy they wanted ate breakfast every 8 am at the Boyle Heights McDonalds. The cops arrested him there.
My wife recently visited the victim, her husband, and her new baby.
Small town cops don't let anything happen in their hood. I was working in a small town in Nevada, accidentally butt dialed 911. After I explained everything to the dispatch, they still sent a cop to visit me.
This transition is fascinating to me, as well - I would love to see Scott (or perhaps this already exists) do a deep dive on the similarities and differences between serial killers and mass shooters.
Columbine was supposed to be mostly a bombing, but the bombs didn’t go off.
It’s an intriguing counterfactual - would the “Columbine effect” and all the downstream copycats and culture warring be different if the Columbine perpetrators had been a little better at improvised explosive construction?
Interesting thought - would we have had a series of school bombings instead of shootings? Seems logical that the numbers would have at least shifted in that case. More bombings and less shootings. That some people would have access to guns but no access to bombs seems likely, though, so I doubt we would have a 1-1 substitution.
I think people tend to overestimate the difficulty of obtaining the material and knowledge to construct an explosive or incendiary device (“block a door and set the building on fire” could also have body counts at least as high as mass shootings, and I think there are some historical examples of this).
And simultaneously underestimate the difficulty of acquiring the weapons used in these shootings - AR style rifles and their ammunition are expensive, and “America has no gun control laws” hysteria notwithstanding you do generally need to pass a formal background check and an informal “most gun store owners don’t actually want to be the guy that sold a gun to a spree killer” vibe check (or live with someone willing and able to do so).
In any case (and perhaps differentiating them from the Malay amok) active shooters seem to usually go through fairly intensive planning for their crime - it is in a deranged way their magnum opus, not a spur of the moment crime of opportunity. So the acquisition difficulty bar would need to be raised quite high to be a successful preventative on its own.
We are lucky that nobody, so far, has copycatted the 2017 Las Vegas shooter who fired from on high into an outdoor music festival crowd, presumably in order to set the record for most killed and wounded.
My guess is that Columbine-style mass killers want to look their victims in the face up close and personal, and thus the Las Vegas shooter's modus operandi is too distant and impersonal.
On the other hand, the LAPD recently bragged that it stopped a Vegas style high-rise attack in Hollywood.
There are many public "facts" about the Las Vegas shooting that lead reasonable people to conclude that it was a total false-flag, FBI-CIA-XXX operation, a massive cover-up for actions by a foreign power, etc.
If you think about certain things, the physical details, the fact that gun-control activists are'nt talking about it, the impossibility of one guy firing 400 rounds etc, and mostly the total silence around it, it seems pretty strange.
I personally am sure it was a govt-approved and covered-up operation.
Interesting, but reading the source Wikipedia uses it's still nothing like a modern school shooting: A guy went on a drinking binge, tried to sleep, got angry at nearby schoolchildren for being loud, slapped one, got hit with a baseball bat, got home, grabbed a shotgun and started shooting.
Whitman was nothing like a stereotypical school shooter. Besides the whole "elevated sniper nest" bit, he didn't back down when confronted by an armed response.
A good friend bought a house in the Los Angeles area, and in the first week, while replacing an electrical outlet, he found a chunk of newspaper inside the wall, with the headline "School Vice-Principal shoots, Kills Six in La Canada". Date was ~1954.
This is not new and anybody claiming so is lying for profit.
Right. And then the next widely publicized school shooting was the "I Don't Like Mondays" one outside San Diego in 1979. I've often argued that, ironically, the Boomtown Rats song about it by beloved humanitarian Sir Bob "Live Aid" Geldof was the key social contagion event that made school shootings a Thing in the United States:
But I don't know if that is true. I was a big Boomtown Rats fan at the time, but in the late 1970s they were much more popular in the UK/Ireland than in the US. "Despite reaching number-one in the United Kingdom, it only reached number 73 on the US Billboard Hot 100."
On the other hand, a lot of New Wave stuff that fizzled on American radio in the 1970s became well known during the 1980s, so I wouldn't rule out the influence of "I Don't Like Mondays." Geldof himself says he regrets the song because he got a letter from the shooter thanking him for making her famous.
I wonder if there weren't significant differences in people's behavior in the past that make them basically unrecognizable, psychologically, to us today.
The example I think of sometimes is Beatlemania -- where, by all reports, people were literally fainting and collapsing and having other strange hysterics about the Beatles playing in the 60s. I wonder if back then lots of people had such different backgrounds, e.g. having grown up with no exposure to mass media, that they really did have hysterical reactions to things we find more mundane today. (There are many other possible stimuli that would have been dramatically changing around the 60s -- fewer traditional/highly-repressive cultures than behavior; relaxed codes of dress and interactions, whatever modern psychology was at the time...) And that's not even that long ago.
Basically I wouldn't be surprised to learn that, if I met somehow met someone from ~1800, their reactions to things would be completely unintelligible to me, but along axes that I have trouble imagining precisely because they're so unintelligible. So perhaps people really did get 'hysteria', but they mostly don't anymore, simply because "times have changed"?
People really did get hysteria. All those women coming to doctor's offices begging for help weren't lying, nor were they all sexists out to slander women. People really did get neurasthenia too, before this culture-bound syndrome also went away: https://en.wikipedia.org/wiki/Neurasthenia
I mean, I basically have this disease? Nowadays I end up with a lousy pile of 'we don't know why but it sure isn't working' diagnostic terms ('functional dyspepsia, bronchial hyperreactivity and autistic burnout') but it matches neurasthenia closer than anything else, it's just nobody will diagnose that any more :-). (it all seems to be downstream of the same thing, which is essentially 'gain on the nervous system turned up too high', but there isn't an active neat diagnosis for this, which is a pity because having to explain all the separate parts is irritating and makes people more inclined to dismiss it than if I had a single sciencey word for it.)
I also don't really see what the difference is between neurasthenia and a variety of "modern" disorders, like panic attacks or anxiety maybe combined with some somatic symptoms.
My 15-year-old mother-in-law screamed through a Sinatra concert in 1945. She probably would have screamed through a Liszt concert in 1845 and a Beatles concert in 1965. She was an outstanding classical pianist (Chopin was her favorite) and had superb taste in music. Liszt, Sinatra, and the Beatles were all great, and teenage girls deserve credit for figuring that out ahead of grown men.
I can't speak from direct experience, but historical clothing folks who do are pretty consistent that the idea that corsets commonly interfered with breathing movement are way overblown.
Corsets were not particularly constraining because they weren't particularly small, at least according to this video by a woman who's worn a corset for a spine issue since age 14 and calls it extremely comfortable: https://www.youtube.com/watch?v=rExJskBZcW0&ab_channel=BernadetteBanner
(I might have first seen this video in a ACX comment. If so, I forgot whose comment it was, so sorry for not giving proper credit!)
No, the idea of corsets and stays causing widespread issues of restricted breathing and fainting is a fiction trope that has little connection to reality. While there were a few very brief fads for tight-lacing among some members of the aristocracy, it was incredibly rare, to the degree of "man bites dog." The idea that tight-lacing was commonplace has been thoroughly debunked by several clothing historians, the most prominent being YouTubers Bernadette Banner, Karolina Żebrowska, and in particular Abby Cox. Cox worked in historically accurate costume for five years in Historic Williamsburg and describes the experience at length here: https://www.youtube.com/watch?v=DyWnm0Blmh4
For what it's worth, I have a minor interest in costuming, and have worn both corsets and stays, usually in the "historically accurate" way where the undergarment is comfortable and supporting, but occasionally tight-lacing to squeeze into a too-small garment.
While tight-lacing created a sensation of constriction which was moderately uncomfortable, I never got anywhere near not being able to breathe, much less feeling faint. Corsets aren't hydraulic presses which smash the body inward; they mostly just displace some of the flesh up or down. I was always able to breathe normally in them.
According to legend, early motion picture audiences were terrified by a movie that consisted of a train rushing towards the camera, reacting as though they really were about to be hit by a train.
The "panic" caused by Orson Welles's infamous "War of the Worlds" broadcast, however, seems to have been greatly exaggerated by newspapers that took a New Media Are Evil stance towards their new competition, radio.
2017 we tried then state of the art fully immersive, full body tracked VR in an Indiana Jones setting. People afraid of heights flat out refused to walk across a bridge that really just was a wooden plank lying on the floor. Personally I needed a couple of seconds to push myself to do it...
According to the staff there, other groups had people going into the screaming fits even.
Orson Welles was awesome, which is why you can't always believe everything Orson Welles says. Same for other contenders for the title of World's Greatest Storyteller, like John Huston, Frank Capra, Shelley Winters, and David Niven.
It's funny that you think of Beatlemania as something significantly different from today, because I always thought of it as being an early example of something I think of as typical of contemporary behavior, ie. the lack of shame at behaving in an uninhibited way, shouting and bouncing about at concerts and the like. I agree that people today are over-exposed to media and desensitivized to it, so maybe they are less likely to "lose it", but on the other hand, maybe not (I have very little exposure to rock concerts and fandom and that kind of thing).
The idea that people have changed so fundamentally in 200 years is hard to understand for me.
It seems that New Kids On the Block and One Direction had similar followings with similar behaviors, despite being almost 30 and almost 60 years away from Beatlemania.
Well, the difference is that the Beatles' music was at least okay. Pop has been relentlessly optimized since then to reach the lowest common denominator.
My highly sane mother-in-law had been a 15-year-old bobby-soxer who screamed through a Frank Sinatra concert in 1945. Personally, I think that shows fine taste: Sinatra and the Beatles were really, really good.
1. Earlier today I was reading an article about Impostor Syndrome in the most recent New Yorker. I don't have Impostor Syndrome, I was just looking for something to read during dinner. But near the end of the article one random sentence clicked for me, something about the way it described the fear of being revealed as not knowing something, and this dread started rising in me, a feeling like when you have to give a presentation in front of a bunch of people that you didn't properly prepare for.
Naturally I suppressed the feeling right away. Just like you would suppress the desire to kill your boss. No good thoughts come from that direction.
Maybe I narrowly avoided contagion with impostor syndrome.
2. I may have written this in the comments before, but German doesn't have a word for "anxiety". Instead you use different words depending on what's happening. Like stage-fright or shyness or fear or nervousness or dread or panic or uncertainty or 'under pressure' or stress or homesickness or sorrow or 'feeling tense' or concern or phobia. I think it's part of American culture to mix a lot of these things together. Sure they have some similarities, but they're also clearly different. Like hunger and thirst are similar but clearly different.
E.g. you might be unable to act because you're shy or because you're uncertain. Americans might just say they're "anxious" in both cases. I can see how if you're both shy and uncertain, then their effects build on each other and you have a stronger combined feeling. But that doesn't make them the same thing. If you're both hungry and thirsty, their effects also build on each other. (and excuse me if I got my example wrong and "shyness" or "uncertainty" are not actually examples of "anxiety". As I said I still don't fully know what the word means)
If Imposter Syndrome is an intellectual contagion, I think it spreads more on a mechanism like the Barnum Effect than koro, where it's describing something completely banal and common but making it sound unique an exotic.d
"Do you ever feel anything less than 100% competent at what you do, and sometimes think that everyone else does something better than you so you to put up a front pretending that you're better than you actually are? Congratulations, I diagnose you with not-being-a-complete-narcissist, A.K.A. 'imposter syndrome'".
Honestly, I think basically everyone has some shades of what gets called "imposter syndrome". I think it's kind of just the default state. Like I'm overall really confident at my ability to do my job, but if I were so inclined, I'm sure I could talk about having "time management imposter syndrome" where I think everyone else is more productive and better able to manage time than I am.
Maybe there's a more core, narrow definition, but it seems to me that a lot of the talk of Imposter Syndrome is this sort of broad idea that could apply to practically everyone.
The other thing about impostor syndrome is that the concept is in vogue in academia, yet academia has a very low retention rate--the vast majority of graduate students will not get full-time jobs. This means that most people who think they're impostors, really are impostors. They really aren't good enough.
I don't think so. I can't say whether it is restricted to academia, but in academia the impostor syndrome is definitely very common among people who are not impostors.
For myself, I always had a pretty strong impostor feeling, and I think this started before I had heard of this term. And I have made a good career in academia. Actually, I *still* frequently have this feeling, even though I am pretty certain that there are no objective reasons for it.
And superstars have it, too. I have recently talked to a guy who is research-wise the most impressive person of his generation in my field. He had more than 25 papers published during his PhD, half of them at the top 3 conferences. Of course, he is now professor at a top place, but he told me that he that after his PhD, he was quite unsure whether he was good enough.
This assumes that the retained ones are actually better than all the ones who quit. As opposed to "had a second income" or just wanted it more or had a more supportive advisor etc.
Rather like Hollywood or political interns. When there are far more applicants than there are positions, a lot of the selection factors have nothing to do with merit.
Do you feel like your experience of "anxiety-adjacent" feelings has changed after acquiring the concept of anxiety? A good friend of mine and I have discussed it at length several times (also procrastination, although not in exactly the same way). Neither of us comes from a culture where there is a word or a singular concept for anxiety *exactly*, and both of us feel that we've started experiencing it only after being immersed in the modern English-speaking culture that focuses on it a fair bit. Our introspections suggest that it became a self-perpetuating attractor in the space of possible experiences: something "anxiety-inducing" happens => you think "anxiety" => it brings up associated feelings from past experiences => "anxiety" becomes stronger => goto the beginning. (For both of us the discovery of the concept has co-occurred with some big life-changes and relocations, so no one can draw any strong conclusions, but still.)
Also, reading that German, which is relatively close to English, doesn't have a word for "anxiety" makes me wonder whether there even are non-English speaking cultures that do.
I have not, but maybe I'm just low "anxiety" in general... I have few problems with stress, few big fears, and don't worry too much about my life or the future.
The one thing where I would score moderately high on "anxiety" is shyness. E.g. I would grab food at the company cafeteria, scan the available tables, and if there's no one I know well, I'd decide to sit alone because I don't want to deal with the awkwardness of talking to new people or people I barely know. And, relatedly, bad stage fright. But I can deal with both of these. I do occasionally force myself to sit with new people, and stagefright can be handled (not overcome) by being very practiced and by going to the bathroom five times in the thirty minutes before it's my turn.
So maybe I haven't connected the dots because only a subset of these feelings are a problem for me.
Well "Angst" seems to me to be the closest thing to "anxiety" in German. English seems to draw the concept from the Latin "anxius": troubled, uneasy. English "fear" is cognate with "Gefahr" (danger/risk), which makes sense- fear is more of a "justified" version of anxiety i.e. there is a real threat or risk of peril.
Angst and anxiety both ultimately have the same PIE etymology, although one has come via Latin and the other Proto-Germanic- "h₂enǵ" which seems to mean something related to narrowness/compression/constriction/anxiety. Ango/angustus in Latin (to cause pain, and narrowness respectively) and angustiz/angasaz in Proto-Germanic (narrowness, worry, anxiety).
Very curious, as one of the main symptoms of anxiety I experience is a tightness in the throat and chest. and as far as I am aware this is a pretty common experience, along with raised pulse and so on. So it might be an example of deriving an emotional state from the physical symptom. Or perhaps it is to do with the very common fear of enclosed spaces, or of being boxed in, or "caged". I suspect it is more to do with the symptomatic similarity.
Interestingly, the proto-Indo-European root word for hungruz in Proto-Germanic (Hungry), is "kenk-/kank-" which meant something like “to burn, dry, pain, desire, hunger, thirst”, which is funny considering the differences between thirst and hunger you pointed out earlier!
Angst is distinct from anxiety, it would be rolled into fear in English. It is not synonymous with the American loan word angst, and thus a false friend. American angst is equal to Existenzangst, a more specific subset of Angst. I would say that Angst is somewhere between fear (Furcht) and horror (Horror)
Using this definiton from wikipedia for the English terror:
>Terror is usually described as the feeling of dread and anticipation that precedes the horrifying experience.
that would be an apt definition for the German word Angst. Funny, because the German word Terror is defined way differently again, as systematic implementation of fear to crack someone's will, similar to the neologism gaslighting, which would fall under Psychoterror in German.
I more than once tried to translate anxiety to the German but always failed. I don't think think it's really a question of bundling other things as much as a different thing...
(interestingly, a similar for angst as in teenage angst which I also fail to find a good translation for)
I wonder to what degree loneliness is a cultural contagion.
Anecdotally, there have been years-long periods in my life when I've had friends and relationships, and years-long periods where I've lived like a hermit- and I've actually mostly found myself to be happier in the latter. When I've made an effort to be social, it's been motivated mostly by a feeling that living like a hermit is embarrassing, and out of a desire not to disappoint people wanting to form relationships. But there's a freedom that comes with being entirely alone for long periods of time, which is often enough to motivate me to avoid all of that. I don't think I've ever felt something that matches what people describe as loneliness, even after spending weeks with no social interaction whatsoever.
Since I was diagnosed with Asperger's at a young age, I've always attributed that lack to my being psychologically unusual. But from a quick look at the data (https://ourworldindata.org/social-connections-and-loneliness#loneliness-and-aloneness-are-not-the-same), it seems that the loneliest countries aren't necessarily the ones where the most people live alone. So I have to wonder: is it possible that loneliness has some large cultural component which my self-image as someone psychologically unusual has sort of inoculated me against? Could it be that it's not something I experience because I never really expected to experience it?
And if that's the case, could that suggest that the high level of loneliness in the U.S. might be helped by more cultural acceptance of less social lifestyles?
A lot of cultures have had similar concepts, usually religious--hermits and such. American society is notorious for being particularly extroverted. One of the 'weird' things I've noticed when watching anime is how much more introverted the modal protagonist is. (Probably has something to do with the popularity of anime among those personality types.)
Men *don’t* get proprioceptive impulses from their penises. (Proprioception is only associated with skeletal muscles, isn’t it?)
Normally you can figure out what your penis is doing based on what you can feel (“the left side is touching skin, the right sight is touching cloth”) combined with what you know about what you’re wearing and assumptions about what direction gravity would be pulling it given your body position. But in situations where that doesn’t work (eg, skinny dipping), you’ll find that you can’t actually tell what direction your penis is pointing without looking at or touching it.
Maybe it is not propioception in the strict sense, but most men are able to tell they have an erection while naked (no contact with clothing) with their eyes closed. Some kind of signal must be coming in.
I've definitely experienced "can't feel my penis" and was concerned about some kind of nerve problem, although I guess it only happens when I've been sitting and leaning forward so it's similar to a limb falling asleep. But I never worried that it was missing, just that there was some medical issue.
I'm also strongly reminded of something Aella said in her recent interview on Lex Fridman's podcast. She recounted how she was confused when she told people about her childhood and they said things like "Oh I'm so sorry, that must have been so traumatic". Because she had been going around with a framing and a worldview that such things were unpleasant but not unexpected - so they were not traumatic. But then she got out into a different culture and adopted a different worldview - and suddenly those childhood experiences *became* traumatic.
My wife had a traumatic childhood and she always tells me the thing she wants to hear most is not "That must have been so terrible" but rather "That wasn't so bad, let me tell you about MY childhood".
That reminds me of an episode from the start of the culture wars, where Richard Dawkins pointed out that sexual assault, like most negative things, comes in a spectrum, and the sexual molestation he experienced as a child, while unpleasant, was not particularly traumatic and not a reason to spend life as a victim.
This did not go over well, since the SJ attitude at the time was to round up everything remotely adjacent to sexual assault to rape, and to depict rape as worse than anything, including death. I'm sure that increased young women's mental well-being...
Just a few weeks ago I had a professor casually express the opinion that being raped is orders of magnitude worse than having a leg amputated in the 18th century. Thankfully I've never experienced either of those things but if forced to choose I sure as hell wouldn't choose the leg...
This all comes back to the personal narratives and framings we carry around. In mine, pain and disability are no big deal - they’re unpleasant but they happen to everybody and all our bodies stop working eventually. So if I happen to painfully lose a limb, that obviously sucks and is unpleasant, but then I’d adapt and it would be no big deal. In my personal worldview, this is the sort of thing that is supposed to just happen sometimes and it’s no one’s fault.
On the other hand if I was raped I would feel tremendously violated. That’s not supposed to happen to me. I’m a man who’s supposed to be able to defend himself.
I can understand that, but I think we're pretty good at constructing our own personal narratives. I think my personal narrative would eventually recover, whereas my actual physical leg would not.
Maybe the ability to construct flattering personal narratives is an important life skill for coping with things.
That's how I always felt. It never seemed "traumatic" because I found ways to cope and go on. Only when people told me that it should be traumatic did it occur to me that I should in someway be "permanently" harmed by it. Except I don't think I am, really, and if I actually am, then so what? My experiences, for better or worse, shaped me, and I cannot change that now.
I find your stance in the following passage a bit perplexing:
"But he quickly moves on to a long section that tries to establish the reality of “voodoo death”, ie the thing where if you believe you are going to die hard enough, you actually die. I think most arguments for voodoo death are pretty bad, and I didn’t find Bures’ convincing....
"Is it weird to stay on the crazy train long enough to agree that cultural effects are strong enough to make you think witches are stealing your penis, and then get off it once people start talking about voodoo death? I think no - these are very different situations. Believing in koro can make you hallucinate that your penis is shrunken or gone, but no belief, however strong, can (directly) remove your penis itself. Culture → beliefs is fine; culture → reality is a step I’m not willing to take."
It doesn't require any ride on the crazy train to explain "voodoo death". I haven't read Bures's book (and hadn't even heard of it before reading your post). Hoeever, if "voodoo death" were observed, it would be much simpler to explain than a lot of what you've written about here. Each of us continuously engages in small acts of self-preservation, each of which decreases our likelihood of dying in some near interval. A person who believes strongly that they will die soon could conclude as a corollary that these acts are futile. So they may do these acts with less care and may omit some of them. At some point this repeated (and possibly even compounding) carelessness may indeed kill them.
I don't think this is what anyone means by voodoo death. It's not that you forget to look both ways when crossing the street and are hit by a car, it's that you mysteriously drop dead after the shaman says you will.
This doesnt detract from the message, but i would point out that sparta had no written records and everything we know about them was written by people who at some point had the shit kicked out of them by Sparta
I would point that if your culture has no written records is a pretty shitty culture. If you let your enemies write your history you deserve what you get.
I don't think we're discussing what Sparta deserves here, just trying to use true examples. Sparta having a shitty culture isn't a great reason for us to believe falsehoods.
From my reading of acoup [0], which was some years ago, I seem to remember that at least some existing sources glorified rather than ridiculed Sparta, to the point where the common meme of Spartans as hardcore badass warriors has little support in the modern historical interpretations. Not only was their way of life among the most repugnant to modern sentiments, not even their military track record is all that impressive (e.g. compared to the Romans).
Also, I don't think male homosexuality (often with an age gap which we would find problematic) was a Spartan specialty, but was also tolerated and common in the Greek societies of the sources. So the claim "Sore loser sources will just say 'spartans are teh gay'" is quite implausible to me.
In my opinion, a culture which does not have written records is not necessarily a shitty culture. I am sure that there are plenty of hunter gatherer cultures which are ok. But any culture which invents cities and then does not bother to research the literature tech tree at all can probably be called shitty. Of course, Sparta would still be shitty even if it had given us Homer, Plato and Shakespeare.
My point wasnt as reductive as that, but that generally speaking claims about spartas internal workings should be taken with a grain of salt, and dont build arguments about them.
Thucydides felt the need to clarify misconceptions about their governance in his history. So misunderstanding sparta is not a new phenomenon.
Judegement of which 2000 year old cultures are shitty. Is well sigh...
1) My wife was a teenager growing up in Hong Kong in 1994, and she says she (and presumably her classmates) had known what anorexia was before this schoolgirl died. She posits that the ensuing rush of cases was a function of diagnosing an existing disease, not of a cultural idea getting implanted. Single data point and all that, make of it what you will.
2) After reading, I immediately ran to Uniprot to see if there really was a sodium channel named BLRG2? There's enough weird ion channels out there that I'm kind of saddened that this wasn't a real one.
Re 1. yeah I was surprised by the claim, since young women starving themselves to look thin is a thing mentioned in Chinese texts going back to imperial era. The difference may just be that it wasn't considered a *bad* thing util recently
There might be a difference between starving yourself to look thin and starving yourself to death because you're still convinced you aren't thin even though you're nothing but bone, which I think happens to some people with anorexia.
The first Columbine-style school shooting I am aware of was at the U. of Texas around 1966. The next was a young woman shooting up a school outside of San Diego around 1978. When asked why she did it, she said, "I don't like Mondays." Bob Geldof of the Boomtown Rats wrote a catchy tune about that shooting, which likely helped make school shootings more of a Thing in American culture.
In contrast, some things that used to be bigger Things in America seem to have receded somewhat, such as serial killings, political assassinations, bombings, kidnappings, and skyjackings.
I read this book a while back and got curious about PMS. Here's a twitter poll that showed a decent correlation between believing in ghosts, and getting PMS: https://twitter.com/Aella_Girl/status/1589509446837075970 (tho I'm slightly more wary of twitter polls that I can't include 'see results' options in)
I then also added in a question about PMS to my big kink survey, asked to biological females only. I'm in transit (and my dataset got too huge so can't rerun it until I figure out how to run it from a hosting service) rn but can share any correlations with that soon.
From my own memories, girls who misfit teen culture because they're interested in not appearing girly, proving themselves tough, or are just unusually interested in sexual privacy, don't like to talk about "having PMS".
Without learning in sex ed that the menstrual cycle may cause diarrhea and flareups in underlying disease, my introduction to menstruating included asthma flareups and embarrassing diarrhea. I didn't consider this "having PMS". I considered this, "Huh, this whole 'blossoming into womanhood' thing sure sucks donkey honkers." I *definitely* didn't want to talk about PMS, since that would sound like making excuses for myself.
When a pulmonologist suggested I start oral contraceptives for asthma control, I balked at first, since I didn't need births controlled, but asthma. As I ran out of other options, I was eventually willing to give oral contraceptives a try. And huh, they worked. The years when womanhood sucked the fewest donkey honkers for me were the years I artificially suppressed those hormonal fluctuations with birth-control pills. Childbearing years, if you have them, require stopping the hormonal straitjacket, though. I've had terrible asthma control during my childbearing years.
In retrospect, I wasn't "less likely to get PMS", but definitely less likely to admit it for a very long time, to the point where it might have been harming me (breathing is kind of important).
Yes. I had the diarrhea, and I had “falling down stairs days” where I observed there were some days when I would wake up and realise I was probably inevitably going to fall over at some point or cut myself (so I should be extra careful), and some nights where my brain’s sleep switch randomly seemed to be broken. None of this had ever been mentioned to me as things that were linked to the menstrual cycle, or “PMS”, and so it took me years to make the link (calendaring and charting seemed like a moon goddess hippie thing to do), and even longer to come across the idea that these were well-known things that women commonly experienced at the start of their periods.
The cramps and mood effects *were* mentioned, along with the possibility that they might be sexist ideas, and so I spent a long time trying to suppress them and pretend they didn’t affect me as much as they did.
Also, all the advice I was given as a teenager told me that I shouldn’t eat lots of chocolate on my period and instead should eat healthy salads, which is exactly what my body does not want and interacts poorly with the diarrhea, so I have to conclude is generic “everyone should eat salads and not chocolate” advice. I do much better with simple sugars, salt, and water on that first day, and with mint. It turns out the mint thing is also a well-known, widely-accepted, way to deal with intestinal discomfort: I look forward to the day the standard advice to girls is to eat Kendal Mint Cake and salty crisps at the beginning of their periods. https://www.nhs.uk/medicines/peppermint-oil/
EDIT: Also, if you asked me if I “get PMS” I’d probably say “no”, because I just don’t think of any of it like that. I don’t think PMS or PMD or any such unified term for some cluster of possible ‘symptoms’ specifically before the period starts is particularly helpful, as it suggests a condition or disorder rather than a whole load of different things. I think, if I were explaining it to a girl now, I would probably say that there’s a lot of different effects that women sometimes find they experience over the course of their menstrual cycle, and some of those effects can suck but there are ways to manage them and make them not as bad, and knowing they are related to your cycle means you can predict when they will start and end, and some of them might be things you should get checked out. That it is well worth keeping a brief diary of your cycle, and noticing anything different about how you feel on each day. And that ibuprofen is magic, so take it according to instructions (always with food) at the beginning of (or even just before) your period, and if you still have proper pain then you should speak to your doctor.
I don’t think I would list off potential symptoms, or tell them “some women get [named condition]”.
I'd love to know! I'm a nerd woman who has never had PMS and doesn't understand what all the fuss is about (I also don't believe in ghosts or astrology).
Re: anorexia, the most plausible-seeming explanation I've seen for the cross-cultural differences in presentation is that we've got the causality all wrong.
The theory is basically that the pathological drive to starve oneself is *caused by* rapid weight loss. All of the explicit conscious thoughts people use to justify self-starvation are either post-hoc rationalizations or amped-up versions of whatever caused the initial weight loss.
So in one society, dutiful daughters might refuse to eat out of grief over their father's death; in another, devout Christians might fast excessively out of religious devotion; in another, high achievers might starve themselves to demonstrate their self-control or achieve the perfect body. (Worth noting that these are all similar personality types.)
If this theory is correct, we'd expect to see something that looks like social contagion: whenever there's a trend of severe food restriction, especially among adolescent girls, we'd expect to see a few who don't seem to be able to stop. But in between the waves of contagion, we'd also see sporadic cases among people (mostly adolescent girls) who stop eating independently for idiosyncratic reasons.
Muslims fast during Ramadan. Why aren't droves of Muslims starving themselves to death? Many monks have ascetic lifestyles, including frequent fasting. Do we have records of lots of monks dying of self-starvation, in the same way as anorexic girls?
Muslims observing Ramadan only fast during daylight hours. Eating is unrestricted after dusk, with (typically) large celebratory evening meals to break the fast. One month of intermittent fasting without caloric restriction doesn't cause rapid weight loss.
There are some historical records of waves of monks starving themselves to death, most notably the Sokushinbutsu in Japan. https://en.m.wikipedia.org/wiki/Sokushinbutsu This seems uncommon relative to the frequency of monastic fasting, and the intentionality of it sets it apart from our usual concept of eating disorders, but monks aren't in the main risk group: anorexia-like syndromes primarily affect adolescent girls.
When girls did participate in prolonged strict religious fasting in medieval Europe, some of them developed anorexia (in this case termed "anorexia mirabilis"). https://en.m.wikipedia.org/wiki/Anorexia_mirabilis
Some other groups:
There's some mixed evidence that concentration camp survivors had high rates of disordered eating, although in their case it's mainly binge eating and food hoarding (I'd hypothesize that there's an important difference between voluntary and involuntary food restriction). Interestingly, their *granddaughters* have unusually high rates of anorexia.
Most people didn't survive the concentration camps. You wonder if there's some trait that helped you survive that had adverse effects in the granddaughters. Though it could certainly be cultural--lots of upper-middle-class Jews who would be well in the typical demographic for anorexia. Kind of like the way they only recently figured out moderate amounts of alcohol weren't cardioprotective because the moderate drinkers were into exercise and vegetables and so on.
"in another, devout Christians might fast excessively out of religious devotion"
I agree that anorexia may have been present in societies before being given a formal name and diagnosis. I think that there is cultural pressure in Asian societies to maintain an acceptable weight, but the idea of Western anorexia isn't (or wasn't) identified there: if you're strictly dieting to stay thin the way you should be, then that isn't seen as a problem. See the fairly recent A4 paper waist size challenge, which started off in China:
"The latest craze from China involves mostly women holding up sheets of paper and taking selfies - they "win" if the paper entirely obscures their waist. It's called the "A4 challenge" after the standard paper size that's just 21cm (8.3in) across.
...Azura Ge is a Chinese student in Boston. She told BBC Trending that she was proud to show off the progress she had made in her fitness sessions.
"A lot of people had a weird assumption that I have anorexia, which I don't have," she says. "That's very interesting for me to think that people actually believe you have to have anorexia to be this skinny."
However, I saw some photos of men doing it as well, so it's not confined to one sex.
As for fasting - again, yes. St Catherine of Siena, the 14th century mystic, had people concerned about her fasting and wrote an exasperated letter about "I want to eat, I just can't":
"TO A RELIGIOUS MAN IN FLORENCE WHO WAS SHOCKED AT HER ASCETIC PRACTICES
In the Name of Jesus Christ crucified and of sweet Mary:
Dearest and most beloved father in Christ sweet Jesus: I Catherine, a useless servant of Jesus Christ, commend me to you: with the desire to see us united and transformed in that sweet, eternal and pure Truth which destroys in us all falsity and lying. I thank you cordially, dearest father, for the holy zeal and jealousy which you have toward my soul: in that you are apparently very anxious over what you hear of my life. I am certain that nothing affects you except desire for the honour of God and for my salvation, which makes you fear the assaults and illusions of devils. As to your special fear, father, concerning my behaviour about eating, I am not surprised; for I assure you, that not only do you fear, but I myself tremble, for fear of devilish wiles. Were it not that I trust in the goodness of God, and distrust myself, knowing that in myself I can have no confidence. For you sent, asking me whether or no I believed that I might be deceived, saying that if I did not believe so, that was a wile of the devil. I answer you, that not only about this, which is above the nature of the body, but about all my other activities also, I am always afraid, on account of my frailty and the astuteness of the devil, and think that I may be deceived; for I am perfectly well aware that the devil lost beatitude, but not wisdom, with which wisdom, as I said, I recognized that he might deceive me. But then I turn me, and lean against the Tree of the Most Holy Cross of Christ crucified, and there will I fasten me; and I do not doubt that if I shall be nailed and held with Him by love and with profound humility, the devils will have no power against me--not through my virtue, but through the virtue of Christ crucified.
You sent me word to pray God particularly that I might eat. I tell you, my father, and I say it in the sight of God, that in all ways within my power I have always forced myself once or twice a day to take food. And I have prayed constantly, and do pray God and shall pray Him, that in this matter of eating He will give me grace to live like other creatures, if it is His will--for it is mine. I tell you, that often enough, when I have done what I could, I enter within myself, to recognize my infirmity, and God, who by most special grace has made me correct the sin of gluttony. I grieve much that I have not corrected that miserable fault of mine through love. I for myself do not know what other remedy to adopt, except that I beg you to pray that Highest Eternal Truth, that He give me grace, if it is more for His honour and the salvation of my soul, to enable me to take food if it please Him. And I am sure that the goodness of God will not despise your prayers. I beg you that if you see any remedy you will write me of it; and provided it be for the honour of God, I will accept it willingly. Also I beg you not to be light in judging, if you are not clearly illumined in the sight of God. I say no more to you. Remain in the holy and sweet grace of God. Sweet Jesus, Jesus Love."
Was there just this constant fear of the devil tricking you into some prideful action and a total dependence on the grace of God in their daily lives, or was this mainly a virtue signaling protocol for letters and other communication?
Penises don't disappear or retract into the body –– but men are subject to hormonal fluctuations, which can be induced by psychological states (I'm not talking about arousal but sort of its opposite) and produce visible bodily effects. These states are plausibly subject to placebo (or, in this case, nocebo) effects. It wouldn't be shocking if some traditional witchcraft worked on this mechanism.
This paper found widespread PTSD symptoms among warriors in a pastoral African society, suggesting that it's not culture-bound. .
From the abstract:
"It is unclear whether combat-related PTSD is a universal evolutionary response to danger or a culture-specific syndrome of industrialized societies. We interviewed 218 Turkana pastoralist warriors in Kenya, who engage in lethal cattle raids, about their combat experiences and PTSD symptoms. Turkana in our sample had a high prevalence of PTSD symptoms, but Turkana with high symptom severity had lower prevalence of depression-like symptoms than American service members with high symptom severity. Symptoms that facilitate responding to danger were better predicted by combat exposure, whereas depressive symptoms were better predicted by exposure to combat-related moral violations. The findings suggest that some PTSD symptoms stem from an evolved response to danger, while depressive PTSD symptoms may be caused by culturally specific moral norm violations."
There is a concept in classics of the "Spartan mirage", almost everything written about Sparta was written by Athenians vilifying or praising them, almost no sources about the Spartans were written by them so we get an extreme and exaggerated impression of them.
I thought the Spartans insulted the Athenians as being "boy-lovers", which would seem to indicate that they thought pederasty was not an acceptable practice. Unless they meant something more along the lines of what we would now call homosexuality; sure, being the eromenos of an erastes is a socially necessary role, but if you're fucking boys/men because that's the kind of sex you like, you're a pervert.
"Since the publication in 1978 of Kenneth Dover's work Greek Homosexuality, the terms erastês and erômenos have been standard for the two pederastic roles. Both words derive from the Greek verb erô, erân, "to love"; see also eros. In Dover's strict dichotomy, the erastês (ἐραστής, plural erastai) is the older sexual actor, seen as the active or dominant participant, with the suffix -tês (-τής) denoting agency. Erastês should be distinguished from Greek paiderastês, which meant "lover of boys" usually with a negative connotation. The Greek word paiderastia (παιδεραστία) is an abstract noun. It is formed from paiderastês, which in turn is a compound of pais ("child", plural paides) and erastês (see below). Although the word pais can refer to a child of either sex, paiderastia is defined by Liddell and Scott's Greek-English Lexicon as "the love of boys", and the verb paiderasteuein as "to be a lover of boys". The erastês himself might only be in his early twenties, and thus the age difference between the two males who engage in sexual activity might be negligible."
So something like the exceptions we permit to statutory rape: if there is only a couple of years difference between the minor and their boyfriend/girlfriend, that's not legally treated as sexual abuse/rape. On the other hand, if you're thirty and they're fourteen, it is.
Rural Afghan culture is also a culture with not a lot of indigenous writing, but instead a lot of writing done by people who have killed them or been killed by them.
When I was stressed at a certain point in my life, I read about people in the past who had “nervous breakdowns“ and were sent by their families to the South of France for six months to recover. I remember thinking that I wanted a nervous breakdown too, it seemed like a good way of escaping. But how would people know it was a nervous breakdown I was having and not just being a bad and lazy person? The question is what cultural position do you have to be in to justify your emotions?
I read somewhere that a lot of what used to be called hysteria (in the 19th century at least) may have been temporal epilepsy which apparently can involve a feeling of something rising up from the lower abdomen. Maybe this is just a retrospective interpretation.
I think we call that burnout today. I was once diagnosed with it, and I did feel better after two weeks off - but I never knew if I was really "burned out" or if I was just tired and needed some more sleep.
Burnout is definitely a culture-bound disorder. I’m American but lived in Europe for a while, and the first time someone told me they got six weeks of paid leave for burnout I think my eyes popped out of my head. It is simply not a thing in the United States, at least not in my cultural corner of it. If at any point I had told my parents I was suffering from a condition called burnout and had to take a medically mandated vacation they would have responded with laughter or rage. Probably both.
Great book review. I can't help but think of Korean Fan Death, which seems analogous to Voodoo Death.
I got the Dalmatian and the cow instantly, whatever that signifies. Unfortunately Scott's text had primed me for the gorilla before I had parsed the instruction not to go further, which might be related.
The transgender ideology bit is confusing, giving the previous context: I can't tell if Scott is proposing a real phenomenon of penis-stealing witches made flesh via academia, or examining the people who are afraid of them.
It's not clear that fan death actually happens in the sense of people dying due to it. It could rather be that it's given as an explanation in circumstances where the actual cause of death is either mysterious or shameful (like drug overdose). Anyway, I don't think it's admitted as an actual legal cause of death anyway, can you image a British insurance company looking at a death certificate for a tourist that had "Cause of death: Fan"?
My state of understanding it was that "fan death" was a way to cover up a famility member's suicide, with a semi-believable cause that people are kinda ready to accept as possible.
But I don't speak korean and never spoke to one, so I can't really tell what's what.
FYI, I tried to unearth the years-old source I had for that piece of trivia, and could find jackshit. For all I know, it may have been a 4chan greentext, so...
Maybe unrelated but parts of Europe went a little crazy after Luther's reformation. (I specifically thinking of Dan Carlin's "Prophets of Doom" episode. (1500's)
I want to interrupt here for an importnt cultural touchstone: The Carpenters
Maybe you are too young (<30) to have heard of The Carpenters, or just never really heard them, or long ago dismissed their music as simple-minded treacle-y pap, un-hip, simple, maybe vaguely icky-Christian or cultlish. Maybe the idea of a brother and sister singing love songs *to each other* weirded you out on some fundamental level. but if so, you need to stop in your cultural tracks and listen to them again. REALLY. NOW. BECAUSE:
Karen Carpenter's voice was absolutely glorious, she was one of the greatest female singers ever recorded. Plus, those recordings were at the Golden Age of Los Angeles studio musicians, and recording technology, even the few bad songs stilll have a magical golden shimmer about them, and ... My God that voice.
I can elaborate below, but you owe it to yourself to hear this.
You could have easily stepped into the cultural disease called "Climate Crisis." But that disease is far too early in it's course for most people to stand outside and measure it's breadth.
Minor warning (25% of a ban): I don't think you're actually making a useful analogy here, I think you're just trying to inject controversial politics in.
Consider that sea level rise is the culmination of all climate change. That if you look at NOAA sea level data for San Francisco, California, sea level rise begins in 1863, a full 87 years before co2 rise.
The fixation of sea levels is not helpful but not your fault so I'll give you a pass. However, it's important to keep in mind that local sea levels may fluctuate a surprising amount, so you shouldn't be looking at sea levels in any one city but the global change in sea level everywhere to avoid understating, or indeed overstating, the effect.
That it is not. It's certainly frequently presented in the pop science press that way, unfortunately -- including the cartoon-model phrase "greenhouse effect", a model of marketing invention but corresponding in no reasonable way to the actual physics.
An interesting and lucid primer on the various components is here:
Even if climate change were not real (which it definitely is...) I don't think "believing in false idea" alone could be considered a "cultural disease". Otherwise we're going to need to add 10,000 new psychiatric disorders to our language. Different groups of humans believe a lot of different dumb shit.
(Also, "regular Chinese" is a bit of a strange phrase in the context you use it. It feels a bit like saying "Basque is not at all related to regular Spanish" - it isn't like there is some kind of "irregular Spanish" that it is related to.)
I'm not sure I completely follow the section on PMS. Even if it were 100% cultural, your wife would still feel the very real symptoms. I don't understand how her mother's ability to diagnose PMS would change based on its position on the cultural-biological spectrum.
The issue is that people seem to have symptoms before they know they are about to have their period. That’s hard to explain with a cultural explanation.
I mean... I think it would still be possible for there to be biological changes during the menstrual cycle noticeable enough for a person to be able to predict their period in advance *and* for the precise way in which those changes manifest (ie, the PMS symptoms) to be culturally determined. Like the pictures in the article, the white and black dots are definitely there, but the dog and the cow are only apparent once this is suggested to us.
True, though I think it gets difficult to falsify if people are subconsciously identifying and expressing patterns before they know what pattern they're matching.
Anecdote against anyway: once when I was nine I had a horrible day where I picked fights with everyone and ran off crying when confronted about it, noticeable and slightly puzzling to everyone. The next day I woke up feeling better, but also mysteriously peeing? leaking?? blood. I got crash course puberty ed that day, continued to have weird mood issues every month, and learned about PMS years later with the rest of my peers.
I don’t think Bouffée délirante is a culture bound syndrome - it’s just the French equivalent of brief psychotic disorder (DSM), acute and transient psychotic disorder (ICD), or Brief Limited Intermittent Psychotic symptoms (CAARMS).
Have you ever seen BPS? I almost never have, and was told it was mostly used as a code for new-onset schizophrenia that didn't satisfy the time criterion yet.
At 3 years follow-up, 1/3 of brief psychotic disorders will have developed a persistent psychotic disorder (ref in my original comment) but I guess that means that most do not.
I'm not a psychiatrist, but I have seen BPS twice (once in a colleague and once in a close acquaintance). Both matched the description of Bouffée délirante/BPS, got better in about 2 weeks, and were not followed by any relapse of any psychotic symptome. (Also, both happened outside France to non-French people.)
I suspect a possible selection effect - bias on your behalf here.
Think about it: Most of those who experience BPS are unlikely to ever see a psychiatrist. Precisely because it is a one-off experience.
...or if they do, they are probably going to terminate their consultations with a psychiatrist much earlier that the skizophrenic types.
...implying that psychiatrists' view of "what is the usual trajectory" is biased toward the long-term ill, rather than the fast-recovering. The latter might theoretically be the dominant/more common group.
Mind you, this is an hypothesis; I have not checked the numbers. (And checking the numbers will in any case be difficult, or almost impossible, to do, if it turns out that most cases of BPS go unrecorded.)
I'm a french senior psychiatrist. I was told in my intership that "Bouffée délirante aigüe" is a clinical entity, not a syndrom, which appears to have a pretty name coined by a french a alienist from classical era. Although unnamed, the concept exist everywhere.
It's simply that, in most psychotic disorders, it's easy to make a syndromic diagnosis, mostly from the biography or other upstream clinical features. For exemple, megalomaniac delusions + speech acceleration + decrease sleep in someone who has post partum depression antecedent and bipolar disorder in her family : easy, it's a manic episod.
But, in some cases it's not possible to draw a firm conclusion. Mostly when it's a first episode (with affective AND psychotic symptoms), without prior symptoms and with fair psycho-social functioning. Hence the concept of "bouffée délirante aigüe" wich mean "I have no clue yet about what the fuck happen". Traditionaly it is said that the outcome is 1/3 schizophrenia, 1/3 bipolar disorder, 1/3 brief psychotic disorder (borderline personnality disorder, undiagnosed pharmacopsychosis, anti-NMDA encephalitis...).
Same issue everywhere, actually. We, French, have a poetic name for it.
To be fair the initial description from Magnan (1866) is limited to the brief psychotis disorder, while "Le manuel d'Henri Hey" (i only have the 1989 edition, but it was mostly writed between 1950-1980) is quite unclear about what is or not the "Bouffé délirante aigüe".
After reading the text I realised I had completely misinterpreted that first picture. I didn't initially notice the penis in her hand or the basket of previously-stolen penises next to her. So I assumed that the penis theft had already happened, and now the guy is sitting there looking dejected, while his female partner is consoling him and assuring him that she still loves him -- in other words, a typical ad for erectile dysfunction treatment! So I guess that counts as another example of culture-mediated interpretation of an ambiguous image.
When I read about Scott's ants and his itches, I myself had an itch (because social contagion, or just suggestibility - is this the same thing?) but I didn't assume it was ants (because I have no prior on ants).
No immediate conclusion, but I wonder, having read this and had this thought, whether when I have another itch whether I will then assume ants.
I wonder if itching should be thought of a bit separately from the rest of these. Having a very particular sensitivity to other people being itchy seems adaptive...
I get the impression that you're working with an understanding of culture-bound illness that is limited to "cultural belief -> psychosomatic condition". Is there anything ruling out the possibility of "cultural belief -> internal mental processes affecting real physical processes -> physical condition (possibly in addition to some strange psychological reaction which may not be itself directly caused by the cultural beliefs, ie someone from another culture would feel the same way if they were affected by the physical condition, but they aren't so they don't)"? I feel like that pathway could explain some scenarios.
I'm pretty sure that Scott believes that internal mental processes are real physical processes, and everything affects everything else on a real physical level.
Leah Libresco Sargeant (above) mentions "...the physical and emotional cost(s) of [gender] dysphoria and associated treatment..." My question, and one that I see very much avoided, is:
-- What about the $$$$ cost?
-- Who is paying for all of these surely $X00,000+ treatments?
-- Where is this money coming from, and why are there suddenly more than 100 "gender" clinics in the US now, when there were zero ten years ago?
Given that insurance, both private and public, dictates and/or causes the vast majority of treatment decisions in the US, surely something suddenly changed ~7-10 years ago and now "gender transition" is booming. I don't think that change was a sudden grass-roots upswell of concern for and about actual LBGT+? issues and kids. I strongly suspect the difference is that suddenly, almost overnight, "gender transitioning" became very, very lucrative.
Do you or any commenter have knowledge of how this industy is financed? I am especially curious that "at-risk" and poor youth, by definition "charity" patients, are a major percentage of gender referrals, government programs or grants must be paying the doctors running these brand-new clinics.
_____________
The late David Foster Wallace, in a great deep-dive into political Talk Radio circa 2004, reminded us that it's always informative to follow the money:
"Whatever the social effects of talk radio or the partisan agendas of certain hosts, it is a fallacy that political talk radio is motivated by ideology. It is not. Political talk radio is a business, and it is motivated by revenue. The conservatism that dominates today's AM airwaves does so because it generates high Arbitron ratings, high ad rates, and maximum profits."
I think that the Occam's Razor perspective in the above paragraph should be uppermost in people's mind when thinking about the intersection of media, social-media, culture, and a US healthcare industry that now consumes 17% of our GDP.
Very much worth reading, BTW. Most of it still incredibly spot-on, even almost 20 years later:
Also, Wallace's troubling description of home morgatge financing companies' being like 50% of the ads on the radio in March 2004, seems a disturbing parallel to how 100+ Gender Transition practices have appeared since 2016:
"As of spring '04, though, the most frequent and concussive ads on KFI are for mortgage and home-refi companies—Green Light Financial, HMS Capital, Home Field Financial, Benchmark Lending. Over and over. Pacific Home Financial, U.S. Mortgage Capital, Crestline Funding, Advantix Lending. Reverse mortgages, negative amortization, adjustable rates, APR, FICO … where did all these firms come from? What were these guys doing five years ago? Why is KFI's audience seen as so especially ripe and ready for refi? Betterloans.com, lendingtree.com, Union Bank of California, on and on and on."
Transition care for trans adults in the clinic setting consists of a few office visits, a few lab tests, and then prescribing dirt cheap generic hormones and refilling them once every 6-12 months, for a disproportionately low-income population whose members are likely to be on Medicaid or uninsured. It's not profitable at all. Most clinics rely on donations and/or public-health money for other services (many are combined/co-located with reproductive health and STI clinics).
Kids get more monitoring, but it's really just office visits, blood tests, and old generic drugs. There aren't any lucrative procedures or fancy new pharmaceuticals. If you wanted to get rich selling drugs to kids, an ADHD clinic would be a vastly better investment than a gender clinic.
Plastic surgeons charge cash rates comparable to their rates for similar surgeries on cis people, so they're compensated well but not so well that they're financially-incentivized to market to us over other groups. And insurance reimbursement rates are much worse than cash, so hardly any surgeons even accept it (especially Medicaid).
I am sure that many of the things you describe are true, or certainly true for some percentage (maybe most) of these patients.
And yet -- there is an enormous rush into this specialty. And, to put it bluntly, doctors exist to make money. Doctors, hospitals, managed-practices, Universities (especially) would not be switching specialties. establishing branded Clinics, investing prestige and money in this field if was not profitable, and quickly profitable, with a very big potential pool of patients.
I agree that it isn't likely to be "Doc Hollywood" profitable on a per-patient basis. But you mentioned a few other sources of funding: "Most clinics rely on donations and/or public-health money...." Since the US Govt pays for and directs so much of the whole medical industry, has something there changed? Huge blocks of new grants allocated to this field? (I've read scuttlebutt that almost any grant proposal with "gender" and "trans" in it is 99% certain to be approved.)
Private donations was a revenue stream I had not immediately thought of, this is surely a visible, popular (some might say *mandatory*) cause among celebrities and overwhelmingly left-leaning charitable orgs. I can imagine a two-way social contagion effect, where rich donors want to "contribute", and need to be publicly seen doing so (lest they get heckled, dogpiled, cancelled, dragged, and generally mau-mau'ed for being "transphobic"), and prestige-seeking universities and colleges, besides just wanting the $$$ per se, also can't afford to be seen as "that Other medical school that doesn't even have a Gender-Affirming-Care-Centre because they are hateful."
This is where I would like to see some numbers. (1) But I never hear $$$ even mentioned. As readers here know, charitable donations are very public records, yet no news organzation seems likely to do some basic journalism and some basic math on a rapidly growing medical field, despite health care and medical "news" dominating the headlines and filling half of every newspaper, even before covid.
Two unpleasant things that need to be said:
1) Even if the clinical practices you mention don't yield huge per-item payments, they also seem to require almost ZERO effort or investment. Or new training, or certification, or even actual patient contact, and as you mentioned very little patient follow-up. (And it seems, so far, very little malpractice risk/exposure.) I could imagine, maybe $4-5000 in revenue, for maybe a half hour, total, of doctor time, and an hour's staff work. And a patiend pool that keeps growing, a constant stream of patients with no cost-of-sales.
2) With children, any billable events here simply did not exist ten years ago. Children, overall, are rarely ever seriously ill, and, statistically speaking almost NEVER die, certainally not from any causes that are medicable. But being able to diagnose a new condition and billable treatment for it is kind of like finding money on the sidewalk, in a major way.
Look, I'm not directly saying all this gender transition stuff is totally made up malarkey, or that all doctors in this field are cynically exploiting a sudden penis-stealing or penis-yearning phobia/mania by exploiting kids to chisel five or ten grand a pop out of some pool of medical funding. I do think some are, and that some recent wellspring of money, whether insurance, grant, foundation, all of the above, suddenly made it much more POSSIBLE for this to take off.
With death certificates, there is usually a underlying cause (cancer, trauma, drug addiction), and then a proximate cause (organ failure, blood loss, overdose.) Scott's excellent post frames social contagion and manias in terms of a fear/anxiety and then its' local cultural form/expression. These sorta correspond to a traditional reporter's questions of "Why?", and "How".
I guess I'm asking the questions, "When", as in, "Why is this happing right now, what changed in the environment?" And the related question of "Who?" In a film noir, "Who" really means "Who paid/got-paid" In the US healthcare system, modeling "When" seems like an engineering calculation where one term -- Government payments and government approvals -- grows exponentially so that all other terms esentially become a rounding error for values of x > n, and to mix and muddle math metaphors, solve for the intercept, or the "knee" where that growth take off....
It has taken me all this time to realize I am trying to say that the witch hunters charged for their services, and they had financial incentives to find witches they could be hired to deal with. perhaps it has been commented upon, but any social contagion surely has some people trying to spread the ideas and fears because they stand to profit from it. And some for whom "profit" actually meant keeping their job, identity, worldview, reason for living, noble goal. Like, say, a pious and dedicated Witch Hunter. (2)
Sorry this became rambling.
BR
1 -- To be clear, I'm not *demanding* you personally, provide those numbers, like right now, on ACX. I'm saying in general I want more info about funding.
2 -- Like what if a town got really worried about wolves replaced that silly crying boy (that they all kicked out of town years ago because he was making stuff up to get attention) and started a Department of Wolfland Security. A dozen full-time guardsmen, looking out for Wolves.
Does the DWS ever go to the Town Elders and say, "Look, we haven't really seen any wolves around lately, and even if we did, you don't need 12 guys. You could easily cut us to just six. And the guys are bored, some want to start a business selling anti-wolf gear, which would be a violation of our contract, so they want to move on...." Hmmm doubtful.
Is it really that inconceivable to you that people might do something because they're convinced it's the right thing to do? Even when you nod toward the possibility of non-financial motivations, you frame them in terms of social pressure.
I am sure it has been mentioned, but "social contagion" around children's health care surely affects the parents as much or even more than the kids. After all, parents are the ones with the money, or at least the authorization that can open the billing spillway. And we see all around us that for many people and of course many parents, virtue-signalling is constant and of vital importance, while "showing-off" your children to society has always been another area of competition in the tribe/society.
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I don't think very highly of doctors, as a group, unfortunately. I believe that lots of medical-gender practice is entirely motivated by revenue and opportunity. I realize that said suspicion might seem to be more political than strictly rational[ist].
In defense of my mistrust, or rather to outline it really, I started writing a kind of unstructured {list} of the huge moral hazards I see around brand-new medical treatments for children. But it quickly became too arch and mean-spirited, like a Zvi Mowshowitz Chat API that "trained" on 24 hours of Don Rickles' jokes. Unlike, say Microsoft, I spiked it before I hit "post".
Then I suddenly realized: the real difference between me and Microsoft, is that, while I am unusually confident that I will never weaponize anything "Sydney" says to destroy Microsoft, I'm not sure about the reciprocal. Hmmmm......
Again, what revenue? What are they billing for that's so much more profitable than anything else an ethically-flexible doctor could do to make money?
I'm pretty sure my primary care doctor loses money on my hormone treatment. He has to submit refills every month because controlled substance, so that's around 15 minutes of work once a month (3 hours a year), plus another hour or so on the phone once a year to redo my prior authorization. If you attribute the entire $185 my insurance pays for my annual physical to my transition care, he's grossing under $50/hr at best. I'd be shocked if that even covered the overhead costs.
Children's gender clinics might be less unprofitable because they actually see the kids pretty often, but we're still talking about office visits and psychotherapy, both of which have notoriously low reimbursement rates.
My prescription itself costs under $25/month (and that's only because my insurance company insists on paying extra for 1-month refills just to be annoying). Not free, but it's a rounding error in an insulin/GLP-1 agonist/fancy ADHD prodrug price tag.
And my surgeon charged me $8200 for a 3-hour major surgery under general anesthesia, including hours of consults and follow-ups. Now, he's obviously making a good living, but that is an incredibly reasonable price. I've seen exploitative medical pricing and that is not it.
(Based on the marketing emails I get from his office, I'm pretty sure most of his profit actually comes from selling scar creams and massage, skin products, and other cosmetic treatments of dubious efficacy.)
Even if you can find some source of significant profit somewhere, it still only explains the US; rates of youth trans identification are rising everywhere where it's perceived to be safe to come out.
This is an attitude (it's not a moneymaker at all) that I haven't seen anyone really raise, and I think it needs to be said because those who make conclusions (regarding moneymaking conspiracies etc.) without knowing the details are just hilariously wrong. I had to go out of pocket for HRT for a while and it was certainly not a traumatic expense of the kind we see in other areas of healthcare.
Before the controversy, Vanderbilt's gender clinic was touting the profitability of its gender clinics because of the multiple follow ups. The hormone visits are frequent and take 30s but are billed for a full rate. Top and particularly bottom surgery require extensive post-op monitoring. See, for example:
Gender affirming treatment in general (I don't know if there's stats for specific interventions) seems to take the rates of suicide in trans teens from 10x control to within normal ranges. That's a level of effectiveness we can only dream of for treatments for depression, where we spend a lot to get a relatively minor effect. So even if the costs are as high as you are claiming I wouldn't be surprised if it worked out positive in dollars per QALY.
I am very skeptical of this claim. For example, here is a dive into a study touted by the researchers as showing the effectiveness of interventions on minors, where it turns out the data actually showed NO improvements.
There tends to be an obsession with medical interventions in this discourse compared to others and I find this bothersome. There's no reason these two claims need to disagree -- gender-affirming psychotherapy, for instance, is much less emphasized than certain endocrine treatments and it might mostly be because those endocrine treatments tend to scare people more, despite being very uncommon.
Well, in terms of the general discourse, I think the reason people spend their time discussing/debating medical interventions rather than talk therapy is that they are worried about the former, and not about the latter. If people aren't opposed to psychotherapy, of course they won't be debating it.
But more to the discussion at hand, I suppose my linking this discussion of medical intervention is really just to paint a picture of where my baseline skepticism of research claims in this field comes from. This piece of research supposedly shows why some particular interventions are effective, when in reality it shows nothing of the sort. So I wouldn't be surprised if something similar is happening with the 10x suicide reduction claim (OP, I would be interested to see where that claim comes from).
And if it is the case that there is reduction in suicide comes mostly from, e.g., psychotherapy rather than medical intervention, I think that is something that should be generally clarified in the conversation (though I appreciate OP's caveat). I think otherwise such figures will be smuggled into arguments in favor of specific, not-supported-by-the-evidence, interventions.
For what it's worth, I've read about transition not being covered by insurance at some time in the past. I assume people saved their own money for the most part-- that it's possible for people to save a fairly large amount for something that's extremely important for them.
I Abro Cinii won the money on Jeopardy for her surgery. This is someone who was well known in east coast sf fandom.
There is a fantastic article on this (the modern profit incentive for trans care) in Tablet, entitled something like “The Rise of Synthetic Sex Identities”. Highly recommend.
"Okay, so which of our mental disorders are culture-bound?"
My first thought upon reading this was, "Am I *really* sure that during the endless hours I (and everyone else affected by this culture) spends staring at the glowing rectangles, that I'm not just hallucinating that there's meaningful content being communicated to me?" From the outside, it would probably look like it, an ever-expanding trend of people spending more and more time sitting and staring at the things.
(No, this idea does not actually hold up unless one posits some *serious* mental dysfunction about everything remotely related to our activity on the glowing rectangles, which now underlies basically every element of life.)
Wow, what an amazing article! It explains so much in such a convincing way! It is a great framework to understand the expression of all these conditions.
And I am also amazed by the way you write your demonstration: your ideas are presented so efficiently that I thought "oh but this is a predictive processing like mechanism" just a few sentences before you explained that it is.
In the case of running amok, it sounds like the culture has a special sort of acceptance/forgiveness for it. I bet that is an active ingredient in the presentation of the condition, as it creates an incentive to channel one's anger into this presentation specifically.
It makes me wonder how important these sorts of things are for the conditions. For instance, has penis-stealing witches just been random accusations, or have they been linked to long-standing conflicts between people?
Or beyond the case of conflicts, I know obesity has increased in a lot of places; how sure are we that anorexia isn't linked to this? (more obesity -> essence of beauty becomes being thin -> more anorexia)
This is commonly discussed in the trans community (under the label of "repression", which was discussed even decades ago), and our culture has become much more gender progressive over time, which probably accounts for a big change in the presentation of gender dysphoria.
I genuinely had an experience like this recently. I'd been putting off going to the dentist for far too long, because it's something I'm anxious about, and felt a cavity with my tongue. This caused me to both make an appointment, and start having a lot of unhealthy thoughts about what the dentist would discover. During this period I didn't look at the tooth visually, all I could do was feel it with my tongue.
I genuinely, unambiguously felt the tooth becoming so weak that it folded in on itself and collapsed. I could move the thinnest wall around it back and forth with my tongue. Clearly the enamel was so thin, it had become flimsy and malleable, there was nothing but enamel left. It was a disaster, how could I have been so neglectful?
Except, of course, it wasn't. And sometimes in that week waiting for the appointment, once I woke up, it didn't feel malleable. It felt like a tooth that happened to have a cavity right next to an old filling, which happens a lot. I went back and forth through these clear, physical perceptions going up and down over the course of several days. Of course once I went to the dentist it turned out to be a run-of-the-mill (though rather bad) cavity, and the physical perceptions completely stabilised. Until it was fixed, it felt like just a tooth with a hole in it, which is what it is.
I still remember the perception of it moving an collapsing so vividly I'm not quite sure how to process at. I also remember thinking AS IT HAPPENED that it wasn't actually happening, that it was a perception driven by anxiety, and yet that not quite getting through to most of my brain. When I read about the men whose penises are retracting, I can't help but think about that damn tooth, so decayed it was collapsing in my mouth, except it wasn't.
>What if transphobia is our culture’s version of the penis-stealing witch panic? Wise but evil women (gender studies professors) are using incomprehensible black arts (post-modernism) to make people lose their penises.
I realise this passage is tongue-in-cheek, but I wouldn't describe this narrative as transphobic. One could frame it as such: "I treat trans people with respect and compassion, but gender dysphoria seems like a debilitating and distressing condition which no one would choose to have if they could help it. If it does spread (partly) via social contagion, it's irresponsible for gender studies professors to promote it or glamorise it."
Pedantic comment from a Queenslander living in Tasmania now. There have been a few claims of Tasmanian tiger sightings in Cape York, the pointy northern bit of Queensland, as there have been in all sorts of other places in mainland Australia (home of the somewhat similar dingo), and one group of local scientists did go have a look. But the wilds of western and northeast Tasmania are where most of the claimed sightings are, and also where dingoes aren’t, and so that’s where the hopeful spotters mostly go.
Basically, the people who had symptoms that resembled today's trauma reactions tended to be people who felt they had committed some kind of moral violation (such as fighting against other Romans) rather than the much larger group of people that participated in and/or were exposed to violence.
I'm surprised by jikoshu-kyofu. Not that it exists and has a name, but that it's not more widespread. I know I am very worried about my body odor, and expected many people (maybe not most, but at least a sizable minority) to be paranoid about it as well.
I believe that Scott's talking about a very extreme fear, not the much more common fear of not smelling as sweet as a daily-shower person should. In the US there's a disorder called Olfactory Reference Disorder, and the person I diagnosed with it literally thought you could smell him across the room. If somebody at the other end of the subway car rubbed their nose he thought it was because of his body odor. He believed showering and similar measures made zero difference in how terrible he smelled. And when people told him they could not smell any body odor at all he did not believe them.
I'm surprised that nobody has mentioned an obvious contributor to that-witch-stole-my-penis: testicles do retract, and penises do shrink, as an unconscious response to fear! Not all the way into the body cavity, obviously, but they do retract and shrink to a very clear effect. (It's a reflex that is probably there to, well, safeguard our balls.) You can see how this works now: if you get really afraid of an imaginary penis-stealing witch in the neighborhood, your bits will noticeably retract, thereby confirming your fear of the penis-stealing witch. The very real sensations you perceive as a result of the cremaster actually doing its work will be amplified and interpreted by your witch-believer brain in the way you'd expect.
Not only that, don't penises shrink in response to the cold? I noticed in the koro story, the thing that happened before the guy noticed his penis was smaller was a cold draft came in. So imagine someone who had never noticed that being cold or anxious made penises smaller, one night a cold draft comes in and he notices his penis is smaller, and now he's anxious, and now it's all shrinking inward!
And now the guy goes "oh god, my penis is shrinking!", everyone around him hears this, it was probably a little cold and now all the guys are anxious and checking their own penises, and becoming more hyperaware of just the random shrinking and expanding that penises do just in ordinary life, and boom, you got a spontaneous social contagion.
And if a guy has a sufficiently large gut, or bushy pelvis, or small penis, he might lose track of its presence altogether, and conclude that it's disappeared!
It also helps to remember that we're talking about people who had pre-scientific ideas about how human biology works where "when that happens, that's a witch doing it" can seem more intuitive than it might from the perspective of someone influenced by modern understanding of biology. We're pretty good at having our theories of how the world works fill in the details of basic sensations. See also culturally determined expressions of hypnagogic hallucinations.
It reinforce this comment, the penis is a hydraulic system, and it lengthens and contracts under autonomous nervous control. A lot of things affect that, but fear, anxiety, confidence, etc. are significant. Also, the actual anchored base of the penis is near the anus, nearly half of the hydraulic system is invisible. So a 25% change in the total length of the penis causes a 50% change in the visible length. (So a lot of this retraction actually is into the body.) A psychological epidemic of fear of penis-stealing witches is likely to cause a physiological epidemic of penis shortening.
What I find strange about all of this is it seems to have been known since forever, at least in rough outline, in American popular culture. E.g. the movie "Little Big Man" has the leading man say, when his wife goes off to give birth and turns him over to her three sisters who have been unlucky in love, "Three young and healthy women with no man for who knows how long. The very idea kinda shrunk me like a spider on a hot stove."
I read a while ago that a certain mental illness (Cotard's syndrome, I believe?) used to be fairly common in France (as in, everybody who had worked in a mental hospital knew some cases), and then became much rarer, at least in its classic presentation, within a generation or two (beginning of the 20th century? I can't locate my (printed, French) source). A doctor reminisced and asked: but what happened to this sweet, philosophical sort of deluded person?
The "classic presentation": Doctor, I have lost my soul. I have no soul.
There were other beliefs associated to that: I am dead and somehow go on living; my insides are hollow... Apparently, the syndrome is more associated to these beliefs nowadays (though there are still religiously tinged cases - upon being taken to South Africa to recover, a Scotsman who was in a motorcycle accident came to believe that he was in hell, guided by his mother's spirit). The standard guess now is that there is an underlying neurological problem (the patient's brain loses the ability to react emotionally to the patient's own face, or else there is something messed up with proprioception) which gets interpreted by the mind in terms of beliefs that are culturally important; it is this interpretation that gets diagnosed.
I think Aella's piece on Trauma might be of interest here, I also think that modern examples of the trauma caused by CSA, likely have a large cultural component as demonstrated by the seeming lack of trauma in many different cultures throughout history. Although it's important to note that historic adult-child relationships seem typically very different from their modern equivalent, probably due to such relationships being pushed out to the fringes of society, where such relationships used to be common among high status individuals in farming societies, they now attract "less desirable" pursuers.
There was a study (I'll track it down if anyone cares) which concluded that PTSD was more likely if there was previous trauma. So it's plausible that people could brush off events that could be traumatic but only actually caused a little damage, until there's one too many.
People could get things wrong in both directions, by either assuming that all potentially traumatic events must cause PTSD or that people who say they have PTSD only believe it because they're heard of PTSD.
Echoing what many say here, really great post, Scott!
Some thoughts about getting off the crazy train:
"Is it weird to stay on the crazy train long enough to agree that cultural effects are strong enough to make you think witches are stealing your penis, and then get off it once people start talking about voodoo death? I think no - these are very different situations. Believing in koro can make you hallucinate that your penis is shrunken or gone, but no belief, however strong, can (directly) remove your penis itself. Culture → beliefs is fine; culture → reality is a step I’m not willing to take."
I think I don't understand the line you're drawing there.
First, if dying from a broken heart (or, if you want to sound fancier and slightly less precise, Takotsubo cardiomyopathy) is something that really happens, why not voodoo death? If I hear a shaman saying that I'll die, and I *really* believe in that shaman's powers, I'd probably get a pretty strong emotional response from that at the very least. That by itself could plausibly lead to serious downstream effects.
Second, and this is a broader point, do we need to draw any lines here at all? "Culture → beliefs" type of effect is already a "culture → reality" type of effect. (And what is meant by "reality" here?) Just to be clear, subjective idealism and social constructionism are cool and all, shout out to Berkeley, but I definitely don't want to say something like "your (cultural) beliefs determine your reality" or anything like that. At the same time, they are a part of it and because of that they do affect it. I wouldn't argue that there are no constraints on how much beliefs can affect reality, but how well do we know what those constraints are, especially when for humans biological and cultural is so intertwined?
The thing is, I know people who transitioned long before it was popular. It's quite possible that culture makes a difference to frequency.
In some ways, culture shapes mental disorders. There are people with OCD who are tormented with the idea that they've run someone over with their car. This presumably was only possible after cars were invented, and possibly only happened after cars were common.
I feel like my model of anorexia isn't "telling people about anorexia gives them anorexia", it's "exposing people to Western dieting culture gives them anorexia?"
like, moral/purity prohibitions about what food is good and bad to eat are a cultural universal and i think people are wired to be good at internalising them -- I pretty successfully did this to become vegetarian
and if your prohibition is "don't eat anything with calories" this is going to run into problems
I guess if this has any historical precedent it's fasting/ascetic traditions in various religions (eg in India)
I'm Malaysian so I was so confused when I got to the koro part. This is the first time I have heard of it. The nearest term to koro in Malay is kura which is half of kura-kura meaning turtle.
Like I said, I had trouble finding out exactly what the relationship to Malaysia was, even though everyone says it's a Malay illness. Some people say it's from South Sulawesi, but I thought that was Indonesian, and I don't know how it would have gotten a Malaysian name. More information at https://en.wikipedia.org/wiki/Koro_(medicine)
Obvious examples of culture-bound psychosomatic conditions: sugar rush/children becoming hyperactive after being given sugar and some (but I think not all?) of the "coffee as stimulant" stuff.
That's just typical confirmation bias: they typically do not ask the children if sugar makes them hyperactive, but the parents and caregivers, and despite what they may think, they are not strictly objective observers of their childrens' behavior.
I guess at one point, do we collapse back into social constructionism or even some Foucault with this sort of thing?
One can really feel or empathize with the earlier wave of ‘culture-strong’ thinkers as they were struck by such stark comparatively different or culture-specific instances across societies.
In some ways, your post seems to implicitly paints a similar “picture of smart people genuinely trying their best in epistemically treacherous situations” of those culture-specific theories.
I just realized that, while there is a small proportion of people who detransition who could say "A witch stole my penis", what we're mostly seeing is people saying "Witches stole *their* penises".
This page contains verse 7974 - 7991 in the source linked by Mark below.
Is "Orenwützel" his word for "penis"? Could be. Amorphophallus titanum is "Titanenwurz" in German. My layman translation: When she has the penis, she takes a pillow in her hand and says: "Fly, fly, penis, a pillow corner is hunting you."
About the ol-german poem "by" Hans Vitler 'flowers of virtue" - that was a translation of an Italian original form 1320* Hans Vitler's famous translation was rather "free", but I guess he would not have added a penis-theft. - Now I found one commented reprint of "Blumen der Tugend" , well actually "Pluemen der Tugent" - it is oooold: https://archive.org/details/diepluemendertu00maxigoog/page/n381/mode/1up no such story there, it seems Vitler considered believe in witchcraft even: sinful superstition. Witch-hunt was NOT a middle-age thing, but came big in (early) modern times. Prof. Marvin Harris has some theories as for "why then": Cows, Pigs, Wars, and Witches: The Riddles of Culture (tl;dr: both big churches THEN felt the need to proof they were "indispensable" - before: the one church just obviously was. Witch-hunts: ON.)
Hello again, I believe that ol' thread was "solved". (We got to the right verses - which were rather short - 'witches stealing phalli from breaches' end-of-story - in a context of the German author giving a long list of believes in witch-craft he considers silly (and were not in the Italian original ) - I assume you got here again via today's link in the new post about Aella and women with PMS being more superstitious or sth..
The division of culture bound delusion seems too vague an interpretation of how beliefs function to be anything but useful. What about the origins of potential beliefs in ancestors trauma or the potential to novel creations like Schreber which go on to become in some species useful behaviours?
...with the headlights on. Like, I thought that was a bush, not a dalmation, but I'm not driving my car into a bush either. (Closest I got for the cow was a close-up of an animal skull, which was obviously wrong because of the fence but still the best I had.)
In large part because we've standardized roads and vehicles to give clear, simplified symbols at night, like white lights go in front, red lights in back, reflective paint and signage is ample. With non-reflective items, like pedestrians trying to cross the road with non-reflective clothing, we rely a lot on context to figure out where to be careful. (Interstate? Probably no pedestrians there. Busiest college campus crossing? Watch out!)
My husband and I recently got lost driving around a city because one reflective sign had lost its reflectiveness.
I really wanted you to end your list of made up diseases around the world with "in America, sometimes people think they have a disease called "Restless Leg Syndrome", and are kept up all not thinking that their legs need to move.
I have a mild case of this syndrome. It seems silly, but that is exactly what it is: my legs sometimes signal that they really really need to move, and it is very difficult to stop them from doing so, which can be problematic when you are trying to sleep!
Naw that one's real. I went through a period of being very anemic without knowing it, and had 3 main symptoms: fatigue; a sort of olfactory version of pica (I *craved* the smell of solvents); and restless leg syndrome. As soon as my anemia was discovered and addressed, all 3 went away. I'd never had restless leg syndrome before, and haven't had it since. I'm positive that it and the pica were caused by the anemia. I'm sure there are people who have heard of "restless leg syndrome," and worry so much that they have it that they become preoccupied with leg sensations, the way one can with a dripping tap. But there is definitely also a version that is biologically driven, and that's what I had. It's a really weird, distinctive, very unpleasant sensation, and it grabs your attention. You don't have to go looking for it.
The entire point is that it's not made up, it's likely some combination of natural phenomena and culturally mediated expectation (as are many things). With restless leg syndrome it's particularly easy to see how that could be the case. Most people twitch as they fall asleep, likely as the brain switches off voluntary control of the body. The propensity to twitch and well as the magnitude and duration of twitching are all likely normally distributed among the population (as well as within an individual across different instances of falling asleep). Sometimes those twitches lead you to wake back up. Some people will wake back up a lot on their own, some sporadically so, and if you primed to it and expect it I suspect it will happen a lot more.
It's not twitches, though. I've had twitches while falling asleep all my life , and they don't bother me at all. Restless leg syndrome is not involuntary movements, it's a weird, intense, unpleasant sensation that makes you crave to move your legs because you have the sense that it will make them feel better. And it does make them feel better, but the sensation comes right back as soon as you stop moving them. You know the feeling you get when your leg has fallen asleep, and then when it's partway recovered it's very sensitive and uncomfortable? It's more like that feeling than anything else. There may be a version that's created by paying too much attention to how your legs feel and tripping out on that, but there's definitely a version that's biologically driven. I had it for a period of a few months when I was extremely anemic without knowing it, so anemic I was given an immediate transfusion when the anemia was discovered. The restless leg syndrome must have been caused by the anemia somehow (I had some other weird symptoms as well). As soon as the anemia was rectified the problem went away and never came back, even though for a while I thought and worried about it when I went to bed. I'd check my legs mentally for the feeling, and the attention I was paying to them did not bring it on. Instead, I kept discovering to my relief that I did not have the feeling, and after a few weeks I stopped worrying that it was going to come back.
As someone who was made miserable restless leg syndrome for a few months 15 years ago, I take issue with this. What I had was nothing remotely like paying too much attention to subtle leg sensations. And have a look at this: https://pubmed.ncbi.nlm.nih.gov/22210354/ Africans rarely report it, but there's plenty of it in Asia, Europe and the Americas. It's related to melatonin levels (abstract did not say how closely correlated) and highly correlated with latitude: Correlates in the mid-70's with distance from equator.
Just a kindof crazy idea, but I'm curious if there is a correlation between being able to 'see' Cube 1 as either Cube 2 or Cube 3 and being able to see the reasoning behind opinions you disagree with (i.e. to the point where you can empathize with them and/or make a coherenet logical arguement for that position)
I did a similar experiment on one of the SSC surveys, using a spinning dancer illusion instead of the Necker cube, and got mostly negative results. Expanding on this, I was able to get some weak and confusing positive results, see https://slatestarcodex.com/2017/07/14/can-we-link-perception-and-cognition/
I don't think I tried the Necker cube because I didn't think anyone would be unable to see it. Are there people who have tried really hard but still can't make it flip?
I think you can almost factor out culture from this explanation.
If you take the view that raw sense data/brain activity is a mess of "blooming and buzzing confusion" which we then build something resembling a consciousness/ego/self out of, then psychological conditions come from one of two places. One is weird raw materials (the brain receives sense data that's wrong, or a part of the brain that's responsible for conveying/processing raw sense data screws up the signal). The other is a badly constructed consciousness (sense data/pre-conscious brain activity gets classified in weird ways, or biological urges get routed into weird motivations/weird motivations are created ex nihilo).
A huge part of constructing a consciousness must be linguistic (I'm not sure it's coherent to talk about having a non-linguistic sense of self) and transmitted from others, although there are presumably parts that are more-or-less hard wired biologically for evolutionary reasons; I doubt you could raise someone to have a consciousness radically different from the norm (no ego, no persistent objects etc). Given it's parents/peers, this will vary markedly by culture; the upper layers of it will be explicit knowledge that changes over the course of a lifetime, which is where some of the more obvious culture-bound stuff is sitting. The lower levels of the consciousness being mal-formed are probably things like personality disorders. Some psychotic illnesses are presumably broken sense-data processing at a pre-conscious level.
>an area in Virginia where the government enforces a ban on electromagnetic transmissions for secret military reasons
an area in *WEST VIRGINIA* and Virginia. A keen eye will note that the Wikipedia page doesn't list any points of relevant interest in the Virginia half of the area.
As fun as it is to say 'secret military reasons,' the government is open about some of the reasons: Sugar Grove Station in WEST VIRGINIA (https://en.wikipedia.org/wiki/Sugar_Grove_Station) is an NSA listening station, and Green Bank Observatory in WEST VIRGINIA (https://en.wikipedia.org/wiki/Green_Bank_Observatory), which has the world's largest steerable radio telescope and they offer quite informative tours. All electronics have to be turned off, of course, though the gift shop will provide disposable cameras.
One thing about “running amok” (both the original Malay version and the American active shooter version) seems to me to be distinct relative to koro and anorexia: while it’s clearly culturally influenced, it’s not (locally) contagious.
The man who runs amok doesn’t generally spark a bunch of copycats in his immediate community, while koro seems to spread in panicked waves that rapidly “infect” lots of socially connected individuals. (There are things that are more like “spontaneous mob violence” or “small military group goes berserker in the face of impossible odds” - but that’s not what we’re talking about here)
I do think this still fits into Scott’s overall model. Maybe there is a “going amok” condition that is pretty rare but is mostly biological. However the exact form it takes is culturally defined in a “choose the form of the destructor” sort of way (catch a demon and go on machete rampage followed by amnesia among the Malays, jihad inspired suicide bombing among the Arabs, Columbine copycats among the Americans, etc.). It’s not really a social contagion, more like a meme that only certain people are vulnerable to.
For the last two years, I've experienced an undiagnosed medical illness with symptoms a bit similar to CFS/long covid symptoms.
Two primary symptoms:
1. when doing cardio exercise (ie running), after a certain level of exertion (significantly lower than where it should be) , my heart rate will spike and my body will start feeling enough stress to force me to stop.
2. I feel fatigued/bad more frequently than I used to
I actually had a ~6 month period where I fully recovered but then the symptoms came back.
Since these symptoms started appearing, I've become hyper conscious of how I'm feeling and various health metrics (ie heart rate when running, overnight resting heart rate).
I've been told that by being hyper sensitive to how one is feeling/recording data can make these symptoms worse as the mind will pattern match.
Given the concerns outlined in this post, does anyone have any suggestions on how they can experiment with trying to psychologically overcome this?
Off the cuff, maybe try out new exercises. You might find that you have an easier time with swimming or cycle than a regular run, as a new sport means you don't have any priors to worry over. Something more mentally stimulating may also be preferable, join a basketball team or find a partner to play tennis against, that way you have something other than your body to pay attention to during the activity.
Assuming this isn't just getting out of shape due to lockdowns or something, I would get a doctor's opinion, that sounds like actual heart trouble. A relative had those symptoms (well, extreme; they eventually couldn't walk up a hill anymore) and ended up getting a triple bypass, at which point their energy came back. Is the exertion level getting lower with time?
For psychological... try listening to music? Pick a target heart rate, find a song that matches it, listen to it before measurements.
Central sensitization is A Thing. But it's often not completely self-perpetuating, but repeatedly renewed by real tissue provocation, even if far too little provocation to normally account for that much pain.
Exercising to the point of symptom provocation can train you to expect symptom provocation, further entrenching central sensitization. It's *rational* to infer from repeated failure that you'll probably keep failing, and from repeated aversive experience during an activity that the activity itself is aversive. So exercising beyond your body's tolerance for it is a bad idea. But maximizing tolerable exercise is probably the closest thing we've got to a cure for chronic discomfort:
Also, it can be socially, as well as psychologically, useful, to somewhat understate discomfort, calling it "discomfort" instead of "pain", "intense" instead of "excruciating", and so on. I'm not convinced that reframing my descriptions like this changes my own perceptions – but it does signal to others that I'm abstaining from self-dramatizing exaggeration that *might* make discomfort worse. And a reputation for not-exaggerating is extremely important to finding appropriate treatment for a chronically-uncomfortable condition, especially if you're a gal.
There are workshops like "Explain Pain" by Lorimer Moseley et al that can be useful, too.
`Psychologist here, specializing in anxiety disorders. I'll tell you what the treatment is for an anxiety disorder of this kind. BUT before trying it you have to go get your heart checked, because the treatment for paying too much attention to heartbeat sensations is the exact opposite of the treatment for some kind of abnormal heart activity set off by exercise. If you have a heart problem, you'll probably need to lay off running, at least until the heart condition is stabilized. If you have an anxiety problem, the treatment is to put away your heart monitor, don't take your pulse, and just run. If you have the uneasy feeling that a certain thing -- say jogging up a hill-- will be too much for your heart, go jog up the hill. Jog up it every day. If you have the feeling at a certain moment might that even a short sprint might make your heart give out, do a short sprint. Stick with that prinicple. Every time you find yourself fretting that something will harm your heart, do at least a brief version of it. If doing these challenges is too daunting at first, just go out an run without measuring your heart rate, and plan in advance how far and how fast you're going to go -- then do that, rather than letting your pace and distance be controlled by the *feeling* that you're just not up to more. Once that gets easier, start building in deliberate defiance, as described above, of your feeling that something is too much to ask of your heart. And once the problem subsides I'd recommend just giving up heart rate monitoring for a good long time, maybe forever. It's a nice aid to training, but hardly essential, and in your case it backfired and interfered with training.
But before doing any of that, get your heart checked. Seems to me that the appropriate test would be a stress test. Even if you're young you can probably get the doctor to give you one if you do NOT say, "this may all be my imagination" but instead say something like "I get a weird feeling in my chest." And while you're there you should maybe also get checked for anemia and any other medical ow-hanging fruit that might cause fatigue.
To add to the calibration-dependent-phantom-sensations bucket:
phantom notifications.
I don't think it's uncommon to hallucinate a phone vibrating in one's pocket, even when it isn't present.
Curiously though, I don't recall if this is dependent on my wearing pants - but I doubt this is a phenomenon that existed 20 years ago (outside of maybe the pager/beeper crowd).
I also recall hallucinating voices in a specific shower at one point, primarily limited to short instances of vocative address.
I used to experience this constantly, and it was maddening. I solved it by constantly rotating which pocket I put my phone in, so that no one area is primed for the buzzing sensation.
"Before anyone gets too excited about this, I want to stress a version of the point Bures got right earlier: there is no neutral culture. Having lots of transgender people is downstream of cultural choices. But having lots of cisgender people is also downstream of cultural choices. There isn’t infinite flexibility - evolution ensures a bias towards heterosexuality, for obvious reasons. But there’s a lot of flexibility - Spartan men married and had sex with women, but they thought this was a dumb annoying thing they had to do to have children, and sex with young boys was the obvious enjoyable satisfying option. Even within evolution’s constraints, culture can do some pretty weird stuff. I think you could probably have a culture where 99% of people were transgender, where it was generally accepted that everyone transitioned on their 18th birthday, and where only a few people (disproportionately schizophrenic) would object or see anything wrong with this."
I have always thought that sexual orientation must be at least in part cultural/environmental, unless someone could point me to a special genotype that ancient Spartans and modern Pashtuns had.
I wonder if there's a better explanation of gender dysphoria's cultural-bound-ness: that discomfort with appearing as the gender you don't identify as is cultural. Most men in the United States, if forced by hand-of-god to spend a day appearing exactly as a woman, and not being able to explain what was happening, so that everyone would assume they were a woman, would feel terribly uncomfortable for the entire day. Though I don't have much knowledge about how people would feel about this in other cultures, I expect (I'm not sure why I expect this) that, in a lot of other cultures, people would feel much better about that: people wouldn't be nearly as terribly uncomfortable in this hypothetical.
So, when people in another culture don't feel like the gender that they would be assigned based on their physical sex characteristics, it doesn't really bother them as much. In American culture, the idea that you might want to dress or act differently from the gender that matches your physical sex characteristics is seen as very shameful: so, people feel terribly uncomfortable. In a culture that doesn't have such a strong idea about how one _should_ act or dress might not feel nearly as uncomfortable, simply because the idea they have (that they might want to dress or act differently from the gender that matches your physical sex characteristics) isn't seen as nearly as shameful.
In other words, the cultural idea of shame surrounding crossdressing and transvestism and whatever else people were thinking of it as previously might be what causes gender dysphoria.
With that said, I've not 100% thought this through. I might not agree with this if I thought about it in more detail.
Is this actually true though? The fastest growing group of people identifying as trans/NB are adolescent natal females, and “being a tomboy” and dressing butch has been not particularly shameful for a long time, certainly less shameful than a male dressing in an obviously feminine way. To be trite, a guy in a dress is going to get funny looks while a girl in a tshirt and baggy pants is basically normal.
I don’t think trans women face less stigma than gay or effeminate men, at least in the US.
There are apparently places where this is true - I believe it’s Iran where being transgender is acceptable in a way that being homosexual is not. But notably, that appears to be evidence that their gender roles are stronger, not weaker.
This is a fundamental misunderstanding of gender dysphoria.
It's hard to make generalizations here because there's a lot of heterogeneity among trans people. But to a first approximation, when you're trying to imagine yourself in the mind of a trans person, you should imagine your internal self-concept actually belonging to the gender you identify as. All of your first-order feelings about gender roles and expression are experienced relative to that internal self-concept.
So, for example, I'm a trans man (FTM). I was raised in a very 1980s-feminist-egalitarian environment where gender was a social construct and anyone could do anything, so I don't have an especially strong need to be gender-conforming, but I did pick up a vague sense that I was supposed to live up to a certain ideal of masculinity in my dress/behavior/body. What limited shame/discomfort/anxiety I have about gender-transgression revolves around my *feminine*-coded tastes and attributes. This discomfort was much stronger before I transitioned, when I felt like I had to prove myself, and receded almost entirely when I began to be consistently perceived as male.
There is of course a second-order layer of discomfort/anxiety: pre-transition trans people understand that people perceive them as the other gender and that there are social risks involved in failing to conform with one's perceived gender role. The conflict between the two layers is a source of stress. But it's not the driving force behind transitioning, at least not in Western liberal democracies. We're all well-aware that the people who would judge us for perceived gender transgression are the same people who would judge us for transitioning.
>you should imagine your internal self-concept actually belonging to the gender you identify as
But I don't "identify" as a "gender" at all. I identify as myself. I understand that there are clusters of aesthetics and social scripts associated with what used to be called "biological males" and "females", and I adhere to the one that corresponds to my biology to the extent that polite society expects, mostly for convenience's sake than anything else, and that's that. This is apparently called "cis by default", so I suppose I can't even in principle imagine what it's like to be trans.
I'm not saying that *you* identify as anything. I'm saying that when you try to put yourself in the mind of a hypothetical trans person, you have to think of your hypothetical self as actually being the gender that your hypothetical self considers themselves to be.
It's hard to explain in the abstract, but it's really not that complicated in practice. If you're trying to cognitively empathize with a trans woman, you think of yourself as a woman (and you at least temporarily adopt a definition of "woman" as a social category, grounded in but not fully determined by biology.)
Well, this topic is very complicated and politically charged and still new enough to be in flux as far as theory is concerned, so I'm not optimistic about anything becoming clear any time soon. But if you don't mind, I still have a question. Suppose this trans woman is lucky enough genetically that she can perfectly pass without any medical transition, just cross-dressing and makeup are enough. (I guess this is much more common in the trans man case.) How likely is she to still experience dysphoria?
This touches on an internal conflict within the trans community. What, exactly, is dysphoria, and can you be trans without experiencing dysphoria?
I'm loosely aligned with the faction that's not-so-affectionately called "truscum": I don't think you can be trans without dysphoria. (I emphasize *loosely* aligned, though. Most people who describe themselves as "truscum" are hateful jerks.)
So to me, your question is tautological. If the person in question is a trans woman as I use the term, then by definition she experiences dysphoria. The effort she makes to "pass" with clothing and makeup is partly a coping mechanism. She almost certainly experiences some distress when applying or removing makeup, showering, and having sex. Her life is probably limited in various ways - she's probably afraid to swim, go camping/hiking, or do anything that's not compatible with heavy makeup and undergarments. And she's almost certainly terrified of aging out of her androgyny.
A member of the opposing faction - a so-called "tucute" - would answer differently because they have a more expansive definition of "trans woman." They believe that so-called "gender euphoria," a feeling of pleasure or validation at being recognized as one's preferred gender, is sufficient for being trans. So in their view, someone who just likes women's clothes or makeup and enjoys being perceived as a woman could be called a trans woman. But I don't know if they could give a quantitative estimate of the number of dysphoric vs. non-dysphoric trans people overall, let alone the ratio in a tiny subpopulation or how it's affected by individual attractiveness.
Thank you for the many insightful comments. It sounds like being trans kinda sucks. And I wonder if you can imagine a world where it wouldn't be so hard. Or is it always dysphoria?
Thanks from me as well for taking the time to clarify these issues. I'm also curious, then, what is your perspective on the rest of the "gender studies cluster", e.g. genderqueer, genderfluid, bigender, etc. Does any of this make sense in the "truscum" framework?
I appreciate this breakdown...as a trans woman (I guess) who's been waaaaaaaay out of the LGBT loop for years now. Had a vague sense of the "truscum" archetype, did not know its inverse had a grouping as "tucute". Useful update. Things sure seem to have gotten a lot more complicated and factional since I last hung around that milieu.
I guess under that taxonomy I don't really fit anywhere, feeling neither dysphoria anymore, nor euphoria. This is just How Life Is now. Nothing particularly traumatic or exciting about it, just the mild routine indignity of medications. The small ouch of being misgendered just...doesn't pass sensitivity threshold much anymore? Like, whatever man (it's almost always men, you'd think women would be better at clocking...?), idgaf really. Not worth my time to correct, barely putting in the bare minimum effort to pass anyways. I think it'd bother me more if I was Actually Trying and not in Minimum Viable Female mode, but that's the comfortable default now. (Thank God for low dress code expectations in SF...)
It's still __preferable__ in a small way to pass, just because that makes life easier...having a Predictable Identity pleases interlocutors both friendly and foul. Nevermind the intepersonal tensions when someone's not __quite__ sure what I am, and has to hazard a potentially-cancellable guess. But I'm not, like, attached to the "transgender" identity or culture at all. The meds are instrumentally useful, even if I'm not seeking the same terminal values and don't, actually, have any firm internal sense of this "gender" thing.
>But I don't know if they could give a quantitative estimate of the number of dysphoric vs. non-dysphoric trans people overall
The various researchers, therapists, etc. I've talked to over the years have suggested this has something to do with the significant fraction of trans women (idk about trans men) who are also autistic. Whatever the actual causal pathways of transgenderism are, we seem to "fall into it" in different fashion from the (more) neuroTypical. The dysphoria hits qualitatively differently...treatments are equivalent, but my sense is that there's really two distinct itches that are getting scratched.
The same goes for me. I do not feel that I am of a particular gender, although my body clearly is. I did not know that this was called "cis by default". I wonder which is the most common feeling: having a strong internal gender identity or being 'cis by default'?
And there is actually an answer to the question I was wondering about, from a Lesswrong survey a few years ago ("I identify with my birth gender only by default: 45.3%; I identify strongly with my birth gender: 39.0%"). Lesswrong people are probably a bit atypical for this point, but I am pretty confident that both feelings, strong and weak gender identity, are common.
Now I wonder what the breakdown is for sexual orientation, and whether or not there is a relationship between a strong gender identity and a strong sexual orientation?
This is a really well-written comment, thank you. I think what I was describing above is what you describe in the last paragraph. I think I neglected the dysphoria you describe, where doing feminine things or appearing feminine makes you feel shame/discomfort/anxiety because your experience and self-concept is that of a man, but now that you describe it I've heard plenty of people describe it. I'd agree with your characterization that it's the defining part of gender dysphoria.
Rather than questioning whether gender dysphoria is a culture bound affliction, isn't it simpler to recognize that there is no objective reason to suppose that 'gender' is anything distinct from biological sex?
I mean 'I have a real self that is not my biological self.' is an inherently religious or at the very least metaphysical belief that our society has decided to treat as a reality.
It's funny that I didn't realize until Scott was explicit that this was about gender, which is funny since 'penis stealing witches' would actually be a pretty awesome invective to use on the 'groomers'. I thought that this was going to be about the pandemic related collective delusions because I had just seen that the NYT had a column this morning about masking being useless, something we all knew in 2019 but forgot recently.
Fact: male and female nervous systems are structurally different in certain minor but predictable ways
Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems
Therefore, it seems clear that when a trans person says "I have a real self that is not my biological self" what they *mean* is that their nervous system does not match up with the rest of their body, and that they should be gendered based on their nervous system. Which I think is a very reasonable conclusion given the relative importance of different body parts.
I would like to see the data for that. What are the specifics of this claim, what are the neurological differences? I would also like to see the variation among members of a sex that identify as cisgender versus those that identify as transgender. How many transpeople have been evaluated to determine which type of nervous system they have?
Men and women are certainly different neurologically, but can you connect the dots to show that transpeople have cross-sexed neurology? Your major premise I concur with wholeheartedly. Your minor premise I await proof, before I evaluate your conclusion.
Also, if this is true, where does this put detransitioners? Is their neurology cross-sexed or not?
Referring to these as differences in the "nervous system" as a whole is a bit of an oversimplification, since there are many different parts of the brain and body where sexual dimorphism may be observed to varying degrees.
Referring to these as differences between "cis people" and "trans people" is also a bit of an oversimplification, since those groups are defined by their behaviors (e.g. self-identifying as trans, or starting medical transition) and not by the underlying biology.
For the same reason, the question "where does this put detransitioners?" is meaningless: neither transitioning nor detransitioning affects the presence or absence of these neurological differences. Either they were there all along, or they weren't.
> Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems
I don't believe this "fact" has been established. As far as I'm aware there is no objective measurement that allows one to distinguish trans & cis people with any degree of reliability.
It's part of a much longer talk which discusses a number of issues, but Rebecca Reilly-Cooper touches on the "gendered brain" here:
"Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems"
This is absolutely untrue. That claim is based on one (1) study featuring about two dozen transsexuals and not only do the error bars on the effect dwarf the effect itself, the actual effect is that trans-identifying men have their values shifted *slightly* in the direction of women but are still almost identical to other men, and much more different from women.
I think metaphysics is a red herring, for most concrete trans rights issues. Like, your name is "Jon Cutchins," and it would be rude of me to decide that I'm calling you "Sam" instead. If you chose to change your name to "Jane Cutchins," it would be equally rude of me to keep calling you "Jon." I think this is true regardless of whether you think "my name is Jon" is a metaphysical religious belief or just a convenient label.
I didn't say anything about names. That is a strawman. I said that believing or disbelieving in 'gender', not transgender or gender dysphoria but gender-the concept that you have a sexual identity other than your biological sex, is a metaphysical or religious choice. It can no more be demonstrated than the coeternality of the divine son or the existence of nirvana. It is like debating nominalism vs realism.
And I'm saying that I don't give a shit whether you believe gender is a mystical essential quality or not, so long as you agree that deadnaming trans people or calling them by the wrong pronouns is wrong.
Since you used the term "groomers" in your OP I assumed you disagreed with trans rights in the concrete legal-and-social-norms sense as well, but if you don't, then I couldn't give a shit what metaphysical framework you subscribe to. The goal is to ensure that trans people are legally protected and socially accepted, everything else is commentary.
Your goal. My goal is both to find truth and make it more known. If I haven't been clear enough I don't believe that 'transpeople' exist because I don't believe in gender. You are demonstrating exactly what I suggested that it is a dogma for you believed emotionally on faith. Which is fine. I don't interfere in your religion. But I will no more accept it as the law of the land than I would allow the worship of Quetzcoatl to be mandated. What name I call anyone except you and your family by is none of your business. Actually even if I call you by a name you don't like that is not actual harm.
There is a whole world of people out here that don't have to agree with you or do what you like. Sorry, not sorry.
>I don't believe that 'transpeople' exist because I don't believe in gender.
If you meet a person whom you know used to go by "Jon, he/him", but now goes by "Jane, she/her," which name do you call her by? Regardless of whether you believe this person is transgender, regardless of whether you believe gender exists or not, names and pronouns do exist and you have to choose one to address this person by. The only claim I'm making is social - that it would be rude to address this person by a name they've clearly expressed a preference for you not to use.
> What name I call anyone except you and your family by is none of your business.
Do you have a similar reaction to, say, schoolyard bullies? If a kid gets called names, that's none of your business because language is never harmful?
>Actually even if I call you by a name you don't like that is not actual harm.
If I tell you that bread and wine is actually human flesh and blood and that anyone you share it with you must refer to as brother or sister do you behave as if my statements are true and comply with my ritual?
Demanding that I do makes you the rude one. As you demonstrate at the end of your post. Thise who try and force others to say what they wish them to say are the bullies. Judge for yourself how I respond to bullying.
And if I decide I'm a gorilla, would it be rude for you to to continue treating me like a human, with human rights and human responsibilities instead of gorilla rights and gorilla responsibilities?
"NYT had a column this morning about masking being useless"
Just looked up this column and the study... The article is wildly misleading. The study says, right up front, that their "wore masks" group *didn't consistently wear masks.*
The strongest statement you can possibly make from that study is "the data on masking is mixed and compliance is terrible, so we probably shouldn't do mask mandates."
Nah, we just need to mask harder next time! With criminal penalties for misinformation and Science Denial! If a person is incapable of obeying what Science mandates, there is no place for them in modern society!
No. It is 'masking doesn't work' and then you can qualify it with 'here's why'but the headline is the intervention doesn't work in the real world. Whether or not it would work in some other world where people wore them 'correctly is irrelevant.(btw it wouldn't this has been known for decades and then forgotten in 2020 lime so much actual science) the real question is why people are so emotionally attached to masks
I don't think that's very hard to answer - people want prophylaxis against disease, and to avoid the risk of giving other people diseases.
We know that people overestimate their own compliance in just about every scenario, so it seems safe to assume that individuals may assume they are getting a benefit even though the bulk of people don't thanks to low compliance.
People want prophylaxis against disease, and to avoid the risk of giving other people diseases, and to feel safe independently of whether they are safe, and to be comfortable, and to feel wise and virtuous, and to be accepted by their ingroup, and to have a way to show their superiority over the outgroup. Deconvolving all of this is going to be rather tough, but it may be worth noting that some of these things are motives to wear a *good* mask *properly*, and others are motives to just wear some mask visibly.
No the bulk of people don't because masks are not ppe for viral transmission. They are ppe for droplets. Other than that they are security blankets, hence the question about psychological attachment.
If your mask 'worked'and you wore it properly it wouldn't matter if my mask worked. We would both be protected from infecting one another.
Just another case of blame the vicimt when the interventio doesn't work.
"The French suffer from bouffée délirante, where a perfectly healthy person suddenly becomes completely psychotic, with well-formed hallucinations and delusions - then recovers just as suddenly, sometimes over hours or days. This is not how psychosis works anywhere except France and a few former French colonies."
Not completely French-bound: King George III of England, who had sudden hallucinatory episodes (famously talking to trees etc.), then would wake up one day completely fine. Admittedly his episodes lasted longer than "days".
Great column as usual. But I was hoping you might mention Havana Syndrome, which is quite fascinating -- dozens of cases of government and military personnel convinced that vague symptoms are the result of a Russian sonic-beam weapon of some sort, which no one has proven even exists. Social contagion but with some unusual aspects
I'm interested in your evidence for this besides the fact that it's obviously true of everything. That is, is tinnitus more this way than, let's say, headaches?
Disclaimer: I don't have really have any evidence for this. I don't know why I made this comment on the internet and I didn't expect to have to justify it.
But here's the story. My friend developed tinnitus a few years back and was very upset by it, but I was interested in his girlfriend's take that "no, everyone always has ringing in their ears, most people just ignore it". That rang true to me - indeed ever since then I've noticed that if I listen I *can* hear ringing in my ears. But I had never realized this before, and I never ""hear"" and/or notice the ringing when I'm not specifically trying to hear it. So I don't consider it a problem or consider myself to have tinnitus. But obviously there's a part of me that realizes I'm neurotic enough that this is the kind of thing that could drive me crazy if I wanted it to.
Meanwhile, my friend hasn't mentioned his tinnitus in years (no longer wears ear plugs afaik, etc), so I just asked him about it! He says: "I still have it but at some point my way of thinking somehow magically changed and it doesn't often bother me anymore"
I've had it my entire life and never thought anything of it until I learned what it was as a child. It's never bothered me, regardless, but I had a moment of "wait, this isn't how everyone's ears work?!?"
"Before anyone gets too excited about this, I want to stress a version of the point Bures got right earlier: there is no neutral culture. Having lots of transgender people is downstream of cultural choices... I think you could probably have a culture where 99% of people were transgender, where it was generally accepted that everyone transitioned on their 18th birthday, and where only a few people (disproportionately schizophrenic) would object or see anything wrong with this."
I don't think this is technically wrong, but it feels... stretched? Like here's a bunch of stuff that had to happen for the disproportionately trans stuff to happen here:
1. A certain (large) amount of sexual-liberation stuff had to happen around the more "normal feeling", easier to justify LGBT issues to garner momentum around "Good people of X political alignment support stuff that 'feels gay' as part of their package deal of political and cultural beliefs"
2. Trans lobby had to convert the people who were reflexively in-tune with 1., starting small with stuff like "use my pronouns - it's a polite fiction but it will make me more comfortable, and don't you want to be polite?". In my (possibly wrong) telling this is where they got you - i.e. Emperor Norton "why not, it's kind" tactics.
3. They had to move from "polite fiction" to "you have to actually believe we are in some substantial way a different sex, and treat it that way" stances, where "women were women" and were to be treated so in every possible way they desired. If you didn't meet this expansion, you'd run afoul of 1-2.
4. They had to move from "Don't you want to be polite and nice?" stances to more forceful tactics - utilizing preexisting legal structures and leveraging their more enthusiastic supporters to get you fired from jobs, blacklisted from academia, etc. If you didn't adopt 1-3, to the point now where you basically have to be anonymous to push back on them or make a career of pushing back on them to be "safe" in doing so.
This is trans lobby, granted, and not necessarily every trans person. But the practical upshot is something like us having a mostly enforceable framework in which:
1. Some small percentage of people think trans women are women, full stop
2. Some larger percentage don't think trans women are women, full stop, but do fancy linguistic stuff to indicate that they are in line with party demands and feel good about doing so, and wish they could think it for reals.
3. Some (probably) even larger percentage doesn't think trans women are women and doesn't feel good about saying they are, but know they have to do something between "Give them everything they want, say whatever they want, or else do a damn good job hiding".
All this to say that there might not be a cultural neutral we can pin down, but an awful lot of shit had to happen here to get to where we are. And we can imagine a culture where 99% of everyone is trans and that's just normal, but the stuff that would have to happen to "bend the average" that far would be astronomical. It's a nitpick, but it's really, really hard to look at a system that can only exist when you've leveraged a ton of stuff into completely shutting down any questioning at all at risk of firing/unhirability as "just as normal" as the usual default of "there's a few trans people, and everyone thinks they are at least kind of weird".
I think this matters here because *every single thing about "manufacturing" more trans people is negative.* This sounds harsh, but consider this pretty accurate rewording of general trans lobby positioning as it exists today:
>>> Transness is a thing, we don't call it an illness, but usually the thing about transness is that you have to go on these really clearly unhealthy hormonal treatments from an early age and get massive surgeries to the reproductive system that are pretty dehabilitating to normal sexual function. And the reason you have to do this is that if you don't you will almost for sure kill yourself.
Yes, they deny any possible downside to massive hormone treatments and stopping puberty and roughly redefining sexual organs as approximations of other sexual organs or removing body parts completely.
So there's this thing where, like, say there's some baseline amount of trans people, and you can't do anything about that no matter what you do, and you want to maximize utility in that situation. That's one thing - you do a certain set of stuff under that. Like maybe you all decide to try your best to believe the polite fiction and make it as real as possible, and you all commit to publically only saying things that assume the polite discourse is true.
But that's not the situation we are dealing with, where it's becoming increasingly clear we are making a social contagion of sorts. In that case, you have to grapple with the negative utility of the social contagion, and the balance of forcing everyone at gunpoint to toe a party line changes an awful lot.
In this case it looks like we would have gotten an awful lot of utility out of something like "not joining or working to stop the active, years-long campaign to get people to pretend along with something, or else to threaten them with as much force as we can muster that we will commit serious harm on them if they don't at least shut up and fall in line". Like a lot of people who might have just been furries instead and wouldn't have actively destroyed the function of their bodies, etc.
So that's sort of my pushback, is that there's no "cultural neutral" in the sense that you can't point at the one pure society all other societies are variations of, but it's a much bigger stretch to look at a pretty extreme outlier culture that's producing pretty extreme outlier results only after an extended campaign to use pretty extreme force to muffle what appears to be the usual general reaction to a thing and institute a sort of fiction most people are only at best playing along with even now, and say "But understand there's no cultural neutral - this is about as normal as anything else". Especially when the upshot of that pretty significant downsides.
I'll even mildly push back on the assertion that there is no neutral culture. Hell, the piece opens with a list of things that are basically universal. If it is in fact the case that, as Scott writes, "having lots of cisgender people is also downstream of cultural choices" then it sure is a weird coincidence that just about every culture that has ever existed has made those exact choices.
It seems to me like gender dysphoria is more similar to something like left-handedness (the body producing the "wrong" hormones in utero, leading to stuff being built in the "wrong" way) than to something like penis-stealing witches.
Gender is clearly a structural neurological phenomenon. Furthermore, I know plenty of trans people who have a certain set of childhood symptoms of gender dysphoria before they were aware of the existence of trans people. Personally, while I was aware of trans people's existence, I hadn't honestly considered if I was trans, but I still had a lot of fairly common symptoms of gender dysphoria. I find it difficult to believe that I almost exclusively enjoyed socializing with women (and a few effeminate men) and constantly felt bad about the masculine traits of my body because of social contagion. I think a far more likely explanation is that I was simply exposed to more estrogen in the womb and my brain took that as a sign to develop in a feminine-structured way.
Now, certainly my choice to *describe* my female-structured central nervous system as me "being a woman" is socially based, but only insofar as my culture believes that the brain is more important to someone's identity than the rest of their body.
There's a Darwinian reason for a small percentage of people to be left-handed: it gives an advantage in a fight against someone not used to fighting against a left-hander.
The term "gender" at one time was used to refer to elements of grammar, then the term was borrowed by feminists to describe the stereotypes associated with biological sex. Some people uncomfortable with using the word "sex" when they didn't mean coitus started using "gender" instead (that was explicitly the case with the Supreme Court). More recently people have started talking about individual "gender identity" as something distinct from the feminist idea of gender as something society imposes on you. But it's not "clear" that there needs to be any "structural neurological phenomenon" in the brain giving people a "gender identity" rather than letting people be "cis by default": https://slatestarcodex.com/2013/02/18/typical-mind-and-gender-identity/
I linked to it in another comment, but Rebecca Reilly-Cooper gives a thorough discussion about whether everyone has an internal gender identity here: https://www.youtube.com/watch?v=QPVNxYkawao
I expect that many people who currently identify as trans had sex-atypical characteristics as children. In the past, that would have been an indicator they were more likely than average to grow up to be homosexual.
"There's a Darwinian reason for a small percentage of people to be left-handed: it gives an advantage in a fight against someone not used to fighting against a left-hander."
In The Steel Bonnets, George MacDonald Fraser mentions a family of borderers, the Kerrs, who were so prevalently left-handed (presumably most of them were right-handed and deliberately trained themselves "wrong") that, he claims, Border people still say that a lefty is "car-handed"; the alleged purpose was to have this advantage in a melee.
"In the past, that would have been an indicator they were more likely than average to grow up to be homosexual."
As Michael Bailey noted in The Man Who Would Be Queen, a strong predictor of whether an effeminate boy will go on to seek transition (rather than growing up as a gay man) is whether he expects to be able to pass as a woman.
Advances in medicine have made that goal more realistic for many of the boys for which it previously wouldn't have been.
I don’t think Scott’s model is incompatible with there being people who experience gender dysphoria the way you have, as a “mostly biological” phenomenon. That is, your symptoms of dysphoria are “autochthonous ” to use Scott’s phrasing. But Scott’s model predicts an additional class of trans people who got there with a balance of causes leaning more toward social and less toward biological. This is not to say their transness or dysphoria are “less real”, just that they were unlikely to have manifested in a social setting that didn’t have gender transition in the metaphorical water.
I think some of the data relating to the rapid and recent increase in the number of individuals identifying as trans, and a flip in the gender balance (trans identification used to be majority mtf, now it’s mostly ftm) make a lot more sense in the “social contagion” model than the “biological model”, because it seems doubtful that the biological mechanics of gender dysphoria would have shifted so dramatically over essentially one generation.
And honestly, there seems to be a lot of overlap between the described experience of gender dysphoria by trans men and that of adolescent cis women experiencing puberty-related body image issues, social awkwardness, etc, as well as autistic cis people struggling with hypersensitivity to certain internal sensations and/or fuzzy social rules. It certainly seems plausible that individuals in one or both of the latter two categories could, on the margin, find their experience pattern matching to that of being trans, and come to the conclusion that they are in fact trans (or at least that gender transition is the solution to their symptoms) through a sort of unconscious confirmation bias and social reinforcement process rather than a purely internal biological one.
I'm very weirded out by this discussion-- it's a very outside view of transness. It's plausible that my social circle might include more trans people than most (there is (was?) a medical center doing transitions in Baltimore) and I'm in fandom, but am I the only person here who knows any trans people? I can see why a trans person might not want to join this discussion.
From another angle, I've got one friend who thinks that m to f tends to work out better than f to m, and I'll note that most of the trans people I know are trans women. Any thoughts about whether both directions work out about equally well?
I know about ten trans people, dated one a few years, have lived in the same group house as two others for a few years. I'm not sure what you think is outside and would be interested in an explanation.
I would say "politically constrained" views. It's really hard to have open discourse about trans people because the arguments tend to be heavily biased by political camp.
I wasn't thinking about you so much-- at least you were careful to say that social contagion leads to real emotions, it was more about what seemed like a majority of commenters.
What I mean by "outside view" is something like "transgenderism is this weird phenomenon, let's see if we can figure out what can be done about it".
My take on it all may be unusual. I've known some people who transitioned before it was cool and were visibly happier. I believe gender dysphoria is real and transitioning is a solution to it for some people.*
On the other hand, I do see pressure to transition in some social circles-- it looks like the assumption that transition can be an urgently needed method of suicide prevention. And also an assumption that trans is cooler than cis. This could lead to people who are a little edgy about their gender or miserable for other reasons getting pushed into transitioning.
I also suspect that transitioning may have become a more difficult medical challenge than it used to be, with a hypothesis that hormone disruption is more common than it used to be, so getting to a new hormone balance that feels right to people might be trickier.
*I've also met a person who apparently had biological dysphoria-- they didn't like being organic. The emotion seemed very real and it was sad because there was no technological solution.
Obviously there's a lot of aesthetic judgement behind "work out equally well", but...
-Testosterone works SO. MUCH. FASTER. Like it's frankly insane how quickly a FtM visibly changes in a short timeframe versus a MtF on estrogen (talking weeks or months vs years). It often takes trans women at least a year or two, and sometimes many more, to get those level of dramatic shifts. And the battle tends to be more...uphill? One-way? T can make you grow body hair, bulk out muscles, etc. without trying too hard, but E won't shave a bear or change male-typical bone structure.
-OTOH, height is Still A Thing in both cases. I personally feel that "taller than average woman" gets a somewhat easier pass than "shorter than average man", though relative proportions matter a lot.
-The surgeries are...well, I'll avoid being prurient and just state that "bottom" surgery for MtF has progressed by leaps and bounds, but FtM isn't so lucky. The old joke used to be "it's easier to dig a ditch than it is to build a tower", or something like that. Architecture is easier when foundations are solid and building materials are readily available.
-OTOH, the aforementioned male bone structure can be a huge pain to deal with. Some are lucky to be born relatively androgynous, but fixing a Classically Square Jaw is...well. It's not easy. Vocal cords also likewise only develop in one direction, so FtM will get a more masculine voice by default, whereas MtF need to invest skillpoints in retraining how to talk. (There are surgeries in this realm too, but they're...very early days still.)
It's harder to get med prescriptions for testosterone. Controlled Substance, and all that. I used to do some care work for a trans man, and it was a real pain whenever it was time to go pick up his prescription..."yes, I'm an Authorized Representative, here's his ID, sure I'll call him on the phone, no I'm not trying to sell this on the black market, sure I'll sign these triplicate release forms"...versus me just, like, getting my pills and vials sent through the mail with no human interaction whatsoever.
Trans men receive a lot less attention than trans women...hardly zero, but it's like night and day. The recent hoopla over ROGD notwithstanding, trans men have kinda always been, like, an also-ran? An afterthought? Hardly ever addressed in the culture war or actual politics, comparatively. Trans women keep being the poster children for the phenomenon, with the attendant lion's share of both spoils and harm. (Remember the last time a trans woman was on the cover of TIME Magazine, front page of NYT, etc? Yes, vividly, and shamefully. Remember the last time a trans man was in a similar position? Yeah, me neither.) Part of this is just numbers - MtF has always(?) been a majority - but there's definitely some weird difference-in-expectations-violations going on too. In many ways, this is beneficial; enemies won't attack you if they don't know you exist. But there's a lot to be said for visibility and awareness too. Everybody Knows who Laverne Cox, Caitlyn Jenner, Chelsea Manning, the Wachowskis, etc. are. On the other side it's like...uh...idk. Buck Angel? Bono?
I could ramble on, but will just finish with saying that I think intra-group variance matters more here than inter-group. I've met trans men with inescapably high-pitched Valley Girl voices that don't "work out" at all, I've met unlucky trans women whose phenotype sadly won't ever let them pass without really drastic intervention and/or super charitable System 1 overrides. And likewise for the other end...trans folks who pass so well that I'd have a really hard time guessing otherwise. It really is a YMMV thing, highly dependent on genetic lottery, access to interventions, and the prevailing level of...I guess call it gender-vigilance in one's society. Don't think it's an easy call as to whether MtF or FtM is the "more successful" path overall, depends on one's values.
What I had in mind for "work out" wasn't just ability to pass, though that's obviously important, but whether the person is overall happy with their results. This would include whether the body feels right as well as whether it looks right.
Here's a possibly weird idea. Could trans women be an irritant to some feminists because, in addition to the usual reasons, they undercut a premise that women get a bad deal compared to men?
(Weird, I still can't find it.) There's been lots of self-report data over the years...most trans people end up happier (if not happy fullstop), largely because they're no longer (as) suicidal, cripplingly depressed, etc. When the usual treatments for such don't work, and transitioning does, there's __something__ going on there. Sort of like how Scott describes exorcisms in the book review: for whatever reason, sometimes the Obvious Nonsense treatment is just the only one that works.
One can of course dispute the "only one that works" part. There's the studies on desistance rates (higher than you'd think), the hair-splitting over which patients are "really trans" vs not, the focus on particular interventions' downsides. (The more early-days experimental the surgery, the less satisfied people tend to be, for obvious reasons. The people who were really unlucky and got rare bad results like nerve damage? Yeah, they're __really__ unhappy.)
It's also devilishly difficult to tease out how much of the "body feels/doesn't feel right" comes from one's own assessment, and how much comes from societal stigma/nonacceptance/transphobia/whatever. To absolutely no one's surprise, trans people are more happy in welcoming environments, and a good chunk of those who desist do so because life harassed them too much otherwise. Would transgenderism actually disappear in a culture with completely tolerant and flexible gender roles, as is sometimes postulated? I don't know, but it's an interesting thought experiment! How much of the confusion here exists in the map, versus the territory? It's an open question.
(Yes, that is one common TERF complaint. Janice Raymond's __The Transsexual Empire__ was an early consolidation of such ideas. The usual retort is that defining women by their suffering is actually really fucking sad, or something along those lines, because it would imply that the __perpetuation__ of such raw deal is essential to the continuing coherence of "womanhood" under this mindset. At least that's how I understand it.)
> Remember the last time a trans woman was on the cover of TIME Magazine, front page of NYT, etc? Yes, vividly, and shamefully. Remember the last time a trans man was in a similar position? Yeah, me neither.
Was being more hyperbolic than literal, but I'd still stand by the claim that such depiction didn't have anywhere near as much impact as The Transgender Moment (or was it The Transgender Tipping Point? forget) TIME cover. That was A Big Deal, both inside the community and also as a culture-shock to the normies. Don't think I'll ever forget the sinking sense of dread from back then, "ah shit, now the gig's up and people will start to pay attention, so much for safety via obscurity". For whatever reason, no matter the context, trans men just seem to have more difficulty making a splash. Idk if that says more about them or about the audience though...
(Although I do think Max Wolf Valerio's "The Testosterone Files" is way more accessible a memoir than most of the MtF ones. Julia Serrano and others are good writers too, but firmly towards the Academic/Theory end of the spectrum...)
>I can see why a trans person might not want to join this discussion.
To repeat something I've repeated here in the past...it's so often the same battles over and over and over. Just gets kinda, well, boring? It's nice to be a SME for once, in some ways, but one could fairly non-satirically make a flowchart for how these sorts of discussions tend to go, from a trans person's perspective. There's the Just Asking Questions characters, the Actual Bigots (I use that term very sparingly - people here rarely reach Jason Maguire levels of self-parody, but there's always at least one), the White Knight Allies, the Talking Point Regurgitator, the Demander of Isolated Rigor, the Moral Crusader. Different sets, same cast every time. (Note that these characters show up on *both* sides of the issue, too.) Like Freddie de Boer says, there's something about this one particular issue that just seems to drive commentariats particularly nuts. One grows understandably weary. Not like "I'm tired of validating my existence to others" - I find such activist hyperbole equally sterile - but it's __intellectually uninteresting__. Which is the entire raisin deter I visit ACX anyway.
There are definitely statistically more of us trans folks on ACX than one would expect otherwise, but it's not particularly high value-add to engage in discussions when the outcome is nearly predetermined. Which is unfortunate, because there's an additional character too: the Honest Dealer, who is genuinely curious and open to new information/perspectives. For almost anything else on ACX, that's the majority of the players. For this issue...man, I dunno where they all go. But it impoverishes the experience for the remaining Good Ones like you that are actually worth engaging constructively with. (Thanks for not defecting.)
Thanks. I try to be a civilized person and it seemed like a light touch of "what's going on here?" was a better idea than denunciation.
I think trans isn't the only flowchart prone discussion. See also guns and abortion at least. Maybe crypto for here. I don't know whether the trans discussion is worse here than the others. There's a large chance of my eyes glazing over, so I might not be keeping track.
If you'll excuse a rant, I realize I'm a failure and a piece of shit by social justice standards because I base my opinion on knowing people and loyalty to them as much as on abstract principles or as (SJ seems to prefer) immediate obedience to my moral superiors. I'm pretty bitter about it. Perhaps someday I will get myself emotionally unhooked.
Hey, lived experience is considered to have high epistemic value among thawt crowd! I gave up on trying to shoot goals for people who constantly engage in goalpost-moving, and it's really improved my life. Principle of Charity doesn't extend to bad-faith bullshitters, and all that. Not all SJ is like that, but way too much is...dogmatic, I guess I'll settle on that term. When actual trans people start getting cancelled by trans activists, you know something's gone rather wrong. (C.f. Natalie Wynn, among others. "Speak your truth! No, not like that!")
Nevermind that a good deal of those abstract principles rely on studies and data that is...uhm...I mean not to do an Isolated Demand for Rigor, but so much of the study of trans people wouldn't pass basic muster to, say, a typical Scottpost level of scrutiny. Claims of moral superiority need to at least come from a firm grounding in reality...not low-powered, really old studies riddled with confounders. (There was an excellent effortpost linked here last year, about how so much of the anthropological basis for "Native Americans had analogues to trans people that they tolerated and treated with great respect, this has been around forever!" is exaggerations at best and outright confabulation at worst. All from one single bad researcher with a terrible case of motivated reasoning. Alas, I can't find it anymore.) But that's all the data there is, so it's natural to try and canonize it, I guess.
Only a small fraction of readers comment here, and usually they feel the most motivated, which can lead to lots of festering-frustrations-as-talking-points posts, but your thoughtful and reasonable contributions here DO get seen by a great majority of Honest Dealers who are lurking these parts. I hope that is small comfort.
> it's so often the same battles over and over and over. Just gets kinda, well, boring? It's nice to be a SME for once, in some ways, but one could fairly non-satirically make a flowchart for how these sorts of discussions tend to go, from a trans person's perspective.
What you need is a chatbot to handle all of the basic repeated questions, and which only alerts you when someone has a truly novel, potentially interesting, question.
Sadly my grant proposal to build "ChatGenderPersonThings" was not approved.
It does bug me a lot when people non-ironically use the "It's not my job to educate you" non-response...like, hey, people have uninformed opinions about stuff all the time. That's just how humans work...social status doesn't care about epistemic status. The terrible old days of LMGTFY were just blargh. (And I hope everyone learned a valuable lesson that Sometimes The Internet Is Wrong Too.) Still...I think especially to someone with a Bayesian sort of mindset, it feels...frustrating? incomprehensible? to form beliefs unsupported by any facts, just for the sake of playing Simulacra Level 3+ games. Yet there's a certain duty too, I guess, to be a #representative of sorts now and then. Any time I neglect to engage someone on the 101-level, that means they might instead get their education from, like, Abigail Shrier or whatever. "if you choose not to define yourself, the world will do it for you" and all that...
I miss the (imaginary?) Good Old Days when Wikipedia was a sort of intellectual DMZ, "good enough" as a ground truth reference for most things for most people. Nothing's really replaced it, at least in terms of convenience and centrality.
Minor aside: the National Radio Quiet Zone isn't just for military use. It's also one of the few places in the county you can operate a radio telescope without getting a bunch of background interference. It's a hotspot for pulsar research, and probably other astrophysics stuff.
I wonder if penis-stealing is more prevalent in tropical countries where men have never jumped in a cold lake in winter and had their penis actually retract into their body.
Is it possible that this is simply a version of discontent?
I know of people who have switched jobs and careers multiple times - not to mention romantic partners. Each situation/person was desired and loved by others, but this person keep moving on to greener pastures.
I am not calling for a total submission/lack of desire/lack of striving, but perhaps havinga bit more gratitude for whatever we got.
I've felt "too big" for most of my life. I have no idea how closely this relates to transgender.
It seems pretty straightforward to me. I am unusually large in height and width, so stuff seems too small. Plus, people comment on my size regularly.
A therapist has told me this is dysphoria, but I don't really see it that way... To me, it seems like a natural response to airplane seats and non-tall-sized clothing being too goddamn small.
Minor nitpick: you said in the illustration accompanying “Flowers Of Virtue” that the box of penises is to her right- it would be her *left*, our right.
(Whimsi nearly won an ACX book review contest with a George Orwell review - and
Oh, and I grossly over-simplify a very fine and long post. Still "3. Exposure to an ideology that serves to ‘explain’ the state of humiliation, ... This can be ready-made or handed down from a formal organization for propaganda, or patchworked from multiple sources by an amateur idealogue with little connection or even a clear understanding of the actual sources of the ideology.
4. Role models that exemplify said ideology are sought and emulated to a greater and greater degree. This will affect the manner of dress, speech, etc.
5. The role models are emulated, and the ideology actuated in steadily more serious infractions against the hated world order. A social unit of some form and scale reinforces the acceptability of said infractions and insulates participants from the social consequences (I feel I have to inject here that DK and EH planned ‘missions’ in the months leading up to the shooting, wherein they vandalized houses, set off small bombs, and even shot young trick-or-treaters with BB guns)."
Is there any good breakdown of where the rise in LGB identity is coming from (that is, mostly a rise in L/G identity, or mostly a rise in B identity)? A Gallup survey says that most (57%) of LGBT people are bisexual, but I don't know if that's a historical shift.
My hypothesis is that a lot of the change is coming from Kinsey scale 2s (say, a dude who exclusively dates women but would totally make out with Channing Tatum if given the opportunity). A generation ago, this guy would say he's straight on a survey (since being bi would lead to ridicule/oppression/lowered social status), but now is saying he's bi (because being LGBT is brave, increased status in left-wing social groups, he can still take women to the towny bar where he might get called a fag if takes a man).
Similarly with the rise in trans identity: is the increase mostly in people who want hormones/surgery, or in AFAB non-binary folk who certainly feel closer to the "woman" identity than the "man" identity but who don't appreciate being saddled with the expectations of womanhood?
B has increased the most, specifically among females, and the large majority of bisexual women who report being in a relationship are with a man. Glenn Greenwald (married to man) & Katie Herzog (married to a woman) discussed that recently:
Well, even if all those Bs were total Kinsey 3s, equally attracted to men and women, AND we exclude social pressure to identify one way or the other, we would still see most bisexual women with men, since there are still more straight men than lesbian/bi women.
I would be curious what the numbers around "few" actually are. I also saw the pictures immediately and was quite puzzled that they were being framed as extremely difficult to see, but apparently that's the case for a decent number of people.
I'd like to know the stats too — I just trusted Scott to have picked them out for a reason.
I also know I have an abnormally keen sense for pattern detection from life experience and some IQ testing I took a while back. You're likely the same.
Scott has used those same two images before in an old SSC post, so I recognized them immediately cause I remembered the answer from years ago.
But that first time...the dog was fairly easy (not that many things have such spot patterns), the cow stumped me for quite a while. I think that's partly me ~never seeing cows in my everyday life, while dogs are everywhere in SF. A former roommate even had a Dalmatian, for that matter. We're more primed to pattern-match things we expect to commonly see, not those we aren't. (I think.)
> The Columbine shooters seem to have been autocthonous American cases... before their fame inscribed amok onto the US collective consciousness
Don't be too sure of this. They weren't the first such shooters, and their actions came after American culture had started to unravel. Compare suicide in Greenland - yes, there may well have been a memetic effect there, but the epidemic occurred after their values had been undermined by exposure to modernity.
It makes more sense to say that some cultures are robust, and others are vulnerable to these kinds of behavioral contagions. If so, we should predict that problems like school shootings will be exacerbated in America as the culture becomes more sick, and alleviated when it is more healthy. I have a test for this...
...YES! School shootings declined noticeably in the aftermath of September 11th, when a shocking narrative of evil enemies Threatening Our Freedoms (TM) galvanized the American people into a patriotic fervor, staving off the creeping cultural anomie and rootlessness for a year.
Lacan’s notion of the symbolic order might actually help provide some kind of answer for why there are culturally coded mental health disorders. Lacan is sort of justly neglected by the anglophone world because he purposefully wrote in an obscure way. But his idea of the symbolic order makes sense. Granted it's more philosophical than most therapists would probably be comfortable with, but it can be expressed in a way that should make sense to people.
Namely it is that people are sometimes unconsciously determined by language, particularly the language of their culture.
You can find examples in the literature of people who are stuck on some issue (this is what Freud's hysteria described), who only get over it by putting it into words, the words of their own particular culture. See this example of a contemporary case:
On Lacan's picture, texture of the symbolic in each place is different, has different weights and emphases, with different consequent eruptions of madness, different forms the ultimately insufficiency of the symbolic take different forms.
So, even if we are only *somewhat* conditioned by the symbolic order, by language (that is, this worldview doesn't have to throw the free will baby out with the bathwater), then we should expect different psychological disorders to obtain in different cultures, because the symbolic order in different cultures itself differs—in fact, it differs down to the level of individuals as well.
The symbolic is neither wholly individual or idiosyncratic or truly transcultural and objective. The moon is coded feminine in most cultures, but not all of them. Our own symbolic chain also has its "man in the moon," where a Chinese person might first think "rabbit in the moon." And some individual might associate the moon with his or her father or mother depending on idiosyncratic personal experience. Etc.
I think the whole penis stealing syndrome thing is also very, very psychoanalytic. One of the core concepts in both Freud and Lacan is castration, and while admittedly both sort of play games with the word such that it's difficult to hammer out a concrete, simple, sciencified concept which would be palatable to the anglo mind (although anglophones like Bruce Fink and Stephanie Swales, Darian Leader etc. do *try* to make it make more sense)—the fact remains that in clinical practice (particularly among schizophrenics), a delusion clustered around or somehow making reference to castration (really, strictly speaking, emasculation) is relatively commonplace.
All of which is to say that such theories could be on to something or could help us think about these things and thus help people.
I immediatly thought about Lacan aswell! I made a comment further down on how I think that treatment for culture bound mental illnesses, taking exorcism for demonic possession as an example, goes through the lacanic signifying chain, in order to clear the subconscious of trauma and resolve the issue, same as psychoanalysis does. Maybe psychoanalysis is a cure to culture-bound mental illnesses that is itself agnostic to culture?
I’d agree that because it’s a meta theory that is cross culturally applicable it’s worth looking into, with the provision that exorcism is real, albeit very rare. As Scott mentions above, in a case where it may be present the standard church practice is to bring the person to a psychologist first. There’s more in heaven and earth, horatio...
I don't really believe in the demonic in a mystical fashion anymore, I actually think principalities, powers, rulers of the darkness of this world and against spiritual wickedness in high places (Eph 6:12) describes Moloch-esque societal dynamics, not literal demons. Although I believe in some weird Kierkegaardian fusion of the spheres of the aesthetic, the moral and the religious, aka the leap of faith that Kierkegaard envied so is realising the seperation between (aesthetic), moral and religious was hazy in the first place, so in that case it may perhaps not make much sense to ask wether a demon is literal in the mystical sense or not, it talks like a demon, acts like a demon, is exorcised by a priest, is it not a demon?
I am anxious that such a “Jungian” treatment of truth (a pragmatic view of spiritual realities which takes them as truths inasmuch as they are psychologically operative) obfuscates truth as such. If autonomous malevolent spiritual intelligences really do exist and harm people (as absurd as it may strike all but the most ardent traditionalists/backwards rustics), then we should behave accordingly. If they don’t, then we should fight vociferously any implication that they do in fact exist. Any other stance strikes me as mildly patronizing. This is my whole problem with Jung, that he causes more religious and scientific confusion than, say, Freud, who was a relatively straightforward enlightenment style atheist (a la Voltaire).
So, in other words, if the Catholic rite of exorcism is merely psychologically operative, then it ought to be replaced by close work with a therapist. Rather, the religion itself should be collapsed and dissolved into psychoanalysis (if religion has no register separate from that of psychology/secular science).
Bruce Fink somewhere writes that the goal of Lacanian analysis is not to make the subject transparent to him or her self, but to reorient their relationship to the other/the world in such a way that it reduces some neurotic suffering. In other words, the end of analysis is not self-knowledge, but healing.
So there is a dimension there to which I see how what you’re saying could be true. My concern is just that by collapsing religion into its effectiveness, we will thereby destroy religion. If it’s untrue, we may as well show our cards and fight against it. Otherwise we risk patronizing religious people, or even lying to them for some greater good. But if religion is simply a lie which gives order and structure to social life, then it ultimately doesn’t--the truth will out, and people will react severely to the discovery that the elites have been systematically deceiving them!
I guess it is Jungian, although I kinda got it from Zizek/Hegelian ideas, although I took a different turn of thought at some junction. I like Jung. Don't like Freud so much.
Lacan actually thought that Catholicism was psychologically superior to psychoanalysis, in terms of being a near perfect Other.
>“The truth, my good friends, leads to religion. You never hear anything of what I tell you about this because I seem to be sneering when I speak of religion. But I am not sneering, I am grinding my teeth! It leads to religion, and to the truth, as I have already said. And as it is the truth, it is exactly for this reason that there would be something to extract from it in terms of knowledge”
He thinks of pilfering religion for its mystical gains in psychoanalysis as he has a very ardent anti-deistic atheist mindset, although I am more in for a synthesis of religion and psychoanalysis.
>My concern is just that by collapsing religion into its effectiveness, we will thereby destroy religion.
I personally take a little mental sidestep here, and take the effectiveness of religion as some evidence for its creator. After all, if God exists in the mystical fashion, wouldn't he fashion his religions to be some of the most effective and best psychological social contracts available? It is somewhat circular in logic, but I think the Kierkegaardian Leap of Faith requires some measure of circular or axiomatic logic.
>Otherwise we risk patronizing religious people, or even lying to them for some greater good.
The bible is not necessarily against patronising people, there is quite a lot in the letters of the New Testament that makes an academic hierarchy like the catholics use permissible. I am not a Catholic, but I have no problem with different perspectives of thought regarding the church among believers, the deeper you delve into the philosophy. Prolly related to the Existentialists Nietzsche and Kierkegaard being elitistic as fuck aswell.
It is the glory of God to conceal a matter; to search out a matter is the glory of kings. (Proverbs 25:2)
Wow, I love this comment! I thought I was the only one who knew about Lacan's uniquely weird take on religion.
To your point in paragraph 3 (your "sidestep"), I'd lay things out in the following way:
If Catholic religion (Lacan's "True Religion") does in fact fit into the human psyche uniquely well, it proves the truth of Catholicism, but if and only if the mind is in fact capable of knowing truth.
As I take it to be absurd and contradictory to post that the mind cannot know truth, then Lacan's insight (if it is not groundless) about Catholicism does in fact provide some oblique support for it—but only if one accepts the existence of objective truth.
I add this because Lacan himself was not a Catholic, so he must have believed that it was ultimately untrue, and that the mind cannot know the truth (or rather, that the mind was not made to know the truth... that it can know the truth, but only by accident—mainly it just knows its own fantasies).
As he was a psychologist and not a philosopher, I think he failed to see that his relativism (for that is what I'm arguing his position boils down to) was ultimately contradictory. Actually, as I think more about it, I consider diagnosing psychoanalysis with an insufficient account of nature. It results in relativism (which contradiction overturns the original denial of nature), but that original denial is the real problem.
I wrote about this all in an essay I probably won't ever publish:
If you want to cut to the chase, please control+F "Psychoanalytic Thought with (dis)respect to Religion"
I am also particularly attached to that verse from Proverbs, in part because it seems to make God into a kind of puzzlemaker, which rather shocking characterization of him I think we seldom see elsewhere throughout the Bible.
>The bible is not necessarily against patronising people...
You make a good point that the Bible has Paul serving the Corinthians "milk, not solid food," i.e: concealing or rather not revealing certain difficult doctrines until such time as the believers are ready for it. This must be distinguished from actual lying, however.
And Christ Himself did not let everyone in on the whole shebang at once: "I still have many things to say to you, but you cannot bear them now."
Nevertheless there can be levels to truth which are deeper and deeper, yet without contradicting what is on the surface. While "God is One" can be revealed to be "God is three persons" without substantial contradiction, I think "God exists" cannot be revealed to be "God does not really exist." Yet maybe all this is more of a question about the stance which we should take towards truth itself. I think JBP somewhere says that he doesn't want to say that he believes in God, because he thinks that by doing so he will obliged to be a saint, and that moreover the slightest failure would show that he was lying, that he never really believed. And that is a common criticism of us so-called Christians, that we obviously do not believe, because we seldom act as if we really do believe (see Scott's interesting "video tape of hell" article). But I think such a view fails to take a properly nuanced approach to truth. There are degrees of faith, hope, and charity. The Church teaches that the truths of faith are the purest and clearest in themselves, but because of our fallenness, they are often the dimmest to the human nature which attempts to seize them. Rather, without supernatural grace it is not even possible for anyone to have faith.
I only take the above detour because I think that (and I blame Protestantism for this) there is a common tendency of failing to make a distinction between the natural and supernatural order. Yet "no one can say, 'Jesus is Lord,' except by the Holy Spirit." Which is to say that the confession of faith is not something infallible earned from a close forensic analysis of history or upon the successful completion of a series of syllogisms; it is an unearned grace which lifts up the mind quite apart from anything we could do on our own. It is a personal act of trust between man and God, not something proven and evident. As Aquinas says, it is a mean between "science" (knowledge) and "opinion," because it comes from and depends upon a person.
Also, apologies if any of my foregoing comments seem chauvinistic or triumphalist or attempting to convert with a kind of cudgel. I have often been guilty of intolerance; I'm glad that you are so intellectually charitable about these things.
How should trans people who share your belief that gender dysphoria is largely cultural behave? If you have a painful mental health condition, the only treatment for which is expensive, invasive, and leads to sterility and social ostracization; don't you have a moral responsibility not to spread it? Do you have a moral obligation not to share your experiences on the chance that people would begin to experience ambiguous dissatisfaction as gender dysphoria and become trapped that way?
I just feel like you dropped an enormous "black pill" on trans people and the suggestion that "actually societies can tolerate lots of different default sexualities, like, Greek pederasty" (great example) is cold comfort. If it's possible for a lot of people to avoid the painful experience of gender dysphoria and transition, shouldn't we strive towards that? If you were a trans person who shared your own beliefs about the nature of gender dysphoria, how would you behave?
I don't know any trans people, but my take on the whole thing (not just the gender dysphoria part.) was that regardless of the cause, the effect is just as real. You are really suffering from gender dysphoria.
The situation is at least complicated by the people (rather a lot of them, it seems) who say they were suffering from something and their lives got better when they got words for it because other people were talking about it.
I don't know. A few months ago I had an injury where I was pretty sure most of my pain was neuropathic in a way that seemed culture-bound, but I couldn't find a good way to leverage that information to actually be in less pain. I also didn't particularly feel like pretending I wasn't in pain to avoid spreading the idea.
I think right now nobody has any obligation because this is all speculative. I think in a hypothetical future where it's confirmed, it would be reasonable to have some kind of agreement between mentally healthy and mentally ill people where the former try to accommodate the needs of the latter, but the latter don't try to be especially loud about their condition. This is easier said than done; I assume all existing people who are loud about their mental illness would say they would stop being loud if they felt people were accommodating them fairly.
I mean, I didn't need Scott to give me any additional reasons, but a lot of his thought processes here are why I already stopped bothering to identify myself as trans most of the time years ago. (Except when it's relevant, like here.) Much better if the kids at work just think I'm That Weird Coolgirl instead of That Weird Transwoman. Like I don't *hide* the fact if someone asks directly or anything...it just basically never comes up organically, and I think it's too charged a lodestar to be strategically salient. Yes, there's some additional #clout to be gotten in SF for being visibly trans. But I don't want that one footnote fact dominating others' perceptions of me, and I really have no patience for being a token in their culture warring either. (Nor do I share their typical SJ/progressive politics anyway.) I already max out my Weirdness Budget in other ways, playing the trans card on top of that is just overkill.
The transition path was less rocky for me than it is for most; all the same, I __would not__ wish this ordeal on anyone if they could reasonably avoid it, precisely *because* I know I doged so many of the typical bullets. And a big part of that means not valorizing being trans, in the same way I don't like telling people I'm a mild autist* either. Yes, it lets me flow state at work easily, and that looks hells a impressive - but it's also an endless parade of frustrations and social missteps, as an extrovert who's nonetheless awful at reading people. To pick just one of many tradeoffs that I think get lost in the Awareness/Acceptance narrative. Neurodivergence might confer superpowers - but with great power comes great responsibility, as comic books once taught. And, boy, do those responsibilities add up. Even at the mild ends...Beware Trivial Inconveniences. The true cost of a mild ouch isn't usually "do a social thing less efficiently" or "spend extra time putting together a Coordinated Outfit". It's "do nothing at all". A flubbed first impression here, a missed party there, and sooner or later we're talking about real quality of life degradations. (Totally leaving aside all the macro costs of meds, surgeries, paperwork changes, wardrobe makeovers, etc, etc., which are not inconsequential.)
If someone is already definitely totally for sure trans, already going down that road - then, sure, I have no problem supporting them in whatever capacity I might as an elder. "The only way out is through", and all that. At that point, any chance for deterrence is long gone, and it's between them and Reality whether this'll be a good fit for them or not. May as well expedite the process and shorten the amount of unnecessary flailing-about-embarrassingly. But one must always think on the margin, as Matt Yglesias so often points out...if me being "stealth" and not evangelizing counterfactually moves even one on-the-fencer to the Desist side and they live happily Normie ever after, that's Worth It. And that makes the next one slightly even less likely, and so on and so on.
I think there will always be some fraction of "trans people", though the category boundaries will continually shift. But the optimal number, by my reckoning, is both nonzero and yet still pretty small. Small enough that one can provide reasonable accommodations without creating Utility Monsters or otherwise creating excessive disutility to the supermajority. "Safe, legal, and rare", as an old slogan once went. A world with 5% trans people - or, God forbid, 99% - that is not actually a reality I'd want to live in. Not just in the sense that Something Was Wrong with such a high rate of genetic defects/mental disorders/environmental contaminants/wonky hormones in womb/whatever causal pathways...but because the reasonable accommodations problem becomes so, so much harder. If we're doing such a shitty job now with only 0.5-1% ...I dunno.
(Full disclosure: I'm also pro-natalist and rather bitter about discovering I actually __really wanted__ biological kids...but only *after* reaching effective sterility. Not the least-biased or most-satisfied trans woman out there. This, too, is another tragedy I wouldn't want to potentially contribute to in someone else. SF has few enough children as it is, to everyone's detriment.)
Hey, Weird Coolgirl, thanks so much for sharing. I might say less stupid things in the future, (like move to the country and raise a family, I assume I don't have to apologize for my ignorance.)
Oh, I didn't mind that one actually. Zvi's blog just gets so much less comment volume compared to here that it feels like a weird place to "socialize". I feel awkward posting any comments there that aren't Super Serious.
There's still a good chunk of me that wishes for a non-city life...it's convenient in many ways (and relevantly, finding tolerance, if not always outright acceptance of quirks like being trans, is way way easier). But there's the constant downers of...well...basically everything Scott spent the last year writing about wrt homelessness, crime, drug use, breakdown of public order, etc. That sorta thing wears on one's soul over the years...every time I see the same damn bus stop glass smashed yet again (it's like the 6th time in as many months, or so), it's like, This Is Why We Can't Have Nice Things. I'd mind it a lot less if no one was even pretending to idealism here. But it's SF, City of Dreams, Progressive Mecca of the USA. That jarring contrast between high-minded do-gooderness and actual shit conditions on the ground - plus the actual literal shit on the ground, that sucks too - it's...just...I don't know. Too much cognitive dissonance in the air. Manifests as some awfully peculiar culture-bound syndromes that I'm tired of dealing with. I'm sure there's plenty other kindsa bullshit in the country, but at least it'd be some different problems. Things closer to Simulacra Level 1, I'd hope...
Geesh, IDK It seems like paradise where I live. (Well it's winter here, cold, windy freezing rain, but if all I have is some nasty weather to complain about...) If you're ever near Buffalo NY you can come out and visit. You'd have to like walking around in nature. I guess a down side is you have to drive if you need food or other stuff. There are some nice small towns around here. There must be some sweet spot that is the right distance from the city. As you move further into the country the people in general get poorer and the towns are also. And too close to the city you have almost solid suburbs. (Which are the worst of both worlds. IMHO)
Re: chatting on Zvi's substack. Huh, I never thought about it. I guess I'll have to ask him. So I'm too chatty over there? I always feel like I have lots to say...
I remember when I was in middle school there was a big awareness campaign around cutting. Assemblies, guest speakers, special sessions of health class, material sent home to parents, etc. Immediately, the number of (predominantly) young women cutting went way up - or at least the number cutting in highly visible locations did. The next year things were mostly back to "normal". Of course there's no way to know for sure, it's entirely possible that those people prominently displaying scars would have been self harming in some other way without the campaign, but it was striking to 7th grade me.
Don't misunderstand me, I don't mean to imply that cutting didn't exist before or stopped existing afterward. And I'll grant that middle schoolers may not be the most representative population. But from an early age I observed that
a. While mental illness has always existed, the specific ways in which it manifests can be extremely malleable, and
b. When you make it clear to people - especially awkward, insecure young people - that compulsive behavior X will result in receiving large amounts of sympathy and positive attention, expect rates of compulsive behavior X to go up. To be clear that doesn't necessarily mean people are *faking* behavior X (although in hindsight I suspect some of those scars were drawn on), but when social incentives are powerful and sudden people will alter their behavior in surprisingly radical ways.
Attention caught because I think this adds to my understanding of the anorexia contagion power/mechanism!
(uh whoops a little personal/heavy)
A different angle -- I grew up pretty prone to deliberate self-injury as a self-soothing technique, and while it was probably never *great*, it never felt like a *problem* until I was a cutter (in my late teens, to my embarrassment/shame at the time).
And the 'misc self-hurt' -> 'cutting, specifically' was pretty culturally mediated, where one day I was in my room having a bad time and wanting to ground myself in a way that I'd been able to do from injury before, trying to figure out *how*, and I realized I was holding scissors, and *duh*, cutting existed. Felt kinda silly for not thinking of it earlier. (*Really* silly, given that I was grinding the point of the scissors into my leg and being dissatisfied with the level of distraction.)
But ALSO 'cutting, specifically' turns out to be particularly attractive (in a statistical sense) form of self-injury because it's practically very easy, and the neurochem state after is strong enough to notice, but it's brief (seconds, unless you manage to really hurt yourself), and you build tolerance, and it (for me, with the shame) maybe makes the instigating unhappiness worse once you're thinking about it. Addiction is complicated but cutting is more habit-friendly than any self-harm I came up with on my own.
Anorexia seems like it involves some maybe similar self-reinforcing physical feedback loops.
Cutting is self-explanatory in how-to, but I think there's a relevant 'teaching at-risk people' -> 'accidental habit escalation' for anorexia, in the form of diet/life habits that marginal people will try if they hear about, and that happen to be unusually self-perpetuating in that particular form.
(I guess as a 'please no one be concerned' but also an 'obligatory other hand?' follow up -- I quit cutting, there's a lot of resources for people quitting cutting, and I actually quit habitual self-injury in general, and it turns out the cutting resources work for that too.)
Great. I broke down and gave you a heart.* Reading this I kept thinking that whatever it is, it seems like its adjacent to the placebo effect. (Which I don't understand either.)
*When you wrote that you liked getting hearts. I said to myself, "OK I'm not sure that is a good incentive, no more hearts."
I think you've got the etiology of the rise in trans identities more or less backwards, but your note that there is no neutral culture rescues you from actually saying anything false. I think we're not so much seeing a result of a stronger cultural sense of being the wrong gender (that probably peaked in the 80s), as we are a weakening of our culture's ability to assign gender at all.
Sex is biologically real. Intersex people are a small, but not statistically negligible, fraction of the population, and the rest of us do fall into two categories with regard to our outward sexual characteristics. But what traits do those sexual characteristics assign?
In 21st-century America, women are less enthusiastic about sex, often unsatisfied by it; therefore, it's only natural that men initiate most sexual encounters. In ancient Athens, women, the irrational sex, were slaves to their desires, and part of the humor of the Lysistrata was the idea that the women took their protest so seriously that they could restrain their sexual appetites.
In 21st-century America, mentioning that a man writes whiny poetry is a great way to call his masculinity into question. In 12th-century England, Richard the Lionheart was the epitome of manliness, and was especially praised for being a warrior poet. Only one of his poems survives (Ja Nus Hons Pris) and it's pretty whiny.
Anthropologists who study gender find gender categories like that in every culture, with anywhere from two to five genders. America right now has two, but its ability to assign those two is breaking down.
Weak prediction (call it 40%, with a very low chance that our current systems hold and a decent chance of something I don't foresee happening instead): in 2073, American culture will have three gender categories that are pretty well respected, with most trans people born after 2048 being in the middle gender (currently called "non-binary", which isn't just one thing now but is seen as one thing then) rather than being AFAB trans men or AMAB trans women. 20%: any attempt to explain what it is to be male in 2073 seems kinda nonsensical; 90%: any such attempt remains very controversial.
(Disclosure of biases: I'm a cis man that's also comfortable with neutral pronouns.)
But isn't this the point in the second to last paragraph?
ACT states that there is no neutral culture. For example in a culture where everyone is transgender after the age of 18 there would be a culture bound condition called 'cis-gender'.
I think it's a point that could stand to be expressed from more angles, so I'm trying to provide another angle. To be clear, I am not saying that Scott is exactly wrong about anything here, but that I understand the same phenomenon in a very different way.
After re-reading I understand where you're coming from more. Even so your conclusions are very out-there. Haven't most cultures had basically two genders, Why is America destined for three?
Also
> Basically, I'm saying that transgender isn't a culture-bound condition - *gender* is.
I don't see how gender could be a culture-bound condition. Since culture is relative, a culture bound condition is definitional abnormal which having the gender you were assigned at birth isn't.
European cultures in the historic period have almost all had two genders, but anthropologists working outside Europe often find more.
I posit that America is moving toward three because, although social justice advocates often note that "non-binary" is an umbrella covering gender-fluid, agender, and a variety of other descriptions, we use one word that covers all of that most of the time, and we're moving toward standardizing on one set of pronouns (they/them/their), which seems like our language (if not yet any of our social institutions) is starting to coalesce around a new norm in which there three categories. If that trend continues (which, note, I'm guessing at more likely than any specific alternative including than status quo, but less than 50%), it won't mean there's only one way to be nonbinary any more than right now there's only one way to be a man or to be a woman, but a lot of assholes will probably insist that there is (as many assholes do about the two binary genders right now).
>but anthropologists working outside Europe often find more.
*anthropologists desperately looking for more genders.
A lot of the actual data on this is pretty underwhelming when people have given me examples. "Look there were eunuchs and tomboys in this culture, it had 4 genders!"
Eunuchs castrated by the powerful to work as borderline slaves aren't a "gender" any culture should aspire to.
And tomboys are not a gender either. There can be masculine women and feminine men, and even people recognized as such without there being new "genders". And more importantly the tomboys are pretty clearly not saying "we aren't women".
I feel like these anthropologists would go to 1800s new England and find six genders two of which would be "Spinsters" and "Priests".
Hijras are generally not forced into that role, but clearly occupy a different social role from men or women.
Fa'afine are similarly clear, in that their gender expression tends to be in between traditional male and female.
You're right that in Europe some people look for a third gender that's not unambiguously there, though the example you should think of for that is Balkan sworn virgins - AFAB people who swear to celibacy and then take on male gender expression and gender roles. This is generally something done for specific contingent reasons rather than expressing an underlying non-female identity, and the social role they step into is not distinguished from that of a man.
Regarding PTSD, could its virtual absence in the past be due to the reporting problem ? Until relatively recently, the world was pretty much in a constant state of war; and for most people, survival was a chancy proposition even in peacetime. In such an environment, some level of (what we now call) PTSD would be expected, and not reported as anything unusual. Today, most of us lead the kinds of lives that would be considered incredibly sheltered and pampered by medieval standards; thus, PTSD is rare and stands out enough to be remarked on.
I realize even as I type it that this comment is likely to be part of an inevitable system of you getting it coming and going, and I also realize that as a Bay Aryan you have to do it to some extent to not get broken on the wheel, but still: I feel like you're really burying the lede here WRT transgenderism, Scott. First all that hedging, and *then* you admit you think transgenderism is about as cultural as anorexia, which you just made a huge deal about how it's super cultural?
I find it telling that your guesses about which DSM conditions are biological vs cultural line up neatly with.the order in which they are socially perceived in our culture as making one a villain vs a victim, with schizophrenia being the most villainous/biological and PTSD being the most victimous/cultural. It suggests that in fact they're all cultural, but that your desire to believe in the rationality and thus morality of your own actions (such as getting people locked up against their will for being labeled as part of a socially designated scapegoat group) makes you want to believe some DSM diagnoses are more biological (read: real).
I find it telling that your guesses about which DSM conditions are biological vs cultural line up neatly with.the order in which they are socially perceived in our culture as making one a villain vs a victim, with schizophrenia being the most villainous/biological and PTSD being the most victimous/cultural. It suggests that in fact they're all cultural, but that your desire to believe in the rationality and thus morality of your own actions (such as getting people locked up against their will for being labeled as part of a socially designated scapegoat group) makes you want to believe some DSM diagnoses are more biological (read: real).
No, they line up with how heritable the conditions are in twin studies. Schizophrenia is about 90% heritable. I don't think schizophrenia is actually especially villanous - that would be the various sexual disorders, personality disorders, or IED.
That's fascinating! However a condition could still be biological without being heritable, by being universally biologically present in every human, until it is triggered by a certain condition. This would mean if every human had the biological potential for PTSD just from the nature of how the fear centrum of the brain works, and some societies just trigger this condition less than others, it could be biological without being hereditary.
Fetal Alcohol Syndrome might count-- assuming my old information is correct, it makes people more impulsive and less intelligent, so a woman with FAS is more likely to drink heavily while pregnant, and pass the disorder on that way.
What do you mean by "biological"? I.e. how would you distinguish a "biological" condition from a "non-biological" one? I ask because my interpretation of your comment is that all conditions would be "biological".
As nobody else has mentioned it yet (I think), I think it would be worth mentioning that 1997 Pokemon episode which caused seizures [0]. A guardian article from last year [1] says
"What Radford and Bartholomew discovered was that the vast majority of affected children had become ill after hearing about the programme’s effects."
From the article, it sounds like there was an actual effect from the episode, but most of the cases appeared after the patients heard about the other cases.
I somewhat cast doubt on this from personal experience. I have never been diagnosed with PTSD, but I have been diagnosed with schizophrenia. After my schizophrenic/psychotic episodes I have been tormented with flashbacks, nightmares and such about it even years after the event itself, and after my almost miraculous complete recovery. I am certain I met the criteria for clinical PTSD as the flashbacks made me visibly flinch in public when as little as a lamppost reminded me of my episodes wandering the streets at night with a frayed mind.
The fear reflex felt way too fast and natural to be learned behaviour, although I can't exclude the possiblity in total, basically something set my mind to wander, a memeory of the traumatic event intruded, and then I was hit by a heavy wave of fear and stress.
I cured it by accident, as I came upon a podcast by Dr. Jordan Peterson and Dr. John Delony where they talked shop about how they treat PTSD patients, and I went and applied some of these routines to myself (basically convince the conscious with a sound narrative of why the unconscious does not have to remind you of your past anymore, as failsafes against fallbacks are in place), and voila, the flashbacks and nightmares reduced 95%, effectively stopped.
I think the romans may have had PTSD, but maybe they didn't have it related to war. If PTSD is indeed a fear mechanism trying to guide your mind away from recreating a pattern that could be devastating for it (i.e. bring a soldier back to Vietnam, bring me back into psychosis) as Peterson/Delony implied, and if the Romans had a culture that glorified war and saw it as a honorous place to be, then it makes sense that PTSD was not connected to war. Why should your mind warn you from going back into war, if the siege of carthago is a great place to be?
In a lecture in Munich in 1913, Carl Gustav Jung said he was led to distinguish between two types, extraverted and introverted, by observing characteristic differences between two groups of his patients, those suffering from hysteria and those suffering from dementia praecox. The latter means schizophrenia (I think), which you judge to be the most biological, non-cultural of your examples.
So perhaps, in a sense, the original meaning of „extraverted“ is „potentially susceptible to the kind of cultural contagion discussed in this post“. Only potentially, of course; he says that hysteria and dementia praecox are extreme cases, where something has gone wrong. And a decade later, in „Psychological Types“ (the book), he does not follow up on this much and instead refers much more to similar (he argues) distinctions in the literature, e.g. Nietzsche‘s „Dionysian“ and „Apollonian“, etc.
1. Bouffé delirante: I remember researching this for a journal club, and the feeling was that it was the French version of another forgotten diagnosis, psychogenic psychosis.
2. We have seen conditions, then classified as 'monosymptomatic hypochondiacal delusions' that resemble the cultural psychoses, except with the contagious aspect. I recall one poor chap who was convinced he had a strange tasting fluid (not saliva or reflux) appearing in his mouth. After seeing lots of docs he was referred to our psychiatric day hospital but nothing made any difference, so my boss (a psychiatrist who made his name quite cynically by picking an understudied area - gambling) did what psychiatrists always do: he blamed the patient for not getting better, at which point the patient took offense and self-discharged.
3. I got to sit in on a couple of gynae clinics with Katerina Dalton at the Obstetric Hospital across Huntley Street behind the old UCH building when I was a student. What a sensible, down-to-earth woman she was. At the time she was into treating PMS (or PMT as we called it then) with progesterone suppositories.
This all seems reminiscent of the Sapir Whorf Hypothesis or those stories/magic systems where giving something a name gives it power (perhaps telling stories of a demon really does, in a sense, give it power).
"What if transphobia is our culture’s version of the penis-stealing witch panic?"
Unlike koro, in the trans panic penises are actually vanishing, everyone can observe this to be the case. How can the man who wrote "Is Everything A Religion?" elide the significance of whether the alleged physical symptoms are real? This is a bullshit comparison and you should know better!
This post keeps touching on "psychosomatic problems are real", but I think it's important to expand on that because there's an important sense in which they're not.
A few years ago I fell and seriously injured my arm. I didn't break it, but for a couple days I couldn't move it at all without debilitating pain. Six months later I still had a reduced range of motion in my arm, if I tried to hold my arms out in a T-pose the right arm was noticeably less extended than the left. I'm pretty sure this was psychosomatic, some lingering "for god's sake don't move your arm"" impulse written into my muscle memory. Because if I grabbed my right arm with my left I could move it around just fine: no pain, and if I let go the muscles could hold the position I left it in, I just couldn't consciously flex the muscles into that position.
Now my reduced range of motion was real, I had some difficulty opening cupboards and so on. But if you just say "Ninety-Three's arm problem is real" then one might conclude my arm remained physically injured and that would be important because I eventually saw a physiotherapist who prescribed exercises based on assumption about what was wrong with me. A cocaine addict with delusional parasitosis has a condition that is more real than his socially-contagioned roommate, and this is important because one of them can probably be treated with CBT or something while the other should be told to stop doing cocaine.
A few years ago I had knee surgery after an injury. During the recovery period, which was quite long, I had an experience similar to yours: I could not bend my knee fully voluntarily, although I could get into this position without pain when the physiotherapist helped me. He explained to me that after an injury or an operation that causes pain for a long time, the brain learns that some movements are painful and restricts them (completely unconsciously) in order to avoid this pain. And it is often long and difficult to "unlearn" this restriction. So the condition is not physical, but I do not think it is "psychological" in the usual sense of the word.
On the other hand I had an injury where once it healed I didn't regain range of motion, and the doctor was like "oh it looked like I missed that X tendon ripped, too late now, you should have told me you had poor range of motion" (I was in a cast, not sure how I would have known).
I still did a year of physical therapy, to absolutely zero effect. The tendon is just not connected anymore.
My only concern, and it's an "Old Man Yells At Cloud" concern, is that "culture" is becoming increasingly disjointed and fractal. Like I don't mind that we have a much higher rate of transgenderism in the U.S. because I don't care about that (and don't understand why 550 comments worth of folks do). It has nothing to do with me, and the transgender folks I know who were able to transition socially and medically have had massively improved QoL as a result. I can't consider that bad, and only really consider that "good" to the extent that it lets them do other interesting things with their lives. If calling my friend by a different name and pronoun makes them able to succeed in their chosen careers, show more kindness to others, be a better friend and partner, etc., etc. then I don't have to understand why they need that to do it.
But I do care that there are now full "cultures" defined entirely by being transgender, or having multiple personalities, or really really hating Infinite Jest. Not because you shouldn't be transgender or have multiple personalities or hate Infinite Jest. But because you're building an incredibly narrow version of both yourself and the world that will be impossible to escape as you grow.
I went through two years of depression that made me miss half of my bachelor's degree and that I still barely recovered from 8 years later due to "hearing someone expressing a wrong opinion during a college class" repeatedly.
I studied computer science in a third world country while being female. Hearing unprompted comments from multiple professors about women's natural propensities and abilities, and realizing that I will be viewed as different and inferior for the rest of my career started a hopelessness spiral. I got it fixed eventually and moved to a more civilized country but my anxiety levels have never returned to baseline despite years of therapy and meditation. I have a great life and a successful career now but I keep wondering sometimes how much more value I could've brought be my professors less vocal about their opinions.
"National Radio Quiet Zone, an area in Virginia where the government enforces a ban on electromagnetic transmissions for secret military reasons)"
Several corrections here.
The NRQZ is centered and mostly located in West Virginia, but does extend into Virginia and Maryland
While it does protect the Sugar Grove NSA facility it also protects the Green Bank Observatory, an NSF-funded radio astronomy observatory and home to the world's largest fully steerable telescope.
There isn't a complete ban on electromagnetic transmissions. Within the NRQZ fixed transmitters have to meet power and directionality requirements. Mobile transmitters are unregulated. The regulations are stricter within 10 miles of the Observatory but there are still ways of mitigating transmitters (e.g. the microwaves at the Observatory are all inside Faraday cages), and exceptions are made for things like emergency communications.
"There is no amount of commitment to the bit which will make people drive metal objects through their penis. "
This has now reminded me of an English court case from years back (1993, looking it up) where a set of men were found guilty of actual bodily harm and wounding, because they engaged in consensual masochism:
"A majority ruling in the House of Lords said the fact that the men had consented to the acts, which included inserting fish hooks through the penis and nailing foreskin and scrotum to a board, provided no defence."
So people will do the weirdest things under strong impulses.
Am I the only one who immediately saw the dalmation and the cow without looking at the answers? I kept searching for a second image, since I assumed that the trick was that there were two possible images.
I had no problem with the cow (since I've seen plenty of cows in real life). The dalmatian took me a little longer but once I figured out the general shape it all came together.
I think more of us may have seen real cows than Scott expected 😁
The comment about overreacting to parental death reminds me of my rage at a manager back ~10 years ago where they were hired to be my new boss at a small ~15 person firm despite me *clearly deserving* (IMO) the position (except I was too young and didn't have the right educational background).
The new manager proceeded to be absolutely horseshit at her job, get absolutely nothing done, then ~6 months in her mother died. This was used as an excuse to get nothing done for another 3+ months and miss many weeks of work (which she didn't have leave for). Then when she came back there were constant comments about how impossible it was to work under the conditions of their 90+ year old parent being dead.
I called bullshit and was pretty rude about it, and left to start my own thing (which went great!). She got fired anyway as soon as was seemly, and the place ended up brining me back off and on in a consulting basis at ~4X the hourly I had been making before, while I also worked for their competitors.
Articles like this make me so glad I subscribe. I asked my wife is PMS really exists, and she said... yeah I think so, aren't I sometimes moodier than others?
> delusional parasitosis - the false belief that you are infested with parasites and can feel them crawling in your skin - is actually an especially interesting case. Two groups are disproportionately represented among patients: menopausal women and cocaine addicts. Relatedly, two biological conditions that can sometimes cause weird skin sensations that feel like crawling insects are . . .
Tangential, but I'm curious how the term "delusional parasitosis" might relate to an experience of mine.
For a period of many months, my house contained a large number of ants. At any given point, it was pretty likely I'd have one or two ants crawling around somewhere on me.
The ants frequently gave me the sensation that I had something on me, as evidenced by perfectly normal events such as 1. feeling a crawly skin sensation, 2. reaching over to it, and 3. coming up with an ant.
However, the sensation became much more decoupled from the actual ants than I would have liked. It was very frequent that I would experience the sensation of ants crawling on my skin where there were obviously no ants. And while this is harder to prove, I tend to suspect that my sensitivity to actual ants went down, that sometimes they'd be crawling on me and I just wouldn't notice.
I chalked up the false crawling sensations to, essentially, overstimulation. I didn't like the sensation and I didn't like that it was frequently provoked by no direct cause. At no time did I believe that the ants (real or spurious) were a danger to me, or that a sensation that occurred in the absence of an ant must indicate that the ant was really there but somehow difficult to observe.
> In our society, it’s commonly believed that War Is Hell, and if you enjoy it too much, you might be a bloodthirsty psychopath. Relatedly, estimates of what percent of veterans get PTSD range from 15% to 85%. I’m not sure the 85% number is accurate, but if it was, and I was a veteran, and I wasn’t getting PTSD, I might start worrying that this was starting to signal negative things about me.
I think there's a major confounder here, which is that, in our society, if you say you have PTSD, the government will give you a bunch of free money and compel other people to change their behavior on your behalf.
Sketching a stylized but potentially helpful model here, consider 4 categories of potential trans people by how their dysphoria is mediated by social contagion:
0. The inevitables. The ones who in a world where 'transgender' is not a concept at all, personally decide that they are the wrong sex, spend the first part of their lives asking how they can change sex or what they need to do be a member of whatever gender, and get told by everyone that it's impossible and made up and they'd have to figure out a way to be happy as they were; then they do their level best cut ties with everyone, get some new clothes, and move somewhere under their target identity.
1. The inevitably weird. The ones who'd go around asking how they can change sex, and, on being told it's impossible, make unhappy faces and ask if you're really really sure? then sigh and work on 'figuring out a way to be happy as they are,' whatever that means. Probably crossdressing. Maybe religion. Maybe they meet a trans person and suddenly understand they're not unique.
2. The inevitably sad. The ones with confusing discomfort with gender and sex and society. The ones who hit puberty (edit: or otherwise encounter gender) and realize they don't like where life is going, but in ways that are complicated and confusing and might take a long time to follow to any particular conclusion. Or, come to a quicker and less confusing time when re-considered with a framework of gender dysphoria.
3. The otherwise fine. The ones who learn about gender dysphoria, and find confusion and discomfort in their experiences with gender and sex and society, and follow patterns of gender dysphoric behavior to try to resolve it.
To be clear all categories can include non-binary people, and cis people / people who don't recognizably transition.
0's semi-hypothetical because anyone who tried that hard and can be reached for comment at this point probably knows that gender dysphoria exists. Group 3 is also semi-hypothetical because it's just 2 with a secret untestable uncondition.
There is no real way, in a world aware of gender dysphoria, to distinguish between 2&3. And there's no external distinction (and no certain internal distinction) between 1&2. That is, please assume that there aren't going to be ways to 'test' or 'screen' people into GID-I -II -III and alter approach accordingly. (Trans communities regularly try to do this, when people feel like some in-fighting.)
Anyone who transitions and probably all of groups 0 and 1 get enormous benefit from social normalization of gender variance, in pure practical payoff of 'allowed into respectable society.' There can still be drawbacks, like for all the people who were happier as 'androgyne' and are now 'trans,' or the ones who were 'transvestites' and now have to pick pronouns about it. The precise syndrome associated with 'transgender' might be a worse time than whatever transgression of gender people would have done otherwise, but at least fewer people will think you're just a pervert.
Group 1 contains a lot of people who are pretty obviously so much better off transitioning, and making that harder for them is cruel. This group is not going to get normal outcomes even without a socially defined conception of gender dysphoria, and on average would probably suffer a lot more.
Group 2&3 people seem increasingly likely to transition younger these days, and get to do it while people question their legitimacy. Some of these people are saving a lot of time by transitioning without spending 20 years figuring it out from first principles. Some of them are missing out on a life that was basically the same except they were cis.
I see people express a lot of concern over group 3. That's the group unhappier because they're in a world where gender dysphoria is an option. They are that by construction, because that's the imaginary line I'm drawing between 2&3. Group 2 looks entirely identical to 3, only the cultural accessibility of gender dysphoria has a more ambiguous impact on them. They already had gender-related issues. They might have eventually resolved them without a dysphoria framework, or been more able to push them aside to a tolerable point. Honestly I don't know whether they win here on net. But I guess generally I'd build for 'suffering with a map' over 'suffering without a map.' Maybe it's worth trying to make it a decent map.
hrmm I'm a bit skeptical of group 3 being particularly large, I think the discomfort is still there, even if you're not noticing it
a category that *is* very hard to distingiush from group 2 is "people who would be comfortable with either gender identity but for some traumatic gendered experience of some kind"
Yeah, my personal sense is that group 3 is pretty rare, and gets some dispoportionate attention.
I would consider "people uncomfortable with their gender due to some traumatic gendered experience" within group 2... though I see I may have muddled that by bringing up puberty. People who are uncomfortable with gender due to gendered experiences. Some gender discomforts are more or less inevitable in ways unrelated to cultural conception of transgender -- the classic one is sexual assault, which *is* evitable, and may be the source of someone's gender discomforts, regardless of whether that person thinks about gender in particular terms.
Tracks. And honestly! There's a whole theory of 'transgender as a reponse to sexism' that mostly seems to be fading from mainstream because it's just not borne out by the evidence, and I'm kind of surprised there isn't even much illusion of evidence, since I do kinda expect the sexism*trans interaction to look like something.
I might be unaware of the latest points. Or maybe I should not be surprised that the theory was not looking very closely.
Isn’t the relevant counterfactual a world where modern transition technology exists but is considered elective, like a facelift or tattoos, rather than a treatment for a psychiatric condition? There would be no concept of gender dysphoria or having a gender identity different from your sex at birth, but some people would transition just for a different body. We have no way of comparing numbers of people who would transition in this world, unlike the actual past. (Sorry for any posting glitches)
I think it might be meaningfully hard to break apart 'modern transition technology' and 'concepts of gender identity' -- ie if you include (as I think you should) things like "a way to legally change sex marker" -- but I think you're getting at a relevant variant path of gender-in-society, yeah.
fwiw, I don't think this is practically very different from the actual experiences of lots of people today. Milieu varies, but in my experience* once you're actually considering 'transition,' you find that marker changes, HRT, surgery, etc are very much considered elective except in the sense that people kind-of** expect a lot of benefit from the change.
*(Many, possibly the majority, of people I know who've changed their gender presentation were actually more/only willing to do it after deciding that it was a personal choice that didn't need justification of some threshold of dysphoria. I expect this to be correlated with my social preferences, so maybe less common over all transitioners.)
**(I do sometimes worry that this -- 'this' the expectation that people are miserable with their working body/pronouns/clothing due to a boy/girl misalignment -- is increasing or will increase in a self-fulfilling and/or annoying way, but I'm not seeing evidence the worry is more than a 'kids these days' disconnect on my part. Honestly, I think trans conversations have moved away from 'fix your painful dysphoria' narratives over the last 20ish years. It's probably still getting more common overall, as mainstream spaces pick up the most legible/marketable trans narratives. I don't know how much various people are influenced by direct trans discussions vs mainstream reflections.)
I grew up spending summers on a ranch. I saw both pictures immediately. I initially didn't understand that either image was an optical illusion. The picture on the right, especially, I don't see how I could miss it. I used to ride in the back of a truck with a bag of range cubes, and they'd come running as soon as they heard the diesel engine coming down the highway to the gate. They knew which truck it was. Scott saying, "of course you don't see them, you have no references to see them," made me laugh. Speak for yourself!
On the other stuff, as an individual I spend a lot of time excluding information from my brain because I know that I am not special. People are highly suggestible, and the only defense I have is to limit bad information from getting in. Scott goes on about Bayes and priors, but it's more about trying not to put too much energy into things which I do not have control over. I refuse to get into AI ethics, for instance, because it's pointless. I have no impact (and neither does almost anyone who does worry about it.) I am more likely to convince world leaders to abstain from invading other countries. It's not worth my time. Also, it's pretty obvious that it will require government regulation because history has plenty of examples of negative externalities which private corporations failed to control. The benefit of unregulated AI to individual corporations is more than the damage the AIs will do to society overall. This is already true in regards to privacy and information gathered by big tech companies, and I don't see why they'll do any better with AI. Why would they?
I put that part in because I wanted to see if one of my later observations holds true.
We have to be suggestible to function. Humans are social creatures more than they are intelligent creatures. Understand that, and you get people. You aren't smart. You are social. No amount of smart compensates for being bad at social, and being good at social requires some smarts but goes a lot farther. The dark side is that we believe stupid things to fit in, because that's more important than truth. No culture is immune. None. Not yours, not you. No one.
An example: Video games. A few of my friends are very good (world class) at exploiting multiplayer video games. One of their strategies is to intentionally find play options the community has rejected and experiment with them. It doesn't always work, but very often it does. Their advantage is that, whatever it is, it hasn't been nerfed because the community as a whole wrote it off. Often, these options have existed for years and no one bothered to try them. It's not because no one was smart enough or lucky enough to find them. In a game with hundreds of thousands or even millions of players it should have happened already. What explains the failure of so many people to discover an effective build is that people heard that the option was bad, so they never tried it. Additionally, a good build is usually a result of skills or gear combinations that require some intuition and experimentation. Most people would rather do what the community thinks is smart than be seen trying something dumb. A few people should not be able to find so many exploits in games with this many players, but they regularly do. This can only be explained by the whole being dumber than the parts.
Football. Coaches are finally, FINALLY, going for it on 4th down. Sports nerds have known for decades that statistically it's better than punting most of the time. Yet, coaches would rather lose than be criticized when it doesn't work. This is a really important observation: individual people will make decisions based on social pressure even when the community is wrong, and provably wrong. One person can't stand up to a group, even if they are right. We all think we can, and would, but I'll say that no, you can't and won't, and don't. That's why we respect some people, long after the fact, when they do stand up. At the time, we hate them. Most of the time no one remembers them.
The more connected people get to the internet, the more social pressure there is, and the dumber people get because they don't want to look bad. I can go into pretty much any forum, say something completely verifiable and obvious, and someone will freak out and "prove" me wrong simply because the group, by a process similar to genetic drift, has happened to latch on to some belief which is nonsense but can't be criticized. The more nonsense it is, the bigger the freak out. The actual politics aren't relevant, if it's even political. Lately, it's about protecting the feelings of people who don't seem to actually exist except as an excuse to say, "shut up." Again, the actual politics are irrelevant, and I don't consider the rationale important, because if it wasn't about protecting feelings, it would just be something else.
Alternately, not "getting" whatever the nonsense is about is proof of how wrong you are (ie if you can tell it's nonsense you are too stupid to understand). I've been wrong many, many times but it used to be someone could show why, and I was fine with that. I thought it was cool, because I like meeting people who can hang. Mostly, I want to learn, and being told to stop asking questions isn't teaching anything other than to do what you're told. Attacking someone's intelligence is the go-to thing online. It's not something that works that well on me, because I know exactly how smart (and dumb) I am, and it isn't something that can be proven except by expert knowledge, which few people by definition possess. Real experts will answer questions and explain their answers. Posers attack your intelligence. Also, outside of their field, experts are not any smarter than I am. In their field, I listen and learn.
Remember the part I stuck in about AI ethics above? That was an example of stuff that gets people upset. Plenty of actual experts can tell me why I'm wrong, I'm sure, but there's not a lot to go on yet. In a debate, I would get a lot of nonsense from people who have no idea about what's really happening.
I don't waste time persisting in saying whatever I wasn't supposed to say to tick people off. There's no point, and people can have whatever rules they want. It's not my job to enforce rules. Rudeness exists. I'm not going to change minds, I'm way over that. The only people I influence I've known for a long time. I'm definitely not especially smart or interesting (way over that, too), but I still think there is some residual value in saying obvious things occasionally just because it's rare.
I've been online since I had to call BBSs long distance (I knew someone who worked for US WEST which saved a lot of money) or connected to TELNET and Usenet by calling the local college UNIX mainframe computer. Internet culture has some continuity but, yeah, it's changed. The huge number of people who serve no function other than to enforce group norms, whatever they are, is the big difference. Social media monopolies bury individual voices and enforce conformity on a scale never seen before online. It's never been a bigger waste of time to say anything online. Oh, I just did.
This is wildly fascinating to me, not least because I'm currently grappling with how to approach the issue of my mother's growing paranoia. On the one hand, she's at the age for and exhibiting the signs of dementia. On the other hand, she's always been highly susceptible to outlandish theories and beliefs, and her day-to-day in-person paranoia (men sneaking around her house, banging on her door, stealing strange things from her yard; despite having many cameras, no pictures of these alleged men) has risen almost perfectly in tandem with her obsession with hardcore conspiracy theories about imminent martial law, societal collapse, rioting in the streets, mass arrests, civil war, nuclear war, EMP attacks, power grid attacks, etc.
This leads me to wonder - is her constant consumption of "bad world" media priming her to be hypersensitive to any immediate stimuli that confirms that the world is scary and dangerous and bad men are lurking around every corner? Or does dementia - as in cumulative *physical* brain changes affecting cognitive function - explain the increasing obsession with global-scale paranoiac media *and* immediate personal-scale paranoia?
As far as I remember the book review of The Body Keeps the Score, van der Kolk had to spend a lot of time convincing people that PTSD is a real thing, based on his evidence of patients with the as-yet-unnamed syndrome. Since this was pre-internet days, it would also have been harder for child abuse victims to form some kind of network and spread the "word" that way - which is evidence in favour of a biological cause, I guess? (I'm sure that veterans, the other major group involved, had their own networks and reunions back then, but child abuse victims in the days before people believed that this was a thing?)
You had that post about temperatures causing illness, but you were confused about obviously mild temperatures also causing sickness in some countries. Could that be a culture bound aspect?
Lol, so, in any other context this would be TMI (it might be TMI in this context), but, I think that I've had my penis stolen by witches before.
Or at least I've had a physiological experience that I can imagine attributing to penis stealing witches if I was inclined to believe in that sort of thing.
For lack of a better way of describing it, occasionally the head of my penis will turtle underneath my foreskin, to the point where it almost looks like my penis has retracted into my body.
It seems pretty related to social anxiety, it tends to happen in situations where my social anxiety is pretty high, not quite to the point of having a panic attack (I occasionally have those too), but pretty close.
I recall it happening several times in a particular college philosophy seminar where I was particularly worried about being put on the spot in front of the seminar.
Continuing the TMI theme, when it happens, I need to manually pull back the foreskin to make my penis reappear, which, if I'm able to excuse myself to the restroom is no big deal, but if I'm in a social situation that's not conducive to that, makes the situation that much more unpleasant.
Since you probably have everyone's attention, having checked yourself right there in the seminar, why not simply stand up, lock the door, and insist that no one can leave until the guilty party returns your penis?
For anyone wondering.... "What do I do with this information? Ca this help me?" (emphasis on I/me)
Get to know yourself. Listen to your internal signals. Don't attach to any single culture's approach or explanation, find the best one for you.
e.g
Chronic pain? Movement (western pt or eastern practices) and eastern acupuncture.
Acute pain from a broken bone? Western surgery and medication with movement to rehabilitate (again, eastern or western). Seemingly conflicting cultural explanations often contains pieces of the missing puzzle, which are more effective as a concept when combined and integrated. People have to do this work and you can't learn it by doing a homework assignment. It ties into my world view, value system, and approach to society... takes time to build up.
“Spartan men married and had sex with women, but they thought this was a dumb annoying thing they had to do to have children, and sex with young boys was the obvious enjoyable satisfying option.”
A historian on Yale Open Courses framed this a little differently. From what he says, sex with wives is the obvious enjoyable thing, but it’s to much of a distraction from their military training, so they live away from their families during service.
I don’t think this detail hurts the argument though.
Not the most relevant piece of the argument by far, but I'm unreasonable focused on it: I don't think the penis actually has much proprioception. Proprioceptive neurons and their related mechanoreceptors are concentrated in joints/tendons/muscles. There's some in the skin, but aside from a bit of muscle around the base of the shaft, the penis likely to be poorly proprioceptive, which is appropriate given that all our motor control over the penis is in the legs/hips anyway.
The touch perception of the penis against clothing is an entirely different sensory modality (and one our recent evolutionary ancestors didn't have.) Without it, it's actually pretty hard to tell where one's penis is using proprioception without other visual/sensory cues. The fact of poor penile proprioception might actually be an underlying issue here, such as the case of the man who looked down and suddenly updated his priors.
I want to comment this every time and forget every time: I notice the "the the" thing without consciously searching for it. It just jumps at me. (My not being a native speaker is possibly relevant, but probably not: I do notice mistakes in Russian at higher rate than most people, too. Not a professional proofreader.)
In terms of the actual text… I feel really bad for humanity if memes (in Dawkins's sense) are so contagious that we can skyrocket (number of occurrences of) something like PTSD or gender dysphoria almost out of thin air. Unfortunately, it doesn't really _contradict_ my observations.
I suffered from jikoshu-kyofu, and this is the first time I've ever heard of that term! I'm American and have never heard of anyone else having this issue before. Getting out of it was actually one major life event that got me interested in rationalism more generally (before I met this community). It got bad enough that I contemplated suicide.
For the first 3 years of high school, I believed my family's house had an odor that was strong enough to make me smell bad after having left the house due to our house cats. I knew this was in principle possible, and that it was possible to grow accustomed to smells, so it was impossible for me to detect! No level of personal hygiene could help me feel better. I avoided social encounters, and this made me behave awkwardly, which caused others to behave oddly, which fed back into my suspicions. Over the 3 years it dealt a serious blow to my otherwise decent social life and drove me into a depression which impacted my grades.
"Evidence" for this belief was subtle things that people would do: avoid sitting to close to me, smelling the inside of their shirt, etc. Things that you really might do if someone smelled bad, and when my brain was looking for evidence I smelled bad, it was able to find plenty. I eventually figured this out and turned my grades and social life back around. Both my parents believe lots of conspiracy theories (also relevant to my interest in rationalism) and I can't help but wonder if I was in some way genetically predisposed to this.
Haven't read all the comments yet, but it seems useful to distinguish between false beliefs and impossible beliefs. The belief that ants are on your skin may be false, but it is hardly impossible. The belief that witches stole your penis is basically impossible.
The belief that are male souls trapped in women's bodies similarly seems like impossible thinking, rather than just false thinking.
Sure, both penis stealing and wrong-body having can be construed in false but possible ways, e.g. it is literally possible to cut off a penis and steal it, and it is literally possible to be born with various conditions which affect the state of the genitalia, but witch-penis-stealing is distinct from "violent castration" just as "transgender" is distinct from intersex medical conditions.
While as noted in the article, all beliefs are a result of some combination of physical stimuli and a priori social stimuli, beliefs in the impossible seem predicated on a specific false belief.
Just as modernizing societies that stopped believing in magic experienced near universal elimination of "witches-stealing-penises," even though they probably retained many of the sorts of physical stimuli that prompted people to experience particular episodes, our society too may (hopefully) eliminate "transgender," by emphasizing that the underlying belief is magical and false.
Hopefully acknowledging the impossibility of the delusion can lead to those with the unfortunate associated physical stimuli to seek out more productive, or at least less destructive solutions. Just as people in formerly koro believing regions much less frequently mutilate themselves attempting to protect or recover their genitals, hopefully people uncomfortable with their bodies can be conditioned away from mutilating them and towards less destructive solutions.
However, it seems like many critics of the transgender craze are fueling the delusion by implicitly acknowledging the underlying thinking and just questioning whether in a given case a person is falsely believing to have the wrong body, rather than truly in the wrong body.
I bet that long covid will be (or is already) rampant among EAs/Rationalists. Some of it will be "real", but a fair share of it will be culture-bound. Unfortunately it will be extremely difficult to tell the difference.
Re anorexia nervosa, in 1969 I came to know well a girl of 14-15 with severe anorexia nervosa. I knew her on a psych ward. When she entered from the medical ward, she resembled an Auschwitz survivor; by discharge some 4-5 months later, she seemed a perfectly normal healthy girl. So no, I don't think Karen Carpenter started it. My non-expert perspective is that the incidence of life-threatening anorexia hasn't changed that much over time, though the more casual type maybe has.
I would argue that the number 1 Western culture-borne disorder is burnout.
I don't know about other European non-English speaking countries, but the very idea of burnout doesn't seem to exist for my Asian parents' generation and my grandparents, from the way they behave. If they ever lose motivation to work, we call that depression, (and they believe that depression is another weird Western cognitohazard but I'm not so sure about that point).
I do fully believe that people who are burned out in the west aren't faking it, they really can't summon anymore motivation. But I want to argue that it's culturally influenced and maybe related to the way motivation is framed in European cultures.
re PMS, it is not exposure to American culture that causes PMS in immigrants to the US. It is exposure to the American diet. Sugar, white flour, fat, alcohol, caffeine, red meat all really cause PMS. Pleas tell your wife about Susan Lark's PMS SELF HELP BOOK.
The sun rises in the east, sets in the west. Snow falls in winter, melts in spring. With the certainty of natural law, I know that if this is a predictive coding post, Scott will use the double the the thing.
I'm what appears to be only a third of the way through the article so far.
I am hoping (but not assuming) that it ends in a laughing trashing of some insanity known to effect the approximate community of most readers, say, gluten-intolerance, covid sickness (the majority of covid symptoms that the majority of people suffered would have not been experienced had they not expected/worries-about them) or that someone with a penis might "really and truly" be a girl (without radically changing what most people meant by the words "girl" and "penis" up until 2015).
I myself am not free from false beliefs or concerns having caused me problems so please do not regard me as calling anybody else particularly nuts for having caused themselves mental problems due to nonsense beliefs. We are all humans and therefore prone to being nuts.
But these are 3 nearly contemporary crazes that are just now finally burning themselves out so it would be a good moment to drop this bucket of cold cultural awareness upon everyone before it lacks the curative sting required.
Do you happen to be familiar with Scott's pre-ACX writing, or... anything else about him?
He has, at least for significant stretches of his life, lived in San Francisco- a location with a much higher than average rate of trans people. He's involved in the rationalist and EA communities- likewise, communities with much higher than average rate of trans people. He has dated at least one trans person. One of his most famous essays (https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/) is to convince a bunch of nerds that they should be more accepting of trans people.
None of those things preclude him from being *wrong*, of course, but he's hardly forming "wild hypotheses based on pure speculation."
Sorry, I was directing this towards the comment section, not towards Scott. 100% a bad habit I picked up from other social media sites. Sorry for the confusion!
I've talked to about twenty trans patients, ten trans friends, and the trans partner I dated for several years. What else do you think I should know?
That is - if you were to ask me why I'm straight, I don't think I could, from personal experience alone, give a useful answer like "Well, clearly it's about 40% genetic and 60% non-shared environment, and even with exactly the same genes I might have been attracted to young boys in ancient Sparta" - going off pure personal experience I would probably say something like "Women seem pretty." To get the useful answer I need to know things about science/history/anthropology. Why do you think your gender situation works differently?
Oh! I see the confusion. Sorry, I was directing the comment at this comment section, not at you. That's 100% my bad and a bad habit I got from other social media sites like reddit. Sorry for the confusion, I really liked this post.
But I do think it's different with my gender situation because people aren't culturally expected to be trans. Like, if a man is attracted to men before they know gay people exist, then that's evidence it's at least partially biological, right?
It's some evidence, but even then it's not clear - it could be the sort of thing that is an unexpected byproduct of some cultural influence. I've heard that studies conducted in the middle of the 20th century found that most people said they dream in black-and-white but recent studies found that most people said they dream in color. The explanation I've heard is that the cultural influence of television was affecting how people describe their dreams to researchers, even if they hadn't heard of a cultural trope of how dreams are supposed to look. Conceivably, even a culture that has no discussion of same-sex sexual attraction might have cultural products that frequently produce same-sex sexual attraction in some people, which another culture might lack, so that same-sex sexual attraction could conceivably be entirely driven by culture. (Though I do suspect that there are some biological components as well.)
but every observed culture has gay people
False:
https://www.theatlantic.com/health/archive/2012/12/where-masturbation-and-homosexuality-do-not-exist/265849/
(Looking at the title I first assumed it would be Russian propaganda, heh.)
The article says that married men and women in those tribes keep having (heterosexual) sex all the time, leaving them no time to even think about masturbation or homosexuality. But what about the rest: teenagers, widows, generally people who do not have a partner at given moment?
I'm not so sure about that.
Here's what I find remarkable -- if you check wikipedia's History of Homosexuality article https://en.wikipedia.org/wiki/History_of_homosexuality then there's an astonishing blank between "Antiquity" and "Early modernity". There's a couple of paragraphs but it's mostly just a list of evidence-free insinuations that hey, someone famous must have been gay.
Given that homosexuality would have been harshly punished in this period, where are the records of it? Where are all the beheadings? It can't have been that they were _that_ good at not getting caught for fifteen centuries in a row. Even the Spanish Inquisition, which charged 500 people for sodomy, only alleged a handful of cases of _homosexual_ sodomy.
Punishment was also directed toward men. Female homosexuality was something barely acknowledged as possible. Of course, conceiving it in terms of "orientation" rather than behavior is also relatively recent.
~40 years ago, used to have a house mate who worked in William Dements sleep lab around its start at Stanford. Told him of my noticing sometimes dreaming in color and sometimes in B&W. He said Dements' lab had determined that color vs B&W was related to remembering and depth of sleep... lighter sleep led to remembering color dreams while deeper only B&W. Interestingly, the color dreaming nights were correlated to my taking Sudafed before bed (before learning of Sudafed sleep impact). Stopped nighttime Sudafed, stopped remembering color dreams.
A messy possibility: what if black and white television affected how people remembered their dreams rather than the actual dreams?
A research possibility: Look at descriptions of dreams from the time and place and see whether color is mentioned.
My family was not well off, so I first saw a color TV when I was in high school. My entier youth was spent with black-and-white TV (albeit not much of it). I can recall no difference whatsoever in the nature of color in my dreams between youth and young adulthood, nor imagine any difference in how I would describe them.
Counter anecdote: when I was a kid I read a lot of books and rarely watched TV. For a number of years, I recalled my dreams as text descriptions of the events, rather than as sensory input directly
Counter-counter anecdote: I read a lot of books as a kid; my remembrance of dreams comes and as far as I can remember has always come in mainly two categories: vivid sensations (associated with the feeling of vividness), immersive situations where I mostly will the dream into existence around me; and unstructured sparse sensations relating to my previous-day concerns (e.g. flashes of gameplay moments from a video game I played with intense focus very late).
Sorry, my mistake, guess I'm feeling too fighty today.
"Culturally expected" is a complicated term - I think the culture-bound-syndrome perspective is that cultural expectations go from "nobody's ever heard of or considered it" (eg transgender in Arabia 100 years ago), "people have heard of it and know it's a think that happens 1% of the time" (eg transgender in US today), "people have heard of it and know it's pretty common" (eg following cis gender roles today), and "people don't even realize they've heard of it because it's just considered the universal obvious thing (being cis in Arabia 100 years ago). I don't think *anything* is at the far extremes of cultural expectation in modern America, except maybe things like "not being object-sexual".
Lots of people have sex with inanimate objects, that usually just gets lumped together with masturbation. There was a mainstream movie more than twenty years ago: https://www.imdb.com/title/tt0163651/
hmm by the by i have discovered
https://en.wikipedia.org/wiki/Schizoid_personality_disorder
by wikipedia surfing and I ... feel like there should be a ddx: gender dysphoria here ( among amab patients?)
like, patients like this will not exactly *tell* you that they fantasise about being a girl on account of that's private
but it's pretty much what undiagonised gender dysphoria looks like
especially suspicious if adolescent onset
tbc I have no idea what psych people think about this but it seemed worth mentioning
I think calling people fantasizing about being a girl “gender dysphoria” is an example of a culture-bound effect.
For example (all details changed on account of “that’s private”), I might fantasize about having wings and flying around the clouds. But calling that “dismorphia” or “body dysphoria” says more about how others see my fantasizing than it says about how I feel about it. I have exactly zero trauma about not having wings, but if people would fuss about how sad I must be about my misshapen, wingless body, especially during my childhood, I might.
What would be your biological / cultural breakdown on "demonic possession"?
Any answer he gives you would just be what the demon possessing him wants him to say.
M Scott Peck, the psychologist who I associate most with runnaway bestsellers (with his book iThe Road Less Traveled from the 1980's) went on to write another book called People of the Lie in which he discusses human evil, and in one chapter actually describes cases of what seemed to him to be demonic possession. As I recall, he puts them forward pretty much straightforwardly. My sense is that there are therapists who encounter these kinds of things and say something like, Yup, More things in Heaven and Earth than are dreamt of in our training programs.
My guess would be that "hard-to-resist impulses to do bizarre/bad/uncharacteristic things" has a large biological component, and "what you attribute the impulses to" is approximately 100% cultural
"Gender dysphoria shares some resemblance to culture-bound illnesses; I would put it around the same level as anorexia."
I agree with this, but I think, given the physical and emotional cost of dysphoria and associated treatment, this implies we should try to *turn the culture knob down* so that we're not steering more people into dysphoria.
In practice, I think this is one of the strongest case for *not* doing awareness campaigns, especially for young kids. Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria.
See the last section of https://astralcodexten.substack.com/p/book-review-crazy-like-us , "Towards Mental Health Unawareness Campaigns".
Yep! I don't think I'm as worried about the spot the "therapy talk dial" is turned to, which is the other very strong awareness/sensitivity campaign. But that might be because one stream of therapy talk is more CBT focused, and thus more skeptical of reifying your passing feelings while the trauma stream is more about introspecting on your feelings and asking "Is this a deep wound that I will struggle to heal?"
I like the Eastern Orthodox framing of some intrusive thoughts/feelings as logismoi, which you don't *need* to incorporate strongly into your sense of self. You can note them, and then choose whether to embrace them or just wave them off.
Whoa! Scott! I think you should be really precise about what you mean here and not vaguely gesture towards endorsing 'unawareness campaigns' for gender dysphoria.
I want to say this without accusing you of transphobia because I don't think you are, or saying you have to be responsible for all readings of your text. But you are basically endorsing the strategic logic of the conservative "anti-groomer" movement. If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal. Heck your theoretical mental health unawareness campaigns involve book burning and cancellations, what would that mean for existing trans adults or the percent of people who will continue to be trans post unawareness campaign? I'm not sure you can do a sort of clinical anti-gender dysphoria awareness campaign without empowering a lot of people who are transphobic and homophobic.
1) I don't think Scott was seriously suggesting a response that extreme, just hypothesizing about a culture as obsessed with "unawareness" campaigns as ours is with awareness campaigns.
2) If (IF!) gender dysphoria is more culture-bound than not, we've got much bigger problems right now than the consequences of possibly empowering transphobes.
>1) I don't think Scott was seriously suggesting a response that extreme, just hypothesizing about a culture as obsessed with "unawareness" campaigns as ours is with awareness campaigns.
And that's fine, but he should be careful about how he talks about it.
Counterpoint: No, he should not be (especially) careful about how he talks about it, because the worldview that says trans stuff is *special* and should be talked about more carefully than suicide or abortion or elections or gangrene is wrong. Lots of things affect people, and we don’t create special rules around how they can be discussed, nor should we.
A basic attempt to be correct and to say what you mean is all that is required.
Suicide and abortion and elections should all be talked about carefully. Gangrene doesn't have the same political connotations. It can be talked about casually.
I'm not saying trans people are special: I'm saying that when people misinterpret well-intentioned comments about trans people it can have disastrous consequences.
About being careful about how he talks about it: I get it, about the dangers of saying things that can be empowering to the transphobes. But I think it's almost always a mistake to keep quiet about your own perceptions and views because they can be weaponized by the wrong side. If the wrong side does pick up on what you said and try to use it, then you have a responsibility to say loudly and often that that is *not* what you meant, and clarify what you did mean. And anyhow, there's already plenty of stuff floating around in the media and cultural soup that can be weaponized, most of which will yield juicier sound bites than Scott's smart little essay.
It's destructive for people with authority to say what they think will make people do what they should, rather than tell to truth an exhort people to do what they should. That's herding, not informing and advising, and people eventually sense what you're up to and began to hate and distrust you. Think about the way the government initially talked about masks -- "No you don't need them" -- because they were concerned about medical staff not having enough. They should have said, yes, masks keep you safer. We are going to transfer most of the supply to medical staff and other essential workers who need it most, so they will be hard to find. Until we can get more on the market, here are some ways to improvise a mask that are better than nothing.
> If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal.
I don't consider myself to be transphobic. Perhaps in the future we will be able to seamlessly transition or alter our bodies without risk or side effects, but until we reach that point I think it is obvious that people who attempt to medically transition are going to endure a very difficult experience.
Modern culture has far too much faith in the medical system. They are better than nothing, but every procedure has enduring costs. I've had a several surgeries and every one has left me with reduced mobility in the joint and nerve damage.
It feels like there's a false choice in the statement "If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal." I think there's a difference between fearing your child will identify as trans vs. fearing your child will become a permanent medical patient from a medical establishment that barely understands what it's doing when it comes to medical care surrounding trans-related questions.
Take 'puberty blockers' as an example. You can't 'pause' puberty any more than you can 'pause' aging. What you can do is SKIP puberty and sexual maturation by messing up endocrine signaling in ways you don't understand. I've heard that some of the kids who get treated never go through puberty and later in life are unable to experience sexual pleasure.
Should an 11-yo be making the decision to take sex off the table for the rest of their life? If they're trans, but got puberty blockers and never developed sexually, maybe they have a bit less dysphoria about their body but they have a lot of anxiety about having mature adult relationships because they never fully sexually developed and therefore can't connect on a pivotal aspect of most relationships. Is it really a decision between that and certain death for large numbers of kids? Call me skeptical, until I see a good meta-analysis of multiple RCTs, with long-term follow-up.
Years ago I read Ending Medical Reversal, www.amazon.com/dp/1421429047/ and a lot of what I hear described sounds like it's ripe for later medical reversal: panics about 'doing something', talk of how the something they're doing 'makes sense' logically, review from medical patients that they're happy with the immediate results of the treatments as justification for treatment efficacy, absence of RCTs and long-term follow-up, medical practice preceding the accumulation of scientific evidence.
I think it's fair to be concerned that your child's treatment will later be realized as a major medical error without linking that concern to their future gender identity.
Yes, that's a different thing. It's possible to say that you will love and accept your child whatever their gender identity but that you are concerned they will be misdiagnosed with gender dysphoria.
However, if you think having gender dysphoria and treating it through gender transition is a really bad life outcome (for many of the reasons you raise about medicalization), and that gender dysphoria is a cultural contagion. The logic of trying to prevent that cultural contagion by limiting trans visibility is hard to resist.
Probably because there's some interaction among the issues at question:
1. Is the incidence of (for lack of a better term) 'transient' gender dysphoria increased by cultural contagion?
2. Do current medical interventions cause long-term/permanent harm to those who eventually detransition/desist?
3. Do current medical interventions cause long-term/permanent harm to those whose trans identity persists?
4. Do cultural attitudes interact with medical decision-making in a way that biases transition and medical interventions with long-term/permanent consequences?
5. What's the ratio of 'transient'/persistent trans identification and medicalization?
If you think, "currently available medical interventions for a 13 yo trans kid generally lead to bad long-term outcomes," you may want the kid to be able to come out and express their gender identity, but still be concerned that this will lead to harmful long-term medical exposure. In that case, you'd want to be an outspoken critic of the current medical system, but encouraging of cultural attitudes.
If you think a majority of those who get medical interventions will likely desist/detransition, you might be opposed to both the medicalization of trans and the cultural attitudes. I'm not sure how to frame this so as to make it less of a false choice, since it doesn't seem we can have a nuanced discussion of the subject. For a lot of issues, it feels like you're either "pro-[whatever]" or you're "[whatever]-phobic/-ist". Sometimes it feels unpopular to be "pro-'I don't have a dog in this fight, but I'd like to take our time gathering evidence for the open questions in this field before making large-scale societal changes, especially those that have potential long-term medical impacts'".
Well, yes, logical outcomes are often hard to resist, even when there is a full progressive-media-medical complex trying to undermine them.
> The logic of trying to prevent that cultural contagion by limiting trans visibility is hard to resist.
I'm not clear on why it should be resisted, in principle. If the causes of gender dysphoria are partly cultural, then anti-awareness campaigns would merely prevent that fraction of the population from developing it for cultural reasons, leaving only the biologically driven gender dysphoric people to receive the prolonged, uncomfortable surgical treatments they need. As long as there's no stigma associated with this condition, what is the problem with this outcome?
You are making a lot of leaps here. I dont see anywhere that supports that Scott "think[s] one of the worst possible life outcomes for your child is that they become trans". I also don't see this echoing any of the "anti-groomer" talking points. In the review of Crazy Like Us, Scott writes, in the Unawareness universe "Secretly the psychiatrists will still treat anybody who comes to them, they’ll just make them swear an oath of secrecy first." So he is clearly not advocating that people should receive treatment. He is only wondering what it would be like if culture didn't promote certain conditions. Thats very very far from the anti-groomer bigotry that casts LGBTQ people as pedophiles and defectives.
No, I think this is hugely loaded and we should be really careful about it. I'm not at all blaming Scott for what the anti-groomer movement does But, if you're suggesting gender dysphoria is largely a cultural contagion, and that maybe we should act to reduce awareness of that cultural contagion, the behavior of the actual movement operating on your theory seems relevant.
Receiving treatment while swearing an oath of secrecy doesn't resolve the problem of trans people being visible in society, not everyone is going to pass and people are going to ask, what happened there?
This strikes me as similar logic to “if you’re questioning biblical science, and the other people questioning biblical science are witches, maybe you should shut up.”
No, in fact, he shouldn’t. He should say what he believes is true rather than being cowed into silence by an argument founded on guilt-by-association. If you have an argument against what he thinks is true, make it; but if all you have to offer is tone policing, your contribution has negative value.
"I'm not sure you can do a sort of clinical anti-gender dysphoria awareness campaign without empowering a lot of people who are transphobic and homophobic."
Interestingly, this doesn't make it a bad idea. Imagine if we could erase anorexia by running an unawareness campaign, but also it would empower the Healthy At Any Size people who say it's perfectly normal to weigh five hundred pounds and die of a heart attack at 40. Would this be bad? Well it depends how many anorexics we avert vs how many morbidly obese people we create. It's not enough to gesture at some possible side effect, you have to actually run the cost-benefit numbers!
>If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal.
I think the trans activists seem to spend a lot of time convincing everyone that absolutely one of the worst things that can happen to people is be trans. They talk incessantly about suicide and abuse and what a struggle it is.
"If you think one of the worst possible life outcomes for your child is that they become trans, limiting all exposure to trans representation is ideal."
But I do think becoming trans is one of the worst possible life outcomes for my child. Their suicide rates are sky high. I didn't get that from anti-groomer conservatives; I got it from trans activists.
Scott, I'm a fan of your work, but I'd be a little less casual about saying stuff like this. What would a "gender dysphoria unawareness campaign" look like in reality?
I understand you're not saying this out of malice, and I'm not saying you're necessarily wrong, but I think it's important to be careful about how talk about it.
Do you think gender dysphoria awareness advocates should be less casual and more careful as well, are you certain they are all incredibly careful to ensure that each word is chosen with the utmost concern, or do you think that their failure modes are less significant than Scott's?
In the Crazy Like Us review, Scott writes "Secretly the psychiatrists will still treat anybody who comes to them, they’ll just make them swear an oath of secrecy first." So in a world with a "gender dysphoria unawareness campaign" people still get the treatment they ask for.
This was just a quick speculation on Scott's part. I don't see him actually proposing unawareness campaigns as a solution to anything. In fact he concludes "I’m not sure if this culture would have more or less mental illness than our own." So he's not even sure it would work!
As the old saw goes, we’re in a hole, the first step is just to stop digging.
So, for starters, we should relax existing awareness campaigns. Take gender ideology out of middle and high school curricula, stop doing events to raise awareness aimed at young kids—like, say, the “drag queen story hours” that became a culture war flashpoint in the past. (Hopefully admitting that the right was correct about them won’t wound your ego too much.) The movement should probably rebrand away from “protect trans kids”. We can understand that the people leading all of those efforts were well-intentioned and sincere, but also recognize that as it so happens the harm outweighs the benefit, and it’s time to put down the signs and go home.
Finally—what should Scott have really put differently here? His tone strikes me as incredibly careful and well-couched with caveats. To go out on a limb, I don’t think the tone here is your problem at all; rather, it seems like you are very uncomfortable with the implications of his ideas, but unable to present an argument against them, and defaulting to criticizing his tone instead. Consider that the truth might be uncomfortable, and you might have been wrong in the past, and don’t shoot the messenger.
Exactly. The only thing we know for sure at this point is that transsexuality and homosexuality are a behaviour. The rest is speculation. First and foremost, all people who practice any kind of behaviour which does not obviously harm others should be treated with respect. That being said, parents are well within their right to encourage or discourage in their children any kind of (non-harmful) behaviour they wish and here is where we have the problem. Certain movements are working to promote "awareness" of certain behaviours in public schools to other people's children. Imagine if someone suggested that we have should be having Catholic storybook hour in public schools which taught kids that bread can turn into flesh and wine into blood? (something which is not much more fantastical than that a man can turn into a woman)... I think all of us need to learn to be content with having our non-harmful behaviours respected and tolerated by society, but not expect that our behaviours should become part of the public school curriculum...
I disagree with the extension of this logic to sexual orientation. It strikes me as less culture-bound than gender dysphoria—even if, as Scott points out, everything is at least a bit. Also, life outcomes for people who are gay—in terms of e.g. suicide rates or lifetime earnings—are far better for people of nonstandard sexuality than people of nonstandard gender. Differences like these make me think that gender and sexuality are different phenomena to investigate separately. The best approach in one case may not work for the other.
For all that gender is useful to us in terms of giving us a pre-assembled toolkit for identity construction and understanding social roles, it is awfully constrictive and oppressive. Many people are not able to find satisfactory ways to self actualize within the confines it sets, and there are considerable social costs to working outside the boundaries. These discussions about gender ideology are helping to break down those boundaries, to expand the Overton window of gender identity, to work towards a future where everyone is a little bit more free to manifest their individuality.
Moreover, "but think of the children" is a rallying cry that has been used to censor, oppress, and enact very real harms onto queer people and queer communities for a very, very long time and I absolutely will shoot the messenger who starts crowing about that.
Fine, but teach that ideology to YOUR children. Not to mine. I absolutely will shoot messengers who start crowing to my children that they are free to be "shes", "hes" or in betweens because gender is subjective. Biological sex is the only objective truth and the one which should be being exclusively taught in public schools to our children. The rest is ideology and can be taught in the home.
Rather than reducing discussion of gender dysphoria, depression, anorexia etc. to reduce social contagion, could the exact opposite approach work? Public education about how social contagion works and how many popular culture-bound illnesses appear to have a strong social contagion component, as a prophylactic.
I'd really love to see a longitudinal study that showed some children cartoons simply explaining these disorders, and how often they are "just in your head" and that if you don't think you'll get them, you won't, and seeing if these children ended up developing less of these culture-bound illnesses. Beyond the internet culture war argument implications, if this turned out to be an ultra-low cost method to reduce prevalence of depression and anorexia it would be incredibly valuable.
"Oh my God! I just heard about this new mental disorder! And it's well known from social contagion theory that people who hear about new mental disorders are disproportionately likely to acquire those disorders! I'm doomed!"
--Not sarcastic. That's exactly how I predict that would go.
A friend remembered hearing about the dangers of lead paint in the late 70's, but as a kid, that just meant "WHAT? YOU CAN EAT PAINT CHIPS? NEATO, LET"S TRY IT"
That exact issue is the problem with D.A.R.E campaigns.
DARE definitely made drugs seem like amazing, wonderful experiences.
And they taste so sweet (apparently the actual reason children-eating-lead-paint becomes a big problem).
"Lead paint - delicious but dangerous" as the Simpsons skit put it.
Go look up medical student syndrome. ;)
It's one level up from that. Jacob is recommending that we expose people to a selection of compelling mind-viruses, and that we pair these with the message: "mind-viruses like these tend to stick in your brain and destroy your life".
Imagine if upon entering med school the students were told: "If you start to think you have a disorder, this wildly increases the chances that you will in fact catch it!" To put it mildly, I do not expect this to decrease medical student syndrome.
By the same token, I do not expect Jacob's recommendation to diminish the spread of mind-viruses.
Might this also mean that the placebo effect would not exist if we didn't know that it does?
https://journals.lww.com/pain/Abstract/2015/12000/Increasing_placebo_responses_over_time_in_U_S_.27.aspx
What if we start telling people that hearing about a disease makes you less likely to think you have it? Call it pathological anpathognosia or something to make it sound really impressive!
Spectacular
Social Contagion, A Basilisk. Someone should tell Elizabeth Sandifer.
Reminds me of the priest and the Eskimo.
Eskimo: If I did not know about God and sin, would I go to hell?
Priest: No, not if you didn't know.
Eskimo: Then why did you tell me?
That would make for a good novel. A secret organisation dedicated to stamping out knowledge of a religion just to guarantee that the shield of ignorance remains.
Plot twist: God sends a double agent to infiltrate the secret organisation and undermine the agenda of ignorance.
I think I'm sympathetic to "telling people gender dysphoria exists is sort of an infohazard if you're not letting them transition, net positive if you are?"
although given how slow our culture is about this this is an argument against telling kids/teens about gender dysphoria
That implies the transition itself is healthy, when it seems distinctly unhealthy due to the lifelong hormone treatments and highly invasive surgeries, which often result in the patient becoming sterile.
Why would you think of it as net positive to be allowed to transition, such that sharing the infohazard itself becomes net positive?
The assumption is that if the transition improves quality of life, then it is healthy. A bit like any psychiatric treatment (anti-psychotic drugs.....).
Right, I get that. Alex seems to be indicating that the "infohazard" part is good if you allow people to transition. I see an infohazard as separate from people who may have "naturally" been trans and were already seeking treatment. The infohazard sounds bad all the way around. Alex's follow up response indicates that they see it as something like "someone may not know they are trans, so allowing that knowledge to exist in general society can provide a path to seeking treatment that would not exist otherwise." I can see the benefit of that, though it's very difficult to weigh that against the problem of an infohazard *causing* orders-of-magnitude more people to believe they are trans and therefore having all of the difficulties that "naturally" trans people have.
So what's your solution? To censor trans people from speaking about their experiences and fighting for their civil rights? To punish them, their friends, and their families if they try to work towards a society more accepting of them?
Go ahead and say the quiet part out loud, Mr. Doolittle.
Assuming that people are either trans or not, what if the full realization of their gender dysphoria actually creates more suffering than the transition can alleviate? Maybe they could have lived their whole lives with a vague discomfort and the occasional thoughts of "Might be nice to be the opposite gender", but when it really hits them, they now experience the stress from knowing exactly what they are dissatisfied about, being misgendered, and wondering if anyone will accept them if they transition. I don't doubt that transition improves quality of life for people who are already suffering from gender dysphoria but it's questionable that it would necessarily improve it for those who *may* experience it but remain blissfully unaware in the mean time.
I can only speak for myself, but as someone who plausibly is trans because of social contagion (was part of a friend group where ~80% of us came out as some flavor of trans over about a 5-year period), I genuinely think my quality of life is as good or better than it would have been otherwise. Being my AGAB has been socially and to a lesser extent physically uncomfortable for as long as I can remember. Drawing attention to that dysphoria was uncomfortable for a few years, but between hormones and not being a teenager anymore, I am literally the most comfortable with my body that I've ever been. Was it the only solution to my problems? Maybe not. Is it better for me than an eating disorder or doing a lot of cocaine? Definitely yes.
I've identified as trans for pretty close to exactly 9 years now. Can't speak to how I'll feel in 9 more, but at the moment I wouldn't change anything about my situation.
I'm glad your life has improved and I hope your experience is typical, but I do find it interesting that you mention 'not being a teenager anymore' because I think that's an important factor in many people's life satisfaction, including my own.
Transition probably improves quality of life over untreated gender dysphoria, but still results in a substantially lower quality of life over not having gender dysphoria, really, not even a little bit, because you never heard of it the way people in pre-1994 Hong Kong never heard of anorexia.
If so, and if gender dysphoria is mostly culture-bound, then knowledge of gender dysphoria is indeed an infohazard that will on average reduce quality of life. Just not as much as it would if we talked a lot about gender dysphoria but didn't allow treatment.
Caveat 1: At present, there is a fairly large support community for transgender individuals; rather less so for other mental illnesses. So it is possible that transition results in a net improvement over quality of life over "I never heard of gender dysphoria, but my depression really sucks and nobody seems to care", because it gains access to that support community.
Caveat 2: All bets are off if we manage to both create a fully tolerant society with no transphobia, and also develop the medical technology for *complete* gender transition, including normal fertility in one's new gender and ideally fully reversible.
> Transition probably improves quality of life over untreated gender dysphoria
Have we done any actual studies on this, though, or are we just guessing?
If we're just guessing, then my guess is that untreated gender dysphoria is usually transient, and that treating it is worse.
And if that's not the case overall, then I think it's probably the case at least for younger and newer cases of gender dysphoria. Starting a kid on the path towards "transitioning" the moment they express a vague wish that they were born the opposite sex is going to ruin the lives of many kids who would otherwise have gotten over this phase on their own.
There have been a number of studies on this, yes, and the numbers for people diagnosed with gender dysphoria who don't get treatment are appallingly bad (double digit suicide rates), while the numbers for post-transition people are significantly worse than for cis people but much less bad.
Of course, every study in this field (as in many fields) is done by a group with strong pre-existing opinions on the issue, so detractors will frequently claim bias - I don't know nearly enough to judge those kinds of claims
Aside from formal health systems, which are vast if under resourced, there are large support networks for a variety of mental illnesses. I'm not sure where you are, but I could probably put you in touch with a local NAMI support group for any number of mental health concerns relatively rapidly.
From my understanding of the OP, culture bound syndromes are caused by the brain noticing various symptoms, and then fitting them into a "narrative" or "theory" that is present in a culture. This then creates a "spiral" effect where they start to notice more and more stuff that fits the theory, exacerbating the illness.
Applying this to gender dysphoria, we have someone who has vague feelings of depression and unhappiness about their life and dysphoria about their body. Because it is available in the memosphere, they lump all these symptoms together into gender dysphoria, and then notice more stuff to be dysphoric about. Then they transition and all the dysphoria goes away or is significantly lessened.
I think where you are coming from is that you are assuming that since those "original" vague feelings of depression and dysphoria were not caused by gender, a gender transition won't fix them. Maybe that's true, but maybe not. Brains are weird. Maybe somehow lumping the "original" symptoms into the gender dysphoria narrative will result in them getting "fixed" by transition. The end result might be someone who is happier on the net.
If this is the case, someone who underwent hormone treatments and surgeries might be happier then someone who never had gender dysphoria, but did have the "original" symptoms that brains sometimes lump together into dysphoria. I don't know, it's highly speculative but most of this field is.
Well or you could just tell them they will be fine in 2 years when they get out of puberty. Or you could give them sugar pills for 2 years. Both of which would probably lead to better total life outcomes (I would bet IDK millions of dollars on this).
Sterility is ambiguous, since some people strongly want to have children, and other people find their fertility to be a burden.
Given human history, in an evolutionary aspect, it seems pretty likely that most people want kids. Some people are abhorred by the ideal, just as some people do not like the taste of meat. But mostly veganism is a social thing, not inate.
I'm not convinced most people want kids. I think most people want sex and are willing to raise children if they have them. That would be enough for evolution, which could hardly anticipate the existence of birth control.
"Willing" to rear children is utterly insufficient to the magnitude of the task of parenting. You have to be deeply devoted to the concept of your children, as well as to the individual children involved, to succeed at the job. Your theory would only work for fruitflies or otters, some species that relies on sheer fecundity, and in which the parental investment is relatively modest, rather than a species like ours, which relies on extraordinarily high parental investment -- we routinely spend 45% of our adult working lifespan (~20 of 45 years) looking after our children.
People don't need to be driven towards procreation to be driven towards behavior that tends to cause procreation in a state of nature. Before you come up with evolutionary just-so stories, you have to notice around you there are plenty of people who either do not want children or want significant control over when and how many they have, with the preference being much lower than their total potential. Evolution self-evidently produces creatures with those desires. This is a fact evolution must accommodate, and if your intuitions about what evolution via natural selection must result in contradict that, that's a sign your intuitions are wrong.
That's a terrible argument. The exception does not prove the rule, biologically speaking. That some people get cancer as children does not prove that there is some adaptivity to childhood cancer. It is (one assumes) an unfortunate side-effect of some other mechanism that is adaptive. Similarly, the existence of a minority of individuals who have zero desire to procreate says jack about what evolution may or may not have built into the generic individual in this respect, so it need no better explanation than "shit happens," and natural selection is hardly a universal amd perfect optimizer.
Sterility might be ambiguous, but having the option removed from you at the age of 11 is much less so.
It is utterly monstrous, when you really think about it.
It’s a net positive for the people who have the sort of gender dysphoria that can only be successfully addressed by transition, and otherwise would have been unaware that this was an option.
It’s a net negative for the people who never would have considered transitioning otherwise and would have found some other less invasive means of addressing whatever symptoms made them susceptible to the “gender dysphoria infohazard”. E.g. upper half of the Kinsey scale female adolescents with typical puberty related body image discomfort.
The balance between these two groups is culturally modulated, but in American culture 2023, I suspect there are more of the latter than the former.
(I ought to add that my personal experience was
-going through puberty and having a sexuality that was not remotely functional and being vaguely dissociated from this and also generally feeling meh
-hearing that gender dysphoria was a thing and as a result of this getting more ~classic dyphoria symptoms and feeling like 'oh fuck I can't live like this"
-transitioning which fixed all of the above)
Having dysfunctional sexuality going through puberty and feeling vaguely dissociated from that is incredibly common in all sorts of people, and something that often gets resolved with time.
Why are you so sure that the counterfactual to receiving classic dysphoria symptoms through contagion is that you live with sexual dysfunction forever rather than growing out of it?
For what it's worth, I've seen transitioning make people I know conspicuously happier for years. It could just be suggestion, but it may be something they really needed.
I've also seen a fair amount from people who said they knew something was wrong, and it took them a long time to find out it was gender dysphoria.
And I've seen interviews with people who detransitioned. (Benjamin Boyce was doing these. I don't know whether he still is.) It's apparently possible for people to be miserable and jump to the conclusion that it might be gender dysphoria when the cause might be something else.
If they're at the point that transition is plausibly the best option, then sure, go ahead. But if the whole dysphoria thing could've been avoided altogether it's a different conversation.
I don't see that dysphoria can be avoided in general, though I agree it also shouldn't be amplified.
If I were running the world, I'd give everyone a year where no one around them cared whether they transitioned or not, just so they can settle their nerves and know what they actually want. This is not feasible.
But wasn't it the whole point of Scott's post? It seems plausible that in not-overdetermined (by hormone imbalance and the like) cases social contagion plays the decisive role, by initiating some kind of feedback loop, which breaks free from normal variance that people ordinarily "grow out of".
"It's apparently possible for people to be miserable and jump to the conclusion that it might be gender dysphoria when the cause might be something else."
Considering that the "something else" might be a condition that really is made worse by one's natal sex, I wonder how much jumping need be involved.
Ehlers-Danlos Syndrome (EDS), a collagen abnormality, provides an instructive example. People with EDS have weaker connective tissues, which keep kicking up their immune system by breaking more, and which can cause some embarrassing cosmetic problems, problems others might have after massive weight loss, only with EDS, you don't have to gain the weight in the first place to have them.
The closest thing to a "cure" for EDS might be androgens. That is, androgens partly compensate for connective-tissue weakness. Androgens help build muscle mass that protect against joint injury, they thicken skin, and so on. Men can suffer from EDS terribly, but overall, the population of men with EDS traits is affected less badly than the population of women. Add in that female fertility is pro-inflammatory, and maybe it's not surprising that the incidence of EDS diagnosis among patients at one gender clinic was measured to be 132 *times* that of the general population (1st reference), with patients with EDS seeking treatment for gender dysphoria being disproportionately born female (89%, 2nd reference), seeking either masculinizing transition or a nonbinary body, with chest masculinization being the most common surgery (58%, 1st reference).
https://parjournal.net/article/view/4858
https://journals.sagepub.com/doi/full/10.1177/20503121221146074
The stereotype is that teen girls' breasts are perky and attractive, that hideously stretch-marked, sagging sacks of flesh are a curse of older womanhood. You don't even have to *want* nice boobs to find growing "granny sacks" instead of "normal breasts" at thelarche embarrassing. The stigma that "granny sacks" are nature's punishment for those who let themselves pork up before slimming down doesn't help. Fat-shaming isn't reserved for the fat to begin with, and appearing formerly-fat is just one more handy excuse for it.
So, EDS can be physically uncomfortable (it isn't always, but it can be), and can make it difficult to conform to notions of what a "normal" body of your sex and youthfulness should look and feel like (not just for women; men with EDS may look and feel "too delicate to be Real Men"). Girls often find the discomfort of EDS worsened by puberty, and the body-horror of puberty dialed up to 11: wishing for a body that's masculinized instead, or to revert to childhood androgyny, seems especially understandable in these circumstances. Add in that androgens can compensate for the underlying defect...
I was diagnosed with EDS in my thirties. I went through female puberty convinced my complaints were either psychosomatic, or a sign that life in general sucks, womanhood sucks, and human sexuality pretty much sucks, too. I was too embarrassed to complain about (what I supposed was really soul-caused) physical suffering to my friends, and too religiously-conservative to transition, but I used to sardonically joke about transitioning. Mightn't God be calling me to transition to manhood and become a monk, some calling that might actually suit me? (Alas, transness is disqualifying for Catholic monastic vows.) I also inferred that the skin signs of EDS were merely evidence that I'd let myself get "fatter than my body could handle", despite not exceeding normal BMI. Maybe a BMI on the high side of normal was just too much for some bodies?... And wasn't "eating too much for your body" gluttony?...
Not "growing out" of "childhood asthma"? Another sign of being "too fat for your body": well-meaning adults reassured me about my asthma in childhood by predicting I'd "grow out of it" (though we now know that's not how asthma works), and everyone knows being a fattie makes asthma worse. Knees already hurt? Not an old lady yet, not an impressive athlete who's "earned" spectacular knee injuries, must just be too fat for your knees! Fatigued? Hey, being fat is tiring! And exactly nobody's surprised when fat girls get painful, heavy periods. Why should a normal BMI rule out being "overweight for you" when other signs of overweight are present? I didn't complain to doctors about my "fat signs", either: I already knew "be thin" was standard advice for such complaints, so why out myself as a delusional whiner?
Since I never got painfully thin, or even model-slim, my guilt never seemed obviously irrational – or even abnormal: teen girls diet. I couldn't manage to abstain from food aggressively enough to achieve typical anorexia, and the horribly-distorted body-image we were taught anorexics have didn't apply to me. I was aware I could count all my ribs, thank you, even as my cellulite dimples remained too numerous to count. Reading through the diagnostic criteria for anorexia as an adult, I went through youthful phases that could have just barely qualified. But not usefully.
My conclusion from all this is that, if going through puberty with EDS induces a desire to transition, the desire is a fairly rational one, and, especially if the EDS goes undiagnosed, transitioning might be the closest thing to symptomatic treatment for EDS that youth – and girls, especially – can convince medical gatekeepers to provide. To jump to the conclusion that transitioning is the solution when "the problem is really EDS" isn't much of a jump. And I have no reason to suppose EDS is unique in this regard. People solve their problems with the tools available to them.
Thank you for the information. I had no idea.
I was thinking of a detransitioner I'd seen interviewed. A substantial part of her apparent gender dysphoria was an eating disorder-- she was hoping that being male would help her lose weight.
"The prevalence of endometriosis in transgender men is" also "higher than the female cisgender population", apparently:
https://www.sciencedirect.com/science/article/pii/S1553465021005598
"Come, you spirits That tend on mortal thoughts, unsex me here" seems an especially appropriate desire for young women with endometriosis that nobody bothers to check for.
I certainly got the message, growing up, that female fertility was supposed to be uncomfortable, but finding it uncomfortable enough to complain of it, much less be impaired by it, was a sign of wussiness, or of something you must've done (like being too fat) to bring additional discomfort upon yourself. Not surprising that this message might lead young women with unaddressed discomforts they did not bring upon themselves to conclude that womanhood itself was the problem.
I know that's how my ancestresses, half of them who had also asthma, and, according to the genetic counselor, probably EDS as well, thought of it. A female body was kind of a raw deal, but also a raw deal one should pride oneself in enduring without complaint or reduced net productivity.
"The closest thing to a "cure" for EDS might be androgens."
Can you say some more about androgens for EDS. I have an acquaintance who has EDS and is having a terrible time coping with grad school because near the end of her first year into her PHD program she developed chronic fatigue syndrome (exhaustion, malaise, exercise intolerance). She and I have read enough of the literature about Chronic Fatigue Syndrome to know that even the doctors who believe the syndrome is a real thing do not feel optimistic about treatment. Seems there's nothing that helps. So she and I are looking for something evidence-based that's worth trying. Can you send me to any info about androgens helping EDS?
First, even the closest thing to a cure for EDS is still likely to be pretty distant. EDS is managed, not cured, and often, slowing decline of function, not restoring it, is what's feasible. (We're premature geezers!) The best way to "recover" function with EDS is to not lose it in the first place (and some lucky people don't). Secondly, for particular vascular problems, such as in vEDS (vascular EDS), doctors may advise blocking androgens to reduce cardiovascular risk (even if that increases suffering and decreases function: funny how high others rate not-dying over not-suffering).
That said:
Tissue laxity from EDS means joints lack normal protection against hyperextension and injury. Joints' range of motion is too wide for safety. To have EDS is to rely more than others do on muscle to stabilize joints, since other stabilizing tissues aren't much help. Muscle-building therapy helps brace joints from inside out, reducing pain and fatigue. Here's a study on strength training as anabolic EDS therapy:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241422/
and one on strength training for the hypermobility spectrum (which EDS is on):
https://pubmed.ncbi.nlm.nih.gov/32670599/
Exercise intolerance makes physical therapy harder, but usually not impossible. Finding a sweet spot that achieves rehab without triggering the intolerance can be maddening though.
And now, to hormones:
The bulk of research suggesting androgens can protect and strengthen connective tissue isn't done for EDS, but to explain the difference in injury rate between male and female athletes, especially, it seems, for knee injury. Complicating matters, genetically male and genetically female cells don't respond to androgens identically, and sex hormones interact. Transmen might not find androgens as protective against EDS as cismen, but testosterone still reduces range of motion (desirable in EDS) in female Wistar rats (measured with a wee goniometer!):
https://pubmed.ncbi.nlm.nih.gov/24642882/
Here's a study showing higher testosterone correlates with stiffer ligaments in human women, too:
https://journals.physiology.org/doi/full/10.1152/ajpregu.00829.2004
Testosterone protects cartilage:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005627/ (this is just on male rats, though)
and strengthens (not just stiffens) ligaments:
https://www.sciencedaily.com/releases/2016/09/160920130838.htm (again, male rats)
and, of course, builds muscle, even in women:
https://www.reuters.com/article/us-health-running-testosterone-women/boosting-womens-testosterone-can-increase-muscle-mass-and-endurance-idUSKBN1WW2ZK
Here's a chapter from a medical book entitled simply "Sex Hormones and Tendon":
https://link.springer.com/chapter/10.1007/978-3-319-33943-6_13
Little research seems done on anabolic steroids for rehabbing damaged tissues, but there's some – for example:
https://journals.sagepub.com/doi/10.1177/03635465990270011101
Anecdotally, EDS patients find that testosterone helps, or are mad as hell that docs won't try it on them, or both:
https://naamahdarling.tumblr.com/post/693428741336072192/testosterone-can-treat-hypermobility-fucking
"I saw a reference on the internet to even low doses of testosterone helping with joint stability- and therefor preventing or slowing joint damage. I brought it up to my doctor tentatively... She agreed readily that this was well known and there were studies to back it up.
"I asked her WHY, in the years she’d been treating me, she NEVER brought this up. She confided that there were Side Effects. I listed the effects I’d seen on my friends who’d been on testosterone for years, and she nodded along. I waited for her to add something more dangerous that might apply to me.
"She had nothing.
"She really believed it was such a sure thing that I would rather have chronic pain and potentially reduced mobility than having a lower voice and some extra hair."
(I would mind if EDS, which has broken so much else, also broke my voice, but then, I sing.)
"Almost exactly 1 year in on low dose testosterone gel and... my pain hasn’t been lower in probably 15 years and I’ve stopped worrying about mobility loss. Every part of my health is improved."
Here's another EDS patient using testosterone shots to enhance physical therapy:
https://www.reddit.com/r/ehlersdanlos/comments/2qh1mv/hypermobility_steroids_and_pt/
"I have been getting testosterone shots for a couple months now, and I have definitely seen improvements. It has helped me build muscle to support my joints, making physical therapy much more effective."
Some people try to treat EDS with the synthetic anabolic steroids bodybuilders use, apparently sometimes with success, but results seem mixed (some of these steroids apparently damage cartilage, others may not).
EDS can suck you into an overexertion-injury-deconditioning cycle, where attempts to recondition provoke injury that forces even more deconditioning, worsening exercise intolerance. EDS can also monkey with the autonomic system and blood pressure, which may worsen exercise intolerance. Some people find eating extra salt helps with this. Autonomic dysfunction can also – whee! – cause/mimic psychiatric distress:
https://edser.weebly.com/notes-from-2013-conference/dr-alan-g-pocinki-pseudo-psychiatric-symptoms-in-ehlers-danlos-syndrome
https://youtu.be/mBBziPPeI1E?t=412
My heart goes out to your acquaintance. I didn't get an EDS diagnosis (much less pertinent treatment) in time to get my PhD, and, even if I had, could I have managed without having personal assistants (which I couldn't afford) to manage the life stuff so I wouldn't be diverting my limited reserves from academics? (A community that loves you enough to offer assistance gratis, and big enough that members don't burn themselves out from that, would be even better, but realistically, how many grad students get that?) If they don't harm sleep, or worsen underlying dysautonomia, ADHD meds can blunt EDS fatigue, help attend away from EDS discomfort, and generally help anyone be their own manager despite a body that's not cooperating. They're just a band-aid, but sometimes we need band-aids.
PS: Here's some info on monkeying with feminine hormones to decrease EDS discomfort:
https://massivesci.com/notes/ehlers-danlos-syndrome-hormonal-treatment-contraceptives/
https://www.hypermobility.org/hormones-and-hypermobility
Midge, thank you so much for this cornucopia of information! Is there a way I can stay in touch with you in case I have more questions? If you have your ACX responses forwarded to your email, I can just contact you by putting a post here. If not, is there some other way I can reach you? Also, do you know of any good resources on the internet for info about EDS or Chronic Fatigue? A forum like this, populated entirely by smart sensible people would be ideal (but that's a pipe dream I know). Friend would probably be willing to try anything that's evidence-based, but not weird faddish stuff (though of course it's not always possible to separate the wheat from the chaff). Her situation is very difficult: She knew from a young age what she wanted for a career, and is very gifted in the needed skills. Managed to go to a top undergrad program and get into a top grad program -- then a year in began to have chronic fatigue. She is continuing to meet her grad school responsibilities, but has a research advisor who has Asperger's or similar, and truly seems to think of my friend as a very well-built AI who can be trained on the adviser's body of research and thereafter will be quite a useful assistant. Advisor makes appointments with friend, then cancels at last minute or is 90 mins late. Asks friend to do investigate certain obscure ideas, and refuses to have meetings to explain things that are so advanced that even the post-docs in the department do not understand them. I'd like to wring her neck. Meanwhile friend's exercise intolerance is so bad that having to walk 15 mins to a meeting left her exhausted for the whole next day.
I do get ACX responses forwarded to email, and have starred your reply. Hopefully, that means any future replies in this thread won't get lost in my inbox.
Overall, the best online resource for EDS is knowledgeable, patient, and skeptical browsing to trawl for information and see what comes up – DIY research, in other words. Since DIY research competes with academic research for an individual's reserves, friends/family who could help your friend with "presearch" (initial trawling) so she can focus on more wheat, less chaff, and divert less energy away from academics, might help her. The good news is that many with these sorts of chronic illness are bright, sensible people whose bodies have to some degree thwarted their career plans, and so who find research on behalf of someone they've never met welcome mental stimulation. The bad news is that chronic illness can leave people desperate and gullible to quackery, or invested in risky experiments. I've noticed there's a paranoid-but-gullible cognitive style that's particularly attracted to quackery, and understandably common among the chronically ill (who've often been genuinely let down by "the system").
That said, here are some specific resources:
The Ehlers-Danlos Society:
https://www.ehlers-danlos.com/
Speaking of which, I forgot to mention that mast-cell activation may play a role in exercise intolerance, too:
https://www.ehlers-danlos.com/2017-eds-classification-non-experts/mast-cell-disorders-ehlers-danlos-syndrome-2/
"To respond rapidly to infection or cellular damage, MCs [mast cells] express germline-encoded pattern recognition receptors (PRRs) that recognize unique bacterial, viral, fungal or parasitic components known as pathogen-associated molecular patterns (PAMPs) and host-derived molecules, called damage-associated molecular patterns (DAMPs)" – and the EDS body seems extra-DAMP:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096630/
Even sterile tissue injury triggers immune mobilization. When everything works right, that's good! It's how you heal – and build muscle:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452982/
But once the immune system is mobilized, it may not settle down. This reference addresses high-energy trauma, not the accumulation of low-energy traumas common in EDS, but since EDS yields poorer prognosis for tissue recovery, it seems relevant:
https://www.frontiersin.org/articles/10.3389/fimmu.2020.01056/full
"Immune dysfunction is accompanied by a temporal shift in the innate and adaptive immune cells distribution... Recent studies have implicated this dysregulated inflammation in the poor prognosis of polytraumatic injuries"
Mast-cell stabilizers are a fairly popular remedy for EDS-related immune, uh... awkwardness. EDS is not an autoimmune disease, but it's common for EDS bloodwork to read as inconclusive for autoimmunity due to vaguely high inflammatory markers. "Immune derangement" seems the official term for conditions of any sort involving abnormal immune activity.
After that digression, onto other resources:
EDS seems something of a cause célèbre in the UK (at least compared to here), so the NHS's and British charitable trusts' info on EDS tends to be fairly good:
https://www.ehlers-danlos.org/
https://www.hypermobility.org/
PainScience.com, run by former Science-Based Medicine editor Paul Ingraham, may be the most useful single consumer reference available on pain management and musculoskeletal care. Why do we hurt? How do we make the most of limited resources in seeking relief and rehab? How can we benefit from exercise despite exercise intolerance? (a personal issue for Paul, an athlete who developed exercise intolerance):
https://www.painscience.com/
(and here's Paul's "Project Try Everything" substack: https://tryeverything.substack.com/ )
The following websites post interesting and informative ME/CF advocacy:
https://www.virology.ws/
https://mecfsskeptic.com/
Now that I've mentioned ME/CF and advocacy, broaching chronic illness to employers or other gatekeepers (including medical gatekeepers!) takes discretion. If not mentioning it at all, then mysteriously floundering, is causing more disruption than seeking available accommodation would, it's fairer to yourself – and others – to pipe up. But even sympathetic people dislike feeling confused or cozened, and while freeloading off claims to illness seems rarer in fact than in people's imagination, it *is* in most people's imagination, especially regarding "invisible illness":
https://sciencebasedmedicine.org/malingering-the-lord-voldermort-of-medicine/
https://www.painscience.com/blog/secondary-gain-is-bollocks.html
My strategy is to avoid multiplying labels. When the geneticist diagnosed me with EDS, he added, "And I'll write down you've got fibromyalgia, too."
"No, you will NOT write that down."
"But fibromyalgia is a normal result of EDS."
"Since it's a normal result of EDS, then EDS, not fibromyalgia, is the specific explanation for my problem. I don't want terms famed for vagueness distracting up my chart."
To his credit, he listened. Others with EDS may attach great importance to accumulating labels describing the symptoms of their EDS, but I'm more cynical, especially regarding labels notorious for harming patient credibility:
https://healthjournalism.org/blog/2018/11/women-more-often-misdiagnosed-because-of-gaps-in-trust-and-knowledge/#:~:text=For%20women%20with%20non,in%2C%20according%20to%20Dusenbery.
"For women with non-acute problems and a longer diagnostic journey, the challenge seems to be to hang on to your credibility as a reliable reporter for as long as it takes for the mystery to be unraveled."
"Too many" labels often strike others as incredible. Though so can blaming a bunch of disparate-seeming stuff on one underlying cause. And certain labels invite distrust, whether or not they should.
For example, since both asthma and EDS involve immune abnormality, I'm not surprised weird aftereffects can linger after I've had a cold. If a cold leaves me with slowly-subsiding vestibular neuritis for two years, then "vestibular neuritis" should make my chart, since it's not a common consequence of either EDS or asthma. But, since slowed or incomplete recovery from infection is more generally a common consequence of both, why mention "vestibular neuritis" anywhere off my chart unless dizziness or vertigo first comes up? Even then, "EDS means I don't bounce back quickly from colds. A cold inflamed my inner ear and my balance hasn't recovered yet," is more prosaic and *unifying*, inviting less speculation like, "Last month it was 'EDS', this month it's 'vestibular neuritis'. Always with the excuses, this one. Wonder what medicalized excuse she'll invent next" – though, if I were *inventing* excuses for myself, I hope I'd invent ones less ridiculous than what I've really got! Plus, since the vertigo is nearly gone now, no point in characterizing myself by it. Many would rather not characterize themselves by their permanent conditions, either, but once something interferes with your life enough, it's a characteristic whether or not you admit it.
An old friend of mine ended up switching PhD programs because his PhD advisor disrespected his marriage. The advisor still had the old-fashioned idea that PhD candidates' spouses count only as candidates' support staff, not as human beings who may need support themselves, and remained stubbornly oblivious on this point. Switching was a wrench, but worked out OK for him. I don't know if requesting telemeetings in lieu of unreliably-scheduled walk-in meetings, or a mobility aid for the walks, would work for your friend, but people who *can* walk, just who shouldn't walk *much* for some reason, aren't "cheating" by using motorized aids to get around – and some aids, like electric bikes, wouldn't even "look like cheating". I know an ex-ballerina whose legs are uninjured but who uses a wheelchair now because docs worry else her aorta might explode. The biggest problem with using mobility aids in EDS is ensuring they don't increase deconditioning. (Though, if the alternative is aortic dissection, deconditioning might be the lesser of evils.)
It sounds like "not answering to a flake" might help your friend the most. Though simply *being* chronically ill can invite the judgment that you're pretty flaky yourself, weakening your bargaining position to demand less flakery from others.
To end on a happier note, this is one of those "inspirational young heroes" pieces that name-drops some EDS research centers:
https://www.statnews.com/2022/12/12/ehlers-danlos-syndrome-patients-turned-researchers/
What I'd like is for less social contagion causing people to feel like failures at life if they don't match gender expectations, but I have no idea how that could be done.
Speaking as an unathletic, un-buff male, I hear you.
I mean not everyone can be above average. IDK some of this I feel like is actually a result of this counterfactual "everyone should be a winner" mentality.
I'm baffled that ordinary adults feel any such thing. I couldn't care less what all the rest of you think men should be like, just like I don't care what you expect from persons with any other of my accidental characteristics -- age, hair color (or more relevantly these days hair volume), weight, fitness, accent, habits. If I don't meet your expectations, that's your problem, not mine. Never felt any different.
I mean, that isn't the same as being an antisocial pain in the ass. I put on a coat and tie when I appear in Court, and I stand at a formal dinner when a lady joins the table, because that's what people expect men to do to show respect, but I don't see that as some constraint on who I am -- the clothes do not make the man -- but rather as me jumping through certain arbitrary ritual hoops to express a respect for the social institutions.
I see it as like a salute in the military. An arbitrary symbol that says "I agree with certain basic constraints on my individual expression for the sake of collective harmony." If men in formal settings were expected to paint themselves blue, wear a feather on their foreheads, and switch from eagle to ostrich at age 65, then I'd do that, too, and not think twice about what it implied about my individual identity (because I think it implies nothing at all).
For what its worth mostly the people I have have known well who were very serious about transitioning, were deeply unhappy with prior trauma, and when they actually had a healthy relationship with the other sex, their desire to transition magically evaporated.
A butch 17 yo woman who likes machines and wearing pants who got abused by a shitty boyfriend will IMO be better off with a good boyfriend who doesn't mind her Tomboyishness, rather than a lifelong struggle against her own biology as she pretends she really "is a man" (whatever that is supposed to mean). Not to mention which, a lot of the time she will just feel better in a few years naturally anyway as almost everyone is happier at 25 than 17.
"Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria."
I haven't seen a sentence I agreed with this much in weeks!
"Encouraging little kids, to cultivate sensitivity to sensitivity seems like it has the potential to elevate a number of manageable discomforts to dysphoria."
It's a problem, and presumably what's needed is a golden mean-- people can be taught too much sensitivity or too much stoicism.
Yes, I agree. As I kid I had all kinds of quirks. I think my parents did a great job of helping me adapt without making a big deal out of it. I had what might now be called "sensory integration issues" -- had a thing about clothing that was snug or rubbed in a certain way, felt intolerable some how. My parents just got me clothes that were comfortable. Had these awful pity attacks for inanimate objects -- once sobbing about my father's intent to cut the grass because I kept imagining it hurt the grass. My father cut the grass anyhow, and my mother comforted me. Said I wanted to be a soldier when I grew up -- parents listened with interest, did not make a big deal of its being a male occupation and not in line with their politics. Believed til age 6 or so that I could learn to fly if tried really really hard. Jumped off living room chair over & over, flapping my arms super fast. Told my mother that I thought I was making progress -- seemed to take longer to hit the ground. "Good for you," she said. "Keep working on it."
Well put. As a parent I am pretty concerned with authority figures telling my children as they go through puberty that if they feel alienated and uncomfortable with their bodies that they may need to castrate themselves or remove their breasts because gender. I’d much rather focus on being at ease with their bodies as normative.
Pretty much everybody feels alienated and uncomfortable with their bodies around puberty. I worried all the time about having a huge, conspicuous menstrual accident, and of course that's a real possibility when you're a beginner. Guys worry about getting huge conspicuous erections, and that's a real possibility too. I think the adults involved have to tolerate the kids' being uncomfortable (while being on the lookout for kids whio aren't just uncomfortable,but are overwhelmed and starting to fall apart). There are lots of things in life you can't have without passing through a period of suffering and confusion, and sexual maturity is one of them. When I was going through puberty, I don't think I would have been enthused about the prospect of sex change -- I thought boys were gross . But if somebody had said, "oh, honey, you feel ugly and embarrassed about your body? That's a sign you have Puberty Inflammation Disorder. We need to get you some medicine." If they'd said that? I'd have totally bought it, and swallowed the pills.
I never felt alienated and uncomfortable with my body at puberty. Indeed, I was very happy to be shooting up in height, and getting hair in various places, and otherwise clearly evolving towards manhood. (Zits I could do without, however.)
Where I do remember a novel uncomfortableness emerging is from the fact that I became abruptly (it seemed) deeply enamored of the female form. Suddenly, it seemed, girls looked and sounded and smelled wonderful, and by comparison I felt loutish and uncouth, a shambling ape-man with all the poetry of a rusty squalling hydraulic press. I despaired that any of these (newly discovered to me) works of art would find something inherently and attractively pretty about me -- pairing us up would be putting Picasso in an unsquare frame nailed together from creosote railroad ties, an unlikely Banksy.
In retrospect I don't even know if I would wish this away from my pimply 15-year-old self. In despair of being admired for my appearance or gait, I worked hard at good manners, at listening well, at being witty and graceful in my speech, as all of these seemed within my power to achieve and might compensate for my clunky form. In retrospect, I'm glad I put the work in, and I dunno if I would have done it had I thought myself the equal (in inherent attractivity) to the girls.
Well, for what it's worth, I'm not a girl and unlikely to be attracted (physically) to you, but I for one am glad you put the work in. (And not just because of your contribution to ACX, I've also read you in various other places for maybe 15 years.)
What a kind thing to say! Thanks very much.
>understanding why teen mental health collapsed in the 2010s. In brief, it’s the transition from a play-based childhood involving a lot of risky unsupervised play, which is essential for overcoming fear and fragility, to a phone-based childhood which blocks normal human development by taking time away from sleep, play, and in-person socializing, as well as causing addiction and drowning kids in social comparisons they can’t win.
https://jonathanhaidt.substack.com/p/social-media-mental-illness-epidemic
What if we're in a sensitivity death spiral? I saw a tiktok the other day along the lines of, kids seem to be getting less and less resilient in every generation. Maybe it's not just a matter of overprotective parents. Maybe it's a matter of children of overprotective parents growing up and becoming even *more* overprotective of their own children. Same thing could be happening with teachers too.
Basically, overprotectiveness -> anxious kids -> anxious adults -> even more overprotectiveness
Relevant: https://www.dailymail.co.uk/news/article-462091/How-children-lost-right-roam-generations.html
I am shocked both by how much of a baby my 9-11 year old youth athletes are, AND how easy it is to break them out of it.
It is as though a huge percentage of them have never before encountered someone "yes you are hurt, now get up and be a man and stop being a baby".
You do it a few times and suddenly they realize that just because they fell down and scraped their knee, we don't need a 5 minute pity party. They can just get up, be hurt with a scraped knee, and keep playing. So many really seem to feel every pain needs validation by everyone stopping and giving them attention.
Those people were around when I was a kid ~30 years ago. But it was the minority, now it seems like it is all of them until you break the habit.
I wonder, have you ever seen Woody Allen's "mockumentary" called "Zelig (the chameleon man)"?
https://www.youtube.com/watch?v=qUW8JsLDsNo
https://www.nytimes.com/1983/07/15/movies/film-zelig-woody-allen-s-story-about-a-chameleon-man-034845.html
Periodically wonder whether that might be part of the explanation for transgenderism, a case of imprinting:
https://en.wikipedia.org/wiki/Imprinting_(psychology)
In any case, I kinda think that your use of "sex-change surgery" should be deprecated if not anathematized. Unless you're going to argue, contrary to standard biological definitions, that penises and vaginas -- or reasonable facsimiles thereof -- constitute the necessary and sufficient conditions for sex category membership 🙂
"Gamete competition, gamete limitation, and the evolution of the two sexes" (Lehtonen & Parker [FRS]):
https://academic.oup.com/molehr/article/20/12/1161/1062990
Just from the first couple paragraphs I can already tell this is gonna be a classic.
This is one of my favorites so far for sure.
I like most of Scott's articles but I find this one especially amazing! It explains so much in a very convincing way.
Top 10 for sure. I love posts that make me challenge my own worldview, and this is definitely one.
In my freshman year of college, my roommate, who was a violin major, got crippling tendonitis in her forearm, presumably from suddenly playing the violin vastly more hours of the day. (Eventually she changed majors.) Guess who ALSO got crippling forearm tendonitis, despite no corresponding lifestyle change? Me. I'm like 99% sure this was social contagion, but the tendonitis was real.
FWIW I got forearm tendonitis from typing a lot at a desk made for someone taller than me. When I got a keyboard tray it went away. Point being, if your desk at college was set up differently than your one at home, you might have gotten real tendonitis. Or maybe you had real but mild tendonitis amplified by the social aspect.
Perhaps! But I wasn't typing much (it was a while back and I didn't have a computer) or even doing a lot of writing.
Children's handwriting skills crashed when the children were taken off a bench, writing on their laps, and placed at a too high desk.
Probably at the bidding of the desk manufacturers
Interesting - I had the same experience in reverse - I was unusually tall even as a kid, and my handwriting was always terrible. Hated it. Always felt like I had to scrunch myself up to write at a desk.
Then in HS science classes, suddenly my handwriting was way better! Happened to be most noticeable at... the tall lab desks.
Very tentative, but I wonder if the social contagion was a matter of physical imitation of how your roommate's arms were tense.
Once in second grade a classmate chipped his tooth while at play during recess. This was like only the second chipped tooth I'd ever heard of.
Later that day during lunchtime, I went up to my teacher and said "I think I chipped my front teeth!" "Nonsense!" came the reply. The teacher knew all about social contagion and its power among susceptible seven-year-olds.
Little did she know how powerful social contagions really were, for indeed I had accidentally chipped my front teeth. Now I understand that it was really the first kid's fault.
Anorexia strikes me as a particularly bad culture-bound mental illness to have, since after patients psychologically recover their metabolisms are frequently still messed up, sometimes forever. Amok damages lots of bystanders, people get killed in kuru-panics etc. etc.
Is there like, a harm-reductive culture-bound mental illness we could import? Hikikomori seems relatively harmless and reversible, if very bleak. "Workaholism" is rather pro-social but doesn't feel like a real mental illness.
As a young American living on the west coast, though admittedly also one who’s deeply in a Japanophile cultural scene, I feel like we’re already working on importing hikikomori-ism. Or maybe the incel identity is already filing that potential-space.
Hikkomori-ism is just a coping mechanism for not having the energy to go running amok.
Surely a lot of it is just that video games have gotten more addictive at the same time that it's become easy to obtain an endless supply of them at trivial or zero cost.
Running amok in video games is also a substitute for running amok in real life that wasn't previously available and, again, comes at much lower cost.
Jogging for recreational exercise is a relatively recent phenomenon that's spread like wildfire all over the world since it was labelled in New Zealand in the 1960s. People frequently get into Jogging and its big brother Running because of friends or family who participate. Cardio has very widely accepted health benefits
This is where the mental illness category gets funny. A culture-bound mental illness has to be a way that a distressed individual acts out in a maladaptive way. Otherwise it's just a trend, not an illness. But maybe unhappy Person A jogs in one culture and runs amok in a different culture, but for time and chance.
I had no idea the term jogging was popularized in New Zealand btw. As with culture bound mental illnesses (or trends in general) it apparently occurred sporadically throughout history. The Wikipedia article on jogging includes Roman mosaic of a jogger which looks so modern I thought it was fake:
https://en.wikipedia.org/wiki/Jogging
I picked up cutting socially in my teens (female born in the 90s) as a way to cope with intense feelings, but quit a few years back because it was starting to genuinely fuck up my life. I white knuckled through urges for a couple years before getting into jogging. It acts as both a healthy outlet when I do feel terrible as well as just boosting my overall mood. If I'd been in the more athletic clique in high school instead of the Tumblr kids, I might've skipped the cutting part altogether.
Self-injurious behavior in the form of self-cutting is a fairly culturally universal symptom of mental illness. One might think that one is peculiar to cultural practices, but it seems cross-cultural enough to be primarily a function of human nature.
It's also still fairly taboo to talk about in the US. In my experience people, including people who self-cut, are often surprised to hear about how common it is.
Is self-cutting as widespread historically and in other cultures as it is in the US/West now? My gut feeling is that it used to be a very strong signal for significant mental illness, but has become more culturally relevant and known, and therefore is a much smaller signal for mental illness, in line with Scott's post.
I think the specific of cutting is sort of cultural, but the idea that mental anguish should have a physical signifier is nearly universal. In times of great distress, I have hit myself with a hammer out of what I think are the same urges but a desire to conceal. The knife seemed very appealing in those times. I think the ancients custom of 'rending their garments' or 'sitting in sackcloth and ashes' are rather more reasonable ways to gratify the same impulse. Our society gets an F at dealing with grief, or any emotions that don't immediately payoff for the collective.
Self-cutting is a subtype of parasuicidal self-injurious behavior/self-harm, which is cross-culturally widespread. Self-cutting specifically, especially if you include scratching, is also common cross-culturally, though estimates of frequency have large ranges as you might predict. Rates vary by demographic, but it's found everywhere.
With respect to the US, it's always been fairly prevalent when we've looked. There's been a strong cultural taboo regarding it, so it's one of those things that people tend to be surprised is as common as it is. It's a common response to distress, often characterized as a coping response in the literature.
I have worked a fair amount with people with cluster B personality disorders and a comorbid cognitive disability. Self-cutting and other forms of parasuicidal self-harm is a classic trait you find among people with borderline personality disorder, and my sense (just my sense!) is that a lot of people associate the behavior specifically with people who present borderline symptoms. But that's not really accurate.
Wait until you see the Roman mosaic of women in bikinis playing volleyball and frisbee: https://www.dailyartmagazine.com/ancient-bikini-girls/
Jogging is absolutely a culture bound mental illness. Mass groups of people running in circles burning scarce valuable calories, for most of human history you'd have to be rich and/or a lunatic to do it
Except sports is part of every human society, and as Ivan said, the Romans jogged. The Greeks ran foot races. If a human universal is a mental illness, then what isn't?
Calories are not scarce. We have them in excess. And we are not the only species that burns energy playing when calories are in excess.
If we ever get an economic crisis so severe that the median person is forced to get by on 1500 calories while we wait it out, I'd expect the popularity of jogging to plummet.
How should people getting exercise injuries be placed in the idea of a culture-bound mental disorder?
<mild snark>
Well, in some areas of the USA, football has been viewed as nearly a religion.
Perhaps football injuries in those areas can be compared to flagellants' injuries?
</mild snark>
I would place it as "sometimes a symptom of muscle dysphoria". As well as anorexia or any other culture-bound disorder that might result in excessive exercise. But people exercise for all kinds of reasons, which sometimes leads to injury, and not all of those reasons are maladaptive. If someone feels tired a lot and is frustrated that they quickly run out of breath, starts exercising more to address that, and develops tendonitis because they didn't stretch enough, that's not a symptom of a mental disorder.
I think your second paragraph implies an interesting follow-up question: is there limited cultural "bandwidth" for culture-bound mental illnesses? If we import new ones will they 'out-compete' the old ones and reduce their prevalence, or will we just end up with anorexic hikikomori?
I get the feeling that school shooters have displaced some older types of bad people, like serial killers. And yet, they probably aren't the same types of individuals.
What do you make of the supposed link between school shootings (and other violent outbursts like killing your family) and SSRIs?
Without reading anything on this,y prior would be that they both have a common cause, namely being depressed.
People were depressed before the 1960s, yet there weren't school shootings. And its not just school shootings, which could be explained by social contagion - its also mothers killing their children and such. People with no prior history of violent behaviour suddenly loose control, and a very high percentage of them are on SSRIs.
People were depressed before the 1960s, but in hilariously-lower numbers.
Why would you kill random people, particularly children, because you are sad and in despair? Killing people is something you do when you are suffused with rage, or too sociopathic to be able to identify with another human being. Doesn't seem to have anything at all to do with feeling bad about yourself all the time.
I’ve been curious about the wave of anarchist assassinations/bombings that occurred in the 1880’s-1910’s, then petered out. It always struck me that the perpetrators had a similar profile to modern school shooters. Not discounting the impact of SSRIs or other modern influences but it seems plausible that angry young men with few social prospects, regardless of the historical era they live in, will seek out specific and culturally contingent methods to justify acting out revenge fantasies against the societies that have ‘wronged’ them.
Interesting thought.
Anarchism was a big deal up through about the Spanish Civil War, with a high death toll of assassinated national leaders and figureheads. But unlike Marxism or Fascism, it's largely forgotten today.
Also worth noting that these incidents were often ‘explained’ through the lens of pre-existing moral panics at the time. In Czar Alexander’s case it was ‘this is what happens when we introduce liberal reforms’ while McKinley’s assassination and Sacco & Venzetti were ‘this is because we’re letting in all these non-Anglo immigrants’. Much like ‘first person shooter games caused Columbine’
I mean both did occur because the US allowed non-Anglo immigrants to enter.
Whimsi says Natural born killers et al "helped" to prime those school shooters.
https://whimsi.substack.com/p/why-did-columbine-happen
(Whimsi nearly won an ACX book review contest with a George Orwell review)
„Priming“ is one of those soc-psy terms that went up in flames in the reproducibility crisis, IMO rightfully so. People can distinguish between reality and fantasy.
well, "sensitizing" is the verb Scott uses in the post. If you are chill with that term? ;)
Btw: yes, you are right, mostly. Nonetheless, some "priming" was reproducible, if I remember correctly. Just a fun add: Putin and his Russians, Trump, Bernie, Marx, Freud, soc-psy- Wokeists - "people's ability to distinguish between reality and fantasy" seems overrated. Reality and its ability to hit those following the fantasists - and hit them hard - is fine as ever.
"Priming" is a concept in Cognitive Psychology too, and plenty of cognitive priming results still seem to be reliable. I think the sequence is that "priming" was a term coined by cogs and then social psychologists extended it in sily ways, but I wasn't able to verify that quickly.
Priming could be nonsense. I believe it's an extreme form of a reasonable idea-- people do get influenced, but this doesn't mean that the exciting idea that people can be reliably influenced by itty bitty stimuli that they don't notice is a lot less likely.
Perhaps it would be more interesting to see whether or how much people are influenced by overt patriotic displays.
Right. People obviously get primed to do stuff all the time. But what works changes all the time, and people who are good at priming (e.g., rock stars) can make a lot of money off their talent. But even rock stars have a hard time staying on top of the world for more than a few years before turning into nostalgia acts.
The Malcolm Gladwell era priming fad was about marketers hoping that psychologists could invent cheap and enduring scientifically valid ways to prime people into buying the marketers' stuff over and over. Not surprisingly, that kind of priming didn't replicate that well.
This is not to say that priming doesn't exist: Red Bull has managed to prime a lot of people into buying Red Bull. But they've worked awfully hard at it and spent huge amounts of money (e.g., sponsoring winning Formula 1 teams) to get people to buy Red Bull rather than the 100 other brands of energy drinks.
I heard earlier that it was Stephen King's "Rage" which kicked off the trend, so he withdrew it from further publication.
Legal novelist John Grisham sponsored a civil lawsuit against filmmaker Oliver Stone after a boyfriend-girlfriend couple watched Stone's "Natural Born Killers" and then murdered at random friend of Grisham's. Stone eventually came out on top.
There are quite a few apparent examples of "Natural Born Killers" copycat murders:
https://en.wikipedia.org/wiki/Natural_Born_Killers_copycat_crimes
Well also school shooters have fewer options. A potential school shooter in 1920 could just drop out of school and join the army or become a gangster or whatever. A potential school shooter in 1870 could go west and kill natives and cattle rustlers (or rustle cattle themselves).
Despite society being much bigger and in some sense easier to "lose yourself" in. We are also more trapped than ever. Particularly high schoolers. The 16 year old who hates everybody and everything about their life who for the vast majority of human history likely just disappeared into the wilderness or took up with another tribe/city/whatever, now is going to have the state drag them back to their family in most cases.
This is a good question. Crazy Like Us talks about how old ones die off (there was an earlier anorexia wave which ended, Freud-era "hysteria" is gone, modern PTSD is quite unlike Da Costa syndrome) but now that I think about it, the book doesn't establish or claim that new culture bound illnesses displaced old ones, just that the old ones went away.
I'd been operating under the assumption that distressed people need some way of acting out, and would reach for whatever is "normal", but yes there are a lot of people who have symptoms of multiple mental illnesses so I suppose we could end up with anorexic hikikomori.
Is "hysteria" gone, or do we have other names for it? The phenomenon we refer to as women being "Karens" seems to fit some of the criteria for hysteria. If we're going with a theory of social contagion, it seems very likely that a lot of the specifics could be cultural baggage.
Classic features of hysteria included things like fainting, convulsions, and catatonic states. Individual symptoms get reproduced in other diseases (like TikTok Tourette's) but I think it would be hard to find modern people with the same combined symptom set that was very common in the late 1800s/early 1900s.
Hmm, perhaps my mental image of hysteria comes from later culture? Men telling women to stop acting up because they are "being hysterical" in the 1950s or something.
Yeah, and they aren't making a clinical diagnosis when they say that, anymore than a teenager is when calling someone "retarded".
Just to throw in some more culture-boundedness: mass shootings are somewhat common in the west, but what we don't get is people throwing acid at other people's faces.
Pretty sure that has something to do with how you don't usually have undiluted acid and chemicals casually for sale. The best an average person can do is bleach from Costco, which some people handle without gloves and don't get more than a slight stinging. If you really tried I supposed you can get salon grade hair bleach but that tends to be pasty not good for disfigurement, or you could break into your local uni Chem Lab?
Guns, on the other hand, are very easy to get in the US.
I feel like the means to violence isn't quite as easy to analyse because there's laws that make a huge impact on accessibility. In Australia, the number one form of violence is just punching someone at the back of the skull, usually drunkenly (not easy to be out and about with any kind of weapon - INCREDIBLY easy to get alcohol, it's 18 and up rather than 21 and up).
Scott's riffing on my Taki's Magazine column from last year:
https://www.takimag.com/article/big-shots/
Everybody has a theory about why school shootings and similar mass killing shootings are so much more numerous today than a half century ago. Trust me, the 1960s and 1970s were not a generally virtuous or restrained era, what with their frequent serial killings, political assassinations, skyjackings, bombings, and muggings—to list five violent crimes that rapidly got worse over the course of those years but now appear to be in decline (as are earlier crime fads such as bank robbery and kidnapping for ransom). Back then, school shootings and the like were just beginning to become a thing in American culture.
Why did school shootings come out of nowhere to turn into a cultural construct, rather like running amok with edged weapons against random passersby was long something that a few (but still too many) men did in some Southeast Asian cultures?
It’s worth considering some alternative timelines that didn’t happen to play out in America. For example, the two worst school atrocities in America appear to have been the 1958 Our Lady of the Angels fire (most likely arson) that killed 95 in Chicago, and the 1927 school bombing in Bath, Mich., that killed 44. (The school fire is remembered locally in Chicago but not nationally, while the bizarre school bombing was largely forgotten until dredged up after Columbine by people looking for something new to say about school shootings.)
I could imagine alternative timelines in which school arsons or school bombings became an American curse rather than school shootings. After all, there are plenty of guys who like setting fires and plenty of others who like blowing stuff up.
For example, bombings became fairly common among radical leftist terrorists at the end of the 1960s. According to Bryan Burroughs, author of Days of Rage:
In a single eighteen-month period during 1971 and 1972 the FBI counted an amazing 2,500 bombings on American soil, almost five a day.
Note that these tended to be smallish bombs set off late at night that mostly broke glass. But antiwar activists did blow up a physicist in the 1970 bombing of Sterling Hall at the U. of Wisconsin-Madison.
School destruction was in the air of popular culture at the time: The 1979 movie Rock ’n’ Roll High School, for instance, ends with the Ramones helping the students blow up and burn down their high school.
But neither school arson nor school bombings became an attention-focusing aspect of American life the way school shootings did.
Why? Was America always fated to have a mass killing shooting problem? Perhaps: America always had a lot of guns. Rifle practice was common in American schools until late in the 20th century. But previous eras didn’t see students getting shot en masse.
One unsatisfying but not implausible theory is that school shootings are just a contingent cultural construct: For most of American history, virtually nobody shot up schools for the same reason that virtually nobody demanded a sex change: Because whoever heard of such a thing? But once a bad idea becomes thinkable, it can sometimes have quite a run among the unhealthy.
For instance, even though there were a few dozen aircraft hijackings in world history before the late 1960s, the concept barely existed in the popular mind. Then, in July 1968, Palestinian terrorists hijacked an Israeli jet and held hostages through forty days of negotiations, finally walking free. This riveted world attention, brought immense publicity to the previously ignored Palestinian nationalist cause, and put the idea in the heads of quite a few jerks that hijacking an airliner would cure whatever ails them.
Soon, skyjackings were a thing. For instance, there were at least ten hijackers who tried to copycat D.B. Cooper. After a few years, airport metal detectors cooled off the trend, and then, hopefully finally, the passengers of Flight 93 deterred most post-9/11 would-be hijackers.
More bizarre examples than skyjackings include castration crazes. The Russian Skoptsy religious sect, which demanded castration of men and mastectomies of women, had about 100,000 members in the early 20th century. Similarly, in the English-speaking world over the past decade, discontented girls demanding top and bottom surgery became a thing.
At least with school shootings, everybody agrees it’s a problem. In contrast, respectable opinion views our new castration cult as a solution.
Isn't respectable opinion right? My understanding of these culture-bound illnesses is that they might only get started because of the ideas floating around in the culture, but once they do get started they're as real as any illness and need to be treated. At the moment, transition is the only real cure for gender dysphoria. Maybe changing our culture's messaging about gender will result in fewer people developing dysphoria in the first place, but once they've developed it it's way too late.
I think you've gotten the concept of "culture bound syndrome" mixed up with the concept of "fad." Culture bound syndromes are not passing fads someone can just shake off, they are genuine illnesses caused by some strange feedback loop between our software and our wetware. Even if the software is where it started, it's entirely possible that the wetware is the only place it can be finished.
I also wouldn't underestimate the perversity of the interaction between human biological systems. It seems entirely plausible that someone might have vague depression-ish symptoms for various reasons, lump all those symptoms together into "gender dysphoria" because that's what's available in our culture, and then have those symptoms be completely cured by surgery, even if the lack of surgery wasn't the original cause of them. Neural pathways are really strange things. It would explain why transition seems to make so many transpeople happy.
>At the moment, transition is the only real cure for gender dysphoria.
I don't think this has been remotely demonstrated.
I've always been sympathetic to the idea that the emergence of national TV news in the 1960s played a big role[1]. Let's suppose you took your revolver and went to your local school in 1924 and shot 2-3 kids before the nearby adults jumped you and beat you to death. Certainly you would have been big news in that community, people would've talked about it for years. But you wouldn't have been national news, or even international, because to the extent those things even existed they were slow and ponderous ("President Wilson Sets Sail For Paris Peace Conference -- More Details In Six Months"). I'm not saying local tragedy might not make the papers at some distance -- your trial might turn into the Lindbergh kidnapping trial -- but it would be an uncertain thing, and not nearly as immediate and universal as the era of national network TV news, in which a news helicopter can be filming the SWAT team cautiously moving in on you within an hour.
It's certainly not obvious that all school shootings are motivated by a twisted desire for attention, but it also seems no small theme. So...create the audience, and the actor appears, willy nilly.
----------------
[1] That emergence has been argued to have played a major role in the difference between the Vietnam and prior wars.
The invention of videotape and satellite transfer of video is one reason a lot of boomers tend to believe, deep down, that history began with JFK's assassination and the Beatles appearing on the Ed Sullivan show in 1963-1964.
The U. of Texas tower mass shooting in 1966 was one of those early events that was covered vividly on the newly dynamic national television news.
On the other hand, there was only about one copycat crime soon after and then the concept faded away for about a dozen years, a period in which other crime concepts like serial killings and skyjackings took off. The next school mass shooting that made a splash was the "I Don't Like Mondays" one outside San Diego in 1978.
If you are looking for an example of cultural contagion, I've long suspected that Alfred Hitchcock's amazing 1960 movie "Psycho" may have had an impact on the rise of serial killings in the 1960s and 1970s.
No, I don't really believe in cultural contagion, or really in almost any socially-derived motivation for radical decisions by individuals. My go-to theory for any radical decision by an individual is that it is rooted in that individual's psychology, and feeds one of the basic drives -- for money, power, fame (or infamy). And then of course individuals leverage the social shibboleths and doom pr0n of the day by pasting it on top of their boringly quotidian actual motivations. I'm not a criminal, I'm a revolutionary! I'm not sick and twisted in the ordinary way people have been sick and twisted since the Pharoahs, I'm a living symbol of the social changes that you all fear! Et cetera.
>people get killed in kuru-panics
It's nitpicky to correct this kind of typo, but I'll pick the nit since kuru is also a disease.
*Kuru* would be an example of a different sort of culture-bound disease, one with clear biological causes: ritual cannibalism spreading a spongiform encephalopathy (https://en.wikipedia.org/wiki/Transmissible_spongiform_encephalopathy).
In this context, it makes me wonder if there's other culture-bound non-mental illnesses.
>In this context, it makes me wonder if there's other culture-bound non-mental illnesses.
Do you count deficiency diseases? Beriberi, scurvy, iodine-deficiency etc.?
Those usually happen due to a combination of economics and culture restricting diets.
Do you count local poisonings? Lead paint pica, Minamata, Itai-itai, black lung disease?
Good questions, thank you!
I would count them when there's a clear cultural connection to the deficiency or poisoning.
I would count black lung due to the way coal was/is tied to Appalachian identity. From reading the Wiki pages Minamata and Itai-itai seem more like mass industrial accidents, and I wouldn't count something like Bhopal or (going back to Appalachia) C8/PFOA. Reminds me of what Scott wrote years ago in a different review about cassava processing, which is culture-bound knowledge *avoiding* poisoning and that's an inverse situation to culture-induced poisoning.
For deficiencies... if it was due to a cultural dietary restriction, that would definitely count. Not if it's economic or coincidental- even though sailing caused the restriction, I don't think scurvy among sailors would count. If sailors had some weird superstition against citrus, though, that would've counted.
Many Thanks!
I suspect that some of the deficiency diseases are going to blur the lines between cultural and economic causes. If a culture traditionally uses N foodstuffs, and some critical nutrient is present in only one or two of them, and some economic problem causes those one or two to become less available then it could be that the combination of culture and economics causes the disease.
One weird case: Consider suicide via carbon monoxide poisoning from vehicle exhaust. That suicidal people considered it as an option probably depended on "cultural contagion" - knowledge of the presence of CO in exhaust, and of its toxicity. And it was culturally limited to industrial cultures with internal combustion engine vehicles (possibly also pre-catalytic-converters).
> that's an inverse situation to culture-induced poisoning.
See also nixtamalization
I love gold hominy but always forget that word. Thank you for another example!
Worth noting that there may be reasons other than cultural for becoming anorexic while living in the US. If you think that at least part of the obesity epidemic, which while worldwide is definitely worse in the US, is due to environmental poisoning especially accumulation of 'something' in the hypothalamus, thyroid or the like, then in such cases of poisoning it is normal for some percentage of the population to have the opposite effect from the poison, instead of inducing obesity inducing severe underweight conditions. Which doesn't entirely explain the psychological impact but it is food for thought. Explained better by the slimemoldtimemold guys. Not sure that I believe it but worth considering.
I've always thought that workaholism is just one symptom of generalized anxiety disorder, mostly based on personal experience of both. On cultural-biological spectrum, GAD is probably at approximately the same point as depression.
> The patient was uncooperative - he was only visiting MDs because the local bishop wouldn’t call in an exorcist until he got a psych exam - and eventually left against medical advice.
I take it you never found out what happened to him?
While this is not the same patient, there are fascinating interviews with Catholic exorcists to be found on youtube which state that in cases where a psychiatrist affirms that the issue is demonic (like the attending doctor here), they have a pretty good success rate at curing the condition.
There was also one quite interesting anecdote where a patient who visited the Bishop for a possession got quite sad when he heard that he was just mentally ill after the examination, as a demonic possession would have at least explained what was wrong with him for him.
The demons here seem like the ants crawling on or under the skin in the other examples.
If your illness is entirely due to some kind of "I believe I am possessed by demons which leads me to feel demon-possession symptoms which makes me believe I am possessed by demons" feedback loop then it seems plausible that an exorcism could break that loop.
The odd thing was that the report of the possessed being treated by the exorcists read extremely similarily, almost verbatim, to Jung recalling how he treated some of his patients with psychoanalysis in Man And His Symbols. Basically they were just doing the same thing with them each day, going through these little rituals without much visual improvement, although some change present, for years, and suddenly the possessed/psychotic stood up, said they were cured, thanked the psychoanalysit/exorcist, said they understood now what happened and they would have never been able to resolve that by themselves, and then went home to never have issues again.
It makes me wonder now, connecting these stories, if maybe exorcism works by the same route as psychoanalysis, by (using their teminology) using the mundane to manipulate the unconscious through the signifying chain to resolve trauma, and if reversed maybe psychoanalysis is some sort of modernised scientified version of exorcism, which would explains why it retains a certain impressive measure of effectivity despite being completely hostile to the scientific method and everything that entails.
Wondered about that too.
Reminded me of this:
"Schizophrenia researchers in Japan in the 60s dealt with a case of a woman who had an alternate personality which claimed to be a fox spirit. They decide what the hell and tried a traditional solution - build it a shrine on the condition it goes away. It went away."
https://twitter.com/PrinceVogel/status/1594664169353142273
This is an all-time great blog post, start to finish.
I kept reading and reading waiting for the reference to Morgellon's disease. Yes, you had to get to gender dysphoria, that was a given. And there is at least a mention of chronic lyme. But the two most striking instances of this phenomenon to my mind are the remarkable upsurge in diagnoses (in some quarters of the culture) of different versions of neuro-atypicality, especially autism, and Morgellon's, which makes people sure they are discovering whisps of cotton-like fibers coming out of their body. Still, I don't want to be churlish. This is a great review, especially as half of a diptych with the one on Watters' book.
Autism, ADHD, and whatever we call the opposite of "neurotypical" - neuro-atypical?
I'm old enough to clearly remember before Autism was something anyone really knew about. It existed, and there are clear cases of it, but people generally didn't know or talk about it. Severe cases were known as "mental retardation" and mild cases were...I guess either ignored or people were considered weird somewhere between quirky and antisocial.
I think the usual blanket term is "neurodivergent".
Ah, yes, thanks!
I've seen neurospicy. It's not common at this point, though.
>Severe cases were known as "mental retardation" and mild cases were...I guess either ignored or people were considered weird somewhere between quirky and antisocial.
The third option was that their family locked them up in a hospital and didn't talk about it.
Depending on what period you are talking about, a lot of people who would receive a autism spectrum disorder diagnosis today were once diagnosed with childhood schizophrenia and/or intellectual disability (formally "mental retardation"). Diagnostic substitution, along with increased clinician awareness, is the main reason for the appearance of an increase in autism in the public.
Or they simply weren't diagnosed with anything at all.
Leaving aside low-functioning individuals who are called autistic today and were called retarded in the past, I suspect that high-functioning autism spectrum / Asperger's Personality individuals were less common in the past. I was born in 1958 and don't recall meeting a schoolkid like that until 1973.
"Mental retardation" primarily covered what is now called intellectual disability, though.
Many people who have an autism spectrum disorder have an intellectual disability. In the relatively recent past, the equivalent of an ID/DD diagnosis is all a person with an autism spectrum disorder might receive.
I don't think I ever met a full-blown "Revenge of the Nerds" / "Big Bang Theory"-style nerd until tenth grade in 1973. He'd do things like write all the dates in his history class book report in Base Eight. He got into Caltech but immediately flunked out.
The next year, I got to know a happier, better adjusted nerd, the son of a famous science fiction writer. He explained that computers were making society better and better for people with his type of personality: tomorrow belongs to me was his view.
He was right.
I remember hearing about Morgellon's in about 2006, but not much since - did it persist or was it a one-time thing, the way vaping-related lung disease was in 2019?
Joni Mitchell thinks that she has it. That tends to come up in interviews.
Autism is an interesting one because as long as it's diagnosed in childhood (which I think is still the most common time to get diagnosed?), it seems pretty unlikely to be a case of social contagion in the *kid*. But I wouldn't be surprised if there end up being "outbreaks" of autism where one parent finds out about it and then a bunch of nearby parents also get their kids diagnosed
I was thinking of more late-childhood / adolescent / adult diagnoses, and especially self-diagnosis. I have no doubt that "spectrum" is a fairly decent metaphor human neurodiversity, and "increased awareness" is a good explanation for a lot of these cases of late- and self-diagnosis; but I am dubious about whether they all qualify as a single "condition." It is unquestionably validating for lots of people to discover that when they talk about what it is like to be them, other people say "Yes, me too, and moreover, this has a name and it's listed in the DSM". Probably this is therapeutic in and of itself to some extent, but that it is also culturally determined seems obvious to me.
Autism spectrum disorder isn't a single condition. It's a collection of conditions that are symptomatically similar such they go under the umbrella term. Someone whose ASD is the result of Rett syndrome doesn't have exactly the same thing someone who has fragile X and ASD. You have neurodevelopmental differences that produce patterns of behavior and cognition similar enough that we bracket that and call it ASD.
That is very helpful to know. So it's professionally acknowledged that the commonality is in the family resemblance of manifestations, and not in any ostensible etiology. I'm not sure this awareness has been popularly disseminated, but that's less surprising. Thank you.
Relevant anecdote for once. So I was nineteen years old, first summer working in the sawmill between college and got sent out to replace a length of chain on one of the many chutes that moves sawdust from the mill to the chip pile. Working that day with a guy from West Virginia named Big John. He’s the millwright and I’m the lowly fire watch.
We drive across the shipping yard and he almost runs us straight into a fork lift. I grab my chest and say “Jesus John, I thought we were ghosts there for a second.”
He laughs but gets a distant look in his eye.
We don’t say anything on the rest of the drive out.
We replace the chain. No big deal. He lights a cigarette because no one ever goes through that part of the mill and I have a hose right there anyway. Without preamble he says:
“A ghost touched my honker when I was a young man. Ghosts are very loving creatures. You don’t have to be afraid of ghosts.”
I ask him “what?”
He tells me he worked a year in a logging camp when he was a young man. Him and another guy shared a room. It was summer and super hot so he’d just sleep under a sheet. The ghost would come into his room at night and just hold his honker then leave.
He tells me this over like ten minutes and I start to ask questions about his roommate. No the roommate didn’t have a girlfriend, never said anything about girls, just wanted to hang out with Big John.
I very politely and compassionately suggest to Big John that he was sexually assaulted by his roommate.
He goes, “nah, he was a Presbyterian.”
He goes back to the machine shop. Had to be reminded he told me this later because it was no big deal.
I just sit out there for two hours with my hose. I go back to the lunchroom when my time is up. I try to tell my friend Dude about the story. A guy named TJ overhears and insists that it happened to him too.
At this point I’m sure they’re fucking with me and it’s all an elaborate ruse, and say so. TJ who usually doesn’t care about anything gets really emotional and says he knows what happened.
Then Aaron the apprentice millwright comes in and TJ tells him to tell his story about being molested by a ghost and Aaron just leaves because it’s too much.
Big John, TJ, and Aaron all also had no teeth due to tobacco use and were the only ones with that affliction so in the course of a day I suddenly knew three people with no teeth who believed they were molested by a ghost.
Over the course of two summers I became satisfied they legitimately believed this all happened. This is also why I don’t fully trust any weird experience I ever have no matter how profound.
I don't have anything insightful to say, but just wanted to note that I enjoyed how this story was told.
I like a good bewildered laugh.
"my 'honker'?"
I now have heard it all.
He was quite religious so he didn’t like to swear. He also yodeled sort of when he talked and everyone I’ve ever met from West Virginia since then says that no one there talks like that, and I just assume that everyone else is from some lame over civilized part of West Virginia.
It took me a while to figure out how grabbing someone's nose was a sexual assault.
>I just sit out there for two hours with my hose.
Was the ghost there too?
(My guess is Succubus)
I think you might be onto something here.
Now that we are clued in to witches and their incorrigible need to steal penises, I think we need to investigate The Succubus Connection here.
There are other explanations besides molestation. Erections happen naturally. He could have dreamed it or unconsciously held it himself as part of a dream while in a hypnagogic state. Interesting story though!
True. Sleep paralysis had crossed my mind. The other two did seem a bit more emotional than him and it’s not uncommon for someone with sexual abuse trauma to pretend it was aliens or ghosts instead.
The second and third ones sound like sleep paralysis. There was a famous case in Halifax, NS, where a journalist wrote a column about being raped by a ghost, which was clearly sleep paralysis: couldn't move, happened while waking, ghostly presence, pressure on chest. Just textbook. (Unfortunately I cannot find the full column, but part of it is below). Funnily, he interviewed a theologist about ghosts instead of a sleep expert.
https://www.gawker.com/221105/great-moments-in-journalism-raped-in-the-ass-by-ghosts
PTSD might be confounded by the fact that war has genuinely gotten more horrible in the modern era - a Roman soldier only had to worry about the guy in front of him trying to stab him, while the modern soldier has to worry about suddenly being exploded by a drone five miles up, or by an artillery unit 20 miles away, or by a cleverly hidden landmine, or... well, there's a lot of things that can suddenly and randomly explode you in modern warfare and I think that would lead to a lot more stress and fear.
I'm not so sure war has gotten more horrible in the modern era. Yes there's artillery now, but there's also things like anaesthetic for wounded soldiers getting amputations.
What I’ve heard of as being potentially the relevant factor that is different in more modern wars is the “anxious wait” where you’re in a combat area but not actively engaged in fighting, but you could still randomly get killed with potentially no warning. The argument goes that this latter wears on the psyche much more than the former.
Think almost a Phobos-Deimos split, the difference between facing a cavalry charge (terror) and patrolling a street in Afghanistan with the constant fear that someone you thought was a random citizen will open fire on you (dread).
Right. The pre-modern soldier might spend many months marching but only one day in actual battle in their whole career. A single day of bad memories is a different prospect to a whole year of them.
Greek city-states in 500 BC tended to fight about one battle each summer that lasted perhaps an hour. So, a respected (and lucky) warrior might see 20 hours of combat in a lifetime from age 18 to 37. In contrast, trench soldiers on the Western Front in WWI might have spent thousands of hours within the reach of sudden death from artillery.
"The battlefield of the logistics soldier lies so heavily entrenched in the realm of the mind - the psychological plane. Unlike our brothers in the combat arms, we rarely go on the offensive. There is no cathartic release for the logistician that an attack can permit an infantryman... Instead, your survival hangs on such random factors as vehicle armour, proximity to a blast, and pure luck. Providence. That is hard to accept. The first move in a convoy fight belongs to the enemy and that is terrifically unsettling. Soon every Toyota that strays too close to your truck resembles a bomb, every colourful kite is a semaphore signal, and every smile from an Afghan pedestrian betrays a sinister secret. Ground convoys extract a continuous toll on the psychological reserves of a logistics unit."
Lieutenant-Colonel John Conrad, What the Thunder Said
Speculation, but there might be a change in perceived levels of control over your fate in war. In the past war took place at shorter ranges, due to the limited range of weapons. You could almost always see your enemy, or at least be in the vicinity of them. But since the mechanisation of war, the range has increased. Today you can be bombed by a plane flying several miles high, blasted by a drone you cannot see or hear, or killed by a missile fired from the other side of a continent.
It is also possible that the way our culture interacts with death and hideous injuries has changed. In the past death was much more a part of daily life, and without modern medical care, people suffered with injuries for longer. Today death has been swept into a corner, and I imagine many people have rarely seen dead bodies or even animals, or had to kill an animal themselves. Medical care means people are generally healthier but also in better shape. Could that mean that when we do experience death and horrific injuries, we are less able to cope with it?
I believe there is a theory that PTSD is actually a result of the compression shock from explosions, but I can't remember where I read this. Might explain the change, though.
Whoa, McArdle's on Substack now? I should buy stock in it.
...except, there's nothing to see. Have you written nothing, or is it entirely restricted access to subscribers?
I basically just squatted the names. May do something with them eventually.
Good thinking. I hope you do sometime, you were more fun to read in the Jane Galt days, and maybe a Substack approach would allow you to cut loose a bit. Begging pardon in advance for the presumption, it seemed to me you were having more fun then, too. Naturally with middle age and responsibility and respectability there arise in any pro-social human being constraints...and age brings nuance to one's thinking, too. Plus we all need to pay the mortgage. So not criticizing in the slightest! Just saying it would be a treat to someday read some (more) McMegan dangerously unbound, so to speak.
PTSD was called "shell shock" in WWI. Then the name was changed to "battle fatigue" in WWII and later to PTSD. The concussion aspect of PTSD is now back to being emphasized after all the IEDs in Iraq.
The factor of control also seems relevant. In an ancient battle, the threat comes from a guy with a sword trying to stab you. That sure is scary - but you also have a sword, and if you're good enough with it, you'll likely prevail. You have a chance to impact your fate, secure your survival with your own ability. Conversely, if you're being shelled from beyond the horizon, there's nothing you can do except take cover and hope you don't get hit by shrapnel.
Couldn't most of the protective factors we have for soldiers be PTSD-enhancing? In the Roman era, you were much more likely to die of even minor wounds. In the modern era, you have a much better chance of surviving. But the terror and pain you'd have felt in the course of being wounded, stay with you. I have to expect that modern war is also simply much louder than ancient warfare, and the wounds soldiers can suffer can be much more gruesome because the weapons we use are so much more powerful.
My (non-expert) picture of an ancient war is a lot of men lined up shoulder to shoulder, yelling and screaming, with metal clanking on metal, getting slashed and having arrows sticking out of them or perhaps being trampled, with most of the wounded dying. Armies would stay in the field for only short periods of time due to severe logistical constraints. Battles were often more or less planned one-day events in which two armies would see each other, line up, offer battle, and fight.
My (non-expert) picture of a modern war is men on patrol in unpredictable urban environments or in the field, with explosions and loud sprays of bullets, having entire limbs blown off with no warning, then potentially being rescued from death despite these severe injuries, potentially being in the trenches or in war zones for weeks or months at a time, and fighting not only against other people but potentially also against enormous machines of war. This seems *much* worse to me.
The current war in Ukraine seems especially horrible because of the precision accuracy of 21st Century weaponry. In the past, an optimistic soldier could hope that the other side would simply miss him over and over until he went home, but now it's harder to trust in your luck.
I was thinking the same thing. One of the first instances of biological(also psychological) warfare was flinging corpses at the enemy. You were also at much higher risk of starvation, freezing to death, that kind of thing which are relatively traumatic. Of course there was also decimation where a captured unit would be lined up and every tenth man killed. If that doesn't give number 9 survivors guilt then nothing will.
Actually being decimated twice and losing 10 and 11 would be more traumatic to number 9. I believe it was sometimes done twice.
It should be noted that corpses are only really dangerous if the person died of disease.
https://westhunt.wordpress.com/2014/11/09/the-evil-dead/
Modern warfare is all of the romantic movement's complaints about industrialisation honed to a sharp point.
You see, in the old days killing each other was an artisanal, communal affair - carried out in the clean open air and reflecting a generally slower pace of life. Most ancient armies could only campaign for part of the year, and a battle was considered gruelling if it went on longer than a few hours. There were the usual horrors of warfare, yes, but you were at least confronted by the person who wanted to kill you and had the ability to kill them back if you were lucky. Arrows and siege engines (both considered unsporting in how they enabled a person far away to maim or kill someone who could not retaliate) only reached out a few hundred metres at most. And you fought surrounded by comrades, giving both physical and psychological security.
By contrast, modern warfare is stressful, grinding and inhuman. Modern soldiers can be menaced by random death for days, weeks, sometimes even months at a time, sometimes with no rest or respite even when they rotate to the rear. And when death comes, the unfeeling hand of artillery and other heavy ordinance tears human bodies apart in ways that ancient human-powered murder weapons simply cannot accomplish. Even bullets to things to the human body that the ancients would have found obscene - having the insides of someone's head scattered all over you was not a common experience for soldiers before the age of gunpowder.
Worse yet, the need to disperse and take shelter from the sheer destructive power that modern industrialised killing can unleash means that modern warfare is an isolated, atomised experience - the common experience of soldiers across the 20th century has been of small numbers of men fighting murderous, individual battles across a massive front whose convulsions are invisible to them.
This is a good argument. If I may rephrase: Modern warfare has actually *extended* the spectrum of human experience in the direction sheer horror, anxiety and despair. The newfound extreme end of the spectrum may cause an equally newfound experience that we call PTSD.
I have seen a lot of grueling footage of the Ukraine war and agree with your description above.
" in the old days killing each other was an artisanal, communal affair "
I love your using "artisanal" here.
Or it could be that in the past a very broad cross section of men went to war. However after WWII predominantly young men went to war. After the draft ended, predominantly young men who had neither prospects for college, nor career went to war.
So you're thinking that young people, maybe due to less maturity in some manner, are more prone to PTSD? Or could you elaborate if I'm not catching your meaning?
Multiple factors. Yes younger people, young people not led by older calmer men, not surrounded by older calmer men. Young people who don't have a clear direction in life. Young people who have less family support. Except for those who start out with a military career plan, people who end up in the modern - post draft military end up there because they have no better options.
A couple of other possible reasons why PTSD might have gotten worse since ancient times:
1) Society has gotten more peaceful, leading to a greater disparity between wartime conditions and peacetime ones. If peacetime society were more violent, some level of hyper-vigilance might actually be useful. It's not a disorder if it's adaptive behavior.
2) Some of the symptoms of PTSD used to be more culturally acceptable in other cultures. An ancient Roman who got drunk frequently and/or beat his wife might have been considered an asshole, but not someone that law enforcement or medical professionals needed to do anything about. Nowadays, our culture doesn't see that kind of behavior as benign.
An alternative to 'society has gotten more peaceful' may be 'life has gotten less deadly'. Very few people die of illness at a young age. Kids don't work in industrial or farming jobs where the risk of death or injury is high. Most people's experience with death is the elderly, dying of conditions associated with age.
I think this may play in to more than just PTSD; we've done our best to insulate kids from the reality of life, that there are a number of things they can do that can lead to life-long consequences.
Most people these days have never personally killed an animal for food, whereas probably virtually all males had hunted wild animals or slaughtered farm animals in, say, Roman times.
I talked to the head psychometrician of one of the major wings of the U.S. military about their officer selection test. One of the best predictors of having the right personality for being an officer was enjoying bloodsports like hunting.
A problem I see in this hypothesis is that most young men these days have "hunted" and "killed" thousands of creatures (including rather lifelike humans) in their virtual gaming world by the time they reach adulthood.
One can of course cry "That's different! There's not real blood, only CG blood! Everyone knows it's not real!" (which is what those who strenuously defend video-game violence from the argument that it crosses over to shit like school shootings say all the time). But I'm a little dubious about this distinction vis-a-vis a tolerance for war if the underlying criteria is "enjoys being the cat in a cat-and-mouse game with a deadly outcome." There doesn''t seem much greater lack of that in AD 2023 than AD 202.
What might be very different, though, is the experience of being the mouse -- and *that* may be very relevant to how well you do in warfare, where some days you're the cat, and some days you're the mouse, and often both on the same day. It would seem very plausible that young people today have much less experience of *being hunted* or even being in danger from an intelligence, animal or human, with harmful intent and unbound by rules of fairness.
Even leaving aside the experience of warfare, there were fewer effective social constraints on individual and familial acts of violence in the ancient world. You might easily have had the experience of a family feud or bully or someone you crossed who might decline to take his vengeance in the modern way of courts and lawyers, but instead just find you in a lonely spot and beat or kill you. Family and tribal rivalries in general seem like they could be much more directly dangerous, like rival gangs in south LA today. And of course there were many more actually dangerous animals around, too.
Contra Grossman and the "murder simulator" hypothesis, video games are a very low-resolution simulator of violence. Sight and sound are limited to the screen and ear-safe levels, you don't get a full sensory experience, including effects of heat, cold, pain, exhaustion, etc. They also miss a key component: high stakes, or "skin in the game". Even today in some remote communities, a bad hunt means no protein for your family. When I worked alongside subsistence hunters on their own land, they were able to read the environment in a way that I simply could not. Likewise, people who have grown up in unstable social environments may be able to tell when it's time to leave before a fight breaks out. For the average N. American, there are multiple layers of insulation between "absent-minded mistake" and "dying a horrible death." It's a shock to be suddenly immersed in an environment where small decisions can have life-or-death consequences.
A while ago, I read a semi-convincing case that many cases of PTSD among war veterans might actually be, or at least made much worse by, symptoms of traumatic brain injury, inflicted by detonations of artillery shells, bombs, IEDs and whatever else goes boom on modern battlefields.
Edit: the connection seems to be fairly well-established empirically: https://www.ptsd.va.gov/professional/treat/cooccurring/tbi_ptsd_vets.asp
The old, WWI name for PTSD is "shell-shock", which suggests that this connection was noticed a long time ago.
Confounded by the fact that if a doctor said that damage to the brain's hardware meant Private Snuffy's brain was not going to will Private Snuffy's body back to the front, Private Snuffy would get rest and treatment. Saying that it was damage to the brain's software that lead to this outcome, would get Private Snuffy a quick trip to the firing squad (or maybe back to the front, if the threat of a firing squad summoned up a bit of extra willpower, but without treatment).
Doctors understood this; officers understood that doctors understood it as well, but most of them didn't actually want to shoot their own men for cowardice, so everyone was highly motivated to agree that yep, it's the exploding shells what did that to poor Snuffy's brain.
I've also seen a David Drake essay about how war is worse because it's more continuous than it used to be. It doesn't stop at night or for planting and harvesting.
It also involves continuous loud noise.
And, as stated, death is more random. Individual courage is less likely to be protective.
Time has also been proposed as a factor. A pre-modern soldier could, under normal circumstances, expect to be in combat for maybe a couple hours on average, and never more than a day as no battle lasted beyond sundown. Further, under most circumstances a pre-modern soldier would receive plenty of warning of an upcoming battle, as baring an ambush or a siege the enemy would always have to approach slowly from the horizon to engage their formation.
In contrast, one month in Flanders in WW1 covered enough time in active danger to equal the entire fighting career of a Roman legionary.
Maybe, but surely being in a siege for months while the city is starving would be pretty much guaranteed to cause PTSD. I am not aware of anywhere that the trauma afterwards is memorialized. Maybe just because it is assumed, or maybe in some way they moved on with their lives, with a capability that we have lost?
I thought of that too, and it's probably true.
I do wonder about the Roman preoccupation with gladiators and other extremely violent sports. Even if less common than our modern interpretation, it's true that they would regularly go watch people die gruesome deaths, for entertainment. Were they simply more comfortable with death and gore than we are? Surely such a society would have less PTSD from witnessing similar acts of violence in other contexts, even if they still had something like PTSD.
"Were they simply more comfortable with death and gore than we are?"
Yes.
Violence to or between animals was extremely common: hunting, slaughtering your farm animals, bullfighting, dogfighting, foxhunting, etc. E.g., in Thackeray's "Vanity Fair," the Oxford-educated son of an aristocratic Church of England prelate has few subjects of conversation other than upcoming dogfights and contests to see which dog can kill the most rats.
I wonder if the incidence of PTSD is as high in the guerilla types. Unlike the American garrisons, they don't generally have to worry about random citizens pulling out a gun, but they do have to worry about drones etc.
Also PTSD is sometimes related to head injuries, modern explosives are probably way more likely to give you head injuries than ancient projectile or hand held weapons...
Not certain if they are more likely. I suppose something exploding will probably generate injuries in more people (with an ancient weapon you can generally only hit one head at a time after all).
How correlated are head injuries and PTSD though? I don't think I've seen any literature on that.
Explosive concussions probably are relevant to the different experiences of WW1 soldiers with "shell shock" compared to earlier.
The constant anxiety is one possible difference. I'm also partial to the idea that you had time to decompress after intense battles in the past, where as now you could have mowed down 50 people in an ambush in the middle east then be back in normal, boring suburbia 36 hours later. That's got to mess with your perceptions. At least after World War I they had a couple of weeks on a boat to acclimatize to normalcy.
"Myalgic encephalomyelitis" and "long covid" (are these the same thing?) are good examples too.
examples of what? koro or schizophrenia?
The main topic of the post: culture-bound psychoses.
Well, Scott suggested that most conditions like that are on the spectrum between biology and culture. Or maybe even more complicated than that. Fibro and Long Covid are somewhere there, most likely. My ex had fibro and refused to accept it for a decade or so, and their condition slowly deteriorated to disability. I know a few people who fought long Covid, some succeeded, others got worse. My gut feeling is that it's more biology on average than culture. But I am quite sure that there are some people out there that just need a metaphorical swift kick in the ass and some psych meds to get better. I wish there was a test to figure out the right remedy.
I took the point, as much, to be that some things wouldn't happen without the culture input. Anorexia being one that is fairly strong to consider. In cultures where that is a thing, you have malnourished people showing up. It is clearly physically degenerate.
As such, it isn't that they need a "metaphorical swift kick in the ass." Whatever full set of inputs go into causing it, once here, it is here.
That is, culture bound activity seems to be part of the input to lead to this situation, but it is a very real situation once you are in it. Right?
I think there is a difference between an illness and a manifestation of it (someone else in the comments pointed out something similar). People rarely just randomly get anorexia, it is usually a manifestation of some underlying severe mental struggle. Before anorexia it would likely manifest differently, say, as self-harm, overeating, "hysteria" etc. The manifestations tend to "lock in", of course, and become addictive habits really hard to get out of, though there is a range of interventions that tend to help manage them.
But long covid, fibro and chronic fatigue are a different beast altogether. Most of the time the symptoms are not relieved by psych interventions, trauma therapy or tough love. There is something physiological going on, and I don't think there is a good handle on what it is exactly. The obvious potential culprit, some Mitochondrial Dysfunction has not been shown to be the main issue.
I'm nervous to accept "before ____, it would have manifested as something else." To wit, jealousy and such are clear evidence that knowing how others are will impact how you react to something. And I don't think it is at all controversial to say that jealousy can lead to physical symptoms.
I've also had times where I was cycling and was not at all "dizzy" until someone asked if I was dizzy. At which point I basically fell over trying to take status on whether I was or not. And vertigo/dizziness is clearly a physical thing.
Fully agreed that there is not a good handle on what, exactly, we are looking at.
Fibromyalgia/chronic fatigue is one of the things discussed in Elaine Showalter's "Hystories". I heard of that book via a Holocaust revisionist citing it as evidence that people were hallucinating poison gas attacks between WW1 & the post-WW2 era.
Ooh, that's an interesting idea. Chemical weapons were definitely a culturally prominent fear at the time.
Lindybeige has a good video about PTSD ("Battle Fatigue") in the Ancient world.
Lindybeige made the point of avoiding the term PTSD in his video, which IMHO was a smart move, because PTSD is a diagnosis with specific criteria. Not all psychological trauma is PTSD, and the instances people like to cite as ancient people traumatized by war, like the blindness of Epizelos, are not symptoms of PTSD.
As someone who has had mild issues with anxiety I can sense that the anxiety exists outside of anything to be anxious about. It’s there and it tries to find a way to manifest itself. I’m assuming this is something similar. The “crazy” exists and will find something to latch on to.
I think this is a crucial insight.
You might be interested in, indeed might have already read, Adam Mastroianni's post related to what you mentioned: https://experimentalhistory.substack.com/p/its-very-weird-to-have-a-skull-full
Thanks for pointing to this. I left a long comment there with my thoughts because it is a framing that echoes some of my experiences really well.
This gets to one of my big questions.
It's possible to be diagnosed with mood and anxiety disorders based entirely on emotions, observable behaviors, and somatic symptoms. The cognitive symptoms - worrying, rumination, catastrophizing, etc. - are just a few of many possible ways to fulfill the criteria. If (simplifying heavily) being in a particular situation triggers tachycardia, sweating, a feeling of lightheadedness, etc., and if I've learned to avoid that situation through, essentially, operant conditioning, then I can meet the criteria for an anxiety disorder without having any conscious thoughts at all.
But the psychotherapeutic constructs of mental disorders *center* the cognitive symptoms. It's just taken for granted that if you have an anxiety disorder, then you worry, and if you have a depressive disorder, then you ruminate and catastrophize. Identifying your maladaptive thought patterns is Step 0 of all the best evidence-based therapies; the fundamental assumption is that bad feelings are caused by wrongthink, and if you correct the wrongthink, the feelings will follow.
If you try to explain to a therapist that you avoid certain situations because you feel anxious but you aren't actually worried *about* anything, you're fully convinced that nothing bad is going to happen, you're actually a pretty optimistic person...they look at you like you grew three heads. They have no idea what to do with that, so they start probing for secret repressed bad thoughts.
I don't know how many other people have had this particular experience, but I suspect the number is not zero. I also feel like someone less stubborn would probably just start agreeing to the leading questions and convince themselves that they actually had all the bad thoughts they were supposed to have. But from my perspective, the whole picture looks inside-out and upside-down.
"I don't know how many other people have had this particular experience, but I suspect the number is not zero."
Avoiding the wrongthink but having the symptoms anyhow? Yep.
Have a therapist look at me like I grew three heads? Nope. Being patronized to because behavioral-health gatekeeper assume that my word that I'm not doing the wrongthink must simply be bogus? Yep. To their credit, some believe me, and even have helpful advice to give on what to do, rather than what to think.
There are some physiological interventions you can try to relieve physiological symptoms associated with stress/tension/negative emotions. DBT workshops do teach some of them often under the banner of "distress tolerance" or "management."
This was my experience with depression as well. My therapist was very insistent on finding the experiences and thoughts I had causing me to be sad and when I insisted that everything was fine except for the depression she thought this just meant I was repressing deeply and needed more therapy. I eventually have up, got put on antidepressants, and all my recurring/compulsive depressive thoughts went away, the physical heaviness and slowness went away, the anhedonia went away..... except for when I forgot to take my meds for several days and relapse. I am now quite skeptical of a lot of therapy-style interventions that confuse the symptom for the cause, because I regret spending years in therapy suffering without making any progress on the problem instead of just trusting myself that the problem was chemical and could be fixed quite simply.
A lot can come from self observation too. It was a revelation to me to find that occasional feelings of doom and gloom in the morning were not linked to either depression or weird premonitions of the world, but to eating sugar before sleep. The sugar low was enough to make me gloomy. Granted this is not "real" depression, my point is, the root cause need not be cognitive, and the root cause need not be something very complicated. It could simply be in the food you eat. BTW ... wasn't that the theme of "Listening to Prozac"?
Doesn't the trope also show up in the Odyssey? I'm almost positive Ulysses is wary of sleeping with Circe less because he's worried about being unfaithful to his wife, and more because he's afraid of, well, you know the drill by now.
Well Circe was a witch!
My point exactly.
Well, i saw the gorilla and counted the right passes and had no prior knowledge, so i must be a superior human right?
However in all my years reading Scott never have I once spotted one of his double thes. Its a life goal of mine. I will snap into enlightenment the moment it happens. One of these days, Scott. you cant quit writing until i get it okay?
I was annoyed at myself for missing that too, and I've read Scott for years. Those pesky double thes keep tripping me up every time.
Huh, curious that people feel this way. I'm happy that my brain filters out irrelevant junk on the fly without tripping me up, that's system working according to specs as far as I'm concerned.
You're right of course. I think for me it's because I went through an education system heavily based on standardized exams that tested (among others) your ability to nitpick quickly and accurately, and I was good at it and got consistently rewarded for that, which likely conditioned me to feel bad whenever I miss nits, a conditioning that's now maladaptive.
I would say even if the feature of your cognition is in the general case useful, if someone knows enough about it to trick it, repetitively, whenever he wants, for years, mildly kicking yourself is a reasonable response. Thats an adaptive process.
I read an essay, years ago, about the importance of proper grammar and punctuation. At the end, it's revealed that the essay itself is full of grammar and punctuation errors. The experience of reading it kind of "broke" my ability to automatically detect such errors, which is annoying in work settings but nice when I just want to read something. Ever since, I've had to "turn on" my grammar checker in order to catch errors.
You reminded me of how I felt reading Lethem's "The Ecstasy of Influence". Basically, me : Lethem's essay : plagiarism :: you : that essay : grammar and punctuation errors.
Guess I'm off to read that now.
I'm still patting myself on the back for instantly seeing the cow. Maybe he's used that image before so I'm not actually seeing it for the first time.
Yes, I saw the cow right away but not the dog.
Same for me. I recognized the dog image but still couldn't see the dog.
Regarding school shootings, I once went through the entirety of https://en.wikipedia.org/wiki/List_of_school_shootings_in_the_United_States_(before_2000) article and it turns out that there were literally zero school shootings before Charles Whitman in 1966. The article lists a lot of shootings _in_ schools, sure, an eight grader accidentally shot a classmate while showing off his new revolver, that kind of stuff, but it took having a brain tumor to come up with an idea of shooting a bunch of schoolchildren to get back at the society. And then twenty-some years of gradually increasing number of copycats to popularize the idea that this is what some people upset at the society do.
I personally find it striking that the US used to have a lot of serial killers in the 70s/80s and now has a lot of mass shootings and no highly publicised serial killers. It could just be reporting bias, (there are still serial killers but they don't get the press the Zodiac killer did?) but it sure feels like the would-be-serial-killers switched to being mass shooters as that became the dominant cultural fear.
The most prolific serial killers in recent times have been medical professionals that killed very ill patients and disguised the murders as natural deaths.
That could very well have been going on for a long time, but no one noticed in the past.
assault weapons aren't really a thing. To the extent that they do exist, they are harder to get now than they used to be. And research has shown approximately no causation (or even correlation) between violence and computer games.
It's interesting how the video game drama refuses to die, whereas the intuitively much more likely culprit - the omnipresent "if it bleeds, it leads" style news - somehow never gets the blame.
If you’re making the narrow point that “AR-15s are not assault rifles because they are not selective fire” and that truly automatic weapons are rare and hard to get, then I agree.
But the thing that the media calls “assault weapons” and are stereotypically used in active shooter crimes are genuinely more common than they used to be and easier to get (they were banned for a period, and they didn’t become the most popular civilian rifle platform until after the ban was lifted).
I could be imagining things but from the inside it sure feels like gun culture has gotten way more “semi-automatic rifle / tacti-cool collector” focused over the last couple decade. In the 90s the prized weapon was a fancy hunting rifle or over-under shotgun, now it’s a tricked out AR with fancy optics and other customizations. I remember “plastic guns” being disdained among the serious gunners in a way that’s been absolutely flipped on its head.
M1 carbines were semi-automatic long-barrelled weapons which were EXTREMELY easy to get decades ago.
https://youtu.be/ihQ-j6eALGc?t=1966
(posting a second timestamp since most won't care about the digression into trademarks)
https://youtu.be/ihQ-j6eALGc?t=2801
Yes, high capacity semi automatic long guns have been widely available in the U.S. for a long time, but I was intending to object to the idea that they “harder to get” than they used to be, or that they barely exist at all. They are much more common and easier to get than during the “assault weapons ban” days to be sure.
M1 carbines (or indeed any semi-auto long guns) never dominated popular gun culture the way “modern sporting rifles” do now.
M1s that were surplussed to the citizenry violated the NFA (minimum barrel length was originally 18") The government response at that time was to change the SBR definition. Contrast that with today's BATFE which has decided that they'd rather just demand that millions of citizens either relinquish their (previously legal) equpiment or become felons.
You could use the culture-bound disorder argument for mass shootings as a justification to ban "guns that look like AR-15s".
If the cultural image of a mass-shooter is a guy with an AR-15 in a tacticool/Matrix outfit, maybe having to do it with a pistol wouldn't be as appealing to a potential mass shooter.
The “mass shooters always use AR-15s” thing seems to be a comparatively recent meme. Pistols have been used in many mass shootings as well (Columbine, Va Tech, Ft Hood, and Tucson (Gabby Giffords) are a few of the more famous).
All other considerations aside, magically disappearing every pistol would have a much greater impact on murders than semiautomatic rifles - homicide by rifle is something like 2% of total homicides.
They're very much a thing - the term is misleading, but an accurate, easy-to-control semi-automatic rifle with 30+ round magazines is pretty fucking handy if you want to shoot a lot of people.
For example, I can finish a 10-plate dueling tree with my AR in about 5 seconds. Sounds impressive, right? Nope. Did it on the first try. It's really easy.
Doing the same with my 1911 pistol? Goddamn difficult.
Semi-automatic rifles didn't *cause* the rise in mass shootings, but they're for damn sure a part of why the body counts are so high.
I'll just be blatantly racist here for a minute, and say that any mass shooting where injuries>deaths, the shooter is black. If Deaths>injuries, shooter is white.
The confouding factor is military service. Black killers who have military training are very good shots, see the DC Sniper. All Other black people, the joke is they shoot like Eazy-E and can't hit jack-crap.
It's a fun game, try it! Oh, shooting in Houston, 14 injured, one fatality. Let me speculate that the incident was gang-related. Utah, 5 dead, one injured: White People
So, the FBI/CIA/whatever agents that you think staged the 2017 Las Vegas shooting. were black? Truly, you have a dizzying intellect.
The information and social and technological safety nets were A LOT looser back in the 1970's and before. There were no cell phones or surveliiance video. It was normal for kids, teenagers to "run away from home" and disappear. People would just up and leave, hard to track them ... that also meant disturbed loners with sketchy pasts could drift from state to state, find a new job/apt/nightlife, without instant questions like, "what was your last job", or, "account for every single second of your life and disclose all your social media posts or we will assume you are a disturbed psychotic sex murderer because you don't have a facebook profile"
TL:dr -- It was Way easier to be a serial killer back then, you could murder dozens of people and even children back then and get away with it for years and years. Until advances in technology changed that and then we suddenly and publicly caught a lot of them at once.
________________
I mean, John Wayne Gacy murdered ~34 young men and teenage boys in mostly in Chicago, in the 70's. Many of them had actually worked for his contracting company, and/or were last seen with him, or said they were going to meet with Gacy to "pick up a paycheck" and were never seen again. Police questioned him several times, but just accepted stories like,
"Yeah, Darrell picked up his check and told me he was gonna split for Ohio, parents were hassling him, kids ya know! What can you do?"
That almost direct quote says volumes about the 70's in partial answer to your question.
BR
My personal favorite tidbit about Gacy and the Chicago PD:
"Oh, those three boy's High School class rings sitting in the candy bowl right by the front door? With, like initials and engraving on them that you cops never thought to look at?
"Well, some kids I hire, they spend all their pay, then ask me to "float" them... one was gonna pawn his class ring, so I had him "pawn" it with me, he knows it'll be here when they can pay me back. Yeah I've did that lotsa times, a few guys never came back to get their rings outta 'hock.' Huh, well kids you know."
Phones.
Your phone triangulates your position between several cell towers, several times a minute.
You might be interested in this article on the subject: https://www.bustle.com/life/112070-how-many-active-serial-killers-are-there-right-now
One of the big pieces of technology that reduced serial killers was information sharing across police departments. Ted Bundy was able to elude capture for a long time because he killed in different jurisdictions that didn't/couldn't communicate.
The Idaho stabber may have wanted to become a serial killer, but he got caught by all the technological resources the cops have at their disposal these days when they really want to catch a killer.
As an example of how crime doesn't pay anymore if you really piss the cops off, like the Idaho stabber did, who got caught by a combination of security camera video and genomics, a lady I know had her throat slashed by a home invader who stole her smartphone. (She somehow survived.)
Less than 48 hours later, I was driving by the local police station and there was a TV news truck out front and a vaguely familiar-looking TV reporter was climbing out of it. It could have been for anything, but for once I felt with a certainty that it was Good News. "They caught the bastard!" I exulted, and raced home and turned on the TV.
Sure enough, the LAPD had tracked down all the lowlifes he'd called on her phone and told them that if they didn't give this would-be killer up, they were going down on whatever charges it took to put them away. Several of his gang-affiliates squealed that the guy they wanted ate breakfast every 8 am at the Boyle Heights McDonalds. The cops arrested him there.
My wife recently visited the victim, her husband, and her new baby.
Small town cops don't let anything happen in their hood. I was working in a small town in Nevada, accidentally butt dialed 911. After I explained everything to the dispatch, they still sent a cop to visit me.
This transition is fascinating to me, as well - I would love to see Scott (or perhaps this already exists) do a deep dive on the similarities and differences between serial killers and mass shooters.
There was a *bombing* in an elementary school in 1927 that killed a lot of children. The attacker detonated a suicide truck bomb when rescuers came.
https://en.wikipedia.org/wiki/Bath_School_disaster
Columbine was supposed to be mostly a bombing, but the bombs didn’t go off.
It’s an intriguing counterfactual - would the “Columbine effect” and all the downstream copycats and culture warring be different if the Columbine perpetrators had been a little better at improvised explosive construction?
Interesting thought - would we have had a series of school bombings instead of shootings? Seems logical that the numbers would have at least shifted in that case. More bombings and less shootings. That some people would have access to guns but no access to bombs seems likely, though, so I doubt we would have a 1-1 substitution.
I think people tend to overestimate the difficulty of obtaining the material and knowledge to construct an explosive or incendiary device (“block a door and set the building on fire” could also have body counts at least as high as mass shootings, and I think there are some historical examples of this).
And simultaneously underestimate the difficulty of acquiring the weapons used in these shootings - AR style rifles and their ammunition are expensive, and “America has no gun control laws” hysteria notwithstanding you do generally need to pass a formal background check and an informal “most gun store owners don’t actually want to be the guy that sold a gun to a spree killer” vibe check (or live with someone willing and able to do so).
In any case (and perhaps differentiating them from the Malay amok) active shooters seem to usually go through fairly intensive planning for their crime - it is in a deranged way their magnum opus, not a spur of the moment crime of opportunity. So the acquisition difficulty bar would need to be raised quite high to be a successful preventative on its own.
"Block a door and set the building on fire" is exactly what happened at the Cinema Rex in 1978 Iran:
https://exiledonline.com/burn-malibu-burn-%e2%80%94-fire-the-most-effective-underused-weapon-in-the-world/
We are lucky that nobody, so far, has copycatted the 2017 Las Vegas shooter who fired from on high into an outdoor music festival crowd, presumably in order to set the record for most killed and wounded.
My guess is that Columbine-style mass killers want to look their victims in the face up close and personal, and thus the Las Vegas shooter's modus operandi is too distant and impersonal.
On the other hand, the LAPD recently bragged that it stopped a Vegas style high-rise attack in Hollywood.
https://www.foxnews.com/us/las-vegas-style-mass-shooting-thwarted-outside-hollywood-high-rise-police
But who really knows?
There are many public "facts" about the Las Vegas shooting that lead reasonable people to conclude that it was a total false-flag, FBI-CIA-XXX operation, a massive cover-up for actions by a foreign power, etc.
If you think about certain things, the physical details, the fact that gun-control activists are'nt talking about it, the impossibility of one guy firing 400 rounds etc, and mostly the total silence around it, it seems pretty strange.
I personally am sure it was a govt-approved and covered-up operation.
>there were literally zero school shootings before Charles Whitman in 1966.
Was this supposed to be Hyperbole because your own list shows this not to be true:
February 17, 1922 John Glover broke into the schoolhouse, where he killed a girl and fatally wounded a boy.
And Charles Whitman was shooting college students, not schoolchildren.
Interesting, but reading the source Wikipedia uses it's still nothing like a modern school shooting: A guy went on a drinking binge, tried to sleep, got angry at nearby schoolchildren for being loud, slapped one, got hit with a baseball bat, got home, grabbed a shotgun and started shooting.
https://www.academia.edu/69669656/The_Three_Deaths_of_John_Glover_1922
Whitman matches the pattern much better, I don't find that distinction all that relevant.
Whitman was nothing like a stereotypical school shooter. Besides the whole "elevated sniper nest" bit, he didn't back down when confronted by an armed response.
A good friend bought a house in the Los Angeles area, and in the first week, while replacing an electrical outlet, he found a chunk of newspaper inside the wall, with the headline "School Vice-Principal shoots, Kills Six in La Canada". Date was ~1954.
This is not new and anybody claiming so is lying for profit.
I don't trust you.
Right. And then the next widely publicized school shooting was the "I Don't Like Mondays" one outside San Diego in 1979. I've often argued that, ironically, the Boomtown Rats song about it by beloved humanitarian Sir Bob "Live Aid" Geldof was the key social contagion event that made school shootings a Thing in the United States:
https://www.youtube.com/watch?v=FcZW0GFLSdw
But I don't know if that is true. I was a big Boomtown Rats fan at the time, but in the late 1970s they were much more popular in the UK/Ireland than in the US. "Despite reaching number-one in the United Kingdom, it only reached number 73 on the US Billboard Hot 100."
On the other hand, a lot of New Wave stuff that fizzled on American radio in the 1970s became well known during the 1980s, so I wouldn't rule out the influence of "I Don't Like Mondays." Geldof himself says he regrets the song because he got a letter from the shooter thanking him for making her famous.
I wonder if there weren't significant differences in people's behavior in the past that make them basically unrecognizable, psychologically, to us today.
The example I think of sometimes is Beatlemania -- where, by all reports, people were literally fainting and collapsing and having other strange hysterics about the Beatles playing in the 60s. I wonder if back then lots of people had such different backgrounds, e.g. having grown up with no exposure to mass media, that they really did have hysterical reactions to things we find more mundane today. (There are many other possible stimuli that would have been dramatically changing around the 60s -- fewer traditional/highly-repressive cultures than behavior; relaxed codes of dress and interactions, whatever modern psychology was at the time...) And that's not even that long ago.
Basically I wouldn't be surprised to learn that, if I met somehow met someone from ~1800, their reactions to things would be completely unintelligible to me, but along axes that I have trouble imagining precisely because they're so unintelligible. So perhaps people really did get 'hysteria', but they mostly don't anymore, simply because "times have changed"?
People really did get hysteria. All those women coming to doctor's offices begging for help weren't lying, nor were they all sexists out to slander women. People really did get neurasthenia too, before this culture-bound syndrome also went away: https://en.wikipedia.org/wiki/Neurasthenia
I mean, I basically have this disease? Nowadays I end up with a lousy pile of 'we don't know why but it sure isn't working' diagnostic terms ('functional dyspepsia, bronchial hyperreactivity and autistic burnout') but it matches neurasthenia closer than anything else, it's just nobody will diagnose that any more :-). (it all seems to be downstream of the same thing, which is essentially 'gain on the nervous system turned up too high', but there isn't an active neat diagnosis for this, which is a pity because having to explain all the separate parts is irritating and makes people more inclined to dismiss it than if I had a single sciencey word for it.)
I also don't really see what the difference is between neurasthenia and a variety of "modern" disorders, like panic attacks or anxiety maybe combined with some somatic symptoms.
True that there were a lot of stimuli changing in the 1960s, but compare Lisztomania happening about a century before.
My 15-year-old mother-in-law screamed through a Sinatra concert in 1945. She probably would have screamed through a Liszt concert in 1845 and a Beatles concert in 1965. She was an outstanding classical pianist (Chopin was her favorite) and had superb taste in music. Liszt, Sinatra, and the Beatles were all great, and teenage girls deserve credit for figuring that out ahead of grown men.
With regard to fainting, I think corsets were still popular at the time.
I can't speak from direct experience, but historical clothing folks who do are pretty consistent that the idea that corsets commonly interfered with breathing movement are way overblown.
Corsets were not particularly constraining because they weren't particularly small, at least according to this video by a woman who's worn a corset for a spine issue since age 14 and calls it extremely comfortable: https://www.youtube.com/watch?v=rExJskBZcW0&ab_channel=BernadetteBanner
(I might have first seen this video in a ACX comment. If so, I forgot whose comment it was, so sorry for not giving proper credit!)
In the 1960s?
No, the idea of corsets and stays causing widespread issues of restricted breathing and fainting is a fiction trope that has little connection to reality. While there were a few very brief fads for tight-lacing among some members of the aristocracy, it was incredibly rare, to the degree of "man bites dog." The idea that tight-lacing was commonplace has been thoroughly debunked by several clothing historians, the most prominent being YouTubers Bernadette Banner, Karolina Żebrowska, and in particular Abby Cox. Cox worked in historically accurate costume for five years in Historic Williamsburg and describes the experience at length here: https://www.youtube.com/watch?v=DyWnm0Blmh4
For what it's worth, I have a minor interest in costuming, and have worn both corsets and stays, usually in the "historically accurate" way where the undergarment is comfortable and supporting, but occasionally tight-lacing to squeeze into a too-small garment.
While tight-lacing created a sensation of constriction which was moderately uncomfortable, I never got anywhere near not being able to breathe, much less feeling faint. Corsets aren't hydraulic presses which smash the body inward; they mostly just displace some of the flesh up or down. I was always able to breathe normally in them.
According to legend, early motion picture audiences were terrified by a movie that consisted of a train rushing towards the camera, reacting as though they really were about to be hit by a train.
The "panic" caused by Orson Welles's infamous "War of the Worlds" broadcast, however, seems to have been greatly exaggerated by newspapers that took a New Media Are Evil stance towards their new competition, radio.
2017 we tried then state of the art fully immersive, full body tracked VR in an Indiana Jones setting. People afraid of heights flat out refused to walk across a bridge that really just was a wooden plank lying on the floor. Personally I needed a couple of seconds to push myself to do it...
According to the staff there, other groups had people going into the screaming fits even.
I think the person most responsible for the myth that Orson Welles' radio broadcast caused an actual panic was... Orson Welles.
Orson Welles was awesome, which is why you can't always believe everything Orson Welles says. Same for other contenders for the title of World's Greatest Storyteller, like John Huston, Frank Capra, Shelley Winters, and David Niven.
It's funny that you think of Beatlemania as something significantly different from today, because I always thought of it as being an early example of something I think of as typical of contemporary behavior, ie. the lack of shame at behaving in an uninhibited way, shouting and bouncing about at concerts and the like. I agree that people today are over-exposed to media and desensitivized to it, so maybe they are less likely to "lose it", but on the other hand, maybe not (I have very little exposure to rock concerts and fandom and that kind of thing).
The idea that people have changed so fundamentally in 200 years is hard to understand for me.
It seems that New Kids On the Block and One Direction had similar followings with similar behaviors, despite being almost 30 and almost 60 years away from Beatlemania.
Well, the difference is that the Beatles' music was at least okay. Pop has been relentlessly optimized since then to reach the lowest common denominator.
I think "first" is a good explanation here, though before the Beatles there was Elvis...
The originator of this particular species of hysterics is considered to be Lisztomania, circa 1840s.
Here is a podcast series exploring that exact topic through the lens of cannibalism: https://martyrmade.com/human-sacrifice-and-cannibalism/
Three very long episodes but they extremely engaging and include a lot of ideas similar to what Scott writes about here.
Oh, and the conclusion of the podcast is basically, yes, people and cultures in the past were not the same humans as us.
My highly sane mother-in-law had been a 15-year-old bobby-soxer who screamed through a Frank Sinatra concert in 1945. Personally, I think that shows fine taste: Sinatra and the Beatles were really, really good.
Two anecdotes:
1. Earlier today I was reading an article about Impostor Syndrome in the most recent New Yorker. I don't have Impostor Syndrome, I was just looking for something to read during dinner. But near the end of the article one random sentence clicked for me, something about the way it described the fear of being revealed as not knowing something, and this dread started rising in me, a feeling like when you have to give a presentation in front of a bunch of people that you didn't properly prepare for.
Naturally I suppressed the feeling right away. Just like you would suppress the desire to kill your boss. No good thoughts come from that direction.
Maybe I narrowly avoided contagion with impostor syndrome.
2. I may have written this in the comments before, but German doesn't have a word for "anxiety". Instead you use different words depending on what's happening. Like stage-fright or shyness or fear or nervousness or dread or panic or uncertainty or 'under pressure' or stress or homesickness or sorrow or 'feeling tense' or concern or phobia. I think it's part of American culture to mix a lot of these things together. Sure they have some similarities, but they're also clearly different. Like hunger and thirst are similar but clearly different.
E.g. you might be unable to act because you're shy or because you're uncertain. Americans might just say they're "anxious" in both cases. I can see how if you're both shy and uncertain, then their effects build on each other and you have a stronger combined feeling. But that doesn't make them the same thing. If you're both hungry and thirsty, their effects also build on each other. (and excuse me if I got my example wrong and "shyness" or "uncertainty" are not actually examples of "anxiety". As I said I still don't fully know what the word means)
If Imposter Syndrome is an intellectual contagion, I think it spreads more on a mechanism like the Barnum Effect than koro, where it's describing something completely banal and common but making it sound unique an exotic.d
"Do you ever feel anything less than 100% competent at what you do, and sometimes think that everyone else does something better than you so you to put up a front pretending that you're better than you actually are? Congratulations, I diagnose you with not-being-a-complete-narcissist, A.K.A. 'imposter syndrome'".
Honestly, I think basically everyone has some shades of what gets called "imposter syndrome". I think it's kind of just the default state. Like I'm overall really confident at my ability to do my job, but if I were so inclined, I'm sure I could talk about having "time management imposter syndrome" where I think everyone else is more productive and better able to manage time than I am.
Maybe there's a more core, narrow definition, but it seems to me that a lot of the talk of Imposter Syndrome is this sort of broad idea that could apply to practically everyone.
The other thing about impostor syndrome is that the concept is in vogue in academia, yet academia has a very low retention rate--the vast majority of graduate students will not get full-time jobs. This means that most people who think they're impostors, really are impostors. They really aren't good enough.
How does this fit by major?
I don't think so. I can't say whether it is restricted to academia, but in academia the impostor syndrome is definitely very common among people who are not impostors.
For myself, I always had a pretty strong impostor feeling, and I think this started before I had heard of this term. And I have made a good career in academia. Actually, I *still* frequently have this feeling, even though I am pretty certain that there are no objective reasons for it.
And superstars have it, too. I have recently talked to a guy who is research-wise the most impressive person of his generation in my field. He had more than 25 papers published during his PhD, half of them at the top 3 conferences. Of course, he is now professor at a top place, but he told me that he that after his PhD, he was quite unsure whether he was good enough.
That's Richard Hanania's take.
https://twitter.com/RichardHanania/status/1528354992444174337
This assumes that the retained ones are actually better than all the ones who quit. As opposed to "had a second income" or just wanted it more or had a more supportive advisor etc.
Rather like Hollywood or political interns. When there are far more applicants than there are positions, a lot of the selection factors have nothing to do with merit.
Do you feel like your experience of "anxiety-adjacent" feelings has changed after acquiring the concept of anxiety? A good friend of mine and I have discussed it at length several times (also procrastination, although not in exactly the same way). Neither of us comes from a culture where there is a word or a singular concept for anxiety *exactly*, and both of us feel that we've started experiencing it only after being immersed in the modern English-speaking culture that focuses on it a fair bit. Our introspections suggest that it became a self-perpetuating attractor in the space of possible experiences: something "anxiety-inducing" happens => you think "anxiety" => it brings up associated feelings from past experiences => "anxiety" becomes stronger => goto the beginning. (For both of us the discovery of the concept has co-occurred with some big life-changes and relocations, so no one can draw any strong conclusions, but still.)
Also, reading that German, which is relatively close to English, doesn't have a word for "anxiety" makes me wonder whether there even are non-English speaking cultures that do.
I have not, but maybe I'm just low "anxiety" in general... I have few problems with stress, few big fears, and don't worry too much about my life or the future.
The one thing where I would score moderately high on "anxiety" is shyness. E.g. I would grab food at the company cafeteria, scan the available tables, and if there's no one I know well, I'd decide to sit alone because I don't want to deal with the awkwardness of talking to new people or people I barely know. And, relatedly, bad stage fright. But I can deal with both of these. I do occasionally force myself to sit with new people, and stagefright can be handled (not overcome) by being very practiced and by going to the bathroom five times in the thirty minutes before it's my turn.
So maybe I haven't connected the dots because only a subset of these feelings are a problem for me.
For me, it enabled me to name a very distinct feeling that previously was there but hard to describe
Well "Angst" seems to me to be the closest thing to "anxiety" in German. English seems to draw the concept from the Latin "anxius": troubled, uneasy. English "fear" is cognate with "Gefahr" (danger/risk), which makes sense- fear is more of a "justified" version of anxiety i.e. there is a real threat or risk of peril.
Angst and anxiety both ultimately have the same PIE etymology, although one has come via Latin and the other Proto-Germanic- "h₂enǵ" which seems to mean something related to narrowness/compression/constriction/anxiety. Ango/angustus in Latin (to cause pain, and narrowness respectively) and angustiz/angasaz in Proto-Germanic (narrowness, worry, anxiety).
Very curious, as one of the main symptoms of anxiety I experience is a tightness in the throat and chest. and as far as I am aware this is a pretty common experience, along with raised pulse and so on. So it might be an example of deriving an emotional state from the physical symptom. Or perhaps it is to do with the very common fear of enclosed spaces, or of being boxed in, or "caged". I suspect it is more to do with the symptomatic similarity.
Interestingly, the proto-Indo-European root word for hungruz in Proto-Germanic (Hungry), is "kenk-/kank-" which meant something like “to burn, dry, pain, desire, hunger, thirst”, which is funny considering the differences between thirst and hunger you pointed out earlier!
Angst is distinct from anxiety, it would be rolled into fear in English. It is not synonymous with the American loan word angst, and thus a false friend. American angst is equal to Existenzangst, a more specific subset of Angst. I would say that Angst is somewhere between fear (Furcht) and horror (Horror)
Using this definiton from wikipedia for the English terror:
>Terror is usually described as the feeling of dread and anticipation that precedes the horrifying experience.
that would be an apt definition for the German word Angst. Funny, because the German word Terror is defined way differently again, as systematic implementation of fear to crack someone's will, similar to the neologism gaslighting, which would fall under Psychoterror in German.
I more than once tried to translate anxiety to the German but always failed. I don't think think it's really a question of bundling other things as much as a different thing...
(interestingly, a similar for angst as in teenage angst which I also fail to find a good translation for)
Fainting used to be fashionable, but has undisputed biological causes. Struck me as a very obvious example.
Really interesting post with a lot of food for thought.
I wonder to what degree loneliness is a cultural contagion.
Anecdotally, there have been years-long periods in my life when I've had friends and relationships, and years-long periods where I've lived like a hermit- and I've actually mostly found myself to be happier in the latter. When I've made an effort to be social, it's been motivated mostly by a feeling that living like a hermit is embarrassing, and out of a desire not to disappoint people wanting to form relationships. But there's a freedom that comes with being entirely alone for long periods of time, which is often enough to motivate me to avoid all of that. I don't think I've ever felt something that matches what people describe as loneliness, even after spending weeks with no social interaction whatsoever.
Since I was diagnosed with Asperger's at a young age, I've always attributed that lack to my being psychologically unusual. But from a quick look at the data (https://ourworldindata.org/social-connections-and-loneliness#loneliness-and-aloneness-are-not-the-same), it seems that the loneliest countries aren't necessarily the ones where the most people live alone. So I have to wonder: is it possible that loneliness has some large cultural component which my self-image as someone psychologically unusual has sort of inoculated me against? Could it be that it's not something I experience because I never really expected to experience it?
And if that's the case, could that suggest that the high level of loneliness in the U.S. might be helped by more cultural acceptance of less social lifestyles?
A lot of cultures have had similar concepts, usually religious--hermits and such. American society is notorious for being particularly extroverted. One of the 'weird' things I've noticed when watching anime is how much more introverted the modal protagonist is. (Probably has something to do with the popularity of anime among those personality types.)
This post really gives me ~2018 Scott vibes, great content.
Men *don’t* get proprioceptive impulses from their penises. (Proprioception is only associated with skeletal muscles, isn’t it?)
Normally you can figure out what your penis is doing based on what you can feel (“the left side is touching skin, the right sight is touching cloth”) combined with what you know about what you’re wearing and assumptions about what direction gravity would be pulling it given your body position. But in situations where that doesn’t work (eg, skinny dipping), you’ll find that you can’t actually tell what direction your penis is pointing without looking at or touching it.
(I assume the same thing would apply to breasts?)
I'm thinking this might be related to minor hernias, with scar tissue healing poorly, bridging, and other problems.
Maybe it is not propioception in the strict sense, but most men are able to tell they have an erection while naked (no contact with clothing) with their eyes closed. Some kind of signal must be coming in.
There's more mass there, so the tissue around it ends up getting tugged down more due to gravity.
Which would also explain the lack of ability during skinny-dipping, since the mass is almost the same density as water.
I've definitely experienced "can't feel my penis" and was concerned about some kind of nerve problem, although I guess it only happens when I've been sitting and leaning forward so it's similar to a limb falling asleep. But I never worried that it was missing, just that there was some medical issue.
Fascinating review... can’t wait to re-read tomorrow.
Absolutely stellar post. Deserved a better title.
I'm also strongly reminded of something Aella said in her recent interview on Lex Fridman's podcast. She recounted how she was confused when she told people about her childhood and they said things like "Oh I'm so sorry, that must have been so traumatic". Because she had been going around with a framing and a worldview that such things were unpleasant but not unexpected - so they were not traumatic. But then she got out into a different culture and adopted a different worldview - and suddenly those childhood experiences *became* traumatic.
(I highly recommend the podcast to anyone who hasn't listened to it yet, here: https://lexfridman.com/aella/)
And all of this combines to paint the picture that the kind of culture and expectations we choose to adopt is very important!
My wife had a traumatic childhood and she always tells me the thing she wants to hear most is not "That must have been so terrible" but rather "That wasn't so bad, let me tell you about MY childhood".
The "Four Yorkshiremen" sketch?
That reminds me of an episode from the start of the culture wars, where Richard Dawkins pointed out that sexual assault, like most negative things, comes in a spectrum, and the sexual molestation he experienced as a child, while unpleasant, was not particularly traumatic and not a reason to spend life as a victim.
This did not go over well, since the SJ attitude at the time was to round up everything remotely adjacent to sexual assault to rape, and to depict rape as worse than anything, including death. I'm sure that increased young women's mental well-being...
Just a few weeks ago I had a professor casually express the opinion that being raped is orders of magnitude worse than having a leg amputated in the 18th century. Thankfully I've never experienced either of those things but if forced to choose I sure as hell wouldn't choose the leg...
Personally I’d rather lose the leg.
This all comes back to the personal narratives and framings we carry around. In mine, pain and disability are no big deal - they’re unpleasant but they happen to everybody and all our bodies stop working eventually. So if I happen to painfully lose a limb, that obviously sucks and is unpleasant, but then I’d adapt and it would be no big deal. In my personal worldview, this is the sort of thing that is supposed to just happen sometimes and it’s no one’s fault.
On the other hand if I was raped I would feel tremendously violated. That’s not supposed to happen to me. I’m a man who’s supposed to be able to defend himself.
I can understand that, but I think we're pretty good at constructing our own personal narratives. I think my personal narrative would eventually recover, whereas my actual physical leg would not.
Maybe the ability to construct flattering personal narratives is an important life skill for coping with things.
Dying happens eventually... but I'd rather lose a limb to put it off for a long while!
That's how I always felt. It never seemed "traumatic" because I found ways to cope and go on. Only when people told me that it should be traumatic did it occur to me that I should in someway be "permanently" harmed by it. Except I don't think I am, really, and if I actually am, then so what? My experiences, for better or worse, shaped me, and I cannot change that now.
She has also written about this, in case anyone prefers reading to listening: https://aella.substack.com/p/the-trauma-narrative
I find your stance in the following passage a bit perplexing:
"But he quickly moves on to a long section that tries to establish the reality of “voodoo death”, ie the thing where if you believe you are going to die hard enough, you actually die. I think most arguments for voodoo death are pretty bad, and I didn’t find Bures’ convincing....
"Is it weird to stay on the crazy train long enough to agree that cultural effects are strong enough to make you think witches are stealing your penis, and then get off it once people start talking about voodoo death? I think no - these are very different situations. Believing in koro can make you hallucinate that your penis is shrunken or gone, but no belief, however strong, can (directly) remove your penis itself. Culture → beliefs is fine; culture → reality is a step I’m not willing to take."
It doesn't require any ride on the crazy train to explain "voodoo death". I haven't read Bures's book (and hadn't even heard of it before reading your post). Hoeever, if "voodoo death" were observed, it would be much simpler to explain than a lot of what you've written about here. Each of us continuously engages in small acts of self-preservation, each of which decreases our likelihood of dying in some near interval. A person who believes strongly that they will die soon could conclude as a corollary that these acts are futile. So they may do these acts with less care and may omit some of them. At some point this repeated (and possibly even compounding) carelessness may indeed kill them.
That wasn't so difficult or mysterious, was it?
I don't think this is what anyone means by voodoo death. It's not that you forget to look both ways when crossing the street and are hit by a car, it's that you mysteriously drop dead after the shaman says you will.
If you're already anxious and getting on in years, you could have a heart attack. Seems like that would kill a lot of people before modern medicine.
Ah, I see. Thank you for explaining, that clears up my perplexity.
This doesnt detract from the message, but i would point out that sparta had no written records and everything we know about them was written by people who at some point had the shit kicked out of them by Sparta
I would point that if your culture has no written records is a pretty shitty culture. If you let your enemies write your history you deserve what you get.
I don't think we're discussing what Sparta deserves here, just trying to use true examples. Sparta having a shitty culture isn't a great reason for us to believe falsehoods.
From my reading of acoup [0], which was some years ago, I seem to remember that at least some existing sources glorified rather than ridiculed Sparta, to the point where the common meme of Spartans as hardcore badass warriors has little support in the modern historical interpretations. Not only was their way of life among the most repugnant to modern sentiments, not even their military track record is all that impressive (e.g. compared to the Romans).
Also, I don't think male homosexuality (often with an age gap which we would find problematic) was a Spartan specialty, but was also tolerated and common in the Greek societies of the sources. So the claim "Sore loser sources will just say 'spartans are teh gay'" is quite implausible to me.
In my opinion, a culture which does not have written records is not necessarily a shitty culture. I am sure that there are plenty of hunter gatherer cultures which are ok. But any culture which invents cities and then does not bother to research the literature tech tree at all can probably be called shitty. Of course, Sparta would still be shitty even if it had given us Homer, Plato and Shakespeare.
[0] https://acoup.blog/2019/08/16/collections-this-isnt-sparta-part-i-spartan-school/
My point wasnt as reductive as that, but that generally speaking claims about spartas internal workings should be taken with a grain of salt, and dont build arguments about them.
Thucydides felt the need to clarify misconceptions about their governance in his history. So misunderstanding sparta is not a new phenomenon.
Judegement of which 2000 year old cultures are shitty. Is well sigh...
A couple items:
1) My wife was a teenager growing up in Hong Kong in 1994, and she says she (and presumably her classmates) had known what anorexia was before this schoolgirl died. She posits that the ensuing rush of cases was a function of diagnosing an existing disease, not of a cultural idea getting implanted. Single data point and all that, make of it what you will.
2) After reading, I immediately ran to Uniprot to see if there really was a sodium channel named BLRG2? There's enough weird ion channels out there that I'm kind of saddened that this wasn't a real one.
On 1, it's probably some of both..
Excellent!
Re 1. yeah I was surprised by the claim, since young women starving themselves to look thin is a thing mentioned in Chinese texts going back to imperial era. The difference may just be that it wasn't considered a *bad* thing util recently
There might be a difference between starving yourself to look thin and starving yourself to death because you're still convinced you aren't thin even though you're nothing but bone, which I think happens to some people with anorexia.
The first Columbine-style school shooting I am aware of was at the U. of Texas around 1966. The next was a young woman shooting up a school outside of San Diego around 1978. When asked why she did it, she said, "I don't like Mondays." Bob Geldof of the Boomtown Rats wrote a catchy tune about that shooting, which likely helped make school shootings more of a Thing in American culture.
In contrast, some things that used to be bigger Things in America seem to have receded somewhat, such as serial killings, political assassinations, bombings, kidnappings, and skyjackings.
Oh man, I never knew that song was based on a school shooting. I thought it was based on Garfield.
Garfield originally liked Mondays, because he didn't have to work.
I read this book a while back and got curious about PMS. Here's a twitter poll that showed a decent correlation between believing in ghosts, and getting PMS: https://twitter.com/Aella_Girl/status/1589509446837075970 (tho I'm slightly more wary of twitter polls that I can't include 'see results' options in)
I then also added in a question about PMS to my big kink survey, asked to biological females only. I'm in transit (and my dataset got too huge so can't rerun it until I figure out how to run it from a hosting service) rn but can share any correlations with that soon.
(edit: Just tweeted another one: https://twitter.com/Aella_Girl/status/1628263635285086208)
Please do follow up with that analysis, when you can! I’m very curious to know what self reported ‘getting PMS’ correlates with in your survey.
I do wonder if it correlates with some 'psychological femininity' trait. Are tomboys (and nerd women) less likely to get PMS?
From my own memories, girls who misfit teen culture because they're interested in not appearing girly, proving themselves tough, or are just unusually interested in sexual privacy, don't like to talk about "having PMS".
Without learning in sex ed that the menstrual cycle may cause diarrhea and flareups in underlying disease, my introduction to menstruating included asthma flareups and embarrassing diarrhea. I didn't consider this "having PMS". I considered this, "Huh, this whole 'blossoming into womanhood' thing sure sucks donkey honkers." I *definitely* didn't want to talk about PMS, since that would sound like making excuses for myself.
When a pulmonologist suggested I start oral contraceptives for asthma control, I balked at first, since I didn't need births controlled, but asthma. As I ran out of other options, I was eventually willing to give oral contraceptives a try. And huh, they worked. The years when womanhood sucked the fewest donkey honkers for me were the years I artificially suppressed those hormonal fluctuations with birth-control pills. Childbearing years, if you have them, require stopping the hormonal straitjacket, though. I've had terrible asthma control during my childbearing years.
In retrospect, I wasn't "less likely to get PMS", but definitely less likely to admit it for a very long time, to the point where it might have been harming me (breathing is kind of important).
Yes. I had the diarrhea, and I had “falling down stairs days” where I observed there were some days when I would wake up and realise I was probably inevitably going to fall over at some point or cut myself (so I should be extra careful), and some nights where my brain’s sleep switch randomly seemed to be broken. None of this had ever been mentioned to me as things that were linked to the menstrual cycle, or “PMS”, and so it took me years to make the link (calendaring and charting seemed like a moon goddess hippie thing to do), and even longer to come across the idea that these were well-known things that women commonly experienced at the start of their periods.
The cramps and mood effects *were* mentioned, along with the possibility that they might be sexist ideas, and so I spent a long time trying to suppress them and pretend they didn’t affect me as much as they did.
Also, all the advice I was given as a teenager told me that I shouldn’t eat lots of chocolate on my period and instead should eat healthy salads, which is exactly what my body does not want and interacts poorly with the diarrhea, so I have to conclude is generic “everyone should eat salads and not chocolate” advice. I do much better with simple sugars, salt, and water on that first day, and with mint. It turns out the mint thing is also a well-known, widely-accepted, way to deal with intestinal discomfort: I look forward to the day the standard advice to girls is to eat Kendal Mint Cake and salty crisps at the beginning of their periods. https://www.nhs.uk/medicines/peppermint-oil/
EDIT: Also, if you asked me if I “get PMS” I’d probably say “no”, because I just don’t think of any of it like that. I don’t think PMS or PMD or any such unified term for some cluster of possible ‘symptoms’ specifically before the period starts is particularly helpful, as it suggests a condition or disorder rather than a whole load of different things. I think, if I were explaining it to a girl now, I would probably say that there’s a lot of different effects that women sometimes find they experience over the course of their menstrual cycle, and some of those effects can suck but there are ways to manage them and make them not as bad, and knowing they are related to your cycle means you can predict when they will start and end, and some of them might be things you should get checked out. That it is well worth keeping a brief diary of your cycle, and noticing anything different about how you feel on each day. And that ibuprofen is magic, so take it according to instructions (always with food) at the beginning of (or even just before) your period, and if you still have proper pain then you should speak to your doctor.
I don’t think I would list off potential symptoms, or tell them “some women get [named condition]”.
I'd love to know! I'm a nerd woman who has never had PMS and doesn't understand what all the fuss is about (I also don't believe in ghosts or astrology).
Re: anorexia, the most plausible-seeming explanation I've seen for the cross-cultural differences in presentation is that we've got the causality all wrong.
The theory is basically that the pathological drive to starve oneself is *caused by* rapid weight loss. All of the explicit conscious thoughts people use to justify self-starvation are either post-hoc rationalizations or amped-up versions of whatever caused the initial weight loss.
So in one society, dutiful daughters might refuse to eat out of grief over their father's death; in another, devout Christians might fast excessively out of religious devotion; in another, high achievers might starve themselves to demonstrate their self-control or achieve the perfect body. (Worth noting that these are all similar personality types.)
If this theory is correct, we'd expect to see something that looks like social contagion: whenever there's a trend of severe food restriction, especially among adolescent girls, we'd expect to see a few who don't seem to be able to stop. But in between the waves of contagion, we'd also see sporadic cases among people (mostly adolescent girls) who stop eating independently for idiosyncratic reasons.
Muslims fast during Ramadan. Why aren't droves of Muslims starving themselves to death? Many monks have ascetic lifestyles, including frequent fasting. Do we have records of lots of monks dying of self-starvation, in the same way as anorexic girls?
Muslims observing Ramadan only fast during daylight hours. Eating is unrestricted after dusk, with (typically) large celebratory evening meals to break the fast. One month of intermittent fasting without caloric restriction doesn't cause rapid weight loss.
There are some historical records of waves of monks starving themselves to death, most notably the Sokushinbutsu in Japan. https://en.m.wikipedia.org/wiki/Sokushinbutsu This seems uncommon relative to the frequency of monastic fasting, and the intentionality of it sets it apart from our usual concept of eating disorders, but monks aren't in the main risk group: anorexia-like syndromes primarily affect adolescent girls.
When girls did participate in prolonged strict religious fasting in medieval Europe, some of them developed anorexia (in this case termed "anorexia mirabilis"). https://en.m.wikipedia.org/wiki/Anorexia_mirabilis
Some other groups:
There's some mixed evidence that concentration camp survivors had high rates of disordered eating, although in their case it's mainly binge eating and food hoarding (I'd hypothesize that there's an important difference between voluntary and involuntary food restriction). Interestingly, their *granddaughters* have unusually high rates of anorexia.
Jains in India occasionally fast to death. This is usually a sort of ritual suicide akin to the Sokushinbutsu, but there are some cases that look a lot like anorexia: https://www.firstpost.com/india/jain-teens-death-raises-questions-about-religious-glorification-of-fasting-3044954.html
Most people didn't survive the concentration camps. You wonder if there's some trait that helped you survive that had adverse effects in the granddaughters. Though it could certainly be cultural--lots of upper-middle-class Jews who would be well in the typical demographic for anorexia. Kind of like the way they only recently figured out moderate amounts of alcohol weren't cardioprotective because the moderate drinkers were into exercise and vegetables and so on.
I thought it was that a fair number of non-drinkers had experience with alcoholism and had already damaged their health.
"in another, devout Christians might fast excessively out of religious devotion"
I agree that anorexia may have been present in societies before being given a formal name and diagnosis. I think that there is cultural pressure in Asian societies to maintain an acceptable weight, but the idea of Western anorexia isn't (or wasn't) identified there: if you're strictly dieting to stay thin the way you should be, then that isn't seen as a problem. See the fairly recent A4 paper waist size challenge, which started off in China:
https://www.bbc.com/news/blogs-trending-35892789
"The latest craze from China involves mostly women holding up sheets of paper and taking selfies - they "win" if the paper entirely obscures their waist. It's called the "A4 challenge" after the standard paper size that's just 21cm (8.3in) across.
...Azura Ge is a Chinese student in Boston. She told BBC Trending that she was proud to show off the progress she had made in her fitness sessions.
"A lot of people had a weird assumption that I have anorexia, which I don't have," she says. "That's very interesting for me to think that people actually believe you have to have anorexia to be this skinny."
However, I saw some photos of men doing it as well, so it's not confined to one sex.
As for fasting - again, yes. St Catherine of Siena, the 14th century mystic, had people concerned about her fasting and wrote an exasperated letter about "I want to eat, I just can't":
http://www.domcentral.org/trad/cathletters.htm#2Religiousman
"TO A RELIGIOUS MAN IN FLORENCE WHO WAS SHOCKED AT HER ASCETIC PRACTICES
In the Name of Jesus Christ crucified and of sweet Mary:
Dearest and most beloved father in Christ sweet Jesus: I Catherine, a useless servant of Jesus Christ, commend me to you: with the desire to see us united and transformed in that sweet, eternal and pure Truth which destroys in us all falsity and lying. I thank you cordially, dearest father, for the holy zeal and jealousy which you have toward my soul: in that you are apparently very anxious over what you hear of my life. I am certain that nothing affects you except desire for the honour of God and for my salvation, which makes you fear the assaults and illusions of devils. As to your special fear, father, concerning my behaviour about eating, I am not surprised; for I assure you, that not only do you fear, but I myself tremble, for fear of devilish wiles. Were it not that I trust in the goodness of God, and distrust myself, knowing that in myself I can have no confidence. For you sent, asking me whether or no I believed that I might be deceived, saying that if I did not believe so, that was a wile of the devil. I answer you, that not only about this, which is above the nature of the body, but about all my other activities also, I am always afraid, on account of my frailty and the astuteness of the devil, and think that I may be deceived; for I am perfectly well aware that the devil lost beatitude, but not wisdom, with which wisdom, as I said, I recognized that he might deceive me. But then I turn me, and lean against the Tree of the Most Holy Cross of Christ crucified, and there will I fasten me; and I do not doubt that if I shall be nailed and held with Him by love and with profound humility, the devils will have no power against me--not through my virtue, but through the virtue of Christ crucified.
You sent me word to pray God particularly that I might eat. I tell you, my father, and I say it in the sight of God, that in all ways within my power I have always forced myself once or twice a day to take food. And I have prayed constantly, and do pray God and shall pray Him, that in this matter of eating He will give me grace to live like other creatures, if it is His will--for it is mine. I tell you, that often enough, when I have done what I could, I enter within myself, to recognize my infirmity, and God, who by most special grace has made me correct the sin of gluttony. I grieve much that I have not corrected that miserable fault of mine through love. I for myself do not know what other remedy to adopt, except that I beg you to pray that Highest Eternal Truth, that He give me grace, if it is more for His honour and the salvation of my soul, to enable me to take food if it please Him. And I am sure that the goodness of God will not despise your prayers. I beg you that if you see any remedy you will write me of it; and provided it be for the honour of God, I will accept it willingly. Also I beg you not to be light in judging, if you are not clearly illumined in the sight of God. I say no more to you. Remain in the holy and sweet grace of God. Sweet Jesus, Jesus Love."
Was there just this constant fear of the devil tricking you into some prideful action and a total dependence on the grace of God in their daily lives, or was this mainly a virtue signaling protocol for letters and other communication?
Penises don't disappear or retract into the body –– but men are subject to hormonal fluctuations, which can be induced by psychological states (I'm not talking about arousal but sort of its opposite) and produce visible bodily effects. These states are plausibly subject to placebo (or, in this case, nocebo) effects. It wouldn't be shocking if some traditional witchcraft worked on this mechanism.
And there I thought my penis had shriveled just because I am old. I much prefer the new diagnosis. Burn, witch, burn!
This paper found widespread PTSD symptoms among warriors in a pastoral African society, suggesting that it's not culture-bound. .
From the abstract:
"It is unclear whether combat-related PTSD is a universal evolutionary response to danger or a culture-specific syndrome of industrialized societies. We interviewed 218 Turkana pastoralist warriors in Kenya, who engage in lethal cattle raids, about their combat experiences and PTSD symptoms. Turkana in our sample had a high prevalence of PTSD symptoms, but Turkana with high symptom severity had lower prevalence of depression-like symptoms than American service members with high symptom severity. Symptoms that facilitate responding to danger were better predicted by combat exposure, whereas depressive symptoms were better predicted by exposure to combat-related moral violations. The findings suggest that some PTSD symptoms stem from an evolved response to danger, while depressive PTSD symptoms may be caused by culturally specific moral norm violations."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054015/
autocthonous > autochthonous
Do we know the Spartans actually acted like that?
There is a concept in classics of the "Spartan mirage", almost everything written about Sparta was written by Athenians vilifying or praising them, almost no sources about the Spartans were written by them so we get an extreme and exaggerated impression of them.
https://yalebooks.yale.edu/2016/10/06/was-there-a-spartan-mirage/
It would be consistent with other cultures we know of, including rural Afghan culture in the modern day.
I thought the Spartans insulted the Athenians as being "boy-lovers", which would seem to indicate that they thought pederasty was not an acceptable practice. Unless they meant something more along the lines of what we would now call homosexuality; sure, being the eromenos of an erastes is a socially necessary role, but if you're fucking boys/men because that's the kind of sex you like, you're a pervert.
https://en.wikipedia.org/wiki/Pederasty_in_ancient_Greece
"Since the publication in 1978 of Kenneth Dover's work Greek Homosexuality, the terms erastês and erômenos have been standard for the two pederastic roles. Both words derive from the Greek verb erô, erân, "to love"; see also eros. In Dover's strict dichotomy, the erastês (ἐραστής, plural erastai) is the older sexual actor, seen as the active or dominant participant, with the suffix -tês (-τής) denoting agency. Erastês should be distinguished from Greek paiderastês, which meant "lover of boys" usually with a negative connotation. The Greek word paiderastia (παιδεραστία) is an abstract noun. It is formed from paiderastês, which in turn is a compound of pais ("child", plural paides) and erastês (see below). Although the word pais can refer to a child of either sex, paiderastia is defined by Liddell and Scott's Greek-English Lexicon as "the love of boys", and the verb paiderasteuein as "to be a lover of boys". The erastês himself might only be in his early twenties, and thus the age difference between the two males who engage in sexual activity might be negligible."
So something like the exceptions we permit to statutory rape: if there is only a couple of years difference between the minor and their boyfriend/girlfriend, that's not legally treated as sexual abuse/rape. On the other hand, if you're thirty and they're fourteen, it is.
https://en.wikipedia.org/wiki/Statutory_rape#Romeo_and_Juliet_laws
I read about some weird Sparta stuff... I think Bret Devereaux. here,
https://acoup.blog/2022/08/19/collections-this-isnt-sparta-retrospective/
There are plenty of cultures where homosexuality is encouraged, but I have never heard of one where hetrosexuality I seen as taboo or men dislike it.
Rural Afghan culture is also a culture with not a lot of indigenous writing, but instead a lot of writing done by people who have killed them or been killed by them.
When I was stressed at a certain point in my life, I read about people in the past who had “nervous breakdowns“ and were sent by their families to the South of France for six months to recover. I remember thinking that I wanted a nervous breakdown too, it seemed like a good way of escaping. But how would people know it was a nervous breakdown I was having and not just being a bad and lazy person? The question is what cultural position do you have to be in to justify your emotions?
I read somewhere that a lot of what used to be called hysteria (in the 19th century at least) may have been temporal epilepsy which apparently can involve a feeling of something rising up from the lower abdomen. Maybe this is just a retrospective interpretation.
I think we call that burnout today. I was once diagnosed with it, and I did feel better after two weeks off - but I never knew if I was really "burned out" or if I was just tired and needed some more sleep.
Burnout is definitely a culture-bound disorder. I’m American but lived in Europe for a while, and the first time someone told me they got six weeks of paid leave for burnout I think my eyes popped out of my head. It is simply not a thing in the United States, at least not in my cultural corner of it. If at any point I had told my parents I was suffering from a condition called burnout and had to take a medically mandated vacation they would have responded with laughter or rage. Probably both.
Rock stars get hospitalized "for exhaustion" but few others do.
Great book review. I can't help but think of Korean Fan Death, which seems analogous to Voodoo Death.
I got the Dalmatian and the cow instantly, whatever that signifies. Unfortunately Scott's text had primed me for the gorilla before I had parsed the instruction not to go further, which might be related.
The transgender ideology bit is confusing, giving the previous context: I can't tell if Scott is proposing a real phenomenon of penis-stealing witches made flesh via academia, or examining the people who are afraid of them.
It's not clear that fan death actually happens in the sense of people dying due to it. It could rather be that it's given as an explanation in circumstances where the actual cause of death is either mysterious or shameful (like drug overdose). Anyway, I don't think it's admitted as an actual legal cause of death anyway, can you image a British insurance company looking at a death certificate for a tourist that had "Cause of death: Fan"?
My state of understanding it was that "fan death" was a way to cover up a famility member's suicide, with a semi-believable cause that people are kinda ready to accept as possible.
But I don't speak korean and never spoke to one, so I can't really tell what's what.
I hadn't heard this sadly plausible explanation before. Thanks to both of you for your replies.
FYI, I tried to unearth the years-old source I had for that piece of trivia, and could find jackshit. For all I know, it may have been a 4chan greentext, so...
I think the British insurance company would just assume that the death was much more gruesome than it actually was.
I thought it was a joke.
I would like to raise awareness of St. Vitus' Dance https://en.wikipedia.org/wiki/Dancing_mania
Maybe unrelated but parts of Europe went a little crazy after Luther's reformation. (I specifically thinking of Dan Carlin's "Prophets of Doom" episode. (1500's)
I want to interrupt here for an importnt cultural touchstone: The Carpenters
Maybe you are too young (<30) to have heard of The Carpenters, or just never really heard them, or long ago dismissed their music as simple-minded treacle-y pap, un-hip, simple, maybe vaguely icky-Christian or cultlish. Maybe the idea of a brother and sister singing love songs *to each other* weirded you out on some fundamental level. but if so, you need to stop in your cultural tracks and listen to them again. REALLY. NOW. BECAUSE:
Karen Carpenter's voice was absolutely glorious, she was one of the greatest female singers ever recorded. Plus, those recordings were at the Golden Age of Los Angeles studio musicians, and recording technology, even the few bad songs stilll have a magical golden shimmer about them, and ... My God that voice.
I can elaborate below, but you owe it to yourself to hear this.
BR
Well, I found a Middle English translation of the Fiore di Virtu.
(https://quod.lib.umich.edu/e/eebo/A16439.0001.001?view=toc) Seemingly no penis theft. But sounds like Die Blumen der Tugend is this plus its own additions, so maybe they added it in.
According to Google Translate, the German word for 'penis' is 'penis', so you can maybe word search it.
You could have easily stepped into the cultural disease called "Climate Crisis." But that disease is far too early in it's course for most people to stand outside and measure it's breadth.
Minor warning (25% of a ban): I don't think you're actually making a useful analogy here, I think you're just trying to inject controversial politics in.
"Climate anxiety", sure, but I think even its sufferers would probably agree. Climate change itself is quite straightforward physics.
Consider that sea level rise is the culmination of all climate change. That if you look at NOAA sea level data for San Francisco, California, sea level rise begins in 1863, a full 87 years before co2 rise.
Does the future control the past?
The fixation of sea levels is not helpful but not your fault so I'll give you a pass. However, it's important to keep in mind that local sea levels may fluctuate a surprising amount, so you shouldn't be looking at sea levels in any one city but the global change in sea level everywhere to avoid understating, or indeed overstating, the effect.
My usual response to this common true-but-misleading data point.
https://skepticalscience.com/sea-level-rise.htm
https://www.nature.com/articles/climate.2010.29.epdf
That it is not. It's certainly frequently presented in the pop science press that way, unfortunately -- including the cartoon-model phrase "greenhouse effect", a model of marketing invention but corresponding in no reasonable way to the actual physics.
An interesting and lucid primer on the various components is here:
https://clivebest.com/blog/?page_id=2949
Even if climate change were not real (which it definitely is...) I don't think "believing in false idea" alone could be considered a "cultural disease". Otherwise we're going to need to add 10,000 new psychiatric disorders to our language. Different groups of humans believe a lot of different dumb shit.
One side or the other is suffering from "cultural disease."
Not in the way Scott is referring to here. Not much more to say.
Lin'guo > Lin'gao
(Also, "regular Chinese" is a bit of a strange phrase in the context you use it. It feels a bit like saying "Basque is not at all related to regular Spanish" - it isn't like there is some kind of "irregular Spanish" that it is related to.)
I'm not sure I completely follow the section on PMS. Even if it were 100% cultural, your wife would still feel the very real symptoms. I don't understand how her mother's ability to diagnose PMS would change based on its position on the cultural-biological spectrum.
I was also confused by this.
The issue is that people seem to have symptoms before they know they are about to have their period. That’s hard to explain with a cultural explanation.
I mean... I think it would still be possible for there to be biological changes during the menstrual cycle noticeable enough for a person to be able to predict their period in advance *and* for the precise way in which those changes manifest (ie, the PMS symptoms) to be culturally determined. Like the pictures in the article, the white and black dots are definitely there, but the dog and the cow are only apparent once this is suggested to us.
True, though I think it gets difficult to falsify if people are subconsciously identifying and expressing patterns before they know what pattern they're matching.
Anecdote against anyway: once when I was nine I had a horrible day where I picked fights with everyone and ran off crying when confronted about it, noticeable and slightly puzzling to everyone. The next day I woke up feeling better, but also mysteriously peeing? leaking?? blood. I got crash course puberty ed that day, continued to have weird mood issues every month, and learned about PMS years later with the rest of my peers.
I don’t think Bouffée délirante is a culture bound syndrome - it’s just the French equivalent of brief psychotic disorder (DSM), acute and transient psychotic disorder (ICD), or Brief Limited Intermittent Psychotic symptoms (CAARMS).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581951/
Have you ever seen BPS? I almost never have, and was told it was mostly used as a code for new-onset schizophrenia that didn't satisfy the time criterion yet.
Yes, in the context of an At Risk Mental State service, where it makes up roughly 20% of referrals https://www.sciencedirect.com/science/article/pii/S0924977X20302510
At 3 years follow-up, 1/3 of brief psychotic disorders will have developed a persistent psychotic disorder (ref in my original comment) but I guess that means that most do not.
I'm not a psychiatrist, but I have seen BPS twice (once in a colleague and once in a close acquaintance). Both matched the description of Bouffée délirante/BPS, got better in about 2 weeks, and were not followed by any relapse of any psychotic symptome. (Also, both happened outside France to non-French people.)
I suspect a possible selection effect - bias on your behalf here.
Think about it: Most of those who experience BPS are unlikely to ever see a psychiatrist. Precisely because it is a one-off experience.
...or if they do, they are probably going to terminate their consultations with a psychiatrist much earlier that the skizophrenic types.
...implying that psychiatrists' view of "what is the usual trajectory" is biased toward the long-term ill, rather than the fast-recovering. The latter might theoretically be the dominant/more common group.
Mind you, this is an hypothesis; I have not checked the numbers. (And checking the numbers will in any case be difficult, or almost impossible, to do, if it turns out that most cases of BPS go unrecorded.)
Yes, this is the Clinician’s Illusion https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493477#
Thanks for the reference.
Hi,
I'm a french senior psychiatrist. I was told in my intership that "Bouffée délirante aigüe" is a clinical entity, not a syndrom, which appears to have a pretty name coined by a french a alienist from classical era. Although unnamed, the concept exist everywhere.
It's simply that, in most psychotic disorders, it's easy to make a syndromic diagnosis, mostly from the biography or other upstream clinical features. For exemple, megalomaniac delusions + speech acceleration + decrease sleep in someone who has post partum depression antecedent and bipolar disorder in her family : easy, it's a manic episod.
But, in some cases it's not possible to draw a firm conclusion. Mostly when it's a first episode (with affective AND psychotic symptoms), without prior symptoms and with fair psycho-social functioning. Hence the concept of "bouffée délirante aigüe" wich mean "I have no clue yet about what the fuck happen". Traditionaly it is said that the outcome is 1/3 schizophrenia, 1/3 bipolar disorder, 1/3 brief psychotic disorder (borderline personnality disorder, undiagnosed pharmacopsychosis, anti-NMDA encephalitis...).
Same issue everywhere, actually. We, French, have a poetic name for it.
To be fair the initial description from Magnan (1866) is limited to the brief psychotis disorder, while "Le manuel d'Henri Hey" (i only have the 1989 edition, but it was mostly writed between 1950-1980) is quite unclear about what is or not the "Bouffé délirante aigüe".
Sorry for my english,
TH.
Always interesting to hear the French perspective, thank you for sharing!
You're welcome. I will follow your substack !
After reading the text I realised I had completely misinterpreted that first picture. I didn't initially notice the penis in her hand or the basket of previously-stolen penises next to her. So I assumed that the penis theft had already happened, and now the guy is sitting there looking dejected, while his female partner is consoling him and assuring him that she still loves him -- in other words, a typical ad for erectile dysfunction treatment! So I guess that counts as another example of culture-mediated interpretation of an ambiguous image.
Huh, I'm still just seeing a dalmation.
Data point:
When I read about Scott's ants and his itches, I myself had an itch (because social contagion, or just suggestibility - is this the same thing?) but I didn't assume it was ants (because I have no prior on ants).
No immediate conclusion, but I wonder, having read this and had this thought, whether when I have another itch whether I will then assume ants.
I wonder if itching should be thought of a bit separately from the rest of these. Having a very particular sensitivity to other people being itchy seems adaptive...
I get the impression that you're working with an understanding of culture-bound illness that is limited to "cultural belief -> psychosomatic condition". Is there anything ruling out the possibility of "cultural belief -> internal mental processes affecting real physical processes -> physical condition (possibly in addition to some strange psychological reaction which may not be itself directly caused by the cultural beliefs, ie someone from another culture would feel the same way if they were affected by the physical condition, but they aren't so they don't)"? I feel like that pathway could explain some scenarios.
I'm pretty sure that Scott believes that internal mental processes are real physical processes, and everything affects everything else on a real physical level.
Scott,
Leah Libresco Sargeant (above) mentions "...the physical and emotional cost(s) of [gender] dysphoria and associated treatment..." My question, and one that I see very much avoided, is:
-- What about the $$$$ cost?
-- Who is paying for all of these surely $X00,000+ treatments?
-- Where is this money coming from, and why are there suddenly more than 100 "gender" clinics in the US now, when there were zero ten years ago?
Given that insurance, both private and public, dictates and/or causes the vast majority of treatment decisions in the US, surely something suddenly changed ~7-10 years ago and now "gender transition" is booming. I don't think that change was a sudden grass-roots upswell of concern for and about actual LBGT+? issues and kids. I strongly suspect the difference is that suddenly, almost overnight, "gender transitioning" became very, very lucrative.
Do you or any commenter have knowledge of how this industy is financed? I am especially curious that "at-risk" and poor youth, by definition "charity" patients, are a major percentage of gender referrals, government programs or grants must be paying the doctors running these brand-new clinics.
_____________
The late David Foster Wallace, in a great deep-dive into political Talk Radio circa 2004, reminded us that it's always informative to follow the money:
"Whatever the social effects of talk radio or the partisan agendas of certain hosts, it is a fallacy that political talk radio is motivated by ideology. It is not. Political talk radio is a business, and it is motivated by revenue. The conservatism that dominates today's AM airwaves does so because it generates high Arbitron ratings, high ad rates, and maximum profits."
I think that the Occam's Razor perspective in the above paragraph should be uppermost in people's mind when thinking about the intersection of media, social-media, culture, and a US healthcare industry that now consumes 17% of our GDP.
Very much worth reading, BTW. Most of it still incredibly spot-on, even almost 20 years later:
https://www.theatlantic.com/magazine/archive/2005/04/host/303812/
BR
_______________
Also, Wallace's troubling description of home morgatge financing companies' being like 50% of the ads on the radio in March 2004, seems a disturbing parallel to how 100+ Gender Transition practices have appeared since 2016:
"As of spring '04, though, the most frequent and concussive ads on KFI are for mortgage and home-refi companies—Green Light Financial, HMS Capital, Home Field Financial, Benchmark Lending. Over and over. Pacific Home Financial, U.S. Mortgage Capital, Crestline Funding, Advantix Lending. Reverse mortgages, negative amortization, adjustable rates, APR, FICO … where did all these firms come from? What were these guys doing five years ago? Why is KFI's audience seen as so especially ripe and ready for refi? Betterloans.com, lendingtree.com, Union Bank of California, on and on and on."
Transition care for trans adults in the clinic setting consists of a few office visits, a few lab tests, and then prescribing dirt cheap generic hormones and refilling them once every 6-12 months, for a disproportionately low-income population whose members are likely to be on Medicaid or uninsured. It's not profitable at all. Most clinics rely on donations and/or public-health money for other services (many are combined/co-located with reproductive health and STI clinics).
Kids get more monitoring, but it's really just office visits, blood tests, and old generic drugs. There aren't any lucrative procedures or fancy new pharmaceuticals. If you wanted to get rich selling drugs to kids, an ADHD clinic would be a vastly better investment than a gender clinic.
Plastic surgeons charge cash rates comparable to their rates for similar surgeries on cis people, so they're compensated well but not so well that they're financially-incentivized to market to us over other groups. And insurance reimbursement rates are much worse than cash, so hardly any surgeons even accept it (especially Medicaid).
I am sure that many of the things you describe are true, or certainly true for some percentage (maybe most) of these patients.
And yet -- there is an enormous rush into this specialty. And, to put it bluntly, doctors exist to make money. Doctors, hospitals, managed-practices, Universities (especially) would not be switching specialties. establishing branded Clinics, investing prestige and money in this field if was not profitable, and quickly profitable, with a very big potential pool of patients.
I agree that it isn't likely to be "Doc Hollywood" profitable on a per-patient basis. But you mentioned a few other sources of funding: "Most clinics rely on donations and/or public-health money...." Since the US Govt pays for and directs so much of the whole medical industry, has something there changed? Huge blocks of new grants allocated to this field? (I've read scuttlebutt that almost any grant proposal with "gender" and "trans" in it is 99% certain to be approved.)
Private donations was a revenue stream I had not immediately thought of, this is surely a visible, popular (some might say *mandatory*) cause among celebrities and overwhelmingly left-leaning charitable orgs. I can imagine a two-way social contagion effect, where rich donors want to "contribute", and need to be publicly seen doing so (lest they get heckled, dogpiled, cancelled, dragged, and generally mau-mau'ed for being "transphobic"), and prestige-seeking universities and colleges, besides just wanting the $$$ per se, also can't afford to be seen as "that Other medical school that doesn't even have a Gender-Affirming-Care-Centre because they are hateful."
This is where I would like to see some numbers. (1) But I never hear $$$ even mentioned. As readers here know, charitable donations are very public records, yet no news organzation seems likely to do some basic journalism and some basic math on a rapidly growing medical field, despite health care and medical "news" dominating the headlines and filling half of every newspaper, even before covid.
Two unpleasant things that need to be said:
1) Even if the clinical practices you mention don't yield huge per-item payments, they also seem to require almost ZERO effort or investment. Or new training, or certification, or even actual patient contact, and as you mentioned very little patient follow-up. (And it seems, so far, very little malpractice risk/exposure.) I could imagine, maybe $4-5000 in revenue, for maybe a half hour, total, of doctor time, and an hour's staff work. And a patiend pool that keeps growing, a constant stream of patients with no cost-of-sales.
2) With children, any billable events here simply did not exist ten years ago. Children, overall, are rarely ever seriously ill, and, statistically speaking almost NEVER die, certainally not from any causes that are medicable. But being able to diagnose a new condition and billable treatment for it is kind of like finding money on the sidewalk, in a major way.
Look, I'm not directly saying all this gender transition stuff is totally made up malarkey, or that all doctors in this field are cynically exploiting a sudden penis-stealing or penis-yearning phobia/mania by exploiting kids to chisel five or ten grand a pop out of some pool of medical funding. I do think some are, and that some recent wellspring of money, whether insurance, grant, foundation, all of the above, suddenly made it much more POSSIBLE for this to take off.
With death certificates, there is usually a underlying cause (cancer, trauma, drug addiction), and then a proximate cause (organ failure, blood loss, overdose.) Scott's excellent post frames social contagion and manias in terms of a fear/anxiety and then its' local cultural form/expression. These sorta correspond to a traditional reporter's questions of "Why?", and "How".
I guess I'm asking the questions, "When", as in, "Why is this happing right now, what changed in the environment?" And the related question of "Who?" In a film noir, "Who" really means "Who paid/got-paid" In the US healthcare system, modeling "When" seems like an engineering calculation where one term -- Government payments and government approvals -- grows exponentially so that all other terms esentially become a rounding error for values of x > n, and to mix and muddle math metaphors, solve for the intercept, or the "knee" where that growth take off....
It has taken me all this time to realize I am trying to say that the witch hunters charged for their services, and they had financial incentives to find witches they could be hired to deal with. perhaps it has been commented upon, but any social contagion surely has some people trying to spread the ideas and fears because they stand to profit from it. And some for whom "profit" actually meant keeping their job, identity, worldview, reason for living, noble goal. Like, say, a pious and dedicated Witch Hunter. (2)
Sorry this became rambling.
BR
1 -- To be clear, I'm not *demanding* you personally, provide those numbers, like right now, on ACX. I'm saying in general I want more info about funding.
2 -- Like what if a town got really worried about wolves replaced that silly crying boy (that they all kicked out of town years ago because he was making stuff up to get attention) and started a Department of Wolfland Security. A dozen full-time guardsmen, looking out for Wolves.
Does the DWS ever go to the Town Elders and say, "Look, we haven't really seen any wolves around lately, and even if we did, you don't need 12 guys. You could easily cut us to just six. And the guys are bored, some want to start a business selling anti-wolf gear, which would be a violation of our contract, so they want to move on...." Hmmm doubtful.
Is it really that inconceivable to you that people might do something because they're convinced it's the right thing to do? Even when you nod toward the possibility of non-financial motivations, you frame them in terms of social pressure.
The concept probably isn't inconceivable to them, but the rate of change might be.
Do you have any sources to back up your claims? Evan James has the receipts for their own care which goes against your claims.
I am sure it has been mentioned, but "social contagion" around children's health care surely affects the parents as much or even more than the kids. After all, parents are the ones with the money, or at least the authorization that can open the billing spillway. And we see all around us that for many people and of course many parents, virtue-signalling is constant and of vital importance, while "showing-off" your children to society has always been another area of competition in the tribe/society.
_____________________
I don't think very highly of doctors, as a group, unfortunately. I believe that lots of medical-gender practice is entirely motivated by revenue and opportunity. I realize that said suspicion might seem to be more political than strictly rational[ist].
In defense of my mistrust, or rather to outline it really, I started writing a kind of unstructured {list} of the huge moral hazards I see around brand-new medical treatments for children. But it quickly became too arch and mean-spirited, like a Zvi Mowshowitz Chat API that "trained" on 24 hours of Don Rickles' jokes. Unlike, say Microsoft, I spiked it before I hit "post".
Then I suddenly realized: the real difference between me and Microsoft, is that, while I am unusually confident that I will never weaponize anything "Sydney" says to destroy Microsoft, I'm not sure about the reciprocal. Hmmmm......
Again, what revenue? What are they billing for that's so much more profitable than anything else an ethically-flexible doctor could do to make money?
I'm pretty sure my primary care doctor loses money on my hormone treatment. He has to submit refills every month because controlled substance, so that's around 15 minutes of work once a month (3 hours a year), plus another hour or so on the phone once a year to redo my prior authorization. If you attribute the entire $185 my insurance pays for my annual physical to my transition care, he's grossing under $50/hr at best. I'd be shocked if that even covered the overhead costs.
Children's gender clinics might be less unprofitable because they actually see the kids pretty often, but we're still talking about office visits and psychotherapy, both of which have notoriously low reimbursement rates.
My prescription itself costs under $25/month (and that's only because my insurance company insists on paying extra for 1-month refills just to be annoying). Not free, but it's a rounding error in an insulin/GLP-1 agonist/fancy ADHD prodrug price tag.
And my surgeon charged me $8200 for a 3-hour major surgery under general anesthesia, including hours of consults and follow-ups. Now, he's obviously making a good living, but that is an incredibly reasonable price. I've seen exploitative medical pricing and that is not it.
(Based on the marketing emails I get from his office, I'm pretty sure most of his profit actually comes from selling scar creams and massage, skin products, and other cosmetic treatments of dubious efficacy.)
Even if you can find some source of significant profit somewhere, it still only explains the US; rates of youth trans identification are rising everywhere where it's perceived to be safe to come out.
This is an attitude (it's not a moneymaker at all) that I haven't seen anyone really raise, and I think it needs to be said because those who make conclusions (regarding moneymaking conspiracies etc.) without knowing the details are just hilariously wrong. I had to go out of pocket for HRT for a while and it was certainly not a traumatic expense of the kind we see in other areas of healthcare.
Before the controversy, Vanderbilt's gender clinic was touting the profitability of its gender clinics because of the multiple follow ups. The hormone visits are frequent and take 30s but are billed for a full rate. Top and particularly bottom surgery require extensive post-op monitoring. See, for example:
https://health.wusf.usf.edu/health-news-florida/2022-09-22/governor-wants-probe-of-vandy-hospital-after-doctor-touts-trans-procedures-are-money-makers
Rikku-chan! Unspeakable crime that you did not post this if that's an accurate description of it.
Gender affirming treatment in general (I don't know if there's stats for specific interventions) seems to take the rates of suicide in trans teens from 10x control to within normal ranges. That's a level of effectiveness we can only dream of for treatments for depression, where we spend a lot to get a relatively minor effect. So even if the costs are as high as you are claiming I wouldn't be surprised if it worked out positive in dollars per QALY.
I am very skeptical of this claim. For example, here is a dive into a study touted by the researchers as showing the effectiveness of interventions on minors, where it turns out the data actually showed NO improvements.
https://jessesingal.substack.com/p/researchers-found-puberty-blockers
There tends to be an obsession with medical interventions in this discourse compared to others and I find this bothersome. There's no reason these two claims need to disagree -- gender-affirming psychotherapy, for instance, is much less emphasized than certain endocrine treatments and it might mostly be because those endocrine treatments tend to scare people more, despite being very uncommon.
Well, in terms of the general discourse, I think the reason people spend their time discussing/debating medical interventions rather than talk therapy is that they are worried about the former, and not about the latter. If people aren't opposed to psychotherapy, of course they won't be debating it.
But more to the discussion at hand, I suppose my linking this discussion of medical intervention is really just to paint a picture of where my baseline skepticism of research claims in this field comes from. This piece of research supposedly shows why some particular interventions are effective, when in reality it shows nothing of the sort. So I wouldn't be surprised if something similar is happening with the 10x suicide reduction claim (OP, I would be interested to see where that claim comes from).
And if it is the case that there is reduction in suicide comes mostly from, e.g., psychotherapy rather than medical intervention, I think that is something that should be generally clarified in the conversation (though I appreciate OP's caveat). I think otherwise such figures will be smuggled into arguments in favor of specific, not-supported-by-the-evidence, interventions.
For what it's worth, I've read about transition not being covered by insurance at some time in the past. I assume people saved their own money for the most part-- that it's possible for people to save a fairly large amount for something that's extremely important for them.
I Abro Cinii won the money on Jeopardy for her surgery. This is someone who was well known in east coast sf fandom.
Hey, what happened to the edit button?
Anyway, more careful memory suggests that she wrote a song called "I Won My Breasts of Jeopardy", so it may not have been all of the surgery.
Hey ! The edit button is gone for me, as well ! I wish it would come back :-(
Estrogen and testosterone are dirt cheap, as are the blood tests to test for them.
There is a fantastic article on this (the modern profit incentive for trans care) in Tablet, entitled something like “The Rise of Synthetic Sex Identities”. Highly recommend.
"Okay, so which of our mental disorders are culture-bound?"
My first thought upon reading this was, "Am I *really* sure that during the endless hours I (and everyone else affected by this culture) spends staring at the glowing rectangles, that I'm not just hallucinating that there's meaningful content being communicated to me?" From the outside, it would probably look like it, an ever-expanding trend of people spending more and more time sitting and staring at the things.
(No, this idea does not actually hold up unless one posits some *serious* mental dysfunction about everything remotely related to our activity on the glowing rectangles, which now underlies basically every element of life.)
There's also the accumulation of huge amounts of knowledge about pastimes.
Wow, what an amazing article! It explains so much in such a convincing way! It is a great framework to understand the expression of all these conditions.
And I am also amazed by the way you write your demonstration: your ideas are presented so efficiently that I thought "oh but this is a predictive processing like mechanism" just a few sentences before you explained that it is.
In the case of running amok, it sounds like the culture has a special sort of acceptance/forgiveness for it. I bet that is an active ingredient in the presentation of the condition, as it creates an incentive to channel one's anger into this presentation specifically.
It makes me wonder how important these sorts of things are for the conditions. For instance, has penis-stealing witches just been random accusations, or have they been linked to long-standing conflicts between people?
Or beyond the case of conflicts, I know obesity has increased in a lot of places; how sure are we that anorexia isn't linked to this? (more obesity -> essence of beauty becomes being thin -> more anorexia)
In the case of gender dysphoria, there is a cultural distinction between those who think it is important for men to be masculine/women to be feminine, and those who don't (or who think gender-atypicality is admirable, and that you can choose your gender). Gender issues are disproportionately reported by the latter: https://surveyanon.wordpress.com/2022/10/12/towards-a-comprehensive-study-of-potential-psychological-causes-of-the-ordinary-range-of-variation-of-affective-gender-identity-in-males/
This is commonly discussed in the trans community (under the label of "repression", which was discussed even decades ago), and our culture has become much more gender progressive over time, which probably accounts for a big change in the presentation of gender dysphoria.
I genuinely had an experience like this recently. I'd been putting off going to the dentist for far too long, because it's something I'm anxious about, and felt a cavity with my tongue. This caused me to both make an appointment, and start having a lot of unhealthy thoughts about what the dentist would discover. During this period I didn't look at the tooth visually, all I could do was feel it with my tongue.
I genuinely, unambiguously felt the tooth becoming so weak that it folded in on itself and collapsed. I could move the thinnest wall around it back and forth with my tongue. Clearly the enamel was so thin, it had become flimsy and malleable, there was nothing but enamel left. It was a disaster, how could I have been so neglectful?
Except, of course, it wasn't. And sometimes in that week waiting for the appointment, once I woke up, it didn't feel malleable. It felt like a tooth that happened to have a cavity right next to an old filling, which happens a lot. I went back and forth through these clear, physical perceptions going up and down over the course of several days. Of course once I went to the dentist it turned out to be a run-of-the-mill (though rather bad) cavity, and the physical perceptions completely stabilised. Until it was fixed, it felt like just a tooth with a hole in it, which is what it is.
I still remember the perception of it moving an collapsing so vividly I'm not quite sure how to process at. I also remember thinking AS IT HAPPENED that it wasn't actually happening, that it was a perception driven by anxiety, and yet that not quite getting through to most of my brain. When I read about the men whose penises are retracting, I can't help but think about that damn tooth, so decayed it was collapsing in my mouth, except it wasn't.
>What if transphobia is our culture’s version of the penis-stealing witch panic? Wise but evil women (gender studies professors) are using incomprehensible black arts (post-modernism) to make people lose their penises.
I realise this passage is tongue-in-cheek, but I wouldn't describe this narrative as transphobic. One could frame it as such: "I treat trans people with respect and compassion, but gender dysphoria seems like a debilitating and distressing condition which no one would choose to have if they could help it. If it does spread (partly) via social contagion, it's irresponsible for gender studies professors to promote it or glamorise it."
Pedantic comment from a Queenslander living in Tasmania now. There have been a few claims of Tasmanian tiger sightings in Cape York, the pointy northern bit of Queensland, as there have been in all sorts of other places in mainland Australia (home of the somewhat similar dingo), and one group of local scientists did go have a look. But the wilds of western and northeast Tasmania are where most of the claimed sightings are, and also where dingoes aren’t, and so that’s where the hopeful spotters mostly go.
yeah I read that and thought "wait, that Cape York? these Tasmanian tigers seem to have gotten very lost"
Hmm, I didn't remember the exact place they were claiming, so I looked it up on Wikipedia, and they suggested it was Cape York. See https://en.wikipedia.org/wiki/Thylacine#Unconfirmed_sightings
A different take on psychological trauma in the ancient world:
https://www.reddit.com/r/AskHistorians/comments/1j6ssm/comment/cbbvfib/
Basically, the people who had symptoms that resembled today's trauma reactions tended to be people who felt they had committed some kind of moral violation (such as fighting against other Romans) rather than the much larger group of people that participated in and/or were exposed to violence.
I'm surprised by jikoshu-kyofu. Not that it exists and has a name, but that it's not more widespread. I know I am very worried about my body odor, and expected many people (maybe not most, but at least a sizable minority) to be paranoid about it as well.
I believe that Scott's talking about a very extreme fear, not the much more common fear of not smelling as sweet as a daily-shower person should. In the US there's a disorder called Olfactory Reference Disorder, and the person I diagnosed with it literally thought you could smell him across the room. If somebody at the other end of the subway car rubbed their nose he thought it was because of his body odor. He believed showering and similar measures made zero difference in how terrible he smelled. And when people told him they could not smell any body odor at all he did not believe them.
I'm surprised that nobody has mentioned an obvious contributor to that-witch-stole-my-penis: testicles do retract, and penises do shrink, as an unconscious response to fear! Not all the way into the body cavity, obviously, but they do retract and shrink to a very clear effect. (It's a reflex that is probably there to, well, safeguard our balls.) You can see how this works now: if you get really afraid of an imaginary penis-stealing witch in the neighborhood, your bits will noticeably retract, thereby confirming your fear of the penis-stealing witch. The very real sensations you perceive as a result of the cremaster actually doing its work will be amplified and interpreted by your witch-believer brain in the way you'd expect.
Not only that, don't penises shrink in response to the cold? I noticed in the koro story, the thing that happened before the guy noticed his penis was smaller was a cold draft came in. So imagine someone who had never noticed that being cold or anxious made penises smaller, one night a cold draft comes in and he notices his penis is smaller, and now he's anxious, and now it's all shrinking inward!
And now the guy goes "oh god, my penis is shrinking!", everyone around him hears this, it was probably a little cold and now all the guys are anxious and checking their own penises, and becoming more hyperaware of just the random shrinking and expanding that penises do just in ordinary life, and boom, you got a spontaneous social contagion.
And if a guy has a sufficiently large gut, or bushy pelvis, or small penis, he might lose track of its presence altogether, and conclude that it's disappeared!
It also helps to remember that we're talking about people who had pre-scientific ideas about how human biology works where "when that happens, that's a witch doing it" can seem more intuitive than it might from the perspective of someone influenced by modern understanding of biology. We're pretty good at having our theories of how the world works fill in the details of basic sensations. See also culturally determined expressions of hypnagogic hallucinations.
It reinforce this comment, the penis is a hydraulic system, and it lengthens and contracts under autonomous nervous control. A lot of things affect that, but fear, anxiety, confidence, etc. are significant. Also, the actual anchored base of the penis is near the anus, nearly half of the hydraulic system is invisible. So a 25% change in the total length of the penis causes a 50% change in the visible length. (So a lot of this retraction actually is into the body.) A psychological epidemic of fear of penis-stealing witches is likely to cause a physiological epidemic of penis shortening.
What I find strange about all of this is it seems to have been known since forever, at least in rough outline, in American popular culture. E.g. the movie "Little Big Man" has the leading man say, when his wife goes off to give birth and turns him over to her three sisters who have been unlucky in love, "Three young and healthy women with no man for who knows how long. The very idea kinda shrunk me like a spider on a hot stove."
I read a while ago that a certain mental illness (Cotard's syndrome, I believe?) used to be fairly common in France (as in, everybody who had worked in a mental hospital knew some cases), and then became much rarer, at least in its classic presentation, within a generation or two (beginning of the 20th century? I can't locate my (printed, French) source). A doctor reminisced and asked: but what happened to this sweet, philosophical sort of deluded person?
The "classic presentation": Doctor, I have lost my soul. I have no soul.
There were other beliefs associated to that: I am dead and somehow go on living; my insides are hollow... Apparently, the syndrome is more associated to these beliefs nowadays (though there are still religiously tinged cases - upon being taken to South Africa to recover, a Scotsman who was in a motorcycle accident came to believe that he was in hell, guided by his mother's spirit). The standard guess now is that there is an underlying neurological problem (the patient's brain loses the ability to react emotionally to the patient's own face, or else there is something messed up with proprioception) which gets interpreted by the mind in terms of beliefs that are culturally important; it is this interpretation that gets diagnosed.
I think Aella's piece on Trauma might be of interest here, I also think that modern examples of the trauma caused by CSA, likely have a large cultural component as demonstrated by the seeming lack of trauma in many different cultures throughout history. Although it's important to note that historic adult-child relationships seem typically very different from their modern equivalent, probably due to such relationships being pushed out to the fringes of society, where such relationships used to be common among high status individuals in farming societies, they now attract "less desirable" pursuers.
There was a study (I'll track it down if anyone cares) which concluded that PTSD was more likely if there was previous trauma. So it's plausible that people could brush off events that could be traumatic but only actually caused a little damage, until there's one too many.
People could get things wrong in both directions, by either assuming that all potentially traumatic events must cause PTSD or that people who say they have PTSD only believe it because they're heard of PTSD.
Echoing what many say here, really great post, Scott!
Some thoughts about getting off the crazy train:
"Is it weird to stay on the crazy train long enough to agree that cultural effects are strong enough to make you think witches are stealing your penis, and then get off it once people start talking about voodoo death? I think no - these are very different situations. Believing in koro can make you hallucinate that your penis is shrunken or gone, but no belief, however strong, can (directly) remove your penis itself. Culture → beliefs is fine; culture → reality is a step I’m not willing to take."
I think I don't understand the line you're drawing there.
First, if dying from a broken heart (or, if you want to sound fancier and slightly less precise, Takotsubo cardiomyopathy) is something that really happens, why not voodoo death? If I hear a shaman saying that I'll die, and I *really* believe in that shaman's powers, I'd probably get a pretty strong emotional response from that at the very least. That by itself could plausibly lead to serious downstream effects.
Second, and this is a broader point, do we need to draw any lines here at all? "Culture → beliefs" type of effect is already a "culture → reality" type of effect. (And what is meant by "reality" here?) Just to be clear, subjective idealism and social constructionism are cool and all, shout out to Berkeley, but I definitely don't want to say something like "your (cultural) beliefs determine your reality" or anything like that. At the same time, they are a part of it and because of that they do affect it. I wouldn't argue that there are no constraints on how much beliefs can affect reality, but how well do we know what those constraints are, especially when for humans biological and cultural is so intertwined?
I haven't been reading this blog long enough to know better, but this feels like an all-time classic post.
The thing is, I know people who transitioned long before it was popular. It's quite possible that culture makes a difference to frequency.
In some ways, culture shapes mental disorders. There are people with OCD who are tormented with the idea that they've run someone over with their car. This presumably was only possible after cars were invented, and possibly only happened after cars were common.
I feel like my model of anorexia isn't "telling people about anorexia gives them anorexia", it's "exposing people to Western dieting culture gives them anorexia?"
like, moral/purity prohibitions about what food is good and bad to eat are a cultural universal and i think people are wired to be good at internalising them -- I pretty successfully did this to become vegetarian
and if your prohibition is "don't eat anything with calories" this is going to run into problems
I guess if this has any historical precedent it's fasting/ascetic traditions in various religions (eg in India)
this explanation feels very Neil Gaiman to me
like, eating disorders are the modern incarnation of the ancient god of Fasting who fought the Buddha many centuries ago or something
I consider PMS/PMDD to be basically a weaker form of postpartum depression (which everyone agrees is real and caused by the effects of hormones).
I think Frank Bures suggested postpartum wasn't real, though I agree he's on thin ice.
I'm Malaysian so I was so confused when I got to the koro part. This is the first time I have heard of it. The nearest term to koro in Malay is kura which is half of kura-kura meaning turtle.
Like I said, I had trouble finding out exactly what the relationship to Malaysia was, even though everyone says it's a Malay illness. Some people say it's from South Sulawesi, but I thought that was Indonesian, and I don't know how it would have gotten a Malaysian name. More information at https://en.wikipedia.org/wiki/Koro_(medicine)
Obvious examples of culture-bound psychosomatic conditions: sugar rush/children becoming hyperactive after being given sugar and some (but I think not all?) of the "coffee as stimulant" stuff.
That's just typical confirmation bias: they typically do not ask the children if sugar makes them hyperactive, but the parents and caregivers, and despite what they may think, they are not strictly objective observers of their childrens' behavior.
I guess at one point, do we collapse back into social constructionism or even some Foucault with this sort of thing?
One can really feel or empathize with the earlier wave of ‘culture-strong’ thinkers as they were struck by such stark comparatively different or culture-specific instances across societies.
In some ways, your post seems to implicitly paints a similar “picture of smart people genuinely trying their best in epistemically treacherous situations” of those culture-specific theories.
I just realized that, while there is a small proportion of people who detransition who could say "A witch stole my penis", what we're mostly seeing is people saying "Witches stole *their* penises".
If anyone wants to try to translate the “Flowers Of Virtue” poem, here it is:
https://www.loc.gov/resource/rbc0001.2015rosen0118/?sp=331&st=image&r=-0.926,-0.022,2.852,1.421,0
Also featuring a hilarious penis with legs missing from the image in the post.
I feel like that walking penis deserves a poem all of its own !
This page contains verse 7974 - 7991 in the source linked by Mark below.
Is "Orenwützel" his word for "penis"? Could be. Amorphophallus titanum is "Titanenwurz" in German. My layman translation: When she has the penis, she takes a pillow in her hand and says: "Fly, fly, penis, a pillow corner is hunting you."
About the ol-german poem "by" Hans Vitler 'flowers of virtue" - that was a translation of an Italian original form 1320* Hans Vitler's famous translation was rather "free", but I guess he would not have added a penis-theft. - Now I found one commented reprint of "Blumen der Tugend" , well actually "Pluemen der Tugent" - it is oooold: https://archive.org/details/diepluemendertu00maxigoog/page/n381/mode/1up no such story there, it seems Vitler considered believe in witchcraft even: sinful superstition. Witch-hunt was NOT a middle-age thing, but came big in (early) modern times. Prof. Marvin Harris has some theories as for "why then": Cows, Pigs, Wars, and Witches: The Riddles of Culture (tl;dr: both big churches THEN felt the need to proof they were "indispensable" - before: the one church just obviously was. Witch-hunts: ON.)
* seems one can find here - it translated automatically(?) on my chrome at least (into a strange kind of modern German) : https://it.wikisource.org/wiki/Fiore_di_virt%C3%B9/I
tl;dr: speed reading it; i saw no witch or penis-theft, though the beginning of the text starts rather misogynistic
As I commented above, have a look at verses 7974 ff.
Hello again, I believe that ol' thread was "solved". (We got to the right verses - which were rather short - 'witches stealing phalli from breaches' end-of-story - in a context of the German author giving a long list of believes in witch-craft he considers silly (and were not in the Italian original ) - I assume you got here again via today's link in the new post about Aella and women with PMS being more superstitious or sth..
The division of culture bound delusion seems too vague an interpretation of how beliefs function to be anything but useful. What about the origins of potential beliefs in ancestors trauma or the potential to novel creations like Schreber which go on to become in some species useful behaviours?
https://en.wikipedia.org/wiki/Daniel_Paul_Schreber
The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind
LOUIS A. SASS
https://www.jstor.org/stable/10.7591/j.ctv3mt99d
I am seriously disturbed that many people who are not under the influence cannot instantly make out a Dalmatian and cow.
How do all of you drive at night?
...with the headlights on. Like, I thought that was a bush, not a dalmation, but I'm not driving my car into a bush either. (Closest I got for the cow was a close-up of an animal skull, which was obviously wrong because of the fence but still the best I had.)
In large part because we've standardized roads and vehicles to give clear, simplified symbols at night, like white lights go in front, red lights in back, reflective paint and signage is ample. With non-reflective items, like pedestrians trying to cross the road with non-reflective clothing, we rely a lot on context to figure out where to be careful. (Interstate? Probably no pedestrians there. Busiest college campus crossing? Watch out!)
My husband and I recently got lost driving around a city because one reflective sign had lost its reflectiveness.
I really wanted you to end your list of made up diseases around the world with "in America, sometimes people think they have a disease called "Restless Leg Syndrome", and are kept up all not thinking that their legs need to move.
Except RLS can be a result of of neurological damage
I know someone with restless leg syndrome. I remember one time when I was sitting next to her in a car, and it seemed like quite genuine leg twitches.
Why do you think it's a made=up disease?
I have a mild case of this syndrome. It seems silly, but that is exactly what it is: my legs sometimes signal that they really really need to move, and it is very difficult to stop them from doing so, which can be problematic when you are trying to sleep!
Naw that one's real. I went through a period of being very anemic without knowing it, and had 3 main symptoms: fatigue; a sort of olfactory version of pica (I *craved* the smell of solvents); and restless leg syndrome. As soon as my anemia was discovered and addressed, all 3 went away. I'd never had restless leg syndrome before, and haven't had it since. I'm positive that it and the pica were caused by the anemia. I'm sure there are people who have heard of "restless leg syndrome," and worry so much that they have it that they become preoccupied with leg sensations, the way one can with a dripping tap. But there is definitely also a version that is biologically driven, and that's what I had. It's a really weird, distinctive, very unpleasant sensation, and it grabs your attention. You don't have to go looking for it.
The entire point is that it's not made up, it's likely some combination of natural phenomena and culturally mediated expectation (as are many things). With restless leg syndrome it's particularly easy to see how that could be the case. Most people twitch as they fall asleep, likely as the brain switches off voluntary control of the body. The propensity to twitch and well as the magnitude and duration of twitching are all likely normally distributed among the population (as well as within an individual across different instances of falling asleep). Sometimes those twitches lead you to wake back up. Some people will wake back up a lot on their own, some sporadically so, and if you primed to it and expect it I suspect it will happen a lot more.
It's not twitches, though. I've had twitches while falling asleep all my life , and they don't bother me at all. Restless leg syndrome is not involuntary movements, it's a weird, intense, unpleasant sensation that makes you crave to move your legs because you have the sense that it will make them feel better. And it does make them feel better, but the sensation comes right back as soon as you stop moving them. You know the feeling you get when your leg has fallen asleep, and then when it's partway recovered it's very sensitive and uncomfortable? It's more like that feeling than anything else. There may be a version that's created by paying too much attention to how your legs feel and tripping out on that, but there's definitely a version that's biologically driven. I had it for a period of a few months when I was extremely anemic without knowing it, so anemic I was given an immediate transfusion when the anemia was discovered. The restless leg syndrome must have been caused by the anemia somehow (I had some other weird symptoms as well). As soon as the anemia was rectified the problem went away and never came back, even though for a while I thought and worried about it when I went to bed. I'd check my legs mentally for the feeling, and the attention I was paying to them did not bring it on. Instead, I kept discovering to my relief that I did not have the feeling, and after a few weeks I stopped worrying that it was going to come back.
As someone who was made miserable restless leg syndrome for a few months 15 years ago, I take issue with this. What I had was nothing remotely like paying too much attention to subtle leg sensations. And have a look at this: https://pubmed.ncbi.nlm.nih.gov/22210354/ Africans rarely report it, but there's plenty of it in Asia, Europe and the Americas. It's related to melatonin levels (abstract did not say how closely correlated) and highly correlated with latitude: Correlates in the mid-70's with distance from equator.
Just a kindof crazy idea, but I'm curious if there is a correlation between being able to 'see' Cube 1 as either Cube 2 or Cube 3 and being able to see the reasoning behind opinions you disagree with (i.e. to the point where you can empathize with them and/or make a coherenet logical arguement for that position)
I did a similar experiment on one of the SSC surveys, using a spinning dancer illusion instead of the Necker cube, and got mostly negative results. Expanding on this, I was able to get some weak and confusing positive results, see https://slatestarcodex.com/2017/07/14/can-we-link-perception-and-cognition/
I don't think I tried the Necker cube because I didn't think anyone would be unable to see it. Are there people who have tried really hard but still can't make it flip?
I think you can almost factor out culture from this explanation.
If you take the view that raw sense data/brain activity is a mess of "blooming and buzzing confusion" which we then build something resembling a consciousness/ego/self out of, then psychological conditions come from one of two places. One is weird raw materials (the brain receives sense data that's wrong, or a part of the brain that's responsible for conveying/processing raw sense data screws up the signal). The other is a badly constructed consciousness (sense data/pre-conscious brain activity gets classified in weird ways, or biological urges get routed into weird motivations/weird motivations are created ex nihilo).
A huge part of constructing a consciousness must be linguistic (I'm not sure it's coherent to talk about having a non-linguistic sense of self) and transmitted from others, although there are presumably parts that are more-or-less hard wired biologically for evolutionary reasons; I doubt you could raise someone to have a consciousness radically different from the norm (no ego, no persistent objects etc). Given it's parents/peers, this will vary markedly by culture; the upper layers of it will be explicit knowledge that changes over the course of a lifetime, which is where some of the more obvious culture-bound stuff is sitting. The lower levels of the consciousness being mal-formed are probably things like personality disorders. Some psychotic illnesses are presumably broken sense-data processing at a pre-conscious level.
>an area in Virginia where the government enforces a ban on electromagnetic transmissions for secret military reasons
an area in *WEST VIRGINIA* and Virginia. A keen eye will note that the Wikipedia page doesn't list any points of relevant interest in the Virginia half of the area.
As fun as it is to say 'secret military reasons,' the government is open about some of the reasons: Sugar Grove Station in WEST VIRGINIA (https://en.wikipedia.org/wiki/Sugar_Grove_Station) is an NSA listening station, and Green Bank Observatory in WEST VIRGINIA (https://en.wikipedia.org/wiki/Green_Bank_Observatory), which has the world's largest steerable radio telescope and they offer quite informative tours. All electronics have to be turned off, of course, though the gift shop will provide disposable cameras.
One thing about “running amok” (both the original Malay version and the American active shooter version) seems to me to be distinct relative to koro and anorexia: while it’s clearly culturally influenced, it’s not (locally) contagious.
The man who runs amok doesn’t generally spark a bunch of copycats in his immediate community, while koro seems to spread in panicked waves that rapidly “infect” lots of socially connected individuals. (There are things that are more like “spontaneous mob violence” or “small military group goes berserker in the face of impossible odds” - but that’s not what we’re talking about here)
I do think this still fits into Scott’s overall model. Maybe there is a “going amok” condition that is pretty rare but is mostly biological. However the exact form it takes is culturally defined in a “choose the form of the destructor” sort of way (catch a demon and go on machete rampage followed by amnesia among the Malays, jihad inspired suicide bombing among the Arabs, Columbine copycats among the Americans, etc.). It’s not really a social contagion, more like a meme that only certain people are vulnerable to.
For the last two years, I've experienced an undiagnosed medical illness with symptoms a bit similar to CFS/long covid symptoms.
Two primary symptoms:
1. when doing cardio exercise (ie running), after a certain level of exertion (significantly lower than where it should be) , my heart rate will spike and my body will start feeling enough stress to force me to stop.
2. I feel fatigued/bad more frequently than I used to
I actually had a ~6 month period where I fully recovered but then the symptoms came back.
Since these symptoms started appearing, I've become hyper conscious of how I'm feeling and various health metrics (ie heart rate when running, overnight resting heart rate).
I've been told that by being hyper sensitive to how one is feeling/recording data can make these symptoms worse as the mind will pattern match.
Given the concerns outlined in this post, does anyone have any suggestions on how they can experiment with trying to psychologically overcome this?
Off the cuff, maybe try out new exercises. You might find that you have an easier time with swimming or cycle than a regular run, as a new sport means you don't have any priors to worry over. Something more mentally stimulating may also be preferable, join a basketball team or find a partner to play tennis against, that way you have something other than your body to pay attention to during the activity.
Have you seen a doctor and ruled out physical explanations?
Assuming this isn't just getting out of shape due to lockdowns or something, I would get a doctor's opinion, that sounds like actual heart trouble. A relative had those symptoms (well, extreme; they eventually couldn't walk up a hill anymore) and ended up getting a triple bypass, at which point their energy came back. Is the exertion level getting lower with time?
For psychological... try listening to music? Pick a target heart rate, find a song that matches it, listen to it before measurements.
Yes! PainScience.com's advice on this topic is excellent!:
https://www.painscience.com/articles/pain-is-weird.php
https://www.painscience.com/articles/mind-over-pain.php
https://www.painscience.com/index-pain-theory.php
Central sensitization is A Thing. But it's often not completely self-perpetuating, but repeatedly renewed by real tissue provocation, even if far too little provocation to normally account for that much pain.
Exercising to the point of symptom provocation can train you to expect symptom provocation, further entrenching central sensitization. It's *rational* to infer from repeated failure that you'll probably keep failing, and from repeated aversive experience during an activity that the activity itself is aversive. So exercising beyond your body's tolerance for it is a bad idea. But maximizing tolerable exercise is probably the closest thing we've got to a cure for chronic discomfort:
https://www.painscience.com/articles/strength-training.php
https://www.painscience.com/articles/pf-rom-exercises.php
Also, it can be socially, as well as psychologically, useful, to somewhat understate discomfort, calling it "discomfort" instead of "pain", "intense" instead of "excruciating", and so on. I'm not convinced that reframing my descriptions like this changes my own perceptions – but it does signal to others that I'm abstaining from self-dramatizing exaggeration that *might* make discomfort worse. And a reputation for not-exaggerating is extremely important to finding appropriate treatment for a chronically-uncomfortable condition, especially if you're a gal.
There are workshops like "Explain Pain" by Lorimer Moseley et al that can be useful, too.
`Psychologist here, specializing in anxiety disorders. I'll tell you what the treatment is for an anxiety disorder of this kind. BUT before trying it you have to go get your heart checked, because the treatment for paying too much attention to heartbeat sensations is the exact opposite of the treatment for some kind of abnormal heart activity set off by exercise. If you have a heart problem, you'll probably need to lay off running, at least until the heart condition is stabilized. If you have an anxiety problem, the treatment is to put away your heart monitor, don't take your pulse, and just run. If you have the uneasy feeling that a certain thing -- say jogging up a hill-- will be too much for your heart, go jog up the hill. Jog up it every day. If you have the feeling at a certain moment might that even a short sprint might make your heart give out, do a short sprint. Stick with that prinicple. Every time you find yourself fretting that something will harm your heart, do at least a brief version of it. If doing these challenges is too daunting at first, just go out an run without measuring your heart rate, and plan in advance how far and how fast you're going to go -- then do that, rather than letting your pace and distance be controlled by the *feeling* that you're just not up to more. Once that gets easier, start building in deliberate defiance, as described above, of your feeling that something is too much to ask of your heart. And once the problem subsides I'd recommend just giving up heart rate monitoring for a good long time, maybe forever. It's a nice aid to training, but hardly essential, and in your case it backfired and interfered with training.
But before doing any of that, get your heart checked. Seems to me that the appropriate test would be a stress test. Even if you're young you can probably get the doctor to give you one if you do NOT say, "this may all be my imagination" but instead say something like "I get a weird feeling in my chest." And while you're there you should maybe also get checked for anemia and any other medical ow-hanging fruit that might cause fatigue.
There's a lot of "medical ow-hanging fruit"!
To add to the calibration-dependent-phantom-sensations bucket:
phantom notifications.
I don't think it's uncommon to hallucinate a phone vibrating in one's pocket, even when it isn't present.
Curiously though, I don't recall if this is dependent on my wearing pants - but I doubt this is a phenomenon that existed 20 years ago (outside of maybe the pager/beeper crowd).
I also recall hallucinating voices in a specific shower at one point, primarily limited to short instances of vocative address.
I used to experience this constantly, and it was maddening. I solved it by constantly rotating which pocket I put my phone in, so that no one area is primed for the buzzing sensation.
Vocative address? Like "O Trylfthsk, showerer of specificity, hast thou finished thy ablutions"?
Aye, though these muses were terser.
"Before anyone gets too excited about this, I want to stress a version of the point Bures got right earlier: there is no neutral culture. Having lots of transgender people is downstream of cultural choices. But having lots of cisgender people is also downstream of cultural choices. There isn’t infinite flexibility - evolution ensures a bias towards heterosexuality, for obvious reasons. But there’s a lot of flexibility - Spartan men married and had sex with women, but they thought this was a dumb annoying thing they had to do to have children, and sex with young boys was the obvious enjoyable satisfying option. Even within evolution’s constraints, culture can do some pretty weird stuff. I think you could probably have a culture where 99% of people were transgender, where it was generally accepted that everyone transitioned on their 18th birthday, and where only a few people (disproportionately schizophrenic) would object or see anything wrong with this."
I have always thought that sexual orientation must be at least in part cultural/environmental, unless someone could point me to a special genotype that ancient Spartans and modern Pashtuns had.
Greg Cochran's theory is that it's pathogenic. Hence its absence from hunter-gatherers like these:
https://www.theatlantic.com/health/archive/2012/12/where-masturbation-and-homosexuality-do-not-exist/265849/
I wonder if there's a better explanation of gender dysphoria's cultural-bound-ness: that discomfort with appearing as the gender you don't identify as is cultural. Most men in the United States, if forced by hand-of-god to spend a day appearing exactly as a woman, and not being able to explain what was happening, so that everyone would assume they were a woman, would feel terribly uncomfortable for the entire day. Though I don't have much knowledge about how people would feel about this in other cultures, I expect (I'm not sure why I expect this) that, in a lot of other cultures, people would feel much better about that: people wouldn't be nearly as terribly uncomfortable in this hypothetical.
So, when people in another culture don't feel like the gender that they would be assigned based on their physical sex characteristics, it doesn't really bother them as much. In American culture, the idea that you might want to dress or act differently from the gender that matches your physical sex characteristics is seen as very shameful: so, people feel terribly uncomfortable. In a culture that doesn't have such a strong idea about how one _should_ act or dress might not feel nearly as uncomfortable, simply because the idea they have (that they might want to dress or act differently from the gender that matches your physical sex characteristics) isn't seen as nearly as shameful.
In other words, the cultural idea of shame surrounding crossdressing and transvestism and whatever else people were thinking of it as previously might be what causes gender dysphoria.
With that said, I've not 100% thought this through. I might not agree with this if I thought about it in more detail.
Is this actually true though? The fastest growing group of people identifying as trans/NB are adolescent natal females, and “being a tomboy” and dressing butch has been not particularly shameful for a long time, certainly less shameful than a male dressing in an obviously feminine way. To be trite, a guy in a dress is going to get funny looks while a girl in a tshirt and baggy pants is basically normal.
But maybe it's the case that trans men have less stigma identifying as such for that exact reason?
I don’t think trans women face less stigma than gay or effeminate men, at least in the US.
There are apparently places where this is true - I believe it’s Iran where being transgender is acceptable in a way that being homosexual is not. But notably, that appears to be evidence that their gender roles are stronger, not weaker.
This is a fundamental misunderstanding of gender dysphoria.
It's hard to make generalizations here because there's a lot of heterogeneity among trans people. But to a first approximation, when you're trying to imagine yourself in the mind of a trans person, you should imagine your internal self-concept actually belonging to the gender you identify as. All of your first-order feelings about gender roles and expression are experienced relative to that internal self-concept.
So, for example, I'm a trans man (FTM). I was raised in a very 1980s-feminist-egalitarian environment where gender was a social construct and anyone could do anything, so I don't have an especially strong need to be gender-conforming, but I did pick up a vague sense that I was supposed to live up to a certain ideal of masculinity in my dress/behavior/body. What limited shame/discomfort/anxiety I have about gender-transgression revolves around my *feminine*-coded tastes and attributes. This discomfort was much stronger before I transitioned, when I felt like I had to prove myself, and receded almost entirely when I began to be consistently perceived as male.
There is of course a second-order layer of discomfort/anxiety: pre-transition trans people understand that people perceive them as the other gender and that there are social risks involved in failing to conform with one's perceived gender role. The conflict between the two layers is a source of stress. But it's not the driving force behind transitioning, at least not in Western liberal democracies. We're all well-aware that the people who would judge us for perceived gender transgression are the same people who would judge us for transitioning.
>you should imagine your internal self-concept actually belonging to the gender you identify as
But I don't "identify" as a "gender" at all. I identify as myself. I understand that there are clusters of aesthetics and social scripts associated with what used to be called "biological males" and "females", and I adhere to the one that corresponds to my biology to the extent that polite society expects, mostly for convenience's sake than anything else, and that's that. This is apparently called "cis by default", so I suppose I can't even in principle imagine what it's like to be trans.
I'm not saying that *you* identify as anything. I'm saying that when you try to put yourself in the mind of a hypothetical trans person, you have to think of your hypothetical self as actually being the gender that your hypothetical self considers themselves to be.
It's hard to explain in the abstract, but it's really not that complicated in practice. If you're trying to cognitively empathize with a trans woman, you think of yourself as a woman (and you at least temporarily adopt a definition of "woman" as a social category, grounded in but not fully determined by biology.)
Well, this topic is very complicated and politically charged and still new enough to be in flux as far as theory is concerned, so I'm not optimistic about anything becoming clear any time soon. But if you don't mind, I still have a question. Suppose this trans woman is lucky enough genetically that she can perfectly pass without any medical transition, just cross-dressing and makeup are enough. (I guess this is much more common in the trans man case.) How likely is she to still experience dysphoria?
This touches on an internal conflict within the trans community. What, exactly, is dysphoria, and can you be trans without experiencing dysphoria?
I'm loosely aligned with the faction that's not-so-affectionately called "truscum": I don't think you can be trans without dysphoria. (I emphasize *loosely* aligned, though. Most people who describe themselves as "truscum" are hateful jerks.)
So to me, your question is tautological. If the person in question is a trans woman as I use the term, then by definition she experiences dysphoria. The effort she makes to "pass" with clothing and makeup is partly a coping mechanism. She almost certainly experiences some distress when applying or removing makeup, showering, and having sex. Her life is probably limited in various ways - she's probably afraid to swim, go camping/hiking, or do anything that's not compatible with heavy makeup and undergarments. And she's almost certainly terrified of aging out of her androgyny.
A member of the opposing faction - a so-called "tucute" - would answer differently because they have a more expansive definition of "trans woman." They believe that so-called "gender euphoria," a feeling of pleasure or validation at being recognized as one's preferred gender, is sufficient for being trans. So in their view, someone who just likes women's clothes or makeup and enjoys being perceived as a woman could be called a trans woman. But I don't know if they could give a quantitative estimate of the number of dysphoric vs. non-dysphoric trans people overall, let alone the ratio in a tiny subpopulation or how it's affected by individual attractiveness.
Thank you for the many insightful comments. It sounds like being trans kinda sucks. And I wonder if you can imagine a world where it wouldn't be so hard. Or is it always dysphoria?
Thanks from me as well for taking the time to clarify these issues. I'm also curious, then, what is your perspective on the rest of the "gender studies cluster", e.g. genderqueer, genderfluid, bigender, etc. Does any of this make sense in the "truscum" framework?
I appreciate this breakdown...as a trans woman (I guess) who's been waaaaaaaay out of the LGBT loop for years now. Had a vague sense of the "truscum" archetype, did not know its inverse had a grouping as "tucute". Useful update. Things sure seem to have gotten a lot more complicated and factional since I last hung around that milieu.
I guess under that taxonomy I don't really fit anywhere, feeling neither dysphoria anymore, nor euphoria. This is just How Life Is now. Nothing particularly traumatic or exciting about it, just the mild routine indignity of medications. The small ouch of being misgendered just...doesn't pass sensitivity threshold much anymore? Like, whatever man (it's almost always men, you'd think women would be better at clocking...?), idgaf really. Not worth my time to correct, barely putting in the bare minimum effort to pass anyways. I think it'd bother me more if I was Actually Trying and not in Minimum Viable Female mode, but that's the comfortable default now. (Thank God for low dress code expectations in SF...)
It's still __preferable__ in a small way to pass, just because that makes life easier...having a Predictable Identity pleases interlocutors both friendly and foul. Nevermind the intepersonal tensions when someone's not __quite__ sure what I am, and has to hazard a potentially-cancellable guess. But I'm not, like, attached to the "transgender" identity or culture at all. The meds are instrumentally useful, even if I'm not seeking the same terminal values and don't, actually, have any firm internal sense of this "gender" thing.
>But I don't know if they could give a quantitative estimate of the number of dysphoric vs. non-dysphoric trans people overall
The various researchers, therapists, etc. I've talked to over the years have suggested this has something to do with the significant fraction of trans women (idk about trans men) who are also autistic. Whatever the actual causal pathways of transgenderism are, we seem to "fall into it" in different fashion from the (more) neuroTypical. The dysphoria hits qualitatively differently...treatments are equivalent, but my sense is that there's really two distinct itches that are getting scratched.
The same goes for me. I do not feel that I am of a particular gender, although my body clearly is. I did not know that this was called "cis by default". I wonder which is the most common feeling: having a strong internal gender identity or being 'cis by default'?
I'm moderately confident that hypothesis and the related phrase originates from Ozy: https://thingofthings.wordpress.com/2015/01/28/cis-by-default/
...which is an interesting read even for non-trans people, I think. One of those "show fish what water is" attempts.
Super interesting, thank you very much!
And there is actually an answer to the question I was wondering about, from a Lesswrong survey a few years ago ("I identify with my birth gender only by default: 45.3%; I identify strongly with my birth gender: 39.0%"). Lesswrong people are probably a bit atypical for this point, but I am pretty confident that both feelings, strong and weak gender identity, are common.
Now I wonder what the breakdown is for sexual orientation, and whether or not there is a relationship between a strong gender identity and a strong sexual orientation?
This is a really well-written comment, thank you. I think what I was describing above is what you describe in the last paragraph. I think I neglected the dysphoria you describe, where doing feminine things or appearing feminine makes you feel shame/discomfort/anxiety because your experience and self-concept is that of a man, but now that you describe it I've heard plenty of people describe it. I'd agree with your characterization that it's the defining part of gender dysphoria.
Thank you!
Rather than questioning whether gender dysphoria is a culture bound affliction, isn't it simpler to recognize that there is no objective reason to suppose that 'gender' is anything distinct from biological sex?
I mean 'I have a real self that is not my biological self.' is an inherently religious or at the very least metaphysical belief that our society has decided to treat as a reality.
It's funny that I didn't realize until Scott was explicit that this was about gender, which is funny since 'penis stealing witches' would actually be a pretty awesome invective to use on the 'groomers'. I thought that this was going to be about the pandemic related collective delusions because I had just seen that the NYT had a column this morning about masking being useless, something we all knew in 2019 but forgot recently.
Once you've equated facts and opinions (usually formulated as a "personal" truth) there is no such thing as an "objective reality."
Fact: male and female nervous systems are structurally different in certain minor but predictable ways
Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems
Therefore, it seems clear that when a trans person says "I have a real self that is not my biological self" what they *mean* is that their nervous system does not match up with the rest of their body, and that they should be gendered based on their nervous system. Which I think is a very reasonable conclusion given the relative importance of different body parts.
I would like to see the data for that. What are the specifics of this claim, what are the neurological differences? I would also like to see the variation among members of a sex that identify as cisgender versus those that identify as transgender. How many transpeople have been evaluated to determine which type of nervous system they have?
Men and women are certainly different neurologically, but can you connect the dots to show that transpeople have cross-sexed neurology? Your major premise I concur with wholeheartedly. Your minor premise I await proof, before I evaluate your conclusion.
Also, if this is true, where does this put detransitioners? Is their neurology cross-sexed or not?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139786/ has an overview of some of the neurological differences, with additional citations.
Referring to these as differences in the "nervous system" as a whole is a bit of an oversimplification, since there are many different parts of the brain and body where sexual dimorphism may be observed to varying degrees.
Referring to these as differences between "cis people" and "trans people" is also a bit of an oversimplification, since those groups are defined by their behaviors (e.g. self-identifying as trans, or starting medical transition) and not by the underlying biology.
For the same reason, the question "where does this put detransitioners?" is meaningless: neither transitioning nor detransitioning affects the presence or absence of these neurological differences. Either they were there all along, or they weren't.
> Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems
I don't believe this "fact" has been established. As far as I'm aware there is no objective measurement that allows one to distinguish trans & cis people with any degree of reliability.
It's part of a much longer talk which discusses a number of issues, but Rebecca Reilly-Cooper touches on the "gendered brain" here:
https://youtu.be/QPVNxYkawao?t=3027
"Fact: trans women have nervous system more like female nervous systems, and trans men have nervous systems more like male nervous systems"
This is absolutely untrue. That claim is based on one (1) study featuring about two dozen transsexuals and not only do the error bars on the effect dwarf the effect itself, the actual effect is that trans-identifying men have their values shifted *slightly* in the direction of women but are still almost identical to other men, and much more different from women.
I think metaphysics is a red herring, for most concrete trans rights issues. Like, your name is "Jon Cutchins," and it would be rude of me to decide that I'm calling you "Sam" instead. If you chose to change your name to "Jane Cutchins," it would be equally rude of me to keep calling you "Jon." I think this is true regardless of whether you think "my name is Jon" is a metaphysical religious belief or just a convenient label.
I didn't say anything about names. That is a strawman. I said that believing or disbelieving in 'gender', not transgender or gender dysphoria but gender-the concept that you have a sexual identity other than your biological sex, is a metaphysical or religious choice. It can no more be demonstrated than the coeternality of the divine son or the existence of nirvana. It is like debating nominalism vs realism.
*edited because I can't type on a phone
And I'm saying that I don't give a shit whether you believe gender is a mystical essential quality or not, so long as you agree that deadnaming trans people or calling them by the wrong pronouns is wrong.
Since you used the term "groomers" in your OP I assumed you disagreed with trans rights in the concrete legal-and-social-norms sense as well, but if you don't, then I couldn't give a shit what metaphysical framework you subscribe to. The goal is to ensure that trans people are legally protected and socially accepted, everything else is commentary.
Your goal. My goal is both to find truth and make it more known. If I haven't been clear enough I don't believe that 'transpeople' exist because I don't believe in gender. You are demonstrating exactly what I suggested that it is a dogma for you believed emotionally on faith. Which is fine. I don't interfere in your religion. But I will no more accept it as the law of the land than I would allow the worship of Quetzcoatl to be mandated. What name I call anyone except you and your family by is none of your business. Actually even if I call you by a name you don't like that is not actual harm.
There is a whole world of people out here that don't have to agree with you or do what you like. Sorry, not sorry.
>I don't believe that 'transpeople' exist because I don't believe in gender.
If you meet a person whom you know used to go by "Jon, he/him", but now goes by "Jane, she/her," which name do you call her by? Regardless of whether you believe this person is transgender, regardless of whether you believe gender exists or not, names and pronouns do exist and you have to choose one to address this person by. The only claim I'm making is social - that it would be rude to address this person by a name they've clearly expressed a preference for you not to use.
> What name I call anyone except you and your family by is none of your business.
Do you have a similar reaction to, say, schoolyard bullies? If a kid gets called names, that's none of your business because language is never harmful?
>Actually even if I call you by a name you don't like that is not actual harm.
Cool. I've decided that your name is Jane now.
If I tell you that bread and wine is actually human flesh and blood and that anyone you share it with you must refer to as brother or sister do you behave as if my statements are true and comply with my ritual?
Demanding that I do makes you the rude one. As you demonstrate at the end of your post. Thise who try and force others to say what they wish them to say are the bullies. Judge for yourself how I respond to bullying.
*edited to remove an incivil comment
And if I decide I'm a gorilla, would it be rude for you to to continue treating me like a human, with human rights and human responsibilities instead of gorilla rights and gorilla responsibilities?
"NYT had a column this morning about masking being useless"
Just looked up this column and the study... The article is wildly misleading. The study says, right up front, that their "wore masks" group *didn't consistently wear masks.*
The strongest statement you can possibly make from that study is "the data on masking is mixed and compliance is terrible, so we probably shouldn't do mask mandates."
Nah, we just need to mask harder next time! With criminal penalties for misinformation and Science Denial! If a person is incapable of obeying what Science mandates, there is no place for them in modern society!
No. It is 'masking doesn't work' and then you can qualify it with 'here's why'but the headline is the intervention doesn't work in the real world. Whether or not it would work in some other world where people wore them 'correctly is irrelevant.(btw it wouldn't this has been known for decades and then forgotten in 2020 lime so much actual science) the real question is why people are so emotionally attached to masks
I don't think that's very hard to answer - people want prophylaxis against disease, and to avoid the risk of giving other people diseases.
We know that people overestimate their own compliance in just about every scenario, so it seems safe to assume that individuals may assume they are getting a benefit even though the bulk of people don't thanks to low compliance.
People want prophylaxis against disease, and to avoid the risk of giving other people diseases, and to feel safe independently of whether they are safe, and to be comfortable, and to feel wise and virtuous, and to be accepted by their ingroup, and to have a way to show their superiority over the outgroup. Deconvolving all of this is going to be rather tough, but it may be worth noting that some of these things are motives to wear a *good* mask *properly*, and others are motives to just wear some mask visibly.
No the bulk of people don't because masks are not ppe for viral transmission. They are ppe for droplets. Other than that they are security blankets, hence the question about psychological attachment.
If your mask 'worked'and you wore it properly it wouldn't matter if my mask worked. We would both be protected from infecting one another.
Just another case of blame the vicimt when the interventio doesn't work.
"The French suffer from bouffée délirante, where a perfectly healthy person suddenly becomes completely psychotic, with well-formed hallucinations and delusions - then recovers just as suddenly, sometimes over hours or days. This is not how psychosis works anywhere except France and a few former French colonies."
Not completely French-bound: King George III of England, who had sudden hallucinatory episodes (famously talking to trees etc.), then would wake up one day completely fine. Admittedly his episodes lasted longer than "days".
Great column as usual. But I was hoping you might mention Havana Syndrome, which is quite fascinating -- dozens of cases of government and military personnel convinced that vague symptoms are the result of a Russian sonic-beam weapon of some sort, which no one has proven even exists. Social contagion but with some unusual aspects
Tinnitus is another example of an ailment that in many cases only becomes one if you ... pay attention to it.
Of course, like all this stuff, it's a spectrum.
I'm interested in your evidence for this besides the fact that it's obviously true of everything. That is, is tinnitus more this way than, let's say, headaches?
Disclaimer: I don't have really have any evidence for this. I don't know why I made this comment on the internet and I didn't expect to have to justify it.
But here's the story. My friend developed tinnitus a few years back and was very upset by it, but I was interested in his girlfriend's take that "no, everyone always has ringing in their ears, most people just ignore it". That rang true to me - indeed ever since then I've noticed that if I listen I *can* hear ringing in my ears. But I had never realized this before, and I never ""hear"" and/or notice the ringing when I'm not specifically trying to hear it. So I don't consider it a problem or consider myself to have tinnitus. But obviously there's a part of me that realizes I'm neurotic enough that this is the kind of thing that could drive me crazy if I wanted it to.
Meanwhile, my friend hasn't mentioned his tinnitus in years (no longer wears ear plugs afaik, etc), so I just asked him about it! He says: "I still have it but at some point my way of thinking somehow magically changed and it doesn't often bother me anymore"
I've had it my entire life and never thought anything of it until I learned what it was as a child. It's never bothered me, regardless, but I had a moment of "wait, this isn't how everyone's ears work?!?"
Naturally, now I can't stop hearing it. >.<
Is this not metaphor, like stolen manhood?
Who doesn't know a man who once said 'that witch has taken what shred of manhood I had left?'
"Before anyone gets too excited about this, I want to stress a version of the point Bures got right earlier: there is no neutral culture. Having lots of transgender people is downstream of cultural choices... I think you could probably have a culture where 99% of people were transgender, where it was generally accepted that everyone transitioned on their 18th birthday, and where only a few people (disproportionately schizophrenic) would object or see anything wrong with this."
I don't think this is technically wrong, but it feels... stretched? Like here's a bunch of stuff that had to happen for the disproportionately trans stuff to happen here:
1. A certain (large) amount of sexual-liberation stuff had to happen around the more "normal feeling", easier to justify LGBT issues to garner momentum around "Good people of X political alignment support stuff that 'feels gay' as part of their package deal of political and cultural beliefs"
2. Trans lobby had to convert the people who were reflexively in-tune with 1., starting small with stuff like "use my pronouns - it's a polite fiction but it will make me more comfortable, and don't you want to be polite?". In my (possibly wrong) telling this is where they got you - i.e. Emperor Norton "why not, it's kind" tactics.
3. They had to move from "polite fiction" to "you have to actually believe we are in some substantial way a different sex, and treat it that way" stances, where "women were women" and were to be treated so in every possible way they desired. If you didn't meet this expansion, you'd run afoul of 1-2.
4. They had to move from "Don't you want to be polite and nice?" stances to more forceful tactics - utilizing preexisting legal structures and leveraging their more enthusiastic supporters to get you fired from jobs, blacklisted from academia, etc. If you didn't adopt 1-3, to the point now where you basically have to be anonymous to push back on them or make a career of pushing back on them to be "safe" in doing so.
This is trans lobby, granted, and not necessarily every trans person. But the practical upshot is something like us having a mostly enforceable framework in which:
1. Some small percentage of people think trans women are women, full stop
2. Some larger percentage don't think trans women are women, full stop, but do fancy linguistic stuff to indicate that they are in line with party demands and feel good about doing so, and wish they could think it for reals.
3. Some (probably) even larger percentage doesn't think trans women are women and doesn't feel good about saying they are, but know they have to do something between "Give them everything they want, say whatever they want, or else do a damn good job hiding".
All this to say that there might not be a cultural neutral we can pin down, but an awful lot of shit had to happen here to get to where we are. And we can imagine a culture where 99% of everyone is trans and that's just normal, but the stuff that would have to happen to "bend the average" that far would be astronomical. It's a nitpick, but it's really, really hard to look at a system that can only exist when you've leveraged a ton of stuff into completely shutting down any questioning at all at risk of firing/unhirability as "just as normal" as the usual default of "there's a few trans people, and everyone thinks they are at least kind of weird".
I think this matters here because *every single thing about "manufacturing" more trans people is negative.* This sounds harsh, but consider this pretty accurate rewording of general trans lobby positioning as it exists today:
>>> Transness is a thing, we don't call it an illness, but usually the thing about transness is that you have to go on these really clearly unhealthy hormonal treatments from an early age and get massive surgeries to the reproductive system that are pretty dehabilitating to normal sexual function. And the reason you have to do this is that if you don't you will almost for sure kill yourself.
Yes, they deny any possible downside to massive hormone treatments and stopping puberty and roughly redefining sexual organs as approximations of other sexual organs or removing body parts completely.
So there's this thing where, like, say there's some baseline amount of trans people, and you can't do anything about that no matter what you do, and you want to maximize utility in that situation. That's one thing - you do a certain set of stuff under that. Like maybe you all decide to try your best to believe the polite fiction and make it as real as possible, and you all commit to publically only saying things that assume the polite discourse is true.
But that's not the situation we are dealing with, where it's becoming increasingly clear we are making a social contagion of sorts. In that case, you have to grapple with the negative utility of the social contagion, and the balance of forcing everyone at gunpoint to toe a party line changes an awful lot.
In this case it looks like we would have gotten an awful lot of utility out of something like "not joining or working to stop the active, years-long campaign to get people to pretend along with something, or else to threaten them with as much force as we can muster that we will commit serious harm on them if they don't at least shut up and fall in line". Like a lot of people who might have just been furries instead and wouldn't have actively destroyed the function of their bodies, etc.
So that's sort of my pushback, is that there's no "cultural neutral" in the sense that you can't point at the one pure society all other societies are variations of, but it's a much bigger stretch to look at a pretty extreme outlier culture that's producing pretty extreme outlier results only after an extended campaign to use pretty extreme force to muffle what appears to be the usual general reaction to a thing and institute a sort of fiction most people are only at best playing along with even now, and say "But understand there's no cultural neutral - this is about as normal as anything else". Especially when the upshot of that pretty significant downsides.
"Some (probably) even larger percentage doesn't think trans women are women and doesn't feel good about saying they are"
Probably? Every study I've ever seen of the US or any European country says a majority of the population hold this belief.
I'll even mildly push back on the assertion that there is no neutral culture. Hell, the piece opens with a list of things that are basically universal. If it is in fact the case that, as Scott writes, "having lots of cisgender people is also downstream of cultural choices" then it sure is a weird coincidence that just about every culture that has ever existed has made those exact choices.
It seems to me like gender dysphoria is more similar to something like left-handedness (the body producing the "wrong" hormones in utero, leading to stuff being built in the "wrong" way) than to something like penis-stealing witches.
Gender is clearly a structural neurological phenomenon. Furthermore, I know plenty of trans people who have a certain set of childhood symptoms of gender dysphoria before they were aware of the existence of trans people. Personally, while I was aware of trans people's existence, I hadn't honestly considered if I was trans, but I still had a lot of fairly common symptoms of gender dysphoria. I find it difficult to believe that I almost exclusively enjoyed socializing with women (and a few effeminate men) and constantly felt bad about the masculine traits of my body because of social contagion. I think a far more likely explanation is that I was simply exposed to more estrogen in the womb and my brain took that as a sign to develop in a feminine-structured way.
Now, certainly my choice to *describe* my female-structured central nervous system as me "being a woman" is socially based, but only insofar as my culture believes that the brain is more important to someone's identity than the rest of their body.
There's a Darwinian reason for a small percentage of people to be left-handed: it gives an advantage in a fight against someone not used to fighting against a left-hander.
The term "gender" at one time was used to refer to elements of grammar, then the term was borrowed by feminists to describe the stereotypes associated with biological sex. Some people uncomfortable with using the word "sex" when they didn't mean coitus started using "gender" instead (that was explicitly the case with the Supreme Court). More recently people have started talking about individual "gender identity" as something distinct from the feminist idea of gender as something society imposes on you. But it's not "clear" that there needs to be any "structural neurological phenomenon" in the brain giving people a "gender identity" rather than letting people be "cis by default": https://slatestarcodex.com/2013/02/18/typical-mind-and-gender-identity/
I linked to it in another comment, but Rebecca Reilly-Cooper gives a thorough discussion about whether everyone has an internal gender identity here: https://www.youtube.com/watch?v=QPVNxYkawao
I expect that many people who currently identify as trans had sex-atypical characteristics as children. In the past, that would have been an indicator they were more likely than average to grow up to be homosexual.
"There's a Darwinian reason for a small percentage of people to be left-handed: it gives an advantage in a fight against someone not used to fighting against a left-hander."
In The Steel Bonnets, George MacDonald Fraser mentions a family of borderers, the Kerrs, who were so prevalently left-handed (presumably most of them were right-handed and deliberately trained themselves "wrong") that, he claims, Border people still say that a lefty is "car-handed"; the alleged purpose was to have this advantage in a melee.
"In the past, that would have been an indicator they were more likely than average to grow up to be homosexual."
As Michael Bailey noted in The Man Who Would Be Queen, a strong predictor of whether an effeminate boy will go on to seek transition (rather than growing up as a gay man) is whether he expects to be able to pass as a woman.
Advances in medicine have made that goal more realistic for many of the boys for which it previously wouldn't have been.
I don’t think Scott’s model is incompatible with there being people who experience gender dysphoria the way you have, as a “mostly biological” phenomenon. That is, your symptoms of dysphoria are “autochthonous ” to use Scott’s phrasing. But Scott’s model predicts an additional class of trans people who got there with a balance of causes leaning more toward social and less toward biological. This is not to say their transness or dysphoria are “less real”, just that they were unlikely to have manifested in a social setting that didn’t have gender transition in the metaphorical water.
I think some of the data relating to the rapid and recent increase in the number of individuals identifying as trans, and a flip in the gender balance (trans identification used to be majority mtf, now it’s mostly ftm) make a lot more sense in the “social contagion” model than the “biological model”, because it seems doubtful that the biological mechanics of gender dysphoria would have shifted so dramatically over essentially one generation.
And honestly, there seems to be a lot of overlap between the described experience of gender dysphoria by trans men and that of adolescent cis women experiencing puberty-related body image issues, social awkwardness, etc, as well as autistic cis people struggling with hypersensitivity to certain internal sensations and/or fuzzy social rules. It certainly seems plausible that individuals in one or both of the latter two categories could, on the margin, find their experience pattern matching to that of being trans, and come to the conclusion that they are in fact trans (or at least that gender transition is the solution to their symptoms) through a sort of unconscious confirmation bias and social reinforcement process rather than a purely internal biological one.
I'm very weirded out by this discussion-- it's a very outside view of transness. It's plausible that my social circle might include more trans people than most (there is (was?) a medical center doing transitions in Baltimore) and I'm in fandom, but am I the only person here who knows any trans people? I can see why a trans person might not want to join this discussion.
From another angle, I've got one friend who thinks that m to f tends to work out better than f to m, and I'll note that most of the trans people I know are trans women. Any thoughts about whether both directions work out about equally well?
I think there's me and one other trans person here
There are at least two of us here, but yes, it's a little exhausting.
hi!
Hi!
How's it going?
Typical Tuesday...wake up, do laundry, defend the validity of my existence...
Yep, yep
I normally do this fridays so this is a big change for me
I know about ten trans people, dated one a few years, have lived in the same group house as two others for a few years. I'm not sure what you think is outside and would be interested in an explanation.
I think they're talking about the other people in this comment section, some of whom have... uninformed views about trans people.
I would say "politically constrained" views. It's really hard to have open discourse about trans people because the arguments tend to be heavily biased by political camp.
I wasn't thinking about you so much-- at least you were careful to say that social contagion leads to real emotions, it was more about what seemed like a majority of commenters.
What I mean by "outside view" is something like "transgenderism is this weird phenomenon, let's see if we can figure out what can be done about it".
My take on it all may be unusual. I've known some people who transitioned before it was cool and were visibly happier. I believe gender dysphoria is real and transitioning is a solution to it for some people.*
On the other hand, I do see pressure to transition in some social circles-- it looks like the assumption that transition can be an urgently needed method of suicide prevention. And also an assumption that trans is cooler than cis. This could lead to people who are a little edgy about their gender or miserable for other reasons getting pushed into transitioning.
I also suspect that transitioning may have become a more difficult medical challenge than it used to be, with a hypothesis that hormone disruption is more common than it used to be, so getting to a new hormone balance that feels right to people might be trickier.
*I've also met a person who apparently had biological dysphoria-- they didn't like being organic. The emotion seemed very real and it was sad because there was no technological solution.
"-- it's a very outside view of transness."
I suspect many of us who've followed Scott's writing for any length of time also have a pretty outside view of even ourselves.
Obviously there's a lot of aesthetic judgement behind "work out equally well", but...
-Testosterone works SO. MUCH. FASTER. Like it's frankly insane how quickly a FtM visibly changes in a short timeframe versus a MtF on estrogen (talking weeks or months vs years). It often takes trans women at least a year or two, and sometimes many more, to get those level of dramatic shifts. And the battle tends to be more...uphill? One-way? T can make you grow body hair, bulk out muscles, etc. without trying too hard, but E won't shave a bear or change male-typical bone structure.
-OTOH, height is Still A Thing in both cases. I personally feel that "taller than average woman" gets a somewhat easier pass than "shorter than average man", though relative proportions matter a lot.
-The surgeries are...well, I'll avoid being prurient and just state that "bottom" surgery for MtF has progressed by leaps and bounds, but FtM isn't so lucky. The old joke used to be "it's easier to dig a ditch than it is to build a tower", or something like that. Architecture is easier when foundations are solid and building materials are readily available.
-OTOH, the aforementioned male bone structure can be a huge pain to deal with. Some are lucky to be born relatively androgynous, but fixing a Classically Square Jaw is...well. It's not easy. Vocal cords also likewise only develop in one direction, so FtM will get a more masculine voice by default, whereas MtF need to invest skillpoints in retraining how to talk. (There are surgeries in this realm too, but they're...very early days still.)
It's harder to get med prescriptions for testosterone. Controlled Substance, and all that. I used to do some care work for a trans man, and it was a real pain whenever it was time to go pick up his prescription..."yes, I'm an Authorized Representative, here's his ID, sure I'll call him on the phone, no I'm not trying to sell this on the black market, sure I'll sign these triplicate release forms"...versus me just, like, getting my pills and vials sent through the mail with no human interaction whatsoever.
Trans men receive a lot less attention than trans women...hardly zero, but it's like night and day. The recent hoopla over ROGD notwithstanding, trans men have kinda always been, like, an also-ran? An afterthought? Hardly ever addressed in the culture war or actual politics, comparatively. Trans women keep being the poster children for the phenomenon, with the attendant lion's share of both spoils and harm. (Remember the last time a trans woman was on the cover of TIME Magazine, front page of NYT, etc? Yes, vividly, and shamefully. Remember the last time a trans man was in a similar position? Yeah, me neither.) Part of this is just numbers - MtF has always(?) been a majority - but there's definitely some weird difference-in-expectations-violations going on too. In many ways, this is beneficial; enemies won't attack you if they don't know you exist. But there's a lot to be said for visibility and awareness too. Everybody Knows who Laverne Cox, Caitlyn Jenner, Chelsea Manning, the Wachowskis, etc. are. On the other side it's like...uh...idk. Buck Angel? Bono?
I could ramble on, but will just finish with saying that I think intra-group variance matters more here than inter-group. I've met trans men with inescapably high-pitched Valley Girl voices that don't "work out" at all, I've met unlucky trans women whose phenotype sadly won't ever let them pass without really drastic intervention and/or super charitable System 1 overrides. And likewise for the other end...trans folks who pass so well that I'd have a really hard time guessing otherwise. It really is a YMMV thing, highly dependent on genetic lottery, access to interventions, and the prevailing level of...I guess call it gender-vigilance in one's society. Don't think it's an easy call as to whether MtF or FtM is the "more successful" path overall, depends on one's values.
What I had in mind for "work out" wasn't just ability to pass, though that's obviously important, but whether the person is overall happy with their results. This would include whether the body feels right as well as whether it looks right.
Here's a possibly weird idea. Could trans women be an irritant to some feminists because, in addition to the usual reasons, they undercut a premise that women get a bad deal compared to men?
(The edit button is back!)
(Weird, I still can't find it.) There's been lots of self-report data over the years...most trans people end up happier (if not happy fullstop), largely because they're no longer (as) suicidal, cripplingly depressed, etc. When the usual treatments for such don't work, and transitioning does, there's __something__ going on there. Sort of like how Scott describes exorcisms in the book review: for whatever reason, sometimes the Obvious Nonsense treatment is just the only one that works.
One can of course dispute the "only one that works" part. There's the studies on desistance rates (higher than you'd think), the hair-splitting over which patients are "really trans" vs not, the focus on particular interventions' downsides. (The more early-days experimental the surgery, the less satisfied people tend to be, for obvious reasons. The people who were really unlucky and got rare bad results like nerve damage? Yeah, they're __really__ unhappy.)
It's also devilishly difficult to tease out how much of the "body feels/doesn't feel right" comes from one's own assessment, and how much comes from societal stigma/nonacceptance/transphobia/whatever. To absolutely no one's surprise, trans people are more happy in welcoming environments, and a good chunk of those who desist do so because life harassed them too much otherwise. Would transgenderism actually disappear in a culture with completely tolerant and flexible gender roles, as is sometimes postulated? I don't know, but it's an interesting thought experiment! How much of the confusion here exists in the map, versus the territory? It's an open question.
(Yes, that is one common TERF complaint. Janice Raymond's __The Transsexual Empire__ was an early consolidation of such ideas. The usual retort is that defining women by their suffering is actually really fucking sad, or something along those lines, because it would imply that the __perpetuation__ of such raw deal is essential to the continuing coherence of "womanhood" under this mindset. At least that's how I understand it.)
> Remember the last time a trans woman was on the cover of TIME Magazine, front page of NYT, etc? Yes, vividly, and shamefully. Remember the last time a trans man was in a similar position? Yeah, me neither.
A little less than two years ago, Elliot Page was the first: https://edition.cnn.com/style/article/elliot-page-time-magazine-cover-transgender-man/index.html
Was being more hyperbolic than literal, but I'd still stand by the claim that such depiction didn't have anywhere near as much impact as The Transgender Moment (or was it The Transgender Tipping Point? forget) TIME cover. That was A Big Deal, both inside the community and also as a culture-shock to the normies. Don't think I'll ever forget the sinking sense of dread from back then, "ah shit, now the gig's up and people will start to pay attention, so much for safety via obscurity". For whatever reason, no matter the context, trans men just seem to have more difficulty making a splash. Idk if that says more about them or about the audience though...
(Although I do think Max Wolf Valerio's "The Testosterone Files" is way more accessible a memoir than most of the MtF ones. Julia Serrano and others are good writers too, but firmly towards the Academic/Theory end of the spectrum...)
>I can see why a trans person might not want to join this discussion.
To repeat something I've repeated here in the past...it's so often the same battles over and over and over. Just gets kinda, well, boring? It's nice to be a SME for once, in some ways, but one could fairly non-satirically make a flowchart for how these sorts of discussions tend to go, from a trans person's perspective. There's the Just Asking Questions characters, the Actual Bigots (I use that term very sparingly - people here rarely reach Jason Maguire levels of self-parody, but there's always at least one), the White Knight Allies, the Talking Point Regurgitator, the Demander of Isolated Rigor, the Moral Crusader. Different sets, same cast every time. (Note that these characters show up on *both* sides of the issue, too.) Like Freddie de Boer says, there's something about this one particular issue that just seems to drive commentariats particularly nuts. One grows understandably weary. Not like "I'm tired of validating my existence to others" - I find such activist hyperbole equally sterile - but it's __intellectually uninteresting__. Which is the entire raisin deter I visit ACX anyway.
There are definitely statistically more of us trans folks on ACX than one would expect otherwise, but it's not particularly high value-add to engage in discussions when the outcome is nearly predetermined. Which is unfortunate, because there's an additional character too: the Honest Dealer, who is genuinely curious and open to new information/perspectives. For almost anything else on ACX, that's the majority of the players. For this issue...man, I dunno where they all go. But it impoverishes the experience for the remaining Good Ones like you that are actually worth engaging constructively with. (Thanks for not defecting.)
Thanks. I try to be a civilized person and it seemed like a light touch of "what's going on here?" was a better idea than denunciation.
I think trans isn't the only flowchart prone discussion. See also guns and abortion at least. Maybe crypto for here. I don't know whether the trans discussion is worse here than the others. There's a large chance of my eyes glazing over, so I might not be keeping track.
If you'll excuse a rant, I realize I'm a failure and a piece of shit by social justice standards because I base my opinion on knowing people and loyalty to them as much as on abstract principles or as (SJ seems to prefer) immediate obedience to my moral superiors. I'm pretty bitter about it. Perhaps someday I will get myself emotionally unhooked.
Hey, lived experience is considered to have high epistemic value among thawt crowd! I gave up on trying to shoot goals for people who constantly engage in goalpost-moving, and it's really improved my life. Principle of Charity doesn't extend to bad-faith bullshitters, and all that. Not all SJ is like that, but way too much is...dogmatic, I guess I'll settle on that term. When actual trans people start getting cancelled by trans activists, you know something's gone rather wrong. (C.f. Natalie Wynn, among others. "Speak your truth! No, not like that!")
Nevermind that a good deal of those abstract principles rely on studies and data that is...uhm...I mean not to do an Isolated Demand for Rigor, but so much of the study of trans people wouldn't pass basic muster to, say, a typical Scottpost level of scrutiny. Claims of moral superiority need to at least come from a firm grounding in reality...not low-powered, really old studies riddled with confounders. (There was an excellent effortpost linked here last year, about how so much of the anthropological basis for "Native Americans had analogues to trans people that they tolerated and treated with great respect, this has been around forever!" is exaggerations at best and outright confabulation at worst. All from one single bad researcher with a terrible case of motivated reasoning. Alas, I can't find it anymore.) But that's all the data there is, so it's natural to try and canonize it, I guess.
Only a small fraction of readers comment here, and usually they feel the most motivated, which can lead to lots of festering-frustrations-as-talking-points posts, but your thoughtful and reasonable contributions here DO get seen by a great majority of Honest Dealers who are lurking these parts. I hope that is small comfort.
> it's so often the same battles over and over and over. Just gets kinda, well, boring? It's nice to be a SME for once, in some ways, but one could fairly non-satirically make a flowchart for how these sorts of discussions tend to go, from a trans person's perspective.
What you need is a chatbot to handle all of the basic repeated questions, and which only alerts you when someone has a truly novel, potentially interesting, question.
Sadly my grant proposal to build "ChatGenderPersonThings" was not approved.
It does bug me a lot when people non-ironically use the "It's not my job to educate you" non-response...like, hey, people have uninformed opinions about stuff all the time. That's just how humans work...social status doesn't care about epistemic status. The terrible old days of LMGTFY were just blargh. (And I hope everyone learned a valuable lesson that Sometimes The Internet Is Wrong Too.) Still...I think especially to someone with a Bayesian sort of mindset, it feels...frustrating? incomprehensible? to form beliefs unsupported by any facts, just for the sake of playing Simulacra Level 3+ games. Yet there's a certain duty too, I guess, to be a #representative of sorts now and then. Any time I neglect to engage someone on the 101-level, that means they might instead get their education from, like, Abigail Shrier or whatever. "if you choose not to define yourself, the world will do it for you" and all that...
I miss the (imaginary?) Good Old Days when Wikipedia was a sort of intellectual DMZ, "good enough" as a ground truth reference for most things for most people. Nothing's really replaced it, at least in terms of convenience and centrality.
This will sound weird, but the penis retraction thing happened to me at about 11 years old.
One night, a bit of foam comes out, and it shrinks to near nothing.
Was very concerned but kept it to myself, and it resolved after a few days.
No clue how this works.
Minor aside: the National Radio Quiet Zone isn't just for military use. It's also one of the few places in the county you can operate a radio telescope without getting a bunch of background interference. It's a hotspot for pulsar research, and probably other astrophysics stuff.
Also astrochemistry, planetary science (via radar), star formation, Galactic structure, cosmology, and SETI.
I wonder if penis-stealing is more prevalent in tropical countries where men have never jumped in a cold lake in winter and had their penis actually retract into their body.
I'd also like to know whether recent weight gain has any association.
Would people care to take a crack at the sense of rightness or wrongness that people can feel about their bodies or perhaps their lives?
Is it possible that this is simply a version of discontent?
I know of people who have switched jobs and careers multiple times - not to mention romantic partners. Each situation/person was desired and loved by others, but this person keep moving on to greener pastures.
I am not calling for a total submission/lack of desire/lack of striving, but perhaps havinga bit more gratitude for whatever we got.
I've felt "too big" for most of my life. I have no idea how closely this relates to transgender.
It seems pretty straightforward to me. I am unusually large in height and width, so stuff seems too small. Plus, people comment on my size regularly.
A therapist has told me this is dysphoria, but I don't really see it that way... To me, it seems like a natural response to airplane seats and non-tall-sized clothing being too goddamn small.
Minor nitpick: you said in the illustration accompanying “Flowers Of Virtue” that the box of penises is to her right- it would be her *left*, our right.
Did Oliver Stones "Natural born killers" sensitized folks to do school shootings? Maybe, see very fine book review by whimsi.
https://whimsi.substack.com/p/why-did-columbine-happen
(Whimsi nearly won an ACX book review contest with a George Orwell review - and
Oh, and I grossly over-simplify a very fine and long post. Still "3. Exposure to an ideology that serves to ‘explain’ the state of humiliation, ... This can be ready-made or handed down from a formal organization for propaganda, or patchworked from multiple sources by an amateur idealogue with little connection or even a clear understanding of the actual sources of the ideology.
4. Role models that exemplify said ideology are sought and emulated to a greater and greater degree. This will affect the manner of dress, speech, etc.
5. The role models are emulated, and the ideology actuated in steadily more serious infractions against the hated world order. A social unit of some form and scale reinforces the acceptability of said infractions and insulates participants from the social consequences (I feel I have to inject here that DK and EH planned ‘missions’ in the months leading up to the shooting, wherein they vandalized houses, set off small bombs, and even shot young trick-or-treaters with BB guns)."
>Wise but evil women (gender studies professors) are using incomprehensible black arts (post-modernism) to make people lose their penises.
>Western civilization turns other culture’s myths into reality... Now we’ve finally gotten around to penis-stealing witches.
This whole post was an excuse to make that joke at the end, wasn't it?
I wanted to ask Scott if he had this idea in mind when he started writing, or if it just came out as it went along.
Reminds me of the Dave Chapelle bit where he can pull a punchline out of a fishbowl and make it work.
https://youtu.be/VHkHw-NQ5Wk
Is there any good breakdown of where the rise in LGB identity is coming from (that is, mostly a rise in L/G identity, or mostly a rise in B identity)? A Gallup survey says that most (57%) of LGBT people are bisexual, but I don't know if that's a historical shift.
My hypothesis is that a lot of the change is coming from Kinsey scale 2s (say, a dude who exclusively dates women but would totally make out with Channing Tatum if given the opportunity). A generation ago, this guy would say he's straight on a survey (since being bi would lead to ridicule/oppression/lowered social status), but now is saying he's bi (because being LGBT is brave, increased status in left-wing social groups, he can still take women to the towny bar where he might get called a fag if takes a man).
Similarly with the rise in trans identity: is the increase mostly in people who want hormones/surgery, or in AFAB non-binary folk who certainly feel closer to the "woman" identity than the "man" identity but who don't appreciate being saddled with the expectations of womanhood?
B has increased the most, specifically among females, and the large majority of bisexual women who report being in a relationship are with a man. Glenn Greenwald (married to man) & Katie Herzog (married to a woman) discussed that recently:
https://greenwald.substack.com/p/video-with-katie-herzog-on-the-expansion
Bryan Caplan (so heterosexual he's practicing what he preaches on pro-natalism) also noticed that sylized fact: https://betonit.substack.com/p/lgbt-explosion
Well, even if all those Bs were total Kinsey 3s, equally attracted to men and women, AND we exclude social pressure to identify one way or the other, we would still see most bisexual women with men, since there are still more straight men than lesbian/bi women.
Katie Herzog relayed from Gallup that about 0.3% of bisexuals are in same-sex marriages. https://youtu.be/wt8BZzLFpzA?t=821
I'm one of the few that correctly saw the sensitization tests without checking the answer.
Also I'm pretty sure the redline on the dog has its hind legs wrong: https://imgur.com/a/PRwO8no
Fascinating read.
I would be curious what the numbers around "few" actually are. I also saw the pictures immediately and was quite puzzled that they were being framed as extremely difficult to see, but apparently that's the case for a decent number of people.
I'd like to know the stats too — I just trusted Scott to have picked them out for a reason.
I also know I have an abnormally keen sense for pattern detection from life experience and some IQ testing I took a while back. You're likely the same.
Scott has used those same two images before in an old SSC post, so I recognized them immediately cause I remembered the answer from years ago.
But that first time...the dog was fairly easy (not that many things have such spot patterns), the cow stumped me for quite a while. I think that's partly me ~never seeing cows in my everyday life, while dogs are everywhere in SF. A former roommate even had a Dalmatian, for that matter. We're more primed to pattern-match things we expect to commonly see, not those we aren't. (I think.)
The cow was instantly apparent but even after seeing the answers the dog was an "I guess I kinda see it" for me.
> The Columbine shooters seem to have been autocthonous American cases... before their fame inscribed amok onto the US collective consciousness
Don't be too sure of this. They weren't the first such shooters, and their actions came after American culture had started to unravel. Compare suicide in Greenland - yes, there may well have been a memetic effect there, but the epidemic occurred after their values had been undermined by exposure to modernity.
It makes more sense to say that some cultures are robust, and others are vulnerable to these kinds of behavioral contagions. If so, we should predict that problems like school shootings will be exacerbated in America as the culture becomes more sick, and alleviated when it is more healthy. I have a test for this...
https://cdn.vox-cdn.com/thumbor/BpkVCLg7NMJUHYINttnFXk1NvPc=/0x0:1229x877/1200x0/filters:focal(0x0:1229x877):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/13616161/school_shooting_deaths.png
...YES! School shootings declined noticeably in the aftermath of September 11th, when a shocking narrative of evil enemies Threatening Our Freedoms (TM) galvanized the American people into a patriotic fervor, staving off the creeping cultural anomie and rootlessness for a year.
Lacan’s notion of the symbolic order might actually help provide some kind of answer for why there are culturally coded mental health disorders. Lacan is sort of justly neglected by the anglophone world because he purposefully wrote in an obscure way. But his idea of the symbolic order makes sense. Granted it's more philosophical than most therapists would probably be comfortable with, but it can be expressed in a way that should make sense to people.
Namely it is that people are sometimes unconsciously determined by language, particularly the language of their culture.
You can find examples in the literature of people who are stuck on some issue (this is what Freud's hysteria described), who only get over it by putting it into words, the words of their own particular culture. See this example of a contemporary case:
https://www.journal-psychoanalysis.eu/articles/hysteria-the-bet-of-psychoanalysis/
On Lacan's picture, texture of the symbolic in each place is different, has different weights and emphases, with different consequent eruptions of madness, different forms the ultimately insufficiency of the symbolic take different forms.
So, even if we are only *somewhat* conditioned by the symbolic order, by language (that is, this worldview doesn't have to throw the free will baby out with the bathwater), then we should expect different psychological disorders to obtain in different cultures, because the symbolic order in different cultures itself differs—in fact, it differs down to the level of individuals as well.
The symbolic is neither wholly individual or idiosyncratic or truly transcultural and objective. The moon is coded feminine in most cultures, but not all of them. Our own symbolic chain also has its "man in the moon," where a Chinese person might first think "rabbit in the moon." And some individual might associate the moon with his or her father or mother depending on idiosyncratic personal experience. Etc.
I think the whole penis stealing syndrome thing is also very, very psychoanalytic. One of the core concepts in both Freud and Lacan is castration, and while admittedly both sort of play games with the word such that it's difficult to hammer out a concrete, simple, sciencified concept which would be palatable to the anglo mind (although anglophones like Bruce Fink and Stephanie Swales, Darian Leader etc. do *try* to make it make more sense)—the fact remains that in clinical practice (particularly among schizophrenics), a delusion clustered around or somehow making reference to castration (really, strictly speaking, emasculation) is relatively commonplace.
All of which is to say that such theories could be on to something or could help us think about these things and thus help people.
I immediatly thought about Lacan aswell! I made a comment further down on how I think that treatment for culture bound mental illnesses, taking exorcism for demonic possession as an example, goes through the lacanic signifying chain, in order to clear the subconscious of trauma and resolve the issue, same as psychoanalysis does. Maybe psychoanalysis is a cure to culture-bound mental illnesses that is itself agnostic to culture?
I’d agree that because it’s a meta theory that is cross culturally applicable it’s worth looking into, with the provision that exorcism is real, albeit very rare. As Scott mentions above, in a case where it may be present the standard church practice is to bring the person to a psychologist first. There’s more in heaven and earth, horatio...
I don't really believe in the demonic in a mystical fashion anymore, I actually think principalities, powers, rulers of the darkness of this world and against spiritual wickedness in high places (Eph 6:12) describes Moloch-esque societal dynamics, not literal demons. Although I believe in some weird Kierkegaardian fusion of the spheres of the aesthetic, the moral and the religious, aka the leap of faith that Kierkegaard envied so is realising the seperation between (aesthetic), moral and religious was hazy in the first place, so in that case it may perhaps not make much sense to ask wether a demon is literal in the mystical sense or not, it talks like a demon, acts like a demon, is exorcised by a priest, is it not a demon?
I am anxious that such a “Jungian” treatment of truth (a pragmatic view of spiritual realities which takes them as truths inasmuch as they are psychologically operative) obfuscates truth as such. If autonomous malevolent spiritual intelligences really do exist and harm people (as absurd as it may strike all but the most ardent traditionalists/backwards rustics), then we should behave accordingly. If they don’t, then we should fight vociferously any implication that they do in fact exist. Any other stance strikes me as mildly patronizing. This is my whole problem with Jung, that he causes more religious and scientific confusion than, say, Freud, who was a relatively straightforward enlightenment style atheist (a la Voltaire).
So, in other words, if the Catholic rite of exorcism is merely psychologically operative, then it ought to be replaced by close work with a therapist. Rather, the religion itself should be collapsed and dissolved into psychoanalysis (if religion has no register separate from that of psychology/secular science).
Bruce Fink somewhere writes that the goal of Lacanian analysis is not to make the subject transparent to him or her self, but to reorient their relationship to the other/the world in such a way that it reduces some neurotic suffering. In other words, the end of analysis is not self-knowledge, but healing.
So there is a dimension there to which I see how what you’re saying could be true. My concern is just that by collapsing religion into its effectiveness, we will thereby destroy religion. If it’s untrue, we may as well show our cards and fight against it. Otherwise we risk patronizing religious people, or even lying to them for some greater good. But if religion is simply a lie which gives order and structure to social life, then it ultimately doesn’t--the truth will out, and people will react severely to the discovery that the elites have been systematically deceiving them!
I guess it is Jungian, although I kinda got it from Zizek/Hegelian ideas, although I took a different turn of thought at some junction. I like Jung. Don't like Freud so much.
Lacan actually thought that Catholicism was psychologically superior to psychoanalysis, in terms of being a near perfect Other.
>“The truth, my good friends, leads to religion. You never hear anything of what I tell you about this because I seem to be sneering when I speak of religion. But I am not sneering, I am grinding my teeth! It leads to religion, and to the truth, as I have already said. And as it is the truth, it is exactly for this reason that there would be something to extract from it in terms of knowledge”
He thinks of pilfering religion for its mystical gains in psychoanalysis as he has a very ardent anti-deistic atheist mindset, although I am more in for a synthesis of religion and psychoanalysis.
>My concern is just that by collapsing religion into its effectiveness, we will thereby destroy religion.
I personally take a little mental sidestep here, and take the effectiveness of religion as some evidence for its creator. After all, if God exists in the mystical fashion, wouldn't he fashion his religions to be some of the most effective and best psychological social contracts available? It is somewhat circular in logic, but I think the Kierkegaardian Leap of Faith requires some measure of circular or axiomatic logic.
>Otherwise we risk patronizing religious people, or even lying to them for some greater good.
The bible is not necessarily against patronising people, there is quite a lot in the letters of the New Testament that makes an academic hierarchy like the catholics use permissible. I am not a Catholic, but I have no problem with different perspectives of thought regarding the church among believers, the deeper you delve into the philosophy. Prolly related to the Existentialists Nietzsche and Kierkegaard being elitistic as fuck aswell.
It is the glory of God to conceal a matter; to search out a matter is the glory of kings. (Proverbs 25:2)
Wow, I love this comment! I thought I was the only one who knew about Lacan's uniquely weird take on religion.
To your point in paragraph 3 (your "sidestep"), I'd lay things out in the following way:
If Catholic religion (Lacan's "True Religion") does in fact fit into the human psyche uniquely well, it proves the truth of Catholicism, but if and only if the mind is in fact capable of knowing truth.
As I take it to be absurd and contradictory to post that the mind cannot know truth, then Lacan's insight (if it is not groundless) about Catholicism does in fact provide some oblique support for it—but only if one accepts the existence of objective truth.
I add this because Lacan himself was not a Catholic, so he must have believed that it was ultimately untrue, and that the mind cannot know the truth (or rather, that the mind was not made to know the truth... that it can know the truth, but only by accident—mainly it just knows its own fantasies).
As he was a psychologist and not a philosopher, I think he failed to see that his relativism (for that is what I'm arguing his position boils down to) was ultimately contradictory. Actually, as I think more about it, I consider diagnosing psychoanalysis with an insufficient account of nature. It results in relativism (which contradiction overturns the original denial of nature), but that original denial is the real problem.
I wrote about this all in an essay I probably won't ever publish:
https://8014543.substack.com/p/890b74ed-2d41-439d-a3f6-50876b2d157a
If you want to cut to the chase, please control+F "Psychoanalytic Thought with (dis)respect to Religion"
I am also particularly attached to that verse from Proverbs, in part because it seems to make God into a kind of puzzlemaker, which rather shocking characterization of him I think we seldom see elsewhere throughout the Bible.
>The bible is not necessarily against patronising people...
You make a good point that the Bible has Paul serving the Corinthians "milk, not solid food," i.e: concealing or rather not revealing certain difficult doctrines until such time as the believers are ready for it. This must be distinguished from actual lying, however.
And Christ Himself did not let everyone in on the whole shebang at once: "I still have many things to say to you, but you cannot bear them now."
Nevertheless there can be levels to truth which are deeper and deeper, yet without contradicting what is on the surface. While "God is One" can be revealed to be "God is three persons" without substantial contradiction, I think "God exists" cannot be revealed to be "God does not really exist." Yet maybe all this is more of a question about the stance which we should take towards truth itself. I think JBP somewhere says that he doesn't want to say that he believes in God, because he thinks that by doing so he will obliged to be a saint, and that moreover the slightest failure would show that he was lying, that he never really believed. And that is a common criticism of us so-called Christians, that we obviously do not believe, because we seldom act as if we really do believe (see Scott's interesting "video tape of hell" article). But I think such a view fails to take a properly nuanced approach to truth. There are degrees of faith, hope, and charity. The Church teaches that the truths of faith are the purest and clearest in themselves, but because of our fallenness, they are often the dimmest to the human nature which attempts to seize them. Rather, without supernatural grace it is not even possible for anyone to have faith.
I only take the above detour because I think that (and I blame Protestantism for this) there is a common tendency of failing to make a distinction between the natural and supernatural order. Yet "no one can say, 'Jesus is Lord,' except by the Holy Spirit." Which is to say that the confession of faith is not something infallible earned from a close forensic analysis of history or upon the successful completion of a series of syllogisms; it is an unearned grace which lifts up the mind quite apart from anything we could do on our own. It is a personal act of trust between man and God, not something proven and evident. As Aquinas says, it is a mean between "science" (knowledge) and "opinion," because it comes from and depends upon a person.
Also, apologies if any of my foregoing comments seem chauvinistic or triumphalist or attempting to convert with a kind of cudgel. I have often been guilty of intolerance; I'm glad that you are so intellectually charitable about these things.
How should trans people who share your belief that gender dysphoria is largely cultural behave? If you have a painful mental health condition, the only treatment for which is expensive, invasive, and leads to sterility and social ostracization; don't you have a moral responsibility not to spread it? Do you have a moral obligation not to share your experiences on the chance that people would begin to experience ambiguous dissatisfaction as gender dysphoria and become trapped that way?
I just feel like you dropped an enormous "black pill" on trans people and the suggestion that "actually societies can tolerate lots of different default sexualities, like, Greek pederasty" (great example) is cold comfort. If it's possible for a lot of people to avoid the painful experience of gender dysphoria and transition, shouldn't we strive towards that? If you were a trans person who shared your own beliefs about the nature of gender dysphoria, how would you behave?
I don't know any trans people, but my take on the whole thing (not just the gender dysphoria part.) was that regardless of the cause, the effect is just as real. You are really suffering from gender dysphoria.
Right, so don't you then have a moral responsibility to prevent other people from experiencing real suffering by limiting cultural contagion?
The situation is at least complicated by the people (rather a lot of them, it seems) who say they were suffering from something and their lives got better when they got words for it because other people were talking about it.
I think gender dysmorphia is well past the point where voluntary quarantine would do anything.
"If it's possible for a lot of people to avoid the painful experience of gender dysphoria and transition, shouldn't we strive towards that?"
Obviously. What problem exactly do you envision with this?
I don't know. A few months ago I had an injury where I was pretty sure most of my pain was neuropathic in a way that seemed culture-bound, but I couldn't find a good way to leverage that information to actually be in less pain. I also didn't particularly feel like pretending I wasn't in pain to avoid spreading the idea.
I think right now nobody has any obligation because this is all speculative. I think in a hypothetical future where it's confirmed, it would be reasonable to have some kind of agreement between mentally healthy and mentally ill people where the former try to accommodate the needs of the latter, but the latter don't try to be especially loud about their condition. This is easier said than done; I assume all existing people who are loud about their mental illness would say they would stop being loud if they felt people were accommodating them fairly.
I mean, I didn't need Scott to give me any additional reasons, but a lot of his thought processes here are why I already stopped bothering to identify myself as trans most of the time years ago. (Except when it's relevant, like here.) Much better if the kids at work just think I'm That Weird Coolgirl instead of That Weird Transwoman. Like I don't *hide* the fact if someone asks directly or anything...it just basically never comes up organically, and I think it's too charged a lodestar to be strategically salient. Yes, there's some additional #clout to be gotten in SF for being visibly trans. But I don't want that one footnote fact dominating others' perceptions of me, and I really have no patience for being a token in their culture warring either. (Nor do I share their typical SJ/progressive politics anyway.) I already max out my Weirdness Budget in other ways, playing the trans card on top of that is just overkill.
The transition path was less rocky for me than it is for most; all the same, I __would not__ wish this ordeal on anyone if they could reasonably avoid it, precisely *because* I know I doged so many of the typical bullets. And a big part of that means not valorizing being trans, in the same way I don't like telling people I'm a mild autist* either. Yes, it lets me flow state at work easily, and that looks hells a impressive - but it's also an endless parade of frustrations and social missteps, as an extrovert who's nonetheless awful at reading people. To pick just one of many tradeoffs that I think get lost in the Awareness/Acceptance narrative. Neurodivergence might confer superpowers - but with great power comes great responsibility, as comic books once taught. And, boy, do those responsibilities add up. Even at the mild ends...Beware Trivial Inconveniences. The true cost of a mild ouch isn't usually "do a social thing less efficiently" or "spend extra time putting together a Coordinated Outfit". It's "do nothing at all". A flubbed first impression here, a missed party there, and sooner or later we're talking about real quality of life degradations. (Totally leaving aside all the macro costs of meds, surgeries, paperwork changes, wardrobe makeovers, etc, etc., which are not inconsequential.)
If someone is already definitely totally for sure trans, already going down that road - then, sure, I have no problem supporting them in whatever capacity I might as an elder. "The only way out is through", and all that. At that point, any chance for deterrence is long gone, and it's between them and Reality whether this'll be a good fit for them or not. May as well expedite the process and shorten the amount of unnecessary flailing-about-embarrassingly. But one must always think on the margin, as Matt Yglesias so often points out...if me being "stealth" and not evangelizing counterfactually moves even one on-the-fencer to the Desist side and they live happily Normie ever after, that's Worth It. And that makes the next one slightly even less likely, and so on and so on.
I think there will always be some fraction of "trans people", though the category boundaries will continually shift. But the optimal number, by my reckoning, is both nonzero and yet still pretty small. Small enough that one can provide reasonable accommodations without creating Utility Monsters or otherwise creating excessive disutility to the supermajority. "Safe, legal, and rare", as an old slogan once went. A world with 5% trans people - or, God forbid, 99% - that is not actually a reality I'd want to live in. Not just in the sense that Something Was Wrong with such a high rate of genetic defects/mental disorders/environmental contaminants/wonky hormones in womb/whatever causal pathways...but because the reasonable accommodations problem becomes so, so much harder. If we're doing such a shitty job now with only 0.5-1% ...I dunno.
(Full disclosure: I'm also pro-natalist and rather bitter about discovering I actually __really wanted__ biological kids...but only *after* reaching effective sterility. Not the least-biased or most-satisfied trans woman out there. This, too, is another tragedy I wouldn't want to potentially contribute to in someone else. SF has few enough children as it is, to everyone's detriment.)
*Same logic as https://slatestarcodex.com/2015/10/12/against-against-autism-cures/ except I also apply it to transgenderism.
Hey, Weird Coolgirl, thanks so much for sharing. I might say less stupid things in the future, (like move to the country and raise a family, I assume I don't have to apologize for my ignorance.)
Oh, I didn't mind that one actually. Zvi's blog just gets so much less comment volume compared to here that it feels like a weird place to "socialize". I feel awkward posting any comments there that aren't Super Serious.
There's still a good chunk of me that wishes for a non-city life...it's convenient in many ways (and relevantly, finding tolerance, if not always outright acceptance of quirks like being trans, is way way easier). But there's the constant downers of...well...basically everything Scott spent the last year writing about wrt homelessness, crime, drug use, breakdown of public order, etc. That sorta thing wears on one's soul over the years...every time I see the same damn bus stop glass smashed yet again (it's like the 6th time in as many months, or so), it's like, This Is Why We Can't Have Nice Things. I'd mind it a lot less if no one was even pretending to idealism here. But it's SF, City of Dreams, Progressive Mecca of the USA. That jarring contrast between high-minded do-gooderness and actual shit conditions on the ground - plus the actual literal shit on the ground, that sucks too - it's...just...I don't know. Too much cognitive dissonance in the air. Manifests as some awfully peculiar culture-bound syndromes that I'm tired of dealing with. I'm sure there's plenty other kindsa bullshit in the country, but at least it'd be some different problems. Things closer to Simulacra Level 1, I'd hope...
Geesh, IDK It seems like paradise where I live. (Well it's winter here, cold, windy freezing rain, but if all I have is some nasty weather to complain about...) If you're ever near Buffalo NY you can come out and visit. You'd have to like walking around in nature. I guess a down side is you have to drive if you need food or other stuff. There are some nice small towns around here. There must be some sweet spot that is the right distance from the city. As you move further into the country the people in general get poorer and the towns are also. And too close to the city you have almost solid suburbs. (Which are the worst of both worlds. IMHO)
Re: chatting on Zvi's substack. Huh, I never thought about it. I guess I'll have to ask him. So I'm too chatty over there? I always feel like I have lots to say...
>the only treatment for which is expensive, invasive, and leads to sterility and social ostracization
It is not remotely clear that is the only treatment.
I remember when I was in middle school there was a big awareness campaign around cutting. Assemblies, guest speakers, special sessions of health class, material sent home to parents, etc. Immediately, the number of (predominantly) young women cutting went way up - or at least the number cutting in highly visible locations did. The next year things were mostly back to "normal". Of course there's no way to know for sure, it's entirely possible that those people prominently displaying scars would have been self harming in some other way without the campaign, but it was striking to 7th grade me.
Don't misunderstand me, I don't mean to imply that cutting didn't exist before or stopped existing afterward. And I'll grant that middle schoolers may not be the most representative population. But from an early age I observed that
a. While mental illness has always existed, the specific ways in which it manifests can be extremely malleable, and
b. When you make it clear to people - especially awkward, insecure young people - that compulsive behavior X will result in receiving large amounts of sympathy and positive attention, expect rates of compulsive behavior X to go up. To be clear that doesn't necessarily mean people are *faking* behavior X (although in hindsight I suspect some of those scars were drawn on), but when social incentives are powerful and sudden people will alter their behavior in surprisingly radical ways.
Attention caught because I think this adds to my understanding of the anorexia contagion power/mechanism!
(uh whoops a little personal/heavy)
A different angle -- I grew up pretty prone to deliberate self-injury as a self-soothing technique, and while it was probably never *great*, it never felt like a *problem* until I was a cutter (in my late teens, to my embarrassment/shame at the time).
And the 'misc self-hurt' -> 'cutting, specifically' was pretty culturally mediated, where one day I was in my room having a bad time and wanting to ground myself in a way that I'd been able to do from injury before, trying to figure out *how*, and I realized I was holding scissors, and *duh*, cutting existed. Felt kinda silly for not thinking of it earlier. (*Really* silly, given that I was grinding the point of the scissors into my leg and being dissatisfied with the level of distraction.)
But ALSO 'cutting, specifically' turns out to be particularly attractive (in a statistical sense) form of self-injury because it's practically very easy, and the neurochem state after is strong enough to notice, but it's brief (seconds, unless you manage to really hurt yourself), and you build tolerance, and it (for me, with the shame) maybe makes the instigating unhappiness worse once you're thinking about it. Addiction is complicated but cutting is more habit-friendly than any self-harm I came up with on my own.
Anorexia seems like it involves some maybe similar self-reinforcing physical feedback loops.
Cutting is self-explanatory in how-to, but I think there's a relevant 'teaching at-risk people' -> 'accidental habit escalation' for anorexia, in the form of diet/life habits that marginal people will try if they hear about, and that happen to be unusually self-perpetuating in that particular form.
(I guess as a 'please no one be concerned' but also an 'obligatory other hand?' follow up -- I quit cutting, there's a lot of resources for people quitting cutting, and I actually quit habitual self-injury in general, and it turns out the cutting resources work for that too.)
Great. I broke down and gave you a heart.* Reading this I kept thinking that whatever it is, it seems like its adjacent to the placebo effect. (Which I don't understand either.)
*When you wrote that you liked getting hearts. I said to myself, "OK I'm not sure that is a good incentive, no more hearts."
I think you've got the etiology of the rise in trans identities more or less backwards, but your note that there is no neutral culture rescues you from actually saying anything false. I think we're not so much seeing a result of a stronger cultural sense of being the wrong gender (that probably peaked in the 80s), as we are a weakening of our culture's ability to assign gender at all.
Sex is biologically real. Intersex people are a small, but not statistically negligible, fraction of the population, and the rest of us do fall into two categories with regard to our outward sexual characteristics. But what traits do those sexual characteristics assign?
In 21st-century America, women are less enthusiastic about sex, often unsatisfied by it; therefore, it's only natural that men initiate most sexual encounters. In ancient Athens, women, the irrational sex, were slaves to their desires, and part of the humor of the Lysistrata was the idea that the women took their protest so seriously that they could restrain their sexual appetites.
In 21st-century America, mentioning that a man writes whiny poetry is a great way to call his masculinity into question. In 12th-century England, Richard the Lionheart was the epitome of manliness, and was especially praised for being a warrior poet. Only one of his poems survives (Ja Nus Hons Pris) and it's pretty whiny.
Anthropologists who study gender find gender categories like that in every culture, with anywhere from two to five genders. America right now has two, but its ability to assign those two is breaking down.
Weak prediction (call it 40%, with a very low chance that our current systems hold and a decent chance of something I don't foresee happening instead): in 2073, American culture will have three gender categories that are pretty well respected, with most trans people born after 2048 being in the middle gender (currently called "non-binary", which isn't just one thing now but is seen as one thing then) rather than being AFAB trans men or AMAB trans women. 20%: any attempt to explain what it is to be male in 2073 seems kinda nonsensical; 90%: any such attempt remains very controversial.
(Disclosure of biases: I'm a cis man that's also comfortable with neutral pronouns.)
Basically, I'm saying that transgender isn't a culture-bound condition - *gender* is.
But isn't this the point in the second to last paragraph?
ACT states that there is no neutral culture. For example in a culture where everyone is transgender after the age of 18 there would be a culture bound condition called 'cis-gender'.
I think it's a point that could stand to be expressed from more angles, so I'm trying to provide another angle. To be clear, I am not saying that Scott is exactly wrong about anything here, but that I understand the same phenomenon in a very different way.
After re-reading I understand where you're coming from more. Even so your conclusions are very out-there. Haven't most cultures had basically two genders, Why is America destined for three?
Also
> Basically, I'm saying that transgender isn't a culture-bound condition - *gender* is.
I don't see how gender could be a culture-bound condition. Since culture is relative, a culture bound condition is definitional abnormal which having the gender you were assigned at birth isn't.
European cultures in the historic period have almost all had two genders, but anthropologists working outside Europe often find more.
I posit that America is moving toward three because, although social justice advocates often note that "non-binary" is an umbrella covering gender-fluid, agender, and a variety of other descriptions, we use one word that covers all of that most of the time, and we're moving toward standardizing on one set of pronouns (they/them/their), which seems like our language (if not yet any of our social institutions) is starting to coalesce around a new norm in which there three categories. If that trend continues (which, note, I'm guessing at more likely than any specific alternative including than status quo, but less than 50%), it won't mean there's only one way to be nonbinary any more than right now there's only one way to be a man or to be a woman, but a lot of assholes will probably insist that there is (as many assholes do about the two binary genders right now).
>but anthropologists working outside Europe often find more.
*anthropologists desperately looking for more genders.
A lot of the actual data on this is pretty underwhelming when people have given me examples. "Look there were eunuchs and tomboys in this culture, it had 4 genders!"
Eunuchs castrated by the powerful to work as borderline slaves aren't a "gender" any culture should aspire to.
And tomboys are not a gender either. There can be masculine women and feminine men, and even people recognized as such without there being new "genders". And more importantly the tomboys are pretty clearly not saying "we aren't women".
I feel like these anthropologists would go to 1800s new England and find six genders two of which would be "Spinsters" and "Priests".
Hijras are generally not forced into that role, but clearly occupy a different social role from men or women.
Fa'afine are similarly clear, in that their gender expression tends to be in between traditional male and female.
You're right that in Europe some people look for a third gender that's not unambiguously there, though the example you should think of for that is Balkan sworn virgins - AFAB people who swear to celibacy and then take on male gender expression and gender roles. This is generally something done for specific contingent reasons rather than expressing an underlying non-female identity, and the social role they step into is not distinguished from that of a man.
Regarding PTSD, could its virtual absence in the past be due to the reporting problem ? Until relatively recently, the world was pretty much in a constant state of war; and for most people, survival was a chancy proposition even in peacetime. In such an environment, some level of (what we now call) PTSD would be expected, and not reported as anything unusual. Today, most of us lead the kinds of lives that would be considered incredibly sheltered and pampered by medieval standards; thus, PTSD is rare and stands out enough to be remarked on.
ACOUP Guy explains fairly extensively in the linked blog post why that's highly unlikely.
I realize even as I type it that this comment is likely to be part of an inevitable system of you getting it coming and going, and I also realize that as a Bay Aryan you have to do it to some extent to not get broken on the wheel, but still: I feel like you're really burying the lede here WRT transgenderism, Scott. First all that hedging, and *then* you admit you think transgenderism is about as cultural as anorexia, which you just made a huge deal about how it's super cultural?
I would just own it, man.
PS: I saw the gorilla, and it stole my penis.
I find it telling that your guesses about which DSM conditions are biological vs cultural line up neatly with.the order in which they are socially perceived in our culture as making one a villain vs a victim, with schizophrenia being the most villainous/biological and PTSD being the most victimous/cultural. It suggests that in fact they're all cultural, but that your desire to believe in the rationality and thus morality of your own actions (such as getting people locked up against their will for being labeled as part of a socially designated scapegoat group) makes you want to believe some DSM diagnoses are more biological (read: real).
I find it telling that your guesses about which DSM conditions are biological vs cultural line up neatly with.the order in which they are socially perceived in our culture as making one a villain vs a victim, with schizophrenia being the most villainous/biological and PTSD being the most victimous/cultural. It suggests that in fact they're all cultural, but that your desire to believe in the rationality and thus morality of your own actions (such as getting people locked up against their will for being labeled as part of a socially designated scapegoat group) makes you want to believe some DSM diagnoses are more biological (read: real).
No, they line up with how heritable the conditions are in twin studies. Schizophrenia is about 90% heritable. I don't think schizophrenia is actually especially villanous - that would be the various sexual disorders, personality disorders, or IED.
That's fascinating! However a condition could still be biological without being heritable, by being universally biologically present in every human, until it is triggered by a certain condition. This would mean if every human had the biological potential for PTSD just from the nature of how the fear centrum of the brain works, and some societies just trigger this condition less than others, it could be biological without being hereditary.
Fetal Alcohol Syndrome might count-- assuming my old information is correct, it makes people more impulsive and less intelligent, so a woman with FAS is more likely to drink heavily while pregnant, and pass the disorder on that way.
There can also be biological causes from physical stimuli - for instance severe injury, especially brain injuries.
What do you mean by "biological"? I.e. how would you distinguish a "biological" condition from a "non-biological" one? I ask because my interpretation of your comment is that all conditions would be "biological".
> Some see it as a giant Jewish conspiracy, others as being guided by the hand of God
The most parsimonious explanation is that the hand of God is guiding the giant Jewish conspiracy.
I'd wager that this is the best ACT post so far!
As nobody else has mentioned it yet (I think), I think it would be worth mentioning that 1997 Pokemon episode which caused seizures [0]. A guardian article from last year [1] says
"What Radford and Bartholomew discovered was that the vast majority of affected children had become ill after hearing about the programme’s effects."
From the article, it sounds like there was an actual effect from the episode, but most of the cases appeared after the patients heard about the other cases.
[0] https://en.wikipedia.org/wiki/Denn%C5%8D_Senshi_Porygon
[1] https://www.theguardian.com/tv-and-radio/2022/dec/16/pokemon-explosion-tv-japan-children-hospital
I wonder how much this applies to long covid... It was certainly an enormously publicised illness.
>PTSD: 20% biological, 80% cultural
I somewhat cast doubt on this from personal experience. I have never been diagnosed with PTSD, but I have been diagnosed with schizophrenia. After my schizophrenic/psychotic episodes I have been tormented with flashbacks, nightmares and such about it even years after the event itself, and after my almost miraculous complete recovery. I am certain I met the criteria for clinical PTSD as the flashbacks made me visibly flinch in public when as little as a lamppost reminded me of my episodes wandering the streets at night with a frayed mind.
The fear reflex felt way too fast and natural to be learned behaviour, although I can't exclude the possiblity in total, basically something set my mind to wander, a memeory of the traumatic event intruded, and then I was hit by a heavy wave of fear and stress.
I cured it by accident, as I came upon a podcast by Dr. Jordan Peterson and Dr. John Delony where they talked shop about how they treat PTSD patients, and I went and applied some of these routines to myself (basically convince the conscious with a sound narrative of why the unconscious does not have to remind you of your past anymore, as failsafes against fallbacks are in place), and voila, the flashbacks and nightmares reduced 95%, effectively stopped.
I think the romans may have had PTSD, but maybe they didn't have it related to war. If PTSD is indeed a fear mechanism trying to guide your mind away from recreating a pattern that could be devastating for it (i.e. bring a soldier back to Vietnam, bring me back into psychosis) as Peterson/Delony implied, and if the Romans had a culture that glorified war and saw it as a honorous place to be, then it makes sense that PTSD was not connected to war. Why should your mind warn you from going back into war, if the siege of carthago is a great place to be?
I remember Dan Carlin mentioning that there were probably Roman soldiers with PTSD in his Punic Nightmares Series (https://www.dancarlin.com/product/hardcore-history-punic-nightmares-series/) one of his best early Series IMO.
In a lecture in Munich in 1913, Carl Gustav Jung said he was led to distinguish between two types, extraverted and introverted, by observing characteristic differences between two groups of his patients, those suffering from hysteria and those suffering from dementia praecox. The latter means schizophrenia (I think), which you judge to be the most biological, non-cultural of your examples.
So perhaps, in a sense, the original meaning of „extraverted“ is „potentially susceptible to the kind of cultural contagion discussed in this post“. Only potentially, of course; he says that hysteria and dementia praecox are extreme cases, where something has gone wrong. And a decade later, in „Psychological Types“ (the book), he does not follow up on this much and instead refers much more to similar (he argues) distinctions in the literature, e.g. Nietzsche‘s „Dionysian“ and „Apollonian“, etc.
Comments:
1. Bouffé delirante: I remember researching this for a journal club, and the feeling was that it was the French version of another forgotten diagnosis, psychogenic psychosis.
2. We have seen conditions, then classified as 'monosymptomatic hypochondiacal delusions' that resemble the cultural psychoses, except with the contagious aspect. I recall one poor chap who was convinced he had a strange tasting fluid (not saliva or reflux) appearing in his mouth. After seeing lots of docs he was referred to our psychiatric day hospital but nothing made any difference, so my boss (a psychiatrist who made his name quite cynically by picking an understudied area - gambling) did what psychiatrists always do: he blamed the patient for not getting better, at which point the patient took offense and self-discharged.
3. I got to sit in on a couple of gynae clinics with Katerina Dalton at the Obstetric Hospital across Huntley Street behind the old UCH building when I was a student. What a sensible, down-to-earth woman she was. At the time she was into treating PMS (or PMT as we called it then) with progesterone suppositories.
Prediction: This is the post that will be cited up and down as evidence that "SCOTT ALEXANDER IS AN EVIL PSYCHO TRANSPHOBE PLOTTING TRANS GENOCIDE"
which may or may not lead to a follow up article in the NYT saying things like "Accusations of Transphobia have been made towards..."
Someone has to ask this question about Scott's dismissal of Voodoo Death:
Does this mean that if you die in Canada, you don't die in real life?
Until next time...
This all seems reminiscent of the Sapir Whorf Hypothesis or those stories/magic systems where giving something a name gives it power (perhaps telling stories of a demon really does, in a sense, give it power).
"What if transphobia is our culture’s version of the penis-stealing witch panic?"
Unlike koro, in the trans panic penises are actually vanishing, everyone can observe this to be the case. How can the man who wrote "Is Everything A Religion?" elide the significance of whether the alleged physical symptoms are real? This is a bullshit comparison and you should know better!
This post keeps touching on "psychosomatic problems are real", but I think it's important to expand on that because there's an important sense in which they're not.
A few years ago I fell and seriously injured my arm. I didn't break it, but for a couple days I couldn't move it at all without debilitating pain. Six months later I still had a reduced range of motion in my arm, if I tried to hold my arms out in a T-pose the right arm was noticeably less extended than the left. I'm pretty sure this was psychosomatic, some lingering "for god's sake don't move your arm"" impulse written into my muscle memory. Because if I grabbed my right arm with my left I could move it around just fine: no pain, and if I let go the muscles could hold the position I left it in, I just couldn't consciously flex the muscles into that position.
Now my reduced range of motion was real, I had some difficulty opening cupboards and so on. But if you just say "Ninety-Three's arm problem is real" then one might conclude my arm remained physically injured and that would be important because I eventually saw a physiotherapist who prescribed exercises based on assumption about what was wrong with me. A cocaine addict with delusional parasitosis has a condition that is more real than his socially-contagioned roommate, and this is important because one of them can probably be treated with CBT or something while the other should be told to stop doing cocaine.
A few years ago I had knee surgery after an injury. During the recovery period, which was quite long, I had an experience similar to yours: I could not bend my knee fully voluntarily, although I could get into this position without pain when the physiotherapist helped me. He explained to me that after an injury or an operation that causes pain for a long time, the brain learns that some movements are painful and restricts them (completely unconsciously) in order to avoid this pain. And it is often long and difficult to "unlearn" this restriction. So the condition is not physical, but I do not think it is "psychological" in the usual sense of the word.
On the other hand I had an injury where once it healed I didn't regain range of motion, and the doctor was like "oh it looked like I missed that X tendon ripped, too late now, you should have told me you had poor range of motion" (I was in a cast, not sure how I would have known).
I still did a year of physical therapy, to absolutely zero effect. The tendon is just not connected anymore.
I sympathise... And this doctor has his own way of unloading his mistake on the patient...
My only concern, and it's an "Old Man Yells At Cloud" concern, is that "culture" is becoming increasingly disjointed and fractal. Like I don't mind that we have a much higher rate of transgenderism in the U.S. because I don't care about that (and don't understand why 550 comments worth of folks do). It has nothing to do with me, and the transgender folks I know who were able to transition socially and medically have had massively improved QoL as a result. I can't consider that bad, and only really consider that "good" to the extent that it lets them do other interesting things with their lives. If calling my friend by a different name and pronoun makes them able to succeed in their chosen careers, show more kindness to others, be a better friend and partner, etc., etc. then I don't have to understand why they need that to do it.
But I do care that there are now full "cultures" defined entirely by being transgender, or having multiple personalities, or really really hating Infinite Jest. Not because you shouldn't be transgender or have multiple personalities or hate Infinite Jest. But because you're building an incredibly narrow version of both yourself and the world that will be impossible to escape as you grow.
I went through two years of depression that made me miss half of my bachelor's degree and that I still barely recovered from 8 years later due to "hearing someone expressing a wrong opinion during a college class" repeatedly.
Are you serious? Care to share some details.
I studied computer science in a third world country while being female. Hearing unprompted comments from multiple professors about women's natural propensities and abilities, and realizing that I will be viewed as different and inferior for the rest of my career started a hopelessness spiral. I got it fixed eventually and moved to a more civilized country but my anxiety levels have never returned to baseline despite years of therapy and meditation. I have a great life and a successful career now but I keep wondering sometimes how much more value I could've brought be my professors less vocal about their opinions.
Thanks for the info. Sorry that happened to you.
"National Radio Quiet Zone, an area in Virginia where the government enforces a ban on electromagnetic transmissions for secret military reasons)"
Several corrections here.
The NRQZ is centered and mostly located in West Virginia, but does extend into Virginia and Maryland
While it does protect the Sugar Grove NSA facility it also protects the Green Bank Observatory, an NSF-funded radio astronomy observatory and home to the world's largest fully steerable telescope.
https://en.wikipedia.org/wiki/Green_Bank_Telescope
There isn't a complete ban on electromagnetic transmissions. Within the NRQZ fixed transmitters have to meet power and directionality requirements. Mobile transmitters are unregulated. The regulations are stricter within 10 miles of the Observatory but there are still ways of mitigating transmitters (e.g. the microwaves at the Observatory are all inside Faraday cages), and exceptions are made for things like emergency communications.
I also can't believe you went the whole article without mentioning Lorena Bobbitt:
https://en.m.wikipedia.org/wiki/John_and_Lorena_Bobbitt
I'm pretty sure I have asymptomatic long covid.
"There is no amount of commitment to the bit which will make people drive metal objects through their penis. "
Huh.
Apparently sex-cult adjacent San Fran is a completely different set of experiences than demi-monde Austin.
Yeah I also thought that line was very wrong about human nature.
"There is no amount of commitment to the bit which will make people drive metal objects through their penis. "
This has now reminded me of an English court case from years back (1993, looking it up) where a set of men were found guilty of actual bodily harm and wounding, because they engaged in consensual masochism:
https://www.theguardian.com/law/2021/feb/17/landmarks-in-law-when-five-men-were-jailed-for-consensual-sex
"A majority ruling in the House of Lords said the fact that the men had consented to the acts, which included inserting fish hooks through the penis and nailing foreskin and scrotum to a board, provided no defence."
So people will do the weirdest things under strong impulses.
As subjects of The Crown, they needed HRM's permission to damage Crown Property no doubt.
> (there’s no such thing as witches, and the penis can’t retract into the body).
Are you saying Seinfeld lied to us? Like a frightened turtle I say!
> And how come knowing about anorexia makes it spread so quickly?
Innate desire for increased attention? The death was widely publicized and people do crazy shit for fame and attention.
Am I the only one who immediately saw the dalmation and the cow without looking at the answers? I kept searching for a second image, since I assumed that the trick was that there were two possible images.
Yeah I had no issue with those.
I had no problem with the cow (since I've seen plenty of cows in real life). The dalmatian took me a little longer but once I figured out the general shape it all came together.
I think more of us may have seen real cows than Scott expected 😁
The comment about overreacting to parental death reminds me of my rage at a manager back ~10 years ago where they were hired to be my new boss at a small ~15 person firm despite me *clearly deserving* (IMO) the position (except I was too young and didn't have the right educational background).
The new manager proceeded to be absolutely horseshit at her job, get absolutely nothing done, then ~6 months in her mother died. This was used as an excuse to get nothing done for another 3+ months and miss many weeks of work (which she didn't have leave for). Then when she came back there were constant comments about how impossible it was to work under the conditions of their 90+ year old parent being dead.
I called bullshit and was pretty rude about it, and left to start my own thing (which went great!). She got fired anyway as soon as was seemly, and the place ended up brining me back off and on in a consulting basis at ~4X the hourly I had been making before, while I also worked for their competitors.
Articles like this make me so glad I subscribe. I asked my wife is PMS really exists, and she said... yeah I think so, aren't I sometimes moodier than others?
So... no evidence there :)
> delusional parasitosis - the false belief that you are infested with parasites and can feel them crawling in your skin - is actually an especially interesting case. Two groups are disproportionately represented among patients: menopausal women and cocaine addicts. Relatedly, two biological conditions that can sometimes cause weird skin sensations that feel like crawling insects are . . .
Tangential, but I'm curious how the term "delusional parasitosis" might relate to an experience of mine.
For a period of many months, my house contained a large number of ants. At any given point, it was pretty likely I'd have one or two ants crawling around somewhere on me.
The ants frequently gave me the sensation that I had something on me, as evidenced by perfectly normal events such as 1. feeling a crawly skin sensation, 2. reaching over to it, and 3. coming up with an ant.
However, the sensation became much more decoupled from the actual ants than I would have liked. It was very frequent that I would experience the sensation of ants crawling on my skin where there were obviously no ants. And while this is harder to prove, I tend to suspect that my sensitivity to actual ants went down, that sometimes they'd be crawling on me and I just wouldn't notice.
I chalked up the false crawling sensations to, essentially, overstimulation. I didn't like the sensation and I didn't like that it was frequently provoked by no direct cause. At no time did I believe that the ants (real or spurious) were a danger to me, or that a sensation that occurred in the absence of an ant must indicate that the ant was really there but somehow difficult to observe.
> In our society, it’s commonly believed that War Is Hell, and if you enjoy it too much, you might be a bloodthirsty psychopath. Relatedly, estimates of what percent of veterans get PTSD range from 15% to 85%. I’m not sure the 85% number is accurate, but if it was, and I was a veteran, and I wasn’t getting PTSD, I might start worrying that this was starting to signal negative things about me.
I think there's a major confounder here, which is that, in our society, if you say you have PTSD, the government will give you a bunch of free money and compel other people to change their behavior on your behalf.
Sketching a stylized but potentially helpful model here, consider 4 categories of potential trans people by how their dysphoria is mediated by social contagion:
0. The inevitables. The ones who in a world where 'transgender' is not a concept at all, personally decide that they are the wrong sex, spend the first part of their lives asking how they can change sex or what they need to do be a member of whatever gender, and get told by everyone that it's impossible and made up and they'd have to figure out a way to be happy as they were; then they do their level best cut ties with everyone, get some new clothes, and move somewhere under their target identity.
1. The inevitably weird. The ones who'd go around asking how they can change sex, and, on being told it's impossible, make unhappy faces and ask if you're really really sure? then sigh and work on 'figuring out a way to be happy as they are,' whatever that means. Probably crossdressing. Maybe religion. Maybe they meet a trans person and suddenly understand they're not unique.
2. The inevitably sad. The ones with confusing discomfort with gender and sex and society. The ones who hit puberty (edit: or otherwise encounter gender) and realize they don't like where life is going, but in ways that are complicated and confusing and might take a long time to follow to any particular conclusion. Or, come to a quicker and less confusing time when re-considered with a framework of gender dysphoria.
3. The otherwise fine. The ones who learn about gender dysphoria, and find confusion and discomfort in their experiences with gender and sex and society, and follow patterns of gender dysphoric behavior to try to resolve it.
To be clear all categories can include non-binary people, and cis people / people who don't recognizably transition.
0's semi-hypothetical because anyone who tried that hard and can be reached for comment at this point probably knows that gender dysphoria exists. Group 3 is also semi-hypothetical because it's just 2 with a secret untestable uncondition.
There is no real way, in a world aware of gender dysphoria, to distinguish between 2&3. And there's no external distinction (and no certain internal distinction) between 1&2. That is, please assume that there aren't going to be ways to 'test' or 'screen' people into GID-I -II -III and alter approach accordingly. (Trans communities regularly try to do this, when people feel like some in-fighting.)
Anyone who transitions and probably all of groups 0 and 1 get enormous benefit from social normalization of gender variance, in pure practical payoff of 'allowed into respectable society.' There can still be drawbacks, like for all the people who were happier as 'androgyne' and are now 'trans,' or the ones who were 'transvestites' and now have to pick pronouns about it. The precise syndrome associated with 'transgender' might be a worse time than whatever transgression of gender people would have done otherwise, but at least fewer people will think you're just a pervert.
Group 1 contains a lot of people who are pretty obviously so much better off transitioning, and making that harder for them is cruel. This group is not going to get normal outcomes even without a socially defined conception of gender dysphoria, and on average would probably suffer a lot more.
Group 2&3 people seem increasingly likely to transition younger these days, and get to do it while people question their legitimacy. Some of these people are saving a lot of time by transitioning without spending 20 years figuring it out from first principles. Some of them are missing out on a life that was basically the same except they were cis.
I see people express a lot of concern over group 3. That's the group unhappier because they're in a world where gender dysphoria is an option. They are that by construction, because that's the imaginary line I'm drawing between 2&3. Group 2 looks entirely identical to 3, only the cultural accessibility of gender dysphoria has a more ambiguous impact on them. They already had gender-related issues. They might have eventually resolved them without a dysphoria framework, or been more able to push them aside to a tolerable point. Honestly I don't know whether they win here on net. But I guess generally I'd build for 'suffering with a map' over 'suffering without a map.' Maybe it's worth trying to make it a decent map.
hrmm I'm a bit skeptical of group 3 being particularly large, I think the discomfort is still there, even if you're not noticing it
a category that *is* very hard to distingiush from group 2 is "people who would be comfortable with either gender identity but for some traumatic gendered experience of some kind"
Yeah, my personal sense is that group 3 is pretty rare, and gets some dispoportionate attention.
I would consider "people uncomfortable with their gender due to some traumatic gendered experience" within group 2... though I see I may have muddled that by bringing up puberty. People who are uncomfortable with gender due to gendered experiences. Some gender discomforts are more or less inevitable in ways unrelated to cultural conception of transgender -- the classic one is sexual assault, which *is* evitable, and may be the source of someone's gender discomforts, regardless of whether that person thinks about gender in particular terms.
I think the really tricky thing here is IME trans people cope with the shitty parts of being whatever ASAB they are unusually badly
Tracks. And honestly! There's a whole theory of 'transgender as a reponse to sexism' that mostly seems to be fading from mainstream because it's just not borne out by the evidence, and I'm kind of surprised there isn't even much illusion of evidence, since I do kinda expect the sexism*trans interaction to look like something.
I might be unaware of the latest points. Or maybe I should not be surprised that the theory was not looking very closely.
Isn’t the relevant counterfactual a world where modern transition technology exists but is considered elective, like a facelift or tattoos, rather than a treatment for a psychiatric condition? There would be no concept of gender dysphoria or having a gender identity different from your sex at birth, but some people would transition just for a different body. We have no way of comparing numbers of people who would transition in this world, unlike the actual past. (Sorry for any posting glitches)
There can be multiple relevant counterfactuals!
I think it might be meaningfully hard to break apart 'modern transition technology' and 'concepts of gender identity' -- ie if you include (as I think you should) things like "a way to legally change sex marker" -- but I think you're getting at a relevant variant path of gender-in-society, yeah.
fwiw, I don't think this is practically very different from the actual experiences of lots of people today. Milieu varies, but in my experience* once you're actually considering 'transition,' you find that marker changes, HRT, surgery, etc are very much considered elective except in the sense that people kind-of** expect a lot of benefit from the change.
*(Many, possibly the majority, of people I know who've changed their gender presentation were actually more/only willing to do it after deciding that it was a personal choice that didn't need justification of some threshold of dysphoria. I expect this to be correlated with my social preferences, so maybe less common over all transitioners.)
**(I do sometimes worry that this -- 'this' the expectation that people are miserable with their working body/pronouns/clothing due to a boy/girl misalignment -- is increasing or will increase in a self-fulfilling and/or annoying way, but I'm not seeing evidence the worry is more than a 'kids these days' disconnect on my part. Honestly, I think trans conversations have moved away from 'fix your painful dysphoria' narratives over the last 20ish years. It's probably still getting more common overall, as mainstream spaces pick up the most legible/marketable trans narratives. I don't know how much various people are influenced by direct trans discussions vs mainstream reflections.)
(Posting seemed normal from my end!)
I think you'd need transition technology several steps beyond modern for that to be something people would chose to do for fun or fashion.
And AI doomerism? A person who cares and is intelligent “should be concerned” and Lo and Behold, Big Yud has spoken...
The optical illusions:
I grew up spending summers on a ranch. I saw both pictures immediately. I initially didn't understand that either image was an optical illusion. The picture on the right, especially, I don't see how I could miss it. I used to ride in the back of a truck with a bag of range cubes, and they'd come running as soon as they heard the diesel engine coming down the highway to the gate. They knew which truck it was. Scott saying, "of course you don't see them, you have no references to see them," made me laugh. Speak for yourself!
On the other stuff, as an individual I spend a lot of time excluding information from my brain because I know that I am not special. People are highly suggestible, and the only defense I have is to limit bad information from getting in. Scott goes on about Bayes and priors, but it's more about trying not to put too much energy into things which I do not have control over. I refuse to get into AI ethics, for instance, because it's pointless. I have no impact (and neither does almost anyone who does worry about it.) I am more likely to convince world leaders to abstain from invading other countries. It's not worth my time. Also, it's pretty obvious that it will require government regulation because history has plenty of examples of negative externalities which private corporations failed to control. The benefit of unregulated AI to individual corporations is more than the damage the AIs will do to society overall. This is already true in regards to privacy and information gathered by big tech companies, and I don't see why they'll do any better with AI. Why would they?
I put that part in because I wanted to see if one of my later observations holds true.
We have to be suggestible to function. Humans are social creatures more than they are intelligent creatures. Understand that, and you get people. You aren't smart. You are social. No amount of smart compensates for being bad at social, and being good at social requires some smarts but goes a lot farther. The dark side is that we believe stupid things to fit in, because that's more important than truth. No culture is immune. None. Not yours, not you. No one.
An example: Video games. A few of my friends are very good (world class) at exploiting multiplayer video games. One of their strategies is to intentionally find play options the community has rejected and experiment with them. It doesn't always work, but very often it does. Their advantage is that, whatever it is, it hasn't been nerfed because the community as a whole wrote it off. Often, these options have existed for years and no one bothered to try them. It's not because no one was smart enough or lucky enough to find them. In a game with hundreds of thousands or even millions of players it should have happened already. What explains the failure of so many people to discover an effective build is that people heard that the option was bad, so they never tried it. Additionally, a good build is usually a result of skills or gear combinations that require some intuition and experimentation. Most people would rather do what the community thinks is smart than be seen trying something dumb. A few people should not be able to find so many exploits in games with this many players, but they regularly do. This can only be explained by the whole being dumber than the parts.
Football. Coaches are finally, FINALLY, going for it on 4th down. Sports nerds have known for decades that statistically it's better than punting most of the time. Yet, coaches would rather lose than be criticized when it doesn't work. This is a really important observation: individual people will make decisions based on social pressure even when the community is wrong, and provably wrong. One person can't stand up to a group, even if they are right. We all think we can, and would, but I'll say that no, you can't and won't, and don't. That's why we respect some people, long after the fact, when they do stand up. At the time, we hate them. Most of the time no one remembers them.
The more connected people get to the internet, the more social pressure there is, and the dumber people get because they don't want to look bad. I can go into pretty much any forum, say something completely verifiable and obvious, and someone will freak out and "prove" me wrong simply because the group, by a process similar to genetic drift, has happened to latch on to some belief which is nonsense but can't be criticized. The more nonsense it is, the bigger the freak out. The actual politics aren't relevant, if it's even political. Lately, it's about protecting the feelings of people who don't seem to actually exist except as an excuse to say, "shut up." Again, the actual politics are irrelevant, and I don't consider the rationale important, because if it wasn't about protecting feelings, it would just be something else.
Alternately, not "getting" whatever the nonsense is about is proof of how wrong you are (ie if you can tell it's nonsense you are too stupid to understand). I've been wrong many, many times but it used to be someone could show why, and I was fine with that. I thought it was cool, because I like meeting people who can hang. Mostly, I want to learn, and being told to stop asking questions isn't teaching anything other than to do what you're told. Attacking someone's intelligence is the go-to thing online. It's not something that works that well on me, because I know exactly how smart (and dumb) I am, and it isn't something that can be proven except by expert knowledge, which few people by definition possess. Real experts will answer questions and explain their answers. Posers attack your intelligence. Also, outside of their field, experts are not any smarter than I am. In their field, I listen and learn.
Remember the part I stuck in about AI ethics above? That was an example of stuff that gets people upset. Plenty of actual experts can tell me why I'm wrong, I'm sure, but there's not a lot to go on yet. In a debate, I would get a lot of nonsense from people who have no idea about what's really happening.
I don't waste time persisting in saying whatever I wasn't supposed to say to tick people off. There's no point, and people can have whatever rules they want. It's not my job to enforce rules. Rudeness exists. I'm not going to change minds, I'm way over that. The only people I influence I've known for a long time. I'm definitely not especially smart or interesting (way over that, too), but I still think there is some residual value in saying obvious things occasionally just because it's rare.
I've been online since I had to call BBSs long distance (I knew someone who worked for US WEST which saved a lot of money) or connected to TELNET and Usenet by calling the local college UNIX mainframe computer. Internet culture has some continuity but, yeah, it's changed. The huge number of people who serve no function other than to enforce group norms, whatever they are, is the big difference. Social media monopolies bury individual voices and enforce conformity on a scale never seen before online. It's never been a bigger waste of time to say anything online. Oh, I just did.
ooops.
FWIW, I found this comment directionally informative on a few different q’s I’ve been chewing on for a while now.
I good example of this would be UFO sightings, with the US and UK absolutely dominating the worldwide reported sightings:
https://www.reddit.com/r/MapPorn/comments/odqjef/this_is_a_map_of_all_reported_ufo_sightings/
I would prefer a more credible source than reddit, but it does ring true that this would be a cultural phenomenon
This is wildly fascinating to me, not least because I'm currently grappling with how to approach the issue of my mother's growing paranoia. On the one hand, she's at the age for and exhibiting the signs of dementia. On the other hand, she's always been highly susceptible to outlandish theories and beliefs, and her day-to-day in-person paranoia (men sneaking around her house, banging on her door, stealing strange things from her yard; despite having many cameras, no pictures of these alleged men) has risen almost perfectly in tandem with her obsession with hardcore conspiracy theories about imminent martial law, societal collapse, rioting in the streets, mass arrests, civil war, nuclear war, EMP attacks, power grid attacks, etc.
This leads me to wonder - is her constant consumption of "bad world" media priming her to be hypersensitive to any immediate stimuli that confirms that the world is scary and dangerous and bad men are lurking around every corner? Or does dementia - as in cumulative *physical* brain changes affecting cognitive function - explain the increasing obsession with global-scale paranoiac media *and* immediate personal-scale paranoia?
As far as I remember the book review of The Body Keeps the Score, van der Kolk had to spend a lot of time convincing people that PTSD is a real thing, based on his evidence of patients with the as-yet-unnamed syndrome. Since this was pre-internet days, it would also have been harder for child abuse victims to form some kind of network and spread the "word" that way - which is evidence in favour of a biological cause, I guess? (I'm sure that veterans, the other major group involved, had their own networks and reunions back then, but child abuse victims in the days before people believed that this was a thing?)
You had that post about temperatures causing illness, but you were confused about obviously mild temperatures also causing sickness in some countries. Could that be a culture bound aspect?
Lol, so, in any other context this would be TMI (it might be TMI in this context), but, I think that I've had my penis stolen by witches before.
Or at least I've had a physiological experience that I can imagine attributing to penis stealing witches if I was inclined to believe in that sort of thing.
For lack of a better way of describing it, occasionally the head of my penis will turtle underneath my foreskin, to the point where it almost looks like my penis has retracted into my body.
It seems pretty related to social anxiety, it tends to happen in situations where my social anxiety is pretty high, not quite to the point of having a panic attack (I occasionally have those too), but pretty close.
I recall it happening several times in a particular college philosophy seminar where I was particularly worried about being put on the spot in front of the seminar.
Continuing the TMI theme, when it happens, I need to manually pull back the foreskin to make my penis reappear, which, if I'm able to excuse myself to the restroom is no big deal, but if I'm in a social situation that's not conducive to that, makes the situation that much more unpleasant.
Since you probably have everyone's attention, having checked yourself right there in the seminar, why not simply stand up, lock the door, and insist that no one can leave until the guilty party returns your penis?
For anyone wondering.... "What do I do with this information? Ca this help me?" (emphasis on I/me)
Get to know yourself. Listen to your internal signals. Don't attach to any single culture's approach or explanation, find the best one for you.
e.g
Chronic pain? Movement (western pt or eastern practices) and eastern acupuncture.
Acute pain from a broken bone? Western surgery and medication with movement to rehabilitate (again, eastern or western). Seemingly conflicting cultural explanations often contains pieces of the missing puzzle, which are more effective as a concept when combined and integrated. People have to do this work and you can't learn it by doing a homework assignment. It ties into my world view, value system, and approach to society... takes time to build up.
“Spartan men married and had sex with women, but they thought this was a dumb annoying thing they had to do to have children, and sex with young boys was the obvious enjoyable satisfying option.”
A historian on Yale Open Courses framed this a little differently. From what he says, sex with wives is the obvious enjoyable thing, but it’s to much of a distraction from their military training, so they live away from their families during service.
I don’t think this detail hurts the argument though.
Not the most relevant piece of the argument by far, but I'm unreasonable focused on it: I don't think the penis actually has much proprioception. Proprioceptive neurons and their related mechanoreceptors are concentrated in joints/tendons/muscles. There's some in the skin, but aside from a bit of muscle around the base of the shaft, the penis likely to be poorly proprioceptive, which is appropriate given that all our motor control over the penis is in the legs/hips anyway.
The touch perception of the penis against clothing is an entirely different sensory modality (and one our recent evolutionary ancestors didn't have.) Without it, it's actually pretty hard to tell where one's penis is using proprioception without other visual/sensory cues. The fact of poor penile proprioception might actually be an underlying issue here, such as the case of the man who looked down and suddenly updated his priors.
"When we remember we are all mad, the mysteries of life disappear, and life stands explained".
Mark Twain, Notebook, 1898.
I want to comment this every time and forget every time: I notice the "the the" thing without consciously searching for it. It just jumps at me. (My not being a native speaker is possibly relevant, but probably not: I do notice mistakes in Russian at higher rate than most people, too. Not a professional proofreader.)
In terms of the actual text… I feel really bad for humanity if memes (in Dawkins's sense) are so contagious that we can skyrocket (number of occurrences of) something like PTSD or gender dysphoria almost out of thin air. Unfortunately, it doesn't really _contradict_ my observations.
I suffered from jikoshu-kyofu, and this is the first time I've ever heard of that term! I'm American and have never heard of anyone else having this issue before. Getting out of it was actually one major life event that got me interested in rationalism more generally (before I met this community). It got bad enough that I contemplated suicide.
For the first 3 years of high school, I believed my family's house had an odor that was strong enough to make me smell bad after having left the house due to our house cats. I knew this was in principle possible, and that it was possible to grow accustomed to smells, so it was impossible for me to detect! No level of personal hygiene could help me feel better. I avoided social encounters, and this made me behave awkwardly, which caused others to behave oddly, which fed back into my suspicions. Over the 3 years it dealt a serious blow to my otherwise decent social life and drove me into a depression which impacted my grades.
"Evidence" for this belief was subtle things that people would do: avoid sitting to close to me, smelling the inside of their shirt, etc. Things that you really might do if someone smelled bad, and when my brain was looking for evidence I smelled bad, it was able to find plenty. I eventually figured this out and turned my grades and social life back around. Both my parents believe lots of conspiracy theories (also relevant to my interest in rationalism) and I can't help but wonder if I was in some way genetically predisposed to this.
Haven't read all the comments yet, but it seems useful to distinguish between false beliefs and impossible beliefs. The belief that ants are on your skin may be false, but it is hardly impossible. The belief that witches stole your penis is basically impossible.
The belief that are male souls trapped in women's bodies similarly seems like impossible thinking, rather than just false thinking.
Sure, both penis stealing and wrong-body having can be construed in false but possible ways, e.g. it is literally possible to cut off a penis and steal it, and it is literally possible to be born with various conditions which affect the state of the genitalia, but witch-penis-stealing is distinct from "violent castration" just as "transgender" is distinct from intersex medical conditions.
While as noted in the article, all beliefs are a result of some combination of physical stimuli and a priori social stimuli, beliefs in the impossible seem predicated on a specific false belief.
Just as modernizing societies that stopped believing in magic experienced near universal elimination of "witches-stealing-penises," even though they probably retained many of the sorts of physical stimuli that prompted people to experience particular episodes, our society too may (hopefully) eliminate "transgender," by emphasizing that the underlying belief is magical and false.
Hopefully acknowledging the impossibility of the delusion can lead to those with the unfortunate associated physical stimuli to seek out more productive, or at least less destructive solutions. Just as people in formerly koro believing regions much less frequently mutilate themselves attempting to protect or recover their genitals, hopefully people uncomfortable with their bodies can be conditioned away from mutilating them and towards less destructive solutions.
However, it seems like many critics of the transgender craze are fueling the delusion by implicitly acknowledging the underlying thinking and just questioning whether in a given case a person is falsely believing to have the wrong body, rather than truly in the wrong body.
I bet that long covid will be (or is already) rampant among EAs/Rationalists. Some of it will be "real", but a fair share of it will be culture-bound. Unfortunately it will be extremely difficult to tell the difference.
Re anorexia nervosa, in 1969 I came to know well a girl of 14-15 with severe anorexia nervosa. I knew her on a psych ward. When she entered from the medical ward, she resembled an Auschwitz survivor; by discharge some 4-5 months later, she seemed a perfectly normal healthy girl. So no, I don't think Karen Carpenter started it. My non-expert perspective is that the incidence of life-threatening anorexia hasn't changed that much over time, though the more casual type maybe has.
Tangentially, I'd love to read something about the Geography of Trauma.
penis shrinking can happens due to psychosomatic reasons.
this is a real phenomenon which makes it harder to pee, and makes sexual functioning markedly harder
it is distinct from non erection.
I'm wondering how common this is. but it definitely happens
from this experience to fearing and imaging penis disappearance, the distance is less than it seems.
I would argue that the number 1 Western culture-borne disorder is burnout.
I don't know about other European non-English speaking countries, but the very idea of burnout doesn't seem to exist for my Asian parents' generation and my grandparents, from the way they behave. If they ever lose motivation to work, we call that depression, (and they believe that depression is another weird Western cognitohazard but I'm not so sure about that point).
I do fully believe that people who are burned out in the west aren't faking it, they really can't summon anymore motivation. But I want to argue that it's culturally influenced and maybe related to the way motivation is framed in European cultures.
re PMS, it is not exposure to American culture that causes PMS in immigrants to the US. It is exposure to the American diet. Sugar, white flour, fat, alcohol, caffeine, red meat all really cause PMS. Pleas tell your wife about Susan Lark's PMS SELF HELP BOOK.
The sun rises in the east, sets in the west. Snow falls in winter, melts in spring. With the certainty of natural law, I know that if this is a predictive coding post, Scott will use the double the the thing.
I'm what appears to be only a third of the way through the article so far.
I am hoping (but not assuming) that it ends in a laughing trashing of some insanity known to effect the approximate community of most readers, say, gluten-intolerance, covid sickness (the majority of covid symptoms that the majority of people suffered would have not been experienced had they not expected/worries-about them) or that someone with a penis might "really and truly" be a girl (without radically changing what most people meant by the words "girl" and "penis" up until 2015).
I myself am not free from false beliefs or concerns having caused me problems so please do not regard me as calling anybody else particularly nuts for having caused themselves mental problems due to nonsense beliefs. We are all humans and therefore prone to being nuts.
But these are 3 nearly contemporary crazes that are just now finally burning themselves out so it would be a good moment to drop this bucket of cold cultural awareness upon everyone before it lacks the curative sting required.