Dangers of pseudo-science

Pseudoscience is anything that is peddled as being scientifically-based but is, in fact, not. That’s a big, broad definition for a big, broad topic. Pseudoscience is often composed of people who want to feel like they have some semblance of control over a situation (often an emotionally fraught one) and those looking to make money by taking advantage of other people by using technical-sounding jargon. Let’s break down these two scenarios while also acknowledging that they are not mutually exclusive.

There is a lot of uncertainty in the health care realm. We know so much while still understanding so little. We quickly reach the limitations of our medical knowledge in discussion about disease, how the body reacts to disease and injury, nutrition, etc. Additionally, our knowledge is constantly changing as we learn more. At some point in life, every single person will feel powerless over what is happening to their body, and that’s not a good feeling. It’s scary. The natural reaction is to look for a way to feel more in control of the situation. It’s an unsettling truth that we don’t have all of the answers and that sometimes the old adage “time will tell” is the best we have or “I don’t know, but maybe” is the best we can do. This place of vulnerability and despair is easy to take advantage of. Often, if someone simply says “Oh, they just don’t know but this thing WORKS,” those who are desperate will easily cling to whatever that thing is, regardless of plausibility. This is where pseudoscience comes in. It’s easy to take advantage of an emotionally fraught situation. People grappling with death or health challenges are looking for any advantage they can to hold on to every last second out of their lives. Enter, pseudoscience.

Pseudoscience can be difficult to pick out because one of its hallmarks is to use technical-sounding language to lend an air of legitimacy to whatever the thing is (e.g., vaginal steaming, homeopathy, acupuncture, etc.). Oftentimes, it’s created as a way to make fast cash—think essential oils and COVID-19. Sometimes it’s created out of a desire for an easy answer. Sometimes, it’s all of these things. Whatever the reason, pseudoscience is a big problem.

Let’s walk through an example of pseudoscience during this pandemic. In the desperation for a cure and a prevention (other than physically distancing, hand-washing, and mask-wearing, that is) the internet was alight with a myriad of suggestions. In a world shrouded in uncertainty and desperation, people were and still are willing to cling to any number of those suggestions, one of which was colloidal silver. Collodial silver has no real medical use. It can and does have serious side effects including turning your body blue, kidney damage, seizures, and possible detrimental interactions with other drugs that you might be taking. With these potential side effects in mind and the fact that colloidal silver doesn’t have any documented medical benefit, this isn’t something that should be taken thoughtlessly or “just in case.” It can, does, and has had, serious consequences. Also, it’s a waste of money, which is something few people can afford right now.

With 5 Short Words, the CEO of McDonald's Just Displayed a Complete Lack of Emotional Intelligence

It's impressive, actually: managing to break all the basic rules of emotional intelligence at once.

This is a story about McDonald’s, emotional intelligence -- and what happens when someone displays almost no emotional intelligence at all.

Here's the background. It starts with two tragedies in Chicago earlier this year:

First, a 13-year-old named Adam Toledo was shot and killed by Chicago police.

Then, a 7-year-old girl named Jaslyn Adams was killed while sitting in a Chicago McDonald's drive-through.

The day after the shooting that took Adams's life, Mayor Lori Lightfoot visited McDonald's headquarters in Chicago. She spoke with CEO Chris Kempczinski, and then Kempczinski texted Mayor Lightfoot.

Activists eventually used a Freedom of Information Act request to learn what he said to her. In what turned out to be the most important part, Kempczinski's texts read like this:

"p.s. tragic shootings in last week, both at our restaurant yesterday and with Adam Toldeo. With both, the parents failed those kids which I know is something you can't say. Even harder to fix."

I've highlighted the five key words: "the parents failed those kids."

Protests ensued, blasting Kempczinski for blaming the parents. In an open letter, some McDonald's workers and community groups called Kempczinski's message: "ignorant, racist and unacceptable."

The mayor's spokesperson commented: "Victim shaming has no place in this conversation."

Rank-and-file workers were upset, too. As one McDonald's employee told Chicago’s WBEZ:

"He doesn't know the circumstances of these parents. [He's] putting the blame on parents for the violence in the streets. He can't relate because he is wealthy, and we are not, and he doesn't understand our struggle."

After the backlash, Kempczinski wrote to all McDonald's corporate employees in the U.S. this week explain the genesis of his text to Lightfood, and maybe to apologize -- although he never actually used that word.

I've had the chance to review what he wrote, and if I can summarize, it really comes down to a simple proposition: a violation of all of the most basic rules of how emotionally intelligent people think through important conversations.

Let's break it all down, using Kempczinski's "quasi-mea-culpa" as a guide:

Rule #1: Imagine yourself in your audience's position.

Emotionally intelligent people realize that almost nobody else sees the world from exactly their perspective.

Sometimes that's fine, but other times -- say, for example, when you're the $10 million-a-year CEO of one of the world's largest corporations -- it's up to you to make the extra effort.

Kempczinski admits right upfront that he didn't do that here:

"I was thinking through my lens as a parent and reacted viscerally. But I have not walked in the shoes of Adam's or Jaslyn's family and so many others who are facing a very different reality."

I'd take that a step further: He wasn't just not thinking about the parents--obviously that was crucial--but he also wasn't thinking about how his words would be perceived by the mayor, and McDonald's employees, and the city writ large.

A little bit of empathy goes a long way, but apparently a lack of empathy can go even further.

Rule #2: Stop and think before you act.

There might be some times when acting quickly, without thinking, is better than deliberative action.

But those times are the exception to the rule. And, texting to the mayor of the third-largest U.S. city (knowing, as the CEO of McDonald's certainly should, that there is no expectation of privacy in that kind of communication), is definitely not an exception to that rule.

Kempczinski knows it was a mistake not to take the time to think through what he was saying.

"Not taking the time to think about this from their viewpoint was wrong," he wrote, "and lacked the empathy and compassion I feel for these families."

Lesson learned -- albeit one I'll bet he wishes he'd learned earlier.

Rule #3: Show strategic kindness.

Kindness and empathy are side-products of emotional intelligence, not the goals. Instead, emotional intelligence is about being aware of emotions and leveraging them to make it more likely that you can achieve your goals.

That said, kindness can be a goal in and of itself--and demonstrating kindness can lead people to be more receptive to what you have to say.

With that backdrop, it was very unkind, just days after the horrific shooting deaths of a 13-year-old and a 7-year-old, to suggest that the parents were to blame.

This would be true even if Kempczinski somehow thought he could back up his claim. (I'm not saying I think he could; I'm just surmising that he probably thought he could, if he thought to say it.)

Regardless, human decency practically begs that you hold your fire in that situation. Much better to remain silent, than to play armchair detective in a way that says those who likely grieve the most should shoulder the burden.

Live and learn

There is an irony in writing about this situation in that I feel compelled to try to write with emotional intelligence: to pause, to put myself in the shoes of others, to write with kindness where I can.

And there's a temptation to express sympathy for Kempczinski: Who among us hasn't said something he or she later regretted, and even cringed to read?

The difference is that Kempczinski isn't just writing for himself; he's writing as the CEO of one of the world's most iconic companies, who was paid more than $10 million last year (a low year, in fact, due to Covid), and who has much more responsibility than most of us have.

I don't know if he's sincere in describing the lessons he's learned, or if he truly wants to craft better messages, or if he cares a whit about leading with emotional intelligence.

Even if Kempczinski apparently hasn't read it, I think you'll find it useful. And maybe reading it will make it just a little bet less likely you'll have to write a "quasi-mea-cupla" someday like he did, too.

I'd take that a step further: He wasn't just not thinking about the parents--obviously that was crucial--but he also wasn't thinking about how his words would be perceived by the mayor, and McDonald's employees, and the city writ large.

A little bit of empathy goes a long way, but apparently a lack of empathy can go even further.

A doctor spread COVID misinformation and renewed her license with a mouse click

For much of the pandemic, Dr. Lee Merritt has appeared on talk shows and in lecture halls to spread false information about COVID-19.

Among her claims: that the SARS-CoV2 virus is a genetically engineered bioweapon (the U.S. intelligence community says it's not). And that vaccination dramatically increases the risk of death from COVID (data show an enormous drop in risk for those who take the vaccine). The entire pandemic, she says in public lectures, is a vast global conspiracy to exert social control.

And yet, in October, she was able to renew her medical license in the state of Nebraska. Documents obtained through a public records request by NPR showed it took just a few clicks: 12 yes-or-no questions answered online allowed her to extend her license for another year.

Critics say that Merritt's renewal is another example of how the nation's state medical boards are failing to protect the public from a small minority of doctors spreading COVID falsehoods.

"State medical boards, for the main part, have been cozy clubs of people who feel their job is to protect the profession," says Imran Ahmed, the CEO of the Center for Countering Digital Hate, a group that tracks vaccine misinformation online.

In the past, that's meant a slow process that provided physicians every opportunity to defend themselves against a complaint, he claims. But in the current pandemic, Ahmed argues, medical boards need to move faster and with more force. "Speeches aren't enough, letters aren't enough, we need action now," he says.

A dangerous message

Few people have been more influential over the course of the pandemic than doctors. They have been at the front lines, battling COVID and facilitating the vaccine rollout. Public health officials also see doctors as a major tool in fighting misinformation. Officials encourage vaccine-hesitant individuals to talk to their physician, as a way of combatting the vortex of false claims and conspiracy theories online.

But a handful of doctors like Dr. Merritt have worked contrary to these efforts: spreading bad information about COVID-19. Their qualifications make their message especially dangerous, says Nick Sawyer, an emergency room doctor who headsNo License For Disinformation, a group seeking action against doctors who spread falsehoods.

"Physicians should be held to a higher standard because people are entrusting us with their lives," he says.

The licensing of physicians in the United States varies from state to state. Medical boards are typically set up under state law and populated with a mix of doctors, lawyers and citizens. The boards can receive complaints from any member of the public. They then investigate and carry out disciplinary action according to their own rules and the laws of the state.

License renewals are often automatic, and Sawyer says he wants that process to be as smooth as possible. But he is also frustrated by the lack of disciplinary action: "If you're a physician in good standing, then you should be able to continue your practice without having to jump through a bunch of hoops," he says. "But that is also assuming that the medical board is doing its job."

Spread of misinformation is not censured

So far, it appears that many physicians spreading bad information have escaped censure. In September, NPR looked at 16 doctors who have spread false claims about COVID, including Merritt. Records show that none have been disciplined, and all but one continue to hold an active medical license. And Dr. Merritt was not the only one who obtained a renewal.

Public records obtained by NPR show that Dr. Sherri Tenpenny, another prominent anti-vaccine physician who claims — among other things — that vaccines make people magnetic, renewed her license online. The Ohio Capitol Journal first reported Tenpenny's renewal in September.

Neither Dr. Merritt nor Nebraska's Department of Health and Human Services, which oversees its medical board, responded to NPR's request for comment. But Dr. Humayun Chaudhry, the president of the Federation of State Medical Boards, an umbrella group, says medical license renewals are designed to be simple for doctors.

"It's a procedural step that is usually automatic and not even deliberated upon by the board," he says. He says boards simply don't have the capacity to review many hundreds or thousands of renewals that come up each year, and that a failure to renew would be equivalent to a license suspension, which cannot be done without due process. But he also says the renewals do not prevent boards from taking action.

"A medical license that's automatically renewed does not mean that an investigation isn't ongoing, nor does it prevent a board from taking a disciplinary action against that licensee," he says.

In fact Chaudhry says a recent survey by the federation found that over half of the nation's medical boards have seen an increase in complaints about doctors disseminating false information about COVID-19. Among those who responded to the FSMB survey, he says 21% have already taken some kind of disciplinary action. Many others are now quietly investigating complaints, Chaudhry says. They just need more time to act.

In the meantime, Lee Merritt continues to travel the country, giving speeches filled with junk science.

Copyright 2021 NPR. To see more, visit NPR.

The COVID-19 pandemic has now killed 5 million people around the world

Global deaths from COVID-19 have now surpassed 5 million, according to the data released Monday from Johns Hopkins University's coronavirus tracker.

The U.S. leads the world in the number of confirmed deaths from the virus with more than 745,800 people dead from COVID-19. Brazil (with more than 607,000 deaths) and India (with more than 450,000 deaths) follow the U.S. in the number of lives lost since the start of the pandemic.

Yet another tragic milestone of the pandemic comes just as the U.S. prepares to start vaccinating children between the ages of 5 and 11.

But in other parts of the world, health officials are seeing worrying signs of a coronavirus surge — just as some nations are relaxing measures to international travelers.

This official global tally only accounts for confirmed cases around the world, according to Amber D'Souza, professor of epidemiology at the university's Bloomberg School of Public Health, who spoke to National Geographic.

Prior to Johns Hopkins releasing the latest global data on Monday D'Souza told the outlet: "It's quite possible that the number of deaths is double what we see. But 5 million is such a staggering number on its own. No country has been able to escape it."

Europe and Southeast Asia report a surge in cases The World Health Organization recently reported a rise in cases in Europe during October.

As of Oct. 26, the European region experienced an 18% surge in new COVID-19 cases. Southeast Asia, a region experiencing a similar rise in new COVID cases, also reported a 13% increase in new COVID-19 deaths.

Globally, as of Oct. 26, the health organization reported more than 2.9 million cases and more than 49, 000 new deaths, a 4% and 5% increase respectively.

Last month, Russian officials registered the highest death toll in Europe: more than 235,000 deaths since the start of the pandemic. Due to skyrocketing infections from the delta strain, officials there launched a temporary lockdown in an attempt to defeat the virus.

But there is skepticism over whether the numbers being shared in Russia are actually the official count. Some believe the numbers may be higher.

On Friday, Reuters reported that Poland's total number of COVID-19 cases since the start of the pandemic passed 3 million. Daily cases are quickly gaining pace as the country is in the middle of the fourth wave of the virus.

In Singapore, where officials have decided to coexist with the coronavirus and cease lockdown measures, a jump in cases has been reported there, too.

More than 80% of Singapore's population has been immunized against COVID-19. Yet as of Oct. 30, cases jumped to well over 3,000 cases a day in about two months.

Copyright 2021 NPR. To see more, visit NPR.

Pat Martino is dead, an American jazz guitarist and composer, a true legend

Martino was born Patrick Azara in Philadelphia, Pennsylvania, USA. After moving to New York City, he started playing professionally at the age of 15. He lived with Les Paul for a while and began to play in jazz clubs such as Smalls Paradise. He later moved into a suite at the President Hotel on 48th Street. He will play at Smalls for six months of the year, and then in the summer at the Harlem Club in Atlantic City, New Jersey. Martino played and recorded with Lloyd Price, Willis Jackson and Eric Klaus early in his career. He has also worked with jazz organists Charles Earland, Richard “Groove” Holmes, Jack McDuff, Don Patterson, Trudy Pitts, Jimmy Smith, Gene Ludwig and Joey DeFrancesco.

Martino continued to perform until 1980 when hemorrhagic arteriovenous malformations caused “near-fatal seizures.” This made him amnesia, and he has no memories or knowledge of his career or how to play the instruments that made him successful.

Martino said he was completely forgetful from the operation and learned to focus on the present rather than what may happen in the past or future. He was forced to learn to play guitar from scratch. This situation is essential to understand his career and his special way of thinking. Martino married Ayako Asahi Martino in Tokyo, Japan in 1995.

He was selected as the guitarist of the year in a 2004 Down Beat magazine reader vote. In 2006, Mobile Fidelity Sound Lab re-released his album East! On Ultradisc UHR SACD. In 2017, he shot a series of educational videos called “A Study of Opposites and Its Performance on the Guitar”. 

A true American hero and a living legend until today, now is a complete legend forever.

Rest in Peace, Maestro!

Supreme Court justices sound skeptical of Texas abortion law

WASHINGTON — The Supreme Court's justices gave a skeptical hearing Monday to Texas and its strict abortion law, sounding as though they are ready to reverse course and allow abortion providers to sue and win a federal court order blocking its enforcement. Justices Amy Coney Barrett and Brett M. Kavanaugh, two of the conservatives who hold key votes, said the state appeared to have gone too far, first by adopting an unconstitutional limit on abortions and then by effectively preventing doctors and clinic owners from challenging it in court. Kavanaugh said Texas had exploited a "loophole" in the law to bar people from going to federal court — even when those people are targeted by an unconstitutional state law. He noted that in 1908, the Supreme Court in a landmark ruling said people or businesses who are targeted by an unconstitutional law could win relief from a federal judge by naming a state official who would enforce the law. But Texas steered around that decision by relying on private lawsuits against abortion doctors and clinics. In response, lawyers for Texas claimed the abortion doctors were free to defend themselves in state courts. But Barrett said that would not work either. She said the state law says a doctor could be sued by hundreds of people over a single abortion, yet state judges could rule on only one suit at a time. "You can't get a global relief" even if the abortion doctor wins in a state court, she said. "The statute can still be enforced against you." A Texas lawyer said state judges, not state officials, are enforcing the Texas abortion law. But Chief Justice John G. Roberts Jr. and Kavanaugh cited a landmark ruling on civil rights in which the high court struck down the use of racially restrictive covenants on deeds that prevented African Americans or Jews from buying house. Those deeds had been defended on the grounds they were private arrangements, not state laws. But as Kavanaugh noted, the high court in the case of Shelley vs. Kraemer in 1948 struck them down because state judges "enforced" those restrictions. He said the same principle should apply in this case. Based on their comments and questions during nearly three hours' argument, it appeared that six of the justices favored clearing the way for the federal courts to block enforcement of the Texas law. This was the third time the high court had considered the Texas law. The court was not focused on the constitutionality of abortion, but rather the procedural restrictions that have prevented abortion doctors and the Justice Department from challenging the Texas law in federal court. While the lawyers argued over procedure, the overriding question is whether the conservative court will stand in the way of a state's bid to stop abortions. So far, the answer has been no. The Texas Heartbeat Act, also known as Senate Bill 8, says it is illegal to perform an abortion after about six weeks of a pregnancy but gives the state no direct role in enforcing that ban. Instead, it authorizes private lawsuits in state courts against doctors or clinic owners who violate its provisions. On Sept. 1, four members of the high court, including Roberts, voted to block the Texas law before it took effect, but they were unable to win over at least one more conservative to form a majority. Two weeks ago, the justices weighed the issue again after the Justice Department entered the case, but they agreed only to hear arguments on the procedural questions. U.S. Solicitor Gen. Elizabeth B. Prelogar, who was confirmed last week by the Senate, called the Texas law an "affront to the Constitution, as well as to the Supreme Court's role in protecting the rights of Americans. "Texas’s various procedural objections do not withstand scrutiny once S.B. 8 is recognized for what it is: a brazen nullification of this court’s precedents," she wrote in a brief filed Friday. "Texas is responsible for S.B. 8. And it is subject to this suit by the United States and an injunction by the federal courts. "Prelogar's argument rests on the idea that federal law is, as the Constitution states, the "supreme law of the land." Yet throughout its history, the Supreme Court has shielded states from being sued directly. States are said to have "sovereign immunity" unless Congress has acted to waive it. After the Civil War, however, the Reconstruction Congress passed the Civil Rights Act of 1871, which authorized suits in federal court against any person who, acting "under color of" state law, deprives others of their rights protected by the Constitution. Typically, lawyers rely on this section of the 1871 act to sue state or local officials who are enforcing an unconstitutional law. But in this instance, the abortion rights advocates were not sure who to sue. They could not point to particular state officials or to the unknown private individuals who may sue an abortion doctor. As a fallback, they named state judges who might have to rule on a suit. But the 5th Circuit Court of Appeals has twice rejected efforts to block the Texas law. The first appeal heard Monday arose from a coalition of abortion providers who sued in July seeking to stop the Texas law. The second comes from the Justice Department, which sued in September, a week after the law took effect. The Biden administration's attorney acknowledged that the procedural law is not clearly on her side. 

"To be sure, no state has ever attacked the supremacy of federal law through this mechanism before," Prelogar wrote. "But the novelty of Texas’s unprecedented scheme does not render the federal courts powerless to redress the state’s ongoing violation of the Constitution." In response, lawyers for Texas say the legal battle should be fought first in state courts. If abortion doctors are sued for violating S.B. 8, they can defend themselves by asserting that the state law violates Roe vs. Wade and is thereby unconstitutional, Texas Atty. Gen. Ken Paxton argued in his brief. "The Constitution does not guaranteed pre-enforcement review of state (or federal) laws in federal court. And there is nothing unprecedented about vindicating constitutional rights as a state-court defendant," he wrote. The two cases heard Monday are Whole Woman's Health vs. Jackson and United States vs. Texas. It is not clear whether the justices will rule quickly because the cases arrived as emergency appeals or will instead follow the usual procedure and spend weeks writing a decision accompanied by dissents.

Originally posted in Los Angeles Times by By David G. Savage

Transgender Rights are Human Rights

Arguments to support transgender rights often rely on “born that way” arguments, which assert that gender identity is innate, immutable, and unassociated with choice. These arguments are vulnerable to attack on several grounds, including on the basis of emerging scientific data. Stronger support for transgender rights arises from human rights arguments.

In March 2016, North Carolina enacted legislation requiring public school students to use the school bathroom consistent with their birth gender. The state law aimed to supersede a Charlotte, North Carolina, ordinance permitting students to use gender-segregated facilities aligned with their expressed gender, irrespective of the gender assigned them at birth. These dueling laws garnered considerable controversy, yet they form only one small chapter in the story of rights for transgender people today.

Proponents of the North Carolina “bathroom bill” claim that such laws prevent violence against women, arguing that “predatory” men, under the auspices of trans-friendly bathroom policies, will enter women’s bathrooms and harm girls and women. However, transpeople and supporters deny there is increased harm to other women from transwomen and note that there is instead a high level of violence against transmen and transwomen, even compared to the high level of violence against other members of the lesbian, gay, bisexual, and transgender (LGBT) community. While rates of homicide generally have dropped across the US over the last decade, the same is not true of homicide rates for transwomen, and in particular for transwomen of color, who account for a percentage of homicides far out of proportion to their numbers in the transgender population.

The need to uphold transgender rights has never been more pressing or more important than today. Although laws regarding choice in bathroom facilities are symbolically important in establishing that transpeople deserve respect, transpeople suffer active discrimination in arguably more important domains, including employment, housing, and access to general and specialized health care. Compelling arguments and concerted action to support transgender rights are crucial. But which arguments offer the strongest and most broadly applicable support for transgender people in the current political climate?

Arguments for Recognition and Expanded Protection of Transpersons’ Rights

Many in the LGBT community rely on arguments that we refer to collectively as “born that way” arguments, namely, arguments for LGBT rights based on the idea that sexual orientation and gender identity are innate, immutable, or unassociated with choice. Two of the authors (TP and ES) have previously addressed the difficulties of using “born that way” arguments in relation to sexual orientation. We now extend that critique to arguments for transgender rights. We argue that “born that way” arguments rely on both shaky science and imperfect logic, and thus fail to provide a solid basis for transgender rights. We find more solid ground in arguments based on human rights.

Interpretations and Critiques of “Born that Way” Arguments

In The Mismeasure of Desire, one of us (ES) has addressed three interpretations of the “born that way” argument, and we briefly summarize those arguments in the context of gender identity.

Innate. We find several problems with the claim that gender identity is innate. First, the claim is essentially unprovable. Gender identity, as with any aspect of human identity, develops over time. An infant cannot be said to experience a fully formed identity of any kind—that sort of self-awareness requires advanced cognitive development, including a nuanced concept of gender that develops over years. Similarly, we are skeptical of the claim that gender identity—one’s perceived sense of belonging to a particular gender, independent of gender assigned at birth—is genetically determined. There is limited biological research supporting such a claim and no semblance of a scientific consensus on it. Gender identity and expression are complex, incorporating ideas of the self along with a vast array of behaviors, thoughts, and feelings. Contemporary biological evidence does not support the notion that gender identity results solely from a single gene or even from the presence of a specific number of X and Y chromosomes. Rather, gender identity emerges from multiple interactions among genes, the environment, and other factors, including personal feelings of authentic gender expression.

Immutable. Another interpretation of “born that way” connotes immutability. This concept is problematic because possibilities for change are not necessarily related to whether a factor is present at birth. Even factors that are primarily determined by genes can change over the life course: hair color and texture are genetically determined, but hair can be present or absent at birth, change color over time, revert from curly to straight or vice versa, and develop different patterns of baldness as a person ages. In contrast, immunity to a disease like measles is not inherited, but vaccination or disease exposure can result in a permanent change in one’s immunological profile. These arguments undermine the link between a trait’s being present at birth and its inalterability.

However, there are additional compelling reasons to avoid relying on immutability as a foundation for transgender rights. Although the scientific study of gender identity has yet to answer many important questions, it does suggest that gender identity is not immutable in everyone. Specifically, gender identity can change in prepubescent children. Indeed, the majority of younger children who experience gender dysphoria do not go on to become transgender adults. Given the evidence of the fluidity of gender identity over time in many children with gender uncertainty, arguments that assume immutability seem particularly unconvincing. True, transgender adults generally do persist in their gender identity. Nonetheless, gender as a concept is understood as more fluid and less rigid today than in the past. Research indicates that various aspects of sexuality, including both gender identity and sexual orientation, are more fluid than previously understood, especially in youth.

Rather than adhering to a rigid male/female binary, many scholars and activists describe gender as existing on a spectrum. Ideas about which attributes are socially appropriate for either male or female gender—or both or neither—have rapidly evolved over the last century. One hundred years ago, in some places, a woman could be arrested for wearing pants in public. Thirty years ago, women encountered more extreme barriers and fewer legal protections than they do today in many occupations, including soldier, pilot, or orthopedic surgeon, to name a few. Even today, men who stay home as full-time parents face questions about their “manliness.” Preserving transgender rights supports the ability of all people to align their gender expressions with a comfortable location for them on the gender spectrum. Insistence on the immutability of gender identity ignores its fluidity during development and the need to adapt to continually evolving standards of gendered behavior.

Not chosen. A third interpretation of “born that way” indicates lack of choice, and this aspect of LGBT identity is often referenced both regarding sexual orientation and gender identity. Transgender people do not typically describe their gender identity as a matter of choice. As one blogger wrote, “nobody really wants to be a trans woman, i.e. nobody wakes up and goes whoa, maybe my life would be better if I transitioned, alienating most of my friends and my family, I wonder what’ll happen at work, I’d love to spend all my money on hormones and surgeries”. More typically, transpersons describe a growing realization of their gender identity over time. They might experience distress from social or other pressures to conform to a binary birth-assigned gender that does not match their authentic experience of gender identity. While gender identity is not subject to conscious choice, the overt expression of gender identity includes many choices, including dress, hair, naming, and all the other options that indicate one gender or another—including which public bathroom to use. Those opposed to transgender rights wish to deny transgender people (and everyone else) these choices. Opponents do not express concern about transpersons’ inner sense of identity but about outwardly expressed choices. To defend transgender rights is to defend the right to choose how one expresses gender and gender identity. Choice, far from being unimportant, is a critical aspect of transgender rights. In sum, “born that way” arguments on behalf of transgender rights are easily undermined on the basis of reasoning and scientific evidence.

Transgender Rights as Human Rights

We argue, in contrast, that transgender rights stem from human rights, i.e., those fundamental rights belonging to every person. Persons with either cisgender (in which assigned and experienced gender are the same) or transgender identities deserve to live and flourish in their communities—with freedom to learn, work, love, and play—and build lives connected with others at home, in the work place, and in public settings without fear for their safety and survival. These deeply personal decisions are and should be the prerogative of the individual and deserve the law’s protection. The United States protects religious freedom in the First Amendment, and religion is quintessentially a choice. We owe the same respect to all members of our communities. We don’t yet know if gender identity emerges from genes, hormones, environmental factors or, most likely, an intricate combination of all these factors and more. It is unlikely that people with a transgender identity simply choose their gender identity, any more than cisgender people do. However, it is crucial that associated choices about the expression of gender—affecting vital aspects of identity in school, the workplace, and the community—are supported by our laws and policies. Supporters of transgender rights should avoid arguments that are logically flawed and that fail to acknowledge current scientific evidence about gender identity. Our best arguments must rely on the concept of inalienable human rights, including the rights to live safely, freely, and without fear of discrimination.

Original from Tia Powell, MD, Sophia Shapiro, MD, and Ed Stein, JD, PhD