Physician assisted suicide and the economic impossibility of safeguarding

For best results and links to related articles and to read my other work, find this post on Substack: https://shirabatya.substack.com/p/death-affirmative-care.

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Last Friday, the UK Parliament voted by a narrow margin to legalise physician-assisted suicide.

Since then, there has been much discussion of the possibility that the House of Lords could tighten up safeguarding for this bill, which has been criticised widely for lacking sufficient safeguards for people who are mentally ill, anorexic, diabetic, or simply socially isolated and therefore easily suggestible by doctors who, according to this law, will be allowed to raise the topic of suicide with patients who have not raised the issue first themselves.

In fact, Parliament explicitly rejected an amendment to prevent doctors from suggesting to patients that they may wish to end their lives, voting only to protect children from such suggestions. Similarly, although Parliament approved an amendment that prevented patients from being deemed terminal due to voluntary stopping of eating and drinking (VSED), this does not apply to anorexics, whose refusal of food is due to a mental health condition and therefore is arguably involuntary.

The erosion of safeguarding is not a matter of if, but of when. It is not a bug but a feature.

A number of people who have concerns about the bill are hopeful that with the correct amendments in the House of Lords, it will be made fit for purpose and add the safeguards that are currently lacking. Although safeguards are obviously to be welcomed, I believe that such people are failing to recognise a more fundamental problem with this proposal, which comes down to economics. In the end, whatever safeguards are officially agreed, as long as this matter is framed in terms of a “right to die”, over time, practical constraints will lead to an erosion of safeguards as has occurred in places such as Australia and Canada. The erosion of safeguarding is not a matter of if, but of when. It is not a bug but a feature.

For those who are in favour of physician-assisted suicide, the discussion about this legislation has been framed in terms of patient choice and the “right to die”. How dare I restrict the choice of somebody else who has freely consented to ending their life? It's their life, not mine. Their body. Their choice.

For those of us who have followed the child gender transition debacle of recent years, this conversation is oddly familiar. It is no coincidence that people such as Kathleen Stock and Fred Sargeant who are critical of physician-assisted gender transition, have also been concerned about physician-assisted suicide. In gender critical circles, we know to be careful when people talk about bodily autonomy and choice; we know that the issues of safeguarding or gatekeeping or autonomy are never as simple as people might think.

How will the NHS deal with this backlog of people demanding to die, particularly if the service is framed in terms of people having a right to die?

Already in recent days, health secretary Wes Streeting has raised concerns about the cost of implementing physician-assisted suicide, possibly topping £15,000 per patient. A whole new service needs to be set up in the NHS to provide this procedure. Personnel need to be trained to assess requests from patients and to determine which patients should be allowed to die, and which should be told “no, not you”. This will also divert resources away from other treatments, possibly away from the important palliative care, provision of which is known already to be inadequate. Adequate palliative care is crucial if patients are to have a real choice between ending their lives and having a dignified death free of excessive pain.

Whether or not the House of Lords strengthens safeguards, we know that implementing this legislation will be difficult and costly. The greater the safeguards that may be added, the greater this cost, as savings are generated only after sick people actually do die. We have already seen that practical constraints (economics) have led to changes in the safeguarding process. A shortage of available high court judges forced the bill’s proponents to remove the safeguard that such a person would need to approve applications, in favour of a more practical panel without a person of such high legal qualifications.

We must ask: What will happen in a few years’ time, when there is a backlog of say hundreds or thousands of patients who have requested assisted suicide? What will we do when the safeguards necessary to make sure that their suicide has not occurred under duress or due to inappropriate factors such as mental illness — when these safeguards lead to unacceptable delays because systems are overwhelmed. How will the NHS deal with this backlog of people demanding to die, particularly if the service is framed in terms of people having a right to die?

Imagine a few years hence, if careful safeguarding and gatekeeping is in place, if the process has not devolved into the informed consent model in which a patient’s “right to die” is simply affirmed and they are pushed down the pipeline towards death. Someone will be frustrated by the delays from “excessive gatekeeping” that interferes with their “right to die” and they will sue complaining that they are being coerced into remaining alive. If strong safeguards are kept in place, this lawsuit will happen (again, not a matter of if but of when). More likely, organisations such as Humanists UK will push for a reduction in safeguards to avoid such delays.

Those of us who have been following the issue of gender-affirmative care in medicine cannot help seeing the obvious parallel: the similarity to another story in which gatekeeping was eroded due to the reality of practical constraints or economics. Years ago, when Dutch doctors initially decided to begin to transition a small number of gender non-conforming children in order, theoretically, to provide them better cosmetic outcomes as fully transitioned adults, there were significant safeguards in place.

Let's leave aside the question about whether, in principle, we think that one should ever block the puberty of a child and medically transform a young person to look like the opposite sex. Leave aside that question for the moment and simply consider the matter of safeguarding. Leave aside for the moment the very valid criticisms of the Dutch protocol, which I know was severely flawed research. Nonetheless they did have safeguards in place. If you have followed the New York Times podcast, The Protocol, you will recall that one had to undergo several months or years of therapy. There was screening for all sorts of mental health problems that disqualified patients from puberty blockers or medical transition.

Thus the “gender-affirmative” care model began to view gatekeeping as a pejorative, something we should not do as we had a duty to affirm patients…

So what happened when American and British doctors saw what was happening in Holland and decided to bring these procedures back to their own countries to replicate them so that patients in their own countries could have access to this new apparently ground-breaking treatment protocol? Quickly, in both the UK and the US is, the number of children seeking “gender-affirmative care” far exceeded what clinics they could cope with following the Dutch model, because along with the patients they expected to see (those who had been gender nonconforming from a young age, mostly boys), there came a multitude of distressed adolescents (mostly girls) with no prior history of gender dysphoria. Thousands of patients built up on waiting lists, or in the case of the United States, patients sought treatment at hospitals hundreds of miles from their homes, and so they could not reasonably be expected to show up for months and months of appointments and therapy sessions (See NYT The Protocol, episode 3).

As a result, as explained in the NYT podcast, the process was changed. It was streamlined to get through the waiting lists. Months of therapy often turned into a single assessment. And thus we ended up with problems that far exceeded those from the Dutch protocol. Again, I am not saying that the Dutch protocol was itself a good process or defending that research, which is deeply flawed. But certainly, what happened in the USA and UK etc. was far, far worse. It became a free-for-all.

You will change the product to fit constraints just like any vendor of any product in a market economy. Therefore, if it is impractical, expensive or onerous, safeguarding gets cast aside.

Johanna Olson Kennedy explains on the Protocol (again episode 3) that she realised it actually made no sense to engage in these sorts of safeguarding / gatekeeping procedures in order to decide which patients should be getting gender-affirmative care and which should not. Gatekeeping did not work because, of course, doctors could not easily tell which patients should and should not be transitioned, and patients would simply change what they told doctors in order to get past gatekeepers, thus hiding other mental health problems. Again, this is a matter of economics, of practical constraints and incentives (people may not be honest with doctors if that does not get them what they want).

Olson Kennedy therefore decided that patients who wanted to transition should be allowed to transition, should be affirmed. Thus the “gender-affirmative” care model began to view gatekeeping as a pejorative, something we should not do as we had a duty to affirm patients and believe them when they claimed a gender identity. Transition was no longer a treatment which would be provided or not based on medical judgment by a trained professional. Rather, transition became purely the exercise of what was framed as “trans rights.”

You could say that this was an ideological development, but I'm going to look at this purely from an economic point of view, since I am trained as an economist. Set aside the culture wars, “woke”, queer theory, all of that. It was inevitable that this would happen. If the resources are not available to do the safeguarding that you would like to implement and you have a backlog of cases, then you will then adapt your product to fit the circumstances so that you can provide a service that satisfies your clients, patients, customers (whatever you wish to call them). You will change the product to fit constraints just like any vendor of any product in a market economy. Therefore, if it is impractical, expensive or onerous, safeguarding gets cast aside.

The better safeguarding functions, the more we will hear people criticizing the gatekeeping that prevents people from dying when they want to.

Of course, to avoid cognitive dissonance, you will then be attracted to an ideology that justifies your actions. Alternatively, jobs providing this care will attract ideologically compatible personnel — people whose mindset allows them to do this new job and still to sleep at night. Self-selection of compatibly minded people will inevitably lead to group think within these clinics. None of this requires any conspiracy, any neo-Marxist strategy to take over the Academy and inflict queer theory on students. This is a process driven by the economics. Ideology is a secondary result.

In short, I don't think that what happened in the States was in any way surprising. It's exactly what you would expect to happen because the only practical alternative to getting rid of all the safeguards would have been what's happening now in so many US States and countries, which is to halt provision of this service completely. You can't transition any children at all because we can't tell which patients should or should not be transitioning as children. Because the reality is that, at any reasonable cost, within realistic practical constraints, it is just not possible to put in place safeguarding or appropriate gatekeeping so that only the correct patients get the treatment. You either have a free for all or you stop doing it completely.

This brings us back to physician-assisted suicide in the UK. I predict that if this law gains royal assent, even if the House of Lords agrees extra safeguards, it will not actually make that much difference. Yes of course, it will help if safeguards are put in place. Some vulnerable patients can of course be protected from killing themselves and it is better if the law closes the anorexia loophole, the diabetes loophole, the doctor-suggestion loophole, etc. However, when it comes down to it, whatever safeguarding we do will be constrained not by what the law says those safeguards should be, but by the economics.

Safeguarding / gatekeeping will be constrained by the funds available to pay personnel on review panels, meaning quicker decisions by less qualified people. It will be constrained by the ability to train health workers for jobs implementing the service, and these new jobs in death-affirmative care will self-select for those who are ideologically committed to the right to die, just as clinicians in “gender-affirmative youth medicine” self-selected for those who believed in queer theory or had themselves transitioned or had supported the transition of a partner or child. We must expect that gatekeeping will not protect vulnerable patients. When this failure occurs, it will not be a surprise, but an economic inevitability of enshrining a “right to die” and to have this death provided by the NHS.

Initially, we may have a good service with careful decisions. Morally problematic, but perhaps analogous to the Dutch protocol. However, over the course of time, as the number of people seeking assistance for suicide increases, as the caseload and the backlog of cases builds up, as the systems in place to provide careful safeguarding become overwhelmed and more ideologues are attracted to the death-affirmative care profession, the death-provision procedure will be streamlined, and safeguarding will be reduced. The better safeguarding functions, the more we will hear people criticizing the gatekeeping that prevents people from dying when they want to: for example, discrimination against the disabled or the mentally ill who all have an equal right to die.

Doctors are paternalistic. They offer us treatments that evidence shows to be beneficial, not treatments we demand as our “right”. We are patients, not customers.

No matter what safeguards are put in place, the reality will be that these safeguards will not be adequate because they cannot be adequate because to put adequate safeguards in place will simply cost too much and place too many obstacles in front of those who see this as a right. Thus, people will find a way of rationalising why a more streamlined approach is consistent with the intention of parliament, or the law will be amended to solve practical difficulties — meaning to remove safeguards that are practically impossible to implement.

There will be lawsuits by patients affected by the delays that will force pragmatism by the NHS. And in the end, we will institute an easy pipeline towards death in the same way that there was, until recently, an easy pipeline in the United States towards gender transition of children. And as we found in the United States to do with child gender transition, the only way to actually stop the abuses of the system will be to abolish the service completely. Except in this case, it is unlikely that a reversal will occur. We will have become efficient at killing off those who are an economic or medical drain on society. The economic cost of reversing this progress will be far too high.

There is a deeper lesson here. The fact is that there are some kinds of choices, medical decisions, medical procedures, where theoretically we might say that some people should get them, but where we can't allow this to become normative medicine paid for by the state or by insurance, because we know that the reality is that the safeguards that one would need to put in place are actually impossible. There is no way to make the care widely available to your target group without catching all sorts of other people who may be harmed if this becomes normalised and paid for by institutions, particularly if this care is framed as a human right.

This is why it is fundamentally wrong to have physician-assisted suicide in the UK, provided by the NHS, framed in terms of a “right to die”. It cannot be done, and the reason is not because I don't think that it is morally justified for people to be able to end their lives if they so choose. This is not because I feel that I have a moral right to tell other people whether they ought to live or die. Rather, the reality is that if you try to put in place physician-assisted suicide based on a right to die, you will end up with exactly the same problem happening that happened with child gender transition. Because even if you believe that some children should be transitioned, (which I don't), there is no way to offer such a service without being swamped by patients who definitely should not be receiving it.

If a service is demand-led, you end up finding it impossible to safeguard patients and to distinguish between those who should be treated, and those who should not. You end up with an assembly line and a free-for-all and a lack of gatekeeping. It is a process driven by the economics, once it receives an initial ideological green light to begin.

Does this mean that it is impossible for there ever to be physician-assisted suicide provided to any patient with any health condition? What about people with terminal cancer, suffering intolerable pain in their final days or hours of life? Do we leave them to suffer in agony? I actually believe there may be a way to help such patients. The key is that any such assisted death must not be framed in the terms of the right to die, in the same way that medical alteration of sex development cannot be framed in terms of a “right to transition” — paid for by the NHS or insurance as the case may be.

This is because there is no “right” to have any particular kind of healthcare. We do not waltz into a doctors office and demand antibiotics because we feel we have an infection. We require a diagnosis, and if the treatment is appropriate, we get the penicillin. Otherwise, the doctor says no. Doctors are paternalistic. They offer us treatments that evidence shows to be beneficial, not treatments we demand as our “right”. We are patients, not customers. The failure to understand this basic fact lies at the root of the scandal that is gender-affirmative care.

Can doctors ever offer death as an option to patients? Possibly yes, but this would have to be offered like any other medical treatment. If there are particular medical circumstances (such as end stage cancer), where evidence shows that even with the best palliative care, a patient cannot control excruciating pain, so that the best treatment possible may be to increase morphine to deadly levels, one might be able to make a clinical argument to offer this. But this would be a very specific clinical judgment, and it is not about whether someone has the “right to die.” It is about caring for a patient who is dying, so that his or her death is less painful.

I think this scenario is what comes to mind for those who make the most emotive arguments for assisted dying. In that case, what a law could do is give authority to NICE to look into the possibility of hastened death being elected by patients with that particular health condition, in order to allow their death to be less agonizing.

But we cannot frame this in terms of the right to die. It’s not about a patient making a choice and then demanding that the NHS provides death to order, with the patient as consumer. Rather, we're talking here about doctors engaging in what effectively is a form of health care for a patient, where medical evidence indicates they may be better served if they are allowed to die sooner, and therefore they are given this as one treatment option.

Even here, the offer would be fraught with risk. This would entail legislation that would protect doctors from prosecution when they offer such help but only subject to enormous safeguards, similar to those proposed for the assisted suicide bill, but not framed in terms of a “right to die.” Moreover, if we are talking about just a small number of conditions for which there is solid medical evidence that palliative care alone cannot prevent an agonising death, we may find that the economics does not necessarily lead to an erosion of safeguarding. Even here, we would need to compare a hastened death to the best possible palliative care, so that patients are not effectively forced to choose death because they are not being provided for properly otherwise.

The key to understanding this is to avoid a misconception about informed consent: namely the mistaken notion that it is reasonable to offer death to patients if they have capacity to consent to that death. This is not how informed consent normally works in medicine. Rather, even where informed consent applies, doctors act paternalistically. They evaluate which treatments can help a patient, and then a patient must consent to treatment and has a right to refuse treatment. But patients do not have a right to demand treatments that doctors do not deem helpful. There is a right to say no, not a right to demand yes.

The problem we have with the so-called “right to die” is similar to what happened with gender-affirmative care. There, treatments were framed in terms of a right to transition as opposed to being framed in terms of evidence-based health care. And that's how we ended up in the mess we're in with a complete free-for-all with the elimination of safeguarding or gatekeeping because patients felt they had a right to the care whether or not there was any evidentiary basis for it.

The key here is to realise that, when given by healthcare providers, death is no more a right of patients than any other kind of healthcare a doctor could give. Doctors do not have a duty to give any patient any medical procedure, any outcome that the patient wants. They have a duty to give healthcare which is evidenced and sensible and also cost effective. When a particular kind of treatment becomes a “right”, we throw out of the window the most important question: whether the treatment does or does not benefit patients, based on evidence. Because if it is truly a right, then it is equally a right for a patient dying in agony of cancer, and for a nineteen year-old with anorexia who has just given up on life and wants doctors to end it. This way of framing medicine is a very, very dangerous, dangerous path to take.

Thanks for reading Heterodox Jewish Woman! Subscribe for free to receive new posts and support my work. https://shirabatya.substack.com/

The disturbing origin of oft-quoted religious narratives of "gendered souls".

To watch this on video and for full access to notes and resources, go to

https://shirabatya.substack.com/trans-biblical-characters-in-jewish2

To watch part 1 (recommended), go to

https://shirabatya.substack.com/p/trans-biblical-characters-in-jewish1

“Queer” teachers such as Abby Stein have sought religious foundations in Judaism for the idea of true trans - that some people are born in the wrong body, with the soul of the opposite sex. They do this by appealing to narratives in Lurianic Kabbalah to do with reincarnation, and by projecting trans identities onto biblical personalities such as Joseph, Dinah, Isaac, and Michal. Such narratives have been promoted by organisations such as Keshet (the American Jewish LGBT charity, whose judgment in promoting these texts must be questioned).

I have explored the texts behind these arguments, including quite a bit of halacha (Jewish legal texts) to do with Michal's tefillin. This quest took me on a very dark journey that ended with homophobia, misogyny and an accusation of witchcraft.

Warning: You will be offended!

This is the second half of a recording of a Zoom shiur (lecture) that I gave on Sunday 23 February. This is a more in depth and uncensored version of a similar session that I gave at Limmud Festival in December 2024 with a slightly different title.

In Part 1, we explored the background to these narratives and the link with gender identity ideology, and I discussed the narratives relating to Dinah, Joseph, and Isaac. We discovered that far from being transgender, Isaac is understood to have been an immature boy with a “female soul” who matured into a proper man who could give his wife children.

We ended Part 1 on the question of what the “soul” really means in these narratives, and whether Judaism is really compatible with the soul / body or mind / body dichotomy inherent in the idea of a “gender” separate from sex.

Here in Part 2, we explore the complex case of Michal. The legend that she wore tefillin will lead us on a journey through the halachah (Jewish legal texts) to do with women and tefillin, and finally to the same text from Chayim Vital that Abby Stein credited for inspiring Stein’s transition when interviewed in 2019. You are best off watching this on video, as I speak quickly, and the slides contain important information. However, if you are on a podcast app, you can also download the slides with the link below and flip through them as you listen.

Slide show here: https://docs.jcob.org/gender/GenderSoulPresentationSubstack.pdf

You can also read the full source sheet here: https://docs.jcob.org/gender/GenderSoulSourcesSubstack.pdf

Links:

Stonewall list of LGBTQ terms

Rabbi Jack Abramowitz An Orthodox Rabbi Discusses Transgender Issues in Jewish Texts (Orthodox Union 2017).

Keshet (USA) resource on Gender Fluidity in the Jewish Tradition

Jericho Vincent on our “trancestors”

Jay Michelson: Kabbalah and Queer Theology (July 22, 2012).

Much more in the full source sheet (see above)

Rabbi Simchah Fuerman: article for NEFESH(International Network of Orthodox Mental Health Professionals)

Ronit Irshai: superb article on cross-dressing

Abby Chava Stein:

source sheet from Limmud Festival 2019

interview in 2019 describing how Sha’ar HaGilgulim changed Stein’s life

source sheet on Sefaria (includes text by Rabbi Yechiel Michael of Zloczow)

upcoming book “Sources of Pride” שורשי גאווה

Sefaria Source Links (misc):

Talmud Berachot 60a: Leah’s child was originally male but Leah prayed that her sister Rachel should have a son so the sexes were switched

Beresishit Rabbah 72:6 sex switch because Rachel prayed for two sons

Rabbi Eliyahu Munk on Dinah’s male nature

Bereishit Rabbah on Joseph’s laddishness

Bereishit Rabbah 87:7: on Joseph finding himself not to be a man [ish].

Or HaChayim on Isaac’s double birth (female then male)

Source Links on Michal:

Michal had no child until her dying day

Prohibition of cross-dressing (Deuteronomy 22:5)

Babylonian Talmud on Michal wearing tefillin

Jerusalem Talmud on Michal wearing tefillin

Rashba that Michal said the brachah (blessing)

Kaf Hachayyim on Michal’s male soul

Yefeh Lalev (Rachamim Palaji): Michal had a male soul

Halachah of Tefillin:

Shulchan Aruch on clean minds (hase’ach da’at)

Shulchan Aruch on clean bodies (guf naki)

Targum Jonathan that tefillin is cross-dressing for women

Sefer Hachinuch that women get a reward for wearing tefillin

Deracheha: various sources on tefillin in practice

Deracheha on clean bodies (guf naki)

Deracheha: various sources on tefillin in practice

Rema: We protest against it

Chayim Vital:

Sha’ar Hagilgulim: only male souls reincarnate

Sha’ar Hagilgulim: on male homosexuals reincarnated as women

Chabbad website on infertility of Chayim Vital’s first wife

Chayim Vital’s unhappy marriage (Wikipedia)

Chayim Vital’s Freudian Dream

Unusual bodies

Women who transform into men (Yosef Palaji)

Aryeh Klapper explains why the Tzitz Eliezer did not really rule that men can medically become women

The Palaji / Falaji / Palacci / Palaggi brothers of Ismir: Wikipedia article

Subscribe for free to receive new posts and support my work. https://shirabatya.substack.com/

The disturbing origin of oft-quoted religious narratives of "gendered souls".

To watch this on video and for full access to notes and resources, go to https://shirabatya.substack.com/p/trans-biblical-characters-in-jewish1

“Queer” teachers such as Abby Stein have sought religious foundations in Judaism for the idea of true trans - that some people are born in the wrong body, with the soul of the opposite sex. They do this by appealing to narratives in Lurianic Kabbalah to do with reincarnation, and by projecting trans identities onto biblical personalities such as Joseph, Dinah, Isaac, and Michal. Such narratives have been promoted by organisations such as Keshet (the Jewish LGBT charity, whose judgment in promoting these texts must be questioned).

I have explored the texts behind these arguments, including quite a bit of halacha (Jewish legal texts) to do with Michal's tefillin. This quest took me on a very dark journey that ended with homophobia, misogyny and an accusation of witchcraft.

Warning: You will be offended!

This is the first half of a recording of a Zoom shiur (lecture) that I gave on Sunday 23 February. This is a more in depth and uncensored version of a similar session that I gave at Limmud Festival in December 2024 with a slightly different title.

In this episode, I cover the background to these narratives and the link with gender identity ideology, and discuss the narratives relating to Dinah, Joseph, and Isaac. Michal’s story will have to wait until next week (Part 2) as she deserves your full attention. (The full shiur is just too long for a single sitting.)

We discover that far from being transgender, Isaac is understood to have been an immature boy with a “female soul” who matured into a proper man who could give his wife children.

We end on the question of what the “soul” really means in these narratives, and whether Judaism is really compatible with the soul / body or mind / body dichotomy inherent in the idea of a “gender” separate from sex.

You are best off watching this on video, as I speak quickly, and the slides contain important information. However, if you are on a podcast app, you can also download the slides with the link below and flip through them as you listen: https://docs.jcob.org/gender/GenderSoulPresentationSubstack1of2.pdf

You can also read the full source sheet here: https://docs.jcob.org/gender/GenderSoulSourcesSubstack.pdf

Links:

Stonewall list of LGBTQ terms

Abby Chava Stein

source sheet from Limmud Festival 2019

interview in 2019 describing how Sha’ar HaGilgulim changed Stein’s life

source sheet on Sefaria (includes text by Rabbi Yechiel Michael of Zloczow)

upcoming book “Sources of Pride” שורשי גאווה

Rabbi Jack Abramowitz An Orthodox Rabbi Discusses Transgender Issues in Jewish Texts (Orthodox Union 2017).

Keshet resource on Gender Fluidity in the Jewish Tradition

Jericho Vincent on our “trancestors”

Jay Michelson: Kabbalah and Queer Theology (July 22, 2012).

Much more in the full source sheet (see above)

Sefaria Source Links:

Talmud Berachot 60a: Leah’s child was originally male but Leah prayed that her sister Rachel should have a son so the sexes were switched

Beresishit Rabbah 72:6 sex switch because Rachel prayed for two sons

Rabbi Eliyahu Munk on Dinah’s male nature

Bereishit Rabbah on Joseph’s laddishness

Bereishit Rabbah 87:7: on Joseph finding himself not to be a man [ish].

Or HaChayim on Isaac’s double birth (female then male)

TO BE CONTINUED

Don't miss Part Two!Subscribe for free to receive new posts and support my work. https://shirabatya.substack.com/

Why no definition of racism can ignore double standards

Originally published on 22 February 2022. Re-posted as a podcast February 2025

Written article with links to resources available from https://shirabatya.substack.com/p/insidious-racism-and-jerusalem-podcast

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I was about 9 or 10 years old when my father taught me the dangers of insidious racism. We were travelling on one of the many flights we took between the USA and South Africa. I cannot recall the precise date, but it was around 1980 and apartheid was still in full swing. The exact details of the incident are hazy, but I recall that there was a black man at the airport and he had said something rude or done something wrong - I can't remember what but he had indeed done something. A white man was telling him off, and I remember that I briefly joined in, as of course, he had done something (I can't remember what).

The next thing I remember was my father taking me to one side and telling me to be quiet. Did I not understand what was really happening here? This black man had done something, but it was minor, the sort of thing you would point out and then move on. This white man was so exercised not because of what the black man had done. Rather, this was about race. The white man was just using this as an excuse to have a go at someone black. I should know better than to support such racist behaviour.

I felt so ashamed. It made me realise how hard we have to work at not being unconsciously racist when racism is normalised around us, as it was in those days.

It is easy to deal with explicit racism. When someone says disparaging things about black people, Jewish people, or whatever other group, we know what we are dealing with. But there is another kind of racism which is insidious and dares not speak its name, and this type is far more dangerous precisely because it is so subtle so that it finds itself at home in polite company. It expresses itself in patterns of behaviour and double standards which can be hard to notice when you are in an environment in which such behaviour is normalised.

So today on my Facebook feed, I noticed an article by David Feldman, promoted by the Guardian, on "What we are getting wrong in the fight against antisemitism in Britain". The article starts out as a reasonable enough discussion, but it quickly became clear that Mr Feldman is simply promoting the Jerusalem Declaration on Antisemitism (which he helped to write) as opposed to the IHRA definition. He argues that the Jerusalem Declaration is better because it helps to distinguish what sorts of criticism of Israel is actually antisemitic, and which is not.

So I took a good look at the Jerusalem Declaration. The main purpose of this declaration is to be an alternative to the IHRA definition, which, it is argued, is faulty because too many of the examples relate to Israel, and, there is a need "to protect a space for open debate about the vexed question of the future of Israel/Palestine."

So what is different about the Jerusalem Declaration? The key point is that the Jerusalem Declaration lists a set of examples of what is antisemitic talk about Israel, and also lists examples of what is not, they argue, antisemitic. In agreement with the IHRA definition they do say that antisemitic stereotypes to describe Israel or holding Jews responsible for the actions of the State of Israel are both antisemitic (point B6).

However, they differ markedly with IHRA on one particular point, to do with double standards. IHRA gives as an example "Applying double standards by requiring of [The State of Israel] a behaviour not expected or demanded of any other democratic nation". By contrast, the Jerusalem Declaration claims as follows:

15. Political speech does not have to be measured, proportional, tempered, or reasonable to be protected under Article 19 of the Universal Declaration of Human Rights or Article 10 of the European Convention on Human Rights and other human rights instruments. Criticism that some may see as excessive or contentious, or as reflecting a “double standard,” is not, in and of itself, antisemitic. In general, the line between antisemitic and non-antisemitic speech is different from the line between unreasonable and reasonable speech.

In other words, the white man who abused that black man at the airport after he did something minor was not being racist. It was a matter of opinion whether he was over-reacting because the black man did after all do something wrong. Who are we to assume that the actions of the white man are racist just because we feel he is being unreasonable and the man he is abusing happens to be black? The race of these people may just be a coincidence.

People don't go around in polite company saying "Hi I hate Jews" any more than they go about saying "Hi I'm a racist". Instead they obsess over the "war crimes" of Israel, while not paying attention while other countries literally commit genocide.

Of course, that would be an absurd argument because we know very well that in that airport the races of the actors were not a coincidence. This happened on a flight between the USA and South Africa during the heyday of apartheid. No one could view race as irrelevant in that interchange unless they were either blind, or a naïve child, or an apologist for racism.

We all understand that in situations of racism, context is everything. When people saw that video of George Floyd being murdered, they did not see just any cop abusing his power over just any man. They saw a white man abusing his power over a black man, in the context of a history of repeated similar incidents in which such abuses of power had been normalised. There was no way to prove conclusively that this specific incident was racist, but the incident reeked of racism - if you had any sense for racism, you could just smell it.

So how can the same people who understand so easily how normalised racist behaviour can lead to double standards applied to people based on skin colour, how can they not understand that antisemitism works the same way - that any kind of entrenched prejudice works that way?

People don't go around in polite company saying "Hi I hate Jews" any more than they go about saying "Hi I'm a racist". Instead they obsess over the "war crimes" of Israel, while not paying attention while other countries literally commit genocide. By engaging in repeated, abusive, disproportionate criticism of Israel, they are no different from that man in the airport and his abuse of that black man.

And this is the problem with the Jerusalem Declaration. It provides cover for antisemites by excusing insidious racism, when of course it is the insidious racism that always does the most damage precisely because it pretends to be respectable.

How we got into the mess we are in, and how we can find a way forward that is compassionate, realistic, and authentically Jewish.

Today I am interviewed by Jo Brew of Women’s Declaration International. The interview was not suitable for WDI’s channel as my positions are not radical feminist, but Jo kindly has allowed me to publish the interview here, which I hope will be a treat for you.

https://shirabatya.substack.com/p/gender-ideology-in-the-jewish-community>

We discuss the challenges that gender identity ideology poses in Judaism, particularly to the very gendered legal structure of Orthodox Judaism, and why this challenge has not been tackled by those in positions of leadership. We also talk about why those movements in Judaism for which gender appears not to matter at all are precisely those who have embraced gender ideology.

I introduce my approach to these issues, which is to pursue the triple value of Inclusion, Realism, and Halachah (Jewish Law). I explain why it is so important to pursue all three of these, no matter how difficult that becomes; also, how the many people who propose simple answers to the problem of gender-identification in Judaism always neglect one or more of these. For example, pushing people out of the community completely, or pretending that transwomen are women (either biologically or within Jewish law).

This recording should work about equally well on audio or on video. If this issue matters to you, please do subscribe as I will soon be publishing a series of shiurim (lectures) that I gave in 2023 in which I addressed these problems in detail. In the current polarised climate, it is more important than ever to adopt a nuanced non-ideological approach to these issues, so I am ready to finally make this work public.

If you enjoyed listening to Jo Brew, you can find her own writing on her Substack, Radical Feminist Essays: https://jobrew.substack.com/

Jo and I have a varied conversation that references a superb article by Kathleen Stock on why it is impossible to get rid of gender completely. You can find that article here: https://kathleenstock.substack.com/p/lets-abolish-the-dream-of-gender

Thanks for reading Heterodox Jewish Woman! Subscribe for free to receive new posts and support my work. https://shirabatya.substack.com/

How a post-modern deconstruction of religious education threatens the most effective tool our society has to inoculate children against antisemitism and other interethnic bigotry.

You will have the best experience if you view this episode as a video on my Substack page: https://shirabatya.substack.com/p/worldviews-and-the-pan-berkshire

You can also find links to the notes at https://www.jcob.org/re.html

You may not realise it, but nothing is more important in the fight against antisemitism and other inter-ethnic hatreds than good quality Religious Education (RE). No I am not exaggerating. Hatred thrives on a diet of ignorance. As I have argued elsewhere, Religious Education offers a far superior model for preventing hatred that is far more effective than what is often marketed as “diversity training.”

Unfortunately, the integrity of RE is under threat, and this relates to a movement to decolonise the curriculum and problematise the concept of religion. This may be just an annoyance to larger religious communities, or those religions that are privileged to be allocated significant time in the classroom. However, to Jews it actually poses a danger to our safety. For us, not being understood has real life consequences.

Today’s episode is a recording of a video seminar I gave last Sunday about my recent experience in Berkshire, where a highly inappropriate Pan Berkshire Religious Education Syllabus was pushed through in the autumn.

This included a shift in focus towards philosophy, viewing religious beliefs as propositions requiring evidence. The final draft also erased the word “Israel” (even the term “Children of Israel”). We were told that the problematic elements in this syllabus came from the new Religion and Worldviews framework, which, it is argued, is the new improved method of teaching RE.

Since we were told that this syllabus came from Worldviews, I researched the history and philosophical underpinnings of the Worldviews Framework. I learned that this new approach to RE is based on a post-modern deconstruction of religion. This critique claims that the concepts of religion and of the religions are colonialist concepts based on power. Instead, religions are now to be viewed as “religious worldviews”, in a framework that is meant to reflect the diversity of lived experience as well as being more inclusive of nonreligious approaches to life such as Humanism.

We are being told that the shift to Worldviews is necessary in order to free us of the “World Religions Paradigm”, a reductive framework that treated religions as self-contained, sometimes stagnant, belief systems. Of course this is false, as in recent years, RE teaching had made a very positive shift to the Believing/Behaving/Belonging (3B’s) framework, which acknowledged that beliefs are just part of the picture in any religion, and that religious traditions are complex and inter-connected. By comparison with 3B’s framework, Worldviews appears regressive, shifting the focus back to belief under the guise of “decolonising the curriculum.”

Find the full video and notes here: https://shirabatya.substack.com

Treating religions as worldviews creates serious challenges for the teaching of Judaism, as Judaism is not a set of viewpoints or beliefs but is founded primarily on identity and practice. In fact, a core aspect of Jewish theology is na’aseh venish’mah - the idea that we perform the commandments and through that we come to understand them and form a relationship with God. Belief is derivative, not primary.

Far from being progressive, the worldviews framework is better understood to be a recolonisation of Judaism in the name of decolonisation.

Other ethno-religions such as Hinduism and Sikhism are similarly threatened by this approach.

Given the incompatibility between Worldviews and Judaism, how should Jews respond to this movement? Can it be stopped? How can we safeguard the coherent teaching of Judaism, which is so crucial in inoculating students against antisemitism? How can we respond to those who are inserting their political views into RE, taking advantage of the chaos that post-modern deconstruction leaves in its wake?

I won’t answer all of these questions, but I hope to clarify a very confusing landscape, so that we are better armed to respond coherently to this movement and expose its post-modern smoke and mirror tactics.

You can find notes at https://www.jcob.org/re.html that parallel the presentation in the video above. You can listen the podcast while following the notes, or else watch the video. Unless you have very good knowledge of Judaism and the current RE world, I strongly advise you to avail yourself of one of these visual aids rather than just listening to the audio, particularly as I speak very fast at times and some material on the screen is not fully read out.

If this video interests you, you will also want to listen to the previous podcast episode, which contains an interfaith panel discussion on how we can teach about our religions while resisting the temptation to persuade others that we have some sort of absolute truth.

To find the full notes to accompany this video / podcast, click here: https://www.jcob.org/re.html.

Thanks for reading Heterodox Jewish Woman! Subscribe for free to receive new posts and support my work.

https://shirabatya.substack.com/

A Rebbetzin, a Priest and a Muslim scholar discuss the problem of Truth in interfaith education

For easily readable notes on this episode, go to https://shirabatya.substack.com/p/but-which-religion-is-correct

This episode is a real treat: a recording of a panel discussion held at the Limmud Festival in Birmingham UK on 23 December 2024.

This is my first post in a while, due to a situation that emerged in Religious Education in Berkshire, which has absorbed almost all of my time in recent months.

The new Religion and Worldviews framework has been accompanied by an increasing emphasis on truth-seeking in religious education, as students are encouraged to examine which religious beliefs are more reasonable and look at arguments between competing religious and non-religious “worldviews.”

As I worked to tackle this dangerous change in pedagogy, numerous theological questions emerged. My conversations with Father Patrick Morrow developed into an interfaith session. We were honoured to be joined by Muslim scholar Dilwar Hussain, MBE. Bios for all participants are below.

Session Description (as in the Limmud Handbook):

Judaism does not proselytise, but this is unusual among faiths in Britain. And do we Jews really have no firm beliefs that we wish others would share? Can we teach about our own faiths passionately, without the conversation slipping into persuasion? Can we allow for multiple religious “truths”, and still be rational? What is religious “truth”?

The panel includes:

* Father Patrick Morrow, a Church of England Priest and Secretary to the Theology Committee of the International Council of Christians and Jews

* Dilwar Hussain MBE of the Woolf Institute, University of Cambridge and Chair of New Horizons in British Islam

* (me) Dr Shira Batya Lewin Solomons, Rebbetzin of the Jewish Community of Berkshire, and Director of JCoB Education (provider of RE Judaism support to schools across England and Wales)

https://www.jcob.org/support_judaism_re.html>

Background

This conversation emerged as a product of the ongoing challenge that I have been facing due to the new Religion and Worldviews framework in Religious Education (RE), which is shifting the focus of learning towards truth-seeking and exploration of “big questions”, as opposed to more traditional RE, which prioritised understanding the beliefs and practices of others without making judgments or seeking answers.

The new approach to teaching RE seeks to avoid claiming to be able to teach Religions as coherent well-defined traditions, due to a post-modern critique that emphasises the diversity within religious traditions. From this perspective, there are many “Judaisms”, “Islams”, “Christianities” etc. - each individual with their own “personal worldview” based on their own “lived experience” that cannot ever really be fully communicated or understood by others.

Teaching has therefore shifted towards developing each child’s “personal worldview”, through the exploration of “big questions” and a shift towards philosophy and theology. This involves students exploring and even debating issues such as “Does God exist?” “Where did the universe come from?” “Is religion dangerous?” “What happens after we die?” In the first draft of the new Berkshire RE Syllabus, children were even asked to rank beliefs for their reasonableness.

This sort of focus raises major concerns as it had been a rule in RE teaching that we were never meant to ask whose beliefs were right or wrong or make judgments as to whether religious beliefs were reasonable or well founded in arguments. Persuasion and proselytising should have no place in RE, which is about listening, learning, and understanding.

When I pushed back at this change in pedagogy, I faced two primary counter-arguments:

* There are some matters (ethics, public policy) that relate to religion, where we need to debate, make arguments and reach consensus.

* By demanding no persuasion, proselytising, (it is argued that) I am imposing my Jewish or liberal view on others. (Andrew Wright) What if a religion believes in proselyting - what if that is part of their religious expression? Can we really share our faiths without making any truth claims?

In my next Substack piece, I will carefully document what has been happening in RE based on our recent experience with the new Pan Berkshire Syllabus. I will look at where this framework came from and at the serious consequences. The discussion here will not address those issues but will focus on the philosophical challenges. I am arguing for RE that is scrupulously free of attempts to persuade, but how do we do that? It’s easy enough when teaching Judaism, as we Jews do not seek converts. But what about Christianity and Islam, which traditionally have sought converts? Are we asking Christians and Muslims to be inauthentic?

Below is an outline of the contributions of the panellists, with some links to material in case you want to read more. Before reading further, I recommend that you listen to the audio, which is the real event. Note that the notes on Patrick and Dilwar’s presentations were written by me and are therefore less detailed.

Shira Solomons (Judaism)

https://shirabatya.substack.com/

I focused on the teachings of two great rabbis: · Joseph Soloveitchik (the Rav) and Rabbi Jonathan Sacks

Rabbi Joseph Ber Soloveitchik

Rabbi Joseph Ber Soloveitchik = Yosef Dov Soloveitchik (1903-1993) “The Rav”Famous essay: On Interfaith Relationships (1964)

Impossibility of interfaith dialogue on theology etc.

* Different religions essentially speak different languages. Different categories and “incommensurate frames” for understanding our place in the world.

* Because we speak different languages, we each have our own “unique relationship to God… moulded by different historical events”

* We cannot understand the “private” elements that express their “individual religious commitment”

When we can and should engage.

* Role of interfaith is to work together in matters for which our beliefs are the same.

* Certain values in common between Jews and Christians such as human beings in the image of God, Imitatio Dei.

* We use our common religious language to work together for things like civil rights, morality, fighting poverty, seeking peace. (Remember he is writing this in 1964.)

* Secular people will find it difficult to understand our shared religious language. [Like tone-deaf people who cannot understand music.]

My evaluation of Soloveitchik

* Judaism has a concept na’aseh venish-mah - In order to understand you must do the action first. So yes, it is impossible to understand fully the religious experience of another faith when we do not and should not share in the practice.

* Soloveitchik is not saying Judaism has a monopoly on truth.Argument relates to our ability to learn from others who are different.

* I ask: How does Soloveitchik know about the beliefs we have in common (or not) with Christians? Surely we found this out by having conversations.

* How do we deal with disagreements when they matter? We do need to agree on some things in order to live together? Not addressed by Soloveitchik at all.

Jonathan Sacks

Rabbi Lord Jonathan Sacks (1948-2020)Controversial book: Dignity of Difference (2002) (Avoid later editions)

All quotes are from the first edition (2002), not the adulterated second edition (2004).First editions are readily available very cheaply on Amazon. The 2nd edition radically altered the core chapter (Exorcising Plato’s Ghost pp. 45-66).Gil Student summarises all the changes Sacks made for the 2nd edition here: https://www.torahmusings.com/2007/10/differences-of-dignity/

Tower of Babel / Exorcising Plato’s Ghost

* Yes different religions speak different languages, but this is something to be celebrated. The will of God.

* Babbling of the languages of the people building the Tower is something wondrous and good.

* Oppressive and totalitarian for everyone to think and speak exactly like each other.

Let there be Diversity:

* “Religion is the translation of God into a particular language … God has spoken to mankind in many languages: through Judaism to Jews, Christianity to Christians, Islam to Muslims.” (p. 55)

* [A core lesson of the Torah is that] “God is God of all humanity, but no single faith is or should be the faith of all humanity.” (p. 55)

* Myth that “If I am right, you are wrong”… “you must be converted, cured, and saved” (p. 50)

Universalism is dangerous

* Sacks is scathing of those who “attempt to impose a man-made unity on divinely created diversity”

* Greatest crimes in history come from attempts to impose universalism on the diversity of human beings.

* “Babel - the first global project - is the turning point in the biblical narrative. From then on, God will not attempt a universal order again until the end of days.”

* [Related to the Talmudic concept of Teiku - pushing off disputes to be resolved at the end of days, acknowledging the limitations of human beings to attain the Truth on certain matters]

Particularity / Covenants

* Myth that universal morality is morally superior to particular moralities. Criticism of Jews for being parochial, only marrying each other, taking care of our own before others. This is prejudice, chauvinism.

* “We are particular and universal, the same and different, human beings as such, but also members of this family, that community, this history, that heritage, our particularity is our window onto universality” (p. 56)

* We understand the human experiences of others by having our own particular human experiences.

* “… we learn to love humanity by loving specific human beings. There is no short-cut.” (p. 58)

Engagement

* Not only are there multiple truths out there, but we can learn something by engaging with them. Unlike Soloveitchik, does not want to hide away, avoid understanding the other.

* Importance of conversation, as opposed to debate (politics).

* “entering into the inner world of someone whose views are opposed to my own” (p. 83)

* In a conversation, you don’t win or lose. You grow. You learn something as you “know what reality looks like from a different perspective.” (p. 83)

Religion and Politics

* How do we deal with difficult questions where we need to agree to live together?

* We first have those conversations, so that we understand each other.

Then political conversations resolve what we actually do as a society together.

* Consequence: Need to be very careful how and where such political debates occur, as they may eclipse the conversations that are really necessary, particularly in educational settings.

Patrick Morrow (Christianity)

Historical tendency of the Church to assumes it possesses all Truth. Vast majority of Christians wish to leave that behind.

Christians tend to prefer Sacks over Soloveitchik. The idea of private truth is very foreign to Christianity due to opposition to Gnosticism (esoteric knowledge). Christianity has taught that its teachings are available to everyone.

Three-fold typology of approaches to non-Christian faiths (proposed by pluralists):

* exclusivism (we alone have the religious good)

* inclusivism (we have the religious good fully, and others may share part of it with us)

* pluralism (no way to distinguish who has more or less of the religious good; we are all equal)

Another approach: Most takes on other faiths are variations on inclusivism. They can tip into exclusivism (one type of error) or into pluralism (another type of error).

Mainstream Christian Inclusivism in the Catholic Tradition

Karl Rahner was a Jesuit, before, during and after Vatican II. 1961 lecture: “Christianity and the Non-Christian Religions”. Published as pages 115-134 of Theological Investigations Vol 5 (London: Darton, Longman and Todd) Available here

Rahner offered four theses. We will look at three:

* Christianity is the absolute religion intended for all. This applies only when Christianity enters with existential power into the life of a person or a community. This happens only when a person has a Pentecostal experience. This cannot be seen, and it cannot be forced.

* Therefore, it is likely that the other religion in which a person finds himself is legitimate (in God’s eyes).

* Therefore, a missionary, meeting someone from another faith, should treat them as an anonymous Christian. (God will be working in that person’s life. Who is God? For Rahner it is the Trinity. Therefore, the Trinity is present for that person and that person is therefore a Christian.)

Catholicism has moved on from here, but this position does mean treating a person from another faith as someone who has their own relationship with God from which one can learn. They may have precisely the teaching that I need right now.

[For those who want to read further, Patrick Morrow has written about this issue at length here. Karl Rahner also entered a dialogue with Jewish theologian Pinchas Lapide that included such matters as the Jewish debate about whether Christianity is monotheistic.]

Dilwar Hussain (Islam)

Importance of humility. Quran teaches people be in awe and wonder of the vastness of Creation and therefore of the Creator.

Three main points:

1. God has an infinite amount to say to us, so cannot be contained in any finite text.

If we believe that all of God’s wisdom is contained in the Quran or in any holy text, then we are making God finite. In the view of Islam (with the focus on monotheism), then lends towards idolatry.

“If all the seas of the earth were turned into ink and all the trees of the earth were turned into pens, then the wisdom of God would not have been exhausted.”

[I shared a laugh here with a fellow Jew in the audience as this is so, so similar to the text in the Jewish prayer Nishmat. “If our mouths were full of song as the sea is with water… we would not be able to sufficiently praise you.”]

2. Diversity is created by God

If diversity is in the world, God intended it to be there. Just like we cannot understand evil, we cannot understand why it is there, but it is there for a reason.

“We created you from one soul, and we created you into nations and tribes, that you may come to know each other.”

Diversity is a source of wonder and learning. This is part of the Divine intention and part of the human journey.

3. How to deal with difference?

There are universals. But there will be differences. We will disagree. This happens both within and between religions and across humanity.

Some disagreements can be resolved. Others cannot and we leave them to the Day. Right and Wrong in the universal sense is the language of God. We cannot know absolutely so must focus on living in peace rather than who has the right or wrong answers.

4. Relevance today / challenges

Why is this such a cause of anxiety for us today? Historically Islam was more inclusive as it saw teachings of Judaism and Christianity as part of its heritage. Today we have too much “brittle religion” because of political conflicts.

Religion that is not soft and flexible, and can break. We end up with “brittle, broken religion” (Hamas, Isis etc.).

It’s not most Muslims, but it is some Muslims and must be acknowledged. A lot of work to do within Islam to reclaim the flexible tradition that is possible.

Thanks for reading Heterodox Jewish Woman! Subscribe for free to receive new posts and support my work. Go to https://shirabatya.substack.com/

https://www.jcob.org/support_judaism_re.html>

J K Rowling's reluctance to forgive Dan and Emma is understandable, but a story from Reb Shlomo Carlebach shows us why she should be more generous. Reb Shlomo tells of a miser who has never given a penny of charity in all his life. Because all he ever offers is a single rusty penny. We assume he offers this to show his disdain for all who ask him for help. But are we correct?

Listen above to learn the full story. This is only a short podcast today. Hastily recorded in the midst of Passover preparations. But with an important lesson that we need to heed in these toxic unforgiving times.

JK Rowling's tweet can be found here: https://twitter.com/jk_rowling/status/1778124467027267804

The Times article can be found here: https://www.thetimes.co.uk/article/jk-rowling-i-wont-forgive-harry-potter-stars-over-pro-trans-views-fp79wpbvn

It's very, very difficult to offer that first rusty penny. We have to help people find the strength to go back and then say, “Yes, I was wrong about this and I was also wrong about that.” And then people can actually find the strength to make amends properly.

And if we act in a miserly way ourselves, and we reject out of hand the tiny little offerings of apologies that come our way; if we do that then we take away the opportunity to pull people out of the rabbit holes that they are buried in.

Because very often we see what appears to be some self-righteous, nasty person. How dare they think that a single rusty penny will make it all better?

But maybe it's a hand reaching up and they are saying: “Please grab my hand. Give me a little, little pull to help me come out.”

Reb Shlomo Carlebach’s story “A Bit of Charity” can be found in the book Shlomo’s Stories: Selected Tales

The most important parts of the story can also be found here: https://issuu.com/jewishhome/docs/currentissue_3816061d4e388f/64

It is a mistake to focus excessively on the problem that children lack capacity to consent to trans medicalisation. The problem is much more serious than that.

This audio essay explores how the concepts of medical care and consent have been queered by those campaigning for “gender affirmative” healthcare. By clarifying the mindset that leads people to find such treatments plausible, we can more effectively argue against them and disabuse those who have been hoodwinked by smoke and mirror tactics as words like “consent” and “healthcare” have multiple meanings so that the absurd is made to appear plausible.

Now trans healthcare, being “healthcare”, must be paid for by your health insurance and you cannot discriminate against trans people by having their “healthcare” not get paid for.

And secondly, it being necessary “healthcare”, you can then loosen up on the requirements for consent by being allowed to be paternalistic and deciding on behalf of a vulnerable patient like somebody who's mentally ill or a child that you know what's in their best interest. Because you understand that this patient is trans because you are the expert.

You can see into their soul.

So paternalistically you will then approve of the child having healthcare done to them for which they do not have the capacity to consent, to which they actually have not consented.

You consent on behalf of them, and you do it in the name of personal autonomy.

Sources on Informed Consent and Medical Necessity in Body-Altering Healthcare

When patients lack capacity, others decide for them in their best interests

* https://www.cqc.org.uk/guidance-providers/learning-safety-incidents/issue-12-capacity-and-consent

* https://code-medical-ethics.ama-assn.org/ethics-opinions/decisions-adult-patients-who-lack-capacity

Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults by Stephen B. Levine, E. Abbruzzese &Julia W. Mason

Summarises the issues to do with consent.

It is common for gender-affirmative specialists to erroneously believe that gender-affirmative interventions are a standard of care

Five scientific observations question and refute the assumption that an individual’s experience of incongruence of sex and gender identity is best addressed by supporting the newly assumed gender identity with psychosocial and medical interventions

AMA to states: Stop interfering in health care of transgender children

Empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression. For gender diverse individuals, standards of care and accepted medically necessary services that affirm gender or treat gender dysphoria may include mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries. Clinical guidelines established by professional medical organizations for the care of minors promote these supportive interventions based on the current evidence and that enable young people to explore and live the gender that they choose. Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people.

Misinformation Obscures Standards Guiding Gender-Affirming Care for Trans Youth

This article defends gender affirming care by pointing out that there is careful assessment to make sure that children have capacity. The Endocrine Society claims most adolescents have capacity by age 16.

Different Aspects of Informed Consent in Aesthetic Surgeries by Nasrin Nejadsarvari and Ali Ebrahimi

About informed consent for aesthetic surgeries. Consent is impossible if patients have psychiatric problems. Surgery may make psychiatric problems worse. Misinformed consent can lead to legal liability for malpractice.

Note: Gender doctors treat the psychological distress of patients as analogous to the distress of an accident victim who is mis-figured and requires reparative surgery to restore their appearance and therefore help their mental health.

Example: https://saberplasticsurgery.com/gender-affirming-breast-removal/

Advertises surgery as helping with gender dysphoria and feeling “comfortable in your skin”. Top surgery is “medically necessary”.

New advertising guidelines for cosmetic surgery in Australia: https://aestheticmedicalpractitioner.com.au/features/cosmetic-practice/new-cosmetic-surgery-advertising-guidelines/

Gender affirmation surgery is not considered cosmetic surgery, and the cosmetic surgery advertising guidelines ‘do not apply to non- surgical cosmetic procedures’.

Cosmetic surgery must not be advertised in a way that exploits the vulnerabilities or insecurities of individuals to increase demand for cosmetic surgery

* testimonials are not allowed

Gender Confirmation Surgery: Cosmetic or Reconstructive Procedure? Alexis Laungani, MDcorresponding author* and Pierre Brassard, MD, FRCS(C)

For the sole purpose of dichotomy, the transgender patient could be considered as having a birth defect by not having a body envelope corresponding to their true gender. Gender confirmation (also called sex reassignment) with hormones, mental therapy, and surgical transition, has been shown to relieve symptoms of gender dysphoria and to provide patients with a regained socialization in their true gender, as opposed to their gender assigned at birth.

Body modification – when consent is not a defence

This is a longstanding legal principle. Where actual bodily harm or above is inflicted upon a person with no good reason, in public or private, the consent of the victim is irrelevant. Whether there is a “good reason” is a matter for the courts to decide.

Organisations such as MEND and Stonewall can no longer be allowed to dominate diversity training. The potential solution may surprise you.

You can find a written version of this article with hyperlinks to sources here:

https://shirabatya.substack.com/p/can-we-mend-diversity-training