In that scenario it's safest to split payment, 400 in Bitcoin and 400 in meth. You gotta diversify your portfolio.

Given the prevalence of forced mutilation of intersex babies as well as medically unnecessary circumcisions, I humbly disagree that these procedures are "weighted on total outcomes".

As I said, it's not a perfect system. However, a lot of the times the flawed treatments of their times were influenced by how physicians perceived cultural norms.

As cultural mores are adjusted and education within the medical community improves, treatment options are usually re-aligned to fit the science. For example circumcisions are becoming a thing of the past and intersex operations nare usually conducted after secondary sex organs develop.

Every doctor who has performed that procedure was fully aware that it was medically unnecessary and did not have reason to believe the baby would not come to regret not being given a choice years down the road. I'd argue these procedures are institutionalized medical malpractice.

Eh.... Doctors are a slave to social mores as much as anyone is. They are unfortunately just as susceptible to belief as lawyers or politicians. There were beliefs that spouted about hygiene etc, but in reality those were just to validate belief systems held by the vast majority of the population. In the end they believed that the harm was not very significant to the pts overall health.

but I think it's critical to acknowledge that the field of medicine still has very strong biases in these matters and is not nearly as Cartesian as it is sometimes made out to be.

I think it's fairly obvious that the medical system has failed several minority groups, most recently trans people. I am proclaiming how medical providers should behave and how we were trained to treat all patients. Unfortunately, as you have stated, beliefs systems unjustly often interjects itself in medical care. Whether that be in prescribing birth control or administrating gender affirming care.

An easier way to avoid taxes while I collect my bribes......don't mind if I do!

The rats are stealing the cargo as they abandon ship, what a bunch of enterprising rodents we have.

While I don't agree that medical providers shouldn't be involved in important healthcare decisions. Unfortunately, at this point I agree the American healthcare system has largely failed the trans community, among others.

I think medical providers should be doing their jobs and keeping their personal beliefs to themselves. If a patient is wanting to transition they should have access to a provider who can make that transition as easy and safe as possible.

was just responding to the argument that any treatment is worth it when the alternative is suicide

That's not the argument.....

The argument is that treatment plans are developed by evaluating risk and reward.

The risk for not treating is very high, even if the treatment doesn't have a high rate of efficacy as long as it doesn't introduce further risk, it's still a valid treatment.

there is no medication without side effects. ADHD meds can have bad consequences, but we should still allow people to take them based on informed consent. apply the same logic to kids on HRT.

People aren't put on ADHD medications or on hormone therapy because of any ability of informed consent. They are prescribed because a medical professional has evaluated that the outcome of their overall health with treatment is improved when compared to not being treated. The parents and the patient have a say....to a point. However a medical professional can be empowered by the courts to supercede the consent of the PT or the parent if and when deemed necessary.

Medications have the potential of negative side effects, it's not guaranteed. Those potential side effects are weighted against the potential negative effect of inaction.

Even if we are accepting that as true, that doesn't really have anything to do with an individual patients treatment plan. You aren't evaluating risk based on the general population, you are evaluating risk based on patient populations with the same diagnosis.

If any risk is mitigated with gender affirming care compared to patient populations who aren't receiving care , and the risk of harmful side effects are minimal then the treatment plan is valid.

I don't really see how you think that comparing them to the general population makes any sense?

That would be like someone saying that people receiving treatment for HIV are still more immuno compromised than the general population.....well yeah, but treatment vastly improves their total outcomes.

The thing is.....hormone replacement therapy isn't really a drastic intervention. If the outcomes are not aligning with the treatment plan you simply stop taking the medication.

There are virtually no long lasting repercussions for temporarily delaying puberty. Really the only notable side effects are that you may be a bit taller than you were going to be.

I don't think many people working outside pediatric healthcare really have an understanding about how comfortable healthcare providers are prescribing interventional care.

When diagnosing and treating a patient we come up with a plan of care that is weighted on total outcomes. Now this isn't a perfect system, for example we may not completely understand the potential harm of new medications. However, we are creating the plan of care with the best information we have at the time. Taking potential side effects and weighing it against the potential harm that could occur without any treatment.

I specialize in pediatric orthopedics and rehabilitation....so take anything I say about gender affirming care with a grain of salt. However, the potential outcome for not treating gender dysphoria as I understand it is pretty bad....self harm and suicide are about as bad as an outcome as one could imagine. Now weigh that against the medications that are usually prescribed for gender affirming care which are well known, and most often prescribed without negative effect for a plethora of treatments ranging from precocious puberty, to monitoring rate of which growth plates close.

Hormone replacement therapy has been going on for decades and is very common place at any hospital that atends to pediatric patients. To claim that intervention isn't appropriate for something with a potential total outcome as bad as suicide, based off "kids can't consent" is a ridiculous notion considering that the same drugs are often prescribed to make sure a child doesn't develop a limb length discrepancy after an orthopedic surgery.

I mean.... Iraq didn't have them until we sold them the precursor chemicals to make them. What they were really upset about was that Saddam was supposed to use all those to kill Iranians and then the Kurds.

You do a guy a favour by helping him eliminate any of his dissonance and what do you get in return? The guy tries to invade Kuwait to pay off all the money he owes for invading Iran. When did empowering ruthless dictators to do your bidding get so complicated?

It really depends on your energy source and your appliance, but the cost to run something like an oven for an hour is pretty negligible, especially if it's a somewhat modern appliance.

Most newer over run somewhere around 2-3,000 kwh, which nationwide averages to around .30 to .50 cents an hour.

The real cost of making food at home really just depends on how much you value your own labour/free time, and how much of a chore cooking is for you.

This guy bought so many rare monkey tokens. Ai is impressive in some aspects, but it's not nearly as impressive as the marketing that drives the massive amounts of investment into it.

The US economy is doing anything it can to create growth, which is causing investors to create a bubble around AI that is "too big to fail".