Miscellany Central

Monday, April 3, 2023

A return to reason in the gender debate

Read time: 2 minutes

A return to reason in the gender debate

What’s changed? Most obviously, the fate of Nicola Sturgeon and the SNP for backing an extension of trans recognition rights

Former SNP leader Nicola Sturgeon

Has the tide turned in the so-called gender wars? Parents are beginning to demand that they are more closely involved in how their offspring are taught at school about biological sex and politicians are having to respond.

For too long a group of activists representing a tiny minority have dictated how the issue of gender identification should be handled in schools, in the workplace and in other walks of life. Our political leaders have been reluctant to call them out or have actively encouraged them. The Government is reviewing the guidance and needs to introduce much more specific rules governing the teaching of this subject, which schools will be required to follow.

Labour is also moving. Last year, Sir Keir Starmer found himself unable to answer a question that until recently simply would not have been asked: does a woman have a penis? Now, the Labour leader finds himself in a position to say “of course they haven’t”, though even then he limited it to 99.9 per cent. In an interview at the weekend Sir Keir said turning the gender issue into “a toxic divide advances the cause of no one” and particularly not of women. Suddenly, the Labour leader appears to be siding with the feminists in his own party, like Rosie Duffield MP, who have been ostracised by colleagues for wanting to defend safe spaces for women.

So what’s changed? Most obviously, the fate of Nicola Sturgeon and the SNP for backing an extension of trans recognition rights, which blew up in their faces, forced her resignation and almost certainly dished their push for independence.

Sir Keir acknowledged this in his interview: “The lesson from Scotland is that if you can’t take the public with you on a journey of reform then you’re probably not on the right journey.” Does that mean he wants to persuade the public that the demands of trans activists should be met or that he now recognises them to be unacceptable and divisive? If the latter, why did he not see this until it became apparent there are serious political downsides to following an extreme trans agenda? Surely Sir Keir, now in his seventh decade, was capable of differentiating the biology of men and women.

Nonetheless, the fiasco in Scotland over this issue has shifted the dynamic. Sir Keir now accepts that women’s rights cannot be trumped by trans rights – which is precisely what Ms Duffield, J K Rowling and millions of others have been saying for years.

Republicans Could Regret Attacking Trump’s Indictment

Jonathan Bernstein | Bloomberg — Read time: 3 minutes

As soon as the indictment of Donald Trump was revealed Thursday, prominent Republicans lashed out against Alvin Bragg, accusing the Manhattan district attorney of bringing a groundless and politically motivated case against the former president.

Florida Governor Ron DeSantis, the leading alternative to Trump in polls so far for the 2024 Republican presidential nomination, managed to invoke liberal financier George Soros twice in his 75-word statement claiming that Bragg was weaponizing government to carry out a political agenda. DeSantis also promised to resist Trump’s extradition to New York from Florida, never mind that Trump’s lawyers said the former president would surrender to be arraigned. Other GOP presidential hopefuls expressed similar sentiments. Former Vice President Mike Pence called the indictment “an outrage,” while South Carolina Senator Tim Scott labeled it a “travesty” and accused Bragg of using the law to go after a political enemy.

But one potential GOP contender, former Arkansas Governor Asa Hutchinson, took a different tack. Trump, he said, should abandon his pursuit of the Republican nomination in light of the indictment, calling it an unnecessary distraction. Hutchinson is hardly a NeverTrumper; he supported Trump’s presidential bids in both 2016 and 2020. But he became critical of the former president following the Jan. 6 attack on the Capitol and has said in recent weeks that an indictment should disqualify Trump from the presidential race.

Is there room in the Republican Party for this perspective? Other Republicans who have turned sharply against Trump tended to wind up shunned by the party. Former Wyoming Representative Liz Cheney lost her leadership post and then her seat in Congress for her role investigating the Jan. 6 siege.

Hutchinson seems to be searching for a middle ground. Perhaps he has been hearing from conservatives within the Republican Party who are ready to fight back against the anti-democratic impulses like those on display during the Trump era.

What’s far more likely is that Republicans who spoke out against Trump’s indictment reflect where the bulk of influential Republicans are right now and that their views will prevail in the nomination contest, whoever winds up winning.

This has major implications. If Trump or another candidate with anti-democratic tendencies secures the nomination, Republicans will go into the 2024 presidential election with a self-imposed disadvantage. While Trump himself did narrowly manage an Electoral College victory in 2016, he has never been popular, and his hand-picked candidates tend to be even less popular.

But more importantly, it means that when they do win, Republicans will be committed to governing with Trump’s attitudes toward justice and the law in mind. That could mean more attempts to undermine elections. It could mean more partisan uses of pardon power (including, if there are federal charges brought, to clear Trump and his supporters). It could mean the demise of neutral expertise in favor of partisan hackery in the federal government.(1) It certainly would mean even more partisanship — and blind loyalty to the president — as governance priorities.

It might seem to Republicans that attacking Bragg was a free shot that will leave them room to maneuver in the future. But suggesting the indictment never should have happened — without knowing the details of the charges — implies that the former president should be treated as being above the law. That is going to be hard to shake.

As candidates progress during the presidential campaign, the positions they take become the party’s new agenda. Political parties define and redefine themselves in all elections, but presidential races are the most important, and they can sometimes direct the course of a party for years to come.

There is an alternative. Hutchinson isn’t piling on Trump the way some NeverTrump Republicans did from early on. But he is showing how a prominent Republican can be a conservative and still support the rule of law. We’ll see whether anyone joins him. I’m not optimistic.

(1) I continue to defend the US version of government bureaucracy and its heavy use of partisan supervision, with presidents and Congress both having unusually strong abilities to influence the civil service compared with other large democracies. But Trump and his allies seek to dismantle neutral expertise altogether, leaving nothing but partisanship. Bad idea.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Jonathan Bernstein is a Bloomberg Opinion columnist covering politics and policy. A former professor of political science at the University of Texas at San Antonio and DePauw University, he wrote A Plain Blog About Politics.

More stories like this are available on bloomberg.com/opinion

Too Much of America Is Emptying Out. More Immigration Can Help.

Matthew Yglesias | Bloomberg — Read time: 5 minutes

Most large American cities are continuing to lose people, the US Census Bureau reported last week, even as many smaller and mid-sized counties are growing. And while politicians (and, increasingly, billionaire investors) like to make hay over the cultural and economic reasons for moving, the most striking aspect of the US’s shifting population isn’t which counties are losing people. It’s the sheer number that are experiencing population loss.

Consider that 48 of West Virginia’s 55 counties lost people, as did 56 of Louisiana’s 64 parishes. A majority of the counties in Iowa, Ohio, Mississippi and North Dakota lost population. Northern New England grew, as remote workers fled the expensive metro areas of the Northeast in search of more rustic accommodations. But almost all of upstate New York shrank, as did Western Massachusetts. Even in fast-growing Texas, most of the arid western counties and much of South Texas lost people. So did big stretches of rural Pennsylvania, southwestern Virginia, and all of Puerto Rico.

Some transition of population from place to place is healthy and natural, and the pandemic induced large dislocations in working habits and daily life. And in some expensive metro areas, such as New York and San Francisco, some population loss may be beneficial.

In New York, for example, Manhattan actually gained population between July 2021 and July 2022 as people took advantage of lower prices to move in from the outer boroughs. Compared to the national average, most of those outer-borough neighborhoods (as well as the inner-ring suburbs that also lost people) remain pretty expensive. Over the next few years, prices will fall to reflect the diminished demand and people will return, just as they already have to Manhattan. The result will be a somewhat poorer, somewhat more affordable metro area — that continues to have all the qualities that people who love New York love about it.

Even so, it will be a challenging fiscal environment for local governments, which have pension and other obligations that were undertaken under different circumstances.

The situation is much worse for places that were affordable before the pandemic. Cities and towns in rural Midwest that lose people are looking at a larger fiscal loss, because there’s no guarantee people will return even at lower prices. They could adjust to the smaller population by raising taxes, but that won’t exactly help attract new residents. A permanent loss of population will be a blow to local businesses, too, which will further reduce government revenue.

Even before the pandemic, several large Midwestern cities — most notably St. Louis, Detroit, Cleveland and Milwaukee — were in a difficult spiral of decline. When demand for living in a place becomes so low that the market price of housing falls below the cost of building a new home, bad things happen. Landlords end up with little financial incentive to invest in the upkeep of their property. (Homeowners are less likely to let their houses fall into disrepair, but the money and sweat equity they put in may be wasted.) Homes stay vacant or get demolished.

The risk is that this dynamic will now spread to a much broader set of communities — smaller towns and suburbs, potentially even Chicago.

In any one of these cases, it’s easy to point to some mix of idiosyncratic factors or policy errors behind the decline. It’s also not so hard to imagine policy tweaks that could make a community more appealing and reverse a cycle of decline.

But this is where scale matters. County A can gain population from County B — but in a country where 47% of all counties are losing people, this is a zero-sum game. The reality is that a huge share of American communities are losing people not just because of specific local conditions, but because the national population growth rate — 0.4% in 2022 — is very, very slow.

Immigration rebounded last year to pre-pandemic levels, which pushed Manhattan and several Sun Belt central cities back into positive population growth. But even pre-pandemic immigration levels remain significantly below those which preceded the Great Recession.

That’s largely a decline in illegal immigration relative to its levels of a few decades ago, which no politician will bemoan. But if the US had replaced that illegal migration with visas for people with in-demand skills, it would have a stronger economy and more resilient communities. Birth rates, meanwhile, have been sliding for a long time, and there’s also been an alarming recent increase in deaths — from Covid, from drug overdoses, from traffic accidents, from homicides and suicides.

The result of this slowdown in population growth is a more challenging landscape for leaders in all kinds of places. It’s easy for partisans to pit Florida against Illinois or Texas against California, or for cities to pit themselves against the suburbs. But the fundamental reality is one of broad decline, in which growth is the exception rather than the rule.

And only national leaders have the power to raise the national level of population growth, which would make life easier for local leaders. There’s no one solution here — making policy more supportive of parents while addressing the frightening decline of life expectancy are both complicated, multifaceted issues. But legal immigration remains a fast-acting and relatively straightforward option that deserves a consideration from Congress, separate from any controversies about asylum-seekers. Educated, skilled workers in particular would help stabilize communities in decline while bolstering the economy as a whole.

There’s no good reason for places to be struggling with population decline even while tens of millions of people want to move to the US. This country can’t and won’t let in everyone who wants to come — but that’s not a good reason to keep all of them out.

The Gun Lobby’s Strength Is Cultural, Not Financial

David A. Hopkins | Bloomberg — Read time: 4 minutes

March 30, 2023 at 1:49 p.m. EDT

Gun politics in the US demonstrates that a popular majority does not always get its way. Even though most Americans support stricter gun-safety laws, proposals for major new regulations reliably face impassable obstacles in Congress.

The standard explanation for this impasse is that the minority is highly mobilized and well-funded. This is only half right: The power of gun-control opponents stems more from their shared sense of identity than from their money.

Frustrated liberals are well aware of the difficulties they face in winning a major legislative battle over gun policy, but they often misunderstand the source of the obstruction. As in other policy areas, such as health care or environmental regulation, many Democrats are predisposed to view Republican opposition as primarily reflecting the supposedly undue influence of wealthy or corporate interests.

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After this week’s mass shooting at a Nashville school, former House Speaker Nancy Pelosi claimed that Congress’s refusal to renew the 1994 federal ban on assault weapons was “all about money … big money in the gun business.” Democratic leaders habitually accuse the National Rifle Association of buying the votes of Republican politicians via direct financial contributions and independent campaign expenditures.

But while the NRA is a famously powerful interest group — despite some serious recent management problems — most of its influence does not derive from the money it spends on elections. As the political scientist Matthew Lacombe explains in his 2021 book Firepower, the NRA’s most transformational achievement was not financial but cultural: It successfully defined gun ownership as a distinctive form of social identity.

For decades, Lacombe writes, the NRA has encouraged gun owners to see themselves as “reputable, honest, patriotic citizens who are self-sufficient and love freedom” but who constantly face unmerited attacks from “politicians, the media and lawyers.” He concludes that gun-control supporters are at a relative disadvantage because they lack a countervailing identity of their own.

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In polls, a majority of Americans mildly favors the additional regulation of firearms. But very few consider not owning a gun as a central element of their personal lifestyle that they will mobilize to defend.

Over the past decade or so, gun-safety advocates have founded several new organizations and engaged in increasingly visible forms of public protest. (One of the most prominent of these groups, Everytown for Gun Safety, is backed by Michael Bloomberg, founder and majority owner of Bloomberg LP.) Much of this activism has openly invoked famous tragedies such as the Sandy Hook and Parkland school shootings, or has been led by victims of gun violence such as former US Representative Gabby Giffords of Arizona. The creation of this institutional infrastructure is a logical attempt to build a counterpart to the NRA and other gun rights groups, with the goal of convincing elected officials that popular passions are not limited to one side of the gun debate.

This activity has met with some success in pressuring Democratic politicians to keep gun control on their policy agenda. And as well-educated suburbanites continue to replace White Southerners and rural residents within the party coalition, it’s getting much easier for Democratic leaders to keep their members united on the issue.

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But gun-safety advocates are unlikely to extend their influence to the other side of the aisle. Gun owners and their family members are an important constituency within the conservative activist community and the Republican primary electorate. Republican officeholders are careful not to alienate gun-rights organizations because they are worried about losing votes, not just PAC money.

So the partisan gridlock over gun policy is less likely to be broken by specific political tactics than by a larger shift in the cultural zeitgeist. If gun ownership loses popular appeal as a salient personal identity — because it becomes socially discouraged or simply goes out of style — one of the major impediments to leftward policy change will become less formidable.

Staunch opponents of gun control may be outnumbered in the US, but they still wield considerable power. Not only have they prevented Congress from passing major gun-safety regulation, they have also succeeded in getting many Republican-controlled states to make it easier for citizens to purchase and carry guns. That’s because in politics, it doesn’t just matter what you say — it also matters how much you care.

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Granola Nazis: Digital Traditionalism, the Folkish Movement and the Normalisation of the Far-Right - GNET

by Catherine Tebaldi

March 2023.

Introduction

Digital traditionalist women carefully cultivate winsome images on Instagram: harvesting fields of beets with the folds of muslin dresses and aprons spilling around bare feet, canning and pickling them in vegetable jars surrounded by laughing blonde children. In the winter, the family stamps sugar cookies with intricate runic patterns, or braid evergreen branches and holly to celebrate the festival of Yule. The accompanying text and videos celebrate health and wellness, but this goes beyond simply bodily health to what they call “reviving folk vitality”: celebrating northern European tradition, heroic men and women at home with a large white family; herbalism and natural health; paganism and occult mythology, and the belief in a white racial spirituality.

This ideology has can be traced through history to the ‘fascist ecology’ of the Third Reich; the Nazi Party had a ‘green wing’ preoccupied with ecology, eugenics and esoteric racial essences. To describe the group with deep roots in the far-right and in contemporary practices of health and nature I use the term Granola Nazis. Their style is taken up by a broader anti-modern movement of digital traditionalism.

This Insight explores the far-right politics of Granola Nazis and Digital Traditionalism – a visual and cultural style in which highly online influencers celebrate a pre-internet culture – a spiritual celebration of ‘ancestral life’ or neo-hippie calls to go ‘back to the land’. While some celebrate farming, health and organic food, others go back to the spirituality, morality and social values not merely of a pre-internet era but of a pre-feminist or pre-civil rights era. Granola Nazis, aligned with groups known as ‘crunchy moms’ and anti-semitic ‘raw egg nationalists’, blend organic living with far-right politics, linking nature and whiteness with anti-feminist leanings.

This link between nature and Nazism has deep roots in the Folkish Movement, a revival of the Nazi Germany era Volkisch movement which celebrated a racial essence formed through a natural link to the land. I explore two key folkish sites; the first traces their history and importance for white nationalism, and the second looks at the digital spread of their traditionalist subcultural style. I demonstrate how the Folkish Movement effectively uses far-right digital strategies to spread, normalise, and advertise its content.

Digital Traditionalism

Granola Nazis are central in the movement I term ‘digital traditionalism’, or the seemingly contradictory online celebration of pre-digital life, which also encodes deeply right-wing social values as atavistic tradition. Much of this media frames itself as a metapolitical battle against corrupt, global modernity and towards an idealised natural tradition. This is manifested in the fight against multiple anti-White conspiracies, from David Lane’s ‘white genocide‘, to the ‘great replacement‘ theory or the recent ‘great reset’. These conspiracies are shared across the right, from neo-Nazis to mainstream conservative and Christian discourses, for example, the mainstream campus conservative group Turning Point USA or the views of Fox News host Tucker Carlson. Digital traditionalism links the esoteric side of health and wellness trends with idealised tradition, spirituality and whiteness in aestheticised landscapes and images of family life, celebrating nature and fertility.

Digital traditionalism expands in part because of the growing link between the far-right and health and wellness movements after COVID-19. This has been seen in the politicisation of health ‘momfluencers’ who use traditional femininity to oppose the vaccine and the rise of conspiracy entrepreneurs selling nutritional supplements in what the New York Times called the “wellness-conspiracy-industrial complex”. Ethnonationalist movements have been quick to enter these discourses, linking anti-vaccine and anti-lockdown sentiment to a broader traditionalist anti-modern movement.

Mediatised images of white folk cultures, like idealised portrayals of farm life and homesteads in Little House on the Prairie, or the hypermasculine Vikings of Netflix’s Tribes of Europa popularise ideas of whiteness as a tribal identity threatened by urban, global multiculturalism. The embrace of Nordic cultures means that white nationalist women can call themselves ‘Viking shieldmaidens‘. Naturalist and mythological language, like Thulean or Hyperborea, is used to euphemise white nationalist ideology from the discussion of White racio-cultural ‘roots’. Even neo–Nazi Jason Kohne now borrows from the wellness movement, describing racism as a movement for “White Wellbeing.”

Fig. 1: The front page of Jason Kohne’s neo-Nazi website School of the West

Granola Nazis and the Folkish Movement

At the heart of the Granola Nazis are a racist neo-pagan group known as the Folkish Movement. A small group, the Folkish Movement have a significant large influence on white supremacist mythology and conspiracy discourses. Their styles, myths and language now circulate online in a wider white supremacist ‘digital traditionalism’ – the broader adaptation of a ‘granola’ or ‘crunchy’ style associated with hippies, nature, or organic farming to convey a white supremacist, anti-modern politics as online counterculture. These groups, especially after COVID-19, are building connections to broader far-right environmentalist, health and wellness movements, thus increasing their online presence. This section provides an introduction to the different groups within the Folkish Movement operating online today, the Granola Nazis whose styles and ideals support the broader movement of digital traditionalism.

‘Folkish’ refers to white supremacist pagans as opposed to other members of the cultic milieu like neo-druids, Wiccans, or ‘universalist’ pagans. The Folkish or neo-volkish Movement is where northern European naturalist religions merge to become the spiritual basis for white male supremacism. Folkish, also called Odinist, Asatru, Wotanist, heathen or pagan, creates a white religion from Nordic or Germanic tribal culture and blends these with German volkish racial ideology, Norse mythology and Nazi mysticism to create a pan-Aryan religion.

Fig. 2: A meme from a far-right pagan account contrasting white-supremacist paganism from other varieties in the form of desirable female personae. Note the presence of the Algiz ‘life’ rune which signifies white supremacy, as well as the modest and folkloric dress.

Granola Nazis can be identified by the aesthetics of their social media pages, featuring runes (especially the Algiz or the Nazi life rune pictured in Fig. 1); gothic fonts; references to Germanic myths; images of evergreen trees and suns, and gothic, melancholy women looking out at temperate landscapes. In their social media posts, calls for white supremacy are coded in a style somewhere between goth and hippie, borrowing from popular cultural representations of the European tradition: pre-Raphaelite images of Lords and Ladies; Netflix shows about Viking warriors; Lord of the Rings references; or blond farmers and maidens straight out of the works of Nazi film director Leni Riefenstahl.

Asatru Folk Assembly

The original American Folkish Movement is acknowledged to be the Asatru Free Assembly (AFA). The AFA was founded in California in 1969 and split into two groups in 1986 – the ‘universalist’ Thoth and the ‘folkish’ Asatru. In 1996, it was refounded as the Asatru Folk Assembly and openly embraced the folkish white supremacist branch. In the rest of this essay, I use ‘folkish’ to refer to this white supremacist natural religion.

Asatru is a small group – their largest gathering had only 153 people – dedicated to old Germanic mythology and religious practices and is said to mean ‘belief in the gods’ in the old Norse language. In Iceland, the AFA is a recognised pagan ( i.e. polytheistic or nature-worshipping) religion. In the United States, Asatru has long been linked to white supremacism and other neo-Nazi, neo-pagan beliefs like Odinism and Wotanism. These see Christianity as fundamentally Jewish, due first to its Abrahamic origins, but also to a conviction that it is replacing or ‘mongrelising’ what they see as Aryan belief. While their rhetoric emphasises ‘roots’, Asatru fundamentally worships whiteness. As founder Stephen McNallen believed only white people could be folkish, folkishness was seen as the religious expression of a white essence – an intense bodily and spiritual racial identity. Still today, only white people are permitted to participate or join their four churches, or Viking ‘hof’ as they describe them.

Wotansvolk

This Nordic stylisation of white supremacy became explicit, and more violent, in the group which followed Asatru – Wotansvolk. Wotansvolk was founded in 1995 by renowned neo-Nazi, David Lane, and his wife Katja, after Lane was imprisoned for murder as part of the white supremacist group The Order. Like Asatru, Wotanism is a neo-pagan ideology embracing a natural, racial spirit, emphasising more strongly its pan-Aryan, German, and Nazi roots. Indeed, WOTAN is an acronym for ‘Will of the Aryan Nation’. Wotanism is fringe and esoteric, yet prefigures the modern far-right’s digital metapolitics and its core ideals. Wotansvolk’s propaganda company ‘14 Words Press’ pushed white supremacist philosophy and ideology and sold ‘white volk’ branded merchandise, often to imprisoned white supremacists and their wives at home.

Fig. 3: A bucolic image of a white family overlaid with ‘14’ and the slogan ‘This is why we fight’

This inspired a broader movement among women to use tropes of pagan religion, nature, and family to normalise, circulate and advertise white supremacy. This movement includes the Women for Aryan Unity (WAU), one of the earliest adopters of this gendered style of framing white nationalism as a defence of the natural home.

Fig. 4: A cover image from Women For Aryan Unity, a publication for women married to white supremacists.

Their message is disseminated in ‘feminine’ media such as magazines, homemaking advice, homeschooling materials, and children’s colouring books. These link the Folkish Movement to a broader movement towards traditionalism, including recent online manifestations of far-right femininity such as far-right ‘Tradwife’ female influencers. Folkish groups like Wotansvolk and WAU prefigure the growing importance of these cissexist narratives for normalising and spreading racist content and evading censorship, as Rae Jereza points out in another GNET Insight. In the next section, I look at a contemporary example of this – the folkish influencers ‘Hearth and Helm’.

Hearth and Helm

Hearth and Helm is a white supremacist hate group which runs a farm, and are active on Instagram, YouTube and Twitter as well as alt-platforms such as Gab. Hearth and Helm participate in alternative economies selling white nationalist branded products and trading in cryptocurrency. In their podcasts, they focus on natural health, childbirth, canning, pickles, herbalism, and raw milk and eggs – traditional practices with the aim of reviving what they term ‘folk vitality’. Their messaging suggests that recovering traditions and associated bodily practices will bring good health, vital manliness and fertile femininity. These become a means to – and a metaphor for – broader white racial vitality. With guests, they discuss homesteading and homeschooling, but also escaping the ‘tyrannical’ government and anti-vaccine politics. They defend a deeply gendered vision of radical sovereignty which opposes all forms of governance, including public schooling and healthcare, and align with violent anti-lockdown groups such as the Michigan Militia which aimed to kidnap Governor Gretchen Whitmer.

Hearth and Helm use the tools of right-wing female influencers like the ‘crunchy moms’ mentioned above to circulate this anti-modern narrative. They disseminate images of old-fashioned, traditional families sporting brightly coloured canned vegetables. They offer the same kind of food, health, wellness, and parenting advice as mainstream health influencers or ‘momfluencers’, but instead frame and politicise it as a fight for ‘folkish vitality’ between traditional family, faith and food, and modern corrupt, decadent, globalism.

Fig. 5: Screenshots from the white supremacist YouTube channel run by Hearth and Helm. These show the visual styles and topics which the group uses in their mission of “reviving folk vitality”.

These women also do the work of building digital networks connecting the folkish community to the broader traditionalist sphere, and normalising white supremacist messaging as pro-‘white culture’. After the pandemic, their ‘granola’ style, which emphasises organic food, homestead-style living, and winsome white children, has become even more influential in the right-wing community. Far-right Tradwife influencers like Robin Riley or Blonde in the Belly of the Beast, as well as women from the British white nationalist group Patriotic Alternative, use this style to spread anti-vaccine, pro-white messaging.

Conclusion

Granola Nazis, the Folkish Movement, and digital traditionalism more broadly should not be underestimated as a growing force in the broader far-right ecological sphere. Their imagery is not just a costume; it is a vision of nature as expressing a white essence which has long roots in the folkish movement’s mix of environmentalism, anti-rationalism, and ultra-nationalism. Combined, they translate eco-fascism not merely into exterminationist violence, but into seemingly innocuous movements for health, wellness, and family. These have profitably translated into popular issues around the pandemic, anti-masking, vaccine, and government, using the language of health and environment to oppose everything from banning gas stoves to equal access to healthcare and ecology on a warming planet.

Tech companies should be aware of the growing presence of Granola Nazis and the broader digital traditionalist movement. The movement’s fascist roots mean that the content produced by its adherents comes with a set of esoteric social values and historical meanings. Tracing the roots of these styles, discourses and symbols can provide useful information for content moderators – identifying which runes, fonts, or symbols are typically used to encode offensive content. More broadly, awareness of how this has happened in the past should make us more aware of how images of nature and tradition spread neo-Nazi ideology in online spaces in the present.

Catherine Tebaldi is a postdoctoral researcher in digital and linguistic anthropology at the University of Luxembourg Culture and Computation Lab, and a Fellow at the Far-Right Analysis Network and the Institute for Research on Male Supremacism.

Sunday, April 2, 2023

Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

jessesingal.substack.com

Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

Jesse Singal

14 - 18 minutes

(This was originally a paid post. I unlocked it 3/17/2023.)

“Top surgery drastically improves quality of life for young transgender people, study finds,” read the CBS headline from September 27. If you’re even faintly familiar with this newsletter, you know what I’m going to say next:

Nope.

We don’t actually know, from the study in question, whether “top surgery drastically improves quality of life for young transgender people” because the authors didn’t ask.

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The study, published in JAMA Pediatrics by a group of Northwestern University medical researchers, went as follows:

This is a nonrandomized prospective cohort study of patients who underwent top surgery between December 2019 and April 2021 and a matched control group who did not receive surgery. Patients completed outcomes measures preoperatively and 3 months postoperatively. This study took place across 3 institutions in a single, large metropolitan city. Patients aged 13 to 24 years who presented for gender-affirming top surgery were recruited into the treatment arm. Patients in the treatment arm were matched with individuals in the control arm based on age and duration of testosterone therapy.

For obvious reasons you can’t do a true double-blind randomized controlled trial of top surgery, so some of the study weaknesses here aren’t the fault of the researchers. But it’s important to note that apples aren’t being compared to apples, because there are, of course, going to be some differences between kids who do and don’t seek top surgery. And three months is a very short follow-up period for this sort of major surgery (NHS: “Most people find their wounds take around 2 to 3 weeks to heal, but it may be several months before your chest and arm area fully recover.”). Even if the researchers had collected excellent, in-depth data, there would be some serious questions about what we could extrapolate from their findings. (Update, shortly after publication: I added the bolded term just to be a bit clearer. A gold-standard RCT is one in which the participants don’t know which arm of the trial they’re in — as in, some are taking the drug being studied, while others are taking a placebo. With surgery this is really difficult. People will know which arm they’re in, and, among the other methodological issues here, you’d expect those randomly given access to a surgery they want to have a very different psychological response from those randomly denied access to it.)

But they didn’t collect excellent, in-depth data. In fact, their study includes zero validated mental health measures: There is nothing on anxiety, depression, or suicidality. This struck me as strange, especially given that the researchers filled in the study’s “Importance” field as follows: “Transgender and nonbinary (TGNB) adolescents and young adults (AYA) designated female at birth (DFAB) experience chest dysphoria, which is associated with depression and anxiety. Top surgery may be performed to treat chest dysphoria.”

Being a generally suspicious and cynical person — a jerk, in other words — the complete absence of these measures in the study itself made me wonder if maybe the researchers had collected this data at baseline but simply chose not to report it because the trajectories were not what they wanted. I emailed Northwestern and posed the question this way:

I'm a New York based journalist (more information here) and I might be writing about this study Northwestern Medicine just published. It's excellent that researchers are gathering data on these patient populations, but I noticed that there didn't appear to be any data about anxiety, depression, or suicide. Would it be possible to check with the researchers whether they did evaluate the patients for these conditions at any point, and if not, why not? If they did, I'm curious whether it would be possible for them to share that analysis. And is the anonymized raw data shareable as well?

No response.

So what did they measure? “The primary outcome was the Chest Dysphoria Measure (CDM). Secondary outcomes included the Transgender Congruence Scale (TCS) and Body Image Scale (BIS).”

The CDM was introduced in a 2018 JAMA Pediatrics paper lead-authored by Johanna Olson-Kennedy, an adolescent medicine physician at the Children’s Hospital of Los Angeles who is an enthusiastic and well-known proponent of youth gender medicine. That paper also looked at the outcomes of a cohort of young people who got double mastectomies — between the ages of 14 and 25, in this case (I guess the surgeons didn’t get the message, oft communicated to me on Twitter, that “No one under 16 is getting top surgery.”). Olson-Kennedy and her authors note that there are “no data documenting the effect of chest surgery on minors.” Not little data, but no data. Ah, okay — so it’s probably time to collect some, right?

Nope. This study also has no validated mental health measures. Instead, its focus is “a novel measure of chest dysphoria,” the Chest Dysphoria Measure, or CDM.

Now, to be fair, this was a retrospective survey study asking people to report on their mental health after getting top surgery, so maybe there just wasn’t baseline mental health data available. But it appears all the kids came through the CHLA gender clinic, so why isn’t this clinic collecting mental health data before referring kids to surgery? I’m not sure, but one potential answer is that Olson-Kennedy simply doesn’t believe in this — as she told me once, she wouldn’t force kids into a mental health exam before giving them insulin, so why would she make that a prerequisite for youth gender medicine?

Anyway, Olson-Kennedy and her team didn’t collect mental health data during the survey they conducted for this study, either: “The 10-minute survey collected demographic information, characteristics of surgery, and chest dysphoria.” Whatever one’s philosophy on “gatekeeping” gender dysphoric youth, couldn’t you get a ton more data with 10 more minutes of questions about anxiety, depression, or suicide, even if you didn’t have a “before” dataset to compare it to? Why not do that? The authors even point out this limitation: “[T]he Chest Dysphoria Scale is not yet validated, and may not represent distress or correlate with validated measures of quality of life, depression, anxiety, or functioning.” (More on that in a moment.)

The CDM still isn’t validated, though you wouldn’t know that from this latest study, which describes it as, well, “the only validated instrument published to date that measures chest dysphoria in [transgender and nonbinary adolescent and young adult] patients.” Do the authors not know that this scale isn’t validated? That’s a bad sign. Weirdly, the authors of an accompanying editorial comment (paywalled) note this limitation — “The Chest Dysphoria Measure, which is the primary outcome in this study, has not yet been validated for use,” they write. But there’s nothing to worry about, because the headline of that comment — about a study that didn’t include any validated measures — is “Top Surgery in Adolescents and Young Adults—Effective and Medically Necessary.” (Listen to experts. Trust the science.)

Here’s the actual CDM, from the Olson-Kennedy study. There are 17 items and each is ranked from 0 (the respondent never feels that way) to 3 (they feel that way all the time), meaning the total score range is 0 to 51:

One thing you might notice is that a lot of these items simply have to do with having breasts. As in, it’s hard to imagine someone’s CDM scale not going down following top surgery. To take perhaps the most obvious example, “I have to buy/wear certain clothes because of my chest” could certainly apply to bras, and after a double mastectomy there’s no longer any reason to wear a bra, so boom — there’s a reduction of two or three points.

Another thing you might notice is that many of these items could be endorsed by a cisgender adolescent female getting used to having breasts for the first time, which can surely be an uncomfortable and sometimes even traumatizing experience. This is concerning given the potential issues with differential diagnosis here. Would this scale be able to differentiate a kid high in anxiety, depression, or other mental health symptoms who is (understandably) freaking out about growing breasts from a kid who has the sort of deep-rooted, specific gender dysphoria supposedly ameliorated by youth gender medicine? There’s no way to know because it doesn’t appear anyone has asked.

Anyway, let’s get to what the JAMA Pediatrics study that CBS News reported on actually found. Its most impressive findings all have to do with the CDM:

Table 2 outlines IPTW [inverse probability treatment weighting] analysis results for the primary and secondary outcomes of interest. Summary statistics for 3-month outcomes scores in each group are also reported. eFigure 2 in the Supplement illustrates boxplot distribution of propensity scores for each group. eFigure 3 in the Supplement illustrates mean and standard deviation of propensity scores across quintiles for each group. The IPTW model estimated a 25.58 (95% CI, –29.18 to –21.98) point decrease in CDM for the surgery group relative to the control group. The Figure illustrates 3-month CDM as a function of baseline CDM. Three-month CDM scores for all surgery patients were low, regardless of baseline CDM score. The mean (SD) difference between baseline and 3-month scores in the treatment group was –28.12 (8.32). In contrast, among control patients, CDM scores did not appear to change significantly at 3 months. The mean (SD) difference between baseline and 3-month scores in the control group was –0.52 (6.29). Table 3 outlines subgroup analysis of outcomes among patients under 18 years. The IPTW model estimated a 25.48 (95% CI, –32.85 to –18.11) point decrease in CDM for the surgery group relative to the control group.

Don’t worry about all the jargon. And I don’t know anything about the IPTW, but I don’t think you need to: The point is, researchers found that scores on a scale that is tightly centered on having breasts went down three months later, when the respondents no longer had breasts. That’s the most impressive finding here, and validated mental health measures are entirely absent.

Maybe that’s because the authors already published a study linking the CDM scores to anxiety and depression: “Our retrospective review demonstrated associations between chest dysphoria and anxiety and depression; top surgery can improve chest dysphoria, thereby leading to improvements in quality of life.” Sure enough, the citation points to a paper by the same team published in the Journal of Adolescent Health that is one of the only pieces of research — maybe the only one — attempting to link the CDM to validated mental health measures.

But if you read that paper, you’ll see that there isn’t much of a correlation there: “Chest dysphoria was positively correlated with anxiety (r = .146; p = .002) and depression (r = .207; p < .001). In multivariate linear regression models, chest dysphoria showed a significant, positive association with anxiety and depression, after accounting for gender dysphoria, degree of appearance congruence, and social transition status.” A univariate correlation of r = .146 means that CDM scores accounted for about 2.1% of the variance in anxiety scores, while a univariate correlation of r = .207 means CDM scores account for about 4.3% of the variance in depression scores. I’m not going to dig deeply into this study’s numbers right now, but surely when you account for other, potentially confounding variables, the correlation grows even weaker.

I wanted to make sure I wasn’t missing something here, so I ran these numbers by my buddy Stuart Ritchie, a psychologist and the author of the (truly excellent) book Science Fictions: How Fraud, Bias, Negligence, and Hype Undermine the Search for Truth. Ritchie is much better than I am at quantitative stuff (but on the other hand, I’m taller and could probably beat him at basketball). “Yeah,” he said via text. “It’s a weak correlation — so it’s all about how you interpret it. If you’re gonna make it seem like ‘chest dysphoria’ is a massive deal for people’s mental health, it doesn’t seem that way from the correlation. An interesting contributor, maybe! But not a massive deal.”

And we aren’t being told that chest dysphoria is “an interesting contributor” to adolescents’ mental health problems — we’re being told we need to give these kids top surgery because otherwise their chest dysphoria will cause them immense psychological harm. The surgery is “medically necessary.” But according to this data, at least, CDM scores just aren’t all that big a predictor of anxiety or depression. Certainly not big enough that a potential reduction in CDM scores alone should make a doctor confident that a double mastectomy for an adolescent is the right choice. And yet, that CBS headline: “Top surgery drastically improves quality of life for young transgender people, study finds.”

And the headline on the editorial comment accompanying the journal article: “Top Surgery in Adolescents and Young Adults—Effective and Medically Necessary.”

A lot of doctors are performing these operations in the States, and a lot of other doctors and psychologists are not only promoting them, but suggesting that if you don’t agree that they are medically necessary, you could do real and permanent harm to trans kids. Suicide is discussed ubiquitously. You’d think that along the way, some of these doctors would collect good data on exactly what effects these surgeries do and don’t have on kids’ mental health.

That doesn’t appear to be the case. It’s completely possible I’m missing something, but I asked a listserv of sex researchers I’m on if any of them were aware of American studies from clinical samples that used validated mental health measures and attempted to control for obvious confounds like counseling, puberty blockers, or cross-sex hormones. Other than James Cantor (who follows this stuff very closely) responding to tell me he wasn’t aware of any, I got crickets. (I posed the same question to Twitter and no one could point me to any.)

Olson-Kennedy’s study was published in 2018, and the majority of the subjects in it had had their mastectomies more than a year prior. These treatments are new, as far as adolescents and gender dysphoria are concerned, but it’s not like they started yesterday — we should certainly have more and better data in 2022. It just seems like no one’s really bothering to collect any, perhaps because some of the clinicians involved are true believers for whom data would be beside the point, given that they just know these treatments work. Like, in their hearts.

What’s the worst that could happen?

Questions? Comments? Proposals for me to get a bunch of unnecessary surgeries as some sort of weird performance art about lax medical standards? I’m at singalminded@gmail.com or on Twitter at @jessesingal. Image: “Surgeon adjusting glove in operating room - stock photo” via Getty.

Saturday, April 1, 2023

Trans care too must meet health science standards

NRC Handelsblad, December 31, 2022

Trans care too must meet health science standards

The demand for [youth] transgender care continues to soar. The use of puberty blockers – as first launched in the Netherlands – is attracting a growing barrage of international opposition. Jan Kuitenbrouwer and Peter Vasterman urge the need for independent research.

A parent protesting outside the Court of Appeal in London before a hearing on the waiting times for transgender care. Photo: Natalie Thomas/Reuters

Photo Natalie Thomas/Reuters

“Transgender care waiting lists too long … It destroys you,” RTL News headlined early this year. Dutch gender clinics are being overwhelmed by an almost exponential rise in demand for gender care. The previous government appointed a “Czar” to arrange a dramatic expansion in capacity. But what kind of care is needed?

Jan Kuitenbrouwer is a journalist and publishes in HP/De Tijd on gender issues.

Peter Vasterman is a media sociologist and researches reporting on gender issues. Both signed the manifesto of Gendertwijfel foundation.

Until 2010, referrals to Dutch gender clinics averaged some 200 a year, including about 60 children and adolescents. Around 2013, numbers doubled and then rose steeply each year. In 2022, there are almost 6,000 people on the waiting list and over 5,000 in treatment, including 1,600 minors. The surge in the latter group is huge, with another 1,800 on the waiting list. These minors “do not feel at home in their own sex” and want to “transition.” This growth trend is international. The number of minors attending the UK Tavistock gender clinic has increased from 51 in 2009 to 3,585 in 2022 – with thousands more on waiting lists.

This sense of alienation from one’s sex is called “gender dysphoria” or, nowadays “gender incongruence”. Its treatment relies mainly on the administration of “cross-sex hormones”; women are given testosterone to become more “masculine” and men receive estrogen to become more “feminine.” Teenage patients are first given “puberty blockers,” drugs that arrest the physical process of puberty. In puberty, boys develop a low voice, beard growth and Adam's apple, while girls develop breasts, wider hips, and a curvier bodies. That process is halted, the secondary sex characteristics do not develop, and the child gains time to explore their “gender identity.” Puberty blockers are called a “pause button.” If the need for transition subsides, treatment is stopped and puberty resumes, with no adverse effects. That is what is promised. If transition goes ahead, no secondary sex characteristics need to be “eliminated.”

This approach was developed in the 1990s at the gender clinic of the VU Medical Centre (now the Knowledge and Care Centre for Gender Dysphoria (KZCG) at the Amsterdam UMC). In 2006, in a study sponsored by the hormone producer Ferring, the clinic adopted strict criteria [for puberty blockers]: gender dysphoria had to be present from an early age, and to have worsened at the onset of puberty; the patient had to be psychologically stable and to be receiving sufficient emotional support. Potential side effects were played down – they were outweighed by the great benefits, consisting of relief from the torment called gender dysphoria. The approach was embraced enthusiastically, and within a few years, the “Dutch Protocol” had become the international standard of care in this field. Many tens of thousands of children worldwide are now believed to have been treated this way. In the Netherlands, estimates – official figures are not available – range from 500 to 1,000 each year.

Wanting to be something else

Today’s patients differ from those in the past. Before this “boom,” the typical “transsexual” was an adult male. Now the main increase is among young people, especially girls (75%). They are often not referred until puberty has already begun, without having reported any history of gender dysphoria. In fact, even when they arrive at the clinic they often don’t mention gender dysphoria. Rather, they claim gender incongruence – they don't report distress so much as a desire to be something else. It is not a disorder but an “identity.” It is striking that many of these young people have additional psychological symptoms, unresolved traumas, or are struggling with their sexual orientation. One in four is on the autism spectrum. Are these symptoms the result of their dysphoria or the cause? What should be treated?

Trans organisations explain this boom as the result of society’s greater acceptance of gender diversity; doubters find it easier to “come out of the closet.” Critics point out that social acceptance of divergent behaviour is a slow process, whereas this is a very abrupt, exponential growth that began around 2013. What happened at that time? Is it a coincidence that this upsurge paralleled the spectacular growth of social media? The statistics look strikingly similar. And if this is about social acceptance, why mainly girls, when girls have traditionally been allowed more scope for gender non-conforming behaviour than boys? In addition, more and more regretters or detransitioners are speaking out, including in the Netherlands: people who feel they were wrongly subjected to this irreversible treatment. They feel they were pushed into it and not adequately protected from themselves.

For all these reasons, the Dutch protocol is coming under growing international scrutiny. Is it the right approach for this new group? And is it really as safe and effective as was long assumed? The answers are worrying. After extensive scientific reviews of treatment, health authorities in Sweden, Finland and the UK have recently decided to prioritise psychological treatment in children from now on, and to prescribe puberty blockers only in very severe cases – or, as in Florida, to stop them altogether.

According to the Swedish review (2021), the available data do not provide sufficient evidence to properly assess the effects on gender dysphoria, psychosocial conditions, cognitive function, or physical health. “At present, the risks outweigh the potential benefits,” the Swedish healthcare authority states. The Finnish report (2020) reaches a similar conclusion, as does the UK's [interim report from the independent] Cass Review (2022). The leading British paediatrician Hilary Cass gave a scathing assessment of the UK's application of the Dutch protocol and her report has led to the immediate closure of the Tavistock youth gender clinic, the largest in the world.

Puberty blockers

One major concern is that puberty blockers are not in fact a “pause button” but rather a self-fulfilling prophecy. Almost all children who take them go on from puberty blockers to cross-sex hormones at age 16. In practice, it appears that puberty blockers are not a pause button for reflection but the start button for transition. The Cass Review was commissioned partly in response to the high-profile case of Keira Bell, a young woman who regrets her transition and claims to have been talked into it by the Tavistock GIDS clinic.

More and more details are emerging of the long-term side effects of puberty blockers. These GNrHs (Gonadotropin Releasing Hormones) interfere with physical sexual development, impair bone formation (causing osteoporosis), can lead to infertility and inability to orgasm, and interfere with the ability to make rational decisions.

In addition, the scientific underpinnings of the Dutch protocol turn out to be pretty shaky. Almost all the publications relied on by the KZG team come from its own practitioners, so the researchers are simply evaluating their own work. Where are the independent studies aimed at replication? The study most often cited is that by child psychiatrist Annelou de Vries and the Amsterdam Gender Team, published in 2011 and 2014. The results supposedly show that the 55 children treated first with puberty blockers and then with cross-sex hormones reported positive results 18 months after surgery. This study has since been discredited in numerous publications, not only because of the absence of a control group and a random sample (from the total of 196 children treated) but also because of the use of two different questionnaires. Conclusion: this is not a sound evidence base.

It is therefore unsurprising that, to date, De Vries's results have not been replicated. A research team at the Tavistock clinic made an unsuccessful attempt to do so, after which the results disappeared into a desk drawer. These results were released only recently – by order of a British court.

Head in the sand

It is striking that while the media in neighbouring countries are reporting at length on this reconsideration of the Dutch protocol, the Dutch media are virtually silent. Does the KZCG enjoy such prestige and goodwill that it is being respectfully shielded from criticism? If the Tavistock clinic worked closely with the Dutch protocol and has effectively been shut down after a review, what is going on at the Dutch clinic where this protocol was invented? And if this treatment has such a solid scientific foundation, why did De Vries recently receive NWO funding for a five-year study into the “missing evidence base”? Has irreversible, life-changing treatment been administered at the Boelelaan in Amsterdam for 20 years without an “evidence base”?

Dutch trans clinicians are burying their heads in the sand. Baudewijntje Kreukels, recently appointed as Professor of Gender and Sex Variations at the Amsterdam UMC, blamed critics in her inaugural address for “opposing … transgender care" and for finding opinions more important than scientific evidence. That’s what you call chutzpah. It is precisely the existing transgender care that would benefit from less wishful thinking and more science. This article's writers respond precisely because they support transgender care – that is, responsible, evidence-based care.

The Netherlands was for many years the leader in this field. That status creates obligations. Before the capacity of Dutch trans care is drastically expanded, existing care must be subjected to critical, independent evaluation. The Healthcare and Youth Inspectorate must act now.