If A Disease Is Untreatable, Incurable and Progressive, Is It A “Medical” Condition at All? Ft. Trans Criticism.

I have seen it pointed out elsewhere that some “conditions” for which the medical establishment offers consumerist goods and services are not actually bona fide medical conditions at all and are in fact money-making schemes advanced by wealthy investors and others who stand to make a fortune off of anyone stupid, naive or deranged enough to accept them.  The conversation I am most familiar with pertains to the medicalized transgender movement where people are persuaded that they can achieve the impossible through medicalized interventions, in that case, that “transgender” individuals can change their biological sex through consuming expensive and dangerous cross-sex hormones, puberty blocking drugs, and surgeries including castration, so-called “facial feminization” surgeries and others.

Whether anyone accepts the psychological or physical transgenderism of individuals or not, the issue remains that there are billions of dollars to be made globally on this phenomenon and thinking people are prone to thinking about such things.  “Follow the money” is a familiar admonition and politically-minded people understand what that means.  They generally accept the reality that where there is money to be made, there will be corruption and wealthy people and entities working in the shadows to further their own interests.  In the above-linked article by Jennifer Bilek entitled “Who Are the Rich, White Men Institutionalizing Transgender Ideology?” she asks and answers that question and names names.  She concludes that it is “Exceedingly rich, white men (and women) who invest in biomedical companies [who] are funding myriad transgender organizations whose agenda will make them gobs of money” including billionaire businessmen George Soros, “Jennifer” Pritzker and others. And it’s difficult to argue with that conclusion which is demonstrably true.  But let’s go further.

Whether the potential or actual opportunity to make “gobs” of money under a capitalist patriarchy renders a potentially legitimate project illegitimate on its face is a discussion for another day.  However, in the case of the legitimacy of medicalizing transgenderism Bilek identifies a specific social discourse that “institutionalizes and normalizes” transgenderism in a way that convinces people that consuming medicalized goods and services literally for life — the entire life of the patient throughout and following medicalized transition — is in the interests of both the patient and society at large.  According to her, it does this by manufacturing a medical condition which arguably does not even exist, and then by encasing the created medical and consumerist issue within a civil rights framework.  In the case of transgender, the intended and actual result is to socialize all people (aka “consumers” whether they themselves are transgender or not) to believe both that there is something physically wrong with so-called transgender people which medical goods and services can fix, and that it is those people’s unalienable human right to have the condition corrected no matter the cost to themselves or to society.  She concludes that

It behooves us all to look at what the real investment is in prioritizing a lifetime of anti-body medical treatments for a miniscule part of the population, building an infrastructure for them, and institutionalizing the way we perceive ourselves as human beings, before being human becomes a quaint concept of the past.

As her argument is narrow and addresses only the issue of transgenderism, I cannot fault her for coming up with such a narrow conclusion.  She does not broadly criticize Big Medicine in general, favoring specificity to make her point which appears to be that medicine does not behave this way in any other area besides transgenderism and that the (alleged) difference should be parsed.  In making that point, she necessarily implies that medical overreach is a small-scale problem affecting only a miniscule part of the population (and that medical consumerism is not inherently problematic and that we needn’t follow they money except in the case of transgender); that “building” social and medical infrastructure to accommodate these new patients is worse than absorbing new patients into the existing infrastructure, or expanding the existing infrastructure to include people it shouldn’t; and that Big Medicine is not fundamentally about “institutionalizing the way we perceive ourselves as human beings” already, and is not generally intended and used as a tool of social control.

And although she rightly characterizes transgender as a problematic “lifestyle” issue, she misses the opportunity to discuss the apparent fact that medicalized goods and services are not effective in treating the (alleged, self-reported) mental and physical pain and symptoms of transgenderism, which analysis would only support her skepticism that transgender is a legitimate diagnosis of a medical disease/illness at all.*

But what if the problems she identifies with the medicalization and normalization of transgenderism are actually a feature and not a bug of Big Medicine and Big Pharma when it comes to defining — if not outright inventing — what constitutes both illness and treatment and engaging consumers long-term or for life?  Feminists have long known and noted that patriarchal medicine “invents” both illnesses and treatment for women as a part of our oppression — hysteria and its dubious treatments being perhaps the most obvious example but there are others.  But the evidence suggests that invented treatments aren’t “just” for invented illnesses: Big Pharma and Big Medicine actually invent “treatments” for untreatable (yet objectively verifiable) disease, for example, in the case of Crohn’s disease which notoriously does not respond to conventional care.

And this has everything to do, in fact, with “institutionalizing the way we perceive ourselves as human beings.”  Doesn’t it?  We have to engage with Big Medicine because that’s what human beings do, it’s one thing that separates us from animals, it separates the sick from the well, even when the medicine itself does nothing but make us worse it is the willingness to engage that’s important.  In cultures that extoll Big Pharma and Big Medicine we seem not to include untreatable disease as part of the human condition and “the way we perceive ourselves” despite all evidence that it is and has always been part of the human experience (and untreatable illness such as autoimmune disease has only become more prevalent over time).  Think about that for a minute.  It is striking.

And if transgender patients can rightly be seen as “lifestylists” making medicalized consumer choices in the absence of therapeutic benefits, and I think they can, what could be said about chronically ill people whose lives revolve around medical interventions which are not therapeutic and which therefore must be something else?  This is a serious question that, I think, deserves serious “treatment” but is a sticky wicket; as far as I can tell it is rarely if ever discussed.  Our alleged “civil right” to medical treatment seals the deal where perhaps Americans in particular will die a million billion deaths before they will fail to exercise a perceived or actual “right,” even if the alleged right has no basis in natural law, and even where the fight and even the prize will likely kill us, and that includes women and feminist women.

They will die on the hill of “rights” again and again and again and again and again, but in the case of the alleged right to medical treatment of chronic illness no one will ever question why and how a condition for which Big Medicine offers no effective treatment and no cure has been “medicalized” in the first place and what that actually means, for one, that a health condition equals a medical condition (meaning that health and misogynistic Western medicine are the same thing).  That our alleged “right” to medical care is not a right at all, but an obligation and that we are therefore coerced into engaging with Big Medicine and Big Pharma.  That “the way we perceive ourselves as human beings” in a medical/medicalized context has been institutionalized (meaning, dictated and normalized) by lying, scheming and powerful men.  That untreatable illness has been written out of the human experience, and that “human history” is therefore fiction.  It’s fiction, as is our human present and our future.  It probably means other things too, but it definitely means that.

And don’t even get me started on the goddamned “disability advocates” who aim to protect sick (and transgender) people’s “civil rights” to a lifetime of painful, dangerous and ineffective medical treatments, but notably do not advocate for anyone’s right to refuse unwanted medical care, even in the United States where that right of refusal is protected by the Constitution, and where so-called disability advocates would universally remove euthanasia from the table for mentally competent yet seriously, incurably and even terminally ill patients because the disability advocates say so.  And thus spake capitalism and patriarchy: (alleged) positive rights yay!  Negative rights, meaning, the right to do nothing, the right to abstain, the right to be left the hell alone, the right to cease to exist at all, especially when it comes to women (and where women are particularly vulnerable to developing untreatable chronic disease) (crickets).

*Note: until very recently there was an excellent online resource providing citations from the medical literature indicating that medical transition is not a reliable treatment or cure for the (alleged, self-reported) distressing symptoms of transgenderism but that site no longer exists, having been deleted by WordPress for speaking ugly truths about the transgender movement that Bilek does not address and which are beyond the scope of this post.