1) spends the most money on healthcare (as a fraction of gdp)

​AND

​2) has the highest rate of treatable deaths

🤡

The other day I finally got around to sitting down and thoroughly reading the Niskanen Center’s Healthcare abundance: an agenda to strengthen healthcare supply. If you’ve ever wondered why it feels like you’re paying for lobster but eating shit when it comes to healthcare, this is prob the best comprehensive review of how we got here and how to fix it.

Here’s the part that I’ve been stewing over for a few days, and I’m gonna tell you a story about it.

“Medicare pays hospital outpatient departments nearly double what it would pay a freestanding physician’s office for the same service.” This causes freestanding physicians to flock to hospitals instead, where they can immediately get paid better. This often happens with no change, or a decrease, in the quality of their services.

TLDR: freestanding doctor’s offices are getting eaten and enshittified by hospitals, because we’ve made bad policy choices.

Storytime.

I was living with serious pain and I needed a surgery to fix it, but that surgery itself comes with high risk of extreme pain - so much that it wouldn’t be worth it. I knew I could avoid that extreme pain simply by leveraging a certain local anesthesia method that has been around since the late 80’s. Nothing fringe, nothing experimental. It’s tried and true local anesthesia tech, that simply hasn’t been applied to this one particular not-relevantly-different surgery.

It took me almost two years to find a doctor willing to do this, and throughout these two years doctors told me it was impossible. I thought I might have to live in pain forever. Not because the tech was difficult - the tech is EASY - but because there was no incentive for any of the doctors to leverage it.

Hospital doctors were usually the ones saying outright that it was impossible. This sounds completely preposterous to anyone who understands the tech, yet they persisted. They live in a world of concepts and procedures all designed around avoiding the legal ramifications of your avoidable death, not your avoidable suffering (because there are almost no legal ramifications to that).

When I finally, ecstatically, almost-disbelievingly succeeded in getting the surgery I needed, it was in a freestanding office - the exact type that’s getting eaten by hospitals.

Do you know how I managed to find that freestanding office???? I had to literally track down the inventor of the local anesthesia method.

He’s retired. I had to track down his phone number and call him up and beg him to help me find someone. I had been expanding my search to Mexico because I couldn’t find any freestanding offices in the US or Europe with the willingness and ability to do it.

Thank god, he had a coinventor. His coinventor is a groundbreaking person and for some reason has maintained a private practice. So that’s where we did it.

The surgery worked perfectly - better than traditional methods. My healing was better, my pain after surgery was better, everything was better. Now doctors can’t tell others that it’s impossible. More people can live without pain. Fewer people can face extreme suffering in surgery or post op.

That depended on a freestanding office. Site-based billing and loopholes that let hospitals devour their competitors are killing the places where innovation actually happens. Hell, they’re killing some of the only places where people do commonsense good work with up-to-date technology.

We need to:

1) Make Medicare pay the same rate for the same service, regardless of whether it’s in a hospital or freestanding clinic.

2) Repeal CON laws, which let hospitals veto the construction of freestanding competitors.

3) Lift the ban on doctor-owned hospitals (which actually tend to provide higher quality care than traditional hospitals!).

4) Close loopholes (340B, MLR) that give hospitals dramatic financial upside from acquiring freestanding clinics without adding any value to those clinics.

𝐀 𝐑𝐞𝐢𝐧𝐭𝐫𝐨𝐝𝐮𝐜𝐭𝐢𝐨𝐧

Hi guys! I’ll be writing more. I have a lot to say.

I spent the last few years learning the language of a culture that was new to me, which now feels like home. I transitioned from woman to man, and in the process I found hubs of gay male culture that are compatible with real, classical liberal values in a way I had never experienced before. This was the second real ideological home I’ve found – the first being rationalism. I now feel bilingual, having spent a few years pouring my heart into each of these cultures, which gives me this wonderful sense of “bigness” and groundedness and perspective. With that knowledge in hand, I plan on putting more of my focus back into the rationalist community now.

I made the biggest achievement of my life in 2024: I determined and proved that it was possible to do full-scale, modern FTM top surgery fully awake.

As far as I’ve been able to tell, I’m the first person in the world to get this type of surgery. I spent about two years to achieve it. First I had to make myself an amateur expert on local anesthesia to determine whether it was possible, and figure out what anesthesia technique would make it work. Then I had to search the globe for a researcher willing to do it. Doctors repeatedly told me it was medically impossible. (Sometimes they STILL tell me it’s impossible, and refuse to believe me until I show them the video of it happening!) They were wrong, of course, and they’re wrong about many other such things. I’ve learned a lot about how far clinical practice can lag behind the research. The surgery worked perfectly. I watched the surgery as it happened, and filmed the entire thing on my phone and camcorder. It was so much fun. Coolest experience of my life.

I will be writing a bunch of essays over the coming months on surgery-related topics, both about the science of it all and the personal blow-by-blow descriptions of what it’s like to watch your own surgery. I’ll also release the entire 4.5 hour footage at some point (with an accompanying highlight reel, in case you don’t have 4.5 hours to kill, lol). I might do a virtual watch party to answer questions. Condensing all the important info into an essay series is a huge project, hence my idea to start with an AMA/watchparty. Let me know if you’re interested in that and what your big questions are. I tend to answer a lot of the same questions over and over (which I love, don’t get me wrong), and I want to make sure the general public gets access to all those questions and answers. Applications of this technique go far beyond trans surgeries – the case offers important evidence about the improvements we can make in tons of routine fat-based surgeries.

If you would like to stay updated, please follow me on Substack or Twitter, which will be my main platforms now. 𝐘𝐨𝐮 𝐜𝐚𝐧 𝐟𝐢𝐧𝐝 𝐭𝐡𝐨𝐬𝐞 𝐡𝐞𝐫𝐞: linktr.ee/tommyjoancrow

I will be talking primarily about surgery, inefficiencies in medicine, gay male culture, and topics broadly related to enlightenment values and classical liberalism. I may also talk about abundance-related ideas (looking for my “healthcare abundance” people – where are you? message me plz), and other topics related to economics and industrialization.

I’ll be using social media to do amateur journalism now (and hopefully professional journalism soon). I made a nice career in private wealth management for the last 3.5 years, but I think I was born to be a writer, so I quit finance to make time for pursuing journalism seriously as a career. Because I am now intending to use social media to do journalism, and because the topics I have expertise in are either connected to hot-button political issues or like, medical gore, lol, I have unfriended a bunch of family members and family-type friends. They will be added to a family-friendly account.

This was a bit agonizing for me, because I cling to the “marketplace of ideas” fantasy of the internet, which makes blocking/unfriending people repulsive to me. Since childhood, my image of a virtuous person is a truth-seeker who shares their ideas unrestrictedly with the world, unafraid of who might think ill. I learned the hard way that this is not how things work. You will get seriously harmed if you make a habit of saying true things without regard to the audience, and then you won’t be able to say true things anymore. So I’m taking a more balanced approach now, and have attempted to make my work more opt-in for some people, rather than opt-out. If you notice that you’ve been unfriended, but you WANT to hear about surgery, sex, and politics, please re-add me! I would love to have you, as long as you know what you’re getting into, and can stomach it in a civil manner. And 𝐢𝐟 𝐲𝐨𝐮’𝐫𝐞 𝐫𝐞𝐚𝐝𝐢𝐧𝐠 𝐭𝐡𝐢𝐬, 𝐛𝐮𝐭 𝐲𝐨𝐮 𝐃𝐎𝐍’𝐓 𝐰𝐚𝐧𝐭 𝐭𝐨 𝐡𝐞𝐚𝐫 𝐚𝐛𝐨𝐮𝐭 𝐬𝐮𝐫𝐠𝐞𝐫𝐲, 𝐬𝐞𝐱, 𝐚𝐧𝐝 𝐩𝐨𝐥𝐢𝐭𝐢𝐜𝐬, 𝐩𝐥𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳𝐳 𝐣𝐮𝐬𝐭 𝐛𝐥𝐨𝐜𝐤 𝐦𝐞 rather than like, stalking me and messaging my loved ones about how obnoxious you think I am lmao. Appreciate it.

Lately I spend much of my time reading/writing about the topics already mentioned (or fighting DaVinci Resolve to edit huge surgery footage files), and I’m also into various biohacking topics, the gym, and big machines, cranes especially. One of the greatest joys of 2024-2025 was being fully able-bodied for the first time since puberty, and experiencing the sheer joy of being able to run, and jump, and dance again with no pain. Nothing slams down onto my ligaments, no dead weight has to be carefully managed - I no longer have the constant engineering problem I’ve dealt with since about 13 years old, where I rotate the placement of dead weight to different spots on my body to minimize the damage, one day placing the bulk of the mass on my shoulders where it eventually sends shooting nerve pain down my arms, the next day placing it onto my ribcage where it eventually breaks into the skin or puts my sternum in enough pain that I can’t take full breaths, much less exercise. Now that I’m fixed, I’ve been trying everything – I’m learning to do handstands, I’m teaching myself lots of different types of dance (badly), I did my first pull-up, I stretch (I can stretch my arms any which way, without it hurting!), I lift, I go to gym classes that involve lots of jumping (that would have absolutely destroyed me before) and I RUN. Oh god, RUNNING. It’s amazing. I was desperate to run again. I will never take running for granted. And I can sit up for 8 hours a day with zero pain. And I can wear a seatbelt without pain. Anyway, I could go on and on. I put my hand to my chest very often just to marvel that there is zero pain there. I hadn’t experienced that in close to fifteen years. Given that I don’t do general anesthesia, I didn’t know if I would ever be able-bodied again. Being able-bodied feels like the greatest blessing in the world. I’m so happy.

I’ve had the good fortune to cultivate an amazing apartment with a beautiful, curated collection of construction/machinery/industrialization-related objects, which have almost all been gifted to me by my two favorite and beloved men, David and Sebastian. I’m constantly grateful to have such a cool and safe home base to do my work from, such wonderful loved ones who are brave and smart and who understand me, and hard but useful work to do. The direction our country is headed is a pretty serious everyday worry, and I’m taking some big calculated risks career-wise, which is stressful, but I feel good about the actions I’m taking to make strategic trade-offs and contribute value to society. On the whole, life is very, very good.

When Sebastian parodies me he holds up a finger and says “If nature is unjust, change nature! Youth liberations now!”, so I’ll close this the same way – if nature is unjust, change nature, and youth liberation now. 🙂 Here’s what I look like lately. As always: new font, same substance.

Healthcare abundance: an agenda to strengthen healthcare supply, Lawson Mansell

Abundance: General/Non-Healthcare

“Someone has to get hurt, occasionally”: How factories were made safe, Jason Crawford

Landsailor Fan Video, Vienna Teng and Rowan Oake

Medieval Kings Would Envy You, Kelsey Piper

Abundance, Ezra Klein and Derek Thompson
I feel obligated to mention this even though it seems almost too-obvious

Classical Liberalism & Enlightenment Values

How to Write for The Argument, Jerusalem Demsas (Last Section)
Funnily enough, my favorite punchy pitch for liberalism, which I find myself returning to whenever someone needs a quick but powerful summary, isn’t an essay - it’s the last section of The Argument’s freelance pitch page.

Youth Rights

Dear Graduating Sixth Graders, Duncan Sabien

Surgery

War Surgery in Afghanistan and Iraq: A Series of Cases, Shawn Christian Nessen, M.D. Lounsbury, Dave Edmond, M.D. Hetz, Stephen P.

Tumescent Technique – Tumescent Anesthesia and Microcannular Liposuction, Jeffrey A. Klein, M.D.

Patients’ Rights

UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings. David Armstrong, Patrick Rucker, Maya Miller

First Person Medicine

I got dysentery so you don’t have to, Georgia Ray

A Way Out: Dying With Dementia, Sara Ness

Brain on Fire, Susannah Cahalan

Misc

Causality Explainer Series, Rishi Banerjee
In my opinion this is the best totally beginner-friendly intro to causal modeling. The link goes to the first post in the series, but you can also skip around using the post guide (scroll down to “Causality”).

Fiction

Movies

The Great Escape

Enemy at the Gates

Disney’s Mulan

Disney’s Narnia Series

Books

Catch-22

Red Mars

All Quiet on the Western Front

One Day in the Life of Ivan Denisovich

I was at Five (local gay club) with Sebastian and an old man made conversation with me for quite a while before I mentioned having been born female, and he went “Wait, wait, wait - what do you mean?” When I explained, he was obviously shocked. This in turn, shocked me. I said, “Wait are you for real? You couldn’t tell?” He said no, absolutely not. He clearly wasn’t faking it, because now he was trying to take not-so-sneaky glances at my crotch to see if I had a dick. I said “How the hell did you not notice my scars?” and he said “I didn’t look,” lol. Cut to the long question-answering session -
> How do you fuck? Do you have a dick? When are you gonna get a dick? Why did you want to be a man? Wow, this trans stuff is just SO confusing! You never know who’s who!
> Haha yeah, it is! It even confuses me sometimes.
> I was so sure you were a regular man! I mean, that sounded bad. I’m sorry -
> No it’s okay, that’s a fine way to say it.
All your standard stuff. Finally after his main questions were answered, I pull Sebastian closer to me and I say “So what do you think he is?” The guy’s jaw just dropped - he took a little step back like I had told him the floor was about to fall out from under him, and said “I don’t know ANYTHING anymore!”

That was the first time I clearly passed while shirtless.

Then a few months later I took David on a field trip to Five, and essentially the same thing happened. I was talking to this other old guy for a long while, and I said a few things that revealed I was trans, but I think they went over his head until the third one, at which point he stopped dead in his tracks, mouth open. We proceeded to recreate the rigamarole from above. I said “How did you not notice my chest scars?” and he said “I actually noticed your chest because it’s really well-shaped. I just thought ‘That guy has a really nice chest.’” (Thank you, Dr. Bergqvist!) This guy was a big chaser, in the hot way. His shock was clearly authentic because his face LIT UP when he found out, and he immediately said “I’ve always wanted to try an ftm!” as if meeting a celebrity. Then turned to David and said “I see your game” as if congratulating him.

God it felt so fucking good to pass. I listened to that triumphant song frequently on the way to work that winter, and replayed the things those two guys said over and over. Held my hand on my chest, over the seatbelt I used to never wear, and thanked a nonexistent god for how good it felt, how male.

Passing has never been my primary goal but man, it feels good. It enhances that feeling of masculinity that I’ve always kinda had, or had the drive towards, in my bones. I have trouble describing the end goal sometimes, but I KNOW what it feels like. I say “the feeling of maleness in my body matters more than passing” and I’m not sure people understand the feeling I’m referencing. I don’t know how to tell you what it is, but it just IS. It was there when I was a kid, then it got chained down by estrogen puberty and atrophied by society, and I spent the next ~12 years trying to free it. And finally, I did free it, and I feel it now every time I put my hand on my chest - it feels like I’m a free healthy animal. It feels strong and virile and, just, male. And that feels RIGHT in my body.

People are always like “What does it even feel like to ‘be a man on the inside?’ I’m a cis man and I don’t even know what that means!” and sometimes trans people will respond “Well it doesn’t really feel like anything; that’s an oversimplification of a more complicated situation.”

I believe their self-reported experiences, and I agree that it’s complicated, but that’s not how it is for me. I do feel it. I know what it feels like to be a man on the inside. There is a distinct feeling of being a man and it’s just, it’s in your bones. It’s in your bones and your chest and your shoulders. It feels strong and red and calm and heavy, and like a horse. Like a big, fast, healthy horse that gets angry when you try to break it. And it feels like a stone on your chest, which sometimes crushes you, but usually calms you. It’s a sense that your bones are big, and strong enough to bear things, and the burden is actually calming. You feel like Steve McQueen on the motorcycle and you also feel like the motorcycle engine is in your own chest. I feel big. I feel so much bigger than 5’2’‘ and I have a cock, spiritually. Idk how to say it any clearer, man. I feel like a fucking man.

My brother described that feeling totally unprompted a little while ago. I didn’t initiate the topic, and I had never told him about it before - he just started telling me how he really enjoys being a man, and described the feeling similarly to the ways I’ve always described it. Loved that.

And when you don’t feel like a man, that feels bad. Right? I think a lot of guys easily understand that, even if they don’t understand the positive version. Maybe the positive version is hard for a lot of regular guys to parse because it’s usually the “water they swim in”. But of course it feels bad when you don’t feel like a man - your bones know you’re meant to be one. When you don’t feel like the man you’re meant to be, you’re instinctively driven to fix that.

Around the same time that those two old guys thought I was a regular man, I made a new friend - the first friend who never knew me with breasts. That alone was so healing, to have something untainted. When I told her Sebastian was also trans, she almost didn’t believe me at first. “But he is SO masculine! I never would have known. He is so manly.” It filled my heart almost to overflowing - that’s my man.

Years earlier, I wrote:

In this period of life, prior to medical transition, I feel an everyday closeness to the he/him lesbians of our history, and the transmen who never knew there were others like them, and the masculine biological females of all types who ended up lobotomized and locked in convents and married off and banned from owning property, and who died and were buried as women. The “women who lived as men” and the “women crossdressers” and the thousands of other people throughout the ages who fought to escape femaleness in their own unique ways, in ways often uncomfortable to our modern ears, in all of their nuanced and beautiful and horrific individual details. Across all of them a shared struggle, a shared unwillingness to stay small and silent and compliant. I wish they were here to see us win now. I will win. I will not die like this.

So last winter I played those sentences over in my head - those old men saying they thought I was a regular guy, my friend marveling about how masculine Sebastian is - so proud of him and so overjoyed for myself, and so awed and humbled by our shared success. Me, finally sometimes passing, and him, passing so well people barely even believe it when I tell them. The things we fought for so hard worked - the things I fought for, the things he fought for, and the things our ancestors fought for on our behalf. Just a few generations earlier, the two of us wouldn’t have been able to own bank accounts. A few generations before that, we would have been closed off from most jobs, unable to make a decent life without putting ourselves at the mercy of a natal male for support. And now we get to be entire men? Thank you, suffragists and other brave ancestors. There is no sweeter joy.

I live alone in a beautiful apartment. There is a small spiral staircase with an iron railing leading upstairs to my office. Downstairs is the bedroom, bathroom, kitchen with eating counter, and a nice spacious living room with a high ceiling and a balcony where I have coffee and stretch in the morning. I keep it very minimalist and bright and clean. In strategic places it’s also filled with aesthetically and philosophically beautiful things - love letters from Sebastian, a damaged1 construction cone from my first night as a man in Chicago (a symbol of the greatness of industrialization and hard work, as well as a souvenir from the place I “found myself”), an empty American/Norwegian WWII howitzer shell from Sebastian, Tom of Finland artwork, my favorite coffee table book War Surgery in Afghanistan and Iraq from David (a great piece of science and a testament to the human will to survive), framed patents of tower cranes and an M4 Sherman tank and tumescent local anesthesia liposuction cannulas (more on that later) gifted to me by Sebastian. For both aesthetic and philosophical reasons I’m drawn to heavy machinery and construction, with a particular interest in cranes and tanks, and I find it beautiful that my home is full of related items but hardly any of them were purchased by me. Probably >90% of them were given to me by those who love me. I have an incredibly rich life. I frequently find myself marveling at the wealth and diversity of love that I get to experience on a daily basis.

David and Sebastian are my two wonderful boyfriends. David I’ve been with for about four and a half years, Sebastian nearly three.

My practical applied ethics as most people would experience it on a day-to-day basis (and most of my policy positions) might be described as classically liberal. I care very much about your right to consensually negotiate for whatever you want and make mutually beneficial trades, even if what you want is strange. I want all conscious creatures to be happier and freer. I support unusual ways of pursuing happiness, as long as they are not interfering with the rights of others. I care about free speech (both legally and culturally), protections for true ideological minorities, expanding our moral circles to often-invisible minority groups (insects, small children, etc.), and enlightenment values broadly.

Some important things I believe, in no particular order:

• You should only believe true things.

• Lots of true facts are unpleasant. That doesn’t make them less true. (For example: facts about biological sex, facts about the prevalence of severe suffering such as in factory farms and hospitals and poor countries, etc.)

• We should try to fix suffering.

• Nature is brutal. Most people in developed countries have no concept of how brutal nature is, and they imagine pre-industrialization being more akin to Disney’s Pocahontas than the ugly affair it was. Industrialization is good. (Obviously, you have to do it in a smart way.)

• Capitalism is good; it makes people both richer and happier. (Obviously, you have to do it in a smart way.)

• Designing good economic policy is hard, and you should not assume that the obvious-looking policy will actually solve the problem you want it to solve. Price ceilings are the obvious example here – they will usually just make people poorer. There are lots of other things like this.

• Most important things in the modern world aren’t zero-sum. For example, most rich people aren’t rich because they “took from poor people”; they’re rich because they created value for everyone, expanding the whole pie we eat from. Usually immigrants aren’t “taking jobs” that you would have gotten yourself; they’re creating value for everyone, expanding the whole pie we eat from. Etc.

• [Insert a bunch of other Econ 101 and abundance-type principles here.] Painting with a very broad brush, academic economists generally do good work. People should pay attention to what they say and everyone should have a basic understanding of how supply and demand works.

• As mentioned earlier, people should generally get to do what they want, unless it interferes with the freedoms of others. But sometimes you will really WANT to interfere with the freedoms of others. In these cases, you should still be honorable and refrain from doing so. For example: You should transition if you want to, but you should not try to force biological females to give up their right to free association so you can play sports with them. You should get gay married if you want to, but you should not try to force a Christian bakery to make your cake. This is part of your responsibility as a member of a free society.

• Sex is good. Lots of needless suffering comes from moral panics around sex.

• People frequently confuse disgust with morality, which causes them to persecute harmless people. Be careful. When you feel disgusted by someone, don’t automatically backfill rationalizations about why they’re a bad person. Think carefully about whether they are actually causing harm. (Steven Pinker stuff.)

• Curiosity is a good thing, and people should be rewarded for posing sincere questions or comments from a place of respect, even if they don’t know the politically correct lingo.

• People can be very, very different from one another. A lifestyle that’s good for one person can be catastrophic to another. “Typical mind”-based rules cause lots of needless suffering.

• Being able to make sacrifices is an important virtue, but simultaneously, sacrifices are less necessary than people assume. You can often come up with creative ways to have your cake and eat it too – and you should do that, when you can. Joy is good.

Today I got up at 8:00 AM and had coffee and tidied up the house and showered. I started work around 10:15 at the library. Around 3:15 I took a break from working and got a rotisserie chicken from Metro Market. I ate rotisserie chicken and an apple at home. I spend a lot of time on the floor, which is another reason I keep it very clean. For a while in college while I was being a woman, I developed very “adult” movement habits, spending my days walking in straight lines on sidewalks, sitting on chairs, or cuddled on soft couches. Not only is that terrible for your mobility, but I think the lack of physical variety actually dulls your creativity. Now I absent-mindedly roll on the ground and squat in various weird positions and use the entirety of the space while I read or work, like kids do, and dance ugly-ly, and I feel much more human.

I like to open all the windows and turn on the fans so the breezes blow through the whole apartment. The trees surrounding all my windows are a gorgeous bright yellow and I just drink it in throughout September. The color always reminds me of my early transition and it feels so good to look at. When I decided to try becoming a man after, really, a lifetime of dabbling in it and experiencing these weird urges that seemed to stem from a nonverbal part of my brain, my own reaction to it was far beyond what I expected. Frankly, before transitioning, I didn’t think I was that transgender. I thought I was maybe just a little bit transgender, or a tomboy, or butch (at the end of the day it doesn’t matter what you call it), and an autoandrophile, which is a real fetish that I definitely do have. But then I tried transitioning and it was like the doors to Heaven cracked open and everything fell into place like it was “meant to be”, in an experience on par only with things I’ve felt in fundamentalist religion. Every aspect of masculinization both socially and physically felt indescribably “right” on this deep instinctive level in my bones. The last time I experienced a powerful sensation of “meant to be” I was religious and actually BELIEVED that things are meant to be. I no longer believe that everything is orchestrated by a cosmic author, and yet my animal brain has a primal instinct that I was “meant to be male”, which is both a fascinating phenomenon from an academic perspective, and a deliriously joyful thing to experience. At this time, I started seeing the color yellow more vividly. It physically looked brighter and felt amazing to look at, and that never went away. Now I decorate my house in yellow accents (I love the Caterpillar logo so much) and look forward to the leaves in September every year.

But every time he left his cottage, he covered it carefully with a hat. For he knew that if anyone saw it, they would think him cursed.

“One day,” he thought, “I will find someone like me. And then I will be able to take off my hat.”

There was also a woman who had a beautiful rose growing out of her head. She too, kept it covered.

“One day,” she thought, “I will find someone like me. And then I will be able to take off my hat.”

One day, the man and the woman found themselves walking opposite one another on the same road. The man touched the tip of his hat in polite greeting, and said “You’re looking lovely today, ma’am.” The woman placed a steadying hand atop her own hat, curtsied, and responded “Thank you, good sir.”

They walked past one another.

They are both very old now. To this day, they both think, “One day, I will find someone like me.”

Once upon a time, in a far away land, there lived a man with a violet growing out of the top of his head. It was warm purple with a bright cream-colored center and glossy leaves, and he found it very beautiful.

Everyone thought him cursed. But he never put on a hat, for he was seeking someone. “When I find someone like me,” he thought, “I want them to recognize me.” And he was very brave.

One day, he found himself walking opposite a woman on the road. She was wearing a hat. As he approached, he was surprised, for the woman did not run away screaming, or spit on him like the others, but merely widened her eyes. When they came face to face, she curtsied, and held out her hand to him. He took it very gently, and haltingly bent to kiss it, noticing with confused joy that she did not recoil from his touch. His heart fluttered as she began to speak. “Sir,” she said, “We —“

But before she could finish, there was a shout from the bushes. “There he is! The cursed one!” A group of townspeople seized the man, dragged him to the town square, and burnt him to death.

The woman no longer hopes to find someone like her.

Often when we think about morality, we’re thinking about normative ethics—what things are right, and what things are wrong. When we’re thinking about normative ethics, we might ask questions like “Is it ever ok to lie?” or make statements like “Murder is unjust” and “It is good to give to charity.” We will refer to these types of statements as moral claims.

We can also take a step back and ask questions about what morality is on a more fundamental level. We might ask questions like “Is morality real?” “Does culture determine which moral claims are true?” and “Would moral facts exist if humans didn’t?” These types of questions fall in the domain of meta-ethics.

I’m going to walk you through a flowchart to determine where you fall as a meta-ethical thinker, which will also serve as a classification scheme for the major theories in meta-ethics. Remember, these are theories about what morality is on a fundamental level, so you won’t see a category for utilitarianism or deontology. Those are normative ethical theories, which tell you what things are right and wrong, and how one ought to behave. Rather, this classification is of theories which attempt to describe the nature of morality, regardless of morality’s specific requirements.

Are moral claims truth-apt?

“Truth-apt” means “having the capacity to be true or false.” Here are some examples of truth-apt sentences.

Both of these statements have the capacity to be true or false. The first is in fact true, and the second is in fact false. So both are truth-apt. Here’s another:

There is some fact of the matter about whether the universe extends infinitely. Even though the truth value of this sentence is unknown, and may be impossible to know, it is either in fact true, or in fact false. So this is also a truth-apt sentence.

Colloquially we might refer to the sentence “I don’t like stealing” as subjective, because only the speaker can know for sure if it’s true, and because it deals exclusively with the speaker’s own internal experience. But there is still a fact about what the speaker is actually experiencing. It’s possible she might not dislike stealing, for example—maybe after robbing a bank I get caught by the cops, and in a pitiful attempt at deceiving them I exclaim, “I don’t even like stealing!” Remember that to be a truth-apt sentence, a sentence merely has to have the capacity to be true or false. This sentence definitely has the capacity to be false! So it is a truth-apt sentence. (Rule of thumb: if it’s possible for a sentence to be a lie, then the sentence is truth-apt.)

Can you think of a non truth-apt sentence? Try to think of one before you go on.

…

…

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Did you think of one?

Here’s one:

The sentence “Wow,” seems like it can’t exactly be true or false. It’s just an expression, which typically corresponds to some emotion, but which doesn’t make any claims. So it’s not the type of thing we can assign a truth value to.

Here’s one of the same type:

Both “Wow,” and “Stealing—ugh!!!” are called emotive sentences. These are important; later we’ll explore a meta-ethical theory which says moral claims are actually just emotive sentences in disguise. E.g., when someone says “Stealing is wrong,” maybe what they really mean is just “Stealing—ugh!!!”

Notice the important difference between “I don’t like stealing” and “Stealing—ugh!!!” The former has the capacity to be true or false, while the latter is related in terms of subject matter but does not have that capacity. There is no way for “Stealing—ugh!!!” to be false.

Here’s another way you could re-interpret the sentence “I don’t like stealing” so as to make it non truth-apt.

“Please don’t steal,” could be said with more or less authentic feeling behind it, but it can’t exactly be false. Similarly, it’s not really true, either. So this sentence and other imperative sentences (sentences where you are telling or asking someone to do something) are not truth-apt.

Finally:

Nonsense can’t be true or false. So nonsense isn’t truth-apt.

Do you think moral claims are truth-apt? Let’s use the sentence “Lying is wrong,” as our example of a moral claim. On one interpretation, the sentence is making a claim about some fact in the world. It could be communicating something like “There are moral laws out there, and they say you shouldn’t lie.” If this is how you interpret moral claims, you might believe that they are truth-apt.

But maybe you think that when someone says “Lying is wrong” what they actually mean is something like “Lying—ugh!!!” or “Please don’t lie.” As we’ve seen, these sentences are not truth-apt.

Meta-ethical theories fall into two broad classes based on whether they interpret moral claims as truth-apt or non truth-apt. This is weird and annoying, because the question of how to properly interpret someone’s moral claim isn’t actually a question about the nature of morality, but about the intentions of the speaker, and speakers can mean different things. It’s completely possible that when I say “Lying is wrong,” what I mean is “There are moral laws out there, and they say you shouldn’t lie,” but when you say “Lying is wrong” you mean “Lying—ugh!!!” So, some moral claims may be truth-apt while others aren’t.

As we progress down the flowchart of meta-ethical theories, keep this in mind—some branching points come from disagreements about what morality is, while others come from disagreements about what people intend to communicate when they make moral claims. The question of what a speaker intends to communicate when they make a moral claim is an empirical question, and I think it’s safe to say that different people mean a variety of different things when they make moral claims. So I don’t think it makes sense to unreservedly jump on board with a conclusion about how to correctly interpret all moral claims. Someone can always come along and be like “Actually, when I make a moral claim I mean something totally different from what your theory says I mean,” and I guess you could just insist that they are lying or very confused about their own internal experience, but that seems like a silly thing to commit yourself to doing all the time.

With that said, an interesting and more useful way to think about this first node of the flowchart is to ask about your own intentions when you make moral claims. When you make a moral claim, is it truth-apt? Examining what you mean when you make a moral claim tells you something about how you usually think about morality (at least when you’re speaking), so that might be a good place to start when coming up with your default theory of meta-ethics.

Here are some questions to help you think about whether your moral claims are truth-apt.

Do you think that you have ever made a moral claim that turned out to be false? Think back over the course of your life, maybe to when you were a child. If you can recall a time when you made a moral claim that you feel you later learned was wrong (you didn’t just change your mind, but discovered the claim to be false) that’s an indicator that you think of your moral claims as truth-apt.

Think back to the last time you made a moral claim, or think of a moral claim you might plausibly make in the coming weeks. Would you feel satisfied rephrasing the moral claim as an emotive or imperative sentence, or would the rephrasing fail to capture your full meaning? For example, if your moral claim was “It’s wrong for you to yell at me,” would your meaning be captured by a rephrasing in the form “Don’t yell at me,” or “You’re yelling at me—ugh”? If an emotive or imperative phrasing seems to capture what you mean by a moral claim, that’s one indicator your moral claims aren’t truth-apt.

I don’t make a ton of explicit moral claims; usually I avoid talking about morality and just make statements about feelings (they’re so much less confusing). But when I do make a moral claim, I do so with the sense that I am communicating a fact about the world. If I say “Lying is wrong,” and then introspect on what I meant by that statement, I realize that I intended to communicate something like: “Moral laws exist in some sort of robust ontological way, and one of those moral laws says that people shouldn’t lie.” This statement has the capacity to be true or false (and I actually think it’s false, but we’ll get to that later), so it is a truth-apt statement.

Ok, you’ve had plenty of time to come to your conclusion, right? Let’s explore the “no” option.

If you said that moral claims are not truth-apt, you’re a non-cognitivist. You have two main options within non-cognitivism, which we’ve already talked about a bit. You could say that moral truths are properly interpreted as imperatives, or as emotives. If you say imperatives, then you’re called a universal prescriptivist. If you say emotives, then you’re a (wait for it) emotivist.

Keep in mind that universal prescriptivism and emotivism differ based on what they say moral claims mean, and the meaning of a moral claim is typically thought to depend on the intention of the speaker. So if you strongly prefer one of these theories over the other, you may have some bullets to bite if a moral reasoner comes along and tells you that they don’t actually mean what your theory says they mean.

Do you notice anything missing under non-cognitivism? Any other ways moral claims could be non truth-apt?

Well, maybe you think a moral claim falls into the same category as “Travel trips taken away around the home.” Maybe peoples’ concepts of rightness and wrongness are somehow internally inconsistent to the point of being completely incomprehensible. It could be that people are deeply confused when they try to make moral claims, and are not actually saying anything meaningful at all—moral claims are just nonsense. This is a weird way you could be a non cognitivist. As far as I know, there isn’t a name for this position (and it’s probably going to be hard to defend, so don’t say you got it from me).

If you said that moral claims are truth-apt, you’re a cognitivist! You believe that moral claims have the capacity to be true or false. My next question for you: Are any moral claims actually true?

It seems like a redundant question, but it’s not. Let’s go back to my statement about lying. I mentioned that when I make the statement “Lying is wrong,” what I mean is “There are moral laws out there, and they say you shouldn’t lie.” I’m actually making two claims with that statement: one about the existence of moral laws, and the other about what those moral laws say. Packaged into my sentence “Lying is wrong” is an implicit claim that moral laws exist. But maybe moral laws don’t exist! If moral laws don’t exist, then my sentence is false.

I think that when I make moral claims, and when many people make moral claims, they are making an implicit claim that moral laws exist in some sort of robust ontological way. I don’t think moral laws exist in any sort of robust ontological way, so I think that moral claims are generally false. That makes me an error theorist.

Any nihilists in the room? Nihilism is a broad category which encompasses all the meta-ethical theories which don’t believe there are true moral claims. That is, error theory and non-cognitivism.

If you said that some moral claims are true, congratulations—you’re a moral realist!

You now have to determine whether moral facts are “objective.” In other words, is the truth of a moral claim independent of whether people believe it to be true?

You might hear philosophers ask this question by saying “Are moral claims mind-independent?” This phrasing can be confusing, because a moral claim can refer to facts about minds while still being mind-independent in the way philosophers use the word. For example, a true moral claim might be “It’s good to make people happy.” This claim is not mind-independent in the sense that it has nothing to do with minds—it has a lot to do with minds, because it is talking about happiness, a thing that exists entirely inside of minds. But it might be mind-independent in the philosophical sense, in which it is a true statement regardless of whether people believe it to be true.

Here’s a question to help you out: Is it conceivable for every person in the world to be incorrect about a particular moral fact? If so, you probably believe that moral facts are independent of whether people believe them to be true. That would make you a moral objectivist.

Some questions the moral objectivist should be prepared for: How do we interact with moral truths in a way that allows us to gain evidence about what they are? Are they causally impacting our beliefs about them, and if so, how? (Causal impact seems like a necessary assumption, if we think that we are able to form true beliefs about morality.) Moral facts presumably aren’t physical things, so if they are causally impacting our beliefs about them, does that commit you to belief in some sort of non-physical entities that can interact with the physical universe?

Ok, maybe you said that the truth of a moral claim is not independent of peoples’ beliefs about it.

So, whose beliefs determine the truth of moral claims? You have three main options within the realm of standard meta-ethics: individuals, society, or God.

You could say that the truth of a moral claim depends on the beliefs of the person making the claim, aligning you with subjectivism. You may think that if someone believes lying to be wrong, then lying is wrong for them. So the statement “Lying is wrong” is true when that person says it, but may not be true for different person who believes that lying is fine.

The aspiring subjectivist might have some bullets to bite when they consider the existence of people generally considered to be really bad. If a psychopath believes murder is good, then is it really true that murder is the right thing for him to do?

Maybe you can fix the psychopath problem by saying that instead, the truth of a moral claim is dependent on the society in which the speaker lives. This would put you in the relativism camp. Perhaps in my society, murder is widely considered to be wrong, and therefore when I say “Murder is wrong,” I make a true statement.

Relativists have some bullets to bite as well though. You might worry about the fact that relativism doesn’t seem to allow for moral progress over time. For example, you probably have the intuition that slavery is morally wrong, and that societies become morally better by virtue of abandoning slavery. But the relativist thinks that if a society deems a practice moral, then that practice is moral, for the people in that society. Since slavery was considered moral in early America, slavery was moral in early America. When American society began to disavow the practice of slavery it wasn’t becoming better, it’s just that moral rules were shifting in time with the shifting social consensus.

Finally, you might say that moral claims are made true by virtue of the fact that God believes or commands them to be true, making you a divine command theorist.

Be careful not to confuse this with conceptions of God in which he is all-good but does not make moral claims true or false by believing or commanding them to be so. Not everyone who believes in God is a divine command theorist, including most Catholics and Protestants. Divine command theory says that God’s commands/beliefs are what determine the truth values of moral claims, which goes beyond a belief that God is all-good.

Wrapping up, a note on the terms “objectivism” and “realism.” I use “realism” to denote any theory which says some moral claims are true, and “objectivism” to further specify which among those theories posits “mind-independence.” This is an accepted way of doing things, but it is also common for philosophers to use “objectivism” and “realism” interchangeably. Specifically, it’s common to see both words used when singling out the mind-independent theories — both words being used to indicate what I have called “objectivism.”

This means, among other confusing things, that you may see subjectivism referred to in philosophical literature as an anti-realist position, even though I have specifically classified it as realist! In that case, the word “realist” is being used as a synonym for what I call “objectivist.”

I prefer the classification scheme I’ve presented here, because it gives you a label for all theories which say there are true moral claims (realism), regardless of what they say makes those moral claims true. “Theories which think there are true moral claims” feels like an important category to have, and if you treat objectivism and realism as synonyms, you no longer have a unique label for that category. But I’ve heard reports that using “objectivism” and “realism” as synonyms might actually be the more common way of doing things, so it’s important to keep in mind that these terms are disputed.

There you have it! Here’s the full flowchart. Leave me a comment to let me know where you ended up, whether you align with one of the theories outlined here, or are in a category all your own.

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Summary: You can use light to improve mood in the winter very effectively, but knowledge of how to do it isn’t well dispersed. Do not get a “SAD lamp” or a “light therapy lamp” or other such branded product. There is nothing special about those lamps, and they probably won’t work. What matters is getting lots of light into your eye cones - much more than a typical SAD lamp can provide. You can do this cheaply and beautifully by filling your house with powerful lightbulbs in a color tone of your choosing.

Right now my house is absolutely full of bright, gorgeous warm light. I absolutely love it, and when I travel I find myself craving it. It treats seasonal depression very effectively, and it also makes nearly everyone feel more uplifted and energized as soon as they come in contact with it. In the rationalist community, due to the efforts of a handful of good writers and scientists, lighting your home this way is almost standard practice. (You can often tell which one is the rationalist house without looking at street numbers, because it’s shining like the sun.)

But tons of people don’t know about this. Especially now that it’s winter in Wisconsin, it makes me really sad when I notice how dark and depressing many indoor places are, because I feel really bad for all the people white-knuckling unnecessary seasonal depression or wasting money on SAD lamps.

Smarter people than me have written extensively about this, so here are some quotes from these two great summary articles (Part 1, Part 2), lightly edited for conciseness. If you only read one other post on this topic, I recommend Part 1.

The amount of light delivered in the scientific studies is only barely enough to be effective. Most of the “SAD lights” people buy give much less light even that that. People try them and conclude “didn’t work for me”—but those things probably wouldn’t work for anyone.

The light dose delivered by most light therapy lamps is less than a tenth of what the medical science recommends.

Light therapy lamps are just ordinary lights; there’s nothing special about them.

Many advertise themselves as “UV-free.” This is effectively meaningless. LEDs don’t emit any UV, so this is like advertising orange juice as “gluten-free.”

Many SAD lights advertise themselves as “full-spectrum.” [This] is meant to suggest that the light emitted is similar to daylight—but that is actually false.

I recommended against buying anything sold as a “light therapy lamp” or “SAD lamp” or “light box.”

[Instead, he recommends buying high quality bright lightbulbs.] You will probably find that using them makes you markedly more cheerful and productive. This may take effect rapidly, possibly even within minutes of first use, although the usual story is that you need to use a SAD light for a couple weeks to get relief. (Maybe that’s because they are badly underpowered?)

So what do you do? Here are my notes and recommendations.

Specs You Care About

- Lumens, not lux: “Any light bulb can be 10,000 lux if you put it next to your eyeball. What we really need to know is the total lumens.”1 Buy HIGH LUMEN lightbulbs. This is the main thing that matters.

- Color Rendering Index (CRI): A measure of how accurately your lights reflect the colors of objects. This might matter to you, particularly if you want cool-toned lights. People often feel depressed in artifical cool light even when it is high lumen, which is surprising, given that people usually feel great under the sun (which is also cool-toned)! This might be due to cool lightbulbs having bad CRI. You can probably avoid having to think about this by getting warmer toned lights.

- Temperature: Largely a matter of personal preference. Cooler lights are more energizing for some people, but this matters less than lumen count. 6000K lights mimic the color of sunlight and look cool. 3000K lights look warm. Some folks recommend less than 3000K for evening to help you wind down, but that’s not required. I use 3000K bulbs throughout my whole house all the way up until bedtime, and just turn a couple off when I want to wind down.

Recommendations

I use these. I absolutely love them. (I am not getting paid to say this.) At five thousand lumens, they are more than 6 times as bright as a standard lightbulb, and my whole house is bathed in warm faux-sunlight.

They’re warm-toned (3000K). They are still extremely energizing, and personally I find the warm tone more beautiful. (This way I also avoid worrying about CRI and people potentially having a bad reaction to cool light.) I get lots of compliments - I have been told that my house is “as bright as a department store but somehow nice, not glaring.”

You can use a lot of them. I have four in my office and three in the bathroom, plus a handful scattered over the main living areas. Many people with treatment-resistant seasonal depression improved dramatically by just adding LOTS MORE LIGHT than recommended.2 Your eyes adjust to different environments, so most people don’t realize how much darker indoor environments are than outdoor environments. Try adding more light than you think you need, and see how it makes you feel. Most people end up loving it.

I put lots in the bathroom because light is most important in the first few hours of the morning. I have a clear shower curtain so I get lots of light while I shower and get ready for work.

Buy one and see if you can swap it into a light fixture you already own! They have a standard base, so many built-in light fixtures will support them.

However, many shades for tabletop lamps won’t fit over the wide head of the bulb. I’ve solved this problem with these paper lanterns.3

I pop them over tabletop lamps, and I also rig them up on hanging cables4 at various heights around the room, so that as many of my eye cones are getting hit with those delicious photons as possible, no matter which way I’m looking.

There you go! Any questions? Please let me know how it goes if you try it.

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Great posts that contributed to this body of knowledge include:

Inadequacy and Modesty part iv
(One of the great classic accounts of figuring this out first-hand)

How to Build a Lumenator
(One of the early how-to posts)

Guide to Rationalist Interior Decorating
(Covers the lighting need-to-knows and lots of other helpful tips)

Why indoor lighting is hard to get right and how to fix it
(An in-depth practical summary)

How to use bright light to improve your life.
(Covers lots of details about timing and color)

100,000 lumens to treat seasonal affective disorder
(A published randomized controlled trial inspired by the work of multiple folks mentioned above)

I was fully healed from top surgery at this point. In a pleasant way, being fully healed and having a “male” chest made the experience of being in The Hole more boring, if you can imagine boringness as pleasant. I still looked FTM, for sure, but there was no longer much of a legitimate argument that I didn’t belong in this place. I had already proved myself a million times over – with taped-down triple D’s, no less — so my claim to the space was probably stronger than that of the average natal male in there. So there was no sense of exotic danger or the thrill of a challenge anymore – just the peaceful happiness of being back in your natural habitat.

A youngish guy across the bar is looking at me as I shimmy into a gap between two huge hairy men and grab the bartender’s attention. The bartender says “Tommy, right?” and we make a little leisurely small talk while I collect my drink. I can see in my periphery that the young guy is still looking. I take a guess that he’s curious about my scars, and maybe new to the scene and trying to be polite. Stares, also, are totally normal to me here, and not negative. Like I said, I still definitely look FTM, and this is very much a man’s world.

I like that. Jackhammer has consistently been one of the most welcoming, safest places I have ever experienced. Part of the reason Jackhammer feels incredibly safe to me is that you get to be a guy at Jackhammer. People are very blunt here. People feel free to let their eyes rove over the parts of your body they like, or the parts they’re curious about. They reach out to touch you and trust that you’ll push their hand away if you don’t like it, no offense taken on either side. I get to do those things. I get to breathe as a regular dude. I’m not afraid of accidentally hurting anyone here, and they aren’t afraid of hurting me. Especially before, when I was first learning the ropes of how to be a man at all, this was priceless. There’s no other place where I felt like I could really just let my instincts take over, and my instincts were truly, naturally aligned with the prevailing social rules.

So, once I collected my drink, I made my way over to him and plunked myself down.

“Hey! I’m Tommy. Can I sit by you?”

“Yeah, totally.” He scooches over.

We make small talk for a little bit. He’s in his early twenties, and he’s been here before but is still skittish-seeming. Obviously friendly, though. My goal is to make him feel safe enough to verbalize whatever question/comment was prompting him to stare at me, because I already approve of whatever it is – honest questions are good questions. Feeling free to ask direct questions is one of the great beauties of this space, and I consider it my duty to actively support that culture. I start poking around, asking leading questions about vaguely political topics and giving blunt answers about my own beliefs especially where they are nonstandard, to show him that it’s safe to ask whatever he wants to ask.

“Ok, so, can I ask you a question?”

Finally! “Sure, shoot.”

“What do you think about nonbinary people?”

I chuckle. This is one I haven’t gotten before. “Ummmm, huh. I guess… I support them?”

I think about it for a few more seconds. “I mean, obviously I don’t support EVERY nonbinary person, haha. I guess ‘nonbinary people’ feels like too broad of a topic to just give a general opinion about. There’s lots of complicated stuff you could say about nonbinary people. Is there a specific issue around nonbinary people that you’re thinking of?”

He gets very quiet, then says, “Well, I have… trouble… with the nonbinary ideology.”

I nod. “Mm, yeah. I have my issues with a lot of leftist-type gender ideas.”

He chews on his thoughts for some seconds in silence. Finally he says, “I think the nonbinary ideology is sexist.”

“Oh, interesting. What makes you say that?”

“My sister got really into the nonbinary ideology. Well, she became nonbinary. I guess I should say they became nonbinary. And she’s an adult, you know. I totally support her right to do whatever she wants. But when she explains the reasoning, the reasoning just sounds sexist.”

“What’s the reasoning?”

“It’s like, she doesn’t feel good in dresses and makeup, she feels good in masculine clothes. And I’m like, is this the 1800s? You sound like you’re from the 1800s, saying you can’t be a woman because you like to wear pants. And she says she feels degraded when people see her as a woman. But that seems sexist! It seems like she’s saying ‘being a woman is degrading’.”

He goes on like this for a while, sharing similar details, then says, “So, do you think the nonbinary ideology is sexist?”

“Well” I say slowly, “There’s no one unified nonbinary ideology.”

He nods. “But like, when nonbinary people transition. Do you think they’re doing it for sexist reasons?”

For a moment I think about the incredible amount of sexism I’ve experienced in trans spaces, from nonbinary and traditional trans people alike. But the way in which that relates to this question is mostly tangential, and the question itself is still poorly formed.

“Here’s the thing.” I say. “Every type of person you can imagine exists.”

He looks at me blankly.

“Imagine the most sexist nonbinary person you can. They think of women as silly and emotional, and they think of men as smart and rational. They decide to transition because they’re sexist, and they don’t want to be a silly, emotional woman. So instead, they try to become a nonbinary. That person exists. There’s definitely a person out there who’s like that. And there are ideologies which encourage this person in their ways.

But now imagine the least sexist nonbinary person you can. A super true nonbinary person. This person was born with a really unusual brain, naturally. They instinctively desire a beard, and feel a deep, indescribable sense of ‘rightness’ when they see a beard on their face. But they also enjoy having breasts. They naturally walk, talk, and act like a man, to the point where they often get mistaken for one, because their gait and posture and mannerisms are insuppressibly masculine. But on the other hand, many aspects of this person’s sexuality are found almost exclusively in females. They’re not trying to do any of this – it’s just how they are. They were born with a very unusual cluster of objectively highly sex-correlated traits. ‘Nonbinary’ seems like a good label for this person. And this person also definitely exists! I know lots of people like this. And there are lots of ideologies that speak articulately about the existence of these people!

So, you asked ‘Do they transition for sexist reasons?’

And I think the answer is: Some of them definitely. And some of them definitely no. The world is so big that there will always be a group of people doing the thing you’re worried about. Which doesn’t mean that it’s not a real problem - it just means that you have to avoid pattern-matching onto everyone who looks similar to the people doing the problem. There are people transitioning for the worst reasons, and there are people transitioning for the best reasons. There are people marrying deadbeats, there are people marrying their soulmates, and there are people marrying the Eiffel Tower. Every type of person you can imagine, exists.”

We went into a lot of the details. It was nice. I explained that I think most people who identify as nonbinary do it for pretty good reasons. I explained that I also think the sexist undertones of certain gender ideologies are a real problem which do sometimes push people into transition when it’s not good for them, especially natal females, and that shouldn’t be ignored. As for his “sister”, it’s possible they are transitioning because of sexism, but it’s also possible that there is so much left unsaid in their conversations. Dysphoria or highly sex-correlated preferences can be truly innate and can cause a legitimate, involuntary sensation of being ‘nonbinary’, but they can also be very difficult to talk about. If the relationship isn’t trusting, people may try explaining things on a more superficial level, and as a result sound shallow and sexist. Brains are really complicated, and I think it’s best to err on the side of believing people.

Towards the end of the conversation he thanked me and gave me a friendly kiss, then said, “I hope this isn’t bad to say. But I wanted to ask you these questions as soon as you came in here, because, you know. Because… I could tell.” He gestured to my scars, then quickly added, “I’m sorry if that’s bad to say. You look good!”

I laughed loudly. “Dude. It’s not bad to say that you could tell I was trans. Obviously I look trans!”

He chuckled in relief.

“I do have a question though.” I said. “How did you feel when you saw me come in? Did you feel like I shouldn’t be here? It’s okay if yes. These things are complicated.”

He looked legitimately taken aback. “What? No. Not at all.”

“Oh. You know, because I look sort of nonbinary. I figured that’s why you were asking me these questions.”

Looking startled, he said, “Wait. You’re a man right?”

I laughed. “Yeah.”

“Ok, yeah. That’s what I thought. I could tell you were trans but you’re obviously a dude.”

I was immediately beaming, and with nothing to prove, I didn’t try to hide it. “Dude. That’s SO nice to hear. Thanks.”

Afterwards, I found “Every type of person exists” sometimes coming in handy as a tool for encouraging people to hone down overly general questions.