Politics encroaches on all aspects of our lives. Powers at be is a column written by External Politics Columnist Maya Tommasi about the ways in which political power — corporate, federal, provincial, Indigenous and municipal — affects the lives of those who call themselves part of the UBC community.
Maya Tommasi (she/her) is a third-year political science student and The Ubyssey’s external politics columnist. She is a trans woman and latine immigrant, and holds a previous degree in psychology with multiple years of research experience. You can find her on Bluesky or reach her by email at m.tommasi@ubyssey.ca.
Throughout history, science has been used to perpetuate systems of oppression and the marginalization of minority groups. As society changed during the Enlightenment to bring science to popular attention, so grew oppressive uses of it.
Scientific racism was used to justify slavery, eugenics, apartheid and genocide. While now discredited, diagnoses like female hysteria justified the institutionalization of women. Instances of that oppression are still with us today.
At the same time, we can acknowledge this without refuting that advancements in fields like medical science, as well as our broader understanding of the natural world, have inevitably led to the betterment of society. Our life expectancy, quality of life and potential are all greater today, often as a direct consequence of scientific advancement. This legacy of societal enhancement, specifically, as well as the heightened objectivity of empiricism, is what drew me into professional scientific research — the field I have worked in for the last six years.
Broadly, we tend to recognize both of these seemingly conflicting stories of science — its emancipatory potential as well as its historical shortcomings. With the increase of scientific rigour and broader ethical standards in the field, the belief goes, that science has moved beyond the excesses of its past.
While this is largely true — methodological improvements have made many historical excesses impossible, and science remains as close as we possess to an objective and unbiased tool for the pursuit of knowledge — modern science is not free of its marginalizing potential.
Higher methodological standards like ethics approval requirements for research projects and researcher certification are welcome. But they do not occur in a vacuum. Human input in judging the quality of a methodology and the interpretation of data will always be necessary; human biases still seep in. Science is not an infallible system.
When we talk about modern science, we too often fail to recognize its discriminatory potential, and regard this as something of the past. And when it comes to the relationship between queerness and science, that potential is not an artifact of the past; we have long been pathologized by science.
In the field I work in — psychology — there is a long history of pathologization of queer identities. The DSM, the American Psychiatric Association’s standard classification of mental disorders and a centrepiece of our understanding of mental health, classified homosexuality as a mental disorder until as recently as 1973. Similarly, transness was still classified in the DSM as a “gender identity disorder” — an unnecessarily stigmatizing label, recognizing our existence as that of a disorder — until 2012.
While those classifications have thankfully changed, the recency of them should remind us we are not far removed from the marginalizing past of science. To this day, queer — particularly trans — communities are marginalized within the medical system, with outright discrimination as well as institutionalized medical gatekeeping is a reality for many.
Crucially, even the best science does not address issues in how that science is disseminated. How specific research is interpreted and used in modern society is, to me, the biggest issue by far in our society.
Methodologically, science will always be imperfect. This is the case not only because methodological perfection is impossible, but also as our attention to ethics rightfully increases, the ease with which high-quality data can be collected becomes more limited. The notion that science is an absolute and perfect source of knowledge is untenable — science is not, and should not be expected to produce absolute or perfect results.
This gets us to our current political climate: while trans issues have taken centre stage in many ways, the debate over health care is the most insidious, especially calls to ban certain medical interventions.
One of the most contentious subjects of that debate is the use of puberty blockers in teenagers — and while there are also attacks on surgery or hormone therapy, those are less common, and the attacks on them are vastly overexaggerating their use.
Puberty blockers are prescribed with the explicit intent of delaying the permanent changes to the body resulting from undergoing puberty. These changes — such as body hair, bone structure and breast growth — can cause serious and acute psychological anguish to trans people, known as dysphoria, risking a decrease in our quality of life and mental health outcomes. While a lack of prescription under appropriate circumstances will condemn children to these changes, it does not preclude them from happening; puberty will resume when medication ceases.
Yet, calls for banning puberty blockers — or vaguely gender-affirming medication — for trans youth are loud among federal and provincial politicians. The federal Conservative Party’s policy declaration says it would prohibit “life altering medicinal or surgical interventions” on minors to treat “gender confusion or dysphoria” to protect children’s mental and physical well-being. The People’s Party of Canada has proposed using the Criminal Code to “outlaw the mutilation of minors,” which is how they describe the effect of puberty blockers. Alberta Premier Danielle Smith’s government considers puberty blockers “not medically necessary,” and National Post columnist Amy Hamm, a former BC nurse, has equated puberty blockers with chemical castration (Hamm rose to prominence resulting from her repeated “discriminatory and derogatory statements” about transgender people).
In forming their criticisms of trans health care, some look to science to back up their claims. One of the best examples of this is Smith and Hamm’s — as well as pieces across a diversity of respectable outlets — use of the Cass Review, a report on gender-affirming care for children commissioned by England’s National Health Service in 2020.
The Cass Review examined most aspects of gender affirming care, and its most notable — and contentious — conclusions were about puberty blockers, finding that while there were multiple studies of the matter, there was an overall lack of randomized controlled trials (RCTs) to prove their efficacy.
The basic idea of an RCT is that participants are randomly assigned to either a treatment or control group — the “treated” one with the intervention and the one without, often using a placebo in its place — and their outcomes are compared. RCTs are often preferred because they minimize the effect of confounding variables, allowing researchers to directly investigate the effects of their treatment isolated from other factors.
While they are often called the “gold standard” in medical research, RCTs are not the only form of acceptable evidence and they can also be difficult to conduct. Chief among those difficulties are ethical concerns: restricting medication from a group that might need it exclusively for the sake of having a control group is ethically questionable. This makes running many RCTs impossible and reliance on other forms of research not uncommon in medical sciences.
A Calgary physician noted in an interview with the CBC that while the Cass Review took issue with the lack of RCTs run on the use of puberty blockers in minors, even common medical interventions like prescribing painkillers or antibiotics for children with ear infections may lack evidence in the form of an RCT. The physician pointed out that exclusively relying on RCTs would be like saying to a pregnant person that, since there is no RCT-based evidence to support the care of people in pregnancy, care won’t be provided.
One need only imagine the implications of banning all medical interventions which lack RCT evidence to understand the problematic logic behind the Cass Review’s concerns relating to trans health care.
After it was published, trans people, physicians, academics and advocacy organizations noted these flaws. Among those who rose to the defence of puberty blockers were the Canadian Pediatric Society, American Academy of Pediatrics and World Professional Association for Transgender Health.
But these criticisms of the review have not prevented it from being cited by those in power; the Cass Review was the basis for the then Conservative government issuing a temporary ban on puberty blockers in the UK, which has more recently been made permanent by the current Labour government. The argument is always the same: that “science” (a stand-in for the Cass Review) shows puberty blockers might not be the way forward, as repeated beyond the UK and by the Premier of Alberta — whose government moved to ban, with exceptions, puberty blockers for teenagers under the age of 16 (puberty blockers are usually prescribed at a much younger age).
The point here is not that the main argument used by those calling to restrict gender-affirming care is reliant on fundamentally flawed evidence — though I do believe it is. I am not concerned with simple political point-scoring by suggesting ‘my evidence is better than yours.’ The point is that we recognize the context in which science is being used.
It seems clear to me that we live in a world which is fundamentally hostile towards trans people. And given how historically science has been used to entrench marginalizations in certain communities, overreliance on the Cass Review and other science which “proves” the harms of procedures that deviate from a traditional gendered norm, serves less as evidence for a genuine concern for trans people but more an explicit presentation of a persistent anti-trans prejudice.
Attacks on trans people are now part of our political life globally, ranging from banning us from using bathrooms, defining our gendered legal statuses, our participation in sports, our gendered medical care and even the ability of trans youth to socially transition. This exists in the context of the cissexist (belief that cis identities are more normal or legitimate than trans ones) society that we live in, where trans people experience substantially more violence, discrimination and poor mental and physical health outcomes.
In our modern world, research and science are often thought of as the gold standard for truth — “facts don’t care about your feelings,” an infamous political commentator would claim. And while I maintain that empiricism and scientific evidence are a reliable form of interpreting our world and creating policy, science is not infallible, especially if accepted uncritically.
Anti-trans actors, be it those who are vehemently engaged in transphobia or those who simply fail to recognize the underlying cissexism of our society — and in turn our thinking — will look to scientific data to argue positions which would further harm an already significantly marginalized community. This doesn’t have to happen in intentionally malicious acts; a review which leads to policy change in major democracies does seem like a compelling source of questions about these issues at home. But it is not solely because of the flaws of the Cass Review that these misguided questions can perpetuate harm against trans people — it is also the underlying dynamics of how our society sees and understands trans identities.
As consumers — and sometimes creators — of media and politics, it serves us to recognize the shortcomings of even our most potent tools. Nothing exists devoid of context; given a systemic and persistent discrimination of certain groups, even a tool as objective as science can still fail us, as it has many times before
This is an opinion article. It reflects the contributor's views and does not reflect the views of The Ubyssey as a whole. Contribute to the conversation by visiting ubyssey.ca/pages/submit-an-opinion.
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