Sunday, July 23, 2017

Of course you can feel like a girl: Reflections on a recent anti-transgender essay

Jamie Shupe made history in June 2016 in becoming the first person in the United States to have a legally designated "non-binary" gender identity, represented on an identity card issued by the Oregon Department of Motor Vehicles. Shupe was born male and today prefers not to be classified as either male or female and wants to be referred to with the pronoun "they" rather than "he" or "she."



Image by j bizzie. Wikimedia Commons, Creative Commons Attribution 2.0 Generic.

Shupe does not see eye-to-eye with people who choose to transition from one gender to another, although Shupe personally attempted a male-to-female transition for several years before settling on a non-binary identity. In a nearly 11,000-word essay "You Can't Feel Like a Girl," posted July 22, 2017 to a blog called "First, Do No Harm: Youth Gender Professionals" with the tagline "Professionals Thinking Critically about the Youth Transgender Narrative," Shupe tears into transgender people and their care providers. Everyone deserves to have their personhood taken seriously. That said, Shupe's argumentation in this essay does not need to be seriously entertained. The essay has no identifiable structure, apparently missing an introduction, conclusion, and section breaks, which makes it more of a rant. It has an infinitude of typos, suggesting a lack of editorial input from a second party.

2023 update: The site has been made private, so you can't read it.

Also, relevantly: There was a 2023 email leak.

The rant includes a lot of personal information, including Shupe's declaration that they have "Complex PTSD" and probably "Asperger's" and implying their disappointment that, after taking female hormones for the past four years, they still haven't achieved the body transformation results they hoped for. "None of it made me look like a female. Whatever changes you’re supposed to get are supposed to happen in the first three years," they say. Shupe never had genital surgery and is happy about that. It seems that Shupe does not, today, have much contact with people who identify as transgender. Shupe refers to people who have transitioned from male to female as "surgery queens," as here — "The surgery queens aren’t proper role models for these trans children. They’re what they get to see at the circus" — and as "monsters," as here — "Trans women are like the beast Cerberus, the monstrous multi-headed dog that guards the gates of the Underworld to prevent the dead from leaving." Thus, while Shupe styles themselves in this essay as someone who can give "insider" criticism because they attempted a male-to-female transition for some years, I'd argue that in certain respects they can only give "outsider" criticism about transgender lives. Using their invective as a reference point, I surmise they're not actively involved in transgender community or organizing and may currently not have a lot of transgender friends or acquaintances with whom they dialogue on these topics. The essay fails to explicitly acknowledge and identify the line between what they do and don't know from personal experience.

Some text is hyperlinked to questionable sources but there are no footnoted citations. Shupe says that their experience comes from reading endless mass media articles. In their words,

"due to my narrow interests and the fact that I have nothing better to do as a retired person, I’ve spent every day of the last four years studying transgenderism through the lens of media articles. I don’t have much use for academia or it’s [sic] articles. I like to see what institutions like the Daily Mail have to say about people like me. It’s not uncommon for me to get 100 Google email alerts per day for keywords like transgender or gender dysphoria. That’s how I spend my days."

It's a fine hobby, but it's unlikely to result in a high-quality essay. If one deliberately restricts one's reading to what is scrawled on the Internet in brief articles for informal consumption, studiously avoids anything that smacks of "academia," and apparently doesn't have conversations with the groups described in those articles because one believes they are monstrous, then one's arguments on that topic are less likely to be rigorous.

If you make it to the end of the rant, you finally see a statement of purpose in the final paragraph: "This is my coming out as a TERF and a SWERF." These terms are not defined within the essay, but they stand for Trans-Exclusionary Radical Feminist and Sex-Worker-Exclusionary Radical Feminist, i.e. someone who identifies as a feminist but rejects the claims of transgender people and sex workers as valid concerns for feminists and who generally takes the opposite position on social and political issues that those groups would take. Shupe's position here is consistent with the title of their blog post: They believe a boy can't coherently say that they "feel like" a girl. A boy can feel feminine, but the boy remains a boy or perhaps third-gender and is not, and will never be, a girl. An important theme of this essay is that, since binary gender transition is invalid (in Shupe's estimation) for people of all ages, healthcare professionals should especially avoid putting gender-variant children on the path of medical transition. Shupe says that "these charlatans deserve to be fired at best and jailed at worst" and twice names a particularly well-respected children's endocrinologist as a "monster."

Shupe claims to be a better role model for gender-variant children than a gender-transitioned person can be, on the basis of their assertion of some kind of emotional superiority. Shupe says that all the emotional difficulty they've experienced in life has been caused by external sources (discrimination, shaming, etc.) and that they have never been suicidal, whereas people who go through gender transition have emotional difficulties that arise from the inside and they tend to be suicidal. There seems to be a lack of introspection and analysis here. Everyone has an inside and an outside, and our feelings arise from complex interactions in our inner and outer worlds. One should be skeptical of a person's claim that all their negative emotions were the result of others dumping those feelings nonconsensually into them. If you discover yourself to have become a reservoir for other people's toxins, you are still responsible for processing it and overcoming it, and whether and how you do it affects whether you are a good emotional role model for others. You can't say: There's toxic crap inside me but I didn't put it there so I'm not responsible for it. Nor can you point at others and say: They put their own toxic crap inside themselves and they must assume full responsibility for it. Furthermore, it isn't obvious that never having been suicidal in the first place makes one a better role model than having suffered with suicidal thoughts and still being alive — especially not for people who are suicidal and would like a role model who has dealt with that. And since Shupe says that transition promotes self-hate in transgender people, it isn't clear how Shupe managed to personally avoid this pitfall when they attempted transition.

Shupe says several times that transgender women are not "real" women. The argument? People who were born male can never menstruate or give birth. This overlooks the obvious, common counterobjection that fertility can't be the essential definition of a woman since many people born female are never fertile. (It would be best to avoid essentialist definitions altogether and admit there is no one essential thing that defines womanhood or manhood, but we cannot hope for too much in a rant.) Shupe goes on to say that the idea of "feeling like a girl" is incoherent; there can only be "feeling feminine." This is where the title of the essay comes from. Unfortunately, it overlooks that there are multiple ways of being feminine (some of them culturally specific) and that they can overlap with ways of being masculine. For example, nurturing can be interpreted as both feminine and masculine. Femininity and masculinity are not always polar opposites, so they are subject to interpretation. I believe that Shupe's thesis makes an incorrect claim here. It is possible to feel like a man or a woman. What that means is that you want to be seen as a man or a woman, no matter what gin joint in the world you walk into, no matter if you're feeling a bit more or less feminine or masculine than usual. You may feel very feminine and want to express your femininity and be perceived as feminine, yet you still want to be seen as a man. You may feel very masculine and want to express your masculinity and be perceived as masculine, yet you still want to be seen as a woman. The gender is a convenient box that you don't mind fitting into on a regular basis because it feels accurate or useful. That's what it means to feel like a man or woman. It's entirely reasonable to feel that way. Many people have that feeling about the sex with which they were born, and they are generally known as cisgender; a relatively smaller number of people have that feeling about the other sex, and they are known as transgender, and they are entitled to have that feeling, too. If Shupe's argument rests on people needing to acknowledge and accept the sex they were born as, then Shupe needs to reconsider their own choice to legally designate their gender as non-binary. That would be consistent only if Shupe were born intersex, which does not seem to be the case.

In one place, Shupe implies that children's gender transition is an attempt to straighten out gay kids. ("They can’t be gay, so they’re being surgically made straight instead.") There's no further discussion on this point, which is unfortunate. Many people who outwardly seem heterosexual before their transition will identify as more homosexual after their transition, as the object of their affections does not change. For other people, sexual orientation does shift during and after gender transition, and many transgender people partner with each other. As far as I know, most prepubescent children don't yet assert a sexual orientation at all, so it isn't clear what adult would be so distressed by a small child's apparent gayness (read: gender expression) that they would try to straighten out the child by changing their physical sex rather than by disciplining their gender expression. This just doesn't seem realistic. I don't think most parents who embrace their child's transgender identity do so because they are homophobic. That doesn't seem typical.

Shupe uses language that implies that transition is something that a doctor does to a transgender person. Language of autonomy — transition is something one chooses and does for oneself — is lacking. In Shupe's essay, transition is also treated as entirely medical, whereas in real life, there is an important social aspect. Throughout history, some individuals have always managed to achieve a complete binary transition without hormones or surgery because they happened to pass very well. That remains possible today. Some people just put on the clothes of the opposite sex and immediately pass. Shupe does not acknowledge this in their essay, probably because they are primarily upset about irreversible medical intervention. Would Shupe accept other people's binary gender transition if they managed to accomplish it without medical intervention or with mild or reversible medical steps?

Transgender men (people who transition from female to male) are largely ignored in this essay, which is probably beneficial for them, although there is an incoherent paragraph that refers to them in the context of the public debate over bathroom use.

"I wish right now that the doctors who are pausing puberty would instead pause for a moment and take a look at the chaos resulting from the mess they’ve created. It’s harming women. The ones that are real women. Trans men have yet to harm men. Testosterone injections have been around for decades and there’s still no trans guy in the NFL. All it’s good for is soldiers in the bathroom war. 'See, I have facial hair, that makes me a man! Women you should be scared.' Women aren’t scared of trans men, I’ve asked them. They’re scared of penises or people that used to have penises. That’s why we don’t have a peace agreement for the bathroom war yet with the conservatives."

The meaning is hard to ascertain, but it was probably intended to be construed more like this: Some cisgender women assert fear or disgust or hypothetical transgender women and say they are reluctant to share the bathroom with them because they assume that transgender women are essentially "guys in dresses" — lecherous, creepy, possibly dangerous, and easy to spot, causing discomfort in others as soon as their faces are visible. Someone might challenge this by asking the cisgender woman: If she indeed believes that transgender women are really men, then logically doesn't she also believe that transgender men are really women? So does she feel comfortable if a transgender man — a person who presents as a man, wearing masculine clothes, who might have a beard, flat chest, deep voice — walks into a women's public bathroom? Well, Shupe has helpfully asked "them" (at least one cisgender woman) whether they believe they are afraid of "trans men," and they said no, so really it's transgender women (not transgender men) who are the primary cause of conflict here. Great. Shupe's interview question is irrelevant. If a furry-faced person dressed as a man walks into a women's bathroom, he isn't immediately identifiable as a "trans man." He is identifiable as someone who doesn't belong in a women's bathroom. It doesn't matter if some cisgender women believe they're unintimidated by their imaginary conception of a transgender man. What matters is that some people who use women's bathrooms (whether cisgender or transgender) would be alarmed by a real transgender man, a stranger, entering it unannounced. The pragmatic conclusion at which transgender men generally arrive is that they should use men's bathrooms. Everyone involved is happier.

The scope of the essay is too wide-ranging. Sometimes it seems to be about children who are offered medical transition, but a lot of it is about adults who transition and don't adjust well, have botched surgeries, or other miscellaneous regrets and disappointments. It would be one thing if Shupe admitted that some adults really are better off transitioning and that there is simply some reason to be cautious with kids. But Shupe's argument isn't limited to kids. The essay says that no one (regardless of age) should transition because binary transgender (male-to-female or female-to-male) is not a valid identity, it increases internal distress, it doesn't dismantle patriarchy, and it injures women. To the contrary, it is a valid identity (given that many people successfully live it; how else, from a liberal humanist perspective, would we validate it?); gender transition greatly reduces the internal distress of many people; our personal gender identities as "woman," "man," or "other" do not need to dismantle patriarchy (everyone is responsible for being an ethical person and taking actions to address injustice, but our identities do not have to dismantle patriarchy while we sleep because that does not make sense); and it isn't at all obvious how the existence of transgender people harms cisgender women (Shupe asserts this multiple times without providing a clue what kind of harm they are referring to).

People with non-binary gender identities deserve a space in society. This is true whether they were born intersex, male, or female, and whether they always identified as non-binary or whether they arrived at it through a process of self-examination or gender transition or adaptation from a binary place to a non-binary place. I am glad that Jamie Shupe has helped clear the way to make legal recognition possible for people who don't feel like either a boy or a girl. For those who do feel like a boy or a girl (although Shupe says it is impossible), I hope that they, too, can feel free to assert that identity, and that they have access to hormones and surgery if that is part of their gender affirmation process. I hope that we can have inclusive politics and move away from terms like "TERF" and "SWERF" whose second letter stands for "exclusion."


You can also feel like cis or trans or binary or nonbinary or none of those.

See here:

"'I’ve never felt like a woman, to be honest with you. I’ve never felt desirable. I’ve never felt feminine. I have to convince myself that I’m, like, a pretty girl,' Eilish explained. 'I identify as ‘she/her’ and things like that, but I’ve never really felt like a girl.'”
Billie Eilish is ‘physically attracted’ to women, but also ‘so intimidated’ by them | Lisa Respers France, CNN Entertainment, November 14, 2023

Eilish doesn't say (at least, the article doesn't quote her as saying) that there is something it feels like to feel like a girl — only that she personally doesn't feel it.

A poem, reflecting the words of "our fierce Zenobian / activist auntie mother of nine / in the serious blue abaya and / sensible shoes with a baby / in her lap":

"And
what is a woman? Certainly
not me. I have never felt like
a woman nor will I
ever be."
— "asushunamir," Banah el Ghadbanah, La Syrena: Visions of a Syrian Mermaid from Space, Ann Arbor, Michigan: Dzanc, 2022. p. 152.

Saturday, July 22, 2017

Willie Parker's 'Life's Work' is informative as a physician's perspective on abortion

Dr. Willie Parker has released a great new book in 2017, Life's Work, that describes his experiences as an abortion provider, his formative years, and the evolution of his personal beliefs as a Christian. He grew up in poverty not knowing who his father was, and his sister became pregnant as a teenager. Initially a hardliner on the subject of sexuality, he negatively judged girls and women who had sex outside of marriage and he refused to perform abortions. But as he continued his medical studies, he came to realize the value of personal autonomy to make this decision. This was so important to him that he gave up a penthouse apartment in Hawaii whose wide windows looked out over the Pacific and he moved back to the South so he could help communities who needed a competent, dedicated abortion provider. In Life's Work, he eloquently describes a wide range of issues related to working in an abortion clinic without shying away from the challenging parts.

He shares a compelling picture of what women go through:

"Every woman sitting in one of the high-backed chairs in the Montgomery clinic has missed a menstrual period. She has peed on a stick at home or in a public restroom or at a friend's house or in a dorm and seen the result; in a flash she has had to digest how a new child will alter the future she imagines for herself. She has had to decide who she can confide in and who will judge her or disapprove and thus needs to be lied to or kept in the dark. She has confronted whatever private thoughts and yearnings she may have about her vision for her life, including deeply held and possibly heretofore unexamined ideas about professional fulfillment, love, parenthood, and God. She has had to consider the sometimes viselike practicalities that circumscribe her days: school schedules, work demands, the responsibility of caring for other children or ailing relatives, the reliable and supportive presence — or not — of the person whose sperm entered her body more than six weeks ago, her financial circumstances, her age, the limits of her own health. By the time a woman is sitting in a clinic awaiting my attention, her intention has been focused and clarified. She has figured out how to scrape together $550 if she's six weeks pregnant, or as much as $1,400 if she's further along. She has had to be true to herself, despite the fact that her decision process has been disrupted and corrupted by these new state laws requiring her to be 'counseled' — by me, a credentialed doctor, or a psychotherapist — in a ginned-up 'protective' encounter that often passes along to these women false or biased information about abortion disguised as scientific truth.

* * *

To the point: A woman who wants to terminate her pregnancy has to make her decision in the context of a culture that shames her and, increasingly, within the constraints of laws that dramatically inconvenience her. They demean her humanity by presuming to know better than she does what her best interests are. They limit her access to clinics and doctors and they convey to her false information. The underlying assumption of all the new laws is that women can't be trusted to make their own health decisions; their doctors can't be trusted to tell them the truth; and scientific knowledge must be subverted in the name of religious truth. I strictly abide by these laws, which I believe violate human freedom, because my first priority is to continue to be able to provide abortions. If I break the law out of frustration or fury and get put out of business, the antis win." (pp. 8-9)

Later in the book, he does complicate this picture by mentioning that some women who enter his office do not yet know what they want, often because they are being pressured by someone, and some women are mistaken about how advanced their pregnancy is.

He also talks about what he goes through as a provider:

"But at that early hour, sitting in my car, sometimes around dawn, I am infuriated that I, who am in my fifties, gray-bearded and entirely bald, a physician with a medical degree from the University of Iowa and a master's in public health from Harvard University, have to do a version of a perp walk in order to enter my own place of work. And I am aware that, even though the intention of these protesters is to throw sticks, not stones — the truth is, you never know. One of them might come unhinged at any moment; any one of them might be carrying a gun. (p. 6)

How his understanding of race informs his understanding of abortion

Women's autonomy is important to Dr. Parker in part because of his awareness of the collective trauma of African-Americans not being allowed to make their own decisions about their bodies since the days of slavery. As he describes it:

"'William James, I'm sure glad you came to see me,' Miss Lula said to me as I sat by her bedside. 'Lord, Lord, Lord, I wish people could see you now. So many people said you were never going to be nothing.' And I realized then that, even though I was considered smart and even though I was 'a good boy,' the people who loved me were betting against me because of the circumstances in which I was raised. Now that I have brought all that I was and all that I've learned back to the communities of my youth, I can truly relate to my patients: I understand how being poor and coming from a racially stigmatized group can threaten your sense of self-determination and agency. The women who come to me for abortions are choosing a path different from what others would script for them." (p. 73)

"I am not the first person to say or think this, but having returned in my adulthood to make my home in the South, it is impossible not to think constantly about the analogy of the limits on women's reproductive rights to slavery. As an African American man descended from slaves and raised in the South, it is too easy for me to imagine what it's like to have no control over your body, your destiny, your life. Less than two hundred years ago, white men owned black people's bodies, and the southern legislatures that represented those white men's interests protected their right not just to buy and sell humans as they passed but also to own the babies the black women carried, even before those babies were born. White men maintained jurisdiction over black women's bodies, in that they owned them and took possession of their babies. Insofar as abortion access is limited, this abuse of power extends to all women. I believe that the men who are passing the laws that limit medication abortion want to control women's bodies, which is not so far from wanting to own them outright." (pp. 107-108)

"But no matter what brought them here, they do not deserve to bear the brunt of a culture's historic and dysfunctional shame." (p. 14)

What is sacred and miraculous?

He identifies as a Christian, but his value system around abortion is based in science and liberalism. As a physician, he maintains that the fertilization of sperm and egg is a natural process. It's not a miracle; a miracle would be an event that intervened in this natural process. As someone who grew up in a neighborhood where parenthood was something that just happened, he sees parenthood as a fact of life. What is sacred to him is an individual woman's freedom of choice, the way in which she consents to become a parent (or not), and the medical skills he has cultivated to support women in their choices. His approach is humanistic: People decide what is sacred. The implication is that we have to listen to each other and respect each other's choices to a large extent. When he calls his clinic a "judgment-free zone," he means he sets aside his judgment and defers to the woman's judgment. He feels that women should focus on their own choices and not be holier-than-thou about their parenting choices or their abortion choices when they look at other women. He understands that these are life decisions and behaviors to which women give careful thought and place a lot of stake on a good outcome, and he would like his patients to understand that people may have different psychological experiences of their abortion and may express their feelings differently and that they should all be taken seriously and should not be invalidated.

"I do not engage in or perpetuate any of the culture's sentimental notions about the primacy of motherhood in women's lives; I regard the meeting of sperm and egg as a biological event, no less miraculous but morally and qualitatively different from a living, breathing human life, imbued with sacredness only when the mother, or the parents, deem it so." (p. 13)

"Who enables the desperate isolation of the women of Mississippi? In part, it's liberal women with children who themselves became enraptured with the sonogram images they saw at the obstetrician's office and who wept when they heard the fetal heartbeat. Especially when I travel in upscale, liberal circles I see a fetishization of motherhood and children that I don't quite understand, a universe away from the hardscrabble world in which I grew up. This sacralization of motherhood in every sector of the privileged classes enables a widespread social conservatism that, at base, diminishes women's liberty: a consensus that motherhood is a woman's most important role. When a society tacitly agrees that a morally neutral, biological process — procreation — is 'miraculous,' then any intervention in that process can be seen as desecrating, and any choice against motherhood will be met with widespread disapproval. (In the churches I come from, a 'miracle' is God's intervention in the natural order of things — an ability, say, to turn a flask of water into wine or one loaf of bread into many. The way I see it, through a doctor's eyes, there is perhaps nothing on earth less miraculous or more ordinary than the animal process of human procreation, which was happening long before the Bible was written and will continue long after today's newborns are dead.) But among the elites, the same people who write checks to Planned Parenthood, the whole enterprise of parenthood has taken on a hothouse aspect, which allows a blurry consensus about the 'sanctity of life' to flourish — instead of a clear-eyed definition of what 'life' really is. Mommy blogs, conversations about 'having it all' and 'helicopter parenting' — all contribute to a cultural neurosis around motherhood that obscures what ought to be a value-free choice. A cultish preference for motherhood is so embedded in culture that even well-meaning women reflexively judge one another for their reproductive choices. Now a 'broad-minded' woman may be heard to disapprove out loud of her sister-in-law's abortion ('She could afford another baby!'), or to privately judge her friend's decision not to have children as 'selfish.' The truth is that there is no intrinsic moral value to becoming a mother or not becoming one. A woman who pursues a pregnancy is merely prioritizing her life around motherhood. And a woman who has an abortion is prioritizing her life around not wanting to become a mother or around devoting herself and her resources to the children she already has. Homo sapiens will continue to reproduce and evolve, with or without any individual woman's participation in that process. (p. 178)

"In the abortion clinics where I work, I try to cultivate compassion — not just in myself, but among the staff and even among the patients themselves, who meet in my waiting rooms having come from all different walks of life and whose pregnancies and abortion decisions mean something different to each one. I have zero tolerance for women who judge one another or who presume that their abortion, and their circumstances, are somehow more stressful or more extenuating than anyone else's. I remember a lawyer who came to see me in Montgomery. She was well educated and charismatic. But as she lay on the table, she began to complain about the irreverent jokes and wisecracks that the other patients were making as they sat, stressing, in the waiting room, drinking soda and eating chips. She said, 'Don't they know that this is very difficult for some of us? Can't they show some respect?' And though I didn't show it, I got angry, because no one is entitled to sit in judgment of others, no matter their education, their status, their station, the circumstances that led them through our doors. She wanted her abortion to be sacred, and more, she wanted others to express their feelings in a way that was compatible with her sensibility. Well, all of this — the procedure, every woman in the waiting room, the nurses and aids and administrators who provide this excellent care, my own hard-won skill — is sacred to me. When she wrote a letter to complain of the atmosphere in our clinic, I was unmoved." (p. 202)

"If God is wholly Other, then the miracle of life is not some ordinary meeting of sperm and ovum — a morally neutral, purely biological event — but the agency and responsibility that come with being able to participate with God in a creative process. God is not human. God is not on the planet. God does not have babies, or make babies. People do. As part of a greater intelligence, as a lover of beauty and creativity, God made the world. And sexual reproduction is part of a collaborative process — between a male and a female and between God and humans. In that process, all distinctions disappear. God has no hands but your hands. God has no ability but your ability. That is what the Bible means when it says that you are God's child.

And if you look at it that way, if you set aside the idea that God is like Siri, telling you to go left or to go right, then the whole business is sacred. All of it. A pregnancy that intimates a baby is not more sacred than an abortion. You don't become sacred, like Mary, just because you conceived, and the termination of a pregnancy is not the resolution of an error. It is merely one of the reproductive outcomes. So is miscarriage. So, now, is surrogacy and in vitro fertilization — all these are on a continuum and they all hold moral weight. The God part is in your agency. The trust — the divine trust — is that you have an opportunity to participate in the population of the planet. And you have an opportunity not to participate. Is God vested one way or another in whether you, as an individual, become pregnant? No. Is a pregnancy sacred because there will be a baby, ultimately, in a bassinet, beautiful, maybe the next Obama? No. The process is bigger than you are. The part of you that's like God is the part that makes a choice. That says, I choose to. Or, I choose not to. That's what's sacred. That's the part of you that's like God to me.

The procedure room in an abortion clinic is as sacred as any other space to me, because that's where I am privileged to honor your choice. In this moment, where you need something that I am trained to give you, God is meeting both of us where we are. (pp. 211-212)

If you think this is fascinating or challenging, you should buy this book and consider the meaning and implications of this — not only for one's views on abortion, but for one's overall worldview.

Book

Dr. Willie Parker. Life's Work: A Moral Argument for Choice. New York: Atria, 2017.

Saturday, July 1, 2017

Seeking a replacement ethical analysis of support for a replacement healthcare plan

After years of asserting that they intend to strike down or replace President Obama's Affordable Care Act, Republicans are struggling to come up with a replacement plan that can be passed. However, they cannot get consensus among their own party to vote for the replacement plan in the Senate. Why? Largely because the replacement plan is bad. It's unethical and Americans are uncomfortable with it.

If Americans eventually do get a replacement healthcare plan that resembles the current proposals, we will have a psychological need to rationalize it to ourselves. This means we'll need a replacement ethical analysis.

Here's the current analysis I've been seeing. It's not direct criticism of the details of the replacement plan but rather criticism of the character of people who would support such a policy approach. With strong words (and strong headlines) the Republicans are criticized:

"The fact that such detached cruelty is so normalized in a certain party’s political discourse is at once infuriating and terrifying."
(Kayla Chadwick, "I Don’t Know How To Explain To You That You Should Care About Other People," Huffington Post, June 26)

"Republicans...have repeatedly broken their promises and defied public opinion in order to release health care bills that cut spending on the poorest Americans to fund massive tax cuts for the richest Americans....at some point, we need to take them at their word: This is what they believe...I want to see a better, more decent conservatism drive the Republican Party. I don’t want to believe that this is the bottom line of GOP policy thinking. But this is clearly the bottom line of GOP policy thinking."
(Ezra Klein, It turns out the liberal caricature of conservatism is correct," Vox, June 29)

"Whether it passes or not, however, remember this moment. For this is what modern Republicans do; this is who they are."
(Paul Krugman, "Understanding Republican cruelty," New York Times, June 30)

I do not want to believe this ethical analysis either but I do not have a replacement analysis.

In case you missed it

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