Placebo Effect

Any time you're having a conversation about gender affirming care, please, really press the issue of placebo-control and placebo-effect. Ask them to conceptualize what sham-gender affirming care would look like. If they can't, to a reasonable person, that's a sign that perhaps this is an elaborate placebo. To an unreasonable person, that's a sign they get to bypass normal rules of evidence. This is NOT limited merely to the pharmaceutical components. This includes what is normally termed "social transition." They want to call this a non-placebo. They want to say it's having some kind of real, medical effect, that can be credited with preventing suicides, and now, according to Chase Strangio, it sounds like, improving diet and exercise patterns, and to other randos on Twitter, it will somehow prevent you from smoking or help you quit smoking, even. These are bold claims that this is the only treatment that has this capacity for this population. What would negate this non-placebo effect? Which part of the cracker is the Jesus Crust, pastor.

Why the placebo treatment of therapy has helped me so much: I’m in severe psychological pain from numerous sources and I needed and continue to need the support, safety, and comfort provided by this placating non-medical extremely necessary, extremely beneficial placebo treatment or close placebo substitutes. I learned a lot about myself through this process, because my severe psychological pain was preventing me from developing. The safe, endogenous opiate-system pain relief I got from going to a treatment and spending a large volume of time in treatment, allowed me to do the work I needed to do, because I was finally at a manageable level of psychological pain, due to the regular placebo treatment therapy provided. I also separately have autism spectrum disorder, and benefited from the practice taking the other person’s perspective. But I am not convinced practicing and getting better at something is equivalent to a non-placebo active medical intervention, which creates an additional medical placebo effect. Language is imperfect. I am describing a system.

We need to preserve and perpetuate the concept of a medical intervention that inherently creates placebo effect, a placebo-only treatment with no additional medical intervention and practicing a skill with the help of a trained therapist who is unlikely to reject you for being bad at the skill. Knowing that you are taking a placebo treatment will not magically block the placebo effect. You can only block the placebo effect with drugs. If you tke medications that are known to blunt or block the opiate system and also participate in therapy I would love to know what if any effect this has had on the therapeutic process in your opinion. I have no idea what this means for congenital insensitivity to pain syndrome but I would absolutely love to interview someone with that disorder about their experiences with placebo treatments. I imagine my severe physical pain which exists alongside my severe psychological pain, worsening it, contributed to my lack of response to placebo treatments and thus my skepticism of bullshit artists.