Worthless Harm-Prevention and Non-Existence

We typically assume that it's really important to prevent great harms.  And indeed, usually it is.  But there are at least a couple of exceptions.

Most obviously, some harms might be outweighed by greater associated benefits.  Benatar thinks it's terrible to allow someone to come into existence given all the subsequent harms their life will contain (no matter how overall happy their life will be).  That's obviously nuts.  These harms are more than compensated for by the overall happiness of the life.  So it's only uncompensated harms, or "net harms", that we should seek to prevent.

More interestingly, even net harms may nevertheless not warrant preventing (in a certain way).  For suppose the harm is comparative in nature: the harmful event does not put the victim in an intrinsically bad state, but rather harms them in virtue of depriving them of some much better alternative.  There are then two very different ways in which a comparative harm could be prevented.  You could ensure that they get the better alternative.  (That's the good way!)  Or, you could prevent the "better alternative" from ever arising as a possibility to be deprived of in the first place.  There is generally no reason whatsoever to prevent a harm (however grave) in this way.

Assessing the NMC's Defense of its Independent Midwifery Ban

After receiving much criticism for its effective ban on independent midwifery, the NMC released a document [pdf] that seeks to explain and justify their position (see especially the fourth and final page).

Their central conclusion is that they are simply following orders, and it isn't their responsibility to do anything to mitigate the harms they're thereby causing:

Medical Indemnity: Protection or Compensation?

One of the (many) puzzling elements of the NMC anti-midwifery fiasco is the NMC's insistence that, by shutting down midwives whom they judge to have "insufficient" indemnity cover, they are thereby "mak[ing] sure that all women and their babies are provided with a sufficient level of protection should anything go wrong," and that they "had to act quickly in the interests of public safety."

This rhetoric strikes me as deeply misleading.  Indemnity cover is not a public safety issue.  Not only does it do nothing to prevent bad medical outcomes from occurring in the first place, it cannot even ensure in general that financial support is available when needed for increased caring costs associated with (e.g.) disability.  All that indemnity cover does for patients is ensure that greater compensation can be paid in a malpractice lawsuit -- a very rare and specific set of circumstances.

Indemnity cannot be relied upon to "protect" families "should anything go wrong" because it does not cover anything going wrong, but only things going wrong due to malpractice on the part of the medical practitioner.  If a baby suffers brain damage due to unavoidable complications, for example, indemnity will not help. For that, we need disability support as part of the general social safety net.

UK Shuts Down Independent Midwives

A new low for harmful over-regulation: The UK has just regulated independent midwives out of business (at least for the time being).  The Nursing and Midwifery Council decided that they did not consider the indemnity cover of Independent Midwives UK (which has worked fine since indemnity cover was legally mandated in 2014) to be "adequate" after all.  So, as of 11 January last week, independent midwives have been legally barred from attending the births of their clients, severely disrupting the birth plans of these expectant parents (threatening their right to a home birth, disrupting their continuity of care, and generally undermining patient autonomy and the values that led these expectant parents to invest in an independent midwife in the first place).

Sex Selection and Gender Norms

Via Daily Nous, I came across this puzzling objection to sex selection by Tamara Browne:

Most parents will not desire a male or female child in the sense of their genitalia. Rather, they will want a child who fulfils socio-cultural definitions of ‘boyhood’ or ‘girlhood’. This is problematic because it assumes our sex determines our adherence to gender-based social norms and behaviours.
At best, acting on assumptions which are not evidence-based is bad science. [... Furthermore,] sex selection is a product of, and perpetuates, false assumptions about gender that keep men and women “in their places”. This prevents progress towards equality and freedom from restrictive gender roles and bias.

This is simply false.  In order for one's gender preferences to motivate sex selection, one needn't assume that the latter perfectly "determines" the former.  It is surely sufficient for there to be a strong correlation, such that by selecting a particular sex one makes it (significantly) more likely that one's child will be of the preferred gender.  And one can hardly pretend that there is zero correlation between the two -- that is not an "evidence-based" position.

An Obligation to Abort? Moral Guidance vs. Reaction

Dawkins was widely condemned for his tweet a couple of weeks ago claiming that it would be "immoral" not to abort a fetus with Down Syndrome. The claim seems pretty implausible on its face if we read "immoral" in the "reactive" sense indicating blameworthiness or moral criticizability. But if we instead address the question of 1st-personal moral guidance -- if faced with this situation, what should I do? -- Dawkins' response strikes me as more defensible. (Dawkins' own elaboration seems to indicate that something more in this vicinity was indeed his intended meaning.)

Procreative Ethics

There's an interesting article in the New Yorker exploring whether it's wrong to have kids.

The author's main concern seems to be overpopulation, but would-be parents can easily offset their impact on global population size by making an appropriate donation to Population Services International or the like. If the result of their choices is that more children are born into prosperity, and correspondingly fewer born into poverty, then that can only be a good thing. And even without such an 'offset', I'd expect the marginal child born to upper-middle class Americans to produce more positive than negative externalities over their lifetime. (As Caplan says, "More people mean more ideas, the fuel of progress.")

A better argument against procreating may be the lost opportunity for adopting/"saving" children from orphanages, etc., where they would otherwise lack the sort of care and opportunities that you could offer them. Adopting children in need is certainly exemplary, though presumably supererogatory if anything is. Setting this ideal option aside, then, I think we can at least say that for many people it is better for the world that they have and raise biological children rather than doing no parenting at all.

NY Times spreads anti-contraceptive lies

According to the NY Times, proposed legislation to call zygotes legal persons would...

bar some birth control methods, including IUDs and “morning-after pills” that prevent fertilized eggs from implanting in the uterus.

Contrast the Journal of the American Medical Association:

The authors of such claims [that Plan B prevents implantation] have offered no supporting evidence regarding Plan B's mechanism of action. On the contrary, what has been offered are assertions that “the exact mechanism of action of Plan B is unknown” and that “the dirty little secret is, nobody really knows.”​ Such sweeping statements of uncertainty not only directly contradict the claim that Plan B's anti-implantation action is “proven” but also promote general misunderstanding and misuse of doubt in science. [...]

Published evidence clearly indicates that Plan B can interfere with sperm migration by altering the cervical and uterine environment, and that preovulatory use of Plan B usually suppresses the LH surge either completely or partially, which in turn either prevents ovulation or leads to the release of ova that are resistant to fertilization. Epidemiological evidence rules strongly against interruption of fallopian tube function by Plan B. Evidence that would support direct involvement of endometrial damage or luteal dysfunction in Plan B's contraceptive mechanism is either weak or lacking altogether. Both epidemiologic and clinical studies of Plan B's efficacy in relation to the timing of ovulation are inconsistent with the hypothesis that Plan B acts to prevent implantation. [...]

[A]ll women should be informed that the ability of Plan B to interfere with implantation remains speculative, since virtually no evidence supports that mechanism and some evidence contradicts it. Women should also be informed that the best available evidence indicates that Plan B's ability to prevent pregnancy can be fully accounted for by mechanisms that do not involve interference with postfertilization events.

Thanks to Helen for informing me on this topic. Does anyone know if the claim about IUDs is similarly misleading? Links welcome!

P.S. Medical disputes aside: Is there a standing legal obligation even to let "people" implant in your uterus? Seems odd.

What's Wrong With 'What Is Marriage?'

A new anti-gay marriage paper ('What is Marriage' by Sherif Girgis, Robert George, and Ryan Anderson) has been getting some attention recently. So I thought it might be useful to set out explicitly where I think their argument goes wrong. (But please don't interpret this as in any way legitimating the paper or indicating that the arguments merit engagement. I think that in a morally sensible society this would not be considered an open question, any more than (say) whether women should be allowed to vote.)

Abortion Review

Is it wrong to kill embryos -- do they have (morally significant) interests that would be violated by their untimely death? I think that reflecting on spontaneous abortion strongly suggests that embryonic death is not an intrinsic bad (though it might be bad for the would-be parents, if they dearly wanted a child). The central challenge for the pro-lifer is to explain how it is that non-sentient embryos have greater moral status than other non-sentient entities like plants and bacteria. There are two basic strategies they can offer in response, but I think that both ultimately fail.

Marquis on Contraception and Identifying Victims

Marquis' (1989) 'Why Abortion is Immoral' famously argues that abortion deprives the fetus of a "future like ours". Towards the end of the paper, he argues that "nothing at all is denied such a future by contraception" (p.201). I think this view is defensible, but not for the reasons he suggests.

Quick thought on reproductive ethics

Everyone agrees it would be a good thing if fewer children were born into poverty (and more born into financial security). The ideal way to achieve this would be for no-one to be in poverty to begin with. That would help the older generation as well as the new. But the benefit to the new generation could also be achieved by another route: namely, by poor people having fewer children, and financially secure people having more children.

That's clearly an inherently desirable outcome (pro tanto, at least -- and 'all things considered' if it is achieved by morally permissible means, e.g. the voluntary choices of all involved). But I suspect many people would not be willing to actually admit this -- perhaps due to the perceived association with eugenicists and other "unsavoury" types. (But remember, Hitler was a vegetarian!)

Anyway, I was struck by this the other day in class when we were discussing an author who claimed the following asymmetry: that although there's some (epistemic) chance that in having an abortion we violate weighty moral reasons, supposedly nobody thinks there's any such moral risk involved in carrying a child to term (at least excepting rare cases of severe disability, such that the child's life would be utterly miserable).

I find it interesting that most people seemed willing to accept this claim without a second thought. Because it seems to me very obviously false. We have pressing moral reasons to increase the average quality of life of future generations. And one way to achieve that is for people in less fortunate circumstances to bring fewer children into those circumstances. This will help bring about less poverty, crime, etc., and that is surely a very good thing indeed.

(To preempt any misunderstandings, I'm not suggesting that abortion is obligatory. It would certainly be inappropriate to demand this choice, or to censure poor women who have many children despite the evidence that they will have worse-than-average lives. That's their business, not anyone else's. But insofar as they are trying to decide for themselves what to do about their pregnancy, I think in many circumstances -- e.g. so long as it wouldn't be traumatic for them or anything -- it really would be best were they to abort.)

Pro-Life, Pro-Zombie?

Here's a curious line of argument. Many pro-lifers hold that an individual has moral status in virtue of its biological kind (being "human") rather than its particular cognitive qualities (being a self-aware "person"). But then, our counterparts in the zombie world are presumably still biologically human. They're physically identical to us, after all, and biology supervenes on physics. As far as biologists are concerned, they are "individual human lives" the same as you and me. So the bio-focused pro-lifer would seem committed to the view that non-conscious zombies have moral status. But that's absurd. (At least, it's absurd to think that they have anything like the kind of moral importance that conscious people do. Maybe complex physical structures can have a kind of value, like ant colonies, or New Zealand's pancake rocks. But I assume the pro-lifer wants to make a stronger claim than that embryos have the value of ants and rocks.)

The upshot is that sophisticated pro-lifers shouldn't be focused on mere biology. It isn't really mere "life", in the third-personal scientific sense, that matters. Rather, it's a special kind of life -- or, rather, the lives of a special kind of being, namely: sentient rational animals. If we understand the kind 'human' in this psychologically loaded sense, then zombies don't qualify as fully human. But embryos - immature members of our kind - do qualify. Sure, they may not yet be sentient or rational themselves. But they are members of a kind with these traits. Intuitively: their acquisition of these traits will occur through natural development (in which they remain the same kind of thing that they already are), rather than radical transformation into a fundamentally different category or kind of thing. (My evil twin explains this picture in more detail, here.)

[Of course, those of us who are pro-choice will insist that it is one's individual traits, rather than one's general kind, that matters morally. But I don't wish to get into that debate here -- see the linked discussion thread instead. The purpose of this post is simply to work out what the most plausible version of a pro-life view would be. I'm especially interested to hear from any actual pro-lifers, whether they are pro-zombie and if not why not -- especially, whether they endorse my evil twin's conception of the pro-life view.]

Childbearing and Incentives

Chris Dillow proposes a Pigovian tax on parents "whose children do badly at school." Some of his commenters complain that poor educational performance might be more the fault of bad schools than bad parents. But this misses the point. The tax is not meant as punishment for bad parenting. It simply serves as an incentive for those in a position of influence to prevent an unfortunate outcome, namely the existence of a child who will likely go on to be a burden to society. Even good parents shouldn't bear kids into a bad situation, i.e. one where it is foreseeable that they will go on to flunk out of school, become criminals, etc. It's not their fault, but if that's the situation they're in, it might nonetheless be better for society were they not to have children. And a well-tailored tax policy will seek to 'nudge' individual incentives into line with social utility, no?

Is it bad for babies to die?

Brandon comments:

[Y]ou find birth a comfortable point [for granting the legal right to life] at least in great measure because you put the point of personation at such a late point in development. Even a lot of pro-choice people would put it at least a bit before birth; and most people would be extremely uncomfortable putting it in 'later infancy'.

Nobody wants to sanction infanticide, of course, and we all agree it's bad to inflict pain on any sentient being; but I wonder whether it's really so unusual to (after reflection) conclude that a baby only becomes a person in later infancy. I will assume, as per my recent post 'Evaluating Life and Death', that personhood tracks whether one is apt to be harmed by an early death. So a newborn is a person iff it is (apt to be) harmed by an early death. Do most people really think babies are harmed by death?

Now, it's a tragedy for the parents when a newborn baby dies. So to prevent this from confounding our intuitions, consider an orphanage. Suppose one day all the newborn babies in an orphanage spontaneously (and painlessly) disintegrate. Assume nobody else cares. Has any harm occurred? Does this make the world a worse place? It doesn't seem so to me. (But maybe I've simply internalized my theory too well. So let me ask: what's your intuition?)

If the example instead involved, say, four year old children, then it would be obvious that their deaths harmed them (assuming they otherwise would have grown up to live decent lives). This is because four year olds are obviously people, who own their futures and may suffer the loss of them. But in the case of newborns, with no self-conception, and no hopes or dreams for the future, it seems equally obvious that the opposite is true. Disintegration makes no difference to them; it doesn't harm them; there's no loss. What this indicates is that they are not yet people with futures of their own.

Of course, that's not to say that infanticide is okay. We've all internalized the rule that extends a right to life at least to the point of birth, and that's for the best. It's a good rule, and so an appropriate component of our practical morality, which determines right and wrong. But that shouldn't stop us from recognizing that the true point of personation is in fact a fair bit later.

Spontaneous Abortions and False Beliefs

Colin Farrelly introduces Toby Ord on Spontaneous Abortion:

The embryo has the same moral status as an adult human (the Claim). Medical studies show that more than 60% of all people are killed by spontaneous abortion (a biological fact). Therefore, spontaneous abortion is one of the most serious problems facing humanity, and we must do our utmost to investigate ways of preventing this death — even if this is to the detriment of other pressing issues (the Conclusion).

The Conclusion is clearly false, so we should likewise reject the Claim. (This is effectively just a real-life version of the 'fire in a fertility clinic' case.) Reflection on these cases reminds us that embryonic death is not a significant intrinsic bad, in stark contrast to the deaths of mental persons. So the crudest pro-life positions, which affirm the above quoted 'Claim', cannot survive reflection. I know some abortion opponents are unimpressed by the above considerations though, so I'd like to explore how (or whether) a more sophisticated pro-life position might remain tenable.

In other words: might there be non-value-based reasons to oppose abortion (reasons that do not depend upon the false assumption that embryonic death is a bad thing)? Consider the analogy of lying, or intentionally causing false beliefs, and how the immorality of this is unaffected by the unproblematic ubiquity of 'spontaneous false beliefs'. It is extremely common for people to acquire false beliefs, and while there may be some instrumental reason to remedy this when possible, it's not usually a big deal. Lying, however, may well be -- not because it brings about anything bad or harmful, but because the act itself is disrespectful -- an inappropriate way of interacting with a fellow human being.

I guess one might attempt to make a parallel case against abortion: though embryonic death is harmless in itself, the very act of abortion [typically? occasionally?] expresses an inappropriate disrespect for the sanctity of human life. A virtuous person wouldn't have one. Or something like that. (Personally, I don't see any reason to respect 'human life' as such, rather than the actual people who matter.)

This strikes me as the strongest pro-life position one could reasonably hold. (Any counterarguments?) So it's worth noting just how moderate it is. Hilzoy, in a post exemplifying this view, compares having an abortion to cutting up a corpse. Neither is the sort of thing one should do for frivolous reasons ('just for fun'). But there may well be non-frivolous reasons which could justify such action. Since the moral issue is wholly a matter of respect and symbolism, not actual consequences, it all comes down to the motives of the agent, and how they conceived of their action. As such, it become extremely difficult on this view to insist that all such actions ought to be prohibited as a matter of law.

Abortion Vetoes

It's uncontroversial that women should not be forced to have abortions against their will. For one thing, this follows from a general right of veto against invasive medical procedures. But we may also think there is a second reason, namely that it would be a great harm to a prospective mother to kill her cherished "unborn child" (her "baby", as she thinks of it), and all her plans for their future together -- plans which may have taken on a central role in her life story and 'identity' as she conceives of it.

This second reason would also seem to apply to the prospective father, though perhaps in a slightly muted fashion. The father is not so intimately acquainted with his "unborn child" -- though if he has felt its kicks through its mothers belly, seen ultrasound images of its little fingers and toes, or even simply observed the growing bulge over the weeks and months of pregnancy, such experiences might conceivably nourish the initial blossoming of paternal love and attachment. I'm unsure how significant an effect this is likely to have, though. Perhaps the greater impact, for the father, is at the level of abstract knowledge: that there exists a particular little human organism that, if properly nourished and protected, will grow into his future son or daughter. It is easy to understand a prospective father investing a great deal of meaning and significance in this fact, and thus feeling harmed - even violated - if he is unable to protect his unborn child--if others terminate it against his will.

Does this then also justify granting a paternal right of veto against abortion? It is some reason in favour, at least, but it may be outweighed by considerations of the unhappy mother's bodily autonomy. What do you think?

Is Sex Selection Desirable?

Here's an odd quote (ht) from an Australian bioethicist:

"I don't think we're seriously looking at a world of only girl children just yet, but I do think that when philosophers start talking about using medical technology to achieve things that aren't about health, so increasing people's IQ or life expectancy for example, you have to ask why we shouldn't all be girls," he said.

Why do you have to ask that?

"There are significant restrictions on the opportunities available to men around gestation, childbirth, and breastfeeding, which will be extremely difficult to overcome via social or technological mechanisms in the foreseeable future. Women also have longer life expectancies than men," he said.

Increased life expectancy would be nice, for sure. I'm not so sold on childbirth, etc., especially when you factor in the whole menstruation thing. (Sounds more like a net negative, if anything.) So it's not at all clear to me that being a particular sex is an advantage in the way that increased IQ, life expectancy, etc., are. (I would wish high IQ on my future children; I wouldn't wish any particular sex on them -- I'm sure they could do perfectly well with either.) Am I missing something?

Apart from intrinsic costs and benefits to selecting a particular sex for one's child, there's also the social milieu to consider. The more of one sex in the general population, the greater the benefit to being of the opposite sex (assuming we haven't also designed out heterosexuality). Some in China are just beginning to notice this.

Finally, apart from individual costs and benefits, we might consider the interests of humanity at large. See 'Gender as Cultural Specialization'. Even if women do better on average, the greater variability in men might make their extinction a notable loss to society at large (assuming the benefit of having more geniuses outweighs the costs of all those delinquents). What do you think?

Annulment and the Essence of Marriage

How curious:

A French court has overturned an order annulling the marriage of a French Muslim woman who is accused by her husband of lying about being a virgin... Under the French civil code, a marriage can be annulled if a spouse has lied about an "essential quality" of the relationship.

I guess that makes sense. But it raises an interesting philosophical question: what determines the 'essential qualities' of a relationship? It would seem to largely depend upon mutual expectations. Though that's not quite right: one might have bizarre and baseless expectations, after all, and it's at least conceivable that both partners might - by sheer coincidence - fall into the same delusion that some X was central to their relationship, even when there's not any reason why this would be so (they've never even discussed X, it's not a common norm in their culture, etc.). So X might thereby be a mutual expectation in some (purely descriptive) sense, even though there's no way it could really be a norm governing their relationship. So we should revise this account to instead say that the 'essential qualities' of the relationship are determined by what would be reasonable expectations for all involved -- and not just any old epistemic expectation, but a reasonable belief about the internal standards or norms of the relationship.

To bring out the intuition that annulment is appropriate in such a case, suppose one's fiance has deceived you about their sex. You get married, and only later discover - to your surprise - that yours was actually a gay marriage (supposing this is legal). This would seem reasonable grounds for annulment (at least against our cultural background -- you might imagine a society where this wouldn't be considered significant): the 'marriage' lacked informed consent in a relevant respect - this isn't the kind of relationship you thought it was - and so should be considered void.

Are there any constraints on the substantive content of such norms? I don't see why there should be. It's possible to have perverse relationships, governed by bad or inappropriate norms. (The conservative norm of virginity seems such an example. We may disapprove, but I don't think we can very well deny that virginity really was a precondition for the marital relationship as the man in this case understood it. We might similarly imagine a norm of 'blue blood' governing aristocratic marriages, such that faked royalty might be grounds for annulling a royal wedding. You might even have racist norms governing the relationships between KKK members, I suppose.)

A further interesting question is whether the relevant norms can be peculiar to the individual couple, or whether they must be based on broader cultural norms. Suppose that instead of virginity, the man confessed a comparably inane obsession, say with blonde hair. After the wedding, he learns that his bleached spouse had lied to him about being a natural blonde. Could that possibly be grounds for annulment? That seems weird. But maybe the problem is not so much the unshared nature of his peculiar obsession, but rather its free-floating status in his worldview. Perhaps if blondeness was tied to other peculiar beliefs and practices of his, so that investing it with such significance would be somewhat more comprehensible, then we would be more sympathetic.

Any thoughts?

P.S. The original article reports some bizarre objections to the original annulment ruling. Conservative politicians claimed the ruling was somehow "incompatible with France's secular principles" -- as if secularism meant you weren't allowed to recognize the different norms and values that define different people's relationships? Or, even weirder:

The Lille court's decision has also angered feminists who say it amounts to a fatwa against women's liberty... Feminist groups said they were ashamed to see the ruling adding it would allow men legally to reject women on the grounds they were not virgins.

Can anyone make sense of this? The freedom to deceive someone into marrying you under false pretenses is not, I would have thought, a principle of "women's liberty" worth defending.

Defining (Gender) Dysfunction

Helen drew my attention to a fascinating NPR story on transgender children: young boys who desire to wear dresses, and more generally self-identify as girls. One psychologist (Zucker) recommends trying to socialize them out of it -- take away their dolls and dresses, and pressure them to act more like boys. Another (Ehrensaft) is more liberal, suggesting that it's a non-issue, and children should feel free to develop however they're inclined, so long as it isn't causing other - real - problems. The article notes:

This divide is so intense that there is very little common ground. There is little common ground even in the ways that the issue is conceptualized.

Sounds like a call for philosophy! Only, there's not much room for pure (a priori) ethical theory here. It's clear enough that we should prefer whatever will best serve the interests of the child, and help them to grow into a happy, well-adjusted adult. So it's really an empirical issue: what are the consequences of the two approaches likely to be? How burdensome is it to grow up transgendered, and how does this compare to Zucker's coercive therapy? (Might the cure be worse than the "disease"?)

Any remaining philosophical dispute lies more in what we might call the philosophy of psychiatry, concerning what counts as a mental "disorder", in contrast to "normal" human variation. Ehrensaft likens transgenderism to such "natural" variations as homosexuality, whereas Zucker compares it to racial identity disorder:

If a black kid walked into a therapist's office saying he was really white, the goal of pretty much any therapist out there would be to make him try to feel more comfortable being black. They would assume his mistaken beliefs were the product of a dysfunctional environment — a dysfunctional family or a dysfunctional cultural environment that led him or her to engage in this wrongheaded and dangerous fantasy. This is how Zucker sees gender-disordered kids. He sees these behaviors primarily as a product of dysfunction.

This strikes me as badly confused. Presumably a disorder is to be defined as that which tends to impede one's living a flourishing life. But that's an entirely forward-looking dispositional property; it does not matter how it came about, so this talk of "products of dysfunction" seems confused and irrelevant. Indeed, given a sensible forward-looking conception, it's not clear why adopting a different ethnicity must be a "disorder" at all. (It's not like losing a limb.)

Maybe the thought is that the expressed desire is actually just a symptom of some more deep-rooted unhappiness or self-loathing, which would survive the desired change and cause more psychological problems down the road? That would be an intrinsic or internal problem. Alternatively, one might think that the desire is problematic purely for extrinsic, situational reasons, e.g. if one lives in a community of Xs, the desire to be not-X might make it more difficult for you to flourish in this particular context. This appears to be at least part of Zucker's objection:

He explained that unless Carol and her husband helped the child to change his behavior, as Bradley grew older, he likely would be rejected by both peer groups. Boys would find his feminine interests unappealing. Girls would want more boyish boys. Bradley would be an outcast.

But there's nothing inherently wrong with outcasts. ('Misfit' is a relative term, remember!) The problem is with the society which doesn't accept or accommodate them. So it's really just the social stigma we should be worried about. But then I wonder why Zucker rejects the homosexuality analogy?

A final possibility is that he thinks it is a disorder in virtue of resting on false beliefs, or an inaccurate conception of the situation (in some sense). The black child who wants to be white may have internalized false beliefs about the inherent inferiority of blacks which explain (away) his preference. We may hold that preferences based on false beliefs lack normative weight and fail to qualify as 'true values', so it is better to change the misguided preference than to cater to it. But this normative principle isn't obviously true: we cater to poor taste and religious preferences all the time. Sometimes it's a better idea to just go with the flow rather than to insist on improving people.

But the point is moot because it doesn't seem that transgender-inclined children have false beliefs in any case. They don't, so far as I'm aware, believe that their birth sex is objectively "inferior" or anything like that. They just feel more drawn to the gender norms of the opposite sex. They're not making any error. So, again, I think Zucker's stance doesn't stand up to scrutiny.