I agree--that the Dems once in power would not only restore funding but also move to reintroduce the Equality Act to give precedence to "gender identity" rather than sex. And given the extent of institutional capture of medical education and professional associations, I think there should at least be a companion initiative to disseminate evidence from the HHS and Cass reviews, develop an explicit consensus(es) if possible, as well as strategies to revise institutional protocols. Other ideas?
I think you have to build the incentives into OSHA, as well as Medicare etc.
You cannot defeat this extortive empathy with:
Better arguments
Better intentions
Better messaging
You defeat it by:
Making non-action measurably unsafe for institutions, and link it to women’s rights for safe workplace; for medicine which is evidence-based (that rule is already in place if I recall with ACA), and aggressive title-IX policy enforcement.
Yes. Large scale businesses are extremely sensitive to OSHA protocols because they are big targets, and insurance requirements are onerous.
Sex-exclusive facilities mandated for health and safety would be a small nuclear bomb. It would only take a single woman seeing a single sex mimic male to bring on a single multi-million dollar claim and penalty. A group of women turns into class action with OSHA.
D&O and EPLI insurance would a compliance path therefore. Or build triple-use facilities - male only / female only / mixed. Retrofit all floors of all leased and owned corporate operating space. Bang.
Social Boundaries normally managed trespass challenges.
Sex mimicry exists partially to intentionally breach those boundaries for sexual gratification under the guise of extortive empathy.
The burden of female privacy loss mimics create is placed on a company (or gym, or sports, or school) and can’t be rejected without high social cost.
The organization typically then diffuses the unwanted burden for privacy onto females to shoulder, having to police their own environments, and assume social costs if they reject it.
Just tip the equation to penalize the organization for diffusing the burden. Employee sex is known, rules to forbid male entry to private female spaces are disseminated, an incident is a fireable offense, incident monitoring is in place.
Just a garden-variety form of sexual harassment, which has all the mechanisms in place for management.
I’m surprised there are not lawsuits already by women for sex discrimination in positioning of male sex mimics in roles, awards and benefits due only to women.
Prima facie.
Protection from abuse by deception by sex mimics will become one of this era’s major women’s rights issues.
Yes, as of now EVERY Democrat in Congress, both House and Senate both, is a CO-SPONSOR of the 2025 Equality Act. (Nominal "independents" Bernie Sanders and Angus King are also co-sponsors.)
It is therefore imperative that the Transqueer Party (formerly known as the Democratic Party) is kept out of full power.
The Senate should be the easiest for the Republicans to hold on to. The House will very likely revert to Transqueer control in 2026, and POTUS in 2028 will be a battle.
With over 70% of Americans opposing/rejecting the gender ideology this may take care of an election issue the Democrats have thus far been too cowardly to address. With this act they can take the moral high ground and say "we oppose a cessation of funding" and when in office they can simply avoid reinstating payments. They have done the same thing with gun control laws. Democrats have had majorities in governance on several occasions but they did little if anything to enact gun control. During election years they blame Republicans and the public buys into it, paying attention to what they say instead of what they do or do not do.
The problem is that there is a very high exit cost currently - socially engineered “extortive empathy”.
However, once exited, the benefit of re-entering is extremely low because the game is made visible, and the risk transfer to insurance liability which bots this.
The cost of not offering is high - social attacks, social engineering
Until the cost of offering is > cost of not offering it can’t be removed.
I’ve been thinking about this for some time.
You can now calculate exactly how expensive extortive empathy is in a context like this.
Interesting to apply the same cost escalation in other contexts….
Considering forcing women to accept men in female-only spaces.
In reality, how do you realign incentives so that institutions bear the cost of failing to provide sex-segregation and allowing sex mimic men to displace women’s needs: instead of offloading it onto individuals via social pressure (“extortive empathy”)?
That problem shows up everywhere regulation exists, and the tools are well known.
First: define the failure mode precisely
“Extortive empathy”
- Moral or reputational pressure is used to block detection
- Institutions avoid action to escape accusations or controversy
- Harm is externalized to:
•Women
•Inmates
•Patients
•Staff
•Statistical integrity
•Costs are diffuse, delayed, and unmeasured
In that equilibrium:
•Doing nothing is cheaper than acting
•Detection becomes irrational behavior for administrators
So escalation must do one thing only:
Make non-detection more expensive than detection.
The governing principle
In regulatory economics:
What gets punished reliably changes faster than what gets debated morally.
You don’t fight empathy narratives directly.
You price the risk correctly.
Category 1: Structural liability transfer (prison example)
Federal decertification / funding leverage
This is one of the strongest tools because it bypasses culture entirely.
Mechanism
Tie certification, accreditation, or federal funding to:
Verified sex classification
Documented segregation protocols
Auditable placement decisions
Effect
Risk shifts from:
“Public backlash if we act”
→ to
“Guaranteed institutional penalty if we don’t”
Why it works
Administrators are optimized to avoid certain loss
Reputational risk is vague; funding loss is concrete
This is why OSHA, CMS, and the DOJ Civil Rights Division work at all.
Category 2: Strict liability for downstream harm
No intent requirement
Harm occurring under ambiguous sex placement = institutional fault
They could, but they lose the backing of the large hospitals with which they are associated and the money pipeline in those institutions. Some might try to go to private clinics, but I think that many of them are going to wait to see if the next president is a Democrat who might reverse policy.
The insurance companies will follow Medicare's lead. They don't want to pay for this crap either. At a minimum they will take RFK Jr's move as a signal that gender medicine is not medically necessary and will stop reimbursing it. So even if a private free-standing clinic and its doctors do no Medicare/Medicaid services, and could therefore survive without that funding, there won't be any insurance reimbursement for the work, either. The clinic would have to survive entirely on out-of-pocket payments from patients. Not very likely unless rich philanthropists are paying for it as "charity" care. Some will, I expect.
I don't know, Leslie. The reality is that some insurance companies own the doctors, the clinics, and hospitals. Example: UnitedHealth Group Inc. Current stock price: $328.14
It hit $600 in April 2025 and is down 35% so far this year. Looks a bit shaky.
The price per share doesn't matter. It's what's happening to the share price that you watch.
Some B.S. from a free stock analysis service:
"Irregularities for medical services began to surface and Department of Justice started to probe about potential Medicare fraud earlier this year. Amid these irregularities, UNH’s former CEO Andrew Witty decided to stepped down and [Stephen] Hemsley took the CEO role." Investors jumped ship.
But you're right. If the ins. co. is the payor as well as the provider, hard to know what the impact will be.
I have believed for the last five years that another thing that will shut this abuse down is when those poor breastless women start winning their lawsuits against those who were parties to their mutilated bodies and wrecked reproductive ability. Follow the money works both ways.
I am thrilled with this action but I’m worried that Dems will reinstate the payments if they return to power.
I agree--that the Dems once in power would not only restore funding but also move to reintroduce the Equality Act to give precedence to "gender identity" rather than sex. And given the extent of institutional capture of medical education and professional associations, I think there should at least be a companion initiative to disseminate evidence from the HHS and Cass reviews, develop an explicit consensus(es) if possible, as well as strategies to revise institutional protocols. Other ideas?
I think you have to build the incentives into OSHA, as well as Medicare etc.
You cannot defeat this extortive empathy with:
Better arguments
Better intentions
Better messaging
You defeat it by:
Making non-action measurably unsafe for institutions, and link it to women’s rights for safe workplace; for medicine which is evidence-based (that rule is already in place if I recall with ACA), and aggressive title-IX policy enforcement.
So, OSHA policy incentive through institutional protocols?
Yes. Large scale businesses are extremely sensitive to OSHA protocols because they are big targets, and insurance requirements are onerous.
Sex-exclusive facilities mandated for health and safety would be a small nuclear bomb. It would only take a single woman seeing a single sex mimic male to bring on a single multi-million dollar claim and penalty. A group of women turns into class action with OSHA.
D&O and EPLI insurance would a compliance path therefore. Or build triple-use facilities - male only / female only / mixed. Retrofit all floors of all leased and owned corporate operating space. Bang.
Social Boundaries normally managed trespass challenges.
Sex mimicry exists partially to intentionally breach those boundaries for sexual gratification under the guise of extortive empathy.
The burden of female privacy loss mimics create is placed on a company (or gym, or sports, or school) and can’t be rejected without high social cost.
The organization typically then diffuses the unwanted burden for privacy onto females to shoulder, having to police their own environments, and assume social costs if they reject it.
Just tip the equation to penalize the organization for diffusing the burden. Employee sex is known, rules to forbid male entry to private female spaces are disseminated, an incident is a fireable offense, incident monitoring is in place.
Just a garden-variety form of sexual harassment, which has all the mechanisms in place for management.
I’m surprised there are not lawsuits already by women for sex discrimination in positioning of male sex mimics in roles, awards and benefits due only to women.
Prima facie.
Protection from abuse by deception by sex mimics will become one of this era’s major women’s rights issues.
Yes, as of now EVERY Democrat in Congress, both House and Senate both, is a CO-SPONSOR of the 2025 Equality Act. (Nominal "independents" Bernie Sanders and Angus King are also co-sponsors.)
It is therefore imperative that the Transqueer Party (formerly known as the Democratic Party) is kept out of full power.
The Senate should be the easiest for the Republicans to hold on to. The House will very likely revert to Transqueer control in 2026, and POTUS in 2028 will be a battle.
With over 70% of Americans opposing/rejecting the gender ideology this may take care of an election issue the Democrats have thus far been too cowardly to address. With this act they can take the moral high ground and say "we oppose a cessation of funding" and when in office they can simply avoid reinstating payments. They have done the same thing with gun control laws. Democrats have had majorities in governance on several occasions but they did little if anything to enact gun control. During election years they blame Republicans and the public buys into it, paying attention to what they say instead of what they do or do not do.
The problem is that there is a very high exit cost currently - socially engineered “extortive empathy”.
However, once exited, the benefit of re-entering is extremely low because the game is made visible, and the risk transfer to insurance liability which bots this.
Great application of game theory.
The cost of not offering is high - social attacks, social engineering
Until the cost of offering is > cost of not offering it can’t be removed.
I’ve been thinking about this for some time.
You can now calculate exactly how expensive extortive empathy is in a context like this.
Interesting to apply the same cost escalation in other contexts….
Considering forcing women to accept men in female-only spaces.
In reality, how do you realign incentives so that institutions bear the cost of failing to provide sex-segregation and allowing sex mimic men to displace women’s needs: instead of offloading it onto individuals via social pressure (“extortive empathy”)?
That problem shows up everywhere regulation exists, and the tools are well known.
First: define the failure mode precisely
“Extortive empathy”
- Moral or reputational pressure is used to block detection
- Institutions avoid action to escape accusations or controversy
- Harm is externalized to:
•Women
•Inmates
•Patients
•Staff
•Statistical integrity
•Costs are diffuse, delayed, and unmeasured
In that equilibrium:
•Doing nothing is cheaper than acting
•Detection becomes irrational behavior for administrators
So escalation must do one thing only:
Make non-detection more expensive than detection.
The governing principle
In regulatory economics:
What gets punished reliably changes faster than what gets debated morally.
You don’t fight empathy narratives directly.
You price the risk correctly.
Category 1: Structural liability transfer (prison example)
Federal decertification / funding leverage
This is one of the strongest tools because it bypasses culture entirely.
Mechanism
Tie certification, accreditation, or federal funding to:
Verified sex classification
Documented segregation protocols
Auditable placement decisions
Effect
Risk shifts from:
“Public backlash if we act”
→ to
“Guaranteed institutional penalty if we don’t”
Why it works
Administrators are optimized to avoid certain loss
Reputational risk is vague; funding loss is concrete
This is why OSHA, CMS, and the DOJ Civil Rights Division work at all.
Category 2: Strict liability for downstream harm
No intent requirement
Harm occurring under ambiguous sex placement = institutional fault
No defense based on “good faith inclusion”
Examples
*Assault in custody
•Pregnancy in prison
•Privacy violations
•Medical harm traceable to sex misclassification
Key feature
Liability triggers on outcome, not motivation
This eliminates:
•Moral argument loops
•HR paralysis
•”We followed guidance” defenses
Category 3: Mandatory classification + audit trails
Make non-classification itself a violation
Instead of arguing what classification should be:
Require that some classification method be chosen
Require it to be:
•Explicit
•Recorded
•Reviewable
Why this matters
Ambiguity becomes noncompliance
“We didn’t ask” becomes sanctionable
Detection becomes bureaucratically safer than avoidance
This is exactly how:
• Financial KYC
• Aviation safety
• Medical triage
• Nuclear safeguards work
Category 4: Personal accountability for decision-makers
Institutions hide behind diffusion of responsibility.
Break that.
Tools
Named sign-off on placement decisions
Professional discipline exposure
Loss of license or certification
Career liability, not just organizational liability
Result
•Risk calculus changes immediately
•”Do nothing” is no longer the safe option
This is why safety-critical industries assign duty officers.
Category 5: Inversion of the burden of proof
Instead of:
“Prove harm occurred”
Shift to:
“Prove adequate detection was performed”
Operationalization
If harm occurs, institution must demonstrate:
•Classification criteria
•Assessment process
•Segregation logic
•Review cadence
Failure = automatic penalty.
This removes:
•Victim burden
•Media-driven adjudication
•Post-hoc moral debate
Category 6: Metrics that surface suppressed costs
What’s invisible stays cheap.
Require reporting of:
*Sex-based incident rates
•Placement changes
•Complaints disaggregated by sex
•Pregnancy, assault, injury data
Key move
Make data absence itself a red flag
Institutions fear published metrics more than ideology.
⸻
Category 7: Parallel protected spaces (exit rather than argument)
Where detection is politically blocked:
Mandate sex-based alternatives
Fund parallel facilities
Require equivalent quality
This:
•Reduces forced-cohabitation risk
•Preserves sex-based safety without surveillance
•Makes refusal costly (duplicated infrastructure)
Why this works better than moral debate
Moral framing:
•Polarizes
•Invites bad-faith interpretation
•Never resolves enforcement
Cost escalation:
•Is boring
•Is technocratic
•Is fast
•Is effective
Biology already solved this:
•Systems that fail to detect parasitism are selected against
•Systems that internalize detection cost survive
Human institutions are no different
One hard truth (worth stating plainly)
You cannot defeat extortive empathy with:
•Better arguments
•Better intentions
•Better messaging
You defeat it by:
Making non-action measurably unsafe for institutions
Once that happens, norms change after incentives do - always.
Review RFKJr’s and Dr Oz’s remarks this morning. The Democrats will just reverse this if/when they are back in control.
This is good news. Thanks Gerald
Thank you, Mr. Posner! Please see J Vee's comment and my reply.
Thank you for covering this all along and for this analysis!!
Couldn't the providers just move to free standing clinics?
They could, but they lose the backing of the large hospitals with which they are associated and the money pipeline in those institutions. Some might try to go to private clinics, but I think that many of them are going to wait to see if the next president is a Democrat who might reverse policy.
The insurance companies will follow Medicare's lead. They don't want to pay for this crap either. At a minimum they will take RFK Jr's move as a signal that gender medicine is not medically necessary and will stop reimbursing it. So even if a private free-standing clinic and its doctors do no Medicare/Medicaid services, and could therefore survive without that funding, there won't be any insurance reimbursement for the work, either. The clinic would have to survive entirely on out-of-pocket payments from patients. Not very likely unless rich philanthropists are paying for it as "charity" care. Some will, I expect.
I don't know, Leslie. The reality is that some insurance companies own the doctors, the clinics, and hospitals. Example: UnitedHealth Group Inc. Current stock price: $328.14
It hit $600 in April 2025 and is down 35% so far this year. Looks a bit shaky.
The price per share doesn't matter. It's what's happening to the share price that you watch.
Some B.S. from a free stock analysis service:
"Irregularities for medical services began to surface and Department of Justice started to probe about potential Medicare fraud earlier this year. Amid these irregularities, UNH’s former CEO Andrew Witty decided to stepped down and [Stephen] Hemsley took the CEO role." Investors jumped ship.
But you're right. If the ins. co. is the payor as well as the provider, hard to know what the impact will be.
I have believed for the last five years that another thing that will shut this abuse down is when those poor breastless women start winning their lawsuits against those who were parties to their mutilated bodies and wrecked reproductive ability. Follow the money works both ways.
Young women like this one: https://lucyleader.substack.com/p/building-resilience-takes-practice need mental health support to come to terms with reality, not "treatments" and "procedures" that don't fix her very real problems.