Imagine a group of powerful, well-connected anorexics gather and formulate a plot to reject the psychiatric framing of anorexia and turn their illness into a healthy identity. They make it discrimination and bigotry to call anorexia a mental disorder and frame access to liposuction and Ozempic as medically necessary and a human right. The whole world goes along with this. In the field of anorexia-affirming care, an anorexic receives immediate affirmation of her anorexic identity and unfettered access to the weight-loss medical treatments that her disorder demands. No psychotherapeutic attempt is made to loosen the grip of the belief. Then, instead of measuring success by objective outcomes such as physical health and quality of life, researchers in the field opt for self-report: in other words, after giving the anorexic the very treatments that her disorder compels her to seek, the researchers ask her if she is happy. When she says yes, this confirms that Ozempic and liposuction are beneficial and appropriate treatments for anorexia. That is the medical world’s current approach to managing the trans phenomenon. Read how this madness happened in my first essay of @Genspect’s REPATH series