Otherkin

Randal Rauser Mod  James Anderson • 

"The question is whether acceding to a *specific kind* of request ... reinforces a person's false self-perception."

One can have morally sufficient reasons for reinforcing a person's false self-perception. For example, if you're interacting with an Alzheimer's patient in a care facility who believes he's a fifteen year old boy living on the farm, the ethical response is to agree with his false self-perception because challenging that perception would lead to greater harm.

That's ingenious but it depends on the example:

i) I doubt the transgendered are any one thing. Some people genuinely suffer from that psychotic disorder. Some impressionable people (mostly adolescent girls) have been swept up in a social contagion. In many cases, gender dysphoria naturally resolves itself. Some people are gaming the system. Claiming to be trans instantly elevates their social status. 

ii) Sure, there are people with incurable conditions we need to accommodate. But the degree of accommodation varies. Take doping adolescent with puberty blockers. That does irreparable damage to their physical (and psychological) maturation. Adolescence is an irreversible phase in the life cycle. Not to mention sex change operations, which are even more harmful. 

A better comparison would be body dysmorphic disorder. Does Rauser think surgeons should amputate perfectly healthy, functional body parts to accommodate their delusion?

iii) To take another example, if someone suffers from lycanthropy, should they be allowed roam naked in the woods year round, where they are likely to die from hunger, thirst, infection, or exposure since they lack the natural equipment and survival skills of a real wolf? Or should they be committed to a secure mental institution for their own good?