My "anon account" tweet seems to be really setting things off. I'm going to mute that thread and dive in. Feel free dive in too if you're interested.

First, let's talk about what "problematic" means and doesn't mean. It means that it has problems within.../1

Problematic doesn't mean "all problem" or even "mostly problem". It means that the issue itself has problems.

I actually find that some of the most perplexing, problematic issues occupy a lot of my thinking. Diving into nuance is what i do, generally.

/2

Example from my expertise:

Suicide media messages. (positive messages good, but constructing them is hard without doing some harm).

Respecting autonomy within suicidality (autonomy of moment vs global).

Predicting risk is problematic. (>99% at ultra-high risk survive)

/3

Problematic means that the issue itself has problems. Some solvable, some perhaps not.

So this is how I see internet anonymity.

/4

What are the benefits to anonymity:
* Freedoms (persecution, threat, repercussion, expression)
* Ability to create/project an identity
* Social liberation
* Many others!

Because of these, for the person who selects anonymity, they could be doing so for *excellent* reasons.

/5

However, anonymity also brings problems:
* Freedom from repercussion / persecution can be a problem here!
* Fabrication
* Impersonation
* Lack of responsibility/accountability

Because of this, people could choose anonymity for **very bad reasons**.
/6

I've been on the for 30 years.

People have both been using for benefit and abusing for harm anonymity for the entire duration.

Due to the nature of anonymity, it's impossible for anyone else judge the reason for anonymity. Because we have no verifiable information.

/7

So, absolutely, people in power dynamics in which they are in threat have a substantial reasons to be anonymous. People who are marginalized. People who wish to share personal details that they couldn't otherwise. Countless other scenarios. Racism. Transphobia. Stalkers.

/8

If you are an anonymous account and felt my tweet was judging you, first, I'm sorry. I shouldn't have generalized something so nuanced in a small tweet. Second, I'm not. I can't. I have many friends follows and followers who are anon on the nets.

/9

On the other hand, I struggle very much with the *problems* (the problematic nature) of medtwitter anonymity. I have personal knowledge of significant abuses of anonymity. Some that I will never share or go further detail into, that are currently ongoing, and I witness harm. /10

(quick aside, my "anon tweet" was scheduled weeks before it was published, after I found out information that was horrific and frustrating. I didn't want to draw attention to it, so I scheduled it for a random # of days away from the incident.)

/10.5

I appreciate nuanced views, not simplistic ones, so my tweet was a mistake. I felt followers who have seen my pvs threads on the topic would understand. But it went further and a whole bunch of people see one tweet and think that I'm saying "anon accounts suck"

/11

For me, it's "beyond problematic" because I feel it's unsolvable. I can't come to terms with it, nor comprehend the solutions.

So yes, anonymous medtwitter accounts are nuanced and beyond problematic. They are both necessary and can cause benefit and harm.

/12

My advice:
* Never assume a person on the internet is who they say they are (named or not)
* Be careful befriending anon users, there are many bad actors currently in our space
* If you're anon, and you use your anonymity to attack others, you're part of the problem.

/Fin