5 ms·

> “Estrogen is not a treatment for ODD. I can’t be more emphatic about that,” McGough said. “You won’t find a reference anywhere that supports the use of estrog

> “Estrogen is not a treatment for ODD. I can’t be more emphatic about that,” McGough said. “You won’t find a reference anywhere that supports the use of estrogen for ODD.” Well certainly the doctor got this theory from someplace. They believed this young man would be better behaved if he had less testosterone and more estrogen, and went ahead with a treatment against scientific evidence (and ethics quite frankly). So where did the doctor get this theory? Let's ask ourselves that question, and follow up with this question: what other theories are medical and science professionals getting that aren't science based?

OminousWeapons 6y ago
Probably many, but that's not really the problem. We want people to be developing and appropriately testing theories. What we don't want is: * Treating people against their will outside of specific extreme circumstances which this was not one of * Coercing vulnerable populations into treatment * Concealing treatment plans from guardians * Treating in a manner that is not in line with evidence based practice * Treating in a manner that is not designed to advance the patient's well-being but is instead designed to pacify the patient for another person's convenience * Running what amount to illegal clinical trials that have not been validated for medical and ethical soundness, safety, and legitimacy by a medical oversight board * Insurance fraud (I don't know how payments work in correctional facilities, but generally speaking there is zero probability this treatment plan would result in reimbursement from an insurer. I would naively assume they lied about what they were doing for reimbursement) As a healthcare practitioner, behavior like this makes me sick. The legal system should open up on this guy with all they've got.
- deleted 6y ago
  [deleted]
hexo 6y ago
(deleting because of not funny unwise comment)
- dang 6y ago
  If you post like this here again we will ban you. Adding a nationalistic flamewar to what is already a gender flamewar is either arson or criminal negligence. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - hexo 6y ago
    I am sorry about that. It haven't been thought in a 'nationalistic flamewar' sense or anything like that, text didnt really carry it. So again, sorry.
    - dang 6y ago
      Appreciated.
floatingatoll 6y ago
Your unspoken assumption is that "treatment" was a primary goal at all. Here, I would consider if "treatment" is instead the weapon of choice used in service of the actual goal: to brutalize one person so severely that it causes others to sit silently in fear, rather than stand up and speak out. "This boy was super aggressive towards me, a doctor! so I must punish him for that transgression against me, a doctor! and ensure that I make an example of him! I have just the thing, I'll humiliate him by making him into a girl! I'll lose my license, but it's worth it because I'll be remembered forever as the boogeyman in every juvey in the country!"
Damorian 6y ago
Not to defend the doctor, but common sense? Sex hormones obviously have a huge effect on behavior, and anyone who has interacted with both men and women can see these effects. I'll refer you to the following study to answer your question about "non-science based theories and treatments": https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094
- ashleyn 6y ago
  Not that I think "oppositional defiant disorder" is even a sound classification to begin with, but the lawyer's assertion that estrogen is not an accepted or common treatment for males with ODD is spot on. This was done solely with the intent to harm, by offending a deep and fundamental aspect of the person in question.
- qtplatypus 6y ago
  However “Common sense” is often wrong. That is why you can’t treat people based on whatever hunch you have. Also you would hope that common sense and basic medial ethics would make you avoid violating the Nuremberg code.
ashleyn 6y ago
There is no "theory". This is a sickening attempt at using a farcical medical diagnosis to ruin the entire life of a prisoner, even worse, a youth prisoner. History is littered with examples of lobotomies and chemical pacifiers being used to control "oppositional defiant" prisoners. A doctor with medical credentials would know far better than anyone else, the foundational and fundamental damage done to someone with induced gender dysphoria, the practical effect of giving an ordinary man estrogen. This is psychopathic behaviour that has become all too routine in our national prison complex.
bzb3 6y ago
It certainly worked, no? https://news.ycombinator.com/item?id=23864426 https://news.ycombinator.com/item?id=23864426
- arp242 6y ago
  That's a rather strange definition of "worked".
auganov 6y ago
> and went ahead with a treatment against scientific evidence Despite a lack of scientific evidence not against. Don't think this has been tested and disproved in a scientific manner. And for ethical reasons probably won't be. A relationship between male hormones and aggressive behavior while sometimes questioned is generally well supported. Yes that's not ODD but one can easily see the train of thought here. What the doctor did is obviously very unethical and wrong (if the story is true) But it certainly doesn't seem like a random out-of-nowhere idea to me. Seems equally likely to me that the doctor was unethically treating based off own untested hunches as it is that it was a purely sadistic action.
- belorn 6y ago
  > A relationship between male hormones and aggressive behavior while sometimes questioned is generally well supported. That a relationship exist is well supported. The cause and effect, as per more modern research, however is one that more recent (ie > last 30 years) has found to be quite different than previous assumptions. Throw in a random number of test subjects in a room, observe aggressiveness, and then measure testosterone and you get a clear pattern. Now change the test by first measuring the testosterone and then observe aggressiveness, and the data is all over the place. The part that more modern research is questioning is not that the relationship does not exist, but rather in what direction the arrow points. Can behavior effect hormone secretion? More and more data seem to support that very theory.
  - collyw 6y ago
    Aggressive dogs get their balls cut off and it seems to work. Would there be a reason to assume that it doesn't work in humans in a similar way?
    - belorn 6y ago
      Yes, because they tried that in the past on violent criminals back in the less ethical days. They also tried cutting out the Amygdala and nearby parts of the brain. The result was not great for either. The more aggressive an individual were the smaller the effect is. Testosterone also get secreted by other areas of the body so you also need to add suppressive drugs for that. Biggest effect was measured by chemically removing testosterone for women as they have the smallest amount to begin with. Going from above average testosterone in men to below average gave no results. Castrating the most violent criminal, usually against their will, has some studies showing minor results while others no results. There is something called the challenge hypothesis. The theory is that testosterone acts as a modulating effect for managing social status. When an individual suddenly gain status the body reacts by secreting testosterone. Testosterone in turn regulate how much energy an individual will spend on behavior to retain that status. For animals that gain and maintain status by exclusively aggression, this then correlate nicely with testosterone. Reducing a male dogs testosterone would reduce the amount of effort they will spend to defend their status against other male dogs, and since dogs are very territorial, there is ample of opportunities where such behavior occurs. However for very aggressive dogs the effect will be much smaller, so its not a solution in those cases and the solution instead tend to be euthanasia. Social status for humans is massively more complex, and the relation to violent crime even more so.
deleted 6y ago
[deleted]

OminousWeapons 6y ago

Probably many, but that's not really the problem. We want people to be developing and appropriately testing theories. What we don't want is: * Treating people against their will outside of specific extreme circumstances which this was not one of * Coercing vulnerable populations into treatment * Concealing treatment plans from guardians * Treating in a manner that is not in line with evidence based practice * Treating in a manner that is not designed to advance the patient's well-being but is instead designed to pacify the patient for another person's convenience * Running what amount to illegal clinical trials that have not been validated for medical and ethical soundness, safety, and legitimacy by a medical oversight board * Insurance fraud (I don't know how payments work in correctional facilities, but generally speaking there is zero probability this treatment plan would result in reimbursement from an insurer. I would naively assume they lied about what they were doing for reimbursement) As a healthcare practitioner, behavior like this makes me sick. The legal system should open up on this guy with all they've got.

deleted 6y ago
[deleted]

hexo 6y ago

(deleting because of not funny unwise comment)

dang 6y ago
If you post like this here again we will ban you. Adding a nationalistic flamewar to what is already a gender flamewar is either arson or criminal negligence. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- hexo 6y ago
  I am sorry about that. It haven't been thought in a 'nationalistic flamewar' sense or anything like that, text didnt really carry it. So again, sorry.
  - dang 6y ago
    Appreciated.

floatingatoll 6y ago

Your unspoken assumption is that "treatment" was a primary goal at all. Here, I would consider if "treatment" is instead the weapon of choice used in service of the actual goal: to brutalize one person so severely that it causes others to sit silently in fear, rather than stand up and speak out. "This boy was super aggressive towards me, a doctor! so I must punish him for that transgression against me, a doctor! and ensure that I make an example of him! I have just the thing, I'll humiliate him by making him into a girl! I'll lose my license, but it's worth it because I'll be remembered forever as the boogeyman in every juvey in the country!"

Damorian 6y ago

Not to defend the doctor, but common sense? Sex hormones obviously have a huge effect on behavior, and anyone who has interacted with both men and women can see these effects. I'll refer you to the following study to answer your question about "non-science based theories and treatments": https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094

ashleyn 6y ago
Not that I think "oppositional defiant disorder" is even a sound classification to begin with, but the lawyer's assertion that estrogen is not an accepted or common treatment for males with ODD is spot on. This was done solely with the intent to harm, by offending a deep and fundamental aspect of the person in question.
qtplatypus 6y ago
However “Common sense” is often wrong. That is why you can’t treat people based on whatever hunch you have. Also you would hope that common sense and basic medial ethics would make you avoid violating the Nuremberg code.

ashleyn 6y ago

There is no "theory". This is a sickening attempt at using a farcical medical diagnosis to ruin the entire life of a prisoner, even worse, a youth prisoner. History is littered with examples of lobotomies and chemical pacifiers being used to control "oppositional defiant" prisoners. A doctor with medical credentials would know far better than anyone else, the foundational and fundamental damage done to someone with induced gender dysphoria, the practical effect of giving an ordinary man estrogen. This is psychopathic behaviour that has become all too routine in our national prison complex.

bzb3 6y ago

It certainly worked, no? https://news.ycombinator.com/item?id=23864426 https://news.ycombinator.com/item?id=23864426

arp242 6y ago
That's a rather strange definition of "worked".

auganov 6y ago

> and went ahead with a treatment against scientific evidence Despite a lack of scientific evidence not against. Don't think this has been tested and disproved in a scientific manner. And for ethical reasons probably won't be. A relationship between male hormones and aggressive behavior while sometimes questioned is generally well supported. Yes that's not ODD but one can easily see the train of thought here. What the doctor did is obviously very unethical and wrong (if the story is true) But it certainly doesn't seem like a random out-of-nowhere idea to me. Seems equally likely to me that the doctor was unethically treating based off own untested hunches as it is that it was a purely sadistic action.

belorn 6y ago
> A relationship between male hormones and aggressive behavior while sometimes questioned is generally well supported. That a relationship exist is well supported. The cause and effect, as per more modern research, however is one that more recent (ie > last 30 years) has found to be quite different than previous assumptions. Throw in a random number of test subjects in a room, observe aggressiveness, and then measure testosterone and you get a clear pattern. Now change the test by first measuring the testosterone and then observe aggressiveness, and the data is all over the place. The part that more modern research is questioning is not that the relationship does not exist, but rather in what direction the arrow points. Can behavior effect hormone secretion? More and more data seem to support that very theory.
- collyw 6y ago
  Aggressive dogs get their balls cut off and it seems to work. Would there be a reason to assume that it doesn't work in humans in a similar way?
  - belorn 6y ago
    Yes, because they tried that in the past on violent criminals back in the less ethical days. They also tried cutting out the Amygdala and nearby parts of the brain. The result was not great for either. The more aggressive an individual were the smaller the effect is. Testosterone also get secreted by other areas of the body so you also need to add suppressive drugs for that. Biggest effect was measured by chemically removing testosterone for women as they have the smallest amount to begin with. Going from above average testosterone in men to below average gave no results. Castrating the most violent criminal, usually against their will, has some studies showing minor results while others no results. There is something called the challenge hypothesis. The theory is that testosterone acts as a modulating effect for managing social status. When an individual suddenly gain status the body reacts by secreting testosterone. Testosterone in turn regulate how much energy an individual will spend on behavior to retain that status. For animals that gain and maintain status by exclusively aggression, this then correlate nicely with testosterone. Reducing a male dogs testosterone would reduce the amount of effort they will spend to defend their status against other male dogs, and since dogs are very territorial, there is ample of opportunities where such behavior occurs. However for very aggressive dogs the effect will be much smaller, so its not a solution in those cases and the solution instead tend to be euthanasia. Social status for humans is massively more complex, and the relation to violent crime even more so.

deleted 6y ago

[deleted]