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> under-18s > children There’s a major difference between those terms. 16-year-olds are definitely not children anymore. They can get tattoos, piercings, get

> under-18s > children There’s a major difference between those terms. 16-year-olds are definitely not children anymore. They can get tattoos, piercings, get a driving license, drink alcohol, enter into contracts, and get jail time if they commit a crime. And cis and inter children at that age can also commit to bodily changing surgeries, e.g. mastectomy for children with gynecomastia is common and legal. The only legal form of body modification for children below that age are circumcision, which should absolutely not be legal, and surgeries for inter children, which shouldn’t be legal either. How come you consider teenagers making decisions for themselves a risk, but parents letting doctors mutilate the genitals of newborn children is something you entirely ignore? That’s what we should worry about. Then there’s the argument regarding puberty blockers, where you’re citing the cass review, which has to be seen in critical light in general. Puberty blockers, when used for cis children, have been well reviewed and approved in wide studies, with lots of evidence proving their safety. There is no evidence gap there – if they’re safe to delay puberty in cis children, they’re just as safe for the same purpose in trans children.

jl6 4y ago
I sure hope you’re right, but the point is that we just don’t know. Reviews of that evidence have determined it to be low quality: https://www.bbc.com/news/health-56601386.amp https://www.bbc.com/news/health-56601386.amp Read Cass for more details. I also 110% oppose circumcision.
- kuschku 4y ago
  The fact that the consensus differs so heavily between countries where this topic has become a political issue, and countries where it’s not yet become one (e.g., Germany), leads me to suspect these sources are biased. This applies especially to british sources on this topic. The NHS and BBC have become heavily influenced by the Tories in recent years, so I’ll have to question your sources.
  - jl6 4y ago
    I keep mentioning Cass because it is a breath of fresh air in this bitterly polarised subject area, compared to news sources. It is level-headed and compassionate, and I encourage you to try reading it, if you can excuse its Britishness.
    - kuschku 4y ago
      I've read it, but its arguments are still at odds with what's done based on it. e.g., the Cass Review explicitly says "The rationale for use of puberty blockers at Tanner Stage 2 of development was based on data that demonstrated that children, particularly birth-registered boys who had early gender incongruence, were unlikely to desist once they reached early puberty" and only recommends reviewing puberty blockers for AFAB people. Yet your comments and british politics instead call for ending the use of puberty blockers for everyone, including AMAB people (and the recent tavistock case actually accomplished that). Most of the other issues the report finds are entirely local to the UK, due to the way healthcare systems differ heavily between countries, and can't be applied elsewhere. I'll be entirely honest, the british system is an absolute mess and needs to be entirely rebuilt (and any british trans person is going to agree), but just stopping all care entirely for years until a new system exists is the worst possible option, and one that's going to cost countless lives.
  - DanBC 4y ago
    Anti-trans campaigners misunderstand what's meant by "low quality evidence". It just means we don't yet have double blind randomised control trials of certain treatments. But that's to be expected: trans children are rare, we don't put anyone on puberty blockers without very good reason, and withholding PBs is not a neutral act. So running RCTs on this population group is very difficult. See also masks: we're pretty sure that masks work, but the evidence for masking is low quality. Anti-trans campaigners also misrepresent the Cass review. The review has said that taivstock (currently the only provider of specialist care to trans children) isn't very good. (Trans children and their families also say that the tavistock is pretty awful). They then say that this proves the anti-trans argument that no gender affirming care should be provided to trans children. But what Cass has said is that care should be taken out of tavistock and new given to new centres across England who will initiate care and then GPs can be allowed to continue that care -- this is a big expansion of gender affirming care for children, and trans people welcome it. It's what people have been asking for for years. Cass does have some weird anti-trans aspects, but it's certainly not the win that anti-trans campaigners are claiming. And this is a core feature of UK anti-trans campaigning: they're fundamentally dishonest about everything all the time. You should always read the sources they're citing, because they always misrepresent those sources.
- DanBC 4y ago
  This is untrue. Puberty blockers have been in use for trans children for over 40 years now, we have lots of evidence of benefit and lots of evidence that there's not much harm. We don't have randomised controlled trials, but if you don't know why we don't have those maybe you should refrain from commenting until you understand the topic a bit more.
  - eoops 4y ago
    What about detransitioners? Most of those kids grew into adults that have been ruined for life. Knowing this, the risk of giving these drugs to kids to outright block their puberty is just too immense. Not to mention the underage surgeries some of them receive.
    - kuschku 4y ago
      > What about detransitioners? Detransitioners are a tragic case, but they amount of detransitioners compared to all trans people is smaller than the amount of trans people compared to the rest of the population. If taking detransitioners into account is the primary priority of trans healthcare for you, then trans people should be an equal or larger priority in overall healthcare as well. > Not to mention the underage surgeries some of them receive. That's something that's questionable, but it's not that simple either. Cis people doing surgery against gynecomastia is the majority of underage surgeries of this type. > to outright block their puberty It's just paused. It continues as if nothing had happened the moment you stop, with no risk to the patient. Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable. If the Cass Review, a paper that was commissioned to find a way to reject healthcare for trans people, argues it's safe, you can trust it is safe.
      - eoops 4y ago
        > Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable. I've read the Interim Report, it asserts neither of these points.

jl6 4y ago

I sure hope you’re right, but the point is that we just don’t know. Reviews of that evidence have determined it to be low quality: https://www.bbc.com/news/health-56601386.amp https://www.bbc.com/news/health-56601386.amp Read Cass for more details. I also 110% oppose circumcision.

kuschku 4y ago
The fact that the consensus differs so heavily between countries where this topic has become a political issue, and countries where it’s not yet become one (e.g., Germany), leads me to suspect these sources are biased. This applies especially to british sources on this topic. The NHS and BBC have become heavily influenced by the Tories in recent years, so I’ll have to question your sources.
- jl6 4y ago
  I keep mentioning Cass because it is a breath of fresh air in this bitterly polarised subject area, compared to news sources. It is level-headed and compassionate, and I encourage you to try reading it, if you can excuse its Britishness.
  - kuschku 4y ago
    I've read it, but its arguments are still at odds with what's done based on it. e.g., the Cass Review explicitly says "The rationale for use of puberty blockers at Tanner Stage 2 of development was based on data that demonstrated that children, particularly birth-registered boys who had early gender incongruence, were unlikely to desist once they reached early puberty" and only recommends reviewing puberty blockers for AFAB people. Yet your comments and british politics instead call for ending the use of puberty blockers for everyone, including AMAB people (and the recent tavistock case actually accomplished that). Most of the other issues the report finds are entirely local to the UK, due to the way healthcare systems differ heavily between countries, and can't be applied elsewhere. I'll be entirely honest, the british system is an absolute mess and needs to be entirely rebuilt (and any british trans person is going to agree), but just stopping all care entirely for years until a new system exists is the worst possible option, and one that's going to cost countless lives.
- DanBC 4y ago
  Anti-trans campaigners misunderstand what's meant by "low quality evidence". It just means we don't yet have double blind randomised control trials of certain treatments. But that's to be expected: trans children are rare, we don't put anyone on puberty blockers without very good reason, and withholding PBs is not a neutral act. So running RCTs on this population group is very difficult. See also masks: we're pretty sure that masks work, but the evidence for masking is low quality. Anti-trans campaigners also misrepresent the Cass review. The review has said that taivstock (currently the only provider of specialist care to trans children) isn't very good. (Trans children and their families also say that the tavistock is pretty awful). They then say that this proves the anti-trans argument that no gender affirming care should be provided to trans children. But what Cass has said is that care should be taken out of tavistock and new given to new centres across England who will initiate care and then GPs can be allowed to continue that care -- this is a big expansion of gender affirming care for children, and trans people welcome it. It's what people have been asking for for years. Cass does have some weird anti-trans aspects, but it's certainly not the win that anti-trans campaigners are claiming. And this is a core feature of UK anti-trans campaigning: they're fundamentally dishonest about everything all the time. You should always read the sources they're citing, because they always misrepresent those sources.
DanBC 4y ago
This is untrue. Puberty blockers have been in use for trans children for over 40 years now, we have lots of evidence of benefit and lots of evidence that there's not much harm. We don't have randomised controlled trials, but if you don't know why we don't have those maybe you should refrain from commenting until you understand the topic a bit more.
- eoops 4y ago
  What about detransitioners? Most of those kids grew into adults that have been ruined for life. Knowing this, the risk of giving these drugs to kids to outright block their puberty is just too immense. Not to mention the underage surgeries some of them receive.
  - kuschku 4y ago
    > What about detransitioners? Detransitioners are a tragic case, but they amount of detransitioners compared to all trans people is smaller than the amount of trans people compared to the rest of the population. If taking detransitioners into account is the primary priority of trans healthcare for you, then trans people should be an equal or larger priority in overall healthcare as well. > Not to mention the underage surgeries some of them receive. That's something that's questionable, but it's not that simple either. Cis people doing surgery against gynecomastia is the majority of underage surgeries of this type. > to outright block their puberty It's just paused. It continues as if nothing had happened the moment you stop, with no risk to the patient. Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable. If the Cass Review, a paper that was commissioned to find a way to reject healthcare for trans people, argues it's safe, you can trust it is safe.
    - eoops 4y ago
      > Even the Cass Review argues that blockers are entirely safe for AMAB trans people. It also argues that AMAB trans people have such a small percentage of detransitioners that it's basically disregardable. I've read the Interim Report, it asserts neither of these points.