3 ms·

It saddens me to see politicians deny patients life-saving treatments on the basis that it will score political points with their base. It’s unjust, immoral, an

It saddens me to see politicians deny patients life-saving treatments on the basis that it will score political points with their base. It’s unjust, immoral, and unscientific. I feel for what the queer community - and in particular the trans community - in the UK has been put through in recent years. It shouldn’t have to be this way.

cempaka 3y ago
The evidence that pre-pubertal HRT (which can lead to lifelong impaired sexual function) and sex reassignment surgeries are "life saving" is extremely flimsy, which is part of why Europe is making this change.
- maxerickson 3y ago
  The New York Times article calls it a "big shift". There's less than 100 young people taking puberty blockers in England: https://www.cbc.ca/news/health/england-national-health-service-puberty-blockers-minors-1.7142300 https://www.cbc.ca/news/health/england-national-health-servi...
  - 000ooo000 3y ago
    >There's less than 100 young people taking puberty blockers in England <100 "prescribed by the NHS". FTA, there's a distinction made re. private prescription. I'm not in the UK so I can't say for sure if this means that there is an unknown number of individuals prescribed puberty blockers privately, plus the <100 via the NHS.
- yoshuaw 3y ago
  Note that this article focuses largely on puberty blockers. These are not the same as hormone replacement treatments or surgeries. The best way to describe puberty blockers is as a way to buy time to make decisions before the irreversible changes of puberty set in. They facilitate the deliberate, conscious decision-making everyone agrees on is important here. The benefits of puberty blockers are well-documented and not hard to find. Here is a recent study of 20.000 trans folks aged 18-36 [1]. Those with access to puberty blockers had significantly better outcomes than their peers who didn’t. When factoring in the statistics about ideation, “life-saving” is undoubtably the right term to use. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/
  - IlIlIllI 3y ago
    https://cass.independent-review.uk/home/publications/final-report/ https://cass.independent-review.uk/home/publications/final-r... "Given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development."
    - yoshuaw 3y ago
      This is the same report which is happy to make claims such as: “For many centuries transgender people have been predominantly trans females", and then leaves it as an exercise to the reader to divine how they arrived at that. The entire report is full of similar claims and does not seem to meet the bar we have for peer-reviewed science. This is the same report cited by the linked article. It will take time to review the entire 300 page report, but as it stands it seems unlikely it will hold up to scrutiny over time.
      - IlIlIllI 3y ago
        Does it really matter if this small piece of background information is unsourced? A historical treatment of trans identity isn't the focus of the report. Seems like rather an irrelevant criticism to be honest. I don't quite understand why you believe this to be a problem, or why you think this somehow undermines the rest of the work.
    - yoshuaw 3y ago
      It did not take long for the claims the report makes to begin to unravel on closer analysis. The TransActual briefing on the Cass report [1] covers a lot of ground very succinctly, including the poor quality of supporting evidence for the claims the report makes on puberty blockers: > The Cass Report reveals that it discarded huge amounts of medical evidence, both from the UK and across the world. Out of 102 studies into puberty blockers and hormones, only 2 were included by the Cass Review team. > Further, the Report criticises the quality of evidence that WPATH (the international body which develops and monitors standards in trans healthcare worldwide) relies upon. No international evidence was considered good enough. > Many, if not most, of these exclusions are on the basis of the studies not including 'blinding' and a control group, which would be not only an unethical approach to research but also practically impossible due to the clear impacts of either puberty blockers or hormones on the patients. > In November 2022, WPATH rejected criticism around the lack of evidence around puberty blockers, stating that most of the evidence included the effects of other medication and interventions and that this was appropriate, and found that puberty blockers did have a beneficial effect for trans young people. This was ignored by the Review Team and by NHS England. For a long-established international medical standards body to simply be ignored is highly concerning. [1]: https://transactual.org.uk/wp-content/uploads/TransActual-Briefing-on-Cass-Review.pdf https://transactual.org.uk/wp-content/uploads/TransActual-Br...
IlIlIllI 3y ago
The report is very clear that the claim of these being "life-saving treatments" is unsupported by evidence. Subjecting children to such serious medical interventions should be evidence led, not ideologically driven.
- throwiforgtnlzy 3y ago
  Creating an impossible barrier by vague demands of evidence for when someone knows they don't want to be their assigned/apparent gender. I don't see how you can argue with someone after they've passed the hurdle of it not being a phase throw extensive counseling and parental interviews, but that they truly would be more comfortable living as another biological variant. It's unlikely to be strictly healthier long term because of the vast differences in X and Y chromosomes, epigenetic interactions, and drastic shifts in hormones, but that's better than someone killing themselves or suffering without the quality of life they could have if they weren't denied.
  - IlIlIllI 3y ago
    It is not a "vague demand" for evidence. Please see the Methodology section of the final report of the Cass Review for the detail of what is considered evidence-based medicine, both generally and within the context of the review: https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf https://cass.independent-review.uk/wp-content/uploads/2024/0... > but that's better than someone killing themselves or suffering without the quality of life they could have if they weren't denied. Again, there isn't sufficient evidence to support this ideological viewpoint.
    - throwiforgtnlzy 3y ago
      > Again, there isn't sufficient evidence to support this ideological viewpoint. People dying and suffering is evidence enough. Disingenuous analysis paralysis to impose an authoritarian worldview on others. Nice try, but you're not fooling anyone. Good luck to you.
      - 3y ago

cempaka 3y ago

The evidence that pre-pubertal HRT (which can lead to lifelong impaired sexual function) and sex reassignment surgeries are "life saving" is extremely flimsy, which is part of why Europe is making this change.

maxerickson 3y ago
The New York Times article calls it a "big shift". There's less than 100 young people taking puberty blockers in England: https://www.cbc.ca/news/health/england-national-health-service-puberty-blockers-minors-1.7142300 https://www.cbc.ca/news/health/england-national-health-servi...
- 000ooo000 3y ago
  >There's less than 100 young people taking puberty blockers in England <100 "prescribed by the NHS". FTA, there's a distinction made re. private prescription. I'm not in the UK so I can't say for sure if this means that there is an unknown number of individuals prescribed puberty blockers privately, plus the <100 via the NHS.
yoshuaw 3y ago
Note that this article focuses largely on puberty blockers. These are not the same as hormone replacement treatments or surgeries. The best way to describe puberty blockers is as a way to buy time to make decisions before the irreversible changes of puberty set in. They facilitate the deliberate, conscious decision-making everyone agrees on is important here. The benefits of puberty blockers are well-documented and not hard to find. Here is a recent study of 20.000 trans folks aged 18-36 [1]. Those with access to puberty blockers had significantly better outcomes than their peers who didn’t. When factoring in the statistics about ideation, “life-saving” is undoubtably the right term to use. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/
- IlIlIllI 3y ago
  https://cass.independent-review.uk/home/publications/final-report/ https://cass.independent-review.uk/home/publications/final-r... "Given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development."
  - yoshuaw 3y ago
    This is the same report which is happy to make claims such as: “For many centuries transgender people have been predominantly trans females", and then leaves it as an exercise to the reader to divine how they arrived at that. The entire report is full of similar claims and does not seem to meet the bar we have for peer-reviewed science. This is the same report cited by the linked article. It will take time to review the entire 300 page report, but as it stands it seems unlikely it will hold up to scrutiny over time.
    - IlIlIllI 3y ago
      Does it really matter if this small piece of background information is unsourced? A historical treatment of trans identity isn't the focus of the report. Seems like rather an irrelevant criticism to be honest. I don't quite understand why you believe this to be a problem, or why you think this somehow undermines the rest of the work.
  - yoshuaw 3y ago
    It did not take long for the claims the report makes to begin to unravel on closer analysis. The TransActual briefing on the Cass report [1] covers a lot of ground very succinctly, including the poor quality of supporting evidence for the claims the report makes on puberty blockers: > The Cass Report reveals that it discarded huge amounts of medical evidence, both from the UK and across the world. Out of 102 studies into puberty blockers and hormones, only 2 were included by the Cass Review team. > Further, the Report criticises the quality of evidence that WPATH (the international body which develops and monitors standards in trans healthcare worldwide) relies upon. No international evidence was considered good enough. > Many, if not most, of these exclusions are on the basis of the studies not including 'blinding' and a control group, which would be not only an unethical approach to research but also practically impossible due to the clear impacts of either puberty blockers or hormones on the patients. > In November 2022, WPATH rejected criticism around the lack of evidence around puberty blockers, stating that most of the evidence included the effects of other medication and interventions and that this was appropriate, and found that puberty blockers did have a beneficial effect for trans young people. This was ignored by the Review Team and by NHS England. For a long-established international medical standards body to simply be ignored is highly concerning. [1]: https://transactual.org.uk/wp-content/uploads/TransActual-Briefing-on-Cass-Review.pdf https://transactual.org.uk/wp-content/uploads/TransActual-Br...

IlIlIllI 3y ago

The report is very clear that the claim of these being "life-saving treatments" is unsupported by evidence. Subjecting children to such serious medical interventions should be evidence led, not ideologically driven.

throwiforgtnlzy 3y ago
Creating an impossible barrier by vague demands of evidence for when someone knows they don't want to be their assigned/apparent gender. I don't see how you can argue with someone after they've passed the hurdle of it not being a phase throw extensive counseling and parental interviews, but that they truly would be more comfortable living as another biological variant. It's unlikely to be strictly healthier long term because of the vast differences in X and Y chromosomes, epigenetic interactions, and drastic shifts in hormones, but that's better than someone killing themselves or suffering without the quality of life they could have if they weren't denied.
- IlIlIllI 3y ago
  It is not a "vague demand" for evidence. Please see the Methodology section of the final report of the Cass Review for the detail of what is considered evidence-based medicine, both generally and within the context of the review: https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf https://cass.independent-review.uk/wp-content/uploads/2024/0... > but that's better than someone killing themselves or suffering without the quality of life they could have if they weren't denied. Again, there isn't sufficient evidence to support this ideological viewpoint.
  - throwiforgtnlzy 3y ago
    > Again, there isn't sufficient evidence to support this ideological viewpoint. People dying and suffering is evidence enough. Disingenuous analysis paralysis to impose an authoritarian worldview on others. Nice try, but you're not fooling anyone. Good luck to you.
    - 3y ago