4 ms·

What isn’t factual in this article? Is it political because it discusses puberty blockers and transgender adolescents?

by abirch 2y ago

leereeves 2y ago
I think GP agrees it is factual. It is also called out in the OP ("contained countless errors and misinterpretations"). So it's a counterexample to the claim "Every piece called out here is clearly labeled 'opinion'"
jl6 2y ago
One part that isn’t factual is the statement on safety of GnRHs which cites their use in treating precocious puberty, which is a completely different indication and treatment (age of treatment, length of treatment, purpose of treatment), and does not consider the impact on psychosexual development, nor consider the impact on desistance of non-trans kids. The “safe and reversible” narrative originates in medical consensus amongst doctors and activists, not evidence from scientific enquiry. The difference between consensus-based medicine and evidence-based medicine eludes most participants in this debate.
- notahacker 2y ago
  The statement regarding precocious puberty is entirely factual, and the statement linking that claim to supplying the same hormones to trans kids is linked to an article containing more detail (including a discussion of possible downsides and links to actual papers). I'd agree wholeheartedly that the difference between consensus and evidence-based medicine eludes most participants in the debate, but frankly that seems to apply far more to the side of the debate whose higher quality analysis is of the form of "it appears the systematic studies the other side have done might exhibit researcher bias, so rather than do our own retrospective on the same research subjects we'll just move for speedy consensus to ban the practice altogether"
  - jl6 2y ago
    It is certainly not factual to claim that a drug which is safe in treatment X (precocious puberty) is also safe in treatment Y (gender dysphoria). The article conflates both as “puberty delaying treatments”, as if the learning from one is completely transferable to the other. It is not. The differences I mentioned are material. The “side” (scare quotes, for there are multiple positions available, not just those that come through the lens of US politics) with the higher quality analysis is that expressed in the Cass Review, which does not call for a ban, but rather for clinical trials and a data linkage study (for which data linking adult outcomes to pediatric gender interventions has so far been withheld by the relevant clinics - draw your own conclusions about why they would not want that to be surfaced).
    - notahacker 2y ago
      The differences may well be material, but as I mentioned in the post above it's simply false to claim SA conflate the two when they link (multiple times) to an article looking at trans people specifically and also mention that they are healthy and safe when prescribed to other young people for other reasons. An article which links to an article discussing outcomes of a drug in young people that also mentions below that it's routinely and uncontroversially prescribed in old people would not be factually inaccurate, even though young people and old people are evidently not identical and it is not impossible the two have different outcomes. The Cass Review itself offers no evidence the blockers are dangerous or inevitably irreversible (or if one takes a less cautious approach, cause patients more problems with irreversibility than not using them), merely finding that only two papers providing evidence for the treatment being safe and optimal were of "high quality" with others being of "moderate" quality or "low" quality and calling for another trial. It did not find higher quality papers drawing opposing conclusions. People more knowledgeable and cynical than me have suggested that treatments for other, less politically-charged but complex conditions may also suffer from the literature that supports clinicians preferred approach being of "moderate" quality but seldom face shutdown as a result. The side that trumpeted this conclusion (because it very much is political, even in the UK) delightedly concluded that as the favourably-disposed evidence mostly fell short of excellence, all gender affirming care must be shut down permanently. Perhaps you view things differently and would very much like to see the new clinics opened and a clinical trial designed to Ms Cass' liking devised, but it's safe to say most of the people trumpeting it as the last word in the debate would not.

What isn’t factual in this article? Is it political because it discusses puberty blockers and transgender adolescents?

by abirch 2y ago

What isn’t factual in this article? Is it political because it discusses puberty blockers and transgender adolescents?

I think GP agrees it is factual. It is also called out in the OP ("contained countless errors and misinterpretations"). So it's a counterexample to the claim "Every piece called out here is clearly labeled 'opinion'"

jl6 2y ago

One part that isn’t factual is the statement on safety of GnRHs which cites their use in treating precocious puberty, which is a completely different indication and treatment (age of treatment, length of treatment, purpose of treatment), and does not consider the impact on psychosexual development, nor consider the impact on desistance of non-trans kids. The “safe and reversible” narrative originates in medical consensus amongst doctors and activists, not evidence from scientific enquiry. The difference between consensus-based medicine and evidence-based medicine eludes most participants in this debate.

notahacker 2y ago
The statement regarding precocious puberty is entirely factual, and the statement linking that claim to supplying the same hormones to trans kids is linked to an article containing more detail (including a discussion of possible downsides and links to actual papers). I'd agree wholeheartedly that the difference between consensus and evidence-based medicine eludes most participants in the debate, but frankly that seems to apply far more to the side of the debate whose higher quality analysis is of the form of "it appears the systematic studies the other side have done might exhibit researcher bias, so rather than do our own retrospective on the same research subjects we'll just move for speedy consensus to ban the practice altogether"
- jl6 2y ago
  It is certainly not factual to claim that a drug which is safe in treatment X (precocious puberty) is also safe in treatment Y (gender dysphoria). The article conflates both as “puberty delaying treatments”, as if the learning from one is completely transferable to the other. It is not. The differences I mentioned are material. The “side” (scare quotes, for there are multiple positions available, not just those that come through the lens of US politics) with the higher quality analysis is that expressed in the Cass Review, which does not call for a ban, but rather for clinical trials and a data linkage study (for which data linking adult outcomes to pediatric gender interventions has so far been withheld by the relevant clinics - draw your own conclusions about why they would not want that to be surfaced).
  - notahacker 2y ago
    The differences may well be material, but as I mentioned in the post above it's simply false to claim SA conflate the two when they link (multiple times) to an article looking at trans people specifically and also mention that they are healthy and safe when prescribed to other young people for other reasons. An article which links to an article discussing outcomes of a drug in young people that also mentions below that it's routinely and uncontroversially prescribed in old people would not be factually inaccurate, even though young people and old people are evidently not identical and it is not impossible the two have different outcomes. The Cass Review itself offers no evidence the blockers are dangerous or inevitably irreversible (or if one takes a less cautious approach, cause patients more problems with irreversibility than not using them), merely finding that only two papers providing evidence for the treatment being safe and optimal were of "high quality" with others being of "moderate" quality or "low" quality and calling for another trial. It did not find higher quality papers drawing opposing conclusions. People more knowledgeable and cynical than me have suggested that treatments for other, less politically-charged but complex conditions may also suffer from the literature that supports clinicians preferred approach being of "moderate" quality but seldom face shutdown as a result. The side that trumpeted this conclusion (because it very much is political, even in the UK) delightedly concluded that as the favourably-disposed evidence mostly fell short of excellence, all gender affirming care must be shut down permanently. Perhaps you view things differently and would very much like to see the new clinics opened and a clinical trial designed to Ms Cass' liking devised, but it's safe to say most of the people trumpeting it as the last word in the debate would not.