Transgender rights discussion

[Gehrman]

J.k weighs in. She started this thread after all.

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[Pogue Mahone]

Is that not precisely what Pogue has highlighted?

When Chris Whitty and Patrick Vallance were effectively chosen by the government to lead the UK's response to Covid, they would have reviewed and rejected a lot of "expert" opinion on how best to deal with the pandemic, including the work of people like Robert Malone.

Generally speaking, the same people that trusted the government approved science of Whitty and Vallance are now taking the opposite stance with the government approved science of Hillary Cass, because the science has reached a conclusion they don't like.

Worth stressing that, as you said above, the recommendations re covid were rushed out at an incredible pace (for obvious reasons) and based upon brand new and rapidly evolving evidence base Which is why you had different governments/regiond coming up with recommendations that differed on certain aspects (although also agreeing on many too) What's interesting is that, with hindsight, even the outliers (like Sweden or the UK) didn't turn out anywhere as big a disaster as many people (including me) thought they would be. Which goes to show that even the unpopular recommendations at the time had a sound rationale. Which is why we should trust medical experts on issues like these. The experience and training they have is very important and should always trump the half-baked opinions of people like you or me.

 

[Alex99]

Worth stressing that, as you said above, the recommendations re covid were rushed out at an incredible pace (for obvious reasons) and based upon brand new and rapidly evolving evidence base Which is why you had different governments/regiond coming up with recommendations that differed on certain aspects (although also agreeing on many too) What's interesting is that, with hindsight, even the outliers (like Sweden or the UK) didn't turn out anywhere as big a disaster as many people (including me) thought they would be. Which goes to show that even the unpopular recommendations at the time had a sound rationale. Which is why we should trust medical experts on issues like these. The experience and training they have is very important and should always trump the half-baked opinions of people like you or me.

Absolutely.

In this particular instance, there's been a lot of time spent discussing the scientific studies reviewed in the Cass report, when frankly, the vast majority of us are not remotely qualified to comment on the science either way. Meanwhile, very little attention has been given to some of the issues we can, as lay-people, have a view on, two of which are the apparent lack of follow-up on the well-being of the young people that have used the service, and the apparent lack of screening of autism, ADHD, etc. and possible mental health issues before and during treatment.

Realistically, I'm never making it through this report because it's nearly 400 pages long and cites even more reports/studies, and I've simply got better things to do than try and parse the specifics of a medical review.

 

[jojojo]

A Guardian follow-up on why some doctors and scientists may be nervous of conducting research or even statistical analysis and follow-up surveys in the area. Essentially suggesting that the career risks aren't worth it unless you're invested in getting a particular result already.

'This isn’t how good scientific debate happens’: academics on culture of fear in gender medicine research https://www.theguardian.com/society...in-gender-medicine-research?CMP=share_btn_url

 

[Tribec]

I won't get into the science as though I have read widely around it, I find it very difficult to understand and the language used in many articles, studies, reports etc is often impenetrable and therefore my grasp on it is sketchy at best!

But speaking from experience of having a teenage child who is unsure about their gender, the support from the NHS is almost nil, waiting lists are worse than those for autism ie years and years and that's not waiting for puberty blockers or surgery or anything extreme, just the chance to talk to an expert in the field who could help unpick some of the angst and confusion.

The politicisation of this is also incredibly harmful, to the point of us having to keep the radio and TV news off in the house yesterday and today as it can quickly feel to a vulnerable child caught up in this that the world is against them and their reality is being questioned and often denied.

People wonder why parts of the trans community are so vociferous in calling people out and often seem to do more harm than good in their approach. But if a core part of what makes you you is regularly and publicly denied and even ridiculed, it is hardly surprising that the response will be aggressive.

People using this issue to promote and agenda or to win votes and lots are, have done and continue to do immeasurable harm to young people just trying to find their way in life. There is a huge lack of compassion or any attempt at understanding in this discussion at all levels, it can even be read in this thread, heard on media outputs and even in parliament. How hard is it to talk about this with an open mind and an ounce of kindness?

Wonderfully said, the harm and distress that the media frenzy has done to trans youth is impossible to quantify. Working with LGBTQ+ youth and having this week off, I'm not sure what this report and the media hype will have done to the trans young people I work with.

 

[Wibble]

Wonderfully said, the harm and distress that the media frenzy has done to trans youth is impossible to quantify. Working with LGBTQ+ youth and having this week off, I'm not sure what this report and the media hype will have done to the trans young people I work with.

Probably not good.

 

[Pogue Mahone]

A Guardian follow-up on why some doctors and scientists may be nervous of conducting research or even statistical analysis and follow-up surveys in the area. Essentially suggesting that the career risks aren't worth it unless you're invested in getting a particular result already.

'This isn’t how good scientific debate happens’: academics on culture of fear in gender medicine research https://www.theguardian.com/society...in-gender-medicine-research?CMP=share_btn_url

I think this bit of the article is particularly relevant to parents like @The Boy

Fuelled by concerns about the poor quality of research, the Cass report has set the stage for a major NHS trial that should start this year. It will look at the safety and efficacy of puberty blockers, but also cross-sex hormones that are used to masculinise or feminise people, and psychosocial interventions, with the aim of establishing a robust evidence base.

Many are hopeful that the Cass report, and the NHS trial it recommends, are an opportunity to draw a line under the infighting and abuse and establish a more constructive field of gender medicine.

“It will take time, but it’s allowed people to breathe and feel confident in questioning treatments,” said Singer. “People work in this field because they want to help young people and that drive will still be there. It’s important and valuable work. Cass has now given us permission to do it.”

Baxendale is acutely aware that many patients and their families, reading coverage of the Cass report this week, will be left wondering whether help will be available, whether treatments work and whether they can trust their doctors.

“It must be so distressing for them,” she said. “But I think there is hope. The NHS research will be rigorous, it’s balanced to look at benefits and harms, and I think once we’ve got the results we will have a proper service for these kids.”

The fact that mental health services have been underfunded for decades is a big issue here. That’s why it takes so long for kids to get the support they need via the NHS. Compounded by the toxicity experienced by people working in the field, as outlined in the article. If medical professionals choose to walk away from an area of medicine where they will get harassment and abuse that means longer and longer wait times. But, at the end of the day, this report is a step towards setting up proper, evidence based, services that will help children and families in distress and make sure they get treatment and interventions that have been proven to give the best long term outcomes. Which is a good thing, even if the price to pay is the fuss being created in the media right now.

 

[africanspur]

Mammalian biology? Why so specific? We are mammals but so what?

In any case many/most non-mammalian species are biologically male or female. Again so what?

In some fish species (gobies and anemome fish) actual physiological sex reversal routinely occurs.

Again so what? Only humans, often routed in religion, stress about such things.

I've never really understood arguments like this. I've used it to argue with religious nutters about homosexuality and it being unnatural.

The difference here is that anemome biologically physiologically make sex changes. We don't. We are giving things that we as a species have produced to produce that change.

I'm not against that happening but let's not pretend the situations are the same?

Because they were correct and not pandering to any non-scientific agenda.

Trans stuff brings the loons out to play.

Because in that occasion, it happened to match with your own views on the matter?

 

[Wibble]

I've never really understood arguments like this. I've used it to argue with religious nutters about homosexuality and it being unnatural.

The difference here is that anemome biologically physiologically make sex changes. We don't. We are giving things that we as a species have produced to produce that change.

I'm not against that happening but let's not pretend the situations are the same?

Anemone fish and Gobies, not anemones.

Because in that occasion, it happened to match with your own views on the matter?

No. Just follow the science. With the pandemic, vaccines and trans issues. All considered the same, sans political pandering.

 

[Pogue Mahone]

Anemone fish and Gobies, not anemones.



No. Just follow the science. With the pandemic, vaccines and trans issues. All considered the same, sans political pandering.

So you’re following the science on trans issues? Which has clearly identified that we need more evidence to support most of the currently used medical interventions. Evidence that the NHS is already working on generating. In the same way it generated evidence on the most appropriate interventions for covid.

 

[africanspur]

Anemone fish and Gobies, not anemones.



No. Just follow the science. With the pandemic, vaccines and trans issues. All considered the same, sans political pandering.

OK, guess you got me there? Question can be ignored because of a typo and an m instead of an n.

Right, except as someone who is also a scientist, 'science' is not always uniform. Very respected international public health scientists had differing views on the extent of the measures taken, especially based on the different circumstances of the countries.

What's the hard science you're referring to with trans issues that reflects the level of science available for vaccines?

 

[VorZakone]

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[Tribec]

The thing is with puberty blockers, the Cass report has stated that they aren't to be stopped being prescribed, they want research on them in relation to use with trans young people. All the crap about the damage they do and yet they are still used more frequently with early onset puberty than were being used with trans young people. How come the people calling for them to stop the use in this field aren't calling for them in the other if they are so damaging???

 

[Pogue Mahone]

The thing is with puberty blockers, the Cass report has stated that they aren't to be stopped being prescribed, they want research on them in relation to use with trans young people. All the crap about the damage they do and yet they are still used more frequently with early onset puberty than were being used with trans young people. How come the people calling for them to stop the use in this field aren't calling for them in the other if they are so damaging???

With all drugs it's risk vs benefit. Prescribing any drug creates risk, so you need a benefit to outweigh that risk. With puberty blockers used in early onset puberty, the benefit is simply delaying puberty. So you run trials to prove that the drugs can help achieve that outcome, make sure they're reasonably safe and then you have enough evidence to prescribe them in that context. Because, let's not forget, these kids still end up going through puberty at about the same age as other "normal" kids.

Prescribing the same drugs to gender dysphoric/trans kids you're looking for different outcomes. The treatment goal here isn't simply delaying puberty. Are there medium to long term psychological/mental health upsides to prescribing drugs these drugs in this, different, context? Is it possible that there are unintended long term physiological downsides of delaying puberty long past the point most people would go through it? These are the questions we need more evidence to answer, according to this report.

 

[Alex99]

The thing is with puberty blockers, the Cass report has stated that they aren't to be stopped being prescribed, they want research on them in relation to use with trans young people. All the crap about the damage they do and yet they are still used more frequently with early onset puberty than were being used with trans young people. How come the people calling for them to stop the use in this field aren't calling for them in the other if they are so damaging???

Where early onset puberty is concerned, their use stops when the child reaches a "normal" age to allow puberty to happen. With young transgender people (or young people questioning their gender), my understanding is that they're being used during "normal" puberty age, and this is where the research falls short.

I think ultimately there's little evidence that a) delaying puberty is as harmless as has been made out, and there are concerns that important milestones are missed outside of the obvious examples (I've definitely seen concerns about mental and skeletal development), and b) that puberty will actually simply start as normal after being delayed, should a young person wish to cease treatment.

 

[nimic]

Terfs really are the dumbest possible people

 

[Tribec]

With all drugs it's risk vs benefit. Prescribing any drug creates risk, so you need a benefit to outweigh that risk. With puberty blockers used in early onset puberty, the benefit is simply delaying puberty. So you run trials to prove that the drugs can help achieve that outcome, make sure they're reasonably safe and then you have enough evidence to prescribe them in that context. Because, let's not forget, these kids still end up going through puberty at about the same age as other "normal" kids.

Prescribing the same drugs to gender dysphoric/trans kids you're looking for different outcomes. The treatment goal here isn't simply delaying puberty. Are there medium to long term psychological/mental health upsides to prescribing drugs these drugs in this, different, context? Is it possible that there are unintended long term physiological downsides of delaying puberty long past the point most people would go through it? These are the questions we need more evidence to answer, according to this report.

The treatment goal is exactly the same to delay puberty, if they then move onto hormones the blockers are removed and they aren't on them for anything more than 1 to 2 years in most cases and they wouldn't be prescribed them till around 14/15 anyway, due to the way the Tavistock worked and how slow they were. Some may get blockers earlier, but from my own experiences those that get the blockers physiocogically are better than they were previously. They are no magic cure to all mental health issues, but they do assist in taking away a huge concern for the trans young people whilst they explore who they are.

I may be slightly biased when I say I don't like the report, I'm fully aware of peer reviewed research documents that were not even looked at by Cass, I know she contacted organisations that operate trans youth groups, but didn't engage with the actual groups. I've read through it and whilst it's suggesting a change in how trans youth are treated i.e. a more holistic approach which something we (those working with trans youth outside of the medical world) have been saying for years and how we need more funding for training and centres, the rest isn't great. I've returned to work this week and the mood amongst the trans youth is very low and it's going to take a lot of work to elevate the mood.

 

[Pogue Mahone]

The treatment goal is exactly the same to delay puberty, if they then move onto hormones the blockers are removed and they aren't on them for anything more than 1 to 2 years in most cases and they wouldn't be prescribed them till around 14/15 anyway, due to the way the Tavistock worked and how slow they were. Some may get blockers earlier, but from my own experiences those that get the blockers physiocogically are better than they were previously. They are no magic cure to all mental health issues, but they do assist in taking away a huge concern for the trans young people whilst they explore who they are.

I may be slightly biased when I say I don't like the report, I'm fully aware of peer reviewed research documents that were not even looked at by Cass, I know she contacted organisations that operate trans youth groups, but didn't engage with the actual groups. I've read through it and whilst it's suggesting a change in how trans youth are treated i.e. a more holistic approach which something we (those working with trans youth outside of the medical world) have been saying for years and how we need more funding for training and centres, the rest isn't great. I've returned to work this week and the mood amongst the trans youth is very low and it's going to take a lot of work to elevate the mood.

No, it isn't the same. The long term treatment goal is better outcomes for trans kids, which is the evidence you need to support the use of puberty blockers in this cohort. Even ignoring that, there's an obvious difference between taking puberty blockers to normalise an abnormally early puberty vs taking them to make a normal puberty abnormally late.