Posible answer to "why aren't more doctors speaking up?"???

[kesstrel]

I saw this question on Twitter, and it made me think: is part of the problem that the responsibility here falls between two stools? That is, the endocrinologists can say that the psychologists told them transition was necessary for mental health/suicide prevention, while the psychologists can say that the endocrinologists told them the procedures are safe/reversible????? With each group influencing the thinking of the other?

I'm thinking here about the identified problem in child protection social work, where different organisations have different areas of responsibility, and no one person was actually entirely responsible. It made it easier for individuals to shrug off concerns.

Does this make any sense?

Or it’s bevause they are frightened of being fired. Just saying.

Fear

No other reason

Threats, intimidation, gaslighting and bullying are the main reasons.

But yes OP - the 'he made me do it' is always a major defence in organisations and given the BMA's track record of gaslighting women, attempting to eradicate the language of women (anyone remember those awful guidelines about chest feeding etc that they subsequently withdrew) I'll bet it's a significant factor.

Yes, you're right, fear is clearly a very big factor at this point in time. But there must have been a stage earlier on, before the trans lobby gained so much power, when it was still possible to speak out? But then I suppose the issue wasn't so salient then, because there hadn't yet been the big upsurge in numbers of children wanting/being pushed to transition.

So probably mainly fear, yeah.

I can just about believe that some Psychologists who are not also qualified medical doctors might not understand the endocrinology.

The other way round, less so.

I agree with other PP, the silence is due to fear, not ignorance.

Doctors have got bills to pay just like everyone else.

It’s fear. We have family members who are doctors and I have discussed this with them and they say it’s more than their jobs are worth to challenge it. So who has created that environment?

There was a blog youthtranscriticalprofessionals.org/ which had very interesting articles but it's now private - and it's obvious why.

The whole Antibiotics over prescription is a very public example of Drs not always doing what is best.
Drs have known for years that they are over prescribing, that ABs aren’t necessary for virus infections, that humans are becoming immune to them because of over prescription, but Drs carry on doing it.
I do have sympathy for them, they are over worked, under funded and their work environment not always healthy, but they really need to take control and “do no harm”, in every instance.

So frightening that professionals, let alone ordinary women are too frightened to speak. Time for a good investigative journalist ....

Our gynae SHO was bleeped by A and E about 8 weeks to attend a trans woman with a problem with her neovagina. She refused to attend and told them to bleep gastro or plastics instead.

I was so anxious for her but nothing has happened. At work I hear a lot of GC stuff. Doctors don’t buy this.

High five for that SHO Tunt

I imagine the suggestion of a gastro referral would have stung too. whilst being completely appropriate.

Some doctors are speaking up.

BMJ
Published 29 October 2018
'Redesigning gender identity services: an opportunity to generate evidence'
authors: Richard Byng, general practitioner and professor in primary care research, Susan Bewley, emeritus professor of obstetrics and women’s health, Damian Clifford, consultant liaison psychiatrist, Margaret McCartney, general practitioner and freelance writer
(extracts)
"A recent feature in The BMJ implied that new services are all that’s needed to improve transgender healthcare. Providing timely, sensitive services for all, including those who decide to not pursue treatment or detransition, is important. But the article did not question the steep rise in referrals of mainly young women or the potential harms of medical overdiagnosis and overtreatment" (continues)

"Regulated medical practitioners should follow a framework of evidence, not simply respond to client expectations. Creating that evidence to inform quality standards is an ethical imperative. We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles" (continues)

open access link here:
www.bmj.com/content/363/bmj.k4490.full?ijkey=6lX93kQA0lz5YoB&keytype=ref
thread:
www.mumsnet.com/Talk/womens_rights/3410257-BMJ-article-We-need-research-to-explore-the-interplays-between-gender-identity-mental-health-and-neurodevelopmental-problems-sexual-orientation-autogynephilia-and-unpalatable-gender-roles

Some doctors are speaking up.

Professor Carl Heneghan was interviewed on recent Panorama, 'Trans Kids: Why Medicine Matters', & as a consequence of his analysis concluded that 'informed consent is not possible'

BMJ EBM Spotlight paper:
'Gender-affirming hormone in children and adolescents – Evidence review'
Posted on 25th February 2019

(extract)
"Gender dysphoria occurs when a person experiences discomfort or distress because of a mismatch between their biological sex and gender identity. Gender dysphoria can arise in childhood and adolescent which raises many questions about how best to handle the condition. This post sets out the current evidence for gender-affirming hormones in adolescents and children to aid decision making. (continues)

"Conclusions

There are significant problems with how the evidence for Gender-affirming cross-sex hormone has been collected and analysed that prevents definitive conclusions to be drawn. Similar to puberty blockers, the evidence is limited by small sample sizes; retrospective methods, loss of considerable numbers of patients in follow-up. The majority of studies also lack a control group (only two studies used controls). Interventions have heterogeneous treatment regimes complicating comparisons between studies. Also adherence to the interventions are either not reported or at best inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding, and many effects can be explained by regression to the mean.

The development of these interventions should, therefore, occur in the context of research. Treatments for under 18 gender dysphoric children and adolescents remain largely experimental. There are a large number of unanswered questions that include the age at start, reversibility; adverse events, long term effects on mental health, quality of life, bone mineral density, osteoporosis in later life and cognition. We wonder whether off label use is appropriate and justified for drugs such as spironolactone which can cause substantial harms, including death. We are also ignorant of the long-term safety profiles of the different GAH regimens. The current evidence base does not support informed decision making and safe practice."
blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/

thread:
www.mumsnet.com/Talk/womens_rights/3518188-BMJ-Prof-Carl-Heneghan-Evidence-Based-Medicine-Oxford-Panorama-Trans-Kids-Gender-affirming-hormone-in-children-and-adolescents-Evidence-review-concludes-There-are-significant-problems

They are not speaking up for the same reason that the rest of us (or many of us) are not doing so - fear of repercussions at work (whether in the NHS, private companies etc etc).

If I did not need my job in order to keep a roof over my family's head I would be shouting about this issue from the rooftops. A reason perhaps that TRAs should be careful about trying to track GC people down and get them sacked - they may then start to speak out very loudly!

If I did not need my job in order to keep a roof over my family's head I would be shouting about this issue from the rooftops. A reason perhaps that TRAs should be careful about trying to track GC people down and get them sacked - they may then start to speak out very loudly!

It doesn't even have to be work related! Any private person who speaks out loudly is in danger of having their social media profiles flooded with vile insults and threats. Peace is gone.
I'm just a soft-spoken 60-something enjoying retirement and my granddaughter and chatting with friends online. I do not want to be bombarded with ugly disgusting posts by aggressive transactivists.
This might sound cowardly but holding up a red flag is not for me, certainly not at my age; I've fought enough battles in my life. I believe it is possible to fight this dreadful thing in more discreet ways, and I absolutely intend to do so.

Often families have rewritten the facts quite extensively by the time they reach the doctors. The family I know well - little girl happy as a little girl, wears skirts, has a doll alongside the dinosaurs, totally normal. When the parents asked her if she was really a boy, they also asked if she'd always felt like a boy. She was 4, always isn't a concept they get. Then recall bias kicked in. They totally rewrote her past, focusing on her dinosaurs and not mentioning the doll. I know two families like this, both actually changed their old FB photos, taking down anything that didn't fit.

Ten years ago a patient would go to a doctor with a symptom (dizzy spells, pain etc) and the Dr could ask and make a good guess at the cause and validity. Hypochondriacs would have vague symptoms of lots of different things. Now hypochondriacs google an illness and present a perfect list of symptoms that fit a scary condition.

Similarly, families with trans children or teenagers swap notes to such a degree that it's really hard to tell who is actually dysphoric or suicidal. The fact that 50% claim to have attempted suicide when the real figure is less than 0.2%, shows this effect. Some of them use terms like dysphoric to mean "don't like," "I'm dyphoric about my leg hair/big nose," etc. What Dr can pull all this apart in 7 minutes?

Psychologists aren't doctors.
Psychiatrists should know better.

^^ Truth. Psychology is not a science.

It is a science but psychologists are not medically qualified.

important current thread with links to four Times articles highlighting serious Safeguarding & Duty of Care issues concerning the treatment of children questioning their gender identity issues. The roles played by GIDS Tavistock, Mermaids, GIRES & Gendered Intelligence are criticised by medical professionals:

www.mumsnet.com/Talk/womens_rights/3553935-Times-article-calls-to-end-transgender-experiment-on-children