AIBU to think puberty blocker trial is child abuse?

What clinical trial evidence is already available for the use of puberty blockers in children with gender dysphoria? A trial will only be ethical if it adds significantly to current knowledge of how best to treat these children.

I believe the Cass review suggested that a carefully performed clinical trial would be necessary to test the idea that puberty blockers were effective.

This.

It's abuse of vulnerable children.

It's absolutely horrifying that any parent would go along with a child asking for this.

There is a difference in blocking puberty for precocious puberty and letting puberty then start and finish and not allowing puberty to finish fully because the treatment is then switched to the sex hormones in quantities for the opposite sex.

It seems dishonest to use precocious puberty comparative to the other usage.

I've been banging on about this for about a decade, I think. The thing that leapt out at me right from the start was that if a child is put on puberty blockers their brain isn't going to mature and they will be stuck with a child's brain. That is a very tough thing for a child to cope with while their peers are going through normal puberty and starting to grow up. But they are then asked to make one of the biggest decisions of their lives, i.e. whether to go onto cross-sex hormones, without the necessary maturity to even understand what they're being asked. Think back to childhood. Did any of us understand what sex was about before puberty? Did we have any grasp of what an orgasm might be like, of what it might be to have sexual attraction to another person? Not really, I'd say. What about having children? So many kids are quite determined they will never want to have children of their own, but the majority will come round to the idea in adult life. How can anybody think that a child who hasn't gone through puberty can make the decision to give up an ordinary sexual response and to become infertile? Of course they can't.

No it isnt a trial as they are giving them to all the kids, and we know what happens with these drugs already.

Not sure any condition even exists where the treatment is to literally stop kids from progressing down the path of growing up into adults. It is absolutely mental.

No I didn't imply that. I said there is a massive difference between using them to delay and to prevent puberty. Those who go on to cross-sex hormones are using them as a way of preventing puberty.

Additionally, it is not clear whether those who use them up delay puberty beyond the normal timeline will go through the normal cognitive development associated with puberty if they come off them. They will have the physical changes though.

Very disturbing, wtf are we doing to our kids.
They need our protection.

As I understand it, it wasn't set up to facilitate that at all. It was a specialist clinic set up in the late 1980s for a tiny number of children and teenagers in England and Wales (about two thirds boys, one third girls) who were experiencing extreme distress related to their gender, i.e. feeling that somehow in spite of having a perfectly healthy male or female boy there was something about their personality that made them feel they couldn't actually be male or female. They felt more like the opposite sex. This makes no sense at all unless you think that there is only one valid way to be a boy/man or a girl/woman, which is obviously nonsense, given how different gender stereotypes are from one society to another and from one historical period to another.

At the time the standard treatment for gender dysphoria in children was watchful waiting. The child and parents/guardians would have many appointments. A detailed medical and developmental history would be taken. The psychiatrists and other clinicians would diagnose any other conditions that might be affecting the child, e.g. depression, anxiety, eating disorder. They would look for signs of neurodevelopmental disorders, e.g. autism, ADHD. They would ask about things that might have affected the child, e.g. medical problems, family break up, bereavement, witnessing domestic violence, experiencing abuse or bullying. There would be a lot of talking. It was important to talk to the adults as well as the children to try to get it across to them that if their little boy was a sensitive, quiet child who liked dressing up and playing with dolls that didn't mean he wasn't a real boy. How were they responding to his developing personality?

The rationale behind watchful waiting was that research showed that virtually all children and teenagers feeling like this became reconciled to their sex once they were through puberty. Only a tiny minority went to the adult gender clinics to ask for medical intervention to make their bodies look more like the opposite sex.

Unfortunately, however, a Dutch gender clinic decided to try a new approach, prescribing puberty blockers and then if the child and parents wanted it to put the child on cross-sex hormones. This was supposed to happen only in a tiny number of cases after exhaustive assessment. It didn't. The US medical industry spotted a huge moneymaking opportunity and very soon the standard treatment across all wealthy countries (oddly, gender dysphoria is not a big thing in poor countries, go figure) was to rush kids onto puberty blockers more or less on request.

Look at the numbers of children seen at GIDS many years ago. Look how fast they were going up and how quickly the balance swung from mostly boys to mostly girls. The clinicians who just accepted this without wanting to know why have failed in their responsibility. They really ought to be held to acccount.

It's not actually clear whether they will go through the cognitive changes associated with puberty, particularly if they start on cross sex hormones

'Puberty is uncomfortable. Painful. Messy. Confusing. This is normal. Calling it dysphoria and claiming it needs irreversible treatment pathologises a perfectly normal condition that everybody experiences.'

Very well said @JellySaurus . Adults should be reassuring youngsters that what they're going through is perfectly normal, and that it will pass. Dysphoria is an unpleasant but common experience when you're going through an enormous hormonal transition - pathologising it does no one any good

Medicine is rarely tested on under-18s because it is fundamentally unethical to do so.

Society needs to stop lying to children. The children think they want these drugs, they think they are "hated", they think if anything negative issaid it its "transphobia".

If they were supported, taught that it was ok to be different, that society doesn't gate them maybe they wouldn't think drugs were necessary.

You are 100% right, OP.

Puberty is uncomfortable. Painful. Messy. Confusing. This is normal. Calling it dysphoria and claiming it needs irreversible treatment pathologises a perfectly normal condition that everybody experiences. Pathologises an important life stage, and replaces it with something even more unpleasant.

She didn't say drug trials are child abuse, she said the puberty blocker trial is child abuse.

We already know they're not safe to prescribe because the expected effects already constitute harm to children's healthy bodies, before even considering unwanted side effects such as loss of bone density and a significant drop in IQ. This study will provide very little useful evidence because the control group are also being given the drugs, just a year later.

It is deeply unethical to prescibe these drugs to a whole new group of children without even bothering to collect and analyse the data from the children who have been previously treated.

Sometimes it's worth trialing and prescribing drugs and treatments with known harms when they are used to treat serious life-threatening and life-limiting conditions. Drugs which reliably induce permanent sterility should only be trialed in children for the most serious conditions, where death is the likely alternative outcome, not for mental health conditions which tend to resolve naturally if puberty is allowed to continue unhindered, not for conditions which weren't even really a 'thing' until a couple of decades ago.

We already know that these drugs are dangerous! There is so much evidence of harmful, permanent, side-effects from their use in slowing down precocious puberty, that they are used for the shortest time possible, just until the child reaches the lowest normal age for puberty. And then they are allowed to go through all the normal hormonal changes of puberty. Which include emotional and mental maturation.

At the Tavistock, almost every single child who was put on puberty blockers went on to take cross-sex hormones. They never had a chance to mature emotionally or mentally. Yet the vast majority of gender-confused/distressed children come to terms with their sexed bodies as they mature - when given the chance to.

What should be being trialled is the role of psychotherapy, social therapy, talking therapies, anti-depressants etc in treating these distressed children and their parents.

What should also be explored are the outcomes for children who were given blockers and those who were allowed to mature without interference: the state of their health, happiness, sexual orientation, and even their gender identity. There should be at least ten years of data…

but even if children are uncomfortable with the body of their sex they can never have the body of the opposite sex.

Puberty blockers will stop the completely natural process of a childs transition to adulthood in favour of being medicalised with artificial hormones for the rest of their lives.

Telling a child that they can be the opposite sex is a lie, cruel and imoral

No child should be given puberty blockers because adults have lied to them by telling them they can change sex. They can't. It's impossible.

They are being sold an impossible dream that will damage them physically and mentally for the rest of their lives.

Very few of them will ever "pass" and those that do will only pass some of the time. Those closest to them might pretend they have changed sex, but literally no one will actually believe it.

These children need honesty from the adults who are supposed to care for them. They need to be encouraged to like and love themselves for who they actually are and not be persuaded that drugs and surgery can make them someone else.

Some will experience severe distress and dysphoria by going through puberty into a body they aren’t comfortable in - I’m not sure how anyone could be against medication that will help with this. Testing is the first step.

Puberty blockers were designed to prevent precocious puberty in very, very young children, ie where babies were already seen to be sexually maturing.

They've since been used to halt sexual maturation in teenagers who think they were born in the wrong body.

One use is outright abuse, one use is medically necessary. Which is which to you?

Yes, they are running tests to see just how much damage it does to children who do not have a condition that needs medicating.

That should be grounds for arrest and the other sort of trial.

For precocious puberty they’re used for a short period to delay puberty, not to stop it forever. Puberty is a huge developmental process the body goes through, it’s not just boobs whatever, the brain changes and so do muscle development, heart & lung development - it’s huge. Why we’d want to do this to children and affect their sexual development forever is beyond me.

What about using the information from the thousands of children worldwide who have already had them?