Newsnight tonight: Britain's Experimented with Puberty blockers

Other than a pause, are there any benefits for taking puberty blockers, at any age, let alone children?

Is there something else they're not saying?

What have they been doing for 9 years?

We know they’ve prescribed a shit load of blockers

Surely they should have at least preliminary results by now?

Interesting, OldCrone.

From the FOI link about the participant information sheet for the study.

What are the potential benefits of taking part?

Early results from similar studies in other countries suggest that:

1. Blocker treatment in early puberty may improve physical outcomes and psychological wellbeing during adolescence and adulthood;

1. Early blocker treatment is reversible and does not have harmful effects on physical or psychological development.

1. Early blocker treatment reduces anxiety in young people with Gender Identity Disorder and allows time and space to think about their gender identity.

What are the possible disadvantages and risks of taking part?

1. We do not know how blocker treatment in early puberty will affect bone strength, sex organ development or body shape in the long-term, or final adult height.

1. Blocker treatment could affect your child’s memory, concentration and mood.

1. Blocker treatment in early puberty could influence your child’s perceived gender identity and how likely they are to change their mind about their gender.

1. Blocker treatment could affect your child’s fertility. It could take 6 to 12 months or longer after stopping the blocker before boys start making sperm again or girls start maturing eggs.

1. There could be other long-term effects of early blocker therapy that we don’t know about.

So puberty blockers are deemed to be reversible and do not have harmful effects on physical or psychological development, but GIDS don't know how puberty blockers affect bone strength, sex organ development or body shape in the long-term, or final adult height.

I'm struggling to marry those two statements in my head.

And this protocol was submitted by GIDS in November 2010. They admit that they didn't know the long term effects of puberty blockers at that point.

9 years later and GIDS somehow still don't have any research data.

Thank you, OldCrone - that is the protocol that I failed to find. It is very helpful at my first glance through and I shall have a thorough read through later today and see if I can sort out the implications of the timeline changes.

The good thing about pre-registering trial designs and outcomes is that you can check the archived updates about changes to the protocol or timelines but, if they haven't, even now, I'd encourage the Tavi to do this.

arran

I just found this - Early Intervention Research Protocol and information for participants.

tavistockandportman.nhs.uk/documents/1544/FOI_18-19398_Paper_on_adolescents_with_Gender_Identity_Disorder.pdf

Just watched it. Or rather, listened.

The production was odd. And gave me a headache with flashing lights and weird camera angles. Very strange for discussion on a serious topic.

Agree with all the criticisms above.

And what the fuck was the point of the teenager being interviewed? To paraphrase 'I always thought puberty blockers were step one and hormones step two, I wouldn't have listened if anyone had warned me of side effects but I trusted that doctors wouldn't offer me anything dangerous'. Person wasn't in the trial and added nothing to conversation.

Thank you OldCrone as those documents were interesting to read tho' they don't describe the protocol for the study.

For clinical trials, researchers are encouraged to register the trial design before the start of the study (tho' it can be done at a later date or even retrospectively). I've selected an example that has pre-registered and that isn't recruiting as yet.

www.clinicaltrials.gov/ct2/show/NCT03808883?cond=gender+identity&rank=2

The registration tells you about the study design, the ethics approval, the eligibility criteria for participating (or for being excluded), and details about the proposed treatment. It should also tell you about the primary outcomes the researchers will look at and any secondary ones.

It's good practice to do this and it would be helpful if GIDS had - not least because it might make some more sense of the timelines and why the data analysis isn't available as yet. They could, even now, retrospectively register a protocol if they haven't done it yet (if they have, it would be very helpful if they'd link to it from their relevant page about the study).

Children don't normally get fractures in the way elderly people with osteoporosis do, but obviously failure to lay down those reserves will have consequences further down the road. Do we know when? I don't think anyone has been on these sorts of treatments long enough to have an answer but I'm sure sure consequences of damaged health will become apparent as these children age.

This makes me think of various reports about Afghani women's health during the Taliban period, which may have some relevance. Basically, you had a situation where females were covered from puberty onwards, which lead to low levels of Vitamin D, and subsequent osteoporosis.

There were reports that the osteoporosis in some women was so bad that, in at least one case, a pregnant women's hips shattered during childbirth.

So you can extrapolate from that to suggest that maybe low bone density in your teens to 20s may actually have an effect far earlier.

arran and OldCrone,

Professor Biggs stated at the end of his last assessment that "Our next post will examine in detail the process undertaken by GIDS to gain ethical approval for this study".

So if either of you are interested in that, it might be worth waiting to see what he's found out. Seems like he's already got the info he needs for that. It might save either of you duplicating the work that he's already done.

As an aside:

OldCrone, did you see my latest posts on this thread about Helen Webberley?

www.mumsnet.com/Talk/womens_rights/3625515-Patient-of-webberlys-commits-suicide?msgid=88687325

arranbubonicplague
I'm not sure if this is what you're asking for, but some of the research details have been obtained under FOI. The link doesn't contain the attached documents, but these, and any others which should be available to the public, could be obtained via another FOI request.

tavistockandportman.nhs.uk/documents/1548/FOI_19-20011_GIDS_Research_Information.pdf

1. Could you please share with me a copy of the initial research application, which was sent to the HRA in July 2010 under (I believe) reference 10/H0718/62?
This document is attached: GID Early Pubertal Suppression Ethics Form
2. Could you please share with me the covering letter sent with the re-submitted application in November 2010?
This document is attached: Response to ethics committee 03.11.10

If FOI requests are done via www.whatdotheyknow.com/ all the attachments will be available for anyone who wants to view them.

More Tavistock FOI disclosures here:
tavistockandportman.nhs.uk/about-us/contact-us/freedom-of-information/foi-disclosure-log/

MPs need to be asking the Health Secretary these questions.

The logic is that you give puberty blockers to kids who may or may not become trans adults. If 100% of the kids given puberty blockers go on to transition, that means that you're doing your assessment of "may or may not become trans adults" much too conservatively. So if that's what's happening (and under the unstated assumption that the benefits of puberty blockers outweigh the harms for the "may or may not become trans" group) you should do a less conservative assessment and put more kids on puberty blockers.

That logic is false. What's more, it's known to be false.

Gender dysphoria, which used to be and should still be called gender identity disorder, is not new. We have around 50 years worth of research into the children suffering from this condition. From that research we know (as PP have pointed out), it is the very hormones that puberty blockers are used to suppress that lead to a child reconciling with their body.

In other words, puberty blockers prevent desistance.

That's why watchful waiting has been international best practice in treating children with gender identity disorder (GID).

It adheres to the principle of "first do no harm", as it is well known among the experts that interfering with normal puberty is harmful to children and would therefore needlessly harm the 80% and more of the children diagnosed with gender dysphoria who will eventually manage a successful mind-body-integration.

The real logic is this:

As puberty blockers prevent desistance, putting all children who suffer from gender dysphoria on blockers will increase the number who persist into adulthood.

And this was the best practice logic:

While watchful waiting cannot cure the child whose gender dysphoria will persist into adulthood, it protects the child who will desist because it will not be exposed to the damage that puberty blockers cause.

Puberty blockers bring only one real benefit to the child who persists - a better aesthetic outcome.

And for that we are now putting much larger numbers of all of these children on a medical pathway that closes off their future, damages their brains, renders them sterile, leaves them with heart problems etc etc.

Yes, we now have evidence that the pathway pushed by these organisations leads to harmful medical interventions for children. They should be no where near schools

Yes, but it isn't enough to keep these organisations away from schools. Much of the grooming takes place online. Much of it is peer to peer.

I am reminded of the 'pro-ana' sites that caused a furore about five minutes ago. There was much talk of how to combat them at the time but I don't recall what, if anything, happened beyond hand wringing. I'm not sure what can be done, the internet has opened up a can of worms in terms of grooming, Islamic extremism is another area that has hit the headlines. I do know it is something society needs to have a serious conversation about.

Bottom line for me is that children should be protected from trans ideology. It is dangerous. Banning it from schools would be a start but that only goes so far.

Assuming this is the study - can anybody find a publicly registered or published protocol for it? (It's not mentioned in the piece as far as I can tell: there is a protocol but not publicly available tho' it's desirable to have them pre-registered at any of the suitable repositories even if the investigators haven't managed to get it published.)

gids.nhs.uk/our-early-intervention-study

Is there any point at which WEP will realise that they owe Heather Brunskell-Evans a substantial and public apology for the way in which they treated her? WEP allowed members with their own agenda to deny due process to HBE and, for me, that is what signalled me to leave WEP.

OvaHere
So true. A few years ago the lead clinician at the Gender Identity Clinic at Charing Cross Hospital described Gender Dysphoria as ‘a vanishingly rare condition’.
www.cambridge.org/core/services/aop-cambridge-core/content/view/5562F75A76C869ED9F6134EBC342E6C2/S135551460001436Xa.pdf/disorders_of_gender_identity.pdf

Look at us now!

They really need to research what puberty blockers are doing to critical brain development in adolescents.

The fact that this treatment 'crystallises' a trans identity in every child that takes them when we know that allowed to experience puberty around 80-90% desist is horrendous malpractice. It's forcing young people down a pathway of becoming lifelong medical patients with very serious side effects.

We know that brain development during puberty is complicated but incredibly necessary, the implications of interfering with this are not minor.

Persistant gender dysphoria well into adulthood until recently has been rare and I suspect when you strip away all the political lobbying, other underlying conditions and circumstances and social contagion, it still is rare in reality.

It seems in many cases all that has been achieved is creating a pathology out of a difficult adolescence.

The Tavi need to step away stop seeking the middle ground. They need to start making sound, defensible clinical decisions!

I think the Tavi needs to be closed immediately pending an independent investigation. This is live experiments on children and no amount of dressing it up with language or accusations of transphobia will conceal it for me. I'm all for discussion and probing and general debate but checks and balances have long since been thrown out the window so the time for that has passed.

I wish I could be more reasonable around this but it's just so infuriating. I hope anyone with an appointment at the Tavi in coming months reconsiders and doesn't go.

If GIDS really have nothing to hide then look at this chronology.

2 March 2019 - Prof. Biggs and Transgender Trend publish an assessment of the puberty blockers trial.

26 March 2019 - Russell Viner at UCL (principal investigator of the study) states "the early intervention study cohort remain under study".

22 May 2019 - Lord Lucas asks question in Parliament. Is told by Parliamentary Under-Secretary for Health that the study "will conclude in 12 months".

June 2019 - Tavistock statement "the study concluded in February 2019".

July 2019 - GIDS website. "This is a study that is currently underway".

Red flag after red flag after red flag.

Yes, we now have evidence that the pathway pushed by these organisations leads to harmful medical interventions for children. They should be no where near schools

Indeed. All this head scratching as to why there were so many children showing up at gender clinics.

It's so frustrating. Children are being taught that masculinity and femininity are evidence of them having the wrong body.

Gah.

Campetvan69

That "child" is apparently a 19 year old adult male acting like a 10 year old girl. So I'd agree that they help show brain development being effected. So sad that instead of receiving proper psychiatric help they will have a sterile, sexless life with a child's brain.

I think the one of the first steps that need to be taken to protect children in the UK is for all schools to distance themselves from Stonewall's propaganda programme and to reject outright the Allsorts guidance that has been pushed into our schools

Yes, we now have evidence that the pathway pushed by these organisations leads to harmful medical interventions for children. They should be no where near schools

Whilst the Tavi seem to think of themselves as shunning the extremes and taking a middle ground, few seem to regard their position as taking the the middle ground and few seem to think they are doing a good job (with the notable exception of their CEO as per R4 yesterday).

The TRAs think they are gatekeeping and conservative and that watchful waiting is tantamount to conversion therapy. Gender critics think the Tavi is like a boiled frog and has stopped taking up their own authority to make good clinical decisions (evidenced by using terms like 'assigned at birth' and suggesting it important not to privilege biology).

The Tavi need to step away stop seeking the middle ground. They need to start making sound, defensible clinical decisions!

Also did I hear correctly that statement from GIDS: including that their staff have always said that ‘blockers may crystallise gender identity’ (at around 33.28 or 45.23)

But if professionals always say and suspect this: (that their TREATMENT not their CONDITION causes the effect

Bloody hell, chattylion, that's right.

How the bloody, bollocking hell can they acknowledge that puberty blockers cements the one-way path, in one breath, and then idly wonder why a hundred percent go on to cross sex hormones, in the other!!

They have drunk the fucking Kool-Aid. It's awful.

I wish the BBC would do a one hour program just on the early intervention puberty blocker study

Yes definitely- there is so much to unpack here.

GIDS stating that the feelings of self-harm noted in the study couldn't be given any weight because "these numbers are far too small to draw final conclusions". And yet, not so small that GIDS couldn't use the initial outcomes (from a study never published, remember) to prescribe puberty blockers to ever-younger children.

Excellent point.

And yes to this being the counter argument to "better a trans child than a dead one". Although someone on twitter has been trying to convince me that this means we should do away with puberty blockers altogether and start children on cross sex hormones around 12.