NHS announce independent review of puberty blockers and cross sex hormones!

Indecent reviews like this would restrict themselves to secondary research (systematic reviews of existing studies). They wouldn’t be doing primary research like followup studies of patients.

Rogdmum - that graphic you posted is very powerful.

Clinics should be obliged to follow up on every single patient they discharge, up to 5 years afterwards. Otherwise how can they know how effective the treatment is?

In the meantime, this review could easily include a follow up review of a sample of discharged patients by an independent objective researcher. Especially those in the 18-28 year old bracket - which cover those discharged by the Tavistock at age 17/18.

Men are apparently more susceptible to viruses according to corona virus analysis, hence slightly more men have so far died.

In the middle of tbe night, I had a health issue so I checked tbe nhs website. I was too busy resolving the health issue to screenshot this last night. But, health issue partially managed, I went back to check this morning. Apparently, sex is real when you are poorly.

I think it’s fairly clear there’s a schism at the Guardian/Observer that goes beyond just the days of the week. This announcement was 3 days ago, nothing in the Guardian, as soon as the woke muppets leave the office, the Observer post an article on it. Same as last time with the Keira Bell case:

www.theguardian.com/society/2020/feb/02/gender-identity-treatments-for-young-expert-review

That is a very pertinent graph given the way schools are being advised to affirm.

It leads to a 'commitment' to medical intervention.

Children and yp potentially face people accusing them of being fake or loosing hero status if they change their minds.

IMO, the only effective review would be one that takes a big step back and looks at the full process.

I agree rogdmum. I fear this won’t though.

The fundamental problem is it’s being done arse backwards. Puberty blockers weren’t started to relieve suicide. They were started by people who thought it was logical to stop puberty in someone who wanted to be the opposite sex.

It then moved on to say that trans kids are at risk of suicide.

It then moved on to say trans kids are at risk of suicide if they don’t get puberty blockers.

It then moved on to looking in retrospect at adults to see if they were more or less suicidal with puberty blockers (the recently published terrible article in Pediatrics).

It’s now looking at whether children who get puberty blockers do better with their mental health prospectively with a few studies but without control groups, with the Tavistock’s study that Michael Biggs took apart conveniently forgotten.

users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf

And eventually we may or may not get a proper RCT, depending on the ethics of it, by which stage the damage is already done to thousands of children worldwide.

In the meantime we get tweets - yes, Twitter is being held as the standard to which we treat our children now - that claim objecting to this experimental treatment means you want to “literally kill kids”.

It’s heartbreaking and infuriating in equal measure.

Very Interesting tweets Neuo. Informed opinion & actual facts can be so inconvenient sometimes.

I’ve been reflecting overnight and pondering the exctract Oldcrone posted upthread. an independent expert group is being established to make recommendations on the evidence, that will support a review of puberty suppressants and cross-sex hormones and whether changes are required to existing clinical policies that underpin the use of these on the NHS.

To unpick this, what were the hypotheses behind the clinical studies? What outcomes were they looking for?

If a medicine improves say lung function, the pharma companies might present data to show improved mortality and quality of life. For an anti-depressant, the data would look at improved ability to function, less anxiety etc.

So there is presumably data that shows puberty blockers delay puberty,
there might also be evidence that drug B is cheaper than drug A and has fewer side effects, but what questions were asked about why and was there ever a watch and wait control group?

The short version is we need to be asking why children are being given hormonal treatments, not which one is best.

Two interesting tweets I saw last night

Christ, if nothing else happens but this...the Tavi ought to have the most enormous slap on the wrist for their dreadful approach to follow ups and what happens when children leave their service. Can you imagine any other area in the NHS being like this? I am too tired and have had wine so cannot draw proper lines but I can’t imagine the uproar if we suddenly started “treating” children in any other area in the same way. Feel bad? Let’s render you infertile and cut bits off you. Seriously. After 3-5 appointments.

Who needs evidence when you have faith?

You are so right, Prodigal

Who needs evidence when you have faith? I've been saying for a while that a. this is a religion and b. that means that everyone should have the legal right not to participate in it, and not to have laws based on it imposed upon them.

The medical evidence says absolutely nothing about the ROGD cohort, because TRA's deny there is a ROGD cohort, and studies into the ROGD cohort don't happen.

So I can't imagine anything this 'independent' review comes up with will remotely apply to these kids. The only thing such a review could honestly say about blockers and cross sex hormones in these kids is...there is no evidence, either for efficiacy or harm. It's evidence-free treatment.

The whole thing is so fucking rotten. Why should we believe, in a landscape of mass regulatory capture, that this will be any different?

That should at least be flagged up as an issue as far as informed consent goes shouldnt it?

That has to surely feature in the review?

The review needs to look at the medical evidence and where it stands. I think that is where all of this keeps circling back to - what does the medical evidence say about who is being treated, what are the outcomes.

From the link in the OP:
To support this planned review, an independent expert group is being established to make recommendations on the evidence, that will support a review of puberty suppressants and cross-sex hormones and whether changes are required to existing clinical policies that underpin the use of these on the NHS.

NICE will also undertake a thorough review of the latest clinical evidence to help inform the working group’s review

The working group will be made up of 20 members from a range of clinical and academic backgrounds and will include members of the public.

Why would they need members of the public on this panel if they are looking at medical evidence? And why describe it as 'an independent expert group' if it includes members of the public? How will they choose these members of the public to be people who are able to understand the evidence but are impartial?

And the other question is what evidence is there? The Tavistock doesn't seem to keep track of their patients and ex-patients with proper follow-ups, and have published nothing from their early intervention study.

This article explains where we are now:
users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf

The review needs to look at the medical evidence and where it stands. I think that is where all of this keeps circling back to - what does the medical evidence say about who is being treated, what are the outcomes. If the opinion of the whistleblowers is correct, than the review should show that there is no evidence for the path being pushed by the clinics. And if the clinics aren't recording things adequately, so that the efficacy of their treatments remains unknown, that should become evident as well.

Those would both be serious outcomes and I think much stronger without the opinions either of the doctors or the patients inserted.

A review of the evidence shouldn't need personal contributions

But they are being used as the first step of "treatment" for gender dysphoria. The contributions from the whistle blowers will help to explain that alot if the dysphoria a result of trauma, homophobia etc which isnt being explored . It's no good just looking at the drugs when its supposed to be drugs and side effects vs suicide. The presence of underlying causes of the GD that haven't been treated are very much relevant

But the whistleblowers are largely saying either 'there is no evidence/strong evidence that this is the right treatment' or 'pressure groups are distorting clinical decision making' - ie neutral review is what's needed. A review of the evidence shouldn't need personal contributions.

Goosefoot Why would you exclude the whistleblowers? They were at the front line of treatment and saw what was happening there. It would be wrong to exclude their evidence as medical professionals. If you only include doctors who are in favour of the medical route which is being taken now, you will get a biased result.

And the medical evidence includes the experience of people who have been treated. Both those who feel it helped them and those who don't. In the absence of any rigorous studies about this treatment, the evidence of the patients is all we have.

I want to know what the studies say and where there are gaps.

It's all gaps. There are no studies. Not even the one the Tavistock said they were carrying out.

So no detransitioners, parents of ROGD kids, whistleblowers from the Tavistock? None of those are independent either. Is anyone independent if you exclude everyone who is 'currently involved in the debate'?

From my perspective, if the idea is to look at the medical evidence of efficacy, it wouldn't include any of those people either. If I am looking at evidence for a controversial cancer treatment, I want to know what the studies say and where there are gaps. Not the opinions of people who tried it, good or bad.

How have we got to a place where gender non-conformity is seen as something that needs medication?

This is the crux of the issue, isn't it?
Sexism is rampant, and homophobia seems to be back with a vengeance. It's not a secret that without puberty blockers and cross-sex hormones most kids will desist and many will be same-sex attracted. For some reason, medical professionals prioritise (prefer?) 'trans'.
Dr. Russell Reid avoided being struck off because apparently he was such a help to the trans community, and that was 10 years ago. I think this review will be a complete whitewash.