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

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

Indeed.

Still, even if you accept the premise of "not identifying with the gender you were assigned at birth", it is still a stretch to recommend that people with such beliefs should be treated with hormones for which the longer term outcomes are largely unknown.

If "not identifying with the gender you were assigned at birth" means just thinking the stereotypes are shit (I certainly don't 'identify' with femininity), then most feminists would have to be included as trans or non-binary.

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

Thanks for those extracts Oldcrone they're not what I would consider to be neutral and objective. Still, even if you accept the premise of "not identifying with the gender you were assigned at birth", it is still a stretch to recommend that people with such beliefs should be treated with hormones for which the longer term outcomes are largely unknown.

I won't cite them here, but we know what is likely to be used as the or-else arguments, but does that demonstrate quality added life years? What would perfect health even have to look like to someone seeking treatments? More hormones, more surgery? Wouldn't it be kinder - seeing as being kind is the phrase du jour - to be honest? Humans cannot change sex.

More from the NHS document, which reads as though it was written by transactivists.

Currently a diversification of gender identifications is taking place. A person may identify with characteristics and behaviours which (their) society may recognise as not being consistent with their experienced gender, or they may identify by another descriptor such as non-binary. Binary implies that an individual identifies exclusively as a man or a woman, however there is a growing recognition that many people do not regard themselves as conforming to the binary male/female classification.

Some children experience anxiety and other forms of distress associated with the difference or incongruence between their assigned sex classified at birth and the gender characteristics and behaviours they identify with.

Why is a dislike of gender stereotypes anything to do with the NHS?

In addition, some may strongly dislike the physical sex characteristics of their biological sex.

Finally, something which might be termed a medical condition, more precisely a mental health condition. A strong dislike of your own body is not a healthy state, and an individual suffering in this way clearly needs psychological support to come to terms with their body.

Some more from the NHS document I posted a link to earlier.

Gender Dysphoria (GD) describes the distress that is caused by a discrepancy between a person’s gender identity and that person’s sex classified at birth (and the associated gender role and/or primary and secondary sex characteristics) (Fisk, 1974; Knudson, De Cuypere, & Bockting, 2010b). Assigned sex is classified at birth based on the appearance of the genitals. The term transgender is used where a person’s gender identity is different to their sex assigned at birth.

So the NHS is using the incorrect terminology that people are 'assigned a sex at birth'. They also say that the 'associated gender role' causes some of this distress. Are they really saying that a person who dislikes the gender role which society imposes on them because of their sex might need to have their body altered to better fit what society expects?

I hope it really will be 'evidenced based' as they claim it will be.

Pharmaceutical companies have had huge influence. When NICE was set up it was thought that they wouldn’t be particularly interested in NICE’s conclusions as the UK is a relatively small drugs market compare to America. But American insurance companies starting paying attention and suddenly pharmaceutical companies were very interested. They would swamp appraisal teams with data, send biased marketing information to patient groups and effectively pay them to lobby NICE - preferably with a few ‘sob stories’ to get mainstream media involved. Beta-interferon for MS was a classic case of forcing NICE to ignore the evidence through campaigning.

I’m actually very worried about this. There is a risk that the Wild West could get a lot wilder.

It’s a while since I’ve worked closely with NICE guidance and so I’m hoping I’m wrong. From experience though, whenever NICE have been asked to appraise something and there isn’t sufficient high grade evidence they push the decision-making back to local clinicians and commissioners. The local process is to assess the needs of individual patients in light of emerging evidence and circumstances and there is some wording which i’ve forgotten about not setting precedents.

As there is limited evidence about the long term effects of these medicines, I can’t see NICE having any different outcome from this review. And however hard the pharma companies and interested parties lobby, I can’t see the risks (and astronomical future payouts) of recommending such treatments to be ignored by the grown-ups either.

Which leaves a vacuum of local decision making. Now who do we think is going to offer to ride into town and offer help with training and policy development?

As I say, I hope I’m wrong.

There seems to be a rigid view that GD must be treated medically which a growing number of people with GD say isn't necessary.

The problem is that self id takes away any hint of it being a medical issue that should be treated.

The narrative that we can be born in the wrong body has been very damaging. So many have believed it. Alongside a society obsessed with appearance and selfies and social media.

I know a NICE review of thyroid guidelines involved many different people - charities put out invites and questionnaires.

There will be a lot of charities putting their penny's worth in, on the affirmative side.

We are going to need to be very active to get the right message through.

What is gender dysphoria, and why does it need to be treated with hormone blockers and cross-sex hormones?

This is from an NHS document about GIDS for children and adolescents.

1.2.1 About Gender Dysphoria
The language in this area is evolving. Gender identity refers to an individual’s subjective sense of being male, female, both, neither or something else.

Is this what passes for a rational statement in the NHS? How can anyone have a "subjective sense of being male, female, both, neither or something else"?

I don't have a "subjective sense of being male, female, both, neither or something else", because these are not feelings. Everyone is either male or female. Nobody is both, neither or anything else.

So the NHS has decided to treat children, who have a 'feeling' that they are something they are not, with medication which endangers their general health. Why?

Could we have a NICE guideline on what is a woman?

Perhaps a short Technical Appraisal on diagnosis?

If this is full of clinicians and lobby groups (all with mega conflicts of interest because they get their incomes from this) then how can it be independent? We know what happens as soon as anyone from a trans lobby group gets anywhere near discussion or debate. They do their normal bluster and fluster to disguise the lack of facts and arguments alongside shovel loads of accusations against anyone who suggests that their way might be problematic. The Chair - no matter how well intentioned - will be silenced by this, accused of transphobia by the third meeting (if not before) and unable to explore co morbidities, lack of research and data, lack of therapy for children and the pressure on all clinicians from self interested adults and groups.
Any group / individual consulted will be dismissed as transphobic and hateful.

It all needs to be tied in together as opposed to just looking at medical.outcomes

It also need to be looked at that blockers directly lead to cross sex hormones in nearly all cases. Its irrelevant how "safe" they find them to be if it's not acknowledged that they start the whole.process and lead to even more damaging treatment.

OldCrone I agree. But it should at least exclude active lobbying organisations and those directly involved in prescribing puberty blockers.

They would be truly stupid to spend this money and resources coming up with yet another unbalanced, overegged TRA political lobby designed answer that excludes everyone that the lobby will tantrum about. All that will happen is that it will be immediately discredited, provide yet more evidence of the concerns in hand including institutional capture and niche politics overwhelming best interests of children, and be used accordingly.

It's going to have to be faced up to sooner or later, and the government and the TRA lobby are going to have to admit that any legitimate case can stand on its own merits without having to be heavily stage managed to force the right answer.

I hope so.

I know she will now be under fire a bit but we are talking kids here and being bullied into what they see as the right answer to avoid grief and threats well that doesnt bear thinking about

independent should mean people not currently involved in the debate at all - so no Stonewall, Mermaids, GIRES, or Tavistock links

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'?

OldCrone independent should mean people not currently involved in the debate at all - so no Stonewall, Mermaids, GIRES, or Tavistock links. Seems unlikely.

If it is like a NICE review then there should be an independent academic team of research scientist who will carry out a systematic review. If there is and if this is rigorous and unbiased then that should show up the paucity of evidence but will just rely on current research evidence (so no detransitioner evidence). Then interested parties will be given the chance to go to town on why this review is not relevant, why they are needed anyway, drum up noise, all of which (and the fact the CRG are ideologues) will mean that an unbiased systematic review will be basically ignored in any recommendations.

The only thing that may give them pause for thought might be the fact that by making recommendations the NHS will be putting itself in the firing line for future litigation (and letting doctors off the hook).

Surely the 'independent expert group' being established is not the same thing as the current 'gender identity programme board'?

It appears that the names of the people in the independent working group have not yet been released. From the link in the OP:

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. We will provide an update on the full membership shortly.