BBC at it again

There are no pychological solutions to gender dysphoria. There are some that help you cope, but none that cure it. Also, gender identity is about who you are, so most trans people wouldn't want a psychological solution because they would feel that it's attempting to turn them into someone else. That's conversion therapy.

This is not unusual - there are many medical conditions that have negative effects on your mental health, and psychiatry can help you cope with that, but what you need is for the underlying condition to be cured. The most effective way to do that with gender dysphoria is transition.

positrans

Your paper is a cross-sectional survey relying on self-recall. Such a design scores pretty low on the evidence hierarchy.

It asked 20619 transgender adults aged 18-36 years to fill in a survey.
It asked them to recall if they ever wanted puberty blockers? Yes = 16.9%
Of that group did they receive them? Yes = 2.5%
It also asks them to assess their suicidality.
It compares lifetime suicidal ideation in the 2.5% that recalls they wanted puberty blockers and received them, to the group that recalls they wanted puberty blockers and didn't receive them. It expresses the result as an odds ratio, a statistical way to express the result that is particularly difficult to understand. However a statistically significant difference is shown, for this retrospective cross-sectional survey.

This is not an evidence base for giving puberty blockers.

This shows that young adults who recall they wanted to receive PBs who went on to receive them have a lower odds ratio of suicidality during their young adult life than young adults who recall they wanted to receive PBs who didn't go on to receive them.

Gold standard evidence would be prospective and randomised.
Take a group of children who have been referred for assessment to GIDS (or wherever)
Randomise half of them to puberty blockers, and half to another treatment (watchful waiting? psychological support?)
Follow them up for suicidal ideation, regret, move to cross sex hormones, surgery, psychological outcomes etc. I'd suggest a long follow up (5-10 years) based on the timecourse of regret seen with detransitioners.

Then hopefully we can stop arguing and implement some proper evidence-based management of these children.

No positrans you are really belittling what many children go through. I can't detail what I went through without breaking Samaritan guidelines, but take it from me it was pretty overwhelming , devastating. And I came out the other side.

But surely thise psychological effects need a psychological solution.

Not drugs that permanently alter a body before a chikd can possibly even understand what the drugs do.

This is great. We need more programmes that show how very normal trans young people actually are to counter all the scaremongering

I tend to agree, as on here trans people are painted as TRA's, something to be scared of etc, and this shows that they're just normal people like everyone else living their lives.

Basically, the psychological effect of a testosterone puberty on a trans girls is exactly the same as if you took a girl who isn't trans and forcibly injected her with testosterone.

You can't possibly know that, as the experiment has never been done.

And you are ignoring all of the physical effects of PBs and CSH. Mental health is incredibly important (I've suffered myself) but it isn't the only thing that is important.

I agree that puberty is a natural process - of course it is, but a testosterone puberty for a trans girls can be absolutely devastating - not the normal discomfort that so many kids feel through puberty, but a totally overwhelming horror.

Basically, the psychological effect of a testosterone puberty on a trans girls is exactly the same as if you took a girl who isn't trans and forcibly injected her with testosterone. That's how horrific it is for them, and was for me.

I started watching this last night too because it was promoted to me after a downloaded episode of HOMES UNDER THE HAMMER!! I will continue to watch it out of curiosity but I know I'll be complaining to the BBC afterwards. I think the timing of the promotion was definitely premeditated and cynical.

Positrans, don't worry, many lives will not be ruined. It's quite possible to grow up. Thousands of girls have done just that down the centuries . What trans identifying teenagers feel today is nothing new at all. It's just recently people have wanted to " treat " it as though it is something that is wrong with a person. There isn't.

If a trans girls is to young to understand what an estrogen puberty will do to her, then she's too young to understand what a testosterone puberty will do to her.

Perhaps. That's not an argument for medicating a child without their proper consent though.

What normal puberty does to a body is not understandable by many children. However , it is totally natural and part of being human and is unlikely to lead to harm for the child

Changing or avoiding puberty is unnatural and will have harmful consequences

Hum.

children cannot possibly understand the consequences of the treatment - how can they understand the loss of something they've never experienced?

I disagree with the judgement. If a trans girls is to young to understand what an estrogen puberty will do to her, then she's too young to understand what a testosterone puberty will do to her.

The judgement will be overturned eventually. Unfortunately, lives may be ruined before then and I strongly suspect some lives will be lost. I dearly hope not, and a lot of us are doing are best to support some of the trans kids who have been refused the treatment they need. It's pretty devastating to watch - some of them are in absolute desperation.

Sorry. My post refers to this

What they need is to have all the information so they can make informed choices.

What they need is to have all the information so they can make informed choices.

Read the judgment from Keira Bell's case last week (link in my earlier post).

Children cannot give informed consent because they cannot understand the consequences of the treatment (because they are children).

Again, three high court judges would disagree.

But please do provide your evidence to the Tavistock as they needed to provide clear evidence that the consequences of using puberty blockers were well understood by children and teens.

I dont think anyone would argue with people having all the evidence based information there is, after all the health treatments I have are based on clinical evidence

the key is that it is 'evidence based' as in robust peer reviewed research

secondly people must have the capacity to understand the information given to them e.g. the capacity to understand evidence based information around loss of fertility differs greatly between a 12 year old and a 33 year old

Just speaking from personal experience, coupled with an observation about the number of women who are not missing from society due to suicide

Has it though.

I mean some of these adult trans people had wives and kids and careers. And the chance to develop mentally.

Are you saying they'd be happier if their kids never existed or they never had their career ?

They cant know they'd have preferred it . We can never know if we would have been happier being somewhere else or being someone else.

Often the grass isn't as green as you think

I would argue that the intensity of feeling of a teenager with dysmorphia means that they would be unable to comprehend that the feelings may be, and indeed in the vast majority of cases , are transient

I would argue that not warning them of what will happen if they miss the opportunity to transition with blockers is irresponsible given that it has been so devastating to so many trans adults. What they need is to have all the information so they can make informed choices.

Not only do the overwhelming majority of children not go on to transition, but it seems an overwhelming sample of older females are bloody glad they were not given the opportunity

Using emotive language and the fear of needing surgery as an adult if a child or teen does not set their path early enough is very irresponsible.

Three high court judges would disagree that someone under 16 (dubious even some under 18) has the life experience to make that decision. Why apply pressure for them to do so?

The statistics tell us that left without medicalisation, the overwhelming majority don’t go on to transition.

@OldCrone sure, here's one using a cross-sectional survey of 20 619 transgender adults aged 18 to 36 years:

pediatrics.aappublications.org/content/145/2/e20191725

RESULTS: Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2–0.6).

CONCLUSIONS: This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.

I am not convinced that would not have been better to go through puberty & accept they are gay, move to a city & live a fabulous life as a gay man. When they went for the surgery I was close to tears, what a horrendous process to go through-& they have now lost sexual function-its inhumane 'treatment'

I think that's what got me really. I mean if you watched a documentary about families who get a puppy, you expect to see waggy tails and lots of love and laughter. But you also expect to see them chew the furniture and pee on the carpet. Does cursing your dog at 7am because you just discovered they ruined your work shoes mean you don't love your puppy or regret your puppy? No. but if you cant talk about your puppy being a puppy should you be getting a puppy?

There was just nothing to indicate they even really understood what path they were on and what the consequences of that path were .Thats what was missing.