Puberty Blockers - impact on the brain

For research to be ethical there is only a narrow window in which it can be carried out - where you do not know whether the benefits of the treatment outweigh the harms and whether these are better than the alternatives. Your research should them be designed to answer this question and monitored so it can be stopped early if harms are too high.
When the Tavistock study was placed before a neutral ethics committee it was found to be unethical. Not least because despite placing children at risk it could not answer the question of whether PB help.

Well, in order to analyse dysphoria we'd first have to define it.

And, that appears to be a bit tricky.

I agree on that too, @Thelnebriati. It all hinges on whether gender dysphoria is treated as an illness or not. As with so many psychological issues, where do we draw the line and decide that something is causing so many problems that it's now an illness rather than a normal life experience?

If we don't treat it as an illness or other medical problem, why is it getting a medical solution?

I agree but go one step further; I don't think that normal biological processes should be routinely pathologised or medicated.

I am a layperson but I would hope that if medical professionals were going to prescribe a drug treatment which they know will have a significant effect on a child's development they would do everything in their power first of all to try to look at what might happen both if they do and don't prescribe it.

In the case of PBs, they have research to consider on how PBs affect children given them for precocious puberty. Are children given PBs for gender dysphoria put on the same dose? Do they take PBs for a longer or shorter time? I assume they start them much later than children suffering from PP. Does that affect how they work?

What happens in normal puberty? There must be research about that, and about all sorts of conditions known and studied where something has gone wrong.

Break it down as much as possible. One detailed list of changes that normally happen in female bodies during puberty, another for male bodies. Which of these would be affected by PBs? If the PBs are stopped, does the process that was halted/prevented get going again? Does it happen as you would normally expect if no PBs have been taken? How important is the change?

Set against all of this the outcomes for children with gender dysphoria who have not had any hormone treatment. Separate out those who got no help or support at all from those who got counselling/therapy/psychiatric drugs for depression, anxiety etc. Make sure you look at girls and boys separately. Look at co-morbid conditions. E.g. how does a child on the autism spectrum disorder cope with puberty where there are no gender issues?

Having done all of that, specialist clinicians could have an informed debate to decide whether the problems resulting from taking PBs are all outweighed by the problems from not taking them.

I genuinely have no idea how much of this work has been done. I have the impression that research in this area has been limited because of fear of claims of transphobia, bigotry etc etc. Also, the numbers of children involved have increased hugely in the last 20 years - have the characteristics of the group changed? Is the older research still relevant?

James Caspian at Bath Spa University was prevented from doing research into detransitioners. Have there been others?

Thanks for doing that Helle

I think those cases are from the US.

[quote KatieAlcock]I wrote a short thread on PBs here but some of the papers have already come up:

twitter.com/threadreaderapp/status/1336607674344103938?s=19[/quote]
PB for puberty blockers after 8? But I thought 9 was a fairly normal age for starting puberty these days?

Katie

I have been updating the breaK it down, I shall add your tweet to the collection.

I wrote a short thread on PBs here but some of the papers have already come up:

twitter.com/threadreaderapp/status/1336607674344103938?s=19

There are a few studies looking at estrogen receptors in relation to autism.

www.sciencedirect.com/science/article/abs/pii/S0165178116309325

Anecdotally a lot of autistic women have PMDD. Women with ADHD also report a correlation between post ovulation and reduced ability to function whether medicated or not.

It does make you wonder whether cross sex hormones and blockers are indeed alleviating psychological symptoms but not because it’s about gender dysphoria.

Pepper = people. Damn autocarrot

wax = sex obviously.

Yes. As two transmen sadly discovered in their own medical care.

The one who allowed testing to go on for months while getting progressively worse and not disclosing their trans status highlights exactly that much of the body retains the original wax markers.

It’s like asking ‘should a transwoman disclose their sex so they don’t receive blood from a female who has been pregnant’. You’d expect the answer to be yes, of course. but if they are constantly being told they have changed sex and now are the sex they feel they are, why would they think it should apply medically.

All this conflating sex with gender is so incredibly harmful when people believe it. Yet, to acknowledge that it is harmful is ‘harmful’ and so the cycle continues.

So, I wonder. Do the posters who continue to post that pepper have changed sex, truly understand that medically they are perpetuating dangerous myths?

Maybe they have not had to heavily advocate for an elderly female’s health to be taken seriously. Because the conditions are more ambiguous and are most often discounted because, well female and elderly. It certainly highlighted to me the significance of sex. Oh and all the workplace sex discrimination. That’s a given though isn’t it? (Or maybe those posters have not experienced that first hand either, it is possible I guess )

It's not just about hormone levels, it's about the receptors as well. You can pump all the testosterone you want into a female body, and it will develop male secondary sexual characteristics. But this will never completely mimic the male body as the distribution of the testosterone receptors, and therefore the biological and physiological affects is very different between men and women.

Warrior

That looks like a good site. I wonder if it is on the break it down for me thread.

This website posted on the trans train 3thread might be helpful OP

genderchallenge.no/home-1/science-1/what-science-tells/

It depends what you mean, by reversible,’ says Dr Richard Quinton, an endocrinologist and senior lecturer at Newcastle University. ‘When the blockers wear off, a young person’s own sex hormones will “wake up” again,’ he says. ‘This includes a resumption of fertility, but the process of building stronger teenage bones is disrupted and may not be entirely recoverable.’

Sex hormones are not going to wake up if your gonads have been removed.

Which is probably why you don’t hear much about detranistioning males who had puberty blocked followed by genital reassignment surgery. And the ones that don’t go for the surgery keep taking blockers because otherwise the male secondary sexual characteristics appear.

The female path tends to not continue blockers and also does not remove gonads.

I wonder if there are situations where it gives up permanently and in that case I guess there will be no reversibility and the person will be on actual HRT for life with all the health risks that entails

It’s definitely a risk. (Andecdote, but relevant) I was only on Triptorelin for six months, but my hormonal balance never recovered. It’s likely that it was implicated in my very early menopause, and in the litany of autoimmune conditions I’ve been left with as a result.

Sorry, we’ve wandered away from the original topic but honestly I never want to miss an opportunity to hammer home how powerful these drugs are.

NutellaEllaElla

Oh dear! Nutella, I just reread what I wrote.

I meant the poster who’d posted the link didn’t thank me for pointing out the fact that it was irrelevant to the point under discussion.

He's been very sensible on vitamin d recently and helped to get the Newcastle numbers of cv deaths down as a result. He knows his stuff.

A big issue for young people who have anorexia is the fact that the highest amount of bone density it laid down during puberty; recovering from the anorexia doesn't cure the risk of long term bone health.

From the previous thread about the Dutch child in the movie, the puberty blockers were described as constantly overloading and challenging the pituitary gland until it 'gave up'.

Yes. I guess if you are determined to take cross sex hormones for the rest of your life, you may not see it as a problem to have to take other synthetic hormones your body can’t then produce.