The ethics of keeping an adult in a child's body - BMJ

Yet there's never been a Cochrane Review because the existing "evidence" is so flimsy it's basically creative writing.

HAs there ever been a medical ethics submission for this stuff?

My impression is that the purpose of this paper is to be cited in that kind of documentation. They aren’t actually doing it yet but want to lay the groundwork by creating lots of “research” that can be used to position this as legitimate and ethical medical treatment.

HAs there ever been a medical ethics submission for this stuff?

I've never seen anything.

Yes — when we have some of our regular visitors dropping in, who like to talk about the “lifesaving” effects of giving puberty blockers to “trans kids” so that they can surgery, I sometimes ask them if they are happy to apply the same logic to children who identify as non-binary and think they want “nullification”….

I never get an answer, presumably because the answer would be far too telling. Saying no reveals they don’t really think the treatment is harmless and reversible. Saying yes is clearly sinister and bonkers but it reveals a bit too much about the idea of using them for “trans kids” too.

Should 11 year olds be allowed to choose to take blockers because they think they will want to have nullification surgery later on…? It’s a good question. Would like to see the Maughams of the world answer that one.

The authors argue that she has capacity to make that decision despite the fact that her brain will not have fully developed, because we don't actually know for certain that there will be harm as the studies haven't been done.

How can any patient give informed consent to a medical procedure if they are not informed about potential harms resulting from that procedure?

Surely we don't actually know for certain that there will be harm as the studies haven't been done is a crucial reason to explain why 'Phoenix' could not make that decision !

Embarrassing Thank you for providing a better link - it is never great when posting links on the phone.

Maybe it was the Ashley X case that I was thinking of and all the coverage around it, but I was sure that a case had gone through the UK courts, I've tried to google but I can't find any reference.

I wouldn't want to draw too many similarities between the two situations, but the end result does seem to be the same - a young person who has had their development stopped or delayed. In the case of Ashley development was totally halted. Obviously in the treatment here there is the added level of disability and society's views on that, but there has been lots of papers and discussions for what is still seems to be a very small number of children. This seems to be in stark contrast to any research around treatments in gender clinics.

In case anyone is interested in the Ashley X situation here is some more information.

www.nytimes.com/2016/03/27/magazine/should-parents-of-severely-disabled-children-be-allowed-to-stop-their-growth.html

www.researchgate.net/publication/5403188_The_Ashley_treatment_A_step_too_far_or_not_far_enough

See also this "ethics round" article about possible long-term use of puberty blockers - it's the slightly older and less sanitised version I think:
publications.aap.org/pediatrics/article/145/2/e20191606/68237/Long-term-Puberty-Suppression-for-a-Nonbinary

Also definitely not hypothetical
In this Ethics Rounds, we present a case that combines features of several real cases that raised issues about prolonged pubertal suppression for a patient with a nonbinary gender.

@EmbarrassingHadrosaurus

The notion of giving puberty blockers to an 11 year old is really sickening. It’s child abuse, plain and simple.

Just who will benefit from adult women who look and think like children? It's certainly a bit of a mystery.

I have thought since the very first day I heard about puberty blockers and trans ideology back in 2015. I was called a "disgusting conspiracy theorist". So strange how all our worst, initially dismissed and rubbished fears, continue to be realised as the years go by.

I'm not actually reassured to learn that Phoenix is not wholly a thought experiment but rather a patchwork of real world patients and clinical scenarios.

In our Feature Article, we describe and analyse a hypothetical case scenario involving Phoenix, a non-binary 18-year-old who started puberty blockers soon after beginning puberty at the age of 11, and who wishes to stay on them throughout adulthood. Although this case is hypothetical, it includes features of several cases we have heard about from practicing clinicians….
…
Although Phoenix is not a real person, their story is not completely hypothetical. Lauren Notini has recently interviewed 14 clinicians from multiple states and territories across Australia who work with TGD youth. Twelve of the 14 reported that they have received requests for puberty suppression from non-binary young people. Some of these clinicians reported that some non-binary young people who start puberty suppression wish to continue it on an ongoing basis (i.e., into adulthood).

blogs.bmj.com/medical-ethics/2020/07/28/ongoing-puberty-suppression-should-be-an-available-treatment-option-for-non-binary-adults-but-case-by-case-analysis-is-also-needed/

For example, Phoenix’s child-like body could mean they have trouble finding a romantic partner. A lack of sex hormones will also reduce Phoenix’s libido.

Bloody hell.

Even someone with the most basic safeguarding training should be able to unpick that one. How can I put it in jolly nice wankerybabble?

What concerns might be anticipated regarding the dating pool of adults sexually interested in a partner with a childlike body and little enjoyment of sex or sex drive?

And what quality of relational experience do we think Phoenix is at risk of receiving?

[quote Whitefire]This is 15 years ago, (and I don't think it was the one I was thinking of) but an interesting read nonetheless.

www.google.com/amp/s/amp.theguardian.com/world/2007/jan/04/health.topstories3[/quote]
The above link didn't work for me but this one did:

The cause of the controversy is the "Ashley Treatment" - a course of surgery and hormone supplements devised for her at her parents' request and with the blessing of doctors - that will for ever keep her small. It involves surgical operations, including a hysterectomy, and hormone prescriptions that will, in effect, freeze-frame her body at its current size.

Although she has a normal life expectancy, she will, physically, always be nine years old
…
Jeffrey Brosco of Miami University has co-written an editorial in the Archives of Pediatrics & Adolescent Medicine criticising the procedure as an experiment without proper research controls. "This is a technological solution to a social problem. I work with severely disabled children and know how hard it is on families, but what we need most is better federal funding so that they can be cared for properly."

www.theguardian.com/world/2007/jan/04/health.topstories3

Some adults and their ideas are truly frightening.

This is 15 years ago, (and I don't think it was the one I was thinking of) but an interesting read nonetheless.

www.google.com/amp/s/amp.theguardian.com/world/2007/jan/04/health.topstories3

I'm sure there was a high court case where a parent wanted their disabled child to have puberty blockers to try to prevent periods and to make their care easier to manage. It was thrown out, I should try and find the details.

if someone had offered me the chance to avoid puberty aged 12 on the (accurate) grounds that I found it all very distressing I'd have bitten their hand off.

I lived within a few doors of several brothels and in an area with a lot of sex workers. Men in the area (residents or 'transactional visitors') took that as wide-ranging permission to assume that all women and girls were plausibly up for al fresco sex work and that there were no consequences to attempting to grab you off the street and to pull you into a garage block.

I'd think a number of girls and young women would have been eager to bypass this part of our mutual development and social maturation had an option been presented to us…

In addition to potential distress associated with any physical harms that eventuate, there may be other psychosocial harms associated with OPS to make Phoenix look ‘more non-binary’. For example, Phoenix’s child-like body could mean they have trouble finding a romantic partner. A lack of sex hormones will also reduce Phoenix’s libido.

Hmm.

For example, Phoenix’s child-like body could mean they have trouble finding a romantic partner.

Awfully fucking coy, aren't they?

("They" the highly suspect individuals who wrote this, not they-Phoenix.)

Christ, if someone had offered me the chance to avoid puberty aged 12 on the (accurate) grounds that I found it all very distressing I'd have bitten their hand off.

Fortunately they didn't.

This is just the new anorexia isn't it? A medical way to permanently keep puberty at bay.

So is this all a massive 'job creation scheme'/(profit creation) for psychologists, university academics, drugs manufacturers, Diversity and Inclusion Managers, plastic surgeons, charities, politicians, pressure groups etc?