BMJ's editor on evidence void and overtreatment of gender dysphoria

I was able to get it free via Spotify last night.

It’s good.

Thanks all, on the Blocked and Reported podcast!

I would agree ....but.......

For instance, in my case, my professional association jumped on the bandwagon around 5-6years ago. They devised a LGBT strategy that was primarily about trans issues.
And, at that, it was primarily around transwomen's health needs.
Which I can summarise as: "affirm without question" or a version of "most vulnerable population ever".
Brief mention for "men can get pregnant too".

Nothing, not a word of guidance for people working with the CAMHS population. Nothing about differential diagnosis, nothing about ROGD, nothing about overlaps with ASD/trauma/ family systems concerns.
Nothing about using evidence-based practice and robust links to same (which would be typical of any other guidance or strategy documents).

That makes it extremely difficult to row against the tide.

It's not a premium episode, so should be on streaming services in a day or two. I'll keep and eye on it and let you know. .

(It's the Gender a Wider Lens one)

This is a great interview with Hannah Barnes if you can't get B&R Mavis:
open.spotify.com/episode/57ZKBY7w4H3JjHrzjbe0vG?si=4i1XoTHYR8-d1KcSttEfFA&app_destination=copy-link

Blocked and Reported sometimes make their subscriber only episodes free to access a bit later on.

the problem at the Tavi was that anyone who expressed disquiet was quietly removed (or not so quietly), it grew very quickly from a relatively small unit to a massive unit mostly staffed by relatively inexperienced staff who were easily captured by "group think" and where the supervision was not robust and perpetuated the appalling culture.
It was/is an open secret in MHealth that the young person side of the Tavi was extreme and several referring units would try not to send young people there, however it's hard to keep people away when your own departments have little/no funding/personel to support the patients.
David Bell is a hero and blew the whistle but at great personal cost, he at least managed to keep a platform and his wits about him.

That’s a song by someone called Gillian Welsh!

This is free:

m.youtube.com/watch?v=wFle2YoQwWg

Is there anyway you can listen without having to subscribe? They want my money.

The latest Blocked and Reported podcast has an interview with Hannah Barnes talking mostly about the Tavistock clinic. It might be worth a listen. It was episode 155.

I happen to know that at least one of the senior editors of Nature has a transgender child and froths about "TERFs".

The endocrinology team at UCLH have come up in the various court cases and tribunals - been doing a sort of ‘We we’re just following orders’ Nuremberg-type defence.

You can sort of see their point.

The endocrinologist didn’t make the diagnosis and the diagnosis is not an endocrinological disorder anyway.

All they can do is monitor for side effects (eg periodic bone density scans). They can’t monitor the effectiveness of the ‘treatment’ because the diagnosis (gender Dysphoria) isn’t in their wheel house.

The main dude at UCLH, Professor Gary Butler is deffo on board the Gender train though:

www.researchgate.net/profile/Gary-Butler-4

One small point in their favour is that at least UCLH were monitoring bone density - GenderGP will happily prescribe the same GNRHa drugs to kids online with no face fo face appointments at all, let alone periodic bone scans.

I totally agree!
Who were the endocrinologists?
Was it at UCLH?
I'm astonished that nobody seems to be investigating this side of things

MavisMcMinty, I wish the Tavistock was the UK’s only gender clinic, as it is being closed down, but unfortunately here in Scotland the Sandyford clinic is sailing on regardless. When confronted with the Cass enquiry, the SNP unbelievably dismissed it as “only applying to England”.

It's the endocrinologists I'm most shocked at. GIDS staff are largely psychotherapists, social workers etc, not medical professionals. They make referrals to endocrinologists who you would hope would have a deeper understanding of the effects of blockers and hormones on young bodies. Polly Carmichael is coming in for a lot of stick but I think those who administer the drugs need examining.

John Launer's piece was temperate and carefully worded.

Over my years at the Tavistock I got to know several colleagues who worked in that unit. I heard how the numbers of young people they saw rose exponentially, in line with social awareness of gender dysphoria and public acceptance of it. They often dealt with hostility from patients, families, and pressure groups who believed that the service should offer treatment more readily. Internally, they faced criticism by some clinicians who believed in a more cautious approach involving a much longer assessment.2 I knew and respected people who held passionate positions on both sides of this question.

www.bmj.com/content/380/bmj.p477

I wonder if Kamran Abassi (author of OP's linked piece) has been persuaded over time to start reflecting on the evidence base by reading Cass, McCartney, Bewley, Meads, and Rogers.

The ones who don't agree are forced out.
No share token, I'm afraid but...

www.telegraph.co.uk/news/2019/12/12/childrens-transgender-clinic-hit-35-resignations-three-years/

Perhaps the BMJ team can have a word with the editors at Nature, who have a really poor record with gender-woo.

Yes, @nepeta - awful enough online, where however neutral and considerate you try to be you manage to somehow offend one or both sides, it has a “chilling”, silencing effect. But to experience it in person, for someone who CHOSE to go and work in the prestigious exciting GIDS centre, to be accused of “transphobia”…? Well, if those principled, concerned clinicians can be called transphobic then so can the rest of the world.

Just finished Barnes' book, and need to digest it a bit. But one thing that she refers to (though not a lot) is the vicious treatment anyone expressing reservations received, and how external 'patient advocate' groups had outsized influence on the very top level of the GID.

I believe that the equivalent of narcissistic rage I see reservations receive on Twitter must be almost unbearable when it is done in real world spaces. Why things were allowed to get as bad as they were really deserves a good explanation. Galileo's Middle Finger already described the hounding and canceling of people who disagreed, however politely, so the problem must have been known.

Polly has made many cry and many will cry for generations over what she did, that is not a legacy of improving the nation's mental health.

And let’s not forget that the director of the service throughout all the turmoil has been Polly Carmichael, who is STILL director. Perhaps she deployed her (evidently very effective) tactic of bursting into tears if/when it was suggested she stand down?

(“You’ve made Polly cry”, from Time to Think by Hannah Barnes.)