Hilary Cass on Woman's Hour 9.10.24

It is not 10 out of 3,306 though is it? The followup data for the majority of the cohort were with-held, lost or didn’t exist. We also know that PB trap children into the medical route so if the other 3,296 had taken PB and continued onto cross sex hormones then that proves harm as when left more than 85% of adolescents desist.

You also just dismissed a pp as just providing anecdote. That is what those poor studies are.

Your telepathy is on the fritz Dadjoke - I learned about the dangers of the drugs by reading about them being used to treat precocious puberty and endometriosis before I knew that the drugs were given to children to treat gender confusion.

It was because I knew about the dangers from the treatments of these other physical conditions that I became concerned about the drugs being given, for a much longer period of time, to children with emotional rather than physical ailments.

Perhaps you could give one example of a study which you believe should have been included but was not?

It just blows my mind that random laypeople go about acting like they are qualified to armchair critique a four year long government-backed healthcare research piece. Blows my mind every time. It's like someone walking into someone's place of work, peering over their shoulder and saying "Ah, I see you have dismissed lots of perfectly good methods. What you should have done is sent a big bag of sweets to my home address. What do you mean, that's not your job?".

NB. The whole report can be downloaded via my link upthread.

‘We are going to start your young daughter on an incredibly powerful drug with a list of side effects as long as my arm. We previously used it to treat terminal cancer patients who took it for a couple of weeks but we are going to put your child on it for life. Evidence? Oh yes, we got a self interested lobby group funded by the drug manufacturers to tell a bunch of children they would commit suicide if they didn’t take this drug (that non of the lobbyists took) then gave a few of them the drug and asked them five minutes later if they were happy to have it. A couple of them said yes so it definitely works. Ok they might have felt more suicidal (a know side affect) but I sure that was just ‘phobia’. What does it do? Well apart from stunt all aspects of their development, nothing for girls.’

"In 2020, WPATH commissioned John Hopkins University to carry out a systematic review of existing research on cross-sex medical treatments. The study found ‘little to no evidence’ to support the medicalisation of gender-distressed children and adolescents. So WPATH blocked researchers from publishing their findings....

Michael Shellenberger, published a shocking 242-page report known as ‘The WPATH Files’. authored by researcher Mia Hughes. Relying on documents sourced from an internal whistleblower, the report brought to light a chilling scandal within the organization. It describes medical malpractice on a massive scale and a total lack of any medical ethics; minors encouraged into treatments and procedures they could not possibly understand or properly consent to, homeless and schizophrenic people undergoing ‘sex change’ surgeries and even “Extreme body modifications performed with no medical justification”.
As Malcolm Clark writes in The Critic, “WPATH is little more than a pressure group made up of a mixture of saucer-eyed trans activists and self-professed experts in disciplines like endocrinology, psychiatry and surgery. “Experts” who just happen to pocket huge profits from the mutilation and sterilisation of deluded people who are convinced they were born in the wrong body. Yet by a combination of external bullying and internal feeble-mindedness, some of the world’s top medical authorities from the BMA to the American American Academy of Pediatrics have given WPATH the stamp of approval.”

The power held by WPATH and its ideological champions, such as Rachel Levine and the AAP, has persisted for too long. Medical practices, particularly those involving children, need to be rooted in evidence rather than driven by ideology.

I prefer to see the research rather than anecdotal evidence. It is however admirable that you have taken interest in the side effects of a drug which up to it being presscribed to trans kids, you had no interest in at all.

But it's moot now. There's a clinical trial.

I've read it. She dismissed a whole bunch of perfectly good studies.

The GIDS Audit she commissioned found less than 10 detransitioners in a discharged cohort of 3,306.

Please see this link.
https://cass.independent-review.uk/home/publications/final-report/final-report-faqs/

It is amazing how these transactivists keep popping up on these threads with easily disprovable misinformation that has been debunked time and time again.

Cass ignored "low quality" evidence, wrongly I believe, using the technical term, which I'd argue was bad because it's impossible to conduct "high quality" - read double blind studies with these kinds of drugs.

Cass did not ignore non-double blind RCTs. That is a lie that was spread by transactivists. But shows you have not read Cass.

@DadJoke My posts earlier in the thread mentioned them specifically being used for precocious puberty (and endometriosis) and made mention of the serious, life-limiting side effects experienced by patients who were treated with blockers for this reason. And I linked to articles with testimonies from those patients.

Puberty blockers have been used for central precocious puberty for decades - one study concluded "Results from studies to date support the use of the histrelin implant as a safe, effective, and well-tolerated option for the treatment of children with CPP."

So the question isn't really how safe they are. No gender critical people have mentioned them in that context at all. There is an issue; this drug will treat it.

So, safety concerns are just a sideline. The real issue is that the very worst gender critical people think being transgender is not a desirable outcome - Helen Joyce said "every one of those people [happy or not] is basically, you know, a huge problem to a sane world." The off-brand use is also as distraction - plenty of drugs are prescribed in this way.

Cass ignored "low quality" evidence, wrongly I believe, using the technical term, which I'd argue was bad because it's impossible to conduct "high quality" - read double blind studies with these kinds of drugs.

That said, she is not so ideologically invested that she denies the reality of gender identity, is supporting a full clinical trial for however many children who require it, and supports offering a range of mental health services to transgender children. She also, however reluctantly, acknowledges that transitioning is absolutely the right thing for some people.

So, it could be worse.

ECT is not always problematic. I had it for the severest form of PND, that left me incapable of getting off the floor on some days (couldn’t even summon up the energy to get into bed).
I was prescribed antidepressants that somehow induced a fit, after which I felt somewhat better, so the psychiatrist suggested ECT. I was horrified at first - it has such a bad press - but eventually agreed. I had three sessions, under general (light) anaesthetic, and it was nothing short of miraculous. Side effects were mild short lived confusion and slight headaches. Within a month I started my degree course in mathematics.

Factual means based on fact or facts. Which fact or facts are these?

Good point. But of course there just isn't enough research done on them for this usage - is this where people have got the 'no proven side effects' line from?

Despite the extensively well documented side effects from when they are used for their intended purpose?

References? I'll bet money this didn't happen.

The drugs are used off-licence. GnrH drugs are licensed for use in late stage prostate cancer treatment and in some very rare cases for precocious puberty, as far as I'm aware.

So, for their licensed uses, no these are not desired outcomes.

(edited for accuracy of use in cancer treatment)

you're assuming that getting children to desist is a preferable outcome to transition

I would agree that being reconciled to the actual sex of your body is preferable to chasing an impossible dream of 'change of sex'. Children do need to understand that their sex cannot change; only their appearance and the words used.

'There are no proven side effects'

This is misinformation. And it is harmful.

The “proven” side effects for a very significant place to start is … halting or preventing puberty!!!

And there are “proven” side effects of putting teenaged girls into menopause.

How fucking dismissive is declaring no proven side effects to the brutality of putting girls into menopause as a teen!!

Blimey.

Aren't some of these side effects (gynaecomastia in males, artificial menopause in females) actually desired outcomes?

'There are no proven side effects'

All the side effects listed by NICE for drugs used off label as 'puberty blockers'.

https://bnf.nice.org.uk/drugs/buserelin/
Common or very common
Depression; mood altered
Rare or very rare
Auditory disorder; hypotension; leucopenia; pituitary tumour benign; thrombocytopenia; tinnitus
Frequency not known
Alopecia; anxiety; appetite change; breast abnormalities; broken nails; concentration impaired; constipation; diarrhoea; dizziness; drowsiness; dry eye; dysuria; embolism and thrombosis; fatigue; feeling of pressure behind the eyes; follicle recruitment increased; galactorrhoea; gastrointestinal discomfort; gynaecomastia; hair changes; headache; hot flush; hydronephrosis; hyperhidrosis; increased risk of fracture; lymphostasis; memory loss; menopausal symptoms; menstrual cycle irregularities; muscle weakness in legs; musculoskeletal discomfort; nausea; oedema; osteoporosis; ovarian and fallopian tube disorders; pain; painful sexual intercourse; palpitations; paraesthesia; QT interval prolongation; sexual dysfunction; shock; skin reactions; sleep disorder; testicular atrophy; thirst; tumour activation temporary; uterine leiomyoma degeneration; vision disorders; vomiting; vulvovaginal disorders; weight changes
https://bnf.nice.org.uk/drugs/gonadorelin/
Uncommon
Pain; skin reactions; swelling
Rare or very rare
Abdominal discomfort; bronchospasm; dizziness; eye erythema; flushing; headache; nausea; tachycardia
Frequency not known
Menorrhagia; sepsis; thrombophlebitis
https://bnf.nice.org.uk/drugs/goserelin/
Common or very common
Alopecia; arthralgia; bone pain; breast abnormalities; depression; glucose tolerance impaired; gynaecomastia; headache; heart failure; hot flush; hyperhidrosis; mood altered; myocardial infarction; neoplasm complications; paraesthesia; sexual dysfunction; skin reactions; spinal cord compression; vulvovaginal disorders; weight increased
Uncommon
Hypercalcaemia (in women); ureteral obstruction
Rare or very rare
Ovarian and fallopian tube disorders; pituitary haemorrhage; pituitary tumour; psychotic disorder
Frequency not known
Abdominal cramps; body hair change; constipation; diarrhoea; fatigue; hepatic function abnormal; interstitial pneumonia; muscle complaints; nausea; nervousness; peripheral oedema (when used for gynaecological conditions); premature menopause; pulmonary embolism; QT interval prolongation; sleep disorder; uterine leiomyoma degeneration; voice alteration; vomiting; vulvovaginal infection; withdrawal bleed
https://bnf.nice.org.uk/drugs/leuprorelin-acetate/
Common or very common
With parenteral use
Appetite decreased; arthralgia; bone pain; breast abnormalities; depression; dizziness; fatigue; gynaecomastia; headache; hepatic disorders; hot flush; hyperhidrosis; insomnia; mood altered; muscle weakness; nausea; paraesthesia; peripheral oedema; sexual dysfunction; testicular atrophy; vulvovaginal dryness; weight change
Uncommon
With parenteral use
Alopecia; diarrhoea; fever; myalgia; palpitations; visual impairment; vomiting
Rare or very rare
With parenteral use
Haemorrhage
Frequency not known
With parenteral use
Anaemia; dyslipidaemia; glucose tolerance impaired; hypertension; hypotension; idiopathic intracranial hypertension; insulin resistance; interstitial lung disease; leucopenia; metabolic syndrome; osteoporosis; paralysis; pulmonary embolism; QT interval prolongation; seizure; severe cutaneous adverse reactions (SCARs); skin reactions; spinal fracture; thrombocytopenia; urinary tract obstruction; vulvovaginal infection
https://bnf.nice.org.uk/drugs/nafarelin/
Common or very common
Artificial menopause; breast abnormalities; chest pain; depression; dyspnoea; emotional lability; headaches; hirsutism; hot flush; hypersensitivity; hypertension; hypotension; insomnia; myalgia; oedema; oestrogen deficiency; paraesthesia; rhinitis; seborrhoea; sexual dysfunction; skin reactions; uterine haemorrhage; vulvovaginal dryness; weight changes
Uncommon
Alopecia; arthralgia; ovarian cyst (may require discontinuation)
Frequency not known
Ovarian hyperstimulation syndrome; palpitations; vision blurred
https://bnf.nice.org.uk/drugs/triptorelin/
Common or very common
Anxiety; asthenia; depression; diabetes mellitus; dizziness; dry mouth; embolism; gastrointestinal discomfort; gynaecomastia; haemorrhage; headache; hot flush; hyperhidrosis; hypersensitivity; hypertension; joint disorders; menstrual cycle irregularities; mood altered; muscle complaints; nausea; oedema; ovarian and fallopian tube disorders; pain; painful sexual intercourse; pelvic pain; sexual dysfunction; skin reactions; sleep disorders; weight changes
Uncommon
Alopecia; appetite abnormal; asthma exacerbated; chills; confusion; constipation; diarrhoea; drowsiness; dyspnoea; flatulence; gout; muscle weakness; taste altered; testicular disorders; tinnitus; vertigo; vision disorders; vomiting
Rare or very rare
Abnormal sensation in eye; chest pain; difficulty standing; fever; hypotension; influenza like illness; musculoskeletal stiffness; nasopharyngitis; orthopnoea; osteoarthritis; QT interval prolongation
Frequency not known
Angioedema; malaise

you're assuming that getting children to desist is a preferable outcome to transition

To live comfortably in your own sex vs the hugely increased morbidity and mortality that results transitioning. Hmm, why should we think the former more preferable? 🤔