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New paper argues that “gender-affirming care” for adolescents should not be measured by whether it’s “effective”

70 replies

UtopiaPlanitia · 27/12/2024 19:27

Thread on TwiX from journalist Leor Sapir:

https://x.com/LeorSapir/status/1872632988531372290

"A new paper argues that “gender-affirming care” for adolescents should not be measured by whether it’s “effective” at reducing psychiatric distress and improving life functioning. Authors (inc. A. de Vries) gesture toward an “autonomy” focused model.

To be clear, this line of thinking has animated the “affirming” model for a while now. The authors are now saying it explicitly. Clinical/psychosocial outcomes don’t really matter, apparently. This isn’t medicine."

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-024-01143-8

Gender-affirming medical treatment for adolescents: a critical reflection on “effective” treatment outcomes - BMC Medical Ethics

Background The scrutiny surrounding gender-affirming medical treatment (GAMT) for youth has increased, particularly concerning the limited evidence on long-term treatment outcomes. The Standards of Care 8 by the World Professional Association for Trans...

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-024-01143-8

OP posts:
OldCrone · 28/12/2024 10:02

Sometimes I feel people like de Vries et al live on a different planet to the rest of us when they justify ruining perfectly healthy bodies and call it medicine. De Vries' continued insistence that her way of practicing gender medicine is the best way reminds me of Dr Freeman who went to his grave fighting to have lobotomies recognised as medically safe and helpful.

This is spot on. They seem to have become so immersed in their delusion that mutilating the healthy bodies of children is "healthcare" that they can't see how insane the whole thing looks to anyone who hasn't succumbed to the cult of genderism.

OldCrone · 28/12/2024 09:58

NotBadConsidering · 28/12/2024 06:24

The very first reference is to a newspaper article by Andrea Long Chu, the sissy porn fetishist and he of “expectant asshole” fame🤮. How do they expect to still be taken seriously?

This is an academic paper. Normally you'd need a very good reason for citing anything that isn't another academic paper or a book.

An opinion piece in a newspaper written by a fetishist really isn't an appropriate source in a paper about child transition.

AmaryllisNightAndDay · 28/12/2024 09:03

They can make whatever they like out of queer theory but what I fucking resent is their dragging in feminist theory which they refer to in the same breath as queer theory to back up giving bad medical care to adolescents. Forced teaming or what. As an aspiring feminist myself - not in my name, arseholes.

AmaryllisNightAndDay · 28/12/2024 08:36

Tnanks @UtopiaPlanitia Like you I expect the negative results started rolling in. I suspect this is a last-gasp attempt to keep the circus on the road. The central content of the paper looks pretty clear - so far there's plenty of evidence that gender affirming treatment doesn't improve function and no evidence to say it does improve function (and we're not going to look at any new data because that might really show us up) But we can tart it up (and justify SOC8) by "using trans negativity as a theoretical lens" and so conclude we should keep taking the medicine anyway - or rather, we should keep spooning the medicine down any adolescent who doesn't run screaming from it - because reasons.

With any luck this paper will be cited forever though not in the way that de Vries (presumably) hopes. I've downloaded in case it vanishes.

Janie143 · 28/12/2024 08:28

AsPP have said if it isn't medicine/ medical intervention it shouldn't be paid for by NHS

Igmum · 28/12/2024 08:00

This is the essence of Queer Theory, they are now simply queering the outcomes so that old fashioned things like physical and mental functioning can be downgraded compared to (elusive) 'patient values'.

Word games defending horrific damage to children and vulnerable young adults.

NotBadConsidering · 28/12/2024 06:24

The very first reference is to a newspaper article by Andrea Long Chu, the sissy porn fetishist and he of “expectant asshole” fame🤮. How do they expect to still be taken seriously?

quixote9 · 28/12/2024 05:28

There's just no end to the shapeshifting squirms these people are ready to go for."If it feels good, do it" has it's place in how we live. But that place isn't medicine. It isn't science. It's how you decide which fun fair car to ride. That's different.

Original poster
UtopiaPlanitia · 28/12/2024 02:44

I wouldn't be entirely surprised if that was something to do with this new paper and its redefinition of happiness and success. I was hoping that the data de Vries was intending to collect would prove to be useful for the current cohorts of children, so I sincerely hope she is planning to release the data and not do an Olson-Kennedy and just sit on it because the outcomes weren't what she wanted.

Redefinition of terms and criteria was what happened when the number of detransitioners became large enough to get public attention - the gender clinics redefined 'transition' into 'gender journey' in which all things that happen to patients, even things that damage them and that they hate, are valid stages in the journey.

After decades of pushing medical transition as the insta-cure to all dysphoria, basically, the queer theory influenced doctors are queering the definition of happiness now too 🙄

OP posts:
Thingybob · 28/12/2024 00:23

Almost three years ago, De Vries told Stella O'Malley that she was busy concluding an updated study on the original cohort that gave rise to the Dutch Protocol, all 70 of them.

I wonder if it was poor outcomes from these ex patients that prompted De Vries to write the linked paper.

Original poster
UtopiaPlanitia · 27/12/2024 23:37

Reading my way through this new paper I was not reassured when it stated that:

'Furthermore, typical evidence-based medicine practices (i.e., relying on scientific evidence and clinical expertise) may not always help to inform decision-making in this context [25]. Meeting the “gold-standard” of evidence-based medicine can help to legitimize the provision of care, protecting against criticism that treatment approaches are unfounded [31,32,33].

However, some scholars argue that meeting this “gold-standard” through performing randomized controlled trials in transgender adolescent care is both methodologically inappropriate and unethical as it may deny or delay treatment, thereby making it difficult to recruit participants willing to risk being assigned to a non-treatment group [27, 34]. Given this context, the “gold-standard” of evidence-based medicine has not been considered suitable for guiding research practices for GAMT for youth, which is believed to contribute to uncertainty around the legitimacy of this care practice and its evidence base [25]. Despite the criticism surrounding GAMT for youth and its corresponding evidence base, experts within the field of transgender adolescent care have aimed to systemize care by integrating available evidence, patient values, and clinical expertise to create care models.'

All of this seems to be more of the effort to exceptionalise children with gender distress to allow them to be treated with a lower standard of medical care. De Vries et al are also writing this paper as if the WPATH SOC were a rational and well-founded series of documents with research to back them up rather than the ideologically-framed hodgepodge that it is.

Sometimes I feel people like de Vries et al live on a different planet to the rest of us when they justify ruining perfectly healthy bodies and call it medicine. De Vries' continued insistence that her way of practicing gender medicine is the best way reminds me of Dr Freeman who went to his grave fighting to have lobotomies recognised as medically safe and helpful.

OP posts:
ArabellaScott · 27/12/2024 23:14

Because WPATH and Eunuch gender just isn't deranged enough for the authors of this paper.

PermanentTemporary · 27/12/2024 21:51

Really weird paper.

I note that it's in a journal with an impact factor of 3.1. Top end medical journals will have an impact factor of 50, 60 or more.

I wish them luck in recasting the point of something identified as a medical treatment for a tiny number of distressed children to an experience for lots of adolescents to go through, like an escape room or a theme park.

RethinkingLife · 27/12/2024 21:16

I shall put that on my reading list for 2025. In the interim, I shall ponder whether I'm in need of an updated course in biomedical ethics or if that's now to be discarded for a new model in which autonomy trumps all (unclear whether informed consent is part of those autonomy considerations).

Original poster
UtopiaPlanitia · 27/12/2024 20:14

RoamingGnome · 27/12/2024 19:34

I haven't read this but surely this is acknowledging that this is all for cosmetic purposes? If there is no measurable benefit US insurers and the NHS should not be getting involved.

There has been a pivot in recent years towards certain doctors describing transition treatments as being part of a 'gender journey'. This means doctors can tell themselves that patients who go on to detransition are just on another stage of this gender journey.

It’s despicable and displaces all sense of responsibility or accountability from doctors to the patients instead.

It’s basically saying ‘We gave them what they said they wanted. If they don’t want it anymore it’s not our fault.'

OP posts:
FlowchartRequired · 27/12/2024 19:49

Sometimes, I hope that there is a circle in Hell reserved for people who experiment on children and vulnerable adults where there is no medical benefit for the patient.

Helleofabore · 27/12/2024 19:41

They are now pivoting to say the quiet bits out loud, aren’t they?

HaddyAbrams · 27/12/2024 19:37

Surely all healthcare should have a measurable outcome?

RoamingGnome · 27/12/2024 19:34

I haven't read this but surely this is acknowledging that this is all for cosmetic purposes? If there is no measurable benefit US insurers and the NHS should not be getting involved.

Original poster
UtopiaPlanitia · 27/12/2024 19:34

The things that de Vries has been saying in recent years about adolescent gender treatments (in various interviews) have really worried me - she seems desperate that the world should accept that there is medical value in her 'Dutch Protocol' and she has never seemed particularly worried or guilty about the death of one of the patients who was part of her original study group. For de Vries, passability of patients appears to be the most important outcome.

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