Thank you TangentialContrivences.
I think you have covered much of it with this excellent post. I can add these links in support of the other countries and organisations that also found 'low evidence' findings that the Cass report found.
NICE
arms.nice.org.uk/resources/hub/1070905/attachment
The summary of the conclusion is
Conclusion
The results of the studies that reported impact on the critical outcomes of gender dysphoria and mental health (depression, anger and anxiety), and the important outcomes of body image and psychosocial impact (global and psychosocial functioning), in children and adolescents with gender dysphoria are of very low certainty using modified GRADE. They suggest little change with GnRH analogues from baseline to follow-up.
And France from National Academy of Medicine. They have issued a press release about treatment for gender disphoria in children and adolescents.
SEGM have translated it, but I have also linked up the original version.
segm.org/France-cautions-regarding-puberty-blockers-and-cross-sex-hormones-for-youth
Extract
Transgender identity is a feeling of identifying as a gender different from that assigned at birth, which is persistent and lasts more than 6 months. This experience can cause significant and prolonged distress, which can contribute to an increased risk of suicide [a].
No genetic predisposition has been found.
While this condition has been long recognized, a sharp increase in demand for medical interventions has been observed (1,2) first in North America, then in Northern Europe, and, more recently, in France, particularly among children and adolescents. A recent study of a number of high schools in Pittsburgh revealed a prevalence that is clearly higher than previously estimated in the United States (3): 10% of students declared themselves to be transgender or non-binary or were unsure of their gender [b]. In 2003, the Royal Children's Hospital in Melbourne diagnosed only one child with gender dysphoria, whereas today it treats nearly 200.
Whatever the mechanisms involved in adolescents - excessive engagement with social media, greater social acceptability, or influence by those in one’s social circle - this epidemic-like phenomenon manifests itself in the emergence of cases or even clusters of cases in the adolescents’ immediate surroundings (4). This primarily social problem is due, in part, to the questioning of an overly dichotomous view of gender identity by some young people.
The demand for medical interventions, due to the distress that this condition (which is not a mental illness per se) causes, leads to a growing supply of care in the form of consultations or care in specialized clinics. This involves many pediatric subspecialties. The psychiatric consultations are utilized first, and if the identity is authentic and the discomfort persists, endocrinology, gynecology and, ultimately, surgery become involved.
However, great medical caution must be taken in children and adolescents, given the vulnerability, particularly psychological, of this population and the many undesirable effects and even serious complications that can be caused by some of the therapies available. In this regard, it is important to recall the recent decision (May 2021) of the Karolinska University Hospital in Stockholm to prohibit the use of puberty blockers.
If France allows the use of puberty blockers or cross-sex hormones with parental authorization and no age limitations, the greatest caution is needed in their use, taking into account the side-effects such as the impact on growth, bone weakening, risk of sterility, emotional and intellectual consequences and, for girls, menopause-like symptoms.
A Canadian team finds low evidence
https://nationalpost.com/news/canada/transgender-treatments-for-kids
https://archive.ph/fLMxA
"The Canadian team combed the available evidence, pooling the results of research on puberty blockers and gender affirming hormones for children and youth up to age 26. They graded the evidence using a scoring system co-developed by Dr. Gordon Guyatt, a celebrated McMaster scientist who coined the phrase evidence-based medicine.
Article content
After screening 6,736 titles and abstracts involving puberty blockers, only 10 studies were included in their review. While children who received puberty blockers compared to those who don’t score higher on “global function” — quality of life, and general physical and psychological wellbeing — the evidence was of “very low certainty.” Very low, meaning researchers have “very little confidence in the effect estimate” and that the true effect “is likely to be substantially different from the estimate of effect.”
The studies also provided low certainty of evidence on the impact of puberty blockers on depression. While they may decrease depression in “male-to-female participants,” they didn’t decrease depression scores in the female-to-male group. “We are very uncertain about the causal effect of the (drugs) on depression,” the researchers wrote.
“Most studies provided very low certainty of evidence about the outcomes of interest thus, we cannot exclude the possibility of benefit or harm,” they said."
New Zealand
https://www.health.govt.nz/news/additional-safeguards-for-puberty-blockers
Publication date: 21 November 2024
The Ministry of Health is today releasing an evidence brief and position statement on the use of puberty blockers for gender identity issues and outlining a more cautious approach to their use.
The evidence brief shows a lack of good quality evidence to back the effectiveness and safety of puberty blockers when used for this purpose.
I think there was a German team that came to similar conclusions too. But as you say, Sweden, Norway and Finland. And didn't Denmark also have a team that found this too?
I find it remarkable to still see discussion about Cass' finding about the quality of evidence. It feels very ideologically driven considering all the other national teams with similar findings are being ignored.