USA Govt Publishes Final Peer-Reviewed Puberty Blockers Report

"highbrow misinformation" , I'm going to be using that in the future. 😁
It's sounds like the same sort of twaddle that greeted the Cass report, I'm glad they're going straight on the attack to counter the false narrative the genderwangers are attempting to create. 👍

I live in the USA and this report isn't getting much general publicity, if I didn't read the feminism boards on Mumsnet I wouldn't know about it. I live in a West Coast Democrat dominated city and the local newspaper hasn't mentioned it as far as I have found. I only see it in newspapers in Republican dominated states such as Tennessee. This is how even intelligent and well educated people are so uninformed about the effects of Gender Ideology, as there will be a silence in the "progressive" Left media whenever information that conflicts with the party line is disseminated. Of course most people aren't getting their news from newspapers and TV anyway but the legacy media will ignore these stories if possible.

Thank you, Karleen! ❤️

and to consider breast binding as a physical intervention

I would go further.

Breast Ironing/Flattening is specifically cited in the UK as Child Abuse and is criminalised:

www.met.police.uk/advice/advice-and-information/caa/child-abuse/breast-ironing-flattening/

I cannot see any reason why the facilitation of Breast Binding children by adults should not also be criminalised, given the injuries that it can cause and the lack of medical need.

The only reason for the distinction IMHO is racism which, ironically, favours the protection of children who are usually born into families from Sub-Saharan Africa.

"In some families, large stones, a hammer or a spatula heated over scorching coals are used to compress the breast tissue. Other families may opt for an elastic belt or binder to press the breasts and prevent them from growing.
Breast flattening usually starts with the first signs of puberty, which can occur as young as nine years old, and is usually carried out by female relatives.

It is important to note that some adolescent girls and boys may choose to bind their breasts using constrictive material due to gender transformation or identity, and this may also cause health problems.

Breast flattening can happen anywhere in the world. The map below represents the countries where research has been conducted. Just because a country is not highlighted doesn’t mean it doesn’t happen; it simply means there is no research available in that area."

nationalfgmcentre.org.uk/breast-flattening/

Breast Ironing/Flattening and Breast Binding are both cultural practices that harm girls.

Breast Binding is tolerated, even celebrated by those who participate in the ideology of transgenderism, as a "Western" cultural practice that harms girls - and is being exported globally.

As such, the children currently affected are primarily white "Western" girls and they are denied protection from this form of child abuse.

However, this also provides a loophole for parents to use breast binders and claim the excuse of "gender identity affirmation" when what they are actually doing is subjecting their daughters to the cultural practice of Breast Ironing/Flattening.

It makes no sense to permit Breast Binding for "gender identity affirmation" while criminalising it as a Breast Ironing/Flattening practice that harms the child.

Therefore, Breast Binders should be banned for all purposes and the adults involved should be prosecuted for child abuse.

If only.

Not as far as I know. I hope I'm wrong!

I was one of the peer reviewers of this research review report. Perhaps of particular interest to Mumsnetters, I commented on the need to make clear the impact of chest masculinisation surgery on breastfeeding and to consider breast binding as a physical intervention unlike other aspects of what is described as social transition- my review can be found at p18 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-supplement.pdf?fbclid=IwY2xjawON1alleHRuA2FlbQIxMQBzcnRjBmFwcF9pZBAyMjIwMzkxNzg4MjAwODkyAAEev98DhSv2dO6SOh28ajDKYBob1ymKJfClYmMwcXi3YFkjsGtJhWqYKV-HxyU_aem_PhwjdU9thB8fxGOvfIscXA

Good summary of the failures of the APA’s attempt at peer review.

https://www.realityslaststand.com/p/eager-to-affirm-yet-unwilling-to-e79

No doubt there's some reason for this in Murican administrative law and how it affects the federal government, but I always scratch my head that Rachel Levine got to be an admiral, while L Ron Hubbard was only ever a commodore.

I very much suspect he's never had anything to do with looking at puberty blocker use and side effects for precicious puberty where there's years of scientific knowledge which seems to get shredded the second you whispher 'gender identity'....

I'm just scunnered that nobody appears to be in prison for having harmed many thousands of children.

Did RJK Jr have anything to do with writing the report itself?

No, then what's the price of potatoes got to do with flying kites. 🤯

It seems really clear, as we all knew \i think, that there was never any evidence for these treatments.

But it seems to me that what is really needed now is not so much a study of proposed treatments, but a deep examination of the diagnosis they are giving these children. And the adults as well.

There seems to be something very wrong with the way this disorder, and maybe other disorders, are being defined, or the idea of the "trans person" in need of treatment.

So long as the diagnosis is off base, any studies of treatments are likely to be skewed.

Great news. The tide is indeed turning.

What now needs to happen is an enquiry into how these untested treatment approaches were pushed onto confused kids willy-nilly, without any proper research studies being done to determine effectiveness and harms.

It should have been obvious to medical authorities that using ND kids and kids with mental health issues as guinea pigs for medical interventions that amount to extreme interference with the natural developmental process of puberty is - at best - highly unethical, and - at worst - actively harmful across the child's whole lifespan.

This is medical ethics 101 - it doesn't pass the Beauchamp and Childress framework. Yet nobody stopped the juggernaut.

I noticed that. Maybe the APA needed to hear it from de Vries about the weaknesses of that study. They should have watched this.

A documentary on the Dutch Protocol

There are currently almost 3,000 young people on the waiting list for gender care in the Netherlands. They are vulnerable adolescents who are frequently subjected to discrimination. Many of them suffer severe mental distress. Doctors at the gender clinic in Amsterdam are pioneers in care for transgender young people. The treatment developed here years ago is now used worldwide. Now, criticism is growing. International experts are questioning the scientific evidence put forward by the clinicians in Amsterdam. Zembla investigates the Dutch transgender protocol.

What this covers is that no gender clinic has been able to replicate the results of the Dutch paper. One patient of the group died due to the surgery complications of gender surgery and even de Vries questioned why no one seemed interested in that patient while accepting the study. Dr Riittakerttu Kaltiala (Professor of Pschyiatry, Tampere and who set up gender clinics) and Mikael Landen (Professor of Pscyhiatry, Gotenberg) and Dr Angela Samfjord (Head of Child and Adolescent Psychiatry at the University of Gotenberg ) all are interviewed about the quality of the study behind the protocol and its flaws that became apparent later. Ie. The 55 patients is so small and de Vries acknowledges that they are not really similar to todays cohort of adolescent transitioners. That only 32 filled in the survey with positive results. The others were not chased up and one died.

Gerard van Breukelen, a professor of Methodology at Maastricht university goes on record to say that the methodology of that initial study was weak. There was no control group so the conclusions should not have been considered as strong as the gender clinicians claimed. Other academics declined to be interviewed due to fear for their employment as it is such a contentious issue. When talking to de Vries, she mentions that many more studies have been done by other countries now. And the doco makers mention that all those studies de Vries refer to have stated that the evidence is low quality. A Swedish team led by Landen was asked to do a full review by the Swedish government and he confirms that the evidence was just not there. Hence the Swedish government withdrew treatment.

Yes the peer reviews are broadly supportive. It is like they couldn't find anything to dismiss the conclusions with.

I also understand why they hid the author's names until it was peer reviewed, although not sure it was a sound ethical decision. However, considering the attack that these authors will now face, it was a protective move.

The de Vries et al paper is the original Dutch research. The full report did reference this paper multiple times. The APA’s peer review is bizarre in claiming those papers weren’t looked at. Of course they were looked at. The “reply to review” on the supplement clearly puts the APA in its place by pointing this out.

Having read a few of those peer reviews (not all 200+ pages) the authors seem to be broadly agreeing with the conclusions with some greater or lesser nitpicking as to methodology as you would expect.

They seem to be fairly united in criticising the lack of transparency as to authorship which I think is fair given there are so many strong views and conflicts of interest on this topic.

The American Psychiatric Association seems to be more critical than most and suggests a list of studies that should also be included. I don't know if the APA has a policy position on child gender treatment or of the strength of the studies they list.

I picked one at random that they suggested: https://pubmed.ncbi.nlm.nih.gov/20646177/
This study is for 70 children. No control group. All went onto cross sex hormones following puberty blockers. They checked behaviour, anger/anxiety and gender dysphoria before starting puberty blockers and again before starting cross sex hormones. Behaviour improved apparently but anxiety/anger and gender dysphoria did not.

Not a great study methodologically and doesn't show great outcomes!

I would love to have that man be accountable for abolishing the age restriction at the very least.

How many more national level review teams around the world have to find the same thing for people to start thinking that these reviews are not 'biased' and if a country's administration finds the same result, then it is likely that 18 months on from the Cass Report, there STILL is no evidence to support the use of these drugs?

Considering the Cass report was launched in 2020, shouldn't some evidence have been undertaken by a treatment supportive national level team in those FIVE years that would counter all the other country's health team reviews?

Considering we have national teams from Sweden, UK, (Finland I believe), France, Canada, Germany, NZ and the Australia and NZ College of Psychiatrists all finding that there is low evidence to support these drugs being used....

Please let this mean that the experiment on puberty blockers in the UK is stopped and that eventually 'Admiral' Levine has to answer in a court for what he has done to children in the US.

Just for @NumbersGuy . Maybe you can find problematic people to use to discredit the following reviews that all say pretty close to the same thing that this USA review 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.

Sweden

genderreport.ca/the-swedish-u-turn-on-gender-transitioning/

Australia and NZ College of Psychiatrists publish a warning there is not enough evidence.

//www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/gender-dysphoria

The Royal Australian and New Zealand College of Psychiatrists have now updated their guidance.

They are now warning that there is NOT ENOUGH evidence to recommend affirming only treatments or indeed any particular treatment plan. They now say that underlying health issues should be treated at the same time. And warn that medicalisation of children and teens be very careful and thoroughly explored considering the ‘paucity’ of evidence at this time.

France - declares there is not enough evidence.

The latest from National Academy of Medicine, France. They have issued a press release about treatment for gender disphoria in children and adolescents.

SEGM have translated it, but 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.

Canada 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."

Here are the studies referenced in the article from McMaster University
https://adc.bmj.com/content/archdischild/early/2025/01/24/archdischild-2024-327909.full.pdf
And
https://adc.bmj.com/content/archdischild/early/2025/01/24/archdischild-2024-327921.full.pdf

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.

UK

And the Cass Report:

Cut and paste the following as the report link has been moved to the national government archive and MN corrupts the links posted.

cass.independent-review.uk/publications/

There were Finnish and German teams that reviewed and found the same as well, I believe. I don't have those links though.

So, Numbers would you like to address the issues that were found in the USA review, or just dismiss it because you don't agree with one man's opinions?

The report is an expert piece of work. The authors are all experts. Opinions of the administration that requested it shouldn’t matter at all.

Just taken a very quick glance at the ‘Peer review supplement’ and found this...

Given the lack of demonstrable benefit and concern about potential harms, the
use of puberty blockers, cross-sex hormones, and gender transition surgery in minors with gender dysphoria cannot be ethically justified.

There is no compelling evidence from studies that psychotherapy as treatment
for gender dysphoria is beneficial. However, psychotherapy is generally shown to be beneficial for the treatment of psychiatric distress and various mental illnesses, and is thought to carry low risk of harm.

Translation "we have been using medical interventions which are (1) not proven to be beneficial, and are (2) clearly concerning in terms of potential harms. Meanwhile (3) nobody has bother to study whether the low risk, potentially highly beneficial, psychotherapy route is better".

It is almost incomprehensible that the medical industry could decide that the high risk, unproven, medical route is a good idea, but the low risk, proven-in-similar-contexts, psychotherapy route is such a bad idea that it shouldn;t even be tried. I say "almost incomprehensible" but most people who have come to this issue with an open mind could have identified the issues (1) to (3) very early on in their research, based on very little evidence and a bit of common sense.