Puberty Blocker Trial Paused

Cass moved the debate on somewhat but no one woman can conclude it. So it moves forward despite where she stays.

Other women will pick up now and the trials hopefully will be stopped not just paused.

Presently, there are more girls seeking PBs than boys. They know that that blocking puberty is unlikely to improve their future capacity to pass and may in fact reduce it through limiting their height, but they still try and obtain them.

Yes, but that is not a rational justification. People are sold all sorts of things on the internet.

When I say 'desired outcome' I mean the reason that the protocol was developed in the first place.

Her work has led her to suspect that there could be a rare medical condition whereby PB could improve outcomes and the way to determine this is a clinical trial

You don't treat children with, by her own admission, non-evidenced drugs, which will have devastating effects on them for a condition that she suspects they might have.

It's the only question. Why are these children gender distressed? What are they actually treating?

we know the desired outcome. It is to prevent male puberty because boys can more easily pass as the opposite sex

Presently, there are more girls seeking PBs than boys. They know that that blocking puberty is unlikely to improve their future capacity to pass and may in fact reduce it through limiting their height, but they still try and obtain them.

In the field of high quality research, stating ‘we know’ needs to be supported by empirical evidence. It shouldn’t be based on opinion, logic, anecdotes or common sense.

People often ridicule research findings for ‘finding’ the obvious. But research often contradicts ‘the obvious’ and highlights flaws and gaps in established narratives used to explain phenomena.

Cass is a single doctor. Her opinions are worth listening to, but we should never consider a single doctor or expert to have the final word in medicine. The worst kind of doctor or scientist is someone who won't change their opinion or belief based on new evidence, and who won't admit doubt. Doesn't matter if the argument is about hip replacements, gender dysphoria or treating ingrowing toe nails. Hanging onto the words of a single expert is risky - see the thread on parental alienation for another example.

As pp observed I do think Cass gave herself away with this:

"“I have not changed my position an inch since I wrote my report, and yet, suddenly, people from the gender-critical side of the debate seem surprised or discomforted that I'm supporting a trial,” she said.

“But I called for a trial two years before the report, and I said in the report that everything that we do to these young people needs to be done in the context of a proper research programme, because otherwise we can't improve what we're doing for them.”"

Bit rich of her to be saying the MHRA intervention is political not scientific, when she admits her report findings were pre-determined by her own beliefs rather than science.

Also explains why she smeared us last week by saying we were supposedly "weaponising" children. She's the one desperately fighting to inflict irreversible harm on children for an ideological purpose, not us.

I think this is bang on.

i also still think that there is valuable “evidence” locked up in the files from previous patients (now adults) that Cass couldn’t access during the review. Retrospective data analysis plus follow up with patients who are willing to participate. It won’t have the kudos of a shiny new trial but it could (although I doubt it) provide Cass’ desired evidence of benefits without causing further harms.

Cass has now lost all credibility with me. As I recall there were many others involved in compiling the report, which now seems just as well, because I would hate to think what sort of report Cass would have written if it had been all her own work.

I still don't know why anyone (let alone a paediatrician) would think 'pausing puberty' is a good idea, what are they pausing it for?, what magic do they expect to happen during the pause?

It is physically impossible for a human to be born in the wrong body or to change their sex, no amount of pausing or thinking is going to change that reality.
🤯😤🤯😤🤯😤🤯

Her work has led her to suspect that there could be a rare medical condition whereby PB could improve outcomes and the way to determine this is a clinical trial

The problem with this approach is that 'trans' is as much a philosophical as a psychological concept.

I know the analogies have been done to death, but if the argument is that this isn't just some kind of dysmorphia or delusion that can be treated like any other mental illness, you are then proposing that there is a right and wrong brain for a man or a woman. There is no evidence of that.

On the other hand there are centuries of sexism.

However, far more needs to be understood about the condition PBs could prove effective for, and the beneficial outcome being sought through their use.

We know the desired outcome. It is to prevent male puberty because boys can more easily pass as the opposite sex.

What I don't understand is how this trial could help the small number of children that Cass really believes are true trans.

Because it's not addressing that. It's not identifying them.

We know that puberty blockers tend to lock in the identity, so how will you know?

Surely, once you strip out the children who've been abused, the ones who are likely gay, the ones with autism, the ones with all the co-morbid issues, and you're left with children who genuinely have none of those things. That's the starting point.

Why are those children (if there are any) gender distressed?

That has to be the beginning of everything. Long before you decide that you should treat them with something that will have horrendous side effects, surely you have to bloody identify what's wrong with them in the first place??

The overarching problem is that of trying to reconcile a position that being trans is natural and a normal part of human variation whilst also seeking medical intervention. The NHS is based on a medical model of treating disease. ‘Being trans’ needs to be conceptualised as a disease or condition for medical intervention to be provided.

Cass’ position is unremarkable from a medical perspective. Her work has led her to suspect that there could be a rare medical condition whereby PB could improve outcomes and the way to determine this is a clinical trial. She is simply saying, we don’t know enough, we need to find out before drawing conclusions.

I am all for evidence based medicine and I think we could get to a place where a PB trial is ethical. However, far more needs to be understood about the condition PBs could prove effective for, and the beneficial outcome being sought through their use. We would need to have a clear understanding of the desired impact of PBs and a informed position of the likelihood of them delivering this. It is unacceptable that the Pathways trial doesn’t set this out.

From a medical perspective, undoubtedly the best outcome is resolution of symptoms without endocrine or surgical intervention. Clearly, it is better if people feel content in their sexed bodies and do not undergo treatment that brings risks and undermines health. However, this isn’t being acknowledged because this isn’t the outcome desired by the ‘patient group’. This is what needs attending to and addressing.

My earliest memory is from before my brother was born, as my mother had to spend the third trimester in bed (1950s) and I was (sort of) looked after by a housekeeper. I vividly remember her chasing me through the house brandishing a window pole after some naughtiness on my part, which dates it to when I was about two and a half. No one else saw - I only told my mother about it when I was an adult - so it’s definitely my own memory.
Apologies for the slight derail.

From the Observer report:
Cass said. “[raising the age limit to 14] would make the design really, really flawed and you should not be subjecting children to a flawed study.”

Oh yeah, THAT is what makes the whole thing flawed and unsuitable for children....

My brother cant remember being 3. He can only remember from age 7 which I find really weird but apparently DH is the same. DS is like me and can remember things from age 2/3.

This is why I find my brothers recollections so weird. I'm older and can remember him being born. The seems to lack context in a way I have.

I think that the notion of being the opposite to birth sex has to start well before 7, more like at the earliest time that someone has memory of, which is about 3, to put them in the “special” group.

Yes, I see what you mean, I suppose it is just the word 'gender' that is triggering. 😆

Many of us struggled or ,at least, certainly reflected on how we measured up to/or didn't the social or familial expectations of our sex.

Well, you have to call it something. And part of the problem of this issue is the multiplicity of terms, many of which are introduced because of objections to previous ones.
As both biological sex exists and socially constructed gender is acknowledged I don’t have a problem with the concept of gender incongruence. (We now know that babies are socially conditioned pretty much from birth, with remarkable discriminatory abilities.)
(I myself felt a degree of “gender incongruence” when growing up, because I was quite a tomboy, and interested in “boy things”. I was always encouraged to do what I liked, though - the idea of incongruence came from within.)
Why a very small number of children seem to think they have always been, at least in their essence, the opposite of their actual sex, how that idea is formed and/or the distortions of memory that makes them think that way, is certainly worthy of study. But not a justification for blocking the mechanisms that make them functioning adults.

I reckon lots of gay men have a secret inner drag queen.

Yes, what they mean is they have been cross dressing since childhood.

Up until about five or six a boy wearing princess dresses etc will be tolerated, but after that age there is more social pressure and disapproval. The activity will then become secretive.

I was looking at it because these middle aged transitioning males ALWAYS seem to say they knew they were trans since age 7.

Many (most? all?) middle aged transitioning males retcon their childhood to support their fetish.

Seven years old ( round about when the second teeth come in) is when the social identity really starts to develop...up until then it is more about ego development. Children leave the infant stage and move into being a junior.

But it seems it wasn't just that she was constrained it seems she believes trans is a real thing.
Maybe it has to happen this way: Cass was the initial step necessary to say: everyone stop and look at the evidence.

In Star Trek VI: The Undiscovered Country Spock quotes the old Vulcan proverb that "Only Nixon could go to China".

What I find so depressing is that safeguarding mechanisms only seem to kick in under legal threat and after harm.

For me the whole term safeguarding has become just a term thrown around, while the evidence that it's something which really protects against harm is negligible.

I've sadly concluded we can never rely on safeguarding to override the human instincts of group think and self protection which are much more powerful it's dangerous to pretend otherwise.

It's a very depressing conclusion but that's where I've got to.

Why does the Observer article mention the puberty blocker trial was from age 11? I thought it was from age 8?

I was looking at this yesterday
https://en.wikipedia.org/wiki/Erikson%27s_stages_of_psychosocial_development#:~:text=A%20comprehensive%20psychoanalytic%20theory%20that%20identifies%20a,pass%20through%20from%20infancy%20to%20late%20adulthood.

I was looking at it because these middle aged transitioning males ALWAYS seem to say they knew they were trans since age 7.

I find this a curious point and can't help feeling it's connected with development milestones and influences from parents.

But the key point I'm making here is that it's long been recognised that a sense of identity crisis during adolescence is a normal stage of human development. Not just the physical side of puberty itself.

We run the risk of pathologising normal human development on both mental and physical basis.

We can't intervene with this process because ultimately we can't change sex. That's always going to cause problems at some stage because you can't run away from yourself.