Hilary Cass sent a document to every single MP and Peer, justifying and defending the puberty blockers trial

But the problem is that these drugs are being given to healthy children anyway. This isn’t a normal clinical trial for drug approval before being approved, where halting the trial means the drugs are never administered. Kids are being given these drugs and have been for years. If you want that to stop, and quickly, a clinical trial which shows risks outweigh benefits or a lack of efficacy will do that.

If you don’t have the trial, kids still get given the drugs. Persuading people to stop without proper clinical evidence will take longer. We know that people are ideologically wedded to this.

A PP admitted that lobotomies would have stopped sooner if there had been a proper trial of them.

In many, probably most, cases, adulthood without an abused body and the mental trouble which comes from having deliberately spoiled a perfectly good set-up and left oneself with life-long physical problems. Most adolescents who have been told they are trans seem to be able to work out for themselves that they are no such thing without any drug involvement; even the ones with troubled or abusive childhoods or other mental problems complicating the issue.

Or to put it another way, kids do grow up, and get past adolescence.

I suspect that the individuals and organisations that were going to be involved in the regional clinics had already beern pencilled in - and that they are not as clinically neutral as one would hope or expect.

That wasn’t what I said.

Oh I think they are wrong. But that doesn’t mean that they don’t believe it. People believe in all sorts of crap.

@nicepotoftea,

"Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if they had not been socially transitioned at that very early stage."

Oh I keep forgetting that bit.

That seems to go against all the evidence that we have - in fact that is presented in the report bearing her name! - of (a) 80% spontaneous desistance in children who are just left alone and not affirmed, and (b) the success rate of “very skilled therapists” working outside of the new services who appear to be doing just fine at helping children think more flexibly about their identities.

Is she saying that she thinks that when the (ehem, parental) transing has gone on for so long there’s no way back? Because that’s pretty disgusting, if so.

But I am already disgusted by her, so…

re concerns over puberty blockers and their effect on cognitive development:
excerpt from linked article:

Adolescence is a sensitive period for neural pruning and reorganization of neural circuits, particularly in the frontal cortical regions which control decision-making, judgement, and emotional regulation (Chen et al., 2020; Steinberg, 2005) and hormonal surges during puberty are known to have wide ranging effects on brain structure, function, and connectivity (Blakemore et al., 2010; Chen et al., 2020).

A single case report described a 10-point drop in global IQ and an overall decrease in intellectual performance, “pointing to immaturity in…cognitive development,” in a 12-year-old child 28 months after starting a GnRH analogue for gender dysphoria (Schneider et al., 2017). While it is difficult to draw conclusions from one case, similar findings have been reported in children treated with GnRH analogues for precocious puberty (Mul et al., 2001; Wojniusz et al., 2016). Experiments in animals raise additional questions about the reversibility of effects on cognition. In sheep, peripubertal administration of GnRH analogues reduced long-term spatial memory (Hough et al., 2017b), and this effect remained after discontinuing GnRH analogues (Hough et al., 2017a).
pmc.ncbi.nlm.nih.gov/articles/PMC11106199/

Only when the child fully understands the impact of treatment and is mentally mature enough to make an informed decision. With lupron, that's not possible because 100% of its use in gender-incongruent children is experimental.

Not when we are talking about children. Teenage angst is temporary. Infertility is for life.

That the person saying it is muddled in his thinking. And that is the kind way to put it.

Exactly!

In the real John Money case it did not work.

I think she seems to suggest that it's best to continue to hold out the possibility of changing sex, even thought that is not possible.

"Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if
they had not been socially transitioned at that very early stage."

But it's not clear what long term alternative there is to coming to terms with the fact that it is impossible to change sex.

"......living in stealth appears to increase a child's level of stress and anxiety with resultant behaviour and mental health problems, including social withdrawal, with children becoming increasingly isolated, including resorting to homeschooling or tutoring, with some distressing descriptions of children rarely leaving their house."

Yet she isn't offering an alternative to living in stealth - just the John Money solution that everyone continues to maintain the pretence.

Her best solution seems to be to kick the can down the road for as long as possible. Perhaps that is just what doctors sometimes do. Have I missed any explanation of what she thinks the long term consequences might be?

Exactly. And for the girls who do not take puberty blockers, there's possible pregnancy to look forward to, and menopause, let alone the normal aging processes (who knows what the girls who do take puberty blockers will go through, but it won't be pregnancy). I still identify inside as a pre-menopausal 35 year old with core muscles, flat midriff, and beautiful long brown hair with no grey. Do I get drugs to help me match my mind to this mythical body? (They're probably called hallucinogenic drugs).

The aging process and time also bring experiences and wisdom, which these children will need as they go through life. We can't protect them from everything, but we can give them the best possible start to adulthood. Puberty blockers, whatever these children's states of mind are now, will not provide these children the best starts in life.

Ok, this is my interpretation, so take it with a grain of salt because (as we have established above) I can’t see into Cass’s head:

Cass is saying, look at this terribly sad case we have - here is a boy who has lived, properly lived for such a long time as a girl, and who is now so desperately afraid of going through the “wrong” puberty that he is self-isolating and won’t leave his house. How could you possibly legislate to prevent this child from getting medication that will stop him going through the wrong puberty and will therefore solve all his mental health problems? (She carefully elides over how he ended up in the situation he is in where he thinks he is a girl but obviously knows he has a boy’s body.). She then appears to be saying something like - and for those of you who are worried about the effect that puberty blockers have on bone density, well his bones are already damaged from never leaving the house, so how could PBs be any worse.

But as I say, grain of salt.

This is because their body starts to change in ways that don’t match how they feel inside.

Is there a person on the planet whose body does NOT change, at puberty, in ways which do not match how that person feels inside? The person feels to him- or herself like a child; the body is turning into an adult. Does any child really feel inside as if he or she were an adult? Even those who pre-puberty are caring for an incapacitated parent know they are not adults, are too young to have this task put on them, are a child who needs not to have adult responsibilities.

@BonfireLady, you are such a swot. Or as we used to say when I was a kid: teacher’s pet!

Miss, miss! <shoots hand in the air> I think I've got the answer!

Yes. As long as every child (and their parents) knows that there are unknown risks, if they genuinely believe that it will help their health to smoke 2 cigarettes a day for 2 years you should go for it! It really doesn't matter whether they continue smoking the cigarettes afterwards for a while and/or decide to move onto something stronger like weed or crystal meth if it didn't do the job on its own of making them feel better. All that matters is data from your 2 year study.

And of course it's ethical. If you deny them their 2 cigarettes a day because you're worried about long term health implications that you can't even prove (assuming we're going back to the time when we didn't have health data for smoking) then you're the unethical one.

Am I right, miss! I do hope so <twiddles hair shyly and hopes the class thinks it sounds clever>

I'm very confused about the example of the child transed at 2. It seems to be suggesting that John Money was right and you can change a child's sex by simply telling a boy that he is a girl.

Let’s say I’m a researcher (yay, I am!) who is interested in finding out the effect of cigarette smoking on people’s health (not me, but let’s play pretend).

Let’s also say that because I have read lots and lots of other people’s research (which is the bare minimum for carrying out a study of this sort) I suspect - nay, hypothesise - that the effect of cigarette smoking is going to be detrimental to health.

I also, from my reading, hypothesise that these detrimental effects will probably only be seen after many years of smoking.

Do I,

A) Give a small group of teenagers who are desperate to smoke, two cigarettes per day for two years, and, at the end of the two years compare heath factors to those in two other groups - another group who are desperate to smoke, but who have only been given cigarettes for a year, and a group who have no interest in smoking and indeed have never smoked;

or

B) Collect health data on as many factors as I can (factors that will be defined by, what’s that? Oh yes, reading lots of other research) from as large a group as possible of adults who have smoked for a significant amount of time, and compare this to outcomes on the same factors for a large group of adults who have never smoked?

Additional question for bonus points: Given that my hypothesis is that smoking is going to have negative effects on health, do you think that an ethics committee should allow me to give two groups of children cigarettes at all?

Yes. It's quite something to consent on behalf of your child to them having a future life of limited sexual function, potential arrested brain development and all manner of potential physical harms. Especially as these are physically healthy children with mental health challenges.

I don't doubt the pressure that groomed and gaslit teenagers can exert on a parent but how can anyone argue that a parent on behalf of (or even the child themselves) can give informed consent to such unimaginable potential limitations on future adult life?

Indeed. Some parents consent to (i.e. drive and obtain) FGM or honour killings. There are all sorts that parents do in support of their own beliefs.

The whole premise of PBs in this context is predicated on a belief: the belief that we each have a gender identity that differs from our sex and that we'll feel better if our bodies are modified to match it if there is a mismatch between the two.

The opening paragraphs of her letter to MPs urge them to set aside ideological differences. Sure. What she means is she wants everyone to accept that the it's a fact that everyone has a gender identity. Even the schools' RSE guidance doesn't go that far. It's not a fact, it's a belief.

Edited for typo.

It's my understanding that for this trial, the parents are doing the consenting.

Which I would have huge misgivings about.

Except that the child transed at 2 is not a real child. It's an illustratory example she made up.

I understand that, having said there is no good data, her impulse is to go and get some. And that impulse is sound.

What I don't understand, is her lending her name to a trial that is as poorly designed as this one seems to be. There were many other avenues she could have gone down.

I think she got corralled by the TRA contingent, into a research process that she probably knows is far from ideal. But she's in too far now to back out.

So who is consenting for these 11 year old children then? The doctors? The parents? Or themselves as Gillick competent?