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

No, you don’t seem to understand is that this very idea is what is so controversial and shouldn’t be going unchallenged.

They didn't really have clinical trials back then, and if they had, they've have figured it out much sooner.

Which jurisdictions are you referring to? If it is in the US, are you confident that the bans would stand if a different political party took control of those jurisdictions? I'd prefer medicine to be evidence-based, not politically-based.

Other countries are certainly looking to improve the evidence base.

And that's the world we live in, while the experts and politicians and media cannot face reality and pivot180 to speaking the truth. They didn't when this phenomenon took hold, they sure as Hell won't now.
So, those snared into this world will themselves, or via their parents, access black market drugs, and find online influencers to back up their choices.
And polite society will sacrifice a cohort of vulnerable teens for some spurious possibility that magical thinking and innate inner feelings will be confirmed and these kids will be medicalized into happiness.
Adults going down this path, if that's what they want, they're of an age to make reasoned decisions. But teens, not able to encompass all the ramifications, including the pathway to irreversible change, how global society deemed this as reasonable and respectable, is a Q for the ages.

The “standards of practice” are not ethical. This logic doesn’t work. The “standards of practice” were created to allow puberty blockers to be given. So then it still needs to be established why they are given and is it ethical to do so.

You don't seem to understand that all an acceptable treatment needs to be is meeting the standards of care & the UK Pathways clinical trial on puberty blockers has officially met the required regulatory and ethical standards of practice.

When lobotomy was banned, there wasn’t a necessity to have a “better trial” for everyone to see sticking things in people’s brains was ultimately a bad idea.

It's not just a small two year trial. It's part of a much larger suite of studies. And it's not just about proving they have negative consequences, they also have to show benefits relative to the risks.

And you don't need to tell me about the risks of nutters grooming kids on the internet. At the moment there's nothing to counter them.

You keep saying this, but why?

Puberty blockers have been banned in several jurisdictions without a trial required to bring that about. This has happened because jurisdictions have seen sense in the logic of the harms and problems with the reason they are given.

Why is a trial a necessity to bring about the final nail in the coffin of their use worldwide?

You’re optimistic to think a relatively small two year trial is going to definitively prove that PBs have such immediately obvious negative consequences that they are forever banned here and globally.

Likewise optimistic to think that even if it’s established that PBs have irrefutable adverse impacts within two years that such findings will stop the likes of Dr W or the 100’s of hard core healthcare genderists who emphatically know better. Or stop those parents on the gender train determined to get scripts online and continue circumventing GPs altogether.

It certainly won’t stop the young trans identifying males that I know never bother with any doctor. They’re in online spaces, get told by TWs who’ve already transitioned and sourced the PBs/xshs that they need to start taking these asap. They tell them it’s needed to keep their wrists small and bodies skinny and then give them the links to the online pharmacies. Job done.

None of that will stop with this trial. It’d be a relief if it did, but I don’t share that optimism.

I didn't say everyone believed it. I said a big chunk of people do.

Do you want a trial of puberty blockers to go ahead or not? Because if you don't, then sorting it out worldwide ain't happening any time soon.

You haven’t named another treatment. Can you name one?

Ethics & standards of practice are inextricably linked. And the standard of practice for mental health medications is another treatment available to children with the similar low quality evidence & risks. So yes PB are ethical if they meet standards of practice.

The “standards of practice” are not ethical. This logic doesn’t work. The “standards of practice” were created to allow puberty blockers to be given. So then it still needs to be established why they are given and is it ethical to do so.

It’s pretty obvious plenty of people who spout “TWAW” don’t deeply believe it to be literally true. Don’t know why you think me believing this has any impact on my sleep 😂

Your original question:

"Can you name another treatment that is still given to children that has such questionable ethics around it?
Do you have an answer to my question as to whether you think THIS is ethical?"

Ethics & standards of practice are inextricably linked. And the standard of practice for mental health medications is another treatment available to children with the similar low quality evidence & risks. So yes PB are ethical if they meet standards of practice.

"According to Karasic, prescribing treatments that have “low quality” evidence is common, especially in pediatrics. “We do all kinds of interventions, routinely where evidence is limited. So, it’s not that we have randomized controlled trials for everything we do. And especially if you’re working in mental health and you’re working with minors, we’re using interventions all the time that are not FDA-approved for minors.”
One of those treatments, Karasic says, is antidepressants. A systematic review performed by Cochrane, an international nonprofit research organization that has conducted thousands of systematic reviews, found that for children and adolescents “most antidepressants may be associated with a ‘small and unimportant’ reduction in depression symptoms.” And even this “small and unimportant” association was “low certainty” for some of these drugs.
And, like gender-affirming treatments, antidepressants come with serious risks. These risks include potential bone density loss, which is a commonly cited risk of puberty blockers, as well as suicidality. “Antidepressants have a black box warning in minors for an increase in suicidality, and yet we use them all the time because they help a lot of people,” Karasic said."

This is about what to do with this trial. And other countries are looking at this trial for their own guidance. Like Australia for instance.

So clearly defining what the purpose of this trial is will go a long way to sorting it out worldwide. It it is determined, through adequate ethical appraisal, that it is not ethical to proceed with this trial because of difficulties even defining the condition being treated, it will mean that there is no way gender clinics around the world can argue it’s ethical to continue with PBs in normal clinical practice.

So forcing this research group to address these issues now would be hugely impactful.

What I am proposing isn’t even controversial. If a trial for chemotherapy is proposed to treat leukaemia in children, the underlying leukaemia is defined down to genetics.

A trial of this magnitude should be subject to the highest scrutiny possible.

If that helps you sleep at night.

Well, I'm slightly more ambitious in that I want the issue to be tackled globally, not just in England.

But they’re not in the UK are they. It’s been stopped. So in order to decide if it should resume, you’re saying the only way is to do a trial anyway, and everyone else is saying clarify what is being treated first.

Lip service to an ideology so they’re not guilty of blasphemy.

And while you grapple with these philosophical questions, hundreds of kids are being prescribed with puberty blockers.

Sure they do. Trans women are women etc etc. What do you think that means?

Yes but it doesn’t answer the important philosophical or ethical questions.

The Utrecht Gender Dysphoria rating scale, for example. How is this worthy? It asks questions like “I prefer to behave like a boy/man”. What does this mean?

And this was the same rating scale that the Dutch used where they switched the questions.

And the eligibility criteria is still a diagnosis of gender incongruence as per ICD11. What does “a strong desire to be a different gender” mean? How is gender defined?

It still relies on the concept of gender incongruence being a diagnosis in its own right, rather than something else. See 1984Now’s post for the next step.

Is gender incongruence a diagnosis? How is that diagnosis reached?

A lot of people still believe that trans women are actually women.

Nobody really believes that, unless they think that a "transwoman" is a woman (an actual female woman) who identifies as trans.

A lot of people still believe that trans women are actually women.

I’m not sure children around the world can afford the time it would take to simply argue people down, versus providing them with clear evidence. And Finland are still prescribing puberty blockers.

That's all a bit vague. There's no explanation of what they think gender incongruence is, or why it's viewed as so important to not be gender incongruent that life-changing drugs which can result in a child becoming an infertile adult with impaired sexual function are the solution.

What's wrong with being gender incongruent anyway? Gender is just a bunch of stereotypes and it would be far better to accept that some people reject them than just get the kids early and sterilise them.