Pathways Puberty Blocker Trial - High Court Proceedings start 27th July

The thing is there was a process that was undergone and it went through the regulatory body. The legislations empowering said body ensure that there is only very narrow scope for legal challenges. The legislation provides that in principal the substance of an application for ethical approval, should be left to the experts and that there is adequate scrutiny within the existing structures which is not for judges in general to visit.

In this case the only admissible point was that there was a failure to follow proper process in so much as they did not correctly follow the Helsinki thingy.

(which is not a treaty and not binding)

It was always a weak case, no matter how right the claimants were in reality.

IANAL but that is how i understand it.

I personally am with Nick let them get on with it, the future is what we have to look towards.

The problem with ‘let them get on with it’ is the only answer the trial is set up to give is ‘are children happier if given something they want straight away and asked then, or if they are made to wait six months and asked before that wait is up’. Of course it is the former because children don’t like waiting. There is insufficient follow up to determine the impact of the drugs and no comparator for longer follow up. In other words, the trial is set up to make PB look good.

Thank you, that's a helpful analysis. I can never reach a conclusion that they just need to get on with it though.

IMO they are missing something else in their trial from a legal perspective: the Nolan Principles of public life. Specifically, that they need to be objective.

This whole trial is predicated on it being a fact that everyone has a gender identity. If it wasn't a fact, it wouldn't be possible to be distressed about having one that differs from one's sex. Except it isn't a fact, it's a belief. A medical trial which is predicated on belief is not objective. Ergo it goes against the NHS code of conduct because the Nolan Principles are included in it.

IANAL but to me that sounds like a process fail when pulling together a medical trial. Surely it should have been shut down at the first hurdle when it became clear that it was about changing someone body to align with an unfalsifiable belief in the concept of gender identity.

I dunno we cannot save everyone as awful as it is. Am not so unsure about the future and feel that a sustained pushback will kill all of this shite eventually.

the GRA is legally dead in the water now and i think we can use this example as to what will likely happen elsewhere.

We have breached the front line, and have a way to go. Onwards and upwards for me.

@theilltemperedmonster I'm afraid that gender affirming care will not go the way of full frontal lobotomies and other unsuccessful treatments, partly because the right data has not, and will not, be collected, and partly because GAC alters its subjects in ways that make success difficult to quantify.

I think - hope - there still may be class action lawsuits in the future when enough children grow up and regret what’s been allowed to be done to them in the name of GAC because I hold that human desire for those currently harming children to be held accountable at some point in the future. The children in question will be living with the consequences and they will search for explanations. I hope.

@Cantunseeit Boom, in one move all those hard won safeguards are gone. The same has happened in Sweden apparently. There are now more kids on PB than before they were banned except as part of a clinical trial

When Cass said should treatment decisions be made by clinicians or politicians, the answer is politicians. At the very least, voters have elections to hold the politicians accountable. No such possibilities with healthcare professionals.

I wonder if trial leads might at some point find themselves in the dock for the criminal offence of providing misleading information about safety to the REC. I hope so.

Did anything ever happen about the data linkage study that would track the children who were already given puberty blockers? I googled it and I can't find was the law ever changed to allow for it https://archive.ph/fUHIL

You would think they would wait for that before starting a new trial but maybe they already know what it will say and don't want pesky figures about bone density etc to get in the way of a nice new trial where those complications won't be known for a long time

I'm unsure how this trial will in anyway be objective regarding mental health, its participants will surely be aware that if they don't say everything is hunky dory that other children won't get blockers too and will likely feel pressure to pretend like they're doing well even if they aren't

I can't see how anyone could have the nerve to cast Keira Bell of all people as a mere "busybody" in this case.
If anyone has the right to stand up and say "please don't do this to MORE kids" surely it's her?

@ElenOfTheWays

Well quite. It's outrageous but that is what the tone was - 'there there we've done all this preparation, we've got all this paperwork, we've got all these experts on our side, < mention Cass several times> . Let us get on with it'.

It’s a shame the decision went this way as experimentation on children is horrible. But perhaps in the end it will end up for the public good.

Ive no skin in the game but in my mind the next steps are to campaign for:

1. the Data Linkage study to progress in parallel
2. extension of the Pathways trial to lifelong 5 year follow ups (possibly as a condition of receiving any further NHS trans “healthcare” to avoid drop out) with a full range of medical/health/psych measures instead of just “happiness” at year 2

If we are going to have this mess then it’s a moral obligation to get as much data out of it as possible. It’s unacceptable to get to the end of Pathways and to not have any more evidence than The Cass Report previously uncovered

@MashaPav whats your take on the outcomes of Pathways? Are you happy with such a seemingly low level of evidence gathering at the end? Wouldn’t you rather they did better science?

Quite, you are describing a well known confound, the demand effect - I’ve no idea how this got through an ethics committee, I’ve known better designed studies turned down for less. There are many examples of such flawed studies in the research literature and we (researchers) all know about them, it’s drummed into you in research lectures!

I am disappointed, though not surprised. But I am grateful to the hearing that we now have it on record that this is not and could not ever be considered a “clinical trial” as has been insisted upon by some supporters on these threads, but is instead a “pragmatic trial”.

Hilary Cass was on the Today programme this morning just after Thought for the Day banging on about how wonderful & necessary the PB trial is. She is utterly captured with the idea of "true trans".

Good point!

Until I read this thread I had no idea a 'Pragmatic Trial' was just made up for this.
I mean I sat in the Court and thought what bollocks this 'trial' is but at least thought there was some precedent for using the phrase.
One more of many made-up/ twisted words and phrases in gender ideology.

Until I read this thread I had no idea a 'Pragmatic Trial' was just made up for this.

It wasn't made up for this trial. It's a long established phrase. In the world of research the word 'pragmatic' means "We know that the methods & data are dodgy but it's the best we can do under the circumstances."

It’s ridiculous, isn’t it?

Cass, weeping and wailing about how desperate the world is for a proper clinical trial so we can all have the real evidence that “her” report found was lacking.

And what do we get?

A big pile of garbage tied up with a “pragmatic trial” bow.

I cannot believe that I had any faith in that woman. She is, in my opinion, as odious as Whittle.

@PrettyDamnCosmic

Ah thanks for the correction.

Cass seems to have gone from saying this trial will teach us something, and latterly, that it will just stop 'trans kids' obtaining drugs illegally.
I don't know what to think about her

I doo and its not allowed on here….

I was heavily criticised after the Cass report for pointing out Cass is not an expert on trials. Like most senior clinicians she jumped into her senior roles direct from being a clinician. Her viewpoint would have been high level not the prior research, information, technical aspects of trials, their designs and their various biases.

She didn’t do the systematic reviews in her report - specialist teams did. So she was restricted in what she could write in her report.

I’ve said before that I would really like to read an interview with the researchers who actually did the work the report is based on, to see how they feel about the way their work is being twisted by the woman who put her name to it. As a (retired) researcher myself, I know how I would feel, and it’s unprintable.

edit for clarity

I hope Cass sees the irony that these are the types of studies and trials that she described as being of low quality in her report.

Yes there is, evidence proves otherwise. No matter how transphobic ideologists like yourself claim.