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

This was always the issue with Cass. She and the report supports the physical transition of children. That means chemically arresting their healthy development when, given we do not have crystal balls, there is absolutely no scientific proof that the child will have a life long desire to be that way and as such cannot consent.

Agree with Wallis that it is a subjectively batshit concept being argued here.

Arse, it won’t let me edit.

objectively batshit concept.

Not enough coffee yet.

Outcome of yesterday's session - taken from Nick Wallis's GenderBlog (I hope he doesn't mind the c&p - Tribunal Tweets were linked to the wrong session so I couldn't copy from there. https://genderblog.net/livetweets/puberty-blocker-trial-judicial-review-permission-hearing-day-2/)

J judgement will be at 2pm on Friday hopefully with a written doc I can hand down at that time. Prob won't circ in advance. If it does it'll be on friday morning. There are a range of possibilities

1. interim relief allowed and permish granted
2. permish granted and interim relief not granted
3. neither granted.

all these options could lead to one or more option being appealed by either party and I have put the CoA on notice.

Yes, a thought experiment I've seen in as an image is "what if children identified as birds?"

To extrapolate this into words that are analogous to this trial....

Birds are smaller than humans and puberty is a particularly distressing time for children who identify as birds. Their bodies are growing and changing. We believe that using puberty blockers to suppress the growth that happens during puberty alleviates this distress.

We are going to trial this for 2 years. All children will receive psychotherapy - this will not involve telling them that they are not birds, as we consider this to be conversion therapy. Half the children will receive PBs immediately, half after a year.

After 2 years, children in the trial will do one of the following:

• stop taking PBs
• continue taking PBs

Things we know:

1. they will lose bone density while taking PBs
2. if they continue taking PBs throughout the natural window of puberty, there will be no puberty (even if other drugs were given, such as testosterone or oestrogen)

Things we don't know:

1. if children who take PBs beyond the age of 8/9 (i.e. those who take them during the natural age range that puberty should be occurring) will suffer brain damage
2. which children will continue to identify as birds

And before anyone gets all bioessentialist and suggests that humans cannot change species, we would like to point out that birds and humans share approximately 60% of their genes. This means that species are a spectrum. These children deserve the chance to be their authentic selves and it is not for anyone else to tell them who they should be.

-------------

Totally batshit. Or birdshit in this case.

FWIW I still do accept that many people believe that they have a gender identity. Many people believe in god, in ghosts and all sorts of things that can never be empirically proven. There are indeed people who believe themselves to be birds - otherkins and therians believe in these kinds of things. The bar/birdshit bit is the NHS offering the chance to physically alter the body to match a belief.

Edited to add in a line that divides the bat/birdshit part of my post from the rest of my points.

Nick went on to say
“Every single premise of every single argument made by the defendants today was "we have a very distressed cohort of young children who are revolted by their bodies. Their parents want them to take hormones, they want to take hormones, their doctors want them to take hormones. We should let them take hormones to see what happens."

To be fair, I started to have some sympathy with that view. If these kids' parents want to let their kids f* themselves up, if these doctors don't mind if they f* themselves up and if the kids themselves are determined to f* themselves up - let them. Let them. Some will be irreversibly damaged. You can't save everyone. Let them do it.”

I think the trial is unethical but maybe we have to sacrifice the long term health of 200 children to save thousands.

I meant to add maybe we need to redirect the campaign to make the PB Trial a longitudinal study that tracks physical and mental health for the whole of those 200 children’s lives.

I was there again and concur with Nick.

We are not going to get anywhere until the whole concept of the 'gender distressed or gender incongruent child' (they are no longer using 'trans child' but we know what they mean) is interrogated.

This was not the forum for that to happen, however, but part of me fears it never will.

An interesting part is that there is not case law where parties have sought an injunction where they were not directly at risk of harm from what they were seeking to prevent. This judge, were he to grant it, would be the first. Not sure if he has the chops for it. The opposing barristers were very much giving the impression that Esses etc are busybodies.

One chink of light that I hope got through to the judge - there are other studies that could and should be done to fill the 'evidence gap' (let's ignore the fact we know the side effects of PBs on unhealthy adults and on kids with precocious pruberty - and are ignoring the fact that the kids on the trial don't have cancer but are perfectly physically healthy...).

Cass, from chatting to others in court definitely touted THIS study as that thing that would fill the gap (it won't - it would just tell us that kids and parents who get something they really really want will be happy, but the ones who have to wait a year will be less happy). But she's now saying it's to stop them obtaining the drugs elsewhere. Cass was mentioned a lot by opposing barristers. She more than anyone has the credibility.

One thing I learned about the trial design - Group 1 gets the PBs straight away and is on them for 2 years, group 2 gets after a year, then only for a year.

Counsel for the Maudsley made a mis-step, IMO, in emphasising how very very dangerous these drugs are. She was talking about when obtained illegally, but I, and others thought the last impression of that statement was how very bad the drugs are. We thought the judge pricked up his ears a bit there. But perhaps wishful thinking.

What is said in court is a fraction of what is in the bundles, so it's frustrating when it focusses on seemingly niche legal staff. but that's what it's there for. Hope the judge has a goos read and 'educates' himself a bit about the things we care about. Because we are not busybodies.

Edited for typos

I don't agree with that argument @Kirschcherries Running the trial makes something dangerous look safer and better justified and more respectable than it is. It leaves the parents who don't want their kids to fuck themselves up with less recourse - how can a parent refuse if the child wants it, what does that do to their relationship with their child? Outside of the 200 (and I dont know that this trial will be limited to 200 children) it gives other parents whose children don't qualify for the trial, and even some children themselves, an excuse to ignore the law - my child should have been given the drugs and it's just some technicality that ruled them out.

Plus the whole point of the judicial review is that in a civilised country we don't run a study that sacrifices any children for the greater good. Not even 200 self-destructive kids with deluded parents for the sake of thousands more. There has to be a reasonable prospect of some worthwhile benefit to the 200 themselves.

@AmaryllisNightAndDay . I agree with you. I had a bit of sympathy with Nick's (frustrated) paragraph about leaving them all to it - FAFO - but we have to keep going.
This is the NHS we are talking about. It must do better.

Well James Esses and Keira Bell don't look like giving up whatever happens. The judge seems to be expecting an appeal and James Esses has said that they have funding to keep going.

I agree with all you say and I hope James, Keira and the Bayswater parents win.

The Government and NHS etc. will never be able to say they were not warned. The future public enquiry will be left in no doubt. It won’t help those harmed but may stop it long term.

I have learnt from bitter personal experience on another issue sometimes you have to let it happen before reality sets in.

@Kirschcherries I think you're right and I am sorry you've ever been through this sort of thing before. I think it's why Nick Wallis has become interested in this. In that court, with all the many many lawyers there on the other side, it felt a bit David and Goliath.
They are very much protecting the Institution

I hope that sensible advisors are pointing that out to the government. I fear not. But you are completely right.

One chink of light that I hope got through to the judge - there are other studies that could and should be done to fill the 'evidence gap' @SodThisHeadache

This is a very good point.

IMO there are at least two things that should be looked at before a puberty blocker trial is even considered.

The diagnosis of gender incongruence in childhood, which is preference driven, poorly defined, and riddled with sexism.

Cross sex hormones. Looking at the physical effects and overall outcomes. There's plenty of evidence of the negative side effects, https://genderblog.net/gender-surgerys-incontinence-problem/ and in light of the recent Finnish study conclusions, there needs to be better research. If, as that study suggests, this pathway as a whole is not working, then it becomes irrelevant whether puberty blockers are safe or not, when they only exist as the first part of a much longer pathway.

edit - typos

@Fidgetbreak

Yes. Re: CSH on day 1 they seemed to be totally open about the fact that most of these kids would go onto CSH. I was really surprised by this open-ness. No pretext at all that this is a pause to think (so why are they bothering with psychotherapy then?). But the patient info leaflet just sticks to talking about PBs - says there are side effects, some are mild, but they stop when you come off PBs. But ,most will not come off PBs!!!

There was someone there watching who I happened to notice (because their* name was plastered all over their* laptop and I was sitting right behind) who is senior in Research at the Dept of Health and Social Care.

*not wishing to reveal the sex; not saying the person was non-binary 😁

So.

We know the drugs are dangerous because we have years and years of effects and side effects from them.

We know they are so bad that for children with precocious puberty they are only allowed to take them for as short a time period as needed. Months rather than years.

So we have dangerous drugs, with oodles of evidence of their dangerousness and we have a very dubious new 'diagnosis' of a 'thing' which is based on self reporting as there is zero 'differential diagnosis' or any ability to actually measure anything in any way possible to determine whether the diagnosis is 'real' or not.

And the drugs are so dangerous that they should not be left to being bought on the internet. But this 'trial' will give these same dangerous drugs to a range of kids, where it is impossible to diagnose for sure whether they have the 'thing' they are treating, and for 2 years or 1 year where the effects and side effects over and above 'happiness' are not measureable.

And we know that these kids are likely to go straight onto cross sex hormones, but there is no mention of that in the bumpf. And no mention of all the damaging effects of the drugs in the bumpf. And no mention of what it is they are actually treating in the bumpf.

What could possibly go wrong?

And if WE know all this how come the people wanting to give these kids these drugs don't appear to be concerned in any way about the harms they will be inducing?

Why is Cass so determined to go down this route?

This is very similar to the argument being put forth by another poster on the earlier PB thread:

https://www.mumsnet.com/talk/womens_rights/5552735-hilary-cass-sent-a-document-to-every-single-mp-and-peer-justifying-and-defending-the-puberty-blockers-trial?page=1

The poster argued continuously that we need to have this trial in order to prove the harm that blockers cause, so that we can stop the use and sale of puberty blockers in other countries where they are still legal. Hopefully.

We need to harm some 200 British children in the hope that everyone else will see the harm, and stop harming their own children.

Argued over and over again for nearly 30 pages. Talk about batshit!

I want doesn’t get

To be clear I do not want the PB trial to go ahead.

@BridgetYourFortyDaysAreUp @WarriorN I think you should read what @Kirschcherries said after that post

Oh yes, I totally get that; was reflecting that they’re all behaving in a very privileged / naval gazing / batshit / ideological manner.

its all want based, not need. Or wants dressed as needs. Peak capitalism.

That’s kind of you, I can be a pragmatist and know my posts are about what is achievable rather than what I believe is right.