Netherlands Puberty Blocker Review Comes to Opposite Conclusion, Dismisses Cass Review

Nothing has changed. It's just moving words around.

Yep. If gender identity is separate from biological sex, by very definition it has to be a feeling or a "soul". Even if those who feel they have a gender identity that differs from their sex don't describe it that way.

They can wriggle about trying to say that sex is not binary all they like but they are objectively wrong on that. Everyone is either male or female. And we've already been around the DSD loop on this thread. I skipped through all of that. I have a horrible feeling we're going back there 😬 I'll skip it again if we do.

It's a trite example, but lack of money causes distress and suffering to far more children globally than gender dysphoria, and that could be remedied very very easily by taking money away from some people and giving it to others. Yet we do not do that.

So it seems that some distress is worth addressing even though we can't even be sure the interventions work, and other distress is not even though there is a clear and obvious remedy.

Odd that. It's almost like actually, sometimes the impact on other people does matter too.

If someone believes the correct name for the colour "red" should actually be "loud", and the quality of volume previously known as "loud" no longer needs a name, it doesn't mean the visual quality of redness has now become a sound or that sounds that were previously thought loud are now silent.

Similarly, if someone believes their gender identity is what makes them a man or a woman, it doesn't follow that gender identity is now the actual basis on which people are men or women, and nor does it follow that the people formerly understood to be men or women because of their sex have now lost the quality of sex.

Nothing has changed. It's just moving words around.

I don't think many clinicians would describe trans people as believing they literally have a "gendered soul", and I don't think that reflects how most trans people describe their own experiences either.

The many of them who refer to themselves as, for example, "a man in a woman's body," do explicitely refer to a non-bodily essence separate from the body, in effect a soul.

You say it's about gendered categories, but then you describe sexed categories.

We can call them "sexed categories" if you prefer; it doesn't change the point. The point is that society recognises these categories and organises many aspects of social life around them.

These categories exist, and so does the experience, for a minority of people, of being in the wrong one, together with the profound distress that can accompany it. That is the phenomenon referred to as gender dysphoria.

There was a suggestion earlier that if we removed the categories themselves, we could remove the experience of being in the wrong one. There's a certain logic to that. The difficulty is that these categories are deeply embedded in society because they arise from real biological differences that have social significance. It therefore seems unrealistic to imagine that they could simply be abolished.

why not allow for the possibility that other people are motivated by much the same underlying needs and are making a similar judgement about the balance of benefits and risks?

Because they are children.

A child's view of risks and benefits is never going to match that of an adult's. And if they and their parents are being told that they'll likely commit suicide if they don't transition, they are going to feel an urgency to "pause" puberty without having a full understanding of what that means. It's not a pause if it never happens.

That didn't really answer my question, but either way -

I think you're assuming that other trans people are motivated differently from you, but you haven't really established that. Why assume that your motivations are unique, or that other people necessarily have less realistic expectations?

If, in your case, the perceived benefits of medical intervention outweighed the drawbacks, why not allow for the possibility that other people are motivated by much the same underlying needs and are making a similar judgement about the balance of benefits and risks?

People often describe their experiences differently and use different language or concepts to make sense of them. That doesn't necessarily mean the underlying motivations are different, or that your reasons for pursuing medical interventions are somehow more valid than theirs.

the severity of the condition

We are talking about a psychological disorder in children which normally resolves itself during puberty (in 80% or more of cases, this is well documented).

Persistent gender dysphoria can cause profound distress with devastating consequences, particularly at such a vulnerable stage of development.

But that's the thing: we don't know that. Plenty of adults who transition were "trans kids" who survived without "devastating consequences" (I was one of them), so why assume that any kid who presents with gender dysphoria will necessarily experience those consequences?

You say it's about gendered categories, but then you describe sexed categories. The sexism comes when we insist particular roles, personalities, behaviours, hairstyles etc must be associated with a sex category. And as you admitted in your previous post, maybe without that sexism they wouldn't wish they were the other sex in the first place.

We all agree I think that they can't actually be the other sex. Any more than a tall person can be short for wishing it. You could attempt drastic medical routes to shorten their legs but it would be a medical harm and unethical as there's nothing medically wrong with them to start with.

What is this "gender" apart from a pretence at being a sex you're not and compliance with the associated gender stereotypes?

Sex is sex. Can't change. Gender is stereotypes. Completely optional. It's fine to be a woman and not behave like an average woman. Tbh not even sure the average woman behaves like the gender role assigned to the female sex either these days.

I didn't have the same benefits in mind as too many of those kids.

I didn't want to become a man, because that's impossible. I didn't even need to pass as a man 24/7. I only wanted to become a woman who presents as a man, and that was achievable, so that was enough for me.

Ah no, I also wanted to masculinise my body, and already the lower voice and the top surgery almost entirely took care of that, though the eventual beard is great too.

So I wanted things that I knew I could achieve and - crucially - which didn't depend on anyone else affirming or validating me.

Whether sex is immutable is a separate question from how we understand the psychological experience of gender dysphoria. I don't think many clinicians would describe trans people as believing they literally have a "gendered soul", and I don't think that reflects how most trans people describe their own experiences either.

You also seem to assume that gender incongruence can only arise from confusion or from internalising sex stereotypes. I don't think that follows. It is a complex psychological phenomenon, and I would be cautious about reducing it to a single explanation that may not reflect people's actual experiences.

You have a strong opinion on this subject which you are presenting as factual. You insist that trans people are confused. My question was and is - have you ever stopped to reflect on whether your own interpretation of these issues may be confused?

Apologies @Seethlaw you covered this with the likelihood of intellectual impact.

I tend to refer to it as a likelihood of brain damage, because to me that's what it is. It's the chemical/biological version of what was done physically with lobotomies.

Edited to add: it's also deeply personal to me as at that point I trusted the NHS fully in what it said. I would have continued to do my research but had it not been said so explicitly on their website (it's very wishy washy now) I would have assumed that the NHS would only ever allow doctors to prescribe treatments that were safe. I would have assumed the unknown aspects related to whether they were effective or not.

I've been appalled at what I then learned about this "treatment". I'm glad it got banned. I'm incredulous that anyone thinks trailing it is ethical.

As above, she's a senior paediatrician, and I don't doubt her expertise within general paediatrics. However, she does not have specialist expertise in this area of clinical care/ practice. She's is no more qualified to speak especially authoratively on this than on paediatric oncology, or neurosurgery or any other specialist area of care.

Feelings and 'interpretations' don't detract from the fact that one's sex is immutable no matter how one feels about it.

If one truly believes that they have an inner 'gendered' soul they are mistaken. The concept of a soul is just that - a concept - not measurable reality. And a concept that is heavily reliant on sex based stereotypes. Children are being led to believe things that are simply not true......this is neglectful at best, and abusive at worst. Confusion is the bedrock of gender ideology. It activley nurtures ambiguity, uncertainty and confusion.

Regardless of whether people like her conclusions; she is a senior paediatrician with a lifetime of experience.

High likelihood of brain damage.

It was the NHS' statement that "the impact on the developing teenage brain is unknown" (now removed from their website and a lot more nebulous) that led my husband and me saying no to my daughter when she asked to go on PBs to give her time to think about whether she really wanted to be a girl.

That was 4 years ago and I can still remember that conversation to this day. I'm sitting in exactly the same chair right now. I had no idea about anything to do with gender identity. I told her that we weren't going to let anyone experiment on her brain but that I would find out everything I could to support her.

That was my WTAF entry into all of this, before I even realised how many more of those moments I would have on my journey of understanding.

You describe trans people as "confused". Have you ever considered that your interpretation of their experience might rather be mistaken?

Feelings come and go. They shift and change, even if some endure for longer than others. 'Liking' one's body more is no guarantee that one always will 'like' one's body going forward. Feelings of discomfort, alienation and/or anxiety have a habit of re-appearing and attaching themselves to different 'objects' or sets of circumstances.

Believing you are the sex other than you are is a perfect example of confusion.

May I add to/tweak the last as I see it?

Benefits:

• Likes their body a little better - maybe [and for a short period of time].

Harms:

• Said body has been subjected to a hormonal treatment with potentially grave [irreversible] intellectual and physical consequences.
• Implicit message from authority that one's sex and puberty type is a choice to be made and will result in full social treatment in line with that choice.
• [Desistence is less likely due to:

If they continue to full medical transition:

• Their body is subjected to a life-long hormonal treatment.
• Their body is subjected to heavy surgery.
• Their body is permanently sterilised.
• [Studies suggest they are more likely than not to be no happier or actively less happy - I must find the links].

I don't find Cass's arguments compelling and I don't think she has the relevant expertise or experience to serious engage on this issue.

There's no compelling evidence that not giving children puberty blockers raises the risk of psychological harm.

Persistent gender dysphoria can cause profound distress with devastating consequences, particularly at such a vulnerable stage of development. I don't think this is seriously disputed by any clinician working in this area.
The relevant question is how best to alleviate that distress while balancing the potential benefits and risks of different interventions.

I didn't ask you to defend that reasoning I asked if you thought it was an example of a quality argument from someone seriously engaged in the issue

Sorry you are right, I was more spinning off your post and thinking about the broader conversation where someone asked me to defend that reasoning.