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

Why does anyone need medicating because of social roles?

Surely social roles are just the expectations of how people should behave in social situations. If these differ for men and women they are based on stereotypes.

They are chasing the pot of gold at the end of the rainbow. But also doing so often as not having had children - something they will deny others.

Exactly. In fact it is other adult selves that are pushing for these children to be 'transitioned' before pubertal change, because these adults are still unhappy and imagine that it is because they 'transitioned' post-puberty, and not for any of the myriad other reasons why 'transition' didn't make them happier.

I fully agree.

That is a very interesting question.
These are the exclusion criteria:

1. Physical conditions preventing puberty commencement or advancement.
2. Unstable physical health requiring active intervention.
3. Hypersensitivity to GnRH, its analogues, or any of its excipients.
4. Known congenital long QT syndrome
5. Unstable mental health impairing ability to provide informed assent/consent. 6. Family/home situation affecting adherence to protocol.
6. Clinical concerns about capacity to consent.
7. Insufficient understanding of PATHWAYS TRIAL
8. New or ongoing safeguarding concerns.

10. Birth-registered females with undiagnosed vaginal bleeding.
11. Birth-registered females who are pregnant or lactating
12. People of child-bearing potential who are at risk of pregnancy during the trial

Now, let's think about the mythical 'Jo', the child that Cass invented to tug at the heartstrings of parliamentarians. 'Jo' was an amalgam of children - transed by parents, unable to function, in danger of bone damage through lack of exercise.

The trial is developed as a way to give children like Jo access to PBs. Yet surely Jo fails the inclusion criteria on points:

1. (bone health)
2. deteriorating mental health
3. Because no child can informed consent/assent to a process that may rob them of an adult sexual function and fertility that they cannot comprehend

and 9. the child's parents are a safeguarding concern.

edit to say you will have to figure out MN's bizarre numbering fail yourselves

I've already explained at length why I think for a small number of kids the harms associated with withholding hormonal interventions outweigh the harms of the interventions themselves.

That's not for you or anyone to decide, though. It's for their adult selves to decide whether transitioning so early was worth not being able to have children. Except their adult selves will never have that opportunity, because of decisions other people made for them when they were children.

This is abject.

People in my clinic rarely describe gender dysphoria in clinical language. They describe it in physical terms. A cold wave that washes over them when they catch their reflection. A sense of looking in the mirror and seeing the wrong face. The feeling of performing in a play that never ends, where the role does not match who they are. One person described it to me as a kind of chronic pain that gnaws at them without any clear physical cause.

This part actually speaks to me. And the condition described seems simple to me: it's a psycho-neurological disconnect between the reality of one's body, and how one perceives that body. Dysmorphia.

The DSM-5-TR defines gender dysphoria as a marked incongruence between someone’s experienced or expressed gender and the gender they were assigned at birth, lasting at least six months, and causing significant distress or impairment in daily life

Nothing to do with gender; everything to do with sex. "Gender dysphoria" would be far better named "sex dysmorphia". But then, since sex transition is actually impossible, you'd have to find other ways to deal with that condition...

Yes I absolutely support this! It sounds like a really important thing to do. Probably more useful that the trial to be honest, and less difficult in terms of the ethics.

Thanks I was just trying to clarify whether you were suggesting there was not such thing as a trans kid or not.
I've already explained at length why I think for a small number of kids the harms associated with withholding hormonal interventions outweigh the harms of the interventions themselves.

Just copying this comment again as it may have got lost in a busy thread.

@Sunnibee what are your thoughts re the data linkage study?

(See wider context in my quoted comment and your previous comment about more research being needed)

this Was discussed at length including why social roles does not refer to stereotypes.

We know for a fact that some of them are not actually trans and will desist later on, so yes, all the kids who present for GAC can only be supposed to be trans.

And you didn't answer why presenting for GAC justifies being sterilised.

There is no way to know that the trigger is the dysphoria.

While showing signs of gender dysphoria over a sustained period of time, my daughter experienced everything on your list, except psychosis. She was so distressed that she was regularly violent at home.

The trigger turned out not to be the dysphoria. It was trauma from bullying. The bullying related to her autism. She ended up telling me, and subsequently her therapist, that she wanted testosterone so that she could be stronger and beat the bullies.

Yes, that's one example of one child. But if we assume that the dysphoria is the trigger, given 97.5% of Tavistock referrals had other underlying issues, I'm willing to bet that in the vast majority of cases that would be wrong.

Here are some excerpts from the blog you posted.

People in my clinic rarely describe gender dysphoria in clinical language. They describe it in physical terms. A cold wave that washes over them when they catch their reflection. A sense of looking in the mirror and seeing the wrong face. The feeling of performing in a play that never ends, where the role does not match who they are. One person described it to me as a kind of chronic pain that gnaws at them without any clear physical cause.

This doesn't say anything about what the condition is.

That embodied quality is one of the things that distinguishes it. Gender dysphoria is not just a thought about gender. It is a felt sense of incongruence between the gender someone experiences themselves to be and the body or social role they are living in.

OK, so here perhaps we're getting somewhere. It's about their body (so a type of dysmorphia) and the social role. Oh dear, we're back to the stereotypes.

The DSM-5-TR defines gender dysphoria as a marked incongruence between someone’s experienced or expressed gender and the gender they were assigned at birth, lasting at least six months, and causing significant distress or impairment in daily life

What, exactly is an "experienced or expressed gender"? Is this about social roles again - the stereotypical expectations around being male or female? Or something else? What exactly?

There is a persistent mismatch between someone’s sense of their own gender and the body or social position they find themselves in, and that mismatch is causing them real distress.

It's just nonsense - what is a sense of their own gender other than knowing what sex they are? Or is it just about stereotypes and wanting to act the part of the opposite sex.

Destroying the health of children for what? So that they can spend their lives cosplaying as the opposite sex?

I don't accept the concept being described because there is no concept being described, just meaningless waffle.

When you say "supposed trans kids..." ?

having gender dysphoria is not a criminal offence.

Then why are supposed trans kids punished with sterilisation?

It's not supposed to make sense. It's supposed to provide calm rational non-answers and authorative assertions that look convincing but dissipate into nothings and maybes when anyone tries to dig further to find facts and consequences and consistency.

Sure - earlier I was talking about what has happened until now.
Im not able to predict the future! ☺️
But encouraging from my perspective to see this possibility in the protocol. Whether and how many children that young will be included or not remains unknown since it can also go up to 16.

It's a mystery. I've given up expecting any of this to make sense.

But as you say - this trial includes 11 year olds so numbers up to now are irrelevant.

So you don’t think distressed individuals always needs people accommodating them then?

Because this has been the case historically in GIDS. The numbers were tiny. This is based on actual data.
This is a new research protocol and it's encouraging to see they are able to include children at the appropriate developmental stage.

Stalkers??
That's the parallel you are drawing?
having gender dysphoria is not a criminal offence.

So why were you earlier telling me hardly any 11 year olds have received PB something something consent…

Stalkers often have deep seated beliefs and distress. Weirdly we don't insist the best way to support them is to insist the object of their fixation accomodates their reality.

Because other people also matter, even if some people's myopic obsession with gender dysphoric children (or perhaps I should say their obsession with ensuring the public's focus is directed to gender dysphoric children) prevents them from acknowledging this possibly even to themselves.