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

So if distressed children are excluded why are the happy children given powerful and harmful drugs?

From the protocol it looks like children can be included from 11 (natal females) and 12 (natal males) if they are in tanner stage 2

actually you've identified the mechanism that can (in extreme cases) lead to the disassociation - but the "lie" is the other way around from the perspective of a person who is trans. We discussed this earlier in relation to the experience of a pp on this thread.

im not suggesting we should give children who are experiencing psychosis medications- that would obviously create issues in terms of consent. I was simply highlighting the mental deterioration that can occur in as a result of intense and long term dysphoria.

According to the trial protocol, these children would be excluded.

Microsoft Word - PATHWAYS Trial Protocol v3.2 18.06.2026 CLEAN

Under 'Exclusion Criteria' on p.5:

5. Unstable mental health impairing ability to provide informed assent/consent.

in what possible world could any child suffering from such a condition be able to consent to experimental treatment?

I genuinely don't believe that pretending to a child who is undergoing psychosis (or any of the above mentioned symptoms) that they can change sex is a good idea. Because it's not true.

Have you considered that continuing the lie might be fundamental in their continuing these symptoms? If those close to them repeatedly lie about reality, don't you think that might cause some psychological dysfunction?

I don’t think the issue here is that the concept is vague — I think you’re not accepting the concept being described. It’s frustrating but predictable that what you have taken from this long exchange is boys/men wanting to use the ladies’ toilet. Have to laugh really and accept that you’re responding to a position you’ve already decided, rather than any of the actual points I’ve been making.

Deep psychological suffering/ pain that affects a person’s everyday functioning and wellbeing. This can result in severe anxiety, depression, social withdrawal, emotional dysregulation, dissociation , self-harm, and suicidal thoughts. severe mental health deterioration triggered by dysphoria can also involve other psychiatric symptoms, including psychosis.

We should remind ourselves that 60-90% of children with gender dysphoria recover from the condition as a consequence of passing through puberty. Cass summarises the various studies in the review that bears her name. Some of these are old 70s and 80s, at least one was published by de Vries of Dutch Protocol fame. IIRC her figures were 60% desistence published around 2015.

I accept that the more embedded the lore that PB are the only kind treatment becomes, the lower the desistence rate is likely to become.

However, any pathway centred on the minority that may persist will harm the majority. There is not yet a way to tell which child will persist and which will desist.

It seems self evident that GAC has created a demand that was not there before (see GIDS referrals to evidence this). A lot of children have suffered unnecessarily.

A focus on genuinely holistic psychological support would stack up much more positively on the risk benefit analysis

It has, but none of the descriptions actually explain what is going on. It's just a vague feeling that some people claim to have which doesn't really correlate to anything. It makes sense when they talk about stereotypes, because we can all understand what effect stereotypical expectations have on people - most of us have probably experienced this ourselves. But you say it's not about stereotypes, it's just about feelings, so we're just left with feelings about nothing in particular which make people unhappy.

The only more concrete 'experience' you mentioned was boys/men feeling that they should be able to use women's toilets and changing rooms, because for unexplained reasons (see first paragraph) they feel that's where they belong. Surely that's not all that it's about?

You keep saying 'distressed'. What exactly do you mean?

This has been covered extensively in the thread, including the link to the online blog I shared.

My aim is simply to find language that allows us to discuss the actual experience being described

But what is the experience being described? You've talked a lot about "a person experiencing themselves as being in the wrong sex category", but this is meaningless. Can you at least explain what it means or what you think it means?

It’s difficult to know whether you are rejecting the reality of gender dysphoria itself or simply objecting to the terminology used to describe it. Gender dysphoria is a recognised condition involving persistent and significant distress caused by a person experiencing themselves as being in the wrong sex category.

If there is alternative shorthand language you would accept that describes this phenomenon without reducing it to generalised distress or attributing it to something else, I’d be very happy to use it. My aim is simply to find language that allows us to discuss the actual experience being described

And on and on it goes...

A small cohort of children are distressed about the reality of their sexed bodies. They don't become any less their sexed bodies by taking hormones or surgeries. They might appear differently, but they are not, in fact, any more or less male or female. That's just a fact.

And the reality they face in society remains because truth matters. So let's talk with them and help them figure it out, but by having truth as a framework, not an ideology.

Honestly, sometimes I think yeah have at it! Sterilise yourselves! And your kids! Yeah, you go for it, we'll just let you get on with it!

But I can't and won't because truth matters and children matter.

And the TRAs seem completely incapable of protecting their own from harm (why might that be?).

Honestly, I genuinely cannot fathom why TRAs fight for children to be sterilised. Maybe we should start supporting it. Maybe they'd change tack.

All trans kids to be given puberty blockers immediately!

It is possible to learn to cope with distress without doing harm to one's body. Given that gender is entirely based on social prescriptions and perceptions - one can learn to adapt and modify one's responses to negative social stimulus. It is called developing emotional and psychological resillience, and ultimately is the healthiest way to manage one's feelings.

But he's not "receiving the hormones necessary for pubertal development", because that would be testosterone.

Thanks for catching that.

Before I lost faith in this poster, (s)he was trying to insist that asumptions about the actual lived experience of the opposite sex aren't a factor in trans identities.

Round and round and round we go, circling the truth but never jumping in.

'Gender' is a social construct...so how can a child ever escape gender distress if their sense of themselves is dependent on other people, usually strangers, validating their sense of themselves as being of the opposite sex?

those interventions can prevent the development of secondary sex characteristics associated with birth sex , and induce those of the child's experienced sex.

'the child's experienced sex' is nonsense. Nobody can experience the opposite sex.

I don't recall discussing evidence about the impact of CSH on brain development, just PBs. Perhaps we did though.

Regarding more research, out of interest do you support the data linkage study? I imagine that there will be a lot of valuable data in it. We know that there are ~2,000 children (now adults) who had PBs, some of whom will have had CSHs later as well. Researching that data is a priority IMO, even if the records are limited in quality/information in some cases. Cass said that too until handwaving it away more recently.

to facilitate any later transition

Except sadly, as it turns out, later transition is actually more complex if puberty has been blocked. See the 'Susie Green laughing' video for details.

The longer this groundhog day thread goes on, the more obvious the deliberate and cynical avoidance of any difficult questions becomes. Nothing to see, move along, let the experts do their thing, evidence will be along to prove them right anytime now so let's just all chill and prescribe, ok?

We discussed the evidence for this earlier in the thread, but I agree that more research is needed

I do think the stakes are higher for birth males in terms of the long term consequences of endogenous puberty . However there are irreversible effects of female puberty as well.
Primarily breast development and pelvic widening, both of which are irreversible without surgery . There are also permanent skeletal changes associated with female puberty. Those are precisely the changes many natal girls with persistent gender dysphoria find most distressing