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

except in phantom limb cases, the brain remembers a limb that used to exist and be attached to the body, which makes sense, while in my case, my brain wholesale made up a limb that never existed, and refuses to acknowledge the existence or position of bits that do exist, which is... a lot weirder

Actually I believe it can also happen in cases where people are born without limbs!

@Seethlaw if you haven't read it can I recommend this book?
Nothing about sex/ gender / dysphoria, but it's a real insight into the neuro-cognition of body awareness. The book argues that our experience of our own bodies is not simply a direct readout of the physical body. Rather, the brain actively constructs a "phantom" representation of our body ( body map). This representation is partly hard-wired but remains plastic, meaning it can sometimes be altered by changes in sensory input or experience.

Oooh, that looks really interesting! Thanks for the rec!

@AimsAndObjectives yes, I think you're right that there are better tenets of Christian belief I could have picked. For me, the most non-sensical one is the idea that Jesus was conceived without sperm.

@Cairngormwildfire yes, I imagine many Christians believe that god started the process of the big bang.

Sunnibee has been posting lots of thoughts on what gender identity means and why it's reasonable to allow medicalisation as a means to support someone whose gender identity doesn't match their sex. There has been a lot of criticism from PPs about not really answering what gender identity is.

I think it's as impossible to argue what gender identity actually is as it would be for someone to make a clear case for Jesus being born without sperm.

Put bluntly, to me, Mary had sex with a man other than Joseph and managed to convince everyone that she hadn't. I think this because I know biology is real and I don't believe that god exists. However, I will never convince Christians that I'm right and they will never convince me that I'm not.

The same is true if someone holds a belief in gender identity. Given Sunnibee does hold one, I can see why it's a conundrum to know whether the cruelty is in giving the PBs or not giving them. To me, that's why we each ended up conceding to the other that there was nowhere else for that particular conversation to go. The most interesting moment for me came when we both agreed the most sensible thing to do was complete the data linkage study before undertaking any trial.

Seethlaw's position is different. Yes, there is a belief of some kind of inner self that is masculine, but the difference is in recognising that this may have come from without, e.g. a maternal influence, rather than it absolutely definitely having come from within.

Just as with variations in Christianity, when tenets of the belief colide with biological facts, each believer has to find their own lines between belief and observable, empirically provable reality.

With gender identity, believers who don't want to concede that it's possible that gender identity may not come from within are left with a choice of doubling-down on using tenets of the belief as the only way to be kind or coopting DSDs to "prove" some form of spectrum of sexes. The latter can be completely torn to shreds scientifically.

With Christianity, we're 2000 years too late to bring in paternity tests and CCTV footage of who Mary was hanging around with around the time when Jesus was conceived. Thankfully Christians stopped demanding everyone follow the tenets of their belief a long time ago and the NHS doesn't deliver healthcare based on any of it being real.

Edited for clarity.

Put bluntly, to me, Mary had sex with a man other than Joseph and managed to convince everyone that she hadn't

Surely the most obvious explanation is that she just had a sex with Joseph? ☺️🤪

Fair point!

We have no way of proving that god is real and we have no way of proving that gender identity is real. Both are real to those who believe they exist. To those that believe in them, several things are also true, including things that biological science says are impossible.

I'm aware you and I won't agree on the medicalisation of children who hold a belief that they have a gender identity that differs from their sex but can I ask where you would stand on other belief-centred medical interventions for children?

For example:

• religiously-led circumcision
• religiously-led FGM

We don't have robust medical evidence for the benefits of either of these. However, here are definitely lots of people who believe that there are benefits.

I googled what the documented harms of each would be. There are multiple complications with both, some severe, including death. This is also true of the documented harms of PBs. There was one death during the trial that led to the Dutch protocol being developed.

Should we run NHS trials on circumcision and FGM for a couple of years to test out the balance of benefit and risk? As children are too young to consent, their parents would need to do it and the children would need to assent to confirm that they understand the choice that they are making.

If a child wanted a foreskin or clitoris replacement at the end of the trial, this could be done. We have no way of knowing if this would be successful, but that's similar to the unknown with the PB trial where we have no idea if any potential brain damage will be reversed or whether the development windows that Sallie Baxendale describes will have closed permanently.

The beliefs behind circumcision and FGM are religious. The belief behind "gender affirming care" is philosophical.

Is a firmly held belief ever enough to justify trialling medical interventions to gather evidence on their efficacy and safety?

Edited for clarity.