To nominate the principle authors of the CASS review for this..

[NameChangeCass]

“Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.”

https://www.bmj.com/content/327/7429/1459.short?fbclid=IwAR0hTt57o-yFS61aJE-IGCpKSPaDs--rdrPlbiby_wBCF1czpAWDaCcAEcM_aem_ATiWMtvZxiSzw8pj9CX271gyDByuMHTOKwQskBcCXx9aZOj1IPusHJ_z79olcRiFlhE

So why do you think we should trust these people to provide trans patients with adequate care?

Just the business of objecting to proper evidence-based controls and research before giving life-altering substances to children and young people.

Precocious puberty and Gender Dysphoria are not a like-for-like comparison as triptorelin is actually licensed for use in precocious puberty, it’s off label for GD, hence Cass’ recommendation that it be used for GD as part of a clinical trial.

The point of delaying precocious puberty until the normal time is so that bone maturation becomes consistent with age.

Giving the same drug to kids who already have normal bone maturation for age throws that out, resulting in teens with delayed maturation for age. Hence the tooth loss and spinal issues that Sweden observed.

I think kids with Gender Dysphoria deserve better care than slapdash application of unlicensed medications with a plethora of side effects.

I don’t really trust them to provide adequate care tbh, but I think they are better than nothing. I am all for health services for trans people being improved, but this needs to involve improved access to hormonal medicines, not further restrictions.

As long as you insist on seeing evidence-based medicine as a negative "restriction", you shouldn't be commenting on as much as vitamin pills.

*Precocious puberty and Gender Dysphoria are not a like-for-like comparison as triptorelin is actually licensed for use in precocious puberty, it’s off label for GD, hence Cass’ recommendation that it be used for GD as part of a clinical trial.

The point of delaying precocious puberty until the normal time is so that bone maturation becomes consistent with age*

I am well aware of this thank you.
that doesn’t change the point that we are without long term control trials that demonstrate outcomes of offering PBs for precocious puberty.

On what basis are you saying that they are better than nothing?

If you do nothing, many of these children will desist.

How can that be a worse outcome than taking the risk of causing irreversible harm to vulnerable children?

I’d need to see the non-anecdotal evidence before I agreed.

If transition was reclassified as body modification rather than medicine it wouldn’t need to be examined in this way. Just slap a warning on it, restrict it to adults and make it self funded.

The NHS requires value-for-money proof.

Abortion is always good value to money because unplanned/unwanted kids cost the government a fortune to house and educate, especially if they end up in the looked-after system.

Not offering them also has life-altering consequences. That is the point.

Such as?

Are we? Do you have a source for that?

Obvs you can’t have a blind trial but do we really have no long term follow up?

A lot of kids with precocious puberty also have significant disabilities or disease (eg brain tumours) which may make data difficult to parse (eg is side effect X a result of the disease, the blocker or the chemo?) but most areas of paediatrics don’t lose track of patients the way GIDs do (most non-gender patients don’t change NHS number for starters).

Again, you need to provide evidence of this before the NHS will prescribe on that basis.

Evidence based medicine requires evidence.

No, the point is that you want them offered without "restriction", ie, without an appropriate level of evidence and research, and you don't care who is harmed by that, as evidenced (haha) by your dismissal, handwaving and oversimplification, as here, of all the reasons why that's dangerous.

I hope you really do just want to embarrass yourself because the alternative is so much worse.

Abortion is always good value to money because unplanned/unwanted kids cost the government a fortune to house and educate, especially if they end up in the looked-after system

this isn’t the reason we offer abortion on the nhs 😱😱 and it would be horrific if it were.

The point is this is the value for money argument. Not that it is the only argument.

Horrific is sterilising gay and autistic kids.

Long term consequences are , for example, the physical effects of endogenous puberty. These are well evidenced me thinks.

I don’t want them offered “without restriction”. I want them to be offered on the basis of careful assessment of individual need, clinical judgement and the best available evidence, as is the standard in all areas of healthcare.

I want this as I understand and care deeply about the harm that will be caused to trans people in this country through withdrawing access to hormonal medications.

So normal physiological development then?

aka growing up with a healthy body?

JINX!

and the best available evidence

You're actively rejecting and denying the best available evidence, despite no actual refutation. Why do you people always think nobody can see through your dishonesty and weak attempts at sophistry?

Do you think your personal assertion is all it
takes to change a clear reality? Oh hang on...

“normal” and “healthy” are value judgements.
Again, let’s use the abortion analogy- we could say that carrying a fetus for 9 months and giving birth is a “normal” and “healthy” physiological result of getting pregnant . That doesn’t mean we should force all women to do it. We recognise for some women that doing so could cause severe physical and mental “injury” (to borrow words
from the abortion act). somehow we know this (although we don’t exactly have long term outcome control trials, using standardised measures of eg mental health, that demonstrate as such.).

Why do you people always think nobody can see through your dishonesty and weak attempts at sophistry.

ok the ad hominem attacks are coming back out, taking a pause for my mental wellbeing 🩷.

An analogy is pointless.

In the case of blockers and GD growing up with a healthy body means not having drug induced obesity, osteoporosis, depression, fertility loss, stunted genitalia, uterine atrophy or elevated risk for testicular cancer.