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

You claim only two studies were considered. Can you explain why this graph clearly displays more than two studies given your assertion?

Read the full thread.

OP the scandalous horror of what has been happening over the past few years is unrolling slowly, but it is very clear that children have been failed, and harmed, by unevidenced, unethical, ideologically-driven treatments.

The NHS has a lot of explaining to do.
The government has a lot of explaining to do.

Children have been sterilised, for god's sake, on the basis of homophobia and sexism.

I have posted the thread unroll for anyone who is unable to read the tweets directly.

Why are you insistent on trying to undercover some nefarious personal agenda?

Because it's the most likely reason why you're so desperately trying to undermine the detailed and comprehensive work of professionals commissioned to engage with it.

Why else would you do that?

I mean you are literally suggesting that parachutes and paediatric drugs should be tested the same so I’m kind of stooping to your level

I meant this mumsnet thread. This particular twitter roll has already been discussed.

They don’t have follow up data because they neglect to follow up.

They do have the data. They've agreed to hand it over now that the relevant minister has insisted that they do.

Their reasons for refusing to hand it over vary depending on who you ask. Most TRAs initially claimed it was because the doctors righteously refused to engage in a government witch-hunt led by Cass. Some then claimed it was because it is unethical to hand over data without the patients consent. I think at least one clinic has said they didn't want to upset patients (exact quote was in yesterday's times).

Personally, I think all those reasons are bullshit. They either know the data will show the harm they've caused, or are so full of religious fervour that any requirement to provide evidence is genuinely really offensive.

Don't forget as least some of the doctors who refused to hand over data had previously worked at Tavi.

You are missing the point. The point is:

• Double blinded randomised control trials aren’t always possible and ethical. This is very normal in paediatric medicine.
• The evidence gathered from observational studies can sometimes be very valuable and sufficient to provide a very high level of “proof”. Evidence shouldn’t be discounted simply because it is observational; this is beyond foolish.

OP, if you can't see the difference between prescribing puberty blockers to children suffering precocious puberty - with all the medical risks that condition carries, and giving children puberty blockers because they feel they want them, then there's no helping you.

Your assertion that all but 2 studies were discarded seems to come from a misreading of the Cass review where it stated that if only found 2 of the studies to be high quality. That does not mean they discarded all but two.

The effects and side effects of puberty blocking drugs have been known for decades. Hence their use for chemical castration and some cancer treatment.
These drugs have been used very rarely and with great caution in a tiny category of children going into extremely premature puberty as a result of abnormal endocrine function. Giving it to confused, autistic, or otherwise vulnerable children is, and has been, unethical at best and criminal at worst.
The damaging effects of cross sex hormones have been observed and reported for years.
Putting children into a clinical trial using a drug in this category would never get through the usual clinical and ethics procedures. I spent many years running clinical trials and I simply cannot get my head around how these drugs were ever given to this particular group of children. All the accepted clinical and ethical standards appear to have been ignored.

Kiera Bell is absolutely right when she says she was just used as the subject of an experiment. So many damaged children is an absolute scandal.

Sometimes you just have to decide who to trust. Do we trust the doctors who have already acted unethically by providing strong, unproven drugs to children without keeping proper records or conducting any follow up? Or so we trust one on the UKs leading paediatricians who has not previously acted unethically and has no reason to do so now, and is being backed up in her research approach by the editor of the BNJ? Personally, I'm gonna trust Cass.

BMJ explainer about the evidence

And screenshots

you're entitled to your own opinion OP but not your own facts

I spent many years running clinical trials and I simply cannot get my head around how these drugs were ever given to this particular group of children. All the accepted clinical and ethical standards appear to have been ignored.

I find this aspect of it utterly horrifying. There needs to be an enquiry around how it happened. Surely this is against all nhs protocols.

Evidence shouldn’t be discounted simply because it is observational

It should be discounted if the methodology is poor though, no?

This literally reports exactly the same facts 💁🏼‍♀️

Double blinded randomised control trials aren’t always possible and ethical. This is very normal in paediatric medicine.

Doesn't make them any less necessary.

The evidence gathered from observational studies can sometimes be very valuable and sufficient to provide a very high level of “proof”. Evidence shouldn’t be discounted simply because it is observational; this is beyond foolish.

They can absolutely be discounted compared to much stronger evidence. Otherwise 100 weak observations would outweigh 2 solid comprehensive studies by weight of numbers. That's what happened here. The weaker studies were considered, and found wanting compared to the very-few higher value ones.

You're effectively demanding that higher-value studies be treated as mere "observations".

It explains that only two were found to be of high quality.

As you have been told that does not mean that only two were considered and the rest discarded.

This literally reports exactly the same facts

It has a rather different view on them than you though OP, why is that?

And explains why the “evidence” was disregarded is some cases - because it was of extremely low quality.

All of this. I mean JFC OP. What is wrong with you?

You know, I'm not particularly GC. I'm the parent of two trans children who are now young adults. Both oppose the use of puberty blockers because they understand the risks and are aware of the lack of evidence of their long term safety. Both have gone through puberty and are taking their time, including much therapy, to reach a decision because they know that any decision they take will be life altering and permanent.

So with all due respect, you are talking bollocks.

Their results/findings were discarded on the grounds that they were judged “low quality “ , mainly do to not being a blinded and having a control group. So I’m asking -AIBU to nominate these scientist for a blinded control trial of parachute efficacy?

I’m really glad to hear your children are doing well.

There are many children in the world who are different to yours.