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

Ok they were considered long enough to decide that they should be ignored, because they came from studies which were not blinded control trials. These were the reasons given. And all agree.

Again, they were not "ignored". They were just found to not provide sufficient evidence to justify the current treatment regime.

All evidence was considered. If the court or medical board finds evidence inconclusive they are not "ignoring" it.

And "not blinded control trials" was not the only reason.

We’ve been over this.

Was there something specifically in those 100 trials that you think was overlooked? That should have changed the conclusions or recommendations?

I asked that, but OP must have missed it, I'm sure it couldn't possibly be evasion or anything.

Puberty blockers haven't been available for most of human history.

Trans children, according to activists, have existed in consistent numbers for all of history.

The idea that having a control group in a test of puberty blockers would be like throwing kids out of a plane is clearly nonsense.

Where are the vast numbers of children throughout history who should have died through lack of PBs?

Again. Just a few examples From one of the systematic reviews.

We’ve been over this.

Not really no. What specifically is being missed in the poor methodology studies which were not given the weight you think they should have been?

My AIBU is about the sense of discounting evidence / results for these reasons.

And how is that poll going for you?

Please describe what is being missed in layman's terms. This is a parenting website, not a medical forum.

The cat is well and truly out of the bag, as it were. There's no going back - we all can see and understand that this country's children were subjected to poor health care administered by ideologically driven doctors funded by our NHS.

No more.

But somehow the op is suggesting that Hilary Cass and her colleagues, tasked with a really difficult job (and I am not talking about the science, I am talking about the strength of feeling), be thrown out of an aeroplane.

Op. You are being very unkind and ridiculous.

Where are the vast numbers of children throughout history who should have died through lack of PBs?

Yes, that absence could be considered "evidence" of a lack of need for them, by the same token.

Where are the vast numbers of children throughout history who should have died through lack of PBs?

Exactly.

That people die from falling a from a great height is known.

That a subpopulation of children commit suicide during/after puberty is not known.

We're "treating" something that hasn't even been observed.

(Of course the original justification for puberty blockers was purely cosmetic - helping males pass better as adults by avoiding testosterone exposure during puberty. But that wasn't sufficient to attempt to claim ethical justification to give such powerful drugs to children. Hence the invented claim to make them "life-saving").

That some children benefit socially and psychologically from the availability of puberty blockers and that there is evidence of this - albeit not from double blinded randomised trials.

But somehow the op is suggesting that Hilary Cass and her colleagues, tasked with a really difficult job (and I am not talking about the science, I am talking about the strength of feeling), be thrown out of an aeroplane.

It's what trans rights activists do. The nastiness is rarely far away.

it feels like this is a very long winded pseudo scientific thread from the OP to say “keep giving children PB”

That some children benefit socially and psychologically from the availability of puberty blockers and that there is evidence of this

Which specific study please?

lol contrary to what you may think I am not out of touch with reality. I was well aware what the poll results were likely to look like.

@NameChangeCass is so frustrated that consent isn’t being muddied and boundaries aren’t being crossed with children so easily. Why, I wonder? Why does the OP have such a strong interest in pushing boundaries with children?

It's a shame that TRAs aren't more furious about the horrific waste of time, opportunity and resources caused by conducting these poor studies.

The whole point of optimal study design is to reduce, as far as possible, the risk of bias. Sadly, these low quality studies neglected to do this and so we just can't use them to reach a conclusion - at best they might suggest whether doing a better study might be worthwhile, but really they were a huge waste of everyone's time.

It's a real shame and sadly very, very common in clinical research for many reasons.

One of the reasons of working to the gold standard of well-conducted randomised controlled trials if at all possible, is it is human nature to assume an intervention is going to be positive and it's really difficult for reseachers and participants to accept that it's just as likely it will show no benefit/harm.

The outcry over these low quality studies is a great indicator that a whole lot of people think that PBs didn't need robust research at all - "they work because we know they do".

PBs are just as likely to be a parachute with a massive hole in the top - shame we don't know for sure because the opportunity to find out was squandered.

Dr Cass asked for all the available evidence, so presumably she read the evidence you mention very carefully before coming to any conclusions.
I enjoy reading clinical research and review papers, so please would you post a link?

OP do you understand the difference between ignoring something and listening but being unconvinced?

For example, my niece wanted an ice cream and asked me to buy her one - she promised to eat all of her dinner if I bought it. Her mum told me not to buy it because the last three times the ice cream (and later dinner) went unfinished. I listened to both sides and decided against buying the ice cream. I didn't ignore or discard the request. I just didn't find my niece's argument as convincing as my sister's. I explained to my niece why I felt her mum was more convincing and offered suggestions as to how to improve her argument.

This is exactly what happened with Cass. Some evidence was less convincing, so the report leans towards the more convincing evidence and has offered suggestions of how to improve the evidence base.

This is very much the "Critical X Studies" approach isn't it, X in this case being "Cass Review".

The complaint is that Cass isn't doing it right, but no actual concrete suggestions of something allegedly better that could be criticised in turn.

Dr Cass asked for all the available evidence, so presumably she read the evidence you mention very carefully before coming to any conclusions.
I enjoy reading clinical research and review papers, so please would you post a link?

Me too. I've already asked for the specific data OP finds so convincing, so I'm sure it will be forthcoming soon. Look forward to reading it.

Blocking children’s puberty due to “gender” and putting them onto a pathway to cross sex hormones is not a good thing to do. To support this is bad enough but to infer that Dr Cass who had had no other interest than protecting children should die is just awful. Just what has your belief in this ideology done to you OP? It’s not a normal way to think.

Death threats have been prominent feature of this movement.