This Dutch protocol?
The Dutch Model is falling apart
By Stella O'Malley / 2 January 2023
First, Stella O’Malley writes about an article in Nederlands that is throwing a great deal of light on the Dutch Protocol. It also seems that there will be a review of the patients that the Dutch team had not previously included in their papers.
This article in the Nederlands points out the dangers on only using a nation’s own sources with no international input or even wide review.
genspect.org/the-dutch-model-is-falling-apart/
And here is a documentary
A documentary on the Dutch Protocol
There are currently almost 3,000 young people on the waiting list for gender care in the Netherlands. They are vulnerable adolescents who are frequently subjected to discrimination. Many of them suffer severe mental distress. Doctors at the gender clinic in Amsterdam are pioneers in care for transgender young people. The treatment developed here years ago is now used worldwide. Now, criticism is growing. International experts are questioning the scientific evidence put forward by the clinicians in Amsterdam. Zembla investigates the Dutch transgender protocol.
What this covers is that no gender clinic has been able to replicate the results of the Dutch paper. One patient of the group died due to the surgery complications of gender surgery and even de Vries questioned why no one seemed interested in that patient while accepting the study. Dr Riittakerttu Kaltiala (Professor of Pschyiatry, Tampere and who set up gender clinics) and Mikael Landen (Professor of Pscyhiatry, Gotenberg) and Dr Angela Samfjord (Head of Child and Adolescent Psychiatry at the University of Gotenberg ) all are interviewed about the quality of the study behind the protocol and its flaws that became apparent later. Ie. The 55 patients is so small and de Vries acknowledges that they are not really similar to todays cohort of adolescent transitioners. That only 32 filled in the survey with positive results. The others were not chased up and one died.
Gerard van Breukelen, a professor of Methodology at Maastricht university goes on record to say that the methodology of that initial study was weak. There was no control group so the conclusions should not have been considered as strong as the gender clinicians claimed. Other academics declined to be interviewed due to fear for their employment as it is such a contentious issue. When talking to de Vries, she mentions that many more studies have been done by other countries now. And the doco makers mention that all those studies de Vries refer to have stated that the evidence is low quality. A Swedish team led by Landen was asked to do a full review by the Swedish government and he confirms that the evidence was just not there. Hence the Swedish government withdrew treatment.
The mention the Cass review and discussion ‘locking in’ of identities contradicts the ‘time to think’ narrative. They interview three transitioners. One detransitionered before surgery and one is happy with transition but not with the process the team followed. The one who detransitioned was put on hormones despite not even socially transitioning as he felt wearing a dress was ‘a man wearing a dress’. But was put on hormones but didn’t go through surgery after all. It also wraps up with Lucy who was stuck on the waiting list and who believes that if she was given PBs, she would not have ended up transitioning. She has obviously detransitioned now after double mastectomy and testosterone, then ovaries and uterus removal.
The documentary refers to the below as well.
The newly released peer reviewed reanalysis of the UK study. McPherson & Freedman both worked on the initial analysis of the patient clinical data.
https://www.tandfonline.com/doi/full/10.1080/0092623X.2023.2281986
Psychological Outcomes of 12–15-Year-Olds with Gender Dysphoria Receiving Pubertal Suppression in the UK: Assessing Reliable and Clinically Significant Change
Susan McPherson & David E. P. Freedman
Published online: 29 Nov 2023
Abstract
The evidence base for psychological benefits of GnRHA for adolescents with gender dysphoria (GD) was deemed “low quality” by the UK National Institute of Health and Care Excellence. Limitations identified include inattention to clinical importance of findings. This secondary analysis of UK clinical study data uses Reliable and Clinically Significant Change approaches to address this gap. The original uncontrolled study collected data within a specialist GD service. Participants were 44 12–15-year-olds with GD. Puberty was suppressed using “triptorelin”; participants were followed-up for 36 months. Secondary analysis used data from parent-report Child Behavior Checklists and Youth Self-Report forms. Reliable change results: 15–34% of participants reliably deteriorated depending on the subscale, time point and parent versus child report. Clinically significant change results: 27–58% were in the borderline (subclinical) or clinical range at baseline (depending on subscale and parent or child report). Rates of clinically significant change ranged from 0 to 35%, decreasing over time toward zero on both self-report and parent-report. The approach offers an established complementary method to analyze individual level change and to examine who might benefit or otherwise from treatment in a field where research designs have been challenged by lack of control groups and low sample sizes.