Woman's hour today (29 October) 10 am

[ScienceRoar]

There will be a discussion of gender dysphoria. The Twitter grapevine says that Transgender Trend will be represented.

Apologies.
It's mimmymum
Still shit

Now Helen is forever shouting about this issue. Is she a clinical expert? In fact are any of the mermaids rabble? I thought they were parents of trans kids, with a particular issue to push, rather than qualified independent medical experts... just saying ..

These are other prominant Mermaid's parents. This is a long article and worth reading. They have support by other influential transactivists:

'UK GIDS Failing Publicly'
(extract)
"This dismissive and damaging rhetoric from GIDS directly feeds into (and is a contributor to) the moral panic that we are facing in the UK today around trans children.

This dismissal and erasure of trans children feeds into the situation in the UK where transphobic groups hold meetings stating on camera ‘trans children do not exist’. Where transphobic groups write damaging schools guidance that has been compared to conversion therapy.

GIDS and their anti-fact media messaging is complicit in the harm that is being caused to trans children across the UK." (continues)

concludes: "In GIDS’ journal paper, Butler, De Graaf, Wren and Carmichael are guilty of many of the same techniques of misinformation, distortion, and cherry-picking literature.

This detailed analysis of the GIDS paper has revealed intentional or incompetent manipulation of data, entirely false claims, misquotations, use of pathologising language, and significant omissions of swathes of recent literature.

GIDS is a failing service stuck in defensive practice.

Our children deserve so much better."

growinguptransgender.com/2018/07/20/gids-failing/

I admit to being wrong on the other thread - this was a respectful and nuanced discussion - well done for WH for (finally) enabling it.

As for the "Stephanie DA is not an expert' claims. Breathtakingly foolish from those choosing to appropriate the identity of the opposite sex.

I enjoyed this. I agree that it was much more polite and nuanced than these discussions typically are. Glad they got to cover the distinction between adults choosing a path and children + the bit about less desistence for kids on puberty blockers. Polly should get stats about how many kids referred to tavistock to how many kids actually put on puberty blockers. That would be good to know.

Interestingly I’ve had a very limited amount of shit on Twitter about my tweet that was read out at the start .

One misogynist who didn’t have a point to make, one butch lesbian (her words), one person who was cross but still entered into a conversation.

Listened to this earlier today and was heartened by the interview overall. I liked how JG asked for evidence and that they were happy to find areas of agreement.

It is odd that whilst polly notes a lack of data, that she did not then push the need for data. Especially as a doctor and one with a PhD!

The thought of a 4 yr old being able to talk in the terms of having the wrong body just doesn’t sit right with me. Most 4 yr olds are struggling with getting their coats on and getting to the toilet on time... it sounds like a very adult assessment of a situation.

Very interesting.

Jane Garvey was very good.

Stephanie Davies-Arai got some good points in.

Not comfortable at all with Polly Carmichael's constant laughs in the background. Hugely unprofessional. This is all fucking serious stuff that massively affects some children, young people and families.

Her light-hearted (to my mind) way of discussing this really put my back up.

Her constant laughter suggested she was not taking this discussion seriously.

Jane asked Stephanie about the 'debate' around this. I think she prefixed it with something like 'people who are not overly involved in this discussion'.

But I think this is itself overly simplistic.

Lots of women are concerned about this because of the issues for women's rights and lots of parents are now affected by this because their own children or their children's friends are directly affected by this.

Lewis came across well. I remember him from a previous TV programme I think.

One thing that really annoyed me, was the question was put by Jane to Polly (Paraphrasing) "Are children too young to know, too young to understand, being given drugs at the Tavistock on the NHS that may have life-changing effects on them?"

Polly replied Yeh, and then said "No" and then said something like "Well I would say no because it is something that we do."

Jane asked "What do you mean about something you do?"

More laughter and then Polly said they were not doing that.

Polly said that the first not fully reversable drugs would not be given until 16.

But possibly over 90% of children (at the Tavistock) who use puberty blockers go on to use cross sex hormones. So in one sense this seems the medical pathway begins quite young and goes on. Polly said the blockers stage started in the early stages of puberty 12-14 (but a handful have started earlier).

I just was not convinced by the way Polly spoke.

The way she said 'Stephanie's name at (35;38 minutes in) sounded condescending and more laughing. No real insight from Polly.

Completely agree with fidgetspinner555 " ...Polly Carmichael cannot look at the bigger picture if her life depended on it! What a load of drivel she spoke. Very dodgy IMO. I personally felt she was hiding something."

I think what she was trying to hide was Stephanie knew more and understood more than her, fidgetspinner555.

The giggling was very off-putting, but didn't sound as if she found things funny iyswim? (I was once told by a training manager that I did little giggles when I was presenting information in a sales pitch, which I was unaware of, and which I put down to nerves form being 'observed')

Someone mentioned upthread that Polly is under a lot of pressure from TRAs and that could perhaps go some way to explaining her odd behaviour

current thread:
www.mumsnet.com/Talk/womens_rights/3410239-Being-The-Dad-Of-A-Boy-Who-Identifies-As-Transgender-article

A quick look at the members of staff page on the GIDS website lists 7 people who are medically trained, 5 of who, are Consultant Endocrinologists and 2 who are Consultant Psychaitrists. There are a couple of Clinical Nurse Specialists too. So that’s 7 people who have undertaken undergraduate and postgraduate training in medicine. Some clinical nurse specialists are allowed to prescribe in certain circumstances. I have no experience of the GIDS service to know if they are nurse prescribers but I would be surprised if they are given that these drugs are being used off label.

Some clinical nurse specialists are allowed to prescribe in certain circumstances. I have no experience of the GIDS service to know if they are nurse prescribers but I would be surprised if they are given that these drugs are being used off label.

(I am not a medic)

Presumably it is possible / likely that within a speciific setting a protocol will have been established by consultants and approved there which then enables others eg clinical nurse specialists etc to prescribe?

The principle of prescribing off-label medication described as 'blockers' to children & young people is obviously accepted by GIDs as it is internationally by other clinics.

I’m not sure about the regulations R0wan. I’m a GP and we have no nurse prescribers where I work. We have a pharmacist who has done some minor ailments training and prescribing for that. He will prescribe for e.g. ear infections but wouldn’t do outside of his competence so for example doesn’t prescribe antidepressants because he’s not trained to. Certainly there are specialist nurses locally for certain services e.f. Rheumatology who will initiate and prescribe drugs for patients under the direct supervision of a consultant and when the consultant has made the decision to start that treatment. As you say, they would then follow a set protocol regarding dose changes, blood tests etc. It may be the same at GIDS but I would think it risky medicolegally given the complexity of caring and prescribing in this area and the potential for litigation. While as doctors we often prescribe drugs off label where this is accepted practice I have not come across a nurse who would do and in such potentially problematic cases. As I GP I would be wary of continuing prescribing in this area, even under the supervision of a Consultant and would want a robust shared care agreement in place and potentially would run it past my defence organisation.

I suppose it would more comparable to a nurse specialist in oncology who as you say would be always be working under the supervision of a consultant? There will be prescribing there which is fairly routine for specific circumstances with medication that would be seen very differently outside that specific circumstance.

I'm just speculating but I do have a friend who is a nurse prescriber in a different acute specialist area. I'll ask her if she has a comparable situation.

Dr Carmichael no doubt represented the view of GIDS that some chidren's gender identity distress is appropriately treated with blockers.

There's increasing focus in USA on the damage done by Lupron to women who were prescribed it.
www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

It is not true that Tavistock don't give cross-sex hormones to under 16s.

Here is a table from the Tavistock's own report from 2 years ago, showing the number of children aged 14 and under given cross-sex hormones.

It has been decreasing. But in 2011 they gave cross-sex hormones to every child under 15 that walked through their doors.

The fact its decreasing suggests they've realised that they were wrong. Maybe they aren't so good at identifying the correct children as they think.

@SonicVersusGynaephobia that is very scary!

"But in 2011 they gave cross-sex hormones to every child under 15 that walked through their doors."

Under 15? I thought you had to be 16 to get those!

That is the table for the under 15s referred for "early intervention".

Very grim reading.

There's not enough information in those tables to really know what the figures mean. If 'under 15' means the age at referral, then by 2016 all those children who were 11 or older when they were referred in 2011 would be 16 or older. Going forward, fewer of the referred children will be 16 or over, since less time has elapsed, so those who were referred in 2015 would all still be under 16. That would explain why the cross-sex hormone numbers are decreasing, and it is zero for those who were referred in 2015.

It would be useful to see some more recent figures, and see if 100% still end up on cross-sex hormones.

Your interpretation sounds better then Old, though I'm not sure I follow - if the numbers on X-Sex H are decreasing, could that mean that some stopped blockers?

I'm assuming that each line of the table is for one group of children, and 'under 15' refers to the age they were at referral. In 2016 when the table was published, the children who were referred in 2011 were 5 years older than they were when they were referred. All those who were 11 or over at referral were 16 or over in 2016. So all old enough for hormones.

For the group who were referred in 2012, if some of them were only 11 at the point of referral, they would have been only 15 in 2016, so too young to have started on cross-sex hormones. There were 11 children in 2012 who started on blockers, but as of 2016 only 7 of them were on hormones. If we could get the 2018 figures, we would be able to see whether the other 4 children started on hormones later or stopped treatment.

For the group who were referred in 2015, only one year has elapsed since referral, so since they were under 15 at referral, they are all still under 16 one year later. So still too young for hormones.

I hope that is clearer. If my interpretation is correct, then it's not saying that children under 15 are being given hormones, it's saying what happens over the next few years to the children who are under 15 when they are referred for 'early intervention'.

@SonicVersusGynaephobia sorry I couldn't see the grid on my phone.

To be honest I don't understand the grid. I also don't see why the numbers are going down when referrals are up exponentially.

I also don't see why the numbers are going down when referrals are up exponentially.

Italiangreyhound Where do you see the numbers going down? The referrals have gone up (from 13 in 2011 to 52 in 2015). The numbers on hormone blockers have also gone up. The lower number in 2015 (52 referrals vs 32 on blockers) might just be because the other 20 had not yet started on blockers, since the referral would have been quite recent when the table was compiled in 2016. This means that the Tavistock is doing what they say they do, and going slowly, which is positive.

The decreasing numbers in the cross-sex hormones column is presumably because for each years figures, the cohort is younger, since less time has elapsed since referral. Until we get to the 2015 cohort, where all of those who were under 15 in 2015 were still under 16 in 2016. So still below the minimum age for hormone treatment.

It would be useful to see how the same table would look in 2018 - and how many of those children were eventually treated with blockers and hormones. Also the figures for early intervention referrals and treatment for 2016-2018 since there has been quite a jump in the number of children referred to the Tavistock.