BMJ article, "We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles"

[R0wantrees]

Published 29 October 2018
'Redesigning gender identity services: an opportunity to generate evidence'
authors: Richard Byng, general practitioner and professor in primary care research, Susan Bewley, emeritus professor of obstetrics and women’s health, Damian Clifford, consultant liaison psychiatrist, Margaret McCartney, general practitioner and freelance writer
(extracts)
"A recent feature in The BMJ implied that new services are all that’s needed to improve transgender healthcare. Providing timely, sensitive services for all, including those who decide to not pursue treatment or detransition, is important. But the article did not question the steep rise in referrals of mainly young women or the potential harms of medical overdiagnosis and overtreatment" (continues)

"Regulated medical practitioners should follow a framework of evidence, not simply respond to client expectations. Creating that evidence to inform quality standards is an ethical imperative. We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles" (continues)

www.bmj.com/content/363/bmj.k4490

It's a good letter and should be seen by a lot of doctors. The more this whole phenomenon, from AGP to ROGD, is discussed and researched by HCP the better for everyone, especially under 18s.

I've actually met R0wantrees and she's even more lovely in the flesh.

Me too and I concur!

Ereshkigal I felt the same of you.

I'm also in the rOwnantrees love club. I love the way you see the threads. You have a brilliant mind. I love your mind.

I just want to share this letter on every bullshit TRAs argument. Go tell the BMJ that they are terfs. Crazy bullies.

am very greatful for the lovely comments and also ing!

So... to return to the thread!

There seems a growing impetus in USA to challenge the producers and prescribers of Lupron.
This is with regards women who were prescribed during their childhood but for reasons other than gender dysphoria.

It has been discussed for some time but I have seen reference to recent US TV programs about it this week.

'Drug used to halt puberty in children may cause lasting health problems'
By CHRISTINA JEWETT — KAISER HEALTH NEWS
FEBRUARY 2017
(extract)
"For years, Sharissa Derricott, 30, had no idea why her body seemed to be failing. At 21, a surgeon replaced her deteriorated jaw joint. She’s been diagnosed with degenerative disc disease and fibromyalgia, a chronic pain condition. Her teeth are shedding enamel and cracking.

None of it made sense to her until she discovered a community of women online who describe similar symptoms and have one thing in common: All had taken a drug called Lupron.

Thousands of parents chose to inject their daughters with the drug, which was approved to shut down puberty in young girls but also is commonly used off-label to help short kids grow taller.

The drug’s pediatric version comes with few warnings about long-term side effects. It is also used in adults to fight prostate cancer or relieve uterine pain and the Food and Drug Administration has warnings on the drug’s adult labels about a variety of side effects.

More than 10,000 adverse event reports filed with the FDA reflect the experiences of women who’ve taken Lupron. The reports describe everything from brittle bones to faulty joints.

In interviews and in online forums, women who took the drug as young girls or initiated a daughter’s treatment described harsh side effects that have been well-documented in adults.

Women who used Lupron a decade or more ago to delay puberty or grow taller described the short-term side effects listed on the pediatric label: pain at the injection site, mood swings, and headaches. Yet they also described conditions that usually affect people much later in life. A 20-year-old from South Carolina was diagnosed with osteopenia, a thinning of the bones, while a 25-year-old from Pennsylvania has osteoporosis and a cracked spine. A 26-year-old in Massachusetts needed a total hip replacement. A 25-year-old in Wisconsin, like Derricott, has chronic pain and degenerative disc disease.

“It just feels like I’m being punished for basically being experimented on when I was a child,” said Derricott, of Lawton, Okla. “I’d hate for a child to be put on Lupron, get to my age and go through the things I have been through.” (continues)

www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

R0wantrees is a FWR legend.

All the and for you R0wantrees!

I love R0wan too! Your excellently timed, informative posts and your clear way of linking things together has helped me to gain a depth of understanding I would never have got to by myself

I wholeheartedly agree about being inspired by other women this year: the reason behind it is shit but it’s bloody glorious to be part of a huge group of women, saying no thanks we’ll keep our boundaries, with each woman chipping into the discussion and donating to crowdfunders, and supporting and meeting and lifting each other up. If this is radical feminism, it’s got a recruit for life in me.

Anyway. The letter is brilliant and so refreshing to hear well-respected medics coming out and saying the unsayable. I hope they do get some research funded, god knows we need some.

I wholeheartedly agree about being inspired by other women this year: the reason behind it is shit but it’s bloody glorious to be part of a huge group of women, saying no thanks we’ll keep our boundaries, with each woman chipping into the discussion and donating to crowdfunders, and supporting and meeting and lifting each other up. If this is radical feminism, it’s got a recruit for life in me.

Do have a look at the FiLiA magazine.
I went to the conference in Manchester and it was so inspiring.
There is so much going on at grassroots level locally, nationally & internationally. The dots really do join up!

filia.org.uk/news/2018/10/22/filia2018-magazine

Lupron: 'Georgia woman says controversial drug led to series of health problems'
Oct 29 2018

"A Georgia woman blames a controversial drug for ruining her life and the lives of thousands of other women. Her lawsuit claims several pharmaceutical companies failed to warn about the drug's crippling side effects.

The drug Lupron was originally approved for prostate cancer, but for the last 20 years women have taken it to relieve pelvic pain.

The Georgia woman’s case is being watched closely by patients both male and female who now

Content Continues Below
consider themselves Lupron victims.
Terry Paulsen is not yet 60 years old, but she looks closer to 80 years old.

“How do you feel right now?” Channel 2’s consumer investigator Jim Strickland asked Paulsen.

“My body is on fire. My joints have arthritis everywhere,” Paulsen answered."

“Has this been going on for 14 years?” asked Strickland. “Since I got Lupron in 2004, we did not know this was coming,” replied Paulsen.

Lupron is an injection. It stops the production of sex hormones. Paulsen had only two shots to treat her endometriosis, painful lesions of uterine-like tissue that feed on estrogen.

“And this drug needs to have a black box warning on it, because I know what it did to me,” said Paulsen. At the time, the Lupron label cautioned about "... a loss in bone density. But for a period of up to six months, this bone loss should not be clinically significant.”

The current label drops that claim.

“Her immune system began to attack her own bones. She got osteopenia and osteoporosis and now she’s got terrible osteoporosis,” said Dr. Alan Levin, he is an immunologist with 50 years of experience, including consulting with the Food and Drug Administration. Levin has a second career. He’s Paulsen’s lawyer."(continues)

www.wsbtv.com/news/local/georgia-woman-says-drug-used-to-treat-endometriosis-led-to-series-of-health-problems/859263892

I will never meet any of you in real life, unless anyone wants a place to stay in Mexico City, but I so much value your brains and your heart.

Coming late to this party just to say R0wan you are amazing. Any of those organisations mentioned would be lucky to have you!! But I am really glad that we do. Thank you.

What has Dr Harrop got to say about this? Chances are pretty high that he is a BMA member and the print edition plopped through his letterbox...

Interesting review of a recent gender identity conference here:

gdworkinggroup.org/2018/11/01/the-science-of-gender-evidence-for-what-influences-gender-development-and-gender-dysphoria-and-what-are-the-respective-influences-of-nature-and-nurture-18-19-10-18-the-tavistock-and-portman-nhs-fo/

I am guessing the author is a psychoanalyst as that is what he didn't find at the conference, but some useful points nonetheless.

The other point I was going to make is that doctors and medical practitioners in Gender Clinics aren't treating people who are asking to be able to identify as the sex they were born; they are dealing with patients who are asking for treatment to identify as the opposite/different gender.

Are there any other areas of medicine where this happens?

James Kirkup, Spectator lead article 6 October 2018: '
Trans rights have gone wrong
The new gender orthodoxy allows no room for dissent'
(extract)
"Is it about tolerance: as society becomes more understanding, more trans people feel able to ‘come out’? Could the internet be accelerating ‘social contagion’, where the idea of being transgender spreads rapidly?

What explains the disproportionate number of girls (child ‘assigned female at birth’, to use the approved term) who are starting a journey that can lead to hormone treatment, then binding and ultimately removing their breasts? Is it possible that this is simply part of a wider crisis of mental health among girls?

I don’t know, and neither do the doctors and scientists who study this issue. If you talk to the clinicians at the Tavistock Clinic in London, the NHS centre for the treatment of gender-variant children, they’ll tell you that all the factors I mentioned may be at work, but the evidence base is still incomplete, that they need more time and data before offering explanations. (They’ll also tell you that quite a lot of the children referred to them as transgender will in time desist – although this is not a term the clinic would use – and decide to live in their original gender.)

The government now intends to commission research into all this. You might think that sounds sensible and mundane. You would be wrong.

According to Tara Hewitt, founder of the Trans Equality Legal Initiative (TELI), prominent campaigner for transgender rights and an adviser to numerous public bodies including the NHS, the proposed research is ‘absurd and offensive’. The project should be ‘dropped in the bin — it’s simply not an inquiry that needs to happen,’ Hewitt reckons.

This is the quintessential trans-rights response to scrutiny: even looking for facts about children’s welfare is transphobic. Just accept that trans girls are girls and trans women are women. End of debate." (continues)
www.spectator.co.uk/2018/10/trans-rights-have-gone-wrong/

Article about current protests in USA has useful summary of issues within US medical practice:
'Parents protest plan by pediatricians to rush sex-change surgery, hormone blockers'

www.thecollegefix.com/parents-protest-plan-by-pediatricians-to-rush-sex-change-surgery-hormone-blockers/

This is absolutely spot on as I think would reflect the attitude of many doctors. Our entire medical education and subsequent practice is grounded in the need of evidence based medicine. Research and quality data to inform practice is paramount and sadly missing in the current debate. Interestingly (and for me it was heartening to read) a GP online forum I am a member of was discussing a request from a private clinic to prescribe hormones for someone wanting v to transition. All respondents said they would not do it and had serious concerns about the safety and ethics of doing so.

R0wantrees refers to the AAP affirmation policy which is pretty gung-ho.

This is a really good analysis of how clinical evidence used as a basis for that statement has been cherry-picked or mis-stated:

gdworkinggroup.org/2018/10/18/american-academy-of-pediatrics-policy-and-trans-kids-fact-checking/

Agree about Susan Bewley being sound. She comes from a solid feminist stance - I worked with her from time to time. Excellent clinician with a big heart.

We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles

This!

Bumping the @R0wantrees love-in because FILIA is asking people to volunteer to help:

We will be expanding our team so please look out for the updates to the website or email us at [email protected] letting us know what you can bring to our team.

twitter.com/FiLiA_charity/status/1061207951690612737

Thanks

It looks like the tradition of online backlash campaigns has a bit of a history. I saw this yeasterday, written by a sexual research academic and intersex academic who is by no means GC, but who still got threatened because she wrote this paper about the incredible, very personal online backlash organised by 3 transwomen against J Micheal Bailey over his book “The Man Who Would Be Queen.”

It makes for VERY interesting reading, covering not only the way they tried to “destroy him” by spreading malicious rumours, undermining his professional reputation, and doxxing his ex-wife and children, but they way their actions have scared other researchers off further research into autogynophilia:

link.springer.com/article/10.1007/s10508-007-9301-1

Well this sounds very positive!!!

The young trans person i know has had various mental health issues, anorexia, depression and anxiety included and has some autistic traits

And would like to add my admiration to the R0wan love

There are certain posters who when they turn up on a thread you know everything is going to be ok, they are informative and calm and explain things in words of one syllable

And R0wan is one of those....an absolute font of knowledge

The Encyclopaedia Rowanicca :)

Quotation from the linked article in the OP - "We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles."

Using the "A-word" in a leading medical journal.

At last. Better late than never.