Medium article about the effect on children of puberty blockers

[Bittermints]

medium.com/@sue.donym1984/the-new-homophobic-bridge-to-nowhere-child-transition-c621d6188d6e

If somebody could archive/screenshot this one quickly before it also disappears it would be a good idea. Thanks.

Saved it. You're right. Will go v quickly.

This is a remarkable piece of writing and well researched. It needs to be spread. Experimenting on children is monstrous.

Archived archive.fo/FFd2l

Bump. This is so good and well researched. Thanks for archiving Nudibranch

Still there for now!

Jesus, that’s good.

“Intelligence The IQ levels for the whole group decreased significantly, from 100.2 (12.7) at T1 to 93.1 (10.5) at T2 (p = 0.002)”
The study’s authors declare this not ‘clinically relevant’,

How, exactly, was this deemed NCS (not clinically significant) when the p value is 0.002?

Almost half the adult bone mass is laid down in puberty. Even if the drug causes no active loss of bone tissue it blocks that addition, meaning the adult will NEVER reach the bone density levels they would have. Most people lose bone mass as they age anyway, so to start without half the mass is potentially disastrous.

This whole thing is going to trigger lawsuits on a huge scale. It’s being pushed through at so many levels and it’s so unethical.

Thanks for those points, Bowl. Way beyond my level of knowledge so I was hoping somebody expert would look at this.

I've not had a chance to read this yet but have pdfed all the writers 3 articles in case their account is taken down suddenly.

They wrote another mammoth well researched article about trans issues.

“Extensive and frequent laboratory examination in transgender adolescents may be unnecessary.”

What an interesting phrase. That is a highly unusual thing to suggest in a situation where children are being given drugs with so little data, for a couple of reasons.

Firstly, if it’s your drug, you WANT that data. It’s valuable - you want to see what it does in a population. Secondly, for legal reasons - you want the data because you should be looking for and open to post marketing findings (ie stuff that wasn’t found in the limited population of a trial) because if it’s known about and you don’t act on it your arse is getting sued
Thirdly, and most importantly, for SAFETY. You are giving a drug off label to a paediatric population. You need to be watching it like a hawk.

This is all just so wrong. It’s against everything that’s been laid down ovEr the years after the neuremberg trials - rules designed to stop unethical use of humans as Guinea pigs.

There is something very wrong and very sinister about all this.

‘Sue’ has done a sterling job with this (did she (?) write the article about funding as well? I am very impressed.

Yes I think so. But it may be more than one person using the account as in another article "we" is mentioned.

Ah. Interesting. Whoever they are, this is well researched.

The reduction in muscle and bone mass reminds me of a lot of science fiction I read. Muscle and bone deteriorate quite rapidly in space. If you are planning an extended trip to the Moon or Mars your body might never fully adapt to Earth in your return. For children born on a space colony Earth will always be an alien environment. That’s what we are doing to our kids now.

Bowl they're making the distinction between statistically significant (which this is - low p value) and clinically important (which it is claimed this isn't - ie this drop in IQ is allegedly of no consequence).

Yes that’s what they’d s to be doing - but dont see how they can justify it. Such a drop IS clinically significant. And it’s a strong signal as well.

I mean they have a signal - almost ten points reduction in IQ. From blocking a process KNOWN to be involved in brain maturation. That’s not trivial. It’s the sort of thing a good researcher should look at - you have a mechanism and an effect.

The p value is really low so it seems to be a consistent signal.

I can’t see how they justify the claim it’s not clinically significant. Do they say anywhere?

Thirty IQ points takes you from average to having a learning disability so of course over seven points is clinically significant. FFS.

7 points is approximately half a standard deviation.

Yes that’s what they’d s to be doing - but dont see how they can justify it. Such a drop IS clinically significant. And it’s a strong signal as well.

Indeed. I would argue that that would even make the use of puberty blockers on six year olds questionable, much less on children who enter puberty at a normal age and therefore don't require them.

(I wonder what could be done to delay puberty in young girls without this kind of harm - apparently early puberty is a problem that's only going to get worse: www.independent.co.uk/news/health/makeup-puberty-girls-chemicals-early-cosmetics-lotion-hormone-disruption-study-california-a8665711.html )

It's also the different mindset - if you're doing a power calculation for a new intervention, yes you need to decide what effect size would be important.

But in this sort of data analysis, the fact that there is an effect at all is surely of interest, in a basic science sort of way. Never mind the fact that it's actually quite a large effect that would seem to me (statistician not psychologist) to be important.

Yes, Bowl, i always value your expertise in these matters. Please say more if you feel inclined.

The effect is highly statistically significant, as well as being clinically significant.
The WHO work around the effects of lead poisoning on children look at a mean IQ loss of approximately 5 points across the population. This shift gives a 57% rise in the number of children with an IQ below 70, the widely accepted definition of learning disability.
I note that the study referenced in the article is of adopted children given puberty blockers for early puberty, NOT trans children. This does complicate any conclusions, since children who have been adopted are likely to face different psychosocial issues, will have had their education disrupted, and so forth.

That’s interesting undercover. to me the inclusion of a cohort given growth hormone suggests a mixed study population...? Did they clarify that they had children with ‘true’ idiopathic precocious puberty and maybe some with GH deficiency?

That would muddy the waters further...

Patients taking the blocker type class for prostate cancer report ‘brain fog’ and cognitive ability loss as well, so any kind of cognitive effect is interesting and noteworthy.
I’m surprised that the authors just wrote this down as NCS. Regardless of it not being a primary outcome it’s a very interesting finding - it’s the kind of thing you’d be able to write up a good grant application for I think. To explore if this happens and why. Is it directly the drugs or caused indirectly by simply not going through puberty correctly?

I think what this also shows is that the whole area is somewhat uncharted. There really isn’t a good solid body of work on it because it’s such a new area (after all, the idea of stopping children going through puberty at all (rather than just delaying for a while until a more normal time) would have been unthinkable even a few years ago.

If I say any more I will Invoke Godwins rule. So i shan’t.