Frack's reference post

[FrackOff]

Hi All
I have been asked in various threads for references. I am starting a new thread as I've lost track of all the conversations. I wasn't going to bother as people usually don't want to read them but since one or two have said they really do want to read them with an open mind, here are a few.

Reidar Schei Jessen & Katrina Roen (2019) Balancing in the margins
of gender: exploring psychologists’ meaning-making in their work with gender non- conforming youth seeking puberty suppression, Psychology & Sexuality, 10:2, 119-131, DOI: 10.1080/19419899.2019.1568290

ABSTRACT
The past 15 years have seen the growth of puberty suppression as the prevailing approach to supporting gender non-conforming children and youth. Puberty suppression is considered to provide time for weighing up the pros and cons of medical transition. Research based on binary under- standings of gender has demonstrated that a carefully selected group of gender non-conforming youth benefit from physical treatment and gender transition, but the research that details how psychologists can best support young people during this time is limited. This is the gap addressed by the current research. The purpose of the present study is to explore the meaning-making framework within which some clinical psychologists and gender non-conforming youth approach discussions of puberty suppression. Five semi-structured interviews were conducted with clinical psychologists working with gender non-conforming youth. The data were analysed using thematic analysis. The results indicate that there is pressure on gender non- conforming youth, often coming from families, friends and mass media, to buy into heteronormative and binary discourses regarding gender and what constitutes a good life. The results also indicate that the participants deploy affirmative and exploratory therapeutic strategies in their work, in order to enable gender non-conforming youth to make informed decisions regarding puberty suppression. Participants emphasized the importance of therapeutic approaches that explore non-binary gender discourses, alongside the use of puberty suppression and other medical interventions that enable clients to fit more with gender norms. The therapeutic balance between affirmation and exploration may shed light on how both research within the binary tradition and critics of binary assumptions are in danger of oversimplifying the process of gender identity development. This research highlights the importance of understanding the complex negotiation of gender discourses that are in tension with one another.

In the fourth study they interviewed 35 children age 9-17, spread across 3 'gender affirming' clinics. The children were asked how they felt about their care and what they wanted out of transition. That's it. That's the study.

We don't know how many of these 35 children had started on blockers because the study is just so fucking qualitative but out of this small group:

• One child on blockers developed numerous stress fractures

I guess the only side effects that I’ve had is that just a couple of weeks ago I guess I found out that my stress fractures were related to the Lupron and I wouldn’t go back and change it because I needed to be on Lupron but I mean it was frustrating just not knowing for a while why I had four stress fractures. I was doing less activities but I guess I found out that actually, having done a lot of activity and then getting injured and going on Lupron not doing much activity, actually contributed then to getting the stress fractures. That’s the only downside I’ve had from Lupron. (Steve, TM, 14 years old)

• One child on blockers made a serious suicide attempt

But I think it’s important to mention that in 2017 I had a serious suicide attempt where I went to the hospital. That was one of my darker periods of my life. Even though I was beginning my medical transition [started in December 2016], estrogen blockers are known for being a little bit wacky on your emotions. I was already in a pretty, not that great place mentally for the past since 2015 at that point. So it was kind of just like a, thank you, a rollercoaster of everything going on. Simulated menopause was not the best thing at that time […] High school was a big jumbled mess, it was a bit of a weird time. I don't know. I was going through some stuff with my friends as well, and my grades are slipping, and everything was slipping. I was sleeping 16 hours, so excessive napping. It was a really big, a really big depressive episode, I'd say. (Jason, TM NB, 17 yo)

• One child on blockers describes vomiting and hot flushes

I get sick randomly now, I just start throwing up, cause of the hot flashes, so I' m like “This is fantastic.” […] Never in a million years would I consider stopping [blockers], this is better for me. (Lyndon, TM, 15 yo)

But overall the children feel positive about the blockers and that's what the study is about so it was all OK in the end.

4: 'Thirty-five trans and gender diverse young people aged 9 to 17 years were recruited to participate in semi-structured interviews through the specialty clinics where they had received or were waiting for gender-affirming medical interventions such as puberty blockers, hormone therapy, and surgery.'

Result: They were happy with a gender-affirming approach and did not regret the interventions.

At 17?

I'm not a medic or a researcher, but what is academic about asking a small group of teens how they feel about the medication they went on that left them vulnerable to stress fractures etc. but meant that they could possibly convince a little better externally as the opposite sex? Surely that is a facile question in this context? What about long term studies?
Frack, why would you find this a convincing reason to so confidently discount ROGD and pour scorn on any need for further research? If you are an academic and 'pro-trans', as others have repeatedly asked you, why are you so blinkeredly opposed to top quality, well funded, thorough and exhaustive research on the effects, long terms of these treatments, and underlying reasons for the presentation of the symptoms in the first place? Why do you care so little for the welfare of these young people? Are they just totems for you?

Second study just looks at what factors were associated with a clinicians decision to prescribe blockers.

Oh look:
The recommendation for blockers was also reliably associated with... a homosexual sexual orientation

Hey Frack, if you want to convince me of the errors of my watchful waiting ways, you are going to have to do better than this. For starters, I want research that strongly and significantly suggests that age of onset of GD is irrelevant to persistence and intractability.

I'd also like to see subjects with onset of GD post puberty randomly assigned to a study of mental health outcomes (including self-harm and suicidality) re social affirmation vs 12 months of individual and group DBT.

That's just for starters. That's to get me even interested in your claim that 'ROGD is debunked'.

If you can link to method, results and discussion sections of the literature writing up these studies (or very similar) so that working class women can access the papers properly without having insititutional log-in privilege, that would be super kind.

OK, so before my head explodes, can someone correct me if I'm wrong?

I seem to have read in this thread that one of these papers, posted as evidence to debunk adolescent onset gender dysphoria, describes a homosexual boy being socially and medically transitioned because he was dealing with both internal and external homophobia.

And this was presented without a disclaimer from the OP that she does not endorse conversion therapy of gay and lesbian teens ? And was presented as a positive outcome ?

I'm asking, because I can't believe I read that, so I must have gotten it wrong. Please correct my misapprehensions, someone!

I dunno Jane, only @FrackOff can tell us whether or not they endorse homosexual conversion therapy

It would be good if you'd clarify though Frack, because it's hard not to draw that conclusion from the studies you've uncritically posted, and you evidently feel you're a good person, so how are you squaring that particular circle?

I expect Frack is washing their hair doing some super important work

www.revealnews.org/article/women-say-drug-used-to-halt-puberty-has-ruined-their-lives/

Sharissa Derricott took Lupron from age 5 to 12 to shut down early puberty. At 30, she’s among the first patients who took the drug – even before it was approved for pediatric use. She says now that she’s had more surgeries than her 79-year-old father and suffers from a blood disorder and bone and joint problems.

“Excuse my language, but it’s hell,” she said.

Sharissa Derricott, 30, prepares her afternoon medication at her parents’ home in Lawton, Okla. After taking Lupron from age 5 to 12 to shut down early puberty, she’s been diagnosed with degenerative disc disease and fibromyalgia, a chronic pain condition. Her teeth are shedding enamel and cracking.

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

Thanks for posting the studies, Frack. I don't have a uni log in so can't access the full texts. Thanks to the other posters who have summarised key points from the studies, that's really helpful.

Are these studies the basis for using puberty blockers to treat children with gender dysphoria?

Does anyone know what happens if you don't use puberty blockers for precocious puberty? Does it mean the person develops at too young an age, and therefore looks strange in comparison to their peers. And they have to deal with it things like menstruation?

Or is there some kind of extra medical problem that arises as a result?

Yes it would be useful to know what would happen if blockers weren't given to children with precocious puberty.

I had my first period when I was about 8-9. Thankfully I wasn't given anything and allowed to just get on with it. The sex and reproductive education was totally absent so I initially thought I was dying lol.

That’s brilliant Frack. It’s very helpful if you to link to those ‘studies’, so the rest of us can see just how wrong it is to experiment on those poor children. It has shown us that we’re doing exactly the right thing in trying to make people aware that children need protection from these quacks.

Re access to articles, any teenager or friend at any uni can download and email these articles. There are people on here who can do that for each other if needed- someone could set up a Dropbox, maybe.

These articles are not THE basis for anything. They are a small sample of what I have read. Academic literature works as a body of work so really to get the overview you have to read lots of it. Individual media-based case studies like Jazz Jennings are not a good basis on which to base an opinion (as many have argued, people want big numbers). There are literature review articles which are specifically designed to gather together prior research, but the ones posted here also have their own lit reviews.

The journals are actually quite highly rated. The last article (Sansfacon et al) is a project led by the Canadian Chair of Transgender Children and Families- a ten year govt funded professorship. It's an early summary of the Canadian dataset but other data is coming in to that project from around five other countries.

Longer term datasets covering several years, plus large surveys to pick up quantitative data are currently ongoing, although people like Zucker (see article above) situate their work within a vast body of work going back to the 80s.

Blockers have been in use for years for other conditions, so would have gone through double blind trials before becoming available. Re blocker side effects, like any medication it's a question of how much someone feels they need it. ADHD, depression and OCD can all be treated with meds which have horrible side effects, including sexual dysfunction, but people have to decide every day which imperfect option to choose.

I am on my phone now so can't post any articles re what people called ROGD but from what I have read and can post later, it is not a robust phenomenon. One big problem with it is that the concept relies on the notion that kids would tell someone when they start feeling that something is wrong- they often don't, and we know that from plenty of other contexts.

The idea of doing a double blind trial on existing trans kids isn't ethical when the vast body of international data, including longterm retrospective data, points firmly towards affirmative care as the approach with the best ourcomes for children's mental health.

As I said I am busy today and not on a computer but I'll check back and try to respond again later

Or is there some kind of extra medical problem that arises as a result?

Yes, I think so but would have to check what.

The journals are actually quite highly rated

🤣

They are niche publications, barely registering an impact factor, and incidentally all published by Taylor and Francis. Do you work for them OP? Are you trying to drive traffic to your weak journals?

Highly rated by Frack, possibly. By either scientists as a whole or the general public, nope.

The idea of doing a double blind trial on existing trans kids isn't ethical

That’s actually disgusting and completely discredits the whole ‘study’.

Blockers have been in use for years for other conditions, so would have gone through double blind trials before becoming available

You actually just typed that, didn't you?

You actually just typed that, didn't you?

Good to know Frack is so thorough in their research.

I dunno just for an ordinary person not scientific at all why would yo be giving these very strong drugs to children instead of looking at what mental health problems they might have

I think I rember recently that Marcus evens ex Tavistock had a recent tweet on this. Will see if I can find

Goodness, OP, for someone so concerned about privilege, yours is shining bright here.

I particularly loved the "gosh, everyone knows someone who they can get to access things you need an academic login for" bit.

Hmm, Frack seems to think we all have kids (possibly grandkids?) who're uni aged. Ageism is super woke.

Found this. On twitter. A person has read it all. And linked to bits but I can’t

journals.sagepub.com/doi/abs/10.1177/0024363919873762?journalCode=lqra&#articleShareContainer

These articles are not THE basis for anything. They are a small sample of what I have read.

So why don’t you post anything useful? These are all nonsense. Small questionnaire studies. They’re junk.

Academic literature works as a body of work so really to get the overview you have to read lots of it. Individual media-based case studies like Jazz Jennings are not a good basis on which to base an opinion (as many have argued, people want big numbers).

I don’t post about Jazz as evidence. I post as an example of how Jazz’s lack of sexual experience, which is the only logical outcome of puberty blockers and cross sex hormones is not discussed in any of the literature, including the studies you’ve linked.

There are literature review articles which are specifically designed to gather together prior research, but the ones posted here also have their own lit reviews

There are no literature reviews and there are no systematic reviews because the evidence is so weak.

The last article (Sansfacon et al) is a project led by the Canadian Chair of Transgender Children and Families- a ten year govt funded professorship. It's an early summary of the Canadian dataset but other data is coming in to that project from around five other countries.

It’s a “study” based on interviews of 35 children. 35! The Tavistock reports over 200 children have been on puberty blockers. And you think this is quality enough to back the use of puberty blockers?!

Longer term datasets covering several years, plus large surveys to pick up quantitative data are currently ongoing

Why are these needed if puberty blockers are safe and effective? Surely it’s been decided? If they are needed, then isn’t there the possibility they’ll show that they make matters worse?

although people like Zucker (see article above) situate their work within a vast body of work going back to the 80s

This is irrelevant because puberty blockers for children only came into use in the 90s.

Blockers have been in use for years for other conditions

and are stopped within a few years for precocious puberty, and are associated with significant side effects when used long term.

so would have gone through double blind trials before becoming available. Re blocker side effects, like any medication it's a question of how much someone feels they need it.

But these are children. It’s not about whether the child feels they need it, it’s about whether puberty blockers are right for the child.

ADHD, depression and OCD can all be treated with meds which have horrible side effects, including sexual dysfunction, but people have to decide every day which imperfect option to choose.

These drugs can be stopped. ADHD medications are generally very well tolerated. The aim and purpose of the drug for ADHD is clear, and the effect easily witnessed. The purported aim of puberty blockers is to relieve psychological distress but there is no evidence they do this long term.

One big problem with it is that the concept relies on the notion that kids would tell someone when they start feeling that something is wrong- they often don't, and we know that from plenty of other contexts.

The implication of this statement is that parents of children with ROGD are not vigilant, don’t have a communicative relationship with their child and are uncaring. It’s incredibly insulting.

The idea of doing a double blind trial on existing trans kids isn't ethical when the vast body of international data, including longterm retrospective data, points firmly towards affirmative care as the approach with the best ourcomes for children's mental health.

It’s unethical to continue without a RCT. There is no “vast” body of international data. There is weak retrospective data, and nothing that looks at people in their 20s and 30s. It’s a scandal.

Once again, for all those at the back, Jazz Jennings has never, and will never have an orgasm as a result of the medical affirmative care for which you advocate. Are you happy with this outcome?