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.

Is goldsmith the place that banned clapping?

I've been trying to figure out what could make reference to Jazz's experience 'triggering'.

I think in certain circles, calling something "triggering" can be an effective way of shutting down debate.

Doesn't work here, of course!

It's an incredibly odd response. That the direct result of what you are advocating for is gross, unethical and triggering.

I just can't leave this alone. To pick up on another point:

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.

The issue is that a) the long-term side effects aren't known (or at least, no trials were performed by the manufacturer with corresponding label information). So how can you choose an imperfect option when you have zero idea what the other option is?

I should probably point out here that the clinical trial on women (when looking for use as a treatment for endometriosis) was withdrawn following severe scientific misconduct:

see here

The FDA is currently looking at cardiac safety and increased incidence of diabetes here. The review notes "Some GnRH agonists are also used in children to treat central precocious puberty. There are no studies that have evaluated the risk of diabetes and heart disease in children taking GnRH agonists." This was updated to change the adult label to include the increased risks of certain cardiac diseases and diabetes here

They are currently evaluating the need for regulatory action in respect of the high number of adverse events in relation to musculoskeletal problems - potential serious risk here

Given that there are no trial results on long-term effects on children, let's have a look at adverse events. Be aware that not all adverse events, particularly where drugs are prescribed off-label or not by your normal doctor are reported (nor necessarily required to be) For Lupron (the paediatric indication), there are 164 serious cases out of 964 patients - an incidence of 17%. 7 deaths were reported. If you download the data here, then you will be able to see that:

1. Seizures occurred in 21 patients (including one death)- incidence of 2%
2. Mental effects (mood swings, depression, insomnia, suicidal ideation, hallucinations etc) occurred in 92 patients (including one successful suicide) - incidence of 9.5%. 21 of these occurred when being treated off-label or for gender dysphoria. If you assume (as has been demonstrated elsewhere see here and here) the high co-morbidity of depression and gender dysphoria, and exclude these, then you still have an incidence of 7%.

To blindly assert that that it is perfectly ok for a child to accept completely unknown risks 'as it is worth it' is profoundly immoral and unethical.

Thanks didtantvorp

Thanks to everyone for all their input and work on this thread.

I have no idea why Frack is so insistent on debunking ROGD, nor why Frack is so cavalier with regard to the appalling side effects that puberty blockers and wrong sex hormones have on children and young adults.

Some of these side effects are irreversible.

Why would people like Frack think that an 'affirmative' pathway is preferable to watchful waiting and proper psychological therapies?

From doctor Andrew Thorne on twitter below. He is worth a folles

We need to consider why children are taking huge risks with their future health. Are these intrusive medical processes to prevent cancer or serious illness? No, these risks being taken by children aided by adults to shift their place from one part of gender "spectrum" to another.

I guess a problem I have with the high levels of medicalisation is that there is no evidence that it improves outcomes over what has existed for centuries ( Ie no option but to get on with life as you are )
Girls did not commit suicide in their thousands as a result of their gender misfit .

once you make the option available, you are messing with minds which might stop people from getting better naturally because they can see another route that seems to be less effort and something external yet concrete and simple to blame? And telling them what to say to ensure that they can get their own way is also telling the, that of course they feel miserable , so it reinforces their miserableness?

Final point and then I really have to get back to work...
@FrackOff You have said:
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.
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.

You seem to be implying that the affirmative approach (ie puberty blockers and cross-sex hormones) results in better mental health outcomes - the 'better a live daughter than a dead son' argument.

How do you square that with the body of evidence that shows that the desistance rate for children presenting with gender dysphoria is extremely high 85% per study here and that there are significant deficiencies in the evidence for medical management of gender dysphoria here?

I feel very grateful to FrackOff for initiating a thread which has served to highlight in such detail the poor to nonexistent evidence for using puberty blockers in children. This may not have been Frack's intention, but like so many others who feel equipped to blind this board with science, OP has been hoist by their own petard.

As for the claim that describing poor Jazz Jennings' problems is gross, unethical and triggering, I find myself baffled. I agree that what was done to Jazz is gross and unethical, but I can't see what's gross or unethical about referring to it. The more publicity this barbaric treatment receives the better.

As for "triggering", I can't see how anyone promoting the medical transition of children and young adults can object to discussions of the inevitable results.

It's that 'gross' word again. It doesn't offer logical reasoning, it merely expresses disgust. Such a juvenile way to argue.

I have no idea why Frack is so insistent on debunking ROGD, nor why Frack is so cavalier with regard to the appalling side effects that puberty blockers and wrong sex hormones have on children and young adults.

And yet at the same time, Frack finds discussion of these effects 'gross, unethical and triggering'.

No, it's just people's insistence on talking about a teenage girl's orgasm

No, it's just people's insistence on talking about a teenage girl's orgasm

Jazz can't orgasm, because of what's been done to them, this is what we were talking about.

Once again your only argument is trying to pretend the discussion is about something it isn't.

What do you want to do then? Silence us for discussing one major impact of this experimental surgery on children.

We do insist on talking about this to debunk your myths and to reveal the true horror of playing God with children's lives.

Discussing sex and sexuality is healthy. Why is discussing the taking away of the joy of orgasm taboo when you are promoting quack research and supporting performing life changing surgery on minors/pumping them with medication (with some hideous lifelong side effects).

Do you have children Frack?

I'm against Fracking.

Your insistence on NOT talking about a teenager's (19 year old) natural feelings and bodily functions seems puritanical, especially given the extreme subject matter.

There's worse, MUCH worse we could talk about here and we've all seen the graphic images of what this surgery entails - especially for ftm.

No, it's just people's insistence on talking about a teenage girl's orgasm

So removing the ability to orgasm from children too young to understand what is being done to them is OK, but talking about it isn't. Is that what you're saying Frack?

No, it's just people's insistence on talking about a teenage girl's orgasm

Oh, give over.

Frack: here's why puberty blockers are fine and dandy.

Feminists: one of our main concerns is that the treatment pathway for minors beginning with puberty blockers renders them unable to orgasm as adults.

Frack: that's gross, unethical and triggering.

Feminists: yes, Frack, that's what we're saying.

Frack: no, not children being rendered anorgasmic as adults: saying it out loud.

Feminists: hi lurkers!

There's nothing gross in talking about powerful and poorly researched medication that affects children's bone development, renders them infertile and incapable of experiencing orgasms.

Have we reversed to some prudish Victorian era where talking about factual issues related to sexual development causes fainting spells among people with delicate sensibilities?!

The ability to experience orgasms is a natural part of reaching sexual maturity and developing into an adult. It is also a way human beings bond with sexual partners by providing mutual affection and pleasure. Orgasms help release chemicals known to induce bonding, relaxation and happiness - one of the various ways humans form long-term loving and romantic relationships.

You think talking about children being denied a normal sexual development that will enable them to forge healthy and mutually pleasurable relationships as adults is gross?!?

There is a reason why adults who transition are usually reluctant to amputate their genitals. They understand the value of sexual intimacy and the joy that orgasms bring to themselves as well their relationships.

Children have no frame of reference as to how important orgasms can be to sexual fulfillment and intimacy in relationships. What happens when they reach adulthood and find difficulty in enjoying the closeness that sex brings? The vast majority of people do not want a relationship with a partner who is incapable of experiencing and appreciating orgasms. People enjoy mutual pleasure and fulfillment and struggle when this isn't the case. You only have to read the experiences of those who aren't trans but who find it hard to orgasm to understand how it can affect a couple's sex life.

The sort of person who doesn't care if their partner has an orgasm is not the sort of person you'd want to be with in a relationship anyway!

Do you need smelling salts after reading this?

Actually, I lied. We can't talk about such things, because that would reveal truth.