Women & Equalities 22nd April 2020 - YES!

[dianebrewster]

From Liz Truss Today

Here

" The final point I’d like to make, Madam Chairman, in this initial part, is on the issue of the Gender Recognition Act. We’ve been doing a lot of work internally, making sure we’re in a position to respond to that consultation and launch what we propose to do on the future of the Gender Recognition Act. We will be in a position to do that by the summer, and there are three very important principles that I will be putting place.

First of all, the protection of single-sex spaces, which is extremely important.

Secondly making sure that transgender adults are free to live their lives as they wish without fear of persecution, whilst maintaining the proper checks and balances in the system.

Finally, which is not a direct issue concerning the Gender Recognition Act, but is relevant, making sure that the under 18s are protected from decisions that they could make, that are irreversible in the future. I believe strongly that adults should have the freedom to lead their lives as they see fit, but I think it’s very important that while people are still developing their decision-making capabilities that we protect them from making those irreversible decisions. "

That meant to read donquixotedelamancha's example..

But what comparable medical pathway would a 'cis' child be likely to choose? We're talking about compromising the future fertility of trans children, or eliminating it altogether if they progress from puberty blockers to cross-sex hormones and then surgery. If a young 'cis' woman (let alone a girl) who is certain that she never wants children goes to her doctor and asks to be referred for a sterilisation procedure she will most likely be refused on the grounds that she might change her mind later

There are a number of TRAs who want to make the comparator access to abortion. Some are keen to frame this as a way in which under 18 females could be denied contraception additionally.

I agree that the comparison with sterilisation is more accurate, elective hysterectomy perhaps more so? The lack of sufficient evidence base for 'puberty blockers' & cross sex hormones should alone have been sufficient for immediate ethical reconsideration

BMJ Prof Carl Heneghan (Oxford Evidence Based Medicine)

'Gender-affirming hormone in children and adolescents – Evidence review'
Posted on 25th February 2019

"Conclusions

There are significant problems with how the evidence for Gender-affirming cross-sex hormone has been collected and analysed that prevents definitive conclusions to be drawn. Similar to puberty blockers, the evidence is limited by small sample sizes; retrospective methods, loss of considerable numbers of patients in follow-up. The majority of studies also lack a control group (only two studies used controls). Interventions have heterogeneous treatment regimes complicating comparisons between studies. Also adherence to the interventions are either not reported or at best inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding, and many effects can be explained by regression to the mean.

The development of these interventions should, therefore, occur in the context of research. Treatments for under 18 gender dysphoric children and adolescents remain largely experimental. There are a large number of unanswered questions that include the age at start, reversibility; adverse events, long term effects on mental health, quality of life, bone mineral density, osteoporosis in later life and cognition. We wonder whether off label use is appropriate and justified for drugs such as spironolactone which can cause substantial harms, including death. We are also ignorant of the long-term safety profiles of the different GAH regimens. The current evidence base does not support informed decision making and safe practice."
blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/

www.mumsnet.com/Talk/womens_rights/3518188-BMJ-Prof-Carl-Heneghan-Evidence-Based-Medicine-Oxford-Panorama-Trans-Kids-Gender-affirming-hormone-in-children-and-adolescents-Evidence-review-concludes-There-are-significant-problems

In no other Gillick case does not doing anything mean continuing to have a physical, healthy body and no changes.

Oh indeed. Every argument they make is disingenuous.

They make a huge deal that cross sex hormones are not prescribed below 16, but campaign to lower that age.

They claim to work to prevent suicide but ignore the guidance against spreading suicide ideation.

They claim the science is on their side but attack every professional who is anything other than a cheerleader for their 'affirmative' approach.

They claim to want more research into how to help trans children but attack anyone who tries to research desistance or side effects and spend none of their vast funding on medical reearch (as opposed to social science haigiographies).

They claim to be a kids Gender Dysphoria charity. Can you imagine a cancer charity or a dementia charity behaving this way?

I think the difference is the result of medical action or inaction.

Yes, I was thinking about this earlier and it's my feeling too.

They claim to be a kids Gender Dysphoria charity. Can you imagine a cancer charity or a dementia charity behaving this way?

TRAs have appropriated cancer proticols eg for preserving fertility.

www.mumsnet.com/Talk/womens_rights/3333708-NHS-faces-lawsuit-for-not-funding-fertility-services-for-transgenders-who-want-kids

www.mumsnet.com/Talk/womens_rights/3326933-NHS-told-give-trans-patients-equal-access-to-fertility-service

I was thinking of the possible consequences of a recent court ruling whereby NHS was required to pay for commercial surgery in USA following a finding of negligence in diagnosing a woman having cervical cancer & her resultant infertility.

www.theguardian.com/law/2020/apr/01/uk-woman-wins-claim-for-nhs-to-pay-us-surrogacy-costs

They are definitely framing it as denying under 18's contraception and abortion. There has been a social media outpouring about comparing it to that since the announcement went out. That is very much the tact they are going to continue to take and will probably shout down anyone who points out how different it is.

Sorry.... they WILL shout down anyone who points out....

It doesn't really matter what they shout about.

This is going all way.

Things that will be asked for will be all the stats, studies and surveys to do with puberty blockers.

Likewise cross sex hormones and follow-ups to do with outcome.

No-one can make a decision without all the information.

And we all know, that information doesn't exist.

Let the world know that children are being given umpteen different types of drugs that are rendering them infertile, with little to no sexual function and are becoming lifelong medical patients. And the decision starts around age 11.

And there is nothing credible to support it.

Oh, alternatively, if there is, let's see it.

They are definitely framing it as denying under 18's contraception and abortion

But an under 18 year old would never be allowed to have a vasectomy or sterilisation. But it’s ok if the effect is the same for those on puberty blockers. It’s also grates to see comments about Gillick competence when one of the main reasons why so many people are concerned about puberty blockers is that it is not clear that children are given enough information to demonstrate Gillick competence. That is one of the points Keira is making, isn’t it?

I can't imagine any child to be competent enough to make choices about fertility, deciding to have a hugely increased risk of brittle bones and future heart problems tbh.

That's what I think Eliza. Very few 14 year olds would be worried by the idea they would be at greater risk of osteoporosis aged 60. I used to listen to a Radio 4 programme called Inside the Ethics Committee about real life ethical dilemmas. They often made the point that young children born with disabilities often made extremely sophisticated decisions about agreeing to/refusing treatment because they were so used to thinking about their condition and how they were affected. A young person who develops gender dysphoria in adolescence but who has never previously experienced any health issues is coming from a very different starting point.