Puberty Blockers 101

[NoCureForLove]

I see the previos thread about Dr Adrian Harrops Youtube video - Puberty Blockers 101 has been deleted as 'not in the spirit'.

Sadly too the good doctor has belatedly worked out that giving viewers the ability to comment on Youtube was a very bad idea indeed. Or has worked out how to turn the comments off...

It's an important message - quite breathtaking really in view of the judgment in Bell v The Tavistock. So am re linking. Discussion 'in the spirit' shouldn't be beyond us?

Does he happen to mention at all that the doctors who pioneered this treatment did not suggest prescribing blockers to children with trauma, with serious co-morbid psychological conditions and only after an intense diagnostic process seeking to discern whether the underlying root cause for the child's gender dysphoria is truly a core cross-sex identity and not psychological injuries? And only alongside intense psychological treatment?

Because that is how the Affirmative Approach was developed and that is most decidedly not what the GIDS did.

Reading the papers written by those Dutch doctors is incredibly sad. They developed this protocol to alleviate suffering, assumed that the vast majority who desist would then come off the blockers and resume with their normal puberty, but without the distress developing secondary sex characteristics can bring to children with gender dysphoria.

They congratulate themselves on picking the right children so very carefully that only those who persisted were put on PBs. They acknowledge the treatment is highly experimental and therefore deeply controversial. They acknowledge how much they do not yet know and urge everyone to collect data and research the consequences of the treatment. They write that the certain loss of fertility is one of the main reasons their child patients decide against going on PBs or decide to come off them as soon as they understand what that means.

Reading all this and knowing how their approach was adulterated to drop the counselling and caution they exercised. Knowing that they were wrong about how the blockers impact the child's ability to reconcile with his or her sex, I feel a lot of sympathy for those doctors back then. They must be in torment now.

Does Harrop mention any of this?

I think that would be a no Charlie.

He actually says "many people demonstrate they have a flawed and incomplete understanding of how and why these are used"

Seems he then goes on to prove his working hypothesis.

Wonder wether he's angling for a job with Gender GP once he meets their recruitment requirements of being struck off the medical register.

Gobsmacked - he has no shame, and is a disgrace to his profession

@vivariumvivariumsvivaria

Wonder wether he's angling for a job with Gender GP once he meets their recruitment requirements of being struck off the medical register.

He does talk a bit about side effects and risks (from around 20:20) including risks of poor bone development and longterm infertility but he says that these "inconsequential" risks are outweighed by the lifesaving benefits.

You wouldn't want him as your Dr if you were suffering from infertility would you?

Theraputic intervention which can potentially reduce a person's risk of dying through suicide and which can dramatically improve their sense of mental wellbeing and future quality of life. Whilst the potential side effects are an important consideration, a relatively modest and perhaps near inconsequential degree of osteopenia and some potential concerns for potential regret in terms of long term impacts on fertility would be insufficient reason to expose a child or young person to the real and substantial risks of significant mental anguish and misery at best and even death through suicide at worst.

I've written a thread on PBs in precocious puberty.
I don't do YouTube but I did arrange my books by colour when I was 11.
twitter.com/wontsomeonethi2/status/1336265436237864963?s=19

@vivariumvivariumsvivaria

Wonder wether he's angling for a job with Gender GP once he meets their recruitment requirements of being struck off the medical register.

Very good.

Dr Harrops YouTube premiere seems to be a flop. Despite him asking people to share it freely, it is only a handful that have taken any interest and no organisations have retweeted. Maybe they are being sensible and choosing to distance themselves from him?

Ouch I bet he's feeling hurt.

the video is popping up on my twitter (clearly, I follow the right people)

He's being eviscerated. People are pointing out that he's not following Samaritan's guidance and that he's contradicting court findings - and reporting him to GMC. Again.

Bookshelves - jury seems to be out. People love it or hate it. I hate it.

Dr Adrian Harrop YouTube presentation published 7 Dec 2020

'Puberty Blockers 101'

(extracts)
11:48
"Blockers don't bring about any permanent or irreversible changes in an adolescent's body."

14:50
"There are benefits that will be gleaned from the use of blockers for transgender adults of the future. The use of blockers helps to minimize the irreversible physical changes that occur in a [child's] body as they progress through puberty. Many of which can only be hoped to be corrected by means of multiple major surgeries if at all.

The use of blockers allows a [child's] growth and development to be manipulated and controlled in such a way that we can enable them to better integrate in society in their affirmed gender role"

20:02
"it's in fact much riskier to not give the blockers than it is to write a prescription for them since ultimately, as previously mentioned, lockers are proven to be a low-risk, temporary, reversible treatment with a minimum of long-term side effects and risks. All of which are far outweighed by considerable and potentially life-saving benefits"

29:12
"The service at the Tavistock is immensely over subscribed with inordinately long waiting times and prior to the pandemic a typical case could expect to wait for approximately three years before even receiving an appointment for a first assessment" (continues)

The number of children who make it through this gatekeeping process set up and sustained by the Tavistock and actually end up receiving puberty blocking treatment at the ideal stage that would be aimed for by anyone practicing gender affirmative care in any comparable nation, is relatively tiny and falls far short of the number of transgender children that one might expect to find in a population the size of that in the United Kingdom"

"I believe that any child or young person presenting to their GP with a gender identity problem or with features of gender dysphoria ought to be guaranteed to have a comprehensive diagnostic assessment performed and appropriate treatment whether that is puberty blockers, psychological support or therapy or a combination of the two started within a period of 18 weeks. As set out as a right within the NHS constitution.
In order to deliver this service and this treatment within what is a fair and realistic time frame, we need to demand a dramatic increase in investment and training for the development of these services and these services need to be decentralized away from super specialist centres based only in the capital city and made available wherever children and young people access other forms of mental health support in the towns and communities where they live. This may involve a combination of outsourcing some of these services to the private sector of which there are a number of established providers already working with uk patients"

transcript as generated by Youtube with punctuation added & 'umms' removed for ease of reading
I have corrected/replaced 'person' with child as is appropriate due to Safeguarding relevance.

Carl Heneghan, Editor in Chief BMJ EBM, Professor of EBM, University of Oxford

Tom Jefferson, Senior Associate Tutor University of Oxford
Visiting Professor Institute of Health & Society, Faculty of Medicine, Newcastle University

BMJ Spotlight published 25th February 2019

'Gender-affirming hormone in children and adolescents'

(extract)
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, and loss of considerable numbers of patients in the follow-up period. 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 is either not reported or inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding.

An Archive of Diseases in Childhood letter referred to GnRHa treatment as a momentous step in the dark. It set out three main concerns: 1) young people are left in a state of ‘developmental limbo’ without secondary sexual characteristics that might consolidate gender identity; 2) use is likely to threaten the maturation of the adolescent mind, and 3) puberty blockers are being used in the context of profound scientific ignorance.

The development of these interventions should, therefore, occur in the context of research, and 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 and even 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 in children."

blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/

some potential concerns for potential regret in terms of long term impacts on fertility

So he accepts these children are rendered infertile, but handwaves away any concerns about this?

In Louis Theroux's documentary on children being transitioned in the U.S., there is a scene that I've not managed to forget since. A 14-year-old male on PBs and Cross-sex hormones is showing concerning levels of distress at the appointment with the specialist. After the child leaves, the doctor comments that this is a normal occurrence for children this age on this treatment regimen, because FOR THE FIRST TIME EVER THEY BEGIN TO TRULY COMPREHEND WHAT THE TREATMENT MEANS.

I am still as stunned at this today as I was when I watched it. I still wonder how these doctors sleep at night.

The Court of Protection judges have done no more and no less than to say hang on a minute. Based on the evidence presented to us, we do not believe children can give consent to a treatment whose consequences they cannot comprehend.

And all of the evidence available to us bears out that the children do not understand what the treatment means. From this documentary to the Dutch doctors reporting in the paper I read that the patients who do come off PBs come off when they begin to understand the consequences. These doctors k-n-o-w the kids do not understand what is being done to them. Our judges have ruled that for children diagnosed with gender dysphoria this means the treatment should not be given.

And once again, for the good doctor, a reminder: the data on side effects of PBs comes from children treated for precocious puberty, who are allowed to go through a complete puberty at the appropriate age.

This affects approximately 0.2% of girls and 0.05% of boys. If left untreated, which is not uncommon, the condition can have physiological consequences, particularly for adult height, which can leave children with such a short stature that this negatively impacts their future lives.

Doctors working in the field continue to urgently recommend more research, because little is known of the longterm consequences (apart from a statistically significant finding of a higher prevalence of polycystic ovarian syndrome in girls treated with PBs for precocious puberty).

Many of these children have underlying health conditions of which precocious puberty is a symptom or result, often discovered because the child is showing premature signs of puberty.

None of this applies in the case of children diagnosed with gender dysphoria who have typically healthy bodies.

Many people organise their bookshelves in this way, if you watch any YouTube videos made by book creators over half will have their bookshelves arranged this way.

Please stop looking for things that aren’t there. Since when did we live in a world where how you arrange your bookshelf has gone from showing whether you are organised or messy to now showing whatever agenda you are trying to push. I assume then on this basis the fact that he has a lot of red books makes him a labour supporter?

I assume then on this basis the fact that he has a lot of red books makes him a labour supporter?

You're not wrong there.

Urgh got as far as " pause button" akd had to switch off.

Wasnt it part of the judgment that they inevitably lead to cross sex hormones so are classed as the the first stage of medical transition as opposed to being a thinking space...

Or something like that...

• if you watch any YouTube videos made by book creators over half will have their bookshelves arranged this way.

What's a book creator?

@vivariumvivariumsvivaria someone who makes YouTube videos about books.

His mother fed him with a catapult.

He’s not charismatic is he?

A look at his Instagram suggests lack of insight too.

Well, I guess I know what Dr H does in his spare time, then.

Never heard of it, never seen colour co ordinated books and I think it's bonkers. Suits him.

@MichelleofzeResistance

Contradicts the court findings and the latest NHS guidance.

I keep trying to think of any other professional role where you could present yourself, under your own name, on YouTube, contradicting official guidance and court judgements like this with your own opinions, and not find yourself on the end of disciplinary procedures if not a pink slip.

I posted this on another thread, but seems relevant here too.

twitter.com/david55034076/status/1333860839753986050

Carson
“Twice today I've read the Adrian Harrop has left the UK for Spain. Is that true? Has he left the NHS?”

David
“dont think so,,gmc or his employers have warned him off,,, their was an active investigation by gmc,,harrops second,,he didnt walk away free this time,, over 2 thousand complaints logged,,some by other doctors,,hes history now and he will be absolutely raging ..oh goody”

Carson
“So.. He was made to leave the NHS? Just a warning?”

David
“just a warnning,,its called an,,undertaking,,,bringing proffession into disrepute..and he most certainly did that,,he thought he was untouchable,,,,he was wrong”

Obviously I am just reposting what’s available on Twatter, I can’t substantiate beyond that.

He stated in the video he was a practicing nhs dr didnt he?

So it can't be true he's been made to leave. Can it?

I mean they're behaviour warrants it obviously but we usually aren't that lucky