Is this going to end? If so, when? What will be the catalyst?

[SybillTrelawney]

Sorry if these are pointless questions — I realise no one really knows the answers. But I need some hope, because I'm feeling so fed up. The attitude many of my colleagues have to gender and sex scares me, and the way that all diversity initiatives at work now revolve around gender ideology (while ignoring women) leaves me in a constant state of low-level anger. I just can't see an end to it, and I'm wondering what it will take for there to be a big shift in attitude amongst the sort of people who are sustaining the current climate of fear.

From the Bell vs Tavistock judgement:

The defendant argues that PBs give the child “time to think”, that is, to decide whether or not to proceed to cross-sex hormones or to revert to development in the natal sex. But the use of puberty blockers is not itself a neutral process by which time stands still for the child on PBs, whether physically or psychologically. PBs prevent the child going through puberty in the normal biological process. As a minimum it seems to us that this means that the child is not undergoing the physical and consequential psychological changes which would contribute to the understanding of a person’s identity

PB's aren't ''time to think''. The child isn't maturing mentally because they're not going through the changes that puberty brings. They're frozen in a dysphoric state. Of course they're going to try the next ''fix'', CSHs.

Robust is not the word I'd use to describe what's going on here.

My post was hidden so quickly, I think it must have tripped some kind of auto filter for MN.

I'm not going to type it all out again, it took bloody ages!

But basically, jj1968 if childhood transition is no problem, why are there so many senior clinicians at GIDS / the Tavistock whistleblowing their concerns?

I'm not going to add links as I don't want to get my post deleted again! So you'll have to google if you're not familiar. But so far they include:

Marcus Evans (Tavistock Governor, resigned & whistleblew after 35 years)
Kirsty Entwhistle (Clinical Psychologist, resigned and wrote an open letter with her concerns)
Sue Evans (Psychologist and former nurse at GIDS) - started court case against GIDS that Keira Bell joined
5 further anon clinicians quit and spoke to the press - read about it in the Times
David Bell Consultant psychiatrist, who served as a staff governor at the Tavistock Trust, who wrote an critical internal report and is now speaking out abotu his concerns.

Plus, I forgot earlier, also the Tavistock's own Safeguarding lead is currently taking GIDS to court.

If everything is so great, why are these people whistleblowing?

The Safeguarding lead, if anyone wants to google, is Sonia Appleby.

Thanks for putting my post back MNHQ!

(I'd tripped the spam filters, apparently - possibly all those links!)

Posting this again. I don't want to be annoying, but I do try to keep up with all aspects of this issue, especially regarding young transitioners, and I'd really like to find out more about this as I haven't heard of it before.

So, apologies for the repetition, but jj1968 said, about detransitioning, all that's happened since that story broke is that quite a few of the first wave of detransitioners have retransed - as you would expect if you are familiar with the research

I admitted that I was not familiar with this research and asked for a link. Do you have one jj?

Excellent post fastwigglylines, spam filter tripping notwithstanding.

@jj1968

Results: Height stunted, bone mass density impaired, no improvement in psychological function, no alleviation of gender dysphoria, all but one progressed to cross-sex hormones.

But that's exactly what you'd expect puberty blockers to do, all that demonstrates is that they work. And that almost everyone went onto hormones suggests the Tavistock's diagnostic criteria was robust.

Quoting this just in case anyone missed it.

According to jj, puberty blockers are expected to:

Stunt height. So a girl who takes them will end up as a very short transman.

Impair bone density. Osteoporosis at a young age.

No improvement in psychological function.

No alleviation of gender dysphoria. So the child will continue to be as distressed as they were before taking them.

But jj, are any benefits expected for children taking these drugs? Why give a child medication with so many negative effects and no benefits?

@AbsintheFriends

Posting this again. I don't want to be annoying, but I do try to keep up with all aspects of this issue, especially regarding young transitioners, and I'd really like to find out more about this as I haven't heard of it before.

So, apologies for the repetition, but jj1968 said, about detransitioning, all that's happened since that story broke is that quite a few of the first wave of detransitioners have retransed - as you would expect if you are familiar with the research

I admitted that I was not familiar with this research and asked for a link. Do you have one jj?

The research shows social factors such as lack of family support often underlies detransition: pubmed.ncbi.nlm.nih.gov/9570489/

Information on detransitioners is somewhat sparse because no researcher has ever been able to find enough of them to get a statistically significant group together but a case study here discusses an example of a retransitioner: linkinghub.elsevier.com/retrieve/pii/S0890856718302193

If an individual's self identity is totally dependent on conspicuous public approval & affirmation it is not going to be very secure; especially if that public is seeing/recognising something 'other' than the preferred identity.

@Justhadathought

If an individual's self identity is totally dependent on conspicuous public approval & affirmation it is not going to be very secure; especially if that public is seeing/recognising something 'other' than the preferred identity.

It's less about affirmation than facing discrimination and harassment or losing family members. Thankfully as people become more accepting of trans people regret rates seem to be falling.

journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

Above is a Swedish study - which focused on the years 1973 -2003

But jj, are any benefits expected for children taking these drugs? Why give a child medication with so many negative effects and no benefits?

The benefits are giving a young person the time to think before going on to take hormones. This is the only benefit. If you were somehow able to establish that someone was definitely trans and would ever regret treatment then the optimal approach would to be to start cross sex hormones as soon as puberty begins. However current treatment protocols are that they are too young to make this decision and so puberty blockers are used to prevent changes until they are old enough to decide. Puberty blockers do not help trans kids, they are used to protect kids who aren't trans from making a mistake.

guideonragingstars.tumblr.com/post/149877706175/female-detransition-and-reidentification-survey

This suggests that other issues, such as physical/medical/mental health issues outnumber those relating to 'lack of family support'.

Puberty blockers do not help trans kids, they are used to protect kids who aren't trans from making a mistake

it all does seem like a very 'grey' area.......Real/ Not Real, True/Not True.....

The benefits are giving a young person the time to think before going on to take hormones

Yes, we know. That was the original idea behind prescribing them and has been the marketing spiel ever since.

But please answer me this. If blockers give kids time to think, and if - as you say - we can't establish who is definitely trans - then why do almost 100% of children taking blockers go on to cross sex hormones? If it was just about giving kids time to think, then some would say "oh, actually, now I've thought about it, I've decided I don't want to transition". But this almost never happens.

Surely you can see that - far from giving children time to think, blockers are locking them into a particular treatment path?

Contrast that with studies that found that, if allowed to go through puberty, the vast majority of children with gender dysphoria get over it.

It looks very possible that the cure for gender dysphoria is puberty, basically, and that blockers are preventing it.

Also, JJ, you haven't answered my question about the professionals who are whistleblowing. What do you think that is all about then?

Thanks for providing links. I can't see anything in them about detransitioners retransing, but perhaps I'm missing those bits?

But please answer me this. If blockers give kids time to think, and if - as you say - we can't establish who is definitely trans - then why do almost 100% of children taking blockers go on to cross sex hormones? If it was just about giving kids time to think, then some would say "oh, actually, now I've thought about it, I've decided I don't want to transition". But this almost never happens.

I think this reflects the amount of gatekeeping in young people's trans healthcare in the UK. When you consider just 161 people were put on blockers in the most recent period then it becomes clear that these were exceptional cases, it represents about 1 in 100,000 under 16s (and in fact many were over 16). That is way way below the number you would expect given the number of trans adults who report gender dysphoria emerging in childhood. It is likely these were young people in great distress, who had significant gender dysphoria which emerged at a very early age and which was consistent and persisted until puberty began. It was therefore a near certainty they would be likely to go on to be trans adults, and as such would want hormone treatment.

What the 1% figure actually suggests is it might have been better to put them straight onto hormones but given the current climate that would have been very difficult (and against current rules). So they did the next best thing.

The recorded effects of puberty blockers include infertility and loss of bone density as discussed in the case between Keira Bell and the Tavistock clinic. There is a much longer list for those that wish to do an internet search on that type of drug.

There are no guidelines from NICE for the use of those drugs for the purpose of delaying puberty in children. (It is not the same as use for precocious puberty).

Keira found that the procedure for ‘diagnosis’ was extremely limited with no exploration of her underlying mental health issues. It appears that this is their standard protocol and that is one of the major areas of concern for the whistleblowers.

The Tavistocks own research (very limited given the time, number of patients they had and money given for the research) demonstrated that almost all patients taking puberty blockers went into cross sex hormones. Some people claim that is because those kids were all reliably diagnosed as trans but as we saw from Keira’s experience, that is not the case - there was very little attempt to do anything other than affirm Keira’s 16 year old feeling that she would be happy if she became a boy.

The Tavistock have been extremely lax in following up their patients and missed huge opportunities for some real robust research into the experience of the children in order to improve the healthcare offered based in strong evidence. They have not attempted to follow up with Keira, instead they have completely ignored the fact that she has had surgery and other irreversible changes unnecessarily, based on their misdiagnosis.

There is no evidence that puberty blockers produce an improved mental health outcome for these children and are very likely to have serious long term effects in their health.

Any suggestion that there are no health consequences to taking these drugs and the implication that they ‘just give some thinking time’ would be wrong.

I think this reflects the amount of gatekeeping in young people's trans healthcare in the UK. When you consider just 161 people were put on blockers in the most recent period then it becomes clear that these were exceptional cases, it represents about 1 in 100,000 under 16s (and in fact many were over 16).

Don’t forget the 6000+ patients claimed by gendergp who promises not to gatekeep treatment for anyone (although if they’re sensible they will have taken that off their website - I’ve got screenshots though). They aim their services and coaching to children and young people as well as adults (although again if they’re sensible they will not be advertising that any more)

@7catsandcounting

I honestly can't cope with feeling angry like this all the time. I keep coming on here, reading articles, watching YouTube vids, FB groups... looking into it all and getting more and more frightened. I think it's a lost battle. I was on Twitter last night, looking at an article a TW had written about her periods and I think that's done it for me. Last straw. I'mI'm fed up now. The TRA movement is too powerful. Most of my friends don't care. My sister doesn't care. Maybe the only thing I can do is make sure no Stonewall (or similar) organisations get their mitts on my DD when she's a teen. That's what I'm worried about after reading Irréversible Damage. I just have to keep an eye that. It's so depressing.

I think we maybe read the same article, and it angered and amazed me too. It's literally like listening to a flat earth convention and being the only sane person in the room. What's astounding are the amount of self proclaimed 'cis women' who respond to these people with saccharin coated sympathy. Some of the 'facts' - transwomen get periods. Fact. They have headaches, cramping!!!, bloating, and get weepy and angry on the run up to their period. Only a hot water bottle eases the cramps, and eating chocolate can help. They even get pain around the mid part of the cycle (where a 'cis' woman will ovulate). Their cycles synchronise with the 'cis' women that they live with. A few brave souls ventured to ask what was cramping and where the mid cycle pain was originating from if it wasn't from a uterus or ovaries, and were promptly blasted as trans phobic. Some dared to mention (gulp) chromosomes, and were told "it's not as simple as that".

It's almost as if these people have read literally every cliche imaginable about what some women experience during a cycle and mash it all up together to result in the most WOMANLY period EVER!!! Why would they feel the need to do that I wonder?

So, I'm hoping the 'end' of this will come when people realise you cannot opt in or out of biology.
We know the earth is not flat. Science won.
I'm hoping it wins again.

You use the word gatekeeping as if it's a bad thing. Whereas most people would argue that any sort of gatekeeping that stops children being unnecessarily medicated would be a good thing.

@jj1968

But jj, are any benefits expected for children taking these drugs? Why give a child medication with so many negative effects and no benefits?

The benefits are giving a young person the time to think before going on to take hormones. This is the only benefit. If you were somehow able to establish that someone was definitely trans and would ever regret treatment then the optimal approach would to be to start cross sex hormones as soon as puberty begins. However current treatment protocols are that they are too young to make this decision and so puberty blockers are used to prevent changes until they are old enough to decide. Puberty blockers do not help trans kids, they are used to protect kids who aren't trans from making a mistake.

Puberty blockers don't help any children. Protecting children who aren't trans would mean letting them go through a natural puberty so that they don't have to contend with the side effects (or according to you the 'expected effects') such as osteoporosis in their 20s.

It doesn't protect those chidren, because as fastwigglylines has already said, almost 100% of those children go on to cross sex hormones because the 'cure' for gender dysphoria in many children is puberty itself.

As the recent High Court judgment showed, a child who is too young to consent to cross sex hormones is also too young to consent to puberty blockers (because of the nearly 100% progression to cross sex hormones amongst these children).

And please explain what you mean by someone who is 'definitely trans'. Do you mean someone who has gender dysphoria which is so severe that no treatment other than physical transition will help them? Or something else?

Keira found that the procedure for ‘diagnosis’ was extremely limited with no exploration of her underlying mental health issues. It appears that this is their standard protocol and that is one of the major areas of concern for the whistleblowers.

In the interests of accuracy it should be pointed out that the court didn't find anything in relation to Kiera's treatment because the case wasn't about her. The Tavistock disputed Kiera's account of her treatment but it was considered irrelevent either way by the court because what was being considered was the legality of the treatment overall, not whether Kiera was treated incorrectly or not.

Puberty blockers don't help any children.

Well the 1% who change their mind before going onto cross sex hormones might beg to disagree, as would many medical experts.

And please explain what you mean by someone who is 'definitely trans'. Do you mean someone who has gender dysphoria which is so severe that no treatment other than physical transition will help them?

Yes, for the purpose of this debate, they are someone who would almost certainly medically transition as an adult.

@wellthatsunusual

You use the word gatekeeping as if it's a bad thing. Whereas most people would argue that any sort of gatekeeping that stops children being unnecessarily medicated would be a good thing.

I think a degree of gatekeeping is the right thing to do with young people, although I'd support a model of informed consent for over 18s. But I also think given the numbers referred for treatment are so low in the UK that it wouldn't worry me much if they started to rise. But I have no problem with thorough assessment including analysis of comorbidities etc, what I don't agree with would be someone trying to convince these kids they aren't trans or promising they could cure them somehow. They need to make up their own minds in a supportive environment, without any pressure in either direction.