Good Law project have succeeded...

[Wandawomble]

goodlawproject.org/news/tavistock-success/

There's increasing evidence that pbs are a massive issue.

The law needs to wait for that evidence to be properly examined.

What would stop them changing the policy?

NICE are reviewing the evidence for the use of PB and this will guide NHS policy.

I suspect they will conclude that there is no, or very poor evidence to support the use of PB as a treatment for gender dysphoria, as did other reviews.

Three separate reviews of the scientific literature (a review by Professor Carl Heneghan, the director of the University of Oxford's Centre for Evidence-Based Medicine; the Swedish Health Authority evidence review; and the Finnish Health Authority evidence review) conclude that the research evidence for hormones to alleviate gender dysphoria in young people is insufficient,(2–4) rendering these interventions experimental. The Endocrine Society, which outlined this hormone protocol for young people, also conducted a review of the evidence and concluded that the quality of the evidence was low to very low (5).

segm.org/UK_HighCourt_Rules_PubertyBlockers_Experimental

This bares repeating:

the essentially experimental nature of PBs should give any parent pause for thought

puberty blockers are entirely reversible

Oh hey. Looking forward to seeing some evidence of this?

Make sure you also show the long term effects of the drugs when prescribed for precocious puberty on females who are now building their class action case because of the significant harm done to their bodies.

We will wait here. I think there is a few in the queue bringing their evidence too.....

Yes I'm looking forward to seeing the evidence.

I'm still not unstanding the title of this thread.

What have the Bad Law Society succeeded at?

In Plain English .

Bad Law Project

The have succeeded in generating positive appearing PR to enable them to raise more money.

I suspect what's stopping them is ethics.

If they had ethical concerns about puberty blockers then they would have withdrawn them of their own volition.

I suspect what's stopping them is that they don't want to concede defeat on the Bell case while there is an appeal still pending. If they lose the appeal then they will move to parental consent.

If they had ethical concerns about puberty blockers then they would have withdrawn them of their own volition.

I think there's clearly an organisational fracture. There will be PB believers there, and there will be more sceptical people there.

Internal battles are happening.

What's stopping them being more pro-PB is that they're not sufficiently captured by the believers - there are enough uncaptured professionals inside the organisation safeguards in the system, and enough external review, that they can't go full GenderGP.

But on the other hand there's not a conclusive enough "this is bad" evidence to point to to go against the WPATH "best practice" that is in their service provision and stop PBs. And that service provision is itself part of the problem - GIDS/Tavistock are doing what this dumb NHS commissioning thing says they do according to the contract.

I'm guessing this means you've got management types not directly involved in the area saying what they should do - their hands are partly tied. I don't know how specialists in areas are supposed to feed back via the commisioning process what they should be doing.

Is that where NICE or whatever come in?

Yes, it's fantastic news.

Does this mean that if you pushed your parents for treatment (which you can't give consent to) and they say yes, you could in ten years time be taking them to court for enabling you to fuck yourself up. Especially if they were abusive or homophobic in the first place?

it's cross sex hormones that can cause sterility, not puberty blockers.

Cross sex hormones on their own do not necessarily cause sterility.

Puberty blockers do not cause permanent sterility if they are stopped in time for the child/young adult to go through normal puberty.

But puberty blockers used before fertility, followed immediately by cross-sex hormones (which seems to be the normal progression once puberty blockers are given) are likely to create lifelong sterility. It’s not specifically either drug, but is the combination that causes the problem.

As for the case, interesting that those bringing it (and specifically JM) are claiming parental consent is now an acceptable alternative pathway, whereas this court case is about a circumscribed situation where the treatment is already under way and this is about continuation, not commencement of treatment.

I hope that GIDS do not jump to direct parental consent in the event they don’t win the appeal. If they were to do so, given the very specific statement before Keira’s case that they had never considered that a suitable model, it would be a deeply cynical move and would remove any doubt about the presence or absence of ethics.

Regarding evidence, this is taken from todays judgement

I have read the evidence of Professor Graham who refers to the studies supporting their use

Professor Graham? I've never heard of him and nor has google. Is this a misprint?

Is that where NICE or whatever come in?

Yes, nice guidance is frequently reviewed and guidance is changed based on new evidence.

@NotDavidTennant

I suspect what's stopping them is ethics.

If they had ethical concerns about puberty blockers then they would have withdrawn them of their own volition.

I suspect what's stopping them is that they don't want to concede defeat on the Bell case while there is an appeal still pending. If they lose the appeal then they will move to parental consent.

GIDS' stated policy in Bell was that it was irrelevant if parents were legally capable of giving consent, as they wouldn't ever consider parental consent to be an appropriate basis for commencing PBs. So this judgment is a bit awkward for them - not because it changes the law, but because they can't easily pivot to suddenly saying that something they previously thought was totally inappropriate is now totally fine (although they are now going to come under significant pressure to do just that).

It's crazy to me that grown ass women in their 30's, some with children already, are refused a hysterectomy in case they make the wrong decision, change their minds later, yet all 12 year olds have to do is have a word with mum/dad and 'there ya go kiddo.'

I see they're still telling porkies about the Bell judgement affecting teenagers access to abortion and contraception, so I think I'll take whatever they say with a pinch of salt for now. Let's see how the appeal and review goes.

from the judgement:

30 Dr Carmichael, the Director of GIDS, sets out the Second Respondent's position in the light of the judgment as follows:
"In relation to referral from GIDS to the endocrine team, the Tavistock would only proceed to refer for treatment where i) it is the clear wish of the young person to be referred for assessment by the endocrinologist and that they understand the nature of the referral (even if their level of understanding falls short of the requirements for 'Gillick Competence' as delineated in the Divisional Court's judgment in Bell); ii) with the agreement and support of the child or young person's parent(s)/carer(s); and iii) with the agreement and recommendation from the clinicians working with the child or young person."

Do you think that’s Polly Carmichael trying to work round to reversing Tavistock’s earlier stated ethical position, R0wantrees?

it's cross sex hormones that can cause sterility, not puberty blockers.

If a child goes on puberty blockers at the onset of puberty and then straight on to cross sex hormones, they are likely not to have developed enough (as they have stopped the normal processes which happen during puberty) to be able to produce any gametes (sperm for male people, ova for female people). So it may not even be an option to "harvest" them for later fertility use.

I thought Polly Carmichael was no longer director of GIDS since the last reshuffle?

My guess is that GLP is laying the ground with this. Their overall aim is fast referral to pb treatment. They will get that if they win both the bell appeal and their suit to reduce the waiting time for a gids appointment.

If tavistock fight & lose the bell appeal but don't adopt parental consent, then I expect glp will try to use the courts to force a change of policy. If this ruling didn't exist then presumably the principle would have to be established at the beginning of that litigation, so it's a building block.

Poor Dr cass. The political context for her review keeps on getting more heightened and fraught.

A parent is fundraising to challenge the legality of the wpath standards of care. I don't know how it's getting on or whether realistically that could come to court before the cass review is published.

When adults who transition later regret and detransition, how on Earth can both parents and children be sure they're making the right decisions?