The Thoughtful Therapists' letter to the Lancet, published today

[ChristinaXYZ]

"We believe that using the outdated statistic that 1% of people who transition will regret their decision is highly irresponsible, and lacks the rigour for which the Lancet group of journals is known."

continues ...

twitter.com/ThoughtfulTs/status/1412345354725507078

This is great , a real sign that academia is waking up

About bloody time.

Link to letter:

www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00197-8/fulltext

Editorial that prompted the letters:

www.thelancet.com/pdfs/journals/lanchi/PIIS2352-4642(21)00139-5.pdf

Richard Armitage also has a published letter in response to the editorial and it's excellent:

The Editorial also states that “puberty blockers reduce suicidality.” However, in the systematic review3 cited in support, only one of the nine included studies involving pubertal suppression during adolescence reported suicidality as an outcome measure, specifically among transgender adults aged 18–36 years. In this cross-sectional survey,4 the 89 participants who wanted and received pubertal suppression were compared with the 3405 who wanted but had not received it. The adjusted odds ratio for lifetime suicide ideation was 0·3 (95% CI 0·2–0·6), and no significant difference was found for lifetime suicide attempts (0·7, 0·4–1·0). The study was limited by its non-probability sample design, unmatched controls, online self-reporting method, and inability to determine causation. As such, it is my opinion that this evidence is insufficient to support the Editorial's statement that removing puberty blockers “is to deny life.”
I believe that the Editorial appears to be agenda-driven, ideological, and highly partisan, and contains numerous claims that misrepresent the evidence cited to support them.

www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00192-9/fulltext#%20

I hope the Lancet reconsiders its editorial because the flaws identified are substantial.

The letter linked to in OP:

As a group of psychotherapists working in the area of gender, we have concerns about the arguments and statistics presented in The Lancet Child & Adolescent Health's Editorial.1
We believe that using the outdated statistic that 1% of people who transition will regret their decision is highly irresponsible, and lacks the rigour for which the Lancet group of journals is known. This 1% refers primarily to studies of adults who transitioned in an era when medical transition was only taken under strict protocol.2 We now find ourselves in a markedly different era, characterised by a 1727% rise in the numbers of children seeking to transition,3 and a gender-affirmative approach, which has been adopted almost universally, making the proffered 1% statistic anachronistic.4 We do not believe puberty blockers are a safe and appropriate option, as supported by a blog by Carl Heneghan and Tom Jefferson,5 especially given that the use of this highly experimental treatment path is being reconsidered by progressive countries in Europe. The Karolinska Institute in Sweden, long considered gold-standard in providing transgender health care, no longer uses puberty blockers;6 nor does Finland promote their use.7 Additionally, a judicial review in the UK found puberty blockers to be an inappropriate option for most children younger than 16 years.8
We urge The Lancet Child & Adolescent Health to take this opportunity to engage with this issue, rather than publishing, in our opinion, inaccurate and careless Editorials.
We declare no competing interests.

Thanks for posting OP, very interesting, let's hope sense prevails.

Excellent stuff.

I'm proud to know one of the contributors.

Wow.

The trouble with medicine, if you are driven by ideology, is that it is full of very clever people who will be able to politely, but completely, challenge and refute your evidence.

If you are a medic but have only ever been in an environment where your beliefs have been affirmed and you have not had to hone your critical thinking because of #nodebate, well, you get this.

And I am glad. The stats were debunked years ago, it is amazing to see them in the letters.

If only there was more evidence, we could have a Cochrane review. That would be interesting.

Brilliant to see.
Every time some thoughtful, researched thing like this comes out, it gives permission to speak to the silent majority who have their doubts but want to be kind, to be nice, to not challenge the dominant narrative.
☀️ ☀️ ☀️

If only there was more evidence, we could have a Cochrane review. That would be interesting.

I wonder if the Cass Review will be illuminating as it will, iirc, include an evidence synthesis.

I suspect that The Lancet is happy to print articles that are biased in favour of the US medical system, or is that unfair? Otherwise I just can't see why they would have printed something so obviously flawed. This is, after all, a respected publication.

@EmbarrassingAdmissions thank you for including Richard Armitage's letter - as he points out, The Lancet's editorial just grabbed papers that didn't actually support their claims.

This is the province of quacks hawking fake medicines or creationists bent on disproving evolution, not genuine medicine or science.

In time, I'm sure they will apologize - just as they did over Andrew Wakefield's paper on MMR and autism.

Astonishing that that editorial was published. Full of comments about 'social conservatives' who are 'creating fear' around 'emotive issues'. Comparing those who are concerned about the unnecessary and harmful medication of children to anti-abortionists and opponents of same sex marriage.

It reads more like a twitter rant or a poorly researched blog post than an editorial in a respected journal.

It ends:

Trans youth seek gender-affirming care because they are trans, and they have the same right to health and wellbeing as all humans.

But who are 'trans youth'? What does it mean for a child to 'be' trans? How are they diagnosed?

Good letter. Clear as a bell.

@OldCrone

Astonishing that that editorial was published. Full of comments about 'social conservatives' who are 'creating fear' around 'emotive issues'. Comparing those who are concerned about the unnecessary and harmful medication of children to anti-abortionists and opponents of same sex marriage.

It reads more like a twitter rant or a poorly researched blog post than an editorial in a respected journal.

It ends:

Trans youth seek gender-affirming care because they are trans, and they have the same right to health and wellbeing as all humans.

But who are 'trans youth'? What does it mean for a child to 'be' trans? How are they diagnosed?

It seems the fact that they are trans is presupposed and then thoughtlessly "affirmed" by the professionals who are meant to be reaching their own judgements. Self-ID seems to imply self-diagnosis.

Karen Davies (You're Kiddin', Right) has some firmly strong opinions about Rachel Levine's support for gender affirming healthcare for children.

It seems the fact that they are trans is presupposed and then thoughtlessly "affirmed" by the professionals who are meant to be reaching their own judgements. Self-ID seems to imply self-diagnosis.

But people like the author of that editorial never explain what they mean by a 'trans child', and what makes a child 'trans'. They just insist that 'trans children' are 'trans'. This is not a good basis for having irreversible treatment and becoming a lifelong medical patient.