The judgment in Keira Bell's case will be given tomorrow

[MaudTheInvincible]

The judgment of the Tavistock's appeal of the case will be given at 2pm.

www.gov.uk/government/publications/royal-courts-of-justice-cause-list/royal-courts-of-justice-daily-cause-list

Brave Keira. You have done so much to protect children from ideologically driven healthcare around the world. Your integrity and courage is inspiring and rare in this ridiculous day and age. 💚🤍💜

It's so obvious that a child can't (or shouldn't) fully understand the implications of loss of sexual function and loss of fertility during adulthood.

I'd like to see Maugham (or anyone) explain how they think a child can understand these things.

@OldCrone

It's so obvious that a child can't (or shouldn't) fully understand the implications of loss of sexual function and loss of fertility during adulthood.

I'd like to see Maugham (or anyone) explain how they think a child can understand these things.

He blocks anyone who asks. I'm sure he has an excellent answer though

Is this a new theory?

yeah - there was an organisation set up to look for an ideal candidate and Keira was it. The organisation disappeared shortly after but she spent several months in a relationship with one of the founders who also dropped her once the court case was over...it's all a bit shit.

twitter.com/ChickenEclectic/status/1438872495768080392?s=20

Does he mean he'll pursue the production of a NICE guideline? That's the only effective external pressure for a clinical decision I can imagine.

Sorry, I'm staying off twitter atm so I don't know any of the ongoing story - just on this thread.

[quote Alekto]Is this a new theory?

yeah - there was an organisation set up to look for an ideal candidate and Keira was it. The organisation disappeared shortly after but she spent several months in a relationship with one of the founders who also dropped her once the court case was over...it's all a bit shit.

twitter.com/ChickenEclectic/status/1438872495768080392?s=20[/quote]
I don't know what the 'organisation' is that they're referring to. I presume it 'disappeared' because it never actually existed in the first place.

The original court action was started by Susan Evans, who used to work at the Tavistock as a psychotherapist, and Mrs A, the mother of a teenage girl who was in danger of being given this treatment. Keira Bell joined them a couple of months later and Susan Evans stepped down as a claimant.

If you search for Susan Evans on the crowdjustice site ('Legal case to protect children from experimental medical treatment') you can see the details.

@oldcrane there's a very funny exchange of comments on that Twitter feed from someone making the claim that 'GC's' found someone for this case, someone asking to know what their evidence is and receiving this reply back -

'find it yourself - I don't deny the organisation folding once they found Keira could be a coincidence as could her being lovebombed and dropped...if it's a conspiracy theory it's a better one than there being a trans cabal run by big pharma.'

So many things to unpick....

Yes Waitwhat23 I thought it was a very odd part of the thread too (although I think the OP of the thread writes for prick news, so odd is only to be expected). I'd never heard the claim that Keira was recruited for the court case then dumped (!?) before.

@NotBadConsidering

In between the original ruling in December and the announcement of this appeal ruling we have had the following:

1. the Tavistock staff published their findings on impact of puberty blockers on mental health. They told the original judges the research wasn’t ready, then published it online just a few days after the ruling . It has then gone to print. The paper shows that puberty blockers bring no overall improvement in psychological functioning.

2. NICE published its review into the evidence for both puberty blockers and cross sex hormones and found the evidence to be lacking or poor quality.

3. Sonia Appleby won her case highlighting problems with safeguarding at the Tavistock.

4. the facts in the original ruling came to light, despite the ongoing attempts to deny them. Children all progress from PBs to CSH, they will be infertile, they will have significantly impaired sexual function, they will have reduced bone density, they will suffer from a myriad of other side effects both known and unknown. This appeal result doesn’t change these facts.

What this successful appeal means is that the clinicians commencing puberty blockers for children are doing so in full knowledge that there is no evidence for such practice, evidence in fact that these children’s mental health will not improve and in acknowledgment that they are committing children to a pathway of significant medicalisation and iatrogenic disease. The onus to justify this is back on them.

Only a fool of a doctor would continue on such a path.

Yes. Having to go to court to get permission to give puberty blockers absolved the clinician of responsibility. Now they lay themselves open to law suits. And against the backdrop of an experimental treatment with known deleterious effects and no evidence for any benefits - it’s a brave doctor that prescribes them.

NRTFT so apologies if this is already well covered but the BBC don’t seem to be reporting the issues around this judgment carefully or objectively enough.

www.bbc.co.uk/news/health-51034461
BBC News: ‘Keira Bell case : What are puberty blockers?’
‘Clinicians can judge whether under-16s can give informed consent to take puberty blockers, the Court of Appeal has ruled.
The ruling followed an appeal brought by the Tavistock Trust, which runs the UK's only youth gender identity clinic.
What are puberty blockers?
Puberty blockers are drugs used to "pause" puberty by suppressing the release of hormones.
The hormones act as messengers telling the body to develop things such as breasts, periods, facial hair or a deeper voice.
Puberty blockers are prescribed to some children who are experiencing gender dysphoria, to temporarily stop their bodies developing.
The NHS describes gender dysphoria as "a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity".
The drugs are also used to treat conditions which cause premature puberty in much younger children.

Why are they used?
The Tavistock's Gender Identity Development Service (Gids) says pausing puberty can give a young person more time to consider their options, without the additional distress of unwanted changes in their body.
By pausing the development of breasts, for example, someone who goes on to have cross-sex hormone therapy may be able to avoid having them removed later on.‘

This BBC News explainer page, which says it has already been up since 1 day ago, repeatedly defines puberty blockers as a ‘pause’. Not acceptable. The Health Research Authority recommended the Tavi not to use that phrase/concept any longer in their letter of response after the HRA investigated after the initial BBC Newsnight investigation into the Tavi. HRA said:
‘Researchers and clinical staff working in gender identity development should consider carefully the terms that they use in describing treatments e.g. avoid referring to puberty suppression as providing a ‘breathing space’, to avoid risk of misunderstanding.’
www.hra.nhs.uk/about-us/governance/feedback-raising-concerns/investigation-study-early-pubertal-suppression-carefully-selected-group-adolescents-gender-identity-disorders/

BBC journalists Deborah Cohen and Hannah Barnes at BBC Newsnight deserve an honourable mention on this thread for that investigation and for their follow up reports for bringing this area of paediatric ‘care’ to the BBC News agenda.

The BBC news website content will be produced by a different set of writers but this is a really shoddy bit of work making it look unfortunately like some very non-objective reference points or sources have been used. It would also be good if the BBC could update their editorial guidelines so this specific point is are actually changed to recommend that all BBC staff avoid using misleading concepts like ‘pause’ or ‘breathing space’, in line with relevant authorities’ views and the NHS who themselves no longer use it.
www.bbc.co.uk/contact/complaints

The NHS web content on this, which the BBC explainer references, says:
‘ Puberty blockers and cross-sex hormones
Puberty blockers (gonadotrophin-releasing hormone analogues) pause the physical changes of puberty, such as breast development or facial hair.
Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.
Although GIDS advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be.
It's also not known whether hormone blockers affect the development of the teenage brain or children's bones. Side effects may also include hot flushes, fatigue and mood alterations.’
www.nhs.uk/conditions/gender-dysphoria/treatment/

I may be wrong, but from memory the NHS webpages previously did use ‘pause’ too and the NHS removed it after this issue had been brought to light by Newsnight. Happy to be corrected on veracity and timing but IIRC we had threads on this issue and then the eventual update to the NHS website.

I also think it’s misleading for that BBC explainer to reference the temporary use of PBs for the medical condition of premature puberty. Blockers are then stopped to allow natural puberty to happen at the earliest end of the normal age range in which puberty would typically happen. The BBC should be pointing out that that is an extremely different treatment intent and usage to use the PBs for years to completely stop natural puberty from ever happening. Which is what can happen here. Giving PBs for gender dysphoria is a medical response to an emotional issue. This is highly contested, seeing that 80% of kids will desist from the dysphoria after natural puberty takes its course. The risks and effects of suppressing puberty entirely long term are not properly evidenced so that’s going to leave a large proportion of children who would have changed their minds emotionally if allowed to have normal puberty, who won’t have that opportunity

The BBC News explainer article also says:
‘It has also been claimed puberty blockers may effect someone's fertility and sexual functioning, but evidence around this is also limited.
Children with gender dysphoria not taking puberty blockers are thought to experience increases in suicidal thoughts over time.‘

Surely any suicidality claim should be referenced, on principle? The BBC does have guidance on how to report around suicide. And why is the fertility/sexual functioning point apparently just a ‘claim’, noted to be evidence-limited, when the suicidality point is not treated equally as a ‘claim’. Surely it’s not just a claim that if you don’t go through any puberty, your sexual function and fertility will be ‘affected’. By definition, you won’t grow to normal adult full post-pubertal sexual maturity. Because no puberty.

It has also been claimed puberty blockers may effect someone's fertility and sexual functioning, but evidence around this is also limited.

For a start, presumably they mean "affect" not "effect", otherwise that's quite a nonsensical statement.
And yes it seems an odd thing to caveat like that! I guess they want as few people as possible to notice that they're sterilising these kids because they don't conform.

That’s really poor from the BBC. Complaint-worthy, even.

If you prevent someone from going through puberty, which is the process by which a child reaches sexual maturity, then obviously they will not be fertile! What the blinking hell do they think is happening, if not that?!

Are they suggesting that the evidence that puberty blockers block puberty is weak? I thought that was a given.

I guess what they're trying to say is about the claimed 'reversibility'. What happens if you just stop taking them at 18, and don't proceed to cross-sex hormones?

Do you get a very late puberty that gives you sexual function? If any child has ever done this, I've never seen any medical report, so it seems basically no-one knows. (For either sex)

I am autistic, I had no sexual feelings AT ALL until about the age of 18. Even then I was very limited. I didn't feel attracted to anyone. I wouldn't say I reached sexual maturity until my mid-twenties. My son is also on the spectrum and is still like a young boy at 14. I just feel that much of this represents another stage in the misdiagnosis and maltreatment of autistic people, which historically has been awful.

@Sophoclesthefox

That’s really poor from the BBC. Complaint-worthy, even.

If you prevent someone from going through puberty, which is the process by which a child reaches sexual maturity, then obviously they will not be fertile! What the blinking hell do they think is happening, if not that?!

Presumably they're referring to what happens if people take them for a bit then come off them.

I guess what they're trying to say is about the claimed 'reversibility'. What happens if you just stop taking them at 18, and don't proceed to cross-sex hormones?

I would be pretty confident that an 18 year old who hadn’t progressed to CSH and still had their gonads would then go through puberty. It would not happen immediately and could take a bit of time. It may need to be kickstarted with oestrogen for females or testosterone for males, as happens with delayed puberty. I would be reasonably confident of this until around 20 maybe. After 20 it becomes less clear. We know from the damage done to gymnasts by intensive training that puberty can progress in the early 20s. But that is not the same as it being drug suppressed. I don’t know if anyone knows and I’ve never been able to get an answer. Remember the same people giving puberty blockers have decided it is ethical to continue them perpetually keeping someone in a “non-binary” state , which actually means forever pre-pubertal. There must be a point at which the hypothalamus just gives up but I don’t think anyone knows for sure. I think it’s extremely unlikely that natural puberty can just kick in whenever puberty blockers are removed, even if that’s at 25 or 30.

Just chalk it up on the long list of parts of this process that are completely unknown and experimental.

Why are you confident that someone who has been on PB since 10 would enter puberty if they were stopped at 18?

Weren't most of the gymnasts who were put on puberty blockers girls? I'm pretty sure that boys external genitals develop at a much younger age than 18. The effects of puberty blockers on boys is likely to be different and drastic.

Why are you confident that someone who has been on PB since 10 would enter puberty if they were stopped at 18?

Because 18 is still an age that puberty can start at the extremes of normal and with a bit of help for those who have delayed puberty. So I think the body is still capable of it potentially. Not 100% certain though.

Weren't most of the gymnasts who were put on puberty blockers girls? I'm pretty sure that boys external genitals develop at a much younger age than 18. The effects of puberty blockers on boys is likely to be different and drastic

I’m not talking about the Eastern European gymnasts who were mistreated with drugs, I was more thinking of those whose bodies were just under too much stress, it’s discussed in Athlete A.

None of this is guaranteed. I just think that even if puberty blockers have been going for 5-6 years these kids still have a chance. But I don’t think anyone knows, and I would also be confident that the window of salvation or a normal adult body isn’t open forever.

Puberty can naturally start at 18 at extremes but for those on PB it is not natural and they had already started puberty when they started on PB so it could be they have passed through their natural 'puberty window'. We just don't know. But it is irrelevant when PB are not an isolated treatment but just the first step on a treatment process that includes cross sex hormone treatment.

The effects of puberty blockers on boys is likely to be different and drastic.
Yeah, from what I can tell a boy might end up with a functioning micropenis, but then from what we know about testicles giving up producing testosterone in bodybuilders who use artificial sources of testosterone (and who need to do post-cycle drugs to kick start their own testosterone production) even that is not a given.

Psychologically though, after being put on blockers, not developing along with peers, possibly having homophobic parents and generally having the pressure of being the "brave trans kid" I think it's highly unlikely many children on these drugs will stop before cross sex hormones anyway so it could be that there's nobody to even study.
Didn't the Tavistock figures show one child who didn't go on to cross sex hormones? I assume we won't ever know what happened there.

But it is irrelevant when PB are not an isolated treatment but just the first step on a treatment process that includes cross sex hormone treatment.

Absolutely. All we are discussing is the potential to rescue kids from this pathway, if they can be convinced, their parents can be convinced, and there are doctors willing to allow it 😞.

Scarpa I feel your concerns about a possible threat to girls being able to access contraception, but I have to say, that connection between puberty blockers and contraception has been made by Jolyon Maugham and others who hated the original judgement. I don’t know if Keira’s lawyer saying the Appeal Court ruling calls Gillick competence into question means that people's suspicions about him were right or not. I think we have to see if the lawyer keeps the focus on the case in question or whether they (like Maugham) are acting as a legal activist on their own account, and whether they are in fact a right wing Christian plant, or just a lawyer who acts for different clients including ones we don’t like.

You also said a while back that contraception has been accessible for a while and that there have never been calls for the sexual age of consent to be lowered, there have in fact been repeated calls, see this slightly random selection from google: 2013 www.bbc.com/news/health-24976929

2014 www.theguardian.com/commentisfree/video/2014/jan/14/should-legal-age-of-consent-be-lowered-video-debate

1979 (feel this one needs a trigger warning) www.theguardian.com/uk-news/2014/jul/08/lower-age-consent-14-1979-home-office-report
And organisations like UNICEF and UNFPA continue to discuss the link between age of sexual consent and age of access to services like contraception and HIV testing.

This now feels like a slight derail but I suppose I am making two points relevant to the thread (1) Keira Bell did not put the question of contraception on the table, that came from people who wanted to delegitimise her and (2) most adults, including me, need to keep questioning whether their approach is centred around the young person, and acknowledge that every service, whether contraception, puberty blockers or HIV testing, is a different intervention and you cannot easily treat any one service as an analogy to decide what to do about the others.

Excellent points IceFisher

Analogies are useful, as long as they're intelligent, and look at the underlying principles. It's useful to check for consistency.

The problem is that we tend to get statements so dumb, they can barely even be described as analogies.

My 'favourite', if that's the word, is "some people used to say X was bad, which we no longer believe, so those people saying Y is bad are also going to turn out to be wrong".

Even if you grant that the current view on X is correct, that's a total non-argument, if X and Y are not related, and it's different people making the claim.

It gets a bit stronger, if X and Y have some similarities and/or it's the same people.

Hence the repeated attempts to associate gay+gender, and to make out that gender dissidents are religious conservatives.

Still fundamentally dumb, because it's not addressing the real issue. Good analogies sharpen the arguments and help establish underlying principles. This is just an 'ad hominem by analogy' attack.