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Feminism: Sex and gender discussions

Sweden strongly urging caution re: medicalisation of under 18s

24 replies

DoubleTweenQueen · 23/02/2022 11:12

Apologies if not new news, but new to me:
threadreaderapp.com/thread/1496221729055727625.html

"treatment should be
offered only in exceptional cases outside the
framework of research"

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Hoardasurass · 23/02/2022 11:29

Good. I hope that this will put more pressure on the cass review and help kiera bell in her appeal

DomesticatedZombie · 23/02/2022 12:00

Good to hear Sweden taking steps to protect children/yp.

I believe they were one country that enthusiastically embraced the affirmation approach, perhaps earlier than most?

DomesticatedZombie · 23/02/2022 12:02

'a risk that the treatment has led to poorer health or quality of life'

No shit.

Doubletoilandtrouble · 23/02/2022 12:12

They were in there very early, affirmation, hormones, the lot. Children got damaged, including so frail bones that the spine fractured on a poor FTM child who I believe now have reverted to female - but with a ruined body due to severe osteoporosis.

The main hospital (Karolinska) persecuted a whistleblower, denied wrongdoing and finally the different departments starting to blame each other. They got caught out by a TV documentary and then changed their tune whereas other hospitals happily kept going.

The damage to children can be enormous.

DoubleTweenQueen · 23/02/2022 12:18

I expect, and will look out, for the translation of the full report, and link when available.

Yes, good news. Along with Finland, tide turning.

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MarshmallowSwede · 23/02/2022 12:36

Yes it has been a great scandal in Sweden. A huge issue around safeguarding and legal action will take place. I think this is only the beginning and I can see many more ppl who were part of this being prosecuted.

DoubleTweenQueen · 23/02/2022 12:52

Yes - I remember the documentary centred on the Karolinska, not too long ago? I could find it........
www.dailymotion.com/video/x770h8o from 2019. You can decline all cookies - opens in a separate window. There is at least one other doc, can’t put finger on at present.

Piece in The Graun, from 2020:
www.theguardian.com/society/2020/feb/22/ssweden-teenage-transgender-row-dysphoria-diagnoses-soar

This, from Karolinska Institute, last May:
segm.org/Sweden_ends_use_of_Dutch_protocol

This may be the Board of Health report in Swedish? :D
www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2022-2-7774.pdf

I have ’translated’ some headline recommendations:

  1. Treatment with GnRH analogue for adolescents with gender incongruence should be provided within the framework of research. Until a research study is in place, the National Board of Health and Welfare's assessment is that treatment with GnRH analogue can be given in exceptional cases, in accordance with the knowledge support's updated recommendations and criteria.

  2. Gender-confirming hormone therapy with testosterone or estrogen for adolescents with gender incongruence should be provided as part of research. Until a research study is in place, the National Board of Health and Welfare's assessment is that gender-confirming hormone treatment can be given in exceptional cases, in accordance with the knowledge support's updated recommendations and criteria.

So caution on all fronts. I could probably do all of it but don’t have time right now!
Also, decision to treat will be patient-centred multidisciplinary team discussion, including psychologists, endocrinologists, parents/guardians (minors).

Star
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DoubleTweenQueen · 23/02/2022 12:59

Demonstrates quite starkly, how the GRA petition debate on Monday was so out of date and way off where we should be aiming, for children and young people certainly.

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DoubleTweenQueen · 23/02/2022 13:00

Am now considering emigration.

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DoubleTweenQueen · 23/02/2022 14:02

Further excerpts from the report:

The investigation teams often see a need to initially offer support interventions with psychopedagogical elements that not only concern gender identity but identity development more generally.
The content of the interventions and the forms of how the support is provided are individually adapted. The purpose of the efforts is both to provide a safe and validating context, and to provide information that can contribute to the person gaining increased knowledge and understanding of their own situation and how they can handle it.

Recommendations:

The health service should offer psychopedagogical interventions, support and counseling to guardians of children and young people who are enrolled in care due to signs of gender incongruence or gender dysphoria.

The health service should offer psychopedagogical interventions, support and counseling to relatives and close relatives of children and young people who are enrolled in care due to signs of gender incongruence or gender dysphoria.

The health service should, in order to prevent and reduce the problems that young people with signs of gender incongruence or gender dysphoria themselves see in relation to the condition in their everyday lives, assist the child or young person in contacts with the social functions involved, such as school and social services.

The health service should carry out the psychological, psychosocial and psychiatric parts of the investigation of gender incongruence with the help of valid investigative methods, investigative conversations and biographies obtained from the child or young person and from the guardian.

The health service should, during the investigation of gender incongruence in children and young people, offer psychosocial support for an unconditional exploration of gender identity.

The health service should - before or at an early stage of the investigation of gender incongruence - for all children and young people systematically examine whether there are signs of AST and ADHD / ADD. In case of signs of AST, neuropsychiatric investigation should be initiated in connection.

Healthcare should
• before or at an early stage of the investigation of gender incongruence, for all children and young people to systematically identify and assess any simultaneous psychiatric problems.
• during the investigation of gender incongruence in children and adolescents, offer psychosocial support and psychiatric treatment to reduce any psychiatric problems.

The health service should at an early stage of the investigation of gender confusion assess the child's or young person's psychosocial situation, including strengths and weaknesses in the family's functioning, the child's or young person's support from the guardians, school situation and peer relationships.

During the investigation of gender incongruence, the health service should pay attention to whether children and young people can take advantage of the psychosocial support offered by the investigative team, and whether they feel that the support is sufficient. If necessary, the health service should offer the child or young person a suitable support or treatment contact outside the investigation team.

During the investigation of gender incongruence, the health service should consider, and if necessary examine, psychological dimensions such as the cognitive, emotional and social ability of the child or young person.

The health service should offer counseling and support to children and young people with gender incongruence or gender dysphoria who are considering social transition or who have already begun to live in accordance with their gender identity in social contexts.

The health service should, at the earliest in the case of a preliminary diagnosis of gender dysphoria and after individual assessment, offer aids in order to make it easier for young people to be able to live in the social role that corresponds to their gender identity.

Treatment with GnRH analogue for adolescents with gender incongruence should be provided within the framework of research. Until a research study is in place, the National Board of Health and Welfare's assessment is that treatment with GnRH analogue can be given in exceptional cases, in accordance with the knowledge support's updated recommendations and criteria.

Gender-confirming hormone therapy with testosterone or estrogen for adolescents with gender incongruence should be provided as part of research. Until a research study is in place, the National Board of Health and Welfare's assessment is that gender-confirming hormone treatment can be given in exceptional cases, in accordance with the knowledge support's updated recommendations and criteria.

There are 122 cited references.

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WarriorN · 23/02/2022 15:49

Thank you for this.

I wonder if the Cass review is taking note?

Pixiedust1234 · 23/02/2022 15:53

Peacemaking so I can comeback later to read properly.

Always thought Sweden was one of the first countries to embrace this so its really good news they are backtracking

DoubleTweenQueen · 23/02/2022 17:03

@WarriorN

Thank you for this.

I wonder if the Cass review is taking note?

I’ve passed on, and plan to distribute widely, although think SEGM will translate it fully and more efficiently asap.
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Goatsaregreat · 23/02/2022 17:26

How amazing to see the welfare and needs of children prioritised by a country and health service. How unlike our own dear NHS where the adult males (and the occasional woman) running the lobby groups are feted and indulged by the NHS with children's health and long term welfare taking second place to ideological demands of these people.

MangyInseam · 23/02/2022 17:37

The health service should, at the earliest in the case of a preliminary diagnosis of gender dysphoria and after individual assessment, offer aids in order to make it easier for young people to be able to live in the social role that corresponds to their gender identity.

I find the fact that this sort of recommendation is being made rather concerning. It's a step up from medicalization, but as far as I am concerned it isn't evidence based.

And people seem to assume it's neutral, and I strongly suspect that it isn't - that for a lot of these kids it's absolutely destabilizing.

DoubleTweenQueen · 23/02/2022 18:10

@MangyInseam

The health service should, at the earliest in the case of a preliminary diagnosis of gender dysphoria and after individual assessment, offer aids in order to make it easier for young people to be able to live in the social role that corresponds to their gender identity.

I find the fact that this sort of recommendation is being made rather concerning. It's a step up from medicalization, but as far as I am concerned it isn't evidence based.

And people seem to assume it's neutral, and I strongly suspect that it isn't - that for a lot of these kids it's absolutely destabilizing.

That’s the headline, and possibly not best translation so I await detail on that!
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WarriorN · 23/02/2022 20:36

Thank you @DoubleTweenQueen. Do you really think they may not have known about it?

I am rather loosing faith in those who run society as I get older!

WarriorN · 23/02/2022 20:41

The health service should, at the earliest in the case of a preliminary diagnosis of gender dysphoria and after individual assessment, offer aids in order to make it easier for young people to be able to live in the social role that corresponds to their gender identity

Based on personal experiences with a child who was gender confused many years ago, (and only that, this is just my feeling) I suspect that exploring the stereotypes is reasonably harmless but official changes to name and pronouns may be more problematic.

DoubleTweenQueen · 23/02/2022 22:11

Yes - the translation may not be very accurate - bit of a rush job - so will wait and see.
This revised approach seems to be far more sensible and measured than many other countries are following - US, Canada - or seeking to follow - Scotland, Germany, and pressure in rest of UK.
Sweden’s traditionally been a liberal benchmark, so this recognition of the dramatic change in patient cohort structure and size, acknowledgement of de-transitioners, and their desire to take a number of steps back to this renewed level of caution is really important and I hope will be taken notice of world-wide - wonder what WPATH will have to say.
This is the Swedish Board of Health press release:
www-socialstyrelsen-se.translate.goog/om-socialstyrelsen/pressrum/press/uppdaterade-rekommendationer-for-hormonbehandling-vid-konsdysfori-hos-unga/?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en&_x_tr_pto=wapp&fbclid=IwAR3lK8s7Y0WWeP8c2uwLJ5tgj8riiFp1rItRpFGrU_Dyqw4IvyZGs9pl2b4

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DoubleTweenQueen · 23/02/2022 22:34

@WarriorN

Thank you *@DoubleTweenQueen*. Do you really think they may not have known about it?

I am rather loosing faith in those who run society as I get older!

Apologies - not sure of your question? But if it’s to do with Cass review knowing about the Swedish report, it’s only just been released and they may or may not have known to expect it, or had prior info.

Would be negligent to not take it into account.
Keep hopeful x

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Monitaurus · 24/02/2022 02:59

Meanwhile in Texas the attourney general is causing outrage by calling interventions with tg youth, child abuse. ( from the Guardian 24/2...sorry can’t link) Good for him)

WarriorN · 24/02/2022 06:13

Yes that's what I mean - I'd really hope that Cass is taking in global information on this. Especially as Sweden was one of the "fore runners."

DoubleTweenQueen · 24/02/2022 06:57

Well I'm going to do my best to make significant people know about it - but see SEGM and other well-respected professional groups are on it.
And the more parents are aware, the more pushback we can create when talking to schools and other agencies we deal with in respect to the young people in our care.

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WarriorN · 24/02/2022 07:52

Thank you very much for doing so; you really never know. Any possible gap in information needs to be plugged.

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