BMJ investigative report into evidence base for medical advice.

[pantsforteaagain]

This is a commissioned investigative article in a major medical journal and a really clear-eyed look at the (lack of) evidence for transition interventions, plus who is recommending them.
BMJ article

My guess is that individually, they are so invested in something so awful and damaging they just can't allow themselves to see it.

This is where robust research on suicide is needed - not on self-reported suicidal ideation, but on risk of actual death due to gender dysphoria.

Because if you think that the risk factor of not treating is death then you're going to be far, far more tolerant of other risks that fall short of death.

We know, because it's right there on Internet forums, that teens are being coached to threaten suicide to get the treatments they want. We know that parents are being told "better a trans child than a dead child".

I agree.

Yeah but this is fundamentally a belief system that requires faith in the emotionally pleasing created reality, with denial and suppression of unwanted facts, evidence, the wreckage of other people etc etc. Anyone protesting this gets screamed at for heresy.

All of this is at root based in a belief that T trumps everything and everything must give way before it. Women, child safeguarding, equality, religious tolerance, equality of access, ethics, medical ethics, standard practice, policy, procedure, human rights, everything.

It is a faith that demand that good people will place their hands on their hearts and swear none of this exists, and that saying it does makes you a Bad Person.

So writing these papers going... hang on a minute, this doesn't hang together? Yeah we know. We all know. But it's rather like saying to someone "Yes yes, obviously I absolutely accept you are definitely Napoleon, but setting that aside.... what do you think about global warming?' Why would you accept that they have decided it is ok to live in a personal, alternative reality and dismiss actual fact as 'hate' but expect them to still make sense on other matters?

It's what I shall in essence be saying to all the political parties knocking on the door. What's a women. Because waffle a lot of confused bullshit on that, and I will have to predict that the party is incapable of a grip on reality or sense in all other matters too.

Until this is addressed, it's pointless gathering up all the Everest high pile of evidence that all says, er, bit of a big problem here guys. Because it keeps piling up. We all keep looking at it. And then we all carry on.

I think it's so slow because of the context.

The thalidomide scandal arose because the effects were so obvious and so widespread, and even then it was prescribed in the UK for 4 years before being banned.

The opioid crisis in the US has been noticed because people were dying and also, I think, because it was linked in many people's minds with drugs like heroin. Despite starting in the 1990s and despite multi billion dollar lawsuits against pharmaceutical companies, the crisis still continues.

The puberty blocker / cross-sex hormone / surgery scandal has not yet had sufficiently obvious and widespread effects. Plus the influence of people and organisations keen to suppress any knowledge of such effects for ideological reasons.

I tend to think that the kind of belief structures we've taught people in places like schools, since about the 90s, have created a situation where they are very vulnerable to this kind of belief system. They are totally unable to asess anything that is attached to social justice ideals or marginalized groups with any kind of intellectual rigor. They must believe, because they have been told by those with lived experience, that transpeople are a real inherent category of people in a material sense, and they must be accepted and affirmed and fought for.

It's like was mentioned in the thread about Canada - the whole focus of our education system seems to be on identifying these small groups and accepting a very particular narrative about them. Even members of those groups, if they dispute the narrative, are ignored or worse. The whole idea of bringing reason into the discussion, or any critique, is seen as immoral and oppressive.

People who learned this way are now adults and cannot bear to see themselves in that light. Even scientists.

I miss this one! I shall add it to the Break it Down for me thread. But what a shame I missed it as it would have been a great addition to this post on how the Dutch Protocol is being heavily questioned.

04/01/2023 07:05

www.mumsnet.com/talk/womens_rights/3145470-Break-it-down-for-me?page=37&reply=124158738

It must have been some coordination surely with Colin Wright and Stella O'Malley knowing that this paper was also coming out at the same time.

ooops. "missed this one"

I am reading this now OP.

There already seems a bias from the reporter. This is not symmetrical.

"The discourse is polarised in the US. Conservative politicians, pundits, and social media influencers accuse providers of pushing “gender ideology” and even “child abuse,” lobbying for laws banning medical transition for minors. Progressives argue that denying access to care is a transphobic violation of human rights."

No mention of the highly emotionally manipulative phrases repeated to support this experimental medical treatments. I wonder if the reporter wrote something and it was edited out, or what?

All of this is at root based in a belief that T trumps everything and everything must give way before it. Women, child safeguarding, equality, religious tolerance, equality of access, ethics, medical ethics, standard practice, policy, procedure, human rights, everything.

Absolutely this!

The article says 2 recent studies show that 20-30% of those who start hormone treatment stop within a few years. So much for the claims that detransition is rare - that's at least 1 in 5!

The situation in the US is made more complicated by the extremely polarised political climate and the rigid two-party system which in practice means that many states really are single-party states.

Because it is Republican states which are making laws against childhood transitioning, being opposed to the gender identity ideology is viewed as being a completely Republican policy (like banning abortion), so Democrats refuse to even contemplate the possibility that there are flaws in the gender affirmation policies.

Biden refuses, too, and so do all progressive politicians. But there are now increasing numbers of ordinary Democrats (women, in particular) who disagree with the forced silence on them. The situation in the US is probably five to seven years behind the UK situation, assuming the same trends would apply.

But what I have heard through the grapevine is that most progressive journalists in the US are still completely on the gender identity side and most of them have done zero research on any of the inconvenient aspects of their belief system.

That makes sense, nepeta. My TWAW sister lives just outside Portland, OR and sees all of this through the Dems v GOP lens. The fact that so many (il)liberal left journalists think that applying normal standards of scepticism and fact-checking on this particular issue is "transphobic" means that she doesn't hear any of this stuff from news sources that she trusts. I do my best to chip away at the nonsense, but apparently "sound like Trump" despite being on the left myself. (Sadly, a similar thing happens when it comes to race, too - she's far more Robin D'Angelo than John McWhorter, which I find somewhat bizarre, especially given their own racial identities, but that's very off-topic.)

Oops, *DiAngelo. Not sure if that was autocarrot or if my fingers need to go on a diet....

The situation in the US is made more complicated by the extremely polarised political climate and the rigid two-party system which in practice means that many states really are single-party states.

One of the things Biggs has said in the latest sex matters webinar on this is that many drs in red states may file under precocious puberty on insurance papers, which I hadn't realised before. Which demonstrates the polarisation, inability to track numbers and how fucked up the system is.

I've experienced the same nepta.

The whistle blower Jamie Reed is important I feel as she has a transman as a partner and so ticks all the progressive boxes. And yet is saying, hang the fuck on what are we doing here?

It’s all so sad

From the BMJ article:

The Endocrine Society acknowledges in its recommendations on early puberty suppression that it is placing “a high value on avoiding an unsatisfactory physical outcome when secondary sex characteristics have become manifest and irreversible, a higher value on psychological well-being, and a lower value on avoiding potential harm."

FFS! "and a lower value on avoiding potential harm" - in plain sight!

Canada starting to query? I'm not sure of the source

nationalpost.com/opinion/whistleblower-accounts-raise-new-alarms-on-youth-transgender-clinics

*”Reed alleges that young patients often had little understanding of the potential side effects of medical transition, including sterilization. “After working at the centre, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor,” she wrote.

Allegedly, the clinic deliberately played down the negative consequences of medical transition, further undermining informed consent. When patients later regretted their transitions, doctors simply abandoned them and refused to gather data on their experiences.”*

Wow, doesn’t this all sound familiar.

I’ve seen statements from TRAs along the lines of “there is no evidence of significant regret or a large percentage of detransitioners.” I see it on countless twatter posts and as ‘rebuttals’ on this board.

Well there never will be, when it’s not in the interests of clinicians to gather data on the long term results of their butchery and the numbers of their ex patients who go on to express regret.

When clinicians have refused to gather, or have tried to ‘massage’ stats on other procedures in the past then it’s never been because they’ve wanted to be modest about their awesome success.

How does the narcissists' prayer go again?

That didn't happen.
And if it did it wasn't that bad.
And it was, then it wasn't my fault.
And if it was, then I didn't mean it.
And if I did, you deserved it.

The effects of these drugs have been widely known by clinicians for decades, bearing in mind they were actually used to chemically castrate males as a main outcome.

How anyone, and I mean, anyone, could write a prescription for these to teens is so far beyond belief it is difficult to imagine.

One recent article states that regret seems to happen fairly late (7-10 years after start of transitioning seems to be quite common), and there is a scarcity of studies that would have data for such a long follow-up. Also, many who detransition drop out of the sampling frames studies might use (stop going to the doctors they had for transitioning, change their names again etc.), so it's difficult to get a representative sample for studies of regret.

“When patients later regretted their transitions, doctors simply abandoned them and refused to gather data on their experiences.”

That’s more of a proactive approach to avoiding data gathering than you’re suggesting. In the article it talks about patients expressing regret within 12 months.

When you have over a third of your patients presenting with autism, and some self-diagnosing with all sorts of conditions (which the clinicians have to acknowledge aren’t based in reality), the sensible approach is NOT to start on a regimen of ‘care’ which, depending if blockers are prescribed, may lead to sterility, bone degradation, developmental delays and stunted genitalia. Not to mention the amputation of healthy tissue and potential long term post surgical complications.

But to do all that AND to then plug your ears and turn your back on your former patients if they express regret..? IMO that’s criminal (or should be).

As a clinical nurse specialist for the last 20 years of my career, it’s the lack of audit and research by the Tavistock that amazes me most. Every year I was expected to audit my service and write an annual report, looking at the numbers of patients, their age, sex, diagnoses, treatments, outcomes, survival from diagnosis to death… everything I could cram in there, really.

So it is quite staggering to me that they were allowed to just carry on, doing their experimental thing, everyone treated with puberty blockers and cross-sex hormones regardless of any other problems, year after year after year. Research and audit are baked in to most NHS services these days, it’s a pain, I always had to do the stats and writing up in my own time, but if I hadn’t bothered to do it at all I’d have lost my job, it was a REQUIREMENT.