'Youth Gender Transition Is Pushed Without Evidence' - joint letter from paediatricians in the wall street journal

[ArabeIIaScott]

This seems rather big news.

https://www.wsj.com/articles/trans-gender-affirming-care-transition-hormone-surgery-evidence-c1961e27

As it's paywalled, here's a thread:

https://threadreaderapp.com/thread/1679603669010989057.html

'21 leading experts on pediatric gender medicine from 8 countries have written a Letter to the Editor of @WSJopinion expressing disagreement with the @TheEndoSociety and its new president @StephenHammes over the treatment of youth gender dysphoria.

This is huge. 🧵 Although they have commented on the problems of the American "affirming" model in the past (e.g., Cass Report), this is the first time international experts have publicly weighed in on the American debate over "gender-affirming care."
Among the intl' experts is Dr. Riita Kaltiala, chief psychiatrist at Tampere University gender clinic, author of numerous peer-reviewed articles on trans medicine, and Finland's top authority on pediatric gender care. '

The letter in full:

*As experienced professionals involved in direct care for the rapidly growing numbers of gender-diverse youth, the evaluation of medical evidence or both, we were surprised by the Endocrine Society’s claims about the state of evidence for gender-affirming care for youth (Letters, July 5). Stephen Hammes, president of the Endocrine Society, writes, “More than 2,000 studies published since 1975 form a clear picture: Gender-affirming care improves the well-being of transgender and gender-diverse people and reduces the risk of suicide.” This claim is not supported by the best available evidence.
Every systematic review of evidence to date, including one published in the Journal of the Endocrine Society, has found the evidence for mental-health benefits of hormonal interventions for minors to be of low or very low certainty. By contrast, the risks are significant and include sterility, lifelong dependence on medication and the anguish of regret. For this reason, more and more European countries and international professional organizations now recommend psychotherapy rather than hormones and surgeries as the first line of treatment for gender-dysphoric youth.
Dr. Hammes’s claim that gender transition reduces suicides is contradicted by every systematic review, including the review published by the Endocrine Society, which states, “We could not draw any conclusions about death by suicide.” There is no reliable evidence to suggest that hormonal transition is an effective suicide-prevention measure.
The politicization of transgender healthcare in the U.S. is unfortunate. The way to combat it is for medical societies to align their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks.

This letter is signed by 21 clinicians and researchers from nine countries.

FINLAND
Prof. Riittakerttu Kaltiala, M.D., Ph.D.
Tampere University
Laura Takala, M.D., Ph.D.
Chief Psychiatrist, Alkupsykiatria Clinic
UNITED KINGDOM
Prof. Richard Byng, M.B.B.Ch., Ph.D.
University of Plymouth
Anna Hutchinson, D.Clin.Psych.
Clinical psychologist, The Integrated Psychology Clinic
Anastassis Spiliadis, Ph.D.(c)
Director, ICF Consultations
SWEDEN
Angela Sämfjord, M.D.
Senior consultant, Sahlgrenska University Hospital
Sven Román, M.D.
Child and Adolescent Psychiatrist
NORWAY
Anne Wæhre, M.D., Ph.D.
Senior consultant, Oslo University Hospital
BELGIUM
Em. Prof. Patrik Vankrunkelsven, M.D. Ph.D.
Katholieke Universiteit Leuven
Honorary senator
Sophie Dechêne, M.R.C.Psych.
Child and adolescent psychiatrist
Beryl Koener, M.D., Ph.D.
Child and adolescent psychiatrist
FRANCE
Prof. Celine Masson, Ph.D.
Picardy Jules Verne University
Psychologist, Oeuvre de Secours aux Enfants
Co-director, Observatory La Petite Sirène
Caroline Eliacheff, M.D.
Child and adolescent psychiatrist
Co-director, Observatory La Petite Sirène
Em. Prof. Maurice Berger, M.D. Ph.D.
Child psychiatrist
SWITZERLAND
Daniel Halpérin, M.D.
Pediatrician
SOUTH AFRICA
Prof. Reitze Rodseth, Ph.D.
University of Kwazulu-Natal
Janet Giddy, M.B.Ch.B., M.P.H.
Family physician and public-health expert
Allan Donkin, M.B.Ch.B.
Family physician
UNITED STATES
Clin. Prof. Stephen B. Levine, M.D.
Case Western Reserve University
Clin. Prof. William Malone, M.D.
Idaho College of Osteopathic Medicine
Director, Society for Evidence Based Gender Medicine
Prof. Patrick K. Hunter, M.D.
Florida State University
Pediatrician and bioethicist
Transgenderism has been highly politicized—on both sides. There are those who will justify any hormonal-replacement intervention for any young person who may have been identified as possibly having gender dysphoria. This is dangerous, as probably only a minority of those so identified truly qualify for this diagnosis. On the other hand, there are those who wouldn’t accept any hormonal intervention, regardless of the specifics of the individual patients.
Endocrinologists aren’t psychiatrists. We aren’t the ones who can identify gender-dysphoric individuals. The point isn’t to open the floodgates and offer an often-irreversible treatment to all people who may have issues with their sexuality, but to determine who would truly benefit from it.
Jesus L. Penabad, M.D.
Tarpon Springs, Fla."

Good letter.

Good news!!

This is so important that medics are finally finding the courage to speak out about the need for evidence based medicine for children.

"the risks are significant and include sterility, lifelong dependence on medication and the anguish of regret".
Unbelievable that this is still happening to children.

Not just happening, but being done to children, by adults.

This latest letter was in response to this one, also in the WSJ:

Endocrine Society Responds on Gender-Affirming Care

It improves the well-being of transgender and gender-diverse people.

July 4, 2023 9:01 am ET

Roy Eappen and Ian Kingsbury’s op-ed “The Endocrine Society’s Dangerous Transgender Politicization” (June 29) ignores scientific evidence and the conclusions reached by the American Medical Association, the American Academy of Pediatrics and other reputable medical organizations. More than 2,000 studies published since 1975 form a clear picture: Gender-affirming care improves the well-being of transgender and gender-diverse people and reduces the risk of suicide.
Based on this evidence, the Endocrine Society developed our clinical-practice guideline through a rigorous process adhering to the Institute of Medicine’s highest standards of trustworthiness and transparency. All 18,000 members had an opportunity to be heard during our extensive vetting process. Based on much of the same evidence, federal judges in Tennessee, Kentucky and Florida have joined the Arkansas judge in striking down bans on lifesaving gender-affirming care.
Do No Harm, the organization with which Messrs. Eappen and Kingsbury are affiliated, produced model legislation used to ban gender-affirming care in Arkansas and two other states, according to the Associated Press. It seeks to keep in place bans fueled by misinformation. It is quite clear who is motivated by politics and who relies on scientific evidence.

Stephen R. Hammes, M.D.
President, Endocrine Society
Rochester, N.Y.

Huge news!
Thanks for the link.
The tide is well and truly turning.

OMG! Medics who look at evidence instead of applying leeches. Thank God.

Pulls no punches by referring to the "politicisation" of this type of healthcare.

If you're prescribing drugs to minors that cause sterility, surely you'd want to constantly review the evidence to reassure yourself?