Public NHS consultation on puberty blockers open

[WarriorN]

www.engage.england.nhs.uk/consultation/puberty-suppressing-hormones/

NHS England commissions gender incongruence and dysphoria services and the purpose of this consultation is to seek views on a proposed interim clinical policy on puberty suppressing hormones (sometimes referred to as ‘puberty blockers’ or ‘hormone blockers’) for children and adolescents who have gender incongruence or dysphoria.

The policy proposition is that puberty suppressing hormones are not recommended to be available as a routine commissioning option for the treatment of children and adolescents who have gender incongruence or dysphoria.

This public consultation will run for 90 days from 3 August to 1 November 2023.

I think NHS England, as well as NICE, generally do public consultations for most medical recommendations - it's just that we don't notice most of them.

Don't worry I think they will be well aware of all the evidence (or lack of it). But it's basically saying, "if there's any evidence we've missed (there isn't), now's your chance to tell us". So no-one can say later, oh we had no opportunity to tell them about this important evidence.

Over in the States...

twitter.com/genspect/status/1687213431235948546?s=46&t=WHoOZ_3Kv5G6-FyQuvE0LQ

"BREAKING- US: FINALLY, the @ AmerAcadPeds has commissioned “a systematic review of medical research on the treatments, following similar efforts in Europe that found uncertain evidence for their effectiveness in adolescents.”"

@ResisterRex

Ooooh, that's fantastic!

From discussions elsewhere, the devil is in the detail.

I believe there are a number of issues with some of the proposals.

All the accompanying documents need analysing.

I hope some orgs release some guidance on what it all means in practise.

Excellent news @ResisterRex!

I haven't the time to clarify details but it seems there's plans for a study on children, which does mean there will be a large group allowed to go on pbs for research purposes. As in several thousand.

From age 16 children will be into adult services.

Ritchie's case will be really important for that.

That's interesting and a huge relief given the impact of these drugs stopping children's normal development. The idea that this could ever have been an ok thing to do just to 'give a child time' was always extreme even if 90% of those taking them desisted, which if course they didn't.

NK's take on research trials, that it's an ethical minefield to restrict experimental treatment to a trial because it forces patients to agree to research, is completely arse-backwards. This is experimental treatment, still, with a poor evidence base. Any child taking these extreme drugs and having their puberty halted should be under the closest scrutiny and she had the opportunity to fight for that. Her failure to advocate for the true interests of those children shows how it has been adult perspectives driving this pathway despite the increasing number of children affected.

A research study would have to be conducted as a proper clinical trial with ethics approval, and with strict criteria and proper consent before recruitment - assuming it gets ethics approval...

I still don’t like it of course, but it is progress.

It strikes me that this particular consultation has the potential to be important, given the known shortcomings and failure to carry out longer term patient monitoring.

If there are patients or parents who are unhappy, but have never had the chance to have their voices heard, then this is an opportunity to speak out.

It is also possible that this research will provide evidence that the treatment is effective and beneficial, at least to a selected group. I just hope the measurements used are robust.

Meanwhile in Scotland we have SPATH which aims to remove all barriers to trans "healthcare"...

https://forwomen.scot/16/11/2022/spath/

One of the biggest things missing from all this is longitudal follow ups.

The other aspect is that it may highlight that there isn't any evidence for efficacy to more people generally hence the need for the study. That actually may put some off.

There are a lot of online popular culture myths about it always seems that they're reversible, safe etc

Yes, I'm finding quite a few issues so far. To pick one out as an example:

"Gender" is a belief, not a fact. The wording in the policy documents fails to acknowledge this. For example, quoting:

"Gender variant behaviours may start between ages 3 and 5 years, the same age at which most typically developing children begin showing gendered behaviours and interests (Fast et al, 2018)."

"Gender refers to the roles, behaviours, activities, attributes and opportunities that any society considers appropriate for girls and boys, and women and men" source: WHO website.

It should be clearly stated that this means people are being treated to change their physical bodies to address the psychological distress associated with not matching sex-based stereotypes. A wider review should consider whether this is a mental health issue and should go through the mental health treatment pathway.

This is in the Interim Policy document.

over 16s will not have pbs and go straight to x sex hormones as will enter adult services at 16.

The study for puberty blockers will be on around 6000 children planned for 2024. I imagine younger teens.

Ritchie's judicial review announcement due son, either this Sunday or next.

(I'm guessing in Sunday times? Or observer?)

I want to celebrate if the wheels are finally coming off this wrecking machine but I could weep for the children and autistic adults whose lives and health have been destroyed by this ideology. The families divided, the estrangements. The absolute abhorrent waste of public money.

Gender variant behaviours may start between ages 3 and 5 years

So basically kids who don't conform to marketed stereotypes will be eligible for medication to make them fit sexist and homophobic consumer ideas.

Can I just say in relation to this I'm actually getting really really down about what's happening in Scotland. I'm so anxious now and worried about it all since I started looking into this. The NHS in Scotland has basically just approved a process to essentially remove all safeguarding, counselling etc and will be cracking on with irreversible surgery and blockers on any vulnerable young person that asks for it. I wish there was a consultation for us up here too; hopefully this English consultation will actually put some safeguarding measures in place.

Sandyford is still continuing on happily despite the Cass review and tavistock scandal investigated by that Newsnight journalist.

Moansthensmum there is going to be a consultation on the Scottish standards. It was supposed rot be underway just now but is currently expected to be held this winter.

To clarify that, they have not approved that process/adoption of the SPATH guidelines, the CMO has approved accepting that proposal for consideration. Consultation towards the end of the year. Discussion here, with link to Express article and govt comment:

https://www.mumsnet.com/talk/womens_rights/4862889-spath-scottish-government-treatment-protocol-for-trans-care-counter-to-cass?page=4&reply=128136348

Brief look at how it's been received by TRAs: Horton did her PhD under Anna Carlisle at Goldsmiths (who attended the TRA meeting TheHarpySings did an expose of TRAs "we're still here," in 2018.)

Horton and Carlise have children who are described as trans and I believe Horton did her PhD on child trans inclusion in primary schools, or has at least written a paper I've seen.

twitter.com/fiercemum/status/1687093040161361920?s=46&t=A2fpFNgDRyXF2d6ye97wEA

Exactly. I felt incensed when I read that. Especially coupled with the WHO definition of gender in the same paragraph.