Hilary Cass Interview in the Times

[Igneococcus]

Depressing that she doesn't feel safe in public anymore:

https://www.thetimes.co.uk/article/3121a27a-fd54-46d9-894a-f715de429675?shareToken=323bde6f9666d56951b1eb073ded85b1

At the end of the day, no individuals with a vested interest in transitioning children should ever be able to override the need for researched ,evidence based medical treatment / health care for children.
The fact that both individuals and groups have been allowed to influence child healthcare to the extent that's happened in the UK and world wide is a scandal of massive proportions. No matter how much groups and individuals whine, rage, lobby, accuse others of being anti trans, dissemble etc - none of them must be allowed any further influence.

Our children deserve so much better than this.

this is a treatment that has a positive and overall beneficial, if imperfect, outcome for a subset of people who present with gender incongruence in childhood and continue to display it throughout their lives.

Whether this feeling will persist throughout someone's life can't be known until that person is an adult.

A child who experiences unhappiness with their sex as a child is more likely than not to grow out of these feelings. At present there is no way of knowing which children will grow out of these feelings and which will not. It is completely inappropriate to treat any of these children with harmful and irreversible drugs just because a small minority of them may not grow out of their unhappiness with their sex.

Oh for god's sake. This again?

For the last bloody time:

I spent my late teens and early twenties at the centre of a vibrant and diverse campus community comprised of multiple overlapping friendship groups. I was popular and well-liked within all of them, and remain very much so amongst the contacts I retain to this day - some of whom now know I am a trans woman, because it is safe for them to know this now and useful to be able to speak about my teenage years sometimes.

Due to the hostile cultural climate of the late 90's and early 00's and the way that I had been able to seamlessly integrate into society without being identifiable as trans, an unusual dilemma presented itself - it was dangerous to disclose my history to classmates, friends, colleagues or partners, and I had the option not to. 'Trans panic' was a well known phenomenon at the time, and general legal protections alongside the accompanying institutional levels of support decidedly weren't as they are now, so I was careful to protect myself from the threat of accidental disclosure wherever possible.

The only people who knew about my history were thus the healthcare professionals involved in the assessment and provision of my ongoing treatment, and those family members and rare friends who I remained in contact with from my childhood. There was no need to disclose my past to my employer, for example, and so I never did.

It isn't pleasant to have to compartmentalise and quarantine a part of your life history - as anyone who has had to do so will understand all too well. It's quite a lonely road to walk, and given the vanishingly small number of other people walking the same road at that time (especially the tiny subset who transitioned in childhood as I did and were able to understand what it is like) there were few sources of support to fall back on. It's more pleasant to do that, however, than it is to make yourself vulnerable to the way that society treats people it perceives as transgender - and the general mental health benefits that come from embodied existence in a form that isn't a source of constant crushing dysphoria cannot be overstated.

Due to the timely intervention that resulted from accessing these services at a young age, I had so many options. I was able to grow up to be happy, popular, fulfilled and successful beyond my wildest expectations in ways that I'd never even dreamed of in my early-mid teens.

I've never experienced any negative side-effects that resulted from the use of puberty blockers in my teens, and I've never encountered another trans person in my cohort who experienced them either. That's not to say I'm discounting that they are possible in some cases - we know that there are additional complexities that result from very early interventions which can have implications for surgical options - but it does make me very suspicious of hyperbolic-seeming claims by individuals or groups with a clear anti-trans agenda.

There are, meanwhile, well documented elevated risk factors and side effects that accompany the provision of oral hormone therapy, and which can apply to anyone under their effects whether they are trans or not. This is the 'Sword of Damocles' that I've been (mis)quoted as mentioning several times - and always, it seems, incorrectly in relation to puberty blockers no matter how many times I correct it.

These risks can be reduced by switching to transdermal patches alongside living a generally healthy lifestyle. I was switched over to patches by my GP a few years ago - my HRT dose hadn't been adjusted since my GRS over a decade and a half ago and was desperately in need of an update! After a minor outpatient procedure, a surgical side-effect that I'd previously been issued medication to deal with is no longer relevant. This leaves one ongoing medication (HRT/CSH or whatever you want to call it to differentiate it from the identical treatment that non-trans people take to have the same outcome) as a result of my transition, with a significantly reduced risk profile to previously.

Now please, no more misquoting me. I'm sure nobody wants to read yet another painstaking clarification post.

The words 'I' and 'me' have fuck all to do with evidence based medicine.

This every time. Medical treatment for children should not be based on the personal experiences of individuals - especially when that "treatment" can lead to sterility, loss of sexual function and negative impacts on physical and mental health. Evidence based every time.

For those who may have missed it, take a look at the information from the sole adult gender clinic who complied with requests to cooperate with the Cass review. Awful revelations suggesting major diagnostic overshadowing that ignored serious mental health co-morbidities. Shows just why the rest of the clinics refused to share data as it showcases their culpability in the medical mistreatment of children - especially girls and especially young lesbians.
https://www.transgendertrend.com/adult-gender-clinics-withhold-data-cass-review/

As scientists like to say: The plural of anecdote is not 'data.'

It's staggering that even after the above script, I STILL had to repeat the point about evidence based medicine.

Tone deaf doesn't cover it.

You are invited to read the reviews conducted by the UoY team in support of the Cass report and reflect upon how you intend to capture a large high quality dataset that provides comprehensive evidence of treatment outcomes - necessarily including mental health assessments - without involving the words 'I' and 'me' at any point.

I'm excited to see your contribution to the research!

Butterfly. Just never stop talking.

It's beautiful.

Yes to this

And often stereotypes don’t help

Choosing not to follow stereotypes is fine and doesn’t have to be ‘trans kid’

Due to the timely intervention that resulted from accessing these services at a young age, I had so many options. I was able to grow up to be happy, popular, fulfilled and successful beyond my wildest expectations in ways that I'd never even dreamed of in my early-mid teens.

I've never experienced any negative side-effects that resulted from the use of puberty blockers in my teens, and I've never encountered another trans person in my cohort who experienced them either.

And yet, if you really started on this path during childhood, you were sterilised as a child. Some people would consider this a pretty significant negative side-effect of the treatment.

When were puberty blockers first used in the UK?

This is the paper by Michael Biggs which gives a timeline of their use.

https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2121238

None of this is my words. They're yours.

But, even tho, your specific experience is irrelevant.

I'm merely quoting you because your claims show how unreliable anecdote is, even within one person's experience.

I'm on three different types of lifelong medication directly associated with side effects of my transition, alongside one that outright would have prevented me from being able to pursue treatment had I been on it at the time. I've a healthy dose of gallows humour regarding the sword of damocles hanging over me after 20 years of HRT, and the likelihood of life-changing implications in the decades to come.

When you spend a lifetime in a well of almost complete, crushing isolation, unable to speak to anyone other than medical gatekeepers who are perpetually looking for excuses to shut off your medication and delay your treatment pathway, then silence becomes a part of who you are.

makes us feel like a bit of an invisible, lost generation who slipped under the radar and disappeared, and for whom there is barely a paper trail now

That was a good few years ago now, wasn't it? How time flies when you're in the middle of a pandemic!

One of those medications I'm not on anymore due to a surgical update that has rendered it unnecessary; one was prescribed at the start of the pandemic and I've since been taken off by my GP as the underlying condition is treated; one is HRT which is indeed still ongoing and lifelong. One has never had anything to do with transition at all but due to the unenlightened past would have been used as an excuse to deny treatment to me had I already been taking it when I was referred - thankfully we've moved on from those days!

None are anything to do with puberty blockers. I'd definitely say so if they were - I've no interest in claiming a treatment is any more or less than it is.

The rest still stands - if you've been through that journey, you learn never to disclose any detail that could reveal your past, and the need to keep people at a safe distance can be quite stressful and lead to feelings of isolation. I was sometimes referred to as 'Ice Queen' at university (amusingly, through parallel evolution, the same nickname my mother had when she'd been at university many years prior, so I wasn't as upset by it as I might have otherwise been) by a cadre of hopefuls within my friendship group who found me aloof and vexingly uninterested in their advances.

The rest still stands - if you've been through that journey, you learn never to disclose any detail that could reveal your past, and the need to keep people at a safe distance can be quite stressful and lead to feelings of isolation.

You admit to these negative effects of spending your life living a lie, pretending to be something you are not, when you could have just been a genuine, authentic feminine man. Some interesting comments about that on this thread:

https://www.mumsnet.com/talk/womens_rights/5061634-5061634-authenticity

Look Butters, I know you've had a shit time of it.

Which is the exact reason the Cass report is so welcome.

Your posts are contradictory and inconsistent and not relevant to it.

The Cass report is a document entirely focussed on the health and happiness of children who have been failed by trans ideology.

So stop trying to undermine it with this 'Cass grudgingly admits' and 'it's been hijacked' crap.

Although you may have benefited from her studies had they happened years ago, It's no longer about you.

Yes to this

Butterfly hatched you "received carefully supervised appropriate treatment, in full knowledge of its experimental nature"

'Experimental' in the sense of, hypothesis, research, proposal, experiment, evidence, conclusion?

If so, I am disappointed for you that you took the risks that you did, and Cass was unable to locate the evidence.

If this experiment were to have high rate of success it would have been career defining for any clincian involved. They would record success and over 30 yrs should be easily placed to publish both quantitative and qualitative data.

You suggested your treatment was carefully supervised and was appropriate. How was it supervised, by whom, how do you now know it was appropriate?

You have a good life now, that's great, but can you be sure that this would not have been the case without this treatment? You are a resilient person who has overcome challenges, but you can never know what your life would be like without this treatment. Perhaps someone in your cohort, with similar degree of distress you had, presented with the same options you were and chose not to take the risk you took. They had an outcome too. They were supported and cared for by the same services. I'd want to know, what was their outcome? Why did the clinicians have no curiosity at all about the range of interventions taken and not taken.

However, if you mean 'experimental' in the sense that clinician/s had an 'I reckon', and conducted the experiment without measurable purpose or evidentiary product. And inexplicably enabled to do so without any oversight or expectation that they maintain records and data.

If that was the case, then I am still glad it worked out for you. That was a risk that you took. However, I can clinicians advocate that anyone else should consider taking the same risk you did in the absence of evidence. Particularly if there was knowledge of other factors which may account for a persons distress.

I fear that the absence of evidence suggests that you were in the minority.

EITHER for some inexplicable reason this experiment was conducted in a distressingly unethical way and NHS gender services omitted to capture any (high or even moderate quality) evidence in this 30 year journey. Which is incredible, is it not?

OR they did indeed capture the evidence and it did not support the hypothesis (and by failing to report findings, they have chosen to bury the evidence). In this case, at some point, the clinicians involved, knew that they were progressing a treatment pathway, in the knowledge there were poor outcomes. And they failed to raise an alarm and prevent future harms associated withthis pathway. Perhaps in time we'll learn why.

There has been a lot invested in promoting affirmation approach in healthcare. Again, perhaps in time we'll better understand why.

I am glad this was successful for you, but you can only speak for you.

It is very important to remember that the poster who is here defending using puberty blockers has also told us in the past that they are a male person who experienced slow or delayed puberty. They are NOT typical of the male children being prescribed puberty blockers.

They are also a male adult who is advising and counselling (proudly) female children who are suffering gender distress without ever acknowledging that the treatments that they are advocating and supporting are brutal to the female body. And yet, they continue to support the use of affirming only treatment and use of these drugs for all children- male or female.

Their posts on this thread need to be viewed with full information and full context.

“I am glad this was successful for you, but you can only speak for you.”

This. Exactly this.

A male patient who had stated that they have a medical condition that slowed their puberty and /or delayed their puberty. Not a child who experienced normal onset puberty for a male person.

Harm is being done with this attempt to say ‘it worked for me, I am great’, is really quite stark when you understand the context.

“None are anything to do with puberty blockers. I'd definitely say so if they were - I've no interest in claiming a treatment is any more or less than it is”

Can you please stop positioning your case as being relevant to the current cohort of children seeking transition. You continue to do this and it is harmful in the many ways we have already discussed with you.

And HRT would be you receiving the dosage of hormones that your body would produce as a male. If you are not receiving that, you are on hormone therapy, but they are not replacing the natural levels at all. So not Hormone Replacement Therapy.

I don't think I've ever come across a TRA, who seems honest, sincere, levelheaded and unselfish.

And you're right Helle, butters doesn't speak of these children with them as the centre of the conversation at all. It's all about how they can justify butter's own life, behaviour, wants.

There is zero curiosity about why it's mostly girls, why would girls want to be identifying as boys, what's happening to them

Just 'Cass grudgingly admits' in order to find something that serves butterfly's own ends.

Butterfly isn't alone, of course, the entire ideology is characterised by the self-serving needs of adult males.

But ffs, the bleating is over. TRAs need to understand that the rest of the country is finally getting this in perspective. And that the scandal of sterilising children will absolutely turn the spotlight on the men who have encouraged it.

And you're right Helle, butters doesn't speak of these children with them as the centre of the conversation at all. It's all about how they can justify butter's own life, behaviour, wants.

There is zero curiosity about why it's mostly girls, why would girls want to be identifying as boys, what's happening to them

MN search is beyond abysmal. But, does anyone else recall the US gender clinic with the psychologist who placed self at the centre of conversations with the children? Claiming that they would get to the end of the initial intake appointment with the child and parents and ask, "Have you ever met a transwoman?" and on hearing, "No" would tinkle, "Well, now you have!" And everybody applauded the parents and child looked on amazed, with tears of gratitude, as they'd had no idea that the person before them, who'd transitioned late in life after fathering a family, was a transwoman.

There would have been nothing genuine and 'authentic' about living the last quarter of a century pretending to be a man in utter misery. Does your ideology dictate that transition is always the wrong choice regardless of evidence or outcomes?

I don't remember that specific occasion, no. But bloody hell, it's a theme running through the narrative a mile wide.

There was a poster on here who said they were at a party with the transwoman heading up Edinburgh rape crisis centre, who got the host to go round to everyone asking in turn if they thought he passed.

These people don't understand that their behaviour isn't just stereotypically male, it's at the extreme end.

And yes, utterly self involved.

Truly, to the point where you think how can anyone even entertain this for five seconds