BMA to vote to 'disavow' the Cass review

[mzdemeanour]

The governing body of the BMA is to hold a vote tomorrow (Wednesday July 17) to 'disavow' the Cass Review. Words fail me to be honest. Any doctors, particularly members of the BMA, able to explain or comment?

Article by Hannah Barnes in the Spectator www.newstatesman.com/politics/health/2024/07/why-are-british-doctors-voting-to-reject-the-cass-report and thread on X/Twitter x.com/hannahsbee/status/1813252387504857241

Is 'Empirical Evidence' in the room with us right now?

On a serious note I am genuinely flabbergasted that DOCTORS, actually scientifically trained people, would believe in all this stuff.

The discussion about this on the doctors' subreddit is interesting. The consensus seems to be that this is a waste of time, it is going against evidence-based medicine and that the BMA should focus on improving working conditions for its members, not getting involved in identity politics. So it does seem that it is an activist fringe that is driving this.

What is the point of all that training when in reality, they can't use any of it and just do what activists tell them to do?

Queer Theory breaks everything.

https://www.bma.org.uk/news-and-opinion/take-pride-in-progress

The NHS doesn't need to medicate anyone's gender. It's cosmetic.

I'm one of those postmodernist types who (allegedly) doesn't believe in truth or science or anything like that. But even I'm surprised at how quickly the scientific method or questions of evidence have been repudiated here. After all, even as a postmodernist, if I were to undertake a medical treatment I'd like to know that I was apt to do better than the placebo group. And that the benefits would likely outweigh the side effect profile. I can put myself in a control group quite easily - all I have to do is nothing. Is the treatment going to get me anywhere? I've never felt a strong desire to transition, but if I did, I'm sure these kinds of questions would be uppermost in my mind too. All the more so given the severity of the interventions and the fact that one is committing oneself to a lifetime as an invalid. So the benefits better be good.

It's almost as if they've read Foucault not as a social critique but as if it were an owners' manual. Regimes of truth enforced through power, you say? Right, let's get on with it! As discussed on here, you can see it in Nature, Cell et al, and maybe, by the end of today, in the BMA too.

It's almost as if they've read Foucault not as a social critique but as if it were an owners' manual
Love it, AlexaAdventuress!

exactly this. Once gay marriage was realised, SW had three choices-1) job done, go home 2) go international where gay rights are still dodgy (i.e. Saudi Arabia-fat chance of that) 3 Glom onto trans rights to remain relevant . Its as if the Salvation Army was taken over by the Mafia.

if I were to undertake a medical treatment I'd like to know that I was apt to do better than the placebo group

I hope you would look for better than that. You really want to know if your treatment is better than the best available alternative. A new painkiller may be better than a placebo but worse than paracetamol. Just testing against a placebo was a common drug company ruse (along with short follow up, small sample size, carefully selected participants that can not be generalised to the whole patient population, only publishing significant results, ignoring those lost to follow-up, lack of blinding of those administering the trial or assessing the results, lack of consideration of adverse/side effects…)

ThePure · Yesterday 18:50
People who engage in medical politics are not representative of the views of all Drs

Yes this. 100%

Ah, you're very kind! I enjoy your interventions too.
We're such an heddiyoucated bunch on here, aren't we? Can't think of any other online forum where I'd have seen Descartes, Wittgenstein and Foucault all on the same day.

This is something the Scottish Government has latch onto with great zeal. Or as they called them “lived experience expert panels”. In other words, a self selecting group of political active individuals in line with SNP ideology

Yes of course, there's a lot more to trial design. I was just using a very simple example of placebo versus intervention for the sake of illustration. There's a few other ruses I've seen, such as measuring outcomes at a large number of points and only reporting those which are favourable to the preferred treatment, comparing a tiny dose of the business-as-usual treatment with a large dose of the new one and so on. You can also make a big difference to the apparent outcome through careful manipulation of the inclusion or exclusion criteria too.

Even so, I think I'd rather trust some sort of experimentally-designed comparison than guesswork, custom and practice and gender ideology!

Absolutely. That is why Cass assessed the quality of the studies too.

The indoctrination has been intense. I had a conversation with the wife of a friend recently. She is a graduate, works in advertising, mid 40s, has children. Assured me that her "friend", born male, couldn't get treatment for their endometriosis until friend transitioned to female. Friend is now having the treatment for their endometriosis that they needed all along. Astonishing.

I've had to read that several times because I actually can't believe it. Surely he is not actually getting any 'treatment' or even pretend treatment? Is he lying to her or is she lying to you to bolster an argument?...fucking nuts.

Yes indeed, except for the lived experience of rape victims, which they weren't so keen to hear about.

There are examples where the patient/service user/'expert by experience' voice has been important. Where things go wrong, it's often the patients and carers who bring the issue up first, and often have to struggle to get their voices heard. I'm thinking about thalidomide, contaminated blood and transvaginal mesh inserts, to name but three examples. It takes a determined effort to break through the 'safe and effective' assurances. Not just healthcare either. Post Office accounting systems spring to mind too.

Having said all that, I'd still rather trust a systematic review of a bunch of decent randomised controlled trials over and above a handful of people with pronouns in their email signatures participating in a focus group. If there was a Cochrane Collaboration appreciation society, I think I'd join it at this point.

There is a patient liaison committee within the BMA. Wonder if this was ever on their agenda

Coming next: The Construction Industry Council 'disavow' gravity.

Interesting that Doctors Reddit is not enthusiastic about this.

I used to be active on Medtwitter and that was very TRA. Mainly male gay posters or women wanting to help disadvantaged groups. Nobody with kids.

Had a look on a closed doctors forum- there they are all saying shit like this is why they left the BMA years ago. Plus an interesting suggestion that it has been proposed to shut the activists down.

There are regular threads by GPs who want nothing to do with trans prescribing and doctors who persuade parents not to touch the Tavistock with a bargepole.

I think the BMA will play right into Wes Streeting's hands if they vote for this shite. It won't be ignored by the press and he can completely discredit their demands in the pay talks as plainly they are unreasonable and as mad as the proverbial box of frogs.

Don’t be silly. You only listen to the CORRECT lived experience, that it why you have lived experience expert panels so you don’t need to bother with any lived experience that contradicts you.

the article (New Statesman, can't see it all) starts by saying that the 'rules do not apply' in gender medicine, which is an entirely bad start, suggesting any experimentation is reasonable. This is worrying if the BMA thinks this. Would they say it of cancer sufferers, girls with anorexia?

Only read the OP. What a bunch of utter cretins, and what a waste of medical training.