Puberty Blockers clinical trial.

[PlainJane999]

Simple question, do those here support the prescription of blockers as part of a clinical trial and why?

Yes, for informed consent one must be able to understand the implications of any treatment not merely be able to describe them.

So do you really think that a 9 or 10 year old who has taken blockers for a year should be able to proceed to cross sex hormones

A step-by-step guide on how to excuse the medical abuse of children.

Especially when blockers block the maturation of the brain (though 10 year olds do not have mature brains even if left alone)

If the above is true, how do you explain the internationally recognised and documented phenomenon of children independently seeking treatment for gender dysphoria, predating even the formal creation of specialised paediatric gender clinics over four decades ago - many of whom did so long before they ever heard the terms 'transsexual' or 'transgender' nor had any association with adult patients whatsoever?

No child understands the concept of long term.

It’s one of the skills we develop over time.

Teenagers and young adults do not have a proper understanding of risk (hence insuring them to drive is hugely expensive).

The elephant in the room - not in FWR - but within the field of gender treatment/ gender medicine is that it remains contentious suggest that the best outcome for gender distressed people is to find a way to re inside their sense of self with their bodies and only when this is shown to be ineffective following meaningful engagement with psychotherapeutic approaches should physical treatment be considered.

Some quarters like to suggest this is conversion therapy - despite it being an approach that can fit within an affirmative model. You can say, yes you are who you say you are and you can be that and have the body and bodily functions you were born with.

Obviously, it can be an approach used to challenge a trans identity and something between this and total affirmation.

It is crazy that prescribing practitioners find it difficult to say that hormones and surgery should be the least preferred option.

Homophobic parents took swishy little boys to doctors to have them ‘cured’ of growing up gay.

Possibly in theory, but contradicted by evidence from the Tavistock clinic (as reported by e.g. Hannah Barnes) that whether children were given blockers depended more on which practitioner the children saw than on any observable clinical variations in the children. We couldn't go so far as to say that the selection was fully random but neither could it account for such a consistent response.

Hence Cass's conclusion that puberty blockers are a pathway not a pause.

Have they demonstrably reached tanner stage 2 at an appropriate age i.e. outside the bounds where treatment of precocious puberty is relevant? Have they already been prescribed GnRH agonists for a year's 'cooling off period' following presentation with persistent incongruence? Are they demonstrably mature enough to understand the implications? Have they been given an in-depth assessment by two relevant field experts?

So average age 11-12 for natal girls to get Testosterone?

Can’t imagine how horrific it would be to deal with vaginal atrophy at 14/15, but that seems to be what you are advocating for?

edit: or at least, it is based on the physical description.

no one would ever be prescribed blockers under 18 based on the physiological readiness bits. Kids aren’t long sighted.

The persistent claim that an affirmative model is inherently incompatible with wider exploration of incongruence seems to be a symptom of historical attempts by staff to act humanely in the face of catastrophic resourcing issues in an underfunded service, rather than any reflection of an inherent limitation of the model itself.

Can you post a some more details of the "internationally recognised and documented phenomenon of children independently seeking treatment for gender dysphoria" from over 40 years ago?

I don't believe that any 10 year old is mature enough to make that decision but for the purposes of my question if it's yes to all your points would you think it was acceptable for a 10 year old to be put on cross sex hormones

Do you really believe that a 9 or 10 year old is mature enough to understand the implications of having impaired sexual function and being infertile?

What experience of sexual acts do you think they might have had that could give them a mature understanding of loss of sexual function? Do you think a child who has not gone through puberty can understand what it means to lose sexual function?

Given that many children of this age think that they'll never want to have children themselves, do you really think they can have a mature, adult perspective on infertility?

No, it doesn't seem remotely reasonable.

You know how many children (and adults) who transition have ausitm? Some children and young people with autism can beautifully describe things of which they have absolutely no realistic concept at all. They are highly verbal and articulate and logical so they seem oh-so-grown-up but their conceptual and experiential understanding is utterly lacking. They can't express what they don't know.

And they are obsessive. Give them a "solution" and they stick with it and systematise everything else to fit round it. Anything rather than accept uncertainty about the future.

"Individual case-by-case" is not how medicine works. Not when we can't reliably predict the outcome for different "cases". It's wishful thinking that there is some magical team of experts who can see into the future and know which children will grow up happier for interventions that have sacrificed their health and fertility.

It's not possible to change sex. Enough of this, now. No child should ever, ever be 'affirmed' in a delusional belief. No medication, no surgeries, no bullshit theories.

A child who is 'gender incongruent' generally should be left alone to get on with being a child, and perhaps be offered some gentle, sensible discussions about sex stereotyping.

If they show distress: Compassion, understanding, therapy. Safeguarding checks on the family.

That's it. That's all.

You missed out have they been groomed and brainwashed at school and by social media.

Doesn't gender incongruence mean ''playing with the wrong toys'?

Sterilising kids who play with the wrong toys.

These people should be in jail.

The recent German study of insurance billing of 5-24 year olds found diagnosis persistence (of gender dysphoria) was below 50% in all age groups; from 27.3% for 15-19 year old females, to a top rate of just 49.7% for 20-24 year old males. The source of the data means they all engaged with the German Health Service for GD - a service that is very ‘gender affirming’. This was over just five years.

https://www.aerzteblatt.de/int/archive/article/239563

Crikey Sloe!

Commenting to say 'gosh!' and to bump.
Important to add to the mix.
Thanks @Sloejelly

One problem here, (ignoring the ethics), is can we even design proper studies that patients will then participate in? With RCTs patients could just drop out if they aren't selected for the medication.

Before even starting to consider if it is at all possible to ethically medicate children with these side effects and long term consequences, and it is entirely without consent because we have a number of adult detransitioners sharing their experience that they begged for this stuff as a short term immediate desired solution and had no idea of what they were doing to themselves, and that they should have been protected from the lifetime regret and damage they were helped into?

Adults with direct skin in the game should not be in any way involved. At all. This is about the children's best interests, not the desperation of adults to use those children to meet their own needs and confirm their own beliefs. Particularly when those adults have absolutely zero capacity to engage with anything but affirmation of their beliefs because of their own vulnerabilities, are not able to neutrally consider the issues, and normally abandon on the spot any child they have championed if that child ceases to be helpful to their needs by detransitioning. (Interestingly they also often fought and fought to say that the child's feelings, wishes and impulses should be absolutely respected and obeyed if the child wished to transition, while denying that it's possible to influence a child towards a decision that isn't right for them - but if the child's feelings, wishes and impulses change to wishing to detransition, the same adults will often deny, ignore or dismiss them, and blame the detransition on failures of others to properly support and affirm. Only SOME feelings are right and only SOME wishes matter. And you cannot miss that the categorisation is linked to the helpfulness to the adult.)

These are issues raised by whistleblowers from years back.

To the OP's question: It's a double bind.

No drug should be prescribed without proper clinical trials, done by the book.

Is it possible to ethically do a clinical trial on these drugs with children? It's very unlikely to ever pass proper, ethical and medical standards.

Adding a video that I believe is an important addition to the discussion on puberty blockers

30 year old man discusses his reality after puberty blockers (MtFtM detransitioner)

link is viewable without a TikTok account.

https://www.tiktok.com/@sexrealitybites/video/7383819274932030725

How can a trial be ethical (for a condition with no objective diagnostic tests and no inevitable fatality without intervention unlike, eg, paediatric cancer) when the participants will be living with the consequences years into the future?

The man in the video is about the same age as Jackie Green, so experienced pubertal blockade at a time when it was still vanishingly rare and restricted to the children with the most severe gender distress (and supportive parents).
It’s inevitable that there will be more adults with similar struggles as we begin to see the consequences on prescribing blockers to an ever widening cohort.