Doctors fear breaking Hippocratic Oath re. prescribing wrong sex hormones

[lcakethereforeIam]

About time there was an article

https://www.sundaypost.com/fp/gps-concerns-over-transgender-prescribing-plans/

Thanks for link.

Thanks for posting cake. From the article:

'The concerned GP said: “It is a huge problem because for many years now when patients are discharged from Gender Identity Clinics into GP care, there has been a failure to formally collect clinical monitoring data across some of the largest areas in Scotland.

“Because of this failure, how can GPs know the extent of the short- and long-term harm caused by these powerful drugs? GPs are responsible for any prescription we sign.

“We are liable if harm is caused by prescribing or by the inadequate long-term follow up of these medicines, such as the blood monitoring we know has not been done.

“We already know gender medications have extremely serious adverse effects. Now we are being asked to accept responsibility for what has been happening here in Scotland, including the very real possibility of future litigation when those harms become apparent.

“Despite the seriousness of the implications for GPs, there has been no acceptable full consultation between HIS and us.

“We are being pressurised to just accept shared care as a done deal.

“If we do, we face breaking our Hippocratic Oath. If we don’t, some GPs may fear action may be taken against them. We’re being put in an impossible position.”'

I hope all GPs, no matter how gung-ho they are for gi, are reading this. I hope they're having a think. I hope the companies that provide their insurance are reading it too.

Does anyone know if responsibility can be handed off upstairs, so to speak. Is there a medical body who has the authority to provide reassurances to GPs, who could say that they will take the heat if/when the wheels come off? Although that has more than a taste of 'just obeying orders'.

I think even if there is such an organisation (the GMC, BMA, whoever) that would, at best, give the GPs someone to sue and perhaps give the victims another target.

Thanks for the link. It quotes part of the GMC statement on trans healthcare but not the section that sys 'no GP should prescribe outside their area of competence'. I think this still stands.... (although the GMC then basically says its upto GPs to make sure they do gain competence 🙄 - how this can even be possible when gender care is not evidenced and long term effects poorly understood is not explained by them).

The recent RCGP is very helpful in saying that shared care (even with NHS GICs) ought to be refused if service pressures are too high. I would love to see it be tested legally as it would force transparency into the evidence/support etc etc.

The GMC are ultimate arbiter of what Dr's can and should do, so I don’t fully understand how HIS initiatives interact with this.

But there's no possibility of GP's having 'competence' in prescribing in this area because as the WPATH files show it's all been a huge scam. The evidence base falls far below what would be expected for any other area of prescribing and there is some data harms can be significant but there hasn't been good follow up data nor large scale monitoring.

Although I do wonder why GPs aren't insisting on follow up blood tests given these can presumably be done at GP practices? Does anyone know?

This is an important article. It shows the potential consequences for professionals of gender zealots being allowed to influence healthcare, to stop evidence and research being collected by screaming "transphobia" and the potential consequences for professionals for failing to speak out against this.

Part of me thinks serves you right for failing to follow medical ethics and good practice. But I know that this has been a societal gaslighting on an unprecedented scale with the judiciary, politicians, educators, psychologists, the forces of law and order, medics & the rest all either remaining silent or colluding with this abuse of the young.

I’d like to know why GPs and other health care professionals care about breaking their Hippocratic Oath now, when so many have actively harmed so many children (and adults) in the past. Yes, it’s encouraging to see that reality is returning, but how did this GI fallacy take such a hold in the first place that medical professionals couldn’t see the harm from the delusion?

Follow up for what?

1. If a patient has been discharged to GP from a GIC then they should be having regular BTs at the practice. Whether or not this happens depends on the quality of the reminder systems within the practice and patient compliance. Given that many patients will have 'changed sex' for record purposes and have refused any kind of transgender coding, it is difficult to create good systems.
2. If a patient is under a GIC they should be getting regular BTs as part if their GIC care (often performed at GP and sent on). Ideally the GIC will make the GP aware if tests are out of date, but comms from private clinics are hit and miss. A patient may choose not to go back to their private clinic and just fall off the radar.

The difficulty creating good systems for trans patients that provide good care and are acceptable to patients is really tricky. Add to this that there are no 'standard bloods' for gender patients - each clinic has a slightly different requirement. There are no GP guidelines for this stuff. And every GP /practice has a different tolerance to what they will prescribe , sgared or unshared, and how on top of the monitoring they are (and how well they know their patients).

And the reason for no standard monitoring is lack of long term evidence for risks and harms. It is a nightmare. Nearly every GP I have ever tlked to about it feels incredibly uncomfortable with the whole thing.

2021 NICE recommended inclisiran (cholesterol-lowering drug to reduce risk of cardiovascular disease and events) for use in the primary care setting. The RCGP mustered its members and refused. A lot of the concerns were, as here, concerns about the lack of long-term data for safety and efficacy.

“Clinicians should note that inclisiran is an siRNA drug and acts diff erently from other PCSK9 inhibitors. It means people should be cautious regarding its safety surveillance before [we have] evidence for long term safety in large populations.”

https://www.bmj.com/bmj/section-pdf/1085922?path=/bmj/382/8394/ThisWeek.full.pdf

tbh, I know the central funding expired in July 2024 but I don't recall what's happening now.

Good! It's about time these medical practitioners started questioning whether they are harming their patients.

One issue is that there are now qualified drs who themselves have transitioned. I know of one who graduated this year and seems to be heading towards being a surgeon.

What are the blood tests looking at, exactly? They will show that the levels of hormones do not correspond to biological sex, but what else are the GPs looking out for? Surely they need to do tests to look for the known risks of cross-sex hormones as well as other general health markers?

The BTs will indeed look at hormone levels but also a different blood parameters that may be deranged when interfering with or having suboptimal hormone levels. So if on testosterone, liver function and haematocrit are often measured as these can become (dangerously) deranged. If on oestrogen, again liver function, prolactin and sometimes other tests like lipids. It depends on what the clinic asks for. Some will want 2 yearly ultrasound monitoring of testosterone therapy (if uterus still in place) to monitor for abnormal thickening. Some don't think this is important.

How GPs are supposed to know if they are doing right by their patients is a mystery.

There is no such thing as doctors taking a Hippocratic oath.
We are regulated by the GMC and have to adhere to the standards they lay down
We do not make oaths

Thank you @DayOfWreckoning

Looks like Scottish doctors are going to have to get with the program

https://archive.ph/STBHj bypass paywall, you just have to ask

www.telegraph.co.uk/news/2024/09/03/scottish-doctors-prescribe-hormones-patients-self-id-risks/

There seems to be no end to the length the Scottish government will go to facilitate harm to adults and children. Quite baffling.