New children's gender identity clinic, clinical trials and Cass

[VegasVagabond]

I'm a regular here but have named changed.

I have come across an advert for a psychologist at the new GI clinic for children in Nottingham. I am concerned that the advert says that the psychologist would be supporting children on 'gender affirming pathways' for children receiving hormones under endocrinologists.

My understanding had been that children should no longer be 'gender affirmed' or given puberty blockers and that psychological support should be exploratory to understand the child's context and wider needs?

I also thought clinical trials had not been agreed and were unlikely to be agreed?

Does anyone have any clarity on the current situation in terms of medical pathways, the new clinics, psychological support and the clinical trials?

Here is an extract from the job advert:

Job overview

Due to the development of a new young people’s gender service, there is an exciting opportunity for a Clinical Psychologist (Band 8a) to join The Nottingham Young people’s Gender Service (NYGS) at the forefront of delivering care and support to young patients. You will receive in-depth training and clinical supervision whilst working with our experienced nurses and MDT within a forward thinking and supportive NHS Trust.

NYGS are recruiting to a new team comprising Consultant Psychiatrist, Paediatrics, Advanced Clinical Practitioners, Clinical Nurse Specialists, Psychologists and Research assistants. You will have the opportunity to work with a progressive team leading the way nationally and international in children and young people’s Transgender Health.

NYGS is a multi-disciplinary service offering psychological support to young people on the gender affirming medical pathway and looked after by the adolescent endocrinologist service, some of them will be awaiting to or prescribed hormone blockers or hormones by the NHS following an assessment by the Gender Identity Development Service.

Main duties of the job

The new service will provide multi-disciplinary care and support to young people aged from 11 to (and including) 17 years old who are about to receive or currently receiving gender affirming medical treatment from the Specialist Paediatric Endocrinology services (SPES) which is the endocrinology arm of the Gender Identity Development Service (GIDs) which will be closing on the 31st of March 2024.
This new service (NYGS) service will work to NHS England’s published interim service specification for specialist gender incongruence services for children and young people (Interim Service Specification).
NYGS will sit within the established NCTH Network which provides the Nottingham Centre for Transgender Health Adult Service, the East of England Gender Service, the Linked Clinic activity with Indigo Gender Service and the Linked Clinic activity with the Sussex Gender Service.

But if both the GRA and PC of GR don't go - ie we keep the latter - activists will just keep on and on. Safeguarding won't be achieved.

This is my greatest apprehension. In the same way that NAMBLA and PIE have never truly gone away and the concepts and ideas behind them continue to be put forward, I have profound reservations about the potential for the opportunistic ongoing harms created by these pieces of legislation.

How is this meeting in any way ethical?

It's literally using children as experimental subjects, putting their fertility, sexual function and brain development at risk.

@ResisterOfTwaddleRex @RethinkingLife that all makes perfect sense.

My gradualist approach mirrors my current IRL journey to support my daughter. I'm in choppy waters right now but luckily I've got some people who've been on the journey all along and their critical thinking continues to kick in. I fully believe that had I gone "full ultra" (which isn't my style anyway) I would be in a more precarious position than I am now. The incremental gains have helped to build a foundation.

But I'm glad I've got the absolutists reminding me of the loopholes. It keeps me on my toes, in a good way.

To add: raising public awareness of autogynophilia is also key to this.

Obviously it's a different paraphilia (and I'm hopefully within MNHQ guidelines here) but paedophilia is a good case study. Prior to heightened public awareness of it, NAMBLA and PIE had a much easier job WRT the loopholes.

As an aside, MN gave me one of my "no way!!" moments re NAMBLA. Prior to being on this board, I just figured it was a made up name and group in a South Park episode. Good old South Park have clearly been all over this whole wider topic for a while, through the medium of comedy.

Spot on. But that's what society have allowed transactivism to do. To upend all our accepted standards for safeguarding children to the extent that all of our safeguarding organisations have been corrupted:

Social Work England exposed this in Rachel Meade's successful case against them.
The NSPCC exposed this with their initial condemnation those exposing their employee wanking in rubber fetish gear in the toilets
The CQC are a Stonewall champion
Ofsted were a Stonewall champion
The DfE threw money at Mermaids (notorious for their paedophile / porn scandals) & Stonewall who were busy dictating to schools that girls must share changing rooms, sport etc with boys claiming to be girls.
Great Ormond Street Charity are tone deaf enough to fly the pride flag at the hospital telling some of the most unwell, disabled and vulnerable children in the country that their bodies could be flawed but fixed with a sex change
And as for the NHS.....

Organisations who should centre children's safety above all else have instead centred a toxic and dangerous lobby who have been allowed to use children to promote their niche beliefs .

I cannot understand how these trials could pass ethics.

The premise of any such trials is: we're going to knowingly harm children if their parents agree to it for a mental health condition we know would likely resolve through natural development.

It's unbelievable we've ever got here it's barbaric.

It's not enough though to just shout safe guarding and think that'll change things.

The Safeguarding concept has been so eroded, and utilised by both sides, it is no longer the clear alarm to all it should be.

Tactical challenges and small gains have to be used whilst continuing the pressure relentlessly.

People deciding policy and making decisions under public scrutiny have to be given reasonable and justifiable arguments they can make whilst maintaining their positions and professional credibility.

There are many people working within the system pushing back but they can't do it just by shouting 'safeguarding' and 'it's all nonsense' kjk style. They'd be ignored sidelined and shut out.
Trust me I know because I've been there.

It's easy to criticise Cass or Genspect or Sex Matters because they're not ultra enough, but give them a break and appreciate their role. Whilst maintaining the pressure to bring the whole shit show down.

Tell me about Ethics.

What do you mean @@mumda

Re shouting about safeguarding. This kind of framing - sorry to say - comes off as a silencing technique and I regard it as one. But you hear it a lot because lots of groups and people say it and I'm not sure it's always said with an intent in mind but like I say, that's how I take it.

There are women who've been pushed to the sidelines. It takes some finding and that's presumably the point of pushing them out. Especially if they are helping us understand why you CAN repeal the GRA.

Example here in a thread: x.com/alessandraaster/status/1863574019812798958?s=46&t=WHoOZ_3Kv5G6-FyQuvE0LQ

Thanks for that X thread.

I watched this "GC infighting" unfolding at the time but didn't see this particular thread.

TBH I'm looking forward to the day when we can all look back on this and wonder how on earth it all happened. Obviously that will also come with a lot of heartache regarding all the children and young people who have been physically and mentally harmed forever. I don't think I'll ever get my head around that part 😢

The safeguarding failures relating to all of it will be wide open for everyone to see at that point, just like all historical safeguarding failures. Sadly, we'll never learn fast enough at a societal level. We'll just be on to the next one.

To add: re the wondering, obviously once you know about the Denton's document, your wondering takes on a new direction. It's so massively messed up. Both the scale and nature of it.

Okey dokes.

Some food for thought on ethics:

If the NHS does fully tracked trials when administering medication that has an unknown (likely permanent) impact on children's brain development, does that make them more or less ethical than Mengele when he did his fully tracked trials on twins (where the outcomes were also unknown and likely permanent) in the second world war?

Is there any detailed info in the public domain on the proposed trial? I know the team and site have been announced but any sign of a protocol or which ethics committee it's going to? If they haven't got their ethics yet I'd be amazed if recruitment started in Jan or Feb - there will definitely be changes requested by the ethics committee (I've had multiple for tiny studies) and just setting up the admin and contracts for a multisite study takes months.

Is there any detailed info in the public domain on the proposed trial?

Beyond what I posted above, I haven't seen any.

It's not on clinicaltrials.gov

Not listed on Be Part of Research
https://bepartofresearch.nihr.ac.uk/results/search-results?query=Gender%20dysphoria&location=

or ISRCTN

https://www.isrctn.com/search?q=&filters=condition%3Agender+dysphoria

Although it looks like it will be an 'invitation' trial, I'd still expect to be able to see the protocol on relevant sites with an elaboration of the inclusion and exclusion criteria and the treatment protocol(s).

Maybe it will eventually appear on KCL's or a related site as Simonoff is the Principal Investigator?

www.kcl.ac.uk/research/pears-maudsley-centre

Ethics approval is supposed to be due this month with recruitment ready to start in Feb. 2025.

They never say "subject to ethics approval" do they? It's almost as if they think ethics approval is in the bag. I wonder why that might be?

A couple of recent tweets from Jamie Reed (the American gender clinic whistleblower) on the proposed clinical trial:

https://x.com/JamieWhistle/status/1864711772600467724

"The nytimes needs to make a correction. Emilty Bazelon & Adam Liptak wrote this sentence: “In Britain, young people can get prescriptions for puberty blockers in clinical trials.”

This is not correct.
Transgender Care for Minors Faces Supreme Court Test

There is no clinical trial that is currently enrolling patients. There is no published or public protocol. There is no published or public inclusion/exclusion criteria. Any clinical trial (FYI my Masters of Science is in Clinical Research Management) will need to be approved. There are serious clinical researchers and ethicists that doubt that this trial will be approved.
Medical Ethics Declaration of Helsinki"

A trial will be done. And kidding ourselves it can’t be done is naive.

(I wrote this on a different thread but copying it here too. Apologies if the Sallie Baxendale link is already on this thread. I can't remember which one I got it from)

There has already been a 9 year trial... in the US. It used US taxpayers' money (it had a huge grant) yet nobody knows the results:

https://www.nytimes.com/2024/10/23/science/puberty-blockers-olson-kennedy.html

Thinking about this a bit more,
given it's of international interest, could Wes Streeting put pressure on the next US government to force its publication? From a UK perspective, I would like the NHS to have access to the methodology and results of this US trial before deciding whether it's ethical to start our own**. Ideally, the Cass Review would have had access to this US trial. Had it done so, we might not be in the position where we "need" to run one here.

**I can't imagine a situation where it's deemed ethical to run a puberty blocker trial in the UK. Fertility and bone density aside (both of which are red flags anyway), the impact on the developing teenage brain is unknown and highly likely permanent in every case.

Sallie Baxendale's explanation of what we already know about brain development tells us all we need to know about whether preventing puberty completely is ethical:

How on earth could it ever be ethical to run a trial where the outcome would be highly like to be permanent brain damage?

I just can’t see how this could get ethical approval.

Just maybe, they could gather kids who are already taking the drugs and give them trial-like follow up.

But giving out new prescriptions to children for drugs which have huge adverse effects and no benefits? One of Cass’ key points is that there’s not even a consistent explanation for WHY the drugs were being prescribed. For a clinical trial, you’d need to be able to say exactly what effect was intended and why you think it outweighs known problems.

The drugs have become an article of faith for gender loons, but there are no medical grounds for prescribing them, only ideological ones.

I’ve no doubt it will be done. The point is it can’t be ethically done.

I can believe setting up the trial is plausible, what I cannot believe is that any parent can or will give informed consent when all the risks are fully explained.

As ever, I applaud Deborah Cohen's courage while acknowledging that this shouldn't need courage:

https://www.mumsnet.com/talk/womens_rights/5226742-puberty-blockers-can-a-drug-trial-solve-one-of-medicines-most-controversial-debates

Some parents are so frightened / bullied / confused / unable to practice firm parenting that they'll sign anything if their child has got caught up with any of the toxic organisations. Groups who will threaten any parent with "better a son than a dead daughter" and attempt to alienate the child from the family, so desperate are these adults to transition other people's children.

I suppose what it does do in the long run is set these parents up as legally culpable in the if they failed to protect their child's long term health, their brain & bone development along with their fertility because they felt threatened by transactivists and their groups? But by the time the child matures and finally understands the damage, it will be too late. Not sure that suing their parents would give them much satisfaction.

I can't imagine how the poor parents who've been gaslit, manipulated and coerced into sterilising their children by the absolute ghouls pushing that narrative must feel.

And it's not borne out by evidence.

Those poor families.

😢

I should imagine most are firmly clinging on to the fact that their child must be truly trans and that this must be life-saving. They won't be listening to any of this until it gets deafeningly loud.

Seeing the pain in Elon Musk's face when he spoke about this was heartbreaking. It's hard to know if it's kinder that his eyes have been opened to it or he remained in the dark. It's impressive that he's channelled his pain into helping get the message to the world about how dangerous it all is.