Puberty blockers: Can a drug trial solve one of medicine's most controversial debates?

[IwantToRetire]

It is among the most delicate and controversial challenges in modern medicine - how to determine whether the benefits of puberty blockers (or drugs that delay puberty) outweigh the potential harms.

This question came to the fore in June 2023 when NHS England proposed that in the future, these drugs would only be prescribed to children questioning their gender as part of clinical research.
Since then, a new government has arrived in Westminster and Health Secretary Wes Streeting has said he is committed to "setting up a clinical trial" to establish the evidence on puberty blockers. The National Institute for Health and Care Research is expected to confirm soon that funding is in place for a trial.

The dilemma that remains is, how will such a trial work?

Eighteen months since the announcement there is still a lack of consensus around how the trial should be conducted. It will also need to be approved by a committee of experts who have to decide, among other things, whether what's being tested might cause undue physical or psychological harm.

But there is a second unanswered question that some, but by no means all, scientists have that is more pressing than the first: is it right to perform this particular trial on children and young people at all?

Article by Deborah Cohen continues at https://www.bbc.co.uk/news/articles/clyd2qe5kkjo

Thank you. I don't feel I live up to your portrayal! I have made many mistakes, though I'm not convinced it would have made any difference if I had handled things better. But in any family, there has to be some degree of acceptance that the people who love us and who we love are bound to hurt us, and to feel hurt, at times. I do not mean through abuse (though in my experience even some abuse can be forgiven, but only if can be done freely) but much more likely through weaknesses. One of mine is speaking too much when it would be better to remain silent.

The thing that is different with trans-related matters, is that trans activists have defined the one and only "right" course of action, which is wall to wall affirmation and support of anything the transgender person wants (or demands).

I think the key word here is "correctly". It's rather ironic that a worldview (trans identity theory, or queer theory, or any variation on those) that is an offshoot or development of postmodernism can be so dogmatic. What you see as "correctly perceived" is "your truth" not "everyone else's truth". My truth is based both on my understanding of "gender" and on physical reality. The truth of the trans people I know is based on their feelings having a mismatch with their physical reality, and rather than confront reality, they want to change reality. Sadly for most of them, that attempt is unlikely to be satisfactory, as physical reality is remarkably resistant to change.

Fantastic post

Managed to miss this one.

What a beautiful way to put it 💐

None of us is perfect. There's no such thing as the perfect parent. Every one of us will make mistakes as parents, as sisters, brothers, daughters, sons etc. But love doesn't expect perfect.

Unfortunately on this subject it one party is deciding what's "correct", and is therefore holding to ransom what is deemed acceptable. And on this board, that party isn't the parents. Parents like Rapid (and me and others) are looking at this from lots of different angles. Sadly, that's deemed unacceptable by TRAs who are whispering in the ears of vulnerable children and young people.

Well said.

I know some people see it as pragmatic and I fully understand their viewpoint.

My viewpoint is that to refuse to refer to, or at least outline, the ideological underpinnings of gender identity ideology Cass has given the concept of gender identity the imprimatur of seeming to be a medical thing rather than a social thing.

Gender incongruence exists because children and young people don’t feel they can tolerate living within the cultural stereotypes associated with their sex. And fixing that requires acknowledging that this is a socially created problem and not something inherently wrong or imbalanced within a particular child.

I see the Cass Review as a wonderful start to restoring balance to the treatment of distressed children. But it does nothing to address the reasons why a group of (largely male, largely middle-aged) activists insisted that preventing children from going through puberty would somehow make these children happier as adults and why the medical profession took them seriously and acted on their assertions.

My treatment was initiated by and overseen by a compassionate and insightful middle-aged woman. Where does this 'male activists' part come from? It's yet another falsehood you are using to paper over the reality we lived. Please stop.

My treatment was initiated by and overseen by a compassionate and insightful middle-aged woman

How are you defining 'woman'?

Oh come on, I thought you were an expert in the history of GIDS?

What's that got to do with the question I asked?

Still waiting for an answer to my question. You have agreed that men should not access women's spaces.
So: If a man tells us he is a woman, should we simply take his word for it and let him into our spaces?

The male activists are the men who claim to be women (after fathering their own children) who claim to think that sterilising children is progressive.

I presume the woman you're talking about, even if this is a female woman, was one of the medics who was taken in by these blokes and their agenda. Or was an ideological zealot like Helen Webberley or Johanna Olson-Kennedy.

Oh Bernadette Wren definitely falls into the zealot category:

https://www.transgendertrend.com/letter-bernadette-wren/

If it's the same person she should turn some of that insight on herself. Sometimes the compassionate thing to do is say 'no' to people who need to but don't want to hear it.

The Principal Investigator is Prof Emily Simonoff and that was announced at least 10 months ago:

https://www.england.nhs.uk/commissioning/spec-services/npc-crg/gender-dysphoria-clinical-programme/implementing-advice-from-the-cass-review/cyp-gender-dysphoria-research-oversight-board/

There are several protocols/methodologies proposed as Cohen describes. NIHR has issued a contract. The matter is with an ethics committee and whatever emerges will be the protocol. Recruitment starts in Jan/Feb 2025.