Ban on puberty blockers to be made indefinite on experts’ advice

[IDareSay]

Good news, just released:

“The Commission on Human Medicines (CHM) has provided independent expert advice that there is currently an unacceptable safety risk in the continued prescription of puberty blockers to children. It recommends indefinite restrictions while work is done to ensure the safety of children and young people.”

www.gov.uk/government/news/ban-on-puberty-blockers-to-be-made-indefinite-on-experts-advice

That's so scary. I can easily imagine being one of these girls if I'd been born a decade later. It was all self harm as you say when I was young.

Very creepy of adults (especially men, what's it got to do with them?) to push this on children! I'm very glad I wasn't of this generation and grew up to have a (fairly) healthy female body.

Cass is a paediatrician, not a feminist. We never expected her to consider the issue from the same angle many of us do here on FWR. But I'm sure she's had an insight into what this movement is really about, given the amount of abuse and violent rhetoric aimed at her by unhinged activists, just for producing a scientific review they didn't like.

Some people choose to treat their gender dysphoria and others choose to let it fester all their lives. Sometimes it does ease, or at least get easier. Other times it reaches a crisis point. There are healthy coping strategies and there are extremely unhealthy ones as well - the same brand of virulent self-denial that leads to people unconvincingly proclaiming themselves to be Ex-Gay, for example.

None, that was my point. There must have been something behind the massive and rapid increase. If it was from seeing happy adult transmen, how did such an increase happen in 7 years? They can't all have been those 15 girls from 2009.

None, that was my point. There must have been something behind the massive and rapid increase. If it was from seeing happy adult transmen, how did such an increase happen in 7 years? They can't all have been those 15 girls from 2009.

And it's an excellent point @JazzyJelly

I welcome conclusive evidence that puberty blockers are catastrophically harmful and do not address gender incongruence. I would be very confused since it would not in any way match my own experiences, but if those turn out to be the findings then something must have caused them.

Your discrepancies in your accounts of having a condition that meant you didn’t progress through puberty and also received puberty blockers at a late age, 17, mean your individual experience counts for little in terms of confusion in relation to outcomes of children puberty blocked earlier, at the ages of 12 or so.

And even despite that, in practically every clinical trial there are outcomes that aren’t the same. It’s not “confusing” it’s part of the evidence. If only 0.1% of children out of puberty blockers are helped, congratulations on being that 0.1%, but the other 99.9% weren’t. This isn’t “confusing”, is it?

What we do from there is important. Saint Cass herself said we should not consider trans and non-trans outcomes in a biased fashion and people should get treatment if they need it.

”Saint Cass.” Pathetic. Biased fashion. What treatment? What treatment do they need? Watching and waiting and supporting through difficult times is treatment. It has better outcomes.

If it is not safe to completely suppress puberty then we may still be able to gain some beneficial effects from partial suppression using a specific medication profile.

This isn’t possible.

It may strengthen the case for earlier interventions with CSH for patients who have a clear clinical need and where PB's aren't with a safe window.

Yes, of course, while all the focus is on puberty blockers, let’s just ignore the incredible harms from wrong sex hormones and pretend putting children on them earlier isn’t also going to cause massive problems 🙄.

There is no safe window for wrong sex hormones either. Cancer, heart disease, liver disease, early death. Given you have a myriad of health problems you’ve admitted to, you’re not naive to the fact that you’re on a pathway to significant morbidity and a shortened lifespan as a result of decades of wrong sex hormones, so why are you so desperate to get kids on them sooner?

At the end of the day, this is about safety and the best possible individual outcome isn't it?

The best individual outcome is for a person to receive therapy for their body dysmorphia, come to terms with the fact they can’t change sex and they have to deal with the body they have, and accept that body modification doesn’t help and risks a myriad of health problems. To anyone sensible, this is win-win for everyone. And it’s achievable. Because it’s happened. It’s just that too many clinicians have taken the easy way out and foregone appropriate treatment because it’s in the too hard basket.

Instead, let’s commit children to a lifetime of medical misery instead🙄

At the end of the day, this is about safety and the best possible individual outcome isn't it?

Isn't it?

Yes.

That's why:

a) data should be available from the 9000 patients who have already had this treatment. It's a valid use of the public task exemption from GDPR. If the harms/benefits are unknown, it's unethical not to do this.

https://ico.org.uk/for-organisations/uk-gdpr-guidance-and-resources/lawful-basis/a-guide-to-lawful-basis/lawful-basis-for-processing/public-task/?q=proportionate

b) parents should not be treated as a risk to their children if they are doing everything they can to stop their child being part of what could best be described as a medical experiment. The temporary, then indefinite, ban has stopped the experiment running wild but a new trial, when the stakes are equally as high as they were to justify that ban, is simply not ethical.

I'm not a member of Bayswater parents' group (and we haven't yet stopped our daughter accessing the internet) but I absolutely recognise the despair of parents in the forum that's described appallingly badly in this article that I stumbled upon recently:

https://www.thebureauinvestigates.com/stories/2024-07-02/one-day-they-may-thank-us-for-that-abuse-inside-the-bayswater-support-group/

If we've got the Tory and Labour parties recognising that the safety and efficacy of puberty blockers is unknown (and we're already seeing healthcare recognising that this applies to cross-sex hormones) and we've got schools and social media telling children that they can be their authentic selves by following this pathway, that anyone who denies them this is a danger to them (including their own parents), Social Services being told that parents are "abusers" etc... who could blame a parent who feels unheard sharing ideas with others? Perhaps destroying their daughter's breast binder is all they could think of to fight against this tide of institutionalised activism.

First trans person I met was a trans guy - and that's the same for quite a few of my vintage. Media portrayals had an effect of letting people know treatment was available and that, combined with the visibility of trans women more generally and the stark realities that made apparent for treatment windows, meant male-assigned transitioners were over represented early on.

One small quibble, there is no such thing as a successful vaginoplasty. You cannot create a vagina in a man. Not a proper functioning one.

@ButterflyHatched , I am quoting @NotBadConsidering deliberately to get you to comment specifically on this:

"The best individual outcome is for a person to receive therapy for their body dysmorphia, come to terms with the fact they can’t change sex and they have to deal with the body they have, and accept that body modification doesn’t help and risks a myriad of health problems. To anyone sensible, this is win-win for everyone. And it’s achievable. Because it’s happened. It’s just that too many clinicians have taken the easy way out and foregone appropriate treatment because it’s in the too hard basket."

Coming to terms with your distress is the ONLY path forward. Medication, surgery, will never, ever make the pain go away.

Take a page out of the buddhists book.

Long-time lurker on this board and rarely post due to burnout so apologies in advance if my replies to this are delayed/brief. But anyway, no one so far (and apologies if I have missed it and someone has pointed it out) has acknowledged that there has already been a clinical trial of puberty blockers on children - the GIDS 2011 trial that absolutely was approved by ethics committee, with the researchers knowing the likely harms when they proposed it. It was rejected by the first ethics committee but approved by a second committee which almost unbelievably was of the researchers' choosing. Despite an increase in suicidality being observed a year into the study, and before the study had even been completed, prescription of puberty blockers for 'gender' reasons was introduced as standard practice. Publication of this study was delayed by years, no positive outcomes were identified. When anyone asks about long-term follow-up of these children there are tumbleweeds. The adult clinics refused to release their data for the Cass review which could have provided useful information on long-term outcomes. Doing more trials on children where some healthy children have their normal pubertal development disrupted and endocrine disturbance induced is completely unethical as well as unnecessary as far as I'm concerned and that this was a recommendation of the Cass review is so disappointing. She even addresses children directly in the review asking them to join the studies to help those who come after. Doctors already know suppressing normal puberty (ie not precocious, ie abnormally early puberty, and they even have to be very selective and treat for the shortest time possible when managing those cases) is harmful so I really don't know how further experiments are needed to prove this is the case before the medical profession says no. It's all backwards. You don't do a study to prove an intervention you already know to be inappropriate, harmful and unethical is indeed inappropriate, harmful and unethical so that you can prove to those demanding it that it's no good so will not be available, sacrificing selected children in order to do so and telling them they are helping those coming after them. I can only hope it is rejected by ethics committee this time but have serious concerns it will go ahead.

I'd actually forgotten that @NotAGentleReminder but I do remember this now. Very important point.

Well I would tend to agree, but the point is that even the people who think they can turn a penis into a vagina agree that you can't do it if you only have a child sized penis to work with.

Wow. I did not know that.

Do you disagree with Baroness Cass who has said on-record that:

-She hopes that for those "where there is a clear, clinical view" that the medical pathway is best will still receive that.
-She emphasised that a medical pathway, with lifetime implications and treatment, required caution but "it's really important to say that a cis outcome and a trans outcome have equal value"
-She expressed concern that her review was being weaponized to suggest that trans people do not exist, saying "that's really disappointing to me that that happens, because that's absolutely not what we're saying." She also clarified that her review was not about defining what trans means or rolling back health care, stating "There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access — under a research protocol, because we need to improve the research — but not assume that that's the right pathway for everyone."

Because it sounds like you do and I would like to understand your stance clearly.

And I should add, that 2011 study should not have been approved either. There never was any need or clinical justification for experimenting on children like this. It was done due to pressure from activists and an attitude of resignation among medics that affirming parents would just take their kids to the Netherlands or USA if they said no.

BonfireLady · Yesterday 18:09

I'm going to add a personal note to this thread. I have a difficult day ahead of me tomorrow (meeting in school... related to the wider subject of gender identity) and I need to vent.

I'm sorry you're having to wade through such a river of bullshit. I hope your daughter gets the decent care she needs, from a counsellor who is not an enabling activist.

Is it only gender dysphoria that can and should be converted away into passive indifference, or are other inconvenient aspects of a person also something that should be corrected?

For those interested, this is the investigation into the decision of the ethics committee regarding the 2011 GIDS study
https://www.hra.nhs.uk/about-us/governance/feedback-raising-concerns/investigation-study-early-pubertal-suppression-carefully-selected-group-adolescents-gender-identity-disorders/

Do you remember what category of children Dr Cass said might benefit from puberty blockers?

Being discontent with your body, your life, your friends, everything is a fundamental part of life as true and unbreakable as the speed of light or that gravity exists - so yes. Everything.

The urge to change something because it is uncomfortable is very human - but some things - you cannot change. You, personally, ARE whatever your birth sex was. That will NEVER change. You will NEVER pass as the sex you want to be to other people, no trans people anywhere do. You don't like that, sorry, but it's still true and it's only by acceptance of the reality of the word - that life is suffering, life is short and then you die, can you get any satisfaction out of life.

The fact that so many on here are so confident the trials won't take place when they are due to start recruiting in 4/8 weeks time, the proposed protocols have been shared by the nhs and Wes said yesterday the trials would not be capped... really really worries me.

Agreed, the trials will start very soon. Deb Cohen said that the NIHR contract is in place. Plausibly, the new service model of the additional GI clinics will be where the recruitment happens if this is to happen with the assistance of a multi-disciplinary team.

But has confirmed trial will take place despite opposition. As I reported 3 days ago, contract with the NIHR is agreed and is methodologically complex

https://x.com/deb_cohen/status/1866858266464014408

Yes. Very good point!

Hahaha.

I guess there are at least four main variables at play, maybe: (a) is the issue something that's objectively bad?; (b) is the issue something that can genuinely be fixed, in a way that's tried and tested, with a high success rate and few complications?; (c) is intervention key, or does 'wait and see' sometimes work?; and (d) will a fix genuinely solve the person's issues, or are the concerns really about something deeper, leaving that they'll move onto something else once this fix has been made?

Something like, say, cleft palate surgery is a no-brainer quadruple ticker:

(a) no-one wants to have a cleft palate if they can possibly help it;

(b) the procedure has a very high success rate, with often little follow up care needed past a certain point;

(c) especially if it's carried out early - first surgery would ideally be carried out on a baby or toddler; and

(d) cleft palate surgery will nearly always improve someone's living standards hugely.

Whereas, the last time i checked:

(a) being a man isn't a bad thing at all, indeed it's very widely considered, other things being equal, advantageous;

(b) current medical knowledge doesn't offer any treatment that can stop a man from being a man. surgical treatment is at best a Faustian pact. the implications of very long term synthetic hormone use are unknown;

(c) a really little kid especially can't possible understand the full implications of a 'sex change'; and

(d) etc.

Edited to add.... That was meant to be a quote tweet @ButterflyHatched 's comments about Baroness Cass.

Ha!

She's neither a saint nor fallen from grace.

It's possible to think that the Cass Report is a gamechanger that marks a rowback to evidence-based care whilst also recognising the limitations that come with a foundation within the report that it's fact that we all have a gender identity. On balance, it's helpful that the call for caution has come from someone who demonstrates a belief that gender identity is real.

Surely our common middle Venn section here is that nobody should be given irrerversible medical interventions for which, according to a 4 year systematic review (not your or my opinion), there is no viable evidence base.