New paper argues that “gender-affirming care” for adolescents should not be measured by whether it’s “effective”

[UtopiaPlanitia]

Thread on TwiX from journalist Leor Sapir:

https://x.com/LeorSapir/status/1872632988531372290

"A new paper argues that “gender-affirming care” for adolescents should not be measured by whether it’s “effective” at reducing psychiatric distress and improving life functioning. Authors (inc. A. de Vries) gesture toward an “autonomy” focused model.

To be clear, this line of thinking has animated the “affirming” model for a while now. The authors are now saying it explicitly. Clinical/psychosocial outcomes don’t really matter, apparently. This isn’t medicine."

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-024-01143-8

The JKR post on this is fire seen by almost 500,000 so far.

This astounding paper reminds me of Hannah Arendt's The Banality of Evil: 'The net effect of this language system was not to keep these people ignorant of what they were doing, but to prevent them from equating it with their old, ‘normal’ knowledge.'

We're all used to the obfuscatory language gender activist medics and their cheerleader, insist upon. 'Gender affirming care/treatment' is so much nicer sounding than 'sterilisation, surgical mutilation and provision of toxic drugs to troubled minors'. 2/5

But this paper breaks new ground. It acknowledges that by the usual medical standards ('old normal knowledge') transitioning minors has not been found to be the unqualified success many have claimed. The proposed solution? Jettison the old knowledge. Redefine success. 3/5

'Yes, some young people given irreversible surgeries and hormone regimes regret it. Yes, some have complex problems that transition doesn't fix and may worsen. But hey, they wanted it and were given it. That should be the new metric of success!' 4/5

I'm not sure I've ever read a better example of what Arendt described when analysing those determined not to break ranks, yet who felt the need to justify their participation in atrocities: 'self-deception, concealing a ruthless desire for conformity at any price.'

Also:

Transgender Trend

New paper deconstructs the concept of "effectiveness" in gender-affirming medical treatment for adolescents.

Because being "effective" is such a normative measure by which to judge medical procedures.

Who needs "effective" treatment anyway?

The paper is going peak more people than ever.

Someone on this board once posted about a surgeon who had carried out Lobotomies. He travelled round in his later life, talking to old patients and trying to show that the procedure had helped them. I imagine that the idea that he could have hurt his patients was just too difficult to admit to himself. I suspect that de Vries will be the same and even on her dying day, no matter how much evidence to the contrary is laid before her, will believe in the benefits of the Dutch Protocol.

In the US, campaigners have ben working on a clever strategy with the medical insurance companies. They have been trying to make it compulsory for any coverage of costs for puberty blockers, cross sex hormones and surgery to automatically entitle costs relating to future treatment needed for complications arising from side effects and de-transition costs, should claimants later wish to de-transition. The insurance companies have made it clear that if they are forced to do this, they will withdraw cover for the gender medicine - which is very telling about their confidence in their safety and efficacy!

Is there any information available about this @Brainworm?

It sounds like a very sensible way of forcing a First Do No Harm approach. If the advocates of medical transition truly believe that what they are doing is good for long term mental and physical health, they should have no problem urging the insurance industry to back this "essential care". Or.... perhaps it will help expose this scandal for what it is, by creating a giant hole in funding it.

It doesn't help address the pipeline of children and young people who end up believing that their distress is because they are "in the wrong body" but it might stop some of them permanently damaging their bodies. Ideally it needs to be accompanied by a change in how schools teach children about the subject of gender identity and also how therapeutic support is delivered when someone does hold a belief and they have a "gendered soul" that differs from their sex. Unless this is addressed at the same time, there will be activists ready to exploit people's distress, who will continue to make (potentially then self-fulfulling) claims about the suicide risk associated with lack of access to "gender affirming care". Whipping up this kind of fear is dangerous to vulnerable, desperate people who may then come to believe that suicide is their only option.

archive version: https://archive.ph/HjXYo

"This would all be rather touching if it weren’t taken from “The Lobotomist,” Jack El-Hai’s biography of Freeman, who was America’s foremost practitioner of the procedure. The patients he visited were people whose brains he had mutilated — inserting a “picklike instrument” through the eye socket, piercing the thin bone, and jamming it into the delicate tissue of the prefrontal lobes, leaving permanent scars on the very seat of personality and consciousness.
Today, we rightly view this procedure with horror. Even within Freeman’s lifetime, it fell into disrepute, a fact of which Freeman seems to have been acutely conscious. He must have hoped that he could find evidence for lobotomy’s benefits, enough to salvage his legacy."

I can’t help feeling sad for that broken old man, at the end riddled with cancer and missing a significant chunk of his colon, yet still clinging to the wheel of his camper bus as though one more mile, one more case history, might somehow turn an atrocity into a triumph. In his desperation to become a medical hero, he had become a hero out of Greek tragedy: consigned to ignominy by his own hubris, and doomed to struggle against a fate that was inevitable.

Sounds somewhat like a pharmaceutical odyssey......which creates and sustains a whole new market for the voracious multinationals.....never under-estimate the appetite of these corporations.

Thank you. That was the exact article I was thinking of.

they might have vaginal intercourse (willingly or otherwise)

I'd say "will", not "might". Our lifetime prevalence of sexual assault is about 90%.

we really made a massive mistake when we shut the loony bins in the eighties. I look forward to this approach being adopted for other areas were measurable outcomes dont matter, like car brakes and fire extinguishers etc. Fucking bonkers.

"not effective"

So how does that interact with medically negligent or medically harmful?

If you do something medical to someone and it's 'not effective' that implies a neutral impact where the situation has not improved.

If the action you take has a serious negative effect in terms of complications or side effects because it's an unregulated procedure or because you've just felt like doing it despite a lack of medical evidence, that's either / and self harm or physical abuse.

At that point ethics and legal protections kick in, even if the treatment is "not effective".

Why?

Cos otherwise we'd have a bunch of people deliberately running around experimenting on children for their own ideological reasons.

This is why fgm is effectively illegal. Not being it's "not effective" but because it's harmed girls.

And yes this is the level we are now at, if have the Blue haired woo woo religion deciding that yes, because you mentally are distressed / believe you are a merman you can have boobs cut off and and your legs stitched together to form a fin even if it's 'not effective'.

Cos Frankenstein was a monster. Who created a monster (the monster wasn't called Frankenstein).

@BonfireLady , I work in a field that involves engagement with gender medicine. Earlier this year, at an international autism conference, some American practitioners told me about t
the campaign to force insurance companies to pay out. They said it wasn't getting much media coverage for several reasons. Firstly, it is common for groups to lobby insurance companies to pay for 'associated costs' with treatments. Also, the campaigners aren't keen for it to be seen or understood as a strategy to have coverage for gender medicine halted. They said that there are different factions and some want no gender medicine, whilst others want it to be more judiciously administered, with safeguards to address on-going issues and complications.

Since then, I have heard Sasha mention it a couple of times on the Wider Lens podcasts. The way she has done so, commenting in passing, made me wonder if there was an episode that discussed it at length. I only dip in and out of the podcast.

How does this tie in with the trope that trans-identifying young people/children must be affirmed and transitioned because otherwise they’ll die by suicide? That is directly stating that transition/affirmation is essential because it effectively reduces a harm. (We know it actually doesn’t, but that’s the claim and one that has pushed many well-meaning parents into supporting affirming “care”.)

So if suicide rates were found to stay the same or increase after transition, that would be fine because the person got what they wanted and were affirmed? But pre-transition, they must be affirmed on the basis of an argument that they’ll be saved from harm?

Thank you.

That's very interesting and something I'll look out for.

Whilst I can see that it's contentious, it remains true that the people who have medical interventions related to gender identity will need lifelong care, including the possibility that they may detransition. Especially as detransitioning is now being rebranded as simply a different embodiment goal (which in itself is scandalous, as per comments above, as it's forcing vulnerable people to take accountability when they thought they were being helped by professionals).

It's a positive that this is on the radar of autism groups. Hopefully that's a step towards sanity.

How does this tie in with the trope that trans-identifying young people/children must be affirmed and transitioned because otherwise they’ll die by suicide?

It ties in by being evidence of how they’re abandoning that trope. They know it isn’t working and isn’t backed up by evidence and data. It won’t be long before they try to convince everyone they’ve never claimed anything dramatic about suicide and we must be thinking of other gender clinicians on another planet.

So if suicide rates were found to stay the same or increase after transition, that would be fine because the person got what they wanted and were affirmed? But pre-transition, they must be affirmed on the basis of an argument that they’ll be saved from harm?

That's about the size of it. And in the meantime, thousands of terrified parents, vulnerable children and vulnerable young adults are under the misapprehension that suicide is the likely outcome if there is no access to medical interventions.

Insurance was discussed on Benjamin Boyce’s recent Calmversation podcast episode with Leor Sapir. I rarely listen to BB these days because he frequently comes across as an old school chauvinist. I made an exception for Leor Sapir and was glad I had. Leor Sapir is following the unravelling of US paediatric gender medicine closely and had some interesting insights.

Thanks Betty. I'm about to go and run off some of the excesses of Christmas and will listen to that as I plod!

And that's changing too. Cass changed that landscape, and the buildup of legal cases ongoing in the US, even the UK govt statement on suicide claims. Scepticism is growing and although everyone wants to "be kind" the misapprehensions about the benefits of transition, suicide and the rest are slowly but in growing patches being replaced by a lot of "really?"

I do see this paper as a bit of last-ditch desperate nonsense trying get past the fact that they're losing their grip on children's medicine rather than something to take very seriously.

So they have more than 20 years of data/evidence from the Dutch protocol and this is the best they can do?

Crikey.

https://ourduty.group/education/the-dutch-protocol/

I do hope so. The fact that this particular group of adults ever got such a grip on children's medicine is a major scandal. It just shows the massive power of this ideology to abuse.

As I understand it, the measure of effectiveness of treatment is whether it makes gender dysphoria disappear. But how can that actually be measured? The happiness or unhappiness of the patient? Surely that could be for other reasons too. It all seems very subjective.

We live in times where self-identification and self-expression has become extremely important compared to historical norms - to the extent that if you modify / mutilate your body to make it conform with your identity, that's your prerogative*. I think that's where the trans lobby are really coming from. I think they see 'effectiveness' in medicine as an old fashioned block to get around, as it sets up an objective standard, rather than the subjective one of self identity. I guess that's what the paper is trying to do.

*The problem is that people are manipulated into one identity or other all the time.