The Cass report - Peer review

[BeizenderKarneval]

There has been some peer review work done on the Cass review, something that a lot of us in the industry knew was problematic but that has been used by government and a number of notably outspoken individuals to justify their hateful positions

The results and conclusions are quite compelling, and I urge you to read them for yourselves:

Critically appraising the cass report: methodological flaws and unsupported claims

I find this section especially interesting:

“It undermines the legal competence of both children and adults to access medical treatment and dismisses almost all existing clinical evidence on trans people’s healthcare by applying impossible evidence standards which, if applied to other medicines would invalidate more than three quarters of the existing treatments used in paediatric care which, like puberty blockers, are currently being prescribed off-label.”

The report’s primary conclusions rest on excluding 98% of the relevant evidence on the safety and efficacy of puberty blockers and hormones for lack of blinding and controls.

What this means is that they require studies in which some patients are given the treatment, and others are unknowingly given placebos.
This is not only a clear breach of medical ethics and monstrous suggestion, but also impossible due to the obviousness of the impacts of puberty blockers and hormones.

The report also strays far beyond its scope and competence in recommending a review of adult services and in suggesting that young people ought to stay under the care of children and young people’s services until the age of 25.
The latter is based on highly questionable understandings of brain development which have been repeatedly debunked as an oversimplification of the constant changes in human neurology over the course of our lives.

This recommendation, especially in a context of an already broken system of care for both adults and children, has the potential to have a significant negative impact on the lives and wellbeing of trans people in the UK.
Underpinning this report is the idea that being trans is an undesirable outcome rather than a natural facet of human diversity.

This is clear not only from the recommendations but also from the exclusion of trans researchers from the design of the review process and the links individual members of the research team have to anti-trans groups, which the Cass team were warned about.

I look forward to an interesting dialogue.

How on earth is he allowed to do that?

Thank you.

Add me to the group who doesn’t give a fuck what misogynists think about Mumsnet. Plus ça change, eh.

OP deflecting because he’s had his bottie spanked on his original attempt at a ‘gotcha’.

plus ca change indeed.

Oh I hadn’t clocked that. Unethical in the sense that the control group don’t get treatment?! Wow.

I visited Dachau concentration camp last year. The camp controllers were supporters of OP’s methodology. Not many others are

I don't care what misogynists think either. Neither do I care what the flat-earthers think.

We didn't really need the Cass review. Anyone with an ounce of intelligence or basic decency knows:

1. Humans can't change sex.
2. Lying to children that they can change sex is unethical.
3. Giving children drugs that mean they will never go through puberty, and therefore never go through the normal physiological process entailed in becoming an adult, is unethical.
4. Sending children down a pathway that puts them on dangerous, life-shortening cross-sex hormones is unethical.

Anyone who thinks that it is acceptable to put children on drugs to permanently stop them going through puberty is either a monster of Mengelian proportions or so stupid they should probably be locked up for their own safety.

This is a really valuable explanation of how echo chambery chat forums work - thank you @TangenitalContrivences .

I assume that the more contested a topic, the more polarisation happens, and happens faster.

I doubt if Mumsnet is perfect seeing as how all (I like to believe ) us posters are humans with our biases and passions, but I can see how Reddit's upvoting and casual mods will be making it more acute

OP Reddit is a very different forum to this one as you know. It's majority users are male and American for one so a very different user base to this primarily female, British forum.

Another poster has gone into detail about how the upvoting and comments promotes groupthink.

I have issues with how women are treated on reddit. Every gender critical subreddit ever made has been banned. If you make a comment on one thread that moderators from a different subreddit see and dislike, you can be banned from all subs they moderate. There remain multiple actively racist, incel, woman hating or otherwise horrible subs that stand but gender critical women cannot be tolerated.

Gay male subs like AskGayBros don't get banned for users saying they don't accept transmen as sexual partners. Lesbians do not get the same privilege and there are no subs where women who are same-sex (not gender) attracted are allowed to post about it.

The main 'lesbian' sub r/lesbians is just porn for men so there were other subs made for women such as r/actuallesbians. The majority users of that sub and others like it are transwomen (males). You can see that by the posts and also by checking what other subs the users are subscribed to using this website: https://subredditstats.com/subreddit-user-overlaps/actuallesbians

Image attached for reference. The users of the lesbian subs are majority also using various transgender subs.

All messages on a MN thread are ordered temporally so unpopular posts don't get buried. In fact, you tend to see them repeated often as people quote them. Posts that get disagreed with don't get deleted and unpopular posters are not banned.

The only way to get posts deleted is according to the Talk Guidelines. Usually on this board its down to personal attacks, prejudiced comments like racism or troll hunting.

I guess he asked, and he said yes?

for @TangenitalContrivences . Really useful reference posts, thank you.

Yes, super informative and helpful. Thank you for your patience and generosity!

Often with drug trials where there's a new treatment, such as happens in carncee trials, instead of a double bind trials 1 group get the existing treatment and the other the new 1. This could be done with pb where 1 group gets affirmation therapy and pbs whilst the other gets watchful waiting, however as we're talking about children it's never going to be ethical to do any sort of trial

patronising fuckwit

we can hardly fucking wait 🙄

Nah..don’t bother

@BeizenderKarneval
At a superficial examination, the section in italics does not come from the "Critically Appraising the Cass Report" paper by Noone and colleagues as implied, it appears to come from a reaction to the Cass report by an organisation called TransActual. The figure of 98% of papers excluded also does not match what is in the paper by Noone, and appears to be an incorrect interpretation, based on the assumption that only high quality papers were included in the synthesis, when the systematic review abstract clearly states moderate and high quality papers were both included in the synthesis. As these are errors that any competent undergraduate student should not be making, any of those "in the industry" having difficulty could benefit from requesting assistance in understanding and correctly citing medical research literature from the hospitals statistics or research departments, or university library. Such services are usually very happy to help.

"On the second point, I've never heard of opposing evidence being closed down and banned on Reddit (maybe it does and I only look at the balanced, kinder sub-Reddits?), but shutting people down for epxressing an opinion that doesn't align with the cult does happen on MN, doesn't it?"

You have got to be kidding me!
Absolutley EVERY female only sub-reddit got shut down and women banned, apart from the porn ones - because men still know what women are when it comes to their sexual satisfaction.

I've seen threads about the complications in trans surgeries shut down because it frightens people who want the surgery.

Gender critical views, no matter how calm and balanced, are shut down and banned. We do have good discussions on Mumsnet. People are allowed and do disagree with each other. Stick to the Talk Guidelines and your posts will stand.

"based on the assumption that only high quality papers were included in the synthesis, when the systematic review abstract clearly states moderate and high quality papers were both included in the synthesis."

I remember Dr Cass clarifying this specifically as well. I will see if I can find her addressing this.

Speaking of bias. 'This is clear not only from the recommendations but also from the exclusion of trans researchers from the design of the review process and the links individual members of the research team have to anti-trans groups, which the Cass team were warned about.'

Anti-trans is an interesting phrase to use on a post expecting balanced discussion.

You sure it didn't say "There has been some poor review work done on the Cass review"?

Yes, often the control group in a drug trial is the existing treatment, so the new drug is compared to that rather than a placebo on its own. So you get one group on the current gold standard plus a placebo pill and the other group on the current gold standard plus the new drug. Ie all study participants are getting the current best proven treatment for their disease and some are getting something maybe even better but not proven.

study design is fascinating - and clinical studies happen in children all the time - otherwise how else would you ever get new treatments for childhood illnesses?

Which is why it would be scientifically possible to run a PB study where, for example, all study participants receive thorough psychological support, and some also receive PBs and/or other hormones, to see if those who also receive hormonal treatments have better outcomes than those who only receive the mental health support. HOWEVER, I think the evidence laid out in Cass makes it clear that the existing evidence for PBs is already so thin as to make it ethically very unsound to conduct such a study. Because we already know the adverse effects of the PBs outweigh the benefits for anything other than precocious puberty. And Wes obviously agrees due to his actions in making it harder and harder to get them.

@BeizenderKarneval maybe familiarise yourself with what a peer review actually is before you come a-lecturing? Also, if you don’t know what placebo-controlled trials are, you’re not ready to be engaging seriously in this kind of discussion.

Puberty is NOT a disease.
Gender identity is an elusive construct.

It cannot be compared with treatment for life threatening illnesses.

I'm sure that Beiz will come along to say that the post 'has done what it was intended to do', or some other such bollocks soon.