Why the NHS puberty blocker trial is appalling

[Soontobe60]

Stella O’Malley from Genspect telling it like it is - that a state endorsed trial of puberty blockers for gender dysphoric children should NOT go ahead.
the NHS are not walking into this nightmare blindly - there are enough experts out there telling them what will happen happen to these children if they’re given these life changing drugs.
https://x.com/genspect/status/1989896741358113127?s=61&t=gKvvk-rWmOlYFGMZN8QVvQ

https://www.whatdotheyknow.com/request/pathways_study_protocol

'This FOI request is being submitted on behalf of TranspariMED.
The NIHR has reportedly decided to fund the PATHWAYS: Puberty suppression And Transitional Healthcare with Adaptive Youth Services Study.
Please provide the following documents:

1. The initial funding application for the PATHWAYS study submitted to NIHR
2. The final funding application for the PATHWAYS study as approved for funding by NIHR (assuming that the initial application was subsequently revised and/or expanded)
3. The full scientific research protocol of the study (If DHSC and NIHR do not hold the full scientific research protocol of the study, please provide the full document that DHSC or NIHR holds that provides the greatest detail about the study design, including but not limited to inclusion/exclusion criteria, target recruitment numbers, and study endpoints.)
4. Information on when and where (e.g. ISRCTN) this study will be pre-registered, and whether that registration will immediately become publicly visible.

For context, what is of interest here is the detailed study methodology. Feel free to redact any or all financial, institutional and personal information.'

Trying to get my head around how someone high up in government or the NHS might think about this if they're not on board with trans ideology. Perhaps they are anticipating that long term the outcome of this study will be enough rationale to shut down the whole thing, so no more puberty blockers for "gender incongruent" children - that sacrificing the health of 226 kids to save thousands more in the future is a rational political choice. As awful as that sounds, could that be it?

I doubt it.

Don't kid yourself. He's one of the ones initially responsible for the current entrenchment. Just because he's done a U turn now doesn't mean he's innocent here. He was fully signed up to kicking women out of the party if they didn't conform for example.

Yes but he did evolve his position very significantly and he has been an (all too rare) voice of moderation and reason for a while now.

It may be that I am giving him too much of the benefit of the doubt, but I see how he could feel trapped between a rock and a hard place here. Given that Dr Cass offered that 'out' in the report, I see how he couldn't see a way to prevent a trial, given how many will be pushing for it internally.

I 100% agree that holding his feet to the fire now is the right thing for us all to do, particularly on the evaluation of the ethics committee, which sits outside of Cass's recommendations.

Surely we should treat mtf and ftm trans differently? Outcomes for girls on pb worse?
We nned more data on the population of trans people: how many successful transitions actually occur, how many people are living depressed due to not seeking to transition, how many failed transitions, how many survive untransitioned to a happy adult life. etc
Definitely more complicated than many comments here pretend.

Outcomes for girls on pb worse?

In what ways? For both girls and boys they are missing out on the physical and mental development that their peers have. If they feel they are outsiders before puberty, won't they feel even more so when their peers have developed and they haven't (at least, not nearly as much)? No wonder most go on to cross sex hormones; it must feel like the only way to go.

Yes, potentially complicated, and guess what - all of that data could be found by tracking down the kids who went through the Tavistock - without subjecting a whole new cohort of children to unnecessary medical interventions.

Bearing in mind that humans cannot change sex, how would you be defining "successful transition"?

This too!

Good question, of course physical sex can't be changed. But you are more than immutable chromosomes. Successful = lack of depression, decreased mortality, maybe even long term happiness. I'm sure these are the success criteria of the medical profession.

The study only proposes following them over a period of two years, it's not going to yield any long term results.

Girls don't need pb?( since transition in adulthood likely possible without them, boys have easier recovery to full fertility after pb withdrawn.)
Higher detransition rates in ftm?
But do pb even help boys? We cant know without the data. Research is important. It would appear that the numbers of genuine transpeople are very small and confounded by many other conditions. Complicated for sure but not beyond us.

We know that these drugs are harmful. There's ample data and evidence from their use for precocious puberty, from their use in end of life care for men with advanced prostate cancer, from their use for chemically castrating sex offenders, from animal trials, and from previous trials.

It would take 20+ years to measure that

Sometimes harmful. Sometimes beneficial. It's not simple. They are still widely prescribed, because they can, under certain circumstances be beneficial. We need studies, data and research to find out what these are.

Beneficial in what way @CyanHelper ?

I'm another one struggling to see what a successful outcome might look like. Presumably it would mean no physical ill-health effects (loss of bone strength etc), and that the child's mental wellbeing remained the same or improved. As the children are also going to be receiving therapy, that's an obvious cofounder, so I don't see how that is going to work.

I agree with a PP that it's plausible that Wes sees this as a way of confirming once and for all that puberty blockers are dangerous and that the sacrifice of 226 children is worth it - perhaps because a two-year trial will do a limited amount of harm.

I wouldn’t bet on it. It sounds like it could easily expand to reintroduction.

He should say no.

Urology is complicated but at least these... Beneficial long term use for: prostate cancer( increasing lifespan), tramatic urological injury (can be decades of use), high testosterone conditions which have detrimental physical and psychological effects. Harm is relative.

They are also given to women to treat endometriosis, breast cancer and problems with fibroids. There was a poster on here a few years ago who had taken them for (I think) only a few months, and was still suffering from the side effects years later.

This is one of the threads I was thinking of. There are actually two posters who talk about their experiences on these drugs.

Michael Biggs paper on the Tavistock | Mumsnet

As far as I understand it, the protocols were originally designed for a small and very specific group of boys/young men who did appear to have some sort of very early onset and persistent issues around their perception of being the opposite sex, and that there is some historical evidence that these issues exist for some boys/men.
It seems utterly inappropriate to extend the same sort of treatment to girls, knowing full well that ROGD is a very recent phenomenon that bears all the hallmarks of a social contagion.

Essentially I suspect this is true. There are lots of ways that the power of a study (ie the number of subjects you need) can be manipulated by tweaking the equations and it happens all the time. Researchers manipulate this the entire time. “Oh look, you happened to show the exact difference expected for the number of subjects you had🤨”.

If the number they need is 226 based on power calculations, in order to show a statistically significant difference in outcomes, it further demonstrates how pathetically weak, statistically speaking, the original Dutch research is with its only 55 subjects.

Prostate cancer: side effects include increased cardiovascular events such as heart attack, hot flushes, cognitive impairment and increased risk of dementia. And depression. Odd to use a drug to improve mental health when the drug itself causes depression.