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

I guess I was including breast development and changes to facial features (which may not be major, but enable us to clock a lot of transmen, even if they have beards) in that, although I agree that it is the changes to the male body during puberty which are harder to erase.

One a slightly different tack, I am sure that there are girls approaching puberty who are distressed by the changes they know their bodies will go through, from body hair and sweatiness to painful periods - especially if an older sibling or their mother has had bad experiences. Their distress or even revulsion may be overwhelming; but if they don't express a wish to 'become a boy' it is never considered as being an indicator that they should be prescribed puberty blockers just to press the pause button until they are better prepared psychologically for becoming an adult woman.

Quite.

A male adult with a pre pubertal boy's body with severe surgical complications, unable to reach any stage of sexual arousal, and with significant questions about the impact on brain and emotional maturity, has not become a woman.

He has become a lifelong patient across multiple specialties and phenomenally vulnerable.

https://www.thefp.com/p/top-trans-doctors-blow-the-whistle

'Like thousands of adolescents in America treated for gender dysphoria (severe discomfort in one’s biological sex), Jazz had been put on puberty blockers. In Jazz’s case, they began at age 11. So at age 17, Jazz’s penis was the size and sexual maturity of an 11-year-old’s. As Bowers explained to Jazz and her family ahead of the surgery, Jazz didn’t have enough penile and scrotal skin to work with. So Bowers took a swatch of Jazz’s stomach lining to complement the available tissue.
At first, Jazz’s surgery seemed to have gone fine, but soon after she said experienced “crazy pain.” She was rushed back to the hospital, where Dr. Jess Ting was waiting. “As I was getting her on the bed, I heard something go pop,” Ting said in an episode of “I Am Jazz.” Jazz’s new vagina — or neovagina, as surgeons say — had split apart.'

'“When you enter a field like this where there’s not a lot of published data, not a lot of studies, the field is in its infancy, you see people sometimes selling protocols like puberty blockers in a dogmatic fashion, like, ‘This is just what we do,’” Bowers told me.

Once an adolescent has halted normal puberty and adopted an opposite-sex name, Bowers said: “You’re going to go socially to school as a girl, and you’ve made this commitment. How do you back out of that?”

Another problem created by puberty blockade — experts prefer “blockade” to “blockage” — was lack of tissue, which Dutch researchers noted back in 2008. At that time, Cohen-Kettenis and other researchers noted that, in natal males, early blockade might lead to “non-normal pubertal phallic growth,” meaning that “the genital tissue available for vaginoplasty might be less than optimal.”'

Research suggests that children whose dysphoria does persist tend to have stronger, more consistent feelings of mismatch, described in ways that clearly differentiate them from those whose feelings shift over time.

I thought there was no way to distinguish between those who will persist and those who grow out of it. Which research suggests there is a way to differentiate?

Professor Progressive Professor Misogyny

@JustMisogyny
Nov 23
Cass said the use of puberty blockers for gender incongruence should be banned from clinical practice and only used in research. So this trial aligns with Cass. But it's not a trial of whether puberty blockers work or not. Instead of testing treatment vs no treatment, it only tests treatment now vs treatment later, so it can’t show whether puberty blockers "work" - only whether starting earlier differs from starting later.

Cass identified four core scientific questions: 1. Do blockers work? 2. How do different pathways compare? 3. Are they safe? 4. What developmental effect do they have? This trial can't answer Q3 or Q4, because it's only running for two years. It can't answer Q1 or Q2, because the trial isn't designed to. Q1 and Q2 are the most important questions, because otherwise WHY ARE WE USING THEM?

The trial does not address primary evidence gaps about whether blockers treat gender dysphoria, whether they pause or alter development, how they compare to alternative pathways, or what the long-term outcomes are. It's a completely pointless study.

https://nitter.net/JustMisogyny/status/1992669659640840231#m

Not to mention that those giveaway phrases (from bitter experience, likely to be things like 'likes pink') will immediately be shared by adults on the internet to coach children to say the right trigger phrases to get surgeries and meds at the time they think they want them. As has been happening for years.

There are whatever (likely sketchy) records adult gender clinics keep on patients who've passed through the Tavi, as well as on those who got private prescriptions or had GPs daft enough to offer "bridging prescriptions" to kids on the Tavi waiting list. The people running those adult clinics simply refused to release the data to Cass. Streeting ordered them to release the data but by then it was too late

Which is why one of the boys in the Dutch Protocol study died. He had been puberty blocked & so had insufficient penile tissue for inversion & an attempt was made to line his cavity with a section of bowel. This led to necrosis, generalised infection & death so they disappeared him from all their reporting on outcomes.

If puberty blockers really were the wonder treatment that TRAs say then why aren't the adults who had puberty blockers as children screaming from the treetops to be enrolled in a follow up study.

If I'd had a wonder treatment that cured all my ills that was no under threat due to lack of evidence I would by signing up to every trial and study available in an effort to prove how wonderful it was.

Surely another issue is that this trial is not happening in a vacuum. These young people & their parents have been groomed in transgenderism, they may believe that it is possible to change sex and that the alternative is suicide. In those circumstances surely many parents/ children would gloss over any side effects in their minds.

And of course once the child has been on PBs it would take a strong parent to say that actually they haven't helped - they would be admitting they had signed their child up by harm , and they would feel that they were "letting down" the trans community overall - TRAs seem to be very focused on benefit to the "community" whilst disregarding negative impacts on the few and shouting down any dissenters.

Yes exactly. Given the timeframes, results reported will almost certainly be positive. It's almost like that was the intent all along.

My understanding is that outcomes worsen after transition.

Do these same doctors give Wegovy to anorexics ?

BIID isnt treated with 'affirmation', either.

I'm interested in knowing about this research too.

The Tavi clinicians said they couldn't tell who would benefit or persist and who wouldn't.

Which is weird because what happened was everyone who takes PB persisted onto cross sex hormones which would either mean:

They were in fact brilliant at identifying 100% of the children who would persist.
Or
PBs don't allow for the natural intervention of puberty so the gender incongruence wasn't resolved for anyone.

Which is more likely?

Rosie Duffield is organising an emergency parliamentary meeting about the trial for tomorrow...

This puberty blocker trial is a wicked betrayal of our children. Wes Streeting must stop it now

https://www.telegraph.co.uk/gift/1f4e9ec3355b31dd

"Right wing politicians" are irrelevant here. I'd remind you that the previous Conservative govts tried three times to get Self ID onto the statute books & like New Labour before them, ignored whistleblowers at the Tavi for over a decade until Keira Bell & her co-claimant secured a judicial review of the Tavi's antics & the judgment went in their favour. It was only then that Cass was commissioned to conduct an independent review & with the state of Conservative polling at the time, it was a safe bet that a 4-year lead time would leave someone else holding the hot potato when she'd done.

On the Right, people like Badenoch & Cates were atypical in their publicly GC views, & Farage's myrmidions still haven't managed even to identify the issues & were forced into immediate reverse ferrets as soon as they tried to trot out a line.

Opposing human trials of GnRHas to arrest chronologically normal puberty is not a left/ right issue, it's a question of medical & research ethics

Let's call puberty a "treatment" here for comparative purposes. We already have a treatment that is effective in ~85% of cases. We have no way at all of identifying the ~15% who are treatment-resistant, nor do we know if their longterm prognosis is good if treated with GnRHas.

The existing evidence in favour of GnRHas from human subjects is poor & weak, & the shamefully limited animal rsch already gives cause for concern.

Nonetheless, the proposal is to needlessly treat 85% of participants in order that we can collect inadequate data on the other 15% (leaving aside all other questions re the study design, it's simply too short a time frame). That's a wholesale failure of ethics.

What we should be doing now is, as you suggest, a proper retrospective analysis of the patients who went through the Tavi, as well as extensive trials in sheep. We should not recruiting more children to be subjected to GnRHas all because some adult men were sad that they didn't look enough like women - that's the original reason for the Dutch study, it was never about "lfesaving", only aesthetics.

Edited for typos

What PBs do for these children is provide a way to avoid the distress of puberty which they fear.

The fear is real, but we know as with all psychological avoidance strategies that avoidance leads to increasing the fear. It escalates the fear and avoidance cycles develop.

The only way forward is exposure to the thing you fear, to realise with support, you can cope, you need to cope and emotional discomfort can be tolerated.

These children are not being given necessary experience of the thing they fear and so never learn they can manage it.

Puberty is both a physical intervention of the hormones and a psychological intervention where they learn they are stronger than they knew, and they can tolerate challenge which is part of becoming an adult.

Avoidance of puberty means their bodies don't develop and it reinforces their belief they are so fragile and can't cope, keeping them emotionally immature too.

So many of the current mental health issues for YP are based around avoidance cycles where they believe difficult emotions can't be tolerated. And they must feel emotionally comfortable at all times.

But this avoidance of puberty is the worst manifestation of it.

If PB have been so successful where is the large scale anecdata?

Not only are we missing actual outcomes data from the Tavistock, but I must have missed all the positive patient stories.

The trial does not address primary evidence gaps about whether blockers treat gender dysphoria,

Again, as a regular reminder for the thread, there is no consensus on what gender dysphoria is, how it is defined, and what is its cause. This should not be forgotten.

There was a while back a TiM MNetter who did often argue their own positive outcomes, but it was often discussed with them that their description of events and outcomes varied considerably. Sometimes being unbearable and sometimes being no issue at all.

It cannot be put aside that untraumatised, happy and successful people with no additional challenges do not often start to worry about their identity.

If puberty blockers really were the wonder treatment that TRAs say then why aren't the adults who had puberty blockers as children screaming from the treetops to be enrolled in a follow up study.

and this is the madness of it.

We have our semi resident TRA on here claiming that they lead a life of crushing isolation speaking only to doctors with a Sword of Damocles hanging over their head in terms of their numerous health conditions.

Whilst at the same time claiming puberty blockers are a good thing.

And the way they argue and speak seriously coming across like an incoherent, indoctrinated adolescent.

In fact, I have yet to see a TRA be anything other than incoherent illogical, and brainwashed.

The only explanation I have seen is distress at not agreeing with societally constructed roles imposed on your sex.

So we will remove your genitals, make sure you never grow up, never have a sex life and struggle to pair bond.

That poater made a lot of claims about passing that were revealed to be spurious.