Cass to blame for puberty blocker experiment

[PeachOctopus]

Dr Tony Rukinski’s article about Cass does seem to ring true about the inherent weakness of Cass in accepting the category of’trans child’ hence giving credence to trans activists and setting up the groundwork for the puberty blocker trial which opens the door to their continuation.

The very drugs that ministers were finally persuaded must be banned ‘banned’ for use in gender clinics will now be given to vulnerable children inside government funded trials, complete with the blessing of senior medics and ethicists.
Worse still is that we have known this particular trial was going to happen for over six months while those doctors who’ve condemned it have been ignored.
For this is exactly what the Cass Review recommended and it is exactly why some of us could not join the chorus of conservatives and Christians hailing Cass as a decisive victory.
As TCW reported last April there was a ‘get-out clause’ included in Cass’s final report. It recommended that puberty-suppressing hormones should be prescribed only in the context of a clinical trial or under the guidance of the national multi-disciplinary team .The NHS in England and Scotland immediately took advantage of this.
Cass did say devastating things about the evidence base behind puberty blockers and cross sex hormones.
It found the research to be weak, biased and often incapable of showing whether these drugs actually improve mental health or reduce suicide risk.
For anyone who had watched Tavistock’s reckless approach for years, that official admission was welcome.
But instead of concluding that medical transition for children should be stopped as inherently unsafe, Cass accepted the category of the ‘trans child’ and recommended a ‘rigorous research programme’ to work out how best to treat them.

Cass to blame for puberty blocker trial

I am not the slightest bit interested in Jonny-come-lately types criticising woman who put their heads above the parapet personally and professionally when there were ENORMOUS consequences for doing so. And I especially find it distasteful months or even YEARS after the fact.

There is something especially grotesque in pretending the context Cass’s review was happening in was the same as today, when the tide is finally turning after so many people - but especially women - have worked so hard and paid such a price for speaking up at earlier points.

We have always known this was going to be a long process to get back to sanity, and we were not going to win everything across the board in one hit. Yes it’s frustrating, but we need to keep plugging away at it - and being “the reasonable side” is the way to do that.

I thought Cass didn’t refer to Trans children’.

To my knowledge, her report wasn’t about trans identity but about children seeking treatment for gender distress.

Her remit was specifically about the healthcare being offered.

Whatever we call the phenomenon, they are children experience distress who are self harming, agoraphobic, experiencing suicidal ideation etc. and who are attributing this to issues relating to gender.

I saw Cass’ position as saying that for the vast majority of these children ‘gender’ is a red herring. I think she remained open to a very small and specific group for whom gender-based treatment might be appropriate- but this can’t be concluded right now.

I don't have the energy or expertise to go through that document, but thanks for posting it. I am sure someone else will be able to parse it.
What I don't understand is if there is so much evidence of pbs being helpful, why Cass would say that there is only weak evidence about the efficacy and recommend another trial - after follow up studies - at all. Were those papers not published at the time?

Drug trials are done against a placebo are nearly always unethical. Drug manufacturers may like such trials as they can show ‘success’ but they say nothing about the relative effectiveness. The provision of mattresses for people jumping out of planes might seem a success with a marginally lower death rate but would be a clear failure against providing parachutes. Drug trials should always be against proven most effective alternatives where these exist.

The problem here is Cass has set up the ‘trans child’ as a fixed condition rather than recognise it could be a manifestation of something else, like depression or delusion, stopping the use of drugs that would enable a child to become comfortable with their sex. And TRAs have presented such drugs as ‘conversion therapy’ which Labour and SNP are going along with.

And I thought she had identified that the cohort who may benefit are the effeminate boys who have displayed a cross sex identity since toddlerhood.

Even then, the hypothesis is that for a group of boys it is better to be castrated to more closely resemble women than to go through puberty.

Supposing that it is possible to identify a group of boys who might be suitable for the trial because we believe that their trans identity will be stable and persistent, are we ignoring the majority of trans identifying men who seem to value their male genitals and their sex lives?

Cass was constrained by her remit.
She was asked to look at medical evidence not opine on the constructs underpinning it.

The recent HHS study in the USA involved a range of professionals including philosophers, which allowed for more analysis of the concepts and language within this movement alongside the medical evidence. This provided a more holistic analysis: the concept is incoherent therefore any evidence for medical intervention cannot be justified.

Cass could not do this.

Who knows what she really thinks?

But one way or another she's carrying the burden of the fight over this issue.

If we were looking for improvement in mental health then we should be looking at anti-depressants and psychotherapy. PB are a physical intervention not a mental health one. And it is worth remembering that ‘transitioning’ has been shown to be associated with an 18-fold increase in suicide.

As for asking a snake oil salesman if they think their snake oil works…

It's a study to measure mental health stabilisation or improvement.

Through castration?

Because that is the end goal, unless the intention is to stop the puberty blockers after a couple of years and allow the child to go through puberty.

Helen Webberley's expertise is in using loopholes to sell drugs on-line.

It reminds me of lobotomies

gender incongruence identification with the opposite sex.

What does this mean?

Why is it a condition that needs medical treatment?

There is also the fact that in boys, effeminacy in early childhood is strongly correlated with being gay as an adult.

I'm always astonished that so many gay men support trans ideology, since most of them presumably appreciate the fact that they were allowed to grow up to have intact and mature genitalia.

It's a study to measure mental health stabilisation or improvement.

Why is it a study to measure mental health stabilisation?
Why isn't it a study to measure acceptance of your healthy body?

Surely that should be the goal? For the body and long term mental health.

Why is destroying your healthy body for short term happiness in any way an ethical aim for a medical intervention?

I think it’s unfortunate that this medical scandal has essentially created major issues for what might be a tiny number of children/ people.

Progeria affects around 1 in 6 million births. They are given cancer meds to slow down aging. It could be the case that there is a rare condition, linked to hormones and neural messaging that leads male infants to feel distressed about their bodies. If something akin to this does exist, gender medicine has royally screwed things up for any decent research to help.

I am not suggesting this is the case, but highlighting how if it were the case, the gender madness prevented this from being properly explored.

My thinking is that everything including the kitchen sink should be done to bring about mental stability without changing the body. Changing the body, if to happen at all, should be regarded as an undesired intervention to be avoided and a last resort.

I think the ‘if to happen at all’ element should be determined by longitudinal studies on adults. I also think that if it were found that hormone and surgical treatment in adults was effective, care would need to taken to ensure the ‘everything plus the kitchen sink’ isn’t treated as hoops to jump through and treatment should not be given to children. Laws also need to be in place to preserve and uphold single sex provision and consent for treatment would need to include accepting that the treatment is not changing a person’s sex.

Exactly.

So what would an everything including the kitchen sink before body modification design look like? That should have been the ethical starting point.

It would be therapy, family support and puberty.

100%

It needs to start before that - not telling children they can chose their sex if they are unhappy with socially imposed sex stereotypes, but that it is ok to be a boy who likes dressing up in flouncy fabrics or play with dolls. And girls can prefer short hair, football and chemistry kits if they wish.

Umm, yes I realise all that (I've worked in clinical research and I know how protocols are set up). I just didn't see the need to go into details of all the options, but since you ask, studies are set up to measure the proposed treatment against the current best alternative (and often a placebo, when that can be done safely). In this case, there is no other standard drug for treatment, but psychotherapy is one possibility, and there have been many studies testing drug therapies vs psychotherapy. This for instance:
Prediction of individual patient outcomes to psychotherapy vs medication for major depression

I mentioned desistence because that is one of the real problems with PBs: do they block desistence, which would otherwise occur as a result of normal physiological puberty? That they are not looking at that is part of why this seems to be a terrible study: it doesn't clear up the biggest questions because there is no real shortage of data for the first year or two from previous studies: what's missing is the long term follow-up, particularly the data from the 6 out of 7 adult gender clinics that children from GIDS went to as they aged out of the Tavistock's age range.

IOW there could easily be an improvement over one year: if we gave gastric surgery to anorexic teenagers I bet they'd be delighted for the first year or two as well. Doesn't make it an appropriate treatment for anorexia though.

It's not clear that the difference between one and two years will be statistically significant either. That doesn't even begin to answer the objections to PBs being given to children so this study won't settle the issue. It can't.

And that its normal to like dressing up in flouncy fabrics and playing football. You don't have to choose.

And then, for his encore, he references Webberley! 🙄