Puberty Blocker Trial Paused

[CrocsNotDocs]

https://www.telegraph.co.uk/gift/e0a6d8e8751dbca8

Good start. Now shut it down.

Yes, while some of these kids have well meaning desperately trying up navigate their way through and are unknowingly trying to retrieve their child from the grip of a cult and just get the best treatment for their child (while being you by the activists that medical harm is the best treatment as opposed to therapy), some parents are very keen to have a ‘trans child’. We have observed apparent motivations being attention seeking (the sets of excited parents featured on breakfast tv), homophobia/rejecting effeminate behaviour in boys (the Susie Green model) and just plain wishing they had a child if the opposite sex and communicating that to the child.

I have come across an influencer local to me who currently has two ‘trans’ identifying kids and apparently the third is considering (but is aged about 4). Her identity and her business is based around ‘trans’ kids so of course that is going to affect them. She seems rather unhinged so who knows what pressure and manipulation occurs behind closed doors.

@fanOfBen:

Has anyone, anywhere, ever, made any serious attempt to develop psychotherapeutic interventions for these children? If they have I haven't heard about it, and I feel that avenue should be explored extremely thoroughly before anyone even considers giving these children life-altering drugs.

I mean, before the Dutch Protocol, psychotherapy and literally doing nothing (the “watchful waiting” approach) were the only things that were done. And in 90-95% of cases, children desisted from their gender distress. Now, as a PP pointed out, we have a completely different cohort of kids presenting with gender distress, and we have a whole society that has been taught that the only approach to gender distress is “gender affirming care,” so it’s not clear how we go back to that approach. But yes, 20 years ago, all anyone would have done would have been talk therapy, at the most.

That sounds like a an anonymous social services report to me. If you don’t want to I will….

True, but that doesn't answer the question. Not all psychotherapy is the same, by any means. What I'm asking about is scientific investigation into what approaches actually work. I suppose you could argue that if doing some random unselected thing works for 90-95% of children that's already pretty good...

The Tavi’s approach, back in the broom
cupboard days, was focussed on ‘reconciling different parts of the self’. It was all about psychotherapy.

One of the surprising elements of the turn that GIDS took is that it happened at the Tavi, whose specialism was/ is psychodynamic psychotherapy. However, this is also why it was able to go so far. If it’s specialism was medicine, it’s likely that existing governance systems would have stopped things going so far.

I think this leads back to what is meant by ‘what works’.

Back in the day, ‘working’ meant desisting and/or alleviation of distressing symptoms.

Today, ‘a good outcome’ means different things to different people.

Aha, yes, fair enough.

I have no idea how new psychotherapies were trialled for this back in the day, if at all. As you say, if you know that just leaving the kid alone and letting them grow up will result in desistance 90% of the time, I can’t imagine there was much call for tests of other things.

And now, of course, you can’t test talk therapies because that counts as a conversion practice.

rather than just drinking the kool-aid, have you actually read any of the official reports around this suicide claim? https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report . you may not be aware of the overall increase in suicides amongst young people in general related to the covid pandemic and its aftermath....as a parent of a young person who became suicidal and self-harming in the 20/21 period, I can tell you the access to medical care and mental health support was abysmal, CAMHS were utterly overwhelmed. Luckily for us, we had the finances to seek private help whilst sat on endless NHS wait lists but far too many families didn't have this option. When you see the stats for the children attending Tavistock, does it not make you consider there is a lot of potential risk factors over and above their gender dysphoria? why do you not consider that treating these co-existing factors effectively might reduce that childs overall mental health distress?

Oh that’s interesting - that the psychotherapists at the Tavistock were so far removed from the medical side of things that they didn’t have the systems in place to stop this before it started.

I think you have given this much deeper consideration and "gaming out" of scenarios than the entirety of people who signed off on the trial, ever did.

I am also simultaneously wondering if there wasn't a strong element of the opposite of the "speak up" rule/culture in aviation (and ironically medicine) where people had concerns but were too cowed to raise them?

I agree to an extent, but what seems to be missing is accurate research evidence on diagnosis. For virtually all medical treatments the first step is diagnosis and then treatments are trialled before they are rolled out generally. The diagnostic criteria for gender distress are so woolly and subjective, and the process so easy to manipulate, that it amounts to little more than self-diagnosis (or parental diagnosis).

If through extensive clinical research it was possible to find a way of establishing exactly who the tiny minority of adolescents who can only live without considerable ongoing distress if their body resembles someone of the opposite sex are, then it might be appropriate to look at research trials to look at the most effective early hormonal treatment (including PBs). Maybe there are research projects doing this at the moment, but Pathways is still jumping the gun and risks harming children whose distress is transient, arises from other causes, or could be alleviated in other ways.

Oh I wasn’t even touching on the nebulousness of the diagnostic criteria for gender distress. Just the lack of research-based motivation for stopping puberty as a possible treatment for that nebulous disorder.

The whole thing is a shitshow, basically.

It's interesting to note that one of the reason's the MHRA have stepped in is because the researchers at King's blithely blew straight past is it safe/necessary and decided to instead focus on what is the best time to interfere with puberty.

Safe/necessary was assumed from the start when those are the very questions that remain unanswered.

There were whistle blowers a go go at the Tavistock, but they were indeed shut down and shut out.

There are whistle blowers in the US and Canada too; same thing.

If this was cocaine of fentanyl I can’t understand only assume the police would actually take some notice. This is just plain sight?

Sometimes time is the greatest healer. People can be in therapy for many years and it is only when the time is right that they feel a sense of relief and release from what it was that was burdening them. Simply monitoring someone's mental health for a couple of years gives no indication of that.

The conditions and relationships in our life inevitably change with the passage of time and with that so do many of our former responses to life's difficulties.

Testosterone is a class C controlled drug, like ketamine and nitrous oxide. Estrogen isn’t, it’s just a prescription only medicine, so it doesn’t attract the same attention from the police etc.

Maybe that should change?

The underlying challenge here is being clear what a good outcome looks like for these kids. If it could be agreed that the best outcome is kids becoming less distressed and being supported to become comfortable with the bodies they have, as opposed to a life time of medication and intervention, that would make trials so much easier. Any other question being asked it would be crystal clear that a life free of on going medication is the best option. But as we know this would meet cries of conversion therapy, and lack of respect for gendered souls. So we are stuck. As long as this theory persists, it will not be possible to run the trials that should be run

And the government's proposed 'conversion' bill is central to its continuance.

But also, the existence of many thousands who have been through 'gender affirming' surgery and the people who have encouraged them to do so will offer, understandably, the greatest reistance.

So we are stuck. As long as this theory persists, it will not be possible to run the trials that should be run.

All of this. Yes. Thank you.
This more simply and clearly states the point I was trying to make earlier.

I once had a conversation with a 'support trans kids!' poster on twitter, where she wanged on about health care and I said but there's nothing wrong with these children, their bodies are fine just as they are. She agreed. Yes, these kids are fine as they are, there's nothing wrong with them. I said great, we're in agreement, these kids are perfect just as they are, they're healthy and normal, nothing needs to be changed.

Why do they need medication and surgery, then?

She couldn't explain it.

@JustSomeWaferThinHam please do take the advice/offer of help regarding reporting that family to social services, those children need protecting.

Thank you @SingleSexSpacesInSchools for the input.

Agree. I also think TwoLoons's analysis above is very good.

Proponents of puberty blockers usually say they act as a "pause button", ie by delaying puberty for a couple of years you give the child time to think about their gender dysphoria, the implication being that the gender dysphoria might resolve on its own.

The obvious flaw with this is that by blocking puberty, you are also blocking the brain development that would enable the gender dysphoria to resolve. We know that in the vast majority of gender dysphoric kids who go through puberty, the dysphoria does resolve. So by giving them puberty blockers you are actively creating an outcome that probably wouldn't happen if you just allowed them to go through puberty.

And I know - there are lots of other reasons to be opposed to puberty blockers, ably pointed out by various PPs.

Unfortunately a lot of these kids are influenced by what they've seen on the internet and a sense of community. Theyve grown up in that time, also being encouraged to question their identity. Medical affirmation has been made to look safe, suggested by the NHS too, they're not told about the true risks. Some won't grow out of it soon enough. Testosterone is still available online it causes harm to young adult women too. It's often too late before they become aware of the harm. They close themselves off from any concerns from family and sometimes reject them. Even testosterone causes sudden menopause usually after 2 years. Not a gradual change.This means osteoporosis, incontinent, aching stiff joints often before they're 30.

Unfortunately a lot of these kids are influenced by what they've seen on the internet and a sense of community.

Which is another good reason why a ban on social media for children can't come soon enough. Children shouldn't have smartphones or unsupervised internet access. As a society, I don't know what possessed us to ever allow that, never mind normalise it

I would also use the word "groomed" not "influenced" for what has happened to these children online.