A UK forum is encouraging a desperate parent of a trans identified male to seek out DIY hormones, without consulting health care professionals, how is this dangerous advice legal?

[SingleSexSpacesInSchools]

OP "If anyone could help me to understand, I would be extremely grateful. I just want my daughter to be alive and happy in her own skin as much as possible ."

Responses: "diy is reliable and safe, there are communities that will be able to help, and really all it is getting a blood test every now and then to check how low or high a couple numbers are and adjusting accordingly."

Full details here:
https://www.reddit.com/r/transgenderUK/comments/1rw0bac/please_help_parent_to_a_16_year_old/

How is this even slightly legal? The pro anorexia sites were shut down right? The pro suicide?

People will swear 100% all sorts of crap made them feel better. It doesn't mean that it did.

That said, I'm pleased your gender distress has resolved.

Omg.

You do don't have the first fucking clue what you are talking about.

Do you understand what a Cochrane Review is? Clear not.

It's painful to watch.

Well what id say is that I didn’t suddenly start feeling better for no reason.

Of course she is!!

Same dipsticks who still haven't managed to claim that JK Rowling prize.

I understand what it is. They specifically searched for randomised controlled trials and didn’t find any that fit their criteria, so they couldn’t say treatment is effective or safe. That’s not the same thing as there being no evidence whatsoever.

There needs to be high quality research done to determine if this treatment is safe and effective for adults. Do you agree?

Have you heard of the placebo effect? Or the Hawthorne effect? Or even regression to the mean?

If they need to do this research still, what the hell have they been pissing about doing for years prescribing off label for something completely unproven just because they've got into a doom loop of saying we'll this is just what we do. Why no good quality research despite it being given to thousands?

The irony is we actually do HAVE the evidence now. It's just that no one wants to permit access to that information. Which rather begs a lot of questions doesn't it?

The fact that no one can pull a good study out their arse despite the sheer numbers who have had these cross sex hormones and surgically transitioned is actually really shocking.

It's quackery that someone is getting rich off.

You know I saw a man who has recently transitioned post on his social media that "they wouldn't prescribe it if it wasn't safe". And all I could think about is how dreadfully naive this is and isn't born out by history or other areas where authority or experts have been overly trusted despite all the evidence to the contrary.

The question remains: if a medical practitioner is prescribing and monitoring this medication and it is claimed that the patient of a responsible professional will have been provided with the necessary information about risks and benefits, why was @TiredOfYourLies unaware of the lack of evidence for its safety and efficacy?

I was provided with the effects and side-effects of taking hormones along wish the associated risks like DVTs. The document I was given had studies listed as the evidence base for treatment.

There is evidence for this treatment. It might not be the highest quality and there certainly should be more quality research done, but there is some evidence for this treatment.

One word for those who need to be more sceptical: OxyContin.

One link for those who think "they wouldn't prescribe it if it wasn't safe": https://archive.is/Pze1A

NB. In the linked article, they are discussing a biological female.

NB2. If anyone is unsure what an 'obtunded state' means -
'Obtundation refers to decreased alertness, responsiveness, and interest in the environment. Obtunded patients may appear drowsy or lethargic, but their responses to stimuli are further reduced. They may only respond to painful stimuli and require more aggressive stimulation to maintain consciousness. Obtundation can be a sign of a more severe underlying medical condition, such as severe brain injury, advanced dementia, or end-stage cancer. In my experience, the obtunded hospice patient is not trying to wake up, and at times, you may get their eyes open.' https://compassioncrossing.info/drowsiness-vs-lethargy-vs-obtunded/

The review that you linked to said “Certainty in this conclusion is limited by high risk of bias in study designs, small sample sizes, and confounding with other interventions”

”Uncontrolled confounding was a major limitation in this literature. Many studies simultaneously assessed different types of gender-affirming care and did not control for gender-affirming surgery status, making it difficult to isolate the effects of hormone therapy. Others failed to report complete information about surgery status. Additional factors that may influence both access to care and psychological outcomes, including extent of social or legal gender affirmation and exposure to determinants of health such as discrimination, were typically not considered. In addition, some evidence indicates that cyproterone acetate, a common anti-androgen assessed in many studies alongside estrogen therapy, may increase depression, which may be a source of confounding [49].”

Do you know how shitty the design of those studies is? No one in evidence-based medicine would take those seriously, they should be discarded from any review. Lots looked at both males and females in the same study despite oestrogen and testosterone having very different impacts. And they didn’t even consider the effect of surgery to the point where some didn’t bother even recording if they’d had it? Ffs.

It is really easy to fuck up a study so that the results are statistically invalid and this is what has happened here. You might as well quote your mum saying it worked.

The irony is we actually do HAVE the evidence now. It's just that no one wants to permit access to that information.

I do not share your optimism, @RedToothBrush that the notoriously poor record-keepers at the gender clinics would produce data any more statistically valid than the previous duff studies.

That’s just one study. Would you need a see a ‘gold standard’ randomised controlled trial to be satisfied the treatment is safe and effective?

We’re talking about a tiny minority here that has never been particularly popular. Until recently, no one has paid much attention to us or our healthcare, let alone been willing to spend money on quality research.

How would you perform a randomised trial for a treatment that has obvious physical changes?

Well what id say is that I didn’t suddenly start feeling better for no reason.

You were provided with a treatment that you were told and believed would make you feel better.

Result for you: you felt better.

• This could be entirely due to the placebo effect.

Results for others: very mixed.

• About 50% felt worse or there was no improvement.

However, these are all findings related to subjective feelings of "patient satisfaction" with the outcomes of an intervention.

There are no studies confirming objective evidence of improvements for the population concerned, eg. reduced psychiatric interventions, reduced suicidality, reduced suicide, reduced mortality. There is, however, objective evidence of surgical complications and long-term negative impact on health, with a shorter time to onset for females who have undergone medicalisation.

It is also extraordinary that whilst we are urged to discount as anecdotal and unrepresentative the evidence given under oath by publicly identified detransitioners, we are expected to give credence to the positive accounts of a handful of anonymous individuals posting on internet forums.

Particularly when there is ample evidence, from both publicly identified and anonymous transitioners, of high levels of self-deception, aggression, narcissistic rage and psychological distress.

Of course there will be some well-adjusted individuals who also, fortunately, do not suffer serious iatrogenic harm and whose life-long, self-inflicted medical needs are well monitored and provided for.

At the moment, the evidence suggests that these are statistical outliers. They are about as useful as indicators of the value of these interventions as my old landlady was of the wisdom of a long-gone GP who recommended cigarette smoking to her in her 30's to curb anxiety.

When I last saw her she was 84, still addicted and puffing away merrily on over 20 a day with no apparent ill effects. A statistical outlier, not proof that cigarette smoking is harmless to health nor that it should be recommended to curb anxiety.

Also LGB health centers in the 80s were focused on testing for AIDs and other STDs. They were not giving hormones to anyone who asked like these days. Especially not teenagers.

The only place that offered sex changes in the US around that time was Johns Hopkins Hospital. They stopped it in 1979.

That's part of the point though isn't it?

You could look at the medical issues of trans people compared to everyone else though and I think they'd be some stark findings.

My grandmother had low iron in her blood whilst pregnant. She was recommended to drink half a pint of Guinness regularly. She kept this habit up until she died in her 90s still citing that it was what the doctor had told her was good for her health.

"Guinness is good for you!"

"The line was famously born after a survey that involved little more than asking people with a pint of Guinness whether they were having a nice time."

🥳

#Science!

There are health benefits though:
https://www.pushdoctor.co.uk/nutrition-advice/is-guinness-good-for-you

When I worked on a Geriatric Unit in the late '70s the evening Drug Round included bottles of Guinness, Mackeson and tots of whisky, prescribed for specific patients by the Consultant in place of medication that would have had a similar effect

🥃

Does everyone remember this study from a team from Yale and Sweden, Branstrom and Pachankis

This is the study that had to be corrected because they drew a conclusion that the data did not evidence.

pubmed.ncbi.nlm.nih.gov/31581798/
Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study

Branstrom & Pachankis (Aug 2020)
Pachankis is a professor from Yale, and was caught out drawing conclusions where the evidence was so weak they had to retract.

And if I remember correctly, in a children’s study, the children were given questions designed to assess the mental health of the opposite sex after those children had been given gender affirming care. Which led to rather significant misreadings.

So, no new studies then?

Despite assertions that there were studies? I was keen to see the studies. I thought we had missed new ones.

But also, very concerning, patients being led to believe that there is evidence in the information given for these treatments and having to check the veracity of studies for themselves.

This is considered a high standard of care?

High enough supposedly, we are then told that clinicians wouldn’t prescribe them if they weren’t confident that there was evidence.

This is playing out like another house of cards scenario in my mind. Trust in clinicians that seems do be wildly misplaced and personal experience that could be related to the placebo effect.

All while assuring people on this thread of the safety and efficacy of these treatments.

This is how misinformation is spread and rather in keeping in the topic of this thread. Who ultimately benefits from the spread of this misinformation?

One group of people who certainly don’t benefit from this type of misinformation is female people.

Considering what is known about the harms in female people of adding testosterone in quantities not produced in the female body to those bodies, I find the breezy blanket and non specific assurances that these hormone treatments are safe to be alarming.

The risk of harm to female people is asymmetric, yet no thought to that seems to be given when blanket statements are given. In fact, it is almost like the male people who claim to be female (particularly those who claim to now have female bodies) don’t actually understand the bodies of the sex they claim to be. Or that they don’t stop and think what is happening to the group of people who is the sex category that they claim to be, despite claiming to be of that sex.

It is just another reason women keep pointing out the inherent misogyny of a movement that continues to ignore the needs of female people while prioritising the needs of male people.

These days, it’s a chorus of anonymous online voices who lead young autistic boys to believe that they need to go on cross sex hormones.

Telling them that they need to do so as young as possible in order to ‘pass’. The anonymous voices also encourage restricted eating and tell the boys to measure their wrists as a metric for passing because ‘women have tiny wrists’. From the sound of it, the anonymous voices are older transitioned males.

The teens are very vulnerable boys found in online gaming chat forums who are autistic and extremely suggestible. This means that, like imprinting, they rigidly hold onto an idea once the thought lands and they can be both incredibly sensitive to comments and emotions of others and yet lack theory of mind. This results in two damaging outcomes. One, the impacts on girls and women just does not enter their minds. Two, they are unable to infer the malfeasance of those online anonymous voices. I’ve known of cases where the teens meet up with the voices from Discord and end up being raped.

Sadly, neither are they able to think ahead to a possibility of changing their minds. Many will find themselves infertile but wishing they could father children in their 20’s.

It would be great if the mother of the boy in question that was the origin of the thread managed to remain and read the many thoughtful comments here highlighting the lack of evidence, the questions about what is this so-called treatment meant to be treating, the motives of those urging her son to transition as well as the associated dangers of medicalising and the irreparable damage of surgery.

It is an absolute scandal. The NHS have perpetuated and in many cases promoted 'transition' as a treatment for a condition they can't even properly define, based on fuckall evidence and the 'reasoning' of groups like WPATH.

Tired, I hope that you continue to feel better and have no adverse effects.