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?

Did you receive proper and on going mental health therapy before you made your decision though?

Do you believe you are not the sex you were born? And have you worked through all aspects of why you might have thought you are the opposite sex or is it more the case that you rejected the concept that you are the sex you were born?

Do you think quality research should be done to establish if the treatment is safe and effective?

That's not a simple yes/no question. It's actually two questions rolled together.

Question 1 is, should we continue to prescribe before doing quality research to establish safety and efficeincy? And the answer to that is no, there has already been too much prescribing done without quality research. That means that general prescribing has to stop until the quality research is done.

Question 2 is, are the outcomes that we do know about so far positive enough, and is the evidence of harms low enough, to justify giving the medication to children so as to get quality research on safety and efficacy? Sadly the answer to that is also "no". Despite long use of these medications in many countries there is still not much evidence of big psychological benefits and there is plenty of evidence of solid physical and some psychological harms. Before it's ethical to experiment on children there must be some confidence that the answer to "is this treatment safer and more effective than the alternatives?" could be "yes". Reviews like the Cass review haven't found enough positive results from previous use of medication to justify giving this treatment to more children even for experimental purposes. The preconditions for starting such a trial are not met.

So prescribing to children without the quality research trial is not justified. And doing the research trial on children isn't justified either. Overall it's a "no" all round.

I'm all for research trials if they can be delivered in a way that meets ethical requirements.

In this case, I'm not sure that's possible for minors. It's similar to trials on pregnant women. Ethically, requirements often cannot be met, so we have to forgo the potential for benefits because it isn't worth the risk of harm.

The other thing that needs to be clarified about any trials is what the desired outcome is. As humans can't change sex, that's not the goal, so what is?

Cass's own ethical justification for the trial is that young people will take the drugs illegally anyway so giving them the drugs in a medically supervised and controlled trial will lead to harm reduction and also to getting some useful trial results. Unfortunately I don't really buy either of those arguments. It's not structured as a harm reduction trial (it's also possible that running the trial could actually encourage illegal medical by other children) and the trial structure is too weak and the funded trial period is too short to give useful results.

So it's not surprising that medical safety experts have thrown a spanner in the trial.

Has this been a justification for any other medical trials I wonder?

I’ve never had particularly severe mental health issues, but I did have therapy before I made the decision to transition.

In my mind I know I should’ve been born female, but I don’t believe I have literally changed sex. That’s not to say transition does nothing. My body and appearance has changed a lot and I have a sense of peace when I look in the mirror now. I don’t see the masculine features that caused me distress anymore. There has also been a significant social change I’ve seen throughout my transition. I’m a 1000x happier than I was before.

Do I know why I turned out this way? No, and I don’t think anyone really knows for sure.

Ok. By the sounds of it, you don’t believe you are a woman. Just that you are happier that you now look more feminine.

Is that an accurate account?

Out of interest, what do you think is too weak about the trial structure?

May I ask why you are so convinced you should've been born female?

To me, it's absolutely fundamental to the reason why people want to transition.

In my mind I know I should’ve been born female

Can you explain a bit more what you mean by this? It seems to be a version of 'born in the wrong body' which is now out of favour as an explanation of what 'being trans' is.

I mean, any of us might say 'I should have been born ...' about any number of attributes. But since we weren't born that way, we just get on with life anyway.

I suppose the answer I'm looking for is what does 'being female' mean for you? Obviously it's not about things like giving birth, because you'll never be able to do that, so what do you think a woman can do that you couldn't do as a man?

I'm glad you feel that the treatment worked for you, because there's no going back, but it seems to me to be a very extreme solution to what is ultimately a mental issue - as you say, it's all in your mind.

Thank you PPs for questioning ‘should’ve been born female’- I share your puzzlement.

I should have been born beautiful/highly intelligent/with the potential to reach 6ft tall/with olive skin/with red hair/green eyes/I should have been born to aristocracy/I should have been born in Australia….

All meaningless statements to me, and based purely on fantasy.

We are born into the bodies we get. They are the right bodies for us. If something feels wrong, that’s coming from the mind.

Well, as I understand it, all it does is to compare children who have to wait a year for puberty blockers against children who get them straight way. And the trial is only 2 years long.

This Inciteful Sisters podcast interview with two GPs goes into depth about the trial.
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More or less. I know I’m not female, but I’m happy with my social role and looking feminine

I find what you say interesting and I appreciate your honest answers.
Can I ask how far you take your social role? Does it extend into women's spaces?

It may be out of favour with trans activists, but it’s how I’d describe my own subjective experience. It’s a hard thing to describe, so I find it a useful if simple way of describing things.

I suppose the answer I'm looking for is what does 'being female' mean for you?
I’d say it means the same thing to me as it means to you. It means being born female with the potential to give birth. I just know deep down that I should’ve been born female. I know being female is impossible for me so I’ve taken steps to align my body more with a female presentation

Who the fuck would hope for that?!

The assertion that anyone questioning gender treatment de facto wishes harm on trans people is enormously harmful - and part of the reason we are in.this mad situation.

Of concern is not just the potential harms done, as much as it is the untreated comorbidities.

Evidence suggested mental health outcomes worsen over time - I'm concerned that after the sudden rise in 'transition' treatments for those with gender incongruence, we may see a subsequent rise in poor outcomes down the line.

Its another of those situations where its horrible to be proved right, tbh. Feminists are quite familiar with those.

We know it isn't safe an effective from the other reason these drugs are administered.

And what is 'safe and effective 'anyway? Especially when the result is sterilisation? the question should be 'what is the differential diagnosis and why is sterilisation the cure?' How does one lead to the other?

I don't think anyone 'hopes' for ruined lives.

I do think that people 'hope' for an accurate finding and that it is a strongly conclusive accurate finding. I know that I do.

The continuation of drifting along with knowledge of adverse impacts but those being dismissed by some in the name of the 'greater good' is not something that anyone should be hoping for. All too often we see this dismissal and it is only ever supported by emotional reasoning.

Not only that, but too often the adverse impacts are dismissed when they are the adverse impacts for female people. Because those are already well documented because we have the life outcomes of testosterone used in sport.

https://www.mumsnet.com/talk/womens_rights/5445882-medical-treatment-for-gender-identity-evidence-archive-thread?page=1

and other studies

https://www.mumsnet.com/talk/womens_rights/5445882-medical-treatment-for-gender-identity-evidence-archive-thread?page=2

What we do not have is conclusive evidence that all these negative outcomes is in anyway productive in better mental health. Using previous studies, the answer is most likely 'no'.

However, having appropriate long term follow up on the patients that have already gone through these procedures would be the very best solution. that is not available though.

In the meantime, female people's experiences are dismissed to focus on male people's experiences in the hope that it is a distraction because if female people's outcomes are not positive, it then brings the entire treatment discussion into question. And that politically, doesn't seem to be allowed to happen.

The assertion that anyone questioning gender treatment de facto wishes harm on trans people is enormously harmful

@ArabellaScott I didn’t say that. But I’ve certainly seen people (not necessarily on MN) desperate to get the data from the gender clinics to find out all the dreadful outcomes that they must have been hiding and ‘expose’ them for the deliberate child harmers they automatically assume them to be.

I don’t have time to watch a podcast but it’s certainly not correct that all it does is compare kids who take the drugs one year apart. There seems to be a lot of misinformation bandied around that ignores the whole family of trials where outcomes from the puberty blocker trial will be compared with a matched cohort from the sister trial who aren’t being given puberty blockers.

Which sister trial, have you got links to this?

Sure: here’s the info for the study linking the matched non-puberty blocker cohort with the puberty blocker cohort.
https://www.kcl.ac.uk/ioppn/assets/pathways/horizon/pathways-horizon-intensive-easy-read.pdf

The non-puberty blocker cohort (Horizon Intensive) are a subset of the much wider Horizon study, which sits in the family of Pathways studies.

https://www.kcl.ac.uk/research/pathways

Cass own ethical justification for the trial is that young people will take the drugs illegally anyway so giving them the drugs in a medically supervised and controlled trial will lead to harm reduction and also to getting some useful trial results.

This feels a bit like the arguments my DN used to give (age 15) that she ought to be able to invite her bf to sleep at her house so they could be free to have sex in a warm bed. Otherwise they’d be forced to go have sex in the park.

It is not on us adults to facilitate an activity that we know to be harmful to our children’s health because they might go elsewhere to do it. The whole point is that elsewhere will be a deterrent to some children/adults. Whilst some will still access the drugs online regardless of the trial.

And if the trial determines harmful outcomes, what then? Does Cass believe that the results will magically stop all online sourcing?

We also need to see gender affirming drugs and surgery through the lens of all other treatments - it's not just whether the treatment works but also in terms of demonstrating it's cost effectiveness and other knock on issues.

We already know that this is done in various areas of women's health. If the downstream costs of transition are high due to complications this should be flagged. This is cold but it's what happens with everything else. Somehow this is getting a free pass just like it's got for every other area of scrutiny. It's not ok. For example there are lots of women who are being refused breast reductions for back pain and mental health reasons or being refused hysterectomies for medical reasons whilst no one questions an 18 or 19 year old identifying as trans...

And one of those costs relates to fertility. It's easier for men to dismiss this and freeze their sperm but the numbers of young women being mislead that they can freeze their eggs and then have a baby later down the line is not reflective of the reality either. Discussion about fertility really isn't adequate and the idea of surrogacy being easy is also one which should be strongly challenged for a variety of reasons (not least the raised risks for women involved).

Ultimately the problem remains that sex is important and cosmetic changes can only ever be cosmetic. Any harm done to an otherwise healthy body which has a high complication rate needs some really robust discussion and data behind it. No just emotive arguments. We need a proper discussion about identity formation in various ways and how it's not just individual but also collective so you never have full control.

It's all so fucked in the head because all of this is shut down because the assumption is we want these conversations before more people are sucked into the trans production line where there is no dissent nor questioning allowed.