Debate on the puberty blocker trial this afternoon, 23rd June

[RoseInAPot]

Opposition day debates today, instigated by the LOTO Kemi Badenoch. She has chosen two issues: defence, and the puberty blocker trial.

Sometime this afternoon, will be worth a watch.

Why not?

Why can't we read the report critically and say, 'I agree with Cass on A, B and C but I think she's very wrong on D and E and here is why ...'?

Exactly. The TRAs claimed at the time that there was no obligation on the government to implement any of it, let alone some.

And let's not forget, it was widely said at the time of the Cass Report's publication, that the trial had to be in the recommendations because if it wasn't, that would look too much like a 'terf victory'; that it was a sop, in other words. Add in the personal pressure Dr Cass faced too.

But the kids won't be happy, will they? Not for long, anyway, since the puberty blockers won't solve their real problems

Is there a control group of trans-identifying children who will NOT be given puberty blockers, and perhaps given talking therapy instead as they go through puberty? And how long will the follow-up of participants be?

If there is a control group, I would bet any money that in, say, 10 years, they will have significantly better mental and physical health than the children put on puberty blockers

Of course, if they just ask the control group how happy they are shortly after being told they can't have puberty blockers, they will report being unhappy at not getting what they (think they) want. But in the longer term they will almost certainly be happier (and definitely physically healthier)

I don't believe there is a control group, just one group of children who will get the blockers immediately, and another who have to wait to have them later. I think that's right, but I'm sure someone here knows for definite.

PATHWAYS TRIAL will use a randomised controlled trial design. This means that everyone taking part will be randomly placed in one of two groups - by chance, like flipping a coin. One group will start the treatment straight away, and the other group will start the treatment after 12 months. No one in the study will decide which group they are in.

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

Thanks, I knew someone here would know! I think my confusion comes from the fact that someone here, eons ago when the trial was first announced, reminded us that of course puberty doesn't wait. So of those who are randomly chosen to wait a year, some are going to find out within that year that they are one of the "waiters" because their puberty will start. And nothing they can do about that!

I think the 'waiters' will know that they are 'waiters'. I don't think that they are being given a placebo.

I wonder how many will go online in search, when they find out they are in the loser 'waiter' group?

Search for blockers online?

Is that right? The previous poster seemed pretty clear about that, in that there was a serious flaw already built into the trial, from the start.

It's possible that they meant that all the "waiters" would then drop out of the trial, rather than wait.

ed. spelling

From the Trial Protocol:
Delayed Start: Participants in the delayed start group will be offered GnRHa treatment one year after randomisation. They will receive the same monitoring and assessments as the immediate start group.

This is the best page for info:
https://www.kcl.ac.uk/research/pathways

Links within the page take you to the various pathways. Links within them take you to the protocols.

Finding out which group the young person is in
A computer programme will randomly pick which group the young person is in. Group 1: This group will start the treatment straight away. Group 2: This group will wait 12 months before starting the treatment. A doctor at the Gender Service will tell the young person and their parent/legal guardian which group they are in.

https://www.kcl.ac.uk/ioppn/assets/pathways/trial/pathways-trial-easy-read.pdf

Thanks, yes I've read through some of that, as much as my brain will allow!
I still think the original poster's (not on this thread) question was, why wouldn't all those in the "wait" group just leave the study? There's nothing here that I can see that would be an incentive to stick around for a year, waiting to get the blockers, if you (meaning the parents, of course) want them now. I suppose some might wait, but I imagine some would just leave the trial and find them illegally online. Except that it would be illegal. And they would have to pay for it.

It doesn't matter, we don't have debate it here. I was just reminded of something that someone wrote when the trial was first announced.

Yes, I think that is entirely possible that some will leave when told that they are in the 'wait' group.

Yes, that's what I meant, as previous posters have alluded to.

Ok, yes, that's what I meant originally about the previous poster. I guess we'll see...

What is the purpose of the ‘wait’ group? How are they a control group? Puberty lasts over 10y, so what is the point of waiting 1-2y? Suppressing puberty may have lifelong effects, effects which - apparently! - we don’t know, and therefore have this glorious study to discover them. So why is it a relatively short-term study, rather than a longitudinal study?

It’s almost as if it’s a study designed to fail, so that nobody can say for certain what the effects of these drugs are in children, and therefore the Wild West of genderaffirmation can continue relatively in challenged.

I saw a tweet from Rosie Duffiled saying 200 Labour MPs had not voted. It would have made a difference if they had had the guts to vote against the trial rather than just not vote for it. These 200 may be good targets for letter writing to try and give them more courage for next time it's needed.

100% agree, this is not a proper control group at all. Surely it's not standard when testing a drug to also give it to the control group but just make them wait for a while? Especially when the participants have such strong preconceptions about the drug they will be taking

It's a really badly designed experiment with an unproven assumption (that the only possible treatment for gender dysphoria is puberty blockers) built into it

Presumably the people who designed the trials are ideologically opposed to watchful waiting or talking therapy because they see it as unethical 'conversion therapy'. The inbuilt bias is glaringly obvious

Well and also the minimum age limit is the minimum not the whole cohort so if the randomised sorting puts a girl of 12 in the start at once group and a girl of 11 in the wait a year group they are both going to start on PBs at the same age. So what will that prove?

Also, they will all also receive psychotherapy IIRC which is surely a confounding factor? Are they happier because of receiving good therapy or because of the PBs? Obviously I am glad for the individual trial participants that they will get therapy as well as this is a huge thing that they are embarking on but it seems to me that it makes it harder to show causation towards any positives.

Finally and also IIRC, there is another group who do not qualify for the PB trial that will undertake different testing and I think there has been argument discussion on other threads over whether this is a control group. I don't think it is as it is not the same cohort of children who the PB participants will be chosen from ....

This is the problem. The adults doing this to children are already so open minded, their brains have fallen out.

Absolutely! Very worrying.