Hilary Cass sent a document to every single MP and Peer, justifying and defending the puberty blockers trial

[SingleSexSpacesInSchools]

https://x.com/JamesEsses/status/2075512549248745744?s=20

There are ten images on X, sorry can't add them all here, or upload a file with it all in.

That's chilling.

Cass commissioned the data-linkage study so she obviously didn't think it was garbage.

https://www.transgendertrend.com/data-linkage-study/

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

“Retrospective studies are a form of observational study looking at earlier data in a
cohort of individuals. They are used to identify potential causal factors that can be
formally tested in more rigorous designs. Retrospective studies have all the
drawbacks of prospective observational methods, outlined above. They also require
that relevant data were collected at earlier timepoints.
It has been suggested that UK research on GnRHa for puberty suppression in
gender incongruence might start with a retrospective study of the young people
previously seen at the Tavistock Service who are now young adults. It would not be
possible to address important questions about GnRHa for several reasons. First,
clinically recorded information on this patient cohort was not standardised or
recorded at specific timepoints. Second, published reports from this cohort suggest
high levels of attrition which are likely to be biased in relation to clinical outcomes.
Third, some important classes of data, including cognition, childhood adverse
experiences and neurodiversity, were not recorded at all. Hence, we conclude that a
retrospective study would not provide alternative evidence.”

and for the adult gender clinics
”The absence of any patient outcomes data, alongside limited and inconsistent quality data reporting, and minimal clinical audit makes it impossible to properly understand patient outcomes and the safety of these services. These gaps place these clinics outside standard NHS quality assurance expectations.”

and “The review heard that, following assessment and treatment, some patients express regret or dissatisfaction; a smaller number choose to discontinue or reverse their gender transition. Some later decide to retransition.
99. The number of patients who express some form of regret, dissatisfaction or choose to detransition is unknown due to the absence of GDC outcomes data.”

https://www.england.nhs.uk/long-read/operational-and-delivery-review-of-nhs-adult-gender-dysphoria-clinics-in-england/

I know I've said this to you before, but it certainly doesn't hurt to say it again. I absolutely love it that you're here on this board. I have a huge admiration for your strength in navigating everything that you read in these threads and making sense of it in relation to your own life and the concern you have for vulnerable children. I'm not sure if I've put it like that before (maybe I did?) but that's the sentiment I've consistently felt reading your posts. Thank you 💐🙏

In the letter linked in the OP she explains why it won't be any use to assess the efficacy of puberty blockers.

Because the data is crap.

Except that it seems that Cass is not (or, at least, no longer) pushing the 'true trans' narrative and has pivoted to children that were socially transitioned by their parents at a young age. How can she know whether those children's distress is because they are 'true trans' or the result of Munchausen-by-proxy or because they have naive parents who were persuaded by bad actors that their children were 'trans' and would kill themselves if not socially transitioned? The presence of girls in the cohort works against the true trans narrative.

As the Transgender Trend article outlines, the problem is that the story about the usefulness or otherwise of the DL study keeps changing. We already have a low level of trust of these people, they are not doing themselves any favours by contradicting themselves and each other.

@BonfireLady

Thank you so much 😍! But to be honest, being here is really not that hard at all. I mean, dealing with the facts of a situation is a whole lot easier for me than keeping the faith in something that doesn't make sense to me. And sure, there are things that are complicated to deal with when you're GC and trans, but there were also complicated stuff to manage previously, so basically I've exchanged one set of problems for another 😛And if I can help as well as learn around here, then so much the better!

But yeah, the kids... That's just not right 😡Like, how many people would agree that the NHS should give nose jobs to 11yo kids, under the pretense that if they don't get it officially, they'll get them on the black market anyway? What about boob jobs (up or down) to 14yo under the pretense that they know what they want anyway, and why would we force them to suffer for years with a boob size that distresses them so much? I mean, yes, there are kids who will indeed go on to have this nose or boob job as soon as they can, but nobody argues that because those kids exist, all the other ones who argue for 6 months that, no, really, they need that surgery or they'll die!!! should be given it too.

People have no problem going, "lol no, you're gonna change your mind, and if you don't, you can decide for yourself when you're old enough" for those purely cosmetic surgeries, but when it comes to so-called trans kids, where the dangers are so much higher, all caution and reason go to the wind. Why??

Ah, well as someone who has some knowledge and experience in this area without needing to be told, if there's a whole bunch of missing data, it's inconsistently recorded, and they didn't record major things like mental health issues before intervention or other medications being taken (e.g. antidepressants) then there is fuck-all useful statistical analysis that can be done to assess the efficacy of a medication or intervention.

If you look at the Finnish study where the data is complete and consistent and then see the extremely limited conclusion that they could statistically draw from the data, you might start to appreciate the limitations of retrospective studies.

No need to be condescending. If you have to appeal to your authority it makes your case appear weaker.

Ah, well as someone who has some knowledge and experience in this area without needing to be told, if there's a whole bunch of missing data, it's inconsistently recorded, and they didn't record major things like mental health issues before intervention or other medications being taken (e.g. antidepressants) then there is fuck-all useful statistical analysis that can be done to assess the efficacy of a medication or intervention.

Are we not being told that the trial will do rigorous selection and no child with mental health issues will be recruited? So no child will be or at age 12 ought to be on antidepressants.

For me, @noblegiraffe you seem to support the trial. Apart from data, what do you see as being achieved by it?

This was a criticism of a retrospective study of the Tavistock patients, not the current puberty blocker trial protocol.

I would hope, if the trial goes ahead, that it shows that puberty blockers provide no benefits compared to the children who are on the comparison study who aren't taking puberty blockers. I hope that any risks are minimal due to short exposure, but if there are any, that they are clearly demonstrated.

I hope that the international medical community then take notice and gender clinics all over the world switch to non-medical interventions.

I don't think that this will happen without a proper trial being conducted. I just can't see it. Therefore I think that not conducting the trial will not prevent harm to children, but potentially prolong it.

I'm not appealing to my authority to convince you, I'm explaining why I don't need to rely in Transgender Trend to form my opinions.

What benefits do you think this treatment will provide to the participants?

What exactly is the condition which is being treated and why are puberty blockers the chosen treatment?

What does a good outcome look like for the participants?

"Scientists use the GRADE method as a tool to evaluate systematic reviews; it rates evidence from “very high quality” to “very low quality.” Randomized controlled trials are presumed “high quality” evidence, and observational studies are rated as “low quality” evidence.
Researchers have said that conducting randomized controlled trials for gender-affirming treatments would be unethical because it would require denying potentially life-saving health care from the control group.
Dr. Dan Karasic, professor emeritus of Psychiatry at UC – San Francisco, said that opponents of gender-affirming care use the GRADE system to hold the evidence on this issue to “an impossible standard”.
“The ‘low quality’ [rating] is just going to be how anything is assigned by GRADE. If you don’t have randomized controlled trials, your study is not going to have a high GRADE score,” said Karasic.
According to Karasic, prescribing treatments that have “low quality” evidence is common, especially in pediatrics. “We do all kinds of interventions, routinely where evidence is limited. So, it’s not that we have randomized controlled trials for everything we do. And especially if you’re working in mental health and you’re working with minors, we’re using interventions all the time that are not FDA-approved for minors.”

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

Many people think that they don't provide any benefits. Many people are equally adamant that they do. I, personally, lean towards thinking that if there are children who would benefit, it's at best a very small subset of the children who have been offered to them in recent years. However we need evidence that it will not provide any benefit. But at the moment, the people who do think they provide benefits are dominating the treatment protocols internationally. Telling people that the drugs don't work isn't going to cut it to stop this. In addition, those people who are making money from providing the kids with the drugs are incentivised to contribute to the discourse that convinces children that they have a problem that means that they need these drugs in the first place. The industry needs shutting down.

There are plenty of people who believed homeopathy provided benefits. They would absolutely 100% swear that the water cured their medical issues. Telling people it was merely water did nothing to change that belief. There are various reasons why people might think an intervention does something that it doesn't actually do. Clinical trials provide the evidence.

"One of those treatments, Karasic says, is antidepressants. A systematic review performed by Cochrane, an international nonprofit research organization that has conducted thousands of systematic reviews, found that for children and adolescents “most antidepressants may be associated with a ‘small and unimportant’ reduction in depression symptoms.” And even this “small and unimportant” association was “low certainty” for some of these drugs.
And, like gender-affirming treatments, antidepressants come with serious risks. These risks include potential bone density loss, which is a commonly cited risk of puberty blockers, as well as suicidality. “Antidepressants have a black box warning in minors for an increase in suicidality, and yet we use them all the time because they help a lot of people,” Karasic said.
Karasic also pointed to the fact that there are no studies showing that anything else works for gender dysphoria. “For those who do need it, there’s not an alternative treatment,” he said.
Dr. Meredithe McNamara, assistant professor of Pediatrics at Yale, agrees that the term “low quality” can be misleading. “I would say that the problem is that ‘low quality’ evidence is a technical term that spiraled out from the GRADE method,” she said.
Last year, McNamara led a team of researchers who wrote a critical analysis of Florida’s new guidelines that cited “low quality” evidence to justify ending Medicaid coverage for gender-affirming care both for children and adults. McNamara’s analysis showed that a consistent application of this standard would force the state to deny coverage for mammograms, routine surgeries, and drugs that lower cholesterol.
She argued that high-quality evidence is often not available to assess treatments on minors and for rare conditions, and so the lack of it isn’t a good reason to deny treatment.
“You don’t need high-quality evidence to practice good care. You don’t need high-quality evidence to follow strong recommendations,” she said."

Those quotes were taken from

"The GOP's War On Trans Kids Relies On Myths About Progressive Europe"
From The Stranger

Can't post link for some reason.

The main problem is that the trial is based on utter nonsense.

This is from your link:

Gender incongruence is when someone’s gender doesn’t match the sex they were registered at birth. Puberty can be a difficult time for young people with gender incongruence. This is because their body starts to change in ways that don’t match how they feel inside.

"Someone's gender". What does this mean? In what way is it expected to match their sex? What does it mean for a gender to match a sex? What does it mean for someone's body to change in ways that don’t match how they feel inside?

The whole thing is meaningless with undefined terms and no explanation of what they are actually trying to achieve.

Is this meant to be an answer to my questions?

Probably because MNHQ filtering our nonsense.

Name another treatment given to children that is like PBs for children with an unexplained condition.

Regardless of other treatments, do you think it’s ethical to sterilise children in this manner?