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.

This is about what to do with this trial. And other countries are looking at this trial for their own guidance. Like Australia for instance.

So clearly defining what the purpose of this trial is will go a long way to sorting it out worldwide. It it is determined, through adequate ethical appraisal, that it is not ethical to proceed with this trial because of difficulties even defining the condition being treated, it will mean that there is no way gender clinics around the world can argue it’s ethical to continue with PBs in normal clinical practice.

So forcing this research group to address these issues now would be hugely impactful.

What I am proposing isn’t even controversial. If a trial for chemotherapy is proposed to treat leukaemia in children, the underlying leukaemia is defined down to genetics.

A trial of this magnitude should be subject to the highest scrutiny possible.

Your original question:

"Can you name another treatment that is still given to children that has such questionable ethics around it?
Do you have an answer to my question as to whether you think THIS is ethical?"

Ethics & standards of practice are inextricably linked. And the standard of practice for mental health medications is another treatment available to children with the similar low quality evidence & risks. So yes PB are ethical if they meet standards of practice.

"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.”
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."

It’s pretty obvious plenty of people who spout “TWAW” don’t deeply believe it to be literally true. Don’t know why you think me believing this has any impact on my sleep 😂

You haven’t named another treatment. Can you name one?

Ethics & standards of practice are inextricably linked. And the standard of practice for mental health medications is another treatment available to children with the similar low quality evidence & risks. So yes PB are ethical if they meet standards of practice.

The “standards of practice” are not ethical. This logic doesn’t work. The “standards of practice” were created to allow puberty blockers to be given. So then it still needs to be established why they are given and is it ethical to do so.

Do you want a trial of puberty blockers to go ahead or not? Because if you don't, then sorting it out worldwide ain't happening any time soon.

I didn't say everyone believed it. I said a big chunk of people do.

You’re optimistic to think a relatively small two year trial is going to definitively prove that PBs have such immediately obvious negative consequences that they are forever banned here and globally.

Likewise optimistic to think that even if it’s established that PBs have irrefutable adverse impacts within two years that such findings will stop the likes of Dr W or the 100’s of hard core healthcare genderists who emphatically know better. Or stop those parents on the gender train determined to get scripts online and continue circumventing GPs altogether.

It certainly won’t stop the young trans identifying males that I know never bother with any doctor. They’re in online spaces, get told by TWs who’ve already transitioned and sourced the PBs/xshs that they need to start taking these asap. They tell them it’s needed to keep their wrists small and bodies skinny and then give them the links to the online pharmacies. Job done.

None of that will stop with this trial. It’d be a relief if it did, but I don’t share that optimism.

You keep saying this, but why?

Puberty blockers have been banned in several jurisdictions without a trial required to bring that about. This has happened because jurisdictions have seen sense in the logic of the harms and problems with the reason they are given.

Why is a trial a necessity to bring about the final nail in the coffin of their use worldwide?

It's not just a small two year trial. It's part of a much larger suite of studies. And it's not just about proving they have negative consequences, they also have to show benefits relative to the risks.

And you don't need to tell me about the risks of nutters grooming kids on the internet. At the moment there's nothing to counter them.

When lobotomy was banned, there wasn’t a necessity to have a “better trial” for everyone to see sticking things in people’s brains was ultimately a bad idea.

The “standards of practice” are not ethical. This logic doesn’t work. The “standards of practice” were created to allow puberty blockers to be given. So then it still needs to be established why they are given and is it ethical to do so.

You don't seem to understand that all an acceptable treatment needs to be is meeting the standards of care & the UK Pathways clinical trial on puberty blockers has officially met the required regulatory and ethical standards of practice.

And that's the world we live in, while the experts and politicians and media cannot face reality and pivot180 to speaking the truth. They didn't when this phenomenon took hold, they sure as Hell won't now.
So, those snared into this world will themselves, or via their parents, access black market drugs, and find online influencers to back up their choices.
And polite society will sacrifice a cohort of vulnerable teens for some spurious possibility that magical thinking and innate inner feelings will be confirmed and these kids will be medicalized into happiness.
Adults going down this path, if that's what they want, they're of an age to make reasoned decisions. But teens, not able to encompass all the ramifications, including the pathway to irreversible change, how global society deemed this as reasonable and respectable, is a Q for the ages.

Which jurisdictions are you referring to? If it is in the US, are you confident that the bans would stand if a different political party took control of those jurisdictions? I'd prefer medicine to be evidence-based, not politically-based.

Other countries are certainly looking to improve the evidence base.

They didn't really have clinical trials back then, and if they had, they've have figured it out much sooner.

No, you don’t seem to understand is that this very idea is what is so controversial and shouldn’t be going unchallenged.

In the US, the HHS Report is one of the most accurate evidence-based document in this field. Those jurisdictions that have banned puberty blockers in the US have followed the evidence.

If other parties would have not done that, then those parties would be guilty of allowing politics to override the evidence.

There are other countries and jurisdictions around the world, not just the US.

Other countries are certainly looking to improve the evidence base.

And again, this should start with the evidence that gender incongruence is an accurate diagnosis and that gender identity exists.

I'd love to know what they think is the benefit of stunting the normal development of adolescents.

Passing better as adult transsexuals?

Sterilisation of children who would grow up to be gay or lesbian?

Sterilisation of autistic children?

Producing a cohort of young people who are physically and mentally immature, but chronologically are adults?

What other "benefits" are there of this treatment?

Of course they had clinical trials “back then” in the 40s and 50s 🙄

The first RCT was in 1948.

Do you think if they'd done proper clinical trials of lobotomies they'd have spotted the problems more quickly and stopped their use more quickly?

If it’s true that they couldn’t do RCTs or “proper trials” back then, then it demonstrates that it’s possible that you can put a stop to a dangerous practice without the need for a proper trial, doesn’t it?

Do you think if they'd done proper clinical trials of lobotomies they'd have spotted the problems more quickly and stopped their use more quickly?

Lobotomy suffered from the same problem as PBs. Ideologically driven practitioners (Walter Freeman) and runaway diffusion of the practice outside of rigorous oversight.

Of course if proper trials had been done at its inception by independent researchers and not relied on small weak studies (sound familiar?) then it may have been stopped sooner.

Was the Soviet Union politically motivated to be the first country to ban it?

Basically, you’re acknowledging you think it’s ethical to sterilise children.

And you think it’s ethical because people who think it’s ethical have set the standards of practice determining that it’s ethical, ergo it’s ethical.

As I said upthread, trade offs are part of why health risks are ethical as in the lesser of two evils.

Ok so explain what the other evil is that balances sterilising children?

At least you’re admitting it’s an evil.

Mental health outcomes.

Like what? What are the mental health outcomes that come from not sterilising children?