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.

Ok, this is my interpretation, so take it with a grain of salt because (as we have established above) I can’t see into Cass’s head:

Cass is saying, look at this terribly sad case we have - here is a boy who has lived, properly lived for such a long time as a girl, and who is now so desperately afraid of going through the “wrong” puberty that he is self-isolating and won’t leave his house. How could you possibly legislate to prevent this child from getting medication that will stop him going through the wrong puberty and will therefore solve all his mental health problems? (She carefully elides over how he ended up in the situation he is in where he thinks he is a girl but obviously knows he has a boy’s body.). She then appears to be saying something like - and for those of you who are worried about the effect that puberty blockers have on bone density, well his bones are already damaged from never leaving the house, so how could PBs be any worse.

But as I say, grain of salt.

Exactly. And for the girls who do not take puberty blockers, there's possible pregnancy to look forward to, and menopause, let alone the normal aging processes (who knows what the girls who do take puberty blockers will go through, but it won't be pregnancy). I still identify inside as a pre-menopausal 35 year old with core muscles, flat midriff, and beautiful long brown hair with no grey. Do I get drugs to help me match my mind to this mythical body? (They're probably called hallucinogenic drugs).

The aging process and time also bring experiences and wisdom, which these children will need as they go through life. We can't protect them from everything, but we can give them the best possible start to adulthood. Puberty blockers, whatever these children's states of mind are now, will not provide these children the best starts in life.

I think she seems to suggest that it's best to continue to hold out the possibility of changing sex, even thought that is not possible.

"Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if
they had not been socially transitioned at that very early stage."

But it's not clear what long term alternative there is to coming to terms with the fact that it is impossible to change sex.

"......living in stealth appears to increase a child's level of stress and anxiety with resultant behaviour and mental health problems, including social withdrawal, with children becoming increasingly isolated, including resorting to homeschooling or tutoring, with some distressing descriptions of children rarely leaving their house."

Yet she isn't offering an alternative to living in stealth - just the John Money solution that everyone continues to maintain the pretence.

Her best solution seems to be to kick the can down the road for as long as possible. Perhaps that is just what doctors sometimes do. Have I missed any explanation of what she thinks the long term consequences might be?

In the real John Money case it did not work.

Exactly!

That the person saying it is muddled in his thinking. And that is the kind way to put it.

Not when we are talking about children. Teenage angst is temporary. Infertility is for life.

Only when the child fully understands the impact of treatment and is mentally mature enough to make an informed decision. With lupron, that's not possible because 100% of its use in gender-incongruent children is experimental.

re concerns over puberty blockers and their effect on cognitive development:
excerpt from linked article:

Adolescence is a sensitive period for neural pruning and reorganization of neural circuits, particularly in the frontal cortical regions which control decision-making, judgement, and emotional regulation (Chen et al., 2020; Steinberg, 2005) and hormonal surges during puberty are known to have wide ranging effects on brain structure, function, and connectivity (Blakemore et al., 2010; Chen et al., 2020).

A single case report described a 10-point drop in global IQ and an overall decrease in intellectual performance, “pointing to immaturity in…cognitive development,” in a 12-year-old child 28 months after starting a GnRH analogue for gender dysphoria (Schneider et al., 2017). While it is difficult to draw conclusions from one case, similar findings have been reported in children treated with GnRH analogues for precocious puberty (Mul et al., 2001; Wojniusz et al., 2016). Experiments in animals raise additional questions about the reversibility of effects on cognition. In sheep, peripubertal administration of GnRH analogues reduced long-term spatial memory (Hough et al., 2017b), and this effect remained after discontinuing GnRH analogues (Hough et al., 2017a).
pmc.ncbi.nlm.nih.gov/articles/PMC11106199/

@nicepotoftea,

"Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if they had not been socially transitioned at that very early stage."

Oh I keep forgetting that bit.

That seems to go against all the evidence that we have - in fact that is presented in the report bearing her name! - of (a) 80% spontaneous desistance in children who are just left alone and not affirmed, and (b) the success rate of “very skilled therapists” working outside of the new services who appear to be doing just fine at helping children think more flexibly about their identities.

Is she saying that she thinks that when the (ehem, parental) transing has gone on for so long there’s no way back? Because that’s pretty disgusting, if so.

But I am already disgusted by her, so…

Oh I think they are wrong. But that doesn’t mean that they don’t believe it. People believe in all sorts of crap.

That wasn’t what I said.

I suspect that the individuals and organisations that were going to be involved in the regional clinics had already beern pencilled in - and that they are not as clinically neutral as one would hope or expect.

In many, probably most, cases, adulthood without an abused body and the mental trouble which comes from having deliberately spoiled a perfectly good set-up and left oneself with life-long physical problems. Most adolescents who have been told they are trans seem to be able to work out for themselves that they are no such thing without any drug involvement; even the ones with troubled or abusive childhoods or other mental problems complicating the issue.

Or to put it another way, kids do grow up, and get past adolescence.

But the problem is that these drugs are being given to healthy children anyway. This isn’t a normal clinical trial for drug approval before being approved, where halting the trial means the drugs are never administered. Kids are being given these drugs and have been for years. If you want that to stop, and quickly, a clinical trial which shows risks outweigh benefits or a lack of efficacy will do that.

If you don’t have the trial, kids still get given the drugs. Persuading people to stop without proper clinical evidence will take longer. We know that people are ideologically wedded to this.

A PP admitted that lobotomies would have stopped sooner if there had been a proper trial of them.

@noblegiraffe Be careful about bait and switch. Short-term harms of puberty blockers are a worry but they are not the biggest worry. The really big worry is the pathway.

We know from Tavistock GIDS that puberty blockers are not just an independent treatment in themselves but a pathway to further treatment. Because one of the things we know for sure about puberty blockers is that - all else being equal - if you start giving a gender distressed child puberty blockers then you massively increase the chance that the child will go on to cross-sex hormones, with all their long list of known harms to health and fertility. You also increase the risk of the child moving on to surgical treatments with all the associated (and known) harms of those.

If you are putting physically healthy children on a treatment pathway that is likely to lead to serious physical harm then you need to be very confident that there are also significant benefits to the pathway as a whole before it is ethical to start putting any children on that pathway, even as a trial. It's unethical to trial the start of a pathway on children unless you can be confident of (at least) one of three things: that starting the pathway doesn't encourage children to continue the pathway; or that the pathway is not obviously dangerous; or that there are so many dangers to not putting the child on that pathway that they outweigh the dangers of starting. We already have enough evidence that each of those are false.

I think Dr Cass is hoping to finesse some of these ethical issues by for example claiming that some of these children will put themselves or be put by their parents onto the pathway anyway, by buying drugs for themsleves. But this is not how trials on children are usually justified.

I get you, but unlike lobotomy there's no guarantee that the harms of puberty blockers show up that fast. After a year or two the kids are still likely to be in the "happy place" of getting what they want.

The NHS could show leadership to the world by showing caution and keeping its ban in place until the long-term effects on the many children and young people who have already been given puberty blockers, and the many young people who have only been given cross-sex hormones, have been followed up to the best of our ability.

😂😂

Once a swot, always a swot. I cringe at my younger self sometimes but equally, I own it. Thankfully these days I can occasionally combine my natural swotty tendancies with sarcasm every now and again. Although that's obviously not what I'm doing here - your proposed study sounds perfectly reasonable to me 🙃

So, if I understand correctly, you are against the general use of PBs, and believe that the only way to get them stopped, worldwide, is to carry out a proper trial which will demonstrate how terrible they are, yes?

In a sense we all want the same thing, which is to stop too many more children getting these drugs.

But what many of us are saying is: although the researchers who designed the trial say that it is rigorous, many other very knowledgeable scientists have looked at it and have said that it will not in fact give any better data than what is already out there - because of (among other things) the lack of falsifiable hypotheses, the shortness of the study duration, the inappropriateness of the mental health tests that are proposed, and the almost certain confounds that will come from the fact that the families that will be enrolled have huge biases towards the study “succeeding,” however that is measured.

This study will not give you your silver bullet. It cannot. It is not long term enough, it is full of methodological holes. You (or Cass, and you agree?) think the existing (as yet unlinked up) data, such as it is, is crap. Well this study will produce equally crap data, which will not get us any closer to stopping the use of PBs in gender confused children, and will poison 250-odd more children along the way.

Fine, if this study was the most iron-clad, tightest-designed study there ever was, then I might, just might, with a lot of persuasion, consider that poisoning those extra 250 kids would be worth it for the outcome. It is not, and I - and many, many other researchers who know so much more than you or I do about this - therefore do not.

❤️❤️

Swots of the world unite!

Plus, if his bones are already damaged, why are we giving him PBs, which may well compound the damage?

Fine, if this study was the most iron-clad, tightest-designed study there ever was, then I might, just might, with a lot of persuasion, consider that poisoning those extra 250 kids would be worth it for the outcome.

I don't think a normal ethics committee could agree on that basis. You can't experiement on some children to benefit others; there has to be potential benefit to the child taking part.

I think I understand your argument, but I don't accept the premise. If children are going to be given the puberty blockers anyway, then, at least in the UK, whoever is providing them is doing so illegally. So let's go after them. Let's not harm another one child in the hope that the harm that is shown will "make" people stop procuring illegal drugs for children. And it isn't one child. It will be hundreds.

If puberty blockers are being procured illegally now, they will still be procured illegally after a trial, no matter what the data show. So, because it's already happening, we should do it to some more children?

Alcohol is illegal for children, yet they still procure it. Should we harm some children in the hope that other children will stop drinking illegally? Same for smoking. Same for heroin.

Another poster has put all these arguments forward already, upthread, yet you seem to want to ignore these. Why are puberty blockers so special that normal methods of enforcing the law (as per alcohol, heroin, etc.) are not even to be entertained?

The more people put forward logical arguments against the trial, the more you seem to vehemently advocate for this trial to go ahead. Why is that?

No data is worth harming one single child for. No data. Not to cure something as ethereal and undefinable as "gender identity." Not to cure cancer. Why is it acceptable to you to harm children to get some data?

Anyone who thinks that the TRAs and the Webberleys and the online groomers and the captured professionals are going to shut up shop as a result of anything that this trial concludes has not been paying attention. The vagueness of the objectives and the short timescales will give plenty of wriggle-room for cherry-picking. In fact, short term 'mental health benefits' from giving a teenager something they desperately want combined with a lack of long term follow-up, which is where many of the dangerous outcomes would be displayed, may actually encourage clinicians to give more children the drugs.

Yeah ok, was trying to concede a point, but you’re right. Even under that scenario it shouldn’t happen.