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.

I don’t think she is being threatened, or that she has a trans relative. I think she is a scientist and that she believes in the existence of the “true trans” person, who we simply cannot identify now because our diagnostic tools are not yet sophisticated enough.

Therefore until the day that such diagnostic tools are developed, we should assume that the true trans person exists, and therefore treat all people who present with the symptoms that come under the trans umbrella as if they were true trans, so that the poor true trans does not miss out on medical treatment. And the people who are not true trans, who will be medicalised unnecessarily, are acceptable sacrifices to progressing the science that will end up helping the true trans.

What I want to know is if Cass has in any way addressed the negatives of a puberty blocker trial. We see women complaining of suffering lifelong debilitating effects from being given PBs for short periods of time to treat precocious puberty, and endometriosis, so children being given these drugs for much longer periods of time are at the same or increased risk of these very negative side effects.

What are the Health Secretary and Baroness Cass proposing to do to help the children who will develop complications and negative side effects because of this trial?

Are these children just to be considered acceptable collateral damage of a flawed medical trial?

If we get confirmation from running this trial that PBs are not helpful, is the damaged health of these children worth gaining that data?

Is our government really content to sacrifice a cohort of children because their politicians are cowards and NHS medics are captured by ideology?

I don't think so. If she was being threatened she would step away, say that her job was done, she had made her recommendations and she didn't have a view on the proposals.

Ego protection I reckon.

I think she is a scientist and that she believes in the existence of the “true trans” person, who we simply cannot identify now because our diagnostic tools are not yet sophisticated enough.

If she believes in the existence of the “true trans” person, which there is no evidence for, this is nothing to do with being a scientist, it's a quasi religious belief. Belief in a concept for which there is no evidence is not science.

I wonder what people like her think a "true trans" person is. Does she believe that some people are literally born in the wrong body, or does she think that for some people their extreme body hatred is and always will be untreatable as a mental condition?

This question should be answered before going ahead with the proposed experiment on children. What is the condition, and what would a positive outcome look like?

Agree. I don’t like that she’s been targeted, but many adults generally are failing children atm.

Are these children just to be considered acceptable collateral damage of a flawed medical trial?

@UtopiaPlanitia It's starting to look exactly like this, isn't it? They will harm these children to demonstrate harm, and that will be the excuse for not harming more children.

I can't for the life of me understand where Cass is coming from.

@OldCrone:

If she believes in the existence of the “true trans” person, which there is no evidence for, this is nothing to do with being a scientist, it's a quasi religious belief. Belief in a concept for which there is no evidence is not science.

No, I totally agree that there is no current evidence for the existence of the “true trans” person. However, for some reason Cass seems to think that the lack of evidence is not because there is no such thing, but that we simply haven’t figured out what the biological markers are yet. Perhaps I should say that she “identifies” as a scientist, because yes, holding onto an idea like that in the face of no evidence is not remotely scientific.

I am away from my computer, so can’t easily go and find the relevant interviews she gave (they were around the time that the PB trial was originally being talked about), but it was clear that although none of the extant studies in “her” report (I use the her advisedly, because I don’t think she had any real input into the science of the report) showed any clear benefit of medicalisation, she nonetheless felt that there was a strong possibility that at some point we would be able to identify some small cohort of people who would benefit (she did not clarify what this benefit would look like) from medicalisation.

It's because she never looked at adults. What happens when these young people grow up was outside her remit and so not looking into adults became - I dunno - a kind of fixed point? A no-go area? It protected her and made her seem more neutral.

But if you don't look at adulthood you've missed these children's future.

For anyone wanting to read the attachments, if you go to thread unroll they can be read there
https://twitter-thread.com/t/2075512549248745744

(I think this is complete - not 100% sure)

Further reason I think Cass is an ideologue:

There was no need for her to intervene in the argument about the PB trial. She put her name to the report and it stands (or falls) on the science; she could simply have left it at that. Whether the trial goes ahead or not does not increase or decrease the validity of that report - she needn’t have stepped away from a “neutral” standpoint at all.

So why did she feel the need to go out of her way to send her thoughts to every single MP and peer? Why is it so important to her personally that this egregiously poor study should take place? Why is she not campaigning equally vigorously and loudly for the data linkage study - which was also recommended in the report?

Good point. I can't recall another "named" review being so vigorously pursued by the reviewer. Normally (and I have done this myself), the reviewer has no skin in the game, is careful to be scrupulously honest, deals with the facts only, writes a conclusion and recommendations based on what the facts uncovered, completes the review, hands it to the client (gets paid, sometimes), then walks away to whatever their day job is. Not hang around to justify every recommendation the client doesn't like, explain every last detail that the client doesn't want to understand, or offer to get involved in the implementation of said recommendations.

The ones I've done have obsessed me while I was working on them, and then were completely forgotten once I'd handed it over and been paid. I couldn't care less if the client implemented my recommendations or not.

When the report was first published I thought that Cass was trying to be scrupulously impartial and was saying that the lack of evidence meant that no one could say that it was either harmful or safe. At this point I thought that she would push for the data linkage review to be completed before a trial could start

As time passed I started to think that she believed PBs were harmful but a trial was needed to prove that harm to parents so they wouldn't obtain PBs elsewhere . A terrible reason for a trial.

Now, I've no clue why she's pushing so hard for the trial to proceed. Her recent comments, particularly about the boy with weakened bones from not going out, sound like she's regurgitating TRA talking points

With any luck the MP's and Peers who are in the know will send her back a detailed document as to why she's wrong, including an assessment of where her report did not get it right. 😤

Hang on, this why journalist activists & political operatives have no business adjudicating complex matters that require expertise.

Cass describes around 250 children who admitted taking various medications as “250 cases of known harm”. That is not supported by the information given. Unsafe or unmonitored medication use creates a risk of harm, but it does not prove that every one of those children was actually harmed.

Nit picking. Its like saying we know women will seek backyard abortions if abortion is illegal but we don't know for sure whether they will be harmed so no harm done.

The existence of illegal prescribing also does not demonstrate that giving puberty blockers through an NHS trial is beneficial or necessary. The alternative is not simply to abandon these children. They can still receive psychological support, treatment for mental-health problems, help with school, neurodevelopmental assessment and family support without suppressing puberty.

The point is like illegal abortion, illegal prescribing is going to happen anyway so the benefit is the difference in care.

The claim that PATHWAYS is not intended to lead to cross-sex hormones is also difficult to reconcile with the trial’s selection criteria and the historic evidence. Participants will be selected partly because they have persistent gender dysphoria, a continuing desire to transition and a repeated request for endocrine treatment. In previous cohorts, the overwhelming majority of children placed on blockers went on to cross-sex hormones.

Of all the claims this is the most spurious. Correlation is not causation. That in previous cohorts the overwhelming majority of children placed on blockers went on to cross-sex hormones maybe purely a function of correct self selection & screening. The argument of withdrawing treatment because it might enable a different treatment that may cause harm without causal evidence is scientifically unsound methodology.

Calling blockers a neutral “pause” or a way of “buying time” is therefore unproven. It is equally possible that suppressing normal puberty prevents the physical and psychological development through which some children would otherwise become reconciled to their sex.

Given the argument is supposedly children aren't mature enough to make serious decisions it's inconsistent to suggest that waiting until they are older to make one is harmful.

The trial also cannot answer many of the most important questions. The randomised blocker-versus-no-blocker comparison lasts only about 12 months. After that, both groups receive blockers. A study of this size and length cannot determine adult fertility, mature sexual function, peak bone mass, fracture risk, later regret or long-term psychological outcomes.

Lots of trial medications have potential for unknown serious long term side affects so this is no different. For this claim to legitimately stand it would have to be consistently applied & we all know it isn't.

Cass is right that the existing evidence is extremely poor. But that does not automatically establish that this particular experiment is ethical, necessary or capable of answering the questions that matter most.

As do other trial medications & yet no political interference there.

For any of these claims to be remotely considered legitimate they need to show the methodology for this trial is inconsistent with the standards of trials & evidence in general….which they conveniently don't.

I hope children affected sue the shit out the government in twenty years. It’s abundantly clear that it’s harmful to these children who cannot validly consent

a mother near me declared her sons to be non binary and they were given puberty blockers. This was around a decade ago. The mother was eloquent but utterly mad and no one dared question her. I am in no doubt it was pushed by her. She moved away and I still worry about what became of her sons.

What do you think the "real motivation" is?

From the link:

"On one level, these commentators’ transphobia functions as a continuation of their Corbyn-era attacks on the left. Evidently, the right has learned that bigotry is more effective when it appears to serve a progressive cause, whether that’s protecting Jews from racism or protecting women from male violence. The left as a whole can be attacked for supposedly failing to listen to a vulnerable group, and members of that group with bigoted beliefs leverage their identities to lend legitimacy to the critiques.

Having opposed Corbyn is certainly no guarantee of transphobia; the Jewish comedy writer Sara Gibbs, for example, who was a consistent critic of his, wrote in the Jewish News earlier this year that Jews should stand with the trans community. But the fact that many purveyors of fear about antisemitism from the Corbyn years have gone on to demonise trans people points to a further connection between rightwing instrumentalisation of antisemitism and transphobia. In fact, these two movements are ideological fellow-travellers, unified by a foundation of extinction phobia."

You have to wonder about the real motives behind James Esses obsession with trans issues same with Bari Weiss, Leo Sapir, Abigail Shrier, Jesse Signal, Bethany Mandel, Hadlee Freeman & on & on.

My suspicion is their real motives are a firm grasp of reality and opposition to willfully harming children.

'Whatever gets you through the night.'

I think it is a combination of things but I have not worked out what the combination is.

I do think that there is a reputational aspect. That she could be trying to shape her future reputation if she believes there are a group of children that can genuinely benefit and she doesn’t want her name to be forever tied (even loosely) in the future to the rejection of treating children with puberty blockers for identity purposes.

For example, if they are to be banned for this purpose, I assume she wants there to be solid research to support the decisions that now have been made in conjunction with her name, if you know what I mean.

She may believe there is a group of very rare children who childhood transition can help and she doesn’t want that group to be harmed ‘in her name’. She may be acting to protect them.

I find the example that she publicised to very confusing, because surely that child requires intensive psychiatric care and not given puberty blockers.

However, her selection of the case has also shone a beacon on the phenomenon of how heavily invested lobby and support groups and the positive stories about puberty blockers have led to a generation of children believing that they are necessary for their survival. The harm of those mantras and the focus from those groups about suicide is also being highlighted.

I remember the Australian team from Westmead Children hospital raising the alarm that it was becoming impossible to find a child patient who had not been influenced by peers, parents and / or media from the groups who supported transitioning children.

After all that is why this trial is so debated after all.

This ⬆️

A rather weak response, which undermines your attempt to present as a thoughtful commentator.