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.

You have dismissed the possibility of any statistical validity of the data on a purely negative view of what you perceive to be available. The idea we can’t gain any insight into outcomes for children by looking in to this is wholly without basis.

I agree.

In the world as it is, people are male or female, and people can't change sex.

In the world as some people would like it to be, we can actually change people's sex (or at least the sex they appear to be), which is what this trial is all about.

Perhaps you should offer your advice to the people who are proposing this trial.

And all responsible adults should tell children that they also have to live in the real world as it is, where people can't change sex, not the world as they would like it to be, where they can.

And finding that they are willing to sacrifice your child for the greater good

That is what I can absolutely not get my head around and I'm a scientist who was prepared to take personal risks during my career (working in extreme environments). Vulnerable children as collateral damage, all while knowing that no TRA will ever accept any outcome of this "study" that doesn't fit their narrative. It's utterly disgraceful.

Vulnerable children as collateral damage

This is it exactly. ⬆

And I'm still hoping to get an answer from @noblegiraffe to my question from yesterday:

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?

Because no one has been willing to answer this question yet. It's so obvious to many people that this is not the way to go about getting data that you want/need. But, apparently not obvious to everyone?

I've looked at the objectives, and also how they define the term "gender incongruence".

Inclusion criteria:
1. Diagnosis of gender incongruence according to
ICD-11, which includes:
a. Strong desire to be a different gender than the birth-registered sex.
b. Strong dislike of sexual anatomy or anticipated secondary sex characteristics.
c. Gender Incongruence persisted for a minimum of 2 years.
d. Strong desire to ‘transition’ and live as the experienced gender.

You're expecting good data from this?

The so-called medical condition under investigation is described as a combination of desires and dislike of the body. An experiment on children is taking place because they dislike the stereotypes for their sex and the changes happening to their bodies at puberty?

Primary Objective
To determine the short/medium-term benefits and
risks of GnRHa for puberty suppression in CYP with
gender incongruence. This will take a comprehensive approach to domains of possible benefit and risk, including quality of life, mental health, gender identity/dysphoria and body satisfaction, impact on cognition and brain development and physical effects including bone mineral density.

Quality of life. How is quality of life measured? Is there some sort of scale that provides good data for this?

Mental health. I'm not sure how keeping someone childlike while all their classmates are going through puberty is likely to help a child's mental health. I would have thought they'd feel more and more isolated so there's unlikely to be any benefit from the drugs.

Gender identity/dysphoria and body satisfaction. What is the scale of measurement here? Surely "body satisfaction" isn't any sort of relevant measurement for a teenager, a time when hating your body is the norm. There's unlikely to be any good data resulting from this.

Impact on cognition and brain development and physical effects including bone mineral density.
These are actual outcomes which can be measured and studies have already been done. We know there is a negative effect on brain development and bone density. We don't need to harm more children in order to know the outcome.

What on earth is the point of this trial really?

If there is no data about these children, and nobody kept any records about anything they saw then
a - where did Hannah Barnes get her stats from?
b - why are all these medical professionals still employed?

I did and have answered this. You didn't like the answer, but that's on you, not me.

My perspective is that thousands of kids around the world are being given these drugs, some illegally, most being prescribed them legally.

There is an opportunity to study a small subset of them. Give them the drugs carefully, in a controlled environment, and collect lots of data as it's done. Really nail down the problems with them. Use that data as evidence to shut down the prescription of these drugs and protect all children, soon and into the future.

Or, we could let thousands of kids take these drugs and not properly study a small subset of them and hope shouting 'no they're not' at the people who are shouting 'they're lifesaving' works eventually.

That's not the world as it is, that's the world as you'd like it to be.

In the world as it is, many adults are telling kids a bunch of crap, and other adults have to deal with the fallout.

The data linkage trial is not a replacement for the puberty blockers trial, it is a necessary precursor to it. We need to analyse the hell out of whatever data we can get before we expose more children.

The data linkage trial can establish at least floor and ceiling values for some of the outcome variables. It can answer methodological questions for a new study. It can establish what data the NHS is capable of storing over a long period, how data gets lost and and how it can be maintained and accessed; it can validate some of the questions that might be asked of the new cohort and raise new issues.

And yes, even weak linkage data with little more than floor and ceiling values might be enough in itself to establish that the puberty blocker trial is unnecessary, infeasible or unethical. (I personally think we have the evidence for unnecessary and unethical already but if the data linkage study came up with results against my expectations then I'd respect that.)

@noblegiraffe:

There is an opportunity to study a small subset of them. Give them the drugs carefully, in a controlled environment, and collect lots of data as it's done. Really nail down the problems with them. Use that data as evidence to shut down the prescription of these drugs and protect all children, soon and into the future.

I don’t know how many times I can say this to you, but I will try once more: the puberty blocker trial will not nail down anything, because the measures that it is proposing to collect, and the circumstances and duration under which it will collect them, are weak and insufficient.

Maybe there is a trial design that could do what you are hoping to do - although, again, as PPs have pointed out, if you were the researcher and you proposed a trial to prove that a particular drug was harmful rather than beneficial, you would be shut down, because that type of study is unethical.

BUT THIS STUDY IS NOT IT.

Thank you. Jesus it’s like arguing with a toddler.

A toddler who has clearly never conducted a piece of research in their life.

'I need a study to prove this drug is harmful'

'What makes you think it is harmful'

'Well, we already use it to castrate sex offenders and we know it is harmful for long periods on other kids as we limit the exposure to the barest minimum to avoid all the thousands of already identified issues, so I was wanting to try it on kids'

'Are you out of your fucking mind?'

Is how the 'trial design' should have gone.

Ok, well, thanks for being honest that you are advocating for using drugs to experiment on a few hundred UK children in order to hopefully get some kind of useful data and, hopefully, possibly, maybe persuade the rest of the world to stop using these drugs on their children.

I hope, if this experiment does go ahead, that these children feel in years to come that sacrificing their physical and mental health for other people's wellbeing was worth it.

(I also hope you don't have any actual influence on whether or not this trial proceeds)

So in your world, we have to spend several years and a load of taxpayers' money doing yet another harmful experiment on children in order to convince a bunch of deranged adults that they shouldn't be telling children that they can change sex.

Do you really think it wouldn't be better to just tell the deranged adults that they can't just demand that more children are harmed in order to prop up the delusional fantasies of adult male fetishists?

"Loads of people have lost their minds so we have to harm a bunch of children in order to convince them they're wrong."

No. People who've lost their minds won't listen to reason. There need to be some actual rational people in charge who just say "no" to the delusional and the fetishists.

There is an opportunity to study a small subset of them. Give them the drugs carefully, in a controlled environment, and collect lots of data as it's done. Really nail down the problems with them. Use that data as evidence to shut down the prescription of these drugs and protect all children, soon and into the future. There is an opportunity to study a small subset of them. Give them the drugs carefully, in a controlled environment, and collect lots of data as it's done. Really nail down the problems with them. Use that data as evidence to shut down the prescription of these drugs and protect all children, soon and into the future.
Nobody who is determined to use these drugs on children for whatever their actual reasons are is going to stop this based on one study with 250 children that we can already see the flaws in the design.

There’s your dealing with the world as you would like it to be again. “How about just telling the adults not to prescribe the drugs”

and the children continue to be prescribed the drugs.

As if your world is any less fantastical:

”We conduct a tiny and ill-designed study and all the world suddenly has their mind changed, when nothing that’s been presented to them previously has done so.”

Magic!

Oh well, best not even try then. Let’s leave them to it.

That’s actually quite funny.

What it highlights to me is the shit quality of what some people must think they can pass off as research because they have no idea what it looks like when it is done properly.

I would invite you to look again at the Finnish study and consider the extremely limited and carefully couched in caveats conclusion that they were able to draw from their far superior dataset.

Yes, I don't think risking the health and fertility of children for this badly thought out experiment is justified and neither did the first ethics committee that looked at it. There are other ways of shutting down illegal trade in PBs (proper long jail sentences might help) and more and more countries that look at available data are stopping legal provision. This trial will do nothing at all whatever its outcome.

I’m far behind in the thread but Cass’ fake two and a half year old makes me think of the Portuguese chicken girl case study. In the 1980s this was considered abuse. I’m not sure why Cass thinks it isn’t abuse now

Isabel Quaresma is ten, but cannot talk, and is only now learning to eat with a spoon.
She is a ‘wild child’ who has only recently been bought into regular contact with human
beings. Since birth the child has lived in a chicken coop. Her mother is a mentally deficient
rural worker living in poverty. The mother works in the fields all day and soon after
Isabel’s birth confined her to the chicken coop where she was thrown pieces of bread
and shared the chicken feed with the fowls. Neighbours gossiped about this scandal for
years but had done nothing, not wanting to interfere with a family matter.
At last, however distinct hospital radiographer at Torres Vedras Hospital approached
Isabel Quaresma
local institutions to accept Isabel. After a string of refusals, the radiographer took her into his own home,
but could not cope. Isabel’s contact with humans had been minimal and she could neither talk nor was
she potty trained – in the chicken coop she had lived in her own excrement. Her gestures and sounds
resembled those of fowls she had lived with since infancy. She scratched food up with her hands. Isabel
now lives at a private clinic for severely handicapped children in Lisbon. The most striking thing about her
appearance is her severely stunted body. She has a tiny head, and the stature of an infant. X rays have
shown her skull structure to be sound. Her dwarfed form is almost certainly due to malnutrition. One eye
is clouded with cataract, thought to be the result of a scratch from the hens she lived with. She
communicates through repetitive calls and beats her arms and drums her feet to express emotion –
actions probably imitative of her only living companions. Dr Joao dos Santos is optimistic about her
chances of a social awakening. But, he explains: it all depends on whether we can build warm human
contacts which will move her to want to speak and communicate with us’ (Source: Jill Joliffe in the Guardian, 12th June
1980)

Ok, I’ll allow myself to be persuaded:

Many posters on this thread have highlighted the known issues with the proposed trial.

As you are clearly a researcher of some expertise, you must have some ideas of how the trial researchers intend to mitigate these issues. How are they planning to ensure that - despite all appearances - this study is more water-tight and rigorous than any other study that has ever been carried out?

I am totally open to being persuaded, but so far no one will tell me how the holes in this study are less worrisome than the holes in other studies that no one has bothered to pay any attention to.

Who is doing the prescribing? This is illegal in the UK. The parents are also culpable.

The solution to people distributing illegal drugs to children isn't to run a state funded trial of whether they're harmful. The solution is to apply the law and prosecute the people who are breaking the law. This includes the children's parents.

Harmful drugs don't become harmless just because it's the NHS supplying them rather than quacks.

Great questions!

As to the trial

As others have already commented, we have evidence (multiple research reports from different decades) that show between 60 and 90% of children will desist from believing they are wanting to be the opposite sex simply by going through puberty.

There is no way of knowing which will persist.

Therefore any trial will explicitly not help at least 60% of participants.

We know from research already conducted on PBs that over 90% (as high as 98%) of children go on to ash from PBs and will further medicalise. This will harm at least 60% of participants who start as physically healthy children and would otherwise desist.

The Dutch results have never been replicated as it was later discovered that they switched the questionnaires so a transitioning boy would fill in the ‘boy’ questionnaire pre medicalisation/surgery and the ‘girl’ one after. So there is no evidence that PBs benefit children as a cohort

There is a body of evidence that suggests very serious risks to giving children PBs.

Looking at all that - and without a coherent definition of the condition being treated- does not lead to a slam dunk conclusion that a trial would be a good idea.

There are also multiple issues with the trial design but there are so many issues even to the principle of running any trial that I still can’t believe an ethics committee signed off on it