Netherlands Puberty Blocker Review Comes to Opposite Conclusion, Dismisses Cass Review

[ForZingyCat]

https://www.gezondheidsraad.nl/adviesonderwerpen/behandeling-en-begeleiding/transgenderzorg-voor-jonger

It isn't a case of someone choosing to believe something irrational

No, it's not necessarily a choice, but it is (sometimes) a case of someone believing in something irrational. A man who believes he's a woman, or believes he thinks like a woman is believing in something irrational.

If he believed he was Napoleon, would it be the right thing to affirm that belief? Believing that he's a woman is no less irrational.

You're asking me to provide evidence for the absence of an effect.

No, I was asking for evidence to back up your claim, which was:
But if you mean that accepting one's sex will reliably resolve gender dysphoria and eliminate the associated distress, the evidence doesn't support that as a universal outcome.

I just asked what evidence you were referring to. It was you who said the evidence existed.

Whether you value my opinion is entirely up to you. But you've responded to an argument I didn't make. I have no problem acknowledging that trans people are a diverse group. My concern is with taking characteristics present in some individuals and presenting them as representative of, or intrinsic to, the wider trans population—particularly where doing so reinforces harmful stereotypes.

That's fair — I should have been clearer in my wording. I wasn't referring to evidence showing that "accepting one's sex" has been tested as a specific intervention in trials and found to be ineffective. I mean that there is no robust evidence demonstrating that this approach reliably resolves gender dysphoria for everyone.

The claim I was challenging was the implication that helping someone "come to terms with their sex" will resolve their dysphoria. That is a much stronger claim, and I am not aware of evidence supporting it as a universal outcome. What we do know is that persistent gender dysphoria into adolescence and adulthood is documented in the literature, which is why the clinical question is how best to support people experiencing ongoing distress.

It’s not the same situation at all. Children with precocious puberty have a medical condition verifiable by blood tests and scans. They are placed on a regimen of medication to treat that medical condition until such point as they are in range for normal puberty at which point they’re taken off the meds. The precocious puberty has negative side effects that can cause long term physical and psychological damage if not treated. The risks associated with puberty blockers are considered to be lower than the risks associated with allowing puberty to progress before the child’s body is ready for it to happen.

Children who present with gender dysphoria have no physical symptoms or medically verifiable traits that can confirm that diagnosis. They have healthy bodies that are developing in line with their natural design. Putting them on puberty blockers is introducing the risks of physical damage with no verifiable way of qualifying whether they will bring an improvement to the psychological health of the child. It is also placing them on a pathway towards lifelong medication, surgical intervention and potentially adding psychological health issues.

If you really can’t see why these are different then you are incredibly obtuse.

If you need a simile then it would be like how we give chemo (which we know has side effects and can cause damage) to people with cancer because the chemo damage is less bad than the cancer. We wouldn’t give chemo to someone who thought they might have cancer but it couldn’t be proved.

This just reads as it being an inconvenient truth that you want to brush under the 'concern about harmful stereotypes' carpet. It is just another version of 'shut up, bigot', to which we are completely immune.
He says the majority are transvestic fetishists; Blanchard originally suggested it was in the region of 70% of trans-identified adult men.
(This is, of course, from the time before the rapid rise in teens presenting with GD.)

The Napoleon analogy doesn't really fit because it treats gender dysphoria as a belief disorder. The phrase "believes he's a woman" already assumes that the person's experience is merely a mistaken belief rather than a complex psychological phenomenon. Gender dysphoria is not understood clinically as simply a false belief that someone is a different person.

A person with gender dysphoria can understand and be aware of the physical characteristics of their body while still experiencing significant distress related to their sex. Recognising that distress and treating it appropriately is not the same thing as affirming a delusion.

We wouldn’t give chemo to someone who thought they might have cancer but it couldn’t be proved.

That's a good analogy @InfoSecInTheCity I'll remember it!

No one is saying that if your kid likes princess dresses they are trans.

A bold claim. The below has been a popular resource in schools through this period.

This isn't about dismissing an uncomfortable claim because it is unpleasant. It is about whether a claim is accurate and whether the way it is framed is justified. I have no problem acknowledging that trans people are not a completely homogeneous group and that some people who seek gender-related care may have a range of motivations or experiences.

Criticising a generalisation because it risks reinforcing harmful stereotypes is not the same thing as saying "don't discuss difficult topics". It is asking whether the conclusion being drawn is proportionate to the evidence.

Blanchard's typology is a contested theory and does not provide a straightforward basis for making claims about all trans people. His samples were drawn from people attending specialist services in a particular time and place; they were not representative samples of the wider trans population, either then or now.

Dr Az Hakeem is promoting harmful stereotypes about trans people.

He is a consultant psychiatrist with over twenty years experience of treating gender dysphoria. What are your qualifications to contradict him?

On what basis can a man be said to be a woman because of how he feels that is not applying sterotypes about women to the entire group of women?

I personally find the assumption that women all have the same way of thinking and feeling, and that it is this inner feeling that makes us women rather than simply our bodies incredibly offensive and degrading, and it undeniably is having real world consequences for women.

Why is this somehow ok just because now it's trans people stereotyping everyone else?

It is asking whether the conclusion being drawn is proportionate to the evidence.

Well, unless you have better evidence, I'll stick with the conclusions of someone who is highly qualified and works in the field.

Expertise is relevant, but it does not make someone's conclusions immune from scrutiny.

People can have considerable clinical experience and still make claims that require challenge, particularly when those claims extend beyond their direct observations to an entire group of people and have potentially harmful real world consequences.

To say "Dr Hakeem has treated many patients, therefore his generalisation about all trans people must be true", is an appeal to authority rather than an argument.

Quite. Stereotypes for me but not for thee.

No, it is an argument from evidence that is bolstered by authority.

The phrase "believes he's a woman" already assumes that the person's experience is merely a mistaken belief rather than a complex psychological phenomenon.

They are the same thing.

THEY ARE THE SAME THING.

Either 1:
He is a woman, which means there is really, in an objectively measureable way, something in him that is also present in all other women and all other trans women but not in men or trans men AND society has decided that this "thing" is the true source of womanhood rather than a female body,

or 2:
He is not a woman but very sincerely believes himself to be.

If the latter is true, then this is a delusion. The reason for it does not change that. It does not become any more true because there is a (hypothetical) organic reason he believes this rather than a social one.

If there were to be a complex psychological phenomenon that caused humans to believe they could fly, this would stil be a deluiosn. They would not in any way be more able to fly than someone who merely has a mistaken belief.

He didn't say "all" though did he?

He said based on his experience, this is what the proportions seem to be.

Whereas you appear to be saying that based on your feeling that this can't be right, this can't be right. And you expect this has equal weight and authority.

I think the disagreement here is that you are assuming the only way someone can experience gender is through stereotypes about how men and women think, behave, or present. I would gently challenge that assumption. Gender incongruence is a complex psychological phenomenon, and reducing it to a single explanation risks overlooking the diversity and complexity of people's actual experiences.

it's not that a 'man' thinks he's in the wrong category because 'he can't get pregnant', it's that society gives recognition and meaning to the concepts of 'male'/'female' based on biological differences

Please describe one or more of these meanings. I can’t think of any which aren’t stereotypes.

I'm not talking about any specific stereotypical meaning attached to being male or female. I'm talking about the act of recognising and giving meaning to something - the process by which societies recognise categories and give them social significance.

So for example - the EHRC guidance recognises sex-based categories as relevant to how some services should be organised. That is a social meaning attached to a category, not a claim that men and women must conform to particular stereotypes.

It strikes me as massively irresponsible to put young people on treatments where the longterm impacts are not known, especially for an issue that barely existed 15 or 20 years ago, and which appears to be psychological.

It is also potentially irresponsible not to provide appropriate treatment where someone is experiencing significant distress and where untreated symptoms may have serious consequences. The fact that long-term evidence is incomplete does not automatically mean that withholding treatment is the safer option; it means clinicians have to weigh the potential benefits and risks of all available approaches.

The question is not simply "are there uncertainties?"—there are uncertainties in many areas of medicine. The question is how those uncertainties compare with the harms of leaving a condition untreated and what approach best supports the individual patient.

Gotta dash, but this is the post I really look forward to you replying to @Sunnibee

Nobody is suggesting that treatment should be withheld. The question is whether the treatment (for the psychological condition of gender dysphoria) should be psychological or physical.