Page 3 | Where did the 'fact' that puberty blockers are reversible come from?

WarriorN · 2023-08-25T13:52:27+00:00

Following the Roisin Murphy thread where a poster on a forum that was linked stated: "puberty blockers are reversible, fact" Does anyone know exactly what the evidence for that claim was based on originally? Bits I've read by Michael Biggs weave a tangled tale of clinicians saying It Is So but no real scientific evidence?

AvengedQuince · 25/08/2023 18:47

BonfireLady · 25/08/2023 15:09

They are totally safe in this scenario. It's what they are licensed to treat.

They are used off-licence to stop puberty all together in "gender affirming care". When the child is old enough they are then given the option (98% take it) of going on to cross sex hormones. These are synthetic and won't lead to puberty of the opposite sex but will allow the body to great physical sexual characteristics that mimic the opposite sex. But the child goes through no puberty.

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Does no real puberty mean their brain does not mature normally? As I thought there are significant changes in adolescence?

BonfireLady · 25/08/2023 19:01

AvengedQuince · 25/08/2023 18:47

Does no real puberty mean their brain does not mature normally? As I thought there are significant changes in adolescence?

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The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

BonfireLady · 25/08/2023 19:03

BonfireLady · 25/08/2023 19:01

The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

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From talking to professionals in psychiatry (I'm not one), the general view seems to support what you say. That the brain goes through crucial development during adolescence until the age of 25. If you don't go through puberty this doesn't happen.

Boomboom22 · 25/08/2023 19:04

I'm.sorry but utterly us not true to say they are safe and reversible even for precocious puberty. The bone density evidence is from girls with precocious puberty who stopped them went through puberty but are disabled at 40. Nit from trans, I don't know of any proper follow up studies at all on trans people who took or take them.
They are licensed despite long term side effects as going through very early puberty is considered more of a problem than the side effects. So now if early is like 8 not 3 then they do not prescribe much any more.

Boomboom22 · 25/08/2023 19:05

On a side note I though depo provera the contraceptive injection was used to treat sex offenders, interesting puberty blockers were used to try to treat homosexuality someone said earlier.

Boomboom22 · 25/08/2023 19:07

BonfireLady · 25/08/2023 19:01

The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

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Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

BonfireLady · 25/08/2023 19:12

Boomboom22 · 25/08/2023 19:05

On a side note I though depo provera the contraceptive injection was used to treat sex offenders, interesting puberty blockers were used to try to treat homosexuality someone said earlier.

They were 😞 Chemical castration uses many of the same brands and/or types of drug that are used today as puberty blockers.
Alan Turing had this done to him 😞

BonfireLady · 25/08/2023 19:14

Boomboom22 · 25/08/2023 19:07

Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

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Seems like a fair point.

We need a medic! Is there a doctor on (the) board?' I'm past the point of speaking from knowledge (acquired from lots of reading since I started researching this stuff to help my daughter) on that one.

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WarriorN · 25/08/2023 19:17

Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

I believe it's more complex than that, mainly as it would be conducting an experiment on children. issues like informed consent etc. (worth noting the Cass reformed GIDs proposals include a properly designed and data tracked study involving many children?)

I do remember a years ago they studied the impact on sheep brains; apparently a sheep's brain is the closest to our own in terms of puberty development (or something like that 🐑 )

There were permanent changes to the area of the brain for spatial awareness iirc, possibly also only studied in one sex? Id have to hunt them down.

I don't know if that's enough evidence to say "definitely" affects brain or they can only say "may."

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Boomboom22 · 25/08/2023 19:18

If they know the teenage brain matures and that 25 year olds to 40 year olds are similar then this must be through scans not pure self report or cognitive tests. So it should be possible to scan a cohort who are still on blockers,detrans who were on padt natural critical period for puberty maybe 21?, and control who took no blockers and compare these to normal 25 to 40 year old and teenage brain scans from the control libraries.

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WarriorN · 25/08/2023 19:20

Don't forget no one wants to do that.

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Boomboom22 · 25/08/2023 19:20

But the kids are choosing to be on the blockers, more unethical to not use this quasi experimental group than to say it is unethical! Only if you randomly allocate teenagers to take them who otherwise wouldn't.

Or no experimental drug trials would ever happen!

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WarriorN · 25/08/2023 19:21

Yes you're talking complete obvious sense.

It's just not happening. That would require funding and research resources and backing etc.

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Boomboom22 · 25/08/2023 19:22

And if they all believe it is fine then no problem being monitored to prove this so future trans kids can have the safest care no?

Boomboom22 · 25/08/2023 19:23

Maybe the detrans would be the most willing to help with this vital research to help save others in future?

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WarriorN · 25/08/2023 19:23

This was one sheep study:

www.ncbi.nlm.nih.gov/pmc/articles/PMC5333793/

A reduction in long-term spatial memory persists after discontinuation of peripubertal GnRH agonist treatment in sheep

	 Peripubertal GnRHa impaired long-term spatial memory.
	&bull; This impairment was not reversed after discontinuing GnRHa-treatment.
	&bull; Spatial orientation and learning performance remained unaffected following GnRHa withdrawal.
	&bull; Speed of progression through these spatial tasks was altered after discontinuing GnRHa.
	&bull; GnRH irreversibly alters these cognitive functions during critical window of development.

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Original poster

WarriorN · 25/08/2023 19:28

That was in Rams.

There is a long discussion at the end around the differing uses of the drugs in different cohorts of patients. Weighing up the risks and benefits.

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Original poster

WarriorN · 25/08/2023 19:32

Whilst looking around for another sheep study, I stumbled across this NZ resource

fullyinformed.nz/docs/literature/

It has simplified versions of studies, e.g.

fullyinformed.nz/docs/literature/
Conclusion
Claims on the Ministry of Health website and in the New Zealand Guidelines that puberty blockers are ”safe and fully reversible” are false. The study demonstrates that in sheep puberty is a critical window for the development of long-term spatial memory, amongst possible other cognitive functions. Suppressing normal puberty will likely have permanent negative impacts on cognitive function.

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AvengedQuince · 25/08/2023 19:35

So a spatial memory impairment, would that be things like navigating in a city? Would it affect driving ability? I wonder if everyday life will be harder for these young people in terms of cognitive function (on top of everything else). Are they going to be like children just with more life experience?

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WarriorN · 25/08/2023 19:36

This is the study that preceded the other sheep study.

www.sciencedirect.com/science/article/pii/S0306453016305595

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WarriorN · 25/08/2023 19:38

Highlights
• Peripubertal GnRHaa impaired long-term spatial reference memory.  • This GnRHa-effect was not counteracted with testosterone replacementt in rams.  • Traverse times of spatial orientation and learning tasks were unaffected by GnRHa.  • GnRHa exaggerated emotional reactivity during these spatial tasks.  • Testosterone replacement decreased emotional reactivity and motivation in tasks.

The last one is interesting

Sorry about formatting

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PaleBlueMoonlight · 25/08/2023 19:46

The impact of puberty blockers on puberty must surely depend on what correct sex hormones are responsible for in relation to puberty. We know they are responsible.for the maturation of genitals, sexual function and secondary sex characteristics, but you would have thought that it would be more complicated than that, with lots going on physically that contributes towards growing up/other aspects of maturation? Presumably lots of different things are interacting or dependent on one another as well?

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WarriorN · 25/08/2023 19:48

AvengedQuince · 25/08/2023 19:35

So a spatial memory impairment, would that be things like navigating in a city? Would it affect driving ability? I wonder if everyday life will be harder for these young people in terms of cognitive function (on top of everything else). Are they going to be like children just with more life experience?

Unfortunately human individuals are so different anyway that it's probably hard to quantify. Hence the "May." Sheep are more uniform too so it is easier to track behavioural changes.

I'm actually more concerned about impacts on mental health which would be more measurable in children (which includes up to 18) whilst they're on them.

This is a mental health concern so "treatment" should be helpful.

The Tavistock data that was salvageable showed worsening MH in teen girls.

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WarriorN · 25/08/2023 19:54

Yes that's one of my concerns Pale; my thyroid condition started during late puberty and I have had to adjust the dosage of thyroxine at key hormonal life stages such as pregnancy, post pregnancy and peri menopause, also some tweaking when hrt was started.

It's common for that to go awry in or after pregnancy and menopause. I remember one of the detransitioned males said hrt had triggered his autoimmune hypothyroidism.

There must be other endocrine systems that rely on natural development.

The concerns around pb use in children with pernicious puberty are linked to bone health and other endocrine issues iirc later in life.

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AlisonDonut · 25/08/2023 20:08

Two things.

1 - GIDS were told that using puberty blockers would not allow genitals to develop properly so that when they operated when older, there would not be enough material to use. Nobody bothered to write this down anywhere so any new medics joining after this session had no idea about this.

2 - if any one of the gender clinics genuinely thought that using these drugs [they would have been taught that it was used to castrate men as part of their training] then one at least would have done follow ups even if it would be to prove that they were effective in order to secure future funding. The fact that not one across the whole planet did [or is willing to release the results if they did] is damning. They bloody knew.