Responding only to the idea that has been put forth here in the past concerning gender affirming care being the "best way" to deal with gender dysphoria in children.
In the US this idea is pushed as a settled fact and "treating" young people in this manner is becoming increasingly acceptable if not outright desirable.
We have no idea what the long term effects might be of pharmacologically "pausing" biology in this manner.
The UK and Europe in general were way ahead of us in this regard, but have changed their stance.
This is an article from one of the most respected peer reviewed publications in the world.
The Lancet:
The Editorial in The Lancet Child & Adolescent Health stated that trans youth “have the same right to health and wellbeing as all humans”. However what constitutes good health care for this population is far from clear based on the available evidence.
From the Editorial and Baams’ related Comment,
readers might perceive that administering gonadotropin hormone-releasing hormone (GnRH) analogues (also known as puberty blockers) to young people with gender dysphoria is a proven, life-saving treatment akin to giving insulin to type 1 diabetics.
Baams’ assertion that puberty blockers prevent suicidality can be traced to a paper by Turban and colleagues, which has been thoroughly critiqued by others, so instead we ask: what is the evidence that the benefits of puberty blockers outweigh the harms?
The statement that puberty blockers improve the mental health of young people with gender dysphoria stems from a seminal study by de Vries and colleagues in 2011.
However, the population studied—ie, youth with gender dysphoria beginning in early childhood and no significant co-occurring mental health difficulties—markedly differs from the population today, which is characterised by post-pubescent young people reporting a trans identity for the first time, often in the context of significant mental health problems.
This difference raises the question of whether this study is still applicable to the majority of currently presenting cases.
Further, the magnitude of the post-treatment improvements in mental health was small. The depression (Beck Depression Inventory) scores improved by around 3 out of 63 points, and the global function (Children's Global Assessment Scale) scores improved by around 4 out of 100 points, and other measures of psychological health had similar improvements of marginal clinical significance—or no improvement at all.
Such modest gains have to be carefully weighed against the risks of puberty blockers to bone health and fertility, and the uncertainty of the long-term health effects of interrupting puberty.
The absence of a control group in de Vries's study made it impossible to determine whether the reported psychological improvements were related to the medical interventions or the psychological interventions that all study participants received (or other factors, such as time).
A study of 14 young people with gender dysphoria who were rejected from puberty suppression due to “psychological or environmental factors” found that at follow-up 1–7 years after the original application, 11 of 14 did not feel any regret about not undergoing gender confirmation.
This result is significant, because most youth who receive puberty blockers proceed to the full medical protocol of gender-affirming care; for example, one UK study showed that 43 (98%) of 44 patients aged 12–15 years proceeded to start hormone therapy after 3 years of taking puberty blockers.
This same study, which to date is the only attempt to replicate de Vries and colleagues, found “no evidence of change in psychological function with GnRHa treatment“, including measures of distress and self-harm.
There is growing acknowledgment worldwide that the practice of providing gender-affirming care for youth is far from settled science.
A systematic review by UK's National Institute for Health and Care Excellence found that in youth with gender dysphoria there was “little change with GnRH analogues from baseline to follow-up” in gender dysphoria, mental health, body image, and psychosocial impact.
The study concluded that the reported psychological improvements are “either of questionable clinical value, or the studies themselves are not reliable and changes could be due to confounding, bias or chance”.
All authors are board members of the Society for Evidence Based Gender Medicine. ME was a witness in the Keira Bell judicial review; his wife Susan Evans initiated the review and was a witness. Neither received any financial benefit from involvement in the case.
What is most troubling is how easy it is to go down this road in some locales. Planned Parenthood is, unsurprisingly, at the forefront of pushing for affirming care with no parental notice or consent required.
Furthermore, many parents are being "counceled" that harboring reservations about getting their child the "help" they need could very likely lead to an increased risk of suicide.
They are demonized for questioning this method of "helping" their child.
Based on the limited understanding and lack of academic study on the effects of these treatments, to guilt parents in this way is nothing more than agenda driven ideology and identity politics run amok.
5/22/2023 8:37 PM (edited)