Transgender Medicine Media Articles
After 30 years as one of England’s top pediatricians, Dr. Hilary Cass ... took on a project that would throw her into an international fire: reviewing England’s treatment guidelines for the rapidly rising number of children with gender distress, known as dysphoria. Staff members who said they felt pressure to approve children for puberty-blocking drugs had filed whistle-blower complaints. Over the next four years, Dr. Cass commissioned systematic reviews of scientific studies on youth gender treatments and international guidelines of care. She also met with young patients and their families, transgender adults, people who had detransitioned, advocacy groups and clinicians. Her final report, published last month, concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.” On her recommendation, the N.H.S. will no longer prescribe puberty blockers outside of clinical trials. Dr. Cass also recommended that testosterone and estrogen, which allow young people to develop the physical characteristics of the opposite sex, be prescribed with “extreme caution.” “We have to stop just seeing these young people through the lens of their gender and see them as whole people, and address the much broader range of challenges that they have ... I’ve spoken to young adults where it was the wrong decision, where they have regret, where they’ve detransitioned. The critical issue is trying to work out how we can best predict who’s going to thrive and who’s not going to do well," [said Dr. Cass]. "Medicine should never be politically driven. It should be driven by evidence and ethics and shared decision-making with patients and listening to patients’ voices. Once it becomes politicized, then that’s seriously concerning, as you know well from the abortion situation in the United States."
Note: We believe that everyone has a right to exist and express themselves the way they want. Yet when it comes to transgender medicine, research suggests significant health concerns. Why aren't we openly discussing this so that people (especially children) can make informed choices about their bodies? Explore our concise summaries of important news articles on transgender medicine.
The toxicity of the culture war over youth gender medicine is well known to most of us. What’s less well understood is how that poisonous climate affects the very cohort being argued about — and those who care for them. The Cass Review, led by Dr. Hilary Cass, examines the events and evidence (or lack thereof) that led to the closing of the UK’s only public youth gender clinic, the Gender Identity Development Services. Social justice/civil rights framing has made it harder to reckon with what Cass calls the “exponential rise” in adolescent patients starting around 2014. Once it was mostly natal males who transitioned, but now it is mostly natal females, many of whom had no history of gender distress but did suffer from other mental health issues. As for the evidence about how to treat these patients and others who have sought care, Cass concludes: “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.” Individual studies may make claims about the efficacy of social transition, puberty blockers, or hormones, but they are too biased and low quality to draw conclusions from. As for the claim that these interventions prevent suicide, Cass reports that “the evidence found did not support this conclusion.” Perhaps most important, Cass notes that “clinicians have told us they are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.”
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The publication of Hilary Cass’s final report on healthcare for gender-questioning children laid bare the devastating scale of NHS failures of a vulnerable group of children and young people, buoyed by adult activists bullying anyone who dared question a treatment model so clearly based on ideology rather than evidence. Cass is a renowned paediatrician and her painstakingly thorough review was four years in the making. She sets out how the now-closed NHS specialist gender clinic for children abandoned evidence-based medicine. Significant numbers of gender-questioning children ... were put on an unevidenced medical pathway of puberty-blocking drugs and/or cross-sex hormones, despite risks of harm in relation to brain development, fertility, bone density, mental health and adult sexual functioning. Cass finds a childhood diagnosis of gender dysphoria is not predictive of a lasting trans identity and clinicians told the review they are unable to determine in which children gender dysphoria will last into adulthood. If this is indeed impossible, is it ever ethical to put a young person on a life-altering medical pathway? If there are no objective diagnostic criteria, on what basis would a clinician be taking this decision other than a professional hunch? Cass’s vision is what gender-questioning children deserve: to be treated with the same level of care as everyone else, not as little projects for activists seeking validation for their own adult identities and belief systems.
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Experienced professionals are increasingly scared to openly discuss their views on the treatment of children questioning their gender identity. This was the conclusion drawn by Hilary Cass in her review of gender identity services for children this week, which warned that a toxic debate had resulted in a culture of fear. Her conclusion was echoed by doctors, academic researchers and scientists. Some said they had been deterred from pursuing what they believed to be crucial studies, saying that merely entering the arena would put their reputation at risk. Others spoke of abuse on social media, academic conferences being shut down, biases in publishing and the personal cost of speaking out. Sallie Baxendale, a professor of clinical neuropsychology ... received abuse after publishing a systematic review of studies that investigated the impact of puberty blockers on brain development. Her review found that “critical questions” remained around the nature, extent and permanence of any arrested development of cognitive function linked to the treatment. The paper, which summarised the state of relevant research, was met with an immediate backlash. “I’ve been accused of being an anti-trans activist, and that now comes up on Google and is never going to go away,” Baxendale said. “Imagine what it’s like if that is the first thing that comes up when people Google you? Anyone who publishes in this field has got to be prepared for that.”
Note: For more along these lines, see concise summaries of deeply revealing news articles on health and corruption in science from reliable major media sources.
A robust British review found guidelines for the treatment of children with gender dysphoria ignored standards and are based on flimsy foundations. Pediatrician Hilary Cass’ much-anticipated report found no reliable evidence on which to base gender-affirming care for youth; the rationale for blocking puberty in young children remains unclear and muddled and that the use of cross-sex hormones in the under-18s presents numerous unknowns. Cass said published studies suffer from “remarkably weak evidence,” that results are “exaggerated or mispresented” by people on both sides of the debate over transgender health care to bolster their own viewpoint. Cass found that there is no solid evidence on the long-term outcomes of any of the interventions. Cass said the toxicity of the debate has been exceptional. “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media and where name-calling echoes the worst bullying behaviour. This must stop,” Cass wrote. The systematic review on puberty blockers found no evidence the drugs improve body image or dysphoria. The drugs might temporarily or permanently disrupt adolescent brain maturation, “which could have a significant impact on the young person’s ability to make complex risk-laden decisions, as well as having possible longer-term neuropsychological consequences,” according to the Cass report.
Note: For more along these lines, see concise summaries of deeply revealing news articles on health and corruption in science from reliable major media sources.
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