An interesting summary of a paper in ‘Current Sexual Health Reports’ of April 2023 reads:
Systematic reviews of evidence conducted by public health authorities in Finland, Sweden, and England concluded that the risk/benefit ratio of youth gender transition ranges from unknown to unfavourable. As a result, there has been a shift from “gender-affirmative care,” which prioritizes access to medical interventions, to a more conservative approach that addresses psychiatric comorbidities and psychotherapeutically explores the developmental aetiology of the trans identity. Debate about the safety and efficacy of “gender-affirming care” in the USA is only recently emerging.
I've landed in Transtoria after living in London since I was 18. I thought all was lost having left Terf Island which is under huge strain. Can't say how much I appreciate your work Bernard. Honestly... I'm working withGenspect and LGB Alliance and looking at the landscape here in Oz. This is the hill I will die on. Glad to have you shining the light for all of us.
Yes Jenny we have been fortunate to have had Bernard’s focus and determination. Let’s hope GCN gets seen by subscribers from among our key profession’s colleges , the statutory regulatory body AHPRA, and key ( lay) politicians. Speaking as a recently retired GP , all our patient’s welfare is paramount and whilst there is no suggestion of an hierarchy of “ value”, what subset of those for whom we ,as doctors, assume clinical responsibility, could be more in need of our best efforts than that subset of confused , yet undifferentiated ,humans, i.,e.,children?
It always come down to money, sex, and power. One of the goals of "gender affirming care" for minors is to create a self-sustaining juggernaut of people stuck in an endlessly spiraling loop of financially lucrative medical procedures and experimental treatments. Insurers refusing to cover claims is a good step but there are many more steps to take.
The proposal that general practitioners become more independently involved in managing young people with gender dysphoria highlights the fact that the “Best practice medical treatment for gender dysphoria is offered following a comprehensive multidisciplinary assessment”.
However, it is important to remember that it is those very institutions, such as the Royal Children’s Hospital, have never undertake a double-blind clinical trial to confirm the efficacy and safety of a treatment in young people that involves irreversible sterilisation, hormonal and surgical interventions.
As a way or reminder, the main purpose of a double-blind clinical is to prevent bias when evaluating patient outcomes
Thus, it could be argued the gold-standard being referred to (the multidisciplinary facility) has no acceptable evidence of such status.
It's true that the RCH guideline was intended to streamline treatment compared with previous guidelines, yet after the re Kelvin ruling, many gender clinicians seemed to have pursued a treatment policy even more radical than that espoused by the guideline.
Exactly. It is all very well to have a systematic review but you need some good studies to review. As there are no randomised studies in gender transition even the systematic reviews are flawed .
Currently there is no acceptable evidence of efficacy or safety of these treatments and they should be stopped until that evidence is provided by a large randomised controlled trial.
FDA is talking about authorising hormones for gender dysphoria without insisting on RCT.
RCT said to be impractical & unethical by the gender-affirming lobby, but it's striking that they won't even run trials in which gender-affirming treatment is compared with some other alternative approach.
This is always the response of clinicians who are the proponents of a new treatment. No doubt the frontal lobectomy enthusiasts resisted a trial, and the pelvic mesh enthusiasts. I know the high dose chemo with stem cell rescue in metastatic breast cancer proponents certainly did.
It is no more impractical than many cancer trials. And it is only unethical (in activists eyes)because the activists keep saying again without evidence that affirmative treatment is life-saving and convince parents and their patients of this myth
A randomised trial can be done and should be done and the control should be psychotherapy with placebo hormone blocking injections.
Gordon Guyatt is an expert in systematic reviews. he helped develope the
GRADE system (grading of recommendations assessment, development, and evaluation) a framework for developing and presenting evidence for making clinical practice recommendations. He is a professor in the Department of Health Research Methods, Evidence, and Impact at McMaster University, Ontario.
He says that “systematic reviews are always possible,” even if few or no studies meet the eligibility criteria. If an entity has made a recommendation without one, he says, “they’d be violating standards of trustworthy guidelines.”
Thats a quote from feb 2023 BMJ article gender dysphoria in youth is rising.
not sure if youve read the cass review summary. it wasnt that complicated. my understanding was they simply found gender biz financed studys in no way supported the claims that were made. just tons of misrepresentations = lies. gender ideology is a PR campaign. these interventions dont work. quacks who claim they do are lying. and it doesnt take much looking to find the blatant lies and religious leaps of faith.
Excellent to hear another medical indemnity provider is getting the wobbles on teen sterilisation and breast amputation. God bless the actuaries!
An interesting summary of a paper in ‘Current Sexual Health Reports’ of April 2023 reads:
Systematic reviews of evidence conducted by public health authorities in Finland, Sweden, and England concluded that the risk/benefit ratio of youth gender transition ranges from unknown to unfavourable. As a result, there has been a shift from “gender-affirmative care,” which prioritizes access to medical interventions, to a more conservative approach that addresses psychiatric comorbidities and psychotherapeutically explores the developmental aetiology of the trans identity. Debate about the safety and efficacy of “gender-affirming care” in the USA is only recently emerging.
I've landed in Transtoria after living in London since I was 18. I thought all was lost having left Terf Island which is under huge strain. Can't say how much I appreciate your work Bernard. Honestly... I'm working withGenspect and LGB Alliance and looking at the landscape here in Oz. This is the hill I will die on. Glad to have you shining the light for all of us.
Yes Jenny we have been fortunate to have had Bernard’s focus and determination. Let’s hope GCN gets seen by subscribers from among our key profession’s colleges , the statutory regulatory body AHPRA, and key ( lay) politicians. Speaking as a recently retired GP , all our patient’s welfare is paramount and whilst there is no suggestion of an hierarchy of “ value”, what subset of those for whom we ,as doctors, assume clinical responsibility, could be more in need of our best efforts than that subset of confused , yet undifferentiated ,humans, i.,e.,children?
Glad to have your wisdom too. I hope the link on X will help drive some traffic and I will forward to all my friends as well.
The mind continues to boggle.
Looking forward to seeing these gender cowboys in the dock.
It always come down to money, sex, and power. One of the goals of "gender affirming care" for minors is to create a self-sustaining juggernaut of people stuck in an endlessly spiraling loop of financially lucrative medical procedures and experimental treatments. Insurers refusing to cover claims is a good step but there are many more steps to take.
The proposal that general practitioners become more independently involved in managing young people with gender dysphoria highlights the fact that the “Best practice medical treatment for gender dysphoria is offered following a comprehensive multidisciplinary assessment”.
However, it is important to remember that it is those very institutions, such as the Royal Children’s Hospital, have never undertake a double-blind clinical trial to confirm the efficacy and safety of a treatment in young people that involves irreversible sterilisation, hormonal and surgical interventions.
As a way or reminder, the main purpose of a double-blind clinical is to prevent bias when evaluating patient outcomes
Thus, it could be argued the gold-standard being referred to (the multidisciplinary facility) has no acceptable evidence of such status.
The blind leading the blind?
It's true that the RCH guideline was intended to streamline treatment compared with previous guidelines, yet after the re Kelvin ruling, many gender clinicians seemed to have pursued a treatment policy even more radical than that espoused by the guideline.
Exactly. It is all very well to have a systematic review but you need some good studies to review. As there are no randomised studies in gender transition even the systematic reviews are flawed .
Currently there is no acceptable evidence of efficacy or safety of these treatments and they should be stopped until that evidence is provided by a large randomised controlled trial.
FDA is talking about authorising hormones for gender dysphoria without insisting on RCT.
RCT said to be impractical & unethical by the gender-affirming lobby, but it's striking that they won't even run trials in which gender-affirming treatment is compared with some other alternative approach.
This is always the response of clinicians who are the proponents of a new treatment. No doubt the frontal lobectomy enthusiasts resisted a trial, and the pelvic mesh enthusiasts. I know the high dose chemo with stem cell rescue in metastatic breast cancer proponents certainly did.
It is no more impractical than many cancer trials. And it is only unethical (in activists eyes)because the activists keep saying again without evidence that affirmative treatment is life-saving and convince parents and their patients of this myth
A randomised trial can be done and should be done and the control should be psychotherapy with placebo hormone blocking injections.
Gordon Guyatt is an expert in systematic reviews. he helped develope the
GRADE system (grading of recommendations assessment, development, and evaluation) a framework for developing and presenting evidence for making clinical practice recommendations. He is a professor in the Department of Health Research Methods, Evidence, and Impact at McMaster University, Ontario.
He says that “systematic reviews are always possible,” even if few or no studies meet the eligibility criteria. If an entity has made a recommendation without one, he says, “they’d be violating standards of trustworthy guidelines.”
Thats a quote from feb 2023 BMJ article gender dysphoria in youth is rising.
not sure if youve read the cass review summary. it wasnt that complicated. my understanding was they simply found gender biz financed studys in no way supported the claims that were made. just tons of misrepresentations = lies. gender ideology is a PR campaign. these interventions dont work. quacks who claim they do are lying. and it doesnt take much looking to find the blatant lies and religious leaps of faith.
Yes. I didn’t mean to debunk the systematic reviews but merely to point out that they are mainly reviewing rubbish data.