Tavistock clinic made early puberty blocking standard clinical treatment mid-way through a study of this intervention, then buried the disappointing results for years.
Hormonal treatments at RCH began to take off with sharply rising patient numbers around 2014. They started recruiting for long-term study in 2017 & published the research protocol two years later with the statement that more evidence for these treatments was “urgently needed”. In 2023 even preliminary data on outcomes is yet to be published.
The UK seems to have had the best political leadership so far — the bureaucracy can’t have encouraged ministers to set up & take seriously the Cass review — and yet even in the UK the politicians are erratic, as seen by the embrace of a gender identity conversion therapy ban, as if it has nothing to do with the Cass review.
"Further aspects are perplexing. The statement “a systematic review regarding outcomes of treatment in adolescents is not possible”(pS46) seems strange, given well-known evidence reviews exist[14,15] but are omitted from SoCv8’s references. Statement 2.1 asserts “strong evidence demonstrating the benefits in quality of life and well-being of gender-affirming treatments” (pS18), yet is supported by 21 references without any explanations of the papers’ context or evidentiary validity. This is unconvincing to those external audiences used to judging clinical effectiveness by quality, not quantity.
SoCv8 is “based on the published literature (direct as well as background evidence) [and] on consensus-based expert opinion”(pS247) including a Delphi process, but evidence curation moved on long ago; WPATHs methods are prone to bias and are not “evidence-based”[16-20]. "
I predict the gender affirming practice of minors will be stopped in nearly every country by the end of 2024. The evidence and public push-back is simply too strong. I only wish the ABC, SBS and commercial TV would take notice of the newsworthy surge in de-transitioners rather then gush over WorldPride 2023. It's a very one-sided coverage based on ideology rather then truth-telling.
A shift away from the apparent obligatory / default 2018 AAP and Endocrine Society’s “ gender- affirmation “ treatment model , which may occur in a due 2023 review represents a huge clinical/cultural repudiation of the ideological basis of “ gender identity “ , which metastasised from Gender Studies, within the Humanities and Social Sciences a couple of decades ago , throughout the West. If, indeed we are seeing the beginnings of retrieval of evidenced based care, and protection for future vulnerable children ( and protection for clinicians, from punitive legislation, for being deemed of providing “ conversion therapy”) such retrieval will require many political champions , across so many legal jurisdictions. A work in progress. Until there is the ideological confrontation the “ beast gets stronger”and it remains an inexplicable stain on my profession. The ideological activists have been better organised, willing to fight harder, and the “ woke” do not take prisoners. Will we see enough champions in our political leaders?
The 2017 Endocrine Society guideline, often invoked to support gender-affirming hormonal treatment, rated the evidence for almost all its recommendations as “low” or “very low” quality.
In 2019, the Melbourne hospital defended its treatment guidelines as “peer reviewed at the highest level [and] adopted by healthcare providers across Australia and the globe.”
It is difficult to comprehend that given the doubts, recommendations for caution and the ever-increasing concerns raised by authoritative bodies, that these mutilating and irreversible violations of young people are allowed to continue.
Tavistock clinic made early puberty blocking standard clinical treatment mid-way through a study of this intervention, then buried the disappointing results for years.
Hormonal treatments at RCH began to take off with sharply rising patient numbers around 2014. They started recruiting for long-term study in 2017 & published the research protocol two years later with the statement that more evidence for these treatments was “urgently needed”. In 2023 even preliminary data on outcomes is yet to be published.
The UK seems to have had the best political leadership so far — the bureaucracy can’t have encouraged ministers to set up & take seriously the Cass review — and yet even in the UK the politicians are erratic, as seen by the embrace of a gender identity conversion therapy ban, as if it has nothing to do with the Cass review.
Thank you!
The 2022 Wpath guidelines were reviewed as a rapid response to the 2021 guideline review you quote:
https://bmjopen.bmj.com/content/11/4/e048943.responses#wpath-standards-of-care-a-new-edition-using-outdated-methods-weakens-the-trustworthiness-of-content
"Further aspects are perplexing. The statement “a systematic review regarding outcomes of treatment in adolescents is not possible”(pS46) seems strange, given well-known evidence reviews exist[14,15] but are omitted from SoCv8’s references. Statement 2.1 asserts “strong evidence demonstrating the benefits in quality of life and well-being of gender-affirming treatments” (pS18), yet is supported by 21 references without any explanations of the papers’ context or evidentiary validity. This is unconvincing to those external audiences used to judging clinical effectiveness by quality, not quantity.
SoCv8 is “based on the published literature (direct as well as background evidence) [and] on consensus-based expert opinion”(pS247) including a Delphi process, but evidence curation moved on long ago; WPATHs methods are prone to bias and are not “evidence-based”[16-20]. "
I predict the gender affirming practice of minors will be stopped in nearly every country by the end of 2024. The evidence and public push-back is simply too strong. I only wish the ABC, SBS and commercial TV would take notice of the newsworthy surge in de-transitioners rather then gush over WorldPride 2023. It's a very one-sided coverage based on ideology rather then truth-telling.
A shift away from the apparent obligatory / default 2018 AAP and Endocrine Society’s “ gender- affirmation “ treatment model , which may occur in a due 2023 review represents a huge clinical/cultural repudiation of the ideological basis of “ gender identity “ , which metastasised from Gender Studies, within the Humanities and Social Sciences a couple of decades ago , throughout the West. If, indeed we are seeing the beginnings of retrieval of evidenced based care, and protection for future vulnerable children ( and protection for clinicians, from punitive legislation, for being deemed of providing “ conversion therapy”) such retrieval will require many political champions , across so many legal jurisdictions. A work in progress. Until there is the ideological confrontation the “ beast gets stronger”and it remains an inexplicable stain on my profession. The ideological activists have been better organised, willing to fight harder, and the “ woke” do not take prisoners. Will we see enough champions in our political leaders?
The 2017 Endocrine Society guideline, often invoked to support gender-affirming hormonal treatment, rated the evidence for almost all its recommendations as “low” or “very low” quality.
In 2019, the Melbourne hospital defended its treatment guidelines as “peer reviewed at the highest level [and] adopted by healthcare providers across Australia and the globe.”
It is difficult to comprehend that given the doubts, recommendations for caution and the ever-increasing concerns raised by authoritative bodies, that these mutilating and irreversible violations of young people are allowed to continue.