The problem with the use of suicidality as an endpoint in assessing the efficacy of the affirmative model is that it relies on the stated intention of the patient. It appears that most of these patients come to clinics having learnt from the internet that the best way to convince their parents and the doctor to consent to give them the puberty blockers is to threaten suicide or to at least say they harbour suicidal thoughts.
Once they have succeed in getting the treatment they obviously will then say initially that those thoughts have gone.
It is only with long term follow up that we get the true picture.
And it appears from Dr Keane’s excellent summary that in fact long term follow up shows no reduction but in fact an increase in suicidality.
The problem with the use of suicidality as an endpoint in assessing the efficacy of the affirmative model is that it relies on the stated intention of the patient. It appears that most of these patients come to clinics having learnt from the internet that the best way to convince their parents and the doctor to consent to give them the puberty blockers is to threaten suicide or to at least say they harbour suicidal thoughts.
Once they have succeed in getting the treatment they obviously will then say initially that those thoughts have gone.
It is only with long term follow up that we get the true picture.
And it appears from Dr Keane’s excellent summary that in fact long term follow up shows no reduction but in fact an increase in suicidality.
Yes, it’s a vicious cycle in which these kids are constantly being told they are suicidal.