An extraordinarily helpful and hopeful development. I hope Mr Butler reads this and that the PM’s commitment to ´kindness’ will entend to the protection of children from this horror. Thank you so much Bernard for your diligence and dedication to exposing this scandal.
Pretty sure that infertility results from the removal of the reproductive organs, some of which are done on minors....and some of these harms do not result in the absence of the interventions, a controlled study isn't needed. Ditto for some of the mastectomy outcomes.
They haven't studied the harms, perhaps they have no motivation? For instance, the consent forms or other information pages by the affirmative MD's tell patients taking estrogen to assume they will be infertile (permanently) after a few years, so much so that there was an excited NYT article about how maybe some fertility could be recovered--https://www.nytimes.com/2022/10/21/science/sperm-retrieval-essm-transgender-fertility.html .
They didn't bother studying it, didn't check. But they all assume it is the case that these people become infertile, and these are the MDs saying one should have these interventions in some cases! But they didn't do a study.
In comparison, for psychotherapy the HHS report notes, as you mention:
"'neither systematic review suggested that there is indication of harm
from psychotherapy.' One of the SRs concluded:
Most analyses of mental health, psychological and/or psychosocial outcomes
showed either benefit or no change, with none indicating any negative/ adverse
effects of the interventions offered."
Perhaps the long term UK outcomes that the Cass Review tried to get and which apparently will become available at some point would also be useful, or maybe the US could also start keeping track of the thousands of minors who have been started on this pathway since 2007! Or their histories until now could be studied. Perhaps those taking them already can be enrolled in the experiment after being properly informed of the risks/alternatives/how little is known (which probably didn't already happen, in the US). Or a record search can be done through insurance, long term. The experiment is being done --perhaps the outcomes should be gathered and studied!!
"With respect to paediatric medical transition, a relevant alternative is some combination of psychotherapeutic interventions"
I quote a letter from the Royal Australian New Zealand College of Psychiatry (RANZCP) following the release of the Cass Review Final Report:
As RANZCP members, we believe our serious professional concerns regarding the gender interventions being provided to Australian children and adolescents are not being adequately represented by the College in its media communications and political advocacy.
On 10 April 2024, the Cass Review Final was released. It reveals there is no clear evidentiary basis for gender affirmation interventions and evidence for puberty suppression and cross-sex hormone treatment is of such poor quality that no foundation exists for clinical decisions and informed consent.
The review recommends puberty blockers be restricted to ethics-approved research trials and cross-sex hormones be used with extreme caution in people between ages 16 and 18, with approval from an independent expert panel required. It cautions that social transition is an active intervention that may have significant effects on psychological functioning and longer-term outcomes. It concluded: “the evidence does not adequately support the claim that gender affirming treatment reduces suicide risk” and that treatment for gender dysphoria should not be based on the “gender-affirming” model, which is the model used by Australian paediatric gender services.
. . . . . This represents a most serious indictment on Australian Hospitals implementing the Affirmative model of gender care:
Gender Dysphoria is classified as a Mental Health condition and is included in the ‘Diagnostic & Statistical Manual of Mental Health Disorders’ (DSM-5)
It would be assumed that psychiatry would be the most appropriate discipline to provide leadership in the assessment, diagnosis and treatment of children presenting with the condition.
. . . .The fact that our major paediatric teaching hospitals are ignoring the advice of those qualified to provide it and are continuing to irreversibly mutilate and sterilise children represents a most serious violation of medical ethics.
I note the WPATH is upset that the ‘expertise’ of gender clinicians has been disregarded in the HHS report.
I would venture to say that their ‘expertise’ has been greatly over-estimated, if as it appears they have been prescribing for years a treatment with no proven efficacy and definite harm.
Currently it appears there is no proven treatment for gender dysphoria and consequently no experts in the field.
I'll echo Jennifer O'Brien's words... thank you so much for your diligence and dedication.
This is such a thorough article.
I hope it's read by policy makers, university boards and content planners, education boards, those with the influence to implement change in this arena.
…..The review highlights a growing body of evidence pointing to significant risks—including irreversible harms such as infertility—while finding very weak evidence of benefit. That weakness has been a consistent finding of systematic reviews of evidence around the world.
Contributors to the review include medical doctors, medical ethicists, and a methodologist. Contributors represent a wide range of political viewpoints and were chosen for their commitment to scientific principles.
“Our duty is to protect our nation’s children—not expose them to unproven and irreversible medical interventions,” said NIH Director Dr. Jay Bhattacharya. “We must follow the gold standard of science, not activist agendas.”
Conclusion
Despite increasing pressure to promote these drastic medical interventions for our nation’s youth, the review makes clear: the science and evidence do not support their use, and the risks cannot be ignored.
. . . . Surely RCH and the rest of those promoting this nonsense must take heed and STOP!
Trans activist in the US have had a complete meltdown and the responses have been vicious: insulting the report and denouncing its content. But was anything else expected?
Here is popular Erin Reed, one of the most followed activist:
I reference another very meaningful Statement from the RANZCP as it relates to Gender Dysphoria
Royal Australian and New Zealand College of Psychiatry (RANZCP) - December 22, 2023
The peak psychiatry college has become the first medical body in the country to acknowledge shifting international evidence on transgender healthcare and puberty blockers in a major position statement challenging the approach of children’s hospitals.
The RANZP declined to endorse gender-¬affirming care as the key intervention for children who believe they may be transgender, highlighting an increasingly cautious approach in some European countries amid a lack of evidence for the medical pathway.
It acknowledged the plight of detransition, who it noted had reported being harmed by medical transition”
The college also attempted to clarify that:
“Sex refers to the biological characteristics that define humans as female or male,” the position statement says. “While these sets of biological characteristics are not mutually exclusive, as there are individuals who possess both, they differentiate humans as males and females in the vast ¬majority of people.”
The RANZCP has developed this position statement to provide the RANZCP’s perspective on the role of psychiatrists in working with TGD people.
The college (or rather the small group involved) has gone through all manner of policy contortions but at least it has never returned to its fleeting 2018 endorsement of the RCH Melbourne treatment guideline.
An extraordinarily helpful and hopeful development. I hope Mr Butler reads this and that the PM’s commitment to ´kindness’ will entend to the protection of children from this horror. Thank you so much Bernard for your diligence and dedication to exposing this scandal.
Pretty sure that infertility results from the removal of the reproductive organs, some of which are done on minors....and some of these harms do not result in the absence of the interventions, a controlled study isn't needed. Ditto for some of the mastectomy outcomes.
They haven't studied the harms, perhaps they have no motivation? For instance, the consent forms or other information pages by the affirmative MD's tell patients taking estrogen to assume they will be infertile (permanently) after a few years, so much so that there was an excited NYT article about how maybe some fertility could be recovered--https://www.nytimes.com/2022/10/21/science/sperm-retrieval-essm-transgender-fertility.html .
They didn't bother studying it, didn't check. But they all assume it is the case that these people become infertile, and these are the MDs saying one should have these interventions in some cases! But they didn't do a study.
In comparison, for psychotherapy the HHS report notes, as you mention:
"'neither systematic review suggested that there is indication of harm
from psychotherapy.' One of the SRs concluded:
Most analyses of mental health, psychological and/or psychosocial outcomes
showed either benefit or no change, with none indicating any negative/ adverse
effects of the interventions offered."
Perhaps the long term UK outcomes that the Cass Review tried to get and which apparently will become available at some point would also be useful, or maybe the US could also start keeping track of the thousands of minors who have been started on this pathway since 2007! Or their histories until now could be studied. Perhaps those taking them already can be enrolled in the experiment after being properly informed of the risks/alternatives/how little is known (which probably didn't already happen, in the US). Or a record search can be done through insurance, long term. The experiment is being done --perhaps the outcomes should be gathered and studied!!
"With respect to paediatric medical transition, a relevant alternative is some combination of psychotherapeutic interventions"
I quote a letter from the Royal Australian New Zealand College of Psychiatry (RANZCP) following the release of the Cass Review Final Report:
As RANZCP members, we believe our serious professional concerns regarding the gender interventions being provided to Australian children and adolescents are not being adequately represented by the College in its media communications and political advocacy.
On 10 April 2024, the Cass Review Final was released. It reveals there is no clear evidentiary basis for gender affirmation interventions and evidence for puberty suppression and cross-sex hormone treatment is of such poor quality that no foundation exists for clinical decisions and informed consent.
The review recommends puberty blockers be restricted to ethics-approved research trials and cross-sex hormones be used with extreme caution in people between ages 16 and 18, with approval from an independent expert panel required. It cautions that social transition is an active intervention that may have significant effects on psychological functioning and longer-term outcomes. It concluded: “the evidence does not adequately support the claim that gender affirming treatment reduces suicide risk” and that treatment for gender dysphoria should not be based on the “gender-affirming” model, which is the model used by Australian paediatric gender services.
. . . . . This represents a most serious indictment on Australian Hospitals implementing the Affirmative model of gender care:
Gender Dysphoria is classified as a Mental Health condition and is included in the ‘Diagnostic & Statistical Manual of Mental Health Disorders’ (DSM-5)
It would be assumed that psychiatry would be the most appropriate discipline to provide leadership in the assessment, diagnosis and treatment of children presenting with the condition.
. . . .The fact that our major paediatric teaching hospitals are ignoring the advice of those qualified to provide it and are continuing to irreversibly mutilate and sterilise children represents a most serious violation of medical ethics.
I note the WPATH is upset that the ‘expertise’ of gender clinicians has been disregarded in the HHS report.
I would venture to say that their ‘expertise’ has been greatly over-estimated, if as it appears they have been prescribing for years a treatment with no proven efficacy and definite harm.
Currently it appears there is no proven treatment for gender dysphoria and consequently no experts in the field.
Their responses do tend to be pathetic & self-refuting.
I'll echo Jennifer O'Brien's words... thank you so much for your diligence and dedication.
This is such a thorough article.
I hope it's read by policy makers, university boards and content planners, education boards, those with the influence to implement change in this arena.
Thank you so much.
I reference a summary of a summary release from the US HHS (Health & Human Services) of May 1st 2025 titled:
‘Comprehensive Review of Medical Interventions for Children and Adolescents with Gender Dysphoria’.
It is readily available on the internet:
www.hhs.gov/press-room/gender-dysphoria-report-release.html
…..The review highlights a growing body of evidence pointing to significant risks—including irreversible harms such as infertility—while finding very weak evidence of benefit. That weakness has been a consistent finding of systematic reviews of evidence around the world.
Contributors to the review include medical doctors, medical ethicists, and a methodologist. Contributors represent a wide range of political viewpoints and were chosen for their commitment to scientific principles.
“Our duty is to protect our nation’s children—not expose them to unproven and irreversible medical interventions,” said NIH Director Dr. Jay Bhattacharya. “We must follow the gold standard of science, not activist agendas.”
Conclusion
Despite increasing pressure to promote these drastic medical interventions for our nation’s youth, the review makes clear: the science and evidence do not support their use, and the risks cannot be ignored.
. . . . Surely RCH and the rest of those promoting this nonsense must take heed and STOP!
Trans activist in the US have had a complete meltdown and the responses have been vicious: insulting the report and denouncing its content. But was anything else expected?
Here is popular Erin Reed, one of the most followed activist:
https://www.erininthemorning.com/p/fact-check-trumps-hhs-review-on-trans
I reference another very meaningful Statement from the RANZCP as it relates to Gender Dysphoria
Royal Australian and New Zealand College of Psychiatry (RANZCP) - December 22, 2023
The peak psychiatry college has become the first medical body in the country to acknowledge shifting international evidence on transgender healthcare and puberty blockers in a major position statement challenging the approach of children’s hospitals.
The RANZP declined to endorse gender-¬affirming care as the key intervention for children who believe they may be transgender, highlighting an increasingly cautious approach in some European countries amid a lack of evidence for the medical pathway.
It acknowledged the plight of detransition, who it noted had reported being harmed by medical transition”
The college also attempted to clarify that:
“Sex refers to the biological characteristics that define humans as female or male,” the position statement says. “While these sets of biological characteristics are not mutually exclusive, as there are individuals who possess both, they differentiate humans as males and females in the vast ¬majority of people.”
The RANZCP has developed this position statement to provide the RANZCP’s perspective on the role of psychiatrists in working with TGD people.
The college (or rather the small group involved) has gone through all manner of policy contortions but at least it has never returned to its fleeting 2018 endorsement of the RCH Melbourne treatment guideline.
Perhaps it's best to acknowledge the kudos when we get it?
True, but journalists are at high risk of succumbing to miserableism.
. . . . perhaps the RANZP, in their wisdom, decided it was as good time to exit the Titanic!