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World Professional Association for Transgender Health (WPATH) Files

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  • Registered Users Posts: 483 ✭✭concerned_tenant


    The Cass Report also detailed how adult gender clinics refused to cooperate with Hillary Cass when she asked them for their data so she could do long-term follow-up. In the report, it says they "thwarted" her efforts to gather this information.

    This is not the action of people acting in good faith, refusing to provide essential data. It's definitely not the actions of people who care about the actual treatment outcomes of the people under their care.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 1,212 ✭✭✭carveone


    The thing about GnRH agonists is that their use as puberty blockers is off-label (ie: not specifically approved for that use). This doesn't prevent physicians from prescribing them however there are supposed to be rules. At least there are in the UK and presumably Ireland; this isn't the US or, god help us, Canada. The rules involve things like evidence of efficacy or where prescribing is part of approved research. Good thing Tavistock was adhering to ethical guidelines and keeping close track of patients and following up right? No? Good stuff.

    When the NHS set out its clinical policy banning the use of GnRH agonists as puberty blockers it was an immediate signal to not only doctors but, more importantly, their insurers that the ability to use this stuff off-label was now over. In my opinion, a private doctor prescribing it would be looking at practically infinite personal liability if their patient wound up with, say, liver cancer. If you were an medical insurer in Ireland (which isn't exactly a country known for not suing at the drop of hat) would you be insuring this risk?

    The only way GnRH agonists will be prescribable now is if they are specifically approved. For which you'll need a ton of evidence. Which, so far, the gender clinics either don't have or are refusing to yield.



  • Registered Users Posts: 1,212 ✭✭✭carveone


    As an aside, I've been getting flashbacks to my childhood reading some of this stuff. I'm in my 50s now but when I was young I was quite short. I was under 5ft until I was about 15. Late developer I suppose but I was 5'8 at 18 which seems pretty reasonable to me.

    Anyway, something that arose at the time was to express concern about shorter children, especially boys (more on this in a second). During the 1970s, these concerns - short stature might cause social and psychological burdens - became medicalised with the use of growth hormones, giving doctors the ability to intervene medically with something that wasn't a medical condition. Cosmetic endocrinolgy if you like.

    Very very expensive of course (ka-ching!). Arguments about ethics and suitability. Off label use of experimental treatments on children with low followup and very little evidentiary reporting. Nothing familiar there.

    So bad news - the growth hormones were taken from the pituitary glands of corpses and not always inadequately screened. A percentage of children wound up with Creuzfeldt-Jakob disease as a result (the bovine version is mad cow disease - there was use of pituitary glands of dead cows to boost the growth rate of live ones, same issue). That's a nasty way to die.

    So why the interventions about short boys? One reason was to make them better conform to gender stereotypes - to be normal at any cost (that's the title of a very depressing book about this which I found much later in my life). The intervention was mirrored for tall girls - tall girls were deemed unfeminine enough to get a man.

    And there's an unpleasant overlap with gender identity. John Money – he's one of the founders of modern theories of gender identity and advocate of medicalization in that area – was a strong advocator that short boys be given HGH, because that might help stop them turning out to be homosexual. Of course, Money was a total monster but he was also expressing the attitudes of the time - short boys and tall girls would turn out to be gay. And you simply can't have that.



  • Registered Users Posts: 846 ✭✭✭MilkyToast


    Its criminal that a medical matter has been turned so highly political by a failed political ideology who see the only path to power as stoking culture wars.

    This "you're engaging in a culture war" narrative is tired.

    I didn't assert that everyone suddenly has an innate gender identity. I didn't suggest that anyone has a frame of reference to know what it's like to 'feel like' the opposite sex. I didn't assert that people who claim to have this identity really do, and that they should be treated legally like the opposite sex or maybe, sometimes, like no sex at all. I didn't start letting men who claim they feel like women into sports, prisons, shelters, bathrooms, changing rooms, groups, lesbian bars, or anywhere else. I didn't assert that lesbians must find men who say that they feel like women attractive or they're 'sexual racists'. I didn't push the belief of this concept into schools and education. I didn't insist that people use the words of my preference over words of their own to assuage people's feelings. I didn't mandate or heavily suggest that anyone put 'pronouns' in their email signature. I didn't start telling little children with no firm grasp on the concept of sex that they could be whatever sex they want. I didn't start giving harmful, cancer causing, vagina atrophying, fertility destroying, development-halting drugs to children and vulnerable adults with barely any assessment. I didn't offer young girls with bodily discomfort 'binders' to damage their bodies with. I didn't sit around on the internet waiting for teenagers to express mental distress so I could swoop in and tell them they're trans and here's a script for your parents. I didn't use my position as a leader, celebrity or politician to push these things because my PR crew told me to. I didn't tell any children that there are expectations based on their sex for how they will behave or what activities or toys they prefer, and that if they don't meet those expectations then maybe they weren't that sex to begin with. I didn't give any 'woman of the year' awards to men.

    I merely noticed this war on culture, and objected.

    It's not the same.

    “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." ~C.S. Lewis



  • Registered Users Posts: 846 ✭✭✭MilkyToast


    The only thing you know about me is that I don’t believe in gender identity and I’m against medical harm visited on children, actually.


    If you have to make me some imaginary fascist bogeyman to support your worldview, maybe your worldview is shít.

    “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." ~C.S. Lewis



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  • Registered Users Posts: 4,314 ✭✭✭Shoog




  • Registered Users Posts: 483 ✭✭concerned_tenant


    Probably the best response I have ever seen to that question.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 483 ✭✭concerned_tenant


    That's the very definition of gaslighting.

    You then went on to say:

    My world view is compassionate, give it a go.

    All dictatorships argue that they act benignly, to act in favour of "what is Good for everyone" — with a capital G, as their Good is better than everyone else's good.

    That's precisely what motivates certain people to control everyone else; the belief that they know best and the need, they feel, to enforce that belief upon everyone else.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    I believe in listening to what people say about themselves and giving them all the help possible to achieve what they see as their own self image. This is the basis of my compassion for others.

    I know at least one adolescent who is transgender and I will do everything I can to support them in their journey and see that they have access to the services they need to achieve that.

    I will do everything I can to shield them from people like yourself.



  • Registered Users Posts: 483 ✭✭concerned_tenant


    What matters is objective, scientific medical evidence — not personal feelings and personal preference.

    The very fact you just stated that independent medical evidence doesn't matter because in your own words just now, you "will do everything you can to shield them" from the best available medical evidence, says far, far more about your position than it does about mine.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



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  • Registered Users Posts: 13,047 ✭✭✭✭hotmail.com




  • Registered Users Posts: 483 ✭✭concerned_tenant


    It's not compassionate to lie to people.

    You have to be truthful and help people as best possible within that framework.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    If you are not listening to the personal experience of real flesh and blood people you have nothing to base your diagnosis on. You cannot treat a person if you do not accept their personal account of themselves.

    The reality is that medicine has long since accepted the reality of transgenderism. You think that the field is based upon makey uppy soft feeling - not at all. If you don't accept the reality of transgenderism you have nothing useful to contribute to the debate because you are denying medical reality.

    I fully understand that most people presenting with gender dysphoria will not go onto seek medical interventions to realign their bodies to their gender - but as I have said many times, this is also totally understood in the medical field because treatment with hormones and surgery is very much the exception rather than the norm. Up until recently it was uneffically difficult to progress in treatment and most people with gender distress were subjected to horrific treatments which attempted to realign the self image with societies view of "normality". Fortunately those dark days have largely been consigned to history.

    I stand in my support for people self identifying as gender dymorphic and seek the best and most appropriate treatment for them.



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    Which is why only a small proportion progress in treatment, and why services filter for this reality.



  • Registered Users Posts: 483 ✭✭concerned_tenant


    Put simply, you have decided to reject the evidence of the Cass Report and WPATH files because you don't like the conclusions.

    That's a point of view. But it's a point of view that is ethically unacceptable given the best available evidence.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    I am sorry but who is lying to gender dymorphic people ?

    You are lying to them by not accepting what they say about themselves.



  • Registered Users Posts: 483 ✭✭concerned_tenant


    Do you support medical evidence and research, or do you not?

    Or is it a case that you only support medical "research" when you agree with its conclusions?

    Medical intervention isn't a la carte; you cannot just decide which parts you accept and which parts you do not accept.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    I have accepted the broad findings of the Cass report but the WPATH files is a politically motivated hatchet job which needs sending to the toilet bowl where it belongs.



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    I thought the conclusion of the Cass report was that we need more evidence, not that the evidence supported your transphobia.



  • Registered Users Posts: 483 ✭✭concerned_tenant


    Which specific allegations against the WPATH files do you have problems with?

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



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  • Registered Users Posts: 4,314 ✭✭✭Shoog


    Its origins and it's funding source are as far away from been impartial unbiased and evidenced based as it is possible to get. It has gained zero traction outside transphobic circles for the very reason that credible commentators wouldn't touch it with a **** barge pole.



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    As lovely as it always is talking to you all, and just in case you imagine I ran away, sleep seems like a better bet than continuing this further. Night.



  • Registered Users Posts: 13,047 ✭✭✭✭hotmail.com


    If you concede they may change their mind, then they may not be trans at all as you maintained. It might be something else.



  • Registered Users Posts: 10,227 ✭✭✭✭Birneybau


    The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.



  • Registered Users Posts: 23,671 ✭✭✭✭One eyed Jack


    I'm just quoting the IT article that you linked.

    The reason I linked the article is because there was some earlier confusion in the discussion around whether or not the concept of gender identity is being taught in Irish schools. I provided the article by way of confirming that it is, that was all. Unfortunately, because of the way the article is written, I see now what you mean. It's why I didn't want to be putting words in your mouth or making assumptions - because right off the bat, learning outcomes are not mandatory. They are expectations which, providing the course has been delivered in accordance with the curriculum, students should be able to demonstrate an understanding of the core concepts of the curriculum. They are the learning outcomes. To suggest that schools would be required to promote anything which undermines the ethos, or the 'characteristic spirit' of the school, would require the Board of Management to violate Section 15 of the Education Act, which would obviously, be unlawful:


    https://www.irishstatutebook.ie/eli/1998/act/51/section/15/enacted/en/html#:~:text=15.%20%E2%80%94%20%281%29%20It%20shall%20be%20the%20duty,the%20school%20for%20which%20that%20board%20has%20responsibility.

    In order for that to happen, the attempt to do an end-run around the Constitution would have to be successful, or confront the issue in the Constitution head-on, by way of holding a referendum on the numerous safeguards against what you'd be trying to do. While it would be ideal to be able to give Government parties credit for having their finger on the pulse of the nation's youth, by way of crediting them for coming up with the idea of policies that "reflect the reality of young people's lives" all by themselves, sadly the reality is that they did not (as partly evidenced as you suggest, by the outcome of the recent referendums). It was young people themselves who made the point that the current RSE curriculum does not reflect the reality of young people's lives, that the curriculum is too biological and so on:

    https://ncca.ie/media/4462/report-on-the-review-of-relationships-and-sexuality-education-rse-in-primary-and-post-primary-school.pdf

    That attempt at an end-run around the Constitution I mentioned earlier? Well, it came from the noble stalwarts on the Left flank, in the form of the Provision of Objective Sex Education Bill 2018, sponsored by the usual suspects, though one will always have my unending admiration and respect for the single act of defiance for which she will always be remembered - Ms. Coppinger's swinging her knickers about in Dáil Chambers. And it's a good thing that she is remembered for something, because her political positions at least, and those of her colleagues in opposition, leave much to be desired.

    A lot of people are quite fed up with that way of thinking - that we just formalise whatever it is that (young) people already know, rather than give them guidance which they can choose to accept or reject.

    As you can see from the above screenshot of a summary of the opinions given by young people who were asked, for the purposes of the development of the new RSE national curriculum - your thinking and theirs is really not that far apart! They're well, well aware of the biological mechanics of sex, and they are aware of sex, in that they know what it is. They do not need guidance in that regard. What they wish for, as they suggest themselves, is a little respect. There's an argument to be made for the idea that in order to get it, you have to give it, but everyone by virtue of the fact that they are a human being and a member of society, is entitled to respect for that much. Personally speaking, I'm a giver, without the necessary expectation of reciprocation. There is of course a line between being a giver, and being a doormat. Establishing clear personal boundaries is all part of that conversation, which deserves its own thread, as it is beyond the scope of this one.

    That's what I'm taking from the article you quoted. I assume they haven't misrepresented the document. It's pretty much what you would expect tbh, given the level of NGO influence over policy.

    At this point I hope to have demonstrated that the author of the article, and his sources, have misrepresented the document, not surprisingly, in order as I suggested earlier - to play the victim. Because in spite of their belief, their views absolutely do not represent the views of the majority of Catholics in this country who wish for their children to have an appropriate form of education which is in accordance with what they believe is in their own children's best interests, as is their right under the same Constitution which applies to everyone in Irish society:


    It is exactly pretty much as I would expect, though I suspect we have different expectations given that while we agree there is an enormous amount of NGO influence over national policy, we may disagree on our understanding of what is an NGO, given that the few hundred non-government organisations are dwarfed in both stature and influence by the largest NGO in the country which is the Catholic Church, with its many, many affiliate organisations such as every one of the 3,000 schools under the Patronage of the Catholic Bishops of Ireland, never mind the numerous voluntary organisations influenced by the Catholic Church in all aspects of Irish Culture and Irish society.



  • Registered Users Posts: 4,314 ✭✭✭Shoog


    What I concede is that the process is robust enough to deal with the whole range of issues people with gender dysphoria present with. It is absolutely not a reason to refuse treatment to transgender individuals.



  • Registered Users Posts: 7,133 ✭✭✭plodder


    It is exactly pretty much as I would expect, though I suspect we have different expectations given that while we agree there is an enormous amount of NGO influence over national policy, we may disagree on our understanding of what is an NGO, given that the few hundred non-government organisations are dwarfed in both stature and influence by the largest NGO in the country which is the Catholic Church, with its many, many affiliate organisations such as every one of the 3,000 schools under the Patronage of the Catholic Bishops of Ireland, never mind the numerous voluntary organisations influenced by the Catholic Church in all aspects of Irish Culture and Irish society.

    I'll give your post another look later, but I don't agree that the Catholic Church dwarfs NGOs in influence. I'd say their influence over policy making, especially in progressive causes célèbre like this is essentially non-existent. When it comes to public consultation, I'm sure their inputs are reviewed carefully, and even concessions made from time to time, especially if they appear to be waving the constitutional stick you mention above, but the policy makers don't call them and ask their opinion, when formulating policies like this imo.



  • Registered Users Posts: 483 ✭✭concerned_tenant


    It's worth considering the background of Dr Hillary Cass:

    Hilary Dawn Cass OBE is a British honorary physician in paediatric disability at the Evelina Hospital, part of Guy's and St Thomas' NHS Foundation Trust, and former president of the Royal College of Paediatrics and Child Health. She is known for establishing the UK's Rett Clinic for children with Rett syndrome in 1992, developing palliative care for children, and leading the Cass Review, completed in 2024.

    Prior to Cass's appointment at the Evelina, she had been consultant at Great Ormond Street Hospital (GOSH) for 15 years. Her research and interests have included autistic spectrum disorders, cognitive impairment due to epilepsy, children with visual loss, and care of children with multiple disabilities.

    In 2015 Cass received an OBE for services to child health. She was subsequently appointed chair of the British Academy of Childhood Disability.

    If through her research, Cass has come to the exact opposite conclusion to you, then I know which of the two conclusions I should support.

    "The further a society drifts from the truth, the more it will hate those that speak it." — George Orwell



  • Registered Users Posts: 13,047 ✭✭✭✭hotmail.com


    But you've admitted that there's a possibility that not everyone who presents as trans are actually trans.

    It's likely something else. The Report basically confirms this.

    Maybe you need to use a new phrase - "suspected to be trans" person.

    I find it a bit strange that someone would identify a child as a transgendered child or transgendered teenager.

    They are a child/teenager. That's it.



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  • Registered Users Posts: 4,314 ✭✭✭Shoog


    All I have said is that medical professional have enough experience and expertise to make the call.

    As I have also said a child knows it's gender from a very early age. A person who identified as transgender at 20 new exactly that reality when they were seven because it is part of who they are. So what you personally find strange is not material to the child who self identified as transgender.



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