World Professional Association for Transgender Health (WPATH) Files

jackboy

https://www.boards.ie/discussion/comment/122069077#Comment_122069077

Of course transgender adults will have known they were transgender since childhood, because they are truly transgender. However, the vast majority of children who think they may be transgender are not, and puberty blockers are not appropriate.

IIt's currently not possible to reliably tell these groups apart.

concerned_tenant

https://www.boards.ie/discussion/comment/122069060#Comment_122069060

I don't accept your characterization.

As the Cass Report shows, children presenting with identity issues typically present with other comorbidities — such as being autistic, or who have suffered trauma, suicidality risks, self-harm, eating disorders, psychosis etc.

A tiny number of those children will later, in adulthood, identify as transgender and if that adult decides to undergo surgery (most do not) to align their body with their identity, then that is an option a consenting adult can make for themselves. In terms of identification, most children will actually just be gay or bisexual (approx. 80-90% of children presenting at clinics with identity issues). Identifying as transgender is not better than being gay or bisexual; both identities are equally valid.

But in terms of the child, a holistic approach is needed to work through the complex web of comorbidities the child has presenting with.

Shoog

https://www.boards.ie/discussion/comment/122069085#Comment_122069085

The service has always been about identifying those individuals - and they have done extremely well at it under extreme resource pressure. A tiny percentage of gender dysphoric children receive any drug or surgical treatment. The percentage who do reflects the percentage of transgender people in society. There is no inappropriate use of puberty blockers - it's damn near impossible to get a doctor to prescribe them to a minor.

Shoog

C

https://www.boards.ie/discussion/comment/122069086#Comment_122069086

Cass never even attempted to establish if those co morbidities are exclusionary of transgenderism. Just because a person is autistic doesn't mean they are not also transgender. Dr Cass asked some very superficial questions.

concerned_tenant

https://www.boards.ie/discussion/comment/122069095#Comment_122069095

There is no inappropriate use of puberty blockers - it's damn near impossible to get a doctor to prescribe them to a minor.

Precisely because it would be inappropriate for a doctor to prescribe them to a minor.

volchitsa

https://www.boards.ie/discussion/comment/122069082#Comment_122069082

Children don’t know. They are told by the adults around them. I’ve known small children who believed they were puppies, Batman or princesses. If the adults around them had taken that seriously, some of those children might well have begun to believe their fantasies.

That’s a very different thing from gender dysphoria which exists, sometimes in childhood, and for a SMALL number of whom the solution MAY be to live as the opposite gender.

The problem is that it is impossible to reliably identify the small number of children with GD whose GD will persist into adulthood and for whom transitioning will improve their GD (because those are two different things as well).

So given that puberty blockers are not in fact fully reversible, they cannot ethically continue to be given in the way they have been recently, ie in the almost complete absence of proper scientific evidence.

Shoog

https://www.boards.ie/discussion/comment/122069099#Comment_122069099

No because a doctor will only prescribe when appropriate. The characterization of transphobic campaigners that they are handed out like candy is just a lie.

volchitsa

https://www.boards.ie/discussion/comment/122069077#Comment_122069077

Still no actual evidence for your claims?
No mechanisms? Just affirmations assertions.

Okay.

concerned_tenant

https://www.boards.ie/discussion/comment/122069102#Comment_122069102

Absolutely.

It has been shown that the vast majority of children presenting with identity issues thankfully end up growing out of those issues, and from adolescence identify as gay or bisexual.

You'd almost get the impression that some people think that's a bad outcome.

volchitsa

https://www.boards.ie/discussion/comment/122069104#Comment_122069104

This is exactly what the Cass report did NOT find.

Shoog

https://www.boards.ie/discussion/comment/122069107#Comment_122069107

So what makes you know you are male ?

volchitsa

https://www.boards.ie/discussion/comment/122069113#Comment_122069113

Nothing because I’m not.

Shoog

https://www.boards.ie/discussion/comment/122069116#Comment_122069116

So how are you certain you are female ?

If the answer is I just do, I hope you see the issue for your assertions.

concerned_tenant

https://www.boards.ie/discussion/comment/122069118#Comment_122069118

This is a red herring away from the Cass Report, which has made its conclusions clear on the matter re: children and affirmation.

The focus was children, not what adults consider their identity.

This seems to be to distract away from the evidence presented by Dr Cass. For that reason, I hope this line of argument is not engaged with.

Birneybau

https://www.boards.ie/discussion/comment/122069019#Comment_122069019

Ok. A wrong 'un so

gym_imposter

https://www.boards.ie/discussion/comment/122069225#Comment_122069225

Fake news

One eyed Jack

https://www.boards.ie/discussion/comment/122069124#Comment_122069124

I don't understand why it's not considered a mental illness, much like other forms of body dysphoria, which could present in childhood or adulthood. It's quite clearly a mental illness and I don't get the shame in that either. 

The reason transgenderism is no longer considered a mental illness is because in and of itself, being transgender doesn’t cause any physical or mental health problems. There is no intervention required from a medical or clinical standpoint. Now, there are some people who still classify being transgender, or to be ‘truly transgender’ as requiring that the individual experiences gender dysphoria:

https://en.m.wikipedia.org/wiki/Transmedicalism

Gender dysphoria is the distress caused by the person’s perception of the difference between their psychological gender, and their physical sex. It can vary anywhere from being just something the person is aware of and doesn’t pay any heed to, to being a debilitating condition which causes all sorts of other problems for the person, which can include body dysmorphia, an entirely separate condition which can lead to other problems such as eating disorders, ill mental health such as depression and so on:

https://www.montenido.com/transgender-anorexia-dysphoria-vs-dysmorphia/#:~:text=To%20put%20in%20simpler%20terms,despite%20medical%20or%20personal%20reassurances.

The reason that legislation is shaped around it is because previously, people who are transgender were not protected by law from discrimination, it was precisely because the idea was regarded with shame and prejudice and as you suggest “the ramifications for society” of its acknowledgment, that there were no laws prohibiting discrimination, and people who are transgender were indeed again, as you suggest- reliant on the idea of people being polite so as to avoid being discriminated against. It’s why they campaigned for recognition in law, so that they were treated as equals in law.

It’s precisely because of the ideas of people like David Bell who proclaim there is no such thing as a transgender child, echoing similar sentiments expressed by Richard Dawkins when he proclaimed that there is no such thing as a Christian child or a Muslim child, that it gives some people the idea that it is permissible to discriminate against people on that basis, contrary to laws which prohibit such discrimination, precisely because of the ramifications for society if it was permitted to do so. Society has been there already, it didn’t work out so well, precisely because it permitted practices which were immoral.

https://www.boards.ie/discussion/comment/122069237#Comment_122069237

You are what you are born, most of us don't like that for one reason or another (big nose, underbite, mental health issues, etc.) but we don't pretend nature somehow made a mistake.

The cosmetic surgery industry is a multi-billion dollar industry (and continues to grow), precisely because people seek to correct the mistakes that they feel nature has made. Mental health is another billion-dollar industry, precisely because nature is regarded as having made a mistake, and the distress that someone is experiencing is not natural - it is a condition which requires clinical and sometimes medical intervention and treatment.

Corrective surgery exists and is so-called precisely because the intent is to correct conditions which are regarded as mistakes in nature. It’s for this reason that corrective surgeries performed on infants who are intersex, are now prohibited in a few countries, because such interventions are now considered immoral as a violation of human rights standards and medically unnecessary, and legislation is required to prohibit and prevent these types of interventions:

https://www.reuters.com/article/idUSL8N2GS5NQ/

Shoog

https://www.boards.ie/discussion/comment/122069237#Comment_122069237

Its like declaring homosexuality as a mental illness, you see the issue with that ?

Birneybau

https://www.boards.ie/discussion/comment/122069579#Comment_122069579

It's nothing of the sort

Shoog

https://www.boards.ie/discussion/comment/122069648#Comment_122069648

So why does anyone feel it acceptable to declare transgenderism a mental illness ?

Shoog

If anyone is genuinely interested in an analysis of the flaws in Dr Cass report (which I doubt) then this is an excellent piece by a transgender person which touches specifically on why Dr David Bell is not an impartial commentator

"That failure to add context reflects a lack of context in the report itself: in which a picture is painted of clinicians who all want the best for their young patients, and have been let down by a lack of evidence. That is not a complete picture. Take Dr David Bell, the psychiatrist behind a critical report of the Tavistock centre, and who has welcomed the Cass review. Bell is often presented as a moderate critic of Gids and yet has argued that trans children do not exist in nature but have been invented, and that cases of gender dysphoria in children can be explained by confusion caused by sexuality, confusion caused by neurodiversity, confusion caused by abuse, trauma or mental health conditions but, crucially, never by that child being, either solely or in addition to other factors, transgender. He has described “top surgery” – shorthand that trans men use for a masculinising double-mastectomy – as “bizarre Orwellian newspeak”."

https://www.theguardian.com/commentisfree/2024/apr/11/hilary-cass-trans-children-review

Birneybau

https://www.boards.ie/discussion/comment/122069656#Comment_122069656

Well, homosexuality is a sexuality.

Transgenderism as you refer to it is not. Unless you are saying it is?

And if so, explain further.

Shoog

https://www.boards.ie/discussion/comment/122069676#Comment_122069676

So here's the simple question you sidestepped - do you believe transgenderism is a mental illness or a state of being ?

concerned_tenant

https://www.boards.ie/discussion/comment/122069664#Comment_122069664

If anyone is genuinely interested in an analysis of the flaws in Dr Cass report (which I doubt) then this is an excellent piece by a transgender person which touches specifically on why Dr David Bell is not an impartial commentator.

There is no logic to that whatsoever.

Your conclusion, "analysis of the flaws in Dr Cass' report", doesn't follow from the premise that Dr Bell is not "impartial".

Doctors are entitled to be partial and biased, particularly when it comes to "doing no harm". That is an active bias — and it's a good one — and Dr Bell has every right to his professional medical opinion on what was then experimental medicine.

The Cass Report vindicated his medical opinion. He was shown to be right.

That's the most important factor.

A doctor can be a far-right lunatic and still be right about their medical judgment. Trying to assassinate someone's character doesn't undermine the medical positions they hold, in other words. They are mutually exclusive things. It's called an Ad hominem argument.

If that's the only argument you have against "the flaws in Dr Cass report"; a report which only yesterday you said was a net positive outcome for your side of the argument, then this is a very weak case indeed.

Shoog

https://www.boards.ie/discussion/comment/122069695#Comment_122069695

Since you obviously didn't read the article I will treat your response with the respect it warrants. None.

One eyed Jack

https://www.boards.ie/discussion/comment/122069676#Comment_122069676

Declaring that homosexuality is a sexuality is the reason it is not recognised as a mental illness, is not the reason homosexuality is no longer recognised as a mental illness. Neither are recognised as mental illnesses any more, whereas once they previously were, because neither being homosexual or transgender requires any clinical or medical intervention.

If one were to follow your logic, then transsexualism (which is still in use as a medical term), would be considered a sexuality simply because it refers to sex:

Early theories often conflated homosexuality with transgender identities and took a pathologizing stance toward gender non-conformity. Caveats about the diagnosis will be listed later in this section.

Magnus Hirschfield is credited as among the first physicians to distinguish between same-sex attraction and “transsexualism.” This was followed in 1949 by David Cauldwell who proposed one of the earliest diagnostic conceptualizations related to gender identity with the term “psychopathia transsexulialis.” In 1966, Harry Benjamin, M.D. published his foundational text The Transsexual Phenomenon and is credited with popularizing the term transsexual as it is used today, educating medical professionals about transgender people, and pioneering hormonal treatments to facilitate gender transition.

https://www.psychiatry.org/psychiatrists/diversity/education/transgender-and-gender-nonconforming-patients/gender-dysphoria-diagnosis

One eyed Jack

https://www.boards.ie/discussion/comment/122069695#Comment_122069695

Doctors are entitled to be partial and biased, particularly when it comes to "doing no harm". That is an active bias — and it's a good one — and Dr Bell has every right to his professional medical opinion on what was then experimental medicine.

They’re not entitled to be partial or biased, under any circumstances. Dr. Bell has every right to his professional medical opinion on medical matters, but the point of the article, which is not a critical analysis of the Cass Report, is that Dr. Bell is not an impartial observer, and his position is not based upon medical evidence, but rather is based upon his personal beliefs.

GMC guidelines already contain a clause for medical professionals to abstain from offering treatments which they have a moral objection to providing to their patients, and in those circumstances they must provide the patient with a referral to another medical professional who is willing to provide the treatment.

The Cass Review certainly did not vindicate Bell’s opinions, it didn’t even come close to it, because the Cass Review acknowledged the legal constraints on the medical profession such as medical professionals being required to obtain the patients informed consent, which Dr. Bell in attempting to portray himself as a whistleblower, has sought to undermine in his expression of his personal beliefs.

plodder

https://www.boards.ie/discussion/comment/122069082#Comment_122069082

Like I said before, this is a false equivalence. Most children recognise themselves as male or female from a young age. They also recognise themselves as human beings. That fact doesn't prove that an adult or teenager who identifies as a cat, must have known this since early childhood.

Large bottle small glass

https://www.boards.ie/discussion/comment/122069023#Comment_122069023

There is not the scientific basis to establish puberty blockers as an "appropriate treatment".

Given you are commenting about the Cass report for about 10 days that should have sank in.

You pushing such a treatment without a scientific basis is the very essence of an ideology driven view.

Not having a scientific basis for treatment is completely unethical.

My irony meter is now wanked

One eyed Jack

https://www.boards.ie/discussion/comment/122070007#Comment_122070007

I’m not sure there’s anything can be done for your irony meter, but the suggestion that not having a scientific basis for medical treatment is completely unethical, is not one of the conclusions of the Cass Review:

That doesn't mean puberty blockers and hormones should be withheld from patients who are likely to benefit from them, Cass cautioned. And U.S. experts told MedPage Today that the report should be taken in "totality" and that treatments should be available while the evidence base is enhanced.

https://www.medpagetoday.com/special-reports/transgender-medicine/109605