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World Professional Association for Transgender Health (WPATH) Files

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Comments

  • Registered Users, Registered Users 2 Posts: 10,108 ✭✭✭✭volchitsa


    But lack of evidence and speculation from trans activists is grand.

    Got that.

    "If a woman cannot stand in a public space and say, without fear of consequences, that men cannot be women, then women have no rights at all." Helen Joyce



  • Posts: 6,626 ✭✭✭ [Deleted User]


    Your double standards are amazing.

    I follow the advice of experts in their field not trans-activists. Your pathetic attempts to paint all clinicians in the field of transgender medicine as activists is a simple bare face lie.



  • Registered Users, Registered Users 2 Posts: 8,003 ✭✭✭El Gato De Negocios


    Such a load of nonsense. Nobody has said trans people are the downfall of society or any such nonsense.

    The majority of people that I've seen on Boards and elsewhere are simply asking questions that need to be asked.

    Areas such as allowing men into women only spaces such as bathrooms and changing rooms absolutely must be discussed.

    Areas such as allowing men participate in female sporting events absolutely must be discussed.

    Areas such as going along with allowing kids that legally cannot have sex decide their own sex and possibly start on a path of irreversible medical treatment absolutely must be discussed.

    Trans people exist and always have, anyone with half a brain can acknowledge and accept that however there is a cohort of extremists that will not be satisfied until women's identities are essentially deleted, all to make a minute minority of MEN "happy". That absolutely must be discussed.

    Raising an eyebrow or asking questions does not a terf / transphobe / bigot / nazi / whatever, make.



  • Posts: 6,626 ✭✭✭ [Deleted User]


    There is a tone of "predatory men" using this to exploit women about what you just wrote. Go back and read it. No mention of transitioned men, no obvious concern about that.

    Almost mainlined from the anti-trans websites.



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    I don't know that one but there is a 1% detransition stat knocked about but it's misleading as there's a large non reply number and it's also for people who transition as adults. When it comes to the current cohort we just don't know what's going to happen.

    Some of the medical professionals are open about the kids who detransition need to take responsibility for their actions in transitioning so how that's going to work out in their minds is unknown.



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  • Registered Users, Registered Users 2 Posts: 8,003 ✭✭✭El Gato De Negocios


    Personally, I'd have zero issue with men who have had genital reassignment surgery using womens bathrooms, changing rooms etc however I absolutely 100% have an issue with men that are still physically intact using these facilities.

    No doubt at all that some of these people pose zero risk to females and they just want to go about their business but on the flip side, there is also no doubt that some of them ARE predatory and DO pose a danger to women in such vulnerable spaces.



  • Registered Users, Registered Users 2 Posts: 41,232 ✭✭✭✭Annasopra


    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    The median age in that study is 15.7 and the median follow up period is 2.6 years. So to say how they'll feel when they're mid to late 20's is unknown still.

    That other article talks about regret which is set at a very high bar. In the leaked files some of the doctors are saying that their patients regret not being able to have kids but that's not marked down as regret. The article also talks about the original Dutch experiments but there's problems there. In one of their studies they had a starting sample of 70 but that reduced to 55 during the study and they were labelled as non participants. No more information is given about them so we don't know if they regretted what they'd done, detransitioned, or were happy where they where and didn't want to continue.

    Post edited by CatFromHue on


  • Registered Users, Registered Users 2 Posts: 42,570 ✭✭✭✭Boggles


    I never could understand the scare mongering around the bathroom thing.

    I mean unisex bathrooms are quite common around the world, especially in Europe and even America.

    Have you evidence that these are more dangerous for women?



  • Registered Users, Registered Users 2 Posts: 10,108 ✭✭✭✭volchitsa




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  • Registered Users, Registered Users 2 Posts: 41,232 ✭✭✭✭Annasopra


    Numerous studies from Spain, Australia, Holland, UK, US all show detransition rates of between 1 to 3% though. You can't dispute that. I presented 4 links above with some of them and their has been reviews of numerous studies which are almost mentioned in the links above.


    Your claim "that it's gay and autistic kids who will lose out as the WPATH's guidelines are a form of conversion therapy." simply doesn't stand upto any scrutiny at all when all the available evidence shows a 1% to 3% detransition rate.

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



  • Registered Users, Registered Users 2 Posts: 10,108 ✭✭✭✭volchitsa


    For some reason, sexual assault of women in mixed spaces is regularly portrayed by trans activists as a bigoted white woman/Karen fake problem in western countries, but when the same problem comes up as a reason why women and girls are assaulted in refugee camps, there doesn't seem to be any ideological objection to saying so.

    Perhaps the mainly white males objecting to such claims are not nearly as offended at the idea that male refugees are likely to assault women as they are by the idea that men like them do so too?

    792a6b89d6dd0f13aae4f0c6c4e33a48.jpg

    The radically simple way to make female refugees safer from sexual assault: decent bathrooms

    https://qz.com/692711/the-radically-simple-way-to-make-female-refugees-safer-from-sexual-assault-decent-bathrooms

    When a safe place to wash can be a life-changing thing.

    "If a woman cannot stand in a public space and say, without fear of consequences, that men cannot be women, then women have no rights at all." Helen Joyce



  • Registered Users, Registered Users 2 Posts: 8,015 ✭✭✭plodder


    If it isn't, then it's contrary to government policy. Amazingly, support for something as strangely detailed and specific as WPATH, found its way into the current program for government. In the LGBTi+ section

    Create and implement a general health policy for Trans people, based on a best-practice model for care, in line with the World Professional Association of Transgender Healthcare (WPATH) and deliver a framework for the development of National Gender Clinics and Multidisciplinary Teams for children and adults.

    “Fanaticism is always a sign of repressed doubt” - Carl Jung



  • Registered Users, Registered Users 2 Posts: 8,015 ✭✭✭plodder


    Probably why it's (still) a war-crime to house male and female prisoners of war together.

    “Fanaticism is always a sign of repressed doubt” - Carl Jung



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    Only reading the first one and I've only access to the abstract. It doesn't look like a study on regret or detransition. It does have a line in there about those who stop but like the second study I did read and comment on we don't know the full story. The second study has a follow up period that's far too short for a median age of 15.

    The third link was to a news article.

    The fourth link, to the Australian study, doesn't give the age at follow up. Or at least not in the abstract which is all I can read. The follow up age is a very important factor as what someone thinks 2 years after transitioning as a 15 year old could be very different after 12 years when their friends are starting to have babies.

    There is another issue here that puberty blockers don't give time to think but it looks like they lock in a gender identity. Which is the problem with ignoring the previous literature that shows that if you leave these kids alone the majority will desist, with most of them realizing their dysphoria was due to struggling with their sexuality. That's why it can be argued that blockers/affirming care is a form of conversion therapy. Left alone most would desist and come to terms with their body, medicalised it looks the opposite.

    As for the autistic comment in the original Dutch study they were very selective on who they let onto the study and autistic kids weren't accepted. Autistic kids healthcare suitable for their needs which the WPATH don't seem too pushed about.

    The biggest group presenting to gender clinics nowadays is teenage girls. This is a very different cohort to what the evidence base is based on and this is a problem.



  • Registered Users, Registered Users 2 Posts: 24,874 ✭✭✭✭One eyed Jack



    When it comes to the current cohort we just don't know what's going to happen.


    Ahh we kinda do though:

    https://www.hcplive.com/view/suicide-risk-reduces-73-transgender-nonbinary-youths-gender-affirming-care

    That’s why some countries, notably apart from the US of course, have decided to implement clinical trials under the auspices of their national public health authorities. In the US it’s pretty much a matter for each State, which means they can introduce laws banning the provision of puberty blockers to minors, effectively ending their treatment.

    It’s those figures that haven’t been accounted for yet, but stopping treatment is obviously not the same thing as either regretting the treatment itself, or that the patient has chosen to take steps to detransition (or as some people refer to it ‘retransition’, which is not the same as those who transition again at a later stage).

    The 1% figure is bandied about for no other reason other than it’s convenient. There are no reliable statistics that provide evidence one way or another of anything. For example most of the studies are done on patients in the respective countries public healthcare systems, and little is known of patients (or their parents) availing of private healthcare, sometimes covered by private healthcare insurers, more often not. It also doesn’t include the statistics for those people who obtain hormones unlawfully.

    At any rate, the whole question of statistics around detransition rates are irrelevant to the question of whether or not it is ethical to withhold, or provide treatment which includes puberty blockers, in children with a diagnosis of gender incongruence.


    Some of the medical professionals are open about the kids who detransition need to take responsibility for their actions in transitioning so how that's going to work out in their minds is unknown.


    In whose minds, the minds of the medical professionals who are open about the idea that children who detransition need to take responsibility for their actions, or the minds of the children who detransition? If it’s the medical professionals you mean - probably not going to work out very well for them. They have a professional and legal duty to their patients, whereas children are under no such obligation, regardless of the opinions of a few in the medical profession who behave like stroppy teenagers because they have difficulty in communicating with their patients.



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    There's other studies which don't show an improvement in mental health after transition.

    Very little of what I post here is my opinion. I've posted this before but this is what's in the Cass Review

    "Key points – context

    • The rapid increase in the number of children requiring support and the complex case-mix means that the current clinical model, with a single national provider, is not sustainable in the longer term. 
    •  We need to know more about the population being referred and outcomes. There has not been routine and consistent data collection, which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service.  
    •  There is lack of consensus and open discussion about the nature of gender dysphoria and therefore about the appropriate clinical response. 
    •  Because the specialist service has evolved rapidly and organically in response to demand, the clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced."  

    On blockers she's written

    "At this stage the Review is not able to provide advice on the use of hormone treatments due to gaps in the evidence base. Recommendations will be developed as our research programme progresses."

    If the evidence base was as strong as some say she wouldn't be saying this.



  • Posts: 6,626 ✭✭✭ [Deleted User]


    Please show us that study that shows no improvement in outcomes for transitioning. If it's what I think it is then it shows nothing of the sort, but let's have the facts you based your belief on so we can be clear.



  • Registered Users, Registered Users 2 Posts: 24,874 ✭✭✭✭One eyed Jack



    If the evidence base was as strong as some say she wouldn't be saying this.


    There’s no reason why she wouldn’t, because it’s her opinion in the interim report based upon the findings of her team. Basically she found that the current system was wholly inadequate in a number of ways and simply couldn’t provide adequate support for the needs of the growing number of patients GIDS were seeing, let alone those people they weren’t seeing who were on waiting lists for years.

    Based on the findings in the interim report (the full report has yet to be published), the NHS implemented the following steps:

    https://www.england.nhs.uk/commissioning/spec-services/npc-crg/gender-dysphoria-clinical-programme/implementing-advice-from-the-cass-review/

    And specifically on the question of the provision of puberty blockers to patients:


    Driving further research and embedding continuous quality improvement

    In her July 2022 letter, Dr Cass emphasised the importance of embedding research into the clinical practice of the new services given the substantial gaps that exist in the evidence base. She also urged NHS England to give rapid consideration as to how it could establish ‘the necessary research infrastructure to prospectively enrol young people being considered for hormone treatment into a formal research protocol with adequate follow up into adulthood, with a more immediate focus on the questions regarding puberty blockers’.



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    The first one that springs to mind was the early intervention study on the use of blockers run by the Tavistock that

    "We identified no changes in psychological function"

    Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK | medRxiv



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  • Posts: 6,626 ✭✭✭ [Deleted User]


    So you didn't think it was worth mentoning that overall response to treatment was positive. Didn't think I would read it did you. I think also you are misreading what no changes in psychological function means in this context:

    "Conclusions Overall patient experience of changes on GnRHa treatment was positive. We identified no changes in psychological function. Changes in BMD were consistent with suppression of growth. Larger and longer-term prospective studies using a range of designs are needed to more fully quantify the benefits and harms of pubertal suppression in GD.


    Fairly much exactly what I have come to expect from anti-trans activists.



  • Registered Users, Registered Users 2 Posts: 24,874 ✭✭✭✭One eyed Jack



    But that’s not saying this?

    There's other studies which don't show an improvement in mental health after transition.


    I totally get that it’s the first study that comes to mind, but it doesn’t support the argument that there was no improvement in mental health after transition, and no changes in psychological function is a positive result!

    What the study does say in relation to mental health is this:

    The paper, ‘Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK’, shows that overall patient experience of changes on gonadotropin releasing hormone analogues (GnRHa) treatment (commonly called ‘puberty blockers’) was positive and there were no unexpected adverse events. Those expected adverse effects reported (headaches, flushes, fatigue, etc) were mainly mild.

    The study identified little change in psychological functioning, but the experience of treatment as reported in interviews was positive for most. The majority reported feeling happier and having better relationships with family and peers once treatment had begun. However, some reported negative changes, which were largely related to the anticipated side effects.

    https://gids.nhs.uk/research/early-intervention-study/


    They spent 8 years in discussions about the study beforehand with clinicians from other countries, then ended up with a 3 year study from which they only had data for 14 patients. I’d say their conclusion that more research is required, is something of an understatement.



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue



    I'd argue that you're anti trans when you keep ignoring the gaps in the evidence base. The psychological function is the important metric.



  • Posts: 6,626 ✭✭✭ [Deleted User]


    Which was broadly positive - so your point is far from compelling.

    The broad conclusion of the study you used as evidence was that puberty blockers improved the lives of the candidates and did not cause any psychological side effects.



  • Moderators, Science, Health & Environment Moderators Posts: 18,361 Mod ✭✭✭✭CatFromHue


    What does broadly positive even mean as it wasn't measured?

    The phycological function is based on the data and was the reason the drug was given.

    "Prespecified analyses were limited to key outcomes: bone mineral content (BMC) and bone mineral density (BMD); Child Behaviour CheckList (CBCL) total t-score; Youth Self-Report (YSR) total t-score; CBCL and YSR self-harm indices; at 12, 24 and 36 months"

    "There were no changes from baseline to 12 or 24 months in CBCL or YSR total t-scores or for CBCL or YSR self-harm indices, nor for CBCL total t-score or self-harm index at 36 months"

    The reason you give the drugs is to improve these metrics.



  • Posts: 6,626 ✭✭✭ [Deleted User]


    That is not why the drug is given in this case, its not given as mood enhancer - a nice little upper.

    Its given because the onset of puberty in transgender individuals is know to cause acute distress.



  • Registered Users, Registered Users 2 Posts: 3,716 ✭✭✭Hamsterchops


    *Breaking News, puberty blockers have been banned in the UK for under 18s. Super result and about time too 👏

    So to clarify, the NHS England have announced that there will be no puberty blockers for under eighteens, in which case there'll be no hormone treatment, ergo "the ideology" and a lot of dangerous nonsense in the WPATH files shall be halted in its tracks.

    Super result.

    https://youtube.com/shorts/YN2tvGNxVMc?si=B5-_UqZpJuNHLzNF



  • Posts: 6,626 ✭✭✭ [Deleted User]


    Thats not what the Cass report recommended so this is a purely ideologically driven decision not best advice.



  • Registered Users, Registered Users 2 Posts: 853 ✭✭✭MilkyToast


    A lot of work yet to be done, but this is a good start.

    “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, Registered Users 2 Posts: 8,003 ✭✭✭El Gato De Negocios


    A victory for common sense. When a person is legally an adult let them make whatever decisions they want.



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