World Professional Association for Transgender Health (WPATH) Files

I see the doctors union, the BMA has backed down in their opposition to Cass.

https://www.newstatesman.com/thestaggers/2024/09/the-bma-turns-away-from-rejecting-the-cass-report

Their opposition was all such a mess too - it's the damage to the BMA's public reputation which has forced the BMA into this screeching U-turn after its ludicrous decision to attack the Cass Review.

Because previous to this, when Hannah Barnes (ex BBC Newsnight, who wrote "Time to think" about puberty blockers) first made public that there had been an initial motion supporting the report which was passed but never acted upon, instead of the BMA being transparent about a vote on an issue that is of such public interest - they chose instead to criticise Barnes for informing people about what was going on!

No, because it’s not forced, certainly not in the same sense that historically if people who are transgender sought to be recognised in law as their preferred gender, they were required to undergo forced sterilisation as a condition of being able to avail of any medical or surgical procedures. There was ne’er a word about that though at the time, until recently when it was determined by the ECHR that such conditions were a violation of Human Rights:

https://www.reuters.com/article/world/transgender-germans-demand-compensation-for-sterilization-idUSKBN1YZ0YE/

https://archive.ph/K336g

https://www.bbc.com/news/world-asia-67213374.amp

It simply means that the treatment is unavailable lawfully in the UK (outside of clinical trials), it doesn’t mean the treatments won’t be available in other countries, and it doesn’t mean that the UK Government will be able to prevent UK citizens from travelling to other countries to avail of treatments available there, as they have always done already and will continue to do so.

No, by forced sterilisation I mean forced sterilisation, or compulsory sterilisation, or mandatory sterilisation:

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

Because as I understand it, a lot of the complaints about transgender healthcare in Ireland and about the Cass report and so on, are that young people can't get this treatment? Yet here you are presenting this as "forced"?

I’m sure you’re aware of the difference between having the choice to undergo sterilisation, and being forced to undergo sterilisation as a condition of being recognised as one’s preferred gender in law? In the UK for instance, people who are transgender are still required to have a diagnosis of gender dysphoria or gender incongruence as a condition of being recognised in law as their preferred gender. That’s not the case in Ireland.

The fact that voluntary sterilisation is unavailable to anyone under 30, isn’t the same thing. The aim of modern medicine is to preserve fertility so that people who are transgender who choose to avail of hormonal treatments which risk their fertility, still have the option of being able to start a family at some point in the future. That’s why treatments like puberty blockers are only administered at Tanner Stage 2, which can happen anywhere between the ages of 8 - 13, and they are presented with options to preserve their fertility, in a way in which medical and ethical guidelines require that they understand the options, risks and so on.

I’m not presenting the treatments as forced, that was Vote4Squirrels characterisation. In the UK the decisions about medical treatment about puberty blockers and cross-sex hormones are being taken out of the hands of medical professionals and their patients. It started with the Judicial Review of the Tavistock and then that decision was overturned by the Court of Appeals which determined that it was a matter for clinicians rather than the Court to decide on competence (in line with provisions established after Gillick):

The appeal court judges stressed that it was established legal principle that “it was for clinicians rather than the court to decide on competence [to consent]”.

https://amp.theguardian.com/society/2021/sep/17/appeal-court-overturns-uk-puberty-blockers-ruling-for-under-16s-tavistock-keira-bell

Then the NHS announced puberty blockers would no longer be prescribed as part of treatment for gender dysphoria (incongruence), and the UK Government decided to do an end-run around the Courts by issuing an emergency ban on puberty blockers. There was no medical justification for the decision, it was purely a political decision, extended under a Labour Government:

https://www.gov.uk/government/news/new-restrictions-on-puberty-blockers

That’s what is meant by forced in that context - people who are transgender were forced to undergo sterilisation before any treatment, because being transsexual (the term used at the time), was considered a mental illness and they were regarded as being unable to care for children. That was the justification anyway. Didn’t just apply to people who are transgender, but in this instance that’s who we’re referring to. That was a political decision too, with no medical justification.

The biggest issue for people who are transgender now isn’t just the waiting list to be seen, it’s that the aftercare services in healthcare in Ireland following treatment abroad, are non-existent. Pointing out that maybe they shouldn’t have sought treatment abroad then, would be a bit, ehh, dick move, y’know? There are people who take a certain glee in making that astute observation. Their observation has nothing to do with the availability of aftercare in Ireland, or indeed the lack thereof. Not saying anyone has to #bekind, just resist the urge to go out of their way to demonstrate their ability to be an asshole when the opportunity presents itself.

Seems to me it can't be both: either it's an essential part of transgender healthcare, and thus a right, or it's a cosmetic procedure and in that case why is the taxpayer being expected to fund it?

Understandably from the way you presented it as though there is an inherent conflict, it can’t be both. There isn’t any conflict between treatments that are forced, being compulsory as a requirement of any further treatment or legal recognition; and treatments that are voluntary, which are not available but should be, and are not a requirement of legal recognition of their preferred gender. The taxpayer doesn’t fund anything, the taxpayer pays their taxes. Government decides how public funds are allocated and spent on the provision of public services such as education and healthcare, as part of public policies.

It’s not the first time that ‘argument’ has been made, though it was presented in other circumstances - specifically when Government decided that abortion would now be available as part of public healthcare and I was in the company of a woman who complained that “they” could pay for abortions, but she couldn’t get a wheelchair for her son. I resisted the urge then too to demonstrate an ability to be that asshole, because I understood her frustration, rather than pointing out that not only has one thing nothing to do with the other, but girls, women and their parents pay taxes too, and in this instance so too do not just people who are transgender, but the parents of children who are transgender pay taxes too, if anyone wants to argue about why are taxpayers funding anything - they aren’t. It’s politicians who make those sorts of decisions as to how public funds are to be spent and allocated, which is why they decided that there is better value for the taxpayer in funding treatments abroad rather than funding services to provide for the treatments in Ireland:

https://www.irishtimes.com/news/health/hse-funds-treatment-for-28-people-to-change-gender-in-2016-1.2979930

https://www.thejournal.ie/transgender-surgery-options-ireland-5370886-Mar2021/

That was in 2016 and 2021 respectively, and nothing much has changed since then.

So some people have to go out foreign to have their breasts removed because having breasts causes gender dysphoria and others don't want to be sterilized retain their sexed reproduction system so they can have a baby as that part doesn't cause gender dysphoria at all. Right I get it now.

A really interesting article here by a woman who spent over a decade living as a man, who's now retransitioning to female, in which she examines the reasons for her original gender distress, and the dangers of unquestioning affirmation as a response to such distress, even for adults who are generally presumed to "know their own mind".

Which country will take in children to give them puberty blockers on an on going basis? Or hormones? I can’t see many adults bring their thirteen year old daughters to the USA to have their breasts removed.

As regards adults going abroad, off with them, they are old enough to go get themselves sterilised, castrated etc.

Not sure why a non medical person, who is a trans activist is put on an equal footing with actual medical professionals in that RTE article.

But at least Ireland is now following the excellent Cass recommendations.

Seems from this the HSE started sending children to Belgium after Cass discredited the affirmative model and the Tavistock was closed down as there was no evidence to support its model.

https://www.thejournal.ie/readme/tavistock-cass-report-ireland-6356357-Apr2024/

In years to come we will see the lawsuits from children damaged by an unscientifically justified treatment.

So the article in the Irish Examiner is a lie?

The article in The Journal written by Dr. Paul Moran where he claims that when the UK Government shut down the Tavistock, that the HSE set up a new arrangement with a private clinic in Belgium?

the HSE continued to give Irish children this unsafe treatment and when the UK government shut down the unfit Tavistock, the HSE set up a new arrangement with a private clinic in Belgium to do the same thing, which is still going on.

I wouldn’t accuse him of lying, that implies an intent to mislead. Instead I would suggest he is simply mistaken.

The same could be said of children with cancer. But you don't get those children or their families actively campaigning against the medics who are expert in the field. 

It could, but the reason you don’t get children or their families actively campaigning against the medics who are expert in the field in those circumstances is partly because medics in the field aren’t trying to deprive their patients of a treatment, and partly because the medics don’t inform either the parents or the patients of the long-term effects and potential negative outcomes of the treatment. It’s often more than a decade later when patients have difficulty conceiving that they realise it’s linked back to the treatment they received for cancer in childhood:

https://www.cancer.ie/cancer-information-and-support/childrens-cancer/treating-childrens-cancers/side-effects-of-childhood-cancer-treatment/infertility-after-childhood-cancer

What potential negative side-effects are there from learning an instrument? The comparison is downright dangerous. The state should be protecting children from this, not facilitating it blindly.

You’re stretching that benign analogy beyond its utility in order to take it completely out of context. But since you ask the question, it’s rather like taking your benign suggestion to it’s extreme in pointing out the harm done to children by their parents who imagine their child is a genius, or a prodigy of some description, and forcing them to rehearse a musical instrument to the detriment of their personal and social development in other areas of a child’s early development, rendering the child ill-prepared as an adult to interact with others in wider society.

The adult may be academically brilliant, but because they lack the social skills to be able to interact with other people in wider society, they can often cause harm to others when it appears to them as though nobody else recognises their genius intellect, or their genius intellect gives them a perceived right to mistreat other people, for example a teacher refusing to accept their employers policies in relation to children who are transgender. Then the adult engages in a rather strange and childlike behaviour of standing around outside their employers premises like they’re maintaining a vigil, until the Courts, acting on behalf of society, accept that the adult in question is right, and entitled to treat other people however they wish based upon their own beliefs, and everyone else is wrong.

In order for the State to step in, there would have to be significant or compelling evidence of harm done to children as a result of a particular course of action or treatment, and that standard is often subjective based upon prevailing cultural and social conditions, which is why the approach to treatment for gender dysphoria in children differs significantly between countries like the US and the UK, or indeed even in Ireland.

Really? Cancer doctors don't inform either the parents or the patients of long term effects of medication? I highly doubt that. Most people know that cancer treatment can have severe side-effects. It would be very irresponsible not to point them out.

It would, and it is, and I highly suspect that even when presented with evidence which contradicts your beliefs, you will continue to maintain your beliefs regardless:

Most (96%) parents valued information about late effects, and 93% considered late effects in their treatment decision-making. Yet, 24% could not recall receiving any information about late effects, and only 51% felt well prepared for potential late effects. Though only 20% of parents considered their child at high risk of experiencing late effects, 61% were extremely/very worried about late effects. Those who felt their child was at high risk of experiencing late effects were more likely to worry (OR=4.7, p=0.02).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541904/

I most certainly am not taking it out of context. The fact it is comparing something quite benign, to something with potentially serious long term consequences is the whole point.

You are, in order to make a point about the potentially serious long term consequences, ignoring the tangible serious long-term benefits which vastly outweigh the potentially serious long term consequences. The analogy could just as easily have referred to teaching a child how to ride a bicycle because they want to, and you taking that out of context to point out that children shouldn’t be taught to ride bicycles because of the potential consequences of them cycling out onto the road in the middle of traffic.

Bravo! That is genius! 😀

Well except that the analogy was referring to children who want to learn a language or an instrument, not ones being forced to.

Doesn’t take a genius to see what you did there 😁

And yes, the analogy was intended to refer to children who want to transition - socially or medically, and to provide them with support, instead of denying them the opportunity to do so because you’re only concerned with the potentially serious long-term effects, and refusing to acknowledge the tangible serious long-term benefits of providing support for children who want to learn a language or an instrument or transition, instead of being forced to adhere to a particular course of action which you believe is in children’s best interests.

Children’s autonomy is a contentious issue in any aspect of medicine, not just treatments for cancer or gender dysphoria. It’s the reason why opponents of the treatments persist in proffering and promoting all sorts of alternative theories that are unrelated to gender dysphoria by way of suggesting those issues should be examined to the exclusion of gender dysphoria. It’s not that they care about those issues not being addressed, it’s that they care first and foremost about maintaining their own beliefs by forcing children to maintain them in spite of the tangible evidence of long-term harm which children who are transgender experience as adults.

That evidence doesn't contradict my beliefs. The closest you get to that is in bold above. Yet 76% recall receiving information and 24% are just not sure about it. But, we're talking about cancer now instead of gender dysphoria, so well done!

It’s as though you didn’t even bother to read the limitations of that study - the fact that it was only a small-scale study done on one site being just two of its limitations. If that site were the Tavistock you’d be calling for it’s closure with those stats 😁 You said you highly doubt that cancer doctors don’t inform patients and their parents about the long term effects of medication (by which I presume you mean treatments for cancer), and I provided you with evidence of parents who have no recollection of being given such information.

Whether I think there are long term benefits is not the point. Hillary Cass has just pointed out there's scant evidence of long term benefits. Treating one of a patient's many symptoms is not going to resolve all of their problems, especially if the symptom being treated is caused by another untreated condition. That would be an uncontroversial thing to say in any other branch of medicine.

Cancer and gender dysphoria are not comparable in that regard. Far more cases of gender dysphoria will resolve themselves without treatment than cases of childhood cancer. 

It is exactly the point when all you’re interested in emphasising are the long-term harms. Hilary Cass did the very same thing in order to come to the conclusion that there was scant evidence of long term benefits, and all the evidence suggests long term harm. Nobody is suggesting that treating one of a patients many symptoms is going to solve all their problems, they’re pointing out that treating a patient for gender dysphoria has nothing to do with the many other issues a patient has, like sexual orientation or autism or depression or being the victim of sexual abuse, etc. That’s why it’s controversial in this particular branch of medicine, because those issues aren’t used by way of an excuse or explanation to deprive children of treatment in any other branch of medicine.

That’s why cancer and gender dysphoria are comparable in that regard, because just like cancer doesn’t resolve on its own, gender dysphoria doesn’t either. That’s why the claims you’re making about gender dysphoria resolving on its own are based on children who were seen at clinics and never diagnosed with gender dysphoria in the first place, like Barbie Kardashian for example who was seen at the Tavistock and was not diagnosed with gender dysphoria - there was no issue with them being transgender, they just didn’t meet the criteria for a diagnosis of gender dysphoria, whatever other issues they have.

I'm not completely disagreeing with you by the way. If you were 100% wrong then there would be no need for a gender service for children at all. My point is we should leave it to the medical professionals to run it and the tough questioning that the patients are receiving is a good thing, not a bad thing.

Leaving it to the medical professionals who agree with your assessment to run it, is I’m sure what you mean there, because if it were simply left to medical professionals to run it, that’s how one ends up with the likes of John Money and David Bell running the shìtshow, and there being no record of the tough questions patients are being asked, or their parents being informed, which is what led to the Judicial Review of the Tavistock on the basis that Kiera Bell felt she should have been questioned more thoroughly by medical professionals at the Tavistock before transitioning, and why the Court of Appeal found that the Tavistock hadn’t any case to answer for, and children’s competency is a matter for clinical professionals involved in each case to determine, that it is not a matter for Courts. It’s possible that two conflicting pieces of information can be true at the same time - like Cass praising the staff at Tavistock, while also writing a letter to the NHS pointing out that medical professionals had approached her with tales of conflicting opinions with work colleagues (as if that’s unique to the medical profession? 😂).

No I think you’ll find that if we were to draw a Venn diagram of objectors (cos they’re not activists like, no, it’s only people who disagree with them are dismissed as activists) to the treatment of gender dysphoria in children, and legislators who are determined to ensure people who are transgender conform to their beliefs, we’d have an almost perfect circle (allowing for one or two fence sitters), because they wouldn’t and don’t accept medical evidence which contradicts their beliefs any more than you do, or Cass does, or the UK Government does, or the Governor of Texas does, which is why he made this order, that was balked at by the Department of Family Protective Services:

March 29 (Reuters) - A Texas appeals court on Friday upheld a lower court's injunction blocking the state from investigating parents who provide their transgender children with gender-affirming medical treatments, which Governor Greg Abbott has called abusive.

Abbott, a Republican, had ordered the state Department of Family Protective Services (DFPS) to carry out child abuse investigations into families whose children were receiving puberty-blocking treatments in February 2022.

A month later, a district court judge imposed a statewide temporary injunction on such investigations, saying the probes endangered children and their families.

https://www.reuters.com/world/us/texas-appeals-court-blocks-state-probing-transgender-kids-parents-2024-03-29/