World Professional Association for Transgender Health (WPATH) Files

So a leading Irish medical expert in this field, who works for the HSE is wrong, and your opinion on here is the correct view of the situation.

Okay.

Well, with sex being such a fundamental part of adult life, if medical treatment is likely to have a negative impact on that then I think an in-depth discussion of outcomes and risks should take place. It doesn't need to be graphic, just fact based. Without such a conversation in advance of treatment, there is no possibility of informed consent.

There’s a flawed assumption underlying your argument there - that sex is such a fundamental part of adult life is based upon your own beliefs. It would be silly to extrapolate that out to the general population, let alone imagine that other individuals feel the same way about sex as you do. It isn’t a conversation that needs to be had at all is the point, because it’s irrelevant to the issue of the provision of transgender healthcare.

Again, a false analogy.

It’s not a false analogy, the point is there isn’t multiple in-depth discussions before an appendectomy is performed. There might be if the patient didn’t agree to certain procedures (such as refusing a blood transfusion should the procedure not go as expected), but that’s what is meant by informed consent - not what you’re thinking that a patient who refuses to discuss their sex life with the clinician vitiates informed consent. It does not.

It is a bit ironic that she complains about the pathologising of transgender healthcare - what is surgically mutilating or giving drugs to physically healthy people if not a pathologisation of their condition?

It’s not at all ironic - depathologising transgender healthcare is one of the reasons why the World Health Organisation declassified transgender health issues as mental and behavioural disorders -

Meanwhile, nine organisations working on gender identity said in a joint statement: "It has taken us a long time to get here. Until a few years ago, removing pathologising categories affecting trans and gender diverse people from the ICD-10 list of mental disorders seemed impossible. 

"Today, we know that full depathologisation can be achieved and will be achieved in our lifetime."

The statement added: "Although placement in this chapter is an improvement, it is by no means perfect. For example, it is somewhat reductive to define trans health as related only to sexual health.''

https://www.bbc.com/news/health-48448804.amp

Despite all your long posts, and linked documents, it is not clear what your position is on the specifics. You seem to be arguing in favour of the affirmative care model, but what do you think about the lifelong effects of cross-sex hormones or gender reassignment surgery (I don't like that term as it implies a medical impossibility, I think castration or mastectomy etc would be more useful)? Or the risk of sterility / sexual disfunction due to puberty blockers or other drugs? Or informed consent?

What difference would it make to you? If it were my child, you wouldn’t have any say in the matter, nor would a failed comedy writer, an author of children’s fiction, a former public defender who imagines the New York Education system is in decline, a psychologist who can’t tell what ‘meeting expectations’ means on her children’s school report cards, or a blogger whose opinions I genuinely couldn’t care less about. A paediatric doctor who is fully aware of the condition of the NHS, making recommendations about providing holistic healthcare and support services in local hubs in the UK probably wouldn’t be a go-to either, seeing as they’d have had to be fully aware of the fact that funding for existing hubs has already been cut to shìt by the same Government who appear to be more concerned about building regulations in relation to the provision of public bathrooms, than the provision of mental healthcare services in the UK:

https://www.gov.uk/government/news/government-to-lay-new-law-to-halt-the-march-of-gender-neutral-toilets-in-buildings

https://www.bps.org.uk/news/restore-investment-mental-health-support-nhs-and-social-care-staff-say-leading-organisations

Making recommendations that are doomed to failure would be an indication that real-world evidence was definitely, unquestionably, undoubtedly ignored in favour of upholding idealistic nonsense that would ensure the protection of shìt public services will continue until morale improves.

cancer and appendicitis can be tested for and measured fairly objectively using medical analyses like blood tests or scans etc, while it is impossible for a healthcare professional to measure someone's level of gender dysphoria other than by what they say.

A diagnosis of gender dysphoria too has objective criteria which must be met in order to diagnose a patient with gender dysphoria. And it can be measured objectively, meaningfully and accurately indeed by what a patient says, and indeed what they’re not saying. That’s where a clinician relies on their training, knowledge, experience and expertise in order to form a professional opinion on whether a patient meets the criteria for gender dysphoria, and if they do, what are the next recommended steps involved in treating the condition.

That’s why Cass was writing a letter to the NHS informing them about clinicians having difficulty with patients having unrealistic expectations - if those patients didn’t voice their concerns and expectations, that would definitely make a clinicians job that much easier as they could simply default to what they know and apply the same assumptions to all their patients, like imagining that for them because sex is such a fundamental part of adult life, it must be the same for everyone.

‘Twould be a poor clinician would operate on that assumption, but I’ve heard of, and personally experienced much worse poorly thought out assumptions. Thankfully it was often rectified quickly when they removed themselves from the team thinking that they couldn’t easily be replaced and they’d be missed 🙄 Other times the patient simply sought treatment elsewhere rather than returning to that particular clinician or therapist.

The objective test exists in the diagnostic guidelines, same as any other condition, whether it’s cancer or anything else. You hardly need to be provided with evidence of the failure of clinical diagnostic testing procedures in testing for cancer and misdiagnoses, given recent events in that regard? The objective tests which you’re referring to are not infallible either.

Satisfaction as defined by whose standards? Yours, or the consensus among clinicians involved in the diagnosis and treatment of gender dysphoria (or gender incongruence as it’s now defined)? The point you’re ignoring or downplaying or dismissing of course is that the patient isn’t healthy, they have a diagnosis of a medical condition, one that in the most extreme circumstances requires extreme treatment. They are not decisions which are taken lightly any more than blasting a child with radiation which is almost guaranteed to render them sterile, in order to treat cancer, is a decision that is taken lightly.

Undoubtedly there is ongoing research in order to improve treatments and clinical practice in order to reduce the risk of adverse outcomes and unintended, unforeseen side-effects which may present in later life depending upon the patient’s choices in later life as to whether or not they wish to start a family for example. That’s why clinicians aim to preserve fertility, so that even if patients don’t wish to even consider the possibility of starting a family in their current circumstances, they may wish to do so at some point in the future, and that option is there for them at that time, more likely through AHR if they wish to have a biological connection to their offspring, than traditional home-methods like the turkey baster method.

I was already at peace with infertility in exchange for any kind of future living as my true self. Transitioning would, I thought, mean losing the ability to conceive. The consent form for starting T made the apparent trade-off clear but I signed it without hesitation, having contemplated what this would mean for years. Plus, the tone of the consultant’s advice seemed clear: 

If you’re really a man, you won’t care much about having kids. In fact, you probably just want to whip that womb out asap, eh?

…

Coincidentally, in 2016 I learned that testosterone probably hadn’t made me infertile after all. I discovered this by chance from a YouTube vlog. In the almost eight years since, I’ve carried and given birth to my two children via artificial insemination and donor sperm. I’ve also, perhaps unsurprisingly, become interested in the research around trans people’s fertility and our reproductive choices. Needless to say, there’s very little research of this kind, including zero empirical evidence that testosterone affects trans male fertility. I still don’t know why doctors tell us it does, but I’m fairly sure that it’s got nothing to do with science.

…

Thankfully, I learned my truth before it was too late. If I’d followed the standard NHS pathway and had a hysterectomy, believing testosterone had made me infertile and that the procedure was necessary to prevent certain cancers (a claim that is now debunked), my kids would not be here today. Having been through this, it pains me to think of women seeing frozen eggs as an investment in their future, only to discover, once they’re already out of other options, that it’s nowhere near as simple as that.

In both contexts – in all contexts – healthcare providers have an absolute duty to provide accurate and unbiased information. Nothing should be allowed to blur those lines, be it profit margins or a misplaced desire to police social and gender norms. Women and trans people of all kinds know equally well what it is like to be misled, ignored and undermined by doctors. Sometimes our experiences are very similar and sometimes very different. In either case, there are insights to be learned and shared.

When it comes to reproductive health and choice, we all need better, more ethical and more affordable person-centred care and we are all much more likely to get it if we work together.

https://amp.theguardian.com/commentisfree/2024/mar/16/women-egg-freezing-doctors-transition-healthcare-trans-gender

That’s written by someone who has been through the process, and given birth, twice:

McConnell announced his second pregnancy in August 2021, with plans to give birth in Sweden in order to be listed as the child's father, rather than mother, on their birth certificate. His second child was born in the UK in January 2022 via emergency c-section.

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

It’s understandable that you’d be confused when you’re still imagining that the fact he is a medical expert working for the HSE is in any way relevant to the claim he is making that the HSE set up an arrangement with a private clinic in Belgium, and when RTE’s Prime Time programme sought clarification from the HSE, it was duly provided, without the need to invoke the Freedom of Information Act to get the information that Prime Time was seeking:

In its statement, the HSE said it "became aware" that this clinic "was accepting patients" under its public health system. It said it "does not recommend the service. It simply informs patients of the availability of that public service".

The claim has nothing whatsoever to do with the person making the claim being a clinical expert. The information is freely available to anyone remotely interested, because the HSE are a public body, as opposed to the individual making claims in an opinion piece in The Journal in a personal capacity, and not as an employee of the National Gender Service which is a public service for adults, provided by the HSE.

https://nationalgenderserviceireland.com/about/

The children’s services operated out of Crumlin, and when the Tavistock closed, the HSE informed families about the clinic in Belgium accepting patients under the public healthcare system, not a private clinic as is being suggested by Moran. After the closure of the Tavistock, patients from Crumlin were referred by the HSE to one of the new centres in the UK:

You can read the full report here, including the HSE’s involvement with Cass for the report:

https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/review-of-the-implications-of-the-cass-report-for-the-provision-of-gender-identity-services-for-children-and-young-people-in-ireland-march-2023-published-version.pdf

Or feel free to continue to believe whatever you wish, whatever makes you feel comfortable 👍

“Plagued mankind for about two decades”?

That’s a bit of a stretch 😂 It’s only a question that’s ever occupied the minds of a few philosophers in recent millennia, and in recent years only occupied the minds of a few idiots.

Everyone else has never really given a shìt.

Woman = Adult Human Female.

A baby girl is born and her sex is assigned observed & recorded. God willing she then grows up to be a healthy young woman & to live a long and fulfilling life into old age.

Last time I posted the above definition of woman I got banned from Boards for a couple of months. Hopefully now the climate has changed.

It’s really not, as nobody but a tiny few people have ever posed the question. People have a fair idea in their own minds already of what a woman is and they rarely feel a need to entertain what they feel is a stupid question.

Even in sports they’re very definite as to what a woman is, it’s why they had nude parades in the ‘40s, and why some people declared that women weren’t women, by their standards anyway 🙄

A Polish journalist suggested Stephens was of questionable femininity. This was silenced when she passed a gender test, and she successfully sued a magazine which repeated the libel. But history was to serve an interesting footnote.

Hitler knew a woman when he met one, though he definitely wasn’t her type 😂

Hitler was impressed by the 18-year-old sprinter who had agonised over whether she should withdraw in protest at Nazi treatment of Jews. Stephens is quoted by Olympic historian David Wallechinsky about her post-race experience with the Fuhrer.

"He comes in and gives me the Nazi salute. I gave him a good, old-fashioned Missouri handshake," she said. "Once more Hitler goes for the jugular vein. He gets hold of my fanny and begins to squeeze and pinch, and hug me up. And he said: You're a true Aryan type. You should be running for Germany.' So after he gave me the once over and a full massage, he asked me if I'd like to spend the weekend in Berchtesgaden."

Stephens, whom it later emerged was a closeted lesbian, refused. Her 100m time survived as the world record until beaten by Wilma Rudolph in 1960.

https://www.heraldscotland.com/default_content/12368031.helen-stephens-hitler-pinched-bottom/

Governments aren’t legislating that the earth is flat though? I know what you mean there in that you’re suggesting that Governments are mandating what a woman is, but they’re not. What Governments are doing, and what the Australian and Irish Governments and even Government in the UK have been forced to do since 2002 at least, is ensure in their laws that people are not being discriminated against on the basis of sex or gender, and that includes individuals who are transgender, who had no legal recognition and therefore no protection in law before legislation which specifically recognises them in law was implemented. Before then, people who are transgender could be subject to discrimination and there was little they could do about it.

We all still know what a woman is, and now we can’t discriminate against people on the basis that we don’t believe they’re a woman (same goes for men btw, as was the case in Dallas where the parents and their sons weren’t comfortable with a student they didn’t agree met their definition of a boy, being permitted to use facilities provided for boys).

What happened in the Australian case was nothing special either - the company relied on software to do the initial screening (and if you’ve seen the pics of Graham Linehan’s looking every bit a middle-aged woman, you’d understand how software being relied upon to distinguish between a man and a woman wouldn’t be able to), and it was only afterwards when a manual check was done that they were kicked off the platform. That’s why the company was found guilty of indirect discrimination under Australian law. Tickle failed to prove direct discrimination, but was able to provide evidence of indirect discrimination that met the standard required to demonstrate that they had been the victim of indirect discrimination as defined in Australian law, pretty much the same as is defined in Irish law, UK law, Canadian law, or laws in various US States.

It’s no different when it comes to healthcare - people who are transgender are entitled to be provided with healthcare without discrimination the same way as everyone else. In Ireland it was touch and go there for a while in regards to legislation around the Health (Regulation of Termination of Pregnancy) Act 2018 when the usual rogues gallery tried to make something out of nothing in order to stymy the legislation. Didn’t work, and the bill passed into Irish law without all the fuss over unintended consequences:

https://gcn.ie/abortion-legislation-trans-men/

https://www.irishstatutebook.ie/eli/2018/act/31

In practice and in practical terms what it simply means is that if someone is seeking a termination of a pregnancy, whether they’re a man or a woman isn’t relevant, and is not something GPs and whomever else who is providing treatment should need to concern themselves with - just treat the patient in accordance with the guidelines of their profession, in most circumstances those will be the guidelines issued by the Irish Medical Council:

https://www.medicalcouncil.ie/news-and-publications/publications/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-2024.pdf

It’s also been updated to reflect changes in legislation around Assisted Decision Making (Capacity), but you get the gist.

As so often Jack, you've gone to all that trouble to post walls of text presumably in the hope that enough waffle will look convincing.

You're still quite sim:ply wrong though.

Well ‘twas more in the hope that you would see where you’re mistaken, but as that was a wasted effort, I’ll try to keep this one brief:

Because I’m familiar with Australian and Irish law, I don’t have to rely on Sal Grover’s interpretation, your interpretation of the BBCs interpretation, or indeed the Judges interpretation in that particular case.

You’re also mistaken in claiming that Australian and Irish law does not reflect biological reality, though more specifically in Irish law when it specifically states under the effects of a gender recognition certificate generally (‘generally’ being the key word there):

18.  (1) Where a gender recognition certificate is issued to a person the person’s gender shall from the date of that issue become for all purposes the preferred gender so that if the preferred gender is the male gender the person’s sex becomes that of a man, and if it is the female gender the person’s sex becomes that of a woman.

Among the many reasons why the word ‘generally’ is the key word there, is because even though a person is recognised in law as a man for the purposes of protecting them from discrimination, in giving birth they are not entitled to be recognised in Irish law as their children’s father. They are recognised as their children’s mother by virtue of having given birth to their children.

In those circumstances, a person is losing out because they are limited to being recognised as a woman and therefore a mother in those particular circumstances, and lose out on the opportunity to be recognised as a man, and therefore in Irish law they simply cannot be recognised as their children’s father. There are people who argue that it is sacrificing men’s needs and interests in the service of someone’s mad beliefs (or words to that effect), but it’s really not any different when it appears that men are losing out, any more than it appears women are losing out because people who weren’t previously protected from discrimination are now protected from discrimination.

Those people who would seek to promote discrimination are the people who should have to suck it up, because now they are no longer permitted to impose their mad beliefs on other people in Irish society. That’s why the likes of Enoch kicked off, because he realised that his ability to impose his world view on people who did not share his world view was being severely restricted by his employer’s policies, regardless of what Irish law had to say on the matter.

Well, that failed miserably! 😂

(my attempt to keep it brief)

It seems an unreasonable standard to expect me to be brief when you’re conflating a few different circumstances as though there are no distinguishing characteristics between them which explains the difference in treatment (at this point we may need new irony meters 😁), but my hope is that the Mods will allow a little leeway to indulge this particular tangent as long as we’re not taking the piss and asserting that it’s relevant to the discussion as it relates to the issue of mental health… oh, thar she blows… my irony meter I mean, not… never mind! 😬

Aaaanyways, in what, if you’ll allow, we’ll refer to as the Forstater case, Forstater sued her employer (a global think tank, of all things! I’ll stop now 😂), for direct and indirect belief discrimination, indirect sex discrimination, and victimisation. The issue that was the subject of a preliminary hearing was to establish whether Forstater's beliefs qualified as a protected belief under the Equality Act 2010. It was determined by the Judge in that hearing that they did not. The appeal, was in relation to that decision, which was overturned. Then it had to be established that now her beliefs qualify as a protected belief, had she been the victim of discrimination as she claims, and could her employer be held liable? It was determined that she had been the victim of direct discrimination on the basis of her gender critical beliefs, which it had been previously established were protected in employment law. It was on that basis that she received compensation of of £91,500 for loss of earnings, injury to feelings and aggravated damages, with an additional £14,900 added as interest. Not bad for a days work 🤔

She was right not to argue that biological reality is real, because much like Enoch and his belief that he is the victim of discrimination for his belief, she’d simply have been told that her argument is not a matter for the Courts to address, same as Enoch is being told to stick to the facts which is that his case is not about his beliefs, it is about his behaviour and whether or not he is entitled to hang around the school like a bad smell when the Courts have told him he is not permitted to engage in that sort of behaviour when it has been established that he has an order against him preventing him from being permitted to do so, regardless of the fact that he is still in the employment of the school at least until a decision has been made following a disciplinary hearing which has yet to take place. Enoch is quite happy to play piggy in the middle between the Courts and the school whose hands are tied, because it makes him look like a martyr in front of his supporters (it doesn’t matter that to anyone else he’s simply… well, y’know yourself 😬).

But that’s also why I just don’t care for Sal Grover’s argument, because it’s simply irrelevant. It has no bearing whatsoever on anything, especially in Australian law, which is why her company (which has since wound down while she got wound up!) was found liable for indirect discrimination against an individual, because equality legislation which applied in that particular case, meant that a woman who is transgender would be considered in an even lesser position than a woman who is not transgender.

Contrary to your belief that the decision ignores biological reality, it actually leans pretty hard into it, relies on it in fact, in recognising the position of people who are transgender in Australian society, and indeed the position of women, doesn’t really have anything to say about the position of men (biological or otherwise), because the position of men was simply not relevant to the case, which is why when Sal tried to explain how CEDAW applied, the Judge in the case was having none of it. It wasn’t because Sal is a woman, it was simply because of the fact that her argument was irrelevant.