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World Professional Association for Transgender Health (WPATH) Files

1525355575865

Comments

  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    @volchitsa , @plodder ,

    Your posts on medication reminded me of something I read a while back. It wasn't based on research but on awareness of clinical observation: the prescription of contraceptives to teens who are undergoing puberty might have unanticipated effects. I can't remember the medical language used, but it was along the lines of artificial hormones messing with natural hormones. The speculation was that it might be contributing to the increasing number of teen girls being diagnosed with mood disorders - they are the demographic with the most rapid rise in psychotropic drug prescriptions, which also don't have long term studies into possible adverse effects.

    We're not great at presenting proper risk/benefit analysis when it comes to medical care.



  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    I'm at an age where very little surprises me, but this is really shocking. Stella O'Malley tells the story of a kids 7th birthday party held at a Lush store, where the goodie bag included flyers relating to affirmative care. This really undermines parents I feel, and should not have been done without advance consultation (that's if you accept the idea that retail organisations should be getting involved in things which are a matter of public policy).

    There's a more in-depth article here, also from the Genspect site:



  • Registered Users, Registered Users 2 Posts: 25,317 ✭✭✭✭One eyed Jack



    Personally, I think you're being overly generous in trying to be fair to the doctors who first prescribed puberty blockers. They were well aware of the effects as they had witnessed the effects of puberty blockers in children being treated for precocious puberty. Those effects are not reversible and to suggest as much would be like me claiming that stopping at a red light means I'm going in reverse. Clearly it does not, what's happening is that the process of reaching my destination is delayed for however long I am stopped at the traffic lights. The same was always the intention of puberty blockers - to delay the onset of puberty with the destination being adulthood. The effects on bone mass density weren't occluded either - they just weren't well studied in the population of patients undergoing treatment using the drugs. As it transpired - the effects on children being treated for precocious puberty, and children being treated for gender dysphoria (as it was called at the time for a cohort which were then known as juvenile transsexuals), were not the same. That's what was swept under the carpet. The BMD thing is often overstated and would have an effect in later life, like pensioner age later life when issues like osteoperosis could arise. The medical profession, and the general public have been aware for quite some time that 'dem bones need calcium' as the jingle used go. The risk is similar to those people who, for whatever reason, choose a vegan diet. A balanced diet is required to maintain a healthy body, it's not rocket science.

    It wasn't only reckless to have failed to examine the issues more closely, it was reckless to provide the parents of children experiencing gender dysphoria with the idea that puberty blockers would give them more time to make decisions around the trajectory of their children's development. I've never seen it acknowledged in medical and scientific literature, or in the many fearmongering articles, books and more recently online media published by opportunistic grifters that prior to 2017, while the opportunity to be recognised in law as their preferred gender did exist, it was only on the precondition of undergoing sterilisation that anyone would be able to avail of the opportunity to exercise this right, or avail of it's protection. This law was in place at the time when what became known as the Dutch Protocol were developed, and it was against this backdrop that parents would also have to choose between whether or not they wished to become a grandparent, so to speak, as the implications were obvious… apart from the idea that the fear of their child coming home pregnant would no longer be a concern! There was no medical justification for forcing anyone to undergo the procedure to be sterilised, it was entirely social, in order to remove a person's reproductive capacity so that even if they wished to, they could neither bear, nor sire offspring.

    Modern society does not care to be aware of the history and development of medical and scientific breakthroughs; people care more about whether such a convenience is available to them, and the same as this is true of puberty blockers, so it is true of the history and development of the hormonal contraceptive pill. In short, a devout Catholic doctor who intended to treat infertility in women, developed a means to give women the illusion that they could control their fertility. He was probably struck off The Vatican's Christmas List for that one, although he was not acting alone, with both men choosing to forego the ethics of their respective professions and skirt around the legal impediments to the development of a contraceptive pill in the jurisdiction in which they practiced, in order to experiment on a vulnerable population (not the first time in medical or scientific history that's happened either) and develop a pill for the US market.



  • Registered Users, Registered Users 2, Paid Member Posts: 8,829 ✭✭✭plodder


    Wow! I have to confess I'd never heard of Lush. They sound like a dystopian 21st century version of the Body Shop. The website is really strange. In their "About" section there is nothing on this at all. They have a load of policies, but nothing about this.

    Their beliefs section includes:

    We believe in happy people making happy soap, putting our faces on our products and making our mums proud.

    We believe in long candlelit baths, sharing showers, massage, filling the world with perfume and in the right to make mistakes, lose everything and start again.

    We believe that all people should enjoy freedom of movement across the world.

    All soap and candle-lit baths, and eh … open borders 😮 …

    Weird.

    If you search for specific stores you'll find three in Dublin, and they are all tagged with a little "in store parties" symbol. You can't click on it to get more information. So, you wouldn't know that birthday parties for seven year olds are catered for, much less the propaganda that is given to the kids. I assume the party mentioned above was in a UK store though since the original article was in two UK papers..

    Just reading a bit more about it, they claim the leaflets weren't supposed to be included in the kids party bags. Then at the same time, they say they are a "Campaigning Company"

    Screenshot 2025-05-07 at 16.00.58.png
    Post edited by plodder on

    “The opposite of 'good' is 'good intentions'”



  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    @One eyed Jack

    Thanks for that link - I didn't know about the trial in Puerto Rico.



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  • Moderators, Social & Fun Moderators Posts: 8,116 Mod ✭✭✭✭circadian


    To quote Genspect

    "We are also concerned about the disproportionate numbers of children and young people who are same-sex attracted"

    Yeah GTFO.



  • Registered Users, Registered Users 2, Paid Member Posts: 8,829 ✭✭✭plodder


    What about the rest of that sentence you selectively quoted? Here is the entire sentence

    We are also concerned about the disproportionate numbers of children and young people who are same-sex attracted or will come to recognize themselves as such and could be described as “pre-gay” among those who choose to medicalize their identity rather than allowing sexual development to occur.

    They are saying that many kids who are being medicalised as trans are in fact gay.

    “The opposite of 'good' is 'good intentions'”



  • Moderators, Social & Fun Moderators Posts: 8,116 Mod ✭✭✭✭circadian


    With zero evidence, where's the numbers for "disproportionate numbers"?



  • Moderators, Science, Health & Environment Moderators Posts: 18,601 Mod ✭✭✭✭CatFromHue


    Where does that quote come from?

    One of the biggest issues people have with gender paediatric care is that before "affirming care" the majority to vast majority of youth who went through gender distress naturally desisted during puberty with majority of desisters being same sex attracted. These kids are now being affirmed and medicalised, and have been from day one

    "in the Dutch studies, 97% of youth were gay, lesbian, or bisexual relative to their natal sex"

    Full article: The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed



  • Registered Users, Registered Users 2, Paid Member Posts: 1,898 ✭✭✭Apiarist


    Regarding the original topic. Instead of taking a measured approach to the gender affirming care for under 18s, the reaction is just to ban the medications. Did they ask adults who received the care as children? They did, actually, and the feedback was overwhelmingly positive, with only a small percentage of adults regretting receiving puberty blockers as children. Banning puberty blockers for children that need them is cruel and inhumane.

    Of course, if someone is anti-trans, than any reasonable hesitation a doctor or a scientist can feel about a life-altering intervention can be used to "prove" that the treatments are not good and therefore need to be banned. The only thing is that the motivation here is not to save kids, the motivation is the desire to harm, to punish trans kids for being different.



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  • Registered Users, Registered Users 2 Posts: 9,043 ✭✭✭ceadaoin.


    Is it also cruel and inhumane to not let kids have sex, drive, take drugs, get married, get tattoos, cosmetic surgery, or do any number of things that we understand that kids can't consent to? It hasn't been that long that these drugs have been used to "give kids time" to decide whether they are actually trans or not and given that most do desist then the permanent harms they cause are in no way justified. Similarly, its only in recent years that children have been given surgical interventions like double mastectomies, and we are only just starting to see the regretters and lawsuits now



  • Registered Users, Registered Users 2, Paid Member Posts: 8,829 ✭✭✭plodder


    Did they ask adults who received the care as children? They did, actually, and the feedback was overwhelmingly positive, with only a small percentage of adults regretting receiving puberty blockers as children. Banning puberty blockers for children that need them is cruel and inhumane.

    The Tavistock didn't ask anyone. That was one of the reasons why they were closed down - their poor standards of data collection and followup. If I recall correctly, they have even resisted sharing what data they do have with Cass's team.

    Also, proper clinical trials of puberty blockers are happening, which is something that should have been done years ago, before they became widely used.

    “The opposite of 'good' is 'good intentions'”



  • Registered Users, Registered Users 2 Posts: 25,317 ✭✭✭✭One eyed Jack


    I'm at an age where very little surprises me, but this is really shocking. 


    Wow! I have to confess I'd never heard of Lush. They sound like a dystopian 21st century version of the Body Shop.

    Lads yiz are gas, and I mean that in the nicest possible way, it’s obvious ye’re not familiar with Lush, no reason ye would be to be fair cos as plodder suggests - they really are a dystopian version of the equally dystopian Body Shop, for a number of reasons aside from the fact that they sell cheap, low-quality tacky products and attach themselves to all sorts of social justice causes in order to promote their brand and sell their wares, no different than many other organisations then that engage in exactly the same sort of behaviour. Having said that, I get the distinct impression from the circumstances described by the parent involved that it was a setup, similar to the “gay cake controversy” a while back. The type of customer that Lush appeals to would be well aware of their campaigns and would be supportive of them… well, apart from this wee gaffe -

    https://news.sky.com/story/boycott-israel-sign-at-dublin-store-leaves-lush-facing-backlash-12982068


    That being said though, I couldn’t get through the linked articles without wondering whether they had been written by ChatGPT with the settings turned up to ‘Mary Whitehouse’, such was the level of hand-wringing and feigned horror. Outside of their incredibly loyal customer base (one which they hope to expand on, as all organisations do), very few people are interested in giving a damn about Lush and whatever they’re campaigning about this month.



  • Registered Users, Registered Users 2 Posts: 25,317 ✭✭✭✭One eyed Jack


    I’m not commenting on whether any of the things in your list which aren’t permitted for children are cruel or inhumane and what not, but it’s really apples and oranges you’re comparing there when the difference is a question of medical necessity and the best interests of the child.

    The whole idea of puberty blockers was to give the parents time, because children under 16 don’t have legal capacity to consent, decisions are made for them by their parents or legal guardian, still not the children themselves, even though their views are taken into consideration.

    Most children who are administered puberty blockers don’t detransition or desist, and the rates of regret for the types of surgeries involved are far lower than regret rates for other types of far more common surgeries. Whether or not that’s enough to justify them is debatable, but they’re still not off the table so to speak, and should Kiera Bell be able to pursue a Judicial Review of treatments for children between the ages of 16 and 18 receiving cross-sex hormones (which are far, far more effective than puberty blockers), that still won’t mean that parents with enough resources won’t be able to procure the treatments in other jurisdictions, nor will it prevent 16 year olds from procuring the treatments themselves -

    https://www.bbc.com/news/articles/cvg748nj42lo


    On a more, light-hearted note I suppose, it’s only in recent years too that we’re seeing an increase in women being mistaken for men, when they’re in the middle of using the facilities for their intended purpose -

    https://www.theguardian.com/us-news/2025/may/06/boston-hotel-bathroom-same-sex-couple


    https://www.lgbtqnation.com/2025/03/cops-burst-into-womens-restroom-to-remove-butch-lesbian-accusing-her-of-being-a-man

    Can’t even pee in peace now 😒



  • Registered Users, Registered Users 2 Posts: 1,336 ✭✭✭Mr.Wemmick


    It is well known in the U.K. that children and adolescent mental health support with psychiatry medical input takes years to access. It is tier 3 service refused unless kids have attended and gone through tier 1& 2 support, but bottom tiers have lengthy waiting lists. Autism diagnosis has anywhere between 2-5 year waiting list (depending on county provision) and the horrible aspect of this for many families is that key support services are unavailable unless you have an official diagnosis.

    So how on earth did the needs of trans children and teenagers by-pass all these crucial stages of assessment, diagnosis and medical understanding to access puberty blockers and surgery? Was it a case of you can’t get that type of mental help, but we have a better approach to help you out?


    At some point there must be a call for an investigation to find out an exact time-line re the interventions on how many kids and by whom? Were key NHS mental health professionals involved prior to transitions or not at all? Was there private funding available for kids to access private medical support for transitioning? I have read info on this in dribs and drabs over the years, but certainly not aware of any overview on it yet?

    Rotten to the core - almost like a creepy idea for a Stephen King novel.

    ”I hate who steals my solitude without, in exchange, offering true company.” - F. Nietzsche



  • Registered Users, Registered Users 2 Posts: 25,317 ✭✭✭✭One eyed Jack


    So how on earth did the needs of trans children and teenagers by-pass all these crucial stages of assessment, diagnosis and medical understanding to access puberty blockers and surgery? Was it a case of you can’t get that type of mental help, but we have a better approach to help you out?


    They didn’t -

    https://www.theguardian.com/society/article/2024/aug/05/waiting-list-for-childrens-gender-care-rose-after-opening-of-new-specialist-hubs#:~:text=Waiting%20list%20for%20children's%20gender%20care%20rose%20after%20opening%20of%20new%20specialist%20hubs,-This%20article%20is&text=The%20national%20waiting%20list%20for,weeks%20for%20a%20first%20appointment.

    There is of course also the fact that autism and gender dysphoria are different conditions, so will be treated differently.



  • Registered Users, Registered Users 2, Paid Member Posts: 1,898 ✭✭✭Apiarist


    This is a whataboutery in its most unintelligent form, for your own sake I hope you can see it. I am not going to reply to your primitive deflections. Your post is one of the reasons why the intelligent debate is failing at Boards.



  • Registered Users, Registered Users 2 Posts: 11,016 ✭✭✭✭volchitsa


    LGBTQ Nation lol. Taken up by the Guardian- and multiple differences in the accounts from each side too.

    I remember most of the mainstream media saying that the Wi Spa controversy was all a set-up to bring opprobrium down on the poor oppressed trans community. Turned out that all came from a single claim by a local gay newspaper.

    I think this really is more likely to be the case here - I mean, I can see how a tall skinny "butch" lesbian might be taken for a man initially. But only until she speaks. I do not believe that anyone can have a 5 minute face to face discussion with another person and not be pretty certain what sex they are.

    So no, I'm calling BS on that.



  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    Oh holy sweet mother of Jesus Christ Almighty tonight, I've seen some selective quoting in my time on boards, but that takes the biscuit. That quote displays either a complete lack of reading comprehension, or a deliberate attempt at misrepresentation. Both are a bit sad really, and maybe an explanation for the situation we find ourselves in.



  • Registered Users, Registered Users 2, Paid Member Posts: 1,898 ✭✭✭Apiarist


    Exactly what I am saying. If an organisation is found not performing to a correct standard, it needs to be reformed or closed, I completely agree with that. But to completely ban a service is an overreaction. For fans of whataboutery, here is an analogy — if your GP is found to be a bad doctor, they don't ban you from receiving medical care, unless they think that it is you who needs to be punished for your GP being bad.

    Clinical trials are all well and good, but in the meantime the correct way is to continue doing what provides the best outcome. The best outcome not for clinics, not for anti-trans complainers, not for "concerned citizens", not for politicians, but for the people who actually need the service. The feedback from adults who received puberty blockers as children needs to be the deciding factor. This is logical, is it not?



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  • Registered Users, Registered Users 2 Posts: 11,016 ✭✭✭✭volchitsa


    Eh, no, you're proving what @Mr.Wemmick is saying: waiting rates rose AFTER the Tavistock was closed. It was closed partly because it was found to be rushing children onto a pathway of drugs on minimal investigation.

    (I'm not saying that waiting lists are a good thing, by the way. What's needed is appropriate treatment in a timely fashion. But that's not the point being made here, which is just one of comparison with waiting times for other mental health issues.)



  • Registered Users, Registered Users 2, Paid Member Posts: 8,829 ✭✭✭plodder


    You can't just demand access to potentially harmful drugs though. They have to be tested and proven for efficacy and safety. The Cass review found there was no good evidence that puberty blockers work. Same for all the other European countries that looked into it.

    “The opposite of 'good' is 'good intentions'”



  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    @One eyed Jack

    question of medical necessity and the best interests of the child.

    That's the bit that many people are not sure about - on what basis is it being decided that it's medically necessary and who's making the decision - the child?

    Editing to add:

    The whole idea of puberty blockers was to give the parents time

    How about giving parents time by…giving them time?



  • Moderators, Social & Fun Moderators Posts: 8,116 Mod ✭✭✭✭circadian


    The entire blurb is unsubstantiated nonsense.

    Gender-affirming care does not have a "low-evidence base" and is endorsed by, and this is not exhaustive;

    American Academy of Pediatrics

    American Medical Association

    American Psychiatric Association

    Endocrine Society

    World Health Organization

    World Professional Association for Transgender Health (WPATH)

    While there is some evidence that ADHD and autism may be more prevalent it does not mean that their identities are mistaken. It actually suggests that neurodivergent individuals experience gender differently or are not as bound by what would be perceived as normal expectations.


    "...disproportionate numbers of children and young people who are same-sex attracted or could be described as 'pre-gay'..."

    What numbers? Where's the evidence? There is no clear, peer-reviewed evidence that large numbers of lesbian, gay, or bisexual youth are transitioning due to confusion about their sexuality.



  • Registered Users, Registered Users 2, Paid Member Posts: 1,898 ✭✭✭Apiarist




  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    I don't want to drag the thread too much OT, but it's questionable if any drugs are properly assessed for efficacy and safety. FDA just require 2 positive trials for approval - there are lots of negative trials that tend only to come to light as a result of litigation, if at all. "Positive" only means better than placebo (statistically significant improvement, doesn't have to be clinically significant), and placebo can look bad for all sorts of reasons. The FDA actually aren't that bothered about safety at all, they regard it as a matter between patient and doctor. Besides, clinical trials tend to be too short for cumulative adverse effects to emerge.

    Edited to fix typo.

    Post edited by aero2k on


  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    Parents who have been told that their child will commit suicide if transition doesn't begin without delay?



  • Registered Users, Registered Users 2 Posts: 11,016 ✭✭✭✭volchitsa


    But that's the problem: the basic hypothesis behind puberty blockers for gender dysphoria has turned out to be wrong.

    It was hypothesised that blocking puberty would give the child "time" to think before the irreversible physical changes of puberty kicked in. Perfectly reasonable idea. They didn't test that before giving it to children with GD, partly because it's very hard to do a double blind test with a drug whose effects are blindingly obvious (pun intended). They just gave it to them - and then mostly failed to properly follow up on the results.-

    But one thing that's unmissable is that where previously, puberty itself led to about 80%* of children "desisting" naturally, those who take PBs are the exact opposite - almost inevitably their gender dysphoria does NOT desist, and they go on to taking cross sex hormones.

    But that wasn't the hypothesis the PBs were being given on: nobody was claiming to be able to identify which children suffering from GD would go on to need cross sex hormones - the idea was that they would be able to desist or not, and have a little more time in which to make that decision.

    So something else was happening with PBs, and it's impossible not to suspect that blocking puberty was in fact crystallising their GD, and preventing them from desisting. That can be explained by the fact that puberty also happens in the brain, and that it's highly likely that brain development is also blocked by PBs.

    Then there's also the social aspect: when a child's peers are all going through puberty and they aren't, socially that is isolating and social isolation increases feelings of dysphoria.

    And all of that is probably why the Tavistock still refuses to make all its information availabe to researchers.

    • * The numbers vary depending on studies, but it's always a LARGE majority desist naturally by the end of puberty, without puberty blockers, versus a MASSIVE majority who don't desist with puberty blockers. It's a stunning reversal of ratios, and it needs explaining.


  • Registered Users, Registered Users 2, Paid Member Posts: 8,829 ✭✭✭plodder


    No, they weren't assessed at all. The usage is all off-label. As far as I know, the manufacturers have declined to undertake any trials themselves up to now.

    “The opposite of 'good' is 'good intentions'”



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  • Registered Users, Registered Users 2, Paid Member Posts: 2,897 ✭✭✭aero2k


    Edit: I was referring to drugs in general, not just PBs.

    Off label usage isn't a bad thing in and of itself - the situation where a doctor closely monitors a patient taking a drug that hasn't been approved for that particular purpose might be better than the scenario where a patient is taking an approved drug with no proper monitoring for adverse effects.

    For Tavistock at least they didn't seem to be doing much in the way of monitoring or follow-up.



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