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World Professional Association for Transgender Health (WPATH) Files

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Comments

  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    What do I mean by a normal sexual response? Well, for a man, I mean one that involves a functioning penis - difficult if it's been loped off or rendered superfluous by medication. I think most people would expect to be able to respond physically to intimate touching, and the ability to orgasm would matter - neither is a given once a patient starts down the gender affirming path. Really normal means what would be normal for that person if they weren't subjected to drugs and or surgery. Despite attempts to convince us that this treatment is to correct something that nature has got wrong, I think Joanna Moncrief's way of considering drug treatment is helpful (she's referring to psychiatric drugs): rather than correcting an abnormal state, these drugs are causing an abnormal state in an otherwise healthy body.

    I think you and I are agreed on the concept of informed consent. I am neither asserting a right, nor expressing a desire to interfere in any particular doctor/patient interaction. I do think it's ok for me to want a general framework where the information doctors are giving their patients in order to inform their consent reflects the actual reality of risks vs benefits as closely as possible, rather than being something pulled out of the collective arses of WPATH (or for that matter NIMH etc). Your link made me smile with the mentions of "reasonable practitioner" and "reasonable patient" - it took me back to a few law lectures I had as part of other studies where the lecture told us "a reasonable man is a pain in the arse"😀.

    Given the context for the Cass Review, I think some social commentary element to the final report was inevitable - I don't think it undermines the important findings regarding research, or the lack thereof.

    And I appreciate the fact that you took the time to understand my perspective on wider healthcare matters - it's hard not to sound like a conspiracy theorist even though I'm just trying to make sense of it for myself at times.



  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack


    There is an enormous chasm between the legal competence that children under 16 in the UK have established in the Gillick case (which was about an U16 wishing to access contraception) as compared with a child under 16 wanting medical treatment…


    The Gillick case wasn’t quite about an U16 wishing to access contraception, it was about an U16 who sought advice regarding contraception, and her mother seeking a declaration that the prescription of contraception to U16 was illegal on the basis that a medical professional would be committing the offence of encouraging sex with a minor. She also sought to have consent declared invalid as consent was vested in the parent. Her case failed, as did the Axon case where your idea of a vast chasm between medical treatments was presented in relation to minors seeking medical advice, medical treatment, sexual matters and confidentiality -

    https://www.theguardian.com/society/2006/jan/23/childrensservices.uknews

    There’s no need for them to come to the same decision today as the prescription of puberty blockers in public healthcare was restricted to clinical trials by Government after that decision was made. The Supreme Court rejected an application to hear the case on the grounds that there was no point of law to be argued.

    Subsequent revelations? Like Helen Webberly? I don’t think that made the hope naive, the vast majority of clinicians do take great care before recommending treatment to a child and are quite aware of, and adhere to, their professional and legal obligations.

    Personally, I wouldn’t wonder about the effect of 42A, it doesn’t place any obligation on doctors. There are a couple of aspects to it, the one that’s most relevant in this instance being that the Constitution recognises that children have rights independent of their parents or the family unit (as opposed to The Family, since the parents marital status is irrelevant in the context of 42a specifically).



  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack


    I think most people would expect to be able to respond physically to intimate touching, and the ability to orgasm would matter - neither is a given once a patient starts down the gender affirming path.


    Neither is a given under any circumstances, nor is it a given that once a patient starts down the gender affirming path, that their capacity to respond physically to intimate touching or orgasm is removed. It can be distressing for a person when the autonomic nervous system makes their body respond in ways in which they have no control over, especially when they do not want to engage in physical intimacy, and doubly so for a person with gender incongruence - that’s the key part you left out of your assessment.



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    The Gillick case wasn’t quite about an U16 wishing to access contraception, it was about an U16 who sought advice regarding contraception, and her mother seeking a declaration that the prescription of contraception to U16 was illegal on the basis that a medical professional would be committing the offence of encouraging sex with a minor. She also sought to have consent declared invalid as consent was vested in the parent. Her case failed, as did the Axon case where your idea of a vast chasm between medical treatments was presented in relation to minors seeking medical advice, medical treatment, sexual matters and confidentiality

    You're splitting hairs, and rephrasing what I said in twice the number of words. I also never mentioned "the Axon case". I am comparing Gillick with the general notion of "informed consent" where pre-teens are trying to access puberty blockers, for which the bar for consent should be way higher than what the Gillick case originally established.

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



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    Well, if I didn't leave some things out, my posts might end up long and rambling like......like.…like some posts I've seen on Boards 😀.

    Your point re involuntary response is well made, not something I had thought about and yes, awful for those affected. But the thing you left out is that we have no biological markers for gender incongruence, hence no objective diagnostic test, so I think some % of those receiving these treatments may not have been suffering from gender incongruence. You have agreed that these treatments are irreversible - should the precautionary principle not apply?

    Post edited by aero2k on


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  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack


    That’s a decision that should ultimately be taken by the patient in consultation with the multi-disciplinary team involved in their care. I don’t think banning puberty blockers is actually going to reduce the numbers of children who are diagnosed with gender incongruence which is so severe that it requires the most extreme treatment which is surgery.

    Banning puberty blockers just means they have to wait anyway until they’re 18, and because nature doesn’t have any capacity for a precautionary approach, the outcomes of surgery in adulthood are less optimal than they could have been had treatment with cross-sex hormones began earlier. Puberty blockers were only ever buying time.

    Given the regret rates of surgeries are estimated to be around 1%, I don’t think the baby needs throwing out with the bath water, so to speak.

    Personally, I liken it to abortion - I don’t agree with it, I don’t like it, I wish it weren’t necessary, and while banning abortion would mean a reduction in recorded figures and those opposed to abortion could all sleep easier in our beds at night, the reality is that all that’s actually happened is that while there was a reduction in recorded figures, the number of unsafe abortions carried out has increased (but depending on one’s point of view, that figure isn’t relevant).

    I don’t imagine those seeking to transition will be any different - they’ll still do it, it’ll just be far more risky, and the outcomes far less optimal than had they been able to transition under proper medical supervision, with the result that rates of regret and those seeking to repair the damage they feel was done, increasing (but again - depending on one’s point of view - that figure isn’t relevant).



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    I'd have a similar perspective on abortion - I don't like it, but a woman's right to bodily integrity takes precedence, so I voted for the right to abortion while hoping the numbers availing of that right would reduce over time.

    Agreed on the involvement of MDTs in healthcare, so long as their approach is based on facts, evidence, and not WPATH bullsh1t.

    The severe gender incongruence you refer to is very rare I suspect, and likely dwarfed by people with all sorts of other things going on who have been convinced that they have been born in the wrong bodies.



  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack


    The severe gender incongruence you refer to is very rare I suspect, and likely dwarfed by people with all sorts of other things going on who have been convinced that they have been born in the wrong bodies.

    It is rare, but it’s the treatment that gets the most focus in the media, and ignore the vast majority of cases where treatment with surgeries aren’t necessary as their condition can be managed with therapy and so on, or the vast majority of cases in which only social transition is necessary to alleviate their incongruence - it fosters a perception that is so outdated it’s not even worth entertaining; that of the idea that people who opt for surgeries were somehow convinced by someone, somewhere, that they were born in the wrong body, and that it isn’t an innate instinct, when in reality that’s exactly what it is. It’s only in recent times that that’s been acknowledged, and the ‘born in the wrong body’ stuff was nothing more than early attempts to convey the concept of what it means when one’s self-perception of their sex doesn’t correspond to their physical sex.

    The concept of ‘gender’ was never necessary, but considering the social context of it’s proliferation at the time, it’s easy to see how it got legs -

    When Brenda was five Dr Money started to publish her case - disguising her by referring to her as Joan/John - in his books. The case became a sensation. It was the proof that feminists in particular were looking for. It was proof, they argued, that there was no biological reason that boys are better at maths and that men should earn more than women. 

    https://www.bbc.co.uk/sn/tvradio/programmes/horizon/dr_money_prog_summary.shtml



  • Moderators, Science, Health & Environment Moderators Posts: 18,599 Mod ✭✭✭✭CatFromHue


    Looks like the UK's trial on puberty blockers has been "paused"

    What happens next after the MHRA halts puberty blockers trial?

    "The Medicines and Healthcare products Regulatory Agency (MHRA) is no longer satisfied the proposed research is safe. It has asked the trial team to look again at the study and make changes."

    "The MHRA — which approved this trial in the first place — has now acknowledged these points, and more. “The expected effects of the drugs include the sterilising effect of puberty blockers followed by cross sex hormones,” the regulator said unequivocally in a letter to KCL. Treatment with puberty blockers beyond a year could “result in persistent and potentially permanent bone structural change,” it added. A government spokesperson described the MHRA’s intervention as raising “new concerns — directly related to the wellbeing of children and young”.Let’s be clear, these concerns are not “new”. They have been raised in recent months by concerned medics, ethicists, clinicians and journalists. And they have been known for years."

    They've worked themselves into a right mess here as there is no safe way of conducting a trial like this.



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    Great article in the NY Times which argues convincingly that three of the major medical representative organisations in the US (the American Medical Association 241,000 members, the American Academy of Pediatrics 67,000 members, and the American Psychological Association 190,000 members) cannot be trusted. They have all issued guidance recently which contradicts their previous guidance on gender care, with no accounting for how or why the change has occurred.

    Leaving the suspicion (most obvious explanation) that the original guidance was obtained from a small number of activist-clinicians with little oversight of what they were doing. And the updated guidance is bowing partly to political pressure from the Trump administration and also the prospect of compensation claims (like the recent $2 million award to a detransitioner).

    At a time when more and more Americans are turning away from expert authority in favor of YouTube quacks and their ilk — and when our own government is pushing scientifically baseless policies on childhood vaccination and climate change — it’s vital that the organizations that represent mainstream science be open, honest and transparent about politically charged issues. If they aren’t, there’s simply no good reason to trust them.

    https://www.nytimes.com/2026/02/24/opinion/medical-associations-youth-gender-care.html?unlocked_article_code=1.OlA.K1Iu.kqVZ50_XCtI7&smid=url-share

    Incidentally, the comments are worth reading. Some half hearted attempts to discredit the article, which the author replies to.

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



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  • Moderators, Science, Health & Environment Moderators Posts: 18,599 Mod ✭✭✭✭CatFromHue


    It's hard to know if it is political pressure or the effect of the Health and Human Services (HHS), the HHS is the US govt's department for healthcare, report published last year on paediatric gender medicine, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which was the US version of the Cass Review. Obviously it came to the same conclusion as Cass but also had sections on Ethics.

    So now there's an official govt report which is undermining all of the medical associations own work. Amazingly as part of it 3 of the associations were asked to, I think, review it and 2 declined. One did but their review was categorically debunked by the authors of the report.

    Post edited by CatFromHue on


  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    For anyone interested, Carl Henegan and Tom Jefferson have an excellent series of posts on their Trust The Evidence Substack regarding Gender medicine. They describe the important factors in doing a follow-up study on GIDS patients i.e. the cohort that Cass found weren't properly followed up.



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    Good interview with Helen Joyce on Newstalk yesterday.

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



  • Moderators, Science, Health & Environment Moderators Posts: 18,599 Mod ✭✭✭✭CatFromHue


    "I could not disagreed more with this guest"

    I'd liked that person who texted in that to say what exactly they disagreed with.



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    And they had Karen Sugrue on to represent the other side of the argument. I heard her a while back debating with Laoise de Brun and sounding completely out of her depth. This interview with Ciara Kelly made me despair for the quality of university lecturers and indeed psychotherapists. She threw out the old chestnuts " they're stopping trans kids playing sports", "they're making trans kids kill themselves", " the Cass Review has been debunked"..... tbf Kelly asked all the right questions.

    The link won't embed for me - just Google Karen Sugrue Newstalk and you should find it easily.



  • Moderators, Science, Health & Environment Moderators Posts: 18,599 Mod ✭✭✭✭CatFromHue


    The "no debate" policy has worked very well for them. The problem is that once you do have to debate things start to fall apart as most of their arguments are emotional and not factual. Evidence based medicine is meant to be based on facts and evidence based medicine puts the person receiving the treatment first.



  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack



    Evidence based medicine is meant to be based on facts and evidence based medicine puts the person receiving the treatment first.

    Well, that’s the theory anyway 😏



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    It's a great practical demonstration of the concept of "garbage in, garbage out"😀. Probably also "alternative facts".



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    That's the inconvenient thing about facts - they don't go away just because you ignore them, and often the delay in dealing with them makes the inevitable day of reckoning all the more difficult.



  • Registered Users, Registered Users 2 Posts: 25,305 ✭✭✭✭One eyed Jack


    In fairness the more practical demonstration, if ever there was one necessary to demonstrate the chasm between theory and practice, was the demonstration by the ‘founder’ of EBM, that the evidence could be made to fit whatever opinions a person was presenting as facts. It’s why he released this statement after it came to light that his opinions could easily be bought and sold, in his case to SEGM for $250k -

    https://hei.healthsci.mcmaster.ca/systematic-reviews-related-to-gender-affirming-care/


    For a lot of these people, integrity doesn’t matter when an opportunity to make a name for themselves presents itself.



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  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    27% persistence and 72% desistance rate after five years among trans identifying females aged 15-19 in Germany, measured between 2017 and 2022

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



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    This is a fantastic piece in the Daily Mail about the new SPHE curriculum here on transgenderism. It also talks to one of five Irish detransitioners who attended an event in the US a couple of weeks ago.

    She says she was failed at every turn — by her school, her medical team, and by Belong To. The organisation, she says, coached young people on what to say to doctors and assessors to get gender reassignment surgery approved. She also raises a safeguarding concern she has never made public before: she has epilepsy, and when she asked Belong To how they would contact her parents if she had a seizure at one of their events, she was told that once she left the building, it was the end of their duty of care. ‘I could have been a Jane Doe lying in a hospital bed at fifteen or sixteen,’ she said. ‘That’s terrifying.’

    After her transition she felt temporary relief — the comfort of moving through the world unquestioned. But practical and legal questions piled up. Nobody could tell her whether she retained the right to access female spaces later in life or to see a female gynaecologist. The HSE has her listed under her male name, which she fears could be dangerous if she ever loses consciousness and needs emergency care. ‘I’m in a complete legal no man’s land,’ she said. ‘And I’m completely on my own with it.’

    She believes that being exposed to gender ideology at school did not ease her distress — it made it worse. In her single-sex school, she could cut her hair short and wear trousers and nobody thought twice about it. When she moved to a mixed school and first encountered the language of transition, the pressure to go further grew. ‘I only ever wanted the double mastectomy originally,’ she said. ‘It was being in that mixed school environment that made me want testosterone as well.’ Her conclusion is one that the Department of Education might usefully sit with: ‘I think I dealt very well with my gender dysphoria until I found gender ideology. I wish I was just able to grow up and see what happens and deal with it.’

    Aside from independent TDs like Carol Nolan, Sean Fleming seems to be one of few party based TDs prepared to speak up. It's a long article that covers a lot (including the video made by former SPHE teacher Mary Creedon).

    Fianna Fáil TD Seán Fleming, who watched Creedon’s video, confirmed he stands by his description of some of the material as a disgrace and said no material of that nature should ever be shown or discussed in schools. Independent TD Carol Nolan went further: ‘The very term gender identity is a highly contested concept that bears no relation to anything but the most subjective understanding of human self-understanding,’ she said. ‘It has been used time and again as an ideological trojan horse within which extreme views on sexual identity and child development are presented as accepted norms. The curriculum absolutely does not represent the wishes of the majority of parents I speak to.’ Her conclusion is blunt: ‘The NCCA and the Department of Education are institutionally captured by gender identity zealots who profess to speak for the majority but who in reality are fringe groups with fringe ideas.

    https://www.dailymail.co.uk/news/article-15686273/lessons-children-learning-trans.html

    I forgot to mention this bit. That the teacher training materials encourages teachers to not tell parents if a child is socially transitioning at school.

    In a training resource produced by the University of Limerick in partnership with TENI, and included in Department-sanctioned SPHE materials, Hannah Foley, TENI’s Family Support and Education Officer, is asked a stark question: do parents need to be told if their child transitions at school?Her answer is strikingly clear. ‘I think in a post-primary school, the only people who need to be told are the students who are going to be in direct contact with the student who’s transitioning,’ she says. ‘No, I don’t think it’s necessary to tell parents, and I certainly don’t think it’s necessary to tell other students in the school who are in other years, who may not even come into contact with students.’

    Post edited by plodder on

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



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    Child safeguarding me arse!

    Just waiting for the pile-on for linking a Daily Mail article😀!



  • Registered Users, Registered Users 2, Paid Member Posts: 2,896 ✭✭✭aero2k


    Apologies, I had meant to respond to this. Is there evidence that he was pressured into finding a particular outcome when SEGM commissioned his review? Or that he succumbed to such pressure?

    The real lack of integrity was in his subsequently signing a document which he apparently hadn't read:



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    They seem to have some good journalists working on the Irish edition. But, yeah that was the only criticism of the piece that I saw on their X post about it.

    "The only people that believe the Daily Mail are those fanatics who agree with whatever drivel it's promoting on any given day." 🙄

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



  • Registered Users, Registered Users 2 Posts: 8,809 ✭✭✭AllForIt


    https://www.dailymail.co.uk/news/article-15686273/lessons-children-learning-trans.html

    Funny, I seem to recall someone on this thread say that all children are being taught is tolerance and respect for different kinds of people, not indoctrination.

    Guess they were dead wrong then weren't they. Honest mistake I'm sure.



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


    "A new curriculum is being taught in EVERY secondary school in Ireland. It tells children that GENDER is not a biological fact but a FEELING. Most parents have never read it. This Mail writer did - and what she discovered may SHOCK you"

    Complete clickbait headline followed by a paywalled article.

    Is there any source on the actual curriculum this is based on, dept of education or similar?



  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder


    I forgot to mention this bit. That the teacher training materials encourages teachers to not tell parents if a child is socially transitioning at school.

    In a training resource produced by the University of Limerick in partnership with TENI, and included in Department-sanctioned SPHE materials, Hannah Foley, TENI’s Family Support and Education Officer, is asked a stark question: do parents need to be told if their child transitions at school?Her answer is strikingly clear. ‘I think in a post-primary school, the only people who need to be told are the students who are going to be in direct contact with the student who’s transitioning,’ she says. ‘No, I don’t think it’s necessary to tell parents, and I certainly don’t think it’s necessary to tell other students in the school who are in other years, who may not even come into contact with students.’

    Full disclosure. I tracked down the video referred to above. At least I think this is it (link below). The question above related to whether parents of other children should be told about a transition. Not the parents of the transitioning child

    https://www.ul.ie/gender-identity-school-resources/section-11

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



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


    UL don't define policy or curriculum though. I'd like to see something official from the relevant departments on what the guidance and teaching philosophy is. The fact that you have to go off to find it yourself (and even then you're not sure), and the actual source is not part of the article, raises concerns. This isn't anything against yourself, moreso the lack of clarity of the article in question.



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  • Registered Users, Registered Users 2, Paid Member Posts: 8,825 ✭✭✭plodder




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