These new rules in the UK have nothing to do with the scientific method. From the article: Doctors prescribe the best available treatment they know of, based on the best available evidence at that...
I do not appreciate the tendency of fellow leftists to reject or downplay the necessity of employing the scientific method when its standard operation happens not to align with their immediate social goals.
These new rules in the UK have nothing to do with the scientific method.
From the article:
As a result, trans children under the age of 16 will now need a clinician to apply to the High Court to be able to access puberty blockers
Doctors prescribe the best available treatment they know of, based on the best available evidence at that time.
I'm not a doctor, and haven't reviewed the medical literature on this topic. But, actual doctors have, and they've decided that puberty blockers are the best available treatment we know of for a class of patients who come in as minors with gender dysphoria. I know this because if it weren't true, there wouldn't be doctors prescribing puberty blockers in the first place.
This is Normal Doctor Stuff. Patients come in, describe their problem, and get (hopefully) a diagnosis and treatment. We have an entire medical establishment, including things like malpractice law, aimed at making sure doctors provide the best medical care we know how to provide. (I was on a jury for a medical malpractice case once and have the phrase standard of care seared into my brain for all eternity)
Why should this one particular treatment be subjected to this ridiculous level of scrutiny, where even if a doctor and patient (and adult parent or caregiver, in this case) all agree on a course of treatment, it requires additional approval from the UK's equivalent of the Supreme fucking Court? (don't they have better things to do, especially right now?)
Is there any other medical treatment that is subjected to the same level of government oversight and red tape?
GIDS says that it is not yet known whether puberty blocker treatment "alters the course of adolescent brain development."
This might never be known with 100% certainty, because you're never going to be able to perform a true randomized controlled trial with N children who receive puberty blockers and N children who receive a placebo, and you follow them for years.
Content Warning: allusions to suicide, childhood cancer Here's the thing - puberty blockers aren't "unproven treatments." We know they work to arrest puberty and give time for kids to make more...
Content Warning: allusions to suicide, childhood cancer
I do not appreciate the tendency of fellow leftists to reject or downplay the necessity of employing the scientific method when its standard operation happens not to align with their immediate social goals. "The safety and efficacy of the coronavirus vaccine is not yet known, and premature adoption may result in unforeseen and unnecessary deaths. Therefore, we should wait until the research period is over instead of rushing a vaccine out to the public." Ok, that sounds reasonable. "The nature of these treatments is not yet known, but there's no need to wait for further research." Sorry, but I don't think that that holds up. Health providers shouldn't be able to offer unproven treatments to children (or anyone) on a mass scale, even if they help address other pressing issues.
Here's the thing - puberty blockers aren't "unproven treatments." We know they work to arrest puberty and give time for kids to make more permanent decisions about whether to medically transition. What we might not know is some of the long term effects, although I am sure it's being studied.
When it comes to medicine, it's not just a matter of what potential side effects a treatment has, but the risk of those versus the risk of bad outcomes if the treatment is withheld. The rate of suicide, suicide attempts, and depression are high in trans kids, particularly when they don't have support. So a lot of the "fellow leftists" probably think similarly as me - we don't reject the scientific method, we just think that the mental health and lives of trans kids outweigh the potential risks. In the same way I'd support a kid with cancer getting chemo if warranted, even if it potentially sterilizes them, I'd rather trans kid have an elevated risk of weaker bones than an elevated risk of death by suicide.
Plus, as @spit-evil-olive-tips says, I trust doctors and researchers who have decided based on research so far that puberty blockers are the best treatment for the moment.
I don’t know anything on this issue, but I think it’s plausible that it’s more complicated than it might seem. Medical issues usually are. However, just for context I’ll point out that big...
I don’t know anything on this issue, but I think it’s plausible that it’s more complicated than it might seem. Medical issues usually are.
However, just for context I’ll point out that big dramatic things are happening to kids all the time, including changes to their bodies that happen without consent. Also, there are many ways that we refuse to accept “natural” changes to our bodies. A very ordinary one is getting braces. People with more health problems get more done, often of necessity.
When I was a kid I got a fair bit of dental work and also wore a back brace to prevent further scoliosis. I still dream about wearing that thing occasionally. I don’t regret it, but I also don’t remember feeling like I had a choice. It seems like when it came to medical issues it was mostly doctor knows best. As far as I can remember I only considered the life choices that people told me I could make, things like thinking about what college I might go to someday. It seems curiously passive and accepting in retrospect, but I didn’t know anything else.
It seems things have changed? People consider doing things I never dreamed of, and do them. There are life decisions being made without knowing all the consequences. How often do we know the consequences, anyway?
I will say that, when there is a scientific study that shows that X changes the brain in an unclear way, I have to ask, doesn’t everything?
But this is all surface-level discussion of priors, not based on any actual knowledge.
Just to let you know but "We have reasonable concerns" is often (as here) used to introduce hate speech. That's because a lot of the discussion from people opposed to internationally agreed...
Just to let you know but "We have reasonable concerns" is often (as here) used to introduce hate speech.
Ultimately, based on the very surface-level discussions of this ruling I see in many places on the internet, I question whether some activists are truly engaging with the issues here to the extent that they should be.
That's because a lot of the discussion from people opposed to internationally agreed medical treatment for gender incongruent children is at the same level as "Jews run the media". It's hateful, and it deserves contempt, no matter how many polite words are used to introduce it into the conversation.
The UK's descent into institutional transphobia been so horrible to watch; it's so upsetting to think of the kids who are being harmed by this court ruling.
The UK's descent into institutional transphobia been so horrible to watch; it's so upsetting to think of the kids who are being harmed by this court ruling.
Yes. It's absolutely rampant here. Transphobia is a completely normalised, main-stream opinion. It's openly platformed by major news organisations like the BBC, the Guardian, the Observer, The...
Yes. It's absolutely rampant here. Transphobia is a completely normalised, main-stream opinion. It's openly platformed by major news organisations like the BBC, the Guardian, the Observer, The Economist. etc. And that's ignoring the shit-tier rags like Daily Mail, Telegraph, The Times, or The Spectator where we'd expect this garbage.
The main political parties all have senior people who take openly transphobic positions, often quoting TERF idiotic talking points.
Registered healthcare professionals feel safe in being transphobic, and I don't think the registration bodies would do anything about it.
So in cases of major news orgs, is that simply a reflection of who holds political power at the moment, or a reflection of the populace's stance on Transgendered people?
So in cases of major news orgs, is that simply a reflection of who holds political power at the moment, or a reflection of the populace's stance on Transgendered people?
I think most people don't care about trans people. They don't know much and they seem to be broadly supportive. But then transphobes constantly lie (eg, talking about children being sterilised,...
I think most people don't care about trans people. They don't know much and they seem to be broadly supportive. But then transphobes constantly lie (eg, talking about children being sterilised, when children in the UK cannot access cross-sex hormones nor surgery) and the misinformation is having effects in the general population.
But I can't emphasise enough how transphobic major media organisations are. BBC recently ran an article about transpeople and included comments from the LGBAlliance, a tiny group specifically set up to campaign against trans-rights. BBC did this in the name of "balance". They were criticised by the boss of OFCOM for doing so, which is pretty remarkable.
I'm submitting this because it's interesting and somewhat depressing to see just how far back the UK is slipping, but also because the BBC is institutionally transphobic and this article (one of...
I'm submitting this because it's interesting and somewhat depressing to see just how far back the UK is slipping, but also because the BBC is institutionally transphobic and this article (one of the very few positive articles) is being buried by the BBC.
Can confirm: like the author of the tweets, I went looking for the article and couldn’t find it on the site — not as a featured story nor as a chronological entry under the education section.
Can confirm: like the author of the tweets, I went looking for the article and couldn’t find it on the site — not as a featured story nor as a chronological entry under the education section.
How much of this is due to the need for consistency (or reform) in terms of recognizing age of majority? I can't speak to British laws, but if this were to be a US ruling, for example, there would...
How much of this is due to the need for consistency (or reform) in terms of recognizing age of majority? I can't speak to British laws, but if this were to be a US ruling, for example, there would have to be comparisons made with if/how youths under 16 are deemed competent to consent to sex, tried as an adult for certain crimes, obtain birth control without parental approval, etc. I'm largely speaking from a position of ignorance when it comes to trans issues, but I can imagine that teens who feel gender dysphoria have likely done much more self-reflection than their peers. Still, even as someone who was much more self-aware at a young age than surrounding adults gave me credit for, I'd be hesitant to advocate that teens under 16 can generally be expected to give informed consent for something as cosmetic as a piercing or a tattoo, so I'm finding myself sympathetic to the requirement for a clinician's recommendation (assuming easy and equitable access to such expertise, of course).
Needing a doctor's prescription was, AFAIK, already the case in the UK, before this new ruling came into effect. The new standard seems to be that even if a doctor, parent, and child all agree on...
I'm finding myself sympathetic to the requirement for a clinician's recommendation (assuming easy and equitable access to such expertise, of course).
Needing a doctor's prescription was, AFAIK, already the case in the UK, before this new ruling came into effect.
The new standard seems to be that even if a doctor, parent, and child all agree on the child taking puberty blockers, the doctor needs to get court approval. From the article:
As a result, trans children under the age of 16 will now need a clinician to apply to the High Court to be able to access puberty blockers
Reminds me of TRAP laws in the US aimed at making access to abortion difficult or impossible.
Also important to note is that these are puberty blockers and not hormones (such as testosterone) that an adult transgender person might take as part of their gender-affirming treatment. Far from being a decision that parents & children rush into, delaying puberty gives the child more time to think about their gender identity and presentation.
If a child "grows out" of being trans (which is the horror story that seems to be lurking behind all these restrictions) they simply stop taking the puberty blockers and continue growing up cisgender.
That makes sense; my comprehension skills failed me. I still am curious about the age of informed consent bit, but maybe it isn't as relevant as I wondered.
That makes sense; my comprehension skills failed me. I still am curious about the age of informed consent bit, but maybe it isn't as relevant as I wondered.
The situation about consent to treatment in England, before this court case: If you are 18 or older you can consent to have any treatment. You can decline to have any treatment, unless you lack...
The situation about consent to treatment in England, before this court case:
If you are 18 or older you can consent to have any treatment. You can decline to have any treatment, unless you lack the capacity to make that decision. You are allowed to make unwise choices -- you're allowed to turn down medical treatment that would save your life.
If you are 16 or 17 years old the situation is almost the same, except you're not allowed to decline life-saving medical treatment. That decision will go in front of the courts who'll decide. (But as soon as you're 18 you can make this decision for yourself. This means we sometimes have Jehova's Witness children who refuse blood transfusions. The courts say they must have them. Then a year or so later the child turns 18 and refuses the treatment and dies.)
If you are 15 years old or younger doctors will see if you're "Gillick Competent". This is a test to see if you can understand and weigh up the implications of getting treatment. If you are you can make your own decisions, although it'll be hard for you to decline life saving treatment.
This means that children can make their own decisions, without parental involvement, across a wide range of healthcare, and some of those decisions will have serious, severe, life-long consequences.
Tavistock & Portman went further.
The child had to show that they were Gillick competent. The child had to agree to the treatment. And also the parent had to consent too. And then two independent medical teams (gender and endo) had to agree that this was the best course.
These new rules in the UK have nothing to do with the scientific method.
From the article:
Doctors prescribe the best available treatment they know of, based on the best available evidence at that time.
I'm not a doctor, and haven't reviewed the medical literature on this topic. But, actual doctors have, and they've decided that puberty blockers are the best available treatment we know of for a class of patients who come in as minors with gender dysphoria. I know this because if it weren't true, there wouldn't be doctors prescribing puberty blockers in the first place.
This is Normal Doctor Stuff. Patients come in, describe their problem, and get (hopefully) a diagnosis and treatment. We have an entire medical establishment, including things like malpractice law, aimed at making sure doctors provide the best medical care we know how to provide. (I was on a jury for a medical malpractice case once and have the phrase standard of care seared into my brain for all eternity)
Why should this one particular treatment be subjected to this ridiculous level of scrutiny, where even if a doctor and patient (and adult parent or caregiver, in this case) all agree on a course of treatment, it requires additional approval from the UK's equivalent of the Supreme fucking Court? (don't they have better things to do, especially right now?)
Is there any other medical treatment that is subjected to the same level of government oversight and red tape?
This might never be known with 100% certainty, because you're never going to be able to perform a true randomized controlled trial with N children who receive puberty blockers and N children who receive a placebo, and you follow them for years.
Despite decades of research, we don't fully understand exactly how antidepressants work either. That doesn't stop doctors from prescribing them when they believe it's necessary.
Content Warning: allusions to suicide, childhood cancer
Here's the thing - puberty blockers aren't "unproven treatments." We know they work to arrest puberty and give time for kids to make more permanent decisions about whether to medically transition. What we might not know is some of the long term effects, although I am sure it's being studied.
When it comes to medicine, it's not just a matter of what potential side effects a treatment has, but the risk of those versus the risk of bad outcomes if the treatment is withheld. The rate of suicide, suicide attempts, and depression are high in trans kids, particularly when they don't have support. So a lot of the "fellow leftists" probably think similarly as me - we don't reject the scientific method, we just think that the mental health and lives of trans kids outweigh the potential risks. In the same way I'd support a kid with cancer getting chemo if warranted, even if it potentially sterilizes them, I'd rather trans kid have an elevated risk of weaker bones than an elevated risk of death by suicide.
Plus, as @spit-evil-olive-tips says, I trust doctors and researchers who have decided based on research so far that puberty blockers are the best treatment for the moment.
I don’t know anything on this issue, but I think it’s plausible that it’s more complicated than it might seem. Medical issues usually are.
However, just for context I’ll point out that big dramatic things are happening to kids all the time, including changes to their bodies that happen without consent. Also, there are many ways that we refuse to accept “natural” changes to our bodies. A very ordinary one is getting braces. People with more health problems get more done, often of necessity.
When I was a kid I got a fair bit of dental work and also wore a back brace to prevent further scoliosis. I still dream about wearing that thing occasionally. I don’t regret it, but I also don’t remember feeling like I had a choice. It seems like when it came to medical issues it was mostly doctor knows best. As far as I can remember I only considered the life choices that people told me I could make, things like thinking about what college I might go to someday. It seems curiously passive and accepting in retrospect, but I didn’t know anything else.
It seems things have changed? People consider doing things I never dreamed of, and do them. There are life decisions being made without knowing all the consequences. How often do we know the consequences, anyway?
I will say that, when there is a scientific study that shows that X changes the brain in an unclear way, I have to ask, doesn’t everything?
But this is all surface-level discussion of priors, not based on any actual knowledge.
Just to let you know but "We have reasonable concerns" is often (as here) used to introduce hate speech.
That's because a lot of the discussion from people opposed to internationally agreed medical treatment for gender incongruent children is at the same level as "Jews run the media". It's hateful, and it deserves contempt, no matter how many polite words are used to introduce it into the conversation.
The UK's descent into institutional transphobia been so horrible to watch; it's so upsetting to think of the kids who are being harmed by this court ruling.
Yes. It's absolutely rampant here. Transphobia is a completely normalised, main-stream opinion. It's openly platformed by major news organisations like the BBC, the Guardian, the Observer, The Economist. etc. And that's ignoring the shit-tier rags like Daily Mail, Telegraph, The Times, or The Spectator where we'd expect this garbage.
The main political parties all have senior people who take openly transphobic positions, often quoting TERF idiotic talking points.
Registered healthcare professionals feel safe in being transphobic, and I don't think the registration bodies would do anything about it.
It's all profoundly depressing.
So in cases of major news orgs, is that simply a reflection of who holds political power at the moment, or a reflection of the populace's stance on Transgendered people?
I think most people don't care about trans people. They don't know much and they seem to be broadly supportive. But then transphobes constantly lie (eg, talking about children being sterilised, when children in the UK cannot access cross-sex hormones nor surgery) and the misinformation is having effects in the general population.
But I can't emphasise enough how transphobic major media organisations are. BBC recently ran an article about transpeople and included comments from the LGBAlliance, a tiny group specifically set up to campaign against trans-rights. BBC did this in the name of "balance". They were criticised by the boss of OFCOM for doing so, which is pretty remarkable.
I don’t have much to add except for this article from 2019.
@DanBC
@tindall
I'm submitting this because it's interesting and somewhat depressing to see just how far back the UK is slipping, but also because the BBC is institutionally transphobic and this article (one of the very few positive articles) is being buried by the BBC.
https://twitter.com/sineadactually/status/1341471547438055433
Can confirm: like the author of the tweets, I went looking for the article and couldn’t find it on the site — not as a featured story nor as a chronological entry under the education section.
How much of this is due to the need for consistency (or reform) in terms of recognizing age of majority? I can't speak to British laws, but if this were to be a US ruling, for example, there would have to be comparisons made with if/how youths under 16 are deemed competent to consent to sex, tried as an adult for certain crimes, obtain birth control without parental approval, etc. I'm largely speaking from a position of ignorance when it comes to trans issues, but I can imagine that teens who feel gender dysphoria have likely done much more self-reflection than their peers. Still, even as someone who was much more self-aware at a young age than surrounding adults gave me credit for, I'd be hesitant to advocate that teens under 16 can generally be expected to give informed consent for something as cosmetic as a piercing or a tattoo, so I'm finding myself sympathetic to the requirement for a clinician's recommendation (assuming easy and equitable access to such expertise, of course).
Needing a doctor's prescription was, AFAIK, already the case in the UK, before this new ruling came into effect.
The new standard seems to be that even if a doctor, parent, and child all agree on the child taking puberty blockers, the doctor needs to get court approval. From the article:
Reminds me of TRAP laws in the US aimed at making access to abortion difficult or impossible.
Also important to note is that these are puberty blockers and not hormones (such as testosterone) that an adult transgender person might take as part of their gender-affirming treatment. Far from being a decision that parents & children rush into, delaying puberty gives the child more time to think about their gender identity and presentation.
If a child "grows out" of being trans (which is the horror story that seems to be lurking behind all these restrictions) they simply stop taking the puberty blockers and continue growing up cisgender.
That makes sense; my comprehension skills failed me. I still am curious about the age of informed consent bit, but maybe it isn't as relevant as I wondered.
The situation about consent to treatment in England, before this court case:
If you are 18 or older you can consent to have any treatment. You can decline to have any treatment, unless you lack the capacity to make that decision. You are allowed to make unwise choices -- you're allowed to turn down medical treatment that would save your life.
If you are 16 or 17 years old the situation is almost the same, except you're not allowed to decline life-saving medical treatment. That decision will go in front of the courts who'll decide. (But as soon as you're 18 you can make this decision for yourself. This means we sometimes have Jehova's Witness children who refuse blood transfusions. The courts say they must have them. Then a year or so later the child turns 18 and refuses the treatment and dies.)
If you are 15 years old or younger doctors will see if you're "Gillick Competent". This is a test to see if you can understand and weigh up the implications of getting treatment. If you are you can make your own decisions, although it'll be hard for you to decline life saving treatment.
This means that children can make their own decisions, without parental involvement, across a wide range of healthcare, and some of those decisions will have serious, severe, life-long consequences.
Tavistock & Portman went further.
The child had to show that they were Gillick competent. The child had to agree to the treatment. And also the parent had to consent too. And then two independent medical teams (gender and endo) had to agree that this was the best course.