NYT contributors blast paper’s coverage of transgender people

[homersapien 12,262]

On 3/6/2023 at 10:49 PM, TexasTiger said:

And medical folks who objectively look at those overly broad claims find the evidence doesn’t support those statements. The biggest problem is we are being failed by the medical & mental health professions & our political bodies. Both sides take too strong & unyielding of positions not warranted by what is precious little data given the stakes.

That's just your opinion.  I vigorously disagree.

This issue has become a politicized "culture war" issue by the right wing.

Here's who's behind the GOP assault on transgender rights (americanindependent.com)

Inside the Secret Working Group That Helped Push Anti-Trans Laws Across the Country – Mother Jones

Far-Right Groups Flood State Legislatures With Anti-Trans Bills Targeting Children | Southern Poverty Law Center (splcenter.org)

The Narrative on Trans Rights Is Being Shaped by Right-Wing Media | Teen Vogue

Current legislation in various states simply reflect the politicization of this.  State legislators have no business legislating medical matters of which they are so ignorant. 

Leave it to the professionals and the parents/caretakers of those afflicted.

 

Edited March 8, 2023 by homersapien

[TexasTiger 14,364]

43 minutes ago, homersapien said:

That's just your opinion.  I vigorously disagree.

This issue has become a politicized "culture war" issue by the right wing.

Here's who's behind the GOP assault on transgender rights (americanindependent.com)

Inside the Secret Working Group That Helped Push Anti-Trans Laws Across the Country – Mother Jones

Far-Right Groups Flood State Legislatures With Anti-Trans Bills Targeting Children | Southern Poverty Law Center (splcenter.org)

The Narrative on Trans Rights Is Being Shaped by Right-Wing Media | Teen Vogue

Current legislation in various states simply reflect the politicization of this.  State legislators have no business legislating such matters of which they are so ignorant. 

Leave it to the professionals and the parents/caretakers of those afflicted.

 

Actually, it’s not just my opinion. I’ve linked to numerous accounts, including just above, where the folks overseeing the “Dutch model” saying it’s a mistake to blindly rely on their results. You ignore everything I provide. You’re as caught up in this battle with the far right as they are on this issue. Neither you nor they seem capable of objectively looking at data. I’ve provided you evidence of the medical establishments of progressive western countries indicating they need to tap the brakes and get better data. I can provide you solid evidence all day long and it would bounce off you like bullets bounce of Superman. 

The legislation goes predictably overboard. Proponents of medicalizing children go predictably overboard. Bigots v. Zealots.

[homersapien 12,262]

8 minutes ago, TexasTiger said:

Actually, it’s not just my opinion. I’ve linked to numerous accounts, including just above, where the folks overseeing the “Dutch model” saying it’s a mistake to blindly rely on their results. You ignore everything I provide. You’re as caught up in this battle with the far right as they are on this issue. Neither you nor they seem capable of objectively looking at data. I’ve provided you evidence of the medical establishments of progressive western countries indicating they need to tap the brakes and get better data. I can provide you solid evidence all day long and it would bounce off you like bullets bounce of Superman. 

The legislation goes predictably overboard. Proponents of medicalizing children go predictably overboard. Bigots v. Zealots.

The only thing that's close to accurate in that is the last sentence.

And I am not on the side of ether the "bigots" or the "zealots".  I am on the side of the science - medical and psychiatric - as revealed by validated data on outcomes.  I resent you trying to align me with one arbitrarily defined political side or the other as you are clearly doing above. 

Finally, you seem to think that "evidence of the medical establishments of progressive western countries indicating they need to tap the brakes and get better data" somehow validates your position over mine, which is not the case.  In fact, it's just the opposite, it validates my position.  This is not - or shouldn't be - a political issue it's a medical/psychiatric issue. 

Keep the politicians out of it. 

As for data, I don't recall seeing it.  All I have seen is anecdotal rhetoric.  If you are aware of statistical data on outcomes vs. treatment protocols, please provide the link.

Frankly, I am not really sure what your position or point actually is.  I sounds like you support more political initiatives to regulate medical and psychiatric practices or norms in these cases.  If so, I disagree. 

Or maybe you are just emoting your personal feelings?

 

 

[TexasTiger 14,364]

1 hour ago, homersapien said:

The only thing that's close to accurate in that is the last sentence.

And I am not on the side of ether the "bigots" or the "zealots".  I am on the side of the science - medical and psychiatric - as revealed by validated data on outcomes.  I resent you trying to align me with one arbitrarily defined political side or the other as you are clearly doing above. 

Finally, you seem to think that "evidence of the medical establishments of progressive western countries indicating they need to tap the brakes and get better data" somehow validates your position over mine, which is not the case.  In fact, it's just the opposite, it validates my position.  This is not - or shouldn't be - a political issue it's a medical/psychiatric issue. 

Keep the politicians out of it. 

As for data, I don't recall seeing it.  All I have seen is anecdotal rhetoric.  If you are aware of statistical data on outcomes vs. treatment protocols, please provide the link.

Frankly, I am not really sure what your position or point actually is.  I sounds like you support more political initiatives to regulate medical and psychiatric practices or norms in these cases.  If so, I disagree. 

Or maybe you are just emoting your personal feelings?

 

 

For whatever reason, we are not communicating effectively. I’ll say this— zealots are loudly proclaiming the science is settled and anyone even questioning that claim is called transphobic. Most so-called, self-styled progressives are taking those claims at face value with little meaningful research beyond quickly finding what supports their position and see themselves as being in opposition to the far right. The far right primarily sees this as culture war issue to exploit and position Democrats as defenders of the worst excesses. They propose over the top legislation while mostly not giving a damn about the human beings involved. This is a complex issue for which the public debate almost totally lacks any nuance.

The medical establishment in this country has largely either been cowed into going along so as not be labeled transphobic or assuming without insufficient inquiry that the science is, in fact, settled and also see taking the opposite position of the bigoted right as the best position to be. Most have little reason to look more deeply. They refer out to someone in this growing industry with a financial interest in it, like this awful human:

https://www.dailymail.co.uk/news/article-11303919/Florida-sex-change-surgeon-dubs-Dr-Teetus-Deletus-REPORTED-consumer-watchdog.html

Let medical experts decide? Sure. But the American medical industry is less about health & well being than money these days and our grossly polarized politics doesn’t help. I’ve followed this issue in European countries where increasingly lately the medical establishments are realizing the practice is ahead of the data. On the other hand, in Iran transgender surgery is huge. That’s how they deal with gays & lesbians.

https://www.economist.com/middle-east-and-africa/2019/04/04/why-iran-is-a-hub-for-sex-reassignment-surgery

Many gays & lesbians in western countries are concerned that the rush to medicalize young people who may be gay, but with qualities often stereotypically associated with the other sex, is happening in the west. 
 

This issue has exploded over the last few years. Anyone thinking the science is settled is a fool.

[DKW 86 7,914]

 

[AURex 2,262]

On 3/6/2023 at 11:18 PM, TexasTiger said:

Shouldn’t you demand hard scientific data showing strong evidence of no harm before puberty blockers are assigned off-label, HRT (which carries significant risk for any person at any age) and removing healthy organs & body parts from minors?  How did this norm get reversed for this one area? You have it backwards. 
 

 

 

No, you have it backwards. These are decisions being made between patients, parents, and their doctors. There is no reason why they should have to justify themselves to some right wing politician who is completely uneducated in any field related to medicine, psychiatry, psychology, biology, human sciences, or social justice. (And I'm betting that includes you.) Just as with abortion, it is another instance of right wing politicians coercing citizens, taking away the natural rights of the people to enforce some state-fabricated justification for destroying individual rights in the name of some holier-than-thou Nazified talking points. As an Individualist Libertarian, I submit that it is YOU who must offer some actual scientific research justifying your *political* oppression of U.S. citizens.

 

[TexasTiger 14,364]

29 minutes ago, AURex said:

No, you have it backwards. These are decisions being made between patients, parents, and their doctors. There is no reason why they should have to justify themselves to some right wing politician who is completely uneducated in any field related to medicine, psychiatry, psychology, biology, human sciences, or social justice. (And I'm betting that includes you.) Just as with abortion, it is another instance of right wing politicians coercing citizens, taking away the natural rights of the people to enforce some state-fabricated justification for destroying individual rights in the name of some holier-than-thou Nazified talking points. As an Individualist Libertarian, I submit that it is YOU who must offer some actual scientific research justifying your *political* oppression of U.S. citizens.

 

You are so enmeshed in arguing a certain point you aren’t even responding to me. You’re a great illustration of how political polarization impedes the rational discussion of a complex issue. You responded to a simple straightforward statement and demanded data on why NOT to engage in  a course of unalterable  medical intervention.

I pointed out that in medicine one typically requires strong evidence PRIOR to extreme experimental treatments— especially experimental treatment not clearly labeled as such.

Nonetheless, I took the time to give you scientific data. It was a waste of time. You were being rhetorical. You weren’t really interested in data or science. I doubt you bothered to read it. You proved my point. Instead, you are somehow under the strange delusion that I’m engaging in “political oppression of US citizens.” Any evidence of that? Oh, you don’t need it. What a psycho rant.

I’ve never indicated support for this legislation, here or anywhere else. I’ve even said it’s extreme and driven by bigots. Get some help. You’ve lost it.

BTW, you would lose your bet. Just like you’ve lost your damn mind.

 

[AURex 2,262]

1 hour ago, TexasTiger said:

You are so enmeshed in arguing a certain point you aren’t even responding to me. You’re a great illustration of how political polarization impedes the rational discussion of a complex issue. You responded to a simple straightforward statement and demanded data on why NOT to engage in  a course of unalterable  medical intervention.

I pointed out that in medicine one typically requires strong evidence PRIOR to extreme experimental treatments— especially experimental treatment not clearly labeled as such.

Nonetheless, I took the time to give you scientific data. It was a waste of time. You were being rhetorical. You weren’t really interested in data or science. I doubt you bothered to read it. You proved my point. Instead, you are somehow under the strange delusion that I’m engaging in “political oppression of US citizens.” Any evidence of that? Oh, you don’t need it. What a psycho rant.

I’ve never indicated support for this legislation, here or anywhere else. I’ve even said it’s extreme and driven by bigots. Get some help. You’ve lost it.

BTW, you would lose your bet. Just like you’ve lost your damn mind.

 

Fact -- this is an issue between doctors and patients/families. Politicians are not health professionals and their intrusion into the healthcare decision-making of Americans violates health professional and patient boundaries.

Fact -- there is no scientific evidence that gender-affirming care damages the patient in the short term or the long term. In fact, most research indicates that those who received treatment years ago remain glad that they did and are living happy lives.

Fact -- It is not "experimental" treatment any more than breast augmentation, jawline procedures, facelift procedures, liposuction, leg-lengthening, hair implants, etc. These procedures have been going on for many years. Suddenly, it is a right wing political issue needing to be condemned and eradicated.

Fact -- you did not provide scientific data. You provided right wing talking points. There is real scientific research. It does not support the conservative march to vilify segments of our citizenry.

Finally -- You have ZERO evidence to assert that I've lost my mind. Like most conservatives, when you can't deal with facts, launch personal attacks.

 

 

Edited March 9, 2023 by AURex

[TexasTiger 14,364]

1 hour ago, AURex said:

Fact -- this is an issue between doctors and patients/families. Politicians are not health professionals and their intrusion into the healthcare decision-making of Americans violates health professional and patient boundaries.

Fact -- there is no scientific evidence that gender-affirming care damages the patient in the short term or the long term. In fact, most research indicates that those who received treatment years ago remain glad that they did and are living happy lives.

Fact -- It is not "experimental" treatment any more than breast augmentation, jawline procedures, facelift procedures, liposuction, leg-lengthening, hair implants, etc. These procedures have been going on for many years. Suddenly, it is a right wing political issue needing to be condemned and eradicated.

Fact -- you did not provide scientific data. You provided right wing talking points. There is real scientific research. It does not support the conservative march to vilify segments of our citizenry.

Finally -- You have ZERO evidence to assert that I've lost my mind. Like most conservatives, when you can't deal with facts, launch personal attacks.

 

 

I’m not a conservative. You, however, are a highly irrational moron who baselessly attacked me as “oppressing US citizens.”

Fact- you don’t know what “facts” are.

I’m actually pretty libertarian when it comes to adults. Live as you like. But outcomes are not nearly so simple as you claim, even for adults. And the jury is certainly out on this recent huge increase in minors receiving these treatments. If you’d read what I’ve posted, you’d realize experts in this field who support transitioning for some minors share that view.

Although it will mean nothing to you, for any open minded folks who may read this, more info.

“Meanwhile, physicians treating children and adolescents with gender dysphoria in Sweden, which did conduct a systematic review, are told by their National Board of Health and Welfare that “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and . . . the treatments should be offered only in exceptional cases.” It recommends mental health support and exploratory psychological care as the first line of treatment for gender dysphoria in youth and states that hormonal interventions “should be restricted to research settings.” 

Across the border in Finland, which also conducted a systematic review, physicians are told by the Council for Choices in Healthcare that psychosocial support is the first-line treatment for adolescent gender dysphoria, along with exploratory therapy and treatment for psychiatric comorbidities. Finland considers the medical transition of minors to be an experimental practice and claims that no medical treatment can be considered evidence based.

In England in 2020, the National Health Service commissioned independent, systematic reviews of the evidence for clinical benefit of prescribing puberty blockers and cross-sex hormones to gender dysphoric youth. The reviews found that studies showing positive correlations between these interventions and improvements in mental health, quality of life, and gender dysphoria were “not deemed strong enough to form the basis of a policy position.”  Last month,  the National Health Service issued a draft guidance that restricts puberty blockers to research settings. Echoing Sweden and Finland, NHS-England now concludes, “The primary intervention for children and young people who are assessed as suitable for The Service is psychosocial (including psychoeducation) and psychological support and intervention.”

Given the vulnerability of youths with gender dysphoria, inconsistencies in clinical guidance for treating these patients are both ethically concerning and medically consequential. A patient in Sweden, Finland, or England will receive blockers or cross-sex hormones only in exceptional circumstances, while  some clinics in the U.S. will prescribe them after a single meeting. This discrepancy in clinical approach cannot be explained by national cultural differences in attitudes toward LGBT+ people; research shows that Sweden, Finland, and the Great Britain all rank higher than the U.S. for acceptance of sexual and gender minorities.”

https://www.thehastingscenter.org/pediatric-gender-care-the-cure-for-politicized-medicine-is-evidence-based-medicine/

These countries allow such treatment for minors in exceptional circumstances. If our medical establishment was similarly driven by data, the US would be similar and it would be far less of a political issue.

Adults:

Results

The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.

Conclusions

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

 

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885Hi 

[homersapien 12,262]

19 hours ago, TexasTiger said:

For whatever reason, we are not communicating effectively. I’ll say this— zealots are loudly proclaiming the science is settled and anyone even questioning that claim is called transphobic.  Most so-called, self-styled progressives are taking those claims at face value with little meaningful research beyond quickly finding what supports their position and see themselves as being in opposition to the far right. The far right primarily sees this as culture war issue to exploit and position Democrats as defenders of the worst excesses. They propose over the top legislation while mostly not giving a damn about the human beings involved. This is a complex issue for which the public debate almost totally lacks any nuance.

The medical establishment in this country has largely either been cowed into going along so as not be labeled transphobic or assuming without insufficient inquiry that the science is, in fact, settled and also see taking the opposite position of the bigoted right as the best position to be. Most have little reason to look more deeply. They refer out to someone in this growing industry with a financial interest in it, like this awful human:

https://www.dailymail.co.uk/news/article-11303919/Florida-sex-change-surgeon-dubs-Dr-Teetus-Deletus-REPORTED-consumer-watchdog.html

Let medical experts decide? Sure. But the American medical industry is less about health & well being than money these days and our grossly polarized politics doesn’t help. I’ve followed this issue in European countries where increasingly lately the medical establishments are realizing the practice is ahead of the data. On the other hand, in Iran transgender surgery is huge. That’s how they deal with gays & lesbians.

https://www.economist.com/middle-east-and-africa/2019/04/04/why-iran-is-a-hub-for-sex-reassignment-surgery

Many gays & lesbians in western countries are concerned that the rush to medicalize young people who may be gay, but with qualities often stereotypically associated with the other sex, is happening in the west. 
 

This issue has exploded over the last few years. Anyone thinking the science is settled is a fool.

Some of your opinions may or may not be true, but only one side in this debate is enacting legislation that will effectively take the matter out of the hands of the medical and psychiatric professionals. 

Apparently, they think the science is settled - or at least believe they know better than the professionals who are actually responsible for setting standards of treatment for gender dysphoria.

Edited March 9, 2023 by homersapien

[TexasTiger 14,364]

1 minute ago, homersapien said:

That may or may not

 

Some of your opinions may or may not be true but only one side in this debate is enacting legislation that will effectively take the matter out of the hands of the medical and psychiatric professionals. 

Apparently, they think the science is settled as well, or at least they know better than the professionals who are actually responsible for setting standards of treatment.

And I’m saying the 2 broadly recognized sides of this debate are both misguided and unyielding. I don’t support any of this legislation. Now, if there was carefully crafted legislation that aligned with the current medical expertise in Sweden, Norway & the UK gleaned from meaningful scientific reviews which assured adequate safeguards, but allowed exceptions under certain circumstances— closer to the actual original Dutch model and practice years ago, I might support that.

[TitanTiger 21,342]

7 minutes ago, homersapien said:

Some of your opinions may or may not be true, but only one side in this debate is enacting legislation that will effectively take the matter out of the hands of the medical and psychiatric professionals. 

Apparently, they think the science is settled - or at least believe they know better than the professionals who are actually responsible for setting standards of treatment for gender dysphoria.

When a business or industry cannot demonstrate an ability to police itself and do what is right on its own, the government often has to step in and put in guard rails, pump the brakes, regulate and so on.  As Tex said, at least in the US the so-called science on the matter seems more led around by the nose by political considerations and social movements than actual, hard, verifiable, measurable science.  That's one issue when it's a full grown, consenting adult of sound mind making such decisions only for themselves.  It's entirely another issue when such decisions are being made by or for minor children.

[homersapien 12,262]

35 minutes ago, TitanTiger said:

When a business or industry cannot demonstrate an ability to police itself and do what is right on its own, the government often has to step in and put in guard rails, pump the brakes, regulate and so on.  As Tex said, at least in the US the so-called science on the matter seems more led around by the nose by political considerations and social movements than actual, hard, verifiable, measurable science.  That's one issue when it's a full grown, consenting adult of sound mind making such decisions only for themselves.  It's entirely another issue when such decisions are being made by or for minor children.

I don't accept the premise that the "industry" in this case has demonstrated an inability to "police" itself.

I'd like to see more data - and other input - from the relevant medical and psychiatric fields before reaching a conclusion.

One or two cases of possible abuse are insufficient.  That's anecdotal evidence, not data.

[TitanTiger 21,342]

36 minutes ago, homersapien said:

I don't accept the premise that the "industry" in this case has demonstrated an inability to "police" itself.

I'd like to see more data - and other input - from the relevant medical and psychiatric fields before reaching a conclusion.

One or two cases of possible abuse are insufficient.  That's anecdotal evidence, not data.

Tex has cited the recent pull back in various Scandanavian countries on this - in terms of how they are treating children - and I hardly think these are bastions of conservatism and hyperventilating over "one or two" cases.

There is also the difficulty in the present cultural climate surrounding gender identity of discussing the matter at all unless you are fully all-in on the side of full affirmation and medical interventions.  The debate doesn't even get to be a serious debate before people are being shouted down, protested and cowed into silence for even questioning it.

I think my problem with the position you seem to be taking is that you've accepted the status quo of the most fervent supporters of these treatments and pharmacological interventions as the default by which everything else gets skeptically measured rather than a position of caution before intervening.

[homersapien 12,262]

2 hours ago, TitanTiger said:

Tex has cited the recent pull back in various Scandanavian countries on this - in terms of how they are treating children - and I hardly think these are bastions of conservatism and hyperventilating over "one or two" cases.

There is also the difficulty in the present cultural climate surrounding gender identity of discussing the matter at all unless you are fully all-in on the side of full affirmation and medical interventions.  The debate doesn't even get to be a serious debate before people are being shouted down, protested and cowed into silence for even questioning it.

I think my problem with the position you seem to be taking is that you've accepted the status quo of the most fervent supporters of these treatments and pharmacological interventions as the default by which everything else gets skeptically measured rather than a position of caution before intervening.

Who are these "most fervent supporters" you speak of? 

What is their association with professional psychiatric organizations?  Are they all practicing professionals in the field?  What are the scientific publications they cite supporting their positions?  Do you include the American Psychiatric Association as a "fervent supporter"?

Personally, I have seen nothing from qualified organizations (hospitals) or professional associations other than outlining treatment options that are first based on thorough individual diagnosis/counseling and are tailored to each individual case.  Obviously, parents or caretakers play a central role in that entire process.

I haven't seen any sort of generalized recommendations.

As a matter of fact, from my (limited) research into the matter, the recommendations of American hospital and psychiatric associations pretty much mirror the policies outlined in "Key Recommendations from the Swedish National Board of Health and Welfare":

Summary of Key Recommendations from the Swedish National Board of Health and Welfare (Socialstyrelsen/NBHW) | SEGM

(Just to be clear, I think those are good standards.)  But my point is we can go through those finding one by one and as far as I can determine, they are pretty much the same standards of treatment followed by American associations.  

Look at the information I cited earlier from the Mayo clinic.  They pretty much parallel the recommendations outlined in the above paper.

Bottom line, until someone can show me some evidence demonstrating the psychiatric/medical practices for gender dysphoria in the U.S. differ markedly from the Swedish revised recommendations referenced above, then I don't accept they do. 

There seems to be an assumption among the political activists that dysphoric children in this country are being inappropriately or prematurely subjected to pharmacological or surgical treatment without first being screened and treated with less intrusive treatments first.  I have no reason (data) to think that is the case, at least systemically.  

Now is it possible for a given patient to be given hormones (for example) prematurely?  Of course.  Medical mistakes happen, all too often. Not all doctors are the same.

I just have no reason to assume that such inappropriate or premature treatment is happening on a systemic basis, which is the only reason legislatures should feel a need to intervene.

This is a personal medical problem that needs to be addressed by the patient, their parents/caretakers and appropriate professionals in the field. This is not a political issue, it's a medical one.  The last thing we need is for state legislatures to get involved.    

 

 

Edited March 9, 2023 by homersapien

[homersapien 12,262]

Here's a piece discussing the most recent update of DSM-5 ("official guideline" for psychiatric diagnosis and treatment) for gender dysphoria in this country:

Gender Dysphoria in the DSM-5: The Change in Terminology (hli.org)

Other relevant references:

Table 2. [DSM-5 Criteria for Gender Dysphoria ()]. - Endotext - NCBI Bookshelf (nih.gov)

APA_DSM-5-Gender-Dysphoria.pdf (psychiatry.org)

 

 

 

[TexasTiger 14,364]

1 hour ago, homersapien said:

Who are these "most fervent supporters" you speak of? 

What is their association with professional psychiatric organizations?  Are they all practicing professionals in the field?  What are the scientific publications they cite supporting their positions?  Do you include the American Psychiatric Association as a "fervent supporter"?

Personally, I have seen nothing from qualified organizations (hospitals) or professional associations other than outlining treatment options that are first based on thorough individual diagnosis/counseling and are tailored to each individual case.  Obviously, parents or caretakers play a central role in that entire process.

I haven't seen any sort of generalized recommendations.

As a matter of fact, from my (limited) research into the matter, the recommendations of American hospital and psychiatric associations pretty much mirror the policies outlined in "Key Recommendations from the Swedish National Board of Health and Welfare":

Summary of Key Recommendations from the Swedish National Board of Health and Welfare (Socialstyrelsen/NBHW) | SEGM

(Just to be clear, I think those are good standards.)  But my point is we can go through those finding one by one and as far as I can determine, they are pretty much the same standards of treatment followed by American associations.  

Look at the information I cited earlier from the Mayo clinic.  They pretty much parallel the recommendations outlined in the above paper.

Bottom line, until someone can show me some evidence demonstrating the psychiatric/medical practices for gender dysphoria in the U.S. differ markedly from the Swedish revised recommendations referenced above, then I don't accept they do. 

There seems to be an assumption among the political activists that dysphoric children in this country are being inappropriately or prematurely subjected to pharmacological or surgical treatment without first being screened and treated with less intrusive treatments first.  I have no reason (data) to think that is the case, at least systemically.  

Now is it possible for a given patient to be given hormones (for example) prematurely?  Of course.  Medical mistakes happen, all too often. Not all doctors are the same.

I just have no reason to assume that such inappropriate or premature treatment is happening on a systemic basis, which is the only reason legislatures should feel a need to intervene.

This is a personal medical problem that needs to be addressed by the patient, their parents/caretakers and appropriate professionals in the field. This is not a political issue, it's a medical one.  The last thing we need is for state legislatures to get involved.    

 

 

I’ve given you links. You don’t read them.

 

“At most of the clinics, a team of professionals – typically a social worker, a psychologist and a doctor specializing in adolescent medicine or endocrinology – initially meets with the parents and child for two hours or more to get to know the family, their medical history and their goals for treatment. They also discuss the benefits and risks of treatment options. Seven of the clinics said that if they don’t see any red flags and the child and parents are in agreement, they are comfortable prescribing puberty blockers or hormones based on the first visit, depending on the age of the child.”

After one meeting. Common.

The former US head of WPATH, a trans woman, cited the same concerns and was hounded out last year.

““I’m afraid what we’re getting are false positives and we’ve subjected them to irreversible physical changes,” said Dr Erica Anderson, a clinical psychologist who previously worked at the University of California San Francisco’s gender clinic. “These errors in judgment are fodder for the naysayers – the people who want to eradicate this care.” Anderson, a transgender woman who still treats children with gender dysphoria in her private practice, resigned as president of WPATH’s U.S. chapter last year after her public comments about “sloppy” care prompted the organization to issue a temporary moratorium on board members speaking to the press.”

https://www.reuters.com/investigates/special-report/usa-transyouth-care/

There will be no deviating from the party line, despite your enormous clinical experience telling you there’s a problem that warrants exploration.

[PUB78 1,413]

21 hours ago, TexasTiger said:

You are so enmeshed in arguing a certain point you aren’t even responding to me. You’re a great illustration of how political polarization impedes the rational discussion of a complex issue. You responded to a simple straightforward statement and demanded data on why NOT to engage in  a course of unalterable  medical intervention.

I pointed out that in medicine one typically requires strong evidence PRIOR to extreme experimental treatments— especially experimental treatment not clearly labeled as such.

Nonetheless, I took the time to give you scientific data. It was a waste of time. You were being rhetorical. You weren’t really interested in data or science. I doubt you bothered to read it. You proved my point. Instead, you are somehow under the strange delusion that I’m engaging in “political oppression of US citizens.” Any evidence of that? Oh, you don’t need it. What a psycho rant.

I’ve never indicated support for this legislation, here or anywhere else. I’ve even said it’s extreme and driven by bigots. Get some help. You’ve lost it.

BTW, you would lose your bet. Just like you’ve lost your damn mind.

 

 

[SaltyTiger 8,600]

21 hours ago, AURex said:

Fact -- It is not "experimental" treatment any more than breast augmentation, jawline procedures, facelift procedures, liposuction, leg-lengthening, hair implants, etc.

Please read and I agree. You are a moron.

Meanwhile, physicians treating children and adolescents with gender dysphoria in Sweden, which did conduct a systematic review, are told by their National Board of Health and Welfare that “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and . . . the treatments should be offered only in exceptional cases.” It recommends mental health support and exploratory psychological care as the first line of treatment for gender dysphoria in youth and states that hormonal interventions “should be restricted to research settings.” 

Across the border in Finland, which also conducted a systematic review, physicians are told by the Council for Choices in Healthcare that psychosocial support is the first-line treatment for adolescent gender dysphoria, along with exploratory therapy and treatment for psychiatric comorbidities. Finland considers the medical transition of minors to be an experimental practice and claims that no medical treatment can be considered evidence based.

In England in 2020, the National Health Service commissioned independent, systematic reviews of the evidence for clinical benefit of prescribing puberty blockers and cross-sex hormones to gender dysphoric youth. The reviews found that studies showing positive correlations between these interventions and improvements in mental health, quality of life, and gender dysphoria were “not deemed strong enough to form the basis of a policy position.”  Last month,  the National Health Service issued a draft guidance that restricts puberty blockers to research settings. Echoing Sweden and Finland, NHS-England now concludes, “The primary intervention for children and young people who are assessed as suitable for The Service is psychosocial (including psychoeducation) and psychological support and intervention.”

Given the vulnerability of youths with gender dysphoria, inconsistencies in clinical guidance for treating these patients are both ethically concerning and medically consequential. A patient in Sweden, Finland, or England will receive blockers or cross-sex hormones only in exceptional circumstances, while  some clinics in the U.S. will prescribe them after a single meeting. This discrepancy in clinical approach cannot be explained by national cultural differences in attitudes toward LGBT+ people; research shows that Sweden, Finland, and the Great Britain all rank higher than the U.S. for acceptance of sexual and gender minorities.”

https://www.thehastingscenter.org/pediatric-gender-care-the-cure-for-politicized-medicine-is-evidence-based-medicine/

These countries allow such treatment for minors in exceptional circumstances. If our medical establishment was similarly driven by data, the US would be similar and it would be far less of a political issue.

[SaltyTiger 8,600]

And ICHY weighs in with down thumbs and slap faces.

[TexasTiger 14,364]

5 minutes ago, SaltyTiger said:

And ICHY weighs in with down thumbs and slap faces.

ICHY dislikes evidence. Hates it! Hates logic & reason even more! Except when he decried folks unmoved by evidence, logic and reason. 

[DKW 86 7,914]

So basically, and comically, homey is yet again telling us he is following the "psychiatry" of a subject. 

Man, if there is one thing everyone on this forum should be well aware of it is your very very strong tendency to believe anything hallucinated by anyone wearing a psychiatric label that supports your talking points, facts, logic, and reason be damned.

Thanks homey, I had a great laugh today and it's only 0455.

Edited March 10, 2023 by DKW 86

[homersapien 12,262]

21 hours ago, TexasTiger said:

I’ve given you links. You don’t read them.

 

“At most of the clinics, a team of professionals – typically a social worker, a psychologist and a doctor specializing in adolescent medicine or endocrinology – initially meets with the parents and child for two hours or more to get to know the family, their medical history and their goals for treatment. They also discuss the benefits and risks of treatment options. Seven of the clinics said that if they don’t see any red flags and the child and parents are in agreement, they are comfortable prescribing puberty blockers or hormones based on the first visit, depending on the age of the child.”

After one meeting. Common.

The former US head of WPATH, a trans woman, cited the same concerns and was hounded out last year.

““I’m afraid what we’re getting are false positives and we’ve subjected them to irreversible physical changes,” said Dr Erica Anderson, a clinical psychologist who previously worked at the University of California San Francisco’s gender clinic. “These errors in judgment are fodder for the naysayers – the people who want to eradicate this care.” Anderson, a transgender woman who still treats children with gender dysphoria in her private practice, resigned as president of WPATH’s U.S. chapter last year after her public comments about “sloppy” care prompted the organization to issue a temporary moratorium on board members speaking to the press.”

https://www.reuters.com/investigates/special-report/usa-transyouth-care/

There will be no deviating from the party line, despite your enormous clinical experience telling you there’s a problem that warrants exploration.

And some of those links have been good references regarding what is going on in other countries.

What I am really looking for is data - or reports of research - that demonstrates treatment of gender dysphoria in this country is so outdated, inappropriate or harmful that (Republican) state legislatures need to regulate it.

Edited March 10, 2023 by homersapien

[homersapien 12,262]

On 3/8/2023 at 9:44 PM, TexasTiger said:

 

"I’ve never indicated support for this legislation, here or anywhere else. I’ve even said it’s extreme and driven by bigots."

Sounds to me like we agree.  What do you think I've been arguing? 

Can you state what you think my position is, in your own words? 

(Hint: I have not been arguing in favor of aggressive, premature or otherwise inappropriate treatment/therapies for gender dysphoric children.)

Edited March 10, 2023 by homersapien

[homersapien 12,262]

10 hours ago, DKW 86 said:

So basically, and comically, homey is yet again telling us he is following the "psychiatry" of a subject. 

Man, if there is one thing everyone on this forum should be well aware of it is your very very strong tendency to believe anything hallucinated by anyone wearing a psychiatric label that supports your talking points, facts, logic, and reason be damned.

Thanks homey, I had a great laugh today and it's only 0455.

Well, what are you following?   Ron Desantis?  Republican state legislatures?  Your favorite blogger?  Your local shaman/witch doctor?

I'll stick with the DSM-5, The American College of Psychiatrists, the AMA and other reputable  and the other reputable professional organizations (including the Swedish National Board of Health and Welfare.  

I am not a psychiatrist, are you?  If not, how do you determine what the "psychiatry" of a subject is.  Do you think these organizations are "hallucinating"?

What I oppose is state legislation/regulation that is ultimately based on a politicized view.

Your post is an irrational rant meant only to fling poo at me. Pure idiocy and sadly typical of you. 

Edited March 10, 2023 by homersapien