NYT contributors blast paper’s coverage of transgender people

[homersapien 12,262]

19 hours ago, SaltyTiger said:

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  Last month,  the National Health Service issued a draft guidance that restricts puberty blockers to research settings.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.

Define "exceptional circumstances".

To me, that's a very wide qualification that does not (legally) restrict the availability of hormone or surgical treatment to candidates pre-qualified for such treatment.  (Qualifications would include extensive therapy and other non "permanent" treatment or therapies, as well as age and maturity.)

1) What makes you assume that psychiatric/medical practices in the U.S. are not consistent with such guidelines?  Do you have any data supporting that?

2) What makes you assume our "medical establishment" is not driven by data?

3) Are any of these countries addressing the regulation of such psychiatric/medical practices via legislation or are they leaving it up to the relevant regulatory bodies and professional associations?

4) What are they doing that the U.S. is failing to do?

5) You really think this is something that is best handled through state legislation?

Edited March 10, 2023 by homersapien

[SaltyTiger 8,600]

28 minutes ago, homersapien said:

Define "exceptional circumstances".

To me, that's a very wide qualification that does not (legally) restrict the availability of hormone or surgical treatment to candidates pre-qualified for such treatment.  (Qualifications would include extensive therapy and other non "permanent" treatment or therapies, as well as age and maturity.)

1) What makes you assume that psychiatric/medical practices in the U.S. are not consistent with such guidelines?  Do you have any data supporting that?

2) What makes you assume our "medical establishment" is not driven by data?

3) Are any of these countries addressing the regulation of such psychiatric/medical practices via legislation or are they leaving it up to the relevant regulatory bodies and professional associations?

4) What are they doing that the U.S. is failing to do?

5) You really think this is something that is best handled through state legislation?

Good questions and no to 5. I dislike seeing abortion handled legislatively.

https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

[icanthearyou 4,468]

18 hours ago, TexasTiger said:

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

You are a liar.

 

[TexasTiger 14,364]

1 hour ago, icanthearyou said:

You are a liar.

 

If I am, it’s not because of anything said in this thread.

[TexasTiger 14,364]

2 hours ago, homersapien said:

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.)

You seem to have a great deal of confidence that treatment of gender dysphoria in this country is science based, backed by strong data and consistently applied across this vast land.

[SaltyTiger 8,600]

2 hours ago, icanthearyou said:

You are a liar.

 

Not true and you know it. Once again ashamed of you.

[DKW 86 7,914]

5 hours ago, homersapien said:

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. 

And all the other drive by psychiatric diagnoses were valid scientific research? Man quit while you are behind. 

[homersapien 12,262]

17 hours ago, TexasTiger said:

You seem to have a great deal of confidence that treatment of gender dysphoria in this country is science based, backed by strong data and consistently applied across this vast land.

No, that's not the case.  I just don't have information or data that suggests otherwise.  

I am sure there have been mistakes made in given cases, which is normal if not inevitable.  But that's doesn't constitute the sort of data that suggests a systemic problem. 

And there's certainly nothing about the various protocols or recommendations made in this country compared to the (revised) recommendations/protocols from other countries that suggests obvious systemic differences between us and them.

It's possible that medical/psychological practitioners in other countries are assuming a (new) more conservative philosophy in treatment of gender dysphoria. But for all I know, the exact same thing may be happening in this country.   The fact that a revised code of recommendations has been published in whatever country says nothing about what is happening here.

All I know for sure is that this whole subject has been thoroughly politicized and nothing good will come of that.

 

[homersapien 12,262]

14 hours ago, DKW 86 said:

And all the other drive by psychiatric diagnoses were valid scientific research? Man quit while you are behind. 

What "drive by" psychiatric diagnoses? 

[TexasTiger 14,364]

1 hour ago, homersapien said:

No, that's not the case.  I just don't have information or data that suggests otherwise.  

I am sure there have been mistakes made in given cases, which is normal if not inevitable.  But that's doesn't constitute the sort of data that suggests a systemic problem. 

And there's certainly nothing about the various protocols or recommendations made in this country compared to the (revised) recommendations/protocols from other countries that suggests obvious systemic differences between us and them.

It's possible that medical/psychological practitioners in other countries are assuming a (new) more conservative philosophy in treatment of gender dysphoria. But for all I know, the exact same thing may be happening in this country.   The fact that a revised code of recommendations has been published in whatever country says nothing about what is happening here.

All I know for sure is that this whole subject has been thoroughly politicized and nothing good will come of that.

 

There’s ample data. You’ve embraced a position driven by whom you see as the opposition to current practices in this country and their extremism persuades you the problems they reference must not exist.

[I_M4_AU 8,980]

42 minutes ago, TexasTiger said:

There’s ample data. You’ve embraced a position driven by whom you see as the opposition to current practices in this country and their extremism persuades you the problems they reference must not exist.

This. All day long.

[homersapien 12,262]

53 minutes ago, TexasTiger said:

There’s ample data. You’ve embraced a position driven by whom you see as the opposition to current practices in this country and their extremism persuades you the problems they reference must not exist.

First, no there's not ample data.

• How many gender dysphorics have been treated in this country?
• How many of those were treated with hormones or surgery?
• What were their ages?
• What were their outcomes?
• What were their outcomes vs. those treated with less aggressive therapies, by age?

Second, you are assuming that current practices in this country are "extreme". 

Again, I have seen no data that suggests that is the case.  Certainly, the published guidelines/recommendations for treatment by the relevant professional associations are not all that different than the recommendations/guidelines published by their European counterparts.

Bottom line, in the absence of data clearly demonstrating otherwise, I think you are selling the professionalism of U.S. practitioners in this field way short.

Having said that, no doubt there are individual cases where inappropriate of premature treatment occurred.  But this is true for all medical procedures. Regardless of how heart-breaking and given "mistake" was, short of more comprehensive data, it doesn't approve the U.S. has a systemic problem with "extremism" in treatment.

Again, my major concern is that because of the rampant politicization of this subject, legislatures are going to jump into it for obvious political reasons.   That's just as likely to cause greater, unintended harm than it is to help.  It's the opposite of a scientific approach.

While you claim to be against this, your assumption that U.S. practitioners in the field are "extreme" is not helping.  That's the very assumption that fuels the politicization in the first place.

Edited March 11, 2023 by homersapien

[TexasTiger 14,364]

26 minutes ago, homersapien said:

First, no there's not ample data.

• How many gender dysphorics have been treated in this country?
• How many of those were treated with hormones or surgery?
• What were their ages?
• What were their outcomes?
• What were their outcomes vs. those treated with less aggressive therapies, by age?

Second, you are assuming that current practices in this country are "extreme". 

Again, I have seen no data that suggests that is the case.  Certainly, the published guidelines/recommendations for treatment by the relevant professional associations are not all that different than the recommendations/guidelines published by their European counterparts.

Bottom line, in the absence of data clearly demonstrating otherwise, I think you are selling the professionalism of U.S. practitioners in this field way short.

Having said that, no doubt there are individual cases where inappropriate of premature treatment occurred.  But this is true for all medical procedures. Regardless of how heart-breaking and given "mistake" was, short of more comprehensive data, it doesn't approve the U.S. has a systemic problem with "extremism" in treatment.

Again, my major concern is that because of the rampant politicization of this subject, legislatures are going to jump into it for obvious political reasons.   That's just as likely to cause greater, unintended harm than it is to help.  It's the opposite of a scientific approach.

While you claim to be against this, your assumption that U.S. practitioners in the field are "extreme" is not helping.  That's the very assumption that fuels the politicization in the first place.

There’s ample evidence that puberty blockers & hormones are given too quickly and easily. I’ve cited prominent folks in the field who are pro-transition who say they have the same concern.  You dismiss these experts because of your politics. The brakes are being tapped in many European countries because after systematic reviews experts saw the same things, including folks involved in the Dutch model cited as the basis for this approach. You ignore every bit of it and then say I’ve presented nothing. This is maddening and useless. You’re obviously totally closed to information that challenges your view, but insist you’re open if someone only would provide evidence. You’re no different that the right wing you decry on their topics of choice. I’m done wasting my time with you. Have a great weekend.

[homersapien 12,262]

BTW, if you are really looking for some evidence to back up your assumption that US practice in this field is "extreme", here are some some good places to start:

Epidemiology of gender dysphoria and transgender identity - PubMed (nih.gov)

Evaluation and Treatment of Gender-Dysphoric/Gender Incongruent Adults - Endotext - NCBI Bookshelf (nih.gov)

Gender Dysphoria in Children | American College of Pediatricians (acpeds.org)

Gender Dysphoria and Its Non-Surgical and Surgical Treatments | Published in Health Psychology Research (openmedicalpublishing.org)

Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study | Pediatrics | American Academy of Pediatrics (aap.org)

 

Obviously, such a literature review would take a lot more time and effort (and $) than most people have to put in it, unless you have professional reasons to do so.

  

 

 

 

 

 

[homersapien 12,262]

20 minutes ago, TexasTiger said:

There’s ample evidence that puberty blockers & hormones are given too quickly and easily. I’ve cited prominent folks in the field who are pro-transition who say they have the same concern.  You dismiss these experts because of your politics. The brakes are being tapped in many European countries because after systematic reviews experts saw the same things, including folks involved in the Dutch model cited as the basis for this approach. You ignore every bit of it and then say I’ve presented nothing. This is maddening and useless. You’re obviously totally closed to information that challenges your view, but insist you’re open if someone only would provide evidence. You’re no different that the right wing you decry on their topics of choice. I’m done wasting my time with you. Have a great weekend.

Blah blah blah....

We are obviously talking past each other.  At least, I am talking past you.

1. I have not dismissed anyone you have presented. I have no doubt that prominent experts in the field have "concerns".  That's par for the course.  It's common in all science.  And their concerns will be taken into account by every other professional in the field, particularly when they are backed by data.

2.  My "politics" on this is to resist the politicization of the issue and focus on the science.  You appear to have taken the opposite course.  That's unfortunate in my eye, but no harm done as long as you don't promote a political response.

(And other than emoting your feelings about things, I haven't discerned what you would like to do about it, if anything.)

Still haven't seen the data from the "Dutch model". Can you provide a link?

I did find this:

Netherlands transgender research - Search (bing.com)

and this:

The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets - PubMed (nih.gov)

(BTW, the above seems to refute your case.)

Maybe this one?

More research is urgently needed into transgender care for young people: "Where does the large increase of children come from?" - Voorzij

 

Regardless, if you have one particular source you have referenced that you think proves your case that American practice is "extreme", please re-cite it.  Frankly I don't have time to go back and try to guess which one it is.

Edited March 11, 2023 by homersapien

[icanthearyou 4,468]

45 minutes ago, homersapien said:

BTW, if you are really looking for some evidence to back up your assumption that US practice in this field is "extreme", here are some some good places to start:

Epidemiology of gender dysphoria and transgender identity - PubMed (nih.gov)

Evaluation and Treatment of Gender-Dysphoric/Gender Incongruent Adults - Endotext - NCBI Bookshelf (nih.gov)

Gender Dysphoria in Children | American College of Pediatricians (acpeds.org)

Gender Dysphoria and Its Non-Surgical and Surgical Treatments | Published in Health Psychology Research (openmedicalpublishing.org)

Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study | Pediatrics | American Academy of Pediatrics (aap.org)

 

Obviously, such a literature review would take a lot more time and effort (and $) than most people have to put in it, unless you have professional reasons to do so.

  

 

 

 

 

 

Why no links to experts such as,,, Libs of Tik Tok?

[TexasTiger 14,364]

Those really 

25 minutes ago, icanthearyou said:

Why no links to experts such as,,, Libs of Tik Tok?

Just those right wing religious nuts from the Norway medical establishment:

 

 

[DKW 86 7,914]

5 hours ago, homersapien said:

What "drive by" psychiatric diagnoses? 

https://youtu.be/b9JDPm_QHk4
 

[TexasTiger 14,364]

Sturgeon insisted everyone who raised concerns over her policies were unenlightened bigots and refused to listen to valid concerns from even supporters. Astonishing arrogance. MAGA-like rigidity. Hope Democrats were paying attention:

https://www.telegraph.co.uk/news/2023/03/16/nicola-sturgeons-gender-reforms-blamed-snp-losing-40pc-membership/?utm_content=telegraph&utm_medium=Social&utm_campaign=Echobox&utm_source=Twitter#Echobox=1678998126