The Cass Review Final Report

[Anonymous]

This is too funny, you all are all about national healthcare, why can't we do it like the Europeans? Then the minute they make an informed decision about healthcare for minors, their quacks over there. Okay.

[Anonymous]

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

Good comment. I fall into that set of people who are very politically liberal and ALSO extremely skeptical about medical interventions. I even find the push for puberty blockers for girls (and it’s always girls) going through early but normal puberty to be creepy and based more on fear (“she’ll feel bad if she’s the earliest developer!”) than medical need of the actual child.

As well, I have a child on the spectrum and know full well how many “professionals” exist out there happy to take my money for little in return, and also how fear can manipulate parents (“the window for intervention is closing!! you need intensive services! if you don’t medicate your child will lose all self esteem and go to jail!”)

[Anonymous]

Anonymous wrote:No, I didn’t read it because I’m not obsessed about what other families choose to do with their medical decisions—especially ones approved by the American Association of Pediatrics.

Did you know that vaccines cause autism? I read it somewhere. It must be true.

So just because a family approves of a certain treatment for gender dysphoria, we all have to shut up, regardless of the harm it may cause? What about faith healing parents who deny their children medical care because it's "against their religion"? Should they be excused?

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

No. The bolded is incorrect. You can review the studies yourself, including the ones relied upon by WPATH. You do not have to trust the Cass review at all, if you don’t want. WPATH cites all studies used to bolster its guidelines; they can be reviewed for their evidentiary weakness on their own merit. And for anyone who has an education in statistical analysis, the weaknesses of those studies on their own become quickly apparent.

As for the medical research community, when academics pointing out the lack of hard evidence are fired from their jobs or forced out of the profession for being transphobic, people who need to feed their families fall into line quickly. When hard discussion is actively suppressed, “broad agreement” is meaningless.

I realize that you want to continue to use the discussion suppression tactics that have been successful for years, but you cannot stop people with open minds and the ability to understand data from looking at the existing body of data forever. This discussion is going to happen now, although probably (and possibly even correctly) not on DCUM. The problems with the underlying medical evidence are just too numerous.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

No. The bolded is incorrect. You can review the studies yourself, including the ones relied upon by WPATH. You do not have to trust the Cass review at all, if you don’t want. WPATH cites all studies used to bolster its guidelines; they can be reviewed for their evidentiary weakness on their own merit. And for anyone who has an education in statistical analysis, the weaknesses of those studies on their own become quickly apparent.

As for the medical research community, when academics pointing out the lack of hard evidence are fired from their jobs or forced out of the profession for being transphobic, people who need to feed their families fall into line quickly. When hard discussion is actively suppressed, “broad agreement” is meaningless.

I realize that you want to continue to use the discussion suppression tactics that have been successful for years, but you cannot stop people with open minds and the ability to understand data from looking at the existing body of data forever. This discussion is going to happen now, although probably (and possibly even correctly) not on DCUM. The problems with the underlying medical evidence are just too numerous.

I agree. The cancel culture surrounding trans issues is incredibly toxic, and being on the receiving end of it myself was a big reason I started to look the issues myself.

I really think the inevitable appearance of detrans young people is what forced the issue open. It’s honestly breathtaking that WPATH members knew full well the difficulty in getting informed consent for loss of fertility and sexual function from children yet suppressed all discussions of it. Well, that was only going to work for so long.

[Anonymous]

https://www.theguardian.com/commentisfree/2024/mar/09/disturbing-leaks-from-us-gender-group-wpath-ring-alarm-bells-in-nhs

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it's a biased report based on the input of transphobic people and organizations.

When you lead with this, the rest of your comment is not worth reading.

Supportive organizations were not allowed to give any input meanwhile the actively transphobic Sex Matters led by transphobe Maya Forstater was allowed to provide input.

AND it neglected to include many big studies.

Biased propaganda.

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

Exactly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

Exactly.

They had objective standards for high-quality research. And the major conclusion is that we need more high-quality research before we can recommend when trans kids should get medically transitioned. That evidence may show benefits for some kids. But you simply cannot shut down the need to produce better evidence.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

Exactly.

They had objective standards for high-quality research. And the major conclusion is that we need more high-quality research before we can recommend when trans kids should get medically transitioned. That evidence may show benefits for some kids. But you simply cannot shut down the need to produce better evidence.

Actual high-quality research would be great, but how are we going to do that when gender clinics are being shut down left and right?

The number of "kids" going through medical transition is extremely small to begin with, and even those are having increasing difficulty accessing baseline care.

[Anonymous]

Anonymous wrote:I’m glader saner heads are prevailing over there. I realize that parents of kids questioning gender face a difficult situation, and the absolutely crazy atmosphere where no questions are allowed in the US is extremely toxic.

Have you actually tried accessing gender affirming healthcare in the US? Even if we leave out the long wait lists, there are TONS of "questions allowed." Youth go through multiple rounds of physical and mental health conversations to determine even the smallest steps, and anything even approaching transition takes years of incremental movement.

This idea that kids are rolling up to the 7/11 for a mastectomy is propaganda and you should feel bad for propagating it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m glader saner heads are prevailing over there. I realize that parents of kids questioning gender face a difficult situation, and the absolutely crazy atmosphere where no questions are allowed in the US is extremely toxic.

Have you actually tried accessing gender affirming healthcare in the US? Even if we leave out the long wait lists, there are TONS of "questions allowed." Youth go through multiple rounds of physical and mental health conversations to determine even the smallest steps, and anything even approaching transition takes years of incremental movement.

This idea that kids are rolling up to the 7/11 for a mastectomy is propaganda and you should feel bad for propagating it.

Taking the bolded as 100% truth (which it not; this is a complex situation and access to care and how that is provided varies widely), there still should be no objective reason to attempt to shut down any critical analysis of the medical evidence that’s used for treatment. If proponents of current medicalized pathways for gender dysphoric youth are confident in those pathways, they should welcome sober and reasoned analysis like the Cass review. If they disagree, they can present their own body of rigorous research as a counterweight. The problems of clinic wait times and access to care in the US — and I agree that there are some, though again it is nuanced — should be orthogonal to a rigorous examination of treatment protocols for youths implemented by those clinics. But I see little evidence that proponents of medicalized treatment for gender dysphoric youth are willing to subject the pool of medical evidence used to support current treatment to rigorous analysis.

The “no questions” model is problematic for patients, but whether that happens is in between a patient’s family, the patient, and their doctor. However, such a model is unforgivable for medical researchers and clinicians, who absolutely should be continually questioning the evidence, particularly when the patient population is so profoundly vulnerable. The abjectly unscientific and purely emotional responses to the Cass review do not lead to great confidence in its critics.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m glader saner heads are prevailing over there. I realize that parents of kids questioning gender face a difficult situation, and the absolutely crazy atmosphere where no questions are allowed in the US is extremely toxic.

Have you actually tried accessing gender affirming healthcare in the US? Even if we leave out the long wait lists, there are TONS of "questions allowed." Youth go through multiple rounds of physical and mental health conversations to determine even the smallest steps, and anything even approaching transition takes years of incremental movement.

This idea that kids are rolling up to the 7/11 for a mastectomy is propaganda and you should feel bad for propagating it.

+1

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

Exactly.

They had objective standards for high-quality research. And the major conclusion is that we need more high-quality research before we can recommend when trans kids should get medically transitioned. That evidence may show benefits for some kids. But you simply cannot shut down the need to produce better evidence.

Explain how a double-blind protocol would be designed here. Ethically.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. The Cass analysis only shines a light on the paltry evidence supporting medicalized treatments for gender dysphoria in youth. The lack of that evidence has been known for years. The studies (and lack thereof) have been plainly visible to anyone with the willingness to be skeptical of religious dogma, neutral, and scientifically-minded for a long time. The criticisms of the report are transparently ideological and not grounded in solid data analysis.

However, thread will get shut down because the hard facts of the weakness of the studies and medical evidence are not welcome in places like DCUM, where religious belief prevails over scientific analysis with respect to discussion of medicalized treatment for gender dysphoria in youth. This is not the place for rigorous discussion of medical evidence and treatment pathways.

I also think it must be supremely painful for those parents who were emotionally manipulated into certain medical treatments with the execrable and not evidence-based threats of “dead son or live daughter,” or vice versa. For those people, this must all be awful. I don’t think the random DCUM threads are helpful to them.

It’s only “paltry” evidence because they excluded 98% of studies that supported transition as a therapy for lack of a double blind protocol without considering whether a double blind protocol would even be ethical/permitted by an IRB.

This is an area where there is broad agreement among the researchers and medical professionals and it’s all been politicized to help divert people’s attention from more important issues.

It’s fine if you want to believe what you want to believe but don’t try to argue “hard facts” support you.

Exactly.

They had objective standards for high-quality research. And the major conclusion is that we need more high-quality research before we can recommend when trans kids should get medically transitioned. That evidence may show benefits for some kids. But you simply cannot shut down the need to produce better evidence.

Actual high-quality research would be great, but how are we going to do that when gender clinics are being shut down left and right?

The number of "kids" going through medical transition is extremely small to begin with, and even those are having increasing difficulty accessing baseline care.

It’s incorrect that gender clinics are being “shut down left and right.” That is plainly untrue or at least extremely exaggerated.

However, even if it were entirely true, it would be possible to do follow-up studies on the patient population. Those patient records would still exist, particularly in large systems. One of the biggest issues with the body of evidence supporting medical transition for gender dysphoric youth is the general lack of rigorous and substantive follow-up data. Even if a clinic is shut down, there will have been enough patients seen that it should be possible to do statistically rigorous outcome analysis, and then statistically rigorous meta analyses. Yes, it will take years, but frankly this is work that should have been done a long time ago given the continued treatment recommendations and the particularly vulnerable patient population.