The Cass Review Final Report

[Anonymous]

Anonymous wrote:

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?

+1 THIS!

[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.

I assume like most research it will be done through university affiliated programs. Not sure how it works with NIH. The idea is that instead of providing an untested treatment to all who come, you have a controlled trial. And of course the only reason we’re even having this discussion is because the number of trans kids seeking out medical care is skyrocketing.

[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.

BCBS literally just changed its coverage for trans affirming care to require only 1 therapist letter, and lowered the age of top surgery from 18 to 16.

Also the slow incremental approach is not what’s happening with kids. That’s the whole problem. Parents are pressured to put them on puberty blockers (which has to be done on a timeline to prevent puberty) and then almost all of those kids go on to cross-sex hormones.

[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.

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

Explain how ethically a child can consent to loss of sexual function and fertility?

The design of research studies is complicated and I don’t pretend to be an expert. But to claim “oh we can’t do those studies therefore you have to accept crap reasearch as THE TRUTH” is totally toxic. Maybe there are some areas where you cannot do controlled research very well. That may be the case, but it doesn’t follow that you can exaggerate the conclusions of the less-definitive research. If all we have is poor quality evidence, then we cannot say “it’s SCIENCE that trans kids should medically transition!”

[Anonymous]

There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

[Anonymous]

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

[Anonymous]

The report is well done and its conclusions are valid. Dismissing it as transphobic—which seems to be the standard knee-jerk response of a very loud group of activists—is a tell that you are not engaging in good faith with the emerging science. Medically harming children should be a universally accepted moral wrong, regardless of ideology.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

Yes, I agree that it should be required that health insurance cover freezing eggs and sperm for people before they transition, provided that there is ongoing work looking at the health impact of that recommendation and solid medical evidence to support the recommendation.

I don’t use hyperbolic terms like “huge supporter” and in any event would never make a blanket statement about being a “huge supporter” of anything where the medical support and evidence is still significantly in flux or not even available.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

Yes, I agree that it should be required that health insurance cover freezing eggs and sperm for people before they transition, provided that there is ongoing work looking at the health impact of that recommendation and solid medical evidence to support the recommendation.

I don’t use hyperbolic terms like “huge supporter” and in any event would never make a blanket statement about being a “huge supporter” of anything where the medical support and evidence is still significantly in flux or not even available.

Are you support adults transitioning after having children regardless of the configuration of the family? examples: trans woman and cis woman, trans woman and cis man, trans man and cis woman, trans man and cis man, trans man and trans woman. Any and all combinations of nonbinary people. I ask because your main concern seems to hyperfocus on fertility. If someone has already had children, there should be no issue transitioning.

I do find the focus on fertility strange because a lot of people (trans and cis) do not want children. There’s a thread on the adult children board that’s been going on FOR MONTHS about someone who’s cisgender children aren’t going to give her grandkids and she thinks she’s a failure of a mother because of that. A lot of people don’t consider having children as important as you do. A lot of cisgender heterosexual grandparents will still, even today, stop talking to their children and grandchildren if their child is gay or trans or if their grandchild is. I speak from first hand experience. Your discussions of fertility are not really relevant to most LGBT people nor are they relevant to most straight cis people because all many of them care about are if their own children and grandchildren are also cis and straight.

I think anyone that wants to preserve fertility should be able to do so with health insurance and I think that anyone that doesn’t want children shouldn’t have to.

[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.

The editor-in-chief of The BMJ disagrees with you:

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

Yes, I agree that it should be required that health insurance cover freezing eggs and sperm for people before they transition, provided that there is ongoing work looking at the health impact of that recommendation and solid medical evidence to support the recommendation.

I don’t use hyperbolic terms like “huge supporter” and in any event would never make a blanket statement about being a “huge supporter” of anything where the medical support and evidence is still significantly in flux or not even available.

Are you support adults transitioning after having children regardless of the configuration of the family? examples: trans woman and cis woman, trans woman and cis man, trans man and cis woman, trans man and cis man, trans man and trans woman. Any and all combinations of nonbinary people. I ask because your main concern seems to hyperfocus on fertility. If someone has already had children, there should be no issue transitioning.

I do find the focus on fertility strange because a lot of people (trans and cis) do not want children. There’s a thread on the adult children board that’s been going on FOR MONTHS about someone who’s cisgender children aren’t going to give her grandkids and she thinks she’s a failure of a mother because of that. A lot of people don’t consider having children as important as you do. A lot of cisgender heterosexual grandparents will still, even today, stop talking to their children and grandchildren if their child is gay or trans or if their grandchild is. I speak from first hand experience. Your discussions of fertility are not really relevant to most LGBT people nor are they relevant to most straight cis people because all many of them care about are if their own children and grandchildren are also cis and straight.

I think anyone that wants to preserve fertility should be able to do so with health insurance and I think that anyone that doesn’t want children shouldn’t have to.

I don’t know why you claim I am hyperfocused on fertility. I have not spoken about fertility in this thread other than the post you are responding to. Your exaggeration is somewhat bizarre to me. I sense you wish to shut down discussion by use of exaggerated language.

My hyperfocus, to use your hyperbolic language, is medical integrity and evidence-based care, which is the key issue of the Cass review. What I care about is that vulnerable patient populations like children with co-morbid mental illnesses and/or developmental disorders are treated with the best evidence-based care. It is obvious that has not been happening in many instances, and the fallout from what is likely to be a significant medical scandal is just beginning.

As for the rest of your questions, they are too extreme, black and white, and not evidence-based to warrant discussion. However, I will note this: it should be evident to anyone who has studied history that removing the fertility of exceptionally vulnerable children is a medical recommendation that must come with an extremely careful understanding of the medical evidence behind that recommendation as well as the dark history in the United States concerning such procedures. Saying “oh but it’s LQBTQ+ kids so it’s all fine!” doesn’t remove the burden of proof. In anything, it makes that burden higher.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

Yes, I agree that it should be required that health insurance cover freezing eggs and sperm for people before they transition, provided that there is ongoing work looking at the health impact of that recommendation and solid medical evidence to support the recommendation.

I don’t use hyperbolic terms like “huge supporter” and in any event would never make a blanket statement about being a “huge supporter” of anything where the medical support and evidence is still significantly in flux or not even available.

Are you support adults transitioning after having children regardless of the configuration of the family? examples: trans woman and cis woman, trans woman and cis man, trans man and cis woman, trans man and cis man, trans man and trans woman. Any and all combinations of nonbinary people. I ask because your main concern seems to hyperfocus on fertility. If someone has already had children, there should be no issue transitioning.

I do find the focus on fertility strange because a lot of people (trans and cis) do not want children. There’s a thread on the adult children board that’s been going on FOR MONTHS about someone who’s cisgender children aren’t going to give her grandkids and she thinks she’s a failure of a mother because of that. A lot of people don’t consider having children as important as you do. A lot of cisgender heterosexual grandparents will still, even today, stop talking to their children and grandchildren if their child is gay or trans or if their grandchild is. I speak from first hand experience. Your discussions of fertility are not really relevant to most LGBT people nor are they relevant to most straight cis people because all many of them care about are if their own children and grandchildren are also cis and straight.

I think anyone that wants to preserve fertility should be able to do so with health insurance and I think that anyone that doesn’t want children shouldn’t have to.

I don’t know why you claim I am hyperfocused on fertility. I have not spoken about fertility in this thread other than the post you are responding to. Your exaggeration is somewhat bizarre to me. I sense you wish to shut down discussion by use of exaggerated language.

My hyperfocus, to use your hyperbolic language, is medical integrity and evidence-based care, which is the key issue of the Cass review. What I care about is that vulnerable patient populations like children with co-morbid mental illnesses and/or developmental disorders are treated with the best evidence-based care. It is obvious that has not been happening in many instances, and the fallout from what is likely to be a significant medical scandal is just beginning.

As for the rest of your questions, they are too extreme, black and white, and not evidence-based to warrant discussion. However, I will note this: it should be evident to anyone who has studied history that removing the fertility of exceptionally vulnerable children is a medical recommendation that must come with an extremely careful understanding of the medical evidence behind that recommendation as well as the dark history in the United States concerning such procedures. Saying “oh but it’s LQBTQ+ kids so it’s all fine!” doesn’t remove the burden of proof. In anything, it makes that burden higher.

So you're ignoring the questions I posed and again mention fertility. As I said, I'm all for freezing eggs and sperm then allowing people to transition. I'm also all for adults transitioning even if they have children already. Dodging these questions is ridiculously transparent to everyone else reading this. DCUM has educated people reading it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s that one poster that is obsessed with fertility. Make sure you go through your natal puberty first, then at 16 freeze frozen sperm and eggs, then transition and this person is a-okay with it! What an ally, thinking about these trans kid’s future fertility. This poster must be a huge supporter of adults that transition after having kids. Thank you ally! 🏳️‍⚧️

There is a brutal and very ugly history in this country of the dismissal of the value of and outright destruction of the fertility, reproductive health, and actual reproductive organs of exceptionally marginalized and vulnerable population groups. You can mock that history and make light of it if you want, but you will not persuade anyone with a sense of decency to your side with that approach.

So you’re a huge supporter of people with kids transitioning or people freezing sperm and eggs and then transitioning?

I actually think it should be required that health insurance cover freezing sperm and eggs for people before they transition. Do you agree?

Yes, I agree that it should be required that health insurance cover freezing eggs and sperm for people before they transition, provided that there is ongoing work looking at the health impact of that recommendation and solid medical evidence to support the recommendation.

I don’t use hyperbolic terms like “huge supporter” and in any event would never make a blanket statement about being a “huge supporter” of anything where the medical support and evidence is still significantly in flux or not even available.

Are you support adults transitioning after having children regardless of the configuration of the family? examples: trans woman and cis woman, trans woman and cis man, trans man and cis woman, trans man and cis man, trans man and trans woman. Any and all combinations of nonbinary people. I ask because your main concern seems to hyperfocus on fertility. If someone has already had children, there should be no issue transitioning.

I do find the focus on fertility strange because a lot of people (trans and cis) do not want children. There’s a thread on the adult children board that’s been going on FOR MONTHS about someone who’s cisgender children aren’t going to give her grandkids and she thinks she’s a failure of a mother because of that. A lot of people don’t consider having children as important as you do. A lot of cisgender heterosexual grandparents will still, even today, stop talking to their children and grandchildren if their child is gay or trans or if their grandchild is. I speak from first hand experience. Your discussions of fertility are not really relevant to most LGBT people nor are they relevant to most straight cis people because all many of them care about are if their own children and grandchildren are also cis and straight.

I think anyone that wants to preserve fertility should be able to do so with health insurance and I think that anyone that doesn’t want children shouldn’t have to.

I don’t know why you claim I am hyperfocused on fertility. I have not spoken about fertility in this thread other than the post you are responding to. Your exaggeration is somewhat bizarre to me. I sense you wish to shut down discussion by use of exaggerated language.

My hyperfocus, to use your hyperbolic language, is medical integrity and evidence-based care, which is the key issue of the Cass review. What I care about is that vulnerable patient populations like children with co-morbid mental illnesses and/or developmental disorders are treated with the best evidence-based care. It is obvious that has not been happening in many instances, and the fallout from what is likely to be a significant medical scandal is just beginning.

As for the rest of your questions, they are too extreme, black and white, and not evidence-based to warrant discussion. However, I will note this: it should be evident to anyone who has studied history that removing the fertility of exceptionally vulnerable children is a medical recommendation that must come with an extremely careful understanding of the medical evidence behind that recommendation as well as the dark history in the United States concerning such procedures. Saying “oh but it’s LQBTQ+ kids so it’s all fine!” doesn’t remove the burden of proof. In anything, it makes that burden higher.

So you're ignoring the questions I posed and again mention fertility. As I said, I'm all for freezing eggs and sperm then allowing people to transition. I'm also all for adults transitioning even if they have children already. Dodging these questions is ridiculously transparent to everyone else reading this. DCUM has educated people reading it.

It appears your real goal is to derail this thread and disrupt discussion of the Cass review, particularly the discussion of the quality of the medical evidence underpinning current recommended treatment pathways for gender dysphoric youth. Your questions are nonsense and irrelevant to the discussion at hand, which is why nobody is going to answer them. Please stop derailing.

[Anonymous]

" it's obvious that has not been happening in many instances, and the fallout from what is likely to be a significant medical scandal is just beginning."

No. It is not obvious. What is obvious is that decades of ignoring transcare has been more detrimental to children and adults a extreme pivot, even if you believe that it's extreme, which I do not.


People who have absolutely no experience with this feel the need to chime in. "Parents are being manipulated. Parents have an agenda. Medical doctors have an agenda."

What do you think their agenda is? Their agenda is the best care of their children and their patients and your endless, useless input on something you have no concept of and do not have to deal with is just exhausting