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Britain’s National Health System announced the closure of its gender identity development service Tavistock last week. This change could have seismic consequences for similar practices in the United States, where activists have promoted “gender affirmation” care for children with gender dysphoria — a condition in which a patient feels psychological distress at the discrepancy between his or her physical sex and their inner sex. Feelings of being male or female. Gender confirmation protocols encourage patients to align their external pronouns, nouns, and physical traits with their internal feelings. Puberty blockers are said to “stop” normal bodily changes as a first step toward the ultimate goal of presenting to the opposite sex.

After the decision was announced, The Economist stated that closing the London-based clinic represented a “victory” for “those who say stated gender identity should not trump biological sex”. “The tide in Britain appears to be turning against groups that espouse the belief that gender identity trumps everything else, and toward maintaining support for gender-based rights and evidence-based medicine.”

The closely watched move followed the release of a damning report by Dr Hilary Cass, former president of the Royal College of Paediatrics and Child Health, which was tasked with investigating allegations and questions raised by the clinic’s sex-confirmation practices, including the provision of puberty blockers to children. Until the age of ten. The whistleblower alleged that the clinic was under pressure from transgender activists to start the transition, while failing to give sufficient weight to the patients’ mental health history.

The decision to close the clinic will shift ‘gender care’ for young people to regional children’s hospitals, where a more ‘holistic’ approach has been recommended, and those receiving puberty blockers will be part of a formal clinical trial that will track their progress into adulthood.

In her report, Dr. Cass notes that the effect of puberty blockers on children has not been studied with sufficient scientific rigor. Did the medication “pause” puberty or serve as an “initial part of the pathway of transmission?” She asked. Is brain development “temporarily or permanently disrupted by pubertal blockers?” US physicians concerned about these practices have raised similar questions, even as professional medical groups have signed on to the practice.

Dr. Paul Herrose, an endocrinologist and endocrinologist in the USA, told the registry that the European medical community has more experience developing treatment models for gender dysphoria, so the forced closure of the Tavistock Clinic should be a wake-up call. Call the American doctors who work in this field.

“Physicians in the United States need to pay attention to what is happening in Europe, but instead of doing so, activists are redoubling their efforts and making claims that a positive approach is being established as the most effective approach,” Dr. Herrose said.

Sue Evans, a nurse and whistleblower who previously worked at the Tavistock Clinic and tried to sound the alarm about her practices, said the news provided a cautionary tale for a prestigious clinic derailed by “activist-driven medicine”.

“Tavistock specializes in treatment – talking about problems with patients – and … we generally don’t prescribe medications,” Evans wrote in an August 4 column for Common Sense on Substack. She expected the same approach would be used in treating gender dysphoria.

Instead, “some staff did not hesitate to recommend puberty contraindications – even to vulnerable children” with other psychological problems.

Furthermore, “the service’s top doctors will regularly meet with Mermaids, an advocacy group for transgender patients.”

“[A]As time progressed, it became clear that groups like the mermaids exert influence on the physicians and physicians on duty – sometimes dictating the expectations of care for our patients.”

And when these activists began to back away from the old medical community’s position that gender dysphoria was a “mental illness,” doctors faced pressure to introduce pubertal blockers more quickly.

Evans joined the clinic nearly two decades ago, when the number of young people seeking medical treatment for gender issues was small. But the numbers started to rise, then took off after social media networks encouraged young people to question and re-evaluate their gender identity.

In 2001, there were only 250 patients, most of whom were male. By 2021, there were more than 5,000 people, and three-quarters of them were adolescent girls with no prior history of gender identity disorder.

Whistleblowers like Evans were excused when the NHS finally took action after Dr. Cass determined that Tavistock was not a “safe or viable long-term option” for young patients who sought treatment.

Cass emphasized that clinicians and clinicians often failed to investigate and treat underlying mental health issues, such as depression, autism, and a history of abuse and trauma. She warned that this failure left patients at “great risk” for future problems. The report cited “very important unanswered questions” regarding the provision of pubertal blockers to very young children.

He noted that there was no follow-up for patients, which would have given clinicians a chance to assess the actual benefits of the drugs over time.

Dr. Hrose, a US endocrinologist, noted that Dr. Cass’ findings “were consistent with the conclusions of the Finnish Council on Health Care Options (COHERE) and the Swedish National Board of Health and Welfare. Unlike the US, these countries chose to go beyond politics and ideology to best serve populations The growing youthfulness of young people with different gender identity.”

He welcomed the shift in focus to the assessment and treatment of “associated psychopathy, whether primary or secondary to a gender dysphoric disorder”.

But Dr. Herrose also stressed that many questions “remain unanswered regarding the best approach to address the well-documented suffering of affected individuals”.

He suggested that clinicians and clinicians in this field should directly address “the shortcomings of the scientific evidence.” [supporting] Current treatment models,” he called “more rigorous testing that includes consideration of alternative hypotheses” regarding the cause or causes of the condition, and “psychological intervention.”

Elsewhere in the United States, reaction to the news from Britain was mixed, even muted.

The New York Times reported last week in an article acknowledging concerns about “the paucity of data on long-term safety and outcomes of clinical transitions.”

But US doctors who perform sex reassignment surgery told The Times they were concerned that closing the Tavistock clinic “will fuel the growing political movement in some states to ban such care altogether.”

For now, however, there is no sign that this earthquake in the world of transgender medicine will overturn the Biden administration’s stated support for gender affirmation care and its also strong opposition to so-called “conversion therapy” designed to help transgender youth solve the problem. The contrast between their inner feelings and their physical gender.

In June, Biden issued an executive order directing the Department of Health and Human Services to restrict coverage of “conversion therapy” for transgender youth in federally funded programs.

In a June 16 article for City Journal, Lior Sapir, a fellow at the Manhattan Institute, explained why the Executive Order attacked “conversion therapy,” and what that means for the debate over pubertal blockers for children.

Sapir noted that the term “conversion therapy” was initially used by gay rights advocates to describe efforts by mental health professionals to transgender same-sex people. In recent years, transgender activists have dedicated the term to targeting the use of psychotherapy as a first resort to help minors in gender-related distress feel comfortable with their bodies.”

Why are transgender activists against this psychotherapy as a first step?

“They insist that any effort to explore whether a transgender teen’s self-identification may result from some other factor — for example, a combination of prior sexual abuse and depression — has been scientifically shown to be highly harmful.”

But the early history of medical interventions for gender dysphoria contradicts this position:

The original Dutch protocol, which laid the foundations for child transsexualism, insisted on a lengthy pre-psychological examination of candidates. …what Dutch experts knew at the time, and what researchers now know with greater confidence, is that minors who seek relocation tend to have unusually high rates of mental health problems, including anxiety, depression, attention deficit disorder, eating disorders, and autism .

But cracks are forming within the American medical establishment that has allowed activists to lead treatment protocols, just as Tavistock has allowed mermaids to sit at the table.

“Perhaps it is no coincidence that on the same day the Biden administration made its announcement, the New York Times magazine published a long article acknowledging, for the first time, that only proven treatment is controversial among medical experts,” Sapir wrote. The article from the log paper not only recorded “the growing skepticism within the research community about the safety and reliability of ‘social transformation’ and puberty blockers,” but cited the work of Abigail Schreier, author of The Irreversible Harm, a previously banned book. on Amazon for violating its user protocols.

Divisions emerge in the institution’s support for gender-affirming therapy. Let’s pray that closing Tavistock will pave the way for a long overdue account.

Sources

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2/ https://www.ncregister.com/blog/tavistock-earthquake-in-trans-medicine

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