This WaPo article below (click headline to read, or find the piece archived here), discusses the new case about gender transitioning being adjudicated by the Supreme Court. It’s judging the constitutionality of a Tennessee law that, according to the paper, “bans the use of puberty blockers and hormones for gender-transition treatments in minors on the grounds that it unlawfully discriminates based on sex.” (23 other states have similar laws). I’m not sure how a ban on blockers can discriminate on the basis of sex if the hormones are banned in both males and females, but I’ll leave that up to the lawyers.
What’s important here is that the dispute about the blockers is now being discussed openly, in an Editorial Board op-ed in the Washington Post, while previously such discussion was taboo. Even questioning the use of such “affirmative treatments” was seen as “transphobic,” though there wasn’t good clinical evidence that they had good outcomes. They could even have been harmful, and in light of a lack of efficacy, they’re now banned in the UK and regarded as experimental treatments in much of Europe.
What we need, as the paper says, are “gold standard” studies: large controlled studies (double blind ones would be impractical given that the drugs have easily discernible effects) over a fairly long period of time.
Read below, and I’ll give some quotes (indented):
This unresolved dispute is why Tennessee has a colorable claim before the court; it would be ludicrous to suggest that patients have a civil right to be harmed by ineffective medical interventions — and, likewise, unconscionable for Tennessee to deny a treatment that improves patient lives, even if the state did so with majestic impartiality. The issue is subject to legal dispute in part because the medical questions have not been properly resolved.
Multiple European health authorities have reviewed the available evidence and concluded that it was “very low certainty,” “lacking” and “limited by methodological weaknesses.” Last week, Britain banned the use of puberty blockers indefinitely due to safety concerns.
“Children’s healthcare must always be evidence-led,” British Health and Social Care Secretary Wes Streeting said in a press release. “The independent expert Commission on Human Medicines found that the current prescribing and care pathway for gender dysphoria and incongruence presents an unacceptable safety risk for children and young people.”
An early Dutch study of blockers showed “promising results”, but the sample was too small to give definitive results, and wasn’t replicable:
Yet as other doctors began copying the Dutch, clinical practice outraced the research, especially as treatment protocols rapidly evolved. A British study attempting to replicate the Dutch researchers’ success with puberty blockers “identified no changes in psychological function” among those treated.
Some clinicians appear reluctant to publish findings that don’t show strong benefits. The British lackluster results were published nine years after the study began, after Britain’s High Court ruled that children younger than 16 were unlikely to be able to form informed consent to such treatments.
And here is the unconscionable censorship on the part of both the American government and the WPATH organization that I haven’t yet written about:
Internal communications from the World Professional Association for Transgender Health [WPATH] suggest that the group tried to interfere with a review commissioned from a team of researchers at Johns Hopkins University
Johanna Olson-Kennedy, medical director of the Center for Transyouth Health and Development at Children’s Hospital of Los Angeles, told the New York Times that a government-funded study of puberty blockers she helped conduct, which started in 2015, had not found mental health improvements, and those results hadn’t been published because more time was needed to ensure the research wouldn’t be “weaponized.” Medical progress is impossible unless null or negative results are published as promptly as positive ones.
Weaponized? WEAPONIZED? The study is done, but the results aren’t ideologically pleasing to gender activists, and so the study languishes, unpublished. That is unethical, for whether or not one uses blockers can have permanent effects on the well being and future fertility of adolescents.
And so we have one more example of science being suppressed because it didn’t give the results activists wanted. But this story isn’t over. As the Post recommends, Congress should fund larger and wlll-conducted trials of blockers with followups on adults who have gone on to estrogen or testosterone therapy. Given the increasing number of people who want to transition, such studies are imperative. But now we lack evidence, and without that the use of blockers should, I think, be stopped. Anecdotal evidence is not enough.