On Children and Hormone Blockers.

anyone who has any kind of clinicla acumen and understanding of evidence base should support affirming care .

you might be well advised to ask 'Doctor' Andrew Thorne a Social worker who could not stay in his lane what happens when you promote right wing extremists and their views ...

Well I'm trans for one, so I've lived it and been bombarded constantly with people showing me all the 'evidence' for it being wrong.

Question; what makes your opinion on the process more prescient than the experts opinion on it? I mean with all due respect i'm more inclined to take a doctors view on this..

lets see

1. I hold a BMedSci (hons) Awarded by the Faculty of Medicine and helath at a Uk red Brick University, a significant part of that award was a primary registerable qualification

2. I have had 15 years of Clinical practice as a Health Professional in UK practice

3. I am transgender myself and have lived experience of navigating the systems and processes as an (expert) patient

and you qualifications and experience on the topic are what exactly ?

<snip>

Given that several clinics are under investigation for doing exactly that...

Interesting of you to claim that
At any rate, i'm not sure why you're getting all uppity as i was addressing a specific other user, not you. Although i see little reason to trust the opinion of an anonymous claim online either way.
Call me old fashioned but i'd rather put my trust in actual doctors and the medical science correspondents at respected publications.

Well I'm trans for one, so I've lived it and been bombarded constantly with people showing me all the 'evidence' for it being wrong.
And two, if you could find me a place where I disagreed with doctors in my initial post that would be swell. I said a lot of people get misinformation on how blockers are handed out.
Do I think they need to be perscribed "more"? Yes. Because dysphoria can result in suicide (something I myself have attempted as a child), severe mental health issues, and a general distaste for living.
But they're not because of underfunding and understaffing of the GICs across the country.
No doctor is handing out hormone blockers left and right, and no doctor thinks they should. It's everyone else who seems to think that you can just waltz into your GP and demand treatment for this, meanwhile I'm having to desperately transfer asap because my GP decided to refer me to a clinic and then say they wouldn't feel comfortable to provide care, something they are required to do after referring me to the clinic.
I really have no idea what your point is. Not only are doctors not handing out hormones willy nilly, but they're not being strongarmed into it either.
And I agree that it should continue to be monitored? Which is what all doctors who specialise in this area of health care want anyway?

Thank you for once again demonstrating your ignorance here .

there is NO hierarchy of Health Professionals in the way you are implying .

It's clear that despite professing to be able to hold an opinion on clinical matters you have no understanding of terms in common use clinically, such as Expert Patient / Expert by Experience.

Every couple of weeks it seems to me like we get someone posting a link to an article or making a discussion post about "How dangerous" blockers are, and about "How they're damaging our children!". Now I understand that many people may not just understand how the system works, so I wanted to make a post which lays out the general process.
This is how, for lack of fringe cases,hormone blockers are prescribed to children. So if you didn't know about this process, hopefully this helps you form a more informed opinion on it.

Children aren't randomly given blockers just because they asked nicely. The process to get blockers requires

A) A referral to a specialist gender clinic service, with a waiting list of commonly 1-3 years. This means that a child won't suddenly say "I'm a boy now" and get drugs, they commonly have to wait. In Wales, before this referral can take place, children are required to have a full psychological evaluation with their local mental health services.

B) A full evaluation during their first session with the service, which rarely results in any prescriptions. When I say rarely I mean rarely. It's traditional for any medical intervention to be flat out denied within the first session, and is normally only finalized in the second or even third. This is the same for adults, but since we're talking about children this would mean that the first appointment gets them nothing in a majority of cases. And the second one is normally anywhere from 6 months to 2 years after the first, so again, not exactly being fast tracked onto drugs.

C) Requires a shared care agreement with the GP. Gender clinics aren't typically qualified to administer hormone treatment or hormone blockers, they're only qualified to prescribe them. I the primary care doctor doesn't feel comfortable providing this care to the child, they don't. There have been cases of children being denied hormone treatment or blockers because their GP denied the recommendation of the gender clinic. These kids normally have to go somewhere else.

D) Close monitoring during the entire time they're on blockers, which will be at the longest 3-4 years. Most children start blockers at the age of 16 anyway, but when looking at the longest possible case this would be just before puberty starts or at the beginning, which would be ages 12-13. And these are the best case scenarios, or the result of seeking private treatment. During this time any and all shots are administered by nursing staff, regular blood tests are mandatory to check levels of E and T in the blood respectively, and all children on this medication are regularly checked for any of the side effects which can occur as a result of being on blockers. And I only say blockers here, because in the UK you must be I believe at least 17 to be prescribed hormones (16 I believe in Scotland), where you basically start the entire process I just laid out from the beginning for a different medication.


I say this sincerely. I wish DESPERATELY that I lived in the world where these hormones were apparently just handed out like everyone is scaremongering they are, because then I wouldn't be looking down the barrel of a 3 year waiting list for a first appointment, and then another year for my second. After being on the waiting list for a year already, mind you.

Kids aren't given blockers on demand, they're closely monitored when they are given blockers, and the ultimate aim is to get them off and get them onto something more stable and long term than to just keep them on blockers forever.

I hope this has helped explain what can be a confusing and emotional subject.

absolutely rubbish I posted because I don't know anything about the subject

All false or misrepresentation of the data.]

These combine together to paint the exact opposite picture of what you are falsely implying. The claims of high desistance rates in prepubescent children are from the conflation of gender non-conformity and gender dysphoria. These children are observed and those that persist in being dysphoric rather than GNC are then prescribed puberty blockers after progressing through the system. A near zero percent desistance rate from that stage suggests that the way the system is set up takes such a high requirement for them to be prescribed that there are minimal false positives (I.e. people diagnosed who are not).

The idea that the drugs cause it given their original use in treating precocious puberty (puberty starting too early) and that those treated progress on to develop as cisgender people when taken off the blockers at the age they should have started puberty is evidently false]

All of those focus on general low sex hormone levels, this is not the intention of affirmative care. Under affirmative care, a trans man does not merely have low oestrogen levels (akin to a post menopausal woman), he instead alters his hormonal make-up to that of a typical man (and similarly trans women don't simply have low testosterone, they adjust to instead having more oestrogen like a typical woman)]

People like you lying about suicide rates can do one. Particularly when you deliberately misrepresent a study of which the author has repeatedly interviewed about and corrected: https://www.transadvocate.com/fact-check-study-shows-transition-makes-trans-people-suicidal_n_15483.htm

The important thing to remember with suicidal ideation with trans people and the efficacy of transition is that you are not comparing it with a cis cohort, you are supposed to be comparing it with trans people who have not had any intervention or tried to deal with it without transition, and the research is very clear:
Transition improves the quality of life, and the main predictor of suicidality is denial of access to affirmative care and general bigotry


https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Firstly you ignore these points:
-puberty is not just for aesthetics and its not cummulative. Important things like fusions of growth plates development of connective tissues and development of facial structure happen during puberty which if you miss thats it https://www.thenewatlantis.com/publi.../growing-pains
-a psychological evaluation Is only as reliable as the person you are evaluating, and kids are too immature to be reliable
-Finally and most importantly no one knows the long term and real affects of what this stuff does, we are litterally using the current kinds under the treatment as guinea pigs


Nope the data i shared shares my conclusions I even gave quotes, you on the otherhand have no data.



Wrong because the kids who don’t go on hormone blockers are also diagnosed with gender dysphoria and report as having GD all throughout their teenage years until adulthood.

Not at all because these kids don't have precocious puberty they have normal puberty, and as i linked before the data shows your wrong anyway.

Bad logic again humans cant change sex, just becuse you change your hormone levels does not mean your body will start acting like the opposite sex when it comes to things like heart disease.

Wow none of this addressed what a said I wrote. I didnt say “transtioning doenst do anything to the suicide rate of trans people” i wrote “transitioning is far from affective method of treating GD since their suicide rate is ridiculously high even after” this “even after” part means I know it decreasese but its still not enough to say transtioning is an effective treatment for GD since trans people post surgery and hormones have a suicide rate higher than black slaves and jews that lived through the holocaust.

provide evidence in your reply and remember to reply to these:
-puberty is not just for aesthetics and its not cummulative. Important things like fusions of growth plates development of connective tissues and development of facial structure happen during puberty which if you miss thats it https://www.thenewatlantis.com/publi.../growing-pains
-a psychological evaluation Is only as reliable as the person you are evaluating, and kids are too immature to be reliable
-Finally and most importantly no one knows the long term and real affects of what this stuff does, we are litterally using the current kinds under the treatment as guinea pigs

Tnnak you for demonstrating that you have a transphobic agenda , driven by right wing extremism

I ignored them because they're either irrelevant or frankly incredibly stupid.

Puberty progresses normally after blocking is ceased, we have over 3 decades of evidence for this with minimal harmful side effects (that would be the long term effects).

The idea that children are too immature to know their gender can be taken one of two ways, block everyone's puberty or force trans kids to try being cis. It's never the former, always the latter and betrays the entire argument as nothing other than cis supremacist notions not worth engaging with.

No, it literally doesn't. The only thing you linked that actually related to trans people specifically (Dhejne 2014) was completely in disagreement with you, hence the interview with the leader author that I linked. I also linked a compilation of the research from Cornell which is very clear on the efficacy of affirmative care in treating gender dysphoria

So in other words they're gatekept and while there are minimal false positives (people who weren't trans but provided access to affirmative care) there are false negatives (people who were trans but were denied access to affirmative care). Really not an argument against affirmative care that

A) no the data does not, you know **** all about the subject. B) whether or not they have precocious puberty is besides the point - the point is the drug is used in exactly the same way for the same base reason - to delay puberty. The motivations for doing so do not affect the physiology of the drug

Actually, yes it will. Your physiology, particularly gendered reactions to disease, are modulated by the endocrine system, not chromosomes or some sort of divine essence from the genitals you had as a kid

Again, the biggest predictors of suicidality are a lack of access to affirmative care and general bigotry. Transition alone doesn't reduce the suicide rates to a cis cohort level, but it does significantly reduce it compared to a non-transitioned trans cohort, which is the question that should actually be considered when assessing is it effective, and the answer is a definitive yes. Now if you want to reduce the suicidality to a cis cohort level, the best thing is for people like yourself and Napp to shut up and go away, because it's your bigotry that's the issue

Hi @princetonalec ,

Thanks for posting such a detailed OP, I learnt stuff from it. I have a quick question, to make sure I'm correctly understanding what you wrote. You said that in Wales, children have to have a psychological examination by the local mental health team. Am I correct in inferring that that's not the case in other parts of the UK? (You mention an examination in the paragraph after you wrote that bit about Wales but, IIRC, you did not specify whether that involves a psychology exam (I assume it does though!), or whether it's carried about by a local mental health team or someone else?)

Just curious and wanting to make sure I have understood everything in your OP accurately. I'm sorry to read that the waiting lists are so horrendously long, and that this lengthy wait is impacting on you personally

So you think not knowing the long term effects of hormone blockers on young children is irrelevant or stupid. Also you think the fact that children are notoriously not reliable subjects in psycho evaluations is again irrelevant. Or that lets just say the child is trans, blocking their natural puberty essentially stops incredibly important things from happening like the development of connective tissue.

Lets be honest you are just ignoring these points because they kill your argument.



No it doesn't and you dont you have any evidence showing that, link me a study that shows that puberty blockers do not affect the long term growth of people. Because ive linked you to one that shows the opposite. yo

“The development of normal bone-mineral density is another concern for children and adolescents treated with puberty-suppressing hormones. Early reports suggested that the patients may have experienced reduced development of bone-mineral density while on puberty-suppressing treatments.”



“cis supremacist” well there goes your creadibility right out the window. Moving on “block everyones puberty” why should we risk the wellbeing of 99.9% of kids pumping drugs into them we dont know the long term effects of so that the 0.1% can gain some aesthetic benefits for treatment that doesn't even work that well. Also we dont force trans kids to be cis, we air on the side of caution and appreciate the fact that a childs brain is not fully developed enough to be a reialble source of information.





Not true almost everything I linked was specifically about trans people, you just cant argue against it. you know i can literally just go back and read my own comment right.

Your first link is both from a deeply unreliable source and didn't argue against my point, no one is saying transitioning does not help or that it makes people suicidal that's a complete straw man miss representation. The point is its not helping enough and trans suicde rates are too high for transitioning to actually be called affective

Your 2nd link same problem,






No in other words puberty is an important factor in helping people come to terms with their own body. Because there is the same gatekeeping for those that did not go on blockers.

Also you don't have minimal false positives you just have a bunch of kids who are ok right now being the gender they transitioned into, there is no long term information on whether they want to detransition later in life or if it any even affects the menal wellbeing/suicide rate. All you have is a bunch of kids from the ages of 12-20 something that seem to be doing fine right now which doesn't mean ****.






No its not, besides the point drugs affect sick people/people with medical conditions differently then they do to healthy people. And again you have literally no evidence for any of your points.





Not true MTF trans have a higher risk of prostate cancer and a bunch of other diseases because of hormones, when a person transitions they do not become the other gender. We aren't frogs we can't swap genders, a trans person can only play the role of the opposing gender they cannot become it.







HAHAHA trans people post transition have a suicide rate higher than black slaves and Jewish holocaust survivors. Their suicide rate is in no way that high because of external forces. Unless you want to argue that trans people in this year have faced hardship hardship then slaves and survivors of literal genocide. Whats more likely is that since thier suicide rate is consistent with paranoid schizophrenics, transitioning doesn't work at treating gender dysphoria.

Also we do need to compare it to cis people because trans people arent aliens and the aim is to treat people so they wont kill themselves at a crazy high rate. The aim is not to put them through years of bull****, make them spend how ever many thousands of pounds all to have their chances of ending up on a rope only drop down to 40%.

You are literally arguing for the use of children as guinea pigs so that a few of them can gain maybe some aesthetic benefits. You have no science behind you,

hey I was just wondering about the side effects you mentioned of E&T, out of sheer curiosity