Suffer, little children
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Oh, the irony
While America enshrines the “science” of ““gender-affirming health care”, the rest of the world reconsiders. Greenwich’s state representative Steve Meyers was unavailable for comment.
UK bans hormone blockers for children.
The backlash against “gender-affirming care” is in full swing in Europe, with Great Britain utterly reversing course on using hormones and puberty blockers on minors.
Until recently Great Britain was going full steam ahead transitioning children. But the Tavistock scandal, where the UK’s gender treatment complex resided, turned out to be an ideologically-driven and utterly corrupt mess that promoted fake science.
Tavistock was closed down, and the UK began reversing course as it became clear that there simply was no scientific backing for the suppression of puberty and transitioning of children from one sex to another.
…Today the UK made it official: outside of clinical trials, the standards for which I am ignorant, using puberty blockers to alter the biology of children for gender transition is prohibited.
…. . A series of Europe-based systematic reviews of evidence for the benefits and risks of puberty blockers and cross-sex hormones have shown a low certainty of benefits. Specifically, longitudinal data collected and analyzed by public health authorities in Finland, Sweden, the Netherlands, and England have concluded that the risk-benefit ratio of youth gender transition ranges from unknown to unfavorable.
As a result, across Europe there has been a gradual shift from care which prioritizes access to pharmaceutical and surgical interventions, to a less medicalized and more conservative approach that addresses possible psychiatric co-morbidities and explores the developmental etiology of trans identity.
In turn, this has brought about the imposition of restrictions in Europe on access to hormones. Currently, minors in most European countries can access puberty blockers and cross-sex hormones, but only if they meet stringent eligibility conditions. And, this is increasingly done in the context of a tightly controlled research setting.
Many European countries do not allow the use of cross-sex hormones until age 16, and only then after completing a number of psychotherapy sessions. In addition, the vast majority of European countries ban surgery until age 16.
From puberty blockers to cross-sex hormones to surgery, the rules across Europe tend to be either stricter than many jurisdictions in the U.S. or in the process of tightening. For example, Sweden’s National Board of Health and Welfare states children should not receive puberty blockers outside clinical trials, and they must be at least 12.
In England, among the reasons for shutting downTavistock’s Gender and Identity Development Service in 2022, physicians reported concerns that some patients were referred to a gender transitioning pathway too quickly. Hilary Cass, who led an independent review of gender identity services for children and young people, said there was “insufficient evidence” for her to give any firm advice regarding the routine use of puberty blockers. She has told the National Health Service to “enroll young people being considered for hormone treatment into a formal research protocol.”
In Finland, gender experts have expressed concern that some patients who’ve been prescribed drug treatments didn’t meet the strict eligibility requirements detailed in the so-called Dutch Protocol. In the 1990s, Dutch gender specialists began laying the foundation for gender-affirming healthcare for minors. Described as a “careful and cautious approach” it was devised by clinicians and documented meticulously, from the late 1990s, through 2012.
As it was envisioned, the Dutch Protocol laid out a set of criteria for treatment eligibility. There needs to be a documented early childhood onset of gender dysphoria, increase of gender dysphoria after pubertal changes, absence of significant psychiatric comorbidity, and demonstrated knowledge and understanding of the consequences of medical transition. Treatment with puberty blockers can only be initiated starting at the age of 12. Interventions with clearly irreversible effects, which include cross-sex hormones and surgery, are not available until ages 16 and 18, respectively. Should patients go through with the transitioning process, all youth are provided with psychotherapy throughout.
Finland was among the first countries to adopt the Dutch Protocol for pediatric gender medicine. By 2015, however, Finnish gender specialists were noticing that most of their patients did not meet the Dutch Protocol’s relatively strict eligibility requirements for drug treatments.
Clinicians in other European countries also observed that guidelines were not being strictly followed, effectively allowing for what could be deemed as unauthorized treatment of many more minors - especially girls - than was envisaged by the Dutch experts who devised the original protocol.
Ultimately, this gave rise to health authorities in Finland, Sweden, and the U.K. conducting systematic reviews of evidence for the benefits and risks of hormonal interventions. Subsequently, the findings from these reviews suggested that studies cited in support of hormonal interventions for adolescents are of “very low” certainty. In turn, this led to the placement of severe restrictions on access to hormones. It also advanced the notion that such interventions are still in an “experimental” phase.
De facto, according to European health authorities and medical experts, there isn’t yet a medical consensus for the use of pharmaceutical and surgical interventions in gender dysphoric minors.
In an article published in February of this year in the Netherlands, the author concludes that “more research on sex changes in young people under the age of 18 is urgently needed,” in particular, referring to the importance of examining the long-term effects of medicalized transgender care.
What is remarkable about the article is that it quotes extensively from one of the original members of the Dutch team of researcher-clinicians who pioneered the use of puberty blockers in children with gender dysphoria more than two decades ago.
To be sure, the Dutch have generally been more careful - even than their European colleagues - in the use of interventions such as puberty blockers. Many Dutch physicians practice “watchful waiting” prior to moving forward with treatments.
Furthermore, recent data analyzed by Dutch clinicians has given them pause about just how watertight even the Dutch Protocol is. They observed that upon monitoring, some patients who transitioned under a strictly adhered to version of the Dutch Protocol appear to have substantial reproductive regret, body shame, and sexual dysfunction. In December 2022, these preliminary findings were presented by Dutch experts at the World Professional Association for Transgender HealthWPATH Symposium.
A common claim by Americans who oppose state restrictions on gender-affirming care for minors is that Sweden, Finland, the Netherlands, and the U.K. have not done away with hormonal interventions, and therefore lawmakers who seek limits are presumably going against what European health authorities recommend. Additionally, voices in America’s “affirmative-medicine” movement point to Europe not having bans on gender-affirming care for minors. It’s true that Europeans aren’t banning such care, and so legislators in the U.S. who pursue bans are at odds with European recommendations. But this only tells part of an evolving and layered story.
At the risk of overgeneralizing, the American approach provides more autonomy to minors, in which the medical establishment’s role is mostly to affirm a child’s declaration that he or she is trans. This affirmative model immediately removes several of the guardrails put in place by, say, the Dutch Protocol, resulting in a possible deficient lack of medical “safeguarding.”
A growing number of nations in Europe are not practicing “gender-affirming care” for minors in quite the same way as America is. In fact, for several years, Europe has been moving in a different direction from the U.S., as Europeans exercise greater restraint when treating children with gender dysphoria. In essence, progressively the message emanating from European gender experts is that until there is reliable long-term evidence that the benefits of youth gender transition outweigh the risks, it is prudent to limit most medical interventions to rigorous clinical research settings.
Compare Europe’s to this country’s politicized judiciary:
Federal judge rips into Florida’s ban on gender-affirming care for kids” (Politico’s phrasing)
(The three children on whose behalf their mothers brought this suit are two eleven-year-old girls and an 8-year-old boy.)
TALLAHASSEE, Fla. — A federal judge delivered a stinging rebuke to Florida Gov. Ron DeSantis and the Republican-controlled Legislature over rules and a new state law that banned minors from receiving “puberty blockers” and other types of gender-affirming care.
U.S. District Judge Robert Hinkle on Tuesday blocked the state from applying the ban to three minors whose parents are part of an ongoing lawsuit, saying they would “suffer irreparable harm” if they were not allowed to continue access to hormones and other types of treatment.
Hinkle’s 44-page ruling called the decision to pursue the ban on puberty blockers and hormonal treatment a political decision and not a “legitimate state interest.” Several states — including Texas — have also recently enacted bans on gender affirming care.
“Nothing could have motivated this remarkable intrusion into parental prerogatives other than opposition to transgender status itself,” wrote Hinkle, who was appointed by former President Bill Clinton.
Hinkle also added that “the statute and the rules were an exercise in politics, not good medicine. This is a politically fraught area. There has long been, and still is, substantial bigotry directed at transgender individuals. Common experience confirms this, as does a Florida legislator’s remarkable reference to transgender witnesses at a committee hearing as ‘mutants’ and ‘demons.’ And even when not based on bigotry, there are those who incorrectly but sincerely believe that gender identity is not real but instead just a choice.”
just sayin’ ….
Maine, California, and, I’m sure, other Blue States now allow minors, even minors who travel there from out of state, to receive sex-transformation “treatment” without parental consent. It’s obvious that the Democrats are waging war against children, but I’m left wondering, why?
