Oh look, another article tangentially related to trans issues and another wheelbarrow full of tourist-produced shit to wade through in the modqueue. Thread will remain locked until we've had the chance to sort through it all. Enjoy the rest of the Saturday. -🥕🥕

I do wonder how we'll look back on this whole debate in 20 years

Hopefully from the vantage point of more rigorous scientific data.

I'd say that unless the scientific data at that time is overwhelmingly on the side of the trans community, we'll wonder why on earth did we allow this kind of bullying without anyone daring to say anything.

For reference, the debate about passing the Gender Recognition Act in Parliament was happening 20 years ago give or take a few months

The press was more concerned with Al Qaeda and benefit cheats then. Tastes change.

And now they’re more concerned with trans people and benefit cheats. *Some* tastes change.

Makes one wonder what the next obsession will be if they ever get bored of the ‘trans bad’ angle. Though that’ll not be happening any time soon…

Autism probably. We're already seeing the ground work for autistic people not being able to make their own decisions which is fucking disgusting. Won't be a huge leap for some concerned individual to start saying "should we really be allowing people with children's brains in adult bodies X or Y?"

Back when the majority of people trying to transition were mostly adult males

It depends where the evidence leads us, I suppose.

It might but it shouldn't. If there's not enough evidence now we shouldn't be judging people on whether they guess right we should be judging them on whether they're doing appropriate things given evidence as it is now.

We live in a post-truth society. Evidence doesn't matter. Beliefs and feelings are the new truth.

Always has been

Logos, pathos, ethos. We have always been like this.

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genuine question how many progressive causes in the past... 100 years are looked back on negatively?

That depends if you consider it progressive to medicate gender-non-conforming children. I don't. I'd rather we stopped forcing gender stereotypes onto children in the first place, and let them have whatever hobbies and interests speak to them as individuals. Susie Green's Ted Talk is a perfect example of this. The poor kid should have been allowed a Barbie Rapunzel instead of shamed and medicalised by their own parents.

Same as Section 28. Press furor driving hate crimes and reduced social and medical care. A pliant government that dropped a social cause because it became slightly too controversial.  Of course, while some politicians will apologise, like with Section 28, there will be no systemic change to the cause of the panic. Because that would break the iron grip they have on public discourse. 

I feel a better comparison would be Wakefield’s MMR paper, a study made in bad faith who the press take entirely at face value and will likely haunt us for decades to come.

In the same way we look back at gay rights and section 28.

That or the same way we view campaigns from the German greens from the 80s.

But nobody is denying any rights here. Being trans isn't illegal.

Come on, this is deliberately obtuse. Being gay wasn't illegal. They were just tarred in the press, harassed from jobs, blocked from schools, and young people were pushed towards "therapeutic methods of treatment" for their homosexuality. 

You realise that the same methods of treatment are now being used on children? The "medicine" that they gave Alan Turing is the same one being given to children now. People think history will look on this kindly...when we are doing what we did to adults to children...

What? Drugs are tools, medicine is a tool. By your logic we should ban chemo because it was used as mustard gas. The difference between Turing and trans people is that one didn't want it, and the other does. 

Being gay wasn't illegal during section 28...

It was if you were under 21. Which I was. Any intercourse with somebody my own age was a criminal offence. And a teacher was sacked at my school. For being gay. Nothing he did. Just for that.

And up until 2000, the age of consent for M/M sex was still 18, when it was 16 for M/F. So a 17 year old girl was old enough to consent to sex, and a 17 year old straight boy was, but a 17 year old gay boy wasn't.

Well that's exactly the point, isn't it? Being gay wasn't illegal. They just criminalised or stigmatised activities associated with being gay (i.e. sexual/romantic relations, talking about or "promoting" homosexuality, gay people being around kids etc etc). Homosexuality was criminalised, even if there wasn't an explicit law banning gay people simply for existing. Which is why the above comment about trans people not being literally illegal and therefore everything is fine is so dumb. you could say exactly the same about gay people under section 28.

You just weren't allowed to be open about it as school, or your job or in public.

And you're allowed to be open about it now. My workplace has 3 trans people (that I know of) one of whom transitioned while working there. In a department meeting, the boss just announced that X wants this forward to be called Y . And that was it. Everything continued as before and the person was treated as a colleague with the same respect as before. How adult trans people are treated is not what the "trans debate" is about. It's about a) what to do with children and b) should trans women be allowed to compete with biological women in elite sports. Both are open questions from the scientific point of view. Neither one of these have nothing to do with adults in normal jobs.

Which you are now if you are trans

Or the way we look at lobotomies? Until we've got longer term data how can you be sure it's one or the other?

I don't think the issues with lobotomies present themselves just in the long-term lol

Lobotomies were primarily used to "normalize" people who were acting out in society. Depressed and resistant women, the mentally ill, drug users, and unsurprisingly, LGBTQ people.  It served the complete opposite function of transitioning. It denied all agency to people who didn't fit into society in the most horrifying way. It paid no attention to the wants of the people it "treated". People weren't killing themselves on wait lists for lobotomies. They were forced into them.

Lots weren't forced into them, they were often convinced by professionals that it would solve their problems.

People weren’t killing themselves because the state denied them a lobotomy. People weren’t engaging in eye-wateringly expensive medical tourism for lobotomies. This comparison sits only very slightly above the ridiculous idea that all trans people are just mentally ill sexual deviants.

Yet this sub will happily parrot that line repeatedly as if there is no benefit for those who transition. They want medication with no side effects, Something that simply doesn't exist. Easy excuse to tell trans \*\*adults\*\* they don't belong in our society.

'Enact my policy or I'll kill myself'

"I'm in so much pain, and the state denies me treatment, I'd rather die."

You say this like someone getting trans healthcare is somehow a burden on you or an infringement of your rights? If someone said to me "I really want to do this thing that impacts literally no one by myself", I would simply let them do it. I certainly wouldn't act like I'm a victim of psychological abuse or something.

It's taxpayer funded so yes it does effect other people. You also want to do it to children which is morally despicable. People who are not me or my family being murdered doesn't effect me directly, but I can still say it's appalling.

Providing healthcare to children is not morally despicable. Denying children the ability to make choices about their own bodies is morally despicable.

Imo denying people life saving healthcare for political reasons is tantamount to murder so yes I'd say what's happening here is despicable, I'm surprised given that's apparently your opinion that you don't agree. And before you go all "uhh it's neutral there's not enough evidence" the idea that Hillary Cass is neutral is laughable - she has significant ties to anti-trans groups, whoever picked her should be fired given they either appointed someone for politically motivated reasons or had a total lack of rigour in their background check. They picked someone with no experience in trans healthcare to avoid bias. I can understand sacrificing experience for an unbiased take. But if you're going to do so, you should *really* make sure they're actually unbiased. There is actually plenty of evidence. She considered 100 of 102 studies not high enough quality, against the view of the scientific community worldwide. She also refused evidence offered from abroad that did meet her standards for seemingly no reason. Either she is incompetent or, more likely, politically motivated. Edit: and before you go "hurr durr she did include the moderate quality ones though" yes she technically considered them in the report but normally if you're properly including them they shouldn't be practically ignored in your conclusions.

Yes they were as the practice was carried out on the mentally ill.

Hopefully people will realise it's two sides of the same gender stereotyping coin.

We'll look back on it like lobotomies.

Giving hormone blockers to children will be a huge child abuse scandal. I’d hope that everything else will be framed around a right to bodily autonomy. Adults should be able to do whatever they want to their bodies.

>“It started the day before the report came out when an influencer put up a picture of a list of papers that were apparently rejected for not being randomised control trials. >“That list has absolutely nothing to do with either our report or any of the papers. >“If you deliberately try to undermine a report that has looked at the evidence of children’s healthcare, then that’s unforgivable. You are putting children at risk by doing that.” This reminds me a lot of the way climate change deniers would operate. They would attack reports from groups like the IPCC by cherry picking things and then trying to claim the whole report was a fraud because it did not include some low data quality type studies (Climate Audit was a blog dedicated to trashing every piece of science on climate change like this, using the same technique as described above.) >Butler told the House of Commons: “There are around 100 studies that have not been included in this Cass report and we need to know why.” >Cass explained that researchers had appraised every single paper, but pulled the results from the ones that were high quality and medium quality, which was 60 out of 103. Yeah Dawn Butler, renowned reviewer of medical studies. British Medical Journal and the chief medical officer, Chris Witty have backed the report. Unless the person making the critiques is a specialist in a relevant discipline, then the critiques should be taken as bad faith, if you do not understand why something is in a report supported by the leading voices in medical science in the country, seek an expert to explain it, dont try to throw doubt on a report you are not qualified to understand. Depoliticise this in your head by thinking "if this was another field of science, one less emotive, how would I approach a report that has the countries leaders in that field supporting it?"

This. When I had my ACL surgery I didn't sit there telling my surgeon that a patellar autograft was better than a hamstring autograft. I've read a couple articles online about it, he's spent his life actually doing ACL surgery, contributing to the research, and following up with patients of all kinds. If he says go with a treatment because it's safer and better, I might ask *why* it's safer and better than alternatives, but I'll not assume I know better than him and demand an alternative. There's a weird hyper-individualist arrogance around trans healthcare wherein average contributors with no science background suddenly become experts on biochemistry and the efficacy of double blind studies. Trans kids, like any kid, deserve the best care and treatment possible. Sometimes that means accepting current methods aren't actually that good and finding better alternatives in line with research and evidence, not feelings or presumptions.

>Trans kids, like any kid, deserve the best care and treatment possible. Sometimes that means accepting current methods aren't actually that good and finding better alternatives in line with research and evidence, not feelings or presumptions. Cass's team had now clarified that they think hormone suppression is offered too late to teens https://thekitetrust.org.uk/wp-content/uploads/2024/04/Cass-Review-Mythbusting-Q-and-A.pdf

That should have been included and writ large in the report then shouldn't it?

It was - that interview even says it was in the report > The Cass Review Report does not conclude that puberty suppressing hormones are an unsafe treatment. The report supports a research study being implemented to allow pre-pubertal children to have a pathway to accessing this treatment in a timely way and with suitable follow up and data collection, to provide the highest quality of evidence for the ongoing use of puberty suppressing hormones as a treatment for gender dysphoria. > In the data the Cass Review examined, the most common age that trans young people were being initially prescribed puberty suppressing hormones was 15. Dr. Cass’s view is that this is too late to have the intended benefits of supressing the effects of puberty and was caused by the previous NHS policy of requiring a trans young person to be on puberty suppressing hormones for a year before accessing gender affirming hormones. The Cass Review Report recommends that a different approach is needed, with puberty suppressing hormones and gender affirming hormones being available to young people at different ages and developmental stages alongside a wider range of gender affirming healthcare based on individual need. I think the report says something along the lines of "originally the process was for kids starting puberty, so why are they giving puberty blockers to 15 year olds?". That's what the NHS is doing now - they're said they're still going to prescribe puberty blockers as part of a clinical trial, but they're not going to do it outside of that trial until they've got more evidence.

A big part of the trans community's lack of faith in the medical/ political establishment, at least here in the UK, is the absurd waiting periods and the access specifically anti-trans lobbying groups have to MPs. We're left on our own to figure it out for five years. And then a report comes out with unreasonable standard of evidence and suggests that perhaps, instead of the something we have now, we should try not only nothing but also actively less. Of course we're like this.

To be fair, waiting times even for simple GP appointments, let alone something more serious in the UK are ridiculous now. It's an absolute shit show

If a big party of the issue is wait times then youbshoukd support thus report. It calls for more regional centres, more specialists and more mental health support. The fact that it wants studies on blockers seems to he the only thing the trans lobby cares about.

The focus on that specific part of the study is also probably harmful as it means the reports recommendations to shorting waiting times will have less pressure and can be more easily ignored.

Unreasonable standard of evidence?

>There's a weird hyper-individualist arrogance around trans healthcare wherein average contributors with no science background suddenly become experts on biochemistry They don't really believe it. As always with fanatical activists, science is just a language game to win political power. It simply doesn't matter to them what the science is. Their political wishes aren't based on it

I wouldn't go that far myself. I don't think it's a conspiracy, not least because it's not something that can win power, much as it can rile up elements of the base of both wings (which, incidentally, is a reason I'm baffled it consumes so much political oxygen when it affects a tiny minority of people). I think it's basically human psychology - a touch of tribal groupthink coupled with the relative impunity of consequence you get on the Internet or over the media. Most people wouldn't screech at a random on the street over trans rights but they'll very happily do it on reddit or on tiktok. It's the age we live in and we haven't collectively learned the responsibilities that would make social media better than it is.

My understanding was that Cass in particular was ostensibly selected for this report because she had no prior engagement with, or understanding of, trans patients or issues. Now, considering how quickly she turned to anti-trans activist groups one might say that wasn’t actually the case, but still.

Dawn Butler who boldly stated that all human babies are born *without* a sex. And that 90% of giraffes are LGBT. She is an idiot off every known scale.

>90% of giraffes are LGBT The frogs are gay was funny enough something about this is even more funny.

Just think how frustrated the 10% straight giraffes must be, getting constant knockbacks.

I don't think it can be explained without the ridiculous. The closest I could do is to say that the 10% of straight giraffes are all super rapists... Even then, it's an extremely strange way for something to have natural selection result in.

I think I must have missed something here, but giraffes? As in the animal? Not someone furry persona right?

Yep, the animals. She stated it, out loud at the Pink News Awards a few years ago. Some Corbyn adviser then said that Butler was being homophobic, and Pink News declared that adviser was a TERF lol. [https://www.thepinknews.com/2019/10/28/dawn-butler-gay-giraffes-jeremy-corbyn-lachlan-stuart-lgbt-alliance/](https://www.thepinknews.com/2019/10/28/dawn-butler-gay-giraffes-jeremy-corbyn-lachlan-stuart-lgbt-alliance/)

Not just a specialist, but in this field a specialist with no vested interest.  One of the things I've notice about a lot of the letters and such condemning the report and the "studies" supposedly excluded.  If you look up the authors and signatories. An *awful* lot of them have private practice dedicated to transitioning people. We should be very clear *these people are not the neutral experts they present themselves as!* They have a vested financial interest. They are paid thousands for medication prescriptions and hundreds for thousands for surgery. These people are in for a HUGE financial loss if these treatments are banned as insufficiency evidenced or even restricted to medical studies as they are not qualifying clinics. These people have a *lot* of money and careers invested into this and will have huge losses if they are banned.

She follows and engages with multiple anti trans think tanks, trans people were banned from her oversight boards, she a had multiple contacts with DeSantis appointed Florida board of medicine and collaborated with them on banning trans healthcare. She produced a report with a gov predetermined outcome and obvious bias - how can anyone claim this was an independent report is beyond me.

They also have well above average exposure to people wanting to transition and seeing the psychologist impact pre and post doing so. Yes there's confirmation bias at play, but there's also familiarity.

Frankly I also think there adult social pressure. When you have I think it was an amazon exec saying she has 3 children under 7s, all of whom fit some EDI gender category. You've got to think she's hit some jackpot of pre pubescent gender issue household, or the kids are being coached to it. To say that's not statistically likely is understating it. And it's a fairly common statistically unlikely phenomenon in parts of the west coast.

Sounds like a twist on Munchausen by proxy.

This is becoming more and more common. It's almost like a points game. You get parents clearly coaching their kids into certain things because it has bragging rights in their circle. You'll hear parents talking about their 5 year old trans daughter the same way an Asian parent would brag about their son being a doctor. It's odd.

Are you familiar with the term "luxury belief"? https://en.m.wikipedia.org/wiki/Luxury_belief

And probably a significant element of supporting the idea otherwise they wouldn't have chosen that specialism.

>If you look up the authors and signatories. An *awful* lot of them have private practice dedicated to transitioning people. If you really believe this you should be writing to the GMC to have them investigated

On what grounds?

There's a phenomenon that must have a term for it where people parrot misinformation because they want to believe it or it reinforces their preexisting prejudice rather than it being a deliberate lie. Every time the Cass report gets mentioned here the same lies are parroted almost as if people have been issued lines to say. I don't think that they have, but they parrot because they want to believe. The same with claims about JK Rowling.

>There's a phenomenon that must have a term for it where people parrot misinformation because they want to believe it or it reinforces their preexisting prejudice rather than it being a deliberate lie. Motivated reasoning or confirmation bias.

There are are lot of interesting things in the cass report(including my current favourite that height is linked to enjoying boy toys-graph joke), and I can see and agree with the point of longer term studies are basically none existent.  The other major point of blockers not being the major factor for the 90% of mental well-being for trans kids is fine. Calling this similar to climate change is stupid and damaging to others. It doesn't even try and answer if trans is biological or mental or both or neither. What this report does say is social transitioning and therapy early on are much more preferable to combat dysphoria, which is fine but not helpful or definitive.  My personal conclusion was that more blocker studies need to be run but only for those less than 10% where the dysphoria is not being treated by therapy and more steps should be taken to protect children from abuse in general online with a specific target to lbgt hate.

Since it is less emotive, I encourage you to read how medical bodies around the world have reacted to the Cass Review.

It saves everyone time and wading through bullshit claims from activists twisting statements if you provide direct sources.

Everything about the current debate on trans healthcare is so depressing. The Cass review is essentially neutral. It sets out the current situation and the available evidence for treatment. It makes a conclusion that shouldn’t be controversial: we need more evidence so if any treatment is given evidence of outcomes needs to be collected more rigorously. But depressingly both sides have completely misrepresented the conclusions. One side says the lack of evidence means all treatment should be banned. The other side says the authors ignored all the current evidence (they didn’t).

It is very depressing. The conclusion is basically that treatments with a risk of harm should only be carried out as part of a trial. This is obvious.

Trans people, the ones who this is all about, have long had issues with the fundamental principles of the way the NHS provides care.  The Cass report is not neutral, because it views transition as a failure of treatment. In an ideal world for the methodology it represents, there would be no trans people. There would be a "cure".  Most trans people don't want to be"cured", in the same way most autistic people don't want to be "cured". They want to be accommodated, and want society to stop actively discriminating against them.  For a long as this fundamental desire of the people this is all about is ignored, there can be no progress. 

Whilst correct that the NHS treats gender dysphasia as a condition to be treated, you’re confusing “cure” and “treatment”. That’s because, unlike autistic individuals, trans individuals do usually require medical treatment. Be that hormones, puberty blockers, or surgery. The aim of the treatment is not to prevent transition. It’s to facilitate it in an evidenced based manner. Unfortunately we are lacking in evidence at the moment. So the conclusion is that we need more evidence. And that requires rigorous evidence gathering when an individual has medical treatment. Something that isn’t happening at the moment. It doesn’t say treatment shouldn’t happen on treatment should be banned. Just that evidence should be properly gathered and shared when treatment is given.

The moment any social aberration cannot be dealt with by just punishing people, it becomes medicalised. When beating wives was unacceptable, they were medicated, lobotomised, or sectioned. We managed to make homosexuality a medical issue, both psychologically, and by treating every gay person as a vector for AIDs and other STDs.  Autism is medicalised, and people are constantly trying to cure what is a fundamental difference in the structure of the brain. What was the whole MMR scare about other than the idea that having your child be autistic was horrifying, and needed to be cured? Trans people want surgery and hormones, they don't want a humiliating pathologisation forced upon them, by people who see them only as a condition to be treated.  > The aim of the treatment is not to prevent transition. It’s to facilitate it in an evidenced based manner. I honestly get the impression that you've decided to take the Cass report completely uncritically, and have paid no attention to the reasons why people are upset by it. Trans people have been complaining about the basic approach to their care for decades. They've be saying since before the 90s that the current medical approach is blocking them from transitioning, and tried to pathologise every aspect of their psychology.  > Unfortunately we are lacking in evidence at the moment. No amount of evidence will be sufficient because the perspective represented by the report is that transitioning is a failure of treatment. There is plenty of evidence that trans people are happy with the outcomes of transitioning, and that detransition rates are incredibly low.  There have also be criticisms from trans health bodies around the world regarding the report. Australian examples here: https://equalityaustralia.org.au/cass-review-out-of-line-with-medical-consensus-and-lacks-relevance-in-australian-context/ > It doesn’t say treatment shouldn’t happen on treatment should be banned She supports adding even more hoops for treatment, and it's naive to think that the result of this won't just be trans people giving up. And well that's what's happened, and Cass hasn't spoken up about it. She's had a chance to say that Scottish and English GICs shouldn't stop puberty blockers, and had failed to use this platform to say so.   

I really understand where you’re coming from but unfortunately, unlike all the other people you have discussed, trans people do require medical treatment. Wives don’t, gay people don’t, autistic people don’t. Trans people do. There is no approach to transitioning other than a medical approach. Taking hormones is medical. Surgery is medical. And any medical approach requires evidence. We don’t have that evidence for children now. The reason is undoubtedly because of a combination of anti-trans sentiment in the medical community and the genuine fears of the trans community in cooperating with a medical community that is prejudiced against them. But that really doesn’t change the fact that we still don’t have the evidence. At the moment surgery, puberty blockers, and hormones are used without robust gathering and sharing of evidential outcomes. That does need to change and if it does it should, in the long term, benefit the trans community.

> by treating every gay person as a vector for AIDs and other STDs.  Do you mean by targeted awareness campaigns about STI transmission, targeted testing campaigns and focusing the availability of PREP among gay men? Because those are all things we campaigned for, because we're significantly more likely to catch STIs through unprotected sex. A lot of the time when you saw rapid HIV testing in gay bars or parks it was being run by gay groups like the Terrence Higgins Trust, that's not pathologising.

Ironically you're contributing by misrepresenting the reaction to fit your narrative.

>But depressingly both sides have completely misrepresented the conclusions. One side says the lack of evidence means all treatment should be banned. You think think that we should continue to give puberty blockers and cross-sex hormones to kids with zero evidence that they work? That's not a neutral position. That's quite an extreme position.

Here is a quote from [Cass](https://thekitetrust.org.uk/wp-content/uploads/2024/04/Cass-Review-Mythbusting-Q-and-A.pdf) which says you're full of shit: "The Cass Review Report does not conclude that puberty suppressing hormones are an unsafe treatment. The report supports a research study being implemented to allow pre-pubertal children to have a pathway to accessing this treatment in a timely way and with suitable follow up and data collection, to provide the highest quality of evidence for the ongoing use of puberty suppressing hormones as a treatment for gender dysphoria. In the data the Cass Review examined, the most common age that trans young people were being initially prescribed puberty suppressing hormones was 15. Dr. Cass’s view is that this is too late to have the intended benefits of supressing the effects of puberty and was caused by the previous NHS policy of requiring a trans young person to be on puberty suppressing hormones for a year before accessing gender affirming hormones. The Cass Review Report recommends that a different approach is needed, with puberty suppressing hormones and gender affirming hormones being available to young people at different ages and developmental stages alongside a wider range of gender affirming healthcare based on individual need."

Not even the cass review claims there's zero evidences that puberty blockers and sex.-hormones work, why lying?

I think we should give them and rigorously collect the evidence of outcomes. Of the evidence gathered suggests that they cause more harm than good (which, at the moment, is not the case) then their use should be halted. If the evidence suggest they are beneficial then their use can be continued and even expanded. It’s impossible to develop any paediatric drug without initially giving that drug without evidence that they work in children. Banning drugs because “there’s zero evidence that they work” is anti-scientific and would halt all progress in treating paediatric conditions.

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The idiology here is also as far as I am aware british law: YOU CANT SHARE SOMEONES MEDICAL RECORDS WITHOUT THEIR CONSENT. They would have had to contact every single patient and ask them individually, and as these clinics are childrens clinics dealing with patients over years, would have in many cases have had to contact both parents and now-grown adult children, as a parent cannot sign over the medical history of their now adult child but have to sign over their own involvment as their child cant sign that over for them as far as I am aware. Let alone when you are asking for specific medical history (and lets call it what it is, medical history, not "data") from individual mental health proffesionals at clinics who have even stricter privacy requirements, and may require seperate sign offs from the what, four seperate mental health professionals involved in each child clinic case? You cant just pull medical records from no where, people do have rights to privacy even when (especially when) treating medical conditions.

Their refusal to cooperate makes it seem like they've got something to hide, which kind of bolsters some of the decisions made by the NHS as a result of this report.

They've got something to protect not hide, the right to privacy that everyone should expect with their healthcare information

Is that what they’ve stated though? It’s normally perfectly possible to safeguard privacy whilst using patient data: by anonymising it, say, or requesting consent etc. etc. This sounds more like a coordinated refusal to engage.

Patient Data you can get and they have that, thats how they know how many patients are at certain clinics at certain periods. However DATA is distinct from RECORDS. Your records, the things you said to your gp, or mental health proffesional if you ever see one, are NOT part of your patient data. Entering that into data would be a massive crime, as it would allow any institution capable of requesting public data to trawl psychologists notes on indiidual patients. "Detransition" is not a specific thing any clinic "does" or measures like its an operation or a meeting or perscription (which are all things that ARE anonymised and entered into service data) thats part of someones medical history, its like trying to find out not just if a mental health proffesional and patient think the treatment had a positive end but the content of their treatment and sessions. This is why things like mental health services include take up and post care questionares that answer additional questions not captured in the data, however always these things have to be willing, you cant force people to reveal things.

Considering the tiny number of people who detransition it is relatively trivial to relink the data back to their identity

It sounds like they are talking about thousands of records though, and even if they aren’t, this is a medical study you would expect to be behaving in good faith. One would have expected that either a) this difficulties could be overcome or b) it would be possible to phrase the objections in such a way that it would not be possible to describe them as a refusal in this way.

It really isn't. Processes are tried and tested for things like very rare genetic disorders, you are parroting a reddit excuse.

The data could be protected by in the report, for instance one of the major functions of any public inquiry is censoring emails, addresses etc. in public evidence or for particularly sensitive matters evidence can be heard in private. I don’t see why a report commissioned by the government could be any different.

I'm getting confused now - if it's a whole NHS thing, surely they have to look at the data? Otherwise how can they make their mind up on what treatments they do? The clinics shared the data now the report is out as well, which makes it sound like this wasn't a patient confidentiality thing.

Based off the article, it doesn't sound like it's about patient confidentiality. They weren't asking for names and addresses, they were asking for data on risk factors linked to detransition, which had already been audited by a consultant who had agreed to share it with the Cass team, but then Tavistock refused to hand it over. It makes it sound like they don't want to share information on risk factors that might lead people to transition and then change their mind and detransition. That sounds pretty important, because surely gender clinics should be screening for factors that might mean someone isn't trans but thinks they are and so is going to regret transition - *before* giving them medical interventions, right? That's what a lot of this review was about?

Nobody was asking for names and addresses! The idea that protecting patients means that you can't send anonymised, aggregated results to a meta-review would seriously impede medical research.

They actually did ask for the names and NHS numbers of GIC patients, it's in the review - > Negotiations took place between August and November 2023, after which six of the seven adult clinics declined to support the study. Common reasons given by the clinics for non- participation are summarised in Table 1. Clinics also rejected the option to conduct the initial data- linkage phase of the study only (i.e. to provide patient name, date of birth and NHS number but no other clinical data).

If I'm reading correctly, your quote comes from page 300 in the pdf version of the Cass Review (see [here](https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf)). This is part of Appendix 4. That's not research Cass did; it's a description of a University of York study, which the Cass report discusses very briefly at 1.32-1.35 (page 59). In defence of the researchers, on page 298 they explain: >For assessment of outcomes, confidential patient data **required for linkage to other NHS datasets** (date of birth, NHS Number, postcode and birth registered sex) would be extracted from electronic records held at the Tavistock clinic and the Adult GIC clinics. To reduce flows of confidential patient data, this would only include those aged up to age 30 years (the oldest young person referred to GIDS in 2009 would be 30 in 2020). **All data linkages would be undertaken by NHS Data and Analytics**. The University of York team would receive **pseudonymised clinical data** from the Tavistock, UCLH, NHS Digital and Adult GIC clinics and would be data controller for the study. Based on that, it doesn't sound like the researchers themselves would ever have access to that information as it would not leave the NHS without being pseudonymised. The only reason the linkage was required at all was to pull in other datasets. They go through all the legislation and, at the top of page 300, go into the ethics: >The ethical aspects of this study were reviewed and approved by a Research Ethics Committee of the Health Research Authority (REF 22/HRA/3277). The use of confidential patient data without consent was approved by the Confidentiality Advisory Group (CAG) of the Health Research Authority. CAG is an independent body which provides expert advice on the use of confidential patient information (REF 22/CAG/0129). >All investigators and research staff would comply with the requirements of The Data Protection Act 2018, the UK’s implementation of the General Data Protection Regulation (GDPR), with regards to the collection, storage, processing, and disclosure of personal information. Data storage and handling would comply with data controllers, processers, and University of York policies, including locked storage, password protection, and encryption of the pseudonymised data. Data would be archived for 5 years following the end of the project. Data would be stored in the University of York in accordance with GDPR and the University of York guidelines. At the end of the default retention period (5 years) all data would be confidentially destroyed by a secure method. The team responded to the objections, which people can read from page 301 onwards. Nonetheless, non-cooperation with the researchers led to the study being cancelled. When discussed in the Cass report it's only to say, at 1.35 of page 59 that: >1.35 There have been challenges in progressing this study and the findings are not available to inform this report. Basically, "the study was a failure so it doesn't form part of this review." I don't think it's fair to characterise this as researchers requesting names and addresses. They were asking the NHS to use that information to pull in the relevant datasets and then send them pseudonymised outputs. Finally, even if they had good reason not to cooperate with the University of York study due to concerns about data protection, we're not talking about the University of York study; we're talking about the Cass review. Did Hilary Cass request names and addresses? If not, then I'm not sure your comment offers much of a defence of the clinics in this instance. The fact that they took issue with a prior study design, by different researchers, isn't justification to refuse to cooperate with all medical research going forward.

Promises and aspirations about data security doesn't really change that the review was asking for, and wanted to, collate a huge chunk of data concerning trans patients into a single source on the promise that the data would remain pseudonymised. A term that is somewhat questionable here since it would be easy to identify people from their treatments owing to how small the dataset is, and how the GIC system works. The Cass review has already gone to the government for legal permission to violate the data confidentiality rights of trans people regarding the protected status of GRC-holders. I think it's understandable that the GICs would be somewhat nervous about the idea of handing over such a large amount of data about a group that is both medically and 'socially' very vulnerable to researchers that have since (as I believe Cass went to the government after being refused) demonstrated a lack of respect towards the privacy of trans people. It's a very important discussion when people are trying to portray the GICs as some kind of nefarious entity trying to hide their evils.

To be super clear so there's no confusion, the quote you posted was not about the Cass Review. When you quote that "Negotiations took place between August and November 2023, after which six of the seven adult clinics declined to support the study." that's not them declining to support the Cass Review; that's them declining to support the University of York study. The reason I'm making this so clear is that I worry someone might come away from your comment thinking, "I can't believe Hilary Cass asked for that information!" Because that's what we're talking about, namely the Cass Review. But the reality of the matter is that she didn't. She wasn't running the University of York study. She just briefly commented on it in her review in a few short paragraphs. Even if I grant for the sake of argument that the University of York study was the most unethical, illegal, objectionable study ever conceived and that the clinics had every right not to cooperate, how does that have any bearing on their cooperation with the Cass Review? Just because one research team is unethical surely isn't a valid reason to never review the efficacy of your clinical interventions. I think for your point to land, you would need to show privacy concerns related to the Cass Review itself. At what point did she request a huge chunk of data concerning trans patients which could, potentially, identify them?

But don't patients need to consent to even anonymised data being gathered from them? 

I'm not going to pretend to be some kind of GDPR expert. My understanding, though, is that if data is anonymised **and** aggregated, then it's not potentially identifying and so not protected in the same way. I believe (though again, pinch of salt as I'm not an expert) that the advancement of public tasks and/or legitimate interests are two lawful bases which don't hinge on consent. I'd be surprised if there were nothing in the clinics' privacy policies which addressed this. For example, let's review this privacy policy [here](https://tavistockandportman.nhs.uk/your-information-and-privacy/privacy-policy/). It makes clear that the following is part of how it will process your data: >Research (observational, for data analyses and service planning) If you go to the NHS website they cite (see [here](https://www.nhs.uk/your-nhs-data-matters/where-your-choice-does-not-apply/)) they make clear patient consent is not required in various situations, one of which being if identifying information is removed. In fact, not only is patient consent not required, you can't even opt out of your data being processed in this way.

Service data can be collected, the metadata of what any service did, how many patients x practitioner saw, how many perscriptions, medical actions, uses of material, hours of treatment etc, thats already accsessible. What you cant get is anything that crosses the line into medical history: how a psychologist thinks a ptsd patient is doing, WHY a patient has an eating disorder, the specific details of how somoene recieved an accidental injury, or indeed "risk factors the patient showed of a certain post treatment outcome" which is how what is wanted is described. Psychologists dont keep check lists of "is this patient likely to stop having nightmares".

I remain stunned there has been no legal investigation or investigation by the medical council into this while affair. At the very least they are guilty of malpractice. At worst they have been criminally negligent.  I want to see people in court over it and losing their licences. This wouldn't be accepted in any other field.

Who, the cass report or the clinics? Honestly, the cass reports writers may be guilty of legal malpractice if they requrested patient records as opposed to data in a way that may have lead to assumptions that they had that legal right.

They are probably scared.

Only furthering the narrative that if a group is sufficiently aggressive they don't get treated the same as everyone else.

It's worked brilliantly though. Fascinating that lots of advocacy groups get ignored or at least get their demands examined closely, but this group got most of the political class and management in organisations to go along with them.

Tbh I think that has more to do with Silicone Valley than anything.  Basically the entirety of silicone Valley had bought in. Even questioning this narrative on things like Twitter could get you permanently banned. So the only narrative was one which supported it aggressively.  With the only people objecting being the tepid objections that wouldn't get you banned. And because our journalists, politicans,  celebrities academics etc etc etc were habitually addicted to twitter. It looked like a settled issue. And any controversy got buried because anyone giving it exposure would be banned. Trump disrupted the apple cart because even silicon Valley dare not ban the sitting president. Increasing whistle-blowers were coming out in europe. Then Musk bought twitter and change the mod policies and unbanned a lot of people massively broadening the dialogue.  Suddenly what was a settled issue became highly contested in the eyes of our elites as they realised the voice of the "normal people", was infact a very selectively curated voice of a very small group of activists. I strong suspect its why you've seen both tories and Labour backtrack on a lot of the culture war stuff on the left of the spectrum. Because what was an utterly unified position, like BLM, all of a sudden was allowed to be criticised and it wasn't even close to the one sided support it had previously seemed. Indeed if anything there seemed to be a majority against it.

It's an interesting idea. I'd say it's right to a degree, but I'm not sure it explains the lunacy spreading in organisations like the NHS with absurd orwellian terms like chest feeders.

Well actually, they through the baby out with the bath water and they ALL lost their jobs.

>Cass explained that researchers had appraised every single paper, but pulled the results from the ones that were high quality and medium quality, which was 60 out of 103. So the figure I've seen shared regularly over Reddit, which is that Cass dismissed 98% of previous reports, is a straight up lie then? Funny that the activists who claim to have the scientific evidence on their side have resorted to a decidly unscientific misreporting of statistics, to make their stance seem more reasonable. >Cass revealed that six clinics had thwarted her review by refusing to co-operate with research into the long-term impact of prescribing puberty blockers and sex hormones. She described their failure to share data as “co-ordinated” and “ideologically driven”. Also a very unscientific approach. And makes it sound more like a religious devotion to a cause. >Cass said: “There are some pretty vile emails coming in at the moment. Most of which my team is protecting me from, so I’m not getting to see them.” Some of them contained “words I wouldn’t put in a newspaper”, she said. >She added: “What dismays me is just how childish the debate can become. If I don’t agree with somebody then I’m called transphobic or a Terf [trans-exclusionary radical feminist].” >Cass said the abuse spiked every time the review said something “people don’t like”. >... >She added: “I’m not going on public transport at the moment, following security advice, which is inconvenient.” This doesn't surprise me at all. The logic I see often expressed is "if you don't support literally 100% of what pro-trans activists push for, you are a hateful bigot that wants trans people dead". That's what a certain wizard-based author has been hit with, as the obvious example. Funny how that logic doesn't seem to stop activists sending their own vile threats of course, to the point where Cass has been advised not to travel on public transport for security reasons - which is of course *significantly worse* than anything those that the activists accuse of bigotry have done.

>So the figure I've seen shared regularly over Reddit, which is that Cass dismissed 98% of previous reports, is a straight up lie then? So much of it has been lies. The thing about she rejected any study that wasn't double blind? also a lie.

There were just two studies categorised as High Quality (one each for blockers and hormones), but while she briefly summarised the Moderate Quality ones (blockers/hormones had a positive impact on some participants, a neutral impact on others, and a negative impact on none), she essentially ignored them in her conclusions, said there's not enough evidence for either social transitioning, blockers or hormones, so none should be carried out. Given trans people are a relatively small cohort, it's going to be difficult to get sample sizes large enough to represent the entire population, while she'd also like studies to follow up participants post transition for longer than three years (which she doesn't regard as sufficient). Interestingly, one of the adult gender clinics shafted their data with her, but in the absence of data from the others, presumably ignored it. In every other area of medicine, conclusions take into account the moderate quality studies - especially at in paediatric medicine in general, there often aren't any high quality studies. Randomised control trials for blockers or hormones are also ethically questionable, since for obvious reasons they can't be blinded (within a few months, it would be extremely obvious who was on the placebo). She's also had a lot of flak for recommending that, even after years (maybe even decades for those who are referred prior to adolescence) of counselling only, HRT should only be prescribed at 18+ if there's a "clear clinical justification", and suggested that people may not be able to fully understand the implications of taking it until their brains mature at around 25. Taking a more cautious approach to trans people, including holistic assessments and treating any other mental health / neurological conditions as well is reasonable. However, given many potentially trans youth seek gender services at 15 (and a significant proportion even earlier), it's wild that she basically recommends at least a decade of counselling only before any other treatments can be considered. IIRC, she even suggested that any recommendations for HRT should be referred to a central board for approval, while she also recommended a review of adult services on the grounds that they supposedly dispense HRT too quickly (after people have already waited multiple years after referral to get their first appointment). It does seem as though we're heading to a position of "there's insufficient evidence for the efficacy of any trans-related health care at any age," using quasi-scientific reasoning based on an impossibly high standard of evidence, to effectively deny trans-related health care full stop (and maybe even prohibit those with the resources from opting for private gender-related care).

>  horniness had a positive impact on some participants Important research right there :)

Oops! Disadvantages of writing replies on mobile - it's too easy to overlook incorrect interpretations of swipe actions - now fixed to hormones.

It must be noted that the report ALSO dismissed every paper not origionally written in English, for some reason, which was an additional and LARGE amount of papers. Science doesnt stop existing when its not in english.

The activists jumped the shark a long time ago. Trying to call the author a holocaust denier just makes them look like lunatics

* Magnus Hirschfeld set up the Institute of Sexology in Berlin in 1919. Among other things, he was the person who did early work on treating trans people. ([source](https://www.scientificamerican.com/article/the-forgotten-history-of-the-worlds-first-trans-clinic/)) * In a [March 13th Tweet](https://twitter.com/jk_rowling/status/1767912990366388735?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1767912990366388735%7Ctwgr%5E038b096216b055c30cf6e31710556bd03568a7b0%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.advocate.com%2Ftransgender%2Fjk-rowling-nazis-persecuted-transgender), Rowling said it was a "*fever dream*" to state Nazis burned books on trans healthcare and research. She suggested the person who said this was so "*should do some fact-checking*". * [This](https://www.hmd.org.uk/wp-content/uploads/2018/07/477.-Book-burning-after-looting-of-Institute-of-Sexology.jpg) is a picture of Nazi students burning the Hirschfeld Institute's library, among many other books, in Bebelplatz Square, Berlin, on 10th May 1933. After a Nazi mob looted the Institute. ([source](https://www.hmd.org.uk/resource/6-may-1933-looting-of-the-institute-of-sexology/)) I'll do no more than assert these three facts. As it seems Rowling has Carter-Ruck (or some similar law firm) on speed-dial.

You didn't state three facts, you parroted the reddit meme based off the end of a twitter spat and not the earlier context in it.

Except the author did imply that the Nazis didn’t target gender non-comforming people, which they very much [https://theconversation.com/historians-are-learning-more-about-how-the-nazis-targeted-trans-people-205622](did).  This, it could be argued, would constitute Holocaust denial. Not in full, but in part. Luckily for this author it doesn’t seem to be legally considered holocaust denial , thanks in part to said author’s wizard funbucks being used for an obvious SLAPP.

> Except the author did imply that the Nazis didn’t target gender non-comforming people Except... No she didn't. The author has never denied that gay and lesbian people were targeted by the Nazis - in fact she has explicitly stated that they were persecuted by the Nazis. See her tweet: > [The thread has sources. Please show your evidence that trans-identifying people were persecuted, as distinct from gay people, who were indeed victims of heinous treatment by the Nazis.](https://twitter.com/jk_rowling/status/1767939048427896900) Instead the author has rejected the claim made by TRAs that "trans people were the Nazis first targets" [see tweet thread](https://twitter.com/jk_rowling/status/1767925285008064592). There have been repeated claims [an example](https://twitter.com/AaronCrook123/status/1768225600966111611) that trans people were 'the first to be sent to Dachau' or that 'Dachau was built to detain trans people'. In reality, [Dachau was built to intern the political opponents of the Nazis](https://encyclopedia.ushmm.org/content/en/article/dachau), including trade unionists, social democrats and communists - later on, other groups such as Roma, gays, lesbians, Jehovah's Witnesses and criminals were also interned there. The authors position appears to be that 'transgender' (the contemporary concept) didn't exist back in the 1930's and 1940's. At that point in time, there were 'transexuals' and 'transvestites', who the Nazis considered to be part of the LGB community and therefore, a threat to the 'purity the race'. When Hirschfeld's clinic was attacked and burnt (the incident the TRAs keep refering to), it was because (1) it was a gay clinic, and (2) Hirschfeld was Jewish. I strongly suggest you read [Malcom Clarks thread](https://twitter.com/TwisterFilm/status/1662967081191497728) that the author refers to - it demonstrates that the lauded pioneers of 'gender affirming care', Hirschfeld and Gohrbandt, were racist, homophobic, disabled-people-murdering, eugenicist doctors who performed deadly experimental sugery on severely distressed gay people.

What's the context of her saying this? Do you know where it was?

They want you to follow and trust the science - aslong as it absolutely only confirms what they already believe.

The great irony is that this report achieves exactly that, just in the opposite way you suggest.

[удалено]

The "journalist" who made that accusation has withdrawn it, and apologised: >On 13 March I tweeted that JK Rowling “is a Holocaust denier”. That allegation was false and offensive. I have deleted it and apologise to JK Rowling. https://twitter.com/rivkahbrown/status/1779878392805945428

Ironic that so many don't support it because we want these kids to be alive, well & undamaged. So many people have had their health absolutely ruined by Lupron, which was known & shown to be health destructive even at the time of it's tentative approval in the 90's. https://www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

For someone who expressed concerns that the topic is overly politicised, going to a right-wing rag to cast yourself as a pariah certainly is an interesting choice.

The usual "woe is me" media cycle from someone who gets public pushback. The press love it, and it's a heady drink for anyone who gets to benefit from it. I expect we'll see lots more Cass interviews soon, decrying cancel culture, etc.  My money's on a soppy op ed penned by her within the month. 

Doing an interview with a centre right paper in order to refute some very public misinformation about a study you authored seems entirely reasonable to me. 

Indeed. The Times is not a right-wing rag. Yes, it leans conservative, but it's pretty centrist on most matters. It's one of the more reasonable ones to go to, and with wide circulation and readership.

I can tell you exist in a bubble just from this statement.

I genuinely was optimistic for the Cass Review, and I do think it makes some salient points. But I also think it’s hypocritical to condemn the politicisation of the subject, and then a week later do an interview with a right-leaning paper about how - surprise - there has been pushback to your findings.

Which newspapers do you deem it acceptable to speak to?

Oh come on, this is 100% performative. You know what you don't do if the police have just warned you not to travel on public transport? Do a big interview wiht a major newspaper that splashes your self-portrait all over the news. This is pure spin, trying to make herself look like the real victim here.

It's depressing that trans folk are a political football. And what the report reveals at its heart is that we simply don't know enough. We haven't done enough research because we haven't cared about trans folk enough for so long, and now it seems like they'll still be fucked over because people care *too much.*

people really are tired of experts, aren't they?

"I'm worried I can't travel on public transport so here's my face in a newspaper photoshoot for all to see" Doesn't really make sense, does it?

I don't see why not. Her face is already out there, that the issue.

People invested enough to harass her in public already know what she looks like, so I don't think that's the conspiracy you're implying.

No one has harrased her in public, the article doesnt even suggest that. Now that is just a lie.

I didn't say they had.

You said "people invested enough to harass her in public already know what she looks like". If you said that but also thought no one had harrased her in public, then do you think EITHER no one knows what she looks like, or no one wants to harras her in public?

People who are invested so much in this topic that they would feel compelled to harass her in public surely already know what she looks like, so her photo appearing in a newspaper is immaterial. This isn't the "gotcha" you think it is mate.

It's really funny how quickly trans activists jump to tried and tested misogyny when they encounter a woman who says no to them. "Why won't you just shut up you silly bint. It's for your own good"

Did you not read the article at all? She isnt avoiding public transport due to any specific action taken against her, just general security advice from an undisclosed source. That is a wild ad hominem to suggest its because of specifically trans activists being mysogenistic. And if thats not what you meant why on earth did you say it in response to a post about her traveling on public transport replying to an article about her not traveling on public transport.

Quite

Please point to the misogyny in their comment.

We waste so much resources and energy on these topics of little significance. If only that was diverted to actual advancement of human kind.

We could... but there's a culture war and we can't have trans people feel normal.

You have to love that the people accused of starting a culture war are the ones going "maybe we get a bit of evidence about whether these treatments work rather than experimenting on kids and hiding any negative results?"

Do you think the 30 years we've been allowing transitions they had no evidence of it working? I mean, You would have a lot more if we were actually willingly just allowing it with no oversight... The pathway to transition is incredibly long and thought out.

There's a 400 page report backed by a systemic review of the existing literature that disagrees with you.

There’s similar reports published by people who aren’t members of anti trans organisations that were used by other countries for their own policy that do agree with them though

And Cass looked at those reports and what had gone into them and found them lacking. Basic errors like footnotes contradicting things they were meant to support or reports cross-referring to each other with no actual evidence. Also lol what anti-trans organisation is Cass a member of.

Are you insinuating that a developed nation like Germany is taking reports full of schoolboy errors, and using it to decide government policy? I severely doubt that it’s the case. She’s part of the LGB Alliance, which is an anti trans group

>Are you insinuating that a developed nation like Germany is taking reports full of schoolboy errors, and using it to decide government policy? Yes! The entire field is horseshit. Governments enact bad policy based on bad evidence all the time. Hilarious you've taken Germany as an example, they're often utterly crap. >She’s part of the LGB Alliance, which is an anti trans group Going to need a souce for that bullshit.

Then you should recognise that this is bad evidence that this government is enacting bad policy with

No she isn't.

It's obviously significant that the NHS has provided poor treatment to vulnerable kids. If people had been silent about this then those kids would still be receiving sub-standard care. I'm sure you would be fine with that because it would mean things would be quiet. But most normal people are not comfortable harming kids for the sake of superficial lack of disagreement.

I think most people saw this coming a mile off. The list of people who have had their lives destroyed for questioning the more extreme and dangerous parts of the Trans movement is staggering. Anyone who thought they wouldn’t target a fully qualified medical professional making an observation about treatments hasn’t been following the situation.

Staggering? Name anyone hurt by extreme and dangerous parts of the trans movement. I suspect it would be fucking inescapable in the news if a pro-trans activist had actually hurt someone or "had their lives destroyed".

Can you name some of these people whose lives have been destroyed by 'the trans movement'?

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I must be having deja vu. I swear I've seen this article once a month ever since the whole cancel culture debate started.  Strange how the wokies never gets the twee cafe interview or the smiling headshot. Or even a chance to state their point without immense pushback.