SANITYThe British Medical Journal is about to be cancelled - Urges US transgender medicine to adopt evidence-based footing, particularly in child care. At odds with Democratic Party and President Biden push to widen accessibility of surgical and medical interventions.

submitted by ClassroomPast6178 from bmj.com

all 9 comments
sorted by:
top
newinsightfulfun

[–]ClassroomPast6178[S] 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (0 children)

An investigation [of US paediatric/youth transgender healthcare] by The BMJ finds that more and more young people are being offered medical and surgical intervention for gender transition, sometimes bypassing any psychological support (doi:10.1136/bmj.p382).5

Much of this clinical practice is supported by guidance from medical societies and associations, but closer inspection of that guidance finds that the strength of clinical recommendations is not in line with the strength of the evidence. The risk of overtreatment of gender dysphoria is real.

If we have the best interests of young people at heart, then surely our duty is to offer evidence informed care? And, if the evidence base is weak, we must provide the necessary support to young people as well as prioritising research to answer questions on issues that are causing a great deal of distress, much of which is amplified by social media. Taking this route is essential: an evidence void not only exposes people to overtreatment but can also be used to deny people the care that they seek, such as through the draconian laws now being introduced in some US states (doi:10.1136/bmj.p533).6

A better appreciation of the evidence, as well as the limits of medicine, is also the basis of a more constructive dialogue.

[–]ClassroomPast6178[S] 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (1 child)

An article about the BMJ piece lays it out quite clearly.

In a TV interview broadcast on Monday evening, he [President Biden] condemned a proposed measure in Florida to ban medical interventions for under-18s as ‘cruel’. Adopting the folksy rhetoric he favours when speaking about the trans issue, Biden sounded like a regretful preacher looking out at a world that’s disappointed him. “What’s going on in Florida is, as my mother would say, close to sinful,” he said.

Florida’s boards of medicine and osteopathic medicine recently carried out an evidence review and voted to restrict hormonal and surgical treatment for minors, although patients already receiving cross-sex hormones are exempt. In the UK, many people are uncomfortable with the prospect of teenage girls being referred for treatments such as double mastectomies, euphemistically known as ‘top surgery’ by trans activists.

The climate in the US is very different, as Biden’s incoherent ramblings attest:

”It’s not like a kid wakes up one morning and says, ‘you know, I decided I wanted to become a man or want to become a woman’ or ‘I want to change’. I mean, what are they thinking about here? They’re human beings. They love. They have feelings. They have inclinations.“- JOE BIDEN

‘Inclinations’ are hardly a reliable guide to treatment. Yet the affirmative model favoured in the US demonises doctors who ask questions, sometimes putting children and adolescents on an irreversible path before they’re old enough to understand the consequences.

[–]Alienhunter糞大名 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (0 children)

It’s not like a kid wakes up one morning and says, ‘you know, I decided I wanted to become a man or want to become a woman’

No someone or something has planted that idea in the kids head and theres some other crap going on in the kids life whatever it is that is making them think that's their answer.

I mean, what are they thinking about here? They’re human beings. They love. They have feelings. They have inclinations.“

A good question. What exactly are they thinking? And why? They want something that is impossible? Should we lie to them and get rich off if medical treatments trying to make them "appear" as much like the thing they say they are as possible but never will truly be? Or should we step back and ask far more basic question like, why? What I see is gender transitions being floated as an answer for depression and while I do think that giving any sort of structure or purpose to someone's life will show immediate improvements there which is why we do see self reported rates of happiness higher among the recently transitioned, it begs the question will the long term outcomes be desirable? It seems there is no real decrease in the suicide rate.

Essentially this just looks to me like a way to profiteer heavily off of depression.

[–]William_World 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (4 children)

i don't care if it helps kids or not. I want it outlawed cuz it's weird and gross.

[–]ClassroomPast6178[S] 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (3 children)

Plenty of things that are done in medicine are weird and gross, the difference is that they are usually supported by reams of evidence. Gender “medicine” is largely evidence-free, and what’s more, collecting evidence and performing research is actively discouraged for fear of finding the wrong thing.

[–]Alienhunter糞大名 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

Yeah all this. If we had actual hard evidence that chopping your dick off cured depression we'd have no shortage of evidence showing that. Hell if we had actually solid proof that gender transitions absolutely resulted in better outcomes for people in the long term then we'd be having a different as argument entirely. But nobody has produced that to my satisfaction.

It goes against the common sense, there's no medical research inconclusively backing it up. Research is one thing but it doesn't take a genius to realize that maybe someone who wants to chop their dick off is a bit touched in the head and might not be making the most rational decisions for their own happiness?

I mean I guess we can get into the whole thorny argument of, if self harm makes people happier, should we just let them harm themselves? But that ultimately leads us to the suicide problem. If someone is depressed and wants to die should we kill them? (And well I'd say that while death is a "cure" for depression, it's evil, and that we should find ways to help the depression)

Plus we're all going to die eventually anyway it's an inevitability to why rush it?

[–]Alan_Crowe 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (1 child)

I'd steel man William_World like this:

I don't care if science says that it helps kids, because science is like soylent green; its made of people.

Science done by angels out ranks human intuition about what is weird and gross.

Human intuition about what is weird and gross out ranks science done by humans.

Money for medical research is scarce. We should use good judgment here. Halt gender medicine, because it is weird and gross. Halt research on gender medicine because there are more promising topics to research. For example: post viral syndromes. They are in the news because of Long COVID, but there have always been problems with people failing to regain their stamina after a viral infection. It gets called ME/CFS and there is enough new knowledge about the immune system to make interesting research possible. Other possible research targets are heart disease. Arteries clogged with fat because of diet in the non-obese is pretty much a dead hypothesis. Arteries clogged with fat because of inflammation due to immune system problems is ripe for research.

[–]ClassroomPast6178[S] 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (0 children)

Halt gender medicine, because it is weird and gross. Halt research on gender medicine because there are more promising topics to research.

Having actually worked in clinical research in a poorly funded area of cancer research I can tell you that withholding funding from one area doesn’t mean that the money goes to a more deserving area, it just stays in the pockets of whatever source it came from.

Things like NIH and MRC are good for getting funding to the poorly supported areas, but if there’s a political movement or possible profit, nothing is stopping money flowing to a particular area of research no matter how weird or gross.

I was in brain cancers first and then moved to lung, two areas seriously underfunded compared to breast and paediatric cancers. We used to laugh about it, but the suite of offices where the breast team worked had air conditioning whereas our offices were barely furnished and sweltering/freezing. The problem is, the way the money came in you couldn’t just divert funds to other causes, so after the institute topsliced their share the rest went to the team and they had to spend it.

[–]8thmonitor 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

Yikes.